bluuebunny/crossref_metadata_2025_split huggingface dataset:
Workshop on normal reference ranges for estradiol in postmenopausal women, September 2019, Chicago, Illinois
Authors: Santen Richard J. , Pinkerton JoAnn V. , Liu James H. , Matsumoto Alvin M. , Lobo Roger A. , Davis Susan R. , Simon James A. 
Published: May 2020

Abstract
The North American Menopause Society (NAMS) organized the Workshop on Normal Ranges for Estradiol in Postmenopausal Women from September 23 to 24, 2019, in Chicago, Illinois. The aim of the workshop was to review existing analytical methodologies for measuring estradiol in postmenopausal women and to assess existing data and study cohorts of postmenopausal women for their suitability to establish normal postmenopausal ranges. The anticipated outcome of the workshop was to develop recommendations for establishing normal ranges generated with a standardized and certified assay that could be adopted by clinical and research communities. The attendees determined that the term reference range was a better descriptor than normal range for estradiol measurements in postmenopausal women. Twenty-eight speakers presented during the workshop.
BETA-PERIPAPILLARY ATROPHY AND GEOGRAPHIC ATROPHY IN THE COMPARISON OF AGE-RELATED MACULAR DEGENERATION TREATMENTS TRIALS
Authors: Kolomeyer Anton M. , Smith Eli , Daniel Ebenezer , Ying Gui-Shuang , Pan Wei , Pistilli Max , Grunwald Juan , Maguire Maureen G. , Kim Benjamin J. ,   for the CATT Research Group
Published: May 2020

Purpose:
To determine associations between beta-peripapillary atrophy (B-PPA) and incidence and growth of geographic atrophy (GA) in eyes treated with anti–vascular endothelial growth factor agents in the Comparison of Age-Related Macular Degeneration Treatments Trials (CATT).

Methods:
We included 245 cases with incident GA and 245 controls matched by baseline demographics and characteristics associated with development of GA in the CATT. Baseline color images were graded for the type of B-PPA, defined as presence of hypopigmentation with visible choroidal vessels and sclera that is adjacent to the optic disk. Beta-peripapillary atrophy was further classified as scleral ring, sclera, sclera/choroidal blood vessels, or combination. Areas of each type of B-PPA and the circumferential extent of B-PPA were measured.

Results:
Beta-peripapillary atrophy was present in 58% of eyes developing GA and in 52% without GA (P = 0.17). The greater circumferential extent of sclera/choroidal blood vessels B-PPA in relation to the optic disk was associated with incident GA (P = 0.02) and the GA size at first observation (P = 0.047). Beta-peripapillary atrophy was not associated with GA growth rates (P>0.05). Patients without B-PPA had a higher number of GA-associated risk alleles of ARMS2 (P = 0.0003) and HTRA1 (P = 0.001).

Conclusion:
The extent of sclera/choroidal blood vessel B-PPA was associated with the GA incidence and size but not with the growth rate in eyes treated for neovascular age-related macular degeneration. Beta-peripapillary atrophy and GA may share some common pathophysiologic pathways unrelated to the GA-associated risk alleles evaluated.
CLINICAL PREDICTORS OF TUBERCULAR RETINAL VASCULITIS IN A HIGH-ENDEMIC COUNTRY
Authors: Kaza Hrishikesh , Tyagi Mudit , Pathengay Avinash , Basu Soumyava 
Published: May 2020

Purpose:
To determine clinical signs suggestive of tubercular etiology in retinal vasculitis.

Methods:
A retrospective comparative study of patients who presented with retinal vasculitis at three tertiary care centers in India. All patients underwent detailed clinical evaluation and tailored laboratory investigations for etiological diagnosis. Tubercular etiology was diagnosed on basis on the presence of retinal periphlebitis in association with ancillary evidence of systemic tuberculosis and exclusion of nontuberculosis entities. Patients with tubercular (Group A) and nontubercular (Group B) etiology were compared for demographic characteristics, supportive diagnostic evidence, and specific ocular signs. Statistical analysis was performed at 5% confidence levels.

