bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Corneal Higher-Order Aberrations on Visual Acuity After Deep Anterior Lamellar Keratoplasty in Treating Keratoconus
Authors: Suzuki Natsume , Yamaguchi Takefumi , Tomida Daisuke , Tsubota Kazuo , Shimazaki Jun 
Published: October 2018

Purpose:
To evaluate the incidence of the Descemet membrane (DM) folds after deep anterior lamellar keratoplasty (DALK) in treating keratoconus. We also evaluated the influence of DM folds and corneal higher-order aberrations (HOAs) on visual acuity after DALK.

Methods:
This retrospective study included 89 consecutive eyes of 87 patients who underwent DALK for the treatment of keratoconus at Tokyo Dental College Ichikawa General Hospital from April 2002 to June 2017. The presence or absence of DM folds was determined by slitlamp microscopy. Visual acuity after DALK was compared between the eyes with and without DM folds. Corneal HOAs of the anterior and posterior surfaces and the total cornea were measured by anterior segment optical coherence tomography. Correlations among the presence of DM folds, corneal HOAs, and visual acuity were analyzed.

Results:
The Descemet membrane folds developed in 28.1% (25/89) eyes after DALK for the treatment of keratoconus. However, there were no significant differences in postoperative visual acuity between the eyes with and without DM folds at 1, 3, 6, and 12 months (P=0.739, P=0.106, P=0.223, and P=0.186, respectively). The visual acuity at 12 months was significantly correlated with corneal HOAs within a 4-mm diameter (anterior surface: R=0.546, P=0.003; total cornea: R=0.506, P=0.007).

Conclusions:
Larger corneal HOAs, but not the presence of DM folds, were associated with poor visual acuity after DALK. In treating advanced keratoconus with DALK, it is important to minimize postoperative corneal HOAs, although DALK improves visual acuity by reducing HOAs due to keratoconus.
Effect of Changes in Hospital Nursing Resources on Improvements in Patient Safety and Quality of Care
Authors: Sloane Douglas M. , Smith Herbert L. , McHugh Matthew D. , Aiken Linda H. 
Published: October 2018

Background:
Evidence shows hospitals with better nursing resources have better outcomes but few studies have shown that outcomes change over time within hospitals as nursing resources change.

Objectives:
To determine whether changes in nursing resources over time within hospitals are related to changes in quality of care and patient safety.

Research Design:
Multilevel logistic response models, using data from a panel of 737 hospitals in which cross-sections of nurse informants surveyed in 2006 and 2016, were used to simultaneously estimate longitudinal and cross-sectional associations between nursing resources, quality of care, and patient safety.

Measures:
Nursing resources included hospital-level measures of work environments, nurse staffing, and nurse education. Care quality was measured by overall rating of care quality, confidence in patients managing care after discharge, confidence in management resolving patient care problems; patient safety was measured by patient safety grade, concern with mistakes, and freedom to question authority.

Results:
After taking into account cross-sectional differences between hospitals, differences among nurses within hospitals, and potential confounding variables, changes within hospitals in nursing resources were associated with significant changes in quality of care and patient safety. Improvements in work environment of 1 SD decrease odds of unfavorable quality care and patient safety by factors ranging from 0.82 to 0.97.

Conclusions:
Improvements within hospitals in work environments, nurse staffing, and educational composition of nurses coincide with improvements in quality of care and patient safety. Cross-sectional results closely approximate longitudinal panel results.
Use of Medicare Claims Data for the Identification of Myocardial Infarction
Authors: Colantonio Lisandro D. , Levitan Emily B. , Yun Huifeng , Kilgore Meredith L. , Rhodes James D. , Howard George , Safford Monika M. , Muntner Paul 
Published: October 2018

Objectives:
Assess the validity of Medicare claims for identifying myocardial infarction (MI).

Methods:
We used data from 9951 Medicare beneficiaries 65 years and above in the Reasons for Geographic And Racial Differences in Stroke study. Between 2003 and 2012, 669 participants had an MI identified and adjudicated through study procedures (ie, the gold standard), and 552 had an overnight inpatient claim with a code for MI (ICD-9 code 410.x0 or 410.x1) in any discharge diagnosis position.

