bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case of Bilateral Keratitis and Bilateral Anterior Uveitis Induced by Pembrolizumab
Authors: Fukuoka Hideki , Yoshioka Maya , Kobayashi Hitomi , Okumura Takahiro , Sotozono Chie 
Published: March 2023

Purpose:
The purpose of this study was to report a case of bilateral keratitis and bilateral anterior uveitis that occurred at different time points after initiating pembrolizumab therapy.

Case report:
A 70-year-old man was referred to our hospital due to blurred vision and conjunctival injection in his right eye. Initial examination revealed conjunctivalization of the cornea with a corneal ulcer, inflammatory cells in the anterior chamber, and bilateral epiretinal membrane. Because the right-eye symptoms included blurred vision and redness immediately postpembrolizumab administration, a diagnosis of ophthalmic immune-related adverse event (irAE) was made. He was treated with antibiotic and betamethasone eye drops in his right eye. Because skin rashes appeared on his face and upper and lower extremities simultaneous with the ocular symptoms, a diagnosis of a grade 2 dermatological irAE was made based on dermatological findings, and pembrolizumab was discontinued. At 3 weeks postpembrolizumab discontinuation, conjunctival injection with inflammatory cells occurred in his left eye, so a treatment with additional antibiotic and betamethasone eye drops was initiated. At 1 month postpembrolizumab discontinuation, the dermatological irAE (skin rashes) disappeared, with no recurrence of ocular and dermatological irAE for more than 2 years post-treatment.

Conclusions:
Because anterior uveitis is a widely known adverse event of the checkpoint inhibitor pembrolizumab, ophthalmologists need to be aware whether their patients are on the medication and conduct timely follow-up examinations in cases in which new eye symptoms occur.
Characterization of Infectious Keratitis in Opioid Users in a County Hospital Setting
Authors: Lopez Jacqueline B. , Chan Lawrence , Saifee Murtaza , Seitzman Gerami D. , Yung Madeline , Chan Matilda F. 
Published: March 2023

Purpose:
The aim of this study was to determine risk factors and clinical course of corneal ulcers in the setting of opioid use.

Methods:
A retrospective cohort study was performed of patients presenting with bacterial or fungal keratitis at a county hospital from 2010 to 2021. Subjects were separated into 3 groups: opioid drug users (heroin, methadone, and fentanyl), nonopioid drug users, and nondrug users. Twenty-four opioid users, 77 nonopioid drug users, and 38 nondrug users were included in the study. Chi-square and t-tests were used to compare hospitalization for corneal ulcer treatment, length of hospitalization, loss to follow-up, final best-corrected visual acuity (BCVA), medication noncompliance, time to ulcer resolution, and visual disability (defined by either the legal limit for driving in California or the federal limit for blindness).

Results:
Opioid users had higher rates of unemployment (P = 0.002), homelessness (P = 0.018), and psychiatric conditions (P = 0.024) compared with nonopioid and nondrug users. They had more severe presentations, with worse initial BCVA of the affected eye (P = 0.003), larger ulcer size (P = 0.023), and higher rates of individuals below the legal vision thresholds for driving (P = 0.009) and blindness (P = 0.033) at initial presentation. Opioid use was associated with increased rates of hospitalization (P < 0.001), higher fortified antibiotic use (P = 0.009), worse final BCVA of the affected eye (P = 0.020), and increased rates of BCVA worse than the legal vision thresholds for driving (P = 0.043) and blindness (P < 0.001) on final presentation.

