bluuebunny/crossref_metadata_2025_split huggingface dataset:
Caracterización clínica y microbiológica de la bacteriemia por Staphylococcus aureus
Authors: Hincapié-Osorno Carolina , Caraballo-Cordovez César , Tibaduiza-García María Fernanda , Garcés-Rodríguez Daniela de Jesús , Echeverri-Toro Lina , Ascuntar-Tello Johana , León-Álvarez Alba Luz , Jaimes-Barragán Fabián 
Published: September 2019

Introducción: Staphylococcus aureus es una frecuente causa de bacteriemias y el incremento en las tasas de resistencia dificulta su tratamiento inicial. La incidencia de bacteriemias por S. aureus resistente a meticilina (SAMR) ha aumentado, principalmente en las infecciones adquiridas en el medio hospitalario. Este estudio pretende caracterizar clínicamente a los pacientes con bacteriemia por S. aureus detectados en un hospital de Medellín y definir su perfil de resistencia microbiana.
Métodos: cohorte retrospectiva en un hospital de tercer nivel. Se incluyeron pacientes ≥16 años con aislamiento para Staphylococcus aureus en sangre periférica. Se registró información relacionada con el episodio, el sitio de adquisición, la clasificación microbiológica y las características clínicas.
Resultados: de 775 reportes de hemocultivos positivos para S. aureus, finalmente se ingresaron 698 pacientes al estudio. La mediana de edad fue de 58 años (RIQ=42-69), 383 eran hombres (54.9%). En 354 pacientes (50.7%) la bacteriemia era de origen nosocomial y el 26.2% (n=183) eran SAMR. En 123 (17.6%) bacteriemias adquiridas en la comunidad, la frecuencia de SAMR fue 33.3% (n=41). El antecedente más frecuente fue tener un catéter vascular en 321 pacientes (46%). Se inició terapia empírica en 67.2% de los casos (n=469). Respecto a la gravedad, la mediana del puntaje SOFA fue de 4 (RIQ=1-5), APACHE II de 15 (RIQ=10-19) y la mortalidad fue del 24.9% (n=174).
Conclusiones: a pesar de que la mayoría de bacteriemias son de origen nosocomial, el reporte más frecuente fue SAMS tanto en el grupo nosocomial como en el de la comunidad. Sin embargo, la mortalidad en el grupo de bacteriemia nosocomial fue inferior comparada con la de la comunidad.
To focus on processes, Les Sciences de l’artificiel , cinquante ans après : Essentielle contribution épistémologique et civique à la formation des Sciences de la Cognition et des Sciences d’Ingénierie
Authors: Le Moigne Jean-Louis 
Published: September 2019

Lorsque parait en 1969 la première édition de The Science of the Artificial , l’ouvrage embarrassa d’abord les libraires et documentalistes : dans quelle rubrique disciplinaire le classer ? Non seulement il témoignait des compétences réfléchies d’H. A. Simon alors âgé de 53 ans dans la plupart des aires de connaissances reconnues par les académies des sciences mais il argumentait aussi la légitimité gnoséologique et épistémologique de ces ‘nouvelles sciences’ que sont les sciences de l’artificiel, les sciences d’ingénierie, les sciences de conception, se formant sur des ‘projets’ plutôt que sur des ‘objets dits naturels’. L’aventure de ce livre dans nos cultures mérite alors d’être contée puisqu’elle se poursuit cinquante après. Genèse de 1945 à 1968 : éclairée par les élections aux Académies des Arts & Sciences en 1959 et 67. Deuxième phase, celle d’une croissance étonnante de 1969 à 1981 : 3 chapitres de plus pour la deuxième édition, prix Turing de l’ACM (Informatique) 1975, prix Nobel (Economie) 1978 ; Troisième phase 1981-1996-2001, marquée par la parution du manifeste épistémologique Reason in Human Affairs (1983) qui va contribuer au renouvellement paradigmatique de l’épistémologie complexe par les ‘nouvelles sciences’ que sont les sciences de l’artificiel, les sciences d’ingénierie, les sciences des systèmes complexes, les sciences de conception.
Predictors of Hospital Nurses' Cultural Competence: The Value of Diversity Training
Authors: McLennon Susan M. , Rogers Tara L. , Davis Altheria 
Published: September 2019

Background:
RNs must be culturally competent to facilitate optimal health outcomes for diverse patients and families. The purpose of this study was to identify factors associated with cultural competence in hospital nurses.

