bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of fluid responsiveness using lung recruitment manoeuvre in paediatric patients receiving lung-protective ventilation
Authors: Kim Eun-Hee , Lee Ji-Hyun , Jang Young-Eun , Ji Sang-Hwan , Kim Hee-Soo , Cho Sung-Ae , Kim Jin-Tae 
Published: November 2020

BACKGROUND
Pressure-based dynamic variables are poor predictors of fluid responsiveness in children, and their predictability is expected to reduce further during lung-protective ventilation with a low tidal volume.

OBJECTIVE
We hypothesised that lung recruitment manoeuvre (LRM)-induced changes in dynamic variables improve their ability to predict fluid responsiveness in children.

DESIGN
Prospective observational study.

SETTING
Tertiary care children's hospital, single-centre study performed from June 2017 to May 2019.

PATIENTS
We included patients less than 7 years of age undergoing cardiac surgery. Neonates and patients with pulmonary hypertension, significant dysrhythmia, ventricular ejection fraction of less than 30% or pulmonary disease were excluded.

INTERVENTION
All patients were provided with lung-protective volume-controlled ventilation (tidal volume 6 ml kg−1, positive end-expiratory pressure 6 cmH2O). A LRM was applied with a continuous inspiratory pressure of 25 cmH2O for 20 s.

MAIN OUTCOME MEASURE
The ability of dynamic variables to predict fluid responsiveness was evaluated by the area under the receiver operating characteristic curve [area under the curve (AUC)]. Fluid responsiveness was defined as an increase in the cardiac index by more than 15% with crystalloid administration (10 ml kg−1).

RESULTS
Thirty patients were included in the final analysis, of whom 19 were responders. The baseline pleth variability index (PVI) (AUC 0.794, 95% confidence interval 0.608 to 0.919, P < 0.001) and LRM-induced PVI (AUC 0.711, 95% confidence interval 0.517 to 0.861, P = 0.026) could predict fluid responsiveness. The respiratory variation of pulse oximetry photoplethysmographic waveform and pulse pressure variation did not predict fluid responsiveness regardless of the LRM.

CONCLUSION
The PVI is effective in predicting fluid responsiveness in paediatric patients with lung-protective ventilation regardless of a LRM. However, the LRM did not improve the ability of the other dynamic variables to predict fluid responsiveness in these patients.

CLINICAL TRIAL REGISTRATION

www.clinicaltrials.gov identifier: NCT03184961.
Association of small dense LDL-cholesterol with disease severity, hypertension status and clinical outcome in patients with coronary artery disease
Authors: Zhang Hui-Wen , Jin Jing-Lu , Cao Ye-Xuan , Liu Hui-Hui , Zhang Yan , Guo Yuan-Lin , Wu Na-Qiong , Zhu Cheng-Gang , Gao Ying , Xu Rui-Xia , Hua Qi , Li Yan-Fang , Cui Chuan-Jue , Dong Qian , Sun Jing , Li Jian-Jun 
Published: November 2020

Objective:
Previous studies have demonstrated that small dense LDL-cholesterol (sdLDL-C) is related to the pathogenesis of coronary artery disease (CAD). However, its prognostic role in hypertensive patients with CAD has been undetermined. The aim of the study was to investigate the association between sdLDL-C with disease severity, hypertensive status and clinical outcome in patients with CAD.

Methods:
A total of 4594 patients with angiography-proven CAD were consecutively enrolled and categorized into subgroups according to blood pressure status. Serum sdLDL-C levels were measured by direct quantitative measurement using automated chemistry analyzers. The severity of coronary artery lesions were determined by Gensini score, Syntax score and the number of lesion vessels. The associations of sdLDL-C with disease severity, hypertensive status and cardiovascular events (CVEs) were evaluated.

Results:
Patients with hypertension had higher sdLDL-C levels than ones without (P = 0.010). In hypertensive patients, sdLDL-C was positively associated with the severity of CAD (P < 0.05). In addition, hypertensive patients with poorly controlled hypertension had higher sdLDL-C levels than those with well controlled (P < 0.05). Moreover, 149 CVEs occurred in patients with poorly controlled hypertension and Cox regression analysis indicated that elevated sdLDL-C levels were independently associated with CVEs in hypertensive patients with poorly controlled hypertension (adjusted hazard ratio: 1.673, 95% confidence interval: 1.105–2.535, P = 0.015).

