bluuebunny/crossref_metadata_2025_split huggingface dataset:
Internet+Continuing Nursing (ICN) Program Promotes Motor Function Rehabilitation of Patients With Ischemic Stroke
Authors: Chen Shuangqin , Huang Jianghua , Yao Lan , Zeng Yahua , Quan Huijun , Kang Huiling , Ou Yulan , Chen Shuangxi 
Published: November 2021

Background and Purpose:
Ischemic stroke is a severe disorder with high rates of death and recurrence that causes disability in patients and for which there is currently no effective treatment. Internet-based rehabilitation helps patients with disability recover at home with the help of their household or family members in a nonclinical setting. However, the effects of the internet+continuing nursing (ICN) program on the recovery of patients after ischemic stroke remains unknown.

Methods:
In the present study, patients were treated with an ICN-based rehabilitation training program; subsequently, the Self-efficacy Scale for Chronic Disease, Questionnaire of Exercise Adherence, Motor Assessment Scale, Activities of Daily Living, and Stroke-specific Quality of Life were performed to evaluate the effects of the ICN program on patient self-confidence to persist with rehabilitation, functional exercise compliance, motor function, ability to live independently and quality of life following ischemic stroke.

Results:
We observed that, after the ICN intervention for 6 weeks and 3 months, the scores of Self-efficacy Scale for Chronic Disease, Questionnaire of Exercise Adherence, Motor Assessment Scale, Activities of Daily Living, and Stroke-specific Quality of Life in the ICN-treated group were significantly higher compared with those in the control group.

Conclusion:
These results suggested that the ICN program may promote the recovery of patients after ischemic stroke.
Bilateral Vestibular Failure May Improve With Treatment of the Underlying Condition
Authors: Smyth Duncan , Mossman Stuart 
Published: November 2021

Introduction:
Bilateral vestibular failure (BVF) is an uncommon condition with numerous etiologies. It causes chronic oscillopsia and imbalance and is usually irreversible. We report 2 cases of BVF due to unusual causes, both of which improved with treatment of the underlying condition.

Case Reports:
The first patient was a 39-year-old female who developed profound BVF due to neurosarcoidosis. She was started on steroids and azathioprine and her vestibular function gradually improved, with essentially normal function 4.5 years after starting treatment. The second patient was a 54-year-old female who developed BVF in the context of glucagonoma. After treatment with octreotide, her vestibular function improved to almost normal, and she thus met the criteria for a probable paraneoplastic syndrome.

Conclusions:
While BVF is usually permanent, this report demonstrates that some cases are likely to be reversible with treatment of the underlying cause. It is therefore imperative for clinicians to ensure that patients with BVF are thoroughly investigated.
Artery of Percheron Occlusion in China
Authors: Cai Lina , Wang Qi , Cui Bin , Wang Peifu 
Published: November 2021

Introduction:
The artery of Percheron (AOP) is a rare anatomical variant in which bilateral paramedian thalami are supplied by a single vascular branch arising from the P1 segment of the posterior cerebral artery. We present a case of AOP occlusion presenting as loss of consciousness and summarize the literature in Chinese to find the clinical characteristics.

Case Report:
An 83-year-old woman was found unconscious for 1 day at home and was sent to the hospital the next day. Cerebral magnetic resonance imaging on day 1 of the patient showed a recent bilateral paramedian thalamic infarction. Simultaneously, magnetic resonance angiography found evident artery stenosis of the right P1 segment of the posterior cerebral artery, suggesting that the patient was diagnosed with AOP occlusion. Since the patient has missed the best time for thrombolytic therapy, anticoagulant therapy was given immediately; as the patient was then found to have pulmonary infections, antibiotic therapy was also initiated. The neurological status of this patient improved very slow. In about 2 weeks, the patient becomes more conscious but still could not speak or move.