Conclusions:
Infectious keratitis associated with opioid use is associated with more severe presentations and poorer outcomes, including higher rates of visual disability.
The CARE Health Advocacy Intervention Improves Trauma-Informed Practices at Domestic Violence Service Organizations to Address Brain Injury, Mental Health, and Substance Use
Authors: Nemeth Julianna , Ramirez Rachel , Debowski Christina , Kulow Emily , Hinton Alice , Wermert Amy , Mengo Cecilia , Malecki Alexis , Glasser Allison , Montgomery Luke , Alexander Cathy 
Published: March 2023

Objective:
The aim of this study was to evaluate the impact that domestic violence (DV) service organizations' (SO) agency-wide adoption of CARE had on improving DVSO trauma-informed care (TIC) practices, overall, and in relation to addressing brain injury and mental health. CARE is an advocacy intervention designed to raise DVSOs' capacity to CONNECT with survivors; ACKNOWLEDGE that head trauma, strangulation, and mental health challenges are common; RESPOND by accommodating needs in services and providing targeted referrals; and EVALUATE effectiveness of response to meet survivors' stated concerns. We hypothesized that TIC would significantly improve among DVSO staff with the agency's use of CARE.

Setting/Participants/Design:
Pre- (n = 53) and 1-year post-CARE (n = 60) implementation online surveys were completed by staff at 5 DVSOs in Ohio from 2017 to 2019.

Main Measures:
Trauma-Informed Practice Scales (TIPS) were used to assess agency support and overall staff impression of implementing TIC; scales were modified to assess the use of TIC-practices related to head trauma, strangulation, mental health, suicide, and substance use. Attitudes Regarding Trauma-Informed Care (ARTIC-45) subscales assessed DVSO staff's endorsement of personal and organizational support in implementing TIC practices. Response options on the Survivor Defined Practice Scale (SDPS) were modified to gain staff insight into DVSO's ability to facilitate survivor empowerment. Differences in endorsement of TIC practices between pre- and post-CARE implementation were evaluated using regression models.

Results:
DVSO agency environment (P < .01) and overall staff impression (P < .001) regarding implementing TIC practices, and in respect to head trauma (P < .01), strangulation (P < .01), mental health (P < .01), suicide (P = .04), and substance use (P < .01), significantly improved with the agency's use of CARE. CARE increased DVSO staff's belief in personal and organizational support to implement TIC (P < .01 and P = .02, respectively) and in their agency's ability to foster survivor empowerment (P < .01).

Conclusion:
CARE improved TIC practices of DVSOs, overall, and to address brain injury and mental health.
The Impact of Blast Exposure—With or Without Traumatic Brain Injury—on Metabolic Abnormalities in Post-9/11 Veterans
Authors: Lendvai Dora , Whittemore Robin , Womack Julie A. , Fortier Catherine B. , Milberg William P. , Fonda Jennifer R. 
Published: March 2023

Objective:
The primary aim included explorations of: (1) the associations between the history of blast exposure (BE), close blast exposure (CBE), and blast-related traumatic brain injury (bTBI) and metabolic abnormality; and (2) the potential mediating effect of comorbid psychological and somatic conditions on these associations. The secondary aim explored the association of dose-response impact of BE, CBE, and bTBI and metabolic abnormality.

Setting:
Data were collected by the Translational Research Center for TBI and Stress Disorders (TRACTS).

Participants:
Post-9/11 veterans from the TRACTS baseline sample who had conflict-zone deployment experience (N = 734).

Design:
Cross-sectional secondary data analysis. We computed relative risks (RRs) and 95% CI using modified Poisson regression. We quantified the impact of co-occurring psychological and somatic conditions on this association using mediation analyses.

Main Measures:
Exposures included BE (<100 m), CBE (<10 m), and bTBI. Metabolic abnormality outcomes included (1) overweight/obesity (defined by abnormal waist-hip ratio [WHR] and abnormal waist circumference [WC]); (2) glucose dysregulation; and (3) meeting criteria for cardiometabolic syndrome (defined by guidelines).

Results:
The sample was majority male (91%) and White (68%), with a mean age of 34.6 years (SD = 8.99). Most participants had 1 or more BE (83%); 48% experienced 1 or more CBE. Overweight/obesity was highly prevalent in the sample (51% had abnormal WHR and 60% abnormal WC). There was no significant direct or indirect association between BE, CBE, and bTBI and metabolic abnormalities (RRs: 0.70-1.51; P's > .05).

