bluuebunny/crossref_metadata_2025_split huggingface dataset:
Topical Corticosteroid Phobia Among Women Affected With Vulvar Lichen Sclerosus: Results From a Cross-sectional Survey
Authors: Borghi Alessandro , Flacco Maria Elena , Pacetti Lucrezia , Toni Giulia , Corazza Monica 
Published: February 2024

Objective
Topical corticosteroid (TC) phobia (TCP) is common in subjects affected with chronic inflammatory skin diseases who need prolonged corticosteroid treatments. The aim of this study was to assess TCP in women affected with vulvar lichen sclerosus (VLS).

Materials and Methods
This observational, cross-sectional study included adult patients with VLS who either started or were undergoing a TC treatment at our vulva unit between May 2022 and May 2023. All patients completed the self-administered TOPICOP questionnaire, which is validated for measuring concerns, worries, and beliefs about TC use. The scores obtained were analyzed in relation to demographic, history, and clinical data.

Results
The majority of the 165 (92.1%, 66.5 ± 11.9 years) included patients who had previously undergone TC treatments, mostly for VLS; 81.8% of them had received information about TCs, mainly from dermatologists (86.7%). The median global TOPICOP score was 16.7% (interquartile range. 8.3–30.6), corresponding to a raw median value of 6.0 (interquartile range, 3.0–11.0). The median subscores for the 2 TOPICOP domains, namely, mistaken beliefs and worries about TCs, were equal to each other. At multivariate analysis, none of the collected variables showed a significant association with the degree of TCP.

Conclusions
In our VLS patients, TCP resulted rather low, probably because of the small skin area being treated and the high percentage of women who had already used TCs and who had received information about them from a dermatologist. This latter point suggests that adequate counseling could be a strong basis for greater awareness and serenity in the long-term use of TCs.
Nurses' Perceptions of Caring at Work
Authors: Drake Jennifer , Davis Theresa M. , O'Brien Anne-Marie , Parker Carla , Swamidoss Douglas Carol , Thomas Donna , Rickard Sarah , Sintich Maureen E. , Gollenberg Audra , Mowery Bernice D. 
Published: February 2024

OBJECTIVES
Study objectives were to explore nurses' perceptions of self-care, co-worker, and leader caring within healthcare work environments and assess reliability of 3 Watson Caritas Scores.

BACKGROUND
Assessing caring in an organization where Watson's Theory of Human Caring guides nursing practice offers insight into the professional practice environment.

METHOD
This study reports quantitative data from mixed-methods descriptive, cross-sectional survey of 1307 RNs at a large healthcare system.

RESULTS
Mean scores were self = 5.46, co-worker = 5.39, and leader score = 5.53, and median scores were >5.6 (range, 1-7). All scales had a positive and significant correlation to likelihood to recommend the organization, with the largest being feeling cared for by leaders. Internal reliability of the 3 scales was ≥0.9.

Conclusion
Nurse perceptions of caring may influence the organization's reputation. Assessing the perception of caring among nursing staff after the introduction and enculturation of this framework is needed. Results support psychometric value for 3 Watson Caritas Scores.
Association Between Serum 25-Hydroxyvitamin D and Trichomonas vaginalis Infection Among American Adults: NHANES 2013–2016
Authors: Zhang Shuangxia , Gao Xiang , Ma Xiaopeng , Wang Jinghua , Zhu Yunxia 
Published: February 2024

According to this cross-sectional study, individuals in the United States between the ages of 20 and 59 years who have low vitamin D levels are more likely to have a prevalent infection of Trichomonas vaginalis.

Background
Previous studies have suggested that vitamin D may possess anti-infection properties, but the relationship between vitamin D and Trichomonas vaginalis infection remains unexplored.

Methods
Using data from the National Health and Nutrition Examination Survey between 2013 and 2016, we conducted multivariate regression analyses and subgroup analyses to investigate the association between 25-hydroxyvitamin D (25[OH]D) levels and T. vaginalis infection, ensuring the robustness of our results.

