bluuebunny/crossref_metadata_2025_split huggingface dataset:
3K3A-Activated Protein C Variant Does Not Interfere With the Plasma Clot Lysis Activity of Tenecteplase
Authors: Mukherjee Purba , Lyden Patrick , Fernández José A. , Davis Thomas P. , Pryor Kent E. , Zlokovic Berislav V. , Griffin John H. 
Published: June 2020

Background and Purpose:
A recombinant engineered variant of APC (activated protein C), 3K3A-APC, lacks anticoagulant properties (<10%) while preserving APCs anti-inflammatory, anti-apoptotic, and neuroprotective functions and is very promising in clinical trials for ischemic stroke. Therapeutic intervention with single bolus administration of the third-generation tPA (tissue-type plasminogen activator), tenecteplase, is anticipated to be widely adopted for treatment of acute ischemic stroke. 3K3A-APC is well-tolerated in stroke patients dosed with alteplase, and in vitro studies show 3K3A-APC does not interfere with alteplase-induced clot lysis. The purpose of this in vitro study was to assess the influence of 3K3A-APC on tenecteplase-induced clot lysis.

Methods:
Tenecteplase-mediated lysis of thrombin generated plasma clots of human normal pooled plasma was monitored in the presence of varying doses of 3K3A-APC. The effects on fibrinolysis by tenecteplase and alteplase were compared.

Results:
The presence of 3K3A-APC shortened the time for clot lysis induced by tenecteplase at very low levels but not at higher therapeutic concentrations of tenecteplase. Comparisons of alteplase-mediated clot lysis to tenecteplase clot lysis showed that both thrombolytic agents behaved similarly in the presence of 3K3A-APC.

Conclusions:
These results indicate that 3K3A-APC does not interfere with tenecteplase’s clot lysis function.
Quantitative Histogram Analysis on Intracranial Atherosclerotic Plaques
Authors: Shi Zhang , Li Jing , Zhao Ming , Peng Wenjia , Meddings Zakaria , Jiang Tao , Liu Qi , Teng Zhongzhao , Lu Jianping 
Published: June 2020

Background and Purpose:
Intracranial atherosclerosis is one of the main causes of stroke, and high-resolution magnetic resonance imaging provides useful imaging biomarkers related to the risk of ischemic events. This study aims to evaluate differences in histogram features between culprit and nonculprit intracranial atherosclerosis using high-resolution magnetic resonance imaging.

Methods:
Two hundred forty-seven patients with intracranial atherosclerosis who underwent high-resolution magnetic resonance imaging sequentially between January 2015 and December 2016 were recruited. Quantitative features, including stenosis, plaque burden, minimum luminal area, intraplaque hemorrhage, enhancement ratio, and dispersion of signal intensity (coefficient of variation), were analyzed based on T2-, T1-, and contrast-enhanced T1-weighted images. Step-wise regression analysis was used to identify key determinates differentiating culprit and nonculprit plaques and to calculate the odds ratios (ORs) with 95% CIs.

Results:

In total, 190 plaques were identified, of which 88 plaques (37 culprit and 51 nonculprit) were located in the middle cerebral artery and 102 (57 culprit and 45 nonculprit) in the basilar artery. Nearly 90% of culprit lesions had a degree of luminal stenosis of <70%. Multiple logistic regression analyses showed that intraplaque hemorrhage (OR, 16.294 [95% CI, 1.043–254.632];
P
=0.047), minimum luminal area (OR, 1.468 [95% CI, 1.032–2.087];
P
=0.033), and coefficient of variation (OR, 13.425 [95% CI, 3.987–45.204];
P
<0.001) were 3 significant features in defining culprit plaques in middle cerebral artery. The enhancement ratio (OR, 9.476 [95% CI, 1.256–71.464];
P
=0.029), intraplaque hemorrhage (OR, 2.847 [95% CI, 0.971–10.203];
P
=0.046), and coefficient of variation (OR, 10.068 [95% CI, 2.820–21.343];
P
<0.001) were significantly associated with plaque type in basilar artery. Coefficient of variation was a strong independent predictor in defining plaque type for both middle cerebral artery and basilar artery with sensitivity, specificity, and accuracy being 0.79, 0.80, and 0.80, respectively.

