bluuebunny/crossref_metadata_2025_split huggingface dataset:
WAXING AND WANING PATTERN OF CHOROIDAL DETACHMENT POSTSCLERAL BUCKLE
Authors: Banerjee Mousumi , Hage Angku , Azad Shorya Vardhan , Venkatesh Pradeep 
Published: August 2023

Purpose:
Description of evolving and resolving pattern of choroidal mounds at different quadrants postscleral buckle surgery in a myopic patient.

Methods:
A 48-year-old man with axial length of 32 mm underwent scleral buckling for subtotal fresh retinal detachment with 360° multiple lattices with superior horse shoe tear. A posterior buckle was placed superiorly traversing 180°, 14 mm beyond muscle insertion. Uneventful drainage of subretinal fluid was performed intraoperatively.

Results:
Postoperative day 1 depicted two choroidal detachment mounds in the ST quadrant with an adequate break buckle relationship. Postoperative day 2 depicted an additional choroidal detachment mound in the inferonasal with an additional mound superonasally on Day 4. Spontaneous resolution of the mounds was observed from Day 7 with complete resolution by 1 month.

Conclusion:
Fragility of the choroidal vasculature in axial myopia can aggravate venous congestion when associated with one or two vortex vein obstruction after scleral buckle. Choroidal vasculature remodeling occurs after vortex vein obstruction leading to formation of new venous drainage routes.
Subperiosteal and Orbital Abscesses: A Comparison of Clinical Features, Management, and Outcomes
Authors: Gibbons Alison B. , Niknahad Ava , Bacorn Colin , Halawa Omar , Li Emily 
Published: August 2023

Purpose:
To compare the clinical features, management, and outcomes between orbital cellulitis patients with subperiosteal abscess (SPA) and those with orbital abscess (OA).

Methods:
A retrospective study was conducted at a tertiary care center through medical record search to identify patients with orbital cellulitis from January 1, 2000 to December 31, 2022. Charts were screened for those with radiographic evidence of SPA or OA. Demographic data and presenting clinical features were compared between the 2 cohorts. Primary outcomes compared included rates of surgical intervention, reoperation, and readmission; and length of hospital stay and final vision.

Results:
A total of 189 patients, 162 with SPA and 27 with OA, met the criteria. The OA group (mean 46.5 ± 18.6 years) was older than the SPA group (mean 19.1 ± 21.4 years). Comorbid sinusitis was significantly more common in the SPA cohort (95.7% SPA; 70.4% OA; p < 0.001), while OA was more likely to occur with orbital trauma (29.6% vs. 8.0%; p = 0.003), implanted hardware (11.1% vs. 0.6%; p = 0.005), and comorbid diabetes (22.2% vs. 4.3%; p = 0.001). OA patients more often presented with a relative afferent pupillary defect (21.7% vs. 3.9%; p = 0.005), vision worse than 20 of 50 (42.3% vs. 16.2%; p = 0.005), and methicillin-resistant Staphylococcus aureus infection (20.8% vs. 5.8%; p = 0.036). OA was associated with a higher reoperation rate (47.8% vs. 21.3%; p = 0.019), readmission rate (18.5% vs. 5.6%, p = 0.047), and limited extraocular motility at follow-up (4.3% vs. 25%; p = 0.013); while mean length of hospital stay and final visual acuity were similar.

Conclusion:
OA may affect an older population with a divergent risk factor profile compared with SPA. OA may cause more severe functional impairment on presentation, warranting more aggressive management to achieve visual outcomes similar to SPA.
Perceptions of Patient-Reported Outcome Measures in Acute Care Pediatric Physical Therapy
Authors: Tischler Dana , Pitney William A. , Wood Janine , Shotwell Mary , Mooney Cade 
Published: August 2023

Purpose:
To explore the perceptions and experiences of acute care pediatric physical therapists (PTs) regarding the use of patient-reported outcome measures (PROMs) and to understand the influence of PROMs on clinical decision-making and the plan of care.

Methods:
Thirteen acute care pediatric PTs participated in individual semistructured interviews using a qualitative phenomenological approach. Interview questions focused on how PROMs influence clinical practice and decision-making. Interviews also explored scenarios where using PROMs positively or negatively impacted patient and caregiver interactions. Researchers analyzed the interview transcripts using an inductive process to generate codes and resultant themes.

