bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Low-Dose Hydrocortisone Therapy in Adult Patients With Septic Shock: A Meta-Analysis With Trial Sequential Analysis of Randomized Controlled Trials
Authors: Lyu Qing-Quan , Chen Qi-Hong , Zheng Rui-Qiang , Yu Jiang-Quan , Gu Xiao-Hua 
Published: October 2018

Background: The efficacy of low-dose hydrocortisone therapy in the management of septic shock remains controversial in critical care for many years. Hence, we performed this meta-analysis of randomized controlled trials (RCTs) with trial sequential analysis (TSA) to evaluate its effect on clinical outcome among adult patients with septic shock. Methods: We identified relevant RCTs published from inception to March 7, 2018 comparing low-dose hydrocortisone with placebo or no intervention in adults admitted to the intensive care unit (ICU) for septic shock. Meta-analyses were performed for the primary and secondary outcomes. The risk of bias was assessed using the Cochrane Collaboration’s instrument. Trial sequential analysis was used to pool the results from the included studies for the primary outcomes. Results: Thirteen studies were retrieved by our literature search strategy. There were no significant differences in 28-day mortality (odds ratio [OR] = 0.90, 95% confidence interval [CI] = 0.81-1.00; P = .05) and hospital mortality (OR = 0.91, 95% CI = 0.82-1.02; P = .09) between the 2 groups, which were confirmed by TSA. However, there was a significant improvement in shock reversal in the hydrocortisone group (OR = 1.33, 95% CI = 1.02-1.72; P = .03). Furthermore, subgroup analyses revealed that hydrocortisone plus fludrocortisone statistically reduced the rate of 28-day mortality (OR = 0.79, 95% CI = 0.64-0.97; P = .03), ICU mortality (OR = 0.77, 95% CI = 0.63-0.95; P = .02), and hospital mortality (OR = 0.77, 95% CI = 0.63-0.95; P = .01) in comparison with the placebo, the results were also confirmed by TSA. Conclusion: Among adult patients with septic shock, the use of low-dose hydrocortisone compared with control did not confer overall survival benefits, albeit improving shock reversal rate. The benefit of reducing 28-day mortality, ICU mortality, and hospital mortality was observed in combination use of hydrocortisone and fludrocortisone.
Vitamin D Deficiency Is Highly Prevalent in Critically Ill Patients and a Risk Factor for Mortality: A Prospective Observational Study Comparing Noncirrhotic Patients and Patients With Cirrhosis
Authors: Mayr Ulrich , Fahrenkrog-Petersen Leonie , Batres-Baires Gonzalo , Rasch Sebastian , Herner Alexander , Schmid Roland M. , Huber Wolfgang , Lahmer Tobias 
Published: October 2018

Introduction: A 25-hydroxyvitamin D, 25(OH)D, deficiency is common among critically ill patients and correlated with increased mortality. Furthermore, deficiency is associated with advanced liver disease. However, there are no studies available comparing the dimensions and consequences of a 25(OH)D deficiency between patients with and without liver cirrhosis in the setting of intensive care units (ICUs). This study focuses on differences in 25(OH)D status between critically ill noncirrhosis patients and patients with cirrhosis (primary end point), hypothesizing that deficiency and its impact on mortality risk are even more pronounced in patients with cirrhosis. Methods: We performed a prospective observational study of 176 patients (noncirrhosis patients, N = 114; patients with cirrhosis, N = 62) with a laboratory assessment of 25(OH)D on ICU admission and survival analyses after 180 days. Results: On admission, 55% of patients showed a severe deficiency, 25(OH)D <10 ng/mL, and a further 23% moderate deficiency (10-19 ng/mL). The overall median level of 25(OH)D was 8.0 (5.0-18.0) ng/mL (10.5 [6.0-21.3] in noncirrhosis patients vs 7.0 [4.8-10.0] in patients with cirrhosis; P < .001). We found extremely low levels particularly in patients without prior vitamin D supplementation (6.0 [4.0-7.5] in patients with cirrhosis vs 8.0 [5.0-12.0] ng/mL in noncirrhosis patients; P = .004). Vitamin D status correlated inversely with the sequential organ failure assessment, acute and physiology chronic health evaluation, model of end-stage liver disease, and Child-Pugh scores. Survival analyses categorized 25(OH)D levels <10 ng/mL as a high-risk factor for mortality 180 days after admission (hazard ratio [HR]: 2.45, 95% confidence interval [CI] = 1.60-3.70; P < .001). In patients with cirrhosis, a severe deficiency (<10 ng/mL) involved a significantly higher mortality risk than in noncirrhosis patients (HR: 2.30, 95% CI = 1.39-3.82; P = .001). In cases of admission levels ≥10 ng/mL, however, mortality risk was similar between patients with cirrhosis and noncirrhosis patients (HR: 1.08, 95% CI = 0.43-2.73; P = .873). Conclusions: Hypovitaminosis D is a highly frequent disorder in critically ill patients admitted to ICU. A severe deficiency with levels <10 ng/mL is a high risk factor for increased mortality, especially in patients with cirrhosis.
The Association of Prediabetes and Diabetes Risk Perception With Leisure-Time Physical Activity and Weight Loss
Authors: Murillo Rosenda , Katic Bozena J. , Gonzalez Tailisha , Vasquez Elizabeth , Echeverria Sandra 
Published: October 2018

