bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Practice Survey of Repeat Endoscopy in Pediatric Inflammatory Bowel Disease in North America
Authors: Moses Jonathan , Sandberg Kelly , Winberry Gabriel , Riera Diana , DeLozier Sarah , Gupta Sandeep K. , Reilly Norelle , Park KT , Picoraro Joseph 
Published: February 2021

ABSTRACTObjectives:Endoscopic remission has become a standard treatment target in inflammatory bowel disease (IBD). It is unclear how widely this practice has been adopted amongst pediatric gastroenterology providers. This study determines the frequency of repeat endoscopy in pediatric IBD and evaluates for predictive baseline characteristics of providers.Methods:We developed a cross‐sectional survey, which was distributed via 3 national email listservs to pediatric gastroenterology providers. We obtained baseline characteristics of respondents and assessed motivations and barriers for the practice of repeat endoscopy compared with none.Results:Two hundred and thirty‐eight unique respondents completed the online survey. Response rate was 11% (238 of 2300 possible participants). The majority practice in an academic setting (77%) and reported participation in ImproveCareNow (63%). Overall, 65% of respondents perform repeat endoscopy to assess for endoscopic remission in pediatric IBD as part of routine clinical practice. Fifty‐six percent reported repeat endoscopy as individuals in the absence of a departmental protocol. “Symptoms are not sufficient to follow IBD patients” was reported by 82% of those who repeat endoscopy; conversely, “I perform endoscopy based on clinical, biomarker, and/or imaging trends” was reported by 81% of those who do not repeat endoscopy. The establishment of a pediatric‐specific guideline was most commonly reported to change current practice, based on rank‐order scoring.Conclusions:A majority of representative providers repeat endoscopy to assess for endoscopic remission in pediatric IBD. Fewer years in practice favored repeating endoscopy. The need for North American pediatric guidelines with pediatric‐specific evidence to support the long‐term benefits of endoscopic remission are highlighted in this study.
Knowledge and Attitudes of Maternity Nurses and Ancillary Team Members about Substance Addiction during Pregnancy and Postpartum
Authors: Munoz Katrina , Suchy Carol , Rutledge Dana N. 
Published: February 2021

Abstract

Objective:
To describe knowledge and attitudes of maternity nurses and other ancillary direct caregivers about addictive substance use by pregnant women and new mothers and to evaluate their perceptions of role preparation, resources available, and educational needs.

Study Design & Methods:
We surveyed maternity nurses and ancillary members of the maternity care team to assess knowledge and attitudes about caring for women with addictive substance use. Data were analyzed using descriptive, parametric, and nonparametric statistics.

Results:
Respondents (N = 109) from a southwestern Magnet community hospital were 100% female, predominantly nurses (89%), and worked mostly on mother–baby or labor and delivery units. They had high average knowledge scores and most had positive attitudes. When asked about preparation to care for pregnant women and new mothers with addictive substance use, some perceived that they were not able to carry out their role due to lack of knowledge.

Clinical Implications:
Findings suggest most maternity nurses have the knowledge and skills they believe are needed to care for women who use addictive substances during pregnancy and postpartum. Most have positive attitudes, but approximately one third may need interventions to encourage and further support empathy and acceptance. Education and skill-building for maternity nurses and other team members related to caring for women using addictive substances may be worth consideration; however, there is minimal evidence of their efficacy. Evaluations of these types of programs are needed in maternity settings.
Differential Association of Spirituality and Religiosity With Rumination
Authors: Saunders David , Svob Connie , Pan Lifang , Abraham Eyal , Posner Jonathan , Weissman Myrna , Wickramaratne Priya 
Published: February 2021

