bluuebunny/crossref_metadata_2025_split huggingface dataset:
A structured mixed method process evaluation of a randomized controlled trial of Individual Placement and Support (IPS)
Authors: Fyhn Tonje , Ludvigsen Kari , Reme Silje E. , Schaafsma Frederieke 
Published: October 2020

Abstract

Background
Individual Placement and Support (IPS) is an evidence-based work rehabilitation program helping people with moderate to severe mental illness to obtain ordinary employment. Although IPS has proven superior to other work rehabilitation programs, in many studies, the majority of the participants remain unemployed. Structured process evaluations of IPS that use mixed methods are scarce, although they could identify implementation aspects that may enhance its effect. The aim of the current study is to assess reach, fidelity, and identify barriers and facilitators to implement IPS.

Methods
The process evaluation was conducted alongside a randomized controlled trial including six IPS centers, comparing IPS with treatment as usual in a population of patients in treatment for moderate to severe mental illness. Mixed methods were used in the process evaluation, including focus group interviews with service providers, individual interviews and survey data from participants, and fidelity reviews using the validated IPS Fidelity Scale.

Results
The intervention reached the intended target group. All centers reached fair to good fidelity according to the IPS Fidelity Scale within the project period (range 97–109, SD 8.1) (see Table 5). Certain fidelity items indicated implementation issues related to employer contact, community-based services, and integration with health services. Survey data showed that less than half of the participants regarded their illness as a barrier for participating in IPS and that freedom of disclosure was important. Participant interviews gave further insight into the role of the IPS specialist, emphasizing their availability and consistent job focus.

Conclusions
Indications of implementation challenges across centers during the first year suggest special attention should be given to these aspects in an early phase to ensure higher fidelity from the start and thus enhance the effectiveness of IPS. The IPS specialist played an important role for participants and was described as positive, pushing in a positive way, and encouraging. More knowledge on the characteristics of successful IPS specialists could further enhance the effectiveness of the intervention.

Trial registration
The study was registered on clinicaltrials.gov prior to the inclusion period (reg.no: NCT01964092, registered 17/07/2013).
Imaging of metastatic cervical nodes: is CT helpful in differentiation of squamous cell carcinoma (SCC) from non-SCC groups?
Authors: Eissa Lamya A. , Mehanna Ahmed Mohamed 
Published: October 2020

Abstract
Background
Cervical node metastasis is frequently encountered in CT neck of patients with squamous cell carcinoma (SCC) and non-(SCC). Differentiation between both entities carries its value on prognosis and choice of treatment plans. The purpose of the study was to compare between the SCC and non-SCC metastatic cervical adenopathies according to different imaging parameters with the use of comparative statistical analysis of any of these criteria. This was made by retrospectively studying 157 patients. Imaging analyzed the following parameters: nodal size, laterality, nodal levels, “grouping” of nodes, nodal shape, and “periphery,” as well as the presence or absence of nodal “necrosis.” Statistics are made to show significant differences between both groups.

Results
The criterion of necrosis had statistical significance, being more prevalent among the SCC groups. Involvement of levels I, II, and supra clavicular was more prevalent among SCC patients. Age and sex had also some statistical significance.

Conclusions
The combination of different imaging parameters could distinguish SCC from non-SCC. Nodal “necrosis”—(excluding “cystic”)—combined with involvement of nodal levels II and being in older-aged men were statistically significant in the SCC compared to non-SCC.
Pneumoparotid: a rare but well-documented cause of parotid gland swelling
Authors: Aljeaid Dhaifallah , Mubarak Ali , Imarli Yasser , Alotaibi Ohoud 
Published: October 2020

Abstract
Background
Pneumoparotid is a rare cause of parotid gland swelling. It is due to reflux of air through Stensen’s duct into the parenchyma of the parotid gland.

Case presentation
A case of self-induced pneumoparotid in a 12-year-old boy is reported. The diagnosis was primarily considered after careful history taking with special attention on the patient’s habits, and it was confirmed by computed tomography.

