bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Modified Septal Extension Grafts on the Nasal Tip in Rhinoplasty
Authors: El Badawy Yasser , El Saloussy Yasmeen 
Published: October 2021

Background:
One of the faced difficulties of nasal tip surgery is progressive loss of nasal tip projection and rotation postoperatively. Nasal base stabilization by septal extension grafts has shown to improve this loss over time. The aim of this study was to demonstrate that a modified septal extension graft can provide the required tip rotation/derotation by changing the angle of the graft’s insertion. In addition, it maintains nasal tip projection without creating a rigid tip. Other than that it avoids the requirement of a large amount of cartilage.

Materials/Methods:
This study involves a retrospective review of 37 patients who underwent open rhinoplasty for primary or secondary cases over a period of 12 months. The average age of the patients was 28 years (range = 20–43 years), and all patients were of Middle Eastern origin. Subjective evaluation based on photographic analysis was used pre and postoperatively.

Results:
All cases included in this study maintained their operative results of tip rotation. Two cases showed a minimal decrease in tip projection documented upon review 6–12 months postoperatively. No patient needed secondary revision surgery due to changes in tip projection or rotation. The objective pre and postoperative findings were satisfying for the patients and surgeons.

Conclusions:
The modified septal extension graft is an effective tool for rotation of the nasal tip as well as derotation of an over rotated tip. It is also capable of maintaining nasal tip projection.
Effect of Cardiac Rehabilitation on Glomerular Filtration Rate Using Serum Cystatin C Concentration in Patients With Cardiovascular Disease and Renal Dysfunction
Authors: Hama Tomoaki , Ushijima Akiko , Goto Tadahiro , Nagamatsu Hirofumi , Morita Norishige , Yoshimachi Fuminobu , Ikari Yuji , Kobayashi Yoshinori 
Published: October 2021

Purpose:
Among patients with chronic kidney disease (CKD), little is known about whether the effect of cardiac rehabilitation (CR) on renal function differs across baseline estimated glomerular filtration rate using the serum concentration of cystatin C (eGFRcys). The aim of this study was to evaluate the effect of CR on renal function in patients with CKD.

Methods:
We performed a retrospective cohort study of patients with CKD (15 ≤ eGFRcys < 60 mL/min/1.73 m2) who participated in our CR program for cardiovascular disease. First, the patients were divided into three groups according to the baseline severity of the eGFRcys: G3a, G3b, and G4 groups. We compared the eGFRcys before and after the CR in each group. Second, to determine the association of baseline eGFRcys with the effect of CR, we fitted a linear regression model using the percent change in the eGFRcys (%ΔeGFRcys) as an outcome.

Results:
Of the 203 patients, 122 were in G3a, 60 were in G3b, and 21 were in G4 groups. The mean improvement of eGFRcys in each group was 1.3, 3.1, and 4.8 mL/min/1.73 m2, respectively. The %ΔeGFRcys was larger among patients with lower baseline eGFRcys (0.47% greater improvement of %ΔeGFRcys/one lower baseline eGFRcys; 95% CI, 0.23-0.72%). This association remained significant after adjustment for potential confounders (0.63% greater improvement of %ΔeGFRcys/one lower baseline eGFRcys; 95% CI, 0.35-0.91%).

Conclusions:
The effect of CR on renal function was greater in patients with worse renal dysfunction measured by eGFRcys. A CR program could be useful for patients with severe renal dysfunction and it might have a beneficial effect on their renal function.
STARDUST SIGN AND RETINAL TEAR DETECTION ON SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY
Authors: Itakura Hirotaka , Itakura Mariko , Sato Taku 
Published: October 2021

Purpose:
The causes of floaters include posterior vitreous detachment and fundus hemorrhage, both of which are risk factors for retinal tears. We observed the vitreous of patients with floaters using swept source optical coherence tomography.

Methods:
Fundus examination was performed, and the vitreous was observed using swept source optical coherence tomography in 202 eyes of 202 patients with floaters. Patients with uveitis, diabetic retinopathy, and other fundus diseases were excluded.

