bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of 6 biometers based on different optical technologies
Authors: Montés-Micó Robert 
Published: June 2021

Purpose:
To evaluate repeatability and agreement between various biometric parameters using 6 biometers based on different optical technologies.

Setting:
University of Valencia, Spain.

Design:
Prospective, comparative case series.

Methods:
150 eyes were measured using the Aladdin, AL-Scan, Argos, IOLMaster700, Lenstar LS900, and OA-2000 biometers. Keratometry (K1 and K2), J0 and J45, central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), axial length (AL), white to white (WTW), and pupil size (PS) were measured 5 times with each device. Intrasubject SD, coefficient of variability (CoV), coefficient of repeatability, intraclass correlation coefficient, and Bland -Altman graphs were analyzed.

Results:
CoV values were <0.30% for K1, K2, and AL and up to 1.61% for CCT, ACD, LT, and WTW. PS values were higher (from 4.2% to 7.68%). There was statistically significant differences between biometers for all parameters evaluated (P < .001), and these differences varied as a function of the parameter analyzed. The limit of agreement (LoA) width of some comparisons for K1 and the majority for K2 were >0.50 diopter. A similar pattern was found for J0/J45. For CCT, many comparisons showed LoA width values of >25 μm. The LoA width for ACD ranged from 0.366 mm to 0.175 mm and for LT was about 0.2 mm. AL showed a highest LoA width of 0.225 mm. The LoA width for WTW was, in most cases, about ≥0.50 mm. The LoA width for PS ranged from 1.578 mm to 3.541 mm.

Conclusions:
The 6 biometers provided repeatable measurements for the different parameters analyzed. The LoA obtained for each comparison should be analyzed carefully to consider the interchangeability of these devices.
Concordance of keratoconus in monozygotic twins before and after combined corneal crosslinking/photorefractive keratectomy (Athens Protocol) using Scheimpflug and OCT tomography
Authors: Vingopoulos Filippos , Zisimopoulos Athanasios , Kanellopoulos Anastasios John 
Published: June 2021

Purpose:
To describe the concordance of keratoconus (KC) expression in 2 pairs of monozygotic twins before and after a combined corneal crosslinking (CXL)/photorefractive keratectomy (PRK) procedure.

Setting:
Private ambulatory eye surgery unit.

Design:
Retrospective interventional twin study.

Methods:
Two pairs of male monozygotic twins with KC were studied retrospectively. Improvement of flattest (K1) and steepest (K2) keratometry, index of height decentration (IHD), and corneal thickness at the thinnest point and corneal epithelial thickness measured by anterior segment optical coherence tomography and Scheimpflug tomography was compared between respective eyes of monozygotic twin siblings 1 to 5 years after the application of combined CXL and topography-guided PRK of part of the refractive error (the Athens Protocol).

Results:
Significant improvement was noted in all the keratometric indices of all 8 eyes after the combined CXL/PRK procedure. The difference in K1, K2, IHD, corneal thickness at the thinnest point, and corneal epithelial thickness percentage improvement between the right eyes of each pair of twins was statistically significant 1 year and 5 years postoperatively (P < .05). Statistically significant discordance in the aforementioned parameters percentage improvement was similarly observed between the left eyes of each pair of twins (P < .05).

Conclusions:
Although a genetic predisposition in KC is well documented, the discordance in keratometric indices improvement after a CXL/PRK procedure between respective eyes of monozygotic twins suggests that environmental influences may contribute to the disease expression as well. Variable degree of synergy in a combined CXL/PRK procedure may also explain the aforementioned discordant improvement.
Femtosecond laser–assisted descemetorhexis for Descemet membrane endothelial keratoplasty: cell-based and tissue-based ex vivo analysis of precision and safety
Authors: Feldhaus Lukas , Dirisamer Martin , Ohlmann Andreas , Luft Nikolaus , Kassumeh Stefan , Shajari Mehdi , Priglinger Siegfried G. , Mayer Wolfgang J. 
Published: June 2021

Purpose:
To analyze precision and safety of femtosecond laser–assisted descemetorhexis and postoperative corneal wound healing in human ex vivo specimens.

