bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic Thrombolytic Therapy for Massive and Submassive Pulmonary Embolism
Authors: Igneri Lauren A. , Hammer John M. 
Published: April 2018

Objective: To critically evaluate the published literature assessing the safety and efficacy of thrombolytic therapy for massive and submassive pulmonary embolism (PE). Methods: A search of human trials in the English-language (September 2017) was conducted through the MEDLINE database using the following terms: PE, tissue plasminogen activator, tenecteplase, and alteplase. 67 unique articles were identified, of which 24 clinical trials discussing clinical outcomes related to administration of either intravenous tenecteplase or alteplase were included. Results: Thrombolytic therapy with anticoagulation significantly reduced mortality compared to anticoagulation alone in massive PE. In submassive PE, thrombolytics reduced the rate of right ventricular dysfunction and hemodynamic collapse; however, there is an increased risk of major and minor bleeding with no benefit on long-term functional outcomes. Conclusions: Patients with massive PE should receive thrombolytics when no major contraindications to therapy exist. Patients with submassive PE at highest risk for progression to hemodynamic instability should receive anticoagulation and be monitored for clinical deterioration. If an imminent risk of hemodynamic instability or cardiac arrest occurs, thrombolytics should be administered if no contraindications exist. Net mortality benefit and risk of bleeding must be considered when deciding to administer thrombolytic therapy in massive or submassive PE.
Professional self-concept and professional values of senior students of the nursing department
Authors: Çöplü Mehtap , Tekinsoy Kartın Pınar 
Published: April 2018

Aim: This study was carried out in order to determine professional self-concept and professional values in the students, who were studying in the final year of the nursing department in schools providing undergraduate education in the Inner Anatolia Region. Method: This cross-sectional study was conducted on a total of 619 senior students of nursing departments in the Inner Anatolia Region. Data were collected using a Student Information Form, Professional Self-Concept Scale for the Student Nurses, and The Nurses’ Professional Values Scale. Descriptive statistics, the Shapiro–Wilk test, the t-test, analysis of variance, and the Bonferroni tests were used for data analysis. Ethical Considerations: A written consent was obtained from Ethics Board of Erciyes University Faculty of Medicine and from nursing schools participating in the study. Prior to data collection, students were informed about the purpose of the study and gave written and verbal consents. Participation in the study was on voluntary basis. Findings: In the study, students’ total and sub-dimension scores from the Professional Self-Concept Scale for the Student Nurses and total scores from the Nurses’ Professional Values Scale were moderately high. It was detected that women received higher scores than men from the sub-dimension of professional attributes; the students who had positive perception of the nursing image and voluntarily selected their department received high scores from professional satisfaction, professional competence, and professional attributes sub-dimensions of the Professional Self-Concept Scale for the Student Nurses ( p < 0.001). Implication: In order to improve students’ perceptions of professional self-concept and professional values, it is thought that students’ awareness should be increased on these topics.
Thirty Minutes of Running Exercise Decreases T2 Signal Intensity but Not Thickness of the Knee Joint Cartilage: A 3.0-T Magnetic Resonance Imaging Study
Authors: Karanfil Yiğitcan , Babayeva Naila , Dönmez Gürhan , Diren H. Barış , Eryılmaz Muzaffer , Doral Mahmut Nedim , Korkusuz Feza 
Published: April 2018

Objective Recent studies showed a potential of magnetic resonance imaging (MRI), which can be used as an additional tool for diagnosing cartilage degeneration in the early stage. We designed a cross-sectional study in order to evaluate knee joint cartilage adaptation to running, using 3.0-T MRI equipped with the 3-dimensional turbo spin echo (VISTA = Volume ISotropic Turbo spin echo Acquisition) software. By this thickness (mm) and signal intensity (mean pixel value) can be quantified, which could be closely related to the fluid content of the knee joint cartilage, before and after running. Methods A total of 22 males, aged 18 to 35 years, dominant (right) and nondominant (left) knees were assessed before and after 30 minutes of running. Cartilage thickness and signal intensity of surfaces of the patella, medial and lateral femoral and tibial condyles were measured. Results Cartilage thickness of the lateral condyle decreased at the dominant knee, while it increased at the medial tibial plateau. Signal intensity decreased at all locations, except the lateral patella in both knees. The most obvious decrease in signal intensity (10.6%) was at the medial tibial plateau from 949.8 to 849.0 of the dominant knee. Conclusion There was an increase in thickness measurements and decrease in signal intensity in medial tibial plateau of the dominant knee after 30 minutes of running. This outcome could be related to fluid outflow from the tissue. Greater reductions in the medial tibial plateau cartilage indicate greater load sharing by these areas of the joint during a 30-minute running.
Metastasis Affecting Craniocervical Junction: Current Concepts and an Update on Surgical Management
Authors: O’Sullivan Michael Denis , Lyons Frank , Morris Seamus , Synnott Keith , Munigangaiah Sudarshan , Devitt Aidan 
Published: April 2018

