bluuebunny/crossref_metadata_2025_split huggingface dataset:
Operationalization of patients’ rights in Sudan: Quantifying nurses’ knowledge
Authors: Abdalla Salma M , Mahgoub Esra AA , Abdelgadir Jihad , Elhassan Nahla , Omer Zulfa 
Published: October 2018

Background: Promoting patients’ rights is essential for defining the standards of clinical services within a country. Given their responsibilities, nurses can be the primary target for research to investigate the issue of patients’ rights within a healthcare system. As such, assessing the knowledge of nurses about patients’ rights is an essential step toward improving the quality of healthcare in limited resource settings like Sudan. Objectives: We aimed to assess the level of knowledge about patients’ rights among the nursing staff at Friendship Teaching Hospital in Sudan. Methods: This hospital-based cross-sectional study was carried out at the Friendship Teaching Hospital in Sudan. We surveyed the totality of nurses (95) at the hospital using an amended survey. The data were analyzed in SPSS software using descriptive and inferential statistics. Ethical consideration: The study was approved by the Research Unit of Khartoum Ministry of Health and the Hospital administration. All respondents gave verbal consent prior to participating in the study. Results: Only 48.4% of the participants knew about the existence of the Sudanese Charter of patients’ rights. Nonetheless, our analysis found that 65.8% of nurses had acceptable level of knowledge (scored more than 75% of the total knowledge score) of patients’ rights, and none of the participant scored less than 50% of the total knowledge score. Finally, we found no statistical association between the knowledge score and demographic data, educational level, whether the participant knows about the existence of the Charter or not and a number of other factors. Conclusion: Nurses’ lack of knowledge about the existence of the Sudanese Charter of patients’ rights adopted in 2009 rights confirms the need for further efforts by Ministry of Health to promote the document. Furthermore, further research is needed to investigate the disconnect between nurses’ lack of knowledge about the existence of the charter and their awareness of the rights within the charter as well as the actual implementation of rights.
EA-DIVA score (Enhanced Adult DIVA score): A new scale to predict difficult preoperative venous cannulation in adult surgical patients
Authors: Civetta Giuseppe , Cortesi Sergio , Mancardi Mattia , De Pirro Antonella , Vischio Marta , Mazzocchi Marco , Scudeller Luigia , Bottazzi Andrea , Iotti Giorgio A , Palo Alessandra 
Published: October 2018

Introduction: Providing peripheral intravenous access is one of the most commonly performed technical procedures in hospitals and it is mandatory for all patients undergoing surgery. Obtaining peripheral intravenous access may be difficult and this may cause delays in patient management, increased risk of adverse events and hospitalization costs. The aim of this study is to develop and validate a scale to identify patients at risk of peripheral difficult intravenous access, applicable to any adult patient undergoing surgery. Methods: A monocentric, observational study was conducted on adult surgical patients between September 2015 and April 2016. The primary outcome was the identification of parameters that could detect peripheral difficult intravenous access. Several parameters were taken into consideration, including patient details, healthcare professionals, and setting. The sample data were randomly divided into two subsets: a multivariate analysis was performed on the first one to define the Enhanced Adult DIVA score; the second subset was used for its validation. Results: We included 1006 patients (607 in the derivation, 399 in the validation cohorts respectively). The peripheral intravenous access was difficult in 127 patients (12.6%). The EA-DIVA score was devised with a score ranging from 0 to 12. The receiver operating characteristic (ROC) curve area under the curve (AUC) in the validation subset was 0.94. The validation study suggested a cut-off score of 8, which maximizes sensitivity (85.5%) and specificity (89.2%) in detecting difficult peripheral intravenous access, with a positive predictive value of 56% and a negative predictive value of 97.5%. Discussion: The EA-DIVA score is a simple tool to identify patients at high risk of peripheral difficult intravenous access. Its implementation is recommended in order to optimize peripheral intravenous access procedures.
Factors affecting the use of home-based services and out-of-home respite care services: A survey of family caregivers for older persons with dementia in Northern Norway
Authors: Moholt Jill-Marit , Friborg Oddgeir , Blix Bodil H , Henriksen Nils 
Published: October 2018

