bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of tear parameters and meibomian gland morphology in keratoconus patients after epithelial-on corneal cross-linking
Authors: Akgöz Hasan , Fındık Hüseyin , Aslan Mehmet Gökhan 
Published: August 2022

Purpose To evaluate the variations in tear parameters and meibomian gland morphology after epithelial-on (epi-on) corneal collagen cross-linking (CXL) in keratoconus (KC) patients. Methods This prospective observational study included 38 KC eyes that underwent epithelium-on CXL. Thirty-three eyes of 33 stable KC patients with no prior CXL treatment formed the KC group and 35 eyes of 35 healthy volunteers were recruited as the control group. All participants were evaluated by Schirmer I test, first and average noninvasive tear break-up time (NITBUT), ocular surface disease index (OSDI) questionnaire, and meibography scores. The CXL patients were evaluated preoperatively and at the 1st, 3rd, and 6th months, and participants without any intervention (KC and control groups) were evaluated initially, at 1st, 3rd, and 6th months. Results The KC patients had significantly lower average NITBUT, higher OSDI scores, and impaired meibomian gland morphology than healthy individuals (NITBUT(seconds): KC, 12.8(2.4–17.6), healthy group (HG), 17.1(6.8–17.6); p = 0.012, OSDI: KC, 27.5(0.0–87.5), HG, 7.5(0.0–55.0); p < 0.001, p < 0.001, respectively). A significant difference was found in Schirmer values of the CXL group at 0-1st months, first NITBUT values at 1–6 months, and average NITBUT values at 1–3 and 1–6 months (p = 0.003, p = 0.001, p = 0.003, p = 0.001, respectively). All meibography parameters remained unchanged after CXL over a 6-month follow-up compared to initial measurements. Conclusions Even though the KC patients had lower NITBUT, higher OSDI scores, and increased meibomian gland disfunction, the CXL treatment did not significantly affect tear quantity, dry eye symptoms, and meibomian gland morphology.
Detection of Hypoglycemia and Hyperglycemia Using Noninvasive Wearable Sensors: Electrocardiograms and Accelerometry
Authors: Dave Darpit , Vyas Kathan , Branan Kimberly , McKay Siripoom , DeSalvo Daniel J. , Gutierrez-Osuna Ricardo , Cote Gerard L. , Erraguntla Madhav 
Published: August 2022

Background: Monitoring glucose excursions is important in diabetes management. This can be achieved using continuous glucose monitors (CGMs). However, CGMs are expensive and invasive. Thus, alternative low-cost noninvasive wearable sensors capable of predicting glycemic excursions could be a game changer to manage diabetes. Methods: In this article, we explore two noninvasive sensor modalities, electrocardiograms (ECGs) and accelerometers, collected on five healthy participants over two weeks, to predict both hypoglycemic and hyperglycemic excursions. We extract 29 features encompassing heart rate variability features from the ECG, and time- and frequency-domain features from the accelerometer. We evaluated two machine learning approaches to predict glycemic excursions: a classification model and a regression model. Results: The best model for both hypoglycemia and hyperglycemia detection was the regression model based on ECG and accelerometer data, yielding 76% sensitivity and specificity for hypoglycemia and 79% sensitivity and specificity for hyperglycemia. This had an improvement of 5% in sensitivity and specificity for both hypoglycemia and hyperglycemia when compared with using ECG data alone. Conclusions: Electrocardiogram is a promising alternative not only to detect hypoglycemia but also to predict hyperglycemia. Supplementing ECG data with contextual information from accelerometer data can improve glucose prediction.
The Use of Beta-Blockers in Hereditary Hemorrhagic Telangiectasia-Related Epistaxis: A Systematic Review
Authors: Albarki Hashm , Rimmer Joanne 
Published: August 2022

