bluuebunny/crossref_metadata_2025_split huggingface dataset:
Older patients’ perspectives on illness and healthcare during the early phase of the COVID-19 pandemic
Authors: Jøranson Nina , Heggestad Anne Kari Tolo , Breievne Grete , Bruun-Olsen Vigdis , Heiberg Kristi Elisabeth , Myrstad Marius , Hylen Ranhoff Anette , Lausund Hilde 
Published: March 2022

Background Equal access to healthcare is a core principle in Norway’s public healthcare system. The COVID-19 pandemic challenged healthcare systems in the early phase – in particular, related to testing and hospital capacity. There is little knowledge on how older people experienced being infected with an unfamiliar and severe disease, and how they experienced the need for healthcare early in the pandemic Aim To explore the experiences of older people infected by COVID-19 and their need for testing and hospitalisation. Research design An explorative and descriptive approach, with qualitative interviews conducted in October 2020. Participants and research context Seventeen participants above 60 years of age hospitalised due to COVID-19 during spring 2020 were recruited 6 months after discharge. Ethical considerations Ethical approval was granted by the Regional Committee for Medical and Health Research Ethics in South-Eastern Norway (155425). Findings The main finding was that the informants experienced vulnerability and arbitrariness. This finding was supported by three sub-themes: experiences with a severe and unfamiliar disease, the strict criteria and the importance of someone advocating needs. Discussion Participants described varying access to healthcare. Those who did not meet the national criteria to be tested or hospitalised struggled against the system. Findings reveal arbitrary access to healthcare, in contrast to Norway’s ethical principle of fair and just access to health services. Moreover, to access and receive necessary healthcare, informants were dependent on their next-of-kin’s advocacy. Conclusion Even when dealing with an unfamiliar disease, health professionals’ assessments of symptoms must be performed with an ethical obligation to applicate competent appraisal and the exercise of discernment; this is in line with care ethics and ethical standards for nurses. These perspectives are a significant part of caring and the intension of doing good.
The Real Story Behind Maternal Health of North Korea
Authors: Oh Seung Jin , Han Jungjin 
Published: March 2022

Introduction: Despite the emphasis on more systematic and high-quality health care services in the maternal period, a high maternal mortality rate in developing countries is still reported. North Korea, one of the closed countries in the world, is no exception. This study aimed to explore the maternal health experiences in North Korea. Methodology: Qualitative content analysis suggested by Graneheim and Lundman was used to analyze the data of 10 female North Korean defectors. Results: Three categories were derived: pregnancy without self-determination rights, a huge gap between the policies on maternal protection and the reality, and discriminatory childbirth and postpartum care. The theme was “perilous existence of maternal health.” Discussion: We highlighted the need for awareness of maternity protection led by health care professionals such as nurses to guarantee Universal Health Coverage as a human right for North Korean women.
Posterior Pseudo-Lenticonus Sign in a Patient with Nipple Cone Keratoconus
Authors: Ghoreishi Mohammad , Peyman Alireza , Sadeghi Amir , Pourazizi Mohsen 
Published: March 2022

Purpose To describe a previously unreported posterior pseudo-lenticonus sign in a patient with nipple cone keratoconus (KC). Case report A 32-year-old female presented with complaints of right eye visual acuity loss. Although she was initially diagnosed with posterior lenticonus, the additional clinical evaluation revealed no true lenticonus. The corneal topography revealed a central nipple cone KC, and the crystalline lend finding was consistent with a pseudo-lenticonus. Conclusion Due to inadvertent visual effects, nipple cone KC may resemble posterior lenticonus.
Reconstruction with a cage outlives patients with metastatic disease involving the acetabulum
Authors: Shiels Sarah J , Gosling Oliver , Mehendale Sanchit A , Baker Richard P 
Published: March 2022

