bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of the 2017 American college of cardiology/American Heart Association Blood Pressure Guidelines for cardiovascular outcomes among Tehranian residents
Authors: Zadeh Seyed Saeed Tamehri , Moazzeni Seyyed Saeed , Matsushita Kunihiro , Hasheminia Mitra , Azizi Fereidoun , Hadaegh Farzad 
Published: February 2022

Objective(s):
To evaluate the associations of cardiovascular disease (CVD) outcomes with elevated blood pressure (BP), stage I of isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic diastolic hypertension (SDH), defined by 2017 ACC/AHA guidelines among the Tehranian adult population.

Method:
We enrolled 7068 residents of Tehran (district No. 13) aged at least 30 years, who were free of CVD and not taking antihypertensive medications at baseline. Participants were categorized into eight categories: normal BP (reference group), elevated BP, stage I IDH, stage I ISH, stage I SDH, and all stage II phenotypes. Significant interactions were found between age groups (<60 versus ≥60 years) and BP categories (P value: 0.017); hence, the analysis was performed in each age group, separately. We used multivariable Cox proportional regression analysis to evaluate the association of different BP categories with incident CVD.

Results:
During 18years of follow-up, 1053 CVD events occurred. In the younger group, stage I of IDH and SDH were associated with increased CVD risk with hazard ratios (HRs) of 1.23 (95% confidence interval: 0.99–1.52) and 1.42 (1.04–1.94), respectively. In the older group, stage I of IDH had a lower risk for coronary heart disease (CHD) [HR 0.53 (0.29–0.96)]. As a sensitivity analysis, among high CVD risk individuals (10-year risk ≥10%), we found a higher risk for CVD among those with elevated BP and stage I of SDH. For individuals with 10-year risk less than 10%, all BP parameters, except stage I of IDH, were associated with increased CVD risk. Although there was no significant interaction between sex and BP categories, elevated BP and stage I of SDH significantly increased the risk of CVD only among men.

Conclusion:
Age is an important potential modifier in the association between stage I of hypertension and CVD/CHD risk. Stage I of IDH was not an alarming status for CVD development, whether the participants had a high CVD risk or not.
Intermediate-term Visual Outcomes and Complications of Type 1 Boston Keratoprosthesis With and Without Glaucoma Surgery
Authors: AlHilali Sara , Martinez-Osorio Hernan , AlObaida Ibrahim , Jomar Deema , AlZendi Nouf , AlJassar Faisal , AlShahwan Sami , Ahmad Abeer , Malik Rizwan , Vargas Jose 
Published: February 2022

Purpose:
Glaucoma is a cause of comorbidity in patients receiving the Boston keratoprosthesis (KPro). The aim of this study was to report the outcomes of the Boston KPro with or without glaucoma surgery.

Methods:
This was a retrospective single-center cohort study. Patients who underwent Boston KPro from March 2009 to February 2019 were included. One eye per patient (the first surgery) was included in this study. Patients were classified into 2 groups: KPro only (group 1) and KPro with any form of glaucoma procedure (group 2). Main outcome measures were Best-corrected visual acuity (BCVA), functional success (BCVA 20/200 or better), anatomical success (retention of KPro at the last follow-up), and complications.

Results:
Seventy-one eyes were included: 27 eyes (38%) in group 1 and 44 (62%) in group 2. There was no statistically significant difference in BCVA between groups 1 and 2 at each time point. Of the eyes in group 1, 11% lost light perception vision and 4.5% in group 2 (P = 0.293). There was no difference in anatomical success with 70% in group 1 and 77% in group 2 (P = 0.703) at the last follow-up, with a median failure time of 18 months. The functional success was 48% for group 1 and 50% for group 2 (P = 0.541).

Conclusions:
Eyes undergoing KPro with glaucoma surgery before or at the same time carry a similar functional and anatomical success to eyes without glaucoma surgery.
Socioeconomic Correlates of Keratoconus Severity and Progression
Authors: Ahmad Tessnim R. , Kong Alan W. , Turner Marcus L. , Barnett Jackson , Kaur Gurbani , O'Brien Kieran S. , Pasricha Neel D. , Indaram Maanasa 
Published: February 2022

Purpose:
The purpose of this study was to investigate the social determinants of health for keratoconus.

