bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Experiences of Couples Affected by Stroke and Nurses Managing Patient Rehabilitation: A Descriptive Study in Singapore
Authors: RAMAZANU Sheena , LEUNG Doris , CHIANG Vico Chung Lim 
Published: June 2020

ABSTRACT

Background
Stroke in a family affects both patients and their spousal caregivers. Despite advances in the medical management of stroke, less is known about the social and cultural factors that impact couples regarding stroke recovery.

Purpose
The purpose of this study was to explore the experiences of stroke from the perspectives of couples affected by stroke and the nurses managing patient rehabilitation.

Methods
An interpretive descriptive study was conducted. Purposive sampling was used to enroll 17 participants, comprising eight nurses, five spousal caregivers, and four stroke survivors. Individual, in-depth interviews were performed at a rehabilitation hospital in Singapore in June 2018.

Results
The primary theme was the diverse meanings of stroke recovery attributed to limited conversations about the care decisions made by couples and rehabilitation nurses. The second theme was the challenges in nursing responsibilities that hindered the recovery of patients with stroke.

Conclusions/Implications for Practice
The meaning of recovery differs between patients and their informal and formal care providers. This issue should be explored in patient–provider conversations, as these conversations highlight the values and preferences that affect the stroke recovery trajectory. Enhancing shared decision making by patients, spousal caregivers, and healthcare providers during the stroke trajectory may promote the alignment of values that are critical to the stroke recovery experience. Further research into whether and how to incorporate shared decision making in rehabilitation hospital settings as an interventional component is warranted to better support stroke survivors before discharge.
Sleep Apnea Screening for Commercial Drivers
Authors: Wilcox Clifton , Yang Justin , Filler Robert , Chen Po-Hua , Hyun Yoo Jin , Rielly Albert , Kales Stefanos N. 
Published: June 2020

Objective:
Compare the 2016 Federal Motor Carrier Safety Administration (FMCSA) and 2006 Joint Task Force (JTF) Guidelines for commercial drivers’ obstructive sleep apnea (OSA) screening.

Methods:
Retrospective review of all commercial driver medical examinations performed in 2017 at an academic occupational medicine clinic. Screening criteria from both the JTF and FMCSA were applied, separately, and jointly. Statistical tests were applied as appropriate.

Results:
Applying the FMCSA or JTF criteria separately to 706 commercial drivers, the positive OSA screening yields were 15.7% and 16.9%, respectively. Using both criteria produced an overall positive OSA screen yield of 20.1%. Positive predictive values for applying both guidelines ranged from 72.7% to 95.5%.

Conclusions:
The combined use of the 2016 FMCSA and 2006 JTF OSA screening criteria in series has a higher screening yield than using either guideline individually.
Psychosocial Factors and Low Back Pain Outcomes in a Pooled Analysis of Low Back Pain Studies
Authors: Thiese Matthew S. , Lu Ming-Lun , Merryweather Andrew , Tang Ruoliang , Ferguson Sue A. , Malloy Elizabeth J. , Marras William S. , Hegmann Kurt T. , Kapellusch Jay 
Published: June 2020

Objective:
Assessment of possible relationships between work-related psychosocial measures and self-reported low back pain (LBP) outcomes in a large pooled dataset of 1929 participants from 82 facilities in the United States.

Methods:
Pooled data from three prospective cohort studies were used to calculate odds ratios (OR) and 95% confidence intervals (95% CI) for relationships between psychosocial factors and the LBP outcomes. Personal and occupational confounders were controlled for in adjusted Logistic regression models.

Results:
Supervisor support and job satisfaction were significantly (P < 0.05) related to all three LBP outcomes. Other psychosocial factors were significantly (P < 0.05) associated with at least one of the LBP outcomes. Adjusted ORs ranged from approximately 1.50 to 3.50 for most associations.

Conclusions:
There is a significant relationship between work-related psychosocial measures and LBP outcomes.
Evaluation of Liquid Versus Dry Specimen Transport With a Newly Validated Isothermal Amplification High-Risk Human Papillomavirus Assay
Authors: Sun Jingfen , Wu Suhui , Hu Longhua , Shang Haixia , Yang Yufeng , Pretorius Robert , Huang Yaling , Yang Xi , Wu Xiaoqin , Belinson Jerome 
Published: June 2020

Objective
The aim of the study was to determine whether the proportion of positive high-risk human papillomavirus (HR-HPV) tests in endocervical specimens transported dry differs from paired specimens transported in liquid media.

