bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of anterior segment changes after femtosecond laser LASIK and SMILE using a dual rotating Scheimpflug analyzer
Authors: Kim Bu Ki , Mun Su Joung , Yang Young Hoon , Kim Ji Sun , Moon Jun Hyung , Chung Young Taek 
Published: December 2019

Abstract
Background
To compare the changes in the anterior segment after femtosecond laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) using a dual rotating Scheimpflug (DRS) analyzer (Galilei®; Ziemer Ophthalmology, Port, Switzerland).

Methods
A total of 218 eyes of 109 patients who underwent FS-LASIK or SMILE for myopic correction were retrospectively studied. Ninety-eight eyes of 49 patients who underwent FS-LASIK were compared to 120 eyes of 60 patients treated with SMILE. A DRS analyzer was used for preoperative and 6-month postoperative anterior segment analyses. Measured variables included the central corneal thickness (CCT), anterior chamber depth (ACD), anterior and posterior keratometry (K), anterior and posterior best-fit sphere radius, and maximum posterior elevation (MPE).

Results
After the procedure, the amount of CCT decrease was higher in the SMILE group than in the FS-LASIK group, but it was not statistically significant. The MPE was significantly increased after both procedures (p < 0.001 and p = 0.001 in the FS-LASIK and SMILE groups, respectively), with the amount of elevation being higher after FS-LASIK than after SMILE even though it was not statistically significant. And there was a significant change in the steep and average posterior K in the FS-LASIK group (p = 0.006 and 0.001, respectively), but not in the SMILE group.

Conclusions
Regarding changes in the MPE and posterior K, changes in the posterior corneal surface were greater after FS-LASIK than after SMILE.

Trial registration
The trial registration number: KCT0003628. Date of registration: 15 March 2019.
Mapping the prevalence and nature of drug related problems among hospitalised children in the United Kingdom: a systematic review
Authors: Sutherland Adam , Phipps Denham L. , Tomlin Stephen , Ashcroft Darren M. 
Published: December 2019

Abstract
Background
Problems arising from medicines usage are recognised as a key patient safety issue. Children are a particular concern, given that they are more likely than adults to experience medication-related harm. While previous reviews have provided an estimate of prevalence in this population, these predate recent developments in the delivery of paediatric care. Hence, there is a need for an updated, focussed and critical review of the prevalence and nature of drug-related problems in hospitalised children in the UK, in order to support the development and targeting of interventions to improve medication safety.

Methods
Nine electronic databases (Medline, Embase, CINAHL, PsychInfo, IPA, Scopus, HMIC, BNI, The Cochrane library and clinical trial databases) were searched from January 1999 to April 2019. Studies were included if they were based in the UK, reported on the frequency of adverse drug reactions (ADRs), adverse drug events (ADEs) or medication errors (MEs) affecting hospitalised children. Quality appraisal of the studies was also conducted.

Results
In all, 26 studies were included. There were no studies which specifically reported prevalence of adverse drug events. Two adverse drug reaction studies reported a median prevalence of 25.6% of patients (IQR 21.8–29.9); 79.2% of reactions warranted withdrawal of medication. Sixteen studies reported on prescribing errors (median prevalence 6.5%; IQR 4.7–13.3); of which, the median rate of dose prescribing errors was 11.1% (IQR 2.9–13). Ten studies reported on administration errors with a median prevalence of 16.3% (IQR 6.4–23). Administration technique errors represented 53% (IQR 52.7–67.4) of these errors. Errors detected during medicines reconciliation at hospital admission affected 43% of patients, 23% (Range 20.1–46) of prescribed medication; 70.3% (Range 50–78) were classified as potentially harmful. Medication errors detected during reconciliation on discharge from hospital affected 33% of patients and 19.7% of medicines, with 22% considered potentially harmful. No studies examined the prevalence of monitoring or dispensing errors.

