bluuebunny/crossref_metadata_2025_split huggingface dataset:
Altered updating of bodily and spatial representations after tool-use in complex regional pain syndrome
Authors: Vittersø Axel D. , Buckingham Gavin , Halicka Monika , Proulx Michael J. , Bultitude Janet H. 
Published: February 2020

Abstract
Distorted representations of the body and peripersonal space are common in complex regional pain syndrome (CRPS), and might modulate its symptoms (eg, asymmetric limb temperature). In pain-free people, such representations are malleable, and update when we interact with objects in our environment (eg, during tool-use). Distortions are also common after immobilisation, but quickly normalise once movement is regained. We tested the hypothesis that people with CRPS have problems updating bodily and spatial representations, which contributes to the maintenance of their distorted representations by preventing normalization. We also explored spatially defined modulations of hand temperature asymmetries, and any influence of updating bodily and spatial representations on this effect. Thirty-six people with unilateral CRPS (18 upper limb and 18 lower limb) and 36 pain-free controls completed tool-use tasks considered to alter body and peripersonal space representations (measured using tactile distance judgements and a visuotactile crossmodal congruency task, respectively). We also tested how the arrangement (crossed and uncrossed) of the hands and tools affected hand temperature. In upper-limb CRPS, the nonaffected arm representation updated normally, but the affected arm representation updated in the opposite to normal direction. A similar pattern was seen in lower-limb CRPS, although not significant. Furthermore, people with CRPS showed more pronounced updating of peripersonal space than the controls. We did not observe any modulation of hand temperature asymmetries by the arrangement of hands or tools. Our findings show enhanced malleability of bodily and spatial representations in CRPS, which may suggest that central mechanisms are altered in this condition.
Increased problematic smartphone use among children with attention-deficit/hyperactivity disorder in the community: The utility of Chinese version of Smartphone Addiction Proneness Scale
Authors: Huang Yu-Chieh , Hu Sz-Chi , Shyu Li-Yu , Yeh Chin-Bin 
Published: February 2020

Background:
Problematic smartphone use is more prevalent in children than before. This study aimed to evaluate the reliability and validity of the Chinese version of the Smartphone Addiction Proneness Scale (SAPS).

Methods:
We recruited 319 students aged 9 to 12 years including 70 attention-deficit/hyperactivity disorder subjects at a university hospital and 249 controls from elementary school. Finally, 164 males and 138 females were collected for data analysis with mean age of 10.99 ± 0.88 years. Item analysis, exploratory factor analysis, internal consistency test, and t test were performed to verify the reliability and validity of the SAPS-Chinese version. Correlations were examined for relation between the score in the SAPS-Chinese version and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnostic criteria.

Results:
Factor analysis showed two factors: problematic use–associated behaviors and impaired daily functions. Item analysis for every item in the SAPS-Chinese version showed significant differences in t values (p < 0.001) and high correlation in all items (r = 0.37-0.79). The Kaiser-Meyer-Olkin (KMO) was equal to 0.94 and Bartlett’s test of Sphericity was significant (p < 0.001). Cronbach’s α for the SAPS-Chinese version was 0.93. It revealed high reliability and validity.

Conclusion:
The SAPS-Chinese version is reliable, valid, and suitable for clinical and research uses with satisfactory properties. Applying the modified SAPS-Chinese version offers early detection of problematic smartphone use.
Biodegradable Stents for the Relief of Vascular Bronchial Compression in Children With Left Atrial Enlargement
Authors: Griffiths Benedict T. , James Paul , Morgan Gareth , Diamantopoulos Athanasios , Durward Andrew , Nyman Andrew 
Published: February 2020

Background:
We report our experience of the biodegradable polydioxanone stent in cases of bronchial compression by a dilated left atrium in children with heart disease.

Methods:
Eight custom-made biodegradable stents were inserted into the left main bronchus in 5 patients diagnosed with critical airway compression. Four of the 5 patients were ventilator-dependent with significant cardiac morbidity.

Results:
Stents were inserted without complication under fluoroscopic guidance. All experienced improvement in symptoms over time. In 3 patients, repeat bronchial stenting was performed where stent degradation was associated with recurrence of vascular airway compression and symptoms. No stents migrated nor was there evidence of bronchial or vascular erosion. There was 1 death, unrelated to the stent, and all remaining survivors were well at a 2-year follow-up.