Methods
Five hundred women aged of 30 to 55 years were recruited, Shanxi Bethune Hospital, China. Two samples were collected from the endocervix per patient, one placed into empty vial, the other into a liquid transport solution. All samples were analyzed by AmpFire HR-HPV assay.

Results
Total 1,000 samples collected from 500 patients were analyzed by the AmpFire HR-HPV assay. The total invalid rate was 0.2% (2/1,000). The proportion of endocervical samples testing positive for HR-HPV transported dry (42.2%, 210/498 [95% CI = 37.8%–46.6%]) was similar to the proportion of paired endocervical samples testing positive transported in liquid media (40.4%, 201/498 [95% CI = 36.0%–44.8%], p = .18 [McNemar test]). That the 2 transport methods are likely measuring the same positive (and negative) specimens is suggested by the finding that κ value for the correlation of positive HR-HPV in endocervical specimens transported dry with those transported in liquid media was 0.86 (95% CI = 0.81–0.90).

Conclusions
Endocervical specimens transported dry have similar proportion of positive HR-HPV tests as those transported in liquid media. Dry brush transport of endocervical samples paired with the special characteristics of AmpFire HR-HPV may become an important addition to population based cervical cancer screening.
Vulvar Lichen Sclerosus: Outcomes Important to Patients in Assessing Disease Severity
Authors: Green Nicole , Sheinis Michal , Selk Amanda 
Published: June 2020

Abstract

Objective
The aim of the study was to determine outcome measures that women with vulvar lichen sclerosus (LS) rate as important in assessing disease severity with the ultimate goal of including these items in a disease severity rating tool.

Methods
An online survey of women older than 18 years with a diagnosis of vulvar LS was performed. The survey was posted in Facebook LS support groups. Participants rated items on a scale from 1 to 5 (not important to include to essential to include) in a disease severity scale. Participants also rated how often they were affected by various symptoms on a scale from 1 to 5 (never to daily). Mean rating of importance and mean rating of frequency for each sign and symptom were calculated. T tests were used to compare patients with biopsy-proven disease with those with a clinical diagnosis of LS.

Results
Nine hundred fifty-eight participants completed the survey (86% completion rate). Patients felt that the most important items to assess disease severity were irritation (4.39), fusion of the labia (4.38), soreness (4.37), itch (4.34), change in vulvar skin (4.34), and decrease in quality of life (4.33). The most frequently experienced items by those with LS were irritation (3.92), changes in appearance of vulvar skin (3.92), and discomfort (3.89). There were no differences between patients with biopsy-proven LS versus those diagnosed on clinical examination.

Conclusions
Future LS severity assessment tools will need to include a combination of patient-rated symptoms, clinical rated signs and anatomical changes, and quality of life measures.
Prevalence and Characteristics of Postpartum Vulvovaginal Atrophy and Lack of Association With Postpartum Dyspareunia
Authors: Lev-Sagie Ahinoam , Amsalem Hagai , Gutman Yaacov , Esh-Broder Efrat , Daum Hagit 
Published: June 2020

Objective
Breastfeeding-related hypoestrogenic state has been reported as a possible risk factor for postpartum dyspareunia. This study aimed to evaluate the prevalence and characteristics of postpartum vulvovaginal atrophy according to 3 different diagnostic methods and to estimate its association with postpartum dyspareunia and daily vulvovaginal symptoms.

Methods
This is a prospective cohort study of puerperal women attending a routine postpartum checkup. Participants completed a questionnaire and underwent a gynecological examination. Atrophy was diagnosed separately according to gynecologist impression, vaginal pH measurement (≥5.1), and cytologic vaginal maturation index. Patients were followed up with a telephone survey 2–3 months later, inquiring about symptoms possibly associated with atrophy.

Results
Of 117 participants, vaginal atrophy was diagnosed in 48% by gynecological examination, 62% by a pH level of 5.1 or greater, and 40.2% had cytological atrophy. Of the 35.9% of women who had resumed sexual intercourse (42/117), 69% reported dyspareunia. No significant association was found between dyspareunia and atrophy parameters. There was no difference in the rates of dyspareunia among women who were exclusively breastfeeding (21/27 = 78%), partially breastfeeding (4/7 = 57%), or not breastfeeding (4/8, 50%). Atrophy was more common in breastfeeding women according to the 3 criteria (gynecological examination: 57.6% vs 16.7%, p = .006; pH: 70% vs 22%, p < .001; vaginal maturation index: 51.1% vs 0%, p < .001). Of the 117 participants, 47% reported daily vulvovaginal symptoms. Those with daily symptoms reported more dyspareunia as compared with those without daily symptoms (85% vs 52%, p = .025).

