bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationships of illness representation and quality of life in patients with end‐stage renal disease receiving haemodialysis
Authors: Chen Yu‐Chun , Lin Chun‐Liang , Lee Bih‐O 
Published: July 2020

AbstractAim and ObjectivesTo examine the relationship between illness representations and quality of life and to test whether illness representations can predict quality of life, in patients with haemodialysis.BackgroundIllness representations are interpretations of and actions taken by individuals when faced with threats to their health. Exploring relationship of illness representations and quality of life in patients with haemodialysis may help patients self‐manage their illness and improve their quality of life.MethodsA cross‐sectional correlation design was used (the checklist STROBE was chosen for this study). The study setting was a haemodialysis centre in a teaching hospital. A total of 172 surveys were completed. The inventory comprised demographic data, illness data, the Brief Illness Perception Questionnaire and the World Health Organization Quality of Life.ResultsThe illness representations of the surveyed patients fell in the middle range of being not too optimistic or pessimistic. Overall quality of life of patients is moderate. The predictors of quality of life included living status, source of income and two illness representation elements.ConclusionsThis study revealed an association between illness representations and quality of life in patients with haemodialysis. New knowledge provided by this study can assist healthcare professionals caring for patients with a Chinese cultural background.Relevance to clinical practiceIllness representation assessment could be added to clinical care standards, and patients living with family or without family could be given different interventions.
Effect of exercise on slowing breastfeeding‐induced bone loss: A meta‐analysis and trial sequential analysis
Authors: Lee Ling‐Ling , Huang Sen‐Fang , Lai Pei‐Chun , Huang Yen‐Ta 
Published: July 2020

AbstractAimThis study systematically reviewed evidence regarding the effectiveness of exercise in slowing breastfeeding‐induced bone loss.MethodsThe evidence‐based approach of a systematic review (PROSPERO registration No. CRD42019111623) was adopted. The inclusion criteria were randomized controlled trials or observational studies. Study samples were breastfeeding women, the intervention was any form of exercise, and bone mineral density (BMD) of the total body, lumbar spine and hip/femur neck before 6 months and at 1 year were the outcome measures. Meta‐analyses were performed using a random effect model, and calculations of mean differences of BMD change and 95% confidence intervals (CIs) were carried out. Studies were further evaluated through trial sequential meta‐analysis (TSA), and the ‘Grading of Recommendations Assessment, Development and Evaluation’ methodology was used to assess the certainty of evidence (CoE).ResultsA total of 1049 studies were screened, and 4 met the inclusion criteria. Weight‐bearing aerobic exercise and resistance training before the 6‐month evaluation slowed breastfeeding‐induced bone loss in the lumbar spine (1.62% BMD change [95% CI = 0.53–2.71]; I2 = 8%). The TSA Z‐curve revealed crossing of the TSA boundary and line of information size, indicating sufficient sampling and significance. The CoE of exercise benefit in the lumbar spine at 6 months was low, whereas the CoE for other areas ranged from low to very low.ConclusionThis first systematic review and meta‐analysis provided some evidence of the advantages of exercise for slowing breastfeeding‐induced bone loss. However, additional randomized controlled trials are warranted to generate more conclusive evidence.
Can variability of serum electrophoretic fractions during pregnancy provide knowledge about maternal and fetal health
Authors: Strawa Agnieszka , Skarżyńska Ewa , Zborowska Hanna , Jakimiuk Artur , Lisowska‐Myjak Barbara 
Published: July 2020

