bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroscopic Management of the Hamate Proximal Pole Arthrosis
Authors: Ali Barkat , Ozyurekoglu Tuna 
Published: March 2023

Background:
Arthrosis of the proximal pole of the hamate is a peculiar cause of ulnar-sided wrist pain. We present clinical, functional, and patient-reported outcomes of arthroscopic management.

Methods:
In this retrospective study, all patients with arthrosis of the proximal pole of the hamate encountered in a 10-year period treated with arthroscopy were reviewed. Patient demographics, arthroscopic details, associated injuries, and procedures were reviewed. Functional and patient-reported clinical outcomes after arthroscopic osteochondroplasty were analyzed.

Results:
An analysis of 39 patients who underwent arthroscopic osteochondroplasty showed a type II lunate prevalence of 87.2%. On wrist arthroscopy, a triangular fibrocartilaginous complex tear was the most common diagnosis (64.1%), followed by scapholunate ligament tear (61.5%) and lunotriquetral ligament tear (35.9%). All patients were managed arthroscopically with 100% procedural success. Average follow-up of 42.8 ± 37.7 months showed statistically significant improvements in the visual analog score and Mayo wrist score postoperatively (P < 0.01). Three patients (7.7%) failed the procedure at a mean of 23 ± 31.4 months. Risk factors for salvage operations were nondominant wrist involvement 100% (P = 0.04), lunotriquetral ligament injury 100% (P = 0.04), the absence of triangular fibrocartilaginous complex injury 100% (P = 0.04), and the presence of scapholunate advanced collapse 100% (P < 0.01).

Conclusions:
Wrist arthroscopy is valuable for accurately diagnosing and treating hamate arthrosis and identifying a wide variety of pathologies associated. This study showed arthroscopic osteochondroplasty produced satisfactory clinical results. Furthermore, the presence of scapholunate advanced collapse wrist offers its prognostic value in determining treatment failure.
Incidence of Corneal Adverse Events in Children Wearing Soft Contact Lenses
Authors: Bullimore Mark A. , Richdale Kathryn 
Published: March 2023

Objectives:
There is increasing interest in fitting children with soft contact lenses, in part due to the increase in prescribing of designs to slow the progression of myopia. This literature review summarizes large prospective and retrospective studies that include data on the incidence of microbial keratitis and corneal infiltrative events (CIEs) in children wearing soft contact lenses.

Methods:
Peer-reviewed prospective and retrospective studies that report contact lens–related complications in children with at least one year of wear and at least 100 patient years of wear were identified.

Results:
Seven prospective studies published between 2004 and 2022 were identified representing 3,752 patient years of wear in 1,756 children, nearly all of whom were fitted at age 12 years or younger. Collectively, they report one case of microbial keratitis and 53 CIEs, of which 16 were classified as symptomatic. The overall incidence of microbial keratitis was 2.7 per 10,000 patient years (95% CI: 0.5–15), and the incidence of symptomatic CIEs was 42 per 10,000 patient years (95% CI: 26–69). Two retrospective studies were identified representing 2,545 patient years of wear in 1,025 children, fitted at age 12 years or younger. One study reports two cases of microbial keratitis giving an incidence of 9.4 per 10,000 patient years (95% CI: 0.5–15).

Conclusions:
Accurate classification of CIEs is challenging, particularly in retrospective studies. The incidence of microbial keratitis in children wearing soft lenses is no higher than in adults, and the incidence of CIEs seems to be markedly lower.
Feasibility of Automated Gonioscopy Imaging in Clinical Practice
Authors: Barbour-Hastie Catriona , Deol Sundeep S. , Peroni Andrea , Gillan Stewart , Trucco Emanuele , Tatham Andrew J. 
Published: March 2023

Précis:
Automated gonioscopy provided good-quality images of the anterior chamber angle. There was a short learning curve for operators, and the examination was well tolerated by patients. Patients expressed a preference for automated gonioscopy compared with traditional gonioscopy.

Purpose:
The purpose of this study was to assess the feasibility of using a desktop automated gonioscopy camera in glaucoma clinics by examining patient tolerability, ease of use, and image quality and comparing patient preference compared with traditional gonioscopy.

