bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of embedding a specialist preventive care clinician in a community mental health service in increasing preventive care provision: A randomised controlled trial
Authors: Fehily Caitlin MC , Bartlem Kate M , Wiggers John H , Wye Paula M , Clancy Richard V , Castle David J , Wilson Andrew , Rissel Chris E , Wutzke Sonia , Hodder Rebecca K , Colyvas Kim , Murphy Fionna , Bowman Jenny A 
Published: May 2020

Objective: Clinical practice guidelines recommend that community mental health services provide preventive care for clients’ chronic disease risk behaviours; however, such care is often not routinely provided. This study aimed to assess the effectiveness of offering clients an additional consultation with a specialist clinician embedded within a community mental health service, in increasing client-reported receipt of, and satisfaction with, preventive care. Method: A randomised controlled trial was undertaken in one Australian community mental health service. Participants ( N = 811) were randomised to receive usual care (preventive care in routine consultations; n = 405) or usual care plus the offer of an additional consultation with a specialist preventive care clinician ( n = 406). Blinded interviewers assessed at baseline and 1-month follow-up the client-reported receipt of preventive care (assessment, advice and referral) for four key risk behaviours individually (smoking, poor nutrition, alcohol overconsumption and physical inactivity) and all applicable risks combined, acceptance of referrals and satisfaction with preventive care received. Results: Analyses indicated significantly greater increases in 12 of the 18 preventive care delivery outcomes in the intervention compared to the usual care condition from baseline to follow-up, including assessment for all risks combined (risk ratio = 4.00; 95% confidence interval = [1.57, 10.22]), advice for all applicable risks combined (risk ratio = 2.40; 95% confidence interval = [1.89, 6.47]) and offer of referral to applicable telephone services combined (risk ratio = 20.13; 95% confidence interval = [2.56, 158.04]). For each component of care, there was a significant intervention effect for at least one of the individual risk behaviours. Participants reported high levels of satisfaction with preventive care received, ranging from 77% (assessment) to 87% (referral), with no significant differences between conditions. Conclusion: The intervention had a significant effect on the provision of the majority of recommended elements of preventive care. Further research is needed to maximise its impact, including identifying strategies to increase client uptake.
REER Imbalances and Macroeconomic Adjustments: Evidence from the CEMAC Zone
Authors: Asongu Simplice A. , Nnanna Joseph 
Published: May 2020

The European Monetary Union (EMU) crisis holds special lessons for existing monetary unions. We assess the behaviour of real effective exchange rates (REERs) of members of the Central African Economic and Monetary Community zone with respect to their long-term equilibrium paths. A reduced form of the fundamental equilibrium exchange rate model is estimated for associated misalignments. Our findings suggest that for majority of countries, macroeconomic fundamentals have the expected associations with the exchange rate fluctuations. The analysis also reveals that only the REER adjustments of Cameroon and Gabon are significant in restoring the long-term equilibrium in the event of a shock. The Cameroonian economic fundamentals of terms of trade, government expenditure and openness have different long-term relations with the REER in comparison to those of other member states. There is no need for an adjustment in the level of the peg based on the present quantitative analysis of REER paths. JEL: F31, F33, F42, F61, O55
Cultural competency: A call to action to address microaggression in preservice health education
Authors: Melendez Krizia , Thompson Amy 
Published: May 2020

Background: The United States Census Bureau projects half of the population to be from a minority group by 2044 and one in five of the population to be foreign born by 2060. Health educators must adapt to and embrace diversity to work effectively with various populations. Purpose: The purpose of this article is to discuss the implications of cultural competency within the context of microaggression and to provide recommendations on how to incorporate cultural competence pedagogy into health education preservice courses. Methods: Microaggressions, when not addressed, can create an unwelcoming classroom for students as well as unwelcoming work environments for graduate students and faculty. It can also result in marginalisation and exclusion that can cause a student, graduate student or instructor to drop a class, leave a programme or leave a department. By reflecting on how other academic disciplines have identified the negative effects of microaggression on college students, the authors demonstrate how addressing microaggression through a cultural competency lens in the classroom can benefit a student’s future career in health service provision. Conclusion: While some work has been published on how to integrate cultural competency into health education, there is an absence of work incorporating microaggression and how to address it within health education pedagogy. It is important to address microaggression in all classrooms to ensure welcoming and inclusive environments for all practices in the field after graduation.
Validation of the ‘paediatric extracorporeal membrane oxygenation prediction’ model in a UK extracorporeal membrane oxygenation centre
Authors: Kanthimathinathan Hari Krishnan , Webb Sarah , Ellis David , Farley Margaret , Jones Timothy J 
Published: May 2020

