bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender Bias in Collaborative Medical Decision Making: Emergent Evidence
Authors: Helzer Erik G. , Myers Christopher G. , Fahim Christine , Sutcliffe Kathleen M. , Abernathy James H. 
Published: July 2020

This initial, exploratory study on gender bias in collaborative medical decision making examined the degree to which physicians’ reliance on a team member’s patient care advice differs as a function of the gender of the advice giver. In 2018, 283 anesthesiologists read a brief, online clinical vignette and were randomly assigned to receive treatment advice from 1 of 8 possible sources (physician or nurse, man or woman, experienced or inexperienced). They then indicated their treatment decision, as well as the degree to which they relied upon the advice given.
The results revealed 2 patterns consistent with gender bias in participants’ advice taking. First, when treatment advice was delivered by an inexperienced physician, participants reported replying significantly more on the advice of a man versus a woman, F(1,61) = 4.24, P = .04. Second, participants’ reliance on the advice of the woman physician was a function of her experience, F(1,62) = 6.96, P = .01, whereas reliance on the advice of the man physician was not, F(1,60) = 0.21, P = .65.
These findings suggest women physicians, relative to men, may encounter additional hurdles to performing their jobs, especially at early stages in their careers. These hurdles are rooted in psychological biases of others, rather than objective features of cases or treatment settings. Cultural stereotypes may shape physicians’ information use and decision-making processes (and hinder collaboration), even in contexts that appear to have little to do with social category membership. The authors recommend institutions adopt policies and practices encouraging equal attention to advice, regardless of the source, to help ensure advice taking is a function of information quality rather than the attributes of the advice giver. Such policies and practices may help surface and implement diverse expert perspectives in collaborative medical decision making, promoting better and more effective patient care.
Derangement of Arginine and Related Amino Acids in Children Undergoing Surgery for Congenital Heart Disease With Cardiopulmonary Bypass
Authors: Navaei Amir H. , Shekerdemian Lara S. , Mohammad Mahmoud A. , Coss-Bu Jorge A. , Bastero Patricia , Ettinger Nicholas A. , Orellana Renan , Fernandes Caraciolo J. , Marini Juan C. 
Published: July 2020

Objectives:
Arginine is a conditionally essential amino acid, the precursor for nitric oxide and a key factor in cell proliferation, protein synthesis, and energy metabolism. When there is increased demand in the setting of inflammation, ischemia-reperfusion injury, and organ dysfunction, endogenous arginine production falls short, and external supplementation may be necessary. The goal of this study was to assess changes in concentrations of plasma arginine, citrulline, ornithine, glutamine, and plasma arginase in infants and children undergoing surgery for congenital heart disease with cardiopulmonary bypass.

Design:
Prospective observational study.

Setting:
The study was conducted in the Heart Center at Texas Children’s Hospital.

Subjects:
Children undergoing surgery for congenital heart disease with cardiopulmonary bypass.

Interventions:
None.

Measurements and Main Results:
Serial perioperative blood samples were collected for quantification of amino acids, arginase, nitric oxide metabolites, and markers of organ function (lactate, Pao
2/Fio
2 ratio, and creatinine clearance). Thirty children (18 males) were included in the study; median (interquartile range) age 0.5 years (0.3–0.9 yr). The mean ± sd for plasma amino acid concentrations before cardiopulmonary bypass: arginine 62 ± 20 µmol/L, citrulline 24 ± 6 µmol/L, ornithine 53 ± 32 µmol/L, and glutamine 591 ± 126 µmol/L. Arginine concentration was decreased within the first 24 hours (43 ± 15 µmol/L; p = 0.004), citrulline and glutamine concentrations decreased over the first 48 hours (11 ± 4 µmol/L; p < 0.001 and 493 ± 131 µmol/L; p = 0.019, respectively) and were associated with an increase in arginase (3.8 ± 3 µg/mL; p < 0.05). There was an increase in Vasoactive-Inotropic Score (5.9 ± 19 vs 0.5 ± 2; p < 0.001), decrease in creatinine clearance (76 ± 24 vs 93 ± 31; p = 0.002), and Pao
2/Fio
2 ratio (243 ± 138 vs 374 ± 200; p = 0.007) comparing to baseline.

