bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Preinjury Symptoms and Postconcussion Symptoms at 4 Weeks in Youth
Authors: Ledoux Andrée-Anne , Tang Ken , Gagnon Isabelle , Osmond Martin H. , Yeates Keith O. , Healey Katherine , Gioia Gerard A. , Zemek Roger L. 
Published: May 2021

Objective:
To investigate whether preinjury physical, emotional, cognitive, and sleep symptoms on the Post-Concussion Symptoms Inventory (PCSI) are associated with persistent postconcussion symptoms (PPCS) at 4 weeks and whether any associations are moderated by sex or age.

Study Setting and Participants:
A total of 3063 participants with acute concussion, presenting to 9 Canadian pediatric emergency departments, were enrolled from August 2013 to June 2015.

Design:
A planned secondary analysis of a prospective, multicenter cohort study (Predicting Persistent Post-concussive Problems in Pediatrics or 5P). Primary outcome was PPCS at 4 weeks, defined as 3 or more new or worsening individual symptoms compared with the preinjury score at 28 days on the PCSI. The association between preinjury scores and PPCS was analyzed with a multivariable logistic regression analysis that included preinjury, sex, age, sex × preinjury, and age × preinjury interactions as predictors. Missing baseline covariates were imputed.

Results:
A total of 2123 (n = 844 [39.8%] girls; median [IQR] age = 12.9 [10.7, 15.0] participants were included in the analysis. Preinjury physical symptom score was associated with PPCS at 4 weeks (χ2 = 13.87, df = 6, P = .031). The preinjury emotional score also contributed to the variability in PPCS (χ2 = 11.79, df = 6, P = .067). While girls reported higher preinjury physical, emotional, and cognitive scores than boys, neither sex nor age interacted with preinjury to predict PPCS at 4 weeks. Independent of age and sex, preinjury physical symptoms were associated with PPCS at 4 weeks (OR = 1.40; 95% CI, 1.15-1.70).

Conclusion:
Preinjury physical symptoms are associated with the probability of having PPCS at 4 weeks postconcussion independent of age and sex. Providers should consider preinjury symptoms to inform prognosis and recovery management.
Report of Early Childhood Traumatic Injury Observations & Symptoms: Preliminary Validation of an Observational Measure of Postconcussive Symptoms
Authors: Dupont Dominique , Beaudoin Cindy , Désiré Naddley , Tran Maria , Gagnon Isabelle , Beauchamp Miriam H. 
Published: May 2021

Objective:
To report preliminary empirical data on a novel, developmentally appropriate, observational postconcussive symptoms inventory for infants, toddlers, and preschoolers.

Setting:
Emergency departments of 2 tertiary, urban pediatric hospitals.

Participants:
Ninety-eight children (0-8 years of age; mean age at injury = 33.00, SD = 24.7 months) with mild traumatic brain injury (concussion) divided into younger (0-2 years) and older (3-8 years) age groups.

Design:
Observational study.

Main Measure:
The Report of Early Childhood Traumatic Injury Observations & Symptoms (REACTIONS) documents 17 postconcussive symptoms representing observable manifestations thereof and was completed by parents in the acute (24-48 hours; n = 65), subacute (7-14 days; n = 78), and/or persistent phase (25-35 days; n = 72) post–mild traumatic brain injury.

Results:
Different patterns of postconcussive symptoms were reported by age group, with behavioral manifestations particularly salient in younger children. More children younger than 2 years had sleep and comfort-seeking symptoms at each of the 3 postinjury time points.

Conclusion:
Postconcussive symptoms may manifest differently after mild traumatic brain injury sustained during early childhood. To fully understand and address their presence and evolution, developmentally sound measures such as the REACTIONS inventory are required.
Application of Trypan Blue Stain in the Microbiological Diagnosis of Infectious Keratitis—A Case Series
Authors: Sharma Supriya , Rathi Varsha M. , Murthy Somasheila I. , Garg Prashant , Sharma Savitri 
Published: May 2021

Purpose:
The purpose of this study was to report 3 cases of microbial keratitis, wherein trypan blue staining was used to aid the microbiological diagnosis of fungal keratitis and Pythium keratitis in a rural setup.

Methods:
Three consecutive patients who presented with a diagnosis of infectious keratitis underwent corneal scraping, and the smears were assessed using trypan blue stain and potassium hydroxide (KOH) mount.

