bluuebunny/crossref_metadata_2025_split huggingface dataset:
I stay at home with headache. A survey to investigate how the lockdown for COVID-19 impacted on headache in Italian children
Authors: Papetti Laura , Alaimo Di Loro Pierfrancesco , Tarantino Samuela , Grazzi Licia , Guidetti Vincenzo , Parisi Pasquale , Raieli Vincenzo , Sciruicchio Vittorio , Termine Cristiano , Toldo Irene , Tozzi Elisabetta , Verdecchia Paola , Carotenuto Marco , Battisti Matteo , Celi Angela , D'Agnano Daniela , Faedda Noemi , Ferilli Michela AN , Grillo Giovanni , Natalucci Giulia , Onofri Agnese , Pelizza Maria Federica , Ursitti Fabiana , Vasta Michelangelo , Velardi Margherita , Balestri Martina , Moavero Romina , Vigevano Federico , Valeriani Massimiliano 
Published: December 2020

Objective The present Italian multicenter study aimed at investigating whether the course of primary headache disorders in children and adolescents was changed during the lockdown necessary to contain the COVID-19 emergency in Italy. Methods During the lockdown, we submitted an online questionnaire to patients already diagnosed with primary headache disorders. Questions explored the course of headache, daily habits, psychological factors related to COVID-19, general mood and school stress. Answers were transformed into data for statistical analysis. Through a bivariate analysis, the main variables affecting the subjective trend of headache, and intensity and frequency of the attacks were selected. The significant variables were then used for the multivariate analysis. Results We collected the answers of 707 patients. In the multivariate analysis, we found that reduction of school effort and anxiety was the main factor explaining the improvement in the subjective trend of headache and the intensity and frequency of the attacks ( p < 0.001). The greater the severity of headache, the larger was the clinical improvement ( p < 0.001). Disease duration was negatively associated with the improvement ( p < 0.001). It is noteworthy that clinical improvement was independent of prophylaxis ( p > 0.05), presence of chronic headache disorders ( p > 0.05) and geographical area ( p > 0.05). Conclusions Our study showed that lifestyle modification represents the main factor impacting the course of primary headache disorders in children and adolescents. In particular, reduction in school-related stress during the lockdown was the main factor explaining the general headache improvement in our population.
Determining On-/Off-track Lesions in Glenohumeral Dislocation Using Multiplanar Reconstruction Computed Tomography Is Easier and More Reproducible Than Using 3-dimensional Computed Tomography
Authors: Mulleneers Laura Irène C. , Van Rompaey Hannah , Haloui Baïdir , Pouliart Nicole 
Published: December 2020

Background: The glenoid track is a useful tool to predict engagement and therefore the risk of recurrence of dislocation in the presence of Hill-Sachs and/or bony Bankart lesions. To assess the glenoid track preoperatively, only methods using 3-dimensional reconstruction (3DR) have been described, but these lack a standardized, reliable, and easy description. Purpose/Hypothesis: The purpose was to evaluate a new method for determining the glenoid track using computed tomography (CT) scan with multiplanar reconstruction (MPR) in comparison with using 3DR images. Our hypothesis was that the MPR method would be easier to standardize and more reproducible. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A total of 52 patients whose arthro-CT scan revealed a Hill-Sachs lesion, whether in combination with a bony Bankart lesion or not, were included. Digital Imaging and Communications in Medicine data from the 52 CT scans were all analyzed using open source image analysis software. Glenoid width, with or without associated bony defect, and the Hill-Sachs interval (HSI) were measured on MPR as well as on 3DR images. All measurements obtained using both methods were directly compared and evaluated for intra- and interobserver reliability. Results: In absolute values, only small differences were seen between the MPR and 3DR methods, amounting to a maximal difference of 0.07 cm for the HSI and 0.04 cm for the glenoid width. For glenoid measurements, both methods were similar. For humeral measurements, the MPR method demonstrated higher inter- and intraobserver reliability than did the 3DR method. Conclusion: The newly described MPR method for the assessment of the glenoid track and HSI is at least as accurate as the published 3DR method, with better intra- and interobserver reliability. Because MPRs are also easier to obtain, this method could be recommended in daily practice.
Clinical Characteristics and Outcomes of Patients With Severe COVID-19 Induced Acute Kidney Injury
Authors: Xu Jingyuan , Xie Jianfeng , Du Bin , Tong Zhaohui , Qiu Haibo , Bagshaw Sean M. 
Published: December 2020

