bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prevalence and characteristics of chronic ocular itch: a cross-sectional survey
Authors: Stull Carolyn , Valdes-Rodriguez Rodrigo , Shafer Brian M. , Shevchenko Alina , Nattkemper Leigh A. , Chan Yiong-Huak , Tabaac Sydney , Schardt Martin J. , Najjar Dany M. , Foster William J. , Yosipovitch Gil 
Published: March 2017

Introduction:
In this cross-sectional study, we aimed to determine the prevalence and characteristics of chronic ocular itch in an outpatient ophthalmology and optometry clinic.

Methods:
Four hundred patients from an outpatient ophthalmology and optometry clinic were enrolled. The presence and characteristics of chronic ocular itch were assessed by a questionnaire. Data regarding ophthalmologic, dermatologic, and systemic conditions as well as current medications were extracted from medical records.

Results:
Chronic ocular itch was present in 118 (29.5%) of 400 participants. Chronic ocular pruritus was significantly more prevalent in females [P=0.015; odds ratio (OR)=1.8; 95% confidence interval (CI), 1.1–2.8] and was significantly associated with the presence of allergic conjunctivitis [51.8% (n=45); P<0.001; OR=5.0; 95% CI, 3.0–8.3], dry eye syndrome [40.1% (75); P<0.001; OR=2.6; 95% CI, 1.7–4.1], blepharitis [43.8% (n=21); P=0.021; OR=2.0; 95% CI, 1.1–3.8], and atopic dermatitis [50.0% (n=10); P=0.023; OR=2.6; 95% CI, 1.1–5.8]. Chronic ocular itch was not significantly associated with systemic conditions, or the use of prescribed ophthalmologic medications.

Discussion:
Chronic ocular itch is common and may be related to ophthalmologic or dermatologic pathologies. The present findings highlight the importance of identifying and managing this uncomfortable symptom that may negatively impact the quality of life and sleep of affected patients.
Pain and pharmacologic pain management in long-stay nursing home residents
Authors: Hunnicutt Jacob N. , Ulbricht Christine M. , Tjia Jennifer , Lapane Kate L. 
Published: March 2017

Abstract
Previous studies estimate that >40% of long-stay nursing home (NH) residents experience persistent pain, with 20% of residents in pain receiving no analgesics. Strengthened NH surveyor guidance and improved pain measures on the Minimum Data Set 3.0 were introduced in March 2009 and October 2010, respectively. This study aimed to provide estimates after the important initiatives of (1) prevalence and correlates of persistent pain; and (2) prevalence and correlates of untreated or undertreated persistent pain. We identified 1,387,405 long-stay residents in U.S. NHs between 2011 and 2012 with 2 Minimum Data Set assessments 90 days apart. Pain was categorized as persistent (pain on both assessments), intermittent (pain on either assessment), or none. Pharmacologic pain management was classified as untreated pain (no scheduled or as needed medications received) or potentially undertreated (no scheduled received). Modified Poisson models adjusting for resident clustering within NHs provided adjusted prevalence ratios (APRs) estimates and 95% confidence intervals (CIs). The prevalence of persistent and intermittent pain was 19.5% and 19.2%, respectively, but varied substantially by age, sex, race and ethnicity, cognitive impairment, and cancer. Of residents in persistent pain, 6.4% and 32.0% were untreated and undertreated, respectively. Racial and ethnic minorities (non-Hispanic blacks vs whites, APR = 1.19, 95% CI: 1.13-1.25) and severely cognitively impaired residents (severe vs no/mild APR = 1.51, 95% CI: 1.44-1.57) had an increased prevalence of untreated and undertreated pain. One in 5 NH residents has persistent pain. Although this estimate is greatly improved, many residents may be undertreated. The disturbing disparities in untreated and undertreated pain need to be addressed.
Allodynia in cluster headache
Authors: Wilbrink Leopoldine A. , Louter Mark A. , Teernstra Onno P.M. , van Zwet Erik W. , Huygen Frank J.P.M. , Haan Joost , Ferrari Michel D. , Terwindt Gisela M. 
Published: March 2017

