bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Classification of Acquired Concomitant Esotropia
Authors: Gisselbaek Sara , Hoeckele Nicole , Klainguti Georges , Kaeser Pierre-François 
Published: April 2021

Abstract
Background Classification and management of acquired concomitant esotropia is controversial. We sought to establish a simple clinical classification in order to determine in which cases further investigations in search of underlying pathologies are necessary.
Patients and Methods Observational retrospective study of the files of 175 consecutive patients examined in our unit between 2009 and 2018 for acute convergent strabismus. One hundred and nine patients were selected, after exclusion of infantile, incomitant, or mechanical esotropias, residual esotropias, and patients examined on a single occasion. All patients received a complete orthoptic and ophthalmological examination. We grouped the patients according to their common characteristics.
Results We established the following categories: 1. Acute esotropia of large angle (20 to 45 prism diopters [PD]), accompanied by mild hyperopia (mean 1.2 D) in children (n = 16) and moderate myopia (mean 3.7 D) in adolescents and adults (n = 13). 2. Decompensated micro-esotropia, which is distinguished from the other categories by the presence of abnormal retinal correspondence (n = 33). 3. Decompensated esophoria, with intermittent deviations of 5 to 30 PD, esotropia being compensated part of the time (n = 25). 4. Esotropia present only at a distance in patients over 50 years of age (n = 20). 5. Small-angle esotropia (< 15 PD) greater at a distance, associated with oculomotor cerebellar syndrome (n = 2). Complementary examinations (MRI or CT scan) were performed on 21 patients, leading to the discovery of a posterior fossa astrocytoma in a 4-year-old boy.
Conclusions The recognition of decompensated micro-esotropia and esophoria, as well as distance esotropia of the elderly, avoids unnecessary additional investigations, which are indicated in any type of acute comitant strabismus if associated with any neurological sign or symptom (e.g., headaches, nausea, vertigo, imbalance, poor coordination, nystagmus, or papilledema). In the absence of neurological findings, there is no consensus about the indication of neuroimaging in large-angle acquired concomitant esotropia, but long-term follow-up of patients that do not undergo neuroimaging is strongly recommended in order to identify later occurring intracranial diseases. This is of particular importance with children.
Pseudomonas cichorii (bacterial blight of endive).
Authors: Osdaghi Ebrahim 
Published: April 2021

Abstract

Under environmental conditions favourable to the pathogen, diseases incited by P. cichorii cause severe damage to the host and can result in outbreaks. Outbreaks in the nursery or in the field during warm winters in Florida, USA, can lead to widespread disease affecting thousands of plants (Jones et al., 1983; Chase and Brunk, 1984; Uddin and McCarter, 1996). Diseases caused by P. cichorii can appear sporadically over a number of years then cause severe outbreaks such as the outbreak of 'varnish spot of lettuce' in California (Grogan et al. 1977) and 'brown stem of celery' in Florida, USA (Pernezny et al., 1994). Severe disease outbreaks on lettuce leading to losses of up to 100% have been reported in California (Grogan et al., 1977), Italy (Bazzi and Mazzucchi, 1979) and Portugal (Ferreira-Pinto and Oliveira, 1993). In Italy and France, P. cichorii is a recurring problem on endive and lettuce (Allex and Rat 1990; D'Ascenzo et al., 1997). In Florida, brown stem of chrysanthemum only occurs about every 5 to 6 years whereas leaf spot occurs annually (Pernezny et al., 1994).
Helium ion beam lithography and liftoff
Authors: Rashid Sabaa , Walia Jaspreet , Northfield Howard , Hahn Choloong , Olivieri Anthony , Lesina Antonio Calà , Variola Fabio , Weck Arnaud , Ramunno Lora , Berini Pierre 
Published: April 2021

