bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arterial diameter following arteriovenous fistula creation predicts aneurysm progression
Authors: Cahalane Alexis M , Sahani Vivek G , Irani Zubin , Cui Jie 
Published: January 2021

Objective: To investigate the relationship between arteriovenous fistula (AVF) arterial diameter (AD) and AVF aneurysm development and progression. Methods: This study identified all patients who underwent fistulograms which demonstrated AVF aneurysms meeting criteria and requiring surgical intervention between 01/01/2014 and 7/30/2016. Patient demographics were collected and AVF dimensions were measured on fistulograms. A control group with nonaneurysmal AVFs who had undergone serial fistulograms between 2013 and 2016 were identified and identical datasets collected. Statistical analysis was performed with STATA 14.0 using student’s t-test, Chi square tests and linear regression. Results: 45 eligible patients were identified in the AVF aneurysm study group and 24 in the control group, with the mean age of AVF creation being older in the control group (61.8 vs 53 years, p = 0.03). The mean interval between AVF creation and first fistulogram in the study group was 1464 ± 282 days, compared to an interval of 263 ± 101 days in the control group ( p = 0.003). The AD on the first fistulogram in those study group patients with aneurysms evident on first fistulogram was greater than in the control group (6.5±1.8 mm vs 5.0 ± 1.8 mm, p = 0.003). The AD on first fistulogram of the study group predicted maximum aneurysm diameter on last fistulogram ( r = 0.6, p = 0.03) as well as the interval between first fistulogram and surgical revision ( r = −0.33, p = 0.03). Conclusion: AVF aneurysms are a later complication in access natural history and AD may help to predict their progression.
Determinants of therapeutic lag in multiple sclerosis
Authors: Roos Izanne , Leray Emmanuelle , Frascoli Federico , Casey Romain , Brown J William L , Horakova Dana , Havrdova Eva Kubala , Debouverie Marc , Trojano Maria , Patti Francesco , Izquierdo Guillermo , Eichau Sara , Edan Gilles , Prat Alexandre , Girard Marc , Duquette Pierre , Onofrj Marco , Lugaresi Alessandra , Grammond Pierre , Ciron Jonathan , Ruet Aurélie , Ozakbas Serkan , De Seze Jérôme , Louapre Céline , Zephir Hélène , Sá Maria José , Sola Patrizia , Ferraro Diana , Labauge Pierre , Defer Gilles , Bergamaschi Roberto , Lebrun-Frenay Christine , Boz Cavit , Cartechini Elisabetta , Moreau Thibault , Laplaud David , Lechner-Scott Jeannette , Grand’Maison Francois , Gerlach Oliver , Terzi Murat , Granella Franco , Alroughani Raed , Iuliano Gerardo , Van Pesch Vincent , Van Wijmeersch Bart , Spitaleri Daniele LA , Soysal Aysun , Berger Eric , Prevost Julie , Aguera-Morales Eduardo , McCombe Pamela , Castillo Triviño Tamara , Clavelou Pierre , Pelletier Jean , Turkoglu Recai , Stankoff Bruno , Gout Olivier , Thouvenot Eric , Heinzlef Olivier , Sidhom Youssef , Gouider Riadh , Csepany Tunde , Bourre Bertrand , Al Khedr Abdullatif , Casez Olivier , Cabre Philippe , Montcuquet Alexis , Wahab Abir , Camdessanche Jean-Philippe , Maurousset Aude , Patry Ivania , Hankiewicz Karolina , Pottier Corinne , Maubeuge Nicolas , Labeyrie Céline , Nifle Chantal , Coles Alasdair , Malpas Charles B , Vukusic Sandra , Butzkueven Helmut , Kalincik Tomas 
Published: January 2021