Results:
Of the 3 cases, the first 2 cases showed septate fungal filaments in trypan blue–stained preparation and KOH mount. Case 3 showed the presence of broad aseptate filaments with ribbon-like folds on both KOH mount and trypan blue stain, consistent with the diagnosis of Pythium keratitis. The first 2 cases improved with topical and systemic antifungals. Case 1 healed with scarring at 7 weeks with improvement in best-corrected visual acuity (BCVA) to 20/60. Case 2 healed within 2 weeks, and BCVA improved to 20/40. Case 3 received topical linezolid (0.2%), azithromycin eye ointment, and oral azithromycin. At 5 weeks the infection decreased but thinning was noted, which necessitated tissue adhesive and bandage contact lens application. Scarring was noted at 10 weeks, and BCVA improved to 20/40.

Conclusions:
In this case series, trypan blue staining showed promising results in the easy identification of aseptate and septate fungal elements. This is the first case series showing the utility of this stain in the management of microbial keratitis.
An Unusual Presentation of Neisseria gonorrhoeae
Authors: Masutani Rebecca , Yen Christina , Stead Wendy 
Published: May 2021

Abstract
Cases of disseminated gonococcal infections are less commonly reported. We present a case of an immunocompetent 46-year-old man who developed a right calf abscess that grew Neisseria gonorrhoeae. This was suspected to have developed from a disseminated gonococcal infection that subsequently seeded a preexisting right calf hematoma.
History of Weight Cycling Is Prospectively Associated With Shorter and Poorer-Quality Sleep and Higher Sleep Apnea Risk in Diverse US Women
Authors: Cao Vivian , Makarem Nour , Maguire Moorea , Samayoa Ivan , Xi Huaqing , Liang Citina , Aggarwal Brooke 
Published: May 2021

Background
Poor sleep and history of weight cycling (HWC) are associated with worse cardiovascular health, yet limited research has evaluated the association between HWC and poor sleep patterns.

Methods
The American Heart Association Go Red for Women Strategically Focused Research Network cohort at Columbia University (n = 506; mean age, 37 ± 15.7 years; 61% racial/ethnic minority) was used to evaluate the cross-sectional associations of HWC and sleep at baseline and the prospective associations of HWC from baseline with sleep at the 1-year visit. History of weight cycling, defined as losing and gaining 10 lb or more at least once (excluding pregnancy), was self-reported. Sleep duration, sleep quality, insomnia severity, and obstructive sleep apnea risk were assessed using the validated Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Berlin questionnaires. Linear and logistic regression models, adjusted for age, race/ethnicity, education, health insurance status, pregnancy history, and menopausal status, were used to evaluate the relation of HWC with sleep.

Results
Most women reported 1 or more episodes of weight cycling (72%). In linear models of cross-sectional and prospective data, each additional weight cycling episode was related to shorter sleep duration, poorer sleep quality, longer sleep onset latency, greater insomnia severity, more sleep disturbances, lower sleep efficiency, and higher sleep medication use frequency. In the logistic models, HWC (≥1 vs 0 episodes) was associated with greater odds for short sleep, poor sleep quality, long sleep onset latency (≥26 minutes), high obstructive sleep apnea risk, and sleep efficiency lower than 85%.

Conclusion
History of weight cycling predicted poor sleep among women, suggesting that weight maintenance may represent an important strategy to promote sleep health. The potential bidirectional relationship between HWC and sleep requires further investigation.
Anastomotic Ulcers: A Tertiary Centre Experience of Endoscopic Management Techniques
Authors: Barraclough Harriet , Girach Ayesha , Rao Prithviraj , Urs Arun , Marven Sean , Murthi Govind , Thomson Mike , Narula Priya 
Published: May 2021

ABSTRACT
Improvements in neonatal care and surgical advances, has led to an increased prevalence of children with small and large bowel anastomoses. Ulceration at the site of anastomosis is a rare, but well-recognised phenomenon, with no clearly understood pathogenesis. Paediatric case series have been reported but there remains no clear effective treatment strategy and there is limited experience with endoscopic techniques in their management. We report our tertiary centre experience of managing nine anastomotic ulcer patients, including endoscopic treatment with argon plasma coagulation and clips.
Two patients with inflammatory bowel disease (IBD) responded to optimisation of medical therapy. In our non-IBD patients, those requiring a blood transfusion (n = 2) ultimately required surgery and those who did not require a blood transfusion responded to aminosalicylate treatment (n = 1) or endoscopic therapeutic techniques (n = 3).
We conclude that endoscopic interventions can be an effective management strategy for anastomotic ulcers when a blood transfusion isn’t required.
A Preliminary Investigation of Psychoneurological Symptoms in Low-Income Mothers
Authors: Salomon Rebecca E. , Muscatell Keely A. , Crandell Jamie , Anderson Ruth A. , Beeber Linda S. 
Published: May 2021

Background
Exposure to chronic stressors may contribute to the development of psychoneurological symptoms (i.e., fatigue, cognitive dysfunction, sleep disturbance, depressed mood, and pain) that can compromise maternal function.

