bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rehabilitation Needs at 5 Years Post-Traumatic Brain Injury: A VA TBI Model Systems Study
Authors: Mahoney Elaine J. , Silva Marc A. , Reljic Tea , Dams-O'Connor Kristen , Hammond Flora M. , Monden Kimberly R. , Chung Joyce S. , Dillahunt-Aspillaga Christina , Nakase-Richardson Risa 
Published: November 2020

Objective:
Describe rehabilitation needs and factors associated with unmet needs at 5 years post–traumatic brain injury (TBI).

Setting:
Five Veterans Affairs (VA) polytrauma rehabilitation centers (PRCs).

Participants:
VA TBI Model Systems participants (N = 283; 96% male, 75%, 57% severe TBI).

Design:
Prospective observational cohort.

Main Measures:
Rehabilitation Needs Survey (21-item survey that assesses cognitive, emotional, social, and functional needs); Craig Hospital Inventory of Environmental Factors (25-item survey of potential environmental barriers).

Results:
Participants endorsed a mean of 8 (SD: 6.2) ongoing and 3 (SD: 4.7) unmet rehabilitation needs at 5 years post-TBI. Approximately 65% of participants reported at least 1 rehabilitation need that remained unmet. The number and nature of needs differed across TBI severity groups. In unadjusted and adjusted linear regression models, Black race and environmental barriers (Craig Hospital Inventory of Environmental Factors total score) were predictive of unmet needs (P < .001). Those with greater unmet needs reported the physical environment (54%-63%), informational sources (54%), social attitudes (55%), healthcare access (40%), public policy (32%-37%), transportation availability (33%), and in-home assistance (32%) as the most frequent environmental barriers at 5 years post-TBI.

Conclusion:
Veterans and Service Members continue to have rehabilitation needs at 5 years post-TBI. Veterans Affairs programs to address ongoing needs and policy to support them are needed.
Procedures, Visits, and Procedure Costs in the Management of Microbial Keratitis
Authors: Ashfaq Hamza , Maganti Nenita , Ballouz Dena , Feng Yilin , Woodward Maria A. 
Published: November 2020

Purpose:
To investigate the burden of procedures, visits, and procedure costs in the management of microbial keratitis (MK).

Methods:
Medical records of patients from an academic hospital outpatient facility between December 2013 and May 2018 were retrospectively reviewed. Patients were included if they were older than the age of 18 years, recruited for study of likely MK, and not concurrently undergoing treatment for other acute eye conditions. For procedural costs, Medicare data for billing were obtained using the Center for Medicare and Medicaid Services Physician Fee Lookup tool.

Results:
A total of 68 patients were included for analysis. Patients were on average 51.3 years (SD = 19.5), 55.9% women (n = 38), and 89.7% White (n = 61). Per person, the average number of procedures was 2.9 (SD = 4.2). The average number of visits was 13.9 (SD = 9.2) over an average of 26.9 weeks (SD = 24.3). Age (P < 0.0001), positive Gram stain (P = 0.03), and mixed Gram stain (P = 0.002) were positively associated with the number of procedures. Age (P = 0.0003), fungal keratitis (P = 0.02), and mixed Gram stain (P = 0.01) were positively associated with the number of visits. Race was inversely associated with the number of procedures (P = 0.045) and visits (0.03). Patients with bacterial keratitis were more likely to have amniotic membrane grafts (P = 0.01) and tarsorrhaphies (P = 0.03) than fungal patients. Across all procedures performed for the management of MK, the mean cost per patient was $1788.7 (SD = $3324.62).

Conclusions:
Patients incur many procedural costs and attend many visits during the management of MK. These findings emphasize the importance of patient–provider communication for frequent follow-up care and the potential need to perform procedures for disease management.
“Doughnut” Amniotic Membrane Transplantation With Penetrating Keratoplasty for Vernal Keratoconjunctivitis With Limbal Stem Cell Disease
Authors: Singh Aastha , Murthy Somasheila I. , Gandhi Arpan , Sangwan Virender S. 
Published: November 2020

Purpose:
Severe vernal keratoconjunctivitis (VKC) can cause ocular surface disease including partial or complete limbal stem cell deficiency (LSCD), especially in early-onset and severe limbal form of VKC. We report a novel technique of doughnut amniotic membrane transplantation (AMT) along with penetrating keratoplasty (PK) for management of partial LSCD and corneal scarring in a case of severe VKC.

Methods:
Case report.

