bluuebunny/crossref_metadata_2025_split huggingface dataset:
Issues in the Professional Preparation of Secondary School Special Educators
Authors: Miller Sidney R. , Sabatino David A. , Larsen Roger P. 
Published: January 2022

The purpose of this study was to contrast university views with those of practitioners in defining professional preparation program efforts for secondary special educators. The impetus for the study was the paucity of secondary special education preparation programs (distinct from elementary, with clearly identifiable course patterns] in university catalog copy in the six states that comprise the US Department of Health, Education, and Welfare's Region Five. Discrepancies were noted between administrators in local education agencies and those in universities on three issues: fa) the preparation of secondary special educators in language remediation, (b) the restructuring of the standard K-12 teaching certificate into a K-6 and 7–12 licensure, and (c) the identification of teaching competencies necessary to the successful implementation of mainstreaming.
Endoscopic Repair of Spontaneous Cerebrospinal Fluid Leaks in the Lateral Recess of the Sphenoid Sinus
Authors: Huang Zhenxiao , Huang Qian , Cui Shunjiu , Qiu E. , Xian Junfang , Yang Bentao , Huo Mingrui , Zhou Bing 
Published: January 2022

ObjectiveThis study aimed to assess the effectiveness of 3 endoscopic endonasal approaches for the management of cerebrospinal fluid (CSF) leaks and meningoencephaloceles in the lateral recess of the sphenoid sinus (LRSS).Study DesignRetrospective study.SettingUniversity hospital.MethodsThis study retrospectively reviewed 49 patients with CSF leaks and meningoencephaloceles in the LRSS. Three endoscopic surgical repair approaches were indicated based on 5 different Rhoton’s types of the LRSS. The postoperative symptoms, complications, and follow‐up outcomes were investigated and evaluated.ResultsThe success rate of endoscopic surgical repair was 100% at a median follow‐up of 75.06 (12‐203.4) months. Endoscopic approaches to the LRSS included the prelacrimal recess (PLR) (18.37%), transsphenoidal (18.37%), and transpterygoid approaches (64.26%). All patients in the PLR approach (PLRA) group and most of the patients in the transpterygoid approach group had a full lateral type LRSS. Hypoesthesia and dry eyes were reported in 5 patients (55.56%) and 1 (11.12%) patient, respectively, from the PLRA group and in 6 (19.35%) and 5 (16.12%) patients, respectively, from the transpterygoid approach group.ConclusionsEndoscopic closure is a safe and effective method for the treatment of CSF leaks and meningoencephaloceles in the LRSS. The transpterygoid approach and PLRA offer adequate exposure of the LRSS with extensive lateral pneumatization or a full LRSS. The endoscopic route of the PLRA is more direct than that of the transpterygoid approach. Careful preoperative imaging evaluation is crucial while selecting the optimal surgical approach for the repair of a skull base defect.
Neuroprotective strategies with circulatory arrest in open aortic surgery – A meta-analysis
Authors: Manoly Imthiaz , Uzzaman Mohsin , Karangelis Dimos , Kuduvalli Manoj , Georgakarakos Efstratios , Quarto Cesare , Ravishankar Ramanish , Mitropoulos Fotis , Nasir Abdul 
Published: January 2022

Objective Deep hypothermic circulatory arrest (DHCA) in aortic surgery is associated with morbidity and mortality despite evolving strategies. With the advent of antegrade cerebral perfusion (ACP), moderate hypothermic circulatory arrest (MHCA) was reported to have better outcomes than DHCA. There is no standardised guideline or consensus regarding the hypothermic strategies to be employed in open aortic surgery. Meta-analysis was performed comparing DHCA with MHCA + ACP in patients having aortic surgery. Methods A systematic review of the literature was undertaken. Any studies with DHCA versus MHCA + ACP in aortic surgeries were selected according to specific inclusion criteria and analysed to generate summative data. Statistical analysis was performed using STATS Direct. The primary outcomes were hospital mortality and post-operative stroke. Secondary outcomes were cardiopulmonary bypass time (CPB), post-operative blood transfusion, length of ICU stay, respiratory complications, renal failure and length of hospital stay. Subgroup analysis of primary outcomes for Arch surgery alone was also performed. Results Fifteen studies were included with a total of 5869 patients. There was significantly reduced mortality (Pooled OR = +0.64, 95% CI = +0.49 to +0.83; p = 0.0006) and stroke rate (Pooled OR = +0.62, 95% CI = +0.49 to +0.79; p < 0.001) in the MHCA group. MHCA was associated significantly with shorter CPB times, shorter duration in ICU, less pulmonary complications, and reduced rates of sepsis. There was no statistical difference between the two groups in terms of circulatory arrest times, X-Clamp times, total operation duration, transfusion requirements, renal failure and post-op hospital stay. Conclusion MHCA + ACP are associated with significantly better post-operative outcomes compared with DHCA for both mortality and stroke and majority of the secondary outcomes.
Use of On-Site Digital Subtraction Angiography for Left Subclavian Artery Management During Hybrid Aortic Arch Repair in DeBakey I Dissection
Authors: Haldenwang Peter-Lukas , Elghannam Mahmoud , Buchwald Dirk , Strauch Justus 
Published: January 2022

