bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined Phacovitrectomy with Metallic Intraocular Foreign Body Removal through Corneal Incision Using A Novel “Magnetic Conduction” Technique
Authors: Wang Yiwen , Chen Baihua , Liu Shaohua , Gong Yujia , Zhang Liwei 
Published: October 2022

Purpose:To describe a “magnetic conduction” technique for the removal of metallic intraocular foreign bodies (IOFBs) in the posterior segment combined with cataract extraction and pars plana vitrectomy and to report its outcomes.Methods:We retrospectively analyzed the data of 42 eyes of 42 patients with posterior metallic IOFBs between April 2020 and February 2022. In all patients, cataract extraction was combined with pars plana vitrectomy. With an external magnet, the IOFBs were captured by a magnetized vitrectomy cutter, delivered to the anterior chamber, and then extracted through a corneal phacoemulsification incision.Results:All patients were men, with a mean age of 45.6 ± 10.7 years. The mean size of the IOFBs was 3.5 ± 1.7 mm (range, 1.5–8.9 mm) in their longest dimension. A final best-corrected visual acuity of 20/200 or better was noted in 24 of 42 patients (57.1%). Postoperatively, recurrent retinal detachment was seen in three eyes. There were no other intraoperative or postoperative complications.Conclusion:The “magnetic conduction” technique combined with phacovitrectomy is a safe and feasible approach to removing IOFBs in the posterior segment.
NONPERFORATING INTRASCLERAL STABBING FOR SUTURELESS 23G SCLEROTOMY CLOSURE
Authors: Yalcinbayir Ozgur , Ucan Gunduz Gamze , Nizam Sema , Yildiz Meral 
Published: October 2022

Purpose:
The need for suturing leaking sclerotomies have not been eliminated completely in transconjunctival sutureless vitrectomy (TSV). This study aims to describe a novel technique for 23-gauge (G) sclerotomy closure in TSV surgery and discuss its effectiveness.

Materials and Methods:
Two hundred and thirty cases of 180 patients who underwent 23G TSV with various diagnoses were included to the study. Cases with connective tissue diseases, thin sclera, and significant conjunctival and scleral scarring were excluded. Nonperforating intrascleral stabbing (NIS) was performed to leaking 23G sclerotomies (n = 650) and 27G chandeliers (n = 84). Demographics, rate of sclerotomy closure with NIS procedure, the need for suturing, and complications of the procedure were recorded.

Results:
The overall success of NIS was found to be 91.0% in sclerotomies. Although 9.1% of sclerotomies required sutures, 592 of the 650 sclerotomies could be closed with NIS procedure (P < 0.001). Nonperforating intrascleral stabbing procedure helped close 98.8% of leaking 27G chandeliers. An average of 1.28 ± 0.52 NIS attempts were needed for successful sclerotomy closure. Closure of sclerotomies with the NIS technique were somewhat related to the location of the sclerotomy, history of TSV and NIS, duration of TSV, and type of endotamponade. Hypotonia and choroidal detachment were seen in one case. No additional interventions were needed to normalize intraocular pressure in any case. Subconjunctival hemorrhage happened to be the leading complication of the procedure.

Conclusion:
NIS procedure seems as a practical, reproducible, cost-effective, and uncomplicated approach, which significantly reduces the need to suture 23G sclerotomies. Further studies are required.
Stand-Alone Xen Gel Microstent Implantation Compared With Kahook Dual Blade Goniotomy
Authors: Duong Ryan T. , Pittner Andrew C. , Roa Tina M. , Dirghangi Arjun J. , Netland Peter A. 
Published: October 2022

Précis:
Both Xen gel Microstent implantation and Kahook Dual Blade (KDB) goniotomy are safe and effective as stand-alone procedures, but the Xen Gel Microstent was associated with more postoperative interventions and achieved higher success at a lower intraocular pressure threshold.

Purpose:
To evaluate outcomes of stand-alone Xen Gel Microstent implantation compared with stand-alone KDB goniotomy for moderate to severe glaucoma.

Methods:
A retrospective, single-center, case-series analysis comparing outcomes of Xen Gel Microstent implantation and KDB goniotomy stand-alone cases in 75 eyes. Primary outcomes included intraocular pressure (IOP) reduction, glaucoma medication reduction, surgical success, and complications. Surgical success was defined using IOP<21 mm Hg and IOP<18 mm Hg thresholds, with or without glaucoma medications, and without further glaucoma surgery. Subjects were followed for at least 24 months after surgery.