Conclusions
A high prevalence of atrophy was observed in puerperal women in association with breastfeeding. There was no significant association between atrophy and dyspareunia or daily vulvovaginal symptoms.
Intraoperative Human Papillomavirus Test Predicts 24-Month High-Grade Squamous Intraepithelial Lesion Recurrence Saving Costs: A Prospective Cohort Study
Authors: Rabasa Jordi , Alcalde Ana , Bradbury Melissa , Sánchez-Iglesias José Luis , Guerrero Diana , Forcada Cristina , Pérez-Benavente Assumpció , Cabrera Silvia , Ramón Y. Cajal Santiago , Hernández Javier , García Ángel , Centeno Cristina , Gil-Moreno Antonio 
Published: June 2020

Objectives
The human papilloma virus (HPV) test is recommended in the posttreatment follow-up of cervical intraepithelial neoplasia. The aim of the study was to assess whether the intraoperative HPV (IOP-HPV) test had a similar diagnostic accuracy that HPV test performed at 6 months to predict high-grade squamous intraepithelial lesion (HSIL) recurrence.

Materials and Methods
In a prospective cohort study, 304 women diagnosed with HSIL by biopsy and/or endocervical curettage before treatment and/or confirmation in the histological specimen were included. Immediately after surgery, HPV testing was performed. This test was compared with the test at 6 months and other predictors of recurrence. Patients were followed for 24 months. An economic analysis was performed to compare the costs of IOP-HPV and HPV test at 6 months.

Results
Recurrence rate of HSIL was 6.2% (19 patients). The diagnostic accuracy of the IOP-HPV test to predict HSIL recurrence at 24 months was similar to the HPV test at 6 months, with comparative sensitivities of 100% versus 86.7%, specificities of 82.0% versus 77.9%, positive predictive values of 27.1% versus 18.1%, and negative predictive values of 100% versus 99.0%. Direct economic saving per high-grade intraepithelial lesion patient was 172.8 €.

Conclusions
The HPV test performed after loop electrosurgical resection procedure predicted recurrence of HSIL at 24 months with a similar diagnostic accuracy than the HPV test at 6 months. The use of the IOP-HPV test in the management of HSIL will allow early detection of the risk of recurrent disease and to save costs because of potential suppression of the need of HPV and follow-up controls at 6 months.
Prognostic significance of cardiac injury in COVID-19 patients with and without coronary artery disease
Authors: Barman Hasan Ali , Atici Adem , Sahin Irfan , Alici Gokhan , Aktas Tekin Esra , Baycan Ömer Faruk , Ozturk Fatih , Oflar Ersan , Tugrul Sevil , Yavuz Mustafa baran , Celik Fatma Betul , Oktay Aysu , Vahaboglu Haluk , Adas Mine , Turgut Namigar , Okuyan Ertugrul , Yildirmak Mustafa Taner , Gungor Baris 
Published: June 2020

Objective
COVID-19 is a disease with high mortality, and risk factors for worse clinical outcome have not been well-defined yet. The aim of this study is to delineate the prognostic importance of presence of concomitant cardiac injury on admission in patients with COVID-19.

Methods
For this multi-center retrospective study, data of consecutive patients who were treated for COVID-19 between 20 March and 20 April 2020 were collected. Clinical characteristics, laboratory findings and outcomes data were obtained from electronic medical records. In-hospital clinical outcome was compared between patients with and without cardiac injury.

Results
A total of 607 hospitalized patients with COVID-19 were included in the study; the median age was 62.5 ± 14.3 years, and 334 (55%) were male. Cardiac injury was detected in 150 (24.7%) of patients included in the study. Mortality rate was higher in patients with cardiac injury (42% vs. 8%; P < 0.01). The frequency of patients who required ICU (72% vs. 19%), who developed acute kidney injury (14% vs. 1%) and acute respiratory distress syndrome (71%vs. 18%) were also higher in patients with cardiac injury. In multivariate analysis, age, coronary artery disease (CAD), elevated CRP levels, and presence of cardiac injury [odds ratio (OR) 10.58, 95% confidence interval (CI) 2.42–46.27; P < 0.001) were found to be independent predictors of mortality. In subgroup analysis, including patients free of history of CAD, presence of cardiac injury on admission also predicted mortality (OR 2.52, 95% CI 1.17–5.45; P = 0.018).

