bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge Attitude and Practice (KAP) survey among healthcare professionals in pediatrics on the psychomotor development of children. Case of urban and rural health areas in South Kivu in the Democratic Republic of Congo: a cross-sectional study
Authors: Muke Kitoga , Ganywamulume Balagizi , Mwilo Mambo , Manegabe Tumsifu , Bruno Masumbuko , Archippe Birindwa 
Published: August 2023

Introduction:
Development refers to change. The study of development is the understanding of how a subject functions at a particular age or time in life. The objective of this study was to evaluate the knowledge, attitude, and practice of pediatric healthcare personnel on the psychomotor development of the child.

Methods:
This was a cross-sectional study of knowledge, attitude, and practice conducted in the health areas of South Kivu.

Results:
Twenty-six caregivers participated in the survey. Men were the most represented (61.5%), mean age 27.62±5.07 years; median experience in pediatrics: 1 year; predominantly urban setting with 69.2%. General practitioners were more represented, with 57.7%. The overall state of knowledge was insufficient in 69.2%. Knowledge1 improves with increasing experience in pediatrics (P=0.008), and qualification improves knowledge1 (P=0.033) and knowledge3 (P=0.009). Knowledge4 improved from rural to urban settings (P=0.022).
A good knowledge of the scales used in the evaluation of psychomotor development influences the use of one or the other (P=0.000). The authors also notice that those who indicate and/or have physical therapy practiced in rehabilitation are generally those who have a good knowledge of the use of psychomotor development assessment tools (P=0.010).

Conclusion:
This study highlights the low theoretical knowledge of caregivers on psychomotor development in our study setting, resulting in late diagnosis and consequently poor treatment of psychomotor development disorders. The results of this study indicate a need for continuing education for pediatric caregivers on the psychomotor development of the child.
A unique presentation of hyponatremia and seizures in a 2-month-old child with cystic fibrosis: a case report
Authors: Allouzi Sana , Rihawi Baraa , Allouzi Joud , Allouzi Mohammad I. , Abdulrahman Najwa , Abdullah Manar 
Published: August 2023

Introduction and importance:
Cystic fibrosis is an autosomal recessive disorder that causes a broad range of clinical findings and can present unusually as electrolyte disturbance, such as hyponatremia that causes seizures in children.

Case presentation:
We report a case of a 2-month-old infant who presented with an episode of grand mal seizure induced by hyponatremia and moderate episodes of milky vomiting after breastfeeding.

Clinical discussion:
Proper investigations showed normal cardiac and renal functions. Ultrasonography showed no pathological changes. Laboratory tests performed showed hyponatremia, mild hypokalemia, and hypochloremia. Urinary electrolyte results were normal. While broadening the scope of differential diagnosis in order to reach a final diagnosis, the sweat chloride level was elevated, which confirmed the diagnosis of cystic fibroses.

Conclusion:
We aim to share our case to keep cystic fibroses in mind as a differential diagnosis when dealing with hyponatremic seizures in children.
Factitious cushing’s syndrome with unusual presentation: a case report and literature review
Authors: Zeer Almotazbellah M. M. , Noman Mahmoud , Zeer Zahraa M. M. , Attawneh Alaa , Bairmani Zinah A. , Alfroukh Khadeejeh M. A. , Oweina Layth 
Published: August 2023

Introduction:
Munchausen syndrome is known as a factitious disorder imposed on the self. Factitious Cushing’s syndrome (CS) is a very rare form of Munchausen syndrome, presenting with varied clinical and biochemical features, making diagnosis challenging.

Case Presentation:
A 40-year-old female patient who worked as a registered nurse presented with clinical features of CS but denied any exogenous corticosteroid use. The endocrine workup revealed that the patient had a high 24 h urinary-free cortisol collection before admission. Subsequent evaluations showed low levels of morning cortisol and plasma adrenocorticotropic hormone along with a suppressed overnight low-dose dexamethasone suppression test, leading to an investigation of hypercortisolism. Unexpectedly, subsequent testing showed a normal 24 h urinary-free cortisol level. Additionally, the patient was diagnosed with panhypopituitarism, the radiological investigations showed normal pituitary and adrenal glands. Despite consistently denying the use of corticosteroids, it was finally discovered that the patient had been surreptitiously taking prednisone and receiving multiple dexamethasone injections over the past few months. The patient received treatment through a gradual prednisone tapering regimen, accompanied by comprehensive psychiatric evaluation and management.