Purpose: A hybrid aortic repair using the frozen elephant trunk (FET) technique with an open distal anastomosis in zone 2 and debranching of the left subclavian artery (LSA) has been demonstrated to be favorable and safe. Although a transposition of the LSA reduces the risk of cerebellar or medullar ischemia, this may be challenging in difficult LSA anatomies. Case Report: We present the case of a 61-year old patient with DeBakey I aortic dissection, treated with FET in moderate hypothermic circulatory arrest (26°C) and selective cerebral perfusion using a Thoraflex-Hybrid (Vascutek Terumo) prosthesis anchored in zone 2, with overstenting of the LSA orifice and no additional LSA debranching. Sufficient perfusion of the LSA was proved intraoperatively using LSA backflow analysis during selective cerebral perfusion in combination with on-site digital subtraction angiography (ARTIS Pheno syngo software). No neurologic dysfunction or ischemia occurred in the postoperative course. An angiographic computed tomography revealed physiologic LSA perfusion, with subsequent thrombotic occlusion of the false lumen in the proximal descending aorta after 7 days. Conclusion: Using an angiography-guided management in patients with complex DeBakey I dissection and difficult anatomy may simplify a proximalization of the distal anastomosis in zone 2 for FET, even without an additional LSA debranching.
Physiological predictors of cardiorespiratory fitness in children and adolescents with cystic fibrosis without ventilatory limitation
Authors: Burghard Marcella , Takken Tim , Nap-van der Vlist Merel M. , Nijhof Sanne L. , van der Ent C. Kors , Heijerman Harry G.M. , Hulzebos H.J. Erik 
Published: January 2022

Objectives: [1] To investigate the cardiorespiratory fitness (CRF) levels in children and adolescents with cystic fibrosis (CF) with no ventilatory limitation (ventilatory reserve ⩾ 15%) during exercise, and [2] to assess which physiological factors are related to CRF. Methods: A cross-sectional study design was used in 8- to 18-year-old children and adolescents with CF. Cardiopulmonary exercise testing was used to determine peak oxygen uptake normalized to body weight as a measure of CRF. Patients were defined as having ‘low CRF’ when CRF was less than 82%predicted. Physiological predictors used in this study were body mass index z-score, P. Aeruginosa lung infection, impaired glucose tolerance (IGT) including CF-related diabetes, CF-related liver disease, sweat chloride concentration, and self-reported physical activity. Backward likelihood ratio (LR) logistic regression analysis was used. Results: Sixty children and adolescents (51.7% boys) with a median age of 15.3 years (25th–75th percentile: 12.9–17.0 years) and a mean percentage predicted forced expiratory volume in 1 second of 88.5% (±16.9) participated. Mean percentage predicted CRF (ppVO2peak/kg) was 81.4% (±12.4, range: 51%–105%). Thirty-three patients (55.0%) were classified as having ‘low CRF’. The final model that best predicted low CRF included IGT ( p = 0.085; Exp(B) = 6.770) and P. Aeruginosa lung infection (p = 0.095; Exp(B) = 3.945). This model was able to explain between 26.7% and 35.6% of variance. Conclusions: CRF is reduced in over half of children and adolescents with CF with normal ventilatory reserve. Glucose intolerance and P. Aeruginosa lung infection seem to be associated to low CRF in children and adolescents with CF.
Clinical effectiveness of symptomatic therapy compared with standard step-up care for the treatment of low-impact psoriatic oligoarthritis: the two-arm parallel group randomised POISE feasibility study
Authors: Rombach Ines , Tucker Laura , Tillett William , Jadon Deepak , Watson Marion , Francis Anne , Sinomati Yvonne , Dutton Susan J , Coates Laura C 
Published: January 2022

