bluuebunny/crossref_metadata_2025_split huggingface dataset:
Body image perception and its psychological influence on prosthesis satisfaction
Authors: Banu R. Fathima , R. Vaishnavi , Kumar V. Anand , Veeravalli Padmanabhan T. 
Published: November 2020

AbstractAimTo identify the body image perception of an individual utilising figure rating scale and assess its psychological influence in altering the prosthetic satisfaction.MethodsOne hundred five of 140 participants were categorised into Groups I, II and III according to their body image satisfaction. Pre‐ and posttreatment denture satisfaction questionnaires, and pretreatment Big Five personality, Life Satisfaction questionnaires were given to the participants in each group. Analysis of variance (ANOVA) and Tukey post hoc tests assessed the significant relation between the groups.ResultsBody image satisfied group (I) was highly contented with the prosthetic treatment (46.90), while body image dissatisfied groups (II and III) had lower denture satisfaction scores (36.80 and 29.70). Neurotic score was significantly different in pairs; Groups I and III, and Groups II and III (P < .001), with high mean for Group III (75.30). The agreeable score was significantly different in Groups I and II (P < .05), with a high mean for Group I (83.60). Life Satisfaction score was significantly different in pairs; Groups I and III, and Groups I and II (P < .001), with a high mean for Group I (30.60).ConclusionThe individual's perception of body image had an effect on their denture satisfaction level, and figure rating scale would help in identifying the psychological profile of the patient.
The relationship of soluble klotho level with uremic cardiomyopathy and ecocardiographic parameters in hemodialysis patients
Authors: Erkus Edip , Buyukterzı Zafer , Karakose Suleyman , Kurku Huseyın , Kurtgoz Pervın O. , Topal Mustafa , Guney Ibrahim 
Published: November 2020

AbstractThere are studies reporting that soluble kltho (sKlotho) deficiency plays a role in cardiovascular disease in addition to traditional risk factors such as diabetes, hypertension, anemia, smoking, and excessive volume burden. Our aim in this study was to investigate the relationship of sKlotho with uremic cardiomyopathy and echocardiographic parameters in patients receiving hemodialysis treatment. According to the median value, the sKlotho value was divided into two groups as ≥1.24 and <1.24 ng/ml. Ventricular wall thicknesses, ejection fractions, left atrium, M mode aorta systole, and diastole diameter measurements were taken. The left ventricular mass (LVM) was calculated using the Devereux formula. There were significant differences between the two groups in terms of age, number of patients with diabetes mellitus, comorbidity, dialysis time, sKlotho, phosphorus, parathormone, and albumin parameters. No significant difference was found between the two groups that were separated according to the median sKlotho value, when the echocardiographic parameters of interventricular septum thickness, left ventricular posterior wall thickness, left atrial diameter, left ventricular ejection fraction, and LVM index were compared. In conclusion, sKlotho is not a marker for showing and predicting uremic cardiomyopathy in hemodialysis patients.
Continuous infusion factor replacement in haemophilia B during and after cardiac surgery: the better choice?
Authors: Farid Saira , Sewaralthahab Sarah , Smith Hedy Patricia 
Published: November 2020

A 57-year-old man with mild haemophilia B was admitted for coronary artery bypass graft surgery. His factor IX (FIX) activity was 15% on admission. Our goal was to maintain his FIX activity at 80%–100% for post-op days (PODs) 0–3, and at 60%–80% for PODs 4–14. Preoperatively, the patient was given recombinant FIX (rFIX) bolus using the formula:Dosage needed=%(desired FIX level−current level of FIX)×weight (kg)×1.3.This increased his activity to 100%. One IU of rFIX increased FIX activity by 0.8%; the half-life of rFIX is 18–24 hours. The rFIX infusion was started intraoperatively and continued after surgery to maintain target FIX activity. He was discharged on POD 9 on rFIX bolus dosing of 5000 IU every 12 hours for an additional 5 days. Using continuous factor infusion, we managed to decrease the amount rFIX used by >60% while maintaining steady state FIX activity level.
Cardiovascular risk profiles in German Air Force pilots
Authors: Sammito Stefan , Güttler N 
Published: November 2020

