bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of Bootstrap Simulation and Asymmetric Causal Approach to Fiscal Deficit-Inflation Nexus
Authors: Olalekan Olaniyi Clement 
Published: May 2020

This paper investigates the symmetric and asymmetric relationship between fiscal deficits and inflation in Nigeria within the context of bootstrap simulations with leverage adjustments using the quarterly frequency data from 1981Q1 to 2016Q4. The findings reveal that there is neither symmetric nor asymmetric causality between fiscal deficits and inflation in Nigeria. This implies that the fiscal deficits in Nigeria are not inflationary; and also, that persistent double-digit inflation rates are not the causal agents spurring perennial increase in fiscal deficits in Nigeria. This study, therefore, concludes that fiscal deficits could be used to stimulate output level in Nigeria without fueling inflationary spiral in the economy. JEL Classification: C32, E17
Naturalistic outcomes of continuation right unilateral ultrabrief ECT in major depression: a retrospective chart review
Authors: Atashnama Azadeh , Aly Husayn , Krishnan Vijay , Howari Rasha , Mayur Prashanth 
Published: May 2020

Objective: Continuation treatment of major depression following an acute course of electroconvulsive treatment (ECT) may be often required to prevent relapse. Data on continuation phase of right unilateral ultrabrief ECT are sparse and there are doubts if it is inherently capable of relapse prevention. Methods: All consecutive adult patients with major depression who received the first ‘run’ of continuation phase of right unilateral ultrabrief ECT over a 10-year period were routinely followed up. ECT frequency varied from weekly to up to once every 4 weeks for a maximum period of 6 months. The data were extracted from a retrospective chart review. Results: 20 out of 22 patients persisted with ultrabrief pulses (0.3 ms) with two needing 0.5 ms pulse widths. The median duration of continuation treatment was 51 days (range: 14–460). At the end of 1 month ( n = 17), treatment gap in days mean (SD): 10.18 (7.08), widening to mean (SD): 20.11 (16.85) at 4 months ( n = 9). Stimulus dose increased throughout the continuation phase: p = 0.026. In 16 out of 22 patients, more than 70% of the visits were charted as being ‘in remission’. Conclusion: As most patients receiving ultrabrief ECT remained well, this study suggests that ultrabrief ECT can be used effectively in continuation therapy.
Reflection of a 2-year journey since the introduction of psychiatric behaviour of concern (Psy-BOC) call, a medical emergency team (MET) call equivalent for the deteriorating mental health of patients
Authors: Rauchberger Ilan , Whitecross Fiona 
Published: May 2020

Objective: To reflect on the challenges encountered and the resultant cultural changes that occurred during the implementation of psychiatric behaviour of concern (Psy-BOC), a medical emergency team (MET) equivalent for the deteriorating mental health of patients within an adult psychiatric inpatient unit. Conclusions: Implementing Psy-BOC on an adult psychiatric inpatient unit has been challenging, but it has successfully embedded a systematic approach to early escalation and capacity building to prevent and manage harmful behaviours.
Monash Gender Clinic: an overview of the current model of care
Authors: Erasmus Jaco 
Published: May 2020

Objective: This paper provides an update on recent developments at the largest state-funded gender clinic for adults in Australia. It focuses on the current staffing profile, the role of the mental health professional and the evolution of the clinic as a provider of specialist care supporting primary care providers who offer an informed consent model of care in accessing gender-affirming treatments. Conclusions: While significant improvements have been made at the clinic to provide comprehensive care in a framework that is viewed more favourably by clients, gaps in clinical service provision persist and are in need of urgent attention.
High-dose antipsychotic therapy and reflective prescribing: development of an online tool for rapid, easy calculation of antipsychotic total daily dose
Authors: Northwood Korinne , Theodoros Theo , Wang Nancy , Siskind Dan 
Published: May 2020

