bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diffractive optic intraocular lens exchange: indications and outcomes
Authors: Alsetri Hasan , Pham Don , Masket Samuel , Fram Nicole R. , Naids Steven , Lee Aron 
Published: September 2021

Purpose:
To assess indications and outcomes of surgical exchange of diffractive optic multifocal and extended depth-of-focus intraocular lenses (IOLs) in favor of monofocal IOLs.

Setting:
Private practice, Los Angeles, California.

Design:
Retrospective chart review.

Methods:
All cases of diffractive optic IOL exchange between June 2007 and October 2020 for diffractive optic dysphotopsia (DOD) (ie, light-induced concentric circles and spider web patterns), poor visual quality, or night vision symptoms were evaluated retrospectively regarding surgical indications, comorbidities, surgical methods, surgical complications, and visual outcomes. Ocular surface disease and ametropia were managed prior to consideration of IOL exchange.

Results:
The charts of 64 eyes of 46 patients were included. 53/64 (83%) had DOD, 50/64 (78%) experienced reduced quality of vision, and 12/64 (19%) complained of night vision difficulties. 27/64 (42%) of eyes had no ocular comorbidities; 15/64 (23%) of eyes had more than 1 comorbid condition, and 12/64 (19%) were post–laser refractive surgery. Laser posterior capsulotomy had been performed in 15/64 (23%) of eyes. There were a variety of inciting diffractive optic IOLs and various monofocal exchange lenses and fixation techniques were used based on symptoms, comorbidities, and status of the posterior capsule. After IOL exchange, all eyes were relieved of DOD, and all eyes had improved or unchanged corrected distance visual acuity.

Conclusions:
Diffractive optic IOLs may induce unsatisfactory visual outcomes. However, in this large series of IOL exchanges, DOD and reduced visual function can be overcome with exchange for a monofocal IOL, despite comorbidities or an open posterior capsule.
Reframing Intersectional Stigma for a South African Context Integrating Tuberculosis, HIV and Poverty Stigmas
Authors: Bergman Alanna , Farley Jason E. , Agarwalla Vidisha , Relf Michael 
Published: September 2021

Abstract
Intersectionality is closely intertwined with Black feminism within the context of the United States. As a result, intersectionality is often overlooked in non-Western contexts where racial homogeneity may reduce some of the impact of race on marginalization. This article will look at intersectional stigma from the South African context using the tuberculosis/HIV (TB/HIV) treatment environment in South Africa to exemplify intersectionality's versatility as an analytic method outside of the United States. We will use colonial history and contemporary research to reframe intersectionality considering a new set of stigmatized identities, including HIV stigma, TB stigma, and poverty stigma, to create a situation-specific framework adapted from a model by Bulent Turan and colleagues.
The World Restart a Heart Initiative: how to save hundreds of thousands of lives worldwide
Authors: Rott Nadine , Böttiger Bernd W. , Lockey Andrew 
Published: September 2021

Purpose of review
Sudden out-of-hospital cardiac arrest (OHCA) is still one of the top reasons for death in industrialized countries. Bystander resuscitation rates differ significantly across the world despite bystanders being easily able to save lives in this situation. In the 4 years since initiation of the International Liaison Committee on Resuscitation (ILCOR) World Restart a Heart (WRAH), the initiative helped educating millions of people and thus enabled them to save lives.

Recent findings
WRAH Day has gained more and more reach, partners and impact over the years. It has the potential of saving hundreds of thousands of lives, changing legislation and inspiring research. During the last year, new strategies had to be developed because of the COVID-pandemic. The importance of educating laypeople is underlined in recent publications and international guidelines.

Summary
The WRAH awareness campaign has reached 194 countries and more than 200 million people in the last years. The success of it could even be kept going in the pandemic due to social media and digital/virtual programmes. International guidelines recommend raising awareness and name ILCOR WRAH as a way to do it.
Intestinal Guanylate Cyclase‐C mRNA Expression in Duodenum and Colon of Children
Authors: Cohen Mitchell B. , Gold Benjamin D. , Xanthakos Stavra A. , CaJacob Nicholas , Weissman Taryn , Bartolini Wilmin , Boinpally Ramesh , Mallick Madhuja , Reasner David S. , O'Dea Christopher R. , Kwak Hanna , Ge Pei 
Published: September 2021

