bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Single-Port Laparoscopic Totally Extraperitoneal Hernioplasty Versus Conventional Laparoscopic Totally Extraperitoneal Hernioplasty
Authors: Fang Chu-Wen , Chiu Allen W. , Huang Steven Kuan-Hua 
Published: November 2020

Background To evaluate the safety and outcomes of single-port laparoscopic totally extraperitoneal (SPLTEP) and conventional laparoscopic totally extraperitoneal (CLTEP) hernioplasty. Methods Retrospectively, we collected patients who underwent a laparoscopic totally extraperitoneal approach. The inclusion criteria were as follows: (1) male patients aged >20 years, (2) untreated hernia, and (3) American Society of Anesthesiologists (ASA) score ≤3. The exclusion criteria included: (1) additional procedures received during surgery, (2) inguinoscrotal hernia, (3) ASA score >3, (4) previous lower abdominal surgery, (5) bleeding disorders, and (6) incarcerated, obstructed, strangulated, or recurrent inguinal hernias. Patients were classified into SPLTEP and CLTEP groups. The demographics, body mass index (BMI), ASA score, comorbidities, blood loss, operation time, postoperative length of stay (LOS)/complications, hernia recurrence, visual analog scale (VAS), and postoperative analgesic requirements were collected for analysis. Results A total of 246 patients were enrolled. There were 103 patients in the SPLTEP group and 143 patients in the CLTEP group. The mean age was 56.1 ± 16.2 years versus 57.9 ± 15.1 years. There were no significances in demographics, BMI, ASA score, comorbidities, blood loss, operation time, postoperative LOS/complications, and hernia recurrence. The SPLTEP group had a shorter postoperative LOS, lower VAS at 18 hours postoperation, and a reduced amount of 24-hour postoperative analgesics. Conclusion SPLTEP hernioplasty is as safe as the CLTEP procedure. In addition, the SPLTEP group had a shorter LOS and a lower VAS score and required less postoperative analgesics. Further studies may focus on long-term complications, hernia recurrence, and chronic pain in these 2 groups.
Employment and suicidal rates during economic recession: A country-targeted integrative review
Authors: Kamekis Apostolos , Rachiotis George , Markaki Adelais , Samara Vasiliki , Symvoulakis Emmanouil K. 
Published: November 2020

Background: The economic crisis’ effects on suicide rates for countries undergoing or exiting austerity measures have been widely debated. This integrative review aimed to identify, appraise, and synthesize available evidence of employment status effect on suicide mortality rates in Greece during the recent economic recession period. Methods: A literature review of studies evaluating suicides in the general Greek population, as well as across age and gender groups, in relation to employment during the economic crisis period was performed. PubMed electronic database was searched for relevant articles published in English or Greek language from 2009 up to February 2020. Appraisal was carried out based on the Hierarchy of Evidence Rating System and the GRADE guidelines. Results: A total of 24 articles met all inclusion criteria with 20 of them at level IV, 2 at level VII, and 2 at level VIII. A total of 18 studies reported increase of suicide rates during the economic recession period. About 12 studies examined the co-relation between unemployment and suicide rate, with ten studies showing a positive correlation. Moreover, thirteen studies reported data on the effect of gender and age variables on suicide rates. Conclusion: Evidence shows that suicide mortality rates in Greece increased after the eruption of economic recession, particularly after the implementation of radical austerity measures (2011–2014). This increase was positively correlated with unemployment and was more prominent among males of working age. Further in depth epidemiological research of regional variations in terms of profile and contributing or enabling factors of suicidal behavior is needed.
Five thousand years of minimal access surgery: 3000BC to 1850: early instruments for viewing body cavities
Authors: Hargest Rachel 
Published: November 2020

