bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychometric evaluation of the shortened version of the Functional Difficulties Questionnaire to assess thoracic physical function
Authors: Katijjahbe Mohd Ali , Denehy Linda , Granger Catherine L , Royse Alistair , Royse Colin , Logie Sarah , Sturgess Tamica , Md Ali Nur Ayub , McManus Margaret , Clarke-Errey Sandy , El-Ansary Doa 
Published: October 2019

Objective: The aim of this study was to investigate the psychometric properties of the shortened version of the Functional Difficulties Questionnaire (FDQ). Design: This is a multisite observational study. Setting: The study was conducted in four tertiary care hospitals in Australia. Subjects: A total of 225 participants, following cardiac surgery, were involved in the study. Intervention: Participants completed the original 13-item FDQ and other measures of physical function, pain and health-related quality of life. Method: Item reduction was utilized to develop the shortened version. Reliability was evaluated using intraclass correlation coefficients (ICCs), the smallest detectable change and Bland–Altman plots. The validity and responsiveness were evaluated using correlation. Anchor and distribution-based calculation was used to calculate the minimal clinical important difference (MCID). Results: Item reduction resulted in the creation of a 10-item shortened version of the questionnaire (FDQ-s). Within the cohort of cardiac surgery patient, the mean (SD) for the FDQ-s was 38.7 (19.61) at baseline; 15.5 (14.01) at four weeks and 7.9 (12.01) at three months. Validity: excellent internal consistency (Cronbach’s α > 0.90) and fair-to-excellent construct validity (>0.4). Reliability: internal consistency was excellent (Cronbach’s α > 0.8). The FDQ-s had excellent test–retest reliability (ICC = 0.89–0.92). Strong responsiveness overtime was demonstrated with large effect sizes (Cohen’s d > 1.0). The MCID of the FDQ-s was calculated between 4 and 10 out of 100 (in cm). Conclusion: The FDQ-s demonstrated robust psychometric properties as a measurement tool of physical function of the thoracic region following cardiac surgery.
Diffusional kurtosis imaging of kidneys in patients with hyperuricemia: initial study
Authors: Cheng Zhong-Yuan , Feng You-Zhen , Liu Xiao-Ling , Ye Yao-Jiang , Hu Jun-Jiao , Cai Xiang-Ran 
Published: October 2019

Background At present, there remains a lack of a reliable indicator for monitoring renal function in patients with hyperuricemia. Purpose This study aimed to evaluate the feasibility of diffusion kurtosis imaging in the assessment of renal function in patients with hyperuricemia. Material and Methods A total of 75 male participants, including 25 with asymptomatic hyperuricemia, 25 with gouty arthritis, and 25 age-matched male healthy controls, were enrolled in this study. Diffusion kurtosis imaging data were acquired to derive axial (Ka), radial (Kr), and mean kurtosis (MK), fractional anisotropy, axial (Da), radial (Dr), and mean diffusivity (MD) for comparisons among the three groups. They were also correlated with estimated glomerular filtration rate (eGFR). Results The MK values of the renal cortex and medulla and Kr value of the renal medulla in patients with asymptomatic hyperuricemia and gouty arthritis significantly increased compared with those in the controls ( P < 0.05). Patients with gouty arthritis showed significant higher cortical and medullary Ka values compared with the other two groups ( P < 0.05). The cortical Kr values of the asymptomatic hyperuricemia and gouty arthritis patients were significantly higher than that of the controls ( P < 0.05). The medullary fractional anisotropy value showed a significant difference between the control and gouty arthritis groups ( P < 0.05). No correlation was found between any diffusion kurtosis imaging parameters and eGFR value. Conclusion Diffusion kurtosis imaging is feasible in the assessment of the early changes of renal cortex and medulla in patients with hyperuricemia.
Survival of carbapenem-resistant Acinetobacter baumannii bacteremia: colistin monotherapy versus colistin plus meropenem
Authors: Park So Yeon , Si Hye Jin , Eom Joong Sik , Lee Jin Seo 
Published: October 2019