Study Design: Literature review. Objectives: Metastatic disease affecting the craniovertebral junction (CVJ) only accounts for 0.5% of all spine metastases. The management of these disease processes is complex, which involves multimodality radiological studies and various surgical approaches. We aimed to review the available evidence and summarize the findings in this review. Methods: The authors conducted search of PubMed and Google Scholar with the following search terms: metastasis, craniovertebral junction (CVJ), occipitocervical, approaches, stability, and radiotherapy. Articles were reviewed by the authors and determined for inclusion based on relevance and level of evidence. Results: The majority of relevant research reviewed composed of literature reviews of particular aspects regarding metastatic disease affecting the craniovertebral junction, including diagnosis, surgical approach, and radiotherapy. Conclusions: Prompt evaluation of rotational neck pain with or without occipital neuralgia may reveal early metastatic disease within a stable CVJ. Magnetic resonance imaging appears to be the gold standard imaging modality in detecting this pathology, with nuclear bone scan playing a role in distinguishing benign and malignant processes. Unfortunately, no level 1 evidence exists for use of either radiotherapy or surgery in these cases; however, from the available literature, spinal instability and evidence of progressive neurology are relative indications for operative intervention.
Depression and Anxiety Among Patients on Chronic Opioid Therapy
Authors: Elrashidi Muhamad Y. , Philpot Lindsey M. , Ramar Priya , Leasure William B. , Ebbert Jon O. 
Published: April 2018

Background: Chronic noncancer pain (CNCP) and chronic opioid therapy (COT) commonly coexist with comorbid depression and anxiety. We investigated the prevalence of depression and anxiety and their correlates at the time of controlled substance agreement (CSA) enrollment among patients with CNCP and a history of depression or anxiety on COT. Methods: Retrospective analysis of 1066 patients in a Midwest primary care practice enrolled in CSAs for COT between May 9, 2013, and August 15, 2016. Patients with self-reported symptoms or a clinical history of depression or anxiety were screened at CSA enrollment using the Patient Health Questionnaire–9 item scale and the Generalized Anxiety Disorder–7 item scale. Results: The percentage of patients screening positive for depression and anxiety at CSA enrollment was 15.4% and 14.4%, respectively. Patients screening positive for depression or anxiety were more likely to be younger, unmarried, unemployed, and live alone compared to patients not screening positive. Patients screening positive for depression or anxiety were more likely to smoke cigarettes and report concern from friends or relatives regarding alcohol consumption. Compared to patients screening negative, patients screening positive for depression had higher odds of receiving opioid doses of ≥50 morphine milligram equivalents per day (adjusted odds ratio: 1.62; 95% confidence interval: 1.01-2.58). Conclusion: Anxiety and depression are prevalent at enrollment in CSAs among patients receiving COT. Future research is needed to determine whether recognition of anxiety and depression leads to improved management and outcomes for this population.
Wellness Coaching to Improve Lifestyle Behaviors Among Adults With Prediabetes: Patients’ Experience and Perceptions to Participation
Authors: DeJesus Ramona S , Clark Matthew M , Rutten Lila J Finney , Hathaway Julie C , Wilson Patrick M , Link Sara M , Sauver Jennifer St 
Published: April 2018

