bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Implementation Approach Comparison of a Child Care Center-Based Obesity Prevention Program
Authors: Natale Ruby A. , Atem Folefac , Weerakoon Sitara , Lebron Cynthia , Mathew M. Sunil , Sardinas Krystal , Chang Catherina , Shelnutt Karla P. , Spector Rachel , Altare Fiorella , Messiah Sarah E. 
Published: September 2020

ABSTRACT:

Objective:
To compare the effectiveness of the Healthy Caregivers-Healthy Children (HC2) phase 1 (2011–2014) and 2 (2015–2018) child care center (CCC)-based obesity prevention intervention(s) on child dietary practices and body mass index percentile (PBMI) outcomes over 2 years. Phase 1 was implemented via a university-based research team, and phase 2 was delivered via a train-the-trainers approach (university-based research team trains preschool-based coaches, who in turn train CCC teachers to implement and disseminate HC2).

Methods:
Phase 1 and 2 were both cluster randomized controlled trials of the HC2 obesity prevention intervention. Phase 1 was composed of 1224 children in 28 CCCs (12 intervention and 16 control). Phase 2 was composed of 825 children in 24 CCCs (12 intervention and 12 control). Both phases included CCCs serving low-resource, predominantly ethnic minority families.

Results:
The mean rate of weekly fruit consumption significantly increased (β = 0.16, p = 0.001) in phase 1, whereas vegetable intake significantly increased (β = 0.16, p = 0.002) in phase 2 intervention CCCs. Fried (β = −0.36, p < 0.001), fast (β = −0.16, p = 0.001), and other unhealthy food (β = −0.57, p < 0.001) consumption significantly decreased in phase 1 only. The mean rate of snack food consumption significantly decreased in phase 2 (β = −0.97, p < 0.001). Mean child PBMI remained in the healthy range over 2 years for all groups in both study phases.

Conclusion:
A university-based research team implementation and dissemination approach seemed to be more effective than a train-the-trainers implementation method in improving dietary intake patterns. This finding suggests that CCCs may need robust educational support beyond their existing internal resources for long-term positive dietary intake pattern changes.
Magnetic Resonance Imaging Evaluation of Changes in Gluteal Muscles After Treatments With the High-Intensity Focused Electromagnetic Procedure
Authors: Palm Melanie 
Published: September 2020

BACKGROUND
High-intensity focused electromagnetic (HIFEM) field procedure induces changes in the gluteal muscles and improves the aesthetic appearance of the buttocks.

OBJECTIVE
This study aims to objectively assess the hypertrophic response of the gluteal muscles after HIFEM treatments.

MATERIALS AND METHODS
Seven subjects (40.00 ± 6.68 years) received 4, 30-minute HIFEM treatments of the buttocks. Magnetic resonance imaging of the pelvic region was obtained at baseline, 1-month, and 3-month follow-up to reconstruct 3D volumes of musculus
gluteus maximus, medius, and minimus. Volumetric changes were calculated and statistically analyzed. Standardized photographs, weight measurements, patient satisfaction, treatment comfort, and adverse events were also documented.

RESULTS
Volumetric analysis revealed a significant increase (p = .001) in the size of the examined muscles at 1-month (+10.81 ± 1.60%) and 3-month (+13.23 ± 0.91%) follow-up. A more profound hypertrophic effect was seen in the upper buttock region. This translated into a visible buttock lifting, also captured by patient photography. Gluteal adipose tissue was insignificantly affected. Patients were satisfied, and they found the treatments comfortable. No adverse events were observed.

CONCLUSION
Simultaneous enhancement of gluteal muscles was documented. This represents the first objective evaluation of the HIFEM-induced structural changes in the gluteal muscles and physiologic documentation of the aesthetic improvement previously reported by other authors.
Shorter Wait Times to Cardiac Rehabilitation Associated With Greater Exercise Capacity Improvements
Authors: Candelaria Dion , Zecchin Robert , Ferry Cate , Ladak Laila , Randall Sue , Gallagher Robyn 
Published: September 2020

Purpose:
Comprehensive exercise-based cardiac rehabilitation (CR) results in improved, though highly variable, exercise capacity outcomes. Whether modifiable factors such as CR program wait time and session duration are associated with exercise capacity outcomes has not been adequately investigated.

Methods:
Patients with coronary heart disease (±primary and elective percutaneous coronary interventions, cardiac surgery) who participated in CR programs involved in a three-state audit (n = 32 sites) were eligible. Exercise capacity was measured using the 6-min walk test before and after a 6- to 12-wk supervised exercise program. CR program characteristics were also recorded (wait time, number of sessions). Correlations and linear mixed-effects models were used to identify associations between sociodemographic and CR program characteristics and change in exercise capacity.

