bluuebunny/crossref_metadata_2025_split huggingface dataset:
Velocity of Money, Endogenous Money and Rate of Interest
Authors: Padhi Satya Prasad 
Published: August 2019

As an alternative to conceptualisation of endogenous money in Taylor’s rule of interest management, the present article considers Keynes’s general theoretic endogenous money supply, which is in response to demand for money generated in income determination process (and the induced growth processes). That money is important, as a real factor production, to actualise expected production (and growth processes). The contribution of the present article is to incorporate the crucial role of liquidity preference insight-based rate of interest to control endogenous money. The setting of such policy rate, in tune with the implicit pressures on liquidity preference, then, on principle, permits constancy of velocity, which permits in turn better monetary aggregate management achieved, now, by this Keynes’s route. JEL: E4; E5; E12
Urodynamic 4D-CT evaluation: 320-row area detector CT scanner combined with PhyZiodynamics software analysis provides an innovative system to evaluate urinary flow and outlet obstructions
Authors: Mori Shintaro , Yashiro Hideki , Inoue Masanori , Takahara Kiyoshi , Kusaka Mamoru , Shiroki Ryoichi 
Published: August 2019

Background Evaluation of the morphology of the lower urinary tract as well as the movements associated with urination are required for the symptomatic diagnosis of lower urinary tract obstruction as well as the assessment of postoperative adaptation. However, no tool currently exists for direct and easy patient evaluation. Purpose To evaluate lower urinary tract obstruction and postoperative adaptation using a four-dimensional (4D) virtual reality urination image (urodynamic 4D-CT image). Material and Methods We used a 320-row area detector CT scanner and PhyZiodynamics image analysis software to perform 197 urodynamic 4D-CT examinations on 175 first-time patients between January 2014 and March 2017. Results A comparison of the obtained images before and after holmium laser enucleation of the prostate revealed the morphological changes due to prostate enucleation and enabled visualization of the ideal urination conditions, showing that the anatomical structural changes during urination and the opening of the urethra play a major role in improving voiding function. Conclusion Using low-dosage radiation, the sharply defined moving image obtained via urodynamic 4D-CT examination can be utilized as a physiological diagnostic tool to evaluate a series of urinary movements from any angle between the prostate, urethra, and bladder in a unitary manner with the time axis added. There was negligible patient impact. This technique could provide new opportunities for the diagnosis of lower urinary tract symptoms and post-surgical adaptation assessment.
A case of extensive ductal carcinoma in situ and sclerosing adenosis with metastasis on sentinel lymph node
Authors: Narter Selin , Hasdemir Secil , Tolunay Sahsine , Gokgoz Sehsuvar 
Published: August 2019

Introduction: Sclerosing adenosis is a form of adenosis characterized by lobulocentric architecture, glandular and stromal proliferation in which the stromal component compresses and distorts the glandular structures. Atypical epithelial proliferations such as atypical lobular hyperplasia, lobular carcinoma in situ, and ductal carcinoma in situ may accompany areas of sclerosing adenosis. We present a case of ductal carcinoma in situ and sclerosing adenosis with metastatic carcinoma on sentinel lymph node. Case description: A 40-year-old woman presented with a palpable mass in her left breast. Radiologic studies showed a lesion suggesting malignancy in the left breast and atypical lymph node in the left axillary region. Left lumpectomy and sentinel lymph node biopsy was performed. Histopathologic examination revealed lobulocentric lesions with glandular proliferation and hyalinizing stroma in between. Foci of high-grade cribriform and solid type ductal carcinoma in situ were observed. Sentinel lymph node biopsy showed micrometastasis in one lymph node section. Based on these findings, the patient was diagnosed with high-grade ductal carcinoma in situ with sclerosing adenosis. However, the presence of micrometastasis in the lymph node suggested occult invasion that we were not able to detect. Conclusion: Ductal carcinoma in situ with sclerosing adenosis can mimic invasive carcinoma both radiologically and histologically. It should be kept in mind that there may be occult invasive carcinoma in patients with ductal carcinoma in situ whether the lesion is accompanied by sclerosing adenosis or not. Multiple sections and immunohistochemical studies can be of help.
The Ideal Location of the Lateral Hinge in Medial Closing Wedge Osteotomy of the Distal Femur: Analysis of Soft Tissue Coverage and Bone Density
Authors: Kim Tae Woo , Lee Myung Chul , Cho Jae Ho , Kim Jong Seop , Lee Yong Seuk 
Published: August 2019

