bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally Invasive Resection of a Pediatric Lumbar Osteoblastoma: Case Report
Authors: Brunette-Clément Tristan , Lavergne Pascal , Shedid Daniel , Weil Alexander G 
Published: June 2020

Abstract

BACKGROUND
Osteoblastomas are locally aggressive bone tumors typically affecting the posterior elements of the vertebral column. The treatment of choice is total surgical resection, traditionally through an open laminectomy, often with facetectomy and fusion when the lesion is in the foramen.

OBJECTIVE
To seek an alternative to open surgery, allowing quick and full functional recovery, to meet the youth and athlete population's specific surgical goals. In this population especially, open surgery can be associated with significant impairment and morbidity.

METHODS
We report a pediatric case of posterior L5 osteoblastoma completely removed using a facet-sparing and fusion-avoiding contralateral foraminal minimally invasive approach using a tubular retractor system. A 12-yr-old male competitive tennis player presented with progressive right L5 lumbosciatica. Computed tomography scan and magnetic resonance imaging revealed a lesion of the right L5 pedicle, facet, and vertebral body with significant foraminal soft-tissue extension. Being unfit for percutaneous radiofrequency ablation, the patient underwent a minimally invasive biopsy and resection using an 18-mm-wide METRx nonexpandable tubular retractor (Medtronic) through a contralateral approach, sparing the facet and avoiding fusion surgery.

RESULTS
Postoperative imaging showed residual tumor. The patient was reoperated in a similar fashion with complete tumor removal. His symptoms resolved completely postoperatively. He resumed tennis within 4 mo and remains symptom- and tumor-free at 12-mo follow-up.

CONCLUSION
Minimally invasive contralateral facet-sparing resection of a pediatric lumbar osteoblastoma is an alternative to standard technique and is associated with significant advantages for young athletes, such as quick and full functional recovery, along with avoidance of fusion when the facet joint is involved.
Conversion of Schedule II Opioids to Buprenorphine Buccal Film: A Retrospective Analysis
Authors: Zimmerman Amanda , Bikdash Rami , Rauck Richard 
Published: June 2020

Abstract

Objective
To provide clinical data for the conversion of Schedule II opioids to buprenorphine buccal film and to demonstrate sustained analgesia and a reduction in morphine milligram equivalents after conversion.

Design
Retrospective review of electronic medical records.

Setting
Group clinical practice providing outpatient chronic pain management care in Winston-Salem, North Carolina.

Subjects
Patients who received opioids for chronic pain between January 1, 2016, and June 30, 2019, were selected for chart review if they were converted to buprenorphine buccal film from a Schedule II opioid.

Methods
Patients who met inclusion criteria were stratified into subgroups on the basis of preconversion morphine milligram equivalents, whether they remained on opioids for breakthrough pain postconversion, and pre- and postconversion numerical rating scale pain scores. Outcomes of interest included the differences between pre- and postconversion numerical rating scale pain scores and daily morphine milligram equivalents for each subgroup.

Results
Of 157 patients reviewed, 87.9% were successfully converted to buprenorphine buccal film. Overall, numerical rating scale pain scores were stable after conversion. Statistically significant reductions were demonstrated in the &lt;90 daily morphine milligram equivalent subgroup. Postconversion daily morphine milligram equivalents decreased by 85.4% from baseline. Change in daily morphine milligram equivalents is representative of patients who remained on breakthrough pain medication.

Conclusions
Results demonstrate continued analgesia after conversion to buprenorphine buccal film despite reductions in daily morphine milligram equivalents. Most patients were able to convert directly from their long-acting opioid to buprenorphine buccal film and stabilized without the use of concomitant opioids for breakthrough pain. Aggressive titration strategies were associated with greater success.
Comparable or higher prevalence of comorbidities in antiphospholipid syndrome vs rheumatoid arthritis: a multicenter, case-control study
Authors: Panopoulos Stylianos , Thomas Konstantinos , Georgiopoulos Georgios , Boumpas Dimitrios , Katsiari Christina , Bertsias George , Drosos Alexandros A , Boki Kyriaki , Dimitroulas Theodoros , Garyfallos Alexandros , Papagoras Charalampos , Katsimbri Pelagia , Tziortziotis Apostolos , Adamichou Christina , Kaltsonoudis Evripidis , Argyriou Evangelia , Vosvotekas Georgios , Sfikakis Petros P , Vassilopoulos Dimitrios , Tektonidou Maria G 
Published: June 2020

Abstract

Objectives
Evidence on comorbidity prevalence in antiphospholipid syndrome (APS) and its difference from high comorbidity burden rheumatic diseases is limited. Herein, we compare multiple comorbidities between APS and RA.

