bluuebunny/crossref_metadata_2025_split huggingface dataset:
End-of-Life Care During the Coronavirus Disease 2019 Pandemic: The 3 Wishes Program
Authors: Neville Thanh H. , Bear Danielle K. , Kao Yuhan , Xu Xueqing Sherry , Hjelmhaug Kristen , Quebral Desiree , Sanaee Natalie , Hainje Jessica , Arriola Genevieve , Granone Maria Carmela , White Elizabeth , Chaturvedi Apurva , Yu Shuyi , Clarke France , Cook Deborah J. 
Published: October 2021

OBJECTIVES:
Patient- and family-centered end-of-life care can be difficult to achieve in light of visitation restrictions and infection-prevention measures. We evaluated how the 3 Wishes Program evolved to allow continued provision of compassionate end-of-life care for critically ill patients during the coronavirus disease 2019 pandemic.

DESIGN:
This is a prospective observational study where data were collected 1 year prior to the coronavirus disease 2019 pandemic and 1 year after (from March 1, 2019, to March 31, 2021). The number of deceased patients whose care involved the 3 Wishes Program, their characteristics, and wishes were compared between prepandemic and pandemic periods.

SETTING:
Six adult ICUs of a two-hospital health system in Los Angeles.

PATIENTS:
Deceased patients whose care involved the 3 Wishes Program.

INTERVENTIONS:
The 3 Wishes Program is a palliative care intervention in which individualized wishes are implemented for dying patients and their families.

MEASUREMENTS AND MAIN RESULTS:
During the study period, the end-of-life care for 523 patients involved the 3 Wishes Program; more patients received the 3 Wishes Program as part of their end-of-life care during the pandemic period than during the prepandemic study period (24.8 vs 17.6 patients/mo; p = 0.044). Patients who died during the pandemic compared with prepandemic were less likely to have family at the bedside and more likely to have postmortem wishes fulfilled for their families. Compared with the 736 wishes implemented during the prepandemic period, the 969 wishes completed during the pandemic were more likely to involve keepsakes. Wishes were most commonly implemented by bedside nurses, although the 3 Wishes Program project manager (not involved in the patient’s clinical care) was more likely to assist remotely during the pandemic (24.8% vs 12.1%; p < 0.001).

CONCLUSIONS:
Bedside innovations, programmatic adaptations, and institutional support made it possible for healthcare workers to continue the 3 Wishes Program and provide compassionate end-of-life care in the ICU during this pandemic.
The impact of deceased versus living donor graft status on kidney transplant outcomes: A Johannesburg single-center 48 years experience of 1685 patients
Authors: Milwid Tanya G , Fabian June , Adam Ahmed 
Published: October 2021

Abstract

Background
This study is aimed to determine the impact of living donor (LD) versus deceased donor (DD) kidney transplantation on renal graft survival and patient overall survival rates within Johannesburg, South Africa.

Materials and methods
A retrospective assessment was conducted of all 1685 adult first kidney-alone kidney transplant recipients transplanted between the years 1966 and 2013 in a single center. The patients were divided according to the source of the transplant: LD versus DD. Demographics and post-transplantation follow-up data were determined and tabulated. Graft and overall survival plots were generated.

Results
Of the recipients enrolled, 84.1% were DD recipients and 15.9% were LD recipients. Living donor recipient status was significantly associated with younger age (p ≤ 0.0001), a higher proportion of white, Asian, or mixed race compared to black race (p ≤ 000.1), a higher proportion of urologic etiology of disease (p = 0.015), and a lower proportion with hypertension (p ≤ 0.0001) as the cause of end stage kidney disease. Results showed a decreased risk of graft failure (hazard ratio, 0.55; 95% confidence interval, 0.45–0.66) and a decreased risk of death (hazard ratio, 0.47; 95% confidence interval, 0.36–0.61) among LD graft recipients as compared to DD graft recipients.

Conclusions
In keeping with internationally reported trends, LD recipients continue to have enhanced patient and graft survival outcomes as compared to DD recipients within our local experience. This Johannesburg experience will serve as a foundation for future related studies in this region of the world.
Neuroadrenergic activation in obstructive sleep apnea syndrome: a systematic review and meta-analysis
Authors: Quarti-Trevano Fosca , Biffi Annalisa , Bonzani Matilde , Seravalle Gino , Corrao Giovanni , Mancia Giuseppe , Grassi Guido 
Published: October 2021

Background:
Neuroadrenergic overdrive occurs in obstructive sleep apnea syndrome (OSAS). However, the small sample size of the microneurographic studies, heterogeneity of the patients examined, presence of comorbidities, represented major weaknesses not allowing to precisely define the main features of the phenomenon, particularly in nonobese patients.

