bluuebunny/crossref_metadata_2025_split huggingface dataset:
A six-week inspiratory muscle training and aerobic exercise improves respiratory muscle strength and exercise capacity in lung cancer patients after video-assisted thoracoscopic surgery: A randomized controlled trial
Authors: Liu Jui-Fang , Kuo Nai-Ying , Fang Teng-Pei , Chen Jui-O , Lu Hung-I , Lin Hui-Ling 
Published: December 2020

Objective: To compare the postoperative outcomes of inspiratory muscle training and aerobic exercise, along with standard care, on lung cancer patients undergoing video-assisted thoracoscopic surgery (VATS). Design: A parallel-group, single-blind randomized clinical trial Setting: Thoracic surgery ward and outpatient clinic in a teaching hospital Subjects: Overall 63 patients underwent VATS were randomly assigned to a triaging (TG, n = 32) or control group (CG, n = 31). A total of 54 patients (TG, n = 26; CG, n = 28) completed the study. Intervention: TG: six-week threshold inspiratory muscle training and aerobic exercise. CG: standard care. Main measures: Maximum inspiratory pressure (PImax), maximum expiratory pressure (PEmax) lung expansion volume, and 6-min walking test (6MWT) were performed on the day of chest tube removal (baseline), and 2, 6, and 12 weeks postoperatively. Results: The TG showed significant improvement in PImax at week 6 (71.6 ± 34.9 vs. 94.3 ± 32.8 cmH2O, P = 0.018), PEmax at week 2 (70.9 ± 24.3 vs. 90.9 ± 28.2 cmH2O, P = 0.015) and week 12 (76.1 ± 20.2 vs. 98.6 ± 35.3 cmH2O, P = 0.012), the lung expansion volume at week 2 (1080 ± 433 vs 1457 ± 624 mL, P = 0.02) and week 12 (1200 ± 387 vs 1885 ± 678 mL, P < 0.001), in addition to the 6MWT at week 2 (332 ± 78 vs 412 ± 74 m, P = 0.002), week 6 (360 ± 70 vs 419 ± 60 m, P = 0.007) and week 12 (360 ± 58 vs 402 ± 65 m, P = 0.036). Conclusion: A six weeks of inspiratory muscle training and aerobic exercise had improved respiratory muscle strength and aerobic exercise postoperatively in lung cancer patients after VATS as early as 2 weeks.
Perspectives of bereaved partners of lung cancer patients on the role of mindfulness in dying and grieving: A qualitative study
Authors: Schellekens Melanie PJ , van den Hurk Desiree GM , Jansen Ellen TM , van der Lee Marije L , Prins Judith B , van der Drift Miep A , Speckens Anne EM 
Published: December 2020

Background: Mindfulness-Based Stress Reduction (MBSR) has been shown to reduce psychological distress in cancer patients but not their partners. Whether MBSR can support patients and partners in coping with the dying and grieving process is less well examined. Aim: We aimed to gain more insight in the role of mindfulness in the dying and grieving process from the perspective of the partner after the patient’s death. Design: As part of a pilot study or subsequent randomized controlled trial, partners had participated together with the patient in MBSR. After the patient’s death partners were invited for qualitative in-depth interviews. Data from the interviews was analyzed using the grounded theory approach. Setting/participants: Interviews were conducted with 11 partners in their homes, on average 11 months after the patient’s death (SD = 7.8). Results: Mindfulness helped couples to allow and regulate difficult thoughts and feelings, which in turn helped them to accept the patient’s impending death. It also facilitated them to enjoy things together and communicate more openly. For a few couples, however, participation was physically too burdensome or emotionally too confrontational. During the partners’ grieving process, mindfulness helped allowing difficult thoughts and feelings, and taking the time to grieve, which helped them to take good care of themselves, giving them faith in the future. Conclusion: The present study showed that MBSR can facilitate lung cancer patients and their partners in accepting the forthcoming death and openly communicating about this, which can support a peaceful death and healthy grieving process.
Knowledge, attitudes and practices regarding COVID-19 among dental health care professionals: a cross-sectional study in Saudi Arabia
Authors: Srivastava Kumar Chandan , Shrivastava Deepti , Sghaireen Mohammed Ghazi , Alsharari Abdalkarem Fedgash , Alduraywish Abdulrahman Abdulwahab , Al-Johani Khalid , Alam Mohammad Khursheed , Khader Yousef , Alzarea Bader Kureyem 
Published: December 2020

