bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimized Protocol for Testing Multipurpose Contact Lens Solution Efficacy Against Acanthamoeba
Authors: Fedorko Daniel P. , Brocious Jeffrey M. , Adams Katherine D. , Hitchins Victoria M. , Hampton Denise L. , Eydelman Malvina B. 
Published: January 2018

Objectives:
To evaluate the interlaboratory and intralaboratory reproducibility of a proposed protocol for multipurpose contact lens solution (MPS) disinfection efficacy against Acanthamoeba.

Methods:

Acanthamoeba castellanii and Acanthamoeba polyphaga and four MPS with different biocidal agents were used to evaluate the protocol in two different laboratories. In addition to the negative control, a positive control and neutralization control were used. One experiment was performed in triplicate, and all other experiments were performed in duplicate in each laboratory. Acanthamoeba trophozoites were grown axenically, and cysts were generated using the starvation method. Trophozoites and cysts at a concentration of 2.0 × 103 to 2.0 × 104 organisms per milliliter were exposed to the test MPS for 0, 4 or 6 (manufacturer's recommended soak time [MRST]), 8, and 24 hr. Survivors were determined by a limiting dilution method that used a most probable number evaluation.

Results:
The positive and negative controls displayed consistent results and trends both within each laboratory and between each laboratory for trophozoites and cysts of both A. castellanii and A. polyphaga. The neutralization control consistently demonstrated the ability of the neutralizing agents to neutralize the MPS and the positive control and demonstrated no inhibition of Acanthamoeba by the negative control. Testing in triplicate and duplicate demonstrated the reproducibility of the protocol both within each laboratory and between the laboratories. Our results demonstrated that the MPS at the MRST and at 8 hr (likely overnight soak time) are generally more effective against trophozoites than they are against cysts. Only the MPS with hydrogen peroxide as the biocidal agent was able to provide a greater than three-log kill of cysts at the MRST and longer. Among the MPS we tested, trophozoites of A. castellanii and A. polyphaga showed similar responses. Some variability was observed when testing cysts of both species. In both laboratories, one nonhydrogen peroxide containing MPS had some effect (>1 log kill) on A. polyphaga cysts. This solution had no effect (<1 log kill) on A. castellanii cysts, A. castellanii trophozoites, and A. polyphaga trophozoites.

Conclusions:
The protocol that we have revised and evaluated is a well-controlled and reproducible procedure that can effectively evaluate the efficacy of MPS against Acanthamoeba trophozoites. Some variability was observed when testing the cyst stage.
Bibliometric Study of Scientific Research on Scleral Lenses
Authors: Povedano-Montero Francisco Javier , Álvarez-Peregrina Cristina , Hidalgo Santa Cruz Fernando , Villa-Collar César , Sánchez Valverde José 
Published: January 2018

Purpose:
To analyze the state of scientific publications in the field of scleral lenses applying a bibliometric study.

Methods:
The database used in this bibliometric study was SCOPUS, the largest abstract and citation database of peer-reviewed literature: scientific journals, books, and conference proceedings. Using remote download techniques, articles published between 1962 (year of first registrations) and 2015 were selected by entering the main descriptors: “scleral contact lenses” and “scleral lenses,” limiting the field for the article, keywords, and abstract, linked with the OR tab. We applied the following bibliometric indicators: Price index, doubling time and annual growth rate, Price transience index, Lotka law of scientific productivity, and Bradford zones.

Results:
The authors recovered 361 contributions (articles, reviews, letters to the editor, etc.) for 1962 to 2016. The distribution for five-year periods shows a significant increase in 2012 to 2016, with a growth of 222.22% in comparison with the previous period 2012 to 2016. The countries with the highest production are the United states with 135 contributions, United Kingdom with 46, and India with 19. The most productive institutions are Harvard Medical school, Boston Foundation for Sight, and Moorfields Eye Hospital National Health Service Foundation Trust. Classification of authors based on productivity is strongly concentrated in small producers, with a transient index of 59.03. The total number of authors is 891, representing a coauthor index of 2.47 for the 361 documents retrieved. The authors with the highest productivity are Kenneth W. Pullum, Perry Rosenthal, and Deborah S. Jacobs, with an h-index between 12 and 19 documents. The number of documents published on scleral lenses shows a significant increase in the last 5 years, and currently, they represent only 1.44% of all publications on contact lenses.

