bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alar Flare Preservation Using the Sandwich Technique as an Adjunct to Alar Base Reduction
Authors: Abdelkader Rasha , El-Noamany Sameh , Taha Ahmed , Raafat Sarah Sherif 
Published: May 2021

Background:
Achieving an aesthetic balance and natural appearance when modifying soft tissues of the nasal tip, alae, and nostrils is fundamental to the success of rhinoplasty surgery. The present study aimed to investigate the ability of a simple “sandwich” technique combined with external alar base reduction to preserve the alar flare and achieve a natural and appealing alar contour.

Methods:
The study included 40 patients who reported dissatisfaction due to excessive nasal flaring. Cartilaginous grafts were harvested from the septum in cases of primary rhinoplasty. Grafts were harvested from the conchal cartilage in cases of secondary rhinoplasty to ensure adequacy of the grafts. The grafts were inserted from the alar wedge excision point along the created pocket to be “sandwiched” in the soft tissue of the alar rim.

Results:
The average preoperative alar flare was 35.2 mm (SD ±1.9 mm), with an average postoperative reduction of 3 mm. Difference between intercanthal distance and postoperative alar flare distance showed a mean of (−0.4 mm) (SD ±1.2 mm) and was highly significant with P < 0.05. A comparison between nasal base width and alar flare measurements was done. Difference between nasal base width and preoperative alar flare distance was (−9.2 mm) (SD ±2.6), and between nasal base width and postoperative alar flare was (−6.3 mm) (SD ±2.1). Postoperatively, overall patient satisfaction was scored 4.1 of 5.

Conclusion:
The use of a trapezoidal graft, in combination with external alar base reduction, markedly improves the basal view while maintaining the natural alar flare and curvature.
mTOR-Mediated Cell Death and Infection
Authors: Li Song , Wang Qijun , Su Bing 
Published: May 2021

Abstract
The battle between pathogens and hosts is an ongoing phenomenon that has been studied for centuries. Although multicellular organisms have developed sophisticated immune systems to defend against pathogens, pathogens are often able to successfully infect their hosts. To enhance their chance of survival, pathogens can hijack the host's metabolism, which serves as a critical control point that can potentially impact infections. Mammalian target of rapamycin (mTOR) is the nutrient sensor and central regulator of metabolism in innate and adaptive immune cells. Rapamycin, a drug targeting the mTOR pathway, has been widely used in clinical practice for decades and is relatively safe. However, some unexpected infections occur after long-term administration of rapamycin, indicating the presence of a close relationship between mTOR signaling and the infection process. In this manuscript, we briefly review the mTOR pathway and the current clinical use of rapamycin; we also summarize the role of the mTOR pathway in immune cell death, including apoptosis, necroptosis, pyroptosis, and ferroptosis, and its impact on anti-infection immunity. Finally, potential application of mTOR inhibitor in coronavirus disease 2019 clinical therapy is discussed.
Is Hyperbaric Oxygen an Effective Treatment for the Prevention of Complications in SARS-CoV-2 Asymptomatic Patients?
Authors: Longobardi Pasquale , Hoxha Klarida , Perreca Fabiana 
Published: May 2021

Abstract
Is hyperbaric oxygen therapy (HBO2T) useful to counteract severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in positive asymptomatic patients? Asymptomatic persons seem to account for approximately 45% of SARS-CoV-2 infections, and they can transmit the virus to others for an extended period, perhaps longer than 14 days. In patients dying from SARS-CoV-2 infection, the mean number of concomitant diseases was 3.6 (median 3, standard deviation 2.1). Many of these diseases are correlated with the nitric oxide synthase genetic polymorphism and reduced nitric oxide synthesis [risk for coronary heart disease: odds ratio (95% confidence interval) = 2.74 (1.78–3.85)]. HBO2T significantly increases the production of nitric oxide and free radicals which, in laboratory tests, inhibit the replication of the SARS-CoV. HBO2T upregulates hypoxia inducible factor, which promotes the expression of human antiviral peptides: defensins and cathelicidins, both effective to block the virus. Thus, HBO2T regulates the inflammatory response. We share our pilot study conclusions as a basis for clinical trials.
Ablative Carbon Dioxide Laser Treatment for Papular Scars of Nose and Chin Due to Acne: A Case Series
Authors: Fonseka Sanjeewani , Wickramaarachchi Dasun Chathumina , Bandara Dilan Dileepa Jayarathne 
Published: May 2021

Abstract

Introduction:
Papular scarring of the nose and chin due to acne is an under-reported, under-recognized, and under-treated condition. Ablative carbon dioxide laser therapy (10,600 nm, continuous mode, energy of 15 W) under local anesthesia is one of the choice. Here, we report series of patients with papular acne scars successfully treated with ablative carbon dioxide laser.