Results:
Swept source optical coherence tomography revealed posterior vitreous detachment in 145 of 202 eyes (71.8%) and dot reflex like stardust in the vitreous in 42 of 202 eyes (20.8%). Posterior vitreous detachment occurred in 35 of 42 eyes (83.3%) and 110 of 160 eyes (68.8%) in the stardust (+) and stardust (−) groups, respectively; a significant difference was observed (P <0.001). In the stardust (+) group, 11 of 42 eyes (26.2%) had retinal tears with posterior vitreous detachment and 21 of 42 eyes (50.0%) had fundus hemorrhage. Three of 160 eyes (1.9%) and 4 of 160 eyes (2.5%) in the stardust (−) group had retinal tears with posterior vitreous detachment and fundus hemorrhage, respectively. Both tears and fundus hemorrhage were more frequent in the stardust (+) group than in the stardust (−) group (P <0.001).

Conclusion:
The stardust sign on swept source optical coherence tomography indicates the risk of retinal tear.
Topical Medication Adherence and Visual Field Progression in Open-angle Glaucoma: Analysis of a Large US Health Care System
Authors: Shu Yu-Hsiang , Wu Jun , Luong Tiffany , Mattox Cynthia , Fang Ervin N. , Lee Brian L. , Jones Jason P. , Campbell Joanna , Shih Vanessa , Zhao Changgeng , Fong Donald S. 
Published: October 2021

Précis:
Modeling of visual field and pharmacy data (Kaiser Permanente, 2001 to 2014) from open-angle/pseudoexfoliation glaucoma patients in clinical practice indicated a significant inverse association between the level of medication adherence and rate of visual field progression.

Purpose:
The aim was to quantify the effect of nonadherence to topical hypotensive medication on glaucomatous visual field progression in clinical practice.

Methods:
Retrospective analysis of combined visual field and pharmacy data from Kaiser Permanente Southern California’s HealthConnect electronic health record database. Patients with a diagnosis of primary open-angle glaucoma or pseudoexfoliation glaucoma (2001 to 2011) and ≥3 subsequent visual field tests of the same Swedish Interactive Threshold Algorithm type were followed up from first medication fill to final visual field test. Medication adherence (proportion of days covered) was estimated from pharmacy refill data. A conditional growth model was used to estimate the effect of adherence level in modifying the progression of mean deviation over time after adjusting for potential confounders, including age, sex, race/ethnicity, baseline glaucoma severity, and comorbidity.

Results:
In total, 6343 eligible patients were included in the study and followed for (mean) 5.8 years; average treatment adherence during follow-up was 73%. After controlling for confounders and the interaction between time and baseline disease severity, the model indicated that mean deviation progression was significantly (P=0.006) reduced by 0.006 dB per year for each 10% (absolute) increase in adherence. Model estimates of time to glaucoma progression (mean deviation change −3 dB from baseline) were 8.3 and 9.3 years for patients with adherence levels of 20% and 80%, respectively.

Conclusions:
Improving patient adherence to topical glaucoma medication may result in slower deterioration in visual function over time.
Resting-state occipital alpha power is associated with treatment outcome in patients with chronic migraine
Authors: Pan Li-Ling Hope , Chen Wei-Ta , Wang Yen-Feng , Chen Shih-Pin , Lai Kuan-Lin , Liu Hung-Yu , Hsiao Fu-Jung , Wang Shuu-Jiun 
Published: October 2021

Abstract
Preventive treatment is crucial for patients with chronic migraine (CM). This study explored the association between resting-state cortical oscillations and 3-month treatment outcome in patients with CM. Treatment-naïve patients with CM were recruited with their demographic data, psychosocial data, and headache profiles as well as the healthy controls (HCs). Resting-state cortical activities were recorded using an electroencephalogram and analysed using source-based and electrode-based spectral power method. The regions of interest were the bilateral primary somatosensory (S1) and visual (V1) cortices. After 3-month treatment with flunarizine, patients with CM were categorized into responders and nonresponders. Demographic, clinical, and electroencephalogram data from 72 patients with CM and 50 HCs were analysed. Elevated anxiety, depression, and stress were observed in patients with CM. Theta power in bilateral S1 and alpha and gamma powers in the right S1 increased in patients with CM. Nonresponders (n = 34) exhibited larger alpha powers in bilateral V1 than those in responders (n = 38). Alpha powers also exhibited significant correlations with changes of monthly headache days. Notably, in responders and nonresponders, occipital alpha powers did not differ at baseline and in the third month. In conclusion, patients with CM who were not responsive to preventive treatment were associated with augmented resting-state occipital alpha activity. Moreover, changes in migraine attack frequency were associated with baseline occipital alpha power. However, the prognostic feature of visual alpha oscillation seems to be inherent because it is not altered by flunarizine treatment. These findings may be useful for developing personalised migraine treatment plans.
Antipsychotic-Related Fatal Poisoning, England and Wales, 1993–2019
Authors: Handley Simon Alfred , Every-Palmer Susanna , Flanagan Robert James 
Published: October 2021

