bluuebunny/crossref_metadata_2025_split huggingface dataset:
Final versus referral diagnosis of childhood visual impairment in an Italian tertiary low vision rehabilitation centre
Authors: Longhin Evelyn , Segalina Sara , Pilotto Elisabetta , Convento Enrica , Midena Edoardo , Bini Silvia 
Published: June 2019

Purpose: To compare the final diagnosis of the causes of low vision in children attending a tertiary rehabilitation centre for visually impaired children versus referral diagnosis. Methods: Retrospective review of clinical charts of all children referred to the Robert Hollman Foundation, a tertiary centre for visually impaired children, between January 2010 and June 2011. The following clinical data were analysed: entry diagnosis made by the referral ophthalmologist and final diagnosis made at Robert Hollman Foundation based on a complete ophthalmic evaluation. Results: Ninety-two consecutive children (mean age = 2.37 ± 1.98 years, range = 0–9) were included. A referral diagnosis was retrieved in 76 cases (82.6%), including cerebral visual impairment (14.1%), retinopathy of prematurity (14.1%), hereditary retinal diseases (10.9%), nystagmus (8.7%) and other rarer diseases (34.8%). In the remaining 16 children (17.4%), a precise referral diagnosis was unavailable. Final clinical diagnosis made at Robert Hollman Foundation was normal visual function in 8.7%, cerebral visual impairment in 30.4%, retinopathy of prematurity in 10.9%, hereditary retinal disease in 9.8% and other in 40.2%. In 17 cases (18.5%), the diagnosis made at the Robert Hollman Foundation did not confirm the entry diagnosis. Among patients where measurement of visual acuity was possible (84), 66.7% were blind or seriously visual impaired, and the main causes were cerebral visual impairment (32.1%) and retinopathy of prematurity (16.1%). Conclusion: The most frequent diseases were cerebral visual impairment, retinopathy of prematurity and hereditary retinal diseases. Approximately one-third of referred children had not a correct diagnosis at baseline. The activity of an ophthalmic tertiary centre is essential to offer a precise diagnosis to visually impaired (sometimes with other deficits) children.
Comparison of axillary-atrial and axillary-iliac arteriovenous grafts for hemodialysis access creation
Authors: Lopez-Pena Gabriel , Anaya-Ayala Javier E , Garcia-Alva Ramon , Luna Lizeth , Lizola Rene , Cuen-Ojeda Cesar , Arzola Luis H , Hinojosa Carlos A 
Published: June 2019

Objective: The aim of this study was to compare two complex vascular access techniques that utilize the axillary artery as inflow and accesses were created with early cannulation grafts: the axillary-atrial arteriovenous graft versus axillary-iliac arteriovenous graft. Methods: This is a retrospective study of end-stage renal disease patients with occluded intrathoracic central veins that underwent complex hemodialysis access creation in our institution after failed endovascular recanalization attempts. Patients’ demographics, comorbidities, number and types of previous accesses, intraoperative variables, and clinical outcomes were collected and compared. Results: Four patients underwent axillary-atrial arteriovenous graft creation with Flixene™ (Atrium™, Hudson, NH, USA) grafts, through a midline sternotomy to expose the right atrium; all were successfully implanted and used for hemodialysis within the first 72 h; one patient developed a pseudoaneurysm in the mid-graft portion, requiring surgical repair, and it is currently functional. Eight axillary-iliac arteriovenous grafts were created; all grafts were patent and were utilized within 96 h after placement. At 6 months of follow-up period, five (62 %) of our patients underwent graft thrombectomy, one (12 %) balloon angioplasty at the vein anastomosis secondary to stenosis, and two (25 %) grafts were removed due to infectious complications. Axillary-atrial arteriovenous graft and axillary-iliac arteriovenous graft primary patency rates at 6 months were 75% and 48%, respectively; 6-month secondary patency of the axillary-atrial arteriovenous graft compares favorably against that of axillary-iliac arteriovenous graft (100% vs 75%, respectively). Conclusion: Despite the invasiveness, direct atrial outflow procedures remain a valid alternative in carefully selected patients with adequate cardiopulmonary reserve.
Secondary traumatic stress in Norwegian SUD-therapists: Symptoms and related factors
Authors: Johansen Ayna B , Kristiansen Eva , Bjelland Ingerid , Tavakoli Shedeh 
Published: June 2019