Conclusion:
The use of the polydioxanone biodegradable stent appeared safe in this cohort of critically ill patients with vascular bronchial compression. There use may aid weaning from mechanical ventilation and support eventual cardiac recovery.
The vessel-depleted neck in head and neck microvascular reconstruction: extreme solutions for extreme situations
Authors: Breik Omar , Praveen Prav , Parmar Satyesh 
Published: February 2020

Purpose of review
The vessel-depleted neck is the ultimate challenge for the head and neck reconstructive surgeon. In patients who have had previous neck dissections or radiotherapy, the arterial and venous options for future reconstruction can be very limited, and it is important for the surgeon to consider alternative options for vessels.

Recent findings
Appropriate preoperative planning is crucial in these patients with a thorough history including previous operation notes, details of previous treatments, and previously used vessels for reconstruction. Clinical examination and a dual phase CT angiogram/MR angiogram can identify vessels available for reconstruction. Arterial options are discussed including tips on using the common carotid artery and the use of Corlett loops for utilizing contralateral arteries. Venous options are also discussed including cephalic vein transposition and Corlett loops. Novel options, such as use of extracorporeal perfusion of flaps have been shown to be effective when all other options have been depleted.

Summary
Creative solutions are needed for these extreme circumstances, and reconstructive surgeons need to be aware of the options available to select the best one in each case. Careful planning and having multiple back-up choices is crucial to successful reconstruction in these cases.
Robotic neck dissection: state of affairs
Authors: Lira Renan Bezerra , Kowalski Luiz Paulo 
Published: February 2020

Purpose of review
The progressive growth of endoscopic and robotic-assisted procedures provided the tools for development of remote approaches to the neck, which could avoid a visible large neck scar usually necessary for neck dissections. This review explores the current experience with robotic neck dissection, looking for pros and cons in surgical, oncologic and aesthetic outcomes.

Recent findings
Robotic neck dissection was shown to be feasible and well tolerated, with adequate oncological outcomes in different tumours. Although difficult to objectively analyse, cosmetic satisfaction seems to be significatively higher in patients submitted to this procedure when compared with those submitted to conventional neck dissection. The only consistently reported disadvantage was longer operative time. Other potential advantages beyond cosmesis such as improvements on oedema, fibrosis, neck movement, sensory loss and social interactions were not well explored so far.

Summary
Surgical treatment of neck metastasis had several evolutions in the last decades. Robotic neck dissection emerged as an option to avoid extensive visible neck scars, improving cosmesis and probably other functional outcomes, although securing oncologic effectiveness. Technological innovation is increasingly dynamic, promising progressive evolution in robotic surgery. Together, the lack of objective data on functional outcomes warrants the need for further investigation on robotic neck dissection.
System-Level Improvements in Work Environments Lead to Lower Nurse Burnout and Higher Patient Satisfaction
Authors: Brooks Carthon J. Margo , Hatfield Linda , Brom Heather , Houton Mary , Kelly-Hellyer Erin , Schlak Amelia , Aiken Linda H. 
Published: February 2020

Background:
Burnout among nurses is associated with lower patient satisfaction, yet few system-level solutions have been identified to improve outcomes.

Purpose:
The purpose of this study was to examine the relationship between nurse burnout and patient satisfaction and determine whether work environments are associated with these outcomes.

Methods:
This study was a cross-sectional analysis of 463 hospitals in 4 states. Burnout was defined using the Maslach Burnout Inventory. Patient satisfaction was obtained from the Hospital Consumer Assessment of Healthcare Providers and Systems survey.

Results:
Fifty percent of hospitals where burnout is high have poor work environments, which is strongly related to lower patient satisfaction.

Conclusions:
High levels of nurse burnout are associated with lower patient satisfaction. Our findings demonstrate that hospitals can improve outcomes through investments in work environments.
Evaluation of the Ability of Emergency Room Doctors at a French University Hospital Center to Identify Adverse Drug Events
Authors: Nizet Pierre , Tching-Sin Martine , Dubreuil Clémentine , Pinaud Virginie , Van Tricht Myriam , Navas Dominique , Huon Jean-François 
Published: February 2020

Objectives
Numerous adverse drug events (ADEs) are not identified by doctors in medical emergencies, and they are a barrier to optimal treatment of patients. Identification of the factors that influence awareness of ADEs by doctors could allow events that compromise patient safety to be avoided. The aims of this study were to quantify the recognition of ADEs by emergency room (ER) doctors and to identify the factors associated with the lack of identification of drug-related risks.

