bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tear Function Alterations and Conjunctival Impression Cytology Findings in Patients With Gout
Authors: Belviranli Selman , Turk Huseyin B. , Oltulu Pembe , Turk Nazli , Mirza Enver , Küçük Adem , Aydemir Harun , Oltulu Refik 
Published: August 2021

Objectives:
The aim of this study was to evaluate the tear functions and conjunctival impression cytology (CIC) findings of patients with gout and compare them with healthy controls.

Methods:
Thirty-four patients with gout (group 1) and 32 age-matched and gender-matched healthy individuals (group 2) were included in this cross-sectional study. Schirmer 1 test, tear breakup time (TBUT), Ocular Surface Disease Index (OSDI) score, and CIC grade were evaluated and compared between the groups.

Results:
There was no significant difference between the groups in gender and age (P=0.923 and P=0.078, respectively). The mean of Schirmer 1 test result was significantly lower in group 1 (9.74±6.03 mm) than that in group 2 (17.16±9.33 mm) (P<0.001). The TBUT was also significantly lower in group 1 (7.00±2.09 seconds) than that in group 2 (12.75±5.25 seconds) (P<0.001). The OSDI score (20.04±12.92) was significantly higher in group 1 than that in group 2 (6.19±10.07) (P<0.001). Although 10 patients (29.4%) in group 1 had the CIC grade of 2 to 3, none of the controls had CIC grade 2 to 3. The mean CIC grade in group 1 (1.15±0.89) was significantly higher than that in group 2 (0.47±0.51) (P<0.001).

Conclusions:
The results of this study suggest that ocular surface alterations assessed by CIC and tear function abnormalities are more common in patients with gout.
Evaluating Well-being of Individuals With Chronic Visual Conditions Requiring Regular Eyecare During COVID-19 Lockdown: A Cross-Sectional Study
Authors: Almhdawi Khader A. , Alsalem Munsif Fayiz , Obeidat Donia , Al-Khateeb Laith T. , Al Aqarbah Mohammad Nayef , Alshiyab Wejdan Mahmoud , Arabiat Alaa Adeeb , Bazel Mohammed Abdullah , Al-Share Zaidoon 
Published: August 2021

Objectives:
To assess health-related quality of life (HRQoL) and its predictors among individuals with chronic vision conditions during COVID-19 lockdown.

Methods:
A cross-sectional, survey-based study targeted Jordanian adults with a variety of chronic vision conditions requiring regular ophthalmic follow-up. Outcome measures included HRQoL measured by the 12-item Short-Form Health Survey (SF-12), mental health symptoms measured by the Depression Anxiety Stress Scale, and vision ability measured by the National Eye Institute Visual Functioning Questionnaire (VFQ-25) General Vision and Role Limitation subscales. Data were analyzed descriptively and using a multiple variable linear regression model to identify HRQoL predictors.

Results:
A total of 203 participants with a mean age of 52.09 (±15.41) years participated, and SF-12 mean scores were 58.15 for the physical component and 57.48 for the mental component. The level of HRQoL was significantly associated with VFQ-25 Role Limitation subscale, diabetes, the need of ophthalmic follow-up, and stress. The regression model explained 47.1% of the variance in HRQoL (r2=0.471, F=35.57, P<0.001).

Conclusions:
Jordanian individuals with chronic vision conditions demonstrated low levels of HRQoL during COVID-19 lockdown. Participants also showed high levels of mental health symptoms and reported low accessibility to ophthalmic care. Access to nonurgent ophthalmic care in individuals with chronic vision diseases should be carefully planned in future pandemics.
New polynomial regression formula to improve second-eye refractive outcomes in sequential bilateral cataract surgery
Authors: Klein Édouard , Malecaze François , Bart Victor , Barnoud Anouk , Lévy Pierre , Gauthier Laurent , Fournié Pierre 
Published: August 2021

Purpose:
To assess a new polynomial regression formula integrating the refractive prediction error of the first-operated eye to improve the intraocular lens power calculation of the second eye in cataract surgery.

Setting:
Centre Hospitalier Universitaire, Toulouse, France.

Design:
Retrospective multicentric dataset study.

Methods:
A polynomial regression formula, WeOptimeye2nd (WO2nd), was developed using a machine-learning algorithm trained on a dataset of 534 patients who underwent sequential bilateral cataract surgery. A separate multicentric dataset was used to retrospectively calculate predicted refraction with WO2nd, SRK/T and Barrett Universal II formulas, and 3 other methods of constant factors (CFs) second-eye refinement (CF0.38, CF0.35, and CF0.5). Mean absolute errors (MAEs) and percentage of eyes within ±0.25, ±0.5, and ±1.0 diopter (D) from predicted spherical equivalent were compared between formulas.

