bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative study of topical steroids vs nonsteroidal anti-inflammatory drugs to control postcataract surgery inflammation
Authors: Deka Amarendra 
Published: June 2020

Purpose:
To evaluate the efficacy of bromfenac ophthalmic solution 0.09% in comparison with topical steroids after phacoemulsification cataract surgery, while specifically looking at differences in visual acuities, anterior chamber reaction, and central retinal thickness changes.

Setting:
Mission Nethralaya, India.

Design:
Prospective, randomized, investigator-masked, comparative clinical trial.

Methods:
Patients were randomly assigned to 3 treatment groups: In group I, bromfenac was prescribed 3 times a day for 1 month; in group II, prednisolone acetate 1% eye suspension was prescribed 4 times a day for 1 month; and in group III, prednisolone acetate 1% was prescribed 4 times a day for 2 weeks and bromfenac 2 times a day for 1 month. All patients received anti-infective preoperative and postoperative standards of care. Study visit assessments included corrected distance visual acuity, biomicroscopy, intraocular pressure, adverse events, and concomitant medication review. Optical coherence tomography was performed on postoperative days 7, 21, and 60.

Results:
Each group included 150 eyes. All treatment groups had similar baseline measurements. There was a significant difference in anterior chamber reaction observed between group I and group II (P < .001) and group I and group III (P < .001) on postoperative days 1 and 7. On postoperative day 21, thickening of the central fovea was observed in group II as compared with group I and group III. This difference was statistically significant (P < .001).

Conclusions:
The combination of topical nonsteroidal anti-inflammatory drugs and topical steroids resulted in positive clinical outcomes after cataract surgery.
Decreased Pulmonary Function Over 5 Years in US Firefighters
Authors: Mathias Kevin C. , Graham Elliot , Stewart Donald , Smith Denise L. 
Published: June 2020

Objective:
To examine changes in pulmonary function over a 5-year period in US firefighters.

Methods:
Spirometry values from occupational medical examinations separated by 5 years (2009 to 2016) were examined from 662 career firefighters in Virginia. Predicted values and expected 5-year changes in one-second forced expiratory volume (FEV1), forced vital capacity (FVC), and FEV1/FVC were estimated using reference equations generated from the Third National Health and Nutrition Examination Survey (NHANES III) data. Paired t-tests were used to identify significant changes over time and between the observed and expected changes.

Results:
FEV1 and FVC (percentage of predicted) decreased (P < 0.001) from 100.9 ± 0.6% to 92.3 ± 0.5% and 99.0 ± 0.6% to 91.9 ± 0.5%, respectfully. The observed decreases in FEV1, FVC, and FEV1/FVC were two to four times greater (P < 0.001) than the expected decrease over 5 years.

Conclusion:
Increased efforts are needed to ensure respiratory protection for US firefighters to minimize their risk of pulmonary damage.
Longitudinal Changes in Prevalence of Colorectal Cancer in Farm and Non-Farm Residents of Saskatchewan
Authors: Watara Abubakari Ibrahim , Ahmed Shahid , Khan Shahedul , Karunanayake Chandima , Dosman James , Pahwa Punam 
Published: June 2020

Objective:To determine predictors associated with longitudinal changes in colorectal cancer (CRC) prevalence in farm and non-farm rural residents in Saskatchewan, Canada.Methods:Data from the Saskatchewan Rural Health Study were collected from 8261 individuals nested within 4624 households at baseline survey in 2010 and 4867 individuals (2797 households) at follow-up survey in 2014. The study sample consists of 5599 individuals (baseline) and 3933 at (follow-up) (more than or equal to 50 years).Results:The prevalence of CRC increased over time among rural farm (baseline: 0.8%; follow-up: 1.3%,P < 0.05) and non-farm (baseline: 1.4%; follow-up: 2.0%,P > 0.05) residents. Longitudinal predictors of CRC prevalence were: quadrant, location of home, mother ever had cancer, age, body mass index (BMI), sex, radiation, natural gas.Conclusions:Longitudinal changes in prevalence of CRC among farm and non-farm residents appear to depend on a complex combination of individual and contextual factors.
Reliability of an Assessment Tool and Outcomes of a Comprehensive Worksite Wellness Intervention
Authors: Ablah Elizabeth , Kellogg Melinda , Okut Hayrettin , Usher Jeff , Lester Ryan 
Published: June 2020

Objective:
The purpose of this study was to determine the reliability of a comprehensive worksite-level assessment and identify which worksite wellness best practices were implemented following a workshop.

