bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cross-sectional study assessing the risk of needlestick injury from an insulin pen among nursing care providers
Authors: Zhang Yanlin , Liu Li , Cai Kaixiu , Zhang Lirong , Liu Ling , Zhou Xianli , Liu Zhiping , Peng Yu 
Published: October 2020

Objective Needlestick injuries caused by insulin pen injection are a serious occupational hazard for health care workers in China. We evaluated the prevalence of stick injuries with insulin pen injection and identified associated risk factors. Methods This cross-sectional survey was conducted from 1 October to 30 November 2018 in two tier three hospitals in Chongqing, China. Self-administered questionnaires were developed by the Chinese Nursing Association Diabetes Care Special Committee. We analyzed associations between potential risk factors and injuries at different operational steps. Results A total 233 of 302 (77%) participants (mean age 28.5±5.3 years) reported a needlestick incident. Most respondents (49%) had 3 to 10 years’ working experience and had received injection safety training. Most needlestick injuries occurred while recapping needles after injection. The risk of injury was significantly associated with department and job position. The injury rate increased with increased number of years worked. Respondents with ≥10 years working experience reported the highest needle-capping injury rate (88%): odds ratio 1.93, 95% confidence interval, 1.01 to 3.69. Conclusion Recapping needles after injection showed the highest risk for stick injury with an insulin pen. Nurses in the surgery department and those with longer work histories were more likely to be injured.
Sleep Disturbance in Older Adults With or Without Mild Cognitive Impairment and Its Associated Factors Residing in Rural Area, China
Authors: Xie Li Qin , Yang Bing Xiang , Liao Yang Hui , Gao Gui Xian , Jiang Na , Zhou Jun , Richmond Christopher J. 
Published: October 2020

Aims: To evaluate the prevalence of sleep disturbance in older adults with or without mild cognitive impairment (MCI) and associated factors among residents in rural central China. Methods: A cross-sectional survey was conducted in adults in rural areas of the Hunan province aged≥60 years. Study participants (N = 1213) included 479 individuals meeting the criteria for MCI and 734 with normal cognitive abilities. The participants completed the Athens Insomnia Scale, Stress Resilience Quotient Scale, Affect Balance Scale and Activities of Daily Living (ADL) Scale. Chi-square test, Wilcoxon rank sum analyses and multiple logistic regression were used in this study. Results: A total of 60.33% of participants with MCI demonstrated sleep disturbance (60.33%, 95% CI: 0.559-0.649), which was significantly higher than in the non-MCI group (43.73%, 95% CI: 0.759-0.838). Multiple logistic regression conducted separately in the populations of older adults with or without MCI showed that age, drinking habits, affect balance and activities of daily life were correlates of self-reported sleep disturbance in rural older adults with MCI ( B = −5.469), whereas age, ADL, living arrangement and resilience were the main influencing factors in older adults without MCI ( B = 2.991). Conclusion: Sleep disturbance is more common in older adults with MCI than without MCI in rural areas of China. The factors influencing sleep disturbances vary between older adults with or without MCI, with age and ADL representing common factors influencing sleep disturbance in both groups. Interventions focusing on the age, drinking habits, affect balance and ADL may improve sleep quality in MCI older adults.
Diagnosis of the coronavirus disease 2019 with chest computed tomography: A retrospective inter-observer agreement study between radiologists and clinicians
Authors: Cengel Ferhat , Gurkan Okan , Calik Mustafa , Demirkol Mustafa Asim , Sargin Altunok Elif , Kaya Mehmet Fatih , Nacar Dogan Sebahat 
Published: October 2020

