bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Clinical Observation of Posterior Chamber Phakic Intraocular Lens Implantation in Young Population
Authors: Haiting Chen , Yu Liu , Xueyan Feng , Guangzeng Niu , Yuxiang Fan 
Published: June 2018

Objectives:
To compare the clinical outcomes and vision-related quality of life after implantable collamer lens (ICL) implantation for younger patients (17 years ≤ age ≤21 years) and for older patients (age >21 years).

Methods:
Design: Retrospective observational study. This study-enrolled patients underwent ICL implantation and finished 5-year follow-up who were divided into two groups based on age. Uncorrected distance visual acuity and corrected distance visual acuity (CDVA), refractions for the evaluation of efficacy, safety, stability, and predictability, intraocular pressure, corneal endothelial cell, ICL vaults, higher-order aberration (HOA), contrast sensitivity (CS) functions, adverse events, and quality of life were evaluated on 1, 3, 7, 14 days, 1, 3, 6 months and 1, 3, 5 years after surgery.

Results:
The study enrolled 164 eyes (82 patients), 84 in younger group (17 years ≤ age ≤21 years) and 80 in older group (age >21 years). The mean postoperative log of minimal angle of resolution CDVA of younger group was better than those of older group. The mean spherical equivalent values were more myopic in younger group than older group. As for CS and HOA, the younger and older groups showed similar data. The NEI-RQL scores of dependence on correction, worry, suboptimal correction, appearance, and satisfaction of older group were higher, whereas the score of symptom and near vision was worse. Both groups showed similar results in vaults, endothelial cell density and adverse events.

Conclusions:
The ICL performed well for the ametropia correction of both younger and older patients throughout the 5-year period. In the younger group, the visual quality was even better, but the myopic shift was quicker.
Utilization of Facial Image Analysis Technology for Blink Detection: A Validation Study
Authors: Kitazawa Momoko , Yoshimura Michitaka , Liang Kuo-Ching , Wada Satoshi , Mimura Masaru , Tsubota Kazuo , Kishimoto Taishiro 
Published: June 2018

Purpose:
The assessment of anterior eye diseases and the understanding of psychological functions of blinking can benefit greatly from a validated blinking detection technology. In this work, we proposed an algorithm based on facial recognition built on current video processing technologies to automatically filter and analyze blinking movements. We compared electrooculography (EOG), the gold standard of blinking measurement, with manual video tape recording counting (mVTRc) and our proposed automated video tape recording analysis (aVTRa) in both static and dynamic conditions to validate our aVTRa method.

Methods:
We measured blinking in both static condition, where the subject was sitting still with chin fixed on the table, and dynamic condition, where the subject's face was not fixed and natural communication was taking place between the subject and interviewer. We defined concordance of blinks between measurement methods as having less than 50 ms difference between eyes opening and closing.

Results:
The subjects consisted of seven healthy Japanese volunteers (3 male, four female) without significant eye disease with average age of 31.4±7.2. The concordance of EOG vs. aVTRa, EOG vs. mVTRc, and aVTRa vs. mVTRc (average±SD) were found to be 92.2±10.8%, 85.0±16.5%, and 99.6±1.0% in static conditions and 32.6±31.0%, 28.0±24.2%, and 98.5±2.7% in dynamic conditions, respectively.

Conclusions:
In static conditions, we have found a high blink concordance rate between the proposed aVTRa versus EOG, and confirmed the validity of aVTRa in both static and dynamic conditions.
Intrasubject Repeatability and Interdevice Agreement of Anterior Chamber Depth Measurements by Orbscan and Pentacam in Different Grades of Keratoconus
Authors: Hashemi Hassan , Asharlous Amir , Aghazadeh Amiri Mohammad , Yekta Abbasali , Ramin Shahroukh , Taheri Azadeh , Aghamirsalim Mohamadreza , Khabazkhoob Mehdi 
Published: June 2018

Objectives:
To evaluate the repeatability of anterior chamber depth (ACD) measurements by Orbscan and Pentacam imaging devices in different grades of keratoconus.

Methods:
One examiner performed 3 consecutive ACD measurements with both devices on 74 eyes of 42 keratoconus patient. Repeatability was assessed using intrasession test–retest variability. Within-subject SD was determined for repeatability, and the coefficient of variation was calculated for each measurement. The intraclass correlation coefficient (ICC) was also determined to assess the variance of repeated data.

