bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Heart Failure Readmission in a High-Risk Primarily Hispanic Population in a Rural Setting
Authors: Carlson Beverly , Hoyt Helina , Gillespie Kristi , Kunath Julie , Lewis Dawn , Bratzke Lisa C. 
Published: March 2019

BACKGROUND
High risk for readmission in patients with heart failure (HF) is associated with Hispanic ethnicity, multimorbidity, smaller hospitals, and hospitals serving low-socioeconomic or heavily Hispanic regions and those with limited cardiac services. Information for hospitals caring primarily for such high-risk patients is lacking.

OBJECTIVE
The aim of this study was to identify factors associated with 30-day HF readmission after HF hospitalization in a rural, primarily Hispanic, low-socioeconomic, and underserved region.

METHODS
Electronic medical records for all HF admissions within a 2-year period to a 107-bed hospital near the California-Mexico border were reviewed. Logistic regression was used to identify independent predictors of readmission.

RESULTS
A total of 189 unique patients had 30-day follow-up data. Patients were primarily Hispanic (71%), male (58%), and overweight or obese (82.5%) with 4 or more chronic conditions (83%) and a mean age of 68 years. The 30-day HF readmission rate was 5.3%. Early readmission was associated with history of HF, more previous emergency department (ED) and hospital visits, higher diastolic blood pressure and hypokalemia at presentation, shorter length of stay, and higher heart rate, diastolic blood pressure, and atrial fibrillation (AF) at discharge. Using logistic regression, previous 6-month ED visits (odds ratio, 1.5; P = .009) and AF at discharge (odds ratio, 5.7; P = .039) were identified as independent predictors of 30-day HF readmission.

CONCLUSIONS
Previous ED use and AF at discharge predicted early HF readmission in a high-risk, primarily Hispanic, rural population in a low-socioeconomic region.
Dietary Sodium Intake is Predicted by Antihypertensive Medication Regimen in Patients With Heart Failure
Authors: Smith Jennifer L. , Lennie Terry A. , Chung Misook L. , Mudd-Martin Gia 
Published: March 2019

Background
Low-sodium diet adherence is foundational to heart failure (HF) self-management. Altered salt taste perception caused by angiotensin-converting enzyme (ACE) inhibitors commonly prescribed to patients with HF may increase sodium consumption. We hypothesized sodium intake, indicated by dietary sodium density, would be significantly higher among patients with HF prescribed ACE inhibitors compared with those not prescribed the drug.

Objective
The aim of this study was to assess the association between prescribed ACE inhibitors and dietary sodium density in patients with HF.

Methods
We conducted a secondary analysis of baseline data from patients with HF in an observational longitudinal study. Sodium density was derived by dividing averaged daily sodium intake from 4-day food diaries by averaged kilocalories consumed. Medical chart review was conducted to ascertain prescribed medications. Patients were categorized as prescribed and not prescribed an ACE inhibitor. t Tests were conducted to compare sodium intake between groups, and linear regression was conducted to examine whether prescribed ACE inhibitors independently predicted sodium density controlling for age, gender, New York Heart Association class, prescribed diuretics, and β-blockers.

Results
Analyses included 255 patients with HF aged 61 ± 12 years, with 67% male, 44% New York Heart Association class III/IV, and 68% prescribed an ACE inhibitor. Compared with those not prescribed an ACE inhibitor, 13% more sodium per kilocalorie was consumed by patients prescribed an ACE inhibitor. Prescribed ACE inhibitor independently predicted dietary sodium density (β = 0.238, P = .009).

Conclusions
Sodium intake was higher among patients prescribed ACE inhibitors. Interventions to assist patients with HF with dietary sodium adherence can be informed by assessing medication regimens.
Validity and Reliability of a Chinese-Language Instrument for Continuous Assessment of Exercise Stages of Change in Adults
Authors: Chen Shih-Hui , Lai Hsiang-Ru , Chen Su-Ru , Lin Pi-Chu , Chou Kuei-Ru , Lee Pi-Hsia 
Published: March 2019

ABSTRACT

Background
Single- and five-item measures have been used prevalently to assess exercise stages of change. Few studies have investigated the development of instruments that are able to continuously measure exercise stages of change and have conducted associated psychometric analyses.

Purpose
This study aimed to translate the original, English-language version of the University of Rhode Island Change Assessment-Exercise 2 (URICA-E2), a continuous exercise stages of change assessment instrument, into Chinese and then to test the validity and reliability of the translated version.