Aim: The aim of this study was to determine whether patients treated with a caged reconstruction for metastatic acetabular disease would have a construct survival superior to that of their life expectancy. Patients and methods: We undertook a retrospective study, in a single centre in the United Kingdom, reviewing outcomes for 19 patients (20 hips) treated with a cage reconstruction for metastatic disease of their acetabulum over 6 years. Inclusion criteria were those with an impending fracture of the acetabulum, metastatic dissociation, fracture of the acetabulum and or femur and those whose life expectancy was considered by the oncology team to be >6 months. Results: In all patients the Restoration GAP II acetabular cage (Stryker, Howmedica Osteonics Corp, NJ, USA) was used in conjunction with a cemented acetabular cup and cemented femoral stem. The mean age at the time of surgery was 68 (44–87) years with breast cancer being the most common primary malignancy (31%) followed by prostate cancer (26%). Radiological survivorship estimates were 94.1% (95% CI, 99.2–65.0) at 12 and 24 months, 70.6% (95% CI, 93.6–16.0) at 36 months and 35.3% (95% CI, 78.2–1.2) at 48 months. There were 3 radiological failures of the implant due to disease progression. Complications occurred in 3 patients with 2 developing deep infection which was treated with suppressive antibiotic therapy following aspiration of the hip. 1 patient suffered a hip dislocation following trauma which was successfully reduced closed and no further intervention was required. Conclusions: This study represents the first published case series of the use of the GAP II cage in patients with metastatic acetabular disease. The construct generally outlives the patient and hence is suitable for the treatment of acetabular metastases.
Spirit possession, mental suffering, and treatment by theurgic flight anthropological study of a culture-bound syndrome among the Turkmens of Iran
Authors: Saki Fatemeh , Ahmadi Abdoljavad 
Published: March 2022

Although shamanism dates back to the prehistoric era, reminiscence of its beliefs and representation of them could still be seen in Central Asian communities and the Turkmens of Iran. Spirit possession, fairy possession and Porkhani are all terms used to describe a severe psychotic disorder; this mental disorder can be found in the Turkmen culture in Iran and Central Asia and is commonly explained as possession of the spirit by forces of evil. In this culture-bound syndrome, the patient experiences severe psychosis and shows resistance towards psychiatric treatments but finds relief through specific cultural rituals. This article, which is the outcome of 2 years of field research, aims to explain a phenomenon that is not yet considered a culture-bound syndrome through ethnography using observation techniques, interviewing patients and healers, attending healing rituals, and taking photos and filming. The author believes that without considering the patient’s cultural background, lifeworld, description of the symptoms, and cultural treatment methods, we cannot come to an accurate understanding of this phenomenon.
Psychodrama with persons with dementia on zoom: Proof of concept
Authors: Brown Nancy , Cedar Tzippi , Tziraki Chariklia 
Published: March 2022

COVID-19 pandemic and subsequent lockdowns created a global public health crisis generating mental health problems including social isolation, stress, and anxiety especially for persons with dementia and their carers. This article reports on the use of digital technology to maintain social connectivity via a virtual group session that focused on the topic of “what is home.” Participants in this session included 16 day-care center clients representing an immigrant community identified with mild to moderate cognitive impairment. A trained psychodrama therapist conducted the virtual group meeting based on five key techniques: spectrogram, role reversal, doubling, mirroring, and soliloquy. The NVivo software was used for the qualitative analysis of the transcribed video recording to identify key themes based on grounded theory methodology. Zooming from home, clients engaged in significant social interaction. Findings of the NVivo analysis identified the following themes of “what is home”: Emotions and home, Home is family, Home is community, and Reminiscence (with objects and traditions). Findings suggest that digital interactive technologies, like Zoom, enhance social connectivity thus mitigating the negative impact of social isolation for persons with dementia especially during pandemic lockdowns. Our pilot findings based on virtual group meetings from home demonstrate that participants can express significant emotive capacity and enhanced connectivity with one another despite a diagnosis of mild to moderate dementia. While larger studies are needed to confirm these findings, we suggest that this methodology may be used to support persons with dementia not only in times of pandemics but also as an addition to other community and home care services. Changes in reimbursement policies to include these innovative home services may be helpful in building more resilient communities for the more highly vulnerable populations.
Billing and Utilization Trends for Hand Surgery Indicate Worsening Barriers to Accessing Care
Authors: Gong Jung Ho , Long Chao , Eltorai Adam E. M. , Sanghavi Kavya K. , Giladi Aviram M. 
Published: March 2022

