bluuebunny/crossref_metadata_2025 huggingface dataset:
Corneal Fourier and Belin–Ambrósio Enhanced Ectasia Analysis in Healthy 4-Year-Old White Children
Authors: Bajtl Dunja , Bjeloš Mirjana , Bušić Mladen , Ćurić Ana , Biuk Dubravka , Barać Josip
Published: February 2023

Purpose:

The aim of this study was to provide normative databases of Fourier analysis (FA) and Belin–Ambrósio enhanced ectasia display (BAD) in healthy White 4-year-old emmetropic children.

Methods:

FA parameters analyzed were spherical component (SRmin), spherical eccentricity (SEcc), maximal decentration (MD), regular astigmatism at the center (Astigm. C) and periphery (Astigm. P), and irregularity (I). The parameters obtained by BAD included summary indicator BAD D, anterior corneal curvature (K1 and K2, D), maximal keratometry (Kmax, D), maximal Ambrósio relational thinnest (ART max), and pachymetric and BAD indices.

Results:

Eighty-nine eyes of eighty-nine 4-year-old children were included. The mean values of FA parameters were the following: SRmin 7.77, SEcc 0.600, MD 0.160, Astigm. C 0.070, Astigm. P 0.050, and I 0.019. The mean K1 and K2 in our study group were 42.92 ± 1.29 D and 43.75 ± 1.41 D, with the mean BAD D value 0.42 ± 0.67. The mean PPI min 0.629 ± 0.117, PPI max 1.059 ± 0.155, PPI avg 0.847 ± 0.103, Kmax 44.10 ± 1.39, and median of ART max 515.0 were recorded. No statistically significant differences between male and female sex in any of FA or BAD parameters were found.

Conclusions:

This is the first study providing large normative data on FA and BAD in 4-year-old White emmetropic children. We proposed a cutoff D value for early ectasia and clinical keratoconus in 4-year-old children.
Results from the Primary Tube Versus Trabeculectomy Study and translation to clinical practice
Authors: Gedde Steven J. , Vinod Kateki , Prum Bruce E.
Published: February 2023

Purpose of review

The Primary Tube Versus Trabeculectomy (PTVT) Study is a multicenter randomized clinical trial comparing the safety and efficacy of tube shunt surgery and trabeculectomy with mitomycin C (MMC) in eyes without previous incisional ocular surgery. This article reviews results from the PTVT Study and suggests how they may be translated to clinical practice.

Recent findings

Tube shunt surgery had a higher failure rate than trabeculectomy with MMC in the PTVT Study, and the difference was statistically significant at 1 year but not at 3 years and 5 years. Both surgical procedures reduced intraocular pressure (IOP) to the low teens throughout 5 years of follow-up. Mean IOPs were lower after trabeculectomy with MMC compared with tube shunt implantation, and the differences were statistically significant during the first postoperative year and at 3 years. The greater IOP reduction after trabeculectomy with MMC was achieved with significantly fewer glaucoma medications relative to tube shunt placement. Surgical complications were common in the PTVT Study, but most were transient and self-limited. The incidence of early postoperative complications was significantly higher after trabeculectomy with MMC than tube shunt surgery. The rates of late postoperative complications, cataract progression, and vision loss were similar with both surgical procedures. Serious complications producing vision loss and/or requiring a reoperation to manage the complication developed more frequently after trabeculectomy with MMC compared with tube shunt surgery, and the difference was statistically significant at 1 year but not at 3 years and 5 years postoperatively.

Tube shunt implantation and trabeculectomy with MMC are both viable surgical options for managing glaucoma in patients without previous incisional ocular surgery. Results from the PTVT Study support further expansion of tube shunt use beyond refractory glaucomas.
Remdesivir Use in Pediatric Patients for SARS-CoV-2 Treatment: Single Academic Center Study
Authors: Samuel Allison M. , Hacker Larissa L. , Zebracki Jessica , Bogenschutz Monica C. , Schulz Lucas , Strayer Jill , Vanderloo Joshua P. , Cengiz Pelin , Henderson Sheryl
Published: February 2023

Background:

Millions of children in the United States have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with many infections leading to hospitalization. For pediatric patients, especially younger children, treatment options are limited. Remdesivir has demonstrated a positive safety and efficacy profile in adults, but little data is published regarding remdesivir use in pediatric patients. Additional data for SARS-CoV-2 treatments in pediatric patients is required to prevent further SARS-CoV-2–related morbidity and mortality. At a single pediatric academic medical center, the safety and efficacy of remdesivir was evaluated.

Methods:

A retrospective review of patients admitted to a pediatric academic medical center who received remdesivir over a 17-month period was completed. All pediatric patients who received at least 1 dose of remdesivir were included. Safety and efficacy were assessed using national organization’s definitions of clinical improvement, bradycardia, hypertension, acute kidney injury and drug-induced liver injury.

Results:

There were 48 pediatric patients included in this study with 29% of patients admitted to the pediatric intensive care unit. Less than one-third of patients received the full treatment course of remdesivir, with over half of patients not completing therapy due to symptomatic improvement or hospital discharge. Majority of patients required some level of supplemental oxygen support. The median World Health Organization score was consistent throughout all 5 days of therapy. No patients experienced significant bradycardia, hypertension, acute kidney injury, or drug-induced liver injury.