Results:
Using Medicare claims with a discharge diagnosis code for MI in any position, the positive predictive value (PPV) was 84.3% [95% confidence interval (CI), 80.9%–87.3%] and the sensitivity was 49.0% (95% CI, 44.9%–53.1%). Sensitivity was lower for men (45.8%) versus women (55.1%), microsize MIs (13.7%) versus other MIs (64.7%), type 2 (30.9%), and 4–5 MIs (11.1%) versus type 1 MIs (76.6%), and MIs occurring in-hospital (28.8%) versus out-of-hospital (66.7%). Using Medicare claims with a code for MI in the primary discharge diagnosis position, the PPV was 89.7% (95% CI, 86.3%–92.5%) and sensitivity was 40.1% (95% CI, 36.1%–44.2%). The sensitivity of claims with a code for MI in the primary discharge diagnosis position was lower for microsize versus other MIs, type 2 and 4–5 MIs versus type 1 MIs and MIs occurring in-hospital versus out-of-hospital. Hazard ratios for MI associated with participant characteristics were similar using adjudicated MIs identified through study procedures or claims for MI without further adjudication.

Conclusions:
Medicare claims have a high PPV but low sensitivity for identifying MI and can be used to investigate individual-level characteristics associated with MI.
Use of Nonpalliative Medications Following Burdensome Health Care Transitions in Hospice Patients
Authors: Zueger Patrick M. , Holmes Holly M. , Qato Dima M. , Pickard A. Simon , Calip Gregory S. , Lee Todd A. 
Published: October 2018

Background:
Limited benefit medications (LBMs), those medications with questionable benefit at the end of life, are often recommended for discontinuation in hospice patients. Transitions in care are associated with inappropriate prescribing in older and terminally ill populations.

Objectives:
To evaluate the association between burdensome health care transitions and subsequent receipt of LBMs in older hospice patients.

Methods:
We conducted a matched cohort analysis of patients admitted to hospice between 2008 and 2013 using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. The prevalence of post–health care transition LBM use was assessed. Adjusted incidence rate ratios (IRRs) were estimated for the association between transitions and subsequent receipt of LBMs.

Results:
In total, 17.9% of 7064 hospice patients received at least 1 LBM following their first burdensome health care transition. Posttransition continuation of a medication class used before hospice admission was most common for antidementia medications (14.2%) and antihypertensives (11.2%). Transitions were associated with a 33% increase in the risk of receiving at least 1 LBM [IRR, 1.33; 95% confidence interval (CI), 1.25–1.42], increasing to 56% when evaluating only hospitalization transitions (IRR, 1.56; 95% CI, 1.39–1.76). Medication classes more likely to be dispensed after a transition included antihyperlipidemics (IRR, 1.38; 95% CI, 1.13–1.70), antihypertensives (IRR, 1.28; 95% CI, 1.16–1.40), and proton-pump inhibitors (IRR, 1.40; 95% CI, 1.20–1.63).

Conclusions:
Burdensome health care transitions were associated with the receipt of nonpalliative medications in older hospice patients. Interventions aimed at improving provider communication and reducing fragmentation in care may help reduce unnecessary medication use in this vulnerable population.
Tranexamic Acid for Prevention and Treatment of Postpartum Hemorrhage: An Update on Management and Clinical Outcomes
Authors: Ahmadzia Homa K. , Phillips Jaclyn M. , Katler Quinton S. , James Andra H. 
Published: October 2018

Importance
Postpartum hemorrhage (PPH) remains a major cause of maternal mortality worldwide, occurring in both vaginal and cesarean deliveries. We have witnessed improvements in both prevention and treatment of PPH. Tranexamic acid (TXA) has been investigated as a potential adjunct therapy to uterotonics within this setting.

Objective
The aim of this article is to summarize existing recommendations on the use of TXA in obstetrics and review current data on clinical outcomes after TXA use.

Evidence Acquisition
We reviewed guidelines from a number of professional societies and performed an extensive literature search reviewing relevant and current data in this area.