Results
The final sample included data from 4318 individuals aged 20 to 59 years, among which 92 were diagnosed with T. vaginalis infection. For every 10 nmol/L increase in serum 25(OH)D level, there was a 22% reduction in the likelihood of T. vaginalis infection incidence (adjusted odds ratio [aOR], 0.78; 95% confidence interval [CI], 0.69–0.90). Similarly, higher concentration tertiles demonstrated relatively lower infection ratios compared with the tertile with the lowest 25(OH)D concentration (aOR, 0.54 [95% CI, 0.30–0.95; P = 0.030] for T2; aOR, 0.23 [95% CI, 0.09–0.61; P < 0.001] for T3).

Conclusions
Our cross-sectional study indicates a negative association between 25(OH)D levels and the prevalence of T. vaginalis infection. However, further high-quality evidence is needed to establish a causal relationship between 25(OH)D levels and T. vaginalis infection, as well as to evaluate the potential role of vitamin D supplementation in preventing T. vaginalis infection.
Optometrists need to incorporate their understanding of the impact of dry eye disease in their patient management
Authors: Mathan Zoë M. J. , van Tilborg Mirjam M. A. 
Published: February 2024

SIGNIFICANCE
The impact of dry eye disease on patients' daily lives is understood by optometrists, but they seldom use this understanding in their patient management.

PURPOSE
Dry eye disease can significantly impact a person's daily life and is known to cause psychological symptoms. Treating and managing patients with dry eye disease can be challenging, as an approach based solely on signs is unlikely to reflect patients' true burden. Because optometrists play a crucial role in the care of dry eye disease patients, it is necessary to examine their awareness of the negative impact of dry eye disease on patients' daily lives and how they manage this during their consultation time, including diagnosis and management.

METHODS
This study has an exploratory, qualitative research design. Twelve semistructured online interviews were conducted with optometrists in second-line eye care through a convenience sample. The interviews were recorded, transcribed verbatim, and analyzed after a thematic analysis.

RESULTS
The main findings were that few optometrists actively asked about patients' perceived burden, many optometrists did not mention all the possible treatment options or practical advice that could benefit dry eye disease patients, and few were aware of the possible help that other health care providers could provide, besides the optometrist.

CONCLUSIONS
Dutch optometrists are aware of the impact that dry eye disease can have on their patients' daily lives, but seldom use this information as part of their management plan.
Objective and subjective assessment of accommodative insufficiency
Authors: León Alejandro , Rosenfield Mark , Medrano Sandra Milena , Durán Sandra Carolina , Pinzón Carol Violet 
Published: February 2024

SIGNIFICANCE
A variety of subjective and objective procedures are available to measure the amplitude of accommodation. However, it is unclear whether the standard criterion of Hofstetter's minimum minus 2 D can be used to diagnose accommodative insufficiency with each of these techniques.

PURPOSE
The use of objective dynamic retinoscopy and three subjective techniques to diagnosis accommodative insufficiency was examined.

METHODS
A total of 632 subjects between 8 and 19 years of age were enrolled. Accommodative lag, monocular accommodative facility, and subjective (push-up, modified push-down, and minus lens) and objective (dynamic retinoscopy) amplitude of accommodation were quantified. Accommodative insufficiency was diagnosed based on Hofstetter's minimum minus 2 D for each subjective method, as well as adding an additional subjective criterion (either accommodative lag exceeding 0.75 D or monocular accommodative facility falling below the age-expected norms).

RESULTS
The prevalence of accommodative insufficiency was lowest and highest with the push-up (7.9 and 1%) and dynamic retinoscopy (94 and 12%) procedures when measured without and with the additional subjective criteria, respectively. Comparing the validity of dynamic retinoscopy against the traditional criterion, moderate to low sensitivity and high specificity were found. However, adding the additional subjective criteria improved the findings with moderate to high sensitivity and high specificity. Using a cutoff for dynamic retinoscopy of 7.50 D showed moderate diagnostic accuracy based on likelihood ratios.

