bluuebunny/crossref_metadata_2025_split huggingface dataset:
Artificial intelligence in cornea, refractive, and cataract surgery
Authors: Siddiqui Aazim A. , Ladas John G. , Lee Jimmy K. 
Published: June 2020

Purpose of review
The subject of artificial intelligence has recently been responsible for the advancement of many industries including aspects of medicine and many of its subspecialties. Within ophthalmology, artificial intelligence technology has found ways of improving the diagnostic and therapeutic processes in cornea, glaucoma, retina, and cataract surgery. As demands on the modern ophthalmologist grow, artificial intelligence can be utilized to help address increased demands of modern medicine and ophthalmology by adding to the physician's clinical and surgical acumen. The purpose of this review is to highlight the integration of artificial intelligence into ophthalmology in recent years in the areas of cornea, refractive, and cataract surgery.

Recent findings
Within the realms of cornea, refractive, and cataract surgery, artificial intelligence has played a major role in identifying ways of improving diagnostic detection. In keratoconus, artificial intelligence algorithms may help with the early detection of keratoconus and other ectatic disorders. In cataract surgery, artificial intelligence may help improve the performance of intraocular lens (IOL) calculation formulas. Further, with its potential integration into automated refraction devices, artificial intelligence can help provide an improved framework for IOL formula optimization that is more accurate and customized to a specific cataract surgeon.

Summary
The future of artificial intelligence in ophthalmology is a promising prospect. With continued advancement of mathematical and computational algorithms, corneal disease processes can be diagnosed sooner and IOL calculations can be made more accurate.
Meropenem-Induced Resistant Hypokalemia
Authors: Glover Jennifer Anne , Alam Farjana , Avasthi Salil , Avasthi Deepti 
Published: June 2020

Abstract
Meropenem is a β-lactam antibiotic from the carbapenem class that has been one of the most effective drugs in treating some of the most serious infections in hospitalized patients. Because of its unique β-lactam structure, it has a wide spectrum of activity against some of the most resistant bugs especially penicillinase-producing gram-positive bacteria, gram-negative bacteria, and anaerobes. Common adverse effects that have been well documented with meropenem include nausea, vomiting, diarrhea, and in rare cases skin rashes from hypersensitivity reactions. Hypokalemia is not a known adverse effect of meropenem use. In this case report, we discuss a patient who developed resistant hypokalemia while getting treatment with meropenem for a severe right upper arm infectious myositis. This effect of meropenem was noted to be secondary to impaired potassium absorption in renal tubules, which was found be reversible after discontinuation of the drug.
“This is not a Drill—Evacuate the Building Now!”
Authors: Burnett Ann Lacy , McGuire Koren 
Published: June 2020

Abstract
This article describes an actual disaster that took place at an outpatient surgical center. Reported are the context of the disaster, the potential dangers, the unprepared reactions of the staff, and the following leadership shown by the staff nurses and clinical nurse specialist in response to the disaster. Described is the didactic education they created, with a tabletop evacuation drill and a hands-on exercise presented to the whole multidisciplinary staff. Participants were given a pre- and posteducation survey to assess the effectiveness of the training. Results showed that staff felt far more confident and prepared to deal with a disaster and evacuation after the didactic education combined with the hands-on exercises. Our findings suggest that a training that uses minimal time, space, and resources can significantly improve confidence and preparedness in staff. Also identified was the need for changes in our existing policy to be modeled on logistics that correspond with an actual disaster and evacuation.
In-hospital outcomes of chronic total occlusion percutaneous coronary intervention in patients with and without prior coronary artery bypass graft
Authors: Liu Mei-Jun , Chen Chao-Feng , Gao Xiao-Fei , Liu Xiao-Hua , Xu Yi-Zhou 
Published: June 2020

