bluuebunny/crossref_metadata_2025_split huggingface dataset:
Troponin Elevation Following Percutaneous Coronary Intervention in Acute Coronary Syndrome
Authors: Miner Daniel G. , Parcetich Kevin , Smith Kellen 
Published: September 2021

Background:
Recent advances in revascularization procedures have improved survival rates for individuals with acute coronary syndrome (ACS). However, evidence to guide clinical decision-making for early mobility following percutaneous coronary intervention (PCI) is extremely limited.

Purpose:
The purpose of this clinical perspective and literature review is to provide context for the clinical interpretation of cardiac troponin (cTn) levels in individuals with ACS following revascularization via PCI and present an evidence-supported clinical decision-making algorithm to guide clinicians in the appropriate timing of initiation of early mobility for individuals with ACS.

Methods:
A literature review on cTn values is presented to guide the clinical interpretation of laboratory values for clinical decision-making. A comparison of consensus-based guidelines for early mobility is presented as the basis for proposing a novel algorithm for clinical decision-making in individuals with ACS following PCI.

Conclusion:
The clinical value and utility of postprocedural cTn levels in individuals with ACS following PCI is to help understand prognosis and mortality but does not provide sufficient information about the safety of initiating early mobility following PCI. Decisions for initiation of early mobility in this population using the proposed evidence-supported algorithm may help avoid unnecessary prolongation of bed rest.
Ambient temperature and infarct size, microvascular obstruction, left ventricular function and clinical outcomes after ST-segment elevation myocardial infarction
Authors: Redfors Björn , Simonato Matheus , Chen Shmuel , Vincent Flavien , Zhang Zixuan , Thiele Holger , Eitel Ingo , Patel Manesh R. , Ohman E. Magnus , Maehara Akiko , Ben-Yehuda Ori , Stone Gregg W. 
Published: September 2021

Objectives
Incidence and prognosis of ST-segment elevation myocardial infarction (STEMI) vary according to ambient temperature and season. We sought to assess whether season and temperature on the day of STEMI are associated with infarct size, microvascular obstruction (MVO), left ventricular ejection fraction (LVEF) and clinical outcomes after primary percutaneous coronary intervention (PCI).

Methods
Individual patient data from 1598 patients undergoing primary PCI in six randomized clinical trials were pooled. Infarct size was evaluated by cardiac magnetic resonance within 30 days in all trials. Patients were categorized either by whether they presented on a day of temperature extremes (minimum temperature <0 °C or maximum temperature >25 °C) or according to season.

Results
A total of 558/1598 (34.9%) patients presented with STEMI on a day of temperature extremes, and 395 (24.7%), 374 (23.4%), 481 (30.1%) and 348 (21.8%) presented in the spring, summer, fall and winter. After multivariable adjustment, temperature extremes were independently associated with larger infarct size (adjusted difference 2.8%; 95% CI, 1.3–4.3; P < 0.001) and smaller LVEF (adjusted difference −2.3%; 95% CI, −3.5 to −1.1; P = 0.0002) but not with MVO (adjusted P = 0.12). In contrast, infarct size, MVO and LVEF were unrelated to season (adjusted P = 0.67; P = 0.36 and P = 0.95, respectively). Neither temperature extremes nor season were independently associated with 1-year risk of death or heart failure hospitalization (adjusted P = 0.79 and P = 0.90, respectively).

Conclusion
STEMI presentation during temperature extremes was independently associated with larger infarct size and lower LVEF but not with MVO after primary PCI, whereas season was unrelated to infarct severity.
Site-based performance of 131I-MIBG imaging and 99mTc-HYNIC-TOC scintigraphy in the detection of nonmetastatic extra-adrenal paraganglioma
Authors: Hou Guozhu , Jiang Yuanyuan , Li Fang , Zhu Zhaohui , Jing Hongli 
Published: September 2021

Objectives
This study aimed to evaluate the performance of 131I-metaiodobenzylguanidine (MIBG) imaging to detect nonmetastatic extra-adrenal paragangliomas at their respective sites (abdominal vs. thoracic vs. head and neck vs. urinary bladder), and compare it with that of 99mTc-hydrazinonicotinyl-tyr3-octreotide (HYNIC-TOC) scintigraphy.