Introduction: In psoriatic arthritis (PsA), treatment recommendations support first-line use of disease-modifying antirheumatic drugs (DMARDs). There are few treatment strategy trials, and no previous studies have investigated tailored treatment choice by disease severity. Studies in oligoarthritis (<5 inflamed joints) are limited but have suggested that some can be managed without DMARDs, preventing unnecessary side effects. This study aimed to assess the feasibility and acceptability of a study comparing standard DMARD treatment against symptomatic therapy in patients with mild psoriatic oligoarthritis. Methods: This trial was embedded within the MONITOR-PsA cohort, which uses a Trials Within Cohorts (TWiCs) design. Patients with newly diagnosed psoriatic oligoarthritis, with low disease activity (PASDAS ⩽ 3.2) and the absence of poor prognostic factors [C reactive protein (CRP) < 5 mg/dL, HAQ < 1, no radiographic erosions] were randomised open-label to either standard care with ‘step-up’ DMARD therapy or to symptomatic therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) and local corticosteroid injections to inflamed joints. Key outcomes were the proportion of eligible cohort patients, consent and study completion rate. Results: Over the 15-month study period, only one eligible patient was randomised. Although oligoarthritis patients represented 45% of patients in this early PsA cohort, the majority did not have mild disease (24% raised CRP, 51% moderate disease activity, 13% radiographic damage and/or poor function). Of those meeting trial inclusion criteria, many patients refused treatment in the observational cohort prior to an invitation into the trial as they did not wish to be treated with DMARDs. Conclusion: The study was not feasible as designed. Oligoarthritis represents around half of initial PsA presentations, but the majority starting therapy have high-impact disease. A small proportion have mild oligoarticular disease but many are not keen on treatment with DMARDs, given the potential side effects of these medications. Further research is needed to support evidence-based treatment in this subgroup. Trial registration number – ClinicalTrials.gov (NCT03797872) and EudraCT (2018-001085-42).
Hospital Greenspaces and the Impacts on Wayfinding and Spatial Experience: An Explorative Experiment Through Immersive Virtual Environment (IVE) Techniques
Authors: Jiang Shan , Allison David , Duchowski Andrew T. 
Published: January 2022

Background: Navigating large hospitals can be very challenging due to the functional complexity as well as the evolving changes and expansions of such facilities. Hospital wayfinding issues could lead to stress, negative mood, and poor healthcare experience among patients, staff, and family members. Objectives: A survey-embedded experiment was conducted using immersive virtual environment (IVE) techniques to explore people’s wayfinding performance and their mood and spatial experience in hospital circulation spaces with or without visible greenspaces. Methods: Seventy-four participants were randomly assigned to either group to complete wayfinding tasks in a timed session. Participants’ wayfinding performances were interpreted using several indicators, including task completion, duration, walking distance, stop, sign-viewing, and route selection. Participants’ mood states and perceived environmental attractiveness and atmosphere were surveyed; their perceived levels of presence in the IVE hospitals were also reported. Results: The results revealed that participants performed better on high complexity wayfinding tasks in the IVE hospital with visible greenspaces, as indicated by less time consumed and shorter walking distance to find the correct destination, less frequent stops and sign viewing, and more efficient route selection. Participants also experienced enhanced mood states and favorable spatial experience and perceived aesthetics in the IVE hospital with visible greenspaces than the same environment without window views. IVE techniques could be an efficient tool to supplement environment-behavior studies with certain conditions noted. Conclusions: Hospital greenspaces located at key decision points could serve as landmarks that positively attract people’s attention, aid wayfinding, and improve their navigational experience.
COVID-19–Associated Acute Asymmetric Hemorrhagic Necrotizing Encephalopathy: A Case Report
Authors: Jomaa Najo , El Halabi Tarek , Melhem Jawad , Dib Georgette , Ghosn Youssef , Hourani Mukbil , Nasreddine Wassim , Beydoun Ahmad 
Published: January 2022

