bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomised phase II trial testing the acceptability and feasibility of a narrative approach to public health communication to increase community engagement with palliative care
Authors: Collins Anna , McLachlan Sue-Anne , Hill Mike , Collins Sue , Philip Jennifer 
Published: June 2020

Background: Communities have limited understanding of palliative care, creating barriers to informed choice around consideration of a full range of care options in the event of serious illness. Few empirically tested interventions are available to educate community about palliative care, and ultimately improve timely access to these services. Aim: To test the acceptability (primary outcome), and feasibility of a narrative approach to public health communication seeking to improve attitudes to possible access to palliative care in the event of serious illness. Design: Randomised phase II trial with six parallel experimental conditions. Outcomes tested included measures of acceptability, feasibility and change in attitudes to possible access to palliative care post-intervention. Contrasts planned for exploratory testing included format, message content and narrator. Setting/participants: Community-based sample of consecutive English-speaking adults who volunteered their participation in response to a study advertisement distributed online through established community groups. Results: A narrative approach to public health communication was found to be acceptable to community members, and feasible to deliver online. Exploratory data suggested it immediately improved attitudes towards possible access to palliative care in the event of serious illness, with the narrative detailing a description of the evidence delivered by a healthcare professional appearing to be the most promising strategy. Conclusions: This study provides preliminary data to inform a future, longitudinal trial evaluating effectiveness and ultimately other evidence-based, public health approaches to improve community engagement with palliative care. Further studies are required to confirm the generalisability of findings to a broader representative sample and other settings including internationally.
Changes in aortic pulse wave velocity in peritoneal dialysis do not mirror changes in extracellular water measured by bioimpedance
Authors: Tangvoraphonkchai Kamonwan , Davenport Andrew 
Published: June 2020

Background: Pulse wave velocity is a measurement of arterial stiffness and associated with increased cardiovascular mortality. Previous reports in peritoneal dialysis have linked increased pulse wave velocity with an expansion in extracellular water. As cardiovascular mortality is increased in peritoneal dialysis patient, we wished to determine whether changes in pulse wave velocity mirrored changes in extracellular water. Methods: We repeated aortic pulse wave velocity and bioimpedance-derived extracellular water measurements in peritoneal dialysis patients attending for assessment of peritoneal membrane function. Results: Sixty-six patients, 41 males (62.1%), mean age of 66.2 ± 13.9 years, median duration of peritoneal dialysis treatment (14.3 (3.1–31.9) months) had repeated measurement 6.4 (5.8–10.2) months apart, with no significant change in aortic pulse wave velocity (10.1 ± 3.2 to 9.9 ± 2.8 m/s). In univariate analysis, the initial aortic pulse wave velocity was associated with extracellular water (r = 0.26, p = 0.034) and serum N-terminal pro brain-type natriuretic peptide (r = 0.25, p = 0.04), and on follow-up, aortic pulse wave velocity with N-terminal pro brain-type natriuretic peptide (r = 0.31, p = 0.01). Aortic pulse wave velocity increased in 50% of patients, and these patients had greater serum C-reactive protein 3(2–10) versus 2(1–4) mg/L, and ferritin (778(444–1099) versus 585(313–811), p < 0.05), but there were no differences in either absolute or adjusted extracellular water. Both log C-reactive protein (odds ratio 4.7 (95% confidence limits 1.3–17.1), p = 0.019) and prescription of calcium channel blockers (odds ratio 4.9 (95% confidence limits 1.2–19.1), p = 0.024) were independently associated with an increase in aortic pulse wave velocity. Conclusion: We did not find an independent association between a change in aortic pulse wave velocity and extracellular water, suggesting that changes in aortic stiffness in peritoneal dialysis patients are more complex than simply following changes in extracellular water.
Transports of Sick Neonates to a Tertiary Care Hospital: Condition at Arrival and Outcomes
Authors: Chandrashekhar Channanayaka , Doreswamy Srinivasa Murthy , Nataraj Nanda , Panachiyil George Mathew , Babu Tirin 
Published: June 2020

