bluuebunny/crossref_metadata_2025_split huggingface dataset:
Condensed Outpatient Rehabilitation Early After Lung Transplantation: A Retrospective Analysis of 6-Minute Walk Distance and Its Predictors
Authors: Byrd Rebecca , Smith Patrick J. , McHugh Hannah F. , Snyder Laurie D. , Pastva Amy M. 
Published: May 2021

Purpose:
The objectives were to evaluate the effect of a condensed post-lung transplant outpatient rehabilitation program started immediately after hospital discharge on 6-minute walk distance (6MWD) and to explore predictors of change in 6MWD and time to complete rehabilitation.

Methods:
Data were retrospectively collected from July 2009 to February 2019 on recipients who completed physical therapy-based posttransplant outpatient rehabilitation (PTOR). Changes in 6MWD prerehabilitation to postrehabilitation were assessed using repeated measures, and predictors were assessed using multiple linear regression.

Results:
Participants (N = 819, 61% men, 61 years) began PTOR 2 days (interquartile range [IQR] 1–3) after hospital discharge. The mean 6MWD of 324 m (SD = 107) improved after rehabilitation to 488 m (SD = 105). Factors associated with improvement were younger age (P = .003), higher baseline forced expiratory volume in 1 second (FEV1) (P < .001), and lower baseline 6MWD (P < .001). Participants averaged 22 sessions in 41 days (IQR 35–50); with lower baseline FEV1 (P = .002) and 6MWD (P < .001) associated with longer completion time.

Conclusions:
A condensed outpatient rehabilitation program early after lung transplantation was associated with a large, clinically meaningful improvement in 6MWD. Salient predictors of improvement included age, lung function, and starting 6MWD. These findings from a large cohort of lung transplant recipients who participated in PTOR can assist clinicians in tailoring strategies to optimize patient management.
Surgical Intervention for Paronychia Induced by Targeted Anticancer Therapies
Authors: Hanania Hannah L. , Pacha Omar , Heberton Meghan , Patel Anisha B. 
Published: May 2021

BACKGROUND
Paronychia is a common toxicity associated with targeted anticancer therapies. Antibiotics and steroids are the standard treatments for severe paronychia, yet they are often inadequate, prolonging the patient's suffering and resulting in changes to effective cancer therapy.

OBJECTIVE
This article describes the clinical course of drug-induced paronychia and attempts to identify circumstances under which nail surgery may be beneficial.

MATERIALS AND METHODS
This is a retrospective case series from a single institution's electronic medical record for patients on paronychia-inducing anticancer therapies with nail disease visit diagnosis codes.

RESULTS
The authors identified 36 nail procedures performed on 12 patients, all of whom were managed with conservative steroid and antibiotic therapy with varying degrees of improvement; however, no further improvement was seen after 90 days. Partial matricectomy, nail avulsion, debridement/clipping, and incision and drainage were performed with resolution rates of 100% (11/11), 38.5% (5/13), 12.5% (1/8), and 0% (0/4), respectively. The average time to surgical intervention was 196 days, and the average time to resolution was 268 days.

CONCLUSION
This series highlights the prolonged course of severe drug-induced paronychia and the importance of surgical intervention to reduce pain and impact on cancer treatment. Partial matricectomy should be considered for paronychia unresponsive to conservative therapy by 3 months.
5-HT7 Receptor Restrains 5-HT–induced 5-HT2A Mediated Contraction in the Isolated Abdominal Vena Cava
Authors: Gonzalez-Pons Romina , McRae Kiera , Thompson Janice M. , Watts Stephanie W. 
Published: May 2021

