bluuebunny/crossref_metadata_2025_split huggingface dataset:
RISK OF EXUDATIVE AGE-RELATED MACULAR DEGENERATION IN PATIENTS WITH CENTRAL SEROUS CHORIORETINOPATHY
Authors: Lee Ju-Yeun , Bae Kunho 
Published: January 2022

Abstract

Purpose:
To estimate the risk of incident age-related macular degeneration (AMD) in patients with central serous chorioretinopathy (CSC).

Methods:
This population-based cohort study was finally conducted from January 2015 to December 2019. All patients with CSC from the entire population aged between 30 and 80 years were included. The incidence of CSC was estimated. Log-rank analysis and Cox proportional hazards regression analysis was used to evaluate the risk of exudative AMD in the CSC group compared with the non-CSC group.

Results:
During a recent 5-year study period, 36,053 patients were identified as having incident CSC. The annual incidence in the latest year was 19.61 (95% confidence interval, 19.58 to 19.63) per 100,000 people. A total of 11,492 patients were included in the study group and 22,984 in the non-CSC group. The CSC and non-CSC groups included 166 (1.44%) and 73 (0.32%) cases of exudative AMD, respectively. The risk of exudative AMD was significantly higher in the CSC group than in the non-CSC group (adjusted hazard ratio: 4.86; 95% confidence interval: 2.98 to 5.88; P < 0.001).

Conclusion:
This study showed that subjects with CSC are at an increased risk of exudative AMD. This evidence supports a possible link between CSC and exudative AMD, particularly in Asian populations.
THREE-DIMENSIONAL HEAD-UP DISPLAY VERSUS STANDARD OPERATING MICROSCOPE FOR VITRECTOMY SURGERY
Authors: Wang Yuelin , Zhao Xinyu , Zhang Wenfei , Yang Jingyuan , Chen Youxin 
Published: January 2022

Purpose:
To evaluate the effects of vitrectomy with three-dimensional head-up display (3D HUD) versus standard operating microscopy (SOM) for retinal diseases.

Methods:
The PubMed, Cochrane Library, and Embase databases were comprehensively searched to identify studies that compared 3D HUD versus SOM in vitrectomy for retinal diseases (PROSPERO protocol CRD42021265827). The primary outcomes are duration of surgical time, postoperative best-corrected visual acuity, endoillumination levels, and intraoperative complications. The secondary outcomes are reattachment rate of rhegmatogenous retinal detachment, macular hole closure rate, and the like.

Results:
Fifteen studies of 2,889 eyes were included. Compared with SOM, 3D HUD vitrectomy took a longer surgical time (weighted mean difference = 1.48; 95% confidence interval, 0.13–2.82), but it needed lower endoillumination levels (weighted mean difference = −16.04, 95% confidence interval, −18.33 to −13.75) than SOM. There were no significant differences in the postoperative best-corrected visual acuity, intraoperative complications, reattachment rate of rhegmatogenous retinal detachment, or closure rate of macular hole.

Conclusion:
Our results suggested that 3D HUD provides lower retinal illumine toxicities but with a longer surgical time. The surgical results and complications of vitrectomy were equally comparable for 3D HUD and SOM.
The Rational Combination Strategy of Immunomodulatory Latency Reversing Agents and Novel Immunotherapy to Achieve HIV-1 Cure
Authors: Li Yangyang , Hong Junxian , Zhang Linqi 
Published: January 2022

Abstract
Human immunodeficiency virus (HIV)-1 infection creates a persistent latent reservoir even after antiretroviral therapy, which is the main barrier to HIV cure. One of the most explored strategies is the use of latent reversal agents (LRAs) to activate HIV latent reservoirs, followed by immunotherapy to remove infected cells. Immunomodulatory LRAs have the dual advantage of activating viral latency and promoting immune cell elimination of HIV-infected cells. The emergence of novel immunotherapies has also enhanced the possibility of HIV clearance. Here we review the activity and potential mechanisms of immunomodulatory agonists and immunotherapies. The possible combinational strategies to achieve HIV functional cure and the problems encountered using this approach are discussed.
Plasma Metagenomic Sequencing Expedites Diagnosis of Disseminated BCG in an Infant With IKBKB Mutation
Authors: Taylor Margaret G. , Nicholas Sarah K. , Forbes Satter Lisa R. , Martinez Caridad , Cameron Lindsay H. 
Published: January 2022