Objective The aim of this study was to compare clinical outcomes between patients with carbapenem-resistant Acinetobacter baumannii (CRAB) bacteremia treated with colistin monotherapy and those treated with colistin plus meropenem. Methods We retrospectively evaluated data from 71 patients with CRAB bacteremia treated from November 2006 to February 2018. Predictors of 14-day mortality were determined through logistic regression analysis. Results Our study cohort included 40 bacteremia patients (44.6 %) treated with colistin monotherapy and 31 (55.4 %) treated with colistin plus meropenem. Overall 14-day mortality tended to be higher with monotherapy rather than combination therapy (47.5% vs 25.8%). The latter also showed a tendency for higher clinical success rate compared with monotherapy (61.3% vs 40.0%). Logistic regression analysis showed that Pitt bacteremia score, pneumonia, and combination therapy were significantly associated with mortality. In patients with higher Pitt bacteremia score (≥4), mortality was significantly higher with monotherapy compared with combination therapy (66.7% vs 27.8%). In patients with lower Pitt bacteremia score (≤3), mortality was similar between the two treatment groups (26.3% vs 23.1%). Conclusion Treatment with colistin plus meropenem improves survival in critically-ill patients with CRAB.
The p48_HPC antithrombogenic flow diverter: initial human experience using single antiplatelet therapy
Authors: Bhogal Pervinder , Bleise Carlos , Chudyk Jorge , Lylyk Ivan , Perez Nicolas , Henkes Hans , Lylyk Pedro 
Published: October 2019

Objective The p48 is a low-profile, intermediate-porosity flow diverter. phenox GmbH-trademarked hydrophilic polymer coating (pHPC) is a hydrophilic coating that has been shown in vitro to reduce the thrombogenicity of nitinol device surfaces. We performed the present study to determine whether the p48_HPC can be implanted using prasugrel alone. Methods We retrospectively identified all patients who were treated with the p48_HPC from January 2017 to December 2018 (n = 5) and underwent single antiplatelet therapy (SAPT) with prasugrel. P2Y12 inhibition was confirmed by the VerifyNow assay. The occurrence of thromboembolic and haemorrhagic complications was recorded alongside the occlusion rates of the treated aneurysms. Results All patients achieved adequate occlusion (Raymond–Roy Occlusion Classification I or II) during the follow-up period. No thromboembolic complications occurred. One patient developed a contained haematoma within the Sylvian fissure from the treated aneurysm 2 weeks postoperatively without clinical sequelae. Conclusions In this small series, no thromboembolic complications occurred in patients treated with the surface modified p48_HPC flow diverter and SAPT. Further studies with longer follow-up periods and larger cohorts should be performed.
Comparative Prognostic Accuracy of Risk Prediction Models for Cardiogenic Shock
Authors: Miller Robert J. H. , Southern Danielle , Wilton Stephen B. , James Matthew T. , Har Bryan , Schnell Greg , van Diepen Sean , Grant Andrew D. M. 
Published: October 2019

Objectives: Despite advances in medical therapy, reperfusion, and mechanical support, cardiogenic shock remains associated with excess morbidity and mortality. Accurate risk stratification may improve patient management. We compared the accuracy of established risk scores for cardiogenic shock. Methods: Patients admitted to tertiary care center cardiac care units in the province of Alberta in 2015 were assessed for cardiogenic shock. The Acute Physiology and Chronic Health Evaluation-II (APACHE-II), CardShock, intra-aortic balloon pump (IABP) Shock II, and sepsis-related organ failure assessment (SOFA) risk scores were compared. Receiver operating characteristic curves were used to assess discrimination of in-hospital mortality and compared using DeLong’s method. Calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test. Results: The study included 3021 patients, among whom 510 (16.9%) had cardiogenic shock. Patients with cardiogenic shock had longer median hospital stays (median 11.0 vs 4.1 days, P < .001) and were more likely to die (29.0% vs 2.5%, P < .001). All risk scores were adequately calibrated for predicting hospital morality except for the APACHE-II score (Hosmer-Lemeshow P < .001). Discrimination of in-hospital mortality with the APACHE-II (area under the curve [AUC]: 0.72, 95% confidence interval [CI]: 0.66-0.76) and IABP-Shock II (AUC: 0.73, 95% CI: 0.68-0.77) scores were similar, while the CardShock (AUC: 0.76, 95% CI: 0.72-0.81) and SOFA (AUC: 0.76, 95%CI: 0.72-0.81) scores had better discrimination for predicting in-hospital mortality. Conclusions: In a real-world population of patients with cardiogenic shock, existing risk scores had modest prognostic accuracy, with no clear superior score. Further investigation is required to improve the discriminative abilities of existing models or establish novel methods.
Performance of a 25% Inferior Vena Cava Collapsibility in Detecting Fluid Responsiveness When Assessed by Novice Versus Expert Physician Sonologists
Authors: Corl Keith A. , Azab Nader , Nayeemuddin Mohammed , Schick Alexandra , Lopardo Thomas , Zeba Fatima , Phillips Gary , Baird Grayson , Merchant Roland C. , Levy Mitchell M. , Blaivas Michael , Abbasi Adeel 
Published: October 2019

