bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medicolegal Considerations Regarding Steroid Use in Otolaryngology: A Review of the Literature
Authors: Young Kurtis , Koshi Elliott J. , Mostales Joshua C. , Saha Bibek , Burgess Lawrence P. 
Published: June 2021

Objective: To review the literature on corticosteroid use and provide recommendations on patient counseling and/or consent to promote judicious prescribing and reduce the incidence of corticosteroid-related lawsuits. Method: A conventional literature search of PubMed on corticosteroid-related medicolegal cases was undertaken. Search terms included “medicolegal,” “otolaryngology,” and “adrenocorticosteroids.” A medical subjects headings search with the keywords “adrenal cortex hormones” and “jurisprudence” was also performed. Results: Corticosteroids have been reported as the third most frequent medication involved in malpractice claims, oftentimes leading to disproportionately costly payments. The most common specialties found to be involved in corticosteroid related medicolegal cases included dermatology (12%), primary care (10%), and neurologists or neurosurgeons (6%). The most common complications encountered were avascular necrosis (39%), changes in mood (16%), infection (14%), and vision changes (14%). Only a few cases corticosteroid-related litigation regarding otolaryngologists were identified. More frequent causes for otolaryngology claims were intraoperative complications, deficits in diagnoses, and failures or delays in treatment. Three medicolegal pitfalls regarding corticosteroid use were identified from this review included: (1) insufficient advising, (2) lack of or incomplete informed consent, and (3) the significance of the patient-physician relationship. Conclusion: Despite the scarcity of corticosteroid-related medicolegal literature pertaining to otolaryngologists, corticosteroids are one of the most widely prescribed medications in the field of otolaryngology and have been shown to have a high rate of medical malpractice claims in medicine. Counseling and consenting the patient, as well as developing a strong physician-patient relationship, are integral processes in addressing any adverse effects occurring during therapy, and may also help to decrease the incidence and success of litigation against otolaryngologists.
Looking for Medical Advice in Everyday Digital Spaces: A Qualitative Study of Indians Connecting with Physicians on Facebook
Authors: Mishra Smeeta 
Published: June 2021

In a world afflicted by COVID-19, many people consult doctors through a digital interface or over the phone, as face-to-face consultations are almost impossible during a lockdown. The Medical Council of India and the NITI Aayog, a policy think tank, formulated new guidelines to empower medical practitioners to practice telemedicine in India in March 2020. Even before the COVID-19 pandemic gripped the world and made digital consultations a necessity in specific cases, academic studies located within a health promotion framework in Western contexts indicated that patients have been very much interested in using social media tools to communicate with their physicians. Previous studies have also highlighted the advantages of information and communication technologies for patient–doctor interaction. Since changes introduced by digital health technologies have primarily been analysed from such health promotion perspectives that often adopt a ‘techno-utopian’ lens ( Lupton, 2013 ), it becomes imperative to critically interrogate how such changes construct specific subjectivities and shape our understandings of health and normative healthcare practices. Specifically, scholars have highlighted how social media platforms and apps act as ‘performative devices’ ( Johnson, 2014 ) that influence ‘everyday management of illness and health’ and help create the ideal of the ‘digitally engaged patient’ ( Lupton, 2013 ). In the Indian context, media reports highlight a growing trend in the use of social media platforms and apps by physicians and patients. However, academic research on such emerging phenomena in this country is still scarce. This exploratory study examines why some Indians connect with physicians on a social media platform such as Facebook, the nature of communication between them and their understandings of health. It uses in-depth interviews and draws upon neoliberal governmentality as a theoretical anchor. The findings show how the internalization of neoliberal values and assumptions are associated with participants’ search for lifestyle and medical advice in everyday digital spaces such as Facebook. This study strives to extend the concept of neoliberal governmentality to performances in everyday digital spaces such as Facebook. In terms of practical implications, the results of the study highlight the critical need for policies that regulate the medical content available in social media spaces. Most importantly, some of the issues highlighted by the participants in this study can help policymakers take adequate precautions while formulating guidelines on digital consultations, especially during pandemics and their aftermath when there is tremendous pressure to promote telemedicine.
Personality Traits Leads to Investor’s Financial Risk Tolerance: A Structural Equation Modelling Approach
Authors: Rai Kamini , Gupta Abha , Tyagi Anshu 
Published: June 2021

