bluuebunny/crossref_metadata_2025_split huggingface dataset:
Delayed encephalopathy after COVID-19: A case series of six patients
Authors: Akimoto Takayoshi , Hara Makoto , Tasaki Kenta , Kurosawa Yusuke , Nakamoto Tadaharu , Hirose Satoshi , Mizoguchi Tomotaka , Yokota Yuki , Ninomiya Satoko , Nakajima Hideto 
Published: October 2022

Rationale:
Acute encephalopathy is a severe neurological complication of coronavirus disease 2019 (COVID-19). Most cases of acute encephalopathy associated with COVID-19 occur within several weeks of COVID-19 onset. We describe a case series of 6 patients who developed delayed encephalopathy (DE) after COVID-19.

Patient concerns and diagnoses:
We evaluated patients who recovered from COVID-19 and showed acute disturbance of consciousness or focal neurological deficits without recurrence of pneumonitis. Six patients, 2 females and 4 males, with ages ranging from 65 to 83 years were included. Durations of hospitalization due to COVID-19 were between 25 and 44 days. The severity of COVID-19 was moderate in 5 and severe in 1 patient. Patients were rehospitalized for acute disturbance of consciousness concomitant with postural tremor and, abnormal behavior, hemiplegia, aphasia, or apraxia between 34 and 67 days after the onset of COVID-19. Chest computed tomography showed no exacerbation of pneumonitis. Brain magnetic resonance imaging showed no specific findings except in 1 patient with an acute lacunar infarction. Electroencephalogram demonstrated diffuse slowing in all patients. Repeat electroencephalogram after recovery from encephalopathy demonstrated normal in all patients. One of the 6 patients had cerebrospinal fluid (CSF) pleocytosis. CSF protein levels were elevated in all patients, ranging from 51 to 115 mg/dL. CSF interleukin-6 levels ranged from 2.9 to 10.9 pg/mL. The immunoglobulin index was 0.39 to 0.44. Qlim(alb) < QAlb indicating dysfunction of the blood–brain barrier was observed in all patients. Severe acute respiratory syndrome coronavirus 2 reverse transcription polymerase chain reaction of CSF was negative in all patients. Neuronal autoantibodies were absent in serum and CSF.

Interventions and outcomes:
Immunotherapy including steroid pulses was administered to 3 patients; however, symptoms of encephalopathy resolved within several days in all patients, regardless of treatment with immunotherapy, and their consciousness levels were recovered fully. Notably, postural tremor remained for 2 weeks to 7 months.

Lessons:
In our patients, DE after COVID-19 was characterized by symptoms of acute encephalopathy accompanied with tremor in the absence of worsening pneumonitis after the fourth week of COVID-19 onset. Our findings indicate blood–brain barrier dysfunction may contribute to the pathogenesis of DE after COVID-19.
Pregnancy outcomes of four different cycle protocols for frozen embryo transfer: a large retrospective cohort study
Authors: Qian Yue , Wan Qi , Bu Xiao-Qing , Li Tian , Tang Xiao-Jun , Jia Yan , Feng Qian , Lv Xing-Yu , Meng Xiang-Qian , Yang Yin , Ding Yu-Bin , Geng Li-Hong , Xia Min , Zhong Zhao-Hui 
Published: October 2022

Objective:
To evaluate the pregnancy outcomes of the four endometrial preparation protocols for people undergoing frozen-thawed embryo transfer (FET), including natural cycle (NC), hormone replacement therapy cycle (HRT), gonadotropin-releasing hormone agonist artificial cycle (GAC), and ovarian stimulation cycle (OC).

Methods:
This retrospective cohort study enrolled 10,333 cycles of frozen embryo transfer performed at Xinan Gynecological Hospital in Sichuan, China, from January 2018 to December 2018. The patient’s baseline characteristics and pregnancy outcomes were extracted from the medical record system. Pregnancy outcomes were compared among the four groups and multiple logistic regression models were used to adjust for the confounding factors.

Results:
After adjusting for covariates, multiple logistic regression analysis showed no statistical significance in pregnancy outcomes in the HRT group, GAC group, and OC group compared to the NC group in the entire population. The adjusted odds ratio of live birth was 0.976 (95% confidence interval [CI] 0.837–1.138) for the HRT group, 0.959 (95% confidence interval 0.797–1.152) for the GAC group, and 0.909 (95% confidence interval 0.763–1.083) for the OC group.