Methods
We retrospectively analyzed 235 patients with nonmetastatic extra-adrenal paragangliomas who underwent preoperative 131I-MIBG imaging or 99mTc-HYNIC-TOC scintigraphy. Of all 235 patients, 145 patients underwent both imaging procedures, 16 patients 131I-MIBG imaging only and 74 patients 99mTc-HYNIC-TOC scintigraphy only.

Results
The overall sensitivity of 131I-MIBG and 99mTc-HYNIC-TOC imaging to detect extra-adrenal paragangliomas regardless of tumor sites was 75.8% (122/161) and 67.6% (148/219), respectively (P = 0.082). However, when stratified by tumor sites, 131I-MIBG imaging showed a significant improvement in the detection of extra-adrenal abdominal paragangliomas with a sensitivity of 90.3% (103/114), which was significantly higher than that of 99mTc-HYNIC-TOC scintigraphy (67.6% (96/142); P = 0.000). In addition, the intensity of tracer uptake in the extra-adrenal abdominal paragangliomas with 131I-MIBG imaging was evidently higher than with 99mTc-HYNIC-TOC scintigraphy. The sensitivity of 131I-MIBG imaging and 99mTc-HYNIC-TOC scintigraphy to detect urinary bladder, head and neck, and thoracic paragangliomas were 18.7 vs. 18.5% (P = 1.000); 17.4% vs. 84.6% (P = 0.000) and 60% vs. 94.4% (P = 0.030), respectively.

Conclusions

131I-MIBG imaging could become the first-line investigation modality in patients with extra-adrenal abdominal paragangliomas. However, 99mTc-HYNIC-TOC scintigraphy has high sensitivity and is superior to 131I-MIBG imaging for detecting head & neck and thoracic paraganglioma. Both 131I-MIBG imaging and 99mTc-HYNIC-TOC scintigraphy have poor performance for detecting urinary bladder paragangliomas.
Effect of Water Exposure on Contact Lens Storage Case Contamination in Soft Lens Wearers
Authors: Arshad Memoona , Carnt Nicole , Tan Jacqueline , Stapleton Fiona 
Published: September 2021

SIGNIFICANCE
Water exposure during contact lens wear can transfer pathogenic microorganisms to the eye, causing ocular complications. This study determined that water exposure is prevalent among lens wearers and is independently associated with higher case contamination. Contact lens compliance education to minimize water exposure should be reenforced by contact lens organizations and practitioners.

PURPOSE
Given the increasing association between water exposure and contact lens disease, this study aimed to explore the effect of water exposure and storage case contamination in soft contact lens users.

METHODS
A total of 165 daily soft lens wearers completed a self-administered questionnaire on contact lens hygiene. Lens cases were collected, and microbial analysis was conducted using an adenosine triphosphate assay (for overall microbial bioburden) and limulus amebocyte lysate assay (for endotoxin levels). The lens hygiene (excellent, >35; moderate, 28 to 35; poor, <28) and water contact (≤1, good; >1, poor) scores measured the compliance and water exposure during lens wear, respectively. Multiple regression determined the association between water behaviors and case contamination.

RESULTS
The average (standard deviation) age of participants was 28 (13.5) years (18 to 78 years), and 65% were female. The average overall microbial bioburden of storage cases was 3.10 (0.98) log colony-forming unit/mL (1.09 to 5.94 log colony-forming unit/mL). Forty-five percent of participants reported showering, 49.7% reported swimming while wearing lenses (65.4% of whom swam without goggles), 27.8% used wet hands to handle lenses, and 17.5% used tap water to rinse storage cases. Showering with lenses significantly increased the risk of higher storage case bioburden (P = .001), whereas using wet hands (P = .01) doubled the risk of higher case endotoxin levels (odds ratio, 2.41; confidence interval 1.19 to 4.86).

CONCLUSIONS
Water contact behavior while wearing lenses is prevalent among soft lens wearers and is associated with higher case contamination. Practitioners may improve contact lens education to reduce water exposure and case contamination to reduce the risk of lens-related adverse events.
Association between Vision Impairment and Physical Quality of Life Assessed Using National Surveillance Data
Authors: VanNasdale Dean A. , Jones-Jordan Lisa A. , Hurley Megan S. , Shelton Erica R. , Robich Matthew L. , Crews John E. 
Published: September 2021

SIGNIFICANCE
Physically unhealthy days assessments in national health surveillance datasets represent a useful metric for quantifying quality-of-life differences in those with and without vision impairment. Disproportionately poorer physical health in the visually impaired population provides further rationale for the inclusion of vision care in multidisciplinary approaches to chronic disease management.