Setting:
Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany.

Design:
Experimental ex vivo study.

Methods:
4 donor corneas underwent femtosecond laser–assisted descemetorhexis. The descemetorhexis was performed using the LDV Z8 femtosecond laser, followed by live/dead staining, phase contrast microscopy, and scanning electron microscopy. The descemetorhexis parameters were set using a modified optical coherence tomography image capturing of 8 segments within a focus of 100 μm at the posterior corneal stroma (reversed capsulotomy program).

Results:
Live/dead sample staining analysis demonstrated that the femtosecond laser had minimal impact on the vitality of surrounding endothelial cells. Phase contrast microscopy and scanning electron microscopy evaluation showed that the laser produced precise, clear-cut edges, leaving no stromal tissue bridges.

Conclusions:
Femtosecond laser–assisted descemetorhexis could serve as a safe and precise technique with only minimal endothelial cell damage. To minimize stromal damage, further laser energy profile adjustments are necessary to optimize corneal treatment within different stages of corneal tissue swelling.
Race Moderates the Relationship Between Perceived Social Support and Self-care Confidence in Patients With Heart Failure
Authors: Cousin Lakeshia , Bugajski Andrew , Buck Harleah , Lennie Terry , Chung Misook Lee , Moser Debra K. 
Published: June 2021

Background
African Americans are at the highest risk of developing heart failure (HF) compared with other races and are hospitalized at 7 to 8 times the rate of Whites. Poor overall self-care, low self-care confidence, and lower levels of perceived social support are factors related to increased risk for hospitalizations in HF. Yet, limited evidence is available regarding the factors that may differentially impact self-care confidence by race in patients with HF.

Objective
The aim of this study was to examine to what extent race moderates the relationship between perceived social support and self-care confidence.

Method
This is a secondary analysis of cross-sectional data from African American and White patients with HF in North America (n = 429). Patients completed the Multidimensional Scale of Perceived Social Support and the Self-Care Confidence Scale of the Self-Care of Heart Failure Index. A moderation analysis was conducted using hierarchal linear regression.

Results
Sample mean age was 60.8 ± 11.5 years, 22.4% were African American, and 54.7% were in New York Heart Association class I or II. Moderation analyses yielded a significant interaction of perceived social support and race, showing White patients, not African Americans, have significantly different self-care confidence scores depending on level of social support: White, b = 0.224, 95% confidence interval [0.046–0.094], t = 5.65, and P < .001; African American, b = −0.776, 95% confidence interval [−0.049 to 0.060], t = 0.212, and P = .832.

Conclusions
Our findings show a variable effect of perceived social support on self-care confidence as a function of race, suggesting the need for further research to develop and test interventions tailored to race and levels of social support in HF.
Effect of Ventricular Assist Device Self-care Simulation-Based Mastery Learning on Driveline Exit Site Infections
Authors: Wilcox Jane E. , Harap Rebecca S. , Stosor Valentina , Cohen Elaine R. , Grady Kathleen L. , Cameron Kenzie A. , Scholtens Denise M. , Wayne Diane B. , Shanklin Kerry B. , Nonog Gretchen P. , Schulze Lauren E. , Jirak Alison M. , Magliola Grace C. , Barsuk Jeffrey H. 
Published: June 2021

Background
Ventricular assist device simulation-based mastery learning (SBML) results in better patient and caregiver self-care skills compared with usual training.

Objective
The aim of this study was to evaluate the effect of SBML on driveline exit site infections.

Methods
We compared the probability of remaining infection free at 3 and 12 months between patients randomized to SBML or usual training.

Results
The SBML-training group had no infections at 3 months and 2 infections at 12 months, yielding a Kaplan-Meier estimate of the probability of remaining infection free of 0.857 (95% confidence interval [CI], 0.692–1.00) at 12 months. The usual-training group had 6 infections at 3 months with no additional infections by 12 months. Kaplan-Meier estimates of remaining infection free at 3 and 12 months were 0.878 (95% CI, 0.758–1.00) and 0.748 (95% CI, 0.591–0.946), respectively. Time-to-infection distributions for SBML versus usual training showed a difference in 12-month infection rates of 0.109 (P = .07).