CONCLUSIONS
It is clear that a revised definition of accommodative insufficiency is required, which must include the method of assessing accommodation. The various objective and subjective methods for quantifying the amplitude of accommodation are not interchangeable, and subjective assessment does not provide a valid measure of the accommodative response.
2022 Glenn A. Fry Award lecture: Enhancing clinical assessment for improved ophthalmic management
Authors: Wolffsohn James S. 
Published: February 2024

ABSTRACTDetailed clinical assessment is critical to allow sensitive evaluation of the eye and its management. As technology advances, these assessment techniques can be adapted and refined to improve the detection of pathological changes of ocular tissue and their impact on visual function. Enhancements in optical medical devices including spectacle, contact, and intraocular lenses have allowed for a better understanding of the mechanism and amelioration of presbyopia and myopia control. Advancements in imaging technology have enabled improved quantification of the tear film and ocular surface, informing diagnosis and treatment strategies. Miniaturized electronics, large processing power, and in-built sensors in smartphones and tablets capacitate more portable assessment tools for clinicians, facilitate self-monitoring and treatment compliance, and aid communication with patients. This article gives an overview of how technology has been used in many areas of eye care to improve assessments and treatment and provides a snapshot of some of my studies validating and using technology to inform better evidence-based patient management.
Durable Efficacy of Switching From a 3- or 4-Drug Tenofovir Alafenamide–Based Regimen to the 2-Drug Regimen Dolutegravir/Lamivudine in the TANGO Study Through Week 196
Authors: De Wit Stéphane , Bonnet Fabrice , Osiyemi Olayemi , Bisshop Fiona , Olalla Julian , Routy Jean-Pierre , Wyen Christoph , Moodley Riya , Pappa Keith , Wang Ruolan , Oyee James , Saggu Parminder , Letang Emilio , Wynne Brian , Jones Bryn , Smith Kimberly Y. , Ait-Khaled Mounir 
Published: February 2024

Background:
Switching to the 2-drug regimen dolutegravir (DTG)/lamivudine (3TC) demonstrated durable noninferior efficacy vs continuing 3- or 4-drug tenofovir alafenamide–based regimens for maintaining virologic suppression in people with HIV-1 through week 144 in TANGO.

Setting:
One hundred thirty-four centers, 10 countries.

Methods:
Adults with HIV-1 RNA <50 copies/mL for >6 months and no history of virologic failure were randomized to switch from stable tenofovir alafenamide–based regimens to DTG/3TC on day 1 [early-switch (ES) group] for 196 weeks. Those randomized to continue tenofovir alafenamide–based regimens on day 1 who maintained virologic suppression at week 144 switched to DTG/3TC at week 148 [late-switch (LS) group]. Efficacy, safety, and tolerability (including weight and biomarker changes) of DTG/3TC in ES and LS groups were assessed through week 196.

Results:
Overall, 369 participants switched to DTG/3TC on day 1 (ES) and 298 switched at week 148 (LS). In the ES group, 83% (306/369) maintained virologic suppression through year 4, and 3% (11/369) reported new adverse events between weeks 144 and 196. The LS group at week 196 and the ES group at week 48 had comparable proportions with virologic suppression (93% each) and similar safety profiles. No LS participants and 1 ES participant met confirmed virologic withdrawal criteria through week 196, with no resistance-associated mutations observed. Treatment continued to be well tolerated long term.

Conclusions:
Switching from tenofovir alafenamide–based regimens to DTG/3TC showed durable efficacy, high barrier to resistance, and good tolerability through 4 years. These results support DTG/3TC as a robust treatment for maintaining virologic suppression.
Virtual Monoenergetic Images Facilitate Better Identification of the Arc of Riolan During Splenic Flexure Takedown
Authors: Li Qian , Zhang Pengfei , Zhang Ranxu , Zhang Jianfeng , Tian Ruoxi , Gao Tianyi , Huang Yu , Zhang Ping , Wei Wei , Hong Rui , Wang Guiying , Zhao Jian 
Published: February 2024

Objective
This study aimed to investigate whether virtual monoenergetic images (VMIs) can aid radiologists and surgeons in better identifying the arc of Riolan (AOR) and to determine the optimal kilo electron volt (keV) level.

