bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral Refraction and Aberration Profiles with Multifocal Lenses
Authors: Fedtke Cathleen , Ehrmann Klaus , Thomas Varghese , Bakaraju Ravi C. 
Published: August 2017

SIGNIFICANCE
The amount of central or peripheral myopic shift, as induced by different multifocal contact lenses when viewing objects at distance or near, may provide insights on the potential efficacy for slowing eye growth.

PURPOSE
The present study aims to compare peripheral refraction and higher-order aberration profiles of four multifocal contact lenses with a single vision control lens.

METHODS
Thirty-five myopes (age 21.2 ± 2.1 years) completed the trial, of whom 16 wore Air Optix Aqua and Proclear Multifocal Distance and Near (Group 1, spherical equivalent: −2.90 ± 0.95D), whereas 19 wore Air Optix Aqua, Air Optix Multifocal, and PureVision Multifocal (Group 2, spherical equivalent: −2.95 ± 0.78D). Refraction and aberration profiles with lenses were measured using the BHVI-EyeMapper with (−2.00 to −5.00D in 1.00D steps) and without (+1.00D fogging) accommodation. Data were quantified using M
2/4 (2nd and 2nd + 4th order), J
0, J
45, and higher-order aberration coefficients coma C[3, 1] and spherical aberration C[4, 0].

RESULTS
The center-distance lens exhibited a relative peripheral myopic shift in M
2/4 and J
0, positive on-axis C[4, 0], negative on-axis C[3, 1] and on-axis M
4 was less negative for accommodative demands ≤−3.00D (P < .05). Inversely, the center-near lenses showed a relative peripheral hyperopic shift in M
2/4 and J
0, negative on-axis C[4, 0], positive on-axis C[3, 1] and on-axis M
4 was more negative for demands of −2.00 and −3.00D (P < .05). Independent of lens type, relative peripheral M
4 significantly decreased during accommodation. Accounting for C[4, 0], a greater change in relative M profiles and accommodative responses was found for multifocal lenses.

CONCLUSIONS
Based on the hypothesis that myopic retinal defocus counters eye growth, center-near multifocal lenses exhibited the preferred on-axis features, i.e., producing a central myopic shift at near compared to the control. The center-distance lens exhibited preferred off-axis features, producing relative peripheral myopia, which increased further during accommodation.
Comparison of Refractive Measures of Three Autorefractors in Children and Adolescents
Authors: Xiong Shuyu , Lv Minzhi , Zou Haidong , Zhu Jianfeng , Lu Lina , Zhang Bo , Deng Junjie , Yao Chunxia , He Xiangui , Xu Xun 
Published: August 2017

SIGNIFICANCE
Our study found a good agreement between three autorefractors. Not only will readers benefit as they can now compare data measured with either device in different studies but the three devices can be used in the same study to generate one pool of data, which can be analyzed together.

PURPOSE
The present study aims to evaluate the agreement of three commonly used autorefractors in children and adolescents, and the potential for their interchangeable application in a large-scale study.

METHODS
Participants from seven schools were enrolled using cluster sampling. Refractive errors were measured using the following three autorefractors under cycloplegic conditions in random sequence: Topcon KR-8900, Nidek ARK-510A, and Huvitz HRK-7000A. Refractive errors were compared in terms of spherical equivalent refraction (SER), cylinder power, and the J
0 and J
45 by repeated-measures analysis of variance (RM-ANOVA) and Bland-Altman 95% limits of agreement (95% LoA).

RESULTS
A total of 2072 participants aged from 4 to 18 years were included. The mean ± SD and 95% LoA of the differences in SER between Topcon and Nidek, Topcon and Huvitz, and Nidek and Huvitz were 0.01 ± 0.24D (−0.46 to 0.48), −0.06 ± 0.31D (−0.66 to 0.54), and −0.07 ± 0.26D (−0.58 to 0.44), and those for the differences in cylinder power were −0.07 ± 0.26D (−0.57 to 0.44), 0.01 ± 0.32D (−0.63 to 0.64), and 0.07 ± 0.28D (−0.48 to 0.62), respectively (RM-ANOVA, P < .001). Further, the mean differences in J
0 and J
45 between each refractor pair ranged from −0.03 to 0.01, and the 95% LoA were −0.78 to 0.74, −0.79 to 0.74, and −0.73 to 0.72 for J
0 and −0.86 to 0.87, −0.86 to 0.88, and −0.83 to 0.84 for J
45, respectively.