PURPOSE
This study aimed to assess the association between vision impairment and health-related quality of life using data from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System.

METHODS
Data from each of the 50 states were extracted from the 2017 Behavioral Risk Factor Surveillance System data set. Self-report of difficulty seeing was used to categorize visually impaired versus nonvisually impaired populations. Self-report number of physically unhealthy days in the previous 30 days was used to quantify quality of life. The number of unhealthy days was calculated for the visually impaired and nonvisually impaired cohorts for each state. The ratio of the number of physically unhealthy days in the visually impaired versus nonvisually impaired population was calculated for each state and for different age cohorts.

RESULTS
Mean numbers of physically unhealthy days among persons with and without severe vision impairment across all states were 10.63 and 3.68 days, respectively, and demonstrated considerable geographic variability. Mean ratios of physically unhealthy healthy days in the visually impaired versus the nonvisually impaired population were 2.91 in the 18- to 39-year-old cohort, 2.87 in the 40- to 64-year-old cohort, and 2.16 in the ≥65-year-old cohort.

CONCLUSIONS
National surveillance data demonstrate a greater number of physically unhealthy days in the visually impaired population, indicating a need to improve our understanding of causes that lead to reduced physical health among those with vision impairment. Additional research is needed to better understand how individuals perceive vision as part of their overall health.
Did Emergency Department Visits in Infants and Young Children Increase in the Last Decade?
Authors: To Teresa , Terebessy Emilie , Zhu Jingqin , Fong Ivy , Liang Jocelyn , Zhang Kimball , McGihon Rachel 
Published: September 2021

Objectives
The aims of the study were to measure overall trends and to identify leading causes for pediatric emergency department (ED) visits among children aged 0 to 4 years.

Methods
We conducted an 11-year population-based open cohort study using health administrative data from 2008 to 2018 in Ontario, Canada. All ED visits were extracted from the National Ambulatory Care Reporting System, along with the most responsible cause of each visit. Annual ED visit rates were calculated per 100 children in each year. Overall and disease-specific rates for all children were calculated and then stratified by sex and age groups. Relative percentage change in rates between 2008 and 2018 were calculated and compared using standardized differences (SDIFs). Statistical significance of time trends was tested using Poisson regression.

Results
This study included an average of 911,566 children from 2008 to 2018. All-cause ED visit rates increased by 28.2% from 2008 to 2018 (43.24–55.42 per 100, SDIF >0.1). Respiratory diseases were consistently the top cause of ED visits, and contributed to 1 in 3 ED visits in 2018. These respiratory conditions include asthma, asthma-related diseases (bronchiolitis, bronchitis, influenza, and pneumonia), and other respiratory diseases. Respiratory ED visit rates increased by 32.8% from 2008 to 2018 (11.51–15.28 per 100, SDIF <0.1), driven by a 46.4% (14.58–21.35 per 100, SDIF >0.1) increase among children younger than 1 year. There was a 78.0% increase in ED visits for bronchiolitis in infants (1.45–2.58 per 100, SDIF <0.1).

Conclusions
Respiratory diseases like bronchiolitis among infants were the consistent leading cause for ED visits. All-cause ED visit rates among young children increased by 28.17% from 2008 to 2018.
Efficacy of Apneic Oxygenation During Pediatric Endotracheal Intubation
Authors: Dancy Mark A. 
Published: September 2021

Objective
Because of the abundance of complications associated with peri-intubation hypoxia, maintaining adequate oxygen saturation during endotracheal intubation (ETI) is of great concern. In addition to standard preoxygenation techniques, apneic oxygenation (AO), the continuous flow of passive oxygenation, is a potential tool that can be used to eliminate hypoxia during ETI. Although scarcely studied in the pediatric population, AO has proven effective in reducing the incidence of hypoxia in adult patients with minimal side effects. The objective of this study is to evaluate the use of apneic oxygenation in pediatric patients and to determine its efficacy in preventing or delaying oxygen desaturation during the apneic period of ETI.

