bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tocilizumab as salvage treatment of refractory pulmonary acute graft-versus-host disease
Authors: Melgarejo-Ortuño Alejandra , Escudero-Vilaplana Vicente , Revuelta-Herrero Jose Luis , Bailen Rebeca , Collado-Borrell Roberto , Gomez-Centurión Ignacio , Oarbeascoa Guillen , Kwon Mi , Herranz-Alonso Ana , Diez-Martin Jose Luis , Sanjurjo-Saez Maria 
Published: August 2020

Introduction Acute graft-versus-host disease GVHD (aGVHD) is the main complication during the first months after bone transplantation. Steroid therapy is clearly the upfront established treatment for aGVHD. However, there are patients with partial response to steroid treatment and steroid-refractory cases. For those patients, a vast number of therapeutic options have emerged, although the evidence is scarce. Case report We report the use of tocilizumab as salvage treatment in a patient with corticosteroid refractory pulmonary aGVHD that was admitted to the critical care unit for respiratory support measures. Management & outcome We decided to use tocilizumab as rescue treatment, after failure of corticosteroid treatment, standard treatment with broad-spectrum antibiotics and etanercept. The patient showed a remarkable clinical improvement two days after first infusion and a total resolution of the symptomatology with normalization of the spirometry tests after 4 weeks of the administration of tocilizumab. Discussion To the authors' knowledge, this is the first case that describes the effective and safe use of tocilizumab as a rescue treatment in a patient with steroid-refractory pulmonary aGVHD. It showed a rapid onset of action and a favorable safety profile, which could make it an interesting option for the treatment of this potentially fatal complication.
Truck Drivers’ Cigarette Smoking and Preferred Smoking Cessation Methods
Authors: Kagabo Robert , Thiese Matthew S. , Eden Emilee , Thatcher Andria Colvin , Gonzalez Melissa , Okuyemi Kolawole 
Published: August 2020

Introduction: Some studies show that truck drivers use tobacco and other stimulants to stay awake as they drive. Despite their increased risks for many of tobacco-related health disparities, there is limited engagement of truck drivers in smoking cessation programs. The objective of this study was to describe smoking characteristics and identify their preferred smoking cessation methods among truck drivers. Methods: This was a cross-sectional mixed methods study. Participants were truck drivers recruited at trucking companies in Utah in 2019. Participants were either individually interviewed (n = 4), or filled out a survey (n = 33). We conducted qualitative data analysis of the interviews followed by descriptive statistics of smoking and cessation characteristics from the survey. Results: Reasons for smoking included, staying awake, stress reduction, or something to do while driving. Of the drivers surveyed, 68.8% were daily smokers while 97% had smoked at least 100 cigarettes in their life time. The mean number of cigarettes per day (cpd) was 15.7, and 25 among those who had 10 or more cpd. Sixty-one percent had made at least a quit attempt. In addition to counseling or brief advice, 68% reported interest in using Nicotine Replacement Therapy (NRT) either as gum or patch to help them quit. 21% reported interest in telephone text messaging to engage them in treatment. Conclusion: Cigarette smoking is a public health problem among truck drivers. Our findings suggest that truck drivers are interested in quitting smoking. Evidence based interventions tailored to this population are needed to help them quit and reduce their smoking-related morbidity.
The Norwegian remote intervention programme for problem gambling: Short- and long-term outcomes
Authors: Erevik Eilin K , Pallesen Ståle , Mohn Mette , Aspeland Trond , Vedaa Øystein , Torsheim Torbjørn 
Published: August 2020