Background Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disease affecting 1 in 5000 individuals. Epistaxis is seen in more than 90% of patients with HHT. Severe recurrent epistaxis can significantly decrease quality of life and may be resistant to standard treatment measures. Dysregulation of angiogenesis has been shown to cause the proliferation of abnormal blood vessels. As such, antiangiogenic treatments have been investigated including beta-blockers. Objective A systematic review of the efficacy of beta-blockers in topical treatment of epistaxis in patients with HHT based on epistaxis duration, frequency, and severity. Methods A systematic search was performed using the PubMed, Embase via Ovid, and Cochrane databases. The Preferred Items for Systematic Reviews and Meta-Analyses guidelines were followed. Studies that measured the efficacy of beta-blocker treatment of epistaxis in patients with HHT were included for qualitative analysis. Results Five studies (3 randomized controlled trials and 2 case series) with a total of 132 patients were included. Administration (systemically or topically via a spray or gel) of timolol and propranolol showed mixed evidence of improvement in epistaxis frequency, severity, and duration when compared with control groups. The evidence for propranolol appears more promising than timolol. Conclusion There are significant limitations in the included studies, and further investigation with larger longitudinal or randomized prospective trials is recommended. The available evidence suggests that beta-blocker treatment may have a positive effect on HHT-related epistaxis.
Liver Disease Among Mexican Americans Aged 67 Years and Older
Authors: Allencherril Ronan P. , Markides Kyriakos S. , Al Snih Soham 
Published: August 2022

Background: The Center for Disease Control and Prevention (CDC) reports that liver disease is a significant cause of morbidity and mortality in the US, afflicting 4.5 million people in 2018, or approximately 1.7% of the American adult population. Objective: To determine the prevalence and risk factors associated with liver disease among older Mexican Americans over 18 years of follow-up. Methods: Non-institutionalized Mexican Americans aged ≥67 years (N = 1938) from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/96-2012/13) were studied. Measures included socio-demographic variables, self-reported liver disease, language of interview, medical conditions, hand-grip strength, physical and cognitive function, depressive symptoms, and body mass index. Generalized estimating equation models were used to estimate the odds ratio and 95% confidence interval (CI) of liver disease over time. Results: The mean age at baseline was 74.9 ± 6.0 years and 58.4% were female. The prevalence of liver disease ranged from 2.4% to 8.4%. Over time, the odds ratio of reporting liver disease was 1.17 (CI = 1.12-1.22). Older age, Spanish interview, arthritis, diabetes, heart failure, cancer, and high scores on the Mini-Mental-State-Examination were factors associated with greater odds of reporting liver disease over time. Married participants reported lower odds of liver disease over time. Conclusions: The prevalence of liver disease in this population was high, ranging from 2.4% to 8.4%. Diabetes, heart failure, arthritis, and cancer were risk factors for liver disease. Screening for liver function among patients with these morbidities may help prevent liver disease in this population with high rates of diabetes and obesity.
Ultrasound-Guided Anterior Talofibular Ligament Repair With Augmentation Can Restore Ankle Kinematics: A Cadaveric Biomechanical Study
Authors: Hattori Soichi , Onishi Kentaro , Chan Calvin K. , Yamakawa Satoshi , Yano Yuji , Winkler Philipp W. , Hogan MaCalus V. , Debski Richard E. 
Published: August 2022

Background: Anterior talofibular ligament (ATFL) repair of the ankle is a common surgical procedure. Ultrasound (US)-guided anchor placement for ATFL repair can be performed anatomically and accurately. However, to our knowledge, no study has investigated ankle kinematics after US-guided ATFL repair. Hypothesis: US-guided ATFL repair with and without inferior extensor retinaculum (IER) augmentation will restore ankle kinematics. Study Design: Controlled laboratory study; Level of evidence, 4. Methods: A 6 degrees of freedom robotic testing system was used to apply multidirectional loads to fresh-frozen cadaveric ankles (N = 9). The following ankle states were evaluated: ATFL intact, ATFL deficient, combined ATFL repair and IER augmentation, and isolated US-guided ATFL repair. Three loading conditions (internal-external rotation torque, anterior-posterior load, and inversion-eversion torque) were applied at 4 ankle positions: 30° of plantarflexion, 15° of plantarflexion, 0° of plantarflexion, and 15° of dorsiflexion. The resulting kinematics were recorded and compared using a 1-way repeated-measures analysis of variance with the Benjamini-Hochberg test. Results: Anterior translation in response to an internal rotation torque significantly increased in the ATFL-deficient state compared with the ATFL-intact state at 30° and 15° of plantarflexion ( P = .022 and .03, respectively). After the combined US-guided ATFL repair and augmentation, anterior translation was reduced significantly compared with the ATFL-deficient state at 30° and 15° of plantarflexion ( P = .0012 and .005, respectively). Anterior translation was not significantly different for the isolated ATFL-repair state compared with the ATFL-deficient or ATFL-intact states at 30° and 15° of plantarflexion. Conclusion: Combined US-guided ATFL repair with augmentation of the IER reduced lateral ankle laxity due to ATFL deficiency. Isolated US-guided ATFL repair did not reduce laxity due to ATFL deficiency, nor did it increase instability compared with the intact ankle. Clinical Relevance: US-guided ATFL repair with IER augmentation is a minimally-invasive technique to reduce lateral ankle laxity due to ATFL deficiency. Isolated US-guided ATFL repair may be a viable option if accompanied by a period of immobilization.
Decline of onset-to-diagnosis interval and its impacts on clinical outcome of COVID-19 in China: a nation-wide observational study
Authors: Lu Qing-Bin , Che Tian-Le , Wang Li-Ping , Zhang An-Ran , Ren Xiang , Wang Tao , Geng Meng-Jie , Wang Yi-Fei , Liu Meng-Yang , Zhang Hai-Yang , Fang Li-Qun , Liu Wei , Li Zhong-Jie 
Published: August 2022