Conclusions:

Remdesivir may correlate with clinical stability or improvement and demonstrates safety when used in pediatric patients. A randomized controlled trial is needed to confirm these findings.
A Case of Fabry Disease With Lacrimal Gland Involvement
Authors: Bruce Carleigh N. , Mancera Norberto , Grover Abhinav , Esmaili Neda
Published: February 2023

Fabry disease is an X-linked lysosomal storage disease resulting from an error in the glycosphingolipid metabolic pathway, which leads to accumulation of globotriaosylceramide in lysosomes of the skin, kidneys, heart, brain, and other organs. There are no existing reports of histologically proven lacrimal gland involvement in Fabry disease. The authors report the case of a 26-year-old male with Fabry disease who presented with bilateral upper eyelid dermatochalasis, steatoblepharon, and prolapsed lacrimal glands. The patient underwent surgical repair of the upper eyelids and biopsy of the lacrimal glands. The pathologic assessment demonstrated lamellated intracytoplasmic inclusions characteristic of Fabry disease. The prevalence of globotriaosylceramide lacrimal gland deposition in Fabry disease and the effect on lacrimal gland morphology and function have yet to be determined.
To Evaluate the Efficacy of Diagnostic Periocular Punch Biopsy: Using a 4-mm Dermatology Punch
Authors: Burgess Nada R. , Rathore Deepa , Gao Anna , Johnson Andria , Ahluwalia Harpreet S.
Published: February 2023

Purpose:

The dermatological punch biopsy is a minimally invasive procedure that provides conclusive diagnosis when managing periocular lesions. It aids with establishing histological diagnosis and subtype thereby facilitating management planning and eliminates the risk of unnecessary tissue sacrifice. The present literature provides limited evidence evaluating the value of punch biopsy in diagnosing periocular lesions.

Methods:

A retrospective case note analysis of 400 consecutive 4-mm periocular punch biopsies performed between 2005 and 2016, from 353 patients was undertaken at a single institution. Three hundred fifty-nine lesions had an initial definite clinical diagnosis of malignancy (group A) and the remaining 41 lesions had an uncertain clinical diagnosis with enough suspicion to merit a biopsy (group B).

Results:

In group A, 75.5% (n = 271) of the biopsies verified the clinical diagnosis of malignancy and 24.5% (n = 88) were benign. In group B, 70.7% (n = 29) of the lesions were benign and 29.3% (n = 12) were malignant and were subsequently treated as group A. Only 4, group A biopsies, which underwent formal excision, did not initially diagnose a malignancy (punch biopsy was repeated) providing a sensitivity of 98.6% and a specificity of 100%. One hundred seventeen were found to be benign avoiding unnecessary tissue sacrifice in 29.25% of cases.

Conclusion:

Our study provides the largest sample size in the literature that evaluates a 4-mm diagnostic periocular punch biopsy in managing eyelid lesions. In 29.5% of punch biopsies, unnecessary tissue sacrifice was avoided as they were histologically benign. The authors found that punch biopsies for lesions <7 mm carry a risk of inadvertent excision of lesion.
Automated Precision Pulse Capsulotomy Versus Manual Capsulorhexis In White Cataracts: Reduction In Procedural Time And Resource Utilization
Authors: Ifantides Cristos , Sretavan David
Published: February 2023

Purpose:

To compare the utility of Precision Pulse Capsulotomy (PPC) with manual capsulorhexis for capsulotomy in white cataracts.

Setting:

Hospital-based academic practice.

Design:

Retrospective analysis of surgical case records and surgical videos from a single surgeon.

Methods:

Cases involving intumescent and non-intumescent white cataracts were identified. Capsulotomy outcomes, surgical outcomes, procedural time, and resource utilization as well as patient demographic and health data were analyzed and subjected to statistical testing.

Results:

15 cases of white cataract (10 Intumescent, 5 non-intumescent) performed using Continuous Curvilinear Capsulorhexis (CCC) were compared to 20 cases (9 Intumescent, 11 non-intumescent) performed using PPC. The cases covered a period of 14 months prior to and 30 months following surgeon adoption of PPC. There were no significant differences between the 2 groups in subject age, sex, ethnicity, ocular history, medical history and medications. PPC resulted in complete capsulotomies without tags or tears and intracapsular IOL implantation with 360-degree capsular overlap in all 20 cases. There was one CCC case resulting in the Argentinian Flag sign. Compared to CCC, PPC white cataract cases also demonstrated significant advantages in capsulotomy time, reduced use of trypan blue and ophthalmic viscosurgical device (OVD), and less overall procedural time.

