bluuebunny/crossref_metadata_2025_split huggingface dataset:
Boosting Perceived Customer Orientation as a Driver of Patient Satisfaction
Authors: Verleye Katrien , De Keyser Arne , Vandepitte Sophie , Trybou Jeroen 
Published: September 2020

ABSTRACT

Objective:
Several hospitals have embraced customer orientation as a strategy to better meet patients' needs, desires, and wishes. This study therefore investigates how hospitals can boost the extent to which patients feel treated in a customer-oriented way by staff (hereafter, “perceived customer orientation”) and its implications for their satisfaction with the hospital.

Design:
A cross-sectional study of hospital staff's interpersonal skills (interpersonal quality) and the atmosphere and physical features of the hospital (environmental quality) as drivers of perceived customer orientation and its satisfaction implications.

Participants and Setting:
Two hundred eighty-nine patients in seven surgery wards and two day-surgery departments of a Belgian hospital.

Main Outcome Measures:
Perceived customer orientation and patient satisfaction.

Results:
Our results show that interpersonal and environmental qualities have a positive impact on perceived customer orientation, with the interpersonal skills of nursing staff having a greater effect than those of physicians. Perceived customer orientation, however, matters most for patient satisfaction when the nature of the service involves high-contact frequency.

Conclusions:
Interpersonal and environmental qualities may help to ensure that patients feel treated in a customer-oriented way, which improves patient satisfaction with the hospital.
A Refugee Child With Lead Poisoning
Authors: Rivers Lexis 
Published: September 2020

Abstract
A case study is presented of a refugee family and children presenting to the refugee clinic, with a positive result for lead toxicity. Clinical presentation and management of pediatric lead toxicity is discussed, and a literature review of refugee screening procedures for the state of California is examined, emphasizing the importance of continuity of care, case management, community resource utilization, and trauma-informed care.
Ultrathin biodegradable polymer sirolimus-eluting stent versus contemporary durable polymer everolimus-eluting stent for percutaneous coronary intervention: a meta-analysis of randomized trials
Authors: Sethi Ankur , Kodumuri Vamsi , Prasad Vinoy , Kassotis John 
Published: September 2020

Introduction
Improvements in coronary drug-eluting stent technology has focused on reducing the long-term complications associated with the effects of the residual footprint on the vessel wall. Although many of the newer stents have exhibited noninferiority to the durable polymer everolimus-eluting stent (DP-EES), they have yet to exhibit clear superiority. We compared the performance of the latest ultrathin strut biodegradable polymer sirolimus-eluting stents (BP-SES) to DP-EES.

Methods
We searched the electronic databases for randomized controlled trials comparing BP-SES to DP-EES. A random effect meta-analysis was performed using the Poisson regression model. The primary end point was target lesion failure (TLF), a composite of target vessel myocardial infarction (TVMI), cardiac death and target lesion revascularization (TLR).

Results
There was no difference between the stents in stent thrombosis [incidence rate ratio (IRR) = 0.79, 95% confidence interval (CI) 0.58–1.06), TLR (IRR = 0.88, 95% CI 0.57–1.38), TVMI (IRR = 0.79, 95% CI 0.61–1.01), cardiac death (IRR = 0.99, 95% CI 0.76–1.29) and target vessel failure (IRR = 0.82, 95% CI 0.64–1.06). In addition, there was no difference in TLF (IRR = 0.82, 95% CI 0.64–1.06). There was evidence of reduced TLF in small vessels with BP-SES based on definition used (defined as ≤2.75 mm; IRR 0.64, 95% CI 0.46–0.91 versus ≤3 mm; IRR 1.11, 95% CI 0.90–1.36).

Conclusion
In our study, the performance of the latest generation BP-SES was comparable to DP-EES but failed to show superiority. The possible benefit in patients with small vessels should be explored future trials.
SMAD4-Expressing Pancreatic Ductal Adenocarcinomas Have Better Response to Neoadjuvant Therapy and Significantly Lower Lymph Node Metastasis Rates
Authors: Kassardjian Ari , Wang Hanlin L. 
Published: September 2020

Objective
For many patients whose pancreatic ductal adenocarcinoma (PDAC) is locally advanced, neoadjuvant therapy has been proposed as a way to decrease tumor burden. Pancreatic ductal adenocarcinoma is generally thought to be resistant to chemotherapy and radiation, however, response to neoadjuvant therapy in PDAC has been described in a subset of patients. The SMAD4 status is considered to be an important molecular feature which distinguishes two subsets of PDAC, SMAD4-positive and -negative tumors. The objective of this study was to evaluate the neoadjuvant treatment response rate as well as compare the different clinicopathologic variables between SMAD4-positive and -negative tumors.

