bluuebunny/crossref_metadata_2025_split huggingface dataset:
Austin and the Scope of Our Knowledge
Authors: Leite Adam 
Published: June 2020

Abstract
In ordinary circumstances in which we know there is a goldfinch on a branch in the garden, do we know that the thing on the branch isn’t stuffed? Austin’s methodology is perfectly compatible with holding both that we do and that we wouldn’t know it’s a goldfinch if we didn’t. Moreover, Austin’s methodology supports the claim that if we had no information whatsoever about whether it is stuffed, we wouldn’t know the thing on the branch is a goldfinch. Finally, Mark Kaplan’s claim that P is part of your evidence if and only if you know that P leaves him with good reason to agree that in ordinary circumstances, you do know that the goldfinch isn’t stuffed. This result suggests a distinctive way of approaching arguments for external world skepticism with the structure of the so-called Argument from Ignorance. And it highlights just how much can be learned from approaching epistemological issues in an Austinian spirit.
Service-learning to improve attitudes towards blood donation among university students
Authors: Fernández de la Iglesia Josefa del Carmen , Martínez-Santos Alba-Elena , Rodríguez-González Raquel , Cebreiro Beatriz , Fernández-Morante Carmen , Casal-Otero Lorena 
Published: June 2020

Objective: The purpose of this study was to describe how a service-learning methodology can promote blood donation among students by increasing levels of knowledge and improving attitudes while developing professional skills. Method: A quasi-experimental study design was utilised. A questionnaire identified barriers and incentives to blood donation in an experimental group and a control group. Participants ( n = 81) were students in nursing and primary teacher training courses at the University of Santiago de Compostela. Non-parametric analyses examined differences between participating and non-participating students within the project. Results: Gender and degree programme differences were found. Students who participated increased their level of knowledge ( U = 325.500, p < .001) and reduced their barriers to blood donation in three of the evaluated dimensions: personal reasons ( U = 520.500, p = .004), fears ( U = 471.500, p = .001) and pretexts ( U = 576.500, p = .020). Non-participants in the service-learning project reported more barriers and fewer external incentives. Conclusion: Service-learning methodology can be a useful strategy to increase blood donation among students in higher education. It increases knowledge, improves attitudes and reduces barriers to donation. This successful interdisciplinary experience could provide the basis for the implementation of new service-learning approaches.
Very long-term outcome of psychotic disorders
Authors: Peritogiannis Vaios , Gogou Afroditi , Samakouri Maria 
Published: June 2020

Background: The outcome of schizophrenia and related psychoses is generally modest, and patients display high rates of disability. Aims: The aim of the review is to present an up-to-date account of the research on the very long-term outcome of psychotic disorders. Method: We conducted a search in the PubMed and Scopus databases for articles published since the publication of the very long-term data of the World Health Organization’s International Study of Schizophrenia (the ISoS study), over the last 18 years (from 2002 to 2019). Studies were included if they reported on at least 15-year outcome and if they had used valid and reliable tools for the estimation of the patients’ outcome in terms of symptomatology and functioning. Results: A total of 16 studies were included in this review, involving 1,391 patients with schizophrenia and related psychoses. Most were single-center studies, with moderate size samples of patients, and 11 were prospective studies. Very long-term outcome of psychotic disorders varies considerably among studies. Good outcome ranges from 8% to 73.8%, and it appears to be better in developing countries, whereas differences are less apparent among Western countries (8%–40.3%). Studies in different settings have used different methods involving a variety of samples of patients to estimate their outcome, whereas definitions of good and poor outcome also varied among studies. Longer duration of untreated psychosis was associated with worse outcome in some studies. Schizophrenia was found to have poorer long-term prognosis compared to other schizophrenia spectrum disorders. A large proportion of patients, ranging from 19% to 48.2%, were not on medication. Conclusion: Recent evidence on the very long-term outcome of psychotic disorders is in line with previous reports and suggests that prognosis remains rather modest. There are several limitations of current research regarding outcome definitions and study design that should be addressed by future research.
Factors associated with the development of post-thrombotic syndrome in patients with iliofemoral deep venous thrombosis who underwent catheter-directed thrombolysis
Authors: Kim Myung Sub , Park Hong Suk , Hyun Dongho , Cho Sung Ki , Park Kwang Bo , Do Young Soo 
Published: June 2020

