bluuebunny/crossref_metadata_2025_split huggingface dataset:
Organisational support and safety management: A study of shipboard safety supervision
Authors: Xue Conghua , Tang Lijun 
Published: August 2019

AbstractShipping is a safety critical industry where operational errors may lead to maritime accidents involving property damage, loss of lives and environmental pollution. As part of the trend towards self-regulation, the International Maritime Organisation has adopted a worldwide International Safety Management Code which made ship managers responsible for workplace health and safety. This study, based on interviews in two Chinese shipping companies, examines how ship managers use ship visits to monitor shipboard safety management. Interviews with managers from company offices and crew members indicated that managerial ship visits mainly take the form of inspections that focus on low-trust surveillance and disciplinary action rather than genuine support, being based on the safe person rather than the more effective safe place approach. From the perspective of crew members, because the managers visited ships only occasionally, they were unlikely to have sound knowledge of the specific situations and work routines on their ships. Consequently, managers’ interventions for safety compliance were seen by crew members as failing to address real risk factors, and leading instead to increased workloads, psychological pressure and fatigue, the very antithesis of safety management. Meanwhile a coherent, supportive system for reducing risk remains underdeveloped in the shipping industry.
Using relational mindfulness to facilitate safety in the clinical encounter
Authors: Parnas Sophia , Isobel Sophie 
Published: August 2019

Objective: The therapeutic relationship in psychiatry is reliant upon first establishing a sense of interpersonal safety. This paper explores relational mindfulness as a way to facilitate safety in the clinical encounter, as well as proposes factors that enhance a clinician’s capacity to remain mindfully present. Conclusions: Through the ongoing practice of mindful awareness, self-care and self-awareness all clinicians can benefit from increased capacity for relational mindfulness to enhance interpersonal safety. This is then likely to benefit not only the patient and the therapeutic relationship but also the clinician.
Smoking Effects in Foot and Ankle Surgery: An Evidence-Based Review
Authors: Beahrs Taylor R. , Reagan James , Bettin Clayton C. , Grear Benjamin J. , Murphy G. Andrew , Richardson David R. 
Published: August 2019

Background: The purpose of this article was to review the basic science pertaining to the harmful effects of cigarette smoke, summarize recent clinical outcome studies, and examine the benefits of smoking cessation and the efficacy of current smoking cessation strategies. Methods: The literature concerning basic science, clinical outcomes, and smoking cessation was reviewed; over half (56%) of the 52 articles reviewed were published in the last 5 years. Results: Smoking is associated with low bone mineral density, delayed fracture union, peri-implant bone loss, and implant failure. Orthopedic surgical patients who smoke have increased pain and lower overall patient satisfaction, along with significantly increased rates of wound healing complications. Discussion/Conclusion: Active smoking is a significant modifiable risk factor and should be discontinued before foot and ankle surgery whenever possible. Orthopedic surgeons play an important role in educating patients on the effects of smoking and facilitating access to smoking cessation resources. Level of Evidence: Level V, expert opinion.
Antimicrobial de-escalation in adult hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin
Authors: Petteys Megan M , Kachur Ekaterina , Pillinger Kelly E , He Jiaxian , Copelan Edward A , Shahid Zainab 
Published: August 2019

