bluuebunny/crossref_metadata_2025_split huggingface dataset:
Repeat Irrigation and Debridement of Upper Extremity Infections: Do Repeat Cultures Change Antibiotic Treatment Regimens?
Authors: Wiekrykas Bradley D. , Wera Jeffrey C. , Rallis Gavin , Solarz Mark K. 
Published: January 2022

Background: Organism identification and their antibiotic sensitivity profile are critical for the successful treatment of upper extremity infections. Although many infections resolve with antibiotics alone, some require 1 or more surgical procedures in which culture data are obtained. The purpose of this study was to determine whether repeat cultures taken at subsequent irrigation and debridement of upper extremity infections changed antibiotic treatment. Methods: A retrospective review was performed using International Classification of Diseases, Ninth Revision codes to identify all adult patients with an upper extremity infection treated with 2 irrigation and debridement procedures with 2 separate culture data sets over a period of 5 years. Culture organisms and antibiotic sensitivity profiles were compared from each procedure, and changes in antibiotic treatment based on repeat culture information were identified. Results: In all, 183 patients who underwent 2 irrigation and debridement procedures with repeat culture data were identified. Organisms identified with repeat culture were the same or there was no growth in 153 patients and were different in 30 patients. The antibiotic treatment did not require a change in 170 (92.9%) of 183 patients. Of the 30 patients with different repeat cultures, antibiotic treatment changed in only 13 patients (43.3%). Patients who had a change in antibiotic treatment were more likely to have hepatitis C ( P = .005). Conclusions: Repeat culture data changed antibiotic treatment in only 7.1% of patients from our cohort. Patients with hepatitis C were more likely to require a change in antibiotic management after obtaining repeat cultures.
Rist Guide Catheter for Endovascular Procedures: Initial Case Series from a Single Center
Authors: Waqas Muhammad , Monteiro Andre , Baig Ammad A , Cappuzzo Justin M , Dossani Rimal H , Almayman Faisal , Singh Trisha , Snyder Kenneth V , Levy Elad I , Siddiqui Adnan H , Davies Jason M 
Published: January 2022

Background The transradial approach (TRA) for endovascular procedures has become a frequent practice in neurointervention. Advantages of the TRA include less access-site complications, early ambulation, and less postprocedural pain. The Rist 079 radial access guide catheter (Medtronic) is the first device designed specifically for neurointerventions performed through the TRA. In this study, we report our initial experience with the Rist catheter in a variety of neurointerventional procedures, aiming to evaluate the performance of this device and discuss its limitations. Methods A prospectively maintained database was retrospectively searched to identify patients who underwent procedures using the Rist catheter. Information on demographics, procedural details, and complications was recorded. Results Seventy-eight patients were included in the study, with a mean age of 60.3 years (range, 25–92 years); 45 (57.7%) were men. The interventional or diagnostic procedure was successfully completed in 77 patients (98.7%). The radial artery was the primary access-site choice in 71 patients (91%). The most frequent type of procedures performed were coiling or stent-assisted coiling (16.7%) and angioplasty and stenting (16.7%), followed by middle meningeal artery embolization (14.1%). Crossover to femoral artery access while maintaining use of the Rist was done in 5 cases (6.4%). Reasons for access or procedural failure included anatomical anomaly of the target vessel, unfavorable geometry of the great vessels, and proximal tortuosity of the supra-aortic vessels. Conclusion We demonstrated a high success rate with use of the Rist catheter system for a variety of procedures.
Economic Uncertainty and Exchange Market Pressure: Evidence From China
Authors: Liu Lin 
Published: January 2022