Purpose: To examine the association of perceived risk of prediabetes and diabetes with leisure-time physical activity (LTPA) and weight loss, and determine whether the association of risk perception with LTPA and weight loss varies by race/ethnicity. Design: Cross-sectional. Setting: National Health and Nutrition Examination Survey (NHANES) 2011-2014. Subjects: Non-Latino white, non-Latino black, and Latino nondiabetic and nonprediabetic NHANES participants ≥18 years of age who were not underweight (n = 9550). Measures: Demographic characteristics, LTPA, attempted weight loss, and perceived risk of prediabetes or diabetes. Analysis: Log-binomial regression models were fit to assess the association of perceived risk with meeting LTPA recommendations and having attempted to lose weight, overall and by race/ethnicity. Results: Individuals reporting that they perceived they could be at risk for diabetes/prediabetes were less likely to meet LTPA recommendations (adjusted prevalence ratio [aPR]: 0.87; 95% confidence interval [CI]: 0.79-0.95), but significantly more likely to report attempting weight loss in the past year (aPR: 1.14; 95%CI: 1.04-1.25), compared with those reporting no risk perception. Latino and non-Latino blacks who perceived they could be at risk for diabetes/prediabetes were 25% and 35% more likely to report trying to lose weight in the past year (aPR: 1.25; 95% CI: 1.08-1.44 and aPR: 1.35; 95% CI: 1.19-1.54, respectively), compared with Latino and non-Latino blacks that did not perceive being at risk. In contrast, non-Latino whites who perceived they were at risk were 20% less likely to report meeting LTPA recommendations (aPR: 0.80; 95% CI: 0.72-0.89), compared with non-Latino whites reporting no risk perception. Conclusion: Findings highlight the role of perceived risk for prediabetes and diabetes in LTPA and weight loss, with findings varying by race/ethnicity. Awareness of prediabetes and diabetes risk could contribute to efforts aimed at improving LTPA and weight loss.
Emerging Market Bidder Returns and the Choice of Payment Method in Mergers and Acquisitions: Evidence from India
Authors: Ladkani Radha M. , Banerjee Ashok 
Published: October 2018

Consistent with other evidence on short-run effects of mergers and acquisitions (M&A) announcements on acquiring firm’s shareholder wealth in emerging markets, our study reveals that M&A deals in India, irrespective of the payment method, are not value destroying. Cash deals and stock deals create shareholder wealth on deal announcements. We offer ‘pseudo-cash deal hypothesis’ to explain this phenomenon. We also observe that bigger the relative size of the deal, greater is the abnormal return on deal announcements. We observe that acquirers with high promoter holdings are highly reluctant to offer stock when they acquire a majority stake. However, bigger deals, deals for listed target firms, and deals in the information technology sector, command stock offers. JEL Classification: G34, G14
Talent Management and Development: Perspectives From Emerging Market Economies
Authors: Dirani Khalil M. , Nafukho Fredrick M. 
Published: October 2018