Objectives
In two studies of low-income mothers, we investigated the presence of psychoneurological symptoms and explored associations between mothers’ stressors and psychoneurological symptoms as well as between symptoms and function. We also considered the possible mediating role of the symptoms between stressors and function.

Methods
We conducted secondary analyses of psychoneurological symptoms in two studies of low-income mothers of infants and toddlers in the United States. Study 1 sampled Latina women with limited English proficiency, whereas Study 2 was conducted with English-speaking women from diverse backgrounds. In both studies, symptoms were measured using items from the Center for Epidemiological Studies Depression Scale and the Medical Outcomes Study Short-Form Health Survey. Maternal function was measured through self-report and researcher observation. In Study 2, stressors were measured using the Everyday Stressors Index. Multiple linear regressions were used to investigate associations while controlling for relevant covariates.

Results
In both studies, mothers endorsed a wide range of psychoneurological symptoms. In Study 1, psychoneurological symptoms had significant negative associations with role function, social function, and developmental stimulation. In Study 2, psychoneurological symptoms had significant negative associations with role function, social function, and physical function. Using Aroian test for mediation, we found that psychoneurological symptoms mediated all significant relationships between stressors and maternal functions in Study 2.

Discussion
In two samples of low-income mothers, psychoneurological symptoms were prevalent and associated with chronic stressors and with maternal function and may mediate the association between those two factors. These findings extend prior research on depressive symptoms in mothers by investigating pain as an additional key symptom. The studies advance symptom science by highlighting psychoneurological symptoms in a heterogeneous sample without known health conditions.
Leveraging E-Learning Infrastructure in Times of Rapid Change: Use of the National Sexually Transmitted Diseases Curriculum in the Era of COVID-19
Authors: Bauer Karin M. , Corcorran Maria A. , Budak Jehan Z. , Johnston Christine , Spach David H. 
Published: May 2021

Abstract
The National Sexually Transmitted Diseases Curriculum is an e-learning platform. New registrations and learning group creations in March to April 2020 were compared with previous 12-month data. Substantial increases in registrations and learning groups demonstrate that the National Sexually Transmitted Diseases Curriculum was successfully leveraged to meet rapidly shifting training needs due to the COVID-19 pandemic.
The Effects of Safety Climate on Psychosocial Factors: An Empirical Study in Healthcare Workplaces
Authors: Wang Jiana-Fu , Wu Chieh-Liang , Tsai Yao-Te , Weng Shao-Jen , Hsu Ya-Chen 
Published: May 2021

Abstract
How to develop a better patient safety culture has been an important goal for healthcare organizations, but the effects of safety culture on psychosocial factors, such as emotional exhaustion and stress, have not been fully addressed. This study aimed to reconfigure important dimensions affecting safety culture and examine the associations between safety culture and psychosocial factors (emotional exhaustion and work-life balance). The partial least squaring technique was used to analyze the data, showing that job satisfaction (β = 0.320, P < 0.001), working conditions (β = 0.307, P < 0.001), and perception of management (β = 0.282, P < 0.001) positively affected the safety climate. The safety climate and work-life balance could reduce the occurrence of emotional exhaustion, whereas a high-stress environment would cause a higher level of emotional exhaustion. Given these findings, hospitals should endeavor to help employees feel safe and not threatened, reduce stress, and advise them to maintain a good work-life balance.
Patterns of Medication Errors Involving Older Adults Reported to the French Medication Error Guichet
Authors: Azar Christine , Thomas Laure , Gras-Champel Valérie , Laroche Marie-Laure , Grau Muriel , Allué Delphine , Saleh Nadine , Maison Patrick 
Published: May 2021

Objectives
The aims of the study were to describe medication errors (MEs) involving older adults reported to the French Medication Error Guichet and to compare them with MEs in younger adults, in each of the hospital and community settings.

Methods
Retrospective secondary data analysis of MEs reported throughout 2013 to 2017 was performed. Descriptive and multivariate analyses were performed to compare actual and potential ME reports between older adults (aged ≥60 y) and younger adults (aged ≥18, <60 y).

