bluuebunny/crossref_metadata_2025_split huggingface dataset:
Late onset of microbial keratitis after laser in situ keratomileusis surgery: case series
Authors: Garcerant Daniel , Cabrera-Aguas Maria , Khoo Pauline , Watson Stephanie L. 
Published: January 2021

Purpose:
To report predisposing factors, clinical features, microbiology spectrum, antibiotic resistance, antimicrobial therapy, and outcomes of patients with a previous laser in situ keratomileusis (LASIK) surgery and diagnosed with presumed microbial keratitis.

Setting:
Sydney Eye Hospital, Sydney, New South Wales, Australia.

Design:
Retrospective case review.

Methods:
Patients were identified from pathology and hospital coding data from 2012 to 2016. Inclusion criteria were all patients with a previous LASIK surgery, a presumed diagnosis of microbial keratitis, and a corneal scrape performed and aged older than 18 years. Demographics, clinical details, and outcomes were collated from the medical records.

Results:
Sixteen patients were included, with median age of 41.5 years (range 22 to 85 years) and 56.2% of women. The median time between LASIK procedure and microbial keratitis presentation was 38.3 months (interquartile range 6.7 to 77.45 months). Cultures were positive for bacteria in 12 (75%) of 16 scrapes. Of the bacterial isolates, 12 (85.7%) were gram-positive and 2 (14.3%) gram-negative. Sensitivity profiles for the isolated bacteria were similar between fortified antibiotics (cefalotin and gentamicin) and commercial products (chloramphenicol and ofloxacin). Complications included the need for tectonic grafts, nonhealing epithelial defects, thinning, and neovascularization.

Conclusions:
Late onset of keratitis after LASIK can occur with no positive cultures for nontuberculous mycobacteria, no interface involvement, and no other usual features reported in case series of infectious keratitis in LASIK patients. It has a similar clinical course to non-LASIK keratitis, such that the surgery may not have been a risk factor for infection.
Agreement and variability of subjective refraction, autorefraction, and wavefront aberrometry in pseudophakic patients
Authors: Ruiss Manuel , Findl Oliver , Draschl Petra , Harrer-Seely Annette , Hirnschall Nino 
Published: January 2021

Purpose:
To evaluate the comparability and variability of subjective refraction (SR), autorefraction (AR), and wavefront aberrometry (WA) in pseudophakic patients.

Setting:
Hanusch Hospital, Vienna, Austria.

Design:
Prospective study.

Methods:
Subjective refraction was performed by 2 independent examiners at 2 study visits. Furthermore, 5 measurements of AR and WA were performed in each patient at both visits. Agreement between the 3 refraction methods for spherical equivalent (M) and cylindrical vectors (J0, J45) was analyzed using Friedman multiple comparison and Bland-Altman plots. Predictability of spherical equivalent determined by SR from AR and WA measurements was tested with partial least squares regression and random forest regression.

Results:
Ninety eyes of 90 pseudophakic patients were measured. The mean absolute error and arithmetic mean difference of SR measurements of M, J0, and J45 were comparable between both examiners. A small mean difference was found for SR between both visits. Spherical equivalent was more negative when measured by AR [−0.87 diopters (D)] and WA (−0.90 D) compared with SR (−0.60 D), whereas astigmatic vectors agreed well. Good test-retest reliability was found between all 3 refraction methods for M, J0, and J45. Partial least squares regression and random forest regression showed moderate predictive power for M measured by objective refraction and SR.

Conclusions:
Reproducibility and reliability of SR measurements in pseudophakic patients showed good agreement. AR and WA measured the spherical equivalent more myopic than SR, whereas astigmatic vectors were comparable between the 3 methods after uneventful cataract surgery.
Contributions of Airway Stent for Long-term Outcome in Patients With Malignant Central Airway Stenosis or Obstruction
Authors: Iyoda Akira , Azuma Yoko , Sano Atsushi , Sakai Takashi , Koezuka Satoshi , Otsuka Hajime , Tochigi Naobumi , Isobe Kazutoshi , Sakamoto Susumu , Takagi Keigo 
Published: January 2021

Background:
Although an airway stent is used for malignant central airway stenosis or obstruction, long-term outcomes are unknown. In this study, we retrospectively analyzed the clinical features of patients who required stenting for malignant central airway stenosis or obstruction.

