bluuebunny/crossref_metadata_2025_split huggingface dataset:
Managing a patient with acute colonic diverticulitis
Authors: Donovan Elizabeth , Rizzolo Denise 
Published: June 2022

ABSTRACT
Acute diverticulitis is a common condition in Western society with the potential for substantial patient morbidity. Depending on the severity, the patient's clinical presentation and treatment options vary considerably, leaving uncertainty about optimal management. Traditionally, surgery was recommended to prevent complications, persistent symptoms, and recurrent episodes. Improvements in the understanding of the disease's natural history, diagnostic imaging, and long-term outcomes have prompted changes to diagnosis and treatment guidelines.
Escalation of Opioid Withdrawal Frequency and Subsequent AMA Rates in Hospitalized Patients From 2017 to 2020
Authors: Horton Terry , Subedi Keshab , Sharma Ram A. , Wilson Beverly , Gbadebo Bayo M. , Jurkovitz Claudine 
Published: June 2022

Objective
To measure trends for the emergence of opioid withdrawal (OW) and leaving against medical advice (AMA) among hospitalized patients.

Method
Retrospective time-series of hospitalized patients with OW, defined by a Clinical Opioid Withdrawal score >8, using electronic health record data at a tertiary health system and of patients with a discharge status of AMA from January 1, 2017 to December 31, 2020.

Results
The average number of monthly hospitalizations with OW showed a year-to-year increment of 15% in 2018, 21% in 2019, and 34% from 2019 to 2020, whereas the total monthly hospitalizations remained stable. The segmented regression analysis showed that the upward trend in hospitalizations with OW became significant after January 2019 (slope: 1.14, 95% confidence interval [CI]: 0.70, 1.57). After August 2019, Fentanyl was added to the hospital urine drug testing panel and was identified in most OW patients. The monthly proportion of patients who left AMA was significantly higher among the OW patients than among all other admitted patients. There was a significant increase of 0.39 (95% CI: 0.29–0.49, P < 0.001) per month in %AMA among patients with OW. The estimated difference in %AMA among OW patients versus all other patients was 7.25 (95% CI: 5.12–9.38) in January 2017, and 16.92 (95% CI: 14.60–19.24) in December 2020.

Conclusions
The number of hospitalized patients either presenting with or developing OW increased between 2017 and 2020 with a significant rise occurring after January 2019. The percentage of patients who left AMA among those who developed OW steadily worsened during the entire study period.
Inconsistent Benefits From Mobile Information Communication Technology in Adults With Peripheral Arterial Disease
Authors: Aronow Wilbert S. , Avanesova Anna A. , Frishman William H. , Shamliyan Tatyana A. 
Published: June 2022

Introduction:
Quality of evidence regarding telemedicine in adults with peripheral arterial disease has not been systematically appraised.

Objectives:
To explore benefits and harms from mobile information communication technology devices and applications in peripheral arterial disease.

Methods:
Systematic rapid evidence review and appraisal with the grading of recommendations assessment, development, and evaluation working group approach.

Results:
Sixteen randomized controlled clinical trials (RCT) examined various self-monitoring devices, telemedicine platforms, and individualized telephone counseling. Low-quality evidence suggested that the odds of treatment failure (pooled Peto odds ratio 0.8; 95% CI, 0.4–1.7; 5 RCTs), adverse effects (pooled Peto odds ratio 0.9; 95% CI, 0.5–1.5; 2 RCTs), and physical performance (standardized mean difference in 6-minute walking test 0.2; 95% CI, –0.3–0.7; 4 RCTs) did not differ between mobile interventions and usual care. Single RCTs suggested large but inconsistent improvement in the quality of life: EuroQol5D standardized mean difference = 5.0 (95% CI, 4.4–5.7; 1 RCT) after telehealth program for promoting patient self-management and standardized mean difference = 1.4 (95% CI, 0.4–2.3; 1 RCT) after structured rehabilitation with mobile self-monitoring. Inconsistent reporting of patient-centered outcomes and small sample sizes hampered the quality of evidence.