Results:
Patients (n = 894) had a mean age of 65.9 ± 11.8 yr, 71% were males, 33% were referred for cardiac surgery, and median wait time was 16 d (interquartile range 9, 26). Exercise capacity improved significantly and clinically (mean increase 70.4 ± 61.8 m). After adjusting for statistically significant factors including younger age (<50 vs ≥80 yr [β = 52.07]), female sex (β = −15.86), exercise capacity at CR entry (β = 0.22) and those nonsignificant (ethnicity, risk factors, and number of sessions), shorter wait time was associated with greater exercise capacity improvement (β = 0.23).

Conclusions:
This study confirms that greater exercise capacity improvements occur with shorter wait times. Coordinators should prioritize implementing strategies to shorten wait time to optimize the benefits of CR.
Improved Outcome of Pythium Keratitis With a Combined Triple Drug Regimen of Linezolid and Azithromycin
Authors: Sane Sayali S. , Madduri Bhagyasree , Mohan Nitin , Mittal Ruchi , Raghava J. V. , Fernandes Merle 
Published: September 2020

Purpose:
To describe the clinical features, microbiological profile, and outcome of a series of cases of Pythium keratitis treated with topical and oral linezolid and topical azithromycin eye drops.

Methods:
This was a retrospective interventional case series of microbiologically and/or histopathologically proven cases of Pythium keratitis seen between October 2016 and December 2019. All patients received a combination of topical linezolid and/or azithromycin eye drops with oral linezolid. Analysis of demographic data, predisposing risk factors, microbiological results, treatment regimen, visual acuity, surgical intervention, and final outcome was performed. A subgroup analysis of cases >6 mm in size was performed. Success was defined as complete resolution on medical management. Failure was defined as worsening of infection necessitating therapeutic penetrating keratoplasty or evisceration.

Results:
Of 21 cases, 2 were lost to follow up, 1 was diagnosed on histopathology, and 1 received only topical linezolid. Characteristic microbiological features were noted on 10% potassium hydroxide calcofluor white wet mount in 20/21 (95.23%) and Gram stain in 18/21 (85.71%). On triple drug regimen, 14/17 cases (82.35%) resolved. Average time to resolution was 87.64 ± 44.44 days. More than 60% infiltrates (13/21) were large, and 66.66% infiltrates resolved in 109.3 ± 57.06 days. Of the 5 failures, 4 needed therapeutic keratoplasty and 1 needed evisceration. All grafts failed.

Conclusions:
The dual topical drug regimen with oral linezolid has good cure rates (over 80%) for Pythium keratitis over prolonged duration. It is recommended to persevere with medical therapy even in large infiltrates because more than two thirds resolved.
Age-Related Corneal Transparency Changes Evaluated With an Alternative Method to Corneal Densitometry
Authors: Consejo Alejandra , Jiménez-García Marta , Rozema Jos J. 
Published: September 2020

Purpose:
To compare densitometry distribution analysis (DDA), a platform-independent method to assess corneal transparency, with traditional corneal densitometry.

Methods:
A total of 196 healthy participants aged 43.3 ± 18.0 years (range 18–79 years) were recruited for assessment. All participants were assessed using the corneal densitometry analysis add-on to the standard software of the Oculus Pentacam HR. In addition, the Scheimpflug image corresponding to the horizontal meridian of each participant was exported for further analysis. For each image, corneal pixel intensities were statistically modeled. The estimated output parameters, α and β, were compared with the corresponding densitometry values. The analysis was performed considering 3 concentric areas and 3 layers defined at fixed corneal depths. To demonstrate the platform independence of the DDA method, a randomly selected subset of 80 participants also had their eye measured with Oculus Corvis ST.

Results:

α and β were found to be well correlated with densitometry, especially α (overall cornea; r = 0.89, P < 0.001), independent of the corneal region investigated. Changes in α, β, and corneal densitometry were correlated with age.

Conclusions:
In this work, we presented the relationship of DDA with age and traditional corneal densitometry. The α and β parameters, the output of DDA, are platform independent and can be used to investigate corneal clarity objectively.
Outbreak of Enterovirus D68 Among Children in Japan—Worldwide Circulation of Enterovirus D68 Clade B3 in 2018
Authors: Ikuse Tatsuki , Aizawa Yuta , Yamanaka Takayuki , Habuka Rie , Watanabe Kanako , Otsuka Taketo , Saitoh Akihiko 
Published: September 2020

Background:
Enterovirus D68 (EV-D68) causes asthma-like respiratory infection in children. Several EV-D68 outbreaks have been reported worldwide since the largest outbreak occurred in the United States in 2014. We experienced an accumulation of pediatric cases with asthma-like respiratory illness in Niigata, Japan, in 2018.