Results:
The study comprised data on 722 patients. In the overall population, WO2nd had the lowest MAE: 0.339 vs 0.347 (P = .137), 0.340 (P = .956), 0.350 (P = .066), 0.399 (P < .001), and 0.410 (P < .001), with CF0.38, CF0.5, and CF0.35, Barrett II, and SRK/T, respectively. WO2nd had the highest percentage of eyes within ±0.5 D of the predicted refraction, and the difference was statistically significant vs SRK/T and Barrett II formulas but not vs CF0.38, CF0.5, and CF0.35. WO2nd performed the best in axial length (AL) < 22 mm with the lowest MAE and a statistically significant difference vs any other formula.

Conclusions:
WO2nd improved the refractive outcome of the second-operated eye and performed well in extreme AL and mean keratometry subgroups.
Outcomes of femtosecond laser–assisted cataract and refractive lens surgery in patients with prior radial keratotomy
Authors: Trinh Tanya , Solomon Benjamin , Mimouni Michael , Cohen Eyal , Gouvea Larissa , Santaella Gisella , Sorkin Nir , AlShaker Sara , Din Nizar , Rootman David S. 
Published: August 2021

Purpose:
To investigate outcomes of femtosecond laser (FL)-assisted cataract surgery (FLACS) and refractive lens exchange (RLE) in patients with prior radial keratotomy (RK).

Setting:
Single clinical practice.

Design:
Retrospective observational case series.

Methods:
All patients with prior RK undergoing FLACS- or FL-assisted RLE surgeries over a 6-year period were reviewed. Inclusion criteria were diurnal stability and stable manifest refraction. Exclusion criteria were any other incisional corneal surgery, macular or glaucomatous pathology, or vision loss due to any other cause. Data collected included demographics, visual acuity, laser settings, and complications. Main outcome measures were intraoperative and postoperative complications and visual outcomes. Safety and efficacy indices were evaluated.

Results:
16 eyes of 9 patients were included. Mean age and follow-up time were 59.9 ± 9.9 years (range 44 to 75 years) and 3.3 ± 2.5 months, respectively. The mean number of RK cuts was 11.8 ± 5.3 (range 8 to 20). Mean preoperative uncorrected (UDVA) and corrected distance visual acuity (CDVA) were 0.9 ± 0.4 logMAR (Snellen 20/160) and 0.2 ± 0.3 logMAR (Snellen 20/30), respectively. 2 intraoperative anterior capsule tears were identified. 1 postoperative intraocular lens dislocation occurred. Postoperatively, the mean UDVA and CDVA were 0.2 ± 0.2 logMAR (20/30) and 0.1 ± 0.1 logMAR (20/25), respectively. The safety index was 1.6, and the efficacy index was 1.2.

Conclusions:
FLACS- or FL-assisted RLE surgery in RK patients has a high risk for anterior capsule tear and should be avoided. Thickened incisional scars are potential sources of incomplete laser penetrance. Toric lens implantation in RK eyes provide unpredictable astigmatic correction and should also be avoided.
Agreement of intraocular lens power calculation between 2 SS-OCT–based biometers
Authors: Pfaeffli Oliver A. , Weber Adrian , Hoffer Kenneth J. , Savini Giacomo , Baenninger Philipp B. , Thiel Michael A. , Taroni Leonardo , Müller Luzia 
Published: August 2021

Purpose:
To assess agreement of measurements by 2 swept-source optical coherence tomography biometers and to evaluate the prediction error (PE) in intraocular lens power calculation with 7 formulas.

Setting:
Tertiary public eye hospital.

Design:
Consecutive observational.

Methods:
Axial length (AL), keratometry (K), anterior chamber depth (ACD), lens thickness (LT), and corneal diameter (CD) were measured with the IOLMaster 700 (Biometer A) and Anterion (Biometer B). Agreement was quantified by the limits of agreement and concordance correlation coefficient (CCC). The PE, the median absolute error, and the mean absolute error of the Barrett Universal II, EVO 2.0, Haigis, Hoffer Q, Holladay 1, Kane, and SRK/T formulas were investigated after constant optimization.