Cases presentation:
Five patients with papular scars of the nose and chin due to acne were treated at an outpatient dermatology clinic. All had type V skin according to the Fitzpatrick skin classification. Ablative carbon dioxide laser therapy (10,600 nm, continuous mode, energy of 15 W) was performed under topical anesthesia. The patients were re-examined at 2- to 3-week intervals, and laser treatment was repeated as needed.

Discussion:
All of the five patients showed encouraging results. Good cosmetic results were achieved in all patients. The drawbacks of treatment were mild to moderate pain during the procedure and the need for post-treatment skin care.

Conclusion:
Ablative carbon dioxide laser therapy can potentially be used as a safe and effective treatment for papular scars of the nose and chin due to acne.
Prevalence of Childhood Maltreatment and Posttraumatic Stress Symptoms Among Male Inmates in Iceland
Authors: Gunnthorsdottir Hrafnhildur , Kristofersson Gisli Kort , Gunnarsdottir Elin Dianna 
Published: May 2021

ABSTRACT

Introduction
Childhood maltreatment is highly correlated with adult criminal behavior, and the prevalence of childhood maltreatment within prison populations is high. Furthermore, studies have repeatedly shown a higher prevalence of posttraumatic stress disorder (PTSD) symptoms in samples of prisoners compared with the general public.

Purpose and Methodology
The aims of the current study were to determine the frequency of childhood maltreatment among male inmates in Iceland and the percentage of male inmates meeting screening criteria for PTSD. The Icelandic versions of the Childhood Trauma Questionnaire–Short Form and the PTSD Symptom Scale–Self-Report (PSS-SR) were used in the study.

Results
Results show a high prevalence of childhood maltreatment among the sample (N = 48), where 87% of participants reported having experienced at least one of the five categories listed (M = 2.33, SD = 1.68). Approximately 52% had experienced emotional abuse, 27% had experienced physical abuse, 48% had experienced sexual abuse, and over half reported experiencing neglect in their childhood. Two thirds of the participants were above the cutoff score for PTSD on the PTSD Symptom Scale–Self-Report, all of whom expressed a reduced quality of life and/or functional impairment because of their symptoms.

Discussion
The results indicate that most male inmates in Icelandic prisons were maltreated during their childhood and that many of them report severe posttraumatic stress symptoms.

Conclusion
By integrating trauma-focused interventions into Iceland's Prison Service, mental health nurses and other mental health professionals have an opportunity to profoundly affect prisoners' functioning and quality of life, thereby potentially reducing the likelihood of recidivism for a large part of this population in the future.
Association of ACO Shared Savings Success and Serious Illness Spending
Authors: Kaufman Brystana G. , Anderson David , Bleser William K. , Muhlestein David B. , Smith Nathan , Clough Jeffrey , McClellan Mark B. , Saunders Robert 
Published: May 2021

EXECUTIVE SUMMARY
Accountable care organizations (ACOs) need confidence in their return on investment to implement changes in care delivery that prioritize seriously ill and high-cost Medicare beneficiaries. The objective of this study was to characterize spending on seriously ill beneficiaries in ACOs with Medicare Shared Savings Program (MSSP) contracts and the association of spending with ACO shared savings. The population included Medicare fee-for-service beneficiaries identified with serious illness (N = 2,109,573) using the Medicare Master Beneficiary Summary File for 100% of ACO-attributed beneficiaries linked to MSSP beneficiary files (2014–2016). Lower spending for seriously ill Medicare beneficiaries and risk-bearing contracts in ACOs were associated with achieving ACO shared savings in the MSSP. For most ACOs, the seriously ill contribute approximately half of the spending and constitute 8%–13% of the attributed population. Patient and geographic (county) factors explained $2,329 of the observed difference in per beneficiary per year spending on seriously ill beneficiaries between high- and low-spending ACOs. The remaining $12,536 may indicate variation as a result of potentially modifiable factors. Consequently, if 10% of attributed beneficiaries were seriously ill, an ACO that moved from the worst to the best quartile of per capita serious illness spending could realize a reduction of $1,200 per beneficiary per year for the ACO population overall. Though the prevalence and case mix of seriously ill populations vary across ACOs, this association suggests that care provided for seriously ill patients is an important consideration for ACOs to achieve MSSP shared savings.
Examining the Business Case for Patient Experience: A Systematic Review
Authors: Quigley Denise D. , Reynolds Kerry , Dellva Stephanie , Price Rebecca Anhang 
Published: May 2021