Background:
Infants with inborn errors of immunity (IEI), born in countries where Bacillus-Calmette-Guerin (BCG) vaccination is recommended at birth, are at risk of developing infectious complications following vaccination. A prompt diagnosis of disseminated BCG infection in these infants is essential, as many will require stem cell transplantation (SCT) for the immunologic cure. In patients with IEI, the mortality risk from disseminated mycobacterial infection is high, both before and following SCT.

Methods:
A 7-month-old Qatari infant with an IEI, homozygous IKBKB gene mutation, was evaluated at our institution for SCT. He had a history of recurrent pneumonias, but pretransplant evaluation revealed negative cultures from bronchoalveolar fluid, blood and urine. At 8 months of age, the infant developed skin nodules of unclear etiology, prompting additional evaluation.

Results:
Given his profound immunosuppression and receipt of broad-spectrum antimicrobials, plasma metagenomic next-generation sequencing (mNGS) was obtained and identified Mycobacterium tuberculosis complex within 72 hours. A skin biopsy was performed, and antimycobacterial therapy was initiated. Mycobacterium bovis-BCG was confirmed from cultures 3 weeks later. Treatment was complicated by elevated serum liver transaminases and aminoglycoside-associated high-frequency hearing loss. The infant completed 14 months of treatment from engraftment. Evaluation for active BCG infection after SCT was negative.

Conclusion:
In an infant with a unique IEI, plasma mNGS provided the first diagnosis of disseminated BCG infection. We believe that early initiation of antimycobacterial treatment improved the infant’s clinical outcome. Plasma mNGS testing should be considered as a noninvasive screen for infectious pathogens in children with IEIs before SCT.
Attitudes Towards Mental Health Among Physician Assistant Students with Shared Living Experiences Through Synchronous Videoconferencing
Authors: Neary Stephanie , Ruggeri Mary , Roman Christopher , Kamauf Renée , Chilton Julie , Martin Andrés 
Published: January 2022

Purpose
We tested the hypothesis that physician assistant (PA) students can benefit from exposure to senior PAs who share their living experiences with mental illness.

Methods
First-year students from 5 PA programs were asked to participate in this mixed methods study. After completing a pre-activity survey, students from 3 programs participated in an intervention consisting of senior PA faculty sharing their mental health experiences, including treatment and recovery. A facilitated discussion followed, and students not exposed to the intervention served as controls. The qualitative component of the study was based on transcripts from 3 focus groups of students in the exposed group.

Results
We recruited 167 students from 5 PA training programs, 112 of whom (67%) completed baseline and endpoint assessments (37 in the exposed group, 75 in the control). The intervention resulted in significant improvements on the Opening Minds to Stigma (OMS-HC, p = 0.002, Cohen's d = 0.38) and Self-Stigma of Seeking Help (SSOSH, p = 0.006, d = 0.31) scales. Change in the OMS-HC was driven by its social distance (p = 0.003) and disclosure (p = 0.02) subscales. No comparable changes were found in the control group. We identified 3 overarching themes: 1) active elements of the intervention; 2) mutuality; and 3) peer relationships.

Conclusions
Senior PAs sharing their lived experiences with mental illness proved to be an effective anti-stigma intervention for PA students. A candid, intimate, and confidential virtual learning space was feasible through synchronized videoconferencing. Our findings can inform programmatic interventions to address stigma, self-stigma, help-seeking behaviors, and the overall mental health of PA students.
Nurse practitioners as primary care site champions for the screening and treatment of hepatitis C virus
Authors: Dale Cheryl H. , Smith Elizabeth , Biondi Mia J. 
Published: January 2022

ABSTRACT

Background:
Primary care providers are often the first point of contact for hepatitis C virus (HCV) care, yet treatment initiation in primary care continues to be low. Nurse practitioners (NPs) are autonomous providers who, in Ontario, currently prescribe HCV therapy; however, methods to engage primary care NPs in HCV care have not occurred.

