bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘More extraordinary than mundane … ’ A phenomenological analysis of the experiences of individuals living with CLE and their taking care in the sun
Authors: McGarry Bláithín , O'Kane Donal , McCourt Collette , Gormley Gerard J 
Published: September 2020

Introduction CLE is a chronic inflammatory autoimmune condition of which photosensitivity is a major symptom. Individuals living with CLE are advised to practice photoprotection. Despite the benefits for disease control, many individuals living with CLE do not practice optimal photoprotection. The aim of this study was to gain a deep insight into the lived experiences of individuals with CLE and their photoprotective practices. Methods A qualitative study approach was conducted, using Hermeneutic phenomenology. Individuals living with CLE were recruited and interviewed. Rich pictures were used to enrich the interviews. Interviews were transcribed and analysed using Template Analysis. Results Analysis revealed four themes: ‘Much more than just a photosensitive skin condition’, ‘The impact of sun on CLE and social dynamics’, ‘Drifting to the sun: personal transitions and social norms’ and ‘Taking care in the sun: easier said than done’. Discussion and conclusion This study provides a nuanced insight into the lived experiences of individuals with CLE and their photoprotective practices. Taking care in the sun is not a simplistic process. Beyond the biomedical model of illness, the social impact that CLE has on individuals has a dominant influence on their photoprotective behaviours. Such insights could help healthcare professionals tailor photoprotective advice.
Prevalence of Extrapyramidal Symptoms in Cancer Patients Referred to Palliative Care: A Multicenter Observational Study (JORTC PAL12)
Authors: Ishiki Hiroto , Hamano Jun , Nagaoka Hiroka , Matsuda Yoshinobu , Tokoro Akihiro , Matsuoka Hiromichi , Izumi Hiroaki , Sakashita Akihiro , Kizawa Yoshiyuki , Oyamada Shunsuke , Yamaguchi Takuhiro , Iwase Satoru 
Published: September 2020

Background: Neuroleptics are commonly used in palliative care settings. However, adverse events of neuroleptics, known as extrapyramidal symptoms (EPSs), might be overlooked in clinical practice. We conducted this study to explore the prevalence of EPSs in palliative care setting. Methods: This multicenter, prospective, observational study included patients who 1) were referred to either a specialist palliative care team or a palliative care unit, 2) had a diagnosis of cancer, and 3) were ≥20 years of age. We investigated the prevalence of EPSs and medications used. The primary outcome was the overall Drug-Induced Extrapyramidal Symptom Scale (DIEPSS) score. Results: Between November 2015 and October 2016, 149 patients from 5 centers in Japan were enrolled. The median age was 67 years (range: 21–88 years) and the study population included 81 men (54.4%). The cancer types included lung (55 patients, 36.9%), upper gastrointestinal tract (5, 3.3%), hepatobiliary (19, 12.8%); breast (12, 8.1%); head and neck (10, 6.7%), gynecologic (10, 6.7%), genitourinary (10, 6.7%), and others (28, 18.8%). The median Karnofsky performance status was 60 (20–100). Most patients (86.6%) did not experience delirium. Thirty-nine (26.2%) patients received one or more EPS-inducing medications. EPSs occurred in 4 (2.7%) patients with a cutoff score of 5 points for 5 parkinsonism items in DIEPSS. Conclusion: A lower frequency (<3%) of patients than expected in this population had EPSs. Therefore, we concluded that an interventional study is not feasible. However, medications that cause EPSs are often used in palliative care; therefore, a longitudinal study is warranted. Trial registration: This study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) (UMIN000019810) on 16, November, 2015.
Anti-Inflammatory Effects of Exercise on Metabolic Syndrome Patients: A Systematic Review and Meta-Analysis
Authors: Alizaei Yousefabadi Heidar , Niyazi Arghavan , Alaee Sahar , Fathi Mehrdad , Mohammad Rahimi Gholam Rasul 
Published: September 2020

