bluuebunny/crossref_metadata_2025_split huggingface dataset:
Telehealth coaching for rural-living young adult cancer survivors: A protocol
Authors: Price Jenson , Brunet Jennifer 
Published: September 2019

Objective: Young adult cancer survivors living in rural areas have reported barriers to participating in health behaviours due to their geographical location and the developmental milestones associated with their age. Existing health behaviour change interventions have generally been delivered face-to-face and have not been tailored to the preferences of young adults living in rural areas, thus not adequately addressing the needs of this population. To address these limitations, this trial aims to examine the feasibility and acceptability of a 12-week telehealth intervention drawing on self-determination theory to promote physical activity participation and fruit and vegetable consumption. Design: The intervention will be tested with young adults who are between the ages of 20 and 39 years, have completed primary treatment, live in an area with fewer than 35,000 inhabitants, are not currently meeting physical activity and fruit and vegetable consumption guidelines, have access to the Internet and audio-visual devices, are ambulatory and are able and willing to provide informed consent. The target sample size is 15. Method: Feasibility data will be collected by recording recommended outcomes throughout the trial. Additional feasibility data as well as acceptability data will be collected using an online questionnaire administered pre- and post-intervention and a semi-structured interview. Results: Results may inform the design and implementation of supportive care services for young adults, and potentially other adults living in rural areas who experience similar barriers to participating in health-promoting behaviours. Conclusion: This trial is one of the first to explore the feasibility and acceptability of a theory-based telehealth behaviour change intervention targeting young adult cancer survivors living in rural areas in order to mitigate the disease burden.
Who provides physical activity support in the workplace? Implications for peer led interventions
Authors: Edmunds Sarah , Sitch Matthew , Lowry Ruth 
Published: September 2019

Objective: Social support is one mechanism through which peer support physical activity (PA) interventions influence behaviour. The aim of this study was to explore the sources and characteristics of social support for PA among office-based work colleagues. Design: A sequential mixed-methods approach was used. First, social network analysis was utilised to map the sources of social support. Then interviews and focus groups were used to explore the characteristics of this support. Setting: One UK public sector employer in the south of England. Method: Using an online survey, 99 employees (40 men; Mage = 40 ± 12 years) reported their PA and named specific colleagues who provided four forms of social support for PA (emotional, informational, companionship, validation). Social network diagrams for each support network were visualised using UCINET and Netdraw. Individuals identified as most frequently providing support for PA participated in one-to-one interviews ( n = 6) to discuss their perspective on social support for PA in the workplace. Three focus groups explored the characteristics of social support for PA among employees identified within the networks as support seekers or disconnected. These qualitative data were analysed thematically. Results: Different patterns of relationships between employees were demonstrated for the four forms of support with informational support provided most frequently and validation least frequently. Qualitative data illustrate how each form of support was provided and received, as well as further perceived characteristics of social support. Conclusion: These findings could help inform the future selection and training of peer PA champions in workplace settings and more widely.
Studying Gaze Behavior to Compare Three Different Hazard Perception Tasks
Authors: Malone Sarah , Brünken Roland 
Published: September 2019

Objective The aim of the current study was to compare the traditional, verbal, and motoric tasks regarding their contributions to hazard perception measurement. Background Traditional hazard perception tasks require the participants to respond to filmed traffic conflicts in an imprecise way, such as by pressing a button. More sophisticated tasks include either verbal specification or motoric localization of the perceived hazards. The present study investigated the participants’ gaze behavior when they were provided with an identical set of traffic animations but were instructed to perform one of three types of hazard perception tasks. Method In an eye tracking study, 69 drivers were shown animated traffic scenarios and instructed to perform the traditional (press button), verbal, or speeded motoric localization hazard perception task. Eye tracking revealed whether and when the participant had fixated a certain hazard cue. Results The participants in the traditional task group were slower to fixate emerging hazards, but quicker to respond to them than the participants of the verbal and the motoric groups. As a specific benefit, the verbal task differentiated between different types of failures. Conclusion Additional verbal or speeded motoric localization tasks seem to have increased the participants’ alertness when watching the animations. The verbal task provides valuable additional information regarding the participants’ performance. To approximate real-life hazard perception ability, it is recommended that researchers and practitioners use a combination of different hazard perception tasks for assessment and training.
Abnormal expression and clinical significance of 25-hydroxyvitamin D and sFlt-1 in patients with preeclampsia
Authors: Chen Xinhua , Xi Xuxia , Cui Fan , Wen Ming , Hong Aijuan , Hu Zemei , Ni Juan 
Published: September 2019