Abstract
The clinical outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in prior coronary artery bypass graft (pCABG) patients have been investigated; however, the results are inconsistent.
The present meta-analysis compared the clinical outcomes of CTO PCI in patients with and without prior CABG (nCABG). The endpoints included technical success, procedural success, all-cause mortality, myocardial infarction (MI), major bleeding, coronary perforation, pericardial tamponade, emergency CABG, and vascular access complication.
A total of 7 studies comprising of 11099 patients were included in this meta-analysis. The results showed that compared to nCABG patents, pCABG patients were associated with lower technical success (82.3% versus 87.8%; OR, 0.60; 95% CI, 0.53–0.68; P < .00001; I
2 = 0%) and procedural success (80.4% versus 86.2%; OR, 0.61; 95% CI, 0.53–0.70; P < .00001; I
2 = 10%); a higher risk of all-cause mortality (OR, 2.95; 95% CI, 1.56–5.57; P = 0.0008; I
2 = 0%), MI (OR, 2.30; 95% CI, 1.40–3.80; P = .001; I
2 = 5%), and coronary perforation (OR, 2.16; 95% CI, 1.51–3.08; P < 0.0001; I
2 = 52%). On the other hand, the risk of pericardial tamponade (OR, 0.42; 95% CI, 0.15–1.18; P = .10; I
2 = 21%), major bleeding (OR, 1.51; 95% CI, 0.90–2.53; P = .11; I
2 = 0%), vascular access complication (OR, 1.50; 95% CI, 0.93–2.41; P = .10; I
2 = 0%), and emergency CABG (OR, 0.99; 95% CI, 0.25–3.91; P = .99; I
2 = 0%) was similar in both groups.
Compared to nCABG patients, pCABG patients had lower CTO PCI success rates, higher rates of in-hospital mortality, MI, and coronary perforation, and similar risk of pericardial tamponade and vascular complication rates.
Type II enteropathy-associated T cell lymphoma in the duodenum
Authors: Liu Zhicheng , He Liang , Jiao Yan , Wang Helei , Suo Jian 
Published: June 2020

Abstract

Introduction:
Enteropathy-associated T-cell lymphoma (EATL) is a very rare form of lymphoma in the gastrointestinal tract. The proximal jejunum and ileum are the most common sites of EATL, whereas EATL rarely arises in the duodenum, and EATL involving metastasis of the bilateral ovaries is even rarer.

Patient concerns:
A 43-year-old female suffered from upper abdominal pain and weight loss for 3 months.

Diagnosis:
Type II EATL.

Interventions:
The patient was initially treated with chemotherapies, including 4 cycles of the CHOP-E and 2 cycles of the DHAP+ chidamide chemotherapy regimens. However, the patient did not respond well to chemotherapy. Surgical treatment of the duodenal obstruction, with perforation of small intestine and the duodenum, was performed successively.

Outcomes:
The patient died of septic shock only 1 day after the surgery for the second perforation. Her overall survival was 11 months from the time of initial diagnosis.

Conclusion:
This case suggests that EALT is highly invasive and its clinical course is very aggressive. Intestinal perforation, intestinal obstruction, or involvement of extraintestinal organs may occur in EALT patients. Additionally, EALT patients respond poorly to chemotherapy and have an extremely unfavorable prognosis.
Utilization of virtual low-keV monoenergetic images generated using dual-layer spectral detector computed tomography for the assessment of peritoneal seeding from ovarian cancer
Authors: Kim Taek Min , Kim Sang Youn , Cho Jeong Yeon , Kim Seung Hyup , Moon Min Hoan 
Published: June 2020

Abstract
This study aimed to compare the quality of virtual low-keV monoenergetic images vs conventional images reconstructed from dual-layer spectral detector computed tomography (SDCT) for the detection of peritoneal implants of ovarian cancer.
Fifty ovarian cancer patients who underwent abdominopelvic SDCT scans were included in this retrospective study. Virtual monoenergetic images at 40 (VMI40) and 50 keV (VMI50), and two conventional images were reconstructed using filtered back projection (FBP) and iterative model reconstruction (IMR) protocols. The mean attenuation of the peritoneal implant, signal-to-noise ratio (SNR), contrast-to-noise ratio relative to ascites (CNRA) and adjacent reference tissues (e.g., bowel wall, hepatic, or splenic parenchyma [CNRB]) were calculated and compared using paired t tests. Qualitative image analysis regarding overall image quality, image noise, image blurring, lesion conspicuity, was performed by two radiologists. A subgroup analysis according to the peritoneal implant region was also conducted.
VMI40 yielded significantly higher mean attenuation (183.35) of SNR and CNR values (SNR 11.69, CNRA 7.39, CNRB 2.68), compared to VMI50, IR, and FBP images (P < .001). The mean attenuation (129.65), SNR and CNR values (SNR 9.37, CNRA 5.72, CNRB 2.02) of VMI50 were also significantly higher than those of IR and FBP images (P < .001). In the subgroup analysis, all values were significantly higher on VMI40 regardless of the peritoneal implant region (P < .05). In both readers, overall image quality and image blurring showed highest score in VMI50, while image noise and lesion conspicuity showed best score in IMR and VMI40 respectively. Inter-reader agreements are moderate to almost perfect in every parameter.
The low-keV VMIs improved both quantitative assessment and lesion conspicuity of peritoneal implants from ovarian cancer compared to conventional images.
Investigation on the status of oral intake management measures during labor in China
Authors: Huang Chuan-Ya , Luo Bi-Ru , Hu Juan 
Published: June 2020

