bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palliative medicine family conferences and caregiver psychological distress during prolonged mechanical ventilation
Authors: Lee Yi-Han , Wang Jiao-Syuan , Curtis Randall , Huang Sheng-Jean , Chang Shy-Shin , Chen Yang Ching 
Published: May 2020

ObjectivesLittle is known about the experience of family caregivers of patients who require prolonged mechanical ventilation (PMV). We examined the perspectives of caregivers of patients who died after PMV to explore the role of palliative care and the quality of dying and death (QODD) in patients and understand the psychological symptoms of these caregivers.MethodsA longitudinal study was performed in five hospitals in Taipei, Taiwan. Routine palliative care family conferences and optional consultation with a palliative care specialist were provided, and family caregivers were asked to complete surveys.ResultsIn total, 136 family caregivers of 136 patients receiving PMV were recruited and underwent face-to-face baseline interviews in 2016–2017. By 2018, 61 (45%) of 136 patients had died. We successfully interviewed 30 caregivers of patients’ death to collect information on the QODD of patients and administer the Impact of Event Scale (IES), Hospital Anxiety and Depression Scale (HADS) and Center for Epidemiologic Studies Depression (CES-D) scale to caregivers. We observed that more frequent palliative care family conferences were associated with poorer QODD in patients (coefficients: −44.04% and 95% CIs −75.65 to −12.44), and more psychological symptoms among caregivers (coefficient: 9.77% and 95% CI 1.63 to 17.90 on CES-D and coefficient: 7.67% and 95% CI 0.78 to 14.55 on HADS). A higher caregiver burden at baseline correlated with lower psychological symptoms (coefficient: −0.35% and 95% CI −0.58 to −0.11 on IES and coefficient: −0.22% and 95% CI −0.40 to −0.05 on CES-D) among caregivers following the patients’ death. Caregivers’ who accepted the concept of palliative care had fewer psychological symptoms after patients’ death (coefficient: −3.29% and 95% CI −6.32 to −0.25 on IES and coefficient: −3.22% and 95% CI −5.24 to −1.20 on CES-D).ConclusionsPalliative care conferences were more common among family members with increased distress. Higher caregiver burden and caregiver acceptance of palliative care at baseline both predicted lower levels of caregiver distress after death.
A macroscopic traffic flow model considering the velocity difference between adjacent vehicles on uphill and downhill slopes
Authors: Zhang Peng , Xue Yu , Zhang Yi-Cai , Wang Xue , Cen Bing-Lin 
Published: May 2020

In this paper, we deduced a macroscopic traffic model on the uphill and downhill slopes by employing the transformation relation from microscopic variables to macroscopic ones based on a microscopic car-following model considering the velocity difference between adjacent vehicles. The angle [Formula: see text] of the uphill and downhill and the gravitational force have a great impact upon the stability of traffic flow. The linear stability analysis for macroscopic traffic model yielded the stability condition. The Korteweg–de Vries (KdV) equation is derived by nonlinear analysis and the corresponding solution to the density wave near the neutral stability line is obtained. By using the upwind finite difference scheme for simulation, the spatiotemporal evolution patterns of traffic flow on the uphill and downhill are attained. The unstable region is shrunken with slope of the gradient increasing and backward-traveling density waves gradually decrease and even disappear on uphill. Conversely, the unstable region on downhill is extended and density waves propagate quickly backward to the whole road with slope of the gradient increasing.
HARMONIC GRADIENTS ON HIGHER-DIMENSIONAL SIERPIŃSKI GASKETS
Authors: BROWN LUKE , FERRER GIOVANNI , MOGRABY GAMAL , ROGERS LUKE G. , SANGAM KARUNA 
Published: May 2020

We consider criteria for the differentiability of functions with continuous Laplacian on the Sierpiński Gasket and its higher-dimensional variants [Formula: see text], [Formula: see text], proving results that generalize those of Teplyaev [Gradients on fractals, J. Funct. Anal. 174(1) (2000) 128–154]. When [Formula: see text] is equipped with the standard Dirichlet form and measure [Formula: see text] we show there is a full [Formula: see text]-measure set on which continuity of the Laplacian implies existence of the gradient [Formula: see text], and that this set is not all of [Formula: see text]. We also show there is a class of non-uniform measures on the usual Sierpiński Gasket with the property that continuity of the Laplacian implies the gradient exists and is continuous everywhere in sharp contrast to the case with the standard measure.
Accuracy of Nonexercise Prediction Equations for Assessing Longitudinal Changes to Cardiorespiratory Fitness in Apparently Healthy Adults: BALL ST Cohort
Authors: Peterman James E. , Harber Matthew P. , Imboden Mary T. , Whaley Mitchell H. , Fleenor Bradley S. , Myers Jonathan , Arena Ross , Finch W. Holmes , Kaminsky Leonard A. 
Published: May 2020

