bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do neurosurgeons receive more patient complaints than other physicians? Describing who is most at risk and how we can improve
Authors: Dambrino Robert J. , Zuckerman Scott L. , Guidry Bradley S. , Domenico Henry J. , Thompson Reid C. , Galloway Mitchell B. , Pichert James W. , Cooper William O. 
Published: July 2020

OBJECTIVE
The number of unsolicited patient complaints (UPCs) about surgeons correlates with surgical complications and malpractice claims. Using a large, national patient complaint database, the authors sought to do the following: 1) compare the rates of UPCs for neurosurgeons to those for other physicians, 2) analyze the risk of UPCs with individual neurosurgeon characteristics, and 3) describe the types of UPCs made about neurosurgeons.

METHODS
Patient and family complaint reports among 36,265 physicians, including 423 neurosurgeons, 8292 other surgeons, and 27,550 nonsurgeons who practiced at 33 medical centers (22 academic and 11 regional) from January 1, 2014, to December 31, 2017, were coded with a previously validated Patient Advocacy Reporting System (PARS) algorithm.

RESULTS
Among 423 neurosurgeons, 93% were male, and most (71%) practiced in academic medical centers. Neurosurgical subspecialties included general practice (25%), spine (25%), tumor (16%), vascular (13%), functional (10%), and pediatrics (10%). Neurosurgeons had more average total UPCs per physician (8.68; 95% CI 7.68–9.67) than nonsurgeons (3.40; 95% CI 3.33–3.47) and other surgeons (5.01; 95% CI 4.85–5.17; p < 0.001). In addition, a significantly higher percentage of neurosurgeons received at least one UPC (71.6%; 95% CI 67.3%–75.9%) than did nonsurgeons (50.2%; 95% CI 49.6%–50.8%) and other surgeons (58.2%; 95% CI 57.1%–59.3%; p < 0.001). Factors most associated with increased average UPCs were younger age, measured as median medical school graduation year (1990.5 in the 0-UPC group vs 1993 in the 14+-UPC group, p = 0.009) and spine subspecialty (13.4 mean UPCs in spine vs 7.9 mean UPCs in other specialties, 95% CI 2.3–8.5, p < 0.001). No difference in complaints was seen in those who graduated from non-US versus US medical schools (p = 0.605). The most common complaint types were related to issues surrounding care and treatment, communication, and accessibility, each of which was significantly more common for neurosurgeons than other surgical specialties (p < 0.001).

CONCLUSIONS
Neurosurgeons were more likely to generate UPCs than other surgical specialties, and almost 3 out of 4 neurosurgeons (71.6%) had at least one UPC during the study period. Prior studies have shown that feedback to physicians about behavior can result in fewer UPCs. These results suggest that neurosurgeons have opportunities to reduce complaints and potentially improve the overall quality of care delivered.
Meta-analysis comparing temperature on arrival at the referral hospital of newborns with hypoxic ischemic encephalopathy cooled with a servo-controlled device versus no device during transport
Authors: Hagan J.L. 
Published: July 2020

BACKGROUND: Therapeutic hypothermia reduces mortality and neurological injury for neonates with hypoxic ischemic encephalopathy (HIE). The aim of this meta-analysis is to evaluate use of servo-controlled devices during transport to the referral hospital. METHODS: PubMed and Medline (Ovid) searches were used to identify studies comparing HIE patients’ temperatures on arrival at the referral hospital for those cooled with servo-controlled devices versus no device during transport. Random effects models were used to conduct a meta-analysis comparing the two groups’ proportion of patients arriving in the target temperature range as well as the mean and variability in body temperature on arrival. Studies’ level of evidence and risk of bias were also assessed. RESULTS: Eight published studies with total of 573 patients met the inclusion criteria, with a “B” grade of recommendation overall. A significantly higher proportion of infants cooled with a servo-controlled device arrived in the target temperature range (pooled relative risk = 2.47, 95% confidence interval: 1.46–4.17, p < 0.001). The arrival temperature in the device cooled group was on average 0.82°C lower (95% CI: 0.29–1.35°C, p = 0.002) with an 82% lower temperature variance. CONCLUSIONS: Although the predominance of observational studies and presence of some risks of bias somewhat limits the strength of recommendation, the existing research consistently indicates that using a servo-controlled device during transport of neonates with HIE increases the probability of arriving at the referral hospital in the target temperature range, with a lower body temperature and less variability. Future research is needed to investigate differences in mortality and neurological impairment.
Questionable necessity of nitroglycerin for diagnostic coronary artery examination using 320-row multi-detector computed tomography
Authors: Lu Nan-Han , Liu Yi-Shan , Liu Ko-In , Hsu Shih-Yen , Huang Yung-Hui , Sun Cheuk-Kwan , Chen Tai-Been 
Published: July 2020

