bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Ocular Surface in Different Contact Lens Replacement Schedules
Authors: Muhafiz Ersin , Bayhan Hasan Ali , Şahin Sevinç , Göçmen Ayşe Yeşim , Aslan Bayhan Seray , Gürdal Canan 
Published: January 2019

Purpose:
To evaluate the effects of different contact lens (CL) replacement schedules and different CL materials on the ocular surface and tear function.

Methods:
Daily disposable hydrogel CLs were given to group 1 (n = 22), daily disposable silicone hydrogel CLs were given to group 2 (n = 25), and reusable silicone hydrogel CLs were given to group 3 (n = 24). Tear function tests and inflammatory cytokine [interleukin (IL)-6, IL-8, IL-17A, and matrix metalloproteinase (MMP)-9] levels were evaluated before and at 1 and 3 months after CL usage. Impression cytology was evaluated before and at 3 months after CL usage.

Results:
At the first and third months of CL usage, a statistically significant difference was determined between the groups in the levels of IL-6, IL-8, and IL-17A in tears, with the lowest levels in group 1 and the highest levels in group 3 (all P < 0.05). At the third month of CL usage, the levels of these cytokines (in picograms/milliliter) were 6.06 ± 0.83, 78.18 ± 12.42, 61.69 ± 13.95, and 37.71 ± 5.95 in group 1 and 8.04 ± 0.89, 107.34 ± 14.40, 68.63 ± 13.72, and 46.26 ± 6.50 in group 3, respectively. A statistically significant decrease was determined over time in the Schirmer test in group 1, in only the tear breakup time in group 2, and in the tear breakup time and Schirmer test in group 3 (all P < 0.05). A statistically significant increase was determined over time in the levels of IL-6, IL-8, IL-17A, and MMP-9 in all groups. In the third month, a significant progression was observed in the Nelson grade (P < 0.05) in all groups.

Conclusions:
The wear of daily disposable CLs can be considered to cause less damage to the ocular surface and less increase in proinflammatory cytokine levels.
Measurement of Corneal Biomechanical Properties in Diabetes Mellitus Using the Ocular Response Analyzer and the Corvis ST
Authors: Ramm Lisa , Herber Robert , Spoerl Eberhard , Pillunat Lutz E. , Terai Naim 
Published: January 2019

Purpose:
Hyperglycemia in diabetes mellitus (DM) might induce changes in corneal biomechanics. Therefore, biomechanical properties of the cornea were measured using the ocular response analyzer and the Corvis ST.

Methods:
In the study, 35 eyes of 35 diabetic patients were included. After an ophthalmological examination, measurements with the ocular response analyzer and the Corvis ST were taken. Additionally, biometry and corneal topography were performed and HbA1c values were collected. Results were compared to an age-, pachymetry- and intraocular pressure-matched group of 35 healthy subjects.

Results:
Mean age (67.6 ± 10.3; 64.1 ± 8.3 years), intraocular pressure (13.4 ± 2.9; 12.8 ± 2.8 mm Hg), and central corneal thickness (556.4 ± 31.7; 548.6 ± 32.9 μm) were not significantly different between the groups (P > 0.05). In DM, the corneal hysteresis (CH) and the corneal resistance factor (CRF) were increased (CH: 10.8 ± 2 vs. 9.4 ± 1.6, P = 0.002; CRF: 10.6 ± 2.1 vs. 9.6 ± 1.5, P = 0.022). Also, most dynamic corneal response parameters showed significant differences. Beside others, A1 and A2 deflection amplitudes were increased (P < 0.001) and highest concavity and A2 time were extended (P < 0.001 and 0.007) in DM. According to current HbA1c value, DM was classified as controlled (≤7%) and poorly controlled (>7%) and significant biomechanical differences were measured between both groups.

