bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of social determinants of health on cardiovascular disease prevention
Authors: Mannoh Ivy , Hussien Merna , Commodore-Mensah Yvonne , Michos Erin D. 
Published: June 2021

Purpose of review
Social determinants of health (SDOH) describe conditions in one's environment that have an impact on health, quality-of-life, outcomes, and risks. These include income, education, employment, culture, language, healthcare access, social support, race, ethnicity, structural racism, discrimination, social support, neighborhood characteristics, and others. SDOH manifest as persistent inequalities in cardiovascular risk factors and disease, and, therefore, contribute to cardiovascular disease (CVD)-related morbidity and mortality. This article reviews how SDOH affect CVD risk and the role they play in CVD prevention.

Recent findings
The 2019 American College of Cardiology/American Heart Association (AHA) guideline on the primary prevention of CVD recommends that clinicians evaluate SDOH on an individual basis to inform treatment decisions for CVD prevention efforts. Recent evidence shows that low socioeconomic status, adverse childhood experiences, less social support, reduced health literacy, and limited healthcare access are associated with higher CVD risk and poorer health outcomes. A 2020 AHA statement emphasized the role of structural racism as a fundamental driver of health disparities. The AHA 2030 Impact Goals state a desire to achieve health equity by identifying and removing barriers to healthcare access and quality.

Summary
SDOH affect CVD prevention efforts. The SDOH that affect cardiovascular risk factors, diseases, and outcomes are complex and intersect. Addressing them can be challenging and will require a multilevel and multidisciplinary approach, involving public health measures, changes in health systems, team-based care, and dismantling of structural racism. More studies are needed to investigate the effect of interventions that improve SDOH and prevent CVD or lower CVD risk.
Improving outcomes after low-risk coronary artery bypass grafting: understanding phase of care mortality analysis, failure to rescue and recent perioperative recommendations
Authors: Yan Weiang , Muller Moran Hellmuth R. , Zelentsov Ivan , Eikelboom Rachel , Lodewyks Carly , Strumpher Johann , Arora Rakesh C. 
Published: June 2021

Purpose of review
Avoidable adverse events are responsible for up to 50% of deaths after low-risk coronary artery bypass grafting. This article reviews recent quality improvement efforts to improve outcomes after cardiac surgery.

Recent findings
Systematic quality improvement methodology in cardiac surgery has improved significantly over the past decade. Contemporary efforts with phase of care mortality analysis (POCMA) focus on identifying and addressing root causes for mortality. Each patient's perioperative course is an interconnected sequence of clinical events, decisions, interventions, and treatment responses occurring across five perioperative phases. A single seminal event within a specific phase of care has been found to often trigger the eventual death of a patient. Several groups have made significant improvements to perioperative outcomes by addressing these avoidable mortality trigger events. Failing that, failure to rescue (FTR) metrics can be used to identify institutional factors responsible for poor perioperative outcomes. This ongoing focus on quality improvement serves to further improve outcomes after low-risk cardiac surgery.

Summary
Modern quality improvement methodology, including POCMA and FTR analysis, has the potential to significantly improve outcomes after cardiac surgery. Larger future studies with multiinstitutional data sharing will be key to facilitate ongoing quality improvement and knowledge translation in this field.
Surgical treatment of severe tricuspid regurgitation
Authors: von Ballmoos Moritz C. Wyler , Reardon Michael J. 
Published: June 2021

Purpose of review
Severe tricuspid regurgitation is associated with both significant symptoms as well as decreased survival. Surgical correction is possible in most cases but is markedly under used in this population. The purpose of this manuscript is to review the indications for treating severe tricuspid regurgitation and the surgical options available.

Recent findings
Surgical correction of isolated severe tricuspid regurgitation has been associated with a high mortality in the surgical literature. This occurs generally from right heart failure associated with the late referral of isolated tricuspid regurgitation for correction. Recent outcomes are improving and tricuspid repair appears to be where mitral valve repair was 30 years ago.