Background Family caregivers contribute substantially to the care for older home-dwelling people with dementia, although community healthcare services tend to be underutilized. In this study, we aimed to explore the use and predictors of use of home-based and out-of-home respite care services available to older home-dwelling persons with dementia, as reported by the family caregivers. Method A cross-sectional survey was administered to family caregivers ( n = 430) in Northern Norway during April to November 2016. The use of healthcare services was categorized into two types according to principal component analysis: home-based services and out-of-home respite care services ( R2 = 44.1%). Predictors of service use were examined with bivariate correlation, multiple linear regression, and Poisson regression analyses. Results The use of home-based services among persons with dementia was significantly higher for persons with advanced age, persons living in urban areas, persons living in an assisted living facility, persons living alone, and persons able to manage being alone for a short period of time. Among the family caregiver variables, higher age, status as a daughter, son, or other family member, higher educational level, and full-time employment also predicted greater use of home-based services. Same ethnicity was associated with use of fewer home-based services. The use of out-of-home respite care services was significantly higher among male persons with dementia and among those living in urban areas. In addition, fewer out-of-home respite care services were used by male caregivers or daughters of the care recipient, while the use was higher when the caregivers experienced more caregiving demands or had provided care for longer periods of time. Conclusions These results indicate areas that policymakers and healthcare providers should consider to identify families who underutilize healthcare services and to achieve a more equal and efficient allocation of services in accordance with families' needs.
Creatine Kinase Isoenzyme BB: A Lung Cancer Associated Marker
Authors: Neri B. , Bartalucci S. , Gemelli M.T. , Tommasi M. , Bacalli S. 
Published: October 2018

We investigated the diagnostic role of creatine kinase isoenzyme BB (CK-BB) in lung cancer. CK-BB was assayed using a radioimmunological system by saturation with Mallinchrodt double antibody 125I labelled (RIA Quant-CPK-BB). Sensitivity was 97% and specificity 90% in 44 cancers (T2-T3), in 36 non-cancers (chronic bronchitis) and in 48 healthy controls. Mean serum CK-BB values for patients with chronic bronchitis (2.64 ± 1.1 ng/ml) were virtually the same as in normal subjects. Patients with lung cancer had markedly higher serum CK-BB values (9.17 ± 2.6 ng/ml) than either the control group (healthy subjects) or the chronic bronchitis patients (p < 0.01). These results lead us to suggest that CK-BB serum determination might prove useful in screening pulmonary disorders. However, further studies are essential to establish: 1) the relationship between serum levels of the isoenzyme and the histology and stage of the neoplastic disease; 2) the relation between CK-BB and the aggressive potential of the neoplastic clone.
Correlation of an Estrogen Receptor-related Phosphoprotein with Histopathological Features in Breast Cancer
Authors: Tomasino R.M. , Daniele E. , Nuara R. , Morello V. , Salvato M. , Florena A.M. 
Published: October 2018

A series of 65 cases of different histological types of breast carcinoma was investigated for the immunohistochemical location of the estrogen receptor-related, 29 kD phosphoprotein using the ER-D5 monoclonal antibody. The ER-D5 response is heterogeneous in relation to some therapeutic limitations and is correlated with histopathological features of the tumors and survival. The main parameters for evaluation of breast cancers are reviewed, both those that are statistically correlated and those that are not apparently always correlated but are known to have considerable biological meaning, such as the ER-status of tumors.
Pain-related white matter tract abnormalities in mild traumatic brain injury patients with persistent headache
Authors: Leung Albert , Yang Eric , Lim Michael , Metzger-Smith Valerie , Theilmann Rebecca , Song David , Lin Lisa , Tsai Alice , Lee Roland 
Published: October 2018