Conclusion
Pneumoparotid is a rare but well-documented clinical entity. It should be included in the differential diagnosis of parotid gland swelling.
Adjunctive benzodiazepines in depression: a clinical dilemma with no recent answers from research
Authors: de Cates Angharad N. , De Giorgi Riccardo 
Published: October 2020

SUMMARYComorbid anxiety symptoms are common in depression, and adding benzodiazepines to antidepressant treatment may seem a rational clinical solution. Benzodiazepines also have potential to reduce the initial anxiety that may be caused by early antidepressant treatment (owing to their inhibitory effect via GABAA receptor binding). This month's Cochrane Corner review examines the evidence behind combination treatment versus antidepressants alone in major depressive disorder, in terms of both the clinical and neuroscientific context. The review provides evidence that, in the first 4 weeks of treatment, additional medication with a benzodiazepine may lead to greater improvements than antidepressant alone on ratings of severity, response rates and remission rates for depression, but not on measures of anxiety.
Financial Distress Among Older Adults With Cancer
Authors: Giri Smith , Clark Deanna , Al-Obaidi Mustafa , Varnado Will , Kumar Seema , Paluri Ravi , Gbolahan Olumide , Bhatia Smita , Williams Grant R. 
Published: October 2020

PURPOSE: Financial distress (FD) among older adults with cancer is not well studied. We sought to characterize prevalence and factors associated with FD among older adults with cancer and the association of FD with geriatric assessment (GA) –identified deficits. PATIENTS AND METHODS: We included adults age ≥ 60 years with cancer in the University of Alabama at Birmingham Cancer and Aging Resilience Evaluation Registry who underwent GA during initial consultation with a medical oncologist before starting systemic therapy. We captured FD using a single-item question: “Do you have to pay for more medical care than you can afford?” We built multivariable models to study the impact of sociodemographic/clinical factors on FD as well as the association of FD with GA impairments. RESULTS: We identified 447 older adults with a median age of 69 years; 60% were men, 75% were White, and colorectal (26%) and pancreatic (19%) cancers were the most common. Overall, 27% (n = 121) reported having FD. Factors associated with FD included being Black (v White; odds ratio [OR], 2.26; 95% CI, 1.35 to 3.81; P = .002), being disabled/unemployed (v employed; OR, 2.60; 95% CI, 1.17 to 5.76; P = .019), and having an advanced degree ( v less than high school; OR, 0.13; 95% CI, 0.03 to 0.65; P = .012). Patients with FD were more likely to report several GA impairments, including depression (OR, 2.10; 95% CI, 1.06 to 4.18; P = .034) and impaired health-related quality of life in physical (β = −2.82; P = .014) and mental health domains (β = −3.31; P = .002). CONCLUSION: More than a quarter of older adults with cancer reported FD at the time of initial presentation to an oncologist. Several demographic factors and GA impairments were associated with FD.
Recurrence Rate of Sporadic Pheochromocytomas After Curative Adrenalectomy: A Systematic Review and Meta-analysis
Authors: Holscher Isabelle , van den Berg Tijs J , Dreijerink Koen M A , Engelsman Anton F , Nieveen van Dijkum Els J M 
Published: October 2020

Abstract

Background
Evidence on follow-up duration for patients with sporadic pheochromocytomas is absent, and current guidelines of the European Society of Endocrinology, American Association of Clinical Endocrinologists and Endocrine Surgeons, and the Endocrine Society are ambiguous about the appropriate duration of follow-up. The aim of this systematic review and meta-analysis is to evaluate the recurrence rate of sporadic pheochromocytomas after curative adrenalectomy.

Materials and Methods
A literature search in PubMed, Embase, and the Cochrane Library was performed. A study was eligible if it included a clear report on the number of sporadic patients, recurrence rate, and follow-up duration. Studies with an inclusion period before 1990, &lt;2 years of follow-up, &lt;10 patients, and unclear data on the sporadic nature of pheochromocytomas were excluded. A meta-analysis on recurrence was performed provided that the heterogeneity was low (I2 &lt; 25%) or intermediate (I2 26–75%). Hozo’s method was used to calculate weighted mean follow-up duration and weighted time to recurrence with combined standard deviations (SDs).