Objective:
This meta-analysis evaluated 850 participants recruited in 26 microneurographic studies, based on muscle sympathetic nerve activity (MSNA) quantification in uncomplicated OSAS of different clinical severity.

Methods:
The evaluation was extended to the relationships of MSNA with heart rate (HR), anthropometric and blood pressure (BP) values, metabolic variables, apnea–hypopnea index (AHI) and oxygen saturation.

Results:
MSNA is activated markedly and almost homogeneously between studies, showing a progressive increase from the healthy state to mild, moderate and severe OSAS (41.6, 48.3, 65.5 and 70.7 bursts/100 heart beats, respectively, P < 0.01). Of special interest are the findings that first, MSNA is significantly related to the AHI, a marker of OSAS severity (r = 0.55, P < 0.02) and O2 saturation but not to body weight and BMI, as it occurs in OSAS associated with obesity; and second, HR is significantly and directly related to MSNA and AHI (r = 0.56 and 0.46, P < 0.03 for both), thus representing a surrogate marker of the sympathetic overdrive.

Conclusion:
OSAS, even when uncomplicated by other cardiometabolic disease, displays a marked sympathetic activation, reflected by the MSNA and HR behavior, becoming a target of therapeutic interventions aimed at exerting sympathomoderating effects, such as continuous positive airway pressure.
CENTRAL SEROUS CHORIORETINOPATHY
Authors: Gerardy Melvin , Yesilirmak Nilufer , Legras Richard , Behar-Cohen Francine , Bousquet Elodie 
Published: October 2021

Purpose:
To investigate cone density in the asymptomatic fellow eye of patients with unilateral central serous chorioretinopathy (CSCR).

Methods:
Seventeen asymptomatic fellow eyes of patients with unilateral CSCR and 17 eyes of aged-matched and gender-matched healthy controls underwent adaptive optics ophthalmoscopy. Cone density and spacing were assessed at the fovea. Clinical and multimodal imaging findings were also recorded.

Results:
In the CSCR group, the patient mean age was 48.9 ± 9.8 years. The mean (±SD) subfoveal choroidal thickness was 417.8 ± 125.2 µm. The foveal external limiting membrane and ellipsoid zone were intact in all patients. Adaptive optics fundus imaging showed a significant decrease in cone density at 2° of eccentricity nasal and temporal to the fovea in asymptomatic fellow eyes of patients with unilateral CSCR compared with controls (P = 0.001 and P = 0.027, respectively). No statistically significant difference in cone density was found at 4° of eccentricity nasal and temporal to the fovea between both groups.

Conclusion:
Asymptomatic fellow eyes of patients with unilateral CSCR showed a reduced density of foveal cones in the absence of a decreased visual acuity and photoreceptor line disruption on optical coherence tomography. These results suggest that the photoreceptors could be damaged independently of the occurrence of a serous retinal detachment.
Peripheral Hypertrophic Subepithelial Corneal Degeneration
Authors: Raber Irving M. , Eagle Ralph C. 
Published: October 2021

Purpose:
The purpose of this study was to report a large series of patients with peripheral hypertrophic subepithelial corneal degeneration (PHSCD) and differentiate the condition from Salzmann nodular degeneration (SND).

Methods:
We retrospectively reviewed the charts of 49 patients diagnosed with PHSCD and reported their clinical, refractive, and topographic/tomographic findings.

Results:
Most of the eyes were white and quiet. Minimal variable injection was present in a few eyes usually in the presence of pseudopterygium. Typical corneal involvement consists of peripheral circumferential-elevated whitish subepithelial opacities with fine superficial vessels along the limbus and linear deposits of iron in the epithelium along the central edge of the opacification. The typical topographic/tomographic findings consist of flattening directly over the corneal opacification with central flattening aligning with the axis of the opacification. In all subjects, the mean refractive astigmatism was significantly less than the mean topographic/tomographic Sim K astigmatism. Thirty-five eyes underwent surgical excision. The surgical eyes demonstrated significantly less astigmatism and better best-spectacle corrected visual acuity than pre-op. Moreover, all the eyes that underwent surgery for discomfort experienced significant improvement in their symptoms. Histopathology of the keratectomy specimens demonstrated paucicellular subepithelial fibrosis with overlying epithelium that was variable in caliber.

