bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elemental Composition at Silicone Hydrogel Contact Lens Surfaces
Authors: Rex Jessica , Knowles Timothy , Zhao Xueying , Lemp Jessie , Maissa Cecile , Perry Scott S. 
Published: January 2018

Objectives:
The outermost surface composition of 11 silicone hydrogel (SiHy) lenses was measured using X-ray photoelectron spectroscopy (XPS) to understand differences in wettability and potential interactions within an ocular environment. The SiHy lenses tested included balafilcon A, lotrafilcon A, lotrafilcon B, senofilcon A, comfilcon A, and somofilcon A reusable 2-week or monthly replacement lenses and delefilcon A, samfilcon A, narafilcon A, stenfilcon A, and somofilcon A daily disposable lenses.

Methods:
All lenses were soaked for 24 hr in phosphate-buffered saline to remove all packaging solution and dried under vacuum overnight before analysis. X-ray photoelectron spectroscopy measurements were performed at 2 take-off angles, 55° and 75°, to evaluate changes in elemental composition as a function of depth from the surface.

Results:
Detailed analysis of the XPS data revealed distinct differences in the chemical makeup of the different lens types. For all lenses, carbon, oxygen, and nitrogen were observed in varying quantities. In addition, fluorine was detected at the outermost surface region of comfilcon A (3.4%) and lotrafilcon A and B (<0.5%). The silicon content of the near-surface region analyzed varied among lens types, ranging from a low of 1.6% (lotrafilcon B) to a high of 16.5% (comfilcon A). In most instances, silicon enrichment at the outermost surface was observed, resulting from differences in lens formulation and design.

Conclusions:
Lenses differed most in their surface silicon concentration, with lotrafilcon B and delefilcon A exhibiting the lowest silicon contents and comfilcon A lens exhibiting the highest. Silicon has hydrophobic properties, which, when found at the surface, may influence the wettability of the contact lenses and their interaction with the tear film and ocular tissues. Higher surface silicon contents have been previously correlated with adverse effects, such as enhanced lipid uptake, thus underscoring the importance of monitoring their presence.
Atopy in Patients With Ocular Cicatricial Pemphigoid
Authors: Ebrahimiadib Nazanin , Hernandez Mikhail , Modjtahedi Bobeck S. , Roohipoor C. Ramak , Foster C. Stephen 
Published: January 2018

Purpose:
To evaluate the presence of atopy in patients with ocular cicatricial pemphigoid (OCP).

Method:
Patient encounters between August 2005 and November 2016 at the Massachusetts Eye Research and Surgery Institute (MERSI) were searched to identify those with biopsy-proven OCP who had concurrent evidence of atopy.

Results:
There were 230 patients with biopsy-proven OCP. Thirty-three of them were found to have clinical symptoms of atopy (asthma, hay fever, and eczema) and of these, 23 had evidence of atopy in their conjunctival biopsy specimens. All patients were administered immunomodulatory therapy for treatment of their OCP with 20 patients requiring additional antiallergy treatment to control residual atopic ocular symptoms. Among patients who used antiallergy medications, 80% showed improvement in residual symptoms. Rituximab and/or intravenous immunoglobulin is a preferred OCP medication for patients with OCP with some evidence of atopy.

Conclusions:
Clinicians should consider the coexistence of atopy in patients with OCP, especially in those with persistent symptoms after initiation of immunomodulatory therapy.
Association of Involutional Lower Eyelid Entropion with Reduced Upper Eyelid Position Relative to the Corneal Light Reflex: Quantification of Facial Asymmetry
Authors: Phelps Paul O. , Wladis Edward J. , Meyer Dale R. 
Published: January 2018

Purpose:
To investigate the association between upper eyelid position relative to the corneal light reflex (MRD1) and to delineate an association between eyelid height and involutional lower eyelid entropion.

Methods:
Retrospective study of patients presenting for entropion repair to an academic ophthalmic plastic surgery service. A total of 111 patients were included in the study; 95 had unilateral involutional lower eyelid entropion, and 16 had bilateral lower eyelid entropion. Patients with a history of previous eyelid surgery, trauma, upper eyelid entropion, or cicatricial changes were excluded from the study.