AbstractAimCharacteristics of variability of concentrations total protein and its electrophoretic fractions in serum of healthy pregnant women between successive trimesters and post‐partum for initial classification of proteins involved in specific metabolic processes associated with pregnancy.MethodsTotal serum protein concentrations were measured by biuret method and serum protein fractions were electrophoretically separated in 166 serum samples collected from healthy pregnant women in three trimesters of pregnancy (1st, n = 55; 2nd, n = 42; 3rd, n = 39) and in post‐partum (n = 30), and in 20 samples from nonpregnant controls.ResultsAcross pregnancy, there were gradual, but occurring at different rates, decreases over time in serum total protein, albumin and gamma globulins compared to controls (P < 0.05). In 1st trimester, serum concentrations of total protein, albumin and gamma globulins were <10% lower than in nonpregnant state, with further decreases in 2nd and 3rd trimesters and in post‐partum. The concentrations of alpha‐1‐, alpha‐2‐, beta‐1‐ and beta‐2‐globulins were elevated compared to controls (P < 0.05) with different dynamics of change and with the highest percentage increase for alpha‐1‐globulin.ConclusionPregnancy‐associated alterations in the serum concentrations of total protein and in its individual electrophoretic protein fractions in each trimester of pregnancy and differences versus normal ranges in nonpregnant healthy females could be a simple screening method for classification useful laboratory parameters that help obstetricians and gynecologists to make multidirectional judgments about the state of health of pregnant women.
Predicting inadequate treatment response in children with chronic spontaneous urticaria
Authors: Park Yu‐Mi , Oh Min‐Su , Kwon Ji‐Won 
Published: July 2020

AbstractBackgroundWe aimed to investigate the treatment response and associated factors for loss of control in children with chronic spontaneous urticaria (CSU).MethodsA total of 240 CSU patients (aged 0‐17 years) were enrolled in a single‐center study in Korea from May 2014 to May 2019. We retrospectively reviewed the medical records and compared the duration of treatment and step of medications using the urticaria control test (UCT, range 0‐16 points). Serum total immunoglobulin levels, eosinophil count, allergic sensitization, autologous serum skin test, antinuclear antibody, thyroid function test, erythrocyte sedimentation rate, and C‐reactive protein were measured. The patients were divided into well‐controlled (sustained UCT ≥12), partly controlled (fluctuating UCT around 12), and poorly controlled (sustained UCT <12) groups.ResultsOf the 240 children, 150 (62.5%) achieved well‐controlled status; 74 (30.8%), partly controlled; and 16 (6.7%), poorly controlled. Longer duration (adjusted odds ratio: 1.09, 95% confidence interval: 1.05‐1.13, P < .001) and higher treatment steps (5.61, 2.82‐11.14, P < .001) for reaching the initial 12 points or more of UCT score, initial urticaria activity score (UAS) score (1.06, 1.03‐1.09, P < .001), and food sensitization (1.88, 1.03‐3.46, P = .041) were associated with inadequate treatment response. The mean duration to symptom free for 1 month without medication was 14.6 months in the well‐controlled group and 22.1 months in the partly controlled group (P = .002).ConclusionChildren with CSU have a good treatment response. Longer duration and higher treatment step until the initial disease control, higher initial UAS7 score, and food sensitization can predict inadequate treatment response.
Representation of women in pediatric dermatology leadership and research: Trends over the past 45 years
Authors: Baker Catherine , Dwan Dennis , Fields Alexandra , Mann Julianne A. , Pace Nicole C. , Hamann Carsten R. 
Published: July 2020

AbstractBackground/ObjectivesThe representation of women among practicing dermatologists has increased over the last several decades. Here, we analyze the evolving representation of women in the Society for Pediatric Dermatology (SPD) and the Pediatric Dermatology Research Alliance (PeDRA), with particular focus on the role of women as society leaders, researchers, and annual meeting speakers.MethodsA retrospective review of SPD and PeDRA professional society leaders (SPD presidents, PeDRA co‐chairs, PeDRA executive committee members), grant recipients (pilot grant recipients, team/collaborative grant recipients, William Weston Research Grant recipients), and annual meeting speakers (named lecturers at the SPD Annual Meeting, plenary lecturers at the PeDRA Annual Conference) was performed. Authors of research articles in Pediatric Dermatology were reviewed at three‐year intervals from 1983 through 2019. The percentage of women among all leadership, grant, authorship, and lectureship categories was analyzed over time.ResultsWomen have represented 70% of SPD presidents since 2011 and 75% of PeDRA co‐chairs since 2013. The percentage of women among first and senior authors of research articles in Pediatric Dermatology increased significantly from 1983 to 2019 (Cochran Armitage test for trend, P < .01), and women earned the majority of SPD/PeDRA pilot project grants (2008‐2018), collaborative team grants (2016‐2018), and William Weston Research Grants (1995‐2015). At SPD Annual meetings from 2010 to 2019, women comprised 44% of named lecturers but accounted for approximately 78% of the pediatric dermatology workforce (P < .01).ConclusionDespite the widespread influence of women in pediatric dermatology leadership and research, gender discrepancies remain among named lecturer positions at national pediatric dermatology meetings.
Bronchoscopic treatments for early‐stage peripheral lung cancer: Are we ready for prime time?
Authors: Steinfort Daniel P. , Herth Felix J.F. 
Published: July 2020

