bluuebunny/crossref_metadata_2025_split huggingface dataset:
TAP AND INJECT VERSUS PARS PLANA VITRECTOMY FOR POSTPROCEDURAL ENDOPHTHALMITIS
Authors: Far Parsa M. , Yeung Shanna C. , Farimani Pedram L. , Qian Jenny , Zhang Angela Q. , Kertes Peter J. , You Yuyi , Yan Peng 
Published: May 2021

Purpose:
To compare the visual outcomes after prompt pars plana vitrectomy (PPV) with tap biopsy and intravitreal antimicrobial injection to treat postinjection and postsurgery endophthalmitis.

Methods:
The Cochrane Central Register of Controlled Trials, Ovid MEDLINE, and Ovid Embase databases were searched for articles published between January 2010 and November 2020. Two independent reviewers selected articles and extracted data. We analyzed data in RevMan 5.3 and assessed methodological quality using the Cochrane ROBINS-I tool. The mean improvement in visual outcome was compared between PPV and intravitreal antimicrobial injection as a relative risk of improving ≥2 lines and a mean logarithm of the minimal angle of resolution difference in improvement.

Results:
Fifteen retrospective case series (1,355 eyes), of which 739 eyes (55%) received intravitreal antimicrobial injection and 616 (45%) received PPV as initial treatment, were included. The overall relative risk of improving 2 or more lines in PPV in comparison with intravitreal antimicrobial injection was 1.04 (95% CI 0.88–1.23; P = 0.61; I2 = 0%) with a mean difference of 0.04 (95% CI −0.18 to 0.27; P = 0.69; I2 = 0%). The results stayed robust when subgroup analysis based on causative procedure for endophthalmitis was performed.

Conclusion:
Intravitreal antimicrobial injection is noninferior to PPV for the treatment of postcataract operation, postinjection, and post-PPV endophthalmitis.
MÜLLER CELL CONE–ASSOCIATED FOVEAL DETACHMENT AS A RISK FACTOR FOR VISUAL ACUITY LOSS AFTER GLAUCOMA FILTERING SURGERY
Authors: Chihara Etsuo , Chihara Tomoyuki , Matsuzaki Shoko 
Published: May 2021

Purpose:
To examine hypotony-associated foveal lesions (FovLs) using optical coherence tomography, and to assess the risk factors of visual deterioration after glaucoma filtering surgery.

Methods:
Parameters that may be associated with postsurgical deterioration of visual acuity were retrospectively studied in 44 eyes of 44 patients who experienced postsurgical intraocular hypotension ≤6 mmHg between 2015 and 2019.

Results:
Six eyes (14%) had FovLs, such as detachment of photoreceptors (5 eyes, 11%) and acquired vitelliform lesions (1 eye, 2%) at 3 months after trabeculectomy. Logistic regression analysis revealed that hypotony maculopathy (P = 0.0141 at 3 months) and FovLs (P = 0.0486 and 0.0296 at 3 and 12 months, respectively) were significant risk factors for Visual acuity loss after trabeculectomy. The FovLs were located just behind the Müller cell cone. Visual acuity at 3 and 12 months after surgery in patients with FovLs was significantly lower than in those without FovLs (P = 0.0013 and P = 0.006, respectively). Epiretinal membrane was more common in eyes with FovLs (5 of 6 eyes, 83%) than in eyes without FovLs (7 of 38 eyes, 18%; P = 0.0037).

Conclusion:
Müller cell cone–associated FovLs lead to long-lasting visual acuity loss after filtering surgery.
Comparison of Topical Instillation From Single-dose and Multidose Eye Drop Containers in Glaucoma: A Multicenter Randomized Cross-sectional Trial
Authors: Aptel Florent , Villemont Anne-Sophie , Cunnac Pierre , Sallit Rébecca , Rabilloud Muriel , Poli Muriel , Denis Philippe 
Published: May 2021

Precis:
We compared the quality of instillation of topical treatments from single-dose (SGD) or multidose (MTD) containers in glaucoma patients and showed neither a significant difference between the type of container nor a significant relationship to upper limb mobility.

Purpose:
To describe and compare the quality of instillation of topical treatments with SGD or MTD containers in glaucoma patients. To assess factors likely to influence instillation, particularly the upper limb mobility.