Objective To identify predictors of post-thrombotic syndrome in patients with iliofemoral deep venous thrombosis who underwent catheter-directed thrombolysis. Methods Fifty-two consecutive patients who underwent catheter-directed thrombolysis were included in this retrospective study. In addition to catheter-directed thrombolysis, aspiration thrombectomy or stent placement was performed if needed. At six months, duplex ultrasound was performed to assess iliofemoral patency and deep venous reflux. Post-thrombotic syndrome was assessed using the clinical, etiologic, anatomic, and pathophysiologic classification (post-thrombotic syndrome present ≥3 on a scale from 0 to 6). Univariate analysis and multivariate logistic regression were used to identify predictors of post-thrombotic syndrome. Results Median follow-up was 52 months and post-thrombotic syndrome developed in nine patients (17.3%). In univariate analysis, stent placement (odds ratio 0.16, p = 0.022) was negatively associated with post-thrombotic syndrome, whereas iliofemoral venous obstruction with reflux at six months (OR 6.08, p = 0.037) was positively associated with post-thrombotic syndrome. Multivariate analysis indicated that stent placement was associated with reduced risk of post-thrombotic syndrome (OR 0.17, p = 0.043), and iliofemoral obstruction with reflux was associated with increased risk (OR 6.67, p = 0.046). Conclusion Stent placement and iliofemoral venous obstruction with reflux, respectively, were important protective and risk factors for post-thrombotic syndrome in patients who underwent catheter-directed thrombolysis.
Identification of patients with potential palliative care needs: A systematic review of screening tools in primary care
Authors: ElMokhallalati Yousuf , Bradley Stephen H , Chapman Emma , Ziegler Lucy , Murtagh Fliss EM , Johnson Miriam J , Bennett Michael I 
Published: June 2020

Background: Despite increasing evidence of the benefits of early access to palliative care, many patients do not receive palliative care in a timely manner. A systematic approach in primary care can facilitate earlier identification of patients with potential palliative care needs and prompt further assessment. Aim: To identify existing screening tools for identification of patients with advanced progressive diseases who are likely to have palliative care needs in primary healthcare and evaluate their accuracy. Design: Systematic review (PROSPERO registration number CRD42019111568). Data sources: Cochrane, MEDLINE, Embase and CINAHL were searched from inception to March 2019 Results: From 4,127 unique articles screened, 25 reported the use or development of 10 screening tools. Most tools use prediction of death and/or deterioration as a proxy for the identification of people with potential palliative care needs. The tools are based on a wide range of general and disease-specific indicators. The accuracy of five tools was assessed in eight studies; these tools differed significantly in their ability to identify patients with potential palliative care needs with sensitivity ranging from 3% to 94% and specificity ranging from 26% to 99%. Conclusion: The ability of current screening tools to identify patients with advanced progressive diseases who are likely to have palliative care needs in primary care is limited. Further research is needed to identify standardised screening processes that are based not only on predicting mortality and deterioration but also on anticipating the palliative care needs and predicting the rate and course of functional decline. This would prompt a comprehensive assessment to identify and meet their needs on time.
Pontine Tegmentum Lesions Accompanying Myelitis During an Enterovirus Outbreak: Differential Diagnosis and Outcome
Authors: Bastemur Mehmet , Gocmen Rahsan , Parlak Safak , Yuksel Deniz , Arslan Elif Acar , Okten Arzu Yilmaz , Iscan Akin , Ekici Baris , Anlar Banu 
Published: June 2020