Background The optimal duration of empiric antimicrobial therapy in febrile neutropenia of unknown origin is unclear. This study evaluated outcomes in autologous and allogeneic hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin who received early de-escalation of broad-spectrum antimicrobials prior to hematopoietic recovery versus those who continued broad-spectrum antimicrobials until hematopoietic recovery. Methods A single-center, retrospective study assessed hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin. Patients were categorized into either cohort 1, representing early de-escalation prior to hematopoietic recovery, or cohort 2, representing continuation of broad-spectrum antimicrobials until hematopoietic recovery. Results A total of 107 patients were included (22.4% in cohort 1 and 77.6% in cohort 2). Most patients (87.5%) in cohort 1 underwent haploidentical hematopoietic cell transplantation, whereas 84.3% of patients in cohort 2 received autologous hematopoietic cell transplantation. There were no significant differences in rates of recurrent fever (4.2% versus 7.2%, in cohorts 1 and 2, respectively, adjusted odds ratio = 0.84, P = 0.85), re-escalation (4.2% versus 4.8%, adjusted odds ratio = 1.57, P = 0.64), and Clostridioides difficile-associated infections (4.2% versus 2.4%, adjusted odds ratio = 2.27, P = 0.43). No patient experienced in-hospital mortality, intensive care unit admission, or bacteremia. Conclusion Hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin in which broad-spectrum antimicrobials were de-escalated prior to hematopoietic recovery did not experience adverse outcomes. These results concur with recently published studies and the Fourth European Conference on Infections in Leukemia guidelines. An early de-escalation approach in haploidentical hematopoietic cell transplantation recipients specifically appears safe and may result in a reduction in antimicrobial utilization.
Durable response after discontinuation of nivolumab therapy in the absence of disease progression or toxicity with two advanced NSCLC patients
Authors: Yilmaz Mesut , Guven Mese Sermin 
Published: August 2019

Background Nivolumab is an immune checkpoint inhibitor that selectively blocks the programmed cell death-1 (PD-1). Nowadays, immune checkpoint inhibitors such as nivolumab are used in the treatment of many different types of cancer. In prospective clinical trials, the duration of therapy with nivolumab has been defined as up to the time of progressive disease or treatment limiting toxicity. Case reports In this article, we present two advanced non-small cell lung cancer (NSCLC) patients that were treated with anti-PD-1 monotherapy in the second-line setting. They have received nivolumab for nine and five months, respectively. After discontinuation of immunotherapy agent because of socioeconomic reasons, they had a durable response. Management and outcome After the discontinuation of nivolumab in the absence of progression or toxicity, the clinic and radiologic response are still ongoing. Discussion Optimal duration of anti-PD-1 therapy has not been established. There are some reports that indicate the durable response for the patients who have interrupted immunotherapy because of toxicity. Here, we present two advanced NSCLC patients having a durable response after discontinuing the treatment in the absence of toxicity and disease progression. More extensive research is needed to determine which subgroups of patients treated with immunotherapy can cease treatment and maintain an ongoing response.
Plasma homocysteine concentration in privately owned healthy adult cats: assessment of biological determinants and establishment of a reference interval
Authors: Drut Amandine , Soetart Nicolas , Bertin Carole , Le Corff Emmanuelle , Berder Caroline , Thorin Chantal , Nguyen Patrick , Simard Gilles , Mallem M Yassine 
Published: August 2019

Objectives The assessment of homocysteine status in diseased cats has indicated high plasma concentrations in chronic kidney disease and yielded conflicting results with respect to cardiovascular disorders. Previous investigations in small populations of normal cats revealed greater-than-expected variability in plasma homocysteine concentration. The purpose of this study was to determine biological determinants and the reference interval (RI) of plasma homocysteine concentration in the feline species, under strict pre-analytical conditions. Methods In this prospective observational study, privately owned healthy adult cats underwent a complete physical examination, urinalysis and blood testing, in order to rule out any signs of disease. Plasma homocysteine concentration was measured using high-performance liquid chromatography–tandem mass spectrometry. Results Of 151 cats recruited, 30 cats were not included owing to abnormal physical examination or fractious behaviour, and 30 cats were excluded based on abnormalities on blood work or urinalysis. Plasma homocysteine concentrations >28 µmol/l were associated with a dietary protein content >9.3 g/100 kcal metabolisable energy. The RI for plasma homocysteine concentration was determined to be 6.2–52.3 µmol/l. Conclusions and relevance Normal values for plasma homocysteine concentration in cats have a wide RI, suggesting high inter-individual variability. Whether some healthy cats exhibit impaired homocysteine metabolism remains to be elucidated.
Circulatory Levels of RANKL, OPG, and Oxidative Stress Markers in Postmenopausal Women With Normal or Low Bone Mineral Density
Authors: Azizieh Fawaz Y , Shehab Diaa , Jarallah Khaled Al , Gupta Renu , Raghupathy Raj 
Published: August 2019

