bluuebunny/crossref_metadata_2025 huggingface dataset:
Premature and early menopause among US women with or at risk for HIV
Authors: Bullington Brooke W. , Edmonds Andrew , Ramirez Catalina , Rahangdale Lisa , Neal-Perry Genevieve , Konkle-Parker Deborah , Weiss Deborah Jones , Moran Caitlin , Golub Elizabeth Topper , Cejtin Helen , Seidman Dominika , Kassaye Seble , Wilson Tracey E. , Sharma Anjali , Adimora Adaora A. , Knittel Andrea K.
Published: March 2022

Objective:

Little is known about the prevalence and treatment of premature and early menopause among people with HIV. We described premature and early menopause and subsequent hormonal treatment in a longitudinal cohort of women living with or at risk for HIV in the US.

Methods:

Data from the Women's Interagency HIV Study between 2008 and 2020 were analyzed to describe premature and early menopause among cohort participants under the age of 51.

Results:

Of 3,059 eligible women during the study period, 1% (n = 35) underwent premature menopause before age 41, 3% (n = 101) underwent menopause between ages 41 and 46, and 21% (n = 442) underwent menopause between ages 46 and 50, inclusive. Of participants who experienced menopause before age 41, between age 41 and 45, and between ages 46 and 50, 51%, 24%, and 7% (respectively) received either menopausal hormone therapy or hormonal contraception.

Conclusion:

These findings suggest that disparities in receipt of recommended hormone therapy for premature and early menopause may contribute, in part, to evident health disparities, such as cardiovascular disease, osteoporosis, and overall mortality. They also suggest a substantial need for education among people experiencing early menopause and their providers, with the goal of improving access to hormone therapy based on guidelines to address health disparities and minimize future health consequences.
Does Diversity of Authorship Matter? An Analysis of Plastic Surgery’s Top 100 Articles
Authors: Asserson Derek B. , Janis Jeffrey E.
Published: March 2022

Background:

Diversity, whether related to age, gender, ethnicity, race, geography, or experience, is increasing in all realms of medicine, including plastic surgery. Research has also become more diverse in those who conduct studies and those who participate in them. Fittingly, surgeons who produce prominent research are likely to come from diverse backgrounds. This study was designed to analyze the diversity of authorship in peer-reviewed plastic surgery journals.

Methods:

Using the Web of Science database, the authors identified the 100 most-cited articles from the highest-impact plastic surgery journals from January 2010 to December 2020. Author, institutional, and topic information was collected.

Results:

There was an average of 5.6 authors on the top 100 articles, of which 96.1% involved collaboration and 75.7% mixed-gender authorship. The average number of affiliations was 2.1, of which 51.5% involved cross-institutional collaboration, 12.6% came from both domestic and international institutions, 30.1% involved multiple specialties, and 10.7% came from both academia and private practice. Having both domestic and international authors was found to be most predictive of more citations on multiple regression, with year as a nonconfounding variable (P < 0.05), followed by mixed-gender authorship (P < 0.10).

Conclusion:

Impactful publications in plastic surgery come from diverse sets of authors and institutions.
Comparing Donor Site Morbidity for Autologous Breast Reconstruction: Thigh vs. Abdomen
Authors: Lee Z-Hye , Chu Carrie K. , Asaad Malke , Liu Jessie , Selber Jesse C. , Butler Charles E. , Largo Rene D.
Published: March 2022

Background:

Although abdominally-based free flaps have long been the gold standard, the profunda artery perforator (PAP) flap has emerged as an important alternative option for autologous breast reconstruction. The aim of this study was to directly compare the donor site morbidity of using the PAP versus deep inferior epigastric perforator (DIEP) free flap.

Methods:

We performed a retrospective review of patients undergoing autologous breast reconstruction using a DIEP and/or PAP flap from January 2017 to December 2020. In total, 30 PAP flap patients were matched with 60 DIEP flap patients. Outcomes included donor site wound dehiscence, length of stay, narcotic consumption, and pain scores. Patient-reported outcomes for the thigh versus abdomen were compared using questions derived from the BREAST-Q.

Results:

There was no significant difference in length of stay (P = 0.182), reoperation rates (P = 0.999), flap failure rates (P = 0.999), or donor site complications (P = 0.999). Both groups had similar mean pain scores, maximum pain scores, daily and total narcotic requirements. In comparing the thigh or abdomen as a donor site, there was no difference in frequency of negative symptoms (difficulty with daily activities, discomfort, tightness, and negative impact on ability to work) or satisfaction scores as related to their appearance in and out of clothing and the appearance of the scar.

Conclusions:

The thigh and abdomen are both suitable donor sites for autologous breast reconstruction with similar flap-related and patient-reported outcomes. The ultimate decision regarding whether to use a PAP or DIEP flap for breast reconstruction should be tailored based on patient anatomy and preference.
Impact of the COVID-19 Pandemic on the Wellness of Canadian Plastic Surgery Residents
Authors: Wong Chloe R. , Moltaji Syena , Cross Karen , Wanzel Kyle R.
Published: March 2022

Background:

On top of preexisting burnout, depression, and anxiety among trainees, the COVID-19 pandemic has introduced novel stressors. The objectives of this study were to determine the effects of the COVID-19 pandemic on Canadian plastic surgery residents’ practice, wellness, and overall training.