Conclusions:

PPC is a safe and highly effective method to create consistent capsulotomies in both intumescent and non-intumescent white cataracts. The use of PPC provides benefits of significant reductions in capsulotomy time, overall procedural time and resource utilization resulting in a streamlined treatment of these complex cataract surgery cases.
Sensitivity and specificity of algorithms for the identification of nonspecific low back pain in medico-administrative databases
Authors: Ly Antarou , Sirois Caroline , Dionne Clermont E.
Published: February 2023

Identifying nonspecific low back pain (LBP) in medico-administrative databases is a major challenge because of the number and heterogeneity of existing diagnostic codes and the absence of standard definitions to use as reference. The objective of this study was to evaluate the sensitivity and specificity of algorithms for the identification of nonspecific LBP from medico-administrative data using self-report information as the reference standard. Self-report data came from the PROspective Québec Study on Work and Health, a 24-year prospective cohort study of white-collar workers. All diagnostic codes that could be associated with nonspecific LBP were identified from the International Classification of Diseases, Ninth and Tenth Revisions (ICD-9 and ICD-10) in physician and hospital claims. Seven algorithms for identifying nonspecific LBP were built and compared with self-report information. Sensitivity analyses were also conducted using more stringent definitions of LBP. There were 5980 study participants with (n = 2847) and without (n = 3133) LBP included in the analyses. An algorithm that included at least 1 diagnostic code for nonspecific LBP was best to identify cases of LBP in medico-administrative data with sensitivity varying between 8.9% (95% confidence interval [CI] 7.9-10.0) for a 1-year window and 21.5% (95% CI 20.0-23.0) for a 3-year window. Specificity varied from 97.1% (95% CI 96.5-97.7) for a 1-year window to 90.4% (95% CI 89.4-91.5) for a 3-year window. The low sensitivity we found reveals that the identification of nonspecific cases of LBP in administrative data is limited, possibly due to the lack of traditional medical consultation.
Low lymphocyte-to-monocyte ratio, calcitriol level, and CD206 level predict the development of acute-on-chronic liver failure in patients cirrhosis with acute decompensation
Authors: Kuo Nai-Rong , Hou Ming-Chih , Chu Wei-Chi , Yang Ying-Ying , Huang Chia-Chang , Li Tzu-Hao , Lee Tzung-Yan , Liu Chih-Wei , Liao Tsai-Ling , Hsieh Shie-Liang , Lin Han-Chieh
Published: February 2023

Background:

Cirrhosis-related acute-on-chronic liver failure (ACLF) is associated with high morbidity and mortality rates. Prognostic models of ACLF have been developed; however, few studies have focused on the occurrence of ACLF. This study aimed to identify the factors that predict the development of ACLF, hepatic encephalopathy (HE), and infection in patients with cirrhosis.

Methods:

Patients with cirrhosis were enrolled, and the serum levels of calcitriol, Cluster of Differentiation 26 (CD206), and macrophage-inducible lectin receptor (Mincle) were measured, and lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio were calculated; all the patients were tracked for 6 months. A generalized estimating equation (GEE) was used to assess the factors associated with ACLF development, HE, and infection. The aforementioned model was derived based on immunological markers, and receiver operating characteristic analysis with area under the curve (AUC) was adopted to evaluate accuracy.

Results:

After screening 325 patients with cirrhosis, 65 patients were eligible. In the GEE model, low levels of calcitriol (odds ratio [OR] = 3.259; 95% confidence interval [CI] = 1.118–8.929) and CD206 (OR = 2.666; 95% CI = 1.082–6.567) were associated with the development of ACLF, and the LMR was a protective factor (OR = 0.356; 95% CI = 0.147–0.861). Low calcitriol levels were a risk factor for HE (OR = 3.827) and infection (OR = 2.489). LMR was found to be a protective factor against HE (OR = 0.388). An immunological model for the discrimination of ACLF development within 6 months was proposed, with an AUC of 0.734 (95% CI = 0.598–0.869).

Conclusion:

Single and combined immunological markers, including low LMR and low levels of calcitriol and CD206, were promising for early prediction of the development of ACLF, HE, and infection in patients with cirrhosis.
Is N-acetylcysteine effective in treating patients with coronavirus disease 2019? A meta-analysis
Authors: Chen Chih-Hao , Hung Kai-Feng , Huang Chii-Yuan , Leong Jing-Li , Chu Yuan-Chia , Chang Chun-Yu , Wang Mong-Lien , Chiou Shih-Hwa , Cheng Yen-Fu
Published: February 2023

Background:

Coronavirus disease 2019 (COVID-19) is a global pandemic caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). It has brought tremendous challenges to public health and medical systems around the world. The current strategy for drug repurposing has accumulated some evidence on the use of N-acetylcysteine (NAC) in treating patients with COVID-19. However, the evidence remains debated.

Methods:

We performed the systematic review and meta-analysis that complies with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases and reference lists were searched from inception to May 14, 2022. Studies evaluating the efficacy of NAC in treating patients with COVID-19 were regarded as eligible. The review was registered prospectively on PROSPERO (CRD42022332791).

Results:

Of 778 records identified from the preliminary search, four studies were enrolled in the final qualitative review and quantitative meta-analysis. A total of 355 patients were allocated into the NAC group and the control group. The evaluated outcomes included intubation rate, improvement, duration of intensive unit stay and hospital stay and mortality. The pooled results showed nonsignificant differences in intubation rate (OR, 0.55; 95% CI, 0.16-1.89; p = 0.34; I
2 = 75%), improvement of oxygenation ([MD], 80.84; 95% CI, -38.16 to 199.84; p = 0.18; I
2 = 98%), ICU stay (MD, -0.74; 95% CI, -3.19 to 1.71; p = 0.55; I
2 = 95%), hospital stay (MD, -1.05; 95% CI, -3.02 to 0.92; p = 0.30; I
2 = 90%), and mortality (OR, 0.58; 95% CI, 0.23-1.45; p = 0.24; I
2 = 54%). Subsequent trial sequential analysis (TSA) showed conclusive nonsignificant results for mortality, while the TSA for the other outcomes suggested that a larger sample size is essential.