Objectives: Inferior vena cava collapsibility (cIVC) measured by point-of-care ultrasound (POCUS) has been proposed as a noninvasive means of assessing fluid responsiveness. We aimed to prospectively evaluate the performance of a 25% cIVC cutoff value to detect fluid responsiveness among spontaneously breathing intensive care unit (ICU) patients when assessed with POCUS by novice versus expert physician sonologists. Methods: Prospective observational study of spontaneously breathing ICU patients. Fluid responsiveness was defined as a >10% increase in cardiac index following a 500 mL fluid bolus, measured by bioreactance. Novice sonologist measured cIVC with POCUS. Their measurements were later compared to an expert physician sonologist who independently reviewed the POCUS images and assessed cIVCs. Results: Of the 85 participants, 44 (52%) were fluid responders. A 25% cIVC cutoff value performed better when assessed by expert sonologists than novice physician sonologists (receiver–operator characteristic curve, ROC = 0.82 [0.74-0.88] vs ROC = 0.69 [0.60-0.77]). Conclusions: A 25% cIVC cutoff value measured by POCUS detects fluid responsiveness. However, the experience of the physician sonologist affects test performance and should be considered when interpreting and clinically using cIVC to direct intravenous fluid resuscitation.
Effect of Aid for Trade Unpredictability on Trade Policy in Recipient-Countries
Authors: Gnangnon Sèna Kimm 
Published: October 2019

This article examines the effect of the unpredictability of Aid for Trade (AfT) flows on trade policy in 124 recipient-countries, of which 42 are least developed countries (LDCs), over the period 2002–2016. The analysis shows that while AfT flows exert a positive effect on trade policy liberalisation, AfT unpredictability induces the adoption of restrictive trade policies. These results apply to LDCs and other countries, although the magnitude of the negative effect of AfT unpredictability on trade policy liberalisation is higher for LDCs than for other countries. Furthermore, AfT unpredictability reduces the positive trade policy liberalisation effect of AfT flows. JEL: F13, F14, F35
Etiology of Cleft Lip Lower Lip Deformity: Use of an Objective Analysis to Measure Severity
Authors: Langeveld Mirte , Bruun Richard A. , Koudstaal Maarten J. , Padwa Bonnie L. 
Published: October 2019

Objective: Measure lower lip thickness and eversion in patients with cleft lip and palate (CLP) and maxillary hypoplasia. The specific aims were to (1) compare lower lip thickness/eversion in patients with CLP to noncleft controls with maxillary hypoplasia, (2) determine differences between patients with unilateral CLP (UCLP) and bilateral CLP (BCLP), and (3) document changes in the lower lip that occur with Le Fort I advancement. Design: Retrospective case–control study. Setting: Tertiary care center. Patients/Participants: Patients with available pre- and postoperative CT scans and 2D lateral photographs who had a Le Fort I advancement between 2009 and 2017. There were 32 patients with CLP (17 females; mean age 17.7 ± 1.9 years) and 33 noncleft controls (21 females; mean age 18.8 ± 2.6 years). Main Outcome Measures: Lower lip thickness and eversion. Results: Patients with CLP and maxillary hypoplasia have a significantly thicker lower lip ( P = .019) and outward rotation of the vermilion border ( P = .003) compared to noncleft controls. The lower lip was significantly thicker in patients with BCLP than in those with UCLP ( P = .035). Lower lip thickness and rotation did not change after maxillary advancement. Conclusions: Patients with CLP and maxillary hypoplasia have a thicker and more everted lower lip than noncleft controls. Patients with BCLP have a significantly thicker lower lip than those with UCLP. Strain of the lower lip musculature appears to be an important contributor to the development of the cleft lip lower lip deformity.
Examination of nursing drug administration practices via central venous catheter: An observational study
Authors: Gürol Arslan Gülşah , Özden Dilek , Alan Nurten , Yilmaz İlkin , Ayik Cahide , Göktuna Gizem 
Published: October 2019

