bluuebunny/crossref_metadata_2025 huggingface dataset:
Bereavement Care
Authors: Lichtenthal Wendy G. , Rosa William E. , Neimeyer Robert A.
Published: January 2023

Grief often begins at the time of a cancer diagnosis, commonly emerging as patients and their families of choice confront multiple losses throughout their illness and as the disease progresses, and often surging most intensely following the patient’s death. This chapter aims to promote family-centered care by equipping psycho-oncology clinicians with the skills needed to support those who are grieving, identify common grief reactions and risk factors for poor bereavement outcomes, and manage the grief experience using evidence-based interventions. Remaining mindful of the family’s cultural and spiritual needs as well as sources of disenfranchised grief, psycho-oncologists can provide empathic support, provide psychoeducation about adaptive reactions to loss and change, assess for maladaptive grief reactions, and make referrals for more specialized bereavement support when warranted.
50 Studies Every Occupational Therapist Should Know
Authors: Lee Elissa , Pyatak Beth
Published: January 2023

50 Studies Every Occupational Therapist Should Know presents a curated collection of the most influential studies guiding occupational therapy practice today. The text is organized into six practice areas, following the American Occupational Therapy Association (AOTA) framework for OT practice: productive aging, health and wellness, work and industry, rehabilitation and disability, children and youth, and mental health. Each section contains a series of chapters, each of which outlines the design, findings, and implications of a key study from that area of practice. Each chapter also includes a case scenario designed to illustrate how the findings of the study relate to clinical practice. This text will be a valuable resource for occupational therapy students and practitioners seeking to understand the breadth, rigor, and trustworthiness of research informing occupational therapy practice, and for others interested in better understanding the profession.
Emerging Occupational Therapy Practice for Inclusive Work Transition and Vocational Programming
Authors: Washington Selena , Jaegers Lisa
Published: January 2023

The provision of occupational therapy services for work transitions is an emerging area of community-based practice. The study discussed in this chapter indicates a broad perspective of occupational needs to be explored when designing evidence-informed interventions for vocational or work outcomes. Specifically, the Employment Options program examined in this study with individuals experiencing AIDS revealed the importance of considering personal narratives to inform work interventions that are tailored to individual needs. Implications for vocational programming in occupational therapy that addresses health challenges, physical limitations, environmental factors, and contextual influences on work pursuits are explored. Related research, resources, and a case study are provided to assist practitioners in applying these vocational programming concepts in occupational therapy practice.
Occupational Time-Use Intervention for People with Serious Mental Illness
Authors: Lambdin-Pattavina Carol
Published: January 2023

Engagement in meaningful occupation is frequently limited in individuals with severe mental illness due to symptomatology as well as societal marginalization and occupational deprivation resulting from stigma. This chapter presents evidence from a randomized study of Action over Inertia (AOI), a manualized program intended to support clients in recognizing the link between occupational engagement and health and move from a state of inertia to action. Results indicated that differences in occupational balance between the intervention and control group were statistically significant, with the intervention group sleeping less each night versus the control group following the 12-week study period. Intervention participants shifted the time gained from sleeping less to activities of interest rather than non-health-promoting behaviors. Intervention administrators described the clinical utility of the program, and participants reported increased time-use awareness and well-being. AOI provides a program focused on developing the occupational potential of those with severe mental illness.
Recovering Energy through Nutrition and Exercise for Weight Loss (RENEW)
Authors: Bae Soyoung Esther
Published: January 2023

“Weight Loss Intervention for People with Serious Mental Illness: A Randomized Controlled Trial of the RENEW Program” examines the effectiveness of the first two phases of the RENEW (Recovering Energy through Nutrition and Exercise for Weight Loss) program, a weight loss program for people living with serious mental illness. This randomized controlled trial compared the weight loss of individuals in the RENEW program compared to those receiving typical day treatment at their community mental health programs over 3- and 6-month periods, finding that individuals who participated in RENEW lost significantly more weight than those in the control group. This chapter includes a clinical case example representing clients who may benefit from programs like the one described in this study.
Evaluation of Sensory Processing Using the Sensory Profile Questionnaire
Authors: Watling Renee , Holland Cristin
Published: January 2023

