bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thoracic vertebral canal stenosis in cats: clinical features, diagnostic imaging findings, treatment and outcome
Authors: Gillespie Sabrina , De Decker Steven 
Published: May 2020

Objectives The aim of this study was to describe the clinical features, diagnostic imaging findings, treatment and outcome in cats with thoracic vertebral canal stenosis (TVCS). Methods Medical records and imaging studies of cats with TVCS were retrospectively reviewed. Outcome was acquired from patient records and from owners or referring veterinary surgeons via a telephone questionnaire. For each case, breed-, age- and sex-matched controls were identified with CT imaging of the thoracic vertebral column. For each cat, vertebral canal height was determined at three levels for each thoracic vertebra. Vertebral canal heights were compared between control cats of different breeds and between affected and control cats of the same breed. Results Nine TVCS cases were included. British Shorthairs and male neutered cats were over-represented ( P <0.05). Median age at presentation was 9 years. All cats were presented for a chronic, progressive, painful, ambulatory, T3–L3 myelopathy. Five cats were treated conservatively, three surgically and one was euthanased. Two cats treated surgically demonstrated improvement of clinical signs and one demonstrated initial improvement followed by deterioration. Of the conservatively treated cats, three deteriorated and two improved. Compared with controls, affected cats had a lower vertebral canal height at multiple thoracic vertebral levels, being most prominent for British Shorthairs and domestic shorthairs ( P <0.05). Unaffected British Shorthairs had a lower thoracic vertebral canal height at multiple levels than control domestic shorthairs ( P <0.05). Conclusions and relevance TVCS should be considered a differential diagnosis in middle-aged to older cats presenting with a chronic, progressive, painful, T3–L3 myelopathy. The predisposition of British Shorthairs could be explained by a narrower vertebral canal in this breed.
Interrogating culture: Anthropology, social work, and the concept trade
Authors: Mathias John , Gulbas Lauren E , Chin Matthew , Perry Tam E 
Published: May 2020

Summary Interdisciplinary contributions to social work have supported the profession’s development as a helping profession. Indeed, drawing from other disciplines has been a way to hone intervention approaches. This article analyzes the history of social work’s use of anthropological theory about “culture” in order to critically examine the profession’s positioning as a “recipient” of theories. At a time when evidence-based practice is a dominant ideal, this paper offers an opportunity to step back and interrogate a key concept, culture, that is often evoked as interventions are tailored for various populations. Findings While social work has substantially debated and revised how it approaches culture difference, the core conceptualization of culture as a relatively static set of shared values and traits remains ill-suited to the complex negotiation of diversity in social work practice. The limitations of the culture concept are symptomatic of an exchange relationship with anthropology that positions social work practitioners primarily as recipients of concepts, rather than as interlocutors. Application By treating intervention as an opportunity for theory revision, anthropologists and social workers can better account for the hybridity, change, and contestation of difference in social work practice. As the social work profession expands globally, a more dialogical engagement with anthropological theories about culture and other key concepts may prove fruitful.
Impact of Institutional Volume on Critical In-Hospital Complications Adjusted for Patient- and Limb-Related Characteristics: An Analysis of a Nationwide Japanese Registry of Endovascular Interventions for PAD
Authors: Iida Osamu , Takahara Mitsuyoshi , Kohsaka Shun , Soga Yoshimitsu , Fujihara Masahiko , Mano Toshiaki , Shinke Toshiro , Amano Tetsuya , Ikari Yuji 
Published: May 2020

