bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Center and Flex-Center Methods of Corneal Endothelial Cell Analysis in the Presence of Guttae
Authors: Huang Jianyan , Liu Xuan , Tepelus Tudor C. , Nazikyan Tigran , Chopra Vikas , Sadda Srinivas R. , Lee Olivia L. 
Published: August 2017

Purpose:
To compare endothelial cell analysis by the center and flex-center methods in corneas with guttae of differing severity and to determine the minimum countable cell number for using only the flex-center method.

Methods:
Forty-seven eyes with corneal guttae and 50 age-matched normal controls were enrolled in the study. Three images were captured in each central cornea with the noncontact specular microscope. Endothelial cell density (ECD), coefficient of variation (CV), and percentage of hexagonal cells (HEX) were analyzed by trained graders, using both center and flex-center methods.

Results:
Consistent ECD and HEX values were obtained in normal eyes by both methods (P > 0.05). In corneas with guttae, ECD values obtained by the center method were 2.4% higher than those obtained with the flex-center method (P < 0.001). ECD values derived by both methods disagreed only when <30 cells were identified or <20 cells were analyzed. CV values obtained by the center method were 17.1% (P < 0.001) lower than those obtained by the flex-center method. HEX values obtained with both methods (P > 0.05) agreed. Regardless of guttae density, the ECD, CV, and HEX values of 3 images of each eye were in agreement (P > 0.05).

Conclusions:
In corneas with guttae, both center and flex-center methods can reliably determine ECD. Although current practice recommends the center method when at least 100 cells can be counted, our study suggests that the center method can provide a reliable ECD value when there are ≥30 contiguous countable cells in a central cornea endothelial image. The flex-center method is recommended when <30 contiguous cells are identified.
Promotion of Corneal Epithelial Wound Healing in Diabetic Rats by the Fibronectin-Derived Peptide PHSRN
Authors: Morishige Naoyuki , Uemura Aiko , Morita Yukiko , Nishida Teruo 
Published: August 2017

Purpose:
Topical application of the fibronectin-derived peptide PHSRN facilitates corneal epithelial wound healing in healthy animals and in patients with nonhealing epithelial defects. We have now examined the effect of PHSRN eye drops on the healing of corneal epithelial wounds in diabetic rats.

Methods:
Wistar rats were injected intraperitoneally with streptozotocin to induce diabetes or with a vehicle as a control. Four weeks after confirmation of the corresponding presence or absence of glycosuria, a 3-mm-diameter portion of the corneal epithelium of the right eye was excised and eye drops containing PHSRN (200 μM) or phosphate-buffered saline (PBS) vehicle were administered to the injured eye every 6 hours.

Results:
The area of the epithelial defect did not differ significantly among the 4 experimental groups (diabetic or nondiabetic rats treated with PHSRN or vehicle) at 12 hours after wounding. At 18 hours, however, the area of the defect in diabetic rats treated with PHSRN (0.50 ± 0.34 mm2) was significantly (P < 0.05) smaller than that in diabetic rats treated with PBS (1.06 ± 0.42 mm2) and was similar to that in nondiabetic rats treated with PBS (0.60 ± 0.23 mm2). The decrease in the size of the epithelial defect in diabetic rats treated with PHSRN was also found to be dependent on the dose of the peptide.

Conclusions:
Administration of PHSRN significantly facilitated healing of corneal epithelial wounds in diabetic rats, which suggests that PHSRN eye drops warrant further investigation as a treatment option for patients with diabetic keratopathy.
Comparison of Central Corneal Thickness Measurements Using Ultrasonic Pachymetry, Anterior Segment OCT and Noncontact Specular Microscopy
Authors: Scotto Riccardo , Bagnis Alessandro , Papadia Marina , Cutolo Carlo Alberto , Risso Domenico , Traverso Carlo Enrico 
Published: August 2017

Purpose:
To evaluate and compare central corneal thickness (CCT) values measured with anterior segment optical coherence tomography (AS-OCT), noncontact specular microscopy (NCSM), and ultrasound pachymetry (USP).

Materials and Methods:
CCT was measured in 182 healthy eyes without ocular abnormalities other than refractive errors. Three consecutive measurements of CCT by the same examiner were obtained during the same session. The testing sequence of AS-OCT and NCSM was randomly selected. The USP always was performed after the noncontact examinations.