This study examined the prevalence of secondary traumatic stress (STS) among substance-abuse therapists in relation to burnout, work-related stressors, as well as peer and leader support. Methods: A quantitative cross-sectional design examining 383 Norwegian substance-abuse therapists. Electronic surveys were distributed to practitioners in Norway via email and social media. Results: A total 22% of the respondents reported experience of secondary trauma, with the most frequently reported symptoms being flashbacks (13%) and intrusive thoughts (13%). More than 72% of therapists had also been exposed to patient direct threats. Female therapists estimated the level of trauma among their patients as higher than did male therapists. Male therapists (32%) were more likely to report secondary trauma than females (19%). Conclusions: The findings indicate a high prevalence of trauma symptoms in substance-abuse therapists, and suggest increased focus on the role of patient direct threats when treating patients with substance-abuse disorder. The study also highlights the need for research that examines variables that interact with gender in predicting STS in therapists treating substance abuse, as well as trauma.
Feminist Theory: A Research Agenda for HRD
Authors: Hirudayaraj Malar , Shields Lauren 
Published: June 2019

The Problem Limited research representing the field of human resource development (HRD) has challenged the masculine rationality in organizational culture, processes, and discourse; questioned power or gender hegemony within organizations; or examined how oppression and hegemony are manifested in the lives of different groups of women in a variety of work contexts. This limited scope of research has resulted in a lack of consideration and application of feminist theory, a valuable framework for examining issues relating to inequity and the subjugation of women. Compared with related fields, studies applying feminist theory in HRD research are fewer in number and less robust in terms of issues explored, research design, and target groups examined. The Solution A deeper examination of (a) populations beyond White middle class women, (b) the lives and experiences of women from varying backgrounds, (c) asymmetrical power relationships, (d) opportunities for women to gain knowledge and power, (e) the use of language and power to silence women, (f) gender as a social construct and essential category of analysis, and (g) ways to promote social change are presented along with recommendations to broaden the scope of research that applies feminist theory in HRD research and practice. The Key Stakeholders The examination of feminist theory is expected to benefit HRD researchers, practitioners, scholars, and women in the workforce.
Renal Safety of Intravenous Ketorolac Use After Donor Nephrectomy
Authors: Tabrizian Parissa , Giacca Massimo , Prigoff Jake , Tran Benjamin , Holzner Matthew L. , Chin Edward , Palese Michael , Herron Daniel , Arvelakis Antonios , Rudow Dianne LaPointe , Florman Sander , Shapiro Ron 
Published: June 2019

Introduction: The benefit and short-term safety of ketorolac have been established in previous studies however, the risk of bleeding and long-term renal impairment in patients undergoing donor nephrectomy remain unclear. We report our experience at a high-volume transplant center. Method: Between January 1996 and January 2014, 862 consecutive patients underwent laparoscopic donor nephrectomy. Exclusion criteria included nonsteroidal anti-inflammatory drug allergy, asthma, bleeding disorders, long-term opioid use, intraoperative blood loss >700 mL, peptic ulcer disease, bleeding diathesis, and baseline creatinine greater than 1.9 mg/dL. Intravenous ketorolac was administered within 30 minutes following the surgical procedure at a dose of 15 to 30 mg every 6 hours. Patients were categorized into 2 groups according to the administration of ketorolac after surgery. Differences between the groups were analyzed. Primary outcomes were changes in serum creatinine and hemoglobin levels. Poor outcome was defined as postsurgical complications. Results: During this time, 469 (55.3%) received ketorolac. The mean donor age was 39 years, and 360 (42.5%) were male. Left kidneys were procured in 82%. Operative time averaged 210 minutes and warm ischemia time117 seconds. Baseline demographic and operative outcomes were comparable in both groups. No statistically significant differences were found between the ketorolac group and the nonketorolac group in preoperative and postoperative hemoglobin levels and serum creatinine at 1 week, 1 year, and 5 years ( P = .6). Ketorolac use was not associated with increased perioperative morbidity ( P = NS). Conclusion: The use of intravenous ketorolac in patients undergoing donor nephrectomy was not associated with an increased risk of bleeding or renal impairment.
Lactate clearance prognosticates outcome in pediatric septic shock during first 24 h of intensive care unit admission
Authors: Nazir Mudasir , Wani Wasim , Dar Sheeraz Ahmad , Mir Inamul-Haq , Charoo Bashir Ahmad , Ahmad Qazi Iqbal , Wajid Syed 
Published: June 2019

