bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Stigma in the Nursing Care of Families Impacted by Neonatal Abstinence Syndrome
Authors: Recto Pamela , McGlothen-Bell Kelly , McGrath Jacqueline , Brownell Elizabeth , Cleveland Lisa M. 
Published: August 2020

Background:
The current US opioid crisis has resulted in a significant increase in opioid use disorder among pregnant and parenting women. Substance use disorders, in general, are highly stigmatized conditions. Stigma serves as a well-documented global barrier to health-seeking behaviors and engagement in healthcare. While extensive research exists on the stigma of mental illness, few studies have explored the stigma experienced by families impacted by neonatal abstinence syndrome (NAS).

Purpose:
Therefore, the purpose of this article is to explore the role of stigma in the care of families impacted by NAS.

Methods:
In this article, we present a discussion about the effects of stigma on this patient population and provide exemplars of stigma experiences from our previous research and the existing literature.

Findings/Results:
Mothers of infants with NAS faced the challenges of overcoming stigma as they were often ostracized, excluded, and shamed. Nurses who provide care for these women and their infants have reported experiencing ethical distress, moral distress, and compassion fatigue.

Implications for Practice:
Greater awareness of the impact of opioid use on the maternal–child population has resulted in numerous educational offerings for healthcare providers; however, this alone is not adequate to end stigma. Fortunately, promising tools and methods have been developed for assisting nurses with addressing stigma in a manner that can be both nonconfrontational and highly effective.

Implications for Research:
Future research is needed to explore and evaluate the efficacy of various existing strategies for counteracting harmful stigma in this patient population.
Does “Coronal Root Angle” Serve as a Parameter in the Removal of Ventral Factors for Foraminal Stenosis at L5-S1 In Stand-alone Microendoscopic Decompression?
Authors: Merter Abdullah , Shibayama Motohide 
Published: August 2020

Study Design.
Prospective single-center cohort study.

Objective.
The present study aims to investigate the causes of failure of L5/S1 foraminal stenosis, and it is hypothesized that the newly defined “L5 coronal root angle (CRA)” may be a parameter in the removal of ventral pathologies.

Summary of Background Data.
Lumbar foraminal stenosis is an important cause of recurrent leg pain after central spinal stenosis surgery. Although it can be seen at all levels, L5/S1 is the level at which it is most frequently seen due to its specific characteristics, with success rate is lower than other levels after foraminal decompression.

Methods.
L5/S1 microendoscopic foraminal decompression was performed to 51 patients. According to Japanese Orthopedic Association (JOA) improvement at 12th-month follow-up, those with improvement >20% were classified as Group 1 and <20% were classified as Group 2. The patients who underwent discectomy in addition to foraminotomy formed Group 3. Lumbar lordosis angle, segmental lordosis angle, anterior disc height, pelvic tilt, pelvic incidence, sacral slope, relative disc height ratio, pedicle height/vertebral body height ratio, L5 depth, L5 CRA, and anterior disc height/ posterior disc height ratio parameters were measured with lumbar radiographic views, computed tomography (CT), and magnetic resonance imaging (MRI).

Results.
Among the parameters compared between groups, L5 CRA, posterior disc height, anterior disc height/posterior disc height, relative disc height ratio, and lumbar lordosis angle during extension were seen to be statistically significantly related with low success rate.

Conclusion.
Failure to remove the ventral pathologies when the L5 CRA is <112. 1º may lead to failed results. Besides, in cases wherein the posterior disc height is <2.85 mm or the anterior/posterior disc height ratio is >3.98, approaches to restoring disc height rather than stand-alone posterior decompression may reduce the possibility of failure.

Level of Evidence: 2
Orthosis in Thoracolumbar Fractures
Authors: Linhares Daniela , Pinto Bernardo Sousa , Ribeiro da Silva Manuel , Neves Nuno , Fonseca João A. 
Published: August 2020

Study Design.
Systematic review and meta-analysis of randomized controlled trial (RCT).

Objective.
The aim of this study was to evaluate radiological and clinical outcomes of acute traumatic thoracolumbar fractures in skeletally mature patients treated with orthosis, versus no immobilization.

Summary of Background Data.
Orthosis is traditionally used in conservative treatment of thoracolumbar fractures. However, recent studies suggest no benefit, and a possible negative impact in recovery.

