bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Single Center Experience With Bilateral Wilms Tumor
Authors: Chen Stephanie Y. , Lee William G.H. , Laifman Eric , Mack Shale J. , Zhou Shengmei , Kim Eugene S. 
Published: May 2023

Background Wilms tumor (WT) is the most common pediatric renal malignancy and bilateral disease (BWT) occurs in 5% of cases and is associated with poor outcomes. Management of BWT includes chemotherapy and oncologic resection while preserving renal function. Previous literature has demonstrated variable approaches in BWT treatment. The aim of this study was to examine a single institution experience and outcomes with BWT. Methods A retrospective chart review was performed for all patients with WT treated at a free-standing tertiary children’s hospital between 1998 and 2018. Patients with BWT were identified and treatment courses were compared. Outcomes of interest included need for dialysis post-operatively, need for renal transplantation post-operatively, disease recurrence, and overall survival. Results Of 120 children with WT, 9 children (6F:3M) of median age 32 months (IQR: 24-50 months) and median weight 13.7 kg (IQR: 10.9-16.2 kg) were diagnosed with and treated for BWT. Pre-operative biopsies were obtained in 4/9 patients, 3 of whom received neoadjuvant chemotherapy and 1 who underwent radical nephrectomy. Of the 5 patients who did not undergo biopsy, 4/5 were treated with neoadjuvant chemotherapy, and 1/5 underwent upfront nephrectomy. Post-operatively, 4/9 children required dialysis, of whom 2 subsequently underwent renal transplantation. Two patients were lost to follow-up, and of the remaining 7 patients, disease recurrence occurred in 5/7 children and overall survival was 71% (n=5). Conclusion Management of BWT varies regarding the use of pre-operative biopsy, neoadjuvant chemotherapy, and extent of disease resection. Further guidelines on treatment protocols may optimize outcomes in children with BWT.
An Ounce of Prevention is the Only Cure: Nationwide Clinical and Financial Outcomes of Self-Inflicted Firearm Injuries
Authors: Tran Zachary , Bonnick Kristine , Byun Julianne , Cho Nam Yong , Benharash Peyman , Mukherjee Kaushik 
Published: May 2023

Background Self-inflicted gunshot wounds (SIGSWs) remain a leading, preventable cause of death in the United States. The present study evaluated patient demographics, operative characteristics, in-hospital outcomes, and resource utilization between patients with SIGSW and other GSW. Methods The 2016-2020 National Inpatient Sample was queried for patients ≥16 years old admitted following gunshot wounds. Patients were categorized as SIGSW if they were injured through self-harm. Multivariable logistic regression was used to evaluate the association of SIGSW on outcomes. The primary endpoint was in-hospital mortality with complications, costs, and length of stay secondarily considered. Results Of an estimated 157,795 surviving to hospital admission, 14,670 (9.30%) were SIGSW. Self-inflicted gunshot wounds were more commonly female (18.1 vs 11.3%), insured by Medicare (21.1 vs 5.0%), and white (70.8 vs 22.3%) (all P < .001) compared to non-SIGSW. Psychiatric illness was more prevalent in SIGSW (46.0 vs 6.6%, P < .001). Additionally, SIGSW more frequently underwent neurologic (10.7 vs 2.9%) and facial operations (12.5 vs 3.2%) (both P < .001). After adjustment, SIGSW was associated with greater odds of mortality (AOR: 12.4, 95% CI: 10.4-14.7). Length of stay (β: +1.5 days, 95% CI: .8-2.1) and costs (β: +$3.6 K, 95% CI: 1.4-5.7) were significantly greater in SIGSW. Conclusions Self-inflicted gunshot wounds are associated with increased mortality compared to other GSW, likely due to the increased proportion of injuries in the head and neck region. This lethality, coupled with the high prevalence of psychiatric illness in this population, indicates that efforts must be made to intervene through primary prevention, including enhanced screening and weapon safety considerations for those at risk.
The Effect of Propofol on Peri-Induction Hemodynamics and Resuscitation in Operative Penetrating Trauma
Authors: Levin Jeremy H. , Wallace Marshall W. , Hess T. Noel , Beavers Jennifer R. , Chang Tony , Beyene Robel T. 
Published: May 2023