Results:
Of the 114 patients diagnosed with retinal vasculitis, Group A had 69 patients (100 eyes) and Group B had 45 patients (75 eyes). Active or healed subvascular lesions (P ≤ 0.0001), focal vascular tortuosity (P ≤ 0.0001), and occlusive vasculitis (P = 0.002) were significantly more common in Group A patients than in Group B patients. All three were independent predictors of tubercular etiology on multivariate regression analysis.

Conclusion:
The presence of healed or active subvascular lesions, focal vascular tortuosity, and occlusive vasculitis could be predictive of tubercular etiology in retinal vasculitis.
Outcomes of Ahmed Glaucoma Valve Implantation With Viscoelastic Fill at Both Beginning and End of Surgery
Authors: Dugan Connor , Zheng Cindy X. , Lin Michael M. , Ustaoglu Melih , Zhang Qiang (Ed) , Hamershock Rose A. , Moster Stephen J. , Moster Marlene R. 
Published: May 2020

Précis:
Intracameral injection of viscoelastic at the beginning of Ahmed FP7 implantation did not reduce early postoperative complication rates.

Purpose:
To evaluate early postoperative complication rates after a modified technique in which the anterior chamber (AC) is filled with viscoelastic at the beginning of Ahmed FP7 implantation before conjunctival peritomy.

Subjects and Methods:
A retrospective chart review was performed of eyes that underwent Ahmed FP7 implantation with or without viscoelastic fill to ~20 mm Hg by finger tension by a single surgeon (M.R.M). Viscoelastic prevented the AC from becoming shallow at any time during surgery, and additional viscoelastic was injected into the AC at the end of surgery to achieve a final intraocular pressure (IOP) of 20 mm Hg.

Results:
A total of 159 eyes of 159 patients were included. Mean age was 76.4±10.4 years. Mean preoperative IOP was 30.3±9.7 mm Hg on 2.7±1.2 glaucoma medications. On postoperative day 1, there was an IOP spike ≥30 mm Hg in 0% of patients. Within the first postoperative month, hypotony (<5 mm Hg) occurred in 19 (21.8%) eyes that received viscoelastic fill compared with 5 (13.2%) eyes that did not receive viscoelastic fill (P=0.26). During the early postoperative period (≤3 mo), there was no difference in AC depth, microhyphema, choroidal effusion, or leakage between the 2 groups (P≥0.30 for all). There was a higher rate of layered hyphemas in the viscoelastic-fill group at postoperative week 1 (P=0.01). At 3-month follow-up, mean IOP was 14.9±5.5 mm Hg on 1.6±0.8 medications in the viscoelastic-fill group and 16.0±5.2 mm Hg on 1.0±1.2 medications in the nonviscoelastic-fill group (IOP P=0.35). Compared with baseline, change in IOP at 3 months was similar between both groups (P=0.15). Rates of additional medications and procedures did not differ between the 2 groups at any postoperative visit.

Conclusions:
Early intracameral injection of viscoelastic during Ahmed glaucoma valve implantation did not reduce early postoperative complication rates.
A Case of Critically Ill Infant of Coronavirus Disease 2019 With Persistent Reduction of T Lymphocytes
Authors: Qiu Liru , Jiao Rong , Zhang Aiming , Chen Xi , Ning Qin , Fang Feng , Zeng Fang , Tian Niannian , Zhang Yi , Huang Yafei , Sun Ziyan , Dhuromsingh Menaka , Li Hao , Li Yang , Xu Rongrong , Chen Yu , Luo Xiaoping 
Published: May 2020

Background:
The outbreak of coronavirus disease 2019 (COVID-19) is becoming a global threat. However, our understanding of the clinical characteristics and treatment of critically ill pediatric patients and their ability of transmitting the coronavirus that causes COVID-19 still remains inadequate because only a handful pediatric cases of COVID-19 have been reported.

