bluuebunny/crossref_metadata_2025_split huggingface dataset:
The accuracy of ultrasound to predict endotracheal tube size for pediatric patients with congenital scoliosis
Authors: Hao Jianhong , Zhang Jie , Dong Buhuai , Luo Zhenguo 
Published: May 2020

Abstract
Background: Ultrasonography has been used for prediction the endotracheal tube(ETT) size through measuring the cricoid cartilage diameter. The aim of this study was to determine the accuracy of ultrasound to predict ETT size for pediatric patients with congenital scoliosis.Methods:Fifty pediatric patients underwent scoliosis surgery were included in the study. According to the position of scoliosis, patients were divided into three groups: Group C (cervical lateral bending); Group T ( thoracic scoliosis); and Group L (lumbar scoliosis). For all participants, the transverse diameter of the cricoid cartilage was measured with ultrasonography and the initial ETT size was chosen according to the measurements, then the leak test was used to determine the best‑fit ETT size. In each group, the ETT size measured by ultrasound and the best‑fit ETT size were compared using Bland-Altman analysis and linear regression analysis.Results: There was a strong correlation between the best‑fit ETT size and the ETT size predicted by ultrasound in Group T (r=0.93, p<0.001) and Group L(r=0.95, p<0.001) and a moderate correlation in Group C(r=0.83, p<0.001). Bland-Altman analysis show that the ETT size was over estimated by ultrasound in pediatric patients with cervical lateral bending.Conclusion: Ultrasound is a reliable tool to predict ETT size for pediatric patients with thoracic scoliosis and lumbar scoliosis. However, compared to what was predicted by ultrasonography, pediatric patients with cervical lateral bending need a smaller sized ETT.
Short- and long-term mortality prediction in critically ill subjects: a cohort study
Authors: Czajka Szymon , Ziębińska Katarzyna , Marczenko Konstanty , Posmyk Barbara , Szczepańska Anna , Krzych Łukasz 
Published: May 2020

Abstract
Background. There are several scoring systems used for in-hospital mortality prediction in critical illness. Their application in a local scenario requires validation to ensure appropriate diagnostic accuracy. Also, their use in assessing post-discharge mortality in the ICU survivors has not been extensively studied.Aim. To evaluate the ability of APACHE II, III and SAPS II to predict in-hospital and post-discharge mortality in adult ICU patients.Material and methods. APACHE II, APACHE III and SAPS II, with corresponding predicted mortality ratios, were calculated for 303 consecutive patients admitted to the 10-bed ICU in 2016. Long-term mortality was calculated based on information taken from PESEL database.Results. Median APACHE II, APACHE III and SAPS II scores were 19, 67 and 44 points, with corresponding in-hospital mortality ratios of 28.1, 18.5 and 34.8%. Observed in-hospital mortality was 35.6%. 12-month post-discharge mortality reached 17.4%. All systems predicted in-hospital mortality (p<0.05): APACHE II (AUC=0.783; 95%CI 0.732-0.828), APACHE III (AUC=0.793; 95%CI 0.743-0.838) and SAPS II (AUC=0.792; 95%CI 0.742-0.836), as well as mortality after ICU discharge (p<0.05): APACHE II (AUC=0.712; 95%CI 0.643-0.775), APACHE III (AUC=0.721; 95%CI 0.653-0.783) and SAPS II (AUC=0.695; 95%CI 0.625-0.759), with no statistically significant difference between them (p>0.05).Conclusions. Although the predictive values were the highest for APACHE III and SAPS II, no differences were noticed between the scores. In case of post-discharge mortality, diagnostic accuracy was much lower. Further studies are needed to create scores estimating the long-term prognosis of subjects successfully discharged from the ICU.
Therapeutic Pulmonary Telerehabilitation Protocol in patients affected by COVID-19, confined in their homes: Study Protocol for a Randomized Control Trial
Authors: Gonzalez-Gerez Juan Jose , Utrera Carlos Bernal , Anarte-Lazo Ernesto , García-Vidal Jose Antonio , Botella-Rico José Martin , Rodriguez-Blanco Cleofas 
Published: May 2020

