American public opinion on artificial intelligence in healthcare.

Billions of dollars are being invested into developing medical artificial intelligence (AI) systems and yet public opinion of AI in the medical field seems to be mixed. Although high expectations for the future of medical AI do exist in the American public, anxiety and uncertainty about what it can do and how it works is widespread. Continuing evaluation of public opinion on AI in healthcare is necessary to ensure alignment between patient attitudes and the technologies adopted. We conducted a representative-sample survey (total N = 203) to measure the trust of the American public towards medical AI. Primarily, we contrasted preferences for AI and human professionals to be medical decision-makers. Additionally, we measured expectations for the impact and use of medical AI in the future. We present four noteworthy results: (1) The general public strongly prefers human medical professionals make medical decisions, while at the same time believing they are more likely to make culturally biased decisions than AI. (2) The general public is more comfortable with a human reading their medical records than an AI, both now and "100 years from now." (3) The general public is nearly evenly split between those who would trust their own doctor to use AI and those who would not. (4) Respondents expect AI will improve medical treatment but more so in the distant future than immediately.

Reproducibility of the Magnitude of Lens Rotation Following Implantation of a Toric Intraocular Lens with Modified Haptics.

Purpose: To evaluate the reproducibility of magnitude of postoperative IOL rotation following implantation of a toric intraocular lens (IOL) with modified haptics, in comparison with a Proof-of-Concept (POC) study of prototype IOLs featuring the same haptic design. Patients and Methods: A post-market, prospective, multicenter, single-arm, open-label clinical study was conducted. TECNIS Toric II IOL (Johnson & Johnson Vision, Irvine, CA, USA, Models ZCU150 to 600) were implanted in 125 subjects and evaluated at 1-day and 1-week postoperatively. An objective photographic method was used to determine postoperative IOL rotation. Uncorrected distance visual acuity (UCDVA), postoperative astigmatism, and surgeon satisfaction were also assessed. Rotation data were compared to the POC study in which two prototype non-toric monofocal IOLs, one with the same haptic design as Model ZCU, were studied. Results: Mean absolute rotation was 0.82° ± 1.0° and 0.84° ± 0.92°at 1-day and 1-week visits, respectively. The percentage of eyes with ≤5° of absolute rotation was 98.9% and 99.5% at the 1-day and 1-week visits, respectively. The magnitude of rotation was similar to the POC study prototype IOLs. At 1-week, mean monocular UCDVA was 0.026 ± 0.135 (~20/21) logMAR and mean residual manifest refractive cylinder was 0.30 D ± 0.35 D. The mean signed axis difference (postoperative minus operative) of the TECNIS Toric II IOL was 0.23° ± 1.27° at 1-day and -0.07° ± 1.25° at 1-week, indicating a clockwise drift. At 1-week, surgeons were very satisfied or satisfied with overall clinical outcomes and rotational stability in 98% of implanted eyes. Conclusion: The TECNIS Toric II IOL, with frosted, squared haptics, demonstrated low magnitude of postoperative IOL rotation, excellent uncorrected distance vision, and minimal residual astigmatism. The POC study design was supported, demonstrating that prototype non-toric monofocal IOLs can predict clinical performance of toric IOLs with the same haptic design.

Visual outcomes and safety of an extended depth-of-focus intraocular lens: results of a pivotal clinical trial.

PURPOSE: To compare the effectiveness and safety of the TECNIS Symfony intraocular lens (IOL; ZXR00) with the TECNIS 1-piece monofocal IOL (ZCB00). SETTING: 15 sites in the United States. DESIGN: Prospective, randomized, patient-masked/evaluator-masked clinical trial. METHODS: Randomized participants received either the ZXR00 or ZCB00 IOL bilaterally. The 6-month postoperative outcomes included monocular and binocular distance, intermediate, and near visual acuity (VA), spherical equivalent refraction and refractive cylinder, spectacle wear, and visual symptoms. RESULTS: Overall, 299 patients were implanted with a study IOL (ZXR00 IOL, n = 148; ZCB00 IOL control, n = 151). At the 6-month follow-up, mean binocular uncorrected distance VA was comparable between ZXR00 and ZCB00 IOL recipients (P = .1011). The ZXR00 IOL group had significantly better mean binocular uncorrected intermediate VA and uncorrected near VA (both P < .0001) than the ZCB00 IOL group. The mean binocular distance-corrected intermediate VA and distance-corrected near VA were also better in the ZXR00 IOL group (both P < .0001). More ZXR00 IOL recipients reported wearing spectacles none of the time or a little of the time for overall vision at 6 months compared with the ZCB00 IOL group (85.0% vs 59.9%, P < .0001). In the ZXR00 IOL-implanted patients, low incidence rates of night glare (mild to moderate, 2.7%), halo (mild to moderate, 13.6%; severe, 2.7%), and starbursts (mild to moderate, 7.5%; severe, 1.4%) were reported. CONCLUSIONS: The TECNIS Symfony IOL provided comparable distance vision and improved uncorrected and distance-corrected intermediate and near vision, along with decreased spectacle wear and low incidence rates of dysphotopsia, compared with the TECNIS 1-piece monofocal IOL.

