bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resistance patterns of bacterial pathogens causing lower respiratory tract infections: Aleppo-Syria
Authors: Arab Ola , Al-Kayali Rawaa , Khouri Abdullah , Haj Kaddour Samer 
Published: May 2023

Background:Globally, lower respiratory tract infections (LRTIs) are one of the lead causes of death. Bacterial and susceptibility profiles are not constant over time and geographically, and different patient factors can be correlated with those infections.Objective:This study aimed to scan the bacterial spectrum causing LRTIs, their susceptibility profile and patient related risk factors.Material and methods:Two hundred sixty-eight specimens from LRTIs suspected patients attending University Hospital were collected. Specimens included bronchial washings, transtracheal aspiration samples and sputum. After appropriate culture and identification tests, susceptibility test was done using minimum inhibitory concentration method. Data were collected from patients for further analysis.Results:of total specimens, 150 showed positive culture results (Acinetobacter baumannii,Pseudomonas aeruginosa,Citrobacter koseri,Escherichia coli,Klebsiella pneumonia, Staphylococcus aureus, Staphylococcus epidermidis,Staphylococcus haemolyticus, Streptococcus pneumoniaandCandida spp.). The antibiogram showed high resistance among all bacterial isolates against most antibiotics. Good susceptibility rates were shown to colistin in Gram-negative group and piperacillin\tazobactam in Gram-positive group. Trimethoprim\sulfamethoxazole showed good susceptibility results in both groups. Many factors showed correlation with LRTIs such as age (P=0.004), smoking (P=0.049), residency (P=0.043), hypertension (P=0.012), lung chronic disease (P=0.007) and cancer (P=0.048).Conclusion:The leading cause of LRTIs in our study wereA. baumanniiandP. aeruginosawhich both are very troublesome pathogens and multidrug resistant frequency was alarming. Random empirical antibiotic using can highly lead to increased resistance. Further care must be taken after patients with risk factors, and adjustments should be done to those modifiable factors.
Exploring the relationship between insomnia and depression: a cross-sectional prospective study
Authors: Mohammed Salih Ahmed Mishaal , Madallah Zeyad Tariq , Ibrahim Radhwan H , Alseadn Mahfoodh Suliaman Hasan , Almushhadany Osama Ismael 
Published: May 2023

Objectives:
This is a cross-sectional prospective study aimed to examine the association between insomnia and depression among individuals attending an outpatient psychiatric clinic.

Methods:
A total of 416 participants were recruited from the psychiatric and mental health outpatient clinic using a cross-sectional design. The participants completed the Pittsburgh Sleep Quality Index (PSQI) and the Beck Depression Inventory (BDI) to measure sleep disturbances and depressive symptoms, respectively. Ethical approval was obtained from the Institutional Review Board at Ninevah University. Descriptive statistics, bivariate correlations, and multivariate regression analysis were used to analyze the data. The data collected in the study was analyzed using SPSS v0.26.

Results:
A total of 416 participants were recruited from the psychiatric and mental health outpatient clinic in Iraq through convenience sampling. The sample included 227 (54.6%) females and 189 (45.4%) males, with a mean age of 35.4 years (SD=9.8, range=18–65). Participants had a mean PSQI score of 11.6 (SD=3.7, range=2–21) and a mean BDI score of 21.8 (SD=11.1, range=0–54). Bivariate correlations showed a significant positive relationship between sleep disturbances (as measured by the PSQI) and depressive symptoms (as measured by the BDI) (r=0.67, P<0.001).

Conclusions:
The study provides valuable insights into the relationship between insomnia and depression in a sample of individuals from Iraq. These findings could contribute to the development of interventions to improve mental health outcomes among this population.
Hepatogastric fistula: a complication of pyogenic liver abscess in a patient with the Brugarda syndrome – A rare case report
Authors: Dev Santosh , Yadav Radheshyam , Sah Birendra , Sah Ashok Kumar , Ghimire Bikal , Shah Jayant Kumar 
Published: May 2023

