bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of venous thromboembolism among postmenopausal women prescribed ospemifene, selective estrogen receptor modulators for noncancer indications, or untreated vulvar and vaginal atrophy
Authors: Nordstrom Beth L. , Cai Bin , De Gregorio Fabio , Dhalwani Nafeesa , Fraeman Kathy H. , Yoshida Yuki , Gibbs Trevor 
Published: May 2020

Abstract

Objective:
Ospemifene is a nonsteroidal selective estrogen receptor modulator (SERM) for the treatment of moderate symptomatic vulvar and vaginal atrophy (VVA) due to menopause. A postauthorization safety study is currently examining the incidence of venous thromboembolism (VTE) among postmenopausal women receiving ospemifene or other SERM (raloxifene, bazedoxifene, or tamoxifen, for noncancer indications), or with untreated VVA.

Methods:
This interim analysis used the US MarketScan Commercial and Medicare Supplemental claims database from 2013 to 2017 to identify incident VTE. The incidence rate and 95% confidence interval of VTE during the first continuous course of treatment (or continuous untreated time for the untreated cohort) were calculated for each cohort overall and by age group, with sensitivity analyses examining incidence in the short term (up to 90 days) and long term (all available follow-up, regardless of treatment changes).

Results:
Analyses included 8,188 ospemifene users, 11,777 other SERM users, and 220,242 women with untreated VVA. The incidence per 1,000 person-years and 95% confidence interval of VTE were 3.7 (1.7-7.1) for ospemifene, 11.5 (8.9-14.6) for other SERM, and 11.3 (10.8-11.7) for untreated VVA. Stratification by age and altering the time frame for analysis produced results with similar patterns to the primary analysis.

Conclusions:
This interim analysis of an ongoing study suggests a favorable safety profile for ospemifene with respect to VTE. Comparative analyses with covariate adjustment will be performed when data accrual is complete.
William H. G. Logan and His Bow
Authors: Manrique Monica , Bryant Justin R. , Benitez Elizabeth , Mantilla-Rivas Esperanza , Rogers Gary F. , Oh Albert K. 
Published: May 2020

Summary:
The Logan Bow is an external device comprising a curved bow-shaped metal bar, with spikes attached to its cross bars, and is widely used as part of a cleft lip management to maintain postoperative apposition and to avoid excessive strain after cheiloplasty for a cleft lip. Since its first description by William Hoffman Gardiner Logan, in the early 20th century, no significant modifications have been made to its original design. Even though this external device continues to be commonly used by cleft care providers, there is a paucity of objective evidence regarding its potential benefits and adverse effects even after almost 100 years since its original description. The goal of the current historical manuscript is to provide the reader an engaging study on the life of the man who invented this device, W. H. G. Logan, his initial description of the bow that bears his name, and how this external device is being used.
Stretching and Strength Training to Improve Postural Ergonomics and Endurance in the Operating Room
Authors: Winters James N. , Sommer Nicole Z. , Romanelli Michael R. , Marschik Chad , Hulcher Leah , Cutler Brigitte J. 
Published: May 2020

Background:
Plastic surgeons report the highest prevalence of chronic musculoskeletal pain and fatigue among surgical subspecialties. Musculoskeletal pain impacts daily life, career longevity, and economic burden secondary to occupational injury. Poor postural awareness and ergonomic set up in the operating room represent the most common etiology.

Methods:
A literature review was performed to highlight the ergonomic set-up, postural pitfalls, occupational injuries, and musculoskeletal pain in the operating room. An institutional survey was administered among resident and attending surgeons regarding musculoskeletal pain, posture, ergonomic education, and future improvements. Literature results, survey data, and intraoperative photographs were analyzed in collaboration with physical therapists and personal trainers.

Results:
Survey results demonstrated that 97% of resident and attending respondents experienced musculoskeletal pain and 83% reported a lack of education in posture and ergonomics. The main postural pitfalls included head forward and flexed positioning, abduction and internal arm rotation, and kyphosis of the thoracic spine. The collaborators developed instructional videos to assess posture and biomechanics and demonstrate targeted stretching and strength exercises to address specific neck, back, and shoulder pain.

