bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation and characterization of SPES/PVA (double-layer) membrane for vanadium redox flow battery
Authors: Xie Jili , Li Guanlin , Tan Wang
Published: January 2018

The double-layer membrane consisting of sulfonated poly(ether sulfone) (SPES) sub-layer and polyvinyl alcohol (PVA) sub-layer (denoted as SPES/PVA membrane) was prepared and employed as the separator for vanadium redox flow battery (VRB) system to evaluate the vanadium ions permeability and cell performance. The SPES/PVA membrane is a double-layer structure and exhibits dramatically lower vanadium ions permeability and better cell performance compared to the pristine SPES membrane, PVA membrane, and Nafion117 membrane. The vanadium ion permeability of SPES/PVA membrane is one order of magnitude lower than that of Nafion117 membrane. In further work, the single cell with SPES/PVA membrane showed significantly lower capacity loss, higher coulombic efficiency (>92.5%), and higher energy efficiency (>83.9%) than Nafion117 membrane. In the self-discharge test, SPES/PVA membrane showed 1.8 times longer duration in the open circuit decay than Nafion117 membrane. With all the good properties and low cost, this new kind of double-layer membrane is suggested to have excellent commercial prospects as an ion exchange membrane for VRB systems.
Some investigations in grindability improvement of Inconel 718 under ecological grinding
Authors: Sinha Manoj Kumar , Madarkar Rajeshkumar , Ghosh Sudarsan , Paruchuri Venkateswara Rao
Published: January 2018

This work explores the improvement in grinding characteristics of Inconel 718 (IN718) using soluble oil under minimum quantity lubrication and liquid nitrogen (LN2) environments. The coolant flow rate in minimum quantity lubrication and LN2 grinding has been regulated through indigenously developed setups. Grinding performance has been studied in terms of on-machine measured grinding forces and centre line average surface roughness ( Ra). The obtained grinding characteristics have been compared with the outcomes under dry and wet grinding. Surface integrity of ground surface, wheel morphology, and chip formation characteristics has been studied using scanning electron microscope, energy dispersive X-ray spectroscopy, and atomic force microscopy. Analysis of variance has been carried out to capture the variability in the experimental data for tangential forces and Ra. The main effect of the factors and their first-order interactions have been considered, and second-order regression equations have been developed using response surface methodology. LN2 grinding has been proved to be more efficient as it yielded lowest grinding forces, least oxidation, minimal ground surface damage and better surface integrity. The occurrence of almost circular chips in dry grinding indicates severe oxidation, whereas small C-type chips formed under minimum quantity lubrication and LN2 conditions indicate effective cooling under these environments. The energy dispersive X-ray spectroscopy analysis of the ground surfaces also supports these results through the occurrence of the highest oxidation in dry grinding. From this work, it has been concluded that LN2 and minimum quantity lubrication grinding offer a clean and effective means to improve grinding performance of IN718 compared to dry and wet grinding.
Assessment of HIV disclosure and sexual behavior among Black men who have sex with men following a randomized controlled intervention
Authors: Serovich Julianne M , Laschober Tanja C , Brown Monique J , Kimberly Judy A
Published: January 2018

Disclosure is important in human immunodeficiency virus (HIV) transmission risk reduction. This randomized controlled intervention assessed changes in and predictors of disclosure and risky sexual behavior among Black men who have sex with men (BMSM) living with HIV in the U.S. BMSM were randomly assigned to either the disclosure intervention or attention control case management group. Predictors of three disclosure types (behavior, beliefs, intentions) and condomless anal intercourse (CAI) included disclosure consequences (rewards and costs), disclosure readiness, and safer sex readiness. Mixed-effect results showed no differences between the groups in any of the outcomes; although disclosure behavior increased over time. Relationships were found between readiness to change and CAI; disclosure consequences and different disclosure types; and disclosure behavior and receptive CAI. When working with BMSM living with HIV, practitioners and prevention specialists should consider the importance of disclosure pertaining to receptive CAI and factors that support overall disclosure and safer sex.
Positive Attitude Toward Math Supports Early Academic Success: Behavioral Evidence and Neurocognitive Mechanisms
Authors: Chen Lang , Bae Se Ri , Battista Christian , Qin Shaozheng , Chen Tianwen , Evans Tanya M. , Menon Vinod
Published: January 2018

Positive attitude is thought to impact academic achievement and learning in children, but little is known about its underlying neurocognitive mechanisms. Using a large behavioral sample of 240 children, we found that positive attitude toward math uniquely predicted math achievement, even after we accounted for multiple other cognitive-affective factors. We then investigated the neural mechanisms underlying the link between positive attitude and academic achievement in two independent cohorts of children (discovery cohort: n = 47; replication cohort: n = 28) and tested competing hypotheses regarding the differential roles of affective-motivational and learning-memory systems. In both cohorts, we found that positive attitude was associated with increased engagement of the hippocampal learning-memory system. Structural equation modeling further revealed that, in both cohorts, increased hippocampal activity and more frequent use of efficient memory-based strategies mediated the relation between positive attitude and higher math achievement. Our study is the first to elucidate the neurocognitive mechanisms by which positive attitude influences learning and academic achievement.
Effectiveness of the phase change material-based thermal energy storage integrated with the conventional cooling systems of the buildings – A review
Authors: Waqas Adeel , Ji Jie , Ali Majid , Alvi Jahan Zeb
Published: January 2018

