bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric tracheomalacia and the perioperative anesthetic management of thoracoscopic posterior tracheopexy
Authors: Masaracchia Melissa M. , Polaner David M. , Prager Jeremy D. , DeBoer Emily M. , Dewberry Lindel C. , Somme Stig , Wine Todd , Janosy Norah R. 
Published: July 2018

SummaryTracheomalacia is a broad term used to describe an abnormally compliant trachea that can lead to exaggerated collapse and obstruction with expiration. We describe the perioperative management of a complex pediatric patient undergoing a posterior tracheopexy which is a relatively new surgical treatment, with a novel surgical approach—thoracoscopy. This procedure has competing surgical and anesthetic needs and presents unique challenges to the physicians involved in caring for these patients. We also review the current literature on pediatric tracheomalacia and examine the newest treatment options to highlight the potential anesthetic challenges and pitfalls associated with management.
Basal cell carcinoma in a 17 year‐old organ transplant recipient
Authors: Borges‐Costa João 
Published: July 2018

AbstractSkin cancer is among the most frequent cancers in pediatric organ transplant recipients. We report a 17‐year‐old Caucasian girl who had had a kidney transplant 6 years before and was referred to our outpatient clinic for a basal cell carcinoma of the scalp. This case emphasizes the importance of teaching sun‐protective behavior to transplant recipients and their parents and having a high index of suspicion and arrange for early referral for dermatologic care if skin changes are observed.
Genotype‐phenotype correlation in type 1 neurofibromatosis: pMet992del mutation and milder disease
Authors: Batalla Ana , Iglesias‐Puzas Álvaro , Freire‐Bruno José , Herrero‐Hermida Javier , Flórez Ángeles 
Published: July 2018

AbstractA few genotype‐phenotype correlations have been described in type 1 neurofibromatosis. One deletion, p.Met992del, seems to be responsible for a mild form of the condition, in which there is absence of externally visible neurofibromas. We report a mother and a son with this mutation.
Applications of plant ingredients for tropical and subtropical freshwater finfish: possibilities and challenges
Authors: Ghosh Koushik , Ray Arun K. , Ringø Einar 
Published: June 2018

AbstractThe demand for cultured finfish has increased tremendously during the last decades, but the success of intensive farming is dependent on several factors, namely management, dietary supplementations and welfare. During the last decades, increasing demand, high price and limited supply of fishmeal have emphasized the need for alternative protein sources in aquafeeds, but plant proteins possess a series of endogenous antinutritional factors (ANFs; e.g. protease inhibitors, tannin, mimosine, phytic acid, nonstarch polysaccharides), and they must be destroyed or inactivated. Inclusion of alternative protein sources has resulted in production losses and is a concern for farmers. However, the problem with ANFs might be solved using advanced processing techniques. The present review, focusing on tropical and subtropical freshwater finfish, will discuss findings on applications of conventional methods, as well as fermentation technology for deactivation of endogenous ANFs, and the use of probiotics with ANF degrading potential when plant ingredients are included in fish feeds.
Examination of muscle morphology and neuromuscular function in normal weight and overfat children aged 7‐10 years
Authors: Herda Trent J. , Ryan Eric D. , Kohlmeier Martin , Trevino Michael A. , Gerstner Gena R. , Roelofs Erica J. 
Published: June 2018