Results
A total of 13 studies, including 430 patients, were included in the synthesis. The meta-analysis results describe a pooled recurrence rate after curative surgery of 3% (95% confidence interval: 2–6%, I2 = 0%), with a weighted mean time to recurrence of 49.4 months (SD = 30.7) and a weighted mean follow-up period of 77.3 months (SD = 32.2).

Conclusions
This meta-analysis shows a very low recurrence rate of 3%. Prospective studies, including economical and health effects of limited follow-up strategies for patients with truly sporadic pheochromocytomas should be considered.
Microvascular Dysfunction in Diabetes Mellitus and Cardiometabolic Disease
Authors: Horton William B , Barrett Eugene J 
Published: October 2020

AbstractThis review takes an inclusive approach to microvascular dysfunction in diabetes mellitus and cardiometabolic disease. In virtually every organ, dynamic interactions between the microvasculature and resident tissue elements normally modulate vascular and tissue function in a homeostatic fashion. This regulation is disordered by diabetes mellitus, by hypertension, by obesity, and by dyslipidemia individually (or combined in cardiometabolic disease), with dysfunction serving as an early marker of change. In particular, we suggest that the familiar retinal, renal, and neural complications of diabetes mellitus are late-stage manifestations of microvascular injury that begins years earlier and is often abetted by other cardiometabolic disease elements (eg, hypertension, obesity, dyslipidemia). We focus on evidence that microvascular dysfunction precedes anatomic microvascular disease in these organs as well as in heart, muscle, and brain. We suggest that early on, diabetes mellitus and/or cardiometabolic disease can each cause reversible microvascular injury with accompanying dysfunction, which in time may or may not become irreversible and anatomically identifiable disease (eg, vascular basement membrane thickening, capillary rarefaction, pericyte loss, etc.). Consequences can include the familiar vision loss, renal insufficiency, and neuropathy, but also heart failure, sarcopenia, cognitive impairment, and escalating metabolic dysfunction. Our understanding of normal microvascular function and early dysfunction is rapidly evolving, aided by innovative genetic and imaging tools. This is leading, in tissues like the retina, to testing novel preventive interventions at early, reversible stages of microvascular injury. Great hope lies in the possibility that some of these interventions may develop into effective therapies.
Suspected Primary Adrenal Lymphoma (PAL) Associated With Hemophagocytic Lymphohistiocytosis (HLH)
Authors: Kim Tara S , Cheng Kwan , Jaiswal Radhika , Gautam-Goyal Pranisha , Myers Alyson K 
Published: October 2020

Abstract
Adrenal incidentalomas, masses noted on imaging performed for other purposes, are common, with 10% to 15% presenting as bilateral adrenal masses. These cases can be challenging as the differential diagnosis is broad, including metastatic disease, primary adrenal lymphoma (PAL), or infection, and often requiring a biopsy if initial biochemical workup is unrevealing. We present here a relevant case description, laboratory and radiologic imaging studies, and discussion of literature. A 62-year-old Korean woman presented with altered mental status and fevers. She was found to have bilateral adrenal incidentalomas and retained acupuncture needles. Adrenal workup did not show biochemical evidence of hormonal excess. Infectious workup was unrevealing, as was a metal/toxin workup due to retained acupuncture needles. Fevers and episodes of hypotension persisted which prevented the patient from obtaining an adrenal biopsy. Bone marrow biopsy was obtained for pancytopenia and revealed B-cell lymphoma with large cell morphology and few histiocytes with hemophagocytosis, raising concern for lymphoma-induced hemophagocytic lymphohistiocytosis (HLH). PAL associated with HLH was highly suspected in our patient, given the large (7 cm) bilateral adrenal masses and bone marrow biopsy findings of lymphoma. The patient was treated for diffuse large B-cell lymphoma, with clinical improvement. PAL is a rare but aggressive lymphoma with few reported cases. It should be considered in the differential for both unilateral and bilateral adrenal masses. An early diagnosis is crucial as the main treatment is chemotherapy rather than surgery and it confers a significant survival benefit.
A computed tomography-based nomogram to predict pneumothorax caused by preoperative localization of ground glass nodules using hook wire
Authors: Liu Junzhong , Liang Changsheng , Wang Xinhua , Sun Minfeng , Kang Liqing 
Published: October 2020

Objective:
To develop and validate a CT-based nomogram to predict the occurrence of loculated pneumothorax due to hook wire placement.

