bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Novel Magnetic Resonance Imaging-based Lumbar Muscle Grade to Predict Health-related Quality of Life Scores Among Patients Requiring Surgery
Authors: Virk Sohrab , Wright-Chisem Joshua , Sandhu Milan , Vaishnav Avani , Albert Todd J. , Gang Catherine Himo , Qureshi Sheeraz 
Published: December 2020

Study Design.
Retrospective cross-sectional cohort.

Objective.
The aim of this sudy was to determine whether muscle health measurements are associated with health-related quality of life scores (HRQOLs) for patients with lumbar spine pathology.

Summary of Background Data.
Poor muscle health has been implicated as a source of pain/dysfunction for patients with lumbar spine pathology. Our aim was to quantify the relationship using muscle health measurements and HRQOLs.

Methods.
Three hundred and eight patients were included (mean age 57.7 ± standard deviation 18.2 years’ old). We randomly selected patients into a derivation cohort (200) and validation cohort (108) to create our muscle health grade. We measured muscle health by the lumbar indentation value (LIV), goutallier classification (GC), and ratio of paralumbar muscle cross-sectional area over body mass index (PL-CSA/BMI). A muscle health grade was derived based on whether a measurement showed a statistically significant impact on visual analog scale back and leg pain (VAS-leg and VAS-leg), Oswestry Disability Index (ODI), short-form 12 physical health score (SF-12 PHS), short-form 12 mental health score (SF-12 MHS) and Patient-reported Outcomes Measurement Information System (PROMIS). A variety of statistical tools were used to determine whether there was a relationship between a measurement and HRQOLs.

Results.
In the derivation cohort, a muscle health grade was created based on the GC and PL-CSA/BMI ratio. For patients with a GC ≤2, one point was given. For patients with a PL-CSA/BMI ≥130, one point was given. Patients with 2 points were graded as “A” and 0 or 1 point were graded “B.” Within the validation cohort of patients, there was a statistically significant higher PROMIS (mean 34.5 ± standard deviation 12.6 vs. 27.6 ± 14.0, P = 0.002), ODI (38.8 ± 18.3 vs. 45.8 ± 18.1, P = 0.05) and SF-12 PHS (34.7 ± 11.3 vs. 29.1 ± 6.3, P = 0.002) for patients with a good muscle health grade of “A.”

Conclusion.
This study offers an objective measurement of muscle health that correlates with HRQOLs for patients with lumbar spine pathology.

Level of Evidence: 3
Facilitators and Barriers to Glaucoma Screening Identified by Key Stakeholders in Underserved Communities: A Community-engaged Research Approach
Authors: Ballouz Dena , Cho Juno , Woodward Maria A. , Elam Angela R. , Musch David C. , Zhang Jason , Moroi Sayoko E. , Johnson Leroy , Cederna Jean , Newman-Casey Paula A. 
Published: December 2020

Précis:
Community-engaged research (CER) enables researchers to identify community-specific barriers and facilitators to program implementation. Broadly applicable barriers to glaucoma care, such as Cost, Transportation, and Trust, and community-specific barriers, such as Language and Convenience/Access, were identified.

Purpose:
The aim was to identify the facilitators and barriers to implementing glaucoma screening programs in 2 community clinics.

Methods:
A concurrent mixed-methods process analysis using CER. Key stakeholders—including patients, providers, and staff members—from 2 community clinics were interviewed using a semistructured interview guide. Interviews had 2 parts: (1) asking patients about community-based facilitators and barriers to implementing glaucoma screening and care and (2) eliciting feedback about a personalized coaching program. The transcripts were coded using Grounded Theory. Number of participants and number of representative citations were counted per theme. The qualitative analysis was coded using Dedoose 8.3.17 (Los Angeles, CA).

