bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative training education with incentive spirometry may reduce postoperative pulmonary complications
Authors: Bilyy Andrey , El-Nakhal Tamer , Kadlec Jakub , Bartosik Waldemar , Tornout Filip Van , Kouritas Vasileios 
Published: September 2020

Objective To assess whether preoperative incentive spirometer training would influence the development of postoperative pulmonary complications after lung resection. Methods Sixty-two lung resection patients were prospectively investigated; 17 were given an incentive spirometer preoperatively and 45 did not have an incentive spirometer preoperatively. Postoperatively, both arms exercised with an incentive spirometer. The number of repetitions per day, balls raised per repetition, correct technique of exercising, and postoperative pulmonary complications were compared between the 2 groups. Univariate binary logistic regression analysis of potential predictors of postoperative pulmonary complications led to multivariate analysis of independent predictors. Receiver operating characteristic analysis established the cutoff points of predictors. Results The group with no preoperative incentive spirometer developed more postoperative pulmonary complications than the preoperative incentive spirometer group (24.4% vs. 5.9%, respectively, p = 0.045). The preoperative incentive spirometer arm achieved more repetitions per day, balls per repetition, and correct incentive spirometer technique ( p = 0.002, p < 0.001, p = 0.034, respectively). Balls raised per repetition and repetitions per day postoperatively were identified as independent predictors of postoperative pulmonary complications ( p = 0.032 and p = 0.021, respectively). Less than 5 repetitions per day (sensitivity 93%, specificity 77%, p < 0.001) and less than 2 balls per repetition (sensitivity 93%, specificity 77%, p < 0.001) were predictive of postoperative pulmonary complications. Conclusion Preoperative incentive spirometer exposure ensured better compliance with postoperative treatment and a more accurate technique (balls raised per repetition, repetitions per day). These variables correlated with a lower postoperative pulmonary complication rate.
Validation of the Distress Thermometer in patients with advanced cancer receiving specialist palliative care in a hospice setting
Authors: Graham-Wisener Lisa , Dempster Martin , Sadler Aaroon , McCann Luke , McCorry Noleen K 
Published: September 2020

Background: Ongoing assessment of psychological reaction to illness in palliative and end of life care settings is recommended, yet validated tools are not routinely used in clinical practice. The Distress Thermometer is a short screening tool developed for use in oncology, to detect individuals who would benefit from further psychological assessment. However the optimal cut-off to detect indicative psychological morbidity in patients with advanced cancer receiving specialist palliative care is unclear. Aim: To provide the first validation of the Distress Thermometer in an advanced cancer population receiving specialist palliative care in a UK hospice setting. Design: Receiver Operating Characteristics analysis was used to compare the sensitivity and specificity of cut-offs indicative of psychological morbidity on the Distress Thermometer in comparison to the Hospital Anxiety and Depression Scale. Setting/Participants: Data were derived from 202 patients with advanced cancer who were approached on admission to inpatient or day hospice care, with 139 patients providing complete data on both measures. Results: The area under the curve was optimal using a Distress Thermometer cut-off score of ⩾6 for total distress and for anxiety, and a cut-off score of ⩾4 optimal when screening for depression. Conclusions: The Distress Thermometer is a valid, accurate screening tool to be used in advanced cancer but with caution in relation to the lack of specificity. With little variation between the area under the curve scores, arguably a Distress Thermometer cut-off score of ⩾5 is most appropriate in screening for all types of psychological morbidity if sensitivity is to be prioritised.
Impact-Related Ground Reaction Forces Are More Strongly Associated With Some Running Injuries Than Others
Authors: Johnson Caleb D. , Tenforde Adam S. , Outerleys Jereme , Reilly Julia , Davis Irene S. 
Published: September 2020

