bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining the Effect of the Training Program by Using the Health Belief Model in Performing Self-Care Behaviors of Rural Patients Having High Blood Pressure
Authors: Afshari Maryam , Gholamaliee Behzad , Kangavari Mehdi , Partoi Naser , Afshari Masomeh , Nazari Mohsen 
Published: March 2021

Background High blood pressure effects on patients’ life. One of the problems in controlling blood pressure is lack of self-care. As a primary form of care, self-care is under patients’ control and the patient's belief plays an important role in self-care behaviors. Using the Health Belief Model, this study aimed to determine the effect of educational program on self-care behaviors of rural patients afflicted with hypertension in Toyserkan city. Methods This study was a quasi-experimental research. It studied 100 hypertensive patients in four health centers in rural areas in Toyserkan city in 2019. The samples were simple random sampling among those people referred to the four health centers. Participants in the intervention group attended three training sessions, but the control group did not take part in any training program. The assessment was conducted in both groups before and after the intervention through personal interviews with patients. The questionnaire including the Health Belief Model and self-care behavior constructs was administered. Results Perceived susceptibility, perceived severity, self-efficacy and self-care behavior constructs did not have significant statistical differences in terms of mean scores before intervention between the two groups, but after intervention, there were statistically significant differences between the two groups. Examining the model factor in predicting self-care in the intervention group showed that the perceived severity and self-efficacy constructs had the highest predictive power. Conclusion The results showed that planning and intervention based on HBM, as the models that were used in education and health promotion could be effective in achieving better performance and attitude of patients suffering from hypertension and their self-care. Also, special mention is needed to health care providers to improve self-care training in patients with high blood pressure.
Patients with Metastatic Lung Cancer and Oncologists’ Views on Achievement of Treatment Goals and Making the Right Treatment Decision: A Prospective Multicenter Study
Authors: Mieras Adinda , Becker-Commissaris Annemarie , Klop Hanna T. , Pasman H. Roeline W. , de Jong Denise , Pronk Lemke , Onwuteaka-Philipsen Bregje D. 
Published: March 2021

Background Previous studies have investigated patients’ treatment goals before starting a treatment for metastatic lung cancer. Data on the evaluation of treatment goals are lacking. Aim To determine if patients with metastatic lung cancer and their oncologists perceive the treatment goals they defined at the start of systemic treatment as achieved after treatment and if in hindsight they believe it was the right decision to start systemic therapy. Design and Participants A prospective multicenter study in 6 hospitals across the Netherlands between 2016 and 2018. Following systemic treatment, 146 patients with metastatic lung cancer and 23 oncologists completed a questionnaire on the achievement of their treatment goals and whether they made the right treatment decision. Additional interviews with 15 patients and 5 oncologists were conducted. Results According to patients and oncologists, treatment goals were achieved in 30% and 37% for ‘quality of life,’ 49% and 41% for ‘life prolongation,’ 26% and 44% for ‘decrease in tumor size,’ and 44% for ‘cure’, respectively. Most patients and oncologists, in hindsight, felt they had made the right decision to start treatment even if they had not achieved their goals (72% and 93%). This was related to the feeling that they had to do ‘something.’ Conclusions Before deciding on treatment, the treatment options, including their benefits and side effects, and the goals patients have should be discussed. It is key that these discussions include not only systemic treatment but also palliative care as effective options for doing ‘something.’
Treatment of Acute Achilles Tendon Ruptures: A Systematic Review and Meta-analysis of Complication Rates With Best- and Worst-Case Analyses for Rerupture Rates
Authors: Seow Dexter , Yasui Youichi , Calder James D.F. , Kennedy John G. , Pearce Christopher J. 
Published: March 2021

