bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a Roy’s Adaptation Model–Guided Support Group Intervention on Sexual Adjustment, Body Image, and Perceived Social Support in Women With Breast Cancer
Authors: Erol Ursavaş Figen , Karayurt Özgül 
Published: July 2020

Background
The side effects of local and systemic treatments for breast cancer negatively impact the body image, sexual functioning, and social life of women on treatment for breast cancer. One of the ways to help these women adapt to their disease and cope with the effects of the disease and the side effects of its treatment is through support groups.

Objective
The aim of this study was to investigate the effect of a support group intervention, guided by Roy’s Adaptation Model, on sexual adaptation, body image, and perceived social support in women on treatment for cancer.

Methods
The study had a quasi-experimental design with pretests and posttests and a control group. The sample included 79 women, 42 in the control group and 37 in the intervention group. Data were gathered with demographic and clinical forms, the Sexual Adjustment and Body Image Scale, and the Multidimensional Scale of Perceived Social Support. The intervention group received a support group intervention guided by Roy’s Adaptation Model.

Results
The intervention group had significantly higher scores for perceived social support, post body image, impact on sexual functioning, and friendly and significant others than the control group did.

Conclusion
The Roy’s Adaptation Model–based support group intervention contributes positively to physiologic, self-concept, role-function, and interdependence modes by creating a positive effect on body image, improving sexual functions, and increasing social support for women on treatment for breast cancer.

Implications for Practice
This support group intervention may enhance care outcomes in women on treatment for cancer and could thus be incorporated into standard care for this patient group.
The Understanding of Dignity Among In-Hospital Patients Living With Incurable Esophageal Cancer
Authors: Missel Malene , Bergenholtz Heidi Maria 
Published: July 2020

Background
Dignity is an inherent value in palliative care, but understanding dignity among people living with and hospitalized for incurable esophageal cancer has not been explored.

Objective
The aim of this study was to empirically explore the meaning of dignity in people hospitalized with incurable esophageal cancer.

Methods
A qualitative hermeneutic approach, inspired by Gadamer, guided the research process and interpretation of the transcribed interviews. Eighteen patients participated in the study.

Results
The meaning of dignity was revealed as reverential response in care relationships and eating as an undignifying activity. A balance of the healthcare system’s framework with the lifeworld of the patient was significant in preserving dignity and gave patients a sense of reverent response. Patients were unable to eat ordinary daily meals, which affected their perception of own body and identity, including interactions with others. The resulting bodily changes and social consequences were of crucial importance to the perceived dignity.

Conclusions
A dialogical and understanding approach is significant in making the patient feel worthy, consequently helping to uphold a sense of dignity. The changing and decaying body due to eating difficulties bears witness to illness, altering the individual’s sense of self, in turn threatening the dignity of identity.

Implication for Practice
The care should be based on a reverential response based on the patients’ lifeworld. In doing so, storytelling might be a way. Palliative care for these people needs to stress that patients share other aspects of life that is not totally dominated by their illness, inability to eat, and unrecognizable body.
Scoring Interpersonal Violence Measures
Authors: Williams Jessica Roberts , Burton Candace W. , Anderson Jocelyn C. , Gonzalez-Guarda Rosa M. 
Published: July 2020

Background
Interpersonal violence, such as intimate partner violence, sexual assault, and adverse childhood experiences, is a significant global health concern. A major challenge to nurses and others working in the field of interpersonal violence deals with the complexity involved in measuring interpersonal violence. Numerous validated instruments exist; however, there is no standard approach for scoring these instruments. There is also a tendency to examine different forms of violence separately, not accounting for the known co-occurrence of violence. This has led to confusion as the interpretation of results often differs depending on the specific method used.

Objectives
The purpose of this article is to summarize the major methods for scoring interpersonal violence measures and implications of each approach with a specific focus on co-occurrence.

Methods
The article begins with a summary of the primary goals of measuring interpersonal violence, major methods for scoring interpersonal violence measures, along with scoring challenges. We then provide a case exemplar examining the relationship between interpersonal violence and posttraumatic stress disorder symptoms to illustrate how scoring methods can affect study results and interpretation of findings.

