bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enabling patients with advanced chronic obstructive pulmonary disease to identify and express their support needs to health care professionals: A qualitative study to develop a tool
Authors: Gardener A Carole , Ewing Gail , Farquhar Morag 
Published: March 2019

Background: Patients with advanced chronic obstructive pulmonary disease have difficulty reporting their holistic support needs to health care professionals, undermining delivery of person-centred care. We lack tools that directly support patients with this. Aim: To develop an evidence-based, designed-for-purpose, tool to enable patients to directly identify and express support needs to health care professionals. Design: Two-stage qualitative study. Stage 1: domains of support need were identified through a systematic review, analysis of an established qualitative dataset and patient/carer focus groups. Stage 2: draft tool developed using the identified domains of need and then refined through feedback from patients, carers and health care professionals, ensuring acceptability and suitability. Setting/participants: Stage 1 patients/carers recruited via four primary care practices and two patient support groups (East of England). Stage 2 health care professionals recruited via the Clinical Research Network and local community trust and patients/carers through two further practices and two additional support groups (East of England). In total, 57 patients, carers and health care professionals participated. Results: A comprehensive set of evidence-based support domains (for example: overcoming boredom or loneliness, knowing what to expect in the future) was identified and formulated into questions. The resulting tool asks patients to consider whether they need more support in 15 broad areas. Patients, carers and clinical stakeholders broadly endorsed the tool’s content and wording. Conclusion: The Support Needs Approach for Patients (SNAP) tool is a concise evidence-based tool designed to help patients with advanced chronic obstructive pulmonary disease identify and express their support needs to enable delivery of person-centred care.
Relationships among Climate of Care, Nursing Family Care and Family Well-being in ICUs
Authors: McAndrew Natalie S , Schiffman Rachel , Leske Jane 
Published: March 2019

Background: Frequent exposure to ethical conflict and a perceived lack of organizational support to address ethical conflict may negatively influence nursing family care in the intensive care unit. Research aims: The specific aims of this study were to determine: (1) if intensive care unit climate of care variables (ethical conflict, organizational resources for ethical conflict, and nurse burnout) were predictive of nursing family care and family wellbeing and (2) direct and indirect effects of the climate of care on the quality of nursing family care and family wellbeing. Research design: A cross-sectional, correlational design was used. Participants and research context: Convenience sample of 111 nurses and 44 family members from five intensive care units at a Midwest hospital in the United States. Instruments: The Ethical Conflict Questionnaire-Critical Care Version, Maslach Burnout Inventory-Human Services Survey and Hospital Ethical Climate Scale were used to measure climate of care. The Family-Centered Care-Adult Version and Nurse Provided Family Social Support Scale were family measures of the quality of nursing family care. The Family Wellbeing Index was used to measure family wellbeing. Data analysis: Hierarchical regression and mediation analysis were used to answer the study aims. Ethical considerations: The study was approved by the Institutional Review Board at the study site. Findings: In separate regression models, organizational resources for ethical conflict (β = .401, p = .006) and depersonalization (β = −.511, p = .006), a component of burnout, were significant predictors of family-centered care. In simple mediation analysis the relationship between organizational resources for ethical conflict and family-centered care was mediated by depersonalization (β = .341, 95% confidence interval (.015, .707)). Discussion: Inadequate organizational resources and depersonalization may be related to family care delivery, and present obstacles to family-centered care in the intensive care unit. Conclusion: Further research to explicate the relationships among organizational resources, ethical conflict, burnout, and family-centered care is needed to guide the development of effective interventions that enhance the quality of nursing family care in the intensive care unit.
On the Asymmetric Effects of Exchange Rate Changes on the Demand for Money: Evidence from Emerging Economies
Authors: Bahmani-Oskooee Mohsen , Bahmani Sahar , Kutan Ali M. , Xi Dan 
Published: March 2019

