bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective cohort study of the presence of SARS-CoV-2 in clinical samples from multiple bodily sites: implications for transmission routes of COVID-19
Authors: Liu Meixian , Huang Huimin , Bian Xiqing , Zheng Zhiyuan , Li Na , Sun Baoqing , Wu Jian-Lin 
Published: October 2021

Objective:
The coronavirus disease 2019 (COVID-19) epidemic resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has still spread globally. The occurrence of the Delta variant, which is more infectious and spreads faster than earlier forms of the virus that causes COVID-19, makes infection prevention more challenging. Therefore, this study aimed to gain a comprehensive insight into the transmission routes of SARS-CoV-2 for curbing the propagation of SARS-CoV-2 in human populations.

Methods:
We studied a prospective cohort of 576 patients admitted consecutively to the First Affiliated Hospital of Guangzhou Medical University from January 21 to June 8, 2020. These patients were chosen based on their similar clinical phenotypes or imaging findings. There were 21 (3.6%) laboratory-confirmed COVID-19 patients (16 severe and 5 mild cases) and 555 non-COVID-19 patients. The antibody response and routes and duration of viral shedding were systematically evaluated in serial clinical specimens. Moreover, SARS-CoV-2 RNA was also detected in a mouth rinse, urine, and tear samples. This study was approved by the Medical Ethical Committee of The First Affiliated Hospital of Guangzhou Medical University (approval No. 2020-77).

Results:
SARS-CoV-2 mainly existed in sputum, nasal and throat swabs, and feces samples. Virus latency was longer in sputum and feces samples than in nasopharyngeal samples. IgG antibody response in respiratory samples was related to disease severity. Although droplets and aerosols are the major transmission routes for COVID-19, covert routes of transmission from asymptomatic patients, contaminated surfaces, and wastewater are also of interest.

Conclusion:
Our findings provide a solid foundation for developing prophylactic measures against SARS-CoV-2.
Staff Beliefs Toward Self-Injurious Behavior in Patients: A Study of Secure Services
Authors: Steene Lisa Maria Beethoven , Ireland Jane L. , Ireland Carol A. 
Published: October 2021

ABSTRACT
Staff beliefs toward patient self-harm in secure forensic services are explored, capturing forensic nurses and other clinical staff from four secure units from one National Health Service trust, comprising high through low and forensic learning disability. One hundred fifty-five respondents took part (overall completion rate: 61%). The Theory-Driven Measure of Self-Injurious Behavior and the Suicide Competency Assessment Form were completed. It was predicted that higher competency and increased levels of training would associate with beliefs toward patient self-harm. Beliefs differed in accordance to location; perceiving self-injurious behavior as planned and within patient control was endorsed more in high-security settings by forensic nurses, with nurses in high security also more likely to endorse the perception that patients engaging in such behaviors were able to cope and felt valued. Competence and training experience were identified as factors of relevance. The study offers suggestions for future research, including a focus on capturing the environment, exploring “endorsed beliefs” as opposed to “negative attitudes,” and proposing the concept of “professional exposure to self-harm” as an important variable.
Patients' Expressed Nursing Care Needs in a Forensic Psychiatric Setting
Authors: Åling Maria , Syrén Susanne , Strömberg Lars 
Published: October 2021

ABSTRACT
The aim of this study was to describe the patients' nursing care needs in a forensic psychiatric setting in line with the NANDA-I classification. Ten patients sentenced to forensic psychiatric care were interviewed. Data were analyzed by means of directed content analysis with a deductive approach, where we used “served time” as a factor in the analysis, thus creating three categories: newly arrived patients with a length of stay of only a couple of years, patients with a length of stay of around 5 years, and patients with a length of stay of more than 5 years. Thirteen NANDA-I diagnoses were identified during the analyses, distributed on seven different domains. When distributing the given NANDA-I diagnoses according to the created categories, an explanatory pattern emerged, and three themes became apparent: denial, insight, and listlessness. Considering the differences in views, the patients' own recognition of what is a problem, a potential, or a risk could improve a “working relation” and, eventually, a recovery. NANDA-I nursing diagnoses may improve individualized and person-centered care as NANDA-I makes care continuously consistent over time.
Vestibular Aqueduct Size Correlates With the Degree of Cochlear Hydrops in Patients With and Without Menière's Disease
Authors: Grosser Desiree , Willenborg Kerstin , Dellani Paulo , Avallone Emilio , Götz Friedrich , Böthig Dietmar , Warnecke Athanasia , Lanfermann Heinrich , Lenarz Thomas , Giesemann Anja 
Published: October 2021

