bluuebunny/crossref_metadata_2025_split huggingface dataset:
The importance of pregnancy planning in lupus pregnancies
Authors: Rajendran Aardra , Eudy Amanda M , Balevic Stephen J , Clowse Megan E B 
Published: January 2021

Objective In seeking new approaches to improve lupus pregnancy outcomes, we study the association between pregnancy planning, behaviors recommended by American College of Rheumatology’s Reproductive Health Guideline 2020, and pregnancy and infant outcomes. Methods Lupus pregnancies in a prospective registry (1/1/2018 to 4/1/2020) were classified as planned or not-planned using the patient-reported London Measure of Unplanned Pregnancy. These groups were compared for demographics, pre-pregnancy disease activity, pregnancy planning behaviors, and delivery outcomes. Results Among 43 women with 43 singleton pregnancies the average age was 29.4 years and 42% were Black. Overall, 60% were planned pregnancies and 40% were not-planned (16 ambivalent, 1 unplanned). Women with not-planned pregnancies had lower age, income, and education, and more required Medicaid. Women with not-planned pregnancies were more likely to conceive when lupus activity was higher (p = 0.001), less likely to receive pre-pregnancy counseling with a rheumatologist (p = 0.02), and less likely to continue pregnancy-compatible medications (p = 0.03). Severe PROMISSE adverse pregnancy outcomes (APOs) and severe neonatal outcomes were higher among women with not-planned than planned pregnancies (43% vs 0% p = 0.003; 70% vs 30% p = 0.06). Conclusion This study identifies pregnancy intention as a potentially modifiable risk factor for poor outcomes in women with lupus. It highlights a unique population of women with lupus at high risk for pregnancy and infant complications: those ambivalent about pregnancy. These women may not be effectively engaging in health behaviors that prevent pregnancy nor those that will prepare for a safe pregnancy. With effective pregnancy planning and contraception guidance, we may decrease their risk for maternal-fetal morbidity and mortality.
Self-perceived quality of life of primary antiphospholipid syndrome patients using vitamin K antagonist
Authors: de Oliveira Vaz Camila , de Moraes Mazetto Fonseca Bruna , Nascimento Silva Vasconcelos Pedro Eduardo , Brito Bastos Larissa , Cursino Maria Aparecida , Coelho França Quintanilha Júlia , Tripiquia Vechiatto Mesquita Gabriela Lisiane , Rosa dos Santos Ana Paula , Cardoso Jacintho Bruna , Oliveira José Diogo , Annichino-Bizzachi Joyce , Andrade Orsi Fernanda 
Published: January 2021

Purpose Primary antiphospholipid syndrome (PAPS) is a chronic autoimmune disorder clinically characterized by thromboembolic events or obstetric complications. Prolonged anticoagulation therapy with vitamin K antagonists (VKA) is the treatment of choice for PAPS patients with thrombosis. However, the efficacy of VKA therapy depends on laboratory monitoring, dose adjustment, adequate lifestyle and adherence to treatment. Difficulties with VKA therapy can affect patients’ self-perceived health related quality of life (HRQOL). This study aims to evaluate PAPS patients' HRQOL, therapy adherence and knowledge of treatment. Methods A general Medical Outcome Study Short Form-36 (SF-36) and the Duke Anticoagulation Satisfaction Scale (DASS) were used to access APS-patients self-perceived HRQOL. Treatment adherence was measured by the Treatment Measure Adhesion (TMA) – oral anticoagulant version instrument, and knowledge of VKA treatment was measured using the MedTake test. Results 66 PAPS patients using VKA were assessed. 63% of them were female; the mean age was 41.9 years old, approximately 60% had unprovoked venous thrombosis and one third of the patients had recurrent thrombotic events. The most impacted domain of DASS was “psychological impacts” and the factors associated to anticoagulation related poor HRQOL were: female sex, presence of arterial thrombosis and INR lability. Using the SF-36 instrument, PAPS-patients self-perceived HRQOL was poorer than that of the general Brazilian population and was associated with female sex and presence of cardiovascular risk factors. Conclusion Despite the high adherence to treatment and knowledge of VKA therapy, self-perceived HRQOL is poor in patients with PAPS and is mainly affected by VKA therapy. Searching for better treatment options is warranted.
Caring for victims of child maltreatment: Pediatric nurses’ moral distress and burnout
Authors: Karakachian Angela , Colbert Alison , Hupp Diane , Berger Rachel 
Published: January 2021

