bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of theory-based digital self-management interventions for improving depression, anxiety, fatigue and self-efficacy in people with neurological disorders: A systematic review and meta-analysis
Authors: Lau Stephen CL , Bhattacharjya Sutanuka , Fong Mandy WM , Nicol Ginger E , Lenze Eric J , Baum Carolyn , Hardi Angela , Wong Alex WK 
Published: September 2020

Introduction This study aimed to (a) review what theories have been applied to the development of digital self-management interventions for people with neurological disorders; (b) examine their effectiveness to improve depression, anxiety, fatigue and self-efficacy; and (c) identify the optimal mode of intervention delivery. Methods Electronic databases (SCOPUS, MEDLINE, EMBASE, CINAHL, Cochrane Library and Clinicaltrials.gov) were searched. Two investigators independently screened studies and extracted data. Study quality and use of theory were also assessed. Results A total of 944 studies were screened, and 16 randomised controlled trials were included. Theory-based digital self-management interventions were effective in reducing depression (standardised mean difference (SMD) = –0.77, 95% confidence interval (CI) –1.04 to –0.49), anxiety (SMD = –0.88, 95% CI –1.54 to –0.21) and fatigue (SMD = –0.62, 95% CI –0.96 to –0.27) and in enhancing self-efficacy (SMD = 1.15, 95% CI 0.11–2.18). Cognitive–behavioural theory (CBT)-based interventions were effective in reducing depression (SMD = –0.81, 95% CI –1.22 to –0.39), anxiety (SMD = –1.15, 95% CI –1.85 to –0.44) and fatigue (SMD = –0.75, 95% CI –0.97 to –0.54) and in improving self-efficacy (SMD = 0.84, 95% CI 0.63–1.05), whereas social cognitive theory (SCT)-based interventions were effective in reducing depression (SMD = –0.73, 95% CI –1.17 to –0.28). Partially digital interventions were more effective than fully digital interventions. Discussion Our findings support the use of theory to guide the development of digital self-management interventions to increase intervention effectiveness. In particular, CBT-based interventions have a positive impact on depression, anxiety, fatigue and self-efficacy, whereas SCT-based interventions have a positive impact on depression.
Patients transferred within a telestroke network for large-vessel occlusion
Authors: Reddy Sujan T , Savitz Sean I , Friedman Elliott , Arevalo Octavio , Zhang Jing , Ankrom Christy , Trevino Alyssa , Wu Tzu-Ching 
Published: September 2020

Introduction In a telestroke network, patients at a referring hospital (RH) with large-vessel occlusion (LVO) are transferred to a comprehensive stroke centre (CSC) for endovascular thrombectomy (EVT). However, a significant number of patients do not ultimately undergo thrombectomy after CSC arrival. Methods Within a 17-hospital telestroke network, we retrospectively analysed patients with suspected or confirmed LVO transferred to a CSC, and characterized the reasons why these patients did not undergo EVT based on the 2019 American Heart Association guidelines. Results Of 400 patients transferred to our hub, 68 (17%) were based on vascular imaging at RH. Time from RH arrival to neuroimaging was significantly longer in patients that underwent both computed tomography (CT) and CT angiography of the brain and neck compared to only CT of the brain (53 vs 13 minutes, p < 0.05). Accuracy of anterior circulation LVO (ACLVO) detection based on clinical suspicion was 62% (205 of 332 patients). Among 234 ACLVO patients, overall, 175 (74%) (early window group: 123 (73%) patients and late window group: 52 (80%) patients) met at least one EVT ineligibility criterion. The reasons for EVT ineligibility varied from large core infarct (aspects <6 or core volume >70 cc on perfusion imaging in late window), low National Institutes of Health Stroke Scale (<6), distal occlusion, and poor baseline modified Rankin Scale score (>1). Discussion Instituting rapid acquisition and interpretation of vascular imaging at RHs for LVO detection and establishing benchmarks for door to vascular imaging is urgently needed for RHs.
Introduction of a ROTEM protocol for the management of trauma-induced coagulopathy
Authors: Spagnolello Ornella , J Reed Matthew , Dauncey Steve , Timony-Nolan Emer , Innes Catherine , Allen Jennifer MM , Williams Michael J , Church Nick , Dunn Mark JG , Blackstock Caroline , Nimmo Alastair F 
Published: September 2020

