bluuebunny/crossref_metadata_2025_split huggingface dataset:
Navigating Student Challenges: From the Lens of First-Year Doctor of Physical Therapy Students
Authors: Plack Margaret M. , Healey William E. , Huhn Karen , Costello Ellen , Maring Joyce , Hilliard Marjorie Johnson 
Published: December 2021

Introduction.
Anxiety, depression, and burnout are being discussed across health professions. Despite rising concern, studies investigating stress in students enrolled in Doctor of Physical Therapy (DPT) programs remain limited. Only recently have studies exploring stress in DPT students surfaced with any consistency. In this study, our aim was to elucidate the self-identified challenges first-year DPT students faced, how they reacted, and what they did to manage them.

Review of the Literature.
Evidence suggests that DPT students, like other health professional students, report high levels of anxiety. Despite rising concern, studies investigating the impact of stress on DPT students remain limited. This concern also raises the question of the role of health professions educators in helping students develop the coping strategies needed to manage stress. Programs across the health professions have been proffered to address student stress; however, limited data exist to effectively guide educators. From the insights gained, we offer recommendations linked to the emic or student perspective that may help educators facilitate adaptive coping skills in their learners.

Subjects.
Participants included first-year DPT students from 3 private universities.

Methods.
A critical incident questionnaire was used to capture the student experience. Narratives were submitted electronically. Responses were deidentified, and researchers were blinded to participation. An inductive interpretivist approach was used to analyze the data. Strategies to ensure trustworthiness included prolonged engagement, triangulation of investigators, and peer review.

Results.
Eighty-two first-year DPT students responded; 70 complete responses were analyzed. Three major themes were identified: 1) first-year DPT students faced academic, personal, and mixed challenges; 2) challenges evoked a range of negatively charged emotions; and 3) students relied on adaptive and some potentially maladaptive personal characteristics, behaviors, and strategies to manage their challenges.

Discussion and Conclusion.
First-year DPT students face many of the same challenges as other health professional students. Most successfully navigated their challenges, however, not without some degree of emotion. As educators, we must prepare students to develop the coping strategies needed to manage not only current academic stressors but ultimately the stressors inherent in clinical practice. Toward that end, we offer recommendations, linked to the emic perspective obtained, that may help educators facilitate adaptive coping skills in their learners.
Mapping of global research output in congenital cataracts from 1903 to 2021
Authors: Idriss Lujain Talaat , Hussain Maryam , Khan Muhammad , Ahmad Tauseef , Muhammad Khushi , Baig Mukhtiar , Khan Muhammad Mumtaz , Inamullah  
Published: December 2021

Abstract

Background and aim:
Globally, congenital cataract remains one of the main causes of visual loss in children. This study was designed to plot the overall research output and evaluate some key bibliometric indicators in congenital cataracts research.

Methods:
Publications on congenital cataracts were retrieved from the Web of Science Core Collection database. The published literature was searched using the keywords “congenital cataract” OR “congenital cataracts” in the title filed with document types and language restrictions. The data were exported into HistCite to analyze; publication year, top authors, countries, institutions, journals, keywords, and most cited studies. VOSviewer software was used to construct network visualization mapping.

Results:
A total of 1427 publications (1903–2021) published in English language were included in this study. Over the past few decades, the total number of publications in congenital cataracts was found to be increased. The most productive year was 2016 (n = 72), while the most cited year was 1941 (1268 citations). The Investigative Ophthalmology & Visual Science (Impact Factor: 4.799) was the most attractive journal with 161 publications, and the Molecular Vision (Impact Factor : 2.367) was the most cited journal with 1915 citations and 161.723 citations per year. The most productive country was the United States of America (USA) (n = 325), while the most active institute was Sun Yat-sen University, China (n = 36). The most prolific author was Yao K (n = 27). The most studied Web of Science category was ophthalmology (n = 852). The most widely used keyword was congenital (n = 1427). The most cited paper in congenital cataracts was “Congenital cataract following German measles in the mother, cited 1268 times. The USA and author keyword congenital cataract had the highest total link strength.