Conclusions:
Features characterized by high-resolution magnetic resonance imaging provided complementary values over luminal stenosis in defined lesion type for intracranial atherosclerosis; the dispersion of signal intensity in histogram analysis was a particularly effective predictive parameter.
Decreased Length of Stay After Laparoscopic Diaphragm Repair for Isolated Diaphragm Injury After Penetrating Trauma
Authors: Chaudhry Haris H. , Grigorian Areg , Lekawa Michael E. , Dolich Matthew O. , Nguyen Ninh T. , Smith Brian R. , Schubl Sebastian D. , Nahmias Jeffry T. 
Published: June 2020

Background Isolated diaphragm injury (IDI) occurs in up to 30% of penetrating left thoracoabdominal injuries. Laparoscopic abdominal procedures have demonstrated improved outcome including decreased postoperative pain and length of stay (LOS) compared to open surgery. However, there is a paucity of data on this topic for penetrating IDI. The aim of this study was to examine the prevalence and outcome of laparoscopic diaphragmatic repair versus open diaphragmatic repair (LDR vs ODR) of IDI. Methods The Trauma Quality Improvement Program (2010-2016) was queried for patients with IDI who underwent ODR versus LDR. A bivariate analysis using Pearson chi-square and Mann-Whitney test was performed to determine LOS among the two groups. Results From 2039 diaphragm injuries, 368 patients had IDI; 281 patients (76.4%) underwent ODR and 87 (23.6%) underwent LDR. Compared to LDR, the ODR patients were older (median, 31 vs 25 years, P < .001) and had a higher injury severity score (mean, 11.2 vs 9.6, P = .03) but had similar rates of intensive care unit LOS, unplanned return to the operating room, ventilator days, and complications ( P > .05). Patients undergoing ODR had a longer LOS (5 vs 4 days, P = .01), compared to LDR. There were no deaths in either group. Conclusions Trauma patients presenting with IDI undergoing ODR had a longer hospital LOS compared to patients undergoing LDR with no difference in complications or mortality. Therefore, we recommend when possible an LDR should be employed to decrease hospital LOS. Further research is needed to examine other benefits of laparoscopy such as postoperative pain, incisional hernia, and wound-related complications.
Relationship-oriented values and marital and life satisfaction among Chinese couples
Authors: Chi Peilian , Wu Qinglu , Cao Hongjian , Zhou Nan , Lin Xiuyun 
Published: June 2020

Objective and background: The present study tested whether the similarity levels of relationship-oriented values among Chinese couples would be higher than those among randomly matched male–female pairs. Furthermore, we examined whether couple similarity of relationship-oriented values would predict spouses’ marital satisfaction and life satisfaction above the actor and partner effects of relationship-oriented values over time and the potential marriage cohort differences. Method: Data were retrieved from the China Family Panel Studies data set in 2010–2014. Our study included a nationally representative sample of 10,860 first-married couples who provided data on relationship-oriented values, marital satisfaction, and life satisfaction. Results: The average profile similarity on relationship-oriented values of the real couples was higher than that of the randomly matched male–female pseudo couples. Actor–Partner Interdependence Model analyses showed that (1) couple similarity of relationship-oriented values was positively associated with husbands’ and wives’ life satisfaction indirectly through wives’ marital satisfaction among couples with short to medium marital duration, even after controlling for life satisfaction 4 years ago and a set of sociodemographic variables; (2) husbands’ relationship-oriented values were positively associated with couples’ life satisfaction indirectly through husbands’ marital satisfaction among couples with short to medium and long marital duration. Conclusion: With a large dyadic sample of Chinese couples, our findings expand the literature on the significant role of couple similarity of relationship-oriented values in personal and relational well-being.
‘This is your golden time. You enjoy it and you’ve plenty time for crying after’: How dysphagia impacts family caregivers of people with amyotrophic lateral sclerosis – A qualitative study
Authors: Lisiecka Dominika , Kelly Helen , Jackson Jeanne 
Published: June 2020

