bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHANGES IN VISUAL ACUITY AND PHOTORECEPTOR DENSITY USING ADAPTIVE OPTICS AFTER RETINAL DETACHMENT REPAIR
Authors: Potic Jelena , Bergin Ciara , Giacuzzo Clarice , Daruich Alejandra , Pournaras Jean-Antoine , Kowalczuk Laura , Behar-Cohen Francine , Konstantinidis Lazaros , Wolfensberger Thomas J. 
Published: November 2018

Purpose:
To quantify changes in photoreceptor density using adaptive optics fundus camera in patients after retinal detachment (RD) and to correlate them with macular involvement and best-corrected visual acuity.

Methods:
At 1 and 3 months (M1 and M3) after vitrectomy, 194 patients underwent adaptive optics imagery in both eyes, at 5 locations, that we matched between time points using anatomical landmarks. Twenty-two patients (10 fovea-OFF [OFF] and 12 fovea-ON [ON]) had matched and analyzable adaptive optics images. We used analysis of variance for repeated measures.

Results:
Best-corrected visual acuity (logarithm of the minimum angle of resolution and Snellen equivalent [SE]) was significantly different between OFF and ON RDs at baseline: 2.0 (2.3–0.95) (SE: 20/2000) versus 0 (0.1–0) (SE: 20/20); at M1: 0.35 (0.5–0.1) (SE: 20/40) versus 0.05 (0–0.1) (SE: 20/25); and at M3: 0.25 (0.3–0.1) (SE: 20/32) versus 0 (0–0) (SE: 20/20). We observed that cone density was stable in fellow eyes between M1 and M3 (P = 0.67); decreased in treated eyes than in fellow eyes (P < 0.05); and increased postoperatively in the ON group (P = 0.02) but not in the OFF group (P = 0.97). Visual acuity and RD type were independently correlated with cone density (P = 0.004, P = 0.000).

Conclusion:
Postoperative cone density was reduced in OFF RD, but also in the ON group, although the drop recovered during the 3-month follow-up. Cone density was significantly correlated with both visual acuity and type of RD at both time points.
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FEATURES OF SUBRETINAL FIBROSIS AFTER MYOPIC NEOVASCULARIZATION
Authors: Milani Paolo , Pellegrini Marco , Massacesi Amedeo , Scotti Fabrizio , Moschini Stefania , Setaccioli Marco , Secondi Roberta , Bergamini Fulvio 
Published: November 2018

Purpose:
To describe the optical coherence tomography (OCT) angiography features of subretinal fibrosis in eyes with myopic choroidal neovascularization after natural evolution or secondary to intravitreal anti–vascular endothelial growth factor therapy.

Methods:
Retrospective observational case series. All eyes underwent a multimodal imaging examination including fluorescein angiography, spectral domain OCT, OCT angiography, and en face OCT.

Results:
Twenty-five eyes of 25 patients with mean age of 56.4 ± 14.9 were included in the study. Subretinal fibrosis was diagnosed at mean 30 (range 6–116) months before inclusion. Within the subretinal fibrosis, an abnormal vascular network was observed in 20/25 (80%) eyes, located typically in the outer retina (18/20, 90%) or the choriocapillaris (14/20, 70%) segmentation. The most prevalent patterns were “round tangle” and “tapered tangle.” On en face OCT, the subretinal fibrosis was evidenced in 24/25 (96%) eyes, most prevalently in the outer retina (21/25, 84%) and in the choriocapillaris (18/25, 72%), where main feature was white-hyperreflective (20/21, 95%) and dark-hyporeflective (17/18, 94%) appearance, respectively. The presence of subretinal fibrosis on en face OCT was positively correlated with the presence of abnormal vascular network on OCT angiography in 61% of the cases (P = 0.005).

Conclusion:
Subretinal fibrosis secondary to myopic choroidal neovascularization frequently contains blood flow within a persistent abnormal vascular network as assessed by OCT angiography.
Vection Responses in Patients With Early Glaucoma
Authors: Brin Taylor A. , Tarita-Nistor Luminita , González Esther G. , Trope Graham E. , Steinbach Martin J. 
Published: November 2018

Purpose:
Our lab has previously shown that patients with early glaucoma have longer vection latencies than controls. We attempted to explain this finding using a combined index of structure and function (CSFI), as proposed by Medeiros and colleagues. The CSFI estimates the proportion of retinal ganglion cell loss.

