bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intracranial Abnormalities of Infantile Hemangiomas in the Head and Neck Regions: A Retrospective MRI Study
Authors: Gao Ying , Yi Xiao-Li 
Published: November 2020

Abstract

Objective:
Few reports have described intracranial hemangiomas and structural brain and/or arterial anomalies in patients with infantile hemangiomas. This study was performed to examine the magnetic resonance imaging findings of intracranial abnormalities in a group of infants with hemangiomas in the head and neck regions.

Methods:
We reviewed our hemangioma treatment center database from January 2010 to July 2018 to assess the prevalence of intracranial abnormalities in infants with hemangiomas in the head and neck regions. Clinical and electronic magnetic resonance imaging data were also retrieved from the patients’ medical charts.

Results:
Of 436 patients with infantile hemangiomas in the head and neck regions, 23 (5%) had intracranial abnormalities, including 20 (23%) with segmental hemangiomas and 3 (1%) with focal hemangiomas. In total, 14 patients had intracranial hemangiomas located within the ventricle and cisterns or ipsilateral lesions involving the extradural space. Eight patients had intracranial structural abnormalities, such as cerebellar dysplasia, Dandy-Walker malformation, and hydrocephalus. Five patients had intracranial arterial anomalies, and three patients had arteriovenous malformations.

Conclusions:
These findings support the hypothesis that intracranial hemangiomas are commonly associated with segmental infantile hemangiomas in the head and neck regions.
Endoscopic Intervention of Aberrant Carotid Artery in the Middle Ear
Authors: Hashim Noor Dina , Jang Seung H. , Moon In Seok 
Published: November 2020

Objective:
To describe surgical management for transcanal endoscopic ear surgery (TEES) in two patients with aberrant internal carotid artery (ICA) in the middle ear.

Patients:
A young girl who complained of pulsatile tinnitus and an elderly man who presented with ear bleeding. Otoendoscopy examination revealed a pulsatile reddish mass protruding through the tympanic membrane in both patients.

Interventions:
A combination of clinical assessments and imaging supported the diagnosis of aberrant ICA in the middle ear. Transcanal endoscopic reinforcement of the artery was performed; tragal cartilage was used as a shield to strengthen the carotid canal defect.

Results:
Assisted by fine endoscopic instruments, the protruding arteries were separated without damage to the surrounding structures and reinforced using tragal cartilage. Both patients’ symptoms improved postoperatively; they reported tinnitus relief and hearing improvement.

Conclusion:
To prevent catastrophic events, diagnosis of aberrant ICA is important before any surgical intervention. With appropriate management, surgical intervention using transcanal endoscopic ear surgery offers a clear view of the surgical field and is an excellent choice for management of aberrant ICA.
Effect of Personal Protection Equipment (PPE) and the Distance From the Eye Piece of Surgical Microscope on the Field of Vision; An Experimental Study
Authors: Iyer Arunachalam , Tikka Theofano , Calder Nicholas , Qamar Sabih Nadeem , Chin Andy 
Published: November 2020

Background:
During the Covid-19 pandemic, otolaryngologists are at risk due to aerosol-generating procedures such as mastoidectomy and need enhanced personal protective equipment (PPE). Eye protection can interfere with the use of a microscope due to a reduction in the field of vision. We aimed to study the effect of PPE on the microsurgical field.

Methods:
Five surgeons measured the visual field using digital calipers at different power settings. They were done with no PPE, a surgical mask, FFP3 mask (N99), and with the addition of small goggles, large vistamax goggles, vistamax plus a face shield, and only a face shield. The measurements were repeated with rings of 5 mm increments. We also measured the “eye relief” of the microscope which is the ideal distance for maximum field of view.

Results:
There was no major reduction of the field with the surgical or FFP3 mask. But even simple goggles reduced the field up to 31.6% and there were progressive reductions of up to 75.7% with large goggles, 76.8% when a face shield was added, and 61.9% when only face shield was used. The distance rings more than 5 mm also affected the field of view.
The eye relief of our eyepiece was found to be 15 mm.