Methods:
Kansas worksites attended a WorkWell Kansas Phase I workshop from 2012 through 2014 and completed a 155-item assessment before the workshop and 1 year later. Cronbach alpha measured the internal consistency of the WorkWell KS Phase I Assessment, and McNemar test assessed differences in proportions from baseline to follow-up.

Results:
Two hundred eighty five worksites completed a baseline assessment, of which, 109 completed the follow-up assessment (32%). The internal consistency of the instrument was 0.96, and worksites reported significant improvements at follow-up from baseline for nine variables.

Conclusions:
Improvements predominantly included creating a wellness committee, assessing needs, and developing goals. There was a lack of policy and systems level improvements at the worksite.
Association of Co-Exposure to Psychosocial Factors With Depression and Anxiety in Korean Workers
Authors: Park Jungsun , Kim Yangho 
Published: June 2020

Introduction:
This study assessed the association of co-exposure to psychosocial factors with depression and anxiety in Korean workers.

Methods:
All data were from the 2017 Korean Working Conditions Survey.

Results:
Males and females who perceived organizational injustice, hid their emotions at the workplace, felt they were paid inappropriately, and had no support from managers were more likely to report depression and anxiety. Males who reported long working hours, no ability to influence decisions, work pressure, and no ability to apply their own ideas at the workplace were more likely to report depression and anxiety. Co-exposure to a greater number of psychosocial factors had stronger associations with depression and anxiety in men and women.

Conclusion:
Employers should reduce depression and anxiety in their workers by providing comprehensive interventions that protect them from co-exposure to work stressors.
Beethoven: His Hearing Loss and His Hearing Aids
Authors: Perciaccante Antonio , Coralli Alessia , Bauman Neil G. 
Published: June 2020

To celebrate the 250th anniversary of the birth of the great classical composer, Ludwig van Beethoven (1770–1827), we point out how his hearing loss affected him and how the primitive hearing aids at that time helped mitigate his hearing loss. From the age of 26, Beethoven began to suffer from a fluctuating, progressive hearing loss (“my hearing grew worse and worse”), This started in his left ear (“in my left ear, with which this illness of my ears had started”), where he had difficulty hearing higher pitched tones (“I don’t hear the high notes of the instruments and voices”) and words (“Sometimes, I cannot hear people who speak quietly, I can hear the sounds, but not the words”) and associated with tinnitus (“my ears, they still keep buzzing and humming day and night”) and loudness recruitment (“if someone yells, it is unbearable to me”).
However, in spite of his hearing loss, Beethoven never lost his love for music and continued composing music, at times using some of the acoustic hearing aids that were just being developed. We analyze and describe the ear trumpets, and the resonant plate that engineer Johan Nepomuk Maelzel and piano-maker Conrad Graf, respectively, constructed to try to improve Beethoven's hearing. Moreover, we discuss the possible use of a wooden drumstick Beethoven might have used to improve his perception of the piano's sound.
Clinicoepidemiologic Profile and Outcome Predicted by Minimal Residual Disease in Children With Mixed-phenotype Acute Leukemia Treated on a Modified MCP-841 Protocol at a Tertiary Cancer Institute in India
Authors: Myint Htar H. , Tandon Sneha , Narula Gaurav , Prasad Maya , Subramanian Papagudi , Patkar Nikhil , Tembhare Prashant , Gujral Sumeet , Banavali Shripad 
Published: June 2020