Results:
Mean baseline IOP was comparable between the Xen Gel Microstent and KDB goniotomy groups (23.7±8.4 and 25.9±7.9 mm Hg, respectively, P=0.32). At 24 months after surgery, the mean IOP after Xen Gel Microstent was 14.7±3.2 mm Hg (32.7% reduction from baseline, P=0.018) and KDB goniotomy was 16.7±3.2 mm Hg (40.4% reduction from baseline, P=0.049). Although the mean IOP was significantly lower during the first month after Xen Gel Microstent implantation, no difference in mean IOP was observed between the 2 treatment groups at 24 months after surgery (P=0.416). At 24 months after surgery, the percent reduction of IOP from baseline was not significantly different between the 2 groups. The mean reduction of glaucoma medications from baseline at 24 months was 1.69 drops after Xen Gel Microstent implantation (P=.008) and 1.67 drops after KDB goniotomy (P=0.038). Postoperative complications were nonvision-threatening and were not significantly different between the 2 groups (P=0.550). Interventions not included with complications were needling performed in 21 (37%) of eyes in the Xen Gel Microstent group and Nd:YAG goniopuncture in 1 (5.6%) eye after KDB goniotomy. With an IOP threshold <21 mm Hg, surgical success was not significantly different between the 2 groups (P=0.06). At a lower IOP threshold (<18 mm Hg), surgical success was higher after Xen Gel Microstent implantation compared with KDB goniotomy (P=0.001).

Conclusions:
Both stand-alone Xen Gel Microstent implantation and KDB goniotomy can effectively and safely reduce IOP for moderate to severe glaucoma. The Xen Gel Microstent was associated with a higher need for postoperative interventions and achieved greater success at a lower IOP threshold.
Real-World Outcomes of Glaucoma Filtration Surgery Using Electronic Health Records: An Informatics Study
Authors: Sun Michelle T. , Singh Kuldev , Wang Sophia Y. 
Published: October 2022

Précis:
Utilizing an automated pipeline for data extraction from electronic health records provides real-world information on the success of various glaucoma procedures, with tube shunt implantation associated with increased failure rates compared with trabeculectomy.

Background:
We aimed to evaluate the long-term survival of glaucoma surgeries using an automated pipeline for extraction of outcomes from electronic health records.

Methods:
A retrospective observational study from a single academic center. Patients undergoing trabeculectomy, Ex-PRESS shunt, Baerveldt, and Ahmed tube shunt insertion from 2009 to 2018 were identified from electronic health record procedure codes. Patient characteristics were identified from structured and unstructured fields using a previously validated natural language processing pipeline.

Results:
Five hundred twelve patients underwent 711 glaucoma surgeries: 287 trabeculectomies, 47 Ex-PRESS shunts, 274 Baerveldt and 103 Ahmed tube implantations. The Median follow-up was 359 days. The mean baseline IOP was 24.4 mm Hg (SD 10.9), and 73.1% were on ≥3 medications. Compared with trabeculectomy, tube shunt surgery had a higher risk of failure (Baerveldt: Hazard Ratio (HR) 1.44, 95% CI 1.02 to 2.02; Ahmed: HR 2.01, 95% CI 1.28 to 3.17). Previous glaucoma surgery was associated with increased failure (≥2 previous surgeries: HR 2.74, 95% CI 1.62 to 4.64), as were fewer baseline medications (<3 medications: HR 2.96, 95% CI 2.12 to 4.13) and male sex (HR 1.40, 95% CI 1.03 to 1.90). At 1 year, tube shunt patients had a 2.53 mm Hg (P=0.002) higher IOP compared with trabeculectomy patients.

Conclusions:
Baerveldt and Ahmed tube shunt implantation was associated with increased failure compared with trabeculectomy. Fewer baseline medications, previous glaucoma surgeries, and male sex were also risk factors for failure. These results demonstrate the utility of applying an informatics pipeline to electronic health records to investigate key clinical questions using real-world evidence.
Healthcare Access and Utilization Among Glaucoma Patients in a Nationwide Cohort
Authors: Delavar Arash , Saseendrakumar Bharanidharan Radha , Weinreb Robert N. , Baxter Sally L. 
Published: October 2022

Précis:
Despite having lower socioeconomic status on several measures, glaucoma patients do not report more barriers to healthcare access and utilization than non-glaucoma patients.