Conclusions:
Improved quality of life after specific mobile applications should be confirmed in powered RCTs and large postmarketing studies.
Correlation among four questionnaires that evaluate menopausal symptoms
Authors: Souza Laura A. Cota e , Araujo Amanda T. , Lima Angelica A. 
Published: June 2022

Abstract

Objective:
The number of specific scales to measure menopausal symptoms has increased significantly in the last decades. However, the lack of standardization as well as prioritization of which scale should be used in exploring menopausal symptoms poses problems in most populations. Thus, we aimed at demonstrating the correlation among four questionnaires evaluating menopausal symptoms: the Menopause Rating Scale (MRS), Greene Climacteric Scale (GCS), Kupperman Menopausal Index, and Women's Health Questionnaire (WHQ).

Methods:
We recruited 336 women between 40 and 65 years of age who responded to all four questionnaires. For each questionnaire, we calculated the overall score and the subscale scores. We then compared variables using the Spearman rank correlation coefficient (Rho).

Results:
We found a very strong correlation (Rho > 0.80; P
< 0.001) between all the questionnaires. The strongest correlations were those observed in the comparisons involving the GCS (Rho 0.92-0.95; P
< 0.001), whereas the weakest ones were observed using the WHQ scale (Rho –0.86 to –0.89; P
< 0.001). Like in the overall score analyses, vasomotor, somatic, and psychological symptoms demonstrated the strongest correlations in the GCS comparisons and the weakest correlations between the WHQ and MRS.

Conclusions:
The MRS, GCS, Kupperman Menopausal Index, and WHQ assessed menopausal symptoms in a very similar way. We recommend further studies to adjust and improve the existing questionnaires, test their robustness in different settings, and ensure their applicability in research and clinical practice.
Physical Characteristics of SurgiMend Meshed Biological ADM in Immediate Prepectoral Implant Breast Reconstruction
Authors: Gui Gerald , Gui Marcus , Gui Adrian , Tasoulis Marios Konstantinos 
Published: June 2022

Summary:
With increasing acceptance of prepectoral implant breast reconstruction, there has been a requirement for biological acellular dermal matrices with conformational properties, high tensile strength, and rapid integration. SurgiMendPRS Meshed is a biological acellular dermal matrix derived from fetal calf with these specific characteristics for prepectoral implant breast reconstruction. The aim of this study was to test the performance of this mesh by recreating its surgical use ex-vivo using a variety of implants in an effort to define its physical properties. The mesh is usually attached with a number of interrupted sutures to the implant periphery, the variable being at the inferior border, where it can be attached as a snug fit at the level of the inframammary crease (“tent” technique) or sewn behind the implant, cradling the lower pole (“hammock” technique). The results show mesh elasticity to stretch with increasing implant weight. When used as a “hammock,” greater stretch was demonstrated compared with the “tent” technique, allowing greater degrees of ptosis to be achieved. The suture points demonstrated lines of tension that progress evenly over the anterior implant surface. The mesh performed better when used at maximum stretch, but should not be forcibly stretched over an implant as the lines of stress show uneven distribution of lines of tension. These data provide a structural basis on optimum clinical use of this acellular dermal matrix in prepectoral implant breast reconstruction.
Spondylodiscitis in Pediatric Age: A Retrospective Cohort Study
Authors: Cavalieri Stefano , Pessina Benedetta , Indolfi Giuseppe , Galli Luisa , Trapani Sandra 
Published: June 2022

Background:
Pediatric spondylodiscitis is rare, hardly diagnosed and treated due to the nonspecificity of clinical presentation and laboratory investigations, difficulty of etiologic identification and lack of management guidelines.

Methods:
A retrospective study was conducted on 29 children with spondylodiscitis. Clinical, hematic and radiologic data were collected and compared between 2 age-subgroups (below and from 4 years old on) to investigate age-related differences. Epidemiologic, management and follow-up data were also described.

Results:
Slight male predominance and a peak of incidence <2 years were observed. Symptoms were significantly differently distributed in the 2 age-subgroups: children <4 years showed mainly refusal/inability to sit or bear weight, irritability, limping and poor general conditions; children ≥4 years most frequently had back pain and fever, and pain upon palpation of the spine. The lumbar spine and more than 1 vertebra were most frequently involved. Median diagnostic delay of 12 days was observed, without significant difference between age-subgroups, and delay >2 months was always associated with multivertebral involvement and complications. All children were treated with broad-spectrum antibiotics for a median of 12 weeks. Only in 1 complicated case, surgical treatment was also required.

