bluuebunny/crossref_metadata_2025_split huggingface dataset:
What Mediates Treatment Effects in a Presurgery Physiotherapy Treatment in Surgical Candidates With Degenerative Lumbar Spine Disorders? A Mediation and Conditional Process Analysis of the PREPARE Randomized Controlled Trial
Authors: Fors Maria , Öberg Birgitta , Lindbäck Yvonne , Enthoven Paul , Abbott Allan 
Published: December 2020

Objectives:
Treatment guidelines recommend targeting both physical and psychological factors in interventions for degenerative lumbar spine disorders. Studying the treatment mechanisms gives information on key factors explaining the outcome improvement that can refine treatments. This study explores treatment mediators in a physiotherapy treatment on disability, pain intensity, and health-related quality of life in surgical candidates with degenerative lumbar spine disorders compared with waiting-list controls. An additional aim was to evaluate patients’ expectation as a moderator of treatment outcome.

Materials and Methods:
Data collected from 197 patients in a single-blinded randomized controlled trial comparing 9 weeks of multifaceted physiotherapy with waiting-list controls were used in this conditional process analysis. Analysis was carried out on group differences for change in Oswestry Disability Index, Pain Visual Analog Scale (VAS) back pain, EuroQol-5D, and EuroQol-VAS. The putative moderation role of expectations and mediation role of change in physical variables and psychosocial variables were tested.

Results:
Change in self-efficacy mediated improvement in all outcomes. Improvement in Oswestry Disability Index was also mediated by change in depression; VAS was mediated by change in fear-avoidance beliefs; and EuroQol-VAS was mediated by change in activity level and fear avoidance beliefs. Improvements were moderated by patients’ treatment expectations.

Discussion:
Self-efficacy, fear-avoidance beliefs, physical activity level, and patients’ treatment expectations were found to be important factors explaining treatment effects. Self-efficacy was the consistent mediator for effects of the presurgical physiotherapy on disability, back pain intensity, and health-related quality of life.
Experience With Cardiology-Oriented Outcomes in Critically Ill Patients With Coronavirus Disease 2019
Authors: Connor-Schuler Randi , Wong A. Ian , Shah Anand , Fiza Babar , Lyle Melissa , Ramonell Richard , Hockstein Maxwell , Chang George , Markham David , Searles Charles , McDaniel Michael , Baer Jefferson , Powell Cindy , Daniels Lisa 
Published: December 2020

Objectives:
Coronavirus disease 2019 is associated with high mortality rates and multiple organ damage. There is increasing evidence that these patients are at risk for various cardiovascular insults; however, there are currently no guidelines for the diagnosis and management of such cardiovascular complications in patients with coronavirus disease 2019. We share data and recommendations from a multidisciplinary team to highlight our institution’s clinical experiences and guidelines for managing cardiovascular complications of coronavirus disease 2019.

Design, Setting, and Patients:
This was a retrospective cohort study of patients admitted to one of six ICUs dedicated to the care of patients with coronavirus disease 2019 located in three hospitals within one academic medical center in Atlanta, Georgia.

Measurements/Interventions:
Chart review was conducted for sociodemographic, laboratory, and clinical data. Rates of specific cardiovascular complications were assessed, and data were analyzed using a chi-square or Wilcoxon rank-sum test for categorical and continuous variables. Additionally, certain cases are presented to demonstrate the sub committee’s recommendations.

Main Results:
Two-hundred eighty-eight patients were admitted to the ICU with coronavirus disease 2019. Of these, 86 died (29.9%), 242 (84.03%) had troponin elevation, 70 (24.31%) had dysrhythmias, four (1.39%) had ST-elevation myocardial infarction, eight (2.78%) developed cor pulmonale, and 190 (65.97%) with shock. There was increased mortality risk in patients with greater degrees of troponin elevation (p < 0.001) and with the development of arrhythmias (p < 0.001), cor pulmonale (p < 0.001), and shock (p < 0.001).