Background Hemorrhaging trauma patients may be disproportionately affected by choice of induction agent during rapid sequence intubation (RSI). Etomidate, ketamine, and propofol are safe in the trauma population-at-large but have not been assessed in patients with ongoing hemorrhage. We hypothesize that in hemorrhaging patients with penetrating injury, propofol deleteriously affects peri-induction hypotension compared to etomidate and ketamine. Methods Retrospective cohort study. Primary outcome was the effect of induction agent on peri-induction systolic blood pressure. Secondary outcomes were the incidence of peri-induction vasopressor use and quantity of peri-induction blood transfusion requirements. Linear multivariate regression modeling assessed the effect of induction agent on the variables of interest. Results 169 patients were included, 146 received propofol and 23 received etomidate or ketamine. Univariate analysis revealed no difference in peri-induction systolic blood pressure (P = .53), peri-induction vasopressor administration (P = .62), or transfusion requirements within the first hour after induction (PRBC P = .24, FFP P = .19, PLT P = .29). Choice of RSI agent did not independently predict peri-induction systolic blood pressure or blood product administration. Rather, only presenting shock index independently predicted peri-induction hypotension. Conclusions This is the first study to directly assess the peri-induction effects of anesthetic induction agent choice in penetrating trauma patients undergoing emergent hemorrhage control surgery. Propofol does not appear to worsen peri-induction hypotension regardless of dose. Patient physiology is most predictive of peri-induction hypotension.
Interpersonal variables and caregiving partners' burden in cardiac illness: A longitudinal study
Authors: Katz Eran , Bar-Kalifa Eran , Pietromonaco Paula , Wolf Hodaya , Klempfner Robert , Hod Hanoch , Vilchinsky Noa 
Published: May 2023

The literature on coping with illness has for many years viewed only the patients as the focal point of attention and support, and only recently have the needs of patients’ caregivers been acknowledged as well. In addition, studies that have focused on factors contributing to caregiving partners’ burden in the context of chronic illness have assessed mostly intrapersonal variables of either the patient or the partner, thus overlooking the dyadic and interpersonal nature of caregiving. In the current longitudinal study, we examined the contribution of interpersonal factors, such as patients’ and partners’ relationship satisfaction and social support perceptions, to caregiving partners’ burden in the context of cardiac illness. Couples comprising male patients and female caregiving partners ( N = 131) completed measures of relationship satisfaction, provided support, and received support upon patients’ admission to a cardiac rehabilitation program after an acute cardiac event (Time 1), and 3 months later (Time 2), upon program completion. Caregiving partners also completed a measure of burden at both measurement times. Path analyses revealed that partners’ relationship satisfaction, provided support, and received support, were all associated with lower levels of different dimensions of burden at both timepoints, as well as over time. Patients’ contribution to their partners’ burden was salient cross-sectionally but not over time. The findings shed light on the substantial role played by interpersonal factors in the caregiving process. Our findings suggest that both patients and partners should be regarded as caregivers and care receivers to each other.
Retrograde Drilling, Ossoscopy, and Autologous Bone Grafting: An Alternative Technique for Treatment of Osteochondral Lesion of the Talus Stage 2 and 3 in Adults
Authors: Huber Thorsten , Schwertner Alexander , Breuer Robert , Charwat-Pessler Christoph G. , Rath Björn , Orthner Ernst 
Published: May 2023

Background: Symptomatic osteochondral lesions of the talus (OLTs) often require surgical intervention. There are various surgical methods. A generally valid, stage-dependent therapeutic algorithm does not exist. The aim of our study is to show long- term results of an alternative technique that combines retrograde drilling, debridement performed under arthroscopic visualization, and autologous bone grafting. Methods: The surgical technique was performed in 24 patients with medial or lateral OLTs, and the data were analyzed retrospectively. In our technique, the affected subchondral bone was overdrilled retrogradely and resected under arthroscopic visualization (ossoscopy) without violating the cartilage. The resulting defect was filled with autologous bone from the medial tibia metaphysis. Outcome parameters were the numeric rating scale (NRS), the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, and range of motion (ROM). The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was assessed and a possible correlation with the clinical outcome scores was calculated. Data concerning complication rates were also collected. Results: The mean surface size of the OLTs was 0.9 ± 0.3 cm2. The mean follow-up was 89 months. The AOFAS score improved significantly from 57.7 points preoperatively to 88.8 points at the final follow-up ( P < .0001). The pain value measured by the NRS decreased significantly from 8 to a pain level of 2. ROM improved in 37.5% of the patients for dorsiflexion and 29.2% for plantarflexion. There were no significant correlations between the MOCART score and the AOFAS score or the pain value on NRS. Conclusion: Retrograde drilling, ossoscopy, and autologous bone grafting for OLTs is a promising technique with good long-term results. The patients’ satisfaction rate, especially in OLT stages 2 and 3, was excellent. Level of Evidence: Level IV, case series.
Outcomes of Combined Posterior Tibial Tendon Tendoscopy and Medializing Calcaneal Osteotomy for Stage IA Progressive Collapsing Foot Deformity
Authors: Saraiva Daniel , Knupp Markus , Rodrigues André Sá , Tulha José , Gomes Tiago Mota , Oliva Xavier Martín , Diaz Tania 
Published: May 2023