Methods:
In this retrospective cohort study of patients with keratoconus, the electronic health record was reviewed for keratometry, treatments received, clinical comorbidities, and social characteristics. Outcomes included severe keratoconus at presentation (steep keratometry ≥52 diopters), disease progression (≥0.75 diopters increase from the first to the most recent clinical visit), and corneal transplantation. Logistic regression was used to evaluate factors associated with severity at presentation and corneal transplantation. Cox proportional hazards modeling was used to evaluate progression.

Results:
A total of 1038 patients with keratoconus were identified, 725 (70%) of whom had baseline imaging. Compared with commercially insured patients, Medicaid recipients were more likely to have severe keratoconus, independent of social and clinical confounders [odds ratio (OR) 1.94, 95% confidence interval (CI), 1.12–3.35, P = 0.017]. Male sex was independently associated with progression (hazard ratio = 1.38, 95% CI, 1.03–1.84, P = 0.030). Medicare and Medicaid recipients were more likely to require transplantation compared with commercially insured patients (OR 2.71, 95% CI, 1.65–4.46, P < 0.001 and OR 1.74, 95% CI, 1.08–2.80, P = 0.022, respectively). Other social determinants of health, including non-White race/ethnicity, limited English proficiency, and unemployment, were associated with the outcomes only in univariate analysis. Obstructive sleep apnea, atopy, body mass index, and tobacco use were not associated with any outcome.

Conclusions:
Socioeconomic factors were more consistent predictors of keratoconus severity and corneal transplantation compared with clinical factors that have received relatively greater attention in the keratoconus literature.
Psychometric Properties of the Korean Version of the Nursing Profession Self-Efficacy Scale
Authors: KIM Seon Mi , KIM Ju Hee , KWAK Jung Min 
Published: February 2022

ABSTRACT

Background
Self-efficacy in the nursing profession has been reported to have a positive effect on personal performance in terms of clinical performance and decision-making abilities, nursing performance, professional intuition, organizational commitment, and turnover intention.

Purpose
The purpose of this study was to verify the validity and reliability of the Korean version of the Nursing Profession Self-Efficacy Scale (K-NPSES).

Methods
This methodological study used questionnaires collected from 307 nurses at medical institutions in South Korea. The content validity of the questionnaire was verified using the averaging method, whereas the criterion-related validity was evaluated by calculating the correlation with the Sherer General Self-Efficacy Scale. The construct validity was determined by analyzing the explanatory and confirmatory factors. Reliability was verified using Cronbach's α and test–retest by calculating intraclass correlation coefficients.

Results
The content validity index of the K-NPSES was found to be greater than .95, and the criterion-related validity was satisfactory (coefficient = .57, p < .001). The original Nursing Profession Self-Efficacy Scale has two subfactors, and the K-NPSES analyzed in this study has four subfactors. The data were appropriate for factor analysis using Kaiser–Meyer–Olkin (.87) and Bartlett's sphericity test (χ2 = 1236.01, df = 137, p < .001). The model fit was acceptable (normed chi-square [χ2/df] = 2.22, root mean square residual = .05, root mean square error of approximation = .09, comparative fit index = .88, Tucker–Lewis index = .86, goodness-of-fit index = .83). Regarding reliability, Cronbach's α was .91 and the intraclass correlation coefficient was .78 (p < .001).

Conclusions/Implications for Practice
The findings of this study confirmed the K-NPSES as having acceptable validity. In addition to predicting nursing clinical performance, a well-established nursing profession self-efficacy scale may be used to improve the quality of clinical nursing.
Effects of Ginseng on Cancer-Related Fatigue
Authors: Luo Wun-Ting , Huang Tsai-Wei 
Published: February 2022

Background
Cancer-related fatigue (CRF) is a common yet troublesome adverse effect that compromises patient quality of life (QoL). Ginseng is often used to boost energy.

Objectives
The aim of this study was to systematically appraise evidence whether ginseng could alleviate CRF and improve QoL.

