bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is perceived social support more important than visual acuity for clinical depression and anxiety in patients with age-related macular degeneration and diabetic retinopathy?
Authors: Hernández-Moreno Laura , Senra Hugo , Moreno Natacha , Macedo António Filipe 
Published: March 2021

Objective: To investigate whether visual acuity has the same importance as a factor of depression and anxiety comparing with other psychological variables, particularly perceived social support, in patients diagnosed with age-related eye diseases, with and without low vision. Design: Observational cross-sectional study. Setting: Patients attending outpatient appointments at the department of ophthalmology of a general hospital in Portugal. Subjects: Patients with age-related macular degeneration and patients with diabetic retinopathy attending routine hospital appointments were recruited for this study. Measures: Anxiety and depression were measured using the hospital anxiety and depression scale and perceived social support using the multidimensional scale of perceived social support. Visual acuity was measured with ETDRS charts. Results: Of the 71 patients, 53 (75%) were diagnosed with diabetic retinopathy, 37 (52%) were female and age (mean ± SD) was 69 ± 12 years. Acuity in the better seeing eye was 0.41 ± 0.33 logMAR. The mean anxiety score was 4.38 ± 3.82 and depression 4.41 ± 3.39. Clinically significant levels of anxiety were found in 21% ( n = 15) of the participants and depression in 18%( n = 13). The total social support score was 5.29 ± 0.61. Significant multivariate regression models were found for anxiety ( R2 = 0.21, P = 0.016) and for depression ( R2 = 0.32, P < 0.0001). Social support was independently associated with levels of anxiety and with levels of depression. Gender was independently associated with levels of anxiety. Conclusion: This study suggests that patients’ perceived social support might be more important than visual acuity as a factor of clinical depression and anxiety in a sample of age-related eye disease patients.
Who Gets the Last Bed? A Discrete-Choice Experiment Examining General Population Preferences for Intensive Care Bed Prioritization in a Pandemic
Authors: Street Amelia E. , Street Deborah J. , Flynn Gordon M. 
Published: March 2021

Objective To explore the key patient attributes important to members of the Australian general population when prioritizing patients for the final intensive care unit (ICU) bed in a pandemic over-capacity scenario. Methods A discrete-choice experiment administered online asked respondents ( N = 306) to imagine the COVID-19 caseload had surged and that they were lay members of a panel tasked to allocate the final ICU bed. They had to decide which patient was more deserving for each of 14 patient pairs. Patients were characterized by 5 attributes: age, occupation, caregiver status, health prior to being infected, and prognosis. Respondents were randomly allocated to one of 7 sets of 14 pairs. Multinomial, mixed logit, and latent class models were used to model the observed choice behavior. Results A latent class model with 3 classes was found to be the most informative. Two classes valued active decision making and were slightly more likely to choose patients with caregiving responsibilities over those without. One of these classes valued prognosis most strongly, with a decreasing probability of bed allocation for those 65 y and older. The other valued both prognosis and age highly, with decreasing probability of bed allocation for those 45 y and older and a slight preference in favor of frontline health care workers. The third class preferred more random decision-making strategies. Conclusions For two-thirds of those sampled, prognosis, age, and caregiving responsibilities were the important features when making allocation decisions, although the emphasis varies. The remainder appeared to choose randomly.
Basing Information on Comprehensive, Critically Appraised, and Up-to-Date Syntheses of the Scientific Evidence: An Update from the International Patient Decision Aid Standards
Authors: Hoffmann Tammy C. , Bakhit Mina , Durand Marie-Anne , Perestelo-Pérez Lilisbeth , Saunders Catherine , Brito Juan P. 
Published: March 2021

