bluuebunny/crossref_metadata_2025_split huggingface dataset:
Masking the Red Reflex of Flash Photography With Prosthetic Lenses
Authors: Balakrishnan Akshaya C. , Badrinarayanan Aparna , Iqbal Asif 
Published: October 2022

Abstract:
The purpose of this case report was to represent the clinical expertise in managing with a patient with visible red fundal reflex on flash photography and its management with a soft prosthetic contact lens (PCL). This unique case report discussed a 31-year-old man complaining of visible red reflex in right eye while taking photographs with flashlight. Ocular history revealed that he is status post intraocular lens implantation and strabismus surgery followed by a nonpenetrating injury with a stick in the right eye 20 years back. The middilated, slow, tonic pupil was making the fundal glow more prominent in bright flashlight. Because cosmesis was the main concern, various types of PCL trials were used. Finally, the red reflex was concealed with a type-D, gray, transparent, iris tinted PCL. Thus, PCL enhanced the aesthetic appearance and created a positive impact on the patient's quality of life and should be considered and prescribed in similar patients.
Severe Acute Respiratory Syndrome Coronavirus 2–Associated Blepharoconjunctivitis and Erythema Multiforme-Like Rash in a Young Man
Authors: Fernandez Karen B. , Sioufi Kareem , Aker Jon E. , Mercer Ryan N. 
Published: October 2022

Purpose:
The aim of this study was to describe the diagnosis and management of bilateral blepharoconjunctivitis and erythema multiforme (EM)-like illness in an otherwise healthy young man who tested positive for severe acute respiratory syndrome coronavirus (SARS-CoV)-2.

Methods:
This is a case report of a 27 year-old man with a positive result for SARS-CoV-2 testing who presented with fever, eye redness, oral ulcerations, cough, sore throat, and progressive rash suspicious for EM-like illness.

Results:
A SARS-CoV-2–positive patient presented to the emergency room with a progressing skin rash, bilateral conjunctivitis, and oropharyngeal mucosal ulcers. On initial ophthalmic examination, visual acuity was 20/25 both eyes (OU), and slit lamp examination demonstrated erythema and ulceration of the eyelid margins with fluorescein uptake at the mucocutaneous junction OU. The patient was admitted for observation and supportive treatment. During and after his hospital stay, he was treated with systemic and topical steroids, topical cyclosporine ophthalmic drops, erythromycin ophthalmic ointment, and artificial tears. At his 1-week follow-up visit after hospital discharge, the patient had complete resolution of his skin findings and improvement of his ocular and oral mucosal findings. Laboratory workup and imaging studies searching for other potential autoimmune and infectious etiologies showed negative results.

Conclusions:
Topical antiinflammatory drops, artificial tears, erythromycin ointment, and systemic steroids were an effective treatment for this bilateral blepharoconjunctivitis and EM-like presentation of SARS-CoV-2.
Exposure-response Relationships of Metronidazole in Infants: Integration of Electronic Health Record Data With Population Pharmacokinetic Modeling-derived Exposure Simulation
Authors: Commander Sarah Jane , Benjamin Daniel K. , Wu Huali , Thompson Elizabeth J. , Lane Morgan , Clark Reese H. , Greenberg Rachel G. , Hornik Christoph P. 
Published: October 2022

Background:
Infants frequently receive metronidazole at variable doses and duration for surgical site infection prophylaxis and treatment of intra-abdominal infections. Seizures are a rare (but potentially devastating) side effect of metronidazole, yet the prevalence of seizures in infants, as well as the relationship with metronidazole dose and exposure, are unknown.

Methods:
We examined the Pediatrix Clinical Data Warehouse for infants in neonatal intensive care units from 1997 to 2018 who received at least 1 dose of metronidazole during their first 120 days of life. We used an existing population pharmacokinetic model to simulate exposure parameters, estimating multivariable associations between metronidazole dosing and exposure parameters, and the occurrence of seizure.

