bluuebunny/crossref_metadata_2025_split huggingface dataset:
The limitation of accessing hospital services due to COVID-19 pandemic: a pilot study of the telephone triage to re-organize the access to a Center for Sexual Health in North-West Italy
Authors: Mastorino Luca , Delmonte Sergio , Ribero Simone , Quaglino Pietro , Testi Roberto ,   CeMuSS Nurse Staff Group, Dal Conte Ivano 
Published: February 2023

Abstract

Background
The COVID-19 pandemic-related health crisis has imposed measures aimed at reducing the overcrowding of health facilities, by developing telemedicine and by forcing many STI clinics to book appointments by telephone. In this work we evaluate the performance of the nursing telephone triage system, introduced in the major STI center in Northwest Italy, for the adequacy of clinical pathways for of symptomatic STI patients.

Methods
From January to March 2021, all symptomatic patients wishing to access the CeMuSS center first underwent nurse-led telephone triage. Symptoms suggestive of STIs were further classified into four syndromic presentations: cutaneous neoformations, genital and oral ulcers, ano-genital discharge, and finally other dermatological manifestations. All other clinical pictures were properly managed and eventually referred to other centres and not considered in the analysis. During the following medical examinations, the concordance between presumptive syndromic diagnosis and confirmed clinical diagnosis were recorded. Cohen's K-test was used to assess concordance.

Results
According to the Cohen’s K-test a good concordance between telephone presumptive diagnoses and medical clinical assessment was found (73.79% with a k = 0.611), whereas only an scarcely acceptable concordance between expected and real waiting time was established (75.51%, k = 0.34).

Conclusion
Concordance between nursing syndromic diagnosis and syndromic medically confirmed diagnosis is good from a clinical point of view but there is a limitation when considering a public health perspective. An optimal training of nurses may improve the method of telephone triage. For future ongoing emergencies, the implementation of telemedicine with accurate patient management systems is mandatory.
A Note on Pre-exposure prophylaxis (PrEP) preferences among women who inject drugs
Authors: Miley Kerry L. , Tran Nguyen K. , Elopre Latesha , Groves Allison , Stockman Jamila K. , Bazzi Angela R. , Carrico Adam , Mazzella Silvana , Roth Alexis M. 
Published: February 2023

ABSTRACT
We informed women who inject drugs about different pre-exposure prophylaxis (PrEP) formulations; they then ranked their preferences. Daily oral PrEP was most preferred, followed by injectable PrEP and vaginal rings/gels, especially among women of color. Multiple PrEP options should be discussed with women who inject drugs to increase uptake.
Assortative Sexual Mixing by Age, Region of Birth, and Time of Arrival in Male-Female Partnerships in Melbourne, Australia
Authors: Greaves Kate E. , Fairley Christopher K. , Engel Jaimie L. , Ong Jason J. , Aung Ei T. , Phillips Tiffany R. , Chow Eric P.F. 
Published: February 2023

Background
Patterns of sexual mixing may be influenced by demographic factors where individuals show a preference for partners with particular traits and may have different levels of risk for HIV and sexually transmitted infection transmission. We aimed to explore age differences and mixing by region of birth among male-female partnerships.

Methods
Male-female partnerships who presented to Melbourne Sexual Health Centre in Australia between 2015 and 2019 were investigated. Age and country of birth of sexual partners were collected. We calculated the age differences between partners and created tables demonstrating partnership mixing by age groups and by international region of birth.

Results
A total of 2112 male-female partnerships (i.e., 4224 individuals) were included. The median age was 27 years (interquartile range, 23–31 years). Between men and women in partnerships, the median age difference was 1 year. Nearly half of all individuals (49.1% [2072 of 4224]) were in a partnership with another individual in the same 5-year interval age group as their own, and a majority of individuals (58.5% [2334 of 3988]) were in a partnership with another individual from the same region of birth when compared with other regions.