Results:
Of the 95 patients with unilateral involutional lower eyelid entropion, 45 (47.4%) had a lesser MRD1 on the side ipsilateral to the involutional lower eyelid entropion. In this unilateral group, the mean MRD1 (± standard deviation) on the ipsilateral to the involutional lower eyelid entropion was 2.9 (±1.2) mm, while the mean MRD1 on the contralateral side was 3.3 (±1.0) mm. This difference was 0.4 mm and was statistically significant (p < 0.0001). Most patients with unilateral involutional entropion demonstrated a right-sided involutional lower eyelid entropion (56 of 95; 58.9%), although this finding was not statistically significant (p = 0.083). The frequency of true blepharoptosis (MRD1 ≤ 2.0 mm) was 24 of 95 (25.3%) in the unilateral involutional entropion group and was even higher in the bilateral involutional lower eyelid entropion group, with 7 of 16 (43.8%) patients exhibiting bilateral blepharoptosis.

Conclusions:
Patients presenting with involutional lower eyelid entropion tend to have a relatively reduced MRD1 on the ipsilateral (affected) side. When both lower eyelids are affected by involutional entropion, the reduced MRD1 tends to be more pronounced.
A Clinical Amalgam
Authors: Lacy Mark , Fuller Audra , Radhi Saba , Warraich Irfan 
Published: January 2018

Abstract
Infectious disease specialists are frequently called to investigate fever of unknown origin, the etiology attributed to noninfectious causes more than half the time. This reports a fever of unknown origin case of intravascular large B-cell lymphoma and secondary hemophagocytic lymphohistoiocytosis despite a negative lymph node pathology result and a myriad of investigations.
Foot Osteomyelitis in Patients Without Diabetes
Authors: Mitbander Urvashi , Musher Daniel , Mindru Cezarina , Barshes Neal R. 
Published: January 2018

Background
Virtually all studies describing osteomyelitis of the foot have confined themselves to patients with diabetes mellitus. Although much less common, infection of bones in the feet does occur in patients without diabetes. We characterized episodes of foot osteomyelitis occurring in patients without diabetes to help guide clinical management.

Methods
Patients treated for probable or definite osteomyelitis at the Michael E. DeBakey Veterans Affairs Medical Center from January 2011 to March 2015 were included in this study. We reviewed patient and infection characteristics, treatments, and outcomes. Nonparametric analyses were used for comparisons.

Results
A total of 184 episodes of foot osteomyelitis met inclusion criteria: 20 in patients without diabetes and 164 in patients with diabetes. Patients without diabetes were older, thinner, had better renal function, and a stronger history of cigarette smoking (P < 0.05 for all comparisons). There were no significant differences in the proportion of patients presenting with various local or systemic signs of infection. Most episodes were polymicrobial (61% overall) and occurred in the toes (85% overall), and the metatarsals were less commonly affected in patients without diabetes (10% vs 38%, P = 0.01). The proportion of episodes with various isolates identified did not differ significantly. The rate of treatment failure was similar in both groups, but 1-year mortality was greater among nondiabetics (P = 0.002).

Conclusions
Patients without diabetes who develop foot osteomyelitis are older and have a much poorer short-term survival, but the presentation and microbiology of foot osteomyelitis occurring in patients without diabetes are largely similar to that occurring in patients with diabetes.
Incidence, Etiology, and Clinicopathologic Features of Endobronchial Benign Lesions
Authors: Marchioni Alessandro , Casalini Eleonora , Andreani Alessandro , Cappiello Gaia , Castaniere Ivana , Fantini Riccardo , Cecilia Mengoli Maria , Tonelli Roberto , Clini Enrico M. , Rossi Giulio 
Published: January 2018

Background:
Airways can be affected by non-neoplastic lesions leading to critical stenosis of the lumen. Incidence, etiology, and clinical significance of endobronchial benign lesions are not systematically characterized.
This study aimed to assess the epidemiology of nonmalignant processes involving the bronchial tree on clinical, pathologic, endoscopic, and radiologic grounds.

Methods:
We retrospectively analyzed bronchoscopy procedures over 10 years at the Bronchoscopy Unit of Modena University Hospital. All the endoscopically growing benign lesions with histologic confirmation were considered. For each lesion, we evaluated demographics, clinical features and outcome, the endoscopic aspect and radiologic characteristics by means of computed tomography as assessed by 2 experienced radiologists blinded with regard to the diagnosis.

Results:
Over the study period, we analyzed 10,431 bronchoscopies and identified 2075 cases of tracheobronchial alterations. Among these, 11.2% had a benign etiology with an average annual incidence of 23 new cases/year and a general incidence of 2.2%. Anthrachosis was the most prevalent bronchial lesion. In total, 22% of benign lesions presented airway stenosis >50% and required bronchoscopic treatment. Bronchial stenosis was most frequently observed in tuberculosis (P=0.031) and aspergillosis (P=0.020) when compared with sarcoidosis. Immunosuppressive status was significantly associated with endobronchial aspergillosis (P=0.0001) and the 1-year survival from diagnosis resulted significantly lower irrespectively to the immune system condition.