Conclusion:
Future research is needed to investigate the association of BE with metabolic abnormalities with larger, more targeted sample selection, and longer follow-up. Effective and sustainable weight management and metabolic health prevention interventions for this veteran cohort are needed.
The Combination Therapy of Glucocorticoids, Tacrolimus, and Mycophenolate Mofetil in Primary Membranous Nephropathy Coexisting with Type 2 Diabetes Mellitus: A Retrospective Study
Authors: Wang Yinhong , Cui Chenkai , Tian Xuefei , Wang Li , Ma Xiaotao , Ge Heng , Zhang Lin , Xue Xiaodong , Chen Zhihao , Huo Yujia , Wang Hao , Fu Rongguo , Jia Lining 
Published: March 2023

ABSTRACTBackground:Primary membranous nephropathy (pMN) is treated with glucocorticoids or immunosuppressive agents, depending on the disease severity. However, treating pMN with type 2 diabetes mellitus (T2DM) remains challenging.Methods:We retrospectively collected and analyzed the data of patients diagnosed with pMN and T2DM. The low-dose multitarget regimen consists of prednisone (10 mg/d), tacrolimus (0.05 mg/kg/d, blood concentration 5–10 ng/mL), and mycophenolate mofetil (1 g/d); The cyclophosphamide (CTX) regimen consists of prednisone (initial dose 1 mg/kg/d) and CTX (0.8–1.0 g/month, cumulative dose 6–9 g).Results:Sixty-seven patients were diagnosed with pMN and T2DM, and 28 were enrolled in this study, with 14 cases each in the low-dose multitarget and CTX groups. Urinary protein excretion decreased significantly in both groups after treatment, which was significantly greater in the low-dose multitarget group than that in the CTX group (2 months: −4800.48 ± 3002.65 mg/24h versus −1663.32 ± 4113.98 mg/24h,P−BH= 0.045; 12 months: −7289.25 ± 2520.92 mg/24h versus −4512.79 ± 3448.85 mg/24h,P−BH= 0.044). Serum albumin levels increased more in the low-dose multitarget group than in the CTX group, although the difference was not significant. Patients treated with glucocorticoids plus CTX had worse glycemic control in two months.Conclusion:The combination of glucocorticoids, tacrolimus, and mycophenolate mofetil was effective for treating pMN with T2DM and not inferior to the CTX regimen in proteinuria reduction. Further studies are needed to confirm the regimen's influence on blood glucose and long-term efficacy.
Race-Modified Equations Estimating Renal Function and the Disparity in Partial Nephrectomy Use in Black Patients
Authors: Abdallah Nour , Benidir Tarik , Hofmann Martin , Haile Eiftu , Palacios Diego Aguilar , Corrigan Dillon , Krishnamurthi Venkatesh , Haywood Samuel , Eltemamy Mohamed , Kaouk Jihad , Abouassaly Robert , Gadegbeku Crystal , Campbell Steven C. , Weight Christopher J. 
Published: March 2023

Purpose:
Black patients with renal tumors are less likely to undergo partial nephrectomy (PN) despite a higher risk of chronic kidney disease (CKD). Racialized equations estimating glomerular filtration rate (eGFR) estimate a 15% to 20% higher renal function for Black patients as opposed to non-Black patients. Whether raced-modified eGFR equations affect the use of nephron-sparing surgery in Black patients has not yet been explored.

Materials and Methods:
This is a single-center, retrospective review of 6327 consecutive patients who underwent PN (n = 3533) or radical nephrectomy (RN) (n = 2794) from 2005 to 2020. Patients were asked to self-report their race preoperatively. We excluded patients with a tumor thrombus (n = 149). Data were dichotomized into Black patients (n = 654) and non-Black patients (n = 5673). Multivariable logistic regression analysis controlled for known factors associated with PN. The impact of the race-modified (2009CKD-EPI) and race-free (2021CKD-EPI-refit) equations on the distribution of patients across CKD stages was analyzed.

