bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corneal Densitometry After Secondary Descemet Membrane Endothelial Keratoplasty
Authors: Agha Bishr , Dawson Daniel G. , Kohnen Thomas , Schmack Ingo 
Published: June 2019

Purpose:
To evaluate Scheimpflug corneal densitometry (CD) in patients undergoing secondary Descemet membrane endothelial keratoplasty (DMEK) after previous Descemet stripping automated endothelial keratoplasty or DMEK surgery.

Methods:
This was a retrospective institutional case series of 37 eyes of 37 patients. Two secondary DMEK groups, group 1A (n = 12 DMEK after Descemet stripping automated endothelial keratoplasty), group 1B (n = 11 repeat DMEK), and group 2 (n = 14 primary DMEK for Fuchs endothelial dystrophy) were formed. CD was obtained preoperatively, 1, 6, and 12 months postoperatively. In addition, corrected distance visual acuity, central corneal thickness, and endothelial cell density were assessed.

Results:
A significant decrease in grayscale units was observed in the 0- to 2-mm and 2- to 6-mm zones in all groups. For the 0- to 2-mm zone, values decreased from 49.11 ± 17.96 preoperatively to 22.87 ± 5.24 at 12 months (group 1A), from 45.16 ± 9.22 to 24.53 ± 14.21 (group 1B), and from 27.90 ± 8.30 to 16.64 ± 1.51 (group 2) (P < 0.01). Group 2 showed significantly lower grayscale units than groups 1A and 1B preoperatively and 12 months postoperatively in the 0- to 2-mm and 2- to 6-mm zones. Significant correlations of CD and corrected distance visual acuity were found in groups 1A and 1B in the 0- to 2-mm zone at 12 months. There were no significant correlations between CD and central corneal thickness postoperatively.

Conclusions:
A decrease in CD could be demonstrated in secondary DMEK. Nevertheless, CD values remained significantly higher than in controls. This might point out the relevance of secondary corneal structural changes.
Efficacy and Safety of Various Amphotericin B Concentrations on Candida albicans in Cold Storage Conditions
Authors: Tran Khoa D. , Aldrich Benjamin T. , D'Amato Tóthová Jana , Skeie Jessica M. , Kondratick Christine M. , Giurgola Laura , Gatto Claudio , Reed Cynthia R. , Schmidt Gregory A. , Terry Mark A. , Greiner Mark A. 
Published: June 2019

Purpose:
To determine the concentration of amphotericin B that would be both effective against Candida albicans contamination and safe for corneal endothelial cells (CECs) in cold storage conditions.

Methods:
Triplicate media cultures were inoculated with 105 colony-forming units (CFUs)/mL of C. albicans (American Type Culture Collection 10231), supplemented with amphotericin B (0–20 μg/mL), stored in cold conditions (2°C–8°C) for 72 hours, and analyzed quantitatively for CFUs. C. albicans concentration in each sample was determined initially and after 6, 24, 48, and 72 hours of storage. CEC mitochondrial function (oxygen consumption rate), apoptosis, and necrosis were examined in donor corneas after 7 days of amphotericin B exposure and compared with untreated controls. CEC viability was also examined by calcein-AM staining and Fiji segmentation after 72 hours or 2 weeks of amphotericin B exposure to mimic potential eye bank practices.

Results:
Amphotericin B concentrations of 1.25, 2.5, and 5.0 μg/mL resulted in 0.47, 1.11, and 1.21 log10 CFU reduction after only 6 hours of cold storage and continued to decrease to 3.50, 3.86, and 4.49 log10 reductions after 72 hours, respectively. By contrast, amphotericin B 0.255 µg/mL showed only 1.01 log10 CFU reduction after 72 hours of incubation. CEC mitochondrial function and viability did not differ in donor corneas exposed to amphotericin B ≤2.59 μg/mL compared with the controls.

Conclusions:
Optimal efficacy of amphotericin B against C. albicans is achieved in cold storage conditions at concentrations ≥1.25 μg/mL, and 2.5 μg/mL reduces Candida contamination by >90% after 6 hours of cold storage without sacrificing CEC health.
Evaluating Dry Eye and Meibomian Gland Dysfunction With Meibography in Patients With Stevens–Johnson Syndrome
Authors: Lekhanont Kaevalin , Jongkhajornpong Passara , Sontichai Vachira , Anothaisintawee Thunyarat , Nijvipakul Sarayut 
Published: June 2019

Purpose:
To investigate ocular surface and meibomian gland characteristics using infrared meibography in patients with Stevens–Johnson syndrome (SJS).

