bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stigma, participation restriction and mental distress in patients affected by leprosy, cutaneous leishmaniasis and Chagas disease: a pilot study in two co-endemic regions of eastern Colombia
Authors: Gómez Libardo J , van Wijk Robin , van Selm Lena , Rivera Alberto , Barbosa Martha C , Parisi Sandra , van Brakel Wim H , Arevalo Jofren , Quintero William , Waltz Mitzi , Puchner Karl Philipp 
Published: December 2019

AbstractBackgroundLeprosy, cutaneous leishmaniasis (CL) and Chagas disease (CD) are neglected tropical diseases with a high psychosocial burden (PSB). These conditions are endemic in Norte de Santander and Arauca in Colombia, but data on the related PSB are scarce. Therefore, we assessed mental distress, participation restriction and stigma among CD, CL and leprosy patients.MethodsIn 2018, 305 leprosy, CD or CL patients were interviewed using a self-report questionnaire to assess mental distress, participation scale for participation restriction and explanatory model interview catalogue (EMIC) for stigma. Descriptive statistics and the significance of median score differences were compared.ResultsFifty percent of CD patients and 49% of leprosy patients exhibited mental distress, percentages which were significantly higher than that of CL (26%). Twenty-seven percent of leprosy patients experienced participation restriction, which was lower for CL (6%) and CD (12%). Median EMIC scores were significantly higher for leprosy patients than for CD (27%) and CL (17%) patients.ConclusionsWe found high levels of PSB among leprosy, CD and CL patients. Mental distress was highest among CD patients. Participation restriction and stigma were more prevalent in leprosy patients. Rural residence or lower educational status may impact PSB. Further investigation is needed to formulate evidence-based, holistic interventions.
Exercise improves metabolic function and alters the microbiome in rats with gestational diabetes
Authors: Mahizir Dayana , Briffa Jessica F. , Wood Jennifer L. , Anevska Kristina , Hill‐Yardin Elisa L. , Jefferies Andrew J. , Gravina Sogand , Mazzarino Gisella , Franks Ashley E. , Moritz Karen M. , Wadley Glenn D. , Wlodek Mary E. 
Published: December 2019

AbstractGestational diabetes mellitus (GDM) is a common pregnancy complication, particularly prevalent in obese women. Importantly, exercise has beneficial impacts on maternal glucose control and may prevent GDM in “at‐risk” women. We aimed to determine whether a high‐fat diet (HFD) exacerbates metabolic dysfunction and alters gut microbiome in GDM and whether endurance exercise prevents these changes. Uteroplacental insufficiency was induced by bilateral uterine vessel ligation (Restricted) or sham (Control) surgery on E18 in Wistar‐Kyoto rats. Female offspring were fed a Chow or HFD (23% fat) from weaning (5 weeks) and at 16 weeks randomly allocated to remain Sedentary or to an exercise protocol of either Exercise prior to and during pregnancy (Exercise); or Exercise during pregnancy only (PregEx). Females were mated (20 weeks) and underwent indirect calorimetry (embryonic day 16; E16), glucose tolerance testing (E18), followed by 24‐hr feces collection at E19 (n = 8‐10/group). HFD consumption in female rats with GDM exacerbated the adverse metabolic adaptations to pregnancy and altered gut microbial populations. Specifically, the Firmicutes‐to‐Bacteroidetes ratio was increased, due to an underlying change in abundance of the orders Clostridiales and Bacteroidales. Maternal Exercise, but not PregEx, prevented the development of metabolic dysfunction, increased pancreatic β‐cell mass, and prevented the alteration of the gut microbiome in GDM females. Our findings suggest that maternal exercise and diet influence metabolic and microbiome dysfunction in females with GDM, which may impact long‐term maternal and offspring health.
A human co‐culture cell model incorporating microglia supports glioblastoma growth and migration, and confers resistance to cytotoxics
Authors: Leite Diana M. , Zvar Baskovic Barbara , Civita Prospero , Neto Catia , Gumbleton Mark , Pilkington Geoffrey J. 
Published: December 2019