Method:

In this cross-sectional, descriptive study, the Cultural Competence Assessment Tool was administered to RNs (
N
= 74) from a 500-bed urban medical center in the southeastern United States. The mean age of participants averaged 40.6 (
SD
= 11.0) years, and most participants were White (63%) and had encountered more than five (66%) different cultures in their work environment in the prior 12 months. Forty-two percent had received two or more different types of diversity training (
M
= 1.6,
SD
= 1.1).

Results:

Mean score for overall cultural competence was 7.3 (
SD
= 0.8) on a scale of 0 to 10 (10 = highest possible). Years of education was positively associated with diversity training (
r
= 0.31,
p
< .01) and cultural competence (
r
= 0.25,
p
< .05). Only diversity training predicted greater cultural competence (β = 0.40,
p
= .001).

Conclusion:

Results suggest that diversity training is associated with greater cultural competence. Further research is needed to identify optimal types, dose, and frequency of diversity training to enhance overall cultural competence.

[
J Contin Educ Nurs.
2019;50(10):469–474.]
Increasing Nursing Knowledge of ST-Elevated Myocardial Infarction Recognition on 12-Lead Electrocardiograms to Improve Patient Outcomes
Authors: Hernandez Joanna M. , Glembocki Margaret M. , McCoy Mary Anne 
Published: September 2019

Background:
Early identification of ST-elevated myocardial infarction (STEMI) on electrocardiograms (ECGs) is vital to patient outcomes. Therefore, nurses need to have the knowledge to quickly recognize this lethal dysrhythmia.

Method:
The purpose of this pretest–posttest study was to increase nursing's knowledge on accurate and timely identification of an STEMI using an online educational intervention delivered via social media.

Results:

This study included a convenience sample of 31 RNs employed in an urban hospital in the Midwest. The mean score on the pretest was 7.53 of 10 (
p
= .028), which improved to 9.11 of 10 (
t
= 6.273;
p
= .000) on the posttest.

Conclusion:

The use of social media to reach adult learners may be an effective means of delivering continuing education. Additional work is needed to further explore the use of educating bedside nurses on the importance of using the 12-lead ECG as a screening tool.

[
J Contin Educ Nurs.
2019;50(10):475–480.]
The Effect of Pulsed Ultrasound in the Treatment of Tibial Stress Fractures
Authors: Rue John-Paul H , Armstrong David W , Frassica Frank J , Deafenbaugh Martin , Wilckens John H 
Published: September 2019

abstract
Tibial stress fractures commonly occur in athletes and military recruits. This prospective, randomized, double-blind clinical study sought to determine whether pulsed ultrasound reduces tibial stress fracture healing time. Twenty-six midshipmen (43 tibial stress fractures) were randomized to pulsed ultrasound or placebo treatment. Twenty-minute daily treatments continued until patients were asymptomatic with signs of healing on plain radiographs. The groups were not significantly different in demographics, delay from symptom onset to diagnosis, missed treatment days, total number of treatments, or time to return to duty. Pulsed ultrasound did not significantly reduce the healing time for tibial stress fractures.
A Retrospective Comparison of LASIK Outcomes for Myopia and Myopic Astigmatism With Conventional NIDEK Versus Wavefront-guided VISX and Alcon Platforms
Authors: Dougherty Paul J. , Bains Harkaran S. 
Published: September 2019

Purpose
To compare visual, refractive, and safety outcomes among a non-wavefront scanning-slit laser (NIDEK EC-5000) and wavefront-driven lasers (Alcon CustomCornea and VISX CustomVue).

Methods

A retrospective comparison of outcomes for 290 eyes that underwent LASIK for myopia and myopic astigmatism with either a conventional or custom ablation excimer laser system were compared. The preoperative refractive error and age of the patients were matched. Outcomes were tested for statistically significant differences among the conventional laser and each of the custom ablation lasers. A
P
value <.05 was considered statistically significant. Data with 3-month follow-up are reported.

Results

Postoperatively, mean manifest refraction spherical equivalent was −0.12±0.31 diopters (D) (range: −1.50 to 0.75 D) for the NIDEK group, −0.13±0.39 D (range: −1.88 to 0.75 D) for the VISX group, and −0.06±0.26 D (range: −0.75 to 0.75 D) for the Alcon group. Eighty-nine percent of eyes in the NIDEK group, 88% of eyes in the VISX group, and 92% of eyes in the Alcon group were within a half-diopter of intended correction. None of the NIDEK and VISX eyes and 3% of Alcon eyes lost 2 or more lines of best spectacle-corrected visual acuity. No statistically significant differences in any of the outcomes studied between conventional and custom ablation treatments were noted (
P
>.05).