Methods
A cross-sectional descriptive study was conducted. Participants consisted of 325 adults from Taipei, Taiwan. The URICA-E2 was translated into Chinese using a standardized procedure. Psychometric analyses, including validity, reliability, and cluster analysis, of the Chinese-version instrument were conducted.

Results
The content validity index was .987. Confirmatory factor analysis confirmed that the overall model fit was standardized, as the factor loadings of all of the items and the composite reliability and average variance extracted for the six exercise stages of change satisfied the convergent validity criteria. The average variance extracted for each construct of the stages of behavior change satisfied the discriminatory validity criteria. Values of Cronbach's α for the six exercise stages ranged from .80 to .94. The intraclass correlation coefficients for test–retest reliability after 2 weeks ranged between .74 and .87.

Conclusions
The Chinese-language version of the URICA-E2 developed in this study exhibited excellent validity and reliability. This instrument may be used by healthcare professionals and the academic community to effectively and continuously measure the intentions and attitudes of adults at various exercise stages of change and to guide the provision of appropriate interventions.
Women With Amenorrhea and Men With Menstruation: The Qualitative Experiences of People With Disorders of Sex Development in Nigeria
Authors: Sani Abdurrahman Muhammad , Arif Ismi Ismail , Arshad Mohd Mursyid , Mungadi Ismaila Arzika , Soh Kim Geok , Soh Kim Lam 
Published: March 2019

ABSTRACT

Background
Disorders of sex development (DSD) affect the quality of life of people who live with this condition. In developing countries, diagnoses of DSD are associated with a delay in presentation until the patients developed ambiguous physical traits and features.

Purpose
This study explores the menstrual experiences of people with DSD and sex reassignment in Nigeria.

Methods
A qualitative approach with a phenomenological study design was employed in this study to explore and describe the experiences of people with DSD at the Usmanu Danfodiyo University Teaching Hospital in Sokoto, Nigeria. The data were collected using face-to-face interviews, transcribed verbatim, and analyzed using NVivo software.

Results
The findings show that the participants experienced menstrual problems: men with menstruation and women with amenorrhea. The female participants generally described amenorrhea as a disappointment and linked menstruation with womanhood. Amenorrhea evinced both emotional and psychological effects. However, some of the female participants considered amenorrhea in a positive light and were happy with their lives without menstruation. The menstrual experiences of male participants included menarche, lower abdominal pain, regular monthly bleeding, and ovulation. The male participants described menstruation as a disaster in their lives and a source of anxiety, suicidal ideation, and depression. Menstruation negatively affected their psychosocial well-being.

Conclusions
The menstrual experience of individuals with DSD negatively affects their quality of life. The women with DSD in this study showed a generally poor knowledge of menarche, menstruation, and puberty, indicating that their parents had ignored the initial symptoms of DSD. DSD were only recognized at puberty because of the development of ambiguous physical traits and of the onset of menstruation in men and the confirmation of amenorrhea in women.
An Exploration of Factors Related to Quality of Life in Indonesian Care Workers in Home-Based Care Settings
Authors: LO Shu-Fen , CHANG Li-Jung , HAYTER Mark , O YANG An-Chi 
Published: March 2019

ABSTRACT

Background
Indonesians constituted 79% of foreign care workers for long-term care in Taiwan in 2015. Therefore, it is crucial to explore the effect of work stress and quality of life (QoL) on this population.

Purpose
This study aims to explore stress levels, social support requirements, and perceived QoL among Indonesian care workers (ICWs) who work in home care settings.

Methods
A cross-sectional design was used. Data were collected between 2014 and 2016 from a convenience sample of ICWs working in eastern Taiwan using a self-administered questionnaire that comprised the Stress Perception Scale (SPS), Social Support Scale (SSS), and World Health Organization Quality of Life-Brief scale. One hundred fifty-seven valid questionnaires were collected. The response rate was 80.51%. Data were analyzed using descriptive statistics, one-way analysis of variance, Pearson's correlation coefficient, and multiple regression analysis.

Results
The results found that the average SPS of the sample was 70.50, with low QoL scores and requirements for more social support. In addition, significant and positive correlations were found between QoL and SPS, SSS, duration of patient care, and hours of care per week. Stepwise regression analysis showed that the most predictive variables for QoL were time spent caring, preservice training, psychological stress, and emotional support, which together accounted for 60.9% of the total variance.