Purpose: To investigate the incidence and clinical predictors, including institutional annual case volume, of critical in-hospital complications after endovascular therapy (EVT) for peripheral artery disease (PAD). Materials and Methods: The data were extracted from the nationwide registry of peripheral interventions in Japan [Japanese EVT (J-EVT)] between 2012 and 2017. A total of 92,224 EVT cases either for chronic limb-threatening ischemia (CLTI) or intermittent claudication were included in the analysis. The primary outcome measure was critical in-hospital complications, which were defined as a composite of urgent surgery and in-hospital death within 30 days after EVT. The institutional volume was classified into quartiles. The association of institutional volume, as well as baseline characteristics, with the critical in-hospital complications was explored using a multivariable logistic regression model with multiple imputation for missing data. Results are presented as the adjusted odds ratio (OR) with the 95% confidence intervals (CI). Results: The estimated prevalence of critical in-hospital complications was 0.3% (95% CI 0.3% to 0.4%). The following 10 patient- and limb-related characteristics were identified as independent risk factors for critical in-hospital complications: (1) female sex (OR 1.75, 95% CI 1.36 to 2.25), (2) age ≥75 years (OR 1.60, 95% CI 1.06 to 2.40), (3) CLTI (OR 2.12, 95% CI 1.47 to 3.05), (4) nonambulatory status (OR 1.66, 95% CI 1.23 to 2.24), (5) regular dialysis (OR 1.35, 95% CI 1.02 to 1.77), (6) cerebrovascular disease (OR 1.76, 95% CI 1.33 to 2.33), (7) urgent revascularization (OR 5.10, 95% CI 3.64 to 7.13), (8) aortoiliac TASC II D lesion (OR 3.65, 95% CI 2.51 to 5.33), (9) femoropopliteal TASC II D lesion (OR 1.77, 95% CI 1.24 to 2.52), and (10) infrapopliteal TASC D lesion (OR 1.52, 95% CI 1.08 to 2.13). In addition, the 4th quartile of the institutional volume (≥158 cases/year), but not the 2nd or 3rd quartile, had a significantly and independently lower risk of critical in-hospital complications than the 1st quartile (OR 0.13, 95% CI 0.07 to 0.23). Conclusion: After EVT for symptomatic PAD, 0.3% of the population encountered critical in-hospital complications. A higher institutional volume was significantly associated with a lower risk of critical in-hospital complications.
Feasibility and Safety of Sac Embolization Using N-Butyl Cyanoacrylate in Emergency Endovascular Aneurysm Repair for Ruptured Abdominal Aortic Aneurysms or Isolated Iliac Artery Aneurysms
Authors: Ohba Shota , Shimohira Masashi , Hashizume Takuya , Muto Masahiro , Ohta Kengo , Sawada Yusuke , Mizuno Akihiro , Nakai Yosuke , Suda Hisao , Shibamoto Yuta 
Published: May 2020

Purpose: To evaluate the feasibility and safety of sac embolization with N-butyl cyanoacrylate (NBCA) in emergency endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (AAA) and iliac artery aneurysm (IAA) in comparison to EVAR without sac embolization. Materials and Methods: Between February 2012 and December 2019, among 44 consecutive patients with ruptured AAA or IAA, 29 underwent EVAR. Of these, 22 patients (median age 77.5 years; 18 men) had concomitant sac embolization using NBCA; the remaining 7 patients (median age 88 years; 6 men) underwent EVAR without sac embolization and form the control group. The technical success, clinical success (hemodynamic stabilization), procedure-related complications, and mortality were compared between the groups. Results: All EVAR procedures and embolizations were successful. The clinical success rates in the NBCA and control groups were 95% (21/22) and 71% (5/7), respectively (p=0.14). There was no complication related to the procedure. Type II endoleak occurred in 4 of 21 patients (19%) in the NBCA group vs none of the control patients. One patient (5%) died in the NBCA group vs 3 (43%) in the controls (p=0.034). Conclusion: Sac embolization using NBCA in emergency EVAR appears to be feasible and safe for ruptured AAA and IAA.
Reasons for Conversion and Adverse Intraoperative Events in Robotically Enhanced Minimally Invasive Coronary Artery Revascularization
Authors: van der Merwe Johan , Casselman Filip , Vermeulen Yvette , Stockman Bernard , Degrieck Ivan , Van Praet Frank 
Published: May 2020