Materials and Methods:
This multicenter, cross-sectional study included open-angle glaucoma patients with the same self-instilled treatment over at least 3 months. Patients were asked to successively self-administer a drop of artificial tears from SGD and MTD containers in front of an observer. The order of instillation (eye and container) was randomized. Correct instillation was defined as the administration of 1 drop in the lower fornix, without any contact between the tip of the device and the ocular surface. The Quick Disabilities of the Arm, Shoulder, and Hand self-questionnaire assessed upper limb mobility.

Results:
A total of 239 eyes from 173 patients were included. For the worst eye group 33% of patients performed correct instillation with MTD versus 32% using SGD (P=1). In the best eye group, 31.7% patients performed a correct instillation with MTD administration versus 27.5% with SGD (P=0.327). Multivariate analysis showed a significant association between an inadequate SGD instillation, old age (P=0.021), the severity of the visual field deficits (P=0.035), and a low quality of life score (P=0.028). No association existed between the Quick Disabilities of the Arm, Shoulder, and Hand score and the quality of instillation.

Conclusions:
These results suggest that the handling of single-use containers should be practiced by patients and evaluated by physicians, especially for the elderly population and those with advanced glaucoma. No difference in instillation quality was found between SGD and MTD.
Framework for opioid stigma in cancer pain
Authors: Bulls Hailey W. , Chu Edward , Goodin Burel R. , Liebschutz Jane M. , Wozniak Antoinette , Schenker Yael , Merlin Jessica S. 
Published: May 2021

Abstract
Millions of patients with cancer pain are treated with prescription opioids each year. However, efforts to mitigate the ongoing opioid crisis result in unintended consequences with opioid pain management, including opioid stigma. Emerging research indicates that opioid stigma is problematic in patients with cancer, but few studies have examined contributors to and impacts of opioid stigma in this population. To guide future research in this area, we propose a conceptual framework—the opioid stigma framework (OSF)—with which to understand and improve opioid stigma in patients with cancer pain. Development of the OSF was guided by a literature review of stigma in health-related conditions, adaptation of the existing Health Stigma and Discrimination Framework, a topical review of challenges related to opioid cancer pain management, and author expertise in cancer, pain, and opioid prescribing. The proposed OSF highlights 5 domains: (1) contributors to opioid stigma, or factors that increase the likelihood that a patient will experience opioid stigma; (2) intersecting stigmas, or the convergence of multiple stigmatized identities within a patient; (3) stigma manifestations, or the ways opioid stigma is manifested in patients, clinicians, and the community; (4) proximal outcomes, or the immediate consequences of opioid stigma in patients; and (5) long-term impacts in patients. The OSF provides 2 main avenues to facilitate future research: (1) providing a framework to explore the mechanisms that underlie opioid stigma and its impact on cancer pain management and (2) supporting the development of targeted, tailored interventions to eliminate opioid stigma.
Rapid On-site Evaluation (ROSE) in Capillary Pull Versus Suction Biopsy Technique With Endobronchial Ultrasound-transbronchial Needle Aspiration (EBUS-TBNA)
Authors: Kassirian Shayan , Mitchell Michael A. , McCormack David G. , Zeman-Pocrnich Cady , Dhaliwal Inderdeep 
Published: May 2021

Background:
Suction and capillary pull are 2 biopsy techniques used in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Although these techniques have been shown to perform comparably in terms of overall diagnostic yield, we hypothesized that the capillary pull technique would be associated with improved rapid on-site evaluation (ROSE) adequacy rates thus allowing for a shorter procedure time.

Methods:
One hundred eighteen patients undergoing EBUS-TBNA for any indication were randomized to suction or capillary pull techniques for the first biopsy pass; the technique used for all subsequent passes was based on operator preference and was not recorded. The first pass was subjected to ROSE and an adequacy assessment was given. ROSE slides were also scored for cellularity of diagnostic/lesional cells and blood contamination. The overall procedure time was also recorded.

Results:
There were no significant differences between suction and capillary pull techniques in terms of ROSE adequacy rates. Cellularity of diagnostic/lesional cells and blood contamination scores were also comparable. There was no significant difference in procedure time for the 2 techniques.