Abstract:
Although discovered as a vasoconstrictor, 5-hydroxytryptamine (5-HT, serotonin) infused into man and rodent reduces blood pressure. This occurs primarily through activation of 5-HT7 receptors and, at least in part, venodilation. Vascular mechanisms by which this could occur include direct receptor activation leading to vasodilation and/or suppression of contractile 5-HT receptor activation. This study tests the hypothesis that the 5-HT7 receptor restrains activation of the 5-HT2A receptor. A subhypothesis is whether agonist-induced activation—independent of constitutive activity—of the 5-HT7 receptor is necessary for this restraint. The isolated abdominal aorta and vena cava from the normal male Sprague–Dawley rat was our model. Studies used real-time PCR and a pharmacological approach in the isolated tissue bath for measurement of isometric tone. Although 5-HT2A receptor mRNA expression in both aorta and vena cava was significantly larger than that of the 5-HT7 receptor mRNA, the 5-HT7/5-HT2A receptor mRNA ratio was greater in the vena cava (0.30) than in the aorta (0.067). 5-HT7 receptor antagonism by SB266970 and DR 4458 increased maximum contraction to 5-HT in the isolated vein by over 50% versus control. The 5-HT2A receptor agonists TCB-2 and NBOH were more potent in the aorta compared with 5-HT but less efficacious, serving as partial agonists. By contrast, these same three agonists caused no contraction in the vena cava isolated from the same rats up to 10 μM agonist. Antagonism of the 5-HT7 receptor by SB269970 did not increase either the potency or efficacy of TCB-2 or NBOH. These data support that the 5-HT7 receptor itself needs to be stimulated to reduce contraction and suggest there is little constitutive activity of the 5-HT7 receptor in the isolate abdominal vena cava.
AAPS Podium Presentations—Has the Level of Evidence Changed over the Past Decade?
Authors: Chattopadhyay Arhana , Wu Robin , Wan Derrick , Momeni Arash 
Published: May 2021

Background:
An increase in the number and quality of randomized controlled trials (RCTs) and trends toward higher levels of evidence (LOE) in the plastic surgery literature has been reported; however, there has not been a specific focus on the LOE of presentations at scientific meetings. The purpose of this study was to ascertain trends in the LOE of studies presented at the annual meeting of the American Association of Plastic Surgeons.

Methods:
A hand search was conducted identifying all abstracts of podium presentations from 2009 to 2019. LOE, using American Society of Plastic Surgeons guidelines, were ascribed to each presentation, along with identification of any corresponding journal publications. RCTs were further analyzed using the 12-item Modified Consolidated Standard of Reporting Trials checklist.

Results:
Four hundred forty-one studies with a median LOE of 3 were included in the study. A non-significant improvement in the mean level of evidence was noted over time (P = 0.09) along with an increase in the number of level 2 studies (P = 0.589) and RCTs (P = 0.717). Level 1 studies were rare (0.91%) and of fair quality (median checklist score 8 out of 12). Seventy-two percent of abstracts resulted in publication, and the mean lag time to publication was 422 days.

Conclusions:
A favorable trend is observed with respect to the mean LOE as well as the number of level 2 studies and RCTs over time. The importance of research meeting attendance to maintain up-to-date information is noteworthy, given the long lag time from presentation to publication.
NIVOLUMAB-INDUCED HARADA-LIKE UVEITIS WITH BACILLARY DETACHMENT MIMICKING CHOROIDAL METASTASIS
Authors: Ng Caleb C. , Ng Joshua C. , Johnson Robert N. , McDonald H. Richard , Agarwal Anita 
Published: May 2021

Purpose:
To describe a patient with metastatic clear cell renal cell carcinoma in remission on maintenance nivolumab therapy who developed late-onset ocular toxicity manifesting as creamy chorioretinal lesions with exudative retinal detachment concerning for choroidal metastasis.

Method:
Case report. Main outcome measures include ophthalmoscopic examination, fundus photography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, spectral domain optical coherence tomography, and B-scan ultrasonography.

Results:
A 49-year-old woman with a medical history of metastatic clear cell renal cell carcinoma in remission for two years after immunotherapy with four cycles of ipilimumab and nivolumab followed by maintenance nivolumab infusions developed lesions concerning for choroidal metastases in her right eye. Optical coherence tomography of the lesions revealed a bacillary layer detachment containing possible fibrinous exudate organized into layers and underlying choroidal thickening with chorioretinal folds. Later, choroidal thickening and chorioretinal folds also occurred in the left eye. Given that pan imaging detected no metastasis and the posterior segment abnormalities resolved after cessation of nivolumab and treatment with systemic corticosteroids, the patient was diagnosed with nivolumab-induced Vogt–Koyanagi–Harada-like uveitis.