Background: Effective triage and early detection are very important for the control and treatment of coronavirus disease 2019. For this purpose, reverse transcription polymerase chain reaction and chest computed tomography are used in emergency departments. Objective: The aim of the study was to examine the diagnostic performance of computed tomography and to compare the inter-observer agreement among radiologists and between clinicians, in a coronavirus disease 2019 pneumonia high-prevalence area. Methods: After exclusions, 534 patients were retrospectively included in this study. Reverse transcription polymerase chain reaction was considered as gold standard for diagnosis. All computed tomography images were independently reviewed by two radiologists who were blinded to reverse transcription polymerase chain reaction results and other clinical information. Each computed tomography scan was scored in four categories as typical, intermediate, atypical, and negative, regarding coronavirus disease 2019 pneumonia according to Radiological Society of North America guideline. As for the evaluation of the diagnostic performance, typical and intermediate appearances were accepted as positive for coronavirus disease 2019. In addition, the computed tomography scans were scored by two clinicians as coronavirus disease 2019 positive and negative. Results: The study group included 534 patients after the exclusion criteria. As a result of the repeated reverse transcription polymerase chain reaction tests, 396 (74%) patients were diagnosed with coronavirus disease 2019, 138 (26%) patients had a negative result and were evaluated as a control group. When the reverse transcription polymerase chain reaction results were referenced as the gold standard; the accuracy rates of radiologists and clinicians (R1, R2, C1, and C2) in the diagnosis of coronavirus disease 2019 were 78%, 79%, 73%, and 71%, their sensitivity rates were 83%, 83%, 74%, and 75%, and the negative predictive values were 57%, 58%, 49%, and 46%, respectively. Inter-observer agreements among the reviewers ranged from good to excellent. Conclusions: Radiological Society of North America guideline related to coronavirus disease 2019 has excellent inter-observer agreement among chest radiologists. In this study, radiologists and clinicians have presented similar and good diagnostic performances in the evaluation of coronavirus disease 2019–suspected patients with chest computed tomography in high-epidemic area.
Commonly Reported Adverse Events Associated With Pediatric Immunotherapy: A Systematic Review From the Children’s Oncology Group
Authors: Withycombe Janice S. , Carlson Aimee , Coleman Carly , Leslie Sharon L. , Skeens Micah , Tseitlin Hanna , Duffy Elizabeth A. 
Published: October 2020

Background: Immunotherapy is a new and promising approach to treating pediatric cancers. These types of therapies have unique mechanisms of action for identifying and fighting cancer, as compared with traditional chemotherapy, and therefore are associated with different therapy-related adverse events (AEs). The purpose of this systematic review was to review available evidence to: (a) identify commonly reported AEs associated with immunotherapy agents frequently used in pediatric oncology and (b) generate recommendations for nursing practice. Method: A clinical question was developed and used to guide the systematic literature review. Five immunotherapy agents (dinutuximab, blinatumomab, rituximab, inotuzumab ozogamicin, brentuximab vedotin) were selected for inclusion secondary to their high relevance to pediatric oncology. A literature search was conducted to locate articles published between January 1, 2003 and October 31, 2018. Results: Seventeen articles met eligibility criteria for inclusion and were evaluated using the Grading of Recommendations Assessment, Development, and Evaluation criteria. The most commonly reported AEs for the selected immunotherapy agents were identified and summarized. Strong recommendations are made for nurses to become familiar with the unique AE profiles associated with individual immunotherapy agents. Agent-specific recommendations for nursing practice regarding AEs associated with dinutuximab and rituximab were generated. Conclusions: Immunotherapy is rapidly emerging as an effective therapy for pediatric cancers. Nurses need to be aware of the breadth of agent-specific, immunotherapy-related AEs to appropriately monitor and manage patients receiving these therapies. Additional work is needed to confidently profile immunotherapy-related AEs in pediatric oncology and to develop agent-specific educational materials for patients/families.
A multicenter review of infusion-related reactions to daratumumab for relapsed multiple myeloma in the real world setting
Authors: Geirnaert Marc , Howarth Jacy , Martin Kristen , Ricard Chad , Streilein Scott , Wasney Danica , Dao Vi , Kotb Rami , Rimmer Emily , Minuk Leonard 
Published: October 2020

Background Daratumumab is used in the treatment of relapsed multiple myeloma. Daratumumab infusion-related reactions can occur with the highest incidence on the first infusion. Methods A retrospective review of all daratumumab infusions used as part of the DVd and DRd regimens for relapsed multiple myeloma was undertaken. The review of infusion-related reactions was conducted by reviewing the treatment room nursing note on the days that daratumumab was administered. If the patient experienced an infusion-related reaction, then the data captured included if the full dose was administered. Results Daratumumab infusion-related reactions occurred most frequently on the first dose. The rates of infusion-related reactions using a split dose approach for daratumumab administration were lower than that reported in clinical trials. All of the infusion-related reactions were managed with appropriate interventions in the outpatient setting. The adoption of rapid infusion daratumumab beginning with cycle 2 of DVd and DRd was well tolerated. Conclusions Our experience of daratumumab infusions using a split dose approach was associated with an infusion-related reaction rate in 28% of patients on cycle 1, day 1 of DVd and DRd regimens. All patients were able to complete full doses of daratumumab by utilizing split dose. The rates of daratumumab infusion-related reactions are highest on the first infusion. In addition, our adoption of rapid infusion daratumumab was safe.
Primary Immunoglobulin G4-Related Laryngeal Disease: A Case Series and Review of Literature
Authors: Maughan Elizabeth F , Michaels Joshua , Miller Benjamin , Weir Justin , Salama Alan , Warner Elinor , Ghufoor Khalid , Sandhu Gurpreet , Al Yaghchi Chadwan 
Published: October 2020