Results:
Overall, the three ACD measurements were not significantly different either with Pentacam or Orbscan. The ICC index values were greater than 90% with both devices, and it significantly reduced at higher grades of keratoconus with Pentacam. Interdevice differences were statistically significant. The interdevice agreement with ACD measurements was 0.981, and the agreement was lower at higher grades of keratoconus. The 95% limits of agreement between the 2 devices for ACD was from −0.19 to 0.04.

Conclusions:
Our results indicate acceptable repeatability for ACD measurements with both Orbscan and Pentacam in keratoconus patients. The progression of keratoconus has no significant effect on repeatability results of these devices. The good agreement between them allows their interchangeable use.
“Therapeutic Penetrating Keratoplasty: A Retrospective Review”
Authors: Roozbahani Mehdi , Hammersmith Kristin M. , Nagra Parveen K. , Ma Jenny F. , Rapuano Christopher J. 
Published: June 2018

Purpose:
To report the indications, outcomes, and complications of therapeutic penetrating keratoplasty (Th PK) in patients with corneal perforation and/or nonhealing corneal ulceration.

Methods:
A retrospective review was conducted of 51 eyes of 51 patients undergoing Th PK between January 1, 2006 and April 15, 2016. Data collected included patient demographics, visual acuity (VA), size of the corneal infiltrate and epithelial defect, degree of corneal thinning/perforation, microbiological results, surgical details, and postoperative complications.

Results:
The average age at presentation was 56.0 years (range 6–92 years), and most of the patients were females (n=31, 60.8%). Th PK was performed for corneal perforation in 28 eyes (54.9% of cases), nonhealing corneal ulcer in 16 eyes (31.4% of cases), and imminent risk of corneal perforation in 7 eyes (13.7% of cases). Infection was the most common reason for performing a Th PK and was present in 92.3% (47/51) of all cases. Of the infectious cases, the most common etiologies were bacterial (44.7%, 21/47) and fungal (31.9%, 15/47). The most common identifiable risk factor for undergoing a Th PK was a history of contact lens wear, which was seen in 32.7% of patients. Initial anatomic success was achieved in all patients after performing Th PK. Most patients (33/51; 64.7%) had clear grafts at their last follow-up examination. There was an improvement in VA in 70.2% (33/47, where data were available) of the patients at the final postoperative visit compared with the preoperative visit. Average best postoperative VA (1.14±0.88 logarithm of the minimum angle of resolution [LogMAR]; 20/276) was significantly better than the presenting (1.98±0.68 LogMAR; 20/1910) and preoperative (2.18±0.55 LogMAR; 20/3,027) visual acuities (P<0.0001). The most common complication after Th PK was cataract, which was present in 81.8% (27/33) of phakic eyes in which lens status could be assessed, followed by graft failure (47.1%; 24/51), and secondary glaucoma (45.1%; 23/51). Five eyes developed infection in the therapeutic graft, four eyes had persistent corneal epithelial defect at their last follow-up visit, and two eyes underwent evisceration.

Conclusions:
Therapeutic penetrating keratoplasty achieves anatomic success and it is a useful procedure for restoring a stable cornea in cases in which infection fails to heal or when the cornea perforates. Furthermore, Th PK achieves corneal clarity and improves vision in most patients.
Relationship of Water Content With Silicon and Fluorine Contents of Silicone-Hydrogel Contact Lens Materials
Authors: Dupre Terin E. , Benjamin William J. 
Published: June 2018

Objectives:
The relationship between water (W) content and silicon (Si) content of silicone-hydrogel (SiHy) contact lens materials was inspected using identical methodologies, equipment, and operators for materials composing 16 types of commercially available SiHy contact lenses. Fluorine (F) content was included in the analysis for the three materials also containing a fluoropolymer. One type of lens consisted of a bulk SiHy material coated with thin layers of conventional hydrogel.

Methods:
SiHy materials were obtained in the form of 16 contact lens brands purchased on the open market in a common range of refractive powers from −3 to +6 D in single lots. All test lenses were equilibrated at room temperature in a standard saline recommended in the American National Standards Institute Z80.20-2016 and International Organization for Standardization (ISO) 18369-4:2017 standards. W content was obtained gravimetrically, in %, according to those standards for 16 lenses of each SiHy material. Si content was determined in % using inductively coupled plasma optical emission spectroscopy for four digested lenses of each material. F content was determined in % using an ion-selective electrode for four combusted lenses of each of the three fluorinated SiHy materials. W and Si contents of the bulk SiHy material of the coated lens were estimated by computational exclusion of the hydrogel layers.

