bluuebunny/crossref_metadata_2025_split huggingface dataset:
Superficial Circumflex Iliac Artery Perforator Flap Elevation Using Preoperative High-Resolution Ultrasonography for Vessel Mapping and Flap Design
Authors: Yoshimatsu Hidehiko , Karakawa Ryo , Fuse Yuma , Hayashi Akitatsu , Yano Tomoyuki 
Published: October 2021

Abstract
Background The superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has gained acceptance among reconstructive microsurgeons, the minimal donor site morbidity being its greatest advantage. The purpose of this article is to introduce the use of preoperative ultrasonography to facilitate elevation and to avoid postoperative complications of the SCIP flap.
Methods Preoperative mapping of the SCIA and the superficial circumflex iliac vein (SCIV) using a high-resolution ultrasound system were performed in patients undergoing reconstruction using a free SCIP flap. The skin paddle was designed placing the SCIA and the SCIV in the middle of the flap.
Results Preoperatively marked SCIA and SCIV were found intraoperatively in all cases. The skin paddle design for sufficient arterial inflow and venous drainage resulted in no postoperative flap complications.
Conclusion The use of a preoperative high-resolution ultrasound system significantly facilitates elevation of the SCIP flap, notably via the following 2 points: 1) pedicle can always be found under the markings made with preoperative ultrasonography, 2) satisfactory perfusion of the flap can be guaranteed via a safe flap design that includes preoperatively marked vessels within the skin paddle.
Beware, an underdog may bite: literature review and brand management framework in the context of underdog brands
Authors: Schmidt Holger J. , Steenkamp Pieter 
Published: October 2021

AbstractAn underdog brand is a brand with humble resources that competes with passion and determination against competitors that dominate a market. Numerous anecdotal examples and a few research articles of underdog brands exist, yet the understanding of what an underdog brand is and how brands can use the underdog effect is still limited. Considering the relevance of underdog brand management for practice, the purpose of our article is to distill the components of the concepts “underdog brand” and “the underdog effect” and to propose a conceptual framework to guide underdog brand management. To achieve this goal, we undertook a systematic review of the extant literature that resulted in (1) a clear and demarking definition of the term underdog brand, (2) an analysis of the usefulness of the underdog effect and (3) a reference frame we termed “the underdog brand management framework”. By doing so, we helped to overcome the research gap in the field of underdog brand management. To validate our findings, we tested the framework against a case study of a successful underdog brand. Our analysis resulted in a robust model that could inspire and guide practitioners who are in charge of underdog brands.
Metastatic Neoplasms Involving the Stomach
Authors: Vyas Monika , Hissong Erika , Gonzalez Raul S , Shia Jinru , Jessurun Jose 
Published: October 2021

Abstract

Objectives
Metastatic neoplasms involving the stomach are rare and diagnostically challenging if clinical history of malignancy is absent or unavailable. This study was designed to identify the tumors that most frequently metastasize to the stomach and the morphologic features that can provide clues to investigate the possibility of metastasis and predict the primary sites.

Methods
All patients with metastatic neoplasms involving the stomach were included in the study. The H&E- and immunohistochemical-stained slides were reviewed, and all clinical, endoscopic, and radiologic information was recorded.

Results
One hundred fifty patients, including 84 (56%) women and 66 (44%) men (mean age, 64 years), were identified. Gastric metastases were the initial presentation in 15% cases. Epithelial tumors (73.3%) comprised the largest group, followed by melanoma (20.6%), sarcomas (4%), germ cell tumors (1.3%), and hematolymphoid neoplasms (0.7%). Lobular breast carcinoma was the most common neoplasm overall in women, while in men, it was melanoma. Solid/diffuse growth pattern (75%) was more common compared with glandular morphology. The solid/diffuse category included lobular breast carcinoma (21.3%), melanoma (20.6%), and renal cell carcinoma (10.6%), while the glandular category was dominated by gynecologic serous carcinomas (7.3%) with papillary/micropapillary architecture.

