bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extracorporeal Membrane Oxygenation in Pregnancy: An Analysis of the Extracorporeal Life Support Organization Registry
Authors: Ramanathan Kollengode , Tan Chuen Seng , Rycus Peter , Anders Marc , Lorusso Roberto , Zhang John J. Y. , MacLaren Graeme 
Published: February 2020

Objectives:
We examined data from the International Registry of the Extracorporeal Life Support Organization to identify risk factors for mortality in pregnant and peripartum patients receiving extracorporeal membrane oxygenation.

Design:
Retrospective analysis.

Setting:
International Registry of Extracorporeal Life Support Organization.

Patients:
We collected de-identified data on all peripartum patients who needed extracorporeal membrane oxygenation between 1997 and 2017 using International Classification of Diseases, 9th and 10th Edition criteria.

Interventions:
Our primary outcome measure was in-hospital mortality. We also collected data on demographics, preextracorporeal membrane oxygenation ventilator, hemodynamic and biochemical parameters, extracorporeal membrane oxygenation mode, duration, and complications. Initial bivariate analysis assessed potential associations between survival and various preextracorporeal membrane oxygenation as well as extracorporeal membrane oxygenation-related factors. Variables with p values of less than 0.1 were considered for logistic regression analysis which identified predictors of mortality.

Measurements and Main Results:
There were 280 peripartum patients who received extracorporeal membrane oxygenation. Overall maternal survival was 70%, with observed mortality for these patients decreasing over the 21-year time period. Multivariate regression identified extracorporeal cardiopulmonary resuscitation (odds ratio, 3.674; 95% CI, 1.425–9.473; overall p = 0.025), duration of extracorporeal membrane oxygenation (< 66 hr: odds ratio, 1; 66–128 hr: odds ratio, 0.281; 95% CI, 0.101–0.777; p = 0.014; 128–232 hr: odds ratio, 0.474; 95% CI, 0.191–1.174; p = 0.107; and > 232 hr: odds ratio, 1.084; 95% CI, 0.429–2.737; p = 0.864; overall p = 0.017), and renal complications on extracorporeal membrane oxygenation (odds ratio, 2.346; 95% CI, 1.203–4.572; p = 0.012) as significant risk factors for mortality. There was no statistically significant difference in mortality between venovenous versus venoarterial versus mixed group extracorporeal membrane oxygenation (23.9 vs 34.4 vs 29.4%; p = 0.2) or between pulmonary versus cardiac indications (1.634; 95% CI, 0.797–3.352; p = 0.18) for extracorporeal membrane oxygenation.

Conclusions:
On analysis of this multicenter database, pregnant and peripartum patients with refractory cardiac or respiratory failure supported on extracorporeal membrane oxygenation had survival rates of 70%. We identified preextracorporeal membrane oxygenation as well as extracorporeal membrane oxygenation-related factors that are associated with mortality.
Refusal of Radiation Results in Inferior Survival in Endometrial Cancer
Authors: Parsons Matthew W. , Francis Samual , Maurer Kathryn A. , Grant Jon , Gaffney David K. 
Published: February 2020

Objective:
We sought to understand factors associated with refusal of adjuvant radiotherapy in endometrial cancer and its impact on outcomes.

Methods:
Data from the National Cancer Database for patients who underwent surgery for nonmetastatic endometrial cancer between 2004 and 2015 were pooled. The Pearson χ2 test and multivariate logistic regression analyses were used to assess demographic, clinical, and treatment factors. Inverse probability of treatment weighting was used to account for differences in baseline characteristics. Kaplan-Meier analyses and doubly-robust estimation with multivariate Cox proportional hazards modeling were used to analyze overall survival (OS).