Background The occurrence of debilitating chronic persistent (24/7) headache after mild traumatic brain injury represents a central neuropathic pain state. Previous studies suggest that this chronic headache state can be attributed to altered supraspinal modulatory functional connectivity in both resting and evoked pain states. Abnormalities in the myelin sheaths along the supraspinal superior longitudinal fasciculus and anterior thalamic radiation are frequently associated with alteration in pain modulation related to functional connectivity deficit with the prefrontal cortex. This study assessed the correlated axonal injury-related white matter tract abnormality underlying these previously observed prefrontal functional connectivity deficits by comparing the fractional anisotropy, axial diffusivity, and radial diffusivity of brain white matter in patients with mild traumatic brain injury-related headache to healthy controls. Result Diffusion tensor imaging data from patients ( N = 12, average age ±  SD = 35.0 ± 8.0 years old, 10 male) with mild traumatic brain injury-headache were compared with images acquired from healthy controls. The mild traumatic brain injury cohort demonstrated two areas of significant ( P < 0.01, F value >16, cluster size >50 voxels) white matter tract abnormalities closely related to pain affective and modulatory functions in (1) the left superior longitudinal fasciculus which connects the prefrontal cortices with the parietal cortices and (2) the right anterior thalamic radiation connecting the prefrontal cortices with the anterior cingulate cortex. In addition, a significant ( P < 0.01) decrease in axial diffusivity and increase in radial diffusivity at the superior longitudinal fasciculus cluster were noted in the mild traumatic brain injury cohort. Conclusion The identified white matter tract abnormalities may represent a state of Wallerian degeneration which correlates with the functional connectivity deficit in pain modulation and can contribute to the development of the chronic persistent headache in the patients with mild traumatic brain injury.
Wide Dissection and Intercostal Vessel Division Allows for Repair of Hypoplastic Aortic Arch Through Thoracotomy
Authors: Sandoval Néstor F. , Acevedo Catalina Vargas , Umaña Juan Bernardo , Pineda Ivonne , Guerrero Albert , Obando Carlos , Umaña Juan P. , Camacho Jaime 
Published: October 2018

Background: The approach to coarctation of the aorta with hypoplastic aortic arch is controversial. We evaluated the outcomes in patients with coarctation of the aorta with or without hypoplastic aortic arch operated through a posterior left lateral thoracotomy. Methods: A retrospective cohort of patients with aortic coarctation, who underwent repair between January 2009 and October 2017, was analyzed. Preoperative, postoperative, and echocardiographic characteristics were reviewed. Statistical analysis examined survival, freedom from reintervention, and freedom from recoarctation. Results: In nine years, 389 patients who underwent surgical treatment for coarctation of the aorta were identified; after exclusion criteria and complete echocardiographic reports, 143 patients were analyzed, of which 29 patients had hypoplastic aortic arch. The modification in the extended end-to-end anastomosis technique was a wide dissection and mobilization of the descending aorta that was achieved due to the ligation and division of 3 to 5 intercostal vessels. In both groups, patients were close to one month of age and had a median weight of 3.6 and 3.4 kg for hypoplastic and nonhypoplastic arch, respectively. In postoperative events, there was no statistically significant difference between the groups ( P = .57 for renal failure, P = .057 for transient, nonpermanent neurologic events, P = .496 for sepsis), as for intensive care unit ( P = .502) and total in-hospital stay ( P = .929). There was one case of postoperative mortality in each group and both were associated with noncardiac comorbidities. Regarding survival (log-rank = 0.060), freedom from reintervention (log-rank = 0.073), and freedom from recoarctation (log-rank = 0.568), there was no statistically significant difference between the groups. Conclusion: We believe that it is the modified technique that allowed greater mobilization of the aorta and successful repair of hypoplastic arch through thoracotomy, without an increase in paraplegia or other adverse outcomes.
Cigarettes, E-cigarettes, and Adolescents’ Oral Health: Findings from the Population Assessment of Tobacco and Health (PATH) Study
Authors: Akinkugbe A.A. 
Published: October 2018

