bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Surgical Critical Care Training Among General Surgery Residents: Pursuing an Ideal Curriculum
Authors: Jordan Rebecca M. , Ullrich Lauryn A. , Decapua-Guarino Alexandria , Klock Brian 
Published: August 2020

Background The Accreditation Council for Graduate Medical Education (ACGME) provides no specific guidelines for surgical critical care (SCC) training during general surgery residency. Growing emphasis is placed on this experience with increasing case requirements and dedicated SCC content on board certification exams. Methods A digital survey was distributed to ACGME-accredited general surgery residencies via email. Respondents reported number and setting of critical care months during residency and rated comfort level within 5 critical care principles and overall satisfaction with their SCC experience. Study cohorts were formed to compare experiences and competencies between respondents based on setting, months, postgraduate year (PGY) level, and formal surgical intensive care unit (SICU) experience. Differences between cohorts were compared using the Mantel-Haenszel test ( P < .05). Results Seventy-three residents responded with 45% training at academic centers versus 46% in community hospitals. Approximately 50% completed a formal SICU rotation, while 9% reported no dedicated critical care rotation during residency. Overall, 78% felt satisfied with their SCC experience. Residents training at academic centers were more satisfied overall and felt more comfortable with ventilator management. Those who completed 5 or more months of critical care training reported greater confidence with intravenous sedation and ventilator management, while residents having a formal SICU rotation felt more confident with vasopressor and ventilator management. Discussion Variability remains within SCC training among general surgery residents with perceived benefits seen in training at academic centers and completing a formal SICU rotation. Although limited, these findings offer a foundation for developing an effective SCC curriculum.
A Collaborative and Cognitive-based Intervention for Young People with Cerebral Palsy
Authors: Sousa Larissa K. , Brandão Marina Brito , Curtin Clare M. , Magalhães Livia C. 
Published: August 2020

Background. Evidence-based approaches to improve function in individuals with cerebral palsy are needed. Purpose. To investigate the effectiveness of the Cognitive Orientation to daily Occupational Performance approach™ (CO-OP) to improve performance on self-chosen, functional goals as compared to traditional occupational therapy for cerebral palsy. Method. Crossover design with 12 participants, aged 6–15 years, randomly assigned to CO-OP and traditional intervention groups, followed by crossover and a 3-month follow-up. The participants identified three occupation-based goals for CO-OP and each group received ten 45-minutes intervention twice weekly in clinical context. Occupational performance, manual dexterity and Gross Motor Function Measures were analysed using generalized estimating equations. Findings. There were clinical and statistically significant improvements in functional goals following CO-OP and not traditional therapy. There were gains in dexterity but not in gross motor skills. Implications. CO-OP was effective to improve functional performance in young people with cerebral palsy and should be more utilized.
Transoral Carbon Dioxide Microsurgery of the Larynx as a Day-Case Outpatient Procedure: An Observational, Retrospective, Single-Center Study
Authors: Chiesa-Estomba Carlos M. , Suarez Jon A. Sistiaga , Ninchritz-Becerra Elisabeth , Soriano-Reixach Maria , González-García Jose A. , Larruscain Ekhiñe , Altuna Xabier 
Published: August 2020

Introduction: Despite good results of transoral laser CO2 microsurgery (CO2TOLMS) of the larynx, a lack of data related to the safety of this technique as a day-case procedure across the literature is evident. Materials and Methods: An observational, retrospective, non-randomized study. Results: One hundred four (62.6%) patients met the inclusion criteria, 96 (92.3%) patients were male, and 8 (7.7%) patients were female. The mean age of the study group was 66 ± 11 years (min: 34/max: 90). All the patients underwent CO2TOLMS were treated as an outpatient procedure. The glottis was the most common location affecting 97 (93.3%) patients, regarding the need of readmission, just 4 (3.8%) patients needed to be readmitted after surgery due to dyspnea secondary to laryngeal edema in 2 cases by laryngeal bleeding, and cervical emphysema in one case, respectively. Being just necessary to reintubate 1 patient (<1%) to control the bleeding. We didn’t find any statistical correlation between variables and the need for readmission of reintubation. Conclusion: According to our results, CO2TOLMS of the larynx can be safely performed as an outpatient procedure. To establish a proper protocol and to perform a careful preoperative assessment are essential to increase our success rate and to prevent any potential complication.
A mixed-methods systematic review on barriers to exclusive breastfeeding
Authors: Patil Divya Sussana , Pundir Prachi , Dhyani Vijay Shree , Krishnan Jisha B. , Parsekar Shradha S , D’Souza Sherize Merlin , Ravishankar N , Renjith Vishnu 
Published: August 2020

