bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vision related quality of life of patients with keratoconus after keratoplasty at a Tertiary Eye Hospital in Saudi Arabia
Authors: Al-Qahtani Bader S , Al-Swailem Samar A , Ahmad Khabir , Khandekar Rajiv 
Published: May 2021

Purpose: To assess the vision-related quality of life (VQoL) for patients with advanced keratoconus (KC) after primary keratoplasty. Methods: This was a cross-sectional study, undertaken at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, in December 2015. Adults (aged 22–75 years) were interviewed via telephone with regard to their VQoL, on the average, 5 years after undergoing primary keratoplasty for advanced KC. VQoL was measured using the Visual Functioning Index (VF-14, Arabic version). The relationship between VQoL and different demographic and clinical factors was evaluated using linear regression. Results: Ninety-five adults participated in the study (54.7 % males; mean age at the interview = 32.05 ± 7.18 years). Eighty-seven (91.6%) of them had undergone PKP. The overall mean VF-14 score was 86.19% (SD: 12.91). VF-14 score was significantly lower for individuals with higher log average K (beta coefficient, −28.32; 95% confidence interval [CI], −55.59 to −1.04; p = 0.042) and hazy graft (beta coefficient, −12.76; 95% CI, −21.16 to −4.36; p = 0.003) adjusting for the effect of keratoplasty technique and BCVA in the better eye at the last follow up. Conclusion: This study suggests that most patients with advanced keratoconus had satisfactory VQoL after primary keratoplasty. Certain subgroups may benefit less substantially than others and would need a particular attention.
Corneal cross-linking for keratoconus: Evaluation of the retina and choroid
Authors: Nasrollahi Kobra , Razmjoo Fatemeh , Naderan Morteza , Peyman Alireza 
Published: May 2021

Purpose: To investigate the possible structural changes of the central choroid and retina after collagen cross-linking (CXL) in patients with progressive keratoconus (KCN). Methods: Twenty-five eyes of 25 patients were included in this study. Patients underwent enhanced depth imaging optical coherence tomography (EDI-OCT) before and 1 month after CXL. The values for central macular thickness (CMT), subfoveal choroidal thickness (CHT), and choroidal volume (CHV) were evaluated. Results: CMT before and after CXL was 263.24 ± 16.25 μm and 263.20 ± 16.51 μm, respectively ( p = 0.98). CHT was 362.08 ± 36.80 μm and 367.84 ± 33.67 μm before and after CXL, respectively ( p = 0.26). CHV was 8.74 ± 0.33 mm3 and 8.68 ± 0.36 mm3 before and after CXL, respectively ( p = 0.11). There was no significant difference in the corrected distance visual acuity before and after CXL (0.06 ± 0.05 and 0.05 ± 0.05 logMAR, respectively, p = 0.65). Conclusion: Central retinal and choroidal thicknesses are not changed after corneal cross- linking.
Assessing Factors Associated With Altmetric Attention Score: A Preliminary Study of 3 Hand Surgery Journals
Authors: Bernstein David N. , Richardson Michelle A. , Hammert Warren C. 
Published: May 2021

Background Traditional measures of evaluating scholarly output do not capture the impact social media can provide in disseminating and promoting research. We sought to better understand the level of online attention that high-quality hand research received. Methods Scientific manuscripts published from 2017 in Journal of Hand Surgery (American Volume) ( JHS-A), Journal of Hand Surgery ( European Volume) ( JHS-E), and HAND were recorded. Manuscript characteristics were determined, including the number of citations. Altmetric Attention Score (AAS), a measure of a manuscript’s online attention and impact, was determined, as well as Twitter mentions, Facebook mentions, and news outlet mentions. Spearman rho (ρ) correlation coefficient was used to evaluate the relationship between the number of citations and AAS. Multivariable linear regression analysis was performed to determine which manuscript factors were associated with AAS. Results A total of 323 manuscripts were identified. There was a weak positive correlation between the number of citations and AAS; however, this relationship did not exist for each individual journal. Publication in HAND and JHS-E were associated with lower average manuscript AAS when using JHS-A as the reference group. Two additional factors were also associated with increased manuscript AAS: (1) being a clinical study focused on a specific upper extremity anatomical location; and (2) increasing number of institutions on a study. Conclusions Publication in HAND and JHS-E were associated with lower manuscript AAS when using JHS-A as the reference group, suggesting that HAND and JHS-E have room for improvement in using social media to share their high-quality hand surgery scientific articles.
Virtual bronchoscopic navigation versus non-virtual bronchoscopic navigation assisted bronchoscopy for the diagnosis of peripheral pulmonary lesions: a systematic review and meta-analysis
Authors: Giri Mohan , Puri Anju , Wang Ting , Huang Guichuan , Guo Shuliang 
Published: May 2021