Conclusion:
These findings provide useful insights, current status, and trends in clinical research in congenital cataracts. This study can be used to identify future research areas and standard bibliography references for better diagnosis and disease control.
Electromyographic study assessing swallowing function in subacute stroke patients with respiratory muscle weakness
Authors: Liaw Mei-Yun , Lin Meng-Chih , Leong Chau-Peng , Wang Lin-Yi , Pong Ya-Ping , Yang Tsung-Hsun , Huang Yu-Chi 
Published: December 2021

Abstract

Background:
Dysphagia has been reported to be associated with the descent of the hyolaryngeal complex. Further, suprahyoid muscles play a greater role than infrahyoid muscles in elevation of the hyolarngeal complex. Respiratory muscle training (RMT) can improve lung function, and expiratory muscle strength training can facilitate elevation of the hyoid bone and increase the motor unit recruitment of submental muscles during normal swallowing. This study aimed to investigate the surface electromyography (sEMG) of the swallowing muscles, bilaterally, and the effect of RMT on swallowing muscles in stroke patients with respiratory muscle weakness.

Methods:
Forty patients with first episode of unilateral stroke were included in this retrospective controlled trial. After exclusion of 11 patients with respiratory muscle strength stronger than 70% of the predicted value, 15 were allocated to the RMT group and 14 to the control group. However, eventually, 11 patients in RMT group and 11 patients in control group completed the study. The sEMG of the orbicularis oris, masseter, submental, and infrahyoid muscles were recorded during dry swallowing, water swallowing (2 mL), and forced exhalation against a threshold breathing trainer set at different intensities, at baseline and after 6-week RMT.

Results:
Regarding the sEMG of submental muscles, there were significant between-group differences on the latency of the unaffected side (P = .048), significant change from baseline force on the unaffected side (P = .035), and significant between-side difference (P = .011) in the RMT group during dry swallowing. Significant change in the duration from baseline was observed on the affected side of the RMT group when blowing was set at 50% maximal expiratory pressure (MEP; P = .015), and on the unaffected side of the control group when blowing set at 15% MEP (P = .005). Significant difference was observed in the duration between 50% MEP and 15% MEP after 6-week program in the control group (P = .049).

Conclusions:
A 6-week RMT can improve the electric signal of the affected swallowing muscles with more effect on the unaffected side than on the affected side during dry swallowing. Furthermore, RMT with 50% MEP rather than 15% MEP can facilitate greater submental muscle activity on the affected side in stroke patients with respiratory muscle weakness.
Dexmedetomidine effect on delirium in elderly patients undergoing general anesthesia
Authors: Wang Youran , Bu Xinyi , Zhao Na , Wang Shuxia , Wang Xiaoliang , Ge Yali , Yi Honggang 
Published: December 2021

Abstract

Background:
Delirium is a common postoperative complication. Many studies have found that dexmedetomidine is associated with a reduced incidence of postoperative delirium (POD). This meta-analysis aimed to analyze the effects of dexmedetomidine on POD incidence among elderly patients undergoing general anesthesia.

Methods:
We searched 4 electronic databases (i.e., Pubmed, Embase, Cochrane, and Web of Science) from inception to November 30, 2020, for randomized controlled trials that evaluated the effects of dexmedetomidine in preventing the occurrence of POD in elderly patients (aged ≥60 years). The study protocol was registered in PROSPERO (CRD42020192114).

Results:
14 studies with 4173 patients showed that dexmedetomidine was significantly associated with a decreased POD incidence among elderly patients (relative risk [RR] = 0.58; 95% confidence interval [CI] = 0.44–0.76). The incidence of POD was significantly reduced in the noncardiac surgery group (RR 0.51; 95% CI 0.37–0.72), when dexmedetomidine was applied during the postoperative period (RR = 0.53; 95% CI = 0.40–0.70), and in patients received low-doses (RR = 0.54; 95% CI = 0.34–0.87) and normal-doses (RR = 0.59; 95% CI = 0.42–0.83). There were no significant differences in POD incidence in the cardiac surgery group (RR = 0.71; 95% CI = 0.45–1.11), and when dexmedetomidine was applied during the intra- (RR = 0.55; 95% CI = 0.29–1.01) or perioperative period (RR = 0.95; 95% CI = 0.64–1.40).

