bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional connectivity and microstructural changes of the brain in primary Sjögren syndrome: the relationship with depression
Authors: Andrianopoulou Artemis , Zikou Anastasia K , Astrakas Loukas G , Gerolymatou Nafsika , Xydis Vasileios , Voulgari Paraskevi , Kiortsis Dimitris-Nikiforos , Argyropoulou Maria I 
Published: March 2020

Background Fatigue and depression are among the most common manifestations of primary Sjögren syndrome (pSS), but information is lacking on the relationship with brain function and microstructural changes. Purpose To investigate microstructural changes and brain connectivity in pSS, and to evaluate their relationship with fatigue and depression. Material and Methods The study included 29 patients with pSS (mean age 61.2 ± 12.1 years; disease duration 10.5 ± 5.9 years) and 28 controls (mean age 58.4 ± 9.2 years). All the patients completed the Beck’s depression and Fatigue Assessment Scale questionnaires. The imaging protocol consisted of: (i) standard magnetic resonance imaging (MRI) pulse sequences (FLAIR, 3D T1W); (ii) a diffusion tensor imaging pulse sequence; and (iii) a resting state functional MRI pulse sequence. Resting state brain networks and maps of diffusion metrics were calculated and compared between patients and controls. Results Compared with the controls, the patients with pSS and depression showed increased axial, radial, and mean diffusivity and decreased fractional anisotropy; those without depression showed decreased axial diffusivity in major white matter tracts (superior longitudinal fasciculus, inferior longitudinal fasciculus, corticospinal tract, anterior thalamic radiation, inferior fronto-occipital fasciculus, cingulum, uncinate fasciculus, and forceps minor-major). Decreased brain activation in the sensorimotor network was observed in the patients with pSS compared with the controls. No correlation was found between fatigue and structural or functional changes of the brain. Conclusion pSS is associated with functional connectivity abnormalities of the somatosensory cortex and microstructural abnormalities in major white matter tracts, which are more pronounced in depression.
Renal transplant biopsy complications: assessment of risk factors and potential of desmopressin to decrease risk of hemorrhage
Authors: Peters Björn , Nasic Salmir , Jensen Gert , Stegmayr Bernd 
Published: March 2020

Background Renal transplant biopsies are essential in nephrology; however, they are invasive and complications can occur. Purpose To explore the risk of transplant kidney biopsy (TxB) complications in relation to possible preventive effects of desmopressin prophylaxis. Material and Methods A total of 515 consecutive TxB (375 patients, median age 53 years) were analyzed. In 252 TxB, the Resistive Index (RI) was measured right before the biopsy. A total of 282 patients had serum creatinine >150 µmol/L. In one of the six hospitals 39/282 patients consecutively received desmopressin (dose 0.3 µg/kg subcutaneously) as prophylaxis within 1 h before the biopsy. Fisher’s exact and χ2 test were used (odds ratio [OR], 95% confidence interval [CI]). Univariate and multiple binary logistic regression analyses were performed. A two-sided P value <0.05 was considered significant. Results RI ≥ 0.8 was a risk factor for major TxB complications (OR 4.2, 95% CI 1.13–15.76). The risk for minor complications decreased with mean arterial blood pressure (MAP) (97.9 vs. 89.5 mmHg, OR 0.97, 95% CI 0.95–0.997). In a multiple regression analysis for overall biopsy complications, the risk remained increased for patients with RI ≥ 0.8 (OR 4.45, 95% CI 1.32–15.04). No patients (0/39) with desmopressin prophylaxis had a major complication versus 8/243 in the other group. In patients with serum creatinine >150 µmol/L, those with a higher MAP had more overall TxB complications (104.5 vs. 98.2 mmHg, OR 1.05, 95% CI 1.004–1.1). Conclusion RI ≥ 0.8 was a risk factor for major and overall complications and a lower MAP for minor biopsy complications. Desmopressin prophylaxis showed yet no verified benefit as prophylaxis in TxB.
Use of a helmet for oxygen therapy in critically ill patients: a systematic review and meta-analysis
Authors: Wang Tao , Yin Hongzhen , Xu Qiancheng , Jiang Xiaogan , Yu Tao 
Published: March 2020

