bluuebunny/crossref_metadata_2025_split huggingface dataset:
In Vivo Measurement of Longitudinal Chromatic Aberration in Patients Implanted With Trifocal Diffractive Intraocular Lenses
Authors: Vinas Maria , Gonzalez-Ramos Ana , Dorronsoro Carlos , Akondi Vyas , Garzon Nuria , Poyales Francisco , Marcos Susana 
Published: November 2017

PURPOSE:
To measure the longitudinal chromatic aberration (LCA) by both psychophysical methods and in vivo double-pass retinal imaging in patients bilaterally implanted with trifocal diffractive intraocular lenses (IOLs).

METHODS:
Measurements were performed with a polychromatic adaptive optics system provided with a supercontinuum laser, a Hartmann-Shack wavefront sensor, a deformable mirror, a motorized Badal system, a pupil monitoring system, a double-pass retinal imaging channel, and a psychophysical channel with monochromatically illuminated stimuli. Ten patients (20 eyes) bilaterally implanted with hydrophilic trifocal diffractive IOLs (POD F [FINeVision]; PhysIOL, Liege, Belgium) participated in the study. Measurements were performed in both eyes at three different viewing distances (0.00, +1.75, and +3.50 diopters [D]). Subjective best focus of monochromatic stimuli at five wavelengths (480 to 700 nm) was obtained using the Badal system. Best focused images of through-focus double-pass image series were obtained at three wavelengths (480 to 700 nm). LCA was computed from chromatic difference of focus curves (objective and subjective) as the difference between 480 and 700 nm at near, intermediate, and far.

RESULTS:
The average subjective LCA was 0.82 ± 0.05 D for far, 0.27 ± 0.15 D for intermediate, and 0.15 ± 0.15 D for near. The average objective LCA was 0.72 ± 0.10 D for far, 0.19 ± 0.15 D for intermediate, and 0.07 ± 0.17 D for near.

CONCLUSIONS:
Objective LCA was lower than subjective LCA, which was in agreement with previous studies on patients with phakic and monofocal IOLs. In vivo measurements of LCA enable understanding of the relative contribution of refractive and diffractive LCA and will eventually optimize IOL designs to improve polychromatic image quality.

[
J Refract Surg.
2017;33(11):736–742.]
Risk Factors for Opaque Bubble Layer in Small Incision Lenticule Extraction (SMILE)
Authors: Li Liuyang , Schallhorn Julie M. , Ma Jiaonan , Zhang Lin , Dou Rui , Wang Yan 
Published: November 2017

PURPOSE:
To assess the independent effect of myopia and astigmatism on the risk of the occurrence of opaque bubble layer (OBL) in small incision lenticule extraction (SMILE) and further investigate the relationship between scanning depth and OBL.

METHODS:
Twenty-two cases and 317 controls were included in a case–control study from the database of Tianjin Eye Hospital from April 2015 to July 2016. Baseline characteristics were recorded and all of the eyes were manually reviewed by two different observers masked to preoperative refractive status. Multiple regression analysis was used to assess the independent relationship between the attempted correction in diopters and the risk of OBL and to further analyze the association between scanning depth and the risk.

RESULTS:

The risk of OBL significantly decreased with increasing myopia (diopters) (odds ratio [OR] = 0.44; 95% confidence interval [CI]: 0.30 to 0.64;
P
< .0001). The risk of OBL also significantly decreased with increasing astigmatism (diopters) (OR = 0.10; 95% CI: 0.02 to 0.42;
P
= .0017). Lenticular thickness changed by 14.86
μ
m per diopter for myopia (β =14.86; 95% CI = 14.56 to 15.15;
P
< .0001) and 15.10
μ
m per diopter for astigmatism (β = 15.10; 95% CI = 13.96 to 16.24;
P
< .0001), respectively.

CONCLUSIONS:
A low correction was a significant independent risk factor for OBL during SMILE and the effect of astigmatism on OBL was greater than that of myopia. Deepening the photodisruption plane appropriately may reduce the risk of OBL.