Aim: To investigate etiology and prognostic significance of pontine tegmentum lesions accompanying a cluster of acute flaccid myelitis. Method: We retrospectively examined patients from 6 centers in Turkey who manifested encephalitis or myelitis associated with dorsal pontine lesions on magnetic resonance imaging (MRI) between July 2018 and February 2019. Results: Twenty-two patients were evaluated. Ten of 22 (45%) presented with acute paralysis and 12 of 22 (55%) with brainstem symptoms only. Reverse transcription polymerase chain reaction for enterovirus was positive in 2 patients’ respiratory tract. Other etiologic factors were detected in 10 cases. On follow-up, patients presenting with symptoms of myelitis developed motor sequalae although spinal cord lesions on MRI resolved in 5 of 9 (55%). Encephalitic symptoms, present in 17 cases, recovered in 13 (76%), and brain MRI showed complete or near-complete resolution in 11 of 14 (78%). Conclusion: Various etiologic agents can be detected in patients with pontine involvement, even in a series collected during an outbreak of EV-D68. Encephalitis has a fair outcome but clinical recovery is slow and motor sequalae are frequent in spinal involvement, irrespective of follow-up spinal MRI findings.
A rare case of diffuse large B-cell lymphoma-associated hemophagocytic lymphohistiocytosis
Authors: Malkan Umit Yavuz , Albayrak Murat , Yildiz Abdulkerim , Maral Senem , Afacan Ozturk Hacer Berna , Comert Pinar 
Published: June 2020

Introduction Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threatening syndrome of excessive immune activation. Herein, we aimed to report a diffuse large B-cell lymphoma (DLBCL) case that was presented as HLH. Case report A 32-year-old man presented to a hospital with complaints of vomiting, nausea and diarrhea in October 2019. Fever and hepatosplenomegaly was detected in physical investigation. Bone marrow aspiration investigation revealed the hemaphagocytosis. HLH-2004 protocol was started for hemophagocytosis. Whole body magnetic resonance imaging (MR) revealed no lymphadenopathy. Bone marrow biopsy revealed high-grade B-cell lymphoma, favoring DLBCL. There were no pathologic cells in lumber puncture investigation. Management and outcome He was diagnosed with secondary hemaphagocytic syndrome due to DLBCL, and chemotherapy was switched to rituximab, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin (R-EPOCH) regimen. After three cycles of R-EPOCH chemotherapy regimen, complete remission was confirmed with positron emission tomography-computerised tomography (PET-CT) scan. Discussion Our patients’ findings are suitable for six out of eight criteria of hemaphagocytic syndrome. The H-score of our patient was more than 250, reflecting the >99% probability of HLH syndrome. Compatible with literature knowledge, our patient had responded very well to etoposide-containing regimens. In our patient, no lymphadenopathy was detected by physical examination or MR scan, and the diagnosis of DLBCL was only made by the result of bone marrow investigation. In conclusion, herein, we have reported a DLBCL case that had presented with HLH, and clinicians should be aware that B-cell lymphomas may be the underlying cause of HLH.
Is consent causing confusion for clinicians? A survey of child and adolescent Mental health professional’s confidence in using Parental Consent, Gillick Competence and the Mental Capacity Act
Authors: Fenton Clare 
Published: June 2020

All professionals engaged in clinical work should be competent to assess consent for the interventions they provide. This study assesses CAMHS clinicians confidence and knowledge in the various forms of consent and the number of minors admitted to mental health units in England under parental consent alone. An online questionnaire using vignettes of possible scenarios was sent to child and adolescent mental health practitioners in Tees Esk and Wear Valleys Trust. A freedom of information request was used to determine the number of young people admitted through parental consent. Thirteen of the 20 trusts contacted had no knowledge of the number of young people admitted under parental consent. A total of 93 participants completed the survey. Out of six vignettes, there were two where the majority of responses were discordant with current legal advice. Both of these vignettes considered the use of parental consent for admission to a mental health unit. This study provides further evidence to indicate that the current consent processes in CAMHS causes confusion for clinicians. There continues to be very few safeguards for children admitted under parental consent, with most trusts in England and Wales having no centralised knowledge of whether this is occurring and the numbers involved if it is.
Antiphospholipid antibodies in patients with dysglycaemia: A neglected cardiovascular risk factor?
Authors: Ferrannini Giulia , Svenungsson Elisabet , Kjellström Barbro , Elvin Kerstin , Grosso Giorgia , Näsman Per , Rydén Lars , Norhammar Anna 
Published: June 2020