Purpose:
To characterize measures of socioeconomic status and barriers to healthcare access and utilization between patients with and without a diagnosis of glaucoma.

Methods:
Patients aged 65 years and over who enrolled in the NIH All of Us Research Program, a nationwide longitudinal cohort, were extracted. We analyzed demographic information and several measures of socioeconomic status and healthcare access and utilization. Survey responses were compared by glaucoma status (any type) with Pearson χ2 tests, univariable logistic regression, and multivariable logistic regression adjusting for age, gender, race/ethnicity, and insurance status.

Results:
Of the 49,487 patients who answered at least 1 question on the All of Us Healthcare Access and Utilization Survey, 4441 (9.0%) had a diagnosis of glaucoma. Majority of the cohort was female (28,162, 56.9%) and nonHispanic White (42,008, 84.9%). Glaucoma patients were observed to have lower rates of education (P=0.004), employment (P<0.001), and home ownership (P<0.001) on χ2tests. On multivariable logistic regression models, those with glaucoma were significantly more likely to speak to an eye doctor (Odds ratio: 2.46; 95% confidence interval: 2.16 to 2.81) and significantly less likely to have trouble affording eyeglasses (OR: 0.85 95% CI: 0.72 to 0.99) in the prior year than those without a diagnosis of glaucoma. No significant association was found for other measures of healthcare access and utilization by glaucoma status.

Conclusion:
Although glaucoma patients aged 65 years and over fared worse on several measures of socioeconomic status, no significant difference was found in measures of healthcare access and utilization.
Two Year Randomized Prospective Comparison of Ahmed Valve Versus Baerveldt Implant in Vitrectomized Eyes
Authors: Kandarakis Stylianos A. , Petrou Petros , Katsimpris Andreas , Papakonstantinou Evangelia , Timpilis Marios , Chronopoulou Konstantina , Lehman Amanda , Ifantides Cristos , Georgalas Ilias 
Published: October 2022

Précis:
Ahmed Valve and Baerveldt shunt are efficacious options in vitrectomized eyes. Baerveldt implant achieves a lower mean intraocular pressure (IOP) at 2 years, with fewer medications and a higher percentage of medication-free patients.

Purpose:
To investigate and compare the efficacy and complications between Ahmed FP7 Glaucoma Valve (AGV) and Baerveldt 101–350 Glaucoma Implant (BGI) in vitrectomized eyes.

Materials and Methods:
In this single-center randomized clinical trial, 43 vitrectomized eyes (39 patients) underwent glaucoma drainage device implantation. Eyes were randomized to receive either an AGV (FP7) or a BGI (101–350) and were followed for 2 years. Surgical success was defined as an IOP measurement≤18 mm Hg and≥5 mm Hg with or without glaucoma medication at 2 or more sequential visits after 3 months. The primary outcome was the comparison of the success rate at 2 years, while mean IOP, mean number of medications, and number of complications were considered secondary outcomes.

Results:
Kaplan-Meier estimates of the 2-year success rates in IOP control after GDD implantation were similar between the 2 groups; AGV group 81.8% (95% CI: 67.2%–99.6%) and BGI group 85.7% (95% CI: 72.0%–100.0%), (log-rank test P value = 0.74). Patients in the BGI group had a statistically significant lower mean IOP compared with the AGV group in all follow-up visits at 2, 6, 12, and 24 months (11.62 vs. 17.45 mm Hg at the latter P value <0.001). The BGI group required a significantly lower number of medications for IOP control at the 2-year visit compared with the AGV group (0.76±0.99 vs. 1.5±1.06 P value = 0.02) but had a higher number of complications (62% vs. 41%, respectively).

Conclusions:
GDDs provide a viable solution for IOP control in vitrectomized eyes. Based on our prospective comparison, both Ahmed FP7 Glaucoma Valve and Baerveldt 101–350 Glaucoma Implant are efficacious options.
Association of Health Literacy and Health Care Utilization Among Glaucoma Patients
Authors: Cheng Brian T. , Tanna Angelo P. 
Published: October 2022

Précis:
Among 7846 adults with self-reported glaucoma, low health literacy (LHL) was associated with fewer outpatient ophthalmological follow-up visits, utilization of a greater number of ocular hypotensive medication classes, and higher costs for glaucoma medications.

Purpose:
Previous studies found LHL is associated with increased difficulty with treatment adherence among adults with glaucoma, which can lead to poor outcomes. This study examined patterns of glaucoma health care utilization associated with LHL.