The Impact of Sleep Duration on Performance Among Competitive Athletes: A Systematic Literature Review.

The athletic advantage of sleep, although commonly touted by coaches, trainers, and sports physicians, is still unclear and likely varies by sport, athletic performance metric, and length of sufficient or insufficient sleep. Although recent literature reviews have highlighted circadian and nutritional factors that influence different aspects of athletic performance, a systematic summary of the effects of sleep duration and sleep quality on performance among competitive athletes is lacking. Here we systematically review the relationship between sleep duration and sleep quality and objective athletic performance among competitive athletes across 19 studies representing 12 sports. Taken holistically, we find that the sports requiring speed, tactical strategy, and technical skill are most sensitive to sleep duration manipulations. Furthermore, longer-term sleep manipulations are more likely than acute sleep manipulations (whether deprivation or extension) to affect athletic performance. Thus, the importance of sleep for competitive athletes to achieve high performance is dependent on the demands of the sport as well as the length of sleep interventions. In light of the limited number of studies investigating sleep quality and performance, the potential relevance of subjective sleep quality remains an interesting question for future work.

Association between late-night tweeting and next-day game performance among professional basketball players.

OBJECTIVES: In sports, decreased sleep duration is generally associated with poorer performance compared to adequate or enhanced sleep duration. Yet, these findings have primarily been taken from small numbers of athletes performing outside of real games or competitions. It remains unknown how acute decreased sleep duration impacts real-game performance among professional athletes. Here, we merged 2 publicly available datasets to jointly measure late-night social media activity (a proxy for sleep deprivation) and next-day game performance. SETTING: Professional basketball competition. PARTICIPANTS: 112 players from the National Basketball Association. MEASUREMENTS: Time-stamped social media activity and in-game individual performance statistics. RESULTS: Late-night tweeting (compared to not late-night tweeting) is associated with within-person reductions in next-day game performance, including fewer points scored and fewer rebounds. However, we also observe less time played per game following late-night tweets and decreases in the negative outputs of turnovers and personal fouls. The critical measure of shooting accuracy - which is not time dependent - provides the clearest evidence of a performance penalty following late-night tweeting activity (between 11:00 pm and 7:00 am); players successfully make shots at a rate 1.7 percentage points less following late-night tweeting. CONCLUSIONS: Our findings suggest that acute sleep deprivation, as measured via late-night Twitter activity, is associated with changes in next-day game performance among professional National Basketball Association athletes. More broadly, the use of late-night social media activity may serve as a useful general proxy for sleep deprivation in other social, occupational, and physical performance-based contexts.

American Political-Party Affiliation as a Predictor of Usage of an Adultery Website.

The more politically conservative Americans are, the more restrictive their sexual attitudes are. A natural follow-up question is how this difference in attitudes relates to actual behavior. But self-reports of sexual behavior may be compromised by a social desirability bias that is influenced by the very sexual attitudes at issue. We employed a non-self-reported measure of sexual behavior: usage of the adultery-focused dating website Ashley Madison. Linking an August 2015 leak of user data from Ashley Madison to 2012 voter registration rolls from five U.S. states, we found 80,000 matches between 200,000 Ashley Madison user accounts and 50 million voters. According to simple rates in the sample, and also to predictively validated regression models controlling for state, gender, and age, we found that Democrats were least likely to use Ashley Madison, Libertarians were most likely, and Republicans, Greens, and unaffiliated voters were in between. Our results provide support for theories arguing that people with stricter sexual attitudes are paradoxically more likely to engage in deviant sexual behavior.

Multicenter randomized phase 3 study of a sustained-release intracanalicular dexamethasone insert for treatment of ocular inflammation and pain after cataract surgery.

