bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurses’ caring behaviour and its correlation with moral sensitivity
Authors: Afrasiabifar Ardashir , Mosavi Asadolah , Dehbanizadeh Abolfazl , Khaki Sahar 
Published: February 2021

Background Different and contradictory results have been reported for nurses’ caring behaviour and moral sensitivity. Aims The present study aimed to examine the correlation between nurses’ caring behaviour and moral sensitivity. Methods The research was a descriptive, correlational study. Data were collected using moral sensitivity (range: 0–100) and caring behaviour (range: 24–144) questionnaires. A total of 250 nurses who worked in the clinical wards of Yasuj teaching hospitals in 2018, were selected by systematic random sampling. The collected data were analysed using SPSS version 19 for descriptive statistics and Pearson correlation tests. Results Seventy-four percent of nurses had moderate moral sensitivity (50–74). Nurses’ moral sensitivity and caring behaviour mean scores were reported to be 59.5 ± 11.1 (range: 31–87) (Potential range 0--100) and 110.99 ± 17.99 (range: 69–94) (Potential range 22–144), respectively. The Pearson test showed a positive correlation between nurses’ caring behaviour and moral sensitivity at a 99% level ( p = 0.001). Conclusions Nurses’ moral sensitivity and caring behaviour were found to be moderate and good, respectively. Furthermore, there was a positive correlation between moral sensitivity and caring behaviour in nurses, that is, nurses provided better caring behaviour as levels of moral sensitivity increased.
Functional deficits as a result of brachial plexus injury in anterior shoulder dislocation
Authors: Jordan Rupert , Wade Ryckie G. , McCauley Gordon , Oxley Suzanne , Bains Robert , Bourke Gráinne 
Published: February 2021

The incidence of brachial plexus injuries in anterior shoulder dislocation remains relatively uncommon. A retrospective study was conducted to observe the natural neurological recovery of patients following these injuries over a 2-year period. Muscle power according to the Medical Research Council scale and sensation were measured from presentation to discharge. In 28 patients, the power grade of proximal muscles supplied by nine injured nerves failed to improve over a median follow-up of 5 months. There was no statistically significant improvement in sensation over a median follow-up of 6 months. Poorer recovery in muscle power score was related to advancing age, whereby every decade increased the risk by approximately 30%. Anterior shoulder dislocation with a plexus injury carries a risk of permanent nerve injury. Patients should be referred for specialist nerve assessment leading to rehabilitation and timely early nerve reconstruction, if indicated. Level of evidence: IV
Effects of Lee Silverman Voice Treatment BIG and conventional physiotherapy on non-motor and motor symptoms in Parkinson’s disease: a randomized controlled study comparing three exercise models
Authors: Schaible Fabian , Maier Franziska , Buchwitz Timo Marcel , Schwartz Frank , Hoock Marius , Schönau Eckhard , Libuda Miriam , Hordt Anke , van Eimeren Thilo , Timmermann Lars , Eggers Carsten 
Published: February 2021

Background: Parkinson’s disease (PD) patients experience disabling motor dysfunctions as well as non-motor symptoms (NMSs) that can highly impact their perceived quality of life. Besides pharmacological treatment options, active intervention programs have set some attention in managing these symptoms. However, previous studies mainly assessed the effectiveness of active intervention programs on functional mobility and motor symptoms. Objective: This study aimed to investigate the effect of Lee Silverman Voice Treatment (LSVT) BIG, an intensified and personalized physiotherapy (INTENSIVE), and a conventional physiotherapy (NORMAL) on NMSs in PD. Method: Forty-four patients with mild to moderate PD were randomly assigned to one of the three treatment groups. LSVT BIG and INTENSIVE were delivered one-on-one in 16 1-hour sessions within 4 weeks (4×/week). Patients assigned to NORMAL received 16 individual 1-hour sessions within 8 weeks (2×/week). The primary outcome measure was the difference in change from baseline in the non-motor symptom assessment scale for Parkinson’s disease (NMSS) between treatment groups to follow up at week 8. Patients were blinded for the NMSS being the primary outcome, but not the different treatment groups. Results: ANCOVA (Analysis of Covariance) showed reduced NMSS scores for all groups, with INTENSIVE being superior to NORMAL ( p = 0.033). For secondary outcome measures (stride length, gait velocity and chair rising test) LSVT BIG and INTENSIVE were both superior to NORMAL. Conclusions: The study provides evidence that all three exercise programs are effective techniques to improve NMSs as well as motor function in PD. DRKS registration number: DRKS00008732
Outcome following management of unstable lateral end clavicle fractures with locking plate and coracoid anchor augmentation
Authors: Karuppaiah Karthik , Bilal Ahmad , Colegate-Stone Toby , Sinha Joydeep , Tahmassebi Ramon , Tavakkolizadeh Adel 
Published: February 2021