Background:Cardiovascular disease is a serious complication in patients with dysglycaemia, defined as either type 2 diabetes or impaired glucose tolerance. Research focusing on the identification of potential markers for atherothrombotic disease in these subjects is warranted. The antiphospholipid syndrome is a common acquired prothrombotic condition, defined by a combination of thrombotic events and/or obstetric morbidity and positivity of specific antiphospholipid antibodies. Available information on antiphospholipid antibodies in dysglycaemia is scarce.Objective:This study investigates the association between antiphospholipid antibodies and dysglycaemia.Patients/Methods:The PAROKRANK (periodontitis and its relation to coronary artery disease) study included 805 patients, investigated 6–10 weeks after a first myocardial infarction, and 805 matched controls. Participants without known diabetes (91%) underwent an oral glucose tolerance test. Associations between antiphospholipid antibodies (anti-cardiolipin and anti-β2 glycoprotein-I IgG, IgM and IgA) and dysglycaemia were analysed.Results:In total, 137 (9%) subjects had previously known type 2 diabetes and 371 (23%) newly diagnosed dysglycaemia. Compared with the normoglycaemic participants, those with dysglycaemia had a higher proportion with first myocardial infarction (61% vs 45%, p < 0.0001) and were more often antiphospholipid antibody IgG positive (8% vs 5%; p = 0.013). HbA1c, fasting glucose and 2-h glucose were significantly associated to antiphospholipid antibody IgG. Odds ratios (ORs) were 1.04 (95% confidence interval [CI] 1.02–1.06), 1.14 (95% CI 1.00 – 1.27) and 1.12 (95% CI 1.04 – 1.21), respectively, after adjustments for age, gender and smoking.Conclusions:This study reports an association between antiphospholipid antibody IgG positivity and dysglycaemia. Further studies are needed to verify these findings and to investigate if antithrombotic therapy reduces vascular complications in antiphospholipid antibody positive subjects with dysglycaemia.
p64 flow diverter: Results in 108 patients from a single center
Authors: De Beule Tom , Boulanger T , Heye S , van Rooij WJ , van Zwam WH , Stockx L 
Published: June 2020

Background and purpose Flow diverters are increasingly used to treat intracranial aneurysms. We report the safety and efficacy of the p64 flow diverter, a resheathable and detachable device for intracranial aneurysms. Materials and methods We retrospectively reviewed 108 patients with 109 aneurysms treated with the p64 between March 2014 and July 2019. There were 87 women and 21 men, mean age 57 years. Of 109 aneurysms, 74 were discovered incidentally, 12 were symptomatic, 18 were previously treated, and five were ruptured dissection aneurysms. A total of 10 aneurysms were located in the posterior circulation. The mean aneurysm or remnant size was 8.1 mm. Results Hemorrhage by perforation with the distal guidewire occurred in two patients with permanent neurological deficits in one. In one patient, acute in-stent occlusion caused infarction with a permanent deficit. Permanent morbidity was 1.9% (2 of 108, 95%CI 0.1–6.9%); there was no mortality. During follow-up, three in-stent occlusions occurred, all asymptomatic. There were no delayed hemorrhagic complications. At six months, 77 of 96 aneurysms (80.2%) were completely occluded, and at last follow-up, this increased to 93 of 96 aneurysms (96.9%). In-stent stenosis at any degree occurred in 11 patients, progressing to asymptomatic complete occlusion in one. In the other patients, stenosis resolved or improved at further follow-up. Conclusion The p64 offers an effective and safe treatment option. Aneurysm occlusion rate was 97% at last follow-up, mostly achieved with a single device. There were no delayed hemorrhagic complications. Delayed in-stent stenosis infrequently progresses to occlusion but remains a matter of concern.
National temporal trends and determinants of cost of abdominal aortic aneurysm repair
Authors: Jayarajan Senthil Nathan , Vlada Claudiu Adrian , Sanchez Luis Arturo , Jim Jeffrey 
Published: June 2020