Methods
Thirty-three patients were included. Conventional images (CIs) and VMI (40–100 keV) were reconstructed using arterial phase spectral-based images. The computed tomography (CT) attenuation and noise of the AOR, the CT attenuation of the erector spinal muscle, and the background noise on VMI and CI were measured, respectively. The signal-to-noise ratio, contrast-to-noise ratio (CNR), and signal intensity ratio were calculated. The image quality of the AOR was evaluated according to a 4-point Likert grade.

Results
The CT attenuation, noise, CNR, and signal intensity ratio of the AOR were significantly higher in VMI at 40 and 50 keV compared with CI (P < 0.001); VMI at 40 keV was significantly higher than 50 keV (P < 0.05). No significant difference in signal-to-noise ratio, background noise, and CT attenuation of the spinal erector muscle was observed between VMI and CI (P > 0.05). virtual monoenergetic image at 40 keV produced the best subjective scores.

Conclusions
Virtual monoenergetic image at 40 keV makes it easier to observe the AOR with optimized subjective and objective image quality. This may prompt radiologists and surgeons to actively search for it and encourage surgeons to preserve it during splenic flexure takedown.
Evaluation of the Usefulness of Contrast-Enhanced Computed Tomography for the Early Detection of Anastomotic Leakage After Esophagectomy
Authors: Morikawa Kazuhiko , Tanishima Yuichiro , Igarashi Takao , Ohki Yohei , Takahashi Keita , Kurogochi Takanori , Yano Fumiaki , Ojiri Hiroya 
Published: February 2024

Objective
Anastomotic leakage is one of the most severe complications after esophagectomy. However, a diagnostic gold standard for anastomotic leakage has not been established yet. This retrospective cohort study aimed to evaluate the potential use of routine postoperative contrast-enhanced computed tomography findings as an early predictor of anastomotic leakage in patients who underwent esophagectomy for esophageal cancer.

Methods
This study included 75 patients who underwent Mckeown esophagectomy, of whom 22 developed anastomotic leakage after surgery. The computed tomography findings for this patient cohort were categorized into 3 grades based on mural enhancement patterns observed at the anastomotic site. Both semiquantitative and quantitative analyses were performed, and the interobserver agreement between the 2 experienced radiologists was assessed.

Results
It was found that poor enhancement in both the early and portal venous phases (grade 2) had a robust association with the occurrence of anastomotic leakage. The computed tomography enhancement ratio that is used to estimate wall degeneration and ischemia was significantly higher in patients with anastomotic leakage.

Conclusions
Routine postoperative contrast-enhanced computed tomography could be beneficial for the early detection of anastomotic leakage, even in asymptomatic patients, after esophagectomy.
Surgical Correction of Depressed Scars After Upper Blepharoplasty: A Turnover Orbicularis-Septum Composite Flap Technique
Authors: Liu Zhigang , Liu Miaoqing , Huang Wen , Wang Zhijun , Shi Heng 
Published: February 2024

Objective:
Depressed scarring is a common complication after incisional upper blepharoplasty and frequently contributes to patient dissatisfaction. Correcting this deformity presents a significant challenge for oculoplastic surgeons. This study aims to investigate the clinical effectiveness of employing the turnover orbicularis-septum composite flap technique in correcting depressed scars after double eyelid surgery.

Methods:
This is a retrospective study of 118 patients who underwent revision blepharoplasty with depressed scar from November 2020 to February 2023. During the revision procedure, the adhesions of the original scar were meticulously dissected, and the residual orbital fat was thoroughly released. The orbicularis-septum composite flap was then inverted downward and smoothly laid over the depressed scar area to address the tissue deficit. After surgery, patient satisfaction was evaluated by assessing the improvement of the depressed scars and the shape of the double eyelid folds.

Results:
Follow-up assessments were conducted over a period of 6 to 24 months postoperatively. The results were judged as fully satisfied in 78 cases (66.1%), basically satisfied in 32 cases (27.1%), and unsatisfied in 8 cases (6.8%). Among the unsatisfied patients, 5 patients complained of eyelid fold shallow or disappear, and 3 patients complained of asymmetry. All patients exhibited varying degrees of improvement in the depressed scars.