Background: The incidence and outcome of Coronavirus disease 2019 (COVID-19)-induced kidney injury have been variably described. We aimed to describe the clinical characteristics, correlates and outcomes of critically ill patients with severe COVID-19 complicated by acute kidney injury (AKI). Methods: We performed a multicenter retrospective cohort study of 671 critically ill adults with laboratory-confirmed COVID-19 from 19 hospitals in China between January 1 to February 29, 2020. Data were captured on demographics, comorbidities, symptoms, acute physiology, laboratory parameters, interventions, and outcomes. The primary exposure was ICU admission for confirmed COVID-19 related critically illness. The primary outcome was 28-day mortality. Secondary outcomes included factors associated with AKI, organ dysfunction, treatment intensity, and health services use. Measurements and Main Results: Of 671 severe COVID-19 patients (median [IQR] 65 [56-73] years; male sex 65% (n = 434); hypertension 43% (n = 287) and APACHE II score 10 [7-14]), 39% developed AKI. Patients with AKI were older, had greater markers of inflammation and coagulation activation, and had greater acuity and organ dysfunction as presentation. Despite similar treatment with antivirals, patients with AKI had lower viral conversion negative rates than those without AKI. The 28-day mortality was much higher in AKI patients than patients without AKI (72% vs. 42%), and there was an increase in 28-day mortality according to the severity of AKI. Non-survivors were less likely to receive antiviral therapy [132 (70%) vs. 65 (88%)] compared with survivors and have lower viral negative conversion rate [17 (9%) vs. 47 (64%)]. Conclusions: Acute kidney injury was quite common in severe COVID-19 pneumonia, which associated with higher mortality.
Implementation of a Protocol for Peripheral Intravenous Norepinephrine: Does It Save Central Line Insertion, Is It Safe?
Authors: Cape Kari M. , Jones Laureen G. , Weber Michele L. , Elefritz Jessica L. 
Published: December 2020

Background Central venous catheters (CVC) are generally recommended for norepinephrine administration due to risk of tissue ischemia. Early resuscitation, leading to decreased infusion duration, may minimize the need for CVCs if norepinephrine can be administered safely through a peripheral intravenous catheter (PIV). Objective A protocol was developed for peripheral administration. Safety, CVC placement, and adherence with protocol elements were evaluated. Methods A single-center, prospective, observational pilot was conducted for patients receiving norepinephrine in the Medical Intensive Care Unit (MICU). Patients were considered for PIV administration of low dose norepinephrine for less than 24 hours based on clinical status and anticipated short-term use. Protocolized interventions for PIV’s included criteria for gauge, number, and site as well as visual inspection and evaluation every 2 hours. Data was collected on protocol elements to evaluate safety and effectiveness of the protocol. Results There were 316 occurrences of norepinephrine infusions including 92 via PIV (patients may have received multiple treatments). 34% (31/92) did not require a CVC. 3 had infiltrated PIV’s without tissue injury. Maximum dose adherence was 73%. 97% of infusions ran less than 24 hours. Nursing adherence included: 91% gauge, 65% proper site, 99% adequate number, 49% blood return on initiation, 55% ongoing blood return, and 61% IV site checked. Conclusion Our results suggest that norepinephrine is safe to administer through a PIV at low doses for less than 24 hours using a protocol. Prevention of unnecessary CVC insertion is beneficial by minimizing the risk of central line complications thus improving patient morbidity.
Role of attitude in nurses’ responses to requests for assisted dying
Authors: Wilson Michael , Wilson Marie , Edwards Suzanne , Cusack Lynette , Wiechula Richard 
Published: December 2020