This paper evaluates the impact of local and external economic uncertainty shocks on China’s exchange market pressure from a time-varying perspective. We first construct a simple behavioral model to provide some economic background for our empirical analysis. The model identifies two channels, namely market sentiment and market demand, through which economic uncertainty has a time-varying impact on exchange market pressure. Notably, we calculate a new exchange market pressure index for China by considering China’s practice. Using the economic policy uncertainty index as a proxy for economic uncertainty and our new estimates of China’s exchange market pressure, we employ a novel TVP-VAR model controlling for over-parameterization to a monthly dataset from January 2001 to October 2020 to analyze the impact of China’s and U.S. economic policy uncertainties on China’s exchange market pressure. Our empirical findings robustly show that an upsurge in U.S. EPU is followed by appreciation pressure of the RMB against the dollar, while a hike in China’s EPU triggers devaluation pressure on the RMB. In addition, the impact of economic policy uncertainty has considerable time variation in magnitude, especially after mid-2011, showing a trade-off mechanism between the effects of domestic and foreign economic uncertainties on China’s exchange market pressure. Moreover, we attribute the time-varying features to the changes in China’s dependence on the U.S. and in the exchange rate flexibility. Finally, China should further improve the exchange rate flexibility, reduce its dependence on the U.S. and develop a more diversified currency basket in the exchange rate formation mechanism. JEL: F31 C50 E70
A Biomechanical Study on Cortical Bone Trajectory Screw Fixation Augmented With Cement in Osteoporotic Spines
Authors: Wang Yuetian , Yang Lei , Li Chunde , Sun Haolin 
Published: January 2022

Study Design A biomechanical study. Objective To evaluate the efficacy and feasibility of cement-augmented cortical bone trajectory (CBT) screw fixation. Methods Forty-nine CBT screws were inserted into lumbar vertebrae guided by three-dimensionally printed templates, and then injected with 0, .5, or 1.0 mL of polymethylmethacrylate. The screw placement accuracy, cement dispersion, and cement leakage rate were evaluated radiologically. Biomechanical tests were performed to measure the axial pull-out strength and torque value. Results Overall, 83.67% of the screws were inserted without pedicle perforation. In the 1.0 mL group, cement dispersed into the pedicle zone and formed a concentrated mass more often than in the .5 mL group, but not significantly more often (P > .05). The total cement leakage rate was 18.75%. Compared with the control group, the torque value was slightly higher in the .5 mL group (P = .735) and significantly higher in the 1.0 mL group (P = .026). However, there was no significant difference between the .5 and 1.0 mL groups (P = .431). The maximal pull-out force (Fmax) was increased by 52.85% and 72.73% in the .5 and 1.0 mL groups, respectively, compared with the control group (P < .05). However, the difference was not significant between the 2 cemented groups (P = .985). Conclusions Cement augmentation is a useful method for increasing CBT screw stability in osteoporotic spines. The cement injection volume is recommended to be 1 mL for each screw, and the cement should disperse into the vertebral body than the pedicle zones.
Weightbearing Stable Bimalleolar Ankle Fractures—Bony Equivalents to the Ligamentous Weber B/SER4a Fracture Type? A Prospective Case Series
Authors: Gregersen Martin G. , Molund Marius 
Published: January 2022

Background: In a recent study, we documented that partially unstable Weber B/SER4a fracture types reach union with preserved normal ankle congruence after treatment with a functional orthosis and weightbearing allowed. In the present article, we present a case series of weightbearing stable bimalleolar fractures treated nonoperatively that extends our previously published research. Methods: We included 5 patients with primarily nondisplaced bimalleolar ankle fractures that were stable on weightbearing radiographs. Participants were treated with a walking boot or cast with weightbearing allowed. We also provide a qualitative anatomical analysis of fracture morphology on computed tomographic scans. Results: Median medial clear space (MCS) of fractured ankles after union were 2.4 mm (range, 1.5-3.1). Qualitative descriptions of fracture morphology showed that all fractures were oblique starting at the intercollicular groove of the medial malleolus and extended anteriorly and proximally. Conclusion: MCS measurements after fracture union of nonoperatively treated weightbearing stable bimalleolar fractures seemed consistent with normative data of ankle congruence in our previous study. We consistently recorded oblique fracture patterns involving the anterior colliculus, leaving the origin of posterior deep deltoid ligament intact. We present our material as an argument for the existence of a bony (bimalleolar) equivalent to the ligamentous SER4a fracture. Level of Evidence: Level IV, prospective case series.
Mortality among Italians and immigrants with COVID-19 hospitalised in Milan, Italy: data from the Luigi Sacco Hospital registry
Authors: Giacomelli Andrea , Ridolfo Anna Lisa , Bonazzetti Cecilia , Oreni Letizia , Conti Federico , Pezzati Laura , Siano Matteo , Bassoli Cinzia , Casalini Giacomo , Schiuma Marco , Covizzi Alice , Passerini Matteo , Piscaglia Marco , Borgonovo Fabio , Galbiati Claudia , Colombo Riccardo , Catena Emanuele , Rizzardini Giuliano , Milazzo Laura , Galli Massimo , Brucato Antonio , Antinori Spinello 
Published: January 2022

Abstract
Background
To compare differences in the probability of COVID-19-related death between native Italians and immigrants hospitalised with COVID-19.