Objective: Immunoglobulin G4-related disease (IgG4-RD) is an increasingly recognised cause of various systemic fibro-inflammatory conditions. However, laryngeal involvement as a primary feature is extremely rare. We aimed to report on a case series of such patients and examine the global literature relating to laryngeal involvement. Methods: Having previously reported a case of IgG4-RD laryngeal pseudotumour, we describe a case series of further 4 patients with primary laryngeal IgG4-RD managed by our UK quaternary airway service and provide a brief overview of laryngeal IgG4-RD. Results: Including our cases, 14 cases of primary laryngeal IgG4-RD have been reported. Vocal cord involvement is relatively uncommon. Repeat biopsies may be required to achieve histological diagnosis. Remission is achievable by commencement of immunomodulatory treatment, following which laryngeal reconstruction may be necessary. Conclusion: Laryngeal involvement is a rare presentation of IgG4-RD, itself a rare and difficult-to-diagnose condition. A high and prolonged index of suspicion is necessary from both surgical and pathological specialists for correct diagnosis and management.
Prognostic Value of the Site of Distant Metastasis and Surgical Interventions in Metastatic Gastric Cancer: A Population-Based Study
Authors: Li Yinghua , Xie Danna , Chen Xiaojing , Hu Teng , Lu Simin , Han Yunwei 
Published: October 2020

Background: Studies on the prognostic significance of site-specific distant metastasis, multiple-site metastases, and the impact of surgery of the primary tumor and metastatic lesion on survival outcomes of patients with metastatic gastric cancer (GC) remain elusive. Therefore, this study aimed to investigate the prognostic significance of the site of distant metastasis among patients with metastatic GC. Furthermore, the effect of surgery of the primary tumor and metastatic lesion on the prognosis of metastatic GC was also analyzed. Methods: The data of 4,221 eligible patients, who were diagnosed with metastatic GC between 2010 and 2015, were identified from the Surveillance Epidemiology and End Results (SEER) database. Multivariate logistic regression analysis was performed to assess the association between potential prognostic factors, including the site of metastasis and surgery, and survival of patients with metastatic GC. Overall survival (OS) and cause-specific survival (CSS) were determined using the Kaplan-Meier survival curves and differences were assessed using the Log-rank test. Results: Out of the total 4,221 GC patients with definite organ metastases, 3312 patients had single-site metastasis while 909 patients had multiple-site metastases. GC patients with single-site metastasis of liver or lung exhibited better CSS and OS compared to those with bone metastasis. Furthermore, GC patients with liver metastasis benefited from surgery of both the primary and metastatic lesions, while those with lung metastasis benefited from surgery of metastasis resection only. Multivariate Cox regression analysis revealed that GC patients with single-site metastasis, well-differentiated tumors, GC patients who underwent surgery of the primary tumor and those who received chemotherapy exhibited favorable prognosis. Conclusions: The site of metastasis was an independent prognostic factor for metastatic GC. Surgery had survival benefits in certain cases of metastatic GC; however, further studies are warranted to clarify these benefits in carefully selected patients.
Scaphotrapeziotrapezoid Arthrodesis: A 10-Year Follow-up Study of Complications in 58 Wrists
Authors: Rogers Miranda J. , Lu Chao-Chin , Stephens Andrew R. , Garcia Brittany N. , Chen Wei , Sauer Brian C. , Tyser Andrew 
Published: October 2020