EXECUTIVE SUMMARYHospitals, physician groups, and other healthcare providers are investing in improved patient care experiences. Prior reviews have concluded that better patient care experiences are associated with less healthcare utilization and better adherence to recommended prevention and treatment, clinical outcomes, and patient safety within hospitals. No comprehensive review has examined the business case for investing in patient experiences. This article reviews the literature on associations between patient experience—measured from the perspective of patients and families—and business outcomes, including patient allegiance and retention, complaints, lawsuits, provider job satisfaction, and profitability. We searched U.S. English-language peer-reviewed articles from January 1990 to July 2019. We followed the preferred reporting items for systematic reviews and meta-analyses guidelines and undertook a full-text review of 564 articles, yielding the inclusion of 40 articles. Our review found that patients with positive care experiences are more likely to return to the same hospital and ambulatory settings for future healthcare needs, retain their health plan, and voice fewer complaints. Associations between patient experiences and profitability or provider job satisfaction were limited/mixed. This suggests that providers can pursue better patient care experiences for the intrinsic value to patients, while also recognizing it is good for intermediate business outcomes: specifically increased recommendations, better patient retention, and fewer complaints. Nursing and physician care, broadly defined, are the only specific aspects of patient experience consistently associated with retention, with evidence pointing to communication and trust as parts of care linked to the intent to return. These aspects of patient experience are also the largest contributors to the overall ratings of a provider or facility.
Learning During Crisis: The Impact of COVID-19 on Hospital-Acquired Pressure Injury Incidence
Authors: Polancich Shea , Hall Allyson G. , Miltner Rebecca , Poe Terri , Enogela Ene M. , Montgomery Aoyjai P. , Patrician Patricia A. 
Published: May 2021

ABSTRACT
The impact of COVID-19, on the health and safety of patients, staff, and healthcare organizations, has yet to be fully uncovered. Patient adverse events, such as hospital-acquired pressure injuries (HAPIs), have been problematic for decades. The introduction of a pandemic to an environment that is potentially at-risk for adverse events may result in unintended patient safety and quality concerns. We use the learning health system framework to motivate our understanding of the impact of the COVID-19 pandemic on the incidence of HAPIs within our health system. Using a retrospective, observational design, we used descriptive statistics to evaluate trends in HAPI from March to July 2020. Hospital-acquired pressure injury numbers have fluctuated from a steady increase from March–May 2020, hitting a peak high of 90 cases in the month of May. However, the trend in the total all stage HAPIs began to decline in June 2020, with a low of 51 in July, the lowest number since March 2020. Patients evaluated in this study did not have a longitudinal increase in HAPIs from March–July 2020 during the COVID-19 pandemic, despite similarities in illness severity between the two time points. Our experience has demonstrated the ability of our organizational leaders to learn quickly during crisis.
American Medical Society for Sports Medicine Sports Ultrasound Curriculum for Sports Medicine Fellowships
Authors: Hall Mederic M. , Bernhardt David T. , Finnoff Jonathan T. , Hoffman Douglas F. , Hrubes Melody R. , Mautner Kenneth R. , Rao Ashwin L. , Ray Jeremiah W. , Smith Jay , Waterbrook Anna L. 
Published: May 2021