Background: Dysphagia (swallowing impairments) is a well-recognised symptom of amyotrophic lateral sclerosis. Caring for a person with amyotrophic lateral sclerosis has been recognised as a complex and demanding task. No study to date investigated the impact of dysphagia on the lives of caregivers of people with amyotrophic lateral sclerosis. Aim: To investigate the experiences of dysphagia from the perspective of family caregivers of people diagnosed with amyotrophic lateral sclerosis. Design: Interpretative phenomenological analysis was employed. Individual interviews (n = 15) plus observations of mealtime preparation were conducted, where possible (seven or n). Setting/participants: Participants comprised family caregivers of people with amyotrophic lateral sclerosis and dysphagia living in the South West of Ireland ( n = 10). Findings: Dysphagia transformed the mealtime experiences of the caregivers and changed their approaches to food. Frustration related to the inability to stabilise the weight of the person with amyotrophic lateral sclerosis and the fear of choking emerged strongly. The caregivers strived to ensure the safety of people with amyotrophic lateral sclerosis during meals by providing constant supervision. Despite the challenges precipitated by dysphagia and amyotrophic lateral sclerosis, the caregivers wished to maintain normality for as long as they perceived it to be possible. Conclusion: This study provides a unique contribution in advancing our understanding of the impact of dysphagia on the caregivers of people with amyotrophic lateral sclerosis. Professionals must explore and recognise the needs of the caregivers and provide them with appropriate support, especially how to manage choking.
The Clinical Research Landscape of Pediatric Drug-Resistant Epilepsy
Authors: Kaal K. Julia , Aguiar Magda , Harrison Mark , McDonald Patrick J. , Illes Judy 
Published: June 2020

Objective: To characterize the clinical research landscape of pediatric drug-resistant epilepsy (DRE) with a focus on neurotechnology. Method: We searched the ClinicalTrials.gov registry using the terms “epilepsy” and “drug resistant” for studies including participants age 0-17 years. Returns were grouped by intervention (eg, neurotechnological, drug). Key trial features such as age range, trial status and outcomes were compared across interventions. Results: We identified 101 registered trials with pediatric DRE patients. Thirty-two (32%) investigate neurotechnological interventions, devices, or diagnostic procedures; 13 (41%) are currently active. Among neurotechnology trials, 15 (46%) investigate vagus nerve stimulation, transcranial direct current stimulation, or deep brain stimulation; few are specific to children. Of the remaining 69 trials, 37 investigate a drug, 17 investigate a dietary therapy, and 15 investigate another intervention. Seizure frequency is the most frequent primary outcome measured in the trials identified. Significance: The landscape of registered trials pertaining to pediatric DRE reflects a lag between clinical research and clinical practice, and highlights the need for timely evidence before novel neurotechnological interventions are widely adopted into clinical practice.
Community Perspectives During a Lead Contaminated Drinking Water Crisis: Lessons for Lactation and Other Health Providers
Authors: Blackwell Dalvery , Morrell Erica 
Published: June 2020

Background Millions of people today live in contaminated environments. Often, these environments disproportionately affect nonwhite, racialized families who are low-income, pregnant, and/or feeding young children. Despite the overwhelming recognition among scholars and practitioners of these realities, however, few lactation or other health professionals center socially disadvantaged families’ perspectives in their work. Community expertise is therefore often absent from the credentialed lactation and associated support that tends to be advanced in contaminated environments. Research Aims The aims of this study were to: (1) Describe how vulnerable community members experience toxic environments, and (2) Explore the strategies vulnerable community members themselves employ and seek out from professionals to achieve resilience in these environments. Methods The research design for this study was prospective and cross-sectional. We surveyed 62 Milwaukeean African American women of childbearing age and their close networks of support from predominantly low-income census tracts, and we engaged 14 women in a community conversation on their experiences, strategies, and desires generated from living in Milwaukee during a lead contaminated drinking water crisis. Results Participants were aware and concerned about toxic poisoning in their environment, especially as it affects their children. Nonetheless, societal factors constrained their levels of preparedness and action in response, including around chestfeeding, breastfeeding, expressed milk feeding, and artificial feeding methods. Conclusion Lactation providers and other health professionals can better support at-risk families by integrating their perspectives into dominant frameworks for information-sharing, preventative resource distribution, and supporting community self-determination.
Altruism and the Difficult Patient
Authors: Kubsch Sylvia , Tyczkowski Brenda , Passel Cheryl 
Published: June 2020

