bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing Meniscectomy and Meniscal Repair: A Matched Cohort Analysis Utilizing a National Insurance Database
Authors: Sochacki Kyle R. , Varshneya Kunal , Calcei Jacob G. , Safran Marc R. , Abrams Geoffrey D. , Donahue Joseph , Sherman Seth L. 
Published: July 2020

Background: Meniscal repair leads to improved patient outcomes compared with meniscectomy in small case series. Purpose: To compare the reoperation rates, 30-day complication rates, and cost differences between meniscectomy and meniscal repair in a large insurance database. Study Design: Cohort study; Level of evidence, 3. Methods: A national insurance database was queried for patients who underwent meniscectomy (Current Procedural Terminology [CPT] code 29880 or 29881) or meniscal repair (CPT code 29882 or 29883) in the outpatient setting and who had a minimum 2-year follow-up. Patients without confirmed laterality and patients who underwent concomitant ligament reconstruction were excluded. Reoperation was defined by ipsilateral knee procedure after the index surgery. The 30-day postoperative complication rates were assessed using the International Classification of Diseases, 9th Revision, Clinical Modification codes. The cost of the procedures per patient was calculated. Propensity score matching was utilized to create matched cohorts with similar characteristics. Statistical comparisons of cohort characteristics, reoperations, postoperative complications, and payments were made. All P values were reported with significance set at P < .05. Results: A total of 27,580 patients (22,064 meniscectomy and 5516 meniscal repair; mean age, 29.9 ± 15.1 years; 41.2% female) were included in this study with a mean follow-up of 45.6 ± 21.0 months. The matched groups were similar with regard to characteristics and comorbidities. There were significantly more patients who required reoperation after index meniscectomy compared with meniscal repair postoperatively (5.3% vs 2.1%; P < .001). Patients undergoing meniscectomy were also significantly more likely to undergo any ipsilateral meniscal surgery ( P < .001), meniscal transplantation ( P = .005), or total knee arthroplasty ( P = .001) postoperatively. There was a significantly higher overall 30-day complication rate after meniscal repair (1.2%) compared with meniscectomy (0.82%; P = .011). The total day-of-surgery payments was significantly higher in the repair group compared with the meniscectomy group ($7094 vs $5423; P < .001). Conclusion: Meniscal repair leads to significantly lower rates of reoperation and higher rates of early complications with a higher total cost compared with meniscectomy in a large database study.
Nurse managers’ perspectives on working with everyday ethics in long-term care
Authors: Devik Siri Andreassen , Munkeby Hilde , Finnanger Monica , Moe Aud 
Published: July 2020

Background: Nurse managers are expected to continuously ensure that ethical standards are met and to support healthcare workers’ ethical competence. Several studies have concluded that nurses across various healthcare settings lack the support needed to provide safe, compassionate and competent ethical care. Objective: The aim of this study was to explore and understand how nurse managers perceive their role in supporting their staff in conducting ethically sound care in nursing homes and home nursing care. Design and participants: Qualitative individual interviews were performed with 10 nurse managers with human resources responsibilities for healthcare workers in four nursing home wards and six home nursing care districts. Content analysis was used to analyse the data. Ethical considerations: The Norwegian Centre for Research Data granted permission for this study. Findings: The analysis resulted in seven subcategories that were grouped into three main categories: managers’ perception of the importance of the role, managers’ experiences of exercising the role and managers’ opportunities to fulfil the role. Challenges with conceptualizing ethics were highlighted, as well as lack of applicable tools or time and varying motivation among employees. Discussion: The leaders tended to perceive ethics as a ‘personal matter’ and that the need for and benefit of ethical support (e.g., ethics reflection) depended on individuals’ vulnerability, attitudes, commitment and previous experiences. The managers did not seem to distinguish between their own responsibility to support ethical competence and the responsibility of the individual employee to provide ethical care. Conclusions: Our findings suggest that nurse managers need support themselves, both to understand and to carry out their responsibilities to foster their staffs’ ethical conduct. Supporting staff in conducting ethically sound care requires more than organizing meeting places for ethical reflection; it also requires greater awareness and understanding of what ethical leadership means.
Concomitant placement of dialysis and infusion catheters in the right internal jugular vein in the intensive care setting: Is it safe?
Authors: Spitzer Blake , Kirkland Kevin , Reyes Jared , Helmer Stephen D , Ammar Chad , Subbarao Chivukula 
Published: July 2020