Conclusions:
Bibliometric studies have become essential tools for evaluating scientific activity, allowing an overview of the growth, size, and distribution of scientific literature associated with a particular discipline.
Effect of the Rigid Gas-Permeable Contact Lens Use on the Endothelial Cells in Patients With Keratoconus
Authors: Dogan Cezmi , Hagverdiyeva Samira , Mergen Burak , İskeleli Guzin 
Published: January 2018

Objectives:
To compare the changes in the corneal endothelial cells of both the patients with keratoconus who use rigid gas-permeable (RGP) contact lens and who do not use any contact lens with healthy population.

Methods:
Thirty-three patients with keratoconus who use RGP contact lenses (group 1), 20 patients with keratoconus who do not use any contact lens (group 2), and 40 healthy controls were included in the study. Changes in the corneal endothelial cells of all patients were evaluated using a noncontact specular microscope. Endothelial cell density (ECD), coefficient of variability (CV), hexagonal cell percentage (%HEX), and central corneal thickness (CCT) of the patients were evaluated in the study.

Results:
In the groups 1, 2, and 3, the mean ECD was 2,420.8±247, 2,579.5±240, and 2,589.5±271 cells/mm2, the mean CV was 357±9, 34±7, and 34±6, the mean %HEX was 54.3±13, 59.1±14, and 57.4±10, and the mean CCT was 508±33, 504±43, and 561±34 μm, respectively. There was no significant difference between the groups in terms of ECD, CV, and %HEX. Although significant differences between the groups 1 to 3 and groups 2 to 3 in terms of CCT were detected (P=0.001 and P=0.004, respectively), no significant difference was observed between the groups 1 and 2.

Conclusions:
Although significant difference was found between the groups 1 to 2 and normal population in terms of CCT, no difference was detected between all the groups in terms of the other parameters. In this study, we report that long-term use of RGP contact lens in patients with keratoconus had no effect on the corneal endothelial cells.
Athletic Remodeling in Female College Athletes: The “Morganroth Hypothesis” Revisited
Authors: Kooreman Zoe , Giraldeau Geneviève , Finocchiaro Gherardo , Kobayashi Yukari , Wheeler Matthew , Perez Marco , Moneghetti Kegan , Oxborough David , George Keith P. , Myers Jonathan , Ashley Euan , Haddad François 
Published: January 2018

Background:
There is limited data regarding ventricular remodeling in college female athletes, especially when appropriate scaling of cardiac dimensions to lean body mass (LBM) is considered. Moreover, it is not well established whether cardiac remodeling in female athletes is a balanced process with proportional increase in left ventricular (LV) mass and volume or the right and LV size.

Methods:
During the preparticipation competitive screening, 72 female college athletes volunteered to undergo dual energy x-ray absorptiometry scan for quantification of LBM and comprehensive 2D echocardiography including assessment of longitudinal myocardial strain. The athletes were divided in 2 groups according to the intensity of the dynamic and static components of their sport categories, ie, a higher intensity dynamic and resistive group (n = 37 participating in rowing, water polo and lacrosse) and a lower intensity group (n = 35, participating in short distance running, sailing, synchronized swimming, and softball). In addition, we recruited a group of 31 age-matched nonathlete controls.

Results:
The mean age of the study population was 18.7 ± 1.0 years. When scaled to body surface area, the higher intensity group had 17.1 ± 3.6% (P < 0.001) greater LV mass when compared with the lower intensity group and 21.7 ± 4.0% (P < 0.001) greater LV mass than the control group. The differences persisted after scaling to LBM with 14.2 ± 3.2% (P < 0.001) greater LV mass in the higher intensity group. By contrast, there was no difference in any of the relative remodeling indices including the LV mass to volume ratio, right to LV area ratio, or left atrial to LV volume ratio (P > 0.50 for all). In addition, no significant difference was noted among the 3 groups in LV ejection fraction (P = 0.22), LV global longitudinal strain (P = 0.55), LV systolic strain rate (P = 0.62), or right ventricular global longitudinal strain (P = 0.61).