AbstractDespite the importance of the tumor microenvironment in regulating tumor progression, few in vitro models have been developed to understand the effects of non‐neoplastic cells and extracellular matrix (ECM) on drug resistance in glioblastoma (GBM) cells. Using CellTrace‐labeled human GBM and microglial (MG) cells, we established a 2D co‐culture including various ratios of the two cell types. Viability, proliferation, migration, and drug response assays were carried out to assess the role of MG. A 3D model was then established using a hyaluronic acid‐gelatin hydrogel to culture a mixture of GBM and MG and evaluate drug resistance. A contact co‐culture of fluorescently labeled GBM and MG demonstrated that MG cells modestly promoted tumor cell proliferation (17%‐30% increase) and greater migration of GBM cells (>1.5‐fold increase). Notably, the presence of MG elicited drug resistance even when in a low ratio (10%‐20%) relative to co‐cultured tumor cells. The protective effect of MG on GBM was greater in the 3D model (>100% survival of GBM when challenged with cytotoxics). This new 3D human model demonstrated the influence of non‐neoplastic cells and matrix on chemoresistance of GBM cells to three agents with different mechanisms of action suggesting that such sophisticated in vitro approaches may facilitate improved preclinical testing.
A Randomized Trial of Multiple-Patient Simulation Preparation to Improve Novice Nurses’ Competence and Self-Efficacy
Authors: Franklin Ashley E. , Sideras Stephanie , Dodd Caitlin , Hutson Jeremy 
Published: December 2019

Abstract

AIM
The purpose of the study was to determine best practices for multiple-patient simulation (MPS) preparation and frequency to improve behavioral performance in nursing students.

BACKGROUND
MPS provides a safe environment for novice nurses to practice priority setting, delegation, and multitasking, but evidence for best practices is needed.

METHOD
A multisite, blinded, randomized trial was conducted to evaluate the effect of three simulation preparation methods (expert modeling, voice-over PowerPoint, and reading assignments) on students’ competence and self-efficacy for providing care to multiple patients in the simulation lab. Participants (n = 73) were enrolled in capstone clinical courses at two schools of nursing.

RESULTS
Though there was no difference in raw change in competence score among the study groups, there was a statistically significant difference in pretest and posttest scores. The change in self-efficacy did not correlate with the change in competence.

CONCLUSION
These findings will help educators understand how novice nurses benefit from repeated MPS activities.
Thoughtful Ileostomy Creation in Patients Undergoing Redo IPAA
Authors: Schwartzberg David M. , Esen Eren , Remzi Feza H. 
Published: December 2019

INTRODUCTION:
Redo IPAA is a viable option to maintain intestinal continuity in patients with ileal pouch failure. Most patients with ileal pouch failure are physiologically and psychologically too deconditioned to undergo a 1- or 2-stage redo ileal pouch surgery, so a 3-staged redo ileal pouch surgery is needed. This consists of an initial proximal diverting loop ileostomy for 6 months, followed by redo ileal pouch construction with temporary stoma, and, lastly, stoma closure. The location of the initial diverting ileostomy is paramount, because 40% of cases will require pouch excision and construction of a de novo pouch, and a thoughtfully placed ileostomy will allow construction of a redo pouch without sacrificing any bowel length. In our report, we described our technique to create thoughtful ileostomy in patients who undergo redo IPAA.

TECHNIQUE:
We create a loop ileostomy ≈20 cm proximal to the existing ileal pouch, from the level of the tip of the J or the proximal inlet of an S-pouch. We call this a thoughtful ileostomy. By doing that, the thoughtful ileostomy site can be used as the apex of the new ileal pouch and become the ileal-anal anastomosis when a de novo ileal pouch needs to be constructed.

RESULTS:
We created a thoughtful ileostomy in 50 patients in the Inflammatory Bowel Disease Center at New York University Langone Health who either subsequently underwent or will undergo a redo IPAA between September 2016 and March 2019 (laparoscopic, n = 37; open, n = 13). Ten of the laparoscopic cases were preemptively converted to open because of dense adhesions.