A significant portion of energy is consumed by the buildings to provide thermal comfort for its occupants. Energy consumed by the conventional cooling machines is expected to increase substantially around the globe. Cooling systems coupled with phase change materials offer a high potential to minimize the cooling energy demand and shifting peak time cooling load to off-peak time period without compromising the indoor comfort conditions. The interest in phase change material utilization for cooling applications has been increasing significantly over the last decade because of their energy saving benefits in building sector. Therefore, in this work, effectiveness of the phase change material storage coupled with free cooling, evaporative cooling, and compressor-based cooling techniques in reducing the energy consumption or shifting the peak cooling load have been discussed and analyzed in detail. Different types of phase change materials used for active cooling systems along with their selection criteria for a particular application have been elaborated and discussed. Techniques to estimate the thermophysical properties of phase change material have also been explained. Phase change material capsulation techniques along with their merits and demerits are also described. Challenges and issues that may arise during integrating of phase change material storage with the active cooling system have also been explained. Finally, this review also presents some current problems that needed further research in this area. Current review will be a useful guide for the research community working or intending to work in the field of phase change material-based cooling system.
The role of truth in psychological science
Authors: Asay Jamin
Published: January 2018

In their 2012 article, Haig and Borsboom explore the relevance of the theory of truth for psychological science. Although they conclude that correspondence theories of truth are best suited to offer the resources for making sense of scientific practice, they leave open the possibility that other theories might accomplish those same ends. I argue that deflationary theories of truth, which deny that there is any substantive property that unifies the class of truths, make equally good sense of scientific practice as the correspondence theory, but at a lesser theoretical cost. I also argue that the considerations Haig and Borsboom draw on are better thought of as issues relevant to realism, and thus separate from the theory of truth. I conclude that while they are correct to engage questions about what makes true the various claims that arise in psychological research, they may do so without saddling themselves with a correspondence theory.
Barriers to Hospice Care in Trauma Patients: The Disparities in End-of-Life Care
Authors: Haines Krista L. , Jung Hee Soo , Zens Tiffany , Turner Scott , Warner-Hillard Charles , Agarwal Suresh
Published: January 2018

Introduction:

End-of-life and palliative care are important aspects of trauma care and are not well defined. This analysis evaluates the racial and socioeconomic disparities in terms of utilization of hospice services for critically ill trauma patients.

Methods:

Trauma patients ≥15 years old from 2012 to 2015 were queried from the National Trauma Databank. Chi-square and multivariate logistic regression analyses for disposition to hospice were performed after controlling for age, gender, comorbidities, injury severity, insurance, race, and ethnicity. Negative binomial regression analysis with margins for length of stay (LOS) was calculated for all patients discharged to hospice.

Results:

Chi-square analysis of 2 966 444 patient’s transition to hospice found patients with cardiac disease, bleeding and psychiatric disorders, chemotherapy, cancer, diabetes, cirrhosis, respiratory disease, renal failure, cirrhosis, and cerebrovascular accident (CVA) affected transfer ( P < .0001). Logistic regression analysis after controlling for covariates showed uninsured patients were discharged to hospice significantly less than insured patients (odds ratio [OR]: 0.71; P < .0001). Asian, African American, and Hispanic patients all received less hospice care than Caucasian patients (OR: 0.65, 0.60, 0.73; P < .0001). Negative binomial regression analysis with margins for LOS showed Medicare patients were transferred to hospice 1.2 days sooner than insured patients while uninsured patients remained in the hospital 1.6 days longer ( P < .001). When compare to Caucasians, African Americans patients stayed 3.7 days longer in the hospital and Hispanics 2.4 days longer prior to transfer to hospice ( P < .0001). In all patients with polytrauma, African Americans stayed 4.9 days longer and Hispanics 2.3 days longer as compared to Caucasians ( P < .0001).

Conclusions:

Race and ethnicity are independent predictors of a trauma patient’s transition to hospice care and significantly affect LOS. Our data demonstrate prominent racial and socioeconomic disparities exist, with uninsured and minority patients being less likely to receive hospice services and having a delay in transition to hospice care when compared to their insured Caucasian counterparts.
Ineffective Health Management in Hemodialysis Patients: Diagnostic Accuracy Study
Authors: Paiva Maria das Graças Mariano Nunes de , Tinôco Jéssica Dantas de Sá , Fernandes Maria Isabel da Conceição Dias , Dantas Juliane Rangel , Nogueira Isadora Lorenna Alves , Medeiros Ana Beatriz de Almeida , Lopes Marcos Venícios de Oliveira , Lira Ana Luisa Brandão de Carvalho
Published: January 2018

This study analyzed the accuracy of clinical indicators of ineffective health management in hemodialysis patients. A diagnostic accuracy study was performed in 200 chronic kidney disease patients undergoing hemodialysis during the first half of 2015. Measures of sensitivity and specificity were calculated using latent class analysis. Ineffective health management was present in 66.28% of patients. Accurate clinical indicators included expressed nonadherence to treatment, daily life choices ineffective to achieve health goals, expression of difficulty with prescribed regimens, inappropriate use of medicines, lack of expression of willingness to control the disease, irregular attendance of dialysis sessions, and infection. Hemodialysis may trigger a set of clinical indicators that predict the presence of ineffective health management. This knowledge provides evidence to clinical practices for hemodialysis patients and contributes to the best clinical performance of nurse practitioners.
Effects of a Nurse-Led, Stage-Matched, Tailored Program for Smoking Cessation in Health Education Centers: A Prospective, Randomized, Controlled Trial
Authors: Lu Chia-Chen , Hsiao Yu-Chuan , Huang Hui-Wen , Lin Jhen-Yi , Huang Chih-Ling
Published: January 2018