Background: Image-guided bronchoscopy techniques such as virtual bronchoscopic navigation (VBN) has emerged as a means of assisting in the biopsy of peripheral pulmonary lesions. However, the role of VBN-assisted (VBNA) bronchoscopy in the diagnosing of peripheral pulmonary lesions (PPLs) has not been well established. This meta-analysis investigated the diagnostic yield of VBN-assisted versus non-VBN-assisted (NVBNA) bronchoscopy for PPLs. Methods: PubMed, Embase, Cochrane library, and Web of Sciences databases were searched up to and including August 2020 to identify randomized controlled trials (RCTs) evaluating the performance of VBNA compared with an NVBNA group. Results were expressed as risk ratio (RR) or mean difference (MD) with accompanying 95% confidence interval (CI). Results: Six RCTs with 1626 patients were included. The overall diagnostic rate was similar in the VBNA (74.17%) and NVBNA (69.51%) groups, with risk ratio of 1.07 (95% CI: 0.98–1.17). However, in the VBNA group, the total examination time was significantly shorter (MD = −3.94 min, 95% CI: −6.57 to −1.36; p = 0.003) than in the NVBNA group. VBNA had superior diagnostic yield than NVBNA for PPLs ⩽ 20 mm (RR = 1.18, 95% CI: 1.05–1.32). In addition, diagnostic yield according to nature of lesion, lesion location in the lung lobe, distance from the hilum, bronchus sign and complications were similar between VBNA and NVBNA groups. Conclusion: VBNA bronchoscopy did not increase overall diagnostic yield in patients with PPLs compared with NVBNA bronchoscopy. The superiority of VBNA over NVBNA was evident among patients with PPLs ⩽ 20 mm. Future multicenter RCTs are needed for further investigation. The reviews of this paper are available via the supplemental material section.
Long-term disability trajectories in relapsing multiple sclerosis patients treated with early intensive or escalation treatment strategies
Authors: Iaffaldano Pietro , Lucisano Giuseppe , Caputo Francesca , Paolicelli Damiano , Patti Francesco , Zaffaroni Mauro , Brescia Morra Vincenzo , Pozzilli Carlo , De Luca Giovanna , Inglese Matilde , Salemi Giuseppe , Maniscalco Giorgia Teresa , Cocco Eleonora , Sola Patrizia , Lus Giacomo , Conte Antonella , Amato Maria Pia , Granella Franco , Gasperini Claudio , Bellantonio Paolo , Totaro Rocco , Rovaris Marco , Salvetti Marco , Torri Clerici Valentina Liliana Adriana , Bergamaschi Roberto , Maimone Davide , Scarpini Elio , Capobianco Marco , Comi Giancarlo , Filippi Massimo , Trojano Maria ,   on behalf of the Italian MS Register
Published: May 2021

Background and aims: No consensus exists on how aggressively to treat relapsing–remitting multiple sclerosis (RRMS) nor on the timing of the treatment. The objective of this study was to evaluate disability trajectories in RRMS patients treated with an early intensive treatment (EIT) or with a moderate-efficacy treatment followed by escalation to higher-efficacy disease modifying therapy (ESC). Methods: RRMS patients with ⩾5-year follow-up and ⩾3 visits after disease modifying therapy (DMT) start were selected from the Italian MS Registry. EIT group included patients who received as first DMT fingolimod, natalizumab, mitoxantrone, alemtuzumab, ocrelizumab, cladribine. ESC group patients received the high efficacy DMT after ⩾1 year of glatiramer acetate, interferons, azathioprine, teriflunomide or dimethylfumarate treatment. Patients were 1:1 propensity score (PS) matched for characteristics at the first DMT. The disability trajectories were evaluated by applying a longitudinal model for repeated measures. The effect of early versus late start of high-efficacy DMT was assessed by the mean annual Expanded Disability Status Scale (EDSS) changes compared with baseline values (delta-EDSS) in EIT and ESC groups. Results: The study cohort included 2702 RRMS patients. The PS matching procedure produced 363 pairs, followed for a median (interquartile range) of 8.5 (6.5–11.7) years. Mean annual delta-EDSS values were all significantly ( p < 0.02) higher in the ESC group compared with the EIT group. In particular, the mean delta-EDSS differences between the two groups tended to increase from 0.1 (0.01–0.19, p = 0.03) at 1 year to 0.30 (0.07–0.53, p = 0.009) at 5 years and to 0.67 (0.31–1.03, p = 0.0003) at 10 years. Conclusion: Our results indicate that EIT strategy is more effective than ESC strategy in controlling disability progression over time.
Phase I study of pucotenlimab (HX008), an anti-PD-1 antibody, for patients with advanced solid tumors
Authors: Liu Rujiao , Li Wenhua , Meng Yanchun , Gao Shuiping , Zhang Jian , Hu Xichun 
Published: May 2021

