bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colchicine for Patients With Coronary Artery Disease: A Systematic Review and Meta-analysis
Authors: Shrestha Dhan B. , Budhathoki Pravash , Sedhai YubRaj , Khadka Manoj , Pokharel Subashchandra , Yadav Stuti , Patel Toralben , Elgendy Islam , Mir Wasey Ali Yadullahi , Patel Nimesh K. 
Published: December 2021

Abstract:
Several randomized controlled trials have studied the role of colchicine, a potent anti-inflammatory drug, to prevent adverse cardiovascular events in patients with coronary artery disease (CAD). In this meta-analysis, we aimed to determine the role of colchicine in patients with CAD in clinical outcomes and mortality. We searched PubMed, PubMed Central, Scopus, and Embase for randomized controlled trials/experimental studies evaluating the role of colchicine in patients with CAD. After assessing the eligibility for inclusion, risk-of-bias assessment, and data extraction from the included studies, a narrative synthesis was conducted. Of 17 studies included for the qualitative analysis, 11 studies reported that inflammatory markers such as C-reactive protein and cytokines were reduced in the colchicine group, suggesting an anti-inflammatory role of colchicine in CAD. Quantitative analysis with pooling of data from 9 studies using a fixed-effect model showed 28% lower odds of acute myocardial infarction [odds ratio (OR) 0.72, 95% CI 0.59–0.86; n = 11,712], 52% lower occurrence of stroke (OR 0.48, 95% CI 0.30–0.76), and 37% reduction in odds of coronary revascularization procedure in the colchicine group (OR 0.63, 95% CI 0.52–0.76; n= 11,258). However, the odds of gastrointestinal adverse events were 50% higher in the colchicine group (OR 1.50, 95% CI 1.01–2.23; n = 12,214). In conclusion, colchicine is associated with a lower risk of acute myocardial infarction, stroke, and coronary revascularization. However, there is some increased risk of gastrointestinal adverse events with the use of colchicine.
Can Epigenetics Help Solve the Puzzle Between Concomitant Cardiovascular Injury and Severity of Coronavirus Disease 2019?
Authors: Braga Cássia L. , Acquarone Mariana , Arona Victor da C. , Osório Brenno S. , Barreto Thiago G. , Kian Ruan M. , Pereira João P. A. L. , Silva Marina de Moraes C. da , Silva Bagnólia A. , de Oliveira Gláucia Maria M. , Macedo Rocco Patricia Rieken , Silva Pedro Leme , Alencar Allan K. N. 
Published: December 2021

Abstract:
The ongoing coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has significant implications in patients with concomitant cardiovascular disease (CVD) because they are the population at the greatest risk of death. The treatment of such patients and complications may represent a new challenge for the fields of cardiology and pharmacology. Thus, understanding the involvement of this viral infection in CVD might help to reduce the aggressiveness of SARS-CoV-2 in causing multiorgan infection and damage. SARS-CoV-2 disturbs the host epigenome and several epigenetic processes involved in the pathophysiology of COVID-19 that can directly affect the function and structure of the cardiovascular system (CVS). Hence, it would be relevant to identify epigenetic alterations that directly impact CVS physiology after SARS-CoV-2 infection. This could contribute to the view of this virus-induced CVS injury and direct forthcoming tackles for COVID-19 treatment to reduce mortality in patients with CVD. Targeting epigenetic marks could offer strong evidence for the development of novel antiviral therapies, especially in the context of COVID-19–related CVS damage. In this review, we address some of the main signaling pathways that are currently known as being involved in COVID-19 pathophysiology and the importance of this glint on epigenetics and some of its modifiers (epidrugs) to control the unregulated epitope activity in the context of SARS-CoV-2 infection, COVID-19, and underlying CVD.
Corneal Sarcoidosis: Diffuse Stromal Granulomatous Inflammation in a Patient With Sarcoidosis
Authors: Shifera Amde Selassie , Sun Karen , Eberhart Charles , Thorne Jennifer E. 
Published: December 2021

Purpose:
The purpose of this study was to present a case of diffuse noncaseating granulomas involving the corneal stroma in a patient with ocular and pulmonary sarcoidosis.

Methods:
This was a single case report.