Methods:
We analyzed 7846 adults with self-reported glaucoma enrolled in the 1996–2017 Medical Expenditure Panel Survey. Adult glaucoma patients with LHL (defined by National Assessment of Adult Literacy score <226) were the compared with those with high health literacy. Multivariable regression models were constructed to examine the association of LHL with number of outpatient glaucoma visits, prescription medications, polypharmacy (≥2 ocular hypotensive classes prescribed), and associated costs.

Results:
Self-reported glaucoma diagnosis was associated with higher rates of LHL [23.9% vs. 9.7%, odds ratio (95% CI): 2.43 (2.25–2.62), P<0.0001]. Among those with glaucoma, LHL was associated with fewer glaucoma outpatient visits [risk ratio: 0.94 (0.89–0.99), P=0.02] and the use of a greater number of ocular hypotensive medications [1.06 (1.01–1.12), P=0.03]. Moreover, those with LHL had higher health care spending on prescription medications [mean: $556.40 vs. $471.87, β (95% CI): $57.05 ($30.22–$83.87)]. Adult glaucoma patients with LHL were also more likely to have polypharmacy [odds ratio (95% CI): 1.26 (1.01–1.59)].

Conclusion:
LHL was more prevalent in patients with glaucoma, compared with those without. Glaucoma patients with LHL were prescribed more medications and had higher medication costs, however, they had fewer outpatient glaucoma visits. Improved glaucoma patient education to address LHL is needed, in addition to studies to understand the impact of these findings on treatment outcomes.
Comparing Surgical and Clinical Success Rates of Ahmed FP7, and Baerveldt 250 and Baerveldt 350 Glaucoma Drainage Devices
Authors: Kilgore Khin P. , Grosinger Alexander J. , Liu Liang Yen , Jamali Sepideh , Arora Nitika , White Launia J. , Khanna Cheryl L. 
Published: October 2022

Précis:
Surgical and clinical success rates were similar among Ahmed FP7, and Baerveldt 250 and 350 glaucoma drainage devices at three years.

Purpose:
To compare rates of surgical and clinical success in patients with Ahmed FP7 (FP7), Baerveldt 250 (B250), or Baerveldt 350 (B350) glaucoma drainage devices (GDDs).

Design:
A retrospective cohort study.

Methods:
A total of 157 eyes of 129 adult patients with FP7, B250, B350 GDDs, and 190 eyes of 99 medically controlled glaucoma patients were enrolled at a tertiary care institution from August 2017 through July 2019. They were followed through April 2020. The main outcome measures included surgical and clinical failure. Surgical failure was defined as intraocular pressure (IOP) outside 5–21 mm Hg, IOP reduced <20% below baseline, additional glaucoma surgery, GDD removal, or no light perception. Eyes that did not meet their goal IOP ranges or required secondary glaucoma interventions were deemed clinical failures.

Results:
A total of 43 (12.4%) FP7, 36 (10.4%) B250, 78 (22.5%) B350, and 190 (54.8%) medically treated control eyes were enrolled. By the postoperative year 3 visit, 10 (23.2%) FP7, 11 (30.6%) B250, and 32 (41.0%) B350 eyes had met a surgical failure criterion (P=0.127). There were no significant differences in the numbers of eyes meeting their IOP target ranges (P=0.510), and rates of secondary glaucoma surgeries (P=0.270). Overall clinical success was attained among 83.3% FP7, 81.8% B250, and 68.0% B350 eyes (P=0.447).

Conclusions:
The GDD groups were similar in their rates of success, based on both the surgical and clinical success definitions.
Psychosocial Predictors and Mediators Relating to the Preventive Behaviors of Hospital Workers During the COVID-19 Pandemic in Turkey
Authors: Selçuk Fatma Ülkü , Solak Grassie Semiha 
Published: October 2022

ObjectiveThe aim is to analyze the relation of psychosocial factors to COVID-19 contraction, vaccination, and preventive health behavior in and outside work.MethodsThe questionnaire data from hospital-workers in Turkey is analyzed using independent-samples t-test, logistic regression, linear regression, and mediation analyses. We developed a questionnaire on mask-hygiene-distance measures and also used previously developed scales including the Big Five Personality Questionnaire, Young Schema Questionnaire Short Form 3, Schwartz's Basic Human Values Scale, Short Dark Triad.ResultsThe odds of being infected by COVID-19 increases by self-direction. The odds of being vaccinated increases by age and conformity, and decreases by emotional stability. Education predicts certain preventive behaviors at work negatively and outside work positively. Older age, being a woman, having chronic disease, the self-transcendence and conservation values, agreeableness, and conscientiousness predict more preventive behaviors. The self-enhancement and openness to change values, the Dark Triad, and early maladaptive schemas predict more risky behaviors.ConclusionsDesigning prohealth policies requires further elaboration on the relation of psychosocial factors to preventive behaviors.
Revitalizing the Muddiest Point for Formative Assessment and Student Engagement in a Large Class
Authors: Mackos Amy R. , Casler Kelly , Tornwall Joni , O'Brien Tara 
Published: October 2022