Introduction:Mixed-phenotype acute leukemia (MPAL) accounts for 1.2% to 5% of acute leukemia across age groups with intermediate prognosis. We evaluated clinicoepidemiologic profiles and outcomes of MPAL.Methods:Records of children younger than 15 years of age with acute leukemia from January 2010 to December 2016 were reviewed on the basis of the MPAL WHO 2008 criteria. Treatment was uniform with a modified MCP-841 protocol. Descriptive analysis tools were used. Outcomes were measured by the Kaplan-Meier method on MedCalc, version 14.8.1.Results:Among 3830 children with acute leukemia in the study period, 2892 received treatment from our center, of whom 24 (0.83%) had MPAL, median age 9 years, with a male:female ratio of 3:1, and median white blood cell of 13.4×109/L. Common immunophenotypes were B/myeloid—12 (50%), T/myeloid—9 (37.5%), and B/T-lymphoid—3 (12.5%). Some B/myeloid cases had abnormal cytogenetics. Seventeen patients were evaluable for outcome. Sixteen patients underwent postinduction bone marrow and 13 (81%) achieved morphologic remission. Thirteen patients underwent flow cytometry–based minimal residual disease evaluation; 9 (69%) were <0.01% (4 postinduction, 5 postconsolidation), and 67% of these had sustained remission till the last follow-up. None underwent bone marrow transplant. The projected 3-year event-free and overall survival rates were 40% and 48%, respectively (median follow-up: 22 mo).Conclusion:MPAL represented <1% of childhood acute leukemia. acute lymphoblastic leukemia–type chemotherapy that incorporated high-dose cytarabine was effective in achieving an minimal residual disease–negativity rate of 69% in evaluated patients, which was also predictive of better outcome.
Grief among Neonatal Intensive Care Nurses
Authors: Rodriguez Alison , Spilker Arlene , Goyal Deepika 
Published: June 2020

Abstract

Background:
Nurses working in the high-stress environment of the neonatal intensive care unit (NICU) are at high risk of experiencing grief after death of a baby.

Design:
Using a quantitative cross-sectional design, a convenience sample of nurses working in a Level IV NICU in Northern California, United States completed online surveys. Level of grief among NICU nurses, perceptions of grief support available at their institution, and past and future grief coping methods were assessed.

Participants:
A diverse sample of 55 NICU nurses, mean age 45.5 (SD = 11.7) years. Setting: A high-acuity NICU in one large Northern California hospital.

Methods:
Participant demographic data and the Revised Grief Experience Inventory were completed online.

Results:
Total grief scores ranged between 22 and 82 with a mean of 46.9 (SD = 17.4). Sixty percent (n = 33) moderately/strongly disagreed on adequacy of current grief support services at their institution and 81% (n = 45) reported hospital staff could benefit from additional grief support. Nurses' past grief support included family, friends, and church. Future grief resources would include family, friends, and co-workers. Participants indicated need for debriefing and additional nurse staffing resources at the time of a patient death.

Conclusions:
Neonatal intensive care unit nurses in our study reported experiencing grief. Debriefing and bereavement support may be helpful for nurses working in high-stress environments where there is a higher likelihood of patient death.
Use of a Novel Couples' Verification Tool in a Male Partner Treatment Study of Women With Recurrent Bacterial Vaginosis
Authors: Muzny Christina A. , Pontius Angela , Woznicki Nicole , Hudak Kathryn E. , Lensing Shelly Y. , Sobel Jack D. , Schwebke Jane R. 
Published: June 2020

Abstract
Verification of relationship status beyond self-report is an important aspect in sexually transmitted infection research, including partner treatment studies where primary sexual partners are targeted for enrollment. This exploratory study describes the use of a novel couples' verification tool in a male partner treatment study of women with recurrent bacterial vaginosis.
Effect of Cyclic Compressive Forces on New Bone Formation during the Distraction Period in Mandibular Distraction Osteogenesis Using a Microactuator-Generated Distractor
Authors: Kwon Hyun-Jin , Cha Jung-Yul , Park Jong-Tae , Kim Hyung Jun , Kim Hee-Jin 
Published: June 2020

Background:
The traditional method of distraction required a long period until the new bone was fully fused. This study aimed to evaluate the effect of cyclic and repetitive compressive force on new bone formation by applying a newly designed microactuator-generated distractor compared with the traditional distraction protocol.

Methods:
The distraction devices were applied to the right and left mandibles of eight mature beagles, four of which were allocated to the experimental group and the other four to the control group. After a 5-day latency period, in the experimental group, 1.5-mm distraction and 0.5-mm compression were alternately applied every 12 hours; and in the control group, 0.5-mm distraction was repeated every 12 hours to perform a total of 7-mm mandibular lengthening. After an 8-week consolidation period, microstructure analysis using micro–computed tomography and histologic evaluations were performed.

