bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occupational Diseases and Perceived Health in Operating Room Nurses: A Multicenter Cross-Sectional Observational Study
Authors: Martí-Ejarque María del Mar , Guiu Lázaro Gemma , Juncal Roser Coutado , Pérez Paredes Salvador , Díez-García Cecilia 
Published: December 2021

Background The surgical environment has multiple factors that could affect nurses’ health. The aim was to determine the effects of the working environment of operating room nurses on their health compared to hospitalization nurses. Methods A sample of operating room nurses and hospitalization nurses were included in the study and participated by filling in a self-report survey containing sociodemographic data items, the validated Nordic and SF12 scales and a list of medical conditions. Results Three hundred and thirty-one nurses participated in the study. Statistically significant results had obtained for diagnoses of musculoskeletal disorders and contact dermatitis among the operating room nurses. Conclusion/Application to Practice Continuous training in ergonomics is essential. Moreover, surgical protocols for preventing infection should be revised, optimizing the chlorhexidine content of soaps to reduce the risk of lesions among the surgical staff.
Moral Injury during the COVID-19 pandemic: A delphi model survey of family medicine residents
Authors: Ngo Sean B , Clark Payson J , Parr Sarah E , Thomas Abel R , Dayal Akshat , Sanker Richard , Hess Burritt W , Stull Dillon C 
Published: December 2021

Objectives The objective is to investigate the primary factors that created experiences leading to moral injury in family medicine residents during the COVID-19 pandemic and also to identify any barriers keeping these residents from seeking or receiving help when they experienced moral injury. Method A DELPHI model study utilizing three rounds of surveys was conducted at four family medicine residency programs in the United States. Resident responses to Survey 1 generated factors perceived to be causing them moral injury or constituting barriers to their seeking help. Thematic analysis identified common themes which were presented to residents in Survey 2 for rating and justification. Results and feedback from Survey 2 were shared with residents in Survey 3, where residents were prompted to reevaluate their ratings for factors and barriers for the purpose of generating consensus among themselves. A ranked list of factors and barriers was thereby created for the participating sites. Results Residents shared several stories about the factors that most pressured them to violate their moral values. The most severe and frequent factors contributing to moral injury involved disruptions to doctor–patient relationships, patient–family relationships, and relationships with other healthcare professionals. Time was the major barrier to residents seeking help. Conclusion During times of crisis, moral injury among residents may be minimized by protecting and promoting important clinical and professional relationships with patients, colleagues, and other medical professionals. While residents report that lack of time was the most significant barrier to seeking help, it is unclear how this complicated and ubiquitous problem would be resolved or mitigated.
Controlling foamability of polypropylene/γ-irradiated ethylene acrylic elastomer blends by extent of crosslinking and domain microstructure of elastomer
Authors: Dutta Anindya , Banerjee Debjyoti , Ghosh Anup K. 
Published: December 2021

Foams of polypropylene/elastomer blends can often lead to softer foams which may not be desirable every time. Incorporating rigidity to the foams can often be made possible by preferentially crosslinking the elastomer phase prior to blending. Although foamability of polypropylene/elastomer blends has been understood in the scientific community, the influence of the extent of crosslinking in the elastomer phase is not yet understood well. The purpose of this investigation is to identify the influence of the extent of elastomer crosslinking and the blend morphological attributes (achieved by varying screw speed during melt mixing) on foamability of polypropylene/partially crosslinked elastomer blends. Crosslinking of ethylene-acrylic elastomer is carried out using gamma radiation with several doses (0, 12.5, 25, 50 kGy) before melt blending and, subsequently, 10 wt.% of the irradiated elastomers (prior optimized) are mixed with polypropylene in a micro-compounder at three different screw speeds. The microstructure development in blends is characterized by scanning electron microscopy. Frequency sweep rheological analysis is done for selected blends to identify the ease of foamability among the series of blends. Foaming of blends is done with supercritical carbon dioxide in batch mode at three different temperatures. The density reduction along with the microcellular morphology development of blends with foaming is analyzed with the screw speed, the extent of crosslinking, and foaming temperature; furthermore, the individual input parameters (the elastomer domain size, controlled by the screw speed and the extent of crosslinking, controlled by gamma radiation dose) are optimized based on the foam morphology. A uniform and good foamability were achieved at 155 and 160°C for blends with elastomers, irradiated at 12.5 and 25 kGy radiation doses. The lowest density foam (0.37 g/cc) was obtained for polypropylene with 12.5 kGy irradiated crosslinked elastomer mixed at 200 rpm at 160°C foaming temperature. The final elastomer domain dispositions within the foam morphologies are characterized and the plausible foaming mechanism is proposed.
Characteristics and Outcomes of Parotid Gland Tumors in Adolescents
Authors: Kanetake Hirofumi , Inaka Yuko , Kinoshita Ichita , Ayani Yusuke , Ozaki Akiko , Omura Shuji , Higashino Masaaki , Terada Tetsuya , Haginomori Shin-ichi , Kawata Ryo 
Published: December 2021