In today’s scenario, investors’ preferences towards different investment avenues depend upon their risk tolerance level and return associated with investment plan. The tolerance level of investors for risk is influenced by many demographic and psychological factors. Personality traits (PTs) are one of the important factors that impact the tolerance levels of investors for risk. Thus, the existing study focuses on whether (a) the direct effect of Big Five PTs on financial risk tolerance (FRT) or (b) PTs as a second-order (higher-order) factor leads to FRT. Data are cross-sectional in nature, which were collected from 599 investors who invested through Angel Broking Co. (Securities co.) in Delhi and the National Capital Region (NCR) by using online structured questionnaire. To examine the strength of the relationship between variables’ correlation and regression tests were applied using the structural equation modelling approach. The study found that among Big Five personality dimensions, only agreeableness, conscientiousness and openness are significantly associated with FRT, whereas PTs as a second-order (higher-order) factor have a strong association with FRT of investors. Thus, the PT as a second order is the preferred model. JEL Code: G02
Regularity of contact with general practitioners and diabetes-related hospitalisation through a period of policy change: A retrospective cohort study
Authors: Youens David , Preen David B , Harris Mark , Wright Cameron , Moorin Rachael 
Published: June 2021

Background This study evaluated changes in regularity of general practitioner (GP) contact (the pattern of visits over time) and the impact of regularity on diabetes-related hospitalisation following introduction of care co-ordination incentives. Methods Linked primary care, hospital and death records covered West Australian adults from 1991–2004. Different eras were evaluated based on incentive program changes and model fit, to assess changes in regularity. Changes in regularity, derived from the variance in the number of days between GP contacts, were evaluated using ordered logistic regression. The impact of regularity on hospitalisation rates and costs were evaluated. Results Two eras prior to program introduction (1991/92–1994/9 and 1995/96–1998/99), and one after (1999/2000–2002/03) were assessed. Among 153,455 at risk of diabetes-related hospitalisation GP contact became slightly less regular in the second era, though there was no change from the second to third era. The most regular decile had 5.5% fewer hospitalisations (95% CI -0.9% to -9.9%) and lower per-patient costs (difference AU$115, CI -$63 to -$167) than the least regular. Associations were similar in each era. Conclusions Ongoing relationships between GPs and patients are important to maintaining health. Historical data provide the opportunity to assess the impact of care co-ordination incentives on relationships.
Musical communities in the society of captives: Exploring the impact of music making on the social world of prison
Authors: Doxat-Pratt Sarah 
Published: June 2021

This article examines the ways in which music making can inspire and facilitate social change amongst the “society of captives.” It explores the social dynamics of prison music projects, and then looks at the ways in which music making can begin to transform the wider social world of prison. It reports a qualitative investigation of two such projects delivered by the Irene Taylor Trust (ITT) in a medium-security, adult male prison in England. Methods comprised participant observations of the projects over a period of 14 months, and semi-structured interviews with prisoner participants, facilitators, and members of prison staff. Much research shows that taking part in prison music projects can help participants develop social skills and thus contribute to their rehabilitation and desistance from crime. The present study revealed that the ITT projects were not merely the setting for learning individual social skills; the participants also felt themselves to be joining or forming a community that was distinct from the wider prison community. The impact of their musical activities on their lives in prison was as important to them as its potential contribution to their lives following release. The findings are discussed with reference to the work of DeNora, suggesting that music projects can provide the setting for removal communities, with norms distinct from and better than those of typical social life in prison, and can transform or refurnish the wider prison environment, as participants continue their music making on the landings and in their cells.
The Intraseptal Course of the Superficial Peroneal Nerve: An Anatomic Study
Authors: Valisena Silvia , Gamulin Axel , Hannouche Didier 
Published: June 2021

Background: Anatomic and clinical studies show many variants of the superficial peroneal nerve (SPN) course and branching within the compartments and at the suprafascial layer. The anatomy of the transition zone from the compartment to the subcutaneous layer has been occasionally described in the literature, mainly in studies reporting the intraseptal SPN variant in 6.6% to 13.6% of patients affected by the SPN entrapment syndrome. Despite the little evidence available, the knowledge of the transition zone is relevant to avoid iatrogenic lesions to the SPN during fasciotomy, open approaches to the leg and ankle, and SPN decompression. Our anatomic study aimed to describe the SPN transition site and to evaluate the occurrence of a peroneal tunnel and of an intraseptal SPN variant. Methods: According to the institutional ethics committee requirements, 15 fresh-frozen lower limbs were dissected to study the SPN course and its branching, focusing on the transition site to the suprafascial layer. Results: The SPN was located in the anterior compartment in 2 cases and in the lateral in 13. An intraseptal tunnel was present in 10 legs (66%), at a mean distance of 10.67 cm from the lateral malleolus. Its mean length was 2.63 cm. The tunnel allowed the passage of the main SPN in 8 cases and of its branches in two. In the remaining 5 legs (33%), the SPN pierced a crural fascia window. Conclusion: In our sample a higher rate than expected of intraseptal SPN variants was found. Clinical Relevance: The knowledge of the anatomy of the SPN course and intraseptal variant is relevant to avoid iatrogenic lesions during operative dissection. Further studies are needed to evaluate the effective prevalence of an intraseptal tunnel, independently from the SPN entrapment syndrome, and how to avoid associated iatrogenic complications.
Vascular access and clinical competency: Which elements matter? The development of three bottom-up and evidence-grounded self-assessment tools
Authors: Rigo Carla , Grazioli Marco , Caravella Giuseppe , Ursino Francesco , Zerla Pietro , Magon Arianna , Dellafiore Federica , Caruso Rosario 
Published: June 2021