Objective This systematic review and meta-analysis was performed to evaluate the efficacy of using a helmet for oxygen therapy in critically ill patients with respiratory failure. Methods The Cochrane Library, Embase, and PubMed databases were searched for all randomized controlled trials (RCTs) examining the efficacy of a helmet versus standard oxygen therapy or a mask in critically ill patients with respiratory failure. The quality of all included studies was evaluated by the method recommended by The Cochrane Collaboration. The systematic review and meta-analysis was conducted using Review Manager software, version 5.3 (Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Results Ten RCTs involving 708 patients were included in the present meta-analysis. The results of the meta-analysis showed that the oxygenation index, partial pressure of carbon dioxide, and complications were not significantly different between the helmet group and the standard oxygen therapy or mask group. The incidence of intubation and the mortality rate were significantly lower in the helmet group than in the standard oxygen therapy or mask group. Conclusion Delivering oxygen via a helmet can decrease the incidence of required intubation and improve the mortality rate, resulting in beneficial outcomes in critically ill patients with respiratory failure.
The association between comorbidities and inpatient mortality with sudden sensorineural hearing loss using a national database in Taiwan
Authors: Kuo Chao-Yin , Chung Chi-Hsiang , Wang Chih-Hung , Chien Wu-Chien , Chen Hsin-Chien 
Published: March 2020

Objective The association between comorbidities and inpatient mortality with sudden sensorineural hearing loss (SSNHL) has not been investigated. Therefore, this study aimed to provide a 14-year nationwide incidence, and identify risk factors and comorbidities of SSNHL inpatient mortality. Methods Data were obtained from the Taiwan National Health Insurance Research Database for 2000 to 2013. Inpatient mortality of 31,258 patients hospitalized with a diagnosis of SSNHL was recorded and analyzed. Results Sixteen patients with SSNHL exhibited mortality with a percentage of 0.05% and an incidence of less than 0.01 per 100,000 people per year. The risk of variables among inpatient mortality was associated with older age (adjusted odds ratio [OR]: 1.042, 95% confidence interval [CI]: 1.009–1.077) and the presence of catastrophic illness (adjusted OR: 4.949, 95% CI: 1.290–18.996). Potential comorbidities included hematologic diseases, cancers, chronic hepatitis, gastrointestinal bleeding, chronic obstructive pulmonary disease, seizures or convulsions, coronary artery disease, diabetes mellitus, and varicose veins and their associated complications. Conclusions This 14-year nationwide study shows that inpatient mortality rate for SSNHL is relatively rare, but suggests we should still be aware of the potential for such underlying conditions to cause SSNHL as well as the mortality associated with these conditions.
Workload and workplace safety in social service organizations
Authors: Turpin Aaron , Shier Micheal L , Nicholas David , Graham John R 
Published: March 2020

Summary Worker experiences of workload is a poorly understood component of health and safety practice in the social services sector. Job Demands-Resources theory is applied to explore how workload contributes to health and safety, workplace violence, and violence prevention. Data from qualitative interviews ( n = 81) of workers in publicly administered social services in Western Canada were analyzed using analytic induction and constant comparison methods. Findings Qualitative themes highlight the role of Workload Management, Equal Distribution of Workload, Stress Management, and Flexibility on worker experiences with workplace violence prevention. These themes are further elaborated on and contextualized within a Job Demands-Resources framework. Finally, a conceptual model of workload management and health and safety is presented. Applications Findings highlight areas of workload development and innovation as a component of violence prevention interventions within social service workplaces.
Exploring how triads of people living with dementia, carers and health care professionals function in dementia health care: A systematic qualitative review and thematic synthesis
Authors: Tuijt Remco , Rees Jessica , Frost Rachael , Wilcock Jane , Manthorpe Jill , Rait Greta , Walters Kate 
Published: March 2020

