bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concurrence of Ocular Cicatricial Pemphigoid in Chronic Ocular Graft-Versus-Host Disease
Authors: Taketani Yukako , Dehghani Shima , Sinha Shruti , Freitag Suzanne K. , Papaliodis George , Foster Stephen , Dohlman Thomas H. , Dana Reza 
Published: December 2023

Purpose:
The aim of this study was to report a series of 3 patients with ocular graft-versus-host disease (oGVHD) with progressive cicatricial conjunctival changes who were diagnosed with ocular cicatricial pemphigoid (OCP) after conjunctival biopsy.

Methods:
This study was a retrospective case series.

Results:
Three patients who received hematopoietic stem cell transplantation for hematologic malignancies developed oGVHD and subsequently were diagnosed with OCP. Case 1 was a 73-year-old woman with oGVHD who developed symblepharon and showed positive IgA, IgG, and C3 staining of the basement membrane zone (BMZ) on conjunctival biopsy, consistent with OCP. She was systemically treated with tacrolimus and prednisone with resolution of conjunctival inflammation. Case 2 was a 68-year-old man with oGVHD who developed symblepharon, severe dry eye, and corneal epithelial defect. An initial conjunctival biopsy was negative, but a repeat biopsy performed 10 years later showed positive BMZ IgA and IgG staining. Healing of the epithelial defect was achieved after treatment with high-dose systemic cyclosporine. Case 3 was a 75-year-old woman with oGVHD who had a nonhealing corneal epithelial defect and symblepharon with positive IgA BMZ staining on conjunctival biopsy, consistent with OCP. The patient responded well to methotrexate with healing of the epithelial defect.

Conclusions:
Although low-grade conjunctival fibrotic changes may be observed in chronic oGVHD, development of severe and progressive cicatricial changes, including symblepharon formation, should prompt consideration of biopsy to rule out concurrent OCP, the management of which differs from that of oGVHD.
Light as a drug: prospective randomized evaluation and comparison of the effect of decreased illumination on visual recovery after cataract surgery
Authors: Rosenberg Eric D. , Shah Lopa S. , Sippel Kimberly C. , Nattis Alanna S. 
Published: December 2023

Purpose:
To compare the effect of decreased illumination on the rate of postoperative visual recovery, and the incidence of cystoid macular edema (CME) with surgical visualization achieved with a traditional analog operating microscope compared with a 3D digital visualization system.

Setting:
Ambulatory surgery center, New York.

Design:
Prospective, randomized, consecutive, single-surgeon series.

Methods:
Patients undergoing routine cataract surgery were randomized into either (1) visualization through the binoculars of a standard operating microscope (“traditional group”) or (2) visualization through a 3D digital visualization system affixed to the same operating microscope (“digital group”). Note was made in each case of light intensity used, light exposure time, cumulative dissipated energy (CDE), femtosecond laser use, preoperative medical and ocular conditions, intraoperative and/or postoperative complications, and preoperative and postoperative visual acuities and optical coherence tomography confirmed CME.

Results:
The study comprised 118 eyes in the traditional group and 96 eyes in the digital group. There were no differences in preoperative visual acuity, light exposure time, CDE, or femtosecond laser use between groups, but the light intensity used in the digital group was significantly less (19.5% ± 0.5%) than in the traditional group (48.6% ± 0.6%; P < .001). Furthermore, the digital group achieved a better decimal postoperative day 1 visual acuity (0.60 ± 0.03) with less rates of CME (2.1%) when compared with that of the traditional group (0.51 ± 0.02, P = .03; and 9.2%, P = .03), respectively.

Conclusions:
Visual recovery and CME rates were significantly better in patients who underwent cataract surgery assisted by the 3D digital visualization platform without an increase in complications or surgical time.
The implementation and impact of an advanced practice recognition program
Authors: Bork Stephanie , LeBar Kiersten 
Published: December 2023

