bluuebunny/crossref_metadata_2025_split huggingface dataset:
Above the Clavicle: A Simplified Screening Method for Asymptomatic Blunt Cerebral Vascular Injury
Authors: McCullough Mary A. , Cairns Ashley L. , Shin Jaewook , Appelbaum Rachel D. , Couture Daniel E. , Nunn Andrew M. , Miller Preston R. , Martin Robert S. , Carmichael Samuel P. 
Published: April 2021

Introduction Blunt cerebrovascular injury (BCVI) is an increasingly detected pattern in trauma with significant morbidity, putting patients at risk for subsequent stoke. Complex screening protocols exist to determine who should undergo CT angiography of the neck (CTAN) to evaluate for BCVI. Once identified, stroke incidence may be reduced with appropriate treatment across grades. We hypothesize that an expanded and simplified method for identifying patients with clinical suspicion for BCVI based upon injury above the clavicle (ATC) will illustrate a previously undiagnosed cohort of patients. Methods A single-institution retrospective review of adult (age ≥18 years) blunt trauma patients with BCVI from January 1, 2010 to December 31, 2019 was conducted at a tertiary academic medical center. Patients undergoing CTAN were divided into 2 groups based upon qualification by either the expanded Denver criteria or clinical evidence of any injury ATC. Results A total of 219 patients were diagnosed with BCVI (25 566 blunt trauma admissions, .9% incidence). Seventeen patients (8%) who did not satisfy expanded Denver were diagnosed with BCVI by ATC, most commonly undergoing CTAN due to facial trauma (n = 8). There were no differences in distribution of carotid artery injuries (CAI) and vertebral artery injuries (VAI) in the expanded Denver criteria group compared to the ATC group. Conclusions CTAN for blunt trauma with any injury ATC is an easy-to-use screening tool and may be seamlessly included with initial whole-body imaging.
The Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ): Estimating Individual Susceptibility to Motion Sickness-Like Symptoms When Using Visual Devices
Authors: Keshavarz Behrang , Murovec Brandy , Mohanathas Niroshica , Golding John F. 
Published: April 2021

Objective Two studies were conducted to develop and validate a questionnaire to estimate individual susceptibility to visually induced motion sickness (VIMS). Background VIMS is a common side-effect when watching dynamic visual content from various sources, such as virtual reality, movie theaters, or smartphones. A reliable questionnaire predicting individual susceptibility to VIMS is currently missing. The aim was to fill this gap by introducing the Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ). Methods A survey and an experimental study were conducted. Survey: The VIMSSQ investigated the frequency of nausea, headache, dizziness, fatigue, and eyestrain when using different visual devices. Data were collected from a survey of 322 participants for the VIMSSQ and other related phenomena such as migraine. Experimental study: 23 participants were exposed to a VIMS-inducing visual stimulus. Participants filled out the VIMSSQ together with other questionnaires and rated their level of VIMS using the Simulator Sickness Questionnaire (SSQ). Results Survey: The most prominent symptom when using visual devices was eyestrain, and females reported more VIMS than males. A one-factor solution with good scale reliability was found for the VIMSSQ. Experimental study: Regression analyses suggested that the VIMSSQ can be useful in predicting VIMS ( R2 = .34) as measured by the SSQ, particularly when combined with questions pertaining to the tendency to avoid visual displays and experience syncope ( R2 = .59). Conclusion We generated normative data for the VIMSSQ and demonstrated its validity. Application The VIMSSQ can become a valuable tool to estimate one’s susceptibility to VIMS based on self-reports.
Psychotic symptoms associate inversely with social support, social autonomy and psychosocial functioning: A community-based study
Authors: Guerrero-Jiménez Margarita , Gutiérrez Blanca , Cervilla Jorge A 
Published: April 2021

