bluuebunny/crossref_metadata_2025_split huggingface dataset:
CONTAMINATION OF ANTI-VEGF DRUGS FOR INTRAVITREAL INJECTION
Authors: Schargus Marc , Werner Benjamin P. , Geerling Gerd , Winter Gerhard 
Published: August 2017

Purpose:
The particle counts and the nature of particles of three different antivascular endothelial growth factor agents (VEGF) in different containers in a laboratory setting were compared.

Methods:
Original prefilled ranibizumab glass syringes, original vials with aflibercept, and repacked ready-to-use plastic syringes with bevacizumab from a compounding pharmacy and a compounding company (CC) were analyzed. Particle counts and size distributions were quantified by different particle characterization methods (nephelometry, light obscuration, Micro-Flow Imaging, nanotracking analysis, resonant mass measurement). Using high-performance size-exclusion chromatography (HP-SEC), levels of protein drug monomer and soluble aggregates were determined.

Results:
Nearly all samples showed similar product quality. Light obscuration and Micro-Flow Imaging showed a 4-fold to 9-fold higher total particle count in compounding company bevacizumab (other samples up to 42,000 particles/mL). Nanotracking analysis revealed highest values for compounding company bevacizumab (6,375 million particles/mL). All containers showed similar amounts of silicone oil microdroplets. Ranibizumab showed lowest particle count of all tested agents with only one monomer peak in HP-SEC. Repackaged bevacizumab from different suppliers showed varying product quality.

Conclusion:
All three tested agents are available in similar quality regarding particulate purity and silicone oil microdroplet count. Repackaging can have a major impact on the quality.
CASE REPORT OF SEVERE PROLIFERATIVE RETINOPATHY IN A PATIENT WITH CONGENITAL LIPODYSTROPHY
Authors: Rosin Boris , Jaouni Tareq 
Published: August 2017

Purpose:
A case report of a patient with severe proliferative retinopathy due to congenital lipodystrophy.

Methods:
We reviewed the medical history, imaging, and surgical procedures of a 25-year-old woman with a history of congenital lipodystrophy, presenting with bilateral combined tractional and exudative retinal detachment, poorly controlled diabetes mellitus, and extreme dislipidemia.

Results:
The patient underwent retinal detachment repair surgery both eyes. On the last follow-up, both retinae were flat, and visual acuity had improved in the right eye to J3 for near and finger counting 3 m for distance.

Conclusion:
Surgery combining pars plana vitrectomy and scleral bucking successfully flattened both retinae and significantly improved visual acuity in one eye in this case of bilateral retinal detachment with combined tractional and exudative components in a patient with congenital lipodystrophy. Surgical control of retinal complications is thus possible, provided there is adequate control of the underlying risk factors.
Recovery From Amiodarone-Induced Cornea Verticillata by Application of Topical Heparin
Authors: Frings Andreas , Schargus Marc 
Published: August 2017

Purpose:
To report a case of amiodarone-induced vortex keratopathy–associated anatomical findings and subjective visual perception before and after treatment with topical heparin eye drops.

Methods:
Case report.

Results:
A 76-year-old man complained of halos in his vision in both his eyes due to prominent bilateral cornea verticillata. For treatment of cornea verticillata, we prescribed unpreserved eye drops of a sterile, phosphate-free solution of 0.1% sodium hyaluronate with 1300 IU/mL heparin sodium 3 times daily to the left eye, whereas the other side served as the control. The area of corneal deposits was measured by 2 examiners before and at the 1- and 3-month examination. At last follow-up, cornea verticillata had been reduced from 6 to 2 mm2 in area by approximately 66% from grade-III to grade-II amiodarone keratopathy.

Conclusions:
In patients using amiodarone, clearing of cornea verticillata may be achieved by topical use of unpreserved eye drops of a sterile, phosphate-free solution of 0.1% sodium hyaluronate with 1300 IU/mL heparin sodium.
Development of Cell Analysis Software for Cultivated Corneal Endothelial Cells
Authors: Okumura Naoki , Ishida Naoya , Kakutani Kazuya , Hongo Akane , Hiwa Satoru , Hiroyasu Tomoyuki , Koizumi Noriko 
Published: August 2017

Purpose:
To develop analysis software for cultured human corneal endothelial cells (HCECs).

Methods:
Software was designed to recognize cell borders and to provide parameters such as cell density, coefficient of variation, and polygonality of cultured HCECs based on phase contrast images. Cultured HCECs with high or low cell density were incubated with Ca2+-free and Mg2+-free phosphate-buffered saline for 10 minutes to reveal the cell borders and were then analyzed with software (n = 50).