Summary
Severe tricuspid regurgitation is associated with severe symptoms as well as decreased survival. Tricuspid valve repair (TVr) for severe regurgitation is almost always technically possible. The high mortality thought to be associated with isolated TVr is likely due to late referral when right heart failure is already far advanced. Consideration for earlier referral for isolated severe tricuspid regurgitation should be considered.
CLINICAL FEATURES, DIAGNOSTIC SIGNIFICANCE, AND PROGNOSIS OF VITREORETINAL LYMPHOMA IN YOUNG PATIENTS
Authors: Liu Shixue , Gu Junxiang , Zhang Ting , Ping Bo , Zhou Min , Huang Xin , Jiang Rui , Xu Gezhi , Chang Qing 
Published: June 2021

Purpose:
To investigate the clinical features, diagnostic approaches, and outcomes of young patients with vitreoretinal lymphoma.

Methods:
Fifty-one vitreoretinal lymphoma patients (97 eyes) referred to the Eye and ENT Hospital of the Fudan University from 2011 to 2020 were grouped based on their onset age (age ≤50 years and age >50 years). Complete eye examinations, evaluation of systemic conditions, and biological analysis of intraocular fluids were performed.

Results:
Young patients accounted for 31.4% (n = 16) of the cohort. More eyes had retinal/subretinal pigment epithelial infiltration (20 [64.5%] vs. 23 [34.8%]; P = 0.018) in young patients than in elderly ones. The mutation rate of Myeloid Differentiation Factor 88 gene (MYD88) was significantly lower in young patients than in elderly ones (5 [50%] vs. 21 [91.3%]; P = 0.016). The median time to new onset of central nervous system lymphoma was significantly shorter in young patients (11.7 vs. 36.2 months; P = 0.012). However, mean overall survival did not differ between the 2 groups (64.9 vs. 57.5 months; P = 0.871).

Conclusion:
Early diagnosis and central nervous system evaluation are crucial for young vitreoretinal lymphoma patients with rapid central nervous system involvement. Meanwhile, young vitreoretinal lymphoma patients have some unique features, including more retinal/subretinal pigment epithelial infiltrations and lower MYD88 mutation rates.
Filaggrin Expression in the Lid Margin During Contact Lens Wear
Authors: Alghamdi Waleed M. , Markoulli Maria , Papas Eric B. 
Published: June 2021

Aim:
To investigate the expression of the keratinization-related protein, filaggrin, in the lid margin epithelium of contact lens (CL) wearers compared with nonwearers.

Methods:
This was a cross-sectional study of 100 individuals with different exposures to CL wear: short, moderate, and long experience; previous CL wearers; and nonwearers as controls. Impression cytology samples were collected from the lid wiper (LW) area of the central upper lid margin. After fixing, an equal, random sample was selected from each group (n=13) for immunocytochemistry analysis using antihuman primary anybody (mouse filaggrin), then stained with secondary antibody (fluorescein isothiocyanate–conjugated donkey anti-mouse immunoglobulin G horseradish peroxidase) to detect filaggrin. Imaging was performed with the 3i-Vivo 2-photon microscope equipped with a Zeiss 20×-objective and SlideBook-reader software.

Results:
Sixty-five samples from 65 participants (37 women; mean age±SD: 25.1±4.1 years) were collected. Filaggrin was detected in all 65 randomly selected immunostained marginal epithelium samples. All samples were similar in showing patchy areas of filaggrin immunostaining, regardless of CL wear, symptoms or epithelium morphology. Because the filaggrin immunostaining showed similar patterns across almost all the observed samples, comparison between subject groups was impractical. The presence of filaggrin in the healthy LW was additionally confirmed by an independent laboratory.

Conclusion:
Filaggrin expression seems to be a normal part of epithelial cell differentiation in the lid margin and may not be a useful keratinization/stress biomarker in the marginal epithelium. Investigating other keratinization biomarkers that are not detected in the normal mucocutaneous junction/LW may help to understand the keratinization nature of LW epithelium changes in CL wearers.
Increased Endothelial Cell Density in Childhood Patients With Thalassemia Major
Authors: Seyyar Sevim Ayca , Tıskaoğlu Nesime Setge , Gürbostan Gizem , Pekpak Esra , Sayglı Oguzhan 
Published: June 2021

Purpose:
We aimed to compare specular microscopy, biometric, refractive, and anterior segment topographic parameters in children with thalassemia major (TM) with normal children of the same age.

