bluuebunny/crossref_metadata_2025_split huggingface dataset:
Critical Thinking Medication Storytelling: A Teaching Strategy to Engage Thoughts, Emotions, and Creativity
Authors: Grady Mary , Bell Renee 
Published: March 2021

Abstract
Nursing students struggle to learn medications that their patients have been prescribed, often regurgitating information found in a drug book or on a drug card. Watching students do this led to the development of the Critical Thinking Medication Storytelling assignment. The assignment was designed to bring information to life in a creative and meaningful way, enabling students to see how specific medications interrelate with the patient’s condition. Qualitative results from students revealed that students embraced this teaching strategy; the strategy was effective for acquiring drug knowledge.
Preferred Teaching/Learning Strategies for Graduate Nursing Students in Web-Enhanced Courses
Authors: Harlan Melissa Dawn , Rosenzweig Margaret Quinn , Hoffmann Rosemary Labarbera 
Published: March 2021

Background
Advanced and continuing education is essential for maintaining competence. Graduate students have shown an increase in online course enrollment, and similar trends are anticipated among nurses with limited access to on-site education due to the current COVID-19 (coronavirus disease 2019) pandemic. Faculty must utilize preferred teaching/learning strategies to provide high-quality online education courses that engage learners and improve outcomes.

Objectives
This study assessed preferred teaching/learning strategies for graduate students enrolled in at least 1 asynchronous nursing course. Correlational data assessed the relationship between preferred teaching/learning strategies and selected demographic information.

Methods
All graduate nursing students enrolled in at least 1 asynchronous course at the University of Pittsburgh School of Nursing during a 3-month period were invited to participate in a survey to assess preferred teaching/learning methods.

Results
Sixty-six graduate students completed the survey. Most participants were comfortable with computer skills, had previously enrolled in a web-enhanced course, and did not enjoy group work. Preferred teaching/learning strategies included voice-over PowerPoints, simulation, case studies, guest speakers, and faculty communication.

Conclusion
Preferred teaching/learning strategies that incorporate asynchronous and synchronous learning should be developed. These strategies will enhance the knowledge base of nurses in all settings and populations.
A Congener-specific and Mixture Analysis of Plasma Polychlorinated Biphenyl Levels and Incident Breast Cancer
Authors: Parada Humberto , Benmarhnia Tarik , Engel Lawrence S. , Sun Xuezheng , Tse Chiu-Kit , Hoh Eunha , Olshan Andrew F. , Troester Melissa A. 
Published: March 2021

Background:
Polychlorinated biphenyls (PCBs), a diverse class of chemicals, are hypothesized mammary carcinogens. We examined plasma levels of 17 PCBs as individual congeners and as a mixture in association with breast cancer using a novel approach based on quantile g-computation.

Methods:
This study included 845 White and 562 Black women who participated in the population-based, case–control Carolina Breast Cancer Study Phase I. Cases (n = 748) were women with a first diagnosis of histologically confirmed, invasive breast cancer residing in 24 counties in central and eastern North Carolina; controls (n = 659) were women without breast cancer from the same counties. PCBs were measured in plasma samples obtained during the study interview. We estimated associations [covariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs)] between individual PCB congeners and breast cancer using multivariable logistic regression. We assessed PCB mixtures using quantile g-computation and examined effect measure modification by race.

Results:
Comparing highest and lowest tertiles of PCBs resulted in ORs of 1.3 (95% CI = 0.95, 1.8) for congener 74, 1.4 (95% CI = 1.0, 1.9) for 99, 1.3 (95% CI = 0.91, 1.8) for 194, and 1.2 (95% CI = 0.90, 1.7) for 201. Among all women, we estimated a joint effect of the PCB mixture with an OR of 1.3 (95% CI = 0.98, 1.6) per tertile change. In race-stratified analyses, associations for tertiles of PCB mixtures were stronger among Black women (OR = 1.5; 95% CI = 1.0, 2.3) than among White women (OR = 1.1; 95% CI = 0.81, 1.6).