Background and aim: Although problem gambling typically involves substantial distress, few seek face-to-face treatment. In Norway, problem gamblers can participate in a governmental supported internet- and telephone-based intervention programme. The current study aimed to evaluate the outcomes of this programme in terms of gambling behaviour, gambling-related cognitions and mental health in a one group pre-test post-test design with a follow-up assessment. Methods: The sample consisted of the 67 participants who completed the intervention programme within a one-year timeframe. Gambling behaviour (SOGS-R), gambling-related cognitions (GBQ) and mental health (SCL-90-R) were measured pre-intervention, post-intervention and at a 6−12 months follow-up. A total of 25 (37.3%) participants completed the follow-up assessment. T-tests were conducted to investigate development in gambling behaviour, gambling-related cognitions and mental health from pre-intervention to post-intervention and follow-up. Results: The analyses showed a significant reduction in gambling behaviour, gambling problems, gambling-related cognitive distortions and mental health symptoms from pre-intervention to post-intervention and follow-up. The corresponding effect sizes for the reductions in gambling and gambling-related cognitive distortions were very large, while the effect sizes for the reductions in mental distress were moderate. Conclusion: The internet/telephone programme appears to have several positive outcomes including reduction in gambling behaviour, gambling problems, gambling-related cognitive distortions and symptoms of mental disorders both in the short and long term. Another positive outcome of participation appears to be a lowered threshold for seeking additional treatment. The current study entails, however, important limitations, and future studies should investigate the outcomes of the programme while including a control group.
Voting Lines, Equal Treatment, and Early Voting Check-In Times in Florida
Authors: Cottrell David , Herron Michael C. , Smith Daniel A. 
Published: August 2020

AbstractLines at the polls raise the cost of voting and can precipitate unequal treatment of voters. Research on voting lines is nonetheless hampered by a fundamental measurement problem: little is known about the distribution of time voters spend in line prior to casting ballots. We argue that early, in-person voter check-in times allow us identify individuals who waited in line to vote. Drawing on election administrative records from two General Elections in Florida—1,031,179 check-ins from 2012 and 1,846,845 from 2016—we find that minority voters incurred disproportionately long wait times in 2012 and that in-person voters who waited excessively in 2012 had a slightly lower probability—approximately one percent—of turning out to vote in 2016, ceteris paribus. These individuals also had slightly lower turnout probabilities in the 2014 Midterm Election, ceteris paribus. Our results draw attention to the ongoing importance of the administrative features of elections that influence the cost of voting and ultimately the extent to which voters are treated equally.
Penetrating Abdominal Aortic Injury: Comparison of ACS-Verified Level-I and II Trauma Centers
Authors: Sheehan Brian Matthew , Grigorian Areg , Maithel Shelley , Borazjani Boris , Fujitani Roy M. , Kabutey Nii-Kabu , Lekawa Michael , Nahmias Jeffry 
Published: August 2020

Objectives: Penetrating abdominal aortic injury (PAAI) is a highly acute injury requiring prompt surgical management. When compared to surgeons at level-II trauma centers, surgeons at level-I trauma centers are more likely to take in-house call, and may more often be available within 15 minutes of patient arrival. Thus, we hypothesized that level-I trauma centers would have a lower mortality rate than level-II trauma centers in patients with PAAI. Methods: We queried the Trauma Quality Improvement Program database for patients with PAAI, and compared patients treated at American College of Surgeons (ACS)-verified level-I centers to those treated at ACS level-II centers. Results: PAAI was identified in 292 patients treated at level-I centers and 86 patients treated at level-II centers. Patients treated at the 2 center types had similar median age, injury severity scores and prevalence of diabetes, hypertension, and smoking (p > 0.05). There was no difference in the frequency of additional intra-abdominal vascular injuries (p > 0.05). Median time to hemorrhage control (level-I: 40.8 vs level-II: 49.2 minutes, p = 0.21) was similar between hospitals at the 2 trauma center levels. We found no difference in the total hospital length of stay or post-operative complications (p > 0.05). When controlling for covariates, we found no difference in the risk of mortality between ACS verified level-I and level-II trauma centers (OR:1.01, CI:0.28-2.64, p = 0.99). Conclusion: Though the majority of PAAIs are treated at level-I trauma centers, we found no difference in the time to hemorrhage control, or the risk of mortality in those treated at level-I centers when compared to those treated at level-II trauma centers. This finding reinforces the ACS-verification process, which strives to achieve similar outcomes between level-I and level-II centers.
Identification of the most important features of knee osteoarthritis structural progressors using machine learning methods
Authors: Jamshidi Afshin , Leclercq Mickael , Labbe Aurelie , Pelletier Jean-Pierre , Abram François , Droit Arnaud , Martel-Pelletier Johanne 
Published: August 2020

