bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social Distancing and SARS-CoV-2 Transmission Potential Early in the Epidemic in Finland
Authors: Auranen Kari , Shubin Mikhail , Karhunen Markku , Sivelä Jonas , Leino Tuija , Nurhonen Markku 
Published: May 2021

Background:
Information about social mixing patterns under heavy social distancing is needed to model the impact of nonpharmaceutical interventions on SARS-CoV-2 transmission.

Methods:
We conducted a survey on daily person-to-person contacts during the early phase of the SARS-CoV-2 epidemic in Finland, one month after strong social distancing measures had been introduced nationwide. We defined a contact as exchange of at least a few words in proximity of another person. We also considered physical (“skin-to-skin”) contacts separately. Based on 3,171 reported contacts by 1,320 participants of 1–79 years of age, we estimated age-stratified contact matrices essential in modeling virus transmission.

Results:
Compared with contacts during prepandemic conditions, as learned from the Finnish part of the Polymod study, there was a 72% (95% credible interval, CI = 71, 74) reduction in the daily number of all contacts and a 69% (95% CI = 66, 73) reduction in the daily number of physical contacts in April 2020. The largest reduction, of almost 90%, occurred in physical contacts by individuals more than 70 years of age. The estimated reduction in the transmission potential of the virus attributable solely to reduced contact frequencies varied between 59% (whole population; physical contacts; 95% CI = 52, 68) and 77% (over 20-year olds; physical contacts; 95% CI = 70, 89).

Conclusions:
We surmise that the large reduction in the daily numbers of social contacts in the early part of the SARS-CoV-2 epidemic in Finland was likely a major contributor to the steady decline of the epidemic in the country since early April.
Non-Respiratory Droplet Transmission of COVID-19 in the Isolation Ward of a Secondary Hospital in Oman
Authors: Al Mayahi Zayid K. , Al Kindi Nawal , Al Shaqsi Nasser , Al Hattali Noaman , Al Hattali Azza , Salim Khalid , Beatty Mark 
Published: May 2021

Front-line health care workers are among the most vulnerable groups at risk for acquiring COVID-19, yet the exact mechanisms of how infections occur in health care settings are yet to be identified.

Objectives
To review the epidemiologic and environmental factors surrounding a cluster of nosocomially acquired COVID-19 cases with possible non respiratory droplet transmission indicating the importance of strict adherence with isolation procedures for patients and staff.

Methods
Contact and environmental investigations were completed to determine the source and possible routes of hospital transmission of COVID-19.

Results
Seven cases of COVID-19 occurred in the COVID-19 isolation ward of a secondary hospital from 12/04/2020 to 01/05/2020. Analysis also included first four COVID-19 patients admitted to this facility. Epidemiologic links included exposure to massive bowel movements of two infected patients in adjoining rooms on the same day. Serious gaps in infection control practices lead to further spread the virus and cross infection between the staff.

Conclusion
Despite preparedness to combat pandemics, the infection control precautions taken at this facility were found not sufficient to prevent nosocomial spread of COVID-19. Issues were identified with compliance, enforcement, and failure to update to the most current guidance. Urgent review of ongoing hygiene and isolation practices in hospitals of this type is indicated. Further studies are required to better understand the role of fecal oral transmission and environmental contamination in the transmission of COVID-19.
Cultural Perspectives on Pain Assessment and Opioid Use: International Neuroscience Nursing Research Symposium Conference Proceedings
Authors: Bautista Cynthia , Amatangelo Mary P. , Baby Priya , Cassier-Woidasky Anne-Kathrin , Dycus Kaleigh , Edoh Esther I. , Green Theresa , Ilano Karen Czarina S. , Kemboi Mary , Littlejohns Linda , Martinez Rudolf Cymorr Kirby P. , Mastamet Gladys , Perera Anjali , Ramazanu Sheena , Ribeiro Rennan Martins , Serondo Diana Jean F. , Sila Faith , Strayer Andrea , Soriano Gil P. , Wessol Jennifer L. 
Published: May 2021