Objective The transition from sternotomy access to minimally invasive coronary artery bypass grafting is associated with steep learning curves. This study reports the reasons for sternotomy conversions from robotically enhanced minimally invasive direct coronary artery bypass grafting (RE-MIDCAB) and describes potential risk reduction strategies. Methods The perioperative data of 759 RE-MIDCAB patients (mean age 65.9 ± 10 years, 25.5% female, 30.2% multivessel disease) operated between July 1, 2002 and November 30, 2018 were reviewed for the reasons of conversion and adverse intraoperative events. Hybrid revascularization was planned in 204 (26.9%) patients. Results Sternotomy conversion occurred in 30 (4.0%) patients. Lung adhesions and unsuccessful single-lung ventilation prohibited safe RE-MIDCAB internal thoracic artery (ITA) harvesting in 11 (36.7%) and 1 (3.3%) patients, respectively. ITA dysfunction ( n = 11, 36.7%) and inadequate target vessel visualization ( n = 3, 10.0%) were among the anatomical reasons for conversions. Adverse intraoperative events included ventricle perforation ( n = 1, 3.3%) and sustained ventricular arrhythmia ( n = 1, 3.3%). The in-hospital mortality and mean length of hospitalization for sternotomy conversion were 3.3% ( n = 1 of 30) and 13.4 ± 14.5 days, respectively. Perioperative morbidities included pneumonia ( n = 4, 13.3%). Premorbid renal dysfunction predicted sternotomy conversion at the 5% level of significance. Conclusions RE-MIDCAB provides an attractive surgical platform for primary- or hybrid coronary artery procedures. The progressive increase in patient risk profiles, strict quality control, and focus on clinical governance require awareness of reasons that potentially contribute RE-MIDCAB to sternotomy conversion to ensure safe and sustainable programs.
The immediate and subsequent impact of a first-time traumatic anterior shoulder dislocation in people aged 16–40: Results from a national cohort study
Authors: Olds M , Ellis R , Parmar P , Kersten P 
Published: May 2020

Background Limited evidence exists which details changes in quality of life, shoulder activity level, kinesiophobia, shoulder pain and disability following a first-time traumatic anterior shoulder dislocation (FTASD) in people treated non-operatively. This study had three objectives: (1) to examine quality of life, pain, disability and kinesiophobia after an FTASD within 12 weeks, (2) to examine whether these variables were different in people with and without recurrent shoulder instability and (3) to assess how these variables changed over 12 months. Methods A prospective cohort study was undertaken in people with an FTASD aged between 16 and 40 years. Measures of quality of life, kinesiophobia, shoulder activity, shoulder pain and disability were recorded within 12 weeks of an FTASD and at 3, 6, 9 and 12 months. Results An FTASD negatively impacted quality of life, shoulder pain and function and these variables improved over time. People with recurrent shoulder instability had poorer quality of life 12 months after an FTASD. Across the entire cohort, kinesiophobia did not significantly change across time in people following an FTASD. Conclusions Quality of life was significantly affected by an FTASD in people with recurrent shoulder instability. Across the entire cohort of people with an FTASD, kinesiophobia remained elevated in people following an FTASD. Level of evidence Level 1 prognostic study.
Virologic failure after 48 weeks of raltegravir-based regimen in low HIV-1 incidence setting
Authors: Chehadeh Wassim , Albaksami Osama , Al-Shammari Shaikhah 
Published: May 2020

Background With the advent of next generation integrase strand transfer inhibitors, the rates of virologic failure in treated subjects are expected to decrease. In this study, we analyzed the mutation patterns leading to virologic failure before and after starting integrase strand transfer inhibitor-based regimen as first-line or salvage therapy. Methods Between 2016 and 2019, blood samples were received from 258 patients with HIV-1 infection. Plasma HIV-1 RNA concentrations, and pol gene sequences were determined at baseline, and 16–48 weeks of treatment with integrase strand transfer inhibitor-based regimen. Only patients who did not achieve viral suppression at 48 weeks of integrase strand transfer inhibitor-based treatment were eligible for the current study. Results Virologic failure was observed in seven patients on raltegravir-based regimen. All patients with virologic failure but one were infected with CRF01_AE virus subtype. Raltegravir based-regimen was offered as first-line therapy for four patients, and as salvage therapy for three patients. M184V mutation associated with high level resistance to lamivudine and emtricitabine was detected in six out of seven patients. Primary mutations (Y143C, N155H, T66I, G118R, E138K) conferring high level resistance to raltegravir were detected in only three patients. Pre-existing polymorphic integrase mutation (T97A) was detected in two patients. Furthermore, two patients reported low adherence to treatment. Conclusions Emergence of primary mutations in the integrase gene can account for virologic failure in less than half of patients on raltegravir-based regimen. Low adherence to treatment, pre-existing accessory mutations, and resistance to reverse transcriptase inhibitors may have some role in virologic outcome.
Participatory design and evaluation of virtual reality games to promote engagement in physical activity for people living with dementia
Authors: Eisapour Mazhar , Cao Shi , Boger Jennifer 
Published: May 2020

