bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the revised intubating laryngeal tube (ILTS-D2) perform better than the intubating laryngeal mask (Fastrach)? – a randomised simulation research study
Authors: Ott Thomas , Tschöpe Katharina , Toenges Gerrit , Buggenhagen Holger , Engelhard Kristin , Kriege Marc 
Published: May 2020

Abstract
Background
The intubating laryngeal tube (ILTS-D™) and the intubating laryngeal mask (Fastrach™) are devices that facilitate both extraglottic application and blind tracheal intubation. A revised model of the iLTS-D (for scientific reasons called ILTS-D2) has been designed but not yet evaluated. Therefore, we compared the ILTS-D2 with the established Fastrach under controlled conditions in a prospective randomised controlled simulation research study.

Methods
After ethical approval, we randomised 126 medical students into two groups. Each participant received either Fastrach or ILTS-D2 to perform five consecutive ventilation attempts in a manikin. The primary endpoint was the time to ventilation in the last attempt of using the devices as extraglottic devices. Secondary endpoints were the time to tracheal intubation and the success rates.

Results
There was no relevant difference between the two devices in the time to ventilation in the last of five attempts (Fastrach: median 14 s [IQR: 12–15]; ILTS-D2: median 13 s [IQR: 12–15], p = 0.592). Secondary endpoints showed a 2 s faster blind tracheal intubation using the Fastrach than using the ILTS-D2 (Fastrach: median 14 s [IQR: 13–17]; ILTS-D2: median 16 s [IQR: 15–20] p < 0.001). For both devices, the success rates were 100% in the last attempt.

Conclusions
Concerning extraglottic airway management, we could not detect a relevant difference between the revised ILTS-D2 and the Fastrach under laboratory conditions. We advocate for an evaluation of the ILTS-D2 in randomised controlled clinical trials.

Trial registration
Identifier at clinicaltrials.gov: NCT03542747. May 31, 2018
Staged open surgery for bicuspid aortic valve regurgitation and coarctation of the aorta in a Jehovah’s witness
Authors: Sumi Kohei , Yoshida Shigehiko , Okamura Yoshitaka , Nakamura Tomokazu 
Published: May 2020

Abstract
Background
Jehovah’s Witnesses refuse allogeneic blood transfusions, which makes cardiovascular surgery challenging. Surgeons must minimize blood and fluid loss within one procedure.

Case presentation
We herein describe a 17-year-old male Jehovah’s Witness with bicuspid aortic valve regurgitation and coarctation of the aorta. The procedures were performed in the following order: aortic valve replacement combined with Nick’s aortic root enlargement, right axillary artery–bilateral external iliac artery bypass, and distal arch–descending aorta bypass.

Conclusions
Axillary artery–bilateral external iliac artery bypass maintained distal perfusion and reduced the amount of heparin during distal arch–descending aorta bypass surgery.
Prognostic prediction tools and clinician communication: a qualitative study of the effect of the STUMBL tool on clinical practice
Authors: O’Neill Claire , Hutchings Hayley A. , Abbott Zoe , Battle Ceri 
Published: May 2020

Abstract
Background
In recent years, researchers and clinicians have been developing prognostic prediction tools (PPTs) as a way of identifying patients at risk of deterioration. The use of PPTs in the clinical environment not only impacts the risk of adverse outcomes for patients, but the use of these tools also effect clinical practice. Much attention has been paid to the clinical performance of PPTs. But more insight is needed on how the use of PPTs impacts clinical practice. The objective of this study was to map some of the ways in which PPTs effect clinical practice.
The STUMBL (STUdy evaluating the impact of a prognostic model for Management of BLunt chest wall trauma patients) feasibility trial evaluated the use of a new prognostic prediction tool (PPT) to guide the management blunt chest wall trauma patients in the emergency departments (ED). The trial was undertaken between October 2016 and September 2018 and conducted at four sites in England and Wales. Nested within the feasibility trial was a qualitative study aimed at understanding how ED clinicians experienced and used the PPT. The qualitative methods included a focus group and telephone interviews with 9 ED clinicians. This study focused on participant perceptions of the feasibility and use of the STUMBL tool on clinical practice in the ED.