ABSTRACT
Meaningful job recognition is a pillar for sustaining healthy work environments and proven beneficial for job satisfaction and retention. However, few dedicated award recognition programs exist for advanced practice registered nurses (APRNs), and no available literature evaluates the impact on professional practice, sense of belonging, and job retention or satisfaction. The purpose of this study was to introduce a novel award recognition program for APRNs and physician associates (PAs) in a large academic medical system and evaluate it's impact on job satisfaction, retention, and sense of belonging. Five awards were created to recognize areas of achievement for clinically practicing APRNs or PAs within an academic health system. Nomination letters were collected, deidentified, and reviewed by an award committee. Winners were announced and received a plaque. A survey was sent to employed APRNs evaluating their response to the program. The survey was sent to both APRNs (83%) and PAs (17%). Survey end points included job satisfaction, willingness to stay in role for 1 and 5 years, sense of community, something to work toward, and increasing recognition of APRNs. Results showed statistical significance in three areas. Advanced practice registered nurses or PAs who were aware of award opportunities and/or nominated for an award showed higher job satisfaction, more likely to stay in job for 1 year, and felt a greater level of recognition. Dedicated APRN award programs may have a positive impact on job satisfaction and retention. This model may be extrapolated to provide greater opportunities for meaningful recognition among clinical APRNs.
Self-Report Measures of Fatigue for People With Multiple Sclerosis: A Systematic Review
Authors: Cohen Evan T. , Matsuda Patricia Noritake , Fritz Nora E. , Allen Diane D. , Yorke Amy M. , Widener Gail L. , Jewell Sarah T. , Potter Kirsten 
Published: December 2023

Background and Purpose:
The symptom of fatigue impairs function in people with multiple sclerosis (MS). Choosing appropriate measures to assess fatigue is challenging. The purpose of this article is to report the findings of a systematic review of patient-reported fatigue measures for people with MS.

Methods:
PubMed, CINAHL, and Embase databases were searched through January 2020 using terms related to fatigue and MS. Studies were included if the sample size was 30 or more or smaller samples if adequately powered, and if information about measurement characteristics (ie, test-retest reliability, content validity, responsiveness, interpretability, or generalizability) of the measure(s) could be extracted. Study quality was appraised with the 2-point COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Data about measurement characteristics, psychometrics, and clinical utility were extracted and results were synthesized.

Results:
Twenty-four articles met inclusion criteria with information about 17 patient-reported fatigue measures. No studies had critical methodologic flaws. Measurement characteristic data were not available for all measures. Clinical utility varied in time to complete and fatigue domains assessed.

Discussion and Conclusions:
Five measures had data pertaining to all properties of interest. Of these, only the Modified Fatigue Impact Scale (MFIS) and Fatigue Severity Scale (FSS) had excellent reliability, responsiveness data, no notable ceiling/floor effects, and high clinical utility. We recommend the MFIS for comprehensive measurement and the FSS for screening of subjective fatigue in people with MS.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A443).
A Mild Phenotype of Overlapping Syndrome With Myelin-Oligodendrocyte Glycoprotein and Glial Fibrillary Acidic Protein Immunoglobulin G
Authors: Pan Danmei , Gu Jina , Zeng Chengjun , Chen Lin 
Published: December 2023

Introduction:
Glial fibrillary acidic protein (GFAP) astrocytopathy, an autoimmune central nervous system disorder characterized by the development of immunoglobulin G reactive with GFAP, has received growing attention in recent years. It is documented that GFAP-immunoglobulin G and other autoantibodies can be both detected in some patients. However, the coexistence of anti–myelin-oligodendrocyte glycoprotein (MOG) and GFAP antibodies is rarely reported.

Case:
A 45-year-old man presented with headache, fever, backache, dysuria, tremble of hands, numbness of lower limbs, without diplopia, decreased vision, or other manifestations of optic neuritis. He was initially diagnosed with viral meningitis. After antiviral therapy, his headache, fever, and dysuria were improved, but the tremble of his upper limbs and numbness of his lower limbs still existed. A lumbar puncture was further performed and found both anti-GFAP and anti-MOG antibodies in the cerebrospinal fluid. No evidence of other immune disorders or infectious diseases was revealed. Meanwhile, a magnetic resonance scan showed enhancement of spinal pia mater in cervical, thoracic, and lumbar segments. He was then treated with immunoglobulin (intravenous immunoglobulin) therapy (25 g for 5 d), and steroid pulse therapy (methylprednisolone, 1 g for 5 d), followed by a gradual tapering of oral prednisolone.