Results:
The average CCT measured by AS-OCT, NCSM, and USP were 535.8±35.5, 547.7±38.2, and 537.4±37.5 μm, respectively. The mean differences between modalities were 11.8±14.7 μm (P<0.01) between NCSM and AS-OCT, 10.3±17.7 μm (P<0.01) between NCSM and USP and 1.6±8.6 μm (P=0.02) between USP and AS-OCT.

Conclusions:
AS-OCT, NCSM, and USP showed an overall strong agreement in measuring CCT. However, CCT measurements with AS-OCT showed a good correlation to those obtained by USP, NCSM tended to give statistically significant higher CCT readings than either alternative and showed the worse repeatability indices. On the basis of our results, CCT measurement obtained with different instruments cannot be considered directly interchangeable.
Change in Visual Field Progression Following Treatment Escalation in Primary Open-angle Glaucoma
Authors: Aptel Florent , Bron Alain M. , Lachkar Yves , Schweitzer Cédric 
Published: August 2017

Purpose:
To evaluate the effect of treatment escalation on the rate of visual field progression in patients with primary open-angle glaucoma (POAG).

Patients and Methods:
Multicenter database study. We reviewed the electronic records of 171 patients with POAG under medical hypotensive treatment who underwent 5 consecutive visits 6 months apart before and after medical treatment escalation or additive laser trabeculoplasty. We calculated the rate of visual field progression (mean deviation change per year) before and after treatment escalation.

Results:
The mean duration of follow-up was 5.1±0.5 years and the mean number of visual field examinations was 10.2±0.2. In 139 eyes with medical treatment escalation, the rate of progression was significantly reduced [from −0.57 to −0.29 dB/y; P=0.022; intraocular pressure (IOP) reduction 11.1%]. In detail, the rate of progression was significantly reduced after escalation from mono to dual therapy, dual to triple therapy, and from mono to triple therapy (−0.35 to −0.24 dB/y, P=0.018; −1.01 to −0.48 dB/y, P=0.038; −1.04 to −0.35 dB/y, P=0.020, respectively). In 32 eyes with additive laser trabeculoplasty, the rate of progression was significantly reduced (−0.60 to −0.24 dB/y; P=0.014; IOP reduction 9.4%).

Conclusions:
Medical treatment escalation or additive laser trabeculoplasty significantly reduced the rate of visual field progression in POAG. Larger IOP reduction has a greater probability of reducing glaucoma progression.
Within-Hospital Variation in 30-Day Adverse Events: Implications for Measuring Quality
Authors: Burke Robert E. , Glorioso Thomas , Barón Anna K. , Kaboli Peter J. , Ho P. Michael 
Published: August 2017

ABSTRACT
Novel measures of hospital quality are needed. Because quality improvement efforts seek to reduce variability in processes and outcomes, hospitals with higher variability in adverse events may be delivering poorer quality care. We sought to evaluate whether within-hospital variability in adverse events after a procedure might function as a quality metric that is correlated with facility-level mortality rates. We analyzed all percutaneous coronary interventions (PCIs) performed in the Veterans Health Administration (VHA) system from 2007 to 2013 to evaluate the correlation between within-hospital variability in 30-day postdischarge adverse events (readmission, emergency department visit, and repeat revascularization), and facility-level mortality rates, after adjustment for patient demographics, comorbidities, PCI indication, and PCI urgency. The study cohort included 47,567 patients at 48 VHA hospitals. The overall 30-day adverse event rate was 22.0% and 1-year mortality rate was 4.9%. The most variable sites had relative changes of 20% in 30-day rates of adverse events period-to-period. However, within-hospital variability in 30-day events was not correlated with 1-year mortality rates (correlation coefficient = .06; p = .66). Thus, measuring within-hospital variability in postdischarge adverse events may not improve identification of low-performing hospitals. Evaluation in other conditions, populations, and in relationship with other quality metrics may reveal stronger correlations with care quality.
Effects of a Novel Microprocessor-Controlled Knee, Kenevo, on the Safety, Mobility, and Satisfaction of Lower-Activity Patients with Transfemoral Amputation
Authors: Mileusnic Milana P. , Hahn Andreas , Reiter Sebastian 
Published: August 2017

ABSTRACT

Introduction
Lower-activity persons with transfemoral amputation experience many comorbidities that limit their ability to satisfactorily use prosthetic knees and safely conduct their life activities. Kenevo is a novel microprocessor-controlled knee designed specifically to accommodate the needs of lower-activity individuals with transfemoral amputation.