Background: Although an appropriate hinge position to prevent unstable lateral hinge fractures is well established in medial opening wedge high tibial osteotomy, the position during medial closing wedge distal femoral osteotomy has not been elucidated. Purpose/Hypothesis: The purpose was to evaluate the ideal hinge position that would prevent an unstable lateral hinge fracture during biplanar medial closing wedge distal femoral osteotomy based on soft tissue coverage and bone density around the hinge area. The hypothesis was that the ideal hinge position could be clarified by analyzing soft tissue coverage and bone density around the lateral hinge area. Study Design: Controlled laboratory study. Methods: In 20 cadaveric knees (mean age, 70.3 ± 19.2 years), the femoral attachment of the gastrocnemius lateral head was quantitatively analyzed as a soft tissue stabilizer using digital photography and fluoroscopy. Then, medial closing wedge distal femoral osteotomy was performed, locating the lateral hinge either inside (group 1) or outside (group 2) the femoral attachment of the gastrocnemius lateral head, and the incidence of unstable lateral hinge fractures was compared between the 2 groups. Cortical bone density around the lateral hinge was measured using Hounsfield units on 30 computed tomography scans and reconstructed as a 3-dimensional mapping model. The transitional zone with low bone density was regarded as the safe hinge position with an increased capacity for bone deformation. Results: The upper and lower margins of the femoral attachment of the gastrocnemius lateral head were 9.1 ± 0.9 mm above and 8.0 ± 1.4 mm below the upper border of the lateral femoral condyle, respectively, and the femoral attachment of the gastrocnemius lateral head was widest in the anteroposterior dimension 0.4 ± 1.7 mm above the upper border of the lateral femoral condyle. The incidence of unstable lateral hinge fractures during osteotomy was significantly decreased in group 1 compared with group 2 (group 1: 0/10; group 2: 5/10; P = .01). An isolated transitional zone with low bone density was observed in all 30 knees and located 1.3 ± 0.8 mm above the upper border of the lateral femoral condyle. Bone density of the transitional zone with low bone density was significantly lower than surrounding femoral cortices ( P < .001). Conclusion: Only the upper border of the lateral femoral condyle can be recommended as an ideal hinge position to prevent unstable lateral hinge fractures during biplanar medial closing wedge distal femoral osteotomy based on soft tissue coverage and bone density. Clinical Relevance: When the hinge is positioned at the upper border of the lateral femoral condyle during biplanar medial closing wedge distal femoral osteotomy, the risk of unstable hinge fractures can be minimized.
Neonatal Eating Assessment Tool—Breastfeeding: Reference Values for Infants Less Than 7 Months old
Authors: Pados Britt Frisk , Park Jinhee , Thoyre Suzanne M. 
Published: August 2019

Background The Neonatal Eating Assessment Tool—Breastfeeding is a valid and reliable 62-item parent-report assessment of symptoms of problematic breastfeeding behavior intended for infants less than 7 months old. Research aim The aim of this study was to describe the Neonatal Eating Assessment Tool—Breastfeeding total score and subscale scores within a sample of full-term, healthy, typically-developing infants under 7 months old. Methods Parents of healthy, full-term breastfeeding infants ( N = 475) less than 7 months old completed the Neonatal Eating Assessment Tool – Breastfeeding through an online survey. Descriptive statistics were calculated for the total score and seven subscale scores within each age group: 0–2, 2–4, 4–6, and 6–7 months. Results Neonatal Eating Assessment Tool—Breastfeeding total scores were highest (i.e., more problematic symptoms) at 0–2 months and decreased in older infant age groups. All subscale scores also had a downward trajectory in symptoms of problematic breastfeeding except the subscale Compelling Symptoms of Problematic Feeding, which was very low across age groups. Conclusion The Neonatal Eating Assessment Tool—Breastfeeding now has reference values to facilitate interpretation of scores and guide decision-making, personalization of interventions, and assessment of response to interventions. For research, the Neonatal Eating Assessment Tool—Breastfeeding can be used to follow longitudinal development of breastfeeding as well as to test efficacy of breastfeeding interventions.
Growth and Change in the Journal of Human Lactation: A Content Analysis 1985–2018
Authors: Bamberger Ethan T. , Eden Aimee R. , Marinelli Kathleen A. , Gonzalez Paola A. , Tinsley Sara , Dodgson Joan E. 
Published: August 2019

