bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vancomycin Prescribing Practices and Therapeutic Drug Monitoring for Critically Ill Neonatal and Pediatric Patients: A Survey of Physicians and Pharmacists in Hong Kong
Authors: Chow Twinny Cheuk Hin , Li Janice Yuen Shun , Wong Jasper Chak Ling , Poon Freddie Man Hong , Lam Hugh Simon , Lam Teddy Tai-ning , Lee Chui Ping , Ewig Celeste Lom-ying , Cheung Yin Ting 
Published: November 2020

Background: Deviations from the optimal vancomycin dosing may occur in the neonatal and pediatric population due to inconsistencies in the recommended dosing algorithms. This study aims to collect the expert opinions of clinicians who practice in the neonatal or pediatric intensive care units (NICU/PICUs) of 12 major medical centers in Hong Kong.Methods: This was a multicenter, cross-sectional study. Eligible physicians and pharmacists completed a structured questionnaire to identify the challenges they encountered when selecting the initial intermittent vancomycin dosing. They also answered questions concerning therapeutic monitoring services (TDM) for vancomycin, including the targeted trough levels for empirical vancomycin regimens administered for complicated and uncomplicated infections.Results: A total of 23 physicians and 43 pharmacists completed the survey. The top clinical parameters reported as most important for determining the initial vancomycin dosing were renal function (90.9%), post-menstrual/postnatal age (81.8%), body weight (66.7%), and suspected/documented pathogen (53.0%). Respondents reported challenges such as difficulties in determining the optimal initial dose for a targeted level (53.0%), inconsistencies between dosing references (43.9%) and a lack of clear hospital guidelines (27.3%). Half of the pharmacists (48.8%) reported that they had helped to interpret the TDM results and recommend vancomycin dose adjustments in &gt;75% of cases. For methicillin-resistant Staphylococcus aureus infection, physicians, and pharmacists reported target trough levels of ~10–15 and 15–20 mg/L, respectively. For suspected moderate/uncomplicated Gram-positive infections physicians tended to prefer a lower trough range of 5–10 mg/L, while pharmacists preferred a range of 10–15 mg/L.Conclusions: Our results demonstrate that clinicians used varying vancomycin dosing guidelines in their practices. The multidisciplinary TDM service in Hong Kong can be improved further by establishing a standardized dosing guideline and implementing a well-structured, evidence-based service protocol. Future work includes conducting drug utilization studies to evaluate real-world antimicrobial usage patterns and the impact on tangible clinical outcomes, and developing pharmacokinetic-guided dose calculator for antimicrobials in critically ill neonates and pediatric patients.
Rationale for COVID-19 Treatment by Nebulized Interferon-β-1b–Literature Review and Personal Preliminary Experience
Authors: Mary Aurélien , Hénaut Lucie , Macq Pierre Yves , Badoux Louise , Cappe Arnaud , Porée Thierry , Eckes Myriam , Dupont Hervé , Brazier Michel 
Published: November 2020