Introduction and Importance:Hepatogastric fistula following pyogenic liver abscess (PLA) is a rare and fatal complication, and only a handful of cases have been reported without co-existing comorbidities of Brugarda syndrome.Case presentation:A 22-year-old male presented to the emergency room with a known case of Brugarda pattern ECG with chief complaints of on-and-off abdominal pain and fever for 2 weeks and shortness of breath for one day. On evaluation, echocardiography showed a clot in the inferior vena cava (IVC) and right atrium (RA), and on computed tomography scan of the abdomen revealed a liver abscess with transmural gastric perforation. During, an exploratory laparotomy where a fistula joining the left lobe of the liver and stomach was detected, and an emergency excision was done. The patient was shifted to the ICU and later developed septic shock, which was managed medically.Clinical discussion:Usually, thrombosis of the portal vein and the hepatic vein is a very common complication of a PLA but vascular complications like IVC, RA thrombosis, and hepatogastric fistula have been reported rarely. Our case is peculiar hepatogastric fistulization along with IVC/RA clots in a patient with Brugarda pattern ECG. The typical clinical manifestation of a patient with hepatogenic fistula is absent in our patient and presented with an on-off type of fever, epigastric pain, and shortness of breath and was managed surgically.Conclusion:Hepatogasric fistula, thrombosis of the IVC, and RA are a rare complications of PLA. The patient with Brugarda syndrome is at high risk as its clinical manifestation gets exaggerated during sepsis.
Kimura disease masquerading tuberculosis: a rare case presentation
Authors: Paneru Rabin , Pokhrel Madalasa , Lamichhane Saral , Basnet Subash , Poudel Saroj , Gautam Sudarshan , Sharma Nava Raj 
Published: May 2023

Introduction and importance:
Kimura disease (KD) is an inflammatory disorder characterized by the development of subcutaneous lymphoid masses and regional lymphadenopathy. Due to its rarity and similarity to another disease, the diagnosis is complex.

Case presentation:
Here, the authors present a case of KD in 26-year-old male from Nepal who initially did not respond to antitubercular therapy. Later on, KD was diagnosed based on histopathology. He was followed up in medical outpatient with a good response to corticosteroid therapy.

Clinical discussion:
The diagnosis of KD is quite difficult in low-resource settings. The diagnosis is histopathological. Associated lymphadenopathy may mimic tuberculosis. Many patients respond well to the high-dose of steroid therapy; some might also require surgical excision or chemotherapy.

Conclusion:
Hence, the physician should include KD as a differential when a male in his 20s or 30s presents with a subcutaneous nodular mass in the head and neck.
Exploring potential pharmacological mechanisms of Yiqi Tuomin Decoction in the treatment of allergic rhinitis utilizing network pharmacology prediction and molecular docking-based strategies: experimental research
Authors: Zhang Weixin , Zhou Qing , Chen Xiaoning , Zhao Jingjing , Shi Jun , Chen Li 
Published: May 2023

Background:Yiqi TuominDecoction (YTD), which originated from the theory of lung deficiency and cold in Chinese medicine, is a common Chinese herbal formula used against allergic rhinitis (AR). In our otolaryngology department, this prescription has been used to treat so many AR patients with lung-deficiency-related colds for nearly 30 years. However, the mechanism of its ingredient–target is still unclear. Based on our early experiments and clinical case studies, in this paper, we explore the mechanism of YTD systematically against AR using bioinformatic methods of network pharmacology and molecular docking.Methods:The Traditional Chinese Medicine Systems Pharmacology (TCMSP) database was used to screen the active ingredients and targets of YTD. The AR-related targets were retrieved from OMIM, GeneCards, TTD, DisGeNET, DrugBank databases, and PharmGKB. The Venn database was used to screen the potential core targets. After that, the STRING database was used to construct the protein–protein interaction (PPI) of the core targets and then visualize it by Cytoscape. The Gene Ontology (GO)-enriched processes and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of the core targets were analyzed by the KOBAS-I database and Sangerbox. Molecular docking was used to assess interactions between potential targets and active ingredients.Results:A total of 169 active ingredients and 238 targets of YTD were predicted. YTD shared 115 common targets with AR from the Venn database. The GO-enriched processes and KEGG pathways indicate that genes involved in inflammation and oxidative stress, accompanying the MAPK signaling pathway, Th17 cell differentiation, IL-17 signaling pathway, and Th1 and Th2 cell differentiation, may play a mediated effect in YTD. The docking results showed good binding ability between the active ingredients and the selected targets.Conclusions:Our study systematically indicated the underlying mechanism of YTD against AR from the perspective of bioinformatics. By studying the active ingredients of YTD, we obtained molecular mechanisms and established a reliable method and molecular theoretical basis for the sensible development of Chinese medicine in the treatment of AR.
Odontogenic myxoma of the mandible: a case report
Authors: Khalil Abdulkarim , Ahmad Karam G. , Khalil Modar , Salloum Rabab 
Published: May 2023