Conclusions:
The natural protocol had comparable pregnancy outcomes compared to the other three endometrial preparation protocols in the overall FET population. More high-quality prospective randomized controlled trials are required to assess the efficacy of the four protocols and explore the optimal one.
Integrated Plastic Surgery Residency Applicant Perceptions of Virtual Interviews
Authors: Yoon Joshua S. , Kim Julia , Puthumana Joseph , Ha Michael , Liang Yuanyuan , Rasko Yvonne , Grant Michael P. , Nam Arthur J. , Steinberg Jordan P. , Gosman Amanda A. , Lifchez Scott D. , Liang Fan 
Published: October 2022

Purpose
The 2020–2021 interview cycle for integrated plastic surgery applicants was the first to be held virtually because of the COVID-19 pandemic. Here, we detail the largest study on integrated plastic surgery applicant perceptions after the virtual interview cycle.

Methods
A 35-question institutional review board–approved survey was distributed to medical students who had applied to the Johns Hopkins/University of Maryland or University of California San Diego integrated residency programs during the 2020–2021 interview cycle. Survey questions assessed the structure, strengths, and weaknesses of the exclusively virtual interview process. Survey administration and data collection were performed using the Qualtrics platform.

Results
Of 318 distributed surveys, 94 were completed. In addition, 91.5% of respondents preferred in-person interviews before the interview season, whereas 54.3% preferred in-person interviews afterward. Applicants who favored virtual interviews did not view being unable to physically meet with program staff as a detriment (P = .001) and felt they could effectively advocate for themselves (P = .002). Overall, the most cited strengths were the ability to complete more interviews (P = .01) and cost benefits (P = .02). Criticisms were directed at the impersonal nature of the exchange (86.2%), lack of physical tour (56.4%), and difficulties at self-advocacy (52.1%).

Conclusion
Preference for virtual interviews increased from 7.5% to 34.0% after the virtual interview cycle. For several students, the ideal interview structure permits both in-person and virtual interviews to maximize flexibility. Augmenting with virtual city tours and one-on-one interviews may mitigate the impersonal nature of virtual interviews as perceived by some applicants.
Division of Fasciocutaneous Pedicled Flaps—Is It Time to Change Practice?
Authors: Mohsina Subair , Sharma Ramesh Kumar , John Jerry R. , Tripathy Satya Swarup , Singh Harbans 
Published: October 2022

Introduction
The study was carried out to evaluate the safety of early division of the pedicled flaps and to identify the optimum day of division.

Methods
This prospective, parallel arm, open-label, noninferiority, randomized controlled trial was carried out from January 2019 to July 2020. All patients (age, ≥5 years) undergoing reconstructive procedures using pedicled flaps were randomized in 1:1 ratio to receive either early division or conventional division protocol. In the early-division group, the flap perfusion, if satisfactory on day 8 by clinical and thermographic methods, a clamp was applied on the pedicle. The clamp was gradually tightened to produce controlled delay, and perfusion assessment was repeated after complete tightening. If satisfactory, the flaps were divided. Primary endpoints were flap at 24 hours after division, day of division, and day of complete inset of the flap. Secondary end points included perfusion of the flap on day 8, morbidity parameters (wound infection/suture dehiscence, need for secondary surgery and donor site morbidity), quality of life, and function scores.

Results
Thirty-five patients were included in each group. The 2 groups were similar in terms of various demographic, clinicopathological variables, defect and flap characteristics. The flap survival rate was similar (P = 0.31) between the early (34/35) and standard (35/35) division groups. The early-division group had a significantly early mean day of flap division (mean difference of 12.74 days; P < 0.00001) and complete flap inset (mean difference of 12.09 days; P < 0.00001). All flaps had satisfactory perfusion on day 8. The wound infection rate was 1.33 times significantly higher in the conventional group (P = 0.033). There was a higher incidence of donor site morbidity (9% vs 0%) in the conventional group when compared with the early division group. The quality of life and function scores at 3 weeks (mean difference 2.37; P < 0.001) and 6 weeks (mean difference 3.76; P < 0.001) and adjacent joint stiffness were significantly higher in the early division group when compared with conventional group.