Conclusions:
A widely variable degree of arginine, citrulline, and glutamine depletion occurs in children after surgery for congenital heart disease. These findings were associated with increased arginase and coincide with some of the markers of organ perfusion.
Digital Quantification of Melanocytic Density in Resection Margins of Lentigo Maligna Using SOX10 Versus Hematoxylin–Eosin Staining
Authors: Siarov Jan , Neittaanmäki Noora , Mölne Johan , Gillstedt Martin , Paoli John 
Published: July 2020

Abstract:
Lentigo maligna (LM) represents an overgrowth of atypical melanocytes at the dermal–epidermal junction of chronically sun-damaged skin. The presence of LM on sun-damaged skin poses a diagnostic challenge because the solar-induced melanocytic hyperplasia makes it difficult to assess the LM margins. Melanocytic density can be used to discriminate sun-damaged skin from LM. The aim of this study was to quantify the melanocytic density at the surgical margins of scanned whole-slide images of LM comparing sections stained with H&E and SOX10. Twenty-six surgically excised LM diagnosed at the Department of Pathology at Sahlgrenska University Hospital were collected. The slides that contained the closest surgical margin or harbored the highest density of melanocytes at the margin were selected for serial sectioning using H&E and SOX10. Whole-slide imaging at ×40 magnification was used, and a circular field with a diameter of 0.5 mm at the surgical margin was superimposed on the image. Five blinded pathologists reviewed the slides in a randomized order. In the majority of the cases (24/26), the pathologists identified more melanocytes on the SOX10 slides than those on the H&E slides. On average, 2.5 times more melanocytes were counted using SOX10 compared with H&E (P < 0.05). Furthermore, the average group SD on the H&E slides was 4.12 compared with 2.83 on the SOX10 slides (P = 0.004). Thus, the use of SOX10 staining leads to higher melanocytic density counts compared with H&E staining when assessing the surgical margins of LM. The use of SOX10 staining also significantly decreased the interobserver variability between pathologists.
Development and performance testing of the low-cost, 3D-printed, smartphone-compatible ‘Tansen Videolaryngoscope’ vs. Pentax-AWS videolaryngoscope vs. direct Macintosh laryngoscope
Authors: Lambert Christopher T. , John Stephen C. , John Anna V. 
Published: July 2020

BACKGROUND
While videolaryngoscopes help in the management of difficult airways, they remain too expensive for those with limited resources. We have developed a robust, re-usable, low-cost videolaryngoscope at United Mission Hospital Tansen, Nepal, by combining a smartphone-compatible endoscope capable of capturing still and video images with a three dimensional-printed, channelled, hyperangulated blade. The computer-aided design file for the videolaryngoscope blade was emailed and printed in London before evaluation of its performance on a difficult airway manikin.

OBJECTIVE
To benchmark the intubation performance of the Tansen Videolaryngoscope (TVL) in a ‘difficult airway’ manikin (SimMan3G, tongue fully inflated, neck stiff), against a commercially available videolaryngoscope and a conventional Macintosh laryngoscope.

DESIGN
A manikin study.

SETTING AND PARTICIPANTS
Forty-three experienced videolaryngoscope users in two London teaching hospitals.

INTERVENTION AND OUTCOME
Primary outcome: Intubation success rate. Secondary outcomes: grade of laryngeal view, median time to intubation and intubator-rated ‘ease of use’.

RESULTS
Our device was equivalent to Pentax-AWS and superior to Macintosh laryngoscope (TVL vs. Pentax-AWS vs. Macintosh) in overall intubation success rate (88 vs. 98 vs. 67%, P < 0.05); grade of view (median Cormack-Lehane grade 1 vs. 1 vs. 3, P < 0.01); median time to intubation (17.5 vs. 15.5 vs. 27 s, P < 0.01). In subjective ‘ease of use’ scores, Pentax-AWS was superior to the TVL, which was superior to Macintosh laryngoscope (Likert-type 1 to 5 scale: 4 vs. 4 vs. 1, P < 0.00001).