Background: Population-based studies exploring psychotic symptoms (PS) show that their prevalence in the community is higher than previously thought. Psychosocial functioning and social support are poorer among people presenting clinical and subclinical PS. Aims: We aimed to estimate the prevalence rate of PS in Andalusia and to explore the association between PS and psychosocial functioning, social support and social autonomy in a Southern European population. Material and methods: This is a cross-sectional study. We undertook multi-stage sampling using different standard stratification techniques. Out of 5496 households approached, we interviewed 4507 (83.7%) randomly selected participants living in the autonomous region of Andalusia (Southern Spain). The Spanish version of the MINI International Neuropsychiatric Interview was used to elicit PS. We also gathered information on socio-demographic factors, suicidality risk, psychosocial functioning, social support and social autonomy. Results: The overall prevalence of PS was 6.7% (95% CI: 5.99–6.45). PS were associated with lower age (OR 0.975; 95% CI (0.967–0.983); p < .0001), female gender (OR = 1.346; 95% CI (1.05–1.07) p = .018), not living in a rural area (OR = 0.677; 95% CI (0.50–0.90) p = 0.009), lower social support (OR = 0.898; 95% CI (0.85–0.94) p < .0001), lower scores on social autonomy (OR = 0.889; 95% CI (0.79–1.00) p = .050), having an increased suicidality risk score (OR = 1.038; 95% CI (1.005–1.07); p = .023) and having lower scores on psychosocial functioning (OR = 0.956; 95% CI (0.95–0.96); p < 0.0001). Conclusions: Social outcomes seem to be strongly inversely associated with PS in spite of presumed higher levels of social support among Southern European cultures.
Comparative Morbidity Profile of Elective vs Therapeutic Neck Dissection
Authors: Dunlap Quinn , Gardner James Reed , Ederle Amanda , King Deanne , Merriweather Maya , Vural Emre , Moreno Mauricio Alejandro 
Published: April 2021

ObjectiveNeck dissection (ND) is one of the most commonly performed procedures in head and neck surgery. We sought to compare the morbidity of elective ND (END) versus therapeutic ND (TND).Study DesignRetrospective chart review.SettingAcademic tertiary care center.MethodsRetrospective chart review of 373 NDs performed from January 2015 to December 2018. Patients with radical ND or inadequate chart documentation were excluded. Demographics, clinicopathologic data, complications, and sacrificed structures during ND were retrieved. Statistical analysis was performed with χ2 and analysis of variance for comparison of categorical and continuous variables, respectively, with statistical alpha set a 0.05.ResultsPatients examined consisted of 224 males (60%) with a mean age of 60 years. TND accounted for 79% (n = 296) as compared with 21% (n = 77) for END. Other than a significantly higher history of radiation (37% vs 7%, P <. 001) and endocrine pathology (34% vs 2.6%, P <. 001) in the TND group, no significant differences in demographics were found between the therapeutic and elective groups. A significantly higher rate of structure sacrifice and extranodal extension within the TND group was noted to hold in overall and subgroup comparisons. No significant difference in rate of surgical complications was appreciated between groups in overall or subgroup analysis.ConclusionWhile the significantly higher rate of structure sacrifice among the TND population represents an increased morbidity profile in these patients, no significant difference was found in the rate of surgical complications between groups. The significant difference seen between groups regarding history of radiation and endocrine pathology likely represents selection bias.
Toward a socio-spiritual approach? A mixed-methods systematic review on the social and spiritual needs of patients in the palliative phase of their illness
Authors: Lormans Tom , de Graaf Everlien , van de Geer Joep , van der Baan Frederieke , Leget Carlo , Teunissen Saskia 
Published: April 2021

Background: Patients express a variety of needs, some of which are labeled social and spiritual. Without an in-depth exploration of patients’ expressions of these needs, it is difficult to differentiate between them and allocate appropriate healthcare interventions. Aim: To gain insight into the social and spiritual needs of patients with a life-limiting illness and the distinction between these needs, as found in the research literature. Design: A mixed-methods systematic review and meta-aggregation were conducted following the Joanna Briggs Institute (JBI) approach to qualitative synthesis and the PALETTE framework and were reported according to the PRISMA statement. This review was registered in PROSPERO (CRD42019133571). Data sources: The search was conducted in PubMed, EMBASE, CINAHL, Scopus, and PsycInfo. Eligible studies reported social and spiritual needs from the patients’ perspective and were published between January 1st 2008 and October 2020. The quality of evidence was assessed using JBI Critical Appraisal Tools. Results: Thirty-four studies (19 qualitative, 1 mixed-methods, and 14 quantitative) were included. The five synthesized findings encompassing social and spiritual needs were: being autonomous, being connected, finding and having meaning, having a positive outlook, and dealing with dying and death. Conclusion: What literature labels as social and spiritual needs shows great similarities and overlap. Instead of distinguishing social from spiritual needs based on patients’ linguistic expressions, needs should always be explored in-depth. We propose a socio-spiritual approach that honors and preserves the multidimensionality of patients’ needs and enables interdisciplinary teamwork to allocate patient-tailored care.
Design and Retrospective Application of a Spine Trauma DVT Prophylaxis Protocol on Level 1 Trauma Center Patient Database
Authors: Nimmons Scott , Rizkalla James , Solis Jaicus , Dawkins Jonathan , Syed Ishaq 
Published: April 2021