Background: Increments in inflammatory indicators and low levels of physical activity are correlated to the expansion of the metabolic syndrome (MetS). Objective: The purpose of this study was to establish if exercise training ameliorates inflammatory status in MetS patients. Data sources: PubMed, CINAHL, and Medline, Google Scholar, and Scopus databases and reference lists of included studies were searched. Study selection: Twenty randomized controlled trials (RCTs) of exercise-training impact on inflammatory markers (tumor necrosis factor (TNF) α, C-reactive protein (CRP), interleukin (IL) 6, IL-8, IL-10, and IL-18) with concurrent control groups were included in this analysis. Results: Results demonstrated an overall significant decrease in serum levels of TNF-α (mean difference (MD): −1.21 pg/ml; 95% confidence interval (CI): −1.77, −0.66), CRP (MD: −0.52 mg/l; 95% CI: −0.79, −0.25), IL-8 (MD: −1.31 pg/ml; 95% CI: −2.57, −0.06), and a significant increase in IL-10 (MD: 0.48 pg/ml; 95% CI: 0.10, 0.86). But exercise training did not change the level of IL-6 (MD: −0.69 pg/ml; 95% CI: −1.53, 0.14) and IL-18 (MD: −53.01 pg/ml; 95% CI: −166.64, 60.62). Conclusion: Exercise training improves TNF-α, CRP, IL-8, and IL-10 levels in patients with MetS. For some variables, isolated aerobic exercise, and combined aerobic and resistance exercise appears to be optimal. Future research is needed to clarify the mechanisms underlying exercise training’s effect on this population’s inflammatory markers. More studies are required to confirm these findings.
Restoring arteriovenous access: Pilot study using a scoring balloon in 50 patients
Authors: Ross JR 
Published: September 2020

Background: Arteriovenous access failure is most often due to the development of neointimal hyperplastic stenoses. Balloon angioplasty remains standard of care for endovascular treatment of stenoses obstructing blood flow in hemodialysis fistulas and grafts. Scoring balloon technologies have been developed to disrupt the atheromatous plaque and have shown to be safe and effective for treating stenosis in the hemodialysis access circuit. However, improvement in patency has yet to be established. Methods: This prospective, single-arm study included 50 patients with stenosed hemodialysis fistula/grafts treated with the AngioSculpt® scoring balloon (Philips) and followed for 6 months. The primary endpoint was target lesion primary patency at 2 and 6 months defined as freedom from re-intervention. Results: Treatment with the scoring balloon resulted in a reduction in stenosis from 78% ± 13.36% to 7.2% ± 7.57% (mean ± standard deviation). Scoring balloon inflation pressures averaged 11.4 atm; no slippage/dissections occurred. After 2 months, 10% of patients required re-intervention. At 6 months, 19% of patients required re-intervention. The 6-month freedom from re-intervention rate was higher for patients with stenosed fistulas (83.3%) compared to patients with stenosed grafts (71.4%). Six-month patency rates were highest for patients with no or one previous intervention (91.6% and 90.0%, respectively); patients with two to five preceding interventions had a 6-month patency rate of 80%, and those with more than five previous interventions had a 50% 6-month patency rate. Conclusion: Results from this pilot study suggest that the AngioSculpt scoring balloon may be a viable treatment option for stenosed arteriovenous fistula/graft access.
Vaccinations in patients with multiple sclerosis: A Delphi consensus statement
Authors: Riva Agostino , Barcella Valeria , Benatti Simone V , Capobianco Marco , Capra Ruggero , Cinque Paola , Comi Giancarlo , Fasolo Maria Michela , Franzetti Fabio , Galli Massimo , Gerevini Simonetta , Meroni Luca , Origoni Massimo , Prosperini Luca , Puoti Massimo , Scarpazza Cristina , Tortorella Carla , Zaffaroni Mauro , Moiola Lucia 
Published: September 2020

Background: Patients with multiple sclerosis (MS) are at increased risk of infection. Vaccination can mitigate these risks but only if safe and effective in MS patients, including those taking disease-modifying drugs. Methods: A modified Delphi consensus process (October 2017–June 2018) was used to develop clinically relevant recommendations for making decisions about vaccinations in patients with MS. A series of statements and recommendations regarding the efficacy, safety and timing of vaccine administration in patients with MS were generated in April 2018 by a panel of experts based on a review of the published literature performed in October 2017. Results: Recommendations include the need for an ‘infectious diseases card’ of each patient’s infectious and immunisation history at diagnosis in order to exclude and eventually treat latent infections. We suggest the implementation of the locally recommended vaccinations, if possible at MS diagnosis, otherwise with vaccination timing tailored to the planned/current MS treatment, and yearly administration of the seasonal influenza vaccine regardless of the treatment received. Conclusion: Patients with MS should be vaccinated with careful consideration of risks and benefits. However, there is an urgent need for more research into vaccinations in patients with MS to guide evidence-based decision making.
Social workers’ constructions of child risk and protection in the Ultra-Orthodox Jewish community
Authors: Gemara Netanel , Nadan Yochay , Roer-Strier Dorit 
Published: September 2020