Results:
A 31-year-old female patient presented with a 6-year history of panuveitis of the right eye along with a history of pulmonary sarcoidosis and a conjunctival biopsy of the right eye that was reported as positive for sarcoidosis. At presentation to our clinic, the patient had band keratopathy, vascularization of the inferonasal cornea, and active anterior uveitis of the right eye. When the patient returned for a follow-up of 15 months after the initial presentation, the cornea of the right eye exhibited widespread stromal scarring and vascularization. Because of the corneal scarring, the patient underwent an implantation of a Boston type 1 keratoprosthesis in the right eye. Histopathological examination of the host corneal tissue removed at the time of the keratoprosthesis procedure revealed extensive noncaseating granulomas in the deep corneal stroma. The patient underwent penetrating keratoplasty 8 months later, and histopathological examination again demonstrated noncaseating granulomas, this time at the edges of the donor corneal graft used during the keratoprosthesis implantation.

Conclusions:
We present the histopathological evidence of sarcoidosis involving the corneal stroma. Interestingly, the stromal keratitis also subsequently involved the donor cornea tissue after the patient underwent a keratoprosthesis implantation. It seems that sarcoidosis is a rare cause of stromal keratitis.
Cell Morphology as an In Vivo Parameter for the Diagnosis of Limbal Stem Cell Deficiency
Authors: Bonnet Clémence , Chauhan Tulika , Encampira Luna Erick , Le Qihua , Tseng Chi-Hong , Deng Sophie X. 
Published: December 2021

Purpose:
The aim of this study was to investigate basal epithelial cell morphology (CM) in the central cornea and limbal areas of eyes with limbal stem cell deficiency (LSCD).

Methods:
This was a prospective, cross-sectional comparative study. We developed a CM scoring system based on basal epithelial cell phenotypes graded from 0 (normal) to 3 (severe morphologic alterations); this system was evaluated by 2 independent masked observers. The CM score was compared with the LSCD clinical score, mean best-corrected visual acuity, and in vivo laser scanning confocal microscopy parameters used to stage LSCD (ie, basal epithelial cell density, basal epithelial thickness, and subbasal corneal nerve fiber length density).

Results:
One hundred sixty-eight eyes with LSCD and 63 normal eyes were included. Compared with the control group, the LSCD group had significantly higher mean (±SD) CM scores in the central cornea (1.8 ± 0.7 vs. 0.5 ± 0.4, respectively; P = 0.01) and limbal areas (1.6 ± 0.2 vs. 1.3 ± 0.0, respectively; P < 0.05). The mean CM score in the central cornea was positively correlated with the clinical score (P < 0.01, r = 0.66) and negatively correlated with the best-corrected visual acuity (P < 0.01, r = 0.42). The CM scores were positively correlated with all other in vivo laser scanning confocal microscopy parameters in the central cornea and limbal areas (all P < 0.001).

Conclusions:
Basal epithelial CM is altered in the central cornea and limbus of eyes with LSCD and thus can be used to stage the clinical severity of the disease.
Pediatric Microbial Keratitis: Identification of Clinical Biomarkers for Prognosis and Outcome of 218 Cases From 2009 to 2019
Authors: Di Zazzo Antonio , Rajan Mugundhan , Dureja Rohit , Antonini Marco , Kanduri Vaibhav , Madduri Bhagyasree , Mohan Nitin , Mohamed Ashik , Fernandes Merle 
Published: December 2021

Purpose:
The aim of this study was to analyze the risk factors, microbiological profile, and treatment efficacy in pediatric microbial keratitis (MK) and to identify clinical biomarkers prognosticating outcome.

Methods:
A retrospective analysis was conducted from patients younger than 16 years with MK-excluding viral, marginal, or interstitial keratitis. Data pertaining to predisposing factors, symptom duration, prior treatment, ulcer characteristics, microbiological profile, time to resolution, and final outcome were recorded. Statistical analysis was performed. The mixed-effects linear regression model with random intercept was used to evaluate factors affecting time to resolution.

Results:
Among 218 episodes of 215 pediatric patients with MK, the geometric mean of central [median 3 mm, interquartile range (IQR) 1–4.3 mm] and peripheral ulcers (median 1 mm, IQR 1–2.5 mm) was significantly different (P < 0.0001). Organisms identified were bacteria (56.9%), fungi (31.5%), and acanthamoebae (2.3%). Of 172 cases (78.8%), which resolved in a median resolution time of 22 days (IQR, 11–44 days), 107 (81.6%) with absent/negative microbiology healed on empirical therapy. On multivariate analysis, peripheral ulcers and geometric mean ulcer size affected time to resolution. Significantly higher percentage of eyes, which worsened or perforated, were on topical steroids compared with those which healed (31.8% vs. 9.2%, P = 0.0061).