Conclusion
Cardiac injury on admission is associated with worse clinical outcome and higher mortality risk in COVID-19 patients including patients free of previous CAD diagnosis.
Effects of Lubiprostone, an Intestinal Secretagogue, on Electrolyte Homeostasis in Chronic Idiopathic and Opioid-induced Constipation
Authors: Rao Satish S.C. , Lichtlen Peter , Habibi Sepideh 
Published: June 2020

Goals:
To assess short-term and long-term effects of lubiprostone, a type-2 chloride channel activator, on electrolyte homeostasis.

Background:
Conventional laxatives are associated with electrolyte imbalances. Lubiprostone is a type-2 chloride channel activator approved for treating chronic idiopathic constipation (CIC), opioid-induced constipation (OIC), and constipation-predominant irritable bowel syndrome in women. It induces intestinal fluid secretion, possibly affecting water and electrolyte homeostasis. We investigated short-term and long-term effects of lubiprostone on electrolyte, blood urea nitrogen (BUN), and creatinine levels using pooled data from CIC and OIC patients.

Study:
Data were pooled from 10 CIC and OIC studies—6 double-blind, randomized, placebo-controlled studies and 4 open-label, long-term studies. Total duration of lubiprostone exposure was from 3 weeks (short-term: CIC, 3 to 4 wk; OIC, placebo-controlled, 12 wk) to 48 weeks (long-term: CIC, 24 to 48 wk; OIC, 48 wk). Sodium, chloride, potassium, magnesium, BUN, and creatinine levels were examined at baseline and final assessment.

Results:
Overall, 3209 patients were assessed. In the double-blind, placebo-controlled studies, there were no clinically meaningful differences in levels of electrolytes, BUN, and creatinine between lubiprostone and placebo groups, and in changes from baseline levels with long-term use of lubiprostone. Analyses of shifts in laboratory values (low/normal/high) at baseline and final assessment showed minimal effects on electrolytes, BUN, and creatinine.

Conclusions:
Lubiprostone did not cause clinically meaningful electrolyte imbalances or affect markers of renal function in either the short-term or long-term treatment of CIC or OIC.
The Usefulness of Patient-Reported Outcomes and the Influence on Palliative Oncology Patients and Health Services
Authors: Howard A. Fuchsia , Medhurst Kerensa , Manhas Domnick S. , Yang Linda Y. , Brown Steven , Brown Erika , Olson Robert A. 
Published: June 2020

Background
Through the British Columbia, Prospective Outcomes and Support Initiative (POSI), registered nurses collect patient-reported outcome (PRO) data during telephone follow-up with palliative oncology patients.

Objective
The research objective was to describe the usefulness and influence of the nursing care provided through POSI follow-up on palliative patients and health services.

Methods
We used a qualitative interpretive description approach involving the collection and analysis of semistructured interview data with 20 palliative patients and 12 oncology nurses. All participant data were subjected to an inductively derived coding framework. Analytic categories were identified and iteratively revised through constant comparative techniques to develop representative themes.

Results
The accounts of patients and nurses suggest that telephone follow-up with PROs enabled the nurses to (1) focus on the priorities of patients experiencing complex health challenges, (2) manage complex symptoms, (3) ease the patient’s transition home, and (4) improve access to and use of health services. Suggestions for improving POSI nurse follow-up centered on flexibility in the timing of the follow-up, creating dedicated POSI work assignments, and having additional time to personalize assessments and nursing care beyond the PRO questionnaires.

Conclusions
Nursing care employing PROs via telephone follow-up can improve palliative cancer patients’ quality of life and health service use.

Implications for Practice
Nurses are optimally positioned to use PROs following cancer treatment completion but require organizational resources and support to optimize patient and system outcomes.
Using the Observational Teamwork Assessment in Surgery Instrument to Measure RN Teamwork During Cardiac Surgery
Authors: Dellefield Mary Ellen , Verkaaik Catherine A. 
Published: June 2020

Background:
Surgical teams aspire to be safe and avoid preventable deaths. A lack of teamwork has been associated with safety failures, including adverse events and errors.

Purpose:
The purpose of the pilot study was to: (1) modify the Observational Teamwork Assessment in Surgery (OTAS) and the original data collection method to measure registered nurse (RN) teamwork during the intraoperative phase of 5 open heart surgical procedures and (2) recommend strategies to further test the reliability and validity of the modified OTAS.