Conclusions
The pedicled flaps can be divided significantly early at an average duration of 10 to 11 days after flap inset with increased patient satisfaction rate and with a reduced postoperative morbidity. The authors have included a diversity of pedicled flaps used in different anatomic locations. By using stratified block randomization, we could ensure that the distribution was similar between the 2 groups, thus minimizing the heterogeneity in the analysis. This could also potentially indicate the usefulness of the controlled delay technique, irrespective of the anatomic location and type of the flap.
Multidisciplinary Team in Severe Infectious Complications Caused by Pharyngeal Foreign Body
Authors: Wang Tianyu , Cheng Yin , Liang Caiquan , Zha Siluo , Lin Bojian , Zha Xudong , Cai Boyu , Peng Hu , Liu Huanhai 
Published: October 2022

Background:
Pharyngeal foreign body is not only a common emergency in people’s daily life, but also a common simple disease in otorhinolaryngology. However, the disease is easy to be ignored due to its common occurrence, which may lead to a series of serious complications including sepsis and local abscess.

Case Presentation:
In this case, a patient with sepsis, piriform fistula, deep neck abscess, and mediastinal abscess caused by a fishbone was reported. After reviewing the international literature on severe infectious complications caused by foreign bodies in pharynx, the authors emphasize the important role of multidisciplinary team in dealing with complex complications.

Result:
The whole process of patient from onset to recovery was summarized in a timeline. During hospitalization, the value of leukocyte counts and C-reactive protein in routine blood test was record dynamically. The electronic laryngoscopy, neck computed tomography and chest computed tomography were used to judge treatment efficacy. After about 2 months of hospitalization, the patient was recovered without sequelae. No adverse reactions were found during the follow-up.

Conclusion:
The incorrect method of removing foreign body after mis-swallowing may develop serious complications. Therefore, It is important to strengthen medical preaching for general population of correct treatments after foreign body ingestion. In addition, the case reminds clinicians to pay more attention to patients’ medical history and details of all medical examinations, which may provide significant clues for making the correct diagnosis and treatment quickly.
Prospective validation and application of the Trauma-Specific Frailty Index: Results of an American Association for the Surgery of Trauma multi-institutional observational trial
Authors: Joseph Bellal , Saljuqi Abdul Tawab , Amos Joseph D. , Teichman Amanda , Whitmill Melissa L. , Anand Tanya , Hosseinpour Hamidreza , Burruss Sigrid K. , Dunn Julie A. , Najafi Kaveh , Godat Laura N. , Enniss Toby M. , Shoultz Thomas H. , Egodage Tanya , Bongiovanni Tasce , Hazelton Joshua P. , Colling Kristin P. , Costantini Todd W. , Stein Deborah M. , Schroeppel Thomas J. , Nahmias Jeffry ,   the AAST Frailty MIT Study Group
Published: October 2022

BACKGROUND
The frailty index is a known predictor of adverse outcomes in geriatric patients. Trauma-Specific Frailty Index (TSFI) was created and validated at a single center to accurately identify frailty and reliably predict worse outcomes among geriatric trauma patients. This study aims to prospectively validate the TSFI in a multi-institutional cohort of geriatric trauma patients.

METHODS
This is a prospective, observational, multi-institutional trial across 17 American College of Surgeons Levels I, II, and III trauma centers. All geriatric trauma patients (65 years and older) presenting during a 3-year period were included. Frailty status was measured within 24 hours of admission using the TSFI (15 variables), and patients were stratified into nonfrail (TSFI, ≤0.12), prefrail (TSFI, 0.13–0.25), and frail (TSFI, >0.25) groups. Outcome measures included index admission mortality, discharge to rehabilitation centers or skilled nursing facilities (rehab/SNFs), and 3-month postdischarge readmissions, fall recurrences, complications, and mortality among survivors of index admission.

RESULTS
A total of 1,321 geriatric trauma patients were identified and enrolled for validation of TSFI (nonfrail, 435 [33%]; prefrail, 392 [30%]; frail, 494 [37%]). The mean ± SD age was 77 ± 8 years; the median (interquartile range) Injury Severity Score was 9 (5–13). Overall, 179 patients (14%) had a major complication, 554 (42%) were discharged to rehab/SNFs, and 63 (5%) died during the index admission. Compared with nonfrail patients, frail patients had significantly higher odds of mortality (adjusted odds ratio [aOR], 1.93; p = 0.018), major complications (aOR, 3.55; p < 0.001), and discharge to rehab/SNFs (aOR, 1.98; p < 0.001). In addition, frailty was significantly associated with higher adjusted odds of mortality, major complications, readmissions, and fall recurrence at 3 months postdischarge (p < 0.05).