Abstract
Background: In December 2019, 27 cases of pneumonia, of unknown cause, were identified in the province of Hubei (China). The WHO declared the situation as a Public Health emergency of International Concern and it was finally declared a global pandemic on March 11, 2020. Spanish Government obliges the entire population to remain confined to their homes, with exception of essential basic services, to stop the spread of COVID-19. Home isolation implies a notable physical deconditioning. Telerehabilitation methods have reported positive experiences and we propose to study in affected patients of COVID-19, due to the general house confinement of the entire Spanish population. Methods: Patients will be recruited in the regions of Andalusia, Murcia and Valencia (Spain). Patients will remain confined to their homes, and there they will carry out their assigned exercise program, which will be controlled telematically. Evaluators will attend to carry out all measurements at the beginning, during, and end of the study, telematically controlled. The patients will be randomly divided into three groups, two of them will perform a home exercise program (breathing exercises or non-specific exercises for muscle toning) and the third group will perform sedentary activities, using mental activation techniques, and will act as a sham group. We will evaluate respiratory variables and other variables of physical state through physical tests, effort and perceived fatigue. The data will be statistically analyzed, and the hypotheses will be tested between the groups, using the SPSS software, v.20, considering a 95% confidence interval. Discussion: We will analyze the results, in terms of level of fatigue and perceived exertion, physical health, and maintenance of respiratory activity of two types of exercise programs, toning and respiratory, applied in patients affected by COVID19 during the period of home confinement. We intend to investigate a field not previously studied, such as the repercussion of carrying out a toning and respiratory exercise program in these patients, in historical circumstances that no one had previously observed in Spain, since the general population has never been forced to remain confined in their homes, due to a pandemic infection, by coronavirus (COVID19). Observing the effects that these two home exercise programs could produce in patients infected with COVID19, we will try to better analyze and understand the mechanisms that are associated with worsening of breathing in this type of patient.
Marks, and their proportioning between examinations, tutorials and assignment, as determinants of the performance of nursing students in a pharmacology course
Authors: Doggrell Sheila 
Published: May 2020

Abstract
Background
In programs with higher proportions of marks allocated to ongoing assessment, the students have higher overall marks than those with a lower proportion allocated to assessment. Little or no attention has been made to how the allocation affects the academic success of students in individual courses. The purpose of this study was to determine how the allocation of marks to examinations, tutorials and an assignment affects the performance of nursing students in a pharmacology course.
Methods
For students who passed a pharmacology course (i) the marks for examinations and ongoing assessment (tutorials and/or an assignment) were compared, and (ii) regression line and correlation analysis was undertaken to determine any association between these marks. In addition, for completing students, modelling was undertaken to determine the effects of changing the allocation of marks on passing and failing rates.
Results
Nursing students who passed a pharmacology course obtained significantly lower marks in examinations than ongoing assessment, and for the ongoing assessment, lower marks in the assignment than tutorials. Regression line analysis showed that the marks in ongoing assessment (tutorials and/or the assignment) versus examination marks were a poor line-fit. The correlation coefficients between ongoing assessment and examinations were weak to moderate. A high percentage of students passed the course (> 90%) and, modelling for completing students, showed that decreasing the marks for examination would have led to slightly more students passing the pharmacology course with higher grades. In contrast, increasing the marks for examination would have dramatically decreased the number of students passing the course, and their grades.
Conclusions
The allocation of marks can have a major effect on student performance. As ongoing assessment is not a good predictor of performance in examination this has implications for students who rely on passing examinations for their advancement. For instance, nursing students in some countries (e.g. USA) are required to pass examinations prior to registration, whereas in others (e.g. Australia) they are not. Consideration needs to be given as to whether it is appropriate for nursing students who fail examinations to pass courses/programs.
Potential benefits of adaptive intensity modulated proton therapy in nasopharyngeal carcinomas: a planning comparison study
Authors: minatogawa hideki , Yasuda Koichi , Dekura Yasuhiro , Takao Seishin , Matsuura Taeko , Yoshimura Takaaki , Suzuki Ryusuke , Yokota Isao , Fujima Noriyuki , Onimaru Rikiya , Shimizu Shinichi , Aoyama Hidefumi , Shirato Hiroki 
Published: May 2020

