bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Double vs. Single Radiation Monitoring Badge System for Fluoroscopy Users
Authors: Caracappa Peter F. , Weintraub Joseph , Krieg Kathleen 
Published: January 2021

Abstract

Objective
To analyze historical radiation dose data from fluoroscopy users at a major university medical center and compare the impact of two alternate dose monitoring methodologies.

Materials and Methods
Interventional radiologists have traditionally worn two radiation monitoring badges to estimate their radiation dose. This study evaluates if a single badge monitoring system can reduce the administrative burden of radiation monitoring without negatively impacting safety or compliance. This study reviewed the dose history data for a 10-y period including 114,500 individual dose measurements. These individuals were each issued two badges for each wear period, including one worn at the collar (outside a protective garment) and one worn at the chest or waist (beneath a protective garment). The dose for each of the badges was derived from the database of personnel dose records. Badges that could be clearly identified as improperly worn were excluded from the study. The EDE as assigned from the two-badge system and as derived from the wear of the collar badge only were both compared to the thresholds for ALARA notifications currently in use.

Results
Calculated EDE values are an average of 2.7 times higher when applying a one-badge system as compared to a two-badge system. This is observed to result in a slight increase in the ALARA notification frequency (excluding badges improperly worn in the two-badge system). The overall increase in notification frequency is small because notifications are dominated by dose to the lens of the eye.

Conclusion
Although providing less accurate personnel dose estimates relative to a two-badge system, the use of a one-badge monitoring system for fluoroscopy users may have a minimal effect on radiation dose records and “as low as (is) reasonably achievable” (ALARA) notifications, with potentially significant savings in notifications due to improper badge wear, volume of radiation monitoring badges handled, and cost of the radiation monitoring system.
Compression Sutures to Treat Acute Hydrops in a Case of Bilateral Post-Laser In Situ Keratomileusis Ectasia
Authors: Bevara Akhil , Vaddavalli Pravin K. 
Published: January 2021

Abstract:
This a case report of acute hydrops with interface fluid syndrome in a patient with post-laser in situ keratomileusis (LASIK) ectasia treated with compression sutures. A patient with post-LASIK ectasia presented with acute hydrops and fluid accumulation in the LASIK flap–stromal interface sequentially in both eyes. Full thickness compression sutures were applied to appose the edges of the Descemet tear, and this resulted in a rapid resolution of stromal edema and interface fluid. The patient had best distance visual acuities of 20/40 and 20/60 at the last follow-up in the right and left eyes, respectively. Hydrops along with fluid in the interface needed early intervention to prevent complications such as epithelial ingrowth and interface haze. Compression sutures were useful in this case to help bridge the gap between the margins of Descemet tear, hastening the resolution of stromal edema and interface fluid.
Influence of Reading on Smartphone Screens on Visual Optical Quality Metrics and Tear Film Stability
Authors: Bettach Emmanuel , Zadok David , Abulafia Adi , Shoshani Avi , Ghebali Rony A. , Weill Yishay , Smadja David 
Published: January 2021

Purpose:
To evaluate the impact of a prolonged reading session on a smartphone screen on optical quality metrics and tear film stability.

Methods:
This prospective study was conducted in 41 healthy volunteers who were asked to read an article on a smartphone screen for 20 minutes. The following tests were performed before the reading task in this consecutive order and repeated after the reading task in the same order: automated noninvasive tear break-up time, optical quality assessment including Objective Scatter Index (OSI), modulation transfer function, Strehl ratio, and tear film dynamic analysis as follows: vision break-up time (VBUT) as a function of OSI changes within 20 seconds, using a double-pass aberrometer imaging system, and fluorescein tear break-up time (FBUT) measured using the slit lamp.

Results:
All break-up time–related parameters (noninvasive tear break-up time, FBUT and VBUT) were significantly reduced after the reading task (P < 0.01). The OSI was significantly worsened after the reading task (P = 0.01), whereas all the other optical quality metrics (modulation transfer function and Strehl ratio) slightly deteriorated, were not statistically significant. A significant correlation was found between the shortening of the FBUT, VBUT, and the worsening of the OSI (r = −0.33, P < 0.05).