The Problem This issue of Advances addresses an important and so far largely unexplored area of practice and research: Talent management and development (TMD) in emerging market economies. Given the growing importance of the emerging markets, understanding how current and future talents in these countries are educated and trained is a matter of high priority for academics, business executives, and policy makers worldwide. However, systematic studies of TMD in emerging markets and especially English-language publications on this topic are scarce. We hope that this work closes an important gap in the academic literature by bridging TMD studies and research on emerging markets, and by providing analysis of TMD practices in a number of key emerging economies. The Solution TMD is one of the important areas of focus for human resource development (HRD) researchers and practitioners. Most research on TMD is conducted in the West, while the current state and indigenous practices of TMD in the majority of countries of the world are not explored. Articles in this special issue provided an overview of TMD in some of the emerging market economies: Asia, Eastern Europe, Middle East, Africa, and BRICS sector (Brazil, Russia, India, China, and South Africa) and cover a range of TMD practices and topics. While some authors focused more on TMD in the business sector (e.g., Brazil, Russia, and India), others discussed such topics as TMD in higher education (e.g., Vietnam), the difference between private and public institutions in TMD for managers and executives (e.g., Korea, UAE), and current practices of TMD in the public and private sectors (China). Chapters from China, South Korea, Vietnam, Russia, India, UAE, Sub-Saharan Africa, and Brazil are included in this special issue. The Stakeholders This issue is expected to benefit HRD researchers, HRD practitioners, and organizations by providing TMD theories, research, and practice from different cultural perspectives around the globe. In addition, practical ways of talent development and talent management for organizations are advanced in the issue.
Seizure predictors and outcome after Onyx embolization in patients with brain arteriovenous malformations
Authors: Zhang Baorui , Feng Xin , Peng Fei , Wang Luyao , Guo Er Kang , Zhang Yupeng , Liu Peng , Wu Zhongxue , Liu Aihua 
Published: October 2018

Background Brain arteriovenous malformation (bAVM)-related epilepsy can significantly affect patient quality of life. We aimed to identify the factors associated with seizures occurrence and evaluate the long-term outcome following Onyx embolization in bAVM patients. Methods Between July 2014 and July 2016, 239 consecutive patients underwent treatment for bAVMs in our institute and were respectively analyzed. Demographics, seizure status and bAVM morphologic characteristics were recorded. Modified Engel classification was used to evaluate the long-term seizure outcomes. Results Of 239 bAVM patients, 68 (28.5%) initially presented with seizures. Seizure occurrence was associated with cerebral hemorrhage history, frontal-temporal location and arterial borderzone location. Of the 37 patients who presented with initial seizures and were treated with Onyx embolization, 23 (62.2%) were treated with antiepileptic drugs (AEDs) before Onyx embolization. At the last follow-up visit, 19 (51.4%) of the 37 patients reached modified Engel class I outcome. Of the 23 patients who had ever been treated with AEDs, 12 (52.2%) were still taking AEDs at the last follow-up visit. Single-factor analysis showed that arterial borderzone location was significantly correlated with higher modified Engel class outcome ( p = 0.046). Conclusion Patients with bAVM hemorrhage history, frontal-temporal location and arterial borderzone location were associated with seizure occurrence. Seizure-free status was not obtained in AVM patients with arterial borderzone after embolization, though it may have benefits in other ways. The seizure-free mechanism of bAVM with Onyx embolization is worth further study.
Carotid artery stenting for patients with occipital–vertebral anastomosis
Authors: Kajikawa Ryuichiro , Fujinaka Toshiyuki , Nakamura Hajime , Kinoshita Manabu , Nishida Takeo , Kishima Haruhiko 
Published: October 2018

Background and purpose We report the outcomes of carotid artery stenting for patients with angiographically visible occipital artery–vertebral artery anastomosis. Methods Among 47 consecutive patients who underwent carotid artery stenting from January 2007 to December 2010, seven patients for whom cerebral angiograms clearly showed occipital artery–vertebral artery anastomosis were selected. Four different protection methods were used: distal internal carotid artery protection; carotid flow reversal; seatbelt and airbag technique; and double protection method of protecting both the external and internal carotid artery. Results One patient with distal internal carotid artery protection showed a high-intensity lesion at the border of the upper thalamus, internal capsule and lateral ventricle wall after carotid artery stenting. The other patient with the double protection method did not show any high-intensity lesions on postoperative diffusion-weighted imaging in the vertebrobasilar territory. All seven patients with visible occipital artery–vertebral artery anastomosis showed ipsilateral vertebral artery severe stenosis or occlusion. Conclusion Large occipital artery–vertebral artery anastomosis may be a pathway for embolic materials during carotid artery stenting. External carotid artery protection is recommended for carotid artery stenting in such patients.
To Pack or Not to Pack: Inpatient Management of Epistaxis in the Elderly
Authors: Zhou Albert H. , Chung Sei Y. , Sylvester Michael J. , Zaki Michael , Svider Peter S. , Hsueh Wayne D. , Baredes Soly , Eloy Jean Anderson 
Published: October 2018

