bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dielectric Blood Coagulometry for the Early Detection of Sepsis-Induced Disseminated Intravascular Coagulation: A Prospective Observational Study
Authors: Takayama Wataru , Endo Akira , Morishita Koji , Otomo Yasuhiro 
Published: August 2021

Objectives:
To evaluate the utility of dielectric blood coagulometry for early sepsis–induced disseminated intravascular coagulation diagnosis.

Design:
Single-center, prospective observational study.

Setting:
Patients with sepsis or septic shock at the Tokyo Medical and Dental University Hospital of Medicine between September 2019 and September 2020.

Patients:
The patients were divided into three groups according to the timing of disseminated intravascular coagulation diagnosis based on the Disseminated Intravascular Coagulation score by the Japanese Association for Acute Medicine: 1) no disseminated intravascular coagulation group, 2) late-diagnosed disseminated intravascular coagulation group: not diagnosed with disseminated intravascular coagulation on day 1 but diagnosed within 48 hours after admission, and 3) disseminated intravascular coagulation group: diagnosed with disseminated intravascular coagulation on day 1. The study evaluated 80 patients (no disseminated intravascular coagulation, 31 [38.8%]; late-diagnosed disseminated intravascular coagulation, 34 (42.5%); disseminated intravascular coagulation, 15 [18.8%]).

Measurements and Main Results:
We compared the clinical severity scores and mortality of the groups and assessed the correlation between the dielectric blood coagulometry–derived coagulation marker, thrombin levels, and Disseminated Intravascular Coagulation score using Spearman rank correlation. The mortality rate was 0% (0/31) in the no disseminated intravascular coagulation group, 35.3% (12/34) in the late-diagnosed disseminated intravascular coagulation group, and 33.3% (5/15) in the disseminated intravascular coagulation group. Although the Disseminated Intravascular Coagulation score on day 1 did not reflect disseminated intravascular coagulation in approximately 70% of patients who developed disseminated intravascular coagulation by day 2, dielectric clot strength measured by dielectric blood coagulometry on day 1 strongly correlated with disseminated intravascular coagulation development by day 2 (Spearman ρ = 0.824; p < 0.05) and with thrombin level on day 1 (Spearman ρ = 0.844; p < 0.05).

Conclusions:
Dielectric blood coagulometry can be used to detect early-phase disseminated intravascular coagulation in patients with sepsis and is strongly correlated with thrombin levels. Larger studies are needed to verify our results for developing clinical applications.
Plasma creatine concentration is associated with incident hypertension in a cohort enriched for the presence of high urinary albumin concentration: the Prevention of Renal and Vascular Endstage Disease study
Authors: Post Adrian , Kremer Daan , Swarte J. Casper , Sokooti Sara , Vogelpohl Fabian A. , Groothof Dion , Kema Ido.P. , Garcia Erwin , Connelly Margery A. , Wallimann Theo , Dullaart Robin P.F. , Franssen Casper F.M. , Bakker Stephan J.L. 
Published: August 2021

Objective
: Hypertension is a major risk factor for cardiovascular disease, kidney disease, and premature death. Increased levels of creatine kinase are associated with development of hypertension. However, it is unknown if creatine, a substrate of CK, is associated with the development of hypertension. We therefore, aimed to investigate the association between plasma creatine concentration and incident hypertension.

Methods:
We measured fasting plasma creatine concentrations by nuclear magnetic resonance spectroscopy in participants of the population-based PREVEND study. The study outcome was incident hypertension, defined as either a SBP of at least 140 mmHg, a DBP of at least 90 mmHg, or the new usage of antihypertensive drugs. Participants with hypertension at baseline were excluded.

Results:
We included 3135 participants (46% men) aged 49 ± 10 years. Mean plasma creatine concentrations were 36.2 ± 17.5 μmol/l, with higher concentrations in women than in men (42.2 ± 17.6 versus 29.2 ± 17.6 μmol/l; P < 0.001). During a median of 7.1 [interquartile range: 3.6–7.6] years of follow-up, 927 participants developed incident hypertension. Higher plasma creatine concentrations were associated with an increased risk of incident hypertension [HR per doubling of plasma creatine: 1.21 (95% confidence interval: 1.10–1.34); P < 0.001], which remained significant after adjustment for potential confounders. Sex-stratified analyses demonstrated higher plasma creatine that was independently associated with an increased risk of incident hypertension in men [hazard ratio: 1.26 (95% CI 1.11–1.44); P < 0.001], but not in women (hazard ratio: 1.13 (95% CI 0.96–1.33); P = 0.14]. Causal pathway analyses demonstrate that the association was not explained by sodium or protein intake.