Methods:
Epidemiology, clinical characteristics, treatment, laboratory data and follow-up information and the treatment of critically ill infant were recorded.

Results:
The infant had life-threatening clinical features including high fever, septic shock, recurrent apnea, petechiae and acute kidney injury and persistent declined CD3+, CD4+ and CD8+ T cells. The duration of nasopharyngeal virus shedding lasted for 49 days even with the administration of lopinavir/ritonavir for 8 days. The CD3+, CD4+ and CD8+ T cells was partially recovered 68 days post onset of the disease. Accumulating of effector memory CD4+ T cells (CD4+TEM) was observed among T-cell compartment. The nucleic acid tests and serum antibody for the severe acute respiratory syndrome coronavirus 2 of the infant’s mother who kept intimate contact with the infant were negative despite no strict personal protection.

Conclusions:
The persistent reduction of CD4+ and CD8+ T cells was the typical feature of critically ill infant with COVID-19. CD4+ and CD8+ T cells might play a key role in aggravating COVID-19 and predicts a more critical course in children. The prolonged nasopharyngeal virus shedding was related with the severity of respiratory injury. The transmission of SARS-CoV-2 from infant (even very critical cases) to adult might be unlikely.
Rapid Rehabilitation With Skin-Muscle Sparing Orbital Exenteration: A Single-Center Series
Authors: Jayaprakasam Anuradha , Vahdani Kaveh , Rose Geoffrey E. , Saleh George M. , Hussain Badrul , Verity David H. , Collin J. Richard O. 
Published: May 2020

Aims:
To examine the features and clinical management of patients who underwent skin-muscle sparing orbital exenteration in a tertiary referral center.

Patients and Method:
Retrospective case-note review for patients undergoing skin-muscle sparing orbital exenteration at Moorfields Eye Hospital between 1997 and 2012. Patient demographics, clinical features, histopathology, clearance, surgery, adjuvant therapy, and outcomes were analyzed.

Results:
Seventy-four patients (33 male; 45%) had skin-muscle sparing orbital exenteration at a median age of 63.8 years (median 65.5, range 13–96 years) for malignancies primarily arising in the eyelids (34 cases; 46%), orbit (25 cases; 34%) or conjunctiva (15 cases; 20%). The commonest pathologies were sebaceous carcinoma (20 cases; 27%), melanoma (19 cases; 26%), squamous cell carcinoma (12 cases; 16%), and basal cell carcinoma (9 cases; 12%). The patients had very rapid rehabilitation with primary closure of skin-muscle flaps over the cavity, either directly (63/74 patients; 85%), or with addition of local flaps. Local radiotherapy had been given before exenteration to 18 (24%) patients, was administered after exenteration in 19 (26%) patients, and both before and after surgery in 5 (7%); those having postoperative radiotherapy were referred at 2–3 weeks after exenteration, and the initial prosthetics fitting was started at 3–6 weeks after surgery. Thirty-eight (51%) patients died during a follow-up of 1–164 months (mean 55, median 47 months); 20/38 (53%) died from metastases—although 9/20 had known metastatic disease prior to palliative exenteration. Three patients were alive with apparently inactive metastases at 30, 39, and 140 months after surgery.

Conclusion:
Direct closure of skin-and-muscle flaps is achievable in almost all undergoing orbital exenteration. In contrast to skin-grafting, free myocutaneous flaps or secondary intention healing, this allows early referral if adjunctive orbital radiotherapy is needed, and the initial fitting of prosthetics can be within weeks of surgery. The technique also avoids the much greater donor-site morbidity of other reconstructive techniques, such as local or free myocutaneous flaps.
Evaluating the effect of intravitreal triamcinolone–moxifloxacin during cataract surgery on central macular edema in patients with preexisting diabetic retinopathy
Authors: Angkadjaja Julia , Chu Joshua , Sierpina David I. , Peng Jiahao , Rauser Michael 
Published: May 2020

Purpose:
To evaluate the effect of intravitreal triamcinolone acetonide–moxifloxacin at the time of cataract surgery on central macular edema in patients with preexisting diabetic retinopathy.