Results
We analyzed 4979 reports. In older adults, both in hospital (n = 1329) and community (n = 1264) settings, antithrombotic agents were frequently reported in MEs and were significantly more likely to be associated with reported MEs in older adults compared with younger adults. In hospital setting, antibacterials for systemic use (adjusted odds ratio [aOR] = 1.87, 95% confidence interval [CI] = 1.19–2.93) and antineoplastic agents (aOR = 2.22, 95% CI = 1.34–3.69), whereas in community setting, psycholeptics (aOR = 1.43, 95% CI = 1.04–1.98) and drugs used in diabetes (aOR = 6.01, 95% CI = 3.21–11.2) were more likely to be associated with reported MEs in older adults. In both settings, wrong dose and wrong drug were the most frequently reported error types in older adults; however, wrong technique error type (aOR = 2.06, 95% CI = 1.30–3.28) in hospital setting and wrong patient (aOR = 2.17, 95% CI = 1.30–3.60) in community setting were more likely to be associated with reported MEs in older adults.

Conclusions
We identified specific ME patterns for older adults, including antithrombotic agents in both settings; antibacterials for systemic use, antineoplastic agents, and wrong technique in hospital setting; and psycholeptics, drugs used in diabetes, and wrong patient in community setting. These findings inform future studies investigating population-specific medication safety strategies.
Medication Errors in the Operating Room: An Analysis of Contributing Factors and Related Drugs in Case Reports from a Japanese Medication Error Database
Authors: Suzuki Ryohei , Imai Tsuneo , Sakai Takamasa , Tanabe Kouichi , Ohtsu Fumiko 
Published: May 2021

Objective
The aim of this study was to prevent drug-related medication errors in the operating room by clarifying the association between the medication error category with related drugs and contributing factors.

Methods
We used data from the Japan Council for Quality Health Care’s open database on the web. We researched the medication error category, related drugs, and contributing factors. We classified each medication error category into case groups and other medication error categories into control groups. We compared the medication error factors of the 2 groups using multivariate logistic regression analysis on the medication error factors.

Results
The total number of analyzed cases was 541. Incorrect dose was the most common medication error category in 170 cases, followed by incorrect drug in 152 cases. Medication error factors (odds ratio, 95% confidence interval) that were found to be significantly positively associated with incorrect dose were “pressor drugs” (3.0, 1.4–6.4), “anesthesia-inducing drugs” (6.3, 1.7–23.4), “lack of knowledge” (2.0, 1.3–3.3), and “drug administration” (3.4, 1.6–7.4). The medication error factors that were found to be significantly positively associated with incorrect drug were “preparation” (5.7, 3.1–10.5) and “medication passed or picked up” (102.2, 35.7–292.8).

Conclusions
Medication errors are frequently occurring during drug preparation and administration in the operating room. Medical staff should thoroughly learn about operating room–specific drugs and closely monitor every step of the drug preparation and administration process. It is also important to create a workflow and improve the environment so that it reduces the likelihood of medication errors.
Implementation of an Electronic Health Record–Based Messaging System in the Emergency Department: Effects on Physician Workflow and Resident Burnout
Authors: Luu Tiffany , Spiegelman Lindsey , Nykin David , Abido Kimberly , Roh Jennifer , Rudkin Scott , Toohey Shannon 
Published: May 2021

Introduction
The traditional methods of communication between nurses and physicians through paging or phone calls have been known to cause patient care interruptions, increase stress and workload, and cause burnout. Our study assessed the impact of using an electronic health record–based messaging system (Epic Secure Chat) for nonemergent communication between nurses and physicians in the emergency department (ED).

Method
This study was performed at a large urban academic ED. Surveys were distributed through e-mail using Google forms. Preimplementation and postimplementation surveys were performed from May 2019 (presurvey) to August 2019 (postsurvey).

Result
The number of nonurgent phone calls from registered nurse staff decreased after intervention (P < 0.001). The frequency of nonurgent calls disrupting workflow decreased after the intervention (P = 0.029). The number of calls that were appropriately alerted to increased but was not significant (P = 0.120), whereas the degree of burnout from nonurgent calls remained relatively the same (P = 0.841).