Background: A professional association journal should reflect the needs of its organization, its readers, and the field it represents. Evaluating the needs that the Journal of Human Lactation has met, and those it has not, is essential if it is to remain relevant to its readers. Aims: (1) Describe the characteristics of articles published from 1985 through 2018. (2) Describe content intended to educate lactation support providers and clinicians. (3) Explore the ways the content has illustrated the growth and development of lactation knowledge, and (4) identify the reoccurring content threads consistent throughout the 34 years. Methods: A prospective mixed methods approach incorporating a quantitative content analysis and a qualitative thematic analysis was used. Frequency distributions were done on all the variables extracted from published articles ( N = 1586). The second level of analysis identified themes using an iterative and consensus approach. Results: Mirroring the growth in the lactation field, the volume of research articles published each year has increased along with the percent of research articles per issue. Research methods have become more diverse. The international scope and relevance, while always present, has been steadily increasing. Threads identified were; striving for international scope, advancing lactation education, developing a body of knowledge that informs clinical practice in lactation, and creating a centralized place for multidisciplinary research about lactation. Conclusion: The body of work published in the Journal of Human Lactation parallels the development of the lactation specialty. We have highlighted areas for improvement and possible further study.
Discontinuation of Exclusive Breastfeeding in Ghana: A Longitudinal, One-Group Observational Study of Postnatal Mothers With Children 0–6 Months old
Authors: Ganle John Kuumuori , Bedwei-Majdoub Vanessa-Marie 
Published: August 2019

Background Although exclusive breastfeeding of infants has several benefits, in Ghana only 52% of children under 6 months old are breastfed exclusively. However, researchers have not conducted longitudinal observational studies to examine exclusive breastfeeding discontinuation and determine risk factors. Research aims (1) To determine exclusive breastfeeding discontinuation, and (2) to examine those factors linked to discontinued exclusive breastfeeding. Methods A longitudinal, one-group observational study was conducted. A total of 322 mothers who had normal and full-term delivery at a district level referral hospital from January to December 2017 were recruited, followed-up every month, and subsequently interviewed after 6 months postpartum. Data were collected using validated questionnaires. Binary and multivariable Poisson regression analyses were the statistical analytical methods used. Results Respondents’ mean age was 29.78 years ( SD = 5.20). Among the 322 mothers who initiated breastfeeding with human milk at birth, 108 (34%) discontinued exclusive breastfeeding before 6 months postpartum. After controlling for possible covariates, attending antenatal care 4 or less times during pregnancy ( aRR = 6.54; 95% CI [1.77–24.22]; p = .005); lack of support from family to breastfeed exclusively ( aRR = 2.41; 95% CI [1.23–4.71]; p = .010), outside pressure to provide other food to the baby < 6 months postpartum ( aRR = 1.87; 95% CI [1.01–3.46]; p = .045), and living in an urban area ( aRR = 2.10; 95% CI [1.17-3.75]; p = .013) significantly increased the risks of discontinuing exclusive breastfeeding. Conclusion Universal exclusive breastfeeding may not be achieved without tackling the key determinants of discontinuation of exclusive breastfeeding. Health facility and community-based exclusive breastfeeding promotion interventions are therefore needed.
Caring for older people with dementia reliving past trauma
Authors: Craftman Åsa Gransjön , Swall Anna , Båkman Kajsa , Grundberg Åke , Hagelin Carina Lundh 
Published: August 2019

