bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental Health Stigma and Wellbeing Among Commercial Construction Workers
Authors: Eyllon Mara , Vallas Steven P. , Dennerlein Jack T. , Garverich Suzanne , Weinstein Daniel , Owens Kathleen , Lincoln Alisa K. 
Published: June 2020

Objective:
The aim of this study was to understand the relationship between mental health stigma and wellbeing in a sample of commercial construction workers.

Methods:
A sequential quantitative to qualitative mixed methods study was conducted. First, 264 workers were surveyed and logistic regression examined the associations between mental health stigma and psychological distress, substance abuse, and sleep; then, data from eight key informant interviews and six focus groups with workers were analyzed thematically.

Results:
Stigma was significantly associated with psychological distress and impaired sleep, but not with substance abuse. Key informants and workers discussed the prominence of stigma on worksites and how the masculine culture of the industry and job insecurity contributed to stigma.

Conclusion:
Stigma poses a barrier to addressing mental health among workers; peer support and improved human resources may be promising.
Surgical treatment of non-functioning pancreatic neuroendocrine tumors: current controversies and challenges
Authors: Memeh Kelvin O. , Vaghaiwalla Tanaz , Keutgen Xavier M. 
Published: June 2020

Abstract
There has been a rising trend in the incidence and prevalence of non-functioning pancreatic neuroendocrine tumors (NFPanNETs). While a significant number of the newly diagnosed NFPanNETs are asymptomatic, a majority of patients will present with liver metastasis (LM) at the time of diagnosis. Surgical resection remains the only curative treatment, especially for localized NFPanNETs. While a majority of small NFPanNETs are indolent, some are not. This heterogeneity in tumor biology presents the surgeon with the unique challenge of determining which patient will benefit from surgery, given the morbidity of pancreatic surgery. There has been a recent push for a more aggressive approach to the care of these patients, given the emergence of data supporting such measures. However, the risk of over or under treatment has generated immense debate amongst experts in the field. The heterogeneity of current practice guidelines and institutional practices around the world is a reflection of the disparate opinion on the management of NFPanNET. In this review, we set out to examine the evidence regarding some of the most controversial and challenging aspects of the surgical treatment of NFPanNET. We evaluate the following questions; should patients with small NFPanNETs ≤ 2 cm in size be resected; should patients with metastatic NFPanNETs undergo surgical debulking, and should there be resection of the primary tumor in the setting of non-resectable metastatic disease?
Although there are currently no Level 1 data to answer these questions conclusively, we believe that the current literature supports a more aggressive approach to the management of NFPanNET.
Efficacy of Ankle Supports on Dynamic Postural Control in Patients with Chronic Ankle Instability
Authors: Hassanpour Samira , Daryabor Aliyeh , Jamshidi Aliashraf , Rezaei Mehdi 
Published: June 2020

ABSTRACT

Introduction
The chronic ankle instability (CAI) that results from a lateral ankle sprain causes balance deficits during quiet standing. Dynamic postural control in patients with CAI can be improved using soft and semirigid braces.

Objective
This study was aimed at investigating the effects of soft and semirigid ankle supports on dynamic postural stability in subjects with CAI.

Materials and Methods
Fifteen subjects with unilateral CAI as the CAI group and 15 healthy control subjects as the control group were recruited for participation in the study. Stability indexes (SIs), including overall SI, anteroposterior SI, and mediolateral SI, were determined using the Biodex Balance System (BBS), and lower-limb reach was ascertained using the Star Excursion Balance Test (SEBT). These indicators were measured under three conditions: without orthosis, with soft orthosis, and with semirigid orthosis.

Results
Significant differences in overall SI were found between the affected and healthy feet of the CAI group (P = 0.009) and between the affected feet of the CAI group and the healthy feet of the control group (P = 0.031). The SEBT revealed significant differences between the injured and uninjured sides of the CAI group in the anterior, anterior-medial, and anterior-lateral directions. With the use of soft ankle supports, no significant differences were found between the affected and unaffected limbs of the CAI group in the overall and mediolateral SIs of BBS test and the anterior-medial (P = 0.057) and anterior-lateral (P = 0.07) directions of SEBT.

Conclusions
The soft ankle support has more effect on the balance of the CAI patients in comparison with the semirigid orthosis.
Prevalence and determinants of masked hypertension among obese individuals at the Yaoundé Central Hospital: a cross-sectional study in sub-Saharan Africa
Authors: Hamadou Bâ , Amougou Sylvie Ndongo , Tchuendem Yolande , Nganou-Gnindjio Chris Nadège , Mfeukeu-Kuate Liliane , Foka Audrey Joyce , Tankeu Aurel T. , Jingi Ahmadou Musa , Menanga Alain Patrick , Kingue Samuel 
Published: June 2020

Objectives
The aim of this study was to investigate the prevalence and associated factors of masked hypertension in obese patients in Yaounde.

