bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Outcomes and Quality Assessment of Trabeculectomy: Leveraging Electronic Health Records for Clinical Data Visualization
Authors: Guo Xinxing , Li Bowen , Friedman David S. , Boland Michael V. 
Published: October 2019

Précis:
This electronic medical record-based study demonstrates 1 approach to monitor clinical outcomes for individual physicians performing trabeculectomy.

Purpose:
The purpose of this study was to develop an interactive data visualization platform for evaluating trabeculectomy outcomes and monitoring clinical care quality.

Patients and Methods:
This is a retrospective electronic health record study in a glaucoma division of an academic medical center. We included 633 patients who underwent trabeculectomy between July 2016 and December 2018. Data were collected for intraocular pressure (IOP), vision loss, number of follow-up visits, and return to the operating room within the initial 3 months. Regression analyses were used to assess factors associated with these study outcomes. Risk of IOP ≤5 mm Hg was assessed using survival analysis. An interactive data visualization platform was created.

Results:
A total of 429 trabeculectomy and 204 combined surgeries were analyzed, with preoperative IOP of 21.9±9.4 and 19.4±6.9 mm Hg, respectively. Mean pressure declined by 53% and 41% (P=0.001) by 3 months. Risk of pressure ≤5 mm Hg was higher in white patients and those who underwent trabeculectomy alone. At 3 months, patients on average had 5 clinic visits; 5.5% required additional surgical procedures, and 18% experienced loss of at least 3 lines of best-recorded (not best-corrected) vision. Returning to the operating room was significantly associated with an increased number of clinic visits (coefficient=3.94) and higher odds of vision loss (odds ratio=11.12).

Conclusions:
Over the initial 3 months after trabeculectomy, additional surgeries are rare, while a significant proportion of patients lost vision, and this was strongly associated with a need to return to the operating room. Interactive electronic health record data visualization can be a useful tool for monitoring clinical outcomes.
Long-Term Follow-up on Glaucoma Patients With Initial Single-Hemifield Defect: Progression Patterns and Associated Factors
Authors: Baek Sung Uk , Kim Young Kook , Park Ki Ho , Jeoung Jin Wook 
Published: October 2019

Purpose:
The purpose of this study was to investigate the clinical outcomes of primary open-angle glaucoma (POAG) with an initial single-hemifield defect on visual field (VF) testing and the related risk factors for the involvement of the opposite hemifield during follow-up.

Methods:
This longitudinal observational study included 108 POAG eyes of 108 patients who met the following conditions: (1) single-hemifield defect at initial VF examination; (2) follow-up >5 years. Eyes having undergone noncataract surgeries and laser treatment during the follow-up period were excluded. Patients were divided into group A (sparing of opposite hemifield) and group B (involvement of opposite hemifield) according to the patterns of VF progression. Baseline demographic and clinical characteristics were compared between the 2 groups. The Cox proportional hazards model was used to identify the risk factors for the involvement of the opposite hemifield.

Results:
A total of 63 eyes (58.3%) were classified as group A and 45 (41.7%) as group B. The average follow-up period was 7.9 years. Between the 2 groups, significant differences were found in the age (55.7±10.7 vs. 61.0±10.5 y, P=0.015) and presence of optic disc vertical tilt (54.0% vs. 28.9%, P=0.034). According to the multivariate Cox proportional hazards model, older age (hazard ratio=1.704; P=0.025) and absence of optic disc vertical tilt (hazard ratio=1.430; P=0.017) were risk factors for the involvement of the opposite hemifield.

Conclusions:
In 108 POAG eyes with an initial single-hemifield defect, 41.7% showed involvement of the opposite hemifield during the average 8.0-year follow-up. Older age and absence of optic disc vertical tilt were significantly associated with a greater probability of involvement of the opposite hemifield.
The Social and Economic Impact of Chronic Obstructive Pulmonary Disease on Maintenance-of-Way Railroad Workers
Authors: Ruttenberg Ruth 
Published: October 2019

Thousands of railroad maintenance-of-way (MOW) workers develop chronic obstructive pulmonary disease (COPD) from their work.

Objective:
This study calculates the social and economic burdens of COPD borne by thousands of MOW workers.

Methods:
Economic calculations are derived from the literature and also from a survey of 4800 MOW respondents, 155 in-depth interviews, and two focus groups.