ABSTRACT

INTRODUCTION: In August of 2020, the 4th International Neuroscience Nursing Research Symposium was held. The purpose of the symposium was to share neuroscience nursing research from around the world. One of the topics thought most notable that stimulated a crucial conversation was how different countries assessed pain and their use of opioids for pain management. BACKGROUND: Neuroscience nurses are global. What is not known is their experience with and what challenges exist with pain management for human beings in their country. Crossing geographic and cultural boundaries, pain affects all human beings. Each culture has unique values and beliefs regarding pain. Patient barriers, pivotal in this article, included poverty, poor health literacy, opioid phobia, and cultural as well as social beliefs. RESULTS: Neuroscience nurses from Australia, Brazil, Germany, Singapore, India, Ghana, Kenya, Philippines, South Africa, and the United States each collaborated to provide a short summary of assessing pain and use of opioids for pain management for the neuroscience patient. CONCLUSION: Neuroscience patients have varying degrees of pain based on many factors. Various countries have religious, spiritual, and cultural traditions that influence the reporting and management of pain. Pain assessment and management can be challenging, especially for the neuroscience nurses around the world.
Relationships Among Phantom Limb Pain, Peripheral Sensations, and Cognition in People with Lower-Limb Loss
Authors: Wong Christopher K. , Wong Caitlin K. 
Published: May 2021

ABSTRACT

Introduction
After amputation, altered sensory input leads to cortical reorganization that partly explains phantom limb pain (PLP). However, many factors impact the PLP phenomenon, and modern conceptualizations of chronic pain including PLP integrate both peripheral inputs and central interpretation. Clinicians without functional MRI could benefit from clinical measures related to PLP to assess clinical presentations. The purpose of this pilot study was to identify peripheral sensation and cognition measures related to PLP to inform outcome measure selection in future PLP research.

Methods
This cross-sectional analysis included people with PLP of any age, sex, and amputation cause or level. Assessments included patient-reported residual limb pain and PLP using the Prosthesis Evaluation Questionnaire, peripheral sensation measures (light touch, temperature, vibration, two-point discrimination), and cognition measures (laterality recognition, trail making, clock drawing). Unadjusted Spearman ρ coefficients were reported.

Results
Eleven volunteers (48.5 ± 13.2 years) with lower-limb amputations (seven transtibial) of various causes (nine medical) participated. More severe PLP symptoms were associated with impaired peripheral sensation (light touch, ρ = 0.514; temperature, ρ = 0.756) and poorer cognition (laterality recognition, ρ = 0.524; trail making, ρ = 0.565). Residual limb pain was not correlated with cognition measures (ρ < 0.4).

Conclusions
This pilot study identified clinical measures assessing cognition and peripheral sensation impairments associated with worse PLP symptoms. Phantom limb pain was related to temperature and light touch sensation measures, but two-point discrimination was not associated with PLP consistent with past research. Laterality recognition was associated with PLP per prior research, and the association of PLP with the Trail Making Test in this pilot study suggests that the Trail Making Test may be an additional cognition measure potentially useful in future clinical research to document the PLP experience.
A Higher Playing Standard, Bowling, and Intermittent Helmet Use Are Related to a Greater Odds of Injury or Concussion in Cricket
Authors: Filbay Stephanie R. , Bullock Garrett S. , Sanchez-Santos Maria T. , Arden Nigel K. , Peirce Nicholas 
Published: May 2021

Objective:
To determine if playing position, a higher playing standard, and nonhelmet use are related to an increased odds of joint-specific injury and concussion in cricket.

Design:
Cross-sectional cohort.

Participants:
Twenty-eight thousand one hundred fifty-two current or former recreational and high-performance cricketers registered on a national database were invited to participate in the Cricket Health and Wellbeing Study. Eligibility requirements were aged ≥18 years and played ≥1 cricket season.

Independent Variables:
Main playing position (bowler/batter/all-rounder), playing standard (high-performance/recreational), and helmet use (always/most of the time/occasionally/never).

Main Outcome Measures:
Cross-sectional questionnaire data included cricket-related injury (hip/groin, knee, ankle, shoulder, hand, back) resulting in ≥4 weeks of reduced exercise and self-reported concussion history. Crude and adjusted (adjusted for seasons played) odds ratios and 95% confidence interval (CIs) were estimated using logistic regression.