Conclusions:
A reading session on a smartphone screen in healthy subjects was found to significantly affect the tear film stability and objectively worsen the retinal image quality.
The role of clinical examination of the optic nerve head in glaucoma today
Authors: Sihota Ramanjit , Sidhu Talvir , Dada Tanuj 
Published: January 2021

Purpose of review
The study was undertaken to assess the current importance of clinical examination of the optic nerve head (ONH) in glaucoma management.

Recent findings
ONH changes in glaucoma are easily assessed with good specificity on examination, whereas imaging has not been able to identify pallor of the neuroretinal rim (NRR), disc hemorrhages, or vascular signs of acquired cupping. Glaucomatous neuropathy in primary open angle glaucoma (POAG) has extensive databases on imaging machines, however, other glaucomas such as primary angle closure glaucoma (PACG), juvenile open angle glaucoma (JOAG), congenital, and secondary glaucomas have been reported to have a significantly different ONH morphology. Clinical evaluation with knowledge of the underlying cause of glaucoma allows easy diagnosis of any abnormality, whereas the absence of an imaging database in such eyes makes diagnosis difficult on optical coherence tomography (OCT) and so forth. In eyes with congenital anomalies and dysplastic discs, clinical examination and history provide better identification of glaucomatous damage. Staging of glaucoma on ONH examination when perimetry is unreliable provides a means of determining the amount of damage and appropriate reduction of intraocular pressure (IOP).

Summary
Clinical examination of the ONH is very relevant for screening, diagnosis, staging, and management of all glaucomas, and is irreplaceable in detecting nonglaucomatous causes of ONH cupping and visual field defects similar to those in glaucoma.
COVID-19–Associated Eosinopenia in a Patient With Chronic Eosinophilia Due to Chronic Strongyloidiasis
Authors: Stylemans Dimitri , Van Cauwelaert Stefan , D'Haenens Alexander , Slabbynck Hans 
Published: January 2021

Abstract
Eosinopenia was frequently encountered in patients with coronavirus disease 2019 (COVID-19). We describe a case of a 59-year-old man who was treated with high-dose corticosteroids and anti-interleukin 1 receptor antagonist therapy because of severe acute respiratory distress syndrome due to a so-called cytokine storm in COVID-19. He had chronic eosinophilia for many years due to an unknown Strongyloides stercoralis infection, proven by serology and a positive polymerase chain reaction test on a stool sample. COVID-19 led to a complete resolution of eosinophilia, even before immunosuppressive treatment was started. Eosinophilia returned after recovery from COVID-19 and started to decline under treatment with ivermectin. Our case confirms previous reports of eosinopenia in COVID-19, as it appears even in patients with chronic eosinophilia. Presence of eosinophilia should prompt screening for strongyloidiasis in all patients eligible for immunosuppressive therapy because of the risk of Strongyloides hyperinfection syndrome, especially if this treatment is empirical.
Prevalence of residual limb pain and symptomatic neuromas after lower extremity amputation: a systematic review and meta-analysis
Authors: List Emile B. , Krijgh David D. , Martin Enrico , Coert J. Henk 
Published: January 2021

Abstract
Residual limb pain (RLP) is associated with (partial) extremity amputations and is defined as pain felt in the remaining part of the amputated limb. A common cause of RLP is neuroma formation after nerve transections. Neuromas can be very painful and severely debilitating pathologies, preventing prosthetic use, reducing quality of life, and requiring medication. Residual limb pain and symptomatic neuromas are often not properly recognized by physicians explaining the varying prevalence in the literature. This systematic review and meta-analysis aim to provide a comprehensive overview of published literature on the prevalence of RLP and symptomatic neuroma after lower extremity amputation. Studies reporting the prevalence of RLP and symptomatic neuroma pain in patients who have had a lower extremity amputation published between 2000 and 2020 were identified in PubMed and Embase. Random-effects meta-analyses of proportions were performed to quantify the prevalence of RLP and symptomatic neuroma. Subgroups were identified and analysed. For RLP, the pooled prevalence was 59% (95% CI: 51-67). For symptomatic neuromas, the pooled prevalence was 15% (95% CI: 7-28). Residual limb pain subgroup analysis showed statistically significant higher prevalence in patients aged >50 years, follow-up >2 years, and in studies using a self-administered questionnaire for data collection. The prevalence of RLP and symptomatic neuroma in patients who have had a lower extremity amputation is 59% and 15%, respectively. Knowledge of their high prevalence may result in better awareness among physicians, in turn providing timely and adequate management.
The Utility of Mayo Clinic's Early Screen for Discharge Planning (ESDP) Tool: A Critical Narrative Review
Authors: Socwell Caitlyn P. , Kanagasaba Kumutha , Pope Rodney 
Published: January 2021

