bluuebunny/crossref_metadata_2025_split huggingface dataset:
External Validation of the Minimum Clinically Important Difference in the Timed-up-and-go Test After Surgery for Lumbar Degenerative Disc Disease
Authors: Maldaner Nicolai , Sosnova Marketa , Ziga Michal , Zeitlberger Anna M. , Bozinov Oliver , Gautschi Oliver P. , Weyerbrock Astrid , Regli Luca , Stienen Martin N. 
Published: May 2021

Study Design.
Prospective observational cohort study.

Objective.
The aim of this study was to provide external validation of the minimum clinically important difference (MCID) of the Timed-up-and-go (TUG) test.

Summary of Background Data.
The TUG test is one of the best explored and most frequently applied objective task-based functional outcome measure in patients with lumbar degenerative disc disease (DDD). The increased use of the TUG test is based on its solid psychometric properties; however, an external validation of the originally determined MCID is lacking.

Methods.
Forty-nine patients with lumbar DDD, scheduled for elective spine surgery, were assessed pre- and 6-weeks (W6) postoperative. MCID values were calculate for raw TUG test times (seconds) and standardized TUG z scores using three different computation methods and the following established patient-reported outcome measures (PROMs) as anchors: Visual Analog Scales (VAS), Core Outcome Measures Index Back, Zurich Claudication Questionnaire (ZCQ).

Results.
The three computation methods generated a range of MCID values, depending on the PROM used as anchor, from 0.9 s (z score of 0.3) based on the VAS leg pain to 3.0 seconds (z score of 2.7) based on the ZCQ physical function scale. The average MCID of the TUG test across all anchors and computation methods was 2.1 s (z score of 1.5). According to the average MCID of raw TUG test values or TUG z scores, 41% and 43% of patients classified as W6 responders to surgery, respectively.

Conclusion.
This study confirms the ordinally reported TUG MCID values in patients undergoing surgery for lumbar. A TUG test time change of 2.1 seconds (or TUG z score change of 1.5) indicates an objective and clinically meaningful change in functional status. This report facilitates the interpretation of TUG test results in clinical routine as well as in research.

Level of Evidence: 3
Using Simulation to Teach Transitions of Care for Hospitalized Patients
Authors: Price Deborah M. , Ursuy Peggy A. , Bathish Melissa A. 
Published: May 2021

Background
Understanding and facilitating the seamless and safe transitions of patients across high-acuity hospital settings are important for students to grasp in order to meet patient and family care needs.

Problem
Clinical placements do not always give students the opportunity to care for patients in various hospital settings or apply complex knowledge and skills learned in their didactic courses. Furthermore, the global pandemic has limited student clinical experiences in health care settings, underscoring the need for simulated clinical learning opportunities.

Approach
A multiscenario simulation using a high-fidelity human patient simulation manikin was incorporated into a senior-level capstone course. Simulated hospital settings included the (1) emergency department, (2) critical care unit, and (3) progressive care unit.

Outcome
Student evaluations revealed positive perceptions of learning, enhanced proficiency of clinical skills, and increased confidence regarding transitions of care. Faculty held agreeable opinions of the simulation's ease of facilitation and effectiveness as a teaching tool.

Conclusion
Application of complex knowledge and skills, understanding the use of bundles of care, and an appreciation for transitions of care hospitalized patients were successfully achieved.
Differential Diagnosis of Low Hemoglobin
Authors: Ianni Colleen M. , McDowall Megan P. , Zuska Inez A. 
Published: May 2021

Background
A low hemoglobin level, commonly referred to as anemia, is frequently encountered in the acute care setting among patients with different comorbidities. It is essential that clinicians understand the pathophysiology of anemia to develop a practical differential diagnosis of the cause of the low hemoglobin level. A systematic approach should be used when determining the diagnosis to provide the correct treatment for the patient.

Objective
This article highlights the equal importance of the patient's history and laboratory values in arriving at the correct diagnosis of low hemoglobin level. The approach to diagnosis is described along with an algorithm to enable the clinician to quickly and effectively diagnose their patients.