Conclusion:
We reported a case of overlapping anti-GFAP and anti-MOG antibody-associated syndrome. This case enriches our understanding of the clinical manifestations of overlapping syndrome and expands the spectrum of this disorder.
Venous thromboembolism in patients with liver cancer: a retrospective study
Authors: Yang Sheng-Li , Zhan Jing , Peng Miao , Hou Ling-Zhi , He Qiu-Yi , Jin Hao-Ran , Wei Bai , Hu Jian-Li 
Published: December 2023

Abstract

Background
Little is known about the association between venous thromboembolism (VTE) and tumors. In this study, we identified the clinical features of patients with liver cancer who presented with at least 1 VTE episode.

Methods
This was a retrospective case-control study of a single-institution database with univariate and multivariate analyses using χ
2 and Fisher exact tests. Statistical significance was set at P < 0.05.

Results
The overall incidence of VTE in the patients with liver cancer was 1.2%. More than half (53.8%) of the 13 patients with liver cancer and venous thrombosis died within 2 months. The thrombus in 12 patients (92.3%) was located within the deep veins, whereas the other patient (7.7%) was diagnosed with a pulmonary embolism. Of the 11 patients, 9 (69.2%) had swelling and/or pain symptoms. All 6 patients with peripherally inserted central catheters (PICCs) had thrombosis, accounting for 46.2% of all patients with liver cancer and venous thrombosis. Compared with the controls, liver cancer patients with PICC tubes, thrombosis-related symptoms such as swelling and pain, traumatic stimulation such as fracture, acute respiratory distress syndrome, and interventional therapy or hemostasis drugs were prone to be diagnosed with VTE (P < 0.05).

Conclusions
Liver cancer and thrombosis are rare and have poor prognoses. Liver cancer with thrombosis may be associated with PICC catheterization, traumatic stimulation, or hemostatic drugs. Patients with liver cancer and thrombosis often present with swelling and pain.
Analysis of EGFR Gene Mutations in Lung Adenocarcinoma in Karamay, Xinjiang
Authors: Ma Yuhua , Li Yuanxin , Jiang Min , Gao Jing , Lai Yining , Kulaixijiang Kamila , Zhu Min , Liang Fei 
Published: December 2023

Abstract

Objective
To investigate the mutation types and mutation rate of the epidermal growth factor receptor (EGFR) gene in patients with lung adenocarcinoma and the clinical features of lung adenocarcinoma with EGFR gene mutations in Karamay, Xinjiang, China.

Methods
Paraffin-embedded tissue samples of adenocarcinoma patients were collected in the Karamay Central Hospital from March 2016 to June 2019, and mutations in exon 18–21 of the EGFR gene were detected by the allele-specific amplification polymerase chain reaction (Amplification Refractory Mutation System–PCR) method. The relationships between the mutation types, mutation incidence, and clinical features were analyzed.

Results
Of the 170 patients with lung adenocarcinoma, 83 had EGFR mutations. The total mutation rate of EGFR in patients with lung adenocarcinoma was 48.8%, which included mutations in exons 18 (1.2% [2/170]), 19 (19.4% [33/170]), 20 (2.4% [4/170]), and 21 (20.6% [35/170]). Intriguingly, there was a case with 9 mutations in exons 20 and 21. The mutations in exon 19 of EGFR resulted in the deletion of codons 746 to 750. The main mutation in exon 21 was L858R (91.4% [32/35]). There was no significant difference in exons 19 and 21 mutation rates (P > 0.05). The mutation rate of EGFR in female patients was significantly higher than that in male patients (P < 0.05) but had no correlation with the age, smoking status, and clinical stage of patients with non–small cell lung cancer (P > 0.05). The EGFR mutation rate may be related to the degree of tumor differentiation.

Conclusion
Among patients with lung adenocarcinoma in Kelamayi (city in Xinjiang), EGFR mutations were more frequently detected in female patients, and the main sites of mutations were exons 19 and 21.
Nomogram for Predicting the Risk of Complications in Hospitalized Children With Peripheral Intravenous Catheters
Authors: Zhang Xin , Xu Shuhui , Sun Jing , Yang Ying , Piao Meihua , Lee Shih-Yu 
Published: December 2023

Objective
The aim of the study is to identify the hospitalized children at risk of peripheral intravenous catheter (PIVC) complications by severity prediction.