Abstract
We introduce a helium ion beam lithography and liftoff process to fabricate arbitrary nanostructures. Exploiting existing high-resolution positive tone resists such as poly (methyl methacrylate) (PMMA), the process offers three significant advantages over electron beam lithography: (a) the exposing helium ion beam produces a high secondary electron yield leading to fast patterning, (b) proximity effects are negligible due to the low count of backscattered helium ions from the substrate, and (c) the process is transferrable with minimal alteration among different types of substrates (e.g. silicon, fused silica). The process can be used to pattern any material compatible with liftoff such as evaporated metals or dielectrics, and allows overlay of nanostructures precision-aligned to microstructures realised beforehand on the same substrate. The process is demonstrated for several PMMA thicknesses to liftoff different thicknesses of deposited material. Resolution trials are conducted to determine the limits of the process for each PMMA thickness. Isolated lines as narrow as 14 nm, and line-space gratings of 40 nm pitch (50% duty cycle), are produced as resolution tests by lifting off a 20 nm thick Au film. Nanostructures of aspect ratio up to ∼3:1 have been realised. Plasmonic nanoantenna arrays overlaid to microscale contacts are produced as device demonstrators, for which optical measurements are in excellent agreement with theory.
Strategic Resource Mobilisation amongst Founder-CEOs of Social Work Organisations in Mainland China
Authors: Wu Juan , Chen Juan 
Published: April 2021

Abstract
Drawing on data from in-depth interviews with twenty-one founder-CEOs of social work organisations (SWOs) in Mainland China, this article develops the concept of ‘strategic resource mobilisation’ and investigates how founder-CEOs’ professional backgrounds influence their mobilisation of resources in three areas—funding, human resources and government relations. We find that founder-CEOs adopt different strategies in mobilising resources, presenting distinct advantages and disadvantages according to their professional background. In particular, founder-CEOs affiliated with universities are viewed with trust and respect by the government and have social work students as human resources but report a lack of management skills; founder-CEOs from a business background have wider access to financial support and make good use of their management experiences and skills but are challenged by frontline social workers; and founder-CEOs with prior government experience rely on connections with officials to secure funding but face greater administrative constraints. The findings provide valuable insights for SWO executives to better assess their organisational capacity, leadership and management. The research further suggests that, to ensure the sustainable development of SWOs in Mainland China, government policies could be introduced to help diversify the funding sources, and efforts should be made to improve the partnership between the government and SWOs.
Influenza Vaccination in Health Centers During the Coronavirus Disease 2019 Pandemic—United States, 7–27 November 2020
Authors: Marks Suzanne M , Clara Alexey , Fiebelkorn Amy Parker , Le Xuan , Armstrong Paige A , Campbell Stephanie , Van Alstyne Judith Mendel , Price Sarah , Bolton Joshua , Sandhu Paramjit K , Bombard Jennifer M , Strona F V 
Published: April 2021

Abstract

Background
Influenza vaccination is the most effective way to prevent influenza and influenza-associated complications including those leading to hospitalization. Resources otherwise used for influenza could support caring for patients with coronavirus disease 2019 (COVID-19). The Health Resources and Services Administration (HRSA) Health Center Program serves 30 million people annually by providing comprehensive primary healthcare, including influenza vaccination, to demographically diverse and historically underserved communities. Because racial and ethnic minority groups have been disproportionately affected by COVID-19, the objective of this analysis was to assess disparities in influenza vaccination at HRSA-funded health centers during the COVID-19 pandemic.

Methods
The Centers for Disease Control and Prevention and HRSA analyzed cross-sectional data on influenza vaccinations from a weekly, voluntary health center COVID-19 survey after addition of an influenza-related question covering 7–11 November 2020.

Results
During the 3-week period, 1126 of 1385 health centers (81%) responded to the survey. Most of the 811 738 influenza vaccinations took place in urban areas and in the Western US region. There were disproportionately more health center influenza vaccinations among racial and ethnic minorities in comparison with county demographics, except among non-Hispanic blacks and American Indian/Alaska Natives.

Conclusions
HRSA-funded health centers were able to quickly vaccinate large numbers of mostly racial or ethnic minority populations, disproportionately more than county demographics. However, additional efforts might be needed to reach specific racial populations and persons in rural areas. Success in influenza vaccination efforts can support success in severe acute respiratory syndrome coronavirus 2 vaccination efforts.
Notions of indifference for genericity: Union sets and subsequence sets
Authors: Bhojraj Tejas 
Published: April 2021