Conclusion:
Female collegiate athletes participating in higher intensity dynamic and resistive sports have higher indexed LV mass even when scaled to LBM. The remodeling process does however appear to be a balanced process not only at the intraventricular level but also at the interventricular and atrioventricular levels.
Hepatic actions of androgens in the regulation of metabolism
Authors: Birzniece Vita 
Published: January 2018

Purpose of reviewThe purpose of this review is to summarize recent findings on hepatic actions of androgens in the regulation of protein, lipid and glucose metabolism. The rationale for liver-targeted testosterone use will be provided.Recent findingsLiver-targeted testosterone administration, via the oral route, induces protein anabolic effect by reducing the rate of protein oxidation to a similar extent to that of systemic testosterone administration. Recent evidence indicates that testosterone exerts whole-body anabolic effect through inhibition of nitrogen loss via the hepatic urea cycle. Several hepatic effects of androgens, particularly on glucose metabolism, are direct and take place before any changes in body composition occur. This includes an increase in insulin secretion and sensitivity, and reduction in hepatic glucose output by testosterone. Furthermore, lack of testosterone in the liver exacerbates diet-induced impairment in glucose metabolism. In the liver, androgens induce the full spectrum of metabolic changes through interaction with growth hormone or aromatization to estradiol.SummaryLiver-targeted testosterone therapy may open up a new approach to achieve whole-body anabolism without systemic side-effects. Aromatizable androgens may be superior to nonaromatizable androgens in inducing a complex spectrum of direct, estrogen-mediated and other hormone-mediated effects of androgens.
Differences in Mental Health Service Use Among Unemployed Veterans of Different Eras
Authors: Levine Debra S. , Valenstein Marcia , Yosef Matheos , Mavandadi Shahrzad , Oslin David W. , Himle Joseph A. , Zivin Kara 
Published: January 2018

Abstract
Mental disorders have been linked to unemployment among veterans. Improving mental health conditions, such as depression, can improve veteran employment outcomes. This study compared mental health treatment among unemployed Operation Enduring Freedom (OEF; in Afghanistan) and Operation Iraqi Freedom (OIF; in Iraq) veterans and veterans from other service eras. The study included 3165 unemployed veterans from six Veterans Affairs medical centers with a positive screen that indicates a possible mental disorder. Chi-squared tests and logistic regression analyses assessed whether veteran era was associated with mental health treatment. Unemployed OEF/OIF veterans were less likely to receive psychotropic medication and four or more psychotherapy sessions compared to veterans from other eras. Multivariable analyses controlling for age found associations based on younger age rather than era. Younger unemployed veterans received fewer mental health services, which is concerning because reducing mental health symptoms may increase employment and employment may reduce symptoms, which are key factors in reintegration into civilian life.
Natural Medicines for Psychotic Disorders
Authors: Hoenders H.J. Rogier , Bartels-Velthuis Agna A. , Vollbehr Nina K. , Bruggeman Richard , Knegtering Henderikus , de Jong Joop T.V.M. 
Published: January 2018

Abstract
Patients with psychotic disorders regularly use natural medicines, although it is unclear whether these are effective and safe. The aim of this study was to provide an overview of evidence for improved outcomes by natural medicines. A systematic literature search was performed through Medline, PsycINFO, CINAHL, and Cochrane until May 2015. In 110 randomized controlled trials, evidence was found for glycine, sarcosine, N-acetylcysteine, some Chinese and ayurvedic herbs, ginkgo biloba, estradiol, and vitamin B6 to improve psychotic symptoms when added to antipsychotics. Ginkgo biloba and vitamin B6 seemed to reduce tardive dyskinesia and akathisia. Results on other compounds were negative or inconclusive. All natural agents, except reserpine, were well tolerated. Most study samples were small, study periods were generally short, and most results need replication. However, there is some evidence for beneficial effects of certain natural medicines.
External Levator Advancement versus Müller Muscle–Conjunctival Resection for Aponeurotic Blepharoptosis: A Randomized Clinical Trial
Authors: Saonanon Preamjit , Sithanon Supapan 
Published: January 2018

Background:
The purpose of this study was to compare the efficacy of external levator advancement and Müller muscle–conjunctival resection in aponeurotic blepharoptosis repair.