Aims Point-of-care viscoelastic tests such as rotational thrombelastometry (ROTEM) and thromboelastography (TEG) give rapid information on the kinetics of clot formation, clot strength and fibrinolysis. We developed a ROTEM algorithm for the management of trauma patients at risk of massive haemorrhage using either 5 or 10 minute EXTEM and FIBTEM ROTEM thresholds. Study aims were (a) to compare time to results for ROTEM testing versus laboratory conventional coagulation testing (CCT) and (b) to compare incidence of Trauma-induced coagulopathy (TIC) for our 5 and 10 minute ROTEM algorithms versus both the CCT-based European guideline algorithm and the ROTEM-based iTACTIC study algorithm, in both MT and non-MT patients. Methods Single centre, prospective, observational Emergency Department based study. All trauma patients who underwent ROTEM testing were included. Data was collected from the ROTEM Sigma machine and hospital Electronic Patient Records and analysed. Results Between April 2016 and May 2019, 57 trauma patients were enrolled. Mean age was 47.4 years (SD 19.4) and 44 patients (77.2%) were male. Eleven patients (19.3%) required massive transfusion (MT), 5 patients died in ED (8.8%) and overall in-hospital mortality was 22.8% (n = 13). Median time from admission to CCT result was 83 minutes (IQR 60–93) compared to 51 minutes (IQR 32-93; p = 0.0006) for ROTEM A5 results. This time difference was present for both MT and non-MT patients. Trauma-induced coagulopathy (TIC) was identified in 14 (24.5%) patients using CCT compared to 22 (38.5%) using ROTEM (p = 0.11 ns). Conclusion Our ROTEM Sigma based algorithm enables a coagulation result to be obtained faster than laboratory CCT and could lead to earlier clinical intervention.
Predictors of job burnout among fieldwork supervisors of social work students
Authors: Malka Menny , Kaspi-Baruch Oshrit , Segev Einav 
Published: September 2020

Summary In the helping professions, professional burnout is widely acknowledged to play a key role in work retention and turnover. However, although the literature on fieldwork education in social work engages with the importance of continuity and commitment regarding the role of fieldwork supervisor, the effects of job burnout are under-researched. Furthermore, there is also a gap in the literature with respect to the internal factors that contextualize burnout and retention among fieldwork supervisors. Against this background, the objective of the present study was to examine the factors that predict professional burnout among fieldwork supervisors in Israel. Questionnaires measuring burnout, as well as several internal explanatory factors for burnout—career identity, work significance, and personality traits—were used. Findings The findings of the study indicated that career identity, together with the personality characteristics of agreeableness and consciousness predict burnout negatively, while neuroticism positively predicts burnout. Applications The article discusses these findings in light of resource conservation and existential theories of burnout, as well as the potential implications for practice and policy.
Venous sinus stenting as a treatment approach in patients with idiopathic intracranial hypertension and encephaloceles
Authors: Drocton Gerald T , Copelan Alexander , Eisenmenger Laura , Villanueva-Meyer Javier E , Dillon William P , Shah Vinil N , Meisel Karl , Amans Matthew 
Published: September 2020

Background Stenosis of a dural venous sinus is the most common cause of idiopathic intracranial hypertension (IIH) and can be classified as either intrinsic or extrinsic. Intrinsic stenoses are characterized by a focal filling defect within the sinus secondary to an enlarged arachnoid granulation or fibrous septa while extrinsic stenoses tend to be long and smooth-tapered and are most commonly secondary to external compression from the adjacent brain parenchyma. Brain herniations, or encephaloceles, into arachnoid granulations in dural venous sinuses have rarely been reported in the literature in patients with IIH. We propose that dural venous sinus stenting (VSS) may be a safe and effective treatment approach in patients with an encephalocele and IIH. Methods We retrospectively analyze three cases of patients with encephalocele who underwent VSS for treatment of medically refractory IIH at our institution. Results One patient underwent stenting ipsilateral and two patients underwent stenting contralateral to the side of their encephaloceles. No technical related issues or complications occurred during either of the three stenting procedures. Two out of the three patients had complete resolution in their IIH-related symptoms and normalization of cerebrospinal (CSF) pressures shortly after stenting. We await clinical follow-up in the third patient. Conclusions Our results suggest that VSS is a technically feasible and effective approach in treating patients with medically refractory IIH and encephaloceles.
Progress in the study of cancer-associated venous thromboembolism
Authors: Yao Yuting , Xu Qixia 
Published: September 2020

