bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of automated cuff blood pressure monitors in special populations: International Organization for Standardization (ISO) Task Group report and call for research
Authors: Stergiou George S. , Menti Ariadni , Asayama Kei , De La Sierra Alejandro , Wang Jiguang , Kinoshita Hiroyuki , Sawanoi Yukiya , Yamashita Shingo , Kollias Anastasios , Wu Colin O. , Ichikawa Tsutomu , Alpert Bruce 
Published: March 2023

Objective:
Automated cuff blood pressure (BP) devices are widely used for ambulatory, home, and office BP measurement. However, an automated device, which is accurate in the general adult population may be inaccurate in some special populations. A 2018 Collaborative Statement by the US Association for the Advancement of Medical Instrumentation, the European Society of Hypertension, and the International Organization for Standardization (ISO) considered three special populations requiring separate validation (children, pregnancy, and atrial fibrillation). An ISO Task Group was appointed to identify evidence for additional special populations.

Method:
Evidence on potential special populations was identified from the STRIDE BP database, which performs systematic PubMed searches for published validation studies of automated cuff BP monitors. Devices that passed in a general population, but failed in potential special populations were identified.

Results:
Of 338 publications (549 validations, 348 devices) in the STRIDE BP database, 29 publications (38 validations, 25 devices) involved four potential special populations: (i) age 12–18 years: three of seven devices failed but passed in a general population; (ii) age more than 65 years: one of 11 devices failed but passed in a general population; (iii) diabetes type-2: four devices (all passed); (iv) chronic kidney disease: two of seven devices failed but passed in a general population.

Conclusion:
Some evidence suggest that the automated cuff BP devices may have different accuracy in adolescents and in patients with chronic kidney disease than in the general population. More research is needed to confirm these findings and investigate other potential special populations.
Central arterial stiffness, brain white matter hyperintensity and total brain volume across the adult lifespan
Authors: Tomoto Tsubasa , Tarumi Takashi , Zhang Rong 
Published: March 2023

Objectives:
Mounting evidence suggests that central arterial stiffening is associated with brain ageing in older adults. The purpose of this study was to determine the associations of age with carotid arterial stiffness and carotid-femoral pulse wave velocity (cfPWV), both measurements of central arterial stiffness, the relationship between age-related arterial stiffness, brain white matter hyperintensity (WMH) and total brain volume (TBV), and whether effects of central arterial stiffness on WMH volume and TBV are mediated by pulsatile cerebral blood flow (CBF).

Methods:
One hundred and seventy-eight healthy adults (21–80 years) underwent measurements of central arterial stiffness using tonometry and ultrasonography, WMH and TBV via MRI, and pulsatile CBF at the middle cerebral artery via transcranial Doppler.

Results:
Advanced age was associated with increases in both carotid arterial stiffness and cfPWV, increases in WMH volume and decreases in TBV (all P < 0.01). Multiple linear regression analysis showed that carotid β-stiffness was positively associated with WMH volume (B = 0.015, P = 0.017) and cfPWV negatively with TBV (B = −0.558, P < 0.001) after adjustment for age, sex and arterial pressure. Pulsatile CBF mediates the associations between carotid β-stiffness and WMH (95% confidence interval: 0.0001–0.0079).

Conclusion:
These findings suggest that age-related central arterial stiffness is associated with increased WMH volume and decreased TBV, which is likely mediated by increased arterial pulsation.
Cutibacterium (Formerly Propionibacterium) acnes Keratitis: A Review
Authors: Ashby Nathaniel S. , Johnson Taylor J. , Castillo-Ronquillo Yasmyne , Payne Carter J. , Davenport Connor , Hoopes Phillip C. , Moshirfar Majid 
Published: March 2023

Abstract:
Infectious keratitis is a devastating cause of vision loss worldwide. Cutibacterium acnes (C. acnes), a commensal bacterium of the skin and ocular surface, is an underrecognized but important cause of bacterial keratitis. This review presents the most comprehensive and up-to-date information for clinicians regarding the risk factors, incidence, diagnosis, management, and prognosis of C. acnes keratitis (CAK). Risk factors are similar to those of general bacterial keratitis and include contact lens use, past ocular surgery, and trauma. The incidence of CAK may be approximately 10%, ranging from 5% to 25% in growth-positive cultures. Accurate diagnosis requires anaerobic blood agar and a long incubation period (≥7 days). Typical clinical presentation includes small (<2 mm) ulcerations with deep stromal infiltrate causing an anterior chamber cell reaction. Small, peripheral lesions are usually resolved, and patients recover a high visual acuity. Severe infections causing VA of 20/200 or worse are common and often do not significantly improve even after treatment. Vancomycin is considered the most potent antibiotic against CAK, although other antibiotics such as moxifloxacin and ceftazidime are more commonly used as first-line treatment.
Long-term results of a new posterior chamber phakic intraocular lens in patients with high myopia: 5-year results
Authors: Cakir Ihsan , Sonmez Orcun , Pehlivanoglu Seren , Cakir Gulay Yalcinkaya , Yildiz Burcin Kepez , Yildirim Yusuf , Agca Alper 
Published: March 2023