Material Method:
This cross-sectional study included 55 eyes of 55 patients with TM and 63 eyes of 63 age–sex-matched healthy children; all patients with TM were receiving treatment with blood transfusions every 3 to 4 weeks and an oral iron chelator deferasirox (DFX) (ICL670) tablet. A comprehensive ophthalmic examination was performed, including refraction (spherical equivalent), best-corrected visual acuity, slit-lamp bio microscopy, specular examination, optical biometry, intraocular pressure, anterior segment topography, and fundus examination.

Results:
Endothelial cell density (ECD) was 3,138 in the TM group and 2,996 in the control group (P=0.003). The mean central corneal thickness was significantly thinner in the TM group (P=0.010). Flat keratometry (K1) was 43.5 D in the study group and 42.9 D in the control group (P=0.039). The mean anterior chamber depth (ACD) was shallower in the TM group (P=0.004); axial length (AL) was significantly shorter in the TM group (P=0.002).

Conclusion:
This study shows that there are differences in ECD, AL, keratometry values, ACD, and anterior segment parameters of pediatric patients with TM compared with healthy controls.
Cationic Surfactant–Natural Clay Complex as a Novel Agent Against Acanthamoeba castellanii Belonging to the T4 Genotype
Authors: Akbar Noor , Siddiqui Ruqaiyyah , Khamis Mustafa , Ibrahim Taleb , Khan Naveed Ahmed 
Published: June 2021

Background:

Acanthamoeba is a protozoan pathogen that is widely distributed in the environment. Given the opportunity, it can cause a serious eye infection known as Acanthamoeba keratitis as well as a fatal brain infection known as granulomatous amoebic encephalitis. Inappropriate use of contact lenses can contribute to contracting Acanthamoeba keratitis, and contact lens disinfectants are not always effective in eradicating Acanthamoeba. Therefore, there is a need to develop novel antimicrobial agents with efficient antiamoebic properties.

Objective:
In this study, we tested octadecyltrimethylammonium (ODTMA)-clay (montmorillonite) complex as a novel antiamoebic agent.

Methods:
Using A. castellanii belonging to the T4 genotype of keratitis origin, amobicidal assays were performed to determine the effects of ODTMA-cay complex on the viability of parasites at various concentrations ranging from 10 to 100 μg. Adhesion and cytopathogenicity assays were performed to investigate ODTMA effects on A. castellanii–mediated binding and damage to human cells. Encystation and excystation assays were conducted to establish ODTMA-mediated inhibitory effects against the cyst stage of A. castellanii.

Results:
Using cell survival assays, the results revealed that ODTMA–clay complex exhibited amobicidal activity against keratitis-causing A. castellanii in a dose-dependent manner. Pretreatment of A. castellanii with ODTMA–clay complex inhibited parasite adhesion to as well as parasite-mediated human cell damage. Using encystation and excystation assays, it was revealed that ODTMA–clay complex inhibited A. castellanii cysts at 100 μg (P<0.05).

Conclusion:
To the best of our knowledge, for the first time, it was shown that ODTMA–clay complex exhibited anti-Acanthamoebic activities. The possibility of adding ODTMA–clay in a contact lens cleaning solution to formulate effective disinfectants is discussed further.
Worries About COVID-19 Infection and Psychological Distress at Work and While Commuting
Authors: Uehara Masamichi , Ishimaru Tomohiro , Ando Hajime , Tateishi Seiichiro , Eguchi Hisashi , Tsuji Mayumi , Mori Koji , Matsuda Shinya , Fujino Yoshihisa 
Published: June 2021

Objective:
This study examined the relationship between worry about COVID-19 infection in the workplace and while commuting to work and psychological distress in Japan.

Methods:
An internet monitor study was conducted. Out of a total of 33,302 participants, 26,841 people were included. The subjects were asked single-item questions about whether they were worried about COVID-19 infection in general, at work and while commuting to work. K6 was used to assess psychological distress.

Results:
The OR was significantly higher in association with worry about infection in the workplace at 1.71 (95%CI 1.53 to 1.92) and worry about infection while commuting at 1.49 (95%CI 1.32 to 1.67).