Background: Coronavirus disease 2019 (COVID-19) has been associated with many neurological complications affecting the central nervous system. Purpose: Our aim was to describe a case of COVID-19 associated with a probable variant of acute necrotizing encephalopathy (ANE). Results: A 60-year-old man who presented with a 3-day history of dyspnea, fever, and cough tested positive for severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2). Five days following his admission, the patient was intubated secondary to respiratory failure. Following his extubation 16 days later, he was found to have a left-sided weakness. Magnetic resonance imaging (MRI) of the brain showed hemorrhagic rim-enhancing lesions involving the right thalamus, left hippocampus, and left parahippocampal gyrus. These lesions showed decreased relative cerebral blood flow on MR perfusion and restricted on diffusion-weighted imaging. These neuroimaging findings were consistent with ANE. The left-sided weakness gradually improved over the subsequent weeks. Conclusions: We concluded that COVID-19 can be associated with ANE, a condition believed to be the result of an immune-mediated process with activation of the innate immune system. Future studies must address whether biological drugs targeting the pro-inflammatory cytokines could prevent the development of this condition.
Anti-NMDAr Encephalitis and COVID-19 in a Patient With Systemic pANCA-Vasculitis and Recurrent Varicella Zoster Infection
Authors: Moura João , Duarte Sara , Sardoeira Ana , Neves-Maia João , Damásio Joana , Taipa Ricardo , Carneiro Paula , Neves Esmeralda , Campar Ana , Santos Ernestina 
Published: January 2022

Introduction There is a complex interplay between systemic autoimmunity, immunosuppression, and infections. Any or all of these can result in neurologic manifestations, requiring diligence on the part of neurologists. Case report We herein report a case of a patient on immunosuppressive treatment for a vasculitis that resulted in zoster meningoencephalitis. This was further complicated by the development of anti-NMDAr encephalitis, the etiology of which is undetermined and further discussed in this paper. The patient eventually developed COVID-19 during hospitalization, succumbing to the respiratory infection. Conclusion This case emphasizes that post-infectious autoimmune disorders are becoming increasingly recognized and that they should still be considered in patients who are on immunosuppression. Practitioners should be aware of the complex relationship between autoimmunity and immunosuppression and consider both throughout the disease course.
Systematic Review of the Influence of Physical Work Environment on Office Workers’ Physical Activity Behavior
Authors: Michalchuk Victoria F. , Lee Soo-Jeong , Waters Catherine M. , Hong Oi Saeng , Fukuoka Yoshimi 
Published: January 2022

Background Many American workers spend over 7 hours a day at work in primarily sedentary office work. Physical activity is a key aspect of optimizing health and preventing disease; yet, 80% of American adults do not meet the recommended guidelines for physical activity. In this systematic review, the relationship between physical work environment and physical activity among office workers was explored. Methods Of the 321 studies screened, 26 studies met the eligibility criteria and were included for evaluation in this systematic review. Results Of the 26 studies, four were cross-sectional studies, 14 were quasi-experimental studies, and eight were randomized control trials. Physical activity during the workday was measured using self-report surveys and electromechanical devices such as accelerometers. Physical work environments examined by the studies included different types of desks ( n = 16), office arrangements ( n = 5), and building design ( n = 5). In nine studies, office environments and building work environments designed to promote activity using active design principles such as stairs and flexible workspaces were associated with increased physical activity. Sit–stand desks reduced overall sitting time, but had a minimal effect on physical activity. Conclusion/Application to practice Offices and buildings designed for activity had the largest impact on physical activity among office workers. To increase physical activity in office workers, focus should be placed on opportunities to increase incidental movement that can increase physical activity throughout the workday. Occupational health nurses should advocate workspace designs that can increase physical activity in workers.
The Awareness and Empowerment Aspects of the Needlesticks and Other Sharps Injuries and Reporting in Nursing Education: A Cross-Sectional Survey
Authors: Bilek Özgür , Kiran Sibel , Duygulu Sergül , Yıldız Ali N. 
Published: January 2022