Objective To determine the association between levels of serum 25-hydroxyvitamin D (25[OH]D) and soluble fms-like tyrosine kinase 1 (sFlt-1) in patients with preeclampsia. Methods Clinical and demographic data were collected from patients with preeclampsia and healthy pregnant controls. Serum 25(OH)D and sFlt-1 levels were evaluated by enzyme-linked immunosorbent assay and their correlations were determined using Spearman’s rank correlation coefficient. Associations between serum 25(OH)D and sFlt-1 levels and disease severity and clinical parameters were evaluated. Results Significantly lower serum 25(OH)D and higher sFlt-1 levels were observed in patients with preeclampsia ( n = 100) versus controls ( n = 100), and 25(OH)D was inversely correlated with sFlt-1 in patients with preeclampsia. Serum 25(OH)D levels were reduced, while sFlt-1 concentration was increased in patients with severe versus mild preeclampsia. Serum 25(OH)D levels were reduced in late-onset versus early-onset severe preeclampsia. Patients with preeclampsia who had lower serum 25(OH)D or elevated sFlt-1 levels showed significantly higher blood pressure indexes versus those with higher 25(OH)D or lower sFlt-1. Conclusions Low serum 25(OH)D and high sFlt-1 may be candidate biomarkers for preeclampsia diagnosis and prognosis.
Combined anesthesia shows better curative effect and less perioperative neuroendocrine disorder than general anesthesia in early stage NSCLC patients
Authors: Pi Jingbo , Sun Yi , Zhang Zhenghong , Wan Chengfu 
Published: September 2019

Objectives We aimed to compare the effects of general anesthesia with combined epidural and general anesthesia in patients with early-stage non-small cell lung carcinoma (NSCLC). Methods Patients scheduled to undergo tumor resection with adjuvant chemoradiotherapy were eligible. Patients in the control group received general anesthesia during surgery, and those in the observation group received combined epidural and general anesthesia. The hemodynamic factors mean arterial pressure (MAP), heart rate, end-tidal carbon dioxide, and oxygen saturation were measured. Serum levels of pro-inflammatory cytokines interleukin (IL)-1, IL-8, high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor (TNF)-α as well as β-endorphin were measured by enzyme-linked immunosorbent assay. Serum malondialdehyde (MDA) was measured using the thiobarbituric acid method. Results The incidence of specific adverse events was reduced and overall and disease-free survival were improved in the observation group compared with the control group. MAP was generally lower in the observation group compared with the control group, as were the serum levels of IL-1, IL-8, hs-CRP, TNF-α, and MDA. Conclusions Compared with general anesthesia, combined epidural and general anesthesia may inhibit the occurrence of short-term adverse events and improve long-term outcomes by inhibiting inflammatory responses in patients with early-stage NSCLC after tumor resection.
Antiemetic efficacy of dexmedetomidine versus dexmedetomidine-dexamethasone combination in patients undergoing breast surgery
Authors: Kwak HyunJeong , Chang Young Jin , Lee Kyung Cheon , Jung Wol Seon , Kwon Sunkoo , Jo Youn Yi 
Published: September 2019

Objective To compare the antiemetic efficacy of dexmedetomidine alone versus combined dexmedetomidine–dexamethasone on incidence of postoperative nausea and vomiting (PONV) in patients undergoing breast surgery. Methods A total of 149 patients (aged 20–65 years) were assigned to receive normal saline (control group, n = 50), dexmedetomidine 0.5 μg/kg (DEX group, n = 49), or a combination of dexmedetomidine 0.5 μg/kg and dexamethasone 5 mg (dual group, n = 50) at 30 minutes prior to the end of surgery. The primary outcome measure was the incidence of PONV in the post-anesthesia care unit (PACU). Results During the first 24 hours after surgery, the incidence of PONV was significantly higher in the control group than in the DEX and dual groups (70% vs. 20% and 12%, respectively), with no intergroup difference observed between the DEX and dual groups. In the PACU, the incidence of PONV differed significantly among the control, DEX, and dual groups (12%, 4%, and 3%, respectively). Conclusion Dexmedetomidine alone and in combination with dexamethasone significantly reduced PONV with similar antiemetic efficacies in female patients during the first 24 hours after breast surgery. Clinical trial registration: ClinicalTrials.gov (NCT 02550795).
Republicanism within IR: A History of Liberty and Empire
Authors: Blachford Kevin 
Published: September 2019