Background: Assessing competency in the speciality of vascular access is still limited, and few valid and reliable tools are available. Therefore, this study aimed to develop and validate three different tools for assessing competency in managing the care of short peripheral cannulas (SPCs), midlines, peripherally inserted central catheters (PICCs), centrally inserted central catheters (CICCs), and arterial catheters (ACs) (tool one), placing SPCs (tool two), placing PICCs and midlines (tool three). Methods: A two-phase and multi-method design was adopted. Phase one was implemented to develop the initial pool of items for each tool, starting from a literature overview. Panel discussions were adopted for developing the items. In phase two, the developed items were tested for content and face validity, involving a panel of 10 experts. Once obtained adequate content validity, a cross-sectional data collection was implemented to enroll three samples of healthcare workers who had to assess their competency through the developed tools. Dimensionality was assessed by performing a principal component analysis (PCA) and assessing internal consistency (Cronbach’s α). Results: Tool one had 26 items, and the dimensionality was given by placement, risk assessment, procedure conformity and traceability, and patient education to self-care. Tool two had 35 items; its principal components were: risk evaluation, identification, clinical assessment and orientation to self-care, placement, and procedure registration shaped the competency of placing SPCs. Tool three had 31 items; its principal components were: risk assessment, placement, conformity to standards and procedure traceability, education, and orientation to self-care were the essential elements for adequately placing midlines and PICCs. Cronbach’s α values ranged between 0.806 and 0.959. Conclusions: The three developed tools reflected the core elements of competency in each application area, representing an initial framework that could be useful in future research and educational projects. Cross-national investigations are required to corroborate the described results.
Taurolidine lock in the treatment of colonization and infection of totally implanted venous access devices in cancer patients
Authors: Brescia Fabrizio , Pittiruti Mauro , Scoppettuolo Giancarlo , Zanier Chiara , Nadalini Elisa , Bottos Paola , Moreal Chiara , Da Ros Valentina , Fabiani Fabio 
Published: June 2021

Background: Taurolidine lock is known to be effective in preventing catheter-related infections in a variety of venous access devices, including long term venous access devices for chemotherapy. Though, literature about the use of taurolidine for treating catheter colonization or catheter-related blood stream infection is scarce. Method: We have retrospectively reviewed the safety and efficacy of 2% taurolidine lock for treatment of catheter-colonization and of catheter-related bloodstream infection in cancer patients with totally implanted venous access devices. Diagnosis of colonization or catheter-related infection was based on paired peripheral and central blood cultures, according to the method of Delayed Time to Positivity. Results: We recorded 24 cases of catheter-related infection and two cases of colonization. Taurolidine lock—associated with systemic antibiotic therapy—was successful in treating all cases of catheter-related infection, with disappearance of clinical symptoms, normalization of laboratory values, and eventually negative blood cultures. Taurolidine lock was also safe and effective in treating device colonization. No adverse effect was reported. Conclusion: In our retrospective analysis, 2% taurolidine lock was completely safe and highly effective in the treatment of both catheter-colonization and catheter-related bloodstream infection in cancer patients with totally implanted venous access devices.
Chest-to-arm tunneling: A novel technique for medium/long term venous access devices
Authors: Annetta Maria Giuseppina , Ostroff Matt , Marche Bruno , Emoli Alessandro , Musarò Andrea , Celentano Davide , Taraschi Cristina , Dolcetti Laura , Greca Antonio La , Scoppettuolo Giancarlo , Pittiruti Mauro 
Published: June 2021

