bluuebunny/crossref_metadata_2025_split huggingface dataset:
The international diffusion of expatriate dual citizenship
Authors: Vink Maarten , Schakel Arjan H , Reichel David , Luk Ngo Chun , de Groot Gerard-René 
Published: April 2019

AbstractWhile the global increase of expatriate dual citizenship acceptance over the past decades has been widely observed, the temporal and spatial contexts of this trend have remained understudied. Based on a novel data set of expatriate dual citizenship policies worldwide since 1960, we find that dual citizenship toleration has increased in the last half century from one-third to three-quarter of states globally. We argue that these domestic policy changes should be understood in light of normative pressure in a world where restrictions on individual choice in citizenship status are increasingly contested and where liberalisation is reinforced through interdependence and diaspora politics. We apply Cox proportional hazard models to examine dual citizenship liberalisation and find that states are more likely to move to a tolerant policy if neighbouring states have done so and that they tend to do so in conjunction with extending voting rights to citizens residing abroad and receiving remittances from abroad. Contrary to other studies, we do not observe significant variation by regime type.
LC8/DYNLL1 is a 53BP1 effector and regulates checkpoint activation
Authors: West Kirk L , Kelliher Jessica L , Xu Zhanzhan , An Liwei , Reed Megan R , Eoff Robert L , Wang Jiadong , Huen Michael S Y , Leung Justin W C 
Published: April 2019

Abstract
The tumor suppressor protein 53BP1 plays key roles in response to DNA double-strand breaks (DSBs) by serving as a master scaffold at the damaged chromatin. Current evidence indicates that 53BP1 assembles a cohort of DNA damage response (DDR) factors to distinctly execute its repertoire of DSB responses, including checkpoint activation and non-homologous end joining (NHEJ) repair. Here, we have uncovered LC8 (a.k.a. DYNLL1) as an important 53BP1 effector. We found that LC8 accumulates at laser-induced DNA damage tracks in a 53BP1-dependent manner and requires the canonical H2AX-MDC1-RNF8-RNF168 signal transduction cascade. Accordingly, genetic inactivation of LC8 or its interaction with 53BP1 resulted in checkpoint defects. Importantly, loss of LC8 alleviated the hypersensitivity of BRCA1-depleted cells to ionizing radiation and PARP inhibition, highlighting the 53BP1-LC8 module in counteracting BRCA1-dependent functions in the DDR. Together, these data establish LC8 as an important mediator of a subset of 53BP1-dependent DSB responses.
Therapeutic Strategies and Prognostic Factors Based on 121 Spinal Neurenteric Cysts
Authors: Weng Jian-Cong , Zhang Zhi-Feng , Li Da , Wang Jun-Mei , Li Gui-Lin , Xu Yu-Lun , Yang Jun , Zhang Jun-Ting , Jia Wen-Qing 
Published: April 2019

Abstract

BACKGROUND
Limited data existed to guide the management of intraspinal neurenteric cysts (ISNECs).

OBJECTIVE
To evaluate the risk factors for progression-free survival (PFS), elucidate the radiological features of ISNECs, and propose a treatment protocol.

METHODS
From 2003 to 2015, 121 patients with pathologically confirmed ISNECs treated at our institute were included in this study. Pertinent risk factors were evaluated.

RESULTS
Gross total resection (GTR) was achieved in 55 (44.6%) patients; 106 (87.6%), 12 (9.9%), and 3 (2.5%) ISNECs were classified as Wilkins A, B, and C, respectively. After a median follow-up duration of 64.2 mo, recurrence occurred in 25 (22.7%) patients, with a median PFS time of 43.1 mo. The actuarial PFS rates at 5 and 10 yr were 73.2% and 66.2%, respectively. The actuarial overall survival rates at 5 and 10 yr were 100% and 97.6%, respectively. Non-GTR (hazard ratio [HR], 5.836; 95% confidence interval [CI], 1.698-20.058; P = .005), Wilkins B/C (HR, 3.129; 95% CI, 1.009-9.702; P = .048), and a history of surgical resection (HR, 3.690; 95% CI, 1.536-8.864; P = .004) were adverse factors.