Purpose: This study examined the safety and efficacy of placing both a central venous dialysis catheter and a central venous catheter for infusion in the right internal jugular vein compared to only a central venous dialysis catheter. Methods: We conducted a retrospective chart review for all adult patients who underwent the placement of the right internal jugular dialysis catheter by a single surgeon. Patients were grouped based on whether they received a tunneled dual lumen dialysis catheter alone or in combination with a central venous infusion catheter in the right internal jugular vein. Catheter-related thrombosis, line infections, line malfunctions, pneumothorax, and need for line replacement were evaluated. Results: There were 97 patients in the dialysis catheter and central venous infusion line group and 63 patients in the dialysis catheter only group. The two groups were not different with regard to age (62.1 ± 16.3 years vs 57.9 ± 17.6 years) and gender (47.4% male vs 55.6% male). No significant differences were found in the incidence of thrombosis (1.0 % vs 0.0%, p > 0.999), line infection (2.1% vs 0.0%, p = 0.519), or line malfunctions (2.1% vs 0.0%, p = 0.516) in patients who did or did not have a central venous infusion catheter placed concomitantly with the dialysis catheter, respectively. No patients in either group had a pneumothorax. Conclusions: Although not currently utilized with frequency, these preliminary data indicate that placing both a dual lumen dialysis catheter and central venous infusion catheter in the right internal jugular simultaneously could be a viable option.
Onset of progressive motor impairment in patients with critical central nervous system demyelinating lesions
Authors: Kassa Roman M , Sechi Elia , Flanagan Eoin P , Kaufmann Timothy J , Kantarci Orhun H , Weinshenker Brian G , Mandrekar Jay , Schmalstieg William F , Paz Soldan M Mateo , Keegan B Mark 
Published: July 2020

Objective: To compare progressive motor impairment onset attributable to a “critical” central nervous system (CNS) demyelinating lesion in patients with highly restricted versus unlimited magnetic resonance imaging (MRI) lesion burden. Methods: We identified 135 patients with progressive motor impairment for ⩾1 year attributable to a “critical” demyelinating lesion with: MRI burden of 1 lesion (“progressive solitary sclerosis”), 2–5 lesions (“progressive paucisclerosis”), or unrestricted (>5) lesions and “progressive unilateral hemiparesis.” Neuroradiology review of brain and spinal cord MRI documented unequivocally demyelinating lesions. Results: A total of 33 (24.4%) patients had progressive solitary sclerosis; 56 (41.5%) patients had progressive paucisclerosis; and 46 (34.1%) patients had progressive unilateral hemiparesis. Median age at onset of progressive motor impairment was younger in progressive solitary sclerosis (49 years; range 24–73) and progressive paucisclerosis (50 years; range 30–64) than in progressive unilateral hemiparesis (54 years; range 39–77; p = 0.02 and p = 0.003, respectively). Within progressive unilateral hemiparesis, motor-progression onset was similar between those with 4–10, 11–20, or >20 brain lesions (55, 54, 53 years of age, respectively; p = 0.44). Conclusion: Motor-progression age is similar, but paradoxically earlier, in cohorts with highly restricted CNS lesion burden than in those with unrestricted lesion burden with progressive unilateral hemiparetic MS. The “critical” demyelinating lesion rather than total brain MRI lesion burden is the major contributor to motor-progression onset in these cohorts.
Effects of language dominance on home reading practices of bilingual families
Authors: Gonzalez-Barrero Ana Maria , Salama-Siroishka Nicholas , Dubé Daphnée , Brouillard Melanie , Byers-Heinlein Krista 
Published: July 2020