CONCLUSIONS
Our study will allow for use of these three autorefractors interchangeably in large screening studies.
Similar Metabolic, Innate Immunity, and Adipokine Profiles in Adult and Pediatric Sepsis Versus Systemic Inflammatory Response Syndrome—A Pilot Study
Authors: Tavladaki Theonymfi , Spanaki Anna Maria , Dimitriou Helen , Kondili Efmorfia , Choulaki Christianna , Georgopoulos Dimitris , Briassoulis George 
Published: August 2017

Objectives:
To examine whether the septic profiles of heat shock protein 72, heat shock protein 90α, resistin, adiponectin, oxygen consumption, CO2 production, energy expenditure, and metabolic pattern, along with illness severity, nutritional, and inflammatory indices, differ between adult and pediatric patients compared with systemic inflammatory response syndrome and healthy controls. To evaluate whether these biomolecules may discriminate sepsis from systemic inflammatory response syndrome in adult and pediatric patients.

Design:
Prospective cohort study.

Setting:
University ICU and PICU.

Patients:
Seventy-eight adults (sepsis/23; systemic inflammatory response syndrome/23; healthy controls/33), 67 children (sepsis/18; systemic inflammatory response syndrome/23; controls/27), mechanically ventilated.

Interventions:
None.

Measurements and Main Results:
Flow cytometry determined mean fluorescence intensity for monocyte or neutrophil heat shock protein expression. Resistin, adiponectin, and extracellular heat shock proteins were measured using enzyme-linked immunosorbent assay; energy expenditure by E-COVX (GE Healthcare). Genomic DNA was extracted with PureLink Genomic DNA kit (Invitrogen, Carlsbad, CA) to detect heat shock protein 72 single nucleotide polymorphisms. Similarly, in adult and pediatric patients, Acute Physiology and Chronic Evaluation-II/Acute Physiology and Pediatric Risk of Mortality-III, Simplified Acute Physiology Score-III, C-reactive protein, lactate, and resistin were higher and myocardial contractility, monocyte heat shock protein 72, oxygen consumption, CO2 production, energy expenditure, metabolic pattern, glucose, and albumin lower in sepsis compared with systemic inflammatory response syndrome or controls (p < 0.05). For discriminating sepsis from systemic inflammatory response syndrome, resistin, extracellular heat shock protein 90α, and lactate achieved a receiver operating characteristic curve greater than 0.80 in children and greater than 0.75 in adults (p < 0.05). In both, adults and children, genotype heat shock protein 72 analysis did not disclose any diagnosis or mortality group differences regarding either rs6457452 or rs1061581 haplotypes.

Conclusions:
Sepsis presents with similar profiles in adult and pediatric patients, characterized by enhanced inflammatory hormonal response and by repressed innate immunity, metabolism, and myocardial contractility. These features early distinguish sepsis from systemic inflammatory response syndrome across all age groups.
Enteral Nutrition Practices in Critically Ill Children Requiring Noninvasive Positive Pressure Ventilation*
Authors: Leroue Matthew K. , Good Ryan J. , Skillman Heather E. , Czaja Angela S. 
Published: August 2017

Objectives:
Evaluate the practice of providing enteral nutrition in critically ill children requiring noninvasive positive pressure ventilation.

Design:
Retrospective cohort study.

Setting:
PICU within a quaternary care children’s hospital.

Patients:
PICU patients older than 30 days requiring noninvasive positive pressure ventilation for greater than or equal to 24 hours from August 2014 to June 2015. Invasive mechanical ventilation prior to noninvasive positive pressure ventilation and inability to receive enteral nutrition at baseline were additional exclusionary criteria.

Interventions:
None.

Measurements and Main Results:
The primary outcome was enteral nutrition initiation within 24 hours of admission. Secondary outcomes included time to goal enteral nutrition rate, adequacy of nutrition, adverse events (pneumonia not present at admission, intubation after enteral nutrition initiation, feeding tube misplacement), and lengths of noninvasive positive pressure ventilation and PICU stay. Among those included (n = 562), the median age was 2 years (interquartile range, 39 d to 6.8 yr), 54% had at least one chronic condition, and 43% had malnutrition at baseline. The most common primary diagnosis was bronchiolitis/viral pneumonia. The median length of time on noninvasive positive pressure ventilation was 2 days (interquartile range, 2.0–4.0). Most (83%) required continuous positive airway pressure or bi-level support during their PICU course. Sixty-four percent started enteral nutrition within 24 hours, with 72% achieving goal enteral nutrition rate within 72 hours. Forty-nine percent and 44% received an adequate cumulative calorie and protein intake, respectively, during their PICU admission. Oral feeding was the most common delivery method. On multivariable analysis, use of bi-level noninvasive positive pressure ventilation (odds ratio, 0.40; 95% CI, 0.25–0.63) and continuous dexmedetomidine (odds ratio, 0.59; 95% CI, 0.35–0.97) were independently associated with decreased likelihood of early enteral nutrition. Twelve percent of patients had at least one adverse event.

