bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined Transcatheter Tricuspid and Pulmonary Valve Replacement
Authors: Small Adam J. , Aksoy Olcay , Levi Daniel S. , Salem Morris M. , Yang Eric H. , Aboulhosn Jamil A. 
Published: July 2020

Background: For patients with combined tricuspid and pulmonary valve disease, operative intervention carries high mortality risk. Published reports of combined transcatheter tricuspid and pulmonary valve replacement have been limited to single cases. Methods: A retrospective chart review was performed including all patients undergoing combined transcatheter tricuspid and pulmonary valve replacement at the Ahmanson/UCLA Adult Congenital Heart Disease Center. Results: Combined transcatheter tricuspid and pulmonary valve replacement was undertaken in five adult patients (median age: 46 years; range: 24-64 years). Three had congenital heart disease and two had carcinoid syndrome. Four patients had previous surgical tricuspid valve replacement and one had a surgical incomplete annuloplasty ring. Four patients had previous surgical pulmonary valve replacement and one had a right ventricle-to-pulmonary artery homograft conduit. Two patients underwent Medtronic Melody valve implantation in both tricuspid and pulmonary positions and three underwent Edwards Sapien S3 implantation in both tricuspid and pulmonary positions. Valve implantation was successful in all. Follow-up ranged from 0.9 to 3.0 years. One patient underwent redo transcatheter tricuspid valve replacement 12 months after the first transcatheter intervention for progressive regurgitation of a Melody valve. This patient died 2.5 years after combined valve placement of complications from refractory heart failure. The remaining patients were alive and free of valve reintervention at follow-up. Conclusions: Combined transcatheter tricuspid and pulmonary valve replacement can be performed successfully, with an acceptable complication rate. This strategy is a feasible option for appropriately selected patients.
Visualization of the Cervicothoracic Junction With EOS Imaging Is Superior to Conventional Lateral Cervical Radiographs
Authors: Hirsch Brandon P. , Vaynrub Max , Siow Matthew , Zou Anthony , Anil Utkarsh , Montes Dennis Vasquez , Protopsaltis Themistocles S. 
Published: July 2020

Study Design: Single-center retrospective review. Objectives: The cervicothoracic junction (CTJ) is typically difficult to visualize using traditional radiographs. Whole-body stereoradiography (EOS) allows for imaging of the entire axial skeleton in a weightbearing position without parallax error and with lower radiation doses. In this study we sought to compare the visibility of the vertebra of the CTJ on lateral EOS images to that of conventional cervical lateral radiographs. Methods: Two fellowship-trained spine surgeons evaluated the images of 50 patients who had both lateral cervical radiographs and EOS images acquired within a 12-month period. The number of visible cortices of the vertebral bodies of C6-T2 were scored 0-4. Patient body mass index and the presence of spondylolisthesis >2 mm at each level was recorded. The incidence of insufficient visibility to detect spondylolisthesis at each level was also calculated for both modalities. Results: On average, there were more visible cortices with EOS versus XR at T1 and T2, whereas visible cortices were equal at C6 and C7. Patient body mass index was inversely correlated with cortical visibility on XR at T2 and on EOS at T1 and T2. There was a significant difference in the incidence of insufficient visibility to detect spondylolisthesis on EOS versus XR at C7-T1 and T1-2, but not at C6-7. Conclusions: EOS imaging is superior at imaging the vertebra of the CTJ. EOS imaging deserves further consideration as a diagnostic tool in the evaluation of patients with cervical deformity given its ability to produce high-quality images of the CTJ with less radiation exposure.
Incidence of Proximal Junctional Kyphosis With Pedicle Screws at Upper Instrumented Vertebrae in Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis
Authors: Ogura Yoji , Glassman Steven D. , Sucato Daniel , Hresko M. Timothy , Carreon Leah Y. 
Published: July 2020