Results:
A 17-year-old boy, with onset of disease at 8 years of age, and development of partial LSCD and corneal scarring over a period of 9 years despite therapy, presented with profound visual loss due to dense bilateral corneal scarring. After the active allergy subsided, he underwent modified AMT (doughnut AMT) with simultaneous PK in his left eye. Histopathology of the excised button revealed conjunctival phenotype and dense corneal scarring up to the posterior stroma. At 1-year follow up, his best spectacle-corrected visual acuity was maintained at 20/30 in the operated eye, the graft was clear, and the ocular surface was stable.

Conclusions:
Severe VKC can cause ocular surface disease including LSCD with corneal scarring, especially in early-onset limbal form of VKC. The modified technique of AMT (doughnut AMT) along with PK can successfully visually rehabilitate and address partial LSCD in such patients.
Corneal Classics: The Most-Cited Article in the 36-Year History of Cornea
Authors: Perry Henry D. 
Published: November 2020

Purpose:
To describe the most cited article in the 36 year history of Cornea.

Methods:
All articles from Cornea in the past 36 years were reviewed to find the the article with the greatest number of citations.

Results:
Descemet-Stripping Automated Endothelial Keratoplasty by Mark S. Gorovoy, MD, Cornea 2006;25:886–889 was found to have the greatest number of citations.

Conclusion:
This study led to the single greatest change of cornea transplant going from Penetrating Keratoplasty to Descemet Stripping Automated Endothelial Keratoplasty.
The Effect of Using Eye Masks and Earplugs on Intensive Care Patients Quality of Sleep and Vital Signs
Authors: Koçak Ayyüce Tuba , Arslan Selda 
Published: November 2020

ABSTRACT

BACKGROUND: Intensive care unit (ICU) patients with severe health problems experience a high rate of sleep deprivation that harms their psychological and physiological health. Environmental factors are considered to be the greatest cause of sleep deprivation in the ICU, and noise and light are leading among these factors. This study aimed to investigate the effect of eye masks and earplugs on the sleep quality and vital signs of conscious ICU patients. METHODS: This study used a quasi-experimental, in similar groups, pretest-posttest design with a control group. The Richards-Campbell Sleep Questionnaire (RCSQ) was used to collect data, and vital signs were recorded every 2 hours. On day 1, standard care was provided to the experimental group (n = 32), and they were provided with eye masks and earplugs on day 2. The control group (n = 32) was provided with standard care on both days. Chi-square, t, and McNemar and McNemar-Bowker tests were used to analyze the data. Multiple regression analysis was used for predictive analysis. RESULTS: The RCSQ mean (SD) pretest and posttest scores were 50.21 (16.02) and 68.50 (17.57), respectively, for the experimental group and 55.34 (16.62) and 49.03 (15.53), respectively, for the control group. In the experimental group, the posttest RCSQ score was significantly higher than the pretest RCSQ score (P < .01). No differences in vital signs were observed in the control group. All the vital signs were found to be similar in the experimental group, except for the mean daily pulse rate. CONCLUSION: The use of earplugs and eye masks may help reduce sleep deprivation. Eye masks and earplugs can be used by nurses to improve the sleep quality of patients in ICUs.
Gabapentinoid and Opioid Utilization and Cost Trends Among Injured Workers
Authors: Liu Che , Lavin Robert A. , Yuspeh Larry , Leung Nina , Kalia Nimisha , Tsourmas Nicholas F. , Williams Leila , Bernacki Edward J. , Tao Xuguang (Grant) 
Published: November 2020

Objective:
To characterize changes in opioid, gabapentin, and pregabalin utilization patterns and cost trends between 2008 and 2018 in a Louisiana workers’ compensation claims population and explore the role of gabapentinoids as alternative analgesics during the opioid epidemic.

Method:
Filled prescriptions for gabapentinoids and opioids were studied for 11 years in a cohort of 18,737 claimants.

Results:
The proportion of claimants prescribed gabapentin increased 2-fold (8.9% to 18.9%) and average drug cost per claimant decreased 22% ($612 to $480). The proportion of claimants prescribed pregabalin decreased approximately 80% (11.7% to 2.5%) and average drug cost per claim increased 224% ($911 to $2952). Proportion of claimants prescribed opioids decreased 20% (80% to 64.2%) and average drug cost per claim decreased 46% ($691 to $371).