Background: A delayed onset of treatment effect, termed therapeutic lag, may influence the assessment of treatment response in some patient subgroups. Objectives: The objective of this study is to explore the associations of patient and disease characteristics with therapeutic lag on relapses and disability accumulation. Methods: Data from MSBase, a multinational multiple sclerosis (MS) registry, and OFSEP, the French MS registry, were used. Patients diagnosed with MS, minimum 1 year of exposure to MS treatment and 3 years of pre-treatment follow-up, were included in the analysis. Studied outcomes were incidence of relapses and disability accumulation. Therapeutic lag was calculated using an objective, validated method in subgroups stratified by patient and disease characteristics. Therapeutic lag under specific circumstances was then estimated in subgroups defined by combinations of clinical and demographic determinants. Results: High baseline disability scores, annualised relapse rate (ARR) ⩾ 1 and male sex were associated with longer therapeutic lag on disability progression in sufficiently populated groups: females with expanded disability status scale (EDSS) < 6 and ARR < 1 had mean lag of 26.6 weeks (95% CI = 18.2–34.9), males with EDSS < 6 and ARR < 1 31.0 weeks (95% CI = 25.3–36.8), females with EDSS < 6 and ARR ⩾ 1 44.8 weeks (95% CI = 24.5–65.1), and females with EDSS ⩾ 6 and ARR < 1 54.3 weeks (95% CI = 47.2–61.5). Conclusions: Pre-treatment EDSS and ARR are the most important determinants of therapeutic lag.
User involvement in interprofessional team meetings within services for substance use disorders
Authors: Wenaas Merethe , Andersson Helle Wessel , Kiik Riina , Juberg Anne 
Published: January 2021

Background: People with substance use disorders (SUD) and concurrent mental health disorders often need prolonged, coordinated health and welfare services. Interprofessional team meetings are designed to tailor services to users’ needs and should be based on interprofessional collaboration involving the user. Aims: To investigate service users’ experiences with interprofessional team meetings and to identify potential barriers to successful user involvement. Methods: Semi-structured interviews with five male service users aged 27–36 years with concurrent substance use and psychiatric disorders, and observations of team meetings involving both users and relevant professionals. Users were interviewed shortly after commencing treatment and after the team meeting. A phenomenographical approach framed the data analysis. Results: Users described the interprofessional team meetings as less than useful, and perceived that lack of a targeted process and of information hindered their collaboration with professionals. Observations revealed that users were given a subordinate role in the meetings, which largely undermined their involvement. Three categories reflecting lack of information as a core obstacle to user involvement emerged from the data material: (i) unclear role responsibilities and unclear professional role functions, (ii) unclear practices regarding rules and routines, and (iii) absence of user knowledge. Conclusions: User involvement in team meetings may be improved by facilitating adequate information, clarifying role expectations, emphasising user knowledge, increasing professionals’ awareness of the importance of collaboration, and by teaching skills that enhance user involvement.
Dynamic Effects of CAM Techniques on Inflammation and Emotional States: An Integrative Single-Case Study on a Breast Cancer Survivor
Authors: Schubert Christian , Ott Michaela , Hannemann Julian , Singer Magdalena , Bliem Harald R. , Fritzsche Kurt , Burbaum Christina , Chamson Emil , Fuchs Dietmar 
Published: January 2021

Background: This study on a breast cancer survivor investigated how episodic practice of various complementary and alternative medicine (CAM) techniques affected the dynamics of emotional states and urinary neopterin—an inflammation marker. Methods: The 49-year-old female patient (diagnosis: ductal breast carcinoma 5 years before study start, suffering from chronic fatigue and depression) collected her entire urine in 12-hour intervals (from about 8 a.m. to 8 p.m. and from about 8 p.m. to 8 a.m.) for 28 days. The resulting 55 consecutive urine samples were analyzed for neopterin and creatinine levels using HPLC. Also in 12-hour intervals, the patient filled out questionnaires on emotional states and everyday routine, including CAM practice. Weekly, she was interviewed to identify emotionally meaningful everyday incidents, including use of CAM techniques. Time series analysis consisted of ARIMA modeling and cross-correlational analyses. Results: Qualitative evaluation revealed that, with the exception of Tai Chi, all CAM techniques, that is, Jin Shin Jyutsu, music, physiotherapy and energy healing, were experienced as positive. Cross-correlational analyses showed that practice of such CAM techniques was followed first by significant ( P < .05) increases in positive mood and mental activity on the same day (lag 0) and then by decreases in positive mood after a total of 72 to 84 hours (+lag 6) and in mental activity after a total of 84 to 96 hours (+lag 7). Negative mood, by contrast, first decreased on the day of CAM practice (lag 0) and then increased after a total of 84 to 96 hours (+lag 7) following CAM. Moreover, urinary neopterin levels first increased on the day of CAM practice (lag 0) and then decreased after a total of 36 to 48 hours (+lag 3). Similar biphasic effects were also detected for irritation in response to CAM, although only partly significant. Conclusion: Cyclic psychophysiological response patterns following CAM practice were attributable to biopsychosocial feedback mechanisms involving personally meaningful experiences. As lower neopterin levels following CAM point to a health-promoting effect, the patient of this study may have actively contributed to her healing process through episodic CAM practice.
The Effect of COVID-19 on Training and Case Volume of Vascular Surgery Trainees
Authors: Ilonzo Nicole , Koleilat Issam , Prakash Vivek , Charitable John , Garg Karan , Han Daniel , Faries Peter , Phair John 
Published: January 2021