Objective Venous thromboembolism is a major cause of morbidity, mortality, and increased medical costs in tumor patients. In the current review, we summarize the progress made in the study of cancer-associated venous thromboembolism. Methods By searching cancer-associated venous thromboembolism-related literature on PubMed, the epidemiology, pathological mechanisms, risk factors, risk prediction models, and prevention and treatment of cancer-associated venous thromboembolism were reviewed. Results The pathophysiological mechanisms of cancer-associated venous thromboembolism are multifactorial. Various blood cell counts (such as platelets and white blood cells) and biomarkers (such as D-dimer and sP-selectin) were considered predictors of thrombosis in cancer patients and were incorporated into the venous thromboembolism risk stratification models. Thromboprophylaxis is currently recommended for all hospitalized cancer patients. In addition, outpatient thromboprophylaxis can be used for selected high-risk patients. Low-molecular-weight heparin was the preferred treatment for cancer-associated venous thromboembolism, but some issues arose in the long-term treatment. In this case, direct oral anticoagulants were a treatment option for tumor patients. The efficacy of direct oral anticoagulant in treating cancer patients is not inferior to low-molecular-weight heparin, but is associated with a higher risk of bleeding. Therefore, there were concerns regarding their safety. Conclusion Since thrombocytopenia, thrombosis recurrence, and bleeding are common in tumor patients, the selection of anticoagulants in this circumstance is a considerable challenge for clinicians.
Characteristics and outcomes of patients with peripheral artery disease undergoing endovascular revascularization: A community hospital perspective
Authors: Michael Gharacholou S , Li Zhuo , Uy Jonathan J , Eckstein Lee H , Flock Carolyn R , Senger Joshua L , Gutierrez Jorge F Trejo , Chapman Scott C 
Published: September 2020

Background There are limited data on outcomes for patients with peripheral artery disease undergoing endovascular revascularization by multi-disciplinary teams in a community hospital setting. Methods From January 2015 through December 2015, we assembled a multi-disciplinary program comprised of cardiologists, surgeons, radiologists, nurses, and administrative staff for managing patients with peripheral artery disease undergoing endovascular revascularization. Demographic, procedural, and outcomes data were collected with use of a template from the Society for Vascular Surgery Vascular Quality Initiative database. We compared characteristics and outcomes of patients with intermittent claudication and critical limb ischemia. We used Kaplan–Meier methods to estimate the rate of overall survival and freedom from rehospitalization between groups. Results After excluding patients with acute limb ischemia ( n = 5), peripheral intervention to the upper extremity ( n = 6), or abdominal aorta ( n = 11), there were 82 patients in the study cohort; 45 had intermittent claudication and 37 had critical limb ischemia. Baseline and procedural characteristics were similar between groups, although critical limb ischemia patients were more likely to have hyperlipidemia (75.7% vs. 53.3%, P = .42). Procedural success was achieved in 91.3% of cases. Actionable access site bleeding occurred in 2.4% of patients. High rates of aspirin (91.5%) and statin (87.8%) were noted at discharge. After two years of post endovascular revascularization, survival was 57.5% for critical limb ischemia patients and 94.4% for intermittent claudication patients ( P < .001). Freedom from rehospitalization was 32.7% for critical limb ischemia patients and 83.5% for intermittent claudication patients ( P < .001). Conclusions We found that favorable outcomes may be achieved with a multi-disciplinary peripheral artery disease program at community hospitals. The incorporation of quality improvement practices may further help to develop standardized and regionalized approaches to care delivery for patients with peripheral artery disease.
Cost-effectiveness analysis of alternative colon cancer screening strategies in the context of the French national screening program
Authors: Barré Stéphanie , Leleu Henri , Benamouzig R. , Saurin Jean-Christophe , Vimont Alexandre , Taleb Sabrine , De Bels Frédéric 
Published: September 2020