Conclusion:
This study suggests no differences in ROSE outcomes between suction and capillary pull techniques in EBUS-TBNA. The technique used should therefore be left to the discretion of the operator.
Clinical characteristics and outcomes of patients with isolated pulmonary embolism
Authors: Lee Yong Hoon , Cha Seung-Ick , Shin Kyung Min , Lim Jae Kwang , Lee Won Kee , Park Ji-Eun , Choi Sun Ha , Seo Hyewon , Yoo Seung-Soo , Lee Shin-Yup , Lee Jaehee , Kim Chang-Ho , Park Jae-Yong 
Published: May 2021

The clinical relevance of concomitant deep vein thrombosis (DVT) in patients with pulmonary embolism remains controversial. The aim of the present study was to assess clinical characteristics of patients with isolated pulmonary embolism, thereby investigating isolated pulmonary embolism related clinical factors.
Patients hospitalized for pulmonary embolism who underwent DVT workup within 3 days of pulmonary embolism diagnosis were retrospectively classified into two groups: patients with isolated pulmonary embolism and patients with DVT-associated pulmonary embolism (DVT-PE). The clinical, laboratorial and radiological parameters were compared between the two groups.
Of 1012 patients, 322 (31.8%) presented with isolated pulmonary embolism, and 690 (68.2%) presented with DVT-PE. In a multivariate analysis, female sex was an independent factor for predicting isolated pulmonary embolism [odds ratio (OR) 1.69, 95% confidence interval (CI) 1.26–2.26, P < 0.001], whereas cancer (OR 0.64, 95% CI 0.43–0.96, P = 0.031), leg pain or swelling (OR 0.08, 95% CI 0.04–0.18, P < 0.001), and central pulmonary embolism (OR 0.44, 95% CI 0.32–0.59, P < 0.001) were negatively associated with isolated pulmonary embolism. There were no significant differences between the two groups with regard to risk stratification and short-term prognosis of pulmonary embolism, including adverse outcomes and pulmonary embolism related in-hospital mortality.
Of pulmonary embolism patients who underwent imaging tests for DVT, approximately 32% presented with isolated pulmonary embolism. Isolated pulmonary embolism was positively associated with female sex, whereas it was negatively associated with cancer, leg pain or swelling, and central pulmonary embolism. The presence or absence of concomitant DVT did not influence the severity and short-term prognosis of pulmonary embolism.
Vitamin D in critical care: where are we now and what is next?
Authors: Amrein Karin , Hoffmann Magdalena , Lobmeyr Elisabeth , Martucci Gennaro 
Published: May 2021

Purpose of review
To summarize the recent evidence on the role of vitamin D deficiency in critically ill patients and emerging data claiming a role of vitamin D in COVID-19.

Recent findings
Vitamin D is a strong predictor for worse outcomes in critically ill patients, and as well in COVID-19. The vitamin D content in typical nutrition regimes is lower than what is recommended for the general population. Although its supplementation has been shown to reduce respiratory tract infections, asthma exacerbations and mortality risk in noncritically ill patients, its role in the acute setting is not yet clear. Several small intervention trials have shown interesting results in COVID-19, and larger studies are ongoing.

Summary
Although research on this topic is still ongoing, it appears reasonable to recommend at least the standard vitamin dose for the healthy population (600--800 IU of native vitamin D3). Many questions remain on the actual role, the best metabolite, regime, and so forth. However, the role for vitamin D in bone health is clear. Elderly ICU survivors have a high risk for osteoporosis/fractures, so at least in this population, an optimal vitamin D status should be targeted.
Higher Medicare Expenditures Are Associated With Better Integrated Care as Perceived by Patients
Authors: Kerrissey Michaela J. , Frean Molly , Traboulsi Abd Al-Rahman , Singer Sara J. 
Published: May 2021

Background:
Integrated care that is continuous, coordinated and patient-centered is vital for Medicare beneficiaries, but its relationship to health care expenditures remains unclear.

Research Objective:
This study explores—for the first time—the relationship between integrated care, as measured from the patient’s perspective, and health care expenditures.

Methods:
Subjects include a sample of continuously eligible fee-for-service Medicare beneficiaries (n=8807) in 2015. Analyses draw on 7 previously validated measures of patient-perceived integrated care from the 2015 Medicare Current Beneficiary Survey. These data are combined with 2015 administrative utilization data that measure health care expenditures. Relationships between patient-perceived integrated care and costs are assessed using generalized linear models with comprehensive control measures.

Results:
Patients who perceive more integrated care have higher expenditures for many, but not all, cost categories examined. Aspects of integrated care pertaining to primary provider and specialist care are associated with higher costs in several areas (particularly inpatient costs associated with specialist knowledge of the patient). Office staff members’ knowledge of the patient’s medical history is associated with lower home health costs.