Methods
This study was carried out at the ER of a French teaching hospital between January 1, 2014, and the December 31, 2017. A previously used form was administered to the patients being treated in the ER, and it was completed using medical files to identify ADEs. The ADEs were then validated by a doctor and a senior pharmacist.

Results
Of the 1870 included patients, 279 (14.9%) exhibited an ADE. Of these 279 ADEs, 201 (72%) had been identified by the doctor. The probability of an ADE being identified was higher when the drug was directly linked with the main ailment of the patient (odds ratio, 1.72; 95% confidence interval, 1.01–2.97). Adverse drug events were identified less well when their severity was limited (spontaneous regression without treatment) (odds ratio, 0.5; 95% confidence interval, 0.27–0.93).

Conclusions
This study showed that ADEs are identified less well when their severity is limited, as well as when the ADE is not directly linked with the main ailment of the patient.
Firearm laws and illegal firearm flow between US states
Authors: Andrade Erin G. , Hoofnagle Mark H. , Kaufman Elinore , Seamon Mark J. , Pah Adam R. , Morrison Christopher N. 
Published: February 2020

BACKGROUNDConsiderable variation in firearm legislation exists. Prior studies show an association between stronger state laws and fewer firearm deaths. We hypothesized that firearms would flow from states with weaker laws to states with stronger laws based on proximity and population.METHODSCrime gun trace data from 2015 to 2017 was accessed from the Bureau of Alcohol, Tobacco, Firearms and Explosives and compared with the count and composition of firearm legislation in 2015 among the contiguous 48 states. Additional independent variables included population, median household income, distance, and presence or absence of a shared border. We used Exponential Random Graph Models to identify predictors of traced firearm transfers between origin and destination states.RESULTSAfter controlling for network structure, firearm laws in origin states were associated with fewer traced firearm transfers (incidence rate ratio [IRR], 0.88; 95% confidence interval [CI], 0.83–0.93;p< 0.001). Conversely, more firearm laws in destination states were associated with more traced firearm transfers (IRR, 1.10; 95% CI, 1.06–1.15;p< 0.001). Larger population at the origin was associated with increased transfers (IRR, 1.38; 95%CI, 1.27–1.50;p< 0.001), as was larger population at the destination state (IRR, 1.45; 95% CI, 1.35–1.56;p< 0.001). Greater distance was associated with fewer transfers (for each 1,000 km; IRR, 0.35; 95% CI, 0.27–0.46;p< 0.001), and transfers were greater between adjacent states (IRR, 2.49; 95% CI, 1.90–3.27;p< 0.001).CONCLUSIONState firearm legislation has a significant impact on gun trafficking even after controlling for network structure. States with stricter firearm legislation are negatively impacted by states with weaker regulations, as crime guns flow from out-of-state.LEVEL OF EVIDENCEEpidemiologic, level III.
Progression Over 5 Years of Prelaminar Hyperreflective Lines to Optic Disc Drusen in the Copenhagen Child Cohort 2000 Eye Study
Authors: Malmqvist Lasse , Li Xiao Q. , Hansen Mathias H. , Thomsen Alexander K. , Skovgaard Anne M. , Olsen Else M. , Larsen Michael , Munch Inger C. , Hamann Steffen 
Published: February 2020

Background:
The purpose of the study was to examine 5-year changes in eyes with optic disc drusen at baseline on optical coherence tomography (OCT) scans and the relation of incident drusen to hyperreflective prelaminar lines.

Methods:
The study included children who presented at baseline, when participants were aged 11–12 years, and again 5 years later. Grading for optic disc drusen was made in all. Grading for prelaminar lines was made in all children at follow-up and in eyes with optic disc drusen at baseline. Analyses included associations with scleral canal diameter at baseline in all children with optic disc drusen and a nested control group of 115 children without optic disc drusen. Data are reported as the number of children having at least one drusen or at least one hyperreflective line per person.