CONCLUSION
In this manikin simulation of a difficult airway, the ‘TVL’ was superior to the Macintosh laryngoscope, and noninferior to the Pentax-AWS videolaryngoscope in intubation success rate, grade of laryngeal view and time to intubation. Participants found the Pentax device easier to use, and their feedback has given us valuable insights for improving our device. The TVL is well suited to settings in which resources are limited, being inexpensive, simple and re-usable.
Assessment of the duration of surgery and patient turnover after the incorporation of a standardized intracameral combination of mydriatics and anesthetics for cataract surgery
Authors: Ben Hadj Salah Wassim , Rousseau Antoine , M'garrech Mohamed , Best Anne Laurence , Barreau Emmanuel , Labetoulle Marc 
Published: July 2020

Purpose:
To evaluate changes in clinical outcomes, duration, and workflow of cataract surgery, before and after the introduction of a commercially available intracameral combination of 2 mydriatics (phenylephrine, tropicamide) and 1 anesthetic (lidocaine) (ICMA).

Setting:
Service d'Ophtalmologie, Hôpital Bicêtre, Université Paris Sud., Le Kremlin-Bicêtre, France.

Design:
Retrospective chart review.

Methods:
Three series of patients who underwent cataract surgery were grouped according to when they had surgery: just before ICMA was approved (early 2016, Series I); just after implementation of ICMA as the standard procedure for surgery (late 2016, Series II); and 21 months after using ICMA routinely for surgery (2018, Series III). Data were collected on patient turnover during the day of surgery and surgical outcomes.

Results:
The study population comprised of 51, 47, and 51 patients in Series I, II, and III respectively. There were no statistical differences between series in the mean change in corrected distance visual acuity from preoperatively to 1 month postoperatively and in complications (P > .05, all comparisons). The mean duration of surgery was significantly shorter in Series III and II, compared with Series I (13.18 ± 4.05 and 13.62 ± 5.26 vs 15.82 ± 6.01 minutes; P = .023 and P = .041, respectively). The mean patient rotation was statistically significantly shorter in Series III compared with Series I (41.50 ± 8.31 vs 47.79 ± 14.66 minutes, respectively; P = .028).

Conclusions:
Implementing ICMA as a routine procedure in cataract surgery resulted in similar vision and safety outcomes than the usual topical eyedrop regimen, while significantly reducing the total surgery and rotation times. Hence, patient turnover during the surgical session was optimized while maintaining safety and efficacy of the procedure.
Identifying oxidized lipid mediators as prognostic biomarkers of chronic posttraumatic headache
Authors: Domenichiello Anthony F. , Jensen Jennifer R. , Zamora Daisy , Horowitz Mark , Yuan Zhi-Xin , Faurot Keturah , Mann J. Douglas , Mannes Andrew J. , Ramsden Christopher E. 
Published: July 2020

Abstract
Chronic posttraumatic headache (PTH) is among the most common and disabling sequelae of traumatic brain injury (TBI). Current PTH treatments are often only partially effective and have problematic side effects. We previously showed in a small randomized trial of patients with chronic nontraumatic headaches that manipulation of dietary fatty acids decreased headache frequency, severity, and pain medication use. Pain reduction was associated with alterations in oxylipins derived from n-3 and n-6 fatty acids, suggesting that oxylipins could potentially mediate clinical pain reduction. The objective of this study was to investigate whether circulating oxylipins measured in the acute setting after TBI could serve as prognostic biomarkers for developing chronic PTH. Participants enrolled in the Traumatic Head Injury Neuroimaging Classification Protocol provided serum within 3 days of TBI and were followed up at 90 days postinjury with a neurobehavioral symptom inventory (NSI) and satisfaction with life survey. Liquid chromatography-tandem mass spectrometry methods profiled 39 oxylipins derived from n-3 docosahexaenoic acid (DHA), and n-6 arachidonic acid and linoleic acid. Statistical analyses assessed the association of oxylipins with headache severity (primary outcome, measured by headache question on NSI) as well as associations between oxylipins and total NSI or satisfaction with life survey scores. Among oxylipins, 4-hydroxy-DHA and 19,20-epoxy-docosapentaenoate (DHA derivatives) were inversely associated with headache severity, and 11-hydroxy-9-epoxy-octadecenoate (a linoleic acid derivative) was positively associated with headache severity. These findings support a potential for DHA-derived oxylipins as prognostic biomarkers for development of chronic PTH.
Person-Centered Care, Job Stress, and Quality of Life Among Long-Term Care Nursing Staff
Authors: CHANG HeeKyung , GIL Chorong , KIM Hyejin , BEA Hanju 
Published: July 2020

ABSTRACT

Background
Although it has been established that person-centered care is an essential aspect in long-term care facilities, the relationship between person-centered care and job stress among nursing staff and the effect of this relationship on their quality of life are not clear.

