bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence, Time Course and Influence on Quality of Life of Intensive Care Unit-Acquired Weakness Symptoms in Long-Term Intensive Care Survivors
Authors: Meyer-Frießem Christine H. , Malewicz Nathalie M. , Rath Sabrina , Ebel Melanie , Kaisler Miriam , Tegenthoff Martin , Schildhauer Thomas A. , Pogatzki-Zahn Esther M. , Maier Christoph , Zahn Peter K. 
Published: August 2020

Purpose: Intensive care unit-acquired weakness (ICUAW) can manifest as muscle weakness or neuropathy-like symptoms, with diagnosis remaining a challenge. Uncertainties surround the long-term cause and sequelae. Therefore, the purpose was to assess incidence, time course and long-term influence on quality of life (QoL) of symptoms in ICU survivors Methods: After ethical approval and registration ( www.drks.de : DRKS00011593), in a single-center cohort study all patients admitted to the ICU in 2007–2017 in a German university hospital were screened. Out of 1,860 patients (≥7d ICU care including ventilation support for ≥72 h, at least 6mo-10y after ICU) 636 were deceased, 912 survivors were contacted. Results: 149 former patients (age: 63.5 ± 13.1y; males: 73%; duration in ICU: 20.8 ± 15.7d; duration of ventilation: 16.5 ± 13.7 h; time post-ICU: 4.4 ± 2.7y, 5-10y: 43%) consented to be interviewed concerning occurrence, duration, recovery and consequences of ICUAW-associated muscle weakness or neuropathy-like symptoms after ICU. In 75% at least 1 persistent or previous symmetrical symptom was reported (myopathy-like muscle weakness: 43%; neuropathy-like symptoms: 13%; both: 44%) and rated as incidence of ICUAW. However, only 18% of participants had received an ICUAW diagnosis by their physicians, although 62% had persistent symptoms up to 10y after ICU (5-10y: 46%). Only 37% of participants reported a complete recovery of symptoms, significantly associated with an initially low number of symptoms after ICU ( p < 0.0001), myopathy-like symptoms ( p = 0.024), and younger age at the time of ICU admission (55.7 ± 13.1 vs. 62.6 ± 10.6y, p < 0.001). ICUAW still impaired the QoL at the time of the interview in 74% of affected survivors, with 30% reporting severe impairment. Conclusion: ICUAW symptoms were disturbingly common in the majority of long-term survivors, indicating that symptoms persist up to 10y and frequently impair QoL. However, only a small number of patients had been diagnosed with ICUAW. Trial registry: Deutsches Register Klinischer Studien (DRKS), https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011593 , registration number: DRKS00011593.
Psychometric Testing of an Instrument to Measure Cultural Humility
Authors: Foronda Cynthia , Porter Andrew , Phitwong Ame 
Published: August 2020

Introduction As the world increasingly diversifies, there is a need to prepare nurses to care for individuals, families, and communities with contrasting lifeways. Although education about cultural humility is needed, there is no way to measure the construct. The purpose of this study was to develop, validate, and psychometrically test an instrument designed to measure cultural humility. Method The lead author extracted key constructs from previous research to develop the instrument. Six expert faculty validated the instrument. An exploratory factor analysis was conducted with 322 health professional students. Results All items had an item content validity index of 0.83 or higher. The factor analysis yielded three factors: context for difference in perspective, self-attributes, and outcomes of cultural humility. The instrument was determined reliable (Cronbach’s alpha = .85). Discussion Foronda’s Cultural Humility Scale may help researchers better operationalize and evaluate achievement of cultural humility.
Duration of Surgery, Ventilation, and Length of Hospital Stay Do Not Affect Breastfeeding in Newborns After Early Cleft Lip Repair
Authors: Burianova Iva , Cerny Milos , Borsky Jiri , Zilinska Kristyna , Dornakova Jana , Martin Aisling , Janota Jan 
Published: August 2020