Patients and Methods:
We retrospectively analyzed clinical data from 116 patients with stenting for central airway stenosis or obstruction who underwent treatment at Toho University Hospital from 1998 to 2018. We evaluated the clinical features, prognoses, and complications for stenting in these patients.

Results:
The distribution of the 116 patients was as follows: lung cancer, 53; esophageal cancer, 40; thyroid cancer, 8; and others, 15. Patients with thyroid cancer had a significantly higher rate of complications after stenting than patients with lung cancer (P=0.0062), esophageal cancer (P=0.0029), and others (P=0.0062). Patients with esophageal cancer had a significantly worse prognosis than patients with lung and thyroid cancer. In patients with lung cancer the prognosis was significantly different between patients who underwent additional treatment for lung cancer after stenting and patients with no treatment (P=0.0398), and patients who received chemoradiotherapy for lung cancer after stenting had a significantly better prognosis than patients with no treatment (P=0.0306).

Conclusion:
Stenting for airway stenosis/obstruction may improve prognosis in patients with lung or thyroid cancer, especially if patients with lung cancer undergo additional treatments after stenting, although airway stenting for patients with esophageal cancer was palliative. New treatment strategies may be necessary for patients with esophageal cancer after stenting to improve prognosis.
Fluorescent Detection of Vestibular Schwannoma Using Intravenous Sodium Fluorescein In Vivo
Authors: Szczupak Mikhaylo , Peña Stefanie A. , Bracho Olena , Mei Christine , Bas Esperanza , Fernandez-Valle Cristina , Liu Xue-Zhong , Telischi Fred F. , Ivan Michael , Dinh Christine T. 
Published: January 2021

Background:
Vestibular schwannoma (VS) are intracranial tumors caused by merlin deficiency. Sodium fluorescein (SF) is a fluorescent compound that accumulates in various intracranial tumors, causing tumors to emit green fluorescence after blue light excitation.

Hypothesis:
Intravenous SF preferentially deposits in VS, helping surgeons differentiate tumor from surrounding tissue.

Methods:
Merlin-deficient Schwann cells were grafted onto cochleovestibular nerves of immunodeficient rats. Rats were randomized to receive SF (7.5 mg/kg; n = 5) or saline (n = 3). Tissues were harvested at 1 hour and photographed in white and blue light. Sixteen surgeons identified and marked the tumor-tissue interfaces on images. Fluorescence was measured on tissue specimens using the IVIS imaging system and on tissue cross-sections obtained with confocal microscopy. Western blot was performed to measure levels of organic anion transporting polypeptide (OATP), a drug transporter specific for SF.

Results:
Under blue light, tumors from SF rats demonstrated bright green fluorescence under direct visualization, higher fluorescence measurements on tissue specimens (p < 0.001), and more SF deposition on tissue cross-sections (p < 0.001), when compared with surrounding tissues and placebo rats. Surgeons were better able to distinguish the tumor-tissue interfaces in SF rats. Furthermore, the expression level of OATP1C1 was significantly higher in tumors than in surrounding tissues (p < 0.0001).

Conclusion:
In a xenograft model of VS, intravenous SF preferentially deposits in tumors, compared with normal surrounding tissue. Under blue light, tumors emit an intense green fluorescence that can help surgeons differentiate tumor from critical structures nearby, which may improve clinical outcomes in complicated VS surgery.
Therapeutic approaches targeting splicing factor mutations in myelodysplastic syndromes and acute myeloid leukemia
Authors: Figg John W. , Barajas Juan M. , Obeng Esther A. 
Published: January 2021

Purpose of review
Mutations in components of the spliceosome are the most common acquired lesions in myelodysplastic syndromes (MDS) and are frequently identified in other myeloid malignancies with a high rate of progression to acute myeloid leukemia (AML) including chronic myelomonocytic leukemia and primary myelofibrosis. The only curative option for these disorders remains allogeneic stem-cell transplantation, which is associated with high morbidity and mortality in these patients. The purpose of this review is to highlight the recent therapeutic developments and strategies being pursued for clinical benefit in splicing factor mutant myeloid malignancies.