PURPOSE: To assess the efficacy and safety of a sustained-release intracanalicular dexamethasone insert for the treatment of postoperative ocular inflammation and pain in patients having cataract surgery. SETTING: Twenty-one United States sites. DESIGN: Prospective multicenter randomized parallel-arm double-masked vehicle-controlled phase 3 study. METHODS: Patients with planned clear corneal cataract surgery were randomized (1:1) to receive dexamethasone insert or placebo, and the treatment was placed in the canaliculus of the eye immediately after surgery (Day 1). The primary efficacy endpoints were complete absence of anterior chamber cells at Day 14 and complete absence of pain at Day 8. RESULTS: The study comprised 438 adult patients (216 in the treatment arm and 222 in the placebo arm). At Day 14, significantly more patients had an absence of anterior chamber cells in the dexamethasone insert arm compared with placebo (52.3% versus 31.1%; P < .0001). At Day 8, significantly more patients had an absence of ocular pain in the dexamethasone insert arm compared with placebo (79.6% versus 61.3%; P < .0001). The dexamethasone insert arm showed no increase compared with placebo in incidence of all adverse events or ocular adverse events. Twice as many placebo patients required rescue therapy, compared with treated patients at Day 14. CONCLUSIONS: Both primary endpoints were successfully met. In addition, patients receiving the dexamethasone insert experienced a decrease in inflammation after surgery as early as Day 4 through Day 45, and a decrease in pain as early as one day after surgery (Day 2) through Day 45. The dexamethasone insert was well-tolerated, and the adverse events profile was similar to placebo.

Social influence and political mobilization: Further evidence from a randomized experiment in the 2012 U.S. presidential election.

A large-scale experiment during the 2010 U.S. Congressional Election demonstrated a positive effect of an online get-out-the-vote message on real world voting behavior. Here, we report results from a replication of the experiment conducted during the U.S. Presidential Election in 2012. In spite of the fact that get-out-the-vote messages typically yield smaller effects during high-stakes elections due to saturation of mobilization efforts from many sources, a significant increase in voting was again observed. Voting also increased significantly among the close friends of those who received the message to go to the polls, and the total effect on the friends was likely larger than the direct effect, suggesting that understanding social influence effects is potentially even more important than understanding the direct effects of messaging. These results replicate earlier work and they add to growing evidence that online social networks can be instrumental for spreading offline behaviors.

The impact of a preloaded intraocular lens delivery system on operating room efficiency in routine cataract surgery.

PURPOSE: The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL) delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. METHODS: Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. RESULTS: The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%-12.0% (P<0.001 for data from Canada and the US and P<0.05 for data from France). Use of the preloaded delivery system also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. CONCLUSION: Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity.

Cortex removal after laser cataract surgery and standard phacoemulsification: a critical analysis of 800 consecutive cases.

PURPOSE: To evaluate the ease of anterior cortex removal and hydrodissection of the lens in femtosecond laser-assisted cataract surgery compared with standard phacoemulsification. METHODS: In the femtosecond laser-assisted cataract surgery group (400 eyes), a femtosecond laser was used for capsulotomy and followed by lens fragmentation. In the standard group, the capsulorhexis was performed manually. In both groups, a normal hydrodissection was set, the nucleus was aspirated with or without ultrasound phacoemulsification energy, and residual cortex removal and posterior capsule polishing were performed using bimanual irrigation/aspiration. The primary end point was the time (in seconds) required for the removal of the cortex from instrument insertion in the eye until aspiration tip removal. Secondary end points were the effective phacoemulsification time, quality of the anterior capsule, and anterior or posterior capsule ruptures. RESULTS: Cortex removal time measured 30 ± 13 seconds (range: 10 to 76 seconds) for the standard group and 27 ± 10 seconds (range: 9 to 72 seconds) for the femtosecond laser-assisted cataract surgery group (P < .005). After laser-assisted capsulotomy, one capsule was still adherent following removal by forceps. No anterior or posterior capsular tears were observed in either group. CONCLUSIONS: In femtosecond laser-assisted cataract surgery, the biaxial cortex removal time was comparable with the time in standard phacoemulsification.

Indications and outcomes of intraocular lens exchange during a recent 5-year period.