Methods
The study included the data of 301 hospitalized children with PIVC complications in 2 tertiary teaching hospitals. A researcher-designed tool was used to collect risk factors associated with PIVC complications. Predictors of PIVC complications at univariate analysis and multivariable logistic regression analysis by backward stepwise. A nomogram was constructed based on the results of the final multivariable model, making it possible to estimate the probability of developing complications.

Results
A total of 182 participants (60.5%) had a moderate injury from PIVC complications. Multivariable logistic regression analysis indicated that the vascular condition, limb immobilization, needle adjustment in venipuncture, infusion length, infusion speed, and insertion site were independent predictors. The nomogram for assessing the severity of PIVC complications indicated good predictive accuracy (area under the curve = 0.79) and good discrimination (concordance index = 0.779). Decision curve analysis demonstrated that the nomogram was a good clinical value with a wide range of threshold probabilities (4%–100%).

Conclusions
The risk prediction model has good predictive performance, and the nomogram provides an easy-to-use visualization to identify the severity of PIVC complications and guide timely nursing care management.
Vulnerability to Decubitus Ulcers and Their Association With Healthcare Utilization: Evidence From Nationwide Inpatient Sample Dataset From 2016 to 2020 in US Hospitals
Authors: Kim Sun Jung , Medina Mar , Hotz Kaci , Kim Juliy , Chang Jongwha 
Published: December 2023

Objective
The aim of the study is to identify vulnerable populations at risk of developing decubitus ulcers and their resultant increase in healthcare utilization to promote the use of early prevention methods.

Methods
The National Inpatient Sample of the United States was used to identify hospitalized patients across the country who had a length of stay of 5 or more days (N = 9,757,245, weighted N = 48,786,216) from 2016 to 2020. We examined the characteristics of the entire inpatient sample based on the presence of decubitus ulcers, temporal trends, risk of decubitus ulcer development, and its association with healthcare utilization, measured by discounted hospital charges and length of stay. The multivariate survey logistic regression model was used to identify predictors for decubitus ulcer occurrence, and the survey linear regression model was used to measure how decubitus ulcers are associated with healthcare utilization.

Results
Among 48,786,216 nationwide inpatients, 3.9% had decubitus ulcers. The percentage of inpatients with decubitus ulcers who subsequently experienced increased healthcare utilization rose with time. The survey logistic regression results indicate that patients who were Black, older, male, or those reliant on Medicare/Medicaid had a statistically significant increased risk of decubitus ulcers. The survey linear regression results demonstrate that inpatients with decubitus ulcers were associated with increased hospital charges and longer lengths of stay.

Conclusions
Patients with government insurance, those of minority races and ethnicities, and those treated in the Northeast and West may be more vulnerable to pressure ulcers and subsequent increased healthcare utilization. Implementation of early prevention methods in these populations is necessary to minimize the risk of developing decubitus ulcers, even if upfront costs may be increased. For example, larger hospitals were found to have a lower risk of decubitus ulcer development but an increased cost of preventative care. Hence, it is imperative to explore and use universal, targeted preventative methods to improve patient safety.
Urine tenofovir and dried blood spot tenofovir diphosphate concentrations and viraemia in people taking efavirenz and dolutegravir-based antiretroviral therapy
Authors: Dorward Jienchi , Govender Katya , Moodley Pravikrishnen , Lessells Richard , Samsunder Natasha , Sookrajh Yukteshwar , Fanshawe Thomas R. , Turner Philip J. , Butler Christopher C. , Drain Paul K. , Hayward Gail N. , Garrett Nigel 
Published: December 2023

Objective:
We aimed to determine whether urine tenofovir (TFV) and dried blood spot (DBS) tenofovir diphosphate (TFV-DP) concentrations are associated with concurrent HIV viraemia.

Design:
Cross-sectional study among people with HIV (PWH) receiving tenofovir disoproxil fumarate (TDF)-based antiretroviral therapy (ART).

Methods:
We used dual tandem liquid chromatography and mass spectrometry to measure urine TFV and DBS TFV-DP concentrations, and evaluated their associations with concurrent viraemia at least 1000 copies/ml using logistic regression models. In exploratory analyses, we used receiver operating curves (ROCs) to estimate optimal urine TFV and DBS TFV-DP thresholds to predict concurrent viraemia.