Background: Posterior tibial tendon (PTT) tendoscopy and medializing calcaneal osteotomy (MCO) are among the available techniques for patients presenting with symptomatic flexible hindfoot valgus (stage IA) progressive collapsing foot deformity (PCFD). The aim of this study was to determine clinical and radiographic outcomes of combined PTT tendoscopy and MCO for patients presenting with symptomatic stage IA PCFD. Methods: A retrospective cohort study was performed in order to determine clinical and radiographic outcomes of 30 combined PTT tendoscopies and MCO on 27 patients presenting with symptomatic stage IA PCFD, with a minimum follow-up of 24 months. Patient satisfaction was assessed at last available follow-up as very satisfied, satisfied, and unsatisfied. Clinical assessment was performed evaluating preoperative and last available follow-up visual analog scale for pain (VAS-P), Foot and Ankle Outcome Score (FAOS), and the 36-Item Short Form Health Survey (SF-36). Magnetic resonance imaging (MRI) was performed preoperatively on all patients. Standard weightbearing anteroposterior, lateral, and long axial view radiographs of the foot and ankle were taken preoperatively, immediate postoperatively, at 6 weeks, 3 months, 6 months, 1 year postoperatively, and last follow-up evaluation available for each patient. Results: The mean follow-up was 38.6 (range, 26-62) months. We registered 27 very satisfied, 1 satisfied, and 2 unsatisfied patients. There was statistically significant improvement on all clinical scores (VAS-P, FAOS and SF-36), as well as on lateral talo–first metatarsal and hindfoot alignment angles. We found low-grade PTT tears in 5 patients (16.67%) in whom preoperative MRI documented PTT tenosynovitis alone. Conclusion: We found that combined PTT tendoscopy and MCO provide significant clinical and radiographic improvement for patients presenting with symptomatic stage IAB PCFD. PTT tendoscopy should be considered in the treatment of all surgically addressed flexible valgus feet as it detects tendon tears which are frequently missed on an MRI. Level of Evidence: Level IV, retrospective case series.
Disruptive Mood Dysregulation Disorder in a Norwegian Clinical Child Population
Authors: Coldevin Marit , Brænden Astrid , Zeiner Pål , Øyen Anne-Siri , Melinder Annika , Stubberud Jan 
Published: May 2023

Background Disruptive Mood Dysregulation Disorder was included in DSM-5 to accommodate new research addressing aspects of emotional dysregulation in children suffering from disruptive behavior problems. Despite growing interest in Disruptive Mood Dysregulation Disorder, few studies have looked at prevalence rates in European clinical populations. The primary objective of this study was to examine the prevalence and characteristics associated with Disruptive Mood Dysregulation Disorder in a Norwegian clinical sample. Methods The present study assessed children 6–12 years of age referred to a mental health clinic for evaluation and treatment ( N = 218, M age = 9.6, 60.4% boys) and compared those who did and did not meet Disruptive Mood Dysregulation Disorder diagnostic criteria. Diagnoses were determined using K-SADS-PL 2013. Associated difficulties at home and in school were measured by Achenbach Systems of Empirically Based Assessment battery. Results In this clinical sample, 24% met the diagnostic criteria for Disruptive Mood Dysregulation Disorder. Children with Disruptive Mood Dysregulation Disorder were more likely than those without Disruptive Mood Dysregulation Disorder to be male (77% vs. 55%, p = .008), be living in poverty, have multiple mental health diagnoses (79% vs. 53%, p = .001), and have lower global functioning levels as measured by Children’s Global Assessment Scale (range 0–100, M = 47, SD = 8.5 vs. M = 57, SD = 11.4, p=<.001). Finally, parents and teachers of children with Disruptive Mood Dysregulation Disorder reported lower overall competence and adaptive functioning, and higher total symptom load than children with other diagnoses. Conclusion Disruptive Mood Dysregulation Disorder is highly prevalent in a Norwegian clinical sample and displays a high symptom load. Our results are in accordance with similar studies. Consistent findings across the world may support Disruptive Mood Dysregulation Disorder as a valid diagnostic category.
A Hierarchy of Learning Needs for Revolutionizing Inclusive Organizational Practices
Authors: Boutwell Katrina R. , Smith Tyrone D. 
Published: May 2023