Introduction: Receptor activator of nuclear factor κB ligand (RANKL), osteoprotegerin (OPG), and oxidative stress markers are suggested to contribute to bone loss in osteoporosis that occurs in menopause. However, the association between these markers and bone mineral density (BMD) is controversial. The aim of this study was to measure circulatory levels of these parameters in postmenopausal women with normal or low BMD. Methods: The study population included 71 postmenopausal women, of whom 25 had normal BMD, 31 had osteopenia, and 15 had osteoporosis. Serum levels of RANKL, OPG, and 5 oxidative stress markers (catalase, peroxiredoxin 2 [PRX2], superoxide dismutase 1 [SOD1], superoxide dismutase 2 [SOD2], and thioredoxin [TRx1]) were measured using the Multiplex system. Results: As compared with subjects having normal BMD, subjects with low BMD had significantly lower median serum levels of OPG, catalase, SOD2, and PRX2 ( P = .004, .031, .044, and .041 respectively). Although levels of RANKL were not different between the 2 groups, the RANKL/OPG ratio was higher in women with low BMD ( P = .027). Conclusions: These data provide insights into the possible roles of OPG, RANKL, and oxidative stress in the pathogenesis of postmenopausal osteoporosis. However, the lack of association between these markers and BMD indicates that osteoporosis is complex and multivariate.
Reversing the trajectory of school disengagement? Lessons from the analysis of Warsaw youth’s educational trajectories
Authors: Tomaszewska-Pękała Hanna , Marchlik Paulina , Wrona Anna 
Published: August 2019

The theoretical framework of the paper combines the notions of school disengagement and educational trajectories. Our current research has demonstrated that several trajectories of school disengagement can be distinguished: unanticipated crisis, parabola, downward spiral, boomerang, resilient route, shading out. The text focuses on two trajectory types – the parabola, when youngsters facing increasing school disengagement are provided with substantial support and their trajectory changes its direction, and the downward spiral, which despite the support leads to further school disengagement and school leaving. Analysing the educational biographies of students from secondary schools in Warsaw, we focus on their perceptions of the support provided by different formal and informal sources. Investigating the protective factors and successful interventions might thus be useful in fostering the educational success of youth at risk. An analysis of the trajectories might be treated as guidance as to how to offset the negative impact of social and educational inequalities and hence to reverse the negative direction in one’s educational trajectory. The text is based on qualitative analysis of data obtained within an international research project: individual semi-structured interviews with Polish students at risk of early school leaving and youngsters who left school early.
Psychosocial Correlates and Early Substance Abuse Associated With Lifetime Hallucinogen Use Among Hispanic Young Adults
Authors: Yockey Andrew , King Keith , Vidourek Rebecca 
Published: August 2019

Introduction: The Hispanic population is among the most rapid growing populations in the United States. Continued research is needed regarding factors associated with substance abuse and Hispanic individuals. The present study examined psychosocial correlates to lifetime hallucinogen use among a national sample of Hispanic adults. Method: A secondary analysis of the 2017 National Survey on Drug Use and Health was conducted. Questions assessing previous lifetime substance use, psychosocial factors, and demographics were completed by 2,866 Hispanic adults. Weighted logistic regression analyses were used to identify significant predictors of lifetime hallucinogen use. Results: Results indicated that greater than one in seven (15.1%) of Hispanic adults reported having ever used hallucinogens (lifetime use). Findings from the final multivariate regression revealed that those most likely to report lifetime hallucinogen use were male, used alcohol, marijuana, cigars, cigarettes, inhalants, and cocaine before the age of 21, and binge drank in the past 30 days. Discussion: Culturally competent prevention strategies aimed at addressing hallucinogen use among Hispanics are needed. Further research studies examining psychosocial reasons explaining the high prevalence of hallucinogen use among this population are warranted.
‘Switch’ technique to restore pronation and radial deviation in 17 patients with brachial plexus birth palsy
Authors: Özkan Türker , Aydin Hasan Utkan , Berköz Ömer , Özkan Safiye , Kozanoğlu Erol 
Published: August 2019

