bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of clinical features of pulmonary cryptococcosis with and without central nervous system involvement in China
Authors: Xue Xinying , Zang Xuelei , Wang Lifeng , Lin Dongliang , Jiang Tianjiao , Gao Jie , Wu Chongchong , Ma Xidong , Deng Hui , Shen Dingxia , Pan Lei 
Published: February 2021

Objective This study aimed to compare the clinical features of pulmonary cryptococcosis (PC) in patients with and without central nervous system (CNS) involvement. Methods We retrospectively reviewed demographics, presenting symptoms, radiographic features, and laboratory findings of patients diagnosed with PC in 28 hospitals from 2010 to 2019. Risk factors for CNS involvement were analyzed using logistic regression models. Result A total of 440 patients were included, and 36 (8.2%) had CNS involvement. Significant differences in fever, headache, and chills occurred between the two groups (overall and with/without CNS involvement) for fever (17.8% [78/440]; 52.8% vs. 14.6% of patients, respectively), headache (4.5% [20/440]; 55.6% vs. 0% of patients, respectively), and chills (4.3% [19/440]; 13.9% vs. 3.5% of patients, respectively). The common imaging manifestation was nodules (66.4%). Multivariate analysis showed that cavitation (adjusted odds ratio [AOR] = 3.552), fever (AOR = 4.182), and headache were risk factors for CNS involvement. Routine blood tests showed no differences between the groups, whereas in cerebrospinal fluid the white blood cell count increased significantly and glucose decreased significantly. Conclusion In patients with PC, the risk of CNS involvement increases in patients with headache, fever, and cavitation; these unique clinical features may be helpful in the diagnosis.
Quantitative susceptibility-weighted imaging in amyotrophic lateral sclerosis with 3.0 T magnetic resonance imaging
Authors: Liu Meng-Yu , Chen Zhi-Ye , Li Jin-Feng , Xiao Hua-Feng , Ma Lin 
Published: February 2021

Objective To evaluate alterations in phase-shift values in the gray matter of patients with amyotrophic lateral sclerosis (ALS) using susceptibility-weighted imaging (SWI). Methods Twenty patients with definite or probable ALS and 19 age- and sex-matched healthy controls were enrolled. SWI was performed using a 3.0 T magnetic resonance imaging scanner. Phase-shift values were measured in corrected phase images using regions of interest, which were placed on the bilateral precentral gyrus, frontal cortex, caudate nucleus, globus pallidus, and putamen. Results Phase-shift values of the precentral gyrus were significantly lower in ALS patients (−0.176 ± 0.050) than in the control group (−0.119 ± 0.016) on SWI. The average phase-shift values of the frontal cortex, caudate nucleus, globus pallidus, and putamen in ALS patients (−0.089 ± 0.023, −0.065 ± 0.016, −0.336 ± 0.191, and −0.227 ± 0.101, respectively) were not significantly different from those in the healthy controls (−0.885 ± 0.015, −0.079 ± 0.018, −0.329 ± 0.136, and −0.229 ± 0.083, respectively). Conclusions Compared with healthy controls, ALS patients had a lower phase-shift value in the precentral gyrus, which may be related to abnormal iron overload. Thus, SWI is a potential method for identifying ALS patients.
Prevalence of erectile dysfunction and its associated factors among patients with diabetes in Ethiopia: a systematic review and meta-analysis
Authors: Weldesenbet Adisu Birhanu , Kebede Sewnet Adem , Tusa Biruk Shalmeno 
Published: February 2021