Conclusions:

The current evidence reveals NAC is not beneficial for treating patients with COVID- 19 with regard to respiratory outcome, mortality, duration of ICU stay and hospital stay.
2,2′,4,4′,5,5′-Hexabromophenyl ether (BDE-153) causes abnormal insulin secretion and disorders of glucose and lipid metabolism in mice
Authors: Liu Zao-Ling , Jiang Shu-Rui , Fan Yong , Wang Jia-Sui , Wang Meng-Lin , Li Mei-Yan
Published: February 2023

Background:

Environmental polybrominated diphenyl ether (PBDE) exposure may be associated with diabetes and obesity. 2,2′,4,4′,5,5′-Hexabromodiphenyl ether (BDE-153) is one of the most abundant and widely distributed homologs of PBDEs detected in humans. This study investigated the effects of BDE-153 on the expression of adipokines and glucose and lipid metabolism.

Methods:

Adult male C57BL/6 mice were divided into five BDE-153 groups and one control group. After BDE-153 exposure for 4 weeks, the levels of biochemical indexes and the mRNA and protein expression levels of leptin, adiponectin, peroxisome proliferators activated receptors gamma (PPARγ), and AMPKα were measured. The histomorphological changes of liver and pancreas tissues were observed.

Results:

After BDE-153 exposure, the weight of mice in the medium–high-dose group at different exposure times was lower than that in the control group (p all <0.05), and the body weight decreased slightly with the increase of the dose of BDE-153. BDE-153 caused the disorder of glucose and lipid metabolism in mice, the weight of liver and pancreas increased, lipid droplets accumulated in liver cells, and the positive rate of insulin staining increased in a dose-dependent manner. BDE-153 also interfered with the expression of PPARγ, AMPKα, and adipokines. The results of restrictive cubic splines (RCS) showed that there were a nonlinear dose–response relationship between the exposure dose of BDE-153 and the expression levels of PPARγ, AMPKα, and adipokines.

Conclusion:

Our results suggest that BDE-153 may interfere with the expression of adipokines and the secretion of insulin by affecting the expression of PPARγ and AMPKα, which play a key role in glucose and lipid metabolism, leading to the occurrence of glucose and lipid metabolism disorder.
The Caprini Risk Score for Early Prediction of Mortality in Patients With Acute Coronary Syndrome
Authors: Li Wentao , Wang Yujia , Li Dongze , Jia Yu , Li Fanghui , Chen Tengda , Liu Yi , Zeng Zhi , Wan Zhi , Zeng Rui , Wu Hongying
Published: February 2023

Background

The Caprini Risk Score (CRS) is a validated predictive instrument for venous thrombosis. Previous investigators have shown that a high CRS is associated with a higher risk of mortality from thrombotic diseases.

Objective

The aim of this study was to assess the association between the CRS and prognosis of patients with acute coronary syndrome (ACS).

Methods

Secondary analysis of data from a retrospective cohort study was conducted. Patients were classified into 3 CRS-based categories (CRS ≤ 2, CRS = 3–4, and CRS ≥ 5, indicating low, medium, and high, respectively). Kaplan-Meier curves and Cox regression models were used to assess the prognosis of patients with ACS. All-cause mortality and cardiac mortality were the end points.

Results

Two hundred fifty-four patients (12.8%) died during follow-up. Multivariate Cox regression models identified CRS as an independent risk factor for all-cause mortality among patients with ACS (CRS = 3–4 vs CRS ≤ 2, hazard ratio: 3.268, 95% confidence interval: 1.396–7.647, P = .006; CRS ≥ 5 vs CRS ≤ 2, hazard ratio: 4.099, 95% confidence interval: 1.708–9.841, P = .002). Pearson correlation analysis showed a positive correlation between CRS and fibrinogen level (r = 0.486, R
2 = 0.765, P < .001) as well as D-dimer level (r = 0.480, R
2 = 0.465, P < .001).

Conclusion

The CRS is a useful prognostic assessment instrument for patients with ACS, and the risk stratification of patients with ACS can be achieved based on their CRS at admission.
Accelerometer Use to Measure Physical Activity in Older Adults With Coronary Artery Disease: An Integrative Review
Authors: Lee Sueyeon , Bohplian Suweena , Bronas Ulf G.
Published: February 2023

Background

Physical activity is necessary for improved health outcomes among older adults with coronary artery disease (CAD), and device-based assessment of physical activity is preferred for accurate measurement. Many previous studies have applied accelerometry to examine physical activity in this population, but no reviews have systematically examined the application of various accelerometers to measure physical activity in older adults with CAD.

Objective

This integrative review aimed to examine accelerometry application to measure physical activity in older adults with CAD and provide guidance for accelerometer selection and settings.

Methods

Six databases—CINAHL, PubMed, PsycINFO, Scopus, EMBASE, and Google Scholar—were searched for information sources. Authors of selected studies applied accelerometers to measure physical activity and included adults 60 years or older with CAD.

Results

Among 12 studies reviewed, 5 were randomized controlled trials, and most used an age cutoff of 65 years for older adults. The most frequently used accelerometer was the RT3, and the most common device placement was the waist/hip. Data collection duration was typically 3 consecutive days. However, many study authors did not report epoch length, sampling frequency, number of valid hours of data required per day, total number of valid days of data needed, or criteria for nonwear time.