This chapter reviews the factor analysis of the Sensory Profile, an 81-item caregiver-completed questionnaire that examines a child’s sensory processing patterns. Factor analysis of 1,037 completed questionnaires from children ages 3–10 years without disabilities identified a nine-factor model sorted by the child’s responsivity to sensory experiences, rather than by sensory system. The model accounted for 47.8% of the variance in the factor loadings. The Sensory Profile factors identified in this study are similar to patterns of sensory modulation found in children with disabilities. A case study illustrates use of the Sensory Profile-2, a revised version of the Sensory Profile, in the occupational therapy evaluation process to gather information about a client’s sensory processing–based behaviors and inform intervention planning.
Moderate- versus Light-Pressure Massage Therapy Leads to Greater Weight Gain in Preterm Infants
Authors: Stein Duker Leah I. , Franklin Marshae D.
Published: January 2023

The objective of this study was to examine the application of moderate-pressure massage and kinesthetic stimulation versus light-pressure massage and kinesthetic stimulation on preterm infant behavioral states, heart rate/vagal tone, and weight. Preterm infants (n = 68; M gestational age = 30 weeks) in the neonatal intensive care unit (NICU) were randomly assigned to a moderate- or light-pressure massage therapy plus kinesthetic stimulation condition, receiving massages three times per day for 15 minutes each for 5 consecutive days. Infants who received moderate-pressure massage therapy demonstrated significant improvements in behavioral states (e.g., active sleep, fussing, crying, movement, stress behavior), deep sleep, heart rate/vagal tone, and weight gain compared to the light-pressure massage therapy group. Overall, the data indicate that providing moderate-pressure massage therapy and kinesthetic stimulation has the potential to improve outcomes for stable preterm infants in the NICU.
Environmental Barriers and Their Impact on Participation for Youth with Physical Disabilities
Authors: Kingsley Karrie , Glennon Tara J.
Published: January 2023

Dyads of 427 parents and children, aged 6–14 years and with a range of health and developmental difficulties, were surveyed, interviewed, and scored on three structured tools to evaluate the perceptions of barriers to participation in school, recreation, and community activities. Perceived barriers were noted in all contexts, ranked highest to lowest in school and work, natural and built environments, policies, services and assistance, and attitudes, respectively. The authors recorded environmental characteristics of accessibility, accommodation, resource availability, social support, and equality as interfering factors and barriers to participation. Adolescents, children with behavioral challenges, and young children with physical limitations were demographic groups with greater perceived barriers.
Effectiveness of Occupational Therapy for Children with Sensory Modulation Disorder
Authors: Reynolds Stacey , Pou Kaelah
Published: January 2023

“A Randomized Controlled Pilot Study of the Effectiveness of Occupational Therapy for Children with Sensory Modulation Disorder” investigates the effectiveness of occupational therapy using a sensory integration approach (OT-SI) in treating children who have sensory modulation disorder (SMD). It specifically examines whether OT-SI is better than an alternate treatment or passive placebo treatment at mitigating attention, cognitive, sensory, and behavioral problems in children with SMD. This randomized controlled trial both references and expands upon previously conducted OT-SI research as it uses a combination of instruments as outcome measures to gauge differences between treatment groups. At the end of this chapter is a case study serving as an example of how Miller et al.’s findings could translate into clinical practice.
Clinical Reasoning among Occupational Therapists
Authors: McLaughlin Gray Julie
Published: January 2023

Clinical Reasoning: Forms of Inquiry in a Therapeutic Practice presents the findings of a multiyear qualitative study of the clinical reasoning of occupational therapists through ethnographic and action research methods. The clinical reasoning of 14 therapists in a large teaching hospital was examined by a team of researchers, including several of the therapists themselves, through participant observation, review of videos, and extensive interviews with the therapists and some patients. Findings revealed three different types of clinical reasoning, procedural, interactive, and conditional, which expert therapists combined in what authors named a three-track mind. Due to the profession’s core values and commitment to treating the whole person and, especially, the phenomenological or lived experience of illness or disability, many occupational therapists experienced tensions between expectations of the institution’s focus on the medical model and their professional commitment to treating the personal and complex experiences associated with navigating disability and illness in everyday life.
Can the Assessment of Motor and Process Skills Predict Behind-the-Wheel Driving Performance?
Authors: Verran Ana
Published: January 2023