Methods:
This was a pilot study of the OTAS using direct observation.

Results:
Although characterized as psychometrically rigorous in prior systematic reviews, using the OTAS to measure RN teamwork in the intraoperative phase of cardiac surgery revealed deficits in its content validity and reliability. The OTAS and its original data collection method were modified.

Conclusion:
Recommendations for further use of the modified OTAS to increase its reliability and validity are given.
Assimilation of Expert Clinician Into the Academy
Authors: Muirhead Lisa , Brasher Susan , Vena Catherine , Hall Priscilla , Cadet Anne 
Published: June 2020

Background
As expert clinicians are recruited to academic positions in response to nursing faculty shortages, comprehensive plans are needed for transitioning and role development.

Problem
Schools of nursing often lack infrastructures to support and develop new faculty.

Approach
Team members from an academic-clinical partnership with the Department of Veterans Affairs created a competency-based faculty development plan.

Outcomes
A comprehensive self-directed faculty development plan was established that included a needs assessment, competency-based guide, and online modular resources.

Conclusion
The faculty development plan provides a tailored approach to support the transition of clinicians to the academic role. This strategy is a potential solution to addressing the faculty shortage, retention, and role strain issues and builds capacity in schools of nursing. This innovative plan is a first step in establishing a mechanism to measure faculty competencies and professional growth.
Men and Women Repeatedly Infected With Chlamydia trachomatis Have a Lower Urogenital Bacterial Load
Authors: Wijers Juliën N.A.P. , van Liere Geneviève A.F.S. , Dukers-Muijrers Nicole H.T.M. , Wolffs Petra F.G. , Hoebe Christian J.P.A. 
Published: June 2020

Abstract
We assessed whether patients repeatedly infected with Chlamydia trachomatis (CT) have a lower urogenital or anorectal CT load. A CT-positive retest was independently associated with higher vaginal and higher urine Cq values (P<0.01). Partial immunity could play a role in repeat urogenital infections, potentially not in anorectal infections.
Clearance of Mycoplasma genitalium and Trichomonas vaginalis Among Adolescents and Young Adults With Pelvic Inflammatory Disease: Results From the Tech-N Study
Authors: Trent Maria , Yusuf Hasiya E. , Perin Jamie , Anders Jennifer , Chung Shang-en , Tabacco-Saeed Lisa , Rowell Julia , Huettner Steven , Rothman Richard , Butz Arlene , Gaydos Charlotte A. 
Published: June 2020

Abstract
Current pelvic inflammatory disease (PID) treatment effectively treats Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT). However, coverage may be inadequate for Mycoplasma genitalium (MG)/Trichomonas vaginalis (TV) infections. We compared the longitudinal MG and TV outcomes with NG/CT outcomes for women enrolled in a longitudinal randomized controlled trial to optimize outcomes after PID. The prevalences of CT and NG were lower at 30- and 90-day follow-up compared with the prevalence at the time of diagnosis. No significant difference was observed for MG (odds ratio, 0.95; 0.86–1.04; P = 0.265) and TV (odds ratio, 0.89; 0.75–1.04; P = 0.146) over time for both treatment groups, showing that persistence and/or reinfection with MG and TV occurs more frequently than with CT or NG after treatment of PID using current national treatment guidelines.
Reliable Postmortem Molecular Diagnosis of Anaphylaxis
Authors: Wang Xiaoyan , Yin Chuanchang , Su Xue , Su Min 
Published: June 2020

AbstractAnaphylaxis is a serious reaction that may cause death in half an hour without diagnostic characteristic in autopsies. Mast cell (MC) degranulation combined with immunoglobulin E (IgE) plays the key roles in anaphylaxis. Unavailability of serum and instability of measured serum in postmortem diagnoses sometimes limit the opinion of medical experts. Allergic tissues are more accessible than serum, and there is a little research on degranulated mast cells and IgE in different human tissues, whereas we hardly know whether the expression will keep stable over the increasing postmortem interval (PMI). In this research, we examined the mast cell counts and degranulation rates and gE contents in human throat, lung, and intestine tissues and preliminarily investigated the correlation of these markers with PMI in anaphylaxis-associated death. Allergic samples showed a significant increase in mast cell degranulation accompanied by an increase in IgE levels than the control group, but the expression was not significantly correlated with increasing PMI only in throat tissues. Elevated mast cell degranulation combined with increased IgE levels may be a reliable biomarker for forensic diagnosis of human tissues due to IgE-mediated allergic sudden death.