bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Pressure Injury Prevention Practices Among ICU Nurses in China
Authors: Hu Li , Sae-Sia Wipa , Kitrungrote Luppana 
Published: September 2021

ABSTRACT

OBJECTIVE
To explore the predictors of knowledge of pressure injury (PI) prevention, attitudes on PI prevention, organization support for PI prevention, and the influence of a healthy work environment (HWE) on PI prevention practices among ICU nurses in China.

METHODS
A descriptive, predictive, online survey was conducted among 510 ICU nurses in Guizhou province, China. A PI prevention knowledge questionnaire, PI prevention attitude questionnaire, organizational support for PI prevention questionnaire, HWE assessment tool, and PI prevention practice questionnaire were used for data collection. A hierarchical regression analysis was used to determine the influence of certain predictive factors.

RESULTS
An HWE, organizational support for PI prevention, and positive attitudes toward PI prevention were significant predictors of good practice regarding PI prevention. However, knowledge of PI prevention was not a significant predictor.

CONCLUSIONS
To achieve optimal nursing quality in terms of PI prevention, hospital and nursing administrators should develop strategies or interventions to create and sustain an HWE and supportive organizational culture for ICU nurses and enhance positive attitudes toward PI prevention.
Decoding Billing Practices in Cochlear Implant Programs
Authors: Hall Melissa W. , Prentiss Sandra M. , Coto Jennifer , Zwolan Teresa A. , Holcomb Meredith A. 
Published: September 2021

Objectives:
The purpose of this study was to examine current cochlear implant (CI) billing practices across CI audiologists in the United States, to determine if CI audiologists are following the National Correct Coding Initiative (NCCI) edits, and to assess the CI audiologist’s exposure to billing education.

Design:
A 48-question survey was electronically distributed to and completed by audiologists who bill for CI services. Demographic data including work setting, population served, years of experience, number of CI patients managed per week, and exposure to billing education were collected. Data were analyzed to identify codes and modifiers used to bill for commonly performed CI procedures such as unilateral and bilateral CI programming, preoperative and postoperative testing, and objective measures.

Results:
Data were obtained from 96 audiologists. The majority (86.3%, n = 82) of respondents agreed or strongly agreed they understand billing and coding practices for cochlear implants and 94.7% (n = 89) rated themselves as somewhat to highly efficient when performing these practices. Only 16.8% (n = 16) of respondents reported receiving formal training for practice management, and half of the respondents (51.1%, n = 48) reported unfamiliarity with national billing guidelines. Those who received formal training reported higher billing efficiency. Wide variability was seen for various billing scenarios. Billing questions were presented, and answers were coded as correct or incorrect based on the NCCI edits. Respondents who reported higher agreement with understanding billing and who received formal training scored better on common billing questions related to the NCCI edits.

Conclusions:
Most CI audiologists rated themselves as efficient in billing; however, wide variance in billing practices was observed. Incorporating practice management and current billing education into daily practice and into audiology training programs is essential to clinic efficiency, practice management, and CI program viability. CI audiologists should be knowledgeable about appropriate billing practices to ensure long-term sustainability of programs.
Biomechanical Comparison of 2 Double Plating Methods in a Coronal Fracture Model of Bicondylar Tibial Plateau Fractures
Authors: Samsami Shabnam , Pätzold Robert , Neuy Tim , Greinwald Markus , Müller Peter E. , Chevalier Yan , Püschel Klaus , Augat Peter 
Published: September 2021

Objectives:
Because management of bicondylar tibial plateau fractures are complicated even for expert surgeons, with using a coronal fracture model, we aimed to compare 2 kinds of double locked plating techniques that consisted of the lateral locking plate and the medial locking plate inserted medial anteriorly (MA-ly) or medial posteriorly (MP-ly).

Methods:
Fourteen fresh-frozen tibias stabilized with the MA or MP methods were allocated into 2 groups with similar bone mineral density values. Implanted samples were tested under incremental fatigue loading conditions using a customized load applicator. An optical motion tracking system was used to assess relative displacements and rotations of fracture fragments during loading. Static and dynamic global stiffness, failure load, failure cycles, as well as movements of fracture fragments were measured.