The chapter "Can the Assessment of Motor and Process Skills Predict Behind-the-Wheel Driving Performance?" in 50 Studies Every Occupational Therapist Should Know describes the development of an algorithm to identify at-risk drivers that would benefit from additional assessment of their potential to drive safely. Support for the algorithm came from a research study comparing participants' performance on instrumental activities of daily living (IADLs), rated using the Assessment of Motor and Process Skills (AMPS), and an assessment of behind-the-wheel (BTW) driving performance conducted by occupational therapist driving rehabilitation specialists. AMPS process scale scores were significantly associated with passing, failing, and driving restriction results on a BTW assessment. The study's findings suggest that occupational therapists can accurately determine safe drivers, those at risk for unsafe driving, and those in need of specialized driving evaluation based on a structured observation of IADLs other than driving.
Participation and Performance Are Not Synonymous
Authors: Rafeedie Samia H.
Published: January 2023

Traditional assessment measurements fail the disability community in that “participation” has unique qualities for people who have different abilities, resources, and needs. Participation includes not only active engagement in life situations at the societal level, but also the personal meaning and satisfaction resulting from that engagement. Participation is a right based on access, opportunity, respect, and inclusion. Participation should include not only the physical aspects of “doing,” but also the choice and control to participate in ways individually perceived as meaningful. The medical and rehabilitation fields need subjective and value-based participation assessment tools that reflect a non-hierarchical conceptualization of participation created with the voice of the disability community, which is contrary to the assumptions of traditional measurement. Researchers must critically examine conventional means of measuring participation via performance of a standard set of roles and activities that do not make sense for all people.
Exploring the Association Between Therapy Time and Functional Recovery Through Mobility and Self Care Clinical Outcomes
Authors: Jordan Katie
Published: January 2023

With therapy minutes generally closely aligned with regulatory and reimbursement requirements, there is little room to consider patient characteristics, time (length of stay [LOS]), and clinical judgment in determining the most cost-effective and clinically optimal plan of care. This study provides valuable insight into client-centered variables (comorbidities, functional outcomes, burden of care) that bring meaning and perspective into determining a value-based rehabilitation plan rather than one based on arbitrary required and assigned minutes. In this study, patients are assigned to one of nine recovery groups following hip fracture surgery. Recovery groups are based on therapy minutes per LOS as low, medium, or high and functional gains in self-care and mobility as measured by the Functional Independence Measure as low, medium, or high. All groups are compared on LOS, providing insight into the role of clinical decision-making and consideration of patient characteristics in determining the dose and intensity of therapy services.
Occupational Therapy is the Cost-Effective Solution to Support High Quality Care and Reduce Readmissions in Hospitals
Authors: Jordan Katie
Published: January 2023

Occupational therapy is the only hospital cost category in which increased spending is statistically significantly associated with reduced readmission rates for conditions covered in the Centers for Medicare and Medicaid Services’ Hospital Readmission Reduction Program. These conditions are heart failure, acute myocardial infarction, and pneumonia. With approximately 75% of patients with heart failure, acute myocardial infarction, or pneumonia who are admitted not typically receiving occupational therapy services, the findings of this study suggest a low-cost and high-yield way for hospitals to improve the quality of care and reduce the number of readmissions by investing in occupational therapy services for more patients.
Supervisory Styles
Authors: Veach Patricia McCarthy
Published: January 2023

This chapter describes and differentiates major types of supervisory styles of consultation, teaching (both directive and evocative teaching), counseling, and evaluation. Illustrative examples clarify these styles in genetic counseling supervision. The chapter identifies benefits and limitations of each style and emphasizes the importance of strategic, intentional use of the various styles. It explains two supervision dynamics, support and guidance, notes their presence within all supervisory styles to varying degrees, and connects support and guidance to issues of power and trust within supervision relationships. The chapter includes learning activities that provide opportunities for practice using each style and reflection upon one’s stylistic preferences.
Evaluation in Supervision
Authors: Atzinger Carrie
Published: January 2023

This chapter describes types and functions of student evaluation in supervision, presents approaches to student and supervisor evaluation, discusses common challenges in evaluation and ways to manage them, and presents strategies to promote effective evaluation processes. It differentiates formative and summative evaluation, indicates typical criteria on which evaluation of genetic counseling students is based, and makes a connection between feedback and evaluation in supervision. It describes and provides examples of evaluation approaches (e.g., Likert-style evaluations and anchored rubrics). It highlights subjectivity and power dynamics as prevalent evaluation challenges and suggests ways to managing these challenges. The chapter concludes with learning activities that provide opportunities for reflection and practice in evaluation.
Fostering Psychosocial Skill Development
Authors: Veach Patricia McCarthy
Published: January 2023