Background: Legal assisted dying is a rare event, but as legalisation expands, requests for it will likely increase, and the nurse most often receives the informal, initial request. Objectives: To assess the effects of attitude in interaction with normative and control beliefs on an intention to respond to a request for legal assisted dying. Ethical considerations: The study had the lead author’s institutional ethics approval, and participants were informed that participation was both anonymous and voluntary. Methodology: This was a cross-sectional correlational study of 377 Australian registered nurses who completed an online survey. Generalised linear modelling assessed the effects of independent variables against intended responses to requests for legal assisted dying. Results: Compared to nurses who did not support legal assisted dying, nurses who did had stronger beliefs in patient rights, perceived social expectations to refer the request and stronger control in that intention. Nurses who did not support legal assisted dying had stronger beliefs in ethics of duty to the patient and often held dual intentions to discuss the request with the patient but also held an intention to deflect the request to consideration of alternatives. Discussion: This study advances the international literature by developing quantified models explaining the complexity of nurses’ experiences with requests for an assisted death. Attitude was operationalised in interaction with other beliefs and was identified as the strongest influence on intentions, but significantly moderated by ethical norms. Conclusion: The complex of determinants of those intentions to respond to requests for an assisted death suggests they are not isolated from each other. Nurses might have distinct intentions, but they can also hold multiple intentions even when they prioritise one. These findings present opportunities to prepare nurses in a way that enhances moral resilience in the face of complex moral encounters.
The Effect of Values on the Attractiveness of Responsible Employers for Young Job Seekers
Authors: Bustamante Silke , Ehlscheidt Rudi , Pelzeter Andrea , Deckmann Andreas , Freudenberger Franziska 
Published: December 2020

Purpose: Empirical studies suggest that corporate social responsibility (CSR) impacts young job seekers’ choices of an employer. Values seem to affect CSR preferences, influencing the felt fit between the person and the organization and hereby the valence of working for that company. This article aims to research in more detail the preference structure of young graduate job seekers. In particular, it seeks to understand whether CSR is important when there is a trade-off between CSR and non-CSR attributes and whether basic value orientations of job seekers have a moderating effect on their employer preferences. Design/methodology/approach: This article used a quantitative approach with a survey sample of 577 German students who were in their last year of study. To gain information on the relative impact of CSR- and non-CSR-related employer characteristics on employer attractiveness, an adaptive conjoint analysis was applied. Correlation analysis and a two-step hierarchical regression were conducted to detect the effects of individual value orientations. Findings: Only a few CSR attributes are relevant for young job seekers compared with other traditional employer attributes. Specific value orientations can be identified as having a moderating effect on CSR preferences. This is particularly the case for value orientations indicating a concern for the welfare of others and the environment positively affect the importance of most CSR attributes while more selfish value orientations have a negative effect. Originality/value: This study sheds light on the relative importance of CSR attributes when compared with non-CSR attributes. Moreover, it relates employee-related preferences to individual value orientations and shows that selected values have a modifying effect on the importance of CSR for job choice.
Experiences of Canadian Parents of Young Children With Cleft Lip and/or Palate
Authors: Breuning Eleonore E. , Courtemanche Rebecca J. , Courtemanche Douglas J. 
Published: December 2020

Purpose: Prior literature has described the perspectives of parents of young children with clip lip and/or palate; however, few studies have described parents’ experiences within a Canadian health care system. This study aims to better understand the experiences of parents of young children with cleft lip and/or palate seen at a Canadian tertiary care center and identify their care needs. Design: In-depth semistructured interviews. Setting: Pediatric tertiary care center. Participants: Parents of children younger than 7 years of age with cleft lip and/or palate. Results: From 14 interviews, 4 themes were identified. The diagnosis theme was associated with reactions, timing, and search for information. Key concerns within the theme of physiology and function were around feeding and speech. The health care experience theme included burden of care, peripheral hospitals and services, the cleft lip and palate clinic, and clinicians. The psychosocial theme included parents’ reactions to their child’s pain, coping strategies, family interactions, and school/day care experiences. Parents felt care could be improved by having: access to good information and community speech therapists, shorter appointment wait times, a peer support network, and increased cleft knowledge within their child’s school and peer groups. Conclusions: The experience of parents of children with cleft lip and/or palate is complex but can be organized into 4 themes. Clinics may consider suggestions offered by parents to improve care. Future work should address parents’ needs and aim to create a parent-reported quality-of-life measure specific to parents of young children with cleft lip and/or palate.
Clinical Practice Patterns and Evidence-Based Medicine in Secondary Cleft Rhinoplasty: A 14-Year Review of Maintenance of Certification Tracer Data From the American Board of Plastic Surgery
Authors: Rokni Alex M. , Kearney Aaron M. , Brandt Keith E. , Gosain Arun K. 
Published: December 2020