Introduction: The World Health Organization recommends exclusive breastfeeding for every newborn during the first 6 months of life, yet women come across various challenges to continuing it. Aim: This systematic review was intended to identify barriers to exclusive breastfeeding among mothers. Methods: MEDLINE, Cumulative Index to Nursing and Allied health literature, ProQuest, Web of Science and Scopus databases were searched from January 1990 to October 2017. The systematic review included quantitative, qualitative and mixed-methods studies to identify barriers to exclusive breastfeeding among mothers of reproductive age with an infant aged between 0 and 12 months. All studies were screened based on titles, abstracts and full text by two reviewers independently. The methodological quality of included studies was assessed using appropriate tools. Of the 9737 eligible records, 44 studies were included for analysis. Classification of barriers to exclusive breastfeeding was adopted from the conceptual framework of factors affecting breastfeeding practices given by Hector and colleagues. Results: In total 32 barriers were grouped under individual, group and society level factors. Meta-analysis indicated that mothers who smoked had 2.49 times more odds of not exclusively breastfeeding than non-smoking mothers and mothers who had undergone caesarean section had 1.69 times more risk of cessation of exclusive breastfeeding than mothers who have had a vaginal childbirth. Conclusion: The systematic review revealed a complex interplay of various barriers related to exclusive breastfeeding. It is recommended that context-specific strategies should be designed in accordance with barriers existing in a region or country.
Magnetic resonance imaging evaluation of posterior spinal tuberculosis: a cross-sectional study
Authors: Boruah Deb K , Gogoi Bidyut B , Prakash Arjun , Lal Navneet R , Hazarika Karuna , Borah Krishna K 
Published: August 2020

Background Isolated posterior spinal (element) tuberculosis (TB) is uncommon compared to classical anterior spinal or para-discal TB. Here, we report magnetic resonance imaging (MRI) findings of posterior spinal TB in 19 patients without involvement of the vertebral body and intervertebral disc. Purpose To evaluate the MRI findings in isolated posterior spinal (element) TB. Material and Methods Clinical and MRI data of 19 patients of isolated posterior spinal TB were retrospectively evaluated. Results Of the 19 patients, group A comprised 4 (21%) patients with rapid onset lower limb weakness and pyramidal signs while group B comprised 15 (79%) patients without any neurological deficit. Lumbar vertebrae commonly affected 9 (47.4%) patients followed by dorsal vertebrae in 8 (42.1%) patients and cervical vertebrae in 2 (10.5%) patients. The pedicle was most commonly involved in 12 (63.2%) patients followed by the lamina in 11 (58%) patients, and spinous process and facet joint in 6 (31.6%) patients each. Extra-spinal inflammation/pyomyositis/paraspinal abscess was found in 13 (68.4%) patients followed by epidural abscess 3 (15.8%) patients and both extra spinal inflammation and epidural abscess in 3 (15.8%) patients (15.8%). Compressive cord myelopathy was observed in 4 (21%) patients, where three patients underwent emergency decompression laminectomy and the remaining 16 patients were treated conservatively with anti-tubercular therapy. Conclusion Initial diagnosis of isolated posterior element TB is challenging and requires a high index of suspicion. Early diagnosis of isolated posterior spinal TB is important as early treatment may be beneficial and decreases patient morbidity.
Survival analysis of afatinib versus erlotinib for individuals with advanced del19 lung adenocarcinoma with asymptomatic brain metastasis after pemetrexed-cisplatin chemotherapy: a retrospective study
Authors: Jiang Ye , Chen Wenli , Yu Weiguang , Shi Ning , Han Guowei , Mao Shuai , Zhang Xinlei , Chen Meiji 
Published: August 2020