Objective: Safe and effective antipsychotic prescribing is a fundamental skill in psychiatric practice; however, antipsychotic medications are not without risk. These risks are increased when antipsychotics are prescribed in high doses, with or without polypharmacy. Decision-making regarding antipsychotic prescribing can be hampered by a lack of readily available or easily approachable tools for calculating and interpreting total daily doses, especially when antipsychotic polypharmacy is involved. Our objective was to create an accessible method for calculating antipsychotic total daily dosing. Methods: We have developed an online calculator for determining antipsychotic total daily dose using information on recommended maximum total daily dosing based on the British National Formulary. Results: This calculator is free, easy to implement and allows for users to input a large variety of possible antipsychotic dosing regimens. Conclusions: It is hoped that this tool will allow clinicians to readily review their prescribing practice, inform decision-making and improve patient safety outcomes. Further research may be appropriate to determine the impact of this tool on these intended goals.
The fentanyls: pharmacological and clinical aspects relevant to Australia
Authors: Greene Shaun L , Scamvougeras Anton , Norman Amanda , Bonomo Yvonne , Castle David J 
Published: May 2020

Objective: North American and other jurisdictions have seen an alarming rise in the abuse of the fentanyls, with related overdose deaths. We sought to review this group of drugs to alert Australian psychiatrists and drug and alcohol clinicians to their clinical effects and potential harms. Conclusions: The extreme potency of the fentanyls underlie their lethality. Vigilance and investment from both policy makers and health care providers are required to mitigate harm from a possible future Australian fentanyl epidemic.
Changes in Homocysteine Levels Affect Serum Lipid Response to Atorvastatin in Patients With Acute Coronary Syndrome: A Retrospective Observational Study
Authors: Wu Dong-Feng , Wu Yin-Xiong , Deng Jin-Long 
Published: May 2020

Objective: The present study investigated whether changes in serum homocysteine (Hcy) levels modify the effects of atorvastatin treatment on blood lipid parameters in patients with acute coronary syndrome (ACS). Methods: A total of 159 patients with ACS who received regular, long-term treatment with 20 mg/d atorvastatin were included. Depending on the changes in Hcy parameters, they were divided into Hcy reduction (HR) and Hcy elevation (HE) groups. Results: After long-term atorvastatin treatment, total cholesterol (TC), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), apolipoprotein (Apo) B, and Hcy levels were decreased ( P < .05), and the ApoAI level was increased ( P < .01). Correlation and stratified analysis showed that Hcy or hyperhomocysteinemia was correlated with blood lipids. In both the HE and HR groups, the TC, LDL-C, and ApoB levels after treatment were lower than those before treatment ( P < .01), and the ApoAI level was increased compared with that before treatment ( P < .05). There was no difference in the reduction of TC, LDL-C, and ApoB levels or in the increase of ApoAI level ( P interaction > .05) between the 2 groups. However, there was a clear opposite trend of the effect of atorvastatin on TG and high-density lipoprotein cholesterol (HDL-C) levels between the HR and HE groups ( P interaction < .05). In the HR group, the HDL-C level was increased ( P < .05), and TGs were decreased compared with those before treatment ( P < .01). Nevertheless, in the HE group, the HDL-C level was decreased ( P < .05), and TGs ( P < .05) were increased compared with those before treatment. Conclusion: The effects of atorvastatin on TGs and HDL-C depend on changes in Hcy levels. Patients with a reduced Hcy level after atorvastatin treatment had more favorable lipid parameters.
The Effect of Noise in the Intensive Care Unit on the Oxidative Stress Response in Rats
Authors: Boyacioglu Nurcan , Ozkan Sultan 
Published: May 2020

Objective: The objective of this study was to determine the effect of noise in the intensive care unit (ICU) on oxidative stress in a rat model. Method: This study had both a descriptive and a randomized controlled experimental stage. In the descriptive stage, to create a laboratory model of noise in the ICU, the noise level was measured for 24 hr on a randomly selected day in a surgical ICU, and voice recording was performed using a sound recording device. In the experimental stage, 30 male Wistar albino rats were randomly divided into 5 groups: a control group and groups exposed to the recording of the noise from the ICU for 24, 48, 72, and 168 hr. Results: The noise level in the ICU was higher than the levels recommended for hospitals. Plasma corticosterone levels of the rats in the group exposed to the ICU noise for 168 hr were significantly higher than those of the control group. Plasma total protein values were significantly reduced in the rats exposed to 48, 72, and 168 hr of ICU noise compared to those of the control group. Superoxide dismutase activity was significantly decreased and malondialdehyde levels significantly increased in serum, spleen, and brain tissues as the duration of noise exposure increased. Conclusion: Findings reveal that rats experienced increasing levels of stress and oxidative stress as time exposed to the ICU noise increased. These results suggest that interventions to reduce noise in the ICU may be warranted.
Synergistic Effect of Low Neutrophil–Lymphocyte Ratio With Physical Activity on Quality of Life in Type 2 Diabetes Mellitus: A Community-Based Study
Authors: Rias Yohanes Andy , Kurniasari Maria Dyah , Traynor Victoria , Niu Shu Fen , Wiratama Bayu Satria , Chang Ching Wen , Tsai Hsiu Ting 
Published: May 2020