Conclusion:
This case expands on the clinical spectrum of nivolumab-induced Vogt–Koyanagi–Harada-like uveitis, a condition that can also present with bacillary layer detachment mimicking an early choroidal metastasis, manifest asymmetrically in each eye, and develop after long-standing treatment.
The “Two-Flaps” Technique for Descemet Stripping Only
Authors: Cohen Eyal , Din Nizar , Mimouni Michael , Trinh Tanya , Gouvea Larissa , AlShaker Sara , Chan Clara C. , Slomovic Allan R. 
Published: May 2021

Purpose:
The success of Descemet stripping only (DSO) is optimized by performing a well-centered, accurately sized diameter of descemetorhexis with a smooth curvilinear border. To achieve this success, we describe a repeatable and relatively straightforward technique to optimize this descemetorhexis for DSO.

Methods:
The “two-flaps” technique uses the Gorovoy DSO forceps. The technique takes advantage of the flat and smooth surface of the forceps to create the desired 4-mm Descemet stripping with minimal stromal trauma along with a continuous curvilinear descemetorhexis, minimizing the risk of postoperative stromal scarring and extension of the rhexis beyond 4 mm.

Results:
This technique has been used successfully in 11 cases performed by 1 surgeon or directly supervised by him. All cases achieved the desired 4-mm circumference without any residual tags or visually significant stromal scarring, with successful clearing of the central cornea and endothelial cells repopulating the central stripped area.

Conclusions:
This technique described provides a consistent, reproducible, and relatively trauma-free peeling of Descemet membrane and associated endothelial cells/guttae to optimize the success of DSO.
Long-Term Safety and Efficacy of Tacrolimus 0.1% in Severe Pediatric Vernal Keratoconjunctivitis
Authors: Caputo Roberto , Marziali Elisa , de Libero Cinzia , Di Grande Laura , Danti Gioia , Virgili Gianni , Villani Edoardo , Mori Francesca , Bacci Giacomo M. , Lucenteforte Ersilia , Pucci Neri 
Published: May 2021

Purpose:
The aim of this study was to evaluate the safety and efficacy of tacrolimus 0.1% eye drops in a large population of pediatric patients affected by a severe form of vernal keratoconjunctivitis (VKC) who responded poorly to cyclosporine eye drops.

Methods:
This is a retrospective study based on standardized clinical charts and data collection of consecutive patients affected by severe VKC who responded poorly to cyclosporine eye drops topical treatment but treated with tacrolimus 0.1% eye drops with a follow-up of 18 months. Four clinical signs were graded for analysis: hyperemia, tarsal papillae, giant papillae, and limbal papillae. The blood tests for kidney and liver function and the tacrolimus level were studied. Visits were scheduled at baseline and at 3, 6, 12, and 18 months. Patients received tacrolimus 0.1% eye drops in both eyes 2 times daily.

Results:
Four hundred thirty-one patients were included. Three hundred twenty-five patients were affected by a seasonal form, whereas the remaining 106 by a perennial form. Statistical analysis on each single score showed a positive relevance (P < 0.001) from baseline to all other visits. No local or systemic complications were recorded.

Conclusions:
Tacrolimus has been proposed as a treatment for severe forms of VKC. This study has confirmed the safety and efficacy of tacrolimus 0.1% eye drops in a large pediatric population of patients affected by a severe form of VKC who responded poorly to cyclosporine eye drops.
Conditional knockout of CRMP2 in neurons, but not astrocytes, disrupts spinal nociceptive neurotransmission to control the initiation and maintenance of chronic neuropathic pain
Authors: Boinon Lisa , Yu Jie , Madura Cynthia L. , Chefdeville Aude , Feinstein Douglas L. , Moutal Aubin , Khanna Rajesh 
Published: May 2021