Abstract
Background
To investigate potential advantages of adaptive intensity modulated proton beam therapy (A-IMPT) by comparing it to adaptive intensity modulated X-ray therapy (A-IMXT) for nasopharyngeal carcinomas (NPC).
Methods
Six patients with NPC treated with A-IMXT (step and shoot approach) and concomitant chemotherapy between 2015 and 2016 were selected. In the actual treatment, 46 Gy in 23fr fractions was prescribed using the initial plan and 24 Gy/12fr was prescribed using an adapted plan thereafter. New treatment planning of A-IMPT was made for the same patients using equivalent dose fractionation schedule and dose constraints. The dose volume statistics based on deformable images and dose accumulation was used in the comparison of A-IMXT with A-IMPT.
Results
The mean doses to the right parotid gland (p = 0.004), left parotid gland (p = 0.012), the oral cavity (p < 0.001), the thyroid gland (p = 0.047), the supraglottic larynx (p < 0.001), the glottic larynx (p = 0.001), the superior pharyngeal constrictor muscle (PCM) (p < 0.001), the middle PCM (p = 0.002), the inferior PCM (p < 0.001), and the cricopharyngeal muscle (p = 0.031) in A-IMPT are statistically significantly lower than those of A-IMRT with the statistical significance. The mean dose to the oral cavity, supraglottic larynx, and glottic larynx were all reduced by more than 20 GyE.
Conclusion
The adaptive approach is suggested to enhance the potential benefit of IMPT compared to IMXT to reduce adverse effects for patients with NPC.
Discovery and validation of mucosal TNF expression combined with histological score - a biomarker for personalized treatment in ulcerative colitis
Authors: Florholmen Jon R. , Johnsen Kay-Martin , Renate Meyer , Olsen Trine , Moe Øystein Kittel , Tandberg Petter , Gundersen Mona D. , Kvamme Jan-Magnus , Johnsen Knut , Løitegård Terje , Raschpichler Gabriele , Vold Cecilia , Sørbye Sveinung W. , Goll Rasmus 
Published: May 2020

Abstract
Background
There are no accurate markers that can predict clinical outcome in ulcerative colitis at time of diagnosis. The aim of this study was to explore a comprehensive data set to identify and validate predictors of clinical outcome in the first year following diagnosis.
Methods
Treatment naive-patients with ulcerative colitis were included at time of initial diagnosis from 2004–2014, followed by a validation study from 2014–2018. Patients were treated according to clinical guidelines following a standard step-up regime. Patients were categorized according to the treatment level necessary to achieve clinical remission: mild, moderate and severe. The biopsies were assessed by Robarts histopathology index (RHI) and TNF gene transcripts.
Results
We included 66 patients in the calibration cohort and 89 patients in the validation. Mucosal TNF transcripts showed high test reliability for predicting severe outcome in UC. When combined with histological activity (RHI) scores the test improved its diagnostic reliability. Based on the cut-off values of mucosal TNF and RHI scores from the calibration cohort, the combined test had still high reliability in the validation cohort (specificity 0.99, sensitivity 0.44, PPV 0.89, NPV 0.87) and a diagnostic odds-ratio (DOR) of 54.
Conclusions
The combined test using TNF transcript and histological score at debut of UC can predict severe outcome and the need for anti-TNF therapy with a high level of precision. These validated data may be of great clinical utility and contribute to a personalized medical approach with the possibility of top-down treatment for selected patients.
OSCE 3D: a virtual clinical skills assessment tool for coronavirus pandemic times
Authors: Faria Alexandre Loureiro , Perdigão Anne Carolinne Bezerra , Marçal Edgar , Kubrusly Marcos , Peixoto Raquel Autran Coelho , Junior Arnaldo Aires Peixoto 
Published: May 2020

