bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and Clinical Impact of Endovenous Glue-Induced Hypersensitivity Among Patients Who Underwent Endovenous Cyanoacrylate Ablation Procedures: A Registry-Based Cohort Study
Authors: Yie Kilsoo , Shin A-Rom , Jung Eun-Hee , Hwang Eun-Jung 
Published: May 2023

BACKGROUND
The characteristics of endovenous glue-induced hypersensitivity (EGIH) remain unclear.

OBJECTIVE
To assess the clinical impacts on patients with EGIH after endovenous cyanoacrylate-glue ablation (CA).

MATERIALS AND METHODS
A prospectively designed endovenous CA-specific registry was created, and a total of 335 limbs from 173 patients who underwent endovenous CA were enrolled for a cohort study.

RESULTS
Symptomatic EGIH was observed in 55 (31.8%) patients. Beyond the target vein area, systemic side effects were noted in 5.8% of the treated patients after CA. The median onset time was 13 postoperative days (range: 1–35 days). The median duration was 7 days, but about 10.9% of the affected patients experienced symptoms lasting longer than 4 weeks. In the EGIH and non-EGIH groups, significant improvements in venous clinical severity score and Chronic Venous Insufficiency Quality of Life Questionnaire-14 scores were observed 3 months postoperatively. The development of EGIH did not affect the postoperative patient-reported satisfaction scores (p = .524).

CONCLUSION
EGIH is observed in a substantial proportion of patients. The side effects do not affect the clinical outcomes and patient-reported outcome measures. Further studies are required on the detailed pathogenesis and definition of EGIH.
Modified Reconstruction Technique to Adapt Management of Severe Group IIB Tanzer Constricted Ear Deformity
Authors: Lashin Riham , Shafik Fady Rezk , Elshahat Ahmed , Mohamed Eman Nagy 
Published: May 2023

Background:
Group IIB constricted ear is described as a deformity of helix, antihelix, and scapha (deficient upper third of ear). The length of the ear is markedly shortened, and the skin cover is insufficient to cover the cartilaginous framework after refashioning. The current study described certain modifications to the known autologous auricular reconstruction technique to adapt specific anatomical features of severe group IIB Tanzer constricted ear and reviewed the postoperative surgical outcomes and complications. It also evaluates the postoperative patient satisfaction.

Methods:
A prospective study includes 20 patients who underwent modified autologous reconstruction using costal cartilage for unilateral severe grade IIB constricted ears in the period between October 2018 and November 2021. Mean follow-up period was 6 months. Satisfaction was recorded using a questionnaire form 4 months after second-stage surgery.

Results:
Patients reported excellent (n = 14) and good (n = 7) results. According to a four-point Likert scale, the average aesthetic outcome score was 3.8. No complications were recorded, except in one patient who shows postoperative collection. The helix, concha, and lobule were the most satisfying parts to patients. The least pleasing subunit to patients was the antihelix. All patients were satisfied with the elevation of the auricle. They reported symmetry in size, shape, and position in 14 of 20 (70%) patients.

Conclusions:
Modified autogenous auricular reconstruction is useful in correcting severe group IIB Tanzer constricted ear deformities. Because it addresses all the anatomical features of this deformity, this technique is reproducible and reliable and has offered consistently effective results.
Network Psychometrics of the 10-Item Perceived Stress Scale Among Patients With High Cardiovascular and Type 2 Diabetes Risk Using Exploratory Graph Analysis
Authors: Lee Chiyoung , Wolever Ruth Q. , Min Se Hee , Vorderstrasse Allison A. , Yang Qing 
Published: May 2023

Background
No studies have explored the internal structure of the 10-item Perceived Stress Scale in patients with high cardiovascular and diabetes risk.

Objective
We scrutinized the dimensionality of the scale in this patient group using exploratory graph analysis, a technique within the developing field of network psychometrics.

Methods
Analyses were conducted on 200 primary care patients. A bootstrap version of exploratory graph analysis assessed the stability of the dimensions based on structural consistency, item stability, and network loadings.

Results
Exploratory graph analysis revealed a 2-dimensional structure; structural consistency of the first dimension was high (0.863), whereas that for the second was low (0.667). Items belonging to the latter dimension did not cluster consistently with each other (ie, low item stability) and were not strongly associated with any particular dimension (ie, weak network loadings).

Conclusion
Exploratory graph analysis offers unique outputs, making it easy to assess the dimensional integrity of scales. Further research is warranted regarding the second dimension of the Perceived Stress Scale.
An Integrative Literature Review of Heart Rate Variability Measures to Determine Autonomic Nervous System Responsiveness Using Pharmacological Manipulation
Authors: Maki Katherine A. , Goodyke Madison P. , Rasmussen Kendra , Bronas Ulf G. 
Published: May 2023

Background
Heart rate variability (HRV) is defined as the difference in the timing of intervals between successive heartbeats and is used as a surrogate measure to the responsiveness of the autonomic nervous system. A review and synthesis of HRV as an indicator of autonomic nervous system responsiveness to pharmacologic stimulation/blockade of sympathetic and/or parasympathetic nervous system branches have not been completed.