Conclusions:
Utilization increased substantially for gabapentin and decreased for pregabalin and opioids.
Craniofacial Anthropometry of Healthy Turkish Young Adults: Outer Canthal, Inner Canthal, Palpebral Fissure, and Interpupillary Distances
Authors: Bahşi Ilhan , Orhan Mustafa , Kervancioğlu Piraye , Karatepe Şeyma , Sayn Semih 
Published: November 2020

Abstract
This study aims to examine the values of the orbital region in Turkish young adults by the two-dimensional photogrammetry. Anthropometric measurements of the eye and eyelid-related parameters were taken from 100 female and 100 male volunteer Turkish young adults, ranging in age from 18 to 25 years. Endocanthion (en), exocanthion (ex), and pupil (p) were identified on the photograph and the distances between these points were measured with the ImageJ program. The average values of the en-en, ex-en (R), ex-en (L), p-p, and ex-ex were found as 32.92 ± 2.84, 32.48 ± 2.06, 32.22 ± 2.01, 65.32 ± 3.77, and 97.75 ± 5.09 mm, respectively. There were statistically significant differences between the genders in all parameters. Although there are many studies examining these parameters, comprehensive studies are needed in different populations and in many cases. In this study, we believe that the results obtained for Turkish young adults can be used as reference values.
Extensive Polyostotic Craniofacial Fibrous Dysplasia With Optic Nerve Impingement
Authors: Hu Allison C. , Lee Christine J. , Hsu Frank P.K. , Vyas Raj M. 
Published: November 2020

Abstract
Fibrous dysplasia is a benign overgrowth of metaplastic fibrous material resulting in disorganized deposition of bony matrix. Surgical intervention is the primary treatment modality. Here the authors present the case of a 36-year-old male with extensive and severe fibrous dysplasia of the calvarium, orbit, sphenoid, and facial bones causing significant facial distortion and impingement of his optic nerve. Combined operative treatment with craniofacial plastic surgery and neurosurgery was performed. Repair consisted of extensive intra- and extracranial resection and contouring of involved bones followed by reconstruction of the superior orbital rims, forehead, orbital roof, and calvarium with custom polyetheretherketone (PEEK) implant. The authors discuss the advantages of using computer assisted design/modeling, intraoperative neuronavigation, and custom prosthetic cranioplasty for surgical treatment of extensive fibrous dysplasia; a review of the current surgical literature is provided.
Subjective Smell Assessment as An Office-based Rapid Procedure In COVID-19 Era
Authors: Abdel-Aziz Mosaad , Abdel-Aziz Nada M. , Abdel-Aziz Dina M. , Azab Noha 
Published: November 2020

Abstract
A recent history of smell disorder may be a potential predictor for COVID-19. The authors used a subjective olfaction score that was demonstrated on a hard paper-bar. The authors examined 480 patients who were attending the outpatient clinic. Ninety-seven patients (20.2%) demonstrated variable degrees of recent smell disorder. For those patients, lab testing including nasopharyngeal swab for real-time polymerase chain reaction (RT-PCR) was performed. Eighty-eight of them (90.7%) have been confirmed to be COVID-19 positive. Although psychophysical testing is more reliable, subjective assessment of smell is a rapid procedure and can be used as an office-based method for patients’ screening in COVID-19 era. Smell disorder could be an alarming sign for COVID-19 even with absent characteristic symptoms.
The Effect of Different Dose Regimens of Tranexamic Acid in Reducing Blood Loss in Rhinoplasty: A Prospective Randomized Controlled Study
Authors: Avci Hakan 
Published: November 2020

Abstract
Rhinoplasty is a common surgical procedure. Bleeding prevention is a crucial part of the surgery. We aimed to evaluate the different dose regimens of tranexamic acid (TXA) in reducing intraoperative blood loss among patients undergoing rhinoplasty.
This prospective randomized study was performed in patients scheduled for rhinoplasty surgery between March 2019 and March 2020. The patients were divided into 3 groups containing 30 patients in each group. The patients in Group 1 received the first dose of 1 g intravenous (IV) TXA 10 minutes before the surgery, and the second dose was administered at the end of the operation. The patients in Group 2 received only a single dose of 1 g of IV TXA 10 minutes before the surgery. The patients in Group 3 did not receive medication. Demographic data were obtained through a review of patient's medical records. Preoperative and postoperative hemoglobin levels, postoperative transfusion, and complications rate were compared between the study groups.
No significant differences were observed between the study groups in terms of age, gender, body mass index, American Society of Anesthesiologists scores, and the level of preoperative Hb values (P > 0.05). The mean total blood loss was lower in Group 1 than the other groups, but the difference was not statistically significant (P = 0.464).
The administration of single-dose IV TXA or intermittent IV doses of TXA could decrease total blood loss in rhinoplasty, but the statistical and clinical relevance was not significant.
Diagnostic Performance of Noninvasive Imaging for Assessment of Axillary Response After Neoadjuvant Systemic Therapy in Clinically Node-positive Breast Cancer
Authors: Samiei Sanaz , de Mooij Cornelis M. , Lobbes Marc B. I. , Keymeulen Kristien B. M. I. , van Nijnatten Thiemo J. A. , Smidt Marjolein L. 
Published: November 2020