Abstract
Cutaneous allodynia is an established marker for central sensitization in migraine. There is debate whether cutaneous allodynia may also occur in cluster headache, another episodic headache disorder. Here, we examined the presence and severity of allodynia in a large well-defined nationwide population of people with cluster headache. Using validated questionnaires we assessed, cross-sectionally, ictal allodynia and comorbid depression and migraine in the nationwide “Leiden University Cluster headache neuro-Analysis” (LUCA) study. Participants with cluster headache were diagnosed according to the International Classification of Headache Disorders criteria. Multivariate regression models were used, with correction for demographic factors and cluster headache subtype (chronic vs episodic; recent attacks <1 month vs no recent attacks). In total, 606/798 (75.9%) participants with cluster headache responded; of whom, 218/606 (36%) had allodynia during attacks. Female gender (odds ratio [OR] 2.05, 95% confidence interval [95% CI] 1.28-3.29), low age at onset (OR 0.98, 95% CI 0.96-0.99), lifetime depression (OR 1.63, 95% CI 1.06-2.50), comorbid migraine (OR 1.96, 95% CI 1.02-3.79), and having recent attacks (OR 1.80, 95% CI 1.13-2.86), but not duration of attacks and chronic cluster headache, were independent risk factors for allodynia. The high prevalence of cutaneous allodynia with similar risk factors for allodynia as found for migraine suggests that central sensitization, like in migraine, also occurs in cluster headache. In clinical practice, awareness that people with cluster headache may suffer from allodynia can in the future be an important feature in treatment options.
Polysubstance use and misuse or abuse of prescription opioid analgesics: a multi-level analysis of international data
Authors: Morley Katherine I. , Ferris Jason A. , Winstock Adam R. , Lynskey Michael T. 
Published: March 2017

Abstract
Increasing mortality and morbidity associated with opioid analgesics has led to concerns about their misuse and abuse, even when obtained through a prescription. These concerns have been most pronounced in the United States, but limited data make it difficult to determine whether it is a problem in other countries. We investigated opioid analgesic misuse and abuse in participants from the Global Drug Survey 2015 resident in the United States (N = 1334), United Kingdom (N = 1199), France (N = 1258), Germany (N = 866), and Australia (N = 1013) who had used at least 1 prescription opioid analgesic medication in the past year. We also investigated the relationship with polysubstance use, one of the most consistent predictors of problematic opioid analgesic use. Data included misuse and abuse of codeine, hydrocodone, oxycodone, and tramadol; ability to obtain a prescription; different sources for obtaining drugs; and past-year use of benzodiazepines and illicit drugs. In multilevel models, country of residence accounted for less than 3% of the variance in opioid analgesic misuse or abuse. Adjusting for country of residence and sociodemographic factors, use of illicit drugs and benzodiazepines was associated with 4-fold greater odds of misuse (odds ratio 4.36, 95% confidence interval 3.29-5.93) and 6-fold greater odds of abuse compared with not using either drug (odds ratio 6.49, 95% confidence interval 4.0-10.48), although the strength of the association with abuse varied by country. Misuse and abuse by those prescribed opioid analgesics seem to be a problem that is not limited to the United States and warrant attention on an international scale.
Resumption of Warfarin After Hospitalization for Lower Gastrointestinal Bleeding and Mortality Benefits
Authors: Patel Parita , Nigam Neha , Sengupta Neil 
Published: March 2017

Goals:
To evaluate whether resumption of warfarin after hospitalization for lower gastrointestinal bleeding (LGIB) is associated with improved 90-day and 6-month survival.

Background:
LGIB is a common complication for patients on warfarin. There is limited data to guide clinicians on the optimal management of warfarin following hospitalization for LGIB.

Study:
We identified patients hospitalized with LGIB while on warfarin using a validated, machine-learning algorithm. Patients were classified as those who had warfarin resumed at discharge and those who did not. Univariate and multivariate Cox proportional hazards were used to determine whether resuming warfarin was associated with improved 90-day and 6-month mortality.