[
J Refract Surg.
2017;33(11):759–764.]
Assessing the Likely Effect of Posterior Corneal Curvature on Toric IOL Calculation for IOLs of 2.50 D or Greater Cylinder Power
Authors: LaHood Benjamin R. , Goggin Michael , Esterman Adrian 
Published: November 2017

PURPOSE:
To establish whether average refractive overcorrection or undercorrection of corneal astigmatism based on the orientation (rule) of the astigmatism occurs if toric intraocular lenses (IOLs) are calculated on the basis of anterior corneal measurements in eyes requiring toric IOL cylinder power of 2.50 diopters (D) or greater.

METHODS:
One hundred thirteen consecutive eyes with anterior corneal keratometric astigmatism requiring IOL cylinder power of 2.50 D or greater underwent phacoemulsification with IOL powers calculated using anterior corneal curvature data alone. Eyes were grouped as either “with-the-rule” (WTR) or “against-the-rule” (ATR) on the basis of the steep anterior corneal meridian. Targeted and achieved astigmatic outcomes were compared. The main outcome measure was the postoperative refractive astigmatic prediction error.

RESULTS:

A mean overcorrection occurred in anterior WTR eyes of 0.16 ± 0.57 D and a mean undercorrection of ATR eyes of −0.14 ± 0.53 D. These were significantly different from the ideal value of zero (WTR:
P
= .04, ATR:
P
= .05). Although statistically significant, the effect sizes of these prediction errors were 0.40 for WTR and 0.36 for ATR and the error values fell below a clinically significant value of 0.25 D.

CONCLUSIONS:
In eyes requiring toric IOLs of cylinder power 2.50 D or greater, an overcorrection occurs in anterior WTR eyes and an undercorrection in ATR eyes. This probable posterior corneal astigmatism effect is not clinically significant. IOL cylinder powers are sufficiently accurately calculated using unadjusted anterior keratometry values in these eyes.

[
J Refract Surg.
2017;33(11):730–734.]
Health Literacy Universal Precautions Are Still a Distant Dream: Analysis of U.S. Data on Health Literate Practices
Authors: Liang Lan , Brach Cindy 
Published: November 2017

Background:
Experts have recommended the adoption of health literacy universal precautions, whereby health care providers make all health information easier to understand, confirm everyone's comprehension, and reduce the difficulty of health-related tasks. The U.S. Department of Health and Human Services selected three health literate practices to track progress in the adoption of health literacy universal precautions.

Objectives:
This study sought to examine whether there has been an increase in the delivery of health literate care and whether recommendations for health literacy universal precautions are being followed.

Methods:
This study used trend and multiple regression analyses of data from 2011 to 2014 from the Medical Expenditure Panel Survey, a national household survey.

Key Results:
The proportion of adults in the U.S. who reported receiving health literate care increased from 2011 to 2014, but fell far short of health literacy universal precautions recommendations of delivering health literate care to everyone. In 2014, 70% of the population reported their providers always gave them instructions that were easy to understand, but only 29% were asked to Teach-Back the instructions and only 17% were offered help with forms. Older, less educated, and racial and ethnic minority group members were more likely to report receiving health literate care than more advantaged groups. People who perceived their health and mental health as fair or poor were less likely to report receiving health literate care.

Conclusions:

Failure to adopt health literacy universal precautions in the face of the high prevalence of limited health literacy in the general population may perpetuate adverse health outcomes that are costly to society. Greater efforts should be made to increase providers' health literacy skills, particularly those who serve populations that are more likely to have limited health literacy, including those with poor health.

[
Health Literacy Research and Practice
. 2017;1(4):e216–e230.]

Plain Language Summary:
This study shows that some health care providers did not always check that their instructions were clear enough for patients to understand. Even fewer providers always offered help in filling out forms. People who were older, less educated, or members of racial or ethnic minority groups were more likely to be asked to confirm their understanding or be offered help with forms. More patients said that their provider was easy to understand, checked their understanding, or offered help with forms in 2014 than in 2011.
Hip Strength as a Predictor of Ankle Sprains in Male Soccer Players: A Prospective Study
Authors: Powers Christopher M. , Ghoddosi Navid , Straub Rachel K. , Khayambashi Khalil 
Published: November 2017

Context:
Diminished hip-abductor strength has been suggested to increase the risk of noncontact lateral ankle sprains.

Objective:
To determine prospectively whether baseline hip-abductor strength predicts future noncontact lateral ankle sprains in competitive male soccer players.