Background: Physical inactivity and Type 2 diabetes mellitus (T2DM)–associated inflammatory biomarkers are correlated with poor quality of life (QoL). However, no study has investigated the synergistic effect of physical activity (PA) and lower neutrophil–lymphocyte ratio (NLR) on QoL. Objective: We examined the independent and synergistic effects of PA and inflammatory biomarkers on three domains of QoL in T2DM. Methods: This cross-sectional study included 294 patients with T2DM from community clinics in Indonesia. The 36-item Short Form Survey and a questionnaire about PA engagement were used to measure QoL and metabolic equivalent of task (MET)-hr/week, respectively. Inflammatory biomarkers were measured in fasting blood. Adjusted coefficients β and 95% confidence interval (CI) were estimated using multiple linear regression. The synergistic effect was analyzed using additive interaction for linear regression. Results: Patients with PA ≥ 7.5 MET-hr/week exhibited significantly higher total QoL (β = 8.41, 95% CI = [6.04, 10.78]) and physical component score (PCS; β = 13.90, 95% CI = [10.52, 17.29]) than those with PA < 7.5 MET-hr/week. Patients with NLR < 1.940 had significantly higher total QoL (β = 4.76, 95% CI = [3.41, 6.11]), mental component score (MCS; β = 2.62, 95% CI = [0.75, 4.49]), and PCS (β = 6.89, 95% CI = [4.97, 8.82]) than patients with NLR ≥ 1.940. PA ≥ 7.5 MET-hr/week and NLR < 1.940 exhibited a synergistic effect on total QoL, MCS, and PCS. Conclusions: High PA level and low NLR had a positive synergistic effect on QoL among patients with T2DM.
Course of the sciatic nerve on magnetic resonance imaging in patients with osteoarthritis of the hip
Authors: Suzuki Koji 
Published: May 2020

Background: Sciatic nerve palsy is a serious complication after total hip arthroplasty (THA). This is the first study to report the relationship between the sciatic nerve and the acetabulum on magnetic resonance imaging (MRI) before THA. Methods: 235 patients underwent 261 elective, primary THAs via the mini-incision posterolateral approach. We measured the horizontal distance (mm) and vertical distance (mm) from the posterior edge of the acetabulum to the sciatic nerve by T1-weighted imaging on an axial section of the centre of the femoral head. We defined the Dysplastic Group as having a posterior acetabular sector angle (PASA) <90° and the Non-dysplastic Group as having a PASA ⩾ 90°. We compared anatomical distances and angles between the 2 groups. Results: The horizontal and vertical distances were (mean ± SD) 8.0 ± 9.2 mm and 14 ± 5.0 mm from the posterior edge of the acetabulum to the lateral edge of the sciatic nerve, respectively. The acetabular anteversion (AA), anterior acetabular sector angle (AASA), and PASA were (mean ± SD) 19 ± 6.7°, 49 ± 8.4°, and 87 ± 8.6°, respectively. The horizontal and vertical distances were positively correlated ( p < 0.0001). AA and PASA were positively correlated with the horizontal distances ( p < 0.0001) as well as with the vertical distances ( p = 0.0017 and p = 0.0438, respectively). The horizontal and vertical distances were significantly shorter in the Dysplastic Group than in the Non-dysplastic Group ( p < 0.0001 and p = 0.021, respectively). Conclusions: In cases of posterior acetabular dysplasia we have to be mindful of the course of the sciatic nerve.
Efficacy of the transjugular approach in endovascular intervention for hemodialysis access comparing with conventional approach
Authors: Lee Chang Hun , Gwon Jun Gyo , Jung Cheol Woong , Cho Sung Bum 
Published: May 2020