Previous studies, that included the exchange rate in the demand for money function to account for currency substitution, assumed that exchange rate changes have symmetric effects on the demand for money in emerging countries. Since assuming symmetric effects implies using a linear model, they were not successful in finding significant link between the exchange rate movements and the demand for money. When we applied a nonlinear model to address the same issue, we found that in most emerging economies in our sample, exchange rate changes do have significant long-run effects on the demand for money and such effects are indeed asymmetric. JEL Classifications: E41, F31
Evaluation of the Effects of Cheiloplasty on Maxillary Arch in UCLP Infants Using Three-Dimensional Digital Models
Authors: Kongprasert Thanawut , Winaikosol Kengkart , Pisek Araya , Manosudprasit Aggasit , Manosudprasit Amornrut , Wangsrimongkol Buddhathida , Pisek Poonsak 
Published: March 2019

Objective: To analyze and identify changes in the maxillary dental arch before and after cheiloplasty in a group of unilateral complete cleft lip and palate (UCLP) infants. Design: This is a cohort study. Material and Method: Study models from 16 infants with nonsyndromic UCLP, who were treated at Khon Kaen University, were taken before (T1) and after cheiloplasty (T2). The dental models underwent a process of scanning through a 3D scanner, from which 9 linear and 2 angular landmarks were evaluated. Paired t test was used to compare the measurement statistically between T1 and T2. Results: Alveolar cleft gap (G-L), anterior basal angle (∠GC-CC′), and anterior arch curvature angle on greater segment (∠GIC) were significantly decreased ( P < .05). Contrarily, anterior ridge length of greater segment (C-I), anterior ridge length of lesser segment (L-C′), and posterior arch width (T-T′) were significantly increased ( P < .05) after cheiloplasty. While, anterior portion of greater segment (I-G), anterior arch width (C-C′), anterior arch depth (I⊥CC′), arch length (G⊥TT′), and arch circumference (T-C-I-G-L-C′-T′) showed no significant difference. The measurements were tested using the Intraclass correlation coefficient. The coefficients indicated high reliability. Conclusion: Cleft gap significantly decreased after lip repair, and the anterior part of maxillary dental arch was also bent palatally after cheiloplasty without any other intervention except cheiloplasty. More studies are needed to assess the amount of lip pressure. If any convincing force is presented, an appliance to prevent undesirable pressure is indicated.
Retrospective evaluation of risk factors and treatment outcome predictors in cats presenting to the emergency room for constipation
Authors: Benjamin Sarah E , Drobatz Kenneth J 
Published: March 2019

Objectives Constipation is a common complaint in cats presenting to the emergency room and can become a frustrating recurrent condition. Despite widespread anecdotal reports of risk factors for constipation, at the time of writing there have been no studies supporting these associations or assessing treatment outcomes. The aim of this study was to identify risk factors in the signalment, history, physical examination and clinicopathologic findings of cats presenting to the emergency room for constipation. In addition, we aimed to assess factors contributing to the success or failure of enemas administered to these cats. Methods A medical record search identified 189 cats with a diagnosis of constipation/obstipation that were treated and discharged by the emergency service at an academic veterinary hospital. Data regarding signalment, medical history, physical examination and clinicopathologic findings, as well as treatments performed, were recorded. Ninety-nine cats presenting to the emergency room for other reasons were identified as controls. Statistical analysis was performed to assess risk factors for constipation, as well as success/failure of enema treatments. Results Older, overweight cats and cats with chronic kidney disease or previous episodes of constipation were found to be at increased risk of constipation ( P <0.0001, P = 0.0004, P = 0.0046 and P <0.0001, respectively). Ionized calcium levels were significantly higher in constipated cats, though varied significantly within the cohort ( P = 0.0133). Cats noted to be painful on abdominal palpation were less likely to defecate following an enema. Adjunctive treatments (fluids, laxatives) increased the likelihood of a successful enema but were not statistically significant. Conclusions and relevance Older, overweight cats with a history of constipation or chronic kidney disease are more likely to present for constipation. Further studies are needed to determine the most appropriate treatment protocol in an urgent care setting.
Effect of a maximal treadmill test on intraocular pressure and ocular perfusion pressure: The mediating role of fitness level
Authors: Vera Jesús , Jiménez Raimundo , Redondo Beatríz , García-Ramos Amador , Cárdenas David 
Published: March 2019