The purpose of this study was to examine the effectiveness of a stage-matched intervention performed at outpatient clinics. Participants were randomly assigned to an intervention group (IG) or usual care group (UCG). The trial was targeted on smoking patients with coronary heart disease or diabetes. After completing the 3-month intervention, both groups received a telephone follow-up at 6 months. This analysis showed that the outcomes of the IG for the 7-day point prevalence (PP) of abstinence (odds ratio [OR] = 2.00; p = .001) and 30-day PP (OR = 2.27; p = .004) at 6 months were significantly better than the UCG. Stage of change (OR = 4.06; p < .001) and decreased daily cigarette consumption by 50% at 6 months (OR = 2.26; p = .019) outcomes also improved significantly. The preliminary results showed that a nurse-led cessation intervention in clinics may be an effective approach to help outpatients quit smoking.
An Intraoral Appliance to Retract the Protrusive Premaxilla in Bilateral Cleft Lip Patients Presenting Late for Primary Lip Repair
Authors: Vura Nandagopal , Gaddipati Rajasekhar , Palla Yudhistar , Kumar Pranay
Published: January 2018

The protruding and deviated premaxilla in bilateral complete cleft lip and palate (BCL/P) patients causes a perplexing problem in achieving a tension-free primary lip closure. An innovative noninvasive active intraoral Fixed Pre-Surgical Cleft Orthopedic (FPSCO) appliance is presented that has enabled to successfully reposition the premaxillary segment to a more favorable position prior to the surgical repair in 4 BCL/P patients, who reported late for treatment with a mean age of 18 ± 3 months. All the patients had at least 1 deciduous tooth erupted in 3 cleft segments, 1 premaxilla (PM), and 2 lateral maxillary (LM) segments. This innovative approach is a noninvasive method of getting the cleft segments closer prior to chelioplasty, where conventional presurgical nasoalveolar molding (PNAM) is not possible, which needs to be done early in life as it requires circulating maternal estrogen levels to achieve results preferably possible in patients younger than 3 to 6 months. Bonding to erupted teeth with glass ionomer cement was implemented to secure the appliance. Nickel-titanium (Ni-Ti) closed-coil springs were used that delivered continuous forces of 150 g/5 oz per side to retract the premaxillary segment. The mean active period of treatment time was 3.5 ± 1.6 months and the retention period was 1.2 ± 0.6 months, following which cheiloplasty was performed.
Differences in the Tensor Veli Palatini Between Adults With and Without Cleft Palate Using High-Resolution 3-Dimensional Magnetic Resonance Imaging
Authors: George Thomas N. , Kotlarek Katelyn J. , Kuehn David P. , Sutton Bradley P. , Perry Jamie L.
Published: January 2018

Objective:

To investigate the dimensions of the tensor veli palatini (TVP) muscle in adults with and without cleft palate.

Design:

Prospective study.

Participants:

There were a total of 14 adult participants, 8 noncleft and 6 with cleft palate.

Methods:

Analysis and comparison of the TVP muscle and surrounding structures was completed using 3D MRI data and Amira 5.5 Visualization Modeling software. TVP muscle volume, hamular process distance, mucosal thickness, TVP muscle length, and TVP muscle diameter were used for comparison between participant groups based upon previous research methods.

Results:

Mann-Whitney U tests revealed a significantly smaller ( U < .001, P = .002) TVP muscle volume in the cleft palate group (median = 536.22 mm3) compared to individuals in the non–cleft palate group (median = 895.19 mm3). The TVP muscle was also significantly shorter ( U = 1.00, P = .003) in the cleft palate group (median = 18.04 mm) versus the non–cleft palate (median = 21.18 mm). No significant differences were noted for the other measured parameters.

Conclusion:

Significant differences in the TVP muscle volume and length among the noncleft participants found in this study may insights into the reported increased incidence of otitis media with effusion (OME) seen in the cleft population. Results from this study contribute to our understanding of the underlying anatomic differences among individuals with cleft palate.
Take CHARGE! A Randomized Controlled Trial of a Social Problem-Solving Curriculum to Support Students With Emotional and Behavioral Disorders
Authors: Van Loan Christopher L. , Garwood Justin D. , Smith Stephen W. , Daunic Ann P.
Published: January 2018

Using a pre–post randomized controlled trial, the purpose of this study was to determine whether a social problem-solving curriculum, Take CHARGE!, based on a cognitive-behavioral approach, could improve students’ knowledge of problem-solving skills, as well as self-report of social behaviors for 92 middle school students with emotional and behavioral disorders (EBD) in 11 self-contained classrooms. Dependent variables included student-report measures of problem-solving knowledge and skills. Findings indicated that the Take CHARGE! curriculum was related to significant increases in students’ social skills knowledge and problem-solving skills for middle school students with EBD. Teachers were able to implement the curriculum with a high degree of fidelity, and they indicated they would like to continue using it in the future. Implications for practicing teachers support the use of role-plays, think-alouds, and explicit instruction in problem-solving steps. Future research methodologies including observational research and longitudinal exploration are discussed.
Facilitating Focused Process Improvement Efforts in Home Health Agencies to Improve Utilization Outcomes Effectively and Efficiently
Authors: Koru Güneş , Parameshwarappa Pooja , Alhuwail Dari , Aifan Abdulrahman
Published: January 2018

