bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of Religiosity and Spirituality on the Happiness, Optimism, and Pessimism of Brazilian Medical Students
Authors: Vitorino Luciano Magalhães , Cazerta Mariana Fernandes , Corrêa Natália Roriz , Foresto Emanuelle dos Passos , Oliveira Marcia Ap. F. de , Lucchetti Giancarlo 
Published: December 2021

Background Mental health problems are very common among medical students, becoming a concern for health care professionals and educators. Despite the fact that there is a growing body of literature supporting the role of religiosity and spirituality (RS) on mental health and on positive psychology outcomes, little evidence is available among medical students, a population subjected to important distress. Aims This study aimed to investigate the role of RS on the levels of optimism, pessimism, and happiness among Brazilian medical students. Methods This is a cross-sectional study including medical students from the first to the eighth semester of a private medical school. The instruments used were: TOT-R for optimism and pessimism, Lyubomirsk and Lepper subjective happiness scale, and sociodemographic profile. The independent variables were Brazilian Portuguese Duke University Religiosity Scale for religiosity, Brief Spiritual Religious Coping (SRC) for negative and positive SRC; and Facit-Sp for spiritual well-being. Results A total of 353 medical students were included (response rate 97.51%). Higher levels of intrinsic religiosity and peace were associated with greater happiness and optimism. However, negative SRC was associated with lower levels of happiness and optimism and higher levels of pessimism. Conclusion Medical students tend to use their RS as a resource for dealing with the challenges of medical school, influencing their happiness and optimism. In this context, it seems that religiousness acts in two different ways, not only have positive but also negative outcomes among the participants.
Effect of Patient-Centered Self-Management Program on Blood Pressure, Renal Function Control, and the Quality of Life of Patients With Hypertensive Nephropathy: A Longitudinal Randomized Controlled Trial
Authors: Lee Mei-Chen , Wu Shu-Fang Vivienne , Lu Kuo-Cheng , Wang Wen-Hug , Chen Yen-Yen , Tai Chun-Yi 
Published: December 2021

This longitudinal study with a randomized controlled trial evaluated the long-term effectiveness of the patient-centered self-management intervention program on the control of blood pressure and renal function, as well as the quality of life of patients with hypertensive nephropathy. The control group ( n = 38) received usual care while the experimental group ( n = 38) participated in a patient-centered self-management program. After the pre-test, the intervention was performed with the experimental group once a week for a total of 4 weeks. Then, the post-test was performed 1, 3, and 6 months later. A questionnaire was used to collect the demographic data and disease characteristics, laboratory data, and quality of life scale. This study tracked three time points (i.e., 1, 3, and 6 months) after the intervention and found that the experimental group achieved significant results in controlling systolic blood pressure ( p < 0.001), diastolic blood pressure ( p = 0.007), and eGFR ( p = 0.013). Significant results were achieved in the overall quality of life ( p < 0.001) and the quality of life in the physical (PHC; p < 0.001) and mental health components (MHC; p < 0.001). Furthermore, the effects in the experimental group lasted for as long as 6 months and were better than those in the control group. Moreover, this program can provide nursing staff with a reference different from traditional health education methods.
Association of nocturnal subconjunctival hemorrhage and non-dipper blood pressure pattern: A benign clue for serious diseases
Authors: Çalış Karanfil Feyza , Karanfil Mustafa , Toklu Yasin 
Published: December 2021