Conclusions
Ventricular assist device self-care SBML resulted in fewer 12-month infections.
Facilitators and Challenges to Exergaming
Authors: Cacciata Marysol C. , Stromberg Anna , Klompstra Leonie , Jaarsma Tiny , Kuriakose Mebin , Lee Jung-Ah , Lombardo Dawn , Evangelista Lorraine S. 
Published: June 2021

Background
Few investigators have explored challenges and facilitators to exergaming, essential factors to exergaming adherence, among patients with heart failure.

Objectives
In this qualitative study, we explored facilitators and challenges using a home-based exergame platform, the Nintendo Wii Sports, in patients with heart failure.

Methods
Semistructured face-to-face interviews were conducted in 13 participants given a diagnosis of heart failure (age range, 34–69 years). Participants were asked about their experiences with exergaming. Transcribed interviews were analyzed with content analysis.

Results
The following 4 facilitators were identified: (1) enjoyment and competition motivated gaming, (2) accessibility at home gave freedom and lowered participants' barriers to exercise, (3) physical benefits when decreasing sedentary lifestyle, and (4) psychosocial benefits on stress, mood, and family interactions. Challenges included (1) diminished engagement over time due to boredom playing similar games and (2) frustrations due to game difficulty and lack of improvement.

Conclusion
Exergaming can increase individuals' physical activity because of easy accessibility and the fun and motivating factors the games offer. Participants initially found exergaming enjoyable and challenging. However, engagement diminished over time because of boredom from playing the same games for a period of time. Participants' preferences and capacities, participants' past experiences, and social support must be considered to avoid boredom and frustrations. Future studies are warranted to determine adherence to exergaming among patients with heart failure and, ultimately, increased overall well-being and healthcare delivery in this patient population.
Ethical Issues Encountered by Forensic Psychiatric Nurses in Japan
Authors: Tsunematsu Kayoko , Fukumoto Yuko , Yanai Keiko 
Published: June 2021

ABSTRACT

Background
Criminals in Japan with mental disorders face penal servitude in prison or treatment under the Medical Treatment and Supervision Act, depending on their ability to take responsibility for their criminal acts. Forensic psychiatric nurses caring for this group may face various ethical issues.

Objective
This study aimed to identify ethical issues forensic psychiatric nurses in Japan encountered.

Method
We used the Ethical Issues Scale to conduct a survey among forensic healthcare ward nurses and analyzed the data using descriptive statistics. We also conducted semistructured interviews with individual nurses who provided signed consent and responded to the initial survey on ethical issues they encountered. These data were analyzed using Berelson's content analysis.

Results
Of 175 nurses, 131 answered our survey. The most frequently encountered ethical issue was “protecting patients' rights and human dignity,” and the most disturbing ethical issue was “providing nursing care with possible health risks.” Seventy-seven percent of the nurses chose to discuss with peers when resolving the ethical issues. Seventeen nurses who were interviewed described these forensic psychiatric nursing-related ethical distresses and conflicts: difficulty in discharge management, prevention of violence and self-harm, compulsory treatment, patient care, and negative emotions toward patient.

Conclusion
Forensic psychiatric nurses in Japan face difficulties regarding respecting patients' rights. They strive to respect patients' rights by using their expertise as nurses while sharing their difficulties with colleagues. It is important to develop a support system for social reintegration to solve ethical issues.
Dosing Tissue Plasminogen Activator on a Mobile Stroke Unit: Comparison Between Estimated and Hospital-Measured Weights
Authors: Jacob Asha P. , Wang Mengxi , Okpala Munachi , Yamal Jose-Miguel , Grotta James C. , Parker Stephanie A. 
Published: June 2021