Background: Inconsistent associations have been reported for impact-related ground reaction force variables and running injuries when grouping all injuries together. However, previous work has shown more consistent associations when focusing on specific injuries. Purpose: To compare ground reaction force variables between healthy and injured runners as a group and within specific common injuries. Study Design: Controlled laboratory study. Methods: A total of 125 runners presenting with patellofemoral pain, tibial bone stress injury, plantar fasciitis, Achilles tendinopathy, or iliotibial band syndrome and 65 healthy controls completed an instrumented treadmill assessment at a self-selected speed. Impact-related ground reaction force variables included vertical average (VALR) and instantaneous (VILR) load rates, posterior and medial/lateral instantaneous load rates, and vertical stiffness at initial loading (VSIL). Mean comparisons were made between the general and specific injury and control groups (α = .05). Cutoff thresholds were established and evaluated using several criteria. Results: VALR (+17.5%; P < .01), VILR (+15.8%; P < .01), and VSIL (+19.7%; P < .01) were significantly higher in the overall injured versus control groups. For individual injuries, VALR, VILR, and VSIL were significantly higher for patellofemoral pain (+23.4%-26.4%; P < .01) and plantar fasciitis (+17.5%-29.0%; P < .01), as well as VSIL for Achilles tendinopathy (+29.4%; P < .01). Cutoff thresholds showed better diagnostic criteria for individual versus grouped injuries. Conclusion: Impact variables (VALR, VILR, and VSIL) were significantly higher when assessing the injured group as a whole. However, these findings were driven by specific injury groups, highlighting the importance of taking an injury-specific approach to biomechanical risk factors for running injury. Clinical Relevance: These results suggest that practitioners may want to address impact loading in their treatment of injured runners, especially in those with patellofemoral pain and plantar fasciitis.
Etomidate, Adrenal Insufficiency and Mortality Associated With Severity of Illness: A Meta-Analysis
Authors: Albert Stewart G. , Sitaula Sujata 
Published: September 2020

Purpose: Etomidate causes adrenal insufficiency. Yet in critically ill patients, it is controversial whether it increases mortality rates above that of comparator anesthetic induction agents. We postulated that etomidate would increase relative mortality rates correspondingly to the severity of illness as defined by SAPS or APACHE scores. Materials and Methods: A literature search was performed on Pub Med, SCOPUS, and Cochrane Reviews for human studies, regardless of language, between 1983 and February 2020. The search strategy used keywords, “etomidate,” “adrenal insufficiency,” “glucocorticoid,” and “intensive care.” Both authors reviewed electronic data search titles, abstracts and extracted data, which were checked by the other reviewer. Primary outcome was 28-day survival. Secondary outcome was adrenal insufficiency. Results: There were 29 trials of etomidate versus comparators in 8584 patients. Etomidate was associated with adrenal insufficiency (risk ratio (rr) = 1·54, 95% CI; 1·42, 1·67, p < 0.001) and increased overall relative mortality rates (rr = 1.09, CI;1.04,1.16, p = 0.001). Meta-regression showed that with etomidate there was a continuous progressive relative risk of mortality associated with increasing severity of illness (predefined in each article by standard critical illness scores). In those patients who had a predicted mortality rate > the median for this analysis (predicted mortality 44%) the relative mortality rate (rr) = 1.20, Ci;1.12,1.29, p < 0.001, the absolute risk difference (rd) = 0.08, CI;0.05,0.11, p < 0.0001 and the number needed to harm (1/rd) was 12.5. In those with a calculated predicted mortality <44% there was no increase in relative mortality rate. Conclusions: Whereas etomidate causes adrenal insufficiency, it was not shown to increase mortality in many analyzed here in ICU settings. However, etomidate associated relative mortality rates increased progressively and correlated with the severity of critical illness scores. Intensivists should anticipate the need for glucocorticoid supplementation after etomidate in those with severe critical illness and in those with acute deterioration of vital signs.
Think Tanks in a Limited Access Order: The Case of Ukraine
Authors: Keudel Oleksandra , Carbou Olena 
Published: September 2020