Recent findings
Cells harboring splicing factor mutations have increased aberrant splicing leading to R-loop formation and cell cycle stalling that create dependencies on Checkpoint kinase 1 (CHK1) activation and canonical splicing maintained by protein arginine methyltransferase activity. Both targeting of the spliceosome and targeting of the downstream consequences of splicing factor mutation expression show promise as selective strategies for the treatment of splicing factor-mutant myeloid malignancies.

Summary
An improved understanding of the therapeutic vulnerabilities in splicing factor-mutant MDS and AML has led to the development of clinical trials of small molecule inhibitors that target the spliceosome, ataxia telangectasia and Rad3 related (ATR)-CHK1 pathway, and methylation of splicing components.
Telemedicine in neonatal medicine and resuscitation
Authors: Lapcharoensap Wannasiri , Lund Kelli , Huynh Trang 
Published: January 2021

Purpose of review
Telehealth in neonatology is a rapidly expanding modality for providing care to neonatal patient populations. In this review, we describe the most recent published innovations in neonatal telehealth, spanning the neonatal ICU (NICU), community/rural hospitals and the patient's home.

Recent findings
Telemedicine for neonatal subspecialty care has continued to expand, from well established uses in retinopathy of prematurity screening and tele-echocardiography, to applications in genetics and neurology. Within the NICU itself, neonatologist-led remote rounding has been shown to be a feasible method of increasing access to expert care for neonates in rural hospitals. Telehealth has improved parental and caregiver education, eased the NICU-to-home transition experience and expanded access to lactation services for rural mothers. Telemedicine-assisted neonatal resuscitation has improved the quality of resuscitation and reduced unnecessary neonatal transports to higher levels of care. Finally, the global COVID-19 pandemic has accelerated the expansion of neonatal telehealth.

Summary
Telehealth provides increased access to expert neonatal care and improves patient outcomes, while reducing the cost of care for neonates in diverse settings. Continued high-quality investigation of the impacts of telehealth on patient outcomes and healthcare systems is critical to the continued development of neonatal telemedicine best practices.
Lifetime Medical Costs of Genital Herpes in the United States: Estimates From Insurance Claims
Authors: Eppink Samuel T. , Kumar Sagar , Miele Kathryn , Chesson Harrell W. 
Published: January 2021

Background
The purpose of this study was to estimate the lifetime direct medical costs per incident case of genital herpes in the United States.

Methods
We used medical claims data to construct a cohort of people continuously enrolled in insurance for at least 48 consecutive months between 2010 and 2018. From this cohort, we identified initial genital herpes diagnoses as well as the cost of related clinical visits and medication during the 36 months after an initial diagnosis. Lifetime costs beyond 36 months were estimated based on treatment use patterns observed in the 36 months of follow-up.

Results
The present value of lifetime direct medical costs of genital herpes was estimated to be $972 per treated case or $165 per infection (2019 dollars), not including costs associated with prevention or treatment of neonatal herpes. The clinical visit at which genital herpes was first diagnosed accounted for 27% of lifetime costs. Subsequent clinical visits and medications related to genital herpes accounted for an additional 13% and 60% of lifetime costs, respectively.

Conclusions
The results from this study can inform cost-effectiveness analysis of genital herpes control interventions as well as help quantify the cost burden of sexually transmitted infections in the United States.
Imaging for Pediatric Blunt Abdominal Trauma With Different Prediction Rules
Authors: Ozcan Ali , Ahn Terrie , Akay Begum , Menoch Margaret 
Published: January 2021

Background
Computerized tomography (CT) of the abdomen and pelvis is the standard imaging modality to diagnose intra-abdominal injury (IAI). Clinicians must weigh the risk-benefit of CT compared with the degree of clinical suspicion for an IAI. Pediatric Emergency Care Applied Research Network (PECARN), Streck, and blunt abdominal trauma in children (BATiC) prediction rules have been published to help guide evaluation of these patients. Pediatric Emergency Care Applied Research Network uses history and physical examination findings, whereas Streck and BATiC use examination plus laboratory and imaging findings. At the time of the study, there was not a protocol that was more routinely sited. Our goal was to compare these different prediction rules.