Results
Our article shows that each scoring method provides a different picture of the distribution of interpersonal violence experiences and varies regarding the ease of interpretation. Scoring methods also affect interpretation of associations between interpersonal violence and other factors, such as having statistical power to detect significant associations. Accounting for the co-occurrence is critical for making accurate inferences by identifying potential confounding interactions between different types of violence.

Discussion
The application of different scoring methods leading to varying interpretations highlights the need for researchers to be purposeful when selecting a method and even applying multiple methods when possible. Recommendations are provided to assist researchers and providers when making decisions about the use of scoring methods in different contexts.
New Approach to Microscopy of Gram-Stained Urethral Smear: The Kissing Slide Method
Authors: Sarier Mehmet , Demir Meltem , Turgut Hasan , Hizel Aydan , Emek Mestan , Kukul Erdal , Sepin Nevgun 
Published: July 2020

Background
The effectiveness of microscopy of Gram-stained smear (GSS) for the detection of male urethral infection is debatable, especially in cases with low inflammation and no visible urethral discharge. This clinical study compared GSS samples collected with the conventional swab method and our new technique, the kissing slide method, together with polymerase chain reaction results to demonstrate the effectiveness of this new method in men with acute urethritis.

Methods
The study included 64 men who presented to the urology outpatient clinic with complaints of acute urethritis between October 2019 and January 2020. Two GSS samples were collected from each patient, first using the kissing slide method (applying the slide directly to the urethral mucosa), followed by the conventional method. The results were compared with polymerase chain reaction findings.

Results
The patients' mean age was 37.4 ± 7.8 years, and 68.7% had no visible urethral discharge on physical examination. At a GSS threshold of ≥5 polymorphonuclear leukocytes/high-power field, sensitivity values were 60% (95% confidence interval [CI], 42.32%–75.41%) for the kissing slide method and 23.33% (95% CI, 11.79%–40.93%) for the conventional method. At a threshold of ≥2 polymorphonuclear leukocytes/high-power field, sensitivity values with the kissing slide and conventional methods were 80% (95% CI, 62.69%–90.5%) and 50% (95% CI, 33.15%–66.85%) in all patients, and 66.67% (95% CI, 41.71%–84.82%) and 20% (95% CI, 7.047%–45.19%) in cases without visible urethral discharge, respectively.

Conclusion
The new kissing slide method is a noninvasive alternative method that may have better sensitivity than the conventional GSS sampling method in the diagnosis of male acute urethritis. Randomized studies are needed to verify these findings.
Barriers to Access to New Gonorrhea Point-of-Care Diagnostic Tests in Low- and Middle-Income Countries and Potential Solutions: A Qualitative Interview-Based Study
Authors: Ferreyra Cecilia , Redard-Jacot Maël , Wi Teodora , Daily Jennifer , Kelly-Cirino Cassandra 
Published: July 2020

Background
To assess the potential market for 2 hypothetical diagnostic tests, one for Neisseria gonorrhoeae/Chlamydia trachomatis (NG/CT) detection and one for NG antimicrobial resistance (AMR) marker identification.

Methods
This is a qualitative interview-based study. Semistructured interviews with global- and country-level experts were performed. Interviewees were provided with simplified versions of Foundation for Innovative New Diagnostics/World Health Organization–developed target product profiles for each test. Interviewees were asked to comment on use cases, test characteristics, and factors that may influence test adoption.

Results
Twenty-one experts were interviewed, including 15 country-level experts (from South Africa, India, Zimbabwe, Ghana, China, Peru, Kenya, and Cambodia). Interviewees welcomed an NG/CT point-of-care test, with near-universal preference for a test that could detect symptomatic and asymptomatic infections. Interviewees also saw value in a test that could be used to screen high-risk populations. Factors that may drive adoption of the NG/CT test identified by interviewees included price, cost-effectiveness, evidence of public health benefit, and World Health Organization guidance. Interviewees felt that AMR test use would likely be limited to patients failing first-line treatment.

