bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Keratoplasty Procedures During 2 Decades in a Major Tertiary Referral Center in Finland: 1995 to 2015
Authors: Ala-Fossi Olli , Krootila Kari , Kivelä Tero T. 
Published: January 2022

Purpose:
The purpose of this study was to analyze trends in number, age-adjusted frequency, and type of keratoplasty in a major tertiary referral center, relative to patient and graft characteristics.

Methods:
A retrospective registry study of 1574 patients who in 1995 to 2015 underwent keratoplasty in the Helsinki University Eye Hospital (HUEH). Graft type and sequence, patient characteristics, and date of surgery were recorded. Main outcome measures were annual number, type, and age-adjusted frequency of keratoplasty; patient and graft characteristics; graft procurement; and national population-adjusted frequency of keratoplasty.

Results:
In HUEH, from 1995 to 2015, a total of 2191 keratoplasties were performed with 48% of the grafts procured intramurally; 76% were primary and 24% regrafts. The age-adjusted frequency of primary penetrating keratoplasty decreased by 52% from 0.96 to 0.46 per 100,000. The corresponding frequency of primary Descemet stripping automated endothelial keratoplasty increased by 367% from 0.3 to 1.4 after 2006, finally accounting for 68% of primary grafts. Men underwent primary penetrating keratoplasty (median 48 vs. 67 yrs, P = 0.0001) and anterior lamellar keratoplasty (median 37 vs. 46 yrs, P = 0.0015) at a younger age than women. Interval to the first regraft was comparable between sexes (median 2.2 vs. 1.9 yrs, respectively, P = 0.17). The national median population-adjusted frequency of keratoplasties was 3.2 per 100,000 from 2009 to 2015, and HUEH accounted for a median of 69% of them.

Conclusions:
The increased frequency of keratoplasty in HUEH resulted from rapid adoption of Descemet stripping automated endothelial keratoplasty after 2006 and was facilitated by centralizing graft procurement to HUEH and the National Cell and Tissue Center Regea.
Recurrence of Varicella-Zoster Virus Keratitis After SARS-CoV-2 Vaccination
Authors: Ryu Kyung Jae , Kim Dong Hyun 
Published: January 2022

Purpose:
The purpose of this study was to report a case of acute exacerbation in varicella-zoster virus (VZV) keratitis after SARS-CoV-2 vaccination.

Methods:
An 87-year-old man, with a history of herpes zoster ophthalmicus 10 years ago, was referred for sudden visual impairment in his left eye that started 2 days after his second dose of SARS-CoV-2 mRNA vaccine BNT162b2.

Results:
At presentation, his visual acuity was hand motion. Slitlamp examination revealed diffuse corneal stromal edema and nasal stromal infiltration. After treatment for 2 weeks with oral valacyclovir and topical corticosteroids, the problematic lesion was recovered and his visual acuity was restored to 20/30.

Conclusions:
We believe that this is the first report of possible association between recurrence of VZV keratitis and SARS-CoV-2 vaccination. We believe that T-cell activation by the host response after vaccination may affect the recurrence of VZV keratitis. Physicians should be aware of the potential of recurrence of VZV keratitis associated with the SARS-CoV-2 messenger RNA vaccine.
A Case of Nonclostridial Gas-Producing Soft Tissue Infection in a Neutropenic Leukemia Patient With Literature Review
Authors: Segarra Chanlir , Sampson Mindy , Pla Fernandez Carlos A. , Nanjappa Sowmya , Greene John N. 
Published: January 2022

Abstract
Gas-producing soft tissue infections have been historically attributed to clostridial species; however, organisms in both the Enterobacteriaceae family as well as certain Gram-positive organisms have also been identified as causative organisms. Soft tissue infections are known to progress with an aggressive course, one that often necessitates urgent surgical debridement, amputation, and a prolonged course of antibiotics. If treatment measures are delayed, the clinical course can progress rapidly leading to life-threatening situations. Patients with significant medical comorbidities, such as those with cancer and its associated immunosuppression due to neutropenia and chemotherapy, are at the highest risk for these life-threatening complications. Here we present a case of a 26-year-old patient with relapsed acute lymphocytic leukemia complicated by neutropenia and a right upper extremity gas-forming infection due to Escherichia coli and discuss the gas-producing soft tissue infections other than Clostridia.
Bamlanivimab for the Prevention of Hospitalizations and Emergency Department Visits in SARS-CoV-2–Positive Patients in a Regional Health Care System
Authors: Priest David H. , Blanchette Lisa M. , Hekman Aliza L. , Maddikunta Rahul , Burleson Paula E. 
Published: January 2022

Introduction
Bamlanivimab (LY-CoV555) was approved by Emergency Use Authorization by the United States Food and Drug Administration in the ambulatory setting to prevent hospitalizations and emergency department visits. We report a retrospective, case-control study of bamlanivimab use in a regional health care system.