Background: An acute Achilles tendon rupture (AATR) is a common injury. The controversy that has surrounded the optimal treatment options for AATRs warrants an updated meta-analysis that is comprehensive, accounts for loss to follow-up, and utilizes the now greater number of available studies for data pooling. Purpose: To meta-analyze the rates of all complications after the treatment of AATRs with a “best-case scenario” and “worst-case scenario” analysis for rerupture rates that assumes that all patients lost to follow-up did not or did experience a rerupture, respectively. Study Design: Systematic review and meta-analysis; Level of evidence, 1. Methods: Two authors performed a systematic review of the PubMed and Embase databases according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines on February 17, 2020. The included studies were assessed in terms of the level of evidence, quality of evidence, and quality of the literature. A meta-analysis by fixed-effects models was performed if heterogeneity was low ( I2 < 25%) and by random-effects models if heterogeneity was moderate to high ( I2≥ 25%). Results: Surgical treatment was significantly favored over nonsurgical treatment for reruptures. Nonsurgical treatment was significantly favored over surgical treatment for complications other than reruptures, notably infections. Minimally invasive surgery was significantly favored over open repair for complications other than reruptures (no difference for reruptures), in particular for minor complications. Conclusion: This meta-analysis demonstrated that surgical treatment was superior to nonsurgical treatment in terms of reruptures. However, the number needed to treat analysis produced nonmeaningful values for all treatment options, except for surgical versus nonsurgical treatment and minimally invasive surgery versus open repair. No single treatment option was revealed to be profoundly favorable with respect to every complication. The results of this meta-analysis can guide clinicians and patients in their treatment decisions that should be made jointly and on a case-by-case basis.
Right Ventricular Strain Is Common in Intubated COVID-19 Patients and Does Not Reflect Severity of Respiratory Illness
Authors: Gibson Lauren E. , Fenza Raffaele Di , Lang Min , Capriles Martin I. , Li Matthew D. , Kalpathy-Cramer Jayashree , Little Brent P. , Arora Pankaj , Mueller Ariel L. , Ichinose Fumito , Bittner Edward A. , Berra Lorenzo , G. Chang Marvin 
Published: March 2021

Background: Right ventricular (RV) dysfunction is common and associated with worse outcomes in patients with coronavirus disease 2019 (COVID-19). In non-COVID-19 acute respiratory distress syndrome, RV dysfunction develops due to pulmonary hypoxic vasoconstriction, inflammation, and alveolar overdistension or atelectasis. Although similar pathogenic mechanisms may induce RV dysfunction in COVID-19, other COVID-19-specific pathology, such as pulmonary endothelialitis, thrombosis, or myocarditis, may also affect RV function. We quantified RV dysfunction by echocardiographic strain analysis and investigated its correlation with disease severity, ventilatory parameters, biomarkers, and imaging findings in critically ill COVID-19 patients. Methods: We determined RV free wall longitudinal strain (FWLS) in 32 patients receiving mechanical ventilation for COVID-19-associated respiratory failure. Demographics, comorbid conditions, ventilatory parameters, medications, and laboratory findings were extracted from the medical record. Chest imaging was assessed to determine the severity of lung disease and the presence of pulmonary embolism. Results: Abnormal FWLS was present in 66% of mechanically ventilated COVID-19 patients and was associated with higher lung compliance (39.6 vs 29.4 mL/cmH2O, P = 0.016), lower airway plateau pressures (21 vs 24 cmH2O, P = 0.043), lower tidal volume ventilation (5.74 vs 6.17 cc/kg, P = 0.031), and reduced left ventricular function. FWLS correlated negatively with age (r = −0.414, P = 0.018) and with serum troponin (r = 0.402, P = 0.034). Patients with abnormal RV strain did not exhibit decreased oxygenation or increased disease severity based on inflammatory markers, vasopressor requirements, or chest imaging findings. Conclusions: RV dysfunction is common among critically ill COVID-19 patients and is not related to abnormal lung mechanics or ventilatory pressures. Instead, patients with abnormal FWLS had more favorable lung compliance. RV dysfunction may be secondary to diffuse intravascular micro- and macro-thrombosis or direct myocardial damage. Trial Registration: National Institutes of Health #NCT04306393. Registered 10 March 2020, https://clinicaltrials.gov/ct2/show/NCT04306393
Visual acuity and progression of macular atrophy in patients receiving intravitreal anti-VEGF for age-related macular degeneration
Authors: Ji Marco H , Callaway Natalia F , Ludwig Cassie A , Vail Daniel , Al-Moujahed Ahmad , Rosenblatt Tatiana R , Leng Theodore , Sanislo Steven R , Moshfeghi Darius M 
Published: March 2021

