bluuebunny/crossref_metadata_2025_split huggingface dataset:
A content analysis of college students’ gaps in knowledge about sexually transmitted infections
Authors: Lederer Alyssa M , Sheena Brittney S 
Published: October 2020

Objective: Sexually transmitted infections (STIs) disproportionately affect young people and can result in severe health consequences. Accurate knowledge about STIs can play an important role in STI prevention. Prior quantitative research has found that college students’ knowledge about STIs is insufficient. However, there is a dearth of information regarding their specific STI knowledge deficiencies. This study sought to fill this gap by using a qualitative approach to elucidate gaps in students’ STI knowledge. Design: Qualitative content analysis of responses to an open-ended online survey question. Setting: A large public Midwestern university in the USA. Method: Students ( N = 289) watched a web-based STI health education programme covering basic information about Chlamydia, gonorrhoea, human papillomavirus (HPV), herpes and syphilis as a course requirement. Afterwards they answered an open-ended question about what information, if any, was new to them. Themes and sub-themes were identified, exemplar quotes were selected for illustrative purposes, and frequencies were calculated. Results: Ten overarching themes were identified about what students learned: everything/a lot (19.7%), prevention (16.6%), treatment/cures (15.6%), prevalence/statistics (14.9%), nothing/not much (14.2%), symptomatology (12.8%), everything about a specific STI (9.7%), health consequences (6.6%), transmission (5.5%) and testing (2.4%). Participants reported learning about HPV most frequently compared to other STIs. Conclusion: Findings demonstrate critical gaps in college students’ STI knowledge and provide a deeper understanding of specific knowledge deficiencies. Study findings highlight important sexual health content that should be integrated into health education initiatives in academic, community and other settings, and provides recommendations on how to do so.
Hearing Improvement in the Patients Operated on Otosclerosis by Right-Handed Surgeons
Authors: Wiatr Agnieszka , Skladzien Jacek , Wiatr Maciej 
Published: October 2020

Background: Otosclerosis is a disease of the osseous labyrinth. The disease causes 5% to 9% of all cases of hearing loss and 18% to 22% of conductive hearing loss. The treatment of choice is a surgery. The hearing improvement after the operation is determined by various factors. Aims/Objectives: The aim of the analysis is to determinate changes in hearing after stapedoplasty in view of surgery side in the patients operated on otosclerosis by right-handed surgeons. Material and Methods: The analysis involved patients hospitalized and operated on otosclerosis between 2012 and 2018. Only patients with their first middle ear surgery due to otosclerosis were included in the study. The patients were operated by 2 right-handed surgeons who used the same surgical technique and had similar experience in otosclerosis surgery. The study included patients who were divided into 2 groups: with self-tightening prosthesis and with manually tightening prosthesis. Results: The procedure performed by right-handed operators on the left side using prostheses requiring manual fixation on the incus was associated with poorer audiometric results compared to the results of surgeries on the right side. In patients with the self-tightening prostheses, the audiometric improvement of hearing was bilaterally comparable independently from operation side. Conclusion: (1) The dependence of hearing improvement on the surgery side was demonstrated in cases of surgeries performed on the left ear by right-handed surgeons, particularly with manually tightening prosthesis. (2) Self-tightening prostheses in stapedotomy limit the human factor, reducing the risk of complications after otosclerosis surgery and provide repeatable hearing improvement.
Patient injuries in the treatment of superficial venous insufficiency registered in Finland between 2004 and 2017
Authors: Laukkavirta Minna , Blomgren Karin , Halmesmäki Karoliina , Nikulainen Veikko , Helmiö Päivi 
Published: October 2020