Objectives With the increasing severity of the coronavirus disease (COVID-19) pandemic, it is essential that dental health care professionals (DHCPs) are prepared. The study aim was to assess the knowledge, attitudes and practices (KAP) regarding COVID-19 among DHCPs in Saudi Arabia. Methods A cross-sectional study using a web-based survey was conducted. A validated and reliable questionnaire was developed that comprised 44 questions. Using Qualtrics survey software, DHCPs working in different settings were approached across five geographical regions of Saudi Arabia. Results A total of 318 respondents voluntarily participated in the survey. Most DHCPs showed a moderate level of knowledge (51.6%), a positive attitude (92.1%) and adequate practice standards (86.5%). We found that 94.7% of DHCPs had an adequate overall level of KAP. DHCPs with a doctorate significantly outscored DHCPs with other educational levels with respect to knowledge and practice. Older (51–60 years) DHCPs reported significantly more knowledge than younger DHCPs. Conclusion DHCPs displayed an average level of knowledge that needs to be enhanced through continuing education programmes. However, they showed a positive attitude and an acceptable level of practice, as they were abiding by guidelines issued from various international and national health agencies.
Systemic lupus erythematosus-related acute pancreatitis
Authors: Dima Alina , Balaban Daniel Vasile , Jurcut Ciprian , Jinga Mariana 
Published: December 2020

Introduction Systemic lupus erythematosus (SLE) is a complex autoimmune pathology that can involve any organ. Lupus-related acute pancreatitis (AP) is, together with lupus mesenteric vasculitis, an important cause of SLE-induced acute abdominal pain. Methods A literature search was conducted using the terms “Pancreatitis” and “Lupus Erythematosus, Systemic” on PubMed/Medline and Web of Science from January 2007 to January 2020. Clinical characteristics, diagnostic approach, and treatment principles in SLE-related AP are presented in this review. Results Mainly retrospective reports were identified. The reported incidence of SLE-associated AP ranges from 0.9 to more than 5% of patients. A total of 264 SLE patients were found in the selected research, with a net female predominance (sex ratio 9:1) and mean age of 31.4 years. Abdominal pain was virtually present in all cases. AP occurrence was more frequent in SLE patients with short disease duration, high activity scores, and multiorgan involvement. The AP definition was based on currently available guidelines and after exclusion of any other known causes (including iatrogenic, i.e. drugs), a diagnosis of “idiopathic” SLE-related AP might be sustained. Management is difficult, as there is no standardized therapeutic approach. Of note, glucocorticoid use remains still controversial as, especially for high doses, subsequent pancreatic injury may occur. Monitoring serum lipase levels after high dose steroids might be considered. One study reported beneficial prognostic effect of plasma exchange. Moreover, AP in SLE might raise awareness about macrophage activation syndrome association. Mortality up to one third of AP cases in SLE was reported. Conclusion The SLE-related AP is a rare, but severe, life-threatening complication. Corticosteroids must be used with caution. Plasma exchange could be considered in selected cases.
OCT angiography analysis in acute non-arteritic anterior ischemic optic neuropathy: The importance of segmentation
Authors: Rougier Marie-Benedicte , Gattoussi Sarra , Le-Goff Melanie , Korobelnik Jean Francois 
Published: December 2020

Background: In non-arteritic anterior ischemic optic neuropathy (NAION), optical coherence tomography angiography (OCTA) shows changes in peripapillary vascularization. However, the presence of an optic disc edema may induce artifacts that prevent visualizing the peripapillary network. The aim of this study was to evaluate the peripapillary vascularization in acute NAION using swept-source OCTA algorithms allowing segmenting only the retinal nerve fiber layer (RNFL). Methods: Retrospective analysis of 15 eyes with acute NAION of 15 patients. The optic nerve head was imaged using swept-source OCTA. Morphological and quantitative analyzes were performed. The capillary flux index (CFI), defined as the total weighted area of perfused vasculature per unit area, and the capillary perfusion density (CPD), defined as the total area of perfused microvasculature per unit area, were quantified. Each NAION eye was compared to the unaffected fellow eye using a Wilcoxon test for matched samples. Results: After segmentation at the RNFL, the morphological analysis showed less vascular dropout and more vascular tortuosity than the analysis of a larger segmentation. The quantitative analysis showed that the mean CFI and the CFI in the four quadrants were significantly higher in NAION eyes compared to healthy eyes ( p = 0.0002 and p < 0.01). The mean CPD and the CFD in the inferior quadrant were lower in NAION eyes ( p = 0.03 and p = 0.0054, respectively). Discussion: The RNFL segmentation allowed better visualizing the peripapillary network because the edema related darkening was reduced. The increased CFI suggests an autoregulatory phenomenon to compensate the ischemic process at the ciliary vasculature.
Optical coherence tomography biomarkers for visual acuity in patients with idiopathic epiretinal membrane
Authors: Karasavvidou Evdoxia-Maria , Panos Georgios D , Koronis Spyridon , Kozobolis Vassilios P , Tranos Paris G 
Published: December 2020