Methods
We conducted a systematic review and meta-analysis of randomized controlled trials on the effectiveness of ginseng for relieving CRF. The primary outcome was fatigue. The secondary outcomes included QoL, anxiety, adverse events, depression, and laboratory markers.

Results
The final sample comprised seven trials. The pooled results showed that ginseng consumption led to significant reductions in CRF levels (standard mean difference [SMD], −0.21; 95% confidence interval [CI], −0.42 to 0.00). Furthermore, improvements in physical well-being (SMD, 0.25; 95% CI, 0.09–0.41) and emotional well-being (SMD, 0.20; 95% CI, 0.01–0.40) were observed, as were nonsignificant trends toward improvement in vigor (SMD, 0.18; 95% CI, −0.02 to 0.38), mitigated nausea (SMD, 0.38; 95% CI, −0.09 to 0.85), dyspnea (SMD, 0.27; 95% CI, −0.04 to 0.59), and anxiety (mean difference, −0.97; 95% CI, −2.12 to 0.18).

Conclusions
Ginseng consumption alleviates CRF and may have certain benefits in improving QoL especially physical well-being.

Implications for Practice
Ginseng may be used as an energy or nutrient supplement to alleviate CRF. However, the concentration of ginseng’s functional components is affected by the production methods and thus probably its effects. Oncology nurses are encouraged to have a better understanding of the benefits and functional limitations of ginseng as an energy or nutrient supplement for CRF.
Point-of-Care Ultrasound–Guided Serratus Anterior Plane Block for Chest Tube Placement in a Spontaneous Pneumothorax
Authors: Khalil Paul A. , Becker Emily 
Published: February 2022

Abstract
Chest tube placement is a common procedure in the pediatric emergency department. There is general emergency medicine literature as well as pediatric cardiac surgery literature supporting the use of an ultrasound-guided serratus anterior plane block for regional anesthesia with no prior pediatric emergency medicine studies to our knowledge. This case describes a pediatric patient who required chest tube placement twice for a pneumothorax and describes his preference for the nerve block over the more commonly used procedural sedation.
Using Telehealth to Conduct Family-Centered, Movement Intervention Research in Children With Autism Spectrum Disorder During the COVID-19 Pandemic
Authors: Cleffi Corina , Su Wan-Chun , Srinivasan Sudha , Bhat Anjana 
Published: February 2022

Purpose:
After the COVID-19 pandemic, several randomized controlled trials came to a halt; however, we chose to reinvent our study and shifted to a home-based, telehealth intervention delivery format to support children with autism spectrum disorder and their families. Children with autism spectrum disorder have social communication impairments as well as perceptuomotor and cognitive comorbidities. Continued access to care is crucial for their long-term development.

Methods:
We created a general movement intervention to target strength, endurance, executive functioning, and social skills through goal-directed games and activities delivered using a telehealth intervention model.

Findings:
Our family-centered approach allowed for collaboration between trainers and caregivers and made it easy for families to replicate training activities at home.

Conclusions:
While more studies comparing telehealth and face-to-face interventions are needed, we encourage researchers and clinicians to consider family-centered telehealth as a valid and feasible intervention delivery method, to increase the likelihood of carryover of skills into the daily lives of children and ultimately enhance their long-term development.
Effect of Contingency Paradigm–Based Interventions on Developmental Outcomes in Young Infants: A Systematic Review
Authors: Inamdar Ketaki , Khurana Sonia , Dusing Stacey C. 
Published: February 2022

Purpose:
The purpose of this systematic review was to identify controlled trials evaluating the efficacy of contingency paradigm–based interventions to improve feeding, motor, or cognitive outcomes during the first year of life.

Summary of Key Points:
Seventeen studies, including 10 randomized controlled trials, incorporating contingency paradigm–based interventions were identified. Three of 3 trials reported improvements in nutritive sucking using pacifier-activated lullaby in preterm infants before term age. Seven of 12 trials reported improvements in reaching, manual exploration, and kicking behaviors in term and preterm infants; and 6 of 10 trials reported gains in early cognition using sticky mittens and contingent toys.

