Faculty Bibliography
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Children's and adolescents' rising animal-source food intakes in 1990-2018 were impacted by age, region, parental education and urbanicity
Animal-source foods (ASF) provide nutrition for children and adolescents' physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world's child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15-19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.
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EMBASE:2022707858
ISSN: 2662-1355
CID: 5515632
Author Correction: Global dietary quality in 185 countries from 1990 to 2018 show wide differences by nation, age, education, and urbanicity (Nature Food, (2022), 3, 9, (694-702), 10.1038/s43016-022-00594-9)
EMBASE:2021228968
ISSN: 2662-1355
CID: 5513812
Comparison Between the Recommendations of Glaucoma Specialists and OCT Report Specialists For Further Ophthalmic Evaluation in a Community-Based Screening Study
PURPOSE/OBJECTIVE:To compare glaucoma referral patterns between glaucoma and OCT report specialists and to determine what influence, if any, a designated OCT reading could have on glaucoma specialist judgments. DESIGN/METHODS:Retrospective exploratory study. SUBJECTS/METHODS:449 eyes (239 individuals) from high-risk NYC neighborhoods screened as part of a mobile van glaucoma screening study from July 2017 to October 2017 were included. METHODS:All participants underwent comprehensive testing including visual acuity, commercial OCT imaging, gonioscopy, intraocular pressure, frequency doubling testing, and funduscopic assessment. Three glaucoma specialists independently evaluated all collected data to determine if further glaucoma workup referral was recommended. Two OCT report specialists evaluated just the OCT image for each eye using the commercial report as well as a specialized customized report. In phase 2, the glaucoma specialists then re-evaluated a subset of these eyes, this time with an OCT report specialist's judgments made available. MAIN OUTCOME MEASURE/METHODS:Comparison of glaucoma specialist referrals made by glaucoma specialists versus OCT report specialists. RESULTS:Inter-grader agreement between glaucoma specialists was 60% (k= 0.42) and report specialists was 95% (k= 0.77). There was agreement between a single OCT report specialist and the consensus (2 of 3) glaucoma specialists in 74% of eyes (k= 0.32). 25% of eyes studied were referred for further glaucoma evaluation by the glaucoma specialists alone and 1% of eyes were referred for further glaucoma workup by only the report specialist. With the addition of the report specialist's judgments, referral pattern changes varied by glaucoma specialist, but overall agreement increased to 85% (κ=0.53). CONCLUSIONS:There was a fair level of agreement regarding glaucoma referral recommendations between glaucoma specialists with access to comprehensive screening data and those made by OCT report specialists with access to only OCT data. Overall agreement increased when the designated OCT evaluation was made available to the glaucoma specialists. These results may aid in the design of future large-scale glaucoma screening studies.
PMID: 35688330
ISSN: 2589-4196
CID: 5248562
Preliminary results of repetitive transorbital alternating current stimulation in optic neuropathies [Meeting Abstract]
Purpose : Repetitive transorbital alternating current stimulation (rtACS) is an application of weak electric current near the eyes used in vision rehabilitation of optic neuropathies (ON). Conceptually rtACS entrains neuronal oscillations, augmenting neuronal function. In subjects with ON we evaluated whether rtACS influenced visual structure and function. Methods : 34 subjects with ON enrolled in a prospective trial underwent comprehensive ophthalmic evaluation, visual field (VF) 24-2 and 10-2 tests (Humphrey Field Analyzer) and OCT (Cirrus HD-OCT) retinal nerve fiber layer (RNFL) and ganglion cell inner plexiform layer (GCIPL) thicknesses at baseline and follow-up (FU) visits. Subjects received rtACS 30-to 45-minutes daily for 10 days. Sham subjects (n=4) underwent the same procedures but received no current. Point-by-point analyses of VF total deviation (TD) values were conducted between rtACS and sham groups. Regression analyses determined rate of change for each TD point per eye (significant points with positive rate of change defined as improved, negative rate of change as progressed; insignificant rate of change as no change) and the association between RNFL and GCIPL between groups. Results : The number of FU visits with VF tests ranged 2 to 7, with no significant differences detected between rtACS vs sham groups' FU duration. No significant differences were detected between groups' baseline VF 24-2 and 10-2 mean deviation (MD) values (Table 1). The average numbers of improved points (VF 10-2) and progressed points (VF 24-2) were greater for rtACS while the average number of no change points was greater for sham (VF 24-2, p0.05, Table 1). Further analysis of FU duration determined a significant interaction with rtACS; number of improved points (VF 10-2) and progressed points (VF 24-2, p<0.02) were not sustained over time. No significant differences were detected in average RNFL and GCIPL thicknesses between groups. Conclusions : Preliminary analyses of the effect of rtACS in ON indicate initial improvement but not a clear benefit over time. Detection of differences between rtACS vs sham groups may be biased due to the small sham sample and range of FU duration as VF test-to-test variability is known to increase with worsening VF MD. Future analyses will assess interim effect at early vs late FU time points to evaluate the role of rtACS in vision rehabilitation