Abstract
A set $I$ is said to be a universal indifferent set for $1$-genericity if for every $1$-generic $G$ and for all $X \subseteq I$, $G \varDelta X$ is also $1$-generic. Miller (2013, The Journal of Symbolic Logic, 78, 113–138) showed that there is no infinite universal indifferent set for $1$-genericity. We introduce two variants (union and subsequence sets for $1$-genericity) of the notion of universal indifference and prove that there are no non-trivial universal sets for $1$-genericity with respect to these notions. In contrast, we show that there is a non-computable subsequence set for weak-$1$-genericity.
Correlation of Aneurysmal Wall Enhancement of Unruptured Intracranial Aneurysms on High-Resolution Vessel-Wall Imaging With Clinical Indices and Surgical Findings
Authors: Bae Heejin , Suh Sang-il , Yoon Won Ki , Roh Haewon , Kim Chungyeul , Kwon Taek-Hyun 
Published: April 2021

Abstract

BACKGROUND
Many physicians consider aneurysmal wall enhancement (AWE) on high resolution-vessel wall imaging (HR-VWI) as an imaging biomarker of unstable unruptured intracranial aneurysms (UIAs).

OBJECTIVE
To evaluate the clinical value of different AWE signal intensities (SIs) by assessing the correlation between the AWE SIs and surgical findings and rupture risk assessment tools.

METHODS
Twenty-six patients with 34 aneurysms who underwent surgical clipping were included. The corrected AWE SI was calculated by comparing T1-weighted images with post-gadolinium enhanced T1-weighted images. The correlation of AWE with the population, hypertension, age, size of aneurysm, earlier subarachnoid hemorrhage from another aneurysm, site of aneurysm (PHASES) and earlier subarachnoid hemorrhage, location of the aneurysm, age >60 years, population, size of the aneurysm, shape of the aneurysm (ELAPSS) scores was evaluated using correlation and linear regression analysis. To quantify the surgical findings, the average color value of the aneurysms expressed in the CIELCh system was measured. Δh, color difference from yellow, was used for statistical analysis.

RESULTS
The mean age of the patients and aneurysm size were 64.08 yr and 6.95 mm, respectively. The mean AWE SI, PHASES and ELAPSS scores, and Δh were 22.30, 8.41, 20.32, and 41.36, respectively. The coefficients of correlation of AWE SI with the PHASES and ELAPSS scores and Δh were 0.526, 0.563, and –0.431. We found that the AWE SI affected the PHASES (β = 0.430) and ELAPSS scores (β = 0.514) and Δh (β = –0.427) in simple linear regression analysis.

CONCLUSION
The AWE on HR-VWI was correlated with the PHASES and ELAPSS scores and the color. The stronger the AWE, the higher were the PHASES and ELAPSS scores and the more abnormal was the color. The AWE might indicate the degree of inflammation.
Maternal sepsis update
Authors: Abir Gillian , Bauer Melissa E. 
Published: April 2021

Purpose of review
Maternal sepsis is the second leading cause of maternal death in the United States. A significant number of these deaths are preventable and the purpose of this review is to highlight causes such as delays in recognition and early treatment.

Recent findings
Maternal sepsis can be difficult to diagnose due to significant overlap of symptoms and signs of normal physiological changes of pregnancy, and current screening tools perform poorly to identify sepsis in pregnant women. Surveillance should not only include during pregnancy, but also throughout the postpartum period, up to 42 days postpartum. Education and awareness to highlight this importance are not only vital for obstetric healthcare provides, but also for nonobstetric healthcare providers, patients, and support persons.

Summary
Through education and continual review and analysis of evidence-based practice, a reduction in maternal morbidity and mortality secondary to maternal sepsis should be attainable with dedication from all disciplines that care for obstetric and postpartum patients. Education and vigilance also extend to patients and support persons who should be empowered to escalate care when needed.
Formal Patient Complaints and Malpractice Events Against Pediatric Orthopaedic Surgeons
Authors: Piper James P. , Barreto Rocha Daniela F. , Hayes Daniel S. , Grandizio Louis C. 
Published: April 2021

Background:
Formal patient complaints are associated with increased malpractice litigation and can have adverse occupational consequences for surgeons. Our purpose was to define and categorize patient complaints within an academic pediatric orthopaedic surgery practice over a 10-year period. We further aimed to define risk factors associated with patient complaints.