Summary Social workers’ perceptions regarding child risk and protection tend to rely on universal criteria that may differ from the perceptions of minority groups. The Ultra-Orthodox Jewish community in Israel is a strictly religious, segregated, close-knit community with idiosyncratic values and norms that differ from those of social workers in the country. This qualitative study aimed to explore social workers’ perceptions and ascribed meanings of child risk and protection in Israel’s Ultra-Orthodox Jewish community. To this end, 30 in-depth interviews were conducted with social workers working with this community. Findings The study identified four distinct primary areas of risk and protection for children in Israel’s Ultra-Orthodox Jewish community: spirituality, collectivism, segregation, and hierarchy. Each of these areas encompasses factors of both protection and risk. Applications The study’s findings highlight the gaps between the Ultra-Orthodox Jewish community and social workers who adopt Western universal views regarding child risk and protection. This article advocates a context-informed approach when dealing with minority communities. Adopting such an approach can contribute to better cooperation between professionals and their clients from minority groups and advance the well-being of children.
Measuring parenting capacity for disabled children using a child protection assessment
Authors: Flynn Susan 
Published: September 2020

Summary Childhood disability can heighten risk of neglect and abuse and may also impinge upon the parenting task. Even so, a gross deficiency of published literature on social work parenting capacity assessment for disabled children is evident. This paper provides a critical commentary on approaches to assessments of the capacity of parents of disabled children. International review of literature on this subject matter is enacted across three themes. Findings Themes refer to limitations to the uptake of disability-specific parenting assessment tools, use of existing generic frameworks and supplementation of generic frameworks, respectively. Throughout, a composite conceptual frame is taken up, entailing the conventions of a seminal social model of disability, extended through an affirmative non-tragedy lens. The intention is to contest articulations of disability grounded in tragedy and melancholia, otherwise instantiated by links between disability with child maltreatment in this paper. Applications Application of insights from this paper within professional social work practice can enhance evidence-informed parenting capacity assessment.
The voices of parents and children in foster care
Authors: Urrea Monclús Aida , Mateos Inchaurrondo Ainoa , Fernández-Rodrigo Laura , Balsells Bailón M Àngels 
Published: September 2020

Summary This article presents the results of a qualitative study whose objective was to collect information on the perceptions of changes in parents and their children who are in the Spanish foster care system after completing a positive parenting programme. Findings The participants in the focus groups included 66 parents and 57 children. Triangulation of the voices of all protagonists identified findings that suggest the need for changes regarding understanding foster care measures and the process of family resilience; the quality and content of visits and contact between parents and children; and the role of professionals involved in the case. Applications The findings indicate the efficacy of the intervention proposed in the ‘Walking family’ programme with the direct and active involvement of children as they become a driver of change for the parents. However, when this does not occur, professionals must work from a critical approach and should provide a realistic view of the family to children.
The Effect of One Session Split-Belt Treadmill Training on Gait Adaptation in People With Parkinson’s Disease and Freezing of Gait
Authors: Seuthe Jana , D’Cruz Nicholas , Ginis Pieter , Becktepe Jos Steffen , Weisser Burkhard , Nieuwboer Alice , Schlenstedt Christian 
Published: September 2020