Conclusions:
A majority of patients requiring noninvasive positive pressure ventilation received enteral nutrition within 24 hours. However, less than half achieved caloric and protein goals during their PICU admission. Further investigation is warranted to determine the safety and effectiveness of early enteral nutrition in this population.
Computed Tomography Use Plateaus Among Children With Emergency Visits for Abdominal Pain
Authors: Fahimi Jahan , Kornblith Aaron E. , Kanzaria Hemal , Herring Andrew , Wang Ralph C. 
Published: August 2017

Objectives
Abdominal pain is a common pediatric complaint to emergency departments (EDs), and clinicians often rely on imaging for diagnosis. Studies have demonstrated an increase in computed tomography (CT) in this population. Following emphasis on radiation reduction by researchers and organizations, this study evaluates recent national trends in CT use among pediatric patients presenting to EDs with abdominal pain.

Methods
This is a cross-sectional analysis of ED patients 18 years or younger with chief complaint of abdominal pain in the National Hospital Ambulatory Medical Care Survey from 2008 to 2011. Outcomes include annual proportions of visits with x-ray, ultrasound, or CT, as well as diagnosis of appendicitis and hospital admission.

Results
Of 32,304 ED visits, 2120 (6.6%) were for abdominal pain. Proportions of visits using CT, ultrasound, and plain x-ray were 16.0%, 10.5%, and 23.4%, respectively. For all outcome measures, including imaging, hospital admission, and diagnosis of appendicitis, there was no change from 2008 to 2011. Considering previous data, there was a significant rise in ultrasound use from 5.4% (95% confidence interval, 2.4%–8.4%) in 1998 to 12.1% (95% confidence interval, 9.4%–13.7%) in 2011. Multivariate analysis of CT use found the strongest predictor to be increasing age. Females, black children, and those with Medicaid insurance had lower odds of having a CT.

Conclusions
In contrast to the earlier dramatic increase in CT use for pediatric patients with abdominal pain, CT remained constant between 2008 and 2011. There was no associated change in the rate of diagnosis of appendicitis or hospitalization; however, ultrasound is increasing.
Comparison of Spot Urine Protein to Creatinine Ratio to 24-Hour Proteinuria to Identify Important Change Over Time in Proteinuria in Lupus
Authors: Medina-Rosas Jorge , Su Jiandong , Cook Richard J. , Sabapathy Arthy , Touma Zahi 
Published: August 2017

Objectives
The aim of this study was to determine whether spot urine protein-to-creatinine ratio (PCR) accurately measures the change in proteinuria compared with 24-hour proteinuria (24H-P).

Methods
This was a retrospective analysis on patients’ paired visits and paired urine samples for PCR and 24H-P. Patients with both abnormal 24H-P (>0.5 g/d) and PCR (>0.05 g/mmol) or both normal 24H-P (≤0.5 g/d) and PCR (≤0.05 g/mmol) at baseline visit were identified.
The first follow-up visit with partial recovery (50% decrease in proteinuria) or complete recovery (≤0.5 g/d) was identified for those with abnormal baseline 24H-P, and new proteinuria (>0.5 g/d) was identified for those with normal 24H-P. Twenty-four-hour urine collection and PCR end-point frequencies were compared. Twenty-four-hour urine collection results were converted to 24H-PCR. Twenty-four-hour PCR and PCR were utilized to measure the magnitude of change (by standardized response mean [SRM]) in patients who achieved the end points.

Results
Of 230 patients, at baseline, 95 patients had abnormal and 109 had normal 24H-P and PCR. On follow-up, 57 achieved partial recovery, and 53 achieved complete recovery by 24H-P. Standardized response mean was −1.03 and −1.10 for 24H-PCR and PCR, respectively. By PCR, 53 patients had partial recovery, and 27 had complete recovery. Standardized response mean was −1.25 and −0.86 by 24H-PCR and PCR, respectively.
For new proteinuria, 28 patients were identified by 24H-P and 21 by PCR. Twenty-four-hour PCR SRM was 0.80, and PCR SRM was 0.68.

