bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of a palliative care outcome measurement tool supplemented by neurological symptoms (HOPE+): Identification of palliative concerns of neurological patients
Authors: Dillen Kim , Ebke Markus , Koch Andreas , Becker Ingrid , Ostgathe Christoph , Voltz Raymond , Golla Heidrun 
Published: July 2019

Background: There is growing interest to integrate palliative care and its structures into the care of neurological patients. However, in Germany there is no comprehensive assessment tool capturing the symptoms of patients with advanced neurological diseases. Aim: To validate a newly developed palliative care measurement tool based on an extension of the validated core documentation system Hospice and Palliative Care Evaluation considering additional neurological issues (HOPE+). Design: Prospective, observational study using HOPE+ and as external criteria, the Eastern Cooperative Oncology Group (ECOG) performance status and the 12 months “surprise” question (12-SQ) in a neurological population, and assessment for its construct validity and diagnostic accuracy. Setting/participants: All newly admitted patients to the Department of Neurorehabilitation, Dr. Becker Rhein-Sieg-Clinic aged 18–100 years (#DRKS00010947). Results: Data from 263 patients (63 ± 14 years of age) were analyzed. HOPE+ revealed a moderately correlated six-factor structure ( r = –0.543–0.525). Correlation analysis to evaluate discriminant validity using ECOG as external criterion was high ( rs(261) = 0.724, p < 0.001) and confirmed for severely affected patients by adding the 12-SQ (“No”-group: 48.00 ± 14.92 vs “Yes”-group: 18.67 ± 7.57, p < 0.009). Operating characteristics show satisfactory diagnostic accuracy (area under the curve: 0.746 ± 0.049, 95% confidence interval = 0.650–0.842). Conclusion: HOPE+ demonstrates promising psychometric properties. It helps to assess palliative care issues of patients in neurological settings and, in combination with the 12-SQ, conceivably conditions when to initiate the palliative care approach in a population underrepresented in palliative care structures so far.
Comparison of clinical outcomes and postoperative quality of life after surgical treatment of type II submucous myoma via laparoscopy or hysteroscopy
Authors: Zhang Rui-chun , Wu Wei , Zou Qing , Zhao Hongmei 
Published: July 2019

Objective This study was performed to compare the clinical outcomes, advantages, and disadvantages of laparoscopic myomectomy (LM) and transcervical resection of myoma (TCRM) in the treatment of type II submucous myoma. Methods In total, 136 patients with type II submucous myoma with a tumour diameter of 4 to 5 cm were randomly assigned to the hysteroscopy group or laparoscopy group. Results The operative duration was shorter and the intraoperative bleeding volume was lower in the hysteroscopy than laparoscopy group. The success rate of the single-stage operation was obviously higher in the laparoscopy than hysteroscopy group. The duration of postoperative antibiotic use and the length of hospital stay were shorter in the hysteroscopy than laparoscopy group. The time to complete healing of the muscle layer was shorter in the hysteroscopy than laparoscopy group. The rate of intraoperative complications was lower in the hysteroscopy than laparoscopy group. Conclusion Both hysteroscopic and laparoscopic surgery have beneficial effects in the treatment of type II submucous myoma. Hysteroscopic surgery has the advantages of a short operative duration, low intraoperative bleeding volume, fast postoperative recovery, and high quality of life. Laparoscopic surgery involves many intraoperative complications and slow recovery of ovarian function.
Cost-effectiveness analysis of a single-use digital flexible cystoscope for double J removal
Authors: Oderda Marco , Antolini Jacopo , Falcone Marco , Lacquaniti Sergio , Fasolis Giuseppe 
Published: July 2019