Conclusions
There is a strong assortative sexual mixing pattern by age and region of birth among male-female partnerships in Melbourne, Australia. These results may have applications in further research to understand sexually transmitted infection transmission among clients attending sexual health centers, particularly those born overseas.
Topical Review: Optometry in Nepal—Clinical Practice, Research Advances, and Challenges
Authors: Khanal Safal , Paudel Nabin , Adhikary Rabindra , Joshi Mahesh Raj 
Published: February 2023

SIGNIFICANCE
This article reviews educational standard, clinical practice, research advances, and challenges associated with optometry in Nepal and provides critical considerations for contemporary and new optometry programs in countries with similar socioeconomic status and health care systems.
Optometry education started in Nepal in 1998 with the primary objective of addressing the unmet needs of eye health and vision care in the country. Over the last two decades, this program has made significant contributions to facilitating and improving the delivery of quality eye care and establishing the nation's eye health system as an exemplary model in South Asia. Despite the positive impact in a short time, optometry education and the profession continue to face several challenges, including a shortage of training resources and facilities, poor quality control and regulation of practice standards, lack of professional recognition, limited pathways for entry to governmental jobs via the national public service commission, and limited clinical and academic opportunities in existing eye care programs. This article reviews current education and clinical practice standards, highlights research advances, and discusses present and future challenges in sustaining and improving the quality of education and advancing the scope of practice of optometry in Nepal. Given the limited access to primary eye care services in Nepal, appropriate professional recognition and integration into the national health system, and initiatives targeted at improving the delivery of optometry education in alignment with successful international models may provide a long-sought solution to making eye care services accessible to all and lowering the burden of visual impairment in the country.
Anterior Corneal High-order Aberrations in Fuchs’ Endothelial Corneal Dystrophy Classified by Scheimpflug Tomography
Authors: Bolac Ruveyde , Yildiz Elvin , Balci Sevcan 
Published: February 2023

SIGNIFICANCE
Visual acuity may be limited after endothelial keratoplasty in Fuchs’ endothelial corneal dystrophy. This may be due to increased anterior high-order aberrations that persist after endothelial keratoplasty. It is not clear at what stage these aberrations begin. We aimed to evaluate how subclinical corneal edema affects anterior corneal high-order aberrations.

PURPOSE
We aimed to evaluate anterior corneal high-order aberrations according to the presence of subclinical corneal edema in Fuchs’ endothelial corneal dystrophy using Scheimpflug topography.

METHODS
All the patients underwent corneal topography (Sirius Scheimpflug-Placido disc camera; CSO Ophthalmic, Scandicci, Italy). Fifty-two eyes of 31 patients with Fuchs’ endothelial corneal dystrophy and 52 eyes of 35 patients without corneal problems were included. In addition, patients with Fuchs’ endothelial corneal dystrophy were divided into two groups according to subclinical corneal edema as with Fuchs’ endothelial corneal dystrophy-edema and Fuchs’ endothelial corneal dystrophy-nonedema. Subclinical corneal edema was defined based on the presence of at least two of three findings of the loss of regular isopachs, displacement of the thinnest point of the cornea, and posterior depression. High-order aberrations were expressed as Zernike polynomials in the 4- and 6-mm optical zone.

RESULTS
We found that subclinical corneal edema in Fuchs’ endothelial corneal dystrophy caused a larger 4-mm trefoil II and a smaller 6-mm spherical aberration II measurements than the nonedema group. The 6-mm total high-order aberrations, 6-mm coma aberration, and 4- and 6-mm trefoil II aberration measurements were larger, and the 6-mm spherical aberration II was smaller in Fuchs’ endothelial corneal dystrophy patients with edema compared with the healthy eyes.

CONCLUSIONS
The presence of subclinical corneal edema in Fuchs’ endothelial corneal dystrophy results in larger 4-mm trefoil II and smaller 6-mm spherical aberration II measurements. More patients with intermediate values are needed to evaluate the effect of these aberrations on visual acuity.
Measurement of Aniseikonia Tolerance in Binocular Fusion
Authors: Hoshikawa Rie , Handa Tomoya , Akaishizawa Chiho , Shoji Nobuyuki 
Published: February 2023

ABSTRACT

SIGNIFICANCE
The determination of aniseikonia tolerance may aid in developing optimal treatment plans for cataract surgery, refractive surgery, and refractive correction with glasses and contact lenses.

PURPOSE
This study aimed to measure aniseikonia tolerance.

