bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Virtual Simulation in De-Escalating a Patient Demonstrating Escalating Behavior
Authors: Conrad Meghan , Harder Nicole , Duff Els , Schönwetter Dieter 
Published: October 2024

Background
Undergraduate nursing students are unprepared to manage patients demonstrating escalating aggressive behavior encountered during their clinical placements. Confidence and competence surrounding de-escalation skills can be achieved through virtual simulated learning opportunities. This study evaluated undergraduate nursing students' perceptions of confidence and success in their de-escalation skills following a virtual simulation intervention.

Method

A quantitative, one-group pretestposttest design was used to complete this study. Students (
n
= 33) completed a 10-question demographic questionnaire with four additional questions on participants' psychosocial well-being considering the pandemic, and a nine-question pre- and postvirtual simulation de-escalation confidence and knowledge survey.

Results
Virtual simulation had positive effects on participants' feelings of confidence and success. Male students and students who reported Caucasian as their ethnicity were the most comfortable with de-escalating behaviors.

Conclusion

These findings emphasize the effectiveness of de-escalation education.

[
J Nurs Educ
. 2024;63(10):698–702.]
The Influence of Chromatic Aberration on Visual Quality in Patients With Trifocal Intraocular Lenses
Authors: Güngör; Helin S. , Łabuz Grzegorz , Yildirim Timur M. , Auffarth Gerd U. , Khoramnia Ramin 
Published: October 2024

Purpose
To investigate how varying levels of longitudinal chromatic aberration (LCA) affect visual quality in patients with trifocal intraocular lenses (IOLs).

Methods
Twenty-nine patients implanted with trifocal IOLs were assessed for corrected distance visual acuity (CDVA), defocus curves, the contrast sensitivity function, and the area under the logarithmic contrast sensitivity function (AULCSF). The measurements were performed under natural viewing conditions after introducing +1.00 and −1.00 diopters (D) of LCA using zero-power triplet lenses.

Results

CDVA was −0.10 ± 0.09, −0.07 ± 0.09, and −0.08 ± 0.08 logarithm of the minimum angle of resolution (logMAR) with natural, enhanced, and reduced LCA, respectively. At defocus levels of 0.00 to −1.50 D, visual acuity decrease was steeper under natural conditions than under conditions with more positive LCA. At a defocus level of −2.50 D, visual acuity was 0.02 ± 0.09, 0.03 ± 0.08, and 0.06 ± 0.14 logMAR with natural, elevated, and reduced LCA, respectively. The AULCSF was 1.19 ± 0.12 under natural and reduced LCA conditions. Increasing LCA lowered the AULCSF to 1.12 ± 0.13 (
P
≤ .0001).

Conclusions
LCA elevation led to a slight enhancement of depth of focus while not substantially affecting vision at far focus. Reducing LCA with an achromatizing triplet lens failed to improve CDVA and contrast sensitivity. Likewise, at intermediate and near viewing distances, lowering LCA did not improve visual function.

[
J Refract Surg
. 2024;40(10):e692–e698.]
ST Elevation during Dobutamine Stress Echocardiography: Important Diagnostic and Prognostic Marker
Authors: Dey Jaideep , Bhadoriya Shailendra , Mustaqueem Arif , Shrivastava Sameer 
Published: October 2024

Abstract
Pharmacological stress echocardiography is an established modality of cardiac assessment before noncardiac surgery. Electrocardiographic changes during stress echocardiography aid in the risk stratification of patients. ST-segment elevation is an uncommon finding during dobutamine stress echocardiography and is associated with extensive coronary artery disease. We report about a positive dobutamine stress echocardiography testing of an elderly patient, who developed asymptomatic, extensive ST-segment elevation during the procedure. Coronary angiography revealed severe, multivessel coronary artery disease, which was treated with percutaneous coronary intervention.
Olanzapine: Are Extrapyramidal Symptoms as Rare as We Think? – A Case Series
Authors: Bhardwaj Akansha , Zahoor Bushra , Yadav Kirti , Chadha Gunjan 
Published: October 2024