ABSTRACTObjectives:Guanylate cyclase‐C (GC‐C) agonists, which increase intestinal secretion and accelerate transit, are used to treat chronic constipation and constipation‐predominant irritable bowel syndrome and are being evaluated for pediatric use. Prior studies suggest GC‐C receptor density may be higher in young children, potentially amplifying GC‐C agonism with treatment implications. We aimed to quantitate duodenal and colonic GC‐C mRNA expression in children.Methods:Mucosal biopsies were obtained from subjects aged 6 months to 18 years during clinically indicated upper, that is, esophago‐gastro‐duodenal, and/or colonic endoscopy. Tissue samples without histologic abnormalities were grouped by subject age (<24 months, 24 months to <6 years, 6 to <12 years, and 12 to <18 years) and analyzed for GC‐C mRNA expression by qPCR. The relationship between GC‐C mRNA levels and age was modeled using regression analyses.Results:Ninety‐nine subjects underwent upper endoscopy/colonoscopy; 93 had evaluable samples. Mean relative GC‐C mRNA expression was 2.36 (range 2.21–2.46) for duodenal samples and 1.56 (range 1.22–1.91) for colonic samples. Predicted and observed normalized GC‐C mRNA expression in each region were comparable among age groups. Pooled expression by region demonstrated lower expression in colonic versus duodenal samples.Conclusions:Uniform levels of GC‐C mRNA expression were detected in children aged >6 months in the duodenum and >12 months in the colon. Higher expression was observed in all age groups in duodenal versus colonic samples, indicating regional variability in GC‐C receptor density. These data are reassuring for further studies of GC‐C agonists in children.
Fracture reduction has a dominant effect over cerclage wiring in increasing stiffness of intertrochanteric OTA/AO 31-A3.1 (reverse oblique) fractures managed with cephalomedullary osteosynthesis
Authors: Hoskins Wayne , Moniz Sheldon , Day Robert , Hayes Alex , Bingham Roger , Kuster Markus 
Published: September 2021

Abstract

Objectives:
To investigate the mechanical properties of cephalomedullary nailing of intertrochanteric OTA/AO 31-A3.1 (reverse oblique) fractures and to test the hypothesis that anatomical reduction and augmentation with cerclage wire produces a more stable construct.

Methods:
A standardized fracture model in composite saw bone was created to stimulate an intertrochaneric 31-A3.1 fracture, using a 3D printed cutting guide. Simulated osteosynthesis was performed with 12 femurs divided into anatomically reduced and varus malreduced groups. Each femur was tested with and without cerclage wire augmentation. All femurs were fixed with a 215 mm, 130 degree, 11.5 mm nail. An Instron 8874 biaxial materials testing machine was used to assess the axial stiffness. Cyclic loading consisted of 5000 cycles of sinusoidal combined axial-torsion loading at 3 Hz. Axial load was 100 N to 2000 N and torsion −4.5 Nm to +4.5 Nm. Stiffness was measured before and after cyclic loading.

Results:
Reduced constructs were stiffer than residual varus constructs. The mean overall fracture stiffness was 508.7 N/mm for reduced constructs and 379.2 N/mm for varus constructs. Removing the cables significantly decreased the fracture stiffness for both constructs (mean difference 60.0 N/mm, 95% CI 7.7–112.3, P = .032).

Conclusions:
Anatomical reduction has a dominant effect on facture stiffness. Anatomically reduced fractures are stiffer than varus malreduced fractures. A cerclage wire further improves construct stiffness if anatomical reduction is achieved. Cerclage wiring is less effective if anatomical reduction is not achieved.
High Burden of Active Syphilis and Human Immunodeficiency Virus/Syphilis Coinfection Among Men Who Have Sex With Men, Transwomen, and Genderqueer Individuals in Zimbabwe
Authors: Parmley Lauren E. , Chingombe Innocent , Wu Yingfeng , Mapingure Munyaradzi , Mugurungi Owen , Samba Chesterfield , Rogers John H. , Hakim Avi J. , Gozhora Perpetua , Miller Sophia S. , Musuka Godfrey , Harris Tiffany G. 
Published: September 2021

Background
Syphilis increases human immunodeficiency virus (HIV) acquisition risk and impacts the immunologic and virologic response among people living with HIV (PLHIV). We assessed the prevalence of active or current syphilis and HIV/syphilis and their correlates among men who have sex with men (MSM), transwomen, and genderqueer (TGW/GQ) individuals in Zimbabwe.