Results:
There were 19,367 intravenous doses of metronidazole given to 1546 infants, and 31 experienced a seizure. Infants with a seizure had a longer median (interquartile values) duration of metronidazole exposure than those without (11 days [6, 15] vs. 7 [4, 11], P = 0.01). Each added day of metronidazole (OR = 1.06, 95% CI: 1.02–1.10), and each standard deviation increase in cumulative area under the plasma concentration−time curve (OR = 1.27, 95% CI: 1.11–1.45) were associated with increased odds of seizure. Higher simulated maximum plasma concentration was associated with lower odds of seizure (OR = 0.88, 95% CI: 0.81–0.96).

Conclusions:
Longer metronidazole exposure and higher cumulative exposure could be associated with increased odds of infant seizures. Using a large observational dataset allowed us to identify a rare adverse event, but prospective studies are needed to validate this finding and further characterize metronidazole dose- and exposure-safety relationships.
Measurement Invariance and Latent Mean Differences in the Nurses' Emotional Labour Scale
Authors: KIM Sun-Hee , LEE Eunkyung , PARK Jin-Hwa 
Published: October 2022

ABSTRACT

Background
The measurement invariance and latent mean differences in emotional labor across different hospital and monthly salary levels among registered nurses have never been confirmed for the Emotional Labour Scale. These issues may influence the application and efficacy of this scale in practice.

Purpose
This study was developed to evaluate the factor structure of the nurses' Emotional Labour Scale and to examine the measurement invariance and latent mean differences for this scale across different hospital and monthly salary levels.

Methods
Data were collected from 461 registered nurses working in four general hospitals and 12 long-term care hospitals. Confirmatory factor analysis and a multigroup confirmatory factor analysis were performed to determine the internal structure and measurement invariance of the Emotional Labour Scale.

Results
The results of the confirmatory factor analysis indicate that the factor structure model proposed by the original scale fits well with our data as well as configural invariance, factor loading invariance, intercept invariance, and uniqueness invariance. Moreover, factor variance/covariance invariance across two hospital levels as well as configural invariance, factor loading invariance, and intercept invariance across two monthly salary levels were supported. The mean score for emotional control effort in the profession of general hospital nurses was lower than that for long-term care hospital nurses. No statistically significant latent mean differences were found across monthly salary levels.

Conclusions/Implications for Practice
The findings show the Emotional Labour Scale to be a valid and reliable tool for assessing registered nurses and also comparing the mean score for emotional labor across hospital and monthly salary levels to be feasible. The scale may contribute to the development of human resource strategies.
Clinical Update on Uses for Mifepristone in Obstetrics and Gynecology
Authors: Hagey Jill M. , Givens Matthew , Bryant Amy G. 
Published: October 2022

Importance
Mifepristone (RU-486) is a selective progesterone receptor modulator that has antagonist properties on the uterus and cervix. Mifepristone is an effective abortifacient, prompting limitations on its use in many countries. Mifepristone has many uses outside of induced abortion, but these are less well known and underutilized by clinicians because of challenges in accessing and prescribing this medication.

Objective
To provide clinicians with a history of the development of mifepristone and mechanism of action and safety profile, as well as detail current research on uses of mifepristone in both obstetrics and gynecology.

Evidence Acquisition
A PubMed search of mifepristone and gynecologic and obstetric conditions was conducted between January 2018 and December 2021. Other resources were also searched, including guidelines from the American College of Obstetricians and Gynecologists and the Society of Family Planning.

Results
Mifepristone is approved by the Food and Drug Administration for first-trimester medication abortion but has other off-label uses in both obstetrics and gynecology. Obstetric uses that have been investigated include management of early pregnancy loss, intrauterine fetal demise, treatment of ectopic pregnancy, and labor induction. Gynecologic uses that have been investigated include contraception, treatment of abnormal uterine bleeding, and as an adjunct in treatment of gynecologic cancers.