Conclusions
Although the potential target population for an NG/CT diagnostic test in low- and middle-income countries is sizeable, there are areas of uncertainty relating to the price of the test and its intended use, warranting further research to determine the most effective positioning. An NG AMR test would likely be used very selectively.
Evaluation of the Reproducibility of Bolus Transit Quantification With Contrast-Enhanced Ultrasound Across Multiple Scanners and Analysis Software Packages—A Quantitative Imaging Biomarker Alliance Study
Authors: Averkiou Michalakis A. , Juang Eric K. , Gallagher Madison K. , Cuevas Maria Alejandra , Wilson Stephanie R. , Barr Richard G. , Carson Paul L. 
Published: July 2020

Objectives
Contrast enhanced ultrasound (CEUS) is now broadly used clinically for liver lesion detection and characterization. Obstacles to the efforts to quantify perfusion with CEUS have been the lack of a standardized approach and undocumented reproducibility. The use of multiple scanners and different analysis software packages compounds the degree of variability. Our objectives were to standardize a CEUS-based approach for quantification of perfusion-related parameters of liver lesions and to evaluate the variability of bolus transit parameters (rise time [RT], mean transit time [MTT], peak intensity, and area under the curve) obtained from various clinical ultrasound scanners and analysis software.

Materials and Methods
Bolus transit as a way of evaluating perfusion has been investigated both in vivo and in vitro in the past but without establishing its reproducibility. We developed a tissue flow phantom that produces time-intensity curves very similar to those extracted from clinical cine loops of liver lesions. We evaluated the variability of the bolus transit parameters with 4 commercial scanners (Philips iU22, Philips EPIQ, GE LOGIQ E9, and Siemens Acuson Sequoia) and 3 different analysis software packages in multiple trials (15 per scanner).

Results
The variability (coefficient of variation) from repeated trials and while using a single scanner and software was less than 8% for RT, less than 12% for MTT, less than 49% for peak intensity, and less than 50% for area under the curve. Currently, it is not possible to directly compare amplitude values from different scanners and analysis software packages owing to the arbitrary linearization algorithm used among manufacturers; however, it is possible for time parameters (RT and MTT). The variability when using a different scanner with the same analysis software package was less than 9% for RT and less than 21% for MTT. The variability when using a different analysis software with the same scanner was less than 9% for RT and less than 15% for MTT. In all the evaluations we have performed, RT is the least variable parameter, while MTT is only slightly more variable.

Conclusions
The present study will lay the groundwork for multicenter patient evaluations with CEUS quantification of perfusion-related parameters with the bolus transit technique. When using the protocol and method developed here, it is possible to perform perfusion quantification on different scanners and analysis software and be able to compare the results. The current work is the first study that presents a comparison of bolus transit parameters derived from multiple systems and software packages.
The Effectiveness and Safety of Botulinum Toxin Injections for the Treatment of Congenital Muscular Torticollis
Authors: Qiu Xin , Cui Zhiwen , Tang Gen , Deng Hansheng , Xiong Zhu , Han Shuai , Tang Shengping 
Published: July 2020

Objective:
Botulinum toxin have been used to treat congenital muscular torticollis for the last 25 years; however, few studies have been published with only limited cases and short-term follow-up. The aim of the present study is to systematically review the effectiveness and safety of botulinum toxin injections for congenital muscular torticollis by analyzing these relevant literatures.

Methods:
The authors searched PubMed, Web of Science, EMBASE, Cochrane Library, China Biology Medicine, for all articles about botulinum toxin injections for the congenital muscular torticollis. The MINORS evaluation tool was adopted to evaluate the quality of these studies. Meta-analysis calculations are made by R software 3.6.2.

Results:
This study search involved strict inclusion criteria and targeted data collection. Ten studies were included, with a total of 411 patients, comprising 1 non-randomized experimental study and 9 cases or case series. The results of our meta-analysis of single rate showed that the overall effective rate of botulinum toxin for congenital muscular torticollis was 84% (95% confidence interval [CI] 67%–96%). After botulinum toxin treatment, the conversion rate to surgery was 9% (95% CI 4%–22%), and the adverse reaction rate was 1% (95% CI 0%–3%). The most common adverse reactions among these included studies involve injection site erythema and transient dysphagia.