Objectives: The aim was to identify the most important features of structural knee osteoarthritis (OA) progressors and classification using machine learning methods. Methods: Participants, features and outcomes were from the Osteoarthritis Initiative. Features were from baseline (1107), including articular knee tissues (135) assessed by quantitative magnetic resonance imaging (MRI). OA progressors were ascertained by four outcomes: cartilage volume loss in medial plateau at 48 and 96 months (Prop_CV_48M, 96M), Kellgren–Lawrence (KL) grade ⩾ 2 and medial joint space narrowing (JSN) ⩾ 1 at 48 months. Six feature selection models were used to identify the common features in each outcome. Six classification methods were applied to measure the accuracy of the selected features in classifying the subjects into progressors and non-progressors. Classification of the best features was done using an automatic machine learning interface and the area under the curve (AUC). To prioritize the top five features, sparse partial least square (sPLS) method was used. Results: For the classification of the best common features in each outcome, Multi-Layer Perceptron (MLP) achieved the highest AUC in Prop_CV_96M, KL and JSN (0.80, 0.88, 0.95), and Gradient Boosting Machine for Prop_CV_48M (0.70). sPLS showed the baseline top five features to predict knee OA progressors are the joint space width, mean cartilage thickness of the medial tibial plateau and sub-regions and JSN. Conclusion: In this comprehensive study using a large number of features ( n = 1107) and MRI outcomes in addition to radiological outcomes, we identified the best features and classification methods for knee OA structural progressors. Data revealed baseline X-ray and MRI-based features could predict early OA knee progressors and that MLP is the best classification method.
Head-to-Head Comparison of Social Network Assessments in Stroke Survivors
Authors: Prust Morgan , Halm Abby , Nedelcu Simona , Nieves Amber , Dhand Amar 
Published: August 2020

Background and Purpose: Social networks influence human health and disease through direct biological and indirect psychosocial mechanisms. They have particular importance in neurologic disease because of support, information, and healthy behavior adoption that circulate in networks. Investigations into social networks as determinants of disease risk and health outcomes have historically relied on summary indices of social support, such as the Lubben Social Network Scale–Revised (LSNS-R) or the Stroke Social Network Scale (SSNS). We compared these 2 survey tools to personal network (PERSNET) mapping tool, a novel social network survey that facilitates detailed mapping of social network structure, extraction of quantitative network structural parameters, and characterization of the demographic and health parameters of each network member. Methods: In a cohort of inpatient and outpatient stroke survivors, we administered LSNS-R, SSNS, and PERSNET in a randomized order to each patient. We used logistic regression to generate correlation matrices between LSNS-R scores, SSNS scores, and PERSNET’s network structure (eg, size and density) and composition metrics (eg, percent kin in network). We also examined the relationship between LSNS-R-derived risk of social isolation with PERSNET-derived network size. Results: We analyzed survey responses for 67 participants and found a significant correlation between LSNS-R, SSNS, and PERSNET-derived indices of network structure. We found no correlation between LSNS-R, SSNS, and PERSNET-derived metrics of network composition. Personal network mapping tool structural and compositional variables were also internally correlated. Social isolation defined by LSNS-R corresponded to a network size of <5. Conclusions: Personal network mapping tool is a valid index of social network structure, with a significant correlation to validated indices of perceived social support. Personal network mapping tool also captures a novel range of health behavioral data that have not been well characterized by previous network surveys. Therefore, PERSNET offers a comprehensive social network assessment with visualization capabilities that quantifies the social environment in a valid and unique manner.
A Retrospective Cohort Study of 45 Cases Treated With Surgery First Approach in Orthognathic Surgery and a Short Review
Authors: Singh Gaurav , Gurung Utsav Singh , Mishra Madan , Gaur Amit 
Published: August 2020