Abstract
Olanzapine, a second-generation antipsychotic has proven to be very efficacious with a low probability of extrapyramidal symptoms (EPS). Here, we wish to report a series of cases where EPS is occurring as a rare side effect due to olanzapine. Such reporting is important as these rare side effects could be confused with other clinical pictures, thereby affecting the management. Case 1 describes a 29-year-old woman with bipolar affective disorder who developed dystonic upward deviation of eyes after taking olanzapine 5 mg. Symptoms remitted within 30 min of injection of promethazine 25 mg. Case 2 describes a 21-year-old male with schizophrenia on olanzapine 15 mg, who presented with a complaint of gradual onset excessive blinking of eyes (blepharospasm). A provisional diagnosis of olanzapine-associated tardive blepharospasm was made based on clinical history and physical examination. On injection of promethazine 25 mg, there was remission of blepharospasm. After 2 weeks of discontinuation of olanzapine, there was resolution of blepharospasm. Case 3 describes a 52-year-old male with schizophrenia on olanzapine 25 mg and trihexyphenidyl 2 mg who presented with a complaint of gradual onset chewing movements and clenching of his jaw for the past 6 months. A provisional diagnosis of olanzapine-associated tardive dyskinesia was made based on clinical history and physical examination. Tablet olanzapine was tapered down slowly to 15 mg. After 4 weeks, the Abnormal Involuntary Movement Scale (AIMS) score showed improvement, so olanzapine was cross-tapered with aripiprazole. After 3 months, the movements had significantly reduced. Reporting such rare side effects is necessary as it can help in appropriate identification as well as prevent confusion with other clinical pictures. Through this, it can positively help in the correct line of management besides enhancing our knowledge of how atypical antipsychotics can lead to the development of extrapyramidal symptoms.
Efficacy and safety of growth hormone therapy in children with systemic lupus erythematosus: A systematic review
Authors: Akbar Lujayn Jamel , Elshaer Rawan Emad , Jaber Samar Asaad , Khader Majd Suleiman , Al-Mayouf Sulaiman Mohammed 
Published: October 2024

Introduction
Childhood-onset systemic lupus erythematosus (cSLE) is a chronic autoimmune disease with long-term consequences, including growth failure and short stature. Growth hormone (GH) therapy is a potential treatment for short stature in cSLE.

Objective
The aim of the study was to evaluate the current evidence on the efficacy and safety of GH therapy in cSLE.

Methods
A systematic review was conducted through PubMed, Cochrane, and Web of Science databases to identify relevant publications from January 1988 to October 2023. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Articles focusing on GH therapy in cSLE were included after an initial screening of their titles and abstracts. The articles were extracted and analyzed by two independent reviewers, with a third reviewer addressing any discrepancies that arose to reach an agreement.

Results
Among the 6364 screened citations, only two case reports fulfilled the inclusion criteria. Both were for males with cSLE who had short stature due to the disease and corticosteroids. Both case reports demonstrated improved linear growth; however, GH therapy was discounted because of a lupus flare concurrent with GH use, with one case necessitating treatment escalation to control disease activity.

Conclusion
GH therapy has shown favorable effects on growth in cSLE; however, it may increase the risk of disease flare. Limited evidence precludes a definitive conclusion, highlighting the need for further studies to fill the knowledge gap on the safety and efficacy of GH therapy in cSLE patients.
Knowledge and competence of primary healthcare physicians in the management of diabetes-related chronic kidney disease
Authors: Alzahrani Abdullah M. , Alghamdi Afnan G. , Alghamdi Danah M. , Shakir Murug O. , Jaha Afnan Y. 
Published: October 2024

BACKGROUND:
Diabetes mellitus (DM) is a primary cause of chronic kidney disease (CKD), a significant and growing global health issue. Primary healthcare physicians (PHPs) are crucial in detecting, managing, and preventing CKD, but many lack the necessary knowledge and skills to effectively diagnose and manage the disease. This study assessed the knowledge and competence of PHPs in managing diabetes-related CKD.

MATERIALS AND METHODS:
This cross-sectional study was conducted among all Primary Healthcare Physicians (PHPs) working at Primary Healthcare Center (PHC) in King Abdulaziz Medical City of the National Guard, Jeddah, Saudi Arabia. An online questionnaire was sent to all PHPs and data were collected from January 2024 to February 2024. Data analysis performed utilizing RStudio (version 4.3.1). Categorical variables were expressed as frequencies and percentages, whereas mean and standard deviations were computed for continuous variables. Kruskal–Wallis rank sum test was used to determine differences in confidence scores across various demographic and occupational characteristics. A multivariable linear regression analysis was performed to identify factors related to confidence.