Conclusion:
Our report suggests that unusual mood disorder and language disorder of aged patients might indicate the AOP occlusion, and cerebral imaging of magnetic resonance imaging (better with magnetic resonance angiography) should be performed to establish the diagnosis of AOP occlusion. The fast and accurate diagnosis of stroke because of AOP occlusion could best benefit the patients.
Balloon-Assisted Angioplasty for the Treatment of In-Stent Restenosis After Vertebral Artery Ostium Stenting
Authors: Cai Xueli , Chen Xueping , Xiang Yian , Chen Liujing , Sun Jingping 
Published: November 2021

Background:
Stenting appears to be a safe means of treatment for vertebral artery ostium stenosis with low complication rates and positive long-term effects, but the incidence of in-stent restenosis (ISR) after stenting is high. Different treatment strategies are applied for the revascularization of ISR; however, currently the optional approach is not recommended. The study was designed to investigate the feasibility, safety, and effectiveness of balloon-assisted angioplasty for the treatment of ISR after vertebral artery ostium stenosis.

Methods:
In this study, we included patients from the Department of Neurology, Lishui Hospital of Zhejiang University, who were treated with balloon-assisted angioplasty as a result of suffering from ISR after previously undergoing vertebral artery ostium stenting. We retrospectively analyzed the clinical and functional outcomes of the patients.

Results:
From January 2015 to December 2019, 11 patients were included in the study. The technical success rate reached 100% and the average operation time was 73 minutes. The Thrombolysis in Cerebral Infarction Score 2b-3 was acquired in all patients except 1 patient, who was presented with symptoms of hypoperfusion syndrome. The remaining 10 patients did not experience any intraoperative or postoperative complications. No restenosis, new cerebral infarction or transient ischemic attack were reported within 6 months of follow-up.

Conclusion:
Balloon-assisted angioplasty could be feasible for the treatment of ISR after vertebral artery ostium stenting, however, more research is needed to confirm this.
Evaluating the Jaccard Similarity Index as a Persistence Measure of Multiple Anal Human Papillomavirus Among Nigerian Men Who Have Sex With Men
Authors: Nowak Rebecca G. , Bentzen Søren M. , Schumaker Lisa M. , Ambulos Nicholas P. , Ndembi Nicaise , Dauda Wuese , Mitchell Andrew , Mathias Trevor J. , Crowell Trevor A. , Baral Stefan D. , Blattner William A. , Charurat Manhattan E. , Palefsky Joel M. , Cullen Kevin J. ,   on behalf of the TRUST/RV368 Study Group
Published: November 2021

Background
Multiple anal human papillomavirus (HPVs) may increase the risk of anal cancer among men who have sex with men (MSM) living with human immunodeficiency virus (HIV). The Jaccard Similarity Index (JSI) was explored as a measure of multiple HPV persistence.

Methods
The TRUST/RV368 cohort enrolled MSM living with and without HIV in Abuja and Lagos, Nigeria. Participants with anal swabs at baseline, 3- and 12-month visits were tested for high- and low-risk HPVs using a next-generation sequencing assay. Persistence of the same HPV genotypes over time was calculated using the JSI and categorized into high, medium, and low similarity tertiles. Factors associated with higher versus lower similarity were estimated with multivariable ordinal logistic regression and reported as adjusted odds ratios (aORs) and 95% confidence intervals (CIs).

Results
Of the 225 participants, median age was 25 years (interquartile range, 22–29 years), 62% were living with HIV, median HPVs was 3 (interquartile range, 2–5), and HPV6 (28%), HPV16 (26%), HPV11 (23%), and HPV45 (20%) were most prevalent. Fifty-three percent of participants had highly similar HPVs at 3 months, and the similarity was associated with HIV (aOR, 3.11; 95% CI, 1.6–5.9) and recent receptive sex (aOR, 1.9; 95% CI, 1.0–3.5). By 12 months, 20% had highly similar HPVs, and it was associated with 12 years or longer since anal coital debut (aOR, 6.8; 95% CI, 3.1–5.2), self-reported genital warts (aOR, 3.1; 95% CI, 1.5–6.6), and 200 or less CD4 cells/mm3 (aOR, 13.3; 95% CI, 2.7–65.2) for those living with HIV.