Results:
Of 2294 participants (59% current cricketers; 97% male; age 52 ± 15 years; played 29 ± 15 seasons; 62% recreational cricketers), 47% reported cricket-related injury and 10% reported concussion. Bowlers had greater odds of hip/groin [odds ratio (95% CI), 1.9 (1.0-3.3)], knee [2.0 (1.4-2.8)], shoulder [2.9 (1.8-4.5)], and back [2.8 (1.7-4.4)] injury compared with batters. High-performance cricketers had greater odds of injury and concussion than recreational cricketers. Wearing a helmet most of the time [2.0 (1.4-3.0)] or occasionally [1.8 (1.3-2.6)] was related to higher odds of self-reported concussion compared with never wearing a helmet. Concussion rates were similar in cricketers who always and never wore a helmet.

Conclusions:
A higher playing standard and bowling (compared with batting) were associated with greater odds of injury. Wearing a helmet occasionally or most of the time was associated with higher odds of self-reported concussion compared with never wearing a helmet.
Nurse Practitioner Student Perceptions of a Multimodal Telemedicine Clinical Course
Authors: Burt Leah , Kilroy Sue 
Published: May 2021

Background
Telemedicine facilitates access to care that is both efficacious and highly satisfactory to patients. As primary health care providers, nurse practitioners (NPs) need to be educated to deliver health care within various settings. With the rapid expansion of telemedicine, NP educational authorities have charged educators to address essential telemedicine-based competencies.

Purpose
Innovative approaches to integrating telemedicine competencies into NP curricula have yet to be established in nursing education.

Methods
Multifocal curricular changes were integrated into an NP clinical course. Students engaged in self-directed learning modules and multiple simulation training sessions and rotated through telemedicine clinical practicums.

Results
Experiences were perceived as realistic and complementary, learning meaningful, and applicability broad and far-reaching. Telemedicine-focused simulation training sessions were viewed as highly satisfactory, and students were confident in simulation-derived learning.

Conclusions
Nursing educators should integrate multimodal telemedicine experiences into curricula, addressing multiple learning phases through experientially designed simulation trainings.
Reducing Disparities: A Virtual Quality Improvement Collaborative Resulted in Better Health Outcomes for 4 Target Populations Disproportionately Affected by HIV
Authors: Steinbock Clemens M. , Chung Rakkoo , Lee Jennifer E. , Leung Shu-Yin John , Kolesar Charles , Tesoriero James 
Published: May 2021

Context:
Although viral suppression rates have recently increased among people with HIV, specific populations still experience disparities in health outcomes, a priority in the national response to end the HIV epidemic.

Purpose:
The end+disparities ECHO Collaborative, a quality improvement initiative among HIV providers in the United States from June 2018 to December 2019, created virtual communities of practice to measurably increase viral suppression rates in populations disproportionately affected by HIV: men who have sex with men of color, Black/African American and Latina women, youth aged 13 to 24 years, and transgender people.

Methods:
Participating Ryan White HIV/AIDS Program–funded providers prioritized their improvement efforts to focus on one target population and joined virtual affinity sessions with other providers focused on that population for guidance by subject matter experts and exchanges with peer providers. During 9 submission cycles, providers reported their viral suppression data for the preceding 12 months.

Main Outcome Measures:
The principal outcome measures were changes in viral suppression rates among 4 target populations and changes in viral suppression gaps compared with the rest of HIV-infected patients served by the same agency.

Results:
A total of 90 providers were included in the data analyses with an average of 110 775 reported patients, out of which 19 442 represented the targeted populations. The average viral suppression rates for agency-selected populations increased from 79.2% to 82.3% (a 3.9% increase), while the remaining caseload increased at a lower rate from 84.9% to 86.1% (a 1.4% increase). The viral suppression gap was reduced from 5.7% to 3.8%, a 33.5% reduction. Improvements were found across all target populations.