Background: Chest-to-arm (CTA) tunneling has been described recently as a technique that allows an optimal exit site at mid-arm even in chronically ill patients with complex clinical issues and challenging problems of vascular access. Method: We adopted CTA tunneling in oncologic and in non-oncologic patients, in totally implanted and in external devices, for both medium and long-term intravenous treatments. We report our experience with 60 cases of CTA tunneling: 19 patients requiring a totally implantable device, who had bilateral contraindication to venous access at the arm and bilateral contraindication to placement of the pocket in the infra-clavicular area; 41 patients requiring an external central venous catheter, who had bilateral contraindication to insertion of peripherally inserted central catheters or femoral catheters, as well as contraindication to an exit site in the infraclavicular area. All venous access devices were inserted with ultrasound guidance and tip location by intracavitary electrocardiography, under local anesthesia. Results: There were no immediate or early complications. Patients with CTA-ports had no late complications. In patients with CTA-tunneled external catheters, there were two dislodgments, four episodes of central line associated blood stream infections, and one local infection. There were no episodes of venous thrombosis or catheter malfunction. Conclusion: Our experience suggests that CTA tunneling is a safe maneuver, with very low risk of complications, and should be considered as an option in patients with complex venous access.
COVID-19 among young adults in Sweden: self-reported long-term symptoms and associated factors
Authors: Ekström Sandra , Andersson Niklas , Lövquist Alexandra , Lauber André , Georgelis Antonios , Kull Inger , Melén Erik , Bergström Anna 
Published: June 2021

Aims: The main aim of the study was to describe self-reported symptoms of COVID-19 and examine if long-term symptoms are associated with lifestyle factors or common chronic diseases among Swedish young adults. A secondary aim was to compare the prevalence of smoking and snuff use before and during the COVID-19 pandemic. Methods: The study population includes 1644 participants aged 23–26 years from the Swedish population-based birth cohort BAMSE. From August to November 2020, the participants answered a web questionnaire on COVID-19 symptoms, lifestyle and health. Information on tobacco use was compared against the previous study follow-up in 2016–2019. Results: The prevalence of suspected COVID-19 symptoms was 45.3% ( n=742), and 80 of these (10.8%) reported long-term symptoms (⩾4 weeks). There was no significant difference in sociodemographic or lifestyle factors in relation to the duration of suspected COVID-19 symptoms. Rhinitis, migraine and lower self-rated health before the pandemic was more common among participants with long-term symptoms. In addition, there was a tendency for higher prevalences of asthma, chronic bronchitis and depression in this group. The prevalence of smoking decreased from 18.9% before the pandemic to 14.7% during the pandemic, while snuff use increased from 12.7% to 22.4% ( P<0.001). Conclusions: Almost half of Swedish young adults have had symptoms of suspected COVID-19 from February up to August 2020. Among these, one out of 10 have had long-term symptoms for at least 4 weeks. Long-term symptoms of suspected COVID-19 were associated with several common chronic conditions. Smoking may have decreased during the pandemic, while snuff use may have increased.
Amylase Is Not a Useful Indicator for Leakage Detection Following Sleeve Gastrectomy: A Prospective Study
Authors: Horn Amyt , Assalia Ahmad , Sayida Sa’d , Mahajna Ahmad 
Published: June 2021

Introduction. Gastric leak after laparoscopic sleeve gastrectomy (LSG) is a severe complication that may lead to sepsis and even death. Early diagnosis and treatment are critical. The aims of this prospective study are to establish normal amylase levels and investigate elevated amylase levels, especially in the drain, for detecting anastomotic leakage following LSG. Material and Methods. One hundred sixty-one patients who underwent LSG during 1 year at Rambam Health Care Campus were included prospectively in the study. Demographic and medical background, peri- and postoperative complications, and laboratory data including amylase levels in blood, urine, and drain were evaluated. Univariate and multivariate analyses were performed to examine independent variables that can predict increases in amylase values. Results. Thirty-five (21.8%) patients had high levels of amylase in blood, urine, and/or drain and 126 (78.2%) normal values of amylase until discharge. No significant differences were found in operation duration, length of hospitalization, or occurrence of complications. One patient had a staple-line leak diagnosed in the third postoperative day that was treated conservatively with endoscopic approach. His amylase levels in the blood and drain were normal, with only a slight hyperamylasuria. Conclusions. High amylase levels after LSG does not necessarily indicate a major complication such as staple-line leak, and in the vast majority of cases, it seems to have no clinical relevancy. Therefore, it should not automatically lead to a full investigation in the absence of further clinical signs. It is suggested that there is no clinical justification to test amylase routinely after LSG.