Methods
This literature review examines 4 studies that evaluate the practice of AO in pediatric patients. A total of 712 patients across 3 randomized control trials and 1 observational study were assigned to either a control group that did not receive any form of AO, a group that did not receive 100% fraction of inspired oxygen (FiO2), or an intervention group where various methods of AO were delivered.

Results
Each AO method that provided 100% FiO2 saw a significantly longer time until initial desaturation when compared with those that did not receive any form of AO or those not receiving 100% FiO2.

Conclusions
The findings in this study confirm that the practice of AO is not only efficacious in increasing the time until initial desaturation but also reduces the overall incidence of hypoxia during laryngoscopy in children.
Neurosurgical Advances for Malignant Gliomas
Authors: Dastagirzada Yosef , Suryadevara Carter , Weiss Hannah , Orringer Daniel 
Published: September 2021

Abstract
The intersection of biology and technology has led to many advancements for the field of neurosurgery. Molecular developments have led to the identification of specific mutations, allowing for more accurate discussions in regard to prognosis and treatment effect. Even amid the progress from basic science benchwork, malignant gliomas continue to have a bleak natural history in lieu of the resistance to chemotherapy and the diffuse nature of the disease, leaving room for further research to discover more effective treatment modalities. Novel imaging methods, including the emerging field of radiogenomics, involve the merging of molecular and radiographic data, enabling earlier, detailed molecular diagnoses and improved surveillance of this pathology. Furthermore, surgical advancements have led to safer and more extensive resections. This review aims to delineate the various advancements in the many facets that are used daily in the care of our glioma population, specifically pertaining to its biology, imaging modalities, and perioperative adjuncts used in the operating room.
Examination of the Allostatic Load Construct and Its Longitudinal Association With Health Outcomes in the Boston Puerto Rican Health Study
Authors: López-Cepero Andrea , McClain Amanda C. , Rosal Milagros C. , Tucker Katherine L. , Mattei Josiemer 
Published: September 2021

ABSTRACT

Objective
Despite evidence on allostatic load (AL) as a model explaining associations between stress and disease, there is no consensus on its operationalization. This study aimed to contrast various AL constructs and their longitudinal associations with disease and disability.

Methods
Baseline and 5-year follow-up data from 738 adults participating in the Boston Puerto Rican Health Study were used. Five AL scores were created by summing the presence of 21 dysregulated multisystem physiological parameters using the following: a) z scores, b) population-based quartile cutoffs, c) clinical-based cutoffs, d) 10 preselected clinical-based cutoffs (AL-reduced), and e) 12 clinical-based cutoffs selected a posteriori based on association with disease (AL-select). Adjusted logistic regression models examined associations between each AL score at baseline and 5-year incident type 2 diabetes (T2D), cardiovascular disease (CVD), activities (or instrumental activities) of daily living (ADL; IADL) for physical impairment, and cognitive impairment.

Results
AL-quartile was associated with greater odds of T2D (odds ratio [OR] = 1.20; 95% confidence interval [CI] = 1.07–1.35) and CVD (OR = 1.14; 95% CI = 1.06–1.22). AL-reduced was associated with higher odds of IADL (OR = 1.21; 95% CI = 1.07–1.37) and AL-clinical with CVD (OR = 1.14; 95% CI = 1.07–1.21), IADL (OR = 1.11; 95% CI = 1.04–1.19), and ADL (OR = 1.15; 95% CI = 1.04–1.26). AL-select showed associations with T2D (OR = 1.35; 95% CI = 1.14–1.61), CVD (OR = 1.21; 95% CI = 1.11–1.32), IADL (OR = 1.15; 95% CI = 1.04–1.26), and ADL (OR = 1.24; 95% CI = 1.08–1.41). No associations were found with AL z-score.