We report outcomes of 17 children with brachial plexus birth palsy that underwent extensor carpi ulnaris to brachioradialis and brachioradialis to abductor pollicis longus transfers to correct supination and ulnar deviation deformity. Mean age at the time of surgery was 8.7 years and mean follow-up time was 21 months (8–44). These patients had marked increases in active forearm rotation and Canadian Occupational Performance Measure scores. Activity performance score on the measure increased from 1.1 to 6.7 and satisfaction score increased from 0.8 to 8.7 at final follow-up. We conclude from our patient series that these tendon transfers are effective in correction of the supination and ulnar deviation deformities in brachial plexus birth palsy. Level of evidence: IV
Non-traumatic primary and secondary osteoarthritis of the distal radioulnar joint
Authors: Benis Szabolcs , Vanhove Wim , Van Tongel Alexander , Hollevoet Nadine 
Published: August 2019

A retrospective radiographic study was conducted to determine the prevalence and severity of non-traumatic primary and secondary osteoarthritis of the distal radioulnar joint in a group of 718 patients. Non-traumatic primary and secondary osteoarthritis was found in 77 patients (11%) with a mean age of 63 years. In 34 cases it was bilateral. Mild signs of osteoarthritis were present in 53, moderate in 17 and severe in seven patients. The prevalence of primary osteoarthritis was 8.2% and 2.5% had secondary non-traumatic osteoarthritis. The prevalence and severity of the osteoarthritis were similar in women and men. Ulnar wrist pain was associated with osteoarthritis of the distal radioulnar joint in 13% of patients with mild, 35% with moderate and 43% with severe radiological degeneration. Level of evidence: IV
Silencing TBX1 Exerts Suppressive Effects on Epithelial–Mesenchymal Transition and Inflammation of Chronic Rhinosinusitis Through Inhibition of the TGFβ-Smad2/3 Signaling Pathway in Mice
Authors: Zhong Yu , Li Yunqiu , Zhang Hua 
Published: August 2019

Background Chronic rhinosinusitis (CRS) is a multifactorial inflammatory disease characterized by high prevalence and morbidity, and little is known about the mechanisms that underlie its pathogenesis. Objective This study focuses on the effect of T-box 1 (TBX1) on the epithelial–mesenchymal transition (EMT) and inflammation of CRS via the transforming growth factor (TGF)β-Smad2/3 signaling pathway. Methods CRS mice models were established by Merocel nasal packing material, followed by the streptococcus pneumoniae cultivation. The expression levels of TBX1 in the sinus mucosa tissues of mice were measured accordingly. The successfully modeled mice were subsequently injected with TBX1 mimic or TBX1 inhibitor and the TGFβ-Smad2/3 signaling pathway inhibitor (SB-431542) to elucidate the influence of TBX1 on EMT and inflammation in CRS, with the expression of the EMT-related factors (E-cadherin, Vimentin, alpha-smooth muscle actin [α-SMA]), Th1 cytokines (interleukin [IL]-2, interferon-γ), and Th2 cytokines (IL-4, IL-8, total immunoglobulin E) assayed. Results TBX1 expression exhibited upregulated levels in the sinus mucosa tissues of the mice. In addition, TBX1 downregulation was found to inhibit the expression of TGFβ as well as the extent of Smad2 and Smad3 phosphorylation. Silencing TBX1 was shown to elevate the expression of Th1 cytokines and E-cadherin, while diminishing expression of Th2 cytokines, Vimentin and α-SMA. Conclusions Taken together, the key findings of our study highlight the inhibitory role of TBX1 in the process of EMT and inflammation in CRS mice via the inhibition of the TGFβ-Smad2/3 signaling pathway, underlining the promise of TBX1 as a potential target for CRS therapy.
Risk of bronchospasm and coronary arteriospasm with sugammadex use: a post marketing analysis
Authors: Aggarwal Pushkar 
Published: August 2019