Background: Hospitals and providers may increase hand surgery charges to compensate for decreasing reimbursement. Higher charges, combined with increasing utilization of ambulatory surgical centers (ASCs), may threaten the accessibility of affordable hand surgery care for uninsured and underinsured patients. Methods: We queried the Physician/Supplier Procedure Summary to collect the number of procedures, charges, and reimbursements of hand procedures from 2010 to 2019. We adjusted procedural volume by Medicare enrollment and monetary values to the 2019 US dollar. We calculated weighted means of charges and reimbursement that were then used to calculate reimbursement-to-charge ratios (RCRs). We calculated overall change and r2 from 2010 to 2019 for all procedures and stratified by procedural type, service setting, and state where service was rendered. Results: Weighted mean charges, reimbursement, and RCRs changed by + 21.0% (from $1,227 to $1,485; r2 = 0.93), +10.8% (from $321 to $356; r2 = 0.69), and -8.4% (from 0.26 to 0.24; r2 = 0.76), respectively. The Medicare enrollment-adjusted number of procedures performed in ASCs increased by 63.8% ( r2 = 0.95). Trends in utilization and billing varied widely across different procedural types, service settings, and states. Conclusions: Charges for hand surgery procedures steadily increased, possibly reflecting an attempt to make up for reimbursements perceived to be inadequate. This trend places uninsured and underinsured patients at greater risk for financial catastrophe, as they are often responsible for full or partial charges. In addition, procedures shifted from inpatient to ASC setting. This may further limit access to affordable hand care for uninsured and underinsured patients.
Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel
Authors: Beit Yosef Aviva , Maeir Talia , Khalailh Fatena , Gilboa Yafit 
Published: March 2022

Aims Our study explored the perceived feasibility of using a home-based telerehabilitation service for older adults with chronic health conditions in Israel. Method This mixed-methods study included two focus groups of registered occupational therapists ( n = 10) working in rehabilitation wards in Israel. Participants completed an open-ended questionnaire and Likert scale items so that data could be gathered on their perspectives regarding using an in-home telerehabilitation service for older adults after discharge from rehabilitation units. Thematic analysis with an a priori coding approach was applied to the data. Results Perceived advantages included transfer to the natural environment and the overcoming of geographical distance. Caregiver support and patient motivation were recognized as enabling factors. Perceived barriers included lack of hands-on contact and the concern that safety could be impeded by technological challenges and the patients’ cognitive status. Conclusions Findings from this study can potentially contribute to facilitating the implementation of a home-based telerehabilitation service as a practical alternative for elderly patients after discharge from rehabilitation units in Israel.
Endovascular embolization for the treatment of epistaxis: Systematic review and meta-analysis
Authors: Hoffman Haydn , Ashok Kumar Apeksha , Raventhiranathan Neveada , Masoud Hesham E , Gould Grahame C 
Published: March 2022

Background Endovascular embolization (EE) is a treatment option for epistaxis refractory to first-line interventions. Data regarding embolization is limited to small case series and a meta-analysis has not been performed. Methods PubMed, Scopus, and EMBASE were used to identify studies that reported outcomes for at least 10 patients undergoing EE for epistaxis. Outcomes included procedural success, rebleeding, and complications. Pooled rates for each outcome were obtained with random effects models. Results A total of 44 studies comprising 1664 patients met the inclusion criteria. The mean age ranged from 28.1 to 67 years and there were 28.4% females. The pooled procedural success rate was 87% (95% CI 83.9–89.6, I 2  = 53%). Age (OR 0.95, 95% CI 0.91–1) and hereditary hemorrhagic telangiectasia ([HHT], OR 0.97, 95% CI 0.96–0.99) were associated with decreased odds of success. The pooled rebleeding rate was 16.4% (95% CI 13.6–19.6, I 2  = 48%), and HHT was associated with greater odds of rebleeding (OR 1.02, 95% CI 1–1.03). The pooled overall complication rate was 14.4% (95% CI 9.8–20.6, I 2  = 85.8%). The pooled rates of stroke and vision loss were 2.1% (95% CI 1.5–3.1, I 2  = 1.5%) and 1.8% (95% CI 1.2–2.6, I 2  = 0%), respectively. Conclusion EE for epistaxis has a high rate of procedural success. Interventionalists should be aware of the risk for rebleeding, especially among patients with HHT.
Transbronchial lung cryobiopsy: prospective safety evaluation and 90-day mortality after a standardized examination protocol
Authors: Hackner Klaus , Stadler Antonia , Schragel Felix , Klamminger Valerie , Ghanim Bahil , Varga Alexander , Errhalt Peter 
Published: March 2022