Study Design: Longitudinal cohort. Objectives: Posterior spinal fusion (PSF) using all-pedicle screw constructs has become the standard procedure in the treatment of adolescent idiopathic scoliosis (AIS). However, there have been several reports that all-pedicle screw constructs or the use of pedicle screws at the upper instrumented vertebrae (UIV) increases the incidence of proximal junctional kyphosis (PJK). We aimed to evaluate the impact of instrumentation type on the incidence of PJK following PSF for AIS. Methods: We performed a stratified random sampling from 3654 patients enrolled in a multicenter database of surgically treated AIS to obtain a representative sample from all Lenke types. Patients were then allocated into 3 groups based on the instrumentation type: all-pedicle screw (PS), hook at UIV with pedicle screws distally (HT), and hybrid constructs (HB). We measured proximal junctional angle (PJA) and defined PJK as PJA ≥ 10° and PJA progression of >10° at the final follow-up. Results: Fifteen (4.3%) of 345 cases had PJK. PJK was significantly more common in PS (11%) compared with HB (1%) and HT (0%) ( P < .001). PJK patients were similar to non-PJK patients regarding age, sex, curve type, UIV, and preoperative coronal Cobb angle. Thoracic kyphosis was significantly higher in the PJK group before surgery. Patients who developed PJK had a statistically significantly larger negative sagittal balance compared with the non-PJK group. Conclusion: The incidence of PJK was 4.3% and was more common in all-pedicle screw constructs. Using hooks at UIV might be a treatment strategy to limit PJK.
Trauma-Informed Care in the Childcare and Family Placement Process: Miracle Foundation’s Approach Within Alternative Care in India
Authors: Choudhury Audria 
Published: July 2020

Trauma-informed care (TIC) is critical in institutional settings to address not only the trauma of experiences that lead children to be enrolled into alternative care, such as childcare institutions (CCIs), but also the inherent trauma that comes from a child being separated from her or his family. This article looks at how Miracle Foundation applies principles of TIC at every stage: from intake and care at a CCI while awaiting placement, to preparing children and families for transition, and finally to supporting post-placement. Following a brief background of the trauma surrounding institutional settings and its damage on children’s development drawn from existing literature, the article defines the principles of TIC: safety, choice, collaboration, trustworthiness and empowerment. The narrative then illustrates how these principles are applied with children, families and CCI staff through capacity building, access to counselling and mental health resources and dedicated guidance by Miracle team members throughout the childcare and placement process. Training government officials through a train-the-trainer model equips them to practise a strength-based approach with children and families. This also positions us for a systematic change when it comes to developing all members of the social workforce through system strengthening.
Outcomes and Complications of Open Versus Posterior Arthroscopic Subtalar Arthrodesis: A Prospective Randomized Multicenter Study
Authors: Rungprai Chamnanni , Sripanich Yantarat , Jaroenarpornwatana Aekachai 
Published: July 2020

Category: Hindfoot; Other Introduction/Purpose: There remains a controversy for treatment of subtalar joint arthritis. Both open and arthroscopic techniques have been reported for successful treatment of subtalar arthritis; however, there is a little evidence to report prospective comparative outcomes between the two techniques. The purpose of this study was to compare clinical and functional outcomes including complications between the two techniques. Methods: A prospective, randomized collected data of 54 consecutive patients who were diagnosed with isolated subtalar joint arthritis and underwent either open (27 patients) or posterior arthroscopic (27 patients) subtalar arthrodesis between 2015 and 2019 in 2 institutions. A minimum follow-up to be included in the study was 12 months (mean, 24.2 months; range, 12 to 41 months). The primary outcome was union time. The secondary outcomes included visual analogue scale (VAS), Short Form-36 (SF-36), and FAAM, union rate, time to return to activity of daily living, sports, work, and complications. Pre- and post-operative SF-36, FAAM, and pain (Visual Analog Scale) were obtained and compared between the two groups using independent t-test and the same group with paired t-test. Results: There were 54 patients (42 male and 12 female) with mean age of 43.7 years (range, 21-68 years) and mean BMI of 25.7 kg/m2 (range, 18.3-33.6 kg/m2). Both techniques demonstrated significant improvement of post-operative functional outcomes (VAS, SF-36, and VAS (<em>p</em> < 0.001 all)) compared to pre-operative period; however, there was no significant difference between the two groups. The secondary outcomes between open and arthroscopic groups were time to return to activity of daily living (8.4 vs 10.8 weeks), works (10.6 vs 12.9 weeks), sports (24.9 vs 32.7 weeks), time to union using CT scan (9.4 vs 12.8 weeks), union rate (100% versus 96.3%), and complications included painful hardware (18.5% vs 22.2%), paresthesia (0 vs 7.4%), and no infection in both groups. Conclusion: Both open and arthroscopic techniques were demonstrated significant improvement in terms of functional outcomes as measured with the FAAM, SF-36, and VAS in patients with subtalar joint arthritis. Although there was no significant difference of short-term of functional outcomes measurement and complications, arthroscopic technique was better in term of fasten recovery time and time to union.
The Effect of CAM Boots on Contact Pressures of the Ankle and Hindfoot Joints
Authors: Smyth Niall A. , Abbasi Pooyan , de Cesar Netto Cesar , Michnick Stuart M. , Casscells Nicholas , Parks Brent , Schon Lew C. 
Published: July 2020