Conclusion:
The current PPE eye protection is not compatible with the use of a microscope. There is scope for research into better eye protection. Mitigation strategies including barrier drapes and alternative techniques such as endoscopic surgery or use of exoscopes should also be considered.
Addressing Positionality Within Case-Based Learning to Mitigate Systemic Racism in Health Care
Authors: Altman Molly R. , Kantrowitz-Gordon Ira , Moise Elba , Malcolm Katie , Vidaković Milan , Barrington Wendy , O'Connor M. Rebecca , de Castro A. B. 
Published: November 2020

Background
Case-based learning has historically focused on the individual patient; however, there is often little consideration within this teaching method of how social determinants of health, such as structural racism and its adverse health effects, bear upon patients' health status and consequent patient outcomes.

Problem
Implementing case studies necessitates taking into account the positionality of patients, as well as health care providers, to counter the racial oppression and discrimination embedded in existing health care and educational systems.

Approach
We describe a process for creating an inclusive, antiracist environment for case-based learning within nursing education, outlining steps for preparing students to more effectively examine case studies through social determinants of health framing and lens to mitigate harmful impacts from systemic racism and racial discrimination in clinical care.

Conclusions
Addressing positionality in case-based learning is one antiracist strategy to begin rectifying health disparities and moving health care toward equity.
Pilot study of educational interventions for pediatric hematopoietic stem cell sibling donors to increase knowledge of donation and transplantation procedures
Authors: Wiener Lori , Childs Richard W. , Shah Nirali N. 
Published: November 2020

Abstract

Background:
Siblings are frequently identified as a tissue match for patients with malignant and nonmalignant diseases and are selected to donate hematopoietic stem cells (HSCs). Research on preparing siblings donors for stem cell donation is limited. Even after donation procedures are explained, siblings have been found to have difficulty understanding the information and may experience anxiety, particularly among younger donors. No prospective studies examining educational tools and transplant knowledge in sibling stem cell donors are currently available. This pilot study assessed donor comprehension of HSC donation procedures and compared knowledge before and after an educational intervention.

Methods:
Assessment of baseline knowledge regarding HSC donation was assessed before and after the consent/information meeting with the medical team. Donors were then stratified into 2 groups by age. Donors aged 10 to 15 years played an adapted version of the therapeutic game ShopTalk and donors aged 16 to 25 years were provided a workbook designed for sibling stem cell donors. Assessment of knowledge was repeated 24 hours after the intervention.

Results:
Participants included 17 siblings of pediatric transplant recipients, aged 10 to 25 years. Mean knowledge scores increased from 59.6% to 68.8% following the meeting with the medical provider and further increased to 88.5% after an educational intervention. Results suggest that education that provides information via a game or workbook increases knowledge in sibling donors.

Conclusion:
Limited interactive educational material on stem cell donation is available for pediatric HSC donors. Additional visual and/or interactive information for sibling donors may increase knowledge and perhaps comfort with the donation process, beyond that which is provided by the medical teams. Providing detailed information about donation and discussion of procedures should be tailored to the individual learning style and supplemented with additional visual information.
Insights into the use of social comparisons within an advanced cancer setting
Authors: Starkings Rachel , Jenkins Valerie , Shilling Valerie 
Published: November 2020

Abstract

Background:
The PROACT (Patient Reported Outcomes in cancer, impact of Age and Carer role demands associated with Treatment) study had the primary aim of developing 2 scales measuring the impact of cancer on wellbeing and caregiving responsibilities, for people with cancer and the individuals supporting them. The project consisted of 4 consecutive studies; the first stage was the collection of qualitative narratives to understand the patient/caregiver experience. This article reports on an incidental finding from these narratives.