Objectives We aimed to estimate the pooled prevalence of erectile dysfunction (ED) among patients with diabetes mellitus (DM) in Ethiopia and to identify its associated factors. Methods We performed a systematic search of scientific databases (PubMed, ScienceDirect); the grey literature was also searched (Google, Google Scholar). Data were extracted from primary studies using a data extraction format and exported for statistical analysis. I2 tests were used to assess the heterogeneity of studies. Owing to heterogeneity among the included studies, we used a random-effects model to determine pooled estimates of ED. Publication bias was assessed using Egger’s and Begg’s tests. Results The pooled prevalence of ED among patients with DM in Ethiopia was 54.3% (95% confidence interval [CI]: 28.2–80.5). Older age (OR: 4.42, 95% CI: 2.83–6.00) and duration of DM (OR: 3.2, 95% CI: 1.74–4.66) had statistically significant associations with ED. Conclusion One in two individuals with DM in Ethiopia also had ED. This finding highlights the need to integrate assessment and management of ED into routine medical care in diabetes follow-up visits. Special attention is recommended for patients with older age and a longer duration of DM.
Evaluation of transverse dorsal lumbotomy in management of PUJ obstruction in patients younger than 6 months
Authors: Alhindi Saeed , Mubarak Mohamed , Alaradi Husain 
Published: February 2021

Objective: The transverse dorsal lumbotomy approach provides excellent exposure to the PUJ and causes minimal tissue damage. In this study, we assess the efficacy of dorsal lumbotomy in PUJ obstruction in children younger than 6 months. Methods: All children less than 6 months who were managed with the dorsal lumbotomy approach between 2009 and 2017 were reviewed prospectively. Data included: demographic data, pre/post-operative renal ultrasound scan with SFU grading and RDS, operative time, post-operative complications, and follow up results. Results: A total of 42 children with a mean age of 4.4 ± 1 months were included. On pre-operative RDS, all patients had an obstructive pattern and a SRF of 30.3 ± 9.3. The mean operative duration was 49 min and analgesia was minimal. Post-operative ultrasound at 6 months showed an improvement in hydronephrosis ( p < 0.05) and a mean SRF of 39.3 ± 6.1 ( p < 0.001). Conclusion: Transverse dorsal lumbotomy approach is a safe and efficient alternative in patients less than 6 month.
Estimating the marginal maintenance cost of different vehicle types on rail infrastructure
Authors: Smith Andrew SJ , Odolinski Kristofer , Hossein-Nia Saeed , Jönsson Per-Anders , Stichel Sebastian , Iwnicki Simon , Wheat Phill 
Published: February 2021

In this paper, we combine engineering and economic methods to estimate the relative maintenance cost of different types of damage on the Swedish rail infrastructure. The engineering method is good at predicting damage from traffic, while the economic method is suitable for establishing a relationship between damage and cost. We exploit the best features of both methods in a two-stage approach and demonstrate its applicability for rail infrastructure charging, based on a sample of 143 track sections comprising about 11,000 km of track. The paper implements for the first time the method previously proposed in Smith et al., whilst also enhancing the method in several respects. We demonstrate how the estimated relative maintenance costs related to different damage mechanisms can be used to calculate the marginal cost of different vehicle types. The results are relevant for infrastructure managers in Europe who wish to differentiate their track access charges such that each vehicle pays its short run-marginal damage cost, which can support more efficient use of the rail infrastructure and influence vehicle design to minimize system costs.
Trust in Classroom-as-Organization Simulations: Parallel Experiences of Participants and Facilitators
Authors: Levesque Laurie L. 
Published: February 2021

Background. As classroom-as-organization (CAO) simulations unfold within corporate or higher education classrooms, novice facilitators and their participants experience uncertainty in the absence of familiar and implicit sources of trust. Initial trust derived from the context, simulation, peers, and one’s self wanes as awareness dawns regarding the magnitude of difference between CAO and typical classrooms. New sources of trust arise from shared sensemaking about unfamiliar roles and interactions, growing confidence in redistributed responsibilities and authority, an environment characterized by psychological safety, feedback, and behavioral experimentation modeled upon the experiential learning cycle ( Kolb, 1976 ). Purpose. This article examines the parallel experiences of participants and novice facilitators as they initially lose trust in CAO simulations and those involved, and discover new sources of trust related to the simulation design. Using first- and second-hand experiences and extant literatures on trust and teaching and learning, the erosion of initial trust is explored, as well as how CAO simulation design principles foster new sources of emergent trust. Conclusion. Understanding the ebb and flow of participants’ trust in CAO simulations allows for targeted facilitation and coaching. Novice facilitators who examine how their own trust experiences parallel those of participants gain insight into interventions and empathy into the participant experience within this fully-experiential learning environment. Empirical research is needed to examine the mechanisms of trust loss and rebuilding in CAO simulations in relation to the enactment of unfamiliar roles, routines, and responsibilities.
“It Made Me Feel Like I Didn’t Know My Own Body”: Patient-Provider Relationships, LGBTQ+ Identity, and End-of-Life Discussions
Authors: Pecanac Kristen E. , Hill Madison Vander , Borkowski Elizabeth 
Published: February 2021