Conclusions/Implications for Practice
This study facilitated understanding of the stress on ICWs and the impact of social support on their QoL. The findings suggest that new immigrants in Taiwan should be introduced to foreign care workers or nursing attendants. Moreover, long-term-care-related teachers should work with home care institutions or agencies to develop a teaching model for innovative care skills to relieve the perceived stress of ICWs.
Safety and Effectiveness of Cochlear Implantation of Young Children, Including Those With Complicating Conditions
Authors: Hoff Stephen , Ryan Maura , Thomas Denise , Tournis Elizabeth , Kenny Hannah , Hajduk John , Young Nancy M. 
Published: March 2019

Objective:
Determine safety and effectiveness of cochlear implantation of children under age 37 months, including below age 12 months.

Study Design:
Retrospective review.

Setting:
Tertiary care children's medical center.

Patients:
219 children implanted before age 37 mos; 39 implanted below age 12 mos and 180 ages 12–36 mos. Mean age CI = 20.9 mos overall; 9.4 mos (5.9–11.8) and 23.4 mos (12.1–36.8) for the two age groups, respectively. All but two ≤12 mos (94.9%) received bilateral implants as did 70.5% of older group. Mean follow-up = 5.8 yrs; age last follow-up = 7.5 yrs, with no difference between groups.

Interventions:
Cochlear implantation.

Main outcome measures:
Surgical and anesthesia complications, measurable open-set speech discrimination, primary communication mode(s).

Results:
Few surgical complications occurred, with no difference by age group. No major anesthetic morbidity occurred, with no critical events requiring intervention in the younger group while 4 older children experienced desaturations or bradycardia/hypotension. Children implanted under 12 mos developed open-set earlier (3.3 yrs vs 4.3 yrs, p ≤ 0.001) and were more likely to develop oral-only communication (88.2% vs 48.8%, p ≤ 0.001). A significant decline in rate of oral-only communication was present if implanted over 24 months, especially when comparing children with and without additional conditions associated with language delay (8.3% and 35%, respectively).

Conclusions:
Implantation of children under 37 months of age can be done safely, including those below age 12 mos. Implantation below 12 mos is positively associated with earlier open-set ability and oral-only communication. Children implanted after age 24 months were much less likely to use oral communication exclusively, especially those with complex medical history or additional conditions associated with language delay.
Efficacy and Safety of AM-111 in the Treatment of Acute Unilateral Sudden Deafness—A Double-blind, Randomized, Placebo-controlled Phase 3 Study
Authors: Staecker Hinrich , Jokovic Galina , Karpishchenko Sergey , Kienle-Gogolok Andrea , Krzyzaniak Andrzej , Lin Chia-Der , Navratil Pavel , Tzvetkov Ventzislav , Wright Nida , Meyer Thomas 
Published: March 2019

Objective:
To confirm the efficacy and safety of AM-111 (brimapitide), a cell-penetrating c-Jun N-terminal Kinase (JNK) inhibitor, in patients suffering from severe to profound acute unilateral idiopathic sudden sensorineural hearing loss (ISSNHL).

Study design:
Prospective, double-blind, randomized, placebo-controlled phase 3 study with follow-up visits on Days 3, 7, 28, and 91.

Setting:
Fifty-one European and Asian sites (tertiary referral centers, private ENT practices).

Patients:
Two hundred fifty-six patients aged 18 to 65 years presenting within 72 hours following ISSNHL onset with mean hearing loss ≥ 40 dB and mean threshold ≥ 60 dB at the 3 worst affected contiguous test frequencies.

Interventions:
Single-dose intratympanic injection of AM-111 (0.4 or 0.8 mg/ml) or placebo; oral prednisolone as reserve therapy if hearing improvement < 10 dB at Day 7.

Main outcome measures:
Hearing improvement to Day 28 was the primary efficacy endpoint; complete hearing recovery, frequency of reserve therapy used, complete tinnitus remission, improvement in word recognition were secondary endpoints. Safety was evaluated by the frequency of clinically relevant hearing deterioration and adverse events.

Results:
While the primary efficacy endpoint was not met in the overall study population, post-hoc analysis showed a clinically relevant and nominally significant treatment effect for AM-111 0.4 mg/ml in patients with profound ISSNHL. The study drug and the administration procedure were well tolerated.