Aims and objectives: Many children grow up in bilingual families; however, little is known about how these families use their two languages in their home reading practices. The goal of this study was to examine the effect of language proficiency on the shared storybook reading practices of bilingual families. Methodology: We gathered questionnaire data about home reading activities in French–English bilingual families with 5-year-old children ( n = 66) who had different proficiency levels in each language. Data and analyses: We compared home reading environment, parent reading practices, and child learning and interest in books across the families’ dominant and non-dominant languages using a series of 2-way mixed analyses of variance. Findings: Families gave more emphasis to reading practices in the family’s dominant language: they owned more books, read more often, spent more time, and started reading to the child at an earlier age in the dominant than in the non-dominant language. Dominance also affected parent reading behaviors: parents reported more often translating words and switching from their non-dominant to their dominant language. Parents reported that children enjoyed being read to and readily learned new words in both languages, but ratings were higher for the dominant language. Effects of dominance were strongest in families with less balanced language dominance. Originality: This study compares bilingual families’ home reading practices in both of their languages, providing a clearer picture of how families navigate early dual-language literacy in a bilingual community where both languages are spoken in everyday life and have similar sociolinguistic status. Significance: Results suggest that even in bilingual communities, family home reading practices may exacerbate uneven development across children’s two languages. These findings highlight the importance of identifying strategies to support enriched home reading practices in bilingual families’ non-dominant language.
CSN COVID-19 Rapid Review Program: Management of Acute Kidney Injury
Authors: Clark Edward G. , Hiremath Swapnil , Soroka Steven D. , Wald Ron , Weir Matthew A. ,   On behalf of the CSN COVID-19 Rapid Response Team, Antonsen John , Banks Cheryl , Clark David , Copland Michael , Davison Sara N. , Goldberg Aviva , Hemmett Juliya , Kappel Joanne , MacRae Jennifer M. , Mac-Way Fabrice , Mathew Anna , McCormick Brendan , Moist Louise , Moran Sarah , Pandeya Sanjay , Qirjazi Elena , Ryz Krista , Singh Suneet , Suri Rita , Tennankore Karthik , Thanabalasingam Susan , White Christine , Zimmerman Deborah , Levin Adeera , Mustafa Reem A. , Nesrallah Gihad 
Published: July 2020

Purpose: Severe acute kidney injury (AKI) is a potential complication of COVID-19-associated critical illness. This has implications for the management of COVID-19-associated AKI and the resulting increased need for kidney replacement therapy (KRT) in the intensive care unit (ICU) and elsewhere in the hospital. The Canadian Society of Nephrology COVID-19 Rapid Review Team has sought to collate and synthesize currently available resources to inform ethically justifiable decisions. The goal is the provision of the best possible care for the largest number of patients with kidney disease while considering how best to ensure the safety of the health care team. Information sources: Local, provincial, national, and international guidance and planning documents related to the COVID-19 pandemic; guidance documents available from nephrology and critical care-related professional organizations; recent journal articles and preprints related to the COVID-19 pandemic; expert opinion from nephrologists from across Canada. Methods: A working group of kidney specialist physicians was established with representation from across Canada. Kidney physician specialists met via teleconference and exchanged e-mails to refine and agree on the proposed suggestions in this document. Key findings: (1) Nephrology programs should work with ICU programs to plan for the possibility that up to 30% or more of critically ill patients with COVID-19 admitted to ICU will require kidney replacement therapy (KRT). (2) Specific suggestions pertinent to the optimal management of AKI and KRT in patients with COVID-19. These suggestions include, but are not limited to, aspects of fluid management, KRT vascular access, and KRT modality choice. (3) We describe considerations related to ensuring adequate provision of KRT, should resources become scarce during the COVID-19 pandemic. Limitations: A systematic review or meta-analysis was not conducted. Our suggestions have not been specifically evaluated in the clinical environment. The local context, including how the provision of acute KRT is organized, may impede the implementation of many suggestions. Knowledge is advancing rapidly in the area of COVID-19 and suggestions may become outdated quickly. Implications: Given that most acute KRT related to COVID-19 is likely to be required initially in the ICU setting, close collaboration and planning between critical care and nephrology programs is required. Suggestions may be updated as newer evidence becomes available.
All-cause mortality in patients with long-term opioid therapy compared with non-opioid analgesics for chronic non-cancer pain: a database study
Authors: Häuser Winfried , Schubert Tino , Vogelmann Tobias , Maier Christoph , Fitzcharles Mary-Ann , Tölle Thomas 
Published: July 2020

Abstract
Background
Hitherto only studies with selected populations have found an increased all-cause mortality of some selected opioids compared to selected non-opioids for chronic non-cancer pain (CNCP). We have examined the all-cause mortality for CNCP associated with all established opioids compared to non-opioid analgesic therapy (anticonvulsants, antidepressants, dipyrone, non-steroidal agents).