Conclusions:
A consistent proportion of endobronchial benign lesions are reported. One fifth of these are associated with critical stenosis of the airway lumen, requiring rigid bronchoscopy. Among these, aspergillosis is characterized by the poorest prognosis, regardless of host immunity status.
Comparison of Diagnostic Potential of Narrow Band Imaging Bronchoscopy Over White Light Bronchoscopy in Lung Cancer
Authors: Advani Manish , Purohit Gopal , Vyas Sunil , Kumari Jyoti 
Published: January 2018

Background:
Worldwide, lung cancer is the largest contributor to new cancer diagnoses and to death from cancer. Narrow band imaging (NBI) is a novel bronchoscopic technique which enables detailed examination of submucosal microcapillary grid and showed great potential in early detection of malignant lesions of the bronchial mucosa. The aim of this study was to compare diagnostic potential of NBI bronchoscopy over white light (WL) bronchoscopy in lung cancer.

Methods:
We enrolled 187 patients having clinical and radiologic findings highly suspicious of lung cancer. Patients were further divided into 2 groups: NBI group (n=102), and control WL group (n=85). Bronchoscopy examination was performed with respective visualization modes and all pathologic lesions were biopsied and histologically confirmed.

Results:
On NBI bronchoscopy, malignancy was suspected in 69 patients, of whom 62 had malignancy, and 33 patients were suspected of inflammation, of whom 32 had inflammation and only 1 patient had malignancy. Under WL bronchoscopy, 54 patients were suspected of malignancy, of whom 36 had malignancy, and 31 patients were suspected of inflammation, of whom 23 had inflammatory disease and 8 had malignancy. NBI bronchoscopy had sensitivity 98.1%, specificity 82.05%, positive predictive value 89.86% and negative predictive value 96.97% in comparison to standard WL bronchoscopy which had sensitivity 81.82%, specificity 56.10%, positive predictive value 66.67% and negative predictive value 74.19%.

Conclusion:
NBI bronchoscopy demonstrated better results in comparison to WL bronchoscopy. The presence of pathologic vascularization of the tumor helps to better identify the malignant process. Inflammatory changes in the mucosa can be easily differentiated from malignant changes by the appearance of vessels.
Trends in Intraoperative Testing During Cochlear Implantation
Authors: Page Joshua Cody , Cox Matthew D. , Hollowoa Blake , Bonilla-Velez Juliana , Trinidade Aaron , Dornhoffer John L. 
Published: January 2018

Objective:
No consensus guidelines exist regarding intraoperative testing during cochlear implantation and wide variation in practice habits exists. The objective of this observational study was to survey otologists/neurotologists to understand practice habits and overall opinion of usefulness of intraoperative testing.

Study Design:
Cross-sectional survey.

Setting:
A web-based survey was sent to 194 practicing Otologists/Neurotologists.

Main Outcome Measures:
Questions included practice setting and experience, habits with respect to electrodes used, intraoperative testing modalities used, overall opinion of intraoperative testing, and practice habits in various scenarios.

Results:
Thirty-nine of 194 (20%) completed the survey. For routine patients, ECAPs and EIs were most commonly used together (38%) while 33% do not perform testing at all. Eighty-nine percent note that testing “rarely” or “never” changes management. Fifty-one percent marked the most important reason for testing is the reassurance provided to the family and/or the surgeon.

Conclusion:
Intraoperative testing habits and opinions regarding testing during cochlear implantation vary widely among otologic surgeons. The majority of surgeons use testing but many think there is minimal benefit and that surgical decision-making is rarely impacted. The importance of testing may change as electrodes continue to evolve.
Multicenter US Clinical Trial With an Electric-Acoustic Stimulation (EAS) System in Adults: Final Outcomes
Authors: Pillsbury Harold C. , Dillon Margaret T. , Buchman Craig A. , Staecker Hinrich , Prentiss Sandra M. , Ruckenstein Michael J. , Bigelow Douglas C. , Telischi Fred F. , Martinez Diane M. , Runge Christina L. , Friedland David R. , Blevins Nikolas H. , Larky Jannine B. , Alexiades George , Kaylie David M. , Roland Peter S. , Miyamoto Richard T. , Backous Douglas D. , Warren Frank M. , El-Kashlan Hussam K. , Slager Heidi K. , Reyes Carisa , Racey Allison I. , Adunka Oliver F. 
Published: January 2018

Objective:
To demonstrate the safety and effectiveness of the MED-EL Electric-Acoustic Stimulation (EAS) System, for adults with residual low-frequency hearing and severe-to-profound hearing loss in the mid to high frequencies.

