bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Efficacy of Intra-articular Subtalar Steroid Injection for Symptomatic Talocalcaneal Coalitions: A 30-Year Single Institution Experience
Authors: Zide Jacob R. , Shivers Claire , Adair Christopher , Le Thanh , Kanaan Yassine , Rathjen Karl , Jo Chan-Hee , Riccio Anthony I. 
Published: March 2022

Purpose:
While intra-articular steroid injection has been used anecdotally in patients with symptomatic talocalcaneal coalitions recalcitrant to traditional conservative modalities, the ability of this treatment to provide symptomatic relief and obviate or delay surgical intervention remains unknown. The purpose of this study is, therefore, to assess the treatment efficacy of intra-articular subtalar steroid injection in children with symptomatic talocalcaneal coalitions.

Methods:
A retrospective study of all patients with isolated subtalar coalitions was performed at a single pediatric orthopaedic institution over a 30-year period. Radiographs were analyzed to identify the type of coalition (osseous or nonosseous), presence of any posterior facet involvement, and presence of a planovalgus foot deformity. Patients who underwent a subtalar joint steroid injection after failing other conservative treatments were identified and compared with those who did not receive an injection as part of their nonoperative management with regard to the need for ultimate surgical intervention and the time from presentation to surgery when applicable.

Results:
A total of 83 patients (125 feet) met inclusion criteria, of whom 25 patients (34 feet) received a subtalar steroid injection. When compared with the 58 patients (91 feet) treated with standard nonoperative modalities, there were no differences with regard to sex, age at presentation (12.4 and 12.3 y, respectively), facet involvement, type of coalition, or the presence of a planovalgus deformity. In all, 12/34 (35%) feet in the injection group eventually elected surgical intervention compared with 36/91 (39%) feet that did not receive an injection (P=0.72). For those patients ultimately selecting surgical intervention, the average time from initial presentation to surgery was 878 days in the injection group versus 211 days in the noninjection group (P<0.001).

Conclusions:
While subtalar steroid injection can alleviate symptoms in some patients with a talocalcaneal coalition, this intervention does not appear to decrease the need for surgery when compared with traditional nonoperative therapies. In patients failing other forms of conservative treatment, subtalar steroid injections can delay surgical intervention by an average of nearly 2 years.

Level of Evidence:
Level-III—therapeutic study.
Bridging the Transition to Assisted Living
Authors: Huebner Carol Ann 
Published: March 2022

ABSTRACT:
The transition from independent living to assisted living is a significant life process that may be compared to crossing a bridge. Faith community nurses can support older adults through this transition. This article presents a conceptual meaning of transition, a framework with a spiritual dimension, and implications for Christian nurses. A case study illustrates how this transition typically occurs across time.
Promises and challenges: cabotegravir for preexposure prophylaxis
Authors: Spinelli Matthew A. , Grinsztejn Beatriz , Landovitz Raphael J. 
Published: March 2022

Purpose of review
Tenofovir-based oral PrEP has been effective in reducing population-level HIV incidence in multiple settings, although disparities remain. Injectable cabotegravir-based PrEP is an alternative that may be attractive to individuals with adherence challenges or who do not desire to take a daily medication. We review promises and challenges of cabotegravir-based PrEP.

Recent findings
Cabotegravir has demonstrated higher effectiveness than oral PrEP in two randomized trials, with a hazard ratio of 0.31 for HIV incidence among MSM and transgender women across multiple settings [95% confidence interval (CI) 0.18–0.62] and 0.11 for cisgender women in sub-Saharan Africa (95% CI 0.040.32). Cabotegravir was also highly effective among populations with disproportionate HIV incidence. Although cabotegravir breakthrough was rare, diagnosis was delayed with use of antigen/antibody-based HIV tests, and resistance occurred with breakthrough infections. Implementation will need to overcome several challenges, including HIV RNA laboratory monitoring not being widely available, requirement for additional staff time and clinic space, and need to provide oral medication during interruptions in dosing.