Objectives This study aimed to identify the unintended incidents that led to patient injuries (PIs) in the treatment of superficial venous insufficiency (SVI). Methods PI claims filed with the Finnish Patient Insurance Centre between 2004 and 2017 involving SVI were reviewed. Factors contributing to PI were identified and classified. Results Eighteen (13.2%) of 136 compensated PIs in the specialty of vascular surgery were related to SVI. Only 4.7% of 383 SVI claims were compensated. The incidence of PIs was 9.9 per 100 000 patients. Fifteen patients had open surgery (83.3%) and three (16.7%) endovenous treatment. Two (11.1%) patients had necrotising fasciitis, four (22.1%) had deep vein injuries and two (11.1%) had a permanent nerve injury. Two (11.1%) patients had retained endovenous material that required surgical removal. Conclusions PIs were identifiable during all stages of care, perioperative injuries related to open surgery being the most common.
Transarterial chemoembolization combined with iodine-125 seed implantation for patients with hepatocellular carcinoma: a retrospective controlled study
Authors: Chen Lei , Sun Tao , Kan Xuefeng , Chen Shi , Ren Yanqiao , Cao Yanyan , Yan Liangliang , Liang Bin , Xiong Bin , Zheng Chuansheng 
Published: October 2020

Objective To determine if iodine-125 seed implantation improved the efficacy of transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) (≤5 cm). Methods We retrospectively reviewed the medical records of 83 consecutive patients with HCC (≤5 cm) who underwent TACE or TACE–iodine-125 from January 2014 to July 2017. The primary endpoint was progression-free survival (PFS). The secondary endpoints were overall survival (OS) and objective response rate (ORR) at 3 months after the first TACE treatment. PFS and OS were calculated using the Kaplan–Meier method and compared using log-rank tests. Independent risk factors for PFS and OS were analyzed using a Cox proportional hazards model. Results Thirty-five patients received TACE–iodine-125 and 48 received TACE alone. The median OS and PFS were both significantly longer in the TACE–iodine-125 compared with the TACE-alone group (42 vs 23 months and 16 vs 8 months, respectively). The ORR was significantly higher in the TACE–iodine-125 compared with the TACE-alone group. There was no significant difference in adverse events, apart from decreased white cell count, between the two groups. Conclusion TACE–iodine-125 might be an effective and safe alternative treatment for patients with HCC (≤5 cm).
Maximum voluntary molar bite force in subjects with malocclusion: multifactor analysis
Authors: Alam Mohammad Khursheed , Alfawzan Ahmed Ali 
Published: October 2020

Objective This study was performed to determine the maximum voluntary molar bite force (MVMBF) in relation to age, sex, lip competency, midline shifting, dental and skeletal malocclusion, overjet, overbite, and crowding. Methods One hundred Saudi patients with orthodontic malocclusion aged 14 to 25 years (51 male and 49 female patients) were investigated in this cross-sectional study. The baseline MVMBF on the right and left side was evaluated in all patients before commencing any orthodontic treatment. The MVMBF was registered with a portable occlusal force gauge in the first molar region during maximal clenching. Results The MVMBF significantly varied with respect to all nine confounding variables. The MVMBF significantly increased with an age of >18 years, male sex, right-side lip competency, no midline shift, dental and skeletal Class I malocclusion, normal overjet, normal overbite, and mild crowding. Conclusion All nine variables examined in the present study significantly influenced the MVMBF.
Local and Systemic Effects of Blood Flow Restriction Therapy in an Animal Model
Authors: Ramme Austin J. , Darcy Rose , Rourke Brennan J. , Davis Carol , Markworth James F. , Junginger Lucas , Maerz Tristan , Brooks Susan V. , Bedi Asheesh 
Published: October 2020