Conclusions
Metastatic neoplasms should be considered in the differential diagnosis of gastric neoplasms, particularly those with a diffuse/solid growth pattern. Glandular neoplasms are difficult to differentiate from gastric primaries except for Müllerian neoplasms, which frequently show a papillary/micropapillary architecture.
Secondary Cases of Delta Variant Coronavirus Disease 2019 Among Vaccinated Healthcare Workers With Breakthrough Infections is Rare
Authors: Waldman Sarah E , Buehring Tara , Escobar Daniel J , Gohil Shruti K , Gonzales Ralph , Huang Susan S , Olenslager Keith , Prabaker Kavitha K , Sandoval Tessa , Yim Jennifer , Yokoe Deborah S , Cohen Stuart H 
Published: October 2021

Abstract
In a retrospective, cohort study at 4 medical centers with high coronavirus disease 2019 vaccination rates, we evaluated breakthrough severe acute respiratory syndrome coronavirus 2 Delta variant infections in vaccinated healthcare workers. Few work-related secondary cases were identified. Breakthrough cases were largely due to unmasked social activities outside of work.
Making Digital Surveillance Unacceptable? Security, Democracy, and the Political Sociology of Disputes
Authors: Aradau Claudia , Mc Cluskey Emma 
Published: October 2021

AbstractDespite extensive criticisms of mass surveillance and mobilization by civil liberties and digital rights activists, surveillance has paradoxically been extended and legalized in the name of security. How do some democratic claims against surveillance appear to be normal and common-sense, whereas others are deemed unacceptable, even outlandish? Instead of starting from particular “logics” of either security or democracy, this paper proposes to develop a political sociology of disputes to trace how the relation between security and democracy is shaped by critique in practice. Disputes entail critique and demands for justification. They allow us to account for the constraints which govern whether an argument is deemed acceptable or improper; common-sensical or peculiar. We mobilize disputes in conjunction with Arjun Appadurai's reflections on “small numbers” in democracies in order to understand how justifications of surveillance for security enact a “rise in generality,” whereas critiques of digital surveillance that mobilize democratic claims enact a “descent into singularity.” To this purpose, we analyze public mobilizations against mass surveillance and challenges brought before the European Court of Human Rights (ECtHR). We draw on interviews with a range of actors involved in the disputes, the parties’ submissions, oral hearings, judgments, and public reports.
Virtual Visits for Outpatient Burn Care During the COVID-19 Pandemic
Authors: Head William T , Garcia Denise , Mukherjee Rupak , Kahn Steven , Lesher Aaron 
Published: October 2021

Abstract
Burn-injured patients must frequently travel long distances to regional burn centers, creating a burden on families and impairing clinical outcomes. Recent federal policies in response to the coronavirus pandemic have relaxed major barriers to conducting synchronous videoconference visits in the home. However, the efficacy and benefits of virtual visits relative to in-person visits remained unclear for burn patients. Accordingly, a clinical quality assurance database maintained during the coronavirus pandemic (3/3/2020 to 9/8/2020) for virtual and/or in-person visits at a comprehensive adult and pediatric burn center was queried for demographics, burn severity, visit quality, and distance data. A total of 143 patients were included in this study with 317 total outpatient encounters (61 virtual and 256 in-person). The savings associated with the average virtual visit were 130 ± 125 miles (mean ± standard deviation), 164 ± 134 travel minutes, $104 ± 99 driving costs, and $81 ± 66 foregone wage earnings. Virtual visit technical issues were experienced by 23% of patients and were significantly lower in pediatric (5%) than in adult patients (44%; P = .006). This study is the first to assess the efficacy of synchronous videoconference visits in the home setting for outpatient burn care. The findings demonstrate major financial and temporal benefits for burn patients and their families. Technical issues remain an important barrier, particularly for the adult population. A clear understanding of these and other barriers may inform future studies as healthcare systems and payors move toward improving access to burn care through remote healthcare delivery services.
COVID-19 outbreaks in hospital workers during the first COVID-19 wave
Authors: Piapan L , De Michieli P , Ronchese F , Rui F , Peresson M , Segat L , D’Agaro P , Negro C , Bovenzi M , Larese Filon F 
Published: October 2021

Abstract

Background
Health care workers (HCWs) are on the frontline, playing a crucial role in the prevention of infection and treatment of patients.

