bluuebunny/crossref_metadata_2025_split huggingface dataset:
Returning a Puppy for Dog Guide Training: Factors That Affect Grief in Puppy Raisers and the Decision to Foster Again
Authors: DeWitt Amy L. 
Published: August 2020

Introduction: Guiding Eyes for the Blind (GEB) breeds, raises, and trains dogs to serve as guides for people with visual impairments (i.e., those who are blind or have low vision). Their puppy raising program enlists volunteers to foster puppies for a year or more, providing socialization, basic skills training, and comfort, so they will grow into confident dogs. The volunteers must ultimately return these dogs to Yorktown Heights, New York, to begin training. For raisers, the emotional toll of this parting can be great. Methods: Utilizing the 2017 GEB Puppy Raiser Survey data, this study analyzed factors that might affect emotional grief and the decision to continue to raise puppies. Cross-tabulation and ordinal regression analyses examined the associations of puppy raiser demographics (i.e., gender, age, marital status, and employment), organizational integration (i.e., number of dogs raised for GEB, perceptions on how well GEB supports raisers in returning a dog, belief that they are part of the GEB community, and formation of friendships), and goal attainment (perceptions on how well GEB communicated progress in training, whether they raised a dog accepted for guide training, and whether they attended a graduation ceremony) with self-reported emotional difficulty, recovery time, and likelihood of raising another puppy. Results: Although the demographics of the raiser had minimal effect on emotional difficulty, recovery time, and likelihood of raising again, factors that measured organization integration and goal attainment were associated with grief and continued participation. Discussion: Raiser demographics are not strong predictors of grief and continued raising; however, a welcoming organization that communicates effectively will inspire volunteers’ commitment. Implications: With a growing need for assistance dogs and puppy raisers, identifying and addressing the challenges that these volunteers face is critical if skilled and dedicated raisers are to be recruited and retained.
Competencies for Diabetes Care and Education Specialists
Authors: Ryan Donna , Burke Sandra Drozdz , Litchman Michelle L. , Bronich-Hall Lauren , Kolb Leslie , Rinker Joanne , Yehl Kirsten 
Published: August 2020

Purpose Diabetes care and education specialists provide collaborative, comprehensive, and person-centered care and education to people with diabetes and cardiometabolic conditions. The implementation of the vision for the specialty has prompted the need to reexamine the knowledge, skills, and abilities necessary for diabetes care and education specialists in today’s dynamic health care environment. The purpose of this article is to introduce an updated set of competencies reflective of the profession in this dynamic health care environment. Diabetes care and education specialists are health care professionals who have achieved a core body of knowledge and skills in the biological and social sciences, communication, counseling, and education and who have experience in the care of people with diabetes and related conditions. Members of this specialty encompass a diverse set of health disciplines, including nurses, dietitians, pharmacists, physicians, mental health professionals, podiatrists, optometrists, exercise physiologists, physicians, and others. The competencies are intended to guide practice regardless of discipline and encourage mastery through continuing education, individual study, and mentorship. Conclusion This document articulates the competencies required for diabetes care and education specialists in today’s dynamic health care environment as they pursue excellence in the specialty.
Vocal Fold Fat Augmentation for Atrophy, Scarring, and Unilateral Paralysis: Long‐term Functional Outcomes
Authors: Lahav Yonatan , Malka‐Yosef Liron , Shapira‐Galitz Yael , Cohen Oded , Halperin Doron , Shoffel‐Havakuk Hagit 
Published: August 2020