Conclusions:
Our meta-analysis suggests that dexmedetomidine may significantly reduce POD incidence in elderly noncardiac surgery patients and when applied during the postoperative period, in addition, both low- and normal-doses of dexmedetomidine may reduce POD incidence. However, its use in cardiac surgery patients and during the intra- or perioperative period may have no significant effects on POD incidence.
Relationship between annualized case volume and in-hospital motality in subarachnoid hemorrhage
Authors: Huang Jian-Yi , Lin Hong-Yu , Wei Qing-Qing , Pan Xing-Hua , Liang Ning-Chao , Gao Wen , Shi Sheng-Liang 
Published: December 2021

Abstract
Studies on the relationship between hospital annualized case volume and in-hospital mortality in patients with subarachnoid hemorrhage (SAH) have shown conflicting results. Therefore, we performed a meta-analysis to further examine this relationship.
The authors searched the PubMed and Embase databases from inception through July 2020 to identify studies that assessed the relationship between hospital annualized SAH case volume and in-hospital SAH mortality. Studies that reported in-hospital mortality in SAH patients and an adjusted odds ratio (OR) comparing mortality between low-volume and high-volume hospitals or provided core data to calculate an adjusted OR were eligible for inclusion. No language or human subject restrictions were imposed.
Five retrospective cohort studies with 46,186 patients were included for analysis. The pooled estimate revealed an inverse relationship between annualized case volume and in-hospital mortality (OR, 0.53; 95% confidence interval, 0.42–0.68, P < .0001). This relationship was consistent in almost all subgroup analyses and was robust in sensitivity analyses.
This meta-analysis confirms an inverse relationship between hospital annualized SAH case volume and in-hospital SAH mortality. Higher annualized case volume was associated with lower in-hospital mortality.
Emergency air evacuation of patients with acute respiratory failure due to SARS-CoV-2 from Mayotte to Reunion Island
Authors: Berguigua Hamza , Iche Ludovic , Roche Philippe , Aubert Cyril , Blondé Renaud , Legrand Antoine , Puech Bérénice , Combe Chloé , Vidal Charles , Caron Margot , Jaffar-Bandjee Marie-Christine , Caralp Christophe , Oulehri Nora , Kerambrun Hugo , Allyn Jérôme , Boué Yvonnick , Allou Nicolas 
Published: December 2021

Abstract
In February 2021, an explosion of cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia overwhelmed the only hospital in Mayotte. To report a case series of patients with acute respiratory failure (ARF) due to SARS-CoV-2 who were evacuated by air from Mayotte to Reunion Island.
This retrospective observational study evaluated all consecutive patients with ARF due to SARS-CoV-2 who were evacuated by air from Mayotte Hospital to the intensive care unit (ICU) of Félix Guyon University Hospital in Reunion Island between February 2, and March 5, 2021.
A total of 43 patients with SARS-CoV-2 pneumonia were evacuated by air, for a total flight time of 2 hours and a total travel time of 6 hours. Of these, 38 patients (88.4%) with a median age of 55 (46–65) years presented with ARF and were hospitalized in our ICU. Fifteen patients were screened for the SARS-CoV-2 501Y.V2 variant, all of whom tested positive. Thirteen patients (34.2%) developed an episode of severe hypoxemia during air transport, and the median paO2/FiO2 ratio was lower on ICU admission (140 [102–192] mmHg) than on departure (165 [150–200], P = .022). Factors associated with severe hypoxemia during air transport was lack of treatment with curare (P = .012) and lack of invasive mechanical ventilation (P = .003). Nine patients (23.7%) received veno-venous extracorporeal membrane oxygenation support in our ICU. Seven deaths (18.4%) occurred in hospital.
Emergency air evacuation of patients with ARF due to SARS-CoV-2 was associated with severe hypoxemia but remained feasible. In cases of ARF due to SARS-CoV-2 requiring emergency air evacuation, sedated patients receiving invasive mechanical ventilation and curare should be prioritized over nonintubated patients. It is noteworthy that patients with SARS-CoV-2 pneumonia related to the 501Y.V2 variant were very severe despite their young age.
Aspirin in the prevention of preeclampsia
Authors: Mkhize P.Z. , Phoswa W.N. , Khaliq O.P. , Dorsamy V. , Moodley J. 
Published: December 2021

