bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison between transpancreatic sphincterotomy and needle-knife fistulotomy in difficulty biliary access, a retrospective study in Taiwan
Authors: Liang Kai-Shun , Chen Chieh-Chang , Liao Wei-Chih , Kuo Yu-ting , Tseng Liang-Wei , He Wen-Tsung , Wang Hsiu-Po 
Published: May 2020

Abstract
Background Selective deep biliary cannulation is the first and the most important step before further biliary therapy. Transpancreatic sphincterotomy(TPS), and needle knife fistulotomy(NKF) were commonly used in patients with difficult cannulation, but few studies compare the outcome between TPS and NKF.Methods A total of 78 patients who met the criteria of difficult cannulation in the National Taiwan University hospital from October 2015 to October 2017 were retrospectively reviewed. Their baseline demographics, success rate of biliary cannulation, and the rate of adverse events were assessed.Results 31 patients and 47 patients underwent TPS and NKF for difficult biliary access, respectively. The characteristics of the 2 groups were similar, but patients in TPS group had more frequent pancreatic duct cannulation. Bile duct cannulation was successful in 23 patients (74.2 %) in the TPS group and 39 (83.0%) in the NKF group (P=0.34). There was no difference between the TPS and NKF in the rate of adverse events, including post-ERCP pancreatitis (PEP) (16.1% vs. 6.4%, p = 0.17), and hemorrhage (3.2% vs. 8.5%, p = 0.35). No perforation occurred.Conclusions Both TPS and NKF have good biliary access rate in patient with difficult cannulation. TPS has acceptable successful rate and similar complication rate, compared with NKF.
Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer care
Authors: Haukland Ellinor Christin , von Plessen Christian , Nieder Carsten , Vonen Barthold 
Published: May 2020

Abstract
Background: Anticancer treatment exposes patients to negative consequences such as increased toxicity and decreased quality of life, and there are clear guidelines recommending limiting use of aggressive anticancer treatments for patients near end of life. The aim of this study is to investigate the association between anticancer treatment given during the last 30 days of life and adverse events contributing to death and elucidate how adverse events can be used as a measure of quality and safety in end-of-life cancer careMethods: Retrospective cohort study of 247 deceased hospitalised cancer patients at three hospitals in Norway in 2012 and 2013. The Global Trigger Tool method were used to identify adverse events. We used Poisson regression and binary logistic regression to compare adverse events and association with use of anticancer treatment given during the last 30 days of life.Results: 30 % of deceased hospitalised cancer patients received some kind of anticancer treatment during the last 30 days of life, mainly systemic anticancer treatment. These patients had 62 % more adverse events compared to patients not being treated last 30 days, 39 vs. 24 adverse events per 1 000 patient days (p<0.001, OR 1.62 (1.23 – 2.15). They also had twice the odds of an adverse event contributing to death compared to patients without such treatment, 33 vs. 18 % (p=0.045, OR 1.85 (1.01 – 3.36)). Receiving follow up by specialist palliative care reduced the rate of AEs per 1 000 patient days in both groups by 29 % (p= 0.02, IRR 0.71, CI 95% 0.53 – 0.96).Conclusions: Anticancer treatment given during the last 30 days of life is associated with a significantly increased rate of adverse events and related mortality. Patients receiving specialist palliative care had significantly fewer adverse events, supporting recommendations of early integration of palliative care in a patient safety perspective.
The effect of problem-based learning after coronary heart disease – A randomised study in primary health care (COR-PRIM)
Authors: Köhler Anita Kärner , Jaarsma Tiny , Tingström Pia , Nilsson Staffan 
Published: May 2020