Abstract

Background
Deaths from antipsychotic (AP) poisoning have increased in England and Wales despite restriction of the use of thioridazine in 2000.

Methods
We analyzed data from the Office for National Statistics drug-related death database, England and Wales, 1993–2019, to investigate fatal AP poisoning.

Results
There were 2286 deaths (62% male patients). Annual numbers of intentional AP-related fatal poisonings (suicides) were relatively stable (1993, 35; 2019, 44; median, 44; range, 30–60). Intentional overdose deaths involving clozapine (96 male, 25 female) increased from 1 in 1994 to 5 in 2003 and have since remained relatively constant (median, 6; range, 3–10 per annum). Unintentional second-generation AP-related fatal poisonings have increased steadily since 1998, featuring in 828 (74%) of all unintentional, AP-related fatal poisonings in the period studied (2019, 89%). There were 181 unintentional clozapine-related deaths, (107 [59%] alone without other drugs ± alcohol) as compared with 291 quetiapine-related deaths (86 [30%] alone without other drugs ± alcohol) and 314 unintentional olanzapine-related deaths (77 [25%] alone without other drugs ± alcohol). Some 75% of all unintentional clozapine- and olanzapine-related deaths were of male patients (78% and 73%, respectively) as compared with 58% of unintentional quetiapine-related fatal poisonings. Clozapine now features prominently in intentional and in unintentional AP-related fatal poisoning in England and Wales. Deaths of male patients predominate in both categories. There were also 77 and 86 deaths attributed to unintentional poisoning with olanzapine and with quetiapine, respectively, in the absence of other drugs.

Conclusions
More effort is needed to prevent unintentional deaths not only from clozapine but also from olanzapine and quetiapine.
Guidelines for the Diagnosis and Treatment of Rosacea in China (2021 Edition)#
Authors: Gu Heng , Hao Fei , He Wei , Jian Dan , Jian Zhe , Jiang Xian , Ju Qiang , Kang Xiao-Jing , Lai Wei , Li Heng-Jin , Li Ji , Li Tie-Nan , Lin Xin-Yu , Liu Wei , Tao Xiao-Hua , Wang Ben , Xie Hong-Fu , Xu Hong-Hui , Xu Yang , Yan Shu-Xian , Yang Jie , Yu Bo 
Published: October 2021

Abstract
Rosacea is a chronic inflammatory skin disease that primarily affects the centrofacial areas and mainly manifests as recurrent flushing and erythema. In recent years, there has been progress in the understanding of the diagnosis and treatment of rosacea. Therefore, a group of dermatological experts updated the guidelines based on the 2016 expert consensus statement on rosacea diagnosis and treatment in China. These new guidelines propose diagnostic criteria for rosacea at different sites to further standardize the diagnosis and treatment of rosacea in China.
The Forensic Nurse's Evolving Role in Addressing Elder Maltreatment in the United States
Authors: Carney Amy 
Published: October 2021

ABSTRACT
U.S. forensic nurses' specialization in elder maltreatment has evolved over the last 30 years. Significant progress in research has led to the ability to define and respond to elder abuse. This article describes the foundation for a specialization in nursing that led to inter vention in abuse and neglect, historical milestones as steps to elder justice, and the evolution of forensic nurse practice with senior victims of abuse.
Effects of Professional Autonomy and Leadership Style on the Team-Based Practice of Acute Care Nurse Practitioners in Taiwan
Authors: HSU Hsiu-Ying , TUNG Heng-Hsin , KAU Kevin , HUANG Sheng-Shiung , TSAY Shiow-Luan 
Published: October 2021

ABSTRACT

Background
Little is known regarding the factors that affect the team-based practice of nurse practitioners (NPs). Examining the relationships between these factors and team-based practice may provide important insights into the strength of the NP practice.