Study Design: Retrospective cohort study. Objective: The purpose of this study was to evaluate and share our experience with the surgery first approach (SFA) for correction of skeletal malocclusion. Methods: After consultation with the department of orthodontics, 45 patients with skeletal malocclusions suitable to undergo SFA were enrolled in this study (14 bimaxillary protrusion and 31 skeletal class III malocclusion). Le Fort I maxillary osteotomy, bilateral sagittal split ramus osteotomy, subapical osteotomy, and genioplasty were performed as required. After a healing period of 2 weeks, postoperative orthodontic treatment was started to achieve the final occlusion. Results: The mean duration of postoperative orthodontic treatment was 15.2 months, which is much shorter than the conventional orthodontic first approach (OFA) where presurgical orthodontic duration alone takes 12-24 months according to an individual. In the bimaxillary protrusion group, it was 18 months, which was significantly longer than for the other group ( P < .05). Conclusions: SFA offers an efficient alternative to conventional OFA with shorter total treatment duration, immediate marked improvement in facial profile, reduced biological costs, and similar operative stability. However, it comes at the cost of heightened challenges regarding case selection, accurate prediction, and surgical precision. With a joint venture between skilled and experienced surgeons and orthodontists, the outcome can be very promising.
The role of pharmacogenetics in keloid scar treatment: A literature review
Authors: Searle Tamara , Ali Faisal R , Al-Niaimi Firas 
Published: August 2020

Background: The pathophysiology of keloid scars is still not fully understood and a universally reliable effective treatment has not been identified. Pharmacogenetics explores how drug response to a particular therapy can relate to genetic variations. Purpose: To investigate how pharmacogenetics could be applied to keloid scars and the relevance of this to clinical practice. Methods: We reviewed the literature and discuss our current knowledge of pharmacogenomics in the treatment of keloid scars. A literature search was performed using the terms ‘Pharmacogenetics’, ‘Pharmacogenomics’, ‘Keloid’ and ‘Scar’. We searched the PubMed, MEDLINE and EMBASE databases to find the relevant articles. Only articles in English were chosen. The level of evidence was evaluated and selected accordingly listing the studies with the highest level of evidence first. Results: Treatments including corticosteroid injections and 5-fluorouracil can be effective in some patients, but less so in others. Polymorphisms of the glucocorticoid receptor and variants of CCL2, YAP1, miR-21-5p and NF-κβ might be responsible for different responses to treatments used in keloid scars such as 5-fluorouracil. Small molecule inhibitors might be utilised to target other implicated genes. Conclusion: Pharmacogenetics aims to produce the most efficacious patient outcomes while reducing adverse effects. Understanding the pharmacogenetics of keloid scars could lead to a new era of personalised medicine in the treatment of keloid scars. At present, there is some evidence (level 3b/4) to suggest genetic variations that are responsible to drug response in keloids, but further research in this field is required. Lay summary The varied response to similar therapeutic treatments in keloids has prompted the consideration of the role of genetic variants on response in the form of pharmacogenetics. Pharmacogenetics refers to drugs and their metabolism and action based on genetic influences. The ideal scenario would involve the selection of treatment based on the individual’s specific genetic variants to ensure maximum efficacy with minimal toxicity. Some evidence currently points to genetic variations in some keloid patients that might be of relevance to the treating clinician.
Beyond Well-being: The Quest for Wholeness and Purpose in Education
Authors: Shirley Dennis 
Published: August 2020

