bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical features and risk factors associated with severe COVID-19 patients in China
Authors: Jiang Ning , Liu Yan-Nan , Bao Jing , Li Ran , Ni Wen-Tao , Tan Xing-Yu , Xu Yu , Peng Li-Ping , Wang Xiao-Rong , Zeng Yi-Ming , Liu Dai-Shun , Xue Qing , Li Jia-Shu , Hu Ke , Zheng Ya-Li , Gao Zhan-Cheng 
Published: April 2021

Abstract

Background:
Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread throughout the world. In this study, we aimed to identify the risk factors for severe COVID-19 to improve treatment guidelines.

Methods:
A multicenter, cross-sectional study was conducted on 313 patients hospitalized with COVID-19. Patients were classified into two groups based on disease severity (nonsevere and severe) according to initial clinical presentation. Laboratory test results and epidemiological and clinical characteristics were analyzed using descriptive statistics. Univariate and multivariate logistic regression models were used to detect potential risk factors associated with severe COVID-19.

Results:
A total of 289 patients (197 nonsevere and 92 severe cases) with a median age of 45.0 (33.0, 61.0) years were included in this study, and 53.3% (154/289) were male. Fever (192/286, 67.1%) and cough (170/289, 58.8%) were commonly observed, followed by sore throat (49/289, 17.0%). Multivariate logistic regression analysis suggested that patients who were aged ≥ 65 years (OR: 2.725, 95% confidence interval [CI]: 1.317–5.636; P = 0.007), were male (OR: 1.878, 95% CI: 1.002–3.520, P = 0.049), had comorbid diabetes (OR: 3.314, 95% CI: 1.126–9.758, P = 0.030), cough (OR: 3.427, 95% CI: 1.752–6.706, P < 0.001), and/or diarrhea (OR: 2.629, 95% CI: 1.109–6.231, P = 0.028) on admission had a higher risk of severe disease. Moreover, stratification analysis indicated that male patients with diabetes were more likely to have severe COVID-19 (71.4% vs. 28.6%, χ

2
= 8.183, P = 0.004).

Conclusions:
The clinical characteristics of those with severe and nonsevere COVID-19 were significantly different. The elderly, male patients with COVID-19, diabetes, and presenting with cough and/or diarrhea on admission may require close monitoring to prevent deterioration.
Earlier and lower dose administration of sugammadex
Authors: Duranteau Olivier , Fernandez Wendy , Tuna Turgay , Engelman Edgard , Van Obbergh Luc , Tabolcea Ionut 
Published: April 2021

BACKGROUND
Sugammadex allows for rapid reversal of muscle relaxation after the use of rocuronium or vecuronium. The lowest recommended dose is 2 mg kg−1 intravenously when there are two twitches during the train-of-four stimulation.

OBJECTIVE
To study the efficacy and risks of a lower dose of sugammadex administered earlier.

DESIGN
Monocentric randomised controlled double-blind study.

SETTING
Academic hospital.

PATIENTS
Eighty patients were enrolled and randomised in 8 groups of 10 patients, 56 were finally evaluated.

INTERVENTIONS
Patients were distributed in two clusters constituting four groups each. In the first cluster, injections were administered after the return of one twitch with the train-of-four (TOF1). In the second cluster, injections were delivered after the return of two twitches with the TOF (TOF2). We created four groups in each cluster for different dosages: placebo, 0.5, 1 or 2 mg kg−1.

MAIN OUTCOME MEASURES
Time between the injection of sugammadex and full recovery (TOF ratio > 0.9) that is expressed in minutes.

RESULTS
Fifty-six successive patients were assessed between February and August 2018. The difference to TOF greater than 0.9 was not statistically significant between groups with the same dose administered at different times (F value = 0.001, P value = 0.975). There was a significant difference between groups with a different dosage administered at the same time (F ratio = 28.34; P value <0.0001). Concerning the time to TOF greater than 0.9 from the time point of TOF1, the timing of the dosages were statistically significant using log rank test (P < 0.0001). No patient presented a reparalysis.

CONCLUSION
No difference between injecting sugammadex at TOF1 or TOF2 was found regarding time to full recovery. Difference regarding sugammadex quantity was found and compatible with other studies.