ObjectiveThere is a debate regarding the durability of fat implants. Our experience and recent publications suggest fat implantation may deliver a long‐lasting improvement. This study aims to present the long‐term outcomes for vocal fold fat augmentation using strict harvesting, preparing, and implantation protocols.Study DesignA prospective cohort conducted between 2014 and 2020 (recruitment 2014‐2017).SettingAn academic tertiary referral center.Subjects and MethodsTwenty‐two patients with glottic insufficiency were enrolled: 11 had unilateral vocal fold paralysis (UVFP), and 11 had atrophy or scar. Harvested fat was injected unilaterally or bilaterally into multiple sites. Six of these patients also had simultaneous microlaryngoscopic removal of other benign glottic lesions. Outcome measurements included video stroboscopy; Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) score; Voice Handicap Index (VHI); and acoustic analysis, performed preoperatively, 3, 12, 24, and 36 months after surgery.ResultsTen augmentations were unilateral and 12 bilateral. Comparing the preoperative and 36‐month postoperative periods, the mean VHI score improved from 73.45 (±22.78) to 44.88 (±28.93), P =. 001, and the mean GRBAS decreased from 8.64 (±3.89) to 2.82 (±2.3), P =. 001; 24 months postoperatively, the mean fundamental frequency decreased from 163.88 Hz (±41.61) to 150.44 Hz (±41.47), P =. 012. Stroboscopic analysis revealed statistically significant improvement in mucosal wave propagation, phase closure, and phase symmetry. Best results were achieved in the UVFP subgroup. Computed tomography scans demonstrated long‐term viability of the implanted adipose tissue.ConclusionFat is an excellent source of autologous graft. With careful patient selection and proper surgical technique, fat is suitable for long‐term correction of glottic insufficiency. Fat augmentation should be considered as a long‐lasting or even permanent solution, rather than temporary.
Individualized positive end-expiratory pressure setting in patients with severe acute respiratory distress syndrome supported with veno-venous extracorporeal membrane oxygenation
Authors: Yin Chengfen , Gao Xinjing , Cao Chao , Xu Lei , Lu Xing 
Published: August 2020

Background: Patients with acute respiratory distress syndrome supported with veno-venous extracorporeal membrane oxygenation benefit from higher positive end-expiratory pressure combined with conventional ventilation during the early extracorporeal membrane oxygenation period. The role of incremental positive end-expiratory pressure titration in patients with severe acute respiratory distress syndrome supported with veno-venous extracorporeal membrane oxygenation remains unclear. This study aimed to determine the preferred method for setting positive end-expiratory pressure in patients with severe acute respiratory distress syndrome on veno-venous extracorporeal membrane oxygenation support. Methods: We retrospectively reviewed all subjects supported with veno-venous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome from 2009 to 2019 in the intensive care units in Tianjin Third Central Hospital. Subjects were divided into two groups according to the positive end-expiratory pressure titration method used: P-V curve (quasi-static pressure-volume curve-guided positive end-expiratory pressure setting) group or Crs (respiratory system compliance-guided positive end-expiratory pressure setting) group. Results: Forty-three subjects were included in the clinical outcome analysis: 20 in the P-V curve group and 23 in the Crs group. Initial positive end-expiratory pressure levels during veno-venous extracorporeal membrane oxygenation were similar in both groups. Incidence rates of barotrauma and hemodynamic events were significantly lower in the Crs group (all p < 0.05). Mechanical ventilation duration, intensive care unit length of stay, and hospital length of stay were significantly shorter in the Crs group than the P-V curve group (all p < 0.05). Subjects in the Crs group showed non-significant improvements in the duration of extracorporeal membrane oxygenation support and 28-day mortality (p > 0.05). Conclusion: Respiratory system compliance-guided positive end-expiratory pressure setting may lead to more optimal clinical outcomes for patients with severe acute respiratory distress syndrome supported by veno-venous extracorporeal membrane oxygenation. Moreover, the operation is simple, safe, and convenient in clinical practice.
Effects of different living conditions on the risk of osteoporosis in Chinese community-dwelling elderly: a 3-year cohort study
Authors: Yu Xing , Zhang Yuanyuan , Han Peipei , Fu Liyuan , Chen Xiaoyu , Hou Lin , Song Peiyu , Zhao Yong , Guo Qi 
Published: August 2020