Background: The occurrence of behavioural changes and problems, and degree of paranoid thoughts, are significantly higher among people who have experienced extreme trauma such as during the Holocaust. People with dementia and traumatic past experiences may have flashbacks reminding them of these experiences, which is of relevance in caring situations. In nursing homes for people with dementia, nursing assistants are often the group of staff who provide help with personal needs. They have firsthand experience of care and managing the devastating outcomes of inadequate understanding of a person’s past experiences. Aim: The aim was to describe nursing assistants’ experiences of caring for older people with dementia who have experienced Holocaust trauma. Research design: A qualitative descriptive and inductive approach was used, including qualitative interviews and content analysis. Participants and research context: Nine nursing assistants from a Jewish nursing home were interviewed. Ethical considerations: The study was approved by the Regional Ethical Review Board, Stockholm. Findings: The theme ‘Adapting and following the survivors’ expression of their situation’ was built on two categories: Knowing the life story enables adjustments in the care and Need for flexibility in managing emotional expressions. Discussion and conclusion: The world still witnesses genocidal violence and such traumatic experiences will therefore be reflected in different ways when caring for survivors with dementia in the future. Person-centred care and an awareness of the meaning of being a survivor of severe trauma make it possible to avoid negative triggers, and confirm emotions and comfort people during negative flashbacks in caring situations and environments. Nursing assistants’ patience and empathy were supported by a wider understanding of the behaviour of people with dementia who have survived trauma.
Spirituality, Religion, and Medicine Education for Internal Medicine Residents
Authors: Piscitello Gina M. , Martin Shannon 
Published: August 2019

Purpose: Spirituality and religion affect patient health. This topic is often not included in medical resident education. We aimed to evaluate resident knowledge, attitudes, and skill regarding spirituality, religion, and medicine and to develop, implement, and evaluate a curriculum to improve these measures. Methods: Internal medicine residents at a large, urban academic center were surveyed to determine their baseline knowledge, attitudes, and skill regarding spirituality and religion (37.4% response rate, n = 46/123). A lecture and discussion-based curriculum was implemented over 1 year, followed by another survey (41.4% response rate, n = 51/123); χ2 statistic was used to compare pre- and postsurveys to evaluate the curriculum. Results: Baseline resident attitudes toward spirituality, religion, and medicine were high with most agreeing chaplains are valuable in patient care (93.5%) and that patient spiritual and religious beliefs can affect health (93.5%). Resident self-reported knowledge and skill were low with few knowing the training chaplains receive (4.3%) or reporting competence taking a spiritual history (15.2%). After the curriculum, resident self-reported knowledge increased regarding the role of chaplains (56.5%-80.4%, P = .011) and the training chaplains receive (4.3%-27.5%, P = .002). No significant postcurriculum change was seen in attitudes or skill. Conclusions: Most internal medicine residents have positive attitudes toward spirituality, religion, and medicine. They do not have adequate knowledge or skill to care for patients in this area, however. Implementation of a curriculum in spirituality, religion, and medicine improved resident self-reported knowledge. Future work should focus on revising the curriculum to better improve resident knowledge and skill.
Proximal and Distal Failure Site Analysis in Percutaneous Achilles Tendon Rupture Repair
Authors: Wagner Pablo , Wagner Emilio , López Mario , Etchevers Gastón , Valencia Oscar , Guzmán-Venegas Rodrigo 
Published: August 2019

Background: Different techniques have been described for percutaneous Achilles tendon rupture repair, but no biomechanical evaluation has been performed separately for proximal and distal suturing techniques. The purpose of this study was to biomechanically analyze proximal versus distal percutaneous Achilles suture configurations during cyclic loading and load to failure. Methods: A simulated, midsubstance rupture was created 6 cm proximal to the calcaneal insertion in fresh-frozen cadaveric Achilles tendons. Fifteen proximal specimens were divided into 3 groups: (A1) triple locking technique, (A2) Bunnell-type technique, and (A3) double Bunnell-type technique. Twelve distal specimens were divided into 2 groups: (B1) triple nonlocking technique and (B2) oblique technique. Repairs were subjected to cyclic testing and load to failure. Load to failure, cause of failure, and tendon elongation were evaluated. Results: None of the proximal specimens and 7/12 of the distal ones failed in cyclic testing. The proximal fixation groups demonstrated significantly more strength than the distal groups ( P = .001), achieving up to 710 N of failure load in Group A3. Groups B1and B2 failed on average at 380 N with no difference between them ( P > .05). The majority of all repairs failed in the suture-tendon interface. Distal groups had more elongation during cyclic testing (13.7 mm) than proximal groups (9.4 mm) ( P = .02). Conclusion: The distal fixation site in this Achilles tendon repair was significantly weaker than the proximal fixation site. A proximal modified suture configuration increased resistance to cyclic loading and load to failure significantly. Clinical Relevance: A modification can be suggested to improve strength of the Achilles repair.
Physicochemical stability of pembrolizumab admixture solution in normal saline intravenous infusion bag
Authors: Sundaramurthi Prakash , Chadwick Sean , Narasimhan Chakravarthy 
Published: August 2019