Conclusions

No statistically significant differences were observed in safety, efficacy, or predictability of eyes that underwent conventional ablation with the NIDEK EC-5000 scanning slit laser compared to custom ablation with the VISX CustomVue or Alcon CustomCornea laser systems. [
J Refract Surg.
2008;24:891–896.]
Multifocal Corneal Ablation for Hyperopic Presbyopes
Authors: Jung Seok Won , Kim Min Jung , Park Shin Hae , Joo Choun-Ki 
Published: September 2019

Purpose
To investigate the clinical results of multi-focal wavefront-guided corneal ablation with a central near zone in hyperopic presbyopes.

Methods
Twenty-seven patients (54 eyes) were analyzed retrospectively. Monocular near and distance uncorrected visual acuity (UCVA) and binocular near and distance UCVA were measured preoperatively, and the near addition power and the manifest refraction were obtained. Measurements of spherical aberration, coma, total higher order aberration, and contrast sensitivity for high and low photopic conditions were performed. All patients received multifocal corneal ablations with a central near zone using the VISX CustomVue System and were examined at 1 month (48 eyes), 2 months (42 eyes), and 6 months (28 eyes) after surgery.

Results
Of 14 patients, 9 (64.3%) achieved both 0.8 or better in binocular distance UCVA and 0.65 or better in binocular near UCVA, and the spherical equivalent refraction and near addition power decreased from +1.16±0.82 diopters (D) to +0.33±0.45 D and from 2.35±0.44 D to 1.42±0.62 D at 6 months after surgery, respectively. No significant changes were noted in total higher order aberration and contrast sensitivity, whereas spherical aberration coefficients (Z-12) changed from positive to negative.

Conclusions

Multifocal wavefront-guided refractive surgery in presbyopia offered effective correction in hypermetropia and satisfactory near vision without significant increase in corneal total higher order aberration or significant decrease in contrast sensitivity. [
J Refract Surg
. 2008;24:903–910.]
Customized Topography-guided Photorefractive Keratectomy With the MEL-70 Platform and Mitomycin C to Correct Hyperopia After Radial Keratotomy
Authors: Ghanem Ramon C. , Ghanem Vinicius C. , de Souza Denise C. , Kara-José Newton , Ghanem Emir A. 
Published: September 2019

Purpose
To evaluate topography-guided photorefractive keratectomy (PRK) for correcting hyperopia and astigmatism after radial keratotomy (RK).

Methods
Prospective study of 12 consecutive patients (19 eyes) who were treated with topography-guided PRK with 0.02% mitomycin C using an Asclepion-Meditec MEL-70 excimer laser with a 9.5-mm ablation zone. All eyes were operated by the same surgeon and followed for 1 year.

Results

Thirteen eyes had complete epithelialization by day 7 and all eyes by day 10. At 1 year, uncorrected visual acuity was 20/25 or better in 42.1% of eyes and 20/40 or better in 68.4%. Preoperative mean spherical equivalent refraction was +3.80±2.47 diopters (D) and +0.24±2.36 D (
P
<.001) 1 year postoperative, with 47.4% of eyes being within ±1.00 D and 73.7% within ±2.00 D. Preoperative mean cylinder was −2.30±1.41 D and −0.62±0.73 D (
P
<.001) 1 year postoperative. At 1 year, 68.4% of eyes gained at least 1 line of best-spectacle corrected visual acuity, 36.8% gained more than 1 line, and only 2 eyes lost 1 line (one due to corneal haze). Three eyes developed central haze. Mean regression from 6 to 12 months in these 3 eyes was +1.83 D and in the remaining 16 eyes was −0.50 D.

Conclusions

Topography-guided PRK with mitomycin C was safe and reasonably effective for the treatment of hyperopia after RK. [
J Refract Surg.
2008;24:911–922.]
Haze Development After Photorefractive Keratectomy: Mechanical vs Ethanol Epithelial Removal in Rabbits
Authors: de Medeiros Fabricio Witzel , Mohan Rajiv R. , Suto Chikako , Sinhá Sunilima , Bonilha Vera L. , Chaurasia Shyam S. , Wilson Steven E. 
Published: September 2019

Purpose
To compare mechanical and ethanol epithelial removal with respect to myofibroblast development and haze formation after photorefractive keratectomy (PRK).

Methods
Seventeen rabbits underwent mechanical or ethanol debridement, and the opposite eye of each rabbit served as an unwounded control. In both groups, the epithelium was removed with a spatula and discarded. A −9.00-diopter PRK was performed in each eye. The level of haze in each cornea at 4 weeks was graded at the slit-lamp microscope according to the Fantes scale. Myofibroblast generation was detected with immunocytochemistry for alpha-smooth muscle actin (alpha-SMA) and cells were quantitatively analyzed.