Background

Repeated assessment of cardiorespiratory fitness (
CRF
) improves mortality risk predictions in apparently healthy adults. Accordingly, the American Heart Association suggests routine clinical assessment of
CRF
using, at a minimum, nonexercise prediction equations. However, the accuracy of nonexercise prediction equations over time is unknown. Therefore, we compared the ability of nonexercise prediction equations to detect changes in directly measured
CRF
.

Methods and Results

The sample included 987 apparently healthy adults from the BALL ST (Ball State Adult Fitness Longitudinal Lifestyle Study) cohort (33% women; average age, 43.1±10.4 years) who completed 2 cardiopulmonary exercise tests ≥3 months apart (3.2±5.4 years of follow‐up). The change in estimated
CRF
(
eCRF
) from 27 distinct nonexercise prediction equations was compared with the change in directly measured
CRF
. Analysis included Pearson product moment correlations,
SEE
values, intraclass correlation coefficient values, Cohen's κ coefficients, γ coefficients, and the Benjamini‐Hochberg procedure to compare
eCRF
with directly measured
CRF
. The change in
eCRF
from 26 of 27 equations was significantly associated to the change in directly measured
CRF
(
P
<0.001), with intraclass correlation coefficient values ranging from 0.06 to 0.63. For 16 of the 27 equations, the change in
eCRF
was significantly different from the change in directly measured
CRF
. The median percentage of participants correctly classified as having increased, decreased, or no change in
CRF
was 56% (range, 39%–61%).

Conclusions

Variability was observed in the accuracy between nonexercise prediction equations and the ability of equations to detect changes in
CRF
. Considering the appreciable error that prediction equations had with detecting even directional changes in
CRF
, these results suggest
eCRF
may have limited clinical utility.
Moving from MPAs to Area-based Management Measures in the South China Sea
Authors: Lyons Youna , Beckman Robert , Choub Loke Ming , Huang Danwei 
Published: May 2020

Abstract
Evolution of the marine protected area discourse into an area-based management tool may provide an avenue for a more progressive approach to protection of the Spratly seamounts. A first step could be the recognition of the Spratlys as an ecologically or biologically significant area (EBSA) under the Convention on Biological Diversity. This purely scientific recognition exercise would be without prejudice to the sovereignty, sovereign rights and jurisdiction of coastal States or State claiming sovereignty over the islands. Furthermore, it is up to the States concerned to later agree on specific restriction on activities in these areas as deemed necessary. This article shows that there are sufficient published data to justify that the Spratly seamounts meet the scientific criteria of an EBSA. However, it also proposes areas that may be prioritised on the basis of distinctive species composition of reef-building corals in the South China Sea.
Religious Volunteer Visitors in the Penal Context of Hong Kong
Authors: Brandner Tobias 
Published: May 2020

Abstract
Religious faith plays a crucial role in the life of people in penal custody. Research generally focuses on the impact of religion on inmates’ rehabilitation. Studies on volunteers in prison receive scholarly attention but largely in regard to how they affect inmates. This study focuses on Christian visitors in prison and their motives, goals, and experiences. The study evaluates the responses of 152 Christian volunteer visitors around prisons in Hong Kong. The study shows that majority of them are at a time of their life when they are most strongly occupied by work and familial obligations and yet they take time off to visit people in prison. It offers evidence how visits to those in prison contribute to visitors’ own spiritual learning and to a changed view of those in prison. The findings of the study indicate that volunteers see themselves as active agents who help, teach, and transform.
Intramuscular Corticosteroids for Acute Upper Respiratory Infections Affects Healthcare Utilization
Authors: Parsel Sean M , Mohammed Alaa E , Fort Daniel , Barton Blair M , McCoul Edward D 
Published: May 2020