Methods:

Surveys for program directors and residents were created and disseminated to all English-speaking Canadian plastic surgery residency training programs. Survey results were pooled and presented as a percentage of responses for each question.

Results:

Response rates were 50% (n = 5/10) and 25% (n = 19/77) for program directors and residents, respectively. All program directors believed that the pandemic has a negative effect on resident wellness, 80% (n = 4/5) of which believed that their residents were coping effectively. They rated program support for resident wellness as neutral or supportive. Most programs (80%; n = 4/5) introduced strategies to support resident well-being. Most trainees (84%; n = 16/19) reported the pandemic as having a negative effect on their well-being, with approximately 50% endorsing worse emotional, social, psychological, and physical wellness, as well as feelings of burnout. Some reported difficulties coping (21%; n = 4/19). Residents felt that their wellness was supported externally by their own resilience (89%; n = 17/19), family members (74%; n = 14/19), friends (74%; n = 14/19), their partner (68%; n = 13/19), or co-residents (53%; n = 10/19). Internal support by their program was rated as neutral or negative (63%; n = 12/19).

Conclusions:

Our findings of negative effects of the COVID-19 pandemic on the wellness of Canadian plastic surgery trainees are concerning. Programs must implement appropriate identification and support strategies to improve resident well-being.
Eyebrow Position Before and After Enucleation
Authors: Custer Philip L. , Maamari Robi N. , Huecker Julia B. , Gordon Mae O.
Published: March 2022

Purpose:

The presence of eyebrow elevation in anophthalmic patients has been used as evidence to support a proprioceptive stimulus for frontalis innervation. In this study, we examined the frequency of brow elevation before and after enucleation and reviewed additional clinical findings to determine if any were associated with eyebrow position.

Methods:

A retrospective study was performed on 134 anophthalmic patients. Demographics, measurements, and photographs were reviewed. Reference photographs were used to subjectively grade brow position and sulcus depth.

Results:

Preoperative eyebrow elevation was present in 56.2% of patients without blepharospasm from a painful eye, of who 62% had chronic visual loss. Ipsilateral ptosis (p = 0.008), deep superior sulcus (p < 0.001), and right-sided pathology (p = 0.045) were more common in patients with brow elevation. Symmetrically elevated brows were more frequent before right than left enucleation (p = 0.05). Brow position remained stable after 61.9% of procedures. While often mild, postoperative brow elevation was seen in 31.0% of patients without preoperative elevation. Deepening of the superior sulcus was more common in patients with new relative brow elevation (p = 0.031). Anophthalmic ptosis and right-left surgical side were not associated with new postoperative brow elevation.

Conclusions:

Eyebrow elevation was often present prior to enucleation and associated with an increased occurrence of ptosis, superior sulcus deepening, and right-sided pathology. Intact vision was not needed to maintain an elevated brow. Superior sulcus deepening, but not ptosis, was more common in patients developing new postoperative brow elevation. The findings support both proprioceptive and compensatory mechanisms for eyebrow elevation.
Elastoma of the Orbit: A Case Report
Authors: Komzak Krishna , McKelvie Penelope , Goold Lucy
Published: March 2022

A 78-year-old man presenting for revision ptosis surgery was found to have an asymptomatic left inferomedial orbital mass visible below the left lower eyelid on external inspection, and subconjunctivally on examination. This was subsequently diagnosed as an isolated elastoma. A mass in a similar location was excised 60 years previously. His other ophthalmological history included stable diplopia corrected with prism, left-sided ectropion, bilateral sequential phacoemulsification, and past bilateral ptosis which has been persistent on the left side despite surgical repair and revision. His examination revealed left hypertropia but was otherwise largely unremarkable. However, imaging demonstrated the soft tissue lesion abutting the left globe. An anterior orbitotomy was performed, and the lesion was biopsied and specimens sent for histopathological examination and immunohistochemistry. This is the first case of an elastoma of the orbit reported in the literature to the best of the authors’ knowledge.
Episcleral Apocrine Hidrocystoma Following Strabismus Surgery
Authors: Charles Norman C. , Panarelli Anthony J.
Published: March 2022

Apocrine hidrocystomas are benign cystic tumors derived from apocrine sweat glands; they are most commonly located in the skin of the head and neck regions. Ophthalmic occurrences typically appear at the lash line and canthi of the eyelid, although rare instances have been described in the conjunctiva, caruncle, and orbit. The authors illustrate an exceptional instance of a mobile episcleral cyst in a 12-year-old girl that developed about 2 years following strabismus surgery. The cyst was located anterior to the insertion of the left medial rectus and was excised in response to the patient’s complaints of irritation. Histopathology of the excised specimen displayed an empty cyst lined by a double layer of cuboidal epithelium with the inner layer exhibiting apical decapitation secretion. Confirmatory immunohistochemistry demonstrated reactivity of both layers with CK7 and the outer myoepithelial layer with D2-40. Postoperative and traumatic cysts formed after interruption of the bulbar conjunctiva are usually conjunctival cysts lined by stratified squamous nonkeratinizing epithelium.
Psychogenic Ptosis
Authors: Ho Tiffany C. , Couch Steven M. , Custer Philip L.
Published: March 2022

Purpose:

Psychogenic ptosis is a rare ophthalmic manifestation of conversion disorder. The aim of this study was to describe the clinical parameters, etiology, psychological, and clinical aspects of psychogenic ptosis.