ProblemDespite organizations adopting diversity, equity, and inclusion (DEI) in organizational initiatives, discrimination, and unjust practices persist. Consequently, organizational environments where individuals feel safe and valued are critical not only to organizational effectiveness but for individual learning, growth, and development.SolutionInclusive leadership models that: (1) integrate organizational learning as the driver for social transformation at the individual, group, and broad organizational levels and (2) develop inclusive leaders who espouse pro-diversity beliefs, enact social change and envision a workplace that values human relations as a basic need for achieving the highest possible degree of human well-being.StakeholdersOrganizational leaders, human resource development educators, researchers, scholars.
Motor Activated Auricular Vagus Nerve Stimulation as a Potential Neuromodulation Approach for Post-Stroke Motor Rehabilitation: A Pilot Study
Authors: Badran Bashar W. , Peng Xiaolong , Baker-Vogel Brenna , Hutchison Scott , Finetto Patricia , Rishe Kelly , Fortune Andrew , Kitchens Ellen , O’Leary Georgia H. , Short Abigail , Finetto Christian , Woodbury Michelle L. , Kautz Steve 
Published: May 2023

Background Implanted vagus nerve stimulation (VNS), when synchronized with post-stroke motor rehabilitation improves conventional motor rehabilitation training. A non-invasive VNS method known as transcutaneous auricular vagus nerves stimulation (taVNS) has emerged, which may mimic the effects of implanted VNS. Objective To determine whether taVNS paired with motor rehabilitation improves post-stroke motor function, and whether synchronization with movement and amount of stimulation is critical to outcomes. Methods We developed a closed-loop taVNS system for motor rehabilitation called motor activated auricular vagus nerve stimulation (MAAVNS) and conducted a randomized, double-blind, pilot trial investigating the use of MAAVNS to improve upper limb function in 20 stroke survivors. Participants attended 12 rehabilitation sessions over 4-weeks, and were assigned to a group that received either MAAVNS or active unpaired taVNS concurrently with task-specific training. Motor assessments were conducted at baseline, and weekly during rehabilitation training. Stimulation pulses were counted for both groups. Results A total of 16 individuals completed the trial, and both MAAVNS (n = 9) and unpaired taVNS (n = 7) demonstrated improved Fugl-Meyer Assessment upper extremity scores (Mean ± SEM, MAAVNS: 5.00 ± 1.02, unpaired taVNS: 3.14 ± 0.63). MAAVNS demonstrated greater effect size (Cohen’s d = 0.63) compared to unpaired taVNS (Cohen’s d = 0.30). Furthermore, MAAVNS participants received significantly fewer stimulation pulses (Mean ± SEM, MAAVNS: 36 070 ± 3205) than the fixed 45 000 pulses unpaired taVNS participants received ( P < .05). Conclusion This trial suggests stimulation timing likely matters, and that pairing taVNS with movements may be superior to an unpaired approach. Additionally, MAAVNS effect size is comparable to that of the implanted VNS approach.
Perceived facilitators and barriers to the provision of sexual and reproductive health services in response to the Syrian refugee crisis in Lebanon
Authors: Fouad Fouad M , Hashoush Mahmoud , Diab Jasmin Lilian , Nabulsi Dana , Bahr Sarah , Ibrahim Sarah , Farhat Theresa , Kobeissi Loulou 
Published: May 2023