Summary
Cabotegravir-based PrEP is a highly effective additional PrEP option that will expand HIV prevention options. For successful roll-out, strategies for streamlined and accessible delivery of cabotegravir in real-world settings will need to be developed.
THE TARGET SIGN
Authors: Newman Hadas , Perlman Ido , Pras Eran , Rozenberg Assaf , Ben-Yosef Tamar , Iovino Claudio , Simonelli Francesca , Di Iorio Valentina , Rotenstreich Ygal , Katzburg Etti , Ehrenberg Miriam , Iglicki Matias , Zur Dinah 
Published: March 2022

Purpose:
Retinol dehydrogenase 5 (RDH5)–related fundus albipunctatus can present with phenotypic variability. Our purpose was to investigate new clinical characteristics and multimodal imaging findings in patients from different ethnic origins, carrying different mutations.

Methods:
Multicenter international retrospective case series of 18 patients with genetically confirmed RDH5-related fundus albipunctatus. Patients' files were reviewed for fundus images, visual acuity, macular optical coherence tomography scans, near-infrared images, fundus autofluorescence, electroretinogram, and genetic mutations. Imaging and electroretinogram findings.

Results:
All eyes (n = 36, 100%) showed small circular findings seen on near-infrared images, termed as the “target sign,” correlating to the yellowish dots seen clinically and to the distinct hyperreflective linear lesions on optical coherence tomography at the level between external limiting membrane and retinal pigment epithelium. Perifoveal atrophy with foveal sparing was seen in 4 eyes of 2 patients (both RDH5—c.160C>T, p.R54X mutation). Fundus autofluorescence revealed small hyperautofluorescent dots (n = 16, 44.4%). Scotopic electroretinograms were significantly reduced in all cases with an electronegative pattern, 66.7% displayed cone dysfunction.

Conclusion:
Our results show distinct imaging findings present in all patients with fundus albipunctatus independent of ethnicity or genetic mutation. Our results can facilitate the current algorithm to diagnose RDH5-related fundus albipunctatus and allow for targeted genetic testing.
NONSURGICAL RESOLUTION OF FULL-THICKNESS MACULAR HOLES WITHOUT VITREOMACULAR TRACTION
Authors: Richards Paige J. , Kulkarni Amol D. , Nork T. Michael , Leys Monique , Hinkle David , Conlin Karina A. , Chang Stanley , Chang Jonathan S. 
Published: March 2022

Background/Purpose:
The purpose of this study was to report a case series of full-thickness macular holes without vitreomacular traction that resolved without surgery.

Methods:
This study is a retrospective case series of 11 patients who demonstrated closure of full-thickness macular holes without surgical intervention.

Results:
All full-thickness macular holes closed, with all patients having improvement in visual acuity. All but one of the cases had visual acuity better than 20/40 at last recorded visit. Most cases presented with associated epiretinal membrane (73%), cystoid changes (64%), defects <150 μm (80%), and resolved within 2 months (91%). Topical anti-inflammatory drops were used in 7 of 11 cases, and dorzolamide was used in one case.

Conclusion:
Full-thickness macular holes can develop in eyes without the presence of vitreomacular traction. Topical therapy without vitrectomy may be particularly helpful in closure of full-thickness macular holes with associated cystoid macular edema. Holes with a lamellar hole component may spontaneously resolve as part of a retinal remodeling process.
RAPID PENTOSAN POLYSULFATE SODIUM MACULOPATHY PROGRESSION
Authors: Somisetty Swathi , Santina Ahmad , Abraham Neda , Lu Anthony , Morales Veronica Romero , Sarraf David 
Published: March 2022

Purpose:
The purpose of this study was to report a unique case of pentosan polysulfate sodium (PPS) maculopathy with remarkable rapid progression over 2 years. These findings show the importance of early detection of macular disease to limit toxic exposure and reduce the risk of progression.

Methods:
Multimodal retinal imaging including fundus autofluorescence, near-infrared reflectance with pseudocolor, and spectral domain optical coherence tomography was performed in an elderly patient with a history of PPS therapy (cumulative dose of 1,205 g) at baseline and 2 years later.