Results
Clinical practice is reshaped as a result of the introduction of the STUMBL PPT into the clinical environment. The PPT enhanced reflexive awareness of prognostic practice; facilitated communication between patients and professionals; helps to guide patient outcomes; and provides a common ground for clinician discussion on prognostication.

Conclusions
The qualitative data collected offered useful insights into the ways in which the tool changes clinical practice. This was a small study of the effect of one kind of PPT on clinical practice. Nevertheless, this study maps areas in which clinical practice is affected by the introduction of a PPT into the clinical environment. More research is needed to better understand these effects, and to understand how these tools become embedded in clinical practice over the longer term.
A cross-sectional study of nausea in functional abdominal pain: relation to mucosal mast cells and psychological functioning
Authors: Friesen Craig , Singh Meenal , Singh Vivekanand , Schurman Jennifer V. 
Published: May 2020

Abstract
Background
Nausea is a common symptom in youth with chronic abdominal pain. The aims of the current study were to assess: 1) the frequency of nausea in patients with functional dyspepsia (FD) and irritable bowel syndrome (IBS), respectively, as defined by Rome IV criteria; and, 2) relationships between nausea and mucosal inflammation as defined by antral and duodenal eosinophil and mast cell densities. A secondary aim was to assess relationships between nausea and other gastrointestinal symptoms, non-gastrointestinal somatic symptoms, and psychological dysfunction.

Methods
Records from patients with pain associated functional gastrointestinal disorders were retrospectively reviewed for gastrointestinal and somatic symptoms and anxiety, depression, and somatizations scores as assessed by the Behavior Assessment System for Children (BASC-2). In addition, previous gastric and mucosal biopsies were assessed for mast cell and eosinophil densities, respectively.

Results
250 patients, ages 8 to 17 years, were assessed. Nausea was reported by 78% and was equally prevalent in those with FD alone, those with IBS alone, and those with both FD and IBS. Nausea was associated with increased mean (21.4 vs. 17.5) and peak (26.2 vs. 22.9) duodenal mast cell densities as compared those without nausea. Nausea was also associated with a wide variety of individual gastrointestinal symptoms, as well as headaches, fatigue, and dizziness. Lastly, nausea was associated with elevated self-report scores for anxiety (55.2 vs. 50.0), depression (50.2 vs. 46.1), and somatization (70.3 vs. 61.8).

Conclusions
Nausea is common in children and adolescents with pain-associated FGIDs as defined by Rome IV and is not unique to either FD or IBS. Nausea is associated with increased mucosal mast cell density, non-gastrointestinal somatic symptoms, and psychologic dysfunction.
Comparative implementation-effectiveness of three strategies to perform hearing screening among older adults in primary care clinics: study design and protocol
Authors: Bettger Janet Prvu , Dolor Rowena J. , Witsell David L. , Dubno Judy R. , Pieper Carl F. , Walker Amy R. , Silberberg Mina , Schulz Kristine A. , Majumder Pranab , Juhlin Erika , Smith Sherri L. , Francis Howard W. , Tucci Debara L. 
Published: May 2020

Abstract
Background
The burden of hearing loss among older adults could be mitigated with appropriate care. This study compares implementation of three hearing screening strategies in primary care, and examines the reliability and validity of patient self-assessment, primary care providers (PCP) and diagnostic audiologists in the identification of ‘red flag’ conditions (those conditions that may require medical consultation and/or intervention).