This chapter defines psychosocial skills in genetic counseling and discusses the importance of psychosocial skills in genetic counseling practice. It presents empirically derived genetic counselor supervisor competencies that explicitly address building students’ psychosocial skills and discusses the role of psychosocial skills as presented in a model of psychosocial adaptation. It uses a Discrimination Model to describe domains of psychosocial skills critical to genetic counseling practice (intervention, conceptualization, and personalization), along with specific examples. It defines 13 types of basic helping skills and includes illustrative examples. The chapter identifies several supervision strategies to foster student development of psychosocial skills, including recognizing and managing misconceptions about using psychosocial skills, modeling of skills, goal setting, and deliberate practice. Learning activities offer opportunities for practice in promoting students’ psychosocial skills.
UK Medical Research Council/British Heart Foundation Heart Protection Study of Cholesterol Lowering with Simvastatin in 20,536 High-Risk Individuals
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in the management of patients with atherosclerotic vascular disease. The UK Medical Research Council/British Heart Foundation Heart Protection Study assessed the role of statins in decreasing major adverse cardiovascular events. The Heart Protection Study demonstrated improved outcomes in patients treated with statin therapy. This chapter describes the basics of the study, including funding, study location, who was studied, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Second Asymptomatic Carotid Surgery Trial (ACST-2)
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery assessing whether carotid stenting improved outcomes compared to carotid endarterectomy in patients with asymptomatic carotid artery disease. The Second Asymptomatic Carotid Surgery Trial (ACST-2), a randomized comparison of carotid artery stenting versus carotid endarterectomy, demonstrated that the long-term effects of both procedures were comparable. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Randomized Comparison of Strategies for Type B Aortic Dissection
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery assessing whether thoracic stenting improved outcomes compared to best medical management in patients with type B aortic dissection. The INSTEAD trial demonstrated that thoracic endovascular aneurysm repair failed to improve 2-year survival and adverse event rates despite favorable aortic remodeling. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Long-Term Outcomes of Immediate Repair Compared with Surveillance of Small Abdominal Aortic Aneurysms
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery assessing whether early elective surgery for small abdominal aortic aneurysms was beneficial compared to surveillance. The United Kingdom Small Aneurysm Trial (UKSAT) demonstrated that early surgery for small abdominal aortic aneurysms does not provide a long-term survival advantage over surveillance. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Endovascular Versus Open Repair of Abdominal Aortic Aneurysm in 15 Years’ Follow-up of the UK Endovascular Aneurysm Repair Trial 1 (EVAR 1)
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery assessing whether endovascular repair improved outcomes compared to open surgery in patients undergoing abdominal aortic aneurysm repair. The Endovascular Aneurysm Repair Trial 1 (EVAR 1) demonstrated that endovascular repair has an early survival benefit but an inferior late survival compared with open repair. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Endovascular Repair of Abdominal Aortic Aneurysm in Patients Physically Ineligible for Open Repair (EVAR 2)
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery assessing whether endovascular repair improved outcomes compared to medical management in patients unfit for open abdominal aortic aneurysm repair. The Endovascular Aneurysm Repair (EVAR 2) trial demonstrated that endovascular aneurysm repair does not increase overall life expectancy in patients ineligible for open repair but can reduce aneurysm-related mortality. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Open Versus Endovascular Repair of Abdominal Aortic Aneurysm (OVER)
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery assessing whether endovascular repair improved outcomes compared to open surgery in patients undergoing abdominal aortic aneurysm repair. The Open Versus Endovascular Repair (OVER) trial demonstrated that long-term overall survival was similar among patients who underwent endovascular repair and those who underwent open repair. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Endovascular or Open Repair Strategy for Ruptured Abdominal Aortic Aneurysm
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery assessing whether an endovascular strategy improved outcomes compared to an open strategy in patients undergoing surgery for a ruptured abdominal aortic aneurysm. The Immediate Management of Patients with Rupture: Open Versus Endovascular Repair (IMPROVE) trial demonstrated that a strategy of endovascular repair was not associated with significant reduction in either 30-day mortality or cost. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Meta-analysis of Fenestrated Endovascular Aneurysm Repair Versus Open Surgical Repair of Juxtarenal Abdominal Aortic Aneurysms
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery comparing short- and long-term outcomes for open and fenestrated endovascular aneurysm repair for juxtarenal aneurysms. This systematic review demonstrated no significant difference in 30-day mortality; however, fenestrated endovascular aneurysm repair was associated with significantly lower morbidity than open repair. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many studies were included, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Patient Survival After Open and Endovascular Mesenteric Revascularization for Chronic Mesenteric Ischemia
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery reporting on the outcomes of open versus endovascular revascularization surgery for patients with chronic mesenteric ischemia. This observational study demonstrated that long-term patient survival rates after mesenteric revascularization were not influenced by the type of arterial reconstruction that had been used. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and concludes with a relevant clinical case.
Bypass Versus Angioplasty in Severe Ischemia of the Leg (BASIL)
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery assessing whether balloon angioplasty improved outcomes compared to bypass surgery in patients with severe ischemia. The Bypass Versus Angioplasty in Severe Ischemia of the Leg (BASIL) study, a multicenter randomized controlled trial, demonstrated that amputation-free survival rates were similar for both procedures. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Dutch Iliac Stent Trial
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery assessing whether primary stenting improved outcomes compared to selective stenting in patients with iliac artery disease. The Dutch Iliac Stent Trial demonstrated that selective stent placement in the iliac artery had a better outcome for symptomatic success compared with patients treated with primary stent placement. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Meta-analysis of Open and Endovascular Repair of Popliteal Artery Aneurysms
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery reporting on the outcomes of open versus endovascular surgery for patients with popliteal artery aneurysms. The meta-analysis conducted in this study demonstrated that endovascular repair for popliteal aneurysms had inferior primary patency but not secondary patency out to 3 years. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and concludes with a relevant clinical case.
5-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery comparing the outcomes of foam sclerotherapy and laser and surgical treatment of primary varicose veins. The Comparison of Laser, Surgery, and Foam Sclerotherapy (CLASS) trial demonstrated similar quality-of-life measures among the study groups, with the exception of a slightly worse disease-specific quality of life in the foam sclerotherapy group. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Long-Term Functional Patency and Cost-Effectiveness of Arteriovenous Fistula Creation Under Regional Anesthesia
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery assessing whether regional anesthesia improved outcomes compared to local anesthesia in patients undergoing arteriovenous fistula formation. The trial, in which patients were randomized to receive regional or local anesthesia during fistula creation, demonstrated improved patency at 1 year and cost-effectiveness with regional anesthesia. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Durability of Endovascular Repair in Blunt Traumatic Thoracic Aortic Injury
Authors: Al Shakarchi Julien
Published: January 2023