Abstract
Background Cardiac rehabilitation including patient education is effective after coronary heart disease (CHD). However, risk factors remain, and patients report fear for recurrence during recovery. Problem-based learning is a pedagogical method, where patients work self-directed in small groups with problem solving of real-life situations to manage CHD risk factors and self-care. The aim of the study was to demonstrate the better effectiveness of patient problem-based learning over home-sent patient information for evaluating long-term effects of patient empowerment and self-care in patients with CHD. The hypothesis tested was that one year of problem-based learning improves patients’ empowerment- and self-efficacy, to change self-care compared to one year of standardised home-sent patient information after CHD. Methods We randomly assigned 157 patients (78% male; age 68±8.5 years) with CHD verified by percutaneous coronary intervention (PCI) (70.1%) or coronary artery by-pass surgery (CABG) and CABG+PCI or myocardial infarction (29.9%) to problem-based learning (experimental group; n = 79) or home-sent patient information group (controls; n = 78). The problem-based learning intervention consisted of patient education in primary care by nurses tutoring groups of 6-9 patients on 13 occasions over one year. Controls received home- sent patient information on 11 occasions during the study year. Results At the one-year follow-up, the primary outcome, patient empowerment, did not significantly differ between the experimental group and controls. We found no significant differences between the groups regarding the secondary outcomes e.g. self-efficacy, although we found significant differences for body mass index (BMI) [-0.17 (SD 1.5) vs. 0.50 (SD 1.6), P=0.033 ], body weight [-0.83 (SD) 4.45 vs. 1.14 kg (SD 4.85), P=0.026 ] and HDL cholesterol [0.1 (SD 0.7) vs. 0.0 mmol/L (SD 0.3), P=0.038 ] favouring the experimental group compared to controls. Conclusions The problem-based learning- and the home-sent patient information interventions had similar results regarding patient empowerment. However, problem-based learning exhibited significant effects on weight loss, BMI, and HDL cholesterol levels, indicating that this intervention positively affected risk factors compared to the home-sent patient information intervention. Trial registration : NCT01462799 (February 2020)
The study on knowledge-attitude-practice of primary care physician toward anticoagulant therapy in patients with Non-valvular atrial fibrillation in Shanghai of China
Authors: Ye Shasha , Wang Tianhao , Liu Arthur , Yu Ying , Pan Zhigang , Gu Jie 
Published: May 2020

Abstract
Background: As the large number of Community Health Service (CHS) centers in China face the majority of non-valvular atrial fibrillation (NVAF) patients, primary care physicians (PCPs) play the primary role in the prevention of embolization. Therefore，an awareness of anticoagulant management in NVAF patients must be brought into focus among PCPs in China. This study will investigate PCPs’ Knowledge, Attitude and Practice toward anticoagulant therapy in patients with NVAF and help PCPs increase their awareness of oral anticoagulant (OAC) therapy for NVAF to prevent embolization.Method: This was a cross-sectional observational study of 462 PCPs in CHS centers across Shanghai. We used a self-administered questionnaire to collect data from September to December 2017. A stratified random cluster sampling was adopted in the 90 CHS centers with the family medicine residency program. Result: Among 462 participants, 69.3% (320/462) of females got a medical bachelor’s degree and over 50% participants had more than 10 years of work experience. According to similar study, each section for knowledge, attitude, and practice were categorized as poor (≤39.0%), fair (40.0%–69.0%), and good (≥70.0%)[18]. The level of knowledge of OAC therapy in patients with NVAF among PCPs was insufficient in over half (75.8%) of participants. The majority (89.8%) of PCPs had a positive attitude and 68.0% had modest performance in the anticoagulant management of patients with NVAF. Conclusion: The knowledge and behaviors of PCPs were insufficient in OAC therapy to prevent embolization in patients with NVAF. The study also revealed there is good potential for PCPs’ educational interventions to positively impact on the care of patients with NVAF.
The impact of albumin infusion on the risk of rebleeding and in-hospital mortality in cirrhotic patients admitted for acute gastrointestinal bleeding: a retrospective study of a single institute
Authors: Wang Zhu , Xie Ya-Wen , Lu Qing , Yan Hai-Lin , Liu Xin-Bin , Long Yi , Zhang Xian , Yang Jinlin 
Published: May 2020