The aim of this study was to identify a smaller set of clinical practices most associated with the utilization outcomes of the home health agencies. A secondary data analysis approach was adopted using the publicly accessible Home Health Compare repository as the main data source; the control variables such as rurality, agency size, and median income levels were obtained from other public data repositories. Checking for fall risks and starting care in a timely manner were most associated with hospital readmissions. These two practices and treating patients for pain are most associated with the emergency room visit rates. The results provide additional guidance to home health agencies in their prioritized and focused performance improvement initiatives to improve their utilization outcomes.
The Impact of Partnership Status on Diabetes Control and Self-Management Behaviors
Authors: Haines Lindsay , Coppa Natalie , Harris Yael , Wisnivesky Juan P. , Lin Jenny J.
Published: January 2018

According to the Centers for Disease Control and Prevention, diabetes affects 29.1 million people in the United States. Marriage has been suggested to have a protective effect on overall health outcomes, but few studies have evaluated the role of partnership status on patients with type 2 diabetes. This study aimed to assess this role of partnership status on diabetes control and self-management behaviors. Patients with type 2 diabetes taking at least one oral hypoglycemic agent were assessed over a 3-month period to measure hemoglobin A1c (HbA1c) changes and adherence to medication, exercise, diet, and glucose monitoring. Partnered participants were more likely to adhere to their medications, but there was no significant difference in HbA1c changes over 3 months or exercise, diet, or glucose monitoring adherence. This study suggests that being partnered improves medication adherence; further analysis with a larger population is required to fully assess the role of partner support for patients with type 2 diabetes.
Positive Transition to Middle School: A Multilevel Model Analysis of a Portuguese School Adjustment Program
Authors: Coelho Vítor Alexandre , Sousa Vanda , Marchante Marta
Published: January 2018

Transition to middle school in Portugal is associated with increased levels of stress for students, as well as an increase in grade retention. This study investigated the impact of a school adjustment program designed to support students during this transition, and its differential results by gender and fourth-grade class size. Multilevel linear modeling (MLM) with a repeated-measures design was used. Three cohorts of students ( n = 743) completed the School Stress Survey in fourth (middle and end) and fifth grades (end). In addition, fifth-grade school records were collected for information about absenteeism and transition. After adjusting for gender and fourth-grade class size, positive interaction effects from the intervention were found in academic and teacher/rules stress, as well as higher rates of transition to sixth grade and lower rates of absenteeism. Differential effects by gender also were found with girls displaying higher school success and lower school absenteeism along the transition; however, they also displayed larger increases in academic and peer-related stress during the period. No gender differences in benefits from program participation were found. The positive results support the implementation of the program among Portuguese fourth graders.
Feline primary erythrocytosis: a multicentre case series of 18 cats
Authors: Darcy Hannah , Simpson Katherine , Gajanayake Isuru , Seth Mayank , McGrotty Yvonne , Szladovits Balazs , Glanemann Barbara
Published: January 2018

Case series summary

A retrospective multicentre case series of feline primary erythrocytosis (PE) was evaluated. The aim was to gain better understanding of disease presentation and progression to guide management and prognostication. Case records were assessed for evidence of increased packed cell volume (PCV; >48%), sufficient investigation to rule out relative and secondary erythrocytosis, and follow-up data for at least 12 months or until death. Eighteen cats were included in the case series. No significant trends in signalment were noted. Seizures and mentation changes were the most common presenting signs (both n = 10). Median PCV was 70% (median total protein concentration of 76 g/l) with no other consistent haematological changes. Sixteen cats survived to discharge. Phlebotomy was performed initially in 15/16 surviving animals and performed after discharge in 10/16. Hydroxyurea was the most common adjunctive therapy, used in 10/16 cats. Of the 16 patients surviving to discharge, 14 patients were still alive at the conclusion of the study (survival time >17 months post-discharge), with the two non-survivors having lived for 5 years or more after diagnosis. PCV, when stabilised, did not correlate with resolution of clinical signs.

Relevance and novel information

In contrast to perceptions, feline PE was generally well managed via a combination of phlebotomy and medical therapy, with evidence of prolonged survival times. The use of hydroxyurea enabled cessation or repeat phlebotomies.
Intravenous rocuronium 0.3 mg/kg improves the conditions for tracheal intubation in cats: a randomized, placebo-controlled trial
Authors: Sakai Daniel M , Zornow Kailee Anne , Campoy Luis , Cable Christina , Appel Leslie D , Putnam Holly J , Martin-Flores Manuel
Published: January 2018

Objectives

We evaluated the use of rocuronium 0.3 mg/kg intravenously (IV) to facilitate tracheal intubation in cats anesthetized for elective ovariohysterectomy.

Methods

Thirty female cats were randomly allocated to receive rocuronium 0.3 mg/kg IV or an equal volume of normal saline, following induction of anesthesia with ketamine and midazolam. Thirty seconds after induction, a single investigator, unaware of treatment allocation, attempted tracheal intubation. The number of attempts and the time to complete intubation were measured. Intubating conditions were assessed as acceptable or unacceptable based on a composite score consisting of five different components. Duration of apnea after induction was measured and cases of hemoglobin desaturation (SpO2 <90%) were identified.