Methods
We analyzed the data of patients who underwent surgical resection for PDAC from 2009–2019. Our cohort from a single institution included 233 patients.

Results
Of the 233 cases, 143 (61.4%) were SMAD4-negative and 90 (38.6%) were SMAD4-positive. Overall, SMAD4-positive tumors with neoadjuvant therapy had better treatment response and better tumor regression scores. In addition, SMAD4-positive tumors had a significantly lower lymph node metastasis rate in both the neoadjuvant and nonneoadjuvant setting.

Conclusions
Further characterization of the role of SMAD4 within the context of neoadjuvant therapy will lead to improved personalized therapeutic strategies.
Inflammatory Bowel Diseases Elevate the Risk of Developing Acute Pancreatitis
Authors: Tél Bálint , Stubnya Bence , Gede Noémi , Varjú Péter , Kiss Zoltán , Márta Katalin , Hegyi Péter Jenő , Garami András , Hegyi Eszter , Szakács Zsolt , Hegyi Péter , Veres Gábor 
Published: September 2020

Objectives
Increasing data suggest that acute pancreatitis (AP) occurs more frequently among patients with inflammatory bowel diseases (IBDs) than in the non-IBD population; however, currently no comprehensive meta-analysis is available.

Methods
Systematic literature search was conducted in 4 major databases. We included observational studies sampling from the general population. Basic study characteristics and crude incidences of AP were extracted. Pooled odds ratios (ORs) with 95% confidence interval (CIs) were calculated using the random-effects model. Subgroups were set up by Crohn disease and ulcerative colitis. Heterogeneity was tested with I
2 statistics.

Results
Eight studies were eligible for the analysis. The odds of AP were 3 times higher in IBD (OR, 3.11; 95% CI, 2.93–3.30; I
2, 0.0%), significantly higher in Crohn disease than in ulcerative colitis (P < 0.001; OR, 4.12 vs OR, 2.61; I
2, 0.0%). The pooled annual incidence of AP in IBD was 210/100,000 person-years (95% CI, 84–392/100,000 person-years; I
2, 98.66%).

Conclusions
We confirmed that IBD elevates the risk of AP and of 100,000 IBD patients 210 AP cases are to be expected annually. Therefore, it is important to include pancreatic enzyme level measurements and radiological investigations in the workup of IBD patients with acute abdominal pain.
Real-world Evidence of Diffusion-weighted Imaging Combined With Magnetic Resonance Cholangiopancreatography for Pancreatic Tumor Screening
Authors: Fukuba Nobuhiko , Ishitobi Hitomi , Takahashi Yoshiko , Nagaoka Makoto , Fukuhara Hiroyuki , Yuki Mika , Komazawa Yoshinori , Kuroda Hiroyuki , Sato Shuichi , Shizuku Toshihiro 
Published: September 2020

Objectives
The aim was to clarify the sensitivity and specificity of diffusion-weighted imaging, as well as of that in combination with magnetic resonance cholangiopancreatography for pancreatic tumor diagnosis in real-world clinical setting.

Methods
Subjects were 217 consecutive patients who underwent both magnetic resonance imaging and contrast-enhanced ultrasound sonography. Cases positive for a pancreatic tumor were confirmed based on pathological diagnosis, whereas negative cases were defined when no solid pancreatic tumor was detected by contrast-enhanced ultrasound sonography or a solid mass was detected but the diagnosis was ultimately denied based on pathological results. Diffusion-weighted imaging-positive was defined as a case with high signals and magnetic resonance cholangiopancreatography-positive when localized main pancreatic duct stenosis with caudal dilation was detected.
We calculated sensitivity and specificity of each modality and those in combination based on sequential use for pancreatic tumor diagnosis.

Results
Diffusion-weighted imaging showed a sensitivity of 94.4% and specificity of 94.5%, whereas those values for magnetic resonance cholangiopancreatography alone were 83.3% and 99.0%, respectively, and for the modalities in combination were 100% and 94.5%, respectively.