Background: Pucotenlimab is a humanized immunoglobulin G4 (IgG4) anti programmed cell death protein 1 (anti-PD-1) monoclonal antibody (mAb) with a S228P hinge mutation and an engineered Fc domain. Preclinical data suggests that pucotenlimab exerts antitumor effects. In this phase I study, which was prospectively registered on www.chinadrugtrials.org.cn (CTR20180125), the safety, maximum tolerated dose, preliminary antitumor activity, pharmacokinetics, and immunogenicity of pucotenlimab were evaluated in patients with advanced solid tumors. Methods: Patients with advanced solid tumors refractory to standard therapies were recruited. In a 3+3 dose escalation study, 13 patients received pucotenlimab intravenously every 3 weeks (Q3W) until disease progression or unacceptable toxicity occurred at doses of 1 mg/kg, 3 mg/kg, 10 mg/kg, and 200 mg. 17 additional patients were assigned in the expansion period. Results: A total of 30 patients were enrolled. No dose-limiting toxicity was observed. The maximum tolerated dose was not reached. The most common treatment-related adverse events of any grade were proteinuria (40%), fatigue (36.7%), weight loss (26.7%), fever (26.7%), increased aspartate aminotransferase (26.7%), rash (23.3%), and anorexia (20.0%). Partial responses occurred in five patients, with an objective response rate of 16.7%. Pharmacokinetics analysis showed rapid absorption followed by slow terminal elimination, with a mean half-life of 17.1–23.5 days across all dose groups. Conclusions: Pucotenlimab had an acceptable toxicity profile at doses up to 10 mg/kg and the maximum tolerated dose was not reached. Based on the pharmacokinetics, efficacy, and safety profile, 3 mg/kg Q3W or 200 mg Q3W are optimal for further drug development.
Anemia, sarcopenia, physical activity, and the risk of tuberculosis in the older population: a nationwide cohort study
Authors: Yoo Jung Eun , Kim Dahye , Choi Hayoung , Kang Young Ae , Han Kyungdo , Lee Hyun , Shin Dong Wook 
Published: May 2021

Background: The aim of this study was to investigate whether physical activity, sarcopenia, and anemia are associated an with increased risk of tuberculosis (TB) among the older population. Methods: We included 1,245,640 66-year-old subjects who participated in the National Screening Program for Transitional Ages for Koreans from 2009 to 2014. At baseline, we assessed common health problems in the older population, including anemia and sarcopenia. The subjects’ performance in the timed up-and-go (TUG) test was used to predict sarcopenia. The incidence of TB was determined using claims data from the National Health Insurance Service database. Results: The median follow-up duration was 6.4 years. There was a significant association between the severity of anemia and TB incidence, with an adjusted hazard ratio (aHR) of 1.28 [95% confidence interval (CI), 1.20–1.36] for mild anemia and 1.69 (95% CI, 1.51–1.88) for moderate to severe anemia. Compared with those who had normal TUG times, participants with slow TUG times (⩾15 s) had a significantly increased risk of TB (aHR 1.19, 95% CI, 1.07–1.33). On the other hand, both irregular (aHR 0.88, 95% CI 0.83–0.93) and regular (aHR 0.84, 95% CI, 0.78–0.92) physical activity reduced the risk of TB. Male sex, lower income, alcohol consumption, smoking, diabetes, and asthma/chronic obstructive pulmonary disease increased the risk of TB. Conclusion: The risk of TB among older adults increased with worsening anemia, sarcopenia, and physical inactivity. Physicians should be aware of those modifiable predictors for TB among the older population.
Hemorrhage and venous thromboembolism in critically ill patients with COVID-19
Authors: Qiu Chenyang , Li Tong , Wei Guoqing , Xu Jun , Yu Wenqiao , Wu Ziheng , Li Donglin , He Yangyan , Chen Tianchi , Zhang Jingchen , He Xujian , Hu Jia , Fang Junjun , Zhang Hongkun 
Published: May 2021

