bluuebunny/crossref_metadata_2025_split huggingface dataset:
VALIDATION OF AN AUTOMATED FLUID ALGORITHM ON REAL-WORLD DATA OF NEOVASCULAR AGE-RELATED MACULAR DEGENERATION OVER FIVE YEARS
Authors: Gerendas Bianca S. , Sadeghipour Amir , Michl Martin , Goldbach Felix , Mylonas Georgios , Gruber Anastasiia , Alten Thomas , Leingang Oliver , Sacu Stefan , Bogunovic Hrvoje , Schmidt-Erfurth Ursula 
Published: July 2022

Background/Purpose:
To apply an automated deep learning automated fluid algorithm on data from real-world management of patients with neovascular age-related macular degeneration for quantification of intraretinal/subretinal fluid volumes in optical coherence tomography images.

Methods:
Data from the Vienna Imaging Biomarker Eye Study (VIBES, 2007–2018) were analyzed. Databases were filtered for treatment-naive neovascular age-related macular degeneration with a baseline optical coherence tomography and at least one follow-up and 1,127 eyes included. Visual acuity and optical coherence tomography at baseline, Months 1 to 3/Years 1 to 5, age, sex, and treatment number were included. Artificial intelligence and certified manual grading were compared in a subanalysis of 20%. Main outcome measures were fluid volumes.

Results:
Intraretinal/subretinal fluid volumes were maximum at baseline (intraretinal fluid: 21.5/76.6/107.1 nL; subretinal fluid 13.7/86/262.5 nL in the 1/3/6-mm area). Intraretinal fluid decreased to 5 nL at M1-M3 (1-mm) and increased to 11 nL (Y1) and 16 nL (Y5). Subretinal fluid decreased to a mean of 4 nL at M1-M3 (1-mm) and remained stable below 7 nL until Y5. Intraretinal fluid was the only variable that reflected VA change over time. Comparison with human expert readings confirmed an area under the curve of >0.9.

Conclusion:
The Vienna Fluid Monitor can precisely quantify fluid volumes in optical coherence tomography images from clinical routine over 5 years. Automated tools will introduce precision medicine based on fluid guidance into real-world management of exudative disease, improving clinical outcomes while saving resources.
ISOLATED RETINAL VASCULITIS
Authors: Silpa-archa Sukhum , Sapthanakorn Withawat , Foster C. Stephen 
Published: July 2022

Purpose:
To identify prognostic factors for poor visual outcomes in patients with isolated retinal vasculitis and to elucidate the outcome of immunosuppressive treatment without the use of antituberculosis drugs for patients with retinal vasculitis associated with a positive QuantiFERON-TB Gold In-Tube (QFT) test.

Methods:
A retrospective chart review was performed of patients presenting with retinal vasculitis. After the diagnosis of active retinal vasculitis had been confirmed by fluorescein angiography and other possible causes of retinal vasculitis had been excluded, patients were categorized into two groups by their QFT result. Potential associated factors between the poor and good visual outcome groups were statistically analyzed by the chi-square test and logistic regression model with generalized estimating equations.

Results:
Seventy-three eyes (48 patients) were enrolled in this study. After univariate analysis, multivariate logistic regression analysis was performed and revealed that logMAR visual acuity at the initial visit (P = 0.01) and outer retinal disruption (P = 0.03) were the two factors significantly associated with poor visual outcomes. Systemic corticosteroids were administered without the use of antituberculosis drugs to all 16 cases of presumed tuberculous retinal vasculitis associated with positive QFT (26 eyes), 10 (63%) of whom were given nonsteroidal immunosuppressive drugs and achieved inflammatory control and treatment success.

Conclusion:
Risk factors leading to poor visual outcome in patients with isolated retinal vasculitis have been identified. Immunosuppressive treatment without antituberculosis drugs seems to be a promising regimen for selected patients with presumed tuberculous retinal vasculitis under vigilant care.
Agreement of infrared ear temperature with nasopharyngeal temperature and diagnostic performance on hypothermia in general anesthetized patients
Authors: Wan Li , Shen Pei-Ying , Zhang Shu-Xian , Wang Li-Zhong 
Published: July 2022

Background:
Infrared ear thermometry is widely used in clinical practice due to its noninvasive, convenient, and quick sampling. However, its accuracy and feasibility in anesthetized patients have not yet been established.