Objective:
The purpose of this study was to perform a systematic review and meta-analysis to determine the diagnostic performance of current noninvasive imaging modalities for assessment of axillary response after neoadjuvant systemic therapy (NST) in clinically node-positive breast cancer patients.

Summary of Background Data:
NST can lead to downstaging of axillary lymph node disease. Imaging can potentially provide information about the axillary response to NST and, consequently, tailor the surgical management.

Methods:
PubMed and Embase were searched for studies that compared noninvasive imaging after NST with axillary surgery outcome to identify axillary response in patients with initial pathologically proven axillary lymph node metastasis. Two reviewers independently screened the studies and extracted the data. A meta-analysis was performed by computing the pooled sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Results:
Thirteen studies describing 2380 patients were included for final analysis. Of these patients, 1322 had undergone axillary ultrasound, 849 breast MRI, and 209 whole-body 18F-FDG PET-CT. The overall axillary pathologic complete response rate was 39.5% (941/2380). For axillary ultrasound, the pooled sensitivity, specificity, PPV, and NPV were 65%, 69%, 77%, 50%, respectively. For breast MRI, the pooled sensitivity, specificity, PPV, and NPV were 60%, 76%, 78%, 58%, respectively. For whole-body 18F-FDG PET-CT, the pooled sensitivity, specificity, PPV, and NPV were 38%, 86%, 78%, 49%, respectively.

Conclusions:
The diagnostic performance of current noninvasive imaging modalities is limited to accurately assess axillary response after NST in clinically node-positive breast cancer patients.
End Colostomy With or Without Mesh to Prevent a Parastomal Hernia (GRECCAR 7)
Authors: Prudhomme Michel , Rullier Eric , Lakkis Zaher , Cotte Eddy , Panis Yves , Meunier Bernard , Rouanet Philippe , Tuech Jean-Jacques , Jafari Mehrdad , Portier Guillaume , Dubois Anne , Sielezneff Igor , Parc Yann , Faucheron Jean-Luc , Meurette Guillaume , Lelong Bernard , Piessen Guillaume , Karoui Mehdi , Fabbro-Peray Pascale , Demattei Christophe , Bertrand Martin M. 
Published: November 2020

Objective:
To evaluate whether systematic mesh implantation upon primary colostomy creation was effective to prevent PSH.

Summary of Background Data:
Previous randomized trials on prevention of PSH by mesh placement have shown contradictory results.

Methods:
This was a prospective, randomized controlled trial in 18 hospitals in France on patients aged ≥18 receiving a first colostomy for an indication other than infection. Participants were randomized by blocks of random size, stratified by center in a 1:1 ratio to colostomy with or without a synthetic, lightweight monofilament mesh. Patients and outcome assessors were blinded to patient group. The primary endpoint was clinically diagnosed PSH rate at 24 months of the intention-to-treat population. This trial was registered at ClinicalTrials.gov, number NCT01380860.

Results:
From November 2012 to October 2016, 200 patients were enrolled. Finally, 65 patients remained in the no mesh group (Group A) and 70 in the mesh group (Group B) at 24 months with the most common reason for drop-out being death (n = 41). At 24 months, PSH was clinically detected in 28 patients (28%) in Group A and 30 (31%) in Group B [P = 0.77, odds ratio = 1.15 95% confidence interval = (0.62;2.13)]. Stoma-related complications were reported in 32 Group A patients and 37 Group B patients, but no mesh infections. There were no deaths related to mesh insertion.