Methods:
Roll and circular vection were evoked using a back-projected screen (experiment 1) and the Oculus Rift system (experiment 2). Vection latency and duration were measured using a button response box. In experiment 1, tilt angles were measured with a tilt sensor, whereas subjective tilt was determined using a joystick attached to a protractor. In experiment 2, subjective vection strength was rated on a 1 to 10 scale. These measurements were compared with the CSFI, which utilizes visual field and optical coherence tomography data.

Results:
For experiment 1 we tested 22 patients (mean age, 70.3±6 y) with glaucoma and 18 controls (mean age, 54.6±9 y); and for experiment 2 we tested 24 patients (mean age, 71.1 ±5 y) and 23 controls (mean age 61.4±10 y), but not all patients experienced vection. In both experiments, vection latency was significantly longer for patients than for controls (smallest P=0.02). The CSFI was not related to vection latency, duration, or objective and subjective measures of vection strength (smallest P=0.06) in either experiment.

Conclusions:
Two experiments have replicated the finding that vection responses are longer in patients with glaucoma than in controls; however, the CSFI is not related to vection responses.
Sonographic Assessment of Optic Disc Cupping and its Diagnostic Performance in Glaucoma
Authors: Chaurasia Shweta , Garg Rajiv , Beri Sarita , Pakhare Abhijit 
Published: November 2018

Purpose:
The purpose of this study was to assess the optic cup diameter sonographically in glaucoma patients and in the normal population and correlate it with their photographic parameters to propose a cut-off value as a predictive index of glaucoma.

Methods:
A total of 95/50 primary open-angle glaucoma and 87/44 control patients with clear media underwent visual field assessment, fundus photography, and B-scan ultrasound. Photographic vertical cup diameter (PVCD) of cases and controls were recorded after magnification correction using the Bengtsson formula. Sonographic vertical cup diameter (SVCD) was measured in the vertical transverse position.

Results:
The mean SVCD was 1.13±0.23 mm in glaucoma and 0.72±0.25 mm in controls (P=0.001). The mean PVCD was 1.024±0.199 mm in glaucoma and 0.636±0.217 mm in controls (P=0.001). A strong correlation between PVCD and SVCD in both groups was found (correlation coefficient r=0.857; P=0.001; glaucoma and r=0.795; P=0.001; control). SVCD had a positive correlation with vertical cup disc ratio (r=0.675; P=0.001 in glaucoma patients) and (r=0.797; P=0.001 in controls) cup area (r=0.798; P=0.001; glaucoma) and (r=0.727, P=0.001; control) a negative correlation with vertical neuroretinal rim diameter (r=−0.5187; P=0.000; glaucoma patients) and (r=−0.699; P=0.001; controls). No correlation of SVCD was found with severity of field grade changes. The receiving operative curve analysis was performed, and Youden’s optimal cut-off method was used to find a cut-off value for SVCD, which came out to be 1.06, with 65.3% (95% confidence interval, 54.8-74.7) sensitivity and 94.3% (95% confidence interval, 87.1-97.1) specificity.

Conclusions:
The sonographic evaluation of the optic cup is a reliable noninvasive procedure and a potentially useful tool in the assessment of nonviewable suspected glaucomatous cups.
Veterans Health Administration's Physician Assistant Primary Care Residency: An Evaluation of the First 3 Years
Authors: Latini David M. , Cole D. Shawn , Woodmansee Denni , Bailey R. Keith , Berner Krista , Breitinger Petar , Carrejo Maurita , Domagalski Jason , McAdow Lurie , Palmer Shelia , VanRuiswyk Jerry , Hettler Debbie , Jones Kenneth R. , Sanders Karen 
Published: November 2018

Purpose
Results from an evaluation of a 12-month postgraduate Veterans Health Administration (VHA) residency in primary care for physician assistants (PAs).

Methods
Descriptive and open-ended data were collected to describe the experience of faculty and trainees participating in the first 3 years of this pilot residency. Quantitative data were summarized using descriptive statistics. Text data were transcribed and reviewed for common themes across residency sites and respondents. Data were collected at 2 time points—the end of the first year and the beginning of year 4.

Results
In the first 3 years of the program, 18 residents were enrolled at 6 sites, with 89% completing the residency. At the second time point, 8 more residents were enrolled. Residents were primarily female (69%). Of the residents completing the program, 56% obtained VHA employment, and 75% of the current residents planned to work for the VHA upon completing the program. Program infrastructure, such as written curriculum, a dedicated administrative staff, and written evaluations for trainees, was more common at the second time point. Recurring themes included the importance of establishing relationships with potential applicants, preceptors, medical center leadership, and trainees to support the program and the importance of securing resources such as space and protected time for faculty.