Results:
Among 124 participants, 68 (54.8%) were women, median age was 39 years [interquartile range (IQR) 34–45] and 74 (59.7%) were receiving efavirenz versus 50 (40.3%) receiving dolutegravir. Higher concentrations of urine TFV [1000 ng/ml increase, odds ratio (OR) 0.97 95% CI 0.94–0.99, P = 0.005] and DBS TFV-DP (100 fmol/punch increase, OR 0.76, 95% CI 0.67–0.86, P < 0.001) were associated with lower odds of viraemia. There was evidence that these associations were stronger among people receiving dolutegravir than among people receiving efavirenz (urine TFV, P = 0.072; DBS TFV-DP, P = 0.003). Nagelkerke pseudo-R
2 for the DBS TFV-DP models was higher for the urine TFV models, demonstrating a stronger relationship between DBS TFV-DP and viraemia. Among people receiving dolutegravir, a DBS TFV-DP concentration of 483 fmol/punch had 88% sensitivity and 85% specificity to predict concurrent viraemia ≥1000 copies/ml.

Conclusion:
Among PWH receiving TDF-based ART, urine TFV concentrations, and in particular DBS TFV-DP concentrations, were strongly associated with concurrent viraemia, especially among people receiving dolutegravir.
Incidence, description, predictors, and consequences of persistent taxane-induced peripheral neuropathy
Authors: Hertz Daniel L. 
Published: December 2023

Purpose of review
This review aims to provide insights into persistent taxane-induced peripheral neuropathy (TIPN). The primary objective is to describe the incidence, predictors, and consequences of TIPN lasting at least 1 year after the end of taxane treatment.

Recent findings
Studies show varying rates of TIPN persistence, with an estimated 30–40% and 40–60% resolving by 1- and 3-year post-treatment. TIPN in the feet and motor symptoms show less resolution post-treatment. Patients who are older or have higher body weight may experience less TIPN resolution, but results may be confounded by TIPN development during treatment. Persistent TIPN negatively impacts long-term functional ability, including gait, balance, and the ability to work. It also reduces overall quality of life (QOL), particularly affecting physical and social aspects.

Summary
Clinicians should be aware of the potential for persistent TIPN and its impact on patients’ function and QOL. Future research should focus on large prospective studies with systematic TIPN assessments during and after treatment to better understand which symptoms and patient characteristics predict resolution. This information can guide treatment decisions, balancing the need for effective chemotherapy with minimizing long-term impairments in function and QOL.
Proportion of Hospitalizations Preventable with Increased Oral SARS-CoV-2 Antiviral Treatment
Authors: Levy Matthew E. , Chilunda Vanessa , Heaton Phillip R. , Grzymski Joseph , Pawloski Pamala A. , Goldman Jason D. , Luo Shishi 
Published: December 2023

AbstractWe estimated the proportion of hospitalizations that could have been averted had all eligible high-risk adults with SARS-CoV-2 infection in a clinical cohort been treated with an oral SARS-CoV-2 antiviral agent early in infection. Among 3,037 patients with risk factors for progressing to severe COVID-19, 946 (31.1%) received an oral antiviral prescription (834 nirmatrelvir and 112 molnupiravir). Only 3.0% of treated patients vs 9.1% of untreated patients were hospitalized (adjusted risk ratio [RR]=0.27; 95% confidence interval [CI]: 0.18-0.41). If all patients had been treated, an estimated 63.3% (95% CI: 50.4-75.1) of hospitalizations within 30 days could have been prevented. This finding is attributed to large gaps in treatment and a strong protective association of antiviral treatment with subsequent hospitalization.
“Fire! Do Not Fire!”: A new paradigm testing how autonomous systems affect agency and moral decision-making
Authors: Salatino Adriana , Prével Arthur , Caspar Émilie , Bue Salvatore Lo 
Published: December 2023

AbstractAutonomous systems have pervaded many aspects of human activities. However, research suggest that the interaction with those machines may influence human decision-making processes. These effects raise ethical concerns in moral situations. We created an ad hoc setup to investigate the effects of system autonomy on moral decision-making and human agency in a trolley-like dilemma. In a battlefield simulation, participants had to decide whether to initiate an attack depending on conflicting moral values. Our results suggest that our paradigm is suitable for future research aimed at understanding the effects of system autonomy on moral decision -making and human agency.