Results:
Participants described their experiences using PROMs in pediatric acute care, and 4 themes emerged: (1) PROMs can be difficult to implement in pediatric acute care, (2) PROMs can benefit pediatric acute care practice, (3) PROMs can improve service delivery and family-centered care, and (4) ideal PROM use in future practice. The Theoretical Domains Framework (TDF) was used to categorize positive and negative factors related to implementing evidence-based guidelines in the pediatric acute care setting.

Conclusions:
Acute care pediatric PTs report benefits and barriers to using PROMs with children and caregivers in the hospital setting. Findings support the need for future knowledge translation initiatives to facilitate the use of PROMs in pediatric acute care.
Patient-Reported Outcome Measure Use by Acute Care Pediatric Physical Therapists
Authors: Tischler Dana , Wood Janine , Shotwell Mary , Pitney William A. , Mooney Cade 
Published: August 2023

Purpose:
To describe the current use of and perceived benefits and barriers to using patient-reported outcome measures (PROMs) by pediatric physical therapists (PTs) in the acute care setting and to explore demographic factors that may explain the use of PROMs.

Methods:
An electronic survey was distributed to PTs who work in a pediatric acute care setting. Descriptive statistics were used to assess the frequency of PROM use, identify differences in PROM use based on demographic factors, and evaluate the likelihood of various benefits and barriers. Open-ended survey responses were analyzed inductively to identify common themes.

Results:
The survey was completed by a convenience sample of 92 pediatric acute care PTs (30% response rate). Half of the respondents (n = 46; 50%) reported “rarely” or “never” using PROMs, while only 4.3% (n = 4) reported “always” using PROMs. No significant differences were found in the frequency of PROM between years of experience, entry-level degree, clinical specialization, or other demographic factors. Participants were “somewhat” or “extremely likely” to use the rate of perceived exertion (71%), the Ages and Stages Questionnaire (24%), and the Pediatric Quality of Life Inventory (17%). The primary facilitator was improving communication with patients (68%), while the main barrier was lack of availability (57%). Thematic analysis of open-ended responses indicated that the benefits of using PROMs include improving communication, providing objective data, and measuring progress. Barriers identified include inadequate resources, lack of time, and irrelevance to clinical practice.

Conclusion:
Many pediatric acute care PTs underutilize PROMs, with reported barriers of limited access and lack of time hindering implementation within the pediatric acute care setting. Survey respondents reported the desire to measure health-related quality of life and participation, which may be feasible through future quality improvement or knowledge translation initiatives.
The Active Leg Raise Test
Authors: Sutter Jonathan R. , Coyer Ben , McGarvey Jeremy , Georgieff Meghan , Pilon Joseph 
Published: August 2023

Background and Purpose:
There are important reasons to provide hospitalized patients with opportunities to move while hospitalized. Yet, it is apparent that, other than actually attempting the task of standing up, there is no predictive test available that would help a hospital professional decide whether the patient has adequate ability to safely attempt standing. The purpose of this research report is to describe a novel test that clinicians can use to help predict whether a patient is anticipated to be capable of standing up with little or no assistance.

Approach:
Hospitalized patients were requested to lift each lower extremity, one at a time, for 5 seconds, above a minimum height. To determine the predictive ability of the test to identify the ability to stand, results were compared against the “gold standard” of whether the patients were able to stand successfully as part of a physical therapy evaluation performed after the leg raise test.

Outcomes:
The sensitivity of the test was 0.91 (95% CI = 0.84-0.96) and the specificity was 0.71 (95% CI = 0.48-0.89). The positive predictive value was 0.94 (95% CI = 0.88-0.98) and the negative predictive value was 0.60 (95% CI = 0.39-0.79).