Study design:
To determine whether EV-D68 was responsible for the case accumulation, this prospective observational study evaluated children hospitalized in 1 of 8 hospitals with asthma-like respiratory illness in Niigata, Japan, during October and November 2018. Diagnoses were made by EV-D68–specific RT-PCR using nasopharyngeal samples. The clade was identified by sequence analyses, and a phylogenetic tree was created. To evaluate seasonal variation, data from pediatric cases with asthma-like respiratory illness in 2018 were retrospectively analyzed.

Results:
In 2018, 114 children were hospitalized with asthma-like respiratory illness in October and November, and 47 nasopharyngeal samples were collected. EV-D68 was detected in 22/47 (47%) patients during the study period. The phylogenetic tree revealed that all strains belonged to the clade B3 branch, which has been detected worldwide every 2 years since 2014.

Conclusions:
EV-D68 was the associated pathogen for asthma-like respiratory illness in children in Japan in 2018. Clade B3, the dominant clade in outbreaks worldwide, was responsible for the outbreak. Detection and detailed virologic analysis of EV-D68 is important as part of worldwide surveillance, as it will aid in understanding the epidemiologic characteristics of EV-D68 infection.
Maternal, Perinatal and Neonatal Outcomes With COVID-19: A Multicenter Study of 242 Pregnancies and Their 248 Infant Newborns During Their First Month of Life
Authors: Marín Gabriel Miguel A , Reyne Vergeli Mar , Caserío Carbonero Sonia , Sole Laia , Carrizosa Molina Tamara , Rivero Calle Irene , Cuadrado Pérez Irene , Álvarez Fernández Blanca , Forti Buratti Azul , Fernández-Cañadas Morillo Aurora ,   on behalf of the Neo-COVID-19 Research Group
Published: September 2020

Background:
Our aim was to describe the clinical features of mothers with coronavirus disease 2019 (COVID-19) infection during gestation or delivery, and the potential vertical transmission. We also wish to evaluate the possible horizontal transmission after hospital discharge, by means of a follow-up of all the newborns included at 1 month of age.

Methods:
This multicenter descriptive study involved 16 Spanish hospitals. We reviewed the medical records of 242 pregnant women diagnosed with COVID-19 from March 13 to May 31, 2020, when they were in their third trimester of pregnancy. They and their 248 newborn infants were monitored until the infant was 1 month old.

Results:
Caesarean sections (C-sections) were performed on 63 (26%) women. The initial clinical symptoms were coughing (33%) and fever (29.7%). Mothers hospitalized due to COVID-19 pathology had a higher risk of ending their pregnancy via C-section (P = 0.027). Newborns whose mothers had been admitted due to their COVID-19 infection had a higher risk of premature delivery (P = 0.006). We admitted 115 (46.3%) newborn infants to the neonatal unit, of those, 87 (75.6%) were only admitted due to organizational circumstances. No infants died and no vertical or horizontal transmission was detected. Regarding type of feeding, 41.7% of the newborns received exclusive breast-feeding at discharge and 40.4% at 1 month.

Conclusions:
We did not detect COVID-19 transmission during delivery or throughout the first month of life in the newborns included in our study. Exclusive breast-feeding rates at discharge and at 1 month of age were lower than expected.
Tomographically normal partner eye in very asymmetrical corneal ectasia: biomechanical analysis
Authors: Fraenkel Doris , Hamon Loïc , Daas Loay , Flockerzi Elias , Suffo Shady , Eppig Timo , Seitz Berthold 
Published: September 2020

Purpose:
To point out the biomechanical changes of the topographically and tomographically normal partner eye (NPE) in patients with very asymmetrical corneal ectasia.

Setting:
Department of Ophthalmology, Saarland University Medical Center in Homburg/Saar, Germany.

Design:
Retrospective study.

Methods:
The topographical and tomographical results of the NPE were assessed using the Pentacam HR and the biomechanical corneal properties using the Ocular Response Analyzer (keratoconus match index [KMI], corneal hysteresis [CH], and corneal resistance factor [CRF]) and the Corvis ST (topographic biomechanical index [TBI] and Corvis biomechanical index) and compared those results with a normal control group (CG).

