bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bowel Ischemia Score Predicts Early Operation in Patients With Adhesive Small Bowel Obstruction
Authors: Morris Rachel S. , Murphy Patrick , Boyle Kelly , Somberg Louis , Webb Travis , Milia David , Tignanelli Christopher J. , de Moya Marc , Trevino Colleen 
Published: January 2021

Background Nonoperative management of adhesive small bowel obstruction (SBO) is successful in up to 80% of patients. Current recommendations advocate for computed tomography (CT) scan in all patients with SBO to supplement surgical decision-making. The hypothesis of this study was that cumulative findings on CT would predict the need for operative intervention in the setting of SBO. Methods This is an analysis of a retrospectively and prospectively collected adhesive SBO database over a 6-year period. A Bowel Ischemia Score (BIS) was developed based on the Eastern Association for the Surgery of Trauma guidelines of CT findings suggestive of bowel ischemia. One point was assigned for each of the six variables. Early operation was defined as surgery within 6 hours of CT scan. Results Of the 275 patients in the database, 249 (90.5%) underwent CT scan. The operative rate was 28.3% with a median time from CT to operation of 21 hours (Interquartile range 5.2-59.2 hours). Most patients (166/217, 76.4%) with a BIS of 0 or 1 were successfully managed nonoperatively, whereas the majority of those with a BIS of 3 required operative intervention (5/6, 83.3%). The discrimination (area under the receiver operating characteristic curve) of BIS for early surgery, any operative intervention, and small bowel resection were 0.83, 0.72, and 0.61, respectively. Conclusion The cumulative signs of bowel ischemia on CT scan represented by BIS, rather than the presence or absence of any one finding, correlate with the need for early operative intervention.
Sex Disparities in the Presentation of Gallbladder Disease
Authors: Bailey Kimberly S. , Marsh Wallis , Daughtery Levi , Hobbs Gerry , Borgstrom David 
Published: January 2021

Introduction Although gallbladder disease is more common in women, there is a trend toward more complicated cases in male patients. Methods All cholecystectomies captured by the National Surgical Quality Improvement Program database for the year 2016 were reviewed. This encompassed 38 736 records. Records were reviewed for age, sex, procedure performed, operative time, postoperative diagnosis, functional status, American Society of Anesthesiologists (ASA) class, preoperative lab values (total bilirubin, alkaline phosphatase, white blood cell count, and aspartate aminotransferase. Descriptive and inferential statistical analyses were conducted. Results Male patients are more likely to undergo cholecystectomy for a diagnosis of cholecystitis, gallstone pancreatitis, or cholangitis than women who are more likely to carry a diagnosis of biliary dyskinesia. The average operative time increases for both sexes as the patients become older. The average operative time is higher for men than women in all age groups and the variance becomes greater as the patients become older. Age, sex, postoperative diagnosis, ASA class, and functional status were all independently significant in predicting operative time. There was no difference in need for cholangiogram between the sexes. Female patients were more likely to have their cholecystectomy completed laparoscopically and they were more likely to have their surgery performed as an outpatient. Conclusion These data show that women were more likely to present with uncomplicated gallbladder disease, while men were more likely to present with complicated gallbladder disease. This suggests that male patients present at a more advanced stage of disease.
‘Even a smile helps’: Exploring the interactions between people experiencing homelessness and passersby in public spaces
Authors: Tate Alyssa , Edwards Kaéla , Holmes Nichole , Buffer Steven , Fusfeld Zachary , Baronet Willie , Frasso Rosemary 
Published: January 2021