Purpose To evaluate the association between non-dipper blood pressure pattern and subconjunctival hemorrhage (SCH). Methods Twenty-seven consecutive patients with nocturnal SCH and 27 age, sex-matched controls were enrolled. Demographic, blood parameters, office blood pressure measurements, 24-h ambulatory blood pressure monitoring (ABPM) were evaluated. Results Mean diastolic blood pressure (DBP) for nighttime (65.03 ± 7.1 vs. 70.78 ± 10.5, p: 0.22), mean heart rate for nighttime (64.54 ± 8.26 vs. 69.93 ± 9.85, p: 0.034), Minimum Systolic Blood pressure(SBP) and DBP values for nighttime (92.44 ± 9.72 vs. 99.44 ± 10.66, p:0.015 and 51.15 ± 8.31 vs. 57.7 ± 11.2, p: 0.018) were higher, nocturnal fall ratio of SBP and DBP were significantly lower in the SCH ( + ) group compared to SCH (-) group (5.38 ± 8.39 vs. 10.34 ± 6.08, p: 0.016 and 4.26 ± 8.92 vs. 13.78 ± 6.97, p < 0001 respectively). Ten patients (37%) in the SCH (-) group and 18 patients (66.7%) in the SCH ( + ) group were non-dippers (p: 0.029). Mean daytime SBP and DBP were higher compared to office measurements of 4 patients (14.8%) in the SCH (-) group and 11 patients (40.7%) in the SCH ( + ) group (p: 0.033) Conclusion SCH had a strong association with non-dipper blood pressure pattern, higher nocturnal heart rate and masked hypertension which are precursors of myocardial infarction, stroke and renal failure. So, SCH should be considered as a clue for serious diseases such as coronary artery disease, myocardial infarction, stroke and patients should be evaluated for ABPM.
Children’s oppositional defiant disorder symptoms make parents difficult to be nice: Longitudinal association among parent emotion regulation, child emotion regulation and children’s oppositional defiant disorder symptoms in Chinese children with oppositional defiant disorder
Authors: Chen Hui , He Ting , Xu Min , Zhao Jianjun , Li Longfeng , Lin Xiuyun 
Published: December 2021

The current study aims to clarify the longitudinal relations among parent emotion regulation (ER), child ER, and children’s oppositional defiant disorder (ODD) symptoms. In the current study, parents of 275 children (195 boys, 70.1%) with ODD symptoms ( Mage = 9.32 years, SD = 1.64) reported their ER using the Difficulties in Emotion Regulation Scale, child ERs using the Emotion Regulation Checklist, and children’s ODD symptoms using the eight symptoms indicated in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) at three time points (T1, T2, and T3) within 2 years. Results indicated the longitudinal relationships between parent ER and children’s ODD symptoms were directly influenced by each other. Children’s ODD symptoms had important effects on both child ER and parent ER. Findings suggested that to reduce children’s ODD symptoms, it is necessary not only to improve child ER but also to improve parent ER.
Modular Endo-Bentall Procedure Using a “Rendez-Vous Access”
Authors: Gandet Thomas , Westermann Dirk , Conradi Lenard , Panuccio Giuseppe , Heidemann Franziska , Rohlffs Fiona , Kölbel Tilo 
Published: December 2021

Purpose: The concept of a single endovascular valve-carrying conduit device was designated endo-Bentall, but published experience is limited to a single case. This technical note describes an alternative modular endo-Bentall technique and a novel access technique to implant it. Technique: A 82-year-old woman with chest pain referred for a 10 cm symptomatic aneurysm of the distal arch and descending aorta. An ascending aortic aneurysm of 5.5 cm prevented endovascular aortic arch repair due to lack of a proximal landing zone. The technique is a modular approach combining a physician-modified endograft (PMEG) with 3 large fenestrations for coronary artery perfusion and a transcatheter aortic valve implantation (TAVI). A “rendez-vous access” with a transapical and transfemoral through-and-through wire offered rapid sequential deployment in a modular fashion of both components. The PMEG was deployed first, landing 5 mm deep in the left ventricular outflow tract (LVOT) and the transcatheter aortic valve was implanted few millimeters below. The endo-Bentall procedure was combined with endovascular aortic arch repair. Conclusion: A modular endo-Bentall procedure combining a PMEG and TAVI is feasible and adaptable to emergent setting using the “rendez-vous access.”
First Experience With The GoBack-Catheter For Successful Crossing of Complex Chronic Total Occlusions in Lower Limb Arteries
Authors: Bakker Olaf , Bausback Yvonne , Wittig Tim , Branzan Daniela , Steiner Sabine , Fischer Axel , Konert Manuela , Düsing Sandra , Banning-Eichenseer Ursula , Scheinert Dierk , Schmidt Andrej 
Published: December 2021