Neuromuscular function in young overweight/obese (OF) children is not well described.AimThis study examined isometric and isokinetic leg extensor strength, muscle size (mCSA) and tissue composition as measured via echo intensity (mEI), and motor unit (MU) firing rates in normal weight (NW) and OF children aged 7‐10 years.MethodsFourteen NW (eight girls and six boys, BMI: 15.8 ± 1.4 kg/m2) and 15 OF (10 girls and five boys, BMI: 20.8 ± 2.3 kg/m2) children volunteered to perform this study. Percentage body fat (%BF) was measured, and mCSA, mEI, and subcutaneous fat (sFAT) of the vastus lateralis (VL) was assessed. MU mean firing rates (MFRs) in relation to recruitment threshold (RT) of the VL were assessed during submaximal isometric contractions. Maximal isokinetic contractions were performed at 1.05 and 4.20 rad/s. The 95% confidence intervals (CI) from the statistical tests are presented.ResultsThe OF children had greater %BF (95% CI = −15.1 to −7.2), mCSA (95% CI = −4.1 to −1.2), mEI (95% CI = −22.3 to −5.9), and sFAT (95% CI = −0.5 to −0.1), greater rate of strength loss with increasing isokinetic velocities (95% CI = 0.4 to 5.4), and a smaller range of MFRs (95% CI = 0.007 to 7.136) at the steady torque than the NW children.ConclusionsThe OF children had poorer muscle tissue composition, greater velocity‐related impairments in muscle strength, and a smaller range of MFRs at the targeted torque that may suggest altered MU recruitment strategies. Interventions in OF children should include exercises and recruit higher‐threshold MUs, such as high‐intensity resistance exercises.
Qualitative study of perspectives concerning recent rehospitalisations among a high-risk cohort of veteran patients in Connecticut, USA
Authors: Antony Sheila M , Grau Lauretta E , Brienza Rebecca S 
Published: June 2018

ObjectivesVeterans Affairs (VA) patients are at risk for rehospitalisation due to their lower socioeconomic status, older age, poor social support or multiple comorbidities. The study explored inpatients’ perceptions about factors contributing to their rehospitalisation and their recommendations to reduce this risk.DesignThematic qualitative data analysis of interviews with 18 VA inpatients.SettingVA Connecticut Healthcare System, West Haven Hospital medical inpatient units.ParticipantsAll were aged 18+ years, rehospitalised within 30 days of most recent discharge, medically stable and competent to provide consent.MeasurementsInterviews assessed inpatients’ health status after last discharge, reason for rehospitalisation, access to and support from primary care providers (PCP), medication management, home support systems and history of substance use or mental health disorders.ResultsThe mean age was 71.6 years (11.1 SD); all were Caucasian, living on limited budgets, and many had serious medical conditions or histories of mental health disorders. Participants considered structural barriers to accessing PCP and limited PCP involvement in medical decision-making as contributing to their rehospitalisation, although most believed that rehospitalisation had been inevitable. Peridischarge themes included beliefs about premature discharge, inadequate understanding of postdischarge plans and insufficiently coordinated postdischarge services. Most highly valued their VA healthcare but recommended increasing PCPs’ involvement and reducing structural barriers to accessing primary and specialty care.ConclusionsIncreased PCP involvement in medical decision-making about rehospitalisation, expanded clinic hours, reduced travel distances, improved communications to patients and their families about predischarge and postdischarge plans and proactive postdischarge outreach to high-risk patients may reduce rehospitalisation risk.
Association between recreational drug use and sexual practices among people who inject drugs in Southwest China: a cross-sectional study
Authors: Su Shu , Zhang Lei , Cheng Feng , Li Shunxiang , Li Shifu , Jing Jun , Fairley Christopher Kincaid , Chen Liang , Zhao Jinxian , Mao Limin 
Published: June 2018