Conclusions:
PHSCD is distinct from SND, primarily occurring in middle-aged women, bilateral and fairly symmetric with larger more peripheral opacities than SND, and absence of inflammatory signs and symptoms.
Modified procedure for Loading “Flat” DMEK Grafts Into an Injector
Authors: Straiko Megan M. W. , Dye Philip K. , Hikes Matthew T. , Tran Khoa D. , Terry Mark A. 
Published: October 2021

Purpose:
The aim of this study was to determine whether loading a Descemet membrane endothelial keratoplasty (DMEK) graft using a drop-in procedure results in more endothelial cell loss (ECL) than the standard suction procedure.

Methods:
Pairs of donor corneas with equivalent preprocessing endothelium were prepared using the standard protocol of our eye bank. One member of each pair was loaded into an injector using the standard suction protocol. The mate graft was loaded using a drop-in protocol, in which the edge of the graft was gently grasped with a forceps, lifted to the edge of the injector, and dropped inside. Grafts were evaluated for ECL and examined for grab marks or other loading-associated damage.

Results:
There was no difference in mean ECL of grafts prepared for DMEK using the standard protocol (20.6% ± 4.5%) compared with that of mate grafts prepared using the drop-in loading protocol (19.5% ± 4.8%, P = 0.59). There was no consistent pattern of damage in the drop-in–loaded grafts, as grab marks or other tissue damage associated with the drop-in loading protocol were not consistently identified by a trained corneal surgeon.

Conclusions:
ECL was not significantly different in grafts prepared using a drop-in loading procedure compared with grafts prepared using the standard suction protocol. The drop-in loading protocol may be particularly useful to surgeons who load their own grafts and eye bank processing technicians who encounter a “flat” DMEK graft that does not scroll or a loosely scrolled DMEK graft.
Opioid Prescribing Patterns for Ulcerative Keratitis
Authors: Thibodeau Alexa R. , Niziol Leslie M. , Tannen Bradford L. , Ballouz Dena , Woodward Maria A. 
Published: October 2021

Purpose:
The purpose of this study was to characterize rates of opioid prescription for different ulcerative keratitis types.

Methods:
This cohort study included patients diagnosed with ulcerative keratitis according to the University of Michigan electronic health record data between September 1, 2014 and December 22, 2020. Ulcerative keratitis was categorized by etiologic type (bacterial, fungal, viral, acanthamoeba, inflammatory, polymicrobial, or unspecified) using rule-based data classification that accounted for billing diagnosis code, antimicrobial or antiinflammatory medications prescribed, laboratory results, and manual chart review. Opioid prescriptions were converted to morphine milligram equivalent and summed over 90 days from diagnosis. Opioid prescription rate and amount were compared between ulcerative keratitis types.

Results:
Of 3322 patients with ulcerative keratitis, 173 (5.2%) were prescribed at least 1 opioid for pain management within 90 days of diagnosis. More patients with acanthamoeba (32.4%), fungal (21.1%), and polymicrobial (25.0%) keratitis were treated with opioids compared with bacterial (6.7%), unspecified (2.9%), or viral (1.8%) keratitis (all Bonferroni adjusted P < 0.05). For the 173 patients who were prescribed opioids, a total of 353 prescriptions were given within 90 days of diagnosis, with half given within the first week after diagnosis. The quantity of opioid prescribed within 90 days from diagnosis was not significantly different between ulcerative keratitis types (P = 0.6559). Morphine milligram equivalent units prescribed ranged from 97.5 for acanthamoeba keratitis to 112.5 for fungal keratitis.