Purpose: To evaluate the use of the GoBack-catheter (Upstream Peripheral Technologies) in complex revascularizations in lower limb arteries. Materials and Methods: In this retrospective single-center study, the results of the first 100 consecutive patients including 101 limb-revascularizations, performed between May 2018 and July 2020 with the study device, were analyzed. In all cases, guidewire-crossing failed, and all lesions were chronic total occlusions (CTO), either de novo, reocclusions, or in-stent reocclusions. Successful crossing was defined as passing the CTO using the study device. Patency at discharge and after 30 days was defined as less than 50% restenosis on duplex sonography, without target lesion revascularization. Results: Median lesion length was 24 cm and 38 patients (37.6%) had a calcium grading according to the peripheral arterial calcium scoring system (PACSS) of 4 or 5. In 20.8% of patients, an occluded stent was treated. CTOs involved the femoropopliteal segment in 91.1%, iliac arteries in 5.9%, and tibial arteries in 7.9%. The GoBack-catheter was employed for entering into or crossing through parts or the full length of a CTO or an occluded stent as well as for re-entering into the true lumen after subintimal crossing. The device was used via contralateral and ipsilateral antegrade as well as retrograde access with an overall technical success rate of 92.1%. In 3 patients minor bleeding occurred at the crossing or re-entry site, which were managed conservatively. Thirty-day adverse limb events comprised minor amputations in 4 patients (4.0%), 1 major amputation (1.0%), and reocclusions in 7 limbs (6.9%). Conclusion: The new GoBack-catheter offers versatile endovascular applicability for complex CTO recanalization in a broad range of peripheral vascular interventions with a high technical success and low complication rate.
Comparative Study of 2 Bone Anchors Using a Limited Open Procedure for the Management of Distal Radioulnar Joint Instability
Authors: Monsivais Jose J. , Herber Agustin , Charest Guy , Ogunleye David , Weaver Mitchell 
Published: December 2021

Background: Arthroscopic and open surgical procedures are commonly used to repair distal radioulnar joint (DRUJ) instability. Both may result in patient dissatisfaction and recurrence of DRUJ instability. An alternative treatment that yields improved outcomes is a limited open approach using a bone anchor to support the DRUJ. Methods: A retrospective chart review of 58 patients (59 extremities) aged 18 to 60 years with type 1B Palmer rupture (3 months or more after injury) of the triangular fibrocartilage complex (TFCC) without distal radius fracture was conducted. Inclusion criteria are: 3 to 12 months after injury, clinical DRUJ instability, and minimum of 6 months of postoperative follow-up. Operative fixation with Stryker Sonic or Depuy Mitek anchor was done by the same surgeon using a limited open procedure. Preoperative and postoperative assessments included Disability of the Arm, Shoulder, and Hand; Brief Pain Inventory; Wong-Baker FACES Pain Rating Scale; Numeric Pain Scale; range of motion; and recurrence of instability. A multivariate analysis of variance model was fit to imputed data to assess the effect of both anchors. Results: Clinical and statistical differences were found in preoperative and postoperative assessments for either the Stryker Sonic or the Depuy Mitek anchor but not between anchor types. There was no recurrence after 3 years with either anchor. Conclusion: Patients requiring TFCC repair using the Stryker Sonic or Depuy Mitek anchor experienced: (1) significant clinical and statistical improvement in postoperative assessments; (2) patient satisfaction; and (3) corrected DRUJ instability. Consequently, major determinants in deciding which bone anchor to use may be based on cost or surgeon’s preference.
A National Survey of Hand Surgeons: Understanding the Rural Landscape
Authors: Meyerson Joseph , Liechty Andrew , Shields Tyler , Netscher David 
Published: December 2021

Background: Twenty percent of the US population is described as being rural and may have limited access to hand surgeons, especially on an emergency basis. Little is known about case type, call hours, employment status, and other relevant details of rural hand surgery. Methods: We surveyed members of the American Society of Surgery for the Hand to begin to describe the problem. Results: There were 471 responses from 2256 members surveyed with 387 completing 100% of questions asked. Ninety (19%) identified themselves as primarily located in a rural population and 381 (81%) in a metropolitan region. In our study, rural hand surgeons were more likely to be employed by a community hospital, followed by independent private practice, multispecialty group, academics, and then locum tenens. Rural surgeons’ practices were 80% solely hand surgery, while metropolitan surgeons’ practices were 89% ( P < .01). Metropolitan surgeons felt that of the transfers from rural facilities, 46% did not need emergency hand care and that 60% of the time, there was not actually a need for specialty hand surgery care. Conclusions: Our survey begins to shed light on the details of rural hand surgery practice. We found that rural surgeons are more likely to be employed in community hospitals and take more call. When available, hand surgery specialists could prevent unnecessary transfer of patients to metropolitan areas. More work needs to be done to describe the differences between rural and metropolitan hand surgery practices as well as create rural hand surgeons.
The Transosseous Internal Four Strand Technique: A New All-Inside Technique for Zone 1 Flexor Tendon Repairs
Authors: Harenberg Patrick S. , Grünert Jörg G. , Christen Samuel M. 
Published: December 2021