Conclusions:
AM-111 provides effective otoprotection in case of profound ISSNHL. Activation of the JNK stress kinase, AM-111's pharmacologic target, seems to set in only following pronounced acute cochlear injury associated with large hearing threshold shifts.
Primary alveolar rhabdomyosarcoma of retrorectal-presacral space in an adult patient
Authors: Zhu Xiu-Liang , Su Wei-Wei , Tang Jin-Long , Yao Li-Ding , Lu Liang-Ji , Sun Xiu-Juan 
Published: March 2019

Abstract

Rationale:
Rhabdomyosarcoma (RMS) has known as a highly malignant soft tissue sarcoma, representing 5% to 10% of all solid tumors in childhood. Alveolar rhabdomyosarcoma (ARMS) of the retrorectal-presacral space is an extremely rare lesion for adult, no study has been reported in the English literature.

Patient concerns:
A 51-year-old male presented with abdominal pain for 1 month, significantly worse when having a bowel movement.

Diagnosis:
Computed tomography (CT) and magnetic resonance imaging (MRI) of the pelvis showed a solid-cystic, enhancing lesion of dimension located in retrorectal-presacral space. The surgical specimen was reported as ARMS after pathological evaluation.

Interventions:
The tumor was complete surgical resection, and after surgery, the patient was treated with combination chemotherapy.

Outcomes:
At 23 months follow up, the patient was asymptomatic with no evidence of metastases or local recurrence.

Lessons:
Improvements in imaging in addition to early surgical intervention and chemotherapy treatment are crucial to improve survival chances against RMS.
Diagnostic value of high b-value (2000 s/mm2) DWI for thyroid micronodules
Authors: Wang Qingjun , Guo Yong , Zhang Jing , Ning Haoyong , Zhang Xiliang , Lu Yuanyuan , Shi Qinglei 
Published: March 2019

Abstract
The aim of the study was to assess the diagnostic value of high b-value (2000 s/mm2) diffusion-weighted imaging (DWI) in differentiating malignant from benign thyroid micronodules.
Consecutive patients with thyroid micronodules scheduled for Ultrasound (US)-guided fine-needle aspiration biopsy (FNAB) or surgery were underwent high b-value DWI with 3 b-values: 0, 800, and 2000 s/mm2. Signal intensity ratios (SIRs) of thyroid micronodules to adjacent normal thyroid tissue on DWI were measured as SIRb0, SIRb800 and SIRb2000. Apparent diffusion coefficients (ADCs) according to the three different b-values were acquired as: ADCb0–800, ADCb0–2000 and ADCb0–800–2000. The 6 diagnostic indicators were evaluated by receiver operating characteristic (ROC) and diagnostic ability was compared between the high b-value DWI and US.
Sixty-two malignant thyroid micronodules (48 patients, 13 men and 35 women, aged 44.8 ± 11.7 years) and 57 benign thyroid micronodules (40 patients, 6 men and 34 women, aged 49.6 ± 12.5 years) were enrolled into the final statistical analysis. Among the alone diagnostic indicators, SIRb2000 had the highest diagnostic ability in differentiating malignant from benign thyroid micronodules with area under curve (AUC) of 0.975, sensitivity of 90.32% and specificity of 96.49%. Compared to US, SIRb2000 had a significantly better diagnostic ability US for thyroid micronodules (P < .001) with dramatically raised positive predict value (96.6% vs 78.9%) and reduced false-positive rate (3.51% vs 26.32%).
High b-value (2000 s/mm2) DWI can contribute to differentiating malignant from benign thyroid micronodules.
Association between osteoarthritis and increased risk of dementia
Authors: Weber Adrian , Mak Shing hung , Berenbaum Francis , Sellam Jérémie , Zheng Yong-Ping , Han Yifan , Wen Chunyi 
Published: March 2019

Abstract

Objective:
To investigate the possible association between osteoarthritis (OA) and the risk of dementia.

Methods:
Cohort, case-control, and cross-sectional studies were obtained from wide literature search up to 20 April 2018 from following electronic databases: PubMed, Embase, Cochrane, using the MeSH terms: “osteoarthritis” AND “dementia”. The literature search was then expanded to congress abstracts. After screening and selection of relevant studies by two investigators, data was extracted. Estimates were then calculated using a random-effect size model. Sensitivity-analysis was conducted for gender and age adjusted studies and pooled for studies with STROBE quality assessment score ≥75%. Publication bias was assessed by Funnel plot. Analyses were performed using Data Analysis and Statistical Software Version 14.2.