Abstract
Mechanistic studies principally focusing on primary afferent nociceptive neurons uncovered the upregulation of collapsin response mediator protein 2 (CRMP2)—a dual trafficking regulator of N-type voltage-gated calcium (Cav2.2) as well as Nav1.7 voltage-gated sodium channels—as a potential determinant of neuropathic pain. Whether CRMP2 contributes to aberrant excitatory synaptic transmission underlying neuropathic pain processing after peripheral nerve injury is unknown. Here, we interrogated CRMP2's role in synaptic transmission and in the initiation or maintenance of chronic pain. In rats, short-interfering RNA-mediated knockdown of CRMP2 in the spinal cord reduced the frequency and amplitude of spontaneous excitatory postsynaptic currents, but not spontaneous inhibitory postsynaptic currents, recorded from superficial dorsal horn neurons in acute spinal cord slices. No effect was observed on miniature excitatory postsynaptic currents and inhibitory postsynaptic currents. In a complementary targeted approach, conditional knockout of CRMP2 from mouse neurons using a calcium/calmodulin-dependent protein kinase II alpha promoter to drive Cre recombinase expression reduced the frequency and amplitude of spontaneous excitatory postsynaptic currents, but not miniature excitatory SCss. Conditional knockout of CRMP2 from mouse astrocytes using a glial fibrillary acidic protein promoter had no effect on synaptic transmission. Conditional knockout of CRMP2 in neurons reversed established mechanical allodynia induced by a spared nerve injury in both male and female mice. In addition, the development of spared nerve injury–induced allodynia was also prevented in these mice. Our data strongly suggest that CRMP2 is a key regulator of glutamatergic neurotransmission driving pain signaling and that it contributes to the transition of physiological pain into pathological pain.
Immersive interactive virtual walking reduces neuropathic pain in spinal cord injury: findings from a preliminary investigation of feasibility and clinical efficacy
Authors: Trost Zina , Anam Monima , Seward Joshua , Shum Corey , Rumble Deanna , Sturgeon John , Mark Victor , Chen Yuying , Mitchell Lucie , Cowan Rachel , Perera Robert , Richardson Elizabeth , Richards Scott , Gustin Sylvia 
Published: May 2021

Abstract
Chronic neuropathic pain (NP) is a common and often debilitating secondary condition for persons with spinal cord injury (SCI) and is minimally responsive to existing pharmacological and nonpharmacological treatments. The current preliminary investigation describes the feasibility and initial comparative efficacy of an interactive virtual reality walking intervention, which is a novel extension of visual feedback/illusory walking therapies shown to reduce SCI NP. Virtual reality walking intervention builds on previous research by, for the first time, allowing individuals with SCI NP to volitionally control virtual gait to interact with a fully immersive virtual environment. The current pilot study compared this interactive, virtual walking intervention to a passive, noninteractive virtual walking condition (analogous to previous illusory walking interventions) in 27 individuals with complete paraplegia (interactive condition, n = 17; passive condition, n = 10; nonrandomized design). The intervention was delivered over 2 weeks in individuals' homes. Participants in the interactive condition endorsed significantly greater reductions in NP intensity and NP-related activity interference preintervention to postintervention. Notable improvements in mood and affect were also observed both within individual sessions and in response to the full intervention. These results, although preliminary, highlight the potentially potent effects of an interactive virtual walking intervention for SCI NP. The current study results require replication in a larger, randomized clinical trial and may form a valuable basis for future inquiry regarding the mechanisms and clinical applications of virtual walking therapies.
Virtual reality-based preprocedural education increases preparedness and satisfaction of patients about the catheter ablation of atrial fibrillation
Authors: Chang Shih-Lin , Kuo Ming-Jen , Lin Yenn-Jiang , Chen Shih-Ann , Chen Chung-Ting , Yang Ying-Ying , Yang Ling-Yu , Kao Shou-Yen , Shulruf Boaz , Lee Fa-Yauh 
Published: May 2021

Background:
A recent study suggested to develop and implement more interacted material for preprocedural education to decrease patients’ anxiety about the atrial fibrillation (AF) ablation. This study compared the effectiveness of using either newly developed virtual reality (VR) materials (VR group) or paper-based materials (paper group) on giving AF preprocedural education.

Methods:
This study consequentially enrolled 33 AF patients preparing for ablation from November 2019 to October 2020. After enrollment, patients were randomized as either paper (n = 22) or VR (n = 11) groups.