Methods
Six primary care practices will implement one of three screening strategies (2 practices per strategy) with 660 patients (220 per strategy) ages 65–75 years with no history of hearing aid use or diagnosis of hearing loss. Strategies differ on the location and use of PCP encouragement to complete a telephone-based hearing screen (tele-HS). Group 1: instructions for tele-HS to complete at home and educational materials on warning signs and consequences of hearing loss. Group 2: PCP counseling/encouragement on importance of hearing screening, instructions to take the tele-HS from home, educational materials. Group 3: PCP counseling/encouragement, in-office tele-HS, and educational materials. Patients from all groups who fail the tele-HS will be referred for diagnostic audiological testing and medical evaluation, and complete a self-assessment of red flag conditions at this follow-up appointment. Due to the expected low incidence of ear disease in the PCP cohort, we will enroll a complementary population of patients (N = 500) from selected otolaryngology head and neck surgery clinics in a national practice-based research network to increase the likelihood of occurrence of medical conditions that might contraindicate hearing aid fitting. The primary outcome is the proportion of patients who complete the tele-HS within 2 months of the PCP appointment comparing Group 3 (PCP encouragement, in-office tele-HS, education) versus Groups 2 and 1 (education and tele-HS at home, with and without PCP encouragement, respectively). The several secondary outcomes include direct and indirect costs, patient, family and provider attitudes of hearing healthcare, and accuracy of red flag condition evaluations compared with expert medical assessment by an otolaryngology provider.

Discussion
Determining the relative effectiveness of three different strategies for hearing screening in primary care and the assessment accuracy of red flag conditions can each lead to practice and policy changes that will reduce individual, family and societal burden from hearing loss among older adults.

Trial registration
Clinicaltrials.gov: NCT02928107; 10/10/2016 protocol version 1.
Podocytic infolding in Schimke immuno-osseous dysplasia with novel SMARCAL1 mutations: a case report
Authors: Xiong Shiqiu , Shuai Lanjun , Li Xiaoyan , Dang Xiqiang , Wu Xiaochuan , He Qingnan 
Published: May 2020

Abstract
Background
Schimke immuno-osseous dysplasia (SIOD) is a rare autosomal recessive disorder characterized by spondyloepiphyseal dysplasia, progressive renal insufficiency and defective cellular immunity. Podocytic infolding glomerulopathy (PIG) is a newly proposed disease entity characterized by microspheres or microtubular structures associated with podocytes infolding into the glomerular basement membrane (GBM) on electron microscopy (EM).

Case presentation
A 4-year-old boy was admitted to our ward due to proteinuria and edema lasting 1 month. He had a short trunk and demonstrated subtle dysmorphology, with a triangular shape, a broad nasal bridge and a bulbous nasal tip. The laboratory findings were as follows: lymphocytes, 0.5 × 109/L; urine protein, 3.67 g/d; albumin, 9.8 g/L; and cholesterol, 11.72 mmol/L. Skeletal X rays showed small iliac wings, small ossification centers of the capital femoral epiphyses, shallow dysplastic acetabular fossae and mildly flattened vertebrae. The specimen for light microscopy (LM) suggested focal segmental glomerulosclerosis (FSGS). EM revealed a focal thickness of the GBM with some cytoplasmic processes of podocyte infolding into the GBM. Gene sequencing showed novel compound heterozygous mutations in the SMARCAL1 gene (c.2141 + 5G > A; c.2528 + 1G > A) that were inherited from his parents. Finally, we established the diagnosis of SIOD and treated him with diuretics and angiotensin-converting enzyme inhibitors (ACEIs).

Conclusion
The pathogenic mechanism of PIG has not been clarified. Further studies are required to understand whether gene mutations, especially those related to podocytes, contribute to the pathogenesis of podocytic infolding.
Healing architecture and Snoezelen in delivery room design: a qualitative study of women’s birth experiences and patient-centeredness of care
Authors: Nielsen Jane Hyldgaard , Overgaard Charlotte 
Published: May 2020

Abstract
Background
The physical place and environment has a profound influence on experiences, health and wellbeing of birthing women. An alternatively designed delivery room, inspired by the principles of healing architecture and Snoezelen, was established in the Regional Hospital in Herning, Denmark. These principles provided knowledge of how building and interior design affects the senses, including users’ pain experience and stress levels. The aim of the study was to explore women’s experience of the environment and its ability to support the concept of patient-centeredness in the care of birthing women.

Methods
Applying a hermeneutical-phenomenological methodology, fourteen semi-structured interviews with low-risk women giving birth in an alternative delivery room at an obstetric unit in Denmark were undertaken 3–7 weeks after birth.