Category: Basic Sciences/Biologics; Ankle; Hindfoot Introduction/Purpose: The tall Controlled Ankle Motion (CAM) boot and the short CAM boot are commonly used devices to immobilize the foot and ankle. However, the effect of these devices on joint contact pressures is unknown. The objective of this study is to assess the effect of the tall CAM boot and short CAM boot on contact pressures of the ankle, subtalar, talonavicular, and calcaneocuboid joints. We hypothesize that both the tall CAM boot and short CAM boot will reduce contact pressures of the ankle and hindfoot joints, with the tall CAM boot having the greatest effect. Methods: Eight lower extremity cadaver specimens were mounted on a servohydraulic test frame. The specimens were loaded to 700 N at a cyclical frequency of 1 Hz with the posterior tibial, peroneus longus, peroneus brevis, flexor hallucis longus, flexor digitorum longus, and Achilles tendon physiologically tensioned. TekScan (TekScan, Boston, MA) pressure sensors were placed in the ankle, subtalar, talonavicular, and calcaneocuboid joints. In the sagittal plane, the specimens were loaded on a neutral surface, followed by 20o of dorsiflexion. Each specimen served as its own control, with contact pressures measured with no immobilization (control), followed by placement in a short CAM boot and tall CAM boot. In addition, contact pressures in the immobilized limbs were measured at muscle loads both equal to and half of the load applied to the control in order to account for decreased muscle activation during immobilization. Results: There was no difference in the average and peak contact pressures of the ankle, subtalar, talonavicular and calcaneocuboid joints when comparing the short CAM boot to no immobilization at equal tendon loads. The tall CAM boot significantly decreased average and peak contact pressures of the ankle, subtalar, and talonavicular joints when compared to no immobilization. The tall CAM decreased the contact pressures of the talonavicular and subtalar joint to a greater degree than the ankle joint. The reduction in contact pressures was accentuated when the load applied to the tendons was decreased in accordance with diminished muscle activation during immobilization. Neither immobilization device decreased the contact pressures of the calcaneocuboid joint at equal tendon loads. Neither CAM boot changed the center of pressure of any joint. Conclusion: Immobilization in a tall CAM boot decreases contact pressures of the ankle and hindfoot in both a neutral position and in dorsiflexion. A tall CAM boot should be used clinically if the goal of its use is to maximally reduce contact pressures of the ankle and hindfoot. The tall CAM boot is better at reducing the contact pressures of the subtalar and talonavicular joint than the ankle joint.
Profile of adverse events following immunization with measles rubella vaccine at a tertiary care hospital in East Delhi, India
Authors: Bhowmik Eshita , Singh Aaradhana , Sachan Ravi 
Published: July 2020