Results:
Among 6327 patients, 10.3% were Black patients. Black patients had higher comorbidity rates and lower preoperative eGFR than non-Black patients (P < .001). Black patients had lower overall PN rates than non-Black patients (49% vs 57%; P < .001), a finding that was most pronounced in the CKD stage 1 group (55.84% vs 67.43%; P = .0011). On multivariable logistic regression analysis, the Black race was associated with lower odds of PN (OR = 0.76 (0.61-0.96), P = .001). CKD-EPI-refit moved 27% of Black patients to a lower and more accurate CKD stage.

Conclusions:
Using a conventional race-modified equation potentially overestimated the renal function of 27% of Black patients who were restaged into worse CKD stages when using the race-free equation. While the surgical approach is multifactorial, race-modified equations may overestimate renal function in a significant portion of Black patients and explain some, but not all, of the observed lower utilization of nephron-sparing surgical approaches in Black patients.
Can high-sensitive troponin levels within the normal range predict positivity in treadmill test?
Authors: Yilmaz Mustafa , Atici Adem , Sonsöz Mehmet Rasih , Çevik Erdem , Orta Hüseyin , Demirtakan Zeynep Gizem , Barman Hasan Ali , Bulat Zubeyir , Karaayvaz Ekrem Bilal , Mercanoğlu Fehmi , Zorkun Cafer 
Published: March 2023

Background
This study aimed to determine whether a high level of high-sensitivity troponin T (hsTnT) predicts a positive treadmill test in patients with suspected stable ischemic heart disease (SIHD).

Methods
In all, 366 patients with suspected SIHD were included in the study. We measured the serum hsTnT levels before the treadmill test. The treadmill test was performed according to the Bruce protocol.

Results
Of the 366 patients, 97 had positive treadmill tests. The hsTnT levels were significantly higher in the positive group than in the negative group. In the binary logistic regression analysis, hsTnT, pretest probability, metabolic equivalents (METs), target heart rate (THR) percentage, and Duke treadmill score (DTS) were independent predictors of a positive treadmill test [hsTnT odds ratio (OR): 2.178, P < 0.001; pretest probability OR: 1.036, P = 0.007; METs OR: 0.755, P = 0.008; THR OR: 0.773, P < 0.001; DTS OR: 2.661, P = 0.012]. In the receiver operating characteristic (ROC) curve analysis, the area under the curve (AUC) value of the model with the combined parameters of hsTnT, pretest probability, METs, THR, and DTS was statistically significant in predicting a positive treadmill test [combined model AUC: 0.945 (0.922–0.968), P < 0.001].

Conclusions
In sum, high pretest hsTnT levels predicted a positive treadmill test in patients with suspected SIHD. Analysis of the hsTnT levels before the treadmill test can increase the sensitivity and specificity of the treadmill test. The methods for measuring hsTnT levels are cheap and easily accessible and can be used before the treadmill test in patients with suspected SIHD.
Drug-coated balloons for the treatment of stent edge restenosis
Authors: Nagasaka Takashi , Amanai Shiro , Ishibashi Yohei , Aihara Kazufumi , Ohyama Yoshiaki , Takama Noriaki , Koitabashi Norimichi , Ishii Hideki 
Published: March 2023

Background
Drug-coated balloon (DCB) is a device for treating patients with in-stent restenosis; however, there are scant data on its efficacy for stent edge restenosis (SER). This study aimed to investigate the clinical outcomes of DCB use for treating SER compared with new-generation drug-eluting stent (DES) implantation.