Conclusions
Studies evaluating the JSI as a predictor of high-grade intraepithelial lesions would further confirm its applicability as a quantitative measure of multiple HPV persistence.
Pediatric Web-based Video Capsule Endoscopy Curriculum: A Pilot Study to Determine the Ability to Implement a Standardized Educational Curriculum
Authors: Phatak Uma Padhye , Scherer Corey , Du Nan , Friedlander Joel A. 
Published: November 2021

Objectives:
Video capsule endoscopy (VCE) is a noninvasive modality to broadly image the gastrointestinal tract. Previously, the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition and its endoscopy committee noted a lack of standardized pediatric VCE training. It was hypothesized that a web-based curriculum could be broadly implemented and help to enhance comfort and develop VCE skills.

Methods:
A pilot web-based VCE curriculum was created using REDCap database. An email invitation asking for participation was sent to a pediatric gastroenterology Listserv. Baseline comfort and knowledge regarding VCE skills were measured. Educational links and materials were provided following which participants completed VCE cases with immediate feedback. Finally, participants completed a posttest and a survey to complete the curriculum.

Results:
Fifty-two participants began the curriculum of which 37 (71%) partially completed, 12 (23%) completed, and 3 (6%) withdrew. Significant improvement was noted regarding self-reported mean comfort level in explaining indications (P = 0.0097), contraindications (P = 0.0036), managing complications (P = 0.0048), using VCE software (P = 0.00035), and interpreting VCE findings (P = 0.00015). Participants showed significant improvement in knowledge (P = 0.041) and photo recognition posttests (P = 0.015). All participants who completed the curriculum found it helpful and reported that they would recommend it to their colleagues.

Conclusions:
This pilot curriculum demonstrated an improvement in participant self-reported comfort and an increase in VCE knowledge. Further resources would make a web-based curriculum easier to navigate and complete. Providing Continuation of Medical Education and Maintenance of Certification credits for future curricular iterations would provide an opportunity for training with recognition for pediatric gastroenterologists.
The Interoceptive Sensitivity and Attention Questionnaire: Evaluating Aspects of Self-Reported Interoception in Patients With Persistent Somatic Symptoms, Stress-Related Syndromes, and Healthy Controls
Authors: Bogaerts Katleen , Walentynowicz Marta , Van Den Houte Maaike , Constantinou Elena , Van den Bergh Omer 
Published: November 2021

ABSTRACT

Objective
This study aimed to validate the Interoceptive Sensitivity and Attention Questionnaire (ISAQ), a 17-item self-report measure assessing sensitivity and attention to interoceptive signals.

Methods
In study 1, exploratory and confirmatory factor analysis was performed in a student convenience sample (n = 1868). In study 2, ISAQ data of a healthy sample (n = 144) and various patient groups experiencing stress-related syndromes (overstrain, n = 63; burnout, n = 37; panic disorder [PD]. n = 60) and/or persistent somatic symptoms in daily life (irritable bowel syndrome, n = 38; fibromyalgia and/or chronic fatigue syndrome, n = 151; medically unexplained dyspnea [MUD], n = 29) were compared.

Results
Three subscales were revealed: (F1) sensitivity to neutral bodily sensations, (F2) attention to unpleasant bodily sensations, and (F3) difficulty disengaging from unpleasant bodily sensations. Overall, patients with fibromyalgia and/or chronic fatigue syndrome and patients with MUD scored significantly higher on F1 (p = .009 and p = .027, respectively) and F2 (p = .002 and p < .001, respectively) than healthy controls. Patients with PD had higher scores on subscales F2 (p < .001) and F3 (p < .001) compared with healthy controls, as well as higher scores on F2 compared with all other patient groups (p
PD versus MUD = .008; all other p values < .001).

Conclusions
Interoceptive sensibility—the self-reported aspect of interoception—is not a homogeneous or unitary construct. The subscales of the ISAQ differentiate healthy controls from patients with persistent somatic and/or stress-related complaints in daily life and distinguish different patient groups. The ISAQ can be used as a concise, reliable, and clinically relevant research tool to further disentangle adaptive and maladaptive aspects of interoceptive ability.
The Influence of Cognitive Behavioral Intervention for Anger Management on Endothelial Function in Patients With Recent Myocardial Infarction: A Randomized Clinical Trial
Authors: Schmidt Karine Elisa Schwarzer , de Quadros Alexandre Schaan , Eibel Bruna , Aires Aline Marques , Gottschall Carlos Antônio Mascia , Moura Mauro Regis Silva , Schmidt Márcia Moura 
Published: November 2021

ABSTRACT

Objective
Anger may cause adverse cardiovascular responses, but the effects of anger management on clinical cardiovascular outcomes are insufficiently understood. We sought to assess the influence of anger management through a cognitive behavioral intervention on endothelial function in patients with a recent myocardial infarction (MI).