CONCLUSION
External applicability of the TSFI (15 variables) was evident at a multicenter cohort of 17 American College of Surgeons trauma centers in geriatric trauma patients. The TSFI emerged as an independent predictor of worse outcomes, both in the short-term and 3-month postdischarge.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
The Reality of Inadequate Patient Care and the Need for a Global Action Framework in Organ Donation and Transplantation
Authors: Domínguez-Gil Beatriz , Ascher Nancy L. , Fadhil Riadh A.S. , Muller Elmi , Cantarovich Marcelo , Ahn Curie , Berenguer Marina , Bušić Mirela , Egawa Hiroto , Gondolesi Gabriel E. , Haberal Mehmet , Harris David , Hirose Ryutaro , Ilbawi André , Jha Vivekanand , López-Fraga Marta , Andrés Madera Sergio , Najafizadeh Katayoun , O’Connell Philip J. , Rahmel Axel , Shaheen Faissal A.M. , Twahir Ahmed , Van Assche Kristof , Wang Haibo , Haraldsson Boerje , Chatzixiros Efstratios , Delmonico Francis L. 
Published: October 2022

Background.
Transplant therapy is considered the best and often the only available treatment for thousands of patients with organ failure that results from communicable and noncommunicable diseases. The number of annual organ transplants is insufficient for the worldwide need.

Methods.
We elaborate the proceedings of the workshop entitled “The Role of Science in the Development of International Standards of Organ Donation and Transplantation,” organized by the Pontifical Academy of Sciences and cosponsored by the World Health Organization in June 2021.

Results.
We detail the urgency and importance of achieving national self-sufficiency in organ transplantation as a public health priority and an important contributor to reaching relevant targets of the United Nations Agenda for Sustainable Development. It details the elements of a global action framework intended for countries at every level of economic development to facilitate either the establishment or enhancement of transplant activity. It sets forth a proposed plan, by addressing the technical considerations for developing and optimizing organ transplantation from both deceased and living organ donors and the regulatory oversight of practices.

Conclusions.
This document can be used in governmental and policy circles as a call to action and as a checklist for actions needed to enable organ transplantation as treatment for organ failure.
Regulation and Function of a Polarly Localized Lignin Barrier in the Exodermis
Authors: Manzano Concepcion , Morimoto Kevin W. , Shaar-Moshe Lidor , Mason G. Alex , Cantó-Pastor Alex , Gouran Mona , Bellis Damien De , Ursache Robertas , Kajala Kaisa , Sinha Neelima , Bailey-Serres Julia , Geldner Niko , Pozo J Carlos del , Brady Siobhan M. 
Published: October 2022

ABSTRACTMulticellular organisms control interactions with their environment through the development of specialized barriers in specific cell types. A conserved barrier in plant roots is the endodermal Casparian strip (CS). The CS is made of polymerized lignin and forms a ring-like structure that seals the apoplastic space between the endodermal cells. Most angiosperms also have another root cell type, the exodermis, that is reported to form a barrier. Our understanding of exodermal developmental and molecular regulation, as well as function, is limited as this cell type is absent from the model speciesArabidopsis thaliana. Using tomato (Solanum lycopersicum) as a model system we demonstrate that in this species, the exodermis does not form a CS. Instead, it forms a polar lignin cap with an equivalent barrier function to the endodermal CS. We demonstrate that although endodermal regulators are conserved between Arabidopsis and tomato, exodermal differentiation occurs by a distinct regulatory pathway involving theSlSCZandSlEXO1transcription factors. Although the exodermis and endodermis both produce barriers that restrict mineral ion uptake, they have unique and overlapping roles in their selectivity. Whether conservation and similarities between the endodermis and exodermis exist in other species remains to be determined. Nonetheless, in tomato, these distinct lignin structures have a convergent function with different genetic regulations.
Socio-political factors underlying the adoption of green bond financing of infrastructure projects: the case of Ghana
Authors: Babon-Ayeng Prosper , Oduro-Ofori Eric , Owusu-Manu De-Graft , Edwards David James , Kissi Ernest , Kukah Augustine Senanu Komla 
Published: October 2022

