bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inspiratory Muscle Training With an Electronic Resistive Loading Device Improves Prolonged Weaning Outcomes in a Randomized Controlled Trial*
Authors: da Silva Guimarães Bruno , de Souza Leonardo Cordeiro , Cordeiro Hebe Faria , Regis Thiago Loureiro , Leite Cristiane Almeida , Puga Fernanda Patricio , Alvim Sergio Hernando , Lugon Jocemir Ronaldo 
Published: December 2020

OBJECTIVES:
To test if the use of an inspiratory muscle training program with an electronic resistive loading device is associated with benefits as to muscle strength, weaning, and survival in the ICU.

DESIGN:
Prospective randomized controlled trial.

SETTINGS:
Study conducted at the ICU of a Navy’s hospital, Rio de Janeiro, Brazil, from January 2016 to September 2018.

PATIENTS:
Tracheostomized patients (18–86 yr) on prolonged weaning.

INTERVENTIONS:
Participants were assigned to inspiratory muscle training (intervention group) or a traditional T-piece protocol (control group). In the inspiratory muscle training group, participants underwent training with an electronic inspiratory training device (POWERbreathe K-5; Technologies Ltd, Birmingham, United Kingdom).

MEASUREMENTS AND MAIN RESULTS:
Changes in respiratory muscle strength and rates of ICU survival and weaning success were compared between groups. Forty-eight participants in the inspiratory muscle training group and 53 ones in the control group were included in the final analysis. The inspiratory muscle training was associated with a substantially higher gain on muscle strength as assessed by the maximal inspiratory pressure (70.5 [51.0–82.5] vs –48.0 cm H2O [36.0–72.0 cm H2O]; p = 0.003) and the timed inspiratory effort index (1.56 [1.25–2.08] vs 0.99 cm H2O/s [0.65–1.71 cm H2O/s]; p = 0.001). Outcomes at the 60th day of ICU were significantly better in the intervention group regarding both survival (71.1% vs 48.9%; p = 0.030) and weaning success (74.8% vs 44.5%; p = 0.001).

CONCLUSIONS:
The use of an inspiratory muscle training program with an electronic resistive loading device was associated with substantial muscle strength gain and positive impacts in two very relevant clinical outcomes: the rates of ICU survival and successful weaning.
Th17 cells are involved in mouse chronic obstructive pulmonary disease complicated with invasive pulmonary aspergillosis
Authors: Geng Wan-Ru , He Hang-Yong , Zhang Qing , Tong Zhao-Hui 
Published: December 2020

Abstract

Background:
The incidence of chronic obstructive pulmonary disease (COPD) complicated with invasive pulmonary aspergillosis (IPA) has increased in the last two decades. The mechanism underpinning susceptibility to and high mortality of COPD complicated with IPA is unclear, and the role of T helper cells 17 (Th17 cells) in the compound disease remains unknown. Therefore, this study aimed to assess the function of Th17 cells in COPD combined with IPA.

Methods:
COPD, IPA, and COPD+IPA mouse models were established in male wild type C57/BL6 mice. The amounts of Th17 cells and retinoic acid-related orphan receptors γt (RORγt) were tested by flow cytometry. Then, serum interleukin (IL)-17 and IL-23 levels were detected by enzyme-linked immunosorbent assay (ELISA) in the control, COPD, IPA and COPD+IPA groups. In addition, COPD+IPA was induced in IL-17 knockout (KO) mice, for determining the role of Th17 cells in COPD+IPA.

Results:
Compared with the COPD group, the COPD+IPA group showed higher amounts of blood RORγt ([35.09 ± 16.12]% vs. [17.92 ± 4.91]%, P = 0.02) and serum IL-17 (17.96 ± 9.59 pg/mL vs. 8.05 ± 4.44 pg/mL, P = 0.02), but blood ([5.18 ± 1.09]% vs. [4.15 ± 0.87]%, P = 0.28) and lung levels of Th17 cells ([1.98 ± 0.83]% vs. [2.03 ± 0.98]%, P = 0.91), lung levels of RORγt ([9.58 ± 6.93]% vs. [9.63 ± 5.98]%, P = 0.49) and serum IL-23 (51.55 ± 27.82 pg/mL vs. 68.70 ± 15.20 pg/mL, P = 0.15) showed no significant differences. Compared with the IPA group, the COPD+IPA group displayed lower amounts of blood ([5.18 ± 1.09]% vs. [9.21 ± 3.56]%, P = 0.01) and lung Th17 cells ([1.98 ± 0.83]% vs. [6.29 ± 1.11]%, P = 0.01) and serum IL-23 (51.55 ± 27.82 pg/mL vs. 154.90 ± 64.60 pg/mL, P = 0.01) and IL-17 (17.96 ± 9.59 pg/mL vs. 39.81 ± 22.37 pg/mL, P = 0.02), while comparable blood ([35.09 ± 16.12]% vs. [29.86 ± 15.42]%, P = 0.25) and lung levels of RORγt ([9.58 ± 6.93]% vs. [15.10 ± 2.95]%, P = 0.18) were found in these two groups. Finally, Aspergillus load in IL-17 KO COPD+IPA mice was almost 2 times that of COPD+IPA mice (1,851,687.69 ± 944,480.43 vs. 892,958.10 ± 686,808.80, t = 2.32, P = 0.02).