Purpose:
To assess the feasibility of a systematic approach to train and support NPs in HCV testing, care, and treatment.

Methodology:
Nurse practitioners from Canada's largest family health team (FHT) were recruited. Nurse practitioners received six hours of training and develop approaches to screen and treat at FHT sites. Treatment algorithms were given, and the number and types of inquiries from NPs were recorded.

Results:
Over 1 year, 9 NPs screened 1,026 patients; 87.4% were screened based on the identification of a risk factor. A mail-out approach for birth cohort screening occurred at a single site, resulting in rapid uptake in screening. Antibody prevalence was 1.66%, with 76.5% RNA positivity. All RNA-positive treatment-eligible individuals were treated by an NP and completed treatment. Thirty-eight consults occurred over 1 year, the majority related to HCV or liver disease staging.

Conclusions:
Formalized initiatives to engage and educate NPs lead to innovative strategies to test for HCV. Nurse practitioners can safely and effectively treat HCV in primary care with minimal support.

Implications:
This work could be extrapolated to NPs in other primary care settings. Implementing formalized strategies has the potential to create NP leaders in the treatment and elimination of HCV in Ontario, Canada, and globally.
Optimizing oxygen delivery to the injured brain
Authors: Taran Shaurya , Pelosi Paolo , Robba Chiara 
Published: January 2022

Purpose of review
The principle of optimizing oxygen delivery to the injured brain rests on the premise that both hypoxia and hyperoxia are important mediators of secondary brain injury and should be avoided. This rationale has prompted a move towards incorporating oxygenation endpoints into the management of neurocritical care patients, particularly those with traumatic brain injury. The present review will seek to describe clinical strategies to optimize oxygenation in the acutely brain-injured patient, drawing upon relevant physiologic principles and clinical data, where it exists.

Recent findings
A phase II randomized trial found that a protocolized approach to improving oxygen delivery resulted in less duration of brain hypoxia and a trend towards lower mortality among patients with severe traumatic brain injury. Recent clinical protocols have been published to guide oxygen delivery based on core physiologic principles: increasing oxygen supply via modulation of mean arterial pressure and intracranial pressure, blood oxygen carrying capacity, and cerebral vasoreactivity; and decreasing oxygen demand via sedation, pharmacologic coma, and hypothermia.

Summary
Although there is growing interest in the use of brain tissue oxygenation as a resuscitative endpoint, many of these therapies are based on physiologic principles with little robust clinical evidence to guide their application. Clinicians must be mindful of this and balance the putative benefits of improving oxygenation against the risks associated with the use of such therapies.
The liver-gut-axis: initiator and responder to sepsis
Authors: Bauer Michael 
Published: January 2022

Purpose of review
The ‘gut-liver axis’ is thought to play an important role in pathogenesis of sepsis. Despite a wealth of experimental data to support the concept of reciprocal crosstalk between gut and liver through bacterial translocation and shaping of the microbiome by liver-derived molecules, for example bile acids, clinical data, and in particular diagnostic and therapeutic options, are limited.

Recent findings
Assessment of organ failure in the current definition of sepsis is operationalized by means of the Sequential Organ Failure Assessment (SOFA) score, including exclusively bilirubin to reflect the complex functions of the liver but ignoring the gut. However, our understanding of the intestinal microbiome and how it is affected by critical illness has clearly improved. Microbiota maintain gut-barrier function and modulate the innate and adaptive immune system. The best-defined intervention affecting the gut microbiome, that is selective decontamination of the digestive tract (SDD) is clinically studied regarding prevention of nosocomial lung infection and antibiotic resistance patterns, although its impact on liver function has not been systematically evaluated in critical illness.

Summary
Characterization of liver function beyond bilirubin and the microbiome can be achieved with contemporary sequencing and metabolomic techniques. Such studies are essential to understand how gut-liver crosstalk and ‘dysbiosis’ affect susceptibility to and outcome of sepsis.
Enteroendocrine cell differentiation and function in the intestine
Authors: Sanchez J. Guillermo , Enriquez Jacob R. , Wells James M. 
Published: January 2022

Purpose of review
The intestinal enteroendocrine cells (EECs) are specialized hormone-secreting cells that respond to both circulating and luminal cues. Collectively, EECs constitute the largest endocrine organ of the body and signal to a multitude of targets including locally to neighboring intestinal cells, enteric neurons, as well as systemically to other organs, such as the pancreas and brain. To accomplish their wide range of downstream signaling effects, EECs secrete multiple hormones; however, the mechanisms that influence EEC development in the embryo and differentiation in adults are not well defined.