Abstract

Introduction:
Aspirin is widely used to prevent pregnancy related vascular disorders such as preeclampsia (PE), intrauterine growth restriction and maternal disorders. However, the indications for the use of aspirin during pregnancy is currently controversial because the dosage of aspirin used and the sample sizes in various studies differ considerably. Furthermore, women of African ancestry are more likely to have higher rates of PE and more severe cases than those of their Caucasian counterparts. Yet, there are very few studies in this population group. Therefore, the aim of this review will be to determine the effect of low-dose aspirin (LDA) for prevention of PE in women of African ancestry.

Methods and Analysis:
This is a protocol for a systematic review and meta-analysis of published studies on the effect of LDA for prevention of PE. Relevant information will be accessed from the following databases; PubMed, Cochrane Central Register of Controlled Trials, Google Scholar, Google, EBSCO Host, and the Web of Science. The studies will be mapped in 2 stages: stage 1 will map studies descriptively by focus and method; stage 2 will involve additional inclusion criteria, quality assessment and data extraction undertaken by 2 reviewers in parallel. Evidence will be synthesized using relevant systematic research tools. Meta-analysis and subgroup analysis will be conducted using RevMan whilst Stata 13 will be used for meta-regressions. We will follow recommendations described in the preferred reporting items for systematic reviews and meta-analyses statement and the Cochrane Handbook for Intervention Reviews.

Discussion:
The use of LDA as a prophylactic treatment has been considered for the prevention of PE. However, studies evaluating the use of LDA in women of African ancestry are few. Therefore, with the increase in the prevalence of PE in the African population, it is critical to further investigate the use of LDA in pregnant women of African ancestry.

Ethics and dissemination:
The review and meta-analysis will not require ethical approval and the findings will be published in peer-reviewed journals and presented at local and international conferences. The findings of this review will inform all stakeholders on current and future guidelines on the use of aspirin in pregnancy, especially in populations of African ancestry.

Systematic review registration:
International prospective Register of Systematic Reviews (PROSERO) number: (CRD42020213213).
Effectiveness of the implementation of pediatric intussusception clinical pathway
Authors: Paek So Hyun , Kim Do Kyun , Kwak Young Ho , Jung Jae Yun , Lee Seuk , Park Joong Wan 
Published: December 2021

Abstract
Intussusception is common among children at the pediatric emergency department (ED) with acute abdomen. Diagnosis and treatment delay remain a challenge. This study aimed to evaluate the impact of intussusception clinical pathways (CPs) implementation, including bedside point-of-care ultrasonography, on patient management in a pediatric ED.
In January 2017, an intussusception management protocol was implemented for children with symptoms of intussusception. We retrospectively examined the charts of patients diagnosed with intussusception during the preprotocol (January 2015 to December 2016) and postprotocol (January 2017 to January 2019) periods and compared their outcomes.
A total of 106 and 108 patients were included in the preprotocol and postprotocol groups, respectively. After CP implementation, the median door-to-ultrasonography time decreased from 66.5 (range: 13, 761) to 54 (20, 191) minutes; meanwhile, door-to-reduction time decreased from 121.5 (37, 1077) to 80.5 (40, 285) minutes; the median ED length of stay decreased from 440 to 303.5  minutes; and finally, admission rate increased from 18.9% to 40.7% (P < .01). There was no between-group difference in the rates of complications, readmission, emergency surgery, or reduction failure.
The implementation of an intussusception CP decreased time-to-diagnosis, time-to-treatment, and ED length of stay estimates among children screened using point-of-care ultrasonography. The present findings suggest that the implementation of an intussusception CP may improve the efficiency of time and resource use.
Angiosarcoma secondary to postirradiation and chronic lymphedema
Authors: Yoon Jin A. , Shin Myung Jun , Shin Yong Beom , Lee Byeong Ju , Choi Kyung Un , Kim Joo Hyoung 
Published: December 2021

Abstract

Introduction:
Angiosarcoma secondary to post-irradiation and lymphedema is rare, but it is aggressive with a poor prognosis. It is essential to understand these patients’ clinical features and distinguish them from benign diseases or other malignant tumors.