Conclusion:
This case underscores the exceptional rarity of factitious CS and emphasizes the importance of considering it as a potential differential diagnosis in hypercortisolism cases, particularly when the patient’s medical history contradicts investigative findings. Furthermore, it highlights the criticality of adopting a multidisciplinary approach to investigate patients whose clinical presentation aligns with factitious CS.
Endogenous endophthalmitis in post-COVID-19 patients: a case report
Authors: Chaudhary Santosh , Sitaula Ranju K. , Karki Pratap , Joshi Sagun N. 
Published: August 2023

Introduction and importance:
Ocular involvement in coronavirus disease 2019 (COVID-19) can be due to direct viral invasion or indirectly due to an immunosuppressed state. Prolonged hospitalization also makes them susceptible to various secondary infections. The purpose of this case report is to report two rare cases of endogenous endophthalmitis (EE) in COVID-19 recovered patients.

Case presentation:
Two patients who were hospitalized and received treatment for COVID-19 pneumonia with remdesivir and systemic steroids presented with decreased vision. The first case had a severe anterior chamber reaction with a hypopyon and dense exudates in the vitreous. The second case had cells and flare in the anterior chamber and exudates in the vitreous. They were diagnosed with EE and underwent a diagnostic vitreous tap followed by pars plana vitrectomy and intravitreal antibiotic and steroid. The culture of vitreous fluid was negative for any bacteria and fungus in both cases. However, the first case demonstrated Escherichia coli in urine culture. The follow-up visual acuity was no perception of light and only perception of light in the first and second case, respectively.

Clinical discussion:
Severe COVID-19 patients who are hospitalized, receive systemic steroid and have associated comorbidities like diabetes mellitus are at high risk of EE.

Conclusion:
Delay in diagnosis and appropriate treatment in these patients leads to poor visual outcome.
An operational maintenance approach for improving physiological monitor by HFMEA process: an empirical case study
Authors: Chia Jen-Shu , Chang Ching , Yang Chen-Hsuan , Yang Ching-Hui , Chiang Yung-Tai , Wu Cheng-En 
Published: August 2023

Background:
This study explored the application of healthcare failure mode and effect analysis (HFMEA) to identify and evaluate risk-associated factors in the intensive care unit (ICU) through a clinical-based expert knowledge (decision) for the physiological monitor operational maintenance process.

Methods and intervention:
A mixed qualitative and quantitative proactive approach to explore the HFMEA process by analyzing 20 units of physiological monitors in the ICU. An HFMEA expert team of six people was formed to perform a risk-based analysis and evaluate the potential hazard index, mitigating the hazard scores and risks.

Results:
From the main processes and possible failure reasons, one high-risk hazard index greater than or equal to 8 of the standard score was found. This standard score indicates the signed manufacturer’s contract for maintenance was the hazard index failure mode on the parts not regularly replaced according to the contract. This systematic hazard index failure mode shows the highest hazard scores in the possible failure reason category, established as a standard maintenance procedure. In addition, the HFMEA expert analysis of the 20 units of physiological monitors within 6 months of the original and remanufactured part maintenance results in operational availability from 90.9% for self-repair to 99.2% for contract manufacturer repair.

Conclusions:
This study concludes a systematic reference in malpractices caused by maintenance negligence. The HFMEA expert team agrees that hazard failure scores greater than or equal to 8 are vital assessments and evaluations for decision-making, especially in maintaining healthcare intensive unit care physiological monitors.
Assessment of sleep quality and its factors among clinicians working in critical care units and operation theaters at North West Ethiopia, 2022: a multicenter cross-sectional study
Authors: Tsegay Yitbarek , Arefayne Nurhusen R. , Fentie Demeke Y. , Workie Misganaw M. , Tegegne Biresaw A. , Berhe Yophtahe W. 
Published: August 2023

Background:
The quality of sleep has an effect on the health of clinicians and the quality of patient care. Maintaining cognitive function/mood, facilitation of glucose metabolism, and strengthening of the immune system are among the roles that adequate sleep may contribute. Poor sleep quality is multifactorial, and studies had shown inconsistencies in the factors that contribute to the development of this poor sleep quality. The prevalence of poor sleep quality among clinicians working in the critical care unit and operation theater in the study setting was not investigated yet.