Purpose: To investigate the correlation between outer and inner retina optical coherence tomography (OCT) biomarkers and visual acuity in patients with idiopathic epiretinal membrane (iERM) and identify which of them may be predictive of visual function. Methods: A retrospective cross-sectional single-center study was conducted that included patients diagnosed with iERM. Spectral domain OCT images were obtained and assessed qualitatively and quantitatively. The association of OCT parameters with best corrected visual acuity was analyzed. Results: Charts of 97 eyes of 97 patients were reviewed. Central foveal thickness, maximal retinal thickness (MRT), photoreceptor outer segment length, outer foveal thickness, ganglion cell-inner plexiform layer complex thickening, inner retinal thickness and inner retinal layer irregularity index were among the major outcome measures. OCT scans were also assessed for the presence of cotton ball sign, ellipsoid zone disruption, ectopic inner foveal layer, disorganization of retinal inner layers (DRIL), intraretinal fluid, subretinal fluid (SRF) and epimacular membrane rip. Univariate analysis showed statistically significant association between all the aforementioned parameters with worse vision, except for cotton ball sign and SRF. Multivariate analysis found that MRT and severe DRIL were strongly correlated with worse vision ( p < 0.001). Conclusion: MRT and severe DRIL should be considered as negative prognostic factors for visual acuity.
Outcome after Hybrid Outflow Interventions for Chronic Limb-threatening Ischemia
Authors: Serna Santos J. , Söderström M. , Helminen R. , Aho P. , Halmesmäki K. , Venermo M. 
Published: December 2020

Background and Aims: Because chronic limb-threatening ischemia (CLTI) is often associated with multilevel arterial disease, it usually requires revascularization at different sites of the limb vasculature. We aim to assess the outcome of the hybrid interventions including open surgical revascularization together with outflow segment percutaneous transluminal angioplasty (PTA) in patients with chronic limb-threatening ischemia. Material and Methods: This study included all hybrid outflow-PTA interventions (n = 80) on patients suffering from CLTI performed in Helsinki University Hospital between 2003 and 2015. Follow-up ended on 31 December 2019. Patient data were prospectively collected into our vascular registry and scrutinized retrospectively. Thirty-one patients (39%) suffered from rest pain (Rutherford category IV) and 49 patients (61%) had ischemic ulcers (Rutherford category V–VI). The most common open surgical procedure was femoral endarterectomy (n = 63, 79%) and the most common endovascular procedure was superficial femoral artery percutaneous transluminal angioplasty (n = 65, 81%). Mean follow-up time was 56 months (range: 4 days–183 months). Results: Limb salvage was at 30 days—92%, at 1 year—91%, and at 5 and 10 years—86%. Survival and amputation-free survival were at 30 days—93% and 86%, at 1 year—80% and 76%, at 5 years—51% and 48%, and at 10 years—21% and 21%. Wound healing at 3, 6, and 12 months was 48%, 71%, and 87%. Freedom from target lesion revascularization was at 30 days—97%, at 1 year—88%, at 5 years—72%, and at 10 years—66%. Conclusion: Hybrid outflow revascularization is an important tool in the vascular surgeon’s armamentarium for treatment of patients with multilevel arterial disease causing chronic limb-threatening ischemia.
Effect of SALL4 on the Proliferation, Invasion and Apoptosis of Breast Cancer Cells
Authors: Liu Chong , Yao Fan , Mao Xiaoyun , Li Wanming , Chen Hang 
Published: December 2020