Conclusions
Children are commonly affected by drug-related problems throughout their hospital journey. Given the high prevalence and risk of patient harm,, there is a need for a deeper theoretical understanding of paediatric medication systems to enable more effective interventions to be developed to improve patient safety.
How involuntary subordination and social support influence the association between self-esteem and depression: a moderated mediation model
Authors: Shen Qiuming , Shi Yue , Zhang Shuxian , Tsamlag Lhakpa , Wang Huwen , Chang Ruijie , Peng Zihe , Wang Ying , Shang Meili , Cai Yong 
Published: December 2019

AbstractBackgroundIn China, young migrants are at elevated risk of mental health problems, such as depression. The influence of self-esteem on depression is well acknowledged. We examined correlates of depression and their mediating and moderating role in the association between self-esteem and depression to promote a better understanding of depression prevention among young migrants.MethodsWe conducted a cross-sectional study among young Chinese migrants. A moderated mediation model was used to test the combined effect of involuntary subordination and social support on the association between self-esteem and depression. The Johnson–Neyman method was used to identify the range of scores for which social support acted as a moderator.ResultsA total of 572 participants completed questionnaires. The median depression score was 19 (interquartile range: 14). Self-esteem had a negative effect on involuntary subordination (β = − 2.1440,p < 0.001). Involuntary subordination (β = 0.2406, p < 0.001), self-esteem (β = − 0.3870,p < 0.01), and social support (β = − 0.1221, p < 0.01) all had significant effects on depression. The effect of involuntary subordination on depression was moderated by social support (β = − 0.0041,p < 0.05), and the effect decreased as social support scores increased.ConclusionsOur results indicated a mediating role of involuntary subordination and a moderating role of social support in the association between self-esteem and depression among young Chinese migrants. Future intervention strategies should focus on these factors to reduce depressive symptoms.
Prevalence and associated factors of zinc deficiency among pregnant women and children in Ethiopia: a systematic review and meta-analysis
Authors: Berhe Kidanemaryam , Gebrearegay Freweini , Gebremariam Hadush 
Published: December 2019

Abstract
Background
Pregnant women and children are the most vulnerable groups to zinc deficiency. Despite the presence of few primary studies, studies that could provide strong evidence that would help policymakers to develop appropriate interventional strategies in addressing zinc deficiency among pregnant women and children are limited in Ethiopia. Therefore, the aim of this systematic review and meta-analysis was to estimate the national pooled prevalence and associated factors of zinc deficiency among pregnant women and children.

Methods
We searched Pub Med, Scopus, CINAHL, Google Scholar, and Google for studies reported on zinc deficiency and associated factors among pregnant women and children. Search terms were ‘zinc deficiency’, ‘zinc status’, ‘associated factors’, ‘children’, ‘pregnant women’, and ‘Ethiopia’ using the boolean operators ‘OR’ or ‘AND’. Searches were using English language. A preferred reporting item for systematic reviews and meta-analysis (PRISMA) checklist was used. Two authors independently reviewed the studies. The effect sizes of the meta-analysis were the prevalence of zinc deficiency and adjusted odds ratio (AOR) of the associated factors. Finally, the Comprehensive Meta-Analysis (CMA) version 3.3.07 was used for statistical analysis by applying the random-effects model and publication bias was assessed using funnel plots and Egger’s test.

Results
Thirteen studies (7 among pregnant women having total participants of 2371 pregnant women and 6 among children with total participants of 5154 children) were included in this systematic review and meta-analysis. Using the random-effects model, the pooled prevalence of zinc deficiency was 59.9% (95%CI: 51.9, 67.7%) and 38.4% (95%CI: 28.6, 49.4) among pregnant women and children, respectively. The associated factors for zinc deficiency among pregnant women were coffee intake (adjusted odds ratio (AOR) =1.76), low intake of animal source foods (AOR = 2.57), and inadequate diet diversity (AOR = 2.12).