Abstract:
Sports ultrasound is commonly used by sports medicine physicians to enhance diagnostic and procedural accuracy. This expert consensus statement serves as an update to the 2015 American Medical Society for Sports Medicine recommended sports ultrasound curriculum for sports medicine fellowships. Although written in the context of the American sports medicine fellowship training model, we present a stepwise progression in both diagnostic and interventional sports ultrasound that may be applicable to the broader sports medicine community. The curriculum is divided into 12 units with each unit including didactic instructional sessions, practical hands-on instruction, independent scanning practice sessions, and mentored clinical experience. To assist with prioritization of learning, we have organized relevant pathology and procedures as essential, desirable, and optional. The expanded content can serve as an outline for continuing education postfellowship or for any physician to further advance their sports ultrasound knowledge and skill. We also provide updated scanning protocols, sample milestones, and a sample objective structured clinical examination (OSCE) to aid fellowships with implementation of the curriculum and ongoing assessment of fellow progress.
Depression, Anxiety, and Stress in Doctor of Physical Therapy Students: Analysis of Incidence and Lived Experiences
Authors: Bogardus Jennifer M. , Blackinton Mary , Litwin Bini , Morrow Nelson Terri , Mitchell Katy 
Published: May 2021

Introduction.
This study was a mixed-methods, multisite design, which aimed to determine incidence and severity of depression, anxiety, and stress in Doctor of Physical Therapy (DPT) students and to explore the lived experience of students managing mental illness while completing their academic requirements.

Methods.
Surveys were emailed to DPT programs and forwarded to students. Students enrolled in 238 DPT programs across the United Sates were eligible for inclusion. A total of 1,238 students completed both surveys. Of those who completed the surveys, 20 volunteers were randomly selected for and completed telephone interviews. Doctor of Physical Therapy students (N = 1,228) completed 2 surveys, including the Depression, Anxiety, and Stress Scale (DASS); 20 of these students volunteered to interview. Students who volunteered were invited to participate based on the DASS results. A total of 20 semi-structured interviews were completed.

Results.
Doctor of Physical Therapy students were found to have higher DASS scores than their age-matched peers in Depression t(1,227) = 2.91, P = .029; Anxiety t(1,227) = 7.33, P ≤ .005; and Stress t(1,227) = 10.76, P ≤ .005. First-year students were found to have significantly higher levels of anxiety (P = .001) and stress (P = .019) as compared with third-year students. Four major themes emerged from the interview data. Theme 4-Fear of Failure Drives Perfection was familiar to the construct of social perfectionism (SP), which has been linked to maladaptive tendencies and mental health disorders, including suicidal ideation.

Discussion/Conclusions.
Doctor of Physical Therapy students have statistically higher DASS scores when compared with their age-matched peers. First-year students seem to be at higher risk for developing anxiety and stress. The construct of SP may influence the depression, anxiety, and stress described by DPT students. Doctor of Physical Therapy programs may want to consider methods to identify maladaptive perfectionism and strategies to enhance students’ ability to manage factors affecting their mental health based on the qualitative findings of this study.
Admissions Holistic Review of Socioeconomic Factors Fosters Diversity in a Doctor of Physical Therapy Program
Authors: Coleman-Salgado Bryan 
Published: May 2021

Background and Purpose.
Holistic admissions practices may be used to increase diversity in Doctor of Physical Therapy (DPT) programs by consideration of race and ethnicity, educational disadvantaged background, low socioeconomic status, and for persons from geographically underrepresented areas. This study describes the holistic review practices in the DPT program at California State University, Sacramento (CSUS) reports the profile of socioeconomic disadvantage (SED), race, and ethnicity; analyzes the relationships between SED and racial identity; and reports acceptance rates by race and SED. The purpose of this study was to strengthen the evidence-based inclusion practices in the program's admissions processes and to offer a model to DPT programs that are seeking to assess and utilize admissions practices to increase the racial, ethnic, and socioeconomic diversity of the physical therapy profession.

Case Description.
The holistic review process at CSUS included weighting 4 Skills and Background Characteristics (SBCs) in determining admissions rankings that encompass the socioeconomic variables of the American Council of Academic Physical Therapy's definition of underrepresented minorities (URMs): 1) second language skills, 2) economic background, 3) educational background, and 4) environmental background. Admissions data were collected on all matriculated students in the first 8 years of the program and all qualified applicants in the last 3 years. Retrospective data analyses explored the relationships between SBC scores, race/ethnicity, and acceptance into the DPT program.

Outcomes.
Nearly 1 in 3 matriculants were the first in their family to graduate from college, and nearly 40% claimed a race/ethnicity other than White alone. Total SBC scores were found to be statistically significantly associated with racial identity and for underrepresented racial minorities (URRMs). Economic, educational, and environmental disadvantages were statistically significantly associated with URRMs. Acceptance into the program was found to be significantly associated with fluency and all SED variables.