Background: Transbronchial lung cryobiopsy (TBLC) is a new method of bronchoscopic tissue sampling in patients with unclear diffuse parenchymal lung disease (DPLD). While not the gold standard, TBLC has a good diagnostic correlation with surgical lung biopsy, and retrospective analyses of peri-interventional complications and mortality are promising. However, prospective reports on 90-day mortality are lacking. Objectives: This study addresses morbidity and 30- and 90-day mortality in TBLC after a standardized protocol. Methods: In this prospective study, 75 patients with DPLD requiring tissue sampling were included. A standardized protocol (including prophylactic use of an endobronchial balloon, postinterventional observation, and minimum sampling requirements) was used in all patients. Adverse events (pneumothorax, bronchial bleeding, premature discontinuation, prolonged monitoring at ICU, and fatal outcome) and 30- and 90-day mortality rates were recorded. Results: A total of 308 cryobiopsies were performed in 75 patients. Peri- and postinterventional pneumothorax were observed in 20% (9.3% mild and 10.7% moderate with the necessity of chest drainage), and bronchial bleeding was found in 29.3% (22.7% moderate and 6.7% severe). Total lung capacity below normal value was associated with the risk of pneumothorax ( p = 0.009), and diffusion limitation for carbon monoxide below normal value was associated with the risk of bronchial bleeding ( p = 0.044). No fatal events were observed within 30 days, and the 90-day mortality rate was 1.3%, but not related to the procedure itself. Conclusion: As it gradually becomes the invasive procedure of choice in unclear DPLD, TBLC is a safe procedure with a low 30- and 90-day mortality. Trial registration ID: DRKS00026746 (German Clinical Trial Register)
Modified Bösch Osteotomy Combined With a Percutaneous Adductor Tendon Release for the Treatment of Hallux Valgus Deformity: Learning Curve
Authors: Ghioldi Mauricio Esteban , Chemes Lucas Nicolás , Dealbera Eric Daniel , De Prado Mariano , Del Vecchio Jorge Javier 
Published: March 2022

Purpose The expression “learning curve” indicates the relation between the time needed to learn a new technique and the technique-related outcome. Percutaneous surgery (also called “minimally invasive surgery”) has experienced sustained and respectable growth, especially in forefoot deformities. The main purpose was to assess the number of feet necessary to become skilled in a specific minimally invasive surgery (MIS) procedure. Methods From January 2015 to June 2018, 46 consecutive patients were evaluated and included in the study. Patients were divided into 2 groups according to the surgery period: first 30 feet (Group 1), and subsequent 30 feet (Group 2) from the whole population evaluated. Age, body mass index, and operative time were evaluated. Hallux valgus angle and the 1 to 2 intermetatarsal angle were also measured. Patients were assessed according to the American Orthopedic Foot and Ankle Society (AOFAS) forefoot scale, the Foot and Ankle Ability Measure activities of daily living (FAAM ADL) subscale and the visual analog scale (VAS). Results The comparison of the 2 groups showed statistically significant differences in hallux valgus angle (HVA) but not in intermetatarsal angle (IMA). The mean improvement between pre- and postoperative FAAM ADL, VAS, and AOFAS score in Group 1 were 12.83, 3.93, and 24.77 points, respectively. In Group 2, the mean improvement between pre- and postoperative FAAM ADL, VAS, and AOFAS scores were 15.19, 4.3, and 24.5 points, respectively. The differences between groups in FAAM ADL score was statistically significant (P = 0.0364). Group 1 showed a global complication rate of 16.67% (n = 5) while group 2 showed 3,3% (n = 1). Conclusion After the first 30 cases, radiographic, clinical, and functional outcomes substantially improved, and the level of the perioperative complications decreased. The results suggest that the learning curve plateau for performing a percutaneous subcapital osteotomy can be reached after 30 surgeries. Levels of Evidence Level III
Recurrence Patterns and Efficacy of Surveillance Modalities for Sinonasal Malignancies
Authors: Tzelnick Sharon , Levin Einav G. , Yacobi Daniel , Mizrachi Aviram , Popovtzer Aron , Soudry Ethan 
Published: March 2022