Introduction and objective: The novel single-use digital flexible cystoscope Isiris™ has been developed to perform in-office JJ stent removal, without the need of special equipment nor limitations linked to the disinfection of a reusable device. The aim of our study was to perform a cost-effectiveness analysis of Isiris™ in our institution. Patients and methods: A total of 127 consecutive patients undergoing in-office stent removal with Isiris™ were prospectively included in study. After each procedure, the urologist filled a questionnaire specifically developed to evaluate the efficiency of the device and the invasiveness of the procedure. We performed a cost analysis of the main variables involved in JJ removal using Isiris™ versus the traditional Storz™ reusable flexible cystoscope used for all our previous patients. Results: The procedure was successful in all cases except for one, where the device did not work due to the failure of the grasper and had to be replaced. Overall, the performance of Isiris™ was judged by the physician “very good” and “good” in 90.6% of the cases. Both median pain and invasiveness felt by the patient were 0 (range = 0–8). The mean cost of procedure was estimated at €361 for in-office stent removal with Isiris™, and €1.126.8 for stent removal in operatory room with a reusable flexible cystoscope. Considering the 127 procedures performed in office, 64 h of operatory room time was saved. Conclusion: In institutions where JJ removal is performed in the operatory room, Isiris™ leads to a significant advantage in terms of money saved per procedure, operatory room time gained and patient satisfaction.
Renal artery pseudoaneurysm after open partial nephrectomy for renal cell carcinoma
Authors: Kisa Erdem , Koc Gokhan , Yucel Cem , Keskin Mehmet Zeynel , Capar Ahmet Ergin , Kozacioglu Zafer 
Published: July 2019

Introduction: Renal artery pseudoaneurysm is a well-described complication of open and laparoscopic partial nephrectomy. Delayed bleeding from a renal artery pseudoaneurysm is rare after open partial nephrectomy. Case description: Here, we present a 75-year-old man who, 14 days after undergoing an open right partial nephrectomy for an endophytic 4.5 cm tumor, developed painless macroscopic hematuria. Prompt computer tomography angiography imaging, followed by therapeutic angio-embolization of segmental renal artery with coils, treated the pseudoaneurysm successfully. Conclusion: Renal artery pseudoaneurysm can be treated rapidly, effectively, and with minimal patient morbidity via percutaneous renal artery embolization.
Effect of bone fracture(s) on blood lead levels from retained lead pellets in craniomaxillofacial region
Authors: Edetanlen BE , Saheeb BD 
Published: July 2019

Background: Missile-related blood lead elevations and toxicity are well documented in the literature but reports on its associated risk factor(s) are few. Objective: To determine if bone fracture(s) contribute to an elevated lead blood level. Method: This is a prospective study of subjects with retained pellets in the craniomaxillofacial region following gunshot injuries who met the inclusion criteria. Blood samples were collected from the test subjects and their corresponding control subjects via venipuncture. Collected blood samples were used for blood lead measurement by the wet method of the atomic absorption spectrophotometry. Using appropriate statistical tests, p < 0.05 was considered significant. Results: A total number of 48 subjects were studied. The mean blood lead levels (BLLs) of the study population were 6.88 ± 1.17 µg/dl while that of the control group was 1.52 ± 0.87 µg/dl and the mean difference was statistically significant ( p = 0.03). The mean and standard deviation of BLL of subjects with fractures were 4.77 ± 0.9, 5.08 ± 1.0, and 5.22 ± 1.0 µg/dl at days 3, 21, and 42 postinjury, respectively, while for those without bone fractures were 3.07 ± 1.4, 3.70 ± 0.8, and 4.33 ± 1.7 µg/dl. The difference was statistically significant ( p = 0.04). Conclusion: Subjects with bone fractures were found to have higher BLLs than those without bone fractures, where pellets were retained in their bodies.
Ethical sensitivity and perceptiveness in palliative home care through co-creation
Authors: Hemberg Jessica , Bergdahl Elisabeth 
Published: July 2019

Background: In research on co-creation in nursing, a caring manner can be used to create opportunities whereby the patient’s quality of life can be increased in palliative home care. This can be described as an ethical cornerstone and the goal of palliative care. To promote quality of life, nurses must be sensitive to patients’ and their relatives’ needs in care encounters. Co-creation can be defined as the joint creation of vital goals for patients through the process of shared knowledge between nurses, patients and their relatives. Aim: The aim of this study was to explore nurses’ experiences of caring encounters and co-creation in palliative home care from an ethical perspective. Research design, participants, and research context: A hermeneutical approach was used. The material consisted of texts from interviews with 12 nurses in a home care context. The method was inspired by thematic analysis. Ethical considerations: Informed consent was sought from the participants regarding study participation and the storage and handling of data for research purposes. Findings: An overall theme, a main theme and four sub-themes emerged. Through ethical sensitivity and perceptivity, nurses can balance their actions in the moment and change their nursing care actions according to the patient’s wishes through co-creation in encounters. Here the time is crucial, as the time needed is unique to each patient. Discussion: The themes together can be considered prerequisites for good palliative home care. If nurses fail to be sensitive and perceptive in encounters with dying patients, good palliative home care cannot be achieved. Ethical sensitivity and perceptiveness can also be considered a part of nurses’ ethical competence. Conclusion: Patients’ dignity can be preserved through ethical sensitivity and perceptiveness, which is fundamental for good palliative care. Co-creation from patients’ perspectives should be the focus of future research.
Intra-lenticular caterpillar seta in ophthalmia nodosa
Authors: Singh Arshi , Behera Umesh Chandra , Agrawal Hitesh 
Published: July 2019