METHODS
We included 33 patients (mean age ± standard deviation, 28.9 ± 6.4 years; male/female, 12:21) with anisometropia ≤1.0 D and best spectacle-corrected visual acuity of 20/20 or more in both eyes, with no ophthalmologic disease other than refractive errors and no history of ocular surgery. The exclusion criteria were anisometropia >1.0 D, axial length difference >0.5 mm, corneal refractive power difference >0.5 D, astigmatism >3.0 D, stereoacuity threshold >100 arcsec according to the Titmus Stereo Test, and >0% aniseikonia according to the New Aniseikonia Test. Aniseikonia tolerance was assessed using Eyemark Hello, a haploscope using gaze detection technology. Although the optotype of one eye was enlarged or reduced at a speed of 2%/s, the patients were instructed to press a button on the controller to indicate blurring, flickering, and diplopia. The value at which the patient responded was considered the aniseikonia tolerance value and assessed thrice per eye, five times if the values were highly variable, and then averaged.

RESULTS
The mean aniseikonia tolerance was approximately 3%; the median value was approximately 2% (range, 1.0 to 11.5%; dominant eye, 3.3 ± 2.6%; nondominant eye, 2.9 ± 1.8%). No significant difference in aniseikonia tolerance between the dominant and nondominant eyes was observed for the enlarged optotypes. No case showed changes in the ocular alignment before discomfort occurred. No significant correlation was observed between aniseikonia tolerance and anisometropia, axial length difference, corneal power difference, and ocular deviation.

CONCLUSIONS
Aniseikonia should be maintained at <2% for a comfortable visual environment. Aniseikonia tolerance may be an important indicator for cataract surgery, refractive surgery, and spectacle correction.
Determining the Association Between Emergency Department Crowding and Debriefing After Pediatric Trauma Resuscitations
Authors: Soriano Pamela , Kanis Jessica , Abulebda Kamal , Schwab Sandra , Coffee R. Lane , Wagers Brian 
Published: February 2023

Background
Debriefing in the pediatric emergency department (PED) is an invaluable tool to improve team well-being, communication, and performance. Despite evidence, surveys have reported heavy workload as a barrier to debriefing leading to missed opportunities for improvement in an already busy ED. The study aims to determine the association between the incidence of debriefing after pediatric trauma resuscitations and PED crowding.

Methods
A total of 491 Trauma One activations in Riley Children's Hospital Pediatric Emergency Department that presented between April 2018 to December 2019 were included in the study. Debriefing documentations, patient demographics, time and date of presentation, mechanism of injury, injury severity score, disposition from PED, and length of stay (LOS) were collected and analyzed. The National Emergency Department Overcrowding Scale score at arrival, Average LOS, total PED census, total PED waiting room census, and rates of left without being seen were compared between groups.

Results
Of 491 Trauma One activations presented to our PED, 50 (10%) trauma evaluations had documented debriefing. The National Emergency Department Overcrowding Scale score at presentation was significantly lower in those with debriefing versus without debriefing. In addition, the PED hourly census, waiting room census, average LOS, and left without being seen were also significantly lower in the group with debriefing. In addition, trauma cases with debriefing had a higher proportion of patients with profound injuries and discharges to the morgue.

Conclusions
Pediatric emergency department crowding is a significant barrier to debriefing after trauma resuscitations. However, profound injuries and traumatic pediatric deaths remain the strongest predictors in conducting debriefing regardless of PED crowding status.
Development and Evaluation of Syndromic Surveillance Definitions for Fall- and Hip Fracture–Related Emergency Department Visits Among Adults Aged 65 Years and Older, United States 2017-2018
Authors: Moreland Briana , Shakya Iju , Idaikkadar Nimi 
Published: February 2023

Objective:
To develop syndromic surveillance definitions for unintentional fall- and hip fracture–related emergency department (ED) visits among older adults (aged ≥65 years) for use in the Centers for Disease Control and Prevention's National Syndromic Surveillance Program (NSSP) data and compare the percentage of ED visits captured using these new syndromes with ED visits from the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample (HCUP-NEDS), a nationally representative administrative data set.