Background Many qualitative studies report the post-diagnostic care experiences of carers and people living with dementia; however, this is not often accompanied by opportunities to hear the corresponding views of their health care professionals and how this triadic relationship functions. The aim of this review was to identify and thematically synthesize the experiences of health care services reported by people living with dementia, their carers and health care professionals. Methods Medline, PsycINFO, Embase and CINAHL were searched from inception to 31 July 2019 for qualitative research including people living with dementia, carers and health care professionals. Data were coded and thematically synthesised using NVivo. Results Of 10,045 search results, 29 papers relating to 27 studies were included in the final synthesis, including 261 people living with dementia, 444 carers and 530 health care professionals. Six themes emerged related to the functioning of a dementia care triad: (1) involving the person living with dementia, (2) establishing expectations of care and the roles of the members of the triad, (3) building trust, (4) effective communication, (5) continuity of care and (6) understanding the unique relationship dynamics within each triad. Discussion The interactions and complexity of triadic dementia care relationships further our understanding of how to improve dementia care. Awareness of possible diverging attitudes highlights areas of necessary improvement and further research into facilitating engagement, such as when multiple professionals are involved or where there are mismatched expectations of the roles of triad members. In order to operate efficiently as a triad member, professionals should be aware of how pre-existing relations can influence the composition of a triad, encourage the involvement of the person living with dementia, clarify the expectations of all parties, establish trusting relationships and enable communication within the direct triad and beyond.
A quality improvement project for delirium prevention and management over the Greater Manchester Critical Care Network
Authors: Davis Jessica , Berry Karen , McIntyre Rebecca , Conway Daniel , Thomas Anthony , Hanison James 
Published: March 2020

Background Delirium is a common complication of critical illness with a significant impact on patient morbidity and mortality. The Greater Manchester Critical Care Network established the Delirium Reduction Working Group in 2015. This article describes a region-wide delirium improvement project launched by that group. Methods Multiple Plan-Do-Study-Act cycles were undertaken. Cycle 1: April 2015 demonstrated only 48% of patients had a formal delirium screen. Following this a network-wide event took place and the Delirium Standards for the Greater Manchester Critical Care Network were produced. Cycle 2: May 2016 quarterly audits across the network monitored compliance against the agreed standards. Group events involved implementation of a delirium care bundle, sharing best practice, educating staff and providing guidance on the management of delirium. Cycle 3: November 2016 quarterly audit continued and a regional delirium study day was rolled out across the region. Results We have 14 different units across our network, all of which have participated in the audit. The first audit showed a delirium point prevalence of 28%, subsequent point prevalence audits demonstrated rates as low as 13%. There has also been an improvement in the use of delirium screening tools. In the first audit 37% of patients had two delirium screens in 24 h, this has increased to 60% in the latest audit. Improvements were also made in availability of sensory aids and pain assessments. Conclusion The project has demonstrated the feasibility of delivering a coordinated delirium improvement project across multiple critical care units.
Developing occupation kits in a Hand Therapy Student Experiential Learning Clinic
Authors: Berlet Logan , Kaskutas Vicki 
Published: March 2020

Introduction Combining occupation-based and biomechanical approaches is effective to increase function after hand injury. This project developed and evaluated occupation kits as a means to increase occupation-based practice. Methods Descriptive study that utilized existing Disabilities of the Arm, Shoulder and Hand data from 642 patients treated by hand surgeon and patients in our Hand Therapy Student Experiential Learning Clinic (HTSELC) to identify difficult activities. These data informed the selection of occupational areas to address with the kits. Biomechanical demands of each kit developed were quantified by 10 student therapists using the Abilities Questionnaire. Fourteen occupational therapists reviewed and rated the usefulness of each kit by survey. Kits were piloted in the HTSELC, and student therapists documented the percentage of time delivering each intervention type: activity/occupation, preparatory methods and tasks, education, advocacy, and group. The degree of occupation-based practice was compared using intervention type percentages before and after introduction of the kits. Results Ten kits were created to address most occupation categories within occupational therapy’s scope of practice. Kits include procedures, safety precautions, and a standardized scale to objectively measure performance. Clinicians noted that kits reflected each occupation well (3.7/5) and 45% reported they were likely to use the kits. After the kits became available in the HTSELC, the percentage of interventions at the occupation/activity level increased from 19% to 26% and biomechanical interventions, including preparatory methods and tasks, decreased from 61% to 49%. Conclusion This research suggests that occupation kits can be a first step to help therapists deliver occupation-based interventions in hand therapy settings.
Quantifying the impact of delayed delivery of cardiac rehabilitation on patients’ health
Authors: Hinde Sebastian , Harrison Alexander , Bojke Laura , Doherty Patrick 
Published: March 2020