Results:
COPD alone costs at least $179 million over the course of cases currently diagnosed among MOW workers. Many individuals work through significant pain and breathing difficulties or have to leave the profession. Some are crippled for life.

Conclusion:
When a worker has COPD, beyond pain and suffering, there are often financial burdens that affect families, railroad companies, insurers, communities, and taxpayers as well as the injured workers.
Can an automatic oscillometric device replace a mercury sphygmomanometer on blood pressure measurement? a systematic review and meta-analysis
Authors: Park Seong-Hi , Park Young-Su 
Published: October 2019

Objective:
A mercury sphygmomanometer has been considered a gold standard for measuring blood pressure. However, by the Minamata Convention on Mercury, the traditional mercury sphygmomanometer is being replaced by an automated oscillometric device. This study aimed to provide scientific evidence to determine whether an automated oscillometric device can replace a mercury sphygmomanometer and if it is applicable in routine practice.

Methods:
MEDLINE, EMBASE, the Cochrane Library, and CINAHL were searched on 4 May 2018. Studies comparing blood pressure measurements between automated oscillometric devices and mercury sphygmomanometers were included. Study characteristics were abstracted using the evidence table, and random-effects meta-analyses were conducted.

Results:
Data were compiled from 24 studies comprising 47 759 subjects. The results of meta-analysis showed that automated oscillometric devices measured lower than mercury sphygmomanometers for both systolic blood pressure (mean differences −1.75 mmHg, 95% confidence intervals: −3.05 to −0.45, I2 = 91.0%) and diastolic blood pressure (mean differences −1.20 mmHg, 95% confidence intervals: −2.16 to −0.24, I2 = 95.0%). In sub-group analyses by manufacturer, BpTRU measured lower than the mercury sphygmomanometer and OMRON showed no difference compared to the mercury sphygmomanometer for both systolic and diastolic blood pressure, but the results differed depending on the devices.

Conclusion:
As a result of this review, the difference in blood pressure between the mercury sphygmomanometer and the automated oscillometric device was within 5 mmHg, but the heterogeneity between the studies was very high. The automated oscillometric devices showed differences in blood pressure results according to the manufacturer and product type.
Safety and effectiveness of the self-aPposing, bAlloon-delivered, siRolimus-eluting stent for the Treatment of the coronary Artery disease: SPARTA, a multicenter experience
Authors: Montefusco Antonio , De Filippo Ovidio , Gili Sebastiano , Mancone Massimo , Calcagno Simone , Cirillo Plinio , Esposito Giovanni , Poli Arnaldo , Ferrara Erika , Smolka Grzegorz , Wanha Wojciech , Palmieri Cataldo , Pastormerlo Luigi Emilio , Baumbach Andreas , Sganzerla Paolo , Tamburino Corrado , Bruno Francesco , Secco Gioel Gabrio , Nicolino Annamaria , Yew Kuang Leon , di Palma Gaetano , Wojakowski Wojciech , Sardella Gennaro , Rinaldi Mauro , Cortese Bernardo , D’Ascenzo Fabrizio 
Published: October 2019

Aims:
To assess the long-term outcomes of patients treated with sirolimus-eluting Stentys stent in a real-life setting.

Background:
Few data regarding the safety and effectiveness of self-apposing sirolimus-eluting Stentys stent are available.

Methods:
278 patients (30% stable coronary artery disease, 70% acute coronary syndromes, and 54% on unprotected left main) treated with sirolimus eluting Stentys stent were retrospectively included in the self-aPposing, bAlloon-delivered, siRolimus-eluting stent for the Treatment of the coronary Artery disease multicenter registry. Major adverse cardiovascular events (MACE, a composite of cardiac death, myocardial infarction, target lesion revascularization, stent thrombosis) were the primary end-point, single components of MACE were the secondary ones.

Results:
After 13 months (interquartile range 5–32), MACE was 14%. Stent thrombosis occurred in 3.9% of the patients (2.5% definite stent thrombosis and 1.4% probable stent thrombosis), 66% of them presenting with ST-segment elevation myocardial infarction (STEMI) at admission. Cardiovascular death, target lesion revascularization and myocardial infarction was 4.7%, 8.3%, and 7.2%, respectively. At multivariate analysis, risk of MACE was increased by diabetes (hazard ratios 4.76; P = 0.002) but was not affected by the indication leading to sirolimus-eluting Stentys stent implantation (marked vessel tapering vs. coronary ecstasies, hazard ratios 0.74, P = 0.71).