Background Exercise is a key component of physical health and quality of life for people living with dementia; however, challenges related to dementia symptoms and aging can make it difficult for people living with dementia to engage in exercise. While immersive virtual reality is showing increasing promise for exercise and rehabilitation applications, there is a lack of research regarding its use with people living with dementia. Methods Through participatory design with exercise therapists, kinesiologists, and people living with dementia, we designed two virtual reality environments (a farm and a gym) that were implemented on head-mounted displays to support five different upper-body exercises. Virtual reality and comparable human-guided exercises were tested with six people living with dementia. Both qualitative and quantitative measures were used, including reaching distance, distance traversed, and speed as well as feelings of enjoyment, engagement, interest, easiness, comfort, and level of effort. Results Participants’ subjective responses, motion, and fitness parameters all demonstrated comparable results between virtual reality and human-guided exercises. Therapists’ feedback also supported virtual reality exercise as an appropriate and engaging method for people living with dementia. Conclusions Collaborating with experts and people living with dementia throughout the design process resulted in an intuitive and engaging design. The results suggest that head-mounted virtual reality has promising potential to support physical activity for people living with dementia.
Unmet Dental Care Need and Associated Barriers by Race/Ethnicity among US Adults
Authors: Bhoopathi V. , Luo H. , Moss M. , Bhagavatula P. 
Published: May 2020

Introduction: Ability to access needed dental care may vary among population subgroups. We assessed 1) the differences in the proportions of adults who reported unmet dental care needs in the past 12 months and the associated barriers (structural, financial, and cognitive) in 2015 to 2016 versus 2003 to 2004 by race/ethnicity and 2) the subgroups that are more likely to report unmet dental care needs. Methods: Data of 10,029 respondents aged ≥19 y from the 2003–2004 and 2015–2016 National Health and Nutrition Examination Surveys were used. Chi-square tests assessed the differences in the proportions of adults who reported not getting the needed dental care between the periods. A multiple logistic regression model was run to identify characteristics that were significantly associated with unmet need after adjusting for other factors. Results: Overall, 19.4% of the adults reported an unmet dental care need in 2015 to 2016, as compared with 21% in 2003 to 2004. The overall unmet dental care need decreased only in the Hispanic groups (34% to 28%, P = 0.045) between 2003–2004 and 2015–2016. Between the periods, unmet need decreased among Hispanics aged 19 to 64 y (35% to 28%, P = 0.02), Hispanics with some college education or above (33.5% to 21.0%, P = 0.008), and nonpoor Hispanic adults (29.8% to 20.4%, P = 0.048). No significant differences were observed in the proportions of adults reporting structural ( P = 0.09), financial ( P = 0.86), or cognitive ( P = 0.07) barriers between the periods. When compared with their counterparts, nonelderly adults, women, Hispanics, adults with a high school education, those with less than a high school education, and poor adults were significantly more likely to report unmet dental care needs. Conclusions: Racial and ethnic disparities in accessing and receiving the needed dental care still exist. Financial barriers to dental care are the most commonly cited reasons for not getting the needed dental care. Knowledge Transfer Statement: The results of the study will inform policy makers, public health planners, and dental professionals about subgroups that still face difficulty in receiving the dental care they need. Policy makers should develop new policies to mitigate the financial barriers that are still prevalent. Dental professionals can mitigate the public’s cognitive and financial barriers by educating the community through outreach programs and by providing services to low-income populations at reduced charges or through alternative payment plans.
CD86-based analysis enables observation of bona fide hematopoietic responses
Authors: Kanayama Masashi , Izumi Yuta , Yamauchi Yasuharu , Kuroda Shoko , Shin Takaei , Ishikawa Shun , Sato Taku , Kajita Mihoko , Ohteki Toshiaki 
Published: May 2020

AbstractHematopoiesis is a system that provides red blood cells (RBCs), leukocytes, and platelets, which are essential for oxygen transport, biodefense, and hemostasis; its balance thus affects the outcome of various disorders. Here, we report that stem cell antigen-1 (Sca-1), a cell surface marker commonly used for the identification of multipotent hematopoietic progenitors (Lin−Sca-1+c-Kit+ cells; LSKs), is not suitable for the analysis of hematopoietic responses under biological stresses with interferon production. Lin−Sca-1−c-Kit+ cells (LKs), downstream progenitors of LSKs, acquire Sca-1 expression upon inflammation, which makes it impossible to distinguish between LSKs and LKs. As an alternative and stable marker even under such stresses, we identified CD86 by screening 180 surface markers. The analysis of infection/inflammation-triggered hematopoiesis on the basis of CD86 expression newly revealed urgent erythropoiesis producing stress-resistant RBCs and intact reconstitution capacity of LSKs, which could not be detected by conventional Sca-1–based analysis.
Influence of time under mechanical ventilation on bronchopulmonary dysplasia severity in extremely preterm infants: a pilot study
Authors: Escobar Victoria , Soares Darllyana S. , Kreling Jane , Ferrari Ligia S. L. , Felcar Josiane M. , Camillo Carlos A. M. , Probst Vanessa S. 
Published: May 2020