Background Management of complex lateral end clavicle fractures with coraco-clavicular ligament disruption can be challenging. Methods We prospectively analysed 19 (17 M:2F) patients from January 2014 to June 2016. Six patients had intra-articular fractures (Edinburgh-3B2) and the remaining were extra-articular (3B1). All patients had open reduction internal fixation with lateral end locking plate augmented with a coracoid anchor. All patients were evaluated at the final follow-up by American Shoulder and Elbow Surgeon score (ASES), Disabilities of the Arm, Shoulder and Hand (DASH), Oxford Shoulder Score (OSS), return to work, sports and radiographs. Results At a mean follow-up of 54 months (range 37–64), 19 patients were available for analysis. Mean age of patients was 34 years (range 24–65). At final follow-up DASH score was 1.66 (range 0–5); ASES score was 98.14 (93.3–100) and OSS was 46.6 (42–48). There was no difference in the functional outcome between 3B1 and 3B2 fractures (DASH – p(0.51); ASES –  p(0.44); OSS – p(0.69)). All patients returned to preinjury level of function, sports and work. Five patients needed implant removal and three developed capsulitis that resolved with conservative treatment. Conclusion Locking plate fixation, augmented with coracoid anchor is an effective option in the management of these complex injuries. The need for implant removal is reduced (26%) and there is no difference in the functional outcome between 3B1 and 3B2 fractures.
Tissue Oxygenation Measurements to Aid Scalpel Debridement Removal in Patients With Diabetes
Authors: Kaile Kacie , Mahadevan Jagadeesh , Leiva Kevin , Khandavilli Dinesh , Narayanan Sivakumar , Muthukrishnan Varalakshmi , Wu Wensong , Mohan Viswanathan , Godavarty Anuradha 
Published: February 2021

Background: Callus formation in the diabetic foot increases the risk of ulcer onset. It is standard procedure to remove these dead tissue layers to reduce rising pressures. In a surgical procedure known as scalpel debridement, or chiropody the callus tissue is removed up to the epidermal layer. Factors may influence the outcome of this surgical process such as clinician inexperience. In an effort to standardize the debridement process, tissue oxygenation (TO) measurements are obtained before and after to study the effect of debridement on callus tissue. Methods: Fifteen debridement cases were analyzed using near infrared (NIR) imaging to study changes in TO. The NIR-based device used in this study estimates effective changes in TO in terms of oxy-, deoxy-, total hemoglobin, and oxygen saturation. Weber contrasts between callus tissue and the surrounding normal tissue were compared following debridement for all TO parameters. In a secondary analysis, callus tissue was segmented into quadrants and a percent of significance (in terms of total TO change) was calculated using a t-test. Results: Results show majority of cases displayed greater than 80% as the significant change in TO following debridement, except in cases with the presence of blood clot (a common precursor for ulceration). In cases where incomplete debridement was suspected, a significant change in TO was still observed. Conclusions: With extensive systematic studies in the future, NIR imaging technique to measure changes in TO may be implemented as a low-cost hand-held imaging device useful for objectively assessing the effectiveness of the scalpel debridement process.
Identifying Mobile Health Technology Experiences and Preferences of Low-Income Pregnant Women with Diabetes
Authors: Leziak Karolina , Birch Eleanor , Jackson Jenise , Strohbach Angelina , Niznik Charlotte , Yee Lynn M. 
Published: February 2021