Objective: To examine the use of intramuscular corticosteroid (IMCS) injections for treatment of acute upper respiratory infections (URI) and the influence on healthcare utilization. Methods: This retrospective cohort study used patient encounter data from a large multicenter regional health care system between 2013 and 2017. Adult patients diagnosed with acute URI (acute pharyngitis, acute sinusitis, acute otitis media, and URI not otherwise specified) during ambulatory encounters were included. Follow-up encounters for a diagnosis of acute URI within 60 days were identified and patient characteristics, encounter details, and procedure codes were retrieved. Frequency data was used to calculate IMCS injection administration prevalence, utilization trends, and associations with covariates. Follow-up data for return encounters within 60 days for the same diagnosis was examined. Results: Of the 153 848 initial encounters, 34 600 (22.5%) patients received IMCS injection for acute URI. Injection rates varied from 0.85% to 49.1% depending on specialty and practitioner type. Internal medicine, family medicine, urgent care, and otorhinolaryngology clinics most commonly administered IMCS. 3788 patients returned for a second encounter of which 751 (19.8%) received an injection. IMCS injection during the first encounter was associated with increased odds of repeat visit within 60 days (OR: 1.74; 95% CI: 1.61–1.88). Conclusion: IMCS use in the treatment of acute URI is highly prevalent despite lack of evidence for impact and safety. Prevalence is variable across multiple medical and surgical specialties including otorhinolaryngology. Administration of IMCS injection may contribute to the likelihood of a subsequent healthcare visit for the same indication.
The “BURP” maneuver improves the glottic view during laryngoscopy but remains a difficult procedure
Authors: Yu Tao , Wu Rong-rong , Longhini Federico , Wang Bin , Wang Ming-fang , Yang Fang-fang , Hua Fu-zhou , Yao Wei-dong , Jin Xiao-ju 
Published: May 2020

Objective We investigated the “BURP” maneuver’s effect on the association between difficult laryngoscopy and difficult intubation, and predictors of a difficult airway. Methods Adult patients who underwent general anesthesia and tracheal intubation from September 2016 to May 2018 were included. The “BURP” maneuver was performed when glottic exposure was classified as Cormack–Lehane grade 3 or 4, suggesting difficult laryngoscopy. The thyromental distance, modified Mallampati score, and interincisor distance were assessed before anesthesia. Results Among this study’s 2028 patients, the “BURP” maneuver decreased difficult laryngoscopies from 428 (21.1%) to 124 (6.1%) cases and increased the difficult intubation to difficult laryngoscopy ratio from 53/428 (12.4%) to 52/124 (41.9%). For laryngoscopies classified as difficult without the “BURP” maneuver, the area under the curve (AUC) of the thyromental distance, modified Mallampati score, and interincisor distance was 0.60, 0.57, and 0.66, respectively. In difficult laryngoscopies using the “BURP” maneuver, the AUC of the thyromental distance, modified Mallampati score, and interincisor distance was 0.71, 0.67, and 0.76, respectively. Conclusions The “BURP” maneuver improves the laryngoscopic view and assists in difficult laryngoscopies. Compared with difficult laryngoscopies without the “BURP” maneuver, those with the “BURP” maneuver are more closely associated with difficult intubations and are more predictable. Trial registration: www.chictr.org.cn identifier: ChiCTR-ROC- 16009050.
Greater increase in femoral offset with use of collum femoris-preserving stem than Tri-Lock stem in primary total hip arthroplasty
Authors: Yao Mengxuan , Wang Yuchuan , Wei Congcong , Han Yongtai , Li Huijie 
Published: May 2020

Objective This study was performed to compare the clinical outcomes and performance of the collum femoris-preserving (CFP) stem (Waldemar Link GmbH & Co., Hamburg, Germany) and the Tri-Lock stem (DePuy Orthopaedics, Warsaw, IN, USA) in terms of femoral offset (FO) and leg length reconstruction. Methods Clinical and radiographic data of patients who underwent total hip arthroplasty with either a CFP stem or Tri-Lock stem from January 2016 to March 2017 were compared (65 and 57 patients, respectively). The Harris hip score and Western Ontario and McMaster Universities Osteoarthritis Index were recorded. The FO, femoral vertical offset, and neck–shaft angle were measured at the last follow-up. The occurrence of dislocation and periprosthetic fracture during the follow-up period was recorded. Results The CFP stem induced significantly more FO than did the Tri-Lock stem on the operated side than contralateral side (3.63 ± 4.28 vs. 0.83 ± 5.46 mm). Significantly fewer patients had a >5-mm decrease in FO on the unaffected side in the CFP stem group ( n = 1) than Tri-Lock stem group ( n = 10). Conclusion Both stems similarly improved hip function and reconstructed the leg length, but the CFP stem was superior to the Tri-Lock stem in reconstructing FO.
Activity of lenvatinib plus everolimus combination in a heavily pretreated patient with papillary renal cell carcinoma: a case report
Authors: Zielli Teresa , Gnetti Letizia , Buti Sebastiano 
Published: May 2020