Methods:

A retrospective case series was conducted of patients with psychogenic ptosis seen between 1990 to 2020. Medical records were reviewed for patient demographics, including psychiatric history, clinical findings, diagnostic studies, treatment, and resolution rates. A literature review was performed to identify cases of psychogenic ptosis previously published between 1990 and 2020.

Results:

Six female patients (aged 14–60 years) were diagnosed with unilateral psychogenic ptosis. Physical trauma preceded the onset of ptosis in all cases. Imaging studies had been previously obtained in all patients, none of who were correctly diagnosed at time of referral. Associated signs included concurrent brow ptosis, orbicularis oculi spasm, squint on upgaze, and variable levator function and eyelid margin measurements. Four patients had preexisting psychological conditions. Patients were primarily managed with reassurance.

Conclusions:

Psychogenic ptosis is an often delayed or misdiagnosed condition, resulting in unnecessary referrals and imaging. Psychogenic ptosis should be considered in patients with atypical findings of ptosis including ipsilateral brow depression, orbicularis oculi spasm, squint on upgaze, and variable eyelid measurements. A prior history of minor trauma and female sex were common in this series. Our experience suggests that psychogenic ptosis can often be treated with reassurance, leading to partial or complete resolution. Given the number of patients with comorbid psychiatric conditions, the authors recommend a low threshold for psychiatric or psychological evaluation.
#Oculoplastics: An Analysis of TikTok’s Top Oculoplastics Content
Authors: Cheng Tiffany , Wang Fei , Barmettler Anne
Published: March 2022

Purpose:

To analyze the source and quality of oculoplastics-related content on TikTok, a popular social media platform.

Methods:

Twenty-five oculoplastics-related hashtags were queried. The top 20 videos for each hashtag were included. The number of views, likes, comments, and shares were recorded for each video. Each video was also categorized by the account owner and by video content characteristics. A subanalysis of the educational videos was conducted using the mDISCERN, Patient Education Materials Assessment Tool, and modified MICI scores to assess video quality, understandability and actionability, and medical accuracy, respectively.

Results:

The included 386 videos amassed 218,997,134 views, 15,033,220 likes, 148,099 comments, and 276,445 shares. Patients were the leading content creators (38.1%), followed by nonophthalmology MDs/DOs (25.6%), and oculoplastic surgeons/ophthalmologists (16.3%). Physician-created videos received more visibility than nonphysician-created videos (median of 23,600 views and 22 shares), though this did not reach statistical significance. However, oculoplastic surgeon-posted content received the lowest median views and shares. The video category that amassed the most views was “live procedure/surgeries,” followed by “educational” and “patient experience.” Subanalysis of 46 educational videos revealed physicians were the chief creators, accounting for 67.4% of all educational videos. Physician-created content demonstrated statistically significant better understandability and actionability, as measured by the Patient Education Materials Assessment Tool (p = 0.0053).

Conclusion:

Physicians play an important role in disseminating evidence-based medicine on social media. While oculoplastics-related TikTok videos are gaining traction, additional research is needed to improve the visibility of oculoplastic-surgeon posted content.
Posttraumatic Endophthalmitis Caused by Medicopsis romeroi
Authors: Garofalo Francesca , Wilcock Jonathan , Lahey Tim
Published: March 2022

Fungal exogenous endophthalmitis is rare. Here, we report a case of posttraumatic endophthalmitis caused by Medicopsis romeroi in a 64-year old man. After a tree branch punctured his right eye while hiking in Laos, the patient's symptoms included pain, blurry vision, limited vision of light and dark, and sensation of a foreign body. The patient was unsuccessfully treated in Thailand with itraconazole and intraocular amphotericin. Upon return to the United States, the patient underwent extensive ophthalmic surgery and voriconazole was prescribed. Fundoscopic examination showed resolution of inflammation 3 months after the surgery, but despite symptomatic improvement, severe visual deficits remained. We performed a comprehensive case review of reported cases of M. romeroi infection, revealing that M. romeroi commonly manifests as a subcutaneous infection on the extremities in immunosuppressed patients who usually resolved with antifungal and surgical therapy. Many patients living in temperate climates were reported to have a travel and/or an immigration pattern from a tropical zone. This case and review extend the clinical spectrum of Medicopsis to include ocular infections, illustrates the importance of considering rare pathogens in patients with exogenous endophthalmitis, and encourages prompt medical and surgical treatment of Medicopsis.
Number of cerebral microbleeds after intracranial/extracranial stenting and dual antiplatelet therapy
Authors: Hsu Huan-Ming , Lu Yueh-Hsun , Su I-Chang , Chan Lung
Published: March 2022

Background:

Cerebral microbleeds (CMBs) are small (<1 cm) perivascular hemosiderin depositions. They may be visible in T2* or susceptibility-weighted magnetic resonance imaging (MRI) sequences. CMBs may indicate an increased risk of intracerebral hemorrhage (ICH) or vascular disease. Cerebral white matter changes indicate small vessel disease (SVD), which is also related to CMBs. In cerebral vascular treatment, dual antiplatelet therapy (DAPT) is routinely used after stenting. We surveyed our cerebral stenting case series for changes in the number of CMBs.