Conclusions:
Poor posture is unavoidable in the operating room at times. These educational videos should be utilized for self-motivated and prophylactic conditioning outside of the operating room to maintain physical well-being throughout a career in plastic surgery. Future focus should be aimed at implementing dedicated ergonomic education and physical wellness programs early in surgical resident training.
COMPARATIVE EFFECTIVENESS OF PROTON BEAM VERSUS PHOTODYNAMIC THERAPY TO SPARE THE VISION IN CIRCUMSCRIBED CHOROIDAL HEMANGIOMA
Authors: Mathis Thibaud , Maschi Célia , Mosci Carlo , Espensen Charlotte A. , Rosier Laurence , Favard Catherine , Tick Sarah , Remignon Charles-Henry , Ligorio Paolo , Bonin Nicolas , Gambrelle Joël , Nguyen Anh-Minh , Faber Carsten , Meyer Laurent , Mouriaux Frederic , Herault Joël , Baillif Stéphanie , Kiilgaard Jens-Folke , Kodjikian Laurent , Caujolle Jean-Pierre , Salleron Julia , Thariat Juliette 
Published: May 2020

Purpose:
The aim of this study was to compare the functional and anatomical effectiveness of photodynamic therapy (PDT) versus proton beam therapy (PBT) in a real-life setting for the treatment of circumscribed choroidal hemangioma.

Methods:
A total of 191 patients with a diagnosis of circumscribed choroidal hemangioma and treated by PBT or PDT were included for analyses.

Results:
The 119 patients (62.3%) treated by PDT were compared with the 72 patients treated by PBT. The final best-corrected visual acuity did not differ significantly between the two groups (P = 0.932) and final thickness was lower in the PBT compared with the PDT group (P = 0.001). None of the patients treated by PBT needed second-line therapy. In comparison, 53 patients (44.5%) initially treated by PDT required at least one other therapy and were associated with worse final best-corrected visual acuity (P = 0.037). In multivariate analysis, only an initial thickness greater than 3 mm remained significant (P = 0.01) to predict PDT failure with an estimated odds ratio of 2.72, 95% confidence interval (1.25–5.89).

Conclusion:
Photodynamic therapy and PBT provide similar anatomical and functional outcomes for circumscribed choroidal hemangioma ≤3 mm, although multiple sessions are sometimes required for PDT. For tumors >3 mm, PBT seems preferable because it can treat the tumor in only 1 session with better functional and anatomical outcomes.
PHOTORECEPTOR OUTER SEGMENT IS EXPANDED IN THE FELLOW EYE OF PATIENTS WITH UNILATERAL CENTRAL SEROUS CHORIORETINOPATHY
Authors: Borrelli Enrico , Battista Marco , Gelormini Francesco , Gabela Maria C. , Pennisi Flavia , Quarta Alberto , Pezzella Mario , Sacconi Riccardo , Querques Lea , Bandello Francesco , Querques Giuseppe 
Published: May 2020

Purpose:
To quantitatively evaluate the photoreceptor structural changes in the fellow unaffected eyes of patients with unilateral central serous chorioretinopathy (CSC).

Methods:
This is a retrospective cross-sectional study. We analyzed data from patients with diagnosis of unilateral CSC, as based on clinical examination and multimodal imaging, who had structural optical coherence tomography obtained. An additional group of age-matched healthy patients was included for comparison. Main outcome measures were as follows: (1) the foveal photoreceptor outer segment lateral surface and (2) the foveal choroidal thickness.

Results:
One hundred and sixty fellow unaffected eyes of 160 unilateral CSC patients and 50 age-matched controls (50 eyes) were included. The mean ± SD age was 51.6 ± 11.1 years (range 28–80 years) in the unilateral CSC group and 52.8 ± 10.8 years (range 31–74 years) in the control group (P = 0.511). The foveal photoreceptor outer segment lateral surface was significantly increased in the unaffected eyes with CSC in the fellow eye (0.068 ± 0.007 mm2) as compared with control eyes (0.060 ± 0.005 mm2, P < 0.0001). The mean ± SD foveal choroidal thickness was 368.0 ± 105.7 µm in the unilateral CSC group and 302.9 ± 92.2 µm in control patients (P < 0.0001). In the Pearson correlation test, the photoreceptor outer segment lateral surface correlated with the choroidal thickness in the CSC group (R = 0.166, P = 0.016) but not in the control group (R = −0.025, P = 0.864).

Conclusion:
Our results corroborate the hypothesis that retinal and choroidal changes affect both eyes of patients with acute/history of unilateral disease. These structural changes could be intended as an imaging evidence of reduced photoreceptor outer segment turnover secondary to retinal pigment epithelium and choroid dysfunction.
EXTENDED FIELD IMAGING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FOR THE STUDY OF RETINAL AND CHOROIDAL CHANGES AFTER RADIATION THERAPY FOR CHOROIDAL MELANOMA
Authors: Preziosa Chiara , Corvi Federico , Staurenghi Giovanni , Pellegrini Marco 
Published: May 2020

Purpose:
Radiation retinopathy is a common side effect of ocular radiotherapy with no long-term effective therapy. Optical coherence tomography angiography (OCTA) and wide-field fluorescein angiography (FA) are widely used for the study of radiation maculopathy and peripheral nonperfusion, respectively. We investigated the role of extended field imaging (EFI-OCTA) for the study of retinal and choroidal alterations after radiotherapy for choroidal melanoma.