Results:
In 78 eyes from 78 patients, excellent agreement was obtained for AL (CCC >0.99), very good agreement for K, ACD, and LT (CCC >0.95), and strong agreement for CD (CCC >0.72). An additive offset of 0.07 mm was measured for ACD and LT whose mean values were higher with Biometer B (P < .001). No statistically significant difference was found between the PEs and their absolute values when comparing the results of each formula between the 2 biometers.

Conclusions:
Agreement of biometric measurements by the 2 biometers was high, although Biometer B provided higher mean values of ACD and LT by 0.07 mm. In cataract patients with normal eye length, measurements by the 2 biometers did not lead to different refractive outcomes with the 7 formulas investigated.
Instrumented and Standard Measures of Physical Performance in Adults With Chronic Kidney Disease
Authors: Johnstone Laura M. , Roshanravan Baback , Rundell Sean D. , Kestenbaum Bryan , Baker Sarah Fay , Berry Donna L. , McGough Ellen 
Published: August 2021

Background:
Chronic kidney disease (CKD) is a common pathology encountered by acute care physical therapists. CKD is associated with reduced physical function and fall risk. The purpose of this study was to (1) examine the test-retest reliability of standard and instrumented physical performance measures and (2) describe the relationship between subjective fall risk and objective physical performance in people with CKD.

Methods:
Twenty-one adults with CKD completed a battery of standard and instrumented physical performance measures 1 week apart. Standard measures were the Short Physical Performance Battery (SPPB), gait speed, 5 times sit-to-stand (FSTS), 2-minute walk test (2MWT), and quadriceps (QS) and grip (GS) strength dynamometry. Instrumented measures included parameters of gait, sit-stand, and postural sway. Intraclass correlation coefficients (ICC) assessed test-retest reliability, and Pearson correlations (adjusted for age) assessed the relationships between the Fall Risk Questionnaire (FRQ) and standard physical performance.

Results:
Excellent to moderate test-retest reliability was demonstrated in the standard and instrumented physical performance measures. A subset of standard measures was significantly associated with the FRQ score.

Conclusions:
This study supports the clinical reliability of a battery of standard physical performance measures and a subset of instrumented parameters for use in adults with CKD. The FRQ may be useful for screening fall risk considering its relationship to objective physical performance.
Effect of dipping and nondipping pattern of blood pressure on subclinical left ventricular dysfunction assessed by two-dimensional speckle tracking in hypertensive patients
Authors: Sayed Amro , Razik Nady A. , Galal Ahmed W. , Al Maashani Said , Hamouda Mohamed A. , Rabat Khalid E. , Bendary Ahmed M. 
Published: August 2021

Objective
The aim of this study was to evaluate the left ventricular (LV) function by conventional two-dimensional speckle tracking echocardiography (2D STE) to detect subclinical LV systolic dysfunction in patients with dipper and nondipper hypertension.

Methods
One hundred consecutive patients with hypertension were included in our study. Clinical evaluation, baseline laboratory investigations, 24 ambulatory blood pressure monitoring 2D echocardiographic examination and 2D STE were performed for all patients. Patients were classified as dippers and nondippers according to their nighttime MAP (mean arterial blood pressure) reduction rate of ≥10 or <10%, respectively.

Results
Of 100 patients, 71% were nondippers while 29% were dippers. Nondippers had a significantly lower global longitudinal strain (LS) value (−22.45 ± 3.26 vs. −18.2 ± 3.3, P < 0.001), global circumferential strain (CS) value (−24.23 ± 3.56 vs. −19.16 ± 8.25, P < 0.001) and global radial strain (RS) value (35.04 ± 11.16 vs. 29.58 ± 8.44, P = 0.009). It was found that nondipper status was associated with worsening of LS by 2.737, (P = 0.001), CS by 3.446, (P = 0.002), RS by −3.256, (P = 0.158) and DM also was found associated with worsening of LS by 1.849, (P = 0.062), CS by 3.284 (P = 0.018), RS by −2.499 (P = 0.381).

Conclusion
The nondipping hypertension pattern is associated with subclinical LV systolic dysfunction as shown by the impaired global myocardial strain in all three directions.
Overall Impact of Coronavirus Disease 2019 Outbreak in Children With Functional Abdominal Pain Disorders
Authors: Strisciuglio Caterina , Martinelli Massimo , Lu Peter , Bar Lev Michal Rozenfeld , Beinvogl Beate , Benninga Marc A. , Di Lorenzo Carlo , Fiori Nastro Francesca , Nurko Samuel , Pearlstein Haley , Rosen Rachel , Shamir Raanan , Staiano Annamaria 
Published: August 2021

