bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of Clinical Outcomes After XEN Gel Stent and EX-PRESS Glaucoma Drainage Device Implantation
Authors: Stoner Ari M. , Capitena Young Cara E. , SooHoo Jeffrey R. , Pantcheva Mina B. , Patnaik Jennifer L. , Kahook Malik Y. , Seibold Leonard K. 
Published: February 2021

Precis:
Although the XEN stent offers a lower risk of hypotony and choroidal effusions with fewer clinic visits postoperatively, its surgical success rate was inferior to the EX-PRESS shunt.

Purpose:
To compare the clinical efficacy and safety outcomes of the XEN stent and EX-PRESS glaucoma drainage device in glaucomatous eyes.

Materials and Methods:
One hundred eyes from 88 patients underwent ab interno XEN stent or EX-PRESS shunt implantation (52 XEN and 48 EX-PRESS) for uncontrolled glaucoma at the University of Colorado Eye Center. The primary outcome was surgical success defined as intraocular pressure (IOP) ≥6 and ≤18 mm Hg, without reoperation for uncontrolled glaucoma, loss of light perception, or use of glaucoma medications (complete success). Secondary outcomes were the same requirements allowing for medications (qualified success), mean IOP, medication use, adverse events, and number of postoperative clinic visits in the first 3 months.

Results:
Baseline characteristics including glaucoma type and severity were similar between groups, with the exception of XEN patients having fewer men (17% vs. 46%), older patients (median age, 78 vs. 68), and a higher percentage of white patients (89% vs. 69%). Adjusted hazard ratio of failure of XEN relative to EX-PRESS was 3.94 (95% confidence interval, 1.73-9.00, P=0.001) for complete success and 1.61 (95% confidence interval, 0.40-6.38, P=0.501) for qualified success. There were significantly fewer postoperative clinic visits during the first 3 months in the XEN group (5.3 vs. 9.1 visits, P<0.001). The incidence of serous choroidal effusions and hypotony was significantly less after XEN compared with EX-PRESS (1 vs. 9, P=0.02 and 15 vs. 25, P=0.023, respectively). Three XEN stents (5.8%) required removal.

Conclusions:
In this population, although the XEN stent offers a better safety profile and fewer postoperative clinic visits, complete surgical success was inferior to the EX-PRESS shunt.
Validation of the Rule of 7’s for Identifying Children at Low-risk for Lyme Meningitis
Authors: Garro Aris , Avery Robert A. , Cohn Keri A. , Neville Desiree N. , Balamuth Fran , Levas Michael N. , Bennett Jonathan E. , Kharbanda Anupam B. , Monuteaux Michael C. , Nigrovic Lise E. 
Published: February 2021

Background:
The Rule of 7’s classifies children as low-risk for Lyme meningitis with the absence of the following: ≥7 days of headache, any cranial neuritis or ≥70% cerebrospinal fluid mononuclear cells. We sought to broadly validate this clinical prediction rule in children with meningitis undergoing evaluation for Lyme disease.

Methods:
We performed a patient-level data meta-analysis of 2 prospective and 2 retrospective cohorts of children ≤21 years of age with cerebrospinal fluid pleocytosis who underwent evaluation for Lyme disease. We defined a case of Lyme meningitis with a positive 2-tier serology result (positive or equivocal first-tier enzyme immunoassay followed by a positive supplemental immunoblot). We applied the Rule of 7’s and report the accuracy for the identification of Lyme meningitis.

Results:
Of 721 included children with meningitis, 178 had Lyme meningitis (24.7%) and 543 had aseptic meningitis (75.3%). The pooled data from the 4 studies showed the Rule of 7’s has a sensitivity of 98% [95% confidence interval (CI): 89%–100%, I
2 = 71%], specificity 40% (95% CI: 30%–50%, I
2 = 75%), and a negative predictive value of 100% (95% CI: 95%–100%, I
2 = 55%).