Methods:
Cross-sectional observational study of 20 eyes of 20 patients diagnosed with radiation retinopathy. All patients underwent a complete imaging evaluation including FA and indocyanine green angiography (ICGA) with 55° and 102° lens (Spectralis Heidelberg Engineering, Heidelberg, Germany). Optical coherence tomography angiography imaging was performed with the Zeiss PlexElite 9000 Swept Source OCTA (Carl Zeiss Meditec, Dublin, CA) using a 12 × 12-mm volume scan pattern centered on the fovea and a +20.00-diopter lens specifically designed to obtain EFI examination. The imaging methods were then compared in terms of visible field of view, extension of nonperfused areas, and vessel density.

Results:
The mean extension ratio of EFI-OCTA compared to OCTA without EFI, FA/ICGA 55° and FA/ICGA 102° was, respectively, 1.98 ± 0.02, 1.21 ± 0.01 and 0.36 ± 0.003. The mean extension of retinal and choroidal nonperfused areas evaluated by EFI-OCTA (63.03 ± 48.21 and 38.63 ± 30.83 mm2) were significantly higher than with OCTA without EFI (40.40 ± 34.87 and 24.26 ± 21.82 mm2, P < 0.001) but lower than with FA/ICGA 102° (140.7 ± 69.23 and 108.3 ± 69.51 mm2, P < 0.001). No significant differences were found between mean extension of retinal and choroidal ischemic areas measured with EFI-OCTA and FA/ICGA 55° (69.64 ± 51.92 and 47.23 ± 33.59 mm2). The mean vessel density of EFI-OCTA (retina and choroid segmentation) was significantly different compared to OCTA without EFI (P < 0.05). Retinal vessel density was negatively correlated to retinal extension of nonperfused areas (r = −0.5, P = 0.02), and choroidal vessel density was negatively correlated to choroidal nonperfused areas (r = −0.6, P = 0.003) measured with EFI-OCTA.

Conclusion:
In our series, EFI-OCTA captured larger areas than OCTA without EFI and FA/ICGA with 55° lens. EFI-OCTA images showed a good definition of retinal and choroidal vascular changes after radiotherapy, suggesting a possible role of this safe and noninvasive imaging technique in the follow-up of patients with radiation retinopathy.
Intraocular Pressure After Cataract Surgery Combined With Ab Interno Trabeculectomy Versus Trabecular Micro-bypass Stent: An Intrasubject Same-surgeon Comparison
Authors: Weiner Adam J. , Weiner Yotam , Weiner Asher 
Published: May 2020

Precis:
Combining Trabectome or iStent with phacoemulsification equally reduces intraocular pressure (IOP) and IOP-lowering medication burden during a 24-month follow-up, with a possible advantage to the Trabectome in the early postoperative period.

Purpose:
Intrasubject same-surgeon comparison between phacoemulsification combined with Trabectome (Phaco/Trabectome) versus one first-generation iStent (Phaco/iStent).

Settings:
Private glaucoma and cataract practice.

Design:
This is a retrospective interventional case series.

Methods:
Data collected at 3 to 4 and 20 to 24 hours and up to 30 months following Phaco/Trabectome in 1 eye and Phaco/iStent in the contralateral eye in patients with bilateral visually-significant cataract and open-angle glaucoma. Evaluations included IOP, intraocular pressure-lowering medications (IOPmeds), visual acuity, and complications.

Results:
Forty-five patients (90 eyes) were identified (age 76.5, 57 to 95 y). At 3 to 4 hours, IOP was above baseline in 12 and 13 eyes following Phaco/Trabectome and Phaco/iStent, respectively, but the degree of IOP elevation was smaller (P=0.048) following Phaco/Trabectome: 4.3 mm Hg, 2.0 to 6.6 mm Hg (95% confidence interval) versus Phaco/iStent: 8.7 mm Hg, 3.8 to 13.6 mm Hg. At 20 to 24 hours, compared with baseline, IOP was significantly lower after Phaco/Trabectome (P=0.004) but not after Phaco/iStent (P=0.14) although the rate of hyphema was higher following Phaco/Trabectome (12/45 vs. 2/45 eyes, P=0.007). IOP reduction from baseline at 3 to 4 hours was significantly larger (P=0.020) in the 21 eyes with hyphema: −3.9, −6.4 to −1.4 versus the 69 eyes without hyphema: −0.3, −2.0 to +1.4. At 1, 6, 12, and 24 months, IOP and number of IOPmeds were similar and significantly lower compared with baseline following either procedure. No complications were encountered in either group.