Results:
In total, 607 patients were admitted with warfarin-associated LGIB. A total of 403 (66.4%) patients had warfarin held at discharge. Discontinuation of warfarin was associated with an increased 90-day and 6-month mortality on univariate analysis [hazard ratio (HR), 2.07, 95% confidence interval (CI), 1.04-4.58, P=0.04; HR, 1.78, 95% CI, 1.02-3.27, P=0.04]. On multivariate regression adjusting for age, comorbidities, and transfusion requirement, only a higher Charlson Index was associated with increased 90-day mortality (HR, 1.18, 95% CI, 1.07-1.29, P=<0.001). At 6 months, only older age was associated with an increased mortality on multivariate regression (HR, 1.02, 95% CI, 1.00-1.05, P=0.02), with no significantly increased mortality risk with holding warfarin (HR, 1.48, 95% CI, 0.84-2.78, P=0.18)

Conclusions:
There was no association between resumption of warfarin at discharge following hospitalization for LGIB and either 90-day or 6-month mortality on multivariate analysis. Mortality in LGIB was largely driven by age and comorbidities.
Chorioamnionitis: time for a new approach
Authors: Randis Tara M. , Polin Richard A. , Saade George 
Published: March 2017

Purpose of review
The association between maternal chorioamnionitis and early-onset sepsis in the newborn has long been recognized, and established guidelines recommend treating all exposed infants with broad-spectrum antibiotics until infection can be ruled out. However, recent data suggest that close observation of well appearing term and late-preterm newborns may be a preferable alternative. The present review addresses the evidence in favor of newly proposed changes to the diagnosis and management of women and newborns following a maternal diagnosis of chorioamnionitis. Potential implications of these new practice guidelines will also be discussed.

Recent findings
A panel of experts assembled in 2015 to provide updated, evidence-based guidelines for the diagnosis and management of women and newborns following a maternal diagnosis of chorioamnionitis. Revised terminology and diagnostic criteria were proposed as well as changes in the management of newborns of mothers with suspected intrauterine infection, most notably a recommendation to observe (rather than treat) well appearing term and late-preterm newborns.

Summary
A management strategy consisting of close observation of well appearing term and late-preterm infants exposed to suspected intrauterine infection is preferable to empiric antimicrobial therapy. Large prospective epidemiologic studies will be needed to ascertain the impact of these new practice guidelines on the outcomes of infants exposed to intrauterine infection and/or inflammation. Improved precision in the clinical diagnosis of intrauterine infection should improve both the quality and reproducibility of data generated from future studies.
Association of Maternal Gestational Weight Gain With the Infant Fecal Microbiota
Authors: Robinson Alyssa , Fiechtner Lauren , Roche Brianna , Ajami Nadim J. , Petrosino Joseph F. , Camargo Carlos A. , Taveras Elsie M. , Hasegawa Kohei 
Published: March 2017

ABSTRACTObjectives:Pregnancy characteristics may influence the infant fecal microbiota during early life. We aimed to examine associations of maternal gestational weight gain with infant fecal microbiota composition, bacterial community richness, and Shannon diversity index.Methods:We analyzed data from a prospective cohort study of healthy infants. We collected prenatal data, including report of mother's gestational weight gain, and infant fecal samples from 84 infant‐mother dyads. By applying 16S rRNA gene sequencing and an unbiased clustering by partitioning around medoids using Bray‐Curtis distances, we identified 4 fecal microbiota profiles, and examined the associations of maternal gestational weight gain with the 4 fecal microbiota profiles, bacterial community richness, and Shannon diversity index.Results:Overall, the median age of infants was 4.0 months and 43% were girls. The mothers of the 84 infants gained a mean of 14.2 kg (standard deviation, 5.4 kg) during pregnancy. We identified 4 distinct microbiota profiles: Bifidobacterium‐dominant (42%), Enterobacter/Veillonella‐dominant (23%), Bacteroides‐dominant (19%), and Escherichia‐dominant (17%). Infants whose mothers had higher gestational weight gain were less likely to have a Bacteroides‐dominant profile, corresponding to a relative risk ratio of 0.83 (95% confidence interval, 0.71–0.96; P = 0.01) per 1 kg increase in weight. In addition, higher gestational weight gain was also associated with lower bacterial community richness and Shannon diversity index (P < 0.05).Conclusions:In this prospective cohort study of healthy infants, maternal gestational weight gain was associated with the infant fecal microbiota profiles, bacterial community richness, and Shannon diversity index.
Diagnosis and Management of Congenital Uterine Anomalies in Pregnancy
Authors: Vaz Sharon A. , Dotters-Katz Sarah K. , Kuller Jeffrey A. 
Published: March 2017

Importance
Congenital uterine anomalies (CUAs) are strongly associated with adverse fertility and pregnancy outcomes. Health care providers must be able to diagnose these anomalies, understand their impact, and counsel women on interventions that might improve rates of pregnancy and live birth.