Patients and Methods:
A prospective study was conducted in a university hospital clinic. Traditional gonioscopy was performed followed by imaging of the iridocorneal angle (ICA) using the Nidek GS-1 camera by 2 glaucoma specialists. Participants were asked to rate the comfort of automated gonioscopy and which method they preferred. The clinicians graded the ease of acquisition for each patient, and the image quality was reviewed by a grader.

Results:
Forty-three eyes of 25 participants were included. Sixty-eight percent of participants viewed automated gonioscopy as “extremely comfortable,” and the remainder reported it “comfortable”. Forty percent preferred automated gonioscopy compared with traditional gonioscopy, while 52% were equivocal. Clinicians scored 32% of participants as “somewhat difficult” to the image. In 46% of eyes, good-quality photographs were obtained for 360 degrees of the ICA. Only 1 eye had no parts of the ICA clearly visible. Seventy-four percent of eyes had at least half of the ICA clearly visible in all 4 quadrants.

Conclusion:
Automated gonioscopy provided good-quality images of the ICA for most patients. It was often not possible to image the entire 360 degrees at the first attempt, but the examination was comfortable for patients, and only 8% preferred traditional gonioscopy to the automated photographic examination.
Sensory Innervation of the Upper Eyelid and Its Implication for Upper Eyelid Surgery
Authors: Mayr-Riedler Michael S. , Broer P. Niclas , Hirtler Lena , Grill Christoph 
Published: March 2023

Purpose:
Sensory alterations of the upper eyelid skin and eyelashes are frequently encountered after upper eyelid surgery. The objective of this study was to provide information on the exact course and distribution of sensory nerve fibers through the anatomic planes in the upper eyelid.

Methods:
Ten formalin-fixed hemifaces were dissected. The nerve branches of the ophthalmic nerve in the upper eyelid were traced in an anterograde fashion.

Results:
A total of 151 nerve fibers were recorded during dissection. The infratrochlear, supratrochlear, supraorbital, and lacrimal nerve contributed each to both the upper eyelid skin innervation and the upper eyelid rim plexus in different distribution patterns. The mean distance from the eyelid margin at which nerve fibers pierced from preseptal into the orbicularis muscle was 14 ± 1.1 mm for nerve fibers targeting the eyelid dermis and 3.7 ± 1.2 mm for nerve fibers targeting the eyelid rim plexus (p < 0.001). The mean intraorbicular course of nerve fibers was 3 mm (0–17; standard deviation 4.1). The mean distance from the eyelid margin at which nerve fibers pierced from the orbicularis muscle into the preorbicular plane was 10 ± 1 mm for nerve fibers innervating the eyelid dermis and 1.3 ± 0.8 mm for nerve fibers innervating the eyelid rim plexus (p < 0.001). The mean distance of the preorbicular course of nerve fibers was 2 mm (0–15; standard deviation 3.6).

Conclusions:
Based on the findings, a certain degree of postoperative eyelid skin numbness is inevitable while eyelash innervation may be spared in upper blepharoplasty.
Nasolacrimal Duct Coronary Stent Recanalization (NCR): First Cadaver Experience and Its Potential as an Alternative to DCR
Authors: Ali Mohammad Javed 
Published: March 2023

Purpose:
To investigate the feasibility of implanting a drug-eluting cobalt-chromium alloy coronary stent in the nasolacrimal ducts (NLDs) of human cadavers.

Methods:
The pilot study was carried out in 5 NLDs of 4 adult human cadavers. Sirolimus-eluting coronary stents of 2 mm in width and lengths of 8 and 12 mm, which were mounted on balloon catheters, were used. Following dilatation of the NLDs, the balloon catheters were introduced into the NLDs under direct endoscopy guidance. The stents were delivered following dilatation of the balloon to 12 ATMs and secured in a locked (spring out) position. The balloon is then deflated and securely extubated. The dacryoendoscopy confirmed the stent position. The lacrimal system was then dissected to assess several key parameters like the uniformity of the NLD expansion, anatomical interactions of the NLD mucosa with the stent rings and struts, integrity of the soft and bony NLD, stent movement on mechanical push and pull, and ease of manual removal.

