bluuebunny/crossref_metadata_2025_split huggingface dataset:
Morphological Changes of Meibomian Glands in Men With Benign Prostate Hyperplasia
Authors: Shimizu Shota , Arita Reiko , Kawashima Motoko , Inoue Sachiko , Itoh Kouzo , Tsubota Kazuo 
Published: August 2020

Purpose:
Meibomian glands are subject to regulation by sex hormones. We have now investigated the possible relation between benign prostate hyperplasia (BPH) and meibomian gland dysfunction (MGD).

Methods:
Men diagnosed with BPH and receiving treatment with tamsulosin and age-matched male control subjects who attended Itoh Clinic, Saitama, Japan, were enrolled. An ocular symptom score, lid margin abnormality score, and superficial punctate keratopathy score as well as the meiboscore (0–6), meibum grade, breakup time of the tear film, and Schirmer test values were evaluated. Male pattern baldness was also graded according to the Hamilton-Norwood scale.

Results:
Forty-four eyes of 44 men with BPH (mean age ± SD, 76.1 ± 2.2 years) and 46 eyes of 46 control subjects (mean age ± SD, 75.3 ± 6.2 years) were enrolled. The meiboscore in the BPH group (4.5 ± 1.4) was significantly higher than that in the control group (1.8 ± 1.5, P < 0.0001). Breakup time of the tear film was significantly shorter (3.6 ± 1.7 vs. 5.6 ± 2.5 seconds, P < 0.0001), and Schirmer test value was significantly smaller (9.8 ± 4.8 vs. 13.3 ± 8.0 mm, P = 0.048) in the BPH group than that in the control group. Other ocular parameters did not differ significantly between the 2 groups. The proportion of men with androgenic alopecia was also higher in the BPH group than that in the control group.

Conclusions:
BPH was associated with meibomian gland loss and instability of the tear film as well as with the presence of androgenic alopecia.
Pooled Efficacy and Safety Profile of Netarsudil Ophthalmic Solution 0.02% in Patients With Open-angle Glaucoma or Ocular Hypertension
Authors: Singh Inder P. , Fechtner Robert D. , Myers Jonathan S. , Kim Terry , Usner Dale W. , McKee Hayley , Sheng Huan , Lewis Richard A. , Heah Theresa , Kopczynski Casey C. 
Published: August 2020

Precis:
In pooled phase III analyses, once-daily netarsudil 0.02% resulted in intraocular pressure (IOP) reduction that was noninferior to twice-daily timolol 0.5%, with minimal treatment-related serious or systemic adverse events (AEs). Ocular AEs were generally tolerable.

Purpose:
The purpose of this study was to assess the efficacy and safety of the Rho kinase inhibitor netarsudil in patients with open-angle glaucoma or ocular hypertension.

Patients and Methods:
Pooled analysis of data from the ROCKET-1 to 4 phase III studies of once-daily (PM) netarsudil or twice-daily timolol in patients with open-angle glaucoma or ocular hypertension. The primary efficacy measure was mean IOP at 8:00 am, 10:00 am, and 4:00 pm at week 2, week 6, and month 3 in patients with baseline IOP <25 mm Hg.

Results:
In the pooled primary efficacy population (netarsudil, n=494; timolol, n=510), once-daily netarsudil was noninferior to twice-daily timolol at all 9 timepoints through month 3. Mean treated IOP ranged from 16.4 to 18.1 mm Hg among netarsudil-treated patients and 16.8 to 17.6 mm Hg among timolol-treated patients. In the pooled safety population (n=839 in each treatment group), treatment-related serious AEs occurred at similar frequencies in each treatment group (netarsudil, 0.1%; timolol, 0%). The most common ocular AE, conjunctival hyperemia (netarsudil, 54.4%; timolol, 10.4%), was graded as mild in 77.6% (354/456) of affected netarsudil-treated patients.