Background: Health and Wellness Coaching has been shown to enhance treatment outcomes in the primary care setting. However, little is known about the experience and perceptions of patients who worked with a wellness coach as an integrated member of their primary health-care team. Objective: This project assessed patients’ experience and obtained their perceptions on barriers and facilitators to participation in a primary care–based wellness coaching program. Method: A survey was mailed to 99 primary care patients with prediabetes who participated in a 12-week wellness coaching program. Results: Sixty-two (63%) completed the survey; responders felt that participation in the wellness coaching program helped move them toward healthier lifestyle behavior and created a personal vision of wellness. Major themes associated with participation were supportive coaching relationship, increased self-accountability, increased goal-setting, and healthy behavior strategies. No significant barrier to participation was reported. Conclusion: Participants reported highly positive experience with the program; how to best integrate health and wellness coaching into the primary care setting needs to be explored.
Delayed immune reconstitution after allogeneic transplantation increases the risks of mortality and chronic GVHD
Authors: Bejanyan Nelli , Brunstein Claudio G. , Cao Qing , Lazaryan Aleksandr , Luo Xianghua , Curtsinger Julie , Mehta Rohtesh S. , Warlick Erica , Cooley Sarah A. , Blazar Bruce R. , Miller Jeffrey S. , Weisdorf Daniel , Wagner John E. , Verneris Michael R. 
Published: April 2018

Key Points
UCB recipients have slower T-cell reconstitution but more robust NK and B-cell recovery after allo-HCT than MSD recipients. Delayed CD4+ total and naive T-cell reconstitution after allo-HCT increases the risk of infection, mortality, and chronic GVHD.
The clinical significance of oropharyngeal cultures in young children with cystic fibrosis
Authors: Breuer Oded , Caudri Daan , Akesson Lauren , Ranganathan Sarath , Stick Stephen M. , Schultz André 
Published: April 2018

In children with cystic fibrosis (CF) the associations between oropharyngeal swabs (OPSs) for detection ofPseudomonasand lung disease have not been evaluated.OPS and bronchoalveolar lavage (BAL) samples were obtained annually in children with CF from 2005 to 2017. OPS test characteristics were calculated using BAL as “gold standard”. Results were related to lung inflammation (BAL neutrophil elastase and interleukin-8), structural lung disease (chest computed tomography PRAGMA-CF (Perth–Rotterdam Annotated Grid Morphometric Analysis for CF) scores), respiratory exacerbations and future detection ofPseudomonason BAL.From 181 patients, 690 paired OPS–BAL cultures were obtained. Prevalence ofPseudomonasin BAL was 7.4%. OPS sensitivity was 23.0% and specificity was 91.4%, reducing the post-test probability for a positive BAL following a negative OPS to 6.3%.Pseudomonason OPS was not associated with lung inflammation or respiratory exacerbations, but was weakly associated with current PRAGMA-CF %Disease score (p=0.043).Pseudomonason BAL was associated with positive neutrophil elastase (OR 4.17, 95% CI 2.04–8.53; p<0.001), increased interleukin-8 (p<0.001), increased all baseline PRAGMA computed tomography scores (p<0.001), progression of PRAGMA computed tomography scores (p<0.05) and increased risk of respiratory exacerbations (incidence rate ratio 2.11, 95% CI 1.15–3.87; p=0.017).In children with CF OPSs only marginally change the probability of detecting lower airwayPseudomonasand are not associated with lung disease indices nor exacerbations risk.
Insulin Resistance, Hyperinsulinemia, and LH: Relative Roles in Peripubertal Obesity-Associated Hyperandrogenemia
Authors: Burt Solorzano Christine M , Knudsen Karen L , Anderson Amy D , Hutchens Eleanor G , Collins Jessicah S , Patrie James T , Marshall John C , McCartney Christopher R 
Published: April 2018