Results

Intubation was completed faster (rocuronium 12 s [range 8–75 s]; saline 60 s [range 9–120 s]) and with fewer attempts (rocuronium 1 [range 1–2]; saline 2 [range 1–3], both P = 0.006) in cats receiving rocuronium. Unacceptable intubating conditions on the first attempt occurred in 3/15 cats with rocuronium and in 10/15 with saline ( P = 0.01). Apnea lasted 4 ± 1.6 mins with rocuronium and 2.3 ± 0.5 mins with saline ( P = 0.0007). No cases of desaturation were observed.

Conclusions and relevance

Rocuronium 0.3 mg/kg IV improves intubating conditions compared with saline, and reduces the time and number of attempts to intubate with only a short period of apnea in cats.
Distance Alternate-Letter Suppression Test for Objective Assessment of Sensorial Status in Intermittent Exotropia
Authors: Yildirim C. , Altinsoy H.I.
Published: January 2018

Purpose

To investigate the value of distance alternate-letter suppression testing in the objective assessment of fusional control of intermittent exotropia.

Methods

A total of 71 consecutive patients with intermittent exotropia (study group) and 112 normal subjects (control group) underwent a series of measurements including distance alternate-letter suppression testing, Worth 4 Dot test at distance and near, and distance and near stereo acuity tests to see whether sensorial behavior differed in the study and control groups. The distance alternate-letter suppression test and distance stereo acuity tests were performed using the Mentor B-VAT II-SG Video Acuity Tester and Binocular Vision Testing System. The TNO test was used to measure near stereo acuity.

Results

Seventeen patients with intermittent exotropia (24%) presented suppression with the distance alternate-letter suppression test, but none of the normal subjects (p<0.001, X2 test). Only, three patients (4%) showed suppression on the Worth 4 Dot test at distance, and all had fusion on the Worth 4 Dot test near. Patients with intermittent exotropia had significantly diminished distance stereo acuity compared to normal subjects (p<0.001). Normal subiects and patients had good near stereo acuity (p>0.05). Patients with intermittent exotropia who had fusion with the distance alternate-letter suppression test had significantly better distance stereo acuity than patients who had suppression (p<0.001).

Conclusionsg

Distance alternate-letter suppression testing and distance stereo acuity tests may be useful as objective measures for assessing sensory loss in patients with intermittent exotropia.
Congenital Lacrimal Fistula
Authors: Uǧurbaş S.H. , Zilelioǧlu G.
Published: January 2018

Purpose

Congenital lacrimal fistula is a rare abnormality of the lacrimal system. The patients may be asymptomatic but treatment of those with symptoms such as epiphora and dacryocystitis is still controversial.

Methods

The clinical findings, methods of surgical treatment and results were evaluated in seven patients (four male, three female) with congenital lacrimal fistula. Three were asymptomatic, types of surgical treatment were fistula excision with dacryocystorhinostomy (DCR) (two cases), fistula excision with conjunctival DCR (one case) and closed fistula excision alone (one case).

Results

Three of the four patients who underwent surgery had relief of symptoms. The fistula recurred in the case that had undergone fistula excision alone.

Conclusions

It is difficult to design controlled studies to detect which method is superior for the treatment of lacrimal fistula, considering the small number of cases in the literature. We recommend treating each case according to its own characteristics.
A Randomized, Comparative Study of Fluorometholone 0.2% and Fluorometholone 0.1% Acetate after Photorefractive Keratectomy
Authors: Vetrugno M. , Quaranta G.M. , Maino A. , Cardia L.
Published: January 2018

Purpose

To compare the efficacy and tolerance of fluorometholone 0.1% acetate and fluorometholone 0.2% eyedrops in the postoperative management of photorefractive keratectomy (PRK).

Methods

A randomised single-blind comparative study was performed on two groups of 30 patients who underwent myopic PRK. The first group was given fluorometholone 0.1% acetate and the second fluorometholone 0.2%. Uncorrected and best corrected visual acuity, haze, IOP and local tolerance were evaluated. Statistical analysis was done using parametric and non-parametric tests.

Results

Visual acuity did not differ in the two groups; both were homogeneous as far as refractive error and haze were concerned. Three patients (10%) treated with fluorometholone 0.2% and two patients (6.6%) with fluorometholone 0.1% acetate developed ocular hypertension, but this was not statistically significant.

Conclusions

Fluorometholone 0.1% acetate was effective on inflammation after PRK, with the same efficacy as fluorometholone 0.2%.
The Triple Classification of Dry Eye for Practical Clinical Use
Authors: Murube J. , NÉmeth J. , HÖh H. , Kaynak-hekimhan P. , Horwath-winter J. , Agarwal A. , Baudouin C. , Benitez del castillo J.M. , Cervenka S. , Chenzhuo L. , Ducasse A. , Durán J. , Holly F. , Javate R. , Nepp J. , Paulsen F. , Rahimi A. , Raus P. , Shalaby O. , Sieg P. , Soriano H. , Spinelli D. , Ugurbas S.H. , Van setten G.
Published: January 2018