Results:
In comparison with the baseline stage, at the posteducation stage, the degree of improvement in patients’ self-assessed self-efficacy on AF ablation knowledge was higher among VR group patients than those in the paper group. At the posteducation stage, the patients’ satisfaction to preprocedural education and used materials were higher among the VR group than that among the paper group. In addition to meet their needs and give accurate medical information, VR group patients reported that VR materials increased the effectiveness of education, increased their preparedness for AF catheter ablation, achieved paperless purposes, and willing to recommend VR materials to others. Operators subjectively reported that the periprocedure cooperation was increased both among paper and VR group patients after preprocedural education for the details of procedure. Better preparedness of VR group patients was supported by less periprocedure pain, anxiety, and impatience than those among paper group patients.

Conclusion:
Interactive VR-based materials are superior to the paper-based materials to provide patients immerse and imagine the journey and detail knowledge of AF catheter ablation before the procedure and better prepared patients for the procedure.
Association of Antidepressant Continuation in Pregnancy and Infant Birth Weight
Authors: Wartko Paige D. , Weiss Noel S. , Enquobahrie Daniel A. , Chan K. C. Gary , Stephenson-Famy Alyssa , Mueller Beth A. , Dublin Sascha 
Published: May 2021

Abstract

Purpose
The aim of the study was to evaluate the association of antidepressant continuation in pregnancy with infant birth weight among women using antidepressants before pregnancy.

Methods
This retrospective cohort study used electronic health data linked with state birth records. We identified singleton live births (2001–2014) to enrolled women with 1 or more antidepressant prescriptions filled 6 months or less before pregnancy, including “continuers” (≥1 antidepressant fills during pregnancy, n = 1775) and “discontinuers” (no fill during pregnancy, n = 1249). We compared birth weight, small or large for gestational age (SGA or LGA), low birth weight (LBW; <2500 g), and macrosomia (>4500 g) between the 2 groups, using inverse probability of treatment weighting to account for pre-pregnancy characteristics, including mental health conditions.

Results
After weighting, infants born to antidepressant continuers weighed 71.9 g less than discontinuers' infants (95% confidence interval [CI], −115.5 to −28.3 g), with a larger difference for female infants (−106.4 g; 95% CI, −164.6 to −48.1) than male infants (−48.5 g; 95% CI, −107.2 to 10.3). For female infants, SGA risk was greater in continuers than discontinuers (relative risk [RR],1.54; 95% CI, 1.02 to 2.32). Low birth weight risk was greater in continuers with 50% or more of days covered (RR, 1.69; 95% CI, 1.11 to 2.58) and exposure in the second trimester (RR, 1.53; 95% CI, 1.02 to 2.29), as compared with discontinuers.

Conclusions
Depending on infant sex, as well as duration and timing of use, continuation of antidepressant use during pregnancy may be associated with lower infant birth weight, with corresponding increases in LBW and SGA.
Value of Interprofessional Education: The VA Quality Scholars Program
Authors: Godwin Kyler M. , Narayanan Anand , Arredondo Kelley , Miltner Rebecca (Suzie) , Bowen Michael E. , Gilman Stuart , Shirks Allan , Eng Jessica A. , Naik Aanand D. , Hysong Sylvia J. 
Published: May 2021

ABSTRACT
Interprofessional collaboration (IPC) has been shown to improve healthcare quality and patient safety; however, formal interprofessional education (IPE) training is insufficient. The VA Quality Scholars (VAQS) program exists to develop interprofessional leaders and scholars in healthcare improvement. The purpose of this study was to examine the impact of integrating interprofessional healthcare learners and designing an interprofessional curriculum for the national VAQS program. VAQS alumni (graduates from 2001 to 2017) across eight national sites (n = 102 [53.1%]) completed a web-based survey to assess alumni perceptions of IPC skill development during the program and IPC skill utilization in their careers. Alumni from 2009 and earlier were physicians; alumni after 2009 came from diverse health professional backgrounds. Overall, IPC and teamwork was identified as the most used skill (n = 82, 70%) during their career. When comparing the pre-IPE period and the post-IPE period, post-IPE alumni identified IPC and teamwork as the area of greatest skill development (n = 38). Integrating interprofessional trainees and robust IPE curricula enhanced an established and successful quality improvement (QI) training program. VAQS alumni endorsed the importance of IPC skills during their careers. The VAQS program is an example of how health professionals can successfully learn IPC skills in healthcare QI.