bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infertility in Uganda: a missed opportunity to improve reproductive knowledge and health
Authors: Kudesia Rashmi , Muyingo Mark , Tran Nam , Shah Meera , Merkatz Irwin , Klatsky Peter 
Published: January 2021

Introduction:
Fertility care is an important unmet need in sub-Saharan Africa and considered low priority by donor countries and agencies. Understanding the social context of infertility may increase effectiveness of reproductive health programs.

Methods:
We conducted a cross-sectional study of fertile and infertile women in Kampala, Uganda, evaluating reproductive knowledge, quality of life (QOL), and infertility-related social morbidity using validated instruments and survey techniques.

Results:
QOL scores were lower than previously reported scores in Europe (P<0.001). A majority of respondents (53%) reported that they would rather contract HIV than live with infertility. In all, 46.7% of women listed “family planning” or a reversible contraceptive as a cause of infertility. Reproductive knowledge was low, with only 16.7% of women able to give 3 accurate causes of infertility. Infertile women reported higher rates of interpersonal violence, but these differences were not statistically significant.

Conclusions:
Infertility in Uganda decreases QOL comparably to other severe medical conditions and more than in prior studies. Common beliefs linking infertility to contraception may hinder implementation of family planning, though the infertility evaluation may help correct misconceptions. The connections between infertility, low reproductive knowledge, contraceptive uptake, and violence demonstrated here merit further study and may assist in designing culturally competent basic reproductive health programs in communities with limited resources.
Detecting Glaucoma in Rural Kenya: Results From a Teleglaucoma Pilot Project in Nyamira, Kenya
Authors: Marco Sheila A. , Amin Samreen , Virani Aleena , Rudnisky Christopher J. , Ishani Sarah , Kiage Dan , Damji Karim F. 
Published: January 2021

Precis:
A teleglaucoma (TG) case-finding model was used in Kenya. Of the patients, 3.46% had definite glaucoma and 4.12% were glaucoma suspects. Most cases were of moderate to advanced stage and referred for further assessment.

Purpose:
The aim was to evaluate glaucoma prevalence in a high-risk population using a TG model.

Methods:
Patients aged 35 or over were referred to the TG program from the outpatient diabetic and hypertensive clinics at Nyamira District Hospital (NDH) and from community awareness programs. Comprehensive ophthalmic examination included structured history, visual acuity, intraocular pressure, central corneal thickness, stereoptic nerve, and macular images. A glaucoma specialist provided diagnosis and management recommendation through virtual consultation. Glaucoma diagnosis and staging were based on at least 1 eye meeting the optic nerve criteria as specified by the Canadian glaucoma guidelines.

Results:
In all, 1206 participants were seen and 19 of these could not complete the examination. Of 1187 patients, 56% were women and the mean age was 56.60±12.36 years. Of the patients, 11.8% had images that were ungradable in at least 1 eye. The prevalence of glaucoma and glaucoma suspects was 3.46% (n=42) and 4.12% (n=50), respectively. The proportion of patients with early, moderate, advanced, and absolute glaucoma was 2.4%, 33.3%, 52.4%, and 2.4%, respectively. Other diagnoses (pathology in at least 1 eye) included cataract in 13.2%, diabetic retinopathy in 1.48%, and optic atrophy in 1.98%. Of the patients, 28.2% were referred to the Innovation Eye Centre, Kisii, for further assessment.

Conclusion:
A structured TG program detected glaucoma in 3.46% of a rural Kenyan population. Timely patient referral was also initiated.
Operative Complications of Glaucoma Drainage Implant Tube Insertion Through the Sulcus for Pseudophakic Eye
Authors: Asaoka Satoko , Kasuga Toshimitsu , Matsunaga Toru , Hayashi Yusuke , Asada Yosuke , Iwamoto Satoshi , Hirakata Toshiaki , Honda Rio , Obazawa Hanako , Sasaki Hidenori , Ohta Toshihiko , Matsuda Akira 
Published: January 2021

Precis:
Malposition of the tube through the ciliary sulcus is more frequently observed with the Ahmed glaucoma valve (AGV) than the Baerveldt drainage implant (BDI) due to the weaker rigidity of the Ahmed tube.