Methods
This retrospective study of prospectively collected data was conducted at the ASST Fatebenefratelli-Sacco Hospital in Milan, Italy, between 21 February and 31 November 2020. Uni- and multivariable Cox proportional hazard models were used to assess the impact of the patients' origin on the probability of COVID-19-related death.

Results
The study population consisted of 1,179 COVID-19 patients: 921 Italians (78.1%) and 258 immigrants (21.9%) who came from Latin America (99, 38%), Asia (72, 28%), Africa (50, 19%) and central/eastern Europe (37, 14%). The Italians were significantly older than the immigrants (median age 70 years, interquartile range (IQR) 58–79 vs 51 years, IQR 41–60; p < 0.001), and more frequently had one or more co-morbidities (79.1% vs 53.9%; p < 0.001). Mortality was significantly greater among the Italians than the immigrants as a whole (26.6% vs 12.8%; p < 0.001), and significantly greater among the immigrants from Latin America than among those from Asia, Africa or central/eastern Europe (21% vs 8%, 6% and 8%; p = 0.016). Univariable analysis showed that the risk of COVID-19-related death was lower among the immigrants (hazard ratio [HR] 0.43, 95% confidence interval [CI] 0.30–0.63; p < 0.0001], but the risk of Latin American immigrants did not significantly differ from that of the Italians (HR 0.74, 95% CI 0.47–1.15; p = 0.183). However, after adjusting for potential confounders, multivariable analysis showed that there was no difference in the risk of death between the immigrants and the Italians (adjusted HR [aHR] 1.04, 95% CI 0.70–1.55; p = 0.831), but being of Latin American origin was independently associated with an increased risk of death (aHR 1.95, 95% CI 1.17–3.23; p = 0.010).

Conclusions
Mortality was lower among the immigrants hospitalised with COVID-19 than among their Italian counterparts, but this difference disappeared after adjusting for confounders. However, the increased risk of death among immigrants of Latin American origin suggests that COVID-19 information and prevention initiatives need to be strengthened in this sub-population.
Comparison of the effectiveness of virtual reality and chewing mint gum on labor pain and anxiety: a randomized controlled trial
Authors: Ebrahimian Atefeh , Bilandi Roghaieh Rahmani , Bilandī Mohammad Reza Rahmani , Sabzeh Zahra 
Published: January 2022

Abstract
Objective
Childbirth pain and anxiety are often unnatural, as opposed to being one of the most practical ways to use non-pharmacological methods. The aim of this study was to compare the effectiveness of virtual reality and chewing mint gum on childbirth pain and anxiety.

Methods
This is a single-blind, three-group clinical trial study on 93 mothers referred to Allameh Bohlool Gonabadi and Sajjadieh Torbate Jam Hospitals for natural childbirth in 2018–2019. Subjects were randomly divided into three groups of chewing gum, virtual reality, and control using six blocks. Chewing gum interventions in one group and virtual reality in the other group were performed twice in 4–5 cm and 7–8 cm dilatations for 20 min. In the control group, no intervention except routine care was performed. The research tools included Visual Analogue Scale of Pain and Spielberger’s Anxiety Inventory. Data were analyzed using SPSS) version 22(, ANOVA, Kruskal–Wallis, Chi-square and Tukey tests. Significance level was considered 0.05 in this study.

Results
The main result was differences in pain and anxiety before and after the intervention. There was no significant difference between pre-intervention pain and anxiety scores in the three groups, but there was a significant difference between pain and anxiety scores immediately and 30 min after the intervention.

Conclusion
The results of this study showed that virtual reality and chewing mint gum intervention reduce pain and anxiety in the first stage of childbirth.