Objective: To evaluate the transport system, condition of the baby on arrival, and the outcome of the sick neonates transported to our hospital. Methodology: This prospective study included 100 neonates referred to our hospital. A pro forma with a questionnaire regarding the transport details was filled with information taken from the parents/attendant accompanying the baby. Results: A total of 100 number of referrals over a period of 8 months were included. Almost half the referrals were in the first week of life: 74% were term and 26% preterm. Only 28% of the babies were sent with prior communication to our hospital. About 69% babies had a referral document of them, but only 26% had complete information regarding the baby’s illness and prior treatment. The modes of transport used were private ambulance (36%), car (25%), and government ambulance (22%). Few newborns were brought by autorickshaw (12%), bus (3%), and two-wheeler (2%) too. None of the babies were brought with kangaroo mother care (KMC) during transit. Intratransport care included supplemental oxygen (53%) and IV medications (14%). On arrival the transported neonates had problems such as prolonged capillary filling time (78%), hypothermia (72%), respiratory distress (23%), hypoglycemia (14%), needing life support (14%), and apnea (8%). Out of them, 85% improved, 12% were discharged against medical advice, 2% died, and 1% referred. Conclusion: The study highlights the unaddressed challenges and the scope for improving the transport of sick neonates between hospitals and further emphasizes the need for devising solutions.
Cardiovascular Risk After Sepsis: Understanding the Role of Statin Indications and the Impact of Clinical Inertia on Prescribing Patterns
Authors: Gupta Vedant A. , Alnabelsi Talal S. , Shringi Sandipan , Leung Steve W. , Sorrell Vincent L. 
Published: June 2020

Introduction: Patients with sepsis have high rates of major adverse cardiovascular events (MACE) in the literature, but the stratification of those at risk has been limited. Statin indicated groups provides clear criteria for therapy, but the risk of MACE after sepsis based on these groups has never been assessed. Materials and Methods: This was a retrospective cohort analysis conducted on adult patients admitted from January 1, 2013, to December 31, 2013, with suspected or confirmed sepsis and data available on statin use. Patients’ past medical history; statin use prior, during, or at time of discharge; and occurrence of MACE were recorded from electronic health records. Result: A total of 321 patients were screened and 265 were found to have data available on statin use. The mean age of the patients was 59 ± 15 years and 47% were female. Overall, 9% were observed to have a MACE at 1 year, with significantly higher rates in those in a statin indicated group (12.2%). On admission, 174 patients were not taking a statin out of whom 52% were in a statin indicated group. Among those in a statin indicated group who survived to hospital discharge, only 10% not on a statin on admission received a statin on discharge, whereas 89% on a statin on admission received a statin on discharge. Conclusion: There is a high risk of MACE after sepsis especially among those in statin indicated groups with significant clinical inertia in prescribing practices.
Early Ambulation After Injury Is Associated With Increased Muscle Size and Strength
Authors: Higgins Jacob T. , Frazier Susan K. , Lennie Terry , Rayens Mary Kay , Avila Jacob 
Published: June 2020

Background: Trauma and management of injuries can result in reduction or loss of mobility, which can lead to skeletal muscle deconditioning and sustained disability. Prior investigators have examined changes in skeletal muscle due to injury and immobility separately. The muscular consequences of combined immobility and trauma have not been systematically investigated. Objective: The purpose of this study was to explore the association of time to first ambulation with skeletal muscle size and strength in patients after major trauma. Methods: Adults ( N = 19) admitted for major trauma (Injury Severity Score [ISS] > 15) provided daily measures of muscle size (ultrasound) and strength (dynamometry) during hospitalization. Participants were grouped based on time to first ambulation. Repeated measures analysis of variance was used to compare muscle measures between the groups across 5 days while controlling for age and gender. Results: Participants were primarily male (63%) aged 40 ± 17 years with a mean ISS of 21 ± 4. Early ambulation was associated with a 10% increase from baseline in bicep size on Days 3 and 4 and a 15% increase from baseline on Day 5. There were no changes in rectus femoris size in either group. The early ambulation group was significantly stronger than the delayed ambulation group throughout the study in measures taken with the biceps (22%–37%) and quadriceps (26%–46%). Conclusion: Early ambulation following major trauma was associated with increased bicep size and greater muscle strength in the biceps and quadriceps muscles over time.
Choroidal neovascularization as a complication of primary vitreous retinal lymphoma
Authors: Ma Ya , Zhao Huiying , Peng Xiaoyan 
Published: June 2020