Purpose:
To report intraoperative and early postoperative complications of ciliary sulcus tube insertion of glaucoma drainage implants (GDIs).

Patients and Methods:
We performed retrospective analysis of 104 eyes of 94 patients with GDI tube insertion through the ciliary sulcus were performed. The rigidities of tubes were also examined using a microcompression tester.

Results:
The mean observation period was 20.0 (range, 6 to 60) months. Thirteen eyes were treated with the BDI and 91 were with the AGV. The mean age of the patients was 69.3 (34 to 90) years. The mean intraocular pressure was 27.9 mm Hg before surgery and 12.9 mm Hg after surgery (P<0.01). Upon tube insertion 42/91 eyes (46%) with the AGV required reinsertion of the tube due to malpositioning, whereas only 1/13 (8%) eyes with BDI did (P<0.01). Transient hyphema (12 eyes) and hypotony (12 eyes) were observed as early postoperative complications with the AGV. Seven eyes with hypotony were treated by proline stenting of the tube. We could not accomplish sulcus insertions in 4 eyes. Microcompression analysis of the tubes showed that the BGI tube was more rigid than that of the AGV.

Conclusions:
Ciliary sulcus insertion of the tube is an effective method to control intraocular pressure. The tube of the AGV was more difficult to insert through the sulcus than the BDI due to its weaker rigidity.
Surgical Technique for Pars Plana Ahmed Glaucoma Valve Implantation in Advanced Glaucoma: The Upside-Down Technique
Authors: Masuda Yoichiro , Saito Yuka , Oki Tetsutaro , Hayashi Takaaki , Takahashi Genichiro , Nakano Tadashi 
Published: January 2021

Précis:
Ahmed glaucoma valve (AGV) implantation using the upside-down technique resulted in an aqueous humor outflow pathway, occurring primarily on the scleral side and secondarily on the conjunctival side, and was effective in treating refractory glaucoma.

Purpose:
To describe the AGV surgical technique, which results in changes in the primary aqueous humor outflow pathway to the scleral side (upside-down technique), and to evaluate the clinical effects and distribution of bleb fluid after surgery in patients with refractory glaucoma.

Patients and Methods:
In this retrospective study, the upside-down technique was used for pars plana AGV implantation in 10 eyes of 10 patients with refractory glaucoma. Surgical success was defined by complications, intraocular pressure (IOP), the glaucoma medication score, and bleb fluid distribution determined by magnetic resonance imaging.

Results:
Postoperatively, there were significant reductions in the IOP and medication score at 23 and 27 months, respectively (P<0.05). Although a transient hypertensive phase was observed in 7 patients, it was controlled without ocular massage and additional surgery. A patient who had suprachoroidal hemorrhage during surgery lost light perception 7 months after the surgery, and another patient developed hypotony at 3 and 4 months after surgery, which spontaneously improved during subsequent examinations. Magnetic resonance imaging showed that the double bleb layer adjacent to the endplate tended to have more bleb fluid on the conjunctival side than on the scleral side facing the outlet (n=8; 1 to 29 mo after surgery).

Conclusions:
Pars plana AGV implantation using the upside-down technique was a relatively effective alternative to manage inadequate IOP control in patients with refractory glaucoma.
Using Best–Worst Scaling to Determine the Most Burdensome Menopausal Symptoms in Cambodian Women Living With HIV
Authors: Yang Youngran , Thapa Roshna , Lewis Frances Marcus 
Published: January 2021