Background: Moral distress is a significant concern for nurses as it can lead to burnout and intentions to leave the profession. Pediatric nurses encounter stressful and ethically challenging situations when they care for suspected victims of child maltreatment. Data on pediatric nurses’ moral distress are limited, as most research in this field has been done in adult inpatient and intensive care units. Aim: The purpose of this study was to describe pediatric nurses’ moral distress and evaluate the impact of caring for suspected victims of child maltreatment on nurses’ moral distress, burnout, and intention to leave. Design and method: This descriptive cross-sectional correlational study was conducted in a mid-Atlantic, urban area Magnet pediatric level I trauma center that cares for over 1800 cases of suspected child maltreatment annually. An anonymous electronic survey was sent to all the nurses working at the hospital. Ethical considerations: Institutional Review Board approval was received from the first author’s university and the hospital where the study was conducted. Findings: Overall, nurses ( N = 146) reported low levels of moral distress with a mean score of 59.54 (SD = 49.22) and a range of 0–300 on the Moral Distress Scale Neonatal–Pediatric version. Although the frequency of caring for suspected child maltreatment victims did not affect nurses’ moral distress, caring for victims with fatal maltreatment contributed to nurses’ intention to leave, χ2 (1) = 5.35, p = 0.02. Conclusion: The results of this study add to the understanding of moral distress in pediatric nursing. Caring for victims with fatal maltreatment impacts pediatric nurses’ intention to leave.
Iatrogenic loneliness and loss of intimacy in residential care
Authors: Cook Catherine , Henrickson Mark , Atefi Nilo , Schouten Vanessa , Mcdonald Sandra 
Published: January 2021

Background: There is an international trend for frail older adults to move to residential care homes, rather than ageing at home. Residential facilities typically espouse a person-centred philosophy, yet evidence points to restrictive policies and surveillance resulting in increased loneliness and diminished opportunities for intimacy and sexual expression. Residents may experience what has been termed social death, rather than perceive they are related to by others as socially alive. Aim: To consider how the loss of intimacy and sexuality in residents’ lives contributes to iatrogenic loneliness experienced in residential care, and the importance of considering these issues together. Research design: The study utilised a constructionist methodology, investigating the meanings associated with intimacy, loneliness, and ageing. Participants and research context: Qualitative data used in this study are drawn from a larger dataset of a mixed-methods study. Interviews were completed as follows: staff, 21 individual interviews, and two groups with a total of 13 additional people; residents, 26 interviews with 28 people; and family members, 12 interviews with 13 people. Findings: Five key themes were identified in the data analysis: loneliness and relational identity, loneliness and functional relationships, loneliness and disrupted intimacy, loneliness and liminality, and loneliness and the built environment. Ethical considerations: The study was approved by a University Human Ethics Committee. Participation was voluntary. Consent was gained and confidentiality upheld. Discussion: Residents’ expression of intimacy and sexuality can be compromised through paternalism, ageism, restrictive policies, care-rationing and functional care, alienating residents from sustaining and developing significant relationships. Attitudes and cultural beliefs of staff and family members about ageing and intimacy, compounded by architectural design, may intensify loneliness. Conclusions: Nurses have a pivotal role in ensuring policies and practice enhance social citizenship.
PAX2 promoter methylation and AIB1 overexpression promote tamoxifen resistance in breast carcinoma patients
Authors: Jahangiri Rosa , Mosaffa Fatemeh , Emami Razavi Amirnader , Teimoori-Toolabi Ladan , Jamialahmadi Khadijeh 
Published: January 2021