Conclusions:
The Rule of 7’s accurately identified children with meningitis at low-risk for Lyme meningitis for whom clinicians should consider outpatient management while awaiting Lyme disease test results.
Think of the Children
Authors: González-Donapetry Patricia , García-Clemente Paloma , Bloise Iván , García-Sánchez Consuelo , Sánchez Castellano Miguel Ángel , Romero María Pilar , Gutiérrez Arroyo Almudena , Mingorance Jesús , de Ceano-Vivas La Calle María , García-Rodriguez Julio 
Published: February 2021

Background:
Real-time reverse transcription-quantitative polymerase chain reaction (RT-qPCR) is the reference laboratory method to diagnose SARS-CoV-2 infection then requires equipment and is time-consuming. There is a crucial demand for rapid techniques such as antigen detection test. Considering the different diagnostic accuracy of tests with other respiratory viruses in adults and children, SARS-CoV-2 antigen test must be evaluated specifically in children.

Methods:
The purpose of this study was to evaluate the performance of Panbio COVID-19 Ag Rapid Test Device (Abbott) as a point-of-care test for diagnosis of SARS-CoV-2 in comparison to RT-qPCR in a pediatric population.

Results:
Four hundred forty nasopharyngeal swabs were tested. Amongst the 18 positive RT-qPCR samples, 14 were detected by the rapid antigen test, given an overall sensitivity of 77.7%. All the samples detected positive with the antigen rapid test were also positive with RT-qPCR.

Conclusion:
The sensitivity of Panbio COVID-19 Ag Rapid Test Device is lower in children than in adults. Nevertheless, considering the good values of specificity, negative and positive predictive values this test could be used as a frontline test to obtain quick results, although the negative values with COVID-19 high clinical suspicion should be confirmed using RT-qPCR.
Surface light scattering from 1-piece hydrophobic acrylic intraocular lenses with hydroxyethyl methacrylate: contralateral observation for 7 years
Authors: Kinoshita Katsuhito , Miyata Kazunori , Nejima Ryohei , Honbo Masato , Mori Yosai , Minami Keiichiro 
Published: February 2021

Purpose:
To quantitatively and intraindividually compare surface light scattering for 7 years after implantation of Clareon and AcrySof intraocular lenses (IOLs).

Setting:
Miyata Eye Hospital, Miyazaki, Japan.

Design:
Retrospective comparative case series.

Methods:
Clinical records of eyes that had contralateral implantation of SN60WF and SY60WF IOLs were reviewed. Light scattering on the anterior surface of IOLs, corrected distance visual acuity (CDVA), and mesopic and photopic contrast sensitivities were examined at 1 year, 3 years, and 7 years postoperatively, and they were intraindividually compared.

Results:
34, 19, and 16 patients visited at 1 year, 3 years, and 7 years postoperatively, respectively. Surface light scattering in eyes with SY60WF IOL was significantly reduced, and the rate of increase was 2.74 computer compatible tapes per year. Although there were prominent increases in eyes with SN60WF IOL, no statistically significant difference was found in their CDVA and contrast sensitivities.

Conclusions:
In eyes with Clareon IOLs, the development of surface light scattering was suppressed up to 7 years. The increase rate demonstrated that the visual acuity would be least deteriorated up to 12 years postoperatively, whereas the influence of straylight induced should be investigated.
Delta opioid receptor regulation of calcitonin gene–related peptide dynamics in the trigeminal complex
Authors: Moye Laura S. , Siegersma Kendra , Dripps Isaac , Witkowski Wiktor , Mangutov Elizaveta , Wang Dong , Scherrer Grégory , Pradhan Amynah A. 
Published: February 2021

Abstract
Migraine is highly prevalent and is the sixth leading cause worldwide for years lost to disability. Therapeutic options specifically targeting migraine are limited, and delta opioid receptor (DOP) agonists were recently identified as a promising pharmacotherapy. The mechanisms by which DOPs regulate migraine are currently unclear. Calcitonin gene–related peptide (CGRP) has been identified as an endogenous migraine trigger and plays a critical role in migraine initiation and susceptibility. The aim of this study was to determine the behavioral effects of DOP agonists on the development of chronic migraine–associated pain and to investigate DOP coexpression with CGRP and CGRP receptor (CGRPR) in the trigeminal system. Chronic migraine–associated pain was induced in mice through repeated intermittent injection of the known human migraine trigger, nitroglycerin. Chronic nitroglycerin resulted in severe chronic cephalic allodynia which was prevented with cotreatment of the DOP-selective agonist, SNC80. In addition, a corresponding increase in CGRP expression in the trigeminal ganglia and trigeminal nucleus caudalis was observed after chronic nitroglycerin, an augmentation that was blocked by SNC80. Moreover, DOP was also upregulated in these head pain-processing regions following the chronic migraine model. Immunohistochemical analysis of the trigeminal ganglia revealed coexpression of DOP with CGRP as well as with a primary component of the CGRPR, RAMP1. In the trigeminal nucleus caudalis, DOP was not coexpressed with CGRP but was highly coexpressed with RAMP1 and calcitonin receptor–like receptor. These results suggest that DOP agonists inhibit migraine-associated pain by attenuating CGRP release and blocking pronociceptive signaling of the CGRPR.
A Glra3 phosphodeficient mouse mutant establishes the critical role of protein kinase A–dependent phosphorylation and inhibition of glycine receptors in spinal inflammatory hyperalgesia
Authors: Werynska Karolina , Gingras Jacinthe , Benke Dietmar , Scheurer Louis , Neumann Elena , Zeilhofer Hanns Ulrich 
Published: February 2021

