bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Descriptive Study of the Attitudes, Perceptions, and Experiences of Human Milk Donation
Authors: Wambach Karen , Bateson Tiffany , Matheny Paige , Easter-Brown Kristan 
Published: November 2019

Background:
The use of pasteurized human donor milk has increased in recent years due to health benefits and rising number of infants who need pasteurized human donor milk. Little is known about milk donors' experiences or what contributes to their motivation to donate.

Purpose:
Using existing evidence and the theory of planned behavior as a guide, our purpose was to describe the personal and social aspects of mothers' milk donation to a milk bank in the Midwest United States.

Methods:
A convenience sample of 50 current human milk donors enrolled in this cross-sectional descriptive study. The investigator-designed online survey consisted of open and closed questions based upon existing evidence and theory of planned behavior for assessing reasons for donation, beliefs about benefits and barriers, social support for donation, donation history, and current experiences. We used the Iowa Infant Feeding Attitude Survey to characterize general breastfeeding attitudes. Data analysis consisted of content analysis for narrative data and descriptive statistics for continuous and dichotomous variables.

Findings/Results:
Six themes represented experiences of discovering donation, reasons and motivations for donating, benefits and barriers to donation, confidence in donating, and support for donation. Practical and altruistic motivations for donation were prevalent. Confidence for donation was instilled by adequate milk supply, growth of the infant, and the milk bank process and professionalism. Support from others was universal.

Implications for Practice:
Findings can inform education regarding human milk donation. Human milk banks may benefit from identified donation barriers to improve support for donors.

Implications for Research:
Findings are being used for instrument development for research regarding women's intentions and donor behavior.
An Observational Study on Early Dyadic Interactive Behaviors of Mothers With Early-Preterm, Late-Preterm, and Full-Term Infants in Malawi
Authors: Gondwe Kaboni Whitney , Brandon Debra , Yang Qing , Malcolm William F. , Small Maria J. , Holditch-Davis Diane 
Published: November 2019

Background:
Mother–infant interactions are necessary for infant growth and development. However, preterm birth is associated with less positive mother–infant interactions than full-term birth. Malawi has the highest preterm birth rate in the world, but studies of the mother–infant relationship in Malawi are limited and studies that observed mother–infant interactions could not be located.

Purpose:
This study explored mother–infant interactions among Malawian mothers of early-preterm, late-preterm, and full-term infants.

Methods:
This observational study explored maternal and infant interactive behaviors. We recruited 83 mother–infant dyads (27 early-preterm, 29 late-preterm, and 27 full-term dyads).

Findings:
Mothers of early-preterm infants looked at and rocked their infants less, and their infants looked at their mothers less, than mothers of either late-preterm infants or full-term infants. The infants in all groups were asleep most of the time, which contributed to low levels of interactive behaviors. Factors that were related to infant behaviors included marital status, maternal occupation, maternal education, infant medical complications, infant gender, history of neonatal deaths, and multiple births.

Implications for Practice:
Our findings provide evidence about the need to encourage mothers to engage interactive behaviors with their infants.

Implications for Research:
Future studies of factors that contribute to positive interactions in Malawi are needed.
A cross-sectional study of acute cor pulmonale in acute respiratory distress syndrome patients in China
Authors: Su Long-Xiang , Shang Xiu-Ling , Zhu Ran , He Wei , Pan Pan , Zhang Hong-Min , Zhang Li-Na , Liu Da-Wei , Yu Rong-Guo , Wang Xiao-Ting 
Published: November 2019

Abstract

Background:
Increased right ventricle afterload during acute respiratory distress syndrome (ARDS) may induce acute cor pulmonale (ACP), which is associated with a poor clinical outcome. Echocardiography is now considered as a rapid and non-invasive tool for diagnosis of ACP. The aims of this study were to investigate the morbidity and mortality rates of ACP in ARDS patients in intensive care units (ICUs) across the mainland of China and to determine the severity and prognosis of ACP in ARDS patients through an ultrasound protocol (TRIP). And the association between ACP related factors and the ICU mortality will be revealed.