AbstractBackgroundTo quantitatively assess the impact of the onset-to-diagnosis interval (ODI) on severity and death for coronavirus disease 2019 (COVID-19) patients.MethodsThis retrospective study was conducted based on the data on COVID-19 cases of China over the age of 40 years reported through China’s National Notifiable Infectious Disease Surveillance System from February 5, 2020 to October 8, 2020. The impacts of ODI on severe rate (SR) and case fatality rate (CFR) were evaluated at individual and population levels, which was further disaggregated by sex, age and geographic origin.ResultsAs the rapid decline of ODI from around 40 days in early January to < 3 days in early March, both CFR and SR of COVID-19 largely dropped below 5% in China. After adjusting for age, sex, and region, an effect of ODI on SR was observed with the highest OR of 2.95 (95% CI 2.37‒3.66) at Day 10–11 and attributable fraction (AF) of 29.1% (95% CI 22.2‒36.1%) at Day 8–9. However, little effect of ODI on CFR was observed. Moreover, discrepancy of effect magnitude was found, showing a greater effect from ODI on SR among patients of male sex, younger age, and those cases in Wuhan.ConclusionThe ODI was significantly associated with the severity of COVID-19, highlighting the importance of timely diagnosis, especially for patients who were confirmed to gain increased benefit from early diagnosis to some extent.
Disparities in dialysis modality decision-making using a social-ecological lens: a qualitative approach
Authors: Vélez-Bermúdez Miriam , Adamowicz Jenna L. , Askelson Natoshia M. , Lutgendorf Susan K. , Fraer Mony , Christensen Alan J. 
Published: August 2022

AbstractBackgroundPatients with end-stage kidney disease (ESKD) may choose to undergo dialysis in-center or at home, but uptake of home dialysis in the US has been minimal despite its benefits over in-center dialysis. Factors that may have led patients to select home dialysis over in-center dialysis are poorly understood in the literature, and interventions to improve selection of home dialysis have focused on patient knowledge and shared decision-making processes between patients and providers. The purpose of this study was to explore micro- and macro-level factors surrounding dialysis modality decision-making among patients undergoing in-center and home dialysis, and explore what leads patients to select home dialysis over in-center dialysis.MethodsSemi-structured qualitative interviews were conducted in a dialysis clinic at a large Midwestern research hospital, from September 2019 to December 2020. Participants were 18 years or older, undergoing dialysis for ESKD, and had the cognitive ability to provide consent. Surveys assessing demographic and clinical information were administered to participants following their interviews.ResultsForty patients completed interviews and surveys (20 [50%] in-center dialysis, 17 [43%] female, mean [SD] age, 59 [15.99] years). Qualitative findings suggested that healthcare access and engagement before entering nephrology care, after entering nephrology care, and following dialysis initiation influenced patients’ awareness regarding their kidney disease status, progression toward ESKD, and dialysis options. Potential modifiers of these outcomes include race, ethnicity, and language barriers. Most participants adopted a passive-approach during decision-making. Finally, fatigue, concerns regarding one’s dialyzing schedule, and problems with fistula/catheter access sites contributed to overall satisfaction with one’s dialysis modality.ConclusionsFindings point to broader factors affecting dialysis selection, including healthcare access and racial/ethnic inequities. Providing dialysis information before entering nephrology and after dialysis initiation may improve patient agency in decision-making. Additional resources should be prioritized for patients of underrepresented backgrounds. Dialysis decision-making may be appropriately modeled under the social-ecological framework to inform future interventions.
Hemoglobin differences in twins are related to the time of cord clamping, not intertwin transfusion – a prospective cohort study
Authors: Kosińska-Kaczyńska Katarzyna , Witwicki Jacek , Saletra-Bielińska Aleksandra , Krajewski Paweł , Krysiak Adam , Brawura-Biskupski-Samaha Robert , Walasik Izabela , Zgliczyńska Magdalena , Malicka Ewa , Szymusik Iwona 
Published: August 2022

