bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pentacam Accuracy in Discriminating Keratoconus From Normal Corneas: A Diagnostic Evaluation Study
Authors: Hashemi Hassan , Khabazkhoob Mehdi , Pakzad Reza , Bakhshi Salomeh , Ostadimoghaddam Hadi , Asaharlous Amir , Yekta Reihaneh , Aghamirsalim Mohamadreza , Yekta Abbasali 
Published: July 2018

Objectives:
This study aims to determine the diagnostic ability of Pentacam indices for keratoconus and identifying the best index for differentiating diseased from normal cases.

Method:
In this study, 150 keratoconus patients and 150 refractive surgery candidates with a definitive diagnosis of normal healthy corneas were enrolled. Initially, the placido disk topography imaging was performed. The keratoconus and normal corneas were defined based on placido disk topographic data from Rabinowitz–McDonnell. After complete eye examinations for all participants, they underwent Pentacam imaging, and corneal surface topographic indices were extracted. Multiple logistic regression was used to determine the best indices for differentiating diseased from healthy corneas, and the receiver operating curve was calculated to determine the diagnostic capability of each index.

Results:
Among the studied indices, the keratoconus index (KI), index of vertical asymmetry (IVA), thinnest point (TP), and maximum keratometry (Kmax) were found capable of detecting keratoconus. Among these, IVA was the best index, with an area under curve (AUC) of 95.24%. The best cutoff point for IVA was 0.20 μm, and its sensitivity and specificity were 87.50% and 96.30%, respectively. Comparison of the AUC of different indices showed that only TP and IVA significantly differed (P=0.002). The combination of KI, IVA, Kmax, and TP indices leads to correct detection in 78% of cases.

Conclusion:
Measuring corneal topographic indices using Pentacam can be helpful in the diagnosis of keratoconus. According to the results of this study, IVA is the best diagnostic index for keratoconus. However, it is recommended to use a combination of Pentacam indices for more accurate differentiation of keratoconus from normal cases.
Anterior Corneal Curvature and Aberration Changes After Scleral Lens Wear in Keratoconus Patients With and Without Ring Segments
Authors: Serramito-Blanco Maria , Carpena-Torres Carlos , Carballo Jesús , Piñero David , Lipson Michael , Carracedo Gonzalo 
Published: July 2018

Objective:
To evaluate changes in the anterior corneal curvature and aberrometry after scleral contact lens wear in keratoconus (KC) subjects with and without intracorneal ring segments (ICRS).

Methods:
Twenty-six subjects diagnosed with keratoconus were selected to participate in the study. Subjects were divided into 2 groups, those with ICRS (KC-ICRS group) and those without ICRS (KC group). Subjects were instructed to wear 16.5-mm scleral lenses for 8 hours. Topographic and aberrometric parameters were evaluated before lens wear and immediately after lens removal. Anterior corneal curvature was evaluated at corneal diameters of 2, 4, 6, and 8 mm, and corneal aberrations were measured at 4-, 6-, and 8-mm pupil diameters.

Results:
The mean age of subjects was 36.95±8.95 years. In KC group, there was a statistically significant flattening of the central corneal curvature, from 6.98 to 7.09 mm (P<0.05). No changes were found in the central corneal curvature in the KC-ICRS group. The KC group showed anterior corneal curvature flattening, mainly in the nasal quadrant. The KC-ICRS group showed flattening primarily in the inferior hemisphere. In the KC group, spherical aberration for 6-mm pupil increased significantly. In the KC-ICRS group, changes in aberrations were significant for high-order root mean square at 4- and 6-mm pupil diameters (P<0.05), for oblique astigmatism for 4 mm and 6 mm, and for vertical coma for 4-mm pupil (P<0.05).

Conclusion:
Short-term scleral lens wear showed flattening of the anterior corneal surface in all subjects. In the KC group, the flattening was more pronounced in the nasal quadrant while changes were more pronounced inferiorly in KC-ICRS group.
Conjunctival Impression Cytology and Tear-Film Changes in Patients With Inflammatory Bowel Disease
Authors: Doğan Mustafa , Özcan Serkan , Acartürk Gürsel , Özdemir Çiğdem 
Published: July 2018

Purpose:
To evaluate the ocular surface changes and tear-film functions in patients with inflammatory bowel disease (IBD).

Methods:
The IBD group included 57 patients, and the control group included 29 healthy individuals. The Schirmer I test, tear breakup time (TBUT), corneal and conjunctiva fluorescent staining, and conjunctival impression cytology tests were performed to both groups.