Methods
A total of 326 patients from the Greek APS registry [237 women, mean age 48.7 (13.4) years, 161 primary APS (PAPS), 165 SLE-APS] were age/sex matched (1:2 ratio) with 652 patients from a Greek multicentre RA cohort of 3115 patients. Prevalence of cardiovascular (CV) risk factors, stroke, coronary artery disease (CAD), osteoporosis, diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), depression and neoplasms were compared between APS and RA patients using multivariate regression analysis.

Results
Ηyperlipidemia and obesity (ΒΜΙ ≥ 30 kg/m2) were comparable while hypertension, smoking, stroke and CAD were more prevalent in APS compared with RA patients. Osteoporosis and depression were more frequent in APS, while DM, COPD and neoplasms did not differ between the two groups. Comparison of APS subgroups to 1:2 matched RA patients revealed that smoking and stroke were more prevalent in both PAPS and SLE-APS vs RA. Hypertension, CAD and osteoporosis were more frequent only in SLE-APS vs RA, whereas DM was less prevalent in PAPS vs RA. Hyperlipidaemia was independently associated with CV events (combined stroke and CAD) in PAPS and SLE-APS, while CS duration was associated with osteoporosis in SLE-APS.

Conclusion
Comorbidity burden in APS (PAPS and SLE-APS) is comparable or higher than that in RA, entailing a high level of diligence for CV risk prevention, awareness for depression and CS exposure minimization.
Interpreting Frequently Amended Constitutions: Singapore’s Dual Approach
Authors: Teo Marcus 
Published: June 2020

Abstract
In a time where many constitutions are as frequently amended as ordinary statutes, purposive constitutional interpretation is both commonplace and normatively justifiable. However, as recent Singaporean decisions demonstrate, a common purpose-related problem arising in statutory interpretation—the existence of conflicting purposes at different levels of abstraction—takes on an additional dimension of complexity in constitutional interpretation. While courts prefer specific over general purposes in statutory interpretation, on grounds that this upholds Parliament’s most precise intent, they hesitate to consistently do the same in constitutional interpretation. This article rationalizes this difference between statutory and constitutional interpretation, taking as its point of departure a unique dual function that all constitutions, even oft-amended constitutions, must discharge: the creation of efficient government and the legitimation of political systems. It develops a dual approach to constitutional interpretation in response to this dual function, which requires courts to prefer specific over general constitutional purposes in the event of conflict, except when those general purposes reflect norms which legitimate the constitution in society’s eyes. In doing so, this article develops an understanding of purposive constitutional interpretation that preserves a constitution’s essence, while accommodating the reality of frequent amendments.
Synchronizing the Biological Clock: Managing Professional and Romantic Risk through Company-Sponsored Egg Freezing
Authors: Zeno Elissa 
Published: June 2020

Abstract
Increasingly, major U.S. employers in industries notorious for work-family conflict are beginning to offer egg freezing as an employee benefit. Proponents celebrate the inclusion of this technology into company-sponsored health plans as empowering professional women to “have it all” by postponing motherhood in favor of their professional pursuits, while critics voice concerns regarding its implications for reproductive autonomy and gender equality. Through 40 interviews with child-free women of reproductive age who work in industries that sponsor egg freezing, I investigate how work and career concerns shape professional women’s engagement with elective egg freezing. The dominant narrative established in earlier research on women’s motivations for undertaking the procedure downplays the significance of career pressures. However, this article finds that egg freezing manifests as an attempt to manage risks inherent to women’s intentions to form families in a professional landscape that is resistant to motherhood and family. Egg freezing suggests a potential reconciliation of future motherhood and professional work by adjusting women’s reproductive timelines to “perfect” the timing of reproduction to synchronize with career trajectory.
Growth performance and apparent total tract nutrient digestibility of limit-fed diets containing wet brewer’s grains to Holstein heifers
Authors: Hatungimana Eric , Stahl Tess C , Erickson Peter S 
Published: June 2020