Purpose: Whether intravitreal anti-vascular endothelial growth factors (VEGFs) cause retinal atrophy is still a subject of debate. We reported 13 eyes that received several injections of anti-VEGF for wet age-related macular degeneration (AMD) with good visual acuity despite geographic atrophy on imaging. Methods: This is a case series study conducted at Byers Eye Institute at Stanford University. Patients of three retina specialists with wet AMD who received six or more intravitreal injection of anti-VEGFs with visual acuity of 20/60 or better and incomplete RPE and outer retina atrophy (iRORA) or complete RPE and outer retinal atrophy (cRORA) were enrolled in this case series. Different imaging modalities were reviewed by three retina specialists comparing the baseline with the most recent exam. Results: About 13 eyes of 10 patients met the selection criteria. Eleven eyes were classified as iRORA and 2 as cRORA. Despite the development of macular atrophy on imaging after an average of 38.1 injections, eyes maintained stable visual acuity. Conclusion: The discrepancy between structural and functional findings in this cohort suggests that patients treated by anti-VEGF drugs exhibit divergent clinical outcomes for currently unknown reasons. The authors propose anti-VEGF may affect melanosomes within RPE without disrupting RPE and photoreceptors function completely. This requires further investigation.
Idiopathic intracranial hypertension and visual function in North Indian population
Authors: Rehman Obaidur , Ichhpujani Parul , Kumar Suresh , Saroa Richa , Sawal Nishit 
Published: March 2021

Background: Idiopathic Intracranial Hypertension (IIH) is a neurological disorder with varied presentation, visual morbidity being the most important one. Literature is sparse as regards the effects of IIH on the visual system in Asians. Objective: Assessment of visual morbidity and change with treatment in IIH patients in North India through a prospective interventional study. Materials and methods: Sixty eyes of newly diagnosed IIH patients were evaluated for functional and structural tests of visual system. Lumbar puncture was performed to establish IIH diagnosis and received oral Carbonic anhydrase inhibitor thereafter. Change in visual function was studied from baseline to 6-month follow-up visit. Results: Mean age of participants at presentation was 33.27 ± 10.68 years and majority were females (73.3%). Seventy percent eyes ( n = 42) had visual acuity 20/20 at presentation. Average Pelli Robson contrast sensitivity (CS) improved from 1.86 ± 0.34 to 2.11 ± 0.24 (Friedman Test: X2 = 59.2, p ⩽ 0.001) while number of eyes with detectable visual field deficits reduced from 70% to 43.7%. Retinal nerve fibre layer (RNFL) thickness reduced from 176.27 to 114.97 µ (Friedman Test: X2 = 69.3, p ⩽ 0.001). Conclusions: The socio-demographic profile in our study showed higher male incidence than noted in previous studies. Visual function deficits were present in patients, even in those with 20/20 visual acuity. Significant improvement was seen after lumbar puncture and initiation of medical treatment. CS and RNFL thickness showed significant improvement even after 1 month of treatment and can be used for monitoring IIH patients.
Prevalence of Substance Use in University Students, Ethiopia
Authors: Shegute Tewodros , Wasihun Yared 
Published: March 2021