Conclusions:
In DM, significant changes in corneal biomechanical properties were detectable. In patients, CH and CRF were increased and most dynamic corneal response parameters were different compared to healthy subjects.
Lucia and Beyond: Development of an Affordable Keratoprosthesis
Authors: Bakshi Shaunak K. , Paschalis Eleftherios I. , Graney John , Chodosh James 
Published: January 2019

Purpose:
Severe corneal disease contributes significantly to the global burden of blindness. Corneal allograft surgery remains the most commonly used treatment, but does not succeed long term in every patient, and the odds of success fall with each repeated graft. The Boston keratoprosthesis type I has emerged as an alternative to repeat corneal allograft. However, cost limits its use in resource-poor settings, where most corneal blind individuals reside.

Methods:
All aspects of the Boston keratoprosthesis design process were examined to determine areas of potential modification and simplification, with dual goals to reduce cost and improve the cosmetic appearance of the device in situ.

Results:
Minor modifications in component design simplified keratoprosthesis manufacturing. Proportional machinist time could be further reduced by adopting a single axial length for aphakic eyes, and a single back plate diameter. The cosmetic appearance was improved by changing the shape of the back plate holes from round to radial, with a petaloid appearance, and by anodization of back plate titanium to impute a more natural color.

Conclusions:
We have developed a modified Boston keratoprosthesis type I, which we call the “Lucia.” The Lucia retains the 2 piece design and ease of assembly of the predicate device, but would allow for manufacturing at a reduced cost. Its appearance should prove more acceptable to implanted patients. Successful keratoprosthesis outcomes require daily medications for the life of the patient and rigorous, frequent, postoperative care. Effective implementation of the device in resource-poor settings will require further innovations in eye care delivery.
Deep Trephination Allows High Rates of Successful Pneumatic Dissection for DALK Independent of Surgical Experience
Authors: Myerscough James , Bovone Cristina , Scorcia Vincenzo , Ricci-Filipovic Benedetta , Leon Pia , Mimouni Michael , Nahum Yoav , Busin Massimo 
Published: January 2019

Purpose:
To evaluate the relationship between surgical experience and the success rate of pneumatic dissection for deep anterior lamellar keratoplasty (DALK) using deep trephination.

Methods:
A noncomparative case series evaluating the first 10 consecutive keratoconic eyes without deep stromal scarring, operated by 8 surgeons of 3 different experience levels, was conducted; there were a total of 80 patients. Standardized DALK was performed, including deep trephination 450 to 550 μm in depth and 9 mm in diameter, pneumatic dissection, removal of the stroma, and transplantation of a 9-mm partial-thickness anterior lamellar graft. The success rate of pneumatic dissection correlated with surgical experience.

Results:
Pneumatic dissection succeeded in 7, 7, 8, and 9 cases of 10 cases in the first group of 4 inexperienced surgeons (under 10 previous keratoplasties of any kind); in 9 and 10 of 10 cases in the second group of 2 relatively experienced surgeons (under 100 keratoplasties); and in 10 and 8 of 10 cases in the third group of 2 very experienced surgeons (more than 1000 previous keratoplasties). No difference between the groups was found to be statistically significant with the χ2 test (P > 0.05).

Conclusions:
The standardized DALK technique using a deep trephination allows high success rates of pneumatic dissection even for surgeons inexperienced in keratoplasty.
Screening Glaucoma With Red-free Fundus Photography Using Deep Learning Classifier and Polar Transformation
Authors: Lee Jinho , Kim Youngwoo , Kim Jong Hyo , Park Ki Ho 
Published: January 2019

Précis:
The novel proposed algorithm using deep learning classifier and polar transformation technique can be an economical as well as an effective tool for early detection of glaucomatous RNFL defect.

Purpose:
The main purpose of this study was to develop novel software to determine whether there is a retinal nerve fiber layer (RNFL) defect in a given fundus image using deep learning classifier and, if there is, where it presents.

Materials and Methods:
In the deep learning classifier, the bottleneck features were extracted, followed by application of the softmax classifier, which outputted the glaucoma probability. For localization of RNFL defect, an image processing algorithm was implemented as follows: (1) the given image was normalized to enhance the contrast; (2) the region of interest (ROI) was set as the circumferential area surrounding the optic disc (internal diameter: 2 disc diameters, external diameter: 3 disc diameter), and converted to a polar image; (3) blood vessels were removed and the average curvatures were calculated. If the local maximum curvature was greater than the cut-off value, the sector was considered to be an RNFL defect.
The images of 100 normal healthy controls and 100 open-angle glaucoma patients were enrolled. Maximum curvatures and area under receiver operating characteristic curve were compared to determine the diagnostic validity.