Abstract
Glycinergic neurons and glycine receptors (GlyRs) exert a critical control over spinal nociception. Prostaglandin E2 (PGE2), a key inflammatory mediator produced in the spinal cord in response to peripheral inflammation, inhibits a certain subtype of GlyRs (α3GlyR) that is defined by the inclusion of α3 subunits and distinctly expressed in the lamina II of the spinal dorsal horn, ie, at the site where most nociceptive nerve fibers terminate. Previous work has shown that the hyperalgesic effect of spinal PGE2 is lost in mice lacking α3GlyRs and suggested that this phenotype results from the prevention of PGE2-evoked protein kinase A (PKA)-dependent phosphorylation and inhibition of α3GlyRs. However, direct proof for a contribution of this phosphorylation event to inflammatory hyperalgesia was still lacking. To address this knowledge gap, a phospho-deficient mouse line was generated that carries a serine to alanine point mutation at a strong consensus site for PKA-dependent phosphorylation in the long intracellular loop of the GlyR α3 subunit. These mice showed unaltered spinal expression of GlyR α3 subunits. In behavioral experiments, they showed no alterations in baseline nociception, but were protected from the hyperalgesic effects of intrathecally injected PGE2 and exhibited markedly reduced inflammatory hyperalgesia. These behavioral phenotypes closely recapitulate those found previously in GlyR α3-deficient mice. Our results thus firmly establish the crucial role of PKA-dependent phosphorylation of α3GlyRs in inflammatory hyperalgesia.
Screening, Brief Intervention, and Referral to Treatment/Motivational Interviewing School-Based Therapy Pilot Study
Authors: Williams Kimberly A. , Lee Eun Jin , Wilmoth Michele , Selwyn Candice , Bydalek Katherine 
Published: February 2021

Abstract
Substance abuse and comorbid psychological disorders are significant problems among adolescents. Hence, school-based interventions could be a promising approach for tackling substance use and mental health symptoms in at-risk youth. This pilot study was aimed at determining the effectiveness of interventions like Screening, Brief Intervention, and Referral to Treatment and motivational interviewing (MI) on depressive anxiety and substance use symptoms in middle school participants. Student psychiatric nurse practitioners who were trained and competent in MI conducted a combined Screening, Brief Intervention, and Referral to Treatment/MI intervention with 19 participants using measurement tools such as the Patient Health Questionnaire-9, the Generalized Anxiety Disorders-7, and the Car, Relax, Alone, Forget, Friends, Trouble Screening Test. Depressive and anxiety symptoms decreased after the intervention. Because the pre–post Car, Relax, Alone, Forget, Friends, Trouble screening period was 4 weeks, there were no significant pre–post differences.
Factors Associated With Relapse in Individuals With Opioid Use Disorder Receiving Suboxone in Rural Areas
Authors: Chang Yu-Ping , Raynor Traci 
Published: February 2021

Abstract

Background
Opioid use disorder (OUD), including opioid misuse, abuse, and overdose, has evolved into a national crisis with a lasting effect on society, individuals, and health care systems. Although an office-based treatment of Suboxone combined with counseling is a viable option for individuals with OUD and has been shown to reduce utilization of medical services, the relapse rate among those individuals remains high. There is a need to investigate factors associated with relapse to tailor treatment programs in an effort to prevent relapse. This study aimed to examine factors associated with relapse in individuals with OUD receiving Suboxone.