Results

No difference was noted between the two groups in alpha-SMA + myofibroblasts 4 weeks after surgery (43.6±2.0/400× field and 45.7±4.8/400× field in ethanol and mechanical groups, respectively) (
P
=.10). A slight difference was noted but did not reach statistical significance with regard to stromal haze between ethanol and mechanical groups (2.0±0.5 and 2.3±0.4, respectively,
P
=.063). The ethanol and mechanical groups were statistically different when compared to controls regarding stromal haze and alpha-SMA+ cells (
P
<.0001 for all comparisons).

Conclusions

No difference was noted in clinical haze or myofibroblast generation between corneas that had PRK with mechanical or ethanol epithelial debridement. [
J Refract Surg.
2008;24:923–927.]
A Prospective Bilateral Comparison of Epi-LASIK and LASEK for Myopia
Authors: Hondur Ahmet , Bilgihan Kamil , Hasanreisoglu Berati 
Published: September 2019

Purpose
To compare the clinical and confocal microscopic results of mechanical (epi-LASIK) versus alcohol-assisted laser epithelial keratomileusis (LASEK) for the correction of myopia.

Methods
Twenty-five patients with myopia received epi-LASIK in one eye and LASEK in the other. The difference of spherical equivalent refraction of myopia and astigmatism was less than 1.00 diopter (D) in two eyes of each case. Mechanical separation of the epithelium was performed with the Lasitome epithelial separator and alcohol-assisted separation with 25 second application of 18% alcohol. Ablation was performed with the ESIRIS laser. Patients were seen daily until epithelial closure, and at 1, 3, 6, and 12 months. Time to epithelial healing, uncorrected visual acuity (UCVA), manifest refraction, haze, and grey scale value in confocal microscopy were recorded.

Results
Preoperative myopic spherical equivalent refraction was −3.95±1.49 D in the epi-LASIK and −3.91±1.39 D in the LASEK-treated eyes. The mean time to epithelial healing was slightly longer after epi-LASIK (4.86±0.64 vs 4.18±0.58 days). Of both epi-LASIK and LASEK-treated eyes, 92% achieved 20/20 or better UCVA and were within ±0.50 D of emmetropia at 12 months. The grade of haze and mean grey scale value in confocal microscopy were similar in epi-LASIK and LASEK-treated eyes at all postoperative periods. One eye treated with epi-LASIK suffered a minor stromal cut.

Conclusions

Epi-LASIK and LASEK offer effective correction of myopia with comparable results at 1 year. [
J Refract Surg
. 2008;24:928–934.]
Corneal Biomechanical Metrics in Eyes With Refraction of −19.00 to +9.00 D in Healthy Brazilian Patients
Authors: Fontes Bruno M. , Ambrósio Renato , Alonso Ruiz S. , Jardim Daniela , Velarde Guillermo C. , Nosé Walton 
Published: September 2019

Purpose
To evaluate corneal biomechanical metrics with tomographic parameters (given by the Oculus Pentacam) and refractive data in a population of healthy Brazilian patients.

Methods
Observational, cross-sectional study of 150 consecutive patients (53 men and 97 women; 260 eyes). Age, gender, central keratometric readings (central K), central corneal thickness (CCT), anterior chamber depth (ACD), spherical equivalent refraction, corneal hysteresis, and corneal resistance factor (CRF) were assessed and analyzed.

Results

Mean patient age was 46.5±21.04 years, average central K was 43.59±1.54 diopters (D), CCT was 545.05±35.41 µm, ACD was 2.96±0.52 mm, spherical equivalent refraction was −1.16±3.48 D, corneal hysteresis was 10.17±1.82, and CRF was 10.14±1.8 (range: 5.45 to 15.1). Mean CRF and corneal hysteresis were distinct among gender: CRF 10.326 in women and 9.810 in men (
P
=.0266); corneal hysteresis 10.421 in women and 9.727 in men (
P
=.0031). A negative correlation was found between both CRF and corneal hysteresis with age (r=−0.1255,
P
=.0434; and r=−0.2445,
P
=.0001, respectively). No association was found between CRF and average central K (r=0.0633,
P
=.3086), ACD (r=−0.0474,
P
=.4498), or spherical equivalent refraction (r=0.1028,
P
=.1061). Corneal hysteresis was not associated with age and average central K (r=0.0572,
P
=.3573), ACD (r=0.0060,
P
=.9236), or spherical equivalent refraction (r=0.0975,
P
=.1253). Corneal resistance factor and corneal hysteresis were positively associated with CCT (r=0.5760,
P
=0; and r=0.4655,
P
=0, respectively).