Conclusion:
Higher plasma creatine is associated with an increased risk of hypertension in men. Future studies are warranted to determine the underlying mechanisms.
Predictive Factors for Resolution of Dematiaceous Fungal Keratitis
Authors: Chaudhary Simmy , Kate Anahita , Bagga Bhupesh , Mohamed Ashik , Sharma Savitri 
Published: August 2021

Purpose:
To ascertain the clinicomicrobiological correlation and evaluate the prognostic factors associated with medical resolution in cases of Curvularia, Alternaria, and Scedosporium keratitis.

Methods:
A retrospective review of clinical and microbiological records of culture-proven cases of Curvularia, Alternaria, and Scedosporium keratitis from 2017 to 2019 was performed. Multivariate logistic regression analyses were performed to assess the predictive factors for medical resolution.

Results:
There were a total of 79 eyes of 79 patients. Among these, there were 56 (70.8%), 15 (18.9%), and 8 (10.1%) patients with Curvularia, Scedosporium, and Alternaria keratitis, respectively. Clinical resolution with medical treatment was achieved in 46 of 56 (82.1%) patients with Curvularia keratitis, 8 of 15 (53.3%) patients with Scedosporium, and 7 of 8 (87.5%) patients with Alternaria keratitis. In comparison between Curvularia and Scedosporium, macroscopic pigmentation [18/56 (32.1%)] of anterior stromal plaque-like infiltrate [20/56 (35.7%)] was clinically more in cases with Curvularia, whereas larger diameter of the infiltrate, P = 0.002, posterior stromal infiltrate (40%), P = 0.03, and hypopyon, P = 0.009, were more common with Scedosporium. Multivariate logistic regression analysis, by backward elimination, showed that maximum dimension of the infiltrate (P = 0.01; odds ratio = 0.52, 95% confidence interval, 0.31–0.86) and presence of a hypopyon (P = 0.02; odds ratio = 0.12, 95% confidence interval, 0.02–0.71) were significant factors that were not favoring medical resolution.

Conclusions:
Larger size of the infiltrate, posterior stromal involvement, and presence of a hypopyon are poor prognostic indicators among all 3 species. Variation in species is not a predictor of clinical resolution.
Anterior Segment OCT in Primary Angle Closure Disease Compared With Normal Subjects With Similar Shallow Anterior Chamber
Authors: Xie Qinghong , Ma Ping , Patlidanon Jutima , Saifee Murtaza , Yonamine Sean , Yu Yinxi , Ying Gui-Shuang , Yang Yangfan , Li Shuning , Han Ying 
Published: August 2021

Précis:
Compared with normal subjects with similar shallow anterior chamber depth (ACD), patients with primary angle closure disease (PACD) had narrower angle structures measured by swept-source optical coherence tomography (SS-OCT) at 250 μm from scleral spur (very root of iris), especially along oblique and vertical axis.

Purpose:
To examine anterior segment structures in normal subjects whose ACD was shallow on slit-lamp examination but did not meet the diagnostic criteria of PACD, and to compare them with PACD patients with similar ACD.

Materials and Methods:
Patients were recruited from glaucoma clinic at Zhongshan Ophthalmic Center. A total of 40 eyes from 29 PACD patients and 40 eyes from 34 normal subjects received full ophthalmic examination and CASIA SS-1000 OCT tests. PACD eyes and control eyes were 1:1 matched for ACD at 0 degree of scan. Generalized linear model that accounted for inter-eye correlation was used to compare differences between the 2 groups for intraocular pressure and SS-OCT parameters. P-values were adjusted for multiple comparisons using the Bonferroni method.

Results:
The PACD and control groups had similar age, but the PACD group had a significantly higher intraocular pressure (18.4 vs. 14.0 mm Hg, P=0.005). Angle parameters, representative of angle area, such as angle recess area and trabecular iris space area measured at 250 μm along axes of 90, 135, 225, and 315 degrees were significantly smaller in PACD group than those of control group (adjusted P<0.05), while most of angle parameters at 500 and 750 μm, volume parameters, and anterior chamber parameters, were similar (adjusted P>0.05).