Conclusions:
Good outcome even in culture negative cases suggests empirical therapy may be instituted for nonsevere peripheral pediatric MK; however, the importance of a microbiological workup cannot be underscored enough. Ulcer location and geometric mean size of ulcer may be used as clinical prognostic markers for resolution.
Development of a Nomogram to Predict Graft Survival After Descemet Stripping Endothelial Keratoplasty
Authors: Cherkas Elliot , Cinar Yasin , Zhang Qiang , Sharpe James , Hammersmith Kristin M. , Nagra Parveen K. , Rapuano Christopher J. , Syed Zeba A. 
Published: December 2021

Background/Purpose:
The purpose of this study was to analyze Descemet stripping endothelial keratoplasty (DSEK) outcomes and develop a nomogram to compute the probability of 3- and 5-year DSEK graft survival based on risk factors.

Study Design/Methods:
The medical records of 794 DSEK procedures between January 1, 2008, and August 1, 2019, were retrospectively reviewed to identify 37 variables. We also evaluated for the presence of corneal graft failure, defined as irreversible and visually significant graft edema, haze, or scarring. Variables were assessed by multivariable Cox models, and a nomogram was created to predict the probability of 3- and 5-year graft survival.

Results:
Graft failure occurred in 80 transplants (10.1%). The strongest risk factors for graft failure included graft detachment [hazard ratio (HR) = 4.46; P < 0.001], prior glaucoma surgery (HR = 3.14; P = 0.001), and glaucoma (HR = 2.23; P = 0.018). A preoperative diagnosis of Fuchs dystrophy was associated with a decreased risk of graft failure (HR = 0.47; P = 0.005) compared with secondary corneal edema. Our nomogram has a concordance index of 0.75 (95% confidence interval, 0.69 to 0.81), which indicates that it may predict the probability of graft survival at 3 and 5 years with reasonable accuracy. We also analyzed graft rejection, which occurred in 39 cases (4.9%). The single risk factor found to be significantly associated with graft rejection was prior glaucoma surgery (HR = 2.87; P = 0.008).

Conclusions:
Our nomogram may accurately predict DSEK graft survival after 3 and 5 years based on 4 variables. This nomogram will empower surgeons to share useful data with patients and improve collective clinical decision-making.
Obstructive Sleep Apnea Risk Is Associated With Severity of Metabolic Syndrome
Authors: Kariuki Jacob K. , Yang Kyeongra , Scott Paul W. , Chasens Eileen R. , Godzik Cassandra , Luyster Faith S. , Imes Christopher C. 
Published: December 2021

Background
Metabolic syndrome (MetS) and obstructive sleep apnea (OSA) are associated with increased risk of cardiometabolic disease. The co-occurrence of OSA with MetS is common, but there are limited data on how OSA risk exacerbates the metabolic impairments present in MetS. The purpose of this analysis was to examine in a representative sample of participants in the National Health and Nutrition Examination Survey 2015–2018 cohorts (1) the association of modifiable cardiometabolic risk factors with OSA risk and MetS severity and (2) the influence of OSA risk and lifestyle behaviors on MetS severity.

Methods
Metabolic syndrome severity was assessed using MetS Z score, whereas the risk of OSA was measured via multivariable apnea prediction index. Data analyses were conducted using the sample weights provided by the National Health and Nutrition Examination Survey.

Results
The sample (N = 11 288) included adults (>20 years old) who were overweight (mean body mass index, 29.6 ± 0.2 kg/m2), representative by race (36.9% non-White) and gender (51.9% female). Overall, 19.3% of the sample had elevated MetS severity (MetS Z score ≥ 1), and 38.4% were at a high risk of OSA (multivariable apnea prediction score of ≥0.50). High OSA risk was associated with having elevated MetS severity (odds ratio [OR], 4.94; 95% confidence interval [CI], 3.68–6.65). Obstructive sleep apnea risk predicted increased MetS severity (adjusted: B = 0.06, SE = 0.02, P = .013). Physical activity provided the highest protection from increased MetS severity (OR, 0.52; 95% CI, 0.39–0.70) and OSA risk (OR, 0.59; 95% CI, 0.53–0.66).

Conclusion
Our findings suggest that increased OSA risk exacerbates MetS severity and that greater physical activity may mitigate the risk.
A National Study of Healthcare Service Patterns at the End of Life Among Children With Cardiac Disease
Authors: Lindley Lisa C. , Svynarenko Radion , Mooney-Doyle Kim , Mendola Annette , Naumann Wendy C. , Harris Robin 
Published: December 2021

Background
Heart diseases are one of the leading causes of health-related deaths among children. Concurrent hospice care offers hospice and nonhospice healthcare services simultaneously, but the use of these services by children with cardiac disease has been rarely investigated.