Background: Papillary renal cell carcinoma (pRCC) represents the second most common histologic subtype of renal cell carcinoma and comprises 2 subtypes. Prognosis for type 2 is associated with poor clinical outcome. Current guidelines are based on phase II trials, phase III trials in patients with clear cell histology, or retrospective data. Case description: To our knowledge, we describe for the first time a case of a patient with heavily pretreated metastatic pRCC who benefited from the combination of lenvatinib plus everolimus for more than 2 years. Conclusion: According to immunohistologic and biological findings in our patient both on primary tumor and liver metastasis, we hypothesize that selected patients with metastatic pRCC, progressed to standard/available treatments (including angiogenic drugs, mTOR inhibitors, and immunotherapy) and dissociated response to everolimus, could benefit from adding lenvatinib to everolimus.
Anatomical Study of Minimally Invasive Lateral Release Techniques for Hallux Valgus Treatment
Authors: Dalmau-Pastor Miki , Malagelada Francesc , Cordier Guillaume , Del Vecchio Jorge Javier , Ghioldi Mauricio Esteban , Vega Jordi 
Published: May 2020

Background: Lateral release (LR) for the treatment of hallux valgus is a routinely performed technique, either by means of open or minimally invasive (MI) surgery. Despite this, there is no available evidence of the efficacy and safety of MI lateral release. Our aim was to study 2 popular techniques for MI LR in cadavers by subsequently dissecting the released anatomical structures. Methods: Twenty-two cadaveric feet were included in the study and allocated into 2 groups, 1 for each procedure: 1 group underwent a MI adductor tendon release (AR), and in the other group, an extensive percutaneous lateral release (EPLR) (adductor tendon, suspensory ligament, phalanx-sesamoid ligament, lateral head of flexor hallucis brevis, and deep transverse metatarsal ligament) was performed. Anatomical dissection was performed to identify neurovascular injuries and to verify the released structures. Results: Both techniques demonstrated to be effective in reproducing a MI LR. A satisfactory release of the adductor tendon was achieved equally in both techniques ( P = .85), being partial in most EPLR cases and full in the majority of AR cases. The EPLR was successful in releasing the intended additional structures ( P < .05). One case of inadvertent complete section of the flexor hallucis longus was identified in the percutaneous adductor tendon release group. No cases of dorsolateral nerve injury were seen with either of the techniques. Conclusion: Percutaneous lateral release was a reliable and accurate technique in this cadaveric model. The MI AR proved to be more effective in fully releasing the adductor tendon while the ER was intended and able to release a number of other structures. Clinical Relevance: MI LR is a safe procedure that could obviate the need for open surgery to achieve the same surgical goal. It can be associated to either open or MI osteotomies in the correction of hallux valgus.
Overexpression of annexin A5 might guide the gemtuzumab ozogamicin treatment choice in patients with pediatric acute myeloid leukemia
Authors: Zhang Nan , Zhang Ying , Zhang Ping , Lou Shifeng , Chen Ying , Li Huan , Zeng Hanqing , Shen Yan , Deng Jianchuan 
Published: May 2020