Discussion and Conclusion:
This test is simple, short, and well suited to the rapid pace of clinical decision-making that health care professionals face on a daily basis. This test is useful in helping acute care professionals answer a clinical question they encounter often, “Is it safe for this patient to try to stand up?”
Family Resilience as an Emerging Concept in Neonatology
Authors: Laporte Geneviève , Sergerie-Richard Sophie , Genest Christine , Aita Marilyn 
Published: August 2023

Background:
Family resilience can be observed through specific resilience-promoting processes, namely, shared belief systems, communication, and organizational processes, but the concept remains mostly unstudied in neonatology. This metasummary aims to evaluate the frequency of family resilience processes in qualitative scientific literature to illustrate how family resilience is exhibited in the neonatal intensive care unit (NICU) setting.

Methods:
A search among 4 databases yielded 7029 results, which were reviewed for inclusion. Following Sandelowski and Barroso's qualitative metasummary method, findings from each study were independently coded and frequency effect size was calculated.

Results:
Forty-six primary qualitative studies published between 2016 and 2022 conducted with parents of preterm infants who discussed their NICU hospitalization experience were included in this metasummary. All 9 of Walsh's family resilience processes were identified in the literature, and their frequency effect size ranged from 4% to 91%. Four additional themes emerged pertaining to specific family resilience behaviors exhibited by NICU families.

Conclusion:
This analysis sheds new light on the most recent qualitative evidence of parents' experiences in the NICU by analyzing it through the lens of family resilience and posits family resilience as a promising concept in relation to the predominance of the family-centered care philosophy in neonatal units.
Individuals Eligible for Lung Cancer Screening Less Likely to Receive Screening When Enrolled in Health Plans With Deductibles
Authors: Wain Kris , Carroll Nikki M. , Honda Stacey , Oshiro Caryn , Ritzwoller Debra P. 
Published: August 2023

Background:
In 2015, the Centers for Medicare & Medicaid Services and commercial insurance plans began covering lung cancer screening (LCS) without patient cost-sharing for all plans. We explore the impact of enrolling into a deductible plan on the utilization of LCS services despite having no out-of-pocket cost requirement.

Methods:
This retrospective study analyzed data from the Population-based Research to Optimize the Screening Process Lung Consortium. Our cohort included non-Medicare LCS-eligible individuals enrolled in managed care organizations between February 5, 2015, and February 28, 2019. We estimate a series of sequential logistic regression models examining utilization across the sequence of events required for baseline LCS. We report the marginal effects of enrollment into deductible plans compared with enrollment in no-deductible plans.

Results:
The total effect of deductible plan enrollment was a 1.8 percentage-point (PP) decrease in baseline LCS. Sequential logistic regression results that explore each transition separately indicate deductible plan enrollment was associated with a 4.3 PP decrease in receipt of clinician visit, a 1.7 PP decrease in receipt of LCS order, and a 7.0 PP decrease in receipt of baseline LCS. Reductions persisted across all observable races and ethnicities.

Conclusions:
These findings suggest individuals enrolled in deductible plans are more likely to forgo preventive LCS services despite requiring no out-of-pocket costs. This result may indicate that increased cost-sharing is associated with suboptimal choices to forgo recommended LCS. Alternatively, this effect may indicate individuals enrolling into deductible plans prefer less health care utilization. Patient outreach interventions at the health plan level may improve LCS.
Uptake of Biosimilar Among Privately Insured Patients Undergoing Infliximab Treatment
Authors: Chang Jessica , Karaca-Mandic Pinar , Jeffery Molly M. 
Published: August 2023

Background:
Recent literature has found rapid uptake of short-acting filgrastim biosimilars but slower uptake of other biosimilars, such as infliximab, in both Medicare and privately insured enrollees.

Objectives:
To describe patient, provider, and health plan characteristics associated with a switch to biosimilar among existing infliximab patients.

Research Design:
We constructed a retrospective panel dataset of patients undergoing active infliximab treatments and the choice of infliximab drug for each infusion. We used mixed logit regression controlling for patient, provider, and health plan characteristics as well as time-fixed effects.

Subjects:
Medicare Advantage and privately insured enrollees with evidence of active infliximab treatments between 2016 and 2020 (n=357,430).

Measures:
Our primary outcome of interest was to switch from infliximab originator to one of the infliximab biosimilars. Exposure variables of interest variables such as out-of-pocket, site of care, and in-network deductible.