ABSTRACTObjective:We aimed to assess how the first phase of coronavirus disease 2019 (COVID‐19) pandemic influenced symptoms in children with functional abdominal pain disorders (FAPDs) and to characterize their quality of life (QoL), anxiety and global health.Methods:This was a multicenter, observational, international study conducted between April and July 2020 at six different referral centers. Children diagnosed with FAPDs between October 2019 and February 2020 were enrolled and prospectively interviewed at 4 months of follow‐up during the first pandemic phase (Quarantine group). Patients were asked to complete PedsQL 4.0 Generic Core Scale and PROMIS Anxiety and Global Health questionnaires. A cohort of children diagnosed with FAPDs between October 2018 and February 2019 was used as a Control group.Results:Three‐hundred‐fifty‐six children were enrolled of whom 180 (mean age at diagnosis: 14 ± 2.8 years) in the Quarantine group and 176 (mean age at diagnosis: 13 ± 2.8 years) in the Control group. At 4 months of follow‐up, we observed a significant reduction of children reporting >5 episodes of abdominal pain per month when compared to baseline, in both groups (Quarantine group: 63.9% vs 42.2%, P < 0.001; Control group: 83.5% vs 50%, P < 0.001). The Quarantine group had median QoL values of 84.8 with 16.6% of children showing high anxiety values and 55% having decreased global health score.Conclusions:We demonstrated symptoms’ improvement at 4 months of follow‐up in both cohorts. During the first months of the COVID‐19 quarantine children with FAPDs showed satisfactory QoL and anxiety scores, suggesting positive effects of school closure and increased parental attention.
Traumatized Refugees in Psychotherapy
Authors: Opaas Marianne , Hartmann Ellen J. 
Published: August 2021

Abstract
This pre- and posttreatment study of 22 severely traumatized adult refugees spanned a mean of 6.5 years. Changes in personality functioning, mental health, and well-being were examined using the Rorschach Performance Assessment System, Harvard Trauma Questionnaire, Hopkins Symptom Checklist–25, and the World Health Organization’s Quality of Life–BREF questionnaire. A paired samples t-test revealed significant improvement after psychotherapy in traumatic ideation and initial severe disruptions in thought processes, reality testing, perception, self and other representations, and relational capacity (Cohen’s d = 0.46–0.59). Symptoms of anxiety, depression, and posttraumatic stress were significantly reduced (d = 0.54–0.84), quality of life in the physical health and psychological health domains increased significantly (d = 0.87 and 0.97), and percentage of participants with exile language proficiency and work/study status increased significantly. The findings demonstrate the potential of psychotherapy to contribute to normalizing perceptual, cognitive, and relational capacities in severely traumatized refugees, paramount to well-being and functioning in exile.
Is Gratitude Associated With Suicidal Ideation in Veterans With Mental Illness and Student Veterans With PTSD Symptoms?
Authors: Umucu Emre , Lo Chu-Ling , Lee Beatrice , Vargas-Medrano Javier , Diaz-Pacheco Valeria , Misra Kiran , Martin Sarah L. , Thompson Peter M. , Gadad Bharathi S. 
Published: August 2021

Abstract
The present study is aimed to identify the effect of gratitude as an adaptive regulating mechanism from suicidal ideation (SI) for veterans with mental illness (study 1) and student veterans with posttraumatic stress disorder (PTSD) symptoms (study 2) in the United States. Descriptive statistics and regression analyses were used to examine sociodemographic characteristics and relationships between gratitude and SI. Our study 1 consisted of 156 veterans with mental illness. The mean age for study 1 was 37.85. Our study 2 consisted of 232 student veterans with PTSD symptoms. The mean age for study 2 was 28.43. Higher gratitude scores in study 1 and study 2 were significantly associated with lower SI scores after adjusting for demographics and depression. This study partially supports the association between gratitude and SI in veterans with mental illness. Based on the results from this study, gratitude interventions may be effective in reducing SI when working with veterans with mental illness.
Conditional Process Modeling of the Relationship Among Self-Reliance, Loneliness, and Depressive Symptoms, and the Moderating Effect of Feeling Understood
Authors: Ogrodniczuk John S. , Oliffe John L. , Kealy David , Seidler Zac E. , Black Nick , Rice Simon M. 
Published: August 2021