Methods:
Patients (n = 177) were divided into pneumothorax (n = 72) and non-pneumothorax (n = 105) groups. Multivariable logistic regression analysis was applied to build a clinical prediction model using significant predictors identified by univariate analysis of imaging features and clinical factors. Receiver operating characteristic (ROC) was applied to evaluate the discrimination of the nomogram, which was calibrated using calibration curve.

Results:
Based on the results of multivariable regression analysis, transfissure approach [odds ratio (OR): 757.94; 95% confidence interval CI (21.20–27099.30) p &lt; 0.0001], transemphysema [OR: 116.73; 95% CI (12.34–1104.04) p &lt; 0.0001], localization of multiple nodules [OR: 8.04; 95% CI (2.09–30.89) p = 0.002], and depth of nodule [OR: 0.77; 95% CI (0.71–0.85) p &lt; 0.0001] were independent risk factors for pneumothorax and were included in the predictive model (p &lt; 0.05). The area under the ROC curve value for the nomogram was 0.95 [95% CI (0.92–0.98)] and the calibration curve indicated good consistency between risk predicted using the model and actual risk.

Conclusion:
A CT-based nomogram combining imaging features and clinical factors can predict the probability of pneumothorax before localization of ground-glass nodules. The nomogram is a decision-making tool to prevent pneumothorax and determine whether to proceed with further treatment.

Advances in knowledge:
A nomogram composed of transfissure, transemphysema, multiple nodule localization, and depth of nodule has been developed to predict the probability of pneumothorax before localization of GGNs.
Prediction of the progression of femoral head collapse in ARCO stage 2-3A osteonecrosis based on the initial bone resorption lesion
Authors: Shi Shan , Luo Ping , Sun Li , Xie Limin , Yu Tong , Wang Zhenchang , Yang Xuedong 
Published: October 2020

Objectives:
To predict the progression of femoral head collapse in Association Research Circulation Osseous (ARCO) Stage 2-3A osteonecrosis based on the initial bone resorption lesion.

Methods:
A retrospective analysis of the location, attenuation, and maximum area in coronal position (MAC) of the initial bone resorption lesion in ARCO Stage 2 and 3A was conducted in 85 cases of osteonecrosis of the femoral head (ONFH). The cases were divided into rapid and slow progression groups according to whether femoral head collapse at follow-up was greater than 2 mm. The characteristics of the bone resorption lesion between the two groups were compared by analysis of variance. Receiver operating characteristic curve was used to analyze the MAC, regions of A2, and C1 of bone resorption lesion in predicting collapse progression.

Results:
The MAC of initial bone resorption lesion in rapid progression group (117.8 ± 72.1 mm2) was significantly larger than slow (53.1 ± 39.5 mm2) (p &lt; 0.001). Regions of A2 and C1 involved were significantly higher in rapid than slow progression group. The area under the receiver operating characteristic curve of MAC, regions of A2 and C1 of bone resorption lesion to predict collapse progression were 0.81, 0.72 and 0.62 respectively. A threshold MAC of 49 mm2 had sensitivity of 86.1% and specificity of 61.9% to predict collapse progression.

Conclusions:
The MAC of initial bone resorption lesion in ARCO Stage 2-3A ONFH can predict the progression of femoral head collapse. If it is greater than 49 mm2 and located in regions of A2 and C1, the possibility of rapid progression is high, active monitoring and intervention should be recommended.