Conclusions
Protein-to-creatinine ratio does not have sufficient accuracy compared with 24H-P for improvement and worsening to be used in lieu of 24H-P.
Strategies for Reducing Population Surgical Costs in Medicare
Authors: Nathan Hari , Thumma Jyothi R. , Norton Edward C. , Dimick Justin B. 
Published: August 2017

Objective:
We sought to assess hospital cost variation for elective inpatient surgical procedures within small geographic areas.

Summary Background Data:
Previous studies have documented cost variation for inpatient surgical procedures on a national basis, suggesting opportunities for savings. Cost variation within small geographic areas is more relevant to policymakers, providers, and patients, but it has not been studied.

Methods:
Using Medicare payment data, we identified elderly patients undergoing 1 of 7 elective inpatient surgical procedures during 2010–2012. We calculated 30-day surgical episode costs including payments for the index hospitalization, readmission, physician services, and post-acute care. Using hierarchical regression models, we identified hospitals with significantly higher average costs than the least expensive hospitals in their metropolitan statistical areas.

Results:
The proportion of patients undergoing surgery at the lowest-cost hospitals in their metropolitan statistical areas ranged from 10% for hip replacement to 25% for coronary artery bypass grafting. In contrast, the proportion of patients undergoing surgery at significantly higher-cost hospitals ranged from 5.0% for bariatric surgery to 64% for hip replacement. These high-cost hospitals had higher complication and readmission rates than their lowest-cost peers. Surgery at high-cost hospitals resulted in Medicare expenditures that were $4427 to $10,417 higher than those at the lowest-cost hospitals, increasing episode costs by 25% to 47% per case.

Conclusions:
Significant excess expenditures are incurred due to care at hospitals with substantially higher average costs than their nearby peers. This finding highlights the potential for substantial savings without the need to refer patients over long distances. Some of the procedures studied may represent appropriate targets for future Medicare bundled payment initiatives.
Faculty Development for the Operating Room
Authors: Gardner Aimee K. , Timberlake Matthew D. , Dunkin Brian J. 
Published: August 2017

Objective:
We describe a half-day faculty development course designed to equip surgical educators with evidence-based teaching frameworks shown to promote learning in the operating room (OR). We hypothesize that participating faculty will deliver improved instruction as perceived by residents.

Methods:
Residents anonymously rated faculty teaching behaviors among whom they had recently worked in the OR (minimum 3 cases in preceding 6 months) using the Briefing - Intraoperative teaching - Debriefing Assessment Tool (BIDAT; 1 = never, 5 = always). Faculty then attended a half-day course. The curriculum was based on the “briefing-intraoperative teaching-debriefing” framework. Discussion and practice centered on goal setting, performance-enhancing instruction, dual task interference, and feedback. After the course, residents again evaluated the faculty. Paired-samples and independent-samples t tests were used to analyze pre and post course changes and differences between groups, respectively.

Results:
Nineteen faculty completed the course. Associate professors (N = 4) demonstrated improved briefing (4.32 ± 0.48 → 4.76 ± 0.45, P < 0.01), debriefing (4.30 ± 0.29 → 4.77 ± 0.43, P < 0.01), and total teaching (4.38 ± 0.78 → 4.79 ± 0.39, P < 0.05). No significant changes were observed among assistant (N = 9) or full professors (N = 6). All 3 faculty members who served as course co-instructors, regardless of rank, improved significantly in briefing (4.42 ± 0.22 → 4.98 ± 0.29, P < 0.05), debriefing (4.27 ± 0.23 → 4.98 ± 0.29, P < 0.04), and total teaching (4.37 ± 0.21 → 4.99 ± 0.02, P < 0.05). Faculty with baseline teaching scores in the bottom quartile improved teaching behaviors in all phases of instruction (P < 0.05). Teaching scores over the same period did not change among faculty who did not attend.

Conclusions:
A half-day course aimed at enhancing intraoperative instruction can contribute to resident-perceived improvement in structured teaching behavior among participating faculty. Initiatives directed at intraoperative instruction might be best targeted towards midlevel faculty with established technical expertise who are motivated to expand teaching efforts and those who have low levels of baseline teaching scores.
Perioperative Use of Erythromycin Reduces Cognitive Decline After Coronary Artery Bypass Grafting Surgery: A Pilot Study
Authors: Thomaidou Evanthia , Argiriadou Helena , Vretzakis Georgios , Megari Kalliopi , Taskos Nikolaos , Chatzigeorgiou Georgios , Anastasiadis Kyriakos 
Published: August 2017

Objectives
Adverse neurologic outcome can be a debilitating complication after cardiac surgery. The aim of this study was to investigate the potential neuroprotective action of erythromycin, a well known antibiotic agent, regarding postoperative cognitive decline in patients undergoing cardiac surgery.