Methods.
Databases were searched from inception to June 2019. Studies were selected in two phases by two blinded reviewers; disagreements were solved by consensus. Inclusion criteria were: RCT; only patients with acute traumatic thoracolumbar fractures; primary conservative treatment; comparison between orthosis and no orthosis. Exclusion criteria were inclusion of nonacute fractures, patients with other significant known diseases and comparison of groups different than use of an orthosis. Two independent reviewers performed data extraction and quality assessment. Fixed-effects models were used upon no heterogeneity, and random-effects model in the remaining cases. A previous plan for extraction of radiological (kyphosis progression; loss of anterior height) and clinical (pain; disability; length of stay) outcomes was applied. PRISMA guidelines were followed.

Results.
Eight articles/five studies were included (267 participants). None reported significant differences in pain, kyphosis progression, and loss of anterior height. One reported a better ODI with orthosis at 12 but not at 24 weeks. No other study reported differences in disability. All authors concluded an equivalence between treatments.
Meta-analysis showed a significant increase of 3.47days (95% confidence interval 1.35–5.60) in mean admission time in orthosis group. No differences were found in kyphosis at 6 and 12 months; kyphosis progression between 0 to 6 and 0 to 12 months; loss of anterior height 0 to 6 months; VAS for pain at 6 months; VAS change 0 to 6 months.

Conclusion.
Orthosis seems to add no benefit in conservative treatment of acute thoracolumbar fractures. This should be considered in guidelines and reviews of health care policies.

Level of Evidence: 3
Lower Mortality and Morbidity with Low-Molecular-Weight Heparin for Venous Thromboembolism Prophylaxis in Spine Trauma
Authors: Neifert Sean N. , Chapman Emily K. , Rothrock Robert J. , Gilligan Jeffrey , Yuk Frank , McNeill Ian T. , Rasouli Jonathan J. , Gal Jonathan S. , Caridi John M. 
Published: August 2020

Study Design.
Retrospective review of prospectively collected data.

Objective.
The objective of this study was to evaluate outcomes between patients receiving LMWH versus UH in a retrospective cohort of patients with spine trauma.

Summary of Background Data.
Although multiple clinical trials have been conducted, current guidelines do not have enough evidence to suggest low-molecular-weight heparin (LMWH) or unfractionated heparin (UH) for venous thromboembolism (VTE) prophylaxis in spine trauma.

Methods.
Patients with spine trauma in the Trauma Quality Improvement Program datasets were identified. Those who died, were transferred within 72 hours, were deemed to have a fatal injury, were discharged within 24 hours, suffered from polytrauma, or were missing data for VTE prophylaxis were excluded. A propensity score was created using age, sex, severity of injury, time to prophylaxis, presence of a cord injury, and altered mental status or hypotension upon arrival, and inverse probability weighted logistic regression modeling was used to evaluate mortality, venous thromboembolic, return to operating room, and total complication rates. E values were used to calculate the likelihood of unmeasured confounders.

Results.
Those receiving UH (n = 7172) were more severely injured (P < 0.0001), with higher rates of spinal cord injury (32.26% vs. 25.32%, P < 0.0001) and surgical stabilization (29.52% vs. 22.94%, P < 0.0001) compared to those receiving LMWH (n = 20,341). Patients receiving LMWH had lower mortality (odds ratio [OR]: 0.47; 95% CI: 0.42–0.53; P < 0.001; E = 3.68), total complication (OR: 0.92; 95% CI: 0.88–0.95; P < 0.001; E = 1.39), and VTE event (OR: 0.80; 95% CI: 0.72–0.88; P < 0.001; E = 1.81) rates than patients receiving UH. There were no differences in rates of unplanned return to the operating room (OR: 1.01; 95% CI: 0.80–1.27; P = 0.93; E = 1.11).

Conclusion.
There is an association between lower mortality and receiving LMWH for VTE prophylaxis in patients with spine trauma. A large randomized clinical trial is necessary to confirm these findings.

Level of Evidence: 3
Removal of Intraocular Foreign Bodies Using a Modified Flute Needle
Authors: Chan Yvonne Y. Y. , Liu Shasha , Tang Geoffrey C. H. , Cheung Janice C. C. , Liu Candice C. H. , Li Kenneth K. W. 
Published: August 2020

Purpose:
To describe the construction of a novel intraocular snare and evaluate its effectiveness in intraocular foreign body (IOFB) removal.