Results:
There were no significant differences in age or sex (P=0.275, P=0.479, respectively) between the 2 groups. In the glaucoma group, the mean deviation was −4.9±5.4 dB. There was a significant difference of maximum curvature (14.37±5.13 in control group, 20.67±10.56 in glaucoma group, P<0.001). Area under receiver operating characteristic curve was 0.939 in deep learning classifier and 0.711 in maximum curvature.

Conclusions:
The proposed software can be an effective tool for automated detection of RNFL defect.
Meta-analysis of the psychometric properties of the Pain Catastrophizing Scale and associations with participant characteristics
Authors: Wheeler Claire H.B. , Williams Amanda C de C. , Morley Stephen J. 
Published: January 2019

Abstract
The aims of this study were to review the psychometric properties of the widely used Pain Catastrophizing Scale (PCS) using meta-analytic methods and to investigate the relationship between PCS scores and participant characteristics. A systematic search from 1995 found 229 experimental, quasi-experimental, and correlational studies that report PCS scores. Multivariate regression explored variables related to pain catastrophizing and participant demographics. Across studies, good internal reliability (α = 0.92, 95% confidence interval 0.91-0.93) and test–retest reliability scores (Spearman ρ = 0.88, 95% confidence interval 0.83-0.93) were found for PCS total scores but not for subscales. Pain Catastrophizing Scale scores were unrelated to age or sex, but strongly related to participants' pain type, highest in those with generalized pain. Language of the PCS also affected PCS scores, with further research necessary to determine linguistic, cultural, or methodological (eg, sampling strategy) influences. Study type influenced PCS scores with nonrandomized controlled trials reporting higher PCS scores than other study types, but results were confounded with pain diagnosis, as controlled trials were more likely than quasi-experimental studies to recruit clinical samples. The meta-analytic results provide insights into demographic influences on pain catastrophizing scores and highlight areas for further research. The advantages of systematic review and meta-analytic methods to achieve greater understanding and precision of psychometric properties—in this case, of the PCS—are applicable to other widely used outcome tools.
Peripheral oxytocin restores light touch and nociceptor sensory afferents towards normal after nerve injury
Authors: Boada M. Danilo , Gutierrez Silvia , Eisenach James C. 
Published: January 2019

Abstract
Oxytocin reduces primary sensory afferent excitability and produces analgesia in part through a peripheral mechanism, yet its actions on physiologically characterized, mechanically sensitive afferents in normal and neuropathic conditions are unknown. We recorded intracellularly from L4 dorsal root ganglion neurons characterized as low-threshold mechanoreceptors (LTMRs) or high-threshold mechanoreceptors (HTMRs) in female rats 1 week after L5 partial spinal nerve injury or sham control (n = 24 rats/group) before, during, and after ganglionic perfusion with oxytocin, 1 nM. Nerve injury desensitized and hyperpolarized LTMRs (membrane potential [Em] was −63 ± 1.8 mV in sham vs −76 ± 1.4 mV in nerve injury; P < 0.001), and sensitized HTMRs without affecting Em. In nerve-injured rats, oxytocin depolarized LTMRs towards normal (Em = −69 ± 1.9 mV) and, in 6 of 21 neurons, resulted in spontaneous action potentials. By contrast, oxytocin hyperpolarized HTMRs (Em = −68 ± 2.7 mV before vs −80 ± 3.2 mV during oxytocin exposure; P < 0.01). These effects were reversed after removal of oxytocin, and oxytocin had minimal effects in neurons from sham surgery animals. Sensory afferent neurons immunopositive for the vasopressin 1a receptor were larger (34 ± 6.3 μm, range 16-57 μm) than immunonegative neurons (26 ± 3.4 μm, range 15-43 μm; P < 0.005). These data replicate findings that neuropathic injury desensitizes LTMRs while sensitizing HTMRs and show rapid and divergent oxytocin effects on these afferent subtypes towards normal, potentially rebalancing input to the central nervous system. Vasopressin 1a receptors are present on medium to large diameter afferent neurons and could represent oxytocin's target.
Three things every nurse practitioner can do to integrate genetics into practice
Authors: Reed E. Kate , Ingram Therese , Edelman Emily A. 
Published: January 2019