Conclusions:
The type of ulcerative keratitis may influence the opioid prescription rate. Providers can better serve patients needing opioids for pain management through improved characterization of pain and development of more tailored pain management regimens.
Psychometric Properties of the Korean Family Reported Outcome Measure for Family Members of Patients With Acquired Brain Injury
Authors: Oh Hay Young , Shin Yong Soon 
Published: October 2021

ABSTRACT

BACKGROUND: Acquired brain injury (ABI) affects not only survivors but also their family members’ quality of life in various ways. The Family Reported Outcome Measure (FROM-16), a self-reported instrument, has been developed to evaluate the impact of diseases on the lives of family members of patients. This study aimed to assess the reliability and validity of the Korean FROM-16 for family members of individuals with ABI. METHODS: A total of 200 family members of patients with ABI in South Korea participated in this study. Internal consistency was assessed using Cronbach α. To establish the validity, we evaluated the semantic equivalence, content, known-group, conduct, concurrent, and convergent validity of the Korean FROM-16. For exploratory factor analysis, common factor analysis with oblique rotation, parallel analysis, an eigenvalue greater than 1.0, and a scree plot were used. RESULTS: Exploratory factor analysis revealed 2 factors for the 16 items, which explained 67.4% of the total variance. Concurrent validity was established by comparison with the Korean World Health Organization Quality of Life Scale Brief (r = −0.57), and regarding the convergent validity, the Korean FROM-16 score positively correlated with the Korean Neurobehavioral Functioning Inventory. Known-group validity was confirmed by showing that family members with advanced age, the burden of caring, and insufficient income, as well as spouses, had a statistically higher score in the Korean FROM-16. Cronbach α was .92, indicating high internal consistency reliability. CONCLUSION: The Korean FROM-16 is a valid and reliable instrument for evaluating the impact of diseases on family members of individuals with ABI in South Korea.
Employee Job Satisfaction and Performance in Association With Workplace Responses to the 9/11 Attacks on New York City's World Trade Center
Authors: Miu Adriana S. , Davis Anna J. , Raitt Josh M. , Lee Min Hyung , Pedrazine Anthony , Canan Fatih , Pollio David E. , North Carol S. 
Published: October 2021

Objective:
Research is needed on disaster-affected workplaces, particularly on employee job satisfaction and performance, to inform workplace responses promoting employee postdisaster adjustment and wellbeing.

Methods:
Quantitative and qualitative data were collected from a volunteer sample of 255 employees of eight workplaces affected by the 9/11 attacks on New York City's World Trade Center nearly 3 years post disaster.

Results:
The effects of 9/11 on both job satisfaction and job performance were more negative than positive, especially for the Ground Zero employees. Effects on job satisfaction and job performance were generally congruent. Workplace responses focused on individual needs were perceived as positive and those focused on workplace needs as negative.

Conclusions:
Workplace responses focused on business improvement intended to improve workplace performance may not have the desired effect and may reduce employee job satisfaction and performance.
Evaluation of efficacy and safety of chemotherapy in the treatment of recurrent or resistant gestational trophoblastic neoplasia
Authors: Luo Fang , Li Li , Gao Qing , Li Yu-Xia 
Published: October 2021

Abstract

Background:
Gestational Trophoblastic Neoplasia (GTN) is a spectrum of pregnancy-associated tumours emerging from placental tissue. Generally, GTN patients are considered to have a high rate of recovery. However, almost 25 per cent of GTN tumours resist, or have a high probability of relapsing following the first line of chemo treatment. Thus, tumours that resist or relapse requires salvage chemotherapy, sometimes accompanied by surgery. Globally, clinicians utilize a range of salvage regimens. Currently, ongoing debates are centred around choosing the best regimens in terms of safety and efficacy. Therefore, the current research aims to appraise the success and level of safeness using chemotherapy to treat patients with resistant or recurrent GTN.

Methods:
The authors will conduct a methodological exploration in online-based databases to find Randomized Controlled Trials related to the adoption of chemotherapy agents as treatment for resistant or recurrent GTN patients. The databases are as follows: EMBASE, PubMed, Cochrane Database Central, UpToDate, Chinese National Knowledge Infrastructure, Web of Science, and WanFang Database. The search will be limited to articles published in either English or Chinese. Moreover, the authors will also perform a search for ongoing trials on online-based clinical trial registries. Two independent authors will screen and select articles for review. A similar process will be followed by two independent authors to complete the extraction of data and evaluate the bias risk. In relevant cases, the authors will contract trial investigators to obtain related, unpublished data. The authors will use the random-effects model for pooling data in RevMan software (v5.3).