This study was undertaken to examine the clinical utility of lactate clearance as an indicator of mortality in pediatric septic shock, and to compare the performance of lactate clearance at 6, 12, and 24 h for predicting in-hospital and 60-day mortality. Pediatric patients with septic shock were prospectively studied. Vital signs, laboratory values, Pediatric Risk of Mortality Score, and pediatric logistic organ dysfunction score were obtained at presentation (hour 0), hour 6, hour 24 and over the first 72 h of hospitalization. Lactate clearance was obtained at 6, 12, and 24 h of hospital admission. Therapy received, outcome parameters of mortality, and duration of hospitalization were recorded. The primary outcome variable of 60-day mortality rate was 31.25%. Only lactate clearance at 6 and 24 h was significantly associated with mortality, with odds of 0.97 (95% CI, 0.951–981; p < 0.001) and 0.975 (95% CI, 0.964–0.986; p < 0.001), respectively. Approximately there was a 24% decrease in likelihood of mortality for each 10% increase in lactate clearance at 24 h. At a threshold value of 10% 6-h lactate clearance had a sensitivity of 0.948 and specificity of 0.571, while at a threshold of 20% 24-h lactate clearance had a sensitivity of 0.922 and specificity of 0.629. The comparison of clearance at 6 and 24 h using receiver operating characteristic showed that former was “fair” (area under the curve = 0.753) and later was “good” (area under the curve = 0.81) in predicting mortality in pediatric septic shock. Conclusion We concluded that optimal lactate clearance in pediatric septic shock both during the early presentation and after the initial “golden hours” is associated with lower in-hospital and 60-day mortality. Further, 24-h lactate clearance appears superior to 6 h lactate clearance in predicting mortality in such patients.
CD8+ PD-1+ T-cells and PD-L1+ circulating tumor cells in chemotherapy-naïve non-small cell lung cancer: towards their clinical relevance?
Authors: Kotsakis Athanasios , Kallergi Galatea , Aggouraki Despoina , Lyristi Zaharoula , Koinis Filippos , Lagoudaki Eleni , Koutsopoulos Anastasios , Georgoulias Vassilis , Vetsika Eleni-Kyriaki 
Published: June 2019

Background: Since tumor cells may escape from immune surveillance through the programmed cell death 1 (PD-1)/programmed death ligand (PD-L)1 axis, this study was designed in order to evaluate whether there is a correlation between the levels of PD-1+ and PD-L1+-expressing immune cells (ICs) and circulating tumor cells (CTCs) in patients with non-small cell lung cancer (NSCLC). Patients and methods: Peripheral blood was obtained from 37 chemotherapy-naïve patients with metastatic NSCLC before treatment. PD-1 and PD-L1 expression was evaluated (1) on ICs with anti-tumor function (CD4+ and CD8+ T-cells, B-cells, monocytes/dendritic cells) using flow cytometry, (2) on CTCs by immunofluorescence and (3) on cells from tumor tissues by immunohistochemistry. The levels of PD-1+ and PD-L1+-expressing ICs were correlated with progression-free survival (PFS). Results: The presence of PD-1+ CD8+ cells, with reduced interferon (IFN)-γ expression, but not other ICs, were positively correlated with PD-L1+ CTCs ( p < 0.04). Increased percentages of PD-1+ CD8+ T-cells, were associated with a worse response to treatment ( p = 0.032) and shorter PFS ( p = 0.023) which, in multivariate analysis, was revealed as an independent predictor for decreased PFS [hazard ratio (HR): 4.1, p = 0.0007]. Conclusion: The results of the current study, for first time, provide evidence for a possible interaction between ICs and CTCs in NSCLC patients via the PD-1/PD-L1 axis and strongly support that the levels of PD-1+ CD8+ in these patients may be of clinical relevance.
One-Year Outcome Study of Anatomic Reconstruction of Lesser Metatarsophalangeal Joints
Authors: Cook Jeremy J. , Cook Emily A. , Hansen Daniel D. , Matthews Michael , Karthas Timothy , Collier Byron , McKenna Bryon , Manning Elena 
Published: June 2019