Objective Parotid tumors are rare neoplasms in adults but are exceedingly infrequent in adolescents. We aimed to determine the clinical characteristics and outcomes of parotid tumors in adolescents under 20 years old. Methods Between 1999 and 2020, 979 cases of benign parotid tumors and 236 cases of malignant parotid tumors were treated surgically in our department. Of these, 12 benign cases (1.2%) and 9 malignant cases (3.8%) were in adolescents. There were no benign or malignant cases for those aged under 10 years. Results Regarding the histological type, all benign tumors were pleomorphic adenomas. About half of malignant tumors were mucoepidermoid carcinomas, and excluding one high-grade case, the grade of malignancy was all low/intermediate. The accuracy of fine-needle aspiration cytology among adolescents showed no significant difference with that of adults. In contrast to adults, adolescent benign tumor cases showed a markedly high rate of pleomorphic adenomas and no postoperative facial nerve palsy. Malignant tumors in adolescents had a different trend than adults; low/intermediate-grade malignancies were common and thus few symptoms/signs of malignancy could be observed. As well, the accuracy of fine-needle aspiration cytology was poor. All cases had a good prognosis and are disease-free survival. Conclusion Parotid tumors in adolescents are rare but have several characteristics that are distinct from adults. As long-term observation is required posttreatment in adolescent patients, recurrence in benign pleomorphic adenomas and poor long-term prognosis in malignant tumors, especially for those with low/intermediate-grade malignancy, are more likely to be observed.
Family Context Surrounding the Use of Technologies and Their Impact in Adolescents’ Media Multitasking
Authors: Pousada Modesta , Malo Sara , Viñas Ferran , Martín-Perpiñá Mercedes , Gómez-Zúñiga Beni 
Published: December 2021

Recent studies pointed out that practically all adolescents are regular users of information and communications technology (ICT). Since the most usual context for the use of technology is the home, our aim is, on the one hand, to characterize the family technology context among adolescents aged between 11 and 18 years and, on the other hand, to analyse the relationship between multitasking and the different variables found within this family context. Participants were 977 adolescents. Significant relationship between the number of devices in the home and the frequency with which these are used are showed. Although a 60% of the adolescents have no parental rules over this use, there does not appear to be any relationship between the existence, or lack thereof, of rules over the use of ICT and multitasking. To reduce adolescents amount of media multitasking, we would recommend having fewer devices in the home rather than imposing rules about their use.
Including Surgical Resection in the Multimodal Management of Very Locally Advanced Sinonasal Cancer
Authors: Karp Jerome M. , Hu Kenneth S. , Persky Michael , Persky Mark , Jacobson Adam , Tran Theresa , Li Zujun , Givi Babak , Tam Moses M. 
Published: December 2021