Abstract
The objective of this study was to evaluate the growth performance and apparent total tract nutrient digestibility of Holstein heifers limit-fed diets containing different amounts of wet brewer’s grains (WBG). A 12-wk randomized complete block study was conducted using 30 yearling Holstein heifers [378 ± 27 d of age, and body weight (BW) of 357.8 ± 27.6 kg (mean ± SD)]. Treatments were 0%, 10% and 20% of WBG on a dry matter (DM) basis and diets were formulated to be limit-fed for dry matter intake (DMI) at 2.35% of BW and provided 15% crude protein (CP) and 2.27 Mcal metabolizable energy/kg of DM. Dry matter intake was recorded daily, while BW and skeletal measurements were measured every 2 wk. During week 12, fecal samples were collected directly from the rectum over four consecutive days and composited by heifer to determine apparent total tract nutrient digestibility using acid detergent insoluble ash as a marker. Data were analyzed using the MIXED procedure of SAS. Dry matter intakes, BW, and average daily gain were not different among treatments (P = 0.2, P = 0.4, and P = 0.6, respectively). Dry matter intakes ranged from 8.6 to 9.0 kg/d. Average BW were 404.4, 411.5, and 409.3 kg for heifers fed the 0%, 10%, and 20% WBG diets, respectively. Average daily gains were 1.03, 1.04, and 0.96 kg/d for heifers fed the 0%, 10%, and 20% WBG diets respectively. Skeletal measurements and body condition scores (BCS) were not different among treatments except for the change in heart girth (P &lt; 0.01) and initial BCS (P &lt; 0.01). Apparent total tract digestibilities of DM, organic matter, CP, fat, and hemicellulose were greater or tended to be greater in heifers fed 0% and 20% WBG treatments than heifers fed 10 % WBG (P = 0.04, P = 0.04, P = 0.06, P = 0.06, and P = 0.01, respectively). Neutral detergent fiber, acid detergent fiber, and fat digestibilities were similar among treatments (P = 0.2, P = 0.3, and P = 0.3, respectively). During the digestibility phase, DMI tended to be greater (P = 0.08) for the 10% WBG treatment. These results demonstrate that limit-feeding heifers with diets containing up to 20% WBG could replace soybean- and corn-based concentrates in diets without adverse consequences to the heifer growth performance.
In-hospital day-by-day systolic blood pressure variability during rehabilitation: a marker of adverse outcome in secondary prevention after myocardial revascularization
Authors: Lazzeroni Davide , Camaiora Umberto , Castiglioni Paolo , Bini Matteo , Garibaldi Silvia , Geroldi Simone , Moderato Luca , Brambilla Lorenzo , Brambilla Valerio , Parati Gianfranco , Coruzzi Paolo 
Published: June 2020

Objective:
Although it is known that increased visit-to-visit or home day-by-day variability of blood pressure (BP), independently of its average value, results in an increased risk of cardiovascular events, the prognostic value of in-hospital day-by-day BP variability in secondary cardiovascular prevention has not yet been established.

Methods:
We studied 1440 consecutive cardiac patients during a cardiovascular rehabilitation program of about 12 days after coronary artery bypass graft (CABG) and/or valve surgery. We measured auscultatory BP at the patient bed in each rehabilitation day twice, in the morning and the afternoon. We correlated SBP variability assessed as standard deviation (SBP-SD) and coefficient of variation (SBP-CoV) of the daily measures with overall mortality, cardiovascular mortality and major adverse cardiocerebrovascular events (MACCEs) after a mean follow-up of 49 months by Cox hazard analysis.

Results:
In our patients (age 68 ± 11years, 61% hypertensive patients) the ranges of SBP-SD tertiles were: 4.1–9.1, 9.2–11.5 and 11.6–24.5 mmHg. Fifty-five percent of the patients underwent CABG, 33% underwent valve surgery, 12% both CABG and valve surgery. In CABG patients, the highest SBP-SD tertile showed the highest overall mortality, cardiovascular mortality and MACCEs (P < 0.01). Results remained significant after multivariate analysis adjusting for age, sex, mean SBP, BMI, hypertension, hyperlipidaemia, and diabetes. No association between SBP-SD and mortality or MACCEs was found in valve surgery patients.