CONCLUSION:
A thoughtful ileostomy is important so as to not sacrifice bowel in patients being prepared for redo ileal pouch surgery. Initial diversion with thoughtful ileostomy 6 months before redo ileal pouch construction also allows patients to be prepared for a major operation both physiologically and psychologically.
Expert Commentary on Complicated Diverticulitis
Authors: Shah Nishit 
Published: December 2019

Complicated diverticulitis encompasses a variety of clinical scenariors as outlined in the well-written and succinct review by Drs Mendez and Garcia-Henriquez. These range from acute presentations, such as abscesses and free perforations with peritonitis, to more chronic, insidious sequelae such as fistulas and strictures.
The contemporary surgical management of diverticular disease has evolved considerably with better appreciation of the pathophysiology and natural history. Just as in uncomplicated diverticulitis, there has been a significant shift toward a less aggressive surgical strategy in complicated diverticulitis, aided further with improved diagnostic and interventional radiology.
I would like to add a few salient points for each listed complication.
Biomarkers that may predict response to immunotherapy in ovarian malignancies
Authors: Chin Curtis D. , Fares Charlene M. , Konecny Gottfried E. , Rao Jianyu 
Published: December 2019

Purpose of reviewImmune checkpoint blockade (ICB) is a promising area of cancer therapeutic research. Therapies targeting the programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) mechanism of tumor immune evasion have resulted in durable responses in many difficult-to-treat tumor types. While these inhibitors are being actively investigated in clinical trials for ovarian cancer, most patients fail to respond to initial treatment with immune therapy. This review focuses on biomarkers for predicting response to treatment, and discusses clinical trials using ICB for recurrent ovarian cancer.Recent findingsWhile PD-L1 detection by immunohistochemistry (IHC) is approved as a companion or complementary diagnostic in some cancers, there are many limitations with its use as a predictive marker. Recent research has explored biomarkers beyond PD-L1 that assess for somatic mutations, immune cell infiltrate, and gene signatures.SummaryWith improved understanding of the tumor microenvironment and genomic classifications of ovarian tumors, new diagnostics and biomarkers that supplement conventional IHC may help predict response to therapy.
Multimodality screening and prevention of cervical cancer in sub-Saharan Africa: a collaborative model
Authors: Chinn Justine , Tewari Krishnansu S. 
Published: December 2019

Purpose of review
Although cervical cancer continues to decrease in incidence throughout the developed world because of rigorous screening and vaccination campaigns, the disease remains a major cause of cancer-related morbidity and mortality in resource-limited regions including sub-Saharan Africa. This review summarizes current efforts to implement cost-effective and widespread cervical cancer education, screening, and community-based interventions in Africa and the challenges faced by local healthcare workers.

Recent findings
Effective screening with cytology (with or without high-risk human papillomavirus [HPV] DNA testing) as well as HPV self-sampling remains problematic in African countries because of a paucity of cytopathologists and resources. Accordingly, visual inspection of the cervix with acetic acid (VIA) with cryotherapy triage has gained traction in mass-screening campaigns because of low-cost supplies.

Summary
Public education to facilitate screening is essential. VIA remains a strong community-based approach. The involvement of technology in teaching local providers, advertising screenings to the community, and helping improve follow-up may also improve screening efforts. Ultimately, the best form of prevention is through HPV vaccination, which also requires implementation of ongoing public education programs.
Effectiveness of acupuncture for the treatment of postoperative pain
Authors: Zhang Qinhong , Yue Jin-Huan , Sun Zhong-Ren , Golianu Brenda 
Published: December 2019

Abstract

Background:
This aim of this study is to assess the effectiveness and safety of acupuncture for the treatment of patients with postoperative pain (PPP).

Methods:
We will carry out a systematic review of the published literature and will comprehensively search Cochrane Library, MEDLINE, EMBASE, CINAHL, PsycINFO, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from inception to the present with no language restrictions. Randomized controlled trials comparing acupuncture with other interventions or sham acupuncture will be included. Two reviewers will independently conduct study selection, data collection, and study quality. A third reviewer will resolve any discrepancies. We will apply RevMan 5.3 software for statistical analysis.

Results:
The protocol of this study will systematically assess the effectiveness and safety of acupuncture for patients with PPP. The primary outcome is postoperative pain intensity. The secondary outcomes comprise of: analgesic consumption, postoperative recovery parameters, vital signs, quality of life, and treatment related adverse events.