Materials and Methods
A prospective observational study was conducted to collect first clinical experiences with Kenevo. Patient-reported measures were conducted to assess patient safety, mobility on level walking, stairs and ramps, as well as preference. In addition, feedback from certified prosthetists/orthotists was collected regarding fitting process, acclimation, and patient benefits.

Results
A total of 29 persons with amputation were fitted with Kenevo. Most of them had unilateral amputations and belonged to the K2 mobility group. Fitting the Kenevo resulted in a positive trend in the Locomotor Capabilities Index 5, Prosthetic Limb Users Survey of Mobility, and Houghton scores (p > 0.05). Kenevo use resulted in a significant reduction of wheelchair dependence for many subjects. Most subjects reported improvements in level walking during various speeds and on uneven ground as well as when walking and standing on ramps and traversing stairs. More than two-thirds of the subjects reported reduction in necessary concentration and perceived exertion when walking with Kenevo. Fear of falling was reduced in 50% of the subjects, whereas the number of subjects who never fell increased from 45% to 72% (p = 0.161) and those who never stumbled from 8% to 50% (p = 0.044). Finally, 89% of the subjects preferred Kenevo to their previous fitting.

Conclusions
First routine fittings of the new Kenevo microprocessor-controlled knee suggest that it offers numerous advantages to lower-activity persons with amputation. Improvements in functional mobility and safety were observed. Of the subjects, 89% preferred Kenevo over their previous knee. Higher-quality research is needed to confirm the conclusions reached in this observational study.
Allogeneic stem-cell transplantation for myelofibrosis
Authors: Lavi Noa , Rowe Jacob M. , Zuckerman Tsila 
Published: August 2017

Purpose of review
Allogeneic hematopoietic stem-cell transplantation (HSCT) remains the only curative therapy for myelofibrosis. The number of HSCTs performed for this indication has been steadily increasing over the past years, even after the approval of the Janus kinase (JAK) inhibitor, ruxolitinib. This increase may be attributed to improved patient selection based on new prognostic molecular markers, more frequent use of matched unrelated donors, secondary to better (high-resolution) human leukocyte antigen typing and supportive care. Ruxolitinib approval raises new questions regarding the role of JAK inhibitors in the transplant setting.

Recent findings
The current review summarizes recent updates on HSCT in myelofibrosis. Predictors for transplant outcomes, and specific considerations related to myelofibrosis patient selection for HSCT (e.g. molecular risk stratification) are reviewed. In addition, this review will consider management of myelofibrosis patients in the peritransplant period, including the role of ruxolitinib in the pretransplant period, pre and posttransplant splenomegaly, transplant protocols, posttransplant follow-up of minimal residual disease and interventions in the event of poor engraftment.

Summary
HSCT remains a highly relevant treatment option for myelofibrosis in the era of JAK inhibitors. Recent advances may contribute to a refined definition of HSCT eligibility and identification of the optimal transplantation time, conditioning protocols and posttransplant management.
Prehospital hemostatic resuscitation to achieve zero preventable deaths after traumatic injury
Authors: Spinella Philip C. , Cap Andrew P. 
Published: August 2017

Purpose of review
To describe how hemostatic resuscitation can be used in the prehospital phase of resuscitation to reduce preventable deaths after traumatic injury.

Recent findings
Hemorrhagic shock is the leading cause of death that is preventable after injury. The National Academy of Sciences, recently, recommended that achievement of zero preventable deaths after traumatic injury should be the goal of a national trauma system. In the United States, there are an estimated 25 000 preventable deaths per year in the prehospital phase of resuscitation because of traumatic hemorrhagic shock. Therefore, to achieve the goal of zero preventable deaths after injury, both shock and hemostatic dysfunction need to be addressed rapidly in the prehospital phase of resuscitation. This review will highlight the epidemiology and outcomes of traumatic hemorrhagic shock, and explore potential solutions such as group O whole blood and platelets stored at 2–6°C. Trauma research receives the lowest funding relative to the burden of morbidity and mortality it creates when compared with all other diseases. Increased resources are required to achieve zero preventable deaths after injury.