Objective Osteoporosis can lead to bone fragility and an increased risk of bone fracture with resultant high morbidity and mortality. Living alone has been associated with various mental and physical health problems. However, the risk of osteoporosis among individuals with different living conditions and changing living conditions is unclear. We examined the risk of osteoporosis in different living conditions over a 3-year period in community-dwelling suburban elderly Chinese. Methods This study involved 288 elderly Chinese suburb-dwelling participants with no documented history of osteoporosis. All were aged ≥60 years (mean, 65.6±3.75 years; 157 men). A quantitative ultrasound scan of the calcaneus with a T score of <−2.5 was used to identify a high risk of osteoporosis. Results In total, 54.2% of participants were determined to have a high risk of osteoporosis (male, 51.6%; female, 57.3%). People who had always lived alone had a significantly higher risk of osteoporosis, even after adjusting for potential confounders. A change from living alone to living with others had no significant impact on the risk of osteoporosis. Conclusion Our results indicate that living alone is associated with a high risk of osteoporosis. Thus, people who live alone may need regular bone tests to avoid adverse events.
An international survey: Tobacco smoking cessation strategies within left ventricular assist device centers
Authors: Combs Pamela , Cohen William , Siddiqi Umar A , Jeevanandam Valluvan 
Published: August 2020

Background: Tobacco smoking is a significant source of morbidity in patients with a durable left ventricular assist device. While various cessation strategies have been investigated, the ability of ventricular assist device centers to implement a successful tobacco cessation program remains uncertain. We explored various cessation strategies employed by ventricular assist device centers and assessed perspectives of their effectiveness, as well as institutional investment in these programs. Methods: A 37-question online self-report survey was created using Survey Monkey® and distributed worldwide. We investigated (1) programmatic strategies utilized for smoking cessation, (2) the respondent’s perspective on the effectiveness of these strategies, (3) the structure with which these therapies are administered, and (4) overall organizational support for these treatments. Results: A total of 47 centers worldwide completed the survey. The most common methods of tobacco cessation were pharmacologic and nicotine replacement therapy (78% and 66%). However, only about half (47% and 50%, respectively) of the centers indicated that these strategies were effective. When asked whether a respondent’s center perceives that tobacco smoking should be a deciding factor in destination therapy evaluations, nearly a third (15, 32%) responded in the affirmative. Conclusion: While significant overlap exists among centers regarding treatments used for smoking cessation with left ventricular assist device patients, the most common treatments are not thought to be effective. While the current recommendations require tobacco smoking cessation in only bridge-to-transplant patients and not destination therapy patients, a number of centers disagree with the national guidelines and believe smoking should be prohibited in both populations.
Is two-stage revision surgery for infected hip arthroplasty worth the suffering, resources and results compared to one-stage?
Authors: Sotiriou Dimitrios , Stigbrand Hampus , Ullmark Gösta 
Published: August 2020

Purpose: Periprosthetic joint infection (PJI) is the most serious complication of total hip arthroplasty. The treatment is usually revision in either 1 or 2 stages. This study analyses revision with impaction bone grafting for periprosthetic joint infection of the hip and compares 1- and 2-stage strategies. Patients and methods: We reviewed 55 consecutive cases (54 patients) of revision arthroplasty for PJI carried out at our hospital between 2002 and 2016. Of these, 46 were 2-stage procedures. 21 had vancomycin mixed in with the bone graft, and all had gentamycin-containing bone cement. The total perioperative blood loss, duration of operation, and length of hospital stay were recorded. Clinical and radiological results were analysed for 48 hips at 2–16 years follow-up. Results: No PJI remained at follow-up. 3 patients (6%) had undergone revision for all causes. 1 had radiological signs of mechanical loosening but was not revised. 2-stage procedures had a significantly longer operating time (409 vs. 238 min) and hospital stay (34 vs. 13 days), greater blood loss (2764 vs. 1638 ml), and lower mean functional hip score (15.9 vs. 17.5) at follow-up than the one-stage procedures. Interpretation: Revision total hip arthroplasty for PJI with vancomycin-loaded impaction bone grafting is a safe method that achieves both the restoration of bone stock and resolution of the infection. This single-stage procedure could therefore be the new gold standard for treatment of non-complicated PJI in the hip.
Glenoid version: the role of genetic and environmental factors on its variability. An MRI study on asymptomatic elderly twins
Authors: Gumina S , Villani C , Carbone S , Venditto T , Candela V 
Published: August 2020