Objective:
To correlate the CT imaging findings of the visibility and size of the vestibular aqueduct (VA) with the degree of the cochlear hydrops determined in MRI late imaging of the hydrops. Study Design: Retrospective study. Setting: Tertiary referral center. Patients: A total of 127 patients (62 women, 65 men, average age 55.6 yrs): 86 of these were diagnosed with Menière's disease (American Academy of Otolaryngology–Head and Neck Surgery [AAO-HNS] criteria; 67 unilateral, 19 bilateral).

Intervention(s):
Temporal bone CT and hydrops MRI were performed in all patients.

Main Outcome Measure(s):
Visibility/width of the VA in temporal bone CT and grade of cochlear hydrops evaluated by MRI.

Results:
The width of the VA is significantly smaller in patients diagnosed with Menière's disease (30% non-visible VA), compared with the patients who did not fulfill the diagnostic criteria of Menière's disease (12% non-visible VA) (double sided Spearman correlation, p < 0.001). In all ears of patients diagnosed with Menière's disease the width of the VA was significantly correlated with the degree of the cochlear hydrops (in cases of non-visible VA 65% [34/52] ears presented with hydrops grade 3 or 4; 13% [7/52] ears presented with hydrops grade 1 or 2 and 21% [11/52] ears showed no hydrops) (Spearman correlation p = 0.001/p < 0.01). This is also true for all ears that can be summarized as hydrophic ear disease (symptomatic ears that present with a hydrops in MRI).

Conclusions:
The results of our study could confirm the importance of the VA in the pathogenesis of the endolymphatic hydrops in vivo.
Validation of a Moroccan Arabic Version of the Tinnitus Handicap Inventory (THI-M)
Authors: Halily Sara , Ardhaoui Hamida , Zoukal Sofia , Abada Redallah larbi , Oukessou Youssef , Rouadi Sami , Roubal Mohamed , Mahtar Mohamed 
Published: October 2021

Objective:
Cultural adaptation of the tinnitus handicap inventory questionnaire to the Moroccan dialect version.

Method:
We conducted a prospective study over a 3 years period (January 2017–January 2020) in the Otolaryngology Department of Casablanca University hospital. Translation was produced by a forward–backward procedure with analysis of the psychometric properties of the Moroccan version of the tinnitus handicap inventory.

Results:
The final Moroccan version of Tinnitus Handicap Inventory (THI) was given to 83 otosclerosis patients suffering from tinnitus. They filled the questionnaire twice before surgery and 1 year after surgery.
The item-total correlations are all statistically significant (p < 0.001) and vary between 0.279 (item 15) and 0.817 (item 12).
The internal consistency of the Moroccan version of THI, assessed through Cronbach's α, was found to be excellent at 0.953. The interclass correlation showed an excellent reliability for all subscales (0.999–1).
THI scores decreased significantly from baseline to 1-year postoperative follow-up on all subscale scores, indicating clinical improvement.

Conclusion:
The Moroccan version of THI has a good reliability comparable with translations in other languages and the original version. It is a valid tool to assess tinnitus improvement after otosclerosis surgery.
Hearing Results in 151 Primary Stapedotomies for Otosclerosis: The Effects of Using Different Audiologic Parameters and Criteria on Success Rates
Authors: Saerens Morgane , Van Damme Jean-Philippe , Bihin Benoit , Garin Pierre 
Published: October 2021

Objective:
To describe the 151 hearing results of primary stapedotomy for otosclerosis using different criteria of success rates.

Design:
Retrospective case series of 151 patients with a diagnosis of otosclerosis and operated on by the same surgeon with the same technique, using a CO2 laser. Patients with revision surgery were excluded. The audiometric data were extracted from the patient files and divided into three groups: early postoperative follow-up (<1 mo after surgery), mid-term follow up (between 1 mo and 1 yr), and late postoperative follow-up (>1 yr).

