bluuebunny/crossref_metadata_2025_split huggingface dataset:
Observational study of effects of pharyngeal stimulation by carbonated solution on repetitive voluntary swallowing in humans
Authors: Tsuchiya Mika , Kubo Yumiko , Maruyama Naomi , Omori Chie , Fukami Hideyuki 
Published: August 2023

In this study, we conducted observational study to examine the effects of pharyngeal stimulation by a bolus of carbonated solution on repetitive voluntary swallowing in humans.
Twelve healthy participants had a fine silicone tube inserted into their pharyngeal region, through which various solutions were slowly infused (0.2 mL/minute) to stimulate the pharyngeal mucosa without activating mechanoreceptors. The solutions included 0.3M NaCl (NaCl), carbonated 0.3M NaCl (NaCl + CA), 0.3M NaCl with acetic acid, distilled water, and carbonated distilled water. We used NaCl to inhibit water-sensitive neurons in the pharyngeal mucosa and enable the evaluation of the effects of carbonic acid stimulation on swallowing. Participants were instructed to repeat swallows as rapidly as possible during the infusion, and the swallowing interval (SI) was measured via submental surface electromyographic activity.
SI was significantly shorter during the infusion of NaCl + CA, distilled water, and carbonated distilled water than during the infusion of NaCl. There was a significant positive correlation between SI with NaCl stimulation and the facilitative effects of the other solutions. Longer SIs with NaCl stimulation indicated potent facilitative effects. Thus, stimulation with NaCl + CA facilitated swallowing by reducing SI. Furthermore, the facilitative effects of SI were more pronounced in participants who had difficulty with repetitive voluntary swallowing.
The sensation induced by carbonated solution may enhance the ability for repetitive voluntary swallowing, making it a potentially useful approach for rehabilitating patients with dysphagia.
Urinary continence in high-risk prostate cancer after robot-assisted radical prostatectomy
Authors: Wu Xiaobo , Wong Chris Ho-Ming , Gandaglia Giorgio , Chiu Peter Ka-Fung 
Published: August 2023

Purpose of review
Urinary incontinence is common postoperative complication following robot-assisted radical prostatectomy (RARP) in patients with prostate cancer (PCa). Despite the increasing adoption of RARP in the treatment of high-risk PCa (HRPC), concerns persist regarding the adequacy of reported continence outcomes in this subgroup. This review aims to illuminate the state of continence recovery in HRPC patients post-RARP.

Recent findings
Urinary continence (UC) recovery rates in HRPC was reported to be lower than the intermediate/low-risk counterparts from 6 to 24 months post-RARP. Predictive models showed that age, obesity, race, disease status, and surgical approaches represent predictors of continence recovery. Special techniques like NeuroSAFE technique and Retzius-Sparing approach also play a role in reducing incontinence also in the high-risk scenario.

Summary
RARP for HRPC appears to be associated with worse continence compared with other risk groups. A multimodality approach for prediction and prevention of incontinence after RARP is vital. Further research into this area is necessary to enhance continence recovery outcomes in HRPC patients undergoing RARP.
Addressing Diversity, Equity, and Inclusivity Contributions in Academic Review
Authors: Noone Joanne , Murray Teri A. 
Published: August 2023

Background:
The nursing profession and academic environments are increasingly calling for nurse educators to incorporate diversity, equity, and inclusion (DEI) goals and actions into their professional practice. Such work aligns with institutional and professional missions of social justice and antiracism.

Problem:
Historically, there has been an undervaluing and lack of recognition in academia of DEI contributions and qualitative or community-based research focused on health equity. This lack of recognition may disproportionately impact faculty who focus their scholarship and research on marginalized communities.

Approach:
The current state of the academic review of DEI contributions for appointment, promotion, and tenure is presented. Examples for teaching, research and scholarship, practice, and service are provided.

Outcomes:
Recommendations include expanding recognition and evaluation of academic scholarship and advocacy against efforts to dismantle social justice and antiracism advances within academia.

Conclusion:
Examining hegemonic norms is vital to promote more equitable power structures in academic environments.
Effects of an Interactive e-Book on Enhancing Nursing Students' Knowledge, Confidence, and Learning Self-efficacy of Nursing Skills
Authors: Yu Tzu-Yuan , Huang Tsai-Wei , Huang Hui-Chuan , Li Siao-Yun , Chuang Yeu-Hui 
Published: August 2023

Background:
Interactive e-books offer multimedia and interactive features that make them particularly suitable for learning nursing skills and also allow for easy content updating, ensuring that students learn the most current skills based on the latest clinical guidelines.

Purpose:
To examine the effectiveness of an interactive e-book in increasing nursing students' knowledge, confidence, and learning self-efficacy of performing nasogastric tube feeding.

Methods:
A randomized controlled trial was conducted with 62 nursing students, with the experimental group using an interactive e-book for learning whereas the comparison group using a printed textbook.