Abstract
Background : In pandemic times where the “lockdown strategy” has been adopted, the use of innovations using technological resources such as the creation of instruments that can replace traditional teaching-learning methods in the training of health professionals is essential. The aim of this study was to develop and evaluate the usability of a realistic interactive simulation computer system using three-dimensional imaging technology and virtual reality with free-access computational tools available on the web. Methods : the development of a prototype (OSCE 3D) was based on the steps used for the construction of simulation software of a "Serious Game". An experimental phase was carried out to assess usability, through a questionnaire based on the System Usability Scale. The study was approved by the Research Ethics Committee of the institution and all patients signed the Informed Consent Form. Results : a total of 39 undergraduate medical students from the 6th semester of a private university center of northeast do Brazil voluntarily participated in the evaluation of the OSCE 3D. The usability evaluation presented a mean score of 75.4 with a margin of error of 3.2, considered a good usability according to the literature. Conclusions : this work allowed the development of a low-cost prototype, using a three-dimension realistic simulation system for OSCE assessment stations. This product, even in the prototype phase, showed good usability.
Quality of Nursing Education in Philippines: Difference in Quality of Nursing Programme in relation to Profile of Faculty Members
Authors: Appiah Stella 
Published: May 2020

Abstract
Background
The subject of continuous quality of nursing education programme is an extremely sensitive issue worldwide, particularly in Philippines where high number of their trained registered nurses are exported to both developed and developing countries. The assessment of quality of nursing education programmes are usually measured using passing rates in licensure examinations by several government organizations. However, few studies have associated quality of nursing education to the quality of nursing instructors, this study probed further and determined whether the quality of nursing education programmes differs according to profile of faculty members in Philippines colleges of higher education in higher educational institutions.
Methods
A cross-sectional survey study design was employed in this study. One hundred and eight-five (185) faculty members in fifteen (15) higher educational institutions were selected for the research using purposive sampling. The study was carried out with the period of January 1 – June 30, 2017. Close-ended structured questionnaires based on study objectives were used to collect data. Frequency and Percentages were used to analyse the profile of faculty members whereas weighted means from a four liker’s scale was used to interpret the extent of perceived quality of nursing education programme.
Results
Majority, 39% and 46% of faculty members had 1–5 years’ clinical experience and 6–10 years of teaching experience respectively. Study participants with a grand weighted mean of 3.84 out of 4.00 strongly agreed that quality of nursing education programme is synonyms with other universities in the world. Significant differences existed in the quality of mission/vision/goals/objectives (p-value = 0.008), curriculum and instruction (p-value = 0.038), administration of nursing programme (p-value = 0.025), faculty development programme (p-value = 0.003), physical structure and equipment (p-value = 0.016), student services (p-value = 0.017), admission of students (p-value = 0.010) and quality assurance system (p-value = 0.009) in relation to teaching experience of faculty members.
Conclusion
Faculty members strongly perceived nursing education programmes to be of good quality in this study. Teaching experience of instructors predicted significant differences in the quality of nursing education programme in all the quality matrix indicators. However, clinical experience and job category of faculty members rather showed that quality of nursing education is the same throughout all the higher educational institutions.
Triaged treatment-based conventional weapon combat wound classification code design and injury spectrum statistical analysis
Authors: PENG BO , Liu Shuo , Pan Fei , He Zhen , Li Tan-shi 
Published: May 2020

Abstract
Purpose
To provide evidence for the rapid and efficient classification of combat casualties while simultaneously determining the types of high-incidence fatal injuries that require emergency treatment to support the triage of combat wounds in mass casualty situations.
Methods
The three-tiered treatment echelon consisting of battlefield on-site first aid, emergency treatment, and early treatment was used to design an expanded combat wound classification code system according to the differential needs of combat wound treatment. Three dimensions of evaluation indicators consisting of likelihood, importance, and suitability were established and an optimized quasi-HHI index was used for the normalization and ranking of expert survey results.
Results
We obtained exhaustive combinations from the massive number of combat wound factors in combat wound classification codes, constructed injury spectrum frameworks within the different treatment echelons, and identified high-incidence fatal injuries in different treatment echelons.
Conclusions
Our combat wound classification codes achieved good results in terms of having higher classification speed and accuracy than traditional methods. The high incidence fatal injuries identified by the constructed combat wound spectrum can provide guidance and support when used for the improvement of treatment techniques and upgrading equipment in the Chinese People’s Liberation Army.
The association between family cohesion and disability following blunt trauma: Findings from a level-I trauma center in Saudi Arabia
Authors: Almarwani Sarah , Hijazi Leen , Alamer Modhi , Alnwaiser Jury , Aldakheel Reem , Alsheikh Khalid , Albabtin Ibrahim , Alghnam Suliman 
Published: May 2020