Results:
The present systematic review aims to evaluate the efficacy and level of safeness associated with using chemotherapy for resistant or recurrent GTN patients.

Conclusion:
The results of the proposed systematic analysis could summarize the most recent evidence for the use of chemotherapy agents on GTN patients.

Ethics and dissemination:
Since the proposed study uses pre-published data, an ethical approval is not required.

Review registration number:
Aug 25, 2021.osf.io/rgzbn. (https://osf.io/rgzbn/).
Validation of the National Early Warning Score (NEWS)-2 for adults in the emergency department in a tertiary-level clinic in Colombia
Authors: Vergara Peter , Forero Daniela , Bastidas Alirio , Garcia Julio-Cesar , Blanco Jhosep , Azocar Jorge , Bustos Rosa-Helena , Liebisch Hans 
Published: October 2021

Abstract
The National Early Warning Score (NEWS)-2 is an early warning scale that is used in emergency departments to identify patients at risk of clinical deterioration and to help establish rapid and timely management. The objective of this study was to determine the validity and prediction of mortality using the NEWS2 scale for adults in the emergency department of a tertiary clinic in Colombia.
A prospective observational study was conducted between August 2018 and June 2019 at the Universidad de La Sabana Clinic.
The nursing staff in the triage classified the patients admitted to the emergency room according to Emergency Severity Index and NEWS2. Demographic data, physiological variables, admission diagnosis, mortality outcome, and comorbidities were extracted.
Three thousand nine hundred eighty-six patients were included in the study. Ninety-two (2%) patients required intensive care unit management, with a mean NEWS2 score of 7. A total of 158 patients died in hospital, of which 63 were women (40%). Of these 65 patients required intensive care unit management. The receiver operating characteristic curve for NEWS2 had an area of 0.90 (CI 95%: 0.87–0.92). A classification and score equivalency analysis was performed between triage and the NEWS2 scale in terms of mortality. Of the patients classified as triage I, 32.3% died, and those who obtained a NEWS2 score greater than or equal to 10 had a mortality of 38.6%.
Among our population, NEWS2 was not inferior in its area under the receiver operating characteristic curve when predicting mortality than triage, and the cutoff point for NEWS2 to predict in-hospital mortality was higher.
Novel WTX nonsense mutation in a family diagnosed with osteopathia striata with cranial sclerosis
Authors: Jeong Changhoon , Kim Myungshin , Yim Jisook , Park Il-Jung , Lee Jiwon , Lee Jaeyoung 
Published: October 2021

Abstract
Rationale: Osteopathia striata with cranial sclerosis is characterized by linear striations in the metaphysis of the long bones and pelvis with cranial sclerosis. It is an X-linked dominant sclerosing bone dysplasia and affected males show fetal or neonatal lethality. Mutations in the gene encoding Wilms tumor on the X chromosome (WTX) was identified as the cause of X-linked osteopathia striata with cranial sclerosis. About 30 pathogenic mutations in WTX have been reported recently. We have identified a novel nonsense mutation in the family diagnosed as osteopathia striata with cranial sclerosis.

Patient concerns:
The proband came to our attention at age 9 for the evaluation of toe-out gait and planovalgus deformity. Clinically, the proband showed coarse facial features including frontal bossing, ocular hypertelorism, wide depressed nasal bridge, dental malocclusion, mild macrocephaly and low set ears. Radiologically, sclerotic linear striations were seen in the X-rays of the pelvis and the metaphyseal region of femur and tibia and the cranial sclerosis was observed. The proband's mother presented similar facial features and the X-rays of the pelvis, femur, and tibia revealed same sclerotic linear striations as the proband's.

Diagnoses:
Osteopathia striata with cranial sclerosis.

Interventions:
A genetic analysis was conducted on genomic DNA isolated from peripheral blood leukocytes of the proband and the mother for confirming the clinical suspicion of osteopathia striata with cranial sclerosis. WTX on Xq11.2 gene was analyzed in direct sequencing for coding exons including intron-exon boundaries.

Outcomes:
One novel nonsense mutation (c.1003C>T, p.Gln335∗) and known single nucleotide variant were observed in a heterozygous form.

Lessons:
We found a novel nonsense mutation in a family diagnosed as osteopathia striata with cranial sclerosis. The relationship between various clinical features and genetic mutations can be clarified by accumulation of genetic database.