Conclusions:
The clinical presentation of spondylodiscitis may be age-specific, with younger children often exhibiting subtle signs and symptoms. Broad-spectrum antibiotics covering for Staphylococcus aureus should be initiated as soon as possible and performed many weeks, being effective in treating the infection without clinical sequelae, even in patients with comorbidities. Surgical treatment should be reserved for complicated cases with neurologic involvement.
Multimodal imaging findings in Purtscher-like retinopathy after retrobulbar anesthesia
Authors: Gliagias Vasiliki , Pandey Avi , Cheela Isha 
Published: June 2022

Introduction:
This is a case of Purtscher-like retinopathy with an unusual etiology of retrobulbar anesthesia, evidenced by optical coherence tomography-angiography (OCT-A) images.

Patient and Clinical Findings:
After cataract surgery with a retrobulbar block, a 65-year-old woman experienced sudden dramatic visual reduction with superficial white retinal patches on fundus examination and corresponding capillary bed infarcts on fluorescein angiography and OCT-A.

Diagnosis, Intervention, and Outcomes:
Using advanced OCT-A, fluorescein angiography imaging, and fundus photography, the patient was diagnosed with Purtscher-like retinopathy. The patient was treated with topical steroids, nonsteroidal anti-inflammatory drops, and antibiotic drops, with gradual and nearly complete resolution of visual acuity.

Conclusions:
This case represents a rare but possible complication of retrobulbar anesthesia associated with cataract surgery. Despite dramatic changes on OCT-A, and in contrast to other reports with similar characteristic findings, our patient regained significant vision.
Elevated 18:0 lysophosphatidylcholine contributes to the development of pain in tissue injury
Authors: Friston Dominic Anthony , Cuddihy Joshua , Souza Luiz Jessica , Truong An Hoai , Ho Laptin , Basra Meirvaan , Santha Peter , Oszlacs Orsolya , de Sousa Valente Joao , Marczylo Tim , Junttila Sini , Laycock Helen , Collins Declan , Vizcaychipi Marcela , Gyenesei Attila , Takats Zoltan , Jancso Gabor , Want Elizabeth , Nagy Istvan 
Published: June 2022

Abstract
Tissue injuries, including burns, are major causes of death and morbidity worldwide. These injuries result in the release of intracellular molecules and subsequent inflammatory reactions, changing the tissues' chemical milieu and leading to the development of persistent pain through activating pain-sensing primary sensory neurons. However, the majority of pain-inducing agents in injured tissues are unknown. Here, we report that, amongst other important metabolite changes, lysophosphatidylcholines (LPCs) including 18:0 LPC exhibit significant and consistent local burn injury-induced changes in concentration. 18:0 LPC induces immediate pain and the development of hypersensitivities to mechanical and heat stimuli through molecules including the transient receptor potential ion channel, vanilloid subfamily, member 1, and member 2 at least partly via increasing lateral pressure in the membrane. As levels of LPCs including 18:0 LPC increase in other tissue injuries, our data reveal a novel role for these lipids in injury-associated pain. These findings have high potential to improve patient care.
Hospital-Based Case Management Model for Child Protection Teams in Taiwan: An Action Research Approach
Authors: CHEN Chia-Jung , CHEN Yi-Wen , CHANG Hsin-Yi , FENG Jui-Ying 
Published: June 2022

ABSTRACT

Background
Hospital-based child protection teams play an important role in the multidisciplinary assessment, treatment, care, and rehabilitation of abused children and their families. However, the process by which these teams are built and promoted has not been explored adequately in the literature.

Purpose
This study was developed to examine the process used to promote child protection team case management and to evaluate the related results.

Methods
An action research model was adopted in this study. The participants and the investigator were members of a child protection team at a medical center in southern Taiwan. Qualitative and quantitative assessments were used to identify problems related to organizational structure, intervention procedures, and evaluation effectiveness. Thereafter, the study program was implemented, and the results were evaluated. Content analysis of the qualitative data, including transcribed interviews with external benchmark members and members of the hospital's team and text entries from the investigator's reflective journal, was conducted. Quantitative data, including monitoring indicators for team case management, were analyzed using descriptive statistics.