Background: Although substance use is a known public health problem and a pressing issue in Ethiopia, its real extent and magnitude are not yet properly explored. The current study aimed to determine the extent and predictors of substance use among regular undergraduate students in the Institute of Technology, Addis Ababa University. Methods: An institution-based cross-sectional study was carried among 794 undergraduate regular students at the Institute of Technology, Addis Ababa University, using a self-administered structured questionnaire filled by study participants. Data entry, cleaning, and coding were performed by EPI-INFO version 3.5.1. Statistical Package for Social Sciences; AOR: Adjusted odds ratio (SPSS) SPSS version 21 software was used to analyze data by performing descriptive statistics, bivariate, and multivariate analysis. Results: 73.7% of the study participants used substances at least once. The lifetime use of each substance includes alcohol (68.2%), khat (53.6%), cigarettes (46.1%), and illicit drugs (23.3%). Loss of family (AOR [95%CI], 34.50 [7.569, 157.263]), pocket money between 500 and 999 Ethiopian birr (AOR [95%CI], 9.978 [1.240, 80.280]), and above 1000 Ethiopian birr (AOR [95%CI], 10.831 [1.333, 87.971]) were identified predictors for khat use. The odds of lifetime alcohol use was higher among students coming from a divorced family (AOR [95%CI], 9.346 [3.162, 27.625]), lost one (AOR [95%CI], 37.406 [11.375, 123.008]), or both of their parents (AOR [95%CI], 18.750 [5.798, 60.633]). Students of urban origin (AOR [95%CI], 3.214 [1.950, 5.296]), and students with anxiety symptoms (AOR [95%CI], 2.655 [1.981, 3.557]) have a higher odds of lifetime cigarette smoking. The lifetime exposure to illicit drugs is higher among students in age groups between 20 and 24 years (AOR [95%CI], 5.963 [1.361, 26.135]), students coming from substance user family (AOR [95%CI], 2.172 [1.161, 4.063]), and students of urban origin (AOR [95%CI], 2.661 [1.202, 5.889]). Conclusion: A higher prevalence of substance use requiring administrative and educational interventions was observed. Awareness creation interventions on the potential impacts of substance abuse should be performed.
Understanding Smoking Behavior among Physicians in Riyadh, Saudi Arabia: A Cross-Sectional Study
Authors: Al Shahrani Abeer S. , Almudaiheem Najd R. , Bakhsh Esraa M. , Sarhan Nora T. , Aldossari Fay S. , bin Huzeim Budur A. 
Published: March 2021

Background: The prevalence of smoking has increased in recent years in Saudi Arabia. Our objectives were to determine the factors affecting smoking among physicians and to assess physicians’ quitting behavior. Methods: A cross-sectional study was carried out at 3 district hospitals in Riyadh, Saudi Arabia. It involved physicians with different levels of experience and different specialties. They were asked to complete a self-administered questionnaire adapted from validated tools. The questionnaire addressed sociodemographic data, lifestyle, and work-related factors as well as smoking cessation and relapse. SPSS statistical software was used for the statistical analysis. Results: The study included 290 physicians, of whom 91% were Saudi and 59.7% were male. About 55.2% were younger than age of 30. Overall, 34.8% were smokers. The following factors had a significant association with smoking: a smoking family member/friend, resident occupational status, medical specialty, and frequent on-call duties increased the likelihood of smoking. One-third of the physicians (31.6%) who tried to quit smoking reported seeking information on social media, television, and/or the internet. The most common causes of relapse were social stress and withdrawal symptoms, while the least common was work-related stress. Conclusions: Smoking was highly prevalent among physicians. The likelihood of smoking was higher in, residents, medical specialists and those with a high number of on-call duties. Moreover, this study described cessation practices in this group, which might be considered when designing and improving counseling programs for physicians who smoke.
Factors associated with cervical cancer screening behaviour of women attending gynaecological clinics in Kazakhstan: A cross-sectional study
Authors: Issa Torgyn , Babi Aisha , Azizan Azliyati , Alibekova Raushan , Khan Saleem A. , Issanov Alpamys , Chan Chee Kai , Aimagambetova Gulzhanat 
Published: March 2021

Objective: Although cervical cancer could be prevented through medical screening, it remains one of the top causes of cancer-related morbidity and mortality all over the world. A number of factors may contribute to cervical cancer screening behaviour of women. The aim of this study was to investigate factors related to cervical cancer screening behaviour of women in Kazakhstan. Methods: This was a cross-sectional survey-based study with a total of 1189 participants. Women attending gynaecological clinics aged between 18 and 70 years were administered paper-based questionnaires about their awareness of cervical cancer, the associated risk factors, and cervical cancer screening. Student t test or Wilcoxon rank-sum test and chi-square test or Fisher’s exact test, where appropriate, were used to determine associations with categorical independent variables. Results: The mean age of participants was 36.5 ± 10.1 years. Less than half (45.7%) of the participants had been screened for cervical cancer. The key factors related to the cervical cancer screening behaviour of women in this study included age, having a larger number of children, regular menstrual function, awareness of Pap smear test, and free screening programme for cervical cancer, and the causal association of human papillomavirus with cervical cancer. Conclusion: This study revealed several significant factors predicting screening behaviour in Kazakhstani women. To improve the rate of screening, there is a need to increase public knowledge and awareness of cervical cancer and opportunities for the free screening programme in the female population of Kazakhstan.
Comparison of outcomes of high-flow nasal cannula and noninvasive positive-pressure ventilation in patients with hypoxemia and various APACHE II scores after extubation
Authors: Shang Xiaoke , Wang Yanggan 
Published: March 2021