Conclusion
Overall, zinc deficiency among pregnant women and children is a significant public health concern in Ethiopia. Promoting dietary modification to enhance the bioavailability of zinc, improving diet diversity, and consuming animal source foods would help in alleviating and/or minimizing the problem among the target groups. Zinc supplementation could also be considered for pregnant women and children.
Prevalence of selected intestinal protozoan infections in marginalized rural communities in Palestine
Authors: Al-Jawabreh Amer , Ereqat Suheir , Dumaidi Kamal , Al-Jawabreh Hanan , Abdeen Ziad , Nasereddin Abdelmajeed 
Published: December 2019

AbstractBackgroundIntestinal parasitic infections are common in rural areas with poor infrastructure and low socioeconomic status. The aim of this study was to estimate the prevalence of selected parasitic infections in marginalized rural areas in the northern part of the Palestinian West Bank Region, using conventional and PCR-based methods, and also to assess risk predictors of infection.MethodsA cross-sectional study was conducted on 104 individuals from three rural villages in the Jordan Valley. Stool samples were collected and examined by a battery of tests that included microscopy of wet fecal samples in normal saline with iodine, concentration by ethyl acetate sedimentation and also by zinc sulfate floatation, a conventional PCR and a real-time PCR (qPCR). Risk factors were assessed that included demographic, socioeconomic, and behavioral characteristics. Data on method performance was analyzed by kappa-statistic, Cochrane’s Q, and McNemar post hoc test. Mid-P exact test and odds ratio were used to discern association between outcome and risk predictors.ResultsThe overall prevalence of intestinal parasitic infections was 48% (49/102). The predominant parasites wereGiardia lambliaat 37% (37/102) andHymenolepis nanaat 9% (9/102). To concentrate cysts and eggs, sedimentation can be used as an alternative to floatation with a loss of 1% of positive cases. The methods employing PCRs proved crucial as it increased the detected infection rate ofG. lambliaapproximately three-fold from 13% by the conventional methods to 37% by the qPCR. Multiple infections were present in 13% (13/102) of the study group, which included double (10%) and triple (3%) infections. Regarding the genusEntamoeba,E. disparandE. coliwere detected at rates of 2 and 8%, respectively. While none of the individuals were infected with the pathogenicE. histolytica,E. nana(4%) was detected for the first time in the area. Age was a risk predictor for infection (OR = 2.61, CI 95% 1.05–6.45,P = 0.038).ConclusionsThe increased prevalence of intestinal parasitic infections in children in marginalized rural areas in Palestine is worrying. The addition of PCR-based methods is important for the diagnosis of such infections as, with cautious interpretation, it increases proficiency and overcomes underestimation and misdiagnosis of cases. Control measures including education on personal hygiene and environmental sanitation, should be introduced to reduce the prevalence of the intestinal parasites and, thus, the infections they cause in this and other areas.
Robot-assisted bronchoscopy for pulmonary lesion diagnosis: results from the initial multicenter experience
Authors: Chaddha Udit , Kovacs Stephen P. , Manley Christopher , Hogarth D. Kyle , Cumbo-Nacheli Gustavo , Bhavani Sivasubramanium V. , Kumar Rohit , Shende Manisha , Egan John P. , Murgu Septimiu 
Published: December 2019