Results and Conclusions
In the prevention of PPH, TXA use before both vaginal and cesarean deliveries reduces the amount of postpartum blood loss and should be considered in patients at higher risk for hemorrhage. In the treatment of PPH, TXA should be initiated early for maximal survival benefit from hemorrhage, and it provides no additional benefit if administered more than 3 hours from delivery. Overall, current evidence assessing the risks of TXA use in an obstetric population is reassuring.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to: define the mechanism of action of TXA; evaluate the utility of TXA in prophylaxis and treatment of PPH; define common doses of TXA used in the peripartum period; and assess associated risk and possible adverse outcome when using TXA.
Promoting Risk Identification and Reduction of Cardiovascular Disease in Women Through Collaboration With Obstetricians and Gynecologists: A Presidential Advisory From the American Heart Association and the American College of Obstetricians and Gynecologists
Authors: Brown Haywood L. , Warner John J. , Gianos Eugenia , Gulati Martha , Hill Alexandria J. , Hollier Lisa M. , Rosen Stacey E. , Rosser Mary L. , Wenger Nanette K. 
Published: October 2018

(Abstracted from Circulation 2018;137(24):e843–e852)
Many traditional atherosclerotic cardiovascular disease (ASCVD) risk factors, such as hypertension, diabetes mellitus, hypercholesterolemia, and obesity, may affect women more than men and in many cases more severely. Cardiovascular mortality is greater in women than in men.
Analgesic Use and Ovarian Cancer Risk: An Analysis in the Ovarian Cancer Cohort Consortium
Authors: Trabert Britton , Poole Elizabeth M. , White Emily , Visvanathan Kala , Adami Hans-Olov , Anderson Garnet L. , Brasky Theodore M. , Brinton Louise A. , Fortner Renee T. , Gaudet Mia , Hartge Patricia , Hoffman-Bolton Judith , Jones Michael , Lacey James V. , Larsson Susanna C. , Mackenzie Gerardo G. , Schouten Leo J. , Sandler Dale P. , O'Brien Katie , Patel Alpa V. , Peters Ulrike , Prizment Anna , Robien Kim , Setiawan Wendy V. , Swerdlow Anthony , van den Brandt Piet A. , Weiderpass Elisabete , Wilkens Lynne R. , Wolk Alicja , Wentzensen Nicolas , Tworoger Shelley S. 
Published: October 2018

(Abstracted from J Natl Cancer Inst 2018; doi: 10.1093/jnci/djy100)
The most fatal gynecologic cancer is ovarian cancer. This is largely due to its delayed symptom presentation and lack of early detection strategies.
Systematic Review of the Clinical Efficacy of Vaginal Progesterone for Luteal Phase Support in Assisted Reproductive Technology Cycles
Authors: Child Tim , Leonard Saoirse A. , Evans Jennifer S. , Lass Amir 
Published: October 2018

(Abstracted from Reprod Biomed Online 2018;36:630–645)
Sufficient luteal phase support (LPS) is essential during assisted reproductive technology (ART) cycles to improve implantation and pregnancy rates. The most common route for LPS in Europe is vaginal progesterone via capsule, gel, or tablet.
Rapid Syphilis Testing for Men Who Have Sex With Men in Outreach Settings: Evaluation of Test Performance and Impact on Time to Treatment
Authors: Obafemi Oluyomi A. , Wendel Karen A. , Anderson Teri S. , Scott Tracy E. , Rowan Sarah E. , Travanty Emily A. , Rietmeijer Cornelis A. 
Published: October 2018

Background
Rapid syphilis tests (RST) may shorten time to syphilis diagnosis and treatment while enhancing access to testing in outreach settings. There are limited data on the performance of RST in outreach settings in the US.

Methods
We offered RST (Syphilis Health Check) at 6 outreach sites to men who reported having sex with men and no prior history of syphilis. Clients accepting RST were also tested with laboratory-based rapid plasma reagin (RPR) and reflex Treponema pallidum particle agglutination (TPPA) assay when RPR or RST were positive. Clients with positive RST were immediately referred to a sexually transmitted infection clinic. Those declining RST were screened with RPR and reflex TPPA only. The validity of the RST-based algorithm was compared with the RPR-based algorithm among participants receiving both. Time to treatment for those accepting RST was compared with those declining RST and to a historical control group screened in outreach settings with RPR and reflex TPPA before the availability of RST.

Results
Rapid syphilis test was accepted by 690 (64%) of 1081 eligible clients. Compared with RPR-based algorithm, RST sensitivity was 90%; specificity, 98.5%; positive predictive value, 47.4%; and negative predictive value, 98.5. The single false-negative case by RST was determined to be a late latent case by RPR/TPPA. Median time to treatment was 1 day (range, 0–6 days) for 9 of 690 accepting RST, compared to 9 days (range, 7–13 days) for 3 of 391 declining RST, and 9 days (range, 6–21 days) for 25 of 1229 historical controls (P < 0.0001).