Conclusions:
Once-daily netarsudil resulted in IOP lowering that was noninferior to twice-daily timolol, with tolerable ocular AEs that were generally mild and self-resolving. As a first-in-class agent in the United States, with a novel mechanism of action, netarsudil may provide a useful therapeutic option for patients who would benefit from IOP lowering.
Comparison of Intraocular Pressure, Usage of Topical Steroids, Need for Intraocular Pressure Lowering Drops, and Incidence of Glaucoma Surgery Up to 2 Years After Penetrating Keratoplasty and Endothelial Keratoplasty
Authors: Vu Priscilla Q. , Aggarwal Sahil , Lu Yvonne , Xie Kate , Wade Matthew , Bhatt Anand 
Published: August 2020

Precis:
A retrospective review of 239 eyes comparing intraocular pressure (IOP), steroid needs, IOP-lowering drop needs, and incidence of glaucoma surgery between endothelial keratoplasty and penetrating keratoplasties (PKP) at multiple timepoints postoperatively up to 2 years.

Purpose:
The purpose of this study was to compare postoperative IOP, steroid use, IOP-lowering drop use, and need for glaucoma surgery between PKP, Descemet membrane endothelial keratoplasty (DMEK) and Descemet stripping automated endothelial keratoplasty (DSEK).

Materials and Methods:
A retrospective chart review of all PKP, DMEK, and DSEK surgeries was performed between July 1, 2012 and July 1, 2017 at the University of California, Irvine. Patients with a prior history of glaucoma, corneal or glaucoma surgery, concurrent major or emergent surgery, active infection, and eye disease with synechiae were excluded. A total of 239 patients who underwent PKP (N=127), DMEK (N=46), or DSEK (N=66) were included. IOP, steroid use, IOP-lowering drop use, and need for glaucoma surgery were compared at postoperative day 1, postoperative week 1 (POW1), and postoperative month 1 to 24 (POM1-24).

Results:
IOP for PKP was higher than DMEK and DSEK at POW1, POM1, POM6, and POM24 (P<0.05). IOP for PKP was higher than DMEK at POM12 (P=0.028). There was no significant difference in IOP between DMEK and DSEK for all timepoints. PKP required more steroids than DSEK and DMEK at POM3, POM6, POM12, and POM24 (P<0.05). More IOP-lowering drops were required for DSEK than DMEK and PKP at postoperative day 1 and POW1 (P<0.05). More IOP-lowering medications were used for DSEK than DMEK at POM3 and POM12 (P<0.05). About 6% to 7% of patients needed glaucoma surgery by POM24.

Conclusions:
Endothelial keratoplasties had decreased IOP and steroid needs compared with PKPs postoperatively up to 2 years. The rate of glaucoma surgery and IOP-lowering drop needs were similar between the groups.
Pediatric Bartonella henselae Infection
Authors: Alattas Nadia H. , Patel Samir N. , Richardson Susan E. , Akseer Nadia , Morris Shaun K. 
Published: August 2020

Background:

Bartonella henselae serology is commonly used to diagnose cat-scratch disease (CSD). Titers above a threshold for positivity suggest either a recent or remote infection. Recent infection can be confirmed by a 4-fold rise in the convalescent titer in some cases. Many atypical presentations attributed to CSD utilize a low threshold for positivity without supportive evidence from convalescent sera or supplemental testing, raising a concern for the overdiagnosis of CSD.

Methods:
We conducted a retrospective chart review of immunocompetent pediatric patients at the Hospital for Sick Children, Toronto, spanning an 11-year period. A total of 154 cases were included with serologic titers ≥1:128. These were divided into 3 groups: group 1 = 1:128, group 2 = 1:256, and group 3 ≥ 1:512. Cases within groups were evaluated with respect to cat contact, clinical presentation, further testing, and final diagnosis.

Results:
One-third of patients with a titer of 1:128 had an alternative diagnosis. Most cases with a titer of 1:128 or 1:256 did not have convalescent serologic testing performed. Within these 2 groups, only 1 case had a 4-fold rise in the convalescent titer. A trend of decreasing number of cases with alternative diagnoses (P = 0.03) and increasing number of cases presenting with regional lymphadenopathy (P = 0.07) was associated with higher titers in group 3 compared with group 1.

Conclusion:
Concerns about the serologic diagnosis of CSD include the use of low titers for positivity, incomplete diagnostic evaluation, and the lack of convalescent serologic testing. We propose a clinical guide to assist in managing suspected cases of CSD.
Gender-Based Differences in the Relationships Among Social Support, Positive Psychological Capital, and Sleep Quality in Patients Implanted With Pacemakers
Authors: Lv Gaorong , Zhao Xiaojing , Xu Xiaofang , Hou Fangyan , Li Ping 
Published: August 2020

Background
Sleep disorders are common and seriously affect the prognosis of patients implanted with pacemakers.