Objective To evaluate survival following afatinib (AF) and erlotinib (ER) treatment in advanced del19 lung adenocarcinoma (AD19LA) with asymptomatic brain metastasis (ABM) after pemetrexed–cisplatin chemotherapy (PCC). Methods Data were retrospectively analysed from individuals with AD19LA and ABM after PCC who received AF or ER for 2 years or until intolerable adverse events (AEs), withdrawal, or death. The primary outcome was survival; secondary outcomes were AEs. Results The final analysis included 174 AD19LA individuals (AF: n = 86; ER: n = 88) with a median follow-up of 24.2 months (IQR 2.1–28.3). Significant differences in overall survival (16.2 months [95%CI 15.4–17.1] for AF vs 7.2 months [95%CI 6.3–8.1] for ER) (HR 0.50, 95%CI 0.36–0.71, p<0.0001) and median progression-free survival (9.4 months [95%CI 8.5–9.7] for AF vs 5.6 months [4.7–6.2] for ER) (HR 0.66, 95%CI 0.47–0.94, p=0.02) were observed between the groups. Rates of all-grade AEs were 82.5% for AF and 72.7% for ER, and rates of grade ≥3 AEs were 37.2% for AF and 34.0% for ER. Conclusion Compared with ER, AF treatment may be more beneficial in terms of survival in the management of AD19LA after PCC with a tolerable safety profile.
Radiographic characteristics and early clinical manifestations of family clustered coronavirus disease 2019 (COVID-19)
Authors: Zhan Bingyan , Lan Shujuan , La Zhoucuomao , Li Deting , Wang Xinmei , Huang Xiaochun 
Published: August 2020

Object To study chest computed tomography (CT) findings in family clusters of coronavirus disease 2019 (COVID-19). Methods Twenty-one patients with confirmed COVID-19 were enrolled at the West District Qingdao Municipal Hospital, the Fifth People's Hospital of Qinghai Province and Jiaozhou Central Hospital. Eleven were family clustered cases and 10 were sporadic cases not associated with family gatherings. Results Ten patients were male and 11 were female. The time elapsed onset of fever and cough to diagnosis was 3 to 7 days. The body temperatures of patients fluctuated between 36.7 and 38.9°C. One elderly female patient had no fever. On chest CT, 14 patients with family clustered COVID-19 had bilateral lung lesions. By contrast, 7 patients with no history of familial gatherings showed single lung exudative lesions or consolidation. Seven patients with family clustered COVID-19 had bilateral multiple exudative lesions. Four patients with no history of familial gathering had unilateral lesions. Conclusion Not all patients with COVID-19 have direct epidemiological links to an infected case. They may become infected because of poor protection. In patients with family clustered COVID-19, chest CT often showed multiple exudative lesions in both lungs. In some patients, symptoms may be complicated by influenza virus infection.
Comparing prospective headache diary and retrospective four-week headache questionnaire over 20 weeks: Secondary data analysis from a randomized controlled trial
Authors: Miller Vanessa E , Faurot Keturah R , Palssson Olafur S , MacIntosh Beth A , Suchindran Chirayath , Honvoh Gilson , Gaylord Susan , Ramsden Christopher E , Mann J Douglas 
Published: August 2020