Conclusion:
In-hospital day-by-day SBP variability predicts mortality and MACCEs in CABG patients, possibly representing a target during rehabilitation and treatment in secondary cardiovascular prevention.
Extrapulmonary Manifestations of SARS-CoV-2
Authors: Osorio María F. , Vaca Richard G. 
Published: June 2020

Abstract
On December 30, 2019, the first reports of a group of patients with unknown etiology pneumonia appeared in Wuhan city, Hubei province, China. Taking into consideration the large amount of similar nucleotide sequences between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the past epidemic coronavirus, it will be appropriate to expect that such pathogens share the same cell line tropism and systemic pathology. Although several studies have, so far, identified the clinical characteristics of COVID-19 cases, there is very little knowledge on the extrapulmonary affection of SARS-CoV-2.
In this review, we summarize reports of the main affected organs besides the pulmonary system such as the liver and kidneys, as well as the cardiovascular and nervous system. The mechanisms of lesion remain largely unclear. The approach of this investigation is to suggest multisystemic work-up in patients with SARS-CoV-2 infection, aside from its respiratory management.
Storytelling Through Music to Improve Well-being in Oncology Nurses
Authors: Phillips Carolyn S. , Volker Deborah L. , Becker Heather , Davidson Kristin L. 
Published: June 2020

Background
Professional grief is one cause of psychosocial stress that, if not attended to, may contribute to burnout and compassion fatigue. Oncology nurses often avoid their emotions and learn to cope with professional grief in isolation. Interventions aimed at professional grief are limited.

Objectives
To determine the feasibility of implementing a multidimensional intervention, Storytelling Through Music, with oncology nurses.

Intervention/Methods
This was a 2-group, quasi-experimental design utilizing both qualitative and quantitative methods. The 6-week intervention combined storytelling, reflective writing, music, and psychoeducation. Descriptive statistics and conventional content analysis were used to analyze the feasibility data.

Results
Most participants (n = 43) were female, white, working full-time in the outpatient oncology setting, with an average 8.5 years (range, 2–36 years) of oncology experience. Ninety-eight percent of the intervention was completed, and 98% of participants were retained. Analysis indicates that the intervention was acceptable, the participants learned they were not alone in their feelings, and they were supported by the group.

Conclusions
Results indicate that Storytelling Through Music is a feasible and acceptable intervention to address work-related emotions and psychosocial stress in this group of oncology nurses.

Implications for Practice
In 2017, the National Academy of Medicine stated clinician well-being must be a priority. Participation in this study was independently sought out by the oncology nurses and completed during their personal time. A future policy recommendation is to make participation in wellness interventions part of the mandatory competency training required by accrediting bodies so that institutions ensure the well-being of clinicians as a priority.
Nursing Students' Mindsets and Choice of Learning Strategies
Authors: Williams Cheryl 
Published: June 2020

Background
Nursing students may not use the most effective learning strategies. Offering students an academic success model such as Dweck's mindset model may improve student learning. The influence of nursing students' mindsets on study strategies has not been explored.

Purpose
This study examined nursing students' mindset proclivity and choice of learning strategies.

Methods
This descriptive, cross-sectional quantitative pilot study used a web-based survey to examine a national sample of 151 nursing students' mindsets and learning habits.

Results
Students with a growth mindset demonstrated the use of more effective learning strategies than their fixed mindset peers.

Conclusions
Nurse educators need to assess student learning because half of the students in this study had never had anyone teach them how to learn effectively. Early evidence is emerging that the growth mindset model may hold promise as an academic success model for nursing education.
Joining Datasets Without Identifiers: Probabilistic Linkage of Virtual Pediatric Systems and PEDSnet*
Authors: Dziorny Adam C. , Lindell Robert B. , Bennett Tellen D. , Bailey L. Charles 
Published: June 2020

Objectives:
To 1) probabilistically link two important pediatric data sources, Virtual Pediatric Systems and PEDSnet, 2) evaluate linkage accuracy overall and in patients with severe sepsis or septic shock, and 3) identify variables important to linkage accuracy.

Design:
Retrospective linkage of prospectively collected datasets from Virtual Pediatrics Systems, Inc (Los Angeles, CA) and the PEDSnet consortium.

Setting:
Single-center academic PICU.