Purpose: LGBTQ+ individuals experience multiple challenges receiving quality care at the end of life, such as lack of confidence in the healthcare system to address their needs and lack of knowledge about advance care planning. Important gaps remain about the needs of LGBTQ+ individuals in the provider-patient relationship and how critical discussions about the end of life occur or do not occur in that relationship. The purpose of this study is to explore patients’ narratives of their relationship with their provider and their experiences discussing end-of-life care with their providers, among patients who do and do not identify as LGBTQ+. Methods: Twenty-nine attendants of an event devoted to LGBTQ+ health, 15 of which identified as LGBTQ+, completed an altered version of the CAHPS® Patient Narrative Elicitation Protocol. We used inductive content analysis to qualitatively analyze the data. Results: Respondents described wanting to be heard, finding safety and trust, and valuing competency in their relationship with their provider. Respondents who identified as LGBTQ+ additionally 1) valued providers who avoided making assumptions, 2) looked for cues of safety to indicate they would be accepted by the provider, and 3) sought providers competent in LGBTQ+ care needs. Few respondents had discussed end-of-life care with their provider, although some assumed that their provider may or may not be able to meet their needs based on aspects of their provider-patient relationship. Conclusions: Strengthening patient-provider relationships may help improve the care of LGBTQ+ populations, particularly for the end of life.
Quantitative association of educational status and effect of patient counseling among cancer patients: A cross-sectional analysis in a tertiary care hospital in South India
Authors: Jyoti Kumar , Manjula Gudhoor , Ganachari Madiwalayya S 
Published: February 2021

Context Patient Counseling is desirable in chronic disease condition which is influenced by innumerable predictors. Educational status is one of the primary predictor which is usually ignored while considering the effect of patient counseling in cancer patients. Therefore, this study was aimed to determine the measure of association between education level and patient counseling among cancer patients. Design and method In the cross-sectional analysis, 90 cancer patients in inpatient setting at Oncology department of tertiary care hospital in South India were examined for a 24-week period through pharmacist-patient interview. The data were recorded in well-customized and validated data collection form. Statistical analysis used: Bivariate analysis and linear regression analysis were performed using IBM SPSS Statistics 16.0, USA to assess the empirical relationship between the two determinants: education level and patient counseling. Results The study participants were aged between 11 to 80 years with 7:11 male to female ratio. Among 90 interviewed patients, 83.3% were counseled. Linear regression analysis demonstrated significant association between education status and patient counseling (p < 0.05). Conclusions The study findings suggest that poor education status can be a barrier to patient’s ability to seek and act on the counseling provided by the health care professionals. Thus, it recommends improvisation of counseling practice on patients from different educational divisions.
Adherence to thalidomide in patients with multiple myeloma: A cross-sectional study in a Brazilian metropolis
Authors: Silveira Lívia Pena , Pádua Cristiane A Menezes de , Drummond Paula Lana de Miranda , Malta Jéssica Soares , Santos Roberta M Marques dos , Costa Naiane Lima , Machado Taísa R Lopes , Hauck Lucas Motta , Reis Adriano Max Moreira 
Published: February 2021