Aims
This study was aimed to evaluate the prevalence of hospital-acquired coronavirus disease 2019 (COVID-19) infection at work and related factors at the University Hospital of Trieste workers exposed to COVID-19 patients.

Methods
From March 1 to May 31, of 4216 employees, 963 were in contact with COVID-19 patients or colleagues and were followed up. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in nasopharyngeal swabs was determined every 3 days, by RT-PCR.

Results
During the follow-up period, 193 workers were positive for COVID-19 (5%), and 165 of these (86%) were symptomatic. We identified five major cluster outbreaks of COVID-19 infection in Trieste Hospitals, four of which occurred before the implementation of universal masking for HCWs and patients (1–14 March 2020). COVID-19 infection was significantly higher in high-risk ward workers (Infectious Diseases, and Geriatric and Emergency Medicine, odds ratio [OR] 13.4; 95% confidence interval [CI] 5.8–31), in subjects with symptoms (OR 5.4; 95% CI 2.9–10) and in those with contacts with COVID-19 patients and colleagues (OR 2.23; 95% CI 1.01–4.9).

Conclusions
Hospital workers were commonly infected due to contact with COVID-19 patients and colleagues, mainly in the first 15 days of the pandemic, before the implementation of universal mask wearing of HCWs and patients. Repetitive testing and follow-up permitted the identification of COVID-19 cases before symptom onset, obtaining better infection prevention and control.
Nonoperative Management of Minimally Displaced Lateral Compression Type 1 Pelvic Ring Injuries With and Without Occult Instability
Authors: Parry Joshua A. , Hadeed Michael M. , Tucker Nicholas J. , Strage Katya E. , Scott Bryan L. , Stacey Stephen C. , Heare Austin , Mauffrey Cyril 
Published: October 2021

Objectives:
To determine the association of pelvic fracture displacement on lateral stress radiographs (LSRs) with the hospital course of patients with minimally displaced lateral compression type 1 (LC1) pelvic injuries.

Design:
Retrospective review.

Setting:
Level 1 trauma center.

Patients/Participants:
Twenty-eight adult patients with minimally displaced (<1 cm) LC1 injuries.

Intervention:
Nonoperative management.

Main Outcome Measurements:
Delayed operative fixation, days to clear physical therapy, mobilization, hospital length of stay, and total hospital opioid morphine equivalent dose.

Results:
LSR displacement was correlated with delayed operative fixation [r = 0.23, 95% confidence interval (CI) 0.05–1.11; P = 0.01], days to clear PT (r = 0.13, CI 0.01–0.28; P = 0.02), length of stay (r = 0.13, CI 0.006–0.26; P = 0.02), and opioid morphine equivalent dose (r = 19.4, CI 1.5–38.1; P = 0.03). A receiver operating characteristic curve for delayed operative fixation over LSR displacement had an area under the curve of 0.87. The LSR displacement threshold that maximized sensitivity and specificity for detecting patients who required delayed fixation was 10 mm (100% sensitivity and 78% specificity). Ten of the 15 patients with ≥10 mm of displacement on LSRs underwent delayed operative fixation for pain with mobilization at a median of 6 days (interquartile range 3.7–7.5). Patients with ≥10 mm of displacement on LSRs took longer to clear PT, took longer to walk 15 feet, had longer hospital stays, and used more opioids.