Results:
The experimental group demonstrated significantly greater knowledge and confidence improvements than the comparison group, but no significant difference was found in learning self-efficacy. The experimental group was significantly more satisfied with the learning materials than the comparison group.

Conclusions:
Interactive e-books are more effective in enhancing nursing students' knowledge and confidence in performing nursing skills than printed textbooks.
“Make-up” Examinations
Authors: Bultas Margaret W. , Schmuke Ashley , Armstrong Kathleen , Rubbelke Cynthia , Alnawman Mohammed , Moran Vicki , Fuller Kelli , Cole Briauna , Lovan-Gold Kelly 
Published: August 2023

Background:
Nursing faculty may have concerns about unfair advantages and inflated examination grades when students take an examination late.

Purpose:
The purpose of the study was to compare make-up examination scores with on-time examination scores to determine whether scores were higher in students who took an examination late.

Methods:
A descriptive, comparative study using retrospective examination scores from a large nursing program was analyzed. Late examination scores were compared with the student's individual on-time examination average and the class's average of on-time examination scores.

Results:
A total of 156 examinations were taken late. There were no statistically significant differences between students’ late examination scores when compared with the student's on-time examinations or the class average of the examination.

Conclusion:
Students do not appear to gain an advantage when taking an examination late. Findings may assist faculty in developing policies for taking make-up examinations.
Designing and delivering public engagement activities together with patient partners: The experience of Public Conference on Cancer
Authors: Savas Sevtap , Follett Alicia , Bishop Derrick , King John , Taylor-Cutting Janine , Bilash Tristan , Etchegary Holly , Whitten Cindy , Stuckless Teri 
Published: August 2023

Abstract
Public outreach and engagement activities can greatly benefit from collaborating with patient partners in planning and execution. Here, we describe and reflect on our experience regarding the organization and delivery of the Public Conference on Cancer, a virtual public event that aimed to exchange knowledge on cancer, cancer lived experiences, and cancer services and support in Newfoundland and Labrador, Canada. The Public Interest Group on Cancer Research, including 12 cancer-affected members, four scientists, as well as a clinician and a research assistant formed the conference organizing team. The team's experiences and reflections and the feedback received after the Conference were used to distill perspectives gained, lessons learned, and opportunities identified. The Public Conference on Cancer was a successful public engagement event. It reached out to the general public, initiated new or strengthened existing connections among stakeholders, disseminated important clinical and social knowledge on cancer, and gave us further ideas and expertise to use in future public outreach activities. We also realized challenges remaining, such as the need to improve accessibility and recruitment, and unique considerations for patient speakers and speakers from special/vulnerable communities. While there are considerations that need to be further elaborated and integrated for widely accessible public engagement activities, partnering with cancer patients and family members in designing and delivering public outreach activities is effective in knowledge dissemination, personal and professional growth, and forming connections with stakeholders.
Evidence-Based Practices in Facial Reanimation Surgery
Authors: Aronson Sofia , Applebaum Sarah A. , Kelsey Lauren J. , Gosain Arun K. 
Published: August 2023

Learning Objectives:
After studying this article, the participant should be able to: 1. Describe the causes and preoperative evaluation of facial paralysis. 2. Discuss techniques to restore corneal sensation and eyelid closure, elevation of the upper lip for smile, and depression of the lower lip for lip symmetry. 3. Outline treatment goals, surgical treatment options, timing of repair, and other patient-specific considerations in appropriate technique selection.

Summary:
Congenital facial paralysis affects 2.7 per 100,000 children; Bell palsy affects 23 per 100,000 people annually; and even more people are affected when considering all other causes. Conditions that impair facial mimetics impact patients’ social functioning and emotional well-being. Dynamic and static reconstructive methods may be used individually or in concert to achieve adequate blink restoration, smile strength and spontaneity, and lower lip depression. Timing of injury and repair, patient characteristics such as age, and cause of facial paralysis are all considered in selecting the most appropriate reconstructive approach. This article describes evidence-based management of facial paralysis.
Immediate Prepectoral Implant-Based Breast Reconstruction after J-Pattern Skin-Reducing Mastectomy
Authors: Caputo Glenda Giorgia , Pisano Gaetano , Albanese Roberta , Mura Sebastiano , Scarabosio Anna , Contessi Negrini Filippo , Parodi Pier Camillo 
Published: August 2023

