bluuebunny/crossref_metadata_2025_split huggingface dataset:
Participation of adults with cognitive, physical, or psychiatric impairments in family of origin and intimate relationships: a grounded theory study
Authors: Pfister Andreas , Georgi-Tscherry Pia , Berger Fabian , Studer Michaela 
Published: May 2020

Abstract
Background
How adults with disabilities perceive participation has received little attention. Our purpose was to formulate a grounded theory on participation, based on the subjective experience of adults with cognitive, physical, or psychiatric impairment(s), and to identify barriers, facilitators, and support needs concerning participation in different areas of life. We aimed to explore whether the United Nations’ Convention on the Rights of Persons with Disabilities (CRPD), ratified by Switzerland in 2014, and its principles are being met. Here we report on the main category and focus on the participation areas ‘family of origin’ and ‘intimate relationships.’

Methods
In a qualitative, grounded theory study, we conducted problem-centered interviews with 23 adults with cognitive, physical, or psychiatric impairments (30–53 years; 11 men, 12 women), with different housing (on their own, assisted living, with parents) and work situations (primary vs. secondary labor market) in nine German-speaking Swiss cantons.

Results
Participation can be understood as a continuum that extends on a horizontal level (from participation is restricted to participation takes place) and a vertical level (separative setting vs. inclusive setting). In separative as well as in inclusive settings, diverse levels of participation are possible. Many participants were stuck in an ‘in-between’ area between separative and inclusion-oriented settings. In the family of origin, there was a thin line between fulfilling relations that enhance participation and conflictual relations and overprotective parenting that limit participation. In intimate relationships, opportunities for participation were limited overall. Many interviewees were single. Social environment and family of origin (e.g., parents) can enable and facilitate intimate relationships and sexual contacts but can also be an important barrier.

Conclusions
Participation can be understood as a continuum. Participation restrictions exist in separative as well as in inclusive-oriented settings, also in the areas of family of origin and intimate relationships. Participation barriers must be torn down in separative as well as in inclusion-oriented settings. Trajectories to inclusive settings should be facilitated. Families with children with impairment(s) should be supported from early on to create the best possible participation possibilities for the (adult) person with impairment(s) and to support the family of origin itself.
Simultaneous quantile regression and determinants of under-five severe chronic malnutrition in Ghana
Authors: Aheto Justice Moses K. 
Published: May 2020

AbstractBackgroundUnder-five malnutrition is a major public health issue contributing to mortality and morbidity, especially in developing countries like Ghana where the rates remain unacceptably high. Identification of critical risk factors of under-five malnutrition using appropriate and advanced statistical methods can help formulate appropriate health programmes and policies aimed at achieving the United Nations SDG Goal 2 target 2. This study attempts to develop a simultaneous quantile regression, an in-depth statistical model to identify critical risk factors of under-five severe chronic malnutrition (severe stunting).MethodsBased on the nationally representative data from the 2014 Ghana Demographic and Health Survey, height-for-age z-score (HAZ) was estimated. Multivariable simultaneous quantile regression modelling was employed to identify critical risk factors for severe stunting based on HAZ (a measure of chronic malnutrition in populations). Quantiles of HAZ with focus on severe stunting were modelled and the impact of the risk factors determined. Significant test of the difference between slopes at different selected quantiles of severe stunting and other quantiles were performed. A quantile regression plots of slopes were developed to visually examine the impact of the risk factors across these quantiles.ResultsData on a total of 2716 children were analysed out of which 144 (5.3%) were severely stunted. The models identified child level factors such as type of birth, sex, age, place of delivery and size at birth as significant risk factors of under-five severe stunting. Maternal and household level factors identified as significant predictors of under-five severe stunting were maternal age and education, maternal national health insurance status, household wealth status, and number of children under-five in households. Highly significant differences exist in the slopes between 0.1 and 0.9 quantiles. The quantile regression plots for the selected quantiles from 0.1 to 0.9 showed substantial differences in the impact of the covariates across the quantiles of HAZ considered.ConclusionCritical risk factors that can aid formulation of child nutrition and health policies and interventions that will improve child nutritional outcomes and survival were identified. Modelling under-five severe stunting using multivariable simultaneous quantile regression models could be beneficial to addressing the under-five severe stunting.
An educational intervention improved knowledge of dietary supplements in college students
Authors: Chiba Tsuyoshi , Kobayashi Etsuko , Okura Takashi , Sekimoto Masashi , Mizuno Hideya , Saito Maki , Umegaki Keizo 
Published: May 2020