Conclusions
Diffusion-weighted imaging was more sensitive than magnetic resonance cholangiopancreatography, whereas those used in combination resulted in increased sensitivity.
Efficacy and Safety of Early Systemic Anticoagulation for Preventing Splanchnic Thrombosis in Acute Necrotizing Pancreatitis
Authors: Zhou Jing , Zhang He , Mao Wenjian , Ke Lu , Li Gang , Ye Bo , Zhang Jingzhu , Lin Jiajia , Gao Lin , Tong Zhihui , Li Weiqin 
Published: September 2020

Objectives
Splanchnic venous thrombosis (SVT) is a relevant complication in patients with acute necrotizing pancreatitis. So far, no specific treatment for preventing development of SVT exists, and the effect of systemic anticoagulation (SAC) is unclear.

Methods
Patients with acute necrotizing pancreatitis admitted to our center within 7 days from onset of abdominal pain were screened. In the historic group, during which period, most patients received no SAC. Patients in the study group received SAC therapy considering the risk of deep vein thrombosis and SVT. The primary outcome measure was the incidence of SVT.

Results
Splenic vein was involved in 71% of all 84 SVT patients. Compared with the historic cohort, patients who received SAC experienced lower incidence of SVT (P < 0.001), especially for splenic venous thrombosis (P = 0.002). Patients in the study group also showed lower mortality (P = 0.04) and incidence of new-onset organ failure (P = 0.03). The incidence of bleeding shows no statistical significance between 2 groups.

Conclusions
Application of SAC seems to reduce the incidence of SVT and improve clinical outcomes without increasing the risk of bleeding. Randomized clinical trials are needed to confirm our findings.
Adipose Tissue From Type 1 Diabetes Mellitus Patients Can Be Used to Generate Insulin-Producing Cells
Authors: Ikemoto Tetsuya , Tokuda Kazunori , Wada Yuma , Gao Luping , Miyazaki Katsuki , Yamada Shinichiro , Saito Yu , Imura Satoru , Morine Yuji , Shimada Mitsuo 
Published: September 2020

Objectives
We aimed to determine whether responsive insulin-producing cells (IPCs) could be generated from adipose-derived stem cells (ADSCs) isolated from patients with type 1 diabetes mellitus (T1DM).

Methods
We isolated ADSCs from adipose tissue of 4 patients (one patient with T1DM and 3 nondiabetic patients), who underwent surgery and differentiated them into IPCs with using a 2-step xeno-antigen free, 3-dimensional culture method. Characteristics of isolated ADSCs, in vitro cell quality, programmed cell death ligand-1 (PDL-1) expression, and transplantation into streptozotocin induced diabetic nude mice were investigated.

Results
Adipose-derived stem cells from T1DM patients and commercially obtained ADSCs showed the same surface markers; CD31−CD34−CD45−CD90+CD105+CD146−. Moreover, the generated IPCs at day 21 demonstrated appropriate autonomous insulin secretion (stimulation index, 3.5; standard deviation, 0.8). Nonfasting blood glucose concentrations of IPC-transplanted mice were normal at 30 days. The normalized rate of IPC-transplanted mice was significantly higher than that of the sham-operated group (P < 0.05). Insulin-producing cells generated from T1DM adipose tissue expressed high levels of PDL-1.

Conclusions
Insulin-producing cells obtained from adipose tissue of T1DM patients are capable of secreting insulin long-term and achieve normoglycemia after transplantation. Expression of PDL-1 suggests the potential for immune circumvention.
Acute Phase Response and Postprocedural Evaluation of Open and Laparoscopic Cryoablation Procedures in Porcine Pancreases
Authors: Imai Shunichi , Kitago Minoru , Matsuda Sachiko , Nakamura Yuki , Shinoda Masahiro , Yagi Hiroshi , Abe Yuta , Fujita Yusuke , Nakano Yutaka , Iwata Kansei , Nakatsuka Seishi , Kitagawa Yuko 
Published: September 2020

Objectives
Cryoablation is a potentially less invasive locoregional ablation modality. Although cryoablation has been used to treat malignancy in various organs, a limited application of this modality in the pancreas has been reported.