Methods
We carried out a cross-sectional study from January to September 2017 at the National Obesity Center of the Yaounde Central Hospital. Masked hypertension was defined when the mean 24 h SBP was greater than or equal to 130 mmHg and/or the mean 24 h DBP was greater than or equal to 80 mmHg with normal office blood pressure (SBP/DBP) <140/90 mmHg. Logistic regression was used to examine the relationship of masked hypertension with associated factors.

Results
Among the 90 participants included, 67.8% were females. The mean age (±SD) was 46 (±8) years. The mean clinical measurements were 120 ± 9.4 mmHg and 75.5 ± 7.9 mmHg, respectively, for the SBP and the DBP. On 24 h ambulatory measurement, the mean was 123.9 ± 14.4/74.7 ± 8.9 mmHg, respectively, for the SBP/DBP. The prevalence of masked hypertension was 33.3%. Masked hypertension was significantly associated with high-normal office blood pressure [odds ratio (OR) = 2.90, P = 0.02] and to dyslipidemia (OR = 3.60, P = 0.01), but not to the male sex, diabetes, physical activity, and tobacco/alcohol.

Conclusion
Our findings suggest that the prevalence of masked hypertension is high and that physicians should consider ambulatory blood pressure monitoring for obese individuals with high-normal office blood pressure or dyslipidemia.
Dynamics of liver stiffness-based risk prediction model during antiviral therapy in patients with chronic hepatitis B
Authors: Chon Hye Yeon , Seo Yeon Seok , Lee Jung il , Kim Byung Seok , Jang Byoung Kuk , Kim Sang Gyune , Suk Ki Tae , Kim In Hee , Lee Jin-Woo , Chon Young Eun , Kim Moon Young , Jeong Soung Won , Lee Han Ah , Yim Sun Young , Um Soon Ho , Lee Hyun Woong , Lee Kwan Sik , Song Jeong Eun , Lee Chang Hyeong , Chung Woo Jin , Hwang Jae Seok , Yoo Jeong-Ju , Kim Young Seok , Kim Dong Joon , Lee Chang Hun , Yu Jung Hwan , Ha Yeon Jung , Kim Mi Na , Lee Joo Ho , Hwang Seong Gyu , Kang Seong Hee , Baik Soon Koo , Jang Jae Young , Suh Sang Jun , Jung Young Kul , Kim Beom Kyung , Park Jun Yong , Kim Do Young , Ahn Sang Hoon , Han Kwang-Hyub , Yim Hyung Joon , Kim Seung Up 
Published: June 2020

Objective
The liver stiffness-based risk prediction models predict hepatocellular carcinoma (HCC) development. We investigated the influence of antiviral therapy (AVT) on liver stiffness-based risk prediction model in patients with chronic hepatitis B (CHB).

Methods
Patients with CHB who initiated AVT were retrospectively recruited from 13 referral Korean institutes. The modified risk estimation for hepatocellular carcinoma in chronic hepatitis B (mREACH-B) model was selected for the analysis.

Results
Between 2007 and 2015, 1034 patients with CHB were recruited. The mean age of the study population (639 men and 395 women) was 46.8 years. During AVT, the mREACH-B score significantly decreased from the baseline to 3 years of AVT (mean 9.21 → 7.46, P < 0.05) and was maintained until 5 years of AVT (mean 7.23, P > 0.05). The proportion of high-risk patients (mREACH-B score ≥11) was significantly reduced from the baseline to 2 years of AVT (36.4% → 16.4%, P < 0.001) and was maintained until 5 years of AVT (12.2%, P > 0.05). The mREACH-B scores at baseline and 1 year of AVT independently predicted HCC development (hazard ratio = 1.209–1.224) (all P < 0.05). The cumulative incidence rate of HCC was significantly different at 5 years of AVT among risk groups (high vs. high-intermediate vs. low-intermediate vs. low) from baseline (4.5% vs. 3.2% vs. 1.5% vs. 0.8%) and 1 year (11.8% vs. 4.6% vs. 1.8% vs. 0.6%) (all P < 0.05, log-rank tests).