Conclusion:
Current evidence shows that botulinum toxin injections for the treatment of congenital muscular torticollis is safe and effective, with few serious adverse reactions. Further well-designed, larger randomized trials are warranted.
Palatal Re-Repair With Double-Opposing Z-Plasty in Treatment of Velopharyngeal Insufficiency of Patients With Unilateral Cleft Lip and Palate
Authors: Ahti Veera , Alaluusua Suvi , Rautio Jorma , Saarikko Anne 
Published: July 2020

Background:
Velopharyngeal insufficiency (VPI) is a common problem after cleft palate repair that is often related to palatal shortening and insufficient levator reconstruction. For VPI correction in our cleft center, palatal re-repair with double-opposing Z-plasty is the standard operation.

Aims:
To assess the efficacy of double-opposing Z-plasty in treatment of VPI after primary surgery for unilateral cleft lip and palate (UCLP).

Methods:
This retrospective analysis comprised 109 consecutive UCLP patients born between 1997 and 2014 with VPI that required re-operation, and were operated on by 2 highvolume cleft surgeons, followed by perceptual and instrumental (Nasometer) evaluation of velopharyngeal competence (VPC).

Results:
Preoperatively, VPI was severe in 96% (105 of 109) and mild-to-moderate in 4% (4 of 109). Median age at surgery was 5.6 years (range 2.8–21.9). Postoperatively, 84% of patients achieved adequate VPC: 65% (71 of 109) were competent and 19% (21 of 109) borderline competent. Postoperative adequate VPC was 89% (70 of 79) in nonsyndromic Finnish patients, 50% (4 of 8) in syndromic patients, and 82% (18 of 22) in adoption children. Compared to Finnish nonsyndromic patients, patients with syndrome had more residual VPI (P = 0.003), but no statistically significant difference existed for adoption patients (P = 0.251). Complications of the double-opposing Z-plasty included hemorrhage, postoperative mild airway obstruction, and wound-healing problems, each arising in 2 (1.8%) patients. Fourteen (13%) patients needed a second VPI operation.

Conclusion:
Double-opposing Z-plasty seems to be a good and safe treatment option for VPI in patients with previously repaired UCLP with a success rate of 84%.
Intraconal Retro-Orbital B-Type Antoni Neurinoma Causing Vision Loss
Authors: Bagaglia Simone Alex , Meduri Alessandro , Inferrera Leandro , Gennaro Paolo , Gabriele Guido , Polito Ennio , Fruschelli Mario , Lorusso Nicola , Tarantello Antonio , Mazzotta Cosimo 
Published: July 2020

Abstract
Schwannoma is a rare benign tumor, originating from Schwann cells of the peripheral nerve sheath. We describe a case of intraconal orbital schwannoma, causing compression to the optic nerve and progressive visual impairment treated with surgical resection. The diagnosis of benign orbital schwannoma was provided by histopathological examination (large spindle cell tumor with AntoniB-type cell pattern) and also with immunohistochemistry (positivity for S-100 protein). The 6 months’ follow-up was performed. The patient was asymptomatic during the 6-month follow-up.
Surgical Treatment of a Child With Acute Cortical Blindness Caused by Depressed Skull Fracture
Authors: Köksal Vaner , Karkucak Ahmet , Yalçinkaya Mirsad 
Published: July 2020

Abstract
Linear skull fractures are relatively common in children, however, it is rarer to see depressed fractures. This report details the case of a 7-year-old boy who was admitted to the emergency department with complete blindness after having experienced an in-car traffic accident. Brain tomography of the patient showed that a large, island-shaped piece of occipital bone was depressed on the visual cortex and superior sagittal sinus in the midline. Presentation of complete loss of vision after an isolated head trauma is very rare, and there are no similar cases in existing literature. The limits of surgical indications for depressed skull fractures are well established in neurosurgical practice. Surgical intervention should be performed immediately, especially in cases where neurological changes develop in the earliest stages after a trauma. The patient underwent emergency surgery to correct the blindness without affecting the vascular neighborhood. The depressed cranium was raised to its original position. The blindness had completely resolved shortly after the patient woke up during the postoperative period.
Risk Factors of Positive Resection Margin in Laparoscopic and Open Liver Surgery for Colorectal Liver Metastases: A New Perspective in the Perioperative Assessment
Authors: Benedetti Cacciaguerra Andrea , Görgec Burak , Cipriani Federica , Aghayan Davit , Borelli Giulia , Aljaiuossi Anas , Dagher Ibrahim , Gayet Brice , Fuks David , Rotellar Fernando , D’Hondt Mathieu , Vanlander Aude , Troisi Roberto I. , Vivarelli Marco , Edwin Bjorn , Aldrighetti Luca , Abu Hilal Mohammad 
Published: July 2020