Methods:

Patients receiving extracranial or intracranial stenting between 2018 and 2020 were included. All patients received DAPT after stenting. Changes in CMBs, SVD degree, and other findings from pretreatment to follow-up MRI were recorded. Differences between stented artery supplying territory and other territories were compared.

Results:

The average age of the 75 enrolled patients was 65.37 years ± 11.53 (50 male and 25 female patients); 84 extracranial or intracranial stentings were performed. The average Fazekas scale score was 1.32 ± 0.77. Significantly more CMBs developed in the initial ≥6 CMB group than in the initial 0 and 1-5 CMB groups (7 ± 3.6 vs 0.56 ± 1.06, 1.45 ± 3.32, p < 0.001). No significant difference in increased CMBs was observed between the initial 0 and 1-5 CMB groups. Significantly more CMBs developed in the stented artery supplying territory than elsewhere (0.6 ± 0.13 vs 0.44 ± 0.17, p < 0.05). No ICH was noted in our case series.

Conclusion:

Preexisting CMB was a risk factor for the onset of new CMBs after stenting and DAPT. Poststenting and DAPT statistically increased CMBs in stented artery supplying territories at short-term follow-up.
Psychometric Testing of the Control Attitudes Scale-Revised for Patients With a Left Ventricular Assist Device
Authors: Thompson Jessica Harman , Moser Debra , Lee Christopher S.
Published: March 2022

Background

Perceived control, an indicator of the patient's ability to cope and thrive with a chronic illness, is a common target of nursing interventions. As of 2019, more than 25 000 patients had been implanted with a left ventricular assist device (LVAD) as a treatment of advanced heart failure. Patients with an LVAD experience significant life changes that affect anxiety, depression, health-related quality of life, and, presumably, perceived control. To adequately intervene and improve perceived control, a reliable and valid measure is needed.

Objectives

The objectives of this analysis were to (1) assess item discrimination and anticipated range of scores of the Control Attitudes Scale-Revised (CAS-R), (2) assess the internal consistency and validity of the CAS-R, and (3) examine perceived control in a sample of patients with an LVAD.

Methods

Two cohorts of patients with an LVAD (n = 113) were combined to evaluate the psychometric qualities of the CAS-R. Correlations among patient-reported outcomes and perceived control were used to evaluate validity. Cronbach α was used to test internal consistency. Item response theory was used to measure item discrimination and anticipated scores. Descriptive statistics describe perceived control in the sample.

Results

Overall, the CAS-R demonstrated good internal consistency and convergent validity with other patient-reported outcomes. Using the item response theory, we saw that the CAS-R was a good predictor of lower-moderate scorers but was not good at differentiating high performers. There were several items that were poor discriminators and could be altered or discarded to create a more predictive instrument.

Conclusions

The CAS-R is a valid and reliable instrument to measure perceived control in patients who have LVAD implants; however, more work could be done to improve item-level information.
Sleep, Stress, and Symptoms Among People With Heart Failure During the COVID-19 Pandemic
Authors: O'Connell Meghan , Jeon Sangchoon , Conley Samantha , Linsky Sarah , Redeker Nancy S.
Published: March 2022

Background

The COVID-19 pandemic raised concerns about the effects of stress on sleep and mental health, particularly among people with chronic conditions, including people with heart failure (HF).

Objective

The aim of this study was to examine changes in sleep, sleep-related cognitions, stress, anxiety, and depression among people with HF who participated in a randomized controlled trial of cognitive behavioral therapy for insomnia before the COVID-19 pandemic.

Methods

Participants self-reported sleep characteristics, symptoms, mood, and stress at baseline, 6 months after cognitive behavioral therapy for insomnia or HF self-management education (attention control), and during the pandemic.

Results

The sample included 112 participants (mean age, 63 ± 12.9 years; 47% women; 13% Black; 68% New York Heart Association class II or III). Statistically significant improvements in sleep, stress, mood, and symptoms that occurred 6 months post treatment were sustained during the pandemic.

Conclusions

Improving sleep and symptoms among people with HF may improve coping during stressful events, and cognitive behavioral therapy for insomnia may be protective.
Association Between Interdisciplinary Collaboration and Leadership Ability in Intensive Care Unit Nurses: A Cross-Sectional Study
Authors: YAMAMOTO Kanako
Published: March 2022

Background

Interdisciplinary collaboration in the intensive care unit (ICU) is crucial for improving the quality of patient care. Furthermore, interdisciplinary team members need to establish team leadership to function effectively in solving problems. However, the influence of improving leadership ability in nurses on interdisciplinary collaboration efficacy is uncertain.