RESULTS:
Of 141 PHPs, 122 filled online questionnaire yielding a response rate of 86.5%. responded. The majority (90.2%) were 18–45 years of age, 68.0% were qualified as family physicians, 38.0% belonged to the specialized poly clinic, and 54.9% had less than 5 years of experience. PHPs showed a varied levels of confidence and knowledge. While 76.2% were confident about the stages of kidney disease and 65.6% acknowledged the importance of the urine albumin-creatinine ratio (uACR) test, 58.1% were uncertain of interpreting uACR results and CKD diagnostic criteria. More than 60.0% were uncertain of the treatment steps postdiagnosis and prediction of CKD prognosis. Age, qualification, specialization in family medicine, and clinic affiliation were significantly related to confidence levels.

CONCLUSION:
The study underscores notable gaps in PHPs' knowledge and confidence concerning CKD screening, diagnosis, and management. Continuous education and targeted interventions are essential for the improvement of PHPs' competence and patient outcomes in the management of CKD.
The wizard of artificial intelligence: Are physicians prepared?
Authors: Radhwi Osman O. , Khafaji Mawyah A. 
Published: October 2024

BACKGROUND:Despite the increasing use of artificial intelligence (AI) in medicine, research into the knowledge and attitudes of medical experts toward AI is limited. This study aimed to assess physicians’ attitudes and perceptions of AI applications in healthcare.MATERIALS AND METHODS:A cross-sectional study was conducted at the College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia between November 1 and December 20, 2023. Data was collected using a web-based validated self-administered questionnaire; information sought included demographics, familiarity with AI technology, attitudes towards AI applications in medicine, and perceived risks associated with its implementation. Data analysis performed using SPSS. Categorical variables were presented as frequencies and percentages, whereas mean and standard deviations were calculated for continuous variables. Four domains were used as study variables: familiarity, attitude, AI application, and possible risks. The domains were compared to the scored individual question using Pearson’s correlation coefficient.RESULTS:A total of 128 academic staff participated (response rate 21.3%). About 41% reported being aware of AI as an emerging field and expressed desire to learn about AI. Concerns about the effect of AI on physicians’ employability were not prominent. Instead, most (65.6%) agreed that new positions would be created and that the job market for those who embraced AI would increase. Thirty-two percent reported actively seeking out new technologies in their practice areas, and 24.2% would be willing to adapt AI to practice if its usefulness was published in scientific journals. Most participants (87.5%) agreed that dedicated courses would help them implement AI in their specialty. The most commonly reported problem of AI was its inability to provide opinions in unexpected scenarios. A quarter of participants believed that both AI creators and doctors should be liable for AI-caused medical errors. Physician’s age, gender, or years of experience were not related to their familiarity with or attitudes toward AI.CONCLUSION:Doctors are open to learning about AI use in medicine. Including AI learning objectives or short courses in medical curricula would help physicians develop the necessary skills for an AI-augmented healthcare system.
Prevalence, characteristics, and risk factors for urinary incontinence among women attending Primary Healthcare Centers in Bahrain, 2023
Authors: Abdulhusain Jasim A. , Darraj Marwa J. , Alasbool Mohamed Y. , Alasoomi Eman K. , Altahoo Yusuf A.J. , Tadayyon Bahnaz E. , Alawainati Mahmood A. 
Published: October 2024

BACKGROUND:
Urinary incontinence (UI) is a common health concern of women that often goes untreated owing to a lack of awareness and social stigma. It is associated with a lower quality of life and negative bio-psycho-social consequences. Therefore, it is crucial to diagnose UI and manage it in its early stages. This study aimed to assess the prevalence, characteristics, and risk factors in females attending Primary Healthcare Centers (PHCCs) in Bahrain.

MATERIALS AND METHODS:
A cross-sectional study was conducted in 8 PHCCs in Bahrain in April 2023. Females aged 18 and above were included. A multistage sampling technique was adopted. A self-administered questionnaire consisting of sociodemographic characteristics, risk factors and the International Consultation on Incontinence Questionnaire Short Form was used. Univariate and logistic regression analyses were performed.