Conclusion:
These findings indicate that Th17 cells might be involved in the pathogenesis of COPD combined with IPA, with IL-17 likely playing an antifungal role.
Long-term results of extensive aortoiliac occlusive disease (EAIOD) treated by endovascular therapy and risk factors for loss of primary patency
Authors: Jiang Xiao-Lang , Shi Yun , Chen Bin , Jiang Jun-Hao , Ma Tao , Lin Chang-Po , Guo Da-Qiao , Xu Xin , Dong Zhi-Hui , Fu Wei-Guo 
Published: December 2020

Abstract

Background:
Although endovascular therapy has been widely used for focal aortoiliac occlusive disease (AIOD), its performance for extensive AIOD (EAIOD) is not fully evaluated. We aimed to demonstrate the long-term results of EAIOD treated by endovascular therapy and to identify the potential risk factors for the loss of primary patency.

Methods:
Between January 2008 and June 2018, patients with a clinical diagnosis of the 2007 TransAtlantic Inter-Society Consensus II (TASC II) C and D AIOD lesions who underwent endovascular treatment in our institution were enrolled. Demographic, diagnosis, procedure characteristics, and follow-up information were reviewed. Univariate analysis was used to identify the correlation between the variables and the primary patency. A multivariate logistic regression model was used to identify the independent risk factors associated with primary patency. Five- and 10-year primary and secondary patency, as well as survival rates, were calculated by Kaplan-Meier analysis.

Results:
A total of 148 patients underwent endovascular treatment in our center. Of these, 39.2% were classified as having TASC II C lesions and 60.8% as having TASC II D lesions. The technical success rate was 88.5%. The mean follow-up time was 79.2 ± 29.2 months. Primary and secondary patency was 82.1% and 89.4% at 5 years, and 74.8% and 83.1% at 10 years, respectively. The 5-year survival rate was 84.2%. Compared with patients without loss of primary patency, patients with this condition showed significant differences in age, TASC II classification, infrainguinal lesions, critical limb ischemia (CLI), and smoking. Multivariate logistic regression analysis showed age <61 years (adjusted odds ratio [aOR]: 6.47; 95% CI: 1.47–28.36; P = 0.01), CLI (aOR: 7.81; 95% CI: 1.92–31.89; P = 0.04), and smoking (aOR: 10.15; 95% CI: 2.79–36.90; P < 0.01) were independent risk factors for the loss of primary patency.

Conclusion:
Endovascular therapy was an effective treatment for EAIOD with encouraging patency and survival rate. Age <61 years, CLI, and smoking were independent risk factors for the loss of primary patency.
What providers need to know about progestogens in hormone therapy
Authors: Liu James H. 
Published: December 2020

Abstract
Progestogens such as micronized progesterone and the synthetic progestins are defined by their ability to transform the estrogen-primed proliferative endometrium into secretory endometrium. More than 200 progestogens have been synthesized, but only a few are used clinically in hormone therapy. Clinicians caring for menopausal women should be familiar with the clinical properties and characteristics of the three most-used progestogens for hormone therapy: micronized progesterone, medroxyprogesterone acetate, and norethindrone acetate.
Identifying major predictors of lower-extremity amputation in patients with diabetic foot ulcers
Authors: Perng Cherng-Kang , Chou Hsuan-Yu , Chiu Yu-Jen 
Published: December 2020

Background:
The aim of the present study was to investigate the risk factors for amputation in patients with diabetic foot ulcer (DFU).

Methods:
Between 2012 and 2017, 646 patients with DFU were admitted to our diabetic foot care center. A retrospective chart review was performed, and the end point was limb salvage and minor or major amputation. Chi-square test, dependent t test, and a multivariate logistic regression analysis were performed to identify risk factors in patients with DFUs.