Objectives: We compared the impact of a maximal treadmill test on intraocular pressure and ocular perfusion pressure between trained and untrained individuals. Methods: Based on the maximal aerobic capacity (relative VO2 max), 31 military helicopter pilots were divided into groups of trained (n = 16; VO2 max = 57.06 ± 1.66) and untrained (n = 15; VO2 max = 43.42 ± 1.19) individuals. Intraocular pressure and blood pressure were collected before effort, just after volitional exhaustion and after 5 and 15 min of recovery. Results: The maximal treadmill test induced significant changes on intraocular pressure (p < 0.001, η2 = 0.52) and ocular perfusion pressure (p < 0.001, η2 = 0.60). Intraocular pressure and ocular perfusion pressure increased just after volitional exhaustion (effect size = 0.88 and 1.59, respectively), and these values returned to baseline levels after 5 (effect size = 0.87 and 1.26, respectively) and 15 (effect size = 1.23 and 1.91, respectively) min of recovery. The untrained group exhibited higher intraocular pressure and ocular perfusion pressure values in comparison with the trained group just after volitional exhaustion (effect size = 1.43 and 0.11 for intraocular pressure and effect size = 2.81 and 0.96 for ocular perfusion pressure). Five minutes of recovery was insufficient to reach baseline intraocular pressure and ocular perfusion pressure values only for the untrained group (effect size = 0.91 and 0.72, respectively). Conclusion: Our findings reveal that fitness level modulates the intraocular pressure and ocular perfusion pressure responses to a maximal treadmill test, being high fitness levels desirable in order to attenuate the impact of maximal efforts on these indices. These outcomes may be of clinical relevance for the management of glaucoma patients or those at risk, although future studies are needed to test these results in a clinical population.
Comparison of performance between two microcatheter systems in ab externo canaloplasty: A retrospective comparison study
Authors: Vastardis Iraklis , Kontopoulou Kalliopi , Fili Sofia , Gatzioufas Zisis , Kohlhaas Markus 
Published: March 2019

Purpose: To compare the performance of two different microcatheter systems, iTrack™ 250A and Glaucolight, in ab externo canaloplasty in three major categories: intraocular pressure reduction, drug therapy reintroduction, and evaluation of viscodilation over distension of the inner wall of Schlemm’s canal. Methods: A total of 56 and 46 eyes from different glaucoma types underwent ab externo canaloplasty using two different microcatheter systems. Group formation was made according to microcatheter system used. Kaplan–Meier test was performed for drug therapy reintroduction in relation to the two microcatheters. Tests of between-subject effects in two-way analysis of variance evaluated the efficacy of the two microcatheters and their features in relation to intraocular pressure reduction. Results: Kaplan–Meier test was not statistically significant (p = 0.20) regardless of microcatheter system. Tests of between-subject effects in relation to intraocular pressure reduction was not statistically different between the two microcatheters (p = 0.26) or between microcatheter and follow-up (p = 0.90). Intraocular pressure reduction in different glaucoma type was statistically significant during the follow-up period and glaucoma types showed different results between them in relation to follow-up (p < 0.001 and p = 0.002, respectively), but the pairwise comparison was not statistically important (p = 0.42). Intraocular pressure reduction was better in pseudophakic eyes in comparison with phakic eyes (p = 0.03), but the selection of microcatheter seemed not to affect this result (p = 0.11 and p = 0.32, respectively). Conclusion: Both microcatheter systems performed equal in terms of intraocular pressure reduction. Drug therapy reintroduction was not affected by the selection of the two microcatheters. Different types of glaucoma responded different to canaloplasty. Pseudophakic eyes responded better to treatment than phakic eyes, but the microcatheter selection seemed not affect this result.
Endophthalmitis associated with fungal keratitis and penetrating injuries in North China
Authors: Liu Meng-Yang , Zhang Li , Yin Xiao-Lin , Sun Shi-Ying 
Published: March 2019