Purpose: To describe a case of primary vitreous retinal lymphoma (PVRL) complicated with choroidal neovascularization (CNV) and presented with severe macular edema (ME). Case description: A 52-year-old female patient was diagnosed with bilateral PVRL. Optical coherence tomography (OCT) showed severe macular edema (ME) and subretinal hyperreflective material in the left eye at the first visit. No sign of choroidal neovascularization (CNV) was found with fundus fluorescein angiography (FFA) or indocyanine green angiography (ICGA). The ME was resolved after standard intraocular chemotherapy, while the subretinal hyperreflective material remained stable. Optical coherence tomography angiography (OCTA) was performed 2 years after chemotherapy. OCTA revealed a well-circumscribed CNV network in the subretinal hyperreflective material. Conclusion: It is a rare occurrence that CNV and ME developed in this PVRL patient. The presence of ME is not an exclusion criterion for PVRL. This case should also raise awareness of the importance of OCTA as a method for monitoring intraocular lymphoma during follow-up.
Effect of unilateral vertical transposition of the horizontal rectus muscles on vertical strabismus
Authors: Rossel Mirjam , Bergholz Richard , Salchow Daniel J 
Published: June 2020

Purpose: To study the effect of vertically transposing both horizontal eye muscles of one eye in the same direction on vertical strabismus. Methods: Retrospective analysis of 33 patients in whom vertical transposition of the medial and lateral rectus muscles was combined with a recession/resection or recession/plication procedure. Preoperative ocular alignment was compared with that 1 day and 3 months postoperatively. Results: Mean preoperative vertical deviation was 7.8 ± 4.3 (median 7.5, range 3–25) prism diopters (PD) at distance and 7.8 ± 4.1 (7, 0–18) PD at near. Vertical transposition of the horizontal rectus muscles averaged 5.6 ± 1.6 mm and reduced the vertical deviation to 3.4 ± 4.2 PD (2, 0–16) at distance and 2.9 ± 3.7 PD (2, 0–14) at near. Mean effect on the vertical deviation was 0.9 ± 0.7 (0.8, –0.8 to 2.13) PD/mm at distance and 0.9 ± 0.9 (0.83, –1 to 3) PD/mm at near, it was similar in patients operated on for esotropia and for exotropia. The surgical effect on the horizontal deviation was 2.1 ± 1.1 PD/mm (distance) and 2.6 ± 1 PD/mm (near). Both the vertical and horizontal surgical dose correlated with the effect in a linear way, but the variability was greater for the vertical transposition. Conclusions: Vertical transposition of the horizontal rectus muscles in the same direction allows for correction of vertical strabismus. This procedure may be performed during primarily horizontal strabismus surgery, without operating on an additional extraocular muscle. The transposition distance correlates with the surgical effect but predictability of the effect is limited.
A Qualitative Exploration of Consumers’ Perceived Impacts, Behavioural Reactions, and Future Reflections of the EU Tobacco Products Directive (2017) as Applied to Electronic Cigarettes
Authors: Ward Emma , Anholt Claudia , Gentry Sarah , Dawkins Lynne , Holland Richard , Notley Caitlin 
Published: June 2020