Conclusions
AL scores computed with clinical-based cutoffs performed robustly in our sample of mainland Puerto Ricans, whereas z scores did not predict disease and disability. AL-select was the most consistent predictor, supporting its use as a disease-predicting model. Future assessment of AL-select in other populations may help operationalize AL.
Evaluation of In-Hospital Venous Thromboembolism Prevention and Management System Using Hospital-Level Metrics: A Nationwide Cross-Sectional Survey in China
Authors: Zhen Kaiyuan , Dong Fen , Fang Fang , Gao Qian , Zhang Zhu , Xia Lei , Wang Wei , Yang Peiran , Jia Cunbo , Liu Peng , Zhai Zhenguo , Wang Chen ,   On behalf of Chinese Prevention Strategy for Venous Thromboembolism (CHIPS-VTE) study group
Published: September 2021

Background
Countries in the world have taken actions to prevent venous thromboembolism (VTE) in hospitals. We have conducted a study in China to assess the establishment of hospital-based systems for VTE prevention and management.

Methods
A nationwide hospital survey was conducted in China to collect hospital-level metrics on their system for VTE prevention between 2019 and 2020. We analyzed hospital-level metrics potentially influencing the implementation of thromboprophylaxis using a multivariable regression model. Characteristics of the hospital, organizational structure, quality control, and staff training were analyzed.

Results
Among 435 hospitals responding to the survey, 328 (75.4%) were able to implement thromboprophylaxis. They performed VTE and bleeding risk assessments and had prophylactic interventions. Institutional VTE steering committee and unit-based working group were set up in 317 (72.9%) and 339 (77.9%) hospitals, respectively. More than 80% of the hospitals performed quality control and staff training. In contrast, digitalization of risk assessment was only accomplished in 196 (45.1%) hospitals. Proportions of the aforementioned metrics were consistently higher in tertiary hospitals than secondary hospitals (P < 0.01) except for quality control. There were geographical disparities in the establishment of VTE steering committees (P = 0.0004). In multivariable analysis, VTE steering committee was an independent factor for the implementation of thromboprophylaxis (odds ratio, 2.22, 95% confidence interval, 1.17–4.23). Working group, quality control, and training on VTE were also positively associated with the implementation of thromboprophylaxis.

Conclusions
In-hospital VTE prevention has been undertaken in China, but system establishment remains suboptimal. Implementation of VTE prevention programs was associated with a decrease in thrombolytic events. Hospitals with VTE steering committees performed better on implementing preventive strategies. Suboptimal adoption of information digitization was identified, and the implementation of computer supporting techniques would be expected to improve the implementation of thromoboprophylaxis.
Responding to COVID-19 Through Interhospital Resource Coordination: A Mixed-Methods Evaluation
Authors: Usher Michael G. , Tignanelli Christopher J. , Hilliard Brian , Kaltenborn Zachary P. , Lupei Monica I. , Simon Gyorgy , Shah Surbhi , Kirsch Jonathan D. , Melton Genevieve B. , Ingraham Nicholas E. , Olson Andrew P.J. , Baum Karyn D. 
Published: September 2021

Objectives
The COVID-19 pandemic stressed hospital operations, requiring rapid innovations to address rise in demand and specialized COVID-19 services while maintaining access to hospital-based care and facilitating expertise. We aimed to describe a novel hospital system approach to managing the COVID-19 pandemic, including multihospital coordination capability and transfer of COVID-19 patients to a single, dedicated hospital.

Methods
We included patients who tested positive for SARS-CoV-2 by polymerase chain reaction admitted to a 12-hospital network including a dedicated COVID-19 hospital. Our primary outcome was adherence to local guidelines, including admission risk stratification, anticoagulation, and dexamethasone treatment assessed by differences-in-differences analysis after guideline dissemination. We evaluated outcomes and health care worker satisfaction. Finally, we assessed barriers to safe transfer including transfer across different electronic health record systems.

Results
During the study, the system admitted a total of 1209 patients. Of these, 56.3% underwent transfer, supported by a physician-led System Operations Center. Patients who were transferred were older (P = 0.001) and had similar risk-adjusted mortality rates. Guideline adherence after dissemination was higher among patients who underwent transfer: admission risk stratification (P < 0.001), anticoagulation (P < 0.001), and dexamethasone administration (P = 0.003). Transfer across electronic health record systems was a perceived barrier to safety and reduced quality. Providers positively viewed our transfer approach.

Conclusions
With standardized communication, interhospital transfers can be a safe and effective method of cohorting COVID-19 patients, are well received by health care providers, and have the potential to improve care quality.