Results:
The postoperative air-bone gap (ABG) was 10 dB or less in 45.2% in the mid-term follow up. For this same follow-up, ABG closure less or equal than 20 dB was achieved in 95.6% of cases. The lower percentage of patients with a postoperative ABG closure of less than or equal to 10 dB can be due to the high rate of bone conduction (BC) overclosure of 15.65%. The functional success described as an air conduction (AC) threshold less than or equal to 30 dB was achieved in 52.2% of patients. The mean speech reception threshold (SRT) in the mid-term follow up was 27.4 dB. The analysis of the data according to the Amsterdam Hearing Evaluation Plots (AHEPs) shows a success rate of 87% at early follow-up.

Conclusions:
The success rate is mainly dependent on the definition and criteria as a measure of success. An analysis of the evolution of the BC is mandatory to avoid a false positive success rate when the ABG closure is used. Therefore, the use of the AHEPs would acquire additional information. The hearing outcome has also been based on the speech audiometry and the number of patients achieving an AC less than or equal to 30 dB as a more realistic measure of success. Our series confirms good long term hearing results achieved in stapedotomy surgery with the CO2 laser.
Radiological Follow-up After the Bony Obliteration Tympanoplasty in Detecting Residual Cholesteatoma: Towards an Optimal Postoperative MR Imaging Protocol
Authors: van der Toom Hylke F. E. , van Dinther Joost J. S. , Zarowski Andrzej , Baazil Adrianus H. A. , De Foer Bert , Bernaerts Anja , Casselman Jan W. , Offeciers Erwin 
Published: October 2021

Introduction and Aim:
There is no consensus in literature on the most optimal follow-up imaging protocol for non-echoplanar diffusion-weighted magnetic resonance imaging (non-EP DW MRI) after the canal wall-up bony obliteration tympanoplasty. Clearly, no residual cholesteatoma should be missed but on the other hand, unnecessary MR controls should be avoided. The aim of this study is to evaluate the postoperative results of non-EP DW MRI after canal wall-up bony obliteration tympanoplasty surgery at our Institute and to propose an optimal postoperative MR imaging scheme based on our data.

Material and Methods:
Retrospective cohort study; all 271 patients who underwent the bony obliteration tympanoplasty between January 2010 and January 2016 with follow-up at our Institute were included. A postoperative MR imaging was systematically performed at 1 year after surgery and repeated at either 5 or both 3 and 5 years after surgery, based on the preferences of the surgeon. Variables of interest were retrieved from electronic patient records.

Results:
The median follow-up time was 60 months (inter-quartile range 56–62 mo). Two hundred seventy-one patients (100%) received a 1-year MRI, 107 (39%) a 3-year MRI, and 216 (79.7%%) a 5-year MRI. Residual cholesteatoma was found in nine cases (3.3%), corresponding with an estimated residual rate at 5 years follow-up of 3.7% when using Kaplan–Meier analysis. Of these nine cases, six cases of residual cholesteatoma (66.7%) were detected at the 1-year MRI (12–14 mo postsurgery), two cases (22.2%) at the 3-year MRI (35–39 mo postsurgery), and one case (11.1%) at the 5-year MRI (51 mo postsurgery, in this patient no 3-year MRI was performed). An uncertain MRI result was found in 15 cases, presenting as relatively hyperintense lesions. However, subsequent follow-up scans did not show persistent evidence for residual disease in 14 of these 15 cases.

Conclusions:
A postoperative MRI scan after 1 and 5 years is essential to detect early and late residual cholesteatoma. In our cohort, 22.2% of residual cases were detected at the 3-year MRI. However, this percentage could potentially have been higher when all patients would have received a 3-year MRI. Therefore, in order to detect residual disease as soon as possible, we propose to perform an MRI scan at 1, 3, and 5 years after the bony obliteration tympanoplasty. In cases with an unclear MR result, we suggest a repeat MRI after 12 months.
Endoscopic Transcanal Labyrinthectomy for Intractable Meniere's Disease: An Alternative to Transmastoid Labyrinthectomy?
Authors: Lee Se A , Lee Yun Ji , Lee Jong Dae 
Published: October 2021

Objective:
To describe a novel approach for intractable Ménière's disease exclusively through a transcanal endoscopic ear surgery (TEES) approach.

Patient:
A 56-year-old male with intractable Ménière's disease despite conservative treatment and chemical labyrinthectomy.