Methods:
We conducted this cross-sectional study to evaluate the agreement between infrared ear temperature and nasopharyngeal temperature in general anesthetized patients and its performance in intraoperative hypothermia, defined as nasopharyngeal temperature <36°C. Adult female patients who underwent gynecological surgery under general anesthesia were enrolled in this study. Infrared ear temperature by Braun ThermoScan PRO 4000 (Braun GmbH, Kronberg, Germany) and nasopharyngeal temperature were measured simultaneously before, during, and after surgery. The agreement between the two temperatures was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. The diagnostic performance of the infrared ear thermometer for hypothermia was evaluated using receiver operating characteristic (ROC) curve analysis.

Results:
Fifty-six patients with 168 pairs of simultaneous infrared ear and nasopharyngeal temperatures were included in this analysis. The mean infrared ear temperature was consistently higher than the nasopharyngeal temperature throughout surgery, but the differences were small (0.22, 0.13, and 0.06°C before, during, and after surgery, respectively). The ICC between the two temperatures before, during, and after surgery was 0.70, 0.75, and 0.80, respectively, and 93.5% of the differences fell within the 95% limits of agreement of ±0.5°C. An infrared ear thermometer had high diagnostic accuracy for hypothermia, with an area under the ROC curve of 0.95 (95% confidence interval [CI], 0.92-0.98). The cutoff of infrared ear temperature for hypothermia was 36.2°C with a sensitivity of 0.89 (95% CI, 0.71-0.98) and a specificity of 0.87 (95% CI, 0.81-0.92).

Conclusion:
The infrared ear temperature is in good agreement with the nasopharyngeal temperature in general anesthetized patients without hyperthermia and has high performance for detecting hypothermia. An infrared ear thermometer can be a diagnostic tool for intraoperative hypothermia.
Patient perceived needs and experiences of person-centered care in patients with inflammatory arthritis
Authors: van Slingerland Kim , Walter Margot J.M. , van der Stege Heleen A. , van Staa AnneLoes , van Pelt Philomine A. , de Jong Pascal H.P. 
Published: July 2022

ABSTRACT

Background:
Health care is shifting toward a person-centered care (PCC) approach. For implementation of PCC, there may be a special role for nurse practitioners (NPs).

Purpose:
The aim of this study was to explore the patient-perceived levels of and needs for of PCC in inflammatory arthritis patients who visited the NP at the outpatient clinic of an academic hospital in the Netherlands.

Methods:
A cross-sectional study was performed. Disease characteristics were inventoried from the patient records. Patients filled out the PCCoc/rheum instrument, an instrument to measure patient perceived PCC, and a questionnaire based on the 14 life areas of the Self-Management Web, extended with areas including pain, fatigue, and night's rest. Participants were asked which life areas caused problems, and whether these problems were discussed. Mean values were calculated for normally distributed data and medians for nonnormally distributed data.

Results:
Most of the patients had well-controlled disease (86.1%). The mean score of the PCCoc/rheum was 55.3 (SD 8.1). Patients experienced most problems in life areas fatigue (37.3%) and pain (35.3%), these were also the life areas that were most often addressed at consultation. The life areas that gave problems and that were least addressed during consultation were intimate relationships & sexuality (66.7%) and household chores (58.8%).

Conclusions:
Despite an overall high level of patient perceived PCC delivered by NPs, patient with low disease activity frequently reported problems in life areas not addressed at consultation.

Implications for practice:
Implementation of the Self-Management Web and changing the focus of NP consultations may help to improve accommodating individual patient needs.
Inotrope and vasopressor use in cardiogenic shock: what, when and why?
Authors: Hu Kira , Mathew Rebecca 
Published: July 2022

Purpose of review
Despite increasing interest in the management of cardiogenic shock (CS), mortality rates remain unacceptably high. The mainstay of supportive treatment includes vasopressors and inotropes. These medications are recommended in international guidelines and are widely used despite limited evidence supporting safety and efficacy in CS.