Aims: The study aimed to compare and analyze the outcomes of high-flow nasal cannula (HFNC) and noninvasive positive-pressure ventilation (NPPV) in the treatment of patients with acute hypoxemic respiratory failure (AHRF) who had extubation after weaning from mechanical ventilation. Methods: A total 120 patients with AHRF were enrolled into this study. These patients underwent tracheal intubation and mechanical ventilation. They were organized into two groups according to the score of Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II); group A: APACHE II score <12; group B: 12⩽ APACHE II score <24. Group A had 72 patients and patients given HFNC were randomly assigned to subgroup I while patients given NPPV were assigned to subgroup II (36 patients in each subgroup). Group B had 48 patients and patients given HFNC were randomly assigned to subgroup I while patients given NPPV were assigned to subgroup II (24 patients in each subgroup). General information, respiratory parameters, endpoint event, and comorbidities of adverse effect were compared and analyzed between the two subgroups. Results: The incidence of abdominal distension was significantly higher in patients treated with NPPV than in those treated with HFNC in group A (19.44% versus 0, p = 0.005) and group B (25% versus 0, p = 0.009). There was no significant difference between the HFNC- and NPPV-treated patients in blood pH, oxygenation index, partial pressure of carbon dioxide, respiratory rate, and blood lactic acid concentration in either group ( p > 0.05). Occurrence rate of re-intubation within 72 h of extubation was slightly, but not significantly, higher in NPPV-treated patients ( p > 0.05). Conclusion: There was no significant difference between HFNC and NPPV in preventing respiratory failure in patients with AHRF with an APACHE II score <24 after extubation. However, HFNC was superior to NPPV with less incidence of abdominal distension. The reviews of this paper are available via the supplemental material section.
The anthill and the beam: A response to Elden
Authors: Latour Bruno 
Published: March 2021

Is it possible to get away from the distinction between physical space and lived space, where the former is conceived as material, objective, and measurable, and the latter is conceived as historical, subjective, and symbolic? In other words, is it possible to get out of the division of labour between physical geography and human geography? Such a proposition is different from wanting to ‘reconcile’ or ‘bring together’ the two branches of geography. In this response to Stuart Elden’s (2021) article, ‘Terrain, Politics, History’, my proposal is that a distinction must be made elsewhere between terrestrial space – which does not mean physical – and extraterrestrial space – which does not mean subjective.
Efficacy of cystone versus tamsulosin in treatment of stent-related lower urinary tract symptoms
Authors: Ghaed Mohammad Ali , Rezaei Reza , Shafeinia Amineh , Maghsoudi Robab 
Published: March 2021

Objective: Double-J stent is a common tool used in urological procedures that is inserted for 2–6 weeks, but it may induce abdominal and flank pain, incontinence and irritative urinary symptoms. Alleviation of such symptoms would be useful to improve the patients’ quality of life. Accordingly, in this study, the efficacy of cystone versus tamsulosin in the treatment of double-J stent-related lower urinary tract symptoms was determined. Materials and methods: In this randomised clinical trial, 128 patients who required double-J stent insertion after transureteral lithotripsy during 2018–2019 were enrolled. They were randomly assigned to receive either cystone, tamsulosin, both, or placebo. The international prostate symptom score and visual analogue score data were recorded at baseline, after 2 and 4 weeks across the groups. Results: The international prostate symptom score and visual analogue score factors were statistically different across the case groups receiving cystone, tamsulosin and both drugs versus placebo ( P=0.001). Two weeks after drug administration, the visual analogue score and international prostate symptom score were not statistically different in the tamsulosin, cystone and dual therapy groups; however, after 4 weeks the cystone group had the lowest symptoms. Conclusion: Both tamsulosin and cystone are efficient drugs which would relieve stent-related lower urinary tract symptoms. The administration of cystone with or without tamsulosin for 4 weeks may have the best result in reducing the visual analogue score and international prostate symptom score. Level of evidence: Level I, 1b, therapeutic study, randomised controlled trial