Results:
Our study found nominally low switching among existing infliximab originator users (3.4%). We found that patients who previously received 1 infliximab originator infusion were 63.7% more likely to switch to biosimilar compared with patients who previously received administration of 20 infliximab originators. We found that biosimilar’s placement as health’s plan preferred drug was attributed to higher likelihood of biosimilar use (odds ratio: 1.666; P-value=0.001). We did not observe any statistically significant effect among out-of-pocket amount or deductible with respect to switch to infliximab biosimilar.

Conclusions:
To encourage uptake and switch to biosimilar, policymakers should consider targeted policies that include leveraging health plan tools such as placement of biosimilar as preferred drug and aim to educate patients on the clinical equivalence between infliximab biosimilar and originator.
Dual organ transplantation: when heart alone is not enough
Authors: Nuqali Abdulelah , Bellumkonda Lavanya 
Published: August 2023

Purpose of review
The number of dual organ transplantations (DOT) are steadily increasing over the past few years. This is both a reflection of increasing complexity and advanced disease process in the patients and greater transplant center experience with performing dual organ transplants. Due to lack of standardization of the process, there remains significant center-based variability in patient selection, perioperative and long-term management of these patients.

Recent findings
Overall posttransplant outcomes for DOT have been acceptable with some immunological advantages because of partial tolerance offered by the second organ. These achievements should, however, be balanced with the ethical implications of bypassing the patients who are listed for single organ transplantation because of the preferential allocation of organs for DOT.

Summary
The field of DOT is expanding rapidly, with good long-term outcomes. There is an urgent need for guidelines to standardize the process of patient selection and listing dual organ transplantation.
Role of complement in humoral immunity
Authors: Podestà Manuel Alfredo , Chun Nicholas 
Published: August 2023

Purpose of review
Antibody-mediated rejection (AMR) after solid organ transplantation remains an unsolved problem and leads to poor early and late patient outcomes. The complement system is a well recognized pathogenic mediator of AMR. Herein, we review the known molecular mechanisms of disease and results from ongoing clinical testing of complement inhibitors after solid organ transplant.

Recent findings
Activation and regulation of the complement cascade is critical not only for the terminal effector function of donor-specific antibodies, but also for the regulation of T and B cell subsets to generate the antidonor humoral response. Donor-specific antibodies (DSA) have heterogenous features, as are their interactions with the complement system. Clinical testing of complement inhibitors in transplant patients have shown good safety profiles but mixed efficacy to date.

Summary
The complement cascade is a critical mediator of AMR and clinical trials have shown early promising results. With the steady emergence of novel complement inhibitors and our greater understanding of the molecular mechanisms linking complement and AMR, there is greater optimism now for new prognostic and therapeutic tools to deploy in transplant patients with AMR.
Progressive multifocal leukoencephalopathy in the background of chlorambucil treated chronic lymphocytic leukemia: a case report from Nepal
Authors: Dhakal Bishal , Upadhaya Regmi Binit , Subedi Ram Chandra , Joshi Sushil , Pathak Bishnu Deep , Bogati Kanchan , Baniya Sunil , Neupane Peter , Paudel Raju 
Published: August 2023

Introduction:
Progressive multifocal leukoencephalopathy is a rare manifestation in itself. Although many immunosuppressive states are associated with the disease, its occurrence in the setting of chronic lymphocytic leukaemia treated with chemotherapy is seldom reported to date.

Case presentation:
A 67-year-old woman with known chronic lymphocytic leukaemia who was previously receiving chlorambucil treatment was identified as having progressive multifocal leukoencephalopathy; her prognosis is currently good.

Clinical discussion:
Although a rare disease in an immunocompromised setting, progressive multifocal leukoencephalopathy often leads to a grave outcome. However, the authors describe a case with a good prognosis to date.