Conclusions and Relevance
Mifepristone is a safe and effective medication both for its approved use in first-trimester medication abortion and other off-label uses. Because of its primary use as an abortifacient, mifepristone is underutilized by clinicians. Providers should consider mifepristone for other indications as clinically appropriate.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to describe the history of the development of mifepristone, including its mechanism of action and safety profile; and explain the uses for mifepristone in both obstetrics and gynecology.
Effect of Intrapartum Maternal Hemoglobin on Mode of Delivery and Short-Term Neonatal Outcome: A Systematic Review
Authors: Smith Julia Sandra , Bullens Lauren Maria , van der Hout-van der Jagt Marieke Beatrijs , van Runnard Heimel Pieter Jurjen , Oei Swan Gied 
Published: October 2022

ABSTRACT

Importance
Maternal anemia in pregnancy is a common condition worldwide and is considered a risk factor for adverse neonatal and maternal outcome. Also high hemoglobin (Hb) levels are associated with adverse pregnancy outcomes. However, studies regarding the influence of intrapartum maternal Hb on mode of delivery and short-term neonatal outcome are limited and contradicting.

Objective
The aim of this study was to provide an overview of current evidence regarding associations between intrapartum maternal Hb levels and mode of delivery and short-term neonatal outcome. In addition, we propose directions for future research.

Evidence Acquisition
We systematically searched the electronic PubMed, EMBASE, and Cochrane databases for studies on maternal Hb levels and mode of delivery maternal and short-term neonatal outcome until January 2021. Eligible articles and their references were independently reviewed by 2 authors. Assessment was based on methodological quality and study results.

Results
We included 14 studies that evaluated the level of maternal pH in relation to clinical outcome, 6 studies on mode of delivery, 10 studies on Apgar score, 1 study on fetal distress, 2 studies on neonatal intensive care unit admission, 1 study on umbilical cord pH, and 5 studies on perinatal mortality.

Conclusions and Relevance
We found a trend toward an increased risk of cesarean delivery in anemic woman. Concerning the short-term neonatal outcomes, the evidence is conflicting, and included studies are too heterogenic to compare. Furthermore, various studies indicated a relation between high Hb levels and increased perinatal mortality. Therefore, we especially recommend attention to elevated Hb levels.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to describe how Hb levels affect mode of delivery and short-term neonatal outcome, and identify abnormal Hb levels and propose appropriate treatment and monitoring recommendations.
The Utility of Physical Examination in Ovarian Cancer Recurrence Detection: A Retrospective Analysis Informing Virtual Surveillance Care
Authors: Janke Monica J. , Santiago Sarah , Straubhar Alli M. , Uppal Shitanshu 
Published: October 2022

(Abstracted from Int J Gynecol Cancer 2022;32:913–917)
Disease recurrence is commonly seen in ovarian cancer despite optimal treatment, with approximately 80% of those with advanced-stage disease experiencing recurrence. Because of this concerning recurrence rate, surveillance, including screening for symptoms, physical examination, serum CA-125 level, and imaging are commonly used by gynecologic oncologists.
Effect of a Novel Mindfulness Curriculum on Burnout During Pediatric Internship: A Cluster Randomized Clinical Trial
Authors: Fraiman Yarden S. , Cheston Christine C. , Cabral Howard J. , Allen Celeste , Asnes Andrea G. , Barrett Jefferson T. , Batra Maneesh , Bernstein William , Bleeker Tammy , Dietz Pam M. , Lewis Joanna , Li Su-Ting T. , Ma T. Marsha , Mahan John D. , Michelson Catherine D. , Poynter Sue E. , Vining Mark A. , Watson Katherine , Sox Colin M. 
Published: October 2022

(Abstracted from JAMA Pediatr 2022;176:365–372)
Burnout, or the combination of emotional exhaustion (EE), depersonalization, and feelings of helplessness, has an adverse impact on providers and patients across the health system. It has been reported that burnout affects between 39% and 75% of pediatric interns.
Fibromyalgia in women: association of inflammatory plasma proteins, muscle blood flow, and metabolism with body mass index and pain characteristics
Authors: Ghafouri Bijar , Edman Emelie , Löf Marie , Lund Eva , Leinhard Olof Dahlqvist , Lundberg Peter , Forsgren Mikael Fredrik , Gerdle Björn , Dong Huan-Ji 
Published: October 2022

Abstract

Introduction:
Obesity is a common comorbidity in fibromyalgia (FM). Both FM and obesity have been connected to low-grade inflammation, although it is possible that previously reported inflammatory alterations in FM primarily may be linked to increased body mass index (BMI).