Conclusion
Compared with an RPR-based algorithm, RST identified all early syphilis cases. Although RST had high specificity and negative predictive value, the low positive predictive value resulted in additional assessments in a sexually transmitted infection clinic for some patients. However, RST use in outreach settings significantly decreased time to treatment for new syphilis cases.
Sudden, Unexpected Death Due to Pseudo-Meigs Syndrome
Authors: Barranco Rosario , Molinelli Andrea , Gentile Raffaella , Ventura Francesco 
Published: October 2018

AbstractMeigs syndrome is the triad of ascites, hydrothorax, and benign ovarian tumor (mostly fibroids). It is a diagnosis of exclusion, and the characteristic symptoms disappear after resection of the tumor. Instead, in Pseudo-Meigs syndrome, the triad includes a nonfibroma ovarian tumor. The latter may consist of benign tumors (ie, of fallopian tube or uterus, struma ovarii, and ovarian leiomyomas) but can also comprise ovarian or metastatic gastrointestinal malignancies.The authors describe a case of sudden death in a 43-year-old woman, with no noteworthy reported history of present illness or medical history and in apparently good health before death.The autopsy showed a picture of bilateral hydrothorax with lung collapse, ascites, and a large left-sided ovarian mass, approximately 15 cm in diameter. Histopathological examinations revealed an ovarian epithelial malignancy (cystadenocarcinoma). There was also lung atelectasis with accompanying thrombosis of small and medium blood vessels. The combination of autopsy and histological findings allowed us to establish the diagnosis of Pseudo-Meigs syndrome, undiagnosed antemortem, resulting in death due to pulmonary and thrombotic complications. Our subsequent review of the literature found no case reports of undiagnosed Pseudo-Meigs syndrome presenting as sudden death, highlighting the uniqueness of the case presented herein.
Pouch Versus No Pouch Following Total Gastrectomy: Meta-analysis of Randomized and Non-randomized Studies
Authors: Syn Nicholas L. , Wee Ian , Shabbir Asim , Kim Guowei , So Jimmy Bok-Yan 
Published: October 2018

Objective:
The aim of the study was to assess the impact of pouch reconstruction on perioperative outcomes, postprandial symptoms, nutritional and anthropometric parameters, and overall quality of life after total gastrectomy for gastric malignancy.

Summary Background Data:
The short-term perioperative risks and longer term functional value of creating a small-bowel reservoir after total gastrectomy are contended.

Methods:
A search for randomized and non-randomized studies comparing reconstruction with or without a pouch was conducted. Treatment effects were computed using pairwise random-effects meta-analysis and meta-regression, and the systematic review was conducted in accordance with PRISMA and MOOSE guidelines.

Results:
A total of 17 randomized trials and 8 observational studies involving 1621 participants were included. Pouch creation is associated with an increased operation time [259.3 vs 235.8 min; weighted mean difference (WMD) 23.5, 95% confidence interval (CI) 9.8–37.2], but not hospitalization duration. There was no difference in overall postsurgical complications, including anastomotic leak and abdominal abscess. Pouch formation markedly reduces the risk of dumping syndrome at 3 to 6 months [8.1% vs 32.4%; risk ratios (RR) 0.36, 95% CI, 0.21–0.60] and 12 to 24 months (2.8% vs 23.6%; RR 0.27, 95% CI, 0.16–0.46). The functional advantages of pouch reconstruction persist at 1 to 2 years, with aggregated data indicating considerably lower risks of esophagitis and heartburn (63% relative reduction), dumping syndrome (73% relative reduction), and food intake disturbance (50% relative reduction). At 12 to 24 months, albumin levels (40.5 vs 37.9 g/L; WMD 2.59, 95% CI, 1.35–3.84) and body mass index (22.2 vs 20.9 kg/m2; WMD 1.28, 95% CI, 0.61–1.94) are significantly higher among participants with a pouch.

Conclusions:
Pouch creation improves long-term functional and nutritional outcomes after total gastrectomy, without greater perioperative morbidity.
Ischemic Optic Neuropathy Secondary to Intravascular Lymphoma
Authors: Dinkin Marc , Lavi Ehud , Winterkorn Jacqueline , Oliveira Cristiano , Merkler Alexander E. 
Published: October 2018

Background:
To describe a case of optic neuropathy associated with intravascular lymphoma (IVL).