Methods:
This is a single-center, prospective, noncontrolled, observational study. Thirty-two Thai patients (64 eyes) with SJS for 1 year or longer (1–44 years) were enrolled in the study. All participants underwent a comprehensive ophthalmic examination including slit-lamp biomicroscopy, tear meniscus height, fluorescein tear breakup time, ocular surface fluorescein staining, eyelid morphology, Schirmer 1 test, meibomian gland expressibility, and upper and lower eyelid meibography using a noncontact infrared meibograph mounted on a slit-lamp biomicroscope.

Results:
The mean age was 42.2 ± 17.7 years (range, 4–68 years). Twenty-nine patients (90.6%) had a history of severe ocular complications in the acute stage of the disease. Medications were the most common cause of SJS (93.8%). Meibum quality could not be assessed in 23 patients (71.9%) due to no glands expressible. Partial or complete loss of the meibomian glands in either the upper or lower eyelid was found in all patients. The degree of meibomian gland dropout significantly correlated with tear breakup time (P < 0.001), meibum quality (P < 0.001), meibum expressibility (P < 0.001), ocular surface staining (P < 0.001), and presence of long-term ocular sequelae including symblepharon (P = 0.027) and limbal stem cell deficiency (P = 0.003).

Conclusions:
SJS is associated with obstructive meibomian gland dysfunction. The severity of meibomian gland dropout has a relationship with abnormal dry eye tests, subjective meibomian gland evaluation, and other ocular sequelae of SJS.
In Vivo Confocal Microscopy of Prominent Conjunctival and Corneal Nerves in Multiple Endocrine Neoplasia Type 2B
Authors: Lam Delphine , Villaret Jeremie , Nguyen Kim Pauline , Gabison Eric , Cochereau Isabelle , Doan Serge 
Published: June 2019

Objective:
To report a case of a patient affected by multiple endocrine neoplasia type 2B (MEN 2B) with imaging of conjunctival neuromas by in vivo confocal microscopy (IVCM).

Methods:
Case report.

Results:
A 48-year-old patient affected by MEN2B complained of progressive visual loss in his right eye and severe red, dry and itchy eyes. Best-corrected visual acuity was 20/63 OD and 20/25 OS. Slit lamp exam showed thickened and turned out lid margins, significant blepharitis, conjunctival injection, multiple presumed subconjunctival neuromas at the bulbar conjunctiva and at the limbus, marked prominence of corneal nerves, exposure keratopathy due to incomplete blinking and corneal hypoesthesia, subepithelial corneal neovascularization and scarring in the mid inferior part of both corneas and bilateral iris nodules. We performed IVCM on conjunctival neuromas, revealing large, thick bundles of nerves with disorganization, prominent loops, bifurcations and dilations measuring as much as 1 mm. The IVCM of corneal nerves demonstrated hypertrophic sub basal plexus.

Conclusions:
To date, this is the first report which documents conjunctival neuromas by confocal microscopy in MEN2B.
Schiotz Scleral Intraocular Pressure Readings Predict Goldmann Applanation Readings Better Than Rebound Tonometry
Authors: Senthil Sirisha , Chary Raghava , Ali Mohammed Hasnat , Choudhari Nikhil , Badakere Swathi , Krishnamurthy Rashmi , Dikshit Siddharth , Garudadri Chandrasekhar 
Published: June 2019

Purpose:
To study the agreement between scleral intraocular pressure (IOP) measurements using the Schiotz, Icare, and Icare PRO tonometers versus Goldmann applanation tonometer (GAT) in eyes with nonscarred corneas.

Methods:
This cross-sectional study included 83 eyes of 55 subjects. The order of IOP estimation was the corneal GAT, followed by ICare, ICare PRO, and Schiotz on the corneal and temporal sclera. The agreement between different tonometers and the 95% limits of agreement (LoA) were assessed using Bland–Altman plots. The repeated measures correlation coefficient was calculated between GAT IOP and scleral Schiotz IOP, and the 95% confidence intervals were calculated by the bootstrap method. The linear mixed effects model was used (adjusted for both eyes of the subjects) to generate an equation to predict GAT IOP from scleral Schiotz IOP. The prediction model was validated with new data from 60 eyes. Statistical analyses were performed using “R” software (version 3.3.2).