Method:
This is a retrospective consecutive case series. Five patients underwent pars plana vitrectomy and IOFB removal using the intraocular snare constructed from modified flute needle.

Results:
All IOFBs were successfully engaged and removed with the snare on the first attempt. Three of the 5 cases (60%) enjoyed good visual outcome (0.4–1.0) postoperatively. No complication related to the use of the snare was encountered in this case series.

Conclusion:
Intraocular foreign body snare is simple, safe, and effective in IOFB removal.
Bilateral Corneal Perforation in a Patient Under Anti-PD1 Therapy
Authors: Ramaekers Anaïs , Aspeslagh Sandrine , De Brucker Nele , Van Mierlo Camille , ten Tusscher Marcel , Schauwvlieghe Pieter-Paul , Termote Karolien 
Published: August 2020

Abstract:
Immune checkpoint inhibition has improved the clinical outcomes for numerous patients with cancer. However, the downside is a whole new spectrum of immune-related adverse events. We report a 68-year-old man with a history of nonsmall cell lung cancer presenting with a spontaneous corneal perforation in the right eye after 22 cycles of pembrolizumab. In addition, a chronic central nonhealing epithelial defect developed after performing a penetrating keratoplasty. Treatment with autologous serum drops resulted in complete healing of the corneal ulcer, where other conventional therapies had no effect. One month after reinitiating pembrolizumab therapy, our patient presented again with a corneal perforation in the fellow eye. This case describes relapsing sterile ulcerations associated with pembrolizumab use and presents an unexpected cure.
Diagnosis of COVID-19 Based on Symptomatic Analysis of Hospital Healthcare Workers in Belgium
Authors: Van Loon Nele , Verbrugghe Mathieu , Cartuyvels Reinoud , Ramaekers Dirk 
Published: August 2020

Objective:
To identify early symptoms allowing rapid appraisal of infection with SARS-CoV-2 among healthcare workers of a large Belgian hospital.

Methods:
Healthcare workers with mild symptoms of an acute respiratory tract infection were systematically screened on clinical characteristics of corona virus disease 2019 (COVID-19). A nasopharyngeal swab was taken and analyzed by real-time Reverse-Transcription-Polymerase-Chain-Reaction (rRT-PCR).

Results:
Fifty percent of 373 workers tested COVID-19 positive. The symptoms cough (82%), headache (78%), myalgia (70%), loss of smell or taste (40%), and fever more than or equal to 37.5 °C (76%) were significantly higher among those infected.

Conclusion:
Where each individual symptom contributes to the clinical evaluation of possible infection, it is the combination of COVID-19 symptoms that could allow for a rapid diagnostic appraisal of the disease in a high prevalence setting. Early transmission control is important at the onset of an epidemic.
Updated Approaches to Cardiac Electrical Stimulation and Pacing in Pediatrics
Authors: Neubrand Tara L. , Topoz Irina , Mistry Rakesh D. 
Published: August 2020

Abstract
Cardiac electrical stimulation is a rarely used but required skill for pediatric emergency physicians. Children who are in cardiac arrest or who demonstrate evidence of hypoperfusion because of cardiac reasons require rapid diagnosis and intervention to minimize patient morbidity and mortality. Both hospital- and community-based personnel must have sufficient access to, and knowledge of, appropriate equipment to provide potentially lifesaving defibrillation, cardioversion, or cardiac pacing. In this review, we will discuss the primary clinical indications for cardioelectrical stimulation in pediatric patients, including the use of automated external defibrillators, internal defibrillators, and pacemakers. We discuss the types of devices that are currently available, emergency management of internal defibrillation and pacemaker devices, and the role of advocacy in improving delivery of emergency cardiovascular care of pediatric patients in the community.
Rehabilitative Good Practices in the Treatment of Sarcopenia
Authors: Agostini Francesco , Bernetti Andrea , Di Giacomo Giorgio , Viva Mattia G. , Paoloni Marco , Mangone Massimiliano , Santilli Valter , Masiero Stefano 
Published: August 2020