Trial registration
IRCT20181214041963N1.
Mindful awareness as a mechanism of change for natural childbirth in pregnant women with high fear of childbirth: a randomised controlled trial
Authors: Veringa-Skiba Irena K. , Ziemer Kelly , de Bruin Esther I. , de Bruin Ed J. , Bögels Susan M. 
Published: January 2022

Abstract
Background
Mindfulness-Based Childbirth and Parenting (MBCP) is effective in increasing natural childbirth in pregnant women with high fear of childbirth (FOC) as compared to enhanced care as usual (ECAU). We aimed to examine through which pathway of action MBCP reaches this effect, based on a model of approaching or avoiding the challenges related to childbirth.

Methods
One hundred eleven pregnant women with high FOC were measured pre- and post-intervention on FOC (emotion pathway), catastrophic beliefs about labour pain (cognition pathway) and mindful awareness (attention pathway). A multiple mediation model was used to examine through which pathway the mechanism of change operated in relation to approach (i.e., natural childbirth) versus avoidance (i.e., self-requested caesarean section).

Results
It was found that greater mindful awareness (18% R2 = 0.18, F[1107] = 22.77, p < 0.0001) was the only significant mechanism of change operating through the attentional pathway leading to natural childbirth. More specifically, nonreactivity to inner experience (a facet of mindful awareness) showed to be the strongest mechanism of change. More extensive meditation practice was positively associated with natural childbirth; however, the number of completed MBCP sessions was not associated with the outcome.

Conclusions
An increase in mindful awareness was the strongest mechanism of change for better adaptation to the challenges of childbirth. Decreases in neither FOC nor catastrophic beliefs about labour pain were identified as mechanisms of change. Additionally, the more one meditated, the more one was inclined towards a natural childbirth. MBCP enhances adaptation to the challenges of childbirth and less use of obstetric interventions in the presence of high FOC.

Trial registration
The Netherlands Trial Register (NTR; 4302).
Surveillance for foodborne disease outbreaks in Zhejiang Province, China, 2015–2020
Authors: Chen Lili , Sun Liang , Zhang Ronghua , Liao Ningbo , Qi Xiaojuan , Chen Jiang 
Published: January 2022

Abstract
Background
Foodborne diseases are a major cause of morbidity and mortality and a major public health problem worldwide. We aim to explore characteristics of foodborne disease outbreaks (FBDOs) in Zhejiang Province and to provide data support for foodborne disease prevention and control. To our knowledge, few such analyses have been published at the provincial level.

Methods
Descriptive statistical methods were used to analyze the data reported by centers for disease control (CDC) at all levels in Zhejiang Province through Foodborne Disease Outbreaks Surveillance System (FDOSS) during 2015–2020.

Results
A total of 962 FBDOs were reported during this period, resulting in 8324 illnesses, 1028 hospitalizations, and 20 deaths. The number of outbreaks (410 outbreaks, 42.62%) and cases (4991 cases, 59.96%) caused by bacteria were the largest, followed by poisonous mushrooms (157 outbreaks, 587 cases), which was the main cause of death (15 deaths, 75%). The highest number of FBDOs occurred in households (381 outbreaks, 39.60%), followed by restaurants (219 outbreaks, 22.77%) and canteens (174 outbreaks, 18.08%). Animal-based foods were the most common single food reported (232 outbreaks, 24.12%), followed by poisonous mushrooms (162 outbreaks, 16.84%), and plant-based foods (133 outbreaks, 13.83%). Poisonous mushrooms took the first place in outbreaks in households (38.32%, 146/381), while bacteria took the first place in outbreaks outside households. Vibrio parahaemolyticus was responsible for the largest number of outbreaks (232 outbreaks, 24.12%), which mainly occurred in catering service units (93.10%, 216/232). Different types of bacteria tended to be found in different food categories, such as Vibrio parahaemolyticus, which was mainly found in aquatic products.

Conclusions
Analysis of FBDOs can provide insight into the most important pathogens and sources of foodborne disease, helping authorities identify high-risk etiologies, high-risk foods, and high-risk settings to guide policies that would reduce FBDOs.
Outcomes of surgery for different types of chronic pulmonary aspergillosis: results from a single-center, retrospective cohort study
Authors: Shen ChangMing , Qiao GaoFeng , Wang Cheng , Jin Feng , Zhang YunZeng 
Published: January 2022

Abstract
Background
The reported experience of surgical treatment for chronic pulmonary aspergillosis (CPA) mainly focused on simple aspergilloma (SA), few about other types of CPA. The present study aims to evaluate the outcomes of surgical treatment for different types of CPA.