AbstractBackgroundThe Robotic Endoscopic System (Auris Health, Inc., Redwood City, CA) has the potential to overcome several limitations of contemporary guided-bronchoscopic technologies for the diagnosis of lung lesions. Our objective is to report on the initial post-marketing feasibility, safety and diagnostic yield of this technology.MethodsWe retrospectively reviewed data on consecutive cases in which robot-assisted bronchoscopy was used to sample lung lesions at four centers in the US (academic and community) from June 15th, 2018 to December 15th, 2018.ResultsOne hundred and sixty-seven lesions in 165 patients were included in the analysis, with an average follow-up of 185 ± 55 days. The average size of target lesions was 25.0 ± 15.0 mm. Seventy-one percent were located in the peripheral third of the lung. Pneumothorax and airway bleeding occurred in 3.6 and 2.4% cases, respectively. Navigation was successful in 88.6% of cases. Tissue samples were successfully obtained in 98.8%. The diagnostic yield estimates ranged from 69.1 to 77% assuming the cases of biopsy-proven inflammation without any follow-up information (N = 13) were non-diagnostic and diagnostic, respectively. The yield was 81.5, 71.7 and 26.9% for concentric, eccentric and absent r-EBUS views, respectively. Diagnostic yield was not affected by lesion size, density, lobar location or centrality.ConclusionsRAB implementation in community and academic centers is safe and feasible, with an initial diagnostic yield of 69.1–77% in patients with lung lesions that require diagnostic bronchoscopy. Comparative trials with the existing bronchoscopic technologies are needed to determine cost-effectiveness of this technology.
Comparison between ultrasound-guided TIVAD via the right innominate vein and the right internal jugular vein approach
Authors: Sun Xingwei , Bai Xuming , Shen Jiaofeng , Yu Ziyang , Zhuang Zhixiang , Jin Yong 
Published: December 2019

AbstractBackgroundTo compare the efficacy and safety of right internal jugular vein (IJV) approach and right innominate vein (INV) approach for US-guided totally implantable venous access devices (TIVADs), and to explore the advantages and disadvantages of the two approaches.MethodsSix hundred and nineteen adult patients had long-term infusion and chemotherapy needs and inconvenience of peripheral venous infusion. Right INV approach was used to implant 339 cases of TIVADs, and right IJV approach was used to implant 280 cases of TIVADs. The success rate of one-time catheterization and the incidence of complications in the two groups were retrospectively analyzed.ResultsAll patients were successfully implanted in TIVAD. The success rates of one-time puncture in INV group and IJV approach group were 98.53% (334/339) and 95.36% (267/280), respectively. There was significant difference between the two groups (P = 0.020). The incidence of perioperative complications and long-term complications in the right INV group were 1.18% (4/339) and 3.54% (12/339), respectively, while those in the right IJV group were 1.43% (4280) and 3.93% (11280). There was no significant difference in the incidence of perioperative or long-term complications between the two groups (P = 0.785,P = 0.799, respectively).ConclusionsUS-guided TIVADs via the right INV approach and the right IJV approach are both safe and reliable. The right INV approach improves the one-time puncture success rate, as long as the technique is properly operated, serious complications rarely occur.
Comparison of parathyroid hormone kinetics in endoscopic thyroidectomy via bilateral areola with open thyroidectomy
Authors: Zhang Daqi , Wang Tie , Dionigi Gianlorenzo , Zhang Jiao , Zhao Yishen , Xue Gaofeng , Liang Nan , Sun Hui 
Published: December 2019

Abstract
Background
In this study, we aimed to compare the kinetics of intact parathyroid hormone (iPTH) during the perioperative period of endoscopic thyroidectomy via bilateral areola approach (ETBAA) in the same period, following a traditional open thyroidectomy approach (OTA).

Methods
We conducted a prospective observational study of patients who were undergoing thyroidectomy and level VI clearance. Patients who had been affected by papillary thyroid cancer (PTC) were stratified into three groups: those eligible for endoscopic treatment (ETBAA); patients who were eligible for ETBAA but had opted for OTA (OTA-L); and patients who were not suitable for endoscopic intervention (OTA-H). A process for locating parathyroid glands was utilized to stratify gland dissection laboriousness. In Type A, the gland is firmly fixed to thyroid gland. This type can be sub-classified into three subtypes. A1: the parathyroid gland is attached to the inherent thyroid capsule. A2: the gland is partially embedded in the thyroid gland. A3: the gland is located in the thyroid tissue. Type B is defined as a gland which is separated from the thyroid gland. The iPTH was sampled at wound closure.