Conclusions:
Patients who experience their care as more integrated may have higher expenditures on average. Thoughtful policy choices, further research, and innovations that enable patients to perceive integrated care at lower or neutral cost are needed.
A Mixed-method Evaluation of the Behavioral Health Integration and Complex Care Initiative Using the Consolidated Framework for Implementation Research
Authors: Siantz Elizabeth , Henwood Benjamin , Rabin Borsika , Center Kimberly , Fenwick Karissa , Gilmer Todd 
Published: May 2021

Background:
Integrated behavioral health and primary care can improve the health of persons with complex chronic conditions. The Behavioral Health Integration and Complex Care Initiative (BHICCI) implemented integrated care across a large health system. Whether Behavioral Health Organizations (BHOs) and Federally Qualified Health Centers (FQHCs) implemented the BHICCI differently is unclear.

Objectives:
The objective of this study was to evaluate integration under the BHICCI and to understand implementation differences between BHOs and FQHCs.

Methods:
We used a convergent parallel mixed-method design. Integration was measured quantitatively using the Maine Health Access Site Self-Assessment (SSA), which was completed by clinic teams at baseline and 24 months, and through n=70 qualitative interviews with initiative stakeholders, which were organized using the Consolidated Framework for Implementation Research. Results were compared to understand how qualitative findings explained quantitative results.

Results:
Data were collected in 7 clinics (n=2 FQHC; n=5 BHOs). FQHCs reported greatest improvement in the client centered subscale, with a baseline score of 4.6 (SD=0.64) and 7.8 (SD=0.89) at 24 months. BHOs reported greatest improvement in the organizational supports for integration subscale, with a baseline score of 4.8 (SD=1.07) and 7.9 (SD=1.1) at 24 months. Our Consolidated Framework for Implementation Research analysis illustrates contextual factors, such as insurance plan supports and clinic-level challenges, that explain these scores.

Conclusions:
All clinical settings received support from the health plan, but differences between BHOs and FQHCs affected integration progress. Study results can help identify organizational practices that advance or undermine the delivery of integrated care across multiple clinical settings.
SNF472: mechanism of action and results from clinical trials
Authors: Sinha Smeeta , Raggi Paolo , Chertow Glenn M. 
Published: May 2021

Purpose of review
Vascular calcification (VC) is associated with increased cardiovascular event rates, particularly in patients with end-stage kidney disease (ESKD). Dysregulated mineral metabolism and inflammation have been shown to promote VC, however, treatment options targeting VC specifically are not available. This review outlines the pathophysiological mechanisms contributing to VC in ESKD and describes recent studies evaluating the effects of the first-in-class inhibitor of VC, SNF472.

Recent findings
SNF472 directly inhibits calcium phosphate crystal formation and aggregation. SNF472 has completed early phase clinical trials with a favourable safety profile and Phase 2 clinical trial data have shown attenuation of coronary artery and aortic valve calcification in patients receiving hemodialysis.

Summary
Therapeutic agents that directly target VC may prevent the multiple complications associated with dystrophic calcification in patients with ESKD.
Recent evidence on the effect of treatment of metabolic acid on the progression of kidney disease
Authors: Hultin Sebastian , Johnson David W. , Badve Sunil V. 
Published: May 2021

Purpose of review
Preclinical and epidemiological studies have shown an association between acidosis and progression of chronic kidney disease (CKD) and kidney fibrosis. This review discusses the recent trials evaluating the effect of treatment of metabolic acidosis on kidney outcomes.

Recent findings
The emerging evidence suggests that bicarbonate treatment may slow the progression of CKD and reduce the risk of kidney failure. However, high-certainty evidence on the efficacy and safety of alkali therapy is still lacking. Ongoing studies are evaluating the effect of veverimer, a novel nonabsorbable polymer, on clinical kidney outcomes.

Summary
Recent studies indicate a potential benefit from reduction in acid load in patients with CKD. Whilst it is reasonable that clinicians institute acid-lowering interventions in CKD patients with acidosis, adequately powered trials are required to evaluate the benefit of correction of metabolic acidosis to delay kidney disease progression.
Genetic determinants of LDL cholesterol and risk of intracerebral haemorrhage
Authors: Szejko Natalia , Kirsch Elayna , Falcone Guido J. 
Published: May 2021

Purpose of review
The role of lipids in spontaneous, nontraumatic intracerebral haemorrhage (ICH) remains controversial, as some studies suggest that lower levels of total and LDL cholesterol could increase the risk of this disease. Because of their random assortment during meiosis, genetic variants known to associate with lipid levels can be used as instruments to evaluate this relationship from a causal perspective. The purpose of this review is to summarize the existing literature related to genetically determined LDL cholesterol levels and risk of ICH.