Conclusions
Although postgraduate residency programs are less common for PAs than for some other health professions, our data suggest that a one-year residency can provide training for new graduates to help solidify their clinical experience and facilitate their transition to practice.
Transtibial Socket Design, Interface, and Suspension: A Clinical Practice Guideline
Authors: Stevens Phillip M. , DePalma Russell R. , Wurdeman Shane R. 
Published: November 2018

ABSTRACT

Materials
N/A

Methods
The guideline is based upon the best available evidence as it relates to socket design, interface, and suspension of definitive transtibial prostheses. Where possible, recommendations are drawn from systematic review and meta-analysis. Where this standard is unavailable, alternate academic literature has been used to support individual recommendations.

Results
Recommendation 1: The static and dynamic pressure distribution of the residual limb within the socket are essential considerations in patient comfort, function and well-being.
Recommendation 2: Total surface bearing sockets are indicated to decrease fitting times and enable higher activity levels.
Recommendation 3: Compared to traditional foam-based interfaces, viscoelastic interface liners are indicated to decrease dependence on walking aides, improve suspension, improve load distribution, decrease pain and increase comfort.
Recommendation 4: Among modern suspension options, vacuum assisted suspension (VAS) sockets permits the least amount of pistoning within the socket, followed by suction suspension and then pin-lock suspension. The traditional suspension options of supracondylar, cuff and sleeve suspension provide comparatively compromised suspension.
Recommendation 5: VAS sockets are indicated to decrease daily limb volume changes of the limb in the socket while facilitating more favorable pressure distribution during gait.
Recommendation 6: VAS sockets require both awareness and compliance on the part of the end user and are not universally indicated.

Conclusions
These clinical practice guidelines summarize the available evidence related to the socket design, interface, and suspension of definitive transitibial prostheses. The noted clinical practice guidelines are meant to serve on as “guides.” They may not apply to all patients and clinical situations.
An exploration of the deleterious effects of hyperoxemia on the morbidity and mortality of hospitalized adult patients
Authors: Cimino Kelly M. 
Published: November 2018

ABSTRACT

Background and purpose:
To explore the deleterious effects of hyperoxia due to liberal oxygen use and clarify the significance of overuse and effects on morbidity and mortality in adult hospitalized patients. This literature review is also intended to bring awareness to nurse practitioners regarding the iatrogenic harm caused by excessive oxygenation and promote individualized patient care.

Methods:
A review of existing literature was conducted using PubMed and CINAHL databases. The keywords “hyperoxia”, “hyperoxemia”, “oxygen toxicity,” and “excessive oxygenation” were used to yield articles for consideration.

Results:
Of the six studies compared for this review, five identified positive correlations between hyperoxia and adverse outcomes. The sixth study found no significant differences in morbidity or mortality with the use of liberal oxygenation versus a more conventional approach.

Conclusions:
Overwhelming evidence suggests that states of hyperoxemia lead to increased mortality and morbidity. However, there is considerable variability on the threshold at which hyperoxia occurs. Further research is required to define levels of hyperoxia to better protect patients from iatrogenic harm.

Implications for practice:
Nurse practitioners in all specialties can increase awareness of the dangers of excessive oxygenation and effect a change in practice through education.
Relationship Between Tinnitus Loudness Measure by Visual Analogue Scale and Psychoacoustic Matching of Tinnitus Loudness
Authors: Raj-Koziak Danuta , Gos Elżbieta , Świerniak Weronika , Karpiesz Lucyna , Niedziałek Iwona , Włodarczyk Elżbieta , Skarżyński Henryk , Skarżyński Piotr H. 
Published: November 2018

Objective:
The aim of the study was to assess the relationship between psychoacoustic matches of tinnitus loudness and tinnitus loudness measured with a visual analogue scale (VAS) in patients with normal hearing and patients with hearing loss.

Study Design:
Cross-sectional study.

Patients:
A clinical group of 140 adult patients (46.4% women, 53.6% men) aged from 19 to 81 years old who had had tinnitus for at least 6 months were included in the study. The most frequent reported localization of their tinnitus sensation was bilateral (48.6%); 40% experienced unilateral tinnitus; and 11.4% heard tinnitus in the head.

Methods:
All participants were first asked to complete a VAS to indicate their tinnitus loudness. Hearing thresholds were then determined for each patient at frequencies from 0.125 to 8 kHz; loudness and frequency of the tinnitus were also matched psychoacoustically.