Purpose
The aim of this integrative review is to synthesize research examining pharmacological modulation of the autonomic nervous system and the response of time domain, frequency domain, and nonlinear measures of HRV.

Conclusions
Sympathetic nervous system blockade resulted in a consistent decrease in the standard deviation of normal-normal interval metric across studies. Stimulation of the parasympathetic nervous system was associated with an increase in several time, frequency, and nonlinear HRV indices, whereas blockade of the parasympathetic nervous system led to a decrease in similar indices.

Clinical Implications
Recommendations to improve the reproducibility of future HRV research are provided for standardization of recording, analysis, and metric decisions and more thorough reporting of HRV indices in published studies. Alterations in autonomic nervous system input to the cardiovascular system are associated with an increased risk for adverse patient outcomes and increased mortality; therefore, understanding the influence of pharmacologic autonomic nervous system modulation on HRV indices and important considerations for reproducible HRV research design will inform future translational research on cardiovascular risk reduction.
Signs and Symptoms Clusters Among Patients With Acute Heart Failure
Authors: Pokhrel Bhattarai Sunita , Dzikowicz Dillon J. , Carey Mary G. 
Published: May 2023

Background
Patients with acute heart failure present to the emergency department with a myriad of signs and symptoms. Symptoms evaluated in clusters may be more meaningful than those evaluated individually by clinicians.

Objective
Among emergency department patients, we aimed to identify signs and symptoms correlations, clusters, and differences in clinical variables between clusters.

Methods
Medical record data included adults older than 18 years, International Classification of Diseases, Tenth Revisions codes, and positive Framingham Heart Failure Diagnostic Criteria. Exclusion criteria included medical records with a ventricular assist device and dialysis. For analysis, correlation, and the Gower distance, the independent t test, Mann-Whitney U test, χ2 test, and regression were performed.

Results
A secondary analysis was conducted from the data set to evaluate door-to-diuretic time among patients with acute heart failure in the emergency department. A total of 218 patients were included, with an average age of 69 ± 15 years and predominantly White (74%, n = 161). Two distinct symptom clusters were identified: severe and mild congestion. The severe congestion cluster had a more comorbidity burden compared with the mild congestion cluster, as measured by the Charlson Comorbidity index (cluster 1 vs cluster 2, 6 [5–7] vs 5 [4–6]; P = .0019). Heart failure with preserved ejection fraction was associated with the severe congestion symptom cluster (P = .009), and heart failure with mildly reduced ejection fraction was associated with the mild congestion cluster (P = .019).

Conclusions
In conclusion, 2 distinct symptom clusters were identified among patients with acute heart failure. Symptom clusters may be related to ejection fraction or overall cardiac output and comorbidity burden.
Gender-Specific Clustering of Lifestyle Behaviors and Its Impacts on Cardiovascular Health
Authors: Noh Songwhi , Choo Jina 
Published: May 2023

Background
Unhealthy lifestyle behaviors associated with cardiovascular risk manifest a clustering pattern.

Objective
Our aim was to identify behavioral clusters by using 5 unhealthy lifestyle behaviors among the Korean population and examine the impacts of identified behavioral clusters on cardiovascular health (CVH).

Methods
A cross-sectional study was conducted using data from the sixth Korea National Health and Nutrition Examination Survey. The participants were 7898, aged 19 to 64 years. The cluster analysis was performed using the behaviors of current smoking, binge drinking, physical inactivity, insufficient fruit intake, and sugar-sweetened beverage drinking. Cardiovascular health was defined as a composite modified z score calculated using biophysical factors.

Results
Men manifested 4 clusters (ie, risky binge drinkers, dominant smokers, dominant sugar-sweetened beverage drinkers, and nonsubstance/low-fruit eaters) characterized predominantly by substance use; women had 4 clusters (ie, substance users, physically inactive/low-fruit eaters, physically inactive/fruit eaters, and active adherers) characterized predominantly by physical inactivity. Among men, the clusters of dominant smokers and risky binge drinkers had significantly lower CVH scores than those with poor eating behaviors. Among women, the clusters of substance users and physically inactive/low-fruit eaters had significantly lower CVH scores than the active adherers. All the clusters in men had lower CVH scores than the worst cluster in women.