ObjectiveSinonasal cancer often presents as locoregionally advanced disease. National guidelines recommend management of stage T4b tumors with systemic therapy and radiotherapy, but recent studies suggest that including surgical resection in the multimodal treatment of these tumors may improve local control and survival. We queried the National Cancer Database to examine patterns of care and outcomes in T4b sinonasal squamous cell carcinoma (SCC).Study DesignProspectively gathered data.SettingNational Cancer Database.MethodsPatients with T4b N0‐3 M0 sinonasal squamous cell carcinoma diagnosed in 2004 to 2016 were stratified between those who received chemoradiotherapy and those who underwent surgical resection with neoadjuvant or adjuvant treatment. The overall survival of each cohort was assessed via Kaplan‐Meier analysis and Cox proportional hazard models, with repeat analysis after reweighting of data via inverse probability of treatment weighting.ResultsAmong 805 patients included in analysis, 2‐year overall survival for patients undergoing surgical resection was 60.8% (95% CI, 56.1%‐65.9%), while for patients undergoing chemoradiotherapy it was 46.7% (95% CI, 41.9%‐52.0%). On Cox regression analysis, the inclusion of surgery in management was associated with improved survival in univariate analysis (hazard ratio [HR], 0.723 [95% CI, 0.606‐0.862]; P <. 001) and multivariate analysis (HR, 0.739 [95% CI, 0.618‐0.885]; P =. 001). Results with reweighted data were consistent in univariate analysis (HR, 0.765 [95% CI, 0.636‐0.920]; P =. 004]).ConclusionSurgical treatment with neoadjuvant or adjuvant treatment for stage T4b sinonasal SCC was associated with promising survival outcomes, suggesting a role for incorporating surgery in treatment of select T4b SCC, particularly when removal of all macroscopic disease is feasible.
Investigating Affective Responding to Daily Positive Events Among Adolescents Using Ecological Momentary Assessment
Authors: Chun Sarah K. , Benjamin Katherine S. , Mezulis Amy H. 
Published: December 2021

The experience of positive events is associated with increased positive affect, which can beneficially impact the physical and mental health outcomes of adolescents. Despite an increase in important life events during adolescence, little research has examined the influence of positive events on affect in this population. This study used Ecological Momentary Assessment to investigate individual differences in the effects of daily positive events on momentary positive and negative affect and event-specific positive affect among 136 adolescents ( M age = 13.03 years). Results indicated that interpersonal and independent events elicited greater event-specific positive affect than non-interpersonal and dependent events. Dependent interpersonal events were associated with the greatest positive affect compared to other combinations of event types. Gender did not moderate these effects. These findings may address the gap in the literature regarding the types of daily positive events that elicit the most positive affect in adolescents, and in turn, may enhance well-being.
Intra- and extra-capsular ganglia at the gastrocnemius origin and association with meniscal tears and severity of osteoarthritis of the knee joint
Authors: Choi Jin Young , Park Hee Jin , Kim Ji Na , Kim Myung Sub , Choi Yoon Jung , Shin Hun Kyu , Son Eun Seok 
Published: December 2021

Background The association between size of ganglia or type of ganglia (intra-articular or extra-articular) and meniscal tears or severity of the osteoarthritis (OA) is not evaluated. Purpose To evaluate the prevalence, size, and location of intra- and extra-capsular ganglia at the gastrocnemius origin and to assess their associations with meniscal injury and grades of OA. Material and Methods This study included 301 consecutive patients who had knee pain and had undergone magnetic resonance imaging (MRI) of the knee. We evaluated presence of ganglia at the gastrocnemius muscle origin site and diagnosed whether it was an intra-capsular located or mixed-capsular located (intra-capsular and extra-capsular) and then measured the diameter of each ganglion. After two weeks, we evaluated whether articular cartilage injury existed. The presence of a meniscal tear was also recorded. Results A total of 186 patients (93%) had intra- and extra-capsular ganglia. Intra-capsular ganglia were found in 183 cases (91%) and mixed-capsular ganglia were found in 16 cases (8%). In cases with intra- and extra-capsular ganglia, more meniscal tears were found ( P = 0.029). Intra-capsular ganglia showed more meniscal tears ( P = 0.021). Intra-capsular ganglia were more likely to have high-grade OA ( P = 0.043). Patients who had a meniscal tear displayed larger-sized ganglia, especially of the intra-capsular type ( P = 0.044). Conclusion Patients with intra- and extra-capsular ganglia, especially of the intra-capsular type, are more likely to have meniscal injury and more severe OA. Patients with a meniscal tear or OA are more likely to have larger intra- and extra-capsular ganglia, especially of the intra-capsular type.
Volunteers: An Effective Medium for Delivering Therapeutic Lifestyle Interventions
Authors: Kent Lillian M. , Rankin Paul M. , Morton Darren P. , Rankin Rebekah M. , Greenlaw Roger L. , Englert Heine S. 
Published: December 2021