Discussion
The differential diagnosis of low hemoglobin level is extensive, and some may be overlooked if an organized approach is not taken. For unstable patients, the diagnosis is usually clearer to the clinician. However, for a stable patient, the diagnosis may be difficult to obtain owing to the many causes of low hemoglobin level. The algorithm allows for easier navigation of the diagnostic process.
Eyebrow Transplantation Using Long Hair Follicular Unit Excision Technique
Authors: Park Jae Hyun , Kim Na Rae , Manonukul Kotchamol 
Published: May 2021

Background:
Long hair follicular unit excision (LHF) allows surgeons to fully visualize hair curliness, which is crucial in eyebrow transplantation where matching curliness is a matter of utmost importance. In this study, we aimed to evaluate the clinical importance of LHF in eyebrow transplantation.

Methods:
A total of 36 patients who had undergone eyebrow transplantation surgery with LHF were enrolled. Twelve of the 36 patients had previously undergone unsatisfactory surgery at another clinic. Of these, 2 patients underwent complete laser eyebrow removal, and 3 patients underwent selective electro-cautery with unmatched hair curliness before surgery. The remaining 7 patients underwent surgery to increase eyebrow hair density or to reshape their eyebrows. A satisfaction survey was administered to patients > 6 months after the procedure.

Results:
All patients showed natural eyebrow transplant results at their follow-up visits and were satisfied with the results. Patient and surgeon satisfaction scores were 4.7 and 4.3, respectively. Four patients underwent a touch-up procedure to increase hair density with 21, 43, 12, and 45 follicular units, respectively, and were satisfied with the results. There were no cases of asymmetry or adverse events, such as folliculitis.

Conclusions:
The authors derived satisfactory results from the patients who underwent eyebrow transplantation by the LHF method. Therefore, we conclude that LHF is a suitable surgical method for eyebrow hair transplantation.
A Case of a Giant Congenital Melanocytic Nevus Treated by Curettage with the Application of Cultured Epidermal Autografts before 6 Months of Age
Authors: Fujito Hikaru , Yamanaka Hiroki , Tsuge Itaru , Katsube Motoki , Sakamoto Michiharu , Fujimoto Masakazu , Morimoto Naoki 
Published: May 2021

Summary
Curettage is common in the treatment of a giant congenital melanocytic nevus (GCMN) in infants and should generally be performed before 6 months of age. Post-curettage retarded epithelialization often interferes with the ability to perform multiple operations within a short interval, and thus, it is difficult to treat large lesions in the neonatal period. We herein report a case of a GCMN comprising 20% of the total body surface area, which required multi-stage curettage, in which a cultured epithelial autograft was used to promote epithelialization of the post-curettage wound. The patient was a 1-month-old boy with a GCMN in his head, neck, chest, back, buttock, left upper arm, and a few satellite lesions. A four-stage operation was performed between 3 and 6 months of age; the cultured epithelial autograft took well after each operation, and complete epithelialization was observed at postoperative days 20, 23, 27, and 12, respectively. Seven months after the last surgery, hypertrophic scar formation was only observed in a small area of the left upper arm without axillary contracture. The color of the treated area improved, except for slight partial re-pigmentation. A skin biopsy was obtained from the re-pigmented area. The results demonstrated that nevus cells remained in the basal layer of the epidermis, hair follicles, and deep layer of the remaining dermis, suggesting that the recurrent nevus cells in the regenerated epidermis migrated from hair follicles. We conclude that the combination of curettage and the application of a cultured epithelial autograft is a promising option for GCMN treatment.
Composite Reparative Surgery of a Postoperative Through-and-through Facial Defect: Case Report
Authors: Abugaliyev Kabylbek R. , Anapiya Baurzhan B. , Samenova Dinara E. 
Published: May 2021