AbstractTo date, rehabilitative good practices that analyze all aspects of the rehabilitation management of the patient with sarcopenia are absent in the literature. The purpose of this article is to carry out research and evaluation of the evidence, good practice, and recommendations in the literature relating to the rehabilitative treatment of disabilities associated with sarcopenia. Bibliographic research was conducted on Medline, PEDro, Cochrane Database, and Google Scholar. All articles published in the last 10 yrs were analyzed. The results of this research generated three guidelines, eight meta-analyses, five systematic reviews, a Cochrane review, 17 reviews, and seven consensus conferences. From the analysis of the literature, it seems that most of the works agree in affirming that exercise and diet supplementation are the cornerstones of rehabilitation treatment of patients with sarcopenia. The practice of an adequate lifestyle received numerous high-grade recommendations in the included guidelines. Based on the data obtained, the rehabilitation management of the patient with sarcopenia must be personalized and must include exercise and nutritional supplementation. These factors are important in increasing the autonomy of the elderly essential for safe walking without neglecting stretching exercises that are important for flexibility and balance and coordination exercises.
Essential Medical Information for Stroke Patients Undergoing Interhospital Transfer
Authors: Kim Jeoung Kun , Hau Yong Sauk , Kwak Soyoung , Chang Min Cheol 
Published: August 2020

Objective
For improving the efficiency of transferring medical records for stroke patients undergoing interhospital transfer, we evaluated what is the essential medical information for physicians using the Delphi method.

Design
We set up an expert panel of 31 physiatrists, who participated in this study. The 32 preliminary items of the transferred medical information were listed by a physiatrist for the first round of the Delphi method, and degree of necessity for these 32 items was evaluated using a 3-point scale (“very necessary,” “necessary,” and “not necessary”). We considered “very necessary” and “necessary” as “agreed to its necessity.” According to the Delphi method, a satisfactory level of consensus can be achieved with the agreement of significant majority (≥80%) in the expert panel.

Results
Based on the experts’ feedback, some items were added as the preliminary items. After the second round of the Delphi method, the items confirmed to be necessary information during interhospital transfer were motor and sensory evoked potentials, Barthel Index, Mini-Mental State Examination/Global Deterioration Scale, Motor-Free Visual Perception Test, Manual Function Test, Purdue Pegboard Test, hand grip power, monofilament, 2-point discrimination test, Manual Muscle Test, Nottingham Scale, modified Brunnstrom Classification, functional ambulation category, Glasgow Coma Scale, language function test, imaging study, videofluoroscopic swallowing study, rehabilitation goal, previous medical history, comorbidity, and medication information.

Conclusions
If the previously mentioned necessary items are presented together at once during interhospital transfer, physicians who receive new stroke patients can evaluate patients’ medical information more easily and completely.
An Analytical Insight Into How Walking Speed and Spatial and Temporal Symmetry Are Related to Ankle Dysfunctions in Children With Hemiplegic Cerebral Palsy
Authors: Elnaggar Ragab K. 
Published: August 2020

ObjectiveThe aim of the study was to identify the major determining factors among ankle dysfunctions for walking speed and symmetry in children with hemiplegic cerebral palsy.DesignThis was a prospective analysis that included 52 children with hemiplegic cerebral palsy, aged between 5 and 8 yrs, had mild spasticity, and were functioning at Gross Motor Function Classification System level I or II. The dorsiflexor and plantar flexor strength, dynamic spasticity (represented by gastrocnemius muscle lengthening velocity during stance phase), plantar flexors stiffness, ankle joint position sense, and walking performance (spatiotemporal parameter) were assessed.ResultsThe least absolute shrinkage and selection operator regression analyses showed that the dorsiflexor strength of the paretic limb was the major determining factor of walking speed (R2= 0.38,P< 0.001). Dynamic spasticity of the plantar flexors explained a portion of the variance in walking speed (R2= 0.15,P< 0.001) and the highest portion of the variance in spatial walking symmetry (R2= 0.18,P= 0.002). In addition, the ankle joint position sense was the primary determinant of temporal walking symmetry (R2= 0.10,P= 0.021).ConclusionsIn children with hemiplegic cerebral palsy, walking speed is mostly influenced by dorsiflexor muscle strength, temporal walking symmetry is associated with the joint position sense, whereas spatial walking symmetry is explicated by the dynamic spasticity of the plantar flexor muscles.
Pulmonary Embolism After Acute Spinal Cord Injury and COVID-19
Authors: Pisano Thomas John , Joki Jaclyn , Hon Beverly , Cuccurullo Sara 
Published: August 2020