Background: The Syrian crisis has resulted in one of the worst humanitarian disasters in modern history. Inadequate access to and use of sexual and reproductive health services is a prevailing issue among adolescent girls and young refugee women in humanitarian settings. Objectives: This article aimed to explore and describe the perceived extent of implementation of the different objectives and activities outlined within the minimum initial service package for reproductive health in crisis services in Lebanon, from the perspectives of a diverse set of stakeholders from leading organizations (public, private, primary health centers, nongovernmental organizations) that were directly engaged with the Syrian refugee crisis response. Design: This study is a cross-sectional survey conducted using a standardized and validated questionnaire. Methods: Centers that provided sexual and reproductive health services to Syrian refugees in Lebanon were mapped. The study was based on a purposive sampling approach, retrieving 52 eligible organizations to cover most areas in the country. A total of 43 centers accepted to take part in the study. The head of the center was then asked to identify one person in their center who holds adequate knowledge of the explained objectives of the survey. Accordingly, the identified person was asked to fill out the survey. Results: A considerable portion of the respondents had limited knowledge about the specific minimum initial service package objectives and related sexual and reproductive health services. The study found the presence of a leading reproductive health agency, the Lebanese MoPH, as an essential facilitating factor for sexual and reproductive health service provision in Lebanon and has helped in overseeing the overall sexual and reproductive health coordination response for Syrian refugees (76.74% of all respondents). The identified challenges impeding adequate sexual and reproductive health services provision for Syrian refugees included (1) insufficient supplies (46.51%); (2) insufficient funds (39.53%); and (3) shortage of staff (39.53%). Conclusion: The recommendations for improved sexual and reproductive health service provision include the need for (1) enforcing the lead minimum initial service package agency for adequate and effective coordination, reporting, and accountability and (2) increasing funding for training staff and healthcare workers, as well as improving the overall quality of services available with the inclusion of family planning services, purchasing the necessary commodities, supplies and equipment, and covering fees associated with the different sexual and reproductive health services.
“Yes, I can bond.” Reflections of autistic women’s mothering experiences in the early postpartum period
Authors: Donovan Jane , Chiatti Beth Desaretz , McKeever Amy , Bloch Joan Rosen , Gonzales Maureen Sullivan , Birati Yosefa 
Published: May 2023

Background: Autism is a neurodevelopmental condition affecting communication and social interaction. Much of the research regarding childbirth and motherhood is focused on non-autistic women. Autistic mothers may experience challenges communicating their needs to health care professionals and find aspects of the hospital environment distressing, indicating a need for more informed practice. Objective: To describe the experiences of autistic women bonding with their newborns after delivery in an acute care setting. Design: The study used a qualitative interpretative description design with data analysis using the method described by Knafl and Webster. The study explored the women’s childbirth experiences in the early postpartum period. Method: Interviews were conducted using a semi-structured interview guide. The women were interviewed in a setting of their choosing and included in person meetings, meetings over Skype, over the telephone, or via Facebook messenger. Twenty-four women ages 29–65 years participated in the study. The women were from the United States, the United Kingdom, and Australia. All women gave birth to a healthy term newborn in an acute care setting. Results: Three major themes emerged from the data: having difficulty communicating, feeling stressed in an uncertain environment, and being an autistic mother. Conclusion: The autistic mothers in the study expressed love and concern for their babies. Some women described needing more time to recover physically and emotionally before assuming care of the newborn. The stress of childbirth left them exhausted and the demands of caring for a newborn could be overwhelming for some women. Miscommunication during labor affected some of the women’s ability to trust the nurses caring for them and, in two cases, left the women feeling judged as mothers.
Perceptions of vaccine trust and conspiracy among those with COVID-19 vaccine hesitancy and resistance: a cross-sectional study
Authors: ERİŞ Hüseyin , KARASU Fatma , AYAR Duygu 
Published: May 2023

Background: Individuals’ beliefs in conspiracy theories and anti-vaccination defense play a role in the rates of COVID-19 spread. Purpose: This study aims to determine the perception of trust in, and the perception of conspiracy theories regarding vaccines among those with COVID-19 vaccine hesitancy and resistance in a province in Turkey. Methods: This study was conducted with 1244 individuals who agreed to participate in the study in the province with the lowest vaccination rate in Turkey. The ‘Personal Information Form’ and the ‘COVID-19 Vaccine Perception and Attitude Scale’ were used to collect data. Findings: Those who were resistant to vaccines had a low mean score on the Perception of Trust and a high mean score on the Perception of Conspiracy. The variable of conspiracy perception had a significantly negative and high effect on the perception of trust. Conclusion: The participants were highly resistant to COVID-19 vaccines. Their perception level of trust in COVID-19 vaccines was moderate and their perception level of conspiracy was high.