This chapter provides a summary of a landmark study in vascular surgery assessing the early and long-term survival and reintervention rates in patients undergoing thoracic stenting for blunt traumatic aortic injury. The study, which was a retrospective review, demonstrated that stenting allowed rapid and effective therapy in trauma patients with blunt aortic injury. This chapter describes the basics of the study, including funding, study location, inclusion and exclusion criteria, how many patients were recruited, study design, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary, and concludes with a relevant clinical case.
Renal stones
Authors: Glass Jonathan
Published: January 2023

Percutaneous surgery is the treatment of choice in the management of large and staghorn stones of the urinary tract. Imaging with preoperative computed tomography scanning is mandatory. The procedure has undergone a number of modifications over the past 40 years since first being described by Alken and colleagues in 1982. Developments have included the challenge as to whether prone is the best position, miniaturization of the access tract, the use of multiple tracts, the abandonment of the post-procedure nephrostomy, and the combination of simultaneous flexible ureteroscopy with percutaneous nephrolithotomy. It is, however, a complex procedure with a significant complication rate including postoperative bleeding and sepsis, particularly with staghorn stones. This case illustrates the use of percutaneous surgery in a patient with a staghorn stone complicated by a postoperative bleed managed by super-selective arterial embolization.
Ureteropelvic junction obstruction
Authors: Pathak Sanjeev , Oakley Neil
Published: January 2023