Methods:
This study is a multicenter and cross-sectional study in China which will include ICU participants when diagnosed as ARDS. The ultrasound protocol, known as the TRIP, is proposed as severity assessment for ACP, which includes tricuspid regurgitation velocity (T), right ventricular size (R), inferior vena cava diameter fluctuation (I), and pulmonary regurgitation velocity (P). The 28-day mortality, ICU/hospital mortality, the length of stay in ICU, mechanical ventilation days, hemodynamic parameters and lab parameters of liver function and kidney function are all recorded.

Discussion:
This large-scale study would give a sufficient epidemic investigation of ACP in ARDS patients in China. In addition, with the TRIP protocol, we expect that we could stratify ACP with more echocardiography parameters.

Trial registration:
NCT03827863, https://clinicaltrials.gov/ct2/show/NCT03827863
A Limited-Versus-Extensive Staging Strategy for Small Cell Prostate Cancer
Authors: Syed Salman , Basourakos Spyridon P. , Ali Faisal S. , Garcia Jessica L. , Zurita-Saavedra Amado , Gong Zimu 
Published: November 2019

Introduction:
Small cell prostate cancer (SCPC) is a rare histologic subtype of prostate cancer, for which the optimal staging strategy remains unclear.

Method:
The Surveillance, Epidemiology, and End Results database was used to analyze the incidence and outcomes of SCPC between the years 2004 through 2016. Limited-stage SCPC (LS-SCPC) was defined as SCPC without any metastasis regardless of local invasion. Extensive stage SCPC (ES-SCPC) was defined as any metastasis to lymph nodes and/or to distant organs.

Result:
A total of 403 SCPC patients were included in the study cohort, accounting for 0.056% of all prostate cancer cases (n=719,655). Of the 358 patients with known metastasis status, 275 (76.8%) patients had ES-SCPC, whereas 83 (23.2%) patients had LS-SCPC. LS-SCPC was associated with better overall survival (17 vs. 9 mo, P<0.001) and disease-specific survival (25 vs. 10 mo, P<0.001) compared with ES-SCPC. All LS-SCPC patients had a similar overall survival regardless of T stage. Similarly, all ES-SCPC patients had similar outcomes regardless of metastasis sites. High prostate-specific antigen (PSA) is paradoxically associated with superior outcome in both localized stage patients (PSA≥4 vs. PSA<4, 19 vs. 10 mo, P=0.002) and extensive stage patients (PSA≥20 vs. PSA<20, 13 vs. 9 mo, P=0.02). Multivariate analysis of treatment showed that chemotherapy was associated with improved survival in ES-SCPC with hazard ratio of 0.52.

Conclusion:
Similar to small cell lung cancer, SCPC can be staged into LS-SCPC or ES-SCPC. The binary staging system correlates well with prognosis.
Mohs Surgery for Advanced Tumors of the Scalp
Authors: Yu Wesley Y. , Salmon Paul , Thuener Jason , Bordeaux Jeremy S. 
Published: November 2019

BACKGROUND
The scalp presents unique surgical challenges, and specialized techniques are sometimes required to achieve optimal results. Tumors arising on the scalp may also be at increased risk of complications such as in-transit metastasis and perineural invasion.

OBJECTIVE
To review challenges to Mohs micrographic surgery on the scalp and techniques for successful tumor extirpation and reconstruction.

METHODS AND MATERIALS
This article reviews our experience with tumors of the scalp including techniques that we have found helpful both for tumor removal and for reconstruction.

CONCLUSION
Familiarity with the anatomy of the scalp as well as common challenges encountered during Mohs surgery may help improve outcomes and impart increase confidence to the practicing surgeon.
Mohs Micrographic Surgery Pearls for the Nose and Lips
Authors: Stiegel Evan , Leach Brian , Albertini John G. 
Published: November 2019

BACKGROUND
Failure to perform Mohs micrographic surgery (MMS) meticulously on the nose and lips can lead to larger defects and tumor recurrence, which can have aesthetic and functional repercussions for patients.

OBJECTIVE
To review pre-, intra-, and postoperative techniques and pearls for performing MMS on the nose and lips to optimize outcomes.