Results:
We identified 4739 of 80,803 patients (5.9%) who refused radiotherapy. Factors associated with refusal were: no insurance (relative risk [RR]=1.66, P<0.01), Medicare (RR=1.42, P<0.01), living >50 miles from treatment (RR=1.34, P<0.01), Charlson-Deyo Comorbidity Scores of 1 (RR=1.16, P<0.01) or ≥2 RR=1.38, P<0.01), age above 60 years (RR=1.28, P<0.01), International Federation of Gynecology and Obstetrics (FIGO) stages IIIA (RR=1.63, P<0.01) and IIIC (RR=1.65, P<0.01) disease, papillary (RR=1.69, P<0.01) and clear cell histology (RR=1.64, P<0.01). Factors associated with radiation therapy receipt included: Hispanic race (RR=0.61, P<0.01), income >$63,000 (RR=0.89, P=0.044), undergoing chemotherapy (RR=0.17, P<0.01), FIGO stages IB (RR=0.81, P<0.01) and II (RR=0.70, P<0.01) disease, and lymphadenectomy (RR=0.79, P<0.01). After weighting, 5-year OS was significantly lower with refusal (74.3% vs. 79.7%, P<0.01). This survival decrement was maintained across FIGO stages.

Conclusions:
We identified characteristics associated with radiation refusal, including socioeconomic barriers, advanced disease stage, and histology. Refusal of radiotherapy conferred decreased OS across FIGO stages.
Nasal Valve Insufficiency in Dermatologic Surgery
Authors: Barbosa Naiara S. , Baum Christian L. , Arpey Christopher J. 
Published: February 2020

BACKGROUND
Few publications have addressed nasal valve (NV) insufficiency as a complication of Mohs micrographic surgery.

OBJECTIVE
To comprehensively review the literature and further characterize the causes, prevalence, evaluation, and management of NV insufficiency as it relates to cutaneous oncology.

MATERIALS AND METHODS
A PubMed search was completed to identify articles related to the NV in the context of Mohs micrographic surgery, cutaneous oncology, and reconstruction.

RESULTS
Nasal valve insufficiency may occur during tumor removal and/or reconstruction. Defect size larger than 1 cm; location on the ala, sidewall, or alar crease; lack of structural support; and poorly planned flaps are the main risk factors for NV insufficiency. Several surgical techniques have been described to avoid and correct this complication.

CONCLUSION
Nasal valve insufficiency may be an underrecognized and underreported complication of Mohs micrographic surgery. Nasal valve insufficiency may be identified with relatively simple tests. Knowledge of NV anatomy and preoperative function assessment is essential. Recognition of this potential complication and awareness of its prevention and management may decrease morbidity in patients undergoing cutaneous surgery.
Peripapillary and Macular Vessel Density Measurement by Optical Coherence Tomography Angiography in Pseudoexfoliation and Primary Open-angle Glaucoma
Authors: Jo Youn Hye , Sung Kyung Rim , Shin Joong Won 
Published: February 2020

Precis:
Pseudoexfoliation glaucoma eyes had a similar level of peripapillary and superficial macular vessel densities compared with primary open-angle glaucoma eyes matched for age and glaucoma severity when assessed by optical coherence tomography angiography (OCT-A).

Purpose:
To compare vessel density (VD) measured by OCT-A between primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG) in the peripapillary and macular areas.

Materials and Methods:
The circumpapillary (cpVD), parafoveal (pfVD), and perifoveal vessel densities (perifVD) were obtained using OCT-A (AngioVue/RTVue-XR) in 98 eyes from 98 subjects [age, visual acuity, visual field (VF) mean deviation (MD) matched 49 POAG and 49 PXG eyes]. Global and 8 sectoral VDs in the peripapillary capillary layer were compared. In the macula, the superficial and deep layers of the pfVD and perifVD were analyzed globally and in 4 quadrants. Univariate and multivariate linear regression models were built using cpVD, pfVD, and perifVD as dependent variables and covariates [age, intraocular pressure (IOP), axial length, signal strength index (SSI), and retinal nerve fiber layer (RNFL) thickness] were considered independent variables.

Results:
In the peripapillary region, none of the VDs differed between groups both before and after adjustment. When we adjusted superficial and deep layer macular VDs for age, IOP, SSI, axial length, and RNFL thickness, all of which could affect measurements, the 2 groups did not differ in any sector. The cpVD in POAG eyes significantly correlated with VF MD and RNFL thickness, whereas IOP, VF MD, and RNFL thickness affected cpVD in PXG. The macular VD in the deep layer was associated with only SSI in both groups.