Conclusion:
The current data, for the first time, showed that serum sdLDL-C levels were correlated with hypertension control, disease severity and worse outcomes in hypertensive patients with CAD, suggesting that paying more attention on sdLDL-C in these patients were warranted.
Relationship between casual serum triglyceride levels and the development of hypertension in Japanese
Authors: Tomita Yusuke , Sakata Satoko , Arima Hisatomi , Yamato Ikumi , Ibaraki Ai , Ohtsubo Toshio , Matsumura Kiyoshi , Fukuhara Masayo , Goto Kenichi , Kitazono Takanari 
Published: November 2020

Objective:
The purpose of the present study was to investigate the effects of serum triglyceride levels on the risk of new-onset hypertension in Japanese.

Methods:
Five thousand nine hundred and thirty-three Japanese workers without hypertension at baseline, who participated in medical check-ups from 2006 to 2018, were followed retrospectively. The participants were divided into quartiles of casual serum triglyceride levels and were followed from the first to last visit of the study period. The outcome was development of hypertension. Risk estimates were computed using Cox's proportional hazards model.

Results:
During the follow-up period (average: 6.7 years), 946 individuals developed hypertension. The crude incidence rates of hypertension (per 1000 person-years) increased with rising serum triglyceride levels: 10.1 for quartile 1 (<0.76 mmol/l), 19.6 for quartile 2 (0.76–1.17 mmol/l), 26.0 for quartile 3 (1.18–1.84 mmol/l), and 36.5 for quartile 4 (>1.84 mmol/l) (P < 0.0001 for trend). These associations remained significant even after adjustment for other risk factors: the multivariable-adjusted hazard ratio was 1.29 (1.01–1.66) for the second quartile, 1.27 (0.99–1.63) for the third quartile, and 1.39 (1.09–1.77) for the highest quartile compared with the lowest. There were comparable effects of serum triglyceride levels for incidence of hypertension between subgroups defined by sex, obesity, and diabetes (all P > 0.1 for interaction), whereas stronger associations were observed for participants under 40 years of age than for those aged 40 or above (P = 0.002 for interaction).

Conclusion:
Serum triglyceride levels were significantly associated with development of hypertension in a Japanese worksite population.
The diagnostic accuracy of adjusted unconventional indices for adrenal vein sampling in the diagnosis of primary aldosteronism subtypes
Authors: Parasiliti-Caprino Mirko , Bioletto Fabio , Ceccato Filippo , Lopez Chiara , Bollati Martina , Voltan Giacomo , Rossato Denis , Giraudo Giuseppe , Scaroni Carla , Ghigo Ezio , Maccario Mauro 
Published: November 2020

Objective:
Simple unconventional indices did not demonstrate a satisfactory accuracy for diagnosing unilateral primary aldosteronism when adrenal vein sampling is not bilaterally selective. This study aimed to evaluate the reliability of clinical/imaging-corrected unconventional indices for adrenal vein sampling in predicting unilateral primary aldosteronism.

Methods:
Data of all consecutive patients with primary aldosteronism subtyped with adrenal vein sampling, referred to two Italian centers, were analyzed retrospectively. All patients with proved unilateral aldosterone hypersecretion underwent adrenalectomy.

Results:
Unilateral disease was diagnosed in 58 cases (54.2%) and idiopathic hyperaldosteronism in 49 individuals (45.8%). The monoadrenal index (aldosterone-to-cortisol ratio in the adrenal vein) showed high accuracy in predicting ipsilateral disease and moderate accuracy in predicting contralateral aldosterone hypersecretion. The monolateral index (aldosterone-to-cortisol ratio in the adrenal vein vs. peripheral blood) revealed moderate accuracy in predicting ipsilateral disease and high accuracy in predicting contralateral aldosterone hypersecretion. Lesion side- and hypokalemia-corrected ROC curves for these unconventional indices revealed a significant improvement in the reliability of predicting ipsilateral/contralateral disease, reaching high accuracy in all models. For an immediate clinical application of our results, the adjusted cut-offs were calculated, according to the Youden's criterion and to a pre-established specificity of 95%, for all possible combinations of lesion side at imaging and presence/absence of hypokalemia.