Study Design: Systematic literature review. Objectives: The impact of thromboembolic disease on the morbidity and mortality of patients with acute spinal cord injury is well documented, with rates as high as 67%-100% among untreated patients. The efficacy of mechanical prophylaxis as a stand-alone measure has been questioned, so we sought to determine a safe perioperative window for chemical anticoagulation use after spine surgery. Many surgeons have concerns anticoagulants may cause post-operative hematoma. Methods: A systematic literature review was performed, ultimately yielding 13 articles. Based on the existing literature and input from our multidisciplinary institutional trauma committee, a Spine Trauma DVT Prophylaxis Protocol was developed. Results: Effort was placed to identify cases within our institution in which patients suffered vertebral column fractures and/or spinal cord injuries. Of these 466 vertebral column fractures and/or spinal cord injuries, 4 patients were identified and diagnosed with DVTs while admitted. Conclusions: Of these patients, there is a clear dilemma with regard to safety of chemoprophylaxis use versus risk of developing a DVT. Though none of the patients developed a PE, utilizing the protocol would have led to earlier IVC filter placement or initiation of a VTE surveillance protocol in 2 of the patients. Initiation of enoxaparin before surgery in one patient (despite delay of surgical timing) may have avoided his subsequent LUE DVT. Though not appropriate for all clinical scenarios, we are confident that our treatment algorithm will prove beneficial for patient care in avoiding DVTs and helping trauma surgeons with evidence-based clinical decision making.
The Psychological Impact of Coronavirus Disease 2019 on Nurses in Saudi Arabia and Their Coping Strategies
Authors: Al Muharraq Essa H. 
Published: April 2021

Aims and Objectives To explore the psychological impact of coronavirus disease 2019 on frontline nurses working in Jazan, Saudi Arabia, and their coping strategies. Background As the coronavirus disease 2019 pandemic continues to expand globally, healthcare systems have become more overwhelmed than ever before, placing a great psychological strain on frontline nurses. Design A cross-sectional, observational, quantitative study. Methods In total, 215 frontline nurses working at 12 hospitals across Jazan, Saudi Arabia, were recruited. Data were collected during August 2020 using a modified version of the severe acute respiratory syndrome team questionnaire. Results Roughly two-thirds (62.3%) of the participants reported moderate to high levels of nervousness and fear at work. Ethical and moral responsibility has been determined as the main motivator for frontline nurses to practice their profession, with 88% of them expressing a willingness to work even if the situation deteriorated further. However, 87% of the participants were extremely concerned about transmitting the disease to their family members. The most common coping strategy adopted by the nurses appeared to be adherence to strict protective measures (93.5%), followed by the acquisition of more knowledge about the disease (82.3%). Conclusion Frontline nurses experience severe psychological stress, which is mainly caused by their fear of contracting the infection or passing it on to their family members. Thus, proper education, adherence to infection control protocols, effective social support system, and access to sufficient personal protective equipment will help nurses enhance their coping abilities.
Theory-Based Advanced Nursing Practice: A Practice Update on the Application of Orem's Self-Care Deficit Nursing Theory
Authors: Yip Jeffrey Yuk Chiu 
Published: April 2021