CONCLUSION
GTR and Wilkins A were favorable factors for PFS. If tolerable, GTR alone was advocated as an optimal treatment. Because of the benign nature and favorable prognosis, non-GTR was an alternative if GTR failed. Close follow-up was needed because of the recurrent tendency of ISNEC. Future study with a large cohort is necessary to verify our findings.
Frailty in Patients With Trauma Who Are Critically Ill: A Prospective Observational Study to Determine Feasibility, Concordance, and Construct and Predictive Validity of 2 Frailty Measures
Authors: Tipping Claire J , Hodgson Carol L , Harrold Meg , Chan Terry , Holland Anne E 
Published: April 2019

Abstract

Background
As the older population increases, more older people are exposed to trauma. Frailty can be used to highlight patients at risk of a poorer outcome.

Objective
The objectives of this study were to compare 2 frailty measures with regard to concordance, floor and ceiling effects, and construct and predictive validity and to determine which is more valid and clinically applicable in a critically ill trauma population.

Design
This was a prospective observational study.

Methods
Patients were included if admitted to an intensive care unit (ICU) under a trauma medical unit and ≥ 50 years old. Frailty was determined using 2 frailty measures, the Frailty Phenotype (FP) and Clinical Frailty Scale (CFS).

Results
One hundred people were enrolled; their mean age was 69.2 years (SD = 10.4) and 81% had major trauma (as determined with the Injury Severity Score). Frailty was identified with the FP in 22 participants and with the CFS in 13 participants. The 2 frailty measures had an excellent correlation (Spearman rank correlation coefficient = 0.77; 95% confidence interval = 0.66–0.85). Both the FP and the CFS had large floor effects but no ceiling effects. The FP and CFS showed construct validity, with frailty being significantly associated with increasing age, requiring an aid to mobilize, and more falls and hospital admissions. Frailty on the FP was predictive of ICU and hospital mortality, whereas frailty on the CFS was predictive of hospital mortality.

Limitations
The limitations of this study include the use of a single site, small sample size, and collection of frailty measures retrospectively.

Conclusions
Measuring frailty in a trauma ICU population was feasible, with excellent correlation between the 2 frailty measures. Both showed aspects of construct and predictive validity; however, the FP identified frailty in more participants and was associated with more comorbidities and higher mortality at ICU discharge. Therefore, the FP might be more clinically relevant in this population.
Fixed Handheld Dynamometry Provides Reliable and Valid Values for Quadriceps Isometric Strength in People With Chronic Obstructive Pulmonary Disease: A Multicenter Study
Authors: Bui Kim-Ly , Mathur Sunita , Dechman Gail , Maltais François , Camp Pat , Saey Didier 
Published: April 2019

Abstract

Background
Quadriceps weakness is associated with poor clinical outcomes in chronic obstructive pulmonary disease (COPD). However, quadriceps isometric strength assessment has not been routinely adopted in clinical practice because of the lack of homogeneity in the devices and protocols and the lack of reliability studies.

Objective
The objectives of this study were to determine the test-retest reliability and the criterion validity of a commercially available handheld dynamometer for evaluating the quadriceps isometric maximal voluntary contraction (iMVCquad) using a standardized protocol and to investigate the relationship between iMVCquad and functional capacity in people with COPD.

Design
This was a prospective, observational, multicenter trial.

Methods
Participants with mild to severe COPD from 4 Canadian sites were tested on 2 separate days. Five iMVCquad measurements were obtained following a standardized procedure with a fixed handheld dynamometer (iMVCquad-HHD), and then 5 iMVCquad measurements were obtained with a computerized dynamometer (iMVCquad-CD; the gold standard). Functional capacity was assessed with the Short Physical Performance Battery. Intraclass correlation coefficients, standard errors of measurement, Bland-Altman plots, and Spearman correlation coefficients were used for analyses.

Results
Sixty-five participants (mean age = 69 years [SD = 8]; forced expiratory volume in 1 second = 48% of predicted value [SD = 21]) completed the study. The mean iMVCquad-HHD values on visits 1 and 2 were 102.7 (SD = 51.6) and 105.6 (SD = 58.8) N·m, respectively; the standard error of measurement was 11.4 N·m. The between-visits intraclass correlation coefficient for iMVCquad-HHD was 0.95 (95% confidence interval = 0.92–0.97), with a mean bias of 2.0 (Bland-Altman plot). There was a strong correlation between iMVCquad-HHD and iMVCquad-CD (Spearman correlation coefficient = 0.86). There was no correlation between iMVCquad-HHD and Short Physical Performance Battery total score.