Background: Rapid expansion of mobile technology has resulted in the development of many mobile health (“mHealth”) platforms for health monitoring and support. However, applicability, desirability, and extent of tailoring of these platforms for pregnant women, particularly in populations who experience the greatest health inequities—such as women with diabetes mellitus (DM) and/or those with greater socioeconomic barriers—remains unknown. The objective is to understand low-income pregnant women’s experiences and preferences for mHealth tools to support DM health and improve DM self-management during pregnancy. Methods: Low-income pregnant and postpartum women were included in individual interviews or focus groups; women with type 2 DM, gestational DM, or no DM were included. Analysis was performed with the constant comparison method. Results: In this population of 45 ( N=37 with DM) low-income, largely minority, pregnant and postpartum women, 100% reported access to smartphones and prior experience with apps. Interest in mHealth to support health and engagement during pregnancy was high. Preferences for general mHealth features included education that reduces uncertainty, support communities, visualizing progress, convenient access to information, and support for better management of pregnancy-related tasks. Preferred design elements included personalization, interactive features, and integrated graphics. Women with DM expressed multiple additional DM-specific needs, including support tools for DM self-management and self-regulation tasks. Conclusion: Pregnant and postpartum women, especially those with DM, desire mHealth technology to support engagement and to adapt lifestyle guidelines and treatment requirements for a healthy pregnancy. Further work to develop mHealth interventions tailored for target populations remains a key step in reducing health inequities and promoting access to evidence-based perinatal health interventions.
Effects of a Dedicated Inpatient Diabetes Management Service on Glycemic Control in a Community Hospital Setting
Authors: Demidowich Andrew P. , Batty Kristine , Love Teresa , Sokolinsky Sam , Grubb Lisa , Miller Catherine , Raymond Larry , Nazarian Jeanette , Ahmed M. Shafeeq , Rotello Leo , Zilbermint Mihail 
Published: February 2021

Background: Community hospitals account for over 84% of all hospitals and over 94% of hospital admissions in the United States. In academic settings, implementation of an Inpatient Diabetes Management Service (IDMS) model of care has been shown to reduce rates of hyper- and hypoglycemia, hospital length of stay (LOS), and associated hospital costs. However, few studies to date have evaluated the implementation of a dedicated IDMS in a community hospital setting. Methods: This retrospective study examined the effects of changing the model of inpatient diabetes consultations from a local, private endocrine practice to a full-time endocrine hospitalist on glycemic control, LOS, and 30-day readmission rates in a 267-bed community hospital. Results: Overall diabetes patient days for the hospital were similar pre- and post-intervention (20,191 vs 20,262); however, the volume of patients seen by IDMS increased significantly after changing models. Rates of hyperglycemia decreased both among patients seen by IDMS (53.8% to 42.5%, P < .0001) and those not consulted on by IDMS (33.2% to 29.9%; P < .0001). When examined over time, rates of hypoglycemia steadily decreased in the 24 months after dedicated IDMS initiation ( P = .02); no such time effect was seen prior to IDMS ( P = .34). LOS and 30DRR were not significantly different between IDMS models. Conclusions: Implementation of an endocrine hospitalist-based IDMS at a community hospital was associated with significantly decreased hyperglycemia, while avoiding concurrent increases in hypoglycemia. Further studies are needed to investigate whether these effects are associated with improvements in clinical outcomes, patient or staff satisfaction scores, or total cost of care.
Biotribological Tests of Osteochondral Grafts after Treatment with Pro-Inflammatory Cytokines
Authors: Bauer Christoph , Göçerler Hakan , Niculescu-Morzsa Eugenia , Jeyakumar Vivek , Stotter Christoph , Klestil Thomas , Franek Friedrich , Nehrer Stefan 
Published: February 2021

