bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interventions to Mitigate Fatigue Induced by Physical Work: A Systematic Review of Research Quality and Levels of Evidence for Intervention Efficacy
Authors: Lu Lin , Megahed Fadel M. , Cavuoto Lora A. 
Published: October 2019

Objective We present a literature review on workplace physical fatigue interventions, focusing on evaluating the methodological quality and strength of evidence. Background Physical fatigue is a recognized workplace problem, with negative effects on performance and health-related complaints. Although many studies have focused on the mechanisms and consequences of fatigue, few have considered the effectiveness of interventions to mitigate fatigue. Method A systematic review of the workplace safety literature for controlled trials of physical fatigue interventions was conducted. Data on intervention type, subject characteristics, targeted tasks and body locations, outcome measures, and study design were extracted. The methodological quality for each study was evaluated using the PEDro scale, and the level of evidence was based on quality, amount, and consistency. Results Forty-five controlled trials were reviewed, examining 18 interventions. We categorized those interventions into individual-focused ( N = 28 studies, nine interventions), workplace-focused ( N = 12 studies, five interventions), and multiple interventions ( N = 5 studies, four interventions). We identified moderate evidence for interventions related to assistive devices and task variation. There was moderate evidence supporting no fatigue attenuation for the garment change category of interventions. The interventions in the remaining categories had limited to minimal evidence of efficacy. The heterogeneity of the included trials precludes the determination of effect size. Conclusion This review showed a lack of high levels of evidence for the effectiveness of most physical fatigue interventions. Application Due to a lack of high levels of evidence for any category of reviewed physical fatigue interventions, further high-quality studies are needed to establish the efficacy of others.
Scientific and Regulatory Policy Committee Points to Consider*: Approaches to the Conduct and Interpretation of Vaccine Safety Studies for Clinical and Anatomic Pathologists
Authors: Sellers Rani S. , Nelson Keith , Bennet Bindu , Wolf Jayanthi , Tripathi Niraj , Chamanza Ronnie , Perron Lepage Marie-France , Adkins Karissa , Laurent Sebastien , Troth Sean P. 
Published: October 2019

The design and execution of toxicology studies supporting vaccine development have some unique considerations relative to those supporting traditional small molecules and biologics. A working group of the Society of Toxicologic Pathology Scientific and Regulatory Policy Committee conducted a review of the scientific, technical, and regulatory considerations for veterinary pathologists and toxicologists related to the design and evaluation of regulatory toxicology studies supporting vaccine clinical trials. Much of the information in this document focuses on the development of prophylactic vaccines for infectious agents. Many of these considerations also apply to therapeutic vaccine development (such as vaccines directed against cancer epitopes); important differences will be identified in various sections as appropriate. The topics addressed in this Points to Consider article include regulatory guidelines for nonclinical vaccine studies, study design (including species selection), technical considerations in dosing and injection site collection, study end point evaluation, and data interpretation. The intent of this publication is to share learnings related to nonclinical studies to support vaccine development to help others as they move into this therapeutic area. [Box: see text]
Adult tetralogy repair: factors affecting early outcome in the current era
Authors: Ramanan Sowmya , Sasikumar Navaneetha , Manohar Krishna , Ramani Salla Sweta , Kumar RaghavanNair Suresh , Agarwal Ravi , Subramanyam Raghavan , Cherian Kotturathu Mammen 
Published: October 2019

Background The benefits of surgical correction of adult tetralogy of Fallot are well known. The current recommendation is for total correction regardless of age. This study analyzed perioperative factors affecting early outcome after corrective surgery in adulthood in the current era. Methods This was a retrospective chart review of 40 consecutive patients over 18 years of age who underwent total correction of tetralogy of Fallot from September 2006 to June 2013. Patients with pulmonary atresia and absent pulmonary valve were excluded. The mean age at surgery was 26.60 ± 8.69 years (range 18–49 years). Results The mean intensive care unit stay was 3.30 ± 2.29 days (range 0.75–12 days) and hospital stay was 9.97 ± 3.39 days (range 7–22 days). Mortality was 5% (2/40). Multiple parameters indicating immediate postoperative outcomes and their relationships to selected pre-, intra-, and postoperative factors were analyzed. Multivariate analysis showed that postoperative right ventricular dysfunction had a significant influence on mortality ( p < 0.001) and hospital stay ( p = 0.01). Performing zero-balance ultrafiltration decreased the need for renal replacement therapy ( p = 0.034), duration of ventilation ( p = 0.009), incidence of low cardiac output ( p = 0.006), intensive care unit stay ( p = 0.01), and hospital stay ( p = 0.009). Conclusions Total correction of tetralogy of Fallot is a safe option for presentations as late as adulthood. The protective effect of zero-balance ultrafiltration on postoperative morbidity needs to be reassessed in larger studies.
Assessment of Anterior Chamber by Ultrasound Biomicroscopy and Anterior Segment Optical Coherence Tomography in Patients with Inflammatory Glaucoma
Authors: Qian Yiyong , Liu Lin , Shi Yuehui , Wang Minli , Li Min , Zou Jun 
Published: October 2019