Setting:
Loma Linda University Eye Institute, California, USA.

Design:
Retrospective observational clinical study.

Methods:
Retrospective chart review included 75 eyes of 64 patients who had cataract surgery between February 2015 and October 2018 performed by 2 surgeons. Intravitreal injection of triamcinolone–moxifloxacin (15 mg/1 mg/mL, 0.2 mL injection with 3.0 mg triamcinolone acetonide and 0.2 mg moxifloxacin) was given at the time of surgery. Visual acuity and central macular thickness (CMT) with optical coherence tomography were recorded at preoperative and postoperative visits.

Results:
Mean visual acuity (logarithm of the minimum angle of resolution) at 4 to 6 weeks, 6 to 12 weeks, and 12 weeks or more postoperatively was 0.32, 0.35, and 0.43, respectively. Baseline mean CMT of 75 eyes was 294 μm (SD = 72). Mean CMT 4 to 6 weeks postoperatively for 46 eyes decreased from 299 μm (78) to 297 μm (79), with a mean decrease of 2 μm (50) (P = .97). Mean CMT 6 to 12 weeks postoperatively for 34 eyes increased from 317 μm (88) to 344 μm (111), with a mean increase of 26 μm (98) (P = .021). Mean CMT 12 weeks or more for 60 eyes increased from 295 μm (72) to 328 μm (108), with a mean increase of 33 μm (85) (P = .0023).

Conclusions:
Triamcinolone acetonide–moxifloxacin maintained stability of postoperative CMT in patients undergoing cataract surgery with preexisting diabetic retinopathy in the short term, with the greatest effect at 4 to 6 weeks postoperatively.
Acute visceral pain relief mediated by A3AR agonists in rats: involvement of N-type voltage-gated calcium channels
Authors: Lucarini Elena , Coppi Elisabetta , Micheli Laura , Parisio Carmen , Vona Alessia , Cherchi Federica , Pugliese Anna M. , Pedata Felicita , Failli Paola , Palomino Seph , Wahl Jared , Largent-Milnes Tally M. , Vanderah Todd W. , Tosh Dilip K. , Jacobson Kenneth A. , Salvemini Daniela , Ghelardini Carla , Di Cesare Mannelli Lorenzo 
Published: May 2020

Abstract
Pharmacological tools for chronic visceral pain management are still limited and inadequate. A3 adenosine receptor (A3AR) agonists are effective in different models of persistent pain. Recently, their activity has been related to the block of N-type voltage-gated Ca2+ channels (Cav2.2) in dorsal root ganglia (DRG) neurons. The present work aimed to evaluate the efficacy of A3AR agonists in reducing postinflammatory visceral hypersensitivity in both male and female rats. Colitis was induced by the intracolonic instillation of 2,4-dinitrobenzenesulfonic acid (DNBS; 30 mg in 0.25 mL 50% EtOH). Visceral hypersensitivity was assessed by measuring the visceromotor response and the abdominal withdrawal reflex to colorectal distension. The effects of A3AR agonists (MRS5980 and Cl-IB-MECA) were evaluated over time after DNBS injection and compared to that of the selective Cav2.2 blocker PD173212, and the clinically used drug linaclotide. A3AR agonists significantly reduced DNBS-evoked visceral pain both in the postinflammatory (14 and 21 days after DNBS injection) and persistence (28 and 35 days after DNBS) phases. Efficacy was comparable to effects induced by linaclotide. PD173212 fully reduced abdominal hypersensitivity to control values, highlighting the role of Cav2.2. The effects of MRS5980 and Cl-IB-MECA were completely abolished by the selective A3AR antagonist MRS1523. Furthermore, patch-clamp recordings showed that A3AR agonists inhibited Cav2.2 in dorsal root ganglia neurons isolated from either control or DNBS-treated rats. The effect on Ca2+ current was PD173212-sensitive and prevented by MRS1523. A3AR agonists are effective in relieving visceral hypersensitivity induced by DNBS, suggesting a potential therapeutic role against abdominal pain.
Factors Associated With Predischarge Versus Postdischarge Scheduling for Early Follow-up Appointments
Authors: Distelhorst Karen , Bena James F. , Morrison Shannon L. , Albert Nancy M. 
Published: May 2020