TRIAL REGISTRATION
clinicaltrials.gov: ‘BRIDION_ERASME’, EudraCT: 2017-005074-19.
A Randomized Phase 2 Trial Comparing Omidenepag Isopropyl 0.002% Once and Twice Daily in Subjects With Primary Open-angle Glaucoma or Ocular Hypertension (SPECTRUM-6)
Authors: Olander Kenneth W. , Sato Michelle A. , Abrams Marc A. , Jerkins Gary W. , Lu Fenghe , Dinh Phillip , Odani-Kawabata Noriko , Chabi Almira , Shams Naveed K. 
Published: April 2021

Précis:
No significant difference was found between the intraocular pressure (IOP) lowering of omidenepag isopropyl 0.002% once daily (QD) and twice daily (BID). However, adverse events (AEs) were higher in the BID arm; thus, QD dosing is the preferred dosing frequency for further investigation.

Purpose:
This phase 2, randomized, double-masked, parallel-arm, multicenter study (NCT03858894) was conducted in the United States to examine whether the efficacy and safety of omidenepag isopropyl 0.002% BID dosing was superior to QD dosing in subjects with primary open-angle glaucoma or ocular hypertension.

Methods:
Randomized subjects (1:1) received omidenepag isopropyl 0.002% QD (n=50) or BID (n=48) for 6 weeks (after a ≤4-week washout period). IOP was measured at 8:00 am, 12:00 pm, and 4:00 pm at baseline and weeks 2 and 6. The primary efficacy endpoint was IOP at each timepoint at weeks 2 and 6. AEs were evaluated.

Results:
Baseline mean diurnal IOP (±SD) post washout was 25.4±2.9 mm Hg (BID) and 24.6±1.9 mm Hg (QD). At weeks 2 and 6, clinically significant IOP reductions from baseline were observed for omidenepag isopropyl BID and QD treatments. Least-squares mean (±SE) IOP differences (BID versus QD) were not statistically significant (week 2: 0.44±0.68 to 1.08±0.65 mm Hg; week 6: 0.36±0.63 to 0.68±0.68 mm Hg) at any timepoint (all P > 0.05). AEs were 3-fold greater in the BID arm (41.7%; QD: 14.0%); the most frequently reported AE was conjunctival/ocular hyperemia (BID: 22.9%; QD: 2.0%). Five subjects discontinued omidenepag isopropyl prematurely, 4 of 5 owing to AEs (BID: 4; QD: 0).

Conclusion:
In this study, the benefit-risk profile of omidenepag isopropyl 0.002% QD was more favorable than the benefit-risk profile of BID. This difference was driven by a higher incidence of local tolerability issues in the BID arm.
Prediction of 10-2 Visual Field Loss Using Optical Coherence Tomography and 24-2 Visual Field Data
Authors: Sullivan-Mee Michael , Hedayat Mahdi , Charry Nicole , Katiyar Suchitra , Kee Helen , Kimura Bryan , Pensyl Denise 
Published: April 2021

Precis:
Using standard glaucoma structural and functional tests, clinicians accurately predicted the presence/absence of 10-2 glaucomatous visual field (VF) loss in 90% of the eyes in this study.

Purpose:
To investigate how well clinicians with variable experience can predict the presence and location of 10-2 VF loss using structural and functional data that are routinely obtained for glaucoma assessment.

Methods:
Within a test set of 416 eyes (210 subjects) who were diagnosed glaucoma suspect or primary open-angle glaucoma (with most eyes having mild disease), 6 clinicians were asked to predict the presence and hemispheric location of 10-2 VF loss using 24-2 VF and spectral-domain optical coherence tomography structural data. Prediction accuracies were calculated for each clinician and compared using the weighted κ-statistic. Receiver operating characteristic analyses were used to evaluate models for predicting 10-2 VF loss.

Results:
Among the 6 clinicians, mean (range) accuracy, false negatives, and false positives for predicting presence/absence of 10-2 VF loss were 90% (87% to 92%), 4.7% (2.4% to 7.0%), and 5.4% (1.7% to 7.5%) respectively. The mean (range) weighted κ-statistic was 0.75 (0.64 to 0.83), suggesting good or very good inter-rater agreement between examiners. Mean accuracy for correctly predicting hemispheric location was 73% (range, 65% to 82%) with the most common error occurring in eyes with both superior and inferior 10-2 VF defects in which one hemisphere was correctly identified but the other missed.

