bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative Analysis of Growth Factors From Cancellous Bone Graft Collected With a Reamer-Irrigator-Aspirator System From Native Long Bones Versus Previously Reamed Long Bones
Authors: Cereijo Cesar , Johnson Samuel R. , Schoenecker Jonathan G. , Collinge Cory A. , Obremskey William T. , Moore-Lotridge Stephanie N. 
Published: January 2022

Objective:
Collection of bone graft with the Reamer-Irrigator-Aspirator (RIA) system has become common practice across the field of orthopaedic surgery. While RIA bone graft is typically obtained from native long bones, grafting material can likewise be harvested from long bones that have previously undergone the placement and removal of an intramedullary nail, a process termed re-reamed RIA (RRR). The purpose of this study was to evaluate the total protein and growth factor concentrations present in native-RIA (NR) compared with RRR samples.

Methods:
NR and RRR bone grafts were collected intraoperatively with the RIA system and processed to evaluate both the aqueous and the hard tissue components. Total protein concentration and specific growth factors were analyzed using standard bicinchoninic acid and multiplex assays, respectively. Analyte levels were then normalized to the total amount of protein detected.

Results:
Total protein levels were comparable between NR and RRR samples for both the aqueous filtrate and the hard tissue samples. When normalized, while levels of bone morphogenic protein-2 and vascular endothelial growth factor were comparable in the hard tissue component, the aqueous filtrate from the RRR sample was found to have elevated levels of growth factors, with bone morphogenic protein-2 reaching statistical significance.

Conclusions:
This study demonstrates that ample protein is found within both NR and RRR samples, with comparable or elevated levels of osteogenic growth factors found within RRR samples. Future, larger, prospective studies will be required to evaluate the osteogenic potential and clinical efficacy of NR and RRR cancellous bone grafts to validate their equivalency.
The impact of transcatheter edge-to-edge repair on mitral valve annular geometry
Authors: Eqbal Adam , Gupta Saurabh , Fam Neil , Ong Géraldine , Bisleri Gianluigi 
Published: January 2022

Purpose of review
Mitral valve transcatheter edge-to-edge repair (TEER) is becoming increasingly common to treat severe mitral regurgitation. However, the lack of concomitant annuloplasty raises concerns regarding its durability. As a result, there is an emerging body of literature evaluating the impacts of TEER on mitral annular geometry. In this review, we summarize the most recent literature evaluating the impacts of TEER on annular geometry in the acute, intermediate and long-term. We also review the relationship between changes in annular geometry and clinical endpoints.

Recent findings
Current evidence suggests that TEER acutely induces favourable changes in mitral annular size and shape, which may persist for at least up to 1 year. Few studies suggest that TEER-induced annular remodelling is associated with positive clinical outcomes.

Summary
The current body of literature is sparse and limited to primarily small case series. Data from the surgical literature suggest that ringless edge-to-edge repair is associated with eventual failure. Unfortunately, few studies evaluate TEER-induced annular changes beyond the acute postprocedural phase. Future research needs to focus on and evaluate the significance of TEER-induced changes in annular dimensions in the long-term.
Valve-sparing aortic root replacement: a primer for cardiologists
Authors: Mazine Amine , Chu Michael W.A. , El-Hamamsy Ismail , Peterson Mark D. 
Published: January 2022

Purpose of review
The purpose of this article is to review the contemporary evidence supporting valve-sparing aortic root replacement as the best option for patients with aortic root aneurysms and preservable aortic valves as well as to review the technical variations and modern adjuncts of these operations that impact both short and long-term durability.

Recent findings
In patients with an aortic root aneurysm, with or without aortic valve regurgitation, valve-sparing aortic root replacement provide excellent clinical outcomes and stable valve function over several decades. Successful execution of this operation depends on careful patient selection and a thorough understanding of the anatomical and physiological relationships between the various components of the aortic root. Echocardiography remains the mainstay of imaging to determine the feasibility of valve-sparing root replacement.