Conclusion:
This study will summarize the current evidence base for the effectiveness and safety of acupuncture for patients with PPP.
Lab monitoring and acute care utilization during initiation of renin angiotensin aldosterone inhibitors or diuretics in chronic kidney disease
Authors: Garlo Katherine G. , Bates David W. , Seger Diane L. , Fiskio Julie M. , Charytan David M. 
Published: December 2019

Abstract
Renin angiotensin aldosterone system inhibitors (RAASi) and diuretics are among the most frequently prescribed anti-hypertensives. Individuals with chronic kidney disease (CKD) are particularly at risk for electrolyte disturbances and kidney injury but the appropriate use of lab monitoring following RAASi or diuretic initiation is uncertain in CKD.
We describe the frequency and time interval of lab monitoring during initiation of RAASi and diuretics in CKD and assess whether close lab monitoring associates with one-year risk of emergency department (ED) visit or hospitalization.
We evaluated an observational cohort of 8,217 individuals with stage 3–5 non-dialysis CKD newly prescribed a RAASi (52.3%) or diuretic (47.7%) from thirty-six primary care offices affiliated with Brigham and Women's Hospital and Massachusetts General Hospital between 2009 and 2011.
Overall, 3306 (40.2%) individuals did not have pre-prescription labs done within 2 weeks, and 5957 (72.5%) did not have post-prescription labs done within 2 weeks which includes 524 (6.4%) individuals without post-prescription within 1 year. Close monitoring occurred in only 1547 (20.1%) and was more likely in individuals prescribed diuretics compared to RAASi (adjusted OR 1.39; 95%CI 1.20–1.62), with CKD stage 4,5 compared with stage 3 (adjusted OR 1.47; 95%CI 1.16–1.86) and with cardiovascular disease (adjusted OR 1.42; 95%CI 1.21–1.66). Close monitoring was not associated with decreased risk of ED visit or hospitalization.
Close lab monitoring during initiation of RAASi or diuretics was more common in participants with cardiovascular disease and advanced CKD suggesting physicians selected high-risk individuals for close monitoring. As nearly 80% of individuals did not receive close lab monitoring there may be value in future research on electronic physician decision tools targeted at lab monitoring.
Effect of placement of acetabular prosthesis on hip joint function after THA
Authors: Fan Guang , Xiang Chuan , Li Shuaijie , Gao Zhenzhong , Liu Xiaohu , He Dongdong , Sun Jian 
Published: December 2019

Abstract
The good recovery of hip function after THA depends on reconstruction of acetabular prosthesis accurately. So we investigated the effect of acetabular prosthesis placement on hip joint function after THA and analyzed the clinical data of 432 patients with unilateral THA retrospectively . The patients were followed-up to evaluate the Harris score and hip range of motion (ROM). The hip ROM, the Harris score and the good rate of Harris score were compared between different groups. Comparison of the good rate of Harris score showed that 85%∼100% group of the rotation center horizontal position ratio was higher than >100% group; 80%∼120% group of the rotation center vertical position ratio was higher than >160% group; and the 90%∼110% group and 110%∼130% group of femoral offset ratio were higher than 90% and >130% groups. Comparison of Harris score showed that 85%∼100% and 70%∼85% groups of rotation center horizontal position ratio were higher than 70% and >100% groups; 80%∼120% group of rotation center vertical position ratio was the highest; and 90%∼110% group and 110%∼130% group of femoral offset ratio were higher than >130% and 90% groups. Comparison of hip ROM showed that 85%∼100% and 70%∼85% groups of the rotation center horizontal position ratio were higher than 70% and >100% groups; 80%∼120% group of the rotation center vertical position ratio was the highest; and hip ROM from high to low are 90%∼110%, 110%∼130%, >130% and 90% groups of femoral offset ratio. These findings indicated that during the early follow-up period of THA, if the horizontal position of femoral head rotation center was reconstructed in 0.85 to 1 times of healthy side when compared with reconstruction >1 times of the healthy side and if the vertical position of femoral head rotation center was reconstructed in 0.8 to 1.2 times of the healthy side when compared with reconstruction in >1.6 times of the healthy side, better hip function recovery and optimal hip ROM were obtained. The optimal reconstruction range of femoral offset is 0.9 to 1.3 times of the healthy side.
Risk factors of chronic urticaria among nurses with insomnia
Authors: Liao Kuang-Ming , Ho Chung-Han , Lee Huan-Fang , Yu Chia-Hung , Wang Jhi-Joung , Liang Fu-wen 
Published: December 2019