Purpose: To report the laboratory findings, management strategies, and visual outcomes of culture-proven exogenous fungal endophthalmitis in North China. Methods: The microbiological and treatment records of patients with culture-positive exogenous fungal endophthalmitis who visited the Affiliated Hospital of Qingdao University from January 2012 to December 2016 were reviewed. Results: A total of 39 eyes (39 patients) were identified over a 5-year period. Exogenous fungal endophthalmitis was associated with penetrating trauma in 22 eyes (56.4%), fungal keratitis in 15 eyes (38.5%), and intraocular surgery in 2 eyes (5.1%). Hyphae were found in 29 of 37 smear samples (78.4%) by direct microscopic examination. Fungal pathogens cultured from 39 samples were identified as 10 genera and 15 species. Filamentous fungi (molds) accounted for 94.9% (37 samples), including Fusarium (19, 48.7%) and Aspergillus (11, 28.2%). Most keratitis cases were caused by Fusarium (11 of 15; 73.3 %). Aspergillus was isolated from nine penetrating ocular trauma cases (9 of 22; 40.9%). Three eyes receiving evisceration had fungal and bacteria coinfection (3 of 39, 7.7%) with Aspergillus and Bacillus. At least, one surgical intervention was performed in all 39 eyes and 28 (71.8%) eyes underwent two or more procedures, including surgeries and intraocular injections. Twenty-nine patients received intraocular antifungal therapy with amphotericin B and/or voriconazole. Visual acuity at discharge from the hospital was significantly better than the initial visual acuity ( p < 0.001). Final vision of 20/400 or better was achieved in 22 (56.4%) eyes. Conclusions: This study highlighted the differences between clinical categories of exogenous fungal endophthalmitis. Trauma was the major etiological factor. Molds were the most common pathogens, with Fusarium ranking first, followed by Aspergillus. Fungal and bacterial coinfection mostly occurred after metal penetrating trauma, and Bacillus was the primary bacterial pathogen. Coinfection may be one reason of evisceration. Immediate intravitreal antifungal therapy combined with vitrectomy was effective for exogenous fungal endophthalmitis. Amphotericin B and voriconazole were commonly used antifungal agents.
Effect of pelvic tilt and rotation on cup orientation in standing anteroposterior radiographs
Authors: Yun Ho Hyun , Murphy William S , Ward Daniel M , Zheng Guoyan , Hayden Brett , Murphy Stephen B 
Published: March 2019

Background: Individual pelvic tilt and rotation have wide variability that can affect the measurement of cup orientation in anteroposterior (AP) radiographs. The purpose of this study was to analyse the effect of pelvic tilt and rotation on radiographic measurements of cup orientation. Methods: A total of 53 patients (63 hips) were included in this study. The patients underwent a computed tomography study with standing AP pelvis radiographs taken both preoperatively and approximately 3 months postoperatively. We used 2-dimensional/3-dimensional matching to measure the pelvic tilt and rotation, and the non-standardised and standardised cup orientation. Results: There was no difference in the pelvic tilt and rotation between the preoperative and postoperative radiographs. The distribution of the differences between the non-standardised and standardised cup anteversion exhibited a change within 5° in only 34/63 (54%) hips. The pelvic tilt correlated with the difference between the non-standardised and standardised cup anteversion, but the pelvic rotation did not. When all 63 hips were separated into the right and left sides, the pelvic rotation inversely correlated with the pelvic tilt-adjusted difference between the non-standardised and standardised cup anteversion of the right side but directly correlated with that of the left side. Conclusions: The current study demonstrated that the measurement of cup anteversion in standing AP radiographs is significantly affected by both the pelvic tilt and pelvic rotation. An improved understanding of the pelvic orientation may eventually allow for desired cup positioning on a patient-specific basis to potentially reduce complications associated with the malposition of the cup.
The rising use of total hip arthroplasty for femoral neck fractures in the United States
Authors: Stronach Benjamin M , Bergin Patrick F , Perez Jorge L , Watson Shawna , Jones LaRita C , McGwin Gerald , Ponce Brent A 
Published: March 2019