Objective:
The objective of this study was conducted for the purpose of assessing the quality of sleep and associated factors among clinicians working in the critical care unit and operation theater.

Methods:
A cross-sectional study was conducted from 15 May to 15 June 2022. Data were collected using a self-administered questionnaire from 421 clinicians selected by simple random sampling techniques. Sleep quality was measured by the Pittsburg sleep quality index. The data were entered into Epi-data and exported to SPSS. Frequency and percentage were used for the descriptive analysis. Binary and multivariate logistic regression analysis were used to identify factors associated with poor quality of sleep. The strength of the association was measured with an OR within the 95% CI and P-value of <0.05.

Result:
About half 220 (52.3%) of the study participants age between 25 and 30 year old and the majority 321 (76.2%) of them were males. The prevalence of poor sleeps quality was 81.5% (95% CI: 77.9–85.5). Working night shift (AOR: 3.37, 95% CI: 1.754–6.484), having depressive symptoms (AOR: 3.25, 95% CI: 1.485–7.147) and having no regular exercises (AOR: 0.299, 95% CI: 0.166–0.537) were predisposing factors for poor sleep quality.

Conclusion and Recommendation:
The prevalence of poor sleep quality among clinicians working in the ICU and operation room was high. Clinicians who had no regular exercise, who worked in night shift, and who had depressive symptoms were associated with poor quality of sleep. Clinicians should have an awareness on the symptoms of depression, implement sleep hygiene education programs and promoting regular exercise. The authors recommend healthcare policy makers for improving working schedules.
Impact of anti-tuberculosis treatment on hematological parameters in newly diagnosed tuberculosis patients at Jimma town: a longitudinal prospective study
Authors: Reta Birhane , Mohammed Abdurehman E. , Tesfaye Kiya Girum , Adissu Wondimagegn , Shenkute Tilahun Y. 
Published: August 2023

Background:
Tuberculosis (TB) is a significant public health problem affecting one-third of the world’s population. In 2021, 1.6 million people died from TB. TB is the 13th leading cause of death and the second leading cause of infectious death after coronavirus disease 2019. Most anti-TB drugs affect hematological parameters in patients.

Methods:
This longitudinal prospective study was conducted from 03 January to 30 December 2019. Patients who completed a course of TB treatment were candidates for analysis. Sputum and blood samples were collected from each study participant and analyzed by the Gene X-pert machine and a HumaCount 30 hematology analyzer (Human GmbH). SPSS version 20 and R programming software version 4.2.3 were used for data analysis. Friedman’s test was used to assess statistical significance. P-values ​​less than 0.05 were considered statistically significant.

Results:
A total of 148 patients who completed the course of TB treatment correctly were a candidate for final analysis. Ninety-one (61.5%) study participants were male; the median age was 27.6±9.8 years. Moreover, most of the study participants (84.4%) had pulmonary TB. Most of the hematological parameters had changed in the phases of TB treatment. After anti-TB treatment, there is a significant difference in hematological parameters in red blood cell count, hemoglobin concentration, hematocrit percentage, platelet count, and white blood cell count.

Conclusion:
Anemia and leucopenia are the most significant problems after TB treatment. Regular checking of these parameters is essential for the patient.
Acute Neuropsychiatric Symptoms During COVID-19
Authors: Everaerd Daphne , Vissers Pim , van Helvoort Marloes , Schellekens Arnt , van de Maat Josephine , Hoogerwerf Jacobien ,   CoviP Consortium, Tendolkar Indira 
Published: August 2023