Design/Setting:
Syndromic definitions were developed using chief complaint terms and discharge diagnosis codes in NSSP data. The percentages of ED visits among older adults related to falls and hip fractures in NSSP were compared with the percentages in HCUP-NEDS in 2017 and 2018.

Measures:
Prevalence ratios were calculated as the relative difference in the percentage of ED visits related to falls or hip fractures in NSSP compared with HCUP-NEDS. Counts and percentages calculated using HCUP-NEDS were weighted to produce nationally representative estimates. Data were analyzed overall and by sex and age group.

Results:
The percentage of ED visits among older adults related to falls in NSSP was 12% less in 2017 (10.81%) and 7% less in 2018 (11.42%) compared with HCUP-NEDS (2017: 12.30%; 2018: 12.26%). The percentage of ED visits among older adults related to hip fractures in NSSP was 41% less in 2017 (0.65%) and 30% less in 2018 (0.76%) compared with HCUP-NEDS (2017: 1.10%; 2018: 1.09%). In both 2017 and 2018, a higher percentage of ED visits among older women and adults aged 85 years or older were related to falls or hip fractures compared with older men and younger age groups across both data sets.

Conclusion:
A smaller percentage of older adults' ED visits met the falls and hip fracture definitions in NSSP compared with HCUP-NEDS in 2017 and 2018. However, demographic trends remained similar across both data sets.
The Differential Impact of the COVID-19 Pandemic on Prenatal Care Utilization Among US Women by Medicaid Expansion and Race and Ethnicity
Authors: Lee Hyunjung , Singh Gopal K. 
Published: February 2023

Background:
The 2014 Medicaid expansion improved racial and ethnic equity in insurance coverage and access to maternal care among women of reproductive age. This study examines differential effects of the COVID-19 pandemic on prenatal care utilization by Medicaid expansion and by race and ethnicity.

Methods:
Using the pooled 2019-2020 National Natality file (N = 7 361 190), logistic regression was used to estimate the effect of COVID-19 on prenatal care utilization among US women aged 10 to 54 years after controlling for maternal age, race, ethnicity, marital status, parity, nativity/immigrant status, education, payment type, and smoking during pregnancy. Outcome measures were having no care and delayed prenatal care (third trimester or no care). Stratified models by race/ethnicity and Medicaid expansion status yielded the differential effects of COVID-19 on prenatal care utilization.

Results:
During the COVID-19 pandemic, the adjusted odds of having no prenatal care decreased by 4% (adjusted odds ratio [AOR] = 0.96; 95% confidence interval [CI], 0.94-0.97) in expansion states but increased by 13% (AOR = 1.13; 95% CI, 1.11-1.15) in nonexpansion states. While most racial and ethnic groups in expansion states experienced a decrease in having no prenatal care, the adjusted odds of having no prenatal care increased by 15% for non-Hispanic Whites, 9% for non-Hispanic Blacks, 33% for American Indians/Alaska Natives, 25% for Asian/Pacific Islanders, and 13% for Hispanics in nonexpansion states. Women in expansion states experienced no change in delayed prenatal care during the pandemic, but women in nonexpansion states experienced an increase in delayed care.

Conclusions:
Prenatal care utilization decreased during the pandemic among women in nonexpansion states, particularly for American Indians/Alaska Natives and Asian/Pacific Islanders, compared with expansion states.
Comparison of different rehabilitation techniques of traditional Chinese and western medicine in the treatment of motor dysfunction after stroke based on frequency method: A network meta-analysis
Authors: Li Ruo Yang , Chen Ke-Yu , Wang Xiao-Rong , Yu Qian , Xu Li 
Published: February 2023

Abstract

Objective
To evaluate the effect of different traditional Chinese and western medicine rehabilitation techniques on motor dysfunction after stroke using a network meta-analysis

Methods
CNKI, Wanfang, PubMed, EMBASE, and Cochrane databases were searched from inception to September 2022. We independently searched and screened randomized controlled trials (RCTs) of rehabilitation techniques for post-stroke motor dysfunction treatment, evaluated the quality, and analyzed the data using Stata 14.0.