Aim: To determine the compliance with nursing drug administration procedure steps associated with access to the central venous catheter for bolus infusion in intensive care units. Methods: This observational study was conducted with 30 nurses working in an intensive care unit of a university hospital. The drug administrations practiced by nurses via central venous catheter were monitored simultaneously at 12:00 a.m., 02:00 p.m., and 06:00 p.m. by two observers. The data were collected using a data collection form and central venous catheter drug administration procedure steps. Results: A total of 90 different drug administrations were observed in three different treatment hours from 30 nurses. The interobserver conformity was found to be moderate in two steps (kappa = 0.520–0.627, P = 0.01) and perfect in all other steps (kappa = 0.821–1.000, P = 0.000). According to the drug administration procedure steps via a central venous catheter, all nurses applied the following steps correctly during all treatment hours: drug card control, preparation of treatment materials, checking the patient’s identity, and steps of drug treatment administration. The following tasks were frequently performed incorrectly or not at all: hand hygiene (before treatment 87.8%; after treatment 82.2%), scrubbing the three-way stopcock entrance with an alcohol swab (55.6%), waiting for the alcohol to dry (81.1%), and flushing the lumen with a compatible fluid (before treatment 84.4%: after treatment 75.6%). Conclusion: Observation of drug administration procedure steps via central venous catheter according to the treatment hours showed that the nurses performed many incomplete or inaccurate drug administration procedure steps and the mistakes increased toward the evening hours.
The long-term outcomes of CIS patients in the Barcelona inception cohort: Looking back to recognize aggressive MS
Authors: Tintore Mar , Arrambide Georgina , Otero-Romero Susana , Carbonell-Mirabent Pere , Río Jordi , Tur Carmen , Comabella Manuel , Nos Carlos , Arévalo María Jesús , Anglada Elisenda , Menendez Rebeca , Midaglia Luciana , Galán Ingrid , Vidal-Jordana Angela , Castilló Joaquin , Mulero Patricia , Zabalza Ana , Rodríguez-Acevedo Breogan , Rodriguez Marta , Espejo Carmen , Sequeira Joao , Mitjana Raquel , de Barros Andrea , Pareto Deborah , Auger Cristina , Pérez-Hoyos Santiago , Sastre-Garriga Jaume , Rovira Alex , Montalban Xavier 
Published: October 2019

Objective: To explore the long-term outcomes of patients with clinically isolated syndromes from the Barcelona cohort. Methods: We selected patients with a follow-up longer than 10 years to (1) estimate the risks of multiple sclerosis (MS) and disability accumulation according to the baseline number of T2 lesions and to compare treated versus untreated patients and early versus delayed treatment, and (2) to study baseline features of patients with aggressive MS (Expanded Disability Status Scale (EDSS) ⩾6.0 at 10 years). Results: In all, 401 patients were included (mean follow-up of 14.4 (standard deviation of 2.9) years). A higher number of T2 lesions was associated with an earlier MS diagnosis and an earlier risk of irreversible disability. Early treatment was associated with a decreased risk of EDSS of 3.0: adjusted hazard ratio = 0.4, 95% confidence interval = (0.2, 0.7). Patients with aggressive MS differed in their baseline brain magnetic resonance images: The median (interquartile range) number of T2 lesions and contrast-enhancing lesions (CEL) was 71 (28–95) versus 7 (1–19) and 3 (1–24) versus 0 (0–1), respectively. The cut-offs that better classified patients with aggressive MS were 20 for T2 lesions and 2 for CEL. Conclusion: Although MS natural history is changing, a high lesion load at onset is helpful to identify patients at risk of presenting an aggressive MS.
A systematic review and thematic synthesis exploring how a previous experience of physical activity influences engagement with cardiac rehabilitation
Authors: McHale Sheona , Astin Felicity , Neubeck Lis , Dawkes Susan , Hanson Coral L 
Published: October 2019