Introduction: There is a need for a universal risk-adjustment model that may be used regardless of the indication and nature of neonatal or paediatric extracorporeal membrane oxygenation support. The ‘paediatric extracorporeal membrane oxygenation prediction’ model appeared to be a promising candidate but required external validation. Methods: We performed a validation study using institutional database of extracorporeal membrane oxygenation patients (2008-2019). We used the published paediatric extracorporeal membrane oxygenation prediction score calculator to derive estimated mortality based on the model in this cohort of patients in our institutional database. We used standardized mortality ratio, area under the receiver operating characteristic curve and Hosmer-Lemeshow goodness-of-fit test in 10 deciles to assess model performance. Results: We analysed 154 extracorporeal membrane oxygenation episodes in 150 patients. About 53% of the patients were full term (age ⩽30 days and gestation at birth ⩾37 weeks) neonates. The commonest category of extracorporeal membrane oxygenation support was cardiac (42%). The overall in-paediatric intensive care unit mortality was 37% (57/154) and the in-hospital mortality was 42% (64/154). Distribution of estimated mortality risk was similar to the derivation study. The calculated standardized mortality ratio was 0.81 based on the paediatric extracorporeal membrane oxygenation prediction model of risk-adjustment. The area under the receiver operating characteristic curve was 0.55 (0.45-0.64) and Hosmer-Lemeshow-test p value <0.001 was unable to support goodness-of-fit. Conclusion: This small single-centre study with a small number of events was unable to validate the paediatric extracorporeal membrane oxygenation prediction-model of risk-adjustment. Although this remains the most promising of all the available models, further validation in larger data sets and/or refinement may be required before widespread use.
Modified unicaval drainage in reoperative isolated tricuspid valve repair via totally thoracoscopic approach
Authors: He Biao-Chuan , Ke Ying-Jie , Zhou Kan , Chen Ze-Rui , Yang Jue , Li Xiao-Hong , Liu Gui-Qing , Guo Hui-Ming , Chen Ji-Mei , Zhuang Jian , Huang Huan-Lei 
Published: May 2020

Aim: The aim of this study was to investigate the feasibility, safety, and clinical effect of modified unicaval drainage for thoracoscopic reoperative isolated tricuspid valve repair, compared with conventional bicaval drainage. Methods: A total of 45 consecutive cases of patients who underwent thoracoscopic reoperative isolated tricuspid valve repair on beating-heart were enrolled and divided into two groups according to the different venous drainage (Group A: modified unicaval drainage, Group B: conventional bicaval drainage). A retrospective analysis of perioperative data and clinical outcomes were performed and all the surviving cases were followed up. Re-evaluation of echocardiography and electrocardiogram was performed prior to discharge, and at first month, sixth month, and every year follow-up. Results: The overall postoperative 30-day mortality was 4.5% in Group A and 8.7% in Group B. The postoperative tricuspid valve regurgitation grade of both groups decreased significantly from preoperative regurgitation grade, p < 0.001, without intergroup significant difference, p = 0.815. Follow-up duration ranged from 6 to 38 months, there was one death at 24 months in Group A, and another at 9 months in Group B, respectively. Nobody from both groups experienced reintervention for residual tricuspid regurgitation. No significant difference could be identified about the incidence of postoperative morbidities and follow-up adverse events. Conclusion: Both strategies of caval venous drainage can provide satisfactory exposure for thoracoscopic reoperative isolated tricuspid valve repair and equivalent favorable postoperative outcome. And the modified unicaval drainage group may even preserve the anesthetic time and decrease the risk of iatrogenic jugular injury, achieving a more simplified procedure with better cosmetic outcome.
Identification of microRNAs associated with the survival of patients with gallbladder carcinoma
Authors: Wang Jianguo , Jin Yuxia , Li Suping , Song Qinhao , Tang Ping 
Published: May 2020