Patients:
All PICU encounters between January 1, 2012, and December 31, 2017, that were deterministically matched between the two datasets.

Interventions:
None.

Measurements and Main Results:
We abstracted records from Virtual Pediatric Systems and PEDSnet corresponding to PICU encounters and probabilistically linked using 44 features shared by the two datasets. We generated a gold standard deterministic linkage using protected health information elements, which were then removed from datasets. We then calculated candidate pair log-likelihood ratios for all pairs of subjects and selected optimal pairs in a two-stage algorithm. A total of 22,051 gold standard PICU encounter pairs were identified over the study period. The optimal linkage model demonstrated excellent discrimination (area under the receiver operating characteristic curve > 0.99); 19,801 cases (89.9%) were matched with 13 false positives. The addition of two protected health information dates (admission month, birth day-of-year) increased to 20,189 (91.6%) the cases matched, with three false positives. Restricting to patients with Virtual Pediatric Systems diagnosis of severe sepsis or septic shock (n = 1,340 [6.1%]) matched 1,250 cases (93.2%) with zero false positives. Increased number of laboratory values present in the first 12 hours of admission significantly increased log-likelihood ratios, suggesting stronger candidate pair matching.

Conclusions:
We demonstrated the use of probabilistic linkage to accurately join two complementary pediatric critical care datasets at a single academic PICU in the absence of protected health information. Combining datasets with curated diagnoses and granular measurements can validate patient acuity metrics and facilitate multicenter machine learning algorithms. We anticipate these methods will generalize to other common PICU diagnoses.
Predictors of Long-term Outcomes in Patients With Connective Tissue Disease Associated With Pulmonary Arterial Hypertension
Authors: Nakayama Kazuhiko , Nakajima Yasuo , Tanaka Rika , Hirata Ken-ichi , Emoto Noriaki 
Published: June 2020

Background/Objective
Pulmonary arterial hypertension (PAH) is a progressive disease characterized by increased pulmonary arterial pressure and pulmonary vascular resistance that can lead to right-sided heart failure. Connective tissue disease–associated PAH (CTD-PAH) often has poorer outcomes than idiopathic or hereditary PAH, suggesting the presence of non-PAH factors that could affect the prognoses. This cohort study aimed to identify prognostic factors for CTD-PAH management.

Methods
Medical records from April 1999 to November 2014 were reviewed to determine the time from treatment initiation to the occurrence of a clinically worsening event and the time elapsed until death. Data at baseline and the final assessment were used to identify prognostic factors associated with events using univariate and multivariate analyses by the stepwise Cox regression method.

Results
In 36 patients with CTD-PAH analyzed, the proportions with no clinically worsening events at 1, 2, and 3 years after treatment initiation were 62%, 52%, and 45%, respectively, with survival rates of 88%, 77%, and 77%, respectively. The regression model showed that reduced hemoglobin at baseline, reduced qR pattern in electrocardiogram lead V1, increased 60-minute erythrocyte sedimentation rate, and increased mean pulmonary arterial pressure at the final assessment were risk factors that were significantly associated with clinical worsening. For survival, no prognostic factor was identifiable.

Conclusions
Hemodynamic and non-PAH factors, such as anemia, nutritional status, and inflammatory activity of the underlying CTD, which are not listed in the risk assessment table of PAH guidelines, should be strictly controlled to improve the prognosis of patients with CTD-PAH. A more multifactorial treatment strategy should be developed.
COVID-19 and Its Potential Effect on Patients With Rheumatic Diseases in Latin America
Authors: Elera-Fitzcarrald Claudia , Ugarte-Gil Manuel F. , Alarcón Graciela S. 
Published: June 2020

Abstract
The COVID-19 (coronavirus disease 2019) pandemic has dramatically affected the entire world. Because of significant disparity levels in Latin American countries with deficient health care access and significant poverty, their population may end up among the most severely impacted. Patients with chronic conditions such as rheumatic diseases are quite vulnerable because of their high flaring risks and subsequent poor outcomes. Additionally, an overuse of antimalarials for the treatment of COVID-19 could lead to shortages in our region. Telemedicine, personal protective equipment use by patients and providers, web conferences, and comprehensive care are tools that will contribute to reduce the risk of infections and other complications in rheumatic disease patients, as well as to improve the knowledge and experience of rheumatologists at a global level.