Background: Many people experiencing homelessness dwell, panhandle, or congregate in public spaces where they frequently cross paths with others. In these spaces, they can be recipients of acts of kindness or emotional and physical insult, but there is little research on the quality, nature, or value of interactions between people living on the street and those who pass them by. Aim: This study explored the lived experiences of unhoused people who panhandle and their interactions with passersby in Philadelphia, Pennsylvania. Methods: Forty semi-structured interviews were conducted with participants who were approached while panhandling and asked to describe their experiences asking for help in public and accessing homelessness services, as well as what they wished to share with passersby. Interviews were coded and analyzed using a directed content analysis approach. Results: Participants described being ignored and subjected to violence, leading them to crave meaningful interaction with passersby. They also described experiences of receiving kindness and support while panhandling. Many shared personal histories of tragedy and called for greater empathy and compassion from passersby, as well as society as a whole, for people experiencing homelessness. Conclusion: Participants’ experiences were consistent with loneliness, as characterized in the literature as distress at lack of social connection, and were also notable for the verbal and physical violence endured in public spaces. Social isolation and trauma are detrimental to mental health in this vulnerable group, so interventions to support this population should provide opportunities for consistent, supportive social connections and focus on providing low-barrier, stable housing.
Knowledge audit as an important tool in organizational management: A review of literature
Authors: Ayinde Lateef , Orekoya Ibrahim Oluwapelumi , Adepeju Qaozara Adebanke , Shomoye Adeyinka M 
Published: January 2021

The purpose of this paper is to review current literature on knowledge management and highlight the importance of knowledge audit in bringing about a holistic knowledge solution to knowledge management. Based on the review of literature on knowledge management, this study points out the role of knowledge audit in solving the challenges in organizations’ tacit and explicit knowledge. Specifically, the paper concentrates on knowledge audit, knowledge risk and international and national standards on knowledge audit processes. The contribution of this study to literature are the suggestions that knowledge risk and international standards procedures could be applied to knowledge audit. The important conclusion of this paper is that knowledge risk management has not been fully explored in the study of knowledge audit. The paper addresses the research question of what organizations must embark on in the process of knowledge audit. The paper attempts to provide answer to the question by highlighting the importance of knowledge audit and the reasons why organizations carry out knowledge audit, and also the existing knowledge audit frameworks and methodologies.
Prevalence and inventory of venous anatomical abnormalities in the arms of patients with combined capillary, venous and lymphatic malformations (Klippel–Trénaunay syndrome)
Authors: Zwerink LGJM , Praster R , van der Vleuten CJM 
Published: January 2021

Objectives To investigate the prevalence of arm-involvement in Klippel-Trénaunay syndrome (KTS)-patients and to describe the venous anatomy and/or venous aberrations present in the arm, and if possible, their relationship to complaints (pain, congestion and thromboembolic events). Methods A retrospective cohort-study was performed with data from medical records of a large KTS-cohort (n = 173) from a tertiary referral center. Within this cohort, a descriptive study (n = 12) was performed on the KTS-patients with arm involvement and who had been examined with Colour Duplex Ultrasonography (CDU). Results Our KTS-cohort (n = 173) comprised 43 patients (24.9%) with arm-involvement; in nineteen patients (11.0%) the arm was the only affected limb. Of those KTS patients investigated with CDU, 9 out of 12 (75%) had an aberrant venous anatomy. Conclusion Future research needs to clarity whether the complaints of KTS-patients in general are caused by an aberrant venous anatomy, coagulation alterations and/or other factors. Herein, the KTS-arms may play an important role.
Efficacy and safety of sugammadex doses calculated on the basis of corrected body weight and total body weight for the reversal of deep neuromuscular blockade in morbidly obese patients
Authors: Li Deming , Wang Yuanyuan , Zhou Yong , Yin Chunming 
Published: January 2021

