bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antiphospholipid syndrome damage index (DIAPS): distinct long-term kinetic in primary antiphospholipid syndrome and antiphospholipid syndrome related to systemic lupus erythematosus
Authors: Torricelli A Kuhl , Ugolini-Lopes M Remião , Bonfá E , Andrade D 
Published: January 2020

Background Antiphospholipid syndrome (APS) is an acquired thrombophilia that affects young productive individuals, with permanent damage and negative impact on quality of life. Recently, a damage index specific for APS (DIAPS) was developed. There are, however, no data regarding the comparison of its performance and long-term damage in primary antiphospholipid syndrome (PAPS) and APS related to systemic lupus erythematosus (SLE; APS + SLE). The primary purpose of this study was therefore to compare the long-term damage in patients with these conditions. Methods This is a retrospective analysis of a single tertiary center cohort followed for approximately 10 years using a standardized prospective electronic chart database. Fifty consecutive PAPS patients age matched with 50 APS+SLE patients were consecutively selected for the study, and DIAPS was calculated once a year during follow-up. Long-term damage and damage kinetics in both groups were compared. Results PAPS and APS + SLE had comparable age (47.10 ± 12.4 vs. 44.04 ± 10.80 years; p = 0.19) and time of follow-up (9.40 ± 3.60 vs. 10.94 ± 4.50 years; p = 0.06). At diagnosis, PAPS had higher DIAPS than APS + SLE (1.72 ± 1.17 vs. 0.82 ± 0.96; p < 0.001). At the end of the 10-year follow-up, both groups presented comparable mean damage scores (2.04 ± 1.50 vs. 2.24 ± 1.61; p = 0.52). The damage increment throughout the observation period for PAPS was solely 35%, whereas for APS + SLE it was gradual, persistent and reached 139% at the end of follow-up, with a total damage increment for PAPS lower than APS + SLE (0.43 ± 0.30 vs. 1.22 ± 1.24; p < 0.001). Of note, the frequency of individuals who acquired damage was lower in PAPS than in APS + SLE (32% vs. 71%; p < 0.001). PAPS also had a longer delay in diagnosis than APS + SLE (4.00 ± 4.20 vs. 2.54 ± 3.05 years; p = 0.04). This delay was positively correlated with a higher damage score at diagnosis ( r = 0.36, p < 0.001) in all groups. Conclusion We identified a distinct pattern of damage in PAPS and APS related to SLE. Damage in PAPS is an early event, while APS+SLE is associated with higher long-term damage, with a striking increment of damage along the follow-up. A diagnosis delay is correlated with higher damage scores. Damage surveillance therefore requires different approaches for these two conditions.
On Judgment: Managing Emotions in Trials of Crimes Against Humanity in Argentina
Authors: Vaisman Noa , Barrera Leticia 
Published: January 2020

For over a decade, judicial accountability of mass human rights violations committed during the last civil-military dictatorship in Argentina (1976–1983) has been carried out in federal courts by regular judges, following the rules of the National Code of Criminal Procedure. Research on these trials has focused mainly on the victims and the accused. This article opens a different path by exploring the affective experiences of the judges presiding over and leading the trials. Based on interviews with 18 federal court judges and some participant observation, in this article we present a descriptive exploration of the judges’ experiences and sensemaking processes. We examine the complex interaction between the professional requirement to separate emotions from judgment and the emotional toll that these trials produce in the personal and professional lives of the judges. We end with short reflections on these crimes against humanity trials in the post-Transitional Justice context.
Tetrahydrocannabinol and Cannabidiol Use in an Outpatient Palliative Medicine Population
Authors: Highet Bridget H. , Lesser Elizabeth R. , Johnson Patrick W. , Kaur Judith S. 
Published: January 2020