Conclusions:
In this study, the presence/absence of 10-2 glaucomatous VF loss was highly predictable using standard functional and structural clinical metrics. These findings suggest that 10-2 VF testing is not needed to reliably recognize and confirm central VF involvement in most eyes with glaucoma. Whether error related to identifying second hemisphere involvement in 10-2 VF loss is important requires further study.
Intraluminal Stent Optimization for the Baerveldt Glaucoma Implant: An Experimental Study
Authors: DiSclafani Mark , Richards David , Schneider Alex , Whitfield Whitney , Ayoubi Yasmin 
Published: April 2021

Precis:
Our laboratory study determined the approximate suture diameter for use in intraluminal stenting of the Baerveldt glaucoma implant (BGI) to prevent postoperative hypotony. Commercial 3-0 monofilament nylon sutures which are commonly used may vary significantly outside of this diameter.

Purpose:
Postoperative hypotony is a complication of surgical treatment of glaucoma using the BGI. One method utilized to prevent early postoperative hypotony is intraluminal stenting of the implant with monofilament sutures. The present study attempted to determine optimal stent diameter in microns for 3-0 monofilament sutures to reduce outflow and thereby reduce the risk of postoperative hypotony using the BGI.

Materials and Methods:
A laboratory bench model of the anterior chamber was utilized to measure the outflow rate of balanced salt solution through the BGI at pressures of 20 and 40 mm Hg while utilizing commercially available 3-0 monofilament nylon stents of various diameters. The BGI tube has an inner diameter of 300 µm. In addition, 3-0 nylon sutures were studied for variability by measuring the diameters at 10 equally spaced points along the length of each sample using a digital micrometer.

Results:
Average experimental flow rates decreased with increasing intraluminal stent diameter and increased with increasing pressure. An intraluminal stent diameter of 250 µm yielded a flow rate of 40 µL/min at a nominal pressure of 20 mm Hg. Diameters of the tested 3-0 monofilament nylon sutures were all within the United States Pharmacopeia diameter range of 200 to 250 µm, but diameters varied significantly depending on the manufacturer.

Conclusions:
In our laboratory model, the optimal stent diameter to reduce aqueous flow to a level approaching the normal aqueous production is at least 250 µm. Secondarily, commercially available 3-0 monofilament nylon suture materials showed variable diameters within the United States Pharmacopeia diameter range.
Endothelial Cell Density After XEN Implant Surgery: Short-term Data From the Italian XEN Glaucoma Treatment Registry (XEN-GTR)
Authors: Oddone Francesco , Roberti Gloria , Posarelli Chiara , Agnifili Luca , Mastropasqua Leonardo , Carnevale Carmela , Micelli Ferrari Tommaso , Pace Vincenzo , Sacchi Matteo , Cremonesi Elena , Uva Maurizio , Menchini Martina , Brescia Lorenza , Figus Michele 
Published: April 2021

Precis:
XEN implant was associated with low endothelial cell density (ECD) reduction. In fact, when combined with phacoemulsification, the reduction in ECD was similar to that expected after phacoemulsification alone.

Purpose:
The purpose of this study was to assess the impact of XEN implant, either alone or in combination with phacoemulsification, on ECD.

Methods:
Multicenter, prospective, observational study conducted on consecutive open-angle glaucoma patients, who were enrolled in the Italian XEN Glaucoma Treatment Registry and have complete endothelial cell count data at baseline and at 6 months after implantation. The primary endpoint was the mean percentage change in ECD between baseline and month 6.

Results:
The study included 108 open-angle glaucoma eyes (68 in the XEN-solo and 40 eyes in the XEN+phaco groups) and 60 control eyes (phaco-solo group). As compared with baseline, mean (95% confidence interval, CI) ECD reduction was −5.6% (−7.0% to −4.9%), −11.3% (−13.8% to −10.9%), and −13.0% (14.8% to −11.8%) in the XEN-solo, XEN+phaco, and phaco-solo groups, respectively (P=0.0004, <0.0001, and <0.0001, respectively). As compared with the XEN-solo group, the ECD reduction was significantly greater in the XEN+phaco group (mean difference=5.7%; 95% CI: 4.1%-7.3%, P<0.0001) and in the phaco-solo group (mean difference=7.4%; 95% CI: 5.7%-9.1%, P<0.0001). ECD reduction was similar in XEN+phaco and phaco-solo groups (P=0.9). In absolute terms, ECD reduction was significantly greater in the XEN+phaco (mean difference=169±306, P=0.021) and in the phaco-solo (mean difference=192±302, P=0.0022) groups than in the XEN-solo group.