Methods:
We reviewed all complaints within our institution’s patient advocacy service filed on behalf of a patient against 4 pediatric orthopaedic surgeons over a 10-year period. Complaints were categorized using the Patient Complaint Analysis System. A control group of all patients seen by the surgeons during the study period was created. We compared baseline demographics between the patients with a complaint and the control group and compared complaint rates between the surgeons. Any malpractice events (lawsuits and claims) associated with the surgeons were obtained. We queried our institutional MIDAS reporting system (which allows for anonymous reporting of potential patient-safety or “near-miss” events), to assess whether patients with a complaint had a reported event.

Results:
The 4 pediatric orthopaedic surgeons saw a total of 25,747 unique patients during the study period. Forty-one patients had a formal complaint, resulting in a complaint rate of 0.15%. Complaint rates varied from 0.08% to 0.30% between surgeons. Humanness was the most frequent complaint designation category (32%) followed by Care and Treatment (19%). Of the 41 patients with a complaint, 18 (44%) underwent surgical treatment. Only 1 patient with a complaint also had an entry within our institutional patient-safety reporting system.

Conclusions:
The rate of patient complaints within an academic pediatric orthopaedic surgery practice over a decade was 0.15%, or ~1 complaint for every 670 new patients seen. The majority of patient complaints involved communication; a potentially modifiable area that can be targeted for improvement. While complaint rates among surgeons can vary, patient demographic factors are not associated with increased complaints. Understanding patient complaints rates and types may allow surgeons to target areas for improvement and decrease exposure to malpractice litigation.

Level of Evidence:
Level II—prognostic.
Association Between Premorbid Beta-Blocker Exposure and Sepsis Outcomes—The Beta-Blockers in European and Australian/American Septic Patients (BEAST) Study
Authors: Tan Kaiquan , Harazim Martin , Simpson Andrew , Tan Yi Chern , Gunawan Gunawan , Robledo Kristy P. , Whitehead Christina , Tang Benjamin , Mclean Anthony , Nalos Marek 
Published: April 2021

OBJECTIVES:
To examine the effect of premorbid β-blocker exposure on mortality and organ dysfunction in sepsis.

DESIGN:
Retrospective observational study.

SETTING:
ICUs in Australia, the Czech Republic, and the United States.

PATIENTS:
Total of 4,086 critical care patients above 18 years old with sepsis between January 2014 and December 2018.

INTERVENTION:
Premorbid beta-blocker exposure.

MEASUREMENTS AND MAIN RESULTS:
One thousand five hundred fifty-six patients (38%) with premorbid β-blocker exposure were identified. Overall ICU mortality rate was 15.1%. In adjusted models, premorbid β-blocker exposure was associated with decreased ICU (adjusted odds ratio, 0.80; 95% CI, 0.66–0.97; p = 0.025) and hospital (adjusted odds ratio, 0.83; 95% CI, 0.71–0.99; p = 0.033) mortality. The risk reduction in ICU mortality of 16% was significant (hazard ratio, 0.84, 95% CI, 0.71–0.99; p = 0.037). In particular, exposure to noncardioselective β-blocker before septic episode was associated with decreased mortality. Sequential Organ Failure Assessment score analysis showed that premorbid β-blocker exposure had potential benefits in reducing respiratory and neurologic dysfunction.

CONCLUSIONS:
This study suggests that β-blocker exposure prior to sepsis, especially to noncardioselective β blockers, may be associated with better outcome. The findings suggest prospective evaluation of β-blocker use in the management of sepsis.
Neuroprognostic Accuracy of Quantitative Versus Standard Pupillary Light Reflex for Adult Postcardiac Arrest Patients: A Systematic Review and Meta-Analysis*
Authors: Wang Chih-Hung , Wu Cheng-Yi , Liu Carolyn Chia-Yu , Hsu Tzu-Chun , Liu Michael A. , Wu Meng-Che , Tsai Min-Shan , Chang Wei-Tien , Huang Chien-Hua , Lee Chien-Chang , Chen Shyr-Chyr , Chen Wen-Jone 
Published: April 2021

OBJECTIVES:
An automated infrared pupillometer measures quantitative pupillary light reflex using a calibrated light stimulus. We examined whether the timing of performing quantitative pupillary light reflex or standard pupillary light reflex may impact its neuroprognostic performance in postcardiac arrest comatose patients and whether quantitative pupillary light reflex may outperform standard pupillary light reflex in early postresuscitation phase.