Conclusion:
Progressive multifocal leukoencephalopathy should be in differentials in immunocompromised patients with dementia. Given that the later prognosis of the disease is unpredictable, an earlier diagnosis would be better for immunological reconstitution.
Weight Self-Efficacy and Recovery Among African-Americans With Serious Mental Illness and High Body Weight
Authors: Corrigan Patrick W. , Nieweglowski Katherine , Qin Sang , Sheehan Lindsay , Puhl Rebecca , Talluri Sai Snigdha 
Published: August 2023

Abstract
Many African-Americans with serious mental illness fail to engage in evidence-based programs that positively affect weight management. We examined how having a weight-related physical illness correlated with self-efficacy, recovery, and quality of life by contrasting illnesses with symptoms that are obviously perceived (e.g., sleep apnea and pain related to weight) versus those that are not (e.g., hypertension). African-Americans with serious mental illness who were overweight (body mass index ≥25) completed the Weight Efficacy Lifestyle Questionnaire, Recovery Assessment Scale, and Quality of Life Scale in this study assessing the impact of a program on weight and health. Silent weight-related physical disorders were not found to correlate with quality of life, recovery, or weight self-efficacy. Differences in recovery were found in people with versus without sleep apnea and weight-related pain. Findings suggest future directions for affirming approaches to promote engagement among African-Americans with serious mental illness in weight management programs.
Integration of Person-Centered Narratives Into the Electronic Health Record
Authors: Coats Heather , Shive Nadia , Adrian Bonnie , Doorenbos Ardith Z. , Schmiege Sarah J. 
Published: August 2023

Background
Care delivery that is not person-centered has been called discordant care. There has been a shift to incorporate more of a person’s narrative into their individual healthcare treatment plan to reduce discordant care. Aligning with this shift in healthcare delivery, we developed a person-centered narrative intervention (PCNI) to address existing gaps in delivery of person-centered care.

Objectives
This study aimed to evaluate the feasibility of conducting a randomized study and describe the outcomes of PCNI to usual care on the following person (patient)-reported outcomes: perceptions of the quality of communication with their nurses and their psychosocial and existential well-being.

Methods
This study’s design was an Obesity-Related Behavioral Intervention Trials model Phase II proof-of-concept randomized study. The participants were people admitted to an acute care hospital diagnosed with heart failure and/or end-stage renal disease.

Results
Despite COVID-19 challenges, the PCNI was feasible in an acute care setting; it showed a moderate positive difference between conditions in the person’s perception of their quality of communication and a small positive difference in their perception of feeling heard and understood. For our secondary outcomes of anxiety, depression, and psychosocial illness effect, there were small or no effects in the acute care setting.

Discussion
Using a person-centered narrative, such as the PCNI, can help inform delivery of care that incorporates a person’s (patient’s) beliefs, values, and preferences into their healthcare. This study used a pragmatic approach to evaluate the PCNI in real time in an acute care setting to assess patient-reported outcomes. These positive results in a small sample indicate the need for continued testing of the PCNI. These promising effects require further testing in a Phase III efficacy study within a larger randomized controlled clinical trial.
Adverse Childhood Experiences, Preventive Care Utilization, and Patient–Nurse Trust Relationship Among Sexual and Gender Minority Individuals
Authors: Zha Peijia , Qureshi Rubab , Porter Sallie , Zhang Crystal 
Published: August 2023

Background
Individuals who identify as sexual and gender minorities often experience high rates of adverse childhood experiences and encounter discrimination and stigma in their interactions with healthcare providers, leading to low utilization of healthcare services. However, the relationship between adverse childhood experiences, preventive care utilization, and trust in nurses among sexual and gender minority individuals remains unclear.

Purpose
This study explored the relationship between adverse childhood experiences and preventive care use and assessed the potential interaction effects of trust in nurses between adverse childhood experiences and preventive care use among individuals from sexual and gender minorities.

Methods
A cross-sectional design was used. A sample of 160 self-reported individuals from sexual and gender minorities completed an electronic online survey. Multiple linear regression and moderation analyses were conducted to examine the association between adverse childhood experiences, preventive care utilization, and nurse trust.

Results
There was a significant negative relationship between adverse childhood experiences and preventive care utilization. There was also a significant positive relationship between trust and preventive care utilization. The results also indicated that trust in nurses moderated the relationship between adverse childhood experiences and preventive care utilization among sexual and gender minority individuals.

Discussion
A significant relationship was found between a high prevalence of adverse childhood experiences and low healthcare service utilization. Strengthening the trust relationship between nurses and sexual and gender minority individuals could serve as a potential intervention point, leading to improved health outcomes for this vulnerable population. Hence, enhancing trust in nurses could be a key factor in increasing healthcare service utilization and overall health outcomes.