Introduction: Sugammadex is used for the reversal of neuromuscular blockade caused by rocuronium bromide and vecuronium bromide. As part of the post licensing phase of drug development, adverse events related to the use of sugammadex are still being uncovered and being reported. The potential association between sugammadex and adverse events bronchospasm and coronary arteriospasm using a retrospective pharmacovigilance signal analysis was carried out. Methods: Food and Drug Administration’s Adverse Event Reporting System database was used to run disproportionality analyses to investigate the potential association of sugammadex with bronchospasm or coronary arteriospasm. In this analysis we report the adverse event signal using frequentist methods of Relative reporting ratio (RRR), proportional reporting ratio (PRR), reporting odds ratio (ROR) and the Bayesian based Information Component metric. Results: A statistically significant disproportionality signal is found between sugammadex and bronchospasm ( n = 44; chi-squared = 2993.87; PRR = 71.95 [95% CI: 54.00–95.85]) and sugammadex and coronary arteriospasm ( n = 6; chi-squared = 209.39; PRR = 43.82 [95% CI: 19.73–97.33]) as per Evans criteria. Both statistically significant disproportionality signals persisted when stratified by gender. Based upon dynamic cumulative PRR graph, the PRR value has steadily increased and the 95% CI narrowed since December 2012. Conclusion: The results of the pharmacovigilance analysis highlight a statistically significant disproportionality signal between sugammadex usage and bronchospasm and coronary arteriospasm adverse events. Physicians need to be aware of these adverse events when using sugammadex. The results of the pharmacovigilance signal analysis highlight a statistically significant disproportionality signal between sugammadex usage and bronchospasm and coronary arteriospasm adverse events. Physicians need to be aware of these adverse events when using sugammadex.
Exercise-induced cardio-pulmonary remodelling in endurance athletes: Not only the heart adapts
Authors: Domenech-Ximenos Blanca , Garza Maria Sanz-de la , Prat-González Susanna , Sepúlveda-Martínez Álvaro , Crispi Fatima , Perea Rosario J , Garcia-Alvarez Ana , Sitges Marta 
Published: August 2019

Background The cumulative effects of intensive endurance exercise may induce a broad spectrum of right ventricular remodelling. The mechanisms underlying these variable responses have been scarcely explored, but may involve differential pulmonary vasculature adaptation. Our aim was to evaluate right ventricular and pulmonary circulation in highly trained endurance athletes. Methods Ninety-three highly trained endurance athletes (>12 h training/week at least during the last five years; age: 36 ± 6 years; 52.7% male) and 72 age- and gender-matched controls underwent resting cardiovascular magnetic resonance imaging to assess cardiac dimensions and function, as well as pulmonary artery dimensions and flow. Pulmonary vascular resistance (PVR) was estimated based on left ventricular ejection fraction and pulmonary artery flow mean velocity. Resting and exercise Doppler echocardiography was also performed in athletes to estimate pulmonary artery pressure. Results Athletes showed larger biventricular and biatrial sizes, slightly reduced systolic biventricular function, increased pulmonary artery dimensions and reduced pulmonary artery flow velocity as compared with controls in both genders ( p < 0.05), which resulted in significantly higher estimated PVR in athletes as compared with controls (2.4 ± 1.2 vs. 1.7 ± 1.1; p < 0.05). Substantially high estimated PVR values (>4.2 WU) were found in seven of the 93 (9.3%) athletes: those exhibiting an enlarged pulmonary artery (indexed area cm2/m2: 4.8 ± 0.6 vs. 3.9 ± 0.6, p < 0.05), a decreased pulmonary artery distensibility index (%: 43.0 ± 15.2 vs. 62.0 ± 17.4, p < 0.05) and a reduced right ventricular ejection fraction (%: 49.3 ± 4.5 vs. 53.6 ± 4.6, p < 0.05). Conclusions Exercise-induced remodelling involves, besides the cardiac chambers, the pulmonary circulation and is associated with an increased estimated PVR. A small subset of athletes exhibited substantial increase of estimated PVR related to pronounced pulmonary circulation remodelling and reduced right ventricular systolic function.