Results:
The rate of dry eye was 56.1% and 10.3% in the IBD and control groups, respectively, as assessed by the Schirmer I test (P<0.001). The rate of dry eye was 52.6% and 20.8% in the IBD and control groups, respectively through TBUT (P=0.004). The Ocular Surface Disease Index scores of the IBD group (15.25±7.31) were significantly higher than the control group (11.75±7.33) (P=0.039). According to the Oxford scheme, mild-to-moderate staining was 54.4% in the IBD group and 6.9% in the control group (P<0.001). Nelson Staging System showed that 69% of the IBD group had stage 2 or 3 impression cytology, whereas none of the control group had stage 2 or 3 impression cytology (P<0.001). Using the Schirmer I test, the rate of dry eye was 55.8% of the patients with IBD receiving 5-aminosalicylic acid (5-ASA) and 61.5% of the patients with IBD receiving both 5-ASA and azathioprine (P=0.485).

Conclusions:
Our study results showed that dry eye was 3 times higher in the IBD group than the control group. But, the duration of disease seems not to have effect on dry eye.
“Eye Dropping”—A Case Report of Transconjunctival Lysergic Acid Diethylamide Drug Abuse
Authors: Lo Danielle , Cobbs Lucy , Chua Michael , Young Joshua , Haberman Ilyse D. , Modi Yasha 
Published: July 2018

Purpose:
To report a case of bilateral toxic corneal and conjunctival epitheliopathy secondary to administration of filter paper impregnated with lysergic acid diethylamide (LSD) in the inferior conjunctival fornices.

Methods:
This is a single case report of an 18-year-old man who presented to the emergency department with acute, bilateral eye pain and redness of 24 hours. The patient admitted to placing folded strips of blotting paper impregnated with LSD into the inferior fornices of his eyes the previous night.

Results:
The patient was found to have localized bilateral corneal and conjunctival abrasions with underlying subconjunctival hemorrhage. Conjunctival abrasion was “kissing,” involving the bulbar and palpebral conjunctiva, corresponding to the presumed location of the filter paper. There was no corneal stromal opacification. He was lost to follow up within 1 week of initial presentation but stated that his symptoms improved.

Conclusions:
To the best of our knowledge, this is the first reported case of bilateral hemorrhagic conjunctival abrasion and corneal abrasion secondary to LSD. “Kissing” conjunctival lesions, which have been previously reported with heroin use, should raise suspicion for drug abuse.
Ethnoracial Disparities in Medicare Annual Wellness Visit Utilization
Authors: Lind Kimberly E. , Hildreth Kerry , Lindrooth Richard , Crane Lori A. , Morrato Elaine , Perraillon Marcelo Coca 
Published: July 2018

Introduction:
In 2011, Medicare began offering annual preventive care visits (annual wellness visit; AWV) to beneficiaries at no charge. Providing free preventive care supports primary and secondary prevention of chronic disease and may reduce ethnoracial disparities in health outcomes.

Objectives:
To estimate AWV utilization trends by ethnoracial group in a nationally representative sample of the Medicare population.

Research Design:
We estimated the probability of AWV utilization using probit regression models with beneficiary-reported ethnoracial group as the primary predictor and demographics, socioeconomic indicators, and factors related to access and utilization of health care as covariates.

Subjects:
In total, 14,687 fee-for-service Medicare beneficiaries aged 66 years or older who participated in the Medicare Current Beneficiary Survey 2011–2013.

Measures:
AWV utilization was identified using procedure codes.

Results:
Overall AWV utilization increased from 8.1% (2011) to 13.4% (2013). In 2011, utilization was highest in non-Hispanic white (8.5%) and lowest in non-Hispanic black (4.5%) beneficiaries. Utilization increased the most in non-Hispanic black beneficiaries, to 15.4% in 2013. Significant differences in AWV utilization by non-Hispanic black and Hispanic/Latino beneficiaries were found in unadjusted models, but did not persist after controlling for income and education. Having a usual (nonemergent) place of care and a nonrural residence were strong predictors of utilization.