Results:
Thematic saturation was reached after coding 12 interviews. 30 participants were interviewed, 13 from Hamilton Clinic (Flint, MI; 8 patients, 5 providers and staff members) and 17 from Hope Clinic (Ypsilanti, MI; 6 patients, 11 providers and staff members). The most commonly cited themes were: Priorities (98 citations, 30 participants), Knowledge (73, 26) Transportation (63, 26), Cost (60, 23), and Convenience/Access (63, 22). Broadly applicable barriers to glaucoma care, such as Cost, Transportation, and Trust were identified alongside community-specific barriers such as Language and Convenience/Access. Participants rated their likelihood to follow up with an ophthalmologist after participating in the personalized coaching program at a mean of 8.83 (on a scale of 1 to 10 with 10 being the most confident).

Conclusions:
CER enables researchers to identify community-specific barriers and facilitators, allowing more effective program implementation.
The Sustainable Development Goals and the Community of Portuguese Speaking Countries (CPLP) in the post-COVID-19 era
Authors: Lapão Manuel J. Clarote 
Published: December 2020

Abstract
The universalization and full realization of the objectives and goals of the United Nations 2030 Agenda for Sustainable Development can be called into question by the significant drop in international funding available to support developing countries. This situation may be worsened by the effects caused by the COVID-19 pandemic and the consequent increase in nonregular cooperation programs, based on humanitarian and emergency actions. The promotion of horizontalization strategies for the Sustainable Development Goals (SDGs), considering interventions with a transversal nature, in a 360° view, which encourages the promotion of strategic alliances, multisectoral and multidimensional partnerships as well as shared financing mechanisms, appears as a credible hypothesis to assure the commitment with sustainable development. The article addresses some perceptions of multilateral organizations, namely within the scope of the United Nations System and Bretton Woods institutions, and how the strategic development cooperation instruments created by Community of Portuguese Speaking Countries may contribute to boosting post-COVID-19 cooperation scenarios aligned with the accomplishment of the SDGs in this community.
Personal Protective Equipment (PPE) in COVID 19 Pandemic
Authors: Battista Rosa Alessia , Ferraro Milena , Piccioni Lucia Oriella , Malzanni Giulia Elvira , Bussi Mario 
Published: December 2020

Objectives:
To assess prevalence of Personal Protective Equipment (PPE)-related symptoms and adverse reactions during Coronavirus Disease 2019 pandemics.

Methods:
We conducted an observational study among people exposed to various degree of infectious risk. Data were collected with a self-administered online questionnaire.

Results:
The entire cohort complained about a wide range of adverse reactions: respiratory symptoms affected 80.3% of respondents, 68.5% referred pressure-related skin lesions, fewer manifested a dermatosis of different grade or ocular symptoms. Most of the affected individuals belonged to healthcare staff and manifestations were predicted by wearing time (more than 6 h/d). Moreover, symptoms were higher in the healthcare staff wearing N95/FFP2 respirator mask.

Conclusions:
Given the crucial role of PPE to contain the pandemic infection, more attention has to be paid to exposed categories, establishing preventive measure of side effects to ensure total safety.
Prevalence and Predictors of Moral Injury Symptoms in Health Care Professionals
Authors: Mantri Sneha , Lawson Jennifer Mah , Wang ZhiZhong , Koenig Harold G. 
Published: December 2020

Abstract
This study examined the prevalence and predictors of moral injury (MI) symptoms in 181 health care professionals (HPs; 71% physicians) recruited from Duke University Health Systems in Durham, NC. Participants completed an online questionnaire between November 13, 2019, and March 12, 2020. Sociodemographic, clinical, religious, depression/anxiety, and clinician burnout were examined as predictors of MI symptoms, assessed by the Moral Injury Symptoms Scale–Health Professional, in bivariate and stepwise multivariate analyses. The prevalence of MI symptoms causing at least moderate functional impairment was 23.9%. Younger age, shorter time in practice, committing medical errors, greater depressive or anxiety symptoms, greater clinician burnout, no religious affiliation, and lower religiosity correlated with MI symptoms in bivariate analyses. Independent predictors in multivariate analyses were the commission of medical errors in the past month, lower religiosity, and, especially, severity of clinician burnout. Functionally limiting MI symptoms are present in a significant proportion of HPs and are associated with medical errors and clinician burnout.
Four Years Later
Authors: Schenk Elizabeth , Marks Nicole , Hoffman Kelli , Goss Lola 
Published: December 2020

OBJECTIVE
To examine changes in registered nurse (RN) perceptions of electronic documentation over a 4-year period.