Purpose The treatment of multiple myeloma (MM) has advanced with the introduction of immunomodulators (IMiDS). Thalidomide is the IMiD available in Brazil with free access to MM patients. Adherence to treatment with IMiDs is essential for a successful therapy. The study proposed to describe adherence to thalidomide treatment in patients diagnosed with MM in onco-hematological outpatient clinics. Methods This is a cross-sectional study with patients over 18 years of age diagnosed with MM undergoing thalidomide treatment. Adherence was measured by the Proportion of Days Covered (PDC), which is an indirect method of measuring adherence that uses database-related medication dispensing information. Patients with PDC ≥90 were classified as adherent. The association between adherence and independent variables was assessed in univariate and multivariate analyses using logistic regression. Results A total of 65 patients with a median age of 62.6 years were identified. The median PDC was 93.7%. The frequency of adherence to thalidomide was 56.9%. Adherence to thalidomide showed a negative association with hospitalization in the last 12 months (OR = 0.202; 95% CI = 0.060–0.687) and with higher schooling (OR =0.161; 95% CI = 0.039–0.667) and a positive association with higher income (OR = 5.115; 95% CI = 1.363–19.190). Conclusion Most patients from onco-hematological outpatient clinics in a metropolitan region of southeastern Brazil showed high adherence to thalidomide, which was independently associated with higher income, hospitalization, and higher schooling. More studies are required to understand better the determinants of adherence to thalidomide in the country.
Ophthalmia neonatorum in a tertiary referral children’s hospital: A retrospective study
Authors: Gildea David , Goetz Reinold , Drew Richard , Chamney Sarah 
Published: February 2021

Objectives: The purpose of this study was to examine the aetiology, investigation and management of ophthalmia neonatorum (ON) presenting to a tertiary referral children’s hospital over 5 years. Methods: The eye swab data of all neonates presenting to Children’s Health Ireland at Temple Street (Dublin, Ireland) between 1st January 2013 and 3rd September 2018 was analysed. The medical records of all patients with positive eye swab results were retrospectively reviewed. Results: A total of 157 neonates had positive eye swab results. 54 cases were identified as ON. Chlamydia trachomatis (20.4%) was the most common organism identified, followed by Staphylococcus aureus (18.5%), Haemophilus influenzae (14.8%), Moraxella catarrhalis (7.4%), Streptococcus pneumoniae (5.6%), Escherischia coli (3.7%), Klebsiella pneumoniae (1.9%) and Pseudomonas aeruginosa (1.9%). A bacterial culture swab was tested in all cases (100%), a C. trachomatis/N. gonorrhoeae PCR swab in 70.4% and a viral PCR swab in 35.2%. On subanalysis of the cases that had C. trachomatis/N. gonorrhoeae PCR testing, C. trachomatis was responsible for 28.9% of cases. 50% of cases were hospitalised, intravenous antibiotics were administered in 46.3% and macrolide therapy was prescribed in 38.9%. Conclusions: C. trachomatis was the most common cause of ON in this study and may be responsible for an even higher proportion of cases due to incomplete testing. In keeping with studies in different populations, S. aureus, H. influenzae and S. pneumoniae were also common. As a result, an improved management algorithm for cases of ON has been introduced in this centre.
Structural and vascular features in cavitary congenital optic disc anomaly associated with metaphyseal acroscyphodysplasia
Authors: Fossataro Federica , D’Andrea Luca , Cennamo Gilda 
Published: February 2021

Purpose: To evaluate the radial peripapillary vascular plexus of a cavitary congenital optic disc anomaly in a young patient with recessive autosomal metaphyseal acroscyphodysplasia using optical coherence tomography angiography (OCTA). Methods: Observational case report. Results: A 17-year-old man, with diagnosis of metaphyseal acroscyphodysplasia was referred to Eye Clinic for fundus examination and multimodal imaging for retinal epithelium hypertrophy in the right eye. Clinical examination showed cup-shaped metaphyses, short stature, hyperthelorism, and telecanthus. An optic disc coloboma was detected in the right eye on fundus examination. Wide field en-face Optical Coherence Tomography (OCT) showed a hyporeflective area corresponding to the right optic disc coloboma. At OCTA examination, the whole papillary region revealed a rarefaction of the vascular network, while the ganglion cell complex’s and retinal fiber layers’ parameters were normal in both eyes. Conclusion: The presence of coloboma disc congenital defect linked to embryological abnormalities during the development process could pave the way for a wider understanding of the pathogenesis of metaphyseal acroscyphodysplasia by increasingly framing it as a systemic disease.
Minimal guidewire length for central venous catheterization of the right subclavian vein: A CT-based consecutive case series
Authors: Adrian Maria , Bengtsson Pär , Borgquist Ola , Bozovic Gracijela , Kander Thomas 
Published: February 2021