The inflammatory response to COVID-19 is specifically associated with an impaired type I interferon (IFN) response and complete blockade of IFN-β secretion. Clinically, nebulization of IFN-α-2b has been historically used in China to treat viral pneumonia associated with SARS-CoV. Very recent data show that the use of inhaled type I IFN is associated with decreased mortality in Chinese COVID-19 patients. However, IFN nebulization is currently not standard in Europe and the United States. Therefore, our group has set up a project aimed to evaluate the possibility to nebulize IFN-β-1b (a drug currently used in Europe to treat multiple sclerosis via subcutaneous injections) and to assess the safety of this new mode of administration in SARS-CoV-2 infected patients. We present here literature data that allowed us to build our hypothesis and to develop collaboration between clinical pharmacists, intensivists and nebulization engineers in order to gain first pre-clinical and clinical experience of IFN-β-1b nebulization. After validation of the nebulization method and verification of droplet size compatible with nebulization, the method has been applied to four intensive care patients treated at our university hospital, for whom none of the COVID-19 therapies initially used in France led to significant clinical improvement. All patients exhibited negative viral carriage and experienced clinical improvement 7–16 days after having initiated nebulized IFN-β-1b inhalation therapy. No side effects were observed. All patients were alive within a 90-days follow-up. Although it is not possible to draw firm conclusions on treatment efficacy based on this case report, our study shows that pulmonary IFN-β-1b administration is feasible, with a good safety profile. This procedure, which presents the advantage of directly targeting the lungs and reducing the risks of systemic side effects, may represent a promising therapeutic strategy for the care of patients with severe COVID-19. However, our preliminary observation requires confirmation by randomized controlled trials.
Pathophysiological Consequences of KATP Channel Overactivity and Pharmacological Response to Glibenclamide in Skeletal Muscle of a Murine Model of Cantù Syndrome
Authors: Scala Rosa , Maqoud Fatima , Zizzo Nicola , Mele Antonietta , Camerino Giulia Maria , Zito Francesco Alfredo , Ranieri Girolamo , McClenaghan Conor , Harter Theresa M. , Nichols Colin G. , Tricarico Domenico 
Published: November 2020

Cantù syndrome (CS) arises from mutations in ABCC9 and KCNJ8 genes that lead to gain of function (GOF) of ATP-sensitive potassium (KATP) channels containing SUR2A and Kir6.1 subunits, respectively, of KATP channels. Pathological consequences of CS have been reported for cardiac and smooth muscle cells but consequences in skeletal muscle are unknown. Children with CS show muscle hypotonia and adult manifest fatigability. We analyzed muscle properties of Kir6.1[V65M] CS mice, by measurements of forelimb strength and ultrasonography of hind-limb muscles, as well as assessing KATP channel properties in native Flexor digitorum brevis (FDB) and Soleus (SOL) fibers by the patch-clamp technique in parallel with histopathological, immunohistochemical and Polymerase Chain Reaction (PCR) analysis. Forelimb strength was lower in Kir6.1wt/VM mice than in WT mice. Also, a significant enhancement of echodensity was observed in hind-limb muscles of Kir6.1wt/VM mice relative to WT, suggesting the presence of fibrous tissue. There was a higher KATP channel current amplitude in Kir6.1wt/VM FDB fibers relative to WT and a reduced response to glibenclamide. The IC50 of glibenclamide to block KATP channels in FDB fibers was 1.3 ± 0.2 × 10−7 M in WT and 1.2 ± 0.1 × 10−6 M in Kir6.1wt/VM mice, respectively; and it was 1.2 ± 0.4 × 10−7 M in SOL WT fibers but not measurable in Kir6.1wt/VM fibers. The sensitivity of the KATP channel to MgATP was not modified in Kir6.1wt/VM fibers. Histopathological/immunohistochemical analysis of SOL revealed degeneration plus regressive-necrotic lesions with regeneration, and up-regulation of Atrogin-1, MuRF1, and BNIP3 mRNA/proteins in Kir6.1wt/VM mice. Kir6.1wt/VM mutation in skeletal muscle leads to changes of the KATP channel response to glibenclamide in FDB and SOL fibers, and it is associated with histopathological and gene expression changes in slow-twitch muscle, suggesting marked atrophy and autophagy.
Does COVID-19 Impact Less on Post-stroke Aphasia? This Is Not the Case
Authors: Pisano Francesca , Giachero Alberto , Rugiero Cristian , Calati Melanie , Marangolo Paola 
Published: November 2020