Summary Surgeons and their patients recognise that one of the major advances in surgical technique over the last 20 years has been the growth of minimal access surgery by means of laparoscopic and robotic approaches. Partnerships with industry have facilitated the development of advanced technical instruments, light sources, recording devices and optics which are almost out of date by the time they are introduced to surgical practice. However, lest we think that technological innovation is entirely a modern concept, we should remember that our predecessors were masters of their craft and able to apply new technologies to surgical practice. The history of minimal access surgery can be traced back to approximately 5000 years ago and this review aims to remind us of the achievements of historical doctors and engineers, as well as bring more modern developments to wider attention. This review will comprise a three-part series: Part I 3000BC to 1850 Early instruments for viewing body cavities Part II 1850 to 1990 Technological developments Part III 1990 to present Organisational issues and the rise of the robots
Does an enhanced recovery after surgery protocol affect perioperative surgical outcomes in stage III tubercular empyema? A comparative analysis of 243 patients
Authors: Pulle Mohan Venkatesh , Tiwari Neha , Asaf Belal Bin , Puri Harsh Vardhan , Bishnoi Sukhram , Gopinath Srinivas Kodaganur , Kumar Arvind 
Published: November 2020

Background Enhanced recovery after surgery protocols in tuberculous empyema surgery have the potential for improved outcomes, but have not been studied widely. This study aimed to analyze the outcomes after implementation of an enhanced recovery after surgery protocol in patients undergoing surgery for tubercular empyema. Methods A retrospective analysis of patients who underwent surgery for tuberculous empyema in a dedicated thoracic surgery center from March 2012 to March 2019 was performed. The control group included patients operated on between March 2012 and March 2016. The enhanced recovery after surgery protocol was strictly introduced into our practice from April 2016. The study group included patients operated on between April 2016 and March 2019. All perioperative outcomes were measured, documented, analyzed, and compared between the two groups. There were 166 patients in the control group and 77 in the study group. Results Intraoperative blood loss ( p = 0.0001), prolonged air leak ( p = 0.04), chest tube duration ( p = 0.005), and length of stay ( p = 0.003) were significantly reduced in the study group. Overall rates of postoperative complications ( p = 0.04) including wound infection ( p = 0.01) were also significantly lower in the study group. Conclusions Implementation of an enhanced recovery after surgery protocol in patients undergoing surgery for tuberculous empyema is feasible and effective. Application of such a protocol leads to less intraoperative blood loss, shorter hospital stay and duration of chest drainage, and fewer complications. Application of enhanced recovery after surgery protocols are strongly recommended in tubercular empyema surgery.
Caregiver Burden and Disability in Somatoform Disorder: An Exploratory Study
Authors: Chinneimawi Esther , Nagarajan Padmavathi , Menon Vikas 
Published: November 2020

Background: Very few Indian studies have explored disability among patients with somatoform disorder and the burden experienced by their caregivers. We aimed to assess the levels of disability among patients with somatoform disorder and the levels of burden among their caregivers and compare these parameters against patients with schizophrenia. Methods: Participants included adults with a diagnosis of somatoform disorders (F45.0–F 45.9) ( n = 28) or schizophrenia (F20.0–F20.9) ( n = 28) diagnosed as per the International Classification of Diseases, Tenth Revision ( ICD-10), clinical descriptions, and diagnostic guidelines, as well as their caregivers. The WHO Disability Assessment Schedule 2.0 and Family Burden Interview Schedule were used to assess patient disability and caregiver burden, respectively. Independent Student’s t-test or chi-square test was used to compare relevant sociodemographic and clinical parameters. Results: Out of 56 patients, the mean (±SD) age of the sample was 38.6 (±10.5) years. Females constituted a slender majority of the sample ( n = 29, 51.8%). The mean disability score of patients with somatoform disorders was slightly higher (83.6 ±20.9) than that of patients with schizophrenia (82.3 ±16.7). Similarly, the mean burden score of caregivers of patients with somatoform disorders was nominally higher (18.96 ±9.9) than that of caregivers of patients with schizophrenia (15.7 ±9.7). Neither of these differences approached statistical significance (P > 0.05). Conclusion: Patients with somatoform disorders experience considerable levels of disability, and their caregivers go through various levels of burden in their daily life that is comparable to schizophrenia.
Social Cognition and Neuro-cognition in Patients with Bipolar Disorder, Their First-Degree Relatives and Healthy Controls
Authors: Ganesh Uma Maheswari , Shwetha TS  , Bhandary Rajeshkrishna P 
Published: November 2020