Introduction Many researchers have commended the self-care deficit nursing theory (SCDNT) developed by Orem as a means of improving patients' health outcomes through nurses' contributions. However, experimental research has investigated specific aspects of SCDNT, such as self-care agency and self-care requisites, rather than how the construct is practiced and understood as a whole. The current research presents a case study in which an advanced practice nurse (APN) used SCDNT-led practice within a primary healthcare setting that illustrates how the theory is applied to case management. Methods A case study was conducted by observing an APN during her work in the asthma clinic of a public hospital in Hong Kong. A comparison was made between the case management of the APN under observation with the nursing processes stipulated by the SCDNT across four key operations: diagnostic, prescriptive, treatment or regulatory, and case management. Conclusion During the observed consultation, the APN applied the four key operations. In SCDNT, the role of the APN is to apply practical nursing knowledge by determining how a patient can best undertake self-care within the circumstances of their living arrangements and support facilities. The case study also demonstrated that SCDNT-based nursing practice has strengths and limitations in a primary healthcare setting. The study concluded that Orem's SCDNT serves as an appropriate theoretical framework for nursing practice within primary healthcare settings. One practical consequence of using SCDNT is that it enables APNs to use nurse-sensitive indicators when evaluating their clinical practice. This study offers a practice update to increase the accountability of nursing practice for nurse-led healthcare services.
Retrograde inferior vena caval perfusion for total aortic arch replacement surgery: a randomized pilot study
Authors: Lin Jing , Qin Zhen , Liu Xinhao , Xiong Jiyue , Wu Zhong , Guo Yingqiang , Kang Deying , Du Lei 
Published: April 2021

AbstractObjectivesAntegrade cerebral perfusion (ACP) under moderate hypothermic circulatory arrest is used during total aortic arch replacement surgery (TARS) in patients with acute type A aortic dissection, but it is associated with high mortality and morbidity. We hypothesized that combining ACP with retrograde inferior vena caval perfusion (RIVP) improves outcomes.MethodsThis pilot study was prospective, randomized, controlled and assessor-blinded. Patients scheduled for TARS were randomly treated with either ACP or RIVP + ACP. The primary outcome was a composite of mortality and major complications including paraplegia, postoperative renal failure, severe liver dysfunction, and gastrointestinal complications. Secondary outcomes included neurological complications, length of intubation and requirement of blood products.ResultsA total of 76 patients were recruited (n = 38 per group). Primary outcome occurred in 23 patients (61%) in the ACP group and 16 (42%) in the RIVP + ACP group (OR: 0.60, 95% CI: 0.21–1.62;p = 0.31). There was a lower incidence of transient neurological deficits in the RIVP + ACP group (26% vs. 58%, OR: 0.26; 95% CI: 0.10–0.67,p = 0.006;). The RIVP + ACP group underwent shorter intubation (25 vs 47 h,p = 0.022) and required fewer blood products (red cells, 3.8 units vs 6.5 units,p = 0.047; platelet: 2.0 units vs 2.0 units, p = 0.023) compared with the ACP group.ConclusionsRIVP + ACP may be associated with lower incidence of transient neurological deficits, shorter intubation and less blood transfusion requirement than ACP alone during TARS. Multi-center, randomized trials with larger samples are required to determine whether RIVP + ACP is associated with lower rates of mortality and major complications.Trial registration: Pilot study of a RCT registered in clinicaltrials.gov (NCT03607786), Registered 30 July, 2018—Retrospectively registered,https://clinicaltrials.gov/ct2/show/NCT03607786.
Case report of portal hepatic schwannoma: presentation of multimodality images
Authors: Amano Maki , Amano Yasuo , Takagi Ryo , Tang Xiaoyan , Omori Yuko , Okada Masahiro 
Published: April 2021

Abstract
Background
Portal hepatic schwannoma is a rare benign tumor and difficult to diagnose preoperatively because of its rarity and imaging manifestations that mimic malignancy. We present a case of portal hepatic schwannoma that showed moderate contrast enhancement on computed tomography (CT), extension along the bile duct on T2-weighted imaging and magnetic resonance cholangiopancreatography (MRCP), and uptake of 18F-fluorodeoxyglucose (FDG) on positron emission tomography.