MATERIALS AND METHODS
Technical nuances and pearls cultured from the authors' own practice, those acquired from mentors and colleagues, and information identified from the literature are discussed to provide a logical approach to performing effective MMS on the nose and lips.

RESULTS
When performing MMS on the nose and lips, sound preoperative preparation, precise surgical technique, and particular attention to reducing false-positives and false-negatives while harvesting Mohs layers enhances the fidelity of the MMS procedure, minimizing defect sizes and reducing tumor recurrence.

CONCLUSION
Refining Mohs technique on the nose and lips allows more effective performance of tumor extirpation, improved microscopic evaluation, and more conservative reconstruction, leading to better patient outcomes.
Introducing Health and Medical Physics to Young Learners in Preschool to Fifth Grade
Authors: Fagerstrom Jessica M. 
Published: November 2019

Abstract
A hands-on learning activity was developed to introduce young learners to concepts and careers in health and medical physics. Inexpensive materials were used to create a work station with learning tools that were designed to be approachable and accessible for this audience. Visitors to a local independent, nonprofit science museum may interact with the activity work station to learn basic information regarding radiation in everyday life and to hear about careers in radiation sciences. Approximately 60 volunteer hours have been contributed associated with the activity. Interested physicists may adapt the lesson plan as a simple and straightforward way to participate in public education efforts in their own communities. A detailed lesson plan, equipment list, and electronic media are available upon request.
Epidemiological Association Between Systemic Diseases and Keratoconus in a Korean Population: A 10-Year Nationwide Cohort Study
Authors: Lee Hyo Kyung , Jung Eun Hye , Cho Bum-Joo 
Published: November 2019

Purpose:
To investigate the association of systemic diseases with keratoconus in the general Korean population.

Methods:
This is a nationwide population-based retrospective cohort study using the Korean National Health Insurance Service-National Sample Cohort database from 2002 to 2015, involving 1,108,369 individuals. Patients with keratoconus were identified using the Korean standard classification of diseases code H18.6. The prevalence and annual incidence rates were estimated. To examine the risk factors, 5 controls were matched per patient with keratoconus by propensity score matching using age and household income. Univariate and multivariate regression analyses were performed to assess the association between relevant factors and keratoconus.

Results:
A total of 613 subjects were identified as patients with keratoconus from the cohort database. The prevalence rate was 55.31 cases per 100,000 people [95% confidence interval (CI): 51.01–59.86]. The annual incidence rate, calculated using a predate 1-year washout period, was 4.47 cases per 100,000 person-years (95% CI: 4.11–4.85). People with allergic conjunctivitis had a 37% increased odds of being diagnosed with keratoconus [odds ratio: 1.37 (95% CI: 1.12–1.67), P = 0.002] compared with those without allergic conjunctivitis. By contrast, people with allergic rhinitis had a 52% reduced odds of being diagnosed with keratoconus [odds ratio: 0.48 (95% CI: 0.38–0.59), P < 0.001]. Atopy and eczema, asthma, connective tissue disorders, diabetes mellitus, sleep apnea, and inflammatory bowel disease had no significant association with a positive keratoconus diagnosis.

Conclusions:
Allergic conjunctivitis may increase the risk of developing keratoconus in Koreans.
Common Determinants of Absence From Work in Employees and Workers
Authors: Mayer Benjamin , Guenther Steffen 
Published: November 2019

Objective:
The aim of this longitudinal retrospective study was to identify possible determinants of absence from work in a productive company in Tyrol/Austria.

Methods:
Data of 974 workers and employees were analyzed. Times of absence were analyzed descriptively and the impact of their possible determinants was evaluated by means of hierarchical linear models.

Results:
The extent of absence was constant during the observed period, that is, former measures of health promotion were not effective. The number of sick days was, among others, significantly associated with working status (worker/employee, P < 0.001) and the company's department (commercial division, P < 0.001).