Conclusions:
The turnover orbicularis-septum composite flap technique provides an effective approach for the treatment of depressed scars with a high satisfaction rate.
Phenotypic antibiotics susceptibility profile of clinical Enterobacteriaceae isolates from Kaduna State, North-west Nigeria
Authors: Ezeh Peace Amarachukwu , Olayinka Busayo Olalekan , Bolaji Rebecca Olajumoke , Suleiman Babangida Ahmed , Olowookere Ahmed 
Published: February 2024

Background: The increasing resistance of clinical Enterobacteriaceae infection to commonly prescribed antibiotics have been reported around the world. Data is generally lacking on the prevalence and antibiotic susceptibility profile of clinical Enterobacteriaceae isolates from Kaduna, northwest Nigeria. This study thus aimed to determine the diversity of clinical Enterobacteriaceae isolates recovered from clinical specimens of patients admitted into two selected healthcare institutions in Kaduna, Nigeria.
Methods: Non-duplicate clinical bacteria isolates recovered from various specimens were collected and identified using rapid biochemical identification kits. The susceptibility of identified Enterobacteriaceae to various antibiotics and phenotypic detection of carbapenemase enzymes were thereafter determined.
Results: Of the 500 collected bacterial isolates, 108 (21.6 %) were identified as Enterobacteriaceae, with Pantoea agglomerans (52, 48.1%), Klebsiella oxytoca (19, 17.6%) as the most prevalent. The isolates exhibited high resistance to azithromycin (69%) and ceftazidime (42%), while exhibiting low resistance to amikacin (7%) and imipenem (10%). Among the carbapenem-resistant Enterobacteriaceae (CRE) isolates, a significant proportion (66.6 %) tested positive for carbapenemase activity.
Conclusion: This study reports a high prevalence of multi-drug resistant Enterobacteriaceae in Kaduna, northwest Nigeria. The emergence of pathogenic P. agglomerans and an alarmingly high prevalence of carbapenemase-producing CRE are also observed. The presence of carbapenemase producers in an area with low carbapenem usage and resistance rates raises significant concerns. Continuous surveillance and robust antibiotic stewardship policies are imperative to preserve the efficacy of carbapenems in this region.
The rasterdiv package for measuring diversity from space
Authors: Marcantonio Matteo , Thouverau Elisa , Rocchini Duccio 
Published: February 2024

AbstractThis book chapter provides an extensive overview of therasterdivpackage which provides a comprehensive suite of functions designed to calculate diversity indices from numerical matrices, including those derived from optical remote sensing imagery. It facilitates a deeper analysis of spatial heterogeneity and ecosystem complexity by translating pixel values into ecological indicators. This package serves as a valuable tool for researchers and practitioners in the fields of landscape ecology, biodiversity monitoring, and environmental management, allowing for an enhanced understanding of landscape patterns and their ecological implications through advanced quantitative measures.
Understanding staff needs for Improving End-of-life Care in Critical Care Units
Authors: Tavabie S , Pearson S , Balabanovic J , Batho A , Juj M , Kastande P , Bennetts J , Collis E , Bonnici T. 
Published: February 2024

AbstractObjectivesCritical care is a place of frequent death, up to a quarter of those admitted die during admission. Caring for dying people provides many challenges, practically, professionally and personally. The aim of this study was to better understand the perspectives of staff caring for dying people in critical care and identify their priorities for improvement.MethodThree multidisciplinary focus groups of critical care staff at a large central London hospitals trust were facilitated with a semi structured format and digitally transcribed. Inductive thematic analysis was conducted to extract themes.ResultsN=34 (18 nursing, 7 allied health professionals, 6 medical, 3 clerical/administrative) The five themes were structured as priority statements: “We need to recognise” included the subthemes of being “sick enough to die” and potential rapid deteriorations in this setting; “We need to understand” with subthemes of perspectives on dying and prioritising time for conversations; “We need to connect” with subthemes of therapeutic relationship and physical presence; “We need to collaborate” with subthemes of critical care working and empowerment, and cross teams working; “We need support” with themes of experiencing support and making time to support others.ConclusionWe present an approach to identifying critical care departmental priorities for an end-of-life care improvement programme. The themes extracted will be used to evaluate systems for dying in critical care, aiming to empower staff to provide excellent care every time they look after a dying person.