Objective: We aimed to identify the expression of Sal-like 4 (SALL4) in breast cancer tissues and to explore the role of this gene in the carcinogenesis of breast cancer cells. Methods: A total of 62 paired breast cancer and noncancerous tissue samples were obtained from patients with breast cancer. SALL4 expression patterns and their association with clinicopathological characteristics were investigated by qRT-PCR, western blotting, and immunochemistry in breast cancer tissues. After the knockdown of SALL4 by short hairpin RNAs (shRNAs), the proliferative, invasive, and apoptotic abilities of MDA-MB-435 and MDA-MB-468 cells (breast cancer cell lines) were measured by colony formation and CCK-8 assays, wound healing and transwell assays, and flow cytometry, respectively. Results: SALL4 expression was higher in breast cancer tissues than that in the paired noncancerous tissues, and increased SALL4 expression in tumor tissues was closely related to tumor size and lymphatic metastasis. Furthermore, functional experiments revealed that SALL4 knockdown inhibited the cell proliferation, induced cell cycle arrest in G0/G1phase and apoptosis, and decreased the ability of migration and invasion in breast cancer cells. Additionally, our study first demonstrated that SALL4 played a critical role in modulating the tumorigenicity of breast cancer cells via the WNT/β-catenin signaling pathway. Conclusions: Our results suggest that the expression of SALL4 is upregulated in breast cancer, and this upregulation is involved in the regulation of cell growth, invasion, and apoptosis. Hence, SALL4 may be a promising target for diagnosis and therapy in patients with breast cancer.
Transcatheter Embolization of the Inferior Epigastric Artery: Technique and Clinical Outcomes
Authors: Diamantopoulos Athanasios , Mulholland Douglas , Katsanos Konstantinos , Ahmed Irfan , McGrath Andrew , Karunanithy Narayan , Sabharwal Tarun 
Published: December 2020

Purpose: Symptomatic rectus muscle sheath hematoma may be the result of bleeding originating from the inferior epigastric artery. We report the technique and the results from a series of consecutive patients treated by transcatheter embolization, evaluating both ipsilateral and contralateral retrograde approaches. Methods: This was a retrospective study including patients with verified rectus muscle sheath hematoma as a result of active extravasation from the inferior epigastric artery referred for transcatheter embolization. Technical success, clinical success and major complications were calculated. In addition, minor complications, blood transfusions required after a technically successful embolization, length of stay, peri-procedural and 30-day mortality and overall survival at 6 months were obtained. All statistical analysis was performed using SPSS. Results: Twenty-one patients (mean age = 59.67 ± 19.51 years old) were included. The cause of the bleeding in the vast majority was iatrogenic trauma (n = 12/21, 57.14%). Both contralateral (n = 12/21, 57.14%%) and ipsilateral (n = 9/21, 42.86%) retrograde approaches were used. Embolic materials included micro-coils (n = 13/20, 65%), microspheres (PVA) (n = 1/20, 5%), a combination of PVA and micro-coils (n = 5/20, 25%) and gel-foam (n = 1/20, 5%). Overall technical success was 95.2% (n = 20/21) while clinical success was achieved in all but one of the technically successful cases 95% (n = 19/20). One patient died peri-procedurally due to profound hemodynamic shock. There were no other major complications. Additional transfusion was necessary in 7 patients (n = 7/21, 33.33%). There was a significant increase in the hemoglobin levels after the embolization (7.03 ± 1.78 g/dL pre-procedure Vs 10.91 ± 1.7 g/dL post-procedure, p = 0.048). The median hospital stay was 8 days. The peri-procedure and 30-day mortality was 4.8% (n = 1/21) and 28.6% (n = 6/21) respectively. The 6-month survival was 61.9% (13/21). Conclusion: Percutaneous embolization of the inferior epigastric artery is a minimally invasive method with satisfactory results. Both ipsilateral and contralateral retrograde approaches are feasible.
Client satisfaction with existing postnatal care and associated factors: A study among mothers in Awi Zone, Amhara region, Ethiopia
Authors: Adane Daniel , Wassihun Biresaw 
Published: December 2020

