bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular Consequences of Excessive Alcohol Drinking via Electrocardiogram
Authors: Farinelli Lisa A. , Piacentino Daria , Browning Brittney D. , Brewer Barbara B. , Leggio Lorenzo 
Published: February 2021

Abstract
There is a link between excessive alcohol drinking and an increased risk to develop cardiovascular disease, including alcoholic cardiomyopathy. This association warrants further research on the potential utility for the electrocardiogram (ECG) in the participatory management of the chronic consequences of alcohol use disorder (AUD). Our goal is to enhance understanding about the pernicious role alcohol plays on cardiac health using the ECG, an accessible, cost-effective, validated tool to inform novel targeted treatments for AUD. In this systematic review of human studies, we examine the relationship between abnormal clinically significant changes to ECG variables and excessive alcohol drinking with the goal of identifying key patterns specific to quantity of alcohol consumed. Three independent reviewers and one consensus reviewer, adhering to the PRISMA guidelines, conducted an initial review on studies published from database inception to April 19, 2019, using PubMed, Embase, CINAHL and COCHRANE databases. The initial search generated 2,225 articles. The final selected number included 153 original articles. This systematic review provides evidence of patterns of clinically significant changes to ECG variables as a consequence of excessive alcohol consumption. Future directions include investigating whether a real-time assessment, such as the ECG, in conjunction with other key behavioral and cardiac measures, can help clinicians and patients realize the progressive and insidious cardiac damage because of excessive alcohol consumption. This theory-guided nurse science review supports the development of personalized symptom monitoring to deliver tailored feedback that illuminate risk factors as a potentially transformative approach in the management of AUD.
Psychosocial Needs of the Parents With Teenagers on Drugs
Authors: Daryoushi Hooman , Jalali Amir , Ezzatei Ebrahim , Dinmohammadi Mohammadreza 
Published: February 2021

Abstract

Background
Dependence on drugs causes several problems for the individual, family, and society. Such problems are more evident in teenagers and deeply affect the parents. Perceiving these parents' problems and needs is a way to help them with such problems and enable them to provide more support to their children. This study is an attempt to elaborate on the psychological needs of the parents with adolescents who use drugs.

Methods
The participants were 19 parents with an adolescent with drug use disorder who were selected purposefully. In-depth and semistructured interviews were conducted face-to-face with the participants. All the interviews were recorded and analyzed by conventional content analysis. Guba and Lincoln's four measures of trustworthiness were observed throughout the study.

Results
Analyses of the interviews revealed three themes, seven categories, and 17 subcategories. The themes were receiving support, need for self-confidence, and need for welfare.

Conclusion
For different reasons, parents of adolescents who use drugs find it incumbent upon themselves to support and treat their adolescents. Given the many problems, these parents need a variety of social, educational, emotional, interpersonal, and financial supports.
Medical Marijuana
Authors: Kameg Brayden , Kameg Kirstyn 
Published: February 2021

Abstract
As of 2019, 33 states, in addition to three territories and the District of Columbia, have approved medical marijuana programs. In the United States, the 12-month prevalence of medical marijuana use increased by 34.2% between 2013 and 2015. The rapid dissemination of medical marijuana use, in conjunction with conflicting data regarding its safety and efficacy, renders mental health providers in an ethical and legal quandary. The purpose of this article was to highlight emerging evidence regarding the efficacy and risks of medical marijuana and to describe medical–legal issues of such use regarding liability for mental health providers. Mental health care providers must be prudent to ensure that they are providing patients with the most accurate, up-to-date information regarding medical marijuana. This is not only to ensure protection from medical liability but also to promote best outcomes for patients experiencing mental health problems.
Hope, Sociodemographic and Clinical Characteristics as Predictors of Stigma-Related Negative Discrimination Experiences of Patients With Primary Malignant Brain Tumor
Authors: Baksi Altun , Arda Sürücü Hamdiye , Genç Hasan 
Published: February 2021