Recent findings
A number of studies have demonstrated that lower LDL levels are associated with a higher risk of ICH and a higher burden of neuroimaging markers of cerebral small vessel disease, such as microbleeds and white matter hyperintensity volume. As for genetically elevated lipid levels, several studies confirmed an inverse association between LDL levels and ICH. However, a number of observational studies and large meta-analyses of clinical trials of statins have failed to show such association.

Summary
Observational studies and clinical trials of statins have yielded inconsistent results regarding a possible link between LDL levels and the risk of ICH. Genetic studies focused on genetically elevated LDL levels and risk of ICH have, for the most, found an inverse association.
Safety and Efficacy of Pegteograstim on Chemotherapy-induced Neutropenia in Children and Adolescents With Solid Tumors
Authors: Cho Hee Won , Lee Ji Won , Ju Hee Young , Hyun Ju Kyung , Yoo Keon Hee , Koo Hong Hoe , Kim Kyunga , Sung Ki Woong 
Published: May 2021

Purpose:
Pegteograstim (Neulapeg) is a recombinant human granulocyte colony-stimulating factor conjugated with methoxy-maleimide-polyethylene glycol. We conducted a single-arm study investigating its safety and noninferiority to conventional filgrastim in children and adolescents

Materials and Methods:
Patients younger than 21 years with solid tumors were eligible for the study. Pegteograstim was administered on day 7 of the fourth chemotherapy cycle. Toxicities were monitored, and the change in absolute neutrophil count was compared with that of the historic control (conventional filgrastim). This trial was registered at ClinicalTrials.gov as NCT02787876.

Results:
Thirty-two patients were enrolled. Adverse events possibly related to pegteograstim were musculoskeletal pain (n=3), skin nodule (n=1), paroxysmal cough (n=1), urticaria (n=2), rash (n=1), and itching (n=1). These adverse events were all grade 1 or 2. Duration of neutropenia (ANC<500/µL) was shorter in the pegteograstim group compared with the historic control (median 6.5 vs. 10 d, P=0.004). The time from day 0 to neutrophil recovery (ANC>500/µL) was shorter in the pegteograstim group (median 15 vs. 18 d, P=0.003).

Conclusions:
Pegteograstim is safe and shows comparable efficacy to conventional filgrastim in children and adolescents. Randomized controlled trials are needed to confirm its safety and efficacy.
The Effect of Novel Medical Nonhormonal Treatments on the Angiogenesis of Endometriotic Lesions
Authors: Thanatsis Nikolaos , Filindris Theodoros , Siampalis Antonios , Papageorgiou Evangelia , Panagodimou Evangelia , Adonakis George , Kaponis Apostolos 
Published: May 2021

Importance
Irrespective of the precise mechanisms leading to endometriosis, angiogenesis is essential for the establishment and long-term proliferation of the disease. As current surgical and medical management options for women with endometriosis have substantial drawbacks and limitations, novel agents are needed and molecules targeting the angiogenic cascade could serve as potential candidates.

Objective
Our aim was to review current data about the role of angiogenesis in the pathophysiology of endometriosis and summarize the novel antiangiogenic agents that could be potentially used in clinical management of patients with endometriosis.

Evidence Acquisition
Original research and review articles were retrieved through a computerized literature search.

Results
Loss of balance between angiogenic activators and suppressors triggers the nonphysiological angiogenesis observed in endometriotic lesions. Several proangiogenic mediators have been identified and most of them have demonstrated increased concentrations in the peritoneal fluid and/or serum of women with endometriosis. Among the antiangiogenic molecules, anti–vascular endothelial growth factor agents, dopamine agonists, romidepsin, and statins have shown the most promising results so far.

Conclusions and Relevance
Given the limitations of current treatments of endometriosis, there is a need for novel, more efficient agents. Antiangiogenic molecules could be used potentially in clinical management of women with endometriosis; however, their safety and efficiency should be carefully assessed prior to that. Further large prospective trials in humans are needed before any treatment is introduced into daily clinical practice.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
After participating in this activity, physicians should be better able to summarize current knowledge about the role of proangiogenic and antiangiogenic mediators in the development of endometriosis; outline the main antiangiogenic agents that are under investigation; and describe their effect on the angiogenic mediators of endometriosis.