DATA SOURCES:
PubMed and Embase databases from their inception to July 2020.

STUDY SELECTION:
We selected studies providing sufficient data of prognostic values of standard pupillary light reflex or quantitative pupillary light reflex to predict neurologic outcomes in adult postcardiac arrest comatose patients.

DATA EXTRACTION:
Quantitative data required for building a 2 × 2 contingency table were extracted, and study quality was assessed using standard criteria.

DATA SYNTHESIS:
We used the bivariate random-effects model to estimate the pooled sensitivity and specificity of standard pupillary light reflex or quantitative pupillary light reflex in predicting poor neurologic outcome during early (< 72 hr), middle (between 72 and 144 hr), and late (≧ 145 hr) postresuscitation periods, respectively. We included 39 studies involving 17,179 patients. For quantitative pupillary light reflex, the cut off points used in included studies to define absent pupillary light reflex ranged from 0% to 13% (median: 7%) and from zero to 2 (median: 2) for pupillary light reflex amplitude and Neurologic Pupil index, respectively. Late standard pupillary light reflex had the highest area under the receiver operating characteristic curve (0.98, 95% CI [CI], 0.97–0.99). For early standard pupillary light reflex, the area under the receiver operating characteristic curve was 0.80 (95% CI, 0.76–0.83), with a specificity of 0.91 (95% CI, 0.85–0.95). For early quantitative pupillary light reflex, the area under the receiver operating characteristic curve was 0.83 (95% CI, 0.79–0.86), with a specificity of 0.99 (95% CI, 0.91–1.00).

CONCLUSIONS:
Timing of pupillary light reflex examination may impact neuroprognostic accuracy. The highest prognostic performance was achieved with late standard pupillary light reflex. Early quantitative pupillary light reflex had a similar specificity to late standard pupillary light reflex and had better specificity than early standard pupillary light reflex. For postresuscitation comatose patients, early quantitative pupillary light reflex may substitute for early standard pupillary light reflex in the neurologic prognostication algorithm.
Identifying High-Risk Subphenotypes and Associated Harms From Delayed Antibiotic Orders and Delivery*
Authors: Han Xuan , Spicer Alexandra , Carey Kyle A. , Gilbert Emily R. , Laiteerapong Neda , Shah Nirav S. , Winslow Christopher , Afshar Majid , Kashiouris Markos G. , Churpek Matthew M. 
Published: April 2021

OBJECTIVES:
Early antibiotic administration is a central component of sepsis guidelines, and delays may increase mortality. However, prior studies have examined the delay to first antibiotic administration as a single time period even though it contains two distinct processes: antibiotic ordering and antibiotic delivery, which can each be targeted for improvement through different interventions. The objective of this study was to characterize and compare patients who experienced order or delivery delays, investigate the association of each delay type with mortality, and identify novel patient subphenotypes with elevated risk of harm from delays.

DESIGN:
Retrospective analysis of multicenter inpatient data.

SETTING:
Two tertiary care medical centers (2008–2018, 2006–2017) and four community-based hospitals (2008–2017).

PATIENTS:
All patients admitted through the emergency department who met clinical criteria for infection.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Patient demographics, vitals, laboratory values, medication order and administration times, and in-hospital survival data were obtained from the electronic health record. Order and delivery delays were calculated for each admission. Adjusted logistic regression models were used to examine the relationship between each delay and in-hospital mortality. Causal forests, a machine learning method, was used to identify a high-risk subgroup. A total of 60,817 admissions were included, and delays occurred in 58% of patients. Each additional hour of order delay (odds ratio, 1.04; 95% CI, 1.03–1.05) and delivery delay (odds ratio, 1.05; 95% CI, 1.02–1.08) was associated with increased mortality. A patient subgroup identified by causal forests with higher comorbidity burden, greater organ dysfunction, and abnormal initial lactate measurements had a higher risk of death associated with delays (odds ratio, 1.07; 95% CI, 1.06–1.09 vs odds ratio, 1.02; 95% CI, 1.01–1.03).

CONCLUSIONS:
Delays in antibiotic ordering and drug delivery are both associated with a similar increase in mortality. A distinct subgroup of high-risk patients exist who could be targeted for more timely therapy.