Summary
Valve-sparing aortic root replacement is an excellent alternative to composite valve graft replacement in nonelderly patients with aortic root aneurysms. Dedicated aortic root surgeons perform several technical variations of valve-sparing procedures aimed at matching the specific aortic root disorder with the optimal operation.
Volunteering Improves Employee Health and Organizational Outcomes Through Bonding With Coworkers and Enhanced Identification With Employers
Authors: Pfeffer Jeffrey , Singer Sara , Stepanek Martin 
Published: January 2022

Objective:To understand the consequences of employee volunteering and possible psychological mechanisms that produce these effects.Methods:Using data from more than 50,000 responses to Britain's Healthiest Workplace survey, we employed structural equation modeling to investigate the effects of people volunteering.Results:Net of a number of controls, people who volunteered reported better self-reported health, less risk of depression, and higher levels of engagement and satisfaction. These results were partly explained by volunteering creating higher levels of interpersonal social bonding and greater identification with their employers.Conclusion:Employers Employers should sponsor volunteer activities and provide workplace flexibility, because employees who volunteer have greater individual wellbeing and also higher levels of pro-employer outcomes such as engagement and job satisfaction.
Individualized cerebral perfusion pressure in acute neurological injury: are we ready for clinical use?
Authors: Weiss Miriam , Meyfroidt Geert , Aries Marcel J.H. 
Published: January 2022

Purpose of review
Individualizing cerebral perfusion pressure based on cerebrovascular autoregulation assessment is a promising concept for neurological injuries where autoregulation is typically impaired. The purpose of this review is to describe the status quo of autoregulation-guided protocols and discuss steps towards clinical use.

Recent findings
Retrospective studies have indicated an association of impaired autoregulation and poor clinical outcome in traumatic brain injury (TBI), hypoxic–ischemic brain injury (HIBI) and aneurysmal subarachnoid hemorrhage (aSAH). The feasibility and safety to target a cerebral perfusion pressure optimal for cerebral autoregulation (CPPopt) after TBI was recently assessed by the COGITATE trial. Similarly, the feasibility to calculate a MAP target (MAPopt) based on near-infrared spectroscopy was demonstrated for HIBI. Failure to meet CPPopt is associated with the occurrence of delayed cerebral ischemia in aSAH but interventional trials in this population are lacking. No level I evidence is available on potential effects of autoregulation-guided protocols on clinical outcomes.

Summary
The effect of autoregulation-guided management on patient outcomes must still be demonstrated in prospective, randomized, controlled trials. Selection of disease-specific protocols and endpoints may serve to evaluate the overall benefit from such approaches.
Hydromorphone vs sufentanil in patient-controlled analgesia for postoperative pain management
Authors: Nie Zhong-Biao , Li Zhi-Hong , Lu Bin , Guo Yao-Yao , Zhang Ran 
Published: January 2022

Abstract

Background:
Patient-controlled analgesia (PCA) is an effective method of postoperative pain, there have been many studies performed that have compared the efficacy of hydromorphone with continuous sufentanil. The purpose of this systematic review is to compare the efficacy and safety of hydromorphone and sufentanil.

Methods:
Seven databases were searched for controlled trials to compare the efficacy and safety of hydromorphone and sufentanil. After selecting the studies, extracting the data, and assessing study quality, the meta-analysis was performed on several of the studies with RevMan 5.3.

Results:
Thirteen studies comprised of 812 patients were found. The pain intensity of the hydromorphone group was significantly lower than that of the sufentanil group at 12 hours. With no statistical difference at 24 to 48 hours (MD12 = −1.52, 95% CI [−2.13, −1.97], P <.05). The sedation intensity of the hydromorphone group at 12, 24, and 48 hours were lower than those of the sufentanil group, with no statistical difference (MD12 = −0.03, 95% CI [−0.18, 0.12], P > .05; MD24 = −0.20, 95% CI [−0.42, 0.03], P > .05; MD48 = −0.03, 95% CI [−0.18, 0.11)], P > .05). The PCA requests in the hydromorphone group were less than that in the sufentanil group, and there was no significant difference (RR = −0.20, 95% CI [−1.93,1.53], P > .05). The incidence of adverse events in the hydromorphone group was less than that in the sufentanil group, and there was a statistical difference: (RR = 0.61, 95% CI [0.47,0.79], P < .05).