Methods
This was a retrospective electronic chart review of all children younger than 18 years presenting for either level 1 or 2 trauma activations at our pediatric emergency department (ED) between June 1, 2015, to June 30, 2017. Charts were manually reviewed for a mechanism concerning for abdominal trauma, and demographic data, history and physical examination findings, laboratory and imaging results per prediction rules, and revisits in 7 days were collected.
The prediction rules were applied to all charts that had all data necessary. For study purposes, a score of zero for PECARN and Streck, and score of ≤5 for modified BATiC (mBATiC) were defined as “low risk.” Patients with no CT, negative CT, and no new injury found on revisit were classified as “no IAI identified,” and patients with positive CT or revisit with injury found as “IAI identified.” The results were compared via Fisher exact test.

Results
A total of 249 patients met the inclusion criteria with a median age of 12 years. Of the low-risk patients, 119 (98.7%) of 121 in PECARN group, 21 (100%) of 21 in Streck, and 48 (85.7%) of 56 in mBATiC group had no IAI identified. None of the low-risk patients required any intra-abdominal intervention. No missed IAI was identified during revisit review. Negative predictive values of all 3 rules were significant for PECARN, Streck, and mBATiC (98.35%, 100%, and 85.71%, respectively). Overall, 27 patients had positive CT results for IAI.

Conclusions
The PECARN and Streck rules have high negative predictive values to predict low-risk patients who do not require CT. When laboratory studies are not obtained, PECARN is an effective means of excluding IAI for low-risk patients. When laboratory tests were obtained, the Streck rule performed well. Overall, the results are similar to the past individual studies done on each individual rule. History and physical examination findings are of high importance in pediatric trauma. This study supports limited imaging when no abnormal findings are present in children with blunt torso trauma. This is the only study found in the literature that has compared 3 different prediction rules.
Consumer Engagement With Information on Performance: A Narrative Review
Authors: Raj Minakshi , Banaszak-Holl Jane 
Published: January 2021

Background and Objectives:
Efforts to provide information on quality of providers assume that consumers and patients are able to use information effectively to guide their decisions. We conducted a narrative literature review to better understand how consumers use information on quality to ultimately select a provider.

Methods:
We used Berwick's Pathways to Quality Improvement Framework to guide a narrative literature review to synthesize past research on consumer choice and to identify and evaluate factors affecting provider selection.

Results:
Reviewed articles reflected factors affecting provider selection, including: information needs, content and delivery of information, use and engagement with information, and social and behavioral mechanisms, such as trust. We also identified gaps in the literature for further study (eg, loyalty to physicians) that have been identified as important for optimal decision-making but are not well explored in the literature.

Discussion:
Health care providers and managers can learn from a more complete model of consumers' selection process to systematically evaluate and improve service provision and information for consumers. Administrators and providers may consider using patient feedback to identify ways to improve their quality and should streamline information for consumers to facilitate thorough, informed decision-making.
Graphic Representation of Hourly Activity Counts May Identify Discharge Outcomes for Older Adults After Critical Illness
Authors: Elías Maya N. , Munro Cindy L. , Liang Zhan 
Published: January 2021

Abstract

Purpose
After transitioning from an intensive care unit (ICU), hospitalized older adults are inactive, which may affect discharge outcomes. We examined trends between post-ICU hourly activity counts and discharge disposition among hospitalized older ICU survivors.

Design
A prospective, exploratory research design was used in this study.

Methods
We enrolled older ICU survivors within 24–48 hours of ICU discharge. Actigraphy measured post-ICU hourly activity counts (0:00 a.m.–23:59 p.m.). Chart review provided discharge disposition. Analyses were conducted to illustrate trends between post-ICU hourly activity counts and discharge disposition.

Findings
Mean hourly activity was about 2,233 ± 569 counts/hour. Graphs revealed trends between hourly activity counts and discharge disposition. Participants with lower post-ICU activity counts, especially during daytime hours, tended to be discharged to a care facility.

Conclusions
Future nursing research should determine whether post-ICU inactivity during hospitalization is a modifiable risk factor for worse discharge outcomes.