Advances in knowledge:
This study is the first to find that the maximum area in coronal position of initial bone resorption lesion in ARCO Stage 2 or 3A can predict progression of the femoral head collapse with a threshold of 49 mm2. If the maximum area is larger than 49 mm2 and located in the anterolateral or lateral column of the femoral head, the possibility of rapid collapse progression is high, therefore, monitoring should be strengthened and active intervention should be considered.
Lethality model for COVID-19 based on social determinants of health: an approximation in 67 countries
Authors: Manrique-Abril Fred G. , Pacheco-López Mario J. , Téllez-Piñerez Cristian F. , Ortíz-Rico Felipe , Sarmiento-Páramo Juan D. 
Published: October 2020

Background: Social, geographic, economic, demographic, and health factors were analysed to identify some social determinants related to case fatality of COVID-19 in 67 countries. Methods: A mixed generalized linear model with beta distribution with random intercept was used to estimate the effects of the explanatory variables on the lethality for COVID-19 in 67 countries. Results: The case fatality rate (CFR) was highest in the countries with the highest percentages of people over 60 years of age, the highest number of hospital beds,the highest mortalit yrate from diabetes, and the highest number of COVID-19 tests. Additional increases were seen based on literacy rates, health investment, death rate from cardiovascular disease, poverty rate, ratio of men, number of air passengers mobilized, number of days from the ﬁrst reported case to the start of quarantine, death rate from respiratory infections, and percentage of people living in urban areas. Conclusions: The statistical model used to predict lethality is novel because it allows the magnitude of the CFR to be analysed over a logistic model that classiﬁes countries considering the presence and absence of deaths. When considering a beta distribution with excess zeros, the model also allows countries without reported deaths due to COVID-19 at the analysed cut-off date to be included.
Innovation in the 21st Century: Architectural Change, Purpose, and the Challenges of Our Time
Authors: Henderson Rebecca 
Published: October 2020

Understanding the process of innovation has been a central concern of management researchers, but despite this progress, there remains much that we do not understand. Deepening our knowledge is critically important given the enormous environmental and social challenges we face as a society. Pursing incremental innovation will continue to be hugely important, but this paper argues that building a richer understanding of architectural or systemic innovation will also be crucial. This paper suggests that the study of organizational purpose may provide a particularly fruitful avenue for future research.This paper was accepted by David Simchi-Levi, Special Section of Management Science: 65th Anniversary.
Tryptophan-rich diet can influence sleep quality in different phases of life
Authors: Marins Lais , Franchini Mariana , Polese Jessica Fabia , Guandalini Valdete , Coitinho Juliana Barbosa , Araújo Maria Teresa Martins 
Published: October 2020

Objetivo: Avaliar como a ingestão de triptofano (fontes alimentares e suplementação) influencia o ritmo circadiano e a qualidade do sono de humanos e animais em diferentes faixas etárias. Métodos: Trata-se de uma revisão integrativa da literatura realizada nos Portais de Periódicos PubMed e Capes, considerados no período de 1998 a 2020 nas línguas portuguesa, inglesa e espanhola. A questão norteadora foi: "A ingestão de triptofano através de fontes alimentares e suplementação interfere no ritmo circadiano e na qualidade do sono?”. Os seguintes critérios de inclusão foram utilizados: análise dos descritores (“tryptophan”, “diet”, “sleep”) no título ou resumo do artigo, contextualização da questão norteadora em todo o artigo, tipo de artigo e amostra estudada no artigo. Ao final, 12 artigos foram incluídos no estudo, sendo oito estudos realizados em humanos e quatro em animais. Resultados: Os 12 estudos mostraram que quando a dieta diurna e/ou noturna rica em triptofano, seja por fontes alimentares ou suplementação, é administrada em crianças (n=2), em adultos (n=6), em animais adultos (n=2) e animais jovens e velhos (n=2), houve significativa contribuição para a síntese de serotonina e melatonina. A presença desses mediadores alterou a cronobiologia do ciclo vigília-sono, interferindo na qualidade do sono de humanos e animais. Conclusão: Alimentos que afetam a disponibilidade de triptofano ou sua suplementação e a síntese de serotonina e melatonina foram capazes de organizar o sono dos recém-nascidos, melhorar o sono de adultos e idosos, independentemente dos períodos do dia. Assim, propostas de dietas cronobiologicamente formuladas com triptofano poderiam contribuir para abordagens terapêuticas de baixo custo que contornariam ou reduziriam os distúrbios do sono.