Abstract
Background: To investigate the effect of albumin infusion on cirrhotic patients admitted for acute gastrointestinal bleeding.Methods: Medical records of cirrhotic patients who admitted due to acute gastrointestinal bleeding through January 2009 to December 2018 were reviewed. Clinical data and the total amount of albumin and red blood cell used during hospitalization were recorded. For patients with rebleeding, the amount of albumin and red blood cell used before rebleeding was also documented. The primary outcome was the occurrence of rebleeding, and the second outcome was in-hospital mortality. Univariate and multivariate logistic analysis was performed to identify risk factors associated with rebleeding and in-hospital mortality.Results: A total of 1503 cirrhotic patients were included in the analysis. There were 146 episodes of in-patient rebleeding occurred, while 81 patients died. Overall, more red blood cells and albumin were prescribed to patients who suffered rebleeding. In terms of the amount before rebleeding, the red blood cell was higher in patients with rebleeding, but the albumin infusion was similar. In the multivariate model, the albumin infusion was an independent risk factor associated with rebleeding (adjusted OR for ≤40g vs 0g, 0.469 [0.274-0.805], p=0.006; adjusted OR for >40g vs 0g, 0.272 [0.122-0.604], p=0.001). In Child-Pugh C class patients, the use of albumin more than 40g during hospitalization associated with a lower risk of in-patient mortality (adjusted OR for >40g vs 0g, 0.136 [0.019-0.741], p=0.031).Conclusions: Albumin infusion was associated with a lower risk of rebleeding and in-hospital deaths in cirrhosis admitted for acute gastrointestinal bleeding.
Moving a neodymium magnet promotes the migration of a magnetic tracer and increases the monitoring counts on the skin surface of sentinel lymph nodes in breast cancer
Authors: Makita Masujiro , Manabe Eriko , Kurita Tomoko , Takei Hiroyuki , Nakamura Seigo , Kuwahata Akihiro , Sekino Masaki , Kusakabe Moriaki , Ohashi Yasuo 
Published: May 2020

Abstract
Background: We suspected that moving a small neodymium magnet would promote migration of the magnetic tracer to the sentinel lymph node (SLN). Higher monitoring counts on the skin surface before making an incision help us detect SLNs easily and successfully. The present study evaluated the enhancement of the monitoring count on the skin surface in SLN detection based on the magnet movement in a sentinel lymph node biopsy (SNB) using superparamagnetic iron oxide (SPIO) nanoparticles.Methods: After induction of general anesthesia, superparamagnetic iron oxide nanoparticles were injected sub-dermally into the subareolar area or peritumorally. The neodymium magnet was moved over the skin from the injection site to the axilla to promote migration of the magnetic tracer without massage. A total of 62 patients were enrolled from February 2018 to November 2018: 13 cases were subjected to magnet movement 20 times (Group A), 8 were subjected to 1-min magnet movement (Group B), 26 were given a short (about 5 min) interval from injection to 1-min magnet movement (Group C), and 15 were given a long (about 25 min) interval before 1-min magnet movement using the magnetometer’s head (Group D). In all cases, an SNB was conducted using both the radioisotope (RI) and SPIO methods. The monitoring counts on the skin surface were measured by a handheld magnetometer and compared among the four groups. Changes in the monitoring count by the interval and magnet movement were evaluated. Results: The identification rates of the SPIO and RI methods were 100% and 95.2%, respectively. The mean monitoring counts of Group A, B, C, and D were 2.39 μT, 2.73 μT, 3.15 μT, and 3.92 μT, respectively (p<0.0001; Kruskal-Wallis test). The monitoring counts were higher with longer magnet movement and with the insertion of an interval. Although there were no relationships between the monitoring count on the skin surface and clinicopathologic factors, magnet movement strongly influenced the monitoring count on the skin surface.Conclusion: Moving a small neodymium magnet is effective for promoting migration of a magnetic tracer and increasing monitoring counts on the skin surface.Trial registration: UMIN, UMIN000029475. Registered 9 October 2017, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000033678
Prevalence and risk factors of falls among community-dwelling older people: results from three consecutive waves of the national health interview survey in Taiwan
Authors: Tsai Yih-Jian , Yang Ping-Yen , Yang Yi-Ching , Lin Mau-Roung , Wang Ying-Wei 
Published: May 2020