Background Glenoid version is the most variable parameter of the shoulder joint. No authors investigated if intrinsic genetic factors or influences from extrinsic sources are responsible for its variability. Aim We compared glenoid version between elderly monozygotic and dizygotic twins intending to separate the contributions of genetics from shared and unique environments. Methods Glenoid version of the dominant shoulder was assessed by MRI using Friedman’s method in 30 pairs of elderly twins (16 monozygotic–14 dizygotic; mean age ± SD: 63.72 ± 3.37, 53–72). Heritability was estimated as twice the difference between the intraclass correlation coefficients for monozygotic and dizygotic pairs. The influence of shared environment was calculated as the difference between monozygotic correlation coefficient and the heritability index. According to job category, one way analysis of variance was used to estimate the differences between groups in the total sample and within zygosity groups. Results Glenoid version angle in monozygotic and dizygotic twins was −2° (SD: 2°) and −3° (SD: 3°), respectively (p = 0.334). Heritability index was 0.98, while the contributions of shared and unique environment were 0 and 0.02, respectively. According to working classes, no significant differences were found between the groups (p = 0.732, F = 0.31). Conclusions Glenoid version is mainly genetically determined and only marginally influenced by environments. Level of evidence: III.
Histologic parameter score does not predict short‐term survival in severe alcoholic hepatitis
Authors: Dubois Margaux , Sciarra Amedeo , Trépo Eric , Marot Astrid , Saldarriaga Joan , Moreno Christophe , Sempoux Christine , Deltenre Pierre 
Published: August 2020

Background and aimThe alcoholic hepatitis histologic score has been proposed as a new prognostic tool to assess the risk of death in alcoholic hepatitis. We aimed to evaluate its prognostic value in patients with severe alcoholic hepatitis.MethodsLiver biopsies were analysed independently by two pathologists according to the alcoholic hepatitis histologic score. The Laennec staging system was also used to evaluate fibrosis.ResultsOne hundred and seven patients were included, and 89% of the patients received corticosteroids. The alcoholic hepatitis histologic score was available in 105 patients. Histologic scoring showed mild, moderate and severe scores in 10, 29 and 66 patients, respectively. Laennec staging was available for 53 patients, among whom 49 had cirrhosis, including 7 with Laennec 4A, 15 with 4B and 27 with 4C. Survival rates in mild, moderate and severe alcoholic hepatitis histologic score groups were 90%, 72% and 69% at 28 days (p  = 0.6), 80%, 52% and 63% at 3 months (p  = 0.3), and 70%, 41% and 58% at 6 months (p  = 0.3), respectively. Within the alcoholic hepatitis histologic score, fibrosis demonstrated the best interobserver reproducibility (agreement = 100%, Κ = 1.00). Compared to patients with Laennec 4B or 4C cirrhosis, survival rates for patients without cirrhosis or with Laennec 4A cirrhosis were 100% vs 83% at 28 days (p  = 0.16), 91% vs 68% at 3 months (p  = 0.13), and 82% vs 64% at 6 months (p  = 0.2), respectively. In multivariate analysis adjusted for age and for model for end‐stage liver disease score, the alcoholic hepatitis histologic score and Laennec stage were not associated with 6‐month mortality.ConclusionsThe alcoholic hepatitis histologic score is not predictive of short‐term survival in this cohort of patients with severe alcoholic hepatitis.
On-Site Occupational Health Nursing Services
Authors: Davidson Gestur , Widtfeldt Anne , Bey Jean 
Published: August 2020