Results:
Baseline multimodal retinal imaging failed to show significant macular findings of PPS toxicity in either eye, but on repeat evaluation 2 years later, advanced features of PPS maculopathy were detected in both eyes with fundus autofluorescence, near-infrared reflectance, pseudocolor, and spectral domain optical coherence tomography.

Conclusion:
This report describes a remarkable case of rapid progression of PPS maculopathy as documented with multimodal retinal imaging. The dramatic progression of macular findings over just 2 years underscores the importance of early detection and prompt withdrawal of therapy, if systemically feasible, to retard the development and rate of progression of PPS maculopathy.
In-hospital venous thromboembolism: are glucocorticoids a prime suspect?
Authors: Feldpausch Brian , Giuliano Christopher , Hartner Carrie L. , Edwin Stephanie B. 
Published: March 2022

The objective of the study was to determine whether glucocorticoid use is associated with an increased incidence of in-hospital VTE. We conducted a case–control study of patients with an in-hospital VTE from October 2015 to December 2019. Adult patient cases were identified by ICD-10 codes for acute venous thromboembolism. Controls were selected from all patients without a VTE diagnosis and matched by hospital length of stay and admission type (medical/surgical). Patients were excluded if they had a history of VTE, received therapeutic anticoagulation, or were pregnant. All patients were evaluated to determine the presence or absence of glucocorticoid exposure. Glucocorticoid dose, duration, and route of administration were assessed for patients with steroid exposure. Overall, 78 patients with VTE and 234 controls were included. Receipt of glucocorticoids within the preceding 90 days was similar between the VTE cases and controls (39.7 vs. 38.9%, P
= 0.89). No differences were noted with regard to oral (21.8 vs. 19.2%, P = 0.62), intravenous (30.8 vs. 29.1%. P = 0.774), or inhaled (6.4 vs. 10.3%, P = 0.31) routes of administration between VTE case and control patients.
Cumulative prednisone equivalent doses were similar between cases and controls (877 ± 1366 vs. 697 ± 1963 mg, P = 0.435). The risk of in-hospital venous thromboembolism was not influenced by glucocorticoid exposure within the past 90 days. These results were consistent across all routes of administration, exposure time, and steroid dose. Blood Coagul Fibrinolysis 33:000–000 Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Implantation of transjugular intrahepatic portosystemic shunt (TIPS): indication and patient selection
Authors: Bettinger Dominik , Thimme Robert , Schultheiß Michael 
Published: March 2022

Purpose of review
This review summarizes indications and contraindications for implantation of transjugular intrahepatic portosystemic shunt (TIPS). Further, patient selection strategies are discussed.

Recent findings
TIPS implantation is a highly effective treatment for portal hypertension. Main indications are ascites and variceal bleeding in patients with liver cirrhosis. There is growing evidence that early TIPS implantation after variceal bleeding is associated with an improved survival (preemptive TIPS).
Preliminary data also suggest that an analogous concept of early TIPS implantation may be beneficial for patients with ascites. Further, well-selected patients with acute or chronic nonmalignant portal vein thrombosis can be effectively treated with TIPS implantation. In contrast, there is generally no recommendation for TIPS implantation in patients with hepatic veno-occlusive disease, noncirrhotic portal hypertension or prior before surgery to avoid complications of portal hypertension. Apart from evidence-based patient selection, the newly developed FIPS score can be an objective component in decision-making.

Summary
Consideration of well-established indications and contraindications for TIPS implantation as well as concise patient selection criteria are essential for an optimal outcome after TIPS implantation.
Health Resource Use in Survivors of Pediatric Septic Shock in the United States
Authors: Maddux Aline B. , Zimmerman Jerry J. , Banks Russell K. , Reeder Ron W. , Meert Kathleen L. , Czaja Angela S. , Berg Robert A. , Sapru Anil , Carcillo Joseph A. , Newth Christopher J. L. , Quasney Michael W. , Mourani Peter M. ,   for the Life After Lapse Sepsis Evaluation (LAPSE) Investigators
Published: March 2022

OBJECTIVES:
To evaluate postdischarge health resource use in pediatric survivors of septic shock and determine patient and hospitalization factors associated with health resource use.