Objective We investigated the efficacy and safety of sugammadex doses calculated using corrected body weight (CBW) for reversing deep rocuronium-induced neuromuscular blockade (NMB) in morbidly obese patients undergoing laparoscopic bariatric surgery. Methods One hundred and twenty-five morbidly obese patients were randomly assigned to three groups: (1) a CBW group, n = 50; (2) a total body weight (TBW) group, n = 50; and (3) a control group, n = 25. Deep NMB was maintained using a continuous infusion of rocuronium. At the reappearance of 1 to 2 post-tetanic counts (PTCs), 4 mg/kg sugammadex, calculated using CBW or TBW, were administered. Results All the participants in the CBW and TBW groups recovered to a train-of-four (TOF) ratio of 0.9 within 5 minutes. The recovery times from the start of sugammadex administration to a TOF ratio of 0.9 were 2.2 ± 0.7 and 2.0 ± 0.7 minutes in the CBW and TBW groups, respectively. Thus, a sugammadex dose calculated using CBW was not inferior to that calculated using TBW for the reversal of rocuronium-induced deep NMB in morbidly obese patients. Conclusion A dose of 4 mg/kg of sugammadex calculated using CBW is efficient and safe for the reversal of deep NMB after a continuous infusion of rocuronium in morbidly obese patients. Clinical Trial Registration Number ChiCTR1900028652 (Chinese Clinical Trial Registry, www.chictr.org.cn )
Safety and efficacy of prostatic artery embolization for large benign prostatic hyperplasia in elderly patients
Authors: Xu Chen , Zhang Gang , Wang Jin-jin , Zhou Chun-xian , Jiang Min-jun 
Published: January 2021

Objective To assess the safety and efficacy of prostatic arterial embolization (PAE) for elderly patients with lower urinary tract symptoms secondary to large benign prostatic hyperplasia. Methods Twenty-eight patients (>80 years of age) with prostate volume >80 mL were enrolled from October 2016 to October 2019. PAE was performed using microspheres and functional results were evaluated at 1, 3, 6, and 12 months postoperatively. The following data were recorded: International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urine flow rate (Qmax), post-void residual urine volume, prostate volume and total prostate-specific antigen level. Results Selective prostatic arterial catheterization and embolization were achieved in 27 of 28 patients. Follow-up data were available for those 27 patients until 12 months postoperatively. Significant improvements were found at all postoperative time points in terms of the mean IPSS, mean QoL score, mean Qmax, mean post-void residual urine volume, mean total prostate-specific antigen level, and mean prostate volume. The overall complication rate was 46.4%. Conclusions PAE is an efficacious and safe treatment for elderly patients with large prostate volume; it may offer an effective approach for patients who are not candidates for open or endoscopic surgical procedures because of comorbidities.
Overall and Gender-specific Associations between Dimensions of Adverse Childhood Experiences and Mental Health Outcomes among Homeless Adults: Associations Générales et Sexospécifiques Entre les Dimensions des Expériences Défavorables de L’enfance et les Résultats de Santé Mentale Chez les Adultes Sans Abri
Authors: Liu Michael , Mejia-Lancheros Cilia , Lachaud James , Latimer Eric , Aubry Tim , Somers Julian , Distasio Jino , Stergiopoulos Vicky , Hwang Stephen W. 
Published: January 2021

Objective: The associations between adverse childhood experiences (ACEs) and psychopathology have been well-established in the general population. Research on ACEs in the homeless population has been limited. This study examined whether ACE exposure is associated with specific mental health outcomes among a national sample of homeless adults with mental illness and whether this association varies according to ACE dimension and gender. Methods: This cross-sectional study utilized data from a national sample of 2,235 homeless adults with mental illness in Canada to evaluate their sociodemographic characteristics, exposure to ACEs, and mental health outcomes. Exploratory and confirmatory factor analyses were conducted to identify and confirm ACE dimensions (maltreatment, sexual abuse, neglect, divorce, and household dysfunction) from individual ACE items. Multivariable logistic regression was used to examine the associations between total ACE score and ACE dimensions with mental illness diagnoses and psychopathology severity. Results: The mean total ACE score among all study participants was 4.44 (standard deviation [ SD]: 2.99). Total ACE score was positively associated with several mental illness diagnoses and psychopathology severity. Unique associations were found between specific ACE dimensions and poor mental health outcomes. The prevalence of almost all ACEs was significantly higher among women. Yet, associations between several ACE dimensions and poor mental health outcomes existed uniquely among men. Conclusions: There are unique and gender-specific associations between specific ACE dimensions and mental health outcomes among homeless adults. Better understanding of the mechanisms underlying these associations is needed to inform screening, prevention, and treatment efforts, particularly given the very high prevalence of ACEs among this vulnerable and marginalized population.
Unprecedented times – The state library of Western Australia’s COVID-19 experience
Authors: Allen Margaret 
Published: January 2021