Methods
Among a respondent-driven sample of MSM and TGW/GQ who were tested for HIV and syphilis in Harare and Bulawayo, Zimbabwe in 2019 (n = 1511), multiple logistic regression was used to assess correlates of active syphilis. Unadjusted logistic regression was used among PLHIV (n = 340) due to small sample size. All analyses were unweighted as data did not reach convergence for HIV.

Results
Prevalence of active syphilis overall and among PLHIV was 5.5% and 10.1%, respectively, in Harare, and 5.6% and 11.0%, respectively, in Bulawayo. Participants were more likely to have active syphilis if they were PLHIV (adjusted odds ratio [aOR], 2.2; 95% confidence interval [CI], 1.4–3.6), aged 25–34 years (aOR, 2.2 years; 95% CI, 1.3–3.8 years; reference, 18–24 years), or self-report sexually transmitted infection symptoms (aOR, 1.8; 95% CI, 1.1–3.0). Compared with Bulawayo TGW/GQ, MSM in Harare (aOR, 0.2; 95% CI, 0.1–0.5) and Bulawayo (aOR, 0.2; 95% CI, 0.1–0.4), and TGW/GQ in Harare (aOR, 0.2; 95% CI, 0.1–0.6) were less likely to have active syphilis. Among PLHIV, coinfection was 13.0% among TGW/GQ and 9.7% among MSM. Odds of coinfection were higher for those aged 25 to 34 years (OR, 3.7 years; 95% CI, 1.2–11.1 years) and lower among Harare MSM (OR, 0.2; 95% CI, 0.1–0.7), Bulawayo MSM (OR, 0.1; 95% CI, 0.0–0.4), and Harare TGW/GQ (OR, 0.1; 95% CI, 0.0–0.4) compared with Bulawayo TGW/GQ.

Conclusions
Findings highlight a high burden of syphilis among MSM and TGW/GQ and underscore the importance of HIV/syphilis detection and improved service delivery for these groups.
Amyand Hernia
Authors: Chiang Elaine , Belfer Joshua , Baker Meredith A. , Ng Lorraine , Fenster Daniel 
Published: September 2021

Abstract
Amyand hernia is a rare type of inguinal hernia defined by the presence of the appendix in the inguinal hernia sac. Clinical diagnosis of Amyand hernia can be challenging because this diagnosis is typically made intraoperatively, often as an incidental finding. Preoperative diagnosis by computed tomography and radiology ultrasound has previously been reported; however, there exists no reports of the diagnosis being made by point-of-care ultrasound. We present a case of Amyand hernia visible on point-of-care ultrasound performed by a pediatric emergency medicine physician.
Evaluating Housing Characteristics Associated With Childhood Lead Exposure in Providence, Rhode Island
Authors: Vasil Taylor-Marie , Rogers Michelle L. , Singleton Cindy , Vivier Patrick M. 
Published: September 2021

Objective:
This research aims to take an in-depth look into the child, housing, and neighborhood characteristics associated with Providence children's likelihood of having elevated blood lead levels (BLLs).

Design and Setting:
The 2019 Providence, Rhode Island, Property Tax Assessor's database, containing each property owner's address, was geocoded and spatially joined with the 2017-2019 blood lead tests for children aged 0 to 6 years from the Rhode Island Department of Health.

Main Outcome Measures:
The prevalence of elevated BLLs (≥5 μg/dL) overall, as well as by property type, number of properties owned, owner occupancy, assessed value, and neighborhood rates of old housing and poverty, was computed. We assessed the relationship between having elevated BLLs and these housing and neighborhood characteristics, adjusting for gender, age at test, and test method.

Results:
We found that, compared with children living in properties with landlords who owned only one property, children living in properties with landlords who owned 4 or more properties had lower odds of having elevated BLLs (odds ratio = 0.98; 95% confidence interval, 0.97-0.99). The proportion of houses built pre-1950 in the neighborhood was associated with increased odds of elevated BLLs. There was no significant association between owner-occupancy status and property type with children having elevated BLLs.