Results:
A total of 399 male and 247 female patients (mean age 64.6 years) were included in this study, of whom 159 (24.6%) underwent lower limb amputation (minor, 17.5; major, 7.1%). Independent risk factors of amputation were peripheral arterial disease (PAD) (odds ratio [OR], 3.196; p < 0.001), C-reactive protein (CRP) level (OR, 1.046; p = 0.001), and hospital stay (OR, 1.019; p = 0.001). Subgroup analysis based on all patients with PAD who underwent amputation showed that endovascular intervention (OR, 0.271; p = 0.049) was a protective factor for major amputation in addition to CRP level (OR, 1.116; p = 0.008).

Conclusion:
DFU remains a major medical and public health issue. PAD, CRP level, and hospital stay are independent risk factors for amputation. Endovascular intervention is an independent protective factor against major amputation among patients with PAD who underwent amputation.
A Qualitative Inquiry Into Patient Reported Factors That Influence Time From Stroke Symptom Onset to Hospitalization
Authors: Amtoft André C. , Danielsen Anne K. , Hornnes Nete , Kruuse Christina 
Published: December 2020

ABSTRACT

BACKGROUND: Approximately 50% of Danish stroke patients did not arrive within the 4.5-hour revascularization window in 2018, and only 20% received acute revascularization therapy. Delay in seeking help was a major factor for missing the time window. This study explored patient-reported factors influencing the timing of a decision to seek help. METHODS: We performed a qualitative interview study to explore prehospital help-seeking behavior. Inclusion was guided by a purposive sampling of stroke and transient ischemic attack patients and, if necessary, bystanders. Semistructured explorative interviews with 8 patients and 2 bystanders were audio-recorded, transcribed verbatim, and analyzed via thematic analysis. RESULTS: Analysis yielded 3 main themes: (1) symptom interpretation, (2) barriers and enablers to response, and (3) participant suggested optimization of acute stroke response and awareness. DISCUSSION: Factors associated with prompt action to seek help were either a perception that the symptom indicated a serious illness or a strong emotional response. Patients with recurrent stroke failed to associate symptoms with a new stroke. Having a stroke in unfamiliar surroundings prompted delay in seeking help. Suggestions for optimization included targeted stroke campaigns. CONCLUSION: Response to stroke onset may be driven by perceptions of symptom severity and emotional response rather than the ability to correctly identify symptoms. Stroke education should include the information that new stroke symptoms may be different from the old ones because different parts of the brain may be affected.
Paraneoplastic Multicentric Reticulohistiocytosis on 18F-FDG PET/CT Breast Carcinoma Follow-up
Authors: Dietz Matthieu , Debarbieux Sebastien , Righetti Morgane , Harou Olivier , Tordo Jeremie 
Published: December 2020

Abstract
We report the case of a 60-year-old woman who underwent 18F-FDG PET/CT to evaluate a metastatic breast carcinoma. Follow-up 18F-FDG PET/CT showed progressive disease with 18F-FDG increased in primary tumor, axillary lymph nodes, and pleural and bone diffuse metastases but also a concomitant uptake in multiples joints. The anatomopathological analysis from skin biopsy revealed a multicentric reticulohistiocytosis, considered paraneoplastic in the context. Second follow-up PET/CT after treatment showed a decrease of 18F-FDG uptake in previously affected joints, consistent with the symptoms evolution. 18F-FDG PET/CT could be helpful in the detection and the evaluation of such rare systemic disorder.
Bone Infarction Mimicking a Bone Metastasis on 18F–Prostate-Specific Membrane Antigen PET/CT
Authors: Elsobky Sherif , Nathan Malavika , Robertson Nicola , Wagner Thomas 
Published: December 2020

Abstract

18F–prostate-specific membrane antigen (PSMA) PET/CT imaging is increasingly used in staging, assessment of biochemical recurrence, and treatment response in men with prostate cancer. We present a case report of a 70-year-old man who underwent 18F-PSMA PET/CT imaging to investigate biochemical recurrence following radical prostatectomy for prostate adenocarcinoma. New focal moderate PSMA uptake was identified in the left femur. A previous PSMA study, performed 5 months earlier, was normal. A subsequent MRI scan demonstrated that the PSMA avidity corresponded to a new femoral bone infarct. An English literature search revealed no previous cases of PSMA tracer uptake in bone infarction.
Does Prostate-Specific Membrane Antigen Avidity of Vertebral Hemangioma Change?
Authors: Oksuzoglu Kevser , Engur Ceren Ozge , Ozguven Salih , Turoglu Halil Turgut , Erdil Tanju Yusuf 
Published: December 2020