Abstract
The World Health Organization recommended that the oral intake of low-risk pregnant women during labor should not be restricted. Hospitals in different countries take different measures to manage the intake during labor, but it is not clear about the current situation of oral intake management measures in the hospital during labor in China. Thus, the objective of this study was to investigate the current situation of oral intake management measures during labor in China, so as not only provide references for developing appropriate midwifery technology training and formulating relevant policies, but also provide a basis for exploring and implementing better oral intake management measures in the future.
A cross-sectional survey was conducted. From December 2017 to November 2018, the oral intake management measures of 1213 hospitals in 22 provinces, cities, and autonomous regions in China were investigated by a self-designed questionnaire. χ
2 test was used for statistical analysis.
Different hospitals in China have adopted different oral intake management measures. Among the 1213 hospitals, 939(77.4%) hospitals took measures to allow pregnant women to bring the easily digestible food, 813(67.0%) hospitals took measures to allow pregnant women to eat what she wanted to eat. Few hospitals provide pregnant women with oral nutrition solution or provide a suitable diet for pregnant women. Thirty-four (2.8%) hospitals still restrict pregnant women's fluid intake.
Oral intake management measures that are more suitable for Chinese pregnant women should be explored to better ensure the women energy needs and they safely go through childbirth.
The association between mastication and mild cognitive impairment in Korean adults
Authors: Kim Mi-Sun , Oh Bumjo , Yoo Ji Won , Han Dong-Hun 
Published: June 2020

Abstract
Currently, a few of studies revealed that there is an association between mastication and cognitive impairment. There is no study of Korean adult representative samples in relation to mastication and cognitive decline. This study was to investigate the relationship between mastication and mild cognitive impairment in Korean adults.
A population-based cross-sectional study was conducted in which a total of 7029 subjects (2987 men and 4042 women) over 45 years old were surveyed from the Korea Longitudinal Study on Aging (KLoSA), Round 5th survey. Logistic regression analysis was performed for the study data controlling for confounding factors such as age, gender, education, income, smoking, drinking, exercise, wearing denture, and the number of chronic diseases.
Decreased chewing function is associated with mild cognitive impairment (odds ratio [OR] = 3.24, 95% confidence interval [CI] = 2.67–3.93) after controlling for confounding variables. In the participants who did not wear dentures, the reduction of chewing function was strongly correlated with mild cognitive impairment (OR = 3.97, 95% CI = 3.11–5.08).
Mastication was associated with mild cognitive impairment. To prevent cognitive decline, health specialists should pay more attention to the decline of the mastication in people without dentures.
Endoscopic management of pancreaticopleural fistula in a pediatric patient
Authors: Yang Jing , Lu Lei , Jin Hang-bin , Yang Jian-feng , Zhang Xiao-feng 
Published: June 2020

Abstract

Introduction:
Pancreaticopleural fistula (PPF) is a rare but serious complication of pancreatic disorders. As the clinical presentations of PPF are often deceptive, it can cause a delay in the timely diagnosis and proper treatment. PPF is extremely uncommon in pediatric patients, and diagnostic and management strategies for PPF among pediatric patients are scanty.

Patient concerns:
A 12-year-old girl presented with cough and dyspnea owing to massive right-side pleural effusion confirmed by Chest X-ray. Biochemical examination of pleural effusion revealed a significant elevation of amylase level. Imaging modalities showed dilated pancreatic duct and fistulous tract connecting pancreatic duct and right thorax.

Diagnosis:
Chronic pancreatitis with PPF was diagnosed.