Conclusion:
Our results are consistent with the hypothesis that exposure to PCB mixtures increase the risk of breast cancer, but studies of populations with different exposure profiles are needed.
ER-positive endocervical adenocarcinoma mimicking endometrioid adenocarcinoma in morphology and immunohistochemical profile
Authors: Chen Ruichao , Qin Ping , Luo Qiuping , Yang Wen , Tan Xuexian , Cai Tonghui , Jiang Qingping , Chen Hui 
Published: March 2021

Abstract

Rationale:
Usual-type endocervical adenocarcinoma (ECA), high-risk HPV associated, is the most common type of glandular carcinoma in the endocervix. Mucin-depleted usual-type ECA is 1 end of morphological lineage of usual-type ECA and morphologically may show endometrioid features, which could cause diagnostic challenge with uterine endometrioid adenocarcinoma (EEC) and primary endometrioid ECA, especially in the setting of small biopsy and endocervical curettage (ECC).

Patient concerns:
A 37-year-old women presented with dyspareunia for 1 year, showing atypical glandular cell on a liquid-based Pap TCT examination and positive for HPV16 detection. ECC showed EEC in another hospital based on its “endometrioid” morphology and immunohistochemical profiles (ER/PR/PAX8 strongly positive, though p16 also strongly positive).

Diagnoses:
The specimen of hysterectomy in our hospital displayed a lesion confined to the uterine cervix showing the same morphology and immunohistochemical profiles as ECC. Finally, we successfully performed HPV RNAscope and detected high-risk human papilloma virus (HPV) E6/E7 mRNA particles in tumor cells in situ, which warranted usual-type ECA with mucin-depleted feature, a rare deviation of usual-type of ECA.

Interventions:
The patient underwent total hysterectomy with lymph node dissection.

Outcomes:
To date, 14 months after surgery, the patient is well without recurrence or distant metastasis, and undergoes regular reexamination.

Lessons subsections:
We report a rare case of mucin-depleted usual-type ECA showing overlapping morphological and immunohistochemical profiles with EEC. The pathological diagnosis was confirmed by high-risk HPV RNAscope detection which is superior than immunohistochemistry to identify usual-type ECA, warranting an important role in assisting the diagnosis of morphological vague cases.
Effectiveness of resistance exercises in the treatment of rheumatoid arthritis
Authors: Wen Zhigang , Chai Yi 
Published: March 2021

Abstract

Background:
We aimed to assess the efficacy of resistance exercise in rheumatoid arthritis (RA) in randomized controlled trials (RCTs).

Method:
PubMed, the Cochrane Library, and Embase were searched according to the index words to identify eligible RCTs, and relevant literature sources were also searched. The latest search was done in August 2019. Odds ratios (OR), mean difference (MD), and 95% confidence interval (95% CI) were used to analyze the main outcomes.

Result:
Seventeen RCTs were included in the meta-analysis with 512 patients in the resistance exercise group and 498 patients in the control group. The results showed that compared with the control group, resistance exercise significantly decreased disease activity score in 28 joints (DAS-28) scores (standard mean difference [SMD]: –0.69, 95% CI: –1.26 to –0.11), reduced erythrocyte sedimentation rate (ESR) (SMD: –0.86, 95% CI: –1.65 to –0.07), and shortened the time of 50 ft. walking (SMD: –0.64, 95% CI: –0.99 to –0.28). No significant difference was observed in visual analog scale (VAS) scores (SMD: –0.61, 95% CI: –1.49–0.27) and health assessment questionnaire (HAQ) scores (weighted mean difference: –0.10, 95% CI: –0.26–0.06).

Conclusion:
Resistance exercise showed reducing DAS-28 score, ESR score, and the time of 50 ft. walking in RA patients compared with the control group. However, high quality multicenter RCTs with larger sample sizes to confirm the conclusion.
A bibliometric analysis of segmentectomy versus lobectomy for non-small cell lung cancer research (1992–2019)
Authors: Xu Zhiyun , Gao Xiang , Ren Binhui , Zhang Shuai , Xu Lin 
Published: March 2021

Abstract

Background:
This study intends to create a series of scientific maps to quantitatively estimate hot spots and emerging trends in segmentectomy versus lobectomy for non-small cell lung cancer (NSCLC) research with bibliometric methods.

Methods:
Articles published on segmentectomy versus lobectomy for NSCLC were extracted from the Web of Science Core Collection (WoSCC). Extracted information was analyzed quantitatively using bibliometric analysis by CiteSpace to find hot spots and frontiers in this research area.