Conclusions:
While there are guidelines for the diagnosis and management of pulmonary complications of coronavirus disease 2019, there needs to be more information regarding the management of cardiovascular complications as well. These recommendations garnered from the coronavirus disease 2019 cardiology subcommittee from our institution will add to the existing knowledge of these potential cardiovascular insults as well as highlight suggestions for the diagnosis and management of the range of cardiovascular complications of coronavirus disease 2019. Additionally, with the spread of coronavirus disease 2019, our case-based recommendations provide a bedside resource for providers newly caring for patients with coronavirus disease 2019.
Feasibility and Safety of Prone Position Transport for Severe Hypoxemic Respiratory Failure Due to Coronavirus Disease 2019
Authors: Seethala Raghu R. , Frakes Michael A. , Cocchi Michael N. , Cohen Jason E. , Dargin James , Friedman Frank , Grant Christian , Kaye Adam , Wilcox Susan R. 
Published: December 2020

Objectives:
To assess the safety and feasibility of a new protocol for interhospital critical care transport of mechanically ventilated patients in the prone position during the coronavirus disease 2019 pandemic by nurse and paramedic critical care transport teams.

Design:
Retrospective observational study.

Setting:
Single critical care transport agency serving multiple centers in the greater Boston area.

Patients:
All transports of intubated patients in the prone position with severe hypoxemic respiratory failure secondary to coronavirus disease 2019.

Interventions:
Records were reviewed for patients transported in the prone position. Major adverse events in transport, defined as severe hypoxemia (oxygen saturation < 80% or an absolute decrease in oxygen saturation > 10%), hypotension (mean arterial pressure < 65 mm Hg) not responsive to vasopressors or inotropes, endotracheal tube or vascular catheter dislodgement, and cardiac arrest, were recorded.

Measurements and Main Results:
A total of 25 patients were transported in prone position. The mean Pao
2:Fio
2 ratio in the group was 101.3 mm Hg, and 76% (n = 19) were on vasopressors. Fourteen patients (56%) had hypotension with at least one episode of mean arterial pressure less than 65 mm Hg en route, and seven (28%) had an episode of oxygen desaturation less than 88%. Only one major adverse event of severe hypoxemia (oxygen saturation < 80%) was noted.

Conclusions:
Critical care transport of severe hypoxemic respiratory failure patients with coronavirus disease 2019 in the prone position is safe when performed by a dedicated team of critical care nurse and paramedics with an established protocol.
The Future of Nursing
Authors: Sanderson Carla D. 
Published: December 2020

ABSTRACT:
As development of the Future of Nursing 2020-30 Report by the National Academy of Medicine is underway, the nursing profession is positioned to continue positively impacting health and health equity in the United States. Progress to date engenders hope that nurses will continue to take a significant role in reducing health disparities. The work to create a culture of health aligns with the Christian imperative to “love your neighbor as yourself.”
Improving Healthcare Access by Teaching Intercultural Communication
Authors: Chatman Sherri H. , Wynn Stephanie T. 
Published: December 2020

ABSTRACT:
Nonnative English speakers may hesitate or avoid accessing healthcare in the United States due to cultural and communication barriers. Role-play is effective as a method of reducing healthcare access due to inadequate communication skills. A role-play activity used with female Muslim immigrants to the United States enabled participants to develop communication skills and gain confidence for future interactions with a healthcare provider.
Selenium modifies associations between multiple metals and neurologic symptoms in Gulf states residents
Authors: Werder Emily J. , Engel Lawrence S. , Curry Matthew D. , Sandler Dale P. 
Published: December 2020

Background:
Metals have been shown to have a wide range of neurologic effects across the life course, but most studies consider neurodevelopment or neurodegenerative diseases in older adults. We investigated exposure to metals during adulthood in association with subclinical neurologic endpoints, considering the metals individually and as a mixture, and potential interactions among exposures.

Methods:
We measured blood levels of cadmium, lead, mercury, manganese, and selenium in 1007 Gulf state residents and estimated cross-sectional associations between ranked levels of blood metals and the presence of self-reported neurologic symptoms. Single pollutant models were mutually adjusted for other metals and we used quantile g-computation to evaluate associations with exposure to the combined mixture. In stratified analyses, we assessed heterogeneity by smoking and blood selenium.

Results:
The highest quartile of cadmium was associated with a higher prevalence of central nervous system symptoms (prevalence ratio [PR] = 1.50; 95% confidence interval [CI] = 1.13, 1.99), with stronger associations among nonsmokers (PR = 1.63; 95% CI = 1.11, 2.38) and those with low selenium (PR = 2.29, 95% CI = 1.50, 3.49). Selenium also modified associations between lead and peripheral nervous system symptoms, with increased symptoms in the low selenium group at all quartiles of exposure (P-trend = 0.07). Conversely, those with the highest co-exposure to mercury and selenium had reduced neurologic symptoms (PR = 0.73, 95% CI = 0.55, 0.96). Results of the mixture analysis were consistent with single chemical results.