Conclusions:
The mean ECD reduction 6 months after XEN implantation was low. The ECD reduction in the XEN+phaco group was larger than in the XEN-solo group but was similar to that observed in the phaco-solo group.
Agreement Between 10-2 and 24-2C Visual Field Test Protocols for Detecting Glaucomatous Central Visual Field Defects
Authors: Chakravarti Tutul , Moghadam Mohamad , Proudfoot James A. , Weinreb Robert N. , Bowd Christopher , Zangwill Linda M. 
Published: April 2021

Precis:
Moderate to substantial agreement between 10-2 and 24-2C perimetry for detecting central field defects suggests that adding central test points to the 24-2 protocol may improve efficiency of visual field (VF) testing for glaucoma management.

Purpose:
The purpose of this study was to assess agreement between Humphrey Visual Field Analyzer 10-2 and 24-2C test protocols for detecting glaucomatous defects in the central 10 degrees of the visual field (CVFDs).

Materials and Methods:
VFs from 165 eyes of 18 healthy individuals, 12 glaucoma suspects and 62 glaucoma patients who completed 10-2 and 24-2C VF testing protocols within 6 months were included. CVFDs on 10-2 and 24-2C (within the central 22 points) test grids required a cluster of 3 contiguous points with P<5%, 5%, and 1% or <5%, 2%, and 2% within a hemifield on the total deviation (TD) or pattern deviation (PD) plot. Cohen kappa (k) was used to assess agreement between 10-2 and 24-2C test grids in identifying CVFDs. Specificity of each testing strategy was assessed in VFs from healthy eyes.

Results:
CVFDs in suspect and glaucoma eyes were combined and reported as localized to superior, inferior or both hemifields based on TD and PD plots for 10-2 and 24-2C test grids. Moderate to substantial agreement was observed between 10-2 and 24-2C grids for detecting any CVFD from PD (k=0.551) and TD (k=0.651) plots. Specificity was high in healthy eyes ranging from 0.94 to 1.0 for both test protocols.

Conclusion:
Substantial agreement for identifying CVFDs using the 24-2C and 10-2 protocols suggests that combining tests by adding central test points to the 24-2 test grid may supplant the need for 2 perimetry regimens for detecting central and peripheral glaucomatous VF damage.
A Novel Approach to Measuring Binocular Visual Fields in Glaucoma
Authors: Kuzhuppilly Neetha I.R. , Pai Vijaya H. , Daruka Ravi , Jain Vikram , Menon Sudha 
Published: April 2021

Precis:
Combined average visual field index (VFI) is a simple, novel tool for binocular visual field which agrees with the existing binocular integrated visual field (IVF) model, as well as patient reported activity limitation in glaucoma.

Purpose:
The aim was to determine the correlation between novel models of binocular visual field with the existing IVF and glaucoma activity limitation (GAL-9).

Materials and Methods:
IVFs were calculated from the monocular visual fields of 58 patients with primary glaucoma and the novel binocular visual field models termed binocular summation visual field index (BiSumVFI) and combined average visual field index (CaVFI) were derived from the VFIs of both fields. GAL-9 questionnaire was administered to the patients. The relationship between IVF and the 2 newer models of binocular fields were determined and the correlation of IVF, BiSumVFI, and CaVFI with GAL-9 was estimated.

Results:
A very strong correlation was seen between IVF and BiSumVFI (r=−0.913, P<0.001, confidence interval: −0.958 to −0.821) and also between IVF and CaVFI (r=−0.896, P<0.001, confidence interval: −0.947 to −0.802). Linear regression analysis showed a significant R
2 of 0.902 (P<0.001) to predict IVF from BiSumVFI and R
2 of 0.847 (P<0.001) to predict IVF from CaVFI. IVF, BiSumVFI, and CaVFI correlated moderately and significantly with GAL-9 with correlation coefficients of 0.481, −0.499, and −0.505, respectively.

Conclusion:
The binocular summation VFI and combined average VFI models of binocular visual field are good predictors of IVF in glaucoma. They correlate well with the existing IVF model in estimating patients’ perception of activity limitation in glaucoma.
Psychological Distress Among Patients With Advanced Cancer
Authors: Huda Nurul , Shaw Malissa Kay , Chang Hsiu-Ju 
Published: April 2021

Background
Psychological distress is a common problem that occurs in advanced cancer patients; however, the concept has not been sufficiently specified or clearly described.