Results:
The clinical records of 26 patients recruited from the Homburg Keratoconus Center diagnosed with a very asymmetrical corneal ectasia were reviewed. The NPE (8.5 ± 1.5 mm Hg) showed a significantly more pathological CH (P < .001) compared with the CG. The CRF was also significantly more pathological (P = .04) for the NPE (8.3 ± 1.5 mm Hg) compared with the CG. The NPE (0.62 ± 0.32) showed a nonsignificant (P = .08) more pathological KMI compared with the CG. Nineteen (73.1%) of 26 NPE had a KMI less than 0.72 and were considered pathological. Compared with the CG, the TBI of the NPE (0.19 ± 0.25) did not differ significantly overall (P = .57). However, 5 (19.2%) of 26 eyes had a TBI more than 0.29 and were considered pathological.

Conclusions:
Topographically and tomographically NPEs in very asymmetrical corneal ectasia frequently showed biomechanical changes. This should be considered before planning any type of refractive corneal surgery in such patients.
Systematic review and meta-analysis of the effectiveness and safety of hydroxychloroquine in treating COVID-19 patients
Authors: Yang Tzu-Han , Chou Chian-Ying , Yang Yi-Fan , Chien Chian-Shiu , Yarmishyn Aliaksandr A. , Yang Tzu-Ying , Liu Cheng-Hsuan , Chang Kao-Jung , Yang Yi-Ping , Chang Yuh-Lih 
Published: September 2020

Background:
Since COVID-19 outbreak, hydroxychloroquine (HCQ) has been tested for effective therapies, and the relevant researches have shown controversial results.

Methods:
Systematic review and meta-analysis were conducted after a thorough search of relevant studies from databases. Trials that have evaluated HCQ for COVID-19 treatment were recruited for statistical analysis with fixed- and random-effect models.

Results:
Nine trials involving 4112 patients were included in present meta-analysis. It was seen that HCQ-azithromycin (HCQ-AZI) combination regimen increased the mortality rate in COVID-19 (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.63–3.36) patients; however, it also showed benefits associated with the viral clearance in patients (OR, 27.18; 95% CI, 1.29–574.32). HCQ-alone when used as a therapy in COVID-19 did not reveal significant changes in mortality rate, clinical progression, viral clearance, and cardiac QT prolongation. Subsequent subgroup analysis showed that HCQ treatment could decrease mortality rate and progression to severe illness in severely infected COVID-19 patients (OR, 0.27; 95% CI, 0.13–0.58). A lower risk of mortality rate was also noted in the stratified group of >14 days follow-up period (OR, 0.27; 95% CI, 0.13–0.58) compared to ≤14 days follow-up period group that conversely showed an increased mortality rate (OR, 2.09; 95% CI, 1.41–3.10).

Conclusion:
Our results indicated that HCQ-AZI combination treatment increased mortality rate in patients with COVID-19, but it also showed benefits associated with viral clearance in patients. HCQ-alone used for treatment has revealed benefits in decreasing the mortality rate among severely infected COVID-19 group and showed potential to be used for COVID-19 treatment in long-term follow-up period group. Accordingly, more rigorous, large-scale, and long follow-up period studies in patients with COVID-19 are needed.
XEN45 Gel Stent implantation in eyes with primary open angle glaucoma: A study from a single hospital in Taiwan
Authors: Chao Yu-Jang , Ko Yu-Chieh , Chen Mei-Ju , Lo Kang-Jung , Chang Yu-Fan , Liu Catherine Jui-Ling 
Published: September 2020

Background:
To evaluate the effectiveness and safety of the XEN45 Gel Stent in East Asian patients with primary open angle glaucoma (POAG).

Methods:
We retrospectively reviewed 37 medically uncontrolled POAG patients who received XEN45 Gel Stent. The primary outcomes were reduction in intraocular pressure (IOP) and in the number of glaucoma medications 12 months after surgery. The secondary outcomes were requirement for intervention and further glaucoma surgery. The adverse intraoperative and postoperative events were investigated.

Results:
At the 12-month postoperative follow-up, the mean IOP was significantly reduced from the preoperative value of 21.7 ± 7.7 mmHg to 15.0 ± 2.0 mmHg (p = 0.001). The mean number of glaucoma medications decreased from 3.4 ± 0.9 to 1.3 ± 1.5 (p < 0.001). Seventeen patients (45.9%) required postoperative interventions. Four patients (10.8%) received additional glaucoma surgery. Postoperative IOP at month 1 was significantly associated with outcomes at the 12-month follow-up and the need for subsequent intervention and additional glaucoma surgery.