Conclusion:
This study demonstrated the high diagnostic accuracy of clinical-/imaging-corrected unconventional indices for adrenal vein sampling in the diagnosis of primary aldosteronism subtypes and suggests the use of these adjusted indices to select patients for adrenalectomy when adrenal vein sampling is not bilaterally selective.
Visit-to-visit variability in blood pressure among cannabis users participating in the Third National Health and Nutrition Examination Survey
Authors: Alshaarawy Omayma , Vanderziel Alyssa 
Published: November 2020

Objective:
Blood pressure variability (BPV) has emerged as an important predictor of cardiovascular morbidity and mortality. Plausible biological mechanisms link cannabis use and blood pressure (BP) regulation. Here, we assess the relationship between cannabis use and BPV, measured by the SD and coefficient of variation across three separate study visits.

Methods:
Data for individuals (17–59 years, n = 758) participating in the United States Third National Health and Nutrition Examination Survey substudy were used. Associations between cannabis use and mean BP, SBP and DBP variability were estimated. Participants were classified according to recency or lifetime frequency of cannabis use. Generalized linear regressions were used to model BPV as the outcome and cannabis use status as the exposure, adjusting for potential confounding variables.

Results:
Compared with nonuse, active cannabis use was associated with higher SD (mmHg) of mean BP [β = 0.97; 95% confidence interval (CI) = 0.22, 1.73], SBP (β = 0.95; 95% CI = 0.04, 1.85) and DBP (β = 1.18; 95% CI = 0.28, 2.08). Similar conclusions were obtained when the coefficient of variation was modelled as the outcome. A robust association was not observed for lifetime use frequency. The association between active cannabis use and SBP variability was stronger in the tobacco smoking subgroup, whereas the association between active cannabis use and DBP variability was stronger in the tobacco nonsmoking subgroup.

Conclusion:
Active cannabis use is associated with BPV. Future research is needed to understand the effects of cannabis use on BP regulation.
Radiofrequency ablation for adenoma in patients with primary aldosteronism and hypertension: ADERADHTA, a pilot study
Authors: Bouhanick Béatrice , Delchier Marie C. , Lagarde Séverine , Boulestreau Romain , Conil Claude , Gosse Philippe , Rousseau Hervé , Lepage Benoit , Olivier Pascale , Papadopoulos Panteleimon , Trillaud Hervé , Cremer Antoine 
Published: November 2020

Objective:
To evaluate the efficacy and the feasibility of radiofrequency ablation to treat aldosterone-producing adenomas.

Methods:
In an open prospective bicentric pilot study, patients with hypertension on ambulatory blood pressure measurement, a primary aldosteronism, an adenoma measuring less than 4 cm, and confirmation of lateralization by adrenal venous sampling were recruited. The primary endpoint, based on ABPM performed at 6 months after the radiofrequency ablation, was a daytime SBP/DBP less than 135/85 mmHg without any antihypertensive drugs or a reduction of at least 20 mmHg for SBP or 10 mmHg for DBP.

Results:
Thirty patients have been included (mean age = 51 ± 11 years; 50% women). Mean baseline daytime SBP and DBP were 144 ± 19 / 95 ± 15 mmHg and 80% received at least two antihypertensive drugs. At 6 months: 47% (95% CI 28–66) of patients reached the primary endpoint, mean daytime SBP and DBP were 131 ± 14 (101–154)/87 ± 10 (71–107) mmHg; 43% of them did not take any antihypertensive drug and 70% of them did not take potassium supplements. Few complications were recorded: four cases of back pain at day 1 postablation; three limited pneumothoraxes, which resolved spontaneously; one lesion of a polar renal artery.

Conclusion:
Radiofrequency ablation for hypertensive patients with aldosterone-producing adenomas seems to be an emerging promising alternative to surgery. Its efficacy and its feasibility have to be confirmed in a larger sample of patients.
Surgical Management of the Ocular Surface in Neurotrophic Keratopathy: Amniotic Membrane, Conjunctival Grafts, Lid Surgery, and Neurotization
Authors: Trinh Tanya , Mimouni Michael , Santaella Gisella , Cohen Eyal , Chan Clara C. 
Published: November 2020

Purpose:
To review the surgical modalities available to treat Mackie stage 2 and stage 3 neurotrophic keratopathy.

Methods:
Literature review and technique descriptions.

Results:
The following procedures are described in detail with accompanying videos: temporary, permanent, and botox-assisted tarsorrhaphy; amniotic membrane transplant; keratoplasty with amniotic membrane and tarsorrhaphy augmentation; Gunderson and conjunctival pedicle flaps; buccal graft transplantation; and neurotization.