Conclusions:
Age-matched and glaucoma severity-matched PXG and POAG did not significantly differ in cpVD or in most of the superficial macular VD parameters.
Determining Factors That Influence Nurses' Perceptions of Quality Implementations Conducted in Hospitals in Turkey
Authors: GÜR Emel , EKICI Dilek 
Published: February 2020

ABSTRACT

Background
Quality management program implementations in health services are team endeavors that involve all health service personnel. Because they are direct providers of care, nurses are best able to evaluate the influence of quality management program implementations on the health services and quality of care provided by hospitals.

Purpose
The aim of this study was to develop an instrument to determine how nurses perceive the implementation of quality management programs in hospitals. Furthermore, the nurses' perceptions of the influence of these implementations on the quality of patient care and their job satisfaction were examined.

Methods
A descriptive, comparative, cross-sectional online survey was conducted using a convenience sample (N = 388) of practicing nurses working at public and university hospitals where quality management programs were implemented. Nurses' perceptions of the implementations were analyzed using confirmatory factor analysis, whereas the influence of nurses' perceptions of quality management implementations on patient care and job satisfaction was measured using structural equation modeling approaches.

Results
This study revealed that the instrument is valid and reliable for the measurement of participant perceptions of quality management program implementations. Nurses' perceptions were generally negative, and they exhibited negative attitudes toward the implementation of quality management in the institutions where they work. However, the quality management program implementations had little influence on perceptions of the quality of patient care. Participant job satisfaction was lower than average, and the quality management program implementations conducted in the hospitals negatively affected job satisfaction. On the other hand, participants who worked at university hospitals perceived quality management program implementations more affirmatively; patient care quality and job satisfaction were viewed more positively as well.

Conclusions/Implications for Practice
Because nurses do not participate effectively in quality management program implementations, they perceive these efforts as unnecessary and the responsibility of the quality control department. It is very important to ensure that all care-service providers participate to effectively implement quality management programs in hospitals and to encourage the adoption of a culture of patient safety in all institutions.
The Use of the Gradual Yielding Mechanism During Downhill Walking in Persons With Transfemoral Amputation—A Case Study
Authors: Alexander Nathalie , Strutzenberger Gerda , Schwameder Hermann 
Published: February 2020

ABSTRACT

Introduction
To avoid collapsing of the prosthetic knee during loading, some prostheses contain a yielding mechanism, which can also be used for a safe downhill gait. The aim of this case study was to investigate 1) the influence of downhill gradient on the utilization of yielding mechanisms during gait in individuals with UTA, 2) whether the yielding gait is linked to altered spatiotemporal parameters, and 3) if prosthetic ankle components influence the selection of the yielding mechanism.

Materials and Methods
Two participants with transfemoral amputation (UFT1 and UFT2) walked overground at various slopes (from 0° to −15°) with their habitual knee device using an articulating and a rigid prosthetic ankle component. Kinematic and kinetic data were recorded at self-selected walking speed.

Results
UTF1 switched to the gradual yielding mechanism at −6° and UTF2 at −12°. UTF2 walked with the yielding mechanism with a decreased speed, step, and stride length. The use of an articulating compared with a rigid ankle component did not influence the yielding pattern.

Conclusions
First, the gradient at which the UTFs first used the yielding mechanism was found to be individual. Second, the yielding mechanism induced different alterations in spatiotemporal parameters to the participant walking at higher speed when not using the yielding mechanism. Third, using an articulating prosthetic ankle component did not alter the yielding gait pattern in two individuals with unilateral transfemoral amputation. The individual differences highlight the need for individual setups taking the different components of the prosthetic limb into account.
Hip Joint Cartilage Defects in Professional Ballet Dancers: A 5-year Longitudinal Study
Authors: Mayes Susan , Smith Peter , Stuart Debbie , Semciw Adam , Cook Jill 
Published: February 2020

Objective:
A causal link between ballet, hip pain, and pathology has not been established. Change in ballet dancers' hip pain and cartilage defect scores were investigated over 5 years.

Design:
Longitudinal.

Setting:
Professional ballet company.