Design:
Prospective cohort study.

Setting:
Athletic training facilities and various athletic fields.

Patients or Other Participants:
Two hundred ten competitive male soccer players.

Main Outcome Measure(s):
Before the start of the sport season, isometric hip-abductor strength was measured bilaterally using a handheld dynamometer. Any previous history of ankle sprain, body mass index, age, height, and weight were documented. During the sport season (30 weeks), ankle injury status was recorded by team medical providers. Injured athletes were further classified based on the mechanism of injury. Only data from injured athletes who sustained noncontact lateral ankle sprains were used for analysis. Postseason, logistic regression was used to determine whether baseline hip strength predicted future noncontact lateral ankle sprains. A receiver operating characteristic curve was constructed for hip strength to determine the cutoff value for distinguishing between high-risk and low-risk outcomes.

Results:
A total of 25 noncontact lateral ankle sprains were confirmed, for an overall annual incidence of 11.9%. Baseline hip-abductor strength was lower in injured players than in uninjured players (P = .008). Logistic regression indicated that impaired hip-abductor strength increased the future injury risk (odds ratio = 1.10 [95% confidence interval = 1.02, 1.18], P = .010). The strength cutoff to define high risk was ≤33.8% body weight, as determined by receiver operating characteristic curve analysis. For athletes classified as high risk, the probability of injury increased from 11.9% to 26.7%.

Conclusions:
Reduced isometric hip-abductor strength predisposed competitive male soccer players to noncontact lateral ankle sprains.
Serum Concentrations of F2-Isoprostanes and 4-Hydroxynonenal in Hemodialysis Patients in Relation to Inflammation and Renal Anemia
Authors: Wiswedel Ingrid , Peter Daniela , Gardemann Andreas , Carluccio Francesco , Hampl Hannelore , Siems Werner 
Published: November 2017

BackgroundPatients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) are apparently exposed to enhanced oxidative stress and to inflammation. It was the aim of this study to characterize the state of systemic oxidative stress of ESRD patients before and following HD using highly specific biomarkers, F2-isoprostanes and 4-hydroxynonenal (HNE). Furthermore the question should be answered, if there are associations between inflammation and systemic oxidative stress and/or between systemic oxidative stress and renal anemia, which is more or less typical for HD patients.Patients and methodsConcentrations of F2-isoprostanes, HNE, C-reactive protein (CRP) as marker of inflammation, and hemoglobin were measured in serum samples of patients with ESRD before and after HD and of healthy control persons for comparison. Total (esterified plus free) F2-isoprostanes were quantified by highly sensitive gas chromatography/mass spectrometry technique, HNE by thin layer chromatography and HPLC/UV detection, CRP by immunoturbidimetry and hemoglobin by clinico-chemical routine assay.Results1. HD patients showed significantly higher serum concentrations of F2-isoprostanes and HNE than healthy human control subjects. 2. Total (esterified plus free) F2-isoprostane levels before HD were not significantly different from those after HD, whereas HNE levels were significantly decreased in patients after HD. 3. F2-isoprostane concentrations in HD patients correlated with the levels of CRP, whereas HNE concentrations inversely correlated with the content of hemoglobin.ConclusionBoth, F2-isoprostanes and HNE serum concentrations are useful oxidative stress parameters in ESRD patients undergoing HD. Whereas HNE strongly correlates with the severity of renal anemia, leading to left heart insufficiency, F2-isoprostanes (sum of free plus esterified) highly correlate with the degree of inflammation.
Excision Repair Cross-Complementation Group 1 Enzyme as a Molecular Determinant of Responsiveness to Platinum-Based Chemotherapy for non Small-Cell Lung Cancer
Authors: Mountzios Giannis , Dimopoulos Meletios-Athanasios , Papadimitriou Christos 
Published: November 2017