Introduction In recent decades, there has been a shift in the management of aortic abdominal aneurysm from open intervention (open aortic aneurysm repair) to an endovascular approach (endovascular aortic aneurysm repair). This shift has yielded clinical as well as socioeconomic reverberations. In our current study, we aim to analyze these effects brought about by the switch to endovascular treatment and to scrutinize the determinants of cost variations between the two treatment modalities. Methods The National (Nationwide) Inpatient Sample database was queried for clinical data ranging from 2001 to 2013 using International Classification of Disease, 9th Revision (ICD-9) codes for open and endovascular aortic repair. Clinical parameters and financial data related to the two treatment modalities were analyzed. Temporal trends of index hospitalization costs were determined. Multivariate linear regression was used to characterize determinants of cost for endovascular aneurysm repair and open abdominal aortic aneurysm repair. Results A total of 128,154 aortic repairs were captured in our analysis, including 62,871 open repairs and 65,283 endovascular repairs. Over the assessed time period, there has been a decrease in the cost of elective endovascular aortic aneurysm repair from $34,975.62 to $31,384.90, a $3,590.72 difference ( p < 0.01), while the cost of open aortic repair has increased from $37,427.77 to $43,640.79 by 2013, a $6,212.79 increase ( p < 0.01). The cost of open aortic aneurysm repair disproportionately increased at urban teaching hospitals, where by 2013, it costs $50,205.59, compared to $34,676.46 at urban nonteaching hospitals, and $34,696.97 at rural institutions. Urban teaching hospitals were found to perform an increasing proportion of complex open aneurysm repairs, involving concomitant renal and visceral bypass procedures. On multivariate analysis, strong determinants of cost increase for both endovascular aortic aneurysm repair and open aortic aneurysm repair are rupture status, prolonged length of stay, occurrence of complications, and the need for disposition to a nursing facility or another acute care institution. Conclusion As the vascular community has shifted from an open repair of abdominal aortic aneurysm to an endovascular approach, a number of unforeseen clinical and economic effects were noted. We have characterized these ramifications to help guide further clinical decision and resource allocation.
Introduction of a specialized consultation prior to insertion of totally implantable access venous devices: Impact on cancellation rate and patient satisfaction
Authors: Colucci Nicola , Gregoris Adrien , Meyer Jeremy , Naiken Surennaidoo Perumal , Staszewicz Wojciech , Gialamas Eleftherios , Toso Christian , Abbassi Ziad 
Published: June 2020

Objectives Preoperative consultation is usually not performed before insertion of a totally implantable venous access device (TIVAD). In our experience, an incomplete preoperative assessment, a predictable medical condition contraindicating surgery, or no-show patients the day of surgery led to several surgery cancellations. Therefore, we introduced a specific preoperative surgical consultation for TIVAD that took place shortly before surgery. The aim of the present study is to evaluate the patients’ satisfaction and to establish the rate of cancellation after the adoption of this strategy. Methods Two-hundred and four patients who benefited from the preoperative consultation before TIVAD insertion from August 2014 to August 2016 were included. Satisfaction of patients and cancellation rate were documented. Results With that strategy, no TIVAD insertion was either delayed or cancelled. The overall level of satisfaction was high (91.8%); 184 patients (90.2%) judged the consultation useful in preparation for the surgery. The surgical procedure met their expectations in 92.2% of cases. Patients known for a psychiatric comorbidity were more likely to express dissatisfaction. Conclusions The introduction of a specific preoperative surgical consultation for TIVAD insertion led to a high level of patients’ satisfaction. After the preoperative consultation, no cancellation was recorded. Special approaches have to be considered for patients with a psychiatric comorbidity.