Objective During osteoarthritis progression, cartilage degrades in a manner that influences its biomechanical and biotribological properties, while chondrocytes reduce the synthesis of extracellular matrix components and become apoptotic. This study investigates the effects of inflammation on cartilage under biomechanical stress using biotribological tests. Methods Bovine osteochondral grafts from five animals were punched out from the medial condyle and treated with or without pro-inflammatory cytokines (interleukin-1β [IL-1β], tumor necrosis factor-α [TNF-α], IL-6) for 2 weeks. After incubation, biotribological tests were performed for 2 hours (alternating 10 minutes test and pause respectively at 39°C, 180 N, 1 Hz, and 2 mm stroke). Before and after testing, the cartilage surface was imaged with a 3-dimensional microscope. During testing, the coefficient of friction (COF) was measured, while gene expression analysis and investigation of metabolic activity of chondrocytes were carried out after testing. Histological sections of the tissue and wear debris from the test fluid were also analyzed. Results After biotribological tests, surface cracks were found in both treated and untreated osteochondral grafts. In treated grafts, the COF increased, and the proteoglycan content in the cartilage tissue decreased, leading to structural changes. Chondrocytes from treated grafts showed increased expression of genes encoding for degradative enzymes, while cartilage-specific gene expression and metabolic activity exhibited no significant differences between treated and untreated groups. No measurable difference in the wear debris in the test fluid was found. Conclusions Treatment of osteochondral grafts with cytokines results in a significantly increased COF, while also leading to significant changes in cartilage proteoglycan content and cartilage matrix compression during biotribological tests.
Dipeptidyl peptidase-4 inhibitor use and mortality in COVID-19 patients with diabetes mellitus: an updated systematic review and meta-analysis
Authors: Pal Rimesh , Banerjee Mainak , Mukherjee Soham , Bhogal Ranjitpal Singh , Kaur Amanpreet , Bhadada Sanjay K. 
Published: February 2021

Background: Few observational studies have shown a beneficial effect of dipeptidyl peptidase-4 inhibitors (DPP4i) in patients with coronavirus disease 2019 (COVID-19), although results are not consistent. The present systematic review and meta-analysis was undertaken to provide a precise summary of the effect of DPP4i use (preadmission or in-hospital) and mortality in COVID-19 patients with diabetes mellitus (DM). Methods: PubMed and Google Scholar databases were systematically searched using appropriate keywords to 4 January 2021, to identify observational studies reporting mortality in COVID-19 patients with DM using DPP4i versus those not using DPP4i. Preadmission and in-hospital use of DPP4i were considered. Study quality was assessed using the Newcastle–Ottawa Scale. Unadjusted and adjusted pooled odds ratio (OR) with 95% confidence intervals (CIs) were calculated. Subgroup analysis was performed for studies reporting preadmission and in-hospital use of DPP4i. Results: We identified nine observational studies of high quality pooling data retrieved from 7008 COVID-19 patients with DM. The pooled analysis of unadjusted and adjusted data did not show any significant association between DPP4i use and mortality in COVID-19 patients with DM. However, on subgroup analysis, we found that in-hospital (and not preadmission) DPP4i use was associated with reduced mortality (unadjusted OR 0.37, 95% CI 0.23, 0.58, p < 0.0001, I2 = 0% and adjusted OR 0.27, 95% CI 0.13, 0.55, p = 0.0003, I2 = 12%). Conclusions: In-hospital use of DPP4i is associated with a significant reduction in COVID-19 mortality. Hence, it would be prudent to initiate or continue DPP4i in COVID-19 patients with DM if not contraindicated.
Measuring ‘self’: preliminary validation of a short form of the Self Experiences Questionnaire in people with chronic pain
Authors: Yu Lin , Scott Whitney , Goodman Rupert , Driscoll Lizzie , McCracken Lance M 
Published: February 2021

Background: People with chronic pain often struggle with their sense of self and this can adversely impact their functioning and well-being. Acceptance and Commitment Therapy particularly includes a process related to this struggle with self. A measure for this process, the Self Experiences Questionnaire (SEQ), was previously developed in people with chronic pain. Purpose: The aim of the current study was to validate a shorter version of the SEQ in people with chronic pain to reduce respondent burden and facilitate further research. Methods: Data from 477 participants attending an interdisciplinary pain management programme were included. Participants completed measures of treatment processes (self-as-context, pain acceptance, cognitive fusion and committed action) and outcomes (pain, pain interference, work and social adjustment and depression) at baseline and post-treatment. Confirmatory factor analysis was used for item reduction. Correlations between scores from the shorter SEQ and other process and outcome variables were calculated to examine validity. Change scores of the shorter SEQ and their correlations with changes in outcome variables were examined for responsiveness. Results: An eight-item SEQ (SEQ-8) scale including two factors, namely Self-as-Distinction and Self-as-Observer, emerged, demonstrating good reliability (Cronbach’s α = .87–.90) and validity (|r| = .14–.52). Scores from SEQ-8 significantly improved after the treatment (d = .15–21), and these improvements correlated with improvements in most outcomes. Conclusions: The SEQ-8 appears to be a reliable and valid measure of self. This shorter format may facilitate intensive longitudinal investigation into sense of self and functioning and well-being.
Coronavirus disease 2019 and the cancellation of face-to-face prostate cancer active surveillance clinic reviews: Does the omission of digital rectal examination alone put patients at risk of missed detection of disease progression?
Authors: Maresca Gianluca , Akinlua Akintobi , Wardlaw Kevin , Macdonald Graham , Royle Justine 
Published: February 2021