Ureteropelvic junction obstruction (UPJO) is a complete or partial obstruction of urine flow from the renal pelvis into the ureter. Congenital UPJO is the most common cause of ureteric obstruction during the antenatal period but often presents in adulthood too. The clinical presentation depends upon whether it is acute or chronic, complete or partial, and/or concomitant urinary infection. In asymptomatic patients, there is a major concern of ‘silent renal loss’ resulting in significant deterioration of irreversible renal function. The aetiology of UPJO is thought to be primarily functional but there is a mechanical component too. Although the incidence of a horseshoe kidney is 1 in 500 in the normal population, there is a disproportional increased incidence of coexisting UPJO. This case involves a 29-year-old male who presented with acute, unilateral UPJO in a horseshoe kidney complicated with a significant bilateral renal stone burden. This complex case facilitates discussion of the clinical presentation and management, along with clinical tips, learning points, evidence base, and an expert commentary.
Localized prostate cancer
Authors: Altan Omer , Lamb Alastair , Hamdy Freddie C.
Published: January 2023

In patients with high-volume, clinically localized, intermediate-risk prostate cancer who are sexually active, preoperative surgical planning is critical. There is an increasing dilemma in deciding whether to undertake a nerve-sparing procedure during radical prostatectomy, or to sacrifice one or both neurovascular bundles, which affects functional outcomes. This case describes such a situation and explains how preoperative information, imaging and histopathology techniques, and careful patient counselling can help surgical management to optimize oncological and functional outcomes in these patients.
Advanced and metastatic penile cancer
Authors: Alnajjar Hussain , Muneer Asif
Published: January 2023

Penile cancer is a rare cancer, and accounts for <1% of all male malignancies in the UK. The incidence of penile cancer in England and Wales is 1.2–1.5 per 100,000 per year. Although the majority of men are diagnosed at a localized stage and carry a good long-term prognosis, up to 40% of patients present with locally advanced or metastatic disease and outcomes for these patients have historically been poor. This case discusses the management of locally advanced and metastatic penile cancer.
Chronic retention, renal failure, and diuresis
Authors: Ho Cherrie , Jenkins James , Drake Marcus
Published: January 2023

Chronic urinary retention is chronic or repeated inability to empty the bladder, despite the ability to pass some urine. High-pressure chronic retention is a risk factor for renal failure. If renal failure is present, catheterization is needed to recover renal function. Catheterization may be followed by post-obstructive diuresis, due to the impaired concentrating ability of the renal tubules, and the accumulated salt, water, and toxins. Consequently, fluid replacement might be needed while renal function improves. Once stabilized, a period of intermittent catheterization may help improve function. Urodynamic testing enables determination of likelihood of response to surgical intervention. Where bladder outlet obstruction is the cause of chronic urinary retention, there is a good chance of responding to procedures such as transurethral resection of the prostate and laser prostatectomy. If detrusor underactivity is the cause, there may be minimal benefit from interventional procedures.
Renal transplantation
Authors: O’Callaghan John M. , Gilbert James A.
Published: January 2023

Renal replacement therapy options for patients with end-stage renal disease include haemodialysis, peritoneal dialysis, and renal transplantation. Renal transplantation offers the best survival benefit and quality of life. Kidney donation options include live donors and deceased donors, which can be following brain death or circulatory death. Donor and recipient assessment are complex and require a multidisciplinary approach prior to surgery. All attempts are made to identify well-matched donors and recipients and to use effective antirejection therapies. While the outcomes of renal transplantation are very good, there can be significant complications in the short and long term for some patients. Cardiovascular and infectious complications are particularly significant in this population. Ultimately, the lifespan of a transplanted organ is finite and many patients will need to have more than one transplant.
Undescended testis
Authors: Figueroa-Díaz María S. , Aikins Kimberly , Mushtaq Imran
Published: January 2023

The first case discusses the management of the common condition of bilateral palpable undescended testes in male infants, debating the issues of optimal age for surgery, the potential impact of delayed surgery, and cancer risk. The second case relates to the presentation of a child with hypospadias in association with bilateral impalpable testes, and what investigations are required and the complexity of management based on the findings at diagnostic laparoscopy.
Acute interventional radiology procedures in urology
Authors: Shahin Yousef , Kennish Steven
Published: January 2023