Patient concerns:
Three patients who had radiotherapy for cancer treatment and chronic lymphedema admitted to the hospital with specific skin lesions at upper or lower extremities.

Diagnosis:
Excisional biopsies revealed prominent, highly atypical cells with a vasoformative area, composed of atypical, large epithelioid cells with vesicular nuclei, prominent nucleoli, and mitoses. Immunohistochemistry revealed diffuse expression of endothelial cell markers suggestive of angiosarcoma.

Interventions:
One patient had shoulder disarticulation with wide excision with adjuvant radiotherapy and chemotherapy and other 2 discontinued the treatment.

Outcomes:
After the treatment, one patient was transferred to rehabilitation department for shoulder disarticulation prosthesis fitting without recurrence sign for 1 year. Two patient refused further treatment and was lost to follow-up.

Conclusion:
In cases of patients with irratiation and chronic lymphedema, clinical findings suggestive of angiosarcoma, biopsy and imaging studies should be performed as soon as possible.
The clinical effects of ultrasound-guided microwave ablation in the treatment of primary hepatic carcinoma
Authors: Ran Bing , Chang Yong-Li , Qi Jing , Zhong Wei , Chen Min-Na , Zhang Wang , Meng Lin-Xia 
Published: December 2021

Abstract

Instruction:
Despite the continuous advancement of liver cancer diagnosis technology and level, there are still nearly two-thirds of patients with primary liver cancer that are already advanced at the time of diagnosis. Ultrasound-guided microwave ablation, as a palliative treatment for intermediate and advanced liver cancer, is currently recognized internationally Standard treatment for patients with unresectable hepatocellular carcinoma. However, recently, some scholars hold that ultrasound-guided microwave ablation does not guarantee complete inactivation of tumor lesions.

Methods/design:
This study will evaluate the safety and effectiveness of ultrasound-guided microwave ablation in patients with advanced hepatocellular carcinoma through retrospective analysis. This study will follow a clinical research method with consecutive enrollment. The overall survival rate, objective tumor remission rate, serum indices and incidence of adverse effects after treatment will be counted for patients.

Discussion:
At present, there are no good treatment options for intermediate and advanced hepatocellular carcinoma. Therefore, there is a strong demand to explore the individualized multidisciplinary combined treatment model based on ultrasound-guided microwave ablation.

Trial registration:
ClinicalTrials.gov, ChiCTR2100052107, Registered on 17 October 2021.
Diagnostic value of microRNA-148/152 family in non-small-cell lung cancer (NSCLC)
Authors: Cheng Long , Li Qinyun , Tan Bangxian , Ma Daiyuan , Du Guobo 
Published: December 2021

Abstract

Backgrounds:
Non-small-cell lung cancer (NSCLC) is the most common type of lung cancer with extremely high morbidity and mortality.

Objective:
To evaluate the diagnostic value of the blood miR-148/152 family to NSCLC by meta-analysis.

Methods:
PubMed, Embase (via Ovid), The Cochrane Library, web of science, and Chinese National Knowledge Infrastructure were retrieved using miR-148, miR-152, and NSCLC as search terms for studies about miR-148/152 family in the diagnosis of NSCLC, the quality assessment of diagnostic accuracy studies was adopted to evaluate the quality of literature, STATA 12.0 and Meta-Disc 1.4 were used to conduct meta-analysis and to probe the clinical utility (with plotting the Fagan Nomogram).

Results:
A total 2145 cases in 8 trials published in 4 studies finally enrolled for final analysis. The area under the curve of the summary receiver operating characteristic was 0.87 [0.83–0.89], the pooled sensitivity was 0.79 [0.74, 0.83], the pooled specificity was 0.81 [0.76, 0.85] and the diagnosis odds ratio was 15.53 [10.88–22.17], the integrated positive likelihood ratio was 4.1 [3.30, 5.20] and the integrated negative likelihood ratio was 0.27 [0.22, 0.33].

Conclusion:
Current evidence indicated that miR-148/152 family might be served as novel non-invasive diagnostic biomarkers for NSCLC diagnosis with good sensitivity and specificity. it still needs more research with high quality, large sample sizes, and multiple centers for further verification.