Purpose:
To evaluate the long-term refractive outcomes of Eyecryl posterior chamber spherical phakic intraocular lens (pIOL) implantation in high myopia and endothelial cell density (ECD) change.

Setting:
Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.

Design:
Retrospective.

Methods:
Eyes that were not suitable for corneal refractive surgery, had high myopia between −6.00 diopters (D) and −20.00 D, had Eyecryl posterior chamber spherical pIOL implantation, and had at least 5 years of follow-up were included. Preoperative ECD was ≥2300 cells/mm2 and cylindrical value was ≤2.0 D in all cases. Preoperative and postoperative first, third, and fifth years of refraction, uncorrected and corrected distance visual acuity (UDVA/CDVA), and ECD were recorded.

Results:
36 eyes of 18 patients were examined. The mean UDVA and CDVA in postoperative fifth years were 0.24 ± 0.19 logMAR and 0.12 ± 0.18 logMAR, respectively. The safety and efficacy indices were 1.52 ± 0.54 and 1.14 ± 0.38, respectively. At 5 years, the spherical equivalent was ±0.50 D in 75% of eyes and ±1.00 D in 92% of eyes. After 5 years, the mean cumulative ECD loss was 6.91% (P = .07). The annual ECD loss was 1.57% in the first year, 0.26% between 1 year and 3 years, and 2.38% between 3 years and 5 years. Asymptomatic anterior capsule opacity developed in 1 eye 4 years after surgery. Rhegmatogenous retinal detachment developed in 1, and myopic choroidal neovascular membrane occurred in 1 eye.

Conclusions:
Eyecryl posterior chamber spherical pIOL implantation is one of the effective and safe refractive surgical methods in correcting high myopia with predictable and stable refractive results over a 5-year period. Longer-term studies are needed for complications such as decreased ECD, retinal complications, and lens opacity.
Comparison of the Barrett toric calculator using measured and predicted posterior corneal astigmatism and the Kane and Abulafia-Koch calculators
Authors: Reitblat Olga , Barnir Megiddo , Qassoom Ayat , Levy Adi , Assia Ehud I. , Kleinmann Guy 
Published: March 2023

Purpose:
To compare the accuracy of the Barrett toric calculator with measured and predicted posterior corneal astigmatism (MPCA and PPCA, respectively), the Abulafia-Koch (AK) formula, and the toric Kane formula.

Setting:
Ein-Tal Eye Center, Tel-Aviv, Israel.

Design:
Retrospective cohort.

Methods:
Consecutive cases of patients who underwent uneventful cataract extraction surgery with implantation of a toric intraocular lens between March 2015 and July 2019 were retrospectively reviewed. 1 eligible eye from each patient was included. The predicted postoperative refractive astigmatism was calculated using each method and compared with the postoperative refractive astigmatism to give the prediction error.

Results:
80 eyes of 80 patients were included in this study. The mean centroid and the mean and median absolute prediction errors using Kane (0.25 diopters [D] ± 0.54 @ 6 degrees, 0.50 D ± 0.31 and 0.45 D, respectively) were significantly different compared with MPCA (0.12 D ± 0.52 @ 16 degrees, P < .001, .44 D ± 0.28 and 0.36 D, P = .027, respectively), PPCA (0.09 D ± 0.49 @ 12 degrees, P < .001, .41 D ± 0.27 and 0.35 D, P < .001, respectively), and AK (0.11 D ± 0.49 @ 11 degrees, P < .001, .42 D ± 0.27 and 0.35 D, P = .004, respectively). No significant differences were found between the calculators in the predictability rates within ±0.25 D, ±0.50 D, ±0.75 D, and ±1.00 D.