Abstract
As persons living with HIV live longer, it is important to understand the symptoms experienced by menopausal women living with HIV (WLWH). This study used best–worst scaling (BWS) to determine the menopausal symptoms that are most burdensome for Cambodian WLWH. Participants were asked to rate a list of menopausal symptoms in terms of the most and least burdensome in their lives via BWS. The final analysis included 183 participants, 67 of whom were premenopausal, 47 perimenopausal, and 69 postmenopausal women. Physical and mental exhaustion (mean best–worst score = 319) was rated as the most burdensome symptom, and hot flushes and sweating were the least burdensome (mean best–worst score = −181). The BWS provides information on priorities for the distribution of health care resources. Understanding how Cambodian WLWH prioritize burdensome menopausal symptoms is crucial for choosing the most contextually sensitive method to provide health care services and interventions.
The Intersection of Cognitive Ability and HIV: A Review of the State of the Nursing Science
Authors: Waldrop Drenna , Irwin Crista , Nicholson W. Chance , Lee Cheryl A. , Webel Allison , Fazeli Pariya L. , Vance David E. 
Published: January 2021

Abstract
Neurocognitive problems have been endemic to the HIV epidemic since its beginning. Four decades later, these problems persist, but currently, they are attributed to HIV-induced inflammation, the long-term effects of combination antiretroviral therapy, lifestyle (i.e., physical activity, drug use), psychiatric, and age-associated comorbidities (i.e., heart disease, hypertension). In many cases, persons living with HIV (PLWH) may develop cognitive problems as a function of accelerated or accentuated normal aging and lifestyle rather than HIV itself. Nonetheless, such cognitive impairments can interfere with HIV care, including medication adherence and attending clinic appointments. With more than half of PLWH 50 years and older, and 30%–50% of all PLWH meeting the criteria for HIV-associated neurocognitive disorder, those aging with HIV may be more vulnerable to developing cognitive problems. This state of the science article provides an overview of current issues and provides implications for practice, policy, and research to promote successful cognitive functioning in PLWH.
A residency style transition to practice program in trauma and critical care: The George Washington University Hospital experience
Authors: Messing Jonathan , Peters Miranda , Vota Amy , Seneff Michael , Sarani Babak 
Published: January 2021

ABSTRACT
Transition to practice programs for nurse practitioners and physician assistants are gaining popularity and becoming more specialized. As these providers seek opportunities to strengthen their clinical skills and bridge the gap from school to practice, it is important to recognize the benefits and barriers of such programs. In this article, The George Washington University Hospital shares its experience in managing a transition to practice program for trauma and critical care.
Evaluation of an international program for nurse practitioner students
Authors: Steinke Mary K. , Rogers Melanie 
Published: January 2021

ABSTRACT

Background:
There are few opportunities for nurse practitioner (NP) students to develop relationships and exchange ideas with international counterparts. In addition, discovering differences in instructional pedagogy between programs is beneficial for every student.

Purpose:
To facilitate an international understanding of health care services and compare curricula of advanced practice programs through an international experience for first year NP students from the United Kingdom and the United States.

Methodological orientation:
The study used a qualitative analysis of responses from specified questions provided to both cohorts of students before and after the experience.

Sample:
A virtual global exchange between 23 advanced practice students and their professors in the spring of 2018 culminated in a trip by the UK students and faculty to the United States in April of that year.

Conclusions:
The UK and US NP students positively evaluated the international encounter and pointed out specific educational activities that were most helpful to their training.

Implications for practice:
International experiences offer NP students the opportunity to experience health care delivery in an alternative cultural milieu.
Modern surgical strategies in the management of complex ureteral strictures
Authors: Paffenholz Pia , Heidenreich Axel 
Published: January 2021

Purpose of review
The purpose of this article is to outline the various therapeutic options of ureteral strictures.

Recent findings
Ureteral strictures with consecutive hydronephrosis can be due to endourological and surgical procedures, inflammatory processes, radiation therapy as well as spontaneous passage of ureteral calculi. When planning surgical correction, stricture length, anatomical location as well as patients’ characteristics like age, comorbidities and previous treatment in the peritoneal cavity, retroperitoneum or pelvis should be taken into consideration. Treatment options include not only surgical reconstruction techniques like simple stricture excision, end-to-end anastomosis, ureterolysis with omental wrapping, ureteroneoimplantation, renal autotransplantation and ureter-ileum replacement, but also minimally invasive procedures such as self-expandable thermostents and pyelovesical bypass prosthesis.