Purpose

This study was designed to clarify the relationship between nursing leadership ability and interdisciplinary collaboration.

Methods

This cross-sectional study included 3,324 nurses with > 3 years of experience working in an ICU in Japan as participants. The investigation period was from April to September 2016. The developed questionnaire addressed leadership ability (Self-Assessment Inventory of Leadership role for staff nurses) and activities and perceptions related to multidisciplinary collaboration (Collaboration and Satisfaction About Care Decisions). The questionnaires were then collected and mailed.

Results

The 2,063 valid questionnaire responses gave a valid response rate of 61%. Nursing leadership ability was found to be significantly higher in advanced practice nurses (APNs; 78.8 ± 9.5, p < .001) and nurses in higher positions (74.9 ± 8.9, p < .001) than in non-APNs. However, no differences were found in terms of ICU management systems (p = .116). In addition, higher levels of nursing leadership were associated with greater team coordination (β = .212), higher levels of interdisciplinary collaboration in the ICU (β = .196), and the perception of many medical staff members, as well as patients and family members, to be team members (β = .140) and APNs (β = .128; p < .001).

Conclusions/Implications for Practice

Improving the leadership ability of critical care nurses may impact interdisciplinary collaboration positively. Leadership ability in nurses was shown to be related to a high level of cooperation among multiple healthcare providers. To enhance leadership ability in critical care nurses, nurses must increase their level of knowledge and ability. However, examining and implementing educational methods, including the improvement of coordination ability mainly by APNs, remain a challenge.
A Survey of Combat Athletes' Rapid Weight Loss Practices and Evaluation of the Relationship With Concussion Symptom Recall
Authors: Uddin Nasir , Waldron Mark , Patterson Stephen D. , Winter Stacy , Tallent Jamie
Published: March 2022

Objective:

There is a high incidence of concussion and frequent utilization of rapid weight loss (RWL) methods among combat sport athletes, yet the apparent similarity in symptoms experienced as a result of a concussion or RWL has not been investigated. This study surveyed combat sports athletes to investigate the differences in symptom onset and recovery between combat sports and evaluated the relationships between concussion and RWL symptoms.

Design:

Cross-sectional study.

Setting:

Data were collected through an online survey.

Participants:

One hundred thirty-two (115 male athletes and 17 female athletes) combat sport athletes.

Interventions:

Modified Sport Concussion Assessment Tool (SCAT) symptom checklist and weight-cutting questionnaire.

Main Outcome Measures:

Survey items included combat sport discipline, weight loss, medical history, weight-cutting questionnaire, and concussion and weight-cutting symptom checklists.

Results:

Strong associations (r
s = 0.6–0.7, P < 0.05) were observed between concussion and RWL symptoms. The most frequently reported symptom resolution times were 24 to 48 hours for a weight cut (WC; 59%) and 3 to 5 days for a concussion (43%), with 60% to 70% of athletes reporting a deterioration and lengthening of concussion symptoms when undergoing a WC. Most of the athletes (65%) also reported at least one WC in their career to “not go according to plan,” resulting in a lack of energy (83%) and strength/power (70%).

Conclusions:

Rapid weight loss and concussion symptoms are strongly associated, with most of the athletes reporting a deterioration of concussion symptoms during a WC. The results indicate that concussion symptoms should be monitored alongside hydration status to avoid any compound effects of prior RWL on the interpretation of concussion assessments and to avoid potential misdiagnoses among combat athletes.
Racial and Gender Disparities Among Obese Patients With Pancreatic Cancer
Authors: Twohig Patrick A. , Butt Muhammad U. , Gardner Timothy B. , Chahal Prabhleen , Sandhu Dalbir S.
Published: March 2022

Background:

Pancreatic cancer (PC) is the third leading cause of cancer death. Obesity can increase the risk of PC by up to 50%. Studies have shown racial and gender disparities in PC, however, there is a paucity of such information in obese PC patients.

Aim:

The aim of this study was to: (1) evaluate the incidence and prevalence of obesity among PC patients in the United States over the last 15 years, and (2) determine if variation exists in the demographic of obese PC patients over the last 15 years. It is hoped that this information could be used to assist in primary prevention and early detection of PC.

Methods:

A population-based retrospective analysis in IBM Explorys, a pooled, national, deidentified database of 63 million patients from 300 hospitals in the United States. Patient populations were identified using SNOMED and ICD codes. Cochrane-Armitage testing was performed to analyze trends in obesity among PC. Subgroup analysis for gender, age, race, and mortality rate were assessed.

Results:

The percentage of obese patients with PC increased over the 15-year period (2.5% to 8.5%, P<0.0001). Rates of obesity among PC patients increased among females (P=0.0004), individuals under age 65 years (P=0.0002), and all races, but especially for African Americans (P=0.0007) and those in minority groups.

Conclusion:

Awareness of disparities in PC and applying targeted care to those at increased risk are essential to improve future outcomes, including increased health care access and recruitment in research studies for minority groups.
Spatial-temporal Distribution and Influencing Factors of Helicobacter pylori Infection in Chinese Mainland, 2001-2020
Authors: Lu Tai-Liang , Zhang Jia-Min , Li Shao-Rong , Chen Chao-Wu
Published: March 2022

Background:

The spatial-temporal distribution of Helicobacter pylori infection in China is poorly understood. We aimed to study the spatial-temporal distribution of H. pylori infection in Chinese mainland and to explore its influencing factors.