Background: Palliative medicine physicians are challenged by lack of guidance regarding effectiveness and dosing of cannabis products in the setting of their emerging popularity. Objective: The aim of this study was to describe early patterns of tetrahydrocannabinol (THC) and cannabidiol (CBD) use in Florida following passage of the state’s first medical marijuana law. We describe here the perceived benefits, side effects, and beliefs expressed by patients in a single outpatient academic palliative medicine practice. Methods: A cross-sectional survey was performed of a sequential convenience sample of patients who presented to an outpatient academic palliative medicine clinic over a 3-month period. Results: In all, 24% (14/58) of respondents reported THC use, with half using THC on a daily basis. Patients reported improvements in pain, appetite, and nausea. In all, 71% (10/14) began using THC after the diagnosis of their chronic illness, and the most common form of usage was vaping. In all, 24% (14/58) of patients reported CBD use. Patients reported improvements in pain, and the most common form of usage was topical application. None of the patients had used CBD prior to the onset of their chronic illness. In all, 21% (3/14) of THC users and 21% (3/14) of CBD users thought that their substance was helping to cure their illness. Individual reported side effects in both groups were minimal. Conclusions: Approximately a quarter of outpatient palliative care patients use THC or CBD, often on a daily basis. Palliative care providers should be aware of the frequency, diverse usage, and beliefs behind cannabis product use in this patient population.
Understanding factors influencing antibiotic prescribing behaviour in rural China: a qualitative process evaluation of a cluster randomized controlled trial
Authors: Wei Xiaolin , Deng Simin , Haldane Victoria , Blacklock Claire , Zhang Wei , Zhang Zhitong , Walley John D , King Rebecca , Hicks Joseph P , Yin Jia , Zou Guanyang , Huang Yunayuan , Vergis Mercy , Jun Zeng , Sun Qiang , Lin Mei 
Published: January 2020

Objectives We conducted a qualitative process evaluation embedded in a cluster randomized controlled trial in rural Guangxi China, which successfully reduced antibiotic use for children upper respiratory tract infections. This study aims to report on the factors that influenced behaviour change among providers and caregivers in the intervention arm, and to explore contextual considerations which may have influenced trial outcomes. Methods A total of 35 in-depth interviews were carried out with hospital directors, doctors, and caregivers of children. Participants were recruited from six purposively selected facilities, including two higher performing and two lower performing facilities per trial results. Interviews were conducted in Chinese and translated to English. We also observed guideline training sessions and prescription peer review meetings. Data were analysed using framework analysis. Results Intervention-arm doctors described that training sessions improved their knowledge, skills and confidence in appropriate prescribing. This was contrasted by control arm participants who did not receive training and reported less agency in reducing prescribing rates. Prescription peer review meetings were seen as an opportunity for further education, action planning and goal setting, particularly in high performing hospitals, where these meetings were led by senior doctors who were perceived to have relevant clinical experience. Caregiver participants reported that intervention educational materials were helpful but they identified information from doctors was more useful. Providers and caregivers also described contextual health system factors, including hospital competition, short consultation times, and antibiotic availability without prescription, which shaped care preferences. Conclusions This qualitative process evaluation identified a range of factors that may have influenced behaviour among providers and caregivers leading to observed changes in reducing inappropriate antibiotic prescribing in China. Future interventions to reduce antibiotic prescribing should consider system level and wider contextual factors to better understand behaviours and patient care preferences.
Patient perception of physician empathy in stroke telemedicine
Authors: Cheshire William P , Barrett Kevin M , Eidelman Benjamin H , Mauricio Elizabeth A , Huang Josephine F , Freeman William D , Robinson Maisha T , Salomon Gary R , Ball Colleen T , Gamble Dale M , Melton Vickie S , Meschia James F 
Published: January 2020