Conclusions

On the basis of data synthesis and previous study results, triaxial research-grade accelerometers, waist/hip placement, and a 5- to 7-day monitoring period are recommended for measuring physical activity in older adults with CAD. However, the study purpose, device and participant characteristics, and physical activity outcomes of interest should be considered during device selection.
Anemia and thrombocytosis associated with erythrodermic psoriasis successfully treated with ixekizumab: A case report
Authors: Chen Li-Hong , Zheng Jie , Li Xia
Published: February 2023

Introduction:

Erythrodermic psoriasis is a rare and potentially life-threatening subtype of psoriasis. It can be accompanied by systemic inflammatory disorders such as arthritic, hematologic, hemodynamic, and metabolic disturbances. We herein report a case involving a woman with erythroderma, joint deformities, anemia, and thrombocytosis who was diagnosed with erythrodermic psoriasis and psoriasis arthritis that were successfully treated with interleukin-17A antibody.

Case presentation:

A 35-year-old woman presented with an almost 20-year history of recurrent erythema and desquamation. She was diagnosed with plaque psoriasis and psoriatic arthritis and treated with acitretin, etanercept combined with methotrexate, and etanercept combined with cyclosporin, respectively. However, at the time of consultation, she was experiencing an episode of severe skin and joint inflammation. Routine laboratory evaluation revealed moderate microcytic hypochromic anemia, thrombocytosis, and increased serum cytokine concentrations. The patient was given the standard dose of ixekizumab, which resulted in clearance of her skin lesions with a Psoriasis Area and Severity Index 90 response at week 12. Her arthritic symptoms, including arthralgia and joint dysfunction, also improved. Moreover, her hemoglobin concentration, platelet count, and inflammatory markers reached the normal ranges.

Discussion:

Multiple cytokines participate in the pathogenesis of erythrodermic psoriasis, including interleukin-17A, interleukin-6, interleukin-1β, and interleukin-8. In the present case, treatment targeting the interleukin-23/interleukin-17 axis showed great efficacy not only for the skin lesions but also for systemic inflammatory comorbidities, such as arthritis, anemia, and thrombocytosis.

Conclusion:

Patients with systemic inflammatory disorders related to psoriasis, such as anemia and thrombocytosis, may benefit from anti-IL-17A treatment.
Pseudoainhum and lepromatous leprosy: a very rare association in the modern world
Authors: Nishad A.A. Nilanga , Pathman Mahathevan , Uwyse S.A. , Mendis Ashan , Abeysundara Prabath Kularathne , de Silva Arjuna P.
Published: February 2023

Introduction:

Pseudoainhum (dactylolysis spontanea) is characterized by the development of a fibrous band around the digit that gradually leads to autoamputation. Digital pain associated with Pseudoainhum may not be evident in patients with neuropathic conditions.

Case presentation:

The current report describes a very rare association of pseudoainhum with leprosy. The case involved a 48-year-old man in the dermatology ward with lepromatous leprosy presenting with a pseudoainhum.

Discussion:

Conclusion: This case highlights the possibility of delayed presentation of patients with pseudoainhum to physicians when the patients have underlying neuropathic conditions that prevent feeling finger pain and cause abnormal appearance of the digits, especially in leprosy.
Reproductive Coercion Among Women With Disabilities
Authors: Amos Vanessa , Lyons Genevieve R. , Laughon Kathryn , Hughes Rosemary B. , Alhusen Jeanne L.
Published: February 2023

Background/Aims

Reproductive coercion (RC) is a widespread yet understudied type of intimate partner violence that is associated with numerous negative outcomes. Women with disabilities may be at an increased risk of RC; however, little research has been conducted among this population. Using population-based data, we sought to examine the prevalence of RC in postpartum women with disabilities.

Methods

This is a secondary analysis of a cross-sectional survey, the Pregnancy Risk Assessment Monitoring System, a nationally representative survey conducted by the Centers for Disease Control and Prevention in partnership with participating states. These analyses include 3,117 respondents who had information on both disability status and experiences of RC.

Results

Approximately 1.9% of respondents reported experiencing RC (95% CI [1.3, 2.4]). When stratified by disability status, approximately 1.7% of respondents without a disability reported RC whereas 6.2% of respondents with at least one disability reported RC (p < 0.001). In univariable logistic models, disability, age, education, relationship status, income, and race were all significantly associated with RC.

Conclusions

Our findings highlight the need for healthcare providers working with women with disabilities to screen for RC and potentially uncover intimate partner violence and prevent its negative health consequences. All states participating in Pregnancy Risk Assessment Monitoring System data collection are urged to incorporate measures of RC and disability status to better address this significant issue.
Association Between Types of Chronic Disease and Receiving Workplace Accommodations
Authors: Harada Arisa , Tateishi Seiichiro , Ishimaru Tomohiro , Nagata Masako , Eguchi Hisashi , Tsuji Mayumi , Ikegami Kazunori , Matsugaki Ryutaro , Fujino Yoshihisa
Published: February 2023

Objective

This study aimed to evaluate the association between the type of chronic disease and receiving workplace accommodations.