RESULTS:
A total of 875 adult females were enrolled in the study with an average age of 37.5 (standard deviation = 12.3) years. Of the cohort, 24.8% patients had UI with stress incontinence as the most common type (71%), followed by urgency UI (21.2%). However, only 21.7% women had sought medical attention. Being a widow (Odds ratio [OR] = 2.49, P=0.007), retired (OR = 1.98, P=0.016), having had multiple pregnancies (95% CI: 0.82, 0.98; P = 0.016), having urogenital infection (OR = 2.50, P=0.001), having undergone surgery other than C-section (OR = 1.60, P=0.017), and constipation (OR = 1.62, P=0.038) were associated with increased risk for UI.

CONCLUSION:
This study revealed a relatively high prevalence of UI in females attending PHCCs. Since most patients with incontinence did not seek medical care, primary care physicians should address UI in patients using a well-structured screening tool and provide relevant health education.
Sliding hiatus hernia (intrathoracic sleeve migration) post-laparoscopic sleeve gastrectomy: A case series and review of literature
Authors: Alqattan Maher Ali , Varkey Roshan George , Abualsel Abdulmenem 
Published: October 2024

Abstract
Intrathoracic sleeve migration (ITSM) is a complication that uncommonly occurs post-sleeve gastrectomy, with an incidence rate anecdotally ranging from 5% to 45%. Its treatment has established difficulties by bariatric surgeons worldwide. Sixteen cases were shown in this case series that commonly encountered the symptoms of weight gain, gastro-oesophageal reflux disease (GERD), epigastric pain, globus sensation, nausea and vomiting as their initial complaints before their diagnosis. Moreover, these symptoms began a few years after the gastric sleeve. The confirmatory results through gastrografin and computed tomography abdomen were performed where relevant findings of Grade I or II GERD, sliding hiatal hernia and post-sleeve anatomy were appreciated. In literature, the most common modality used to treat ITSM was the conversion to Roux-en-Y bypass. However, other treatment modalities were also utilised for the cases presented due to the different patients’ preferences, including mini-gastric bypass and laparoscopic hiatal hernia repair with/without posterior cruroplasty and buttress plication with the falciform ligament. In addition, anchoring to pre-pancreatic fascia post-gastric sleeve has been shown to prevent such presentations further in the future. Postoperatively, all patients were stable with no complications acutely or after 3 months follow-up. Hence, this concludes that despite Roux-en-Y being considered the golden standard treatment of ITSM, laparoscopic hiatal hernia repair with cruroplasty and plication reflects an equivalent, cost-effective and valuable alternative to treating relevant patients.
Therapeutic effects of single-port thoracoscopic anatomical segmentectomy on early-stage non-small-cell lung cancer
Authors: Zhang Weijie , Zhu Danyang 
Published: October 2024

Abstract

Background:
We aimed to assess the therapeutic effects of single-port thoracoscopic anatomical segmentectomy on early-stage non-small-cell lung cancer (NSCLC).

Patients and Methods:
Sixty patients with early-stage NSCLC admitted from December 2022 to July 2023 were selected and divided into a lobectomy group (n = 30) and a segmentectomy group (n = 30) according to the different procedures. Their perioperative indicators, pre-operative and post-operative pulmonary function indicators, pain degree 24 h, 48 h, 72 h and 7 day after operation, the incidence of post-operative complications and recurrence, survival and mortality rates 1 year after operation were compared.

Results:
The segmentectomy group had significantly smaller intraoperative blood loss, shorter length of drainage and length of hospital stay and longer operation time than those of the lobectomy group (P < 0.05). The pulmonary function decreased significantly in both groups 1 week, 1 month and 3 months after operation. Compared with the lobectomy group, the forced expiratory volume in 1 s per cent, forced-vital capacity per cent and maximal voluntary ventilation of the segmentectomy group significantly increased at each time point after operation (P < 0.05). The Visual Analogue Scale scores 24 h, 48 h, 72 h and 7 days after operation were significantly lower in the segmentectomy group than those in the lobectomy group (P < 0.05). There were no significant differences in the incidence of post-operative complications and recurrence, survival and mortality rates 1 year after operation between the two groups (P > 0.05).