Recent findings
The OptimaCC trial further supports that norepinephrine should continue to be the first-line vasopressor of choice in CS. The CAPITAL DOREMI trial found that milrinone is not superior to dobutamine in reducing morbidity and mortality in CS. Two studies currently underway will offer the first evidence of the necessity of inotrope therapy in placebo-controlled trials: CAPITAL DOREMI2 will randomize CS patients to inotrope or placebo in the initial resuscitation of shock to evaluate the efficacy of inotrope therapy and LevoHeartShock will examine the efficacy of levosimendan against placebo in early CS requiring vasopressor therapy.

Summary
Review of the current literature fails to show significant mortality benefit with any specific vasopressor or inotropic in CS patients. The upcoming DOREMI 2 and levosimendan versus placebo trials will further tackle the question of inotrope necessity in CS. At this time, inotrope selection should be guided by physician experience, availability, cost, and most importantly, individual patients’ response to therapy.
Caring for adolescents and young adults with attention-deficit/hyperactivity disorder in primary care: seizing opportunities to address youth mental health needs
Authors: Driscoll Hannah , Kimberg Amanda D. , Chung Richard J. 
Published: July 2022

Purpose of review
To provide primary care providers (PCPs) with updated practical guidance around the assessment and management of attention-deficit/hyperactivity disorder (ADHD) in adolescents and young adults (AYA).

Recent findings
Of the three different presentations of ADHD delineated in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the Predominantly Inattentive presentation is the most common among AYA. Multiple rating scales exist to assist clinicians in identifying ADHD symptoms and monitoring treatment effects. Importantly, ADHD frequently persists into adulthood with negative impacts in many life domains if left untreated. It is important for PCPs to provide support for AYA as they transition to adulthood, as treatment adherence often drops sharply at that time, and, once treatment is discontinued, it is rarely restarted. Further, clinicians should be aware of the negative psychological, behavioral, and social impacts that COVID-19 has had on AYA with ADHD.

Summary
AYA with ADHD often seek care first from PCPs. However, diagnosis and management of ADHD among AYA are challenging, and many clinicians feel ill-equipped, creating concern that many youth may go undiagnosed and untreated. Despite these long-standing challenges, recent advances have opened up critical opportunities for PCPs to proactively address ADHD in primary care settings and make a profound impact on youth as they seek to realize their full potential.
Comparing Eosinophilic Esophagitis in a Black and Non-Black Pediatric Cohort
Authors: Edwards-Salmon Sofia , Moraczewski Jason , Offerle Thomas , Sinclair Elizabeth M. , Xiang Yijin , Gillespie Scott , Kruszewski Patrice 
Published: July 2022

Objectives:
To compare presenting symptoms, comorbidities, disease, and treatment characteristics of a black pediatric eosinophilic esophagitis (EoE) group to a non-black pediatric EoE group.

Methods:
A retrospective chart review consisting of pediatric patients diagnosed with EoE between the years of 2010 and 2018 at a single urban pediatric hospital system comprising 143 black pediatric patients compared with 142 non-black pediatric patients with similar distribution of age and sex.

Results:
Both groups were majority male, and the median age of diagnosis between the black and non-black group was 5.1 and 6.7 years old, respectively. Comorbidities more commonly seen in the black group included food allergies, atopic dermatitis, asthma, and allergic rhinitis. Black patients were more likely to present with failure to thrive (FTT)/poor growth, whereas non-black patients were more likely to present with abdominal pain. There was no statistically significant difference between the groups in achieving remission using current therapies. The black group had higher rates of nonadherence to medical therapies.