ABSTRACT

BACKGROUND: Prehospital tissue plasminogen activator dosing in a mobile stroke unit (MSU) is estimated by the paramedic and nurse. We aimed to determine the accuracy of the estimated weight method compared with the actual weight of patients treated with tissue plasminogen activator on the MSU. METHODS: We prospectively collected the estimated weight used on the MSU for treatment and the first-documented hospital-measured weight (bed scale) within 24 hours of hospital arrival. Median absolute and percent difference in weights were calculated; less than 10% of difference in weights was considered acceptable. To compare the estimated and measured weights, we conducted a Wilcoxon signed rank test and Fisher exact test to explore the association between weight difference of greater than 10% and patient outcomes. RESULTS: Among 337 patients, median estimated and hospital-measured weights were 79.0 kg (interquartile range [IQR], 66.0–94.5) and 78.5 kg (IQR, 65.0–91.7), respectively. The median of the absolute value of the difference in estimated versus measured weight was 2.7 kg (IQR, 0.6–7.6; P < .0001). The median percent difference in weight was 3.6% (IQR, 0.8%–9.4%). The median difference between the tissue plasminogen activator dosage administered on the MSU and the recommended dose based on the actual weight was 1.3 mg (IQR, 0.06–4.8) in absolute value. In 56 patients (16.6% of the entire sample) with overestimation of weight by greater than 10%, there were no symptomatic intracerebral hemorrhages. There was no association between weight difference and discharge modified Rankin score (P = .59). CONCLUSION: Weight estimation on an MSU can lead to similar tissue plasminogen activator dosing for 83.4% of subjects compared with if dosing were determined based on actual weight. Weight overestimation or underestimation had no detected impact on tissue plasminogen activator outcomes.
Effectiveness of a Nurse-Delivered Intervention on Illness Perceptions and Quality of Life in Patients With Injury
Authors: FANN Wen-Chih , HUNG Chang-Chiao , CHABOYER Wendy , LEE Bih-O 
Published: June 2021

ABSTRACT

Background
Research has shown that nursing interventions are able to affect short-term outcomes in patients with injury. However, evidence based on a comprehensive nurse-led intervention may be beneficial for trauma care.

Purpose
This study was designed to assess the effect of a nursing intervention on the illness perceptions and quality of life of patients with injury.

Methods
A two-group experimental design and a follow-up period of 12 months were used. Ninety-four patients were randomly assigned to either the experimental group or the control group. A nurse-led cognitive behavioral therapy intervention was used to improve outcomes.

Results
The illness perception variables of “personal control” and “treatment control” were found to be significantly improved in the experimental group at 3 months after discharge, whereas “emotional perception” was significantly improved at 6 months after discharge. The intervention was also shown to improve “social quality of life” at 6 and 12 months after injury.

Conclusions
This study adds new knowledge related to nursing interventions for patients with injury in terms of the intervention achieving longer-term effects than the interventions examined in previous studies. The results highlight the importance of providing interprofessional collaborative care. However, the intervention protocol should be tested further in future studies.
Working From Home During a Pandemic
Authors: Guler Mehmet Akif , Guler Kutay , Guneser Gulec Meryem , Ozdoglar Elif 
Published: June 2021

Objective:
To determine ergonomic problems when working from home during the COVID-19 pandemic with regard to musculoskeletal pain, sleep conditions, physical activity, resting, equipment, and productivity.

Methods:
In this cross-sectional study, office workers who switched to working from home during the COVID-19 pandemic participated in an online survey (n = 194). The data were interpreted using descriptive and multivariate regression analysis.

Results:
A significant increase in back pain was revealed (P < 0.001). Significant weight gain was observed (P < 0.001) connected to a decrease in physical activity and an increase in the consumption of junk food. Despite the negative health impact, participants self-reported an increase in productivity.

Conclusion:
The self-reported productivity was higher during the working from home, but a declining trend in employee health can be observed including low back pain and weight gain.
Association Between Business Travel, Health-Related Behaviors, and Adiposity
Authors: Bergquist Sharon H. , Marcus Michele , Meng Qi , Fei Teng , Robichaux Chad , Roberts David L. , Moore Reneé H. 
Published: June 2021

Objective:
To evaluate the associations between frequency of business travel and health behaviors and adiposity.