Results:
Bone volume fraction and trabecular number were significantly higher in the experimental group. Trabecular thickness did not show a significant difference, and trabecular separation was significantly higher in the control group. The measurement of new bone was significantly higher in the experimental group, but the difference in mineral apposition rate between the experimental and control groups was not statistically significant.

Conclusions:
This study has revealed that applying cyclic compressive and tensile forces during the distraction period induces better new bone formation than repetitive distraction alone. In addition, the new distraction device produced reliable distraction results during the experiment.
The Functional Anatomy of the Ophthalmic Angiosome and Its Implications in Blindness as a Complication of Cosmetic Facial Filler Procedures
Authors: Taylor G. Ian , Shoukath Sajna , Gascoigne Adam , Corlett Russell J. , Ashton Mark W. 
Published: June 2020

Background:
Blindness following facial filler procedures, although rare, is devastating, usually acute, permanent, and attributed to an ophthalmic artery embolus. However, blindness may be delayed for up to 2 weeks, sometimes following injection at remote sites, suggesting alternative pathways and pathogenesis.

Methods:
Seeking solutions, fresh cadaver radiographic lead oxide injection, dissection, and histologic studies of the orbital and facial pathways of the ophthalmic angiosome, performed by the ophthalmic artery and vein, both isolated and together, and facial artery perfusions, were combined with total body archival arterial and venous investigations.

Results:
These revealed (1) arteriovenous connections between the ophthalmic artery and vein in the orbit and between vessels in the inner canthus, allowing passage of large globules of lead oxide; (2) the glabella, inner canthi, and nasal dorsum are the most vulnerable injection sites because ophthalmic artery branches are anchored to the orbital rim as they exit, a plexus of large-caliber avalvular veins drain into the orbits, and arteriovenous connections are present; (3) choke anastomoses between posterior and anterior ciliary vessels supplying the choroid and eye muscles may react with spasm to confine territories impacted with ophthalmic artery embolus; (4) true anastomoses exist between ophthalmic and ipsilateral or contralateral facial arteries, without reduction in caliber, permitting unobstructed embolus from remote sites; and (5) ophthalmic and facial veins are avalvular, allowing reverse flow.

Conclusion:
The authors’ study has shown potential arterial and venous pathways for filler embolus to cause blindness or visual field defects, and is supported clinically by a review of the case literature of blindness following facial filler injection.
Long-Term Outcomes of Spring-Assisted Surgery for Sagittal Craniosynostosis
Authors: Runyan Christopher M. , Gabrick Kyle S. , Park Jungwon G. , Massary Dominic , Hemal Kshipra , Owens Elizabeth S. , Thompson James T. , Couture Daniel , David Lisa R. 
Published: June 2020

Background:
Spring-assisted surgery is an accepted alternative to cranial vault remodeling for treatment of sagittal craniosynostosis. The long-term safety and efficacy profiles of spring-assisted surgery have not been established.

Methods:
This study is a retrospective examination of all patients treated with spring-assisted surgery (n = 175) or cranial vault remodeling (n = 50) for sagittal craniosynostosis at the authors’ institution from 2003 to 2017. Data collected included demographic and operative parameters, preoperative and postoperative Cephalic Indices, and complications. Whitaker grades were assigned blindly by a craniofacial surgeon not involved in patients’ care.

Results:
The mean age at surgery was significantly lower for the spring-assisted surgery group compared with the cranial vault remodeling group (4.6 months versus 22.2 months; p < 0.001). Even when combining spring placement with spring removal operations, total surgical time (71.1 minutes versus 173.5 minutes), blood loss (25.0 ml versus 111.2 ml), and hospital stays (41.5 hours versus 90.0 hours) were significantly lower for the spring-assisted surgery cohort versus the cranial vault remodeling group (p < 0.001 for all). There were no differences in infection, reoperation rate, or headaches between the groups. The percentage improvement in Cephalic Index was not significantly different at 1 (p = 0.13), 2 (p = 0.99), and 6 (p = 0.86) years postoperatively. At 12 years postoperatively, the spring-assisted surgery group had persistently improved Cephalic Index (75.7 preoperatively versus 70.7 preoperatively). Those undergoing spring-assisted surgery had significantly better Whitaker scores, indicating less need for revision surgery, compared with the cranial vault remodeling group (p = 0.006).