Results:
A total of 362 scientific articles on segmentectomy versus lobectomy for NSCLC were collected, and the annual publication rate increased over time from 1992 to 2019. The leading country and the leading institution were the United States and University of Pittsburgh, respectively. Furthermore, the most prolific researchers were, namely, James D. Luketich, Rodney J. Landreneau, Matthew J. Schuchert, Morihito Okada, and David O. Wilson. The analysis of keywords pointed out that carcinoma, bronchogenic carcinoma, limited resection, segmental resection, and morbidity are hot spots and lymph node dissection, minimally invasive surgery, impact, epidemiology, and high risk are research frontiers in this field.

Conclusion:
Publications related to segmentectomy versus lobectomy for NSCLC have made great achievements based on bibliometric analysis in recent years. However, further research and global collaboration are still required. Finally, we find that segmentectomy for the treatment of NSCLC is receiving much more attention from researchers globally compared with lobectomy in this research area.
Immune checkpoint inhibitors in patients with solid tumors and poor performance status
Authors: Kapoor Akhil , Noronha Vanita , Patil Vijay M. , Menon Nandini , Joshi Amit , Abraham George , Prabhash Kumar 
Published: March 2021

Abstract
Immune checkpoint inhibitors (ICIs) are rapidly being incorporated as treatment option either alone or in combination with chemotherapy in most of the solid tumors. Since there is very limited data of ICI in patients with poor performance status (PS) from the real world settings, we performed a retrospective audit of patients who received ICI and report the analysis based on ECOG PS of these patients.
This study is a retrospective audit of a prospectively collected database of patients receiving ICIs for advanced solid tumors in any line between August 2015 and November 2018 at Tata Memorial Hospital, Mumbai, India. All statistical calculations were performed using SPSS statistical software for windows version 20.0.
A total of 155 patients who received ICIs during the specified period were evaluated for this study. Baseline ECOG PS 0–1 (n = 103, 66.4%) patients was associated with median OS 9.1 (95% CI [confidence interval], 4.4-NR) months when compared to ECOG 2–4 (n = 52, 33.5%) which had a median OS of 2.9 (95% CI; 1.8–5.5) months (HR, 1.7, 95% CI, 1.1–2.7, log rank P = .017). The disease control rate for the poor PS group was 34.6%. However, 27.3% patients (95% CI: 20.3–34.3) were still alive at 1 year. Median OS in patients with PS 2 was 3.7 months (95% CI: 0–11.6) as compared to 1.8 months (95% CI: 0.2–3.4) for those with PS 3–4 (HR-2.0; 95% CI: 1.0–3.9, P = .041). The tolerance to ICIs was good with no grade 3/4 toxicities in 44 (84.6%) patients.
Immune checkpoint inhibitors are a safe and effective therapeutic option even in solid tumor patients with poor performance status.
Fungal liver infection mimicking hepatic malignant tumor on contrast enhanced ultrasound
Authors: Yang Jie , Zhang Ya-han , Huang Jia-yan , Lu Qiang 
Published: March 2021

Abstract

Rational:
Fungal liver infection mostly occurs in immunocompromised patients, and is often associated with delayed diagnosis and high mortality rates. Dynamic contrast enhanced imaging is crucial for the diagnosis of fungal liver infection and has been reported having variable manifestations.

Patient concerns:
A 38-year-old Chinese man, with a history of diabetes and chronic hepatitis B, was admitted to our hospital due to prolonged fever of unknown cause. He had a medical history of receiving broad-spectrum antibiotic treatment for pulmonary inflammation at the local hospital. The blood test results showed that the white cell count (14.0 × 109/L) and neutrophil count ratio (77.0%) were subtly elevated. C-reactive protein (92.0 mg/l) and cancer antigen (CA)-125 (904.50 U/ml) were elevated. Non-small cell lung cancer antigen was within the normal limit. Hepatitis B virus DNA load was 3.28 × 103 IU/ml. Sputum and blood cultures were normal. Abdominal ultrasonography (US) found a large heterogeneous mass, with diffused echogenic foci without infiltrating the surrounding vascular, which exhibiting “rapid wash in and out” on contrast-enhanced ultrasound (CEUS).

Diagnosis:
The diagnosis of liver fungal infection was confirmed pathologically via ultrasound-guided biopsy.

Interventions:
Antibiotic and antifungal therapy with imipenem and voriconazole.

Outcomes:
The patient's body temperature had been controlled and the huge mass disappeared on follow-up ultrasound 1-year later.