Conclusion:
We failed to show efficiency of a prophylactic mesh on PSH rate. Placement of a mesh in a retro-muscular position with a central incision to allow colon passage cannot be recommended to prevent PSH. Optimization of mesh location and reinforcement material should be performed.
A Propensity Score-matched Analysis of Long-term Oncologic Outcomes After Nipple-sparing Versus Conventional Mastectomy for Locally Advanced Breast Cancer
Authors: Wu Zhen-Yu , Han Hyun Ho , Kim Hee Jeong , Chung Il-Yong , Kim Jisun , Lee Sae Byul , Son Byung-Ho , Eom Jin Sup , Kim Sung-Bae , Ahn Jin-Hee , Gong Gyung Yub , Kim Hak-Hee , Ahn Sei-Hyun , Ko BeomSeok 
Published: November 2020

Objectives:
To compare the long-term oncologic outcomes of nipple-sparing mastectomy (NSM) with those of conventional mastectomy (CM) in patients with locally advanced breast cancer (LABC) receiving neoadjuvant chemotherapy (NACT).

Summary of Background Data:
NSM has been increasingly implemented in patients with breast cancer. However, oncologic efficacy of NSM in patients with LABC has not been sufficiently demonstrated.

Methods:
The study group comprised 850 patients with clinical stage IIB to IIIC breast cancer who underwent NACT followed by either NSM and immediate breast reconstruction or CM alone. After propensity score-matching, 418 patients were included in the analysis. Local recurrence-free survival, disease-free survival (DFS), distant metastasis-free survival, and overall survival (OS) rates were calculated using the Kaplan-Meier method and compared using log-rank tests between the NSM and CM groups.

Results:
After matching, the mean follow-up period was 70 ± 25 months for the NSM group and 74 ± 27 months for the CM group (P = 0.181). There were no significant differences between the groups in terms of 6-year local recurrence-free survival (91.6% vs. 95.8%; P = 0.239), DFS (70.5% vs. 73.4%; P = 0.583), distant metastasis-free survival (79.8% vs. 77.4%; P = 0.320), or OS (87.6% vs. 84.8%; P = 0.465) rates. Additionally, we identified 30 patients in the NSM group who initially presented with tumor extension in the subareolar area; the nipple-areola complex was successfully preserved after NACT, and no recurrence at the nipple was observed in these patients.

Conclusions:
In this matched control study, we demonstrated comparable long-term oncologic outcomes between NSM with immediate reconstruction and CM alone after NACT for LABC. In patients who had tumors extending to the subareolar area before NACT, NSM can be tried if tumor involvement of the nipple-areola complex appears resolved on imaging studies after chemotherapy.
Assessing the impact of non-pharmaceutical interventions (NPI) on the dynamics of COVID-19: A mathematical modelling study in the case of Ethiopia
Authors: Ejigu Bedilu Alamirie , Asfaw Manalebish Debalike , Cavalerie Lisa , Abebaw Tilahun , Nanyingi Mark , Baylis Matthew 
Published: November 2020

AbstractThe World Health Organisation (WHO) declared COVID-19 a pandemic on March 11, 2020 and by November 14, 2020 there were 53.3M confirmed cases and 1.3M reported deaths in the world. In the same period, Ethiopia reported 102K cases and 1.5K deaths. Effective public health preparedness and response to COVID-19 requires timely projections of the time and size of the peak of the outbreak. Currently, in the absence of vaccine or effective treatment, the implementation of NPIs (non-pharmaceutical interventions), like hand washing, wearing face coverings or social distancing, is recommended by WHO to bring the pandemic under control. This study proposes a modified Susceptible Exposed Infected and Recovered (SEIR) model to predict the number of COVID-19 cases at different stages of the disease under the implementation of NPIs with different adherence levels in both urban and rural settings of Ethiopia. To estimate the number of cases and their peak time, 30 different scenarios were simulated. The results reveal that the peak time of the pandemic is different in urban and rural populations of Ethiopia. In the urban population, under moderate implementation of three NPIs the pandemic will be expected to reach its peak in December, 2020 with 147,972 cases, of which 18,100 are symptomatic and 957 will require admission to an Intensive Care Unit (ICU). Among the implemented NPIs, increasing the coverage of wearing masks by 10% could reduce the number of new cases on average by one-fifth in urban-populations. Varying the coverage of wearing masks in rural populations minimally reduces the number of cases. In conclusion, the projection result reveals that the projected number of hospital cases is higher than the Ethiopian health system capacity during the peak time. To contain symptomatic and ICU cases within health system capacity, the government should give attention to the strict implementation of the existing NPIs or impose additional public health measures.