This case presents and discusses the complex management of an 81-year-old male patient who underwent radical surgery (anterior pelvic exenteration) for advanced rectal carcinoma and developed several complications in the postoperative course. The role of interventional radiology was of paramount importance in the management of these complications as immediate surgery would have been extensive and high risk. The patient developed a leak from the ileal conduit which was managed by initially diverting urine with the insertion of bilateral nephrostomies (non-dilated urinary collecting systems) and the percutaneous drainage of the urinoma. The urostomy subsequently became ischaemic and a laparotomy was performed to revise it, although the leaking proximal portion was too stuck down to safely mobilize. The patient continued to have a persistent leak from the ileal conduit resulting in a presacral collection which was drained multiple times under computed tomography guidance. The patient had bilateral retrograde ureteric stents inserted utilizing the nephrostomy access for antegrade guidewire placement and the nephrostomy drains were subsequently removed. The patient is now clinically stable on follow-up.
Solar wind interaction with Mars: electric field morphology and source terms
Authors: Wang Xiao-Dong , Fatemi Shahab , Nilsson Hans , Futaana Yoshifumi , Holmström Mats , Barabash Stas
Published: January 2023

The correlation between space environment conditions and the properties of escaping ions is a central topic of Mars research. Although empirical correlations have been visible in the data, a physics-based interpretation, rather than statistics-based pictures, has not been established yet. As a first effort, we investigate the electric field, the direct contributor to ion acceleration, in the Mars plasma environment from a hybrid plasma model (particle ions and fluid electrons). We use Amitis, a hybrid model combined with an observation-based ionospheric model, to simulate the Mars–solar wind interaction under nominal solar wind plasma conditions for perpendicular and Parker spiral directions of the interplanetary magnetic field (IMF). The simulations show following results: (1) the electric field morphology is structured by the IMF direction and the different plasma domains in the solar wind–Mars interaction; (2) asymmetry of the electric field between the hemispheres where the convective electric field points inward and outward, respectively, due to the mass loading and asymmetric draping of the magnetic field lines; (3) the motional electric field dominates in most regions, especially in the dayside magnetosheath; and (4) the Hall term is an order of magnitude weaker and significant in the magnetotail and plasma boundaries for a perpendicular IMF case. The Hall term is relatively stronger for the Parker spiral case. (5) The ambipolar electric field, in principle, agrees with Mars Atmosphere and Volatile Evolution measurements in the magnetosheath.
Quakes of compact stars
Authors: Lu Ruipeng , Yue Han , Lai Xiaoyu , Wang Weihua , Zhang Shenjian , Xu Renxin
Published: January 2023

Glitches are commonly observed for pulsars, which are explained by various mechanisms. One hypothesis attributes the glitch effect to the instantaneous moment of inertia change of the whole star caused by a starquake, which is similar to earthquakes caused by fast dislocation occurring on planar faults for the static stress, though the quake-induced dynamics responsible for glitch (superfluid vortex versus pure starquake) remains still unknown. However, a theoretical model to quantitatively explain the stress loading, types of starquakes, and co-seismic change of moment of inertia is rarely discussed. In this study, we incorporate elastic deformation theories of earthquakes into the starquake problems. We compute the field of stress loading associated with rotation deceleration and determine the optimal type of starquakes at various locations. Two types of pulsar structure models, i.e. neutron and strangeon star models, are included in the computation, and their differences are notable. Our calculation shows that the observed glitch amplitude can be explained by the starquakes in the strangeon star model, though the required scaled starquake magnitude is much larger than that occurred on Earth. We further discuss the possibility to compute the energy budget and other glitch phenomena using the starquake model in the elastic medium framework.
Perceived Sensory Characteristics of Blended and Ambiguous “Concept” Flavors Among Adolescent and Young Adult E-cigarette Users
Authors: Kreslake Jennifer M , O’Connor Katie M , Stephens Daniel , Vallone Donna M , Hair Elizabeth C
Published: January 2023

Introduction

Flavors with names describing blended tastes/sensations or with ambiguous terminology (“concept flavors”) are available on the e-cigarette market.

Aims and Methods

This study investigates adolescent and young adult use and sensory perceptions of blended and concept flavors. Current e-cigarette users aged 15–24 years (N = 2281) completed an online convenience sample survey (October 20–November 23, 2020) and rated the sensory attributes (fruity, cooling, sweet, and minty) of their current flavor(s) using nine-point scales. T-tests compared mean sensory perception scores within and between flavors. To compare concept flavors to blends, reference categories used the average of blends with relevant descriptors: fruit (Banana Ice, Iced Mango, Melon Ice, Cool Cucumber); cooling (Banana Ice, Iced Mango, Melon Ice, Blue B Ice, Cool Cucumber, Lush Ice, and Menthol Purple); sweet (Vivid Vanilla) and mint (Mint-sation).