Background: As a part of a measles and rubella (MR) campaign, the MR vaccine replaced the two-dose measles vaccine at 9–12 months and 16–24 months of age under the Universal Immunization Program (UIP). Although adverse events following immunization (AEFIs) following the measles and MMR vaccine at 9 months of age have been studied, AEFIs following the MR vaccine at 9 months of age have not been studied. As the MR vaccine a is very recent introduction in the UIP for routine immunization at 9 months of age, we intend to investigate the AEFI profile of MR vaccination at 9 months of age by active surveillance. Aim: We aimed to study the profile of the AEFIs with MR vaccine at 9-12 months of age in children vaccinated at the immunization clinic at the Pediatrics Department of a tertiary care hospital in East Delhi, India. Methods: Our study was a prospective observational study (telephonic survey). Children who attended Pediatrics OPD for the first dose of the MR vaccine at 9–12 months of age were enrolled in the study. Demographic details of the children who received the first dose of MR vaccine at 9–12 months of age at the immunization clinic of the hospital were recorded in a case record form. A telephone survey was conducted on day 7 and day 30 post-vaccination for AEFIs. Result: A total of 278 children were enrolled in the study, but 7 were unavailable for the further telephone survey. A total of 42 (15.5%) AEFIs were reported, of which 39 (94%) were in the initial 7 days and 3 (6%) were in the following 21 days following immunization. Of the AEFIs reported, the most common symptom was fever (38%), followed by upper respiratory tract infection (30.9%), local swelling at injection site (26.1%), and skin rash (4%). Conclusion: MR vaccine introduced in National Immunization Schedule is found to be safe for use in children except for a few minor reactions.
The JAK-STAT pathway regulates CD38 on myeloma cells in the bone marrow microenvironment: therapeutic implications
Authors: Ogiya Daisuke , Liu Jiye , Ohguchi Hiroto , Kurata Keiji , Samur Mehmet K. , Tai Yu-Tzu , Adamia Sophia , Ando Kiyoshi , Hideshima Teru , Anderson Kenneth C. 
Published: July 2020

AbstractAnti-CD38 monoclonal antibody (MoAb) treatments including daratumumab (DARA) are effective therapies for both newly diagnosed and relapsed multiple myeloma (MM). In this study, we examined the soluble factors that modulate CD38 expression and are associated with sensitivity to DARA-mediated antibody-dependent cellular cytotoxicity (ADCC) in the bone marrow (BM) microenvironment. Importantly, primary BM stromal cell (BMSC) culture supernatant (BMSC-sup) and interleukin-6 (IL-6) downregulated CD38 expression and reduced DARA-mediated ADCC. Both cytokine profiling of the BMSC-sup and genome-scale clustered regularly interspaced short palindromic repeats (CRISPR)–CRISPR-associated protein 9 (Cas9) knockout screening in MM cell lines identified and validated the JAK-STAT3 signaling pathway mediating CD38 downregulation, whereas the JAK-STAT1 pathway mediated CD38 upregulation. STAT3 knockdown abrogated BMSC-sup– and IL-6–induced CD38 downregulation on MM cell lines. We also confirmed that STAT3 and CD38 is negatively correlated in primary MM cells. To assess potential clinical relevance, pharmacological inhibition of the JAK-STAT pathway on BMSC-sup–induced CD38 downregulation was further examined. JAK inhibitor ruxolitinib inhibited STAT3 phosphorylation in MM cell lines, upregulated CD38 expression in MM cell lines and primary patient MM cells, and augmented DARA-mediated ADCC against MM cell lines. Taken together, our results suggest that CD38 expression on MM cells in the BM microenvironment is regulated by both STAT1 (positively) and STAT3 (negatively), and that inhibition of the JAK-STAT3 pathway represents a novel therapeutic option to enhance CD38 expression and anti-CD38 MoAb-mediated MM cytotoxicity.
Safety and efficacy of the combination of sonidegib and ruxolitinib in myelofibrosis: a phase 1b/2 dose-finding study
Authors: Gupta Vikas , Wolleschak Denise , Hasselbalch Hans , Vannucchi Alessandro Maria , Koschmieder Steffen , Cervantes Francisco , Li Yang , Dong Tuochuan , Wroclawska Monika , Bharathy Savita , Harrison Claire 
Published: July 2020