This article belongs to the special cluster, “Think Tanks in Central and Eastern Europe”, guest-edited by Katarzyna Jezierska and Serena Giusti. Think tanks outside liberal democracies have distinctive features that go beyond the features of the original concept that emerged within the US context. Departing from this empirical observation, we investigate the sources of the organizational power of think tanks in Ukraine as a case of a limited access order (LAO), a social order where privileged individuals maintain discretionary access to societal resources, functions, and institutions. To accomplish this goal, we apply Thomas Medvetz’s analytical concept of a “boundary organization,” which allows us to highlight the hybridity and flexibility of think tanks and thus understand their methods of gaining political access in an LAO. The analysis of interviews with senior representatives of nongovernmental think tanks in Ukraine in 2016–2017 demonstrates that Ukrainian think tanks are resourceful and find indirect ways of influencing politics. These organizations publish their reports in the media and deliver assessments of Ukraine’s international commitments to the country’s donors, thereby indirectly influencing the policy process in the country. Ukrainian think tanks also comply with the expectations of a boundary organization, accumulating and converting economic, academic, and media capital into political capital, using advocacy and networking as conversion tools. One important difference between the expectations of Medvetz’s framework and our findings is that political capital seems to be the goal of think tank activity, while the three other types are used merely instrumentally.
Dangling in a Vacuum: A Presentation of Polish Think Tanks in Political Life
Authors: Jezierska Katarzyna 
Published: September 2020

This article belongs to the special cluster, “Think Tanks in Central and Eastern Europe”, guest-edited by Katarzyna Jezierska and Serena Giusti. This article explores the image and reputation of think tanks in their reciprocal relationship with their environment. The aim is to unravel the logic of think tanks’ institutional identity formation in the largely understudied context of Poland. How do Polish think tanks present themselves and how are they (re)presented by others? To answer these questions, the Goffmanian microsociological framework and positioning theory are adjusted to a study of institutions. The analysis of original interview and media data reveals that Polish think tanks project an image of and are perceived by the media as being weak. I argue that this image and reputation of weakness should primarily be explained by think tanks’ and the media’s perceptions of the political field, which confine the possible identity and positioning of think tanks.
Severe pulmonary arterial hypertension and interstitial pneumonia related to systemic lupus erythematosus successfully treated with mycophenolate mofetil: A novel case report
Authors: Nawata Masao , Nagayasu Atsushi , Fujita Yuya , Nawata Aya , Saito Kazuyoshi , Tanaka Yoshiya 
Published: September 2020

Background Pulmonary arterial hypertension (PAH) and interstitial pneumonia (IP) are relatively rare complications of systemic lupus erythematosus (SLE) and are associated with a poor prognosis. Overcoming these complications is a challenge for improving the prognosis. Case report A 41-year-old woman was diagnosed with SLE complicated by IP at the age of 21 years and with antiphospholipid syndrome at the age of 32 years at another hospital. She had been administered prednisolone (PSL) at a dose ≥15 mg daily, as well as various immunosuppressants and antiplatelet/anticoagulation therapy. On day I of hospitalization, She presented to our emergency outpatient department with fever, marked dyspnea, and skin ulcer on the left lower leg and was admitted the same day. Chest radiography revealed marked cardiomegaly and interstitial shadow, and right heart catheterization showed elevation in the mean pulmonary arterial pressure to 47 mmHg, indicating PAH. While oxygen therapy was started, high-dose steroid therapy and mycophenolate mofetil (MMF) were administered for treatment of SLE complicated by PAH/IP, and prostacyclin (prostaglandin I2), endothelin receptor antagonist, and PDE5 inhibitor were administered for PAH. Both SLE disease activity and PAH/IP improved and were maintained with no exacerbation for 2 years. The PSL dose could eventually be reduced to 5 mg/day. Conclusion In SLE complicated by PAH/IP, reports on the efficacy of MMF are scarce, and our findings suggested that MMF may be a treatment option in such cases.
Recommendation of Aspirin-Guide App and Physicians Clinical Decision of Aspirin Use to Prevent CVD Among Diabetic Patients, Is there any Differences?
Authors: Batais Mohammed Ali , Almutairi Khalid M. , Almigbal Turky H. , Alodhayani Abdulaziz , Alonazi Wadi B. , Vinluan Jason M. , Asnar Joram B. , Salem Rahaf ElHussein , Aljubab Reem Abdulwahab 
Published: September 2020