Objective: There are minimal data available on nutrition after early repair of cleft lip and the factors influencing initiation of breastfeeding. This study assessed the impact of the length of surgery, length of ventilation support, and duration of hospital stay on breastfeeding rates after early cleft lip surgery. Design: This is a prospective observational cohort study comparing 2 hospitals providing early surgical repair of facial clefts from January 2014 to December 2016. Both hospitals are designated as Baby-Friendly Hospitals. Demographic and anthropometric data from mothers and newborns were recorded. Setting: Tertiary neonatal and pediatric surgery center. Patients: Hospital A: 61 newborns, Hospital B: 157 newborns. Interventions: Early (day 5 to 14) cheiloplasty in newborns with cleft lip or cleft lip and palate. Main Outcome Measures: Influence of duration of hospital stay, length of operation, and artificial ventilation on the rate of breastfeeding. Results: Significantly, more newborns were breastfed following early surgical repair of an isolated cleft lip compared to those with both cleft lip and palate, in both hospitals (hospital A 82% vs 0%, P = .0001, hospital B 66% vs 5%, P = .0001). Duration of hospital stay, length of operation, and duration of artificial ventilation did not significantly affect the rate of breastfeeding. Conclusions: The factors associated with early cleft lip repair (length of operation, length of ventilation support, and duration of hospital stay) do not affect breastfeeding rate.
For Patients With Isolated Cleft Palate Does Revision Palatoplasty Have an Increased Risk of Inpatient Complication Compared to Primary Palatal Repair?
Authors: Lee Kevin C. , Halepas Steven , Wu Brendan W. , Chuang Sung-Kiang 
Published: August 2020

Objective: The purpose of this study was to determine whether revision palatoplasty was associated with increased rates of inpatient complication and wound dehiscence compared to primary palatal repair. Materials and Methods: This was a retrospective study of patients with isolated cleft palate treated with primary palatoplasty or revision surgery for fistula repair. The records were obtained from the Kids’ Inpatient Database between 2000 and 2014. The primary predictor was the type of surgery, classified as either primary or revision palatoplasty. Secondary predictors included demographics and comorbidities. Primary study outcomes were the postoperative complication and dehiscence rates as noted during the hospitalization course. The secondary outcomes related to health care utilization as measured through length of stay (LOS) and hospital charges. Results: A total of 5357 total admissions (95.5% primary, 4.5% revision) were included in the final sample. Fistula repairs (odds ratio = 14.37, P < .01) had significantly greater odds of wound dehiscence. The rates of inpatient complication ranged from 3.5% to 3.7%, and there were no significant differences between primary and revision surgery ( P = .82). Complications were independently associated with insurance status and congenital anomalies. Complications and wound dehiscence both significantly increased the LOS and the hospital charges. Fistula repairs had a shorter mean LOS ( P = .02), however this did not translate into cost savings ( P = .60). Conclusions: Although the rates of inpatient complications were not significantly different, revision palatoplasty was associated with a greater odds of wound dehiscence. Failure of a primary repair may portend an increased risk of wound failure with subsequent surgeries.
Comparing Quality of Life and Perceptual Speech Ratings in Children With Cleft Palate
Authors: Pedersen Hailey M. , Goodie Paige A. , Braden Maia N. , Thibeault Susan L. 
Published: August 2020