Conclusions:
In PACD patients compared with normal subjects with similar anterior chamber shallowing, OCT findings measured at the iris root 250 μm from the scleral spur, especially in the oblique and vertical axes, including angle recess area and trabecular iris space area, may match gonioscopic findings more closely and provide further insight into mechanisms of PACD.
Closure of Anchor Businesses Reduced COVID-19 Transmission During the Early Months of the Pandemic
Authors: McHugh Megan , Tian Yao , Maechling Claude R. , Farley Diane , Holl Jane L. 
Published: August 2021

Objectives:
To investigate the relationship between the closure of “anchor businesses” – manufacturing plants and distribution centers employing >1000 workers – and the daily, county-level COVID-19 rate between March 1, 2020 and May 31, 2020.

Methods:
We conducted a comparative, interrupted time series analysis of publicly available county-level data. Our main variable of interest was closure, indicating whether one or more of the anchor businesses within the county experienced a full or partial closure of at least 22 days (main analysis) or at least 1 day (sensitivity analyses).

Results:
Closure of an anchor business was associated with 142 fewer positive COVID-19 tests per 100,000 population over a 40-day period. Even short-term and partial closures were associated with reduced spread.

Conclusions:
Temporary closure of anchor businesses appears to have slowed, but not completely contained, the spread of COVID-19.
Movement Impairments in Women With and Without Urinary Urgency/Frequency
Authors: Erbes Nicole A. , Foster Stefanie Nicole , Harris-Hayes Marcie , Spitznagle Theresa M. 
Published: August 2021

Objectives:
To (1) examine the relationship between spine, hip, and pelvis movement patterns and urinary urgency and frequency; (2) report the prevalence of pelvic girdle and hip joint impairments among women with and without urinary urgency and frequency; and (3) report the most common movement impairments observed in women with and without urinary urgency and frequency.

Methods:
Women age 18 to 60 years with urinary urgency and frequency were matched 1:1 to women without based on age, body mass index, and vaginal parity. Participants completed primary movement tests of the hip, pelvis, and spine. Additional clinical tests included Stork test, side-lying position, pubic symphysis palpation, flexion-abduction-external rotation, flexion-adduction-internal rotation, and seated hip internal and external rotation. Urge symptoms were monitored before and during each test. Movement patterns and positioning of the thoracic and lumbar spine, pelvis, and hips were observed. Secondary tests to correct a movement or positional impairment were performed if an impairment was noted or if symptoms were provoked during the primary test.

Results:
Forty-two women completed testing. More participants with urinary urgency and frequency (1) demonstrated impairments during forward bend, single-leg stance, side-lying, and Stork tests; (2) reported urgency provocation during forward bend, flexion-adduction-internal rotation test, pubic symphysis palpation, and hip internal rotation; and (3) reported symptom relief with side-lying position secondary test; and secondary tests of the thoracic, lumbar, and hip regions compared with those without.

Conclusion:
Musculoskeletal impairments may be associated with urinary urgency and frequency and should therefore be considered when determining management options for these patients.
Caffeine Consumption Habits, Sleep Quality, Sleep Quantity, and Perceived Stress of Undergraduate Nursing Students
Authors: Higbee Mykin R. , Gipson Christine S. , El-Saidi Mohammed 
Published: August 2021

Background:
Consumption of energy drinks is prevalent among college students and has increased over the last decade. There is inadequate research about the energy drink consumption habits of prelicensure nursing students.

Purpose:
This study determined if there were differences in sleep quality, sleep quantity, and perceived stress levels in nursing students who consume energy drinks compared with those who consume other sources of caffeine and those who abstain.

Methods:
A comparative study design was used. Participants (n = 272) from universities in 2 regions of the United States answered questions about sleep, perceived stress, caffeine, and energy drink consumption.

Results:
Nursing students at both universities who consumed energy drinks reported poorer sleep quality, fewer sleep hours, and higher levels of perceived stress than caffeine-only consumers and non-caffeine consumers.

Conclusions:
Prelicensure nursing students may be unaware of the relationships among energy drink consumption, sleep quality, sleep quantity, and perceived stress levels.
Enhancing the Prelicensure Clinical Learning Experience
Authors: Donovan Laureen M. , Strunk Julie A. , Lam Christina , Argenbright Christine , Robinson Jamie , Leisen Melissa , Puffenbarger Nancy 
Published: August 2021

Background:
Studies of the clinical learning environment document the importance of the student's clinical learning process.