Interventions:
Medical therapy was initially attempted for 2 weeks. Endoscopic therapy with naso-pancreatic drainage tube placement was then performed without any complications after failed medical therapy.

Outcomes:
The patient has remained healthy and symptom-free during 2 years of follow-up.

Conclusion:
When pediatric patients presented with recurrent pleural effusion with unknown etiology, PPF should be taken into consideration. Pleural effusion amylase level is the most important laboratory test and magnetic resonance cholangiopancreatography is recommended to visualize the fistula. Optimal management of PPF should be based on pancreatic duct morphology.
How to advise patients on the risk of chronic proton pump inhibitor therapy
Authors: Moayyedi Paul 
Published: June 2020

Purpose of review
Proton pump inhibitors (PPIs) are widely prescribed and have excellent short-term tolerability. Administrative database studies have highlighted that many diseases are associated with PPI therapy including pneumonia, fracture, cardiovascular disease, and all-cause mortality. This review therefore reviews the evidence of the risks and benefits of these drugs.

Recent findings
There is high-to-moderate quality evidence that PPIs are effective at treating many acid-related disorders. Recent randomized trials have suggested that the associations between PPIs and various diseases are likely to be related to bias and residual confounding and these drugs appear to be safe apart from a possible increased risk of enteric infections.

Summary
PPIs should be used at the lowest dose and for the shortest duration possible. They are still relatively well-tolerated drugs but should only be prescribed for proven indications.
Neighborhood-Level Chronic Disease Surveillance: Utility of Primary Care Electronic Health Records and Emergency Department Claims Data
Authors: Chan Pui Ying , Perlman Sharon E. , Lee David C. , Smolen Jenny R. , Lim Sungwoo 
Published: June 2020

Context:
Disease burden may vary substantively across neighborhoods in an urban setting. Yet, data available for monitoring chronic conditions at the neighborhood level are scarce. Large health care data sets have potential to complement population health surveillance. Few studies have examined the utility of health care data for neighborhood-level surveillance.

Objective:
We examined the use of primary care electronic health records (EHRs) and emergency department (ED) claims for identifying neighborhoods with higher chronic disease burden and neighborhood-level prevalence estimation.

Design:
Comparison of hypertension and diabetes estimates from EHRs and ED claims with survey-based estimates.

Setting:
Forty-two United Hospital Fund neighborhoods in New York City.

Participants:
The EHR sample comprised 708 452 patients from the Hub Population Health System (the Hub) in 2015, and the ED claim sample comprised 1 567 870 patients from the Statewide Planning and Research Cooperative System in 2015. We derived survey-based estimates from 2012 to 2016 Community Health Survey (n = 44 189).

Main Outcome Measure:
We calculated hypertension and diabetes prevalence estimates by neighborhood from each data source. We obtained Pearson correlation and absolute difference between EHR-based or claims-based estimates and survey-based estimates.

Results:
Both EHR-based and claims-based estimates correlated strongly with survey-based estimates for hypertension (0.91 and 0.72, respectively) and diabetes (0.83 and 0.82, respectively) and identified similar neighborhoods of higher burden. For hypertension, 10 and 17 neighborhoods from the EHRs and ED claims, respectively, had an absolute difference of more than 5 percentage points from the survey-based estimate. For diabetes, 15 and 4 neighborhoods from the EHRs and ED claims, respectively, differed from the survey-based estimate by more than 5 percentage points.

Conclusions:
Both EHRs and ED claims data are useful for identifying neighborhoods with greater disease burden and have potential for monitoring chronic conditions at the neighborhood level.
Examining the Implementation of Activity-Friendly Zoning and Land Use Policies Through the Use of Google Street View Measures: A Pilot Study
Authors: Slater Sandy J. , Leider Julien , Chriqui Jamie F. 
Published: June 2020

Introduction:
Pedestrian-oriented zoning and land use policies are being used by local jurisdictions as tools to implement population-level built environmental changes to create more walkable communities. There is a paucity of evidence examining whether these policies lead to actual changes in the built environment. We used Google Street View (GSV), an established, less expensive, alternative built environment data collection method, to conduct an exploratory pilot study of 19 jurisdictions to examine associations between variations in the presence of these adopted zoning policies and their corresponding specific street-level built environment features.