Background: Blood flow restriction therapy (BFRT) has been increasingly applied to improve athletic performance and injury recovery. Validation of BFRT has lagged behind commercialization, and currently the mechanism by which this therapy acts is unknown. BFRT is one type of ischemic therapy, which involves exercising with blood flow restriction. Repetitive restriction of muscle blood flow (RRMBF) is another ischemic therapy type, which does not include exercise. Hypothesis/Purpose: The purpose was to develop a rat model of ischemic therapy, characterize changes to muscle contractility, and evaluate local and systemic biochemical and histologic responses of 2 ischemic therapy types. We hypothesized that ischemic therapy would improve muscle mass and strength as compared with the control group. Study Design: Controlled laboratory study. Methods: Four groups of 10 Sprague-Dawley rats were established: control, stimulation, RRMBF, and BFRT. One hindlimb of each subject underwent 8 treatment sessions over 4 weeks. To simulate exercise, the stimulation group underwent peroneal nerve stimulation for 2 minutes. The RRMBF group used a pneumatic cuff inflated to 100 mm Hg with a 48-minute protocol. The BFRT group involved 100–mm Hg pneumatic cuff inflation and peroneal nerve stimulation for a 5-minute protocol. Four methods of evaluation were performed: in vivo contractility testing, histology, immunohistochemistry, and ELISA. Analysis of variance with post hoc Tukey test and linear mixed effects modeling were used to compare the treatment groups. Results: There was no difference in muscle mass among groups ( P = .40) or between hindlimbs ( P = .73). In vivo contractility testing showed no difference in maximum contractile force among groups ( P = .64) or between hindlimbs ( P = .30). On histology, myocyte cross-sectional area was not different among groups ( P = .55) or between hindlimbs ( P = .44). Pax7 immunohistochemistry demonstrated no difference in muscle satellite cell density among groups ( P = .06) or between hindlimbs ( P = .046). ELISA demonstrated the RRMBF group as eliciting elevated GH levels as compared with the other groups ( P < .001). Conclusion: Ischemic therapy did not induce gains in muscle mass, contractility strength, fiber cross-sectional area, or satellite cell density locally or systemically in this model, although the RRMBF group did have elevated GH levels on ELISA. Clinical Relevance: This animal model does not support ischemic therapy as a method to improve muscle mass, function, or satellite cell density.
Engineered Cell Sheets for the Effective Delivery of Adipose-Derived Stem Cells for Tendon-to-Bone Healing
Authors: Shin Myung Jin , Shim In Kyong , Kim Dong Min , Choi Jae Hee , Lee Yu Na , Jeon In-Ho , Kim Hyojune , Park Dongjun , Kholinne Erica , Yang Ha-Sol , Koh Kyoung Hwan 
Published: October 2020

Background: Efforts are being made to treat rotator cuff tears (RCTs) that exhibit poor healing and high retear rates. Tendon-to-bone healing using mesenchymal stem cells is being explored, but research is needed to establish effective delivery options. Purpose: To evaluate the effects of an adipose-derived stem cell (ADSC) sheet on mesenchymal stem cell delivery for tendon-to-bone healing of a chronic RCT in rats and to demonstrate that ADSC sheets enhance tendon-to-bone healing. Study Design: Controlled laboratory study. Methods: Mesenchymal stem cells were obtained from rat adipose tissue, and a cell sheet was prepared using a temperature-responsive dish. To evaluate the efficacy of stem cells produced in a sheet for the lesion, the experiment was conducted with 3 groups: repair group, cell sheet transplantation after repair group, and cell sheet–only group. Histological, biomechanical, and micro–computed tomography (micro-CT) results were compared among the groups. Results: Hematoxylin and eosin staining for histomorphological analysis revealed that the cell sheet transplantation after repair group (5.75 ± 0.95) showed statistically significant higher scores than the repair (2.75 ± 0.50) and cell sheet–only (3.25 ± 0.50) groups ( P < .001). On safranin O staining, the cell sheet transplantation after repair group (0.51 ± 0.04 mm2) had a larger fibrocartilage area than the repair (0.31 ± 0.06 mm2) and cell sheet–only (0.32 ± 0.03 mm2) groups ( P = .001). On micro-CT, bone volume/total volume values were significantly higher in the cell sheet transplantation after repair group (23.98% ± 1.75%) than in the other groups ( P < .039); there was no significant difference in the other values. On the biomechanical test, the cell sheet transplantation after repair group (4 weeks after repair) showed significantly higher results than the other groups ( P < .005). Conclusion: Our study shows that engineered stem cells are a clinically feasible stem cell delivery tool for rotator cuff repair. Clinical Relevance: This laboratory study provides evidence that ADSCs are effective in repairing RCTs, which are common sports injuries.
Character Strengths Involving an Orientation to Promote Good Can Help Your Health and Well-Being. Evidence From two Longitudinal Studies
Authors: Weziak-Bialowolska Dorota , Bialowolski Piotr , VanderWeele Tyler J. , McNeely Eileen 
Published: October 2020