Methods:
Case report and review of the literature.

Results:
A case of asymmetric binocular vision loss is described, preceded by transient vision loss. Associated optic perineural enhancement and enhancing and diffusion-positive cortical lesions were observed on magnetic resonance imaging. Biopsy of the cerebellum revealed exclusively intraluminal neoplastic B-cells consistent with IVL.

Conclusions:
Patients with IVL may rarely present with optic nerve involvement, presumably due to small vessel occlusion. The presentation may mimic features of anterior ischemic optic neuropathy including an acute onset and disc edema. Although optic nerve enhancement and associated white matter lesions may suggest optic neuritis, enhancement of the optic nerve sheath, as in this case, has a wide differential diagnosis, which includes giant cell arteritis. IVL should be considered in atypical cases of optic neuropathy accompanied by enhancing, diffusion-positive brain lesions that are not within a specific vascular territory.
Use of Next Generation Sequencing to study two cowpox virus outbreaks
Authors: Antwerpen Markus H. , Georgi Enrico , Nikolic Alexandra , Zöller Gudrun , Wohlsein Peter , Baumgärtner Wolfgang , Peyrefitte Christophe , Charell Remi , Meyer Hermann 
Published: October 2018

AbstractBackgroundBetween 2008 and 2011 about 40 cases of human cowpox were reported from Germany and France. Infections had been acquired via close contact to infected, young pet rats. Sequencing of the hemagglutinin gene of various cowpox virus (CPXV) isolates resulted in an identical and unique sequence in each case pointing to a common source. In a second CPXV outbreak in cats in a small animal clinic in Germany in 2015, four out of five hospitalized cats showed identical hemagglutinin sequences and thus, a hospital-acquired transmission was assumed.MethodsHomogenates of lesion material from rats, cats and humans were cultivated in cell culture. The genomes of 4 virus isolates, 9 CPXVs from our strain collections and from DNA of 3 paraffin-embedded lesion materials were determined by Next Generation Sequencing (NGS). For phylogenetic analyses a MAFFT-alignment was generated. A distance matrix based on concatenated SNPs was calculated and plotted as dendrogram using Unweighted Pair Group Method with Arithmetic mean (UPGMA) for visualization.ResultsAligning of about 200.000 nucleotides of 8 virus isolates associated with the pet rat outbreak revealed complete identity of six genomes, the remainder two genomes differed in as little as 3 SNPs. When comparing this dataset with four already published CPXV genomes also associated with the pet rat outbreak, again a maximum difference of 3 SNPs was found. The outbreak which lasted from 2008 till 2011 was indeed caused by a single strain which has maintained an extremely high level of clonality over 4 years.Aligning genomic sequences from 4 cases of feline cowpox revealed 3 identical sequences and one sequence which differed in 65 nucleotides. Although identical hemagglutinin sequences had been obtained from four hospitalized cats, genomic sequencing proved that a hospital-acquired transmission had occurred in only three cats.DiscussionAnalyzing the rather short sequence of the hemagglutinin gene is not sufficient to conduct molecular trace back analyses. Instead, whole genome sequencing is the method of choice which can even be applied to paraffin-embedded specimens.Funding StatementThis publication was supported by the European Virus Archive goes Global (EVAg) project that has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 653316.This study was also supported in part by the European Union’s Horizon 2020 research and innovation program under grant agreement No 643476 (COMPARE).The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Ecosystem tipping points in an evolving world
Authors: Dakos Vasilis , Matthews Blake , Hendry Andrew , Levine Jonathan , Loeuille Nicolas , Norberg Jon , Nosil Patrik , Scheffer Marten , Meester Luc De 
Published: October 2018

AbstractThere is growing concern over tipping points arising in ecosystems due to the crossing of environmental thresholds. Tipping points lead to strong and possibly irreversible shifts between alternative ecosystem states incurring high societal costs. Traits are central to the feedbacks that maintain alternative ecosystem states, as they govern the responses of populations to environmental change that could stabilize or destabilize ecosystem states. However, we know little about how evolutionary changes in trait distributions over time affect the occurrence of tipping points, and even less about how big scale ecological shifts reciprocally interact with trait dynamics. We argue that interactions between ecological and evolutionary processes should be taken into account for understanding the balance of feedbacks governing tipping points in nature.