Methods

This online cross-sectional study analyzed a self-reported questionnaire administered in Japan. A total of 6775 full-time workers who reported needing work accommodations were included.

Results

Workplace accommodations were more likely to be provided for workers with cancer, mental illness, and benign gynecological disorders than for workers with no disease under treatment. In contrast, workplace accommodations were less likely for workers with low back pain and skin diseases.

Conclusions

Receiving workplace accommodations depends on the type of chronic disease. Chronic diseases for which workers frequently receive workplace accommodations may be those for which support is encouraged by law. It is necessary to support workers with chronic diseases that do not receive adequate workplace accommodations.
Association Between Night Shift and Hypertension
Authors: Zhu Jin-liang , Liu Meng-yu , Qin Qi-rong , He Jia-liu , Hu Ming-jun , Zhu Zhen-yu , Liu Jian-jun , Huang Fen
Published: February 2023

Objective

The purpose of this study was to explore the effect of night-shift work on the risk of hypertension for improving workers' health.

Methods

A total of 10,038 Chinese participants were constituted in the cross-sectional study. Logistic regression and restricted cubic spline were used to estimate the effect of night shift on hypertension.

Results

There were higher odds of having hypertension in any night-shift workers (odds ratio [OR], 1.16 [95% confidence interval, 1.03–1.30]) when compared with day workers. Having 5 to 10 night shifts per month were significantly more likely to be hypertensive (OR, 1.19 [95% confidence interval, 1.03–1.38]). The OR for hypertension increased as the number of night shifts increased as the result of the restricted cubic spline.

Conclusions

Our results support the hypothesis that night shift is associated with an elevated risk of hypertension.
Innovative Approach for Teaching Physician Assistant Students About Social Determinants of Health and Empowering Action
Authors: Hulse Betty
Published: February 2023

Social determinants, the conditions in which people are born, grow, live, work, and age, play a crucial role in the health of individuals. The University of South Dakota Physician Assistant Studies Program uses a multimodal approach to teaching social determinants of health (SDOH) to students. The SDOH learning session consists of assigned pre-session reading, a didactic presentation introducing SDOH and their impact, and a table-top activity that simulates how SDOH affect individuals. During the table-top activity a list of community resources is available for students to locate services for the game characters when other resources have been depleted. Prior to entering clinical rotations, students will briefly review SDOH identification and connection to services during a training session for patient encounter logging. A check for implementation of learning will occur during the clinical phase by reviewing students' patient encounter logs for the presence of SDOH-related diagnoses and CPT codes. Although screening to identify SDOH and assisting patients through connect to services is not standard in all healthcare systems, PA students with the knowledge and tools can be prepared to provide this component of care to their patients.
Mining Literature to Identify Factors Influencing Prosthetic Prescription and Rehabilitation of Persons With Lower-Limb Amputations
Authors: Saravanan Pratima , Menold Jessica
Published: February 2023

Introduction

Proper prosthetic prescription directly impacts rehabilitation and the quality of life of an individual with amputation, yet complications during the prescription process remain a challenge for prosthetists as a variety of patient-specific and prosthetic-specific factors need to be considered simultaneously during prescription. This research aims to identify the factors that affect decision making during prosthetic prescription and rehabilitation processes of individuals with lower-limb amputation via evidence-based approaches.

Materials and Methods

Abstracts of 140 articles were analyzed using topic modeling—a natural language processing algorithm.

Results

Mining abstracts of relevant literature revealed seven factors that influence prosthetic prescription and six factors that affect rehabilitation of individuals with amputation.

Conclusion

The findings of this study focus on improving the rehabilitation process of individuals with lower-limb amputation, enhancing the patient-provider relationship, and improving the overall quality of life via evidence-based methods.

Clinical Relevance

Understanding the factors that affect prosthetic prescription and patient rehabilitation from the past literature is critical to the establishment of formal and standard prescription strategies that can eventually improve the quality of life of persons with lower-limb amputation.
Implementation of a Shielding Guideline for Pediatric Patients Receiving Intraoperative Ionizing Radiation
Authors: Stoner Heather , Falyar Christian , Hooge Nicolette , Pitman Jessica , Thompson Julie A. , Sattin Sarah , Funk Emily M.
Published: February 2023

Introduction

Approximately 350 million diagnostic radiation imaging procedures are performed on pediatric patients annually. This population is at a greater risk of developing cancer after exposure to ionizing radiation because of a higher intake, accumulation, and increased sensitivity to radiation as well as a long-life expectancy postexposure.

Methods

This quality improvement project used convenience sampling with a pre–post design to evaluate two independent samples: (a) pediatric intraoperative staff members including registered nurses and scrub technicians and (b) pediatric patients receiving intraoperative ionizing radiation imaging. Outcome measures included pediatric intraoperative staff knowledge and confidence of education for intraoperative shielding (preimplementation: n = 9; postimplementation: n = 6). Shielding audits were performed to assess for frequency of shield placement to radiosensitive organs and accuracy of shield placement (preimplementation: n = 26; postimplementation: n = 27).

Results

Data analysis showed improvement in staff confidence related to gonad shield placement ( p = .013) and self-reported frequency of gonad shield use ( p = .032). Knowledge scores showed nonsignificant improvement ( p = .076). Shielding audits showed statistically significant improvement in shield placements for thyroid, gonads, and breast tissue ( p < .05).