Conclusions:
The measured posterior corneal curvature in the Barrett calculator yielded comparable outcomes to its prediction by the Barrett and AK formulas. The Kane calculator showed a slight against-the-rule prediction error compared with the other methods, resulting in a small higher median absolute error with marginal clinical importance.
Monitoring of Serum TWEAK Level Guides Glucocorticoid Dosages in the Treatment of Systemic Lupus Erythematosus
Authors: Chen Jing-Yun , Zhang Yu-Fei , Wu Yi , Wu Xiao-Kang , Wang Li , Luo Mai , Xiao Sheng-Xiang , Wang Hui-Xia , Xia Yu-Min 
Published: March 2023

Objective:
Accurate assessment of systemic lupus erythematosus (SLE) disease activity is critical. This study explored the relationship between the serum level of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score as well as the role of TWEAK in guiding the glucocorticoid dosage in SLE treatment.

Methods:
This study involved 131 patients with SLE, 34 with subacute cutaneous lupus erythematosus (SCLE), 22 with discoid lupus erythematosus (DLE), and 32 healthy volunteers. The serum and urinary TWEAK levels were determined. Monomeric C-reactive protein (mCRP), anti-dsDNA IgG, antinuclear antibody (ANA), complements in serum and urinary albumin level were measured. The SLEDAI 2000 (SLEDAI-2K) was used to evaluate disease activity. The correlation of the SLEDAI-2K score with all biomarkers was determined. Methylprednisolone was orally administered to patients with SLE depending on the serum level of TWEAK.

Results:
TWEAK levels were higher in patients with SLE or SCLE than in patients with DLE or healthy controls. The serum TWEAK level was positively correlated with the SLEDAI-2K score in patients with SLE (P < 0.001), and was more strongly correlated with the SLEDAI-2K score than other parameters (P < 0.001). Moreover, TWEAK-based glucocorticoid therapy was associated with lower SLEDAI-2K scores, better tapering of glucocorticoid doses, and fewer lupus flares in patients with SLE.

Conclusions:
Serum TWEAK is a useful biomarker reflecting SLE disease activity. Monitoring of the serum TWEAK level can improve the outcomes of glucocorticoid therapy in patients with SLE.
Deficiency of Autophagy-Related Gene 5 in Keratinocytes Leads to Aggravation of Epidermal Damage in 2,4-dinitrochlorobenzene-induced Allergic Contact Dermatitis
Authors: Zhang Yi-Qun , Xiao Ta , Song Chang-Jun , Ke Yang-Ying , Gao Xiang , Li Min , Gu Heng , Chen Xu 
Published: March 2023

Objective:
To determine whether keratinocyte-specific autophagy-related gene 5 (ATG5) deficiency can regulate apoptosis to inhibit skin damage in mice with 2,4-dinitrochlorobenzene (DNCB)-induced allergic contact dermatitis (ACD).

Methods:
This study involved keratinocyte-specific Atg5 conditional knockout (cKO) mice (Krt14cre/+-Atg5
flox/flox) and control mice (Krt14+/+-Atg5
flox/flox). We painted DNCB on the right ear of each mouse to induce ACD. Dermatitis scoring and measurements of ear weight and thickness were performed to evaluate inflammation levels. An immunohistochemical assay was performed to analyze immune cell infiltration. Histological study and TUNEL staining were performed to compare the differences in skin lesions between Atg5 cKO mice and control mice. Immunofluorescence and western blotting were used to examine the levels of ATG5 and apoptosis-related protein. The results were statistically analyzed by t test.

Results:
After DNCB stimulation of mice ears, we observed a more severe phenotype in Atg5 cKO mice than in control mice (dermatitis score: 7.5 ± 2.5884 vs. 3.25 ± 0.8216, P = 0.0033). Further analysis of ATG5 protein confirmed keratinocyte-specific ablation of Atg5 in cKO mice and showed that DNCB did not influence ATG5 expression. Immunohistochemistry assay revealed that the infiltrated immune cells were not involved in aggravation of the phenotype of DNCB-stimulated Atg5 cKO mice. However, the histological study (P = 0.0238), TUNEL staining (P = 0.0238), immunofluorescence (P = 0.0357), and western blotting showed that the increase in keratinocyte death, especially apoptosis, contributed to aggravation of the phenotype of DNCB-stimulated Atg5 cKO mice.

Conclusion:
Deficiency of Atg5 in keratinocytes increases apoptosis, aggravating skin damage in DNCB-induced ACD mice. This has no relationship with the involvement of immune cells.
Early Syphilis Presenting as Thickened Penile Plaques With an Embedded Recurrent Ulcer (Chancre Redux): A Case Report
Authors: Davies Stephen C. , Hannaford Rodney , Cotter Joseph 
Published: March 2023

Introduction:
The manifestations of syphilis are varied, and serology can establish the diagnosis early, especially in rare cases.
We report a case of chancre redux (a rare recurrence of primary syphilis), which was embedded within a secondary syphilitic penile skin plaque. There were missed opportunities at earlier diagnosis as serology for syphilis was not ordered.