Materials and Methods:

We searched the relevant literature from 2001 to 2021 and applied meta-analysis to obtain the pooled prevalence estimates of all studies and subgroups. Then, we used the pooled prevalence as the dependent variable for the following analysis, including time series analysis, statistical mapping, spatial autocorrelation analysis, and influencing factor analysis based on generalized additive model and panel data model.

Results:

A total of 726 articles and 3,407,392 people were included. The pooled prevalence was 43.7% (95% confidence interval: 42.7%–44.8%). The prevalence decreased in the past 20 years, with high in the eastern and western regions and low in the central region. Qinghai Tibet Plateau and Guizhou Plateau were the high incidence areas of this disease. The intake of vegetable oil, aquatic products, meat, milk, per capita gross domestic product, and annual average humidity were significantly correlated with H. pylori.

Conclusions:

The prevalence of H. pylori is decreasing in Chinese mainland, but still high in underdeveloped areas. Appropriate strategies for the prevention need greater attention.
Mediating Effect of Illness Perception on Psychological Distress in Patients With Newly Diagnosed Gastric Cancer
Authors: Lee Ji Yea , Jang Yeonsoo , Hyung Woojin
Published: March 2022

Background

A cancer diagnosis is a life-threatening event, but studies on psychological distress in patients with cancer after diagnosis are relatively limited, particularly those in early-stage cancer.

Objectives

On the basis of Leventhal's common-sense model of self-regulation, this study examined the mediating effects of illness perception on psychological distress and identified the factors influencing illness perception in patients with newly diagnosed gastric cancer.

Methods

A cross-sectional survey was conducted, and a mediation analysis was performed to determine the role of illness perception in the relationship between social support, the presence of physical symptoms, satisfaction with patient education, and psychological distress.

Results

Participants were 184 patients with recently diagnosed early gastric cancer who are waiting for surgery in a tertiary hospital in Seoul, Korea. The population had a moderate level of psychological distress. Social support, physical symptoms, and satisfaction with patient education significantly influenced illness perception (β = −0.14, P = .048; β = 0.18, P = .015; β = −0.17, P = .019, respectively), and illness perception had a full mediation effect between these 3 variables and psychological distress (β = 0.66, P < .001).

Conclusion

Healthcare providers need to focus on patients' psychological distress following a diagnosis of cancer because this distress could be easily overlooked in clinical settings, even in patients with early-stage cancer.

Implication for Practice

Healthcare providers might alleviate patients' psychological distress by improving unrealistic illness perceptions, alleviating physical symptoms, and providing clear and sufficient patient education in patients with cancer after diagnosis.
Metacognitive Training to Improve Insight and Work Outcome in Schizophrenia
Authors: Zalzala Aieyat , Fiszdon Joanna M. , Moritz Steffen , Wardwell Patricia , Petrik Tammy , Mathews Laura , Shagan Dana , Bracken Daniel , Bell Morris D. , Pearlson Godfrey D. , Choi Jimmy
Published: March 2022

Individuals with psychotic disorders have deficits in metacognition. Thirty-four adults with schizophrenia were randomized to 2 months of metacognitive training (MCT) or a healthy living skills control group. All participants were enrolled in a work therapy program, followed by a supported employment program. Assessments were conducted at baseline, at the end of the 2-month active intervention, and at 4- and 12-month follow-ups. At the end of active intervention, the MCT group demonstrated greater improvement and better work behavior relative to controls. At follow-up, the MCT group demonstrated significantly greater insight and fewer positive symptoms and a greater percentage were employed in the community. We speculate that being better able to think about one’s thoughts, recognize biases in thinking, and correct those thoughts may aid in responding to workplace challenges and hence improve work outcomes.
Enhancing Exam Performance to Increase Retention Among Students in an Associate Degree Nursing Program
Authors: Ingram Donna , Russell Kendra , Hill Kassi , Daly Shannon
Published: March 2022

Background:

High rates of attrition are problematic for nursing programs in meeting program graduation expectations and the nursing workforce demand.

Purpose:

In an effort to address declining program completion rates over the past 3 years and to assist with student retention, the authors explored the benefits of using The Exam Analysis (TEA) procedure with first-semester nursing students in an associate of science in nursing program.

Methods:

This descriptive pilot study used TEA Worksheet and surveys to collect data with 50 first-semester students. Retention, exam performance, and student experiences were explored.

Results:

Use of TEA procedure benefitted students, with results revealing a retention rate of 90% (n = 45) of first-semester students and a positive rate of change between the exam average score and the final exam score.

Conclusions:

Findings support improved retention for first-semester associate degree nursing students, better exam performance, and positive experiences with using TEA procedure.
Leveraging a Successful Faculty Practice Model to Recruit and Retain Early-Career Nurse Faculty
Authors: Moss Angela , Rousseau Jennifer , Swartwout Kathryn , Kalensky Melissa , Gallagher Therese , Gorenz Annika , Dickins Kirsten
Published: March 2022

Background:

The shortage of nursing faculty is well documented as are the challenges of attracting and retaining early-career faculty, in part, due to difficulties transitioning expert clinicians into faculty roles.