Results:
There were no significant differences between the 2 fixation methods regarding global stiffness, failure load, or failure cycles (P = 0.67–0.98, depending on the parameter). The kinematic evaluations, however, revealed that different positions of the medial locking plates altered the directions of movements for the medial-anterior or medial-posterior fracture segments.

Conclusions:
The mechanical stability of tibia-implant constructs fixed with the double plating methods was not remarkably affected by the location of the medial locking plate. Depending on clinical conditions and surgeons' preferences, bicondylar tibial plateau fractures can be managed with either MA or MP methods.
Risk of Surgical Site Infections in OTA/AO Type C Tibial Plateau and Tibial Plafond Fractures: A Systematic Review and Meta-Analysis
Authors: Bullock Travis S. , Ornell Samuel S. , Naranjo Jose M. G. , Morton-Gonzaba Nicholas , Ryan Patrick , Petershack Matthew , Salazar Luis M. , Moreira Alvaro , Zelle Boris A. 
Published: September 2021

Objectives:
To analyze the current incidence of postoperative infection for OTA/AO type C fractures of the tibial plateau and tibial plafond.

Data Sources:
Three medical databases: PubMed/MEDLINE, ScienceDirect, and the Cochrane Library, were used in our systematic literature search. Search results were restricted to articles transcribed in English/Spanish and publication date after January 1, 2000, to present day.

Study Selection:
Inclusion criteria were studies reporting postoperative infection data for OTA/AO type 41C, 43C, or equivalent fractures of skeletally mature individuals. A minimum of 6 total fractures of interest and a frequency of 75% overall were required. Studies reporting on pathologic fractures, stress fractures, or low-energy fracture types were excluded.

Data Extraction:
Two authors independently screened abstracts, evaluated full-text manuscripts, and extracted relevant data from included studies. Any instances of discrepancy were resolved within the study committee by consensus.

Data Synthesis:
Outcomes were expressed using direct proportions (PR) with a 95% confidence interval. The effects of comorbidities on infection rates were reported using odds ratios with a 95% confidence interval. All analyses used a DerSimonian–Laird estimate with a random-effects model based on heterogeneity. The presence of publication bias was evaluated using funnel plots and Egger's tests.

Conclusions:
Patients with these specific fractures develop infections at a notable frequency. The rates of deep infections were approximately 6% in tibial plateau fractures and 9% in tibial plafond fractures. These results may be useful as a reference for patient counseling and other future studies aimed at minimizing postoperative infection for these injuries.

Level of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Financial Analysis of Cardiac Rehabilitation and the Impact of COVID-19
Authors: Melbostad Heidi S. , Savage Patrick D. , Mahoney Katharine , Gaalema Diann E. , Ades Philip A. , Shepard Donald S. 
Published: September 2021

Purpose:
Provision of phase 2 cardiac rehabilitation (CR) has been directly impacted by coronavirus disease-19 (COVID-19). Economic analyses to date have not identified the financial implications of pandemic-related changes to CR. The aim of this study was to compare the costs and reimbursements of CR between two periods: (1) pre-COVID-19 and (2) during the COVID-19 pandemic.

Methods:
Health care costs of providing CR were calculated using a microcosting approach. Unit costs of CR were based on staff time, consumables, and overhead costs. Reimbursement rates were derived from commercial and public health insurance. The mean cost and reimbursement/participant were calculated. Staff and participant COVID-19 infections were also examined.

Results:
The mean number of CR participants enrolled/mo declined during the pandemic (−10%; 33.8 ± 2.0 vs 30.5 ± 3.2, P = .39), the mean cost/participant increased marginally (+13%; $2897 ± $131 vs $3265 ± $149, P = .09), and the mean reimbursement/participant decreased slightly (−4%; $2959 ± $224 vs $2844 ± $181, P = .70). However, these differences did not reach statistical significance. The pre-COVID mean operating surplus/participant ($62 ± $140) eroded into a deficit of −$421 ± $170/participant during the pandemic. No known COVID-19 infections occurred among the 183 participants and 14 on-site staff members during the pandemic period.