Conclusions:
This study suggests the need for psychological intervention to reduce worry about infection in response to public mental health challenges associated with the COVID-19 pandemic.
A narrative review on endopancreatic interventions: an innovative access to the pancreas
Authors: Frey Michael C. , Eigl Benjamin , Steinemann Daniel C. , Hackert Thilo , Rössler Fabian , Nickel Felix , Müller-Stich Beat P. , Z’graggen Kaspar , Müller Philip C. 
Published: June 2021

Abstract
The natural connection between the duodenum and the pancreatic duct enables a minimally invasive access to the pancreas. Endoscopically this access is already regularly used, mainly for diagnostic and even for certain therapeutic purposes. With per-oral pancreatoscopy the endopancreatic approach allows the direct visualization of the pancreatic duct system potentially improving the diagnostic work-up of pancreatic cystic neoplasms, intrapancreatic strictures and removal of pancreatic duct stones. However, the endopancreatic access can equally be applied for surgical interventions. The objective of this review is to summarize endoscopic and surgical interventions using the endopancreatic access. Endopancreatic surgery stands for a further development of the endoscopic technique: a rigid endoscope is transabdominally introduced over the duodenum and the papilla to enable resections of strictures and inflamed tissue from inside the pancreas under visual control. While the orientation and localization of target structures using this minimally invasive approach is difficult, the development of an accurate image guidance system will play a key role for the clinical implementation and widespread use of endoscopic and surgical endopancreatic interventions.
Association Between Fear of Pain and Sports-Related Concussion Recovery in a Pediatric Population
Authors: Arnold Jennifer T. , Franklin Elizabeth V. , Baker Zachary G. , Abowd Marian , Santana Jonathan A. 
Published: June 2021

Objective:
To determine whether an association exists between fear of pain and recovery time from sports-related concussion in a pediatric population.

Design:
Prospective observational study.

Setting:
Primary outpatient sports medicine clinic of a large pediatric hospital.

Patients:
One hundred twenty-eight pediatric patients aged 8 to 18 years who presented to clinic with a primary diagnosis of concussion from September 2018 to March 2020. Inclusion criteria included presentation within 2 weeks of injury and symptomatic on initial visit. Patients who sustained a concussion because of motor vehicle collisions or assault were excluded.

Independent Variables:
There was no intervention. Study participants who met inclusion criteria were administered the Fear of Pain Questionnaire (FOPQ) at their initial visit.

Main Outcome Measures:
Time to clinical recovery was the main outcome measure and was determined by the fellowship-trained sports medicine physician based on resolution of concussion symptoms, resumption of normal physical and cognitive daily activities, no use of accommodations or medications, and normalization of physical exam.

Results:
There was a significant difference in FOPQ scores for those with prolonged recovery (M = 33.12, SD = 18.36) compared with those recovering in fewer than 28 days (M = 26.16, SD = 18.44; t [126] = −2.18, P = 0.036).

Conclusions:
Consistent with the adult literature, we found that pediatric patients are more likely to have a prolonged recovery from concussion when they have higher fear of pain.
Pediatric Revision Anterior Cruciate Ligament Reconstruction: Current Concepts Review
Authors: Malige Ajith , Leska Tomasina , Baghdadi Soroush , Ganley Theodore 
Published: June 2021

Objective:
We present a review of revision anterior cruciate ligament (ACL) reconstruction in pediatric patients, discussing risk factors for rerupture, physical examination and imaging, treatment principles and surgical techniques, postoperative rehabilitation, and clinical outcomes.

Data Sources:
PubMed, Cochrane, and Embase databases were queried for relevant articles about revision ACL topics. All types of manuscripts, including clinical studies, basic science studies, case series, current concepts reviews, and systematic reviews were analyzed for relevant information. Current concepts on risk factors for rerupture, physical examination and imaging, treatment principles and surgical techniques, postoperative rehabilitation, and clinical outcomes were synthesized.