Conclusions:
The collaborative demonstrated improved health outcomes and reductions in HIV-related health disparities, moving toward ending the HIV epidemic. The model of utilizing low-cost videoconferencing technologies to create virtual communities of learning is well suited to mitigate other disease-related disparities, nationally and abroad.
Depressive Symptoms and Overperception of Airflow Obstruction in Older Adults With Asthma
Authors: Feldman Jonathan M. , Becker Jacqueline , Arora Arushi , DeLeon Jesenya , Torres-Hernandez Tatiana , Greenfield Naomi , Wiviott Allyana , Jariwala Sunit , Shim Chang , Federman Alex D. , Wisnivesky Juan P. 
Published: May 2021

ABSTRACT

Objective
Older adults are at increased risk for depression and poor asthma outcomes. We examined whether depressive symptoms are associated with overperception of airflow obstruction and a pattern of worse asthma control, but not pulmonary function.

Methods
We recruited a cohort of adults with asthma 60 years and older in East Harlem and the Bronx, New York. Baseline measures included the Geriatric Depression Scale, Asthma Control Questionnaire, and Mini Asthma Quality of Life Questionnaire. Spirometry was conducted at baseline to assess pulmonary function. Perception of airflow obstruction was assessed for 6 weeks following baseline by participants entering estimates of peak expiratory flow (PEF) into a programmable peak flow meter followed by PEF blows. Participants were blinded to actual PEF values. The percentage of time that participants were in the overperception zone was calculated as an average.

Results
Among the 334 participants (51% Hispanic, 25% Black), depressive symptoms were associated with overperception of airflow obstruction (β = 0.14, p = .029), worse self-reported asthma control (β = 0.17, p = .003), and lower asthma-related quality of life (β = −0.33, p < .001), but not with lung function (β = −0.01, p = .82). Overperception was also associated with worse self-reported asthma control (β = 0.14, p = .021), but not lung function (β = −0.05, p = .41).

Conclusions
Depressive symptoms were associated with greater perceived impairment from asthma, but not pulmonary function. Overperception of asthma symptoms may play a key role in the relationship between depression and asthma outcomes in older adults.
Patient Safety Monitoring in Acute Care in a Decentralized National Health Care System: Conceptual Framework and Initial Set of Actionable Indicators
Authors: Labella Barbara , De Blasi Roberta , Raho Vanda , Tozzi Quinto , Caracci Giovanni , Klazinga Niek Sieds , Carinci Fabrizio 
Published: May 2021

Objectives
Monitoring patient safety is critical for continuous quality improvement in acute care. We carried out a national project to identify a conceptual framework with core indicators that could be uniformly applied in the decentralized health system of Italy.

Methods
We used key international references to identify a framework with a core list of indicators and data sources for calculation in 4 hospitals in the Lombardy region. Two different data processing methods were applied: (a) centralized analysis of national databases and (b) decentralized data extraction and calculation using different hospital data available in Lombardy.

Results
Agreement was reached on a conceptual framework for patient safety monitoring in acute care, including structures, processes, and outcomes as vertical dimensions and health care needs as horizontal axes. We were able to compute 15 of 32 indicators through the application of a range of methods. The calculation of indicators using national databases was based on international standards. The consistency of the estimates obtained through the use of different methods and data sources seemed limited.

Conclusions
We successfully identified a conceptual framework for patient safety in acute care including actionable indicators that can be calculated routinely using different data sources at national, regional, and hospital levels. Further work is required to compare methods and understand whether a combination of strategies at national and local levels could be proven effective.
The Expression Level of FOXO3a in Patients With Autoimmune Diseases
Authors: Xu Shanshan , Zhang Xiaoyi , Ma Yubo , Xu Shengqian , Pan Faming 
Published: May 2021

Objective
Numerous studies have investigated the expression of forkhead box O3a (FOXO3a) in autoimmune diseases, but the results were inconsistent. This meta-analysis aims to synthetically evaluate the levels of FOXO3a in autoimmune diseases.

Methods
PubMed, Web of Science, and China National Knowledge Infrastructure were used to retrieve relevant articles. The pooled standard mean difference with 95% confidence interval was calculated.

Results
Totally, 10 studies from 7 publications were included. The levels of FOXO3a were significantly decreased in patients with autoimmune diseases compared with healthy controls (standard mean difference, −1.045; 95% confidence interval, −1.892 to −0.197). When stratified by disease, FOXO3a levels were significantly decreased in rheumatoid arthritis (RA) and inflammatory bowel disease (IBD), but were significantly increased in systemic lupus erythematosus. FOXO3a levels of specific tissues or cells in patients with autoimmune diseases were significantly decreased, but no significant difference was observed in the subgroup of peripheral blood mononuclear cells. In the subgroup analysis combining disease and sample, significant differences of FOXO3a were observed in non-PMBCs of RA and IBD patients.