Background Patients and clinicians expect the information in patient decision aids to be based on the best available research evidence. The objectives of this International Patient Decision Aid Standards (IPDAS) review were to 1) check the currency of, and where needed, update evidence for the domain of “basing the information in decision aids on comprehensive, critically appraised, and up-to-date syntheses of the evidence”; 2) analyze the evidence characteristics of decision aids; and 3) propose updates to relevant IPDAS criteria. Methods We searched MEDLINE and PubMed to inform updates of this domain’s definitions, justifications, and components. We also searched 5 sources to identify all publicly available decision aids ( N = 471). Two assessors independently extracted each aid’s evidence characteristics. Results Minor updates to the definitions and theoretical justifications of this IPDAS domain are provided and changes to relevant IPDAS criteria proposed. Nearly all aids (97%) provided a year of creation/update, but most (81%) did not report an explicit update or expiration policy. No scientific references were cited in 33% of aids. Of the 314 that cited at least 1 reference, 39% cited at least 1 guideline, 44% cited at least 1 systematic review, and 23% cited at least 1 randomized trial. In 35%, it was unclear what statement in the aid the citations referred to. Only 14% reported any of the processes used to find and decide on evidence inclusion. Only 14% reported the evidence quality. Many emerging issues and future research areas were identified. Conclusions Although many emerging issues need to be addressed, this IPDAS domain is validated and criteria refined. High-quality patient decision aids should be based on comprehensive and up-to-date syntheses of critically appraised evidence.
Development and evaluation of a computer-based decision support system for diffuse lung diseases at high-resolution computed tomography
Authors: Martin Simon S , Kolaneci Delina , Wichmann Julian L , Lenga Lukas , Leithner Doris , Vogl Thomas J , Jacobi Volkmar 
Published: March 2021

Background High-resolution computed tomography (HRCT) is essential in narrowing the possible differential diagnoses of diffuse and interstitial lung diseases. Purpose To investigate the value of a novel computer-based decision support system (CDSS) for facilitating diagnosis of diffuse lung diseases at HRCT. Material and Methods A CDSS was developed that includes about 100 different illustrations of the most common HRCT signs and patterns and describes the corresponding pathologies in detail. The logical set-up of the software facilitates a structured evaluation. By selecting one or more CT patterns, the program generates a ranked list of the most likely differential diagnoses. Three independent and blinded radiology residents initially evaluated 40 cases with different lung diseases alone; after at least 12 weeks, observers re-evaluated all cases using the CDSS. Results In 40 patients, a total of 113 HRCT patterns were evaluated. The percentage of correctly classified patterns was higher with CDSS (96.8%) compared to assessment without CDSS (90.3%; P < 0.01). Moreover, the percentage of correct diagnosis (81.7% vs. 64.2%) and differential diagnoses (89.2% vs. 38.3%) were superior with CDSS compared to evaluation without CDSS (both P < 0.01). Conclusion Addition of a CDSS using a structured approach providing explanations of typical HRCT patterns and graphical illustrations significantly improved the performance of trainees in characterizing and correctly identifying diffuse lung diseases.
Clinical outcomes and survival analysis in patients with psycho-cardiological disease: a retrospective analysis of 132 cases
Authors: Lai Minhua , Shen Teimei , Cui Hong , Lin Lixia , Ran Peng , Huo Peixia , Chen Ling , Li Jingzhi 
Published: March 2021

Objectives The deleterious effects of psychological problems on coronary heart disease (CHD) are not satisfactorily explained. We explored influential factors associated with mortality in psycho-cardiological disease in a Chinese sample. Methods Of 7460 cardiac patients, we selected 132 patients with CHD and mental illness. Follow-up was conducted via telephone. We analyzed clinical characteristics, clinical outcomes, and survival. Results The clinical detection rate of psycho-cardiological disease in the overall patient population was 1.8%. Of these, 113 patients completed follow-up; 18 died owing to cardiovascular diseases during follow-up. Kaplan–Meier analysis showed dysphagia, limb function, self-care ability, percutaneous coronary intervention, low-density lipoprotein, total cholesterol, pro-brain natriuretic peptide and high-sensitivity (hs) troponin T had significant associations with cumulative survival. Cox regression analysis showed total cholesterol (hazard ratio [HR]: 2.765, 95% confidence interval [CI]: 1.001–7.641), hs troponin T (HR: 4.668, 95% CI: 1.293–16.854), and percutaneous coronary intervention (HR: 3.619, 95% CI: 1.383–9.474) were independently associated with cumulative survival. Conclusions The clinical detection rate of psycho-cardiological disease was far lower than expected. Normal total cholesterol and hs troponin T were associated with reduced cardiovascular disease mortality over 2 years. Percutaneous coronary intervention is a prognostic risk factor in patients with psycho-cardiological disease.
Correlation of Patient-Reported Outcomes After Periacetabular Osteotomy With Femoral Head Coverage and Acetabular Orientation: A Single-Center Cohort Study
Authors: Ibrahim Mazen M. , Smit Kevin , Poitras Stéphane , Grammatopoulos George , Beaulé Paul E. 
Published: March 2021