Recent findings
This review highlights the recent discoveries in EEC differentiation and function while also discussing newly revealed roles of transcription factors and signaling networks involved in the allocation of EEC subtypes that were discovered using a combination of novel intestinal model systems and genetic sequencing. We also discuss the potential of these new experimental models that study the mechanisms regulating EEC function and development both to uncover novel therapeutic targets.

Summary
Several EEC hormones are being used to treat various metabolic disorders, such as type 2 diabetes and obesity. Therefore, understanding the signaling pathways and gene regulatory networks that facilitate EEC formation is paramount to the development of novel therapies.
The Role of Financial Security on Physical and Mental Health in Young-Midlife Couples Surviving Cancer
Authors: Lyons Karen S. , Firkins Jenny , Hanan Diana M. , Hansen Lissi , Hayes-Lattin Brandon 
Published: January 2022

Background
A cancer diagnosis carries a significant economic burden. Yet little is known about perceived financial security on the health of couples with a partner diagnosed with cancer.

Objective
The current study explored perceived financial security in young-midlife couples.

Methods
The study included 49 couples (aged 27-58 years) 1 to 3 years after diagnosis. Multilevel modeling was used to examine the association of perceived financial security on physical and mental health of couples controlling for interdependent data; hierarchical linear regression was used to examine perceived financial security on survivor symptoms and partner care strain.

Results
Mean age of survivors was 43.5 (±9.0) years. Most survivors were female (69%) and 2.2 (±0.6) years after diagnosis. Lower levels of perceived financial security were significantly associated with poorer physical (P < .001) and mental (P < .05) health status for survivors, controlling for age, sex, education, and years since diagnosis; there were no significant associations with partner health status. Lower levels of perceived financial security were significantly associated with higher survivor pain severity (P < .001), pain interference (P < .001), and fatigue (P < .01); there was no significant association with partner care strain.

Conclusions
Financial security plays a role on the physical and mental health of couples after diagnosis.

Implications for Practice
Screening for financial hardship at diagnosis and posttreatment can identify couples at high risk and in need of additional resources and counseling. Greater assessment and reporting of financial security in studies of families surviving cancer are needed to understand the impact on health outcomes.
Patients’ Perceptions at Diagnosis: Lung Cancer Discovery and Provider Relationships
Authors: Somayaji Darryl , Mohedat Heba , Dean Grace E. , Dickerson Suzanne S. 
Published: January 2022

Background
In the United States, most lung cancer cases are diagnosed at advanced stages, limiting treatment options and impacting survival. This study presents patients’ perspectives on the complexity of factors influencing a lung cancer diagnosis. Lung cancer awareness regarding risks, symptoms, smoking behaviors, family history, and environmental factors can lead to preventative and early detection measures.

Objective
The aim of this study was to explore lung cancer patient perspectives on lung cancer awareness within the context of an earlier study to understand sleep-wake disturbances in adults with non–small cell lung cancer.

Methods
A content analysis was used to analyze the original deidentified longitudinal interview data collected from 26 patients diagnosed with lung cancer.

Results
Of the original 26 participants, 16 were included in this secondary data analysis. The participants were primarily females (n = 10) and Whites (n = 13), with ages ranging between 49 and 83 years. Half of the sample was diagnosed with stage IV lung cancer and most of the sample was on chemotherapy (n = 10). Two key themes were identified: the lung cancer discovery and the patient-physician relationship.

Conclusions
Unspecific initial symptoms, lack of knowledge and screening, as well as fear of the diagnosis delayed seeking medical care. Patient-physician relationships were hindered by smoking-associated stigma, inadequate sharing of information, and lack of coordinated, holistic care. Positive communication strategies are critical between patients and providers to meet patients’ specific needs.