Results:
Nearly 1549 publication references were initially retrieved. Twenty-six publications were checked with full-text. Six observational studies with 388,252 individuals were included. OA was associated with a significantly increased risk for dementia (OR = 1.20; 95% confidence interval (CI), 1.03–1.39, I
2 = 95.6%, P < .05). After pooling the studies with adjustment of age and gender, the risk increased (OR 1.36; 95% CI, 1.22–1.51, I
2 = 75.6%, P < .0001). After pooling the study with a STROBE Quality score ≥75% the risk for dementia was slightly increased (OR 1.33; 95% CI, 1.17–1.5, I
2 = 93.5%, p < 0.0001).

Conclusions:
There is an association between osteoarthritis and the risk of dementia. This meta-analysis does not provide causality. Further prospective cohort studies are needed to clarify, if knee-, hip-, or hand-OA are independent risk factors for Alzheimer's disease and vascular dementia.
Diagnosis and treatment of a penetrating brain injury caused by a welding electrode
Authors: Shi Lin , Sun Yue , Chen Limin , Xue Hang , Zhang Weitao , Yang Hongfa 
Published: March 2019

Abstract

Rationale:
Penetrating brain injury caused by a welding electrode is a rare occurrence. This type of injury requires careful preoperative assessment and timely treatment measures to avoid secondary damage.

Patient concerns:
A 55-year-old male patient fell from a height of approximately 5 m during when a welding electrode in his left hand was inadvertently inserted into his brain. The patient had a GCS score of 15 and complaints of dizziness and headache. CT showed an object of metallic density penetrating the skull and entering the brain parenchyma in the frontotemporal region.

Diagnosis:
According to the clinical findings and preoperative imaging examination, the diagnosis was open craniocerebral injury with intracranial foreign body and left orbital wall fracture.

Intervention:
After definite diagnosis and sufficient preoperative preparation, active surgical treatment was carried out to remove intracranial foreign body. Anti-infection and other symptomatic treatment were given after operation. The signs of infection and changes of vital signs were closely observed.

Outcomes:
After treatment, no obvious adverse reactions were found and the patient was discharged. No complications such as infection occurred during the follow-up period of 6 months.

Lessons:
In treating patient with a welding electrode penetrating the brain, assessments need to be made preoperatively, the welding electrode needs to be removed in a timely manner, complete hemostasis needs to be achieved during surgery with total repair of the damaged area, and anti-inflammatory treatment needs to be administered postoperatively to achieve good results.
A randomized study on the effect of sequential acupoint stimulation on pulmonary function of patients with spontaneous pneumothorax during VATS perioperative period
Authors: Sui Tie-Quan , Zhang Fa-Yue , Jiang Ai-Ling , Zhang Xiu-Qiang , Zhang Zhi-Wei , Yang Yang , Sun Li-Ping 
Published: March 2019

Abstract
This study aims to explore the effect of sequential acupoint stimulation on the postoperative pulmonary function of patients with spontaneous pneumothorax who underwent video-assisted thoracoscopic surgery (VATS).
Using a random number table, the patients were randomly divided into 2 groups: routine nursing group and sequential acupoint stimulation group. Patients in the routine nursing group received standard nursing care of thoracic surgery, while patients in the acupoint group received sequential acupoint stimulation on Shenshu (BL23), Gaohuang (BL43), Feishu (BL13), and Tiantu (CV22). Then, the maximal ventilatory volume (MVV), oxygen saturation (SpO2), postoperative drainage volume, postoperative drainage time, postoperative hospitalization days, and procalcitonin (PCT) were observed on the first, third, fifth and 30th day after VATS operation.
On the fifth day after spontaneous pneumothorax was treated with VATS, MVV, and SpO2 of the sequential acupoint stimulation group were significantly higher than those of the routine nursing group (P < .05). On both the third day and fifth day after VATS, PCT of the sequential acupoint stimulation group was significantly lower than that of the routine nursing group (P < .01). Furthermore, the difference in postoperative drainage volume between the 2 groups was not statistically significant (P > .05), while chest tube drainage time (P < .01) and postoperative hospitalization days (P < .05) of the sequential acupoint stimulation group were significantly lower than those of the routine nursing group.
In spontaneous pneumothorax patients who underwent VATS, sequential acupoint stimulation nursing was significantly more effective than routine postoperative nursing in promoting postoperative recovery of lung function, alleviating inflammatory response and shortening hospitalization days.