Clinicians need a practical classification to face diagnosis, prognosis, and treatment. Dry eyes have many etiologies and pathogenesis, different affectation of the various dacryoglands and ocular surface epithelium, and diverse grades of severity. The specialists in xero-dacryology must know these three parameters to evaluate any case of dry eye, and to establish an adequate treatment. To facilitate this, an open session in the VIII congress of the International Society of Dacryology and Dry Eye (Madrid, April, 2005) proposed modifying the Triple Classification of Dry Eye approved in the XIV congress of the European Society of Ophthalmology (Madrid, June 2003). The following classification has been established: first, a classification of the etiopathogenesis, distributed in 10 groups: age-related, hormonal, pharmacologic, immunopathic, hypo nutritional, dysgenic, infectious/inflammatory traumatic, neurologic, and tantalic; second, a classification of the affected glands and tissues, which under the acronym of ALMEN includes the aqueo-serous deficient, lipo deficient, mucin deficient, and epitheliopathic dry eyes, and the non-dacryologic affected exocrine glands (i.e., saliva, nasal secretion, tracheo-pharyngeal secretion); third, a classification of severity, in three grades: grade 1 or mild (symptoms without slit lamp signs), grade 2 or moderate (symptoms with reversible signs), and grade 3 or severe (symptoms with permanent signs).
Dependence of Wave Front Refraction on Pupil Size Due to the Presence of Higher Order Aberrations
Authors: Iseli H.P. , Bueeler M. , Hafezi F. , Seiler T. , Mrochen M.
Published: January 2018

Purpose

Propagation of light through the optical pathway within the eye can lead to a deformation of the wave front that might affect objective but also subjective refraction depending on pupil size. The aim of this study was to investigate the change in wave front refraction that is calculated on the basis of second order Zernike polynomials when varying the pupil size from 6 mm to 3 mm. The change was correlated with the amount of fourth and sixth order spherical aberration and fourth and sixth order astigmatism.

Methods

Wave front aberrations were measured in 130 eyes by means of a Tscherning wave front sensor at a pupil size of 6 mm. Wave front aberrations in terms of Zernike coefficients up to sixth order were approximated for 6 mm and 3 mm pupil size. The wave front refraction was calculated based on the second order Zernike coefficients for both pupil diameters. Resulting differences in wave front refraction (sphere or cylinder) due to the change in pupil size were correlated with the initial higher order aberrations determined for the 6.0 mm pupil by means of a linear regression (Spearman rank correlation coefficient).

Results

The correlation between the change in sphere and cylinder on one hand and the spherical aberration and higher order astigmatism on the other hand was found to be highly significant (p<0.001), with a correlation coefficient of R = 0.96 for sphere and R = 0.85 for cylinder.

Conclusions

Calculating the wave front refraction on the basis of second order Zernike polynomials is plagued with the influence of the higher order aberration preexisting in the individual eye. This is one reason why this method does not represent precisely enough subjective refraction. Other methods that calculate the refraction based on wave front measurement independent from the pupil size should be established in the ophthalmic community.
The Effect of Hyperopic Laser in Situ Keratomileusis on Refractive Accommodative Esotropia
Authors: Farahi A. , Hashemi H.
Published: January 2018

Purpose

To evaluate the efficacy of laser in situ keratomileusis (LASIK) for discarding spectacles and simultaneously correcting ocular alignment in patients with refractive accommodative esotropia.

Methods

LASIK was performed on 20 eyes of 10 patients (mean age, 24.3 years; range, 11 to 43 years) using a Technolas 217C excimer laser. The target refraction was emmetropia. Visual acuity (uncorrected and best-corrected), refractive error, and ocular alignment were recorded before and after LASIK. Minimum follow-up was 12 months.

Results

The mean preoperative uncorrected and corrected angle of deviation was 37.1 prism diopters (PD) (range, 17 to 80; standard deviation (SD), 19.8)) and 14.74 PD (range, 0 to 50; SD, 12.9) of esotropia, respectively, which changed to 7.2 PD (range, 0 to 50; SD, 15.78) without correction postoperatively (p=0.005). Of 20 eyes, 15% lost one line of best-corrected visual acuity, 10% gained two lines, and 75% showed no change.

Conclusions

LASIK could be considered an alternative treatment for patients with refractive accommodative esotropia with intolerance to glasses and contact lenses.
Fluorescein Angiography and Indocyanine Green Angiography for Identifying Occult Choroidal Neovascularization in Age-Related Macular Degeneration
Authors: Pece A , Sannace C. , Menchini U. , Virgili G. , Galli L. , Isola V. , Brancato R.
Published: January 2018

Purpose

To assess whether fluorescein angiography (FA) alone without indocyanine green angiography (ICGA) can identify and localize occult choroidal neovascularization (CNV) in age-related macular degeneration (ARMD).

Methods

Seventy-nine eyes of 77 consecutive patients with occult CNV were evaluated independently by two skilled physicians at first with FA alone and then with FA combined with ICGA by fundus camera.

Results

The agreement between FA and ICGA was 73% and 68% for the two physicians (K=0.585 and 0.512, respectively). The first operator correctly identified 20/27 as plaque CNV; six had different sizes and locations. The second operator identified 25/30, with one mistaken for size and location. For focal CNV the first operator identified 34/39, and the second one 23/35.

Conclusions

Comparing the FA results with ICGA, CNV was correctly identified in about 60% of cases. Therefore, ICGA should be considered an indispensable diagnostic test to identify the presence, the type, and the location of occult CNV.
Homocysteine, Vitamin B12, and Folic Acid in Age-Related Macular Degeneration
Authors: Nowak M. , Świetochowska E. , Wielkoszyński T. , Marek B. , Kos-kudła B. , Szapska B. , Kajdaniuk D. , Głogowska-szelág J. , Siemińska L. , Ostrowska Z. , Kozioł H. , Klimek J.
Published: January 2018

Purpose

Hyperhomocysteinemia is considered an independent risk factor for atherosclerosis and thrombosis. The purpose of this study was to evaluate plasma homocysteine, red blood cell folate, plasma folate, and plasma vitamin B12 concentration in patients with exudative age-related macular degeneration (ARMD).