Case presentation:
A 56-year-old man presented with thickened penile plaques for five months. He reported a small penile ulcer approximately one month prior. There was no history of other skin lesions or rash. However, clinically there was an asymptomatic, indurated ulcer embedded within a plaque which was swab-positive for syphilis by PCR. A punch biopsy of a plaque was spirochaete-positive using an immunoperoxidase stain. The patient’s lesions resolved three weeks after treatment with intramuscular benzathine penicillin.

Discussion:
Uncommonly reported even in the preantibiotic era, chancre redux is now rare. The ulcer usually recurs at or near the site of the original chancre, and has similar morphological features. The skin lesions of secondary syphilis can exhibit remarkable morphological variety. The most common skin manifestation, a generalized macular rash, was not present at any time in this case. Rather, there were only a couple of nonspecific penile plaques. If biopsy is performed, histologic findings are variable, though typically the inflammatory infiltrate includes plasma cells. A special immunoperoxidase stain can highlight spirochaetes in biopsy sections.

Conclusion:
This case highlights the importance of considering syphilis in the differential diagnosis of persistent, atypical penile lesions and underscores the need for appropriate serological testing in such instances.
More or Less Job Performance in an Insecure Job? A Study on the Relationship between Job Insecurity and In-Role and Extra-Role Performance
Authors: Roodbol Janine , Stynen Dave 
Published: March 2023

ObjectiveTo gain insight into the complex relationship between job insecurity and in-role and extra-role performance. Autonomous work motivation is investigated as a mediator in this relationship. The quality of the employee-supervisor relationship (LMX) is investigated as a moderator between job insecurity and autonomous work motivation.MethodsCross-sectional data were collected by online surveys among 206 Dutch and Belgian employees. Multiple regression analyses were performed to test the hypotheses.ResultsJob insecurity was negatively associated with both in-role and extra-role performance. Autonomous work motivation mediated the negative relationship between job insecurity and in-role and extra-role performance. LMX did not moderate the negative relationship between job insecurity and autonomous work motivation.ConclusionsOrganizations need to prevent job insecurity and limit the negative consequences of job insecurity for sustaining employees' autonomous work motivation and job performance.
Elevated Diaphragmatic Tonic Activity in PICU Patients: Age-Specific Definitions, Prevalence, and Associations*
Authors: Plante Virginie , Poirier Clarice , Guay Hélène , Said Carla , Sauthier Michael , Al-Omar Sally , Harrington Karen , Emeriaud Guillaume 
Published: March 2023

OBJECTIVES:
Tonic diaphragmatic activity (tonic Edi, i.e., sustained diaphragm activation throughout expiration) reflects diaphragmatic effort to defend end-expiratory lung volumes. Detection of such elevated tonic Edi may be useful in identifying patients who need increased positive end-expiratory pressure. We aimed to: 1) identify age-specific definitions for elevated tonic Edi in ventilated PICU patients and 2) describe the prevalence and factors associated with sustained episodes of high tonic Edi.

DESIGN:
Retrospective study using a high-resolution database.

SETTING:
Single-center tertiary PICU.

PATIENTS:
Four hundred thirty-one children admitted between 2015 and 2020 with continuous Edi monitoring.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We characterized our definition of tonic Edi using data from the recovery phase of respiratory illness (i.e., final 3 hr of Edi monitoring, excluding patients with significant persistent disease or with diaphragm pathology). High tonic Edi was defined as population data exceeding the 97.5th percentile, which for infants younger than 1 year was greater than 3.2 μV and for older children as greater than 1.9 μV. These thresholds were then used to identify patients with episodes of sustained elevated tonic Edi in the first 48 hours of ventilation (acute phase). Overall, 62 of 200 (31%) of intubated patients and 138 of 222 (62%) of patients on noninvasive ventilation (NIV) had at least one episode of high tonic Edi. These episodes were independently associated with the diagnosis of bronchiolitis (intubated patients: adjusted odds [aOR], 2.79 [95% CI, 1.12–7.11]); NIV patients: aOR, 2.71 [1.24–6.0]). There was also an association with tachypnea and, in NIV patients, more severe hypoxemia.