Background: We examined the trends in the treatment of femoral neck fractures with arthroplasty in the United States from 2004–2013. Methods: We used the National Inpatient Sample database in conjunction with codes from the International Classification of Diseases, Ninth Revision, to identify patients receiving hemiarthroplasty (HA) or total hip arthroplasty (THA) for the treatment of closed femoral neck fracture from 2004–2013. We evaluated the trend of these 2 treatments along with demographics, comorbidities, length of stay and same admission mortality. Results: Our study identified 1,059,414 patients who underwent arthroplasty for the treatment of femoral neck fracture. We found a 42% increase in the use of THA during the study period from 8.4% in 2004 to 12.9% in 2013. While the large majority of patients received HA (87.1%), there was an overall decline in the use of HA (89,132 in 2004 to 85,635 in 2013) and increase in the use of THA (8,177 in 2004 to 11,375 in 2013). Patients receiving THA were younger (mean age 74.7 THA vs. 80.4 HA, p < 0.001) with fewer comorbidities, higher likelihood of discharge to home (24% THA vs. 10% HA, p < 0.001) and lower inpatient mortality rates (1.5 % THA vs. 2.4 % HA, p < 0.001) in comparison to HA. Conclusion: There has been a significant increase in the use of THA over the last decade. Patients receiving THA were younger and healthier with fewer comorbidities, less likely to sustain a same admission mortality and more likely to discharge to home in comparison to HA patients.
Sphenoid Sinus Cholesteatoma—Complications and Skull Base Osteomyelitis: Case Report and Review of Literature
Authors: Kanjanawasee Dichapong , Chaowanapanja Pattraporn , Keelawat Somboon , Snidvongs Kornkiat 
Published: March 2019

Introduction: Cholesteatoma of the paranasal sinuses is uncommon. Its clinical characteristics are an expanding growth of the affected paranasal sinuses consisting of keratinizing squamous epithelium with bony wall destruction. Among involved paranasal sinuses, sphenoid sinus cholesteatoma is the least common. Case presentation: An 82-year-old female diabetic patient presented with subacute onset of fever after experiencing chronic progressive headaches for more than 20 years. Nasal endoscopy found purulent discharge from left sphenoethmoidal recess. Computed tomography (CT) scan of the paranasal sinus showed soft tissue lesions that totally filled the left sphenoid sinus with posterior and inferior wall destruction. There was no evidence of connection to the left mastoid cavity. Management and outcome: Left sphenoidotomy was performed. Histopathology revealed cholesteatoma. Two months after surgery, she became worse and CT showed extensive skull base destruction. The patient underwent bilateral sphenoidectomy and craniotomy with surgical debridement of osteomyelitis of the skull base. She received long-term intravenous ertapenam and sitafloxacin for treating drug-resistant Klebsiella infection. The osteomyelitis could not be controlled, and she died. Discussion: Progressive headache can be caused by an uncommon disease such as sphenoid sinus cholesteatoma, which is a surgical condition. Complicating osteomyelitis of the skull base requires extensive debridement surgery and should be anticipated.
Patient empowerment and its correlates in young persons with congenital heart disease
Authors: Acuña Mora Mariela , Sparud-Lundin Carina , Burström Åsa , Hanseus Katarina , Rydberg Annika , Moons Philip , Bratt Ewa-Lena 
Published: March 2019

Objective: The objective of this study was to measure the level of empowerment and identify its correlates in young persons with congenital heart disease. Study design: Patients aged 14–18 years with congenital heart disease, and under active follow-up in one of four paediatric cardiology centres in Sweden were invited to participate in a cross-sectional study. A total of 202 young persons returned the questionnaires. Patient empowerment was measured with the Gothenburg Young Persons Empowerment Scale that allows the calculation of total and subscale scores. Univariate and multivariate linear regression analyses were undertaken to analyse possible correlates, including: sex, age, health behaviours, knowledge of congenital heart disease, quality of life, patient-reported health, congenital heart disease complexity, transition readiness and illness perception. Results: The mean empowerment score was 54.6±10.6 (scale of 15–75). Univariate analyses showed that empowerment was associated with age, quality of life, transition readiness, illness perception, health behaviours and patient-reported health (perceived physical appearance, treatment anxiety, cognitive problems and communication issues). However, multivariable linear regression analyses identified that only transition readiness (β=0.28, P<0.001) and communication (β=0.36, P<0.001) had a positive association with patient empowerment. These variables were also significantly associated with the subscale scores of the empowerment scale of knowledge and understanding ( P<0.001), shared decision-making ( P<0.001) and enabling others ( P<0.01). The overall models’ explained variance ranged from 8% to 37%. Conclusion: Patient empowerment was associated with transition readiness and fewer problems communicating. While it is not possible to establish the directionality of the associations, interventions looking to increase empowerment could benefit from using these variables (or measurements) for evaluation purposes.