Aims
In this study, it was investigated whether social support directly impacts sleep quality and whether positive psychological capital mediates and gender moderates the relationship between social support and sleep quality among this group.

Methods
A total of 178 patients implanted with pacemakers were recruited to participate in the study from 2 tertiary hospitals in Shandong, China. Patients were assessed using the Perceived Social Support Scale, Positive PsyCap Questionnaire, and Pittsburgh Sleep Quality Index (PSQI). Multiple linear regression and the PROCESS macro were used to test the mediating and moderated mediating effects.

Results
Patients' mean PSQI score was (8.48 ± 4.50), and 71.30% of the patients had sleep problems (PSQI > 5). Social support scores were negatively correlated with PSQI scores (r = −0.19, P = .010) and positively correlated with positive psychological capital scores (r = 0.45, P < .001). In addition, positive psychological capital scores were negatively related to PSQI scores (r = −0.39, P < .001). The confidence interval (CI) from the bootstrap output indicated that positive psychological capital played a mediating role between social support and sleep quality (95% CI, −0.098 to −0.033), and gender moderated the association between social support and sleep via positive psychological capital (95% CI, −0.087 to −0.006).

Conclusion
The sleep problems of this population cannot be ignored. Gender-based differences should be considered when guiding such patients toward using internal and external resources to cope with sleep problems.
Risk of Prolonged Corrected QT Interval With Amisulpride Therapy for Renal Function Management in Patients With Schizophrenia
Authors: Chen Binbin , Wang Chen , Xu Xiangzhen , Lyu Haiyan , Ma Chunling , Cheng Gang 
Published: August 2020

Abstract

Background
Amisulpride (AMI) is a popular antipsychotic drug prescribed for the management of schizophrenia. However, patients may experience prolonged corrected QT (QTc) interval. We therefore aimed to assess the risk factors for QTc prolongation during AMI therapy in patients with schizophrenia.

Methods
This study retrospectively enrolled 271 patients with schizophrenia. Continuous variables were analyzed with a t test or analysis of variance, and categorical variables were analyzed with a χ2 test. Patients with and without QTc prolongation were compared using a backward stepwise logistic regression analysis to identify the important variables.

Results
Comedication of AMI with clozapine (odds ratio, 3.5 [95% confidence interval, 1.3–9.7]) and decreased renal function (mildly decrease, 3.4 [1.2–10.1]; mild to moderately decreased, 4.8 [1.3–17.3]; moderately decreased, 13.6 [2.0–90.6]) were identified as the independent risk factors of QTc prolongation. The dose-normalized plasma concentration of AMI (plasma concentration per dose) was significantly higher in the QTc prolongation group (z = −1.735, P = 0.015) and renal dysfunction group (F = 16.002, P < 0.001).

Conclusions
Renal function should be monitored in patients prescribed with AMI, particularly in those taking clozapine. Plasma concentration per dose values can be considered as a risk factor of QTc interval prolongation. The founding help clinicians to analyze the risk of QTc prolongation before prescribing AMI and to monitor QTc prolongation during AMI therapy.
Development, Success Factors, and Challenges of Government-Led Health and Productivity Management Initiatives in Japan
Authors: Mori Koji , Nagata Tomohisa , Nagata Masako , Okahara Shintaro , Odagami Kiminori , Takahashi Hirosuke , Mori Takahiro 
Published: August 2020

Objective:
This study aimed to describe the Japanese government-led health and productivity management (HPM) strategy, specific initiatives, and success factors.

Methods:
Self-described corporation data obtained from the Ministry of Economy, Trade and Industry for 2014 to 2019 were analyzed descriptively.

Results:
Nationally, more than 8000 corporations participated in the HPM initiative, and performance improved each year. The range of public and private sector incentives supporting the government initiatives also increased.