Results:
The cobalt-chromium alloy coronary stents could be delivered with ease and secured in the cadaveric NLDs. Its position was confirmed by a dacryoendoscopy and later by the direct NLD dissection. The NLD was uniformly dilated 360° with a wide and uniform lumen. NLD mucosa was noted to be uniformly distributed in spaces between the stent rings without influencing the expanded lumen. Following the lacrimal sac’s dissection, the NLD stent showed significant resistance to downward movement but could be easily retrieved with forceps. The 12-mm stents could reach the near total length of the NLD with good luminal expansion. The integrity of the bony and soft-tissue NLD was maintained. The learning curve is shallow if the surgeon is adept with the techniques of balloon dacryoplasty.

Conclusion:
Drug-eluting cobalt-chromium alloy coronary stents can be precisely deployed and secured within the human NLDs. The study is the first of its kind to demonstrate the technique of NLD coronary stent recanalization in human cadavers. It is a step forward in the journey to evaluate their use in patients with primary acquired NLD obstructions and other NLD disorders.
Exploring Plan of Care Communication With a Multidisciplinary Rounding Plan to Nursing Care Plans
Authors: Perera Anjali C. , Joseph Sonia , Marshall Jade L. , Olson DaiWai M. 
Published: March 2023

ABSTRACT

BACKGROUND: The nursing care plan (NCP) was developed approximately 100 years ago as a teaching tool for nursing students. Our neuroscience intensive care unit (NSICU) uses a multidisciplinary rounding plan (MDRP) that may provide more relevant and up-to-date information than the standard NCP. METHODS: In this prospective single-blind randomized pilot study, we examined nurses' abilities to respond to 7 clinical scenarios common to the NSICU. The NCPs and MDRPs from 70 patients were randomly assigned to 14 nurses (10 per nurse) who answered each of the 7 questions using only data from an NCP or data from an MDR. RESULTS: The MDRP mean score of 4.51 (1.50) correct answers was statistically significantly higher than the NCP mean score of 0.31 (0.71) correct answer (P < .0001). CONCLUSION: The MDRP was designed to address the modern-day communication needs of NSICU staff by leveraging technological advances. Data from this study suggest that the MDRP may have advantages over the NCP in providing contextually relevant information. Additional research is warranted to develop the MDRP as a replacement for the NCP in the NSICU setting.
Endobronchial Ultrasound-guided Mediastinal Lymph Nodal Cryobiopsy in Patients With Nondiagnostic/Inadequate Rapid On-site Evaluation
Authors: Maturu Venkata N. , Prasad Virender P. , Vaddepally Chetan R. , Dommata Raghotham R. , Sethi Shweta 
Published: March 2023

Background:
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is considered the investigation of choice for sampling mediastinal nodes. A major drawback of EBUS-TBNA is its lower diagnostic yield for lymphoma and benign diseases. EBUS-guided mediastinal cryobiopsy (EBUS-MCB) is a novel technique that provides larger nodal biopsy samples, with an acceptable safety profile. In this study, we aimed to evaluate the diagnostic yield of EBUS-MCB in patients with an inconclusive rapid on-site evaluation (ROSE).

Methods:
This is a prospective study of patients who underwent EBUS-TBNA for undiagnosed mediastinal lymphadenopathy. Patients in whom ROSE did not yield a diagnosis (nondiagnostic ROSE) or ROSE revealed scanty atypical cells (inadequate ROSE) were subjected to EBUS-MCB. The diagnostic yield, adequacy, and complications of EBUS-MCB were analyzed.

Results:
Of the 196 patients undergoing EBUS-TBNA, 46 patients underwent EBUS-MCB. Thirty-two cases underwent EBUS-MCB for a nondiagnostic ROSE. EBUS-MCB confirmed the diagnosis in 19/32 (59.3%) cases. The additive diagnostic yield of EBUS-MCB over EBUS-TBNA was 43.7% (14/32 cases). In all 14 cases where EBUS-MCB was performed for an inadequate ROSE, the material obtained by EBUS-MCB was adequate for ancillary studies. The most common complication observed was a minor bleed in 13 cases.

Conclusion:
EBUS-MCB has a diagnostic yield of 59.3% when performed in cases with a nondiagnostic EBUS-ROSE. The tissue obtained by EBUS-MCB is adequate for ancillary studies. We propose EBUS-MCB as an additional diagnostic step in cases with an inconclusive ROSE while performing EBUS-TBNA. Larger studies are, however, needed before EBUS-MCB can be incorporated in the diagnostic algorithm for the evaluation of mediastinal lesions.
Mass gathering events and transmission of respiratory tract infections: updates pre and post COVID-19 lockdown
Authors: Hui David S.C. , Zumla Alimuddin 
Published: March 2023

Purpose of review
This article reviews the epidemiology and transmission of respiratory tract infections (RTIs) during mass gathering events (MGEs) before and during the COVID-19 pandemic.