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has greatly affected people’s mental health resulting in severe psychological consequences. One of the leading causes of long-term disability worldwide is aphasia. The language changes experienced by a person with aphasia (PWA) often have a sudden and long-lasting negative impact on social interaction, quality of life, and emotional wellbeing. The main aim of this study was to investigate the impact of COVID-19 on the different psychosocial dimensions which affect PWA.MethodsThis retrospective study included 73 PWA and 81 elderly matched controls. All patients were in the chronic phase. They were all discharged from rehabilitation services, which left them with different degrees of language deficits (i.e., severe vs. mild vs. moderate). All participants were administered the hospital anxiety and depression scale (HADS) through an online survey. PWA also took part in the stroke and aphasia quality of life scale questionnaire (SAQOL-39).ResultsAlthough the comparison between two different time points [one month before (T0) and one month after the lockdown (T1)] led to a significant increase in depression and anxiety symptoms in both groups (PWA vs. control), lower rates of depression and anxiety were found in PWA compared to the healthy group. Significant deterioration was also present in PWA in the communication and psychosocial scales of the SAQOL-39 test, which correlated with the observed changes in the psychological domains. Interestingly, the results were not significantly influenced by the degree of aphasia severity. Similarly, in both groups, none of the demographic variables (gender, age, and educational level) significantly affected the scores in the different subscales.ConclusionsThis evidence which, at first glance, seems to suggest that PWA have been partially spared from the impact of COVID-19, actually masks a dramatic situation that has always characterized this population. Indeed, given that PWA already live in a state of social isolation and emotional instability, these conditions might have, paradoxically, limited the effects of the coronavirus. However, as our results showed a deterioration in the emotional state and communication skills of our patients, possible solutions are discussed in order to prevent further decline of their cognitive abilities.
Effects of COVID-19 Infection Control Measures on Appointment Cancelation in an Italian Outpatient Memory Clinic
Authors: Spalletta Gianfranco , Porcari Desirée Estela , Banaj Nerisa , Ciullo Valentina , Palmer Katie 
Published: November 2020

Background: In the first wave of the COVID-19 pandemic in 2020, many countries made changes to the routine management of patients with non-communicable diseases, including neurocognitive disorders. Therefore, many “so-called” non-urgent elective procedures and outpatient appointments have been canceled or postponed, possibly impacting negatively on health and well-being of patients in the short- and long-term.Aim: Here, we aimed at describing numbers and types of outpatient appointments canceled as a result of government's restrictive measures in our memory clinic.Methods: The scheduled appointments at the memory clinic of the Santa Lucia Foundation IRCCS, Rome, Italy, are recorded in a comprehensive dataset under strict administrative control. Here, we compared appointments (first-time and follow-up) that were canceled from January to April 2020 with those of the corresponding months in 2019.Results: We observed a substantial decrease in appointments during 2020. The majority of scheduled appointments were follow-up, and about a quarter were first-time appointments. We estimated that 66.7% and 77.4% of patients missed out respectively their first and follow-up appointments in our memory clinic due to government's restrictive measures in March–April 2020.Conclusions: A large number of patients with neurocognitive disorders missed crucial appointments due to government's restrictive measures, and many experienced a delay in initial diagnosis and initiation of treatment. This has relevant impact on their treatment and consequently has (is still having and potentially will have) an increase on the healthcare service burden of clinics. Furthermore, as a second wave of COVID-19 affects Europe, and with winter approaching, it is a compelling priority to ensure easy and rapid access to appropriate assessment, care and treatment in the event of a new outbreak and potential subsequent lockdowns, with particular attention to the development of specific healthcare technologies customized to older persons with cognitive impairment.
Prediction of Epidemics Trend of COVID-19 in Bangladesh
Authors: Hassan Raguib , Dosar Abu Sayem , Mondol Joytu Kumar , Khan Tahmid Hassan , Noman Abdullah Al , Sayem Mirajus Salehin , Hasan Moinul , Juyena Nasrin Sultana 
Published: November 2020