Conclusions
The mREACH-B score was dynamically changed during AVT. Thus, repeated assessment of the mREACH-B score is required to predict the changing risk of HCC development in patients with CHB undergoing AVT.
Analysis of risk factors for gallbladder polyp formation – A retrospective study based on serial ultrasounds
Authors: Yao Guibin , Bai Xuesong , Yang Changlin , Liu Liwei , Zhou Zhen , Huang Yue , Zheng Yamin 
Published: June 2020

Aim
To evaluate gallbladder polyp (GBP) formation related risk factors based on serial ultrasounds (US).

Methods
Risk factors related GBP formation were retrospectively investigated among participants, who had US reexamination and interval >180 days in 5 years. After groups were divided based on US, we compared final data and initial data in GBP new incidence group. Then compared the data in GBP new incidence group and GBP(−) group.

Results
Overall 20 447 participants were recruited, including 18 243 in GBP (−) group and 2204 in GBP group. The mean diameters of polyps were 0.455 ± 0.198 mm in initial and 0.420 ± 0.180 mm in final examination. GBP new incidence group included 797 participants. Percentage of GBP new incidence participants was higher than GBP resolved (36.16% vs. 11.71%). Participants in middle age were more likely have GBP size increase or new incidence, and participants in old age (≥60 years old) were with GBP size decrease or resolved. In GBP new incidence group, participants in final US showed higher FBG, higher LDL, lower HDL, higher ALT and higher AST than initial US. Compared with GBP (−) group and, same risk factors, in addition with age, were shown in GBP new incidence group, Logistic regression analysis show that higher LDL, lower HDL and higher AST were risk factors for GBP formation.

Conclusion
Participants in middle age were more likely to have GBP new incidence. Higher LDL, lower HDL and higher AST were independently risk factors for GBP formation.
A Multimodal Approach for the First-Line Treatment of Infected Pancreatic Necrosis
Authors: Ocampo Carlos , Zandalazini Hugo , Alonso Facundo , Canullan Carlos , Stagnaro Gabriel , Leyton Vanina , Chiappetta Luis 
Published: June 2020

Objectives
Because infected pancreatic necrosis (IPN) has multiple presentations, not all patients are likely to benefit from the same first-line treatment. Our objective was to evaluate morbidity and mortality in a series of patients treated with a multimodal therapeutic approach.

Methods
Between May 2012 and May 2019, 51 patients diagnosed with IPN were treated. The 5 initial treatment alternatives were as follows: percutaneous drainage, minimally invasive necrosectomy, antibiotics alone, transgastric necrosectomy, and temporizing percutaneous/endoscopic drainage. Initial treatment selection depended on evolution, clinical condition, and extension of pancreatic necrosis. Success, morbidity, and mortality rates were determined.

Results
In terms of determinant-based classification, 37 were classified as severe, and 14 as critical. Percutaneous, temporizing drainage, minimally invasive necrosectomy, antibiotics alone and transgastric necrosectomy approaches were used in 21, 10, 11, 4, and 5 patients, respectively. Necrosectomy was not required in 18 patients (35%). There were no significant differences in mortality among the different treatment approaches (P < 0.45). Overall success, morbidity, and mortality rates were 68.6%, 52.9%, and 7.8%, respectively.

Conclusions
The multimodal approach seems to be a rational and efficient strategy for the initial treatment of IPN.
Alterations in Enteroendocrine Hormones After Total Pancreatectomy With Islet Autotransplantation
Authors: McEachron Kendall R. , Yang Yi , Hodges James S. , Beilman Gregory J. , Pruett Timothy L. , Kirchner Varvara A. , Dunn Ty B. , Freeman Martin L. , Trikudanathan Guru , Mulier Kristine E. , Ptacek Peggy , Bellin Melena D. 
Published: June 2020

Objective
When total pancreatectomy with islet autotransplantation (TPIAT) is performed for chronic pancreatitis, the pancreas and most of the duodenum are removed, with Roux-en-Y reconstruction of the gastrointestinal tract. Enteroendocrine cells in the intestines and pancreas secrete hormones coordinating digestion and motility, but anatomic reconstruction alters transit of nutrients to these cells. We hypothesized that TPIAT leads to changes in enteroendocrine hormones.

Methods
Glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and pancreatic polypeptide (PP) were measured from mixed-meal tolerance tests of 34 clinical trial participants before and 18 months after TPIAT. Area under the curve of GLP-1 and PYY-stimulated responses were calculated by trapezoidal method, and the PP response was measured as the stimulated max minus baseline (ΔPP).