Methods
A convenience sample was recruited from an outpatient Suboxone facility located in a rural county of New York. Measures included urine drug testing obtained through the medical record, patterns of time to relapse as measured by the Time to Relapse Questionnaire, pain intensity, and a demographic questionnaire. Descriptive statistics, independent t test, and chi-square statistics were utilized for data analysis.

Results
Forty-six patients participated in the study. Length of time in a Suboxone program, scores in sudden and long delay relapse, and the type of treatment program were statistically associated with relapse.

Conclusion
This study provided insight regarding factors contributing to relapse and different time-to-relapse styles that could be incorporated into clinical practice to help prevent relapse.
The Healthy Addiction Treatment Recovery Model
Authors: Comiskey Catherine , Galligan Karen , Flanagan Jean , Deegan Joan , Farnann Jane , Hall Aine 
Published: February 2021

Abstract
The current model of nursing within international addiction services has been described as task oriented and reactive. Yet, it is known that nursing models should be led by client need and operate within the domain of the client and their wider environment. The aim of this study was to address this gap within addiction nursing and to develop an evidence-based addiction nursing model.
To objectively assess the needs of clients, a cross-sectional survey was implemented within a representative selection of six drug treatment clinics and a sample of clients in receipt of opiate agonist treatment in Dublin, Ireland. The Opiate Treatment Index with the General Health Questionnaire embedded was used to measure heroin use, polydrug use, infectious disease risk, physical health, psychological adjustment, criminality and social well-being. To develop the addiction model, a mapping of relevant features of potential nursing models was conducted by nurses working in addiction services.
The key finding from the client assessments was a lack of psychological adjustment; a cutoff score of 4 was recommended. The mean score among women was 11 (95% CI [8, 14]), and that among men was 8 (95% CI [6, 10]). Findings from the mapping of models highlighted the benefits of the BRENDA, FRAMES, and Tidal models. A focus on practical implementation and measurable outcomes was stressed. Results informed the development of the Healthy Addiction Treatment Recovery Model. The model refocused services on clients' objective needs and eradicated entrenched practices.
Investigating the Clinical Utility of the Combined Use of Objective and Subjective Measures of ADHD During Treatment Optimization
Authors: Martin-Key Nayra A. , Stevenson Amy , Roy Perry 
Published: February 2021

Abstract

Background
This study investigated the clinical utility of the combined use of objective and subjective measures of attention-deficit/hyperactivity disorder (ADHD) prepharmacological and postpharmacological treatment.

Methods
Adults with ADHD (N = 77) completed the Quantified Behavioral Test, self-ratings of ADHD-related symptoms, and quality of life measures pretreatment and posttreatment.

Results
The use of objective and subjective measures of ADHD-related symptoms during initiation and follow-up of pharmacological treatment resulted in significant improvements in quality of life after 6 months. Both objective and subjective measures captured changes in ADHD-related symptoms, with more patients showing clinically relevant treatment effects on objective measures. Convergence rates between objective and subjective measures were low to moderate, and improvements on these measures correlated with increased quality of life.

Conclusions
Objective and subjective measures of ADHD capture important components of the condition. The findings from this study have important implications for clinical practice.
Ambulatory Heart Rate Variability in Schizophrenia or Depression
Authors: Bengtsson Johan , Olsson Erik , Igelström Helena , Persson Jonas , Bodén Robert 
Published: February 2021

Abstract

Background
Heart rate variability (HRV) has been found reduced in patients with schizophrenia and depression. However, there is a lack of knowledge on how demographic, lifestyle, and pharmacological factors contribute to the reduction in HRV in these patients.

Methods
We recruited 37 patients with schizophrenia, 43 patients with unipolar depression, and 64 healthy controls. A combined chest-worn HRV and accelerometer device was used in an ambulatory measurement. Age, sex, anticholinergic burden of medication, nicotine use, body mass index, and ongoing physical activity were assessed in multiple regression models regarding their influence on HRV, measured as the standard deviation of all the RR intervals (SDNN).

Results
In the fully adjusted model, schizophrenia (β = −0.23, P = 0.019), depression (β = −0.18, P = 0.028), age (β = −0.34, P < 0.000), ongoing physical activity (β = −0.23, P = 0.001), and anticholinergic burden (β = −0.19, P = 0.025) influenced SDNN negatively. Sex, nicotine use, and BMI had negligible effects on SDNN.