ABSTRACTLung cancer is the leading cause of cancer‐related death worldwide and surgical lobectomy remains the preferred therapy for patients with early‐stage NSCLC. Medical comorbidities and advanced age preclude resection in many patients and minimally invasive ablative therapies are needed for treatment. Stereotactic ablative radiation is established as an effective modality in this patient group, although may be contraindicated in some patients with prior radiation exposure, comorbidities or centrally positioned tumours. Percutaneous ablative methods are available, although are frequently associated with significant complications. Numerous endoscopic ablative techniques are under evaluation. With a more favourable safety profile and the ability to provide diagnosis and staging information potentially within a single procedure, there is a strong rationale for development of bronchoscopic ablative modalities. In the following article, the authors aim to explore the role bronchoscopic ablation may play in treatment of peripheral lung tumours, and to describe a pathway to establishing these modalities as part of routine care. The current status of several bronchoscopic ablative options is discussed in detail.
Immunohematological work‐up, severity analysis and transfusion support in autoimmune hemolytic anemia patients
Authors: Ray Gopal Krushna , Mahapatra Smita , Mishra Debasish , Parida Pankaj , Jena Rabindra Kumar , Panigrahi Rashmita 
Published: July 2020

Background and ObjectiveAutoimmune haemolytic anaemia (AIHA) is a clinical condition of reduced red cell survival by binding of antibodies (IgG/IgM) to self‐antigen and classified as warm, cold or mixed type. AIHA patients frequently have sufficient severity of anaemia as to require a blood transfusion. But little is known from India about the distribution and severity of AIHA. The objective of the study was to find out the type of AIHA, severity of haemolysis and the hindrances in transfusing these patients.Materials and methodsNinety‐four cases were included in the study. All the laboratory parameters (Hb, bilirubin, LDH, reticulocyte count) were analysed from the case sheet. All the immunohaematological workup like direct antiglobulin test, antibody screening/identification, elution–adsorption and compatibility testing were performed as per the American Association of Blood Banking (AABB) methods.ResultWarm AIHA was a more common type (61·4%) followed by mixed (23·7%) and cold type (14·9%). Fifty‐three (56%) cases were secondary AIHA. Females (68%) were more affected than males. The severity of haemolysis was found to be a significant correlation with the strength of DAT only, not with gender, type of AIHA or autoagglutinin. Thirty‐eight cases of AIHA required transfusion support, and best‐match blood units were issued to fourteen cases.ConclusionIn this region, the mixed type is more common after warm type and presented with very severe haemolysis. DAT strength directly related to the severity of haemolysis. AIHA patients with underlying alloantibody could be transfused corresponding antigen‐negative best‐match unit.
Structural Design Space Exploration Using Principal Component Analysis
Authors: Bunnell Spencer , Gorrell Steven , Salmon John , Thelin Christopher , Ruoti Christopher 
Published: July 2020

Abstract
Design space exploration (DSE) is the process whereby a designer seeks to understand some results across a set of design variations. Structural DSE of turbomachinery compressor blades is often challenging because the large number of design variables make it difficult to learn the effect that each variable has upon the stress contours. Principal component analysis (PCA) of the stress contours is used as a way to understand how the stress contours change over the design space. Two methods are introduced to address the challenge of understanding how the stress changes over a large number of variables. First, a two-point correlation is applied to relate the design variables to the scores of each principal component. Second, a coupling of the stress and coordinate location of each node in PCA is developed which also indicates how the stress variations relate to geometric variations. These provide insight to how design variables influence the stress. It is shown how these methods use PCA as DSE tools to better explore the structural design space of compressor blades. Better DSE can improve compressor blades and the computational cost needed for their design.
Delivering water, sanitation and hygiene interventions to women and children in conflict settings: a systematic review
Authors: Als Daina , Meteke Sarah , Stefopulos Marianne , Gaffey Michelle F , Kamali Mahdis , Munyuzangabo Mariella , Shah Shailja , Jain Reena P , Radhakrishnan Amruta , Siddiqui Fahad J , Ataullahjan Anushka , Bhutta Zulfiqar A 
Published: July 2020