Background: Amid a critical and emergent situation like the coronavirus disease (COVID-19) pandemic related to extreme health and economic repercussions, we used and presented the mathematical modeling like susceptible–infectious–recovered (SIR) to have a numerical demonstration that can shed light to decide the fate of the scourge in Bangladesh. To describe the idea about the factors influencing the outbreak data, we presented the current situation of the COVID-19 outbreak with graphical trends.Methods: Primary data were collected and analyzed by using a pre-created Google Survey form having a pre-set questionnaire on the social distancing status of different districts. Secondary data on the total and the daily number of laboratory tests, confirmed positive cases, and death cases were extracted from the publicly available sources to make predictions. We estimated the basic reproduction number (R◦) based on the SIR mathematical model and predicted the probable fate of this pandemic in Bangladesh.Results: Quarantine situations in different regions of Bangladesh were evaluated and presented. We also provided tentative forecasts until 31 May 2020 and found that the predicted curve followed the actual curve approximately. Estimated R◦-values (6.924) indicated that infection rate would be greater than the recovery rate. Furthermore, by calibrating the parameters of the SIR model to fit the reported data, we assume the ultimate ending of the pandemic in Bangladesh by December 2022.Conclusion: We hope that the results of our analysis could contribute to the elucidation of critical aspects of this outbreak and help the concerned authority toward decision making.
Lost in Transition: Health Care Experiences of Adults Born Very Preterm—A Qualitative Approach
Authors: Perez Anna , Thiede Luise , Lüdecke Daniel , Ebenebe Chinedu Ulrich , von dem Knesebeck Olaf , Singer Dominique 
Published: November 2020

Introduction: Adults Born Very Preterm (ABP) are an underperceived but steadily increasing patient population. It has been shown that they face multiple physical, mental and emotional health problems as they age. Very little is known about their specific health care needs beyond childhood and adolescence. This article focuses on their personal perspectives: it explores how they feel embedded in established health care structures and points to health care-related barriers they face.Methods: We conducted 20 individual in-depth interviews with adults born preterm aged 20–54 years with a gestational age (GA) below 33 weeks at birth and birth weights ranging from 870–1,950 g. Qualitative content analysis of the narrative interview data was conducted to identify themes related to self-perceived health, health care satisfaction, and social well-being.Results: The majority (85%) of the study participants reported that their former prematurity is still of concern in their everyday lives as adults. The prevalence of self-reported physical (65%) and mental (45%) long-term sequelae of prematurity was high. Most participants expressed dissatisfaction with health care services regarding their former prematurity. Lack of consideration for their prematurity status by adult health care providers and the invisibility of the often subtle impairments they face were named as main barriers to receiving adequate health care. Age and burden of disease were important factors influencing participants' perception of their own health and their health care satisfaction. All participants expressed great interest in the provision of specialized, custom-tailored health-care services, taking the individual history of prematurity into account.Discussion: Adults born preterm are a patient population underperceived by the health care system. Longterm effects of very preterm birth, affecting various domains of life, may become a substantial burden of disease in a subgroup of formerly preterm individuals and should therefore be taken into consideration by adult health care providers.
Inhomogeneous in-plane distribution of preferential glide planes of β dislocations in a metamorphic InGaAs solar cell
Authors: Ogura Akio , Nogawa Shota , Kawano Masahiro , Minematsu Ryo , Kubo Koshiro , Imaizumi Mitsuru , Suzuki Hidetoshi 
Published: November 2020

Abstract
By using synchrotron X-ray diffraction, we investigated the in-plane distribution of preferential glide planes in a metamorphic InGaAs solar cell with a relatively low open-circuit voltage (V
oc) compared to other cells fabricated on the same wafer. The reciprocal-space maps revealed that the low-V
oc cell contains several domains with different preferential glide planes of β dislocations. Since fluctuations of the average β-glide plane have not been observed for high-V
oc cells, the observed inhomogeneous distribution should be related to the V
oc degradation. Understanding preferential glide-plane changes within a cell can help to improve the uniformity of cell properties over the whole wafer.
Assessment of Physicians' Perspective of Shared Decision Making in a Tertiary Care Hospital in Riyadh, Saudi Arabia
Authors: Almudaimegh Hind , Alkanhal Sarah , Alanazi Futun , Alquraishi Norah 
Published: November 2020