Implications for Practice
Educational interventions that enhance lung cancer awareness may improve prevention and screening actions, improve timely healthcare intervention, and reduce incidence and mortality.
The Impact of Body Mass Index Classification on Outcomes After Stroke Rehabilitation
Authors: Weidman Melissa , MacDonald Shannon L. 
Published: January 2022

Abstract
With improving stroke mortality rates, more individuals are living with the consequences of stroke. Obesity is a known risk factor for stroke, but its effect on functional outcomes poststroke is less clear. The aim of this study was to determine the association between body mass index classification (underweight, normal weight, overweight, and obese) and functional outcomes, as measured by Functional Independence Measure change, Functional Independence Measure efficiency, and rehabilitation length of stay after inpatient stroke rehabilitation. A retrospective cohort study of individuals with a diagnosis of stroke admitted to a high-intensity inpatient rehabilitation program was performed. Patients were divided into 4 groups based on body mass index category using normal body mass index as the reference. Overall, 34 individuals (4.5%) were classified as underweight, 303 (40.1%) had body mass indices within the normal range, 269 (35.6%) were overweight, and 149 (19.7%) were obese. Ischemic stroke was the most common stroke type across all body mass index categories. Patients in the overweight and obese groups tended to be younger. There were no statistically significant differences in rehabilitation length of stay, Functional Independence Measure change, or Functional Independence Measure efficiency with all groups demonstrating significant functional improvements. Based on these findings, patients admitted for inpatient rehabilitation after stroke can be expected to make similar functional improvements regardless of BMI class.
Congenital Facial Paralysis Revealing an Aplasic Facial Nerve
Authors: Tomé Sónia , Matos Joana , Barreto José , Carvalho João , Leal Joana , Aguiar Branco Catarina 
Published: January 2022

Abstract
Congenital facial palsy is a rare condition, usually related to a traumatic event during birth or as a feature of a syndrome. In this report, two cases of infants with peripheral facial palsy since birth are described, in which magnetic resonance imaging demonstrated unilateral aplasia of the facial nerve. There are only a few cases with similar findings described in the literature. A multidisciplinary approach is recommended to provide the best care. Although no reinnervation of the facial muscles is likely to occur, rehabilitative therapies may be valuable as complementary treatments.
Psychosocial Intervention in Chronic Obstructive Pulmonary Disease: Meta-Analysis of Randomized Controlled Trials
Authors: Farver-Vestergaard Ingeborg , Danielsen Josefine Tingdal Taube , Løkke Anders , Zachariae Robert 
Published: January 2022

ABSTRACT

Objective
Many patients with chronic obstructive pulmonary disease (COPD) experience persistent interrelated psychological and physical symptoms despite optimal treatment. Several studies of psychosocial intervention in COPD have been published in recent years. The present study aimed to conduct a quantitative summary of the efficacy of such interventions on psychological and physical outcomes.

Methods
Two independent raters screened PubMed, PsycINFO, Embase, Web of Science, Cochrane Library, and CINAHL for eligible studies. In all, 35 independent, randomized controlled trials with a total of 3,120 patients with COPD were included, assessed for their methodological quality, and subjected to meta-analytic evaluation.

Results
Meta-analyses revealed small, statistically significant effects of psychosocial intervention on combined psychological (Hedges’s g = 0.28; 95%CI: 0.16–0.41) and physical outcomes (g = 0.21; 95%CI: 0.07–0.35) with no indications of publication bias. Supplementary Bayesian meta-analyses provided strong evidence for a non-zero overall effect on psychological outcomes (Bayes factor (BF) = 305) and moderate support for physical outcomes (BF = 6.1). Exploring sources of heterogeneity with meta-regression indicated that older age of patients and longer duration of interventions were associated with smaller effects on psychological outcomes.

Conclusions
The results support psychosocial intervention as an additional, useful tool in multidisciplinary respiratory care with the potential to improve both psychological and physical outcomes. Future studies are recommended to monitor adverse effects, apply blinding of active control conditions, and determine sample sizes with a priori power calculations.

Registration
Registered with Prospero (www.crd.york.ac.uk/prospero/) prior to initiation of the literature search (Reg. ID: CRD42020170083).