Purpose: To report the clinical course of ophthalmia nodosa with a retained lenticular seta misdiagnosed and treated as non-infectious posterior uveitis for 7 consecutive years. Methods: Meticulous clinical examination led to discovery of the caterpillar seta embedded in the crystalline lens and the intravitreal setae. Results: Lens-sparing pars plana vitrectomy and removal of free-floating vitreal seta resulted in complete resolution of vitritis and uveitis. Conclusion: Embedded seta within a clear lens may remain sequestered, and may be left untouched under close observation, precluding a clear lens extraction in such patients.
Exploring and Addressing ‘Concerns’ for Significant Others to Extend the Understanding of Quality of Life With Amyotrophic Lateral Sclerosis: A Qualitative Study
Authors: Ando Hikari , Cousins Rosanna , Young Carolyn A 
Published: July 2019

Background: The absence of curative medication for amyotrophic lateral sclerosis (ALS) makes palliative care and understanding quality of life (QoL) in ALS a clinical priority. Previous qualitative research has explored the concept of QoL in terms of illness impact on life perspectives and sense of self. Objective: In this research, we explored ‘concerns’ – one of the four aspects in the World Health Organisation’s conceptualisation of QoL – towards adding to the literature. Methods: In-depth interviews with 26 individuals with ALS were subjected to thematic analysis involving both inductive and deductive approaches to explore participant’s concerns, and to evaluate the relevance of their concerns for understanding QoL in ALS. Findings: The analysis showed that concerns for significant others contribute to participant’s QoL because of their existential value. It was important for participants to minimise the impact of limitations and burdens associated with ALS on significant others, even at a cost to self. Discussion: The current study supports a holistic approach in service provision, ensuring the inclusion of relevant significant others. It is further suggested that clinicians explore the specifics of burdens perceived by patients in order to support them in minimising the burdens for their significant others.
Association of ABO Blood Groups and Risk of Gastric Cancer
Authors: Yu Hao , Xu Na , Li Zhong-Kun , Xia Hong , Ren Hong-Tao , Li Na , Wei Jan-Biao , Bao Hui-Zheng 
Published: July 2019

Objective: This study sought to investigate the relationship between ABO blood groups and the risk of gastric cancer as well as clinical pathological parameters and prognosis. Methods: Gastric cancer patient data were collected from January 1995 to January 2012 at Jilin Cancer Hospital, and the blood group information of the blood donors at Jilin City Blood Center was recorded. The relationships between ABO blood group and both clinicopathological parameters and the risk of gastric cancer were analyzed retrospectively. The impact of ABO blood type on the 5-year survival rate of patients with gastric cancer was evaluated through outpatient and telephone interviews. Results: (1) Compared with the healthy population, the frequency distribution of gastric cancer patients with the A blood group was significantly increased (χ2 = 4.708, P = 0.000), whereas the frequency distribution of gastric cancer patients with the AB blood group was significantly decreased (χ2 = 9.630, P = 0.002). However, there was no significant difference in the distributions of the B blood group and O blood group (P > 0.05). (2) The risk of gastric cancer in people with the A blood group was higher, whereas the risk of gastric cancer in people with the AB blood group was lower. There was no significant difference in the risk of gastric cancer between type B and type O patients (P > 0.05). (3) The ABO blood group was not related to pathological factors, including the size of the gastric tumor or the T stage or N stage of the disease (P > 0.05). (4) Univariate analysis results showed that the degree of differentiation, tumor size, T stage, lymph node metastasis, and type O blood were factors affecting the 5-year survival rate of gastric cancer patients (P < 0.05). Multivariate analysis results showed that tumor size, T stage, lymph node metastasis, and O blood group were independent prognostic factors. The 5-year survival rate for gastric cancer was significantly better in patients with type O blood (hazard ratio = 0.97, 95% confidence interval = 1.67–3.92). Conclusion: (1) The risk of gastric cancer was higher in patients with the A blood group and lower in those with the AB blood group. (2) The ABO blood group showed no significant effect on the clinicopathological parameters of gastric cancer. (3) The O blood group may be a prognostic factor for gastric cancer patients.
Association of serum FAM19A5 with metabolic and vascular risk factors in human subjects with or without type 2 diabetes
Authors: Lee You-Bin , Hwang Hwan-Jin , Kim Jung A , Hwang Soon Young , Roh Eun , Hong So-hyeon , Choi Kyung Mook , Baik Sei Hyun , Yoo Hye Jin 
Published: July 2019