AbstractContextPeripubertal obesity is associated with variable hyperandrogenemia, but precise mechanisms remain unclear.ObjectiveTo assess insulin resistance, hyperinsulinemia, and LH roles in peripubertal obesity–associated hyperandrogenemia.DesignCross-sectional analysis.SettingAcademic clinical research unit.ParticipantsEleven obese (body mass index for age ≥95%) peripubertal girls.InterventionBlood samples were taken during a mixed-meal tolerance test (1900 to 2100), overnight (2100 to 0700), while fasting (0700 to 0900), and during an 80 mU/m2/min hyperinsulinemic-euglycemic clamp (0900 to 1100).Main Outcome MeasuresThe dependent variable was morning free testosterone level; independent variables were insulin sensitivity index (ISI), estimated 24-hour insulin, and estimated 24-hour LH levels.ResultsAll participants demonstrated insulin resistance and hyperinsulinemia. ISI, but not estimated 24-hour insulin level, correlated positively with morning free testosterone level when correcting for estimated 24-hour LH level and Tanner stage (rs = 0.68, P = 0.046). The correlation between estimated 24-hour LH and free testosterone levels approached significance after adjusting for estimated 24-hour insulin level and Tanner stage (rs = 0.63, P = 0.067). Estimated 24-hour insulin level did not correlate with free testosterone level after adjusting for estimated 24-hour LH level and Tanner stage (rs = 0.47, P = 0.20).ConclusionIn insulin-resistant obese girls with hyperinsulinemia, free testosterone levels correlated positively with insulin sensitivity and, likely, circulating LH concentrations but not with circulating insulin levels. In the setting of relatively uniform hyperinsulinemia, variable steroidogenic-cell insulin sensitivity may correlate with metabolic insulin sensitivity and contribute to variable free testosterone concentrations.
Development and Validation of an Algorithm to Classify as Equivalent the Procedures in ICD-10-PCS That Differ Only by Laterality
Authors: Epstein Richard H. , Dexter Franklin , O’Neill Liam 
Published: April 2018

BACKGROUND:
The switch from International Classification of Diseases, Ninth Revision, Clinical Modification to International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) for coding of inpatient procedures in the United States increased the number of procedural codes more than 19-fold, in large part due to the addition of laterality. We examined ICD-10-PCS codes for pairs of mirror-image procedures that are surgically equivalent.

METHODS:
We developed an algorithm in structured query language (SQL) to identify ICD-10-PCS codes differing only by laterality. We quantified the impact of laterality on the number of commonly performed major therapeutic procedures (ie, surgical diversity) using 2 quarters of discharge abstracts from Texas.

RESULTS:
Of the 75,789 ICD-10-PCS codes from federal fiscal year 2017, 16,839 (22.3%) pairs differed only by laterality (with each pair contributing 2 codes). With the combining of equivalent codes, diversity in the state of Texas decreased from 78.2 to 74.1 operative procedures (95% confidence interval, 5.1 to −3.1; P < .001).

CONCLUSIONS:
Our algorithm identifies ICD-10-PCS codes that differ only by laterality. However, laterality had a small effect on surgical diversity among major therapeutic procedures. Our SQL code and the lookup table will be useful for all US inpatient analyses of ICD-10-PCS surgical data, because combining procedures differing only by laterality will often be desired.
Harmful or Physiologic: Diagnosing Fibrinolysis Shutdown in a Trauma Cohort With Rotational Thromboelastometry
Authors: Gomez-Builes J. Carolina , Acuna Sergio A. , Nascimento Bartolomeu , Madotto Fabiana , Rizoli Sandro B. 
Published: April 2018

BACKGROUND:
Despite its central role in early trauma coagulopathy, abnormal fibrinolysis continues to be poorly understood. Excessive fibrinolysis is a known contributor to mortality. Recent studies with thromboelastography (TEG) suggest decreased fibrinolysis (or shutdown) may be just as harmful. Considering the broad use of 2 different viscoelastic assays, which are not interchangeable, we proposed for the first time to define and characterize fibrinolysis shutdown using rotational thromboelastometry (ROTEM).

METHODS:
Retrospective cohort study of severely injured patients with admission ROTEM. Shutdown was defined by the best Youden index value of the maximum lysis. Fibrinolysis phenotypes were physiologic, hyperfibrinolysis, and shutdown. Multivariable logistic regression evaluated association between Injury Severity Score and the fibrinolysis phenotypes, and the association among shutdown phenotype with mortality, blood transfusion, and thrombotic events.