Background
Per national guidelines, early follow-up appointments should be scheduled before discharge, but in previous research, appointments scheduled before discharge were not associated with appointment adherence.

Objectives
The purpose of this study was to determine whether patient, heart failure (HF), and hospital factors were associated with predischarge appointment scheduling.

Methods
A secondary analysis of a medical record review included patients hospitalized for decompensated HF at 3 health system hospitals who had a scheduled office appointment post discharge at 14 days or less. Patient demographics, and social, HF, and hospital factors were studied for association with predischarge scheduling.

Results
In multivariable modeling, the odds of having an appointment scheduled predischarge were based on 3 factors: nonwhite race, history of chronic renal insufficiency, and no admission within 14 days before HF hospitalization.

Conclusions
Appointment scheduling may be based on provider perceptions of readmission risk. Follow-up appointment scheduling practices should be based on systematic processes.
Evolution of Forensic Nursing Theory——Introduction of the Constructed Theory of Forensic Nursing Care: A Middle-Range Theory
Authors: Valentine Julie L. , Sekula L. Kathleen , Lynch Virginia 
Published: May 2020

ABSTRACT
The constructed theory of forensic nursing care is a middle-range nursing theory developed from the integrated practice model for forensic nursing science, a conceptual framework. Theory evolution was achieved following a critique of the conceptual framework and through inductive and deductive reasoning. A review of nursing theory growth and significance of middle-range theories is presented as background information in understanding the importance of this emerging forensic nursing middle-range theory. The philosophical and theoretical foundations of forensic nursing are bolstered with the addition of three nursing theories, two healthcare models and one social theory. Links are made between theory components and the current state of forensic nursing. Assumptions and concepts are clearly defined. The middle-range theory provides three testable propositions to frame forensic nursing practice, education, and research. Research conducted on the propositions will expand the forensic nursing scientific base leading to enhanced evidence-based practice. A pictorial model illustrates the propositions as relational statements. The constructed theory of forensic nursing care affirms the focus of forensic nursing care is on the nurse–patient relationship and improved health outcomes. Additional results of forensic nursing care are improved forensic science and criminal justice system outcomes.
Evaluation of a nurse practitioner–led project to improve communication and collaboration in the acute care setting
Authors: Austin Star , Powers Kelly , Florea Sorin , Gaston Teresa 
Published: May 2020

ABSTRACT

Background:
Effective communication between patients and the health care team is essential. The Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) survey measures discharged patients' perceptions of their hospital experience, including nurse and doctor (physician) communication. These scores affect hospital reimbursement for Medicare and Medicaid patients.

Local problem:
In 2015, the project facility was penalized for low HCAHPS scores, causing a loss in revenue. The facility's medical–surgical unit scores were still failing in 2016.

Methods:
A quality improvement project on Interprofessional Bedside Rounds (IBR) was designed and implemented, and the effect of hiring nurse practitioners (NPs) to the unit's hospitalist service was also examined. Analysis of variance was used to detect significant changes in nurse and doctor HCAHPS communication scores from baseline in 2016, after NPs were hired in 2017, and post-IBR in 2018. The Interprofessional Collaborative Competency Attainment Scale (ICCAS) was also used to measure changes in staff competencies.

Interventions:
The IBR intervention was conducted with the NP, nurse, and doctor present. It was structured to promote effective communication and patient engagement.