Conclusions:
Utilization of the AWV has increased modestly since its introduction, but remains low. Utilization varies by ethnoracial group, with disparities largely explained by differences in income and education. Further efforts are needed to evaluate AWV utilization and effectiveness, especially among low socioeconomic status ethnoracial minorities.
Using the Relational Coordination Instrument With a Diverse Patient Sample
Authors: Wells Rebecca , Armstrong Trey W. , Brossart Daniel F. 
Published: July 2018

Background:The Relational Coordination (RC) instrument has been used extensively in the context of health care interprofessional coordination. However, the instrument’s applicability to patient experiences of their interactions with professionals is largely untested.Objectives:This study’s objectives were to determine: (1) whether the RC instrument could be modified for phone administration to yield internally consistent results when used with a diverse group of patients with complex health needs; and (2) whether the RC factor was invariant across patients of differing education, levels of emotional problems, race, and ethnicity, thereby showing similar interpretation of items across these groups.Research Design:The RC instrument was administered through a phone survey to patients in Texas (n=346) who reported receiving care coordination. Data collection occurred between 2014 and 2016. Cronbach α coefficients and confirmatory factor analysis were used to determine whether the original set of RC items could be used for phone surveys with patients. Factorial invariance testing was used to assess how consistently the instrument was interpreted across patient subgroups.Results:The RC scale generally met acceptable α statistic and confirmatory factor analysis thresholds for internal consistency. Factorial invariance results indicated that the scale also generally performed consistently across patient subgroups.Conclusions:This study provides preliminary evidence that the RC instrument can be used for surveying diverse patient populations. Future use of this instrument with patients can better reflect their experiences as partners with professionals in improving their health.
Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?
Authors: Park Jeongyoung , Wu Xiaoli , Frogner Bianca K. , Pittman Patricia 
Published: July 2018

Background:
Few studies have looked under the hood of practice redesign to understand whether and, if so, how staffing changed with the adoption of patient-centered medical home (PCMH), and whether these staffing changes impacted utilization.

Objectives:
To examine the workforce transformation occurring in community health centers that have achieved PCMH status, and to assess the relationship of those changes to utilization, as measured by the number of visits.

Research Design, Subjects, Measures:
Using a difference-in-differences approach, we compared staffing and utilization outcomes in 450 community health centers that had adopted a PCMH model between 2007 and 2013 to a matched sample of 243 nonadopters located in the 50 states and the District of Columbia.

Results:
We found that adopting a PCMH model was significantly associated with a growth in use of advanced practice staff (nurse practitioners and physician assistants) [0.53 full-time equivalent (FTE), 8.77%; P<0.001], other medical staff (medical assistants, nurse aides, and quality assurance staff) (1.23 FTE, 7.46%; P=0.001), mental health/substance abuse staff (0.73 FTE, 17.63%; P=0.005), and enabling service staff (case managers and health educators) (0.36 FTE, 6.14%; P=0.079), but not primary care physicians or nurses. We did not observe a significant increase in utilization, as measured in total number of visits per year. However, the visits marginally attributed to advanced practice staff (539 FTE, 0.89%; P=0.037) and mental health/substance abuse staff (353 FTE, 0.59%; P=0.051) significantly increased.

Conclusions:
Our findings suggest that the implementation of PCMH actively reengineers staff composition and this, in turn, results in changes in marginal utilization by each staff type.
Emerging applications of aptamers for anticoagulation and hemostasis
Authors: Chabata Charlene V. , Frederiksen James W. , Sullenger Bruce A. , Gunaratne Ruwan 
Published: July 2018

Purpose of review
Since the selection of the first thrombin-binding aptamer in 1992, the use of nucleic acid aptamers to target specific coagulation factors has emerged as a valuable approach for generating novel anticoagulant and procoagulant therapeutics. Herein, we highlight the most recent discoveries involving application of aptamers for those purposes.

Recent findings
Learning from the successes and pitfalls of the FIXa-targeting aptamer pegnivacogin in preclinical and clinical studies, the latest efforts to develop antidote-controllable anticoagulation strategies for cardiopulmonary bypass that avoid unfractionated heparin involve potentiation of the exosite-binding factor X (FX)a aptamer 11F7t by combination with either a small molecule FXa catalytic site inhibitor or a thrombin aptamer. Recent work has also focused on identifying aptamer inhibitors of contact pathway factors such as FXIa and kallikrein, which may prove to be well tolerated and effective antithrombotic agents in certain clinical settings. Finally, new approaches to develop procoagulant aptamers to control bleeding associated with hemophilia and other coagulopathies involve targeting activated protein C and tissue plasminogen activator.