Introduction: Adolescents are a population group that actively uses tobacco products; however, limited reports are available on the effects of tobacco products on adolescents’ oral health. Objectives: This study investigated associations between self-reported use of cigarettes and e-cigarettes on the oral health status of a representative sample of US adolescents. Methods: Data came from 13,650 adolescents aged 12 to 17 y who participated in the 2013–2014 wave of the Population Assessment of Tobacco and Health study. Participants self-reported current use (i.e., past 30 d) and ever use of cigarettes and e-cigarettes, as well as past-year diagnoses with dental problems by a doctor, dentist, or other health professional (self-reported by parent or emancipated youth). Survey-adjusted logistic regression was used to estimate prevalence odds ratios (PORs) and 95% CIs. Results: The proportion of adolescents who self-reported current use of only cigarettes was 3.2%, while 1.7% reported current use of only e-cigarettes. Similarly, 1.4% reported current use of both cigarettes and e-cigarettes, while 7.1% reported ever use of both. About 22% self-reported a provider diagnosis with dental problems in the past year. The covariate-adjusted associations between current cigarette and e-cigarette use on self-reported provider-diagnosed dental problems in the past year were, respectively, POR = 1.50 (95% CI, 1.18 to 1.90) and POR = 1.11 (95% CI, 0.79 to 1.55), while self-reported current use of both was associated with POR = 1.72 (95% CI, 1.24 to 2.38). Ever use of cigarettes and e-cigarettes was likewise associated with increased prevalence odds of self-reported past-year diagnosis with dental problems, although to a lesser magnitude. Conclusion: Findings suggest that dual use of e-cigarettes and conventional cigarettes is associated with poor oral health outcomes among adolescents. However, studies of a longitudinal nature are needed to confirm these findings. Knowledge Transfer Statement: The results of this study are relevant to public health and oral health practitioners seeking to intervene during developmental periods in which adolescents may have access to tobacco products in the home and in social settings.
Eight-Patient Case Series of Palmoplantar Pustulosis Treated Successfully With Apremilast
Authors: Mikhailitchenko Amy L. , Crowley Erika L. , Gooderham Melinda J. 
Published: October 2018

Background: Palmoplantar pustulosis (PPP) is a chronic inflammatory skin disease characterized by sterile pustules, erythema, and scaling on the palms or soles of the feet. Apremilast is a systemic agent that inhibits phosphodiesterase 4 and is approved for the treatment of plaque psoriasis and psoriatic arthritis. Objective: To demonstrate the safety and efficacy of apremilast use in a small patient population with PPP. Methods: A retrospective review of medical charts between September 2008 and October 2017 identified 8 patients diagnosed with PPP and treated with apremilast; relevant literature was also reviewed. Results: The patient population was primarily female (3:1 female to male ratio), had comorbidities, and ranged in age from 39 to 66 years. Traditional PPP therapies were first attempted with limited or failure of response. All 8 patients responded to apremilast and currently remain on apremilast therapy ranging from 4 to 30 months of duration. Apremilast was effective either as monotherapy or in combination with ustekinumab or methotrexate. Minimal side effects were noted. Conclusions: This retrospective review demonstrates the potential for apremilast as a suitable systemic treatment option for PPP when conventional therapies fail or are contraindicated. Other studies have found similar results. Additional case series with larger patient populations or formal clinical trials would provide more definitive conclusions on the usefulness of apremilast in PPP.
Fingernail Involvement is a Bigger Burden Than Face and Scalp Involvement in Patients With Psoriasis
Authors: Ohata Chika , Ohyama Bungo , Kuwahara Fumi , Katayama Eri , Nakama Takekuni 
Published: October 2018