Background: Electronic cigarette regulations included in the Tobacco Products Directive (TPD), Article 20, implemented in Europe by May 2017, aimed to improve safety for e-cigarette consumers, and prevent uptake among non-smokers, particularly young people. Before implementation, there were significant concerns from consumers, industry, and some in the scientific community about the potential negative impact of the TPD on people using e-cigarettes to remain abstinent from smoking. To date, there is limited evidence on how the TPD has affected consumers. This study aimed to add insight into how consumers perceived and experienced the regulations. Methods: Qualitative data, collected between March 2018 and March 2019, relating to participant views of the TPD were extracted from 160 interviews/extended surveys of e-cigarette consumers as part of a wider study into e-cigarette use trajectories (ECtra study). Data were thematically analysed. Results: Awareness of the TPD among consumers was not universal. Participants’ smoking behaviour did not appear to be influenced by the legislation. Participants were reassured by manufacturing regulations and requirements for ingredients labels. Participants responded negatively to changes perceived to cause inconvenience and extra plastic waste. The product restrictions prompted some participants to purchase non-compliant products illegally, potentially putting their safety at risk. Conclusions: E-cigarette regulation should focus on ensuring product safety. Raising awareness of the TPD among consumers and smokers could be beneficial.
Prevalence of Opportunistic Infections and Associated Factors in HIV-Infected Men Who Have Sex With Men on Antiretroviral Therapy in Bach Mai Hospital, Hanoi, Vietnam: A Case-Control Study
Authors: Dang Linh Vu Phuong , Nguyen Quan Hai , Ishizaki Azumi , Larsson Mattias , Vu Nhung Thi Phuong , Do Duy Cuong , Olson Linus , Dinh Thanh Thi 
Published: June 2020

Objective: To investigate the distribution of opportunistic infections (OIs) and factors associated with acquiring OIs in human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) in comparison to those of heterosexual patients. Method: A cross-sectional study was conducted on 82 HIV-infected MSM and 120 HIV-infected heterosexual men in Bach Mai Hospital, Hanoi, Vietnam. Demographical characteristics and clinical data were collected and analyzed using appropriate statistics (Mann–Whitney, Chi-square, Fisher’s exact test, and logistic regression). Results: The prevalence of OIs among MSM and heterosexual patients were 63.4% and 81.7%, respectively. The most frequent OI in the MSM group was human papilloma virus (HPV) (11%), followed by hepatitis B virus (8.5%), mycobacterium tuberculosis (7.3%), and Talaromycosis (2.4%). Conclusions: Multivariate logistic regression analysis showed that buying sex (odds ratio (OR) = 4, 95% confidence interval (CI): 1.13–14.25) and injecting drugs (OR = 13.05, 95% CI: 2.39–71.21) were associated with increased odds of having OIs in heterosexual patients while increasing age (OR = 1.1, 95% CI: 1.01–1.24) was correlated to increased odd of acquiring OIs in the MSM group. HIV-infected MSM accumulates OIs with increasing age, while heterosexual individuals increase opportunistic infections by buying sex or injecting drugs.
S-shaped distal access catheter supported microcatheter navigation into the lenticulostriate artery feeders of brain arteriovenous malformations
Authors: Koizumi Satoshi , Shojima Masaaki , Ishikawa Osamu , Hasegawa Hirotaka , Miyawaki Satoru , Nakatomi Hirofumi , Saito Nobuhito 
Published: June 2020

Background Although the embolization of lenticulostriate artery feeders is often warranted in the treatment of brain arteriovenous malformations, it is technically challenging due to steep and repeated angulations. Here, we describe our novel technique of navigating a flow-guided microcatheter into lenticulostriate artery feeders using the strong support provided by an S-shaped distal access catheter. Methods We reviewed our retrospective cohort of brain arteriovenous malformations, in which lenticulostriate artery feeders were attempted to embolize. Result During the study period, endovascular embolization was performed in 25 arteriovenous malformations cases. Of these, eight lenticulostriate artery feeders were present in six cases (24%). In two cases, lenticulostriate artery feeder catheterization was avoided from the beginning due to the small diameters of the feeders. After all, microcatheter navigation for lenticulostriate artery feeders were attempted in four cases with six lenticulostriate artery feeders. In all the six feeders, the S-shaped distal access catheter was successful in supporting the microcatheter to advance distally to the lenticulostriate artery feeders, even if other approaches were unsuccessful. Of the six catheterized lenticulostriate artery feeders, four were embolized. Symptomatic infarction in the lenticulostriate artery territory and mild vasospasm occurred in two cases each, but they did not result in permanent neurological deficits. Conclusion Although some potential complications need to be considered, the S-shaped distal access catheter technique appears to be an effective alternative approach to gaining access to difficult feeders of arteriovenous malformations.
Syndesmotic Screw Breakage May Be More Problematic Than Previously Reported: Increased Rates of Hardware Removal Secondary to Pain With Intraosseous Screw Breakage
Authors: Ibrahim Ishaq O. , Velasco Brian T. , Ye Michael Y. , Miller Christopher P. , Kwon John Y. 
Published: June 2020