Conclusion and Recommendations for Clinical Practice:
Contingency paradigm–based interventions can improve feeding outcomes in the neonatal intensive care unit in very preterm infants, and increase reaching, and perceptual-cognitive behaviors in term infants. Future research is needed to establish contingency paradigms as an effective early intervention strategy.

What This Adds to the Evidence:
This review synthesizes a body of literature on contingency paradigm-based interventions and highlights its potential paradigm–based interventions to improve developmental outcomes in infants.
Medication-Related Osteonecrosis of the Jaw Associated in a Patient Treated With Etanercept
Authors: Nisi Marco , Izzetti Rossana , Graziani Filippo 
Published: February 2022

Abstract:
Medication-related osteonecrosis of the jaws (MRONJ) is defined as a pathologic condition affecting the maxillary and mandibular bones arising subsequently to pharmacological treatment with antiresorptive and antiangiogenic drugs.
In this case report, the occurrence of MRONJ is described in a 66-year-old female patient affected by rheumatoid arthritis and treated with Etanercept, a Tumor Necrosis Factor (TNF)-a inhibitor. The patient developed a mandibular MRONJ following the extraction of teeth 3.4 and 3.5. The patient was then treated with conservative surgery of the necrotic bone. At 12-month follow-up complete resolution was observed. According to the data presented, the evaluation of the effects of new immunosuppressive biological therapies on the oral cavity appears of utmost importance in preventing the development of MRONJ. Although the risk related to TNF-a inhibitors has not been quantified yet, the clinician should be aware of the potential adverse effects on the oral cavity.
Vein Bypass Versus Nitinol Stent in Long Femoropopliteal Lesions
Authors: Enzmann Florian K. , Nierlich Patrick , Hölzenbein Thomas , Aspalter Manuela , Kluckner Michaela , Hitzl Wolfgang , Opperer Mathias , Linni Klaus 
Published: February 2022

Objectives:
The aim of this study was to compare technical success, patency rates and clinical outcomes of vein bypass (VBP) with angioplasty and nitinol stents (NS) in femoropopliteal Trans-Atlantic Intersociety Consensus (TASC) II C and D lesions.

Summary Background Data:
Guidelines widely recommend an endovas-cular-first strategy for long femoropopliteal lesions without sufficient data comparing it with vein bypass surgery.

Methods:
A single-center prospective, randomized controlled trial (RCT) was performed, after approval of the local ethics committee, with technical success, primary and secondary patency as primary endpoints. Secondary endpoints were limb salvage, survival, complications, and clinical improvement.

Results:
Between 2016 and 2020, 218 limbs (109 per group) in 209 patients were included. Baseline and lesion characteristics were similar in both groups with a mean lesion length of 268 mm. The indication for treatment was chronic limb threatening ischemia in 53% of limbs in both groups. Technical success was feasible in 88% in the stent group. During a 4-year follow-up, primary patency, freedom from target lesion revascularizations, limb salvage, survival and complications showed no significant differences between the groups. At 48 months secondary patency for the bypass group was 73% versus 50% in the stent group (P = 0.021). Clinical improvement was significantly superior in the bypass group with 52% versus 19% reaching a Rutherford 0 category (P < 0.001).

Conclusions:
This is the largest RCT comparing angioplasty with NS and vein bypass in femoropopliteal TASC II C and D lesions and the first to report 4-year results. The data underline the feasibility of endovascular treatment in long lesions but also emphasize the advantages of VBP.
Working Definitions of “Critical Portions”
Authors: Langerman Alexander , Brelsford Kathleen , Hammack-Aviran Catherine 
Published: February 2022

Objective:
Identify the considerations academic surgeons use when determining which portions of a procedure are “critical” and necessitate their presence.

Background:
Teaching physicians are required to be present for the “critical portion” of surgical procedures, but the definition of what constitutes a critical portion remains elusive. Current guidelines defer to surgeons' expert judgment in identifying critical portion(s) of a procedure; little is known about what concepts surgeons apply when deciding what parts of a procedure are critical.