Background: Scaphotrapeziotrapezoid (STT) arthrodesis is a procedure used for specific degenerative arthritis and instability patterns of the wrist. This study evaluates nonunion rate and risk factors for reoperation after STT arthrodesis in the Veterans Affairs Department patient population. The purpose of our study was to assess the long-term nonunion rate following STT arthrodesis and to identify factors associated with reoperation. Methods: The national Veterans Health Administration Corporate Data Warehouse and Current Procedural Terminology codes identified STT arthrodesis procedures from 1995 to 2016. Frequencies of total wrist arthrodesis (TWA) and secondary operations were determined. Univariate analyses provided odds ratios for risk factors associated with complications. Results: Fifty-eight STT arthrodeses were performed in 54 patients with a mean follow-up of 120 months. Kirschner wires (K-wires) were the most common fixation method (69%). Six wrists (10%) required secondary procedures: 5 TWAs and 1 revision STT arthrodesis. Four patients underwent additional procedures for nonunion (7%). Twenty-four patients required K-wire removal, 8 (14%) of these in the operating room, which were not included in regression analysis. Every increase in 1 year of age resulted in a 15% decrease in likelihood of reoperation (95% confidence interval: 0.77-0.93; P < .0001). Opioid use within 90 days before surgery ( P = 1.00), positive smoking history ( P = 1.00), race ( P = .30), comorbidity count ( P = .25), and body mass index ( P = .19) were not associated with increased risk of reoperation. Conclusions: At a mean follow-up of 10 years, patients undergoing STT arthrodesis have a 10% risk of reoperation, and this risk decreases with older patient age. There was a symptomatic nonunion rate of 7%, similar to prior published rates. Patient demographics, comorbidity, smoking history, and opioid use did not appear to increase risk of reoperation.
Gait Training Using a Wearable Robotic Device for Non-Traumatic Spinal Cord Injury: A Case Report
Authors: Yoshikawa Kenichi , Mutsuzaki Hirotaka , Koseki Kazunori , Endo Yusuke , Hashizume Yuko , Nakazawa Ryo , Aoyama Toshiyuki , Yozu Arito , Kohno Yutaka 
Published: October 2020

Introduction: We aimed to report the clinical evaluation results of gait training with the Honda Walking Assist Device® (HWAT) in a patient with spinal cord injury (SCI). Patients and Methods: A 63-year-old male with SCI (grade D on the American Spinal Injury Association Impairment Scale) underwent 20 HWAT sessions over 4 weeks. The self-selected walking speed (SWS), mean step length, cadence, 6-minute walking test (6MWT), Walking Index for SCI score, SCI Functional Ambulation Inventory gait score, American Spinal Injury Association Impairment Scale grade, neurological level, upper and lower extremity motor scores, modified Ashworth Scale, Penn Spasm Frequency Scale, and Spinal Cord Independence Measure version III were measured on admission, at the start of HWAT, at 2 and 4 weeks post-HWAT, and at discharge. Three-dimensional kinematic gait analysis and electromyographic assessments were performed before and after HWAT. Results: The patient safely completed 20 HWAT sessions. We found improvements above the clinically meaningful difference in SWS and 6MWT as well as increased hip extension, ankle plantar- and dorsi-flexion range of motion and increased hip extensor, abductor, adductor, and ankle plantar flexor muscle activity. Discussion: The SWS improved more markedly during the HWAT intervention, exceeding the minimal clinically important difference (0.10 to 0.15 m/s) in walking speed for people with SCI until discharge. Moreover, the 6MWT results at 2 weeks after the start of HWAT exceeded the cutoff value (472.5 m) for community ambulation and remained at a similar value at discharge. Conclusion: The walking distance (6MWT) and the walking speed (SWS) both demonstrated clinically important improvements following 20 treatment sessions which included HWAT.
What Comprises Well-being at Workplace? A Qualitative Inquiry Among Service Sector Employees in India
Authors: Jaiswal Akanksha , C. Joe Arun, S J  
Published: October 2020