BackgroundAccess to safe water and sanitation facilities and the adoption of effective hygiene practices are fundamental to reducing maternal and child morbidity and mortality globally. In armed conflict settings, inadequate water, sanitation and hygiene (WASH) infrastructure poses major health risks for women and children. This review aimed to synthesise the existing information on WASH interventions being delivered to women and children in conflict settings in low-income and middle-income countries (LMICs) and to identify the personnel, sites and platforms being used to deliver such interventions.MethodsWe conducted a systematic search for publications indexed in four databases, and grey literature was searched through the websites of humanitarian agencies and organisations. Eligible publications reported WASH interventions delivered to conflict-affected women or children. We extracted and synthesised information on intervention delivery characteristics, as well as barriers and facilitators.ResultsWe identified 58 eligible publications reporting on the delivery of WASH interventions, mostly in Sub-Saharan Africa. Non-Governmental Organization (NGO)/United Nations (UN) agency staff were reported to be involved in delivering interventions in 62% of publications, with the most commonly reported delivery site being community spaces (50%). Only one publication reported quantitative data on intervention effectiveness among women or children.DiscussionThis review revealed gaps in the current evidence on WASH intervention delivery in conflict settings. Little information is available on the delivery of water treatment or environmental hygiene interventions, or about the sites and personnel used to deliver WASH interventions. Limited quantitative data on WASH intervention coverage or effectiveness with respect to women or children are important gaps, as multiple factors can affect how WASH services are accessed differently by women and men, and the hygiene needs of adolescent girls and boys differ; these factors must be taken into account when delivering interventions in conflict settings.PROSPERO registration numberCRD42019125221
‘Only twice a year’: a qualitative exploration of 6-month antiretroviral treatment refills in adherence clubs for people living with HIV in Khayelitsha, South Africa
Authors: Keene Claire Marriott , Zokufa Nompumelelo , Venables Emilie C , Wilkinson Lynne , Hoffman Risa , Cassidy Tali , Snyman Leigh , Grimsrud Anna , Voget Jacqueline , von der Heyden Erin , Zide-Ndzungu Siphokazi , Bhardwaj Vinayak , Isaakidis Petros 
Published: July 2020

ObjectiveLonger intervals between routine clinic visits and medication refills are part of patient-centred, differentiated service delivery (DSD). They have been shown to improve patient outcomes as well as optimise health services—vital as ‘universal test-and-treat’ targets increase numbers of HIV patients on antiretroviral treatment (ART). This qualitative study explored patient, healthcare worker and key informant experiences and perceptions of extending ART refills to 6 months in adherence clubs in Khayelitsha, South Africa.Design and settingIn-depth interviews were conducted in isiXhosa with purposively selected patients and in English with healthcare workers and key informants. All transcripts were audio-recorded, transcribed and translated to English, manually coded and thematically analysed. The participants had been involved in a randomised controlled trial evaluating multi-month ART dispensing in adherence clubs, comparing 6-month and 2-month refills.ParticipantsTwenty-three patients, seven healthcare workers and six key informants.ResultsPatients found that 6-month refills increased convenience and reduced unintended disclosure. Contrary to key informant concerns about patients’ responsibility to manage larger quantities of ART, patients receiving 6-month refills were highly motivated and did not face challenges transporting, storing or adhering to treatment. All participant groups suggested that strict eligibility criteria were necessary for patients to realise the benefits of extended dispensing intervals. Six-month refills were felt to increase health system efficiency, but there were concerns about whether the existing drug supply system could adapt to 6-month refills on a larger scale.ConclusionsPatients, healthcare workers and key informants found 6-month refills within adherence clubs acceptable and beneficial, but concerns were raised about the reliability of the supply chain to manage extended multi-month dispensing. Stepwise, slow expansion could avoid overstressing supply and allow time for the health system to adapt, permitting 6-month ART refills to enhance current DSD options to be more efficient and patient-centred within current health system constraints.
Furosemide in end-stage heart failure: community subcutaneous infusions
Authors: Brown Andrew , Westley Katharine , Robson Judith , Armstrong Leonie , Matthews Iain , Runnett Craig , Ripley David , Thomas Honey 
Published: July 2020