Although platinum-based chemotherapy remains the “standard” in advanced non small-cell lung cancer, not all patients derive clinical benefit from such a treatment. Hence, the development of predictive biomarkers able to identify lung cancer patients who are most likely to benefit from cisplatin-based chemotherapy has become a scientific priority. Among the molecular pathways involved in DNA damage control after chemotherapy, the nucleotide excision repair (NER) is a critical process for the repair of DNA damage caused by cisplatin-induced DNA adducts. Many reports have explored the role of the excision repair cross-complementation group 1 enzyme (ERCC1) expression in the repair mechanism of cisplatin-induced DNA adducts in cancer cells. Using immunohistochemistry in resected tumors from patients included in the International Adjuvant Lung Cancer Trial, the study of important biomarkers showed that high ERCC1 protein expression was associated with improved survival in chemo-naïve patients. On the contrary, the benefit of adjuvant cisplatin-based chemotherapy was more profound in patients with low ERCC1 expression. In a prospective cohort studying mRNA expression in tumor biopsies from patients receiving customized therapy with cisplatin and gemcitabine depending on the molecular profile of the tumour, results showed that patients with low ERCC1 mRNA expression had a longer median survival compared to those with high expression. These data suggest the potent use of ERCC1 as a molecular predictor of clinical resistance to platinum-based chemotherapy in the adjuvant setting of NSCLC. Nevertheless, optimization of methodology, including standardization of technical procedures, as well as validation of ERCC1 protein expression in large prospective cohorts, seem necessary before any routine immunohistochemical validation of ERCC1 can be implemented in daily practice.
Serum and Ascitic Fluid Superoxide Dismutase and Malondialdehyde Levels in Patients with Cirrhosis
Authors: Ozenirler Seren , Sancak Banu , Coskun Ugur 
Published: November 2017

Serum and ascitic fluid superoxide dismutase (SOD) and malondialdehyde (MDA) levels were measured in 43 patients with cirrhosis and in a 10 healthy control group. Compensated cirrhotic patients had no clinically detectable ascites, but decompensated patients had massive ascites. Cirrhotic patients were divided into three groups: patients with compensated cirrhosis (n = 16), patients with decompensated cirrhosis with Spontaneous bacterial peritonitis (SBP) (n = 14), and patients with decompensated cirrhosis without SBP (n = 13). All cirrhotic patients in the experimental group had significantly higher serum SOD (p < 0.001) and MDA levels (p < 0.01) than those in the control group. There were no significant differences with respect to serum SOD and MDA levels among the three different groups of patients. There was no remarkable difference in ascitic fluid SOD and MDA levels between decompensated cirrhotic patients with and without SBP (p > 0.05). These results suggest that the increase in serum SOD and MDA levels are not related to the presence of SBP and the status of liver cirrhosis. To sum up, clarifying the impact of increased serum SOD and MDA levels in cirrhotic patients needs further investigation.
Comparison of the Calibration Standards of Three Commercially Available Multiplex Kits for Human Cytokine Measurement to WHO Standards Reveals Striking Differences
Authors: Nechansky Andreas , Grunt Susanne , Roitt Ivan M. , Kircheis Ralf 
Published: November 2017

Serum parameters as indicators for the efficacy of therapeutic drugs are currently in the focus of intensive research. The induction of certain cytokines (or cytokine patterns) is known to be related to the status of the immune response e.g. in regulating the TH1/TH2 balance. Regarding their potential value as surrogate parameters in clinical trials and subsequently for the assignment of treatment efficacy, the accurate and reliable determination of cytokines in patient serum is mandatory. Because serum samples are precious and limited, test methods–-like the xMAP multiplex technology–-that allow for the simultaneous determination of a variety of cytokines from only a small sample aliquot, can offer great advantages. We here have compared multiplex kits from three different manufactures and found striking differences upon standardizing using WHO standards for selected cytokines. We therefore extended our xMAP multiplex measurements investigations to an ex-vivo situation by testing serum samples and found that the cytokine amounts measured was critically influenced by the actual kit used. The presented data indicate that statements regarding the quantitive determination of cytokines–-and therefore their use as biomarkers–-in serum samples have to be interpreted with caution.
Tracking Differential Gene Expression in MRL/MpJ versus C57BL/6 Anergic B Cells: Molecular Markers of Autoimmunity
Authors: Clark Amy G. , Mackin Katherine M. , Foster Mary H. 
Published: November 2017