Results:
Comparing the scleral IOP measurements, the mean IOP difference (95% LoA) was the lowest with Schiotz, underestimating by −1.21 mm Hg (7.32, −9.74). Both ICare and ICare PRO significantly overestimated GAT IOP: ICare, 24.6 mm Hg (53.2, −3.97); and ICare PRO, 21.56 mm Hg (52.9, −9.79). The correlation coefficient between scleral Schiotz and GAT IOP was 0.92 (95% bootstrap confidence interval: 0.89, 98). The derived predictive equation was

JOURNAL/corne/04.03/00003226-201909000-00008/inline-formula1/v/2023-09-12T173450Z/r/image-tiff

. The mean difference between the predicted GAT IOP and the actual GAT IOP was 0.96 mm Hg with narrow LoA (+1.79, −3.71), validating the prediction model.

Conclusions:
Among the tonometers tested, the scleral IOP measurements with Schiotz had the best agreement with the GAT although LoA were wide. The predictive equation may have great potential to predict GAT IOP from scleral IOP readings in eyes with scarred/prosthetic corneas.
Why Should We Advocate Maternal Immunization?
Authors: Boonyaratanakornkit Jim , Chu Helen Y. 
Published: June 2019

Summary:
Maternal vaccination provides a method for protecting the pregnant woman, fetus and neonate during a period when there is increased susceptibility to infectious diseases. A dynamic state of immune tolerance during pregnancy and the need to develop adaptive memory to a new foreign antigen-rich environment lead to windows of vulnerability to infection for the mother and neonate, respectively. Passive transfer of humoral immunity through the placenta and breast milk from the mother can bridge the gap in immunity for the neonate. Studies on boosting this natural process of antibody transfer have led to the recommendation for administering inactivated influenza, diphtheria, tetanus toxoid and acellular pertussis vaccines during pregnancy. Several new maternal vaccine candidates are on the horizon.
Pain-related gaze biases and later functioning among adults with chronic pain: a longitudinal eye-tracking study
Authors: Jackson Todd , Yang Zhou , Su Lin 
Published: June 2019

Abstract
In previous studies that examined the impact of attention biases (ABs) on later pain outcomes, reaction times (RTs) in response to brief stimulus presentations had been used as measures of attention. Consequently, little is known about effects of ABs assessed during presentations of cues or biases in prolonged attention towards pain stimuli as influences on subsequent functioning. To address these gaps, 89 adults with chronic pain (68 women, 21 men) engaged in a baseline dot-probe task in which visual attention was tracked during injury-neutral (I-N) image pair presentations as well as a 6-month follow-up reassessing pain intensity and interference from pain. Neither RTs to probes after image pair offsets nor biases in initial orienting of gaze towards injury images predicted follow-up outcomes. However, participants who gazed at injury images for longer durations during I-N trials reported significantly more pain and interference at follow-up than did peers who gazed at injury images for less time, even after the impact of other significant baseline predictors had been controlled. In sum, results provided initial evidence for gaze biases reflecting prolonged vigilance towards pain-related information as a potential risk factor for relative elevations in pain and interference from chronic pain.
Repressor element 1–silencing transcription factor drives the development of chronic pain states
Authors: Zhang Fan , Gigout Sylvain , Liu Yu , Wang Yiying , Hao Han , Buckley Noel J. , Zhang Hailin , Wood Ian C. , Gamper Nikita 
Published: June 2019

Abstract
Chronic pain is an unmet clinical problem with vast individual, societal, and economic impact. Pathologic activity of the peripheral somatosensory afferents is one of the major drivers of chronic pain. This overexcitable state of somatosensory neurons is, in part, produced by the dysregulation of genes controlling neuronal excitability. Despite intense research, a unifying theory behind neuropathic remodelling is lacking. Here, we show that transcriptional suppressor, repressor element 1–silencing transcription factor (REST; neuron-restrictive silencing factor, NRSF), is necessary and sufficient for the development of hyperalgesic state after chronic nerve injury or inflammation. Viral overexpression of REST in mouse dorsal root ganglion (DRG) induced prominent mechanical and thermal hyperalgesia in vivo. Sensory neuron-specific, inducible Rest knockout prevented the development of such hyperalgesic state in 3 different chronic pain models. Genetic deletion of Rest reverted injury-induced hyperalgesia. Moreover, viral overexpression of REST in the same neurons in which its gene has been genetically deleted restored neuropathic hyperalgesia. Finally, sensory neuron specific Rest knockout prevented injury-induced downregulation of REST target genes in DRG neurons. This work identified REST as a major regulator of peripheral somatosensory neuron remodelling leading to chronic pain. The findings might help to develop a novel therapeutic approache to combat chronic pain.
Associations of mental health and family background with opioid analgesic therapy: a nationwide Swedish register-based study
Authors: Quinn Patrick D. , Rickert Martin E. , Franck Johan , Sariaslan Amir , Boersma Katja , Lichtenstein Paul , Larsson Henrik , D'Onofrio Brian M. 
Published: June 2019