Summary
Various therapeutic options can be offered in the treatment of ureteral strictures, potentially leading to long-term success rate of more than 90% and a rate of significant complications < 5%.
An Examination of Work Characteristics, Fatigue, and Recovery Among Acute Care Nurses
Authors: Cochran Karen R. 
Published: January 2021

OBJECTIVE
To examine self-perceived fatigue among nurses and to quantify levels of fatigue and the ability to recover from fatigue between worked shifts across various work characteristics.

BACKGROUND
Fatigue is associated with working long hours, disruption of sleep, and inadequate time to recover between shifts. Fatigue degrades the nurses' performance leading to poorer patient outcomes and increased occupational injuries.

METHODS
This quantitative study surveyed 573 nurses across 5 hospitals in the southeastern United States.

RESULTS
Significant levels of acute fatigue were associated with working labor and delivery and medical-surgical units and working a 12-hour shift. Nurses working night shift and on the behavioral health unit showed a significantly lower ability to recover between worked shifts.

CONCLUSIONS
Fatigue threatens safety and the quality of patient care. Leaders should ensure that nurses take duty-free breaks and schedule adequate time off to recover between worked shifts.
Interactive Learning for Nurses Through Gamification
Authors: Garrison Elisabeth , Colin Sharon , Lemberger Olivia , Lugod Maureen 
Published: January 2021

OBJECTIVE
The nursing professional development department purchased technology to create an innovative structure to engage nurses in educational offerings. The purpose of this study is to examine the effect of incorporating gamification on knowledge acquisition.

BACKGROUND
Nursing administrators should support the use of gamification to improve the nurses' acquisition of knowledge. The clinical educators traditionally utilize lecture-based educational offerings preventing students from active participation. Gamification promotes learner engagement, critical thinking, and enjoyment.

METHODS
A quasi-experimental study design with a 230-person convenience sample compared the knowledge acquisition of nurses before and after new hire orientation and basic electrocardiogram course. Technology purchased included iPad, GoPro, mobile apps, and websites.

RESULTS
Incorporating gamification technology resulted in an increase in knowledge acquisition and engagement of learners.

CONCLUSION
Findings demonstrate gamification as an effective way to increase knowledge acquisition when compared with traditional methods.
Examining Associations With Mental, Well-Being and Faith in Nurses (LIFT)
Authors: Harris Stephanie L. , Green Jeanette F. , Tao Hong , Robinson Patricia S. 
Published: January 2021

OBJECTIVE
The aim of this study was to explore the association between religion/spirituality (r/s) and mental health outcomes in hospital-based nursing staff.

BACKGROUND
The relationship between r/s and health has been studied extensively. Most frequently, r/s has been studied in association with mental health outcomes, including depression, anxiety, and distress among patients. However, hospital-based nurses suffer from the mental health effects of working in high-stress work environments. To date, little research has focused on the relationship between r/s and mental health outcomes in nurses.

METHODS
A cross-sectional online survey was completed by 207 nurses from 6 community hospitals.

RESULTS
Approximately half of the nurses sampled identified as religious, whereas nearly 75% identified as spiritual. There were significant associations between measures of r/s and mental health outcomes such as depression, anxiety, and mental well-being.

CONCLUSIONS
This whole-person assessment of nurses may inform future retention and engagement strategies focused on faith-based interventions.
Deep Learning‐Based Automated Abdominal Organ Segmentation in the UK Biobank and German National Cohort Magnetic Resonance Imaging Studies
Authors: Kart Turkay , Fischer Marc , Küstner Thomas , Hepp Tobias , Bamberg Fabian , Winzeck Stefan , Glocker Ben , Rueckert Daniel , Gatidis Sergios 
Published: January 2021

Purpose
The aims of this study were to train and evaluate deep learning models for automated segmentation of abdominal organs in whole-body magnetic resonance (MR) images from the UK Biobank (UKBB) and German National Cohort (GNC) MR imaging studies and to make these models available to the scientific community for analysis of these data sets.