Summary
We report our positive experience on the treatment of a patient with a composite facial maxillary defect. The stoma was formed following the removal of the adenoid cystic carcinoma of the maxillary sinus. We propose reconstruction repair of the postoperative facial maxillary defect using an inverted cutaneous flap and a split-thickness skin graft.
Essential Elements of Forensic Assertive Community Treatment
Authors: Lamberti J. Steven , Weisman Robert L. 
Published: May 2021

Learning objective
After participating in this activity, learners should be better able to:
• Assess characteristics of forensic assertive community treatment programs

Abstract
Forensic assertive community treatment (FACT) has emerged internationally as an intervention strategy for people with serious mental disorders who are involved with the criminal justice system. Studies to date have shown marked variability, however, in FACT program design and operation. Based upon a literature review and relevant experience, the authors present their perspective on the essential elements of FACT. Given that FACT is an adaptation of the evidence-based assertive community treatment (ACT) model, it is recommended that FACT programs maintain a high-fidelity ACT component. FACT programs should also have both mental health and criminal justice admission criteria because service recipients are involved in both service systems. For optimal effectiveness, FACT team clinicians must partner with criminal justice agencies that provide community-based supervision to their patients. Prospective FACT enrollees should receive a clear explanation of the program, including how their respective mental health and criminal justice service providers will work collaboratively with them to prevent incarceration. FACT programs should also use risk/need assessment to inform treatment planning, evidence-based mental health and community correctional practices to promote both wellness and public safety, and shared training to promote effective collaboration. Additional elements to consider include housing, medical care, and transitional services. These elements are presented and discussed, including a rationale and evidence to support each component. The article concludes with introduction of a FACT fidelity scale, the Rochester Forensic Assertive Community Treatment Scale (R-FACTS). By operationalizing essential FACT elements, the R-FACTS is designed to support FACT program development, implementation, and dissemination in a more consistent and measurable manner.
BILATERAL SPONTANEOUS VITREOUS BASE DETACHMENT IN A FEMALE PATIENT WITH NEUROFIBROMATOSIS TYPE 1
Authors: Jordan Valence A. , Gordon-Bennett Patel S. C. 
Published: May 2021

Purpose:
We describe a unique case of bilateral spontaneous vitreous base detachment in a female patient with neurofibromatosis Type 1 and no known history of ocular injury. This serves to add further to the medical literature.

Discussion:
Vitreous base detachments usually occur after significant ocular trauma. There is only one other published case of this occurring spontaneously also in a female patient with neurofibromatosis Type 1.

Conclusion:
This suggests a rare association between neurofibromatosis Type 1 and spontaneous detachment of the vitreous base.
Atypical Pylephlebitis
Authors: Vanaparthy Rachana , Greene John N. 
Published: May 2021

Abstract
Pylephlebitis is also called suppurative thrombophlebitis of the portal venous mesenteric system. It is often seen as a complication of intra-abdominal infection, mainly diverticulitis and appendicitis. It is a rare disease with high mortality. Because of its nonspecific presentation, diagnosis is usually missed. So, it is important to consider pylephlebitis as one of the differential diagnoses if the patient presents with signs of abdominal sepsis. Pylephlebitis usually begins with thrombophlebitis of small veins draining an area of intra-abdominal infection and extends into larger veins that cause septic thrombophlebitis of the portal vein and further extending to mesenteric veins. Here, we present the case series of 6 patients older than 60 years who have underlying abdominal cancer at the Moffitt Cancer Center and Research Institute and review the literature.
Clinical characteristics, treatment, and prognosis of 74 2019 novel coronavirus disease patients in Hefei
Authors: Yang Jiazhao , Wu Kerong , Ding Ao , Li Li , Lu Hui , Zhu Wanbo , Xie Kai , Yao Ziqin , Fang Shiyuan 
Published: May 2021