ABSTRACT

BACKGROUND: A brain tumor can cause specific dysfunctions including psychosocial problems, and neurological, cognitive, mental, personality, behavioral, body image, and self-concept changes. Hope is reported in previous studies as an important and protective factor during the difficult duration of the disease. The purpose of this study is to examine hope and related factors as predictors of the stigma-induced negative discrimination experience of patients with primary malignant brain tumor. METHODS: The relational research method was used. The study was conducted in neurosurgery and oncology clinics and outpatient clinics of a university hospital in Southeastern Turkey between July 2018 and March 2020. The research data were collected using an information form, the Discrimination and Stigma Scale, and the Dispositional Hope Scale. The research sample consisted of 124 patients with primary malignant brain tumor. The data were analyzed by stepwise multiple linear regression analysis. RESULTS: The average age of the patients with primary malignant brain tumor was 46.64 (±12.00) years. Of all the patients, 61.3% were male, and 25% received radiotherapy. When the negative discrimination experience of patients with primary malignant brain tumor was examined, age (β = −0.244, P = .004), total dispositional hope (β = −0.225, P = .009), and currently receiving radiotherapy (β = 0.169, P = .048) were determined to be significant predictors. CONCLUSION: This study demonstrates the importance of hope, age, and treatment type in the negative discrimination experience of patients with primary malignant brain tumor. Initiatives taking hope into account should be planned by nurses and healthcare professionals to reduce patients' experience of negative discrimination.
Impacts of a Re-designed Care Path for Back Pain Directing Patients to Physiotherapists
Authors: Kiljańska Małgorzata , Soszyński Piotr , Motyl Agnieszka , Walewska-Zielecka Bożena 
Published: February 2021

Objective:
To evaluate impact of directing patients with back pain for first visit to a physiotherapist on sick leaves, healthcare utilization, and patient satisfaction.

Methods:
Pre–post intervention study of 70,138 patients treated in Poland for back pain: 27,034 before the care pathway redesign and 43,104 after.

Results:
After the redesign, all per-patient measures (mean ± SD) significantly decreased over the 12-month follow-up: sick leaves number from 0.32 ± 0.87 to 0.29 ± 0.86, sick leaves days from 2.78 ± 11.56 to 2.56 ± 11.25, doctors’ visits from 2.02 ± 1.70 to 1.51 ± 1.63, diagnostic imaging services from 0.63 ± 0.79 to 0.43 ± 0.71 and rehabilitation services from 7.55 ± 14.90 to 4.70 ± 12.61.
The Net Promoter Score was higher for physiotherapist (83), than for orthopedists (59), primary care (74), or neurologists (67).

Conclusions:
Involving physiotherapists early in the back pain care may result in benefits for patients and healthcare organizations.
Determining the Best Time to Integrate Opioid Use Disorder Training into the Curriculum Based on Student Perceptions
Authors: Brown Sheena D. , Solh Tia M. 
Published: February 2021

Purpose
The clinical phase of physician assistant (PA) education has been reported to be the best time period to deliver opioid prescribing education (OPE) and opioid addiction education (OAE); however, there are no current published studies that evaluate the timing of OPE and OAE instruction in PA curricula.

Methods
This pilot study compared didactic and clinical phase cohorts' perceived confidence in their ability to evaluate patients with opioid use disorder (OUD) after receiving identical training at different time points within the curriculum.

Results
As expected, clinical phase students displayed high confidence levels in their abilities both before and after implementation of OUD-focused patient simulations. Interestingly, didactic phase students' confidence levels were comparable to clinical phase students' confidence levels after participating in the patient simulations.

Conclusions
Our findings suggest that students can benefit from this training in both phases of the curriculum, which may encourage and help PA programs to insert this important and timely information into their curriculum.
Technical Report: Gait Performance at Two Speeds and Carrying Capacity by Men with an Osteomyoplastic Transfemoral Limb and Comparable Controls
Authors: Dionne Carol P. , Regens James L. , Day Jonathan D. , Fagg Andrew H. , Bryant Douglas J. , Veirs Kimberly P. , Ertl William J.J. 
Published: February 2021

ABSTRACT

Introduction
With advances in surgical approach like osteomyoplastic amputation, it is unknown whether outcomes of walking at different speeds or carrying performance by men with an osteomyoplastic transfemoral limb (OTFL) are comparable with those of intact controls.