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has resulted in the cancellation or postponement of face-to-face clinic appointments, meaning patients on active surveillance (AS) for low- or intermediate-risk prostate cancer have been unable to undergo the recommended clinical assessment and digital rectal examination (DRE) during these times. This study aimed to determine whether the omission of DRE during the COVID-19 pandemic has put AS patients at risk by missing early detection of disease progression. Methods: This was a retrospective, regional study looking at the data of 142 men who qualified for placement on the Grampian AS protocol over a six-year span. It paid particular attention to the reasons for progression in those men who moved to active treatment (AT) during this six-year period. Results: The results showed that DRE played no role in triggering the move of these 42 patients onto AT. Nineteen (45%) of these patients moved to AT due to progression on trans-rectal ultrasound biopsy, 10 (24%) due to progression on multi-parametric magnetic resonance imaging, eight (19%) due to a rising prostate-specific antigen and five (12%) due to patient choice. Conclusion: This audit reassures us that those patients who cannot receive a timely DRE during the COVID-19 pandemic are unlikely to be at an increased risk of missing disease progression in our region. Level of evidence: Retrospective cohort study – level 3.
Personalised inpatient multidisciplinary rehabilitation elicits clinically relevant improvements in physical function in patients with multiple sclerosis – The Danish MS Hospitals Rehabilitation Study
Authors: Hvid Lars G , Gaemelke Tobias , Dalgas Ulrik , Slipsager Mette K , Rasmussen Peter V , Petersen Thor , Nørgaard Michael , Skjerbaek Anders G , Boesen Finn 
Published: February 2021

Purpose Evidence of the effects of inpatient multidisciplinary rehabilitation (MDR) on physical function in patients with multiple sclerosis (MS) is limited, particularly whether clinically relevant improvements can be achieved. The aim of this study, therefore, was to investigate the effects of personalised inpatient MDR on the physical function of MS patients. Methods Embedded in the Danish MS Hospitals Rehabilitation Study, a pragmatic study was performed in MS patients undergoing four weeks of inpatient MDR specifically targeting physical function. Outcomes were assessed at baseline (n = 142), at discharge (n = 137) and at six months follow-up (n = 126) using the six-minute walk test (6MWT), six-spot step test (SSST), five times sit to stand test (5STS), nine-hole peg test (NHPT), dynamic gait index (DGI) and 12-item MS walking scale (MSWS). Results From Baseline-to-Discharge, significant and clinically relevant improvements were found in all measures of walking capacity (6MWT, SSST, 5STS, DGI and MSWS; p < 0.05) along with significant (but not clinically relevant) improvements in upper extremity function (NHPT; p < 0.05). Whilst comparable improvements were observed within subgroups of MS phenotype (relapsing-remitting [RR] vs. secondary + primary progressive [SP + PP]), disease severity (moderate [EDSS2.5–5.5] vs. severe [EDSS6.0–7.5]) and age (young/middle-aged [Age24–59] vs. old [Age60–65]), an attenuated adaptation was nevertheless observed for 6MWT in the most affected and vulnerable subgroups (i.e. SP + PP, EDSS6.0–7.5 and Age60–65). The significant improvements in walking capacity and upper extremity function persisted at six months follow-up but did not exceed anymore the thresholds regarded as clinically relevant. Conclusion The results provide novel evidence that personalised inpatient MDR targeting physical function in MS patients elicits significant and clinically relevant improvements in physical function.