The republican tradition has long been influential within political theory, but has been less acknowledged within the discipline of International Relations (IR). Republican theorists and republican ideas of political liberty underlie many normative claims made by both liberal and realist schools of thought. The following examination of republicanism takes an interdisciplinary approach to argue the relevance of republicanism for IR theory. When republicanism is recognised within IR, it is often through a triumphalist reading of the early American republic and its founding. This article opens new ground by presenting a more critical account of republicanism. It does so by focusing on the connections between republican liberty and the history of republics to dominate those outside the polis. El republicanismo en el ámbito de las relaciones internacionales: Una historia de libertad e imperio
Multiple Concussions Increase Odds and Rate of Lower Extremity Injury in National Collegiate Athletic Association Athletes After Return to Play
Authors: Harada Garrett K. , Rugg Caitlin M. , Arshi Armin , Vail Jeremy , Hame Sharon L. 
Published: September 2019

Background: Concussion in collegiate athletics is one of the most prevalent sport-related injuries in the United States, with recent studies suggesting persistent deficits in neuromuscular control after a concussion and an associated increase in risk of lower extremity injury. Purpose: To expand on the relationship between concussion and lower extremity injury by examining the effect of multiple concussions (MC) on rate and odds of future lower extremity injury in collegiate athletes after return to play (RTP) compared with matched controls. Study Design: Cohort study; Level of evidence, 3. Methods: From 2001 to 2016, 48 National Collegiate Athletic Association Division I athletes sustaining multiple concussions at a single institution were identified. Athletes with multiple concussions (MC) were matched directly to athletes with a single concussion (SC) and to athletes with no concussion history (NC) by sex, sport, position, and games played. Incidence of, time to, and location of lower extremity injury were recorded for each group after RTP from their first reported concussion until completion of their collegiate career. Logistic regression was used to analyze odds ratios (ORs) for sustaining lower extremity injury, whereas time to injury was summarized by use of Kaplan-Meier curves and log rank test analysis. Results: The incidence of lower extremity injury after RTP was significantly greater ( P = .049) in the MC cohort (36/48, 75%) than in SC athletes (25/48 = 52%) and NC athletes (27/48 = 56%). Similarly, odds of lower extremity injury were significantly greater in the MC cohort than in SC athletes (OR, 3.00; 95% CI, 1.26-7.12; P = .01) and NC athletes (OR, 1.66; 95% CI, 1.07-2.56; P = .02). Time to lower extremity injury was significantly shorter in the MC group compared with matched controls ( P = .01). No difference was found in odds of lower extremity injury or time to lower extremity injury between SC and NC athletes. Conclusion: Collegiate athletes with MC were more likely to sustain a lower extremity injury after RTP in a shorter time frame than were the matched SC and NC athletes. This may suggest the presence of a cohort more susceptible to neuromuscular deficits after concussion or more injury prone due to player behavior, and it may imply the need for more stringent RTP protocols for athletes experiencing MC.
Bone Bruise and Anterior Cruciate Ligament Tears: Presence, Distribution Pattern, and Associated Lesions in the Pediatric Population
Authors: Bordoni Vittorio , di Laura Frattura Giorgio , Previtali Davide , Tamborini Simone , Candrian Christian , Cristallo Lacalamita Marirosa , Del Grande Filippo , Filardo Giuseppe 
Published: September 2019