Abstract
Chronic urticaria has a high economic burden and reduces patient's quality of life. Nurses experience insomnia because of their shifting work, especially if they work night shifts and 3-shift rotational schedules. This study aimed to examine whether insomnia is a risk factor of chronic urticaria in nurses.
Data were obtained from the Registry for Medical Personnel, which contains all registered medical staff between 2007 and 2008. All study subjects were divided into those with insomnia and without insomnia. The primary exposure of interest was chronic urticaria. In addition, potential comorbidities including diabetes mellitus, hypertension, hyperlipidemia, anxiety, and depression were estimated.
A total of 103,242 registered nurses between 2007 and 2008 were enrolled. Around 97,899 (94.8%) nurses did not have insomnia, and 5343 (5.2%) had insomnia. The proportion of chronic urticaria in nurses with insomnia was significantly higher than those without (0.92% vs 0.50%, P < .0001). The odds ratio of chronic urticaria in nurses with insomnia was 1.67 (95% confidence interval: 1.22–2.29, P = 0.0014) compared to those without insomnia after adjusting for age, sex, hospital level, and comorbidities.
The risk of chronic urticaria was higher in nurses with insomnia than in those without insomnia. The relationship between insomnia and chronic urticaria might not be a direct causal association. Other contributing factors of insomnia include different perceptions of stress from night shift work, stress coping and adaptation, positive self-image, and emotional equilibrium related to person's capacity to adapt to change. The same situation may have different effects on different individuals.
Percutaneous endoscopic lumbar discectomy for lumbar disc herniation as day surgery – short-term clinical results of 235 consecutive cases
Authors: Cao Jian , Huang Wenzhou , Wu Tianlong , Jia JingYu , Cheng Xigao 
Published: December 2019

Abstract
Many studies have reported the good outcomes of percutaneous endoscopic lumbar discectomy (PELD) for the treatment of lumbar disc herniation (LDH). However, the majority of published studies on PELD showed an average hospital stay of 2 to 5 days. Thus, the purpose of this retrospective study was to evaluate and compare the clinical outcomes of patients undergoing PELD for LDH as day surgery with the outcomes of patients managed as inpatients.
A total of 402 patients who underwent PELD for single-level LDH were included. The visual analog scale score (VAS) for leg and back pain, Oswestry Disability Index (ODI) score, and Macnab criteria were evaluated preoperatively and at 2 years postoperatively (final follow-up). Operation time, duration of hospital stay, cost, postoperative complications, and the rates of and reasons for delayed discharge and readmission were recorded and analyzed.
The mean operative time was 45.8 ± 8.4 minutes in the PELD-A (nonday surgery mode) group and 41.3 ± 8.7 minutes in the PELD-D (day surgery mode) group (P = .63). The average duration of hospital stay was 2.8 ± 1.1 days in the PELD-A group and 3.2 ± 0.9 hours in the PELD-D group (P < .001). The average hospitalization expenses of the PELD-A and PELD-D groups were 28,090 ± 286 RMB and 24,356 ± 126 RMB (P = .03), respectively. In both groups, the mean VAS and ODI scores improved significantly postoperatively compared with the preoperative scores. The satisfactory result rate was 89.8% in the PELD-D group and 91.0% in the PELD-A group, without a significant difference (P = .68). The delayed discharge rate in the PELD-A and PELD-D groups was 8.20% and 8.43%, respectively (P = .93). The main reasons for delayed discharge were dysesthesia, neurologic deficit, nausea, headache and residential distance from the hospital. The overall readmission rates were 5.99% and 5.53% in the PELD-A and PELD-D groups, respectively (P = .85). The most common reasons for readmission were reherniation, sequestered herniation and pain.
In conclusion, PELD is safe and effective for the treatment of LDH and can reduce medical costs as day surgery, and it thus warrants increased attention.