Purpose
This study was designed to examine the effects of practice autonomy and leadership style on the team-based practice of acute care NPs working in hospitals.

Methods
A cross-sectional, national survey design was conducted to examine the autonomy, leadership, and team-based practice of NPs. One thousand three hundred ninety-one NPs completed the questionnaire, which included demographic and practice variables, the Dempster Practice Behavior Scale, the Multifactor Leadership Questionnaire, and the NP–physician relations subscale of the Nurse Practitioner Primary Care Organizational Climate Questionnaire. The hierarchical linear model was used to differentiate between the NP-level and organization-level effects on team-based practice. Multiple regression was applied to explore the factors associated with team-based practice.

Results
The hierarchical linear model results identified no organization-level effect on team-based practice. Moreover, the results of the regression model found that NPs with greater autonomy in actualization, empowerment and readiness, and idealized influence leadership style enhanced the performance of the doctor of medicine–NP team-based practice. The final model explained 39% of the variance in doctor of medicine–NP team-based practice. Autonomy in actualization and empowerment were identified as the two most important predictors.

Conclusions/Implications for Practice
The practice autonomy and leadership style of NPs influence the efficiency of team-based practice in Taiwan. To improve the team-based practice of NPs, healthcare administrators must support the practice autonomy of NPs.
An Interrupted Time-series Evaluation of the Association Between State Laws Mandating Prescriber Use of Prescription Drug Monitoring Programs and Discontinuation of Chronic Opioid Therapy in US Veterans
Authors: Arnold Jonathan , Zhao Xinhua , Cashy John P. , Sileanu Florentina E. , Mor Maria K. , Moyo Patience , Thorpe Carolyn T. , Good Chester B. , Radomski Thomas R. , Fine Michael J. , Gellad Walid F. 
Published: October 2021

Background:
Most states have recently passed laws requiring prescribers to use prescription drug monitoring programs (PDMPs) before prescribing opioid medications. The impact of these mandates on discontinuing chronic opioid therapy among Veterans managed in the Veterans Health Administration (VA) is unknown. We assess the association between the earliest of these laws and discontinuation of chronic opioid therapy in Veterans receiving VA health care.

Methods:
We conducted a comparative interrupted time-series study in the 5 states mandating PDMP use before August 2013 (Ohio, West Virginia, Kentucky, New Mexico, and Tennessee), adjusting for trends in the 17 neighboring control states without such mandates. We modeled 25 months of prescribing for each state centered on the month the mandate became effective. We included Veterans prescribed long-term outpatient opioid therapy (305 of the preceding 365 d). Our outcomes were discontinuation of chronic opioid therapy (primary outcome) and the average daily quantity of opioids per Veteran over the following 6 months (secondary outcome).

Results:
We included 250 monthly cohorts with 225,665 unique Veterans and 3.4 million Veteran-months. Baseline discontinuation rates before the PDMP mandates were 0.4%–2.7% per month. Kentucky saw a discontinuation increase of 1 absolute percentage point following its PDMP mandate which decreased over time. The other 4 states had no significant association between their mandates and change in opioid discontinuation. There was no evidence of decreasing opioid quantities following PDMP mandates.

Conclusion:
We did not find consistent evidence that state laws mandating provider PDMP use were associated with the discontinuation of chronic opioid therapy within the VA for the time period studied.
Impact of 18F-fluciclovine PET/CT on salvage radiotherapy plans for men with recurrence of prostate cancer postradical prostatectomy
Authors: Payne Heather , Bomanji Jamshed , Bottomley David , Scarsbrook Andrew F. , Teoh Eugene J. ,   on behalf of the FALCON study group
Published: October 2021

Objectives
Imaging options to localize biochemical recurrence (BCR) of prostate cancer after radical prostatectomy (RP) are limited, especially at low prostate-specific antigen (PSA) levels. The FALCON study evaluated the impact of 18F-fluciclovine PET/CT on management plans for patients with BCR. Here, we evaluate salvage radiotherapy decisions in patients post-RP.