Results:
Tinnitus loudness measured in dB SL was significantly lower in patients with bilateral hearing loss than in patients with unilateral hearing loss or in patients with normal hearing. Tinnitus loudness measured with VAS was significantly higher in patients with bilateral hearing loss than in patients with normal hearing. In patients with normal hearing there was a relationship between psychoacoustic matches of tinnitus loudness and tinnitus loudness measured with VAS, but this relationship did not hold for the hearing loss patients.

Conclusions:
The VAS scale for tinnitus loudness does not generally correspond to psychoacoustic measures of tinnitus loudness. It is only indicative for tinnitus patients who have normal hearing.
Lymphocyte hydrogen sulfide production predicts intravenous immunoglobulin resistance in children with Kawasaki disease
Authors: Lin Jing , Zhao Huacai , Jiao Fuyong , Ma Lei , Ma Le 
Published: November 2018

Abstract
The aim of the study was to identify whether lymphocyte hydrogen sulfide production is a potential biomarker to predict intravenous immunoglobulin (IVIG) resistance in children with Kawasaki disease (KD).
This preliminary, single-center, case–control study conducted between June 2016 and March 2018 in Shaanxi Provincial People's Hospital, 85 children (50 with KD and 35 healthy controls) were included. Laboratory biomarkers were collected from the medical records. All patients with KD received 1 g/kg/d IVIG for 2 days and 30–50 mg/kg/d oral aspirin. The aspirin dose was reduced from 3 to 5 mg/kg/d after body temperature normalized. Plasma hydrogen sulfide levels were detected using sulfide electrode. Lymphocyte hydrogen sulfide levels were detected using the human hydrogen sulfide ELISA kits at the acute stage.
Of 50 patients with KD, 31 and 19 were diagnosed with complete KD (cKD) and incomplete KD (iKD), respectively. Eleven patients with KD were resistant to IVIG treatment. The laboratory biomarker findings and levels of plasma and lymphocyte hydrogen sulfide were significantly different between the patients with KD and control group (P < .001). Moreover, lymphocyte hydrogen sulfide production was significantly greater in IVIG-resistant patients than in the IVIG-responsive patients, both in cKD and iKD (P = .018 and P < .001 respectively). Receiver operating characteristic curve indicated that when the lymphocyte hydrogen sulfide production was >15.285 nmol/min/108 lymphocytes, the sensitivity and specificity for predicting IVIG resistance were 90.9% and 76.9%, respectively.
Lymphocyte hydrogen sulfide production could serve as a predictor of the therapeutic efficacy of IVIG in children with KD.
Comorbidities, risk, and socioeconomic factors of uninsured cancer survivors
Authors: Mirza Abu-Sayeef , Pabbathi Smitha , Lu Yuanyuan , Ayoubi Noura , Ewing Aldenise , Jaglal Michael , Roetzheim Richard 
Published: November 2018

Abstract
Cancer patients can be well-connected to resources during treatment but become lost to follow-up and subsequently may receive treatment in free clinics for chronic morbidities. Few studies have examined outcomes for uninsured patients with cancer histories in free clinics, but research examining socioeconomic determinants emphasizes poor cancer outcomes for patients with lower socioeconomic statuses (SES).
Demographic data and chronic disease measures were extracted from medical charts of patients treated in 8 free clinics in 2016 in Tampa Bay. Descriptive statistics and Pearson correlation coefficients were used to demonstrate relationships between socioeconomic factors, cancer diagnoses, and comorbidities. Charlson Comorbidity Index (CCI) was used to assess mortality risk and severity of disease burden.
The histories of 4804 uninsured patients were evaluated, identifying 86 (1.7%) as having had cancer. They were predominantly female (65.1%) and significantly older than those without cancer histories. Average duration from initial diagnosis was approximately 8.53 years (standard deviation [SD] 7.55). Overall, cancer patients had higher CCI scores (3.04 [1.928 SD] versus 0.90 [1.209 SD]; P <.001); thus reflecting more weighted comorbidities than patients without cancer (P <.001). Other factors of chronic disease including obesity and substance abuse correlated with cancer history.
Among uninsured patients, those with cancer histories had greater mortality risk by CCI than those without. Chronic conditions such as diabetes, cerebrovascular disease, and chronic pulmonary disease existed in patients with cancer histories, affecting their mortality risk. Uninsured patients with a history of cancer are in greater need for chronic disease management and prevention.
Interleukin-6 for early diagnosis of neonatal sepsis with premature rupture of the membranes
Authors: Qiu Xia , Zhang Li , Tong Yu , Qu Yi , Wang Huiqing , Mu Dezhi 
Published: November 2018

Abstract

Background:
Premature rupture of the membranes (PROM) is the principal risk factor for neonatal sepsis. Interleukin-6 (IL-6) has been investigated for early diagnosis of neonatal sepsis, but not for diagnosis of neonatal sepsis with PROM. The objective of this study is to investigate the early diagnostic value of IL-6 for neonatal sepsis with PROM.