ABSTRACT
Genetic and genomic information has the potential to improve patient care and outcomes by improving clinicians' ability to identify patients at increased risk of disease and, in some cases, personalize treatment and management. However, many clinicians report that they feel unprepared and lack confidence in talking about genomics with their patients. By focusing on family history information and knowing when and how to refer to genetic experts, clinicians can take meaningful steps to improve integration of genetics into patient care.
Observed Colposcopy Practice in US Community-Based Clinics: The Retrospective Control Arm of the IMPROVE-COLPO Study
Authors: Huh Warner K. , Papagiannakis Emmanouil , Gold Michael A. 
Published: January 2019

Objective
The aim of the study was to characterize colposcopy practice and management of women with cervical abnormalities in US community-based clinics.

Materials and Methods
IMPROVE-COLPO was a 2-arm study of colposcopy patients with an abnormal screening result. The prospective arm recruited women to undergo examination with a commercial digital colposcope. The retrospective-control arm collected data (chart review) from previous colposcopies performed using standard equipment and methods. From the retrospective arm, we analyzed referral trends, colposcopy and biopsy practice, and management patterns.

Results
We collected data of 3,602 eligible women (median age = 34 years) that had been examined from 2012 to 2017 by 154 colposcopists at 44 clinics across 12 states. Most patients were premenopausal (87.9%), privately insured (88.2%), and had a low-grade (low-grade squamous intraepithelial lesion/atypical squamous cells of undetermined significance/human papillomavirus positive) indication (87.2%). Most colposcopists performed less than 3 colposcopies monthly and their biopsy rate was 1.47 biopsies/patient for high-grade referrals and 0.97 for low-grade referrals (p < .001). Random biopsy was rare (0.4% of biopsies). Most women (74.9%) underwent endocervical sampling, including 62.5% of women aged 21 to 24 years. Colposcopic impression was frequently not reported (58.8%), and its sensitivity to predict histology-confirmed cervical intraepithelial neoplasia (CIN) 2+ as “high-grade” was 56.5% for high-grade referrals and 23.2% for low-grade referrals. Excisions often (44.5%) returned <CIN 2, including patients aged 21–40 years (37.4%).

Conclusions
In this analysis, most colposcopists performed few colposcopies and took less than 2 biopsies per patient. Colposcopic impression had a poor sensitivity to predict histology-confirmed CIN 2+. Although recent research indicates that taking multiple biopsies improves sensitivity and detection of CIN 2+, this is not being practiced in the US.
Increased Risk of Benign Paroxysmal Positional Vertigo in Patients With a History of Sudden Sensory Neural Hearing Loss: A Longitudinal Follow-up Study Using a National Sample Cohort
Authors: Lee Sang-Yeon , Kong Il Gyu , Oh Dong Jun , Choi Hyo Geun 
Published: January 2019

Objective:
To evaluate the association between benign paroxysmal positional vertigo (BPPV) and sudden sensorineural hearing loss (SSNHL) using a national sample cohort from Korea.

Methods:
Data from the years 2002 through 2013 were collected for individuals aged more than or equal to 20 years from the Korean National Health Insurance Service-National Sample Cohort. SSNHL was classified based on the International Classification of Disease-10 (ICD-10) code H91.2. We included only participants who received an audiometry examination and steroid treatment. After exclusion of participants diagnosed with Menière's disease (H81.0), we extracted data for SSNHL patients (n = 4,109) and 1:4-matched controls (n = 16,436). Matching was performed based on age, sex, income, region of residence, and medical history. BPPV was diagnosed with the ICD-10 code H81.1. Among them, we only included the participants who visit more than or equal to two times for BPPV that does not mean recurrent BPPV. The crude and adjusted hazard ratios (HRs) were calculated using Cox proportional hazard models, and the 95% confidence intervals (CIs) were determined. Subgroup analyses were also performed according to age and sex.