Conclusions
Our study indicated that FOXO3a were significantly decreased in patients with autoimmune diseases. FOXO3a levels was a potential therapeutic target of autoimmune diseases.
18F-FDG and 68GA–Prostate-Specific Membrane Antigen PET/CT Perform Better Than CT Alone in Restaging Papillary Renal Cell Carcinoma Recurrence
Authors: Gasparro Donatello , Scarlattei Maura , Manuguerra Roberta , Guglielmo Priscilla , Migliari Silvia , Sammartano Antonino , Baldari Giorgio , Maestroni Umberto , Silini Enrico Maria , Ruffini Livia 
Published: May 2021

Abstract
Renal cell carcinoma (RCC) shows variable FDG uptake; recently, PET/CT with prostate-specific membrane antigen (PSMA)–target radiotracers was demonstrated to be a promising tool in staging and restaging of RCC patients. We describe the case of a 77-year-old man with a lung metastasis of papillary RCC missed by CT scan who successfully underwent [18F]FDG PET/CT restaging. Targeted therapy with sunitinib was administered. A [68Ga]PSMA PET/CT performed during follow-up demonstrated, among the already known lesions, also a bone marrow metastasis, missed by previous CT scans. This case demonstrates that PET/CT molecular imaging with [18F]FDG and [68Ga]PSMA is superior to conventional imaging in RCC restaging and in assessing therapy response.
18F-Fluciclovine–Avid Pulmonary Hamartoma
Authors: Baldeosingh Sacha C. , Rowe Steven P. , Greco Stephen C. , Paller Channing J. , Goel Reema 
Published: May 2021

Abstract
A 73-year-old man with history of grade group 1/Gleason 3 + 3 = 6 prostate adenocarcinoma status post prostatectomy had subsequent biochemical recurrence with serum prostate-specific antigen level of 2.4 ng/mL. He underwent an 18F-fluciclovine PET/CT scan that demonstrated a left prostate bed recurrence and an incidental 18F-fluciclovine–avid smooth-edged solitary lung nodule with internal fat attenuation. Such uptake of 18F-fluciclovine in a lung hamartoma could be mistaken for prostate cancer metastasis. Given the increasing use of advanced imaging for prostate cancer, there is need for the imaging specialist to know about pitfalls and how to interpret them.
Evaluation of Nasal Mucociliary Clearance Time in COVID-19 Patients
Authors: Çeçen Ayse , Bayraktar Cem , Özgür Abdulkadir , Akgül Gökhan , Günal Özgür 
Published: May 2021

Background:
Coronavirus Disease 2019 (COVID-19) is a viral pandemic emerging in East Asia and spreading rapidly to the rest of the world and continuing in our country. The number of studies examining the symptoms of the otolaryngology system and organs in COVID-19 patients is limited. The purpose of this study is to show whether COVID-19 infections cause any changes in nasal physiology in adult patients by measuring the mucociliary clearance (MCC) time with the saccharin test.

Methods:
One hundred one patients with laboratory-confirmed COVID-19 infection (group 1, n = 42 smokers and group 2, n = 59 nonsmokers) and 87 individuals without COVID-19 infection as the control group (group 3, n = 33 smokers and group 4, n = 54 nonsmokers) were included in the study. A saccharin test was used to evaluate the nasal MCC time.

Results:
Mucociliary clearance test averages of the groups were determined as 473.571 ± 263.684, 442.966 ± 228.463, 468.333 ± 267.367, 412.629 ± 192.179 seconds, respectively. When the test durations were examined, the group with the most prolonged MCC duration was determined as the smoking COVID (+) patient group (473.571 ± 263.684 seconds). The second group, with the most prolonged MCC duration, was determined as the smoking control group (468.333 ± 267.367 seconds). No statistically significant difference was found in intergroup mucociliary clearance time (P = 0.760).

Conclusion:
Although the authors found that smoking and viral infections prolong the MCC duration in our study, they did not find a statistically significant difference between the groups in terms of MCC duration.