Conclusion:
Sirolimus-eluting Stentys stent may represent a potential solution for specific coronary anatomies such as bifurcation, ectasic, or tapered vessels. Risk of stent thrombosis appears related to clinical presentation with STEMI and to anatomic features, stressing the importance of the use of intracoronary imaging for self-expandable stents implantation.
The effect of complete revascularization in patients with ST-segment elevation myocardial infarction with Killip class ≥ III
Authors: Lee Wei-Chieh , Chen Tien-Yu , Chen Chien-Jen , Yang Cheng-Hsu , Fang Chih-Yuan , Wu Chiung-Jen , Fang Hsiu-Yu 
Published: October 2019

Background:
The effect of complete revascularization (CR) on high-risk patients with ST-segment elevation myocardial infarction (STEMI) has remains a controversial issue, especially on patients in a critical condition. The aim of this study was to explore the effect of CR on patients with STEMI with Killip class ≥ III.

Methods:
From January 2008 to December 2014, 185 patients diagnosed with STEMI with Killip class ≥ III and multiple vessel coronary artery disease received primary percutaneous coronary intervention (PCI). Eighty-nine patients underwent culprit-only PCI, and the remaining 96 patients underwent immediate or staged PCI for CR. Out of the 96 patients in the CR group, 51 patients underwent immediate CR, and 45 patients underwent CR during the same hospitalization. Thirty-day and 1-year clinical outcomes were compared between the culprit-only PCI group and the CR group as well as between the immediate CR group and staged CR group.

Results:
There was a trend toward a lower incidence of post-PCI acute kidney injury in the culprit-only PCI group when compared with the CR group (14.8% vs. 26.0%; P = 0.069). Thirty-day and 1-year cardiovascular mortality and all-cause mortality were similar between the culprit-only PCI group and CR group. Decreased 1-year cardiovascular mortality and all-cause mortality were noted in the staged CR group compared with the immediate CR group.

Conclusion
was associated a higher possibility of post-PCI acute kidney injury and did not seem to improve 30-day or 1-year clinical outcomes. Patients undergoing staged CR during the same hospitalization had better clinical outcomes.
Anatomical features and clinical outcome of a honeycomb-like structure in the coronary artery: reports from 16 consecutive patients
Authors: Xu Tian , Shrestha Rajiv , Pan Tao , Huang Xiaoyu , Xu Haimei , Zhang Jun-Jie , Tao Ling , Han Yaling , Chen Shao-Liang 
Published: October 2019

Background:
Recanalization of thrombus in coronary artery tree is defined as a honeycomb-like structure. However, the anatomic features and appropriate treatment of honeycomb-like structure still remain largely unclear.

Methods and results:
Between 2014 July and 2017 December, 17 honeycomb-like structure in 16 patients based on optical coherence tomography and intravascular ultrasound were included. Fractional flow reserve was measured for patients who had thrombolysis in myocardial infarction flow grade 3. Angiographic and optical coherence tomography/intravascular ultrasound-derived variables were studied. Clinical events (until to 2018 December) were collected. Honeycomb-like structures mostly involved left anterior descending artery (68.8%) and localized at proximal-mid (88.2%) segment of vessels. Eight patients had a side branch ≥ 2 mm in diameter taking from honeycomb-like structure. Only one patient had a normal fractional flow reserve. Fifteen patients underwent implantation of a stent. Stent implantation was associated with side branch compromise or closure (4 in each). Of 4 patients with side branch closure, all had a creatine kinase myocardial band > 5 times increase in hospital, with 3 deaths and 1 target lesion revascularization during follow-up.

Conclusions:
Despite the presence of recanalization, most honeycomb-like structure lesion have a positive fractional flow reserve. Further study is required to address how to protect a large side branch taking from honeycomb-like structure.
Six months follow-up of protected high-risk percutaneous coronary intervention with the microaxial Impella pump: results from the German Impella registry
Authors: Baumann Stefan , Werner Nikos , Al-Rashid Fadi , Schäfer Andreas , Bauer Timm , Sotoudeh Ramin , Bojara Waldemar , Shamekhi Jasmin , Sinning Jan-Malte , Becher Tobias , Eder Frederik , Akin Ibrahim 
Published: October 2019

Background:
Percutaneous coronary intervention (PCI) represents an important alternative to coronary bypass surgery for the treatment of patients with complex coronary artery disease and high perioperative risk. Protected percutaneous coronary intervention applies temporary percutaneous ventricular assist devices to mitigate potential hemodynamic compromise in high-risk patients. The Impella system is currently the most commonly used device for protected percutaneous coronary intervention and showed improved hemodynamic parameters in earlier trials.