Conclusions:
This is the largest study to date comparing a black versus non-black pediatric EoE population. The black population had more atopic comorbidities and FTT at presentation and had significantly more issues with nonadherence. This new knowledge describing EoE in a minority population will hopefully improve awareness, diagnosis, and management of EoE in this population.
Blood Pressure Cuff Inflation Briefly Increases Female Adolescents’ Restlessness During Sleep on the First But Not Second Night of Ambulatory Blood Pressure Monitoring
Authors: Lehrer H. Matthew , Zhang Gehui , Matthews Karen A. , Krafty Robert T. , Evans Marissa A. , Taylor Briana J. , Hall Martica H. 
Published: July 2022

ABSTRACT

Objective
Ambulatory blood pressure monitoring (ABPM) increases restlessness during adults’ sleep in laboratory settings, but there is little evidence of an association among adolescents or in naturalistic environments. This study examined activity levels before and after blood pressure cuff inflation during sleep to determine whether and for how long ABPM increased restlessness during sleep in healthy adolescents.

Methods
Two hundred thirty-four healthy adolescents (mean age = 15.72 [1.30] years; 54% female; 57% Black) completed two consecutive nights of hourly ABPM and wrist-worn actigraphy. Activity counts during sleep, averaged across 5-minute bins, were compared in the 20 minutes before and after blood pressure cuff inflation using a four-level mixed model (bins within hours within nights within participants). Interactions of bin with night, sex, and race were examined. Covariates included age, sex, and race.

Results
Activity counts in the 5-minute bin immediately after cuff inflation were 10% to 14% higher than all other bins before (p < .001) and after (p < .001) cuff inflation. This effect differed by night and sex, as activity levels during 5-minute post–cuff inflation were elevated only on night 1 (p values < .001) and only in female participants (p values < .001). Effects did not differ by race.

Conclusions
Cuff inflation during ABPM briefly increased adolescent female participants’ restlessness during sleep. Habituation occurred after one night, so two nights of ABPM may minimize impact on sleep. If only one night of ABPM is feasible, excluding 5 minutes of actigraphy data after each cuff inflation may accommodate the impact of ABPM on restlessness during sleep.
Cognitive Function Is Associated With Multiple Indices of Adiposity in the Canadian Longitudinal Study on Aging: A Cross-Sectional Analysis
Authors: Sakib Mohammad Nazmus , Ramezan Reza , Thompson Mary E. , Best John R. , Hall Peter A. 
Published: July 2022

ABSTRACT

Objective
Prior studies have suggested reciprocal relationships between cognitive function and adiposity, but this has not been investigated with population representative data sets. The purpose of this study was to examine the association between cognitive function and adiposity in a large population-based sample of middle-aged and older adults. It was hypothesized that better scores on tests of cognitive function would be associated with lower adiposity, and this association would be primarily mediated through life-style behavior and physical health status.

Methods
Using baseline data from the Canadian Longitudinal Study on Aging (N = 30,097), we tested our hypotheses using three indicators of cognitive function (animal fluency, Stroop interference, and reaction time) and four indicators of adiposity (body mass index, total fat mass, waist circumference, and waist-hip ratio). Hierarchical multivariable linear regression modeling was conducted followed by tests for moderation by socioeconomic status and mediation through diet, physical activity, hypertension, and diabetes status.

Results
All measures of cognitive indicators were significantly associated with adiposity after adjusting for confounders. In general, superior performance on animal fluency, Stroop, and reaction time tasks were associated with lower adiposity by most metrics. Stroop interference was associated with lower adiposity across all metrics, including body mass index (b = − 0.04, 95 % confidence interval [CI] = − 0.06  to − 0.01), total fat mass (b = 19.35, 95 % CI = 8.57  to 30.12), waist circumference (b = 33.83, 95 % CI = 10.08  to 57.58), and waist-hip ratio (b = 0.13, 95 % CI = 0.01  to 0.24). These associations were more substantial for moderate- and high-income subpopulations. Mediation analyses suggested that the aforementioned effects were mediated through life-style behavior (e.g., diet and physical activity) and physical health conditions (e.g., diabetes and hypertension).