Introduction Disease recurrence is an important obstacle in estrogen receptor positive (ER+) tamoxifen treated breast carcinoma patients. Tamoxifen resistance-related molecular mechanisms are not fully understood. Alteration in DNA methylation which contributes to transcriptional regulation of cancer-related genes plays a crucial role in tamoxifen response. In the present study, the contribution of promoter methylation and mRNA expression of PAX2 and AIB1 in the development of breast carcinoma and tamoxifen refractory was assessed. Methods Methylation specific-high resolution melting (MS-HRM) analysis and Real-time quantitative PCR (RT-qPCR) experiment were performed to analyze the promoter methylation and mRNA expression levels of PAX2 and AIB1 genes in 102 breast tumors and adjacent normal breast specimens. Results We indicated that PAX2 expression is decreased in breast tissues due to hypermethylation in its promoter region. Compared to the adjacent normal tissues, the tumors exhibited significantly lower relative mRNA levels of PAX2 and increased expression of AIB1. Aberrant promoter methylation of PAX2 and overexpression of AIB1 was observed in tamoxifen resistance patients compared to the sensitive ones. Cox regression analysis exhibited that the increased promoter methylation status of PAX2 and overexpression of AIB1 remained as unfavorable identifiers which influence patients' survival independently. Conclusions Our results revealed that the aberration in PAX2 promoter methylation and AIB1 overexpression are associated with the tamoxifen response in breast carcinoma patients. Further research is needed to demonstrate the potential of using PAX2 and AIB1 expression and their methylation-mediated regulation as predictive or prognostic biomarkers or as a new target therapy for better disease management.
Longitudinal Assessment of Relationships Between Health Behaviors and IL-6 in Overweight and Obese Pregnancy
Authors: Wallace McKenzie K. , Shivappa Nitin , Wirth Michael D. , Hébert James R. , Huston-Gordesky Larraine , Alvarado Fernanda , Mouzon Sylvie Hauguel-de , Catalano Patrick M. 
Published: January 2021

Background: Inflammation is a common factor in adverse pregnancy outcomes (APOs). Behavioral factors influence inflammatory markers and APOs but rarely have been investigated simultaneously in pregnancy. Our purpose was to determine how diet, physical activity, and obesity are associated with interleukin (IL)-6 in early and late pregnancy. Methods: We conducted a secondary analysis of 49 overweight/obese pregnant women. Health behavior data, including diet quality using the Dietary Inflammatory Index (DII®); physical activity (Leisure Time Physical Activity scale); body mass index (BMI); and plasma IL-6 concentrations were collected at 13–16 weeks (early pregnancy) and 34–36 weeks (late pregnancy) gestation. Multiple linear regression analyses were used to determine the amount of variance explained in early and late pregnancy IL-6 concentrations by early and late pregnancy diet, physical activity, and BMI. Results: Early diet and early BMI were the strongest predictors of early IL-6 concentrations (R2 = 0.43; p < .001) and late IL-6 concentrations (R2 = 0.30; p < .001). Late BMI predicted late IL-6 (R2 = .11; p = .02). Change in diet over pregnancy predicted late IL-6 (R2 = 0.17; p = .03). Conclusion: These findings suggest that maternal diet and BMI in early pregnancy, which likely reflects prepregnancy status, may have a greater impact on inflammatory processes than factors later in pregnancy. Future work should assess if behavioral factors before pregnancy produce similar relationships to those reported here, which may clarify the timing and type of lifestyle interventions to effectively reduce APOs.
Optical coherence tomography angiography findings of diabetic patients with and without retinopathy
Authors: Temel Emine , Batıoğlu Figen 
Published: January 2021

Purpose: To emphasize the importance of optical coherence tomography angiography (OCTA) in the diagnosis and follow-up of diabetic individuals with and without retinopathy. Methods: Retrospective, cross-sectional, observational study of healthy persons and diabetic individuals with and without retinopathy. Area of the foveal avascular zone (FAZ) (mm²), non-perfused areas in the superficial capillary plexus (SCP), mean vessel density (VD) in the SCP, and deep capillary plexus (DCP) were calculated. In eyes with diabetic retinopathy (DR), measurements at baseline, 3rd, 6th, 9th, and 12th months were evaluated. Results: This study conducted on 39 eyes of 23 patients with DR (group 1), 59 eyes of 30 diabetic individuals without DR (group 2), and 51 eyes of 27 healthy persons (group 3). When the mean area of the FAZ at baseline was compared between groups, the difference among groups 1 and 3 ( p < 0.001) and the difference among groups 2 and 3 ( p = 0.001) were statistically significant. There was no significant difference among the measurements of mean area of the FAZ, mean non-perfused area in the SCP, mean VD in SCP, and DCP at baseline, 3rd, 6th, 9th, and 12th months in group 1. Conclusion: OCTA is a developing technology that can detect early microvascular changes in diabetic patients.
Granulomatous uveitis and choroidal detachment in a patient after topical treatment with Bimatoprost: A case report
Authors: Massimo Lorusso , Micelli Ferrari Luisa , Nikolopoulou Gisotti Eleni , Zito Roberta , MicelliFerrari Tommaso , Anna Ferretta , Bordinone Marco Antonio 
Published: January 2021