Objective: To delineate the relationship between patient and parent-reported quality of life (QOL) ratings and perceptual characteristics of speech assigned by a speech-language pathologist (SLP) in children with repaired cleft palate. Design: Prospective. Setting: Academic Children’s Hospital. Participants: This population-based sample included children, aged 3 to 18 with a history of repaired cleft palate, and their parents. Intervention: Participants completed the Velopharyngeal Insufficiency Effects on Life Outcomes Questionnaire (VELO). Children’s speech was judged perceptually by an expert SLP using the Pittsburgh Weighted Speech Scale (PWSS). Main Outcome Measure(s): Velopharyngeal Insufficiency Effects on Life Outcomes questionnaire assessed participant and parent perceptions of impact of velopharyngeal function on QOL. Pittsburgh Weighted Speech Scale assessed nasal emissions, facial grimacing, nasality, quality of phonation, and articulation. Results: Enrollment included 48 participant parent dyads. Overall, participants reported high QOL scores within the 95% CI with children reporting slightly better yet not significantly different QOL (86.27 ± 8.96) compared to their parents (81.81 ± 15.2). Children received an average score of 1.38 ± 1.96 on the PWSS corresponding to borderline velopharyngeal competence. A significant moderate negative correlation was found between PWSS total score and parent VELO total score (r = −0.51103, P = .0002). Mild–moderate significant negative correlations were measured between PWSS total and the 5 subscales of the VELO. No significant correlations were measured between PWSS and child VELO total responses or between total scores and subscales. Conclusions: Results suggest that as perceptual analysis of speech improves, overall QOL improves moderately.
Characterizing the impact of magnesium and potassium-supplemented hydration with cisplatin and the subsequent electrolyte replacement requirements
Authors: Uhm So Jung , Meszaros Elizabeth , Hammonds Kendall , Patel Ina , Herrington Jon D 
Published: August 2020

Background Cisplatin-associated electrolyte dysregulation is a prevalent therapy-related adverse effect. There are numerous electrolyte-supplemented hydration regimens that have been evaluated, however these studies focused on the development of nephrotoxicity. The objective of this study was to characterize the impact of magnesium and potassium-supplemented hydration during cisplatin administration on subsequent magnesium and potassium imbalances. Methods A single-region retrospective study from central Texas at Baylor Scott & White Cancer Clinics who were treated with two or more cycles of cisplatin were included. Standard hydration for this study was defined as normal saline before and after cisplatin along with potassium chloride 10 mEq and magnesium sulfate 1 g added to the cisplatin bag. Results A total of 477 patients were included in the study with376 patients receiving the standard hydration. Overall, 17 percent of patients experienced a potassium level below 3.5 mEq/L, but no major depletion was observed. Thirty-three percent of the patients experienced a magnesium level below 1.8 mg/dL, and time to first rescue magnesium supplementation was 4 weeks. Conclusion Our study demonstrated despite routine magnesium and potassium supplementation in hydration, magnesium imbalances were observed. Potassium levels post cisplatin administration were maintained with minimal routine supplementation in hydration.
Acute pancreatitis in a patient treated with imatinib and gefitinib
Authors: Escudero-Vilaplana Vicente , Collado-Borrell Roberto , Villanueva-Bueno Cristina , Álvarez Rosa , Herranz Ana , Sanjurjo María 
Published: August 2020

Introduction Use of oral antineoplastic agents (OAAs) has increased significantly in recent years. OAAs currently represent 30-50% of all cancer treatments. Drug interactions are the most frequent drug-related problem affecting OAAs. We describe the case of a patient who presented acute pancreatitis, possibly induced by the concomitant use of imatinib and gefitinib. Case report A female patient received imatinib and gefitinib for the treatment of chronic myeloid leukemia and lung adenocarcinoma, respectively. Liver function and pancreatic enzyme values gradually worsened after initiation of imatinib, and the patient was diagnosed with acute pancreatitis. Management and outcomes Imatinib was discontinued owing to pancreatic toxicity. Gefitinib was subsequently discontinued owing to tumor progression. The patient received supportive measures for pancreatitis, although she eventually died 3 months after the onset of symptoms. Discussion To our knowledge, this is the first case in the medical literature of acute pancreatitis possibly induced by an interaction between imatinib and gefitinib. The interaction most likely arose because imatinib is a CYP2D6 inhibitor and could therefore impair the metabolism of gefitinib (a CYP2D6 substrate) and increase its serum concentration. This interaction is extremely rare. However, due to its severity, hepatic and pancreatic function should be carefully monitored in patients treated with imatinib and/or gefitinib and other inhibitors or inducers of CYP2D6 and CYP3A4.
Atypical response patterns in metastatic melanoma and renal cell carcinoma patients treated with nivolumab: A single center experience
Authors: Yilmaz Mesut 
Published: August 2020