Objective There is limited information regarding the recurrence patterns and efficacy of surveillance modalities in patients with sinonasal malignancies. Methods A retrospective study was conducted between the years 2001–2018 at a tertiary care center. Included were all patients with sinonasal malignancies treated in our institution. Data regarding recurrence and survival were analyzed. Results Eighty-one patients were included. Multimodal treatment was administered to the majority of patients. 24 (35.3%) patients recurred with a median time of 17 months (range, 4–180). Although the majority of recurrences occurred within the first 5 years (83.3%), 4 (16.6%) recurred later on (5−15 years). Recurrences were local in 83.3%, regional in 20.8% and distant in 16.6%. All local recurrences occurred within the radiation treatment field and all patients with distant failure had mucosal melanoma. The majority of recurrences (70.6%) were diagnosed clinically or endoscopically, mainly in patients with SCC during the first 2 years of follow up. MRI or PET-CT were crucial in detecting extra-sinus and distant failures. Salvage surgery was feasible in the majority of patients (58.3%). Overall, 5 years survival (OS) rate was 60.9%. Conclusions Frequent clinic visits with nasal endoscopy combined with frequent imaging studies should be routinely practiced as part of a long-term surveillance plan. Longer follow up duration should be considered in these patients.
The World Society for Pediatric and Congenital Heart Surgery: 2021 Update of the World Database for Pediatric and Congenital Heart Surgery
Authors: St Louis James D. , Deng Luqin , Covington Claire , Timkovich Nicholas A. , Crethers Danielle , Collum Craig S. , Pennington John K. , Broser Taylor , Dabal Robert J. , Jacobs Jeffrey P. , O’Brien James E. , Austin Erle H. , Tchervenkov Christo I. , Kirklin James K. 
Published: March 2022

Background The World Database for Pediatric and Congenital Heart Surgery (WDPCHS), sponsored by the World Society for Pediatric and Congenital Heart Surgery (WSPCHS), provides complex programmatic outcomes analyses for all members of the WSPCHS. Methods The Data center, currently at Kirklin Institute for Research in Surgical Outcomes (KIRSO), University of Alabama, Birmingham (USA), provides biannual reports to all active members of the database. This report presents a descriptive analysis of these procedures submitted from January 1, 2017 to December 31, 2020. Results A total of 37,386 procedures were submitted with an overall mortality of 4.3%. The majority of submissions were from Asian countries. The majority of cases submitted from these countries were of Society of Thoracic Surgeons (STS)-European Association for Cardio-Thoracic Surgery (STAT) Mortality Categories I and II. Conclusions The WSPCHS accomplished one of its missions in 2017 when the WDPCHS began accepting data from pediatric and congenital heart surgery programs across the globe. In doing so, it became one of the first organizations to create a platform for the exchange of knowledge and experience, regardless of the socioeconomic status of the particular program or country.
Wood identification of Japanese and Chinese wooden statues owned by the Museum of Fine Arts, Boston, USA
Authors: Tazuru Suyako , Mertz Mechtild , Itoh Takao , Sugiyama Junji 
Published: March 2022

AbstractPrecious cultural assets of East Asia are found worldwide and hold many important art-historical meanings, for example Buddhist statues. In this study, we conducted wood identification of Japanese and Chinese statues owned by the Museum of Fine Arts, Boston, USA. From the eight Japanese wood sculptures and one Chinese sculpture, 15 samples were collected. The anatomical features of these 15 samples were scrutinized using synchrotron X-ray microtomography or conventional optical microscopy. The results showed that the eight Japanese statues were made from Chamaecyparis obtusa, except for the base of one Japanese statue that was made from Cryptomeria japonica. Both species are important conifers in Japan. In contrast, the Chinese statue was made from hardwood, Paulownia sp.