Conclusions:
A number of determinants for increased operational absence were identified. These may be considered specifically when adapting workplace health management. Since the observed times of absence mostly not normally distributed, future reports shall use nonparametric methods.
Nakao mesenteric approach in pancreatoduodenectomy for pancreatic head cancer
Authors: Nakao Akimasa 
Published: November 2019

Abstract
The ideal surgery for pancreatic head cancer is isolated pancreatoduodenectomy (PD); that is, en bloc resection using a non-touch isolation technique. We have been developing isolated PD for pancreatic cancer since 1981, when we developed an anti-thrombogenic bypass catheter for the portal vein. In this operation, the first and most important step is the use of a mesenteric approach instead of Kocher's maneuver. The mesenteric approach allows dissection from the non-cancer infiltrating side and determination of cancer-free surgical margins and resectability, followed by systemic lymphadenectomy around the superior mesenteric artery. This approach enables early ligation of the inferior pancreatoduodenal artery and mesopancreas excision. The mesopancreas is the second portion of the pancreatic head nerve plexus. Isolated PD is the ideal surgery for pancreatic head cancer from both surgical and oncological viewpoints. In patients with resectable pancreatic head cancer, isolated PD using the mesenteric approach is suspected to have a higher survival rate than conventional PD using Kocher's maneuver. The precise surgical techniques of the mesenteric approach are herein described.
Pancreatic cystic neoplasms: current and future approaches to identify patients at risk
Authors: Zhang Qi , Chen Yiwen , Bai Xueli , Liang Tingbo 
Published: November 2019

Abstract
Pancreatic cystic neoplasms (PCNs) are a group of entities with distinct risks and various treatments. Identification of the PCN patients at risk is thus critical. A correct diagnosis is the key to select high-risk patients. However, the misdiagnosis rate is extremely high even computer tomography, magnetic resonance imaging, and endoscopic ultrasonography were applied. Current approaches for differential diagnosis and identifying high-risk patients in certain types of PCNs are not powerful enough to make a clinical acceptable accuracy of diagnosis. The approaches mainly rely on imaging and tumor marker test. We here summarized the current approaches, and reviewed novel approaches under development. For instance, cyst fluid test of glucose or vascular endothelial growth factor A shows the best performance in identifying mucinous cystic neoplasms or serous cystic neoplasms. Multidisciplinary team (MDT) discussion is another way to improve the accuracy of diagnosis. Combination of MDT with validated novel approaches with high sensitivity and specificity is the best way to select truly high-risk patients with PCNs.
Laxative effects of wheat bran and psyllium: Resolving enduring misconceptions about fiber in treatment guidelines for chronic idiopathic constipation
Authors: McRorie Johnson W. , Fahey George C. , Gibb Roger D. , Chey William D. 
Published: November 2019

ABSTRACTBackground:Treatment guidelines for chronic idiopathic constipation (CIC) recommend an “increase in fiber intake” as a first-line therapy, but most epidemiologic studies fail to support an association between a high-fiber diet and a reduced risk of constipation. Furthermore, randomized controlled clinical studies show that most isolated fibers (e.g., supplements) are not different from placebo for a laxative effect, and several may be constipating.Objectives:The objective of this review was to compare the effects of two isolated fibers, coarse wheat bran and psyllium, on stool output and stool water content in patients with CIC. This review will also address misconceptions about fiber that are perpetuated by treatment guidelines.Data sources:A comprehensive literature review was conducted with the use of the Scopus, SciFinder, and PubMed scientific databases, limited to the previous 50 years (1968–2018; latest date included, December 31, 2018).Conclusions:In patients with CIC, nonfermented gel-forming psyllium was 3.4 times more effective than insoluble wheat bran for increasing stool output. Both psyllium and coarse wheat bran increased stool water content, a stool-softening effect, but finely ground wheat bran decreased stool water content, a stool-hardening effect.Implications for practice:It is a misconception that dietary fiber and all isolated fibers provide a laxative effect in patients with CIC. Our analysis suggests that treatment guidelines for CIC should make specific evidence-based recommendations as it pertains to fiber. To do otherwise takes the risk of perpetuating myth and misunderstanding and depriving patients of an effective therapy for CIC. A generic recommendation to “increase fiber intake” is akin to a recommendation to “increase pill intake” without regard to therapeutic or adverse effects.
The anticoagulants rivaroxaban and low molecular weight heparin prevent PICC-related upper extremity venous thrombosis in cancer patients
Authors: Lv Shoutian , Liu Yongmei , Wei Gang , Shi Xueyan , Chen Shaoping , Zhang Xuehui 
Published: November 2019