Results
Overall, women’s experiences of given birth in the alternative delivery room were positive. Our analysis suggests that the environment was well adapted to the women’s needs, as it offered a stress- and anxiety-reducing transition to the hospital setting, at the same time as it helped them obtain physical comfort. The environment also signaled respect for the family’s needs as it supported physical and emotional interaction between the woman and her partner and helped relieve her concern for the partner’s well-being. The psychosocial support provided by the midwives appeared inseparable from the alternative delivery room, as both affected, amplified, and occasionally restricted the women’s experience of the physical environment.

Conclusion
Our findings support the use of principles of healing architecture and Snoezelen in birth environments and add to the evidence on how the physical design of hospital environments influence on both social and physical aspects of the well-being of patients. The environment appeared to encompass several dimensions of the concept of patient-centered care.
Knowledge-based analyses reveal new candidate genes associated with risk of hepatitis B virus related hepatocellular carcinoma
Authors: Jiang Deke , Deng Jiaen , Dong Changzheng , Ma Xiaopin , Xiao Qianyi , Zhou Bin , Yang Chou , Wei Lin , Conran Carly , Zheng S. Lilly , Ng Irene Oi-lin , Yu Long , Xu Jianfeng , Sham Pak C. , Qi Xiaolong , Hou Jinlin , Ji Yuan , Cao Guangwen , Li Miaoxin 
Published: May 2020

AbstractBackgroundRecent genome-wide association studies (GWASs) have suggested several susceptibility loci of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) by statistical analysis at individual single-nucleotide polymorphisms (SNPs). However, these loci only explain a small fraction of HBV-related HCC heritability. In the present study, we aimed to identify additional susceptibility loci of HBV-related HCC using advanced knowledge-based analysis.MethodsWe performed knowledge-based analysis (including gene- and gene-set-based association tests) on variant-level associationp-values from two existing GWASs of HBV-related HCC. Five different types of gene-sets were collected for the association analysis. A number of SNPs within the gene prioritized by the knowledge-based association tests were selected to replicate genetic associations in an independent sample of 965 cases and 923 controls.ResultsThe gene-based association analysis detected four genes significantly or suggestively associated with HBV-related HCC risk:SLC39A8,GOLGA8M,SMIM31, andWHAMMP2. The gene-set-based association analysis prioritized two promising gene sets for HCC, cell cycle G1/S transition and NOTCH1 intracellular domain regulates transcription. Within the gene sets, three promising candidate genes (CDC45,NCOR1andKAT2A) were further prioritized for HCC. Among genes of liver-specific expression, multiple genes previously implicated in HCC were also highlighted. However, probably due to small sample size, none of the genes prioritized by the knowledge-based association analyses were successfully replicated by variant-level association test in the independent sample.ConclusionsThis comprehensive knowledge-based association mining study suggested several promising genes and gene-sets associated with HBV-related HCC risks, which would facilitate follow-up functional studies on the pathogenic mechanism of HCC.
Wearable cardioverter-defibrillator as bridging to ICD in pediatric hypertrophic cardiomyopathy with myocardial bridging – a case report
Authors: Kurath-Koller Stefan , Sallmon Hannes , Scherr Daniel , Bisping Egbert , Burmas Ante , Knez Igor , Koestenberger Martin 
Published: May 2020

Abstract
Background
There is only limited experience with wearable cardioverter-defibrillators (WCD) in pediatric patients. We report on the successful application of a WCD in an adolescent patient with hypertrophic cardiomyopathy and myocardial bridging.

Case presentation
A 15-year-old girl presented with a history of recurrent syncope, dyspnea, and vertigo with exercise. Diagnostic work-up revealed non-obstructive hypertrophic cardiomyopathy and signs of myocardial ischemia with exercise. Given this high-risk constellation, the patient was scheduled for prophylactic implantation of an implantable cardioverter-defibrillator (ICD). One month after initial presentation and days prior to the planned ICD implantation, the patient collapsed during an episode of sustained ventricular tachycardia (VT) while running. VT was terminated by WCD shock delivery. Following this event, computerized tomography scan revealed myocardial bridging of the left anterior descending coronary artery causing a 90% stenosis in systole. After coronary surgery, life threatening arrhythmias have not recurred, but due to progressive heart failure, the patient underwent successful heart transplantation after 2 years.