Conclusions
There was a gender difference in the clustering pattern. The clusters with smoking and binge drinking in men and women were associated with negative impacts on CVH. Healthcare professionals should pay attention to the clustering pattern to design an efficient lifestyle intervention for cardiovascular disease prevention.
Lived Experience of Violence Perpetrated by Treated Patients and Their Visitors in Intensive Care Units: A Qualitative Study of Nurses
Authors: FANG I-Lu , HSU Mei-Chi , OUYANG Wen-Chen 
Published: May 2023

ABSTRACT

Background
Patient and visitor violence (PVV) is a widespread problem for health professionals. Nurses working in intensive care units (ICUs) face a relatively high risk of experiencing PVV, which significantly impacts both the health of nurses and the institution as a whole. The subjective perceptions of ICU nurses regarding PVV are inadequately explored in the literature.

Purpose
The purpose of this study was to explore the perspectives, experiences, and perceptions of PVV in ICU nurses and to better understand the precipitating factors of violence.

Methods
A phenomenological qualitative design and purposive sampling were used. A semistructured interview guide was used to conduct in-depth interviews with 12 ICU nurses with PVV experiences. Giorgi's method of analysis was used to discover and identify the essential categories of experience.

Results
Five main experience categories were identified: family and patient factors as flashpoints, managing suppressed emotions by weathering the emotional storm, spiritual awakening after violence, and strategies for surviving further violence. The participants' experiences with PVV included a range of caring and mental health difficulties. In ICU settings, patient progress is often unpredictable, resulting in discrepancies between patient/family expectations and reality. Because feelings of frustration and powerlessness can eventually cause exhaustion in ICU nurses, implementing effective emotional management, stress adjustment, psychological counseling, team support, and violence intervention programs are crucial.

Conclusions/Implications for Practice
This study provides new information on the process by which nurses can progress from inner trauma to self-recovery, moving from a negative affectivity disposition to a better understanding of threat appraisals and coping response options. Nurses should increase their awareness of the complexity of the phenomenon and of the interplay among the factors underlying PVV. The results of this study suggest that routine confusion and delirium assessments to rule out patients with ICU delirium in ICUs are important to preventing PVV. This study considers some of the implications of the research findings for nursing managers. Interventions, training programs, and/or management action should be used to ensure psychological and mental support is extended to all witnesses of PVV events and not only to those targeted by violence.
Promoting physical activity in clinical practice through wearable technology
Authors: Carter LaGary , Ford Cassandra D. 
Published: May 2023

ABSTRACTThe negative health consequences of physical inactivity continue to be a global problem that must be addressed from the highest levels of government down to local primary care providers. Physical activity has been identified as a useful patient vital sign in health care. Advanced practice nurses should aggressively prescribe physical activity as an evidence-based intervention to help mitigate the increased mortality and morbidity associated with a sedentary lifestyle. A focused literature review was conducted using PubMed, CINAHL, and the Cochrane online databases. Fitness wearables and mobile health trackers are a catalyst for lifestyle behavior change and cultivate a health care partnership between the patient and their provider. The evolution of fitness wearables into mainstream health care hinges on the ability of devices to integrate into electronic health records, uniformity of manufacturer standards, intuitiveness, and the assurance of user privacy and security. It is incumbent on nurse practitioners to educate themselves about the reliability and practicality of fitness trackers for their patient population. Future research should focus on adopting quality standards for all consumer devices, the seamless integration of device data into electronic health records and ensuring personal privacy and security.
New metrics of dietary carbohydrate quality
Authors: Tan Denise , Drewnowski Adam , Lê Kim-Anne 
Published: May 2023

Purpose of review
The aim of this study was to introduce novel metrics of dietary carbohydrates quality relevant for products and diets.

Recent findings
Carbohydrate quality has long been associated with a low glycemic index. More recently, novel metrics of carbohydrate quality featuring variations of total carbohydrates-fibers-free sugars ratios have been applied to carbohydrate-rich foods, including grains, beans, vegetables, and fruit. High scoring products had higher levels of health-promoting nutrients (protein, dietary fiber, iron, magnesium, zinc, potassium, selenium, and various B-vitamins) and lower levels of nutrients of public health concern (total sugar, added/free sugars, and fat profile). Cross-sectional studies also found variants of carbohydrate quality metrics to be associated with better markers of cardiometabolic disease, including lower levels of blood triglycerides:high-density lipoprotein cholesterol ratio, homeostatic model assessment of insulin resistance, and SBP.