Summary
Overall, these recent findings exemplify the versatility of aptamers to modulate a variety of procoagulant and anticoagulant factors, along with their capacity to be used complementarily with other aptamers or drugs for wide-ranging applications.
FDG PET/CT of Metabolic Myopathy With Posttreatment Follow-up
Authors: McNamee Anitia , Robertson Thomas , Sounness Brett , O’Gorman Patricia 
Published: July 2018

Abstract
A 38-year-old woman presented with extreme fatigue and multiple lung nodules. She was referred for a PET/CT, which demonstrated multiple FDG-avid pulmonary nodules and lymph nodes with intense uptake within multiple muscle groups predominantly involving the paraspinal muscles and muscles of mastication. Histopathology of a paraspinal muscle biopsy revealed increased skeletal muscle lipid stores and increased mitochondria with normal morphology. This abnormality is seen in metabolic myopathy due to a disorder of fatty acid oxidation. Transbronchial biopsy showed no evidence of sarcoidosis. The patient was commenced on carnitine and riboflavin supplementation, and a follow-up PET/CT was performed.
The Role of SPECT/CT of Foot and Ankle in the Evaluation of Heel Pain
Authors: Lee Minkyung , Kim Bom Soo , Kim Yeoju , Hyun In Young 
Published: July 2018

Abstract
Heel pain is a common symptom in foot and ankle disorders. Typical heel pain can be assessed according to the patient’s history and the location of pain. In some atypical inconclusive cases, bone SPECT/CT is the upcoming imaging modality for the detection of causes of heel pain. We present the case of 57-year-old man with atypical heel pain, plantar and Achilles spurs. SPECT/CT images demonstrated increased bony activity in arthritis of midfoot, not plantar and Achilles spurs. It suggests potential role of SPECT/CT in the evaluation and management of heel pain by showing hidden pathology of foot and ankle.
Intense FDG Uptake in the Muscles Due to Severe Vomiting
Authors: Liu Jie , Wang Wei , Yuan Leilei , Kan Ying , Yang Jigang 
Published: July 2018

Abstract
A 22-year-old woman with acute lymphoblastic leukemia underwent FDG PET/CT to evaluate possible extramedullary disease. The patient experienced severe nausea and vomiting due to ongoing chemotherapy. The image demonstrated increased FDG uptake in multiple muscle groups, including intercostal, bilateral external oblique, internal oblique, transverse abdominal muscles, and psoas major. One week after the patient stopped vomiting, a repeated PET/CT showed much less muscle uptake.
18F-FDOPA PET/CT of Nonfunctioning Paraganglioma of the Gastroepiploic Pedicle
Authors: Leroy Freschini Benjamin , Addeo Pietro , Averous Gerlinde , Goichot Bernard , Bachellier Philippe , Imperiale Alessio 
Published: July 2018

Abstract
We report the case of a 54-year-old woman with a nonfunctioning paraganglioma arising from the gastroepiploic pedicle demonstrated by 18F-FDOPA PET/CT. Because gastroepiploic arcade can be assimilated to the gastric mesentery, this tumor has been classified as a mesenteric paraganglioma (PGL). Neural crest cells are a multipotent population of cells characterized by effective migratory properties potentially explaining PGL atypical localization as in the mesentery. Mesenteric PGLs are often nonfunctioning and can mimic gastric, colic, or pancreatic primary tumor because of their anatomical boundaries, making more difficult the diagnosis on preoperative imaging.
Examining Factors Related to Health-Related Quality of Life in People With Parkinson’s Disease
Authors: Kwok JoJo Yan Yan , Auyeung Man , Chan Helen Yue Lai 
Published: July 2018

Abstract

Purpose
Parkinson’s disease (PD) results in a range of dysfunctions and disabilities as it progresses to later stages. All these not only affect a patient’s physical well-being but also emotional, social, and spiritual well-being. To tailor interventions that can address these concerns, this study aimed to examine the impacts of PD on their health-related quality of life (HRQOL).

Design
A cross-sectional study with 123 PD patients.

Methods
Measures included the following: Hospital Anxiety and Depression Scale, Unified PD Rating Scale–Motor Examination, Hoehn and Yahr Stage, PD Questionnaire-8. Associating factors of HRQOL was examined using stepwise linear regression.

Findings
Psychological distress and functional impairment are significantly associated with the HRQOL of the PD population. Psychological distress is associated most to the variance of HRQOL (42.4%).

Conclusion
Considering that PD is chronic, rehabilitation programs should be applied to address not just functional but also psychosocial needs of PD patients.

