bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Evaluation of Visual Outcomes After Bilateral Implantation of a Diffractive Trifocal Intraocular Lens and an Extended Depth of Focus Intraocular Lens
Authors: Singh Bhupesh , Sharma Sourabh , Dadia Suchit , Bharti Neha , Bharti Sudhank 
Published: July 2019

Objectives:
To compare visual outcomes and clinical performance of diffractive trifocal and extended depth of focus (EDOF) intraocular lenses (IOLs).

Methods:
This prospective, consecutive, nonrandomized, comparative study of 6-month duration included assessment of 160 eyes of 80 patients (40 patients in each group). The patients had bilateral cataract surgery with implantation of a trifocal (FineVision Micro F; PhysIOL SA, Liège, Belgium) or EDOF IOL (TECNIS Symfony; Abbott Medical Optics, Inc., Abbott Park, IL) in both eyes. Ophthalmological evaluation included measurement of monocular uncorrected distance visual acuity (UDVA) and corrected distance VA (CDVA), uncorrected intermediate VA (UIVA) and distance-corrected intermediate VA (DCIVA), uncorrected near VA (UNVA) and distance-corrected near VA (DCNVA). Analysis of point-spread function and modulation transfer function was also performed postoperatively, and quality of vision and spectacle-dependence questionnaires were assessed.

Results:
There was no statistically significant difference between groups in monocular UDVA (P=0.65), CDVA (P=0.82), and binocular UDVA (P=0.81). The monocular UIVA, monocular DCIVA, and binocular UIVA were also comparable among the two groups (P=0.70, 0.74, and 0.81, respectively). Monocular UNVA, DCNVA, and binocular UNVA were statistically and significantly better for the trifocal group than for the EDOF (P=0.01, P=0.009, and P=0.001, respectively). There were no differences in visual symptoms and quality among groups.

Conclusions:
Trifocal IOL had a clear advantage over EDOF IOLs in near VA, while both IOLs showed excellent performance in distance and intermediate VA. Both IOLs provided high percentage of spectacle independence and patient satisfaction with minimal level of disturbing photic phenomena.
Association of Magnet Nursing Status With Hospital Performance on Nationwide Quality Metrics
Authors: Boylan Matthew R. , Suchman Kelly I. , Korolikova Helen , Slover James D. , Bosco Joseph A. 
Published: July 2019

ABSTRACT

Introduction:
Magnet Recognition is the highest distinction a healthcare organization can receive for excellence in nursing. Although Magnet status is generally associated with superior clinical outcomes and patient satisfaction, its association with performance on nationwide quality metrics is currently unknown.

Methods:
Within a propensity score–matched cohort, we compared performance on the Hospital-Acquired Condition Reduction Program (HACRP), Hospital Value-Based Purchasing (VBP), and Hospital Readmissions Reduction Program (RRP) initiatives.

Results:
The mean HACRP total performance score was inferior at Magnet versus non-Magnet hospitals (p < .001), and HACRP penalties were more likely to be levied against Magnet hospitals (p = .003). There was no significant difference according to Magnet status for VBP penalties after correcting for multiple comparisons (p = .049). There were no significant difference in RRP penalties according to Magnet status (p = .999).

Conclusions:
Magnet hospitals performed worse on a number of hospitalwide quality metrics tied to reimbursement by the Centers for Medicare and Medicaid Service. Although Magnet hospitals are known for superior nursing care and organizational support for safety and quality improvement, this is not captured within these composite measures of quality, which can be influenced at many levels of care. These data underscore the need for comprehensive quality improvement across multiple domains of care outside of nursing.

Level of Evidence:
Level III, retrospective study.
Workforce Competencies for Healthcare Quality Professionals: Leading Quality-Driven Healthcare
Authors: Schrimmer Karen , Williams Nidia , Mercado Stephanie , Pitts Jennifer , Polancich Shea 
Published: July 2019