Conclusions
We show for the first time that a quantified score of anticholinergic burden of medication has a negative relationship to HRV in patients with schizophrenia or depression, but that the diagnoses themselves still exhibit an effect on HRV.
Patient Satisfaction With the Quality of Counseling Provided by Advanced Practice Nurses Specialized in Multiple Sclerosis: A Quantitative Analysis
Authors: Weilenmann Melanie , Händler-Schuster Daniela , Petry Heidi , Zanolari Diana , Schmid-Mohler Gabriela , Beckmann Sonja 
Published: February 2021

ABSTRACT

BACKGROUND: The challenges in dealing with multiple sclerosis (MS) have increased considerably in recent years. In addition to neurologists, MS nurse specialists are key to the management of MS patients, but there is a lack of evidence regarding their quality of counseling. METHODS: The data collection took place between October 2018 and March 2019 in the outpatient clinic of a university hospital. The quality of counseling was assessed using the APN-BQ, an instrument that contains 19 items that can be assigned to 4 dimensions. Participants were asked to rate their satisfaction on a scale from 0 to 3. General satisfaction was assessed on a scale from 0 to 100. RESULTS: The participants (n = 110) rated the quality of counseling and their general satisfaction high. The mean (SD) of the structure quality dimension was 2.64 (0.44), and satisfaction with length and frequency of consultations (2.53 [0.63]) scored better than outcome quality (1.99 [0.62]) and process quality (2.13 [0.60]). CONCLUSION: Overall, there was a high rate of satisfaction with the quality of counseling. In addition to the length and frequency of consultations, MS patients particularly appreciated the availability and expertise of MS nurse specialists.
Effectiveness of a Delirium Prevention Initiative on an Inpatient Neuroscience Unit
Authors: Cyrus Teresa , Wenthold Rebecca , Hall Brenda , Tu Lisa , Hedquist Katie , Omodt Jean , Kozub Elizabeth , Guthrie Patricia Finch 
Published: February 2021

ABSTRACT

BACKGROUND: Delirium frequently develops in hospitalized patients and results in increased mortality, longer length of stay, and need for transitional care. Neurological patients are at an increased risk for developing delirium. There is a paucity of research on effective prevention strategies for this population. PURPOSE: The objectives of this project were to improve nurses' knowledge and confidence in delirium prevention, design a delirium volunteer program, and establish ongoing monitoring for continued improvement. METHODS: This study is a quality improvement project using a pretest-posttest design to examine the benefits of refocusing care from delirium management to delirium prevention. The sample included 304 patients pre and 332 post intervention. The interventions included delirium education for nurses and the recruitment of trained volunteers to implement nonpharmacological, multicomponent delirium prevention interventions. RESULTS: Forty-eight nurses completed delirium education, and 11 volunteers were recruited and trained. There was a significant increase in nursing knowledge (z = 3.967, P < .0005) and confidence (z = 3.989, P < .0005). Volunteers visited 54 patients and implemented 99 interventions post implementation. CONCLUSION: This pre-post improvement project provides beginning evidence that nursing education increased nurses' knowledge and confidence in preventing and treating delirium. Trained volunteers supported using nonpharmacological delirium prevention interventions, but ongoing evaluation is needed to determine the impact of volunteers on delirium rates.
Symptoms of Anxiety and Depression in Relation to Work Patterns During the First Wave of the COVID-19 Epidemic in Philadelphia PA
Authors: Burstyn Igor , Huynh Tran 
Published: February 2021

Objective:
We investigated whether patterns of work during COVID-19 pandemic altered by effort to contain the outbreak affected anxiety and depression.

Methods:
We conducted a cross-sectional online survey of 911 residents of Philadelphia, inquiring about their working lives during early months of the epidemic, symptoms of anxiety and depression, plus demographics, perceived sources of support, and general health.

Results:
Occupational contact with suspected COVID-19 cases was associated with anxiety. Concerns about return to work, childcare, lack of sick leave, and loss/reduction in work correlated with anxiety and depression, even when there was no evidence of occupational contact with infected persons; patterns differed by sex.

Conclusions:
Heightened anxiety and depression during COVID-19 pandemic can be due to widespread disruption of working lives, especially in “non-essential” low-income industries, on par with experience in healthcare.