Conclusions:
COVID-19-related safety protocols required CR programs to modify service delivery. Results demonstrate that it was possible to safely maintain this critically important service; however, CR program costs exceeded revenues. The challenge going forward is to optimize CR service delivery to increase participation and achieve financial solvency.
THE SPECTRUM OF INTERNAL LIMITING MEMBRANE DISEASE IN ALPORT SYNDROME
Authors: Cicinelli Maria Vittoria , Ritter Markus , Ghossein Cybele , Aschauer Constantin , Laccone Franco , Nagel Mato , Schmidt-Erfurth Ursula M. , Jampol Lee M. , Gill Manjot K. 
Published: September 2021

Purpose:
To characterize the spectrum of internal limiting membrane (ILM) disease in Alport syndrome using multimodal imaging, including widefield (WF) and ultra-widefield (UWF) modalities, and to report their relative prevalence according to the genetic pattern of inheritance.

Methods:
Cross-sectional clinical study of patients diagnosed with Alport syndrome. All patients underwent UWF color photography and autofluorescence, WF-optical coherence tomography angiography and spectral-domain optical coherence tomography. Demographics, past medical and ophthalmic history, and genetic mutation history were collected.

Results:
Forty-two eyes of 21 patients (11 men; age 36.6 ± 12.9 years) were included. Macular spectral-domain optical coherence tomography revealed ILM granularity, more frequent in X-linked Alport syndrome and corresponding to dot maculopathy on color fundus. Mid-peripheral spectral-domain optical coherence tomography scans revealed multilamellated ILM in eight eyes (19%), presumably progressive, which corresponded to a cavitary pattern on en-face OCT. En-face OCT revealed multiple areas of retinal nerve fiber layer dehiscence in the macula, overlapping with vascular lacunae on optical coherence tomography angiography, and a coarse arrangement of retinal nerve fiber layer above and below the temporal raphe in 20 eyes (52%).

Conclusion:
Multimodal imaging allowed for the detection/characterization of retinal findings (ILM granularity, progressive ILM lamellation, retinal nerve fiber layer dehiscence, vascular lacunae, and coarse arrangement of retinal nerve fiber layer toward the disc) as multifaceted manifestations of ILM disease in Alport syndrome.
MYOPIC PRESENTATION OF CENTRAL SEROUS CHORIORETINOPATHY
Authors: Ravenstijn Monica , van Dijk Elon H. C. , Haarman Annechien E. G. , Kaden Talia R. , Vermeer Koenraad A. , Boon Camiel J. F. , Yannuzzi Lawrence A. , Klaver Caroline C. W. , Yzer Suzanne 
Published: September 2021

Purpose:
To increase insight into the myopic presentation of central serous chorioretinopathy (CSC) by comparing a large group of myopic patients with CSC with reference groups with only one of the diagnoses.

Methods:
Myopic patients with CSC (spherical equivalent ≤−3D, n = 46), emmetropic patients with CSC (spherical equivalent −0.5 to 0.5 D, n = 83), and myopic, non-CSC patients (n = 50) were included in this multicenter cross-sectional study. Disease characteristics and imaging parameters, such as subfoveal choroidal thickness and indocyanine green angiography patterns, were compared between cases and reference groups.

Results:
In myopic patients with CSC, median subfoveal choroidal thickness (286 µm [IQR 226–372 µm]) was significantly thicker than subfoveal choroidal thickness in myopic, non-CSC patients (200 µm [IQR 152–228 µm], P < 0.001) but thinner than emmetropic patients with CSC (452 µm [IQR 342–538 µm], P < 0.001). They also had pachyvessels in 70% of the eyes comparable with emmetropic CSC (76%, P = 0.70). Choroidal hyperpermeability was frequently present on indocyanine green angiography in both myopic and emmetropic CSC eyes. Need for treatment, treatment success, and recurrence rate were not significantly different between CSC groups.

Conclusion:
Myopic CSC presents with similar imaging and clinical characteristics as emmetropic CSC, apart from their thinner choroids. Keeping in mind the structural changes of myopia, other imaging characteristics could aid the diagnostic process.
Anterior Scleral and Limbal Inflammatory Necrosis After Adjuvant Miltefosine for Recalcitrant Acanthamoeba Keratitis
Authors: de la Presa Martin , Ibach Mitch , Berdahl John , Holland Edward J. 
Published: September 2021

Purpose:
The purpose of this study was to report a retrospective case series of anterior scleral and limbal inflammatory necrosis after adjuvant miltefosine for recalcitrant Acanthamoeba keratitis (AK).