Results:
The analysis included 724 children who attended both rounds of the study. Of these, 11 (1.5%) had optic disc drusen at baseline. Five additional children had developed optic disc drusen at follow-up, whereas optic disc drusen had disappeared in none, so that 16 (2.2%) children had optic disc drusen in one or both eyes at follow-up. Children with optic disc drusen at the 5-year follow-up had had a mean scleral canal diameter of 1,364 µm (interquartile range [IQR] 81 µm), compared with 1,457 µm (IQR 197) µm in 115 nested controls without optic disc drusen (P < 0.001). Optic disc drusen at follow-up were associated with more hypermetropic refraction. All children who had optic disc drusen at follow-up also had prelaminar hyperreflective lines. In addition, such lines were found at follow-up in 24 of the remaining 708 children without optic disc drusen (P < 0.001). Prelaminar hyperreflective lines with or without optic disc drusen were associated with a narrower scleral canal (diameter 1,364 µm, IQR 119 µm) compared with absence of prelaminar lines (1,486 µm, IQR 206 µm; P < 0.0001).

Conclusion:
This study provides the first evidence from a prospective study that small optic discs and prelaminar hyperreflective lines on OCT are risk factors for the development of optic disc drusen. The association between prelaminar hyperreflective lines, hypermetropia, and a narrow scleral canal supports that a crowded disc is an essential predisposing factor for the development of optic disc drusen.
Clinical characteristics of 25 death cases with COVID-19: a retrospective review of medical records in a single medical center, Wuhan, China
Authors: Li Xun , Wang Luwen , Yan Shaonan , Yang Fan , Xiang Longkui , Zhu Jiling , Shen Bo , Gong Zuojiong 
Published: February 2020

SummaryBackgroundThe pneumonia caused by the 2019 novel coronavirus (SARS-CoV-2) is a highly infectious disease, which was occurred in Wuhan, Hubei Province, China in December 2019. As of February 13, 2020, a total of 59883 cases of COVID-19 in China have been confirmed and 1368 patients have died from the disease. However, the clinical characteristics of the dyed patients were still not clearly clarified. This study aims to summarize the clinical characteristics of death cases with COVID-19 and to identify critically ill patients of COVID-19 early and reduce their mortality.MethodsThe clinical records, laboratory findings and radiologic assessments included chest X-ray or computed tomography were extracted from electronic medical records of 25 died patients with COVID-19 in Renmin Hospital of Wuhan University from Jan 14 to Feb 13, 2020. Two experienced clinicians reviewed and abstracted the data.FindingsThe mean age of the dead was 71.48 ± 12.42 years, the average course of the disease was 10.56 ± 4.42 days, all patients eventually died of respiratory failure. All of those who died had underlying diseases, the most common of which was hypertension (16/25, 64%), followed by diabetes (10/25, 40%), heart diseases (8/25, 32%), kidney diseases (5/25, 20%), cerebral infarction (4/25, 16%), chronic obstructive pulmonary disease (COPD, 2/25, 8%), malignant tumors (2/25, 8%) and acute pancreatitis (1/25, 4%). The most common organ damage outside the lungs was the heart, followed by kidney and liver. In the patients’ last examination before death, white blood cell and neutrophil counts were elevated in 17 patients (17/25, 68%) and 18 patients (18/25, 72%), lymphocyte counts were decreased in 22 patients (22/25, 88%). Most patients’ PCT, CRP and SAA levels were elevated, the percentages were 90.5% (19/21), 85% (19/20) and 100% (21/21) respectively. The levels of the last test of neutrophils (15/16, 93.8%), PCT (11/11, 100%), CRP (11/13, 84.6%), cTnI (8/9, 88.9%), D-Dimer (11/12, 91.6%) and LDH (9/9, 100%) were increased as compared to the first test, while the levels of lymphocytes were decreased (14/16, 87.5%).InterpretationThe age and underlying diseases (hypertension, diabetes, etc.) were the most important risk factors for death of COVID-19 pneumonia. Bacterial infections may play an important role in promoting the death of patients. Malnutrition was common to severe patients. Multiple organ dysfunction can be observed, the most common organ damage was lung, followed by heart, kidney and liver. The rising of neutrophils, SAA, PCT, CRP, cTnI, D-Dimer and LDH levels can be used as indicators of disease progression, as well as the decline of lymphocytes counts.
Neurological Manifestations of Hospitalized Patients with COVID-19 in Wuhan, China: a retrospective case series study
Authors: Mao Ling , Wang Mengdie , Chen Shengcai , He Quanwei , Chang Jiang , Hong Candong , Zhou Yifan , Wang David , Li Yanan , Jin Huijuan , Hu Bo 
Published: February 2020