Summary:
Skin-reducing mastectomy for single-stage reconstruction is an oncologically safe procedure used in women with large and ptotic breasts. This study describes a new technique, the J-pattern skin-reducing breast reconstruction with prepectoral implant and acellular dermal matrix (Braxon fast), which is indicated for patients with large and ptotic breasts who would benefit from a breast reduction and need a mastectomy for curative or prophylactic purposes. The authors present a case series of 35 breasts of 19 women who underwent this procedure from January of 2021 through December of 2022 at the Plastic and Reconstructive Surgery Department of the University Hospital Santa Maria della Misericordia, in Udine, Italy, with a median follow-up of 15 months. The advantages of the J scar consist of a reduced risk of skin necrosis, a reduced bottoming-out rate, simplification of the surgical design, and lower impact of scars not involving the medial quadrants of the breast. Patients were administered the BREAST-Q 2.0 postoperative questionnaire at 3 months postoperatively, which showed a high average level of satisfaction with the reconstruction. This surgical technique is a valid option for patients who have voluminous breasts and adequate pinch test results who wish to undergo immediate heterologous reconstruction along with curative or prophylactic mastectomy.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Patient-Reported Satisfaction and Health-Related Quality of Life in Patients with Breast Augmentation: A Follow-Up of 6 Months
Authors: Luong Kim Phi , Peters Magdalena , Slijper Harm P. , Hummelink Stefan , Ulrich Dietmar J. O. 
Published: August 2023

Background:
To evaluate the success of a breast augmentation, it is essential to measure outcomes from the patient perspective, because a successful aesthetic result is, in particular, determined by the patient. This study aimed to evaluate patient-reported satisfaction with their breasts, and psychosocial, physical, and sexual well-being in patients undergoing breast augmentation using validated questionnaires.

Methods:
This is a multicenter cohort study based on ongoing routinely collected data. Patient-reported satisfaction and health-related quality of life were assessed with the BREAST-Q augmentation module at intake and 6 months postoperatively.

Results:
A total of 1405 patients were included. Large changes in BREAST-Q scores (range, 0 to 100) between intake and 6 months postoperatively were seen in satisfaction with breasts (mean, effect size: +57, 3.8), psychosocial well-being (mean, effect size: +38, 2.1), physical well-being (mean, effect size: −14, −1.2), and sexual well-being (mean, effect size: +44, 2.4). Moreover, improvements in all four scales were not dependent on their intake scores, and all postoperative scores reached similar levels. A decreased physical well-being of the chest was measured after surgery. The satisfaction with breasts scale correlated moderately to strongly with the psychosocial and sexual well-being scale 6 months after surgery. Subgroup analysis based on patient characteristics found no differences in outcomes, except for body mass index.

Conclusions:
Significant improvement in patient-reported satisfaction with breasts, psychosocial well-being, and sexual well-being can be seen 6 months after breast augmentation, despite a decline in physical well-being after treatment. Postoperative satisfaction levels did not depend on preoperative scores. These insights can contribute to improving preoperative communication between surgeon and patient regarding the expected outcomes.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Does medial calcaneal wedge improve static balance and load distribution in young adults with pronated foot?
Authors: Guven Izgi , Yagci Gozde , Erel Suat 
Published: August 2023

Background:
Foot orthoses changing the momentum in the subtalar joint are often recommended, especially in activities loading the foot, to bring the pronated foot posture closer to neutral.

Objective(s):
To examine the immediate effect of medial heel wedge on static balance and load distribution in patients with increased pronation in the foot.

Study Design:
Experimental study design.

Methods:
Forty people with right dominant lower extremity participated in the study. For static balance assessment, we assessed ellipse surface, sway length, x-y mean, AP index, and Romberg ratio on 1 foot and measured load distribution as right-left foot and fore-hind foot with and without wedge.

Results:
There was a difference between the parameters of the ellipse surface and the Romberg ratio on the left side in the measurements performed with and without wedge for static balance on the left side (P < 0.05) while there was no difference in the remaining values (P > 0.05). In the load distribution, the change in the right anteroposterior foot was significant, increasing the load on the forefoot with the wedge (P < 0.05) while we observed no difference in the left fore-hind foot load distribution and right-left foot load distribution (P > 0.05).

Conclusion:
Our study showed that for static balance, medial wedge can improve balance on the left side by decreasing sway, and for load distribution, the medial wedge changed the load distribution from back to front on the right side. These small differences in young healthy individuals are a preliminary indication that further studies are needed.
Does the Type of Failure and the Choice of the Second Biologic Influence Response and Persistence on Medication in Rheumatoid Arthritis?
Authors: Bessette Louis , Movahedi Mohammad , Reed George , Kremer Joel M. , Kane Kevin , Keystone Edward 
Published: August 2023

Background
The type of failure may predict response to a second biologic. We evaluated the response to a second tumor necrosis factor inhibitor (TNFi) or non-TNFi in patients failing their initial TNFi, either primarily or secondarily.