Conclusions
Reliable associations exist between cognitive function and adiposity in middle-aged and older adults. The associations seem to be mediated through life-style behavior and physical health conditions.
Disparities in Adverse Event Reporting for Hospitalized Children
Authors: Halvorson Elizabeth Eby , Thurtle Danielle P. , Easter Ashley , Lovato James , Stockwell David 
Published: July 2022

Objectives
Hospitals rely on voluntary event reporting (VER) for adverse event (AE) identification, although it captures fewer events than a trigger tool, such as Global Assessment of Pediatric Patient Safety (GAPPS). Medical providers exhibit bias based on patient weight status, race, and English proficiency. We compared the AE rate identified by VER with that identified using the GAPPS between hospitalized children by weight category, race, and English proficiency.

Methods
We identified a cohort of patients 2 years to younger than 18 years consecutively discharged from an academic children’s hospital between June and October 2018. We collected data on patient weight status from age, sex, height, and weight, race/ethnicity by self-report, and limited English proficiency by record of interpreter use. We reviewed each chart with the GAPPS to identify AEs and reviewed VER entries for each encounter. We calculated an AE rate per 1000 patient-days using each method and compared these using analysis of variance.

Results
We reviewed 834 encounters in 680 subjects; 262 (38.5%) had overweight or obesity, 144 (21.2%) identified as Black, and 112 (16.5%) identified as Hispanic; 82 (9.8%) of encounters involved an interpreter. We identified 288 total AEs, 270 (93.8%) by the GAPPS and 18 (6.3%) by VER. A disparity in AE reporting was found for children with limited English proficiency, with fewer AEs by VER (P = 0.03) compared with no difference in AEs by GAPPS. No disparities were found by weight category or race.

Conclusions
Voluntary event reporting may systematically underreport AEs in hospitalized children with limited English proficiency.
Social Distancing to Avoid SARS-CoV-2 Infection in Cancer and Noncancer Patients
Authors: Kloecker Goetz , Nolan Joseph , Korbee Leslie , Calhoun Royce , Logan Barbara , Flora Dan , Flora Douglas , Hartman Philip 
Published: July 2022

Background
Social distancing has been recommended by the Centers for Disease Control and Prevention to avoid exposure to SARS-CoV-2 (Epidemiol Prev 2020;44:353–362).
Cancer patients on or after active therapy seem to be more prone to COVID being symptomatic and life-threatening. When evaluating cancer patients’ risk of acquiring COVID, it is essential to know the behavior of cancer patients that will affect their risk of exposure. However, it is not known to what degree social distancing is practiced by cancer patients compared with noncancer patients and what factors lead to the decision to distance oneself.

Method
After a pilot phase using patients’ MyChart messaging, links to the electronic questionnaires were texted to patients using Twillio. Responses were stored on REDCap (Vanderbilt University, Nashville, TN). Six questions about their social distancing behavior and mask wearing were posed and responses were compared between cancer and noncancer patients. Demographics, comorbidities, and a questionnaire about anxiety (Generalized Anxiety Disorder 7-item scale) were recorded. To assess differences between cancer and noncancer groups, Bonferroni-corrected χ2 tests and proportions confidence intervals were used.

Results
The pilot survey was sent in mid-2020 and the full survey followed in January 2021 during a high community COVID incidence. Three hundred eighty-seven cancer patients (32.4% responded) and 503 noncancer patients (22.9% responded) completed the survey. Questions about leaving their houses, driving, shopping, friends, and family indicated that patients with cancer are more cautious (P < 0.001). Cancer patients were up to 20% more likely to distance themselves. No difference was seen in wearing a mask—both groups wore approximately 90% of the time. Most respondents were female (63% versus 71%). Cancer patients were older (>60 y, 69% versus 45%) and less likely to work (52% versus 31%) or less likely to be White collar workers (21% versus 38%). In both groups, 54% marked “not at all anxious.”

Conclusions
Cancer patients’ responses revealed a distancing behavior that would likely lower the risk exposure to SARS-CoV-2. It is unclear which of the demographic differences would account for this behavior, although remarkably anxiety was not a clear motivating factor. The high acceptance of masks is encouraging. Early publications during the pandemic and patient education suggesting a higher COVID risk for cancer patients may have reduced risk prone behavior. Considering COVID’s impact on the vulnerable cancer population and uncertainty in immunosuppressed patients about clearing the virus or adequately responding to a vaccine, further studies about health behavior and health promotion during the pandemic are needed.