Background For some nurses, providing altruistic care to difficult patients is a challenge, leading to the use of negative coping strategies such as anger or avoidance, leaving the nurse frustrated and patients feeling rejected. Yet other nurses can deal positively with difficult patients. Purpose To study how the stress of caring for difficult patients affects the level of altruism and use of negative coping strategies in their care and to find out what positive coping strategies and interventions could be used. Design/Method A mixed-methods design was used. A survey tested the level of altruism, the use of negative coping strategies, and several demographics. Thematic analysis examined narratives generated by participants to three questions regarding how to provide altruistic care to difficult patients. Findings A purposive sample of 67 registered nurses (RNs) participated. The average level of altruism used by RNs with difficult patients was 99.7/120 points. An inverse relationship was found between the level of altruism and use of negative coping strategies ( r = −0.577, p < .001). Qualitative analysis of narratives identified three themes—Developing Psychological Hardiness, Bearing Witness, and Fending for Oneself. Conclusions This study provides insight into the experiences of RNs caring for difficult patients and how to ensure altruistic caring.
Transferability of Evidence-Based Parenting Programs to Routine Implementation in Postconflict South Sudan
Authors: Janowski Roselinde K. , Wessels Inge , Bojo Samuel , Monday Felix , Maloney Kaitlyn , Achut Victoria , Oliver Daniel , Lachman Jamie M. , Cluver Lucie , Ward Catherine L. 
Published: June 2020

Purpose: This study investigated process and outcomes of the Parenting for Lifelong Health (PLH) for Young Children and for Adolescents programs implemented as part of routine service delivery in postconflict settings. Methods: These group-based programs were delivered by trained facilitators to 97 caregivers (PLH for Young Children) and 108 caregiver–adolescent dyads (PLH for Adolescents) over 12 or 14 (respectively) weekly sessions. Routine monitoring data were collected by the implementing partners using standardized self-report measures. Reducing harsh discipline was specified as the primary outcome, with secondary outcomes including improvements in positive parenting and reductions in poor parental supervision and parental inefficacy. Results: Analyses were intention to treat. Both PLH programs retained effectiveness in routine conditions in a postwar setting, with moderate to large effect sizes. The programs also had high enrollment and attendance rates, indicating high acceptability. Conclusions: Findings suggest promising viability for the implementation of evidence-based parenting programs in challenging postconflict contexts.
Unilateral multiple serous retinal detachments secondary to non-Hodgkin’s lymphoma responsive to systemic steroids
Authors: Vujosevic Stela , Toma Caterina , Muraca Andrea , Alkabes Micol , Villani Edoardo , Nucci Paolo , De Cilla Stefano 
Published: June 2020

Purpose: To describe a case of unilateral multiple bullous neurosensory retina detachments (NRDs) secondary to non-Hodgkin’s aggressive large B-cell lymphoma treated with chemotherapy and high doses of systemic steroids. Methods: A case report based on patient observation, clinical records, and retinal imaging during 2 years of follow-up. Results: A 26-year-old Hispanic man presented at our clinic with sudden unilateral visual loss and multiple NRDs in the left eye with increased choroidal thickness, 1 week after oral steroid treatment due to low back pain and fever. In the following days, a non-Hodgkin’s aggressive large B-cell lymphoma was diagnosed. The patient underwent three cycles of chemotherapy (CHT) with protocol R-CHOP21 (including oral prednisone) with complete resolution of NRD. During 2 years of follow-up, no recurrence of NRD occurred, despite the need to continue CHT with oral steroids for a year due to lymphoma relapse. Conclusion: Neurosensory retina detachments may be an initial manifestation of large B-cell lymphoma as a consequence of a pro-inflammatory state involving the chorioretinal structures, thus adding steroid treatment could be useful for its resolution.
Posterolateral or direct lateral approach for hemiarthroplasty after femoral neck fractures: a systematic review
Authors: Tol Maria C J M , van Beers Loes W A H , Willigenburg Nienke W , Gosens Taco , Heetveld Martin J , Willems Hanna C , Bhandari Mohit , Poolman Rudolf W 
Published: June 2020