Conclusions:
Single-port thoracoscopic anatomical segmentectomy has obvious therapeutic effects on early-stage NSCLC, characterised by smaller surgical trauma, milder post-operative pain and less impact on pulmonary function.
Impact of low-pressure pneumoperitoneum and deep neuromuscular blockade on surgeon satisfaction and patient outcomes in laparoscopic cholecystectomy patients: A prospective randomised controlled study
Authors: Koç Alparslan , Memiş Ufuk , Onk Didem , Karataş Talha , Gazi Mustafa , Sayar Ali Caner , Arı Muhammet Ali 
Published: October 2024

Abstract

Introduction:
The impact of laparoscopic surgery on homeostatic systems necessitates careful consideration of intra-abdominal pressure (IAP) management. This study investigated the effects of low-pressure pneumoperitoneum with deep neuromuscular blockade (NMB) on surgeon satisfaction, haemodynamics and post-operative outcomes in laparoscopic cholecystectomy patients.

Patients and Methods:
The study design involves prospective randomised control. Ninety patients were assigned to low (7–10 mmHg, n = 45) or normal (12–16 mmHg, n = 45) IAP groups. Deep NMB, guided by train-of-four monitoring, was administered. This study evaluated surgical rating scale scores, haemodynamics and post-operative outcomes through a literature review. A computer programme (IBM, SPSS) was used for statistical analysis. Chi-square and Mann-Whitney U tests were used to analyse patients’ IAP levels, additional NMB requirements, surgical rating scale scores and numerical rating scales. Patient demographics and other intraoperative and post-operative variables were analysed with Student’s t-test and the Mann-Whitney U test. Values of P < 0.05 were considered to indicate statistical significance.

Results:
No significant demographic differences were observed. The low-pressure group exhibited lower post-operative pain (P < 0.01) and reduced analgesia requirements (P = 0.00). On analysis of the surgeon rating scale, no disparities were evident between the groups. NMB usage correlated with height and weight (P < 0.01). Heart rate showed no intergroup differences. The MAP measured after 15 min was lower in Group L, and the difference was significant (P = 0.023). The SAP measured after 30 min was lower in Group L, and the difference was significant (P = 0.017). Blood gas values and surgical field visibility were unaffected by the IAP. The positive correlations between NMB, height and weight aligned with previous research.

Conclusion:
This study highlights successful laparoscopic cholecystectomy under low IAP, deep NMB and favourable post-operative outcomes. Despite these limitations, the findings contribute to optimising laparoscopic surgical approaches.
Anterior Crowns in Paediatric Dentistry
Authors: Sujith Anagha , Indulekshmi M. , Girija Parvathy 
Published: October 2024

Abstract
Primary dentition exposed to caries mainly affects the primary maxillary anterior teeth and primary molars. Restoring primary maxillary anterior teeth requires material to be retentive, resistant to fracture and should be esthetic. Anterior crowns thus help in phonation and aesthetics. Crowns available for restoration of primary anterior teeth include those that are directly bonded to the tooth and those crowns that are luted onto the tooth such as stainless steel crown and zirconia crowns. Over the years, many types of crowns have been developed and advanced to aid the clinician in rehabilitating deciduous anterior teeth. This review is to discuss various anterior crowns available for restoring anterior primary teeth.
Vertical Maxillary Excess Simplified: A Non-surgical Management with Mini-Implants
Authors: Bhavya V. , Shaloob KM Muhamed , Antony Vincy , Puthiyapurayil Greeshma , Nayaz VP Mohammed 
Published: October 2024

Abstract
Vertical maxillary excess (VME) refers to an excessive growth of the maxilla and related dentoalveolar structures in an inferior direction, which can affect the entire maxilla. This clinical condition can result in a long face, an excessive display of gums when smiling, and occasionally an open bite. In non-growing patients, this may often require a surgical intervention. This article describes the orthodontic treatment of a 20-year-old female patient who presented with proclination of incisors and excess visibility of teeth during smile. Clinical and radiographic examination revealed a convex facial profile, Angle’s Class I malocclusion and VME. A comprehensive orthodontic treatment plan with the help of temporary anchorage devices was executed which resulted in achieving all the treatment objectives. Hence, these simple biomechanics contributed to the effective intrusion of upper teeth correcting the gummy smile which is found to be non-inferior to the surgical counterpart.