Abstract
Since December 2019, pneumonia caused by a novel coronavirus (SARS-CoV-2), namely 2019 novel coronavirus disease (COVID-19), has rapidly spread from Wuhan city to other cities across China. The present study was designed to describe the epidemiology, clinical characteristics, treatment, and prognosis of 74 hospitalized patients with COVID-19.
Clinical data of 74 COVID-19 patients were collected to analyze the epidemiological, demographic, laboratory, radiological, and treatment data. Thirty-two patients were followed up and tested for the presence of the viral nucleic acid and by pulmonary computed tomography (CT) scan at 7 and 14 days after they were discharged.
Among all COVID-19 patients, the median incubation period for patients and the median period from symptom onset to admission was all 6 days; the median length of hospitalization was 13 days. Fever symptoms were presented in 83.78% of the patients, and the second most common symptom was cough (74.32%), followed by fatigue and expectoration (27.03%). Inflammatory indicators, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) of the intensive care unit (ICU) patients were significantly higher than that of the non-ICU patients (P < .05). However, 50.00% of the ICU patients had their the ratio of T helper cells to cytotoxic T cells (CD4/CD8) ratio lower than 1.1, whose proportion is much higher than that in non-ICU patients (P < .01).
Compared with patients in Wuhan, COVID-19 patients in Anhui Province seemed to have milder symptoms of infection, suggesting that there may be some regional differences in the transmission of SARS-CoV-2 between different cities.
Importance of early detection of infantile inflammatory bowel disease with defective IL-10 pathway
Authors: Hung Hua-Hsi , Lee Hung-Chang , Yeung Chun-Yan , Wang Nien-Lu , Tang Tzu-Yin , Winter Harland S. , Kelsen Judith R. , Jiang Chuen-Bin 
Published: May 2021

Abstract

Rationale:
Infantile inflammatory bowel disease (IBD) is an extremely rare subgroup of IBD that includes patients whose age of onset is younger than 2 years old. These patients can have more surgical interventions, and a severe and refractory disease course with higher rates of conventional treatment failure. Monogenic defects play an important role in this subgroup of IBD, and identification of the underlying defect can guide the therapeutic approach.

Patient concerns:
In 2007, a 4-month-old girl from a nonconsanguineous family presenting with anal fistula, chronic diarrhea, and failure to thrive. She underwent multiple surgical repairs but continued to have persistent colitis and perianal fistulas.

Diagnosis:
Crohn's disease was confirmed by endoscopic and histologic finding.

Intervention:
Conventional pediatric IBD therapy including multiple surgical interventions and antitumor necrosis factor alpha agents were applied.

Outcomes:
The patient did not respond to conventional pediatric IBD therapy. Interleukin-10 (IL-10) receptor mutation was discovered by whole-exome sequencing and defective IL-10 signaling was proved by functional test of IL-10 signaling pathway by the age of 12. The patient is currently awaiting hematopoietic stem cell transplantation.

Lessons:
Early detection of underlying genetic causes of patients with infantile-IBD is crucial, since it may prevent patients from undergoing unnecessary surgeries and adverse effects from ineffective medical therapies. Moreover, infantile-IBD patients with complex perianal disease, intractable early onset enterocolitis and extraintestinal manifestations including oral ulcers and skin folliculitis, should undergo genetic and functional testing for IL-10 pathway defect.
The efficacy and safety of acupuncture in the treatment of erectile dysfunction
Authors: Zhou Yuliang , Chen Shenghui , Zhang Duanjun , Lu Huiyu , Yao Wenliang , Jiang Wanxue , Yu Yinglv , Jiang Chaoren 
Published: May 2021

Abstract

Background:
Erectile dysfunction (ED) can negatively affect men's mental health, interpersonal relationships, and overall well-being. ED has affected >150 million men worldwide, and this number will reach approximately 322 million by 2025. Although PDE5-Is is a landmark in the treatment of erectile dysfunction, it may have side effects such as penile pain, cardiovascular dysfunction, and deafness. Some studies have shown that acupuncture may have a positive effect on the pathophysiology of ED. Therefore, we will select all randomized controlled trials related to evaluate the efficacy and safety of acupuncture treatment of ED.