OBJECTIVE: This study aims to analyze and compare the diagnostic effectiveness of 320-row multi-detector computed tomography for coronary artery angiography (MDCTA) in subjects with and without sublingual vasodilator (nitroglycerin). MATERIALS AND METHODS: From September 2015 to September 2016, 70 individuals without history of major cardiovascular diseases who underwent MDCTA for health examination were retrospectively categorized into sublingual nitroglycerin (NTG) and non-NTG groups. Medical history, CT dose index (CTDI), and multi-slice CT images were compared between two groups. A diameter of coronary artery (DA, mm) was computed and analyzed. RESULTS: A total of 41 males and 29 females (mean age: 55.43±8.84 years, range: 34– 76) were reviewed. Normal and abnormal MDCTA findings were noted in 54 and 16 participants, respectively, with the detection rate of coronary artery disease being 23%. There was no significant difference in inter-observer variability of coronary CTA image quality and diagnosis between the NTG and non-NTG groups among three experienced radiologists. Although the percentage dilatation of left anterior descending branch (LAD), right coronary artery (RCA) and left circumflex branch (LCX) following in the NTG group were 12.4%, 12.8% and 25.3%, respectively ( p < 0.01), there was no significant difference in image quality and diagnosis between the two groups. CONCLUSIONS: Despite the recommendation of routine nitroglycerin use for subjects undergoing computed tomography for coronary artery angiography, our results showed no significant advantage of its use in improving image quality and rate of diagnosis accuracy.
Monitoreo de la Savia del Peciolo de Vegetales
Authors: Hochmuth George , Kinslow Maria Paz 
Published: July 2020

A medida que los productores y consultores comienzan a usar la tecnología de monitoreo de savia, surgen preguntas sobre los procedimientos del monitoreo de savia. Las siguientes guías deberían ayudar a las personas que actualmente usan o están interesadas en usar el monitoreo de savia. La mayoría de estas guías se han desarrollado a través de investigaciones en Florida, o se basan en la experiencia de campo.
This is the Spanish translation of CIR1144/CV004, Plant Petiole Sap-Testing For Vegetable Crops. Written by George Hochmuth, translated by Maria Paz Kinslow, and published by the UF/IFAS Horticultural Sciences Department.
Wildlife of Florida Factsheet: Nine-banded Armadillo
Authors: Fitzwilliam Simon , Boughton Raoul K. 
Published: July 2020

Learn more about nine-banded armadillos!
The Wildlife of Florida Factsheet series was created to provide the public with a quick, accurate introduction to Florida’s wildlife, including both native and invasive species. Authors Simon Fitzwilliam and Raoul Boughton hope this 2-page quick guide and others in the series published by the UF/IFAS Department of Wildlife Ecology and Conservation will inspire readers to investigate wildlife in their own backyards and communities and understand the amazing biodiversity of wildlife in the state of Florida. http://edis.ifas.ufl.edu/uw456
Need for pyloroplasty and vagotomy in case of perforated duodenal ulcer
Authors: Podoluzhniy V. I. , Startsev A. B. , Radionov I. A. 
Published: July 2020

Aim. Estimation of the incidence of stenosis, need for pyloroplasty and validity of vagotomy for perforated duodenal ulcer (PDU).
Materials and methods. Twenty-year nature of surgical treatment of patients with PDC in the hospital surgery clinic is analyzed.
Results. Over 20 years, 726 patients were operated on: 151 women (20.8%), 575 men (79.2%), mean age 39.1±6.3 years. Surgeries were performed both from laparotomic access and video laparoscopically. It is found that PDU is combined with stenosis in 8.5% and with bleeding in 1.6%, which requires Jadd excision of an ulcer on the anterior wall or gastroduodenotomy for flashing a bleeding ulcer on the posterior wall (0.7%) with subsequent Heineke — Mikulicz pyloroplasty and vagotomy. Both stem vagotomy and selective proximal were used by the method of skeletonization of lesser curvature or chemoneurolysis. Suturing with selective proximal vagotomy was performed in 567 patients, isolated suturing — in 77. B-II distal gastric resection was required in 2.1%. Repeated admission of patients with complications of a duodenal ulcer is observed after isolated suturing of PDU without surgical intervention in the mechanisms of ulcer formation.
Conclusion. During surgical treatment of PDU are found in 79.2% of men, in 20.8% of women. There is an emerging stenosis in 8.5% of those who have PDU, which requires a gastric drainage operation. The subjects of choice may be Heineke-Mikulicz pyloroplasty or Jadd excision of an ulcer on the anterior wall. It is advisable to suture or excise an ulcer with pyloroplasty accompanied by vagotomy that normalizes the acid-proteolytic activity of gastric juice in the postoperative period and eliminates need for antisecretory drugs to prevent the recurrence of the disease.
Idiopathic recurrent pancreatitis in a young woman: unexpected clue
Authors: Gubergrits N. B. , Monogarova N. Ye. , Byelyayeva N. V. , Zeynalova A. A. , Fomenko P. G. , Shpak S. A. , Bakhchevan E. L. , Burka A. A. 
Published: July 2020