ABSTRACTOBJECTIVETo study the neurological manifestations of patients with coronavirus disease 2019 (COVID-19).DESIGNRetrospective case seriesSETTINGThree designated COVID-19 care hospitals of the Union Hospital of Huazhong University of Science and Technology in Wuhan, China.PARTICIPANTSTwo hundred fourteen hospitalized patients with laboratory confirmed diagnosis of severe acute respiratory syndrome from coronavirus 2 (SARS-CoV-2) infection. Data were collected from 16 January 2020 to 19 February 2020.MAIN OUTCOME MEASURESClinical data were extracted from electronic medical records and reviewed by a trained team of physicians. Neurological symptoms fall into three categories: central nervous system (CNS) symptoms or diseases (headache, dizziness, impaired consciousness, ataxia, acute cerebrovascular disease, and epilepsy), peripheral nervous system (PNS) symptoms (hypogeusia, hyposmia, hypopsia, and neuralgia), and skeletal muscular symptoms. Data of all neurological symptoms were checked by two trained neurologists.RESULTSOf 214 patients studied, 88 (41.1%) were severe and 126 (58.9%) were non-severe patients. Compared with non-severe patients, severe patients were older (58.7 ± 15.0 years vs 48.9 ± 14.7 years), had more underlying disorders (42 [47.7%] vs 41 [32.5%]), especially hypertension (32 [36.4%] vs 19 [15.1%]), and showed less typical symptoms such as fever (40 [45.5%] vs 92 [73%]) and cough (30 [34.1%] vs 77 [61.1%]). Seventy-eight (36.4%) patients had neurologic manifestations. More severe patients were likely to have neurologic symptoms (40 [45.5%] vs 38 [30.2%]), such as acute cerebrovascular diseases (5 [5.7%] vs 1 [0.8%]), impaired consciousness (13 [14.8%] vs 3 [2.4%]) and skeletal muscle injury (17 [19.3%] vs 6 [4.8%]).CONCLUSIONCompared with non-severe patients with COVID-19, severe patients commonly had neurologic symptoms manifested as acute cerebrovascular diseases, consciousness impairment and skeletal muscle symptoms.
The HOSPITAL score and LACE index for predicting the risk of hospital readmission do not show sex discrimination in a retrospective study
Authors: Robinson Robert 
Published: February 2020

AbstractIntroductionThe perceived absence of human implicit and explicit biases, scalability, and the potential for rapid improvement with algorithmic decision-making systems make compelling arguments for the widespread use of this technology. Unfortunately, real-world performance of some algorithmic decision-making systems demonstrates the reinforcement of discriminatory human biases in a way that is hidden from the human user. This study aims to retrospectively investigate if the widely used HOSPITAL score and LACE index used to predict hospital readmissions exhibit bias on the basis of sex.Materials and MethodsAll adult medical patients discharged from the SIU-School of Medicine (SIU-SOM) Hospitalist service from Memorial Medical Center from January 1, 2015, to January 1, 2017, were studied retrospectively to determine if patient sex had an influence on the ability of the HOSPTIAL score and LACE index to predict the likelihood of any cause hospital readmission within 30 days. Receiver operating characteristic (ROC) curves were constructed comparing risk prediction tool performance by sex by measuring the area under the curve (AUC).ResultsThe analysis includes data for the 1781 discharges for 1410 individual patients that met inclusion criteria. Of these discharges, 456 (27%) were readmitted to the same hospital within 30 days. The overall study population was 47% women, had an average age of 63 years and spent an average of 7.9 days in the hospital. Comparison of the performance of the LACE index in women and men showed no differences between AUCs (0.565 and 0.578, p = 0.613) and an ABROCA of 0.013. Sensitivity (67% and 70%), specificity (46% and 46%), PPV (30% and 31%), NPV (80% and 82%) and accuracy (51% and 52%) for the LACE index are very similar for women and men.Comparison of the performance of the HOSPITAL in women and men showed no differences between AUCs (0.56 and 0.58, p = 0.407) and an ABROCA of 0.008 indicating highly similar performance. Sensitivity (16% and 21%), specificity (96% and 95%), PPV (59% and 57%), NPV (77% and 78%) and accuracy (76% and 76%) for the HOSPITAL score are very similar for women and men.Discussion and ConclusionsThe performance of the HOSPITAL and LACE readmission risk prediction tools appears to have equivalent performance when used for women or men in this small, single-center, retrospective study. Further research is needed to explore the potential of bias and discrimination on risk prediction tools used in healthcare.