Methods
The study used the InGef (Institute for Applied Health Research Berlin) database which is an anonymized healthcare claims database including 4,711,668 insured persons who were covered by 61 German statutory health insurances between 2013 and 2017.The health insurance companies are the owners of the database. All-cause mortality was determined from death certificates. Adjusted hazard ratios (HRs) including age, gender, comorbidity index, and propensity score as covariates and risk differences (RD) in incidence of death between patients with long-term opioid therapy (LTOT) and control-drug therapy were calculated.

Results
The mean age of participants was 66 years; 55% were women. There were 554 deaths during 10,435 person-years for the LTOT patients, whereas there were 340 deaths during 11,342 person-years in the control group. The HR for all-cause mortality was 1.59 (95% CI, 1.38–1.82) with a risk difference of 148 excess deaths (95% CI 99–198) per 10,000 person-years. The elevated risk of death for LTOT was confined to the out-of-hospital deaths: LTOT patients had 288 out-of-hospital deaths during 10,435 person-years (276 per 10,000 person-years) whereas there were 110 deaths during 11,342 person-years (97 per 10,000 person-years) in the control group. HR was 2.29 (95% CI 1.86, 2.83). Although our propensity score matching model indicated a good classification, residual confounding cannot be fully excluded. The opioid group had a higher prevalence of heart failure and a higher use of anti-thrombotic and antiplatelet agents and of psycholeptics.

Conclusions
LTOT for CNCP compared to non-opioid analgesics was associated with an increased risk for all-cause mortality. When considering treatment options for patients with CNCP, the relevant risk of increased all-cause mortality with opioids should be discussed.

Trial registration
ClinicalTrials.gov, NCT03778450, Registered on 7 December 2018
ASXL3 bridges BRD4 to BAP1 complex and governs enhancer activity in small cell lung cancer
Authors: Szczepanski Aileen Patricia , Zhao Zibo , Sosnowski Tori , Goo Young Ah , Bartom Elizabeth Thomas , Wang Lu 
Published: July 2020

AbstractBackgroundSmall cell lung cancer (SCLC) is a more aggressive subtype of lung cancer that often results in rapid tumor growth, early metastasis, and acquired therapeutic resistance. Consequently, such phenotypical characteristics of SCLC set limitations on viable procedural options, making it difficult to develop both screenings and effective treatments. In this study, we examine a novel mechanistic insight in SCLC cells that could potentially provide a more sensitive therapeutic alternative for SCLC patients.MethodsBiochemistry studies, including size exclusion chromatography, mass spectrometry, and western blot analysis, were conducted to determine the protein-protein interaction between additional sex combs-like protein 3 (ASXL3) and bromodomain-containing protein 4 (BRD4). Genomic studies, including chromatin immunoprecipitation sequencing (ChIP-seq), RNA sequencing, and genome-wide analysis, were performed in both human and mouse SCLC cells to determine the dynamic relationship between BRD4/ASXL3/BAP1 epigenetic axis in chromatin binding and its effects on transcriptional activity.ResultsWe report a critical link between BAP1 complex and BRD4, which is bridged by the physical interaction between ASXL3 and BRD4 in an SCLC subtype (SCLC-A), which expresses a high level ofASCL1. We further showed that ASXL3 functions as an adaptor protein, which directly interacts with BRD4’s extra-terminal (ET) domain via a novel BRD4 binding motif (BBM), and maintains chromatin occupancy of BRD4 to active enhancers. Genetic depletion of ASXL3 results in a genome-wide reduction of histone H3K27Ac levels and BRD4-dependent gene expression in SCLC. Pharmacologically induced inhibition with BET-specific chemical degrader (dBET6) selectively inhibits cell proliferation of a subtype of SCLC that is characterized with high expression of ASXL3.ConclusionsCollectively, this study provides a mechanistic insight into the oncogenic function of BRD4/ASXL3/BAP1 epigenetic axis at active chromatin enhancers in SCLC-A subtype, as well as a potential new therapeutic option that could become more effective in treating SCLC patients with a biomarker of ASXL3-highly expressed SCLC cells.
The lack of keratinized mucosa is associated with poor peri-implant tissue health: a cross-sectional study
Authors: Kungsadalpipob Kajorn , Supanimitkul Kakanang , Manopattanasoontorn Sukuma , Sophon Navawan , Tangsathian Teerawut , Arunyanak Sirikarn P. 
Published: July 2020