Interventions:
Transcanal endoscopic labyrinthectomy.

Main Outcome Measure:
Subjective vertigo control, surgical morbidity.

Results:
The TEES approach provided a wide exposure of the oval window. This facilitated removal of stapes crura and footplate. After widening of the oval window, the perilymph was suctioned, and gentamicin was injected through the oval window. The oval window was obliterated using the perichondrium of the tragal cartilage and fibrin glue. After 2 years of follow-up, there was no recurrence of vertigo.

Conclusions:
As a compelling alternative to the transmastoid approach, we propose endoscopic labyrinthectomy as an option for patients with intractable MD without functional hearing who have failed chemical labyrinthectomy. Additional studies are needed to determine the risk-benefit profile of this technique.
Impact of Duration of Deafness on Speech Perception in Single-Sided Deafness Cochlear Implantation in Adults
Authors: Nassiri Ashley M. , Wallerius Katherine P. , Saoji Aniket A. , Neff Brian A. , Driscoll Colin L. W. , Carlson Matthew L. 
Published: October 2021

Objective:
To evaluate the impact of prolonged auditory deprivation on speech perception outcomes in adult acquired single-sided deafness (SSD) cochlear implant (CI) recipients.

Study Design:
Retrospective case series.

Setting:
Tertiary care academic center.

Patients:
Acquired SSD in adults with and without prolonged duration of deafness (defined as >10 yr) who underwent CI between 2014 and 2019.

Interventions:
CI.

Main Outcome Measures:
Consonant-nucleus-consonant (CNC) and AzBio in quiet scores within first year of follow-up.

Results:
A total of 35 adult patients with SSD were evaluated, with a median overall duration of deafness of 2.4 years (interquartile range [IQR] 1.2–6.0 yr): seven patients with prolonged auditory deprivation (median 18 yr, IQR 15–28) were compared with 28 SSD patients with duration of deafness less than 10 years (median 1.7 yr, IQR 1.1–3.2). At last follow-up, the median CNC scores were 39% (IQR 31–64) and 54% (IQR 46–64) for the prolonged and shorter duration of deafness cohorts, respectively (p = 0.3). The median AzBio scores were 66% (IQR 65–68) and 72% (IQR 60–82) for the prolonged and shorter duration of deafness cohorts, respectively (p = 0.6). In a separate analysis evaluating duration of deafness as a continuous variable across all 35 patients, Spearman correlation coefficients for associations of duration of deafness with most recent CNC and AzBio scores were –0.02 (p = 0.9) and 0.02 (p = 0.9), respectively.

Conclusions:
Adult CI recipients with acquired SSD, with and without prolonged auditory deprivation, demonstrated comparable speech perception scores. Prolonged duration of deafness alone should not preclude a motivated SSD patient from undergoing cochlear implantation.
Identification of Breast Cancer Survivors With High Symptom Burden
Authors: Whisenant Meagan S. , Williams Loretta A. , Mendoza Tito , Cleeland Charles , Chen Tsun-Hsuan , Fisch Michael J. , Shi Quiling 
Published: October 2021

Background
While women diagnosed with breast cancer have increased survival when compared with other cancers, survivorship may include residual symptom burden from treatment and continuing endocrine therapies.

Objective
The objective of this study was to identify subgroups of breast cancer survivors experiencing similar symptom severity.

Methods
Participants were 498 women with breast cancer, not on active treatment. Symptom severity was self-reported using the MD Anderson Symptom Inventory. Target symptoms were included in a latent profile analysis. Factors related to subgroup membership and differences in quality of life (QOL) and functioning were explored using logistic regression.

Results
Mean age was 60.11 (SD, 11.32) years, 86.1% were white, and 79.1% were receiving endocrine therapy. Target symptoms included fatigue (reported at ≥5 by 22.8% of women), sleep disturbance (24.8%), and trouble remembering (17.2%). Two subgroups were identified: low symptom severity (77.0% of women) and high (23.0%). Older women (odds ratio [OR], 0.971; 95% confidence interval [CI], 0.952–0.989) and employed women (OR, 0.621; 95% CI, 0404–0.956) were less likely to be in the high subgroup; women with poorer performance status (OR, 1.653; 95% CI, 1.188–2.299) were more likely to be in the high subgroup. Women in the high subgroup reported lower QOL (P = .000) and greater interference with functioning (P = .000).