Methods
Patients with rheumatoid arthritis who were biologic-naive and had a Clinical Disease Activity Index (CDAI) >10, who started their first TNFi for ≥3 months and then switched to a second biologic, were included in the study. Secondary failure was defined as 2 consecutive low-CDAI visits and then switching to a second biologic while they had moderate/severe CDAI. Primary failure was defined if it did not meet the definition of secondary failure, or if they had at least 1 moderate/severe CDAI after 3 months on treatment. We used multivariable logistic regression comparing primary versus secondary failure for achievement of CDAI ≤10 (primary outcome) and minimal clinically important differences (secondary outcome) at 6 months after switch.

Results
Of the 462 patients included, 64.3% and 35.7% stopped the first TNFi because of a primary and secondary failure, respectively. Patients with primary failure had a more severe disease (CDAI mean, 26.39 vs. 21.61; p < 0.001). The likelihood of achieving CDAI ≤10 (odds ratio, 4.367; 95% confidence interval, 2.428–7.856) and minimal clinically important difference (odds ratio, 2.851; 95% confidence interval, 1.619–5.020) was significantly higher for secondary than primary failure regardless of choice of a second agent.

Conclusion
Patients with rheumatoid arthritis with secondary failure to a first TNFi responded better to a second biologic agent, regardless of the choice of biologic.
Unveiling the Significance of Dynamic Arterial Elastance: An Insightful Approach to Assessing Arterial Load in an Endotoxin Shock Model
Authors: Alvarado Sánchez Jorge I. , Caicedo Ruiz Juan D. , Diaztagle Fernández Juan J. , Monge Garcia Manuel I. , Cruz Martínez Luis E. 
Published: August 2023

Abstract

Background
The aim of this study was to investigate the relationship between dynamic arterial elastance (EaDyn) and the pulsatile and steady components of arterial load in an endotoxin shock model using a two-element Windkessel model and to describe the behavior of EaDyn in this model.

Methods
Ten female Yorkshire pigs were administered lipopolysaccharide intravenously to induce endotoxin shock, while three female pigs served as the control group. Measurements of EaDyn (ratio between pulse pressure variation (PPV) and stroke volume variation (SVV)), effective arterial elastance, arterial compliance (Cart), and systemic vascular resistance were taken every 30 minutes in the endotoxin group until shock was induced. In the control group, these variables were measured every 30 minutes for 3 hours. Subsequently, a fluid load was administered to both groups, and measurements were repeated every 30 minutes. After one hour of shock induction, the endotoxin group was divided into two subgroups: one receiving norepinephrine (END-NE) and the other not receiving it (END-F).

Results
EaDyn showed an association with Cart, while PPV was connected to both pulsatile and steady components, and SVV was solely associated with steady components. Additionally, EaDyn exhibited higher values in the END groups than in the control group when shock was achieved. Furthermore, after the administration of norepinephrine, EaDyn displayed higher values in END-F than in END-NE.

Conclusions
The EaDyn variable helps identify changes in the pulsatile component of arterial load, providing valuable guidance for management strategies aimed at improving cardiac performance.
Isolated Sixth Nerve Palsy and COVID-19: A Recurrent Case in a 7-Month-Old Child and Analysis of Reported Cases
Authors: Baldwin Grace E. , Gaier Eric D. , Hennein Lauren M. 
Published: August 2023

Background:
With the SARS-CoV-2 pandemic (COVID-19), data on central and peripheral nervous system involvement, including those causing cranial nerve 6 (CN6) palsy, have been limited to case reports. To extract clinically relevant features of COVID-19–related CN6 palsy, we report on a recurrent pediatric case and analysis of reported cases associated with infection or immunization.

Methods:
A PubMed search revealed 18 cases of isolated CN6 palsy in addition to the index case (n = 19). Clinical characteristics, workup, and temporal associations between systemic symptoms onset or vaccination, symptoms onset, and resolution were compiled and analyzed.

Results:
The median age of CN6 onset was 43 years (interquartile range [IQR]: 28–52). Sixteen cases (84.2%) were associated with COVID-19 illness and 3 (15.8%) were associated with COVID-19 vaccination. Four cases (23.5%) had positive neuroimaging findings. The median latency from first COVID-19 symptoms or vaccination to onset of CN6 palsy was 6 days (IQR: 2.3–16), and the median time from onset to resolution was 30 days (IQR: 14–60). Latency to onset of CN6 palsy was significantly and directly associated with time to resolution (R2 = 0.401, P = 0.010). Patients who had a positive SARS-CoV-2 antibody test had significantly longer days from symptoms to onset (6.0 vs 24.5, P = 0.030), and patients with a positive SARS-CoV-2 polymerase chain reaction test had a significantly shorter time to resolution (17.50 vs 90, P = 0.042).

Conclusions:
Isolated CN6 palsy from COVID-19 is rare, can occur in infants as young as 7 months, and can be recurrent. Longer latency from systemic symptoms onset portends greater recovery times, and this relationship may reflect multiple mechanisms by which COVID-19 (and/or an immune response thereto) causes cranial neuropathies with direct clinical relevance.