Methods:
The researchers conducted semistructured interviews exploring participants’ views on the impact cancer had on their quality of life. They interviewed 24 people with stage III/IV cancer from 3 tumor groups, lung (n = 6), melanoma (n = 9), and ovarian (n = 9), and 23 informal caregivers. Interviews were recorded and transcribed verbatim and a framework was developed through open coding. A framework approach to thematic analysis was employed.

Results:
Twenty themes and 33 subthemes were identified including topics such as impact for caregiving and employment. There was an unplanned finding of participants recurrently using concepts of “luck” or good fortune when describing their situations. Although not a theme itself, this narrative was present across the framework, occurring when individuals made comparisons to “other” groups of people perceived as facing more difficulties.

Conclusions:
This analysis provides insight into the use of language by both patients and informal caregivers in the advanced disease setting, laying the foundation for future research exploring any effects this has on dyadic wellbeing. These interpretations form a basis to explore whether this language can be harnessed by healthcare professionals to deliver information in line with an individual's conceptualization of their situation.
Relationship intimacy processes during treatment for couple-focused interventions for prostate cancer patients and their spouses
Authors: Manne Sharon L. , Kashy Deborah A. , Kissane David , Zaider Talia , Heckman Carolyn J. , Penedo Frank J. , Myers Shannon 
Published: November 2020

Abstract

Objective:
In a previously published trial, we compared the effect of an intimacy-enhancing therapy (IET) and a General Health and Wellness intervention (GHW) on psychological and relationship outcomes among men diagnosed with localized prostate cancer and their partners. Results suggested partial effects of IET on psychological adjustment and relationship satisfaction. To understand these partial effects, the first aim of this study was to evaluate self-disclosure, perceived partner disclosure, perceived partner responsiveness, and levels of intimacy rated after sessions, and the second aim of this study was to examine the role of pre-treatment holding back on these intimacy processes.

Methods:
A total of 156 couples who participated in treatment reported on self- and perceived partner disclosure, responsiveness, and intimacy during sessions. Participants rated levels of holding back before treatment. Linear growth models were estimated using multilevel modeling. Each intimacy process variable was predicted to be a function of time, role, condition, and all interactions among these variables. The effects of own and partner pretreatment holding back on average intimacy process and change in intimacy process were tested in moderated growth models.

Results:
Self- and perceived partner disclosure were significantly higher during IET sessions than GHW sessions. Self-disclosure, perceived partner disclosure, and perceived partner responsiveness increased in both IET and GHW. Intimacy was not higher and did not increase more in IET compared with GHW. Participants who held back reported that their partner disclosed less to them during sessions, perceived that their partner was less responsive to them during sessions, and reported less intimacy during sessions. Partners of participants who held back were seen as less responsive and their interactions were seen as less intimate.

Conclusions:
Although IET focused on enhancing couples’ responsiveness and intimacy, it did not have a stronger effect on these processes during sessions than GHW. The lack of an effect may, in part, be because of the fact that IET did not help those couples who may have been in the greatest need for it because they held back more.
Building the capacity for psycho-Oncology research: a survey of the research barriers and training needs within the International Psycho-Oncology Society
Authors: Lambert Sylvie D. , Coumoundouros Chelsea , Hulbert-Williams Nick J. , Shaw Joanne , Schaffler Jamie 
Published: November 2020

Abstract

Background:
The International Psycho-Oncology Society (IPOS) is a multidisciplinary professional network that aims to improve psychosocial care for individuals impacted by cancer. IPOS encourages research activity, recognizing that a high-quality evidence base is essential to provide best-practice, data-driven clinical care. This study aimed to determine the barriers to research involvement and the training needs and priorities of IPOS members, with the goal of facilitating the development of training resources tailored to the needs of IPOS members.

Methods:
A link to an online, cross-sectional survey was disseminated to all registered members of IPOS via email. The online survey platform SimpleSurvey was used, and questions included demographic characteristics and items related to research interests, involvement, and training needs. High priority research training needs were identified as research tasks respondents rated as highly important, yet possessed a low perceived skill level in.