Methods:
Samples of 10 large and 9 small jurisdictions (18 municipalities and 1 county) were purposively selected on the basis of the presence of activity-friendly zoning policy provisions (sidewalks, crosswalks, bike-pedestrian connectivity, street connectivity, trails/paths, bike lanes, bike parking, and other items). Corresponding activity-friendly street-level built environment measures were constructed using GSV. Street segments in these jurisdictions were sampled using ArcGIS and stratified by type (residential and arterial) and income (high, medium, and low).

Results:
A total of 4363 street segments were audited across the 19 sampled jurisdictions. Results show significant differences in the presence of activity-friendly street features when the corresponding zoning policy element was addressed in New Urbanist zones/districts in the site's zoning code (eg, crosswalks, 24.48% vs 16.18%; and bike lanes, 12.60% vs 7.14%). Street segments in the middle- and high-income block groups were less likely to have activity-friendly features than low-income segments, except bike lanes.

Conclusions:
Results show that having activity-friendly policy provisions embedded in a jurisdiction's (municipality/county) zoning codes was associated with a greater presence of the corresponding built environmental street feature on the ground. Results suggest that the methods tested in this article may be a useful policy tool for local governments to identify high need areas that should be prioritized for built environment improvements.
Local Health Departments' Engagement in Activities to Address Opioid Use and Abuse: The Influence of Surveillance Systems' Use
Authors: Nguyen Tran Ha , Shah Gulzar H. , Khurshid Anjum , Olivas Maria I. 
Published: June 2020

Aims:
To examine the extent to which local health departments (LHDs) conduct activities to address opioid use and abuse. To test the hypothesis that (i) LHDs' access to data from an electronic syndromic surveillance system is associated with conducting activities to address opioid use and abuse, and (ii) among those LHDs with access to syndromic surveillance data, the use of syndromic and other surveillance data on opioid-related events is associated with LHDs' report of conducting activities to address opioid use and abuse.

Methods:
Logistic regression was used to analyze data from the 2018 Forces of Change Survey of a statistically representative sample of 966 LHDs, of which 591 participated in the survey.

Results:
The LHDs' access to a syndromic surveillance system was significantly associated with their report of conducting activities to address opioid use and abuse. Compared with LHDs that had no surveillance systems, odds of participating in activities to address the opioid use or abuse were higher for LHDs that managed their own surveillance systems (adjusted odds ratio, AOR = 3.022, P = .03) and those who had but did not manage their own surveillance systems (AOR = 1.920, P < .01). The LHDs' use of syndromic surveillance systems (AOR = 2.98, P = .01) or other surveillance systems (AOR = 2.21, P = .03) was also associated with higher odds to participate in activities to address the opioid use or abuse (vs no such use).

Conclusion:
The LHDs are strategically well positioned to play their role in addressing this multifaceted epidemic. Access to data or information from electronic syndromic surveillance systems that use hospital emergency department data might significantly improve LHDs' engagement in conducting activities to address opioid use and abuse within their communities while building their capacity to face the next epidemic.
Community Health Worker Initiatives: An Approach to Design and Measurement
Authors: Jayapaul-Philip Bina , Shantharam Sharada S. , Moeti Refilwe , Kumar Gayathri S. , Barbero Colleen , Rohan Elizabeth A. , Mensa-Wilmot Yvonne , Soler Robin 
Published: June 2020

Context:
The Centers for Disease Control and Prevention supports the engagement of community health workers (CHWs) to help vulnerable populations achieve optimum health through a variety of initiatives implemented in several organizational units.

Program:
This article provides a unified and comprehensive logic model for these initiatives that also serves as a common framework for monitoring and evaluation.

Implementation:
We developed a logic model to fully describe the levels of effort needed to effectively and sustainably engage CHWs. We mapped monitoring and evaluation metrics currently used by federally funded organizations to the logic model to assess the extent to which measurement and evaluation are aligned to programmatic efforts.

Evaluation:
We found that the largest proportion of monitoring and evaluation metrics (61%) currently used maps to the “CHW intervention level” of the logic model, a smaller proportion (37%) maps to the “health system and community organizational level,” and a minimal proportion (3%) to the “statewide infrastructure level.”

Discussion:
Organizations engaging CHWs can use the logic model to guide the design as well as performance measurement and evaluation of their CHW initiatives.