Participants:
Twenty-one professional ballet dancers (52% men).

Independent Variables:
Baseline and follow-up Copenhagen Hip and Groin Outcome Score (HAGOS—pain subscale); incidence of hip-related pain and levels of dance participation collected daily over 5 years; bony morphology measured on baseline 3T magnetic resonance imaging (MRI).

Main Outcome Measure:
Change in cartilage defect score on MRI between baseline and 5-year follow-up.

Results:
Cartilage scores did not increase in 19 (90%) dancers. There was one new cartilage defect and one progressed in severity. At follow-up, all 6 dancers with cartilage defects were men. Group HAGOS pain scores were high 97.5 (7.5) and not related to cartilage defects (P = 0.12). Five (83%) dancers with baseline cartilage defects reported HAGOS pain scores <100 at follow-up. There were no time-loss hip injuries over 5 years. Two (33%) dancers with cartilage defects recorded hip-related pain (one reported minor training modification). Femoral neck-shaft angles (NSAs) were lower in men with cartilage defects [129.3 degrees (3.4 degrees)] compared with those without cartilage defects [138.4 degrees (4.5 degrees); P = 0.004].

Conclusions:
Elite level ballet did not negatively affect cartilage health over 5 years. Cartilage defects were related to low femoral NSAs. Most cartilage defects did not progress and there was minimal impact on dance participation and pain levels. Longer follow-up is required to determine the long-term sequelae for those with cartilage defects.

Level of Evidence:
1b.
Initial high-dose corticosteroids and renal impairment are risk factors for early severe infections in elderly patients with antineutrophil cytoplasmic autoantibody-associated vasculitis
Authors: Waki Daisuke , Nishimura Keisuke , Tokumasu Hironobu , Kadoba Keiichiro , Mukoyama Hiroki , Saito Rintaro , Murabe Hiroyuki , Yokota Toshihiko 
Published: February 2020

Abstract
Recent large observational studies of antineutrophil cytoplasmic autoantibody-associated vasculitis (AAV) show that severe infection is a major cause of death and that the majority of infections occur during the early phase of initiating remission-induction therapy. Many risk factors for severe infection have been suggested, but these have been inconsistent. Nevertheless, infectious risk factors in elderly patients with AAV have not been adequately investigated in previous studies.
In this retrospective observational study, we examined potential predictors of severe infection within 90 days (early severe infections) after remission-induction therapy in patients with AAV aged 65 years or older. We included 167 consecutive elderly patients with AAV admitted to our hospital. Data from medical history and remission-induction therapy were analyzed for predictive risk factors associated with early severe infections. The relationship between initial doses of corticosteroids and cumulative incidence of severe infections was also analyzed. A multivariate analysis of risk factors for early severe infections was performed using logistic regression analysis. The Kaplan–Meier method was used to estimate the overall survival, and the log-rank test was used to evaluate the differences between patients with and without early severe infections. Gray method was used to compare the cumulative incidence of severe infections in patients who did and did not receive initial high-dose corticosteroids.
Logistic regression analysis showed that initial high-dose corticosteroid administration (prednisolone ≥0.8 mg/kg/d) (odds ratio [OR] 3.86, P = .030) and serum creatinine levels at diagnosis ≥1.5 mg/dL (OR 5.13, P
= .003) were independent predictors of early severe infection although administration of cyclophosphamide or rituximab was not. The cumulative incidence of severe infections was also significantly higher in patients who received initial high-dose corticosteroids (P = .042), and patients with early severe infections exhibited a high mortality rate within 6 months (P < .001).
Our findings suggest that initial high-dose corticosteroids and renal impairment at diagnosis are associated with a higher risk of early severe infections and early death in elderly patients with AAV.
Colorectal patients’ readiness for hospital discharge following management of enhanced recovery after surgery pathway
Authors: Yang Jie , He Yuhua , Jiang Lili , Li Ka 
Published: February 2020