Background Epistaxis is common in elderly patients, occasionally necessitating hospitalization for the management of severe bleeds. In this study, we aim to explore the impact of nasal packing versus nonpacking interventions (cauterization, embolization, and ligation) on outcomes and complications of epistaxis hospitalization in the elderly. Methods The 2008–2013 National Inpatient Sample was queried for elderly patients (≥65 years) with a primary diagnosis of epistaxis and accompanying procedure codes for anterior and posterior nasal packing or nonpacking interventions. Results A total of 8449 cases met the inclusion criteria, with 62.4% receiving only nasal packing and 37.6% receiving nonpacking interventions. On average, nonpacking interventions were associated with a 9.9% increase in length of stay and a 54.0% increase in hospital charges. Comorbidity rates did not vary between cohorts, except for diabetes mellitus, which was less common in the nonpacking cohort (26.6% vs 29.0%; P = .014). Nonpacking interventions were associated with an increased rate of blood transfusion (24.5% vs. 21.8%; P = .004), but no significant differences in rates of stroke, blindness, aspiration pneumonia, infectious pneumonia, thromboembolism, urinary/renal complications, pulmonary complications, cardiac complications, or in-hospital mortality. Comparing patients receiving ligation or embolization, no differences in length of stay, complications, or in-hospital mortality were found; however, embolization patients incurred 232.1% greater hospital charges ( P < .001). Conclusion Nonpacking interventions in the elderly do not appear to be associated with increased morbidity or mortality when compared to nasal packing only but appear to be associated with increased hospital charges and length of stay. Embolization in the elderly results in greater hospital charges but no change in outcome when compared to ligation.
Sex differences in health outcomes at one year following acute myocardial infarction: A report from the China Patient-Centered Evaluative Assessment of Cardiac Events prospective acute myocardial infarction study
Authors: Dreyer Rachel P , Zheng Xin , Xu Xiao , Liu Shuling , Li Jing , Ding Qinglan , Du Xue , Li Xi , Zhang Haibo , Masoudi Fredrick A , Spertus John A , Krumholz Harlan M , Jiang Lixin 
Published: October 2018

Background: We examined sex differences in long-term health outcomes following acute myocardial infarction in China, including mortality, major adverse cardiac events and health status (symptoms, functioning, quality of life). Methods: A total of 3415 acute myocardial infarction patients (23.2% women) aged ⩾18 years were enrolled across 10 geographic regions in China (2012–2014) in the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) study. Clinical data was abstracted from medical records. Generic (Euro-Quality of Life Scale) and disease-specific (Seattle Angina Questionnaire) health status was obtained through interviews at baseline and one year. Results: At one year, women with acute myocardial infarction had a higher risk of death from all causes ( p<0.001), but had similar rates of major adverse cardiac events ( p=0.2). Women had lower mean generic (Euro-Quality of Life Scale utility index score: 0.90±0.13 vs 0.94±0.11) and disease specific health scores indicating poorer functioning (Seattle Angina Questionnaire summary score: 75.3±11.4 vs 78.4±9.7) and higher rates of daily/weekly angina (Seattle Angina Questionnaire angina frequency score ⩽60 vs >60: 9.1% vs 4.7%; all p<0.001). In multivariable analysis, there was a significant association between female sex and mortality (β=0.45, standard error=0.21, p=0.03) but not for major adverse cardiac events (β=−0.02, standard error=0.14, p=0.89). The association between female sex and worse generic health status persisted (β=−0.02, standard error=0.01, p=0.003), but was no longer significant between sexes for disease-specific health status (β=−0.82, standard error=0.58, p=0.154) or daily/weekly angina (odds ratio=1.39; 95% confidence interval 0.88–2.21). Conclusion: Women in China have higher crude rates of all-cause/cardiovascular death versus men, as well as worse generic/disease specific health status at one-year post-acute myocardial infarction. The association between female sex and worse generic health status persisted following adjustment.
A single case experimental design: how do different psychological outcome measures capture the experience of a client undergoing CBT for chronic pain
Authors: Jones Steve , Hurrell Ellie 
Published: October 2018