Objectives
The aims of this study were to characterize CUAs and their effects on adverse fertility and pregnancy outcomes, to describe the best imaging modalities to diagnose specific uterine anomalies, and to learn about interventions that may improve the reproductive outcomes of infertile and pregnant women.

Evidence Acquisition
A search of the PubMed database revealed 56 relevant studies, 49 of which were referenced in this comprehensive summary of the literature.

Results
Congenital uterine anomalies are strongly associated with recurrent pregnancy loss, low birth weight, preterm birth, hypertensive disorders of pregnancy, malpresentation, and cesarean delivery. Transvaginal 3-dimensional ultrasonography appears to be the best initial test for uterine anomaly evaluation. Prior to conception, women who undergo hysteroscopic metroplasty may have better fertility and pregnancy outcomes.

Conclusions and Relevance
Congenital uterine anomalies, although rare in the general population, pose significant challenges to women and their clinicians with regard to fertility and pregnancy management. Accurate diagnosis, preconception counseling and metroplasty, and antenatal monitoring may improve reproductive outcomes for women with CUAs.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to (1) characterize congenital uterine anomalies and their potential effects on adverse fertility and pregnancy outcomes, (2) determine the best imaging modalities to diagnose specific uterine anomalies, and (3) counsel both infertile and pregnant patients about interventions that may improve their reproductive outcomes.
Asphyxia in Motor Vehicle Crashes
Authors: Storvik Steven G. , Campbell Julius Q. , Wheeler Jeffrey B. 
Published: March 2017

Abstract
Rates of death because of asphyxia in motor vehicle crashes have been previously estimated using county and statewide data sets, but national estimates have not been reported. The literature regarding asphyxia in motor vehicle crashes primarily involves discussions about clinical findings, and crash-related variables have been sparsely reported. The current study calculated a nationwide fatality rate for asphyxia in motor vehicle crashes of 1.4%. Seventeen case studies of asphyxia were also reported providing crash-, vehicle-, and occupant-related variables. These included type of accident, crash severity, seat belt use, containment status, extent of occupant compartment intrusion, height, weight, and injury pattern. The data presented can be used to better understand the injury mechanism, identify risk factors, develop possible protective countermeasures, and create situational awareness for emergency responders and investigators.
Influence of opioid-related side effects on disability, mood, and opioid misuse risk among patients with chronic pain in primary care
Authors: Jamison Robert N. , Dorado Kathleen , Mei Anna , Edwards Robert R. , Martel Marc O. 
Published: March 2017

Abstract

Background:
There is increasing concern among primary care practitioners about the use of opioids for chronic pain, including their adverse effects, but little attention has been given to how reports of side effects from prescription medication can contribute to outcomes among patients with chronic pain. The aim of this study was to investigate the impact of frequently reported side effects on mood, disability, and opioid misuse in patients with chronic pain prescribed opioids within primary care.

Methods:
Two hundred (N = 200) patients with chronic pain taking opioids for pain were recruited into the study. All patients completed baseline measures and a monthly side effects checklist once a month for 6 months. Patients were divided evenly based on a median split of the number of endorsed side effects over 6 months. The subjects repeated the baseline measures at the end of the study period.

Results:
Over time, reports of medication side effects tended to decrease, but differences in frequency of reported side effects from baseline to follow-up (6-month time) were not significant, and the order of the frequency of the reported side effects remained similar. Patients who reported significant medication-related adverse effects reported significantly greater activity interference, negative affect, and catastrophizing compared with those with fewer side effects (P < 0.01). In addition, those patients with pain who reported more side effects showed significantly higher scores on opioid misuse risk (P < 0.001).