ABSTRACT
As healthcare delivery systems increasingly adopt models designed to reward cost-efficient and high-quality care, the demand for expertise in healthcare quality continues to grow. There has been wide variation and limited conformity in the definition of the quality competencies that are essential for healthcare professionals. To address the need for a standard, widely accepted, comprehensive definition of the competencies required for healthcare quality, the National Association for Healthcare Quality (NAHQ) made a strategic commitment to develop a comprehensive healthcare quality competency framework applicable to all practice settings across the care continuum. In this article, the authors describe the development of NAHQ's Healthcare Quality Competency Framework depicting eight competency dimensions required for success in current and future healthcare quality positions. In addition, they discuss a self-assessment survey tool to identify individual and organizational gaps in the workforce competencies of Healthcare Quality Professionals.
Propofol Infusion and Acute Pancreatitis: A Review
Authors: Asghar Muhammad U. , Cheema Hira A. , Tanveer Khurram , Leinwand Joshua 
Published: July 2019

Background:Propofol is a short-acting anesthetic used to induce sedation in various ambulatory and inpatient surgical procedures. It is a US Food and Drug Administration approved lipid-based intravenous hypnotic agent, which has been used clinically for the induction and maintenance of anesthesia for over 3 decades. In addition to general anesthesia, it is used to sedate patients undergoing mechanical ventilation or short procedures such as endoscopy, transesophageal echocardiogram, and abscess drainage. An infrequent but serious complication of propofol is acute pancreatitis (AP), with potentially significant morbidity and possible mortality. In this review, we will discuss the proposed mechanisms of AP secondary to propofol, a number of reported cases, studies conducted, and treatment strategies.Areas of Uncertainty:There are several case reports in the literature that have shown an association between propofol and pancreatitis. The exact mechanism behind propofol-induced pancreatitis is not fully understood, but proposed mechanisms include hypertriglyceridemia (HTG), hypersensitivity, or direct pancreatic toxicity of the drug. Although the association of propofol and pancreatitis has not been proven conclusively, clinicians should be aware of this possible rare complication to prevent the devastating consequences of AP.Data Sources:We gathered articles on previously documented case reports and up-to-date studies on propofol-induced pancreatitis by searching databases such as PubMed and Google Scholar.Results:Based on previous studies and case reports, we suggest that propofol should be added to a list of drugs having a direct association with AP.Conclusions:Although, the mechanism of propofol-induced pancreatitis is not fully understood, and the causal relationship of propofol-induced hypertriglyceridemia or idiosyncratic drug reaction has remained unproven. Clinicians should be aware of the association between propofol and pancreatitis, and any patient presenting with abdominal pain after propofol infusion should be evaluated for AP and treated promptly to avoid complications.
Adherence to Home-Based Rehabilitation in Older Adults With Diabetes After Hip Fracture
Authors: Kuo Wen-Yu , Shyu Yea-Ing Lotus , Wang Jong-Shyan , Chen Min-Chi , Wu Chi-Chuan , Chen Mei-Ling 
Published: July 2019

Abstract

Background
Adherence to rehabilitation is beneficial to patients with hip fracture. However, the relationships between different levels of adherence and postoperative recovery among older adults after hip fracture have not been addressed thoroughly in the literature.

Objectives
The aims of this study were to explore the trajectories of adherence to home-based rehabilitation during the 12-month period after hospital discharge and to examine the effects of adhering to prescribed home-based rehabilitation on postoperative recovery of physical functions.

Methods
We employed a secondary data analysis, and 88 hip-fractured older adults with diabetes were recruited. The Chinese Barthel Index was used to measure daily physical functions, a goniometer was used to measure range of motion, and the MicroFET2 dynamometer was used to measure muscle power. Adherence was measured as the rate of adherence to the suggested frequency of home-based rehabilitation activities.

Results
Adherence to home-based rehabilitation decreased over time. The high-adherence group was more likely to recover prefracture physical functions than was the low-adherence group, and the high-adherence group had better self-care abilities, greater range of motion for ankle extension, and higher muscular strength on both adduction and abduction than did the low-adherence group.