Introduction: Reports suggest that many people who experience chronic pain also experience associated mental health difficulties. Currently the first line psychotherapeutic intervention for people who experience anxiety and depression within the context of chronic pain is Cognitive Behaviour Therapy. Anecdotal clinical reports suggest that commonly used psychological outcome measures do not truly reflect the experience and improvement of clients who experience chronic pain following CBT. The present study therefore aimed to compare the outcomes of a CBT intervention within one client’s journey through CBT. Methods: A single case experimental design (SCED) was used to evaluate generic measures of mood, pain specific measures of wellbeing and client specific cognitions. Results: All outcome measures suggested that the CBT intervention had been at least somewhat successful. Results suggest that the more specific the measure was to the client’s experience; the more improvement was demonstrated on the measure.
Histologic retrieval rate of a newly designed side‐bevelled 20G needle for EUS‐guided tissue acquisition of solid pancreatic lesions
Authors: Armellini Elia , Manfrin Erminia , Trisolini Elena , Andorno Silvano , Ballarè Marco , Bernardoni Laura , Boldorini Renzo Luciano , Gabbrielli Armando , Frulloni Luca , Larghi Alberto , Occhipinti Pietro , Scarpa Aldo , Crinò Stefano Francesco 
Published: October 2018

BackgroundInnovative approaches to improve diagnostic yield of endoscopic ultrasound‐guided tissue acquisition (EUS‐TA) have focused on needle design with development of fine‐needle biopsy (FNB) needles with microcore‐acquisition technology. Recently, a 20‐gauge (20G) antegrade‐cutting‐side‐bevelled biopsy needle (ProCore®) was developed for EUS‐TA, but data about its diagnostic performance and histological capability are scant.ObjectivesWe assessed the diagnostic performance and histologic retrieval rate of a new 20G antegrade‐cutting‐side‐bevelled biopsy needle compared with a 22G reverse‐side‐bevelled needle for EUS sampling of solid pancreatic lesions.Patients and methodsA retrospective analysis of 238 consecutively collected patients who underwent EUS‐TA using a 20G or a 22G ProCore® needle, without rapid on‐site evaluation (ROSE), was conducted at two centres.Sensitivity, specificity, positive predictive value and negative predictive value were calculated. Histologic tissue retrieval was evaluated applying a scoring system for each case.ResultsSensitivity and specificity were estimated as 98.4–100% in the 20G‐, and 94.9–100% in the 22G‐needle groups, respectively (p > 0.99). The 20G procured more histologic‐grade tissues (92.6% vs 49.5%, p < 0.0001) achieved by a lower number of passes (2.64 vs 3.44, p < 0.0001) compared to the 22G.ConclusionsBoth side‐bevelled FNB needles achieved a high diagnostic sensitivity. The 20G‐side‐bevelled needle obtained a significantly higher microcore retrieval rate.
Validity of patient-reported complications after total hip and knee arthroplasty
Authors: Dang Kinh Luan Thanh , Badge Helen , Harris Ian A 
Published: October 2018

Background: Evaluating the effectiveness of total hip arthroplasty (THA) and total knee arthroplasty (TKA) often relies on accurate patient reporting of postoperative complications. Despite this, there is little research regarding the accuracy of patient reports. We aimed to determine the accuracy of patient-reported significant complications after THA and TKA. Methods: Patients were recruited prior to undergoing primary hip or knee arthroplasty at 19 high-volume hospitals. After surgery, follow-up of patients via telephone interviews at 35, 90 and 365 days recorded surgical outcomes including readmission, reoperation and venous thromboembolism (VTE). Patient-reported complications were verified via medical record audits and liaison with surgeons, general practitioners or other health professionals. Surgical and demographic information and patient-reported and verified complications were entered into a database. Patient-reported and verified complications were compared for readmission, reoperation and VTE. Results: The sample included 150 of 1811 patients who reported a total of 242 significant complications. Of the 242 patient-reported complications, 224 (92.6%) were correct (true positive). The type of complication had variable levels of accuracy in patient reports. Readmission to hospital was accurately reported by 90.2% (129/143) of patients. Reoperation (including any manipulations under anaesthesia, joint washouts, reductions of dislocated joints and revisions) was accurately reported by 98.7% (75/76) of patients. VTE was accurately reported by 86.7% (20/23) of patients. Conclusion: A high level of accuracy in patient-reported experience of complications was demonstrated following THA and TKA. Patient-reported complications may be reliably used for post-operative surveillance of joint replacement surgery.