Objective
The aims of this study were to identify patterns of nonhospice healthcare services used in concurrent hospice care and describe the profile of children with cardiac disease in these clusters.

Methods
This study was a retrospective cohort analysis of Medicaid claims data collected between 2011 and 2013 from 1635 pediatric cardiac patients. The analysis included descriptive statistics and latent class analysis.

Results
Children in the sample used more than 314 000 nonhospice healthcare services. The most common services were inpatient hospital procedures, durable medical equipment, and home health. Latent class analysis clustered children into “moderate intensity” (60.0%) and “high intensity” classes (40.0%). Children in “moderate intensity” had dysrhythmias (31.7%), comorbidities (85.0%), mental/behavioral health conditions (55%), and technology dependence (71%). They commonly resided in urban areas (60.1%) in the Northeast (44.4%). The health profile of children in the “high intensity” class included dysrhythmias (39.4%), comorbidities (97.6%), mental/behavioral health conditions (71.5%), and technology dependence (85.8%). These children resided in rural communities (50.7%) in the South (53.1%).

Conclusions
Two patterns of use of nonhospice healthcare services were identified in this study. This information may be used by nurses and other healthcare professionals working in concurrent hospice care to assess the healthcare service needs of children with cardiac conditions at the end of life.
Establishing Validity of the Midlife Black Women's Stress-Reduction Wellness Program Materials Using a Mixed Methods Approach
Authors: Jones Holly J. , Kovacic Melinda Butsch , Bakas Tamilyn 
Published: December 2021

Background and Objective
Content validation is an integral part of intervention development and should be established before initiation of trials. In collaboration with a community research advisory board, the objective of this study was to analyze expert ratings and qualitative feedback for the Midlife Black Women's Stress-Reduction Wellness (B-SWELL) intervention materials.

Methods
The B-SWELL intervention is a culturally tailored 8-week intervention designed to lower cardiovascular disease risk in midlife Black women by leveraging stress reduction and promoting the adoption of the American Heart Association's Life's Simple 7 healthy lifestyle behaviors. Using a mixed methods approach, 12 experts consisting of midlife Black women (n = 6), researchers (n = 3), and integrative health specialists (n = 3) rated the B-SWELL materials for content accuracy, topic relevance, stress relevance, cultural appropriateness, feasibility, usefulness, ease of use, and appeal using a 5-point Likert scale (1, strongly disagree, to 5, strongly agree). Qualitative narrative data were integrated with the ratings.

Results
Combined expert ratings for the B-SWELL materials were high (range, 4.43–4.66). Group ratings differed, with midlife Black women having the highest mean ratings for both the individual B-SWELL modules and the overall binder (4.71 and 4.97, respectively), followed by researchers (4.56 and 4.73, respectively) and integrative health specialists (4.11 and 4.40, respectively). Qualitative data provided insight into deficiencies, supporting refinements of the B-SWELL materials.

Conclusions
The B-SWELL materials exhibited strong evidence of content and face validity. Researchers and clinicians are encouraged to establish content validity before implementation of culturally appropriate interventions aimed at high-risk populations.
Psychometric Validation of the Chinese Version of the Atrial Fibrillation Knowledge Scale in Chinese Patients With Atrial Fibrillation
Authors: Li Polly W.C. , Yu Doris S.F. , Yan Bryan P. , Hendriks Jeroen M. , Wong Cathy W.Y. , Chan Bernice S. 
Published: December 2021

Background
Assessment of patients' knowledge on atrial fibrillation (AF) and its management is important for evaluating their learning needs. However, a validated and comprehensive instrument to be used among Chinese patients is yet to be developed.

Objectives
The aim of this study was to develop and validate the Chinese version of the Atrial Fibrillation Knowledge Scale (AFKS-C) in Chinese patients.

Methods
The 11-item AFKS was translated, and then content and face validations were conducted by an expert panel and patients with AF. A sample of 255 patients with AF was recruited from a university-affiliated hospital to evaluate its psychometric properties. The internal consistency and test-retest reliability were evaluated using the Kuder-Richardson formula 20 and κ statistics. Item analysis determined the item difficulty index and item discrimination coefficients. Factorial and discriminant validity were evaluated using exploratory factor analysis and the known-groups method.