Method
From December 2013 to January 2019, patients who underwent DES implantation or DCB for SER were enrolled. Clinical outcomes were analyzed, and propensity score with matching was conducted. The primary outcome was target-vessel revascularization (TVR). The secondary outcomes were the incidence of all-cause mortality, major adverse cardiovascular events (MACE), and target lesion revascularization (TLR).

Result
A total of 291 patients with SER were included: 160 were treated with DCB, and 131 with new-generation DES. DCB treatment for SER treatment was associated with a lower risk of TVR than DES [hazard ratio, 0.549; 95% confidence interval (CI), 0.339–0.891] at a median follow-up of 1080 days (interquartile range; 729–1080 days). Propensity score matching (PSM) was performed to adjust for baseline clinical and lesion characteristics. After PSM, no significant difference in the risk of TVR was observed (hazard ratio, 0.965; 95% CI, 0.523–1.781). Similarly, the risk for all-cause death (hazard ratio, 0.507; 95% CI, 0.093–2.770), MACE (hazard ratio: 0.812; 95% CI, 0.451–1.462), and TLR (hazard ratio: 0.962; 95% CI, 0.505–1.833) were comparable between the two groups.

Conclusion
DCB treatment efficacy for SER was similar to that of new-generation DES after PSM. DCB is a significant alternative to obtain comparable results with new-generation DES for the treatment of SER.
The State of Health and Intentions for Action to Advance Mental Health and Well-being for the Nursing Workforce
Authors: Heath Janie , Wiggins Amanda T. , Meador Donna , Kennison Monica , Woodall Marsha , Pendleton Michelle , MacCallum Tricia , Butler Karen M. 
Published: March 2023

OBJECTIVE
The aims of this study were to explore the health of nurse leaders and assess intentions to integrate workplace mental health/wellness practices.

BACKGROUND
National efforts address high rates of poor mental health and lifestyle behaviors among nurses. Few studies describe the extent to which nurse leaders in academic and clinical environments can influence a strategic mission for health/well-being among the nursing workforce.

METHODS
Two hundred seventeen email invitations were distributed to nurse leaders from 5 Kentucky nursing organizations to complete a 1-time 46-item online survey assessing individual health behaviors and intentions to build a culture of workplace health/well-being.

RESULTS
Most respondents reported positive physical health (86%), positive mental health/intentions for action to change behaviors (80%), improved self-care practices (86%), integration of self-care practices in the workplace (79%), and commitment to integrate suicide prevention training (55%).

CONCLUSIONS
Overall, nurse leaders reported positive healthy behaviors. The finding that the highest intentions were reported to integrate, sustain, and/or advance lifestyle behaviors for self-care practices as well as to integrate practices for mental health and well-being in the work environment is encouraging. Enhanced strategies and efforts are needed to prioritize workplace cultures of wellness to benefit nurses and further promote well-being among nurse leaders.
An Evaluation of a Narrative Expressive Writing Program for Nurses During the COVID-19 Pandemic
Authors: Cochran Kathryn L. , Mealer Meredith 
Published: March 2023

OBJECTIVE
This study aimed to evaluate a writing program targeted to reduce stress and improve resilience in nurses during the coronavirus pandemic (COVID-19).

BACKGROUND
Occupational hazards often result in poor mental health outcomes. The pandemic highlighted this problem. Because nurses face barriers to accessing support, brief interventions are needed to process stressful events.

METHODS
Over 5 weeks, nurses across the United States detailed their COVID-19 experiences through narrative expressive writing. Trained mental health professionals provided confidential feedback.

RESULTS
One thousand one hundred three nurses enrolled in the program, with 430 continuing to the 1st session. Approximately 36% who began the program completed all 5 sessions. Feedback suggested high satisfaction with their experience in the program, but no significant changes in perceived levels of stress or resilience were observed.