CONCLUSIONS:
Our proposed definition of elevated tonic Edi quantifies abnormal diaphragmatic activity during expiration. Such a definition may help clinicians to identify those patients using abnormal effort to defend end-expiratory lung volume. In our experience, high tonic Edi episodes are frequent, especially during NIV and in patients with bronchiolitis.
Anticoagulation-Free Pediatric Extracorporeal Membrane Oxygenation: Single-Center Retrospective Study*
Authors: Rabinowitz Edon J. , Danzo Megan T. , Anderson Mark J. , Wallendorf Michael , Eghtesady Pirooz , Said Ahmed S. 
Published: March 2023

Objectives:
To analyze hemorrhage and thrombosis data related to anticoagulation-free pediatric extracorporeal membrane oxygenation (ECMO).

Design:
Retrospective cohort study.

Settings:
High-volume ECMO single institution data.

Patients:
Children (0–18 yr) supported with ECMO (>24 hr) with initial anticoagulation-free period of greater than or equal to 6 hours.

Interventions:
None.

Measurements and Main Results:
Utilizing consensus American Thoracic Society definitions for hemorrhage and thrombosis on ECMO, we evaluated thrombosis and associated patient and ECMO characteristics during anticoagulation-free period. Thirty-five patients met inclusion criteria from 2018 to 2021 having a median age (interquartile range [IQR]) of 13.5 months (IQR, 3–91 mo), median ECMO duration of 135 hours (IQR, 64–217 hr), and 964 anticoagulation-free hours. Increased RBC transfusion needs were associated with longer anticoagulation-free periods (p = 0.03). We identified 20 thrombotic events: only four during the anticoagulation-free period and occurring in three of 35 (8%) patients. Compared with those without thrombotic events, anticoagulation-free clotting events were associated with younger age (i.e., 0.3 mo [IQR, 0.2–0.3 mo] vs 22.9 mo [IQR, 3.6–112.9 mo]; p = 0.02), lower weight (2.7 kg [IQR, 2.7–3.25 kg] vs 13.2 kg [5.9–36.4 kg]; p = 0.006), support with lower median ECMO flow rate (0.5 kg [IQR, 0.45–0.55 kg] vs 1.25 kg [IQR, 0.65–2.5 kg]; p = 0.04), and longer anticoagulation-free ECMO duration (44.5 hr [IQR, 40–85 hr] vs 17.6 hr [IQR, 13–24.1]; p = 0.008).

Conclusions:
In selected high-risk-for-bleeding patients, our experience is that we can use ECMO in our center for limited periods without systemic anticoagulation, with lower frequency of patient or circuit thrombosis. Larger multicentered studies are required to assess weight, age, ECMO flow, and anticoagulation-free time limitations that are likely to pose risk for thrombotic events.
Statistical and methodological considerations for randomized-controlled trial design in physical medicine and rehabilitation
Authors: Thakur Bhaskar , Ayers Gregory D. , Atem Folefac , DeClerq Josh , Jain Nitin B. 
Published: March 2023

Abstract
Well-designed randomized-controlled clinical trials assessing treatments in the field of physical medicine and rehabilitation (PM&R) are essential for evidence-based patient care. However, there are challenges unique to clinical trials in PM&R due to complex health interventions in this field. We highlight routinely encountered empirical challenges and provide evidence-based recommendations on statistical and methodological approaches for the design and conduct of randomized controlled trials. Some of the issues addressed include challenges with blinding treatment groups in a rehabilitation setting, heterogeneity in treatment therapy, heterogeneity of treatment effects, uniformity in patient-reported outcome measures, and effect on power with varying scales of information. Further, we discuss challenges with estimation of sample size and power, adaption to poor compliance with treatment and missing outcomes, and preferred statistical approaches for longitudinal data analysis.
High Level Spinal Cord Injury and the Failure of U.S. Acute Rehabilitation: An Analysis and Commentary
Authors: Bach John R. , Shih Tiffany 
Published: March 2023

Abstract
Acute and long-term morbidity and mortality rates have not changed in the United States for people with high level spinal cord injury in 40 years, neither has the conventional invasive respiratory management for these patients. This is despite a 2006 challenge to institutions for a paradigm shift to avoid or decannulate patients of tracheostomy tubes. Centers in Portugal, Japan, Mexico, and South Korea decannulate high level patients to up to continuous noninvasive ventilatory support and use mechanical insufflation exsufflation, as we have done and reported since 1990, but there has been no such paradigm shift in U.S. rehabilitation institutions. The quality of life and financial consequences of this are discussed. An example of decannulation of a relatively easy case, after failure to do so during 3 months of acute rehabilitation, is presented to encourage institutions to begin to learn and apply noninvasive management before decannulating more severe patients with little to no ventilator free breathing ability.