Objective
To develop succinct understanding of psychological distress among advanced cancer patients.

Methods
A literature search was conducted using the CINAHL, PubMed, and MEDLINE databases from 1988 to 2018. The analysis used the 8 steps of concept analysis developed by Walker and Avant. The final articles selected focused on definitions, predictors, determinant factors, and measurements of psychological distress in advanced cancer.

Results
Analysis identified that psychological distress in terms of advanced cancer has 5 defining attributes: (1) anxiety, (2) depression, (3) death anxiety, (4) demoralization, and (5) a perceived inability to cope effectively. The primary antecedent is treatment complexity. The consequences are acceptance and living in the present positively, lower performance status, poor quality of life, suicide, and hastened death.

Conclusions
This concept analysis clarifies the meaning of the concept and differentiates the concept of psychological distress from other emotional symptoms that advanced cancer patients commonly experience. It provides clarity in meaning by examining various ways the concept is used in the area of nursing.

Implications for Practice
The identified attributes of psychological distress play vital roles in nursing assessments and should be used as guidance for nurses to provide appropriate nursing care for advanced cancer patients. Interventions should address antecedents and consequences of the concept and consider individuals as persons with unique characteristics.
Breast Cancer Screening Practices and Satisfaction With Healthcare Providers in Chinese Women
Authors: Zhang Xuehui , Li Ping , Zhang Chunmiao , Guo Pingping , Wang Jie , Liu Na , Yang Shu , Yu Lin , Zhang Wei 
Published: April 2021

Background
The Chinese government has proposed cancer screening guidelines and launched 2 cancer screening programs to improve screening practices. However, the screening participation rates of Chinese women remain low. Exploring the factors affecting breast cancer screening to promote cancer screening is necessary.

Objective
The aim of this study was to investigate women's satisfaction with healthcare providers and screening practices.

Methods
A cross-sectional survey was conducted from November 2019 to April 2020 in Changchun, Jilin Province, China. The Medical Care Satisfaction Scale and SERVQUAL were used to quantify women's satisfaction with doctors and nurses, respectively.

Results
Women's satisfaction with doctors (68.81 ± 11.08; range, 20–100) and with nurses (87.64 ± 16.17; range, 22–110) was moderate. Compared with women who had not participated in screening within the past 2 years, screened women reported higher satisfaction with doctors (P = .026) and nurses (P = .012). Older age (P = .004) was an independent predictor of women's satisfaction with doctors. Similarly, women's education level (P = .049), chronic disease history (P = .029), and physical examination history (P = .039) were 3 independent predictors of women's satisfaction with nurses.

Conclusions
Future intervention strategies can not only increase the screening rates by providing existing intervention methods but also improve women's satisfaction with healthcare providers to promote screening practices.

Implications for Practice
This article provides a theoretical basis for healthcare providers to increase female screening practices. It also provides references for improving existing intervention methods.
Fatigue and Vigilance-Related Factors in Family Caregivers of Patients With Advanced Cancer
Authors: Yiin Jia-Jean , Chen Ya-Yun , Lee Kwo-Chen 
Published: April 2021

Background
Family caregivers (FCs) commonly experience fatigue during caregiving. The factors of fatigue in the FCs of patients with advanced cancer have not yet been investigated in Taiwan.

Objective
This study investigated potential predictors of fatigue in the FCs of patients with advanced cancer.

Methods
A descriptive, cross-sectional study was conducted on 184 FCs. Data were collected using the Checklist Individual Strength and the palm-based psychomotor vigilance test. A linear regression model was the main statistical method for identifying the factors predictive of fatigue in FCs.

Results
Subjective and objective measurements revealed that 95% of the FCs had fatigue and poor vigilance. Those who spent more time each day on caregiving tasks, had no religious beliefs, had a full- or part-time job, and had a greater caregiver burden experienced greater fatigue.

Conclusions
Fatigue and poor vigilance were common in the Taiwanese FCs of patients with advanced cancer. Family caregivers with risk factors for fatigue must be identified and given access to resources for assistance.

Implication for Practice
Healthcare providers must proactively assess FCs for fatigue and vigilance status and provide interventions appropriate for individual needs.