Purpose: This article develops a critique of contemporary understandings and practices related to well-being in education. It proposes a fuller development of wholeness and purpose that supplements and goes beyond the new well-being agenda. Design/Approach/Methods: This article draws upon a document analysis of conceptual and policy frameworks related to well-being. It builds its critique of well-being with reference to a qualitative study consisting of 222 interviews with educators in the Canadian province of Ontario with regard to their understandings of well-being. It includes references to the research and development work in the U.S., Germany, and Norway. Findings: The inclusion of well-being in policy agendas is an important step forward in the field of educational change, but this indication of progress is in danger of being reified through simplistic understandings of life satisfaction and other frameworks that evade the complexity of human development. Wholeness and purpose are concepts that include but also go beyond well-being that should be addressed by educators. Originality/Value: Most of the criticisms of the new well-being agenda in educational policies and research simply assume its status as a summum bonum for human development. This essay acknowledges the importance of well-being but expands beyond it to define wholeness and purpose as an alternative set of constructs with their own independent integrity that should not simply be subsumed into current well-being agendas.
Internationalization of Canadian Teacher Education: Teacher Candidates’ Experiences and Perspectives
Authors: Guo (郭燕) Yan , Guo (郭世宝) Shibao 
Published: August 2020

Purpose: Informed by social imaginary, Canadian exceptionalism, and social inclusion, this study explores how teacher candidates experience and interpret internationalization at home at one university in Canada. Design/Approach/Methods: Data were collected from three sources: (a) policy analyses of public documents related to internationalization in Canada and at the university; (b) a student survey on the internationalization of higher education; and (c) individual interviews with 12 teacher candidates. Eight interviewees were local, four White and four racialized minorities, and four were international. Findings: Findings indicate that most participants relate internationalization to student mobility. They present the Canadian society and themselves as open, tolerant, and accepting. Such an imaginary of Canadian exceptionalism does not necessarily coincide with everyday realities of international and racialized teacher candidates. They reported that they experienced Eurocentric curricula, different forms of exclusion, and racism. Some participants enacted agency to disrupt the dominance of White perspectives. Originality/Value: This research addresses knowledge gaps related to internationalization policy as teacher candidates’ voices are not often heard in internationalization initiatives. The study suggests that the internationalization of teacher education requires decolonization of curriculum, bridging with anti-racism education, and the internationalization of teacher educators.
Surgical Outcomes of C1-2 Posterior Stabilization in Patients With Chiari Malformation Type 1
Authors: Arslan Ali , Olguner Semih Kivanc , Acik Vedat , İstemen İsmail , Arslan Barış , Ökten Ali İhsan , Gezercan Yurdal 
Published: August 2020

Study Design: Retrospective chart review. Objectives: Chiari malformation (CM) is characterized by a downward displacement of the cerebellar tonsils through the foramen magnum. This tonsillar herniation may sometimes be accompanied by syringomyelia and/or basilar invagination (BI). In this study, we examined the surgical outcomes of patients by underwent C1-2 reduction + fixation (C1-2RF), which is a new method defined by Goel, in the literature. Methods: Between 2015 and 2018, 21 patients (mean age and duration of follow-up: 39 years and 20 months, respectively) with CM were treated with atlantoaxial fixation. We found syringomyelia in all patients and BI in 9 of them. In all cases, radiography, computed tomography, and magnetic resonance imaging were performed radiologically. C1-2RF was performed in all patients. Preoperative and postoperative clinical Japanese Orthopaedic Association scores were obtained. Syrinx size and cerebrospinal fluid flow rate were compared radiologically. Results: All patients were treated with C1-2RF. None of the patients underwent foramen magnum decompression or intervention for the syrinx. Occipital bone and subaxial spinal structures were not included in the fixation. In addition to significant clinical improvement, significant improvement in syringomyelia and cerebrospinal fluid flow rate was seen on the radiographs of all patients. Conclusions: Although posterior fossa decompression and/or duraplasty is a common treatment modality in CM, we propose that the C1-2RF method described by Goel is a radiologically and clinically effective treatment method, whether or not BI and/or syringomyelia in CM are present. This article is the first article of central and axial atlantoaxial dislocation, except for Goel’s writings in the literature.