Conclusions:
Cadmium exhibited the most consistent relationship with increased neurologic symptoms, though lead was an important exposure in subgroup analyses. Selenium may modify subclinical neurotoxic effects of metals at non-occupational levels in adults.
Efficacy of intra-operative administration of iron isomaltoside for preventing postoperative anaemia after total knee arthroplasty
Authors: Yoo Seokha , Bae Jinyoung , Ro Du H. , Han Hyuk-Soo , Lee Myung C. , Park Sun-Kyung , Lim Young-Jin , Bahk Jae-Hyon , Kim Jin-Tae 
Published: December 2020

BACKGROUND
Postoperative anaemia is common after total knee arthroplasty (TKA). Emerging evidence shows the beneficial effects of peri-operative iron supplementation in patients at risk of postoperative anaemia.

OBJECTIVE
To evaluate the efficacy of intra-operative administration of iron isomaltoside for the prevention of postoperative anaemia in patients undergoing TKA.

DESIGN
Randomised, controlled, double-blind, parallel-group study.

SETTING
A tertiary care teaching hospital; between 29 March 2018 and 16 April 2019.

PATIENTS
Eighty-nine patients scheduled for unilateral TKA were included.

INTERVENTION
Iron isomaltoside or placebo were administered intravenously over 30 min during surgical wound closure.

MAIN OUTCOME MEASURES
The primary outcome measure was the incidence of anaemia at 30 days after TKA: anaemia was defined as haemoglobin less than 12 g dl−1 for female and less than 13 g dl−1 for male.

RESULTS
In total, 89 patients were included in the final analysis (44 in the treatment group; 45 in the control group). The administered dose of iron isomaltoside in the treatment group was 1136 ± 225 mg. The incidence of anaemia at 30 days after TKA was significantly lower in the treatment group (34.1%, 15/44) than that in the control group (62.2%, 28/45): relative risk 0.55 (95% confidence interval, 0.34 to 0.88), P = 0.008. Haemoglobin concentration, serum ferritin concentrations, and transferrin saturation were also significantly higher in the treatment group at 30 days after TKA.

CONCLUSION
The intra-operative administration of iron isomaltoside effectively prevents postoperative anaemia in patients undergoing TKA, and thus it can be included in patient blood management protocols for reducing postoperative anaemia in these population.

TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT03470649.
Chronic stress indicated by hair cortisol concentration in anaesthesiologists and its relationship to work experience and emotional intelligence
Authors: van der Wal Raymond A.B. , Bijleveld Erik , Herwaarden Antonius E. van , Bucx Martin J.L. , Prins Judith B. , Scheffer GertJan 
Published: December 2020

BACKGROUND
Anaesthesia is a stressful medical specialty. The reaction to stress is constituted by behavioural, psychological and physiological components. Chronic physiological stress can have negative consequences for health.

OBJECTIVES
First, we hypothesised that chronic physiological stress is higher for both beginning and late-career consultant anaesthesiologists. Second, we hypothesised that individuals high in emotional intelligence endure lower physiological stress.

DESIGN
Cross-sectional biomarker and survey study.

SETTING
Participants were recruited during the May 2019 annual meeting of the Dutch Anaesthesia Society.

PARTICIPANTS
Of the 1348 colleagues who attended the meeting, 184 (70 male/114 female) participated in the study. Of the study participants, 123 (67%) were consultant anaesthesiologists (52 male/71 female) and 61 (33%) were resident anaesthesiologists (18 male/43 female). Exclusion criteria were endocrine disorders and not having enough hair. Also, experience of a recent major life event led to exclusion from analysis of our hypotheses.

MAIN OUTCOME MEASURES
Chronic physiological stress was measured by hair cortisol concentration. Emotional intelligence was assessed using a validated Dutch version of the Trait Emotional Intelligence Questionnaire. As secondary measures, psychological sources of stress were assessed using validated Dutch versions of the home-work interference (SWING) and the effort-reward imbalance questionnaires.