Introduction Pembrolizumab is an anti-PD-1 monoclonal antibody, approved and under development for numerous indications in oncology. It is available as either lyophilized powder for reconstitution or ready-to-use solution. Both are required to be diluted in saline or dextrose solution prior to intravenous infusion. After dilution, the recommendation per summary of product characteristics is 24 h at 2–8℃ and 6 h at room temperature. The purpose of this study was to investigate the physicochemical stability of pembrolizumab diluted solution (1 mg/mL) at both refrigerated and room temperature conditions for an extended period. Methods Under aseptic conditions, pembrolizumab was diluted in 250 mL of saline injection in polyolefin bags to obtain the final protein concentration of 1 mg/mL. Thus, prepared bags were then stored at either 5℃ ± 3℃, refrigerator exposing the product to ambient light or room temperature (20℃ ± 3℃) on the benchtop. Results Using several analytical methods, it was demonstrated that pembrolizumab solution for infusion, diluted in normal saline can be stored in polyolefin infusion bags for at least 1 week at 5℃ or RT with no evidence of chemical or physical instability. No aggregation was observed. Conclusion Thus, the practical use of aseptically prepared diluted pembrolizumab in saline can be safely extended to optimize the workload of centralized preparation units and to minimize costs. However, it is the responsibility of the end-user to maintain overall quality of prepared admixture solution that is administered to patient, by following aseptic compounding process as recommended in the packaging insert.
External contamination of antineoplastic drug containers from a Canadian wholesaler
Authors: Hilliquin D , Bussières JF 
Published: August 2019

Introduction Contamination of hospitals’ surfaces with antineoplastic drugs is documented despite safe handling practices. The exterior of commercial containers is often contaminated during the manufacturing process and can cross-contaminate hospitals’ surfaces. The aim was to investigate the contamination of the exterior of antineoplastic drug vials available in Canada in 2018. Methods Cross-sectional study. All available antineoplastic drugs vials from a single wholesaler were targeted. Containers were sampled upon their receipt by the pharmacy staff, before they were cleaned. One wipe was used to sample the external surface of five vials from a single batch from the same manufacturer. Nine antineoplastic drugs were quantified by ultra-performance liquid chromatography–tandem mass spectrometer: cyclophosphamide, docetaxel, 5-fluorouracil, gemcitabine, ifosfamide, irinotecan, methotrexate, paclitaxel, vinorelbine. Results Twenty-one samplings were done (105 containers from nine different manufacturers): cyclophosphamide = 2, docetaxel = 1, gemcitabine = 2, 5-fluorouracil = 2, ifosfamide = 2, irinotecan = 3, methotrexate = 6, paclitaxel = 2, vinorelbine = 1. One of these samplings was done on blister packaging, the remainder were done on glass vials. A total of 15/21 samples (71%) were positive to at least one drug (docetaxel, 5-fluorouracil, ifosfamide, and vinorelbine). A maximum of 272 ng/vial was quantified (gemcitabine). Cross contamination with other antineoplastic drugs was detected on 16/21 (76%) samples. Conclusion The majority of samples were positive to at least one antineoplastic drug, confirming that the exterior of antineoplastic drugs containers is still an important source of contamination. Manufacturers should reduce this contamination. Vials should be washed upon receipt, before they are stored in pharmacy. Gloves must be worn at all times to avoid occupational exposure.