BACKGROUND
The investigators previously reported differences in RN perceptions prior to and 1 year after adoption of a comprehensive electronic health record (EHR).

METHODS
Investigators repeated the study 4 years after adoption, using the Nurses' Perceptions of Electronic Documentation tool and interviews with a subset of RNs.

RESULTS
Nurses scored higher on ease of use domain and lower on concern about the EHR domain and showed no difference on the impacts of the EHR domain. Interviews revealed that 4 years later, some aspects of documentation were easier; the tool was comprehensive, but not without risk, and nurses remained ambivalent about the EHR.

CONCLUSIONS
Use of EHR technology impacts nursing work. It is important to understand how nurses' perceptions change over time. This study gives nursing leaders insight into adoption and acceptance of an EHR.
Inconsistency in Faculty and Student Perceptions of DNP and PhD Leader Scholarly Activity
Authors: Jenkins Peggy , Meek Paula , Amura Claudia , Robertson Glenda 
Published: December 2020

OBJECTIVE
We aimed to quantify faculty and student perceptions of scholarly activities for doctor of nursing practice (DNP) and PhD leaders.

BACKGROUND
The American Association of Colleges of Nursing describes DNP as a practice-focused degree and PhD as a research-focused degree. In 2016, the Council on Graduate Education for Administration in Nursing (now Association for Leadership Science in Nursing) published in the Journal of Nursing Administration sample practice objectives for DNP and research objectives for PhD leaders.

METHODS
Using the published objectives, we surveyed faculty and students to quantify congruence with the publication and consistency within groups. The data informed intraprofessional education constructed using action research.

RESULTS
There was low congruence between faculty and student responses with the article. PhD faculty had the least, and PhD students, the greatest, consistency in survey responses.

CONCLUSIONS
Confusion exists within our faculty and students around differentiating PhD and DNP scholarly activities. Data supported need to clarify scholarly role boundaries through intraprofessional education.
Effects of Platelet-Rich Fibrin/Collagen Membrane on Sciatic Nerve Regeneration
Authors: Vares Peyman , Dehghan Mohammad Mehdi , Bastami Farshid , Biazar Esmaeil , Shamloo Nafiseh , Heidari Keshel Saeed , Khojasteh Arash 
Published: December 2020

Abstract
Alternative treatment approaches to improve the regeneration ability of damaged peripheral nerves are currently under investigation. The aim of the current study was to evaluate the effects of leucocyte/platelet-rich fibrin (L-PRF) with or without a collagen membrane as a supporter on crushed sciatic nerve healing in a rat model. Recovery of motor function and electrophysiologic measurements were evaluated at 4 weeks postoperatively. The whole number of myelinated axons, peripheral nerve axon density, average nerve fiber diameter (μm), and G-ratio were analyzed and compered among the groups. Functional, electrophysiological, and histological evaluations showed no significant difference among the groups with the exception of the L-PRF with collagen membrane groups that showed relatively positive effects on the functional and histological nerve recovery. In addition, the collagen membrane with L-PRF can be effect in nerve regeneration.
Analysis of National Outcomes for Simple Versus Complex Nasal Dermoid Cyst Excision
Authors: Kalmar Christopher L. , Patel Vijay A. , Taylor Jesse A. 
Published: December 2020