Abstract
Background
We have previously reported on the prevalence of dietary supplements among college students; it was deduced that their intake of supplements increased according to their grade (i.e., 13.1% in the first grade to 20.5% in the sixth grade). We also reported that some students had experienced adverse events in Japan due to their intake of these supplements. However, awareness of dietary supplements among college students remains limited, even among pharmaceutical students. Being appropriately educated about them is important for pharmaceutical students, both for themselves as well as for their future careers as pharmacists.

Methods
We conducted a lecture-based educational intervention about dietary supplements on 328 college students in Japan—184 from pharmaceutical science and 144 from environmental science or food and life science disciplines. The purpose of this study was to evaluate the effects of an educational intervention on college students’ understanding of dietary supplements. The intervention involved a lecture that covered the quality of dietary supplements, how they differed from drugs, and a summary of their adverse events. The lecture was evaluated using a 14-question questionnaire. We then compared the pre- and post-intervention responses to the same questionnaire using a Wilcoxon signed-rank test. The questions were assessed using a Likert scale that ranged from “strongly agree” to “strongly disagree”; the latter being the preferred answer.

Results
Before the intervention had taken place, the students’ understanding of dietary supplements was shown to be deficient. Conversely, post-intervention, their knowledge levels had significantly improved, especially concerning agreement on whether “Dietary supplements are safe because they are just food items”. Pre-intervention, 2.7% strongly agreed and 37.5% agreed; post-intervention, 1.2% strongly agreed and 15.6% agreed. On whether “Dietary supplements made from natural ingredients or herbs are safe”, at the pre-intervention stage 2.8% strongly agreed and 44.0% agreed and post-intervention, 2.2% strongly agreed and 16.9% agreed. On whether “Dietary supplements made from food items are safe”, 4.0% strongly agreed and 43.6% agreed pre-intervention and 0.9% strongly agreed and 16.6% agreed post-intervention. Despite there being a greater number of pharmaceutical students who had a correct understanding of dietary supplements before the intervention, these students still showed improvement after the lecture.

Conclusion
An intervention in the form of a single educational lecture has the capacity to improve college students’ understanding of dietary supplements. It is important for pharmacists to be appropriately educated about dietary supplements when they consult with patients. We will evaluate the long-term effects of the intervention on the alumni (pharmacists) in a subsequent study.
Efficacy, safety, and tolerability of combined pirfenidone and N-acetylcysteine therapy: a systematic review and meta-analysis
Authors: Shi Hanyu , Yin Dawei , Bonella Francesco , Kreuter Michael , Oltmanns Ute , Li Xuren , Peng Shouchun , Wei Luqing 
Published: May 2020

Abstract
Background
While antifibrotic drugs significantly decrease lung function decline in idiopathic pulmonary fibrosis (IPF), there is still an unmet need to halt disease progression. Antioxidative therapy with N-acetylcysteine (NAC) is considered a potential additional therapy that can be combined with antifibrotics in some patients in clinical practice. However, data on the efficacy, tolerability, and safety of this combination are scarce. We performed a systematic review and meta-analysis to appraise the safety, tolerability, and efficacy of the combination compared to treatment with pirfenidone alone.

Methods
We systematically reviewed all the published studies with combined pirfenidone (PFD) and NAC (PFD + NAC) treatment in IPF patients. The primary outcomes referred to decline in pulmonary function tests (PFTs) and the rates of IPF patients with side effects.

Results
In the meta-analysis, 6 studies with 319 total IPF patients were included. The PFD + NAC group was comparable to the PFD alone group in terms of the predicted forced vital capacity (FVC%) and predicted diffusion capacity for carbon monoxide (DLco%) from treatment start to week 24. Side effects and treatment discontinuation rates were also comparable in both groups.