The article presents a complex clinical case of idiopathic recurrent pancreatitis in a young woman, 23 years old. The main clinical manifestation of the disease was acute, intense, recurrent abdominal pain. Despite ongoing symptomatic therapy, the patient’s condition had been worsened, and the intensity of abdominal pain increased. Adequate dosage of the enzyme replacement therapy allowed increasing the duration of remission. Differential diagnosis, additional laboratory and instrumental studies allowed determining the cause of recurrent pancreatitis and confirming the diagnosis of cystic fibrosis with a primary lesion of the pancreas. A distinctive feature of this clinical case is the diagnosis of a hereditary cystic fibrosis disease in adulthood, the absence of clinical symptoms of lungs’ involvement in the pathological process, as well as the absence of underdevelopment, malnutrition. The diagnosis of cystic fibrosis is confirmed by German specialists; currently, the patient continues treatment in a German clinic.
The article presents current data on idiopathic pancreatitis, discusses a diagnostic algorithm for identification of the cause of the disease. The etiology, pathogenetic mechanisms of cystic fibrosis occurrence are considered, the known types of CFTR gene mutations, causing the development of the disease, as well as the principles of replacement enzyme therapy in patients with cystic fibrosis are described. Evidence-based medicine data are presented, revealing the efficacy and safety of taking enzyme preparations in the correction of the exocrine pancreatic insufficiency.
Gallbladder polyps: the more cases we observe, the more questions we ask
Authors: Shirinskaya N. V. , Kalyatina N. V. , Shirinskaya A. V. 
Published: July 2020

Background. Gallbladder polyps have recently become more common in practice of general practitioners and gastroenterologists due to the improvement of instrumental imaging of the abdominal cavity.
Aim of study: to analyze the dynamics of development of gallbladder polyps at an outpatient appointment of a general practitioner (gastroenterologist).
Materials and methods. A prospective clinical five-year study of patients with gallbladder polyps was conducted. All patients underwent ultrasound examination of the abdominal organs (Voluson E10) once every six months during five years. Number and nature of the growth of polyps, size of the gallbladder, presence/absence of complaints, and burdened history of neoplastic diseases were evaluated in the dynamics of observation. Data obtained were subjected to standard statistical processing.
Results. The study included 33 patients (14 men, 19 women aged 24–65 years, average age 45.19±1.73 yrs). In the initial ultrasound study, the number of visualized polyps varied from 1 to 5 (on average, 2.09±0.95), the size of the neoplasms ranged from 2 mm to 10 mm (on average, 5.75±1.10 mm). Burdened heredity in oncopathology was noted in 42.86% of men and 31.58% of women. Legless polyps were more often diagnosed in men (14.29%), while in women, polyps increased in size in the dynamics of observation >10 mm and a higher frequency of surgical interventions (cholecystectomy) were more often recorded.
Conclusion. Gallbladder polyps tend to grow slowly. We outlined the questions facing the clinician in the management of patients with gallbladder polyps in terms of choosing the optimal tactic and surgical treatment due to the possible malignancy of these formations.
A Symptom-based COVID-19 Diagnostic Tool in case of Limited Testing Facilities
Authors: Ridwan Raiiq , Amin Md Robed , Rahman Md Ridwanur 
Published: July 2020