Abstract
The sonidegib and ruxolitinib combination was assessed in an open-label study in JAK inhibitor-naive patients with myelofibrosis (MF). The primary objective of phase 1b was to establish the maximum tolerated dose (MTD) and/or recommended phase 2 dose (RP2D) and phase 2 was to assess spleen volume reduction at weeks 24 and 48. Fifty patients were enrolled. In the dose-escalation phase (n = 23), doses for sonidegib once daily/ruxolitinib twice daily were 400/10 mg (level 1, n = 8), 400/15 mg (level 2, n = 10), and 400/20 mg (level 3, n = 5). Two patients had dose-limiting toxicity at level 2: increased blood creatine phosphokinase (grades 3 and 4, n = 1 each). MTD/RP2D was determined as sonidegib 400 mg daily + ruxolitinib 20 mg twice daily. In phase 1b expansion and phase 2 stage 1 (n = 27), by weeks 24 and 48, ≥35% reduction in spleen volume was observed in 44.4% and 29.6% patients, respectively. By weeks 24 and 48, 42.0% and 26.0% patients had ≥50% reduction in Myelofibrosis Symptom Assessment Form total symptom score, respectively. Most common treatment-related adverse events (grade 3/4) were increased blood creatine phosphokinase (18%), anemia (14%), and thrombocytopenia (12%). Four deaths were reported due to multiple organ dysfunction syndrome (on-treatment; no relationship with study treatment), acute myeloid leukemia, MF progression, and aspiration pneumonia. Although well tolerated, this combination will not be further developed in MF patients due to modest overall benefit compared with historical ruxolitinib monotherapy. This trial was registered at www.clinicaltrials.gov as #NCT01787552.
Reducing catheter-associated urinary tract infections: a systematic review of barriers and facilitators and strategic behavioural analysis of interventions
Authors: Atkins Lou , Sallis Anna , Chadborn Tim , Shaw Karen , Schneider Annegret , Hopkins Susan , Bunten Amanda , Michie Susan , Lorencatto Fabiana 
Published: July 2020

Abstract
Background
Reducing the need for antibiotics is crucial in addressing the global threat of antimicrobial resistance. Catheter-associated urinary tract infection (CAUTI) is one of the most frequent device-related infections that may be amenable to prevention. Interventions implemented nationally in England target behaviours related to catheter insertion, maintenance and removal, but the extent to which they target barriers to and facilitators of these behaviours is unclear.
This strategic behavioural analysis applied behavioural science frameworks to (i) identify barriers to and facilitators of behaviours that lead to CAUTI (CAUTI-related behaviours) in primary, community and secondary care and nursing homes; (ii) describe the content of nationally adopted interventions; and (iii) assess the extent to which intervention content is theoretically congruent with barriers and facilitators.

Methods
A mixed-methods, three-phased study: (1) systematic review of 25 studies to identify (i) behaviours relevant to CAUTI and (ii) barriers to and facilitators of CAUTI-related behaviours, classified using the COM-B model and Theoretical Domains Framework (TDF); (2) content analysis of nationally adopted CAUTI interventions in England identified through stakeholder consultation, classified using the Behaviour Change Wheel (BCW) and Behaviour Change Techniques Taxonomy (BCTTv1); and (3) findings from 1 and 2 were linked using matrices linking COM-B and TDF to BCW/BCTTv1 in order to signpost to intervention design and refinement.

Results
The most frequently reported barriers to and facilitators of CAUTI-related behaviours related to ‘environmental context and resources’; ‘knowledge’; ‘beliefs about consequences’; ‘social influences’; ‘memory, attention and decision processes’; and ‘social professional role and identity.’
Eleven interventions aiming to reduce CAUTI were identifed. Interventions were primarily guidelines and included on average 2.3 intervention functions (1–5) and six BCTs (2–11), most frequently ‘education’, ‘training’ and ‘enablement.’ The most frequently used BCT was ‘information about health consequences’ which was used in almost all interventions. Social professional role and identity and environmental context and resources were targeted least frequently with potentially relevant BCTs.

Conclusions
Interventions incorporated half the potentially relevant content to target identifed barriers to and facilitators of CAUTI-related behaviours. There were missed opportunities for intervention as most focus on shaping knowledge rather than addressing motivational, social and environmental influences. This study suggests that targeting motivational, social and environmental influences may lead to more effective intervention design and refinement.