Limitations
Participants had stable COPD with few comorbidities and were more physically active than the general population of people with COPD; results might not be applicable to patients with acute exacerbations of the disease or more comorbidities. Assessment order between handheld and computerized dynamometers has not been randomized, but analyses did not highlight any systematic bias or learning effect.

Conclusions
Quadriceps strength assessment can be implemented in a reliable and valid way in people with COPD using a fixed handheld dynamometer and standardized procedure. This protocol should be established in clinical practice to facilitate the assessment of muscle strength in people with COPD.
Suspected hematologic malignancy complicates lupus cerebritis treatment
Authors: Walgren Morgan 
Published: April 2019

ABSTRACT
Comorbidities make determining a patient's optimal treatment plan substantially more difficult. This article describes lupus cerebritis, a neuropsychiatric presentation of systemic lupus erythematosus, in a patient with a risk for hematologic malignancies. The patient's primary care team had to weigh the benefit versus potential harm of various therapies to find the best treatment.
Longitudinal survey of clinician behavior change in CKD management
Authors: Shaw-Gallagher Marlene , Boyle Rebecca , Zuber Kim 
Published: April 2019

ABSTRACT

Objective:
To assess longitudinal improvement for a simple intervention to teach physician assistants (PAs) and NPs management of patients with diabetes and chronic kidney disease (CKD).

Methods:
The original cohort from the Kidneys in a Box quality improvement project was revisited at the 3-year mark and asked about patient statin use, A1C measurement, urine albumin-creatinine ratio (UACR), CKD staging, distribution of over-the-counter (OTC) medication caution lists, and documentation of smoking history.

Results:
A statistically significant increase in quality metrics was seen at 3 months postintervention for the original cohort. At the 3-year mark, these improvements were sustained. For UACR and smoking quality metrics, performance increased beyond the gains initially seen at 3 months.

Conclusions:
This study demonstrates that a single-intervention quality improvement program can affect sustained improvements in clinical care of patients with diabetes and CKD. The results provide evidence that one-time quality improvement interventions have the power to promote longitudinal practice changes associated with reduced rates of CKD progression and potentially reduced healthcare costs.
Atypical Lipomatous Tumors
Authors: Fourman Mitchell S. , van Eck Carola F. , Weiss Kurt R. , Goodman Mark A. , McGough Richard L. 
Published: April 2019

Objectives:
Misnaming low-grade lipomatous tumors poses a clinical and medicolegal challenge, potentially subjecting patients to expensive and unnecessary surgeries. The terms atypical lipomatous tumor (ALT) and “well-differentiated” liposarcoma (WDL) have been used interchangeably in pathology reports, scholarly works and consensus recommendations, creating vagaries between low-virulence extremity tumors and retroperitoneal disease with metastatic potential.

Methods:
A systematic review was performed on all studies that reported on the local recurrence rate and metastasis of ALTs and WDLs in living human subjects. Local recurrence and metastases were compared using Fisher’s Exact Test.

Results:
In total, 20 studies evaluated ALTs (n=936), whereas 13 studied WDLs (n=626). Mean follow-up was 6.6±2.0 years (median, 7.0 y). No metastatic disease was observed among ALTs, whereas 15 patients with WDLs (2.7%, P<0.0001) had metastases. The local recurrence rate of ALTs was significantly lower than WDLs after both marginal (15.1%, 141/936 vs. 46.0%, 288/626, P<0.0001) and wide excisions (3.3%, 2/59 in ALT vs. 17.4%, 19/109, P=0.007).

Conclusions:
ALT should be reserved for extremity lesions meeting appropriate histopathologic criteria that represent nonmetastatic disease, reducing over-diagnosis, over-treatment, and patient risk.
CAR T Cell Toxicity: Current Management and Future Directions
Authors: Yáñez Lucrecia , Sánchez‐Escamilla Miriam , Perales Miguel‐Angel 
Published: April 2019