Background: Bone bruise characteristics after anterior cruciate ligament (ACL) injury have been correlated with the level of joint derangement in adults. However, the literature lacks information about younger patients, whose higher ligamentous laxity may lead to different lesion patterns. Purpose: To investigate the prevalence, size, location, and role of bone bruise associated with ACL rupture in the pediatric population. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Knee magnetic resonance imaging scans (MRIs) of patients aged 8 to 16 years with ACL tears from 2010 to 2018 were selected from the institution database. Inclusion criteria were open or partially open physes, less than 90 days between trauma and MRI, and no history of injury or surgery. Presence, localization, and size of bone bruise were analyzed by 2 blinded researchers and scored with the Whole-Organ Magnetic Resonance Imaging Score (WORMS) bone bruise subscale. Ligamentous, cartilaginous, meniscal, and other lesions were documented. Results: Of the 78 pediatric patients selected from the database, 54 (69%) had bone bruise. The mean area of bone bruise was larger in males than in females (femur, 3.8 ± 2.8 vs 2.2 ± 1.4 cm2, respectively, P = .006; tibia, 2.6 ± 1.6 vs 1.5 ± 0.8 cm2, respectively, P = .007). The subregions most affected by bone bruise were the lateral posterior tibia and the lateral central femur (in 83% and 80% of the knees affected, respectively). A low correlation was found between age and bone bruise area (biggest areas r = 0.30, P = .03, and sum of areas r = 0.27, P = .04), but no correlation was found between age and WORMS (femur, r = −0.03, P = .85; tibia, r = −0.04, P = .76). The injuries most associated with bone bruise were 23 meniscal lesions (43%), 10 lesions of other ligaments (19.0%), 2 cartilage lesions (3.7%), and 2 patellar fractures (3.7%). Conclusion: The prevalence of bone bruises in pediatric patients with ACL tears is high, although it seems slightly lower than the prevalence documented in adults but with similar localization. The area and the distribution pattern of bone bruises are similar among different ages. The pediatric patients had a lower presence of cartilage and meniscal lesions compared with that reported in adults, which suggests a different effect of this trauma on the knee of pediatric patients.
The electrocardiographic method for positioning the tip of central venous access device
Authors: Yu Yanfen , Yuan Lingling 
Published: September 2019

Background: The electrocardiogram-based insertion method is non-radiative, allowing real-time positioning verification and reducing the need for postoperative repositioning. Methods: Relevant databases published from January 1990 to January 2019 in PubMed, Web of Knowledge, Medline and Ovid’s database were searched, comparing the effectiveness of electrocardiogram-guided catheter tip positioning (electrocardiogram-guided group) and the landmarks-guided insertion plus chest X-ray confirmation (landmarks-guided group). The primary outcome was accurate catheter tip placement and the secondary outcomes were complications. Results: A total of 13 studies were finally included with a total of 4988 patients, of whom 2789 cases were in the electrocardiogram-guided group and 2199 cases received landmarks-guided insertion plus chest X-ray. Compared with the landmarks-guided group, our meta-analysis showed that the electrocardiogram-guided group had a higher success rate of tip placement (odds ratio = 0.21, 95% confidence interval = 0.14–0.34, p < 0.00001) and fewer total complications (odds ratio = 0.10, 95% confidence interval = 0.04–0.23, p < 0.000001). Conclusion: Based on our findings, electrocardiogram-guided tip placement for central venous access device was more accurate and safer than landmarks-guided positioning, which may be considered as an alternative method to the standard radiological control of tip placement.
High success rate in salvage of catheter-related bloodstream infections due to Staphylococcus aureus, on behalf of project group of Italian society of nephrology
Authors: Mandolfo Salvatore , Anesi Adriano , Maggio Milena , Rognoni Vanina , Galli Franco , Forneris Giacomo 
Published: September 2019