Background: The majority of maternal and neonatal adverse events take place during the postnatal period. However, it is the most neglected period for the provision of quality care. Objective: The aim of this study among mothers in the Awi Zone, Amhara region, Ethiopia, was to assess client satisfaction with existing postnatal care and associated factors. Methods: An institution-based cross-sectional study was conducted in Awi Zone hospitals from 1 to 30 April 2018. A total of 422 post-partum mothers were selected by systematic sampling. The data were collected using a pre-tested structured questionnaire via a face-to-face interview. Data entry and analysis were completed using EpiData version 3.1 and SPSS version 22, respectively. The data were summarized with frequency and cross-tabulation. Both binary and multiple logistic regressions were used to identify predictor variables using odds ratios and 95% confidence intervals. Result: The prevalence of postnatal care satisfaction was 63%. Being from urban area (AOR = 2.1, 95% CI = (1.11–3.99)), having a history of antenatal care follow up (AOR = 1.62, 95% CI = (1.23–1.64)), spontaneous vaginal birth (AOR = 3.14, 95% CI = (1.77–3.28)), and those who did not face any complications during birth (AOR = 2.90, 95% CI = (1.47–1.69)) were some of the factors associated with client satisfaction. Conclusion: According to the results of this study, the majority of mothers were satisfied with post-partum care services. The study findings indicate that maternal satisfaction on post-partum care is mainly affected by residency, antenatal care follow up, mode of delivery, and complications during birth. Therefore, health care providers and other concerned bodies should give special attention to those mothers who are from rural areas, who face complications during birth or who have instrumental-assisted or cesarean section birth. Also, every pregnant mother should be supported to have at least four regular antenatal care visits.
Rupture risk assessment for multiple intracranial aneurysms: why there is no need for dozens of clinical, morphological and hemodynamic parameters
Authors: Neyazi Belal , Swiatek Vanessa M. , Skalej Martin , Beuing Oliver , Stein Klaus-Peter , Hattingen Jörg , Preim Bernhard , Berg Philipp , Saalfeld Sylvia , Sandalcioglu I. Erol 
Published: December 2020

Introduction: A multitude of approaches have been postulated for assessing the risk of intracranial aneurysm rupture. However, the amount of potential predictive factors is not applicable in clinical practice and they are rejected in favor of the more practical PHASES score. For the subgroup of multiple intracranial aneurysms (MIAs), the PHASES score might severely underestimate the rupture risk, as only the aneurysm with the largest diameter is considered for risk evaluation. Methods: In this study, we investigated 38 patients harboring a total number of 87 MIAs with respect to their morphological and hemodynamical characteristics. For the determination of the best suited parameters regarding their predictive power for aneurysm rupture, we conducted three phases of statistical evaluation. The statistical analysis aimed to identify parameters that differ significantly between ruptured and unruptured aneurysms, show smallest possible correlations among each other and have a high impact on rupture risk prediction. Results: Significant differences between ruptured and unruptured aneurysms were found in 16 out of 49 parameters. The lowest correlation were found for gamma, aspect ratio (AR1), aneurysm maximal relative residence time (Aneurysm_RRT_max) and aneurysm mean relative residence time. The data-driven parameter selection yielded a significant correlation of only two parameters (AR1 and the Aneurysm_RRT_max) with rupture state (area under curve = 0.75). Conclusion: A high number of established morphological and hemodynamical parameters seem to have no or only low effect on prediction of aneurysm rupture in patients with MIAs. For best possible rupture risk assessment of patients with MIAs, only the morphological parameter AR1 and the hemodynamical parameter Aneurysm_RRT_max need to be included in the prediction model.
UK Vessel Health and Preservation (VHP) Framework: a commentary on the updated VHP 2020
Authors: Hallam Carole , Denton Andrea , Weston Valya , Dunn Helen , Jackson Tim , Keeling Susan , Hill Steve 
Published: December 2020

Background: In 2016, a UK vessel health and preservation (VHP) framework was developed to support healthcare staff to select the most appropriate vascular access device for patients requiring intravenous therapy. The VHP framework was based on available evidence and expert consensus. The VHP was based on available evidence and expert consensus. Development of the VHP 2020 Framework: A multidisciplinary team reviewed the original UK VHP framework and considered new published evidence, national and international guidelines and expert opinion. A literature search was performed using Cinahl and Medline, incorporating a variety of terms linked to vascular access devices, assessment and selection. Articles published in and after 2014 in English were included. Twelve articles were found to be relevant including three evidence-based guidelines, two randomised control trials and one systematic review. Findings: Three main studies provided the evidence for the update: the MAGIC study that assessed the appropriateness of peripherally inserted central catheters in patients; a study that utilised the ‘A-DIVA scale’ to predict the likelihood of difficult venous access; and a study that incorporated an ‘I-DECIDED tool’ for peripheral intravenous catheter assessment and decision-making for device removal. In addition, published guidelines provided evidence that the original advice on appropriate osmolarity of medicines for peripheral administration needed updating. Conclusion: The 2020 UK VHP framework reflects latest evidence-based research and guidelines, providing healthcare staff updated guidance to assist in maintaining good practice in vascular access assessment and device selection and patient safety.