AbstractBy late 2018, 2 chimeric antigen receptor T (CAR T) cell products have been approved by US and European regulatory authorities. Tisagenlecleucel (Kymriah, Novartis) is indicated in the treatment of patients up to 25 years of age with B‐cell acute lymphoblastic leukemia (ALL) that is refractory or in second or later relapse, or adult patients with large B‐cell lymphoma relapsed or refractory (r/r) after 2 or more lines of systemic therapy, including diffuse large B‐cell lymphoma (DLBCL) not otherwise specified, high grade B‐cell lymphoma and DLBCL arising from follicular lymphoma. Axicabtagene ciloleucel (Yescarta, Kite) is indicated for the treatment of adult patients with large B‐cell lymphoma relapsed or refractory after 2 or more lines of systemic therapy, including DLBCL not otherwise specified, primary mediastinal large B‐cell lymphoma, high grade B‐cell lymphoma, and DLBCL arising from follicular lymphoma (ZUMA‐1 trial).This review will offer a practical guide for the recognition and management of the most important toxicities related to the use of the current commercial CAR T cells, and also highlight strategies to diminish these side effects in the future.
Management of Ocular Allergy Itch With an Antihistamine-Releasing Contact Lens
Authors: Pall Brian , Gomes Paul , Yi Frank , Torkildsen Gail 
Published: April 2019

Purpose:
A contact lens (CL)-based drug delivery system for therapeutic delivery of the antihistamine ketotifen was tested in 2 parallel, conjunctival allergen challenge-based trials.

Methods:
Both trials employed the same multicenter, randomized, placebo-controlled protocol. Test lenses were etafilcon A with 0.019 mg ketotifen; control lenses were etafilcon A with no added drug. Subjects were randomized into 3 treatment groups. Group 1 received test lens in one eye and control lens in the contralateral eye; the eye chosen to receive test lens was randomly selected in a 1:1 ratio. Group 2 received test lenses bilaterally, and group 3 received control lenses bilaterally. Allergen challenges were conducted on 2 separate visits: following lens insertion, the subjects were challenged at 15 minutes (to test onset) and 12 hours (to test duration). The primary endpoint was ocular itching measured using a 0 to 4 scale with half-unit steps. Secondary endpoints included ciliary, conjunctival, and episcleral hyperemia.

Results:
The mean itching scores were lower for eyes wearing the test lens as compared to those that received control lenses, indicating that the test lens effectively reduced allergic responses. Mean differences in itching were statistically and clinically significant (mean score difference ≥ 1) at both onset and duration for both trials.

Conclusions:
This large-scale assessment (n = 244) is the first demonstration of efficacy for CL delivery of a therapeutic for ocular allergy. Results are comparable to direct topical drug delivery and suggest that the lens/ketotifen combination can provide a means of simultaneous vision correction and treatment for CL wearers with ocular allergies.
Work-Related Predictors of Sleep Quality in Chinese Nurses: Testing a Path Analysis Model
Authors: LI Yuan , FANG Jinbo , ZHOU Chunfen 
Published: April 2019

ABSTRACT

Background
Good sleep is essential to human health. Insufficient quality sleep may compromise the wellness of nurses and even jeopardize the safety of patients. Although the contributors of sleep quality in nurses have been previously studied, the direct and indirect effects of modifiable work-related predictors remain uncertain.

Purpose
The study was designed to explore the direct and indirect effects of modifiable work-related factors on sleep quality in Chinese nurses.

Methods
A multistage sampling method was employed in this cross-sectional study to recruit 923 participants. An evidence-based predicting model was postulated and then subsequently tested and optimized using path analysis.

Results
The final model fit the data well, with the involved predictors accounting for 34.1% of the variance in sleep quality of the participants. Shift work, job demands, exposure to hazards in work environments, chronic fatigue, and inter-shift recovery were identified as direct predictors, while whereas job satisfaction, job control, support at work, and acute fatigue were identified as indirect predictors.

Conclusions/Implications for Practice
Sleep quality in Chinese nurses is influenced directly and indirectly by various modifiable work-related factors. Interventions such as adjusting work shifts and reducing job burdens should be prioritized by administrative staff to ensure the sleep quality and clinical performance of Chinese nurses and to subsequently improve nursing care quality.
Predictors of Hospitals' Nonachievement of Baseline Nursing Standards for Pediatric Oncology
Authors: Sullivan Courtney E. , Morrissey Lisa , Day Sara W. , Chen Yanjun , Shirey Maria , Landier Wendy 
Published: April 2019

Background
The International Society of Pediatric Oncology established baseline standards for pediatric oncology nursing; limited evidence is available to predict hospitals' capacity to meet these standards internationally.

Objectives
The aims of this study were to (1) determine the proportion of hospitals that met, partially met or did not meet baseline standards for pediatric oncology nursing and (2) identify predictors of hospitals' nonachievement of baseline standards for pediatric oncology nursing.