Purpose:
The aim of this study was to gather information on students' perceptions of their learning in the clinical environment.

Methods:
A mixed-method strategy was used to explore nursing students' (N = 194) perceptions of their clinical learning experiences. Data were collected using the Clinical Learning Environment Inventory (CLEI) survey and open-ended questions.

Results:
The results showed that significant CLEI factors were affordances and engagement, student-centeredness, valuing nurses' work, and fostering workplace learning and that these factors were important to prelicensure nursing students' learning in the clinical environment. In addition, the thematic concepts that enhanced their learning were clinical faculty who exhibited strong communication, encouraged and challenged learners, and were readily available.

Conclusions:
Clinical faculty in the clinical environment must be competent and able to support the prelicensure nursing student learner.
Individuals With Parkinson Disease Are Adherent to a High-Intensity Community-Based Cycling Exercise Program
Authors: Rosenfeldt Anson B. , Miller Koop Mandy , Penko Amanda L. , Alberts Jay L. 
Published: August 2021

Background and Purpose:
Parkinson disease is a progressive neurological disorder with no known cure or proven method of slowing progression. High-intensity, laboratory-based aerobic exercise interventions are currently being pursued as candidates for altering disease progression. The aim of this project was to evaluate the translation of a laboratory-based intervention to the community by monitoring exercise adherence (eg, attendance) and intensity (eg, heart rate [HR] and cadence) in 5 established Pedaling for Parkinson's exercise classes. A secondary aim was to determine the impact of disease severity and demographics variables on exercise adherence.

Methods:
A 12-month pragmatic design was utilized to monitor attendance, HR, and cadence during each Pedaling for Parkinson's class session. Over the course of 1 year, approximately 130 sessions were offered. Forty-nine (n = 30 males) persons with mild to moderate Parkinson disease from 5 community fitness facilities participated.

Results:
Out of the approximately 130 cycling sessions offered at each site over 12 months, 37% of the participants attended greater than 2 classes per week (80-130 total sessions), 47% attended 1 to 1.9 classes per week (40-79 total sessions), and less than 17% attended less than 1 class per week (<40 total sessions). Average pedaling cadence was 74.1 ± 9.6 rpms while average percentage of HR maximum was 68.9 ± 12.0%. There were no significant differences between cycling adherence and intensity variables based on disease severity, age, or sex.

Discussion and Conclusions:
Consistent attendance and exercise performance at moderate to high intensities are feasible in the context of a community-based Pedaling for Parkinson's class. Consistency and intensity of aerobic exercise have been proposed as critical features to elicit potential disease modification benefits associated with exercise. Community-based fitness programs that bring laboratory protocols to the “real world” are a feasible intervention to augment current Parkinson disease treatment approaches. See the Supplementary Video, available at: http://links.lww.com/JNPT/A357.
Intramedullary nailing versus external fixation for open tibia fractures in Tanzania: a cost analysis
Authors: Roberts Heather J. , Donnelley Claire A. , Haonga Billy T. , Kramer Erik , Eliezer Edmund N. , Morshed Saam , Shearer David 
Published: August 2021

Abstract

Objectives:
Open tibia fractures pose a clinical and economic burden that is disproportionately borne by low-income countries. A randomized trial conducted by our group showed no difference in infection and nonunion comparing 2 treatments: external fixation (EF) and intramedullary nailing (IMN). Secondary outcomes favored IMN. In the absence of clear clinical superiority, we sought to compare costs between EF and IMN.

Design:
Secondary cost analysis.

Setting:
Single institution in Tanzania.

Patients/Participants:
Adult patients with acute diaphyseal open tibia fractures who participated in a previous randomized controlled trial.

Intervention:
SIGN IMN versus monoplanar EF.

Main Outcome Measurements:
Direct costs of initial surgery and hospitalization and subsequent reoperation: implant, instrumentation, medications, disposable supplies, and personnel costs.
Indirect costs from lost productivity of patient and caregiver.
Societal (total) costs: sum of direct and indirect costs.
All costs were reported in 2018 USD.