Conclusion:
Compared with sufentanil, PCA with hydromorphone was more effective in relieving pain and PCA requests 12, 24, and 48 hours after operation, and significantly reduced the incidence of adverse events, but it did not have an advantage in sedation intensity.
Clinical characteristics and outcomes of post-COVID-19 pulmonary fibrosis
Authors: Farghaly Shereen , Badedi Mohammed , Ibrahim Rehab , Sadhan Murad H. , Alamoudi Aymn , Alnami Awaji , Muhajir Abdulrahman 
Published: January 2022

Abstract
The development of pulmonary fibrosis is a rare complication of the novel coronavirus disease 2019 (COVID-19). Limited information is available in the literature about that, and the present study aimed to address this gap.
This case-control study included 64 patients with post-COVID-19 pulmonary fibrosis who were hospitalized for COVID-19.
The percentage of patients aged ≥65 years (44%) who demised was higher than those who survived (25%). Male patients (62%) had higher mortality than female patients (37%). The most frequently reported clinical symptoms were shortness of breath (98%), cough (91%), and fever (70%). Most COVID-19 patients with pulmonary fibrosis (81%) were admitted to an intensive care unit (ICU), and 63% required mechanical ventilation. Bilateral lung infiltrates (94%), “ground glass” opacity (91%), “honeycomb” lung (25%), and pulmonary consolidation (9%) were commonly identified in COVID-19 patients with pulmonary fibrosis who survived. The findings for computed tomography and dyspnea scale were significantly higher in severe cases admitted to the ICU who required mechanical ventilation. A higher computerized tomography score also correlated significantly with a longer duration of stay in hospital and a higher degree of dyspnea. Half of the COVID-19 patients with pulmonary fibrosis (50%) who survived required oxygen therapy, and those with “honeycomb” lung required long-term oxygen therapy to a far greater extent than others. Cox regression revealed that smoking and asthma were significantly associated with ICU admission and the risk of mortality.
Post-COVID-19 pulmonary fibrosis is a severe complication that leads to permanent lung damage or death.
Dispelling Magnet® Myths
Authors: Lal M. Maureen 
Published: January 2022

ABSTRACT:
Organizations on the journey to Magnet® excellence have questions. In many cases, those questions are based on myth, not fact. In this month's Magnet Perspectives, we break down the most commonly asked questions, dispel the myths, and explore the resources available to help organizations get the answers they need to achieve Magnet® recognition.
Nurses' Perspectives of Their Impact While Serving on Boards
Authors: Sundean Lisa J. , O'Lynn Chad E. , Christopher Roberta , Cherry Barbara 
Published: January 2022

OBJECTIVE
The study objective was to identify nurses' perceptions of their impact while serving on boards.

BACKGROUND
Nurse leaders serving as voting board members are key experts for board effectiveness and may be associated with stronger performing organizations. Extant research indicates that nurse leaders are qualified for board service; however, no research explores the impact of nurses on boards.

METHODS
We conducted an exploratory qualitative study by interviewing 20 nurses serving on boards. Hermeneutic analysis of the data resulted in 1 overarching pattern and 7 traversing themes.

RESULTS
Nurses who serve on boards reported leveraging expert knowledge of healthcare and caring wisdom to influence strategic thinking to meet stakeholder needs.

CONCLUSION
Nurses promote effective board governance by ensuring that the perspectives and needs of all stakeholders are represented in board processes. We recommend health-related organization executives and board leaders appoint nurses as voting members of their governing boards.
Posttraumatic Stress Disorder in Nurses During a Pandemic
Authors: Zeiher Wendy , Sego Emily , Trimmer Derek , Bowers Cynthia 
Published: January 2022

OBJECTIVE
This study aimed to explore the association between nurses' practice environment (NPE), posttraumatic stress disorder (PTSD), and intent to leave among nurses working during the COVID-19 pandemic.

BACKGROUND
High levels of physiological and psychological stress in the workplace render nurses susceptible to PTSD. To date, little research has focused on the relationship between NPE, PTSD, and intent to leave during a major health crisis such as the COVID-19 pandemic.

METHODS
A cross-sectional online survey was completed by nurses who were members of northeastern and midwestern state nurses' associations.

RESULTS
Approximately 44% of nurses sampled indicated a preference for leaving their position. Significant associations were identified between NPE and PTSD and between NPE and intent to leave.