Background: Psoriasis can cause considerable emotional distress. There are a small amount of data regarding this subject. Objective: To evaluate distress in patients with psoriasis. Methods: We studied the impact of scalp, face, and fingernail involvement in 118 patients with psoriasis between October 2017 and March 2018 in Kurume University Hospital using Dermatology Life Quality Index (DLQI). Results: Dermatology Life Quality Index was significantly higher in patients with scalp, face, and fingernail involvement. Psoriasis area and severity index (PASI) was significantly higher in those with scalp and face involvement; however, no significant difference was found in the PASI of the patients with and without fingernail involvement. In the subcohorts with low PASI, there was no significant difference of DLQI between patients with and without scalp and face involvement; however, DLQI in patients with fingernail involvement was significantly higher than that in those without nail involvement. Conclusion: Fingernail involvement is a big burden even in patients with mild psoriasis.
RETRACTED ARTICLE: Alpha-synuclein overexpression in the olfactory bulb initiates prodromal symptoms and pathology of Parkinson’s disease
Authors: Niu Haichen , Shen Lingyu , Li Tongzhou , Ren Chao , Ding Sheng , Wang Lei , Zhang Zhonghai , Liu Xiaoyu , Zhang Qiang , Geng Deqin , Wu Xiujuan , Li Haiying 
Published: October 2018

Abstract
Background
Parkinson’s disease (PD) is a neurodegenerative disease characterized by intraneuronal Lewy Body (LB) aggregates composed of misfolded alpha-synuclein (α-syn). The spread of misfolded α-syn follows a typical pattern: starting in the olfactory bulb (OB) and the gut, this pathology is followed by the progressive invasion of misfolded α-syn to the posterior part of the brain. It is unknown whether the administration of human mutant alpha-synuclein (hm-α-syn, a human mutation which occurs in familial PD) into the OB of rats would trigger similar α-syn propagation and subsequently cause pathological changes in broader brain fields associated to PD and establish an animal model of prodromal PD.

Methods
hm-α-syn was overexpressed in the OB of rats with an AAV injection. Then motor and non-motor symptoms of the SD rats were tested in different behavioral tasks following the AAV injection. In follow-up studies, pathological mechanisms of α-syn spread were explored at the histological, biochemical and micro-structure levels.

Results
The experimental results indicated that hm-α-syn was overexpressed in the OB 3 weeks after the AAV injection. 1) overexpression of the Hm-α-syn in the OB by the AAV injection could transfer to wider adjacent fields beyond the monosynaptic scope. 2) The number of tyrosine hydroxylase positive cells body and fibers was decreased in the substantia nigra (SN) 12 weeks after AAV injection. This was consistent with decreased levels of the DA neurotransmitter. Importantly, behavioral dysfunctions were found that included olfactory impairment after 3 weeks, motor ability impairment and decreased muscular coordination on a rotarod 6 weeks after the AAV injection.3) The morphological level studies found that the Golgi staining revealed the number of neuronal branches and synapses in the OB, prefrontal cortex (PFC), hippocampus (Hip) and striatum caudate putamen (CPU) were decreased. 4) phosphorylated α-syn, at Ser-129 (pSer129), was found to be increased in hm-α-syn injected animals in comparison to controls that overexpressed GFP alone, which was also found in the most of LB stained by the thioflavine S (ThS) in the SN field. 5) A marker of autophagy (LC3B) was increased in serval fields, which was colacolizated with a marker of apoptosis in the SN field.

Conclusions
These results demonstrate that expression of exogenous mutant α-syn in the OB induces pathological changes in the sensitive brain fields by transferring pathogenic α-syn to adjacent fields. This method may be useful for establishing an animal model of prodromal PD.
Word to the mother(tongue): language access and Medicaid for Limited English Proficient migrants
Authors: Liou Wayne 
Published: October 2018

AbstractLimited language proficiency among migrants has been shown to limit migrants from various aspects of everyday life, from the labor market to government services. In the USA, language access laws have been enacted to help provide Limited English Proficient (LEP) individuals and households access to public benefits. The most extensive efforts in language access are in health care, with numerous states requiring Medicaid agencies to provide interpreters or translated documents. In this paper, I take advantage of heterogeneity in state-level language access laws to examine whether these efforts do indeed increase Medicaid take-up rates. I find that language access improves Medicaid take-up rates among LEP migrants without crowding out private health insurance; in fact, private health insurance coverage improves with the enactment of language access laws. There is some variation in efficacy across states, with some evidence that California and New York are the main drivers of the increased take-up rates. Lastly, I find that even though many of the language access laws primarily target Spanish speakers, the laws might not be as helpful to Spanish-speaking migrants.