Purpose Lifestyle modification programs have been shown to effectively treat chronic disease. The Coronary Health Improvement Program has been delivered by both paid professional and unpaid volunteer facilitators. This study compared participant outcomes of each mode in the United States. Design Pre-/post-analysis of CHIP interventions delivered between 1999 and 2012. Setting Professional-delivered programs in Rockford Illinois 1999-2004 and volunteer-delivered programs across North America 2005-2012. Subjects Adults ≥21 years (professional programs N = 3158 34.3% men, mean age = 54.0 ± 11.4 years; volunteer programs N = 7115 33.4% men, mean age = 57.4 ± 13.0 years). Measures Body mass index, blood pressure (systolic and diastolic), blood lipid profile (total cholesterol, high-density lipoprotein, triglycerides, low-density lipoprotein), and fasting plasma glucose. Analysis Analysis of Covariance, with adjustment for age, gender, BMI change and baseline biometric and effect sizes. Results The professional-delivered programs achieved significantly greater reductions in BMI (.4%, P < .001) and HDL (1.9%, P < .001) and the volunteer-delivered programs achieved greater reductions in SBP (1.4%, P < .001), DBP (1.1%, P < .001), TC (1.4%, P = .004), LDL (2.3%, P < .001), TG (4.0%, P = .006), and FPG (2.7%, P < .001). However, the effect size differences between the groups were minimal (Cohen’s d .1-.2). Conclusions Lifestyle modification programs have been shown to effectively treat chronic disease. The Complete Health Improvement Program (CHIP) lifestyle intervention has been delivered by both paid professional and unpaid volunteer facilitators. This study compared selected chronic disease biometric outcomes of participants in each mode in the United States. It found volunteer-delivered programs do not appear to be any less effective than programs delivered by paid professionals, which is noteworthy as volunteers may provide important social capital in the combat of chronic disease.
Onset of Transient Sadness Following the Concomitant Use of a Triptan and Selective Serotonin Reuptake Inhibitor/Serotonin Norepinephrine Reuptake Inhibitors Therapy: A Case Report
Authors: Meng Yuki , Yuen Jamie 
Published: December 2021

Background: Migraine and depression have a bi-directional, positive association. The likelihood of these conditions being comorbidities is high, thus, the possibility of concomitant use of an antidepressant and a triptan is also increased. Case Presentation: We present a case of a 39-year-old female with a history of migraine with aura and depression who had brief episodes of exacerbated depressive symptoms following oral administration of sumatriptan 100 mg daily as needed while taking various selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) medications on different occasions. The patient experienced 30-minute episodes of sweating and subjective increase in temperature approximately 2–3 hours after administration of sumatriptan 100 mg. This was followed by a transient exacerbation of sadness described by the patient as unhappiness, hopelessness, and tearfulness, which lasted 1 to 2 hours. To date, there are no other published case reports that have described this particular presentation. Several studies have reported possible serotonin syndrome as a result of the combination. Current evidence and known pharmacological actions of SSRIs/SNRIs and triptans are not well-defined enough to explain how one can experience episodic worsening depression. Conclusion: This case illustrates that clinicians should consider other potential adverse effects of the combined use of triptans and SSRIs/SNRIs beyond serotonin syndrome.
Electromagnetic interference shielding effectiveness of polypyrrole-silver nanocomposite films on silane-modified flexible sheet
Authors: Benzaoui Karim , Ales Achour , Mekki Ahmed , Zaoui Abdelhalim , Bouaouina Boudjemaa , Singh Ajay , Mehelli Oussama , Derradji Mehdi 
Published: December 2021