Methods:
This study was designed as a retrospective, observational multi-center registry conducted in ten hospitals in Germany. We included consecutive patients undergoing protected high-risk percutaneous coronary intervention with Impella support. The primary endpoint was defined as the occurrence of a major adverse cardiac event defined as all-cause mortality, ST-elevation myocardial infarction, or stroke during a postprocedural 180-day follow-up period.

Results:
In total, 157 patients (80.3% male; mean age 71.8 ± 10.8 years) were included in the present study, and 180-day follow-up was complete for 149 patients (94.9%). At baseline, the patients had a median left ventricular ejection fraction of 39.0% (interquartile range, 25.0–50.0%). The median SYNergy between PCI with TAXUS and Cardiac Surgery-Score I was 33.0 (interquartile range, 24.0–40.5) and the median EuroSCORE II was 7.2% (interquartile range, 3.2-17.1%). During postprocedural follow-up, 34 patients (22.8%) suffered a major adverse cardiac event. All-cause mortality was 18.1% (27 patients). Nine patients (6.0%) sustained a ST-elevation myocardial infarction, while 4 patients (2.7%) had a stroke.

Conclusions:
Patients undergoing protected high-risk percutaneous coronary intervention with Impella support showed an acceptable 180-day clinical outcome regarding major adverse cardiac event and mortality.
Clinical benefits of prolonged dual antiplatelet therapy following complex percutaneous coronary intervention
Authors: Subhaharan Deloshaan , Mridha Naim , Singh Kuljit 
Published: October 2019

Aims
Prolonged dual antiplatelet therapy (DAPT) requires consideration of both reduced thrombotic events and increased bleeding risk. The associated subtle balance between the benefits and harms depends upon patient's clinical factors and complexity of the coronary anatomy. Our aim was to assess the safety and efficacy of prolonged (>12 months) DAPT in patients undergoing complex percutaneous coronary intervention (PCI).

Methods and Results
A thorough computer-based search was performed using four major databases. Complex PCI was defined as a procedure with at least one of the following angiographic characteristics: 3 vessels treated, >3 stents implanted, >3 lesions treated, bifurcation lesions, total stent length >60 mm, left main or proximal left anterior descending, a vein graft stent, or chronic total occlusion as target lesion. Of the 3543 titles searched, 5 studies met the inclusion criteria comparing short and prolonged DAPT therapy. We applied a random-effects model to acknowledge the variation in study design, treatment duration, and length of follow-up among studies. There was a reduction in cardiac mortality [odds ratio (OR) 0.57, 95% confidence interval (CI): 0.35–0.92; P = 0.02, I
2 = 0%] and major adverse cardiovascular events (OR 0.76, 95% CI: 0.59–0.96; P = 0.02, I
2 = 22%) with prolonged DAPT. Major bleeding was increased with prolonged DAPT (OR 1.75, 95% CI: 1.20–2.20; P = 0.004, I
2 = 0%). There was no difference in the all-cause mortality (OR 0.86, 95% CI: 0.61–1.22; P = 0.41, I
2 = 0%).

Conclusion
Prolonged DAPT reduces cardiac mortality and major adverse cardiovascular events in complex PCI. The results would need confirmation in a larger randomized study.
Exploration of interventional therapy strategy for portal vein occlusion: a case series study
Authors: Liu Jiacheng , Zhou Chen , Shi Qin , Ma Jinqiang , Ye Tianhe , Zheng Chuansheng , Feng Gansheng , Xiong Bin 
Published: October 2019

Objectives
To explore the candidates, efficacy and safety of interventional therapies in the treatment of portal vein occlusion (PVO).

Methods
In our study, 13 patients diagnosed with PVO were included. Of all 13 patients, two received percutaneous portal vein recanalization (PVR), 10 received PVR and transjugular intrahepatic portosystemic shunt (PVR-TIPS), and one underwent intrahepatic portal branch-large collateral vessel shunt.