Study Design:
Prospective, repeated measures.

Setting:
Multicenter, hospital.

Patients:
Seventy-three subjects implanted with PULSAR or SONATA cochlear implants with FLEX24 electrode arrays.

Intervention:
Subjects were fit postoperatively with an audio processor, combining electric stimulation and acoustic amplification.

Main Outcome Measures:
Unaided thresholds were measured preoperatively and at 3, 6, and 12 months postactivation. Speech perception was assessed at these intervals using City University of New York sentences in noise and consonant–nucleus–consonant words in quiet. Subjective benefit was assessed at these intervals via the Abbreviated Profile of Hearing Aid Benefit and Hearing Device Satisfaction Scale questionnaires.

Results:
Sixty-seven of 73 subjects (92%) completed outcome measures for all study intervals. Of those 67 subjects, 79% experienced less than a 30 dB HL low-frequency pure-tone average (250–1000 Hz) shift, and 97% were able to use the acoustic unit at 12 months postactivation. In the EAS condition, 94% of subjects performed similarly to or better than their preoperative performance on City University of New York sentences in noise at 12 months postactivation, with 85% demonstrating improvement. Ninety-seven percent of subjects performed similarly or better on consonant–nucleus–consonant words in quiet, with 84% demonstrating improvement.

Conclusion:
The MED-EL EAS System is a safe and effective treatment option for adults with normal hearing to moderate sensorineural hearing loss in the low frequencies and severe-to-profound sensorineural hearing loss in the high frequencies who do not benefit from traditional amplification.
Benefit of Preoperative Temporal Bone CT for Atraumatic Cochlear Implantation
Authors: Karkas Alexandre , Champfleur Nicolas Menjot de , Uziel Alain , Mondain Michel , Puel Jean-Luc , Venail Frédéric 
Published: January 2018

Hypothesis:
Evaluate the benefit of preoperative surgical planning using computed tomography (CT) for atraumatic cochlear implantation.

Background:
The surgical technique has a direct impact on hearing and structure preservation. Much interest has been given to depth of electrode insertion. We focused on electrode diameter depending on exposure of round window membrane (RWM) as calculated on preoperative CT.

Methods:
Measurements were calculated radiologically and anatomically on 10 temporal bones. Results were compared with CT scans of a control population. Thereafter, preoperative CT scan measurements were applied to seven additional temporal bones that underwent cochlear implantation with the insertion of two electrodes of different diameters (14 implantations) to validate radiological analysis.

Results:
RWM size was 1.5 ± 0.2 mm on CT and 1.2 ± 0.2 mm during dissection; posterosuperior bony overhang of round window niche was 1.1 ± 0.1 mm on CT and 1.3 ± 0.2 mm during dissection. There was no statistically significant difference between radiological and anatomical measurements and between radiological measurements of cadaveric temporal bones and control population (p > 0.05 for both). Also, preoperative surgical planning was reliable in the seven temporal bones implanted with two electrode types (accuracy 93%, sensitivity 85.7%, specificity 100%) yielding no damage to intracochlear structures.

Conclusion:
Difficulties to access RWM could be predicted on preoperative CT of temporal bones and control population, which correlated well with anatomical dissections and surgical findings during cochlear implantation. According to CT planning, electrode insertion through RWM was feasible in most patients, with or without drilling posterosuperior bony overhang of round window niche. Promontory cochleostomy could be recommended when electrode apical diameter exceeded maximal RWM exposure. There was no case of intracochlear trauma on microdissections.
Long-term Administration of Salicylate-induced Changes in BDNF Expression and CREB Phosphorylation in the Auditory Cortex of Rats
Authors: Yi Bin , Wu Cong , Shi Runjie , Han Kun , Sheng Haibin , Li Bei , Mei Ling , Wang Xueling , Huang Zhiwu , Wu Hao 
Published: January 2018