Conclusions:
Success factors include matching the approach to the company's business environment, reinforcing government-led initiatives and programs, and partnering with the healthcare sector. Despite many challenges, early experience with the countrywide HPM strategy and initiatives may lead to better business outcomes and support the sustainability of Japanese society.
Financial Incentives and Employer-Sponsored Health Activities
Authors: Bernstein Adam , Liang Annie , Luo Fan , Mann Eric , Shilts Erik , Serxner Seth 
Published: August 2020

Objective:
To understand how employer-sponsored incentives and participant-level characteristics drive health activity engagement.

Methods:
Multivariable hierarchical logistic regression models evaluated 283,365 individuals eligible for incentives through health savings accounts, health reimbursement accounts, health incentive accounts, gift cards, and other means, and estimated log odds of (1) completing a health survey; (2) participating in a biometric screening; (3) attaining a biometric target; (4) participating in a weight loss program; undergoing (5) breast, (6) colorectal, or (7) cervical cancer screening.

Results:
Larger incentives were associated with higher odds of participating in biometric screenings only (2% higher for every $25). Obesity, tobacco use, and lack of primary care were associated with lower odds.

Conclusion:
Employers may wish to tailor incentive plans to the unique characteristics and needs of their populations to better drive participation in sponsored health activities.
Practical Solutions for Healthcare Worker Protection During the COVID-19 Pandemic Response in the Ambulatory, Emergency, and Inpatient Settings
Authors: Kraus Anthony , Awoniyi Oluwafunbi , AlMalki Yousef , Bardeesi Adham Sameer A. , Edwards Bridget , AlHajjaj Fahad , Alossaimi Bader , Benham Todd , Bortolin Michalengelo , Cattamanchi Srihari , Court Michael , Groves John , Hernandez Anthony , Issa Fadi , Macgregor-Skinner Gavin , Manners Philip , Molloy Michael , Romney Douglas , Voskanyan Amalia , Weiner Debra , Yogman Madeline , Hart Alexander , Ciottone Gregory 
Published: August 2020

Objective:
Protecting healthcare workers is an essential component of a successful response to the COVID-19 pandemic. The resource intensive nature of infectious disease protection, budgetary constraints, and global shortages of personal protective equipment (PPE) make this a daunting task. Practical, easily implemented strategies for healthcare workers (HCW) protection are needed.

Methods:
We cross-reference the “Systems, Space, Staff, and Stuff” paradigm from disaster management and the “Hierarchy of Controls” approach to infection prevention from the Center for Disease Control and Prevention (CDC) to generate a narrative overview of worker protection strategies relevant to COVID-19.

Results:
Alternative types of PPE, management of hazards, and reorganizing how people work can optimize HCWs protection.

Conclusions:
A comprehensive PPE strategy can utilize the “systems, space, staff, stuff” paradigm of disaster management to identify new or underutilized solutions to HCWs protection.
Improving Timely Annual Ocular Examinations for Patients With Diabetes Mellitus in a Primary Care Office
Authors: Park Summer 
Published: August 2020

Background:
A common complication of diabetes mellitus (DM) is diabetic retinopathy (DR).

Local Problem:
An audit in a primary care office found that fewer than 50% of patients with DM received an annual ocular examination. The aim of this project was to increase timely annual ocular examinations among patients with type 2 DM to 85% within 90 days.

Methods:
The model for improvement with 4 Plan-Do-Study-Act (PDSA) cycles was implemented in a rapid cycle format as well as changes in an electronic medical record (EMR) checklist and referral processes.

Interventions:
Interventions included team huddles and trainings, the Association of Diabetes Care and Education Specialists checklist with additional information about DR, an EMR checklist, and a logbook referral tracking process changes.

Results:
Of the patients referred during the project, 87% completed the ocular appointment, and the rate for patients with DM having annual ocular examinations increased from 48% to 86% meeting the current guideline of the American Diabetes Association.

Conclusions:
Timely annual ocular examinations increased to 86% in 90 days, thus improving current DM treatment guidelines in primary care.
Implementation of an Intensive Care Unit Diary Program at a Veterans Affairs Hospital
Authors: Drumright Kelly , Jones Abigail C. , Gervasio Ralph , Hill Christopher , Russell Margaret , Boehm Leanne M. 
Published: August 2020

Background:
Intensive care unit (ICU) diaries are recommended to address psychological sequelae following critical illness. Diaries are correlated with reduced prevalence of posttraumatic stress disorder in survivors of critical illness and their families.