Main Results:
Surgical treatment should be individualized, and the graft type, fixation devices, tunnel placement, and complementary procedures (eg, extra-articular tenodesis) should be tailored to the patient's needs and previous surgeries. Rehabilitation programs should also be centered around eccentric strengthening, isometric quadriceps strengthening, active flexion range of motion of the knee, and an emphasis on closed chain exercises. Despite adherence to strict surgical and postoperative rehabilitation principles, graft refailure rate is high, and return to sports rate is low.

Conclusion:
Rerupture of the ACL in the pediatric population is a challenging complication that requires special attention. Diagnostic evaluation of repeat ACL ruptures is similar to primary injuries. Although outcomes after revision ACL reconstruction are expectedly worse than after primary reconstruction, athletes do return to sport after proper rehabilitation. Further research is needed to continue to improve outcomes in this high-risk population, aimed at continued knee stability, graft survivorship, and improved quality of life.
Acceptability of Nurse-Driven HIV Screening for Key Populations in Emergency Departments
Authors: Leblanc Judith , Côté José , Auger Patricia , Rouleau Geneviève , Bastide Théophile , Piquet Hélène , Fromentin Hélène , Jegou Carole , Duchêne Gaëlle , Verbrugghe Rachel , Lancien Cécile , Simon Tabassome , Crémieux Anne-Claude ,   for the DICI-VIH (Dépistage Infirmier CIblé du VIH) group
Published: June 2021

Background
Optimizing care continuum entry interventions is key to ending the HIV epidemic. Offering HIV screening to key populations in emergency departments (EDs) is a strategy that has been demonstrated to be effective. Analyzing patient and provider perceptions of such screening can help identify implementation facilitators and barriers.

Objectives
The aim of this study was to investigate the acceptability of offering nurse-driven HIV screening to key populations based on data collected from patients, nurses, and other service providers.

Methods
This convergent mixed-methods study was a substudy of a cluster-randomized two-period crossover trial conducted in eight EDs to evaluate the effectiveness of the screening strategy. During the DICI-VIH (Dépistage Infirmier CIblé du VIH) trial, questionnaires were distributed to patients aged 18–64 years. Based on their responses, nurses offered screening to members of key populations.
Over 5 days during the intervention period in four EDs, 218 patients were secondarily questioned about the acceptability of screening. Nurses completed 271 questionnaires pre- and posttrial regarding acceptability in all eight EDs. Descriptive analyses were conducted on these quantitative data. Convenience and purposeful sampling was used to recruit 53 providers to be interviewed posttrial. Two coders conducted a directed qualitative content analysis of the interview transcripts independently.

Results
The vast majority of patients (95%) were comfortable with questions asked to determine membership in key populations and agreed (89%) that screening should be offered to key populations in EDs. Nurses mostly agreed that offering screening to key populations was well accepted by patients (62.2% pretrial and 71.4% posttrial), was easy to implement, and fell within the nursing sphere of competence. Pretrial, 73% of the nurses felt that such screening could be implemented in EDs. Posttrial, the proportion was 41%. Three themes emerged from the interviews: preference for targeted screening and a written questionnaire to identify key populations, facilitators of long-term implementation, and implementation barriers. Nurses were favorable to such screening provided specific conditions were met regarding training, support, collective involvement, and flexibility of application to overcome organizational and individual barriers.

Discussion
Screening for key populations was perceived as acceptable and beneficial by patients and providers. Addressing the identified facilitators and barriers would help increase screening implementation in EDs.
Isolated Anterior Interosseous Neuropathy Affecting Only the Flexor Digitorum Profundus to the Index Finger After Shoulder Arthroscopy
Authors: Carrier Jonathan , Colorado Berdale 
Published: June 2021

Abstract
Anterior interosseous nerve neuropathy is an uncommon neuropathy with multiple potential etiologies. We present a rare case of anterior interosseous nerve neuropathy affecting only the flexor digitorum profundus to the index finger and occurring after shoulder arthroscopy. This unique presentation used a combination of both electrodiagnostic testing and neuromuscular ultrasound to obtain an accurate diagnosis and highlights the importance of these complementary tests in the evaluation of nerve disorders. To our knowledge, anterior interosseous nerve neuropathy after shoulder arthroscopy affecting only the flexor digitorum profundus to the index finger has not been previously described in the literature.