BackgroundAnergy is a key mechanism controlling expression of autoreactive B cells and a major site for failed regulation in autoimmune diseases. Yet the molecular basis for this differentiated cell state remains poorly understood. The current lack of well-characterized surface or molecular markers hinders the isolation of anergic cells for further study. Global gene profiling recently identified transcripts whose expression differentiates anergic from naïve B cells in model mouse systems. The objective of the current study was to evaluate the molecular and cellular processes that differentiate anergic cells that develop in the healthy C57BL/6 (B6) milieu from those that develop in the autoimmune-prone MRL/MpJ (MRL) background. This approach takes advantage of B6 and MRL mice bearing an anti-laminin Ig transgene with a well characterized anergic B cell phenotype.ResultsGlobal gene expression was evaluated in purified transgenic B cells using Operon version 3.0 oligonucleotide microarray assaying > 31,000 oligoprobes. Genes with a 2-fold expression difference in B6 as compared to MRL anergic B cells were identified. Expression of selected genes was confirmed using quantitative RT-PCR. This approach identified 43 probes corresponding to 37 characterized genes, including Ptpn22, CD74, Birc1f/Naip, and Ctla4, as differentially expressed in anergic B cells in the two strains. Gene Ontology classification identified differentiation, cell cycle, proliferation, development, apoptosis, and cell death as prominently represented ontology groups. Ingenuity Pathway Analysis identified two major networks incorporating 27 qualifying genes. Network 1 centers on beta-estradiol and TP53, and Network 2 encompasses RB1, p38 MAPK, and NFkB cell growth, proliferation, and cell cycle signaling pathways.ConclusionUsing microarray analysis we identified 37 characterized genes and two functional pathways engaged in maintenance of B cell anergy for which expression is distorted by underlying autoimmune genetic susceptibility. This approach identifes a new biological role for multiple genes and potential new therapeutic targets in autoimmunity.
Competency Assessment in Family Medicine Residency: Observations, Knowledge-Based Examinations, and Advancement
Authors: Mainous Arch G. , Fang Bo , Peterson Lars E. 
Published: November 2017

ABSTRACT

Background
The Family Medicine (FM) Milestones are competency-based assessments of residents in key dimensions relevant to practice in the specialty. Residency programs use the milestones in semiannual reviews of resident performance from the time of entry into the program to graduation.

Objective
Using a national sample, we investigated the relationship of FM competency-based assessments to resident progress and the complementarity of milestones with knowledge-based assessments in FM residencies.

Methods
We used midyear and end-of-year milestone ratings for all FM residents in Accreditation Council for Graduate Medical Education–accredited programs during academic years 2014–2015 and 2015–2016. The milestones contain 22 items across 6 competencies. We created a summative index across the milestones. The American Board of Family Medicine database provided resident demographics and in-training examination (ITE) scores. We linked information to the milestone data.

Results
The sample encompassed 6630 FM residents. The summative milestone index increased, on average, for each cohort (postgraduate year 1 [PGY-1] to PGY-2 and PGY-2 to PGY-3) at each assessment. The correlation between the milestone index that excluded the medical knowledge milestone and ITE scores was r = .195 (P &lt; .001) for PGY-1 to PGY-2 cohort and r = .254 (P &lt; .001) for PGY-2 to PGY-3 cohort. For both cohorts, ITE scores and composite milestone assessments were higher for residents who advanced than for those who did not.

Conclusions
Competency-based assessment using the milestones for FM residents seems to be a viable multidimensional tool to assess the successful progression of residents.
La enseñanza del Derecho en aulas masivas. El caso de una Facultad de Derecho argentina.
Authors: Gapel Redcozub Guillermo 
Published: November 2017

<p>Este trabajo analiza el efecto de la masificación de la matrícula sobre las prácticas docentes en una Facultad de Derecho perteneciente a una Universidad Pública argentina. Describe el contexto general del fenómeno y detalla sus principales consecuencias sobre las prácticas áulicas. Luego reflexiona sobre el proceso enseñanza-aprendizaje en la Facultad de Derecho en su estado actual, caracterizando la perspectiva epistemológica subyacente, la teoría del aprendizaje implícita, el enfoque didáctico predominante y el plan de estudios de la carrera. A continuación, evalúa el efecto de la universalización del acceso a la educación superior sobre el proyecto educativo de la institución. Concluye ofreciendo una propuesta alternativa para alcanzar los objetivos educativos institucionales en un contexto de masificación.</p><p> </p>