Background: Exercise-based cardiac rehabilitation is recognised internationally as an effective therapy to improve quality of life and reduce the risk of hospital readmission for individuals diagnosed with acute coronary syndrome. Despite this, half of eligible individuals choose not to engage and the main reason is lack of interest. Furthermore, prior to attending, 40% of eligible individuals report meeting physical activity guidelines. It is unclear whether this influences decisions about engagement. Aims: The aim of this review is to examine systematically qualitative evidence describing patients’ perceptions and experiences, and synthesise what is known about how a previous experience of physical activity in adults diagnosed with acute coronary syndrome influences engagement with physical activity during cardiac rehabilitation. Methods: A systematic review and thematic synthesis was conducted of primary qualitative studies to examine peer-reviewed literature published between1990 and 2017, accessed from database searches of MEDLINE, CINHAL, PsycINFO and Embase. Results: The initial search produced 486 studies, and of these 12 relevant studies were included in this review. Studies included 388 participants from six countries. For previously active individuals, communication factors, self-perceptions of an exercise identity and experience of cardiac rehabilitation influence engagement in physical activity during cardiac rehabilitation. Conclusion: In adults diagnosed with acute coronary syndrome, communication post event and during cardiac rehabilitation is a source of self-appraisal and creates expectations of cardiac rehabilitation. In addition, perceptions of an exercise identity and experience of exercise-based cardiac rehabilitation influence decisions about engagement. To improve uptake and adherence, health professionals should consider previous physical activity levels and tailor information to optimise physical activity post event.
Protocol for the Study of Heart and Renal Protection-Extended Review: Additional 5-Year Follow-up of the Australian, New Zealand, and Malaysian SHARP Cohort
Authors: Sukkar Louisa , Talbot Ben , Jun Min , Dempsey Erika , Walker Robert , Hooi Lai , Cass Alan , Jardine Meg , Gallagher Martin 
Published: October 2019

Background: There are limited studies on the effects of statins on outcomes in the moderate chronic kidney disease (CKD) population and their trajectory to end-stage kidney disease. Objective: To examine the long-term effects of lipid-lowering therapy on all-cause mortality, cardiovascular morbidity, CKD progression, and socioeconomic well-being in Australian, New Zealand, and Malaysian SHARP (Study of Heart and Renal Protection) trial participants—a randomized controlled trial of a combination of simvastatin and ezetimibe, compared with placebo, for the reduction of cardiovascular events in moderate to severe CKD. Design: Protocol for an extended prospective observational follow-up. Setting: Australian, New Zealand, and Malaysian participating centers in patients with advanced CKD. Patients: All SHARP trial participants alive at the final study visit. Measurements: Primary outcomes were measured by participant self-report and verified by hospital administrative data. In addition, secondary outcomes were measured using a validated study questionnaire of health-related quality of life, a 56-item economic survey. Methods: Participants were followed up with alternating face-to-face visits and telephone calls on a 6-monthly basis until 5 years following their final SHARP Study visit. In addition, there were 6-monthly follow-up telephone calls in between these visits. Data linkage to health registries in Australia, New Zealand, and Malaysia was also performed. Results: The SHARP-Extended Review (SHARP-ER) cohort comprised 1136 SHARP participants with a median of 4.6 years of follow-up. Compared with all SHARP participants who originally participated in the Australian, New Zealand, and Malaysian regions, the SHARP-ER participants were younger (57.2 [48.3-66.4] vs 60.5 [50.3-70.7] years) with a lower proportion of men (61.5% vs 62.8%). There were a lower proportion of participants with hypertension (83.7% vs 85.0%) and diabetes (20.0% vs 23.5%). Limitations: As a long-term follow-up study, the surviving cohort of SHARP-ER is a selected group of the original study participants, which may limit the generalizability of the findings. Conclusion: The SHARP-ER study will contribute important evidence on the long-term outcomes of cholesterol-lowering therapy in patients with advanced CKD with a total of 10 years of follow-up. Novel analyses of the socioeconomic impact of CKD over time will guide resource allocation. Trial Registration: The SHARP trial was registered at ClinicalTrials.gov NCT00125593 and ISRCTN 54137607.