Conclusions:
Combined phacoemulsification with either Trabectome or first-generation iStent similarly lowers IOP and IOPmeds burden at 1, 6, 12, and 24 months following surgery. The Trabectome may have an advantage in lowering IOP faster and lessening the degree of IOP elevations in the early postoperative period.
Drug Provocation Tests for Assessing Antibiotic Hypersensitivity
Authors: García-Boyano Miguel , Gómez-Traseira Carmen , Umpiérrez Ana María , Quirce Santiago , Boyano-Martínez Teresa 
Published: May 2020

Background:
Suspected antibiotic hypersensitivity in children is a frequent reason for consultation. Skin test performance and drug provocation test (DPT) duration are controversial issues. The objective of this study was to assess the effectiveness of diagnostic tests used in the study of antibiotic hypersensitivity and to estimate an optimal duration for DPT.

Methods:
Sixty-two children with a suspected hypersensitivity reaction to antibiotics were studied. Skin tests were performed on all patients. In the case of negative results, DPTs were performed for a duration similar to the time elapsed from the start of treatment until the onset of the reaction.

Results:
The frequency of antibiotic hypersensitivity in the study population was 8.1% (5 of 62). Only 1 patient showed positive skin tests. The other allergic patients were diagnosed by DPT, which reproduced the reaction within the first 6 hours in all but one of them.

Conclusions:
Shortening DPT duration may decrease the sensitivity of the test for the diagnosis of non–IgE-mediated hypersensitivity; however, it should be considered as an opportunity to reduce the resulting microbial resistances.
Nicolau Syndrome Following Metamizole Injection: A Case Report
Authors: Menteşoğlu Dilek , Khurami Hamidullah , Karaduman Ayşen , Gököz Özay 
Published: May 2020

Abstract

Introduction:
Nicolau syndrome is a rare complication following intramuscular injections of various drugs. It is characterized by severe pain, skin and sometimes muscle necrosis after drug injection. However the pathogenesis of Nicolau syndrome remains unclear.
Here, we report a case of Nicolau syndrome following metamizole injection.

Case presentation:
A 35-year-old female presented with an painful necrotic ulcer who developed Nicolau syndrome after an intramuscular injection of metamizole in her right thigh due to reccurent episodes of back pain. This reaction is typical for Nicolau syndrome.

Discussion:
The most common finding of Nicolau syndrome in the early period was severe pain at the injection site. Other common findings were skin discoloration, tenderness, and swelling; indurated livedoid plaques; and erythematous, ecchymotic and purpuric patches. The histopathological results of the case with Nicolau syndrome showed formation of ulceration and fat necrosis.

Conclusion:
Although Nicolau syndrome is an uncommon cutaneous adverse reaction, clinicians should be aware of this complication to prevent or minimize the severity of Nicolau syndrome.
Work-to-Family Conflict and its Associations With Workers’ Burnout, Poor Self-Rated Health, and Minor Mental Disorder
Authors: Pien Li-Chung , Chen I-Shin , Cheng Wan-Ju , Cheng Yawen 
Published: May 2020

Objectives:
To examine the distribution of work-to-family conflict (W-FC) across socio-demographic groups and a wide spectrum of occupations, and its associations with workers’ burnout, self-rated health, and mental health status by sex.

Methods:
A cross-sectional household survey of representative employees was conducted in 2013. A standardized questionnaire was administered to collect information.

Results:
W-FC was high in employees aged 35 to 44 years old and in certain occupational groups. Long working hours, rotating work shift, high work demands, high job control, low workplace justice, and family care burden were risk factors for W-FC, and high W-FC score was significantly associated with burnout, poor self-rated health, and minor mental disorder.

Conclusions:
To improve workers’ health, it is essential to identify high risk groups and adopt measures to reduce conflicts between work and family life.
Investigating the Factors Influencing the Attitudes of Workplace Employees Toward Paying to Use Technology-Based Health Care Products
Authors: Chen Mei-Ju , Kao Feng-Hsia 
Published: May 2020

Objective:
This study explored whether perceived usefulness and perceived ease-of-use generate mediating effects between personal involvement and attitudes toward paying for usage, and further examining the moderating effects of social influence and company type.