Discussion
The results of our study suggest that patients adhere to more than 50% of prescribed rehabilitation. Future studies should continue to explore interventions to enhance rehabilitation adherence after hospital discharge.
Decreased Mortality After Establishing a Pediatric Emergency Unit at an Urban Referral Hospital in Ghana
Authors: Sylverken Justice , Robison Jeff A. , Osei-Akoto Alex , Nguah Samuel Blay , Addo-Yobo Emmanuel , Balch Alfred , Bolte Robert , Ansong Daniel 
Published: July 2019

AbstractEmergently ill infants and children are often inadequately recognized and stabilized by health care facilities in low- and middle-income countries. Limited reports have shown that process improvements and prioritization of emergency care for children presenting to the hospital can improve pediatric hospital mortality.A dedicated pediatric emergency unit (PEU) was established for nontrauma emergencies at a busy teaching and referral hospital in Kumasi, Ghana, in response to high inpatient mortality early during hospitalization. The PEU was designed to identify and separate critically ill children from more stable children on admission. Locally available hospital resources were reallocated from other areas of the hospital to prioritize staffing and supplies for the PEU.A multiyear data set of nonnewborn inpatient mortality was analyzed with a change point model to find the point at which mortality changed the most within the Department of Child Health or the maximum likelihood estimate. Relative risk of mortality for the periods 1 and 2 years immediately before and after the implementation of the PEU and each individual year compared with its preceding year was analyzed to further establish a temporal correlation of changes in mortality rates to the PEU implementation. Individual years were also analyzed against preimplementation data to establish the durability of mortality improvements.Patient mortality decreased over the analyzed period with the maximum change point strongly associated with implementation of the PEU. Relative risk values of mortality 1 year and 2 years immediately before and after implementation of the PEU were 0.70 (0.62–0.78) and 0.69 (0.64–0.74) respectively, representing a one-third reduction in mortality. The only other mortality improvements seen in the year-to-year analysis were between July 2004–June 2005 compared with July 2005–June 2006 with a relative risk of 0.86 (0.77–0.96).Prioritizing and redirecting limited resources toward pediatric emergency care in low- and middle-income country hospitals is associated with reductions in inpatient mortality that are both immediate and sustained.
Quality Assurance for Point-of-Care Ultrasound in North American Pediatric Emergency Medicine Fellowships
Authors: Thomas-Mohtat Rosemary , Breslin Kristen , Cohen Joanna S. 
Published: July 2019

Objectives
The American Academy of Pediatrics, the Society for Academic Emergency Medicine, and the American College of Emergency Physicians released a policy statement endorsing the use of point-of-care ultrasound (POCUS) by pediatric emergency medicine (PEM) providers. This statement specifically recommends that emergency departments have a credentialing and quality assurance (QA) program for POCUS. There is limited knowledge of how QA for POCUS is currently carried out in pediatric emergency departments with PEM training programs.

Methods
We sent a cross-sectional web-based survey to all 81 PEM fellowship-training programs in the United States and Canada between June 2016 and June 2017.

Results
Sixty-six of 81 programs (81.2%) responded. Sixty-five percent of responding PEM training programs had POCUS-trained faculty or a POCUS champion at their institution. Forty-six percent had a POCUS fellowship in their institution, with 10 programs having PEM-specific POCUS fellowships. Programs with POCUS fellowships were more likely to save all images, review all scans, review scans more frequently, provide feedback, and bill compared with programs without POCUS fellowships.

Conclusions
Point-of-care ultrasound is growing in PEM fellowship-training programs, with a majority of programs now having faculty members trained or interested specifically in POCUS. Most programs prefer more frequent and thorough QA processes, and programs with POCUS fellowships are more likely to have more frequent and thorough QA processes.
Association Between Insurance and the Transfer of Children With Mental Health Emergencies
Authors: Kissee Jamie L. , Huang Yunru , Dayal Parul , Yellowlees Peter , Sigal Ilana , Marcin James P. 
Published: July 2019

Objectives
This study sought to investigate the association between a patient's insurance coverage and a hospital's decision to admit or transfer pediatric patients presenting to the emergency department (ED) with a mental health disorder.

Methods
This is a cross-sectional study of pediatric mental health ED admission and transfer events using the Healthcare Cost and Utilization Project 2014 Nationwide Emergency Department Sample. Children presenting to an ED with a primary mental health disorder who were either admitted locally or transferred to another hospital were included. Multivariable logistic regression models were used to adjust for confounders.

Results
Nineteem thousand eighty-one acute mental health ED events among children were included in the analyses. The odds of transfer relative to admission were higher for children without insurance (odds ratio, 3.30; 95% confidence interval, 1.73–6.31) compared with patients with private insurance. The odds of transfer were similar for children with Medicaid compared with children with private insurance (odds ratio, 1.23; 95% confidence interval, 0.80–1.88). Transfer rates also varied across mental health diagnostic categories. Patients without insurance had higher odds of transfer compared with those with private insurance when they presented with depressive disorder, bipolar disorder, attention-deficit/conduct disorders, and schizophrenia.