PURPOSE: To analyze and classify the indications, clinical presentations, and surgical outcomes of intraocular lens (IOL) exchange performed in a recent 5-year period. DESIGN: Retrospective, interventional case series. METHODS: setting: Private clinical practice. study population: Chart records of 57 eyes of 53 consecutive patients who had undergone IOL exchange between May 2007 and December 2011 were reviewed. observation procedures and main outcome measures: The preoperative clinical characteristics, treatment parameters, intraoperative and postoperative complications, and pre- and postoperative logarithm of the minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA) were recorded and analyzed. RESULTS: IOL dislocation (46%), incorrect IOL power (23%), patient dissatisfaction (21%), and optic opacification (7%) were the most common indications for IOL exchange. In the IOL dislocation group, posterior capsule opening presented in 57% of eyes (8/14) with in-the-bag dislocation. Of the dissatisfaction patients, 42% (5/11) had undesired visual acuity without symptoms of glare/optical aberrations. Surface calcification of silicone lenses associated with asteroid hyalosis accounted for the most cases (3/4) of optic opacification. Overall, the mean logMAR BCVA improved significantly (P < .001) and 88% of all eyes were 20/40 or better, including 73% in the IOL dislocation group and 100% in all other groups. No vision-threatening complications occurred in this series. CONCLUSIONS: The request for IOL exchange owing to patient dissatisfaction is increasing, especially for those with undesired visual acuity in the absence of photic symptoms. Surface calcification of silicone lenses suggests that this type of lens is not appropriate in the presence of asteroid hyalosis. Optimal visual results with a low rate of complications can be achieved in each category of indication. The findings of the study may stimulate discussion of a question: Does in-the-bag IOL dislocation occur only in eyes with an intact posterior capsule?

Yahtzee: an anonymized group level matching procedure.

Researchers often face the problem of needing to protect the privacy of subjects while also needing to integrate data that contains personal information from diverse data sources. The advent of computational social science and the enormous amount of data about people that is being collected makes protecting the privacy of research subjects ever more important. However, strict privacy procedures can hinder the process of joining diverse sources of data that contain information about specific individual behaviors. In this paper we present a procedure to keep information about specific individuals from being "leaked" or shared in either direction between two sources of data without need of a trusted third party. To achieve this goal, we randomly assign individuals to anonymous groups before combining the anonymized information between the two sources of data. We refer to this method as the Yahtzee procedure, and show that it performs as predicted by theoretical analysis when we apply it to data from Facebook and public voter records.

Inferring tie strength from online directed behavior.

Some social connections are stronger than others. People have not only friends, but also best friends. Social scientists have long recognized this characteristic of social connections and researchers frequently use the term tie strength to refer to this concept. We used online interaction data (specifically, Facebook interactions) to successfully identify real-world strong ties. Ground truth was established by asking users themselves to name their closest friends in real life. We found the frequency of online interaction was diagnostic of strong ties, and interaction frequency was much more useful diagnostically than were attributes of the user or the user's friends. More private communications (messages) were not necessarily more informative than public communications (comments, wall posts, and other interactions).

Reverse optic capture of the single-piece acrylic intraocular lens in eyes with posterior capsule rupture.

BACKGROUND AND OBJECTIVE: To evaluate the clinical results of reverse optic capture (ROC) with single-piece posterior chamber intraocular lenses (PC-IOLs) in cases of phacoemulsification cataract and IOL surgery with posterior capsular rupture. PATIENTS AND METHODS: Preoperative diagnosis, intraoperative events, surgical parameters, intraoperative and postoperative complications, and preoperative and postoperative visual acuity and refraction of 16 eyes that underwent ROC were reviewed and analyzed. The fellow eye of 12 patients undergoing uneventful phacoemulsification without optic capture served as the control group. RESULTS: Over a mean of 19 months' follow-up, 94% of eyes in the ROC group and 92% in the control group achieved a best-corrected visual acuity of 20/25 or better. Ninety-four percent of eyes in the ROC group and 100% in the control group had postoperative spherical equivalent ± 1.00 D of the intended refraction. Refraction was stable between 1 month and final follow-up in both groups. In all eyes with ROC, the IOL remained well centered with a securely captured optic. There were no vision-threatening complications throughout the follow-up. CONCLUSION: The comparable outcomes in both groups suggests that optic capture of a single-piece acrylic IOL through an anterior capsulorhexis merits consideration for IOL placement in selected cases of insufficient posterior capsule support.

A 61-million-person experiment in social influence and political mobilization.

Human behaviour is thought to spread through face-to-face social networks, but it is difficult to identify social influence effects in observational studies, and it is unknown whether online social networks operate in the same way. Here we report results from a randomized controlled trial of political mobilization messages delivered to 61 million Facebook users during the 2010 US congressional elections. The results show that the messages directly influenced political self-expression, information seeking and real-world voting behaviour of millions of people. Furthermore, the messages not only influenced the users who received them but also the users' friends, and friends of friends. The effect of social transmission on real-world voting was greater than the direct effect of the messages themselves, and nearly all the transmission occurred between 'close friends' who were more likely to have a face-to-face relationship. These results suggest that strong ties are instrumental for spreading both online and real-world behaviour in human social networks.