BackgroundIn chronic heart failure many patients have recurrent hospital admissions and it is the leading cause of admission in people aged over 65 years. In those with end-stage heart failure, there is limited evidence that furosemide can be given subcutaneously to relieve symptoms and avoid hospital admission.MethodWe initiated a community-based continuous subcutaneous infusion (CSCI) furosemide service for the treatment of advanced heart failure. We aimed to increase patient choice, offer an alternative to hospital admission and, in patients at the end of their life, allow them to die at their preferred place of care with symptom alleviation. We retrospectively reviewed case notes.Results36 consecutive episodes of CSCI of treatment were recorded in 28 patients. 15 patients (54%) survived beyond the initial treatment course with 13 patients (87%) avoiding acute hospital admission. There was a reduction in mean hospital admission rates from 2.87 to 0.73 (p<0.001) in the 6-month periods either side of the first episode of CSCI furosemide. A median reduction of 4 kg weight loss was recorded. 13 patients died during the initial treatment course. 12 (92%) died at home and 1 died at the hospital palliative care unit. All had symptoms controlled.ConclusionSubcutaneous furosemide can be successfully delivered in the community. In addition to palliation in the final days of life, community subcutaneous furosemide can be an effective treatment leading to weight loss and improved symptoms with survival for several months.
Prevalence and Outcome of Potential Candidates for Left Atrial Appendage Closure After Stroke With Atrial Fibrillation
Authors: Ong Elodie , Meseguer Elena , Guidoux Celine , Lavallée Philippa C. , Hobeanu Cristina , Charles Hugo , Labreuche Julien , Cabrejo Lucie , Martin-Bechet Anna , Rigual Ricardo , Nighoghossian Norbert , Amarenco Pierre 
Published: July 2020

Background and Purpose:
As a result of contraindications (eg, frailty, cognitive impairment, comorbidities) or patient refusal, many patients with stroke and atrial fibrillation cannot be discharged on oral anticoagulant. Among them, the proportion of potential candidates for left atrial appendage closure (LAAC) and their 12-month outcome is not well known.

Methods:
The prospective WATCH-AF registry (Warfarin Aspirin Ten-A Inhibitors and Cerebral Infarction and Hemorrhage and Atrial Fibrillation) enrolled consecutive patients admitted within 72 hours of an acute stroke associated with atrial fibrillation in 2 stroke centers. Scales to evaluate stroke severity, disability, functional independence, risk of fall, cognition, ischemic and hemorrhagic risk-stratification, and comorbidities were systematically collected at admission, discharge, 3, 12 months poststroke. The 2 main end points were death or dependency (modified Rankin Scale score >3) and recurrent stroke (brain infarction and brain hemorrhage).

Results:
Among 400 enrolled patients (370 with brain infarction, 30 with brain hemorrhage), 31 died before discharge and 57 (14.3%) were possible European Heart Rhythm Association/European Society of Cardiology and American Heart Association/American College of Cardiology/Heart Rhythm Society candidates for LAAC. At 12 months, the rate of death or dependency was 17.9%, and the rate of stroke recurrence was 9.8% in the 274/400 (68.5%) patients discharged on a long-term oral anticoagulant strategy, as compared with 17.5% and 24.7%, respectively, in 57 patients candidate for LAAC. As compared with patients on a long-term oral anticoagulant strategy, there was a 2-fold increase in the risk of stroke recurrence in the group with an indication for LAAC (adjusted hazard ratio, 2.58 [95% CI, 1.40–4.76]; P=0.002).

Conclusions:
Fourteen percent of patients with stroke associated with atrial fibrillation were potential candidates for LAAC. The 12-month stroke risk of these candidates was 3-fold the risk of anticoagulated patients.