Methods:
The literature was searched using PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wan Fang, VIP, and CBM databases until March 2018. Each study was evaluated using Quality Assessment of Diagnostic Accuracy Studies tool-2. We used a bivariate diagnostic random-effects model.

Results:
The overall pooled sensitivity, specificity, positive likelihood rate, negative likelihood rate, diagnostic odds ratio, and area under the summary receiver operating characteristic curve were 0.85 (95% confidence interval [CI]: 0.81–0.91), 0.88 (95% CI: 0.86–0.91), 9.94 (95% CI: 4.27–23.15), 0.14 (95% CI: 0.06–0.32), 79.26 (95% CI: 23.42–268.26), and 0.9473, respectively, which showed high accuracy in diagnosing neonatal sepsis with PROM. The types of sepsis might be connected with the source of heterogeneity (P = .0351).

Conclusion:
IL-6 is therefore a sensitive and specific diagnostic marker for the early diagnosis of neonatal sepsis with PROM.
Efficacy and safety of alfacalcidol in Chinese postmenopausal women aged over 65 with osteoporosis or osteopenia
Authors: Li Nan , Jiang Yan , He Shuli , Zhao Zhen , Sun Jing , Li Mei , Wang Ou , Xing Xiaoping , Xia Weibo 
Published: November 2018

Abstract
This study aimed to explore the therapeutic efficacy and safety of alfacalcidol among Chinese postmenopausal women (age >65 years) with osteoporosis or osteopenia.
A total of 62 postmenopausal women with osteoporosis or osteopenia (>65 years) were recruited from urban residential community of Beijing. The patients daily took oral calcium and alfacalcidol (Alpha D3, 1 μg) for 9 months. Safety and efficacy assessments were performed at baseline and regular intervals. Alfacalcidol was adjusted to a daily dose of 0.5 μg in case of hypercalcemia or hypercalciuria.
A significant improvement in “timed up and go test” and “chair rising test” was achieved 3 months after treatment. Significant decreases in bone turnover markers were observed 3 months after the treatment and lasted throughout the study. Nineteen patients discontinued due to adverse events (17 hypercalciuria, 1 hydronephrosis, and 1 stomach ache), while alfacalcidol was adjusted to a daily dose of 0.5 μg in 18 patients (29.0%). Increased serum creatinine was observed when compared to baseline (P <.001), but all the values were in normal range.
The treatment with 1 μg alfacalcidol can significantly improve muscle function and bone metabolism. Regular monitoring of urine calcium and timely dosage-adjustments are very important to guarantee the safety of alfacalcidol treatment in Chinese menopausal women.
Three mutations of adult type 1 Gaucher disease found in a Chinese patient
Authors: Du Xiaoli , Ding Qian , Chen Qi , Guo Pengxiang , Wang Qing 
Published: November 2018

Abstract

Rationale:
Gaucher disease (GD), characterized by glucosylceramide accumulation in the macrophage-monocyte system, is caused by glucosidase b acid (GBA) gene mutations which lead to the deficiency of lysosomal enzyme glucocerebrosidase. The mutation spectrum of GBA in Chinese patients is quite different from those seen in Jewish and non-Jewish Caucasian patients. Thus, it is relatively hard to diagnose GD in Chinese.

Patient concerns:
A 24-year-old Chinese female with intermittent abdominal distension and progressive decrease in strength but without neurologic symptoms was initially referred for femoral head necrosis on the right feet. Laboratory examinations results indicated panhematopenia. Bone marrow aspiration smear and biopsy specimen found typical “wrinkled” Gaucher cells. Molecular-genetic testing of GBA gene revealed 3 mutations including R159W (c. 475 C > T), V1230G (c. 689T > G), and G241A (c. 721G > A).

Diagnoses:
On the basis of these findings and clinical manifestations, the final diagnosis of type 1 GD was made.

Interventions:
Enzyme replacement therapy (ERT) with velaglucerase α was carried out after the diagnosis of type 1 GD.

Outcomes:
The platelet and hemoglobin levels were restored by ERT.

Lessons:
To our knowledge, this is the first report of GD patient carrying 3 mutations in Chinese. These mutations in GBA in the present case imply a potential pool of patients with GD with this mutation in Chinese.