Local Problem:
Our ICU was not adequately meeting the psychological needs of patients and families.

Methods:
We established an interprofessional team to implement an ICU diary program in partnership with implementation of the ABCDEF (Assess, prevent, and manage pain; Both awakening and breathing trials; Choice of analgesia and sedation; Delirium: assess, prevent, and manage; Early mobility and exercise; Family engagement and empowerment) bundle and peer support programs. Staff knowledge and perception of ICU diaries were obtained.

Interventions:
Diaries were initiated for patients at high risk for post-intensive care syndrome, and entries by all ICU staff and family members/visitors were encouraged.

Results:
A total of 75 diaries were initiated between January 2017 and January 2019. The ICU diaries have been received positively by patients, family members, and staff.

Conclusions:
The ICU diary is a cost-effective and efficient intervention to help patients and family members cope with the burden of critical illness.
Effect of Intravenous Infiltration Management Program on Peripheral Intravenous Catheter Success and Infiltration in Hospitalized Infants
Authors: Taşdelen Yeliz , Çağlar Seda 
Published: August 2020

Background:
Peripheral intravenous catheter (PIVC) insertion is the most frequently used method for intravenous (IV) treatment in pediatric patients.

Purpose:
The aim of this study was to determine the effect of the Intravenous Infiltration Management Program on the success of PIVC insertion and infiltration in infants.

Methods:
The study was carried out using a quasi-experimental design with pretest-posttest control groups and included 750 PIVC procedures for 218 infants between 28 days and 12 months of age.

Results:
The program decreased the number of PIVC insertions per patient, although it was not statistically significant (P = .076) and had an impact on the success of the PIVC attempt (P < .001), first PIVC attempt (P < .001), PIVC dwell time, and early detection of infiltration (P < .001).

Conclusion:
The program is effective in the success of the PIVC insertion process and early detection of infiltration.
Improving Teamwork and Communication in Schools of Nursing
Authors: Cooke Marcia , Valentine Nancy M. 
Published: August 2020

Background:
Teamwork training has been identified as an intervention to promote collaboration, improve communication, and reduce conflict. While teamwork training has been implemented in the clinical setting, most schools of nursing are lacking in standardized teamwork training programs.

Local Problem:
A lack of teamwork, poor communication, and deficient conflict resolution skills among faculty and staff was impacting the ability to form supportive relationships in the interest of working collaboratively.

Methods:
This quality improvement (QI) project examined perceptions of teamwork at 3 points over 18 months.

Intervention:
Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) was adapted for the academic setting and used for the intervention.

Results:
Results indicated significant improvement in Team Structure, Leadership, and Communication. Situation Monitoring and Mutual Support were identified for continued development.

Conclusion:
Results suggest that a QI intervention using TeamSTEPPS improved teamwork, communication, collaboration, and conflict resolution in one academic setting.
The Impact of Receiving a Family-Oriented Therapeutic Conversation Intervention Before and During Bereavement Among Family Cancer Caregivers
Authors: Petursdottir Asta B. , Sigurdardottir Valgerdur , Rayens Mary Kay , Svavarsdottir Erla Kolbrun 
Published: August 2020

Effective communication is the foundation of quality care in palliative nursing. As frontline palliative home care providers, nurses could foster more effective bereavement coping skills through therapeutic conversations. The purpose of this study was to evaluate the impact of a nursing intervention offered to bereaved family cancer caregivers. This was a quasi-experimental design, with a posttest-only comparison of the intervention and control groups receiving usual care. Bereaved caregivers (n = 51) receiving services from a specialized palliative home care unit participated and completed measures of depression, anxiety, stress, and grief reactions 3, 5, and 6 months after their close relative had died.
There was a significant decrease in anxiety symptoms in the intervention group compared with the control group across all 3 time points. Anxiety and stress symptoms also decreased over time in the 2 groups combined, but this decrease was not observed for depression. When evaluating grief reactions, the intervention group had a lower mean of controlled grief responses, across the posttest period, than the control group.
Results demonstrate that providing bereaved family caregivers the opportunity to participate in a therapeutic conversation intervention might reduce distressing symptoms in early bereavement.