Problem:

There is little guidance in the literature describing successful formal transition models.

Approach:

An urban College of Nursing Faculty Practice (CON FP) underwent an operational redesign beginning in 2014, resulting in an intentional success: a pipeline for attracting and developing early-career faculty. This article describes how the CON FP leverages faculty practice to develop early-career faculty.

Outcomes:

Across a 6-year time span, at least 20 early-career CON FP clinicians have transitioned to full-time faculty roles. In addition, CON FP clinicians provide more than 75 000 direct care nursing services and support more than 25 000 student clinical and project hours annually.

Conclusions:

We offer this early-career faculty practice pipeline model as a solution for attracting and growing a contemporary nursing faculty workforce.
Fostering Nursing Students' Moral Decision-Making Through Use of an Affective Learning Module
Authors: Morrill Deborah , Westrick Susan J.
Published: March 2022

Background:

The emphasis on disciplinary and preventive approaches to combating academic misconduct does little to foster student professional identity and core nursing value formation.

Problem:

There is a need for pedagogy designed to navigate moral decision-making within ambiguous areas of practice as nursing students integrate personal and professional values while becoming a nurse.

Approach:

Rest's theory of moral development offers a framework for constructing purposeful affective learning activities that operationalize moral sensitivity, judgment, motivation, and character, whereas Krathwohl's theory provides a means to identify affective learning objectives. Offering prelicensure nursing students an opportunity to discuss, reflect on, and consider actions and consequences associated with academic and practice-based situations forms the basis for this affective learning module that fosters connections between academic and professional behaviors of integrity.

Conclusion:

Rest's theoretical model provides a viable structured approach to moral development. Curriculum designed to engage moral decision-making offers an innovative approach to cultivating student integrity.
Entrustable Professional Activities in Clinical Education
Authors: Corrigan Catherine , Moran Katherine , Kesten Karen , Conrad Dianne , Manderscheid Amy , Beebe Sarah L. , Pohl Elizabeth
Published: March 2022

Background:

Competency attainment is foremost in the ethos of this project that provides a practical guide to implementing entrustable professional activities (EPAs) as one approach to competency acquisition in the clinical education component of a health care program. EPAs are units of work that provide evidence of required competencies for the clinical education component of a program of study for educators, preceptors, and students.

Problem:

The American Association of Colleges of Nursing has raised the importance of competency-based education and need for a practical approach to assess clinical competency challenges (eg, EPAs) in nursing education.

Approach:

The implementation of EPAs in the clinical component of advanced nursing education is detailed as an example in this article. Prioritizing a systematic approach, the Knowledge to Action framework, was chosen to guide the process.

Conclusion:

Nursing must act now to put in place a robust competency acquisition and validation system.
Nurse Educator Perceptions of Workplace Collegiality
Authors: Davis Sandra G. , Davis Emily , Kintz Kim , Opsahl Angela
Published: March 2022

Background:

The nursing faculty shortage challenges nursing educators, administrators, and staff to find innovative ways to understand and address faculty retention.

Purpose:

The purpose of this study was to examine nurse educators' perceptions of workplace collegiality and the possible correlation to role satisfaction and role persistence.

Methods:

Participants (n = 177) were recruited nationally from a Commission on Collegiate Nursing Education accredited schools listing. Three survey instruments were utilized: Survey of Collegial Communication, Job Satisfaction Survey, and Michigan Organizational Assessment Questionnaire.

Results:

The study found a positive relationship between collegiality and job satisfaction in academia. The Pearson correlation results indicated there was a significant negative correlation between the intent to remain and collegiality.

Conclusion:

The findings suggest nursing educators perceive collegiality as an important component of job satisfaction and intent to remain.
Design and custom fabrication of specialized orthoses for the upper-limb stabilization in childhood dyskinesia
Authors: Garavaglia Lorenzo , Pagliano Emanuela , LoMauro Antonella , Pittaccio Simone
Published: March 2022

Background:

Childhood dyskinesia (CD) is a complex movement disorder with components of dystonic and hyperkinetic nature, characterized by involuntary, sometimes stereotypical postures and gestures that are often impossible to control and hinder the execution of willful motion. The standard orthoses for the treatment of neurological diseases, including CD, are generally poorly differentiated for functional characteristics. The application of similar devices for movement disorders is far less generalized because of the very different symptoms, including the incapacity to control rather than initiate movement.

Objectives:

This article aims to describe an innovative method to fabricate personalized orthoses for the elbow-wrist joints in CD, taking into account anatomical and functional diversities. It also proposes functional elements to implement the required dynamic postural control.

Methods:

Wearable custom-made upper-limb orthoses have been fabricated and preliminarily tested on five patients with CD. Optoelectronic stereophotogrammetry was used as an innovative tool for all-in-one–frame acquisition of limb geometry. A new process for the functional personalization of the orthoses has been developed using shape memory alloys.