Conclusions:
Children living in properties with landlords who owned 4 or more properties were less likely to have elevated BLLs. This association may suggest that the current lead legislation is having some impact, but public health efforts should address lead exposure in properties that are currently exempt from the law.
Do External Supports Influence Proprioception in Patients With Chronic Ankle Instability?
Authors: Xue Xiao’ao , Chen Ziyi , Xu Xiaoyun , Tao Weichu , Hua Yinghui 
Published: September 2021

Objective
Individuals with chronic ankle instability experience recurring sprains and impaired proprioception, and the effect of external support in the proprioception of injured ankles is still inconsistent in existing studies. Therefore, this study aimed to investigate whether external support could enhance the proprioception of injured ankles in patients with chronic ankle instability.

Design
This was a systematic review and meta-analysis.

Results
Eight studies from PubMed, Embase, Cochrane Library, Web of Science, SPORTDiscus, Scopus, and CINAHL were finally included after applying the exclusion criteria. Meta-analyses revealed a significantly higher joint position sense on inversion with a weighted mean difference of 1.25 degrees and plantar flexion (weighted mean difference, 1.74 degrees) and lower kinesthesia in eversion (weighted mean difference = −0.70 degrees) with the application of external support in the injured ankles of patients with chronic ankle instability.

Conclusion
Applying external support has statistically significant negative effects on kinesthesia and a positive effect on the active joint position sense in the injured ankles of patients with chronic ankle instability. However, this study did not support the restoration of proprioception deficits as a mechanism of external support in preventing reinjuries, owing to its potentially negative effect on kinesthesia, clinically small changes in proprioception, and poor methodologic quality of existing studies.
A Model of Collaboration Can Expand the Opportunities in Adaptive Sports Equipment
Authors: Heasley Victoria , Meyer Daniel , Foster Timothy , Blauwet Cheri 
Published: September 2021

Abstract
Physical medicine and rehabilitation requires teamwork and innovation to help patients reach their goals and to optimize their quality of life, and one way is through participation in sports (Sports Med Arthrosc Rev. 2019;27:73–82; PM R. 2015;7(10):1081–8; PM R. 2012;4(11):851–6; Phys Med Rehabil Clin N Am. 2019;30(1):289–99). Unfortunately, people with disabilities participate in sports ~20% less than their peers, and reasons for this disparity include equipment cost and availability (Sports Med Arthrosc Rev. 2019;27:73–82; PM R. 2015;7(10):1081–8; Pediatrics. 2008;121(5):1057–61; Res Dev Disabil. 2017;67:9–18). A unique way for physical medicine and rehabilitation clinicians to aid in overcoming these barriers is to collaborate with other fields to make adaptive equipment that meets patients’ needs.
A multidisciplinary team including a physical medicine and rehabilitation resident physician and biomedical engineer, physical therapist, and machinist collaborated through a local nonprofit organization to design and build adaptive equipment solutions. This team designed two types of adaptive putters that are useable by golfers of various ages and functional ranges and a removable golf club grip for a player with limited grip strength.
Implementation of a design team for creating adaptive equipment solutions is possible and can be done in the community setting or as part of a hospital system. In the authors’ experience, taking a multidisciplinary team approach allowed developing more innovative and diverse solutions, and the athletes benefited by being able to participate in their desired sports activities.
Factors Associated With Ambulation and Transfer Ability
Authors: Benjamin Nicholas L. , McKernan Gina , Izzo Sara , Crytzer Theresa M. , Clayton Gerald H. , Wilson Pamela E. , Houtrow Amy J. , Dicianno Brad E. 
Published: September 2021

ObjectivesThis study used a spina bifida electronic medical record and the National Spina Bifida Patient Registry to explore the relationship between neurosurgical/orthopedic surgeries and other variables on ambulation and transfer ability over time in individuals with spina bifida.DesignThis study was an analysis of longitudinal data collected within the National Spina Bifida Patient Registry and spina bifida electronic medical record. Logistic regression models were used to determine which variables were associated with ambulation/transfer ability in the myelomeningocele (MMC) and non-MMC populations.ResultsLongitudinal data from 806 individuals were collected. In the MMC group, decreased ambulation ability was associated with higher motor levels, tethered cord releases, spine/scoliosis surgeries, hip orthopedic surgeries, and having supplemental insurance. Increased ambulatory ability was associated with lower motor levels, tibial torsion/related surgeries, ankle/foot surgeries, being female, and being non-Hispanic/Latinx. Decreased transfer ability was associated with being Hispanic/Latinx and having higher motor levels. Lower motor level and ankle/foot surgeries were associated with increased transfer ability. No significant associations were found in the non-MMC group.ConclusionsMotor level is an important predictor of ambulation and transfer ability in MMC. Surgeries distal to the knee were associated with higher levels of function; surgeries proximal to the knee were associated with lower functional levels.
Multifactorial Interventions to Reduce Duration and Variability in Delays to Identification of Serious Injury After Falls in Hospital Inpatients
Authors: Saleem Jawaad , Sarma Dhruv , Wright Hannah , Fisher Kelly , Pinnington Benjamin , Kostas Valandis , Chua Kia-Chong , Sommerville Peter 
Published: September 2021