Introduction:
The odontogenic myxoma is a tumor of the jaws which arises from the mesenchymal portion of the tooth germ, either the dental papilla, the follicle, or the periodontal ligament. It is a slow-growing, painless, nonmetastasizing, central tumor of the jaws, chiefly the mandible. Radiographically, the classic presentation may vary from a unilocular radiolucency to a multilocular lesion with well-defined or diffuse margins. On histological study, it is composed of triangular or stellate connective cells, anastomosed by fine extensions, and embedded in abundant mucoid material.

Case presentation:
We present the unusual case of an odontogenic myxoma involving a 37-year-old female patient, which had acquired large dimensions and involved the right half of the mandible, including the ramus; the patient was treated with large resection surgery, with satisfying medium-term results.

Clinical discussion:
Early diagnosis of such lesions is very important, as the patient avoids extensive surgical procedures that involve losing a large part of the jawbones and their subsequent impact on the patient’s quality of life.

Conclusion:
Although there is no fixed treatment plan for the management of odontogenic myxoma, treatment includes surgical management that may range from simple enucleation and curettage to surgical excision; wide surgical resection is appropriate for cases of large size to avoid recurrence.
A rare case of chondrosarcoma at the posterior costovertebral junction: a case report
Authors: Abdullah Lava , Alsulaiman Sihaam Saleh , Alsalhani Obai Mustafa , Alkheder Ahmad , Al-Sulaiman Ibrahim Ali 
Published: May 2023

Introduction:
Chodrosarcoma is the third most common primary malignancy of the bone, it is considered the most frequent malignancy of the chest wall. Chondrosarcoma at the costovertebral junction is rare and few cases are described in the literature.

Case Presentation:
The authors present a case of a 47-year-old female with a complaint of chronic pain in the right posterior upper chest, dyspnea, and episodes of dizziness.
The diagnosis of low-grade chondrosarcoma at the posterior costovertebral junction was made by video-assisted thoracic surgery and computed tomography.
The surgical management included resection of the tumor and parts of adjacent ribs.

Discussion:
Chondrosarcoma is chemotherapy and radiotherapy-resistant. The total surgical excision of the tumor with sufficient margins is usually curative.

Conclusion:
A follow-up is necessary because of the potential for recurrence.
Using a right-angle forceps clamp to pass a suture under the coracoid base in coracoclavicular stabilization: a technical note
Authors: Klabklay Prapakorn , Maliwankul Korakot , Chuaychoosakoon Chaiwat 
Published: May 2023

Introduction and importance:
A distal clavicle fracture is a common injury of the shoulder joint. Coracoclavicular (CC) stabilization is one of the recommended procedures for treating the distal clavicle fracture. However, it is difficult to pass the suture under the coracoid process with instruments normally available in the operating room (OR). Herein, the authors describe a simple technique to accomplish this suture passing quickly and easily using tools available in the OR.

Case presentation:
A 59-year-old Thai female presented with right shoulder pain after a fall. The physical examination showed a prominent bulge and tenderness at the right distal clavicle. A radiograph of both clavicles showed a right displaced distal clavicle fracture. After discussing the possible treatments with her, she decided to have CC stabilization as we recommended.

Clinical discussion:
In CC stabilization, the most important but difficult step is passing a suture under the coracoid base. There are some specialized commercial instruments which are matched to the shape of the coracoid process to make it easy to perform this step, but all are highly expensive (~$1400–1500 per piece) and thus often not available in ORs in resource-limited settings.

Conclusion:
The authors devised a technique using standard surgical instruments and materials available in all ORs to enable them to pass a suture easily and quickly under the coracoid base.
Adaption of the Casey-Fink Survey Tool for Nurse Residency Programs
Authors: Godzik Cassandra M. , Hurley Susan Lysaght , Buck Harleah G. , Yacinthus Blandine A. , Brennan Caitlin W. 
Published: May 2023

OBJECTIVE
This evaluation project focused on assessing the content validity of an adapted version of the Casey-Fink (CF) Graduate Nurse Experience Survey, which is aimed at measuring role transitions in nursing.