Abstract
There is evidence of greater opioid prescription to individuals in the United States with mental health conditions. Whether these associations generalize beyond the US prescription environment and to familial mental health and socioeconomic status (SES) has not been examined comprehensively. This study estimated associations of diverse preexisting mental health diagnoses, parental mental health history, and SES in childhood with opioid analgesic prescription patterns nationwide in Sweden. Using register-based data, we identified 5,071,193 (48.4% female) adolescents and adults who were naive to prescription opioid analgesics and followed them from 2007 to 2014. The cumulative incidence of any dispensed opioid analgesic within 3 years was 11.4% (95% CI, 11.3%-11.4%). Individuals with preexisting self-injurious behavior, as well as opioid and other substance use, attention-deficit/hyperactivity, depressive, anxiety, and bipolar disorders had greater opioid therapy initiation rates than did individuals without the respective conditions (hazard ratios from 1.24 [1.20-1.27] for bipolar disorder to 2.12 [2.04-2.21] for opioid use disorder). Among 1,298,083 opioid recipients, the cumulative incidence of long-term opioid therapy (LTOT) was 7.6% (7.6%-7.7%) within 3 years of initiation. All mental health conditions were associated with greater LTOT rates (hazard ratios from 1.66 [1.56-1.77] for bipolar disorder to 3.82 [3.51-4.15] for opioid use disorder) and were similarly associated with concurrent benzodiazepine-opioid therapy. Among 1,482,462 adolescents and young adults, initiation and LTOT rates were greater for those with parental mental health history or lower childhood SES. Efforts to understand and ameliorate potential adverse effects of opioid analgesics must account for these patterns.
Attitudes Toward Long-Term Medication Use—A Comparison Between Concerned Populations and a Sample From the German General Population
Authors: Engelke Christina , Cordes Joachim , Kahl Kai G. , Schmidt-Kraepelin Christian 
Published: June 2019

Abstract

Purpose/Background
The present study was conducted to investigate the difference in attitudes toward psychiatric drugs, long-term medication, and depot formulations between psychiatric patients and patient-related groups and the German general public.

Methods/Procedures
Different groups (n = 50 patients, n = 34 relatives of patients, n = 42 psychiatrists, n = 70 medical students, and n = 58 psychiatric nursing professionals) were surveyed using a questionnaire to investigate their attitude toward depot medication and compared with matched participants from the German general public.

Findings/Results
Patients did not differ from their matched controls regarding their attitude toward potential reasons to reject a depot, whereas psychiatrists (P = 0.002) and nursing staff (P = 0.003) were more concerned about patients fearing an injection than their matched controls.

Implications/Conclusions
Psychiatrists and psychiatric nurses were significantly more concerned about giving an (intragluteal) injection because of concerns about patients' fears of this administration method than their matched controls. In contrast, patients' concerns about receiving an injection did not differ from their matched controls. Furthermore, we found that psychiatrists tended to believe that giving an injection might be time-consuming than giving oral medication. These results may emphasize the fact that the low rate of depot medication use is derived from subjective reservations of medical staff rather than actual negative attitudes or fears of patients.
Case Reports of Aripiprazole and Problematic Gambling in Schizophrenia
Authors: Lachance Alexandre , Corbeil Olivier , Corbeil Stéphanie , Chalifour Guillaume , Breault Ann-Sophie , Roy Marc-André , Demers Marie-France 
Published: June 2019

Abstract

Background
Pharmacovigilance studies have reported a higher risk of problematic gambling (PG) in people receiving aripiprazole (ARI), a partial dopamine agonist. This association needs to be specifically assessed in schizophrenia (SZ) given the high prevalence of risk factors for PG in this population (eg, comorbid substance use) and given the nature of the dopamine dysfunction in this disorder. At the present stage, case studies may shed light on such an association.

Methods
All published cases involving SZ patients with PG while on ARI were systematically identified. Two instruments were used to assess causality.