Abstract
Nasal dermoid cysts represent a spectrum of complexity from dermal sacs to multiloculated sinus tracts with intracranial extension with treatments ranging from outpatient excision to transcranial procedures involving dissection of the dermoid from the dura mater. In this study, the authors examined national outcomes across the spectrum utilizing the NSQIP database. Interestingly, complication rates were uniformly low at 1.2% even though those requiring transcranial excision required significantly longer surgical procedures (P = 0.001), and were significantly more likely to be admitted as inpatients (P < 0.001). Risk factors for longer surgery included patients with comorbidities (P = 0.006), patients requiring rhinoplasty (P = 0.001), and patients requiring a craniotomy (P = 0.023). While uncommon (0.3%), infectious complications remain primary drivers of postoperative morbidity. The NSQIP database does not allow for calculation of recurrence risk, likely a driver of poorer long-term outcomes, and efforts to quantify recurrence risk will be the subject of future research.
Titanium Fan Plate Reconstruction for Lateral Orbital Traumatic Defects
Authors: O’Connor Kate E. , Pinzas Lauren A. , Sivam Sunthosh K. 
Published: December 2020

Abstract
Fractures of the orbit often require operative repair with materials ranging from autologous tissue to titanium implants. Reconstructive techniques of the lateral orbital rim and wall offer a unique challenge due to the structural and aesthetic demands with regard to its natural contour. The authors present a case in which a patient sustained a ballistic injury involving the lateral orbital rim and wall requiring reconstruction. The authors employed the use of a single titanium orbital mesh fan plate (DePuy Synthes, Warsaw IN) in an injury-specific and cost-effective technique to rapidly restore the contour and structure of the lateral orbit rivaling the result of a 3D printed custom plate.
Endoscopic Versus Open Total Vault Reconstruction of Sagittal Craniosynostosis
Authors: Al-Shaqsi Sultan Z. , Lam Nicole Wing , Forrest Christopher R. , Phillips John H. 
Published: December 2020

Sagittal craniosynostosis is the most common form of congenital cranial deformity. Surgical interventions are performed either open or endoscopic. Advancements in minimally invasive surgery have enabled the development of the endoscopic suturectomy technique. This is contrasted to the traditional open cranial vault reconstruction. There is a paucity of data comparing the head shape changes from both techniques. This study aims to compare the morphological outcome of endoscopic suturectomy versus total cranial vault reconstruction.

Methods:
This is a retrospective comparative study involving 55 cases of sagittal craniosynostosis, 37 of which has open total cranial vault reconstruction and 18 had endoscopic suturectomy procedure. Preoperative and postoperative 3D photographs of both groups were analyzed and compared. The change in correction between preoperative and postoperative state was measured against a crowd-driven standard for acceptable head shape.

Results:
Total cranial vault had higher percentage change between pre and postoperative cranial index than endoscopic suturectomy (14.7% versus 7.7%, P = 0.003). However, both techniques were able to achieve the minimum standard of 70% correction (TCV 107.5%, ES 100.4%, P = 0.02).

Conclusion:
Total cranial vault and endoscopic suturectomy are effective in correcting scaphocephaly among children with sagittal craniosynostosis. Additionally, both techniques are able to achieve a percentage correction that exceeds the 70% benchmark established by the lay public.
Superolateral Dislocation of Bilateral Mandibular Condyles With a Mandibular Body and Condyle Fracture
Authors: Han Song Hyun , Kim Soon Heum , Jo Dong In 
Published: December 2020

Abstract
An 82-year-old man fell from a motorcycle and was admitted with superolateral dislocation of the bilateral mandibular condyles. The displaced condyles on the right and left were hooked in the posterior root of the zygomatic arch and in the temporal fossa beyond the zygomatic arch, respectively. There was a sagittal split fracture on the medial side of the right mandibular condyle and a right mandibular body fracture. Under general anesthesia, manual reduction of the dislocation was successfully performed the day after the injury. Bilateral superolateral dislocations hooked to the temporal fossa or zygomatic arch are very rare, as they may require multiple strong impacts to occur. Open reduction and closed reduction are possible treatment modalities, and the period from trauma to treatment is relevant for the choice of treatment.
Burn Injury Impairs Neutrophil Chemotaxis Through Increased Ceramide
Authors: Beckmann Nadine , Schumacher Fabian , Kleuser Burkhard , Gulbins Erich , Nomellini Vanessa , Caldwell Charles C. 
Published: December 2020