Methods
A total of 200 T1-weighted MR image data sets of healthy volunteers each from UKBB and GNC (400 data sets in total) were available in this study. Liver, spleen, left and right kidney, and pancreas were segmented manually on all 400 data sets, providing labeled ground truth data for training of a previously described U-Net-based deep learning framework for automated medical image segmentation (nnU-Net). The trained models were tested on all data sets using a 4-fold cross-validation scheme. Qualitative analysis of automated segmentation results was performed visually; performance metrics between automated and manual segmentation results were computed for quantitative analysis. In addition, interobserver segmentation variability between 2 human readers was assessed on a subset of the data.

Results
Automated abdominal organ segmentation was performed with high qualitative and quantitative accuracy on UKBB and GNC data. In more than 90% of data sets, no or only minor visually detectable qualitative segmentation errors occurred. Mean Dice scores of automated segmentations compared with manual reference segmentations were well higher than 0.9 for the liver, spleen, and kidneys on UKBB and GNC data and around 0.82 and 0.89 for the pancreas on UKBB and GNC data, respectively. Mean average symmetric surface distance was between 0.3 and 1.5 mm for the liver, spleen, and kidneys and between 2 and 2.2 mm for pancreas segmentation. The quantitative accuracy of automated segmentation was comparable with the agreement between 2 human readers for all organs on UKBB and GNC data.

Conclusion
Automated segmentation of abdominal organs is possible with high qualitative and quantitative accuracy on whole-body MR imaging data acquired as part of UKBB and GNC. The results obtained and deep learning models trained in this study can be used as a foundation for automated analysis of thousands of MR data sets of UKBB and GNC and thus contribute to tackling topical and original scientific questions.
A Multicenter Analysis of Wide Excision and Reconstruction for Severe Anogenital Hidradenitis Suppurativa
Authors: Ovadja Zachri N. , Bartelink Sophieke A.W. , Hadi Kany , van de Kar Annekatrien L. , van der Horst Chantal M.A.M. , Lapid Oren 
Published: January 2021

Background
An appropriate reconstruction strategy after wide excision for severe cases of anogenital hidradenitis suppurativa (aHS) is important to optimize outcomes, but there is no consensus on which reconstruction strategy should be preferred.

Objective
Evaluate which reconstruction strategy after wide excision in patients with severe aHS is associated with the best outcomes in terms of recurrence rate, complications and patient-reported outcomes on range of motion, pain, appearance, sexual health and satisfaction.

Methods
Multicenter retrospective analysis between 2009 and 2019 of wide excision and reconstruction by primary closure, secondary intention healing, split-thickness skin grafts or fasciocutaneous flaps (FCF). The recurrence rate was the primary endpoint of multivariable logistic regressions to determine variables with an independent effect on recurrence.

Results
A total of 93 patients were included. The overall recurrence rate was 62% after a median follow-up of 43 months, without statistical significance between reconstruction strategies (P = 0.737). The number of interventions during follow-up was an independent risk factor for recurrence (odds ratio, 2.55; confidence interval, 1.24–5.25; P = 0.011). Complications (37%) were more severe after FCF (P = 0.007). The mean score regarding patient-reported outcomes was 14.9 ± 2.8, of 24, with best appearance after FCF (P = 0.042).

Conclusions
These long-term follow-up data on severe aHS demonstrate a high recurrence rate after wide excision and reconstruction. Patients should be informed that treatment consists of long-term medicinal and surgical interventions with high recurrence rates, and surgeons may choose their own preferred reconstruction methods. Furthermore, more attention should be paid to the sexual health of patients with aHS.
Transoral Approach to the Giant Deep Lobe Parotid Gland Pleomorphic Adenoma
Authors: Yavuz Haluk , Vural Omer 
Published: January 2021

Abstract
Parapharyngeal space tumors are rare tumors that make up about 0.5% to 1% of all head and neck neoplasms. The majority of parapharyngeal space tumors, which are usually benign, consist of salivary gland tumors and neurogenic tumors. Although the transcervical, transparotid or transmandibular approach is generally preferred for the excision of these tumors, the transoral approach, which is more advantageous in terms of cosmetics and function, can be applied in selected cases. This article presents a case in which the giant pleomorphic adenoma originating from the deep lobe of the parotid gland is removed by transoral approach.