ObjectiveTo describe the differences in sexual practices among individuals with various drug administration patterns.SettingA detoxification centre in Southwest China, a part of the Chinese national sentential surveillance network for hepatitis C virus (HCV), HIV and syphilis infections, was recruited.ParticipantsA total of 610 newly enrolled injection drug users (IDUs) from detoxification centre were included during 2015.Primary and secondary outcome measuresSelf-reported sexual activities, drug-related practices and laboratory-confirmed HCV, HIV and syphilis infection status were collected.ResultsOf the 610 IDU, 295 (48.4%) used heroin only, 277 (45.4%) poly-drug users reported the mixed use of synthetic drugs (SDs) with heroin and 38 (6.2%) used SDs only. The average daily drug injection frequency for poly-drug users (3.3±1.2 times) was the highest, followed by heroin-only (2.2±0.8 times) and SD-only users (1.2±0.4 time). SD-only drug users reported the highest proportion (86.8%) of engaging in sexual activities in the previous month, with more than half (54.5%) reporting any condomless sex. A higher frequency of daily injecting in heroin-only users was significantly correlated with the less likelihood of sex, condomless sex in the past month, having sex with fixed partners, condomless commercial sex in the previous 12 months (all p<0.01). In poly-drug users, who injected drugs two times per day was associated with the highest proportion of people who engaged in sex and commercial sex (p<0.05). For SD-only users, increased drug use was not associated with reducing sexual risk (p>0.05). Different patterns of HCV, HIV and syphilis infections prevalence rates were shown among the IDU depending on the roles and length of exposure.ConclusionsThe daily drug injecting frequency of heroin-only and poly-drug users was negatively associated with sexual activities, but SD-only users kept a high frequent engagement in sex. The interventions for relevant diseases should adapt to characteristics of IDU.
Factors associated with continued smoking after the diagnosis of type 2 diabetes: a retrospective study in the Korean cohort
Authors: Cho Mi Hee , Kim Sung Min , Lee Kiheon , Park Sang Min , Chang Jooyoung , Choi Seulggie , Kim Kyuwoong , Koo Hye-Yeon , Jun Ji-Hye 
Published: June 2018

ObjectiveTo investigate the factors associated with continued smoking in patients newly diagnosed with type 2 diabetes.DesignRetrospective study using the Korean National Health Insurance Service-National Health Screening Cohort (2002–2013) database.ParticipantsMale patients newly diagnosed with type 2 diabetes between 1 January 2004 and 31 December 2011.MeasurementChange in smoking behaviour after the diabetes diagnosis was assessed using a self-reported questionnaire, which was administered before and after the diagnosis. To identify the factors associated with continued smoking after diabetes diagnosis, a multivariate-adjusted logistic regression was conducted using only the variables with statistical significance from the univariate analyses.ResultsYounger age, lower economic status, heavier smoking habit, lower Charlson Comorbidity Index and comorbid hypertension were identified as factors associated with continued smoking after the diagnosis of type 2 diabetes. Older patients (adjusted OR (aOR) 0.71, 95% CI 0.63 to 0.79) and patients with longer diabetic duration (1–2 years OR 0.88, 95% CI 0.80 to 0.98, ≥3 years OR 0.63, 95% CI 0.55 to 0.73) were more likely to quit smoking. Contrastingly, smokers in the lower economic status (aOR 1.29, 95% CI 1.18 to 1.42) and heavier smoking habit (moderate: aOR 1.53, 95% CI 1.35 to 1.72; heavy: aOR 1.90, 95% CI 1.67 to 2.17) categories were more likely to continue smoking after the diagnosis.ConclusionsIt is important to identify the factors associated with smoking behaviour in patients with type 2 diabetes. Recognising the factors that contribute to the vulnerability of patients to continued smoking will be helpful in developing policies and intervention strategies in future. Vulnerable patients may require intensive education and encouragement to quit smoking. We recommend physicians to take a more proactive approach, such as encouraging frequent clinical sessions for behavioural counselling and even early pharmacological interventions, when they encounter patients with the factors outlined in this study.
Systematic review and meta-analysis of the effect of SGLT-2 inhibitors on microvascular outcomes in patients with type 2 diabetes: a review protocol
Authors: Dorsey-Treviño Edgar Gerardo , Contreras-Garza Belinda Maricela , González-González José Gerardo , Álvarez-Villalobos Neri , Salcido-Montenegro Alejandro , Díaz González-Colmenero Alejandro , Farrell Ann M , González-Nava Victoria , Rodríguez-Tamez Giselle , Montori Victor M , Rodriguez-Gutierrez René 
Published: June 2018