Objectives: A recent experimental study revealed that family with sequence similarity 19 [chemokine (C-C motif)-like] member A5 (FAM19A5), a novel secreted adipokine, has inhibitory effects on vascular smooth muscle cell proliferation and migration, and on neointima formation in injured arteries. We investigated the associations between serum FAM19A5 concentration and cardio-metabolic risk factors for the first time in human subjects. Methods: Circulating FAM19A5 concentrations and their associations with cardio-metabolic risk factors were explored in 223 individuals (45 without diabetes and 178 with type 2 diabetes). Results: Serum FAM19A5 concentrations (pg/mL) were greater in patients with type 2 diabetes [median (interquartile range), 172.70 (116.19, 286.42)] compared with non-diabetic subjects [92.09 (70.32, 147.24)] ( p < 0.001). Increasing serum FAM19A5 tertile was associated with trends of increasing waist-to-hip ratio, fasting plasma glucose, glycated haemoglobin and mean brachial-ankle pulse wave velocity. Serum FAM19A5 was positively correlated with waist circumference, waist-to-hip ratio, alanine aminotransferase, fasting plasma glucose, glycated haemoglobin and mean brachial-ankle pulse wave velocity. Multiple stepwise regression analyses identified waist-to-hip ratio, low-density lipoprotein cholesterol and brachial-ankle pulse wave velocity as determining factors for log-transformed serum FAM19A5 concentration (R2 = 0.0689). Conclusion: A novel adipokine FAM19A5 was related to various metabolic and vascular risk factors in humans, suggesting its potential as a biomarker of cardio-metabolic disease.
Exploring the factors associated with non-urgent emergency department utilisation for mental health care
Authors: Mowbray Fabrice I , Omar Abeer E , Pfaff Kathyrn , El-Masri Maher M 
Published: July 2019

Background Emergency department visits for mental health care are on the rise across North America. Patients with mental illness are at an increased risk for frequent and non-urgent emergency department visitation. Aims The purpose of this study was to examine the independent predictors of non-urgent emergency department use for mental health care. Methods A secondary data analysis was conducted with archived data provided by the Erie St. Clair Local Health Integration Network in Ontario. Results A total of 13,114 mental health-related emergency department visits were analysed using logistic regression with generalised estimating equations modelling. The findings suggest the following characteristics are predictive of non-urgent emergency department use for mental health care: age, season, time of day, access to primary health care, mode of arrival, hospital type, referral source and patient diagnosis. Conclusions The findings of this study can be utilised to assist clinicians and policy makers in identifying and managing patients using the emergency department for non-urgent mental health care.
The National Institute for Health Research Critical Care Research Priority Setting Survey 2018
Authors: Tatham Kate C , McAuley Daniel F , Borthwick Mark , Henderson Neil G , Bashevoy Gemma , Brett Stephen J 
Published: July 2019