Abstract
Vertebral hemangiomas are the most common benign tumors of the spine and mostly occur in the thoracic spine. Mostly they are detected incidentally during imaging studies for other reasons. We present the case of vertebral hemangioma that showed prostate-specific membrane antigen uptake in the second 68Ga–prostate-specific membrane antigen PET/CT, whereas no uptake was observed in the initial study.
Incidental Detection of Radiotracer Uptake in Intracranial Dermoid Cyst on 18F-Prostate-Specific Membrane Antigen PET/CT During Staging for Prostate Carcinoma
Authors: Hod Nir , Levin Daniel , Novoa Rosa , Lantsberg Sophie 
Published: December 2020

Abstract
A 68-year-old man underwent 18F–prostate-specific membrane antigen (PSMA) PET/CT for staging of a newly diagnosed prostate adenocarcinoma. Unexpectedly, PET/CT revealed high focal 18F-PSMA brain uptake, which initially was suspected for a brain metastasis. Corresponding CT and MRI scans revealed characteristic imaging features of an intracranial dermoid cyst at this site. This is an exceptional location for a dermoid cyst, which had been followed up conservatively with no substantial changes. This case shows that dermoid cyst should be added to the reported list of benign neoplasms that shows “false-positive” PSMA uptake during evaluation of patients with prostate carcinoma, representing a potential interpretative pitfall.
Understanding the low adoption of prefabrication prefinished volumetric construction (PPVC) among SMEs in Singapore: from a change management perspective
Authors: Shang Gao , Pheng Low Sui , Gina Ong Le Tian 
Published: December 2020

PurposeConstruction productivity issues have constantly surfaced in Singapore's construction industry. To push for productivity, the Government has implemented various initiatives to encourage industry players, particularly small and medium enterprises (SMEs), and to adopt more productive construction technologies. One of these technologies is prefabrication prefinished volumetric construction (PPVC), a concept of the design for manufacturing and assembly (DfMA) approach. This exploratory study sheds lights on PPVC adoption and its issues in Singapore in the context of the launch of the Construction Industry Transformation Map (ITM).Design/methodology/approachThe methodology used here is mainly a quantitative approach in the form of a survey. A questionnaire was developed and distributed to a pool of about 100 contractors, randomly chosen as part of a stratified sample. The questionnaire survey helps gain further insights into the industry's perceptions of PPVC and its adoption.FindingsThe study succeeded in identifying and analysing a list of drivers of and barriers to the adoption of PPVC. The top three most important potential drivers were “increase efficiency,” “technological change” and “changing nature of composition of workforce”. The three most important barriers were “ineffective on-site storage,” “high up-front payment” and “transportation issues”.Originality/valueThis study also looked into the organizational change management theory. Various theories were considered to help understand and implement change. It is understood that it is not only important for an organization to focus on the steps of these frameworks and models when the change is initiated but also for the organization to acknowledge and be mindful of the emotions of employees and take measures to overcome their emotions as part of organizational change management.
International tax competition and foreign direct investment in the Asia–Pacific region: a panel data analysis
Authors: Xu Chengwei , Wu Alfred M. 
Published: December 2020

PurposeThe purpose of this study is to investigate how a country's competitive tax policy influences its inward foreign direct investments (FDI) in the Asia–Pacific region, even when given particular constraints (e.g., population, public governance, skilled labor, and so on) exist.Design/methodology/approachThe paper uses the system GMM estimation approach to test the hypothesis. Data on FDI, corporate income tax, and various confounding factors were drawn from Ernst and Young's worldwide corporate tax guide, the World Bank, and other sources to create a panel of 28 economies over the period 2000–2016.FindingsThe present research confirms the negative association between corporate income tax (CIT) and FDI inflows. The effects of other confounding factors on FDI net inflows are also supported (e.g., connectivity, GDP per capita, population, skilled labor, and trade openness). Our results support the argument that foreign investments may be more sensitive to CIT. Therefore, CIT is an effective indicator to observe international tax competition.Originality/valueThe present research uses rich data on statutory CIT and other economic and public governance factors to investigate the relationship between tax competition and FDI inflows in the Asia–Pacific region. The findings add important supplements to the nuanced understanding of the political-economic dynamics in this region, especially when cut-throat tax competition, trade tensions, and stagnant economic growth have been key challenges for global economies.
Feminization of multidimensional urban poverty in sub‐Saharan Africa: Evidence from selected countries
Authors: Zenebe Ede'o Amlaksetegn , Ketebo Jibril Haji , Chala Badassa Wolteji 
Published: December 2020