Purpose: We examined the impact of an orientation to promote good—one aspect of strengths of character, understood as having consistent thoughts and taking actions that contribute to the good of oneself and others—on flourishing outcomes. Design: We used data from 2 longitudinal observational studies. The primary study used 2 waves of data collected in June 2018 and July 2019. The secondary study used 3 waves of data collected in February 2017, March 2018, and March 2019. Setting: Two culturally different populations of adults were examined: (1) a large service organization based in the United States and (2) a Mexican apparel company in the supply chain of a major global brand. Subjects: 1,209 U.S. employees and 495 Mexican apparel workers were included in the study. Measures: Self-reports of orientation to promote good, Well-Being Assessment, Flourishing Index, the CDC Health-Related Quality of Life and the Job-Related Affective Well-Being Scale were used. Analysis: An outcome-wide approach and lagged regression analyses were applied. To combine the estimates across samples meta-analytic estimates were computed. Bonferroni correction was used to correct for multiple testing. Robustness of the results to potential unmeasured confounding was examined using E-values. Results: Orientation to promote good was positively associated with subsequently higher levels of life satisfaction and happiness (β = 0.14, 95% CI: 0.09, 0.19), self-assessed mental health (β = 0.11, 95% CI: 0.06, 0.15) and physical health (β = 0.08, 95% CI: 0.04, 0.12), social connectedness (β = 0.102, 95% CI: 0.06, 0.15) and purpose in life (β = 0.07, 95% CI: 0.03, 0.11). It was also associated with decreased anxiety (β = -0.11, 95% CI: -0.17, -0.06), depression (β = -0.07, 95% CI: -0.1, -0.02) and loneliness (β = -0.09, 95% CI: -0.13, -0.04). Possible effects on both positive affect (feeling happy) and negative affect (feeling sad, stressed and lonely) in general and while-at-work were also identified. Conclusions: Policymakers and practitioners should consider orientation to promote good as an important factor for improving population health and human flourishing while also at work.
Continuous Infusion Low-Dose Unfractionated Heparin for the Management of Hypercoagulability Associated With COVID-19
Authors: Li Matthew , Gitarts Steven , Nyabera Akwe , Kondaveeti Ravali , Hammudeh Yousef , Gonzalez Carlos , Trandafirescu Theo , Penumadu Arunakumari , Lopez Ricardo , Sahibzada Asad , La Cruz Angel De , Rahman Habibur 
Published: October 2020

Introduction: The Coronavirus Disease 2019 (COVID-19) is associated with severe hypercoagulability. There is currently limited evidence supporting the routine use of therapeutic anticoagulation in the setting of COVID-19. Objectives: The primary objective was to compare the incidence of thromboembolic events in adult patients with COVID-19 treated with an unfractionated heparin (UFH) infusion versus prophylactic dose anticoagulation. Secondary objectives included exploration of the efficacy and safety of an UFH infusion through the evaluation of organ function and incidence of minor and major bleeding. Methods: Retrospective observational cohort study with propensity score matching of COVID-19 patients who received an UFH infusion targeting an aPTT between 40 and 60 seconds. Results: Fifty-six patients were included in this study. There was no difference in the composite of thromboembolic events comprised of venous thromboembolism, arterial thrombosis, and catheter-related thrombosis between the UFH and control group (17.9% vs. 3.6%, P = 0.19). There was a significant increase in median D-dimer concentrations from day 1 to day 7 in the control group (475 ng/mL [291-999] vs. 10820 ng/mL [606-21033], P = 0.04). Patients treated with UFH had a higher incidence of minor bleeding (35.7% vs. 0%, P < 0.005) and required more units of packed red blood cell transfusion (0.8 units ± 1.6 vs. 0 units, P = 0.01). Conclusion: Continuous infusion of UFH for patients with COVID-19 infection did not decrease the overall incidence of thromboembolic complications. UFH was associated with stabilization of D-dimer concentrations and increased rates of minor bleeding and transfusions.
Transition to comfort-focused care: Moral agency of acute care nurses
Authors: Meeker Mary Ann , White Dianne 
Published: October 2020