BACKGROUND
Registered nurses in the hospice and palliative care field need training and confidence to be proficient in core skills including communication, interprofessional competence, and clinical skills required to care for the dying patient. However, a review of the literature revealed a gap in the availability of survey instruments to measure the confidence of nurses entering the field of hospice and palliative care.

METHODS
Ten items from the CF survey were revised by the project team and then evaluated for relevance by a group of 7 national hospice and palliative experts. The content validity index (CVI) was used to determine item relevance.

RESULTS
Item-level CVI (I-CVI) calculations ranged from 0.57 to 1.0. The 8 items scored between 0.80 and 1.0 were retained as written. One item required further revision (I-CVI, 0.71), and 1 item revision was eliminated (I-CVI, 0.57). Experts also suggested 5 additional items in the original CF-survey need modification.

CONCLUSION
The adapted CF-survey tool is ready for further psychometric testing, and next steps include administration to a new sample of nurse residents to determine construct validity.
Thinking, Feeling, Behaving
Authors: Price Deborah M. , Figueroa Nicole , Macera-DiClemente Linda , Wintermeyer-Pingel Sue , Riley Penny , Tschannen Dana 
Published: May 2023

OBJECTIVE
This study examined the impact of the MINDBODYSTRONG® program on mental health and lifestyle behaviors among a sample of staff nurses, clinical nurse leaders, and faculty, when offered after the onset of the COVID-19 pandemic.

BACKGROUND
Previous studies have demonstrated the MINDBODYSTRONG program decreased anxiety and depressive symptoms, improved job satisfaction, and sustained healthy lifestyle behaviors in newly licensed RNs. This program has not been studied with experienced nurses. In addition, the use of a virtual format is unique.

METHODS
A pre-post design was used for this pilot study. Subjects were recruited from a large Midwestern medical center and affiliated school of nursing. Registered participants of the MINDBODYSTRONG program attended 7 weekly sessions virtually.

RESULTS
The MINDBODYSTRONG intervention suggests sustained improvement in perceived stress, anxiety, depression, and use of healthy behaviors.

CONCLUSION
This pilot study supports that the MINDBODYSTRONG program may be effective in addressing mental health and healthy lifestyle beliefs for staff nurses, clinical nurse leaders, and nursing faculty.
Diagnostic Yield and Utility of Radiographic Imaging in the Evaluation of Pulsatile Tinnitus: A Systematic Review
Authors: Cao Austin C. , Hwa Tiffany P. , Cavarocchi Caitlin , Quimby Alexandra , Eliades Steven J. , Ruckenstein Michael J. , Bigelow Douglas C. , Choudhri Omar A. , Brant Jason A. 
Published: May 2023

Objective:
The objective of this study is to assess diagnostic yield of imaging modalities used to evaluate patients presenting with pulsatile tinnitus (PT).

Databases Reviewed:
PubMed, Embase, and Scopus were queried using the search terms “pulsatile tinnitus,” “pulse-synchronous tinnitus,” and “pulse synchronous tinnitus” with no date limitations.

Methods:
Studies that reported diagnostic imaging for patients presenting with PT were included. Data were reviewed for sample size, gender, age, imaging study, indications, and diagnoses. The primary outcome measure from aggregated data was the yield of positive diagnoses made with each imaging modality. The quality of evidence was assessed for risk of bias.

Results:
From an initial search of 1145 articles, 17 manuscripts met inclusion criteria, of which 12 studies evaluated individual imaging modalities. The number of unique patients included was 1232. The diagnostic yield varied between modalities: carotid ultrasound (21%, 95% confidence interval [CI]: 12%–35%), CT temporal bone (65%, CI: 20%–93%), computed tomographic angiography (86%, CI: 80%–90%), and MRI/magnetic resonance angiography (58%, CI: 43%–72%).

Conclusion:
Studies on the diagnostic approach to PT are limited by heterogeneity in both inclusion criteria and reporting standards. A wide range of imaging modalities are used in practice during the initial evaluation of PT, and the diagnostic yield for imaging can be improved by utilizing more specific clinical indications.
Bilateral Buccal Flap Revision Palatoplasty to Correct Velopharyngeal Dysfunction in Patients with Repaired Cleft Palate: Perceptual Speech, Acoustic, and Aerodynamic Outcomes
Authors: Napoli Joseph A. , Kalmar Christopher L. , Low David W. , Buckley James , Bunnell H. Timothy , Vallino Linda D. 
Published: May 2023

Background:
The purpose of this study was to analyze perceptual, acoustic, and aerodynamic changes in speech and velopharyngeal function after bilateral buccal flap revision palatoplasty (BBFRP). in patients with repaired cleft palate.