Results:
The rate of BPPV in the SSNHL group (3.8% [157/4,109]) was higher than that in the control group (1.9% [220/16,436], p < 0.001). The adjusted HR of BPPV was 2.90 (95% CI = 2.36–3.56, p < 0.05). After experiencing SSNHL, the rate of BPPV in the SSNHL group was significantly higher for patients with two, three to four, and more than or equal to five visits for BPPV. In the subgroup analyses, a significant association between SSNHL and BPPV was observed regardless of age and sex.

Conclusion:
The risk of BPPV is greater in patients with SSNHL.
Long-term Vertigo Control and Vestibular Function After Low-dose On-demand Transtympanic Gentamicin for Refractory Menière's Disease
Authors: Nicolas Sarah , Kmeid Michel , Mansour Charles , Fraysse Bernard , Deguine Olivier , Marx Mathieu , Fraysse Marie-José Esteve 
Published: January 2019

Objective:
To describe the long-term clinical vertigo control along with measured lateral canal vestibular function in patients with unilateral refractory Menière's disease (MD) treated with gentamicin transtympanic injections (TTI).

Study Design:
Retrospective analytic study.

Setting:
Tertiary referral center.

Patients:
Thirty-eight patients treated by TTI for medically refractory unilateral MD, defined by the 1995 AAO-HNS criteria, between May 2006 and December 2012.

Intervention(s):
One-year course of treatment with gentamicin TTI following a low dose on-demand protocol. TTI were repeated in new courses of treatment when MD recurrence occurred.

Main Outcome Measure(s):
AAO-HNS class of control, caloric tests (CalT), recurrence rate.

Results:
After an average clinical follow-up of 71 months, all patients entered a class of control A (78%) or B (22%), with an average of 2.3 TTI received. The mean maximal obtained deficit was 88.5%, and the mean long-term deficit was 85.5%. Ten (26%) patients had disease recurrence requiring a new course of treatment. A value of the first CalT in the 3 months following the first TTI strictly higher than 78% was significantly associated with disease control and the absence of symptom recurrence (p≤0.01). In the “recurrence” group, four patients had a significantly lower mean value of all CalT performed after the first TTI when compared with other patients (p≤0.001), indicating gentamicin resistance

Conclusion:
Achieving a sustainable vestibular deficit on caloric testing is key for MD symptom control after gentamicin TTI. Gentamicin resistance must be diagnosed early to adapt therapeutic strategies.
Efficacy and Safety of Endoscopic Ultrasound-guided Choledochoduodenostomy
Authors: Mohan Babu P. , Shakhatreh Mohammed , Garg Rajat , Ponnada Suresh , Navaneethan Udayakumar , Adler Douglas G. 
Published: January 2019

Introduction:
Endoscopic retrograde cholangiopancreatography is the preferred method in biliary drainage. Endoscopic ultrasound (EUS) guidance has shown tremendous success in situations where endoscopic retrograde cholangiopancreatography fails or is contraindicated. EUS-guided choledochoduodenostomy (CDD) in particular is gathering a lot of interest due to its ease, and high rates of success. The reported adverse events with this procedure have been inconsistent among studies.

Methods:
We conducted a search of multiple electronic databases and conference proceedings from inception through June 2018. The primary outcome was to estimate the risk of adverse events, and the commonly reported subtype of adverse events in EUS-CDD. The secondary outcome was to estimate the pooled technical and clinical success rates.

Results:
Thirteen studies including 572 patients underwent biliary drainage with EUS-CDD. The pooled rate of all adverse events was 0.136 (95% confidence interval, 0.097-0.188; P=0.01) with moderate heterogeneity (I
2=56.9), and pooled rate of cholangitis was 4.2%, bleeding was 4.1%, bile leak was 3.7%, and perforation was 2.9%. On subgroup analysis, the pooled rate of adverse events with the use of lumen-apposing metal stent was 9.3% (95% confidence interval, 4.8-17.3).

Conclusions:
On the basis of our analysis EUS-CDD has an adverse event risk of 13.4%, which is lowest reported in literature so far. Reported adverse rates appeared to be lower with the use of lumen-apposing metal stent, except for perforation.