Recent findings
RTIs of viral cause such as influenza, rhinovirus and coronaviruses (229E, HKU1, OC43) are common in MGEs. No cases of MERS-CoV have yet been identified in pilgrims during Hajj, despite the fact that MERS-CoV continues to circulate in the Middle East. Due to the COVID-19 pandemic, organizers of mass gathering religious and sporting events have implemented risk-based infection control measures and lockdowns that limited transmission of RTIs.

Summary
Large-scale RTI outbreaks at MGEs are uncommon due to more robust public health planning, prevention, risk assessment and improved health infrastructures in host countries during the COVID-19 pandemic.
Evolving threat of pediatric ingestions: a discussion of cannabis and button batteries and their implications for children
Authors: Lorenzo Melissa , Beno Suzanne 
Published: March 2023

Purpose of Review
Pediatric button battery and cannabis ingestions are rising in incidence and have the potential for significant harm. This review will focus on the clinical presentation and complications of these two common inadvertent ingestions in children, as well as recent regulatory efforts and advocacy opportunities.

Recent Findings
The rising incidence of cannabis toxicity in children has corresponded with its legalization across several countries in the last decade. Inadvertent pediatric cannabis intoxication is most commonly due to the ingestion of edible forms discovered by children in their own home. The clinical presentation can be nonspecific, therefore clinicians should have a low threshold for including it on their differential diagnosis. Button battery ingestions are also increasing in incidence. While many children are asymptomatic at presentation, button battery ingestions can quickly cause esophageal injury and lead to several serious and potentially life-threatening complications. Prompt recognition and removal of esophageal button batteries is essential for reducing harm.

Summary
Cannabis and button battery ingestions are important for physicians who take care of children to recognize and manage appropriately. Given their rising incidence, there are many opportunities for policy improvements and advocacy efforts to make a difference in preventing these ingestions altogether.
Impressions of the Nursing Profession Among Nursing Students and New Graduates During the First Wave of COVID-19
Authors: Bongiorno Anne Watson , Armstrong Normadeane , Moore Geraldine A. , Mannino Jennifer Emilie , Watters Pamela , Cotter Elizabeth , Kelley Randy 
Published: March 2023

Background:
The COVID-19 pandemic has been a defining event for the next generation of the nursing workforce. Complex pandemic practice environments have raised concerns for the preparation and support of novice nurses, even as a multitude of nurses leave the profession.

Purpose:
Researchers sought to examine nursing students' and new graduate nurses' impressions of the nursing profession in contrasting regions of New York State during the first wave of the COVID-19 pandemic.

Methods:
Inductive content analysis was performed on narrative text responses (n = 295) drawn from a larger multisite mixed-methods survey.

Results:
Five subconcepts were abstracted, leading to the main concept of shocked moral distress.

Conclusion:
Nursing students and new graduate nurses have experienced high levels of moral distress but remain committed to the profession. Building moral resilience, fostering ethical decision making, and implementing protective policies can reduce the incidence of moral distress.
Supporting family members requested to donate hematopoietic stem cells to a relative: development and pilot testing of a psycho-educational resource
Authors: Zomerdijk Nienke , Turner Jane , Gottlieb David , Barnes Annette , Butler Jason P. , Markey Kate A. , Hill Geoffrey R. 
Published: March 2023

Abstract

Background:
In light of the increased demand for related donors in allogeneic stem cell transplantation, recognition of the psychosocial issues has also emerged. While resources supporting unrelated volunteer donors exist, none address the emotional issues specific to being a related donor. Providing related donors with preparatory information could help improve the overall donation experience and donor's outcomes.

Objective:
The objectives of this study were to develop and pilot test a print-based psycho-educational resource to support donors in coping with the physical and emotional aspects of donating to a relative. This article describes the development and pilot testing of the resource.

Methods:
Seventeen related donors and eight transplant nurses and physicians (transplant professionals) completed a survey and provided quantitative and qualitative feedback on the acceptability of the resource and preferences regarding the ideal distribution time.