Methods

The participants of this study included 30 patients aged 60 to llyears (mean age 66.2±3.6) with exudative ARMD. Plasma homocysteine levels were determined by high performance liquid chromatography (HPLC). Red blood cell folate, plasma folate, and plasma vitamin B12 concentration were determined using a standard kit (Dualcount Solid Phase No Boill radioassay kit for B12/folic acid, DPC Diagnostic, USA) by radioassay method.

Results

The plasma concentration of Hey (14.88±6.23 μmol/L) in ARMD patients was significantly increased (p<0.0001) compared with the control group (8,.72±3,.34 μmol/L). We found not a significant decrease of the plasma vitamin B12 concentration in the ARMD group (476.88±220.91 pg/mL) compared with the control group (527.08±208.97 pg/mL). Red blood cell folate (158.44±56.30 ng/mL) and plasma folate (6.5±3.4 ng/mL) in ARMD patients were also not significantly decreased when compared with the control group (183.86±59.33 ng/mL and 7.93±5.05 ng/mL).

Conclusions

Hyperhomocysteinemia might be one of the risk factors for the exudative form of ARMD.
Visual Acuity after Vitrectomy and Epiretinal Membrane Peeling with or without Premacular Indocyanine Green Injection
Authors: Koestinger A , Bovey E.H.
Published: January 2018

Purpose

To compare postoperative visual acuity of eyes operated for an epiretinal membrane (ERM), with or without intraoperative intraocular indocyanine green (ICG) injection.

Methods

Retrospective study of 75 Pseudophakic eyes with epiretinal membrane operated by vitrectomy-peeling. In 20 cases operated in 2001 and 2002 (Group 1), ICG diluted in 5% glucose solution was injected intraoperatively into the vitreous. In another group of 55 cases operated between 1996 and 1999 (Group 2), ICG was not used.

Results

The mean visual acuity was 0.32+1 and 0.32+2 preoperatively 0.4+2 and 0.5 at 1 month, and 0.63 and 0.63+2 on the final examination in Groups 1 and 2, respectively. Visual acuities were not significantly different between the two groups.

Conclusions

Premacular injection of ICG during vitrectomy to facilitate epiretinal membrane peeling did not appear to compromise postoperative improvement of visual acuity. However, its use is questioned since it did not yield better postoperative results and because potential toxic adverse reactions could not be excluded by this study.
Subretinal Neovascularization Associated with Retinochoroidal Coloboma
Authors: Takenaka J. , Yamane K. , Minamoto A. , Mishima H.K. , Hayashida H.
Published: January 2018

Purpose

To report a case of subretinal neovascularization associated with retinochoroidal coboma.

METHODS AND RESULTS

A 44-year-old female presented with metamorphopsia in her right eye for 4 weeks. Funduscopic examination revealed bilateral inferior retinochoroidal coloboma. Fluorescein angiography disclosed foci of subretinal neovascularization at the margin between the colobomatous defect and the normal-appearing retina. Five month later, multiple small areas of subretinal hemorrhages were noted. The hemorrhage was gradually absorbed. Six years after initial presentation, subretinal hemorrhage did not recur and her right VA was 0.2.

Conclusions

Ophthalmologists should be aware of this rare but important complication of retinochoroidal coloboma.
Brucella Meningitis and Papilledema in a Child
Authors: Levy J. , Shneck M. , Marcus M. , Lifshitz T.
Published: January 2018

Purpose

To report a rare case of Brucella meningitis with papilledema in a child and to discuss the findings of neurobrucellosis in children.

Methods

A 6-year-old girl was admitted with headache, fever, and vomiting for 1 week. Her family reported intake of raw unpasteurized goat's milk in the past. Meningeal signs were strongly positive. Bilateral moderate optic disc edema with flame-shaped hemorrhages was observed.

Results

The diagnosis of Brucella infection was established by positive blood culture for Brucella species, serum agglutination titer of antibodies to Brucella >1:160, and positive CSF culture. After treatment consisting of trimethoprim-sulfamethoxazole, rifampin, and doxycycline, the patient's condition gradually improved. One month later, the papilledema disappeared. One year after presentation, the patient remains free of symptoms.

Conclusions

Brucella meningitis must be ruled out in symptomatic patients reporting ingestion of raw unpasteurized goat's milk. Papilledema is a frequent clinical feature, but irreversible visual impairment is extremely rare.
Mini-Trabeculectomy in Comparison to Conventional Trabeculectomy in Primary Open Angle Glaucoma
Authors: Thimmarayan S.K. , Rao V.A. , Gupta A.
Published: January 2018

Purpose

To evaluate the safety and efficacy of mini-trabeculectomy in comparison to conventional trabeculectomy in primary open angle glaucoma (POAG).

Methods

A prospective interventional study of mini-trabeculectomy versus conventional trabeculectomy was undertaken on 60 eyes of 54 medically uncontrolled POAG patients requiring glaucoma surgery. They were divided into two groups: Group I underwent mini-trabeculectomy (30 eyes of 26 patients) and Group II underwent conventional trabeculectomy (30 eyes of 28 patients). All patients were followed up for at least 15 months. Statistical analysis was carried using Student's t test and paired t test for quantitative data and Pearson's chi-square test for qualitative data.