CONCLUSION
Narrative expressive writing is an accessible intervention with the potential to decrease stress. This program is a flexible, personalized model that managers can offer to staff to promote healthy coping strategies.
Evaluation of a Pilot Protocol for Detecting Infant Hyperopia
Authors: Morrison Ann M. , Mutti Donald O. 
Published: March 2023

SIGNIFICANCE
Highly hyperopic children are at greater risk for developing conditions such as strabismus, amblyopia, and early literacy and reading problems. High hyperopia is a common finding in infants in a pediatric medical practice, and early detection can be done effectively in that setting with tropicamide autorefraction.

PURPOSE
This study aimed to evaluate the effectiveness of a pilot screening program to detect high hyperopia in 2-month-old infants in a pediatric medical practice in Columbus, Ohio.

METHODS
Cycloplegic refractive error (1% tropicamide) was measured by retinoscopy and autorefraction with the Welch Allyn SureSight (Welch Allyn/Hillrom, Skaneateles Falls, NY) in 473 infants (55.4% female) who were undergoing their 2-month well-baby visit at their pediatrician's medical practice. Cycloplegic retinoscopy (1% cyclopentolate) was repeated at a subsequent visit in 35 infants with ≥+5.00 D hyperopia in the most hyperopic meridian during the screening.

RESULTS
Twenty-eight infants (5.9%) had high hyperopia (spherical equivalent, ≥+5.00 D), and 61 (12.9%) had high hyperopia (≥+5.00 D in at least one meridian of at least one eye) by retinoscopy with 1% tropicamide. The mean ± standard deviation spherical equivalent tropicamide cycloplegic refractive error measured with retinoscopy was +2.54 ± 1.54 D (range, −3.25 to +7.00 D) and with SureSight was +2.29 ± 1.64 D (range, −2.90 to +7.53 D). Retinoscopy done using 1% cyclopentolate was 0.44 ± 0.54 D more hyperopic in spherical equivalent than with 1% tropicamide (P < .001).

CONCLUSIONS
High hyperopia was a common finding in 2-month-old infants in a pediatric medical setting that could be detected effectively by cycloplegic autorefraction using tropicamide. Greater cooperation between pediatric primary vision and medical care could lead to effective vision screenings designed to detect high hyperopia in infants.
Case Report: Asymmetric Changes of Ophthalmic Findings in Bilateral Solar Eclipse Maculopathy
Authors: Hou Xinzhu , Zhang Xin , Zhang Zhiyong 
Published: March 2023

SIGNIFICANCE
A more profound understanding of the relationship between ophthalmic findings and eye dominance is needed to guide the timely and proper treatment of binocular photic maculopathy or other macular degeneration.

PURPOSE
A patient with binocular solar maculopathy presented with asymmetric ophthalmic manifestations and changes during 14 months of observation. Early recognition of solar maculopathy can be vital for early diagnosis and better prognosis.

CASE REPORT
A 21-year-old man was reported to have blurred vision after staring directly at an annular solar eclipse several times for a few seconds on June 21, 2020. His Snellen best-corrected visual acuity declined to 20/50 in both eyes. He was right-eye dominant according to the hole-in-the-card test. The funduscopy found a yellow spot in the center of both maculae. Spectral-domain optical coherence tomography images revealed a full-thickness hyperreflectivity extending from the inner retinal layers to the retinal pigment epithelium (RPE) along with a localized disruption of the ellipsoid portion of the inner segments and RPE in both eyes. The medical history and clinical manifestations described previously supported the diagnosis of solar maculopathy. Spectral-domain optical coherence tomography images during follow-up indicated a diminishing disruption of the ellipsoid portion of the inner segments and RPE without treatment. Interestingly, the nondominant left eye made a better anatomical recovery. Finally, the Snellen best-corrected visual acuity remained 20/20 in both eyes after 14 months.

CONCLUSIONS
Binocular solar maculopathy can present asymmetrically and recover asymmetrically as well. The dominant eye suffered more obvious damage and poorer anatomical recovery than the nondominant eye.