Methods
Patients with ST-elevation MI and a low anger control score were enrolled during hospitalization in a randomized, parallel, controlled clinical trial. Intervention was anger management with cognitive behavioral techniques implemented by a psychologist in two individual monthly sessions. The primary end point was the between-group difference in the variation of flow-mediated dilation (FMD) in the brachial artery from baseline to the 3-month follow-up. The second end point comprised major cardiovascular events at 24-month follow-up.

Results
A total of 43 patients (age = 56 [9] years; 23.3% women) were randomized to the intervention group and 47 patients (age = 58 [10] years; 19.1% women) to the control group. Baseline clinical characteristics were not statistically different between groups. Both groups showed a significant improvement in anger control from baseline to end point; however, the difference in intergroup variation was not statistically significant. The difference in FMD variation from baseline to the 3-month follow-up was significantly higher in the intervention group. The partial η
2 was 0.057 (p = .024), indicating a medium effect size. There was no difference between groups regarding major cardiovascular events.

Conclusions
Anger management by cognitive behavioral techniques may improve endothelial function in post-MI patients with low anger control, but it remains unclear via which mechanism these effects occurred. Further studies with larger numbers of patients, assessments of changes in anger, improved comparability of preintervention FMD, and longer follow-up are warranted.

Trial Registration:
ClinicalTrials.gov identifier: NCT02868216.
Comparisons of Fall Prevention Activities Using Electronic Nursing Records: A Case-Control Study
Authors: Jung Hyesil , Park Hyeoun-Ae , Lee Ho-Young 
Published: November 2021

Objective
The aim of this study was to compare the current fall prevention nursing practices with the evidence-based practices recommended in clinical practice guidelines according to the risk of falling and specific risk factors.

Methods
The standardized nursing statements of 12,277 patients were extracted from electronic nursing records and classified into groups according to the risk of falling and individual patients’ specific risk factors. The mean frequencies of the fall prevention practices in 10 categories derived from clinical practice guidelines were compared among the groups. We additionally analyzed the differences in the mean frequencies of tailored fall prevention practices according to individual patients’ specific risk factors.

Results
The nurses documented more fall prevention practices for patients at a high risk of falling and nonfallers than for patients at a low risk of falling and fallers. Specifically, the difference in nursing practices related to environmental modifications was largest between patients at a high risk of falling and those at a low risk of falling. There were also large differences in the nursing practices related to mental status, dizziness/vertigo, and mobility limitations between fallers and nonfallers. There was more documentation of tailored fall prevention practices related to mobility limitations for patient with mild lower limb weakness than for those with good power and balance. In contrast, patients with severe lower limb weakness had received fewer fall prevention practices related to mobility limitations.

Conclusions
The present findings emphasize that individual risk-specific nursing interventions in addition to universal precautions are crucial for preventing falls among patients.
Impact of Variation in Pill/Package Appearance of Drugs on Patients’ Behavior: A Systematic Review
Authors: Lumbreras Blanca , Sanz-Valero Javier , López-Pintor Elsa 
Published: November 2021

Objective
This systematic review aims to identify and critically evaluate the available evidence on the impact of switches in pill appearance/packaging on patient’s behavior.

Methods
Studies from inception to March 2021 were searched across MEDLINE through PubMed, the Cochrane Library, Embase, and Scopus. Included studies carried out an original evaluation in English or Spanish language that evaluated the impact of switches in pill appearance/packaging on patient’s behavior. Two authors independently extracted study data and evaluated studies for methodological quality according to the STROBE guidelines.

Results
Ten studies were included, and the mean (SD) number of STROBE criteria satisfied was 17.2 (3.9). Three of 5 studies found a significant association between change in pill appearance and persistence to treatment; the 3 studies that evaluated the impact of a change on adherence to treatment found a significant association; 1 of the 2 studies that evaluated the relationship between a change a clinical outcome found a significant association with the prevalence of uncontrolled blood pressure; and 1 study showed lower rates of switchbacks to the branded product compared with patients who switched to generic drug products, with different appearance.