Methods:
Mild to moderate blepharoptosis patients with good levator function and a positive phenylephrine test were randomized to upper blepharoplasty with either external levator advancement or Müller muscle–conjunctival resection. The primary outcome was marginal reflex distance 1 at 1 month after surgery. Secondary outcomes were cosmetic outcome, complications, and operating room time.

Results:
Forty patients were enrolled, six men and 34 women, with an average age of 62.4 years. The mean preoperative marginal reflex distance 1 in the levator group (39 eyes/20 subjects) and the Müller group (38 eyes/20 subjects) was 1.2 ± 0.8 mm and 1.5 ± 0.7 mm, respectively. The mean postoperative marginal reflex distance 1 in the levator and Müller groups was 3.0 ± 1.0 mm and 3.2 ± 1.0 mm, respectively. The difference in the mean change was 0.008, and was not statistically different (95 percent CI, −0.59 to 0.61; p = 0.978). The mean cosmetic outcome was 2.69 ± 0.81 for the levator group and 3.07 ± 0.68 for the Müller group, with a mean difference of 0.373 (95 percent CI, 0.06 to 0.69; p = 0.020). The average operating room time was 75 ± 19.2 minutes for the levator group and 71 ± 23.6 minutes for the Müller group (p = 0.439). There were four eyes that underwent reoperation, three in the levator group (7.7 percent) and one in the Müller group (2.6 percent).

Conclusions:
External elevator advancement and Müller muscle–conjunctival resection are both effective in correction of mild to moderate blepharoptosis. However, Müller muscle–conjunctival resection yields a statistically significant better cosmetic outcome and causes less eyelid asymmetry.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
Plastic Surgeon–Led Ultrasound
Authors: Oni Georgette , Chow Whitney , Ramakrishnan Venkat , Griffiths Matthew 
Published: January 2018

Background:
Portable high-frequency ultrasound is a useful adjunct to a plastic surgeon's practice. With a short learning curve, this patient-friendly imaging modality has a variety of uses that aid patient management/treatment plans. The authors describe clinical cases and review the literature regarding ultrasound performed by the surgeon.

Methods:
The Sonosite S-Nerve machine with the L25X transducer was used (depth, 4.3 cm). Clinical cases that ordinarily would have been referred to the radiology department were taken from the day-to-day practice of the senior author (M.G.). The clinical scenarios ranged from acute presentations to planned elective settings.

Results:
Ultrasound was a useful adjunct in a variety of applications, ranging from acute hand trauma visualizing neurovascular bundles and tendons, to elements of reconstructive breast surgery such as fat grafting over an implant and scar release. The ultrasound machine was also used for determination of the depth and size of collections such as seromas to facilitate drainage, for identification of lymph nodes before transfer, and for acute presentations of conditions ranging from undiagnosed swelling to foreign body localization.

Conclusions:
The portable ultrasound machine has become an invaluable tool in the senior author’s practice. In a short time and with a short learning curve, the authors’ unit identified numerous applications for its use. From a patient perspective, it is noninvasive/nonpainful and has no deleterious radiation effects, and treatment plans can be enacted without delay. It is highly recommended that surgeons become familiar with this imaging modality and assimilate it into their daily practice.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Virtual Monoenergetic Images From a Novel Dual-Layer Spectral Detector Computed Tomography Scanner in Portal Venous Phase: Adjusted Window Settings Depending on Assessment Focus Are Essential for Image Interpretation
Authors: Hickethier Tilman , Iuga Andra-Iza , Lennartz Simon , Hauger Myriam , Byrtus Jonathan , Luetkens Julian A. , Haneder Stefan , Maintz David , Doerner Jonas 
Published: January 2018

Objective
We aimed to determine optimal window settings for conventional polyenergetic (PolyE) and virtual monoenergetic images (MonoE) derived from abdominal portal venous phase computed tomography (CT) examinations on a novel dual-layer spectral-detector CT (SDCT).