Discussion:
This study demonstrates the important role of monitoring medication-related side effects among patients with chronic pain who are prescribed opioid medication for pain within primary care.
Preoperative Computed Tomographic Angiogram Measurement of Abdominal Muscles Is a Valuable Risk Assessment for Bulge Formation after Microsurgical Abdominal Free Flap Breast Reconstruction
Authors: Kappos Elisabeth A. , Jaskolka Jeff , Butler Kate , O’Neill Anne C. , Hofer Stefan O. P. , Zhong Toni 
Published: March 2017

Background:
A major shortcoming associated with abdominal tissue breast reconstruction is long-term abdominal wall morbidity. Although abdominal muscle size on computed tomographic angiography has been correlated with morbidity following many abdominal operations, it has not been studied for breast reconstruction. Therefore, the authors evaluated the association between preoperative computed tomography angiography–derived measurements of abdominal core muscles and postoperative abdominal wall morbidity after abdominal tissue breast reconstruction.

Methods:
In this retrospective matched case-control study of women who underwent microsurgical abdominal flap breast reconstruction at one institution between January 2011 and June 2015, the authors evaluated all cases of postoperative bulge/hernia, matched by type of abdominal flap and body mass index in a ratio of 1:2 to controls without bulge/hernia. The authors obtained morphometric measurements of abdominal core muscles on preoperative computed tomographic angiographs. Using univariable and multivariable logistic regressions, the authors examined the effects of clinical risk factors and computed tomographic angiography morphometric measurements on postoperative bulge/hernia formation.

Results:
Of the 589 patients who underwent abdominal free flap breast reconstruction, symptomatic bulges/hernias were identified in 35 patients (5.9 percent). When compared to the 70 matched controls, multivariable analysis showed that decreased area of rectus abdominis muscle (OR, 0.18; p < 0.01) and increased inter-rectus abdominis distance (OR, 1.14; p < 0.01) on computed tomographic angiography were significant risk factors associated with postoperative bulge/hernia.

Conclusion:
Preoperative computed tomographic angiography allows objective measurements of the patient’s abdominal muscle anatomy that provide valuable prognostic information on the risk of bulge/hernia formation following abdominally based microsurgical breast reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Impact of Primary Tumor Location on Postoperative Recurrence and Subsequent Prognosis in Nonmetastatic Colon Cancers
Authors: Ishihara Soichiro , Murono Koji , Sasaki Kazuhito , Yasuda Koji , Otani Kensuke , Nishikawa Takeshi , Tanaka Toshiaki , Kiyomatsu Tomomichi , Kawai Kazushige , Hata Keisuke , Nozawa Hioaki , Sugihara Kenichi , Watanabe Toshiaki 
Published: March 2017

Objective:
We aimed to clarify the prognostic impact of primary tumor location on recurrence after curative surgery and subsequent survival in patients with nonmetastatic colon cancer.

Summary of Background Data:
Right and left colon cancers are suggested to be oncologically different; however, their prognostic differences have been conflictingly reported.

Methods:
A total of 5664 patients with curatively resected stage II-III colon cancer were reviewed, retrospectively. Relapse-free survival (RFS) after primary surgery and cancer-specific survival (CSS) after recurrence were compared between patients with right and left colon cancer. Patients’ backgrounds were matched using propensity scores.

Results:
Although patients with right colon cancer had more advanced disease, their 5-year RFS rate was significantly superior compared with that in those with left colon cancer (83.9% vs 81.1%, P = 0.019). However, the 5-year CSS after recurrence rate was significantly inferior in patients with right colon cancer compared with that in those with left colon cancer (30.6% vs 43.6%, P = 0.016).

Conclusions:
The primary tumor location of nonmetastatic colon cancer might have different prognostic implications for the rates of recurrence after curative resection and cancer-specific mortality after recurrence.
Introduction Wind farms in complex terrains: an introduction
Authors: Alfredsson P. H. , Segalini A. 
Published: March 2017

Wind energy is one of the fastest growing sources of sustainable energy production. As more wind turbines are coming into operation, the best locations are already becoming occupied by turbines, and wind-farm developers have to look for new and still available areas—locations that may not be ideal such as complex terrain landscapes. In these locations, turbulence and wind shear are higher, and in general wind conditions are harder to predict. Also, the modelling of the wakes behind the turbines is more complicated, which makes energy-yield estimates more uncertain than under ideal conditions. This theme issue includes 10 research papers devoted to various fluid-mechanics aspects of using wind energy in complex terrains and illustrates recent progress and future developments in this important field.
This article is part of the themed issue ‘Wind energy in complex terrains’.