Background: Lesser metatarsophalangeal joint (MTPJ) and plantar plate pathologies are commonly seen forefoot conditions. Traditional rebalancing techniques are commonly used but can have concerning adverse effects. The purpose of this study was to analyze the 1-year outcomes of a new technique consisting of anatomic repair of the plantar plate and collateral ligaments involving lesser MTPJs. Methodology: A retrospective cohort study of 50 consecutive patients treated with anatomic plantar plate and collateral ligament reconstruction were evaluated for lesser MTPJ imbalances between 2013 and 2016. The primary outcome was postoperative digital stability defined as a normal dorsal drawer test and normal paper pull-out test. Secondary outcomes included pre- and postoperative visual analogue scale pain measurements, MTPJ radiographic alignment, and ACFAS Forefoot module scores. Results: All patients had digital instability prior to the surgical intervention. Final follow-up revealed that 92% of patients showed improved digital stability, P = .0005. Multivariate regression found statistically significant improvement in pain reduction via the visual analogue scale of 51.2 mm ( P < .0001) and ACFAS Forefoot module scores improved to 92 ( P < .0001). The 45 joints with preoperative abnormal transverse plane deformity, had either complete (n = 29) or partial (n = 16) radiographic MTPJ correction. Conclusion: These results suggest that anatomic repair of lesser MTPJ improved digital stability, pain, function and radiographic alignment with greater than one year of follow-up. Levels of Evidence: Level IV: Retrospective cohort study
Accuracy of apparent diffusion coefficients and enhancement ratios on magnetic resonance imaging in differentiating primary cerebral lymphomas from glioblastoma
Authors: Anwar Shayan Sirat Maheen , Baig Mirza Zain , Laghari Altaf Ali , Mubarak Fatima , Shamim Muhammad Shahzad , Jilani Umaima Ayesha , Khalid Muhammad Usman 
Published: June 2019

Background and purpose This study aimed to determine the accuracy of apparent diffusion coefficient (ADC) and enhancement ratio (ER) in discriminating primary cerebral lymphomas (PCL) and glioblastomas. Materials and methods Circular regions of interest were randomly placed centrally within the largest solid-enhancing area of all lymphomas and glioblastomas on both post-contrast T1-weighted images and corresponding ADC maps. Regions of interest were also drawn in the contralateral hemisphere to obtain enhancement and ADC values of normal-appearing white matter. This helped us to calculate the ER and ADC ratio. Results Mean enhancement and ADC (mm2/s) values for PCL were 2220.56 ± 2948.30 and 712.00 ± 137.87, respectively. Mean enhancement and ADC values for glioblastoma were 1537.07 ± 1668.33 and 1037.93 ± 280.52, respectively. Differences in ADC values, ratios and ERs were all statistically significant between the two groups ( p < 0.05). ADC values correctly predicted 71.4% of the lesions as glioblastoma and 83.3% as PCL (area under the curve (AUC) = 0.86 on receiver operating characteristic curve analysis). ADC ratios correctly predicted 85.7% of the lesions as glioblastoma and 100% as PCL (AUC = 0.93). ERs correctly predicted 71.4% of the lesions as glioblastoma and 88.9% as PCL (AUC = 0.92). The combination of ADC ratio and ER correctly predicted 100% tumour type in both patient subgroups. Conclusions ADC values, ADC ratios and ERs may serve as useful variables to distinguish PCL from glioblastoma. The combination of ADC ratio and ER yielded the best results in identification of both patient subgroups.
Sleep quality matters more to community-dwelling individuals than nocturia frequency
Authors: Rose GE , Ervin C , Bower WF 
Published: June 2019