Background: Acute myeloid leukemia (AML) is a common hematological malignancy. Gemtuzumab ozogamicin (GO), a humanized anti-CD33 antibody conjugated with the potent anti-tumor antibiotic calicheamicin, represents a promising targeted therapy for AML. Annexin A5 (ANXA5) is a proposed marker for the clinical prognosis of AML to guide treatment choice. Methods: In total, 253 patients with pediatric AML were enrolled and divided into two treatment groups: conventional chemotherapy alone and conventional chemotherapy in combination with GO. Univariate, multivariate, and Kaplan–Meier survival analyses were conducted to assess risk factors and clinical outcomes, and to estimate hazard ratios (HRs) and their 95% confidence interval. The level of statistical significance was set at p < 0.05. Results: In the GO treatment group, high ANXA5 expression was considered a favorable prognostic factor for overall survival (OS) and event-free survival (EFS). Multivariate analysis showed that high ANXA5 expression was an independent favorable factor for OS (HR = 0.629, p = 0.084) and EFS (HR = 0.544, p = 0.024) distinct from the curative effect of GO treatment. When all patients were again divided into two groups, this time based on the median expression of ANXA5, patients undergoing chemotherapy combined with GO had significantly better OS ( p = 0.0012) and EFS ( p = 0.0003) in the ANXA5 high-expression group. Gene set enrichment analysis identified a relevant series of pathways associated with glutathione metabolism, leukocyte transendothelial migration, and hematopoietic cell lineage. Conclusion: The expression level of ANXA5 can help optimize the treatment regimen for individual patients, and patients with overexpression of ANXA5 may circumvent poor outcomes from chemotherapy combined with GO.
Smoking is Associated With Increased Risk of Not Achieving Glycemic Target, Increased Glycemic Variability, and Increased Risk of Hypoglycemia for People With Type 1 Diabetes
Authors: Jensen Morten Hasselstrøm , Cichosz Simon Lebech , Hirsch Irl B. , Vestergaard Peter , Hejlesen Ole , Seto Edmund 
Published: May 2020

Background: The prevalence of smoking and diabetes is increasing in many developing countries. The aim of this study was to investigate the association of smoking with inadequate glycemic control and glycemic variability with continuous glucose monitoring (CGM) data in people with type 1 diabetes. Methods: Forty-nine smokers and 320 nonsmokers were obtained from the Novo Nordisk Onset 5 trial. After 16 weeks of treatment with continuous subcutaneous insulin infusion, risk of not achieving glycemic target and glycemic variability from six CGM measures was investigated. Analyzes were carried out with logistic regression models (glycemic target) and general linear models (glycemic variability). Finally, CGM median profiles were examined for the identification of daily glucose excursions. Results: A 4.7-fold (95% confidence interval: 1.5-15.4) increased risk of not achieving glycemic target was observed for smokers compared with nonsmokers. Increased time in hyperglycemia, decreased time in range, increased time in hypoglycemia (very low interstitial glucose), and increased fluctuation were observed for smokers compared with nonsmokers from CGM measures. CGM measures of coefficient of variation and time in hypoglycemia were not statistically significantly different. Examination of CGM median profiles revealed that risk of morning hypoglycemia is increased for smokers. Conclusions: In conclusion, smoking is associated with inadequate glycemic control and increased glycemic variability for people with type 1 diabetes with especially risk of morning hypoglycemia. It is important for clinicians to know that if the patient has type 1 diabetes and is smoking, a preemptive action to treat high glycated hemoglobin levels should not necessarily be treatment intensification due to the risk of hypoglycemia.
Properties of Cartilage–Subchondral Bone Junctions: A Narrative Review with Specific Focus on the Growth Plate
Authors: Kazemi Masumeh , Williams John Leicester 
Published: May 2020

Objective The purpose of this narrative review is to summarize what is currently known about the structural, chemical, and mechanical properties of cartilage-bone interfaces, which provide tissue integrity across a bimaterial interface of 2 very different structural materials. Maintaining these mechanical interfaces is a key factor for normal bone growth and articular cartilage function and maintenance. Materials and Methods A comprehensive search was conducted using Google Scholar and PubMed/Medline with a specific focus on the growth plate cartilage–subchondral bone interface. All original articles, reviews in journals, and book chapters were considered. Following a review of the overall structural and functional characteristics of the physis, the literature on histological studies of both articular and growth plate chondro-osseous junctions is briefly reviewed. Next the literature on biochemical properties of these interfaces is reviewed, specifically the literature on elemental analyses across the cartilage–subchondral bone junctions. The literature on biomechanical studies of these junctions at the articular and physeal interfaces is also reviewed and compared. Results Unlike the interface between articular cartilage and bone, growth plate cartilage has 2 chondro-osseous junctions. The reserve zone of the mature growth plate is intimately connected to a plate of subchondral bone on the epiphyseal side. This interface resembles that between the subchondral bone and articular cartilage, although much less is known about its makeup and formation. Conclusion There is a notably paucity of information available on the structural and mechanical properties of reserve zone–subchondral epiphyseal bone interface. This review reveals that further studies are needed on the microstructural and mechanical properties of chondro-osseous junction with the reserve zone.