Background: Catheter-related bloodstream infections caused by Staphylococcus aureus represent one of the most fearful infections in chronic haemodialysis patients with tunnelled central venous catheters. Current guidelines suggest prompt catheter removal in patients with positive blood cultures for S. aureus. This manoeuvre requires inserting a new catheter into the same vein or another one and is not without its risks. Methods: A protocol based on early, prompt diagnosis and treatment has been utilized in our renal unit since 2012 in an attempt to salvage infected tunnelled central venous catheters. We prospectively observed 247 tunnelled central venous catheters in 173 haemodialysis patients involving 167,511 catheter days. Results: We identified 113 catheter-related bloodstream infections (0.67 episodes per 1000 days/tunnelled central venous catheter). Forty were caused by S. aureus, including 19 by methicillin-resistant S. aureus (79% saved) and 21 by methicillin-sensitive S. aureus (90% saved), of which 34 (85%) were treated successfully. Eight recurrences occurred and six (75%) were successfully treated. A greater than 12 h time to blood culture positivity for S. aureus was a good prognostic index for successful therapy and tunnelled central venous catheter rescue. Conclusion: Our data lead us to believe that it is possible to successfully treat catheter-related bloodstream infection caused by S. aureus and to avoid removing the tunnelled central venous catheter in many more cases than what has been reported in the literature. On the third day, it is mandatory to decide whether to replace the tunnelled central venous catheter or to carry on with antibiotic therapy. Apyrexia and amelioration of laboratory parameters suggest continuing systemic and antibiotic lock therapy for no less than 4 weeks, otherwise, tunnelled central venous catheter removal is recommended.
Effectiveness of Therapy on Post-Extubation Dysphagia: Clinical and Electromyographic Findings
Authors: El Gharib Aretuza Zaupa Gasparim , Berretin-Felix Giédre , Rossoni Diogo Francisco , Seiji Yamada Sergio 
Published: September 2019

Introduction: Patients who require prolonged endotracheal intubation (>48 hours) are at risk of dysphagia. Speech-language pathologists should perform swallowing exercises after extubation due to the high probability of developing aspiration pneumonia. There are no studies describing the use of swallowing techniques employed in post-extubation therapy aided by surface electromyography. Objectives: To evaluate the effects of swallowing function therapy in extubated patients after prolonged orotracheal intubation by means of clinical and electromyographic evaluation. Methods: A total of 15 patients were enrolled in this study (average age 48.6 ± 16.5 years). The study was carried out in three phases: (1) Clinical and electromyographic evaluation using the Dysphagia Risk Assessment Protocol following dysphagia scores criteria, and the measurement of the suprahyoid muscles amplitude (μV) expressed by root mean square (RMS), respectively; (2) swallowing rehabilitation program; and (3) reevaluation of patients after therapy. The Wilcoxon paired test assuming a significance level of 5% was used for statistical analysis. Results: By means of the swallowing scale, it was verified that patients suffered from severe oropharyngeal dysphagia at the first evaluation (80%), but the rehabilitation therapy reduced clinical signs, persistent only in one patient (6.7%) post-therapy, thus, improving swallowing. Significant differences, pre- and post-therapy, for suprahyoid muscles during maximal voluntary isometric contractions of right ( P = .0067) and left ( P = .0215), saliva swallowing by right ( P = .0413) and left ( P = .0151), and liquid swallowing by right ( P = .0479) and left ( P = .0215) sides, were found, as shown by electromyography. Conclusions: Swallowing exercises carried out by extubated patients after prolonged orotracheal intubation increased neuromuscular recruitment of suprahyoid muscles involved with swallowing and reduced dysphagia levels.
29 recommendations to combat social inequalities in health. The Norwegian Council on Social Inequalities in Health
Authors: Arntzen Annett , Bøe Tormod , Dahl Espen , Drange Nina , Eikemo Terje A , Elstad Jon Ivar , Fosse Elisabeth , Krokstad Steinar , Syse Astri , Sletten Mira Aaboen , Strand Bjorn Heine 
Published: September 2019

All political parties in Norway agree that social inequalities in health comprise a public health problem and should be reduced. Against this background, the Council on Social Inequalities in Health has taken action to provide specific advice to reduce social health differences. Our recommendations focus on the entire social gradient rather than just poverty and the socially disadvantaged. By proposing action on the social determinants of health such as affordable child-care, education, living environments and income structures, we aim to facilitate a possible re-orientation of policy away from redistribution to universalism. The striking challenges of the causes of health differences are complex, and the 29 recommendations to combat social inequality of health demand cross sectorial actions. The recommendations are listed thematically and have not been prioritized. Some are fundamental and require pronounced changes across sectors, whereas others are minor and sector-specific.