Abstract
The coronavirus virus disease 2019 is best known for its pulmonary sequelae. Understanding of the disease process is rapidly growing, and the medical community already appreciates a hypercoagulable state associated with coronavirus virus disease 2019. Acute spinal cord injury has an inherent increased risk for venous thromboembolism. In this case report, the patient presented with bilateral lower limb weakness and sensory loss secondary to thoracic disc herniation. Incidentally, at the same time as the initial presentation, the patient was also found to have coronavirus virus disease 2019 without significant respiratory symptoms. During hospitalization, the patient developed extensive bilateral lower limb deep vein thrombosis despite chemoprophylaxis. Therapeutic anticoagulation was initiated, yet several days later, he developed pleuritic chest pain. Computed tomography angiography revealed bilateral pulmonary emboli. This case highlights the need for clinicians to have elevated vigilance with regard to screening and treatment for venous thromboembolism in high-risk patients, such as spinal cord injury with a concurrent diagnosis of coronavirus virus disease 2019.
The Role of Prediagnosis Audiovestibular Dysfunction Versus Distress, Illness-Related Cognitions, and Behaviors in Predicted Ongoing Dizziness Handicap
Authors: Herdman David , Norton Sam , Pavlou Marousa , Murdin Louisa , Moss-Morris Rona 
Published: August 2020

ABSTRACT

Objective
People with chronic vestibular diseases experience variable degrees of self-perceived disability. However, longitudinal data examining the predictive validity of relevant clinical variables alongside psychological variables are limited. The present study examined whether these factors predict self-reported dizziness handicap 3 months after assessment and diagnosis.

Methods
Patients were recruited from a waiting list of a tertiary neuro-otology clinic and completed standardized mood, cognitive, behavioral, and dizziness handicap questionnaires before and 3 months after their initial consultation and diagnosis. All patients were clinically assessed and underwent comprehensive audiovestibular investigations.

Results
Seventy-three percent of participants responded at follow-up (n = 135, 73% female, mean [standard deviation] age = 54.23 [17.53] years), of whom 88% were diagnosed with a neurotological condition. There were significant improvements in handicap, depression, and anxiety at 3 months. Thirty (22%) of 135 showed clinically meaningful improvement in handicap. The percentage of case-level depression and anxiety remained the same. Negative illness perceptions and symptom responses reduced, although participants still tended to view their condition negatively. Vestibular tests and type of diagnosis were not associated with self-reported handicap. Most baseline psychological variables significantly correlated with handicap at 3 months. When adjusting for baseline handicap and demographics, the baseline psychological variables only explained a significant ~3% of the variance in dizziness handicap at follow-up, with baseline handicap explaining most of the variance. All-or-nothing behavior was the most significant predictor.

Conclusions
Tertiary patients with vertigo and dizziness report negative illness perceptions and cognitive and behavioral responses to symptoms that are associated with self-reported handicap over time. Future studies are needed to investigate whether targeting these factors alongside traditional treatment approaches improves handicap in patients with chronic dizziness.
Functional Classification of Isolated Zygomatic Arch Fracture: New Proposal
Authors: Valdés Reyes José Manuel , Zapata Ocampo Sebastian 
Published: August 2020

Abstract
Isolated zygomatic arch fractures are common fractures in maxillofacial trauma. These fractures can trigger a functional alteration in the mouth opening and closing. Until now, there is no published classification of an isolated zygomatic arch fracture that contains the presence or not of coronoid impingement. So we propose a new classification that is easy to handle and has the largest number of scenarios that can occur in this type of fracture. The isolated zygomatic arch fracture is classified as Type I: Nondisplaced fractures, Type II: Greenstick fracture with or without coronoid impingement, Type III: Single displaced fracture with or without coronoid impingement, Type IV: Multiple displaced fracture with or without coronoid impingement, Type V: Comminuted fracture with or without coronoid impingement. We consider it to be a comprehensive classification, with general concepts of bone fractures, that can be incorporated into professional daily practice.