Results:
The linear coefficients of determination (R2, n=16) were −0.7576 (relating mean dry Si content [n=4] to mean W content [n=16]) and −0.8819 (relating mean hydrated Si content [n=4] to mean W content [n=16]). When the 4 SiHy materials that were fluorinated or coated were excluded from the analysis, the R2 values (n=12) were −0.8869 and −0.9263, respectively. When F contents and the coating were added to the assessments, the linear coefficients of determination (R2, n=16) became −0.8948 (relating mean dry [Si+F] content to mean W content) and −0.9397 (relating mean hydrated [Si+F] content to mean W content).

Conclusions:
There is a fundamental negative linear relationship between Si and W contents for SiHy contact lens materials above 35% W content that is followed when F content and hydrogel coatings are empirically added to the analysis below 35% W content. The relationship was tightest for hydrated (Si+F) content and W content, for which the regression equation had an R2 of −0.9397: (Si+F)=−0.3073 (W)+22.148. The relationship between (Si+F) and W therefore seems to be based on composition rather than structure of available SiHy contact lens materials.
Investigation of the Effect of Orthokeratology Lenses on Quality of Life and Behaviors of Children
Authors: Zhao Feng , Zhao Guiyang , Zhao Zhihua 
Published: June 2018

Purpose:
To investigate the changes in the quality of life and behaviors in children before and after wearing orthokeratology lenses and to analyze the potential impact of orthokeratology lenses on children's quality of life, behaviors, and the progression of myopia.

Methods:
A total of 100 children receiving orthokeratology lenses in the People's Hospital of Hebei Province and the Nanjing First Hospital from January 2016 to February 2017 were enrolled in this study. A questionnaire survey was conducted for the orthokeratology lenses wearers before and 3 months after wearing the orthokeratology lenses, and analysis was performed for the 69 valid questionnaires.

Results:
The scores of symptom module, entertainment module, and study and life module marked by the children differed significantly 3 months after wearing the orthokeratology lenses. Among 20 entries, the life quality scores of nine surveys before and after wearing lenses were statistically significant (P<0.05). The main reason why the children chose orthokeratology lenses was more convenience in athletic activities (43.5%). The majority of children (75.4%) were willing to accept orthokeratology lenses to correct vision and to alleviate myopia progression.

Conclusion:
Orthokeratology lenses have a good effect on children's quality of life, behaviors, and psychology. The children who wore lenses were more self-confident, more willing to try new things, and more active in participating in sports and entertainment, resulting in an increasing trend of the total time spent on outdoor activities.
Pseudonormalization of the Typical Electrocardiography Repolarization Pattern of a Black Athlete
Authors: Dehghani Mohammadabadi Mina , Chan Winnie , Antiperovitch Pavel , Abdirahman Ifrah , Glover Benedict , Baranchuk Adrian 
Published: June 2018

Abstract:
Cardiac repolarization of black athletes has a distinctive pattern. During an episode of pericarditis, this pattern may evolve into a “pseudonormalized” electrocardiography (ECG). On resolution of the pericardial inflammation, the ECG may return to the normal variant for a black athlete, sounding the alarms of extended disease to the myocardium. Recognizing the normal variant for a black athlete will reduce the need for unnecessary further testing or treatments. The case is discussed in detail.
Serum sodium, model for end-stage liver disease, and a recent invasive procedure are risk factors for severe acute-on-chronic liver failure and death in cirrhotic patients hospitalized with bacterial infection
Authors: Lopes-Secundo Tirzah M. , Sevá-Pereira Tiago , Correa Bárbara R. , Silva Natalie C.M. , Imbrizi Marcello R. , Cunha-Silva Marlone , Soares Elza C. , Almeida Jazon R.S. 
Published: June 2018

Introduction
Bacterial infection is present in up to 30% of hospitalized cirrhotic patients. It can lead, even after its resolution, to organ dysfunction and even acute-on-chronic liver failure (ACLF). It is the precipitating factor of ACLF in one third of the cases and is the main cause of mortality in patients with liver cirrhosis.

Objectives
The aim of this study was to evaluate the prevalence and identify early risk factors for severe ACLF and death in hospitalized patients with liver cirrhosis with bacterial infection.