Conclusion
This systematic review and meta-analysis suggests that combination with NAC does not alter the efficacy, safety, or tolerability of PFD in comparison to PFD alone in IPF patients.
The effect of 50% oxygen on PtCO2 in patients with stable COPD, bronchiectasis, and neuromuscular disease or kyphoscoliosis: randomised cross-over trials
Authors: Pilcher Janine , Thayabaran Darmiga , Ebmeier Stefan , Williams Mathew , Back Geraldine , Collie Hamish , Richards Michael , Bibby Susan , Semprini Ruth , Weatherall Mark , Beasley Richard 
Published: May 2020

AbstractBackgroundHigh-concentration oxygen therapy causes increased arterial partial pressure of carbon dioxide (PaCO2) in patients with COPD, asthma, pneumonia, obesity and acute lung injury. The objective of these studies was to investigate whether this physiological response to oxygen therapy occurs in stable patients with neuromuscular disease or kyphoscoliosis, and bronchiectasis.MethodsThree randomised cross-over trials recruited stable patients with neuromuscular disease or kyphoscoliosis (n = 20), bronchiectasis (n = 24), and COPD (n = 24). Participants were randomised to receive 50% oxygen and 21% oxygen (air), each for 30 min, in randomly assigned order. The primary outcome was transcutaneous partial pressure of carbon dioxide (PtCO2) at 30 min. The primary analysis was a mixed linear model.ResultsSixty six of the 68 participants had baseline PtCO2values < 45 mmHg. The intervention baseline adjusted PtCO2difference (95% CI) between oxygen and room air after 30 min was 0.2 mmHg (− 0.4 to 0.9),P = 0.40; 0.5 mmHg (− 0.2 to 1.2),P = 0.18; and 1.3 mmHg (0.7 to 1.8),P < 0.001, in the neuromuscular/kyphoscoliosis, bronchiectasis and COPD participants respectively.ConclusionsThe small increase in PtCO2in the stable COPD patients with high-concentration oxygen therapy contrasts with the marked increases in PaCO2seen in the setting of acute exacerbations of COPD. This suggests that the model of studying the effects of high-concentration oxygen therapy in patients with stable respiratory disease is not generalisable to the use of oxygen therapy in the acute clinical setting. Appropriate studies of high-concentration compared to titrated oxygen in acute clinical settings are needed to determine if there is a risk of oxygen-induced hypercapnia in patients with neuromuscular disease, kyphoscoliosis or bronchiectasis.Trial registrationAustralian New Zealand Clinical Trials RegistryACTRN12615000970549Registered 16/9/15,ACTRN12615000971538Registered 16/9/15 andACTRN12615001056583Registered 7/10/15.
Validation of the Hungarian version of the SRI Questionnaire
Authors: Valko Luca , Baglyas Szabolcs , Kunos Laszlo , Terray-Horvath Attila , Lorx Andras , Gal Janos , Windisch Wolfram 
Published: May 2020

Abstract
Background
Home mechanical ventilation is a reliable treatment for patients suffering from chronic respiratory failure, improving survival and quality of life. Prevalence has been increasing worldwide as a result of evolving technical possibilities, telemedicine and improving national guidelines. Projects to establish a national guideline and registry for patients treated with home mechanical ventilation are currently under way in Hungary and our aim was to validate a quality of life questionnaire suited for evaluation and follow up in this specific patient group. The Severe Respiratory Insufficiency Questionnaire (SRI) is a quality of life tool designed to evaluate patients receiving home mechanical ventilation and has been validated both in patient groups receiving invasive and noninvasive ventilation.

Methods
The Hungarian version of the SRI was created using the translation-backtranslation method, which was then tested for validity, viability and reliability in a cohort involving patients from three centers, receiving long-term home mechanical ventilation for chronic respiratory failure through an invasive or noninvasive interface. Patient data was collected (demographic data, lung function test, arterial blood gas, ventilation settings) and quality of life was measured with the previously validated SF-36 and newly created Hungarian SRI Questionnaires at two time points.