Lessons:
This case highlights the unusual imaging features of fungal liver infection, presenting as huge heterogeneous mass with diffusive echogenic foci without infiltrating the surrounding vascular on grayscale US and the enhancement pattern of “rapid wash in and out” on CEUS. Additionally, ultrasound-guided biopsy is necessary for the correct diagnosis of suspected liver lesions.
Does washing medical devices before and after use decrease bacterial contamination?
Authors: Nai Gisele Alborghetti , Medina Denis Aloísio Lopes , Martelli Cesar Alberto Talavera , de Oliveira Mayla Silva Cayres , Portelinha Maria Júlia Schadeck , Henriques Bruno Carvalho , Caldeira Isadora Delfino , Almeida Mércia de Carvalho , Eller Lizziane Kretli Winkelstroter , Neto Fausto Viterbo de Oliveira , Marques Mariângela Esther Alencar 
Published: March 2021

Abstract
Surface treatment of medical devices may be a way of avoiding the need for replacement of these devices and the comorbidities associated with infection. The aim of this study was to evaluate whether pre- and postcontamination washing of 2 prostheses with different textures can decrease bacterial contamination.
The following microorganisms were evaluated: Staphylococcus aureus, Staphylococcus epidermidis, Proteus mirabilis and Enterococcus faecalis. Silicone and expanded polytetrafluoroethylene vascular prostheses were used and divided into 3 groups: prostheses contaminated; prostheses contaminated and treated before contamination; and prostheses contaminated and treated after contamination. Treatments were performed with antibiotic solution, chlorhexidine and lidocaine. After one week of incubation, the prostheses were sown in culture medium, which was incubated for 48 hours. The area of colony formation was evaluated by fractal dimension, an image analysis tool.
The antibiotic solution inhibited the growth of S epidermidis and chlorhexidine decrease in 53% the colonization density for S aureus in for both prostheses in the pre-washing. In postcontamination washing, the antibiotic solution inhibited the growth of all bacteria evaluated; there was a 60% decrease in the colonization density of S aureus and absence of colonization for E faecalis with chlorhexidine; and lidocaine inhibited the growth of S aureus in both prostheses.
Antibiotic solution showed the highest efficiency in inhibiting bacterial growth, especially for S epidermidis, in both washings. Lidocaine was able to reduce colonization by S aureus in post-contamination washing, showing that it can be used as an alternative adjuvant treatment in these cases.
Effects of smoking on the optimal effect-site concentration of remifentanil required for preventing cough during anesthetic emergence in male patients undergoing laparoscopic or robotic cholecystectomy
Authors: Kim Ha Yeon , Choi Jong Bum , Lee Eunyoung A. , Kwon Sei Hyuk , Kim Ji Eun , Lee Sook Young 
Published: March 2021

Abstract
Target-controlled infusion of remifentanil is known to reduce cough effectively during emergence from general anesthesia. The effect of smoking on emergence cough remains controversial. Therefore, we aimed to investigate the effect-site concentration (Ce) of remifentanil in the male patients undergoing laparoscopic or robotic cholecystectomy for suppressing emergence cough in smokers and non-smokers.
Twenty smokers and 24 non-smokers (sex, male; age range, 20–65 years) were enrolled in this study. Anesthesia was maintained using sevoflurane and remifentanil. The Ce of remifentanil in 50% (EC50) and 95% (EC95) of the patients required for suppressing emergence cough were determined for each group (smokers and non-smokers) using Dixon up-and-down method and isotonic regression method with a bootstrapping approach.
Dixon up-and-down method revealed that the EC50 value was significantly higher in smokers (3.51 ± 0.60 ng/mL) than in non-smokers (2.71 ± 0.30 ng/mL) (P < 0.001). In smokers and non-smokers, isotonic regression revealed EC50 to be 4.40 (83% CI, 4.17–4.58) ng/mL and 2.58 (83% CI, 2.31–2.87) ng/mL, respectively, and EC95 to be 4.76 (95% CI, 4.73–4.78) ng/mL and 3.15 (95% CI, 3.04–3.18) ng/mL, respectively.
The Ces of remifentanil required to prevent cough during emergence were significantly higher in smokers than in non-smokers. Therefore, clinicians should pay attention to the smoking history of a patient to prevent cough during emergence.
A prospective randomized controlled trial to evaluate effect of chewing gum on postoperative ileus in elderly patient after hip fracture
Authors: Cha Yong-Han , Nam Dae Cheol , Song Sang-Youn , Yoo Jun-Il 
Published: March 2021