Methods
Acute phase response assessments and postprocedural course evaluations of 2 experimental locoregional ablation methods were conducted. In one method, open and laparoscopic cryoablation of a porcine pancreas using an argon-helium gas–based cryoablation system and monitoring of tissue temperature during the procedure were performed. In the other method, open cryoablation of a porcine pancreas using liquid nitrogen was performed. The animals were evaluated postoperatively.

Results
The size of the cryolesion was larger in the second treatment than in the first. Laparoscopic cryoablation was associated with the formation of an iceball, which possibly affected the surrounding structures. The ablated region was adequately cooled with 10 minutes of freeze/repeat cycles. The area cooled to a temperature of less than −40°C was approximately half the size of the cryolesion in diameter. The swine used for the evaluation of the postprocedural course survived 3 weeks after the procedure with a temporal elevation of the serum lipase level.

Conclusions
Cryoablation of the pancreas was experimentally practicable without severe complications under direct or laparoscopic vision.
Surveillance of Lung Cancer and Mesothelioma Patients With Noncurative Treatment Intent
Authors: Fraser Anne , McNeill Rob 
Published: September 2020

Background
Lung cancer patients with advanced disease and no active treatment options currently face frequent follow-up visits to outpatient clinics, associated with significant anxiety, time commitment, and costs. Visits also place considerable strain on the health system. Evidence from other cancers and chronic health conditions suggests virtual or remote follow-up can lead to higher patient satisfaction without negatively impacting health outcomes such as survival time.

Objective
The aim of this review was to identify patient preferences for, and any evidence of relative effectiveness of, different surveillance protocols for patients who have noncurative treatment intent for lung cancer or mesothelioma.

Interventions/Methods
MEDLINE, PubMed, and CINAHL Plus databases were searched for articles published between 1998 and June 2018. The search was restricted to English-language publications and included all original research.

Results
Nine studies met the inclusion criteria, with most studies being retrospective. Findings identified the need for reassurance and hope as part of surveillance, the importance of trust and relationship, and the lack of consistency and evidence around frequency and method of surveillance models.

Conclusions
Current surveillance is based on expert opinion with little consideration of patient preferences, quality of life, impact on anxiety, and impact on survival outcomes.

Implications for Practice
Nurses play a key role in managing surveillance programs for noncurative lung cancer patients. Programs should be built using codesign approaches to ensure best outcomes. Further research needs to be conducted, ensuring directed surveillance models that meet the holistic needs of patients.
Impact of COVID–19-Related Stress and Lockdown on Mental Health Among People Living With HIV in Argentina
Authors: Ballivian Jamile , Alcaide Maria L. , Cecchini Diego , Jones Deborah L. , Abbamonte John M. , Cassetti Isabel 
Published: September 2020

Background:The spread of severe acute respiratory syndrome coronavirus 2, causative agent of the coronavirus disease 2019 (COVID-19), has necessitated widespread lockdown to mitigate the pandemic. This study examines the influence of resilience on the impact of COVID-related stress and enforced lockdown on mental health, drug use, and treatment adherence among people living with HIV (PLWH) in Argentina.Setting:PLWH residing predominantly in Buenos Aires Metropolitan Area and urban regions of Argentina were identified from a private clinic electronic database.Methods:Participants completed an anonymous online survey to evaluate the impact of COVID-19 on economic disruption, resilience, mental health outcomes (depression, anxiety, stress, and loneliness), adherence to HIV treatment, and substance use. We performed ordinary least squares and logistic regressions to test whether resilient coping buffered the impact of economic disruption on mental health and drug use during quarantine.Results:A total of 1336 PLWH aged 18–82 were enrolled. The impact of economic disruption on mental health ΔF(1,1321) = 8.86,P= 0.003 and loneliness ΔF(1,1326) = 5.77,P= 0.016 was buffered by resilience. A 3-way interaction between resilient buffering, stress, and sex was significant ΔF(1,1325) = 4.76,P= 0.029. Participants reported less than excellent adherence to medication (33%), disruption to mental health services (11%), and disruption to substance abuse treatment (1.3%) during lockdown.Discussion:The impact of COVID-stress and lockdown on emotional distress seemed mitigated by resilience coping strategies, and the buffering impact of resilience on perceived stress was greater among women. Results highlight PLWH's capacity to adhere to treatment in challenging circumstances and the importance of developing resilience skills for better coping with stress and adversity.
Brief Report: Time to Repeat Viral Load Testing Among Unsuppressed Adolescents and Young Adults Living With HIV in Kenya
Authors: Mugo Cyrus , Wilson Katherine S. , Onyango Alvin , Njuguna Irene N. , Mburu Caren W. , Richardson Barbra A. , Oyiengo Laura , Inwani Irene , John-Stewart Grace , Wamalwa Dalton C. , Kohler Pamela K. 
Published: September 2020