Background: Bimatoprost 0.03% is an intraocular pressure (IOP) lowering prostaglandin analog with different adverse side effects such as potential ocular inflammatory effect and ocular hyperemia. Case presentation: We report a case of 80-year-old woman diagnosed with bilateral glaucomatous uveitis, and choroidal detachment in the left eye after topical bimatoprost administration. During the patient’s hospitalization, Bimatoprost treatment was discontinued and local steroid therapy was administrated. After 1 week we reported a marked improvement of visual acuity, IOP measurement was 12 mmHg in both eyes. Anterior segment examination showed complete resolution of conjunctival and pericheratic hyperemia with significant reduction of endothelial precipitates in both eyes. Conclusions: In our case, the anterior granulomatous uveitis occurred in both pseudophakic eyes and the choroidal detachment (CD) in the eye that previously had trabeculectomy. Probably the scar tissue of the trabeculectomy allowed a better penetration of the Bimatoprost or a greater sensitivity due to an altered trabecular tissue. This work confirms that the onset physiopathology mechanism of granulomatous uveitis and CD following instillation of Bimatoprost remains uncertain.
Outer nuclear layer relevance in visual function correlated to quantitative enface OCT parameters in Stargardt disease
Authors: Mucciolo Dario Pasquale , Lippera Myrta , Giorgio Dario , Sodi Andrea , Passerini Ilaria , Cipollini Francesca , Virgili Gianni , Giansanti Fabrizio , Murro Vittoria 
Published: January 2021

Purpose: To evaluate the correlation between Best Corrected Visual Acuity (BCVA) and the following parameters in Stargardt Disease (STGD): Central Retinal Thickness (CR-T), Central Outer Nuclear Layer Thickness (C-ONL-T), Areas of macular Photoreceptor loss (PHRa), and Retinal Pigment Epithelium (RPE) loss (RPEa). Methods: A total of 64 eyes of 32 STGD patients were included in the study. All patients received a comprehensive ophthalmological examination, color fundus photographs, fundus auto-fluorescence imaging, and Optical Coherence Tomography (OCT). The CR-T and C-ONL-T were evaluated from standard SD-OCT scans. The PHRa and RPEa were calculated from enface OCT scans (sub RPE slab and photoreceptor slab). The collected OCT parameters were evaluated for possible association with BCVA. Results: The mean macular PHRa and RPEa was 16.16 ± 13.36 and 12.05 ± 12.57 mm2 respectively. The mean CR-T measured 120.78 ± 41.49 μm while the mean C-ONL-T was assessed at 4.60 ± 13.73 μm. BCVA showed the highest correlation with the C-ONL-T ( r = −0.72; p < 0.001) while there was no correlation with the CR-T ( r = −0.17; p = 1.00). Conclusions: Enface OCT permits a rapid and precise quantitative evaluation of the macular PHR and RPE atrophy area in STGD. Nonetheless, the OCT parameter that showed the highest correlation with visual acuity in STGD was the ONL thickness.
Long-term outcomes of half-fluence photodynamic therapy and eplerenone in chronic central serous chorioretinopathy: A comparative study
Authors: Manayath George , Verghese Shishir , Ranjan Ratnesh , Agrawal Hitesh , Khanna Amishi , Narendran Venkatapathy , Chhablani Jay 
Published: January 2021