Results:
Phase contrast images showed that cell borders were not distinctly outlined, but these borders became more distinctly outlined after phosphate-buffered saline treatment and were recognized by cell analysis software. The cell density value provided by software was similar to that obtained using manual cell counting by an experienced researcher. Morphometric parameters, such as the coefficient of variation and polygonality, were also produced by software, and these values were significantly correlated with cell density (Pearson correlation coefficients −0.62 and 0.63, respectively).

Conclusions:
The software described here provides morphometric information from phase contrast images, and it enables subjective and noninvasive quality assessment for tissue engineering therapy of the corneal endothelium.
Long-Term Follow-up of Intrastromal Corneal Ring Segments (210-Degree Arc Length) in Central Keratoconus With High Corneal Asphericity
Authors: Lisa C. , Fernández-Vega Cueto L. , Poo-López A. , Madrid-Costa D. , Alfonso José F. 
Published: August 2017

Purpose:
To assess the long-term outcomes of implanting intrastromal corneal ring segments (ICRSs) to correct central keratoconus with a high corneal asphericity value.

Methods:
Forty-three eyes with central keratoconus with a corneal asphericity value ≥−1.00 were evaluated before and after implanting an inferior 210-degree arc-length Ferrara-type AFR5 ICRS (AJL Ophthalmic, Spain). Logarithm of the minimum angle of resolution uncorrected (UDVA) and best-corrected (CDVA) distance visual acuity, corneal asphericity, root mean square for coma-like aberrations [computed for the Zernike terms Z (3, 1) and Z (3, −1)], and residual refractive errors analyzed using vector analysis were recorded before and at all follow-up visits. The postoperative follow-up duration was 3 years in all cases.

Results:
Mean UDVA (logarithm of the minimum angle of resolution scale) rose from 1.18 ± 0.59 to a postoperative 0.53 ± 0.39 after ICRS implantation (P < 0.0001). Mean CDVA varied in turn from 0.36 ± 0.18 to 0.17 ± 0.10 (P < 0.0001). CDVA remained unchanged or improved in all eyes after surgery. Both UDVA and CDVA were stable over the postoperative period (P > 0.05). The spherical equivalent declined steeply after ICRS implantation (P < 0.0001). Both spherical equivalent and refractive cylinder were stable over the postoperative period. The corneal asphericity and root mean square values for coma-like aberrations exhibited statistically significant decreases 6 months after ICRS implantation (P < 0.0001) and were also stable over postoperative follow-up (P > 0.05).

Conclusions:
These results suggest that implanting a single, inferior, 210-degree arc-length Ferrara-type ICRS is a safe, effective, and stable procedure for treating patients with central hyperprolate keratoconus.
Corneal Tomographic Changes After UV Cross-Linking for Corneal Ectasia (1-Year Results)
Authors: Baksoellah Zainab , Lavy Itay , Baydoun Lamis , Hooijmaijers Hilde C. M. , van Dijk Korine , Melles Gerrit R. J. 
Published: August 2017

Purpose:To evaluate changes in maximum keratometry (Kmax), corneal higher-order aberrations (HOAs), and densitometry (backscattered light) up to 1 year after UV cross-linking and their possible relation with changes in the visual outcome.Methods:Retrospective cohort study on 18 eyes of 16 patients, who underwent UV cross-linking after the Dresden protocol for progressive keratoconus or ectasia after laser-assisted in situ keratomileusis. Corrected distance visual acuity (CDVA), Scheimpflug-based corneal tomography, mean image brightness (corneal densitometry) from the anterior 120 μm of the midcornea, and posterior 60 μm of the central 6 mm of the cornea, and HOAs were evaluated.Results:Kmax at 1 month (59.7 ± 6.0D) after UV cross-linking resembled preoperative Kmax (59.3 ± 6.4D,P= 0.368), decreased until 3 months postoperatively (58.3 ± 6.3D,P= 0.002), and stabilized thereafter (P> 0.227). All postoperative corneal densitometry values were higher than preoperative values in all measured depths (P <0.05). One-month anterior and total corneal HOAs (4.28 ± 1.64 μm and 3.87 ± 1.62 μm, respectively) resembled preoperative values (4.10 ± 1.70 μm and 3.67 ± 1.62 μm, respectively;P> 0.221) and then decreased until 12 months postoperatively (3.86 ± 1.84 μm and 3.40 ± 1.80 μm, respectively;P< 0.005). Thinnest point thickness decreased from before (442 ± 25 μm) to 3 months postoperatively (427 ± 25 μm,P< 0.001), with no difference at 12 months postoperatively compared with preoperative values (437 ± 29 μm,P= 0.149). CDVA and endothelial cell density remained unchanged (P> 0.345 andP> 0.257, respectively). No relations were found between CDVA and the evaluated parameters (P> 0.05).Conclusions:One year after UV cross-linking, the observation of stable CDVA and thinnest point thickness, together with reduced Kmax suggests no ectasia progression within the study period in these cases. Although HOAs showed a trend toward improvement, corneal densitometry remained elevated.
Intraocular Pressure Responses to Maximal Cycling Sprints Against Different Resistances: The Influence of Fitness Level
Authors: Vera Jesús , Jiménez Raimundo , Redondo Beatriz , Cárdenas David , De Moraes Carlos Gustavo , Garcia-Ramos Amador 
Published: August 2017