Results:
Hospital Consumer Assessment of Health Care Providers and Systems scores improved, with nurse scores increasing from 2016 (79%) to 2017 (86%) to 2018 (90%) (p = .310). Doctor scores improved from 2016 (69%) to 2017 (88%) but slightly decreased to 2018 (85%) (p = .040). Interprofessional Collaborative Competency Attainment Scale results showed a 29% improvement in staff's perceived ability to collaborate (p = .000).

Conclusions:
Results indicate that the addition of NPs greatly improved HCAHPS communication scores. To improve communication, medical–surgical units should consider a team-based approach that includes NP leadership for implementing evidence-based interventions such as IBR.
The effect of remote patient monitoring on discharge outcomes in post-coronary artery bypass graft surgery patients
Authors: Shaughnessy Kathleen , White Krista A. , Murphy Marilynn , Crowell Nancy A. , Anderson Kelley M. 
Published: May 2020

ABSTRACT
Coronary artery bypass graft (CABG) surgery is a lifesaving procedure for patients with coronary artery disease but ranks highest (13.5%) for preventable hospital readmissions and second highest in average Medicare payment ($8,136) per readmission. Care transitions after hospital discharge warrant exploration to improve outcomes. The purpose of this brief report was to compare the effect of remote patient monitoring (RPM) on 30-day outcomes in Medicare beneficiaries after isolated CABG surgery. Results demonstrated no statistically significant difference in 30-day readmission (p = .568) or emergency department encounters (p = .785) between groups. However, time to achieve a cardiology follow-up appointment decreased from 19.8 to 13.7 days (p = .062) in the RPM group. Although the findings were not statistically significant, this study demonstrated a reduction in CABG readmissions and timely provider follow-up with RPM. In addition, study findings contribute to the body of nursing knowledge and support the need for further studies to identify high-risk CABG patients who may benefit from RPM after hospital discharge.
Risk of Recurrence After Treatment for Cervical Intraepithelial Neoplasia 3 and Adenocarcinoma In Situ of the Cervix: Recurrence of CIN 3 and AIS of Cervix
Authors: Swift Brenna E. , Wang Li , Jembere Nathaniel , Kupets Rachel 
Published: May 2020

Objectives
The aim of the study was to evaluate recurrence risk of cervical intraepithelial neoplasia (CIN) 3+ and adenocarcinoma in situ (AIS)+ in a large population cohort of women previously treated for CIN 3/AIS.

Methods
Merging administrative databases with information on health services utilization and jurisdictional cancer registry, we identified all women undergoing treatment for CIN 3 or AIS from 2006 to 2010. Recurrence rate 1–5 years after treatment was defined as a biopsy finding of CIN 3/AIS or retreatment (loop electrosurgical excision procedure [LEEP], laser, cone, hysterectomy). Logistic regression was used to determine odds of recurrence.

Results
A total of 15,177 women underwent treatment for CIN 3 (n = 14,668) and AIS (n = 509). The recurrence rate for 5 years was greater for AIS (9.0%) compared with CIN 3 (6.1%). In a multivariate analysis, increased risk of recurrence was shown for age older than 45 years (hazard ratio (HR) = 1.3, 95% CI = 1.1–1.6), AIS compared with CIN 3 (HR = 2.2, 95% CI = 1.5–3.5) first cytology after treatment showing high grade (HR = 12.4, 95% CI = 9.7–15.7), and no normal Pap smears after treatment (HR = 2.8, 95% CI = 2.2–3.7). There was no difference in recurrence risk with treatment type (cone vs LEEP: HR = 1.0, 95% CI = 0.8–1.2, and laser vs LEEP: HR = 1.1, 95% CI = 0.8–1.4) or number of procedures per year performed by physicians (<40 vs >40 procedures: HR = 1.1, 95% CI = 0.9–1.3).

Conclusions
Recurrence risk of CIN 3 and AIS is related to age, histology, and posttreatment cytology, which should assist with discharge planning from colposcopy. Definitive treatment with hysterectomy should be considered in women older than 45 years with additional risk factors for recurrence.