Conclusions
The reported case highlights the importance and applicability of WCDs and the potentially malign nature of myocardial bridging in pediatric high-risk patients.
Psychiatric disorders risk in patients with iron deficiency anemia and association with iron supplementation medications: a nationwide database analysis
Authors: Lee Herng-Sheng , Chao Hsin-Hao , Huang Wan-Ting , Chen Solomon Chih-Cheng , Yang Hsin-Yi 
Published: May 2020

Abstract
Background
It has been shown that iron deficiency anemia (IDA) is associated with psychosocial consequences and psychiatric morbidity. However, the association between adults with IDA and psychiatric disorders has not been clarified. The purpose of this study was to investigate the psychiatric disorder morbidity of an IDA group in comparison with a non-IDA group and to examine the risk of psychiatric disorders in IDA patients treated with iron supplementation.

Methods
All study subjects were 20 years of age or over with newly diagnosed IDA enrolled in the Taiwan National Health Insurance Database from 2000 to 2012. We matched IDA and non-IDA subjects according to age and gender in a 1:2 ratio. Our primary outcome was diagnosis of psychiatric disorders and the patients were monitored until the end of 2013. A multivariate Cox proportional hazards regression model was used to explore the risk of psychiatric disorders in patients with IDA after adjustment for confounders, including demographic characteristics and comorbidities.

Results
The adjusted hazard ratios (aHRs) of psychiatric disorders was 1.52 (95% CI = 1.45–1.59) in the IDA group compared with the non-IDA group. Among the different types of psychiatric disorders, the IDA group was associated with significantly higher incidence and risks of anxiety disorders, depression, sleep disorders, and psychotic disorders (p <  0.05). Furthermore, iron supplementation in IDA subjects was associated with a significantly lower risk of psychiatric disorders compared to non-iron supplementation in IDA patients.

Conclusions
Our study indicates that IDA subjects had an increased risk of psychiatric disorders, regardless of other confounders. In IDA patients, iron supplementation was associated with a decreased risk of psychiatric disorders. Moreover, IDA patients receiving iron supplementation also had a lower risk of sleep disorders.
The effects of suicidal ideation and constructs of theory of planned behavior on suicidal intention in women: a structural equation modeling approach
Authors: Rezapur-Shahkolai Forouzan , Khezeli Mehdi , Hazavehei Seyyed-Mohammad-Mahdi , Ariapooran Saeed , Soltanian Ali Reza , Ahmadi Alireza 
Published: May 2020

Abstract
Background
The Theory of Planned Behavior (TPB) is proposed to predict behavioral intention. We conducted this study aimed to investigate the effects of Suicidal Ideation (SI) and constructs of TPB on suicidal intention.

Methods
This cross-sectional study was conducted with 923 married women selected by multi-stage sampling method from Gilan-e Gharb County, the west part of Iran, in 2018. Data gathering tools were a questionnaire on demographic characteristics, the Beck Scale for Suicidal Ideation, and a four-part questionnaire based on constructs of TPB, including Attitude, Subjective Norms, Perceived Behavioral Control (PBC), and Intention. Data were analyzed by SPSS 19 and AMOS using Structural Equation Modeling (SEM).

Results
Out of 923 participants, 345 women (37.4%) had some degree of suicidal ideation. The mean score of suicidal ideation in all of participants was 5.98 ± 7.79, while in the 345 individuals with suicidal ideation was 15.53 ± 3.65. Suicidal ideation had the strongest positive total effect on suicide intent, while PBC and attitude had the negative effect on suicide intent.

Conclusions
Since suicidal ideation had the strongest direct effect on suicidal intent, it is suggested that this variable be used for risk assessment in all suicide prevention programs and counseling measures be implemented to reduce suicidal thoughts. Also, undesirable attitudes toward suicide and perceived behavioral control on suicide intention can be considered and emphasized in planning future interventions.