EMBASE:635836504
ISSN: 1552-5783
CID: 4982182
Designing a quality monitoring system for low-resource ophthalmology clinics using Bayesian analysis [Meeting Abstract]
Purpose : Ophthalmology clinics with minimal statistical analytics capabilities may struggle to implement a quality monitoring system to evaluate patient outcomes. We performed a quality improvement study by designing a quality monitoring system for a low-resource ophthalmology clinic that would use small samples to estimate outcomes for larger patient populations. Methods : We evaluated the proportion of primary open-angle glaucoma (POAG) patients who were treated successfully according to American Academy of Ophthalmology Preferred Practice Patterns (PPPs). We analyzed 100 patients seen in the clinic over 3 months in 2019 as the input for our Bayesian analysis. We also created a standardized note template for use by clinicians in the electronic medical record (EMR) for POAG patient visits to facilitate monitoring of treatment successes without requiring clinical expertise. We evaluated adherence to clinician template use in POAG patient notes on the weekly day of glaucoma patient visits over 9 weeks in 2020. Results : Using Bayesian analysis based on our initial data, we created tables that allow for quality monitoring of future 3 month intervals using parameters from smaller samples. Using a small sample of 30 patients, we were able to determine that there was a 100% probability that the clinic as a whole was not achieving the pre-defined target percentage of 80% of POAG patients successfully treated, as defined by the PPPs. Regarding adherence to use of the note template for POAG patients, the median proportion of patients for which the template was used on a single clinic day was 27%, with a maximum of 53% and a minimum of 11%. Conclusions : Based on the input parameters of the number of patients in the sample, the number of treatment successes in that sample, and the target proportion of successfully treated patients, a small sample Bayesian analysis can be used for quality monitoring of patient outcomes for larger patient populations in low-resource clinical settings. Future work includes creation of an open-access database of tables derived from Bayesian analysis for use as a reference by other low-resource clinics in quality monitoring efforts
EMBASE:635836207
ISSN: 1552-5783
CID: 4982212
Late-onset angle closure in pseudophakic eyes with posterior chamber intraocular lenses
Two patients presented with angle closure many years after cataract extraction. The first patient presented with acute intraocular pressure (IOP) elevation and closed iridocorneal angle that resolved with a laser iridotomy. The second patient presented with an insidious course of high IOP and progressive narrowing of the iridocorneal angle, ultimately requiring a pars plana vitrectomy and glaucoma valve implant, with subsequent normalization of pressure and angle anatomy. While rare, angle closure in eyes with posterior chamber intraocular lenses is a dangerous complication that can occur many years after cataract extraction. Retained lens fragments, and perhaps repeated intravitreal injections, might place susceptible patients at risk.
PMID: 32991504
ISSN: 1873-4502
CID: 4616742
Gender differences in promotion and scholarly impact: an analysis of 1460 academic ophthalmologists
OBJECTIVES/OBJECTIVE:In recent years, gender differences in academic promotion have been documented within surgical fields. To the best of our knowledge, gender discrepancies in association with scholarly productivity have not been well assessed among academic ophthalmologists. Because research productivity is strongly associated with academic career advancement, we sought to determine whether gender differences in scholarly impact, measured by the h-index, exist among academic ophthalmologists. DESIGN/METHODS:Academic rank and gender were determined using faculty listings from academic ophthalmology departments. h-index and publication experience (in years) of faculty members were determined using the Scopus database. SETTING/METHODS:Academic medical center. RESULTS:From assistant professor through professor, the h-index increased with subsequent academic rank (p < 0.001), although between chairpersons and professors no statistical difference was found (p > 0.05). Overall, men had higher h-indices (h = 10.4 ± 0.34 standard error of mean) than women (h = 6.0 ± 0.38 standard error of mean), a finding that was only statistically significant among assistant professors in a subgroup analysis. Women were generally underrepresented among senior positions. When controlling for publication range (i.e., length of time publishing), men had higher h-indices among those with 1 to 10 years of publication experience (p < 0.0001), whereas women had scholarly impact equivalent to and even exceeding that of men later in their careers. CONCLUSION/CONCLUSIONS:Women in academic ophthalmology continue to be underrepresented among senior faculty. Although women surpass men in scholarly productivity during the later stages of their careers, low scholarly impact during the earlier stages may impede academic advancement and partly explain the gender disparity in senior academic positions.