Discussion and Conclusion.
Admissions weighting of SBC factors led to increased linguistic, socioeconomic, and racial diversity. Methods used in this study may serve as a model to other US Doctor of Physical Therapy programs that are seeking to offset the disadvantages that URMs have in gaining acceptance into physical therapist education programs. The expanded use of data-driven holistic admissions practices may contribute to the racial, ethnic, and socioeconomic diversity of the physical therapy profession.
Validation of the YuWell YE900 oscillometric blood pressure monitor for professional office use in adults and children according to the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018)
Authors: Zhang Hui-Jie , Zhang Juan , Wang Su-Lan , Zhang Jin , Teng Li-Ni , Zhang Shu-Juan , Zhou De-Jun , Long Ming-Zhi 
Published: May 2021

Objective
To evaluate the accuracy of the YuWell YE900 oscillometric upper-arm professional office blood pressure monitor in adults and children according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2:2018).

Methods
Subjects were recruited to fulfill the age, sex, blood pressure and cuff distribution criteria of the AAMI/ESH/ISO Universal Standard in adults and children (aged 3–12 years) using the same arm sequential blood pressure measurement method. Three cuffs of the test device were used for arm circumference 18–22 cm (small), 22–32 cm (medium) and 32–42 cm (large).

Results
Ninety-two subjects were recruited, and 85 (50 adults and 35 children) were analyzed. For validation criterion 1, the mean ± SD of the differences between the test device and reference blood pressure readings was 1.7 ± 6.62/3.1 ± 5.76 mmHg (systolic/diastolic). For validation criterion 2, the SD of the averaged blood pressure differences between the test device and reference blood pressure per subject was 5.25/5.13 mmHg (systolic/diastolic).

Conclusion
The YuWell YE900 professional electronic blood pressure monitor has passed the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) in adults and children and can be recommended for clinical use.
Clinical impact of blood pressure variability in patients with COVID-19 and hypertension
Authors: Nam Jong-Ho , Park Jong Il , Kim Byung-Jun , Kim Hun-Tae , Lee Jung-Hee , Lee Chan-Hee , Son Jang-Won , Kim Ung , Park Jong-Seon , Shin Dong-Gu , Hong Kyung Soo , Jang Jong Geol , Ahn June Hong , Jin Hyun Jung , Choi Eun Young , Shin Kyeong-Cheol , Chung Jin Hong , Lee Kwan Ho , Hur Jian , Hong Young-Hoon , Lee Choong-Ki 
Published: May 2021

Objective
This study aimed to investigate the relationship between blood pressure variability (BPV) and clinical outcomes in patients with coronavirus disease 2019 (COVID-19) and hypertension.

Methods
A total of 136 patients hospitalized with COVID-19 were enrolled in this study. Patients were grouped according to the presence of hypertension and BPV. Mean arterial pressure (MAP) measured at 8 a.m. and 8 p.m. was analyzed, and BPV was calculated as the coefficient of variation of MAP (MAPCV). High BPV was defined as MAPCV values above the median. We compared the age, level of C-reactive protein (CRP), creatine kinase-MB (CK-MB), N-terminal pro-B type natriuretic peptide (NT-proBNP), creatinine and in-hospital mortality and investigated the relationship among the groups.

Results
COVID-19 patients with hypertension were older (70 ± 12 vs. 53 ± 17 years; P < 0.001), had higher levels of CRP (9.4 ± 9.2 vs. 5.3 ± 8.2 mg/dL; P = 0.009), MAPCV (11.4 ± 4.8 vs. 8.9 ± 3.2; P = 0.002), and higher in-hospital mortality (19.6% vs. 5.9%; P = 0.013) than those without hypertension. There was a proportional relationship between BPV and age, levels of CRP, CK-MB, NT-proBNP, creatinine and in-hospital mortality (all, P < 0.05). In Cox regression analysis, advanced age [≥80 years, hazard ratio (HR) 10.4, 95% confidence interval (CI) 2.264–47.772, P = 0.003] and higher MAPCV (HR 1.617, 95% CI, 1.281–2.040, P < 0.001) were significantly associated with in-hospital mortality.

Conclusion
High BPV in COVID-19 patients with hypertension is significantly associated with in-hospital mortality. Advanced age and systemic inflammation are proportional to high BPV. Additional attention is needed for COVID-19 patients with hypertension and high BPV.