IntroductionCardiovascular disease (CVD) is the leading cause of death in western industrial countries and one of the most frequent causes of sudden incapacitation in flight for pilots. There are limited data available on cardiovascular risk profiles of pilots, and especially military pilots. The aim of this study was to assess the prevalence of cardiovascular risk factors (CVRF) in German military pilots.MethodsThe changing prevalence of CVRF in active military pilots was studied using a cross-sectional survey during two distinct periods, 2007–2009 and 2016–2018. Data collected included sex, body mass index (BMI), smoking status, resting blood pressure, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides and glucose. The use of antihypertensive drugs, diagnosis of diabetes mellitus and positive family history of myocardial infarction were also captured. Based on these data, the PROCAM (Prospective Cardiovascular Münster) score was calculated.ResultsData from 5353 flight medical examinations were analysed, 3397 from 2007 to 2009, and 1959 from 2016 to 2018. Between the cohorts, age, BMI, total cholesterol, HDL, LDL, glucose and triglycerides increased significantly. The number of pilots on antihypertensive medication decreased significantly. The PROCAM score increased between cohorts from 18 to 23 points predicting a 10-year risk of an acute coronary event of <1% and 1.3%, respectively.ConclusionThe German military pilot population has become older with increased CVRF. CVD will be a future challenge for the German Armed Forces and probably other military forces. However, there was only a mild increase of the PROCAM score over time.
‘Where have all the doctors gone?’ A protocol for an ethnographic study of the retention problem in emergency medicine in the UK
Authors: Darbyshire Daniel , Brewster Liz , Isba Rachel , Body Richard , Goodwin Dawn 
Published: November 2020

Introduction‘Emergency medicine (EM) in the UK has a medical staffing crisis.’ Inadequate staffing, in EM and across healthcare, is a problem that affects the quality of patient care globally. Retention of doctors in EM is a particularly acute problem in the UK’s National Health Service. Sustainable careers in healthcare are gaining increasing attention at a national and international policy level, but research to understand the factors that facilitate retention is lacking.This study aims to develop understanding of what drives retention of doctors in EM by focusing on those who remain in these careers, where previous research has targeted those who have left. By addressing the problem of retention in a different way, using innovative methods in this context, we aim to develop a deeper and more nuanced understanding of sustainable careers in EM.Methods and analysisThis is an ethnographic study combining participant observation in two emergency departments, interviews with doctors from these departments, from organisations with influence or interest at a policy level and with doctors who have left EM. The analyses will integrate detailed workplace observation alongside key academic and policy documents using reflexive thematic analysis.Ethics and disseminationApprovals have been obtained from Lancaster University via the Faculty of Health and Medicine Research Ethics Committee (FHMREC18058) and the Health Research Authority (IRAS number 256306). The findings will inform understanding of sustainable careers in EM that may be transferable to other settings, professions, and locations that share key characteristics with EM such as paediatrics, emergency nursing and general practice. Findings will be disseminated through a series of academic publications and presentations, through local and specialty research engagement, and through targeted policy statements.
Safety and efficacy of mycophenolate mofetil in treating neuromyelitis optica spectrum disorders: a protocol for systematic review and meta-analysis
Authors: Han Mengyu , Nong Luqi , Liu Ziqiang , Chen You , Chen Yang , Meng Huan , Qin Yali , Wang Zhijun , Jin Ming 
Published: November 2020

IntroductionNeuromyelitis optica spectrum disorders (NMOSD) is an inflammatory and heterogeneous astrocyte disorder of the central nervous system with the characteristic of higher incidence in women and Asian people. Most patients with NMOSD have a course of recurrence and remission that is prone to cause paralysis and blindness. Several studies have confirmed the efficacy and promising prospect of mycophenolate mofetil (MMF) in the treatment of NMOSD. Yet its therapeutic effect and safety are controversial. Although there has been two published literature that is relevant to the topic of this study, both of them have certain defects, and they can only provide answers about the efficacy or safety of MMF in the treatment of NMOSD from partial perspectives or conclusions. This research aims to perform a direct and comprehensive systematic review and meta-analysis to evaluate MMF’s effectiveness and safety in treating NMOSD.Methods and analysisThis systematic review will cover all comparative researches, from randomised controlled trials to cohort studies, and case–control study. A relevant literature search will be conducted in PubMed, Web of Science, EMBASE, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database and Chinese Biomedical Literature Database from their inception to 31 June 2020. We will also search registers of clinical trials, potential grey literature and abstracts from conferences. There are no limits on language and publication status. The reporting quality and risk of bias will be assessed by two researchers independently. Expanded Disability Status Scales and annualised relapse rate will be evaluated as the primary outcome. The secondary outcomes will consist of the frequency and severity of adverse events, best-corrected visual acuity, relapse-free rate and time to the next attack. A meta-analysis will be performed using RevMan V.5.3 software provided by the Cochrane Collaboration and Stata V.12.0.Ethics and disseminationBecause the data used for this systematic review will be exclusively extracted from published studies, ethical approval and informed consent of patients will not be required. The systematic review will be published in a peer-reviewed journal, presented at conferences and will be shared on social media platforms.PROSPERO registration numberCRD42020164179.
Interface management concepts in healthcare for rare diseases in Germany: a study protocol for a mixed-methods study to develop best practice recommendations
Authors: Inhestern Laura , Zybarth David , Otto Ramona , Brandt Maja , Härter Martin , Bergelt Corinna 
Published: November 2020