Introduction Defining research priorities in intensive care is key to determining appropriate allocation of funding. Several topics were identified from the 2014 James Lind Alliance priority setting exercise conducted with the Intensive Care Society. The James Lind Alliance process included significant (and vital) patient/public contribution, but excluded professionals without a bedside role. As a result it may have failed to identify potential early-stage translational research topics, which are more likely identified by medical and/or academic members of relevant specialist basic science groups. The objective of the present project was to complement the James Lind Alliance project by generating an updated list of research priorities by facilitating academic research input. Method A survey was conducted by the National Institute for Health Research (NIHR) to identify the key research priorities from intensive care clinicians, including allied health professionals and academics, along with any evolving themes arising from translational research. Feasibility of all identified topics were then discussed and allocated to themes by a joint clinical academics/NIHR focus group. Results The survey was completed by 94 intensive care clinicians (including subspecialists), academics and allied health professions. In total, 203 research questions were identified, with the top five themes focusing on: appropriate case selection (e.g. who and when to treat; 24%), ventilation (7%), sepsis (6%), delirium (5%) and rehabilitation (5%). Discussion Utilising a methodology distinct from that employed by the James Lind Alliance process, from a broad spectrum of intensive care clinicians/scientists, enabled identification of a variety of priority research areas. These topics can now inform not only the investigator-led research agenda, but will also be considered in due course by the NIHR for potential future funding calls.
Effect of Combined Leukocyte-Poor Platelet-Rich Plasma and Hyaluronic Acid on Bone Marrow–Derived Mesenchymal Stem Cell and Chondrocyte Metabolism
Authors: Satin Alexander M. , Norelli Jolanta B. , Sgaglione Nicholas A. , Grande Daniel A. 
Published: July 2019

Objective Given the potential applications of combined biologics, the authors sought to evaluate the in vitro effect of combined platelet-rich plasma (PRP) and hyaluronic acid (HA) on cellular metabolism. Design Bone marrow–derived mesenchymal stem cells (BMSCs) and chondrocytes were obtained from the femurs of Sprague-Dawley rats. An inflammatory model was created by adding 10 ng/mL interleukin-1-beta to culture media. Non-crosslinked high-molecular-weight HA, activated-PRP (aPRP), and unactivated-PRP (uPRP) were tested. Cellular proliferation and gene expression were measured at 1 week. Genes of interest included aggrecan, matrix metalloproteinase (MMP)-9, and MMP-13. Results Combined uPRP-HA was associated with a significant increase in chondrocyte and BMSC proliferation at numerous preparations. There was a trend of increased chondrocyte aggrecan expression with combined PRP-HA. The greatest and only significant decrease in BMSC MMP-9 expression was observed with combined PRP-HA. While a significant reduction of BMSC MMP-13 expression was seen with PRP and HA-alone, a greater reduction was observed with PRP-HA. MMP-9 chondrocyte expression was significantly reduced in cells treated with PRP-HA. PRP-alone and HA-alone at identical concentrations did not result in a significant reduction. The greatest reduction of MMP-13 chondrocyte expression was observed in chondrocytes plus combined PRP-HA. Conclusions We demonstrated a statistically significant increase in BMSC and chondrocyte proliferation and decreased expression of catabolic enzymes with combined PRP-HA. These results demonstrate the additive in vitro effect of combined PRP-HA to stimulate cellular growth, restore components of the articular extracellular matrix, and reduce inflammation.
Prospective trial of single-use, flexible cystoscope for ureteric double-J stent removal: Cost and utility analysis
Authors: Donato Peter , Honore Matthew , Zana Tafadzwa , Pokorny Morgan , Bowes William , Meyer Jon Paul , Rukin Nicholas 
Published: July 2019

Objective: The objective of this study is to evaluate the costs and benefits of Isiris (Coloplast, Denmark), a mobile, single-use, flexible cystoscope with a built-in stent grasper. Methods: A prospectively collected database was reviewed to define procedural outcomes for Isiris ureteric stent removal. Variables assessed included stent duration and location of removal. A cost assessment was performed evaluating the impact on costs, funding and facility use. Results: Seventy-five procedures were performed using Isiris between April and September 2017. There were no complications. Two procedures failed because of encrustation and poor visibility secondary to haematuria. The mean (SD), median (interquartile range) and range of delay were 2.1 (0–5.3), 0 (0–2) and 0–40 days, respectively. Only one patient was delayed more than two weeks; this occurred because he was placed on a theatre waiting list, which resulted in the 40-day delay. Overall, the cost benefit for our department with the introduction of the Isiris system has been a surplus of $104,434, with an extra 65 elective spaces free for diagnostic flexible cystoscopy cases. Conclusion: Isiris flexible stent removal offers our patients a rapid stent-removal service with low rates of removal delay. Savings have been made in scope repair costs, sterilisation and scope maintenance, as well as optimisation of theatre and procedure room space. Level of evidence: 1c