Results

Most respondents had used at least one product with blended descriptors (74.8%) or concept flavor (57.9%) in the past 30 days. All flavors had high perceived strength for at least two sensory attributes. Mint taste was not perceived to be a strong sensory characteristic for all but two flavors (Mint-sation and Winter) in the study. The most commonly used flavors used blended descriptors (Iced Mango was used by 30.2% of the sample; Banana Ice: 26.2%; Lush Ice: 23.8%; Melon Ice: 22.9%). Some concept flavors did not significantly differ from flavor blend reference categories for strength of: fruit taste (Bahama Mama and Tropic); cooling sensation (Marigold, Island Breeze, Winter); sweet taste (Bahama Mama, Honeymoon, Island Breeze, Island Cream, Meteor Milk, OMG, Royal Dagger and Tropic); and mint taste (Winter).

Conclusions

Blended and concept flavors are used by most young e-cigarette users, who describe these products as fruity, sweet, and cooling. A variety of flavored products with high youth appeal are available in the U.S. market.

Implications

This study of adolescent and young adult e-cigarette users finds evidence of the popularity of e-cigarette flavors combining a cooling sensation with fruity and sweet flavorings. Some products with this flavor profile do not use characterizing descriptors. Findings inform public health interventions intended to reduce e-cigarette use in young people.
Real-world Use of Bezlotoxumab and Fecal Microbiota Transplantation for the Treatment of Clostridioides difficile Infection
Authors: de la Villa Sofía , Herrero Sergio , Muñoz Patricia , Rodríguez Carmen , Valerio Maricela , Reigadas Elena , Álvarez-Uría Ana , Alcalá Luis , Marín Mercedes , Olmedo María , Kestler Martha , Chamorro Esther , Bouza Emilio
Published: January 2023

Background

We aimed to describe the frequency of use and effectiveness of bezlotoxumab (BZX) and fecal microbiota transplantation (FMT) in patients with Clostridioides difficile infection (CDI) in real-world practice.

Methods

This was a retrospective study conducted in a university hospital in which adult patients treated with BZX or FMT from January 2018 to April 2021 were included. The primary objective was to evaluate the effectiveness of BZX and FMT in preventing early (within 8 weeks) and late (within 1 year) CDI recurrences (rCDI). A multivariate analysis of risk factors for early recurrence was performed.

Results

Of 1377 consecutive CDI episodes, 117 (8.5%) received BZX or FMT, with full information available for 100 of the episodes: 51 received BZX, and 49 received FMT. BZX was used mostly in immunosuppressed patients (66.7%) and in first episodes or first recurrences in 70.6% of the cases. FMT was prescribed only in CDI recurrences. Despite the different conditions of the patients, there were no significant differences between BZX and FMT in preventing early rCDI (19.6% vs 24.5%; P = .55) or late rCDI (9.8% vs 18.4%; P = .31). In the multivariate analysis, risk factors for recurrence were presence of ≥2 previous rCDI episodes (odds ratio [OR], 2.90; 95% CI, 1.03–8.63) and use of non-CDI antibiotics (OR, 3.45; 95% CI, 1.24–9.57).

Conclusions

BZX and FMT were infrequently used in real-world practice. Both treatments had similar effectiveness in preventing CDI recurrence despite their application to different populations.
Diagnostic and Therapeutic Challenges in DisseminatedMycobacterium colombienseInfection Caused by Interferon-γ Neutralizing Autoantibodies
Authors: Matono Takashi , Suzuki Shotaro , Yamate Ryosuke , Nakamura Kenichi , Sakagami Takuro
Published: January 2023

Adult-onset immunodeficiency due to interferon-γ-neutralizing autoantibodies (nIFNγ-autoAbs) can remain underdiagnosed. We present a case of severe Mycobacterium colombiense infection with nIFNγ-autoAbs. To ensure early diagnosis, clinicians should have a high index of suspicion in patients of Asian descent with opportunistic infections and perform QuantiFERON-TB assay for disease screening.