DESIGN
Secondary analyses of a multicenter prospective observational cohort study.

SETTING:
Twelve academic PICUs.

PATIENTS:
Children greater than or equal to 1 month and less than 18 years old hospitalized for community-acquired septic shock who survived to 1 year.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
For 308/338 patients (91%) with baseline and greater than or equal to one postdischarge survey, we evaluated readmission, emergency department (ED) visits, new medication class, and new device class use during the year after sepsis. Using negative binomial regression with bidirectional stepwise selection, we identified factors associated with each outcome. Median age was 7 years (interquartile range, 2–13), 157 (51%) had a chronic condition, and nearly all patients had insurance (private [n = 135; 44%] or government [n = 157; 51%]). During the year after sepsis, 128 patients (42%) were readmitted, 145 (47%) had an ED visit, 156 (51%) started a new medication class, and 102 (33%) instituted a new device class. Having a complex chronic condition was independently associated with readmission and ED visit. Documented infection and higher sum of Pediatric Logistic Organ Dysfunction--2 hematologic score were associated with readmission, whereas younger age and having a noncomplex chronic condition were associated with ED visit. Factors associated with new medication class use were private insurance, neurologic insult, and longer PICU stays. Factors associated with new device class use were preadmission chemotherapy or radiotherapy, presepsis Functional Status Scale score, and ventilation duration greater than or equal to 10 days. Of patients who had a new medication or device class, most had a readmission (56% and 61%) or ED visit (62% and 67%).

CONCLUSIONS:
Children with septic shock represent a high-risk cohort with high-resource needs after discharge. Interventions and targeted outcomes to mitigate postdischarge resource use may differ based on patients’ preexisting conditions.
Caregiver Practices and Knowledge Regarding Leftover Prescription Medications in Homes With Children
Authors: Renny Madeline H. , Thaker Riddhi H. , Dayan Peter S. 
Published: March 2022

Objectives
The aims of the study were to determine the frequency of and factors associated with leftover or expired prescription medication (“leftover medication”) presence in homes with children and to assess caregivers' reported behaviors and knowledge regarding disposal of leftover medications in the home.

Methods
This study is a planned secondary analysis from a survey of primary caregivers of children aged 1 to 17 years presenting to an emergency department. The survey assessed leftover medications in the home and medication disposal practices, knowledge, and guidance. The survey was developed iteratively and pilot tested. Multivariable logistic regression was used to identify factors associated with leftover medication presence in the home.

Results
We enrolled 550 primary caregivers; 97 of the 538 analyzed (18.0%; 95% confidence interval [CI], 14.8–21.5) reported having leftover medications in their home, most commonly antibiotics and opioids. Of respondents, 217/536 (40.5%) reported not knowing how to properly dispose of medications and only 88/535 (16.4%) reported receiving guidance regarding medication disposal. Most caregivers reported throwing leftover medications in the trash (55.7%) or flushing them down the toilet (38.5%). Caregivers with private insurance for their child were more likely to have leftover medications (adjusted odds ratio [aOR], 1.99; CI, 1.15–3.44), whereas Hispanic caregivers (aOR, 0.24; CI, 0.14–0.42) and those who received guidance on leftover medications (aOR, 0.30; CI, 0.11–0.81) were less likely to have leftover medications in the home.

Conclusions
Leftover medications are commonly stored in homes with children and most caregivers do not receive guidance on medication disposal. Improved education and targeted interventions are needed to ensure proper medication disposal practices.
Clinician Knowledge of Incontinence-Associated Dermatitis
Authors: Barakat-Johnson Michelle , Stephenson John , Basjarahil Shifa , Campbell Jayne , Cunich Michelle , Disher Gary , Geering Samara , Ko Natalie , Lai Michelle , Leahy Catherine , Leong Thomas , McClure Eve , O'Grady Melissa , Walsh Joan , White Kate , Coyer Fiona 
Published: March 2022

PURPOSE:
This study examined clinicians' knowledge of incontinence-associated dermatitis (IAD) using the Barakat-Johnson Incontinence-Associated Dermatitis Knowledge Tool (Know-IAD).