Abstract
Recent studies have shown that religiosity (R) is associated with lower rates of depression, whereas spirituality (S) is associated with higher rates. Rumination has also been associated with higher rates of depression. Some have hypothesized that rumination mediates the differential association of religiosity and spirituality with depression. We empirically test this hypothesis in a longitudinal, multigenerational sample through associations between rumination and depression, R/S and depression, and R/S and rumination. Cross-sectionally, total rumination scores were predicted by spirituality (standardized β = 0.13; 95% confidence interval [CI], 0.00–0.26), with subscale (reflection, depression, and brooding) standardized betas ranging from 0.11 to 0.15 (95% CI, −0.03 to –0.29). Cross-sectionally, rumination was not predicted by religiosity. Longitudinally, and consistent with previous findings, religiosity, but not spirituality, predicted reduced depressive symptoms (standardized β = −0.3; 95% CI, −0.58 to −0.01). The association between spirituality and rumination was driven by millennials. Psychotherapies that target rumination for depression might therefore be especially effective in the millennial demographic.
Association Between Attachment Patterns and Personality Disorders
Authors: Nakash Ora , Nagar Maayan , Razon Liat , Westen Drew 
Published: February 2021

Abstract
We investigated the association between personality disorders (PDs) and attachment patterns, and examined the construct validity of attachment patterns against adaptive functioning. We used a multimeasure multi-informant approach, which allowed us to disentangle the effects of the methods and to examine the utility of the various methods for measuring these constructs. The participants included 80 clinicians and 170 clinical outpatients, recruited via convenience sampling. Results showed that secure attachment was positively associated with adaptive functioning, whereas insecure patterns were negatively associated with adaptive functioning. Both categorical and dimensional PD diagnoses were associated with insecure attachment patterns. However, after controlling for comorbidity among the PD diagnoses, only some findings remained significant, most notably the association between borderline PD and the clinicians' assessment of preoccupied and incoherent/disorganized attachment, and the patients' self-reported attachment anxiety. Our findings underscore the importance of controlling for comorbidity in examining the associations between attachment patterns and PDs.
Generalized Anxiety Disorder During the COVID-19 Outbreak in Iran
Authors: Zakeri Mohammad Ali , Hossini Rafsanjanipoor Sayed Mortaza , Kahnooji Mahmood , Ghaedi Heidari Fatemeh , Dehghan Mahlagha 
Published: February 2021

Abstract
The COVID-19 epidemic has both physical and psychosocial consequences for the general population. The present study aimed to investigate the relationship between the prevalence of generalized anxiety disorder (GAD) and social dysfunction during the COVID-19 epidemic in Iran. This cross-sectional web-based study was conducted on 1000 Rafsanjani citizens in southeastern Iran. Data were collected by using the Generalized Anxiety Disorder-7 and the General Health Questionnaire from March 15 to March 30, 2020. The prevalence of GAD was 27.8%. The mean score of social functioning was 9.71 ± 2.66, and all participants had social dysfunction. Multivariate logistic regression test showed a significant correlation between anxiety and social functioning (confidence interval [CI], 1.16–1.30; p < 0.001), sex (CI, 1.49–3.04; p < 0.001), and concern about COVID-19 (CI, 1.38–2.73; p < 0.001). The COVID-19 epidemic had negative psychosocial consequences in the general population in Iran.
Poor Sleep Predicts Increased Pain Perception Among Adults With Mild Cognitive Impairment
Authors: Bowen Mary Elizabeth , Ji Xiaopeng , Griffioen Mari A. 
Published: February 2021

Background
Older adults with mild cognitive impairment are at an increased risk for dementia of the Alzheimer’s type. These older adults also report poorer sleep and more pain than their cognitively intact adult counterparts. Poor sleep and pain are both symptoms associated with an increased risk for dementia in later life. Symptom science research in the direction of how poor sleep affects pain among older adults, especially those with mild cognitive impairment, is needed for the development of targeted sleep interventions to reduce pain and potentially delay/reduce the risk for Alzheimer’s disease in this population.

Objective
The aim of the study was to examine a predictive model of the relationship between poor sleep and pain perception among community-dwelling older adults with mild cognitive impairment.