Background: Moving into the last phase of life comprises a developmental transition with specific needs and risks. Facilitating transitions is an important component of the work of nurses. When curative interventions are no longer helpful, nurses enact key roles in caring for patients and families. Aim: The aim of this study was to examine the experiences of registered nurses in acute care settings as they worked with patients and families to facilitate transition to comfort-focused care. Research design: Sampling, data collection, and data analysis were guided by constructivist grounded theory, chosen because of its strength in identifying and explicating social processes. Participants and context: A purposeful sample of 26 registered nurses working in acute care hospitals in one community in the northeastern United States participated in this study through semi-structured interviews. Ethical considerations: The study received approval from the university’s Institutional Review Board for the Protection of Human Subjects. Participants provided informed consent. Findings: Nurses facilitated transition to comfort-focused care by enacting their moral commitments to patients and families. They focused on building relationships, honoring patient self-determination, and maintaining respect for personhood. In this context, they discerned a need for transition, opened a discussion, and used diverse strategies to facilitate achieving consensus on the part of patients, family members, and care providers. Regardless of how the process unfolded, nurses offered support throughout. Discussion: Achievement of consensus by all stakeholders is critical in the transition to comfort-focused care. This study deepens our understanding of how nurses as moral agents utilize specific strategies to assist progress toward consensus. It also offers an example of recognizing the moral agency of nurses through listening to their voices. Conclusion: Increased understanding of effective nursing strategies for facilitating transition to comfort-focused care is essential for developing needed evidence for excellent care and strengthening end-of-life nursing education.
A Randomized Controlled Trial of Cognitive Behavioral Group Prevention Program for Mainland Chinese University Students in Hong Kong
Authors: Pan Jia-Yan , Ye Shengquan , Ng Petrus Yat-Nam , Lu Lucy 
Published: October 2020

Purpose: This study developed a culturally appropriate cognitive behavioral group prevention program for Mainland Chinese university students in Hong Kong and tested its effectiveness. Method: A total of 74 Chinese students were recruited and randomly assigned to an 8-week cognitive behavior prevention program (experimental group) or a waiting list control (WLC) group. Results: Compared with the WLC group, participants in the experimental group significantly reduced psychological distress, acculturative stress, negative emotions, and negative thoughts and increased positive emotions, positive thoughts, and postmigration growth, with medium to large effect sizes. Upon immediate completion of the program, about 46% and 30% of the participants in the experimental group and WLC group, respectively, were classified as non-at-risk cases for developing mental health problems. Discussion: The positive intervention effects and clinical implication of cultural adaptation of cognitive behavioral group therapy to Chinese students are discussed.
Risk Factors for Anterior Tibial Tendon Pathology
Authors: Levitsky Matthew M. , Freibott Christina E. , Greisberg Justin K. , Vosseller J. Turner 
Published: October 2020

Background: Though the tibialis anterior (TA) serves a vital role in ankle dorsiflexion, there is little information regarding risk factors and demographic information that might predispose one to tendinopathy or rupture. This study investigates the features of patients in a single institution who presented with either TA tendinopathy or rupture. The circumstances surrounding rupture were also noted. Methods: ICD-9/10 codes were used to find patients who presented with TA pathology to 2 foot and ankle surgeons at 1 academic medical center from 2011 to 2018. Patient characteristics were noted, including age, sex, body mass index, and the presence of a gastrocnemius equinus contracture. Characteristics of patients with traumatic and atraumatic ruptures were compared. Results: Ninety-four patients presented between 2011 and 2018 (79 cases of tendinopathy and 15 ruptures). The average patient age was 56 years, and the ratio of women to men was 74:20 (3.7:1). With regard to those who experienced rupture, there were 2 ruptures directly related to athletic activity (traumatic), whereas 13 ruptures were found on examination with no overt history of injury (atraumatic). The average age for patients with traumatic ruptures was 39 years compared with 73 years for those with atraumatic rupture ( P < .05). Conclusion: This study investigates the features of patients in a single institution who presented with TA pathology. With regard to tendon ruptures, traumatic ruptures tend to occur in younger patients, whereas older patients are more likely to suffer atraumatic ruptures. Nonoperative treatment often appears to be effective for TA pathology. Level of Evidence: Level III, retrospective comparative series.