Objective: The majority of patients with COVID-19 showed mild symptoms. However, approximately 5% of them were critically ill and require intensive care unit admission for advanced life supports. Patients in the intensive care unit were high risk for venous thromboembolism and hemorrhage due to the immobility and anticoagulants used during advanced life supports. The aim of the study was to report the incidence and treatments of the two complications in such patients. Method: Patients with COVID-19 (Group 1) and patients with community-acquired pneumonia (Group 2) that required intensive care unit admission were enrolled in this retrospective study. Their demographics, laboratory results, ultrasound findings and complications such as venous thromboembolism and hemorrhage were collected and compared. Results: Thirty-four patients with COVID-19 and 51 patients with community-acquired pneumonia were included. The mean ages were 66 and 63 years in Groups 1 and 2, respectively. Venous thromboembolism was detected in 6 (18%) patients with COVID-19 and 18 (35%) patients with community-acquired pneumonia (P = 0.09). The major type was distal deep venous thrombosis. Twenty-one bleeding events occurred in 12 (35%) patients with COVID-19 and 5 bleeding events occurred in 5 (10%) patients with community-acquired pneumonia, respectively (P = 0.01). Gastrointestinal system was the most common source of bleeding. With the exception of one death due to intracranial bleeding, blood transfusion with or without surgical/endoscopic treatments was able to manage the bleeding in the remaining patients. Multivariable logistic regression showed increasing odds of hemorrhage with extracorporeal membrane oxygenation (odds ratio: 13.9, 95% confidence interval: 4.0–48.1) and COVID-19 (odds ratio: 4.7, 95% confidence interval: 1.2–17.9). Conclusion: Venous thromboembolism and hemorrhage were common in both groups. The predominant type of venous thromboembolism was distal deep venous thrombosis, which presented a low risk of progression. COVID-19 and extracorporeal membrane oxygenation were risk factors for hemorrhage. Blood transfusion with or without surgical/endoscopic treatments was able to manage it in most cases.
2019 Novel Coronavirus Vaccination among Post-graduate Residents and Fellows
Authors: Abohelwa Mostafa , Elmassry Mohamed , Abdelmalek John , Payne Drew , Nugent Kenneth 
Published: May 2021

Background Coronavirus-2 (COVID-19) has caused a worldwide pandemic since December 2019. Since then, clinical trials with vaccines have been started and completed, and at present, 3 COVID-19 vaccines have been approved for use in the United States. Healthcare providers were among the first to get vaccinated, but the precise attitudes of healthcare workers toward vaccination are uncertain. Objective To understand residents and fellows’ attitudes toward vaccination and record any side effects after vaccination. Methods We conducted an anonymous survey that was open from 3-1-2021 to 3-12-2021 using distribution lists from the Graduate Medical Education office on the Lubbock campus of the Texas Tech University Health Sciences Center after getting approval from the Institutional Review Board (L21-088). Results Eighty-one residents and fellows (26.6% out of 304) responded to our survey. Among those who responded, 63 (77.8 %) were between 25 and 35 years old, and 41 (50.6%) were males. Seventy-seven (95.1%) received the vaccine (Pfizer-BioNTech), 78 (96.3%) reported that they supported vaccination, and 3 (3.7%) reported that they did not want vaccination. Eight members (9.8%) had tested positive for COVID-19 infection before vaccination, but only 1 (1.23%) had tested positive for COVID-19 antibodies. All residents and fellows reported side effects after the vaccination, including pain at the injection site (77; 100%), local redness (9; 11.6%), local swelling (13; 16.8%), fever (25; 32.5%), fatigue (25; 32.5%), chills (34; 44.1 %), headache (38; 49.4%). Conclusions Most medical trainees have a high interest in COVID-19 vaccination; however, a few reported that they did not want vaccination.
Implementing Silent Disco Headphones in a Hospital Unit: A Qualitative Study of Feasibility, Acceptance, and Experience Among Patients and Staff
Authors: Hung, PhD, RN Lillian , Dahl, BMT Kevin , Peake Gail , Poljak Luka , Wong Lily , Mann, LLD Jim , Wilkins-Ho, MD Michael , Chaudhury, PhD Habib 
Published: May 2021