IntroductionPatients and families affected by a rare disease are burdened in multiple ways. Functional interface management can unburden patients or relatives from the need to be solely accountable for the navigation through the healthcare system. This study aims at (1) providing an assessment of approaches and interface management concepts in the care of rare diseases, (2) evaluating selected existing approaches and concepts and (3) developing best practice recommendations for interface management.Methods and analysisWe will conduct a mixed-methods study with three phases. In phase 1, we will develop a tool to assess existing concepts of interface management for rare diseases based on a literature search and an expert workshop. The tool will be applied in a telephone survey with representatives of centres or clinics of expertise for rare diseases (target: n=100) and cooperating practitioners (target: n=60). Based on the results of phase 1, we will select four to six centres of expertise with interface management concepts, which will be evaluated extensively in phase 2. For the evaluation, we will conduct semistructured interviews with practitioners cooperating with centres or clinics for rare diseases (target: n=50), a paper-based survey including patients or parents/legal guardians (target: n=300) from the selected centres or clinics, and semistructured interviews with patients or parents/legal guardians (target: n=50). The final phase of the study will be an integration of results from phases 1 and 2 to develop best practice recommendations for interface management in healthcare of rare diseases. In a concluding expert workshop, recommendations will be presented and finalised.Ethics and disseminationThis study was approved by the Local Psychological Ethics Committee of the Center for Psychosocial Medicine of the University Medical Center Hamburg-Eppendorf (LPEK-0062). The findings of our study will be presented on national and international conferences and published in scientific, peer-reviewed journals. To assure that centres for rare diseases get access to the study results, centres are invited to send a representative to a final expert workshop in phase 3. Moreover, an executive summary will be provided and sent to relevant stakeholders.Trial registration numberGerman Clinical Trials Registry (DRKS00020488).
Multicentre randomised phase II study of the perioperative administration of flurbiprofen axetil in patients with non-small cell lung cancer: study protocol of the FLAX Study
Authors: Sakamaki Kentaro , Watanabe Katsuya , Woo Tetsukan , Masuda Munetaka 
Published: November 2020

IntroductionIn patients with non-small cell lung cancer, surgical treatment with postoperative adjuvant chemotherapy is performed. However, the improvement of overall survival achieved by postoperative adjuvant chemotherapy may be insufficient in consideration of the deterioration of quality of life (QOL). Considering the relationships among surgical treatments, inflammation and carcinogenesis, non-steroidal anti-inflammatory drugs (NSAIDs) are a candidate postoperative treatment for preventing recurrence and maintaining QOL. In this study, we investigate the effects of the perioperative administration of flurbiprofen axetil on postoperative recurrence in patients with non-small cell lung cancer.Methods and analysisThis study is a multicentre, parallel group, open label, randomised controlled trial. Patients clinically suspected of non-small cell lung cancer are randomly assigned to the flurbiprofen axetil group or the no-NSAIDs group. A total of 420 patients (210 per group) will be registered. The primary analysis will evaluate the treatment effect of flurbiprofen axetil on postoperative recurrence.Ethics and disseminationThe study protocol was approved by the Clinical Research Review Board of Saitama Medical University in September 2019 (No. 192002) and will be approved by each institutional review board of all participating institutions before patient enrolment. This study complies with the latest version of the Declaration of Helsinki, Clinical Trial Act and related notifications. Results will be published in a peer-reviewed journal.Trial registration numberJapan Registry of Clinical Trials (jRCTs031190167; Pre-results) (https://jrct.niph.go.jp/).
The ‘Walker dip’
Authors: Walker A J 
Published: November 2020

AbstractThroughout recent history there has been a pattern whereby military medical care improves in wartime and these advances are lost by the time the next conflict occurs. This dip in medical performance potentially represents lives that may be lost and recovery that may be impaired for our young servicemen and women at the start of every new conflict. When reviewing the wars of the last two centuries, three themes emerge. Firstly, post-war military cuts fall disproportionately on medical services, leaving a mismatch between the size of forces that can be deployed and the ability to care for them when injured. Secondly, insufficient medical representation in military operational planning results in the neglect of medical logistics; and finally, technical and procedural lessons are not adequately captured and incorporated into training and doctrine.
Field recognition and management of freezing and non-freezing cold injuries
Authors: Kuht J , Smith B , Brown A 
Published: November 2020