Background Headache diaries and recall questionnaires are frequently used to assess headache frequency and severity in clinical and research settings. Methods Using 20 weeks of data from an intervention trial with 182 participants, we evaluated concordance between an electronic headache diary administered on a daily basis and designed to capture the presence and severity of headaches on an hourly basis (the headache diary) and a recall questionnaire, with retrospective estimation of the number of headache days assessed on a monthly basis. We further examined whether the duration or severity of headaches assessed by the electronic diary impacted concordance between these two measures. Results Over the course of four 28-day periods, people with migraine participating in a dietary intervention reported an average of 13.7 and 11.1 headache days in the headache diary and recall questionnaire, respectively. Conclusion Over time, the concordance between headache days reported in these two measures tended to increase; however, the recall questionnaire headache estimates were lower than the diary measures in all four periods. When analysis was restricted to headaches lasting 8 hours or more, the number of headache days was more closely aligned with days reported in the recall questionnaire, indicating that the accuracy of recall estimates is likely to be influenced by headache duration. Restriction of analyses to moderate-to-severe headaches did not change results as much as headache duration. The findings indicate that recall questionnaires administered on a monthly basis may underestimate headache frequency and therefore should not be used interchangeably with headache diaries. Clinical Trials.gov Identifier: NCT02012790
Disparities on Baseline Performance Using Neurocognitive and Oculomotor Clinical Measures of Concussion
Authors: Wallace Jessica , Moran Ryan , Beidler Erica , McAllister Deitrick Jamie , Shina James , Covassin Tracey 
Published: August 2020

Background: Given the high participation of Black/African American individuals in high school sports, especially high-risk sports for concussion, it is important to note if racial and socioeconomic status (SES) differences exist in baseline performance on clinical measures of concussion. Purpose: To explore the association between race and SES on baseline concussion assessments of neurocognitive performance and oculomotor function in adolescent athletes. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: A total of 564 high school athletes (mean ± SD age, 15.33 ± 1.1 years) completed the baseline Immediate Post-Concussion Assessment and Cognitive Test and King-Devick (KD) battery before the start of their competitive season. Race was defined as either White/non-Hispanic or Black/African American. SES status was determined by whether the individual’s participating high school was a Title I or non–Title I school. A series of multivariable linear regression analyses were conducted to evaluate the association of computerized neurocognitive test scores (verbal memory, visual memory, motor processing speed, and reaction time), symptom severity scores, and KD scores by race and SES. Results: White/non-Hispanic individuals performed significantly better than Black/African American individuals on verbal memory ( P < .01), visual memory ( P < .01), visual motor processing speed ( P < .01), and reaction time ( P < .01) and had a lower symptom score ( P < .01). Regarding SES, individuals from non–Title I schools performed better on visual memory ( P = .05) and reaction time ( P = .02) than individuals from Title I schools. Examination of cumulative KD test reading time revealed that there was no association between race on baseline reading times ( P = .12). There was a significant association between cumulative reading time and SES ( P = .02). Individuals from non–Title I schools performed significantly faster than individuals from Title I schools on KD test time. Conclusion: Overall, race and SES influence neurocognitive and oculomotor concussion baseline performance in high school athletes. These findings add to the growing literature on the influence of race and SES on neurocognitive and oculomotor function baseline concussion assessments; they highlight the necessity for individualized concussion baseline measurements or race-specific normative reference values.
Human Milk Intake of Thai Breastfed Infants During the First 6 Months Using the Dose-to-Mother Deuterium Dilution Method
Authors: Tongchom Wanabhorn , Pongcharoen Tippawan , Judprasong Kunchit , Udomkesmalee Emorn , Kriengsinyos Wantanee , Winichagoon Pattanee 
Published: August 2020

Background: Data on infant human milk intakes in low- and middle-income countries are limited, although the deuterium oxide dose-to-mother method (DTM) is an accurate tool for its estimation. Objective: We assessed human milk intakes of Thai infants during the first 6 months comparing exclusive breastfeeding (EBF), predominant breastfeeding (PBF), and partial breastfeeding (PartBF). Methods: One hundred and ten healthy Thai lactating mother–infant pairs were followed from birth. Human milk intakes were determined at 6 weeks, 3 months, and 6 months using the DTM method. Daily energy and protein intakes were assessed using 3-day nonconsecutive 24-hour recalls. Sociodemographic characteristics were collected using a questionnaire. To compare breastfeeding practices, one-way analysis of variance with Tukey post hoc test assessed normally distributed data, while the Kruskal-Wallis test with Mann-Whitney U test was used for not normally distributed data. Results: No difference existed in human milk intakes during the first 6 months between EBF (743-776 g/d) and PBF (748-862 g/d). Human milk intakes of PartBF infants were significantly lower compared to other infants. Human milk intake was sufficient to meet infant energy and protein requirements during the first 3 months for EBF and PBF groups. Infant formula largely replaced human milk during the first 3 months; other solid foods were also introduced among the PartBF infants. Conclusions: Human milk intakes were comparable between EBF and PBF infants during the first 6 months and provided adequate energy and protein to meet requirements. Infant formula largely replaced breast milk among PartBF infants, although other foods were also given early. This study was registered at clinicaltrials.gov as NCT04020640.
Traduction et validation du questionnaire de dépistage Borderline Personality Questionnaire
Authors: Larivière, erg. Nadine , Pérusse Frédéric , David Pierre 
Published: August 2020