Results
Area under the curve of GLP-1 and PYY increased significantly after TPIAT (GLP-1 average +553.1 pg/mL per minute, P = 0.004; PYY average +4647.9 pg/mL per minute, P = 0.02). ΔPP trended toward lower after TPIAT (average, −52.2 pg/mL, P = 0.06).

Conclusions
In this novel study of enteroendocrine hormones in TPIAT patients, stimulated levels of GLP-1 and PYY were significantly higher after versus before TPIAT. ΔPP was lower after TPIAT, but not significantly. These hormone changes have potential clinical implications that warrant further research.
Characterization of Esophageal Motility in Children With Operated Esophageal Atresia Using High‐resolution Impedance Manometry and Pressure Flow Analysis
Authors: Courbette Olivier , Omari Taher , Aspirot Ann , Faure Christophe 
Published: June 2020

ABSTRACTObjectives:Esophageal dysmotility is common in patients with esophageal atresia (EA). High‐resolution impedance manometry and pressure flow analysis (PFA) allow characterization of biomechanical events that drive bolus flow. The aims were to assess esophageal motility in children with EA, using PFA, and to test whether there is a correlation between PFA parameters and symptoms or endoscopic/histologic findings.Methods:High‐resolution impedance manometry was performed in 16 children with EA (median age 11 years), compared with 13 patient controls (median age 14 years; P = NS vs patients). Wet swallows were analyzed using PFA. Medical charts were reviewed for symptoms and pathology results of the attendant esophagoscopy. Patients with EA were arbitrarily subgrouped according to their motility pattern: group A with presence of distal contraction in ≥50% of the swallows and group B with presence of distal contractions in <50% of the swallows.Results:Esophageal peristaltic motor patterns were abnormal in all patients with EA. Bolus transport was impaired as shown by the higher impedance ratio in EA than in controls (0.47 vs 0.22; P < 0.001). Impedance ratio was also higher in group B (n = 8) versus group A (n = 8) (P < 0.001). Symptoms of dysphagia were not correlated with the PFA measures. Contractile segment impedance, a marker of mucosal integrity, was significantly lower in the EA group.Conclusions:Bolus transport was severely altered in patients with EA but was not predictive of symptoms. The presence of residual distal contractions is associated with a more efficient bolus propulsion.
Who's at Risk? A Prognostic Model for Severity Prediction in Pediatric Acute Pancreatitis
Authors: Farrell Peter R. , Hornung Lindsey , Farmer Peter , DesPain Angelica W. , Kim Esther , Pearman Ryan , Neway Beemnet , Serrette Ashley , Sehgal Sona , Heubi James E. , Lin Tom K. , Nathan Jaimie D. , Vitale David S. , Abu‐El‐Haija Maisam 
Published: June 2020

ABSTRACTObjectives:The aim of the study was to validate and optimize a severity prediction model for acute pancreatitis (AP) and to examine blood urea nitrogen (BUN) level changes from admission as a severity predictor.Study Design:Patients from 2 hospitals were included for the validation model (Children's Hospital of the King's Daughters and Children's National Hospital). Children's Hospital of the King's Daughters and Cincinnati Children's Hospital Medical Center data were used for analysis of BUN at 24 to 48 hours.Results:The validation cohort included 73 patients; 22 (30%) with either severe or moderately severe AP, combined into the all severe AP (SAP) group. Patients with SAP had higher BUN (P = 0.002) and lower albumin (P = 0.005). Admission BUN was confirmed as a significant predictor (P = 0.005) of SAP (area under the receiver operating characteristic [AUROC] 0.73, 95% confidence interval [CI] 0.60–0.86). Combining BUN (P = 0.005) and albumin (P = 0.004) resulted in better prediction for SAP (AUROC 0.83, 95% CI 0.72–0.94). A total of 176 AP patients were analyzed at 24–48 hours; 39 (22%) met criteria for SAP. Patients who developed SAP had a significantly higher BUN (P < 0.001) after 24 hours. Elevated BUN levels within 24 to 48 hours were independently predictive of developing SAP (AUROC: 0.76, 95% CI: 0.66–0.85). Patients who developed SAP had a significantly smaller percentage decrease in BUN from admission to 24 to 48 hours (P = 0.002).Conclusion:We externally validated the prior model with admission BUN levels and further optimized it by incorporating albumin. We also found that persistent elevation of BUN is associated with development of SAP. Our model can be used to risk stratify patients with AP on admission and again at 24 to 48 hours.
Introducing Nurse-Led Patient Education Visits
Authors: Goodman Kassandra J. , Dougan Brian M. , Stevens Dawn M. , Smith Jessica R. , Mikhail Michael A. , Majka Andrew J. 
Published: June 2020

Background:
The literature includes multiple descriptions of successful nurse-led interventions, but the effects of nurse-led education on nurse and patient satisfaction in an executive health program are unknown.