Background: In many facilities, the coronavirus disease (COVID-19) pandemic caused suspension of elective surgery. We therefore sought to determine the impact of this on the surgical experience of vascular trainees. Methods: Surgical case volume, breadth, and the participating trainee post-graduate level from 3 large New York City Hospitals with integrated residency and fellowship programs (Mount Sinai, Montefiore Medical Center/Albert Einstein College of Medicine, and New York University) were reviewed. Procedures performed between February 26 to March 25, 2020 (pre-pandemic month) and March 26 to April 25, 2020 (peak pandemic period) were compared to those performed during the same time period in 2019. The trainees from these programs were also sent surveys to evaluate their subjective experience during this time. Results: The total number of cases during the month leading into the peak pandemic period was 635 cases in 2019 and 560 cases in 2020 (12% decrease). During the peak pandemic period, case volume decreased from 445 in 2019 to 114 in 2020 (74% reduction). The highest volume procedures during the peak pandemic month in 2020 were amputations and peripheral cases for acute limb ischemia; during the 2019 period, the most common cases were therapeutic endovascular procedures. There was a decrease in case volume for vascular senior residents of 77% and vascular junior and midlevel residents of 75%. There was a 77% survey response rate with 50% of respondents in the senior years of training. Overall, 20% of respondents expressed concern about completing ACGME requirements due to the COVID-19 pandemic. Conclusions: Vascular surgery-specific clinical educational and operative experiences during redeployment efforts have been limited. Further efforts should be directed to quantify the impact on training and to evaluate the efficacy of training supplements such as teleconferences and simulation.
COVID-19 Risk Perceptions and Social Distancing Practice in Latin America
Authors: Alicea-Planas Jessica , Trudeau Jennifer M. , Vásquez Mazariegos William F. 
Published: January 2021

Objectives: Many developing countries use social distancing as part of their mitigation strategy during epidemics. This study aimed to understand individual decisions to practice different social distancing measures in the immediate emergence of COVID-19. Study design: Utilizing social media advertising and snowball sampling, a web-based survey was administered in 16 Latin American countries. Methods: We estimated seemingly unrelated Probit models to identify factors associated with the decision to implement social distancing practices. Results: From 5,480 respondents, estimated marginal effects indicate that risk perceptions are positively related to distancing from friends or relatives and avoiding public places but do not seem to influence the decision to stay home. Results also indicate that risk perceptions are related to household income, the number of reported COVID-19 cases in the country, and perceived preparedness of the health care system. Conclusions: Our findings support the notion that people will follow social distancing measures if there is a clear understanding of risk. Providing the public ways to access accurate numbers of confirmed cases can inform perception of disease severity. Since household income was a determinant of practicing social distancing, without financial assistance, some will be forced to break regulations in order to procure food or resources for their survival.
Robotic Pneumonectomy for Lung Cancer: Perioperative Outcomes and Factors Leading to Conversion to Thoracotomy
Authors: Patton Byron D. , Zarif Daniel , Bahroloomi Donna M. , Sarmiento Iam C. , Lee Paul C. , Lazzaro Richard S. 
Published: January 2021