Purpose: Compared with the conventional approach, the benefits of the transjugular approach in endovascular intervention for hemodialysis access avoids complications due to direct puncture and reduces direct radiation exposure to the hands of operator. The aim of this non-inferiority study was to evaluate the efficacy of the transjugular approach in endovascular intervention for hemodialysis access comparing with conventional approach. Methods: We retrospectively assessed endovascular intervention for hemodialysis access performed in our hospital from 2012 to 2016, divided into the conventional approach group and the transjugular approach group. The hemodialysis access survival rate, re-intervention survival rate, and lesion characteristics were comparatively evaluated. Results: We included 223 cases in 118 patients (146 cases with conventional approaches and 77 cases with transjugular approaches). There was a higher incidence of thrombosis with the conventional approach (p < 0.001), however, no significant difference in the hemodialysis access type or main lesion location. The transjugular approach showed either a better hemodialysis access survival rate (p = 0.017) and a trend toward improved re-intervention survival rate (p = 0.098) than the conventional approach. Following classification according to the presence of thrombus, there was no significant difference in either the hemodialysis access survival rate or the re-intervention survival rate between the approaches with or without thrombus. Conclusion: The transjugular approach could be performed in most cases and was similar to the conventional approach in terms of outcomes. The transjugular approach should be considered as an alternative to either replace or use in combination with the conventional approach in endovascular intervention for hemodialysis access.
Predicting arterio-venous fistula failure by urea–method derived access blood flow in chronic hemodialysis patients
Authors: Lelamali Kumtorn , Papirachanat Piyarek , Puavilai Thitiya 
Published: May 2020

Background: Dialysis access is an essential part of hemodialysis. Determining the access blood flow (Qa) can help predict arterio-venous fistula thrombosis. Qa determination by the urea method, which was previously described in the past is simple and is available in most of the dialysis units but was not be able to predict arterio-venous fistula thrombosis. Aim: To compare the efficacy of Qa determination by the urea method and by ultrasound dilution methods in predicting arterio-venous fistula failure. Methods: Qa was measured by urea method and by ultrasound dilution simultaneously, every 3 months for a period of 1 year, in stable chronic hemodialysis patients with arterio-venous fistula. Arterio-venous fistula failure determined by clinical parameters and confirmed by Doppler ultrasound before sending the patient for interventional angioplasty. Results: This study enrolled a total of 16 patients, with 63% being male, 75% with lower-arm arterio-venous fistula and around 43% with previously done angioplasty. 59-Qa measurements were done, and 6 patients underwent angioplasty (one patient for severe upper limb edema, one for access thrombosis, and four for access dysfunction). Qa determination by the urea method had non-significantly lower Qa, (745 mL/min (interquartile range: 509–1143) and 779 mL/min (interquartile range: 530–1160), (p = 0.58)) and high correlation (r = 0.83, p < 0.001) to Qa by ultrasound dilution. The cut-off criteria with its sensitivity and specificity in predicting the access failure were 440 mL/min, 66.67%, and 96.15% for Qa determination by the urea and 400 mL/min, 66.67% and 90.38% for Qa by ultrasound dilution, respectively, with no difference in the area under the receiver operating characteristic curve. Conclusion: Measurement of Qa determination by the urea method is well correlated with Qa by ultrasound dilution and can be used to predict vascular access failure.
(Un)intended consequences of the 2016 educational reform on early childhood education and care in Poland. The story of a few applications that led to significant disorder
Authors: Ciepielewska-Kowalik Anna 
Published: May 2020