Introduction Music is so widely available and inexpensive in the modern world; it is a common option for stress reduction, comfort and enjoyment. Silent disco headphones are used among young people; however, no study has yet investigated whether it is feasible to use these headphones to support mental health and well-being among older people with dementia in hospital settings. Objective The study’s main objective is to explore whether music delivered by silent disco headphones was feasible and acceptable to a sample of inpatients staying in an older adult mental health unit of a large urban hospital. Methods We employed a video-ethnographic design in data collection, including conversational interviews and observations with video recording among ten patient participants in a hospital unit. A focus group was conducted with ten hospital staff on the unit. Results Our analysis identified three themes that represented experiences of patients and staff: (1) perceived usefulness, (2) perceived ease of use, and (3) attitude. Patient participants reported the music delivered by the headphones brought positive benefits. Witnessing the positive effects on patients influenced the staff’s view of how music could be used in the clinical setting to support patients’ well-being. Conclusions The music delivered by the silent disco headphones in an older adult mental health unit was found to be an acceptable and feasible intervention for patients. Leadership support is identified as an enabling factor in supporting technology adoption in the clinical setting. The findings can be used to inform practice development and future research.
Experience with a Clinical Audit Requirement for Interns in the Emergency Department
Authors: Windish Ryan , Morel Douglas , Forristal Catherine E 
Published: May 2021

Background: The clinical audit is an important evaluation tool to ensure quality assurance. A clinical audit requirement for interns during their emergency department (ED) term may be a valuable educational activity. Methods: The Emergency Audit Initiative (EAI) Program was initiated at Redcliffe Hospital in January 2018. Interns, who were paired with a staff specialist audit mentor, chose a topic of interest and carried out a clinical audit during their 10-week ED term. At the end of term, interns formally presented audit findings in a grand round setting. Interns and staff specialists were surveyed at the end of the intern year regarding aspects of the program. Surveys aimed to assess: (1) value of the program as an educational activity, (2) availability of time and resources to conduct the audit, and (3) perceived impact on practice. Results: During the first year of the program, 27 clinical audits were carried out. 16 interns (59%) and 8 staff specialists (57%) responded to the surveys. Interns and staff specialists reported that the audit was a valuable educational experience (88% and 100%). Interns also reported that they had adequate time (94%) and resources (81%) to conduct the audit. Interns and staff specialists however reported only a modest impact on clinical practice because of the audit program. Conclusions: Our experience with the EAI program suggests that incorporating a clinical audit requirement into the ED term is possible. Interns and staff specialists reported it to be a beneficial educational and professional development activity.
The Effect of the Educational Environment on the rate of Burnout among Postgraduate Medical Trainees – A Narrative Literature Review
Authors: Grech Marco 
Published: May 2021

Background: Burnout among postgraduate medical trainees is common. It is a syndrome characterised by emotional exhaustion, depersonalisation and reduced personal accomplishment. Burnout is seen as an organisational problem rather than the result of an individual’s ability to cope with the stress at work. The educational environment can play a pivotal role in the prevention of burnout among postgraduate medical trainees. This narrative literature review is aimed at assessing the effect of the educational environment on burnout in postgraduate doctors-in-training. Methods: A search of the databases Medline and PscyInfo for articles published between 2015 and 2020 was performed with the key words ‘burnout’ and ‘educational environment’ or ‘clinical learning environment’ or ‘postgraduate medical education’ or ‘learning environment’. Results: A total of 27 studies were identified and reviewed by the author. The prevalence of burnout reported varied widely between studies, ranging from 10% to 62%. Many of the factors that contribute to burnout form part of the educational environment, for example, hours worked, mistreatment, harassment and perceptions of injustice. Residency itself is a stressful period wherein trainees have to balance their responsibilities towards their patients with their responsibilities at home, all while furthering their studies and taking on new responsibilities. Interventions to prevent burnout and tackle existing burnout are multiple but very little solid evidence exists to attest to their efficacy. More research is needed to identify the most effective ways to deal with burnout in postgraduate medical trainees.