Discussion

The pediatric population has unique characteristics to consider when making decisions about shielding practice. This project discusses these characteristics, considerations for “exception-based shielding,” and how to improve the rates of shielding in situations where the practice is appropriate.
Patient-Centered Paradigm for Managing Autonomic Long COVID Symptoms During Sports and Exercise
Authors: Messinger-Rapport Barbara , Grubb Blair
Published: February 2023

This report highlights a new, patient-centered paradigm for managing post–COVID-19 dysautonomia symptoms during sports and exercise. The patient was a healthcare worker exposed before vaccination. She experienced postural orthostatic tachycardia plus exertional tachycardia, with postexertional fatigue, beginning a few weeks after testing positive for COVID-19. Stress test, echo, and an extensive dysautonomia evaluation were negative. Recommended nonpharmacological and pharmacological interventions were poorly tolerated. Prescription of a novel regimen of “basal-dose” ivabradine, plus very low-dose metoprolol according to an exertional “sliding scale” managed symptoms to an acceptable level for work and recreation.
A Transformative Leadership Journey: Experiences of Graduates of the American Physical Therapy Association Fellowship in Education Leadership
Authors: Jette Diane U. , Nordstrom Terrence M. , Gresham Barbara , Peel Claire , Majsak Michael J. , Mohr Thomas
Published: February 2023

Introduction.

Physical therapy education has an acute need for effective leaders due to multiple factors, including increasing numbers of programs and retirement of experienced leaders. Recognizing the need for formal leadership education, the American Physical Therapy Association (APTA) developed a fellowship in physical therapy educational leadership in 2011. This study aimed to understand participants' perceptions of their leadership experience and the role of the APTA fellowship.

Literature Review.

A commonly reported approach to evaluating leadership education programs was designed by Kirkpatrick.

Participants.

Twenty-five fellowship graduates from 2012 to 2019 participated.

Methods.

We used a qualitative methodological approach incorporating a heuristic technique to gain an understanding of fellowship graduates' long-term perspectives. Semi-structured interviews were conducted via Zoom. Data were analyzed using thematic analysis.

Results.

Three themes were constructed using a journey metaphor: embarking on the journey, engaging in the journey, and realizing the effects of the journey. 1) Embarking on the journey included 2 subthemes: a) participants' personal aspirations as career planners, reluctant leaders, or explorers; and b) institutions' goals for a change in leadership or intentional succession planning. 2) Engaging in the journey included 3 subthemes: a) the fellowship learning environment builds a sense of community; b) consideration of leadership frames influences participants' thinking about leadership; and c) participants' institutional environment influences their learning. 3) Effects of the journey included 3 subthemes: a) personal growth as a leader including personal awareness and confidence; b) institutions' benefits from participants' leadership projects and increased engagement in institutional leadership; and c) physical therapy professions' gains from participants' seeking leadership positions in professional organizations.

Discussion/Conclusions.

The APTA Fellowship in Educational Leadership results in transformative change of participants as leaders. Findings offer guidance to individuals considering embarking on a leadership journey and institutions considering how to prepare and support emerging leaders in physical therapy education.
Developing a Transformative Praxis-Based Curriculum to Educate Physical Therapy Students for Social Responsibility: A Philippine Qualitative Case Study
Authors: Palad Yves Y. , Armsby Pauline , Qualter Anne
Published: February 2023

Introduction.

Physical therapy (PT) academic institutions are called upon to strengthen their transformative role in developing more socially responsible graduates. Study objectives were to explore faculty perspectives on educating PT students for social responsibility (SR) and to identify strategies for improvement.

Review of Literature.

Adopting a “curriculum as praxis” orientation for curriculum development supports educating for SR because of its focus on transforming self and the world through recurring critical reflection and action. To complement the curriculum, ensuring SR in the entire academic environment, including institutional structures and capable educators, will enrich student development.

Subjects.

Six PT educators from a Philippine university with distinct SR mandates were purposively invited to participate based on their key involvements in various aspects of educating for SR.

Methods.

A participatory approach guided the methods to encourage collaborative creation of practical knowledge. Participant perspectives were gathered through focus group discussions, which were informed by research on SR in Philippine PT. Discussions were transcribed and then subjected to thematic analysis.

Results.

Three themes highlighted main areas for practice improvement: 1) strengthening curricular focus on SR through a whole-of-curriculum approach to incorporating opportunities for cognitive learning on SR and praxis (reflection and action); 2) maximizing institutional programs by helping students recognize them as further opportunities for developing SR; 3) and ensuring faculty has the capacity to educate for SR.

Discussion and Conclusion.

Educating for SR requires a transformative curriculum supported by aligned institutional programs and capable educators. This study enjoins PT educators to ensure a strong SR agenda in their PT programs by analyzing and acting on the transformative purpose of their curricula, including the influence of institutional structures, and support needed by educators to enable students to respond to the needs of the society they serve.
Postradiotherapy Urinary Extracellular Vesicle Concentrations Predict Late Bladder Toxicity in Patients with Prostate Cancer
Authors: Molony Ryan D. , Kerns Sarah L. , Marples Brian , Oshodi Emmanuel , Chen YuhChyau , Lee Yi-Fen
Published: February 2023

Purpose:

Radiotherapy (RT) is a standard-of-care option for over 50% of patients with prostate cancer (PCa), but up to 25% develop delayed bladder toxicities months to years after treatment. Late radiation cystitis is a form of dose-limiting toxicity that can cause hematuria and other potentially severe symptoms, leading to further morbidity and decisional regret. Additional work is needed to define early biomarkers of late radiation cystitis to better guide patient care. Extracellular vesicles (EVs) are stable membrane-enclosed particles that are released from diverse cell types and are present at high levels in biofluid samples. This study was developed to explore the relationships between late hematuria incidence and urinary and serum EV concentrations analyzed in a cohort of patients with PCa undergoing RT.