Objective: This study aims to identify the prevalence of aspirin use among type 2 diabetic (T2DM) patients and assess the concordance in aspirin use among these patients as prescribed by physicians and as recommended by the Aspirin-Guide app. Methods: A total of 301 T2DM patients from King Khalid University Hospital in Riyadh, Saudi Arabia participated in this cross-sectional study. Patient’s electronic medical records through eSihi system were reviewed and all data included in the free online and mobile app called Aspirin-Guide were collected in a specially designed data checklist. Result: The prevalence of aspirin use was more common in patients who were in the age group of 51 to 59 and male participants’ with T2DM. Males were nearly twice more likely to use aspirin compared to females ( P = 0.001). Based on recommendations from the Aspirin-Guide app, 26% of the patients who were on aspirin (N = 51) were not eligible for aspirin therapy, while 37.7% (N = 40) of the patients eligible for aspirin therapy had not been put on aspirin by their physicians ( P = 0.039). Male sex ( P = 0.003), use of statins ( P = 0.001), and being advised to use aspirin ( P = 0.041), were significantly associated with aspirin use in T2DM patients. Conclusion: There was a significant difference in the proportion of patients currently on aspirin as prescribed by their physicians and those eligible for aspirin therapy as per the Aspirin-Guide app. The use of an app to uniformized aspirin use among eligible patients should be based on up-to-date guidelines and account for patient acceptability and willingness to commence treatment.
Laboratory abnormalities in children with novel Coronavirus Disease 2019
Authors: Bourkhissi Laila , Fakiri Karima EL , Nassih Houda , Qadiry Rabiy EL , Bourrahouat Aicha , Ait Sab Imane , Rada Noureddine , Draiss Ghizlane , Bouskraoui Mohammed 
Published: September 2020

The novel Coronavirus disease 2019 continues to be a worldwide pandemic. Yet, little is still known about the biological features of this emergent infection in children. In this prospective study, we collected 68 children infected with SARS-COV-2 from March 2020 to May 2020, in Marrakesh, Morocco. No severe cases were observed in this cohort, and 66% of the patients were asymptomatic. The main laboratory abnormalities were hematological, as we found Leucopoenia in 4.4% of the cases, hyperleukocytosis in 1.6%. Neutropenia was found in 5 patients (7%) and only 2 cases (3%) had Lymphopenia. The inflammation and coagulation biomarkers were normal in the majority of the cases, as for liver and kidney function. Lactate dehydrogenase (LDH) serum levels were elevated in 8 cases (11.67%). The COVID-19 in children seems to have mild course and better outcome than in adults, which impacts the laboratory findings in this category. More studies must be conducted to learn more about the laboratory abnormalities in pediatric COVID-19.
Primary Dermal Melanoma (PDM): Histological and Clinical Interdependence to Guide Therapy
Authors: Zamir Hadas , Feinmesser Meora , Gutman Haim 
Published: September 2020