Results
The content validity index of the AFKS-C was 0.94, and the Kuder-Richardson formula 20 value was 0.60. The difficulty indices of the items ranged from 0.36 to 0.89, and the point-biserial coefficients of the items ranged from 0.122 to 0.255, indicating sufficient discriminatory ability. The test-retest reliability was acceptable, because the κ values ranged from 0.234 to 0.710. The principal axis factoring analysis indicated a 3-factor structure that explained 50.4% of the total variance. The AFKS-C also demonstrated satisfactory discriminant validity, having yielded significantly different scores between patients with newly diagnosed and established AF.

Conclusion
The AFKS-C has acceptable psychometric properties and can be used to measure the knowledge of patients and evaluate the effects of patient education programs.
Accelerometers-Embedded Lycra Sleeves to Test Wear Compliance and Upper-Limb Activity in People with Stroke: A Feasibility Study
Authors: Kumar Praveen , Leake Jason , Brodie Shannon , Molton Jennifer , O'Reilly Rosie , Pearce Alex , Steele Jade , Caleb-Solly Praminda 
Published: December 2021

ABSTRACT

Introduction
To establish a possible effect of Lycra sleeves, accurate recording of wear time is critical. The aim of this study was to test whether an accelerometer-embedded Lycra sleeve can measure wear compliance and record upper-limb (UL) movements/activity in people with stroke.

Methods
Seven adults with stroke resulting in unilateral UL weakness were approached for participation in this study as a convenience sample, and five participants were recruited. Participants wore accelerometer-embedded Lycra sleeve on their affected arm for 8 to 10 hrs/d for 14 days and were prescribed four simple UL exercises. They completed a diary to record daily sleeve wear time and exercise times. Upper-limb function, shoulder muscle strength, range of movement, and pain were assessed at days 1 and 14.

Results
Seven participants were approached, and five participants (72 ± 10 years) were recruited. The mean time since stroke was 20 months. Using an acceleration movement threshold of 0.01 g (g = acceleration of gravity) and the constructed algorithm, the sleeve donning and doffing time was identified. The mean accelerometer and diary-recorded wear time were 11.64 hrs/d (SD, 2.64) and 11.27 hrs/d (SD, 2.03), respectively. Individual spikes above threshold indicated UL activity but could not distinguish participant-recorded exercises from daily UL use. Arm function showed improvement in three of five participants.

Conclusions
Accelerometers provide a practical method to record wear time of a Lycra sleeve, overcoming the necessity for patients to keep diaries, which can often be unreliable. A more sensitive accelerometer that can detect the direction of the acceleration and movement should be considered in future studies.

Clinical Relevance
Accelerometers provide accurate data on Lycra sleeve wear time and may help with monitoring adherence.
Influence of provider type on chronic pain prescribing patterns A systematic review
Authors: Nikpour Jacqueline , Franklin Michelle , Calhoun Nicole , Broome Marion 
Published: December 2021

ABSTRACT

Background:
Chronic pain affects 100 million Americans and is most often treated in primary care, where the health care provider shortage remains a challenge. Nurse practitioners (NPs) represent a growing solution, yet their patterns of chronic pain management are understudied. Additionally, prescriptive authority limitations in many states limit NPs from prescribing opioids and often exist due to concerns of NP-driven opioid overprescribing. Little evidence on NP pain management prescribing patterns exists to address these issues.

Objective:
Systematic review, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, to examine opioid and nonopioid prescribing patterns of physicians, NPs, and physician assistants (PAs) in primary care. Eligible studies scored ≥60% on the Joanna Briggs Institute Critical Appraisal checklist.

Data sources:
Searches within PubMed, Embase, CINAHL, and Web of Science.

Conclusions:
Three themes were elucidated: 1) opioid prescribing in primary care, 2) similarities and differences in opioid prescribing by provider type, and 3) nonopioid pain management strategies. All provider groups had similar opioid prescribing patterns, although NPs and PAs may be slightly less likely to prescribe opioids than physicians. Although some studies suggested that NPs/PAs had higher opioid prescribing rates compared with physicians, methodological flaws may undermine these conclusions. Evidence is also lacking on nonopioid prescribing patterns across disciplines.

Implications for practice:
Nurse practitioner/PA prescriptive authority limitations may not be as effective of a solution for addressing opioid overprescribing as transdisciplinary interventions targeting the highest subset of opioid prescribers. Future research should examine prescribing patterns of nonopioid, including nonpharmacologic, therapies.