Conclusions
Two subgroups of women with distinct symptom severity were identified.

Implications for Practice
Identification of women at risk for high symptoms during survivorship may allow clinicians to intensify their approach to symptom management, thereby mitigating poor outcomes and impairments in QOL.
Predictors for Telephone Outreach Post-hospital Discharge
Authors: Vergara Franz H. , Budhathoki Chakra , Sheridan Daniel J. , Davis Jean E. , Sullivan Nancy J. 
Published: October 2021

Purpose of Study:
The specific aims of this study were to examine whether sociodemographic variables and medical–surgical diagnoses were associated with telephone follow-up (TFU) reach rates, emergency department visits, and hospital readmissions.

Primary Practice of Setting:
Acute care inpatient units in an academic medical center.

Methodology and Sample:
A correlational design was utilized, and a prospective medical record review of patients was conducted while implementing face-to-face prehospital discharge meeting interventions. The study sample (N = 176) included adult patients in two neurosurgical wards who were admitted between June 2016 and September 2016. Parametric and nonparametric tests were used to explore the balance between the intervention group receiving a face-to-face prehospital discharge meeting and comparison group receiving standard prehospital discharge care. Bivariate statistics were employed to determine associations between variables.

Results:
A total of 15 sociodemographic and medical–surgical variables were used to correlate TFU reach rates, emergency department (ED) visits, and readmission rates. Educational attainment (p = .002), employment status (p = .014), parental status (p = .010), and hospital service (p = .039) had significant differences between the intervention and comparison groups. Results demonstrated an improved reach rate for the intervention group but despite the differences in the groups, phi and Cramer's V coefficients did not correlate any associations with TFU reach rate, ED visits, and readmission rates with sociodemographic and surgical variables. This outcome affirmed that despite the similarities and differences in the sample, a face-to-face meeting prehospital discharge is an effective intervention to improve telephone outreach.

Implications to Case Management Practice:
There is a need to determine the most cost-effective way to increase TFU reach rates to prevent subsequent ED visits and hospital readmissions. There is also a need to develop a tool that can predict the hardest-to-reach patients posthospital discharge, so that case managers can meet those patients before leaving the hospital. In addition, it is important to identify alternative methods of “face-to-face” interactions during the COVID-19 pandemic crises. Case managers must explore ways with caution to leverage secured digital technology to bridge the gap of communicating with patients and family members when hospital visitations are limited.
Virtual Interviewing for Pediatric Emergency Medicine Fellowship—A National Survey
Authors: van der Laan Lyndsey , George Rachel , Nesiama Jo-Ann , Nagler Joshua , Langhan Melissa L. , Yen Kenneth , Ngo Thuy L. , Rose Jerri A. , Caglar Derya , Kant Shruti , Ciener Daisy , Feng Sing-Yi 
Published: October 2021

Objective
This study aimed to evaluate both applicant and interviewer satisfaction with the virtual interviewing process for pediatric emergency medicine (PEM) fellowship in hopes to improve the fellowship interviewing process. It was proposed that fellowship programs and applicants would prefer virtual interviews over traditional interviews.

Methods
A survey developed in collaboration with UT Southwestern PEM fellowship leaders and national PEM leaders was sent to all PEM fellowship applicants and programs at the conclusion of the 2020 interview season and rank list submission. The applicant survey obtained information on ease of virtual interviews and whether applicants felt that they obtained adequate information from virtual interviews to make informed program selections. Program director surveys collected data on thoughts and feelings about virtual interviews and obstacles encountered during the recruitment season. Both surveys asked about costs for interviews and interview type preference.

Results
A response rate of 49% from applicants and 47% from programs was obtained. Virtual interview days were similar in the amount of time and staff hours used compared with traditional days. Applicants spent less on virtual interviews compared with those who underwent traditional interviews (average $725 vs $4312). Programs received more applications than the prior year and spent less money during the virtual cycle. The majority of the applicants (90%) were comfortable with the virtual interview platform, and most (66%) agreed that virtual interviews provided adequate information to determine program rank. Geography was the number 1 rank determining factor. Programs and applicants preferred a form of in-person interviews.

Conclusions
Virtual interviews provide cost savings for both applicants and programs. Despite this, both parties prefer a form of in-person interviews.