Methods:
This study will systematically search 7 digital databases including China National Knowledge Infrastructure, Wanfang, VIP, China Biology Medicine, Cochrane Library, PubMed, and Embase for randomized controlled trials without language restrictions. Two researchers will independently read the title, abstract, and full text to screen for studies that can be included in the meta-analysis. If there is any dispute, the third party will be required to reach a consensus.

Results:
The purpose of this study is to evaluate the efficacy and safety of acupuncture in the treatment of ED and the difference in the impact of different types of acupuncture on ED.

Conclusion:
Judge whether acupuncture and moxibustion can help improve the symptoms of ED by evaluating relevant literatures, and make up for the lack of relevant research.

INPLASY registration number:
INPLASY 202140040
Prevalence and influencing factors of anxiety and depression symptoms among the first-line medical staff in Wuhan mobile cabin hospital during the COVID-19 epidemic
Authors: Zhang Xiao-Bo , Xiao Wei , Lei Jing , Li Ming-Xia , Wang Xin , Hong Yun-Jun , Xu Ping , Sun Juan 
Published: May 2021

Abstract
To investigate the prevalence of anxiety and depressive symptoms and the associated risk factors among first-line medical staff in Wuhan during the coronavirus disease 2019 (COVID-19) epidemic.
From March 5 to 15, 2020, the Hamilton Anxiety Scale and Hamilton Depression scale were used to investigate the anxiety and depression status of medical staff in Wuhan Cabin Hospital (a Hospital). Two hundred seventy-six questionnaires were received from 96 doctors and 180 nurses, including 79 males and 197 females.
During the COVID-19 epidemic, the prevalence rate of anxiety and depression was 27.9% and 18.1%, respectively, among 276 front-line medical staff in Wuhan. The prevalence rate of anxiety and depression among doctors was 19.8% and 11.5%, respectively, and the prevalence rate of anxiety and depression among nurses was 32.2% and 21.7%, respectively. Females recorded higher total scores for anxiety and depression than males, and nurses recorded higher scores for anxiety and depression than doctors.
During the COVID-19 epidemic, some first-line medical staff experienced mental health problems such as depression and anxiety. Nurses were more prone to anxiety and depression than doctors. Effective strategies toward to improving the mental health should be provided to first-line medical staff, especially female medical staff and nurses.
Graft kidney hydronephrosis caused by transplant ureter inguinal hernia
Authors: Chang Tian-You , Chang Chao-Hsiang , Lai Ping-Chin , Lin Wei-Ching 
Published: May 2021

Abstract

Rationale:
Ureteral obstruction of the graft kidney is a common complication of kidney transplantation. However, ureteral obstruction caused by inguinal hernia has rarely been reported. We present a rare case of ureteral obstruction with allograft dysfunction caused by an inguinal hernia.

Patient concerns:
A 76-year-old man, who was a renal transplant recipient, presented with bilateral pitting oedema, reduced urine output, and right inguinal hernia.

Diagnoses:
Abdominal computed tomography revealed severe hydroureteronephrosis of the kidney allograft. A right inguinal hernia with ureteral incarceration was observed.

Interventions:
The patient underwent graft percutaneous nephrostomy, followed by antegrade insertion of a double-J tube (DJ). Gradual improvement was observed in his renal function. Right inguinal herniorrhaphy was performed 5 days later.

Outcomes:
The renal function returned to normal after percutaneous nephrostomy and insertion of the DJ. A right inguinal direct-type hernia with ureter adhesion to the hernial sac was observed during the surgery. The posterior wall defect was repaired by the McVay technique. The DJ was removed after 1 month. The patient's renal function remained stable at 6-month follow-up.

Lessons:
The orientation of the graft kidney has a significant influence on the location of the ureter. Upward orientation of the hilum will result in superficial location of the ureter, rendering it close to the hernial sac and susceptible to incarceration. The transplant surgeon should be aware of such a presentation of graft dysfunction with inguinal hernia to prevent a delay in the diagnosis and graft loss.