IntroductionSodium glucose cotransporter 2 (SGLT-2) inhibitors are a relatively new drug-class of glucose-lowering medications. Several trials and systematic reviews have demonstrated their beneficial effect on some macrovascular outcomes. Their effect on microvascular outcomes has been reported as positive in several trials, however, their effect remains uncertain. Therefore, we report the protocol of a systematic review and meta-analysis aimed at determining the effect of SGLT-2 inhibitors regarding patient-important and surrogate microvascular outcomes in patients with type 2 diabetes.Methods and analysisA comprehensive search will be conducted to find eligible articles from each database’s earliest inception to November 2017. These databases will include Ovid, MEDLINE, EMBASE, Web of Science, and Scopus. We will search for randomized controlled trials (RCTs) that compare any of the SGLT-2 inhibitors with any other active treatment or placebo assessing microvascular outcomes in either their primary or secondary outcomes. Reviewers working independently and in duplicate will review all abstracts, and full-text manuscripts for eligibility, and will systematically extract the data and will assess the risk of bias in the included studies. Random-effects models will also be used.Ethics and disseminationThe results of the systematic review will be disseminated via publication in a peer-reviewed journal regardless of outcome and will be presented at relevant conferences. The data we will use do not include individual patient data, so ethical approval is not requiredPROSPERO registration numberCRD42017076460.
Quality of life among individuals with rugby-related spinal cord injuries in South Africa: a descriptive cross-sectional study
Authors: Badenhorst Marelise , Brown James Craig , Lambert Mike I , Van Mechelen Willem , Verhagen Evert 
Published: June 2018

ObjectivesRugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa, by using the International Classification of Functioning, Disability and Health (ICF) framework.DesignDescriptive cross-sectional study.SettingRugby-related SCI population of South Africa, as captured in the BokSmart/Chris Burger Petro Jackson Players’ Fund database.ParticipantsNinety (n=90) of the 102 eligible players on the database agreed to participate in the study.Main outcome measureThe relationship between QoL, as measured with the WHO Quality of Life questionnaire (WHOQOL-BREF) and specific independent variables (demographic information, level of independence and participation in various activities and life roles) was investigated. Variables that were significantly associated with QoL in bivariate analyses were included in multiple linear regression analyses.ResultsThe mean score and SD of the WHOQOL-BREF was 15.1±2.3 arbitrary units. Participation (an ICF framework construct) and income were significantly associated with overall QoL (p<0.001). Participation was the only variable significantly associated with all QoL subdomains (p<0.001). Additionally, number of health concerns, type of healthcare (public vs private) and level of education were significantly associated with various QoL domains (p<0.001).ConclusionsOn average, these individuals with rugby-related SCI presented with higher QoL scores than other comparable SCI studies. However, lower levels of participation and income, certain levels of education, increased health concerns and use of public healthcare were associated with lower levels of QoL. Sporting bodies have a responsibility to optimise player welfare, by acting on the modifiable factors associated with QoL.
What can make things better for parents when babies need abdominal surgery in their first year of life? A qualitative interview study in the UK
Authors: Hinton Lisa , Locock Louise , Long Anna-May , Knight Marian 
Published: June 2018

ObjectivesTo understand the experiences of parents of infants who required surgery early in life. To identify messages and training needs for the extended clinical teams caring for these families—including paediatric surgeons, neonatologists, nurses, obstetricians, midwives and sonographers.SettingUK-wide interview study, including England, Wales and Scotland.ParticipantsIn-depth interviews were conducted with 44 parents who had a baby who underwent early abdominal surgery. Conditions included those diagnosed antenatally (eg, exomphalos, gastroschisis, congenital diaphragmatic hernia) or those which were detected postnatally (eg, Hirschsprung’s disease, necrotising enterocolitis). Interviews were video and audio recorded and analysed using a modified grounded-theory approach.ResultsWhile some parents reported experiencing excellent communication and felt they were listened to and involved by the care team, this was not always the case. Dealing with large, complex medical and surgical teams could result in conflicting messages, uncertainty and distress. Parents wanted information but also described being overwhelmed and wanting to distance themselves to maintain hope. Information and support from other parents in hospital and online groups were highly valued. Of particular concern was support when going home and caring for their baby after discharge; an open access policy for readmission offered a helpful safety net.ConclusionsListening to the experience of parents provides rich data to enhance clinical understandings on how to improve information and communication with parents, and ameliorate the deep and lasting distress and anxiety that some parents feel when their infants face early surgery. We suggest that the writings of Bourdieu could have resonance in interpreting the experiences of parents as they enter the world of highly technical neonatal medicine and surgery and the knowledge of the professionals who work in these environments.
Mindful Self-Care and Resiliency (MSCR): protocol for a pilot trial of a brief mindfulness intervention to promote occupational resilience in rural general practitioners
Authors: Rees Clare , Craigie Mark , Slatyer Susan , Heritage Brody , Harvey Clare , Brough Paula , Hegney Desley 
Published: June 2018