Background: Multiple techniques for the repair of flexor tendon injuries in zone 1 have been proposed over time. While pull-out suture techniques and bone anchor seem to be stronger than internal suture techniques, they are associated with a higher complication rate. We therefore developed an alternative internal suture repair with similar biomechanical stability to those of pull-out sutures and bone anchors. Methods: Twenty porcine distal phalanges and deep flexor tendons were randomized to 2 groups of 10 each. The tendons were transsected at the level of the distal interphalangeal joint. In group 1, repairs were performed with a well-established intraosseous suture repair and in group 2 with our new multistrand technique. The repairs were biomechanically tested with linear distraction until failure. Results: We recorded a significantly higher 2-mm gap force (2GF)—and thus higher stability—of the repairs in group 1 in comparison to group 2. With a 2GF of more than 50 N, our suture technique allows for a modern early active motion rehabilitation protocol. Breakage of the suture construct occurred at random places in the repair in both groups. No pull-outs were noted. Conclusions: This study presents a strong transosseous multistrand repair technique for flexor tendon repair in zone 1 that is simple and fast to perform and should have enough strength to withstand early active motion rehabilitation.
Surgical Treatment for Recurrent Dupuytren Disease
Authors: Hozack Bryan A. , Rayan Ghazi M. 
Published: December 2021

Background: Revision procedures for recurrent Dupuytren disease (DD) can be difficult and carry a high risk of complications. Our goal was to describe surgical strategies used for cases of recurrence and report on their outcomes. Methods: We reviewed 1 surgeon’s operative cases for recurrent DD performed at 1 institution. Prior procedures included collagenase injection, percutaneous needle fasciotomy, or open surgical fasciectomy in the same digit or area of the hand. Results: From January 1981 to December 2020, 54 procedures were performed on 33 patients for recurrent DD. Most patients were men (82%), had bilateral involvement (64%) and family history (52%), and some had ectopic disease in their feet (24%). The small finger was involved in 76% of the cases, and the proximal interphalangeal (PIP) joint was involved in 83% of these digits. The procedures included 38 partial fasciectomies (72%), 12 dermofasciectomies (23%), 3 radical fasciectomies (6%), 1 of each needle fasciotomy, ray amputation, and PIP joint arthrodesis (2%). Twenty-three patients (43%) required full thickness skin grafts with an average area of 7.1 cm2 (range: 1-20 cm2). Conclusions: This study highlights the complexity of recurrent DD case management and found the treatment required for 95% of patients in this series was open partial fasciectomy with or without demofasciectomy. Full thickness skin grafting was necessary in nearly half of the cases.
Does the Nail Bed Regenerate?
Authors: Silva Jefferson Braga , Magnus Gabriela A. , Stanham Valentina , Wolff Cecília G. , Aranchipe Carolina S. , Cauduro Carolina 
Published: December 2021

Background: The regenerative potential of the nail bed after trauma remains controversial. Methods: We performed a retrospective review of 51 patients who underwent nail bed reconstruction with 2 techniques (direct flow island flap or a Tranquilli-Leali “Atasoy” flap) due to trauma involving the nail bed complex. These 2 flaps were used to support the loss of distal substance and to allow the regeneration of the nail bed. Outcomes were analyzed for at least 18 months. There were 34 men (66.7%), and the average age was 16.1 years. Most patients (56.9%) had crush injuries. The little (16) and index (14) fingers were the most affected. Twenty-seven were children (range: 4-11) with an average age of 7.4 ± 1.9 years. The middle finger was the most affected (29.2%). Results: The outcomes were good to excellent in 41 operated patients (80.4%). Hook nail was absent in 84.3% of the patients. Most patients (98%) did not develop necrosis. Children had an excellent/good outcome rate of 85.2%, while in adults, the rate was 75% of cases ( P = .485). Conclusion: The direct flow island flap is superior in terms of outcome, regardless of age, sex, affected finger, dominant hand, type of trauma, and injury zone. In cases where there was a correct reconstruction of the hyponychium, there was regeneration of the nail bed.
Nerves in Continuity Following Hand Trauma: A Descriptive Report
Authors: Pereira Daniel E. , Desai Mihir J. 
Published: December 2021