Introduction We assessed patients’ perceptions of physician empathy during telemedicine consultations as compared to in-person consultations during clinical encounters for acute stroke. Methods This prospective cohort study was undertaken at a comprehensive stroke centre hub in collaboration with a distant community hospital spoke site. Eligible participants presented to hub or spoke emergency departments with suspected acute stroke within three hours of symptom onset. Participants were evaluated at the hub site in person or at the remote site via telemedicine by the same group of neurologists. Following acute care decisions, single-visit data including participant-reported assessments of physician empathy were collected within 24 h. The primary outcome was the Consultation and Relational Empathy score. The secondary outcome for the telemedicine cohort was the Telemedicine Patient Satisfaction Measure score. Results Between 31 May 2013–13 March 2019, 70 patients completed the study. Fifty patients were seen by telemedicine and 20 patients were seen in person. Median Consultation and Relational Empathy scores (with a possible score of 10–50) were 49 (range 27–50) for telemedicine and 45 (range 26–50) for in-person consultations (Wilcoxon rank sum p = 0.18). Each item of the Consultation and Relational Empathy questionnaire was rated very good or excellent by at least 87% of participants in the telemedicine group. The median Telemedicine Patient Satisfaction Measure score was 54 (range 12–60), with each item rated agree or strongly agree by at least 84% of participants. Discussion We found no difference between telemedicine and in-person visits in patient perception of physician empathy in acute stroke care. Therefore, we conclude that empathy can be conveyed by facial expression, voice and attentiveness in a telemedicine encounter and, in the setting of acute stroke care, does not require physical touch or proximity.
Liver transplant recipients’ experiences and perspectives of a telehealth-delivered lifestyle programme: A qualitative study
Authors: Barnett Amandine , Campbell Katrina L , Mayr Hannah L , Keating Shelley E , Macdonald Graeme A , Hickman Ingrid J 
Published: January 2020

Introduction Dietary modification and exercise are encouraged to address cardiometabolic risk factors after solid organ transplantation. However, the lived experience of attempting positive lifestyle changes for liver transplant recipients is not known. The aim of this study was to explore the experiences of liver transplant recipients and their perspectives of a 12-week telehealth lifestyle programme and assess the feasibility of this innovative health service. Methods Focus groups and one-on-one interviews were conducted with participants who had completed a 12-week, group-based, telehealth-delivered diet and exercise programme and thematic qualitative analysis was used to code and theme the data. Results In total, 19 liver transplant recipients participated in the study (25–68 years, median time since transplant 4.4 years, 63% male). Overarching themes included: (a) ‘broad telehealth advantages' which highlighted that telehealth reduced the perceived burdens of face-to-face care; (b) ‘impact of employment' which identified employment as a competing priority and appeared to effect involvement with the programme; (c) ‘adapting Mediterranean eating pattern to meet individual needs' which identified the adaptability of the Mediterranean diet supported by sessions with the dietitian; (d) ‘increasing exercise confidence' which recognised that a tailored approach facilitated confidence and acceptability of the exercise component of the programme. Discussion A telehealth lifestyle programme delivered by dietitians and exercise physiologists is an acceptable alternative to face-to-face care that can meet the needs of liver transplant recipients. There is a need to further innovate and broaden the scope of routine service delivery beyond face-to-face consultations.
The role of style in the ethnolect: Style-shifting in the use of ethnolectal features in first- and second-generation speakers
Authors: Gnevsheva Ksenia 
Published: January 2020

Aims and Objectives/Purpose/Research Questions: The paper aimed to investigate style-shifting in the use of ethnolectal features in first- and second- generation bilingual migrants. Design/Methodology/Approach: Three groups of speakers (first- and second-generation Russian–English bilinguals as well as monolingual Anglo Australians) were audio-recorded in three different styles (conversation, interview, and reading). Data and Analysis: Their production of the goose and trap vowels across the styles was analyzed quantitatively. Findings/Conclusions: Overall differences were found between the groups such that first- and second-generation speakers produced more Russian-like vowels compared to the monolinguals; with the biggest differences between the first-generation speakers and the other two groups. In terms of style-shifting, no significant differences were found in the monolingual speakers, and both first- and second-generation speakers were found to produce most Australian English-like vowels in the conversation style. At the same time, certain differences between the two bilingual groups surfaced, such as no significant differences in the first-generation speakers’ production of the goose vowel and in the vowels’ linguistic conditioning. Originality: Previous studies have compared ethnolects in the first- and second-generations of migrants and mainstream varieties in order to theorize ethnolect formation. Several studies have also investigated intraspeaker style-shifting between more ‘mainstream’ and more ‘ethnic’ in ethnolect speakers, but such style-shifting is rarely compared across generations. Significance/Implications: The similarities and differences between the two bilingual groups suggest that ethnolectal features may be originally derived from the community language but may be reallocated to other sociolinguistic meanings in the second generation.
Inhibition of Knee Osteoarthritis Progression in Mice by Administering SRT2014, an Activator of Silent Information Regulator 2 Ortholog 1
Authors: Miyaji Nobuaki , Nishida Kyohei , Tanaka Toshikazu , Araki Daisuke , Kanzaki Noriyuki , Hoshino Yuichi , Kuroda Ryosuke , Matsushita Takehiko 
Published: January 2020