Background Occurrence and underreporting of needlesticks and other sharps injuries (NSIs) are still immediate concerns among nursing students. This study examined the relationship between occupational health and safety (OHS) awareness and empowerment levels of nursing students and the occurrence and reporting of NSIs. Methods This cross-sectional study was conducted among purposively selected 840 students in a nursing school in 2018–2019. A self-report questionnaire was used to collect data about students’ sociodemographic characteristics, OHS awareness and empowerment levels, and NSIs characteristics. After bivariate analyses, multivariate logistic regression was used. Results The number of evaluated questionnaires was 469, for a response rate of 55.8%. Participants, 21.2% ( n = 99), had suffered NSIs, and 47.8% had reported their injuries. The NSIs were statistically related to age, academic year, working night shift, OHS awareness level of students, and the number of clinical placements completed by students. The odds of experiencing NSIs was 2.3 (95% confidence interval [CI] = [1.0, 5.3]) times higher in male students, 4.3 (95% CI = [2.4, 7.4]) times higher in those beyond the second academic year, and 2.5 (95% CI = [1.4, 4.4]) times higher in those who had received OHS training for a shorter period than the average duration. Conclusion/Application to practice The levels of awareness and empowerment were higher in students who received OHS and NSIs prevention training and those who received OHS training for the above-average duration. Increasing awareness and empowerment levels of nursing students through training can reduce the occurrence and the underreporting of NSIs.
Epidemiology of Lower Leg Soft Tissue Injuries in High School Athletes
Authors: Spitnale Michael J. , Mathews Candler G. , Barnes Allen J. , Thier Zachary T. , Jackson J. Benjamin 
Published: January 2022

Background Annually there are an estimated 4.5 million sports- and recreation-related injuries among children and young adults in the United States. The most common sports-related injuries are to the lower extremities, with two-thirds occurring among children and young adults (age range 5-24 years). The objective is to describe the epidemiology of lower leg injuries across 27 high school (HS) sports over a 3-year period. Methods The Datalys Center for Sports Injury Research and Prevention provided lower leg injury data for 27 sports in 147 high schools for 2011-2012 through 2013-2014 academic years from National Athletic Treatment, Injury and Outcomes Network (NATION) HS Surveillance Program. Results The overall rate of lower leg injuries over this 3-year period was 1.70 per 10 000 acute events (AEs) (95% CI, 1.59-1.82). In men, the highest number of lower leg injuries was in football (n=181), but indoor track had the highest rate of injury at 2.80 per 10 000 AEs (95% CI, 2.14-3.58). In women, the highest number of lower leg injuries and the highest rate of injury were in cross-country (n=76) at 3.85 per 10 000 AEs (95% CI, 3.03-4.81). The practice injury rate was 0.91 times the competition injury rate (95% CI, 0.78-1.07). Conclusion An improved understanding of the most common sports in which lower leg injuries are seen may help direct appropriate resource utilization. Our data would suggest efforts toward prevention of these overuse injuries, especially in football, track, and cross-country may have the greatest impact on the health of student athletes. Level of Evidence: Level IV, case series.
An Easy-to-Use Protocol for Segmenting and 3-D Printing Craniofacial CT-Images Using Open-Source Software
Authors: Pakvasa Mikhail , Prescher Hannes , Hendren-Santiago Bryce , Da Lomba Tony , McKenzie Nicholas , Orsbon Courtney , Collier Zachary , Ramirez-Garcia Richard , Gomez Isabella , Reid Russell R. 
Published: January 2022

Introduction: Stereolithography, also known as 3D printing (3DP), is a versatile and useful technology with many healthcare applications. While 3DP has gained tremendous popularity, it remains a daunting and perceptibly time-consuming process for the inexperienced user, with most turning to commercially printed products. Commercial vendors are expensive. We propose that 3DP is feasible for the inexperienced user with the appropriate knowledge and tools. Methods: A 3DP protocol was created for model design and printing using open-source software and a low-cost desktop printer. It was betatested by 3 inexperienced users. The fidelity of the protocol was then tested in direct comparison to industry models made for 3 patients undergoing mandibular distraction osteogenesis, using standard cephalometric measurements. Results: All inexperienced testers were able to successfully create a 3D model using the easy-to-follow protocol without the use of any other resources. The models were created in a mean time of 170 minutes. All cephalometric measurements on the open-source printed models were equal to within 0.5 to 1.0 mm of the respective industry models. Conclusions: As the 3DP process is simplified and desktop printers and materials become more affordable, we anticipate that its implementation will become more commonplace. We describe a step-by-step, protocol using open-source software and affordable materials to create 3D models.