Methods:
Qualitative analysis of interviews with 51 practicing surgeons from a range of specialties regarding their working definition of critical portions.

Results:
Surgeons identified 4 common themes that they use in practice to define the critical portions of procedures: portions that require their first-hand observation of events, those involving challenging anatomy or structures that cannot be repaired if injured, and portions where an error would result in severe consequences for the patient. Surgeons also recognized contextual factors regarding the patient, trainee, surgeon, and team that might alter determinations for individual cases.

Conclusions:
Although critical portion definitions are largely treated as subjective, surgeons across multiple specialties identified consistent themes defining “critical portions'', suggesting that setting a minimum standard for criticality is feasible for specific procedures. Surgeons also recognized contextual factors that support the need for case-specific judgement beyond minimum standard. This framework of procedure features and contextual factors may be used as a guide for surgeons making day-to-day decisions and in future work to formally define critical portions for a given procedure.
“The Triptan's Hangover”
Authors: Rueda Vega Mónica , Martínez-Fernández Alicia , Quintas Sonia , Díaz de Terán Javier , Latorre González Germán , Trabajos García Olga , Vivancos Mora Jose , Gago-Veiga Ana Beatriz 
Published: February 2022

Abstract
The emergence of triptans represented a breakthrough in the treatment of migraine, but in clinical practice, patients describe symptoms that resemble those of a hangover after taking them. We propose the use of the Hangover Symptoms Scale (HSS) to evaluate this syndrome in patients that take triptans, which may help identify patients at higher risk of presenting these adverse effects that may interfere with therapeutic compliance.
A cross-sectional observational pilot study with prospective data collection through a clinical-demographic questionnaire and the HSS was carried out on patients with migraine treated in headache units in 3 tertiary hospitals in Madrid.
Sixty-six patients were included in the study. The median HSS was 4 and all symptoms were present in at least 15% of the patients, with difficulty to concentrate being the most frequent (57.6%). No significant differences were found between the presence of a higher HSS score and the sociodemographic characteristics of the patient or his migraine. The presence of aura was associated with a higher percentage of trembling (P = 0.029) and fatigue (nonvisual, polymodal auras; P = 0.017).
According to our study, triptans are responsible for a set of symptoms overlapping with those that occur during a hangover. Therefore, we propose that the HSS could be a useful tool for the evaluation and quantification of these effects in patients receiving triptans. In addition, we found that clinical features could be more frequently associated with the appearance of these adverse effects that, however, are not related to any particular patient profile.
Radiographic Imaging of Power Injectable Medical Access Ports as a Supplemental Identification Tool
Authors: Goyal Nikhil , Do Huy M. , Toscano Alexandra P. , Spear Lillian G. , Hazen Lindsey A. , Folio Les R. 
Published: February 2022

AbstractPurposeOur aims were to describe characteristic radiographic features of two power injectable medical access ports (MAPs) on various imaging modalities for rapid and precise identification; and to demonstrate the value of this approach in identifying other types of MAPs via “pictorial atlas”.MethodsWe analyzed two commonly seen MAPs at our clinical center, Smart Port® CT-Injectable Port and PowerPort® M.R.I.® Implantable Port. Photographs of these two MAPs were retrospectively compared with identity-verified MAPs seen on chest X-ray (CXR), computed tomography (CT) and dual energy subtraction radiography (DESR) images from routine patient encounters at our clinical center. Visualized radiographic features were used for MAP differentiation and identification.ResultsBased on selected patient case examples for these two MAPs, physical characteristics seen on imaging were used for MAP identification. These properties included port body and chamber shape; location and number of suture holes; and radiopaque and radiolucent features. Each imaging modality provided a unique set of radiographic features and highlighted specific components of each MAP for rapid and precise identification. CXR offered better visualization of unique MAP features compared to CT.ConclusionsRadiographic imaging can serve as a tool for medical staff to quickly identify MAPs. Hospital-specific “pictorial atlases” can be developed to display MAPs along with their associated distinctive radiographic and physical features for rapid and precise identification. This may be useful for large referral centers that see a wide array of MAPs by mitigating complications associated with MAP misidentification and usage, thus improving patient care.