Background:
Repeat HIV viral load (VL) testing is required after unsuppressed VL to confirm treatment failure. We assessed proportion of adolescents and young adults living with HIV (AYALHIV) in Kenya with a confirmatory VL test and time to repeat testing.

Design:
A retrospective analysis of longitudinal data abstracted from Kenya's national VL database.

Methods:
VL data for AYALHIV who were 10–24 year old between April 2017 and May 2019 were abstracted from 117 HIV care clinics. Records were eligible if at least one VL test was performed ≥6 months after antiretroviral therapy (ART) initiation. The proportion of unsuppressed AYALHIV (≥1000 copies/mL) and time in months between first unsuppressed VL and repeat VL was determined.

Results:
We abstracted 40,928 VL records for 23,969 AYALHIV; of whom, 17,092 (71%) were eligible for this analysis. Of these, 12,122 (71%) were women, median age of 19 years [interquartile range (IQR): 13–23], and median ART duration of 38 months (IQR: 16–76). Among eligible AYALHIV, 4010 (23%) had an unsuppressed VL at first eligible measurement. Only 316 (8%) of the unsuppressed AYALHIV had a repeat VL within 3 months and 1176 (29%) within 6 months. Among 2311 virally unsuppressed AYALHIV with a repeat VL, the median time between the first and the repeat VL was 6 months (IQR: 4–8), with 1330 (58%) having confirmed treatment failure.

Conclusions:
One-quarter of AYALHIV on ART had unsuppressed VL, with less than a third receiving a repeat VL within 6 months. Strategies to improve VL testing practices are needed to improve AYALHIV's outcomes.
Reduction of aggressive and violent behavior toward behavioral health unit staff and other patients: a best practice implementation project
Authors: Badeaux Jennifer E. , Triche Tyrus , Bennett Marsha J. 
Published: September 2020

ABSTRACT

Objectives:
The current project aimed to implement evidence-based recommendations for the management of inpatient aggressive and violent behaviors in four behavioral health units (BHUs) in a mental healthcare area within an academic medical center.

Introduction:
Patient violence against healthcare workers is a global concern, particularly in mental health care. All employees who work in inpatient psychiatric environments are at higher risk for targeted violence than are other healthcare workers. For healthcare organizations and staff, violent episodes involving patients can bring about medical expenses, potential legal expenditure, sick leave and a high turnover rate. The hospital at which this project was implemented had been experiencing a steady increase in violence and aggressive behavior.

Methods:
The project used the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit tool for promoting practice change in four BHUs. A baseline retrospective audit of 10 electronic health records from four BHUs assessed compliance with best practice regarding violent episodes. The Getting Research into Practice tool was used to identify barriers and develop an evidence-based educational strategy for 70 BHU staff aimed to improve compliance with best practice for managing aggression and violence. Staff education compliance was assessed via hospital education department records. A pre and postimplementation staff satisfaction survey assessed perceptions about education, confidence and unit safety.

Results:
The baseline audit indicated that one of the three criteria had 0% compliance. Following implementation of an educational strategy using mock codes for BHU staff, there was 96% improvement in compliance for the BHU staff education audit criterion. Staff de-escalated patients in 83% of the episodes postimplementation. There was a slight decrease (9.1%) in the rate of violence across all four inpatient BHUs. Staff satisfaction survey findings did not show a statistically significant difference.

Conclusion:
Enhanced evidence-based education and mock codes resulted in BHU staff competence and confidence in managing aggressive and/or violent patients. Early signs of a decrease in the violence rate and improvement in the efficient use of de-escalation will be sustained with on-going yearly education, quarterly mock codes and future audits. This project was limited by its small size and short timeframe (21 weeks), making results not generalizable.