Results
There were 100 patients in each group. We found a significant difference between the ETBAA and OTA-H groups for type A2, as well as a loss of parathyroid glands and a number of parathyroid transplantation procedures. The endoscopic group was treated during an earlier stage of thyroid cancer. The iPTH profile of each group decreased, although this was the most consistent in the OTA-H group. A comparison of ETBAA with OTA-L demonstrates that the iPTH level change is similar.

Conclusion
There is no advantage of endoscopic treatment for preserving parathyroid function.
Implementing a clinical-educator curriculum to enrich internal medicine residents’ teaching capacity
Authors: Habboush Yacob , Stoner Alexis , Torres Claribel , Beidas Sary 
Published: December 2019

Abstract
Introduction
Physicians-in-training (residents) are typically the primary educators for medical students during clinical clerkships. However, residents are not formally trained to teach or to assess their teaching. The aim of this study was to assess the implementation of a clinical educator rotation aimed at developing residents’ competencies related to clinical teaching.

Methods
A mixed-methods approach was used to develop and assess the clinical educator rotation at a teaching community hospital. Internal medicine residents who participated in the rotation and consented to the research were assigned to the clinical educator trainee (CET) group, the remaining residents were assigned to the control group. Osteopathic medical students rotating in the medicine service line were invited to participate. The study used descriptive and qualitative analyses to measure primary and secondary outcomes.

Results
The primary outcome measure showed a positive change in resident knowledge, skills and behaviors in communication, reflection, feedback, precepting, and facilitation. Medical student perceptions of resident teaching skills confirmed the observed changes in CETs. Some CETs continued to practice and build their capacity for teaching after completing the rotation. Qualitatively, we derived four common themes among the data; communication, professional engagement, practice-based learning, and systems-based learning.

Conclusion
Resident teaching capacity was enriched after completing the clinical educator rotation. Other benefits included: enhanced patient communication and education, increased resident confidence, personal satisfaction with training, work life-balance and enhanced career satisfaction. Future research should focus on curricular content, faculty development, and delivery assessment. In addition, research efforts should identify appropriate emerging technologies to include in the curriculum for enhancing teaching capacity.
Medical education trends for future physicians in the era of advanced technology and artificial intelligence: an integrative review
Authors: Han Eui-Ryoung , Yeo Sanghee , Kim Min-Jeong , Lee Young-Hee , Park Kwi-Hwa , Roh Hyerin 
Published: December 2019

Abstract
Background
Medical education must adapt to different health care contexts, including digitalized health care systems and a digital generation of students in a hyper-connected world. The aims of this study are to identify and synthesize the values that medical educators need to implement in the curricula and to introduce representative educational programs.

Methods
An integrative review was conducted to combine data from various research designs. We searched for articles on PubMed, Scopus, Web of Science, and EBSCO ERIC between 2011 and 2017. Key search terms were “undergraduate medical education,” “future,” “twenty-first century,” “millennium,” “curriculum,” “teaching,” “learning,” and “assessment.” We screened and extracted them according to inclusion and exclusion criteria from titles and abstracts. All authors read the full texts and discussed them to reach a consensus about the themes and subthemes. Data appraisal was performed using a modified Hawker ‘s evaluation form.

Results
Among the 7616 abstracts initially identified, 28 full-text articles were selected to reflect medical education trends and suggest suitable educational programs. The integrative themes and subthemes of future medical education are as follows: 1) a humanistic approach to patient safety that involves encouraging humanistic doctors and facilitating collaboration; 2) early experience and longitudinal integration by early exposure to patient-oriented integration and longitudinal integrated clerkships; 3) going beyond hospitals toward society by responding to changing community needs and showing respect for diversity; and 4) student-driven learning with advanced technology through active learning with individualization, social interaction, and resource accessibility.

Conclusions
This review integrated the trends in undergraduate medical education in readiness for the anticipated changes in medical environments. The detailed programs introduced in this study could be useful for medical educators in the development of curricula. Further research is required to integrate the educational trends into graduate and continuing medical education, and to investigate the status or effects of innovative educational programs in each medical school or environment.