Abstract
Background
Delayed cord clamping increases placental transfusion. In vaginal deliveries higher hemoglobin concentrations are found in the second-born twin. We hypothesized it is unrelated to intertwin transfusion but to the time of cord clamping. Methods: It was a prospective cohort study of 202 women delivering twins > 32 weeks of gestation. Monoamniotic pregnancy, antenatal intertwin transfusions, fetal demise or major abnormalities were excluded from the study. The time of cord clamping depended on the obstetrician’s decision. Hemoglobin, hematocrit, and reticulocyte count were measured at birth and during the second day of life.

Results
At birth, hemoglobin and hematocrit levels were significantly higher in the first-born twins delivered with delayed than with early cord clamping. Higher hemoglobin and hematocrit levels were observed during the second day of life in all twins delivered with delayed cord clamping. The lowest levels were observed in twins delivered with early cord clamping. Infants delivered with delayed cord clamping were at a lower risk of respiratory disorders and NICU hospitalization.

Conclusion
The observed differences in Hgb concentrations between the infants in a twin pregnancy are related to cord clamping time.
Prognostic value of systemic inflammation response index in nasopharyngeal carcinoma with negative Epstein-Barr virus DNA
Authors: Yuan Xiaofei , Yang Hua , Zeng Fangfang , Zhou Shiyu , Wu Shuting , Yuan Yue , Cui Linchong , Feng Huiru , Lin Danfan , Chen Zilu , Liu Xiong , Chen Jing , Wang Fan 
Published: August 2022

Abstract
Background
Inflammatory parameters and Epstein–Barr virus (EBV) DNA status have been confirmed to be associated with prognosis in nasopharyngeal carcinoma (NPC) patients. However, there are few in-depth studies on the prognosis of NPC patients with negative EBV DNA. Our study aimed to look for inflammatory biomarkers that can identify disease progression in NPC patients with negative EBV DNA.

Methods
A total of 795 NPC patients were recruited, and ultimately 325 NPC patients with negative EBV DNA were included in this study (170 in training cohort and 155 in validation cohort). Kaplan–Meier method and log-rank test were used to analyze progression-free survival (PFS) and overall survival (OS). The multivariate analysis of Cox proportional hazards regression model was used to determine the independent prognostic factors. Receiver operating characteristic (ROC) curves were used to assess prognostic value. The logistic regression was used to evaluate the relationship between EBV DNA status and inflammatory parameters. The correlation between clinical characteristics was analyzed by the chi-squared test or the Fisher’s exact test.

Results
The optimal cutoff point for the SIRI was 1.12. The EBV DNA-negative NPC patients with high SIRI level had worse PFS and OS (all p < 0.001). In multivariate Cox proportional hazard models analysis, SIRI was an independent prognostic factor for PFS and OS (all p < 0.05), and had higher prognostic value than other indicators. Above results were found in the training cohort and confirmed in the validation cohort. In addition, EBV DNA status was not associated with any inflammatory parameters.