Objective This study investigated micro (mi)RNAs associated with the survival of patients with gallbladder carcinoma (GBC). Methods miRNA expression profiling was carried out of 40 cancerous tissues from GBC patients with long-term (n = 20) and short-term (n = 20) survival and eight healthy gallbladder tissues from the Gene Expression Omnibus database. miRNAs dysregulated in GBC patients with long-term or short-term survival were identified using GEO2R and VennDiagram packages, and analyzed by miRNA target prediction tools and the clusterProfiler package. Results Compared with healthy gallbladder tissues, 104 and 124 miRNAs were dysregulated in cancerous tissues of GBC patients with long-term survival and short-term survival, respectively. Two miRNAs (hsa-miR-142-5p and hsa-miR-146b-5p) and 22 miRNAs (such as hsa-miR-30a-3p, hsa-miR-660-5p, and hsa-miR-338-3p) were exclusively dysregulated in GBC patients with long-term and short-term survival, respectively. Enrichment analysis revealed that miRNAs exclusively dysregulated in GBC patients with short-term survival were involved in 46 biological processes, 10 cellular components, 11 molecular functions, and 44 pathways such as morphogenesis of an epithelium, response to transforming growth factor beta, heterochromatin, and phosphatase binding. Conclusion This study not only identified some promising biomarkers for predicting survival in GBC patients, but also contributed to our understanding of the pathogenesis and prognosis of GBC.
Primary leiomyosarcoma of the uterine cervix: report of 4 cases, systematic review, and meta-analysis
Authors: Kiliç Cigdem , Yuksel Dilek , Cakir Caner , Turkmen Osman , Kimyon Comert Gunsu , Başaran Derman , Turan Taner 
Published: May 2020

Background: Primary cervical leiomyosarcomas (CLMS) constitute 21% of all cervical sarcomas. Because of their rarity, to our knowledge, fewer than 40 cases have been reported. The aim of this study is to evaluate the clinical and surgical–pathological features, prognosis, treatment options, and survival of primary CLMS. Methods: A systematic review of the medical literature was conducted to evaluate articles about primary CLMS. The literature was searched between 1959 and May 2019. On final evaluation, there were 29 articles (one consisted of 8 cases; one consisted of 3 cases) and 42 cases with the addition of our 4 cases. Results: Age (⩾48 versus ⩽47 years) (hazard ratio.HR], 4.528; 95% confidence interval.CI], 1.550–13.227; p=0.006) and mitoses count (<10/10 high-power field [HPF] versus ⩾10/10 HPF) (HR, 3.865; 95% CI, 1.046–14.278; p=0.043) are independent prognostic factors for recurrence and age (HR, 5.318; 95% CI, 1.671–16.920; p=0.005) and hysterectomy (performed versus not performed) (HR, 4.377; 95% CI, 1.341–14.283; p=0.014) are independent prognostic factors for death because of disease on multivariate analysis. Conclusions: Information on primary CLMS is sparse and obtained from rare case reports and case series. Hysterectomy must be the first choice of treatment in these patients according to our results on multivariate analysis. The type of hysterectomy does not have an effect on oncologic outcome. Radical hysterectomy is not obligatory and more data are needed to make more accurate conclusions.
Visualization of Proximal and Distal Kaplan Fibers Using 3-Dimensional Magnetic Resonance Imaging and Anatomic Dissection
Authors: Berthold Daniel P. , Willinger Lukas , Muench Lukas N. , Forkel Philipp , Schmitt Andreas , Woertler Klaus , Imhoff Andreas B. , Herbst Elmar 
Published: May 2020