Background: A nationwide colorectal cancer (CRC) screening program was set up in France from 2009 for average-risk, asymptomatic people aged 50–74 years based on an immunochemical fecal occult blood test [faecal immunochemical test (FIT)] every 2 years, followed by colonoscopy if positive. The European standard recommends a participation rate of 45% for the program to be cost-effective, yet the latest published rate in France was 34%. The objective of this study was to compare the cost effectiveness of screening alternatives taking real-world participation rates into account. Methods: Eight screening strategies were compared, based either on a screening test (Guaiac or FIT testing, blood-based, stool DNA, computed tomography colonography, colon capsules, and sigmoidoscopy) followed by full colonoscopy if positive or direct colonoscopy. A microsimulation model was used to estimate the cost effectiveness associated with each strategy. Results: Compared with no screening, FIT was associated with a 14.0 quality-adjusted life year (QALY) increase of €50,520 per 1000 individuals, giving an incremental cost-effectiveness ratio (ICER) of €3600/QALY. Only stool DNA and blood-based testing were associated with a QALY increase compared with FIT, with stool DNA weakly dominated by blood-based testing, and the latter associated with an ICER of €154,600/QALY compared with FIT. All other strategies were dominated by FIT. Conclusion: FIT every 2 years appears to be the most cost-effective CRC screening strategy when taking into account a real-world participation rate of 34%.
Factors affecting biomechanical strength of Latarjet constructs: A systematic review and meta-regression
Authors: Huish Jr Eric G , Kelly Shayne R , Cutter Brenden M 
Published: September 2020

Background The Latarjet procedure reduces recurrent glenohumeral instability but has potential hardware and graft complications. The procedure has been modified to use various screw types as well as suture buttons. Biomechanical studies have evaluated the effect of these implants on construct strength. With varying results it is unclear whether there is an optimal implant to use. Methods We conducted a systematic review of human cadaveric biomechanical studies evaluating Latarjet ultimate failure load. Two independent reviewers screened articles and included them after full text review. Additional factors including implants used, graft orientation, cortices engaged, drill diameter, and screw characteristics were recorded. Meta-regression was performed on the 145 specimens from eight studies that met inclusion criteria. Results Screw fixation resulted in a 396.8 N (95% CI, 149.8–643.7) N higher ultimate failure load against shear stresses than suture buttons (p = 0.002). There were no differences between implants for ultimate failure load against tensile forces. Tensile strength was significantly affected by drill diameter with each millimeter of increase reducing the mean ultimate failure load by 127.4 N (95% CI, 41.2–213.6) N (p = 0.004). Conclusions These results suggest that using screw fixation and minimizing drill diameter can obtain the maximum ultimate failure load against both shear and tensile forces in a Latarjet construct.
Prognostic and clinicopathological value of Ki-67 expression in patients with nasopharyngeal carcinoma: a meta-analysis
Authors: Shi Zhaohui , Jiang Weihong , Chen Xiaodong , Xu Min , Wang Xiaocheng , Zha Dingjun 
Published: September 2020

Background: This meta-analysis aimed to identify the prognostic role of Ki-67 in patients with nasopharyngeal carcinoma (NPC). Methods: Relevant studies were retrieved in the PubMed, Embase, Web of Science, and Cochrane Library databases up to November 2019. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to estimate the association between Ki-67 expression and survival outcomes. Combined odds ratios (ORs) and 95% CIs were measured as effect size on the association between Ki-67 expression and clinical factors. Results: A total of eight studies involving 936 patients with NPC were included in this meta-analysis. The pooled HR indicated that Ki-67 expression was significantly associated with poor overall survival (HR = 2.86, 95% CI = 1.91–4.27, p < 0.001), progression-free survival (HR = 1.78, 95% CI = 1.15–2.74, p = 0.009), and distant metastasis-free survival (HR = 1.65, 95% CI = 1.15–2.36, p = 0.007). However, there was no significant correlation between Ki-67 expression and local recurrence-free survival (HR = 1.07, 95% CI = 0.54–2.14, p = 0.843). Ki-67 overexpression was associated with higher T stage (OR = 1.48, 95% CI = 1.00–2.20, p = 0.052), and the relationship between Ki-67 expression and advanced stage was nearly significant (OR = 2.25, 95% CI = 0.99–5.14, p = 0.054). However, high Ki-67 expression was not significantly correlated with sex, age, N stage, or histological type. Conclusion: This meta-analysis demonstrated that Ki-67 overexpression was a significant marker for poor prognosis in patients with NPC. Ki-67 should be recommended as a useful index for prognostication in patients with NPC.
The role of adjuvant chemotherapy in stage I–III male breast cancer: a SEER-based analysis
Authors: Li Wei-Ping , Gao Hong-Fei , Ji Fei , Zhu Teng , Cheng Min-Yi , Yang Mei , Yang Ci-Qiu , Zhang Liu-Lu , Li Jie-Qing , Zhang Jun-Sheng , Wang Kun 
Published: September 2020