AbstractPeripheral cold injuries have disabled entire armies in the past and, as recently as the Falklands conflict of 1982, jeopardised the success of an entire military operation. They can be divided into those that involve freezing of the peripheral tissue and those that do not, termed Freezing Cold Injury (FCI) and Non-Freezing Cold Injury (NFCI) respectively.This article focuses on the recognition and management of cold injuries in the field. It draws from the current literature, briefly outlining the pathophysiological basis of the two injuries, then focuses on the challenges of field recognition of cold injuries, especially NFCI, which is characterised by a lack of overt physical signs. A framework for field management of these injuries is then outlined, with an emphasis on the contrasting re-warming strategies for FCI and NFCI, and the pharmacological therapies used in each condition.The article is pertinent to those who may train or deploy to an area with temperatures lower than 20° Celsius, the generally accepted temperature below which peripheral cold injuries may occur. It is hoped that improved awareness of the risks coupled with better field recognition and management may reduce the incidence of cold injury, especially in light of recent observations that re-exposure to cold in those with NFCI can cause more significant morbidity, highlighting the importance of getting the diagnosis and management right in the field.
Operation LITTEN: a year delivering medical care during the peak of the Mediterranean migrant crisis, 2016-2017
Authors: Sharp W M J , Tanzer W J , Castledine B 
Published: November 2020

AbstractThe increased movement of migrants across the Mediterranean to the European Union intensified in 2015. This paper will focus on the complex experiences and lessons learnt by three Medical Officers (MOs) involved in one year of maritime rescue operations in the Mediterranean (August 2016 to July 2017). During this period a total of 7930 people were rescued by the Royal Navy (RN), with the largest single rescue involving 712 people. The medical teams involved delivered sustained care for periods of up to 80 hours, often with no immediate casualty evacuation available. The scope of clinical practice was wide and challenging, from the birth of infants, to the delivery of care to those with burns, gunshot wounds, sepsis and drowning. The teams were often confronted with mass casualty events, a challenge for any deployed unit.
The involvement of the French military medical service in helicopter rescue missions for Emergency Medical Aid at Sea: the current situation and prospects for the future.
Authors: Guénot P , Leigh-Smith S , Granger-Veyron N , Carfantan C , Dulaurent E 
Published: November 2020

AbstractFrench military Search and Rescue (SAR) is primarily for the recovery of downed aircrew in an operational environment but has traditionally also played an important civilian role. Military doctors and nurses with competence in this area frequently form part of civilian teams, their experience being transferable between operational and civilian spheres. A recent re-organisation of French Medical Aid at Sea (MAS) has seen greater involvement of civilian medical services in this sector with consequent potential for negative impact on future military involvement.The French Military Medical Service / Service de Santé des Armées (SSA) 2020 plan provides opportunities for mutually advantageous, deeper engagement and joint working between the SSA and the French National Health Service / Service Public de Santé (SPS).This article describes the current structure for MAS and the involvement of SSA therein before considering some of the challenges and potential solutions with respect to deeper civilian-military engagement in this domain in future.
Test Accuracy of the Montreal Cognitive Assessment in Screening for Early Poststroke Neurocognitive Disorder
Authors: Munthe-Kaas Ragnhild , Aam Stina , Saltvedt Ingvild , Wyller Torgeir Bruun , Pendlebury Sarah T. , Lydersen Stian , Ihle-Hansen Hege 
Published: November 2020

Background and Purpose:
We determined the diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) for poststroke neurocognitive disorder defined according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria in a prospective observational study.

Methods:
Consecutive participants able to complete a cognitive test battery and MoCA 3 months poststroke were included. The reference standard of neurocognitive disorder was defined as a score of ≥1.5 SD below the normative mean in ≥1 cognitive domain on the cognitive test battery.

Results:
Among 521 participants (43.6% women; mean age/SD, 71.5/12.0 years; mean education/SD, 12.4/3.8 years), the area under the receiver operating characteristic curve of MoCA for neurocognitive disorder was 0.80 (95% CI, 0.76–0.84). Using the standard MoCA cutoff <26, sensitivity was 0.71 (0.66–0.76) with specificity of 0.73 (0.67–0.79). MoCA cutoff of <27 gave higher sensitivity (0.82 [0.77–0.85]) at the expense of specificity (0.60 [0.53–0.66]).

Discussion:
MoCA has reasonable accuracy for poststroke neurocognitive disorder diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02650531.
A Novel Neural Model With Lateral Interaction for Learning Tasks
Authors: Jin Dequan , Qin Ziyan , Yang Murong , Chen Penghe 
Published: November 2020

Abstract
We propose a novel neural model with lateral interaction for learning tasks. The model consists of two functional fields: an elementary field to extract features and a high-level field to store and recognize patterns. Each field is composed of some neurons with lateral interaction, and the neurons in different fields are connected by the rules of synaptic plasticity. The model is established on the current research of cognition and neuroscience, making it more transparent and biologically explainable. Our proposed model is applied to data classification and clustering. The corresponding algorithms share similar processes without requiring any parameter tuning and optimization processes. Numerical experiments validate that the proposed model is feasible in different learning tasks and superior to some state-of-the-art methods, especially in small sample learning, one-shot learning, and clustering.