Background: Central venous catheter (CVC) misplacement occurs frequently after right subclavian vein catheterization. It can be avoided by using ultrasound to confirm correct guidewire tip position in the lower superior vena cava prior to CVC insertion. However, retraction of the guidewire during the CVC insertion may dislocate the guidewire tip from its desired and confirmed position, thereby resulting in CVC misplacement. The aim of this study was to determine the minimal guidewire length required to maintain correct guidewire tip position in the lower superior vena cava throughout an ultrasound-guided CVC placement in the right subclavian vein. Methods: One hundred adult patients with a computed tomography scan of the chest were included. By using multiplanar reconstructions from thin-sliced images, the distance from the most plausible distal puncture site of the right subclavian vein to the optimal guidewire tip position in the lower superior vena cava was measured (vessel length). In addition, measurements of equipment in common commercial over-the-wire percutaneous 15–16 cm CVC kits were performed. The 95th percentile of the vessel length was used to calculate the required minimal guidewire length for each CVC kit. Results: The 95th percentile of the vessel length was 153 mm. When compared to the calculated minimal guidewire length, the guidewires were up to 108 mm too short in eight of eleven CVC kits. Conclusion: After confirmation of a correct guidewire position, retraction of the guidewire tip above the junction of the brachiocephalic veins should be avoided prior to CVC insertion in order to preclude dislocation of the catheter tip towards the right internal jugular vein or the left subclavian vein. This study shows that many commercial over-the-wire percutaneous 15–16 cm CVC kits contain guidewires that are too short for right subclavian vein catheterization, i.e., guidewire retraction is needed prior to CVC insertion.
Skin perfusion pressure for predicting access-related hand ischemia following arteriovenous fistula surgery based on the brachial artery
Authors: Bae Miju , Chung Sung Woon , Lee Chung Won , Huh Up , Jin Moran , Jeon Chang Ho 
Published: February 2021

Background: Access-related hand ischemia (ARHI) is a major complication of arteriovenous fistula (AVF). This study aimed to assess the predictive efficacy of skin perfusion pressure (SPP) measurement for ARHI by examining the relationship between SPP and ARHI development and progression after AVF surgery. Methods: Twenty-five patients (16 men and 9 women) who underwent AVF surgery based on the brachial artery between January 2018 and December 2018 were included. The pre- and postoperative SPP values were measured on the day of surgery. ARHI occurrence and severity were measured within 3 days and at 6 months after surgery. Receiver operating characteristic curve analysis was used to evaluate the prediction model of ARHI, and the cutoff points for the calculated coefficients were determined. Results: There was a significant correlation between the occurrence of immediate ARHI and the SPP gradient ( p = 0.024). An SPP gradient value >50 mmHg had sensitivity and specificity values of 53.85% and 91.67%, respectively, in predicting the occurrence of immediate ARHI. A postoperative SPP <48 mmHg was significantly correlated with the occurrence of 6-month ARHI ( p = 0.005), with sensitivity and specificity values of 71.43% and 83.33%, respectively. Conclusion: The SPP gradient and postoperative SPP values may be effective clinical predictors of ARHI occurring immediately and 6 months after surgery, respectively, with high specificity. These findings could allow clinicians to diagnose and begin early interventions to help prevent ischemic tissue damage in hemodialysis patients following AVF surgery.