Methods
A longitudinal prospective design with 58 continuous matched sleep–pain observations of 15 older adults with mild cognitive impairment for up to 6 months was used. Multilevel, mixed-modeling, statistical techniques were used to examine the effects of prior-week sleep on subsequent pain perception. Pain perception (pain intensity, pain interference, and pain behavior) is measured by the Patient-Reported Outcomes Measurement Information System during monthly in-person visits. The ActiGraph GT3X+ was used to measure sleep (total sleep time, sleep efficiency, awakenings after sleep onset) objectively and continuously for up to 6 months, along with other covariates (e.g., physical activity).

Results
Increased awakenings after sleep onset in the prior week is associated with increased pain intensity, pain interference, and pain behavior. There was a trend toward sleep efficiency, and increased pain intensity and sleep efficiency predicted increased pain interference and pain behavior. There was no relationship between prior-week total sleep time and subsequent pain perception.

Discussion
In this study, poor sleep in the prior week increased pain intensity, pain interference, and pain behavior. Interventions designed to decrease awakening after sleep onset and increase sleep efficiency specifically may effectively reduce pain in this population. Given that these symptoms are prevalent among older adults with mild cognitive impairment, sleep and pain interventions may also ameliorate some of the risk for Alzheimer’s disease in this population.
Polytrauma: update on basic science and clinical evidence
Authors: Nauth Aaron , Hildebrand Frank , Vallier Heather , Moore Timothy , Leenen Luke , Mckinley Todd , Pape Hans-Christoph 
Published: February 2021

Abstract
The management of multiply injured or severely injured patients is a complex and dynamic process. Timely and safe fracture fixation is a critical component of the multidisciplinary care that these patients require. Effective management of these patients, and their orthopaedic injuries, requires a strong understanding of the pathophysiology of the response to trauma and indicators of patient status, as well as an appreciation for the dynamic nature of these parameters. Substantial progress in both clinical and basic science research in this area has advanced our understanding of these concepts and our approach to management of the polytraumatized patient. This article summarizes a symposium on this topic that was presented by an international panel of experts at the 2020 Virtual Annual Meeting of the Orthopaedic Trauma Association.
Case Report: Endogenous Candida Endophthalmitis in Cornelia de Lange Syndrome: Atypical Stellate Neuroretinitis
Authors: El Hamichi Sophia , Kon Graversen Veronica , Gold Aaron S. , Berrocal Audina M. , Murray Timothy G. 
Published: February 2021

SIGNIFICANCE
This study aimed to highlight the association of stellate neuroretinitis occurring secondary to endogenous candidemia.

PURPOSE
We report an unusual presentation of endogenous Candida endophthalmitis as a stellate neuroretinitis in the setting of Cornelia de Lange syndrome.

CASE REPORT
A 34-month-old girl with severe Cornelia de Lange syndrome and a history of parenteral nutrition dependence requiring a chronic central venous catheter presented with bilateral endophthalmitis secondary to candidemia. In one eye, the endophthalmitis had the atypical presentation as a stellate neuroretinitis.

CONCLUSIONS
This case represents a unique association of stellate neuroretinitis secondary to Candida infection in a patient with Cornelia de Lange syndrome.
Case Report: Focal Choroidal Excavation: Conversion from Conforming to Nonconforming in a Pregnant Female
Authors: Bhakhri Raman , Yacoub Robert , Patel Reena 
Published: February 2021

ABSTRACT

SIGNIFICANCE
Although rarely seen, clinicians should closely monitor patients, especially pregnant patients with focal choroidal excavation (FCE), as it can convert between subtypes and has been linked to pachychoroidal disease and potential for vision loss.

PURPOSE
This study aimed to report a case of the conversion of conforming FCE to nonconforming FCE with spontaneous resolution in a pregnant female.

CASE REPORT
A 35-year-old Indian woman presented with a slightly decreased vision in the right eye. The patient was 3 months pregnant at this visit. Her ocular history included stable conforming FCE in both eyes that was diagnosed 1 year earlier. Retinal pigmentary changes were noted in both eyes and consistent with previous examinations as being conforming FCEs in both eyes. Optical coherence tomography through the pigmented changes revealed FCE in the right eye with overlying serous fluid, with the left eye showing stable conforming FCE. She was diagnosed with a nonconforming FCE in the right eye secondary to her pregnancy. She was monitored with subsequent visits showing spontaneous resolution of the fluid and conversion back to a conforming FCE.