Methods
Forty patients scheduled for elective coronary artery bypass grafting surgery were prospectively randomly assigned in 2 groups: the erythromycin group (n = 19) who received erythromycin at a dose of 25 mg/kg before and after surgery and the control group (n = 21) who did not receive it. All patients were monitored with near-infrared spectroscopy during the operation. Interleukin (IL) 1 and IL-6 as inflammatory markers and tau protein as a marker of brain injury were measured before and after surgery. Neurocognitive assessment was performed before surgery, on the day of discharge, and at 3 months postoperatively.

Results
Both groups were comparable in terms of demographic and clinical data. Patients who took erythromycin presented with significantly better cognitive performance before discharge and 3 months after surgery. No significant differences between the 2 groups referring to IL-1 and IL-6 values were detected. Tau serum values were lower in the erythromycin group after surgery.

Conclusions
Erythromycin administration attenuates cerebral damage and postoperative cognitive decline after coronary artery bypass grafting surgery.

Trial registration
The study was retrospectively registered at ClinicalTrials.gov (NCT01274754). Study start day: November 2008.
Curatr: a web application for creating, curating, and sharing a mass spectral library
Authors: Palmer Andrew , Phapale Prasad , Fay Dominik , Alexandrov Theodore 
Published: August 2017

AbstractMotivationIdentification from metabolomics mass spectrometry experiments requires comparison of fragmentation spectra from experimental samples to spectra from analytical standards. As the quality of identification depends directly on the quality of the reference spectra, manual curation is routine during the selection of reference spectra to include in a spectral library. Whilst building our own in-house spectral library we realised that there is currently no vendor neutral open access tool for for facilitating manual curation of spectra from raw LC-MS data into a custom spectral library.ResultsWe developed a web applicationcuratrfor the rapid generation of high quality mass spectral fragmentation libraries for liquid-chromatography mass spectrometry analysis. Curatr handles datasets from single or multiplexed standards, automatically extracting chromatographic profiles and potential fragmentation spectra for multiple adducts. These are presented through an intuitive interface for manual curation before being documented in a custom spectral library. Searchable molecular information and the providence of each standard is stored along with metadata on the experimental protocol. Curatr support the export of spectral libraries in several standard formats for easy use with third party software or submission to community databases, maximising the return on investment for these costly measurements. We demonstrate the use of curatr to generate the EMBL Metabolomics Core Facility spectral library which is publicly available athttp://curatr.mcf.embl.de.AvailabilityThe source code is freely available athttp://github.com/alexandrovteam/curatr/along with example data.Supplementary informationA step-by step user manual is available in the supplementary information
Quantifying the thermostability landscape separating plant sesquiterpene synthase orthologs using Maximum Entropy
Authors: Nartey Charisse M. , Aljadeff Johnatan , Fernandez Irma , Laurendon Caroline , Koo Hyun Jo , O’Maille Paul E. , Sharpee Tatyana O. , Noel Joseph P. 
Published: August 2017

AbstractAs global temperatures rise due to climate change, crops are becoming increasingly vulnerable to failure. We tested the accessibility of thermodynamic phenotypic diversity within limited positional changes using 29=512 mutants of a terpene synthase (TPS), Tobacco 5-epi-Aristolchene synthase. First, we measured the thermal unfolding curves of each mutant and found that mutations shifted the Tms both higher and lower, including a cohort of mutants that failed to fold. The low correlation coefficient between the Tms of these mutants and the proportions of each terpene product output by the enzymes revealed that thermostability and product output are independent traits. Maximum Noise Entropy analyses were used to analyze the impact of the 9 mutational positions on thermostability, revealing that three of these positions were mainly responsible for the trait of increased Tm. These positions form a functional network as measured by the nonlinearity of their combined effects on thermostability. Unexpectedly, the strongly destabilizing positions combine nonlinearly to ameliorate each other’s deleterious effects resulting in a synergistic dampening. Taken together, our study shows the high potential for specialized metabolic enzyme engineering but also reveals a complex interconnected system of amino acids that will continue to evade perfect predictability.