The State Library of Western Australia was forced to close to the public under a declared State of Emergency due to the COVID-19 pandemic. During the 56 days of full closure, the Library quickly adapted services to meet restrictions, collected COVID-19 related material, transitioned some staff to working from home and undertook collection-related projects and minor refurbishment works. The Library had maintained a current pandemic plan, but significant decisions about service closure, risks and responses and strategic human resource considerations were made at the highest levels of government. Although not considered essential services enabling them to remain open to the community, the State Library and public libraries in Western Australia were among the first services to reopen within strict protocols under a staged lifting of restrictions. Social media was an essential tool in staying connected with the community, providing advice about service changes, delivering online services and engaging the community to secure donations of COVID-19-related material for the Library’s collections. Difficulties in collecting material efficiently and quickly about the Western Australian experience of an event of global significance were highlighted. Transitioning some staff to working from home arrangements presented policy and technology challenges and highlighted a digital divide for Library staff including their lack of access to appropriate technology at home. Although the pandemic is ongoing and uncertainty still exists, the COVID-19 experience is informing collection development policy, digital service delivery direction, human resource policies and advocacy.
COVID-19 Pandemic Impacts on U.S. Hospice Agencies: A National Survey of Hospice Nurses and Physicians
Authors: Rogers Janna E. Baker , Constantine Lori A. , Thompson Jesse M. , Mupamombe Charles T. , Vanin Jennifer M. , Navia R. Osvaldo 
Published: January 2021

Background: Hospice agencies face unique challenges during times of widespread public health emergencies. The pandemic of novel coronavirus disease COVID-19 is widely affecting global healthcare systems. Aim: This study assesses effects of the COVID-19 pandemic on U.S. hospice agencies, staff, and patients as reported by hospice agency staff. Design: An anonymous electronic survey was developed. Free-text comments were assessed for impacts on hospice agencies, staff, and patients and their families. Setting/Participants: The target audience was members of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association who self-identified as being active with hospice agencies in the United States. Results: Reported impacts include inadequate supplies of personal protective equipment, changes in hospice services, and decreased access by hospice personnel to patients in long term care facilities. Flow of patients through hospice care settings was impeded. Agencies experienced changes in workforce availability and increased emotional support needs of staff. Patient and families experienced increased bereavement needs. Nearly one-third of respondents reported negative effects on patient outcomes, such as inadequate symptom management and negative psychosocial effects. Conclusion: Respondents indicate that the COVID-19 pandemic had negative effects on both hospice patient care and hospice agency functioning. Hospice agencies appear to face challenges unique among U.S. healthcare agencies due to their service delivery model and focus on interdisciplinary care. There is need for further exploration of the effects that the COVID-19 pandemic has on hospice agencies in order to improve care for their patient population during public health emergencies.
Progressive multifocal leukoencephalopathy in a patient with occult hypogammaglobulinemia experiencing bilateral visual impairment
Authors: Hettipathirannahelage Sameera , Wijetilleka Sidath , Jewsbury Hugh 
Published: January 2021

Introduction: Progressive multifocal leukoencephalopathy (PML) is a rare, lethal, demyelinating disease classically seen in profoundly immunosuppressed individuals. It is caused by intracerebral infection by John Cunningham polyomavirus (JCV). We report a rare case of PML in a man with presumed immunocompetence at presentation experiencing bilateral painless visual impairment. Case Description: A 60-year-old man with a 3-week history of bilateral painless visual impairment attended our ophthalmology department. Unusually, he navigated around the room well and was able to read 4 of 13 Ishihara test plates in spite of a best-corrected visual acuity of counting fingers at 1 m bilaterally. Slit lamp examination, routine blood tests and optical coherence tomography (OCT) of the maculae and discs were unremarkable. Diffuse hyperintense white matter lesions on T2-weighted magnetic resonance imaging of the brain and detection of JCV within the parietal lobe tissue obtained by biopsy confirmed PML. Additional investigations identified an underlying hypogammaglobulinaemia, which may have initiated PML. He received intravenous immunoglobulin but passed away 2 months after diagnosis. Conclusions: To our knowledge this case is one of only a handful worldwide to describe PML developing in a patient with presumed immunocompetence at presentation – there was no previous history of recurrent, chronic, or atypical infections. There has only been one other report of visual symptoms presenting as the primary complaint. The case illustrates the importance of ruling out organic, central nervous system pathology in patients presenting with visual loss and normal objective visual function tests such as slit lamp examination and OCT.
Necrosis of the optic nerve and chiasm with safe radiation doses: Report of two rare cases
Authors: Abri Aghdam Kaveh , Soltan Sanjari Mostafa , Khosravi Farsani Mohsen , Moghadasi Mehdi , Aghajani Ali 
Published: January 2021