Patients and methods
This was a prospective observational study. Hospitalized patients with liver cirrhosis and bacterial infection were included. Clinical and laboratory data and their evolution to organ dysfunction and death were assessed. A statistical analysis were carried out to identify predictors of severe ACLF and in-hospital mortality.

Results
This study included 88 patients. ACLF was observed in 62 (70%) patients, with 48 (55%) grade 2 or higher. Of the 27 deaths (31% of all patients), 26 had severe ACLF (54% mortality) (P<0.0001). The independent risk factors for ACLF of at least 2 and death were baseline serum sodium [odds ratio (OR): 0.874; P=0.01, and OR: 0.9, P=0.04], initial MELD (OR: 1.255, P=0.0001, and OR: 1.162, P=0.005), and a recent invasive procedure (OR: 3.169, P=0.01, and OR: 6.648, P=0.003).

Conclusion
Lower serum sodium values, higher MELD scores at diagnosis of infection, and a recent history of invasive procedures were independent risk factors for severe ACLF and death in patients with cirrhosis and bacterial infection.
A Case Report of Overlapping Miller Fisher Syndrome, Guillain-Barré Syndrome, and the Bickerstaff Brainstem Encephalitis
Authors: Chae Choong Sik , Kwon Kyoung Min , Lee Jung Soo , Kim Yeo Hyung 
Published: June 2018

Introduction:
Patients with overlapping Miller Fisher syndrome (MFS), Guillain-Barré syndrome (GBS), and the Bickerstaff brainstem encephalitis (BBE) have rarely been reported, and the diverse clinical features and sequelae are challenging for physicians. Through this case report, we present the clinical course, treatment, recovery, and sequelae of an overlapping MFS, GBS, and BBE syndrome and provide a review of the literature.

Case Report:
A 76-year-old woman was initially presented with diplopia, ophthalmoplegia, and ataxia, but she later developed weakness of limbs, respiratory failure, deterioration of consciousness, and cognitive impairment. After IV immunoglobulin and corticosteroid therapy, she began to recover consciousness and from the weakness from day 18. After 8 months of rehabilitative therapy, she was able to swallow food without difficulty, but she still cannot walk without assistance, showed cognitive impairment, and the tracheostomy remained in place because of persistent respiratory muscle weakness.

Conclusions:
As the clinical course of MFS-GBS-BBE overlapping syndrome is variable, involving not only the peripheral but also the central nervous system, the establishment of a comprehensive therapeutic strategy is warranted.
Inter-rater Agreement for the Diagnosis of Stroke Versus Stroke Mimic
Authors: Liberman Ava L. , Rostanski Sara K. , Ruff Ilana M. , Meyer Ashley N.D. , Maas Matthew B. , Prabhakaran Shyam 
Published: June 2018

Background and Purpose:
Patients who present emergently with acute neurological signs and symptoms represent unique diagnostic challenges for clinicians. We sought to characterize the reliability of physician diagnosis in differentiating aborted or imaging-negative acute ischemic stroke from stroke mimic.

Methods:
We constructed 10 case-vignettes of patients treated with thrombolysis with subsequent clinical improvement who lacked radiographic evidence of infarction. Using an online survey, we asked physicians to select a most likely final diagnosis after reading each case-vignette. Inter-rater agreement was evaluated using percent agreement and κ statistic for multiple raters with 95% confidence intervals reported.

Results:
Sixty-five physicians participated in the survey. Most participants were in practice for ≥5 years and over half were vascular neurologists. Physicians agreed on the most likely final diagnosis 71% of the time, κ of 0.21 (95% confidence interval, 0.06-0.54). Percent agreement was similar across participant practice locations, years of experience, subspecialty training, and personal experience with thrombolysis.

Conclusions:
We found modest agreement among surveyed physicians in distinguishing ischemic stroke syndromes from stroke mimics in patients without radiographic evidence of infarction and clinical improvement after thrombolysis. Methods to improve diagnostic consensus after thrombolysis are needed to assure acute ischemic stroke patients and stroke mimics are treated safely and accurately.
Prevalence and Correlates of Point-of-sex Human Immunodeficiency Virus Self-testing Among Human Immunodeficiency Virus-negative Men Who Have Sex With Men in China
Authors: Wei Chongyi , Yan Li , Lippman Sheri A. , Su Xiaoyou , Li Jianjun , Chen Liping , Raymond H. Fisher , Yan Hongjing 
Published: June 2018

Background
Human immunodeficiency virus (HIV) self-testing (HIVST) provides a promising tool to screen sex partners for men who have sex with men (MSM) who engage in condomless sex and want to avoid HIV infection. Although previous studies have demonstrated HIVST acceptability and increased testing uptake, limited data exist on its use between sex partners for point-of-sex HIV testing. This study examined prevalence and correlates of point-of-sex HIVST among Chinese MSM.