Local Problem:
Nursing staff desire to practice more fully within their scope of licensure. Increased practice demands raised questions about whether nurse-led education would improve staff and patient satisfaction.

Methods/Interventions:
A structured quality improvement process was used to design a nurse-led patient education program. Pilot measures included 5-point Likert scale patient and staff satisfaction surveys. Nurse burnout was also measured before and after the pilot.

Results:
Patient satisfaction was high; 96% reported favorable satisfaction during the pilot, with sustained results over the following 3 years. Nurses' sense of achievement improved by 12 percentage points, and perception of making good use of skills and abilities increased by 39 percentage points.

Conclusions:
A nurse-led patient education intervention contributed to improved staff satisfaction while sustaining a positive patient experience.
Distorted Time Perspective in Adolescent Afghan and Syrian Refugees Is Associated With Psychological Distress
Authors: Walg Marco , Eder Lara L. , Martin Alexandra , Hapfelmeier Gerhard 
Published: June 2020

Abstract
Young refugees are a high-risk group for mental disorders, particularly for posttraumatic stress disorder (PTSD). Individuals with PTSD suffer from an altered time perspective with a focus on negative experiences in the past and a disregard for positive life events and the future. This study investigates time perspectives and psychological distress in 30 adolescent refugees from Syria and Afghanistan in Germany. Time perspective was assessed using the Zimbardo Time Perspective Inventory. The refugees exhibited a distorted time perspective that is common for individuals with PTSD: a high orientation toward the negative past and a low orientation toward the positive past and future. A high orientation toward the negative past was associated with high levels of general psychological distress, PTSD symptoms, and depression. A low orientation toward the future was related to high levels of anxiety. Taking time perspective and corresponding beliefs into consideration may be advantageous when treating refugees with trauma-related disorders.
Clinical Demonstration of the Potential of Parental Feedback in Reducing Deterioration During Group Psychotherapy With Children
Authors: Tzur Bitan Dana , Zilcha-Mano Sigal , Asper Ariel , Bloch Yuval 
Published: June 2020

Abstract
In recent years, great efforts have been exerted to minimize the rates of deterioration in clinical practice, especially in child psychotherapy. The present study explored the potential effect of routine outcome monitoring (ROM) with parents as a preventive intervention to reduce deterioration in children. Twenty-five children receiving treatment for emotional problems were randomized to parent-based, ROM-assisted group psychotherapy or to treatment as usual (TAU). A mixed-methods approach was utilized, with the number of deteriorating cases compared at the group level and two case illustrations assessed at the individual level. At the group level, there were fewer cases of deterioration in child's anxiety, parental stress, and quality of parent's alliance in the ROM-assisted group, compared with TAU. Case studies illustrated how ROM can be used as a tool to communicate with parents to prevent deterioration. Routine outcome monitoring in child psychotherapy may thus benefit therapy process and outcome. Limitations and directions for future research are discussed.
Homicide-Suicide
Authors: Loughney Elizabeth , Kemp Walter L. 
Published: June 2020

Abstract
Strangulation is commonly associated with certain findings at autopsy, including petechial hemorrhages in the conjunctiva and oral mucosa, contusions or abrasions of the neck, hemorrhage within the anterior and posterior neck musculature, and fractures of the hyoid bone or thyroid cartilage. We present the case of a 68-year-old woman who was found dead in her bedroom, with her husband being found dead in the garage. Her husband had shot himself, and the woman, who was lying partially on her side, had blood coming from her ear that was facing upward and was, at the scene, also believed to have been shot. Autopsy revealed no gunshot wound, but instead florid petechial hemorrhages of the face and conjunctivae, a few contusions of the left and right sides of the neck, a laceration of the lower lip, oral mucosal petechiae, focal hemorrhage in the soft tissue around the hyoid bone, and focal hemorrhages in the left and right sternohyoid muscle. The tongue had multiple contusions. Her cause of death was certified as homicidal asphyxiation, including probable strangulation. Extensive contusions of the tongue are not routine findings with strangulation but occur in about 25% of cases, especially those involving the elderly, and hemorrhage from the ear is rarely reported. This case illustrates uncommon and rare autopsy findings for strangulation, which under the right circumstances, deceived investigators into thinking that a gunshot wound had occurred.