Introduction The response patterns of immune checkpoint inhibitors (ICIs) have been recognized to differ from those seen in standard cytotoxic and targeted therapy. Pseudoprogression and hyperprogression are new clinical phenomena specific to the field of immuno-oncology. In this study, we aimed to assess the frequency of hyperprogression and pseudoprogression in metastatic RCC and melanoma patients treated in our institution with the programmed cell death protein–1 inhibitor nivolumab. Methods The medical records of all metastatic melanoma and renal cell carcinoma patients that were treated with nivolumab (n = 54) in Bakirkoy Dr. Sadi Konuk Training and Research Hospital (Istanbul-Turkey), Medical Oncology Clinic between June 2017 and December 2019 were retrospectively analyzed. Results Hyperprogression and pseudoprogression rates were 12% and 9%, respectively and that is consistent with published data. Discussion Pseudoprogression and hyperprogression are new radiologic response patterns with immunotherapy agents. It is critical to be aware of these two phenomena in order to make the right decisions for patients.
Effect of Regional Analgesia Techniques on Opioid Consumption and Length of Stay After Thoracic Surgery
Authors: Dunham Wills C. , Lombard Frederick W. , Edwards David A. , Shi Yaping , Shotwell Matthew S. , Siegrist Kara , Eagle Susan S. , Pretorius Mias , McEvoy Matthew D. , Gillaspie Erin A. , Nesbitt Jonathan C. , Wanderer Jonathan P. , Kertai Miklos D. 
Published: August 2020

Background We examined how intercostal nerve block (ICNB) with standard bupivacaine and ICNB with extended-release liposomal bupivacaine, compared with thoracic epidural analgesia (TEA), were associated with postoperative opioid pain medication consumption and hospital length of stay (LOS) after thoracic surgery. Methods We studied 1935 patients who underwent thoracic surgery between January 1, 2010, and November 30, 2017, at a tertiary academic center. Primary and secondary outcomes were postoperative opioid consumption expressed as morphine milligram equivalents (MMEs) at 24, 48, and 72 hours after surgery, the LOS, and total MME consumption from surgery to discharge. Results Of these patients, 888 (45.9%) received TEA, 730 (37.7%) ICNB with standard bupivacaine, 127 (6.6%) ICNB with liposomal bupivacaine, and 190 (9.8%) no regional analgesia. Compared with epidural analgesia, in 2017, ICNB liposomal bupivacaine provided similar pain control in terms of MME consumption at 24 and 72 hours, but decreased MME consumption at 48 hours (odds ratio [OR] = 0.33; confidence interval [CI] = 0.14-0.81) and at discharge (OR = 0.28; CI = 0.12-0.68) and was associated with a higher likelihood for a shorter LOS (hazard ratio = 3.46; CI = 2.42-4.96). Compared with TEA, ICNB with standard bupivacaine and no regional analgesia use showed varying impact on MME consumption between 24 and 72 hours after surgery, and their use was not associated with a significantly reduced MME consumption at discharge but with a shorter hospital LOS. Conclusions Multimodal analgesia involving regional anesthetic alternatives to TEA could help manage postoperative pain in thoracic surgery patients.
Four petal evisceration versus standard technique: A retrospective study
Authors: Ranno Stefano , Serafino Massimiliano , Nucci Paolo 
Published: August 2020

Purpose: To compare the four-petal evisceration technique and the standard evisceration technique. Methods: In this retrospective, comparative case series study, sixteen charts of patients fulfilled the inclusion criteria and were were reviewed. Orbital implant exposition and complication rates between the two surgical techniques were evaluated. Results: A total of 16 eye of 16 patients fulfilled the inclusion criteria and were included in the analysis (eight in the four petal group and eight in the standard evisceration group). During postoperative follow-up there were no cases of implant exposure or migration in the four-petal group and two cases (25%) of implant exposure in the standard evisceration group. Exposed orbital implants dimension were both 16 mm and patients eviscerated for phtisis bulbi All surgeries were uneventful, and there were no serious complications during the study. Conclusion: Four petal evisceration technique seems particularly useful in patients with phtisis bulbi because it allowed the placement of an implant significantly larger than the standard technique with low rate of esposition.
Successes and failures in treatment of substance abuse: Treatment system perspectives and lessons from the European continent
Authors: Klingemann Harald 
Published: August 2020