Methods:
Retrospective cross-sectional analysis of de-identified electronic medical records from 795 corporate physical exams.

Results:
Business travel frequency demonstrates a curvilinear relationship with body mass index and body composition in men and women, with domestic and international travel. Linear and quadratic term beta coefficients indicate stronger associations between the sum of domestic and international travel and BMI, body fat percentage, and visceral adipose tissue in women than men, after accounting for age, exercise, and sleep. Based on our male sample population, international travel frequency has a greater influence on adiposity than summed (mostly domestic) travel.

Conclusions:
Frequent business travel adversely affects body composition, with differences by gender and type of travel.
Silica Dust Exposure Increases Risk for Rheumatoid Arthritis
Authors: Wrangel Oscar , Graff Pål , Bryngelsson Ing-Liss , Fornander Louise , Wiebert Pernilla , Vihlborg Per 
Published: June 2021

Objective:Rheumatoid arthritis (RA) is an inflammatory disease with unknown etiology. This study examines if silica dust exposure increases the risk for seropositive and seronegative RA.Methods:A nationwide registry case–control study was conducted that included all cases of RA in Sweden between 2005 and 2016. In total, 31,139 cases with two matched controls were included. A JEM was used to estimate exposure.Results:Silica dust exposure was associated with a statistically significant increase in odds ratio (OR) for seropositive (OR 1.22, 95% CI 1.05 to 1.40) and seronegative (OR 1.23, 95% CI 1.04 to 1.46) RA among men.Conclusion:This study found an increased OR for RA in silica-exposed men. The OR was equal for seropositive and seronegative RA. These findings further support the hypothesis that silica dust may be a trigger for RA.
Investigating the Impact of Job Loss and Decreased Work Hours on Physical and Mental Health Outcomes Among US Adults During the COVID-19 Pandemic
Authors: Guerin Rebecca J. , Barile John P. , Thompson William W. , McKnight-Eily Lela , Okun Andrea H. 
Published: June 2021

Objective:
To investigate associations between adverse changes in employment status and physical and mental health among US adults (aged 18 years or older) during the COVID-19 pandemic.

Methods:
Data from participants (N = 2565) of a national Internet panel (June 2020) were assessed using path analyses to test associations between changes in self-reported employment status and hours worked and physical and mental health outcomes.

Results:
Respondents who lost a job after March 1, 2020 (vs those who did not) reported more than twice the number of mentally unhealthy days. Females and those lacking social support had significantly worse physical and mental health outcomes. Participants in the lowest, pre-pandemic household income groups reported experiencing worse mental health.

Conclusions:
Results demonstrate the importance of providing economic and social support services to US adults experiencing poor mental and physical health during the COVID-19 pandemic.
Institutional Protocol Evolution for Screening Surgical Patients During the COVID-19 Pandemic
Authors: Dibbs Rami P. , Ferry Andrew M. , Mehl Steven C. , Dunn James J. , Enochs Joyce A. , Ferguson Susannah M. , Archer Nakeisha M. , Ward Amanda A. , Winebar Janet M. 
Published: June 2021

Abstract
The provisions of healthcare have significantly changed globally as a result of the impact of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Consequently, SARS-CoV-2 has required hospitals to create institution-specific preoperative screening protocols to minimize nosocomial transmission. Nursing leadership at our institution has served an important role in the evolving screening process. Over 260,000 people have been infected with SARS-CoV-2 within Harris County, significantly impacting healthcare systems within the greater Houston area. Institutional surgical screening protocols have thus been designed to improve patient and provider safety while delivering optimal care in accordance with our institution's guidelines and the Centers for Disease Control and Prevention recommendations. Implementation of screening protocols has helped limit transmission of SARS-CoV-2 infection while maintaining high standards of patient care. Through this experience, perioperative nursing personnel have effectively helped design and implement surgical screening protocols while also safely and properly screening patients. In addition, nurses have shown flexibility in response to the evolving nature of the coronavirus disease 2019 pandemic.