Objective Previous findings suggest that silent information regulator 2 ortholog 1 (SIRT1) plays essential roles in chondrocytes and prevents osteoarthritis (OA) development. The purpose of this study was to investigate the effects of intraperitoneal (i.p.) and intra-articular (i.a.) administration of the SIRT1 activator SRT2104, which has been approved for use in humans. Design OA was induced by destabilizing the medial meniscus in the knee joint of 12-week-old CL57BL/6J mice. The mice were divided into 3 groups, that is, the control group, SRT2104 i.p.-injection group, and SRT2104 i.a.-injection group. Tissues were harvested at 4, 8, 12, and 16 weeks postsurgery. OA progression was evaluated using the Osteoarthritis Research Society International (OARSI) score. The production of OA-related proteins in cartilage and synovium was examined by immunohistochemistry. Results OARSI scores in the control group were significantly higher at 8 and 12 weeks compared with other 2 groups. Immunohistochemical analysis showed that Sirt1 and type-2 collagen significantly increased, whereas MMP-13, ADAMTS-5, IL-1β, IL-6, cleaved caspase 3, PARP p85, acetylated NF-κB p65, and iNOS decreased significantly in cartilage tissues from the i.p. and i.a, SRT2104 groups. In the synovium, more iNOS-positive M1-like macrophages were observed in the control group than in the i.p. and i.a, SRT2104 groups, whereas more CD206-positive M2-like macrophages were detected in the i.p. and i.a. SRT2104 groups. Conclusions Both i.p. and i.a. SRT2104 injection reduced OA progression in the mouse OA model, suggesting that SRT2104 can serve as a new treatment for OA.
Elevated admission urinary N-acetyl-β-D-glucosamidase level is associated with worse long-term clinical outcomes in patients with acute heart failure
Authors: Funabashi Sayaka , Omote Kazunori , Nagai Toshiyuki , Honda Yasuyuki , Nakano Hiroki , Honda Satoshi , Iwakami Naotsugu , Hamatani Yasuhiro , Nakai Michikazu , Nishimura Kunihiro , Asaumi Yasuhide , Aiba Takeshi , Noguchi Teruo , Kusano Kengo , Yokoyama Hiroyuki , Yasuda Satoshi , Ogawa Hisao , Anzai Toshihisa 
Published: January 2020

Background:
The prognostic significance of urinary N-acetyl-β-D-glucosamidase in acute heart failure has not been fully elucidated. Accordingly, this study investigated whether urinary N-acetyl-β-D-glucosamidase could be associated with subsequent adverse events in acute heart failure patients.

Methods:
We studied 708 consecutive acute heart failure patients who had accessible N-acetyl-β-D-glucosamidase data on admission from the National Cerebral and Cardiovascular Center Acute Decompensated Heart Failure registry. We assessed the relationship between the admission N-acetyl-β-D-glucosamidase level and the combined endpoint of all-cause death and worsening heart failure. Worsening heart failure was defined as worsening symptoms and signs of heart failure requiring intensification of intravenous therapy such as diuretics, vasodilators and inotropes or initiation of mechanical support after stabilisation with initial treatment during hospitalisation, or readmission due to heart failure after discharge.

Results:
During a median follow-up period of 763 (interquartile range 431–1028) days, higher urinary N-acetyl-β-D-glucosamidase was significantly related to increased events of all-cause death and worsening heart failure. In addition, patients with higher urinary N-acetyl-β-D-glucosamidase and lower estimated glomerular filtration rate on admission had the worst clinical outcomes. In multivariable Cox regression, urinary N-acetyl-β-D-glucosamidase on admission was independently associated with adverse events (hazard ratio 1.19, 95% confidence interval 1.04–1.35) even after adjustment by covariates including the baseline estimated glomerular filtration rate.