Materials and Methods
Otherwise healthy men with unilateral OTFL and intact controls consented to participate. All were independent walkers without history of diabetes or other dysvascular condition. All underwent 2-minute walk tests (2MWTs) at self-paced and brisk-paced speeds and 25-ft carry-to-capacity testing as part of a multiyear work performance study. For the current report, investigators compared walking and carrying baseline outcomes between OTFL and control groups.

Results
Six men with OTFL (mean age, 33.7 ± 14.8 years) and 20 controls (mean age, 31.7 ±11.1 years) completed the study. No initial differences between groups were found in age, height, weight, heart rate, blood oxygen saturation, hemoglobin A1c, overall reported pain, or report of perceived exertion scores. However, the OTFL group walked shorter mean distances at self-paced (137.2 ±18.1 m) and brisk-paced (167.8 ± 20.3 m) 2MWTs than the controls did (self-paced, 155.7 ± 19.9 m, P = 0.015; brisk paced, 211.7 ± 3.0 m, P < 0.0001) and demonstrated less 25 ft-carry capacity (18.1 ± 9.7 kg) than the controls did (26.8 ± 3.1 kg; P = 0.001). Reported pain by the OTFL group was greater only during carry testing (P < 0.046).

Conclusions
Despite receiving similar, well-fitted prosthetic limbs and standard rehabilitation after osteomyoplastic amputation, the OTFL group demonstrated lower walking and carrying capacities than a comparable control group. Results may reflect that the OTFL group may still be at risk of injury, demonstrating the need for further investigation of gait and other work performance outcomes by work-eligible men with OTFL and standard rehabilitation approaches.
Can an Outpatient Exercise Program for Pregnancy-Related Pelvic Girdle Pain Improve Pain and Function Versus Education? A Feasibility Study
Authors: Guan Jennifer , Hamnett Claire , Jakucionis Samantha , Hameed Farah , Chiarello Cynthia 
Published: February 2021

Introduction:
Pregnancy-related pelvic girdle pain (PRPGP) is a type of low back pain located between the posterior iliac crest and the gluteal fold that is exacerbated with load transfer activities and may be due to inadequate muscle activation and laxity. PRPGP affects a high percentage of pregnant women and can continue to persist postpartum.

Objectives:
The purpose of this study was to determine the feasibility for women with PRPGP to perform exercises designed to target core musculature throughout their pregnancy. Exercise and education (EE) was compared with education alone (EA).

Study Design:
This pilot study is a longitudinal, 2-group, repeated-measure, time series design.

Methods:
Women with PRPGP were randomly assigned to the EE group or the EA group. Pain and function were measured with the Numeric Pain Rating Scale and the Pelvic Girdle Questionnaire (PGQ), respectively, beginning at 20 to 28 weeks' gestation for 5 total sessions.

Results:
There was a significant main effect of session for group, as both EE and EA demonstrated a decrease in current pain (P = .019), worst pain (P = .007), and an increase in the PGQ (P = .0001) over time. There was no statistical difference between the groups. Best pain was not significant (P = .174).

Conclusions:
Women with PRPGP improved in pain and function from their second trimester to 6 weeks postpartum regardless of group assignment. This suggests that this population may benefit from additional education and a targeted exercise program for core musculature. Future research is needed to confirm these findings.
(see the Video, Supplemental Digital Content 1, which is the video abstract, available at: http://links.lww.com/JWHPT/A42).
Developing and implementing a novel program to prepare nursing home-based geriatric nurse practitioners in primary palliative care
Authors: Carpenter Joan G. , Ersek Mary 
Published: February 2021

ABSTRACT
Current palliative care workforce projections indicate that the growing palliative care needs of older adults in US nursing homes cannot be met by specialists, leaving them vulnerable and at risk for poor end-of-life outcomes. The purpose of this article is to describe the development, implementation, and initial evaluation of a program to support primary care nursing home nurse practitioners (NPs) in palliative care. The program aimed to improve geriatric NPs' knowledge and skills related to palliative care and to provide a structured protocol for integrating palliative care encounters into NPs' practice. It comprised three phases consisting of asynchronous online learning modules, a 1-day face-to-face communication skills and patient simulation workshop, and ongoing monthly virtual meetings to support NP clinical practice. Over a 1-year period, the program was developed and implemented with 12 practicing NPs in a national organization. Through an online survey and face-to-face feedback, NPs reported satisfaction with the curriculum and expressed it as valuable to their clinical practice. Future work will focus on sustaining implementation of the program, measuring patient level outcomes, and refining the curriculum based on NP feedback.
Clinical Challenges in Managing Cervical Intraepithelial Neoplasia 2: A Report From a Cross-sectional Survey
Authors: Bradbury Melissa , Centeno Cristina , Pérez-Benavente Assumpció , Gil-Moreno Antonio 
Published: February 2021