Background: Studies focusing on assessing social cognition deficits in schizophrenia have been expanded to bipolar disorder considering the similarities shared between the two conditions. Existing research has identified significant deficits in social cognitive skills independent of mood states and neurocognitive deficits, which could indicate the potentiality of this domain to be an endophenotype for bipolar disorder. Methods: The current study assesses the impairments in social cognition in patients with bipolar disorder and their first degree relatives, simultaneously testing for neurocognition as well, and comparing their performance to healthy controls. Fifty four participants were recruited, with 18 participants in each group. MATRICS Consensus Cognitive Battery was used to test neurocognition and Social Cognition Rating Tool in Indian Setting was administered for testing social cognition. Results: Significant deficits were found in social cognition and neurocognition (at p<.01) in the patient group when compared to both probands and healthy controls but no difference between probands and healthy controls. This finding established impairments in socio-cognitive functioning in remitted patients. Conclusion: The study has identified persistent deficits in social and neuro-cognition despite remission, having significant clinical implications in terms developing remediation programs for social cognition and planning early intervention as social cognition deficits have been identified as potential risk factors.
Psychological Distress, Coping and Perceived Social Support Among Partners of Women with Postpartum Onset Severe Mental Illness (SMI) Admitted to a Mother–Baby Unit
Authors: Pradeepkumar PC , Hamza Ameer , Ragesh G , Ganjekar Sundarnag , Thippeswamy Harish , Chandra Prabha S , Desai Geetha 
Published: November 2020

Background: The presence of a severe mental illness in the mother during the postpartum period may impact the whole family and specifically have an effect on the health of the spouse. The current study aimed to assess psychological distress, coping, and perceived social support of spouses of women with postpartum onset severe mental illness. Methodology: A cross-sectional descriptive research design was used, and 30 spouses of the women admitted to the mother–baby unit (MBU) for psychiatric inpatient care were included in the study. The assessments included sociodemographic details, Kessler psychological distress scale (K10), brief coping orientation to problems experienced scale (brief COPE), and Zimets’ multidimensional scale of perceived social support. Results: Around 50% of the spouses experienced severe psychological distress. Nearly 40% of spouses reported poor coping and 56.7% of spouses had moderate social support from family and friends. Conclusion: The findings indicate the need to address distress and coping in spouses of women with postpartum onset SMI.
Telerehabilitation in Psychiatry
Authors: Jayarajan Deepak , Sivakumar Thanapal , Torous John B , Thirthalli Jagadisha 
Published: November 2020

The COVID-19 pandemic has interrupted the usual mechanisms of healthcare delivery and exacerbated symptoms of mental illnesses. Telemedicine has morphed from niche service to essential platform, with newly released guidelines that cover various aspects of tele-mental health delivery. Rehabilitation services, which incorporate a range of psychosocial interventions and liaison services, have been significantly impacted too. They are currently more institute-based than community-based in India. However, recent legislation has mandated that community-based rehabilitation options be available. While a large treatment gap for mental health issues has always existed, telemedicine provides an opportunity to scale services up to minimize this gap. Community-based rehabilitation can be delivered over various platforms, from text to phone to videoconferencing, and various devices. Telemedicine is cost-effective, and enables delivery of services where existing services are inadequate. The recent guidelines allow other healthcare workers to be involved in mental health service delivery. Hence, in addition to direct delivery of services, telerehabilitation can facilitate task-shifting, with mental health professionals mentoring and supervising existing human resources, such as ASHA workers, VRWs, DMHP programme staff, and others. Tele-rehabilitation also poses challenges - not all needs can be met; access and privacy can be a problem in resource-scarce settings; liaison with existing services is required; and organisations need to plan appropriately and re-allocate resources. Digital access to welfare benefits and interventions must be expanded without disadvantaging those without internet access. Yet, many rehabilitation interventions can be adapted to telemedicine platforms smoothly, and task-shifting can broaden access to care for persons with disability.
Comparison of single-stage and two-stage bilateral video-assisted thoracic surgery
Authors: Lan Lan , Qiu Yuan , Zhang Canzhou , Ma Tongtong , Cen Yanyi 
Published: November 2020