Purpose
This study aims to investigate correlations among job stress, quality of life, and person-centered care of nurses as well as factors affecting the person-centered care abilities of nursing staff working at long-term care hospitals.

Methods
Nursing staff (N = 183) in three long-term care hospitals in South Korea completed a questionnaire on job stress, quality of life, and person-centered care. Data were analyzed using the SPSS 22.0 program for descriptive statistics, using an independent t test, a one-way analysis of variance, Pearson's correlation coefficient, and multiple stepwise regression analyses.

Results
Significant factors found to be associated with person-centered care included the quality of life (r = .411, p < .001) and job stress (r = −.305, p < .001) of the participant. The regression model with job stress and quality of life as predictor variables accounted for 29.2% of the variance in person-centered care.

Conclusions/Implications for Practice
Higher quality of life and lower job stress were found to increase the person-centered care abilities of nurses in long-term care facilities.
The Symptom Experience and Self-management Strategies of Women Undergoing Cervical Cancer Treatment
Authors: Christiansen Mille Guldager , Piil Karin , Jarden Mary 
Published: July 2020

Background
Cervical cancer treatment modalities, such as surgery, chemotherapy, radiation, and brachytherapy, often result in short- and long-term adverse effects such as nausea, fatigue, and sexual dysfunction. Chemotherapy and radiation are typically provided on an outpatient basis, requiring women to be more active in self-managing their symptoms at home.

Objective
The aim of this study was to explore how women with cervical cancer experience symptoms and manage daily life during treatment.

Methods
Individual interviews with 10 women diagnosed with cervical cancer and undergoing curative concurrent chemotherapy and radiation were carried out. Data analysis was conducted using a phenomenological-hermeneutic perspective, inspired by Ricoeur.

Results
Three themes were identified based on the interviews: (1) new life perspectives, (2) suffering in silence, and (3) enhanced symptom self-management strategies.

Conclusion
Diagnosis and treatment create an opportunity for the women to critically reflect on their lives and to develop new life perspectives. During treatment, a mental transformation involving the use of various individual social, mental, and physical coping strategies allowed the women to manage their daily lives. This enabled self-management strategies, resulting in maintaining a sense of normalcy, trying to defy the adverse effects, and prioritizing themselves, their families, and the treatment.

Implications for Practice
Women with cervical cancer undergoing oncological treatment need more specific and detailed information about the course of treatment, symptom management, adverse effects, and psychological reactions to better manage their daily lives. Healthcare professionals play a crucial role in supporting and guiding the women and in ensuring optimal symptom management.
Emergency Preparedness Competencies Among Nurses
Authors: McNeill Charleen , Adams Lavonne , Heagele Tara , Swanson Melvin , Alfred Danita 
Published: July 2020

OBJECTIVE
The aim of this study was to examine current levels of self-reported professional emergency preparedness competence among nurses. In addition, relationships between nurse professional emergency preparedness competence, personal preparation for a disaster, and perceived likelihood of reporting to work after a disaster are examined.

BACKGROUND
Evidence suggests wide gaps in nurses' familiarity with the dimensions of professional emergency preparedness competence and their likelihood to report, potentially impacting human life after a disaster.

METHODS
An exploratory, cross-sectional survey design was used with a sample of 186 RNs and licensed practical nurses.

RESULTS
Results indicate significant weaknesses in nurses' professional emergency preparedness competence. There are positive correlations between likelihood to report, personal preparedness, and professional emergency preparedness competence.

CONCLUSIONS
Nurses across the United States lack sufficient competence in professional emergency preparedness. Results demonstrate the need to improve the education of nurses to meet the demands of populations in urgent situations. Action items nurse administrators can take are provided.
Photogrammetric Analysis of Eyebrow and Eyelid Dimensions in Indian American Adults
Authors: Sadacharan Chakravarthy Marx , Packirisamy Vasanthakumar 
Published: July 2020