Hypothesis:We investigated whether salicylate induces tinnitus through alteration of the expression levels of brain-derived neurotrophic factor (BDNF), proBDNF, tyrosine kinase receptor B (TrkB), cAMP-responsive element-binding protein (CREB), and phosphorylated CREB (p-CREB) in the auditory cortex (AC).Background:Salicylate medication is frequently used for long-term treatment in clinical settings, but it may cause reversible tinnitus. Salicylate-induced tinnitus is associated with changes related to central auditory neuroplasticity. Our previous studies revealed enhanced neural activity and ultrastructural synaptic changes in the central auditory system after long-term salicylate administration. However, the underlying mechanisms remained unclear.Methods:Salicylate-induced tinnitus-like behavior in rats was confirmed using gap prepulse inhibition of acoustic startle and prepulse inhibition testing, followed by comparison of the expression levels of BDNF, proBDNF, TrkB, CREB, and p-CREB. Synaptic ultrastructure was observed under a transmission electron microscope.Results:BDNF and p-CREB were upregulated along with ultrastructural changes at the synapses in the AC of rats treated chronically with salicylate (p < 0.05, compared with control group). These changes returned to normal after 14 days of recovery (p > 0.05).Conclusion:Long-term administration of salicylate increased BDNF expression and CREB activation, upregulated synaptic efficacy, and changed synaptic ultrastructure in the AC. There may be a relationship between these factors and the mechanism of tinnitus.
Near-infrared spectroscopy to predict organ failure and outcome in sepsis: the Assessing Risk in Sepsis using a Tissue Oxygen Saturation (ARISTOS) study
Authors: Macdonald Stephen P.J. , Kinnear Frances B. , Arendts Glenn , Ho Kwok M. , Fatovich Daniel M. 
Published: January 2018

Objectives
Sepsis is acute organ dysfunction in the setting of infection. An accurate diagnosis is important to guide treatment and disposition. Tissue oxygen saturation (StO2) can be estimated noninvasively by near-infrared spectroscopy (NIRS), and may be an indicator of microcirculatory dysfunction in early sepsis. We aimed to determine the utility of StO2 for sepsis recognition and outcome prediction among patients presenting to the emergency department (ED) with infection.

Patients and methods
A multicentre, prospective, observational cohort study recruited patients who were being admitted to hospital with infection. StO2 was measured in the ED using a handheld NIRS device, Inspectra 300. Outcomes were sepsis, defined as an increase in sequential organ failure assessment score of at least 2 points within 72 h, and composite in-hospital mortality/ICU admission at least 3 days.

Results
A cohort of 323 participants, median age 64 (interquartile range: 47–77) years, was recruited at three Australian hospitals. 143 (44%) fulfilled the criteria for sepsis and 22 (7%) died within 30 days. The mean ± SD StO2 was 74 ± 8% in sepsis and 78 ± 7% in nonsepsis (P < 0.0001). StO2 correlated with the peak sequential organ failure assessment score (Spearman’s ρ −0.27, P  <  0.0001). Area under the receiver operating characteristic curve was 0.66 (95% confidence interval: 0.60–0.72) for sepsis and 0.66 (0.58–0.75) for the composite outcome. StO2 less than 75% had an odds ratio of 2.67 (1.45–4.94; P = 0.002), for the composite outcome compared with StO2 at least 75%.

Conclusion
NIRS-derived StO2 correlates with organ failure and is associated with outcome in sepsis. However, its ability to differentiate sepsis among ED patients with infection is limited. NIRS cannot be recommended for this purpose.
Obesity and chronic kidney disease
Authors: Nehus Edward 
Published: January 2018

Purpose of review
To review recent advances in the epidemiology, pathophysiology, clinical features, and treatment of obesity-related kidney disease.

Recent findings
Studies have confirmed that obesity is associated with increased risk of developing chronic kidney disease (CKD). This risk extends to those who are metabolically healthy, indicating that obesity per se contributes to CKD independent of the metabolic syndrome. Recent developments in the pathophysiology of obesity-related kidney disease indicate that chronic inflammation and abnormal lipid metabolism contribute to kidney cell injury. Children with severe obesity have increased prevalence of early kidney abnormalities, including albuminuria, decreased kidney function, and elevated biomarkers of early kidney injury. For these patients, bariatric surgery has emerged as a treatment option to consider. Longitudinal studies in children and adults have demonstrated that in patients with obesity-related kidney disease, kidney function and albuminuria improve following bariatric surgery.

Summary
The injurious renal effects of obesity are present in childhood, although the natural history and clinical spectrum of obesity-related kidney disease in children are not known. In obese children with early kidney disease, identification of kidney injury, implementation of preventive strategies, and prompt treatment are essential to improving clinical outcomes.