Background: In current magnetic resonance imaging (MRI) of the knee, injuries to the anterolateral ligament complex (ALC) and the Kaplan fibers (KFs) are not routinely assessed. As ruptures of the KFs contribute to anterolateral rotatory instability in the anterior cruciate ligament–deficient knee, detecting these injuries on MRI may help surgeons to individualize treatment. Purpose: To visualize the KFs on 3-T MRI and to conduct a layer-by-layer dissection of the ALC. Study Design: Descriptive laboratory study. Methods: Ten fresh-frozen human cadaveric knees (mean ± SD age, 72 ± 8.5 years) without history of ligament injury were used in this study. Before layer-by-layer dissection of the ALC, MRI was performed to define the radiologic anatomy of the KFs. A coronal T1-weighted 3-dimensional turbo spin echo sequence and a transverse T2-weighted turbo spin echo sequence were obtained. Three-dimensional data sets were used for multiplanar reconstructions. Results: KFs were identified in 100% of cases on MRI and in anatomic dissection. The mean length of the proximal and distal KFs was 17.9 ± 3.6 mm and 12.4 ± 6.5 mm, respectively. On MRI, the distance from the lateral femoral epicondyle to the proximal KFs was 35.9 ± 6.9 mm and to the distal KFs, 16.6 ± 4.1 mm; in anatomic dissection, the distances were 41.4 ± 8.1 mm for proximal KFs and 28.2 ± 8.1 mm for distal KFs. The distance from the lateral joint line to the proximal KFs was 63.5 ± 7.6 mm and to the distal KFs, 45.3 ± 3.7 mm. Interobserver reliability for image analysis was excellent for all measurements. Conclusion: KFs can be consistently identified on MRI with use of 3-dimensional sequences. Subsequent anatomic dissection confirmed their close topography to the superior lateral genicular artery. For clinical implications, the integrity of the KFs should be routinely reviewed on MRI scans Clinical Relevance: As ruptures of the KFs contribute to anterolateral rotatory instability, accurate visualization of the KFs on MRI may facilitate surgical decision making for additional anterolateral procedures in the anterior cruciate ligament–deficient knee.
Trends and Utilization of Inpatient Palliative Care Among Patients With Metastatic Bladder Cancer
Authors: Han Hedong , Yu Feifei , Wu Cheng , Dai Lihe , Ruan Yiming , Cao Yang , He Jia 
Published: May 2020

Objective: To explore the trends and utilization of palliative care (PC) service among inpatients with metastatic bladder cancer (MBC). Methods: A retrospective, cross-sectional analysis was performed using data from the 2003 to 2014 National Inpatient Sample. Palliative care was identified through International Classification of Diseases, Ninth Revision code V66.7. Demographics, comorbidities, hospital characteristics, tumor-related, and treatment-related factors were compared between patients with and without PC. Multivariable logistic regression was used to explore predictors of PC use. Results: Among 131 852 patients with MBC, 13 224 (10.03%) received PC. Rate of PC increased from 2.49% in 2003 to 28.39% in 2014 ( P < .0001). Similarly, rate of PC in decedents increased from 7.02% in 2003 to 54.86% in 2014 ( P < .0001). Patients receiving PC were older, tendered to be white, had more comorbidities, and higher all-patient refined diagnosis-related group mortality risk. Predictors of PC included age (odds ratio [OR]: 1.02; 95% CI: 1.01-1.02; P < .0001), Medicaid (OR: 1.87; 95%.CI: 1.54-2.26; P < .0001), and private (OR: 1.61; 95% CI: 1.40-1.84; P < .0001) insurance, hospitals in the West (OR: 1.33; 95% CI: 1.10-1.61; P = .0032), and Mid-west (OR: 1.46; 95% CI: 1.22-1.75; P = .0032), major (OR: 1.32; 95% CI: 1.11-1.49; P < .0001), and extreme (OR: 2.37; 95% CI: 2.04-2.76; P < .0001) mortality risk. Chemotherapy and mechanical ventilation were related with lower odds of PC use. Palliative care predictors in the decedents were similar to those in overall patients with bladder cancer. Conclusions: Palliative care encounter in MBC shows an increasing trend. However, it still remains very low. Disparities in PC use covered age, insurance, and hospital characteristics among metastatic bladder cancer in the United States.
Crossover effects of ultrasound-guided percutaneous neuromodulation on contralateral hamstring flexibility
Authors: De-la-Cruz-Torres Blanca , Carrasco-Iglesias Carlos , Minaya-Muñoz Francisco , Romero-Morales Carlos 
Published: May 2020