Objective:
To assess the risk factors associated with R1 resection in patients undergoing OLS and LLS for CRLMs.

Background:
The clinical impact of R1 resection in liver surgery for CRLMs has been continuously appraised, but R1 risk factors have not been clearly defined yet.

Methods:
A cohort study of patients who underwent OLS and LLS for CRLMs in 9 European high-volume referral centers was performed. A multivariate analysis and the receiver operating characteristic curves were used to investigate the risk factors for R1 resection. A model predicting the likelihood of R1 resection was developed.

Results:
Overall, 3387 consecutive liver resections for CRLMs were included. OLS was performed in 1792 cases whereas LLS in 1595; the R1 resection rate was 14% and 14.2%, respectively. The risk factors for R1 resection were: the type of resection (nonanatomic and anatomic/nonanatomic), the number of nodules and the size of tumor. In the LLS group only, blood loss was a risk factor, whereas the Pringle maneuver had a protective effect. The predictive size of tumor for R1 resection was >45 mm in OLS and >30 mm in LLS, > 2 lesions was significative in both groups and blood loss >350 cc in LLS. The model was able to predict R1 resection in OLS (area under curve 0.712; 95% confidence interval 0.665–0.739) and in LLS (area under curve 0.724; 95% confidence interval 0.671–0.745).

Conclusions:
The study describes the risk factors for R1 resection after liver surgery for CRLMs, which may be used to plan better the perioperative strategies to reduce the incidence of R1 resection during OLS and LLS.
Predicting the Outcome of Limb Revascularization in Patients With Lower-extremity Arterial Trauma
Authors: Perkins Zane B. , Yet Barbaros , Sharrock Anna , Rickard Rory , Marsh William , Rasmussen Todd E. , Tai Nigel R. M. 
Published: July 2020

Objectives:
Estimating the likely success of limb revascularization in patients with lower-extremity arterial trauma is central to decisions between attempting limb salvage and amputation. However, the projected outcome is often unclear at the time these decisions need to be made, making them difficult and threatening sound judgement. The objective of this study was to develop and validate a prediction model that can quantify an individual patient's risk of failed revascularization.

Methods:
A BN prognostic model was developed using domain knowledge and data from the US joint trauma system. Performance (discrimination, calibration, and accuracy) was tested using ten-fold cross validation and externally validated on data from the UK Joint Theatre Trauma Registry. BN performance was compared to the mangled extremity severity score.

Results:
Rates of amputation performed because of nonviable limb tissue were 12.2% and 19.6% in the US joint trauma system (n = 508) and UK Joint Theatre Trauma Registry (n = 51) populations respectively. A 10-predictor BN accurately predicted failed revascularization: area under the receiver operating characteristic curve (AUROC) 0.95, calibration slope 1.96, Brier score (BS) 0.05, and Brier skill score 0.50. The model maintained excellent performance in an external validation population: AUROC 0.97, calibration slope 1.72, Brier score 0.08, Brier skill score 0.58, and had significantly better performance than mangled extremity severity score at predicting the need for amputation [AUROC 0.95 (0.92–0.98) vs 0.74 (0.67–0.80); P < 0.0001].

Conclusions:
A BN (https://www.traumamodels.com) can accurately predict the outcome of limb revascularization at the time of initial wound evaluation. This information may complement clinical judgement, support rational and shared treatment decisions, and establish sensible treatment expectations.