ABSTRACT
Infection is a common and often deadly complication after burn injury. A major underlying factor is burn-induced immune dysfunction, particularly with respect to neutrophils as the primary responders to infection. Temporally after murine scald injury, we demonstrate impaired bone marrow neutrophil chemotaxis toward CXCL1 ex vivo. Additionally, we observed a reduced recruitment of neutrophils to the peritoneal after elicitation 7 days after injury. We demonstrate that neutrophil ceramide levels increase after burn injury, and this is associated with decreased expression of CXCR2 and blunted chemotaxis. A major signaling event upon CXCR2 activation is Akt phosphorylation and this was reduced when ceramide was elevated. In contrast, PTEN levels were elevated and PTEN-inhibition elevated phospho-Akt levels and mitigated the burn-induced neutrophil chemotaxis defect. Altogether, this study identifies a newly described pathway of ceramide-mediated suppression of neutrophil chemotaxis after burn injury and introduces potential targets to mitigate this defect and reduce infection-related morbidity and mortality after burn.
Development and Considerations for Virtual Reality Simulations for Resuscitation Training and Stress Inoculation
Authors: Chang Todd P. , Hollinger Trevor , Dolby Thomas , Sherman Joshua M. 
Published: December 2020

Introduction
Resuscitation simulations immerse learners into the complexity of emergency patient management. Head-Mounted Display Virtual Reality (VR) has been used for stress inoculation therapy for phobias and posttraumatic stress disorder. However, VR for stress inoculation in resuscitation leadership training has not been studied. We sought to develop VR simulation for stress inoculation, as exposure therapy training, for resuscitations.

Methods
We explain the conceptual design, development, production, and initial evaluation process for 2 VR simulations in infant status epilepticus and pediatric anaphylactic shock. We further describe deliberate game mechanic choices to maximize psychological fidelity. In–virtual reality performance data for time-to-critical actions and stress physiology markers (heart rate, salivary cortisol) were collected from expert pediatric emergency physicians and novice pediatric residents. Data were analyzed to examine differences between the 2 groups for both outcome types to determine the extent of stress response or performance deficit the VR induced.

Results
Multiple difficulties and distractions were designed for the 2 scenarios; we evaluated the highest difficulty and environmental distraction versions. Between 19 expert physicians and 15 novice physicians, no performance differences were found in typical airway, breathing, and circulation actions. Residents preferred more lorazepam first-line antiepileptics than attendings (P = 0.003) and performed a cricothyrotomy later than attendings (P = 0.02). Residents, however, manifested higher salivary cortisol levels than attendings (+0.07 μg/dL, 95% confidence interval = 0.03–0.12, P = 0.001).

Conclusions
A VR resuscitation simulation manifested expected stress physiology changes in physicians. Further evaluation is needed to determine the effect of VR simulation as longitudinal stress inoculation for healthcare providers.
Use of Simulation to Measure the Effects of Just-in-Time Information to Prevent Nursing Medication Errors
Authors: Berg Thomas A. , Hebert Susan H. , Chyka Deb , Nidiffer Stephanie , Springer Cary 
Published: December 2020

Introduction
Medication administration error (MAE) is the improper dispensing of medication. It is a significant contributor to the occurrence of medical errors. A novel systems thinking approach using a pediatric simulation and student nurses were used to evaluate the benefit of applying just-in-time information (JITI) to reduce medication errors. Just-in-time information applies highly focused information delivered when needed.

Methods
A smart device app was developed to provide JITI medication administration information. The effect JITI had on MAE occurrence was assessed via a controlled study. The study population included 38 teams having 2 to 3 senior nursing students on each team. The teams were separated into a control and 2 intervention groups to complete a medication administration simulation.

Results
The intervention groups (100%, N = 10) that made significant use of the JITI app demonstrated improved performance for medication administration over the control group. Familiarity with the app was pivotal to how frequently it was used and to the success of the groups in administering medications. Although those with access to the app having limited training successfully executed the simulation 27.3% (n = 11) of the time, those with extended training had a success rate of 77.8% (n = 9).

Conclusions
Providing JITI significantly reduced the occurrence of MAEs for these student nurses. Familiarity with the app, including extended training opportunities, contributed significantly to student success.