Results:
Thirty-two percent of IPOS members (n = 142) completed the survey. Participants represented 49 countries and were at a variety of career stages. Overall, participants reported spending an average of 17.3 hours per week on research (range 0–80 hours per week), with 69% of respondents wanting to increase their research involvement. The main barriers to research participation included lack of research funding (80%) and lack of protected time (63%). IPOS members identified 5 high-priority training needs: preparing successful grant applications; preparing research budgets; community-based participatory research; working with decision makers; and finding collaborators or expert consultants. Participants suggested funding access, statistical advisors, and networking and mentorship opportunities as ways to enhance research involvement. Members preferred online training modules (39%) and mentorship programs (19%) as methods by which IPOS could provide research support. IPOS was viewed as being able to contribute to many aspects of research capacity building such as networking, training, and dissemination of research findings.

Conclusions:
IPOS has an important role in encouraging research capacity building among members. This survey provides an agenda for workshops and training opportunities. Mainly, for respondents it was less about training in research methods and more about training in how to prepare successful grant applications, including budgets, and receiving mentorship on this as well as having opportunities to collaborate with other researchers.
Post-traumatic stress in parents of long-term childhood cancer survivors compared to parents of the Swiss general population
Authors: Baenziger Julia , Roser Katharina , Mader Luzius , Harju Erika , Ansari Marc , Waespe Nicolas , Scheinemann Katrin , Michel Gisela 
Published: November 2020

Abstract

Background:
We describe post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in parents of long-term childhood cancer survivors (CCS-parents) and compare them to parents of similar-aged children (comparison-parents) of the Swiss general population (SGP). We compare type of reported stressful event, prevalence of PTSS and PTSD, and psychosocial and cancer-related characteristics associated with PTSS. We further describe the respective normative data for the SGP.

Methods:
We conducted a nationwide cross-sectional questionnaire survey in a population-based sample of long-term CCS-parents (survivors aged ≤16 years at diagnosis, ≥20 years at study, >5 years post-diagnosis) and in the SGP. Using the Impact of Event Scale-Revised, we measured PTSS regarding the most stressful event experienced, and computed probable cases of PTSD.

Results:
Participants included 663 CCS-parents (39.4% fathers) and 1035 individuals of the SGP (40.0% male), of which we identified 391 comparison-parents (41.2% fathers). Illness was most often indicated as stressful event (CCS-parents: 49.5%, comparison-parents: 27.6%, SGP: 25.3%). Prevalence of PTSS and PTSD (CCS-parents: 4.8%, comparison-parents: 6.7%, SGP: 5.6%) did not significantly differ. Lower education was associated with higher intrusion, avoidance, and hyperarousal in all samples (all P ≤ .003). Parents of children with a chronic illness reported higher intrusion (all P ≤ .004). We found no associations with cancer-related characteristics.

Conclusions:
No increased risk for PTSS or PTSD was found among CCS-parents. Individuals with lower education and those with a chronically ill child might benefit from additional support to help manage and resolve the stress symptoms in the long term.
Single cases from multiple perspectives: a qualitative study comparing the experiences of patients, patients’ caregivers, surgeons, and nurses when bad news is delivered about cancer
Authors: Matthews Tamyra , Baken Donald , Ross Kirsty 
Published: November 2020

Abstract

Background:
Qualitative literature on the experiences of those delivering and receiving bad news about cancer has revealed what these parties consider important during the process across many different patient cases. The current study aims to add to this understanding by employing a “linked case" study design to directly compare the perspectives of patients, their caregivers, and health care professionals (HCPs) involved in a series of single-patient cases of breaking bad news.

Method:
Semistructured interviews were conducted with 13 participants (5 patients, 4 caregivers, 2 surgeons, and 2 nurses) who formed 5 linked cases. Interviews were analyzed using interpretative phenomenological analysis and directly compared within each linked case.