Conclusion:
Compared with the authors’ cranial vault remodeling technique, spring-assisted surgery requires less operating room time and is associated with less blood loss, but it has equivalent long-term Cephalic Indices and subjectively better shape outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Registration and Management of “Never Events” in Swiss Hospitals—The Perspective of Clinical Risk Managers
Authors: Schwappach David L. B. , Pfeiffer Yvonne 
Published: June 2020

Background
In Switzerland, there is no mandatory reporting of “never events.” Little is known about how hospitals in countries with no “never event” policies deal with these incidents in terms of registration and analyses.

Objective
The aim of our study was to explore how hospitals outside mandatory “never event” regulations identify, register, and manage “never events” and whether practices are associated with hospital size.

Methods
Cross-sectional survey data were collected from risk managers of Swiss acute care hospitals.

Results
Clinical risk managers representing 95 hospitals completed the survey (55% response rate). Among responding risk and quality managers, only 45% would be formally notified through a designated reporting channel if a “never event” has happened in their hospital. Averaged over a list of 8 specified events, only half of hospitals could report a systematic count of the number of events. Hospital size was not associated with “never event” management. Respondents reported that their hospital pays “too little attention” to the recording (46%), the analysis (34%), and the prevention (40%) of “never events.” All respondents rated the systematic registration and analysis of “never events” as very (81%) or rather important (19%) for the improvement of patient safety.

Conclusions
A substantial fraction of Swiss hospitals do not have valid data on the occurrence of “never events” available and do not have reliable processes installed for the registration and exam of these events. Surprisingly, larger hospitals do not seem to be better prepared for “never events” management.
Role of Prophylactic Cholecystectomy After Endoscopic Sphincterotomy for Biliary Stone Disease
Authors: McCarty Thomas R. , Farrelly James , Njei Basile , Jamidar Priya , Muniraj Thiruvengadam 
Published: June 2020

Objective:
The aim of this study was to perform a structured systematic review and meta-analysis to evaluate the effectiveness and complication rate of cholecystectomy deferral versus prophylactic cholecystectomy among patients post-endoscopic biliary sphincterotomy for common bile duct stones.

Background:
Although previous reports suggest a decreased risk of biliary complications with prophylactic cholecystectomy, biliary endoscopic cholangiopancreatography (ERCP) with sphincterotomy may provide a role for deferring cholecystectomy with the gallbladder left in situ.

Methods:
Searches of PubMed, EMBASE, Web of Science, and Cochrane Library databases were performed through August 2019 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-Analysis of Observational Studies in Epidemiology guidelines. Measured outcomes included: mortality, recurrent biliary pain or cholecystitis, pancreatitis, cholangitis, and eventual need for cholecystectomy. Random effects models were used to determine pooled effect size and corresponding 95% confidence intervals (CIs).

Results:
Nine studies (n = 1605) were included. A total of 53.8% (n = 864) patients had deferred cholecystectomy post-sphincterotomy. Deferral cholecystectomy as compared to prophylactic cholecystectomy resulted in a significant increased risk of mortality [odds raio (OR) 2.56 (95% confidence interval, CI 1.54–4.23); P < 0.0001; I
2 = 18.49]. Patients who did not undergo prophylactic cholecystectomy developed more recurrent biliary pain or cholecystitis [OR 5.10 (95% CI 3.39–7.67); P < 0.0001; I
2 = 0.00]. Rate of pancreatitis [OR 3.11 (95% CI 0.99–9.83); P = 0.053; I
2 = 0.00] and cholangitis [OR 1.49 (95% CI 0.74–2.98); P = 0.264; I
2 = 0.00] was unaffected. Overall, 26.00% (95% CI 14.00–40.00) of patients with deferred prophylactic cholecystectomy required eventual cholecystectomy.

Conclusions:
Prophylactic cholecystectomy remains the preferred strategy compared to a deferral approach with gallbladder in situ post-sphincterotomy for patients with bile duct stones. Future studies may highlight a subset of patients (ie, those with large balloon biliary dilation) that may not require cholecystectomy.