Objectives
Inpatient falls are the most commonly reported safety incidents and are associated with serious injuries. This study aimed to use multifactorial interventions to reduce the delays to the diagnosis of serious injury in a time series analysis after serious incidents relating to falls within a central London Trust.

Methods
A multiprofessional project team undertook process mapping to identify opportunities for improvement at different stages in the management of a fall. The interventions included an educational teaching session aimed at doctors, a lanyard card designed by doctors using the plan-do-study-act methodology, a falls-specific pager for radiographers, and a new system to refer to portering. Quantitative data were obtained using an serious incident database where serious injury occurred (SI data; n = 65) and routinely collected incident reporting database on falls regardless of injury (IR data; n = 178). Qualitative questionnaire data (n = 70) were also used to evaluate doctors’ confidence in falls assessment before and after interventions.

Results
Results in the IR data demonstrated a significant reduction in the median (interquartile range) minutes delay in the time to review a patient after a fall from 81 (43–180) to 51 (26–112; P = 0.003) and the time to order imaging from 102 (45–370) to 50 (33–96; P = 0.04). Analysis of the SI database demonstrated a nonstatistically significant reduction in the overall time taken to detect serious injury after a fall from 348 (126–756) to 192 (108–384) minutes (P = 0.070). Furthermore, analysis using statistical process control charts showed evidence of special cause variation and a shift in the process in detecting serious harm after a fall. Junior doctors’ confidence in investigations improved from 53% to 76% (P = 0.04) after the intervention.

Conclusions
The cumulative application of multiple interventions with small individual effects resulted in a substantial positive effect on delays and variability in diagnosis of serious harm. Given a similar institutional context, the more effective interventions in our study could be adopted elsewhere.
Development and Validation of an Evaluation Tool of Consumers’ Knowledge and Confidence to Report Patient Deterioration in Hospitals
Authors: King Lindy , Ullah Shahid , Belan Ingrid , Clark Robyn A. , Young Tom , Grantham Hugh , Peacock Guy , Kidd Michael R. 
Published: September 2021

Objectives
Studies have shown that many preventable hospital deaths may be reduced through early reporting of deterioration by patients and their visitors to health professionals. Engagement of patients and families for safer health care was recommended by the World Health Organization. As no validated tool was identified, the objective of the study was to develop and validate a tool to measure the impact of messages contained in self-developed educational materials on consumers’ knowledge and confidence to report patient deterioration.

Methods
A tool was created using consumer-based input. A test-retest methodology was used 2 weeks apart, using 37 participants sourced from consumer groups. Fourteen 5-point Likert scale questionnaire items were categorized into knowledge and confidence components to identify the impact of the materials in both of these areas.

Results
Test-retest reliability confirmed 10 of the 14 proposed questionnaire items (4 knowledge items and 6 confidence) had at least moderate κ agreement ranging from 0.42 to 0.69 and an intraclass correlation coefficient of 0.66. An exploratory factor analysis of the 10 remaining items indicated a 2-factor solution had the best interpretability accounting for 96.9% of variability. The Cronbach α and factor loadings for the factors, knowledge, and confidence suggested an acceptable level of reliability and validity.

Conclusions
The study confirms our tool for assessment of educational materials to be a reliable, context-specific, and validated instrument. The tool is an appropriate instrument to assess the effectiveness of educational materials in public awareness campaigns that focus on consumer reporting of patient deterioration within hospitals.
FDG PET/CT in Isolated Thoracic Vertebral Rosai-Dorfman Disease
Authors: Zhao Qian , Bai Yushu , Dong Aisheng , Zuo Changjing 
Published: September 2021

Abstract
Isolated osseous Rosai-Dorfman disease is rare. We describe FDG PET/CT findings of solitary thoracic vertebral Rosai-Dorfman disease without extraosseous involvement. The vertebral lesion caused osteolytic destruction of the vertebral body and showed intense FDG uptake.