Methods
From 50 patients, SDCT data sets MonoE at 40 kiloelectron volt as well as PolyE were reconstructed and best individual window width and level values manually were assessed separately for evaluation of abdominal arteries as well as for liver lesions. Via regression analysis, optimized individual values were mathematically calculated. Subjective image quality parameters, vessel, and liver lesion diameters were measured to determine influences of different W/L settings.

Results
Attenuation and contrast-to-noise values were significantly higher in MonoE compared with PolyE. Compared with standard settings, almost all adjusted W/L settings varied significantly and yielded higher subjective scoring. No differences were found between manually adjusted and mathematically calculated W/L settings.

Conclusions
PolyE and MonoE from abdominal portal venous phase SDCT examinations require appropriate W/L settings depending on reconstruction technique and assessment focus.
Establishing a Virtual Community of Practice in Simulation
Authors: Thoma Brent , Brazil Victoria , Spurr Jesse , Palaganas Janice , Eppich Walter , Grant Vincent , Cheng Adam 
Published: January 2018

Summary Statement
Professional development opportunities are not readily accessible for most simulation educators, who may only connect with simulation experts at periodic and costly conferences. Virtual communities of practice consist of individuals with a shared passion who communicate via virtual media to advance their own learning and that of others. A nascent virtual community of practice is developing online for healthcare simulation on social media platforms. Simulation educators should consider engaging on these platforms for their own benefit and to help develop healthcare simulation educators around the world. Herein, we describe this developing virtual community of practice and offer guidance to assist educators to engage, learn, and contribute to the growth of the community.
How has the Affordable Care Act changed outcomes in emergency general surgery?
Authors: Hamel Michelle G. , Godat Laura N. , Coimbra Raul , Doucet Jay J. 
Published: January 2018

INTRODUCTION
Lack of insurance coverage increases complications and mortality from surgical procedures. The 2014 Affordable Care Act (ACA) Open Enrollment (OE) insured more Americans, but it is unknown if this improved outcomes from emergency general surgery (EGS) procedures. This study seeks to determine how ACA OE coverage changes outcomes in EGS.

METHODS
This is a retrospective review using the Nationwide Inpatient Sample database from 2012 to 2014. Patients aged 18 to 64 years undergoing EGS procedures were identified by International Classification of Diseases, Ninth Revision, codes. Medicare patients were excluded. Patient demographics, hospital characteristics, and Charlson comorbidity index were obtained. Outcomes were measured by mortality, complications, and calculated costs. Univariate and difference-in-differences multivariate analyses were performed to determine the effect of the ACA OE on EGS outcomes.

RESULTS
A total of 304,110 EGS cases were identified. After Medicare patients were excluded, there were 275,425 cases. In 2014, Medicaid admissions increased 18.2% from 18,495 to 22,615 (p < 0.001) and self-pay admissions decreased 33% from 14,938 to 10,630 (p < 0.001). Mortality significantly increased for self-pay patients in 2014 from 0.81% to 1.22% (p < 0.001). Difference-in-differences analysis indicated that, after risk adjustment, the ACA OE was associated with a small reduction in mortality for insured patients (−0.12%, p = 0.034), increased complications (1.4%, p = 0.009), and increased wage-index adjusted mean costs (4.6%, p < 0.001). There was a significant increase in Medicare (+26.5%) and private (+12.2%, p < 0.001) insurance admissions in teaching hospitals, while nonteaching hospitals had fewer EGS admissions with a greater reduction in uninsured EGS admissions.

CONCLUSIONS
The ACA OE created a significant reduction in uninsured EGS admissions but did not reduce EGS mortality. Mortality decreased in insured patients but increased in uninsured patients, indicating that the ACA OE primarily insured lower-risk patients. The ACA OE did increase cost and complications in insured admissions. Teaching hospitals saw the majority of the increase in Medicaid and private insurance EGS admissions. A national registry would improve future study of insurance policy on EGS outcomes.

LEVEL OF EVIDENCE
Economic analysis, level IV.