Since December 2019, when a cluster of atypical pneumonia cases were identified in Wuhan, China a new disease has spread across the world. COVID-19 has since become the biggest pandemic in a century, touching lives in almost every country in the world. At the outset of COVID-19, the World Health Organization advised for testing to become a priority so that patients with COVID-19 could be quickly identified, isolated and treated to interrupt transmission of disease. However, testing shortages have been an increasing problem in low and middle income countries. Even when tests are available, it has proved time-consuming. Therefore, we propose a symptom-based tool to assist in the diagnosis of COVID-19 management in low and middle income Countries. It is based on the symptoms that have so far been described in the literature and advises the frontline healthcare worker on how to diagnose the likelihood of having COVID-19 and separate the patient into Red (very likely), Yellow (possible) and Green (unlikely) categories.
J Bangladesh Coll Phys Surg 2020; 38(0): 71-75
Rehabilitation Perspectives of COVID-19 Pandemic in Bangladesh
Authors: Uddin Taslim , Islam Mohammad Tariqul , Rahim Hasna Raihan , Islam Md Jahidul , Hossian Md Shahdat , Hassan Md Israt , Mamun Muhammed Abdullah Al , Hossain Mohammad Shawkat , Rahman Mohammad Azizur , Chobi Farida Khatun 
Published: July 2020

Introduction: The COVID-19 has overwhelmed health systems across the countries globally. This pandemic has also impacted health related rehabilitation services worldwide which is particularly profound in low and middle-income countries including Bangladesh.
Methods: Information used in the study gathered from World Health Organization (WHO) Bangladesh Director General of Health Services (DGHS), Institute of Epidemiology Disease Control and Research (IEDCR), online literature search using PubMed and PubMed Central research engines. Information also collected over personal telephone and email correspondence from the selected government, public, corporate, non-government institutes, and rehabilitation personals during the period of March-May 2020. Gathered data were analyzed; a set of challenges identified, and recommendations were made for a safe and standard working rehabilitation environment in the altered COVID-19 situation.
Results: Rehabilitation doctors and therapists at most of the public and private institutes are dedicated to COVID-19 services as per the local administrative directives keeping routine rehabilitation services apart. Few rehabilitation workforces to continue team works, environmental hygiene maintenance and space crisis at service outlets were the major challenges. Specially arranged virtual OPD and telerehabilitation services opened to minimize the rehabilitation burden and sufferings of the patient during the COVID-19 pandemic lock down restriction period.
Conclusion: COVID-19 seriously impacted the overall schedule of rehabilitation services. Rehabilitation must be recognized as an un-omissible part of COVID-19 management which requires a planned accommodative working environment in the altered situation within the health care system. Recommendations are provided to keep this pandemic contained while providing adequate and standard rehabilitation services to the disabled in the safe environment in line with WHO rehabilitation 2030.
J Bangladesh Coll Phys Surg 2020; 38(0): 76-81
Real Time-PCR (RT-PCR) Positivity for SARS-CoV-2 in Suspected COVID-19 Patients Presented in a Tertiary Care Hospital
Authors: Biswas Sarmistha , Azad Khan Abul Kalam , Hoque Mohammad Mahfuzul , Mowla Syed Ghulam Mogni , Banu Sultana Shahana , Sharmin Rabeya , Shamsuzzaman SM 
Published: July 2020

Introduction: Corona Virus Disease 2019 (COVID-19) is caused by SARS-CoV-2, a newly emergent virus. World Health Organization declared COVID-19 as pandemic on March 11, 2020 for its rapid spreading. Not only to diagnose the disease (confirm case) but also to control and contain the transmission; test, trace and isolation are fundamental. RT-PCR for SARS-CoV-2 is used to detect and diagnose COVID-19 which started in Dhaka Medical College Hospital (DMCH) on 2nd April 2020. In this study we described our observation of RT-PCR done in patients presented in DMCH in the first month after starting the test.
Methods: This observational, cross sectional study was done to find out the rate of RT-PCR positivity in suspected COVID -19 patients presented to DMCH from 2nd April to 3rd May, 2020 by the Department of Medicine in association with the Department of Virology. Data was collected from the registry book of the Department of Virology. The rate of RT-PCR for SARS-CoV-2 positivity among the suspected COVID-19 patients and demographical variable was observed.
Results: Among the total studied patients (n=3206), 58.8% (n=1886) was male and mean age was 37.7(±14.38784) years. RT-PCR for SARS- CoV-2 was positive in 26.9% (n=864). Mean age was higher in patients positive for test (39.6± 15.9 year vs. 37±14.4 year). Male predominance was more marked in patients with positive PCR test (68.4 vs. 55.9).
Conclusion: High rate of positivity of RT PCR for SARSCoV- 2 among the suspected patient for COVID 19 indicated high disease burden and transmission in this highly populated area in the early period of pandemic which should be considered as was alarming.
J Bangladesh Coll Phys Surg 2020; 38(0): 67-70
Corona Virus Infection among Healthcare Workers in a COVID Dedicated Tertiary Care Hospital in Dhaka, Bangladesh
Authors: Yasmin Rubina , Parveen Rahnuma , Azad Nazim Al , Deb Sudip Ranjan , Paul Nandita , Haque Md Manjurul , Haque Md Ahsanul , Azad Shehreen 
Published: July 2020