Design:
A cross-sectional multicenter survey.

SUBJECTS AND SETTING:
The setting was 6 hospitals across 5 health districts in New South Wales, Australia. The participants were nurses (registered nurses and enrolled nurses), physicians, allied health (occupational therapists, dietitians, and physiotherapists), and students (nursing and allied health).

METHODS:
Data about IAD knowledge were collected from November 2019 to January 2020. The Know-IAD, an 18-item validated instrument that measures knowledge of IAD in 3 domains (etiology and risk, classification and diagnosis, and prevention and management), was administered to a cross section of eligible clinicians. The participants anonymously completed hard copy surveys. Descriptive and exploratory analyses were conducted to quantify clinicians' knowledge about the etiology and risk, classification and diagnosis, and prevention and management of IAD. A mean knowledge score of 70% was considered to be satisfactory.

RESULTS:
Four hundred twelve respondents completed the survey. One hundred twenty nine respondents (31.3%) achieved 70% correct responses and greater for the entire set of items. For the etiology and risk domain, 348 respondents (84.5%) obtained a score of 70% correct responses and greater, 67 respondents (16.3%) achieved 70% correct responses and greater for the classification and diagnosis domain, and 84 respondents (20.4%) achieved 70% correct responses and greater for the prevention and management domain.

CONCLUSION:
Clinicians tend to have low knowledge and recognition of IAD, particularly in the areas of classification and diagnosis along with prevention and management. They tend to have higher knowledge of how IAD is caused and the risk factors. This study has identified knowledge gaps for further education that can improve assessment, prevention, and management of IAD.
Factors Influencing Nursing Students' Knowledge of and Attitudes Toward Urinary Incontinence
Authors: Cheng Winnie Lai-Sheung , Kam Mei Kuk , Liong Yu Yan , Tang Tat Cheong , Tse Eleni Hiu Lam , Tse Ho Kwan , Tsao Wing Hei , Cheung Ka Chai 
Published: March 2022

PURPOSE:
This study aimed to determine nursing students' knowledge about and attitudes toward patients with urinary incontinence.

SUBJECTS AND SETTING:
The sample comprised 392 nursing students from 5 educational institutions in Hong Kong; all participants were enrolled in year 4 or 5 of their undergraduate nursing program, and all had completed formal education on urinary incontinence and clinical experience caring for patients with urinary incontinence.

METHODS:
A cross-sectional survey was conducted in February 2017. Participants completed a 55-item questionnaire that included items querying demographic and pertinent professional background information, along with 2 validated instruments: the Urinary Incontinence Knowledge Scale (UIKS) and the Urinary Incontinence Attitude Scale (UIAS). Analysis of variance was performed to compare the differences in scores among nursing students based on demographic or educational background. Pearson's correlation coefficient or χ2 was used to examine the relationships between variables and multivariate regression analyses were performed to identify the predictors of attitude toward urinary incontinence.

RESULTS:
Urinary incontinence knowledge was moderate (mean 22.0/30, SD 4.4) and attitudes about urinary incontinence were positive (mean 41.6/60, SD 4.5). There was a significant correlation between attitudes and knowledge (r = 0.175, P = .001), institution at which the students received training (χ2 = 161.790, P = .000), and the experience of having taken a course that included instruction about urinary incontinence (χ2 = 37.707, P = .014). Regression analysis revealed that knowledge and institution were predictors of attitudes. Participants reported high level of interest in learning more about urinary incontinence (71.2%).

CONCLUSIONS:
Nursing students residing in Hong Kong have a moderate level of knowledge and positive attitude toward urinary incontinence. This study suggests that educational institution and specific instruction about urinary incontinence play key roles in developing positive attitudes toward caring for patients with urinary incontinence.