RESULTS
In support of Hypothesis 1, hair cortisol concentration was highest among early and late-career consultant anaesthesiologists (quadratic effect: b = 45.5, SE = 16.1, t = 2.8, P = 0.006, R
2 = 0.14). This nonlinear pattern was not mirrored by self-reported sources of psychological stress. Our results did not support Hypothesis 2; we found no evidence for a relationship between emotional intelligence and physiological stress.

CONCLUSION
In the early and later phases of an anaesthesiologist's career, physiological chronic stress is higher than in the middle of the career. However, this physiological response could not be explained from known sources of psychological stress. We discuss these findings against the background of key differences between physiological and psychological stress.
The efficacy of high flow nasal oxygenation for maintaining maternal oxygenation during rapid sequence induction in pregnancy
Authors: Zhou Shuangqiong , Zhou Yao , Cao Xiuhong , Ni Xiu , Du Weijia , Xu Zhendong , Liu Zhiqiang 
Published: December 2020

BACKGROUND
High-flow nasal oxygenation (HFNO) for pre-oxygenation in rapid sequence induction (RSI) has only been assessed in volunteer parturients without intubation.

OBJECTIVES
To evaluate the efficacy of HFNO in comparison with the conventional facemask for oxygenation during RSI for caesarean section under general anaesthesia.

SETTING
Operating room in a tertiary hospital.

DESIGN
Prospective randomised, controlled study.

PARTICIPANTS
Thirty-four healthy parturients undergoing general anaesthesia for caesarean section.

INTERVENTIONS
Parturients were randomly assigned to HFNO or standard facemask (SFM) group.

MAIN OUTCOME MEASURES
The primary outcome measure was the PaO2 immediately after intubation. Secondary outcomes included lowest saturation throughout the intubation procedure, end-tidal oxygen concentration (EtO2) on commencing ventilation, blood gas analysis (pH, PaCO2), fetal outcomes and intubation-related adverse events.

RESULTS
PaO2 in the HFNO group was significantly higher than that in SFM group (441.41 ± 46.73 mmHg versus 328.71 ± 72.80 mmHg, P < 0.0001). The EtO2 concentration in the HFNO group was higher than that in the SFM group (86.71 ± 4.12% versus 76.94 ± 7.74%, P < 0.0001). Compared to baseline, PaCO2 immediately after intubation also increased significantly in both groups (HFNO group: 30.87 ± 2.50 mmHg versus 38.28 ± 3.18 mmHg; SFM group: 29.82 ± 2.57 mmHg versus 38.05 ± 5.76 mmHg, P < 0.0001), but there was no difference in PaCO2 between the two groups. There was no difference in lowest saturation, intubation times, duration of apnoea, pH value or fetal outcomes.

CONCLUSIONS
Compared with SFM, HFNO provided a higher PaO2 and EtO2 immediately after intubation in parturients. HFNO is safe as a method of oxygenation during RSI in parturients undergoing general anaesthesia for caesarean section.

TRIAL REGISTRATION
Clinical trial ChiCTR1900023121.
Alkali Burn Over a LASIK Flap
Authors: Witsberger Emily M. , Patel Sanjay V. 
Published: December 2020

Purpose:
To describe the management and outcome of an ocular surface alkali burn in the setting of previous laser in situ keratomileusis (LASIK).

Methods:
This is a case report and review of relevant literature.

Results:
A 25-year-old man with a history of LASIK presented 4 weeks after a sodium hydroxide splash to his left eye with visual acuity of 20/60 and a nonhealing epithelial defect adjacent to sectoral inferior limbal ischemia in the setting of trichiasis from upper eyelid cicatricial entropion. After topical corticosteroids were discontinued following the repair of the entropion, the patient returned 3 days later with worsening vision and severe diffuse lamellar keratitis with the melting of the LASIK flap. After promptly lifting the flap and debriding the interface, inflammation was managed with oral, instead of topical, corticosteroids. Over several weeks, the epithelium healed, and inflammation and interface edema resolved. At 10 years of follow-up, the patient had developed a localized pseudopterygium with mild corneal neovascularization but maintained 20/20 uncorrected visual acuity.

Conclusions:
A chemical burn over a LASIK flap poses a challenge for managing corticosteroids, which are required to prevent diffuse lamellar keratitis but can also contribute to keratolysis beyond the first week after an alkali injury. Oral corticosteroid therapy may be beneficial in this situation, with a low threshold to lift the LASIK flap and debride the interface if inflammation occurs.
Investigating the Geometry and Mechanical Properties of Human Round Window Membranes Using Micro-Fringe Projection
Authors: Liang Junfeng , Nakmali Don , Gan Rong Z. , Lu Hongbing , Dai Chenkai 
Published: December 2020

Hypothesis:
The geometry and the mechanical property of the round window membrane (RWM) have a fundamental impact on the function of cochlea.