Results
One hundred four patients receiving home mechanical ventilation were enrolled. The time to complete the SRI Questionnaire was 8.6 (±3.1) minutes, 69.2% questionnaires were self-administered. Exploratory factor analysis explained 73.8% of the variance of the questionnaire, but resulted in 13 scales. We found correlations between the SRI subscale scores to corresponding scales of the previously validated general quality of life survey SF-36. The Cronbach alpha coefficient was 0.928 for the Summary Scale of the SRI Questionnaire, proving high internal consistency. Reproducibility was high for most scales, resulting in a high overall correlation for the summary score (0.877, p < 0.001).

Conclusions
The Hungarian version of the SRI Questionnaire is a viable, valid, reliable and reproduceable quality of life tool applicable for patients treated with home mechanical ventilation.
A new mini-open technique of arthroscopically assisted Latarjet
Authors: Taverna Ettore , Longo Umile Giuseppe , Guarrella Vincenzo , Garavaglia Guido , Perfetti Carlo , Sconfienza Luca Maria , Broffoni Laura , Denaro Vincenzo 
Published: May 2020

Abstract
Background
The aim is to describe a new arthroscopically assisted Latarjet technique.

Methods
We evaluated the clinical and radiological findings of 60 patients with chronic recurrent anterior gleno-humeral instability who underwent, between September 2013 and November 2014, an arthroscopically-assisted Latarjet procedure with double round endobutton fixation. Inclusion criteria were: chronic anterior recurrent instability, Instability Severity Index Score (ISIS) greater than three points, a glenoid bone defect > 15% or a Hill Sachs lesion with concomitant glenoid bone defect > 10%. During surgery the joint capsule and the anterior glenoid labrum were detached. Two drill tunnels perpendicular to the neck of the glenoid were made through a guide. An accessible pilot hole through the glenoid was created to allows the passage of guidewires for coracoid guidance and final fixation onto the anterior glenoid. Through a restricted deltopectoral access a coracoid osteotomy was made. Finally, the graft was prepared, inserted and secured using half-stitches.

Results
The mean follow-up was 32.5 months (range 24–32 months). At a mean follow-up, 56 of the 60 subjects claimed a stable shoulder without postoperative complaints, two (3.3%) had an anterior dislocation after new traumatic injury, and two (3.3%) complained of subjective instability. At the latest follow-up, four subjects complained of painful recurrent anterior instability during abduction-external rotation with apprehension. At 1 year, the graft had migrated in one patient (1.7%) and judged not healed and high positioned in another patient (1.7%). Moreover, a glenoid bony gain of 26.3% was recorded. At the latest follow-up, three patients had grade 1 according to Samilson and Prieto classification asymptomatic degenerative changes. Nerve injuries and infections were not detected. None of the 60 patients underwent revision surgery. Healing rate of the graft was 96.7%.

Conclusions
This technique of arthroscopically assisted Latarjet combines mini-open and arthroscopic approach for improving the precision of the bony tunnels in the glenoid and coracoid placement, minimizing any potential risk of neurologic complications. It can be an option in subjects with anterior gleno-humeral instability and glenoid bone defect. Further studies should be performed to confirm our preliminary results.

Trial registration
Trial registration number 61/int/2017
Name of registry: ORS
Date of registration 11.5.2017
Date of enrolment of the first participant to the trial: September 2013 ‘retrospectively registered’

Level of evidence
IV
Effect of hip abductor strengthening exercises in knee osteoarthritis: a randomized controlled trial
Authors: Yuenyongviwat Varah , Duangmanee Siwakorn , Iamthanaporn Khanin , Tuntarattanapong Pakjai , Hongnaparak Theerawit 
Published: May 2020

Abstract
Background
Osteoarthritis knee (OA) for patients whom had varus malalignment had higher peak adductor moment. Hip abductor strength played an important role in the decreasement of knee adduction moment. This study aimed to evaluate the effect of hip abductor exercises for patients who had medial compartment knees OA.