Results
Interventional approaches were completed in all patients, and the technical success rate was 100%. The portal pressure gradient of patients treated with PVR-TIPS fell from 31 ± 4 to 12 ± 3 mmHg. During the procedures, no life-threatening complications occurred. All the clinical symptoms were effectively controlled after the interventional therapies and all the patients survived during the follow-up, with no rebleeding or overt hepatic encephalopathy. But stent thrombosis occurred in one patient, the cumulative rate of stent patency was 92%.

Conclusion
Interventional therapy was proved to be a well tolerated and effective strategy for PVO. For PVO patients without high intrahepatic resistance, if the patient is equipped with available portal inflow tract (superior mesenteric vein or splenic vein) and outflow tract (intrahepatic portal branches), PVR is the first choice; if the outflow tract is completely blocked with only available inflow tract, PVR-TIPS can be considered. For PVO patients with high intrahepatic resistance, as long as there is an available portal inflow tract, PVR-TIPS can be adopted.
Posttraumatic Stress and Depression Among Syrian Refugees Living in Turkey
Authors: Kaya Edip , Kiliç Cengiz , Karadağ Çaman Özge , Üner Sarp 
Published: October 2019

Abstract
Although most of the 3.6 million Syrian refugees in Turkey live outside refugee camps, most mental health research is on camp residents and few are on those living in cities. We aimed to assess the prevalence and predictors of posttraumatic stress disorder (PTSD) and depression in Syrian refugees living in an urban area in Turkey. A total of 420 adult Syrians living in Ankara were assessed using the Harvard Trauma Questionnaire and the Beck Depression Inventory. Probable PTSD and depression rates were 36.5% and 47.7%, respectively. Female sex, physical illness, and greater number of potentially traumatic events predicted both PTSD and depression. PTSD was additionally predicted by past psychiatric illness, and depression was predicted by lower economic status. Interestingly, lower economic status predicted depression among men, but not among women. Studies on refugees should be sensitive to factors that could have a significant effect on mental health such as sex or residence.
Extracorporeal Membrane Oxygenation Support After Heart Transplantation in Children—Outcomes of a Single Center Cohort
Authors: Nair Asha G. , Sleeper Lynn A. , Smoot Leslie B. , Wigmore Daniel , Mecklosky Jessica , Andren Kristofer , Bastardi Heather J. , Blume Elizabeth D. , Fynn-Thompson Francis , Thiagarajan Ravi R. , Alexander Peta M. A. 
Published: October 2019

Objectives:
Extracorporeal membrane oxygenation is used for postcardiotomy low cardiac output but is less established following heart transplantation. We characterized outcomes for children supported with extracorporeal membrane oxygenation after heart transplantation.

Design:
Single-center retrospective study.

Setting:
Large pediatric cardiac referral center.

Patients:
All patients who received heart transplantation and were cannulated to extracorporeal membrane oxygenation between 1995 and 2016.

Interventions:
Primary outcome measure was mortality 12 months postextracorporeal membrane oxygenation. Patient characteristics were analyzed for association with outcome according to early graft failure (extracorporeal membrane oxygenation ≤ 7 d after heart transplantation), or late graft failure.

Measurements and Main Results:
There were 246 heart transplants during the study period and 50 extracorporeal membrane oxygenation runs in 44 patients. Median time from transplant to extracorporeal membrane oxygenation was 1 day (range, 0–11.7 yr), with early graft failure in 28 patients (median 1, range 0–2 d) and 22 extracorporeal membrane oxygenation runs in 20 late graft failure patients (median, 0.8 yr; range, 8 d to 11.7 yr), including four patients with prior extracorporeal membrane oxygenation for early graft failure. Twenty-six patients (59%) survived to hospital discharge, and survival 12 months postextracorporeal membrane oxygenation was 24 patients (55%), lower in those with late graft failure (40% vs 67%; p 0.02). Independent risk factors for 12-month mortality were congenital heart disease, higher pulmonary vascular resistance indexed to body surface area (> 2.2 Woods U/m2), and higher creatinine. Higher panel reactive antibody levels were associated with 12-month mortality in the late graft failure group only.

Conclusions:
Extracorporeal membrane oxygenation can be effectively used to rescue patients with graft dysfunction after heart transplantation but is associated with high early mortality. Factors associated with mortality within 12 months include presence of congenital heart disease, renal dysfunction, elevated pulmonary vascular resistance indexed to body surface area and in those supported with extracorporeal membrane oxygenation late after heart transplantation, significant human leukocyte antigen sensitization.