Background: Health care workers (HCWs) are at high risk of acquiring infections during this ongoing COVID-19 outbreak. This study was aimed at determining the prevalence of SARS-CoV-2 infection, the socio demographic and clinical profile and the possible risk factors for infection among the HCWs at Mugda Medical College Hospital (MuMCH).
Method: This retrospective observational study was done among the HCWs of MuMCH from 19 April, 2020 to 15 May, 2020. The SARS-CoV-2 positive 37 HCWs were interviewed over telephone by a structured questionnaire and the obtained data were analyzed by using descriptive statistics.
Result: Out of total 343 HCWs, total 37(10.79%) cases were detected COVID-19 positive. Out of them, 13(35.14%) were male and 24 (64.86%) were female. The median age was 36 years. Among the infected HCWs, 26 (70.27%) did not have any pre-existing comorbidities. Bronchial asthma (13.51%) and HTN (13.51%) were the most prevalent comorbidities. Around 43.24% (16) had no definite symptoms for COVID- 19. Among the 21(56.76%) symptomatic cases, 15(40.54%) had mild and 6(16.22%) had moderate symptoms. The most common symptoms were cough (16, 43.24%), fever (11, 29.73%), sore throat (7, 18.92%) and fatigue/malaise (7, 18.92%). All had completely recovered uneventfully although 22(59.46%) got admitted to hospital. Only 12(32.43%) were involved in aerosol generating procedure. Total 26 cases (70.27%) used appropriate PPE during their duty. Although only 4(10.81%) got adequate training on PPE use, 33(89.19%) of them had adequate knowledge on that. About 15(40.54%) were reusing PPEs. Most of them (33, 89.20%) were not taking any chemoprophylaxis; all were following traditional preventive measures. Among the HCWs, 26(70.27%) were not satisfied with the infection prevention and control (IPC) measures taken by the hospital authority. All of them presumed that, their occupational exposure was the possible source of COVID-19 infection.
Conclusion: More than 1 in 10 HCWs at MuMCH was infected with SARS-CoV-2 while working at the hospital. They represented the younger age group, had fewer comorbidities. Nurses were the most affected category. All experienced uneventful recovery and most of them were not satisfied with the IPC measures taken by the hospital authority. Further studies are required to identify the level of risk of infection, possible risk factors and outcomes and to improve the IPC measures of the hospital.
J Bangladesh Coll Phys Surg 2020; 38(0): 43-49
Sociodemography and Clinical Profile of COVID 19 Positive Physicians at a Tertiary Level Hospital, Dhaka
Authors: Islam Mohammad Rafiqul , Bashar Khondaker Abul , Matin Shariful , Tanveer Tahmid , Rahman Atiqur , Mowla Syed Ghulam Mogni , Murshed KM Mamun , Barua Uttam Kumar 
Published: July 2020

Introduction: On 11th March, 2020 COVID19 was declared as a pandemic and it currently involves 210 countries worldwide. Bangladesh declared its first case on 8th March 2020. Currently, the highest case detection of COVID is in the Dhaka district. Due to a lack of quality PPE (personal protection equipment) and proper knowledge of donning, doffing and transmission dynamics of COVID 19 thought to be high infection rate among physicians. Material and
Methods: A pretested questionnaire was set and distributed among COVID 19 infected physicians working at Shaheed Suhrawardy Medical College Hospital through internet to know about the clinical and epidemiological characteristics.
Results: 65.3% of the respondents were male and had a mean age were 35.7 years. Among all the respondents, the highest number of physicians involved were from medicine department (26.9%). Lethargy, body ache and fever were observed in 57.69%, 50% and 30.7% patients respectively. Among 52 infected physicians, first time RT-PCR for COVID 19 yield 78.8% positive results. Prophylactic dose of hydroxychloroquine taken by 15.3% patients before being infected with COVID19.
Conclusion: Health care workers are getting infected in a alarming number but fortunately at Shaheed Suhrawardy Medical college all the cases were in mild form.
J Bangladesh Coll Phys Surg 2020; 38(0): 56-60