Background. The majority of retained syndesmotic screws will either loosen or break once the patient resumes weight-bearing. While evidence is limited, anecdotal experience suggests that intraosseous screw breakage may be problematic for some patients due to painful bony erosion. This study seeks to identify the incidence of intraosseous screw breakage, variables that may predict intraosseous screw breakage, and whether intraosseous screw breakage is associated with higher rates of implant removal secondary to pain. Methods. Five hundred thirty-one patients undergoing syndesmotic stabilization were screened, of which 43 patients (with 58 screws) experiencing postoperative screw breakage met inclusion criteria. Patient charts were retrospectively reviewed for demographic data, comorbidities, time to screw breakage, location of screw breakage, and implant removal. Several radiographic parameters were evaluated for their potential to influence the site of screw breakage. Results. Intraosseous screw breakage occurred in 32 patients (74.4%). Screw breakage occurred exclusively in the tibiofibular clear space in the remaining 11 instances (25.6%). Intraosseous screw breakage was significantly associated with eventual implant removal after breakage (P = .034). Screws placed further from the tibiotalar joint were at less risk for intraosseous breakage (odds ratio 0.818, P = .002). Screws placed at a threshold height of 20 mm or greater were more likely to break in the clear space (odds ratio 12.1, P = .002). Conclusion. Syndesmotic screw breakage may be more problematic than previously described. Intraosseous breakage was associated with higher rates of implant removal secondary to pain in this study. Placement of screws 20 mm or higher from the tibiotalar joint may decrease risk of intraosseous breakage. Levels of Evidence: Level III: Retrospective study
PRP Injections for the Treatment of Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials
Authors: Filardo Giuseppe , Previtali Davide , Napoli Francesca , Candrian Christian , Zaffagnini Stefano , Grassi Alberto 
Published: June 2020

Objective To evaluate effectiveness, in terms of patient-reported outcome measures, of platelet-rich plasma (PRP) injections for knee osteoarthritis compared to placebo and other intraarticular treatments. Design PubMed, Cochrane Library, Scopus, Embase, Web of Science, as well as the gray literature were searched on January 17, 2020. Randomized controlled trials (RCTs) comparing PRP injections with placebo or other injectable treatments, in any language, on humans, were included. Risk of bias was assessed following the Cochrane guidelines; quality of evidence was graded using the GRADE guidelines. Results Thirty-four RCTs, including 1403 knees in PRP groups and 1426 in control groups, were selected. WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score favored PRP, with a statistically and clinically significant difference versus placebo at 12-month follow-up ( P = 0.02) and versus HA (hyaluronic acid) at 6-month ( P < 0.001) and 12-month ( P < 0.001) follow-ups. A clinically significant difference favoring PRP versus steroids was documented for VAS (Visual Analogue Scale) pain ( P < 0.001), KOOS (Knee Injury and Osteoarthritis Outcome Score) pain ( P < 0.001), function in daily activities ( P = 0.001), and quality of life ( P < 0.001) at 6-month follow-up. However, superiority of PRP did not reach the minimal clinically important difference for all outcomes, and quality of evidence was low. Conclusions The effect of platelet concentrates goes beyond its mere placebo effect, and PRP injections provide better results than other injectable options. This benefit increases over time, being not significant at earlier follow-ups but becoming clinically significant after 6 to 12 months. However, although substantial, the improvement remains partial and supported by low level of evidence. This finding urges further research to confirm benefits and identify the best formulation and indications for PRP injections in knee OA.