Purpose:
This study investigated the acute effect of maximal cycling sprint against difference resistances on intraocular pressure (IOP) depending on participants’ fitness level.

Methods:
In total, 26 physically active collegiate men performed 5 maximal cycling sprints against different resistances in a randomized order, and IOP was measured immediately before and after each sprint. Participants were divided in 2 subgroups (low fit and high fit) according to their maximum power output relative to body weight to assess the influence of fitness level. Two identical testing sessions were performed to assess the repeatability of IOP values.

Results:
We found that IOP decreases with the lightest resistance (P<0.01), whereas IOP increases with heavier resistances (P<0.01), and it showed a positive linear tendency (r=0.99). Our results suggest that participants’ fitness level seems to influence IOP responses, with a more stable response in the high-fit group. A strong intersession repeatability of IOP values was observed (intraclass correlation coefficient range, 0.82 to 0.98; coefficients of variations range, 1.76% to 6.23%).

Conclusions:
We conclude that (1) IOP is sensitive to cycling resistance in all-out sprints, with a lowering effect on the lightest resistance and an increasing effect with medium and heavy resistances, (2) high fitness level is beneficial to avoid IOP fluctuations during sprints, and (3) these changes are comparable when measured on 2 different days under the same experimental conditions. A progressive involvement in physical activity may be desirable to avoid IOP peaks during highly demanding physical effort. Future studies are needed to clarify the consequences of exercise in glaucoma patients.
Enterovirus Infection and Subsequent Risk of Kawasaki Disease: A Population-based Cohort Study
Authors: Weng Ken-Pen , Cheng-Chung Wei James , Hung Yao-Min , Huang Shih-Hui , Chien Kuang-Jen , Lin Chu-Chuan , Huang Shih-Ming , Lin Cheng-Li , Cheng Ming-Fang 
Published: August 2017

Background:
The relationship of enterovirus (EV) infection and Kawasaki disease (KD) is still unclear. The purpose of this study was to conduct a population-based cohort study to determine the relationship between KD and EV infection in Taiwan.

Methods:
A population-based cohort study was conducted to analyze the children file (age < 18 years) of the Taiwan National Health Insurance program between 2000 and 2008. In total, 285,636 children with EV infection and 285,636 children without EV infection were included and followed up. The subsequent KD was the major outcome event.

Results:
The cumulative incidence of KD was significantly higher in the EV-infected cohort than in the non-EV–infected cohort (log-rank test, P < 0.001). The overall incidence of KD was 56% higher in the EV-infected cohort than in the non-EV–infected cohort, with an adjusted hazard ratio of 1.56 (95% confidence interval: 1.44–1.69). Stratified analysis showed higher KD risk associated with previous EV infection in children 3–5 years old, in girls, in children living in less urbanization levels, in children with parental low-income occupation, and in children with allergic diseases.

Conclusions:
There is a higher association between KD and previous EV infection in Taiwanese children, especially in those 3–5 years old, with female sex, with less urbanization level, with low-income parental occupation, and with allergy.
Low Varicella Zoster Virus Seroprevalence Among Young Children in the Democratic Republic of the Congo
Authors: Doshi Reena H. , Alfonso Vivian H. , Mukadi Patrick , Hoff Nicole A. , Gerber Sue , Bwaka Ado , Higgins Stephen G. , Sinai Cyrus , Cowell Brian , Ngoie Mwamba Guillaume , Okitolonda Emile , Muyembe-Tamfum Jean-Jacques , Rimoin Anne W. 
Published: August 2017

Background:
Varicella zoster virus (VZV) causes both varicella (chickenpox) and herpes zoster (shingles) and is associated with significant global morbidity. Most epidemiological data on VZV come from high-income countries, and to date there are limited data on the burden of VZV in Africa.