The notion of well-being has been evolving as research continues to unfurl its multidimensional nature. The importance of well-being in the organizational context is becoming a valuable line of inquiry, and employee well-being has emerged as a pivotal focus in positive psychology. Despite this, employees report high levels of disengagement and stress at work. Thus, we conducted 15 in-depth interviews with middle- and senior-level managers in the service sector in India to understand the factors that impact an employee’s well-being. Research question: What comprises an individual’s well-being at the workplace? Theory: Conservation-of-resources theory, broaden-and-build theory. Type of the case: Applied problem-solving. Basis of the Case: Phenomenon. Protagonist: Not needed. Findings: Data was analysed using grounded theory. We synthesized the factors contributing to employee well-being into the following themes: encouraging organizational culture, providing social support, demonstrating positive leadership, integrating work and life, finding meaning in work, providing autonomy and ensuring good working conditions. Discussion: Study findings extend the conservation-of-resources and broaden-and-build theories by emphasizing on gain spirals; that is, individuals use a positive effect to conserve, replenish, broaden, and build their inner resources and well-being. While leaders in an organization invest in enhancing employees’ well-being, they need to be cognizant of the several factors at interplay. An overall positive environment, autonomy, safety and meaningfulness contribute holistically towards the well-being of employees.
A Multidisciplinary Hand Clinic Using Physiatrists for the Evaluation of Non-Operative Pathologies
Authors: Mardinger Cynthia , Steve Anna K. , Yeung Justin K. 
Published: October 2020

Purpose: The purpose of this study was to describe the impact of using a multidisciplinary hand clinic on (1) hand clinic waitlists for urgent operative pathologies and (2) the volume of urgent operative referrals seen by plastic surgery. Methods: A retrospective data analysis of all new referrals to the Peter Lougheed Centre hand clinic in Calgary, Alberta, was performed. Data were collected from 6 months before and after the introduction of the multidisciplinary model (ie, between January 2017 and January 2018). Demographics for all new referrals were collected from the clinic database, including wait times, triage type, and volume of referrals triaged to each discipline. Results: Prior to using a multidisciplinary model, 81% (n = 591) of new patient referrals were triaged directly to plastic surgery, 4% (n = 28) to physiotherapy, and 6% (n = 43) to minor surgery (N = 728). However, following the addition of physiatry to the clinic, 62% (n = 451) of new patient referrals were triaged directly to plastic surgery, 24% (n = 173) to physiatry, 2% (n = 17) to physiotherapy, and 4% (n = 31) to minor surgery (N = 730). Overall, the number of urgent operative referrals triaged to plastic surgery proportionally increased by 7%, from 67% to 74%. Mean wait times for urgent referrals to plastic surgery decreased by 1.7 ± 1.0 months ( P = .09). Conclusion: Applying a multidisciplinary model to a hand clinic can allow non-operative cases to be triaged directly to physiotherapy and physiatry, allowing plastic surgeons to manage a higher volume of urgent and operative referrals. Implementing a multidisciplinary hand clinic can, therefore, decrease waitlist volumes and shorten the time to assessment by a plastic surgeon. Type of Study: Level II Prognostic Study.
Epidemiology of Hip Injuries in Professional Rodeo: A 4-Year Analysis
Authors: Sinclair Elder Amanda J. , Tincknell Rachel 
Published: October 2020

Background: Professional rodeo is a sport with a high risk of injuries for which research is needed to support interventions. To date, there have been no epidemiological studies performed specifically on hip conditions sustained during rodeo. Purpose: To describe the epidemiology of hip conditions in professional rodeo. Study Design: Case series; Level of evidence, 4. Methods: Deidentified hip injury data from electronic medical records of the Justin Sportsmedicine Team from 2011 to 2014 were analyzed for risk, frequency, type, location, and mechanism, as well as activity phase, of hip injuries. Results: A total of 84 hip injuries among 82 adult male and female athletes were reported, resulting in an overall hip injury density of 0.41 injuries per 1000 competitor-exposures (95% CI, 0.0003-0.0005) and a risk probability of 0.04%. Rough stock athletes sustained 83.3% of hip injuries, with bull riders sustaining 50.0% of the injuries. Contusions (45.2%), impingement (15.5%), and hip strains (13.1%) were the most common injuries. Athletes were most likely to be injured during the dismount (36.1%), and 36.9% of injuries were due to contact with the ground. Conclusion: Rough stock athletes have the greatest risk for hip injury in professional rodeo, with bull riders sustaining the most hip injuries. Athletes are most likely to be injured during the dismount. Common hip injuries in professional rodeo are contusions, impingement, and strains. The majority of contusions result from collision with the ground. Applicable measures to prevent or reduce the severity of injuries to the hip, such as protective padding, proprioceptive training, and eccentric strength training, should be implemented.