Summary
Prehospital hemostatic resuscitation has the potential to significantly reduce preventable death from hemorrhage.
Suicidal Ideation Among Medical Students
Authors: Torres Albina R. , Campos Luana M. , Lima Maria Cristina P. , Ramos-Cerqueira Ana Teresa A. 
Published: August 2017

Abstract
Suicide is one of the leading causes of death among medical students, second to car accidents. We investigated the prevalence and predictors of suicidal ideation (SI) among medical students in Brazil. This is a cross-sectional study with 475 medical students of a public university. The research protocol included data on sociodemographics and academic life, and structured instruments to assess social support and psychopathological symptoms, including the Beck Depression Inventory (BDI). The outcome was evaluated using the BDI suicide item. Bivariate analyses were followed by logistic regression. SI was present in 34 participants (7.2%). In the logistic regression, SI remained associated with living alone, thoughts of abandoning the course, moderate or severe depressive symptoms, and probable obsessive-compulsive disorder. SI is frequent among medical students and can be identified with a simple screening question. Special attention should be given to students living alone, with thoughts of abandoning the course, and relevant depressive or obsessive-compulsive symptoms.
Multifractality, Interactivity, and the Adaptive Capacity of the Human Movement System: A Perspective for Advancing the Conceptual Basis of Neurologic Physical Therapy
Authors: Cavanaugh James T. , Kelty-Stephen Damian G. , Stergiou Nicholas 
Published: August 2017

Background and Purpose:
Physical therapists seek to optimize movement as a means of reducing disability and improving health. The short-term effects of interventions designed to optimize movement ultimately are intended to be adapted for use across various future patterns of behavior, in potentially unpredictable ways, with varying frequency, and in the context of multiple tasks and environmental conditions. In this perspective article, we review and discuss the implications of recent evidence that optimal movement variability, which previously had been associated with adaptable motor behavior, contains a specific complex nonlinear feature known as “multifractality.”

Summary of Key Points:
Multifractal movement fluctuation patterns reflect robust physiologic interactivity occurring within the movement system across multiple time scales. Such patterns provide conceptual support for the idea that patterns of motor behavior occurring in the moment are inextricably linked in complex, physiologic ways to patterns of motor behavior occurring over much longer periods. The human movement system appears to be particularly tuned to multifractal fluctuation patterns and exhibits the ability to reorganize its output in response to external stimulation embedded with multifractal features.

Recommendations for Clinical Practice:
As a fundamental feature of human movement, multifractality opens new avenues for conceptualizing the link between physiologic interactivity and adaptive capacity. Preliminary evidence supporting the positive influence of multifractal rhythmic auditory stimulation on the gait patterns of individuals with Parkinson disease is used to illustrate how physical therapy interventions might be devised to specifically target the adaptive capacity of the human movement system.

Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A183).
Performance of Commercial Enzyme-Linked Immunoassays for Diagnosis of Herpes Simplex Virus-1 and Herpes Simplex Virus-2 Infection in a Clinical Setting
Authors: Agyemang Elfriede , Le Quynh-An , Warren Terri , Magaret Amalia S. , Selke Stacy , Johnston Christine , Jerome Keith R. , Wald Anna 
Published: August 2017

Background
US Food and Drug Administration-approved enzyme-linked immunoassays (EIA) for determining type-specific herpes simplex virus (HSV) serostatus are widely used in clinical practice. We compared the performance of such assays with the University of Washington Western blot (UW WB) in patients who sought confirmation of their HSV serology result.

Methods
We reviewed charts of all persons evaluated at the Westover Heights Clinic in Portland, Oregon, from July 2010 through September 2015, who had a HSV EIA, followed by UW WB.