Part I of this article describes a quantitative assessment model that was developed to provide useful information to a large corporation about the benefits and costs of an on-site occupational health nursing program. The large number and complex nature of the effects of such programs both complicate this task and restrict the comprehensiveness of its assessment. Part I focuses on estimating the net cost savings arising from the direct substitution of on-site for off-site provided occupational health nursing services. The six factors comprising this assessment model are identified. How these quantitative factors might be estimated in practical applications of this model is discussed, and cost effective approaches to this estimation task are suggested. The on-site provision of occupational health nursing services clearly continues to be an issue of interest to large corporations concerned with cost containment, productivity, and good employee relations. The model described in this article is restricted to measurable, short term benefits. However, the careful measurement of these benefits and costs can usefully inform management decision making until more comprehensive, longer term assessment models can be empirically implemented.
Molecular background delineates outcome of double protein expressor diffuse large B-cell lymphoma
Authors: Meriranta Leo , Pasanen Annika , Alkodsi Amjad , Haukka Jari , Karjalainen-Lindsberg Marja-Liisa , Leppä Sirpa 
Published: August 2020

Abstract
Concomitant deregulation of MYC and BCL2 comprises clinically significant, yet poorly characterized biological high-risk feature in diffuse large B-cell lymphoma (DLBCL). To interrogate these lymphomas, we analyzed translocations and protein expression of BCL2, BCL6, and MYC; correlated the findings with comprehensive mutational, transcriptomic, and clinical data in 181 patients with primary DLBCL; and validated the key findings in independent data sets. Structural variations of BCL2 were subtype-specific and specifically increased BCL2 expression. Molecular dissection of MYC deregulation revealed associations with other lymphoma drivers, including loss of TP53, and distinctive gene expression profiles. Double protein expression (DPE) arose from heterogeneous molecular backgrounds that exhibited subtype-dependent patterns. In the germinal center B-cell (GCB) DLBCL, concurrent alterations of MYC and BCL2 loci gave rise to the majority of DPE DLBCLs, whereas among the activated B-cell (ABC) DLBCLs, concurrent alterations were infrequent. Clinically, DPE DLBCL defined a prognostic entity, which was independent of the International Prognostic Index (IPI) and cell of origin, and together with the loss of TP53 had a synergistic dismal impact on survival. In the DPE DLBCL, the loss of TP53 was associated with a chemorefractory disease, whereas among the other DLBCLs, no correlation with survival was seen. Importantly, BCL6 translocations identified non-GCB lymphomas with favorable BN2/C1-like survival independent of IPI and concurrent DPE status. Taken together, our findings define molecular characteristics of the DPE in DLBCL, and recognize clinically feasible predictors of outcome. Given the emerging taxonomical significance of BCL2, BCL6, MYC, and TP53, our findings provide further depth and validation to the genomic classification of DLBCL.
Physical activity in children at risk of postthrombotic sequelae: a pilot randomized controlled trial
Authors: Hasan Rida , Hanna Maria , Zhang Song , Malone Kendra , Tong Elizabeth , Salas Niavana , Sarode Ravi , Journeycake Janna , Zia Ayesha 
Published: August 2020

Abstract
Increased physical activity is protective against worsening of postthrombotic syndrome (PTS) in adults. We assessed patient eligibility, consent, adherence, and retention rates in a pilot trial of prescribed physical activity following venous thromboembolism (VTE) in children. Secondary objectives were to describe the within-subject changes in PTS, quality of life, and coagulation biomarkers before and after the intervention in each group. We enrolled and randomized patients between 7 and 21 years of age to the physical activity group or the standard care (education-only) group in a 1:1 allocation ratio. The physical activity group wore a Fitbit for 4 weeks to determine habitual activity and then increased activity over an 8-week “active” period, followed by a 4-week “do-as-you-wish” period. Two hundred thirty-five children were diagnosed with VTE; 111 patients were screened, of whom 40 (36%) met study eligibility criteria. Of these, 23 (57%) consented to participate and were randomized (Fitbit,11; standard group, 12). The trial was of greater interest to overweight and obese children, as they comprised 83% of consented patients. Only 33% adhered to the activity prescription, and 65% (15/23) completed the trial. The PTS scores (P = .001) improved in the physical activity group compared with the education-only group. It is feasible to enroll and randomize pediatric VTE patients to a prescribed physical activity regimen 3 months following VTE. Metrics for adherence to enhanced physical activity and retention were not met. These results provide the rationale to explore low adherence and retention rates before moving forward with a larger trial of exercise training following VTE. This trial was registered at www.clinicaltrials.gov as #NCT03075761.