ABSTRACTIntroductionShared decision making is an essential component of a patient-centered healthcare system. Several studies have evaluated patients' perception of shared decision making; however, studies reporting physicians' perception of the shared decision-making process are lacking. The objective of this study was to assess physicians' perspectives on shared decision making with their patients in a tertiary care hospital in Riyadh, Saudi Arabia.MethodsThis is a cross-sectional study, in which we adopted the nine-item physician version of the shared decision-making questionnaire (SDM-Q-Doc) to assess physicians' perception of shared decision making. The questionnaire was distributed online and in hard copy form randomly to our institution's physicians.ResultsWe collected a total of 125 responses from various specialties. Means and percentage of agreement were tested, with the highest percentage of agreement ranging from 88% to 96.8%. There were significant differences between the groups regarding age and medical degree. There were no significant differences noted for sex or department.ConclusionOur findings suggest that most physicians at our institution have a positive attitude toward the process of sharing medical decisions with their patients.
Evaluation of Telomere Length in Granulosa Cells; Effects of Ketogenic and Western Diet
Authors: Doganay Songul , Budak Ozcan , Ozdemir Ayla Eren 
Published: November 2020

Objective: In this study, it was aimed to research the effects of nutrition with different diets on the telomere length of granulosa cells.
Material and Methods: In the study, 21 BALB C female rats (in each group; n = 7) were divided into three groups as the standard diet group (SD), the ketogenic diet group (KD) and the western diet group. The animals in the SD group were fed with standard mouse feed, while the KD and WD groups were fed with specially prepared diets. At the end of the experiment, a controlled superovulation stimulation protocol was applied to both ovaries. Smear preparations were ready for telomere length (GLT) and apoptotic (caspase-3) evaluations from granulosa cells taken from oocytes collected from ovaries.
Results: There was a negative correlation between GLT and body weight (r = -0.424; p = 0.056). However, this correlate was not statistically significant. At the end of the experiment, body weight was significantly higher in the WD group compared to the KD group (p<0.05). GTL value of KD group was higher compared to WD and SD groups (p = 0.000). There was a significant negative correlation between Caspase 3 activity and GLT (r = -0.594; p = 0.004). Caspase-3 H score was statistically significantly lower in the KD group compared to SD and WD groups (p <0.05).
Conclusion: As a result of the study, it was observed that diet types cause changes in GTL, and there was a negative relationship between ¨body weight and caspase-3 activity¨ and GTL. It has also been observed that low KD prevents cells from undergoing apoptosis by increasing GTL and decreasing caspase 3 activity.
KIDNEY BIOPSY – AN IMPORTANTTOOL FOR THE DIAGNOSIS, TREATMENT AND DETERMINATION OF THE PROGNOSIS OF PATIENTS WITH LUPUS NEPHRITIS
Authors: Dubovik Violetta 
Published: November 2020

Introduction. Kidney damage can vary from mild to severe and occurs in 50% -70% of patients with systemic lupus erythematosus (SLE) [4], more often develops during 2-3 years [2]. Lupus nephritis (LN) has various morphological manifestations with different clinical signs and consequences. Percutaneous kidney biopsy is the gold standard for the diagnosis of LN according to the WHO classification since 1974 [1].
The purpose. This review reveals the importance of kidney biopsy for diagnosis and prognosis.
Material and methods. Review of contemporary and foreign literary sources; techniques – description, analysis, abstracting.
Results. There are many reports of clinical using of the renal biopsy classification of LN, but the number of studies evaluating its validity is not yet sufficient. Renal biopsy of LN provides vague data, which raises serious doubts about validity and clinical use, because it can lead to serious errors during diagnosis, treatment and prognosis.
Conclusions. The molecular analysis of the bioptate will be the key to a personalized approach to drug selection in LN. The molecular characteristics of kidney damage available with LN will provide the necessary supplements to more accurately classify the disease, predict outcomes, and further use of new therapeutics.