Conclusions
The SIRI can provide more accurate risk stratification and better prognostic prediction for NPC patients with negative EBV DNA.
Effectiveness and safety of tafluprost in primary open-angle glaucoma and ocular hypertension: a post-marketing phase IV study in China
Authors: Sun Xinghuai , Liu Qinghuai , Tang Xin , Yao Ke , Li Yan , Yang Jin , Zhang Mingchang , Yuan Huiping , Zheng Yan , Li Weining , Peng Huacong 
Published: August 2022

Abstract
Background
Prostaglandin analogs (PGAs) are the first-line treatment for primary open-angle glaucoma (POAG) and ocular hypertension (OH). This study aimed to confirm the effectiveness and safety of Tapros® (0.0015% tafluprost eye drops) in Chinese patients with POAG and OH.

Methods
This phase IV, multicenter, non-comparative, prospective study enrolled patients with POAG and OH in China between 12/27/2017 and 04/15/2020. Patients who were treatment-naïve or untreated within one month (group A) or with unreached intraocular pressure (IOP) target after previous monotherapy of other PGAs (group B) or non-PGA IOP-lowering drugs (group C) were treated with 0.0015% tafluprost for three months. The IOP reduction, response rate, and safety were observed.

Results
There were 165, 89, and 31 patients in groups A, B, and C, with baseline IOPs of 22.4 ± 4.7, 21.0 ± 3.5, and 22.5 ± 3.2 mmHg, respectively. The least-square means and percentages of IOP reduction at 3 months for groups A, B, and C were 4.7 (19.8%), 1.6 (6.1%), and 4.6 mmHg (20.3%), respectively. A significant reduction in IOP was observed at each visit compared with baseline (all P < 0.05). At the final visit, 57.0% of the participants in group A achieved an IOP reduction of ≥ 20%, while 40.4% and 77.4% in groups B and C achieved an IOP reduction of ≥ 10%. Fifty-eight treatment-related adverse events occurred in 46 participants (15.7%), of which the most common one was conjunctival hyperemia (34/293, 11.6%).

Conclusions
Tafluprost showed a sustained and significant effect with tolerable adverse events in Chinese patients with POAG and OH who were treatment-naïve or untreated within one month or received prior treatments with unsatisfying outcomes.
Life in lockdown: a longitudinal study investigating the impact of the UK COVID-19 lockdown measures on lifestyle behaviours and mental health
Authors: Solomon-Moore Emma , Lambert Jeffrey , Grey Elisabeth , Gillison Fiona , Townsend Nick , Busam Betty , Velemis Kyriakos , Millen Christopher , Baber Fran , Griffin Tania 
Published: August 2022

Abstract
Background
The COVID-19 pandemic led to the UK government enforcing lockdown restrictions to control virus transmission. Such restrictions present opportunities and barriers for physical activity and healthy eating. Emerging research suggests that in the early stages of the pandemic, physical activity levels decreased, consumption of unhealthy foods increased, while levels of mental distress increased. Our aims were to understand patterns of diet, physical activity, and mental health during the first lockdown, how these had changed twelve-months later, and the factors associated with change.

Methods
An online survey was conducted with UK adults (N = 636; 78% female) during the first national lockdown (May–June 2020). The survey collected information on demographics, physical activity, diet, mental health, and how participants perceived lifestyle behaviours had changed from before the pandemic. Participants who provided contact details were invited to complete a twelve-month follow-up survey (May–June 2021), 160 adults completed the survey at both time-points. Descriptive statistics, T-tests and McNemar Chi Square statistics were used to assess patterns of diet, physical activity, and mental health at baseline and change in behaviours between baseline and follow-up. Linear regression models were conducted to explore prospective associations between demographic and psycho-social variables at baseline with change in healthy eating habit, anxiety, and wellbeing respectively.

Results
Between baseline and follow-up, healthy eating habit strength, and the importance of and confidence in eating healthily reduced. Self-rated health (positively) and confidence in eating healthily (negatively) were associated with change in healthy eating habit. There were no differences between baseline and follow-up for depression or physical activity. Mean anxiety score reduced, and wellbeing increased, from baseline to follow-up. Living with children aged 12–17 (compared to living alone) was associated with an increase in anxiety, while perceiving mental health to have worsened during the first lockdown (compared to staying the same) was associated with reduced anxiety and an increase in mental wellbeing.

Conclusions
While healthy eating habits worsened in the 12 months since the onset of the pandemic, anxiety and mental wellbeing improved. However, anxiety may have increased for parents of secondary school aged children.