Purpose:
The aim of this critical narrative review was to identify and synthesize available research evidence on the utility of Mayo Clinic's Early Screen for Discharge Planning (ESDP) tool to (1) identify adult patients early during their hospital stay who require referral to specialized hospital discharge planning services (SHDCPS) and (2) review its utility in predicting patient outcomes including hospital length of stay (LOS), readmission risk, and discharge destination. This review also begins by highlighting the important role of physical therapists in discharge planning.

Methods:
A critical narrative review was conducted of relevant studies identified through a systematic search of PubMed, CINAHL, Embase, and ProQuest databases and subsequent systematic screening and selection process. Studies were included and critically appraised if they met eligibility criteria: studies investigating the development, predictive validity and utility of the ESDP in hospital patient populations, and studies comparing the ESDP with other discharge planning tools. Key data were then extracted and tabulated before a critical narrative synthesis of key findings was completed.

Results:
Seven studies met the eligibility criteria, with 5 studies receiving a rating of “good” quality. The included studies investigated the ESDP tool in adults within acute inpatient hospital settings, including heart failure, colorectal surgery, general medical and surgical, and oncology wards.

Conclusion:
Five of the 7 included studies were of good quality and, together, studies provided evidence that the ESDP tool correctly identifies adults requiring referral to SHDCPS. However, further research of the ESDP tool is recommended to account for variations observed in special populations and expand knowledge of its utility to predict outcomes such as hospital LOS, readmission risk, and discharge destination.
Acne Vulgaris Significantly Lowers the Self-Concept of Girls in Junior High School: A Prospective Cross-Sectional Study
Authors: Liu Qian , Ge Yi-Ping , Cao Chun-Yan 
Published: January 2021

Abstract

Objective:
To evaluate the self-concept level of female students with acne vulgaris in junior high school and the relevant influencing factors.

Methods:
A total of 598 students in Grade 7 at two junior high schools in Nantong City, Jiangsu Province, China were sampled by cluster sampling method, and divided into two groups: the acne group and the healthy control. Both groups were surveyed using a self-designed demographic questionnaire, and the self-concept level was determined using the six-dimensional Piers-Harris Children's Self-Concept Scale (PHCSS). The differences were compared between two groups using Chi-square test, non-parametric test, and multiple regression analysis.

Results:
We released a total of 598 questionnaires, and 576 valid questionnaires were received, including 267 in the acne group and 309 in the healthy group. The subscale score of the popularity dimension of the PHCSS in the acne group (8.89 ± 1.780) was significantly lower than that in the healthy group (9.45 ± 1.78, P < 0.01). When only the girls were considered, compared with the healthy group, the acne group had a significantly lower total PHCSS score (58.72 ± 12.15 vs. 61.47 ± 11.14, P < 0.05) and significantly lower subscale scores for physical appearance and attributes (6.68 ± 3.26 vs. 7.97 ± 3.30, P < 0.05), happiness and satisfaction (7.70 ± 1.85 vs. 8.12 ± 1.47, P < 0.05), and popularity (8.69 ± 1.82 vs. 9.84 ± 1.67, P < 0.01). Furthermore, multiple regression analysis revealed the girls’ relationship with their parents and classmates, and the paternal educational background showed a significantly impact on the self-consciousness of the acne girls.