Summary
New ratio-based carbohydrate quality metrics are built around high fiber and whole grain content, combined with a low free sugar content. Such metrics allow the identification of food products of higher overall nutritional quality, and are associated with improved diet quality and certain health outcomes.
Malignant Self-Regard as an Overarching Framework for the Theory and Treatment of Depressive and Masochistic (Self-Defeating) Personalities
Authors: Malone Brady C. , Huprich Steven K. 
Published: May 2023

Abstract
Kernberg and McWilliams have spawned differing conceptualizations of the relationship between depressive and masochistic (self-defeating) personalities. Kernberg describes these personality styles as largely overlapping in features, whereas McWilliams accentuates important clinical differences that make up two distinct personalities. In this article, their theoretical perspectives are discussed and framed as more complementary than competitive. The malignant self-regard (MSR) construct is introduced and reviewed as an integrative self-representation that is shared by both depressive and masochistic personalities, as well as those often referred to as vulnerably narcissistic. We investigate developmental conflicts, motivations for perfectionism, countertransference patterns, and overall level of functioning as four primary clinical features through which a therapist may differentiate a depressive from a masochistic personality. We argue that depressive personalities tend to have more dependency-related conflicts and perfectionistic strivings motivated by lost object reunification, elicit more insidiously positive countertransference reactions in session, and are generally higher-functioning individuals. Masochistic personalities have more oedipal-related conflicts and perfectionistic strivings motivated by object control, elicit more aggressive countertransference reactions, and are relatively lower functioning. MSR is positioned as a bridge between Kernberg's and McWilliam's ideas. We close with a discussion of treatment implications for both disorders as well as how to understand and treat MSR.
Social stigma associated with cancer in the Newfoundland and Labrador population: an exploratory study
Authors: Savas Sevtap , Winsor Mercy , Tenkorang Eric Y. , Simmonds Charlene , Stuckless Teri 
Published: May 2023

Abstract

Background:
Among all Canadians, residents of the province of Newfoundland and Labrador (NL) have the highest risk of developing and dying of cancer. Effects of cancer-associated stigma and discrimination can contribute to the negative consequences of cancer and unnecessarily burden individuals diagnosed with cancer. In this study, we aimed to examine stigma and discrimination-related experiences of individuals diagnosed with cancer and predictors of experiencing stigma in NL.

Methods:
This was a cross-sectional and self-administered online survey study. The survey instrument included both open-ended and closed-ended items, and data were collected between June 2019 and February 2020. Descriptive statistics, thematic analyses, and regression techniques were used for data analysis.

Results:
A total of 325 respondents participated in this study. Self-perceived stigmatization and discrimination were reported by 24% and 14% of the participants, respectively. The most common sources contributing to these experiences were friends, insurance and financial companies, and workplace relations. Issues related to insurance, social relations, and workplace opportunities were among the most common reported impacts of cancer. A large portion of the participants had not experienced stigma and discrimination or experienced anything but positive support from others. Several factors associated with experiencing stigma were also identified, such as age, disease stage, ethnicity, and socioeconomic status. Misconceptions related to cancer, issues with insurance companies, and change of life after cancer were the top themes identified by thematic analysis.

Conclusions:
This study identified a rich overview of cancer-associated lived experiences in the NL population. Educational campaigns on cancer, integration of stigma-related support in cancer care, and stronger antidiscriminatory legislations and practices should be encouraged in NL.
The mediating effect of environmental reward on activity restriction and depressive mood in cancer survivors: a cross-sectional study
Authors: Hata Kotone , Tajima Emi , Suzuki Shin-ichi 
Published: May 2023

Abstract

Background:
Activity restriction is known as a predictor of depressive mood in cancer survivors. However, there is inconsistent evidence about precisely how this takes place. Environmental reward is a state where a person senses mastery or pleasure because of their activity, and this is known to be a possible mediator of the activity restriction effect on depressive mood. We sought to investigate that the mediating effect environmental reward could have on the relationship between activity restriction and depressive mood when moderated by cancer-related fatigue.

Methods:
Cancer survivors (n = 94; mean age, 60.07 years) recruited through cancer support groups in Japan participated in this study. They completed a battery of questionnaires, including demographic and clinical information about the respondents, the Activity Restriction Scale for Cancer Patients—Revised, the Environmental Reward Observation Scale, the Cancer Fatigue Scale, and the Hospital Anxiety and Depression Scale.

Results:
Moderated mediation analysis revealed that high levels of activity restriction predict a decrease in environmental reward, and a decrease in environmental reward exacerbates depressive mood. The full mediating effect (when the indirect effect is statistically significant and there is no direct effect from the antecedent to outcome) of environmental reward was observed when cancer-related fatigue was moderated by ±1 SD of the mean score. This implies that, regardless of the level of fatigue cancer survivors experience, it is not the activity restriction per se that predicts depressive mood but rather the inability to experience pleasurable emotions because of the activity restriction that leads to the exacerbation of depressive mood.

Conclusion:
From these results, environmental reward was found to be a possible mediator of activity restriction on depressive mood, consistent with behavioral models of depression. These results could explain the inconsistent findings about the direct effect of activity restriction on depressive mood and provide theoretical evidence for the effectiveness of psychological treatments for cancer survivors that focus on positive affect, such as behavioral activation interventions.