Objective Single-stage sequential bilateral video-assisted thoracoscopic surgery (VATS) is a controversial procedure. In the present study, we retrospectively compared the outcomes of single-stage and two-stage VATS. Methods This study involved patients who underwent single-stage sequential bilateral VATS (SS-VATS group) or two-stage VATS at a 3-month interval (TS-VATS group) for treatment of non-small cell lung cancer from 2010 to 2018. The major outcome was the comparison of intraoperative changes. Results The inspiratory peak pressure was higher, the incidences of intraoperative hypoxia and unstable hemodynamics were higher, the surgical time was longer, and the durations of the intensive care unit stay and postoperative hospitalization were longer in the SS-VATS group than in the TS-VATS group. However, the chest tube duration, incidence of postoperative mechanical ventilation, and clinical complications were not different between the two groups. Conclusions Compared with two-stage VATS, single-stage sequential bilateral VATS can be performed for successful treatment of bilateral pulmonary lesions with a shorter total time and higher cost-effectiveness in terms of anesthesia and hospitalization but with a higher incidence of intraoperative adverse effects and a longer hospital stay.
Investigating joint attention in a guided interaction between a child with ASD and therapists: A pilot eye-tracking study
Authors: Ambrose David , MacKenzie Diane E , Ghanouni Parisa , Neyedli Heather F 
Published: November 2020

Introduction Deficits in joint attention are commonly seen in children with autism spectrum disorder. Research examining joint attention in autism spectrum disorder commonly uses two broad strategies to cue and measure joint attention: behavioral observation and eye tracking. These strategies trade off prioritizing ecological validity vs. gaze measurement accuracy, with a focus on one sacrificing the other. The purpose of this case study was to develop a method to accurately measure gaze position while maintaining an ecologically valid dyadic interaction. Methods A child with autism spectrum disorder completed two developmentally appropriate tabletop activities. Each activity was guided by a different occupational therapist who purposefully used a different interaction style with the child. Mobile eye trackers worn by both the child and the therapist recorded the dyadic interactions. Data collection included audio and video recording of interactive behaviors, eye movements and visual fixations in regions of shared interest. Results Differences were detected in gaze use and interactive joint attention behaviors between the therapists working with the child and within the child’s respective dyadic interactions. Conclusions The proof of concept method maintained both ecological validity and measurement accuracy of therapist–child joint attention. This method has promise to be scaled for larger studies.
Assessment of Hearing Impairment in NICU Graduates by Otoacoustic Emission and Brainstem Evoked Response Audiometry Tests
Authors: Aradhana Aparna , Sarangi Gadadhar , Saboth Prasant , Tripathy Radha 
Published: November 2020

Objectives: To find out the incidence of hearing impairment in Neonatal Intensive Care Unit (NICU)-admitted newborns and to correlate between several risk factors. Design: Prospective observational study. Setting: In a tertiary teaching hospital of Odisha between October 2014 and October 2016. Study population: 100 newborns delivered in the institution and admitted in NICU with usual indications and risk factors that underwent otoacoustic emission 1 and 2 (OAE1, OAE2) and Brainstem Evoked Response Audiometry (BERA). Results: 84 babies in OAE1 and 86 babies in OAE2 got “pass” results. In BERA test, 92 babies got normal waveform. 7 (13.7%) of 51 premature babies, 5 (38.5%) of 13 very low birth weight babies, 7 (17.5%) of 40 babies receiving ototoxic medication for >5 days, 7 (31.8%) of 22 babies with hyperbilirubinemia, 6 (42.9%) of 14 babies with sepsis, 5 (20%) of 20 babies with birth asphyxia, 3 (60%) of 5 babies under mechanical ventilation for >5 days, 1 baby with ear abnormality, and 1 (50%) out of 2 babies with congenital infections had hearing impairment and statistically significant association with abnormal OAE and BERA test. Conclusion: There is high incidence of hearing loss in NICU-admitted newborns. OAE and BERA both should be performed for complete evaluation of hearing. Important risk factors are elaborated. Predischarge hearing assessment in NICU is most important.
The extension of collective agreements in France, Portugal and Spain
Authors: García Calavia Miguel Ángel , Rigby Michael 
Published: November 2020