CONCLUSIONS
This case highlights the conversion of a conforming FCE to a nonconforming FCE with spontaneous resolution in a pregnant female. Similarities are seen in terms of pathophysiology with central serous chorioretinopathy, a fellow pachychoroidal disease, which also has pregnancy as a risk factor. Risk factors in pregnant patients such as increased cortisol and increased ocular blood flow may play an important part in the pathophysiology of the conditions, as they both result in choroidal hyperpermeability. Frequent monitoring and follow-up times are suggested for the patients. Lifelong monitoring is also indicated, as reoccurrences have been reported. Further research is needed at this time to elucidate the exact etiology of FCE and conversions between conforming and nonconforming FCE.
Relationship of Sighting Ocular Dominance with Macular Photostress Test Time and Thickness of the Middle Macular Layers
Authors: Pekel Gökhan , Akbulut Selen , Pekel Evre , Çetin Ebru Nevin 
Published: February 2021

SIGNIFICANCE
The mechanisms of sighting ocular dominance, which is particularly important in monovision therapies and sports vision, are not fully understood yet. Whether the macula affects ocular dominance or ocular dominance affects the macula is also a subject of interest.

PURPOSE
The aim of this study was to investigate the relationship of sighting ocular dominance with macular photostress test time and middle macular layer thickness.

METHODS
One-hundred eyes of 50 healthy adult volunteers were included in this cross-sectional study. Sighting eye dominance was decided by a hole-in-the-card test. The macular photostress test was performed by exposing the eye to the ophthalmoscope light for 10 seconds and measuring the time taken to return to visual acuity within one row of pre-light exposure acuity. The spectral-domain optical coherence tomography examinations were performed to measure thickness of middle macular layers (i.e., outer nuclear, outer plexiform, inner nuclear, and inner plexiform). Refractive error and intraocular pressure (IOP) measurements were also recorded.

RESULTS
The comparison of dominant and nondominant eyes in the aspect of refractive error, IOP, and macular photostress test time did not show statistically significant differences (P > .05). The thicknesses of macular outer nuclear, outer plexiform, inner nuclear, and inner plexiform layers were similar in the dominant and nondominant eyes (P > .05). In addition, macular photostress time was not statistically significantly correlated with the thickness of middle macular layers (P > .05).

CONCLUSIONS
The thickness of middle macular layers and macular photostress recovery time are similar in dominant and nondominant eyes.
When Clinical Diagnosis Differs From Advanced Imaging
Authors: Kitei Paul M. , Bresnahan James J. , Surrey David E. , Simon Jeremy I. 
Published: February 2021

Abstract
Radiculopathy is diagnosed using a combination of history, physical examination, and imaging. Unfortunately, well-established dermatomal and myotomal maps are an oversimplification of the convoluted nature of spinal sensory and motor innervation. When clinical presentation and imaging seemingly contradict one another, it is important to consider variant innervation patterns. This article presents three patients with objective dermatomal and/or myotomal deficits due to disc herniations whose clinical presentations are “textbook” for nerve root pathology that is adjacent to the nerve root that is actually compromised. In addition, the literature is reviewed to discuss the history of dermatomal and myotomal maps, the effectiveness of a clinician’s ability to determine the precise pathologic disc and nerve root level in patients presenting with radiculopathy, and anatomical explanations as to why inconsistencies such as those seen in the patients in these cases exist.
Exploring the Underlying Mechanisms of Action of Dry Needling
Authors: De Meulemeester Kayleigh , Calders Patrick , Cagnie Barbara 
Published: February 2021