Methods
Patients who had medial compartmental OA knee were randomized into two groups. The first group performed hip abductor strengthening exercises, combined with quadriceps strengthening exercises; whereas, the second group performed standalone quadriceps strengthening exercises. Self-reported Knee Injury and Osteoarthritis Outcome Scores (KOOS) were collected by patients on follow-up visits.

Results
Eighty-six patients completed the trial. All KOOS subscales were significantly improved in both groups after 10 weeks of treatment. However, there was no significant difference in the scores between either group at 2–10 weeks after treatment. Nevertheless, the effects of exercise for pain, symptoms, function in daily living and knee-related quality of life were found to have faster improvement within the hip abduction exercise group compared to the control group (2 weeks faster; pain, function in daily living and knee-related quality of life, 4 weeks faster; symptoms.)

Conclusion
Since, adding quadriceps exercises could expedite improvement of less pain, symptoms, activity in daily living and quality of life faster than quadriceps exercises solely for a 2–4 weeks period. However, the effect size was small and there were no differences after this; hence, consideration of adding hip abductor exercises in the treatment protocol should be based on the patients and doctors appraisal.

Trial registration
TCTR, TCTR20180517005. Registered 17 May 2018.
The importance of radial multiplanar reconstructions for assessment of triangular fibrocartilage complex injury in CT arthrography of the wrist
Authors: Grunz Jan-Peter , Gietzen Carsten Herbert , Luetkens Karsten , Wagner Matthias , Kalb Karlheinz , Bley Thorsten Alexander , Lehmkuhl Lukas , van Schoonhoven Jörg , Gassenmaier Tobias , Schmitt Rainer 
Published: May 2020

Abstract
Background
Triangular fibrocartilage complex (TFCC) lesions commonly cause ulnar-sided wrist pain and instability of the distal radioulnar joint. Due to its triangular shape, discontinuity of the TFCC is oftentimes difficult to visualize in radiological standard planes. Radial multiplanar reconstructions (MPR) may have the potential to simplify diagnosis in CT wrist arthrography. The objective of this study was to assess diagnostic advantages provided by radial MPR over standard planes for TFCC lesions in CT arthrography.

Methods
One hundred six patients (49 women, 57 men; mean age 44.2 ± 15.8 years) underwent CT imaging after wrist arthrography. Two radiologists (R1, R2) retrospectively analyzed three randomized datasets for each CT arthrography. One set contained axial, coronal and sagittal planes (MPRStandard), while the other two included an additional radial reconstruction with the rotating center either atop the ulnar styloid (MPRStyloid) or in the ulnar fovea (MPRFovea). Readers evaluated TFCC differentiability and condition. Suspected lesions were categorized using Palmer’s and Atzei’s classification and diagnostic confidence was stated on a five-point Likert scale.

Results
Compared to standard planes, differentiability of the superficial and deep TFCC layer was superior in radial reconstructions (R1/R2; MPRFovea: p < 0.001; MPRStyloid: p ≤ 0.007). Palmer and Atzei lesions were present in 86.8% (92/106) and 52.8% (56/106) of patients, respectively. Specificity, sensitivity and accuracy for central Palmer lesions did not differ in radial and standard MPR. For peripheral Atzei lesions, sensitivity (MPRStandard 78.6%/80.4%, MPRStyloid 94.6%/94.6%, MPRFovea 91.1%/89.3%) and accuracy (MPRStandard 86.8%/86.8%, MPRStyloid 96.2%/96.2%, MPRFovea 94.3%/93.4%) improved with additional styloid-centered (p = 0.004/0.008) and fovea-centered (p = 0.039/0.125) reconstructions. No substantial difference was observed between both radial MPR (p = 0.688/0.250). Interrater agreement was almost perfect for each dataset (κStandard = 0.876, κStyloid = 0.894, κFovea = 0.949). Diagnostic confidence increased with addition of either radial MPR (p < 0.001).

Conclusions
Ancillary radial planes improve accuracy and diagnostic confidence for detection of peripheral TFCC lesions in CT arthrography of the wrist.