This article examines the role of extension provisions for collective agreements in France, Portugal and Spain, three countries that have faced pressure to introduce more flexibility in their employment regimes during recent economic crises. The article establishes the continuing importance of extension provisions for maintaining high bargaining coverage in all three countries and traces the origin of national differences in their evolution to the strategies of the various actors, governments, employers and trade unions, and the context in which they are operating. It also looks at the characteristics of the extension regulations themselves. Cet article examine le rôle des mécanismes d’extension des accords collectifs en France, au Portugal et en Espagne, trois pays qui ont été contraints d’introduire plus de flexibilité dans leurs régimes d’emploi durant les récentes crises économiques. L’article établit l’importance constante des dispositifs d’extension pour maintenir une couverture de négociation élevée dans ces trois pays et retrace l’origine des différences nationales dans leur évolution par rapport aux stratégies des différents acteurs, gouvernements, employeurs et syndicats, et au contexte dans lequel ils fonctionnent. Il examine également les caractéristiques des règles d’extension proprement dites. Der vorliegende Artikel untersucht die Regelungen für die Ausweitung von Tarifverträgen in Frankreich, Portugal und Spanien. In diesen drei Ländern gibt es Forderungen nach mehr Flexibilität in der Gestaltung von Arbeitsverträgen vor dem Hintergrund der Wirtschaftskrisen der letzten Jahre. Der Artikel beschreibt die unverminderte Bedeutung dieser Ausweitungsregelungen für den Erhalt eines hohen Deckungsgrades von Tarifverträgen in allen drei Ländern und geht den Ursachen für unterschiedliche nationale Entwicklungen entsprechend den Strategien der einzelnen Akteure, Regierungen, Arbeitgeber und Gewerkschaften in ihrem jeweiligen Handlungskontext nach. Der Artikel befasst sich ebenfalls mit den Merkmalen der verschiedenen Ausweitungsregelungen.
Coping with the residency program during COVID-19: Hematology oncology pharmacy residents’ perspective
Authors: AlAzmi Aeshah A , AlNajjar Fouad , AlShomrani Majed 
Published: November 2020

Introduction The COVID-19 pandemic has led to significant changes in all governmental activities in Saudi Arabia including training and teaching, with the majority of such activities suspended in response to the COVID-19 pandemic. We aim to share the challenges that Hematology Oncology Pharmacy (HOP) residents faced during the quarantine period and provide recommendations on how to cope with the residency journey. Method We followed a qualitative methodological approach in March 2020 using a structured virtual group discussion for data generation. Results All six PGY2 hematology oncology pharmacy (HOP) residents were included in the group discussion. The group agreed that the need for HOP services during this pandemic is beyond the scope of oncology pharmacists’ normal daily practice. The group recognized two fundamental points. First, the goal of the current training should be customized to the most pressing need and recognized at the national level. Second, the current training system should be improved to ensure efficient use of current resources. On this basis, the group developed six main recommendations for action. Conclusion The current situation is a challenge for all healthcare providers, and the majority of the nation’s current generation never dealt with such a situation in days gone by. This paper presents the challenges that should be addressed at the national level and provide a fundamental consensus recommendation for practical approaches to maximize learning and minimize disruption to trainees’ progression while maintaining patient-pharmacy quality of care.