Methods
We performed a retrospective analysis of 85 patients with CPA who underwent surgery from 2014 to 2020 at Shandong Provincial Chest Hospital. The patients were divided into four types, including SA, chronic cavitary pulmonary aspergillosis (CCPA), chronic fibrosing pulmonary aspergillosis (CFPA), aspergillus nodule (AN). We collected and analyzed the preoperative, perioperative, and postoperative data to evaluate the outcomes of surgical treatment of different types of CPA.

Results
The four groups had similar age (p = 0.22), symptoms (p = 0.36), lesion location (p = 0.09), VATS rate (p = 0.08), recurrence rate (p = 0.95), and had significant difference in surgical procedures (p < 0.01), time of surgery (p < 0.01), intraoperative blood loss (p < 0.01), postoperative complication (p = 0.01). CFPA (P = 0.01), longer surgical time (P = 0.001), and more intraoperative blood loss (P = 0.004) were risk factors of postoperative complication, more intraoperative blood loss (> 400 ml) was the independent risk factor (OR 13.5, 95% CI 1.6–112.1, P = 0.02). 6 patients relapsed after surgery with a recurrence rate of 7.1%. The mean time to relapse was 14.8 months (2–30 months) after surgery. Relapse occurred in 2 SA patients, 3 CCPA, and 1 CFPA, respectively, while none of the AN patients relapsed. No risk factor for recurrence was found.

Conclusions
Surgical resection seems safe and effective in the treatment of SA, AN, CCPA with a low complication and recurrence rate, while surgery for CFPA should be limited to selected patients because of its higher complication rate.
Nursing allocation in isolation wards of COVID-19 designated hospitals: a nationwide study in China
Authors: Ren Hong-fei , Chen Feng-jiao , He Ling-xiao , Liu Chang-qing , Liu Ying-ying , Huang Yu-jia , Han Hui , Fu Su , Zhang Ming-guang , Jiang Yan 
Published: January 2022

Abstract
Background
Appropriate allocation of nursing staff is key to ensuring efficient nursing in hospitals, and is significantly correlated with patient safety, nursing quality, and nurse job satisfaction. However, there are few studies on nursing workforce allocation in the isolation wards of COVID-19 designated hospitals globally. This study aims to better understand the nursing workforce allocation in the isolation wards of COVID-19 designated hospitals in China, and provide a theoretical basis for efficiently deploying first-line nurses in China and across the world in the future.

Methods
An online survey was conducted among the head nurses (n = 229) and nurses (n = 1378) in the isolation wards of 117 hospitals (selected by stratified sampling), using a self-reported human resource allocation questionnaire.

Results
The average bed-to-nurse ratios of different isolation wards were different (Z = 36.742, P = 0.000). The bed-to-nurse ratios of the ICU, suspected COVID-19 cases ward, and confirmed COVID-19 cases ward, were 1:1.88, 1:0.56, and 1:0.45, respectively. The nurse work hours per shift in different isolation wards were also different (Z = 8.468, P = 0.014), with the specific values of the ICU, suspected COVID-19 cases ward, and confirmed COVID-19 cases ward, being 5, 6, and 6 h, respectively. A correlation analysis showed that the average work hours per shift was proportional to the overtime work of nurses (rs = 0.146), the proportion of nurse practitioners was proportional to the overall utilization rate of nursing human resources in the wards (rs = 0.136), and the proportion of nurses with college degrees was proportional to teamwork (rs = 0.142). The proportion of nurses above grade 10 was inversely proportional to teamwork and psychological problems (rs = 0.135, rs = 0.203). The results of multiple stepwise regression analyses showed that the work hours of nurses per shift was the main factor affecting nurse satisfaction and that the proportion of nurses and the work hours of nurses per shift were both independent factors affecting the length of stay (LOS) of patients.

Conclusion
Hospitals in China have made good nursing workforce allocations during the COVID-19 pandemic, but there are certain shortcomings. Therefore, scientific and efficient nursing workforce allocation practice plans should be established to improve the ability of hospitals to deal with public health emergencies and are urgent problems that need to be addressed soon.