Abstract
Self-reliance features as one of the notable male norms espoused by traditional masculine socialization. Strict adherence to a self-reliant attitude has been found to confer risk for depression and suicidality among men. Yet, little research has investigated the factors that may contribute to self-reliance having a negative impact for men. Using data from a large sample of Canadian men (N = 530), the present study examined the association between self-reliance and depression, while also assessing the roles of loneliness and not feeling understood as contributing factors in this process. Findings indicated that the moderated mediation model was significant, pointing to loneliness as a significant mediator in the association between self-reliance and depression. Furthermore, the findings revealed that not feeling understood moderated the relationship between self-reliance and loneliness, indicating that this association applies mainly to those men who do not feel understood by at least one important person in their life.
Assessment of a Situation Awareness Quality Improvement Intervention to Reduce Cardiac Arrests in the PICU
Authors: Dewan Maya , Soberano Blaise , Sosa Tina , Zackoff Matthew , Hagedorn Philip , Brady Patrick W. , Chima Ranjit S. , Stalets Erika L. , Moore Lindsey , Britto Maria , Sutton Robert M. , Nadkarni Vinay , Tegtmeyer Ken , Wolfe Heather 
Published: August 2021

OBJECTIVES:
To use improved situation awareness to decrease cardiopulmonary resuscitation events by 25% over 18 months and demonstrate process and outcome sustainability.

DESIGN:
Structured quality improvement initiative.

SETTING:
Single-center, 35-bed quaternary-care PICU.

PATIENTS:
All patients admitted to the PICU from February 1, 2017, to December 31, 2020.

INTERVENTIONS:
Interventions targeted situation awareness and included bid safety huddles, bedside mitigation signs and huddles, smaller pod-based huddles, and an automated clinical decision support tool to identify high-risk patients.

MEASUREMENTS AND MAIN RESULTS:
The primary outcome metric, cardiopulmonary resuscitation event rate per 1,000 patient-days, decreased from a baseline of 3.1–1.5 cardiopulmonary resuscitation events per 1,000 patient-days or by 52%. The secondary outcome metric, mortality rate, decreased from a baseline of 6.6 deaths per 1,000 patient-days to 3.6 deaths per 1,000 patient-days. Process metrics included percent of clinical deterioration events predicted, which increased from 40% to 67%, and percent of high-risk patients with shared situation awareness, which increased from 43% to 71%. Balancing metrics included time spent in daily safety huddle, median 0.4 minutes per patient (interquartile range, 0.3–0.5), and a number needed to alert of 16 (95% CI, 14–25). Neither unit acuity as measured by Pediatric Risk of Mortality III scores nor the percent of deaths in patients with do-not-attempt resuscitation orders or electing withdrawal of life-sustaining technologies changed over time.

CONCLUSIONS:
Interprofessional teams using shared situation awareness may reduce cardiopulmonary resuscitation events and, thereby, improve outcomes.
Streptococcal Pharyngitis
Authors: Thompson Jennifer M. , Zagel Alicia L. , Spaulding Alicen B. , Krause Ernest A. , Arms Joseph L. 
Published: August 2021

Objectives
The Infectious Diseases Society of America (IDSA) guidelines regarding group A streptococcal (GAS) pharyngitis advise against routine testing for patients younger than 3 years, patients without pharyngitis, and patients with symptoms suggesting a viral infection. Group A streptococcal testing may be overused in some clinical settings; thus, we conducted this study to evaluate compliance with the IDSA guidelines in a pediatric emergency department (ED) setting.

Methods
This retrospective cohort study describes patients younger than 18 years presenting to 2 urban pediatric EDs in 2016 who underwent rapid antigen detection testing for GAS pharyngitis. Testing was classified as noncompliant with the IDSA guidelines if the chief complaint was not indicative of GAS infection and/or the patient age was younger than 3 years. Appropriate nonparametric tests compared groups by IDSA testing compliance status.

Results
A total of 13,585 patient encounters met inclusion criteria; 5255 (39%) were noncompliant with the IDSA testing guidelines, the majority due to a chief complaint inconsistent with GAS pharyngitis (67%) and secondarily due to the age of younger than 3 years (48%). Among the patients with noncompliant testing, 51% were prescribed an antibiotic, and return encounters were more likely to occur (13% vs 10%, P < 0.001). Return encounters more commonly resulted in respiratory diagnoses in those with noncompliant GAS testing (60% vs 45%, P < 0.001).

Conclusions
Nearly 40% of all pediatric ED encounters with GAS testing were noncompliant with the IDSA guidelines and were associated with greater return encounter rates. Potential negative outcomes from noncompliant GAS testing include misdiagnosis, inappropriate use of antibiotics, allergic reactions, and loss of school days. Informed interventions to reduce unnecessary GAS testing are warranted.