Results:
Two hundred eighteen patients were included (110 IMN, 108 EF). From a payer perspective, costs were $365.83 (95% CI: $332.75–405.76) for IMN compared with $331.25 ($301.01–363.14) for EF, whereas from a societal perspective, costs were $2664.59 ($1711.22–3955.25) for IMN and $2560.81 ($1700.54–3715.09) for EF. The largest drivers of cost were reoperation and lost productivity. Accounting for uncertainty in multiple variables, probabilistic sensitivity analysis demonstrated that EF was less costly than IMN from the societal perspective in only 55% of simulations.

Conclusions:
Intramedullary nail fixation compared with external fixation of open tibia fractures in a resource-constrained setting is not associated with increased cost from a societal perspective.
Trends in HIV Care Outcomes Among Adults and Adolescents—33 Jurisdictions, United States, 2014–2018
Authors: Dailey André , Johnson Anna Satcher , Hu Xiaohong , Gant Zanetta , Lyons Shacara Johnson , Adih William 
Published: August 2021

Background:
With significant improvements in the diagnosis and treatment of HIV, the number of people with HIV in the United States steadily increases. Monitoring trends in HIV-related care outcomes is needed to inform programs aimed at reducing new HIV infections in the United States.

Setting:
The setting is 33 United States jurisdictions that had mandatory and complete reporting of all levels of CD4 and viral load test results for each year during 2014–2018.

Methods:
Estimated annual percentage change and 95% confidence intervals were calculated to assess trends in stage of disease at time of diagnosis, linkage to HIV medical care within 1 month of HIV diagnosis, and viral suppression within 6 months after HIV diagnosis. Differences in percentages were analyzed by sex, age, race/ethnicity, and transmission category for persons with HIV diagnosed from 2014 to 2018.

Results:
Among 133,477 persons with HIV diagnosed during 2014–2018, the percentage of persons who received a diagnosis classified as stage 0 increased 13.7%, stages 1–2 (early infections) increased 2.9%, stage 3 (AIDS) declined 1.5%, linkage to HIV medical care within 1 month of HIV diagnosis increased 2.3%, and viral suppression within 6 months after HIV diagnosis increased 6.5% per year, on average. Subpopulations and areas that showed the least progress were persons aged 45–54 years, American Indian/Alaska Native persons, Asian persons, Native Hawaiian/other Pacific Islander persons, and rural areas with substantial HIV prevalence, respectively.

Conclusions:
New infections will continue to occur unless improvements are made in implementing the Ending the HIV Epidemic: A Plan for America strategies of diagnosing, treating, and preventing HIV infection.
Effectiveness of Subcostal Transversus Abdominis Plane Block in Subcutaneous Onlay Laparoscopic Approach (SCOLA) Surgery: A Retrospective Observational Study
Authors: Toscano Antonio , Cuccomarino Salvatore , Capuano Paolo , Bonomo Luca D. , Forcella Katia M.R. , Aprà Fabrizio , Jannaci Alberto , Brazzi Luca 
Published: August 2021

Background:
Postoperative analgesia in SCOLA (subcutaneous onlay laparoscopic approach) surgery is traditionally based on intravenous opioids. The aim of this retrospective observational study was to evaluate the efficacy of bilateral subcostal transversus abdominis plane (SCTAP) block on postoperative pain relief in the first 48 postoperative hours following SCOLA.

Materials and Methods:
From August 2017 to December 2019, 163 patients were eligible for the analysis. Postoperative analgesia was managed either with an intravenous tramadol continuous infusion (opioid group) or a multimodal opioid-sparing strategy based on bilateral SCTAP block (SCTAP group), according to the anesthesiologist’s postoperative plan. After data collection, 103 patients were assigned post hoc to the SCTAP group and 60 patients to the opioid group. The primary outcome was the evaluation of postoperative pain, considering both the Numeric Rating Scale score and the percentage of patients with uncontrolled pain at 6, 12, 24, or 48 hours. Secondary outcomes were differences in the administration of ketorolac rescue analgesia and incidence of mild adverse effects.

Results:
There were no significant differences in median Numeric Rating Scale at 6, 12, 24, and 48 hours and ketorolac rescue dose consumption in both groups. Five patients (4.85% of a total of 103 patients) referred postoperative nausea and vomiting in the SCTAP group versus 10 patients (16.67% of a total of 60 patients) in the opioid group (P=0.02).

Conclusion:
Analgesia with SCTAP block seems to represent a feasible and efficient strategy for pain management in patients undergoing SCOLA surgery, allowing good quality analgesia, low opioids requirements, and reduced incidence of postoperative nausea and vomiting.