Abstract
Background
Injuries pose a significant burden on population health of Saudi Arabia. Even in nonfatal injuries, the burden varies from temporary to permanent disabilities. Health outcomes following injuries can vary, and predictors of recovery from disability are not well understood. In the Kingdom, family values and cohesion can differ from other countries due to several factors, including religious beliefs and cultural traditions. Learning about predictors of injury recovery can improve prevention as well as planning for rehabilitation programs. Therefore, the study aims to evaluate the association between family cohesion and recovery following blunt injuries.
Methods
This prospective study included 249 patients who were hospitalized for at least one day following blunt trauma in King Abdulaziz Medical City, Riyadh. Adult patients were interviewed twice: initially during admission, and a second interview via the phone three months after discharge. Baseline information included: demographics, injury characteristics, the five dimensions EQ-5D and family support scale. The follow-up interview captured only EQ-5D. Suboptimal family cohesion was defined as any issue with the relationship with parents, friends, spouse, or siblings. Any disability was defined as a reported limitation in one or more domains of the EQ-5D scale. Logistic regression was used to assess the association between family cohesion and recovery at three months.
Results
Of the overall sample, 169 (67.8%) responded to the second interview, and three patients passed away. About 95.2% of patients reported disabilities at baseline, while 88.1% continued to report disabilities after three months. Forty patients (16.1%) reported suboptimal family cohesion. Of these patients, 37(94.87%) were in pain, 33(82.5%) reported problems with usual activities, 32(80%) faced problems with self-care, 32 (80%) patients had difficulty in mobility, and 23(57.5%) were depressed. Multivariable regression suggested that patients with suboptimal family cohesion were less likely to recover from disabilities.
Conclusion
The prevalence of any disability three months after discharge is striking. This study suggests that health outcomes after blunt trauma are affected by the strength of the patient’s family cohesion. More research is needed to identify effective ways through which the provision of social support can reduce long term disability after trauma.
Effectiveness of switching between TNF inhibitors in patients with axial spondyloarthritis: is the reason to switch relevant?
Authors: Manica Santiago Rodrigues , Sepriano Alexandre , Pimentel-Santos Fernando M , Gouveia Nélia , Barcelos Anabela , Branco Jaime , Bernardes Miguel , Ferreira Raquel Miriam , Vieira-Sousa Elsa , Barreira Sofia , Vinagre Filipe , Roque Raquel , Santos Helena , Madeira Nathalie , Rovisco João , Daniel Alexandra , Ramiro Sofia 
Published: May 2020

Abstract
Background: To investigate whether the reason to discontinue the first TNF inhibitor (TNFi) affects the response to a second TNFi in axial spondyloartrhtis (axSpA).Methods: Patients with axSpA from the Rheumatic Diseases Portuguese Register (ReumaPt), who discontinued their first TNFi and started a second TNFi between June 2008 and May 2018 were included. Response was assessed by the Ankylosing Spondylitis Disease Activity Score (ASDAS) clinically important improvement (ASDAS-CII), major important improvement (ASDAS-MI), low disease activity (ASDAS-LDA) and inactive disease (ASDAS-ID). The reason for discontinuation of the first TNFi was defined, according to ASDAS-CII as: primary failure (no response ≤6 months); secondary failure (response ≤6 months but lost thereafter); adverse events; other. The association between the reason of discontinuation of the first TNFi and response to the second TNFi over time was assessed in multivariable generalized equation (GEE) models.Results: In total, 193 patients were included. The reason of discontinuation of the first TNFi did not influence the response to a second TNFi, according to the ASDAS-CII. However, a difference was found with more stringent outcomes, e.g. there was a higher likelihood to achieve ASDAS-ID with the second TNFi for patients discontinuing the first TNFi due to secondary failure (OR: 7.3 [(95%CI: 1.9; 27.7]), adverse events (OR: 9.1 [2.5; 33.3]), or other reasons (OR: 7.7 [1.6; 37.9]) compared to primary failure.Conclusion: Patients with axSpA with secondary failure to their first TNFi, compared to those with primary failure, have better response to the second TNFi according to stringent outcomes.