Conclusion:
Acne vulgaris significantly lowers the self-concept of girls in junior high school. The factors influencing the PHCSS scores of girls with acne were the relationship with parents and classmates, and the paternal educational background.
Relationship between primary percutaneous coronary intervention time of day, infarct size, microvascular obstruction and prognosis in ST-segment elevation myocardial infarction
Authors: Chen Shmuel , Redfors Björn , Crowley Aaron , Thiele Holger , Eitel Ingo , Ben-Yehuda Ori , Gkargkoulas Fotis , Mehdipoor Ghazaleh , Stone Gregg W. 
Published: January 2021

Background
Whether the time of day of primary percutaneous coronary intervention (pPCI) in patients with ST-segment elevation myocardial infarction (STEMI) is associated with infarct size, microvascular obstruction (MVO), and prognosis is uncertain. We compared infarct size assessed by cardiac MRI (CMR) and clinical outcomes in STEMI patients according to the pPCI time of day from a large, individual patient-data pooled database.

Methods
We pooled patient-level data from five randomized pPCI trials in which infarct size was measured within 1 month by CMR. Patients were categorized according to the pPCI time of day.

Results
Among 1519 patients with STEMI, 794 (52.2%) underwent pPCI between 8:00 h and 15:59 h, 431 (28.4%) between 16:00 h and 23:59 h, and 294 (19.4%) between 24:00 h and 7:59 h. Infarct size was assessed in 1331 patients at a median of 3.0 days (interquartile range 2.0–5.0) after pPCI. Compared with patients who underwent PCI between 8:00 h and 15:59 h, infarct size was not significantly different for patients undergoing PCI from 16:00 h to 23:59 h [adjusted difference –0.7%, 95% confidence interval (CI) –3.1 to 1.7%, P = 0.46] or 24:00 h to 7:59 h (adjusted difference 0.9%, 95% CI –1.2 to 3.1%, P = 0.29). The time of day of pPCI was also unrelated to MVO and the 1-year risks of death or heart failure hospitalization.

Conclusion
In this large-scale, individual patient data pooled analysis, no association was found between the time of day of pPCI and infarct size, MVO, or prognosis after STEMI.
Association between angiographic and intravascular ultrasound optimizations after new-generation drug-eluting stent implantation and clinical outcomes
Authors: Cha Jung-Joon , Kim Daehoon , Kim Byeong-Keuk , Hong Sung-Jin , Ahn Chul-Min , Kim Jung-Sun , Ko Young-Guk , Choi Donghoon , Hong Myeong-Ki , Jang Yangsoo 
Published: January 2021

Background
Uncertainty remains regarding the associations of angiographic optimization and intravascular ultrasound (IVUS) optimization after new-generation drug-eluting stent (DES) implantation.

Methods
From four randomized trials comparing outcomes between IVUS and angiography-guidance for long or chronic total occlusion (CTO) lesions, 1396 patients who underwent IVUS-guided new-generation DES implantation were enrolled. Of these, 1112 patients (80%) met angiographic optimization criteria (postprocedural diameter stenosis, ≤20%) and were further classified into the matched (same results for angiographic optimization and IVUS optimization) and the mismatched group (opposite results for angiographic optimization and IVUS optimization) according to the meeting of IVUS optimization criteria (minimal stent area, ≥5.5 mm2 or ≥80% of mean reference lumen area). The major adverse clinical events (MACE) were compared.

Results
Of 1112 patients with angiographic optimization, 675 patients met the IVUS optimization criteria (61%; matched), but 437 patients (39%; mismatched) failed to meet IVUS optimization criteria (false-positive rate = 76%). On multivariate analyses, age >60 years, reference vessel diameter ≤2.7 mm, left circumflex artery and lesion length ≥33 mm were significant predictors for the mismatched. When comparing the 12-month MACE rates, the mismatched group (6.8%) showed a significantly higher rate than the matched group (1.5%; hazard ratio = 2.62; 95% confidence interval = 1.20–5.72; P = 0.012), mainly driven by a higher target-vessel revascularization rate (6.4 vs 1.4%; P = 0.021).