Background Freezing of gait (FOG) in Parkinson’s disease (PD) is associated with gait asymmetry and switching difficulty. A split-belt treadmill may potentially address those deficits. Objective To investigate the immediate and retention effects of one-session split-belt treadmill training (SBT) in contrast to regular tied-belt treadmill training (TBT) on gait asymmetry and adaptation in people with PD and FOG (PD + FOG) and healthy controls (HC). Additionally, to investigate differential effects of 3 SBT protocols and compare different gait adaptation outcomes. Methods PD + FOG (n = 45) and HC (n = 36) were randomized to 1 of 3 SBT groups (belt speeds’ ratio 0.75:1; 0.5:1 or changing ratios) or TBT group. Participants were tested at Pre, Post, and Retention after one treadmill training session. Gait asymmetry was measured during a standardized adaptation test on the split-belt treadmill Results SBT proved beneficial for gait adaptation in PD + FOG and HC ( P < .0001); however, HC improved more. SBT with changing ratios demonstrated significant effects on gait adaptation from Pre to Post in PD + FOG, supported by strong effect sizes ( d = 1.14) and improvements being retained for 24 hours. Mean step length asymmetry during initial exposure was lower in HC compared with PD + FOG ( P = .035) and differentiated best between the groups. Conclusions PD + FOG improved gait adaptation after a single SBT session although effects were smaller than in HC. SBT with changing ratios was the most effective to ameliorate gait adaptation in PD + FOG. These promising results warrant future study on whether long-term SBT strengthens adaptation in PD + FOG and has potential to induce a better resilience to FOG. Clinical trial ID: NCT03725215.
Thymic Neuroendocrine Tumors and Thymic Carcinoma: Demographics, Treatment, and Survival
Authors: Bakhos Charles T. , Salami Aitua C. , Kaiser Larry R. , Petrov Roman V. , Abbas Abbas E. 
Published: September 2020

Objective Although rare, thymic neuroendocrine tumors (TNET) and thymic carcinoma (TC) are the most common thymic nonthymomatous malignancies; their survival outcomes have not been thoroughly compared. We analyzed the clinical, treatment, and survival characteristics of TNET and TC. Methods We retrospectively identified patients with a histologic diagnosis of TNET or TC in the National Cancer Database (2004 to 2015). Exclusion criteria were age <18 years and unstaged tumors. Descriptive statistics, survival analysis, and multivariable Cox regression analyses were used in elucidating associations. Results One thousand four hundred eighty-nine patients were included (TNET: 19.8%). Patients with TNET were significantly younger (57 vs 62.5 years), more likely to be male (70.5% vs 60.0%), and have localized tumors (45.4% vs 32.3%). Patients with TC more frequently underwent chemotherapy (56.1% vs 34.9%), radiation (56.9% vs 39.3%), and trimodality therapy (21.3% vs 11.5%), while resection rates were similar (55.3% vs 58.3%). The 5-year survival was 62% for TNET and 52% for TC, but comparable following multivariable adjustment. Age, stage, and Charlson–Deyo score were negative predictors of survival, while surgery and trimodality therapy were positive predictors. On subanalysis, adjuvant radiation therapy (ART) improved the survival of margin-positive tumors and was an independent predictor of survival for both tumor types (hazard ratio = 0.5). Conclusions Our analysis of the largest series of TNET and TC showed a survival rate surpassing 50% at 5 years. These outcomes seem to be influenced by surgical resection and ART. Standardized staging and surgical protocols including lymph node sampling are still warranted to better elucidate the treatment algorithm of these tumors.
Oxidative Stress is Associated with Reduced Sperm Motility in Normal Semen
Authors: Kurkowska Wiktoria , Bogacz Agnieszka , Janiszewska Marta , Gabryś Ewa , Tiszler Michał , Bellanti Francesco , Kasperczyk Sławomir , Machoń-Grecka Anna , Dobrakowski Michał , Kasperczyk Aleksandra 
Published: September 2020

Infertility is among the most serious medical problems worldwide. Male factors contribute to 40%–50% of all infertility cases, and approximately 7% of men worldwide are affected by infertility. Spermatozoa are extremely vulnerable to oxidative insult. Oxidative stress results in axonemal damage and increased midpiece sperm morphological defects, which lead to reduced sperm motility. The aim of the study is to evaluate the association between sperm motility and the levels of selected antioxidants, cytokines, and markers of oxidative damage in the seminal plasma. The study group included 107 healthy males, who were split into two subgroups based on the percentage of motile spermatozoa after 1 hr: low motility (LM, n = 51) and high motility (HM, n = 56). The glucose-6-phosphate dehydrogenase (G6PD) activity was 52% lower in the LM group compared to that in the HM group. The level of malondialdehyde (MDA) was 12% higher in the LM group compared to that in the HM group. Similarly, the median values of interleukin (IL)-1β, IL-10, IL-12, and tumor necrosis factor alpha (TNF-α) were higher in the LM group than those in the HM group. Results of the present study revealed that the percentage of motile spermatozoa after 1 hr correlated positively with the levels of IL-1β, IL-10, IL-12, and TNFα. The lower motility of spermatozoa in healthy men is associated with a decreased activity of G6PD and increased levels of cytokines, which may be related to increased oxidative stress in seminal plasma that manifests as an increased level of MDA.
Return to Activities After Simultaneous Bilateral Endoscopic Carpal Tunnel Release
Authors: Hein Rachel E. , Hollins Andrew W. , Fletcher Amanda N. , Ruch David S. , Richard Marc J. , Mithani Suhail K. 
Published: September 2020