Background:
Understanding the mechanical behavior of RWM is important for cochlear surgery and design for the cochlear implant. Although the anatomy of RWM has been widely studied and described in the literature, argument remains regarding the true shape of RWM. The mechanical properties of RWM are also scarcely reported due to the difficulty of the measurement of the small size RWM.

Methods:
In this paper, micro-fringe projection was used to reconstruct the 3-dimensional geometries of 14 RWMs. Mechanical properties of the RWMs were subsequently measured using finite element (FE) model and an inverse method. The three-dimensional surface topographies and the curvatures of the two major directions reconstructed from the micro-fringe projection both demonstrated wide variations among samples.

Results:
The diameters of the RWMs vary from 1.65 to 2.2 mm and the curvatures vary from −0.97 to 3.76 mm−1. The nonlinear elasticity parameters in the Ogden model for each sample was measured and the average effective Young's modulus is approximately 1.98 MPa.

Conclusion:
The geometries and mechanical properties of the human RWM measured in the work could potentially be applied to surgery design and on modeling analysis for the cochlea.
High expression of microRNA 221 is a poor predictor for glioma
Authors: Song Yanlin , He Min , Zhang Jing , Xu Jianguo 
Published: December 2020

Abstract

Background:
MicroRNA 221 has been found to be a good marker for several cancers. Some studies also focused on the relationship between microRNA 221 and glioma. However, the results are controversial. We aimed to systematically evaluate the prognostic role of microRNA 221 in glioma through performing a meta-analysis.

Methods:
The articles which were included in our study were searched on the Web of Science, EMBASE, PubMed, Cochrane Library and China National Knowledge Infrastructure. The basic characteristics and relevant data were extracted. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled to evaluate the prognostic role of microRNA 221 in glioma.

Results:
Eight studies with 1069 patients were included. We systematically evaluated the role of microRNA 221 for overall survival (OS) and disease free survival (DFS) in glioma patients (HR for OS = 1.66, 95% CI, 1.34–2.04; HR for DFS = 1.14, 95% CI, 1.02–1.26). Subgroup analyses were performed according to the nation of the studies, the origin of the samples, the stage of the tumors, the cut-off value, and the method for detecting the microRNA 221. No significant publication bias was found (P = .133).

Conclusion:
In conclusion, high expression of microRNA 221 was related to poor prognosis of glioma. These findings may assist future exploration on microRNA 221 and help predict the prognosis of glioma. However, due to the significant heterogeneity of these studies, more studies are warranted.
Breast metastasis from EGFR/ALK negative lung adenocarcinoma
Authors: Cao Liyu , Lv Liting 
Published: December 2020

Abstract

Introduction:
Lung adenocarcinoma is the most common type of lung cancer. Distant metastasis of lung adenocarcinoma often occurs in multiple organs. The common metastasis sites of lung cancer include the lungs, brain, bones, adrenal glands, and lymph nodes; however, breast metastasis is rare.

Patient concerns:
In this report, we describe a case of breast metastasis from lung adenocarcinoma. A 55-year-old woman reported left breast pain for more than 1 month.

Diagnosis:
Based on imaging, pathological examination, and immunohistochemical examination, the diagnosis of breast metastasis from lung adenocarcinoma was confirmed. Epidermal growth factor receptor mutations and anaplastic lymphoma kinase rearrangement were not detected by next-generation sequencing.

Interventions:
The patient was treated with six courses of a combination of albumin-bound paclitaxel, cisplatin, and bevacizumab over 21 days.

Outcomes:
After six cycles of palliative chemotherapy, her left breast pain and swelling subsided; in addition, her serum CA12-5, CYFRA, and CEA levels normalized by April 2019. PR status was evaluated as per the RECIST 1.1 criteria. The patient developed brain metastases 3 months later and died due to multiple organ failure.

Conclusion:
The possibility of breast metastasis should be considered in patients with existing malignant tumors and breast pain. Clinical and imaging examinations are helpful for diagnosis, and pathological and immunohistochemical analyses are the most important diagnostic tools.