Objective: The objective of this study is to identify variables that describe nocturia-related bother in a sample of community-dwelling individuals. Materials and methods: Community-dwelling individuals age 40 years and older who woke to pass urine at night completed an online questionnaire. Participants were asked (i) their top three concerns in relation to nocturia, (ii) to agree or disagree with a list of statements related to bother, and (iii) to complete the Nocturia Impact Diary items. Fisher exact test and the Mann–Whitney U test were used to assess whether differences in nocturia-related bother existed when comparing participants stratified by nocturia severity. Results: Moderate to extreme nocturia-related bother was described by 56% of the 202 respondents and by 68% of individuals with nocturia two or more times per night. Effects of nocturia, specifically sleep disruption and impact on daytime function, were the most cited concerns. Low nocturia-related health literacy was evident. The sample was younger (83% age <70 years), predominantly female (74%) and nocturia treatment naïve (95%). Conclusion: The study highlights the potential to evaluate patient care based on change in sleep and daytime function rather than solely on nocturia frequency. A suite of patient-reported outcome measures adjunctive to clinical data may have utility in quantifying meaningful change to patients after treatment for nocturia. Level of evidence: Not applicable for this multicentre audit.
A 12-Week Pilot Exercise Program for Inactive Adults With Celiac Disease: Study Protocol
Authors: Dowd A Justine , Kronlund Liam , Parmar Candice , Daun Julia T , Wytsma-Fisher Kathryn , Reimer Raylene A , Millet Guillaume Y , Culos-Reed S Nicole 
Published: June 2019

Background Individuals with celiac disease must follow a strict gluten-free diet (GFD) in order to avoid negative short- and long-term health consequences. Unfortunately, many people with celiac disease report poor quality of life (QoL) despite following a strict GFD, and up to 30% still report negative symptoms (eg, gastrointestinal upset). Purpose The purpose of the MOVE-C (understanding the relationship between the Microbi Ome, Vitality, and Exercise in Celiac disease) pilot study is to explore the effects of a 12-week supervised progressive high-intensity interval training (HIIT) and lifestyle intervention on physiological, behavioral, and psychosocial outcomes among inactive adults with celiac disease. Methods/Design: Sixty inactive adults diagnosed with celiac disease will be randomized to HIIT+ or waitlist control (WLC). Participants in the HIIT+ will engage in a 12-week HIIT + lifestyle education program. HIIT sessions will be comprised of 2 workouts per week, working up to 14 × 30-second intervals at 90% maximal heart rate (HRmax) followed by 2 minutes recovery at 50% HRmax. The 6 biweekly lifestyle sessions will involve education on the promotion of a whole foods GFD, sleep hygiene, psychosocial coping skills (eg, self-compassion), and self-regulatory skills to master changes in behaviors. Assessments will occur at pre and post 12-week intervention and 3-month follow-up. WLC participants will be offered a 12-week HIIT program + online lifestyle education sessions after completing the final assessment. The primary outcomes are QoL and gut microbiota composition assessed with 16S rRNA sequencing. The secondary outcomes are markers of metabolic syndrome (waist circumference, fasting glucose, serum lipids, blood pressure, and body composition), gastrointestinal symptoms, sleep quality, adherence to a GFD, exercise behavior, self-regulatory efficacy, and self-compassion. It is hypothesized that participants in the HIIT+ will experience improvements in all outcomes when compared to those in the WLC. These improvements are expected to be maintained at the 3-month follow-up. Discussion The findings from this study will advance the knowledge regarding the effects of HIIT and lifestyle education on key outcomes for an at-risk chronic disease population. Furthermore, the findings can be used to inform future programs to improve fitness and physical and mental health outcomes for people with celiac disease.