Methods:
Questionnaires were used. A total of 365 employees, 218 from the private sector and 147 from the municipal government in Taipei City were collected.

Results:
Perceived ease-of-use mediates between personal involvement and attitude toward paying for usage. The social influences of different types of public and private employment differ significantly in terms of their moderating effects on personal involvement and perceived ease-of-use.

Conclusion:
Due to the different workplace characteristics of private sector and government employees, they have different attitudes toward paying for technology-based health management applications in the future, and social influence is also an important moderating factor.
Relationship Between Faculty Characteristics and Emotional Exhaustion in a Large Academic Medical Center
Authors: Zivin Kara , Brower Kirk J. , Sen Srijan , Brownlee Rebecca M. , Gold Katherine J. 
Published: May 2020

Objective:
We evaluated associations between emotional exhaustion (EE), a measure of burnout, among medical school faculty and: demographic and professional characteristics, workplace stressors, coping skills, resilience, sufficient personal time, and depressive symptoms. Respondents completed surveys in November 2017.

Methods:
We conducted bivariate and multivariable logistic regression and recycled predictions models to estimate associations between characteristics and probability of EE.

Results:
Of 1401 respondents, 42% endorsed EE. Faculty with more clinical effort, more workplace stress, less resilience, less personal time, and more depressive symptoms reported statistically significantly higher probabilities of EE compared with their counterparts. Female sex, mid-career stage, and coping skills were no longer associated with EE, after accounting for stress, resilience, personal time, and depressive symptoms.

Conclusions:
Coping skills may not mitigate physician EE when coupled with substantial time and mental health burdens.
Education and Training to Build Capacity in Total Worker Health®
Authors: Newman Lee S. , Scott Joshua G. , Childress Adele , Linnan Laura , Newhall Wilbert J. , McLellan Deborah L. , Campo Shelly , Freewynn Sabrina , Hammer Leslie B. , Leff Maija , Macy Gretchen , Maples Elizabeth H. , Rogers Bonnie , Rohlman Diane S. , Tenney Liliana , Watkins Cecilia 
Published: May 2020

Objective:
Establishment of core competencies for education and training of professionals entering the emerging field of Total Worker Health®.

Methods:
Compilation and distillation of information obtained over a 5-year period from Total Worker Health symposia, workshops, and academic offerings, plus contributions from key stakeholders regarding education and training needs.

Results:
A proposed set of Total Worker Health competencies aligns under six broad domains: Subject Matter Expertize; Advocacy and Engagement; Program Planning, Implementation and Evaluation; Communications and Dissemination; Leadership and Management; and Partnership Building and Coordination.

Conclusions:
Proposed set of core competencies will help standardize education and training for professionals being trained in Total Worker Health. It serves as an invitation for further input from stakeholders in academia, business, labor, and government.
The efficacy of single-photon emission computed tomography in identifying dystonic muscles in cervical dystonia
Authors: Feng Liang , Zhang Zhuoyu , Malam Djibo Issa , Chen Shuzhen , Li Bing , Pan Yougui , Zhang Xiaolong , Xu Yifei , Su Junhui , Ma Hongxing , Teng Fei , Jin Lingjing 
Published: May 2020

Introduction
The key point for botulinum toxin type A injection in treating cervical dystonia is to accurately identify dystonic muscles. This study aimed to evaluate the efficacy of 99mtechnetium-sestamibi single-photon emission computed tomography in identifying target muscles in cervical dystonia.

Methods
In the study group (n = 18), target muscles were selected according to clinical evaluation combined with 99mtechnetium-sestamibi single-photon emission computed tomography, while in the control group (n = 18), target muscles were selected by clinical evaluation alone. All patients were followed-up at 2 weeks, 1, 3 and 6 months after botulinum toxin type A injection. The primary outcomes were the reduction rates in Toronto Western Spasmodic Torticollis Rating Scale and Tsui score at 1 month.

Results
Although the reduction rates in Toronto Western Spasmodic Torticollis Rating Scale and Tsui scores were not different between the two groups at 2 weeks and 1 month, the reduction rates in both scores were significantly higher in the study group at 3 and 6 months. The number of patients receiving re-injection within 6 months was significantly lower in the study group. Also, the re-injection interval was significantly longer in the study group. In the study group, more deep cervical muscles were injected, which concerns especially semispinalis capitis, longissimus capitis, and obliques capitis inferior muscles.

Conclusion

99mtechnetium-sestamibi single-photon emission computed tomography is a useful method for screening target muscles in cervical dystonia. It helps clinicians draw a ‘blueprint’ for the distribution of dystonic muscles before botulinum toxin type A injection.