Methods:
A case series and literature review.

Result:
Four eyes of 3 patients with recalcitrant AK developed anterior scleral and limbal inflammatory necrosis with significant scleral-limbal thinning after treatment with miltefosine. The average age was 38 years, and the average duration of infection before miltefosine treatment was 239 days. All cases required urgent surgical intervention to either prevent or mitigate corneal–limbal perforation.

Conclusions:
Miltefosine has been observed to result in the resolution of AK when used as an adjunctive therapy. It may also lead to a consecutive inflammatory necrosis of the anterior sclera and limbus. This inflammatory response may be significant enough to cause rapid scleral-limbal thinning with subsequent perforation.
Home Coping Strategies for Fatigue Used by Patients With Lung Cancer Receiving Chemotherapy in Rural China: A Qualitative Study
Authors: DONG Xiaomeng , PENG Jianying , LI Xingxing , ZHAO Qiyuan , ZHANG Xiuwei 
Published: September 2021

ABSTRACT

Background
Cancer-related fatigue, a distressing symptom, is frequently reported by patients with lung cancer as increasing in severity with the number of rounds of chemotherapy. Yet, patients and healthcare providers are challenged to control this fatigue. Thus, healthcare providers must have interventions to effectively enhance coping engagement in patients with lung cancer.

Purpose
The aims of this study were to explore how patients with lung cancer in a rural area of China undergoing chemotherapy cope with the fatigue at home and to summarize their strategies.

Methods
A descriptive qualitative research approach was used, and data were collected using semistructured interviews. Sixteen patients with lung cancer with chemotherapy-related fatigue living in rural communities were recruited from a large, tertiary teaching hospital in Huzhou in eastern China. The transcripts of the interviews were analyzed using content analysis.

Results
Coping strategies for cancer-related fatigue were delineated into the three themes of (a) psychological adjustment, (b) efforts to change lifestyles and act as a Chinese health practitioner, and (c) relying on social support.

Conclusions/Implications for Practice
The participants in this study provided information on a variety of approaches to reducing/alleviating cancer-related fatigue that were influenced by Chinese culture. Healthcare providers and patients may work together in clinical settings to identify appropriate, effective coping solutions and then to incorporate these into the regular care regimen to help patients transition between hospital and home.
Comparison of therapeutic effects of different acupuncture and moxibustion therapies on irritable bowel syndrome
Authors: Guo Jialei , Yang Li , He Jing , Yang Zhengming 
Published: September 2021

Abstract

Background:
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with recurrent abdominal pain and changes in bowel habits. Many pieces of evidence show that acupuncture and moxibustion therapy has advantages in the treatment of IBS, but there are many acupuncture and moxibustion therapy options, each of which has different therapeutic effects. This study will evaluate the clinical efficacy of different acupuncture and moxibustion therapies in the treatment of IBS by means of a network meta-analysis.

Methods:
According to the retrieval strategy, we retrieved the randomized controlled trials of acupuncture and moxibustion treatment of IBS from China National Knowledge Infrastructure, Wanfang, VIP, Chinese biomedical databases, PubMed, Embase, Web of Science, and the Cochrane Library databases from the database establishment to July 2021. We assessed the quality of the studies using the Cochrane Risk Bias Assessment Tool and assessed the strength of the evidence using the Grading of Recommendation Assessment, Development, and Evaluation methodology. All data analyses were performed by RevMan5.3, Gemtc 0.14.3, and Stata 14.0.

Results:
This study evaluated the efficacy of different acupuncture and moxibustion therapies in the treatment of IBS by evaluating the clinical efficacy rate, symptom scores, quality of life scores, adverse reactions, etc, and further explore the mechanism of action of each therapy.

Conclusion:
This study will provide a reliable evidence-based basis for selecting the best acupuncture and moxibustion therapy for IBS.

Ethics and dissemination:
Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.