The conventional electromagnetic interference (EMI) shielding materials are being gradually replaced by a new generation of supported conducting polymer composites (CPC) films due to their many advantages. This work presents a contribution on the effects of silane surface–modified flexible polypyrrole-silver nanocomposite films on the electromagnetic interference shielding effectiveness (EMI-SE). Thus, the UV-polymerization was used to in-situ deposit the PPy-Ag on the biaxial oriented polyethylene terephthalate (BOPET) flexible substrates whose surfaces were treated by 3-aminopropyltrimethoxysilane (APTMS). X-ray Photoelectron Spectroscopy (XPS) analyzes confirmed the APTMS grafting procedure. Structural, morphological, thermal, and electrical characteristics of the prepared films were correlated to the effect of substrate surface treatment. Thereafter, EMI-SE measurements of the elaborated films were carried out as per ASTM D4935 standard for a wide frequency band extending from 50 MHz to 18 GHz. The obtained results confirmed that the APTMS-treated BOPET film exhibit higher EMI shielding performance and better electrical characteristics compared to the untreated film. In fact, a 32% enhancement of EMI-SE was noted for the treated films compared to the untreated ones. Overall, these results put forward the role played by the surface treatment in strengthening the position of flexible PPy-Ag supported films as high-performance materials in electronic devices and electromagnetic interference shielding applications.
Five-Year Prospective Roentgen Stereophotogrammetric and Clinical Outcomes of the BioPro MTP-1 Hemiarthroplasty
Authors: Balesar Vinay V. , Koster Lennard A. , Kaptein Bart L. , Keizer Stefan B. 
Published: December 2021

Background: Mixed results for functional outcomes and long-term fixation have been reported for first metatarsophalangeal arthroplasty. This prospective study was designed to evaluate the migration of the BioPro metatarsophalangeal-1 (MTP-1) joint hemiprosthesis with Roentgen stereophotogrammetric analysis (RSA). Migration patterns of the prosthesis, prosthesis-induced erosion of the metatarsal bone, and clinical outcomes were evaluated sequentially to 5 years postoperation (PO). Methods: Eleven female patients received the BioPro-1 hemiprosthesis. Prosthesis translation and metatarsal erosion were measured with RSA at immediately PO, 6 weeks, and 3, 6, 12, 36, and 60 months postoperatively. Clinical assessment was done by patient questionnaires. Results: RSA data of 9 patients were available for analysis. Median (range) number of markers used in RSA analysis, condition number, and mean error of markers around the prosthesis were 4 (3-7), 320 (208-862), and 0.13 (0.02-0.28), respectively. Progressive subsidence was seen up to 3 years PO (mean 2.1 mm, SE 0.32). Progressive metatarsal erosion was found from 1 year PO (mean 0.49 mm, SE 0.15). Pain, function, and quality scores improved after surgery and did not deteriorate at later follow-up moments. Conclusion: Model-based RSA of the BioPro-1 prosthesis shows nonstabilizing medial and distal translation and metatarsal erosion. Despite the measured migration and erosion, clinical outcomes improved and remained similar up to 5 years postoperation. Level of Evidence: Level II, prospective analysis of MTP-1 hemiprosthesis.
Placental Heterogeneity in Stillbirth and Its Relations to Maternal Exogenous Characteristics
Authors: Mtshali Nompumelelo Z. , Burgess Steven M. , Maswime Salome , Wright Colleen A. 
Published: December 2021

Introduction: Heterogeneous patterns of placental lesions in stillbirth signal important variations in placental histopathology that may be diagnostic in stillbirth. We explore placental heterogeneity and its associations with maternal characteristics (including HIV) using latent class analysis. Methods: Placental and maternal data and slides were assessed retrospectively for 122 confirmed stillbirths (gestational age ≥ 28 weeks) delivered at a major South African academic hospital between January 2016–July 2018. The slides were reviewed by 2 pathologists and classified using the Amsterdam Consensus Classification System. Latent class analyses were conducted on raw data. Results: We identify 5 latent placental classes in stillbirth based on similarity in patterns of observed diagnostic criteria and their associations with maternal characteristics. Three classes bear similarity to generalized patterns of placental injury identified previously. Our study shows that intrauterine infection was the commonest histopathological condition associated with stillbirth in our setting. Novel findings include 2 classes, distinguished by high placental RPH and maternal HIV, respectively, and the non-emergence of a class distinguished by VUE. Conclusion: The size and content of the latent classes and their similarity/dissimilarity to the more generalized patterns identified previously suggest potential new avenues for investigation and theory development concerning the role of the placenta in stillbirth and the impact of HIV.