Background: Gaining a better understanding of the underlying pattern of acetabular dysplasia 3-dimensionally can help better guide treatment and optimize clinical outcomes after periacetabular osteotomy (PAO). Purpose: (1) To examine the relationship between femoral head coverage before and after PAO for dysplasia and patient-reported outcome measure (PROM) scores and (2) to assess if the direction/orientation of correction of the acetabulum can be predicted based on the Ottawa classification. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective analysis of a prospectively collected database from a single-center institutional registry of PAO was conducted, and PROM scores at a minimum of 2 years were analyzed. A total of 79 hips (67 patients [56 female]; mean age at surgery, 27.5 years [range, 15.8-53.7 years]) were available for inclusion. According to the Ottawa classification, 54 hips (68.4%) had global deficiency, 15 hips (18.9%) had posterior deficiency, and 10 hips (12.7%) had anterior deficiency. Hip2Norm software was used to analyze the 3-dimensional coverage of the femoral head. Statistical analysis was conducted to look at significant predictors of improvements in PROMs using the minimal clinically important difference (MCID) for the Hip disability and Osteoarthritis Outcome Score (HOOS) Activities of Daily Living subscale. Results: At a mean follow-up of 3.1 years (range, 2.0-7.4 years), all functional outcome scores improved significantly. A postoperative total femoral coverage <75.7%, posterior coverage (PC) <45.2%, and femoral head extrusion index >15.5% were all associated with not reaching the MCID for the HOOS Activities of Daily Living subscale. Multivariate analysis showed that PC was the single most important significant modifier influencing functional outcomes after PAO for the treatment of acetabular dysplasia, with an odds ratio of 6.0 (95% CI, 1.8-20.4; P = .004). One-way analysis of variance showed a significant difference comparing the mean change in radiographic measurements, that is, anterior coverage, PC, and total femoral coverage, per the Ottawa classification ( P < .001). Conclusion: Our study demonstrated that postoperative femoral head coverage and acetabular orientation were significant predictors of PROM scores. Classifying acetabular dysplasia into 3 groups based on the plane of instability could optimize the planning of PAO by giving a better understanding of the 3-dimensional deformity.
Reducing Barriers and Achieving Success in Registration Examination Among Internationally Educated Nurses: A Participatory Action Research Project
Authors: Belita Lydia Lorna , Ford Patricia Ann 
Published: March 2021

Background Multiple challenges impede the Internationally Educated Nurses (IENs) professional development and success in writing the registration examination. This paper aims to explore these challenges and describes the educational program which adopts a tailored mentoring approach to facilitate their successful completion of the registration exam. Methodology: Participatory Action Research model informed the development and revision of the educational process. For this qualitative study, individual 1:1 audiotaped and telephone interviews were conducted among the initial participants to explore their experiences in the program. Results Findings from this study provided more insights as to participants’ success in passing registration examination and enhanced performance in their clinical practices. From the thematic analysis, we interpreted the IEN’s journey in their knowledge transition into four major themes: Acknowledging the barriers, Learning the new culture, Making progress, Transitioning into power. Conclusion This project demonstrated that the integration of a strong mentor-mentee relationship that gives voice to the participants’ learning experience so as to meet their knowledge gaps, engenders a deeper understanding of Canadian professional nursing practice, positions them for success in writing the registration examination and builds a sense of empowerment among them.
Extent of and Reasons for Vaccine Hesitancy in Adults at High-Risk for Pneumococcal Disease
Authors: Gatwood Justin , McKnight Madison , Frederick Kelsey , Hohmeier Kenneth , Kapan Shiyar , Chiu Chi-Yang , Renfro Chelsea , Hagemann Tracy 
Published: March 2021