Objectives
The aims of the study were to determine the management strategies offered to women with cervical intraepithelial neoplasia 2 (CIN 2) and the attitude of colposcopists toward its histological diagnosis and to identify the criteria used to select women for conservative management.

Methods
Colposcopists working in Spain were invited to participate in an online questionnaire via the Spanish Gynecology and Colposcopy Societies. The survey included 42 questions covering the 3 objectives of the study. One hundred eighty-two colposcopists representing all autonomous regions in Spain responded. The response rate was 26.2%, considering the total number of members.

Results
Most colposcopists offer conservative management in selected cases (153/182). The preferred follow-up interval is 6 months (65%), followed by 3–4 months (30%). Observation was considered no longer appropriate after 24 months (29.5%) and 12 months (26.3%), and 24.3% expressed that it depended on women's plan to conceive. During conservative management, 93.9% always perform a cytology, 62.7% human papillomavirus testing, 96.8% colposcopy, 47.9% cervical biopsy, and 28.1% endocervical curettage. Forty-five percent consider that CIN 2 merely represents a misclassified CIN 1 or CIN 3, whereas 46.2% think that CIN 2 lesions are unlikely to regress. Most respondents considered that age older than 40 years (81.3%), human papillomavirus 16 infection (62.1%), HIV infection (76.8%), positive p16 immunostaining (60.2%), a large lesion occupying more than 50% of the cervix (87%), endocervical involvement (91.6%), and previous treatment for CIN 2–3 (77%) are contraindications for conservative management.

Conclusions
Management of CIN 2 remains challenging for colposcopists, and a lack of consensus still exists in clinical practice. A better understanding of the natural history of CIN 2 and its clinical outcomes is still necessary to guide clinicians in its management.
The International Society for the Study of Vulvovaginal Disease Vaginal Wet Mount Microscopy Guidelines: How to Perform, Applications, and Interpretation
Authors: Vieira-Baptista Pedro , Grincevičienė Švitrigailė , Oliveira Caroline , Fonseca-Moutinho José , Cherey Facundo , Stockdale Colleen Kennedy 
Published: February 2021

Objectives
The aims of the study were to assess the available literature concerning the indications, performance, technique, and classification of wet mount microscopy (WMM) and to establish evidence-based recommendations.

Methods
Literature review from the main scientific databases was performed by the ad hoc “Vaginitis and Microbiome Committee” of the International Society for the Study of Vulvovaginal Disease. The document was approved by the executive council and membership of the International Society for the Study of Vulvovaginal Disease.

Results
Available data are limited and usually of low level of evidence. Nevertheless, it shows that WMM is capable of reducing misdiagnosis, overtreatment, and undertreatment of vaginal conditions. It has an excellent performance for the diagnosis of bacterial vaginosis and variable performance for trichomoniasis and candidiasis. It is the gold standard for aerobic vaginitis/desquamative inflammatory vaginitis. Currently, there is no recommendation to use WMM in the screening of asymptomatic women.
The use of phase contrast is recommended to improve performance and reproducibility. Sampling location, devices, and technique have an impact on the results.
Available scoring and classification scores have significant limitations.

Conclusions
Wet mount microscopy is a point-of-care, inexpensive, and fast technique that, with practice, can be mastered by office clinicians. It should be considered a basic skill in the curricula of gynecology and obstetrics residencies. Recommendations are provided on sampling, reading, and scoring.
Editorial: Light shielding of bags and tubing used for parenteral nutrition of infants
Authors: Mihatsch Walter A. , Koletzko Berthold 
Published: February 2021

Purpose of review
In July 2019, the Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) recommended light protection of all parenteral nutrition (PN) solutions containing amino acids (AA) and/or lipids, with or without admixture of vitamins or trace elements, during administration for preterm infants, term infants and children less than 2 years of age. The aim of the present paper was to review the available evidence and to provide recommendations for in hospital and home PN light protection in children.