Objective:
This study aimed to investigate whether the inflammatory plasma protein profile, muscle blood flow, and metabolism and pain characteristics (clinical parameters and patient-reported outcome measurements) differed between female patients with FM with and without obesity.

Methods:
Patients with FM underwent clinical examinations, physical tests, and answered questionnaires. They were dichotomized according to BMI (<30 kg/m2 [n = 14]; ≥30 kg/m2 [n = 13]). Blood samples were collected and analyzed using a panel of 71 inflammatory plasma proteins.

Results:
There were significant (P < 0.05) differences in blood pressure, pulse, max VO2, pain intensity, physical capacity, and Fibromyalgia Impact Questionnaire between the groups; the obese group had higher blood pressure, pulse, pain intensity, and Fibromyalgia Impact Questionnaire. There were 14 proteins that contributed to the group belonging. The 4 most important proteins for the group discrimination were MIP1β, MCP4, IL1RA, and IL6, which showed higher concentrations in obese patients with FM. Significantly decreased blood flow and increased concentration of pyruvate were detected in obese patients compared with nonobese patients. There was significant correlation between inflammatory proteins and sedentary behavior and health status in obese patients with FM.

Conclusions:
These findings suggest that metabolism and inflammation interact in female patients with FM with obesity and might cause chronic low-grade inflammation. Screening for obesity and monitoring of BMI changes should be considered in the treatment of patients with FM.
Somatoform Symptoms in Parkinson Disease
Authors: Glovinsky David , Gruber-Baldini Ann L. , Himelhoch Seth , Anderson Karen E. , Shulman Lisa M. 
Published: October 2022

Background:
Co-occurring somatoform symptoms complicate the diagnosis and treatment of Parkinson disease (PD).

Objective:
To learn more about the relationship between somatoform symptoms and PD by comparing demographic and clinical features across PD groups differing in somatoform symptom severity.

Method:
Using standardized Brief Symptom Inventory—18 (BSI–18) scores to measure somatoform symptom severity, we assigned 1093 individuals with PD to one of four subgroups using comparisons to normative means: low (M < –½ SD), average (M ± ½ SD), high (M +½ SD to +1 SD), very high (M > +1 SD). We used demographics and disease severity measures to assess each subgroup.

Results:
Most of the individuals with PD (56%) had high or very high somatoform symptom levels. Increased somatoform symptom levels were associated with female gender, lower socioeconomic status, greater disease duration, increased PD severity (Total Unified Parkinson’s Disease Rating Scale), greater disability (Older Americans Resource and Services Disability subscale), increased BSI–18 Depression and Anxiety subscale scores, lower cognitive function (Mini-Mental State Examination), lower self-efficacy scores (Self-Efficacy to Manage Chronic Disease Scale), lower quality of life scores (SF–12 Health Status Survey), and greater medical comorbidity (Cumulative Illness Rating Scale—Geriatrics) (all comparisons: P < 0.001). We found no significant between-group differences for age, race, or marital status.

Conclusion:
Somatoform symptom severity in individuals with PD is associated with greater PD severity and disability and is more common in females and in individuals with low socioeconomic status. Greater awareness of somatoform symptoms should help improve PD treatment.
After NICU Discharge: Preterm Infant Feeding and Growth Through the First Year
Authors: Fernández Cristina R. 
Published: October 2022