Background/purpose This study examined clinical and histological parameters of primary dermal melanoma (PDM) to aid in its distinction from dermal metastasis. Methods Retrospective analysis of a prospective cohort of PDM patients. Includes patients fulfilling the strict histologic criteria for PDM ( N = 9) and patients who did not, but clinically, unequivocally had an intradermal melanoma—clinical PDM (cPDM; N = 17). Histopathology slides were re-examined. Prognosticators and outcome measures were compared between groups. Sentinel nodes’ retrieval and wide local excision (WLE) were offered to all patients as primary treatment. Results 26 patients identified, 15 females with a median age of 69 years (range 3.5-85). Mean Breslow was 7.9 ± 5.7 mm (median 5.8, range 1.8-25.0), and the mean mitotic rate was 4.9 ± 3.8/mm2 (median 4.0, range 0-17). Initial treatment and follow-up were as for cutaneous melanoma. One patient in each group with a palpable stage III underwent primary radical dissection. Sentinel nodes were retrieved in all 20 lymphatic mappings performed and found to be metastatic in 5 (25%) patients. Treatment consisted of completion lymph-node dissection. At a median postoperative follow-up of 62 months (range 8-132), 20 patients were disease-free, including 6 of 7 patients with stage III disease at presentation. Six patients died all of cPDM; 5 of 6 patients had primary ulcerated or epidermal-abutting melanomas. Conclusions This is the first study to highlight cPDM. Diagnosis requires expert pathology review and a tight correlation to the clinical parameters. Patients seem to benefit from WLE with sentinel node retrieval and complete dissection when appropriate. However, clinical guidelines for dissection have changed since the time period of this retrospective review. Based on this series, complete nodal dissection in these melanomas is associated with better than expected outcome, for stage III disease.
The impact of adolescent parentification on family relationship and civic engagement
Authors: Wei Hsi-Sheng , Shih An-Ti , Chen Yi-Fu , Hong Jun Sung 
Published: September 2020

Summary This study examined the relationships between parentification, family relationship, political interest, and civic beliefs using a large sample of Taiwanese adolescents. Data were collected from 1648 junior and senior high school students in Taichung City, Taiwan. Parentification was hypothesized to positively affect family relationship, which in turn influences adolescents’ political interest and civic beliefs. A series of structural equation models were constructed and tested. Implications of the findings for practice and policy-making are discussed. Findings Two dimensions of parentification, instrumental and emotional caregiving, were found to be positively associated with the parent–child relationship while perceived unfairness was negatively associated with the family relations. Family relationship was positively related to youth’s civic beliefs as well as their political interests. Potential gender, age (junior high/senior high), and family (living with/not with both parents) effects were examined through multi-group comparisons. The model was robust with minor differences between gender, age, and family type subgroups. Applications Social workers should recognize the developmental benefits of parentification and utilize such experiences when working with adolescents. With cultural sensitivity, a healthy inter-dependence between youth and parents can be appreciated as a source of strength, which facilitates young people’s civic responsibility and concern for public affairs beyond family.
Disadvantage of Small (<60 kg) Adult Candidates on the Liver Transplantation Waitlist
Authors: van Dijk Anne-Baue R. M. , Sneiders Dimitri , Murad Sarwa Darwish , Polak Wojciech G. , Hartog Hermien 
Published: September 2020

Background: Small adult patients with lower bodyweight wait-listed for liver transplantation may face a shortage of size-matched whole-liver grafts. The objective of this study is to compare time to transplantation in adult patients with a bodyweight of <60 kg to patients with bodyweight ≥60 kg. Methods: A matched case–control study was conducted. Patients aged 18 years and older listed for liver transplantation at our transplant center, from 2007 to 2016 with a bodyweight <60 kg were manually matched 1:2 to control patients ≥ 60 kg. Matching was performed based on ABO blood type, model for end-stage liver disease score, (non)-standard exception status, and eligibility for donation after cardiac death. Time to transplantation was assessed with univariable Cox-regression. Results: In total, 23 cases with a bodyweight < 60 kg were matched to 46 average-sized control patients. Small adults were significantly disadvantaged for receiving a liver transplantation as compared to their average-sized counterpart (hazard ratio 0.47; 95% confidence interval 0.29-0.75, P = .002). At the end of follow-up, 14/23 (60.9%) of cases versus 35/46 of controls (76.1%) had received a liver transplantation. Conclusion: Small adults with a bodyweight below 60 kg are disadvantaged on the waitlist for a size-matched whole liver graft.