RESULTS:
Five hundred fifty patients were included. Maximum lysis <3.5% was selected to define shutdown. Predominant phenotype was physiologic (70.7%), followed by shutdown (25.6%) and hyperfibrinolysis (3.6%). Shutdown patients had higher Injury Severity Score, lower base excess, and required more transfusions than physiologic group. Shutdown was associated with acidosis (base excess: odds ratio [OR] for a 1 mEq/L increase, 0.93; 95% confidence interval [CI], 0.88–0.98; P = .0094) and the combination of clotting derangements, higher clot firmness (maximum clot formation: OR for a 2 mm increase, 1.8; 95% CI, 1.5–2.27; P < .0001), lower fibrinogen (OR for a 0.5 g/dL decrease, 1.47; 95% CI, 1.18–1.84; P = .0006), and poor clot formation dynamics (clot formation time: OR for a 5 seconds increase, 1.25; 95% CI, 1.15–1.36; P < .0001). Fibrinolysis shutdown was not independently associated with mortality (OR, 0.61; 95% CI, 0.28–1.33; P = .21), massive transfusion (OR, 2.14; 95% CI, 0.79–5.74; P = .1308), or thrombotic events (OR, 1.08; 95% CI, 0.37–3.15; P = .874). Shutdown was associated with increased 24-hour transfusion (OR, 2.24; 95% CI, 1.24–4.04; P = .007).

CONCLUSIONS:
Despite higher injury burden, evidence of shock, and greater need for blood transfusions, early fibrinolysis shutdown was not associated with mortality, suggesting that it could represent an adaptive physiologic response to life-threatening trauma.
Encarnação e Ressurreição de Cristo: duplicação de um modelo textual
Authors: Freitas Filipa 
Published: April 2018

INCARNATION AND RESURRECTION OF CHRIST: DUPLICATING A TEXTUAL MODEL
There is a manuscript of the 17th century, at Biblioteca Pública de Évora, which has two religious texts related to the pedagogical activity of the Jesuits. These texts present a large number of identical fragments, despite the existence of pragmatic differences originated by the festivities for which they were composed. The comparison between them will establish the extra‑textual characteristics of each and the progressive distance among them, from the simple textual variant to the rewriting process. This article will clarify the circumstances of the composition and performance of the texts, in the context of jesuitic teaching.
Estudo contrastivo da configuração das categorias verbais em português e em búlgaro
Authors: Chergova Vesela 
Published: April 2018

CONTRASTIVE STUDY OF THE CONFIGURATION OF THE VERBAL CATEGORIES IN PORTUGUESE AND BULGARIAN
The contrastive typological study of the Portuguese and the Bulgarian verbal systems is based on a methodological premise considering the semantic content of each verbal category as a functional relation defined on the universal level of language activity and bound to a specific formal realization in any language on the historical level of the same activity. We assume that the internal category’s organisation within the language system is a hierarchical one in the terms of Greenberg [1971: 295‑313] and Gerdžikov [2003]. Therefore, the distribution of the categorial semantic load represents the “worldview” of the historically constituted linguistic community.
língua portuguesa na transcrição cirílica num dicionário do século XVIII
Authors: Dębowiak Przemysław 
Published: April 2018

THE PORTUGUESE LANGUAGE IN CYRILLIC TRANSCRIPTION IN AN EIGHTEENTH-CENTURY DICTIONARY
In 1787‑1789 two volumes of a huge lexicographic work were published, with the title Linguarum totius orbis vocabularia comparativa (…), commonly called Catherine the Great’s Dictionary. The dictionary contains 273 Russian entries from different thematic groups, each one with semantic equivalents in two hundred European and Asiatic languages. All the words, with no exception, are transcribed in the Russian Cyrillic alphabet, independently from the language they represent. The paper deals, in general terms, with the transcription of Portuguese words included in the dictionary.
Caraterísticas fonéticas do Português da Ilha Terceira
Authors: Mikołajczak Sylwia 
Published: April 2018

PHONETIC CHARACTERISTICS OF THE PORTUGUESE ISLAND OF TERCEIRA
A historical and geographical context of a natural expansion of a language leads to a formation of dialects. The aim of this article is to present some examples of phonetic, distinctive characteristics of Portuguese spoken in Terceira Island (the Azores). The dialect reveals such phonetic properties as anti‑hiatic vowel release and diphthongization, of which the first is almost totally limited to Terceira Island. Whereas, other phonetic characteristics such as labialization of the vowel [u], commonly occurring in the western and eastern groups of the islands, does not apply to the dialect of Terceira. Therefore, it is anticipated that the features of the northern dialects of Portugal had more influence on the Portuguese of Terceira Island than the southern ones.