CONCLUSION
This assessment of nurses working during the COVID-19 pandemic may inform future mental health strategies and stress management interventions that support nurses continuing to work during a major health crisis.
Bilateral Hypertrophic Olivary Degeneration as a Paraneoplastic Syndrome of a Poorly Differentiated Carcinoma of the Upper Gastrointestinal Tract
Authors: Daneshmand Ameneh , Borhani-Haghighi Afshin , Monabati Ahmad , Karimi Mojtaba , Ostovan Vahid R. 
Published: January 2022

Introduction:
Hypertrophic olivary degeneration (HOD) is a unique form of trans-synaptic neuronal degeneration within the dentato-rubro-olivary pathway which is manifested by the enlargement and hyperintensities of the inferior olivary nucleus in the brain magnetic resonance imaging.

Case Report:
We report a 53-year-old man admitted to our emergency department with a history of progressive ataxia and vertigo for 6 months before admission. Neurological examination revealed cerebellar dysfunction, and the brain magnetic resonance imaging showed bilateral HOD without an identifiable causative lesion within the brain or abnormal meningeal enhancement. Cerebrospinal fluid analysis showed mild lymphocytic pleocytosis, elevated protein, and negative cytology. Malignancy and paraneoplastic workup exhibited marked elevation of carbohydrate antigen 19-9 level and para-aortic lymphadenopathy. A histologic examination demonstrated the infiltration of lymph nodes by a malignant, poorly differentiated carcinomatous tumor that arises from the upper gastrointestinal tract. Considering the primary site of the tumor and HOD as a paraneoplastic effect of carcinoma, a FOLFIRINOX regimen, intravenous immunoglobulin, and pulse methylprednisolone were started. A follow-up imaging after 3 months depicted a significant resolution of HOD but the neurological status only mildly improved. The patient developed liver and adrenal metastasis over the following 6 months, culminating in his death.

Conclusion:
This study strengthens a relationship between HOD and malignancy as a paraneoplastic syndrome and provides a new incentive for further researches to confirm this association.
Major Neurological Deficit Following Neck Hyperextension During Dental Treatment
Authors: El-Hajj Victor G. , El-Hajj Gabriel , Mantoura Joseph 
Published: January 2022

Introduction:
Medical literature has long reported the disastrous effects of neck hyperextension on posterior cerebral circulation. Hairdresser-related ischemic cerebrovascular event, also called beauty parlor syndrome, among other examples, is considered an epitome of this phenomenon.

Case Report:
In this report, alluding to hairdresser-related ischemic cerebrovascular event, 2 cases of neurological impairment following hyperextension of the neck during dental treatment append to the many others, yet being 2 of the first reported in this setting. In one of the cases, the patient developed classic stroke symptoms during dental treatment, while in the other, the deficit developed the day after the dental procedure. Both patients were treated with low–molecular-weight heparin during their stay at the hospital. In the first patient, the deficit was permanent, while in the second, the deficit was more subtle and temporary.

Conclusions:
Pathogenesis, as well as predisposing factors, are discussed, and new terminology is established as a means to encourage research on this rare complication of neck positioning on dental chairs.
AiRDose
Authors: Waltuch Temima , Munjal Kevin , Loo George T. , Lim Czer Anthoney 
Published: January 2022

Objectives
Inaccurate weight estimation is a contributing factor to medical error in pediatric emergencies, especially in the prehospital setting. Current American Heart Association guidelines recommend the use of length-based weight estimation tools such as the Broselow tape. We developed the AiRDose smartphone application that uses augmented reality to provide length-based weight estimates, as well as medication dosing, defibrillation energy, and equipment sizing recommendations; AiRDose was programmed to use Broselow conversions to obtain these estimates. The primary objective was to compare the length estimated by AiRDose with the actual length obtained by the standard tape measure. The secondary objectives were to compare the estimated weights and critical medication doses from AiRDose with current established methods.

Methods
In this prospective validation study, lengths and estimated weights were obtained for children presenting to 2 emergency departments using AiRDose, Broselow, and a standard tape measure; actual weight was recorded from the patient chart. Using the AiRDose estimated weights, hypothetical doses of epinephrine and lorazepam were calculated and compared with doses recommended via Broselow and to actual weight-based doses. Spearman rank correlation coefficients were calculated. We defined an acceptable difference of 20% between AiRDose and standard measurements as clinically relevant.

Results
Five hundred forty-nine children (mean age, 4.8 years; standard deviation [SD], 2.9 years) were recruited. There were 99.6% of AiRDose lengths within a 20% difference of tape-measure lengths. There was a significant correlation between AiRDose and tape-measure length measurements (r = 0.989, P < 0.0001), and between AiRDose and Broselow weights (r = 0.983, P < 0.0001) and AiRDose and actual weights (r = 0.886, P < 0.0001). AiRDose lorazepam and epinephrine doses correlated significantly with Broselow lorazepam (r = 0.963, P < 0.0001) and epinephrine (r = 0.966, P < 0.0001) doses.