Purpose: To determine the extent of and reasons for hesitancy toward vaccination among adults at high-risk for pneumococcal disease. Design: Cross-sectional. Setting: Online survey in March-April 2019 via QuestionPro. Subjects: Tennessee adults (18-64 years) at high-risk of pneumococcal disease (n = 1,002). Measures: Modified version of the validated Vaccine Hesitancy Scale assessed vaccine-related beliefs, reasons for hesitancy, external influences on vaccination, and prior vaccination Analysis: Descriptive and inferential statistics provided an overview of the responses and comparisons among subgroups. Logistic regression determined the odds of being hesitant using the listed beliefs and influencers as predictors. Thematic analysis was performed on the qualitative data gathered from free response questions throughout the survey. Results: Analysis included 1,002 complete responses (12% response rate [total viewed = 8,331]) with 34.3% indicating hesitancy toward one or more recommended vaccinations, with 53% of which indicating hesitancy to the pneumococcal vaccine despite it being recommended by the Advisory Committee on Immunization Practices (ACIP) for all respondents. The odds of vaccine hesitancy or resistance were higher in minorities (OR: 1.6; 95% CI: 1.19-2.11), those not believing others like them get vaccinated (OR: 1.82; 95% CI: 1.262-2.613), and respondents recalling negative media about vaccines (OR: 2.56; 95% CI: 1.797-3.643). Conclusions: Patients at high-risk of pneumococcal disease lack awareness of the need for the recommended vaccine, and provider education may need improving to increase vaccination in this population.
One-year prospective nerve conduction study of thalidomide neuropathy in lupus erythematosus: Incidence, coasting effect and drug plasma levels
Authors: Yuki Emily Figueiredo Neves , Soares Renata , Kupa Léonard de Vinci Kanda , Heise Carlos Otto , Aikawa Nadia Emi , Arnone Marcelo , Romiti Ricardo , Pedrosa Tatiana do Nascimento , Silva Clovis Artur Almeida da , Bonfa Eloisa , Pasoto Sandra Gofinet 
Published: March 2021

Background Few prospective studies in cutaneous and systemic lupus erythematosus (CLE/SLE) assessed thalidomide-induced peripheral neuropathy (TiPN) incidence/reversibility, and most have not excluded confounding causes neither monitored thalidomide plasma levels. Objectives To evaluate TiPN incidence/reversibility, coasting effect and its association with thalidomide plasma levels in CLE/SLE. Methods One-year prospective study of thalidomide in 20 CLE/SLE patients without pregnancy potential, with normal nerve conduction study (NCS), and excluded other PN causes. Thalidomide levels were determined by high-performance liquid chromatography/tandem mass spectrometry. Results Twelve patients (60%) developed TiPN: 33.3% were symptomatic and 66.6% asymptomatic. Half of this latter group developed coasting effect (TiPN symptoms 1-3 months after drug withdrawal). The main predictive factors for TiPN were treatment duration ≥6 months (p = 0.025) and cumulative dose (p = 0.023). No difference in plasma thalidomide levels between patients with/without TiPN was observed (p = 0.464). After drug withdrawal, 75% symptomatic TiPN patients improved their symptoms. Seven TiPN patients underwent an additional NCS after drug withdrawal: 42.8% worsened NCS, 14.2% was stable, and 42.8% had improved NCS. Conclusion Our data provides novel evidence of coasting effect in half of asymptomatic patients with TiPN. The irreversible nature of this lesion in 25% of TiPN patients reinforces the relevance of early NCS monitoring, and suggests thalidomide use solely as a bridge for other effective therapy for refractory cutaneous lupus patients.
Combined aerobic and resistance training improves physical and executive functions in women with systemic lupus erythematosus
Authors: Kao Victoria PY , Wen Huei-Jhen , Pan Yu-Jen , Pai Chia-Sheng , Tsai Shih-Tzu , Su Kuei-Ying 
Published: March 2021