BackgroundDespite its role as an effective intervention to improve the long-term health of patients with cardiovascular disease and existence of national guidelines on timeliness, many health services still fail to offer cardiac rehabilitation in a timely manner after referral. The impact of this failure on patient health and the additional burden on healthcare providers in an English setting is quantified in this article.MethodsTwo logistic regressions are conducted, using the British Heart Foundation National Audit of Cardiac Rehabilitation dataset, to estimate the impact of delayed cardiac rehabilitation initiation on the level of uptake and completion. The results of these regressions are applied to a decision model to estimate the long-term implications of these factors on patient health and National Health Service expenditure.ResultsWe demonstrate that the failure of 43.6% of patients in England to start cardiac rehabilitation within the recommended timeframe results in a 15.3% reduction in uptake, and 7.4% in completion. These combine to cause an average lifetime loss of 0.08 years of life expectancy per person. Scaled up to an annual cohort this implies 10,753 patients not taking up cardiac rehabilitation due to the delay, equating to a loss of 3936 years of life expectancy. We estimate that an additional £12.3 million of National Health Service funding could be invested to alleviate the current delay.ConclusionsThe current delay in many patients starting cardiac rehabilitation is causing quantifiable and avoidable harm to their long-term health; policy and research must now look at both supply and demand solutions in tackling this issue.
The acromion–greater tuberosity impingement index: A new radiographic measurement and its association with rotator cuff pathology
Authors: Liu Hai-Xiao , Xu Xin Xian , Xu Dao Liang , Hu Yue Zheng , Pan Xiao-Yun , Yu Zhang , Xu You-Jia 
Published: March 2020

Purpose: Several radiographic parameters describe humeral head coverage by the acromion. We describe a new radiographic measurement, the acromion–greater tuberosity impingement index (ATI), and its ability to predict rotator cuff pathology. Methods: The ATI was measured with magnetic resonance imaging (MRI) and X-ray analysis in 83 patients with rotator cuff pathology and 76 patients with acute rotator cuff tears. The lateral acromial angle (LAA), acromion type, the acromion index (AI) and the critical shoulder angle (CSA) were measured to assess their correlations with the ATI. Receiver operating characteristic (ROC) curves were used to predict degenerative rotator cuff pathology. The change in the ATI after acromion surgery was evaluated in both groups. Results: According to the ROC curves, the ATI is a good predictor of degenerative rotator cuff pathology on both X-ray (cut-off, 0.865) and MRI (cut-off, 0.965). Patients with degenerative rotator cuff pathology had a significantly higher average ATI compared to the trauma group ( p = 0.001 for X-ray and MRI). The degenerative group had a significantly lower LAA ( p = 0.001) and a higher ratio of type III acromion ( p = 0.035) than the trauma group. The ATI on X-ray was negatively related to the LAA and positively related to the AI, the CSA and acromion type (each p < 0.05). The ATI on MRI was negatively related to the LAA and positively related to the AI and acromion type (each p <0.05). More patients in the degenerative group than the trauma group needed acromioplasty or acromion decompression ( p < 0.05). The ATI on MRI was significantly lower after acromion surgery compared to before surgery in both groups ( p < 0.05). Conclusion: The ATI is a good predictor of degenerative supraspinatus tendon tears or subacromial impingement syndrome. The ATI on MRI is more accurate and can precisely guide acromion surgery.
Injury-Related Fears During the Return-to-Sport Phase of ACL Reconstruction Rehabilitation
Authors: Meierbachtol Adam , Obermeier Michael , Yungtum William , Bottoms John , Paur Eric , Nelson Bradley J. , Tompkins Marc , Russell Hayley C. , Chmielewski Terese L. 
Published: March 2020