Case presentation
Ultrasonography at an annual health checkup identified a hepatic mass in a 38-year-old woman. CT showed a well-defined portal hepatic tumor with mild contrast enhancement. T2-weighted imaging and MRCP showed a clavate tumor extending along the intrahepatic bile ducts but no dilatation of the ducts. The tumor exhibited increased FDG uptake, such as maximum standardized uptake values of 5.0 and 6.5 in the early and late phases, respectively. Neither dilatation of intrahepatic bile ducts nor lymphadenopathy was identified, and the multimodality imaging suggested hepatic portal lymphoma, gastrointestinal tumor, or IgG4-related disease rather than cholangiocarcinoma. A needle biopsy via endoscopic ultrasonography was performed, and immunohistology confirmed the tumor as a schwannoma.

Conclusions
The diagnosis of a portal hepatic schwannoma requires immunohistological examinations in addition to multimodality imaging studies to reflect fully the pathohistological characteristics of the tumor.
High levels of anti-Leishmania IgG3 and low CD4+ T cells count were associated with relapses in visceral leishmaniasis
Authors: Kuschnir Renata Caetano , Pereira Leonardo Soares , Dutra Maria Rita Teixeira , de Paula Ludmila , Silva-Freitas Maria Luciana , Corrêa-Castro Gabriela , da Costa Cruz Silva Simone , Cota Glaucia , Santos-Oliveira Joanna Reis , Da-Cruz Alda Maria 
Published: April 2021

AbstractBackgroundVisceral leishmaniasis (VL) is severe and potentially fatal. Brazil is one of the countries with the greatest endemicity for the disease in the world. The reduction of CD4+T lymphocytes, B cells activation and high levels of inflammatory cytokines (IL-6/IL-8/TNF/IL-1β), plasma LPS, soluble CD14, anti-LeishmaniaIgG3 and low leptin levels are involved in the immunopathogenesis of VL, most associated with severe VL. Despite relapses occurring in about 4–5% of patients with VL not associated with HIV infection, the factors underlying relapses are little known. Our aim was to identify clinical, laboratory and immunological parameters that may be associated with recurrences in VL.MethodsFifteen VL patients recruited from Hospital Eduardo de Menezes (BH-MG) were grouped into relapsing (R-VL,n = 5) and non-relapsing (NR-VL,n = 10) and evaluated during active disease, immediately after treatment (post-treatment) and 6 months post-treatment (6mpt). Clinical and laboratory data obtained from medical records were correlated with CD4+and CD8+T cell counts and anti-LeishmaniaIgs and IL-6 plasma levels and compared to those parameters of ten healthy controls.ResultsDuring the active phase of VL, despite similarity in the clinical symptoms, the rates of thrombocytopenia, elevated transaminases (AST and ALT) and hyperbilirubinemia were higher in the NR-VL group compared to R-VL (p < 0.05), a profile reversed during the post-treatment phase. All patients had low CD4+T counts in active phase, however, NR-VL patients had a higher gain of this cell type than R-VL in the post-treatment (p < 0.05). There was a significant reduction in IgG3 levels during the follow-up in the NR-VL group compared to the R-VL, especially at 6mpt (p < 0.05). In addition, IgG3 levels were negatively correlated with CD4+T counts in the R-VL group (r = − 0.52). Elevated levels of IL-6 were observed in active VL and correlated with clinical markers of severity.ConclusionsDuring active phase of VL, the NR-VL patients presented more severe laboratorial abnormalities compared to R-VL, probably because the latter had already received previous treatment. On the other hand, R-VL exhibited greater impairment of immune reconstitution and a high degree of B lymphocyte activation, which must be a factor that favored relapses.
Delayed bowel perforation after instilling over warmed peritoneal dialysate
Authors: Lai Xueli , Nie Mingming , Xu Xiaodong , Chen Yuanjie , Guo Zhiyong 
Published: April 2021

Abstract
Background
Peritoneal dialysis (PD) is a safe and home-based treatment for end-stage renal disease (ESRD) patients. The direct thermal damage of abdominal organs is very rare.

Case presentation
We report a peritoneal dialysis patient presented abdominal pain and feculent effluent 3 weeks after he instilled hot dialysis solution. In spite of emergency exploratory laparotomy and active treatment, the patient died of septic shock. Biopsy revealed necrosis and perforation of the intestines.

Conclusions
Delayed bowel perforation by hot fluid is very rare. Standardized performance is of the first importance for peritoneal dialysis patients.