Methods/Analysis
A secondary analysis of International Society of Pediatric Oncology web-based survey data of baseline nursing standards was conducted. Predictor variables were derived from surveyed hospital characteristics and external data sources. Multivariable parsimonious logistic regression models identified predictors of hospitals' nonachievement of each standard.

Results
Nurses from 101 hospitals across 54 countries completed the survey; 12% to 66% of hospitals reported meeting each of 6 baseline standards. Predictors of nonachievement of standards included low current health expenditure as percentage of gross domestic product, World Health Organization Region of Africa, United Nations “developing or transition” country classification, countries with fewer than 3 nurses/midwives per 1000 population, and hospitals without bone marrow transplant and/or intensive care units.

Conclusions
Hospitals with characteristics predictive of inability to meet baseline standards will likely require greater capacity-building support and advocacy to improve the quality of nursing care.

Implications for Practice
Findings from this study highlight internal and external factors that challenge the delivery of high-quality pediatric oncology nursing care internationally.
A Controlled Clinical Trial on the Effects of Exercise on Lower Urinary Tract Symptoms in Women With Multiple Sclerosis
Authors: Silva Ferreira Ana Paula , de Souza Pegorare Ana Beatriz Gomes , Miotto Junior Ari , Salgado Pedro Rippel , Medola Fausto Orsi , Christofoletti Gustavo 
Published: April 2019

Objective
The aim of the study was to investigate the effects of two pelvic floor exercise programs on lower urinary tract symptoms and quality of life in participants with multiple sclerosis.

Design
This is a prospective, single-blind, clinical trial.

Settings
The study used a community rehabilitation program within a large metropolitan health service.

Participants
Thirty women in moderate stage of multiple sclerosis were referred for outpatient rehabilitation.

Interventions
In a period of 6 mos, participants underwent a pelvic floor exercise program, associated or not with vaginal electrotherapy.

Main Outcomes
The main outcomes are overactive bladder, perineal contraction, and quality of life.

Results
The findings showed benefits of both programs on overactive bladder and quality of life. Participants undergoing exercise plus electrotherapy presented greater improvement on contraction of the perineal musculature and quality of life.

Conclusions
Six months of exercise provided benefits on lower urinary tract symptoms and quality of life in women with multiple sclerosis. Electrical stimulation potentiated the improvement on perineal musculature and quality of life. This trial was registered prospectively with the Clinical Trials Register, ID: BR-287q65 (http://www.ensaiosclinicos.gov.br/rg/RBR-287q65/).
Perceptions of Pediatric Hospital Safety Culture in the United States: An Analysis of the 2016 Hospital Survey on Patient Safety Culture
Authors: Gampetro Pamela J. , Segvich John P. , Jordan Neil , Velsor-Friedrich Barbara , Burkhart Lisa 
Published: April 2019

Introduction
Medical errors in the pediatric population can quickly cause harm. Research identified that hospitals with positive safety cultures work collaboratively to reduce errors. Strategies that identify gaps in hospital’s safety culture within the pediatric milieu have not been initiated. This study addressed this gap from an interprofessional perspective.

Methods
This cross-sectional descriptive study used data from the Agency for Healthcare Research and Quality’s 2016 Hospital Patient Safety Culture survey measuring 12 safety culture dimensions for registered nurses (RNs), physician assistants/nurse practitioners (PAs/NPs), physicians (MDs), and administrators/managers (n = 6682) in the United States that were employed in 287 (42%) pediatric hospitals or specialty units.

Results
Findings indicated that in the United States, the overall safety culture had low levels of agreement. Pairings between pediatric RNs, PAs/NPs, and MDs had similar levels of agreement for all dimensions but the perceptions of these three practitioners differed when compared with pediatric administrators/managers in nine of the 12 dimensions. The perceptions of pediatric RNs and MDs differed in six of the 12 dimensions, with MDs indicating higher levels of agreement. All four professional groups rated teamwork within hospital units with the highest level of agreement (mean, 4.14), with hospital handoffs and transitions rated the lowest (mean, 2.64). All four professional groups found punitive cultures (mean, 2.71) throughout the pediatric specialty.

Conclusions
Variations regarding pediatric professional’s perception of safety culture exist within U.S. hospitals. Effective and creative management will support cultures that prevents harm and improves the overall safety of children’s care with initiatives that are dedicated to excellence.