Conclusions
This systematic review showed an impact of the change in pill/package appearance on patients’ behavior in 7 of the 10 studies included. Generic switching may lead to unintended consequences on patients’ behavior, mainly regarding adherence to treatment.
Evaluation of the Culture of Safety and Quality in Pediatric Primary Care Practices
Authors: Oyegoke Sarah , Gigli Kristin Hittle 
Published: November 2021

Objectives
The purposes of this article were to describe the perceptions of the culture of safety in pediatric primary care and evaluate whether organizational factors and staff roles are associated with perceptions of the culture of safety.

Methods
We conducted a secondary data analysis using 2020 Agency for Healthcare Research and Quality Medical Office Survey on Patient Safety Culture to examine the culture of safety and quality in pediatric primary care practices. We used descriptive statistics and calculated differences in perceptions of patient safety and quality based on practice size, ownership, and staff roles using bivariate and logistic regressions.

Results
The sample included 99 pediatric primary care practices and 1228 staff (physicians n = 169, advanced practice providers n = 70, nurses n = 338, and administration/management n = 651). The “teamwork” domain had the highest positive ratings (≥81.6% positive responses), whereas the “work pressure and pace” domain had the lowest positive ratings (≤28.6% positive response). There were no differences in perceptions of safety or quality based on practice size or ownership. However, there were differences based on staff roles, specifically between administration/management and direct care staff.

Conclusions
Overall, perceptions of the culture of safety and quality in pediatric primary care practices were positive. Differences in perceptions existed based on staff role. Future studies are needed to determine whether differences are clinically meaningful and how to narrow differences in perceptions among staff and improve of the culture of safety as a mechanism to improve the safety and quality of pediatric primary care.
Implementation of a Preoperative Huddle at a Level 1 Trauma Center
Authors: Scofield Harrison , Teigen Kari , Blair Somer , Rechter Griffin R. , Webb Brian 
Published: November 2021

Objective
Medical errors resulting in patient harm still occur at an alarmingly high rate. Surgery is a high-risk area that can frequently result in patient harm if errors occur. There is a need for standardization of communication and processes to decrease errors. We sought to determine whether the implementation of a preoperative huddle at our hospital could standardize communication and decrease medical errors.

Methods
A unique preoperative huddle was developed and implemented at a level 1 trauma center. We reviewed data before and after the implementation of the preoperative huddle including patient surveys and comments, the percentage of on-time operating room (OR) starts, OR turnover times, and the number of sentinel events.

Results
After huddle implementation, we observed a trend of improvement in our patient survey results on patient’s perception that the doctors/nurses explained the procedure understandably after huddle implementation. There was a statistically yet limited clinically significant increase in OR turnover time from 37 to 40 minutes (P < 0.001). There was also an increase in on-time OR starts from 37% to 45% (P < 0.001). We observed a decrease in the number of sentinel events, with only 1 occurring each year since implementation.

Conclusions
A preoperative huddle was successfully implemented at a level 1 trauma hospital and helped standardize communication without significantly disrupting workflow. To our knowledge, this method of preoperative huddling has not been previously described in the literature.
Precision medicine in secondary prevention of ischemic stroke: how may blood-based biomarkers help in clinical routine? An expert opinion
Authors: Bicciato Giulio , Arnold Markus , Gebhardt Aidan , Katan Mira 
Published: November 2021

Purpose of review
One in eight patients unfortunately suffers a new stroke within 5 years of their first stroke, even today. Research in precision medicine could lead to a more individualized treatment allocation, possibly achieving lower recurrence rates of ischemic stroke. In this narrative review, we aim to discuss potential clinical implementation of several promising candidate blood biomarkers.

Recent findings
We discuss specifically some promising blood-based biomarkers, which may improve the identification of underlying causes as well as risk stratification of patients according to their specific cerebrovascular risk factor pattern.

Summary
Multimodal profiling of ischemic stroke patients by means of blood biomarkers, in addition to established clinical and neuroradiological data, may allow in the future a refinement of decision algorithms for treatment allocation in secondary ischemic stroke prevention.