PMID: 24852601
ISSN: 1878-7452
CID: 4112472
Management of sinonasal teratocarcinosarcoma: a systematic review
PURPOSE/OBJECTIVE:Sinonasal teratocarcinosarcoma (SNTCS) is a rare and highly malignant neoplasm that often involves the anterior skull base. This study reviews the published literature related to SNTCS. Clinical presentation, demographics, radiographic diagnosis, pathology, treatment, and management outcomes of this uncommon disease are reported. METHODS:A systematic review in the published English literature was conducted. A MEDLINE/PubMed search and bibliographic examination of articles pertaining to SNTCS were performed. Each case was analyzed for patient demographics, clinical presentation, tumor location, diagnosis, treatment, and survival outcome. RESULTS:A total of 49 journal articles were included. Individual patient data were reported in 86 cases. The average age of the patients was 54.5 years (range, 0.1 to 85 years), with a strong male predilection (7:1). Average follow-up was found to be 38.9 months (range, 2 to 372 months). The most common treatment method was surgery with radiation therapy, utilized in 59.3% of patients. Out of 71 cases with reported outcome and follow-up, there were 21 cases of recurrence, 8 cases with metastasis, and 6 cases reporting both recurrence and metastasis. Forty-two out of 71 (59.2%) patients survived at the time of follow-up. CONCLUSIONS:This study describes the largest pool of SNTCS patients to date. SNTCS is a rare and aggressive malignant skull base tumor with a poor prognosis with frequent recurrence and metastasis. Although a variety of treatment paradigms have been reported in the literature, radical surgical resection followed by radiation therapy appears to be the most commonly used treatment option.
PMID: 23731851
ISSN: 1532-818x
CID: 4112452
Incidence trends and long-term survival analysis of sinonasal rhabdomyosarcoma
PURPOSE/OBJECTIVE:Sinonasal rhabdomyosarcoma (SNRMS) is a rare malignancy which often presents with nasal obstruction, rhinorrhea and epistaxis. It is the most common sarcoma in children. In this study, we analyze the incidence and long-term survival for SNRMS using a national population-based database. METHODS:The United States National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) registry was utilized to calculate incidence and survival trends for SNRMS between 1973 and 2009. In addition, data were grouped by age, gender, race, and histopathological subtype. RESULTS:A total of 181 cases of SNRMS were analyzed for incidence trends, showing a 1.23:1 female to male ratio. While the overall incidence of SNRMS increased by 1.02% annually over the last 20years, this pattern was not equal amongst gender and racial groups. The incidence in males has increased, while in females incidence has decreased. An increase in incidence was noted in white and "others," but decreased in blacks. Using a total of 314 cases for survival analysis, we found that the rate in the white population has been consistently highest with a 5-year survival of 49.45%, 10- and 20-year survival of 48.81%. Survival rates in cases of embryonal SNRMS were also consistently higher than in cases of alveolar SNRMS. CONCLUSION/CONCLUSIONS:Overall incidence of SNRMS is increasing. Histologic subtype and race are important considerations in the long-term prognosis of SNRMS. Future studies will further elucidate gender and race related trends.
PMID: 23743294
ISSN: 1532-818x
CID: 4112462
Readability assessment of the American Rhinologic Society patient education materials
BACKGROUND: The extensive amount of medical literature available on the Internet is frequently accessed by patients. To effectively contribute to healthcare decision-making, these online resources should be worded at a level that is readable by any patient seeking information. The American Medical Association and National Institutes of Health recommend the readability of patient information material should be between a 4th to 6th grade level. In this study, we evaluate the readability of online patient education information available from the American Rhinologic Society (ARS) website using 9 different assessment tools that analyze the materials for reading ease and grade level of the target audience. METHODS: Online patient education material from the ARS was downloaded in February 2012 and assessed for level of readability using the Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook (SMOG) Grading, Coleman-Liau Index, Gunning-Fog Index, FORCAST formula, Raygor Readability Estimate, the Fry Graph, and the New Dale-Chall Readability Formula. Each article was pasted as plain text into a Microsoft(R) Word(R) document and each subsection was analyzed using the software package Readability Studio Professional Edition Version 2012.1. RESULTS: All healthcare education materials assessed were written between a 9th grade and graduate reading level and were considered "difficult" to read by the assessment scales. CONCLUSION: Online patient education materials on the ARS website are written above the recommended 6th grade level and may require revision to make them easily understood by a broader audience.
PMID: 23044857
ISSN: 2042-6984
CID: 305032