Objective To investigate the clinical indications of ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (AS-OCT) in eyes with inflammatory glaucoma. Methods Sixteen patients (16 eyes) with inflammatory glaucoma were analysed retrospectively. All of the subjects underwent UBM and AS-OCT scans, measuring the following parameters: central corneal thickness (CCT), central anterior chamber depth (ACD), angle-opening distance (AOD500), and trabecular-iris angle (TIA500) in four quadrants. Results Both the UBM and AS-OCT generated detailed, high-resolution images of the anterior segments of the eyes with inflammatory glaucoma. Moreover, the UBM and AS-OCT exhibited statistically similar measurement results for all of the indices. A Bland–Altman analysis showed a high level of agreement between the two imaging techniques. Additionally, the UBM was able to visualize the ciliary body and pars plana, while the cells and the flare in the anterior chamber appeared more pronounced in the UBM images. Conclusions Both the UBM and AS-OCT are useful tools for anterior segment imaging and taking measurements needed for evaluating inflammatory glaucoma. The AS-OCT has the advantages of being noninvasive and fast, whereas the UBM is presently unparalleled in the visualization of the ciliary body and pars plana.
Salvation or Commodification? The Role of Money and Markets in Global Ecological Preservation
Authors: Davis Ann E. 
Published: October 2019

Rather than view the market as a tool for addressing climate change, through carbon tax or carbon permits, we argue that redefining “property” is more effective. Instead of right to exclude and absolute individual ownershp, we recommend ecological communities which prioritize human relationships and ecological stewardship. Global federations of ecological regions will manage nutrient flows on the local and global level, with democratic participation informed by ecological science. New values of caring for the earth will support and sustain new forms of solidarity. JEL Classification: B5, Q5
Temporizing External Fixation vs Splinting Following Ankle Fracture Dislocation
Authors: Wawrose Richard A. , Grossman Leonid S. , Tagliaferro Matthew , Siska Peter A. , Moloney Gele B. , Tarkin Ivan S. 
Published: October 2019

Background: Closed reduction and splinting followed by outpatient management is standard of care for temporizing most ankle fractures. However, ankle fracture-dislocation potentially warrants a different approach based on the propensity for loss of reduction. The purpose of this study was to determine the rate of complications associated with closed reduction and splinting of unstable ankle fracture-dislocations. Further, we sought to determine the efficacy of immediate external fixation as an alternative to splinting in cases too swollen for acute operation. Methods: This retrospective chart review analyzed all ankle-fracture dislocations that came through a large health care system from 2008 to 2018. Patients managed with acute open reduction internal fixation (ORIF) and open fractures were excluded. In patients managed late, the cohorts were divided into those temporized with closed reduction/splinting vs external fixation. Reduction quality and splint technique were additionally assessed in splinted patients. A total of 354 closed ankle fracture-dislocations were identified: 298 patients (84%) underwent ORIF within 48 hours and were excluded; 28 (15 female/13 male, average age 46.8 years) were placed in an external fixator and 28 (22 female/6 male, average age 57.2 years) were reduced, splinted, and discharged. Results: At follow-up, 14 of the patients (50%) in the splint group developed loss of reduction and 5 of these patients (17.6%) developed anteromedial skin necrosis from skin tenting. None of the patients in the ex-fix group developed loss of reduction or skin necrosis. The rate of redislocation and the rate of development of skin necrosis was statistically higher in cases temporized with a splint versus an external fixator ( P < .01 and P = .05, respectively). Conclusion: We found that in ankle fracture-dislocations not treated with acute ORIF, splint immobilization was associated with an increased risk of complications, including redislocation and skin necrosis, when compared to a temporizing external fixator. Level of Evidence: Level III, retrospective comparative study.
Evaluation of the use of non-formulary oncology medications restricted to outpatient use in hospitalized patients after implementation of a criteria-for-use algorithm
Authors: Randle Hope , Smith Leticia V , Padilla-Tolentino Eimeira , Goodgame Boone W 
Published: October 2019