Background: The posterolateral approach (PLA) and direct lateral approach (DLA) are the most commonly used approaches for inserting a hemiarthroplasty in the treatment of femoral neck fractures. A recent review concluded that the routine use of PLA should be questioned, but this conclusion itself can be questioned. The aim of this study is to provide an updated overview and critical appraisal of the available evidence, focussing on outcomes most relevant for patients. Methods: We conducted a comprehensive search of literature in the MEDLINE and EMBASE databases and Cochrane Library. Studies (till June 2018) to identify hip fracture clinical trials/comparative studies comparing alternative surgical approaches (PLA and DLA). We explored sources of heterogeneity and conducted pooled analyses when appropriate. Results: 264 potentially eligible studies were identified of which 1 RCT, 3 prospective, 3 registry data and 5 retrospective studies were included. The RCT consisted performance and attrition bias. The mean MINORS score of the prospective/register studies was 17.3 (SD 3.5) and 13.8 (SD 1.9) of the 5 retrospective studies. The GRADE score for all the outcomes was very low. Due to the high and various types of biases across the included studies, we did not pool the data. None of studies assessed the activities of daily living functionality. 6 studies reported significantly more dislocations or reoperations due to dislocation in the PLA group, 6 other studies found no differences. DLA patients were more likely to develop abductor insufficiency leading to limping and more need for walking aids. The PLA patients tended to have better quality of life, less pain and more satisfaction compared to the DLA patients. Conclusion: Based on low-quality studies, PLA may be associated with more dislocations, but patients had less walking problems and a lower tendency to abductor insufficiency compared with DLA. Further clinical trials with methodology rigor are needed to determine which approach is more effective in terms of outcomes relevant to patients.
Common Gastrointestinal Symptoms and Associated Factors Among Under-5 Children in Rural Dembiya, Northwest Ethiopia: A Community-Based Cross-Sectional Study
Authors: Gizaw Zemichael , Addisu Ayenew , Guadie Destaye 
Published: June 2020

Background: Gastrointestinal (GI) symptoms such as abdominal discomfort, abdominal cramp, nausea, vomiting, gas in the GI tract, changes in bowel habits (e.g. diarrhea), or heartburn are common in the community. However, these symptoms may be misinterpreted and their impact and significance misunderstood, especially in the rural communities. This study was, therefore, conducted to assess common GI symptoms among children in rural Dembiya, northwest Ethiopia. Methods: A community-based cross-sectional study was conducted in May 2017 among 225 randomly selected under-5 children. We primarily used mothers’ report to assess GI symptoms. Health professionals also diagnosed for some symptoms. Direct stool examination technique was used to identify parasitic infections. Bacteriological analysis of drinking water was done to determine the quality of drinking water. Food safety, environmental sanitation, and hygiene condition of children were assessed using observation checklists. Multivariable binary logistic regression analysis was employed to identify factors associated with GI symptoms on the basis of adjusted odds ratio (OR) with 95% confidence interval (CI) and P < .05. Results: The current study depicted that 139 of 225(61.8%) of the children had GI symptoms. Abdominal discomfort (137 of 139 [98.7%]), abdominal cramp (125 of 139 [89.9%]), and diarrhea (118 of 139 [84.9%]) were the highest GI symptoms reported. GI symptoms were significantly associated with childhood intestinal parasitic infections (OR = 13.69, 95% CI = 3.31-56.59), unclipped and unclean finger nails (OR = 2.28, 95% CI = 1.02-5.10), inadequate living environment sanitation (OR = 2.37, 95% CI = 1.08-5.18), unclean living houses (OR = 9.06, 95% CI = 2.60-31.54), and owning livestock (OR = 4.68, 95% CI = 1.82, 12.03). Conclusion: The prevalence of GI symptoms among under-5 children in rural Dembiya, northwest Ethiopia, was found to be high. GI symptoms were significantly associated with childhood intestinal parasitic infections, hand hygiene condition of children, and sanitation condition of the living environment. Therefore, preventing intestinal parasitic infections, improving hand hygiene condition, and promoting environmental sanitation will have overriding contributions to prevent symptoms among children in rural Dembiya.