Conclusion
Despite meeting angiographic optimization criteria in long or CTO lesions, more than one-third of the patients with IVUS-guided new-generation DES implantation failed to meet the IVUS optimization criteria and had worse clinical outcomes. Therefore, IVUS optimization should be considered for patients who had predictors of mismatch.
Routine fixed-dose heparin vs. ACT-guided heparin administration for elective PCI and its influence on patient in-hospital outcome: a retrospective study
Authors: Berkowitz Oron , Halabi Majdi , Goldberg Alexander , Rosenfeld Inna , Sharabi-Nov Adi , Regev-Avraham Zippi , Israeli Zeev 
Published: January 2021

Objective
Activated clotting time (ACT)-based heparin dosing during percutaneous intervention (PCI) is recommended by Society guidelines. However, the relationship between ACT and outcome in the setting of elective PCI has not been sufficiently studied. We sought to evaluate the in-hospital outcome of patients undergoing elective PCI while receiving fixed-dose heparin without ACT measurement versus those with ACT-guided management.

Methods
This retrospective study included consecutive patients undergoing elective PCI in a single-center between 11/2015 and 12/2018. Patients were divided into two groups, depending on whether ACT was measured. Heparin-only anticoagulation and non-femoral procedures were allowed. Patient demographics, procedural data and in-hospital outcomes were collected. The primary outcome was in-hospital major adverse cardiovascular events (MACE), secondary (safety) outcomes were in-hospital definite stent thrombosis, Bleeding Academic Research Consortium bleeding, access-related complications (any) as well as peri-procedural complications.

Results
In total, 500 procedures were included in the study, 151 ACT and 349 fixed-dose. Patient demographics and medical history in both groups were well balanced, but those having ACTs were younger (63.2 ± 10.9 vs. 66.5 ± 11.3; P = 0.003) and less likely to have a history of coronary artery disease (74 vs. 82%; P = 0.032) or kidney failure. Procedural data were similar; however, total heparin dose and procedure length were higher in the ACT group (6232 ± 1388 vs.5032 ± 417 units; P < 0.001; 40.1 ± 14.0 vs. 30.3 ± 12.7 min; P < 0.001). Primary and secondary outcome events were rare and similar (MACE 1.1 vs. 1.3%; P = 0.86).

Conclusions
A fixed-dose heparin injection (5000 IU) approach for elective PCI while omitting ACT offers slightly shortened procedural time and similar in-hospital safety profile.
Impact of aging on the effects of intracoronary adenosine, peak hyperemia and its duration during fractional flow reserve assessment
Authors: Verdoia Monica , Gioscia Rocco , Suryapranata Harry , Kedhi Elvin , De Luca Giuseppe 
Published: January 2021

Introduction
Functional assessment of coronary stenoses is crucial for determining the correct therapeutic strategy. Age-related modifications in cardiovascular function could alter the functional significance of an intermediate coronary lesion. Therefore, the aim of the present study was to investigate the impact of age on fractional flow reserve (FFR) measurements in patients with intermediate coronary artery disease.

Methods
We included patients undergoing coronary angiography at our Division of Cardiology from June 2008 to February 2019 for elective indication or recent acute coronary syndrome and receiving FFR assessment for an intermediate coronary stenosis (angiographic 40–70% stenoses). FFR measurement was performed by pressure-recording guidewire (Prime Wire; Volcano Imaging System Philips Healthcare, San Diego, California, USA), after induction of hyperemia with intracoronary boluses of adenosine (from 60 to 720 μg, with dose doubling at each step).

Results
We included in our study 276 patients, undergoing FFR evaluation on 314 lesions, that were divided according to age (< or ≥70 years). Elderly patients displayed a higher cardiovascular risk profile and received more often specific therapy. We found significantly higher FFR values and lower Delta FFR and time to recovery in patients with age ≥70 years old even with high-dose adenosine. Elderly patients showed a trend in lower percentage of positive FFRs, especially with high-dose (P = 0.09). Overall, any FFR ≤ 0.80 was observed in 33.5% of younger patients and 21.1% of patients ≥70 years (P = 0.02). Results were confirmed after correction for baseline differences [adjusted odds ratio (95% confidence interval) = 0.60 (0.33–1.09), P = 0.08].

Conclusion
This is one of the first studies investigating the impact of age on the measurement of FFR with high-dose adenosine. Patients with age >70 years old with intermediate CAD are more likely to have higher FFR values and lower duration of hyperemia after adenosine boluses, as compared with younger patients.