Abstract
Factors related to developing postoperative ileus (POI) vary from pharmacologic, inflammatory, hormonal, metabolic, gastrointestinal physiology, neurologic, to psychological factors. Although orthopedic-related incidence of postoperative ileus is about 10%, these studies are limited to spine surgery and pelvic surgery. The purpose of this study was to investigate prevalence of POI and to analyze effect of chewing gum on POI and bowel function in elderly patients after hip fracture surgery.
A prospective randomized controlled trial was conducted at the Gyeongsang National University Hospital. Elderly patients with hip fracture who underwent surgery from March 2017 to June 2018 were eligible to participate. Patients were excluded if they had a mastication disability, impaired cognitive function, previous history of gastrointestinal disease, respiratory disease and low oxygen saturation, hip arthroplasty with causes other than hip fractures, acetabular fractures, periprosthetic fractures, or pathological fractures. Patients with consciousness problem by excessive anesthesia were also excluded. Patients were classified into 2 groups by randomization. Group I received sugar-free gum and were encouraged to chew 6 hours following surgery until the first intestinal gas is released. Group II was given the same postoperative procedure and encouraged to consume water after 6 hours.
After applying exclusion criteria, 74 patients were finally included. Thirty-one patients were classified to Group I and 43 patients were classified to the Group II. Prevalence of POI in all patients with hip fracture was 63.5% (47/74). Prevalence of POI in Group I was statistically significant lower than that in Group II (Group I: 41%, Group II: 79.1%, P = .01)
The prevalence of POI in elderly patients with hip fracture was 63.5%. Chewing gum had a significant effect on reduction of POI in elderly patients with hip fractures.
Clinical characteristics of non-idiopathic pulmonary fibrosis, progressive fibrosing interstitial lung diseases
Authors: Komatsu Masamichi , Yamamoto Hiroshi , Kitaguchi Yoshiaki , Kawakami Satoshi , Matsushita Mina , Uehara Takeshi , Kinjo Takumi , Wada Yosuke , Ichiyama Takashi , Urushihata Kazuhisa , Ushiki Atsuhito , Yasuo Masanori , Hanaoka Masayuki 
Published: March 2021

Abstract
Progressive fibrosing interstitial lung disease (PF-ILD) is a progressive phenotype of fibrosing ILDs with varying definitions and elusive clinical characteristics. We aimed to clarify the clinical features and prognosis of PF-ILD cases based on the deterioration of pulmonary function.
Altogether, 91 consecutive ILD patients who underwent at least 2 pulmonary function tests (PFTs) with an interval of at least 24 months, as the screening period, between January 2009 and December 2015 were retrospectively reviewed. The deterioration of forced vital capacity (FVC) and diffusing capacity of the lung for carbon monoxide (DLco) was calculated based on PFT data and screening period. The definition of PF-ILD was
Medical records of 34 patients with idiopathic pulmonary fibrosis (IPF), 11 patients with non-IPF, PF-ILD, and 46 patients with non-IPF, non-PF-ILD were retrospectively analyzed. Patient characteristics, pharmacologic or non-pharmacologic treatment status, and prognosis were compared between the IPF and non-IPF groups and between the non-IPF, PF-ILD and non-IPF, non-PF-ILD groups.
Eleven patients (19.3%) showed a progressive phenotype in the non-IPF group. The pulmonary function data at the first PFT were worse in non-IPF, PF-ILD patients than in non-IPF, non-PF-ILD patients. There were no differences in the proportion of patients who were observed without pharmacologic treatment or of those receiving pharmacologic treatment between the non-IPF, PF-ILD and non-IPF, non-PF-ILD groups. Low %FVC at the first PFT and the usual interstitial pneumonia-like fibrotic pattern on high-resolution computed tomography were risk factors for PF-ILD in the non-IPF group. The mortality in the non-IPF, PF-ILD group was significantly worse than that of the non-IPF, non-PF-ILD group and was as poor as that of the IPF group. Multivariate logistic analysis showed that aging and low %DLco at the first PFT were risk factors for mortality within the non-IPF group.
The prognosis of non-IPF, PF-ILD patients was as poor as that of IPF patients. Non-IPF, PF-ILD patients require more intensive treatment before disease progression.