Phacotrabeculectomy: assessment of outcomes and surgical improvements.

PURPOSE: To evaluate the outcomes and progress after phacotrabeculectomy at the same clinical setting and/or performed by the same surgeon over the past decade. SETTING: Eye Institute of Utah, Salt Lake City, Utah, USA. METHODS: This retrospective study included 60 eyes of 43 patients who had phacotrabeculectomy at a single institute between 1999 and 2005. A modified phacotrabeculectomy surgical technique was used that included a 2-site incision approach, fornix-based flap, use of mitomycin-C, acrylic intraocular lens implantation, sutured scleral and conjunctival flaps, and sutured temporal clear corneal incision. RESULTS: Over a mean 30-month follow-up, 57 of the 60 eyes (95%) achieved intraocular pressure (IOP) control (

Intraocular lens exchange due to incorrect lens power.

PURPOSE: To evaluate patients who had intraocular lens (IOL) exchange for unexpected postoperative refractive errors, determine the sources associated with the errors, and derive an empiric approach to estimating the power for IOL exchange. DESIGN: Retrospective review of interventional case series. PARTICIPANTS: Twenty-two eyes that underwent IOL exchange for correcting unexpected refractive errors after cataract surgery with IOL implantation were reviewed. INTERVENTION: All the IOLs for IOL exchange were placed in-the-bag. The same type of IOLs was used for original IOL implantation and IOL exchange in 91% (20/22) of eyes. MAIN OUTCOME MEASURES: Uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), refraction, and reasons for IOL exchange. The equation derived from refractive change and change in IOL power was developed to calculate IOL power for exchange. RESULTS: Of the 22 cases, the identified reasons were keratometry errors in 5 (23%) and incorrect axial length (AL) determination in 3 (14%). In 3 other cases, a wrong IOL was implanted. After IOL exchange, 82% (18/22) of eyes were within +/-0.50 diopters (D) and 86% (19/22) within +/-1.00 D of emmetropia. Uncorrected visual acuity was 20/40 or better in 82% of eyes, and BSCVA was 20/40 or better in 95% (21/22) of eyes. The correlation between change of refraction and IOL power was significant (P<0.002). CONCLUSIONS: Among the identified causes, incorrect corneal power determination was the most frequent reason for incorrect IOL power implantation, followed by error in AL measurement and inserting a wrong IOL. The pre-exchange refraction can be used theoretically to calculate the IOL power for exchange.

Changing indications for and improving outcomes of intraocular lens exchange.

PURPOSE: To evaluate the indications for and outcomes of intraocular lens (IOL) exchange at the same clinical setting over the past decade, as well as compare the efficacy and safety of anterior chamber lens (AC-IOL) and posterior chamber lens (PC-IOL) implantation for IOL exchange. DESIGN: Retrospective, nonrandomized case series. METHODS: The charts of all patients who had an IOL exchange at the Eye Institute of Utah between January 1998 and December 2004 were reviewed. The rate, indications, and outcomes are compared with the data of our previous study conducted between 1986 and 1990. RESULTS: This study comprised 51 eyes of 51 consecutive patients. The rate of IOL exchange was 0.77% of all cataract surgeries during the time considered. Incorrect IOL power (41.2%), decentration/dislocation (37.3%), and glare (7.8%) were the most common indications for IOL exchange. An AC-IOL was used in 14 eyes (27.5%) and a PC-IOL in 37 eyes (72.5%) for IOL exchange. None of the PC-IOLs was sutured to the sclera or iris. Overall, 90.2% of patients obtained a best-spectacle corrected visual acuity (BSCVA) of 20/40 or better. All eyes in AC-IOL group and 94.6% of eyes in PC-IOL group maintained within 1 line or improved 2 to 5 lines of the pre-exchange vision. CONCLUSIONS: The improvements in IOL design and materials as well as surgical techniques have greatly minimized the incidence, changed the indications for, and improved the visual outcomes of IOL exchange over the past decade. Our study suggests that the open loop, flexible AC-IOL poses no greater risk than PC-IOL with respect to visual outcome and safety for IOL exchange. An AC-IOL may be preferable to a PC-IOL suture fixation for IOL exchange in the absence of posterior capsular support.