Abstract
The aim of this study was to ascertain the status quo of perceived readiness for hospital discharge in colorectal cancer patients who underwent enhanced recovery pathway and identify the variables that affect patients’ perceptions about their readiness for discharge.
A cross-sectional survey was conducted in West China Hospital, Sichuan University. The Readiness for Hospital Discharge Scale and the Quality of Discharge Teaching Scale were delivered to 130 colorectal cancer (CRC) patients who underwent enhanced recovery pathway. Data collection was carried out 4 hours before discharge.
The total score of readiness for hospital discharge was 149.86 ± 33.65. The multiple linear regression analysis revealed that the quality of discharge teaching, discharge to a rehabilitative institution were associated with the readiness for hospital discharge.
The level of CRC patients’ readiness for hospital discharge needs to be improved. Medical staff should improve the quality of discharge guidance and pay more attention to patients transferred to rehabilitation institutions when they leave hospital.
Effects of vitamin C supplementation on essential hypertension
Authors: Guan Yuanyuan , Dai Pengju , Wang Hongwu 
Published: February 2020

Abstract

Background:
Vitamin C as a supplement to treat hypertension has been proposed. However, it remains controversial whether vitamin C can improve blood pressure in patients with primary hypertension.

Objectives:
To analyze the effect of vitamin C (VitC) supplementation on systolic (SBP) and diastolic (DBP) blood pressure in patients with essential hypertension.

Methods:
We searched the Chinese Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, WANFANG Data, Cochrane Library, National Library of Medicine's PubMed, EMBASE, and other databases until June 2019. Eight RCTs involving 614 participants were analyzed. SBP and DBP before and after VitC supplementation were compared between the intervention and control groups. The risk of bias of individual studies was assessed using the Cochrane Collaboration risk of bias tool. Two reviewers selected studies independently of each other. The Cochrane Collaboration Review Manager 5.3 was used to perform the meta-analysis.

Results:
There was a significant difference in the change of SBP (weighted mean difference [WMD] = −4.09; 95% confidence interval [CI] −5.56, −2.62; P < .001) and DBP (WMD = −2.30; 95% CI −4.27, −.331; P = .02) between the groups. Further, there was a significant difference in the SBP (WMD = -3.75, 95% CI -6.24, -1.26, P = .003) and DBP (WMD = −3.29, 95% CI −5.98, −.60, P = .02) for the subgroup with an age ≥60 years and that with ≥35 participants. In the subgroup analysis, result for SBP with a study duration ≥6 weeks was statistically significant different (WMD = −4.77; 95% CI −6.46, −3.08; P < .001). For an intervention dose of VitC ≥500 mg daily, SBP was statistically significant (WMD = −5.01; 95% CI −8.55, −1.48; P = .005).

Conclusion:
VitC supplementation resulted in a significant reduction of blood pressure in patients with essential hypertension.
The disadvantage of morning blood pressure management in hypertensive patients
Authors: Liu Kai , Xu Ying , Gong Shenzhen , Li Jiangbo , Li Xinran , Ye Runyu , Liao Hang , Chen Xiaoping 
Published: February 2020

Abstract
To investigate whether the control of morning blood pressure (MBP) reflects the control of blood pressure (BP) in other periods (daytime, nighttime and 24-hour) and to assess whether morning BP displays a closer association with subclinical target organ damage (TOD) than the BP measured in other periods.
One thousand one hundred forty patients with primary hypertension who completed subclinical TOD detection and 24-hour ambulatory BP monitoring were included in the analysis. Pearson correlation analysis, Kappa consistency test, multiple linear regression analysis, and area under the receiver operating curve were used to analyze the data.
Morning BP and daytime BP displayed good agreement, but not 24-hour BP , particularly the nighttime BP (all P < .001). Approximately 39.4% of the hypertensive patients receiving drug treatment who had achieved control of the morning BP presented masked nocturnal hypertension, which was associated with worse subclinical TOD. The BP measured in all periods correlated with subclinical TOD, and the correlation was more obvious in the treatment subgroup. However, morning BP did not independently affect subclinical TOD. Morning BP appeared to exhibit less discriminatory power than nighttime BP, particularly with respect to the urinary albumin to creatinine ratio.
The use of morning BP for monitoring during hypertension management may not be enough. Masked uncontrolled nocturnal hypertension should be screened when morning BP is controlled.