Abstract
Peripherally inserted central catheter (PICC) is often applied in chemotherapy patients and commonly causes upper extremity venous thrombosis (UEVT), which should be prevented.
To assess the preventive effects of the anticoagulants rivaroxaban and low molecular weight heparin (LMWH) on UEVT in patients receiving chemotherapy through PICCs.
A total of 423 chemotherapy patients with continuous PICC use between January 2014 and June 2015 at the Oncology Department of Dongying People's Hospital were divided into 3 groups: rivaroxaban (10 mg/day, orally), LMWH (Enoxaparine, 4000 anti-Xa IU/day, subcutaneous injection), and control (no anticoagulant). UEVT incidence and other complications during PICC use were observed and recorded.
The rivaroxaban, LMWH, and control groups included 138 (79 males; 54.9 ± 11.0 years), 144 (76 males; 56.0 ± 10.9 years), and 141 (71 males; 53.3 ± 10.9 years) patients, (P = .402 and P = .623 for age and sex respectively). There were no differences in cancer location (P = .628), PICC implantation site (P > .05), body mass index (BMI) (P = .434), blood pressure (all P > .05), blood lipids (5 laboratory parameters included, all P > .5), smoking (P = .138), history of lower limb venous thrombosis (P = .082), and 10 other associated comorbidities (all P > .5). Twenty-nine patients withdrew from the study (5 from the rivaroxaban, 12 from the LMWH, and 12 from the control groups, respectively), and 394 patients were analyzed. There were significant differences in the rivaroxaban group and the LMWH group compared to the control group (P = .010 and P = .009, respectively), but no significant difference was observed between the rivaroxaban group and the LMWH group (P = .743).
Anticoagulants such as rivaroxaban and LMWH may reduce the incidence of PICC-related UEVT in patients receiving chemotherapy.
Usefulness of contrast-enhanced ultrasonography for diagnosis of renal cell carcinoma in dialysis patients
Authors: Hashimoto Masahiro , Ohkuma Kiyoshi , Akita Hirotaka , Yamada Yoshitake , Nakatsuka Seishi , Mizuno Ryuichi , Oya Mototsugu , Jinzaki Masahiro 
Published: November 2019

Abstract

Aims:
To investigate the usefulness of contrast-enhanced ultrasonography for diagnosing renal cell carcinoma (RCC) in dialysis patients.

Material and methods:
Of 1301 dialysis patients who underwent abdominal computed tomography (CT) between January 2012 and March 2017, 19 were suspected to have solid renal lesions; of these patients, 18 gave consent for and underwent contrast-enhanced ultrasonography with perflubutane in addition to CT; 13 underwent dynamic contrast-enhanced CT, and 5, who could not be administered iodinated contrast media, underwent unenhanced CT. The final diagnoses were based on histopathological findings or the presence/absence of enlargement of the lesion during follow-up.

Results:
Of the 19 lesions in 18 patients, 14 were diagnosed as RCC and 5 as benign cysts. CT facilitated accurate diagnosis in 10/19 lesions (52.6%) with obvious enhancement (≥20 Hounsfield units [HU]), while definitive diagnosis by CT was difficult in 9 lesions: 2 lesions showed ambiguous enhancement (10–20 HU), 1 lesion was an inflammatory cyst with obvious enhancement, and 6 lesions were assessed by unenhanced CT. Compared with CT, contrast-enhanced ultrasonography allowed more accurate diagnosis (McNemar test, P = .02) in 17/19 lesions (89.5%, 14 RCC and 3 cysts; including all lesions assessed by unenhanced CT and 2 with ambiguous enhancement on CT), with 1 false-positive (inflammatory cyst with hyper-enhancement) and 1 false-negative result due to deep location of the lesion.

Conclusions:
Contrast-enhanced ultrasonography was useful for the diagnosis of RCC in dialysis patients with suspected solid renal lesions especially when contrast enhancement was not obvious on CT or contrast-enhanced CT could not be performed.