Methods:
Ten consecutive patients, aged 4-18 years with velopharyngeal dysfunction (VPD) treated with BBFRP by a single surgeon, were evaluated. Using a visual analog scale (VAS), nine blinded speech-language pathologists independently rated hypernasality, hyponasality, audible nasal emission (ANE) and speech acceptability. Measurements of the acoustic speech signal were used to quantify changes in hypernasality and nasal emission. The pressure-flow technique was used to determine changes in velopharyngeal gap size.

Results:
Complete records were available for 8 patients. After surgery, hypernasality significantly decreased (p<.001) and speech acceptability increased (p<.001). ANE was significantly reduced (p<.001). Postoperative acoustic measures showed a reduction of nasal emission and improved nasalization. VP gap size significantly decreased after BBFRP (p<.001), correlating with lower VAS ratings of hypernasality (p=.015). Hyponasality did not significantly change after surgery (p=.964). No patient developed sleep disordered breathing.

Conclusions:
BBFRP resulted in a measurable improvement in hypernasal speech, audible nasal emission, and speech acceptability without significant changes in hyponasality or risk of obstructive sleep apnea.
The Natural History of Fibrous Dysplasia of the Orbit
Authors: Blum Jessica D. , Cho Daniel Y , Villavisanis Dillan F. , Goncalves Fabricio G. , Swanson Jordan W. , Storm Philip B. , Taylor Jesse A. , Bartlett Scott P. 
Published: May 2023

Background:
Orbital fibrous dysplasia (FD) is a disease of disordered fibro-osseous proliferation secondary to altered osteogenesis, with potential sequelae including compressive neuropathy and irreversible vision loss. The purpose of this study was to evaluate the natural history and longitudinal outcomes of 37 patients with orbital FD who underwent stratified surgical management.

Methods:
All patients treated for FD from 2015-2021 were identified, yielding 185 patients, 39 with orbital involvement. Impressions from head CTs were analyzed by a craniofacial radiologist to evaluate location and timing of tumor growth. Operative records were reviewed to determine surgical approach (partial excision/contouring, complete excision, or partial excision with optic nerve decompression).

Results:
Average age at diagnosis was 10.7±4.5 years, with average follow up of 5.2±4.7 years. Of the 37 patients with orbital involvement, 28 (75.7%) had optic canal involvement. Of those with optic canal involvement, 13 (46.4%) required partial excision with optic nerve decompression while 15 (53.6%) did not. Of those without optic canal involvement, two patients (22.2%) underwent partial excision/contouring of the anterior orbit to correct dystopia and/or proptosis and four patients (44.4%) underwent complete excision of the orbital component and reconstruction with bone graft or mesh. Younger age at diagnosis was associated with an increased number of surgical interventions (p=.011), younger age at first optic canal decompression (p=.003) and worse visual outcomes (p=.009).

Conclusions:
In our cohort, patients diagnosed at a younger age required more surgeries, underwent decompression earlier, and had worse visual outcomes.
3D-printable Open-source Cleft Lip and Palate Impression Trays – A Single-Impression-Workflow
Authors: Meyer Simon , Benitez Benito K. , Thieringer Florian M. , Mueller Andreas A. 
Published: May 2023

Summary:
Documenting the complex three-dimensional cleft lip and palate malformation by plaster casts based on maxillary impressions is standard care. Presurgical orthopedic treatment also requires an impression. Digital impression-taking in patients with cleft lip and palate becomes feasible, but procurement costs still hinder clinical implementation. Individualized impression trays allow for a precise impression, limiting the airway risk. We present an open-source impression tray library with scalable impression trays not requiring 3D modeling knowledge. The cleft lip and palate impression tray library is accessible on Open Science Framework. Different shapes are available, and the tray size is selected based on the tuber distance. This allows 3D printing with biocompatible material at the point-of-care complying with local regulations. Our presented open-source cleft tray library offers a hybrid solution for cleft centers, pending the implementation of digital impression.