Conclusions

Corneal biomechanical metrics of healthy Brazilian patients were associated with CCT, gender, and age. Corneal steepness, ACD, and spherical equivalent refraction did not affect corneal hysteresis and CRF values in the studied population. [
J Refract Surg
. 2008;24:941–945.]
Tracking Difficulties After Femtosecond Laser Flap Creation With the LADARVision Excimer Laser System
Authors: Ramos-Esteban Jerome C. , Bamba Sonya , Krueger Ronald R. 
Published: September 2019

Purpose
To describe a series of myopic patients in whom a LASIK flap was created with the IntraLase femtosecond laser. The LADARVision (Alcon Laboratories Inc) tracking system failed and resulted in postponement of surgery.

Methods
Five myopic Asian patients with darkly pigmented irides underwent bilateral superior hinge flap creation with three different femtosecond laser (IntraLase Corp) pulse frequencies: 15, 30, and 60 kHz. Mean patient age, preoperative best spectacle-corrected visual acuity (BSCVA), and spherical equivalent refraction were 33 years, 20/20, and −6.25 diopters (D), respectively. Despite uncomplicated flap-lift and adequate pharmacologic dilated pupil diameter >7 mm, difficulty was experienced with LADAR-Vision eye tracking in 9 of 10 eyes. Intraoperative manipulations (fluid application, levitation of the laser bed, and tracking through a repositioned flap) were attempted to facilitate eye tracking at the time of femtosecond laser flap creation, but without success.

Results
The flap was repositioned, and patients were asked to return 1 to 5 days later, at which time the flap was relifted, eye tracking was successfully achieved, and the surgery was completed. Mean postoperative uncorrected visual acuity was 20/18 and no eyes lost any lines of BSCVA at 1 year.

Conclusions

Irregularities of the IntraLASIK stromal bed surface induce forward light scatter, and dark ocular pigmentation further reduces retinal reflectance, leading to tracking failure with the Alcon LADARVision platform. Delaying the surgery by 1 to 5 days may aid in reducing the light scatter, so that eye tracking can be achieved. [
J Refract Surg
. 2008;24:953–956.]
The Visian Myopic Implantable Collamer Lens Does Not Significantly Affect Axial Length Measurement With the IOLMaster
Authors: Sanders Donald R. , Bernitsky David A. , Harton Paul J. , Rivera Robert P. 
Published: September 2019

Purpose
To compare pre- to postoperative axial length measurements with the IOLMaster (Zeiss Humphrey Systems) to determine whether a correction factor for later intraocular lens (IOL) power calculation is necessary with an Implantable Collamer Lens (ICL; STAAR Surgical) in place.

Methods
The commercially approved Visian ICL was implanted in 60 eyes from 3 separate sites (20 eyes each). Pre- and postoperative axial length measurements were obtained using partial coherence interferometry.

Results

The pre- and postoperative axial lengths were highly correlated with an R
2
value of 0.9963. For all ranges of axial lengths tested, the use of postoperative axial length instead of preoperative axial length resulted in a <0.1-mm error in axial length measurements.

Conclusions

Based on the SRK formula, a 0.1-mm axial length difference would result in a 0.25-diopter (D) change in calculated IOL power; possibly a 0.20-D change in manifest refraction. These differences are so small as to make any correction to IOL power calculation formula based on the presence of an ICL unnecessary. [
J Refract Surg
. 2008;24:957–959.]
Urrets-Zavalia Syndrome Following Iris-claw Phakic Intraocular Lens Implantation
Authors: Park Shin Hae , Kim So Youl , Kim Hyung Il , Yang Suk Woo 
Published: September 2019

Purpose
To report a patient who had a fixed and dilated pupil after uneventful iris-claw phakic intraocular lens (IOL) implantation.

Methods
A 27-year-old woman with bilateral high myopia underwent bilateral implantation of iris-claw phakic IOLs.

Results
No specific ocular findings were noted until postoperative week 1. Intraocular pressure (IOP) was within normal range in both eyes after surgery. At postoperative week 2, the right pupil was normal, but the left pupil was fully dilated and non-reactive to light, accommodative effort, and 0.125% and 2% pilocarpine. Best spectacle-corrected visual acuity was 1.0, and IOP was 13 mmHg in the left eye. There was no history of perioperative mydriatic use.

Conclusions

Urrets-Zavalia syndrome, unrelated to IOP elevation, occurred after uneventful phakic IOL implantation. Clinicians performing phakic IOL implantation should be aware of this complication. [
J Refract Surg
. 2008;24:959–961.]