Conclusions
Anthropometric estimates and medication dose recommendations provided by AiRDose strongly correlate with established techniques. Further study will establish the feasibility of using AiRDose to accurately obtain weight estimates and medication doses for pediatric patients in the prehospital setting.
A Quality Improvement Initiative to Increase Central Line Maintenance Bundle Compliance through Nursing-led Rounds
Authors: Hugo Maria C. , Rzucidlo Rheannon R. , Weisert Lauren M. , Parakati Isaac , Schroeder Sangeeta K. 
Published: January 2022

Introduction:
Improvements in maintenance bundle compliance around central line-associated bloodstream infections (CLABSIs) lack standardization. The objective was to implement a formalized nursing-led rounding process, Rounds for Influence, with a goal of 12 rounds/wk on each inpatient unit and Ambulatory Infusion Center, achieving > 90% maintenance bundle compliance.

Methods:
Nurses served as peer “influencers” to perform rounds. The CLABSI prevention team created three comprehensive rounding tools (line access, dressing change/port needle insertion, and cap change) on a digital platform. The team designed these tools to assess clinical competence for maintenance bundle components and implemented nine plan-do-study-act cycles throughout the study period.

Results:
Influencers completed 191 rounds after the first month of implementation, resulting in a 264.2% increase from the baseline of 52.5 rounds per month. Over the 2.5 years postimplementation, rounds resulted in 7836 total observations. Maintenance bundle compliance decreased from 86.9% (centerline value from November 2017 to September 2018) to 40.8% after the first month of implementation. Compliance increased iteratively (two separate centerline shifts) to a current centerline value of 87.1%. The CLABSI 12-month cumulative standardized infection ratio (SIR) was 0.9 in November 2017 and dropped to 0.53 in June 2021.

Conclusion:
Implementing a formalized nursing-led rounding process led to increased maintenance bundle compliance, decreased CLABSI SIR, and is an integral part of nursing practice. Given this success, there is interest from other hospital-acquired condition improvement teams in applying this rounding practice to their improvement work.
Shifting the Paradigm: A Quality Improvement Approach to Proactive Cardiac Arrest Reduction in the Pediatric Cardiac Intensive Care Unit
Authors: Riley Christine M. , Diddle J. Wesley , Harlow Ashleigh , Klem Kara , Patregnani Jason , Hochberg Evan , Cheng Jenhao Jacob , Bhattarai Sopnil , Hom Lisa , Fortkiewicz Justine M. , Klugman Darren 
Published: January 2022

Introduction:
Children with cardiac conditions are at higher risk of in-hospital pediatric cardiopulmonary arrest (CA), resulting in significant morbidity and mortality. Despite the elevated risk, proactive cardiac arrest prevention programs in the cardiac intensive care unit (CICU) remain underdeveloped. Our team developed a multidisciplinary program centered on developing a quality improvement (QI) bundle for patients at high risk of CA.

Methods:
This project occurred in a 26-bed pediatric CICU of a tertiary care children’s hospital. Statistical process control methodology tracked changes in CA rates over time. The global aim was to reduce CICU mortality; the smart aim was to reduce the CA rate by 50% over 12 months. Interprofessional development and implementation of a QI bundle included visual cues to identify high-risk patients, risk mitigation strategies, a new rounding paradigm, and defined escalation algorithms. Additionally, weekly event and long-term data reviews, arrest debriefs, and weekly unit-wide dissemination of key findings supported a culture change.

Results:
After bundle implementation, CA rates decreased by 68% compared to baseline and 45% from the historical baseline. Major complications decreased from 17.1% to 12.6% (P < 0.001) and mortality decreased from 5.7% to 5.0% (P = 0.048). These results were sustained for 30 months.

Conclusions:
Cardiac arrest is a modifiable, rather than inevitable, metric in the CICU. Reduction is achievable through the interprofessional implementation of bundled interventions targeting proactive CA prevention. Once incorporated into widespread efforts to engage multidisciplinary CICU stakeholders, these patient-focused interventions resulted in sustained improvement.