Methods:
We assessed the seroprevalence of VZV antibodies among children in the Democratic Republic of Congo in collaboration with the 2013–2014 Demographic and Health Survey. Dried blood spot samples collected from children 6–59 months of age were run on Dynex™ Technologies Multiplier FLEX® chemiluminescent immunoassay platform to assess serologic response. Multivariate logistic regression was then used to determine risk factors for VZV seropositivity.

Results:
Serologic and survey data were matched for 7,195 children 6–59 months of age, among whom 8% were positive and 2% indeterminate for VZV antibodies in weighted analyses. In multivariate analyses, the odds of seropositivity increased with increasing age, increasing socioeconomic status, mother’s education level, rural residence, and province (South Kivu, North Kivu, Bandundu, Bas Congo had the highest odds of a positive test result compared with Kinshasa).

Conclusion:
Our data suggest that VZV is circulating in DRC, and seropositivity is low among children 6–59 months. Seropositivity increased with age and varied by other sociodemographic factors, such as geographic location. This study provides the first nationally representative estimates of VZV infection among children in the DRC.
Identifying Persistent Asthma in Children: A Comparison of Healthcare Effectiveness Data and Information Set Criteria and National Heart, Lung, and Blood Institute Guidelines
Authors: Hall Ashleigh , Smolij Carol , Moughan Beth , Kechli Amer , Aronoff Stephen 
Published: August 2017

ABSTRACT
Persistent asthma requires a daily controller medication. National Heart, Lung, and Blood Institute (NHLBI) guidelines and Healthcare Effectiveness Data and Information Set (HEDIS) quality measures are used to identify persistent asthma, the former method used by clinicians, and the latter by managed care organizations (MCOs). This study aims to determine the degree of agreement between these criteria in classifying pediatric persistent asthma. Asthmatic patients aged 5–18 years old in a university pediatric practice who were continuously enrolled with one MCO from January 1, 2012 to December 31, 2013 (Cohort 1: 329 patients) and January 1, 2013 to December 31, 2014 (Cohort 2: 212 patients) were identified. Subjects with at least one asthma visit were included. Independence of NHLBI and HEDIS criteria was determined by the McNemar test. Agreement was determined by confusion matrix analysis and Cohen kappa statistic with continuity correction. Agreement in controller assignment was 82% in Cohort 1 and 88% in Cohort 2. Agreement was fair in Cohort 1 (Cohen kappa = 0.364; 95% confidence interval [CI] = 0.217–0.511) and moderate in Cohort 2 (Cohen kappa = 0.447; 95% CI = 0.247–0.646). The HEDIS misclassified persistent asthma by 16.4% (95% CI: 11.5–21.2%) and 11.8% (95% CI: 6.8–16.7%) in Cohorts 1 and 2, respectively. NHLBI and HEDIS criteria show fair to moderate agreement; however, the HEDIS consistently misclassified persistent asthma, suggesting that it is a poor measure of practice performance.
Neisseria gonorrhoeae Transmission Among Men Who Have Sex With Men: An Anatomical Site-Specific Mathematical Model Evaluating the Potential Preventive Impact of Mouthwash
Authors: Zhang Lei , Regan David G. , Chow Eric P.F. , Gambhir Manoj , Cornelisse Vincent , Grulich Andrew , Ong Jason , Lewis David A. , Hocking Jane , Fairley Christopher K. 
Published: August 2017

Background
Gonorrhoea notifications are rapidly rising in men who have sex with men (MSM). We developed a model to assess mouthwash as a novel intervention for gonorrhoea control.

Methods
We developed a model of Neisseria gonorrhoeae (NG) transmission to explain anatomic site-specific prevalence of gonorrhoea among MSM. The model was calibrated to available epidemiological and behavioral data. We estimated the contribution of various sexual acts to gonorrhoea incidence and evaluate the potential impacts of screening scale-up and utilization of mouthwash on the gonorrhoea epidemic.