Conclusions
Children presenting to an ED with a mental health emergency who do not have insurance are more likely to be transferred to another hospital than to be admitted and treated locally compared with those with private insurance. Future studies are needed to determine factors that may protect patients without insurance from disparities in access to care.
Back to the Future
Authors: Pieper Claus Christian , Hur Saebeom , Sommer Christof-Matthias , Nadolski Gregory , Maleux Geert , Kim Jinoo , Itkin Maxim 
Published: July 2019

Abstract
Lipiodol is an iodinated poppy seed oil first synthesized in 1901. Originally developed for therapeutic purposes, it has mainly become a diagnostic contrast medium since the 1920s. At the end of the 20th century, Lipiodol underwent a transition back to a therapeutic agent, as exemplified by its increasing use in lymphangiography and lymphatic interventions. Nowadays, indications for lymphangiography include chylothorax, chylous ascites, chyluria, and peripheral lymphatic fistula or lymphoceles. In these indications, Lipiodol alone has a therapeutic effect with clinical success in 51% to 100% of cases. The 2 main access sites to the lymphatic system for lymphangiography are cannulation of lymphatic vessels in the foot (transpedal) and direct puncture of (mainly inguinal) lymph nodes (transnodal). In case of failure of lymphangiography alone to occlude the leaking lymphatic vessel as well as in indications such as protein-losing enteropathy, postoperative hepatic lymphorrhea, or plastic bronchitis, lymphatic vessels can also be embolized directly by injecting a mixture of Lipiodol and surgical glues (most commonly in thoracic duct embolization). The aim of this article is to review the historical role of Lipiodol and the evolution of its clinical application in lymphangiography over time until the current state-of-the-art lymphatic imaging techniques and interventions.
Incidental Detection of Ovarian Thecoma by 99mTc-MDP Whole-Body Bone Scan
Authors: Zhang Linqi , He Qiao , Zhou Tao , Zhang Rusen 
Published: July 2019

Abstract
Ovarian thecoma is a benign and rare neoplasm that accounts for 0.5% to 1% of all ovarian tumors. A 55-year-old woman with known breast cancer underwent a metastatic workup before surgery. The 99mTc-MDP whole-body bone scan revealed intense uptake in the left pelvic region. Hybrid SPECT/CT imaging showed that the elevated 99mTc-MDP activity was in a tumor with calcification in the left adnexa. Dynamic enhanced MRI revealed marked enhancement of the tumor. Resection of the tumor was subsequently performed, and pathologic analysis confirmed the diagnosis of an ovarian thecoma.
Integration of 68Ga-PSMA-PET/CT in Radiotherapy Planning for Prostate Cancer Patients
Authors: Onal Cem , Torun Nese , Akyol Fadil , Guler Ozan Cem , Hurmuz Pervin , Yildirim Berna Akkus , Cağlar Meltem , Reyhan Mehmet , Ozyigit Gokhan 
Published: July 2019

Purpose
To assess the role of 68Gallium-labeled-prostate-specific membrane antigen PET/CT (68Ga-PSMA-PET/CT) in risk group definition and radiotherapy planning in the initially planned definitive radiotherapy (RT) for prostate cancer patients.

Methods
The clinical data of 191 prostate cancer patients treated with definitive intensity-modulated RT were retrospectively analyzed. All patients were initially staged with thoracoabdominal CT and bone scintigraphy, and the second staging was performed using 68Ga-PSMA-PET/CT. Both stages were evaluated for the decision making of RT and any change in RT target volumes.

Results
After staging with 68Ga-PSMA-PET/CT, 26 patients (13.6%) had risk group changes, 16 patients (8.4%) had an increase in risk group, and 10 patients (5.2%) had a decrease in risk group. Down-staging occurred in 22 patients (11.5%), and upstaging was observed in 30 patients (15.7%). A total of 26 patients (13.6%) had nodal stage changes. After the 68Ga-PSMA-PET/CT scans, the number of metastatic patient increased to 17 (8.9%), with 4 of them moving from oligo- to polymetastatic disease. An additional irradiation of pelvic lymphatics and metastatic site was performed in 13 patients (6.8%) and 6 patients (3.2%), respectively. The RT was aborted in 4 patients (2.1%) because of parenchymal or distant site metastasis observed in the 68Ga-PSMA-PET/CT.