Results:
Respondents endorsed the resource and found it useful and appropriate for the information needs at different stages of the donation and transplant process. The most useful reported components of the resource were testimonials from previous donors and explanations of blood cancers and the stem cell donation process. Most donor respondents indicated that the resource should be distributed as soon as possible while transplant professionals felt this should be after tissue typing, once the donor is confirmed as suitable. Respondents requested additional information on the side effects of donating and the possibility of being asked to repeat donation if the recipient relapses. More donor testimonials were also desired.

Conclusion:
The resource appears to be acceptable to donors and transplant professionals and helpful for developing confidence about coping with the physical and emotional aspects of donation. Findings from this study are currently being used to further refine and deliver the resource in additional formats.
Hemodynamic Effects of a High-Frequency Oscillatory Ventilation Open-Lung Strategy in Critically Ill Children With Acquired or Congenital Cardiac Disease
Authors: de Jager Pauline , Curley Martha A. Q. , Cheifetz Ira M. , Kneyber Martin C. J. 
Published: March 2023

OBJECTIVES:
To study the hemodynamic consequences of an open-lung high-frequency oscillatory ventilation (HFOV) strategy in patients with an underlying cardiac anomaly with or without intracardiac shunt or primary pulmonary hypertension with severe lung injury.

DESIGN:
Secondary analysis of prospectively collected data.

SETTING:
Medical-surgical PICU.

PATIENTS:
Children less than 18 years old with cardiac anomalies (± intracardiac shunt) or primary pulmonary hypertension.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Data from 52 subjects were analyzed, of whom 39 of 52 with cardiac anomaly (23/39 with intracardiac shunt) and 13 of 52 with primary pulmonary hypertension. Fourteen patients were admitted postoperatively, and 26 patients were admitted with acute respiratory failure. Five subjects (9.6%) were canulated for ECMO (of whom four for worsening respiratory status). Ten patients (19.2%) died during PICU stay. Median conventional mechanical ventilation settings prior to HFOV were peak inspiratory pressure 30 cm H2O (27–33 cm H2O), positive end-expiratory pressure 8 cm H2O (6–10 cm H2O), and Fio
2 0.72 (0.56–0.94). After transitioning to HFOV, there was no negative effect on mean arterial blood pressure, central venous pressure, or arterial lactate. Heart rate decreased significantly over time (p < 0.0001), without group differences. The percentage of subjects receiving a fluid bolus decreased over time (p = 0.003), especially in those with primary pulmonary hypertension (p = 0.0155) and without intracardiac shunt (p = 0.0328). There were no significant differences in the cumulative number of daily boluses over time. Vasoactive Infusion Score did not increase over time. Paco
2 decreased (p < 0.0002) and arterial pH significantly improved (p < 0.0001) over time in the whole cohort. Neuromuscular blocking agents were used in all subjects switched to HFOV. Daily cumulative sedative doses were unchanged, and no clinically apparent barotrauma was found.

CONCLUSIONS:
No negative hemodynamic consequences occurred with an individualized, physiology-based open-lung HFOV approach in patients with cardiac anomalies or primary pulmonary hypertension suffering from severe lung injury.
LIP SHORTENING SURGERY
Authors: Gatti John E. 
Published: March 2023

SUMMARY:
Many changes are associated with the aging face. Upper lip lengthening with atrophy, lip thinning, and diminution of the lip margin are commonly seen.

Methods:
Lip shortening surgery over a 32-year period by a single surgeon is reviewed. A direct surgical excision of the upper lip skin at the base of the nose with an irregular or curvilinear incision was employed.

Results:
Facial aesthetics were improved with this direct surgical approach. A more youthful vermillion border and an increased lip projection were achieved. Lip asymmetry and an improvement in lip dynamics were also observed. A high rate of revisional surgery (approximately one-fourth) was found in this series. The highly visible, delicate, central facial landmarks involved in lip shortening magnify small scar irregularities and revision, while relatively minor, is often necessary. Patient satisfaction is high as a subjective improvement in lip aesthetics is readily appreciated. Patients frequently request further shortening.

Discussion:
Surgeons need to review the exigent nature of this surgery with their patients and be willing to perform the associated revisions inherent in the procedure. Lip shortening surgery reliably improves facial aesthetics and should be utilized by plastic surgeons when treating the aging face.