Background and aims: Male breast cancer is an uncommon disease. The benefit of adjuvant chemotherapy in the treatment of male breast cancer patients has not been determined. The aim of this study was to explore the value of adjuvant chemotherapy in men with stage I–III breast cancer, and we hypothesized that some male patients may safely skip adjuvant chemotherapy. Methods: Male breast cancer patients between 2010 and 2015 from the Surveillance Epidemiology and End Results database were included. Univariate and multivariate Cox analyses were used to analyse the factors associated with survival. The propensity score matching method was adopted to balance baseline characteristics. Kaplan–Meier curves were used to evaluate the impacts of adjuvant chemotherapy on survival. The primary endpoint was survival. Results: We enrolled 514 patients for this study, including 257 patients treated with chemotherapy and 257 patients without. There was a significant difference in overall survival (OS) but not in breast cancer-specific survival (BCSS) between the two groups ( p < 0.001 for OS and p = 0.128 for BCSS, respectively). Compared with the non-chemotherapy group, the chemotherapy group had a higher 4-year OS rate (97.5% versus 95.2%, p < 0.001), while 4-year BCSS was similar (98% versus 98.8%, p = 0.128). The chemotherapy group had longer OS than the non-chemotherapy group among HR+, HER2–, tumour size >2 cm, lymph node-positive male breast cancer patients ( p < 0.05). Regardless of tumour size, there were no differences in OS or BCSS between the chemotherapy and non-chemotherapy cohorts for lymph node-negative patients (OS: p > 0.05, BCSS: p > 0.05). Adjuvant chemotherapy showed no signiﬁcant effects on both OS and BCSS in patients with stage I (OS: p = 0.100, BCSS: p = 0.858) and stage IIA breast cancer (OS: p > 0.05, BCSS: p > 0.05). Conclusion: For stage I and stage IIA patients, adjuvant chemotherapy could not improve OS and BCSS. Therefore, adjuvant chemotherapy might be skipped for stage I and stage IIA male breast cancer patients.
Improvement of nutritional intake for the low-income urban dwellers with hypertension in Malaysia
Authors: Azizan Nurul Ain , Majid Hazreen Abdul , Nahar Mohamed Azmi , Su Tin Tin 
Published: September 2020

Objective: To ascertain the effect of dietary practice modification and a peer-support home blood pressure monitoring program on the nutritional intake (macronutrients and micronutrients), blood pressure and biochemical profiles of hypertension patients in a low-income community setting. Methods: This is a pre- and post-measurement intervention study conducted in low-income community housing projects in Kuala Lumpur, Malaysia. A total of 90 participants aged 18 years and above with hypertension received intervention. The participants were divided into small groups and received instructions on the use of home blood pressure measurement. They also attended a series of talks on dietary intake modification and exercise demonstration for the first six months (active phase). In another 6 months (maintenance phase), they received only pamphlet and SMS reminders. Their anthropometry, blood pressure, dietary, and biochemical parameter changes were measured at baseline, 6 months, and 12 months of intervention. Results: Macronutrients and micronutrients showed a significant improvement at the end of 12-month dietary intervention. The energy, carbohydrate, protein, total fat, sodium, and potassium are showing significant reduction from baseline to end of the 12-month intervention. There is no significant reduction in blood pressure. Fasting blood glucose, renal sodium, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol showed a significant improvement, after controlling for age and reported physical activity. Conclusion: The intervention improved the nutritional intake and biochemical profiles of the low-income urban population with hypertension. This promising result should be replicated in a larger scale study.