Abstract
In cosmetic surgery, knowledge of the average dimensions of periorbital features based on gender and ethnicity is essential to improve the patient appearance and maintain the ethnicity. The aim the study was to establish gender-specific periorbital anthropometric and anthroposcopic data for Indian Americans (IA) and to assess the statistically ethnic differences by comparing with published data of Malaysian Indians (MI). Evaluation of periorbital features was done on the standardized frontal photographs of 400 IA, aged 18 to 26 years. The measured values were evaluated by an independent t-test. Sexual dimorphism was found in all 15 measurements. The eyebrow height, combined height of the orbit and eyebrow, eyebrow apex inclination, apex to lateral canthus distance, medial end of brow to medial canthus distance, lateral end of brow to lateral canthus distance; pretarsal skin height, palpebral fissure height, palpebral fissure inclination (PFI), and medial canthus tilt were significantly greater in female than the males. In males, eyebrow apex hairline distance, apex to lateral limbus distance, eyebrow apex angle (EAA), lower eyelid height, and interpupillary distance was significantly greater than the females. Significant ethnic difference was found between IA and MI for eyebrow height, apex to lateral limbus distance, EAA, palpebral fissure height, and PFI in male group. In female group, EAA, medial canthus tilt, and PFI were significantly greater in MI. Four types of epicanthus were observed and the brow apex between lateral limbus and lateral canthus was the most common position. The generated normative data may be useful during diagnosis and treatment planning.
Use of Kinesiography to Assess Mandibular Function Following Segmental Resection and Microvascular Reconstruction
Authors: Venturi Giulio , Defila Luca , Battaglia Salvatore , Cicciù Marco , Crimi Salvatore , Bianchi Aberto , Marchetti Claudio , Tarsitano Achille 
Published: July 2020

Abstract
Mandibular reconstruction has attained adequate morphological outcomes. However, some patients encounter difficulties in oral function and limited mandibular movements. An objective: evaluation has seldom featured actual kinetic measurements after mandibular reconstruction.
Thirty patients who underwent mandibular reconstruction using bony free flap were enrolled in the study. Twenty-two patients were recruited after surgery and compared to a control group of 8 healthy subjects; 8 patients underwent both pre and postoperative evaluations. For each patient, a kinesiographic scan was obtained, recording maximum mouth opening, maximal laterality, and maximal protrusion.
All postoperative kinesiographic evaluations were performed at least 6 months after surgery to ensure complete healing. In the first group of 22 patients, all measured movements were less than those of healthy controls, in particular maximum mouth opening. In the second study group (pre and postoperative evaluation), the postsurgical values did not achieve the control ones, but were no less than the preoperative values, granting adequate functional outcomes.
The kinesiograph appears useful for objectively recording the functional outcomes in patients who have undergone mandibular reconstruction. The postoperative jaw movements were acceptable, ensuring a sufficient functional recovery.
Development and Validation of a Vaginal Anterior Repair Simulation Model for Surgical Training
Authors: O’Meara Amanda , Ramaseshan Aparna S. , O’Sullivan David M. , Tunitsky-Bitton Elena 
Published: July 2020

Objective
The aims of this study were to design and to validate a surgical simulation model for vaginal anterior colporrhaphy.

Methods
Obstetrics and gynecology residents were divided into two groups: “novice” and “advanced.” “Expert” group comprised female pelvic medicine and reconstructive surgery (FPMRS) fellows and faculty. All subjects were recorded performing anterior colporrhaphy using the simulation model. Deidentified, silent videos of recorded performances were evaluated by a blinded reviewer using the Objective Structured Assessment of Technical Skills (OSATS) and a procedure-specific assessment, based on the American Board of Obstetrics and Gynecology milestone evaluation. Analysis of variance was used for statistical comparisons.

Results
Thirty-seven participants included 13 novices, 18 advanced residents, and six experts. The experts scored significantly higher than both resident groups in each of the domains of the OSATS and the procedure assessment. The mean OSATS score for experts was 32.30 (±6.06) (maximum, 35); novice, 17.15 (±5.84); and advanced, 21.11 (±5.61) (P = 0.001). The experts’ scores for the procedure assessment (maximum, 25) was 23.00 (±3.95); novice, 10.62 (±4.70); and advanced, 14.33 (±4.73) (P < 0.001). The two trainee groups did not differ significantly in their overall performance. Most trainees (29 [94%]) evaluated the model as a useful tool in learning this procedure.

Conclusions
This low-fidelity model can be constructed easily using common materials. The model cost is $43.92 with reusable components ($11 per use). Higher scores by experts versus trainees confirm construct validity of this model. It may serve as a valuable simulation tool allowing trainees to improve their surgical technique for anterior colporrhaphy.