Conclusions:
LC1 fracture displacement on LSRs is associated with delayed operative fixation, difficulty mobilizing secondary to pain, longer hospital stays, and opioid use.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Therapeutic Drug Monitoring of Anti-infective Drugs: Implementation Strategies for 3 Different Scenarios
Authors: Kim Hannah Yejin , Byashalira Kenneth C. , Heysell Scott K. , Märtson Anne-Grete , Mpagama Stellah G. , Rao Prakruti , Sturkenboom Marieke G.G. , Alffenaar Jan-Willem C. 
Published: October 2021

Background:
Therapeutic drug monitoring (TDM) supports personalized treatment. For successful implementation, TDM must have a turnaround time suited to the clinical needs of patients and their health care settings. Here, the authors share their views of how a TDM strategy can be tailored to specific settings and patient groups.

Methods:
The authors selected distinct scenarios for TDM: high-risk, complex, and/or critically ill patient population; outpatients; and settings with limited laboratory resources. In addition to the TDM scenario approach, they explored potential issues with the legal framework governing dose escalation.

Results:
The most important issues identified in the different scenarios are that critically ill patients require rapid turnaround time, outpatients require an easy sampling procedure for the sample matrix and sample collection times, settings with limited laboratory resources necessitate setting-specific analytic techniques, and all scenarios warrant a legal framework to capture the use of escalated dosages, ideally with the use of trackable dosing software.

Conclusions:
To benefit patients, TDM strategies need to be tailored to the intended population. Strategies can be adapted for rapid turnaround time for critically ill patients, convenient sampling for outpatients, and feasibility for those in settings with limited laboratory resources.
Corneal Epithelial Remodeling as a Cause of Chalazion-Induced Hypermetropia
Authors: Kalas Timothy , Gunn David 
Published: October 2021

Purpose:
The importance of the corneal epithelium and its role in influencing the refractive state of the eye is well established, as is the association between periocular mass lesions, such as chalazia, and changes in corneal refractive status. This case report provides new evidence linking these 2 phenomena.

Methods and Results:
A 74-year-old man presented with gradual onset of blurred vision in his right eye. Examination revealed a large central right upper lid chalazion, with associated hypermetropic shift. Corneal topography showed central corneal flattening, and anterior segment optical coherence tomography epithelial thickness mapping showed central focal epithelial thinning. The chalazion was treated with incision and drainage and subsequent LipiFlow thermal pulsation treatment. At 3- and 4-month review, corneal epithelial thickness and topographic changes were seen to normalize, with a corresponding return toward emmetropic refractive status.

Conclusions:
Chalazia can cause reversible corneal epithelial remodeling and should be considered as a differential diagnosis in cases of unexplained vision loss and changes in refractive status.
Spirituality and Vicarious Trauma Among Trauma Clinicians: A Qualitative Study
Authors: Muehlhausen Beth L. 
Published: October 2021

Background:
There has been a lack of research so far on spirituality and trauma. There has been some indication that religion and spirituality are resources in protection against burnout.

Objective:
The aim of this study was to understand the phenomenon of spirituality in the context of vicarious trauma among trauma clinicians.

Methods:
This was a qualitative study based on hermeneutic phenomenological methodology. Individual interviews were conducted with 36 physicians, nurse practitioners, and physician assistants on the relationship between their spirituality and trauma work.

Results:
Participants were recruited from a large Midwest metropolitan Level I trauma center and attendees at the 2018 Eastern Association for the Surgery of Trauma annual conference. Four patterns emerged from the interviews that transcended religious or spiritual affiliation and medical specialty. These included (1) the world of trauma; (2) religious or spiritual beliefs guiding their work; (3) the need for support systems; and (4) the importance of coping mechanisms.

Conclusion:
Religion or spirituality plays a role in underlying meaning making and, in the moment, coping for trauma professionals.
The level of quality care nurse practitioners provide compared with their physician colleagues in the primary care setting: A systematic review
Authors: Barnett Michael , Balkissoon Christopher , Sandhu Jodie 
Published: October 2021

ABSTRACT

Background:
There is an increasing demand for high-quality primary care providers without adequate supply to meet the need. Nurse practitioners (NPs) are uniquely positioned to fill this demand but influence on regulatory practice authority from concerned groups regarding patient safety and quality of care has delayed this as an effective solution.