Objective To decrease the number of orders and total hospital spend for inpatient use of antineoplastic drugs of interest, while evaluating each case for urgent or emergent need for administration. Methodology This study is a multicenter, retrospective, cost-evaluation, cohort study performed in five Ascension Seton hospitals in the Austin, Texas area between 1 January 2013 and 31 December 2018. Patients were identified via a dispense analysis report for the antineoplastic drugs of interest. Results An overall reduction of 56% was seen in orders processed with a 62% decrease in annual hospital spending after implementation of the criteria-for-use algorithm. When results were evaluated without including rituximab orders, a reduction of 17% was seen in orders processed with a 21% decrease in annual hospital spending. Discussion and conclusion The decreases in our primary outcomes were primarily driven by a reduction in the use of one drug, rituximab. Overall, implementation of a criteria-for-use algorithm was effective in reducing both overall number of orders and hospital spending for restricted antineoplastic agents.
Durable response after interruption of nivolumab in patients with metastatic renal cell carcinoma: Is renal toxicity a marker to predict the benefit of nivolumab?
Authors: Kus Tulay , Aktas Gokmen 
Published: October 2019

Introduction Nivolumab is a human IgG4 programmed death-1 immune checkpoint inhibitor antibody. Immune-related toxicity may be associated with higher response even after interruption of nivolumab. Case report We reported a case diagnosed with metastatic clear cell renal cell carcinoma and treated with nivolumab as fourth-line therapy. Although nivolumab treatment was stopped after two cycles due to grade 3 renal toxicity, progression-free survival rates of 11 months, that is quite a long time for fourth-line treatment of renal cell carcinoma was observed. Management and outcome Therefore, we speculate that when renal toxicity develops, response may continue even after interruption of nivolumab in renal cell carcinoma. Discussion Nivolumab was approved to be used for second-line treatment of renal cell carcinoma with 4.6 months of median progression-free survival benefit. Higher immune-related toxicity can produce higher efficacy for some instances such as malignant melanoma, lung cancer, and renal cell carcinoma. Renal disturbance during nivolumab treatment is extremely rare, and there are no data on survival after interruption due to renal toxicity of nivolumab without further treatment in renal cell carcinoma. In the present case, we obtained long duration of stable disease, with two cycles of nivolumab after the development of nephrotoxicity. Close follow-up without any treatment until progression may be a treatment choice, because nephrotoxicity can be a sign of benefit and durable response to nivolumab.
How do they measure up? Differences in stakeholder perceptions of quality measures used in English community nursing
Authors: Pollard Katherine , Horrocks Sue , Duncan Lorna , Petsoulas Christina , Allen Pauline , Cameron Ailsa , Cook Jane , Gibbard Emma , Harland Lizanne , Husband Pete , Loydon Geoff , McDonald Ruth , Wye Lesley , Salisbury Chris 
Published: October 2019

Objectives To establish how quality indicators used in English community nursing are selected and applied, and their perceived usefulness to service users, commissioners and service providers. Methods A qualitative multi-site case study was conducted with five commissioning organizations and their service providers. Participants included commissioners, provider organization managers, nurses and service users. Results Indicator selection and application often entail complex processes influenced by wider health system and cross-organizational factors. All participants felt that current indicators, while useful for accountability and management purposes, fail to reflect the true quality of community nursing care and may sometimes indirectly compromise care. Conclusions Valuable resources may be better used for comprehensive system redesign, to ensure that patient, carer and nurse priorities are given equivalence with those of other stakeholders.
De-individualising the ‘NEET problem’: An ecological systems analysis
Authors: Lőrinc Magdolna , Ryan Louise , D’Angelo Alessio , Kaye Neil 
Published: October 2019

Periods of being NEET (not in education, employment or training) can have long-term consequences for individuals’ future job opportunities, earnings, psycho-social well-being and health, all with high societal costs. Therefore, policy-makers across Europe seek interventions that successfully reduce NEET numbers. Drawing on a longitudinal qualitative study in London, this paper explores the processes and mechanisms that contribute to young people becoming NEET after leaving education. Through analysis of 53 young NEETs’ accounts of their school and transition experiences, we draw upon Bronfenbrenner’s ecological systems theory to explore the multitude of factors and structures of disadvantage that might have contributed to these young people’s marginalisation in education and employment. We discuss how unfulfilled support needs, a lack of career advice and socio-economic disadvantage can lead to educational disengagement, dropping out and, ultimately, becoming NEET. While many of these issues were presented as personal difficulties, in this article we reject the individualisation of the ‘NEET problem’. Instead, we argue that negative school experiences need to be understood in the context of structural conditions, including funding cuts in education and support services, transformations in the labour market and socio-economic deprivation.
Producing Antipetismo: Media activism and the rise of the radical, nationalist right in contemporary Brazil
Authors: Davis Stuart , Straubhaar Joe 
Published: October 2019