Abstract
Objectives
The aim of this cross-sectional study is to determine the association between the absence of keratinized mucosa and peri-implant tissue health.

Methods and materials
This cross-sectional study comprised 412 implants from 200 patients from faculty-based clinics. Demographic, medical, and clinical information were collected. The modified sulcus bleeding index, modified plaque index, mucosal recession, probing depth, bone level, the width of keratinized mucosa, and implant status were evaluated by three calibrated examiners. Each implant was categorized into either of two peri-implant mucosa groups: keratinized mucosa (KM) or non-keratinized mucosa (NKM). The chi-square test was performed to the association between the keratinized mucosa groups and peri-implant clinical parameters and peri-implant status. Multiple logistic regression models were analyzed to test potential associations between peri-implant clinical parameters and the presence or absence of keratinized mucosa.

Results
Thirty-two implants (7.8%) were categorized into the NKM group. The prevalence of peri-implantitis was 12.5% and 8.3% at the subject level and implant level, respectively. The NKM group was associated with more plaque accumulation, mucosal recession, interproximal bone level ≥ 3 mm, and peri-implantitis (p < 0.05). After controlling for confounding factors, the NKM group demonstrated higher plaque accumulation, mucosal recession, and interproximal bone level ≥ 3 mm with adjusted odds ratios of 2.98 (1.33–6.66), 3.20 (95% CI, 1.03–9.90), and 4.62 (1.70–12.58), respectively.

Conclusion
Within the limitation of this study, the lack of keratinized mucosa around the dental implants was significantly associated with more plaque accumulation, mucosal recession, interproximal bone level ≥ 3 mm, and peri-implantitis.
Catching up! The sexual behaviour and opinions of Italian students (2000–2017)
Authors: Minello Alessandra , Caltabiano Marcantonio , Dalla-Zuanna Gianpiero , Vignoli Daniele 
Published: July 2020

AbstractWhile sexuality has radically changed across middle–high-income societies in recent years, only outdated studies are available for Italy. We aim to provide novel insights into the sexual behaviour and opinions of young Italians diachronically and through a gendered lens. Our analysis compares the results of two national samples of university students collected in 2000 and 2017. The sexual behaviour and opinions of young men and women seem to be converging in several respects. We observed a feminisation of male opinions and behaviour within couples, which is to say that men are more likely to experience first intercourse with a young woman of roughly the same age while in a stable relationship, and betray—or accept betrayal—with less frequency and willingness than in the past. Similarly, we found a masculinisation of female opinions and behaviour outside of stable relationships, for example, an increase in occasional partners, a net drop in the expectation that other women hold virgin status before marriage, and a doubling of the acceptance of casual sex. A few gender differences remain, especially concerning sexual double standards: young men and women are still subject to diverse rules guiding their sexual behaviour. Finally, acceptance of homosexuality has risen substantially—particularly among women.
Efficiency of Indian banks with non-performing assets: evidence from two-stage network DEA
Authors: Hafsal K. , Suvvari Anandarao , Durai S. Raja Sethu 
Published: July 2020

AbstractThis paper addresses the concerns regarding the sustainability of the banking sector in India prompted by the recent unintended high level of non-performing assets (NPAs). It uncovers the linkage between NPAs and banking efficiency by integrating NPAs into the measurement of bank efficiency to provide a holistic efficiency profile of the Indian banking sector. We apply the general two-stage data envelopment analysis of Kao [16] by incorporating NPAs as an exogenous output from the first stage, and the empirical results identify an efficiency gap of 16.2% due to NPAs in the Indian banking sector for the year 2016. Further, it also documents that the efficiency gap/loss is increasing over the years and differs according to the shareholding pattern of the banks.