Methods
A cross-sectional survey was conducted among 400 HIV-negative Chinese MSM in 2017. Participants were recruited through a multifaceted sampling approach and self-administered an electronic questionnaire. Point-of-sex HIVST was measured by asking participants if they had ever conducted HIVST with a sex partner before sex to ensure that they both knew their HIV statuses. Multivariable logistic regression was used to identify correlates of point-of-sex HIVST after controlling for age, education and sexual orientation.

Results
Overall, 19.2% (77/400) men reported point-of-sex HIVST (51.3% among self-testers). Participants who had four or more HIV self-tests before had 7.57-fold greater odds (95% confidence interval, 3.75, 15.28) of reporting point-of-sex HIVST compared to those who had fewer HIVST experiences. Point-of-sex HIVST was otherwise not associated with most other socio-demographic or behavioral practices, suggesting that it may be broadly acceptable.

Conclusions
A substantial proportion of Chinese MSM had utilized HIVST with their partners before sex, especially among those who were more experienced with HIVST. Scale up and routine implementation of HIVST programs are further warranted to facilitate point-of-sex HIV testing.
The Nature and Severity of Adverse Events in Select Outpatient Surgical Procedures in the Veterans Health Administration
Authors: Mull Hillary J. , Itani Kamal M. F. , Charns Martin P. , Pizer Steven D. , Rivard Peter E. , Hawn Mary T. , Rosen Amy K. 
Published: June 2018

Background:
Research on adverse events (AEs) in outpatient surgery has been limited. As part of a Veterans Health Administration (VA) project on AE surveillance, we chart-reviewed selected outpatient surgical cases to characterize the nature and severity of AEs.

Methods:
We abstracted financial year 2012-2015 VA outpatient surgery cases selected with high (n = 1185) and low (n = 1072) likelihood of an AE based on postoperative health care utilization. The abstraction tool included established AE definitions and validated harm and severity scales.

Results:
We found AEs in 608 high-likelihood (51%) and 126 low-likelihood outpatient surgical procedures (12%). Among 1010 unique AEs, the most common were wound issues (n = 261, 26%), urinary retention (23%), and urinary tract infections (12%). While 63% of all AEs involved minimal harm, 28% required hospitalization, and 9% were severely harmful including 8 AEs requiring intervention to sustain life and 2 deaths. Overall, 102 AEs (10%) required, at minimum, a repeat surgery to treat.

Conclusions:
Among VA outpatient surgical procedures selected based on likelihood of an AE, nearly 40% of identified events carried more than minimal patient harm, undermining the claim that outpatient surgery is relatively safe. Prevalent and preventable AEs such as wound dehiscence and urinary retention may be useful targets for quality improvement.
Long-Term Results for a One-Stage Surgery Technique for Patients With Craniofacial Plexiform Neurofibroma
Authors: Chen Liangbo , Guo Chengrui , Song Xuefei , Yan Chenxi , Hu Xiaojie 
Published: June 2018

Background:
Neurofibromatosis (NF) is an autosomal dominant genetic disorder, and NF type 1 (NF1) is one of the most common forms. Plexiform neurofibroma (PNF) is one of the characteristic expressions of NF1. The proper treatment for patients with craniofacial PNF is surgery. The evaluation methods for the surgical outcome of these patients are still controversial. As a consequence, a one-stage surgical technique and an appropriate evaluation method for patients with craniofacial PNF were discussed in this article.

Methods:
This research is a retrospective study. Nine patients with craniofacial PNF were included in this study. They had undergone a one-stage surgical technique of tumor debulking and nasolabial fold reconstruction. Three methods had been applied to evaluate the surgical outcome.

Results:
Significant improvement was observed in 8 patients. Eight patients were assessed by the relatively objective evaluation method. Obvious symmetry improvement was calculated using Mimics software in 7 patients.

Conclusion:
The surgical technique could achieve good surgical outcomes in both functional and cosmetic terms. Additionally, the relatively objective evaluation technique based on Mimics software could be a more convincing method for evaluating the surgical outcomes of craniofacial patients with PNF.