Materials and Methods:

We analyzed EV profiles of preserved urine and serum samples from a longitudinal study of bladder toxicity in 30 patients with PCa undergoing standard-of-care pelvic RT. EVs in these samples were quantified through nanoparticle tracking analyses. EV concentrations at different collection time points were then compared between patients who did and did not develop hematuria.

Results:

RT was found to significantly increase urinary EV concentrations relative to pre-RT levels in patients who subsequently developed late hematuria, whereas such EV induction was absent in patients without hematuria. The same effect was evident but less robust in patient serum samples.

Conclusion:

These results suggest that RT-induced changes in EV dynamics may offer value as a robust biomarker that can predict the risk of late radiation cystitis months before overt symptom presentation.
De novo metabolic syndrome after liver transplantation: a meta-analysis on cumulative incidence, risk factors, and outcomes
Authors: Lim Wen Hui , Tan Caitlyn , Xiao Jieling , Tan Darren Jun Hao , Ng Cheng Han , Yong Jie Ning , Fu Clarissa , Chan Kai En , Zeng Rebecca Wenling , Ren Yi Ping , Goh Xin Lei , Chew Nicholas , Tseng Michael , Syn Nicholas , Mak Lung Yi , Fung James , Muthiah Mark , Siddiqui Mohammad Shadab , Tan Eunice X.X.
Published: February 2023

Post-transplant metabolic syndrome (PTMS) has been associated with increased cardiovascular risk which significantly impacts the morbidity and mortality rates of liver transplant (LT) recipients. This study sought to conduct a meta-analysis and systematic review on the cumulative incidence, risk factors, and cardiovascular outcomes associated with de novo PTMS.Medline and Embase were searched for articles describing the incidence, risk factors, and cardiovascular outcomes of de novo PTMS. Meta-analysis of proportions was conducted to calculate incidence. Conventional pairwise analysis using random effects model was used to tabulate OR and hazard ratio for risk factors and cardiovascular outcomes, respectively. Fifteen studies involving 2683 LT recipients were included. Overall rate of de novo PTMS was 24.7% (CI: 18.0%–32.9%) over a mean follow-up period of 15.3 months and was highest in patients with NAFLD (60.0%, CI: 52.0%–67.5%) compared with other liver diseases. Older age (OR: 1.05, CI: 1.01–1.09, p = 0.02) and pre-LT type II diabetes mellitus (OR: 5.00, CI: 4.17–5.99, p < 0.01) were predictive factors of de novo PTMS. Patients with de novo PTMS had significantly higher likelihood of cardiovascular disease events compared with those who did not (hazard ratio: 2.42, CI: 1.54–3.81, p < 0.01). De novo PTMS is a common complication and is significantly associated with increased cardiovascular disease morbidity. High-risk patients such as elderly recipients, those with pre-LT type II diabetes mellitus, or NASH-related cirrhosis should undergo routine screening to allow timely intervention.
Evolution of pretransplant cardiac risk factor burden and major adverse cardiovascular events in liver transplant recipients over time
Authors: Harrington Claire R. , Levy Paul , Cabrera Elizabeth , Gao Jing , Gregory Dyanna L. , Padilla Cynthia , Crespo Gonzalo , VanWagner Lisa B.
Published: February 2023

Major adverse cardiovascular events (MACEs) are the leading cause of early (<1 y) complications after liver transplantation (LT). NASH, the leading indication for waitlisting for LT, is associated with high cardiac risk factor burden. The contemporary prevalence and temporal trends in pretransplant cardiac risk factor burden and post-LT MACE among LT recipients (LTRs) with and without NASH are unknown. The aim of this study was to evaluate (1) the evolution of post-LT cardiac risk factors in LTRs over time and (2) post-LT MACE over time, stratified by NASH status. This is a retrospective cohort of 1775 adult LTRs at a single transplant center (2003–2020). MACE was defined as death or hospitalization from myocardial infarction, revascularization, stroke, heart failure during the first post-LT year. Between 2003 and 2020, there was a significant increase in pre-LT NASH (p
trend <0.05). There was also a significant increase in pre-LT obesity, atherosclerotic cardiovascular (CV) disease, and older age (≥65 y old) (p
trend<0.05 for all). There was no significant change in the proportion of LTRs with diabetes, chronic kidney disease, or heart failure. Unexpectedly, there were no changes in the rate of post-LT MACE over the study period (−0.1% per year, p
trend=0.44). The lack of change in MACE despite an increase in CV risk factor prevalence may reflect advancement in the identification and management of CV risk factors in LTRs. With projected continued increase in cardiac risk burden and the proportion of patients transplanted for NASH, it is critical for LT programs to develop and implement quality improvement efforts to optimize CV care in LTRs.