Methods
A retrospective case-control study for SARS-CoV-2–positive patients receiving bamlanivimab and matched controls between October 2020 and March 2021 was performed. End points included all-cause hospitalization, emergency department visits, and mortality.

Results
No statistically significant difference was noted in all-cause hospitalization, emergency department visits, or mortality, including patients 65 years or older, body mass index of 35 or higher, diagnosis of diabetes mellitus, or cancer (high-risk patients). No difference was seen based on timing of bamlanivimab infusion relative to symptom onset or timing of infusion within the study period.

Conclusions
Based on the evaluated endpoints, there was no benefit from bamlanivimab, regardless of when it was received in a patient's clinical course or when during the study period it was received. A lack of efficacy of monoclonal antibodies in patients infected with COVID-19 variants has been noted, but the impact of local variants on these results could not be assessed given a lack of available variant diagnostic tools. These findings do not support bamlanivimab for the prevention of hospitalization or emergency department visits for patients with mild to moderate SARS-CoV-2 infection.
The Association Between Organizational Justice and Health-Related Productivity Loss Among Korean Employees
Authors: Park Hanul , Lee Dong-Wook , Lee June-Hee , Cho Seong-Sik , Kim Hyoung-Ryoul , Kang Mo-Yeol 
Published: January 2022

Objectives:
To investigate the association between organizational justice (OJ) and health-related productivity loss (HRPL) among Korean employees.

Methods:
From January 6, 2020 to February 18, 2020, data were collected using a web-based questionnaire. This study measured HRPL using the Work Productivity and Activity Impairment Questionnaire: General Health version. Procedural and interactional justice were measured using the Korean organizational justice questionnaire. Generalized linear models were used for estimating productivity loss based on tertiles of OJ levels, while the productivity loss of employees in low OJ categories was used as a reference group.

Results:
The nonparametric associations between the OJ levels and the overall HRPL level were observed. High levels of OJ significantly reduced HRPL.

Conclusions:
Our results support the hypothesis that high OJ is associated with improved labor productivity.
Updated Standardized Mortality Ratio Evaluation of Disease Risks of Shipyard Workers Exposed to Low Dose Ionizing Radiation
Authors: Tao Xuguang (Grant) , Curriero Frank C. , Chee Elsbeth M. , Mahesh Mahadevappa 
Published: January 2022

Objective:
: To examine the risk of diseases among industrial workers with low and fractionated radiation exposures.

Method:
The 372,047 US male shipyard radiation and non-radiation workers were followed for 54 years and compared with US men using standardized mortality ratio (SMR) method.

Results:
: SMRs for both radiation and non-radiation workers had lower risks of death from all causes (0.74; 95% confidence interval [CI] 0.74 to 0.75 and 0.77; 95% Cl 0.77 to 0.78, respectively) and from all cancers (0.92; 95% CI 0.91 to 0.93 and 0.90; 95% CI 0.89 to 0.91, respectively) compared with US men. Asbestos-related diseases including pleural cancers, mesothelioma, and asbestosis, but not lung cancers, were statistically higher in both radiation and non-radiation workers compared with the US men.

Conclusion:
: US shipyard male radiation and non-radiation workers did not show any elevated mortality risks that might be associated with radiation exposure.
Obesity Among Industrial Workers in Brazil
Authors: Xavier Paula Brustolin , Garcez Anderson , Silva Janaína Cristina da , Cibeira Gabriela Herrmann , Germano Antonino , Olinto Maria Teresa Anselmo 
Published: January 2022

Objective:Estimate the prevalence of obesity and its associated factors among industrial workers.Methods:This is a cross-sectional study of secondary data from workers aged 18 to 59 years in the State of Rio Grande do Sul, Brazil.Results:A total of 20,820 workers (12,372 men and 8448 women) were investigated. The overall prevalence of obesity was 14.6% (95% CI [confidence interval]: 14.2 to 15.1), 16.4% (95% CI: 15.6 to 17.2) among women and 13.5% (95% ci: 12.9 to 14.1) among men. After adjusting, obesity was significantly associated with increasing age, living with a partner, lower education, and ex-smoking status in both sexes. However, it was associated with lower income in women, and higher income and physical inactivity in men.Conclusions:Obesity was prevalent among Brazilian industrial workers and sociodemographic characteristics are important factors related to obesity.
Economic Costs of Pain in the Spanish Working Population
Authors: Sarria-Santamera Antonio , Kuntuganova Anargul , Alonso Marcos 
Published: January 2022

Objective:
The objective of this paper is to provide an overview of the epidemiology of pain in the Spanish working population and to investigate the incremental costs of the different levels of pain on medical costs and productivity losses.