Introduction: Radiation-induced optic neuropathy (RION) is still a devastating complication of brain and skull base radiation that has no effective treatment up until today, thus uttermost caution must be taken in treating patients that brain radiotherapy is needed. We present two cases of RION that happened in seemingly safe radiation doses. Case description: A 48-year-old female with a history of pleomorphic pituitary adenoma developed bilateral and painless loss of vision 10 months after radiation to the brain; the total radiation dose was 45 Gy in 25 fractions and no other risk factors of RION were found. Magnetic resonance imaging of the brain depicted bilateral prechiasmatic optic nerve enhancement with involvement of the optic chiasm. Treatment with high doses of corticosteroids was unsuccessful. A 62-year-old female with a history of lung adenocarcinoma and brain metastases presented with a 1-month history of decreased vision in both eyes. He had undergone whole-brain radiotherapy with a total dose of 30 Gy over 10 fractions and concurrent chemotherapy with cisplatin and pemetrexed. Brain magnetic resonance imaging (MRI) with contrast showed bilateral intracranial optic nerve enhancement. Conclusions: This is the second case report of RION in a patient with a history of brain radiotherapy and concurrent chemotherapy with pemetrexed. History of chiasmal compression, concurrent use of chemotherapeutic agents, and high fraction size (despite the safety of total radiation dose) were possible contributing risk factors to develop RION in our cases. Hence, adjusting the radiation dose according to the presence of these risk factors is recommended.
The effect of insulin pump therapy in retinal vasculature in type 1 diabetic patients
Authors: de Oliveira Loureiro Tomás , Cardoso João Nobre , Lopes Carlos Diogo Pinheiro Lima , Carreira Ana Rita , Rodrigues-Barros Sandra , Vide-Escada Ana , Campos Nuno Patrício 
Published: January 2021

Background/objectives: Continuous subcutaneous insulin infusion (CSII) is a treatment for type 1 diabetes that improves metabolic control and reduces micro and macrovascular complications. The aim of this study was to compare the effect of CSII versus traditional multiple daily injections (MDI) therapy on retinal vasculature. Methods: We performed a prospective study with type 1 diabetic patients with no prior history of ocular pathology other than mild diabetic retinopathy. The patients were divided into two groups according to their therapeutic modality (CSII vs MDI). The retinal nerve fiber layers thickness and vascular densities were compared between groups in both macula and optic disc. The correlations between vascular density and clinical features were also determined. Statistical significance was defined as p < 0.05. Results: The study included 52 eyes, 28 in the insulin CSII group. The mean age was 36.66 ± 12.97 years, with no difference between groups ( p = 0.49). The mean glycated hemoglobin (HbA1c) was found to be lower in the CSII group (7.1% ± 0.7 vs 7.5% ± 0.7 p < 0.01). The parafoveal vascular density was found to be higher in the CSII group (42.5% ± 0.4 vs 37.7% ± 0.6, p < 0.01). We found an inverse correlation between HbA1c value and parafoveal vascular densities ( p < 0.01, r = −0.50). Conclusion: We found that CSII provided better metabolic control than MDI and this seemed to result in higher parafoveal vascular density. As lower vascular density is associated with an increased risk of diabetic retinopathy, these results suggest that CSII could be the safest therapeutic option to prevent retinopathy.