Background:
Ascertaining student understanding can be challenging in large-enrollment and hybrid or asynchronous courses.

Problem:
Instructors needed an innovative instructional strategy to encourage student engagement and support learning in a large-enrollment, mixed-format pathophysiology class.

Approach:
A weekly, graded assignment was created by merging the formative assessment commonly referred to as the muddiest point (MP) with an asynchronous discussion board activity within the learning management system. Each week, students were required to submit a question and respond to a peer. Instructors created a remediation lecture based on the most common student questions.

Outcomes:
The majority of students reported they benefitted from the MP discussion boards and remediation lectures.

Conclusions:
The MP discussion board activity is a flexible, instructional strategy to determine areas of confusion, increase student engagement, and facilitate learning in large-enrollment classes offered in multiple formats.
Evaluation of the Patient With Paroxysmal Spells Mimicking Epileptic Seizures
Authors: Feyissa Anteneh M. , Bower James H. 
Published: October 2022

Background:
The diagnostic issue of paroxysmal spells, including epileptic seizure (ES) mimics, is one that neurologists frequently encounter. This review provides an up-to-date overview of the most common causes of ES mimics encountered in the outpatient setting.

Review Summary:
Paroxysmal spells are characterized by changes in awareness, attention, perception, or abnormal movements. These can be broadly classified as ES and nonepileptic spells (NES). NES mimics ES but are distinguished by their symptomatology and lack of epileptiform activity on electroencephalography. NES may have psychological or physiological underpinnings. Psychogenic non-ES are the most common mimics of ES. Physiological causes of NES include syncope, cerebrovascular, movement, and sleep-related disorders.

Conclusions:
Distinguishing NES from ES at times may be challenging even to the most experienced clinicians. However, detailed history with an emphasis on the clinical clues, including taking a moment-by-moment history of the event from the patient and observers and physical examination, helps create an appropriate differential diagnosis to guide further diagnostic testing. An accurate diagnosis of NES prevents iatrogenic harm, including unnecessary exposure to antiseizure medications and overuse of health care resources. It also allows for the correct specialist referral and appropriate treatment.
Rising to Meet the Moment: What Does the Public Health Workforce Need to Modernize?
Authors: Balio Casey P. , Galler Nicole , Meit Michael , Hale Nathan , Beatty Kate E. 
Published: October 2022

Objective:
This study uses findings from the most recent iterations of the Public Health Workforce Interest and Needs Survey (PH WINS) to describe importance, skill level, and gaps of key public health competencies as well as characteristics associated with gaps.

Design:
Repeated cross-sectional analysis of the 2017 and 2021 PH WINS data.

Setting:
State and local health departments.

Participants:
Nationally representative population of state and local governmental public health workers.

Main Outcome Measures:
Gaps of key public health competencies related to data, evidence-based approaches, health equity and social justice, factors that affect public health, cross-sectoral partnerships, and community health assessments and improvement plans. Gaps reflect areas of high importance and low skill level. Differences in gaps among the traditional public health workforce and those hired specifically for COVID-19 response.

Results:
For most competency areas, more than 20% of the public health workforce perceived a gap. Gaps related to environmental factors that affect public health, social determinants of health and cross-sector partnerships, and community health assessments and improvement plans were the largest. Tenure in public health practice, highest level of education, and having formal public health training were associated with lower odds of gaps in most areas. In a secondary analysis of traditional public health workforce compared with those hired specifically for COVID-19 response, those hired for COVID-19 response reported significantly fewer gaps for all but one competency considered.

Conclusions:
A substantial proportion of the public health workforce perceives gaps in competency areas that are of high importance to the evolving role of public health. As public health continues to adjust and modernize in response to the COVID-19 pandemic and other historic changes, understanding and addressing training needs of the workforce will be instrumental to public health's ability to respond to the needs of the public.