Results
We identified 16 published SZ cases exposed to ARI experiencing PG. Half of whom had a gambling history before ARI exposition. Naranjo scores led to the estimation of a possible link between ARI exposition and PG in 15 of 16 cases (average score of 3) and probable (score of 5) in 1 case. More than 50% of items were left unknown owing to the lack of information or scale limitations. Using the Liverpool algorithm, causality estimation was raised to probable in 13 of 16 cases, definite in 1 case, and nonassessable in 2 cases.

Conclusions
The present review confirms that ARI may be involved in the occurrence of PG in some SZ patients. However, important information to assess causality was frequently missing, and the 2 scales used did not yield the same degree of certainty. The current article calls for including more details in future case reports and for well-powered studies carefully assessing factors such as comorbid diagnoses.
Achieving Clinical Instructor Competence: A Phenomenological Study of Clinical Instructors' Perspectives
Authors: Coleman-Ferreira Kimberly , Tovin Melissa , Rone-Adams Shari , Rindflesch Aaron 
Published: June 2019

Introduction.
Defining best practice in clinical education is currently a primary focus of the American Physical Therapy Association and the American Council of Academic Physical Therapy. Although professional standards exist for physical therapist clinical instructors (CIs), there is little published research regarding the pathway to achieving competence as a CI. Moreover, there is currently no published definition for competence as a CI within the profession of physical therapy (PT). This study attempts to describe the meaning of competence and the experience of achieving competence as perceived by both credentialed and noncredentialed CIs.

Subjects.
Twenty-nine physical therapist CIs who had independently supervised at least one full-time physical therapist student served as the subjects for this study.

Methods.
A phenomenological methodology was used to understand and interpret the meaning of CI competence and the experience of achieving competence from the CI participants' perspectives. Data were collected through focus group interviews and written statements and then were analyzed using thematic analysis.

Results.
The journey to competence, though unique to each CI, included commonalities. An overarching theme of “Empowerment” emerged from the data analysis and was supported by 6 subthemes: (1) the meaning of competence, (2) my first student, (3) finding the way, (4) barriers to achieving competence, (5) confidence, and (6) lifelong learning. Participants' descriptions of the meaning of competence included the roles of skilled clinician, teacher, mentor, reflective learning, collaborator, and effective communicator.

Discussion and Conclusion.
Findings can inform CIs striving for effectiveness in clinical teaching by defining the meaning of competence, as well as revealing a variety of pathways used to achieve competence. These examples could be helpful for Site Coordinators of Clinical Education, Directors of Clinical Education and others who teach CI development. The physical therapy education community and its professional bodies can use these findings to define CI competence and to direct future efforts and programs designed to prepare clinicians to effectively educate students in the clinical setting.
An Intervention Enhances Resilience in Entry-Level Physical Therapy Students: A Preliminary Randomized Controlled Trial
Authors: Mejia-Downs Anne 
Published: June 2019

Introduction:
The purpose of this study was to assess the impact of a resilience curriculum on stress levels, resilience, and protective factors, among physical therapist (PT) students during academic stress. Physical therapist students experience high levels of psychological stress during their education. Individuals with greater resilience are better equipped to handle stress. There is a lack of research examining the effect of resilience interventions in PT students. All students enrolled in an entry-level Doctor of Physical Therapy (DPT) program in Indianapolis, IN were eligible. Forty-three students volunteered to participate and all contributed preintervention and postintervention data for the study.

Methods:
Participants were randomly assigned to receive a resilience curriculum (n = 22) or to a wait-list control group (n = 21), with the researcher blinded to the assignment. An 8-hour resilience curriculum was delivered in 4 consecutive, 2-hour weekly sessions to the intervention group. Both the intervention and the control groups completed baseline and follow-up assessments. The control group was offered a 2-hour condensed version of the curriculum after postintervention assessments. Outcomes measured included stress, resilience, coping flexibility, optimism, emotions, social support, and illness.

Results:
There were significantly greater increases in resilience (P = .03) and positive emotions (P = .02) in the intervention group compared to the control group. There were no significant differences in stress, coping flexibility, negative emotions, optimism, social support, or illness symptoms. Less perceived stress, greater coping flexibility, and higher positive mood scores predicted greater baseline resilience, accounting for 56% of the variance.

Discussion and Conclusion:
This preliminary study demonstrates that a resilience curriculum delivered to DPT students increases resilience and positive emotions. Providing DPT students with tools to improve psychological resilience may better prepare them to meet the demands inherent in entry-level DPT educational programs.