Objectif: Disposer d’outils de dépistage valides pour évaluer le trouble de la personnalité limite est essentiel en pratique clinique et en recherche. Parmi les outils existants, le questionnaire sur la personnalité limite (BPQ) présente plusieurs qualités. Cependant, il n’existe pas de version française et il n’a pas été validé avec des adultes dans un échantillon clinique. Les objectifs de cette étude étaient : 1) traduire le BPQ en français; 2) mesurer la validité convergente, prédictive et discriminante, la cohérence interne et la fidélité test-retest. Méthode: Les recommandations de Streiner, Norman et Cairney (2014) sur la traduction d’évaluations ont été suivies. Quarante adultes référés à un programme spécialisé en troubles de la personnalité ont participé à l’étude. Pour évaluer la validité du BPQ français, le questionnaire SCID-II (entrevue et auto-évaluation) fut administré et le diagnostic psychiatrique fut établi par un psychiatre à l’insu. Résultats: Aucune modification majeure n’a été apportée au BPQ français. Les analyses ont montré une cohérence interne élevée (α = 0,84), une bonne fidélité test-retest (r = 0,77), une discrimination significative avec le trouble de la personnalité schizotypique (r = -0,31; p < 0,05), une convergence significative avec le SCID-II (r = 0,72) et une validité prédictive significative du diagnostic psychiatrique (p < 0,01). Conclusions: La version française du BPQ présente des qualités psychométriques prometteuses à un usage auprès des personnes ayant un trouble de la personnalité limite.
Plasma Endothelial Glycocalyx Components as a Potential Biomarker for Predicting the Development of Disseminated Intravascular Coagulation in Patients With Sepsis
Authors: Huang Xiao , Hu Haoran , Sun Ting , Zhu Weiwei , Tian Huanhuan , Hao Dong , Wang Tao , Wang Xiaozhi 
Published: August 2020

Background: Sepsis coagulopathy or disseminated intravascular coagulation (DIC) mainly due to progressive endothelial disruption and damage. The glycocalyx is expressed on the endothelial cell surface and contributes to anti-thrombogenicity, anti-inflammatory, and regulates vascular permeability. We aimed to evaluate the clinical utility of plasma glycocalyx components as biomarkers in predicting the onset of DIC in sepsis. Materials and methods: This was a prospective observational study of 45 patients with sepsis (June to December 2018). Demographic, clinical (Acute Physiology, Age, Chronic Health Evaluation II [APACHE II], Sequential Organ Failure Assessment [SOFA]), and laboratory data from medical records were analyzed. Endothelial glycocalyx components (syndecan-1, heparan sulfate, hyaluronan) were measured using an ELISA kit. Results: Among the 45 patients (23, sepsis; 22, septic shock), plasma syndecan-1, heparan sulfate, and hyaluronan levels were higher in those with septic shock and were positively correlated with disease severity as determined by the APACHE II and SOFA scores and lactate levels. Receiver operating characteristic curve analysis revealed high sensitivity and specificity of syndecan-1 for predicting septic shock. Further, these levels were compared between patients with or without the development of DIC. Plasma syndecan-1 and hyaluronan levels were significantly elevated in patients with DIC compared to those in patients without DIC and were strongly associated with activated partial thromboplastin time, prothrombin time, and platelet counts. Area under the curve values for predicting DIC based on syndecan-1 and hyaluronan levels measurements were 0.774 and 0.740, respectively. Conclusions: Increased plasma syndecan-1 and hyaluronan levels may be indicators of disease severity and useful predictors for DIC development in sepsis.