Abstract
Background: An aging society incurs great losses due to fall-related injuries and mortalities. The foreseeable increased burden of fall-related injury among older people requires a nationwide study on the fall epidemic in Taiwan. Methods: The fall epidemic was examined using data from three consecutive waves of the National Health Interview Survey (2005, 2009, and 2013). Common explanatory variables across these surveys included sociodemographic factors (age, sex, and difficulty in performing activities of daily living (ADL) or instrumental ADL), biological factors (vision, comorbidities, urinary incontinence, and depressive symptoms), and behavioral risk factors (sleeping pill use, and frequency of exercise). After the univariate and bivariate analyses, the prevalence of falls was investigated using multiple linear regression models adjusted for age group, sex, and year of survey. A multivariate logistic regression model for falls with adjustments for these common explanatory variables was established across three waves of surveys. Results: For each survey, there were consecutively 2,722; 2,900; and 3,200 respondents with a mean age of 75.1, 75.6, and 76.4 years, respectively. The multiple linear regression model yielded a negative association between the prevalence of falls and year of survey. Several sociodemographic and biological factors, including female sex, difficulty in performing one basic ADL, difficulty in performing two or more instrumental ADLs, unclear vision, comorbidities, urinary incontinence, and depressive symptoms, were significantly associated with falls.Conclusion: Although information regarding the change in fall prevalence over time supports existing fall intervention strategies in Taiwan, the identification of risk factors in older people may increase the effectiveness of future fall prevention programs.
Proximal and distal predictors of self-regulatory change in children aged 4 to 7 years
Authors: Williams Kate E , Howard Steven J. 
Published: May 2020

Abstract
Background Growth in early self-regulation skills has been linked to positive health, wellbeing, and achievement trajectories across the lifespan. While individual studies have documented specific influences on self-regulation competencies in early childhood, few have modelled a comprehensive range of predictors of self-regulation change across health, development, and environment simultaneously. This study aimed to examine the concurrent associations among a range of proximal and distal influences on change in children’s self-regulation skills over 2 years from age 4-5 years.Methods Data from the Longitudinal Study of Australian Children (N= 4983) were used in a structural equation model, predicting a multi-source composite measure of self-regulation at each of 4-5 years and 6-7 years. By controlling for earlier self-regulation and covariates, the model examined the relative contributions of a comprehensive range of variables to self-regulation change including health, development, educational, home environment, time-use, and neighbourhood characteristics. Results The significant predictors of children’s self-regulation growth across 4 to 7 years were fewer behavioural sleep problems, higher gross motor and pre-academic skills, lower levels of maternal and paternal angry parenting, and lower levels of financial hardship. There were also marginal effects for high-quality home learning environments and child-educator relationships.Conclusion Findings suggest that if we are to successfully foster children’s self-regulation skills, interventionists would do well to operate not only on children’s current capacities but also key aspects of their surrounding context.
Research on Robot Boxing Movement Simulation Based on Kinect Sensor
Authors: Li Peicong 
Published: May 2020

Abstract
In the process of continuous development, robot technology has been widely used in aerospace, medical, education and service industries, and the relationship between robots and people is getting closer and closer. The improvement of robot intelligence is a process of continuous learning of external knowledge. Since the introduction of human-computer interaction technology, it has provided more and more technical support for human research robots. This paper firstly takes Tai Chi as an example, analyzes and deconstructs its standard Tai Chi putter movements, and obtains the corresponding movement parameter information. Then, the human body depth image and bone structure are obtained through the Kinect sensor, and the human joint position data is recorded, and then the coordinate data is sent to the brain robot, thereby realizing the imitation learning of the robot's push movements in Tai Chi. The experimental results show that the proposed method can simulate the practice process of inversion of Tai Chi, and can well analyze the shortcomings in the practice process, and then promote the development of the sport.
Factors associated with the burden of family caregivers of elderly patients with femoral neck fracture: a cross-sectional study
Authors: Xiao Peifen , Zhou Yongchun 
Published: May 2020