Results:
Analyses identified 2 main superordinate themes. The first labeled “accurately perceiving and responding to needs," included HCPs recognizing and responding to patients’ and caregivers’ individual emotional and informational needs. The second labeled “carers fulfilling necessary roles," identified the various roles HCPs and patients’ caregivers took to satisfactorily meet patients’ needs.

Conclusions:
The findings suggest the importance of HCPs accurately perceiving and responding to patients’ and caregivers’ various needs and caregivers ability and willingness to fulfilling support roles in a way that aligns with their own resources and patients’ needs. This highlights the value of HCPs developing and applying interpersonal skills within bad news encounters, working as a team, and exploring caregivers’ resources for patient support.
Cytokine Panels and Pediatric Acute Respiratory Distress Syndrome: A Translational Investigation*
Authors: McKeone Daniel J. , Mathewson Margaret , Dalal Priti G. , Spear Debbie , Umstead Todd M. , Hicks Steven D. , Chroneos Zissis C. , Wang Ming , Thomas Neal J. , Halstead E. Scott 
Published: November 2020

Objectives:
To identify and compare serum and lower respiratory tract fluid biomarkers of lung injury using well-characterized mouse models of lung injury. To explore the relationship between these preclinical biomarkers and clinical outcomes in a discovery cohort of pediatric patients with acute respiratory failure from pneumonia.

Design:
Prospective, observational cohort study.

Setting:
A basic science laboratory and the PICU of a tertiary-care children’s hospital.

Patients:
PICU patients intubated for respiratory failure from a suspected respiratory infection.

Interventions:
Prospective enrollment and collection of lower respiratory tract fluid samples.

Measurements and Main Results:
C57BL6/J mice were intranasally inoculated with escalating doses of influenza A virus or toll-like receptor agonists to simulate varying degrees of lung injury. Serum and bronchoalveolar lavage fluid were measured for the presence of cytokines using commercially available multiplex cytokine assays. Elevated levels of C-C motif chemokine ligand 7 at the peak of inflammation in both bronchoalveolar lavage fluid and serum correlated with lethality, with the bronchoalveolar lavage fluid ratio of C-C motif chemokine ligand 7:C-C motif chemokine ligand 22 providing the best prediction in the mouse models. These preclinical biomarkers were examined in the plasma and lower respiratory tract fluid of a discovery cohort of pediatric patients with acute respiratory failure from pneumonia. The primary clinical outcome measure was ventilator-free days, with secondary outcomes of pediatric acute respiratory distress syndrome severity and mortality. Elevation in peak lower respiratory tract fluid C-C motif chemokine ligand 7:C-C motif chemokine ligand 22 ratios demonstrated a significant negative correlation with ventilator-free days (r = –0.805; p < 0.02).

Conclusions:
This study provides evidence that lung immune profiling via lower respiratory tract fluid cytokine analysis is feasible and may provide insight into clinical outcomes. Further validation of markers, including the C-C motif chemokine ligand 7:C-C motif chemokine ligand 22 ratio in this limited study, in a larger cohort of patients is necessary.
Increased FAPI Uptake in Brain Metastasis From Lung Cancer on 68Ga-FAPI PET/CT
Authors: Fu Wenhui , Liu Lin , Liu Huipan , Zhou Zhijun , Chen Yue 
Published: November 2020

Abstract
A 51-year-old woman with newly diagnosed lung cancer experienced progressive left hip pain for 1 month. 18F-FDG PET/CT showed multiple hypermetabolic lesions throughout the body, including a suspicious lesion in the brain. Elevated FDG activity in select muscles was visualized, which was attributed to altered weight bearing. Unexpectedly, 68Ga-fibroblast activation protein inhibitor PET/CT showed the FDG-avid lesion in the brain with excellent imaging contrast. Brain metastasis was confirmed by a cerebral MRI.