OSF Registration number:
DOI 10.17605/OSF.IO/3278Y
The postoperative choledochoscopy in the management of the residual hepatolithiasis involving the caudate lobe
Authors: Liang Li , Zhuang Donghai , Feng Xianguang , Zhang Kai , Zhi Xuting 
Published: September 2021

Abstract
To reveal the role of the postoperative choledochoscopy in treating the residual calculi in the caudate lobe (CL) of the liver.
We recruited 66 patients with T-tube/percutaneous transhepatic cholangioscopy tract who still had residual gallstones in the CL at least 6 weeks after the operation. Imaging examinations determined the gallstones’ locations in the patients, and all of them underwent the postoperative choledochoscopic examination through the T-tube/percutaneous transhepatic cholangioscopy tract for therapeutic intervention.
Among the 66 patients, the residual gallstones were mostly located in the Spiegel lobe (48/66, 72.7%), and the residual gallstones that located in the origin of the CL bile branches were successfully determined in the 57 patients (57/66, 86.4%), the remaining 9 patients were unclear because the proximal ducts were severely narrow or even atresia. The mean frequency of the postoperative choledochoscopy was 3.6 (range, 1–10) times. There were 9 patients with complications, and no mortality occurred. In the origin-proved 57 patients, 6 patients failed to remove the gallstones altogether, and the final residual gallstone clearance rate was 77.3% (51/66). There was no significant difference between the Spiegel lobe and the other parts of the CL in determining the bile duct's origins, gallstone clearance rate, and complications. However, the frequency of choledochoscopy in the other parts of the CL was more than in the Spiegel lobe.
The postoperative choledochoscopy, an essential method for treating the residual gallstones in the CL, commands high efficiency for calculi extraction and fewer complications. The main reasons for failing to remove the residual gallstones are that the bile duct's origins could not be determined, and the distal bile ducts are atretic in the CL.
Natural course of hemoglobin level after total knee arthroplasty and the benefit of tranexamic acid injection in the joint
Authors: Cho Myung Rae , Jun Chung Mu , Song Suk Kyoon , Choi Won Kee 
Published: September 2021

Abstract
We retrospectively investigated the natural course of hemoglobin (Hb) level after total knee arthroplasty (TKA) and identified the benefit of tranexamic acid injection at the operation field for unilateral TKA patients who have not received blood transfusions.
There were 115 cases conducted by a surgeon who performed TKA without injecting tranexamic acid and 62 cases by another surgeon with injection. During 2-weeks of hospitalization, Hb level was checked on the day of surgery and 1, 2, 3, 5, 7, 11 days after surgery.
Regardless of whether whom the operator was and tranexamic acid was injected or not, the same natural course of Hb level after TKA was observed. The lowest value of Hb was shown at postoperative day 3, after which it tended to recover. In repeated measures analysis of variance test, mean difference from preoperative Hb level showed a statistically significant difference between tranexamic acid injected and noninjected groups (P = .01). In post hoc test, the differences from preoperative Hb levels were significantly lower at all measurements in surgeon with injection of tranexamic acid.
When deciding whether to transfuse after TKA, it should be noted that the patient tends to show the lowest Hb level on postoperative day 3. Also, the authors emphasize that tranexamic acid injection in the joint at the operation field is an effective method to reduce the loss of Hb after TKA.
Cardiopulmonary function findings of pediatric patients with patent ductus arteriosus
Authors: Huang Hung Ya , Wang Shang Po , Tuan Sheng Hui , Li Min Hui , Lin Ko Long 
Published: September 2021

Abstract
Transcatheter occlusion and surgical ligation are the treatments of choice for most patent ductus arteriosus (PDA) in children. Fifty-five children who had PDA completed a pulmonary function test and a symptom-limited treadmill exercise test from 2016 to 2018 at 1 medical center in southern Taiwan. The study group was divided into surgical ligation and catheterization groups, which were compared to a healthy control group matched for age, sex, and body mass index. Data about the performance on the exercise test, including metabolic equivalent at anaerobic threshold and peak, were analyzed. No differences in the pulmonary function and ventilatory parameters were observed between the surgery, catheterization, and control groups. Heart rate at peak and at anaerobic threshold significantly differed in the investigated groups. The post hoc analysis showed that the surgery group had a lower heart rate at peak and threshold compared to the catheterization and control groups (P = .02, P < .001, respectively). No significant difference was found between the catheterization group and the control group. A larger and younger group of patients were recruited, allowing for newer data about the cardiopulmonary function to be obtained. The findings suggest that patients with PDA could undergo physical training after intervention. The imposition of restrictions to limit sports activities should be avoided.