Methods:
This is a cross-sectional study of costs of pain in the Spanish working population from a societal perspective using data from a national representative survey.

Results:
Data from the 9919 respondents were analyzed. The prevalence of reported pain was 38.5%: 21.9% mild or very mild; 11.5% moderate; 5.1% severe or extreme. Increased self-reported pain was independently associated with significant increases in direct and indirect costs. Those reporting severe or extreme pain showed excess annual costs of €5118.97 per case, being 85% indirect costs.

Conclusions:
Spain is paying a heavy price for the high prevalence of pain in its working population.
Understanding Public Perceptions Regarding Cochlear Implant Surgery in Adults
Authors: Zhang Lisa , Ding Andy S. , Xie Deborah X. , Creighton Francis X. 
Published: January 2022

Background and Objective:
Approximately 6% of adults eligible for cochlear implantation (CI) undergo surgery. This study aims to understand how general perceptions about CI contribute to barriers causing this low utilization rate.

Methods:
Participants completed an online survey regarding their perceptions about cochlear implantation. They were asked to rank CIQOL-10 Global priorities and corresponding risk tolerance for minor complications (changes in taste, vertigo) and major complications (infections requiring hospitalization, meningitis, reimplantation, facial paralysis, and cerebrospinal fluid [CSF] leak).

Results:
A total of 615 responses (female 55%, mean age 39 years [range 20–78]) were included. Respondents identified issues with insurance (46%) and fear of undergoing surgery (21%) as barriers preventing eligible adults from receiving CI. Regarding surgical risk, respondents significantly underestimated rates of minor complications (p < 0.0001) and almost all major complications (all p < 0.0001) while overestimating rates of serious infections and need for reimplantation (both p < 0.005). The ability to hear strangers in noisy environments was identified as the highest priority for CI (26%). Individuals who knew someone with a cochlear implantation were willing to tolerate higher rates of all minor and major complications (all p < 0.05). Healthcare workers were similarly willing to tolerate significantly higher rates of meningitis, facial paralysis, and CSF leak to achieve their highest priority (all p < 0.05).

Conclusions:
Respondents identify insurance coverage and fear of surgery as primary reasons for low utilization of adult CI in the United States. However, healthcare workers or those who knew someone with a cochlear implantation indicated significantly higher rates of risk tolerance to achieve their highest quality of life priorities, indicating the potential that the benefits of cochlear implantation are underappreciated in the general population.
The pulmonary microbiome: recent advances in understanding its role in chronic lung allograft dysfunction
Authors: Mitchell Alicia B. , Glanville Allan R. 
Published: January 2022

Purpose of review
Lung transplantation presents a rescue therapy for those with end-stage lung disease. Survival in lung transplant patients remains limited due to chronic lung allograft dysfunction (CLAD), a range of pathologic manifestations leading to graft loss. The mechanisms underlying CLAD remain poorly understood, and the lung microbiome has been suggested as a potential contributor to this condition. This review aims to explore how the pulmonary microbiome is impacted by lung transplantation, and how alterations in this microbiome may contribute to the pathogenesis of CLAD.

Recent findings
The pulmonary microbiome is made up of a range of microorganisms, and it varies considerably in lung transplant patients when compared with healthy controls. The lung microbiome changes over the early transplant period, and the composition of species appears to have an impact on inflammatory responses within the lungs. A number of studies have shown that an increase in bacterial biomass in the allograft, and enrichment with the genera Proteobacteria, or more specifically, Pseudomonas species, is associated with CLAD.

Summary
This area of research is still in its infancy; however, the suggestion that changes in the composition of the microbiome and enrichment with certain species may predispose to the pathologic changes that underlie CLAD indicate that modulation of the microbiome may be of use in potential future therapeutics.
Short cephalomedullary nail toggle: a closer examination
Authors: George Albert V. , Bober Kamil , Eller Erik B. , Hakeos William M. , Hoegler Joseph , Jawad Ali H. , Guthrie S. Trent 
Published: January 2022

Abstract

Objectives:
In patients with wide femoral canals, an undersized short nail may not provide adequate stability, leading to toggling of the nail around the distal interlocking screw and subsequent loss of reduction. The purpose of this study was to identify risk factors associated with nail toggle and to examine whether increased nail toggle is associated with increased varus collapse.