Objective In the tide of robot-assisted minimally invasive surgery, few cases of robot-assisted pneumonectomy exist in the literature. This study evaluates the perioperative outcomes and risk factors for conversion to thoracotomy with an initial robotic approach to pneumonectomy for lung cancer. Methods This study is a single-center retrospective review of all pneumonectomies for lung cancer with an initial robotic approach between 2015 and 2019. Patients were divided into 2 groups: surgeries completed robotically and surgeries converted to thoracotomy. Patient demographics, preoperative clinical data, surgical pathology, and perioperative outcomes were compared for meaningful differences between the groups. Results Thirteen total patients underwent robotic pneumonectomy with 8 of them completed robotically and 5 converted to thoracotomy. There were no significant differences in patient characteristics between the groups. The Robotic group had a shorter operative time ( P < 0.01) and less estimated blood loss ( P = 0.02). There were more lymph nodes harvested in the Robotic group ( P = 0.08) but without statistical significance. There were 2 major complications in the Robotic group and none in the Conversion group. Neither tumor size nor stage were predictive of conversion to thoracotomy. Conversions decreased over time with a majority occurring in the first 2 years. There were no conversions for bleeding and no mortalities. Conclusions Robotic pneumonectomy for lung cancer is a safe procedure and a reasonable alternative to thoracotomy. With meticulous technique, major bleeding can be avoided and most procedures can be completed robotically. Larger studies are needed to elucidate any advantages of a robotic versus open approach.
Development of the final version of the occupational adaptation questionnaire for family caregivers
Authors: Nagai Takashi , Ishii Yoshikazu , Kohiyama Kengo , Takenaka Takahiro , Yamada Takashi 
Published: January 2021

Background Given the growing role of family caregivers in meeting the increasing demand for ageing-related care in Japan, the occupational adaptation of family caregivers needs to be evaluated. Methods This study developed the Occupational Adaptation Questionnaire for Family Caregivers (OAQC) and evaluated its reliability, validity, and effectiveness. To develop the OAQC item pool, the construct ‘Occupation of nursing care engaged in by family caregivers’ was evaluated. Using the Delphi method, 8 experts evaluated 64 items and confirmed that 41 items adequately represented the domain. The scale was then completed by 216 family caregivers of users of outpatient service establishments affiliated with hospitals in the Chubu region. The validity of the scale items was tested, and statistical analysis was performed. The construct validity and internal consistency of the OAQC were examined using exploratory factor analysis and the ω coefficient, respectively. Results The discrimination ability and difficulty level were calculated using the item response theory. The findings showed that the scale’s reliability and validity were satisfactory. Construct validity was acceptable for 16 items with 5 factors. The OAQC also had high internal consistency, reliability, and effectiveness. The item slope parameters and difficulty parameters revealed good item response, indicating that the scale could effectively measure family caregivers’ occupational adaptation. Conclusion The scale was compatible with the data obtained from family caregivers. Given its overall effectiveness, data obtained using the OAQC can contribute towards implementing personal care support programs for caregivers and enriching their lives by offering support from an occupational adaptation perspective.
Study on the predictive effect of fibrinogen on vascular calcification
Authors: Zhang Jing , Yang Yan , Zhang Hongsong , Gao Pengju , Zhang Zepeng , Fu Wenxiu , Zheng Lihua , Zhao Yaheng 
Published: January 2021

Background Fibrinogen, lipoprotein, and high-density lipoprotein levels were associated with vascular calcification, but their predictive capacity for a vascular calcification was not reported. Aims The purpose of this study was to evaluate the predictive efficacy of fibrinogen, lipoprotein, and high-density lipoprotein by retrospective analysis of fibrinogen, lipoprotein, and high-density lipoprotein levels in patients with vascular calcification, to explore the effective predictive indexes of vascular calcification, to predict the occurrence and development of vascular calcification, and to provide a simple and effective method for the diagnosis and prevention of vascular calcification. Hypothesis: Fibrinogen is a good prediction of vascular calcification. Methods Univariate and multivariate analyses were used to assess the effects of fibrinogen, lipoprotein, and high-density lipoprotein on the CV, and the ROC curve of the predictive model was used to assess its predictive effectiveness. We collected the relevant indicators of 462 patients admitted to the Department of Vascular Surgery of the First Hospital of Hebei Medical University from August 2018 to July 2020, including 189 patients with vascular calcification (40.9%) and 273 patients without vascular calcification (59.1%); 75% of the collected data is used for modeling (modeling group) and 25% for verification (verification group). Results Results from the multivariate analysis showed fibrinogen, lipoprotein, and high-density lipoprotein to be independent predictors of vascular calcification. Next, the three-factor models are developed respectively. The area below the ROC curve in the fibrinogen, lipoprotein, and high-density lipoprotein forecast model was 0.8018, 0.7348, and 0.7019, respectively. Conclusions Fibrinogen is more predictive than high-density lipoprotein and lipoprotein in patients with arteriosclerosis.
Clinical features and management strategy of symptomatic spontaneous isolated celiac artery dissection
Authors: Gao Xiujuan , Xie Weiping , Shang Dan , Liu Jianyong , Jin Bi , Xu Ying Jiang 
Published: January 2021