Conclusions
The findings provide insight into the implementation of an EMR messaging system in an ED setting. These findings suggest the messaging system can decrease unnecessary nonurgent calls from registered nurses and medical doctors, allowing for more efficient workflow in the ED. These findings suggest further research especially regarding burnout implemented on a larger scale and yield redesign suggestions in the ED.
Lateral Hepatic Fissure Peritoneal Carcinomatosis as a Pitfall for Hepatic Metastasis of Advanced Ovarian Cancer
Authors: Gabiache Erwan , Chantalat Elodie , Zerdoud Slimane , Martinez Alejandra , Ferron Gwénaël 
Published: May 2021

Abstract
A 52-year-old woman previously treated for a stage IIIc high-grade ovarian serous carcinoma presented right upper quadrant abdominal pain, 3 years after extended surgery and chemotherapy. Abdominal CT, MRI, and 18F-FDG PET/CT showed a right hepatic mass, consistent for lone recurrence nearby the hepatic lateral fissure. Preoperative and histologic examination identified a peritoneal lateral fissure lesion. The patient underwent atypic segment 5 segmentectomy. She has been disease-free for 3 years now. Advanced ovarian cancer can be responsible for perihepatic sulcus lesions, such as this right fissure lesion. They should not be mistaken for inoperable parenchyma metastases.
Dissecting Mycotic RCA Aneurysm Detected on 67Ga Scintigraphy
Authors: Campos Rossana , Yung Grace , Russo Robert , Mansberg Robert 
Published: May 2021

Abstract
A 61-year-old man presented with pneumonia and myocardial infarction on a background of diabetes and end-stage renal failure. Methicillin-resistant Staphylococcus aureus bacteremia was confirmed in the setting of ongoing pyrexia. The patient was referred for a 67Ga study, which revealed Ga-avid active disease in the pericardial effusion. This was localized further on CT/MRI and coronary angiography to a dissecting right coronary artery aneurysm, which was treated with surgical repair and long-term antibiotic treatment.
Pelvic Plexiform Schwannoma on 18F-FDG PET/MRI
Authors: Zeng Yuping , Luo Jiandong , Nie Jieyu , Leng Xiaoming 
Published: May 2021

Abstract
Plexiform schwannoma (PS), a subtype of schwannoma, is a rare benign nerve sheath tumor characterized by a multinodular plexiform growth pattern. It is usually confined to the head and neck or skin. Pelvic PS is an extremely rare occurrence and signifies a challenge for the imaging diagnosis. In this work, we present a 42-year-old woman with pelvic PS, who was initially suspected of malignant tumor on 18F-FDG PET/MRI but confirmed as PS by postoperative pathology. We consider that this case would contribute to the literature and provide a further insight into diagnosing this kind of rare tumor.
Evaluation of Effects of Systemic Zoledronic Acid Application on Bone Maturation in the Consolidation Period in Distraction Osteogenesis
Authors: Akbulut Yasin , Gul Mehmet , Dundar Serkan , Ozcan Erhan Cahit , Ozercan Ibrahim Hanifi , Bozoglan Alihan , Karasu Necmettin , Acikan Izzet , Bingül Muhammet Bahattin 
Published: May 2021

Abstract
Distraction osteogenesis (DO) is a physiological process that generates new bone tissue formation, using progressively separated bone fragments. Recently, several techniques have been investigated to develop the maturation of the new bone tissue. Bisphosphonates was an effective material for the acceleration of bone formation in DO procedures. The purpose of this study was to evaluate the effects of the systemic zoledronic acid application at the beginning of the consolidation period on new bone genesis in a DO model of rat femurs. The rats were divided randomly into 3 groups, as follows: Control group (CNT group) (n = 10), zoledronic acid dosage-1 (n = 10), and dosage-2 (n = 10) groups (ZA-D-1 and ZA-D-2). No treatment was administered in controls, but DO was applied to the rat femurs. A single dose of 0.1 mg/kg and 0.2 mg/kg of zoledronic acid was administered systematically at the beginning of the consolidation period after the distraction in treatment groups, respectively. Histomorphometric analyses were performed on the original distracted bone area and the surrounding bone tissue. Osteoblasts, new bone formation, and fibrosis were scored. New bone formation in the ZA-D-1 and ZA-D-2 groups, when compared with the control group, was detected highly (P < 0.05). The numbers of osteoblasts in the ZA-D-1 and ZA-D-2 groups were higher when compared with the controls (P < 0.05). Fibrosis in the controls, when compared with the ZA-D-1 and ZA-D-2 groups, was found to be higher (P < 0.05). Zoledronic acid application is an effective method for bone maturation in consolidation period in DO.