Design:
Retrospective cohort study.

Setting:
Level 1 and level 3 trauma center.

Patients/Participants:
Seventy-one patients with intertrochanteric femur fractures treated with short cephalomedullary nails (CMN) from October 2013 to December 2017.

Intervention:
Short CMN.

Main Outcome Measurements:
Nail toggle and varus collapse were measured on intraoperative and final follow-up radiographs. Risk factors for nail toggle including demographics, fracture classification, quality of reduction, Dorr type, nail/canal diameter ratio, lag screw engaging the lateral cortex, and tip-apex distance (TAD) were recorded.

Results:
On multivariate regression analysis, shorter TAD (P = .005) and smaller nail/canal ratio (P < .001) were associated with increased nail toggle. Seven patients (10%) sustained nail toggle >4 degrees. They had a smaller nail/canal ratio (0.54 vs 0.74, P < .001), more commonly Dorr C (57% vs 14%, P = .025), lower incidence of lag screw engaging the lateral cortex (29% vs 73%, P = .026), shorter TAD (13.4 mm vs 18.5 mm, P = .042), and greater varus collapse (6.2 degrees vs 1.3 degrees, P < .001) compared to patients with nail toggle < 4 degrees.

Conclusions:
Lower percentage nail fill of the canal and shorter TAD are risk factors for increased nail toggle in short CMNs. Increased nail toggle is associated with increased varus collapse.

Level of evidence: Therapeutic Level III
Screening for Factors Influencing Parental Psychological Vulnerability During a Child’s PICU Admission*
Authors: Woolgar Francesca A. , Wilcoxon Lucy , Pathan Nazima , Daubney Esther , White Deborah , Meiser-Stedman Richard , Colville Gillian A. 
Published: January 2022

OBJECTIVES:
To identify the risks of developing post-traumatic stress disorder (PTSD) and/or depression in parents following their child’s PICU admission using a brief screening instrument and to examine the associations with these risks.

DESIGN:
A cross-sectional parental survey.

SETTING:
A general 13-bed PICU at a large teaching hospital.

SUBJECTS:
One hundred and seven parents of 75 children admitted to the PICU.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
All parents completed the 10-item Posttraumatic Adjustment Screen (PAS) before discharge. The PAS assesses risk factors known to be associated with poorer psychological outcome, including psychosocial variables pretrauma and peritrauma, and acute stress. Parents’ scores on the PAS indicated that 64 (60%) were at risk of developing PTSD and 80 (75%) were at risk of developing depression following their child’s admission. Univariate analyses suggested that psychosocial variables, such as preexisting stressors and a history of previous mental health problems, were more strongly associated with PAS risk scores for PTSD and depression than medical or sociodemographic factors. In logistic regression analyses, a history of previous mental health problems was significantly associated with risk of developing PTSD and depression (p < 0.001) explaining 28% and 43% of the variance in these outcomes.

CONCLUSIONS:
This study suggests that a significant number of parents on PICU are potentially at risk of developing PTSD and/or depression postdischarge and that psychosocial factors, pretrauma and peritrauma, are stronger determinants of this risk, and of acute distress, than other variables. Identification of vulnerable parents during admission, using a measure such as the PAS, could facilitate the targeting of support and monitoring, acutely and postdischarge, at those who might be most likely to benefit.
Mealtime Support: A Pilot Case Series study of an Effective, Cost-saving Outpatient Hunger-Based Feeding Program for Tube Dependency
Authors: Huynh Geraldine , Vishram Alysha , Graham-Parker Carol , Blatz Debbie , Carroll Matthew , Turner Justine 
Published: January 2022

Background:
Tube feeding is essential for children who cannot meet nutritional requirements orally. Over time, this can lead to tube dependency with negative impacts on the quality of life of children and families.

Objective:
We aimed to examine the efficacy of a multidisciplinary child-led, hunger-based approach called “Mealtime Support” at the Stollery Children’s Hospital in Edmonton. Nutritional outcomes, parental satisfaction, and cost implications were evaluated over 9 months postprogram completion per child.