Conclusion:
A variety of surgical options exist to manage neurotrophic keratopathy when medical treatments alone fail to resolve epitheliopathy. Ongoing protection and optimization of the ocular surface health remains crucial to prevent recurrent epithelial breakdown.
Flanged fixation: Yamane technique and its application
Authors: Yamane Shin , Ito Arisa 
Published: November 2020

Purpose of review
To review variations of flanged intraocular lens fixation (Yamane technique) and their outcomes.

Recent findings
Sutureless intrascleral IOL fixation has become popular, and many techniques have been reported. Among them, the Yamane technique has been widely used in recent years, and there are many variations. However, there are no reports that systematically compare them.

Summary
There are variations of the Yamane technique, such as those used to create a scleral tunnel or to dock needles and haptics. Although few reports have directly compared each technique, small scleral wounds appear to be beneficial for long-term stability of the IOL. A method of fixing a capsule tension segment or iris using a flange has also been reported, demonstrating the diverse range of uses of the flange.
Electrocochleography Observations in a Series of Cochlear Implant Electrode Tip Fold-Overs
Authors: Trecca Eleonora M. C. , Adunka Oliver F. , Mattingly Jameson K. , Hiss Meghan M. , Cassano Michele , Malhotra Prashant S. , Riggs William J. 
Published: November 2020

Objective:
Tip fold-over is a rare but serious complication of cochlear implant (CI) surgery. The purpose of this study was to present intraoperative electrocochleography (ECochG) observations in a series of CI electrode tip fold-overs.

Patients:
Five pediatric subjects undergoing CI surgery through a round window (RW) approach with a perimodiolar electrode array, who were diagnosed with either auditory neuropathy spectrum disorder or enlarged vestibular aqueduct.

Interventions:
Intraoperative RW ECochG during CI surgery: tone burst stimuli were presented from 95 to 110 dB SPL.

Main Outcome Measure(s):
Magnitude and phase characteristics of ECochG responses obtained intraoperatively before and immediately after electrode insertion were examined for patients with and without tip fold-over.

Results:
Three subjects presented with tip fold-over and two formed the control group. Among fold-over cases, one participant exhibited an inversion in the starting phase of the cochlear microphonic response and a decrease in spectral magnitude from pre- to postinsertion. Both subjects who did not exhibit a change in phase had an increase in the ECochG-total response (ECochG-TR) magnitude. No case in the control group exhibited a change in starting phase. In regard to the ECochG-TR, all controls showed a decrease in the magnitude.

Conclusions:
Despite the small number of patients, heterogeneous ECochG response patterns were observed within the fold-over group. Though these results are not conclusive, they can serve as a framework to begin to understand ECochG's utility in detecting intraoperative tip fold-over.
Assessment of myocardial function by two-dimensional speckle tracking echocardiography in patients with Kawasaki disease: a mid-term follow-up study
Authors: Wang Haiyong , Tong Minghui , Mu Jingjing , Wu Tingting , Ruan Litao 
Published: November 2020

Background
Myocardial impairment proved by histological studies persists in late convalescent phase Kawasaki disease patients. Whether Kawasaki disease-induced myocardial lesions can be detected in an earlier time is not well explored. In this study, we aimed to evaluate left ventricular (LV) myocardial function by two dimensional speckle tracking echocardiography (2DSTE) in late convalescent phase Kawasaki disease patients.

Methods
A total of 68 Kawasaki disease patients during mid-term phase including 47 with no coronary artery aneurysm (NCAA) and 21 with coronary artery aneurysm (CAA), and 60 controls with age matched were consecutively enrolled.

Results
No significant differences on conventional echocardiographic LV systolic function indices were found among group comparison. Compared with controls, Kawasaki disease patients had lower global longitudinal stain (GLS) and global circumferential stain (GCS). In subgroup analysis, both those with CAA and without CAA had lower GLS, lower GCS, higher amino-terminal propeptide of type III procollagen (PIIINP) and higher carboxyterminal propeptide of procollagen type I (PIPC) than in controls. GLS had significantly negative correlations with PIIINP (r = −0.69, P = 0.002) and PIPC (r = −0.82, P = 0.000).