Objective: To evaluate evolving practice patterns in secondary cleft rhinoplasty. Design: Retrospective review of data submitted during Maintenance of Certification (MOC). Setting: Evaluation of MOC data from the American Board of Plastic Surgery. Participants: Tracer data for secondary cleft rhinoplasty were reviewed from August 2006 through March 2020, and the data subdivided from 20062012 and 20132020 to evaluate changes in practice patterns. Interventions: Practice patterns in tracer data were compared to those from evidence-based medicine (EBM) literature over this time period. Main Outcome Measures: Practice patterns were compared to EBM trends during the study period. Results: A total of 90 cases of secondary cleft rhinoplasty were identified. The average age at operation was 13 years (range 4-77). Cumulative data demonstrated 61% to present with nasal airway obstruction and 21% to have undergone primary nasal correction at the time of cleft lip repair; 72% of patients experienced no complications, with the most common complications being asymmetry (10%) and vertical asymmetry of alar dome position (6%). Cartilage graft was used in 68% of cases, with 32% employing septal cartilage. Change in practice patterns between 2006 to 2012 and 2013 to 2020 demonstrated increase in dorsal nasal surgery (26% vs 43%, P = .034), use of osteotomies (14% vs 38%, P = .010), septal resection and/or straightening (26% vs 48%, P = .034), and turbinate reduction (8% vs 30%, P = .007). Conclusions: These tracer data provide long-term data by which to evaluate evolving practice patterns for secondary cleft rhinoplasty. When evaluated relative to EBM literature, future research to further improve outcomes can be better directed.
Development of a Predictive Immune-Related Gene Signature Associated With Hepatocellular Carcinoma Patient Prognosis
Authors: Lei Jiasheng , Zhang Dengyong , Yao Chao , Ding Sheng , Lu Zheng 
Published: December 2020

Background: Hepatocellular carcinoma (HCC) remains the third leader cancer-associated cause of death globally, but the etiological basis for this complex disease remains poorly clarified. The present study was thus conceptualized to define a prognostic immune-related gene (IRG) signature capable of predicting immunotherapy responsiveness and overall survival (OS) in patients with HCC. Methods: Five differentially expressed IRG associated with HCC were established the immune-related risk model through univariate Cox regression and least absolute shrinkage and selection operator (LASSO) regression analyses. Patients were separated at random into training and testing cohorts, after which the association between the identified IRG signature and OS was evaluated using the “survival” R package. In addition, maftools was leveraged to assess mutational data, with tumor mutation burden (TMB) scores being calculated as follows: (total mutations/total bases) × 106. Immune-related risk term abundance was quantified via “ssGSEA” algorithm using the “gsva” R package. Results: HCC patients were successfully stratified into low-risk and high-risk groups based upon a signature composed of 5 differentially expressed IRGs, with overall survival being significantly different between these 2 groups in training cohort, testing cohort and overall patient cohort ( P = 1.745e-06, P = 1.888e-02, P = 4.281e-07). No association was observed between TMB and this IRG risk score in the overall patient cohort ( P = 0.461). Notably, 19 out of 29 immune-related risk terms differed substantially in the overall patient dataset. These risk terms mainly included checkpoints, human leukocyte antigens, natural killer cells, dendritic cells, and major histocompatibility complex class I. Conclusion: In summary, an immune-related prognostic gene signature was successfully developed and used to predict survival outcomes and immune system status in patients with HCC. This signature has the potential to help guide immunotherapeutic treatment planning for patients affected by this deadly cancer.
Chemotherapy-Induced Reduction of Neutrophil-to-Lymphocyte Ratio Is Associated With Better Survival in Pancreatic Adenocarcinoma: A Meta-Analysis
Authors: Luo Xin , Yu Bo , Jiang Nan , Du Qiong , Ye Xuan , Li Huan , Wang Wen-Quan , Zhai Qing 
Published: December 2020