Methods:
The ambulatory meal program was delivered 2–3 times a day, for 2 weeks, by an occupational therapist and dietitian, under medical supervision. Hunger was promoted by reducing tube fed calories by 80% before commencement. Caregivers completed 12-question subjective surveys pre- and postintervention. Microcosting methods compared costs between the program and ongoing tube feeding.

Results:
From 2016 to 2017, 6 children were enrolled and 5 completed the program. At 1-month postintervention, 4/5 of the children were 100% orally fed. Parents reported improvement in mealtime struggles (P = 0.005), reduction in worry about their child’s eating (P = 0.005), and improvement in their child’s appetite/variety foods eaten (P = 0.004). Over 2 years, the potential cost savings were estimated at $43,471.00. By 6 months, all feeding tubes were removed.

Conclusions:
Mealtime support was safe and successful in reducing tube dependency and cost-effective compared to no intervention or hospital based programs, which suggests that there is a need to develop and fund Canadian outpatient feeding programs.
Characteristics and Frequency of Pediatric Inflammatory Bowel Disease-Associated Pancreatitis: A Japanese Nationwide Survey
Authors: Hosoi Kenji , Minowa Kei , Suzuki Mitsuyoshi , Kudo Takahiro , Ohtsuka Yoshikazu , Tomomasa Takeshi , Tajiri Hitoshi , Ishige Takashi , Yamada Hiroyuki , Arai Katsuhiro , Yoden Atsushi , Ushijima Kosuke , Aomatsu Tomoki , Nagata Satoru , Uchida Keiichi , Takeuchi Kazuo , Shimizu Toshiaki 
Published: January 2022

Objective:
Acute pancreatitis (AP) develops in approximately 2% of patients with the diagnosis of inflammatory bowel disease (IBD), but the characteristics and frequency of childhood-onset IBD-associated AP in Japan have not been studied. The present study aimed to clarify the characteristics of IBD-associated AP in Japan.

Methods:
A nationwide survey of pediatric patients with IBD (age, <17 years) was conducted from December 2012 to March 2013 at 683 hospitals and medical centers in Japan. A secondary survey was also sent to the centers with the target patients to evaluate their characteristics.

Results:
The response rate to the first part of the survey was 61.2% (n = 418). In total, 871 patients with Crohn disease and 1671 patients with ulcerative colitis were enrolled. The second part of the survey found that 11 (1.3%) patients with Crohn disease and 23 (1.4%) patients with ulcerative colitis experienced IBD-associated AP caused by medication (n = 18, 53%), a primary disease (n = 11, 32%), autoimmune pancreatitis (n = 1, 3%), or an anatomical abnormality (n = 1, 3%). All the patients had only mild AP.

Conclusions:
IBD-associated AP was not very frequent and was generally mild. The major cause of the pancreatitis was the medication used to treat the IBD.
Gene Expression Scoring of Immune Activity Levels for Precision Use of Hydrocortisone in Vasodilatory Shock
Authors: Yao Lijing , Rey Diego Ariel , Bulgarelli Lucas , Kast Rachel , Osborn Jeff , Van Ark Emily , Fang Li Tai , Lau Bayo , Lam Hugo , Teixeira Leonardo Maestri , Neto Ary Serpa , Bellomo Rinaldo , Deliberato Rodrigo Octávio 
Published: January 2022

ABSTRACT

Purpose:
Among patients with vasodilatory shock, gene expression scores may identify different immune states. We aimed to test whether such scores are robust in identifying patients’ immune state and predicting response to hydrocortisone treatment in vasodilatory shock.

Materials and Methods:
We selected genes to generate continuous scores to define previously established subclasses of sepsis. We used these scores to identify a patient's immune state. We evaluated the potential for these states to assess the differential effect of hydrocortisone in two randomized clinical trials of hydrocortisone versus placebo in vasodilatory shock.

Results:
We initially identified genes associated with immune-adaptive, immune-innate, immune-coagulant functions. From these genes, 15 were most relevant to generate expression scores related to each of the functions. These scores were used to identify patients as immune-adaptive prevalent (IA-P) and immune-innate prevalent (IN-P). In IA-P patients, hydrocortisone therapy increased 28-day mortality in both trials (43.3% vs 14.7%, P = 0.028) and (57.1% vs 0.0%, P = 0.99). In IN-P patients, this effect was numerically reversed.

Conclusions:
Gene expression scores identified the immune state of vasodilatory shock patients, one of which (IA-P) identified those who may be harmed by hydrocortisone. Gene expression scores may help advance the field of personalized medicine.