Methods
We conducted a subgroup analysis of post-RP patients enrolled in FALCON who had a prescan plan for salvage radiotherapy (± androgen-deprivation therapy). Patients’ treatment plans post-18F-fluciclovine PET/CT were compared with their prescan plans. Fisher exact test was used to determine the impact of PSA and Gleason sum on positivity and anatomical patterns of uptake.

Results
Sixty-five (63%) FALCON patients had undergone RP. Of these, 62 (median PSA, 0.32 ng/mL) had a prescan plan for salvage radiotherapy. Twenty-one (34%) had 18F-fluciclovine-avid lesions. Disease was confined to the prostate bed in 11 patients (52%) and to the pelvis in a further 5 (24%), while 5 (24%) had extrapelvic findings. Trends towards more disseminated disease with increasing PSA or Gleason sum were observed but did not reach statistical significance. Postscan, 25 (40%) patients had a management change; 17 (68%) were changed to the treatment modality (8 to systemic therapy, 8 to active surveillance, 1 other) and 8 (32%) were radiotherapy field modifications.

Conclusions
Incorporating 18F-fluciclovine PET/CT into treatment planning may help identify patients suitable for salvage radiotherapy, help augment planned radiotherapy to better target lesions and support the clinician to optimise patient management.
Effectiveness of Immersive Virtual Reality in Nursing Education
Authors: Choi Jeeyae , Thompson C Elise , Choi Jeungok , Waddill Colette B. , Choi Soyoung 
Published: October 2021

Background:
Digital education using immersive virtual reality (VR) technology is available in nursing. Evidence of its effectiveness is essential.

Purpose:
This review analyzed the effectiveness of and barriers to using immersive VR in nursing education.

Methods:
A structured search was performed in PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, PsycINFO, Web of Science, and ProQuest Nursing & Allied Health Database. The Medical Education Research Study Quality Instrument was used to assess the quality of studies.

Results:
The final review was composed of 9 studies of moderate to high quality published between 2018 and 2020. The review indicated that immersive VR increased learning, cognitive, and psychomotor performance. Most participants of the studies preferred using immersive VR in education and with a variety of experiential scenarios. Barriers were associated with technological hardware and software (eg, simulation sickness, lack of visual comfort).

Conclusion:
The review supports the viability of immersive VR technology in nursing education.
Experiences of Home Care Nurses During the COVID-19 Pandemic
Authors: Ruíz-Fernández María Dolores , Fernández-Medina Isabel María , Gálvez Ramírez Felisa , Granero-Molina José , Fernández-Sola Cayetano , Hernández-Padilla José Manuel 
Published: October 2021

Background
The COVID-19 pandemic has provoked several changes in home care. Understanding home care nurses’ experiences during the COVID-19 pandemic plays an essential role in home care management.

Objective
This study aimed to explore and articulate the experience of home care nurses during the COVID-19 pandemic in Spain.

Design
A qualitative study using hermeneutic phenomenology was carried out. Twenty home care nurses were interviewed by teleconference between January and March 2021. Interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative data analysis software.

Results
Three main themes with five subthemes emerged from the data analysis: (a) “The effect of COVID-19 pandemic on home care,” with the subtheme “the reorganization of home care nurses’ competencies”; (b) “The role of telehealth in home care,” which included the subthemes “home care nurses’ satisfaction with telehealth” and “barriers to implement telehealth in home care”; and (c) “Effects of the pandemic on home care nurses’ lives,” including the subthemes “working in a pandemic is emotionally draining” and “the continuing fear of infecting others.”

Discussion
The findings from this study demonstrate the profound effect that home care has experienced during the COVID-19 pandemic. Home care nurses’ competencies were modified to care for and diagnose COVID-19 patients. Face-to-face home care was replaced by telehealth. All home care nurses experienced physical and psychological symptoms and the fear of infecting others.