Results
Seventy-four RCTs involving nine rehabilitation techniques and 5128 patients were included. The results of network meta-analysis showed the following orders regarding improvement of the total scores of Fugl Meyer assessment (FMA), action research arm test, and Berg Balance Scale: biofeedback therapy (BT) > mirror therapy (MT) > repetitive transcranial magnetic stimulation (rTMS) > acupuncture therapy (AT) > transcranial direct current stimulation (tDCS) > Taichi > common therapy (CT), virtual reality (VR) > tDCS > rTMS > MT > CT, and AT > VR > neuromuscular electrical stimulation (NMES) > MT > CT > tDCS, respectively.

Conclusion
BT had the best comprehensive effect, while VR was the best intervention for improving the index of action research arm test and FMA-lower extremity. AT improved lower limb balance function.
Abdominal Wall Reconstruction with Retrorectus Self-Adhering Mesh: A Single-Center Long-Term Follow-up
Authors: Bashian Elizabeth , Daoud Georges , Khansa Ibrahim , Janis Jeffrey E. 
Published: February 2023

Introduction:
Mesh repair has been demonstrated to be superior to suture alone in ventral hernia repair. In a previous short-term pilot study, we found lower postoperative narcotic requirements with self-adhering mesh. The aim of this study is to follow-up on that pilot study, using long term data.

Methods:
This is a retrospective review of a prospectively collected database. All patients who underwent ventral hernia repair with retrorectus mesh and who had at least 12-months follow-up were reviewed. Comparisons were performed between patients who received self-adhering mesh and those who received transfascially-sutured mesh, using matched-pair analysis, examining perioperative outcomes, surgical-site occurrences (SSOs), and hernia recurrence/bulge.

Results:
Forty-two patients were included in the study, with 21 patients undergoing repair with transfacially sutured mesh and 21 patients receiving self-adhering mesh. Average length of follow-up was 1,078 days. There were no significant differences between the two groups in baseline characteristics. Patients receiving self-adhering mesh had significantly shorter surgery, and a shorter hospital length-of-stay. They also had a tendency towards lower narcotic requirements. There were no significant differences in the rate of SSOs, hernia recurrences, or bulge between the two groups.

Discussion:
This long-term study shows that self-adhering mesh in ventral hernia repair results in similar long-term outcomes to transfascially-sutured mesh, with shorter surgery, shorter length-of-stay and a tendency towards improved pain control. These findings mirror the known advantages of self-adhering mesh in inguinal hernia repair. Further research is needed to study the incidence of chronic pain and the cost-effectiveness of self-adhering mesh.
Evidence-Based Patient Selection in Headache Surgery: The Impact of Preoperative RFA Treatment on Surgical Outcomes
Authors: Casari Maria E. , Chartier Christian , Gfrerer Lisa , Austen William G. 
Published: February 2023

Background:
Radiofrequency ablation (RFA) of the greater occipital nerve (GON) is a minimally- invasive treatment option commonly used in patients with occipital neuralgia. Patients who undergo occipital surgery for headaches after failed RFA treatment present a unique opportunity to evaluate RFA- treated occipital nerves and determine the impact on headache surgery outcomes.

Methods:
Of 115 patients who underwent headache surgery at the occipital site, twenty- nine had a history of prior RFA treatment. Migraine Headache Index, Pain Self- Efficacy Questionnaire, and Pain Health Questionnaire- 2 outcome scores were recorded preoperatively and at follow- up visits. Intraoperative macroscopic nerve damage and surgical outcomes were compared between RFA and non- RFA patients.

Results:
RFA- treated patients had a higher rate of macroscopic nerve damage (45%) than non RFA- treated patients (24%) (p= 0.03), and were significantly more likely to require a second surgery at the site of primary decompression (27.6% versus 5.8%; p= 0.001), as well as GON transection (13.8% versus 3.5%; p= 0.04). Outcome scores at the last follow up visit showed no statistically significant difference between RFA- treated and non RFA- treated patients (p= 0.96).

Conclusion:
RFA patients can ultimately achieve outcomes that are not significantly different from non- RFA patients in occipital headache surgery. However, a higher number of secondary surgery at the site of primary decompression and nerve transections are required to treat refractory symptoms. RFA- treated patients should be counselled about an increased risk of same-site surgery and possible GON transection to achieve acceptable outcomes.