AbstractThe main purpose of this study was to examine feminization of poverty in urban areas of sub‐Saharan Africa (SSA). The paper used the Alkire–Foster multidimensional poverty approach and compared the wellbeing of female‐headed households with their male‐headed counterparts. The study utilized data compiled from demographic and health surveys of selected SSA countries, namely, Ethiopia, Malawi, Rwanda, and Tanzania. It applied a multilevel mixed effect logistic regression model to analyze the effects of household‐ and country‐level variables on the incidence of multidimensional poverty on the two household structures separately. The study confirmed that female‐headed households were poorer than male‐headed households. Among household‐level variables, having access to finance, a higher level of education completed by the household head, the age of the household head, having a smaller‐sized family, and being employed have a positive and significant effect on multidimensional wellbeing of households. Moreover, expenditures on primary school and health significantly reduce the incidence of multidimensional poverty. The effects of these micro and macro variables are found to be different for the two household structures. Therefore, antipoverty policies and programs should be implemented in such a way that they mitigate these differences in household characteristics in favor of female‐headed households.
Differential benefits of cardiac care regionalization based on driving time to percutaneous coronary intervention
Authors: Shen Yu‐Chu , Hsia Renee Y. 
Published: December 2020

AbstractBackgroundPatients with ST‐elevation myocardial infarction (STEMI) require timely reperfusion, and percutaneous coronary intervention (PCI) decreases morbidity and mortality. Regionalization of STEMI care has increased timeliness and use of PCI, but it is unknown whether benefits to regionalization depend on a community's distance from its nearest PCI center. We sought to determine whether STEMI regionalization benefits, measured by access to PCI centers, timeliness of treatment (same‐day or in‐hospital PCI), and mortality, differ by baseline distance to nearest PCI center.MethodsUsing a difference‐in‐difference‐in‐differences model, we examined access to PCI‐capable hospitals, receipt of PCI either on the day of admission or during the care episode, and health outcomes for patients hospitalized from January 1, 2006, to September 30, 2015.ResultsOf 139,408 patients (2006 to 2015), 51% could reach the nearest PCI center in <30 minutes, and 49% required ≥30 minutes driving time. For communities with baseline access ≥30 minutes, regionalization increased the probability of admission to a PCI‐capable hospital by 9.4% and also increased the likelihood of receiving same‐day PCI (by 11.2%) and PCI during the hospitalization (by 7.4%). Patients living within 30 minutes did not accrue significant benefits (measured by admission to a PCI‐capable hospital or receipt of PCI) from regionalization initiatives. Regionalization more than halved access disparities and completely eliminated treatment disparities between communities ≥30 minutes and communities <30 minutes from the nearest PCI hospital.ConclusionsMeasured by likelihood of admission to a PCI‐capable facility and receipt of PCI, benefits of STEMI regionalization in California accrued only to patients whose nearest PCI center was ≥30 minutes away. We found no mortality benefits of regionalization based on distance from PCI center. Our results suggest that policymakers focus STEMI regionalization efforts in communities that are not already well serviced by PCI‐capable hospitals.
Childhood trauma and adult mental disorder: A systematic review and meta‐analysis of longitudinal cohort studies
Authors: McKay Michael T. , Cannon Mary , Chambers Derek , Conroy Ronán M. , Coughlan Helen , Dodd Philip , Healy Colm , O’Donnell Laurie , Clarke Mary C. 
Published: December 2020

AbstractObjectiveTo systematically review evidence for the association between trauma experienced in childhood or adolescence, and the subsequent experience of affective or psychotic mental disorders in adulthood.MethodsElectronic databases (Scopus, Medline (for Ovid), EMBASE and PsychINFO) were searched for peer‐reviewed, longitudinal cohort studies in the English language examining child or adolescent exposure to trauma, and adult‐diagnosed depression, anxiety, psychotic disorder or bipolar disorder. A total of 23 manuscripts were retained.ResultsResults revealed a significant association between the following childhood exposures and adult mental disorder: bullying (victimhood, perpetration and frequency); emotional abuse; physical neglect; parental loss; and general maltreatment (unspecified and/or multiple trauma exposure). There was some evidence of a dose‐response relationship with those exposed to multiple forms of maltreatment having more than three times the odds of developing a mental disorder (Odds ratio = 3.11, 95% CI = 1.36–7.14). There was no significant association found between physical or sexual abuse and adult mental disorder; however, this is likely an artefact of how these adversities were assessed.ConclusionThere is strong evidence of an association between childhood trauma and later mental illness. This association is particularly evident for exposure to bullying, emotional abuse, maltreatment and parental loss. The evidence suggests that childhood and adolescence are an important time for risk for later mental illness, and an important period in which to focus intervention strategies.