Results
Of 864 persons, 47% were women. The median age was 36 years (range, 18–73 years). Using UW WB to define infection status, 286 (33%) persons were HSV-1 seropositive only, 104 (12%) were HSV-2 seropositive only, 134 (16%) were both HSV-1 and HSV-2 seropositive, 235 (27%) were HSV seronegative, and 105 (12%) had indeterminate results. Compared with the UW WB as the criterion standard, EIA was 70.2% sensitive and 91.6% specific for HSV-1, and 91.9% sensitive and 57.4% specific for HSV-2.
Among 278 persons who were HSV-1 seropositive by EIA, 255 were confirmed by the UW WB (positive predictive value [PPV], 91.7%). Of the 360 persons that were HSV-1 seronegative by the EIA, 252 were seronegative by UW WB (negative predictive value [NPV], 70.0%). Among 381 persons with HSV-2 EIA seropositivity, 193 tested HSV-2 seropositive by the UW WB (PPV, 50.7%). Of the 270 persons HSV-2 seronegative by EIA, 17 were seropositive with the UW WB (NPV, 93.7%). Among 261 persons with an EIA HSV-2 index value = 1.1–2.9, 39.8% of results were confirmed by UW WB, compared with 78.6% of the 70 persons with an EIA index value of 3 or greater (P < 0.001). The risk of false-positive HSV-2 EIA results was higher in those with HSV-1 antibody (47.1% vs 37.1%, P = 0.036).

Conclusions
US Food and Drug Administration-approved EIAs have poor PPV for HSV-2 and poor NPV for HSV-1 in clinical practice. More accurate rapid type-specific HSV antibody tests are needed.
Prevalence of Gonorrhea and Chlamydia Testing by Anatomical Site Among Men Who Have Sex With Men in HIV Medical Care, United States, 2013–2014
Authors: Patel Monita R. , Brooks John T. , Tie Yunfeng , Garg Shikha , Bradley Heather 
Published: August 2017

Abstract
Fewer than one-third of men who have sex with men were tested for Neisseria gonorrhoeae or Chlamydia trachomatis as part of HIV medical care in the United States in 2013 to 2014, and only 11.6% were tested for either sexually transmitted disease at an extragenital site.
Heterogeneity of Herpes Simplex Virus Type 2 Seroprevalence From a National Probability Survey In Mexico, 2012
Authors: Sanchez-Aleman Miguel Angel , Del Villar-Tapia Yamira Georgina , Gutierrez Juan Pablo , Garcia-Cisneros Santa , Olamendi-Portugal Ma. Leonidez , Herrera-Ortiz Antonia , Velazquez-Meza Manuel , Conde-Glez Carlos J. 
Published: August 2017

Background
Herpes simplex virus type 2 (HSV-2) seroprevalence and associated infection risk factors show differences by regions and countries. The aims of the study were to determine the HSV-2 seroprevalence and to evaluate the risk factors for HSV-2 in a national representative survey among adolescents and adults in Mexico.

Methods
A cross-sectional study was carried out in Mexico on the basis of the National Health and Nutrition Survey 2012, a national representative survey. Demographic, sexual behavior, reproductive health, and lifestyles indicators were considered in the current study. Participants provided biological samples—dried blood spots—to test for HSV-2 antibodies using enzyme-linked immunosorbent assay and Western blot. Bivariate and multivariate analyses were performed to identify variables associated with HSV-2 infections analyzed by sex.

Results
National HSV-2 seroprevalence was 9.9%, 2.4% among adolescents and 11.7% among adults with HSV-2 seroprevalence heterogeneous across the country. Women had 12.2% of antibodies against HSV-2 and men had 7.5%. The factors associated with HSV-2 infection among women were age (45–49 years; odds ratio [OR], 19.8), region (southwest; OR, 3.0), urbanization (urban; OR, 1.9), age at sexual debut (≤14 years; OR, 3.4), education level (any; OR, 3.0), and previous abortion (≥2 abortion; OR, 2.1). Among men, age (45–49 years; OR, 11.7), region (southwest; OR, 3.0), urbanization (urban, odds ratio [OR], 1.7), and HIV care (OR, 7.1) were associated with the infection.

Conclusions
Approximately 10% of Mexicans aged 15 to 49 years had HSV-2 antibodies, with differences by sex, region, education level, urbanization, HIV care, and childbirth, highlighting the relevance of health inequalities in the country: social inequalities seem to matter in terms of the probability of HSV-2 infections.