Objective: The article offers an inventory of controversial basic issues related to treatment responses and their sociocultural political context, highlighting policy failures and successes, with a focus on Europe. As a reference point for this assessment, serves a conceptual framework of an “ideal type of treatment system”, which is built upon the following normative assumptions: the objective of harm minimisation or preventing substance-use-related consequences, evidence-based decision making, securing equity and accessibility also from a user perspective as well as efficiency in terms of the diversity and choice of treatment options. Method: Five major issues of addiction treatment systems, as identified and exemplified by an expert survey among 14 countries conducted in 2014, served as a reference for discussing fundamental gaps between an assumed ideal type of treatment system and the treatment response in practice: (1) Resistance to change, consensus building and innovation, (2) Political influence and target group bias beyond evidence, (3) Assumptions about rationality and universal evidence, (4) Myths of addiction and ethical deficits and (5) The treatment gap and user perspectives. Results/conclusions: Recommendations relevant for politicians, system planners, and clinicians are formulated for each of the five issues, specifically focusing on embeddedness of treatment systems in macro-societal conditions, the abstinence paradigm and outcome diversity, ethnocentric biases of the “evidence credo”, learning from self-change as the major road to recovery, and questioning implicit conceptions of the “addict as a human being”. Furthermore, it is concluded that theories regarding the diffusion of innovation and knowledge exchange can inform future research.
Israeli-Palestinian social work encounters
Authors: Blit-Cohen Edith 
Published: August 2020

Summary This study deals with the encounters of Arab social work students who are citizens of Israel, with Palestinian clients from East Jerusalem. The study was based on interviews with social work students who carried out their field work in East Jerusalem. This article discusses a special kind of transcultural practice in social work on the basis of a case study analysis of the dynamics and strategies reported by 15 Arab Israeli citizens students regarding their practice with Palestinian Arabs from East Jerusalem. Findings The findings indicate two themes: (1) The encounters aroused inner-personal conflicts regarding the students’ identity. (2) The students noted the importance of creating a dialogue with the clients as a way of coping with the difficulties entailed by their work. Applications This case study calls attention to the importance of embracing a transcultural perspective in practice theory. A transcultural perspective needs to go beyond the conceptualization of culture and ethnicity to include other relevant contextual variables such as structural factors, power relations, and an understanding of the political context. In addition, academic institutions need to develop culturally sensitive training programs while creating a safe space to discuss cultural challenges and while clarifying different identities faced by social work students from minority groups who share similar backgrounds with their clients.
Navigating helping relationships amidst heavy workloads: An institutional ethnography of social workers’ accounts
Authors: Sinai-Glazer Hagit , Krane Julia 
Published: August 2020

Summary One major effect of the demise of the welfare state on public social services is increased heavy workload which leads to stress, burnout, and compromised well-being among social workers. Less explored are the ways in which heavy workload shapes the helping relationship between social workers and clients. Extrapolating from the narratives of 14 Israeli social workers who participated in an institutional ethnographic study, this paper offers a nuanced understanding of the toll that heavy workload takes on the helping relationship. Findings Results showcase heavy workload as a ruling relation, an organizational reality outside the control of social workers and clients. The damaging effects of heavy workload on the helping relationship as well as on the social workers were apparent: social workers expected to slice themselves thin and deal with frustration and guilt in the face of an organizational reality that deters them from investing in their clients the time and energy required to cultivate helping relationships. Application The helping relationship has been paramount to social work throughout the history of the profession. This research contributes to this longstanding focus with a renewed understanding of the helping relationship in public social services as a political and public encounter between social workers and clients, one that is governed by extra-local relations of ruling. Heavy workload is one such ruling relation that organizes the helping relationship. As such, this organizational reality can be reorganized to eliminate, or at least reduce, the toll that heavy workload takes on the helping relationship.