Objectives Exercise is considered as an adjuvant therapeutic modality to alleviate symptoms of several rheumatic diseases. However, data regarding the benefits of exercise to patients with systemic lupus erythematosus (SLE) are relatively scant. Methods This study aimed to assess the effects of regular, moderate-intensity, aerobic exercise combined with resistance training on women with SLE who had no regular exercise. Patients were recruited and allocated into either the exercise or control group by their willingness. Patients in the exercise group (n = 12) underwent 12 weeks of combined exercise (five days per week), whereas those in the control group (n = 11) maintained their usual lifestyle. Results At baseline, there were no between-group differences in body composition, disease activity, two-kilometer walking test, and executive function test. After the combined exercise intervention for 12 weeks, significant improvements of both fitness index and reaction time to the stimuli in the go/no-go test were observed in the exercise group, but not in the control group. The disease activities in both study groups did not change significantly at the end of the study period. Conclusion Our results suggest that regular moderate-intensity aerobic exercise combined with resistance training improves the physical and executive functions of SLE patients without exacerbating disease activity.
Nailfold capillary abnormalities in childhood-onset systemic lupus erythematosus: a cross-sectional study compared with healthy controls
Authors: Schonenberg-Meinema Dieneke , Bergkamp Sandy C , Nassar-Sheikh Rashid Amara , van der Aa Leontien B , de Bree Godelieve J , ten Cate Rebecca , Cutolo Maurizio , Hak A Elisabeth , Hissink Muller Petra CE , van Onna Marieke , Kuijpers Taco W , Smith Vanessa , van den Berg J Merlijn 
Published: March 2021

Objectives For selection of high-risk systemic lupus erythematosus (SLE) patients it is necessary to obtain indicators of disease severity that predict disease damage. As in systemic sclerosis, nailfold capillary abnormalities could be such a biomarker in SLE. The primary objective of this cross-sectional study is to describe capillary abnormalities in childhood-onset SLE (cSLE) cohort (onset < 18 years) and compare them with matched healthy controls. The secondary objective is to correlate the observed capillary abnormalities with demographical variables in both cohorts and with disease-specific variables in cSLE patients. Methods Healthy controls were matched for ethnic background, age and gender. Videocapillaroscopy was performed in eight fingers with 2-4 images per finger. Quantitative and qualitative assessments of nailfold capillaroscopy images were performed according to the definitions of the EULAR study group on microcirculation in Rheumatic Diseases. Results Both groups (n = 41 cSLE-patients and n = 41 healthy controls) were comparable for ethnic background (p = 0.317). Counted per mm, cSLE-patients showed significantly more ‘giants’ (p = 0.032), ‘abnormal capillary shapes’ (p = 0.003), ‘large capillary hemorrhages’ (p < 0.001) and ‘pericapillary extravasations’ (p < 0.001). Combined ‘abnormal capillary shapes and pericapillary extravasations’ (in the same finger) were detected in 78% (32/41 patients). By qualitative analysis, ‘microangiopathy’ was detected in 68.3% (28/41) and a ‘scleroderma pattern’ in 17.1% (7/41) of the cSLE-patients (without scleroderma symptoms). The difference of percentage positive anti-RNP antibodies in the group with or without a scleroderma pattern was not significant (p = 0.089). The number of ‘abnormal capillary shapes per mm’ was significantly correlated with treatment-naivety. The number of ‘large pathological hemorrhages per mm’ was significantly correlated with SLEDAI score and presence of nephritis. Compared to healthy controls, ‘pericapillary extravasations’ were found in significantly higher numbers per mm (p < 0.001) as well as in percentage of patients (p < 0.001). Conclusions Our observations confirm that giants, abnormal capillary morphology and capillary hemorrhages are also observed in cSLE, as was already known for adults with SLE. Number of capillary hemorrhages in cSLE was significantly correlated with disease activity. A high frequency and total amount of “pericapillary extravasations” was observed in cSLE patients, possibly revealing a new subtype of capillary hemorrhage that might reflect endothelial damage in these pediatric patients.
Testing and Diagnosis as Social Interventions: An Interview with Annemarie Jutel
Authors: Pienaar Kiran , Petersen Alan 
Published: March 2021

Kiran Pienaar (KP) and Alan Petersen (AP): Thank you, Annemarie, for agreeing to share your perspectives in this interview. We are delighted to have this opportunity to engage with your insights and scholarly contributions on the sociology of diagnosis. In 2011 you co-edited a special issue of Social Science and Medicine entitled ‘Toward a Sociology of Diagnosis’ in which you called for sociologists to pay more attention to medical diagnosis as a central practice and classification tool of medicine. In the introduction, you note that ‘diagnosis has had an absent presence in the sociology of health and illness’ (Jutel & Nettleton, 2011, p. 793). Do you think this is still the case or has the field developed since then to attend more closely to the social issues and processes at work in diagnosis? In your view, does diagnosis merit continued/renewed sociological attention? And if so, why?