Background: Fear of reinjury is common after anterior cruciate ligament reconstruction (ACLR) and often deters a return to preinjury sport participation. A better understanding of injury-related fear is needed to inform rehabilitation strategies. Purpose/Hypothesis: The purpose of this study was to (1) identify individual fear-evoking tasks or situations, (2) compare the intensity and amount of change relative to other injury-related fears (reinjury, knee giving way, and knee pain) after completion of a return-to-sport training program, and (3) determine whether standardized questionnaires can identify the intensity of fear for the individual fear-evoking task or situation and for fear of reinjury. The hypothesis was that the task or situation that evokes fear would vary across patients and the intensity of that fear would be higher and show less change after return-to-sport training compared with other injury-related fears. Study Design: Case series; Level of evidence, 4. Methods: Participants included 33 patients (15 males; mean age, 18 years) with ACLR who enrolled in a group-format return-to-sport training program. Questionnaires completed before and after return-to-sport training included items to specify fear-evoking tasks or situations, items to rate the intensity of various injury-related fears, the Anterior Cruciate Ligament Return to Sport after Injury scale (ACL-RSI), and the Tampa Scale for Kinesiophobia (TSK-11). Results: The most common fear-evoking task or situation was cutting, followed by contact, jumping, and other. Intensity of fear-evoking task or situation was higher than other injury-related fears, but all fears decreased in intensity after training. The ACL-RSI score better identified the intensity of fear for the individual fear-evoking task or situation and for fear of reinjury than did the TSK-11 score. Conclusion: Activities that evoke fear vary across patients, but fear of cutting is common. The intensity of common fears after ACLR decreased after advanced group training, and large effect sizes were seen for nearly all examined fears. Fear of reinjury and intensity of individually feared tasks may be better reflected in the ACL-RSI score than the TSK-11 score.
Export Sophistication and Trade Elasticities
Authors: Thorbecke Willem , Salike Nimesh 
Published: March 2020

Does a country’s export structure impact the way that exchange rates affect trade? Do more sophisticated products exhibit lower demand elasticities? Using panel data for major exporters over the 1992–2016 period and dynamic ordinary least squares techniques, we find that price elasticities are higher for low-technology goods such as textiles and footwear than for high-technology goods such as pharmaceuticals and medical equipment. We also find that elasticities are larger for less advanced countries such as China than for more advanced countries such as Switzerland. We draw policy implications from these findings for countries exposed to safe haven capital flows, for countries facing long-term appreciation pressures and for countries that specialise in low-technology exports.JEL Classification: F14, F10
Targeting CD300f to enhance hematopoietic stem cell transplantation in acute myeloid leukemia
Authors: Abadir Edward , Silveira Pablo A. , Gasiorowski Robin E. , Ramesh Murari , Romano Adelina , Mekkawy Ahmed H. , Lo Tsun-Ho , Kabani Karieshma , Sutherland Sarah , Pietersz Geoffrey A. , Ho P. Joy , Bryant Christian E. , Larsen Stephen R. , Clark Georgina J. 
Published: March 2020

Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) significantly reduces the rate of relapse in acute myeloid leukemia (AML) but comes at the cost of significant treatment-related mortality. Despite the reduction in relapse overall, it remains common, especially in high-risk groups. The outcomes for patients who relapse after transplant remains very poor. A large proportion of the morbidity that prevents most patients from accessing allo-HSCT is due to toxic nonspecific conditioning agents that are required to remove recipient hematopoietic stem and progenitor cells (HSPCs), allowing for successful donor engraftment. CD300f is expressed evenly across HSPC subtypes. CD300f has transcription and protein expression equivalent to CD33 on AML. We have developed an anti-CD300f antibody that efficiently internalizes into target cells. We have generated a highly potent anti-CD300f antibody-drug conjugate (ADC) with a pyrrolobenzodiazepine warhead that selectively depletes AML cell lines and colony forming units in vitro. The ADC synergizes with fludarabine, making it a natural combination to use in a minimal toxicity conditioning regimen. Our ADC prolongs the survival of mice engrafted with human cell lines and depletes primary human AML engrafted with a single injection. In a humanized mouse model, a single injection of the ADC depletes CD34+ HSPCs and CD34+CD38−CD90+ hematopoietic stem cells. This work establishes an anti-CD300f ADC as an attractive potential therapeutic that, if validated in transplant models using a larger cohort of primary AML samples, will reduce relapse rate and toxicity for patients with AML undergoing allo-HSCT.