Results
We calibrated the model to prevalence of oropharyngeal, anal, and urethral gonorrhoea of 8.6% (7.7–9.5%), 8.3% (7.4–9.1%), and 0.20% (0.04–0.35%), respectively, among MSM. Oropharynx to oropharynx transmission through kissing is estimated to account for nearly three quarters of all incident cases (71.6% [64.4–80.5%]) of gonorrhoea in MSM. Substantially increasing annual oropharynx screening for gonorrhoea from the current 40% to 100% may only halve the prevalence of gonorrhoea in MSM. In contrast, the use of mouthwash with moderate efficacy (additional 1% clearance per daily use) would further reduce the corresponding prevalence rates to 3.1% (2.2–4.4%), 3.8% (2.3–4.9%), and 0.10% (0.06–0.11%), and a high-efficacy mouthwash (additional 1.5% clearance per daily use) may further halve the gonorrhoea prevalence. Without oropharynx to oropharynx transmission, we could not replicate current prevalence data.

Conclusions
Despite a dearth of empirical data, our model suggests that kissing could potentially play an important role in NG transmission among MSM. Control through sexually transmitted infection screening alone is unlikely to have a substantial impact on the gonorrhoea epidemic in MSM.
A Systematic Review of Hospital Trauma Team Activation Criteria for Children
Authors: Drendel Amy L. , Gray Matthew P. , Lerner E. Brooke 
Published: August 2017

Objectives
Hospital trauma activation criteria are intended to identify children who are likely to require aggressive resuscitation or specific surgical interventions that are time sensitive and require the resources of a trauma team at the bedside. Evidence to support criteria is limited, and no prior publication has provided historical or current perspectives on hospital practices toward informing best practice. This study aimed to describe the published variation in (1) highest level of hospital trauma team activation criteria for pediatric patients and (2) hospital trauma team membership and (3) compare these finding to the current ACS recommendations.

Methods
Using an Ovid MEDLINE In-Process & Other Non-Indexed Citations search, any published description of hospital trauma team activation criteria for children that used information captured in the prehospital setting was identified. Only studies of children were included. If the study included both adults and children, it was included if the number of children assessed with the criteria was included.

Results
Eighteen studies spanning 20 years and 13,184 children were included. Hospital trauma team activation and trauma team membership were variable. Nearly all (92%) of the trauma criteria used physiologic factors. Penetrating trauma (83%) was frequently included in the trauma team activation criteria. Mechanisms of injury (52%) were least likely to be included in the highest level of activation. No predictable pattern of criterion adoption was found. Only 2 of the published criteria and 1 of published trauma team membership are consistent with the current American College of Surgeons recommendations.

Conclusions
Published hospital trauma team activation criteria and trauma team membership for children were variable. Future prospective studies are needed to define the optimal hospital trauma team activation criteria and trauma team membership and assess its impact on improving outcomes for children.
Perceived Need Versus Current Spending: Gaps in Providing Foundational Public Health Services in Communities
Authors: Bekemeier Betty , Marlowe Justin , Squires Linda Sharee , Tebaldi Jennifer , Park Seungeun 
Published: August 2017

Objective:
Our objective was to estimate the gap between the costs for local health jurisdictions (LHJs) to provide foundational public health services (FPHS) and actual spending on FPHS and to examine factors associated with that gap.

Design:
We employed resource-based cost estimation methods for this observational study and conducted multivariate analyses with measures derived from secondary administrative data. We used primary data collected from LHJ leaders that depicted 2014 spending and perceived need. We also included secondary administrative data depicting annual 2000-2013 expenditures organized into categories containing key elements of FPHS areas.

Setting:
We included primary data from a representative sample of 10 LHJs in Washington State and secondary data for all 35 LHJs in Washington.

Participants:
Participants were public health practice leaders from each sample LHJ.

Main Outcome Measure:
Our main outcome of interest was the gap identified between current spending and the perceived spending needed to provide FPHS in a jurisdiction.

Results:
Actual FPHS spending was approximately 65% of spending needed to provide overall FPHS for our sample LHJs, but the size of the gap varied substantially by program. Some gaps also varied widely by LHJ, with spending gaps widest among rural and high poverty communities. Percent poverty and the metropolitan nature of a jurisdiction were factors significantly related to FPHS spending in our multivariate analyses.

Conclusions:
Actual spending lags far behind local officials' estimates of spending needed to provide FPHS and is likely influenced by local conditions. Major apparent gaps between spending and need, particularly in areas such as costly Business Competencies, underscore the need for cross-cutting capabilities to support public health system responsiveness and for attention to be paid to local conditions.