Conclusion
Subclinical myocardial dysfunction in mid-term follow-up Kawasaki disease patients existed regardless of coronary artery status despite normal measurements of LV systolic function by routine echocardiography, and myocardial fibrosis may play a contributed role in this subclinical myocardial function impairment. 2DSTE is a valuable imaging modality for detecting regional and global myocardial dysfunction in Kawasaki disease patients in an early time.
Spontaneous coronary artery dissection and Takotsubo syndrome: comparison of baseline clinical and angiographic characteristics and in-hospital outcomes
Authors: Salamanca Jorge , García-Guimaraes Marcos , Camacho-Freire Santiago Jesús , Ojeda Soledad , Veiga Gabriela , Jiménez-Valero Santiago , Hernández-Antolín Rosana , Trillo Ramiro , Velázquez Maite , Cortes Carlos , Gutiérrez-Barrios Alejandro , Franco-Pelaez Juan Antonio , Lezcano-Pertejo Cristina , Diez-Delhoyo Felipe , Gamarra Alvaro , Aguilar Rio , Díez-Villanueva Pablo , Bastante Teresa , Alfonso Fernando 
Published: November 2020

Background
Spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS) constitute two relatively common nonatherosclerotic causes of acute coronary syndrome particularly frequent in women.

Methods
This study sought to compare the baseline clinical and angiographic characteristics and in-hospital outcomes of patients from two large prospective registries on SCAD and TTS (the prospective nation-wide Spanish SCAD Registry and a prospective single-center TTS registry).

Results
A total of 318 SCAD and 106 TTS consecutive patients were included. Most patients in both groups (88%) were women. Patients in the TTS group were older [74 (interquartile range, IQR 67–81) vs. 53 years-old (IQR 47–60), P < 0.001] and presented a higher prevalence of cardiovascular risk factors. Precipitating triggers were more frequent in TTS (56% vs. 42%, P = 0.009) but emotional stress was more common in the SCAD group (25% vs. 15%, P = 0.037). TTS patients showed a reduced release of cardiac biomarkers but had more severe left ventricular dysfunction (ejection fraction <50%: 73% vs. 12%, P < 0.001). In-hospital major adverse cardiovascular events occurred more frequently in TTS patients (12% vs. 4.7%, P < 0.001). Notably, TTS patients showed more frequently congestive heart failure (10% vs. 0.6%, P < 0.001), atrial fibrillation (11% vs. 1%, P < 0.001) and had a higher all-cause in-hospital mortality (5.7% vs. 1.3%, P = 0.032).

Conclusion
TTS patients are older and present a higher prevalence of some cardiovascular risk factors than patients with SCAD. TTS is linked to a worse in-hospital prognosis with higher mortality.
2-Stage Collaborative Testing Results in Improved Academic Performance and Student Satisfaction in a PreLicensure Nursing Course
Authors: Riley Elizabeth , McCormack Leslie , Ward Nicole , Renteria Fermin , Steele Taylor 
Published: November 2020

Background
The results remain mixed regarding improved student academic performance and satisfaction when 2-stage collaborative testing (CT) is used in nursing education.

Purpose
The purpose of this study was to evaluate student academic performance and perceived satisfaction after a CT experience and to compare academic performance between a CT and non-CT cohort.

Methods
A quantitative design was used to evaluate the effect of CT on academic performance by comparing examination scores and item difficulty values (IDVs) within a CT cohort (n = 111) and between the CT cohort and non-CT retrospective cohort (n = 105). A faculty-created survey was used to measure student-perceived satisfaction in the CT cohort.

Results
Student examination scores increased after the CT experience on a duplicate unit examination. The IDVs on 8 content-specific duplicate final examination items 1 month after the CT experience were significantly increased. There were no significant differences in the IDVs on the 8 content-specific items between a CT and non-CT retrospective cohort.

Conclusions
Collaborative testing is an active learning modality that can be used in nursing programs to aid students in their learning of specific nursing concepts.
Nursing Faculty Perceptions Regarding Students With Physical Disabilities
Authors: Elting Julie Kientz , Avit Elaina , Gordon Rebecca 
Published: November 2020

Background
Students with physical disabilities continue to face barriers seeking entry into nursing programs even as the nursing profession advocates vigorously for the rights of these individuals.

Purpose
The purpose of this study was to identify faculty perceptions that create barriers for students with physical disabilities to meet the requirements of a BSN education.

Methods
Nursing faculty (n = 111) completed an online survey about the ability of a student who uses a wheelchair for mobility to meet required outcomes.

Results
Participants believed students could meet the 14 cognitive and affective domain outcomes (88%-100%) for generalist practice. Their agreement that students could meet psychomotor domain outcomes was lower (66%-90%). Younger faculty expressed more positive perceptions.

Conclusions
Using the psychomotor requirements of bedside nursing as the technical standard for nursing education is a barrier for students with physical disabilities. Faculty should expand their perceptions of the essentials of nursing education to create an inclusive environment.