Objectives:
The objective was to address concerns abovt NP-led care by examining evidence regarding patient safety, clinical outcomes, cost, and patient satisfaction that reflect on the ability of NPs to provide high-quality care within the primary care setting and to compare their ability with standard models of care led by physicians.

Data sources:
A systematic review was completed using PubMed, CINHAL Complete, and Scopus. Using PRISMA guidelines to critique literature and the John's Hopkins Research Evidence Appraisal tool, articles were analyzed comparing the quality of care between NP and physician providers in the primary care setting.

Conclusions:
A total of 11 articles met the criteria and reveal that NPs provide equal or better quality of care for all outcomes outcomes when compared with their physician colleagues.

Implications for practice:
Quality patient care provided by NPs in the primary care setting is equal to, and in several cases superior to, that of physicians. Concerns for patient safety and quality care outcomes seem unsupported by data, and state legislatures should continue to grant full practice authority. as an effective source of providing high-quality primary health care.
Evaluation of acupuncture treatments of postpartum female pelvic floor dysfunction by four-dimensional transperineal pelvic floor ultrasound
Authors: Yao Liping , Li Fengzhi , Wang Dandan , Sheng Shaoqin 
Published: October 2021

Abstract

Introduction:
In the present investigation, a systematic evaluation of the clinical treatment performance of diagnosed with pelvic floor dysfunction is explored. By comparing the 4Dtransperineal pelvic floor ultrasound images with the acupuncture treatment performance of the patients, an evaluation system with various parameters is established to provide critical information to guide the clinical treatment fpostpartum female pelvic floor dysfunction (FPFD).

Methods:
Eighty patients diagnosed with FPFD are divided into 2 groups. After the designated treatment to the patients, they are carefully examined using transperineal pelvic floor ultrasound. The shape and activity of bladder neck, cervix and rectum anal canal under resting, anal sphincter and Valsalva movements are observed and recorded. The morphology and continuous shape of levator ani muscle in different states after 4D image reconstruction are obtained.

Results:
After the acupuncture treatment, the bladder neck descent is decreased by 3.8 cm and the anal levator muscle area is decreased by 3.4 cm2 comparing with the control group. The anal levator muscle hole diameter is decreased by 0.3 cm, while the anterior and posterior diameter is reduced by 0.5 cm. Reduced possibility of cystocele and uterine prolapse is demonstrated by X2 test. These changes upon acupuncture therapy are in line with the improved conditions of the patients, indicating these parameters can help evaluate the therapy performance.

Conclusion:
4D pelvic floor ultrasound imaging provides objective and quantified information for the clinical diagnosis and treatment of FPFD and the assessment of therapy efficacy, making it a promising novel method in practical applications.
How motor elements at 3 months influence motor performance at the age of 6 months
Authors: Gajewska Ewa , Moczko Jerzy , Kroll Paweł , Naczk Mariusz , Naczk Alicja , Sobieska Magdalena 
Published: October 2021

Abstract
One of the most important achievements of infancy is mobility, through which the child gradually becomes independent and can discover new places and objects. One form of mobility that occurs in a child's development is rolling over from supine-to-prone.
The assumption of the work was to check whether all particular motor elements from the 3rd month had a comparable effect on development in the 6th month of life.
The study population included 119 children, 69 born at term, and 50 born preterm. Children were born at week 38 ± 3 (born at term 40  ± 1/preterm 34 ± 3), with a mean body weight of 3100 ± 814 g (born at term 3462 ± 505/ preterm 2282 ± 788). Pre-term children were assessed at the corrected age. The physiotherapeutic qualitative assessment at the age of 3 months was performed in the prone and supine positions, and the qualitative assessment included 15 elements in the prone position and 15 in the supine position. A detailed mathematical analysis was then performed. Values of Cramer's V coefficient with confidence range, Goodman–Kruskal's coefficient, and the values of the probability coefficient p were given.
The position of the scapulae and pelvis (3rd month) had the strongest impact on achieving proper support on the upper extremities in the 6th month of life, while the supine position was most significantly affected by the position of the head, spine, and pelvis.