Clinical Relevance
Early recognition and management of psychological distress in PD patients is indispensable to promote their HRQOL.
The RESTORE Randomized Controlled Trial
Authors: O’Neill Linda M. , Guinan Emer , Doyle Suzanne L. , Bennett Annemarie E. , Murphy Conor , Elliott Jessie A. , O'Sullivan Jacintha , Reynolds John V. , Hussey Juliette 
Published: July 2018

Objective:
The Rehabilitation Strategies in Esophagogastric cancer (RESTORE) randomized controlled trial evaluated the efficacy of a 12-week multidisciplinary program to increase the cardiorespiratory fitness and health-related quality of life (HRQOL) of esophagogastric cancer survivors.

Background:
Patients following treatment for esophagogastric cancer are at risk of physical deconditioning, nutritional compromise, and sarcopenia. Accordingly, compelling rationale exists to target these impairments in recovery.

Methods:
Disease-free patients treated for esophagogastric cancer were randomized to either usual care or the 12-week RESTORE program (exercise training, dietary counseling, and multidisciplinary education). The primary outcome was cardiopulmonary exercise testing (VO2peak). Secondary outcomes included body composition (bioimpedance analysis), and HRQOL (EORTC-QLQ-C30). Outcomes were assessed at baseline (T0), postintervention (T1), and at 3-month follow-up (T2).

Results:
Twenty-two participants were randomized to the control group [mean (standard deviation) age 64.14 (10.46) yr, body mass index 25.67 (4.83) kg/m2, time postsurgery 33.68 (19.56) mo], and 21 to the intervention group [age 67.19(7.49) yr, body mass index 25.69(4.02) kg/m2, time postsurgery 23.52(15.23) mo]. Mean adherence to prescribed exercise sessions were 94(12)% (supervised) and 78(27)% (unsupervised). Correcting for baseline VO2peak, the intervention arm had significantly higher VO2peak at both T1, 22.20 (4.35) versus 21.41 (4.49) mL · min−1 · kg−1, P < 0.001, and T2, 21.75 (4.27) versus 20.74 (4.65) mL · min−1 · kg−1, P = 0.001, compared with the control group. Correcting for baseline values, no changes in body composition or HRQOL were observed.

Conclusions:
The RESTORE program significantly improved cardiorespiratory fitness of disease-free patients after esophagogastric cancer surgery, without compromise to body composition. This randomized controlled trial provides proof of principle for rehabilitation programs in esophagogastric cancer.

Clinical Trial Registration Number:
NCT03314311.
No Clinical Benefit of Intramuscular Delivery of Bone Marrow-derived Mononuclear Cells in Nonreconstructable Peripheral Arterial Disease
Authors: Lindeman Jan H. N. , Zwaginga Jaap Jan , Kallenberg-Lantrua Graziella , van Wissen Rob C. , Schepers Abbey , van Bockel Hajo J. , Fibbe Willem E. , Hamming Jaap F. 
Published: July 2018

Background and Aims:
Prospects for no-option, end-stage peripheral artery disease (PAD) patients remain poor. Although results from open and semiblinded studies fuel hope for cell-based strategies in no-option patients, so far conclusions from the available placebo-controlled studies are not supportive. With the intention to end the remaining controversy with regard to cell therapy for PAD we conducted a confirmatory, double-blinded randomized placebo-controlled phase 3 trial.

Study Design:
This randomized controlled trial was registered (NCT00539266). Inclusion criteria included stable or progressive disabling PAD, no imminent need for amputation, absent accepted options for revascularization. Diabetic disease was an exclusion criterion. Bone marrow (500–700 mL) was harvested and bone marrow-derived mononuclear cells were concentrated to 40 mL. Concentrated cells or placebo (diluted blood) were intramuscularly injected at 40 locations of the calf muscle.

Results:
Fifty-four patients (mean (sd) age 58.2 (14.2) yrs, 58% males) were randomized. Twenty-eight patients received BM-MNCs, 26 placebo. Baseline criteria were similar in the 2 groups. No significant differences were observed for the primary (number of amputations, (pain free) walking distance) and secondary outcome parameters (ankle brachial index, pain scores, quality of life (SF-36)).

Discussion:
This fully blinded replication trial of autologous BM-MNC fails to confirm a benefit for cell therapy in no-option PAD patients, consequently BM-MNC therapy should not be offered as a clinical treatment. Apparent contrasting conclusions from open and controlled studies underscore the importance of a controlled trial design in evaluating cell-based interventions in PAD.