Objectives The aim of this study was to evaluate the clinical features and management strategy for patients with symptomatic spontaneous isolated celiac artery dissection (SICAD). Methods In this retrospective study, consecutive patients with symptomatic SICAD from two institutions were included. The demographics, clinical manifestations, comorbidities, imaging findings and treatment strategy selection were obtained from the medical records. The general epidemiological data, treatment regimens and clinical and follow-up outcomes were analysed. Results Patients were divided into the conservative treatment group (group A, n = 26) and endovascular treatment group (group B, n = 11). Of these 37 patients, extent of dissection in both groups included only celiac trunk (61.54%% vs. 18.18%, p = 0.03), common hepatic artery (CHA) and splenic artery (SA) (3.85%% vs. 54.55%, p = 0.001), CHA (7.69% vs. 18.18%, p = 0.57), SA (23.08% vs. 9.09, p = 0.65) and left gastric artery (LGA) (3.85% vs. 54.55%, p = 0.99). Of note, the extension of the lesion in group A was shorter than that in group B. In addition, there were significantly more type IIb in group A than in group B (42.31% vs. 9.09%, p = 0.06) and the mean length of dissection in group A was 42.3 ± 54.71 mm which was significantly shorter than that in the group B 58.45 ± 3.71 mm ( p =0.04). During a median follow-up of 11.5 months, the 1, 3, 6 and 12 month follow-ups were completed in 100% (37/37), 100% (37/37), 94.59% (35/37) and 91.19% (34/37) of patients, respectively. The cumulative rate of persistent disease stability in patients with endovascular treatment group was higher than in that conservative treatment group at the 3, 6, 9 and 12 months (50% vs. 16.67%, p = 0.001; 80% vs. 37.5%, p =0.03; 100% vs. 62.5%, p = 0.012;100% vs. 91.67%, p = 0.02 respectively). Conclusion Most symptomatic SICAD have a tendency to persistent disease stability after conservative treatment. Risk factors for failed conservative treatment were length of dissection and branch involvement. Furthermore, endovascular treatment was associated with a high technical success and persistent disease stability rate, which might be reserved for patients with failed conservative treatment.
Alterations of serum levels of plasminogen, TNF-α, and IDO in granulomatosis with polyangiitis patients
Authors: Kyurkchiev Dobroslav , Yoneva Tsvetelina , Yordanova Adelina , Kurteva Ekaterina , Vasilev Georgi , Zdravkova Yana , Sheytanov Ivan , Rashkov Rasho , Ivanova-Todorova Ekaterina 
Published: January 2021

Background Granulomatosis with polyangiitis (GPA) is a representative of vasculitides associated with anti-neutrophil cytoplasmic autoantibodies. “Classical” antibodies directed against proteinase 3 are involved in the pathogenesis and are part of the GPA diagnosis at the same time. Along with them, however, antibodies against Lysosomal-Associated Membrane Protein-2 (LAMP-2) and antibodies directed against plasminogen have been described in GPA. Objectives and methodology: We performed a cross-sectional study enrolling 34 patients diagnosed with GPA. Our study was aimed at looking for correlations between serum levels of LAMP-2 and plasminogen and the clinical manifestations of the GPA. Furthermore, we examined serum levels of tumor necrosis factor-alpha (TNF-α) and its associated indoleamine-pyrrole 2,3-dioxygenase (IDO), as well as we looked for a correlation between these cytokines and the clinical manifestations of GPA. Results The results showed that in GPA, serum plasminogen levels were negatively associated with renal involvement (receiver operating characteristic (ROC) area under the curve (AUC) of 0.78) (95% CI 0.53–0.91), p = 0.035, and the extent of proteinuria, Spearman’s Rho = –0.4, p = 0.015. Increased levels of TNF-α and IDO correlated with disease activity, Spearman’s Rho =0.62, p = 0.001 and Spearman’s Rho = 0.4, p = 0.022, respectively, whereas only TNF-α was increased in severe forms of GPA with lung involvement (ROC AUC of 0.8) (95% CI 0.66–0.94), p = 0.005. Conclusions In this study, we demonstrate the alteration of soluble factors, which play an important role in the pathogenesis of GPA and their relationship with the clinical manifestations of the disease. Our main results confirm the associations of increased secretory TNF-α and some clinical manifestations, and we describe for the first time decreased serum plasminogen levels and their association with renal involvement.