Background Crossover effects refer to the responses of a non-exercised contralateral limb. There is evidence of this effect, as it relates to muscle fatigue, strength, and stretch, but not as it relates to neuromodulation. Objectives To compare the crossover effects of percutaneous neuromodulation (PNM) on hip range of motion (ROM), observed in a straight leg raise (SLR) test, in asymptomatic participants with bilateral reduced hamstring flexibility, versus the neurodynamic sciatic sliding technique, hamstring stretching and mechanical stimulation of the sciatic nerve using a needle (without electrical stimulation). To evaluate the tensiomyographic changes between the two lower limbs after these interventions. Methods 80 participants with bilateral reduced hamstring flexibility were randomized into four groups: Stretching, Neurodynamic, PNM, and Needle groups. All interventions were performed on the right limb. Each participant’s leg was subjected to SLR testing and tensiomyography before and after the interventions. Results Each group improved their SLR values in the non-intervention limb compared to baseline values, but the PNM and Needle groups obtained higher values for the SLR test in the non-intervention limb compared with the Neurodynamic and Stretching groups. There were statistically significant differences for mean SLR measures between limbs pre- and post-intervention for all groups except the PNM group, suggesting crossover effects for PNM but not the other techniques studied. There were no differences in tensiomyographic assessments between groups or between sides, at baseline or upon completion of the study. Conclusion PNM produced benefits in the SLR test in the non-intervention limb and only 1.5 min was enough to obtain this effect. In addition, no technique interfered with muscle activation.
Economic evaluation alongside a randomised controlled trial to assess the effectiveness and cost-effectiveness of acupuncture in the management of chemotherapy-induced peripheral neuropathy
Authors: Molassiotis Alex , Dawkins Bryony , Longo Roberta , Suen Lorna KP , Cheng Hui Lin , Mok Tony , Hulme Claire T , Yeo Winnie 
Published: May 2020

Objective To assess the cost-effectiveness of acupuncture in the management of chemotherapy-induced peripheral neuropathy (CIPN) in Hong Kong. Methods A within trial cost-utility analysis with the primary endpoint for the economic evaluation being the Quality Adjusted Life Year (QALY) and associated Incremental Cost Effectiveness Ratio (ICER) over 14 weeks of treatment. A secondary cost-effectiveness analysis was undertaken with the endpoint being change in pain as measured on the Brief Pain Inventory (BPI). Results Eighty-seven patients were randomised to acupuncture or usual care. Acupuncture resulted in significant improvements in pain intensity (8- and 14-week mean changes compared to usual care of −1.8 and −1.8, respectively), pain interference (8- and 14-week mean changes compared to usual care of −1.5 and −0.9, respectively) and indicators of quality of life and neurotoxicity-related symptoms. However, in the economic evaluation there was little difference in QALYs between the two arms (mean change 0.209 and 0.200 in the acupuncture and usual care arms, respectively). Also, costs yielded deterministic ICERs of HK$616,965.62, HK$824,083.44 and HK$540,727.56 per QALY gained from the health care provider perspective, the societal perspective and the patient perspective, respectively. These costs are significantly higher than the cost-effectiveness threshold of HK$180,450 that was used for the base case analysis. Conclusion While acupuncture can improve symptoms and quality of life indicators related to CIPN, it is unlikely to be a cost-effective treatment for CIPN-related pain in health care systems with limited resources. Trial registration number NCT02553863 (ClinicalTrials.gov) post-results.