When examining the decline of the leftist Partido dos Trabalhadores and the ascension of the right-wing extremist Jair Bolsanaro of the far-right Partido Liberal Social to the 2018 presidency, political scientists David Samuels and Cesar Zucco have argued that this shift is best understood not through positive characteristics of Bolsonaro’s candidacy but through antipetismo [‘anti-PT-ism’], an intensely personal resentment of the Partido dos Trabalhadores. We assert that popular right-wing Facebook groups and networks formed around the communication network WhatsApp-fueled antipetismo by channeling anger originating in the 2013 nationwide protests away from a variety of social, political, and issues and toward a villainous depiction of Partido dos Trabalhadores leaders and valorization of anti-Partido dos Trabalhadores activists like Bolsanaro, as well as some focus on his own conservative, nationalist agenda. To interrogate this assertion, we propose two specific lines of research. The first is a qualitative textual analysis of the social media accounts of two of the most active anti-Partido dos Trabalhadores groups: Vem Pra Rua and O Movimento Brasil Livre. Through close reading of the materials distributed on these sites, we will illustrate how they channeled general unrest into a specifically partisan attack. The next line of research and case will be an examination of the role of mainstream news networks (namely TV Record) and WhatsApp by those campaigning for recently elected president Bolsonaro for a continued negative campaign against left candidates, specifically the Partido dos Trabalhadores, using fake news items like the supposed ‘gay kit’ that was being circulated in schools by the Partido dos Trabalhadores and others on the left to persuade children to become gay. When possible, we will analyze examples of the materials that were circulated that have emerged in the press coverage and will examine the processes that were used to target and persuade people to forward the materials created for the campaign.
The duration of acupuncture effects and its associated factors in chronic severe functional constipation: secondary analysis of a randomized controlled trial
Authors: Wang Yang , Liu Yan , Zhou Kehua , Bauer Brent A. , Liu Baoyan , Su Tongsheng , Mo Qian , Liu Zhishun 
Published: October 2019

Background: Electroacupuncture (EA) has been shown to improve complete spontaneous bowel movements (CSBMs), but the duration of its effects remains unknown. The objective of this study was to explore the duration of acupuncture effects after treatment and its associated factors for chronic severe functional constipation (CSFC). Methods: This was a secondary analysis of a multicenter, randomized, sham-acupuncture (SA) controlled trial that included 1075 participants with CSFC. The primary outcome, the duration of acupuncture effects after treatment, was the number of weeks during the 12-week follow-up period that participants were to meet the weekly CSBM responder criteria. A weekly CSBM responder was defined as a participant who had at least three CSBMs for a given week and an increase from baseline of at least one CSBM for that same week. We performed a retrospective multivariate analysis to explore potential factors associated with sustained acupuncture effects. Results: The duration of acupuncture effects in the EA group (5.5 weeks) was significantly higher than the duration of SA effects in the SA group (2.2 weeks) with a between-group difference of 3.2 weeks (95% CI, 2.77–3.78; p < 0.001). A younger age and higher baseline CSBMs per week [regression coefficient (RC) –0.06, 95% confidence interval (CI) (−0.06 to −0.04); RC 2.43, 95% CI 1.78–3.60; respectively] were associated with longer durations of acupuncture effects. Conclusions: EA had sustained post-treatment effects for CFSC. A significant association among a younger age, higher baseline CSBMs and sustained acupuncture effects was observed. Further research is needed to confirm the association. Trial registration: ClinicalTrials.gov (NCT01726504). Registered on 26 August 2012.
Prediction of Diabetic Foot Ulceration: The Value of Using Microclimate Sensor Arrays
Authors: Jones Petra , Bibb Richard , Davies Melanie , Khunti Kamlesh , McCarthy Matthew , Webb David , Zaccardi Francesco 
Published: October 2019

Background: Accurately predicting the risk of diabetic foot ulceration (DFU) could dramatically reduce the enormous burden of chronic wound management and amputation. Yet, the current prognostic models are unable to precisely predict DFU events. Typically, efforts have focused on individual factors like temperature, pressure, or shear rather than the overall foot microclimate. Methods: A systematic review was conducted by searching PubMed reports with no restrictions on start date covering the literature published until February 20, 2019 using relevant keywords, including temperature, pressure, shear, and relative humidity. We review the use of these variables as predictors of DFU, highlighting gaps in our current understanding and suggesting which specific features should be combined to develop a real-time microclimate prognostic model. Results: The current prognostic models rely either solely on contralateral temperature, pressure, or shear measurement; these parameters, however, rarely reach 50% specificity in relation to DFU. There is also considerable variation in methodological investigation, anatomical sensor configuration, and resting time prior to temperature measurements (5-20 minutes). Few studies have considered relative humidity and mean skin resistance. Conclusion: Very limited evidence supports the use of single clinical parameters in predicting the risk of DFU. We suggest that the microclimate as a whole should be considered to predict DFU more effectively and suggest nine specific features which appear to be implicated for further investigation. Technology supports real-time in-shoe data collection and wireless transmission, providing a potentially rich source of data to better predict the risk of DFU.