Abstract
Background
The relation between mechanical ventilation (MV) and bronchopulmonary dysplasia (BPD) - a common disease in extremely premature newborn (PTNB) - is well stabilished, but is unknown, however, how much time under MV influences the severity of the disease.

Aim
To define the duration under MV with greater chance to develop moderate to severe BPD in extremely PTNB and to compare clinical outcomes before and during hospitalization among patients with mild and moderate to severe BPD.

Methods
Fifty-three PTNB were separated into mild and moderate to severe BPD groups and their data were analyzed. Time under MV with a greater chance of developing moderate to severe BPD was estimated by the ROC curve. Perinatal and hospitalization outcomes were compared between groups. A logistic regression was performed to verify the influence of variables associated to moderate to severe BPD development, such as pulmonary hypertension (PH), gender, gestational age (GA) and weight at birth, as well the time under MV found with ROC curve. The result of ROC curve was validated using an independent sample (n = 16) by Chi-square test.

Results
Time under MV related to a greater chance of developing moderate to severe BPD was 36 days. Moderate to severe BPD group had more males (14 vs 5, p = 0,047), longer time under MV (43 vs 19 days, p < 0,001), more individuals with PH (12 vs 3, p = 0,016), worse retinopathy of prematurity (grade 3, 2 vs 11, p = 0,003), longer hospital length of stay (109 vs 81,5 days, p < 0,001), greater PMA (41 vs 38 weeks, p < 0,001) and weight (2620 vs 2031 g, p < 0,001) at discharge and the mild BPD group had more CPAP use prior to MV (12 vs 7, p = 0,043). Among all variables included in logistic regression, only PH and MV < 36 days were significant in the model, explaining 72% of variation in moderate to severe BPD development. In the validation sample, prevalence of preterm infants who needed MV for more than 36 days in the moderate to severe BPD group was 100% (n = 6) and 0% in mild BPD group (p = 0,0001).

Conclusion
Time under MV related to moderate to severe BPD development is 36 days, and worst outcomes are related to disease severity. PH and time under MV for more than 36 days are related to development of moderate to severe BPD.
Assessment of medical intern’s knowledge, awareness and practice of familial hypercholesterolemia at academic institutes in Jeddah, Saudi Arabia
Authors: Alzahrani Sami H. , Bima Abdulhadi , Algethami Mohammed R. , Awan Zuhier 
Published: May 2020

Abstract
Background
Familial Hypercholesterolemia (FH) is a serious under-diagnosed disease characterized by raised low-density lipoprotein cholesterol (LDL-C) and premature coronary artery diseases (CAD). The scarcity of FH reported patients in Saudi Arabia indicates lack of FH awareness among physicians.

Objective
The goal of this research was to assess knowledge, awareness, and practice (KAP) about FH disorder among Saudi medical interns and to identify areas that need educational attention.

Methods
This cross-sectional study involved 170 Saudi medical interns (83 males and 87 females) from academic institutes in Jeddah, Saudi Arabia. The interns were asked to fill an online FH-KAP questionnaire. Total score for each separate domain measured by adding correct answers.

Results
Although, knowledge of FH definition (76.5%) and classical lipid profile (52.4%) were reasonable; knowledge on inheritance (43.5%), prevalence (12.4%) and CAD risks (7.1%) were poor. Knowledge score was significantly higher in female than male (7.5 ± 3 vs. 5.3 ± 2.6, P < 0.001). Regarding awareness, 54.1% were familiar with FH disorder, 50.6% with the presence of lipid clinic but only 16.5% were acquainted with guidelines. Furthermore, in the practice domain 82.9% selected statin as first line treatment and 62.9% chose routinely checking the rest of the family, while 15.3% chose ages 13–18 years to screen for hypercholesterolemia in patients with a positive family history of premature CAD.

Conclusion
Substantial defects in FH-KAP among Saudi medical interns were found, emphasizing the importance of professional training. Extensive and constant medical education programs as early as an internship are required to close the gap in CAD prevention.