Recent findings
Lipid emulsions and multivitamins are susceptible to photooxidation and generation of oxidation products. There is no conclusive evidence to justify recommending light protection for PN solutions without lipid emulsions and/or vitamins during administration (solutions containing e.g. AA, glucose, electrolytes, or trace elements).

Summary
Lipid emulsions and/or vitamins containing PN solutions should be protected from light during administration (bags and tubing) to reduce the generation of oxidation products.
Coronavirus disease 2019 management
Authors: Wilson Kevin C. 
Published: February 2021

Purpose of review
Coronavirus disease 2019 (COVID-19) is an acute multisystem disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Investigations are ongoing in the search for effective therapeutics, with clinical approaches evolving based upon such evidence.

Recent findings
The antiviral agent, remdesivir, and the immunomodulator, dexamethasone, are the first therapeutics for which there is evidence of efficacy from randomized trials. Subgroup analyses suggest remdesivir is beneficial in hospitalized patients whose severity of illness falls at the lower end of the spectrum, while dexamethasone is more beneficial in hospitalized patients whose severity of illness falls at the higher end of the spectrum. We recommend that inpatients who require supplemental oxygen but are not mechanically ventilated receive both remdesivir and dexamethasone, and inpatients who require mechanical ventilation receive dexamethasone monotherapy. Additional evidence regarding anti-SARS-CoV-2 antibodies, convalescent plasma, and a variety of antiinterleukin therapies is forthcoming.

Summary
The body of evidence related to COVID-19 therapeutics continues to evolve and, as a result, management is likely to change with time. As new evidence is generated and published, the optimal approach to managing patients with COVID-19 should be reconsidered.
Care of the postcoronavirus disease 2019 patient
Authors: LaFond Elyse , Weidman Karissa , Lief Lindsay 
Published: February 2021

Purpose of review
In under a year, coronavirus disease 2019 (COVID-19) has taken the lives of hundreds of thousands of Americans, leaving millions of survivors in its wake. The enormous number of people who survived acute illness but continue to have symptoms has highlighted the need for standardized evaluation of the post-COVID-19 patient. This review, based on the current literature and our experience, aims to guide the care of patients who have survived COVID-19.

Recent findings
The literature on this topic is rapidly expanding and covers both pulmonary and nonpulmonary complications of COVID-19. Pulmonary complications include dyspnea with normoxia, organizing pneumonia and pulmonary fibrosis. Nonpulmonary complications include neurologic, cardiac, and thromboembolic disease. Special consideration should be taken for COVID-19 survivors of intensive care.

Summary
The current review outlines the major clinical findings in post-COVID-19 patients and provides a guidelines to the evaluation and management of prolonged symptoms.
COVID-19 – pathogenesis and immunological findings across the clinical manifestation spectrum
Authors: Carsetti Rita , Quinti Isabella , Locatelli Franco 
Published: February 2021

Purpose of review
The wide spectrum of COVID-19 clinical manifestations demonstrates the determinant role played by the individual immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the course of the disease. Thanks to the large number of published data, we are beginning to understand the logic of the human response to a virus adapted to bat immunity.

Recent findings
Impairment of types I and III interferon responses may facilitate the occurrence of severe COVID-19 with reduced antiviral activity associated to potent inflammation. The human T and B-cell germline repertoire contain the specificities able to react against SARS-CoV-2 antigens. Although inflammation disrupts the structure of germinal centers, memory T and B cells can be found in the blood of patients after mild and severe COVID 19.

Summary
Further studies are indispensable to better understand the human immune response to SARS-CoV-2. The diversity of the individual reaction may contribute to explain the clinical manifestation spectrum. Immunological memory can be demonstrated in patients, convalescent from mild, moderate, or severe COVID-19, but we do not know whether asymptomatic individuals have memory of the virus. Tailored vaccination protocols may be needed for individuals with previous SAS-CoV-2 infection.