Abstract
Converging evidence suggests that COVID-19 infects not only the respiratory system, but also has a large impact on the central nervous system (CNS), leading to acute neuropsychiatric symptoms (NPSs) such as anxiety and delirium. It is thus far unclear which acute NPSs are most common in COVID-19 and if NPSs are associated with an altered COVID-19 disease course. We used data from two independent retrospective cohort studies performed in an academic hospital. A total of 93 patients with NPS and 125 patients without NPS were included. Main outcome measures consisted of type of acute NPS, COVID-19 severity (based on CT severity score), admission to the intensive care unit (ICU), and mortality. Most common acute NPSs were delirium, anxiety, and mood symptoms. NPS patients were more often admitted to the ICU than patients without NPS. However, there was no difference in duration of ICU admission, CT severity score, and mortality. Somatic comorbidity was similar between the two groups. These data suggest that delirium, anxiety, and mood symptoms were the most common NPS. Independent of other clinical characteristics, ICU admission in COVID-19 patients was associated with NPS. We recommend that all COVID-19 patients should be actively screened for acute NPS such as delirium, anxiety, and mood symptoms, especially when admitted to an ICU.
Just Culture
Authors: Walker Danielle , Hromadik Lora , Baker Manisa , McQuiston Linda 
Published: August 2023

Background:
Although just culture is reportedly integrated across education and practice, little is known about how perceptions may change across time as students transition from prelicensure education to registered nurse in the practice setting.

Purpose:
The purpose of this study was to describe and compare just culture perceptions of registered nurses at 2 time points: (1) as prelicensure students and (2) as new graduate nurses with a minimum of 6 months of experience.

Methods:
Utilizing the Just Culture Assessment Tool for Nursing Education (JCAT-NE) and the Just Culture Assessment Tool (JCAT), this within-subject, longitudinal study measured just culture perceptions across time.

Results:
Although there was no statistically significant change in total scores across time, 8 individual items demonstrated statistically significant change.

Conclusions:
Students use the knowledge, skills, and attitudes about just culture taught in prelicensure education as new graduate nurses. However, findings reveal areas where the practice environment has altered perceptions of just culture.
What Bedside Skills Could the Modern Rheumatologist Possess? Part I. The Basics
Authors: Ike Robert W. , McCoy Sara S. , Kalunian Kenneth C. 
Published: August 2023

Abstract
The hands-on aspect of rheumatologic practice serves to balance its more cerebral features with the everyday necessity to touch patients to assess their condition, obtain samples for diagnosis, and deliver therapy, all cementing the important bond between patient and physician. Factors over recent years, ranging from the intercession of the electronic medical record to COVID, have weakened this bond, which we must restore if the practice of rheumatology is to return to previous levels of satisfaction. We review herein, in 2 parts, the many ways rheumatologists may interact physically with patients, with hope that pursuit of these measures can enhance satisfaction of physician and patient alike. This first installment reviews those simple skills in place before more involved technical bedside skill began to evolve over the last half century.
The Assessment of External Nasal Valve Efficiency After Le Fort I Surgery
Authors: Dilaver Emrah , Suzen Muazzez , Seyidoglu Ayda , Uckan Sina 
Published: August 2023

Background
The present study investigated how external nasal valve function is affected after Le Fort I osteotomy using external nasal valve efficiency (ENVE) index.

Materials and Methods
Twenty-one patients who underwent Le Fort I osteotomy with or without mandibular osteotomy were included in the retrospective study. Preoperative and postoperative standardized videos of basal view of the nose during breathing were recorded, and 2 screenshots were taken, 1 in the resting position and the other after deep inspiration. External nasal valve efficiency was calculated at preoperative and postoperative periods for each patient.

Results
Of the 21 patients, 12 were women and 9 were men (mean age, 26.63 ± 8.20 years). The mean ENVE index was 0.75 ± 0.16 for the preoperative period and 0.82 ± 0.17 for the postoperative period. There was a significant difference between these values (P = 0.002). When the correlation of the ENVE with maxillary movements was analyzed, the ENVE was negatively affected by maxillary impaction (P = 0.011, r = −0.540).

Conclusions
These findings imply that Le Fort I osteotomy positively affects the ENVE index. However, because of the antagonistic relation between maxillary impaction and ENVE, higher maxillary impaction amounts or isolated maxillary impaction should be carefully planned in patients with low ENVE index.
Surgical Management in Isolated Squamosal Craniosynostosis
Authors: Fallahian Fedra , Meyer Anne , Tadisina Kashyap Komarraju , Lin Alexander Y. 
Published: August 2023