Results
Three important concepts emerged related to changes in the promotion of case management by hospital child protection teams. These included formulation of a team operation model through visits to benchmark hospitals, establishment of the case management and monitoring mechanism based on team consensus, and expansion of collaboration with external agencies through the establishment of a child and adolescent protection medical regional integration center. The results of the promotion process were affected by factors that included member willingness, teamwork, hospital support, and national policy.

Conclusions/Implications for Practice
Use of the hospital child protection team case management model developed in this study was shown to facilitate the provision of consultation services, integrate the opinions and resources of experts from various fields, and allow the timely provision of acute care, follow-up family environment support, and social resources required by children and their family members. These measures help prevent the reoccurrence of child abuse and enable children to grow up healthily and free from violence.
Burn Pit Exposure Is Associated With Increased Sinonasal Disease
Authors: Hill Christopher J. , Meyer Charles D. , McLean James E. , Anderson Danielle C. , Hao Yajing , Lin Feng-Chang , Kimple Adam J. , Capra Gregory G. 
Published: June 2022

Objective
The aim of this study was to determine whether self-reported burn pit exposure is associated with increased subjective and objective sinus disease.

Design
A cross-sectional study was performed evaluating consecutive adult patients presenting to a US Military rhinology clinic. Demographics, medical histories, sinonasal quality-of-life scores, and nasal endoscopy examinations were obtained. Participants were divided into three cohorts based on self-reported exposure histories and outcomes compared.

Results
One hundred eighty-six patients met the inclusion criteria, the majority of whom were male. Patients with burn pit exposure had worse Sinonasal Outcome Test-22 scores (49.9) compared with those deployed without burn pit exposure (31.8) or never deployed (31.5). Endoscopic findings demonstrated worse disease within those exposed (Lund-Kennedy score, 3.3) compared with the other cohorts (1.8 and 1.7, respectively).

Conclusions
These novel findings suggest that deployment-related burn pit exposure is associated with increased subjective and objective sinus disease.
Disparity in Occupational Health Risk During the Pandemic
Authors: Yuan Bocong , Lan Junbang , Li Jiannan 
Published: June 2022

Objective
This study clarifies potential misestimation of occupational risk caused by the dichotomy of frontline essential and nonessential occupations in prior studies.

Methods
The linear regression is used to investigate the occupational risk in terms of incidence rate, hospitalization, and mortality on community level during the pandemic.

Results
Overall, frontline essential occupations were positively associated with incidence rate, hospitalization, and mortality (156.06, 18.47, and 3.49; P < 0.01). Among essential occupations, however, education, training, and library occupations were negatively associated with them, whereas transportation, protective service, food preparation, and serving occupations were insignificantly associated with them. Moreover, among nonessential occupations, building and grounds cleaning, construction, and extraction occupations were positively associated with them.

Conclusion
The dichotomy of frontline essential and nonessential occupations can bring overestimation and underestimation of occupational risk during the COVID-19 pandemic.
Migraine Headache in an Employed Population
Authors: Burton Wayne N. , Schultz Alyssa B. , Shepherd Martha E. , Hines David 
Published: June 2022

Objective
Demographics, health risks, pharmaceutical utilization, and other characteristics of adults with and without migraine who were employed by a school district in the southern United States were compared.

Methods
A total of 4528 employees completed a health risk appraisal. A diagnosis of migraine was reported by 11%. Employees with and without migraine were compared on several measures.

Results
Demographic and health risk differences were observed among the comparison groups. One-fifth of migraineurs had a prescription for an opioid, which was associated with very high average annual health care costs ($17,791) compared with migraineurs without opioid ($3907).

Conclusions
Migraine is common in the workforce. Employers may want to educate employees with migraine about evidence-based treatments. Benefit plan design should be consistent with current accepted treatment guidelines for opioid use.
Development of the National Institute for Occupational Safety and Health Worker Well-Being Questionnaire
Authors: Chari Ramya , Sauter Steven L. , Petrun Sayers Elizabeth L. , Huang Wenjing , Fisher Gwenith G. , Chang Chia-Chia 
Published: June 2022

Objective
This article describes development of the National Institute for Occupational Safety and Health (NIOSH) Worker Well-Being Questionnaire (WellBQ).