Objectives: Numerous studies have suggested that an increase in neutrophil-to-lymphocyte ratio (NLR) before treatment is associated with worse survival in pancreatic adenocarcinoma (PAC). The aim of this study was to investigate the prognostic value of treatment-induced NLR change among PAC patients so as to better identify the characteristics of those who can benefit more from treatment. Methods: This meta-analysis was undertaken using the PRISMA statement. Previously published studies between the correlation of NLR change and patients’ survival were searched in Pubmed, Embase, and Web of Science databases. RevMan 5.3 was used to conduct statistical analysis. Results: A total of 1213 patients with PAC from 6 retrospective studies were included in this meta-analysis. Four studies investigated the HR of pre-treatment NLR, demonstrating its prognostic impact on overall survival (OS) (HR = 2.21, 95%CI: 1.45-3.36). One study reported that an elevated post-treatment NLR was associated with poorer OS (HR = 1.28, 95%CI = 1.08-1.52). Pooled analysis indicated that NLR reduction might predict favorable survival in both the overall population (HR = 1.52, 95% CI: 1.34–1.73) and the subgroup treated with chemotherapy (HR = 1.50, 95% CI: 1.32-1.70). Conclusion: Treatment-induced NLR change can act as an early predictor for PAC. Patients with reduced NLR after chemotherapy are expected to have better survival.
The Impact of Renal Impairment on Survival Outcomes in Patients With Metastatic Renal Cell Carcinoma Treated With Tyrosine Kinase Inhibitors
Authors: Zhang Haoran , Zhang Xingming , Zhu Xudong , Ni Yuchao , Dai Jindong , Zhu Sha , Sun Guangxi , Wang Zhipeng , Chen Junru , Zhao Jinge , Zeng Hao , Li Zi , Shen Pengfei 
Published: December 2020

Purpose: It remained unclear whether tyrosine kinase inhibitors (TKIs) related renal impairment had impact on the survival of patients with metastatic renal cell carcinoma (mRCC). Methods: Clinicopathological parameters of patients with mRCC treated with TKIs were retrospectively reviewed. Blood urea nitrogen (BUN), proteinuria and estimated glomerular filtration rate (eGFR) at baseline and during TKIs treatment were recorded. BUN > 7.1mol/L, eGFR <60 ml/min/1.73m2 and/or proteinuria level > 0.3 g/L were defined as renal impairment. eGFR and proteinuria were furtherly classified into different levels. Treatment outcomes were defined as progression-free survival (PFS) and overall survival (OS). Results: At baseline, the presence of abnormal BUN, eGFR and proteinuria level were observed in 25 (22.7%), 27 (25.5%) and 30 (27.3%) patients, which increased to 46 (41.8%), 55 (50.0%) and 64 (58.2%) respectively after TKIs treatment. In the whole cohort (N = 110), survival analysis suggested that only post-treatment renal impairment was related to survival outcomes. Interestingly, sub-analysis showed that post-treatment eGFR level (p = 0.004), proteinuria (p = 0.014) and eGFR decrease >10% (p = 0.012) and elevated proteinuria compared with baseline (p = 0.006) were statistically correlated with OS among patients without RI at baseline (N = 51). On the contrary, deterioration of renal impairment after TKIs treatment in patients with renal impairment at baseline (N = 59) had no relationship with either PFS or OS. Furthermore, eGFR (p = 0.020) and eGFR decrease >10% (p = 0.016) within 1 year after TKIs therapy were potential biomarkers for OS. Conclusion: Dynamic changes of TKI-induced RI during TKIs treatment, especially eGFR and proteinuria level, could be considered as potential biomarkers predicting survival outcomes of mRCC patients.