ObjectiveDry needling is a commonly used treatment technique for myofascial pain syndromes, such as trapezius myalgia. Despite the shown positive clinical effects on pain, the underlying mechanisms of action, such as the effect on muscle electrophysiology, remain unclear. The aim of this study was to investigate the effect of dry needling, compared with sham needling, in the upper trapezius muscle on surface electromyography activity and the relation with pain in office workers with trapezius myalgia.DesignFor this experimental randomized controlled trial, 43 office workers with work-related trapezius myalgia were included. Surface electromyography activity was measured before and after a pain-provoking computer task and immediately after, 15, and 30 mins after treatment with dry or sham needling. Pain scores were evaluated at the same time points as well as 1, 2, and 7 days after treatment.ResultsNo significant differences in surface electromyography activity between dry needling and sham needling were found. Significant positive low to moderate Spearman correlations were found between surface electromyography activity and pain levels after dry needling treatment.ConclusionsThis study shows no immediate effects of dry needling on the electrophysiology of the upper trapezius muscle, compared with sham needling.
Enhanced Home Care Interventions for Community Residing Adults Compared With Usual Care on Health and Cost-effectiveness Outcomes
Authors: Flemming Julie , Armijo-Olivo Susan , Dennett Liz , Lapointe Paul , Robertson David , Wang Jian , Ohinmaa Arto 
Published: February 2021

Abstract
The need for home care services is expanding around the world with increased attention to the resources required to produce them. To assist decision making, there is a need to assess the cost-effectiveness of alternative programs within home care. Electronic searches were performed in five databases (before February 2020) identifying 3292 potentially relevant studies that assessed new or enhanced home care interventions compared with usual care for adults with an accompanying economic evaluation. From these, 133 articles were selected for full-text screening; 17 met the inclusion criteria and were analyzed. Six main areas of research were identified including the following: alternative nursing care (n = 4), interdisciplinary care coordination (n = 4), fall prevention (n = 4), telemedicine/remote monitoring (n = 2), restorative/reablement care (n = 2), and one multifactorial undernutrition intervention study. Risk of bias was found to be high/weak (n = 7) or have some concerns/moderate (n = 6) rating, in addition to inconsistent reporting of important information required for economic evaluations. Both health and cost outcomes had mixed results. Cost-effective interventions were found in two areas including alternative nursing care and reablement/restorative care. Clinicians and decision makers are encouraged to carefully evaluate the quality of the studies because of issues with risk of bias and incomplete reporting of economic outcomes.
Time Since Lower-Limb Amputation
Authors: Seth Mayank , Beisheim Emma Haldane , Pohlig Ryan Todd , Horne John Robert , Sarlo Frank Bernard , Sions Jaclyn Megan 
Published: February 2021

Objective
The aim of this study was to evaluate associations between time since amputation (TSAmp) and mobility outcomes of adults with lower-limb amputation.

Design
A secondary analysis of a cross-sectional dataset, including 109 community-dwelling adults, 1 yr or more after unilateral transfemoral (n = 39; mean age, 54 ± 15 yrs) or transtibial (n = 70; mean age = 58 ± 14 yrs) amputation, was conducted. Participants attended standardized clinical evaluations and completed mobility-related outcome measures: Prosthesis Evaluation Questionnaire–Mobility Subscale, timed up and go, 10-m walk test, and 6-min walk test.

Results
After controlling for age, sex, amputation level, and etiology, TSAmp was significantly associated with each mobility outcome. Prosthesis Evaluation Questionnaire–Mobility Subscale and TSAmp were linearly associated, with TSAmp explaining 10.6% of the overall variance. Timed up and go test time and TSAmp were linearly associated, with TSAmp and an interaction term (LevelxTSAmp) explaining 8.4% of the overall variance; 10-m walk test speed and 6-min walk test distance had nonlinear associations with TSAmp, with TSAmp and nonlinear terms (TSAmp2) explaining 12.1% and 13.2% of the overall variance, respectively.

Conclusions
Based on the findings, longer TSAmp may be associated with better Prosthesis Evaluation Questionnaire–Mobility Subscale score and timed up and go test time, whereas longer TSAmp may be associated with better or worse 10-m walk test speed and 6-min walk test distance depending upon time elapsed since lower-limb amputation. Estimations of postamputation mobility among adults with lower-limb amputation should consider TSAmp.