Background Approximately 56% of patients diagnosed with carpal tunnel syndrome present with bilateral symptoms; however, few studies have investigated bilateral simultaneous endoscopic carpal tunnel release (ECTR) and postoperative effect on return to activity. The purpose of this study was to evaluate the length of recovery in patients who received bilateral simultaneous ECTR, including pain medication requirements, return to activities of daily living, return to work, and return to recreational activities. Methods A retrospective analysis was performed on patients who underwent bilateral ECTR by a single hand fellowship–trained surgeon from 2013 to 2019. Demographic, operative, and clinical outcomes were collected via chart review and a telephone interview. Student t tests and χ2 tests were conducted for analysis. Results Eighty patients were included in the study; 40 were successfully contacted for telephone interview follow-up. Patients reported an average of 2 days of use of postoperative narcotic pain medication and an average of 5, 7, and 19 days of return to activities of daily living, work, and recreational activities, respectively. Female patients reported more days of narcotic pain medications (1 day vs 3 days, P = .0483) and an average of longer return to work than men (9 days vs 5 days, P = .0477). Manual laborers reported longer return to work (9 days vs 5 days, P = .0500). Older patients (aged >65 years) reported longer return to recreational activities (39 days vs 11 days, P = .0189). Conclusions Simultaneous bilateral ECTR is a successful procedure with shorter recovery times than reported previously. Female patients, manual laborers, and older patients experience a longer recovery and should be counseled appropriately.
Closed Reduction and Immobilization of Pediatric Fifth Metacarpal Neck Fractures
Authors: Lee Stella J. , Merrison Hannah , Williams Kathryn A. , Vuillermin Carley B. , Bauer Andrea S. 
Published: September 2020

Background There is no clear consensus for the criteria for closed treatment of metacarpal neck fractures. Our objective was to determine whether closed reduction of pediatric fifth metacarpal neck fractures results in a clinically meaningful improvement in radiographic angulation. Methods We performed a retrospective cohort study of pediatric patients with fifth metacarpal neck fractures treated with closed reduction. Radiographs were examined for sagittal fracture angulation measured post-reduction, 2 to 14 days post-reduction, and 21 to 35 days post-reduction. We compared the angulation for open versus closed physes, initial fracture angulation greater than or less than 50°, and immobilization in extension versus intrinsic-plus position. Results Fifty-four subjects were included with an average age of 14.8 years at the time of injury and a mean initial fracture angulation of 42.7°. The improvement in fracture angulation was 8.3° (90% confidence interval [CI], 5.9-10.7) on post-reduction radiographs, 8.5° (90% CI, 6.1-10.9) at 2 to 14 days post-reduction, and 4.3° (90% CI, 1.4-7.2) at 21 to 35 days post-reduction. Subgroup analysis showed that patients with injury angle greater than or equal to 50° had significantly higher mean reductions than those with injury angle less than 50°. In this group, angulation improved 15.6° (90% CI, 8.5-22.7) post-reduction, 15.1° (90% CI, 10.1-20.1) at 2 to 14 days post-reduction, and 16.5° (90% CI, 10.4-22.6) at 21 to 35 days post-reduction. Conclusions Closed reduction of pediatric fifth metacarpal neck fractures with initial fracture angulation less than 50° may not meaningfully improve sagittal alignment. For fractures with initial angulation greater than or equal to 50°, closed reduction resulted in clinically important, statistically significant, and lasting improvements of 16.5°.