Aims: To compare the long-term outcomes in chronic central serous chorioretinopathy (cCSC) following half-fluence photodynamic therapy (HF-PDT) and oral eplerenone treatment. Methods: This retrospective comparative study included consecutive patients of cCSC treated with either HF-PDT or eplerenone. The treatment outcomes of the two groups were analyzed at 3-month, 6-month, and 12-month post-treatment. Results: This study included 20 eyes (20 patients) in HF-PDT group, and 18 eyes (18 patients) in eplerenone group. All baseline parameters in HF-PDT and eplerenone groups were comparable including neurosensory detachment height (217.05 ± 140.25 µm vs 178.05 ± 164.24 µm respectively, p = 0.09), best-corrected visual acuity (BCVA) (logMAR 0.24 ± 0.13 vs logMAR 0.46 ± 0.37 respectively, p = 0.1), and subfoveal choroidal thickness (SFCT) [427.4 ± 117.4 µm vs 456.38 ± 119.25 µm respectively, p = 0.45]. HF-PDT resulted in complete resolution of neurosensory detachment in higher proportion of eyes compared to eplerenone at each follow-up visits (3 months: 90% vs 27.7%, p = 0; 6 months: 100% vs 61.1%, p = 0.003; and 12 months: 100% vs 70%, p = 0.03) with a significantly shorter duration to resolution (3.3 ± 0.9 months vs 5.8 ± 3.3 months respectively, p = 0.02). Intergroup comparison showed no significant difference between mean BCVA ( p = 0.38 at 3 months, p = 0.14 at 6 months, and p = 0.19 at 12 months). Mean SFCT at 12 months of the two groups differed significantly ( p = 0.003) due to increased choroidal thickness of eplerenone group. Conclusion: HF-PDT has a superior efficacy to achieve faster, greater and long-lasting resolution of subretinal fluid in cCSC compared to eplerenone therapy.
A crossover study assessing the protective efficacy of improvised snorkel-based improvised respirators
Authors: Greig Paul R , Bradshaw James , Carvalho Clarissa , Iwaszko Luke , Ramessur Suniel , Schumacher Jan , El-Boghdadly Kariem 
Published: January 2021

Introduction This study was designed to determine whether improvised respirators based on modified full-face snorkel masks are able to pass a standard qualitative fit test. Methods This is a prospective crossover study conducted in 16 staff. Fit-tests were conducted on masks mated to (1) an anaesthetic breathing circuit heat and moisture exchange filter and (2) a CE-marked P3 grade filter. P3 filters were mounted using both epoxy-coated and uncoated adaptors. Results None of the tests using anaesthetic filters passed. Only one overall pass was observed using the P3-rated filter mated to the snorkel mask. Conclusions These data suggest that improvised PPE designs cannot provide reliable protection against aerosols. Failures are likely due to poor fit, but the suitability of 3D printed materials is also uncertain as fused-filament manufacturing yields parts that are not reliably gas-tight. Improvised PPE cannot be recommended as a substitute for purpose designed systems.
Study of the Physical Environment of Waiting Areas and Its Effects on Patient Satisfaction, Experience, Perceived Waiting Time, and Behavior in China
Authors: Xuan Xiaodong , Li Zongfei , Chen Xixi , Cao Yuan , Feng Zihao 
Published: January 2021

Objectives: This study examines the physical environment in the outpatient waiting area and its effects on overall satisfaction, experience, perceived waiting time, and behavior. Background: Waiting can be a frustrating experience for patients. Previous studies on waiting areas in hospitals have been rooted mainly in the Western cultural context, and research focusing on the impact of the physical environment on the waiting experience with the denser patient concentration in China is important. Methods: Physical environment measurements, observations, and questionnaire surveys were employed. Results: The actual lighting intensity and sound level did not meet the national standards. Sound level and satisfaction with the size of the waiting area, signage system, and visual art on the wall were significant predictors ( R 2 = .463, p = .000) for overall satisfaction. Experiences related to the size of the waiting area, seating, signage system, and restrooms were significant predictors ( R 2 = .373, p = .000) of overall waiting experience. The experience related to the acoustic environment (β = −.184, p = .006) had a significant relationship with perceived waiting time. The increase in participants’ behaviors of looking out of a window and the decrease in looking at other people, looking around, dozing, and looking at a wall might result from a substantial increase in lighting and the availability of a nature view from the window. Conclusions: The effect of the physical setting of waiting areas may positively impact patient satisfaction, waiting experience, perceived waiting time, and behavior, which has implications for patient-centered design.