Background: Understanding the clinical presentation of nontransected nerve injuries in acute hand trauma/wrist trauma will help in early intervention, which is vital for maximizing return of function in patients. This retrospective study evaluated patients who experienced traumatic hand injuries with nerve in continuity within the zone of injury. Methods: This was a single-center retrospective chart review of 20 patients with hand or wrist trauma resulting in damage to bone, tendon, or soft tissues within Zones II to V. Patients were 18 to 70 years of age and had documented visualization of at least one nerve within the zone of injury at the time of surgery but no documented full or partial nerve transection. The cohort was characterized using descriptive statistics including mechanism of injury, extent of strength and sensation deficits, and outcomes. Resolution of symptoms was defined as full, partial, or none. Results: Of the 20 patients included in the study, 15 patients (75%) showed symptoms of impaired nerve function either prior to surgery or at the first post-surgical follow-up visit. Without direct nerve treatment, only 23% (3/13) of patients experienced full recovery based on qualitative sensory assessment. However, patients reporting pain after surgery (57%; 8/14) showed full recovery from pain despite no direct nerve treatment. Conclusions: In our retrospective cohort of patients with hand/wrist trauma that presented with an intact nerve in continuity, we found that a majority showed symptoms of nerve injury. Further, these patients showed slow recovery over time with a minority achieving partial or full recovery or improvement in pain.
Impact of renal chimney intra-aortic stent length on branch and end-stent angle in chimney endovascular aneurysm repair and endovascular aneurysm sealing configurations
Authors: Ullery Brant W , Suh Ga-Young , Thompson Patrick , Lee Jason T. , Holden Andrew , Dalman Ronald L. , Cheng Christopher P 
Published: December 2021

Objective Practice patterns and durability of parallel stent graft techniques in complex endovascular aneurysm repair (EVAR) remain poorly defined. We aimed to quantify and compare the impact of renal chimney intra-aortic stent length (IASL) on geometric deformations of renal arteries in complex EVAR. Methods Thirty-eight nonconsecutive patients underwent EVAR utilizing parallel stent graft techniques (chimney EVAR [chEVAR], n = 28; chimney endovascular aneurysm sealing [chEVAS], n = 10) between 2010 and 2016. A total of 59 renal chimney stent grafts were used. Geometric quantification was derived from three-dimensional model-based centerline extraction. Renal chimney intra-aortic stent length (IASL) was defined as the length of chimney stent that extended from the proximal edge of the chimney stent to the ostium of the corresponding renal artery. Results Mean IASL for both left and right renal arteries in the cohort was 35.7 mm. Renal arteries containing chimney IASL <30 mm trended toward a greater branch angle (135.4 vs. 127.8°, p = .06). Left renal arteries showed significantly greater branch angle among those with IASL <40 mm (135.5 vs. 121.7°, p = .045). Mean IASL for renal arteries in chEVAR was significantly longer compared to chEVAS (39.2 vs. 26.3 mm, p = .003). No difference was noted in overall branch angle or end-stent angle based on procedure type. ChEVAR with IASL <30 mm had significantly greater end-stent angle (48.2 vs. 33.5°, p = .03). In contrast, chEVAS patients showed no difference in end-stent angle based on IASL thresholds, but did have significantly greater branch angle among those with IASL <30 mm when grouped by both all renal arteries (133.5 vs. 113.5°, p = .004) and right renal arteries (134.3 vs. 111.6°, p = .02). Conclusions Renal chimney stents with longer IASL appear to exhibit less renal artery deformation, suggesting a more gradual and perpendicular transition of the chimney stent across the renal ostium.