Merton’s law on unintended consequences (1936) warns against the undesirable and unanticipated outcomes of every action and policy. More recent research (Zhao, 2017) in the field of education, in relation to Merton, claims that these consequences are usually treated as inconvenient side effect of a policy, but are, in fact, planned by policy-makers or other stakeholders to benefit them. It is therefore more appropriate to call them ‘(un)intended consequences’, which are not written into the policy but are a result of how the policy translates into practice. This paper, in relation to the above approaches, aims at revealing (un)intended consequences and hidden agendas of the educational reform conducted by the Polish government in 2016, with a special focus on their impact on ECEC. (Un)intended consequences are investigated here in four dimensions, including ECEC: organisational changes, curriculum, management and educators.  The paper is based on the review of literature and on the author’s qualitative and quantitative research among parents, teachers and representatives of local authorities, carried out in the 2018/2019 school year.
Side-by-Side Stenting Repair of a Traumatic Pseudoaneurysm at a Venous Confluence
Authors: Dutmers Jennifer , Soule Erik , Bertran Mario Agrait , Andreou Sonia , Matteo Jerry 
Published: May 2020

Objectives: The incidence and prevalence of iatrogenic vascular trauma in the United States is staggering. This has led to the advent and implementation of more efficient and effective vascular repair methods. Although open surgical repair may still be considered gold standard, new endovascular solutions have emerged as other viable options. When using an endovascular approach, proper stent sizing is vital to a successful repair. Methods: We present a case of a traumatic injury and pseudoaneurysm formation at the confluence of the right internal jugular and right subclavian veins during a central line placement. This iatrogenic pseudoaneurysm was treated with endovascular placement of side-by-side stents. A mathematical formula, which we have designated “Matteo’s law,” was utilized to select properly sized stent grafts to reconstruct the confluence and prevent infolding and endoleaks. Results: After deployment of kissing stents at the confluence of the right internal jugular and right subclavian veins, a venogram was performed, which demonstrated successful exclusion of the pseudoaneurysm and no endoleaks. Clinical follow-up confirms continued wide open flow through the reconstructed venous confluence at 8 months post-procedure. Conclusion: In reconstruction of a venous confluence, selection of properly sized stent grafts is paramount to preventing infolding and endoleaks. Matteo’s law states that the circumference of the native receiving vessel must equal the sum of the circumferences of both kissing stent grafts, subtracting the redundant material where the 2 stents interface.
PreImplantation Factor immunohistochemical expression correlates with prostate cancer aggressiveness
Authors: Raspollini Maria Rosaria , Montagnani Ilaria , Cirri Paolo , Baroni Gianna , Cimadamore Alessia , Scarpelli Marina , Cheng Liang , Lopez-Beltran Antonio , Montironi Rodolfo , Barnea Eytan R. 
Published: May 2020

Background: The PreImplantation Factor (PIF)—a peptide secreted by viable embryos—exerts autotrophic protective effects, promotes endometrial receptivity and controls trophoblast invasion. Synthetic PIF (sPIF) has both immune-protective and regenerative properties, and reduces oxidative stress and protein misfolding. PIF is detected by immunohistochemistry (IHC) in hyperplastic endometriotic lesions and advanced uterine cancer. sPIF reduces graft-versus-host disease while maintaining a graft-versus-leukemia effect. Methods: PIF detection in prostate cancer was assessed in 50 human prostate samples following radical prostatectomy using tumor-microarray-based IHC correlating PIF immune staining with Gleason score (GS) and cancer aggressiveness. Results: PIF was detected in moderate-to-high risk prostate cancer (GS 4+3 and beyond, prognostic groups 3 to 5). In prostate cancer (GS (WHO Grade Group (GG)5), PIF was detected in 50% of cases; in prostate cancer (GS 4+4 GG4), PIF was observed in 62.5% of cases; in prostate cancer (GS 4+3 GG3), PIF immunostaining was observed in 57.1% of cases. In prostate cancer, (GS 3+4 GG2) and (GS 3+3 GG1) cases where PIF staining was negative to weak, membranous staining was observed in 20% of cases (staining pattern considered negative). High-grade prostate intraepithelial neoplasia PIF positive stain in 28.57% of cases (6 of 21) was observed. In contrast, PIF was not detected in normal prostate glands. Importantly, sPIF added to the PC3 cell line alone or combined with prostate cancer fibroblast feeder-cells did not affect proliferation. Only when peripheral blood mononuclear cells were added to the culture, a minor increase in cell proliferation was noted, reflecting local proliferation control. Conclusions: Collectively, PIF assessment could be a valuable, simple-to-use immunohistochemical biomarker to evaluate aggressiveness/prognosis in specimens from prostate cancer patients.