BackgroundAlthough craniosynostoses involving the major sutures have been well described, the frequency of isolated minor suture craniosynostoses is much lower. Squamosal craniosynostosis (SQS) is a rare form of cranial synostosis, and the paucity of literature has made the creation of a standardized treatment plan difficult. We present a systematic review of the literature on isolated SQS to identify disease characteristics that lead to a need for operative intervention and to delineate patterns in surgical management.MethodsA systematic literature review was performed using the electronic databases of PubMed, Scopus, and MEDLINE and the key words “squamosal AND craniosynostosis,” “squamous AND craniosynostosis,” “squamosal craniosynostosis, “squamosal suture craniosynostosis,” and “isolated squamosal craniosynostosis.” Only human studies that described presentation and management of SQS were included. A blinded, 2-reviewer analysis of the articles was performed. Data collected included patient and disease characteristics, imaging workup, and treatment specifics, which were analyzed by descriptive statistics.ResultsA total of 19 studies examining 119 patients with SQS were reviewed, with 97 (82%) multisutural cases and 22 isolated cases (18%). Of the isolated cases, 6 (27%) required surgical craniosynostosis repair, of which 1 (17%) had unilateral sutural involvement and 5 (83%) had bilateral involvement. Of the patients with isolated SQS, 7 (32%) had a congenital syndrome and comprised 33% of patients who required surgical intervention. The nonsyndromic patients with isolated SQS who required surgery presented with a wide array of phenotypic findings; 3 patients underwent some form of cranial vault remodeling, whereas 1 patient underwent ventriculoperitoneal shunt only. Of the 4 nonsyndromic patients with isolated SQS who underwent surgical repair, half required operative intervention because of elevated intracranial pressure and the other half because of dysmorphic head shape.ConclusionThe findings of this updated systematic review suggest a trend toward surgical management in bilateral SQS versus unilateral SQS, and that patients with isolated SQS, previously considered to be a nonsurgical finding, should be carefully monitored, as there remains risk of increased intracranial pressure. Pooled systematic review data suggest isolated SQS has a 27% operative intervention rate, with the presence of coexisting syndromic diagnoses increasing that risk.
Multidimensional Assessment of Patient-Reported Outcomes After Gender-Affirming Surgeries Using a Validated Instrument
Authors: Hung Ya-Ching , Park Benjamin C. , Assi Patrick E. , Perdikis Galen , Drolet Brian C. , Kassis Salam A. 
Published: August 2023

Introduction
Limited literatures used validated instruments to evaluate patient-reported outcomes (PROs) for transgender and gender-diverse population undergoing gender-affirming surgeries (GASs). This study aimed to evaluate PROs using a newly validated psychometric instrument, Vanderbilt Mini Patient-Reported Outcome Measures—Gender (VMP-G).

Methods
Vanderbilt Mini Patient-Reported Outcome Measures—Gender assesses 4 scales: quality of life, self-concept, satisfaction, and gender dysphoria. Scores range from 20 to 100, with higher scores representing superior PROs. Descriptive analysis was performed, and outcomes were compared in different races/ethnicities, gender identities, age, types of GAS, and time. Patients seeking GAS at Vanderbilt University Medical Center from October 11, 2021, to October 11, 2022, were included. Data were collected anonymously via the Research Electronic Data Capture survey tool at preoperative or postoperative clinic visits.

Results
A total of 207 patients completed VMP-G. Average age was 31.8 years (SD, ±11.5 years). Fifty-three percent of patients were postoperative GAS. In bivariate and linear regression analyses, postoperative patients scored higher on all scales compared with preoperative patients (P < 0.001). After adjustment, postoperative patients scored 12.5 higher on VMP-G compared with preoperative patients (P < 0.01). In subset analyses, GAS was associated with improved PROs in White, non-White, binary, and nonbinary and patients younger than 21 years (P < 0.05). After GAS, patients younger than 21 years reported similar outcomes, compared with patients older than 21 years (P > 0.05). No PROs differences were reported between patients who underwent top versus bottom surgery (P = 0.2). Postoperative patients reported low rates of regret (2.8%). Scores on the VMP-G were sustained even 1 year after GAS. Each month after GAS was associated with a score improvement of 0.02 in the gender dysphoria domain after adjusting for patient demographics (P = 0.02).

Conclusions
Using a validated GAS-specific measure, we found that surgery sustainably improves patients' self-reported outcomes including gender dysphoria.