Conclusions:

The innovative method presented, encompassing data acquisition, virtual design, fabrication, and assembling, overcomes the problems due to the involuntary movements of the patients, which cannot be avoided during the fitting operations, providing comfortable and useful orthoses with minimal nuisance for the patients. Initial tests show that the orthoses were well tolerated by all the subjects; the promising comments of caregivers, together with improvements, were observed by the clinicians using specific clinical scales.
The Use of Virtual Standardized Patients for Practice in High Value Care
Authors: Bond William F. , Mischler Matthew J. , Lynch Teresa J. , Ebert-Allen Rebecca A. , Mou Kyle M. , Aiyer Meenakshy , Park Yoon Soo
Published: March 2022

Introduction

This study examined the influence of high value care (HVC)-focused virtual standardized patients (VSPs) on learner attitudes toward cost-conscious care (CCC), performance on subsequent standardized patient (SP) encounters, and the correlation of VSP performance with educational outcomes.

Method

After didactic sessions on HVC, third-year medical students participated in a randomized crossover design of simulation modalities consisting of 4 VSPs and 3 SPs. Surveys of attitudes toward CCC were administered before didactics and after the first simulation method. Performance markers included automated VSP grading and, for SP cases, faculty-graded observational checklists and patient notes. Performance was compared between modalities using t tests and analysis of variance and then correlated with US Medical Licensing Examination performance.

Results

Sixty-six students participated (VSP first: n = 37; SP-first: n = 29). Attitudes toward CCC significantly improved after training (Cohen d = 0.35, P = 0.043), regardless of modality. Simulation order did not impact learner performance for SP encounters. Learners randomized to VSP first performed significantly better within VSP cases for interview (Cohen d = 0.55, P = 0.001) and treatment (Cohen d = 0.50, P = 0.043). The HVC component of learner performance on the SP simulations significantly correlated with US Medical Licensing Examination step 1 (r = 0.26, P = 0.038) and step 2 clinical knowledge (r = 0.33, P = 0.031).

Conclusions

High value care didactics combined with either VSPs or SPs positively influenced attitudes toward CCC. The ability to detect an impact of VSPs on learner SP performance was limited by content specificity and sample size.
Electroclinical Features in Epilepsy Surgery Candidates With Epileptic Spasms
Authors: Moosa Ahsan N. , Velayudam Kohila vani , Erdemir Gozde
Published: March 2022

Electroclinical features in surgical candidates with epileptic spasms differ significantly from the other focal epilepsy phenotypes. EEG findings tend to be more diffuse and less localizing in children with epileptic spasms. These are illustrated with five case studies to highlight three different categories of findings on interictal and ictal EEG: lateralizing, nonlateralizing, and false lateralizing. Hemihypsarrhythmia on interictal EEG is the most striking lateralizing abnormality that occurs in a minority of surgical candidates. Persistent focal epileptiform discharges in one region or asymmetric physiologic rhythms decreased over the abnormal hemisphere may provide localization clues. Ictal EEG patterns are diffuse and nonlocalizing in over half of the patients. Ictal patterns are best expressed in the posterior head regions even in patients with epileptogenic zone in anterior regions. Semiologically, epileptic spasms tend to be symmetrical in majority of surgical candidates. Asymmetric spasms and coexisting focal seizures (concurrent or remote), when present, may provide localization findings. False lateralizing interictal or ictal EEG abnormalities, paradoxically higher over the healthier hemisphere, occur in the setting of large encephaloclastic/volume loss lesions. In these patients, the diffuse discharges are less expressed over the abnormal hemisphere with less cerebral tissue. Recognition of such false lateralizing findings is important to avoid excluding appropriate surgical candidates based on the EEG findings alone. Epileptogenic lesions are visible on brain MRI in majority of surgical candidates with epileptic spasms. Electroclinical findings are often concordant with the lesion, but discordant findings are not uncommon in children with epileptic spasms.
Historical Overview of Hypsarrhythmia and Its Association to Epileptic Spasms: A Review of the Medical Literature From 1952 to 1982
Authors: Pestana Knight Elia M. , Mani Jayanti
Published: March 2022

The initial description of infantile spasms and its association to developmental abnormalities was attributed to Dr. Williams J. West in 1841 but the clinical scenario at the time had also been seen by other physicians. French physician Henry Gastaut proposed the eponym of West syndrome in the 9th Colloquium de Marseille in 1960. The description of hypsarrhythmia in 1952 by Gibbs and Gibbs added the EEG component to the triad of infantile spasms. The hypsarrhythmia discovery led to a sudden interest in understanding the etiology and developing treatments for this devastating disease affecting infants and young children. It was in the 1950s when cases of infantile spasms with absence of hypsarrhythmia were initially observed. Also, the treatment with adrenocorticotrophic hormone was initially reported as efficacious for treating infantile spasms and hypsarrhythmia in the late 1950s. Adrenocorticotrophic hormone remains the best treatment option for these epilepsy types. This article will provide a historical review of knowledge developments about hypsarrhythmia and infantile spasms, emphasizing the period 1952 to 1982. The goal of the article was to highlight clinical elements that were discovered then and remain clinically relevant today.