ABSTRACTBackgroundLittle is known about preterm infant feeding and growth in the outpatient community setting and there are no standardized post-hospital discharge feeding guidelines.ObjectiveTo describe the post-neonatal intensive care unit (NICU) discharge growth trajectories of very preterm (<32 weeks gestational age (GA)) and moderately preterm (32-34 6/7 weeks GA) infants managed by community pediatric providers and to determine the association between post-discharge feeding type and growth Z-scores and z-score changes through 12 months corrected age (CA).MethodsVery preterm infants (n=104) and moderately preterm infants (n=109) born 2010-2014 and followed in hospital-affiliated community health clinics were enrolled in a single-center retrospective cohort study. Infant home feeding type and anthropometry were abstracted from outpatient medical chart review, and repeated measures analysis of variance calculated adjusted growth z-scores and z-score differences between 4 and 12 months CA. Linear regression models tested the relationship between type of home feeding at 4 months CA and anthropometry at 12 months CA.ResultsBy 12 months CA, 5% of very preterm and 10% of moderately preterm infants were overweight. Moderately preterm infants on nutrient-enriched vs. standard term feeds had lower length z-scores at 12 months CA (−0.04 vs. 0.37, P=.03). Feeding type at 4 months CA predicted 12 month CA body mass index z-scores for very preterm infants (β=-0.66(−1.28, -0.04)).ConclusionCommunity pediatric providers may manage preterm infant post-NICU discharge feeding in the context of growth. Further research is needed to explore modifiable drivers of obesity risk in preterm infants to optimize infant development.
Effectiveness and duration of a second COVID-19 vaccine booster
Authors: Jara Alejandro , Cuadrado Cristobal , Undurraga Eduardo A. , García Christian , Nájera Manuel , Bertoglia María Paz , Vergara Verónica , Fernández Jorge , Garcia Heriberto , Araos Rafael 
Published: October 2022

AbstractUsing a prospective national cohort of 3.75 million individuals aged 20 or older, we evaluated the effectiveness against COVID-19 related ICU admissions and death of mRNA-based second vaccine boosters for four different three-dose background regimes: BNT162b2 primary series plus a homologous booster, and CoronaVac primary series plus an mRNA booster, a homologous booster, and a ChAdOx-1 booster. We estimated the vaccine effectiveness weekly from February 14 to August 15, 2022, by estimating hazard ratios of immunization over non-vaccination, accounting for relevant confounders. The overall adjusted effectiveness of a second mRNA booster shot was 88.2% (95%CI, 86.2-89.9) and 90.5% (95%CI 89.4-91.4) against ICU admissions and death, respectively. Vaccine effectiveness showed a mild decrease for all regimens and outcomes, probably associated with the introduction of BA.4 and BA.5 Omicron sub-lineages and immunity waning. The duration of effectiveness suggests that no additional boosters are needed six months following a second booster shot.
Interpretable deep learning architectures for improving drug response prediction performance: myth or reality?
Authors: Li Yihui , Hostallero David Earl , Emad Amin 
Published: October 2022

AbstractMotivation: Recent advances in deep learning model development have enabled more accurate prediction of drug response in cancer. However, the black-box nature of these models still remains a hurdle in their adoption for precision cancer medicine. Recent efforts have focused on making these models interpretable by incorporating signaling pathway information in model architecture. While these models improve interpretability, it is unclear whether this higher interpretability comes at the cost of less accurate predictions, or a prediction improvement can also be obtained. Results: In this study, we comprehensively and systematically assessed four state-of-the-art interpretable models developed for drug response prediction to answer this question using three pathway collections. Our results showed that models that explicitly incorporate pathway information in the form of a latent layer perform worse compared to models that incorporate this information implicitly. Moreover, in most evaluation setups the best performance is achieved using a simple black-box model. In addition, replacing the signaling pathways with randomly generated pathways shows a comparable performance for the majority of these interpretable models. Our results suggest that new interpretable models are necessary to improve the drug response prediction performance. In addition, the current study provides different baseline models and evaluation setups necessary for such new models to demonstrate their superior prediction performance. Availability and Implementation: Implementation of all methods are provided inhttps://github.com/Emad-COMBINE-lab/InterpretableAI_for_DRP. Generated uniform datasets are inhttps://zenodo.org/record/7101665#.YzS79HbMKUk. Contact:amin.emad@mcgill.caSupplementary Information: Online-only supplementary data is available at the journal’s website.