IntroductionThe Mindful Self-Care and Resiliency (MSCR) programme is a brief psychosocial intervention designed to promote resilience among various occupational groups. The intervention is based on the principles of mindfulness and also incorporates an educational self-care component. The current paper presents the protocol for a pilot study that will evaluate the effectiveness of this programme among general practitioners working in rural Queensland, Australia.Methods and analysisWe will measure the impact of the MSCR programme on levels of employee resilience (Connor-Davidson Resilience Scale; State-Trait Assessment of Resilience STARS), compassion satisfaction and compassion fatigue (Professional Quality of Life Scale), self-compassion (Self-Compassion Scale) and mood (Positive and Negative Affect Scale). We will also assess the impact of the programme on job satisfaction (The Abridged Job in General Scale), absenteeism/presenteeism (The WHO Health and Work Performance Questionnaire) and general well-being (WHO Five Well-being Index). Repeated measures analysis of variance will be used to analyse the impact of the intervention on the outcome measures taken at pre, post, 1-month, 3-month and 6-month follow-ups. We will conduct individual interviews with participants to gather data on the feasibility and acceptability of the programme. Finally, we will conduct an initial cost-effectiveness analysis of the programme.Ethics and disseminationApproval for this study was obtained from the Curtin University Human Research ethics committee and the study has been registered with the Australian Clinical Trials Registry. Results will be published and presented at national and international congresses.Trial registration numberACTRN12617001479392p; Pre-results.
Facilitators and barriers to the effective implementation of the individual maternal near-miss case reviews in low/middle-income countries: a systematic review of qualitative studies
Authors: Lazzerini Marzia , Ciuch Margherita , Rusconi Silvia , Covi Benedetta 
Published: June 2018

BackgroundThe maternal near-miss cases review (NMCR), a type of clinical audit, proved to be effective in improving quality of care and decreasing maternal mortality in low/middle-income countries (LMICs). However, challenges in its implementation have been described.ObjectivesSynthesising the evidence on facilitators and barriers to the effective implementation of NMCR in LMICs.DesignSystematic review of qualitative studies.Data sourcesMEDLINE, LILACS, Global Health Library, SCI-EXPANDED, SSCI, Cochrane library and Embase were searched in December 2017.Eligibility criteria for selecting studiesQualitative studies exploring facilitators and/or barriers of implementing NMCR in LMIC were included.Data extraction and synthesisTwo independent reviewers extracted data, performed thematic analysis and assessed risk of bias.ResultsOut of 25 361 papers retrieved, 9 studies from Benin, Brazil, Burkina Faso, Cote D’Ivoire, Ghana, Malawi, Morocco, Tanzania, Uganda could be included in the review. The most frequently reported barriers to NMCR implementation were the following: absence of national guidelines and local protocols; insufficient training on how to perform the audit; lack of leadership, coordination, monitoring and supervision; lack of resources and work overload; fear of blame and punishment; poor knowledge of evidenced-based medicine; hierarchical differences among staff and poor understating of the benefits of the NMCR. Major facilitators to NMCR implementation included: good leadership and coordination; training of all key staff; a good cultural environment; clear staff’s perception on the benefits of conducting audit; patient empowerment and the availability of external support.ConclusionsIn planning the NMCR implementation in LMICs, policy-makers should consider actions to prevent and mitigate common challenges to successful NMCR implementation. Future studies should aim at documenting facilitators and barriers to NMCR outside the African Region.