Conclusion:
The XEN45 Gel Stent effectively reduced the IOP values and number of glaucoma medications in East Asian patients with POAG. No major complications were observed, but almost half of the eyes in the study required intervention for wound healing modification. Postoperative IOP at month 1 was a predictor of surgical success at 12 months after surgery.
Gay and Bisexual Men in the US Lack Basic Information About Anal Cancer
Authors: Wheldon Christopher W. , Maness Sarah B. , Islam Jessica Y. , Deshmukh Ashish A. , Nyitray Alan G. 
Published: September 2020

Objective
The purpose of this study was to assess knowledge of human papillomavirus (HPV) as a cause of anal cancer among at-risk gay, bisexual, and other men who have sex with men (GBM).

Materials and Methods
Secondary analysis was conducted of cross-sectional data from 3 cycles of the Health Information National Trends Survey (2017, 2018, 2019). Results were reported for the subset of adults who identified as GBM (N = 212). Knowledge that HPV can cause anal cancer was the main outcome. Differences in knowledge were evaluated (using χ2 and multiple logistic regression) by demographic, health information factors, and access to care.

Results
Sixty-eight percent of GBM were aware of HPV. Knowledge that HPV causes anal cancer was low (<20%) in the overall sample and sample of GBM (17.9%; 95% CI = 11.0–24.7). Gay, bisexual, and other men who have sex with men were no more knowledgeable that HPV causes anal cancer than heterosexual men (14.8%; 95% CI = 12.9–16.9; p = .376). College-educated GBM had higher odds (adjusted odds ratio = 3.50; 95% CI = 1.02–11.97) of knowing HPV causes anal cancer than GBM with no college degree. No other factors were associated with knowledge.

Conclusions
Gay, bisexual, and other men who have sex with men are largely unaware that HPV can cause anal cancer, despite high awareness of HPV itself. This is concerning given that GBM are at increased risk of HPV-associated anal cancer than the general population. Our findings suggest that information about anal cancer and health information about the benefits of HPV vaccination for anal cancer prevention are only reaching a small subset of college-educated GBM. Targeted anal cancer education programs are needed.
Association between history of cancer and major adverse cardiovascular events in patients with chest pain presenting to the emergency department: a secondary analysis of a prospective cohort study
Authors: Faramand Ziad , Li Hongjin , Al-Rifai Nada , Frisch Stephanie O. , Abu-Jaradeh Omar , Mahmoud Ahmad , Al-Zaiti Salah 
Published: September 2020

Objectives
Cancer survivorship status among patients evaluated for chest pain at the emergency department (ED) warrants high degree of suspicion. However, it remains unclear whether cancer survivorship is associated with different risk of major adverse cardiac events (MACE) compared to those with no history of cancer. Furthermore, while HEART score is widely used in ED evaluation, it is unclear whether it can adequately triage chest pain events in cancer survivors. We sought to compare the rate of MACE in patients with a recent history of cancer in remission evaluated for acute chest pain at the ED to those with no history of cancer, and compare the performance of a common chest pain risk stratification score (HEART) between the two groups.

Methods
We performed a secondary analysis of a prospective observational cohort study of chest pain patients presenting to the EDs of three tertiary care hospitals in the USA. Cancer survivorship status, HEART scores, and the presence of MACE within 30 days of admission were retrospectively adjudicated from the charts. We defined patients with recent history of cancer in remission as those with a past history of cancer of less than 10 years, and currently cured or in remission.

Results
The sample included 750 patients (age: 59 ± 17; 42% females, 40% Black), while 69 patients (9.1%) had recent history of cancer in remission. A cancer in remission status was associated with a higher comorbidity burden, older age, and female sex. There was no difference in risk of MACE between those with a cancer in remission and their counterparts in both univariate [17.4 vs. 19.5%, odds ratio (OR) = 0.87 (95% confidence interval (CI), 0.45–1.66], P = 0.67] and multivariable analysis adjusting for demographics and comorbidities [OR = 0.62 (95% CI, 0.31–1.25), P = 0.18]. Patients with cancer in remission had higher HEART score (4.6 ± 1.8 vs. 3.9 ± 2.0, P = 0.006), and a higher proportion triaged as intermediate risk [68 vs. 56%, OR = 1.67 (95% CI, 1.00–2.84), P = 0.05]; however, no difference in the performance of HEART score existed between the groups (area under the curve = 0.86 vs. 0.84, P = 0.76).

Conclusions
There was no difference in rate of MACE between those with recent history of cancer in remission compared to their counterparts. A higher proportion of patients with cancer in remission was triaged as intermediate risk by the HEART score, but we found no difference in the performance of the HEART score between the groups.