Methods
The NIOSH WellBQ was developed through literature reviews and expert panel recommendations. We drew from a representative sample of the civilian, noninstitutionalized, US working population to pilot the questionnaire. Psychometric analyses were performed on data from 975 respondents to finalize items and optimize the NIOSH WellBQ's psychometric properties.

Results
The final questionnaire consists of 16 scales, 5 indices, and 31 single items across 5 domains: (1) work evaluation and experience; (2) workplace policies and culture; (3) workplace physical environment and safety climate; (4) health status; and (5) home, community, and society (experiences and activities outside of work). The instrument demonstrated adequate reliability and validity.

Conclusions
The NIOSH WellBQ is a reliable and valid instrument that comprehensively measures worker well-being.
Lasers for benign prostatic hyperplasia (hybrid, blue diode, TFL, Moses). Which one to choose?
Authors: Doizi Steeve 
Published: June 2022

Purpose of review
To present the evidence of latest developments of lasers for the surgical treatment of benign prostatic hyperplasia (BPH). We focused on recent advancements in Ho:YAG laser such as Moses technology, the Thulium Fiber Laser (TFL), the blue diode laser, and hybrid laser.

Recent findings
Laser enucleation of prostate techniques using either Ho:YAG laser with the Moses technology and Moses 2.0, or TFL seem efficient and safe compared with the standard enucleation using Ho:YAG laser. Only in vitro studies evaluated the blue diode laser and hybrid laser (combination of a continuous wave TFL and blue diode laser). Blue diode laser showed intermediate incision depth and minimal coagulation depth compared with Ho:YAG laser and Super Pulse TFL. Hybrid laser showed deep incision depth and small coagulation area compared with Ho:YAG laser and continuous wave TFL.

Summary
Surgical treatment of BPH using Moses technology, Moses 2.0, and TFL shows encouraging results comparable to the standard enucleation using Ho:YAG laser. Only in vitro data are currently available for blue diode laser and hybrid laser. Future well-designed studies comparing these technologies and evaluating them on specific risk groups of patients as well as the long-term durability of outcomes are needed.
Systematic Review and Meta-Analysis to Estimate the Treatment Effect and Inform a Noninferiority Margin for a Phase 3 Noninferiority Trial in Uncomplicated Urogenital Gonorrhea
Authors: Mitrani-Gold Fanny S. , Fix Jonathan , Donald Alison 
Published: June 2022

Background
Active-controlled noninferiority studies are used to investigate novel agents for uncomplicated urogenital gonorrhea (uUGC) as placebo-controlled trials are unethical. A systematic literature review and meta-analysis were conducted to estimate the ceftriaxone and proxy-for-placebo microbiological treatment effect and determine an appropriate noninferiority margin for phase 3 trials.

Methods
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. To account for interstudy variability, a weighted, noniterative random-effects model was fitted using “R” software to estimate the microbiological response rate and 95% confidence intervals (CIs) for ceftriaxone and proxy-for-placebo (treatment with an antibiotic the isolate was subsequently confirmed resistant to, or spontaneous resolution without treatment). I
2, τ
2, and P values were computed and included in the meta-analysis forest plot.

Results
Seventeen studies were included in the meta-analysis; 14 reported ceftriaxone response in micro-intent-to-treat and microbiologically evaluable populations, and 3 reported proxy-for-placebo treatment response in uUGC (microbiologically evaluable population only). Microbiological treatment effect was estimated by subtracting the upper end of the CI for placebo from the lower end of the CI for ceftriaxone. Overall microbiological response was 98% (95% CI, 97–99) for ceftriaxone and 44% (95% CI, 34–54) for proxy-for-placebo, resulting in a microbiological treatment effect of 43%. A noninferiority margin of 15% preserved 65% of the ceftriaxone treatment effect, exceeding the 50% recommended per US Food and Drug Administration guidance for noninferiority studies.

Conclusions
Results of this systematic literature review and meta-analysis could help inform the design, conduct, and analysis of future clinical studies in uUGC.