Abstract
Background: This study aimed to study the factors associated with caregiver burden among caregivers of elderly patients with femoral neck fracture. Methods: This cross-sectional study was based on a non-probabilistic sampling of 183 elderly postoperative patients (aged 65 years or older) with femoral neck fracture who were hospitalized in the orthopaedic centre in our hospital and their family caregivers. Data were collected from January 2016 to June 2019. Patients and family caregivers completed the sociodemographic questionnaire. The Social Support Rating Scale (SSRS), the General Self-Efficacy Scale (GSE) and the Chinese version of the Zarit Burden Interview (ZBI) were used to evaluate social support, self-efficacy and caregiver burden, respectively. By analysing the clinical data of patients and family caregivers and combining the factors that affect the caregiver burden in parallel studies, we selected the factors that affected the caregiver burden in this study and conducted a multivariate analysis of these factors. P <0.05 was considered statistically significant. Results: We observed 176 caregivers aged 69.28 ± 7.19 years old, among whom 52.3% were male, 58.0% lived in the city, 84.0% were spouses of the patients, and 67.0% had a primary school educational background. The ZBI score of the family caregivers was 37.8 ± 8.9, and 82.7% of the caregivers were under a moderate to severe burden. The patient’s functional status, Harris score, and pain score and the caregiver’s SSRS scores, GSE scores, and the ratio of medical expenses to monthly income per capita were factors that affected the caregiver burden. Conclusions: Most family caregivers of elderly patients with femoral neck fracture are subject to a considerable care burden, and social support and self-efficacy intervention are conducive to reducing the caregiver burden.
A modified surgical technique of shortening renal ischemia time in left renal cancer patients with Mayo level II-IV tumor thrombus
Authors: Zhuo Liu , Guodong Zhu , Xun Zhao , Shiying Tang , Peng Hong , Li Zhang , Liwei Li , Shudong Zhang , Guoliang Wang , Xiaojun Tian , Cheng Liu , Hongxian Zhang , Ma Lulin 
Published: May 2020

Abstract
Background To explore the safety and effectiveness of a modified surgical technique which could shorten the time of renal ischemia in left renal cancer and Mayo level II to IV inferior vena cava (IVC) tumor thrombusMethod We retrospectively analyzed the clinical data of 14 cases with left renal cell carcinoma (RCC) and Mayo level II to IV IVC tumor thrombus from February 2015 to July 2019. Preoperative imaging showed that there was no obvious sign of tumor thrombus invading the blood vessel wall. During the surgery, after the right renal artery, the right renal vein and the distal end of IVC were blocked, the balloon catheter was used and the tumor thrombus was removed completely from the IVC. The incision of IVC was closed by Satinsky clamp to make IVC partially blocked. Then the right renal artery and right renal vein were released. The incision of IVC was sutured continuously. At last, the Satinsky clamp and the blocking band at the distal end of the IVC were released.Result There were 8 cases (57.1%) of Mayo level II, 3 cases (21.4%) of Mayo level III and 3 cases (21.4%) of Mayo level IV. The operation was successfully completed in all 14 patients. There were 2 cases (14.3%) operated by complete laparoscopic approach, 8 cases (57.1%) by open approach, and 4 patients (28.6%) by laparoscopic conversion to open approach. The occlusion time of right renal artery and vein (renal ischemia time) was 3 to 15 minutes, with an average of (6.8 ±3.2) minutes. The mean time of IVC occlusion was (19.4 ±4.9) min. Preoperative creatinine was 66 to 130 μmol/L, with an average of (96.6 ±21.2) μmol/L. One week after operation, serum creatinine was 64 to 632 μmol/L, with an average of (132.4 ±144.9) μmol/L. Among the 14 cases, 5 (42.9%) had early postoperative complications. Besides one of the 14 patients died in perioperative period, the median follow-up of other 13 cases was 10 months (range: 4-29 months). The 5 (35.7%) of the 14 cases were died of disease.Conclusion This modified procedure was relatively safe and effective in shortening the time of renal ischemia in left RCC patients with Mayo II to IV IVC tumor thrombus.