Conclusions:
Higher urinary N-acetyl-β-D-glucosamidase level on admission was independently associated with worse clinical outcomes. Our findings indicate the potential value of assessing urinary N-acetyl-β-D-glucosamidase on admission for further risk stratification in patients with acute heart failure.
Duration of natalizumab therapy and reasons for discontinuation in a multiple sclerosis population
Authors: Conway Devon S , Hersh Carrie M , Harris Haleigh C , Hua Le H 
Published: January 2020

Objective To determine multiple sclerosis patient characteristics that predict a shorter duration of natalizumab treatment. Methods The Tysabri Outreach: Unified Commitment to Health database was reviewed to identify patients treated with natalizumab at our centers. Cox proportional hazards models were used to evaluate patient characteristics associated with shorter treatment durations on natalizumab. Associations were also assessed with respect to specific reasons for stopping natalizumab. Results We identified 554 patients who began and stopped natalizumab treatment during the observation period. The average disease duration at natalizumab initiation was 7.6 years, and the average number of infusions was 30. The multivariable Cox proportional hazards model identified greater age ( P = 0.035), longer disease duration ( P < 0.001), progressive relapsing multiple sclerosis phenotype ( P = 0.003), current smoking ( P = 0.031), and greater depression ( P = 0.026) as significant predictors for natalizumab discontinuation. Greater disability levels ( P = 0.022) and gadolinium-enhancing lesions on baseline magnetic resonance imaging ( P < 0.001) were significantly associated with longer natalizumab treatment. Individuals with progressive relapsing multiple sclerosis had a 14-fold increased hazard of discontinuing natalizumab due to inflammatory events ( P < 0.001) than those with relapsing–remitting multiple sclerosis. Smokers had an 80% increased hazard of discontinuation due to intolerance ( P = 0.008). Conclusions Our results suggest that smoking, depression, and a progressive relapsing multiple sclerosis phenotype are associated with shorter natalizumab treatment durations.
Does the Number of Levels Fused Affect Spinopelvic Parameters and Clinical Outcomes Following Posterolateral Lumbar Fusion for Low-Grade Spondylolisthesis?
Authors: Harada Garrett K. , Khan Jannat M. , Vetter Christian , Basques Bryce A. , Sayari Arash J. , Hayani Zayd , Tchalukov Konstantin , Louie Philip K. , Colman Matthew , An Howard S. 
Published: January 2020

Study Design: Retrospective cohort. Objectives: To determine how the number of fused intervertebral levels affects radiographic parameters and clinical outcomes in patients undergoing open posterolateral lumbar fusion (PLF) for low-grade degenerative spondylolisthesis. Methods: This was a retrospective cohort study on patients who underwent open PLF for low-grade spondylolisthesis at a single institution from 2011 to 2018. Patients were divided into groups based on number of levels fused during their procedure (1, 2, or 3 or more). Preoperative and postoperative spinopelvic radiographic parameters, patient-reported outcomes (Visual Analog Scale [VAS]-back, VAS-leg, Oswestry Disability Index [ODI]), and postoperative complications were compared. Results: Of the 316 patients eligible (203 one-level, 95 two-level, 18 three or more levels), change in initial postoperative to final pelvic incidence-lumbar lordosis was greatest in 2-level fusions ( P = .039), while 3 or more level fusions had worse final pelvic tilt measures ( P = .021). In addition, multilevel fusions had worse final VAS-back scores (2-level: P = .015; 3 or more levels: P = .011), higher rates of dural tears (2-level: P = .001), reoperation (2-level: P = .039), and discharge to facility (3 or more levels: P = .047) when compared with 1-level fusions. Conclusions: Patients in multilevel fusions experienced less improvement in back pain, had more complications, and were more commonly discharged to a facility compared with single-level PLF patients. These findings are important for operative planning, for setting appropriate preoperative expectations, and for risk stratification in patients undergoing posterior lumbar fusion for low-grade spondylolisthesis.