Conclusions
We found that 68Ga-PSMA-PET/CT causes considerable migration in stage, risk group, and RT field arrangements, especially in high-risk patients regardless of the GS and baseline prostate-specific antigen values alone. 68Ga-PSMA-PET/CT seems to have a great influence on RT decision making in prostate cancer patients.
Focal Immunotherapy-Induced Pancreatitis Mimicking Metastasis on FDG PET/CT
Authors: Das Jeeban Paul , Halpenny Darragh , Do Richard K. , Ulaner Gary A. 
Published: July 2019

Abstract
A 46-year-old man with metastatic lung adenocarcinoma was treated with pembrolizumab. FDG PET/CT was performed after 3 cycles of treatment and revealed a focal region of pancreatic tail enlargement with an SUVmax value of 7. Following treatment with corticosteroids and discontinuation of pembrolizumab, radiological resolution was observed, and a diagnosis of focal immunotherapy-induced pancreatitis was made. A unique spectrum of FDG-avid adverse events can develop in patients treated with immune-checkpoint inhibitors that may mimic metastatic disease. Knowledge of the radiologic features of these potential imaging pitfalls is crucial among those interpreting FDG PET/CT to allow prompt and decisive treatment.
Thymic Tuberculosis Shown on FDG PET/CT Despite Coexisting Pulmonary Tuberculosis With No Increased FDG Activity
Authors: Li Hongyan , Long Yu , Shao Fuqiang , Lan Xiaoli 
Published: July 2019

Abstract
Extrapulmonary tuberculosis could involve multiple organs. However, thymic tuberculosis is relatively rare. We report a 21-year-old man who was referred for an 18F-FDG PET/CT imaging to assess his newly detected pulmonary nodule. The images showed the pulmonary nodule had minimal activity uptake. Unexpectedly, the thymus with elevated FDG accumulation was noted. The pulmonary nodule and thymic lesion were confirmed as tuberculosis by pathology.
Recovery of Renal Function Under PSMA Mediated Radioligand Therapy of Advanced Metastasized Castration Resistant Prostate Cancer
Authors: Ries Martin , Khreish Fadi , Berchem Guy , Ezziddin Samer 
Published: July 2019

Abstract
Radioligand therapy targeting prostate specific membrane antigen (PSMA-RLT) is becoming increasingly important in palliative care of metastasized castration resistant prostate cancer (mCRPC) as a highly effective and low toxicity therapy option. In addition to its overexpression in prostate cancer cells, PSMA is also physiologically expressed in the kidneys which is raising concerns over dose related nephrotoxicity of PSMA-RLT. We describe potential positive short-term effects of PSMA-RLT on renal function with marked recovery of a pretreatment compromised kidney.
FDG PET/CT of Mediastinal Epithelioid Hemangioendothelioma
Authors: Hod Nir , Anconina Reut , Levin Daniel , Delgado Bertha , Dudnik Julia , Lantsberg Sophie 
Published: July 2019

AbstractEpithelioid hemangioendothelioma is a rare low- to intermediate-grade malignant vascular neoplasm with a variable clinical course and currently no standardized treatment. We present a case of a 65-year-old woman diagnosed as having mediastinal epithelioid hemangioendothelioma, a location which is very exceptional. FDG PET/CT was more sensitive than CT for staging, revealing intense FDG uptake in the primary tumor and in the metastatic disease. Despite high FDG uptake, the disease was stable with no further specific treatment. Only few reports utilizing FDG PET/CT are available; review of the literature on this subject is included.
The Mandibular Ramus: An Alternative Donor Site for Secondary Alveolar Bone Grafting in Clefts of the Alveolus
Authors: Blatter Jeannine , May Laurence , De Buys Roessingh Anthony , Medinger Laurent , Broome Martin 
Published: July 2019

Abstract
The authors describe the use of the mandibular ramus as an autologous bone graft material for secondary alveolar bone grafting in cleft patients. This technique represents a safe and effective alternative to currently used donor sites. Furthermore, it allows to minimize patient discomfort, so that they can be treated as outpatients.