Clinical Relevance
Activity could be a prognostic indicator of discharge disposition for older ICU survivors.
Association Between Blood Donor Demographics and Post-injury Multiple Organ Failure after Polytrauma
Authors: Amico Francesco , Efird Jimmy T. , Briggs Gabrielle D. , Lott Natalie J. , King Kate L. , Hirani Rena , Balogh Zsolt J. 
Published: January 2021

Objective:
To test the hypothesis that blood donor demographics are associated with transfused polytrauma patients’ post-injury multiple organ failure (MOF) status.

Summary of Background Data:
Traumatic shock and MOF are preventable causes of death and post-traumatic hemorrhage is a frequent indication for transfusion. The role of blood donor demographics on transfusion recipients is not well known.

Methods:
A log-linear analysis accounting for the correlated structure of the data based on our prospective MOF database was utilized. Tests for trend and interaction were computed using a likelihood ratio procedure.

Results:
A total of 229 critically injured transfused trauma patients were included, with 68% of them being males and a mean age of 45 years. On average 10 units of blood components were transfused per patient. A total of 4379 units of blood components were donated by donors aged 46 years on average, 74% of whom were males. Blood components used were red blood cells (47%), cryoprecipitate (29%), fresh frozen plasma (24%), and platelets (less than 1%). Donor-recipient sex mismatched red blood cells transfusions were more likely to be associated with MOF (P = 0.0012); fresh frozen plasma and cryoprecipitate recipients were more likely to experience MOF when transfused with a male (vs female) component (P = 0.0014 and <0.0001, respectively). Donor age was not significantly associated with MOF for all blood components.

Conclusions:
Blood components donor sex, but not age, may be an important factor associated with post-injury MOF. Further validation of our findings will help guide future risk mitigation strategies specific to blood donor demographics.
Psychological Health of Surgeons in a Time of COVID-19
Authors: Tan Yi Quan , Wang Ziting , Yap Qai Ven , Chan Yiong Huak , Ho Roger C. , Hamid Agus Rizal Ardy Hariandy , Landaluce-Olavarria Aitor , Pellino Gianluca , Gauhar Vineet , Chand Manish , Wroclawski Marcelo Langer , Hameed BM Zeeshan , Ling Samuel Ka-Kin , Sengupta Shomik , Gallo Gaetano , Chiu Peter Ka-Fung , Tanidir Yiloren , Tallada M. Pilar Villanova , Garcia Bernardo Nunez , Colleoni Ramiro , Abiddin Zainal Adwin Zainal , Campi Riccardo , Esperto Francesco , Carrion Diego , Elterman Dean , Chung Amanda Shu Jun , Ng Anthony Chi Fai , Moschini Marco , Rivas Juan Gomez , Mayol Julio , Teoh Jeremy Yuen-Chun , Chiong Edmund ,   SoMe4Surgery working group Collaborators
Published: January 2021

Objective:
To assess the degree of psychological impact among surgical providers during the COVID-19 pandemic.

Summary of Background Data:
The COVID-19 pandemic has extensively impacted global healthcare systems. We hypothesized that the degree of psychological impact would be higher for surgical providers deployed for COVID-19 work, certain surgical specialties, and for those who knew of someone diagnosed with, or who died, of COVID-19.

Methods:
We conducted a global web-based survey to investigate the psychological impact of COVID-19. The primary outcomes were the depression anxiety stress scale-21 and Impact of Event Scale-Revised scores.

Results:
A total of 4283 participants from 101 countries responded. 32.8%, 30.8%, 25.9%, and 24.0% screened positive for depression, anxiety, stress, and PTSD respectively. Respondents who knew someone who died of COVID-19 were more likely to screen positive for depression, anxiety, stress, and PTSD (OR 1.3, 1.6, 1.4, 1.7 respectively, all P < 0.05). Respondents who knew of someone diagnosed with COVID-19 were more likely to screen positive for depression, stress, and PTSD (OR 1.2, 1.2, and 1.3 respectively, all P < 0.05). Surgical specialties that operated in the head and neck region had higher psychological distress among its surgeons. Deployment for COVID- 19-related work was not associated with increased psychological distress.

Conclusions:
The COVID-19 pandemic may have a mental health legacy outlasting its course. The long-term impact of this ongoing traumatic event underscores the importance of longitudinal mental health care for healthcare personnel, with particular attention to those who know of someone diagnosed with, or who died of COVID-19.