Results

The mean intraocular pressures (IOP) at the end of 15 months of follow-up in Groups I and II were 15.80±4.3 mmHg and 16.13±3.3 mmHg versus mean preoperative IOP of 28.63±2.74 and 28.60±2.44, p<0.0001, respectively. The difference in IOP control was significant only at 6 months of follow up (13.65±3.45 versus 15.98±4.05, p=0.041). The complications and failure were comparatively less in Group I.

Conclusions

Mini-trabeculectomy is a safe and effective alternative to conventional trabeculectomy in terms of IOP control. A modified tunnel incision employed in mini-trabeculectomy may be responsible for avoiding some of the complications.
Comparison of Topical and Subconjunctival Anesthesia in Intravitreal Injection Administrations
Authors: Kaderli B. , Avci R.
Published: January 2018

Purpose

To compare the effectiveness of topical and subconjunctival anesthesia in intravitreal injection administrations.

Methods

Twenty-eight patients from a university clinic with bilateral diabetic macular edema were prospectively randomized to receive intravitreal injection of 4 mg triamcinolone under topical anesthesia for one eye and subconjunctival anesthesia for the other eye by using lidocaine 4%. Patients were asked to grade the pain they experienced during administration of both anesthesia and intravitreal injection by using a 4-point pain scale: from 0=no pain to 3=severe pain. Complications that developed during both procedures were recorded.

Results

The mean pain score experienced during subconjunctival injections was 0.78 ± 0.62, whereas no anesthesia-related pain was reported in the topical group. The mean pain score experienced during intravitreal injection was 1.64±0.67 in the topical and 0.85±0.52 in the subconjunctival group (p<0.001). The mean total pain scores of both procedures were 0.82±0.34 in the topical and 0.82±0.51 in the subconjunctival group (p>0.05). Nine eyes (32%) developed subconjunctival haemorrhage after subconjunctival injection, whereas no anesthesia-related complication developed in the topical group. Subconjunctival haemorrhage was also observed in 5 eyes (18%) in the topical group and in 11 eyes (40%) in the subconjunctival group (p>0.05) after intravitreal injection.

Conclusions

Although subconjunctival anesthesia provides better pain control during intravitreal injections, its application is more painful and leads to subconjunctival haemorrhage. Moreover, the mean total pain scores are similar in both methods. Therefore, topical anesthesia may be more suitable for daily practice.
Spontaneous Extrusion of a Stainless Steel Glaucoma Drainage Implant (Ex-PRESS)
Authors: Tavolato M. , Babighian S. , Galan A.
Published: January 2018

Purpose

To report a case of spontaneous extrusion of a stainless steel glaucoma drainage implant (Ex-PRESS).

Methods

An Ex-PRESS was implanted under the conjunctiva in a 76-year-old man with primary open-angle glaucoma.

Results

Two years after implantation, the Ex-PRESS extruded spontaneously. Despite this adverse event, there was no increase in intraocular pressure.

Conclusions

This is the first report of spontaneous extrusion of an Ex-PRESS device. Implanting the device under a scleral flap should be considered to avoid adverse events such as extrusion or conjunctival erosion.
Argon Laser Trabeculoplasty in Triamcinolone Acetonide Induced Ocular Hypertension Refractory to Maximal Medical Treatment
Authors: Ricci F. , Missiroli F. , Parravano M.
Published: January 2018

Purpose

To report two cases of intraocular hypertension after intravitreal injection of triamcinolone acetonide (iTAA) that were refractory to maximal medical therapy and were successfully treated with argon laser trabeculoplasty (ALT).

Methods

Two patients with history of primary open angle glaucoma were treated with intravitreal injection of triamcinolone acetonide for chronic macular edema secondary to branch retinal vein occlusion. Both patients (Case 1 after 2 months and Case 2 after 5 days) developed intraocular hypertension that did not respond to maximal medical therapy. Despite medical therapy, intraocular pressure (IOP) was 45 mmHg in Case 1 and between 34 and 37 mmHg in Case 2. ALT was performed in the inferior 180° angle using the following parameters: 50 μm size, 700 mW, 0.50 sec, 100 spots.

Results

In both patients IOP returned to normal level a few days after ALT.

Conclusions

ALT seems to be effective at reducing IOP in patients with intraocular hypertension secondary to iTAA that does not respond to maximal medical treatment.
Bevacizumab for Occult Subfoveal Neovascularization in Age-Related Macular Degeneration
Authors: Jonas J.B. , Harder B. , Spandau U.H. , Kamppeter B.A. , Libondi T. , Sauder G.
Published: January 2018

Purpose

To report on the treatment of exudative age-related macular degeneration by intravitreal bevacizumab (Avastin).

Methods

A 78-year-old patient experienced a progressive loss of visual acuity in her right eye due to an occult subfoveal neovascular membrane in age-related macular degeneration. She received an intravitreal injection of 1.5 mg bevacizumab.

Results

Within 4 weeks after the injection, visual acuity improved from 0.40 to 0.60 with complete resolution of subretinal and intraretinal leakage and edema as shown on optical coherence tomography. Pre-existing metamorphopsias disappeared. Intraocular pressure remained in the normal range. During the follow-up, there were no sings of intraocular inflammation or any other intraocular pathology induced by the intravitreal injection.

Conclusions

Intravitreal bevacizumab may potentially be helpful in the treatment of exudative age-related macular degeneration and may deserve further evaluation.