PurposeThere is a pressing need to increase investments in sustainable infrastructure to promote low carbon economic growth and ensure environmental sustainability. Consequently, this study examines the socio-political factors underlying the adoption of green bond financing of infrastructure projects.Design/methodology/approachPrimary data was gathered from experts with advanced experience in, or knowledge of green bonds in the Kumasi Metropolis. To identify respondents with pertinent knowledge that is relevant to the study, purposive and snowball sampling techniques were used. One-sample t-test and relative importance index were used in this study's statistical analysis.Findings‘Training and experience with sustainable finance’ was seen as the most important social factor underlying the adoption of green bond financing of infrastructure projects by the respondents and ‘Governmental tax-based incentives’ was rated as the leading political factor.Originality/valueThis pioneering research attempts to ascertain the socio-political factors affecting the adoption of green bond financing of infrastructure projects. Emergent results of analysis and concomitant discussions add knowledge to fill a void in literature on the social and political factors affecting the adoption of green bond financing of infrastructure projects in developing countries.
A comprehensive evaluation of factors affecting nurse leaders’ work-related well-being
Authors: Niinihuhta Milja , Terkamo-Moisio Anja , Kvist Tarja , Häggman-Laitila Arja 
Published: October 2022

Purpose
This study aims to describe nurse leaders’ experiences of work-related well-being and its association with background variables, working conditions, work engagement, sense of coherence and burnout.

Design/methodology/approach
An electronic survey design was used. Data was collected between December 2015 and May 2016 with an instrument that included demographic questions and four internationally validated scales: the Utrecht Work Engagement Scale, QPS Nordic 34+, the shortened Sense of Coherence scale and the Maslach Burnout Inventory. Data was analysed using statistical methods.

Findings
A total of 155 nurse leaders completed the questionnaire, giving a 44% response rate. Most of them worked as nurse managers (89%). Participants’ work-related well-being scores ranged from 8 to 10. Statistically significant relationships were found between participants’ work-related well-being and their leadership skills, current position, sense of coherence and levels of burnout. In addition, there were statistically significant relationships between work-related well-being and all dimensions of working conditions.

Originality/value
This study underlines the fact that work-related well-being should not be evaluated based on a single factor. The participants’ perceived work-related well-being was high, although almost half of them reported always or often experiencing stress. The results suggest that nurse leaders may have resources such as good leadership and problem-solving skills, supportive working conditions and a high sense of coherence that prevent the experienced stress from adversely affecting their work-related well-being.
Will Truss's Time end in Failure? Assessing the Prospects of the latest ‘Takeover’ Prime Minister
Authors: Worthy Ben 
Published: October 2022

AbstractIn September 2022, Elizabeth Truss became the third Prime Minister in a row to take office directly as a result of a party leadership election. My study of takeovers between 1916 and 2016 found they have a shorter time in office than those who are elected, because they inherit deep crisis and divided parties. They also face the dilemma of whether, and when, to call a general election.
Developing the EQUIPED approach to quality management using multi‐grounded theory
Authors: Kirkegaard Amy , Mitchell Lana , Ball Lauren , Williams Lauren T. 
Published: October 2022

AbstractAimThis study aimed to develop a theoretical approach to quality management for dietetics services operating in primary care settings in Australia.MethodsMulti‐grounded theory was used to develop a theoretical approach to quality management across three phases. A preliminary approach was developed in the first phase using empirical data outlining quality management activities employed by primary care dietetics services. In the second phase, the preliminary approach was matched to theoretical data captured from the Australian National Safety and Quality in Primary and Community Healthcare Standards, the Quality in Nutrition Care Model for Dietitians, and complex adaptive systems theory. Central concepts were defined and described in the final phase.ResultsSeventeen small (n = 7) and medium‐large (n = 10) dietetics services from all Australian states and territories, except Tasmania, participated. The theoretical approach to quality management comprised 107 rules organised into six attractors (culture, integrated care, evidence‐based care, safe environment and care, client partnerships and personalised care) and 10 governance elements. Rules had one or more foci that aimed to: improve quality within the service (internally focused), improve care by influencing other healthcare professionals (externally focused), improve the client relationship (client‐focused), or monitor and respond to external systems (system‐focused).ConclusionsThe theoretical approach developed in this study produced a set of rules that primary care dietetics services can use to inform quality management activities. The use of multi‐grounded theory should be investigated in other healthcare disciplines and settings to address quality.