bluuebunny/crossref_metadata_2025_split huggingface dataset:
COT-20 Clinical experience with tumor-treating fields therapy for newly diagnosed glioblastoma
Authors: Saito Norihiko , Hirai Nozomi , Sato Sho , Hiramoto Yu , Fujita Satoshi , Nakayama Haruo , Hayashi Morito , Sakurai Takatoshi , Yagihashi Akinori , Takahagi Shusaku , Iwabuchi Satoshi 
Published: November 2020

Abstract
Introduction: Tumor-treating fields (TTF) is an established modality for glioblastoma (GBM) treatment administered through the portable Optune system. The efficacy of Optune for newly diagnosed GBM was demonstrated in the EF-14 phase 3 trial. Although TTF is now included as part of initial treatment in the Japan GBM guideline, it is not yet a standard therapy because the procedures are cumbersome and may impose unnecessary psychological burdens on patients with dire prognoses. In our institution, TTF therapy has been offered as a treatment option for GBM patients since January 2018. This report summarizes our initial experience with this novel treatment.
Methods: The medical records of the first eight patients with newly diagnosed glioblastoma who underwent TTF were retrospectively reviewed.
Results: The eight patients with newly diagnosed glioblastoma treated with TTF comprised five men and three women (median age, 68 years; range 34–83 years). Nine patients were offered TTF therapy, but one declined because of the need for a shaved head. The patients continued TTF for 1–7 months, without major complications. Skin reaction was the most prevalent adverse event (n = 5). One patient could not continue TTF treatment after femoral neck fracture due to the weight of the mobile battery. One patient who did not have a helper at home received TTF treatment from a nurse visiting his home.
Conclusions: Patients should be provided with information on TTF, such as the timing of informed consent during and after chemoradiotherapy, to help them better understand this new modality and secure their consent.
Premalignant and malignant lesions of oral cavity in eastern India: a hospital-based study
Authors: Sahoo Pranab Kumar , Sarkar Sinjini , Ghosh Dipanwita , Mahata Sutapa , Pal Ranita , Mistry Tanuma , Ghosh Sushmita , Roy Asoke , Bucha Hitesh , Mandal Syamsundar , Nasare Vilas D. 
Published: November 2020

Background
Oral carcinoma and precancers are major public health challenges in India and other developing countries.

Objectives
Aim of the study was to assess the associations of demographic characteristics, addictions, chief complaints of mouth/oral and clinical diagnosis by cytology smear and punch biopsy in early detection of oral premalignant and malignant lesions. Methods Study was designed on retrospective data of case files of CDC, CNCI, Kolkata, from patients attended from January 1996 to September 2016. History was taken, histopathology and Pap smear were performed. Descriptive statistical analysis, cross-tabulation and Pearson’s Chi-square test were done.

Results
Total participants (n = 692); 110 (15.9%) having history of swallowing betel leaf, nut lime, dokta, jarda, catecheu with an average of 11 years. Three hundred twenty-five (46.9%) had multiple addiction (cigarette/bidi/tobacco/all). Ninety-eight (12.1%), 99 (12.2%) and 68 (8.4%) were addicted to cigarette, bidi and chewing tobacco, respectively. Twenty-nine participants were addicted to alcohol; 18 (2.6%) and 11 (1.5%) took country and foreign alcohol correspondingly. Clinicians thoroughly examined lips (4.1%), buccal mucosa (27.3%), gingival (2.8%), tongue (23.1%), hard and soft palate (4.9%), mouth loor (5.2%) and other parts (32.3%); diagnosed participants as normal (22.8%)/benign (23.1%)/premalignant (39.1%)/malignant (14.8%). Smears confirmed 60, 131, 42, 9 and 8 cases as carcinoma, mild, moderate, severe dysplasia and inflammation, respectively. The punch biopsy identified 11 carcinomas, two severe, two moderate and seveeen mild dysplasia’s. Chi-square test showed significant association between smear and examination (P = 0.022), diagnosis and examinations of the oral cancer patients (P = 0.0001).

Conclusion
The study provided strong evidence that betel leaf, chewing tobacco, smoking and alcohol are independent risk factors for oral cancer. Cytological smear and biopsy are cost-effective approaches for early detection.
Validation of ICD-10 Codes for Gestational and Pregestational Diabetes During Pregnancy in a Large, Public Hospital
Authors: Stanhope Kaitlyn K. , Joseph Naima T. , Platner Marissa , Hutchison Ciara , Wen Shawn , Laboe Adrienne , Labgold Katie , Jamieson Denise J. , Boulet Sheree L. 
Published: November 2020

Background:
The use of billing codes (ICD-10) to identify and track cases of gestational and pregestational diabetes during pregnancy is common in clinical quality improvement, research, and surveillance. However, specific diagnoses may be misclassified using ICD-10 codes, potentially biasing estimates. The goal of this study is to provide estimates of validation parameters (sensitivity, specificity, positive predictive value, and negative predictive value) for pregestational and gestational diabetes diagnosis using ICD-10 diagnosis codes compared with medical record abstraction at a large public hospital in Atlanta, Georgia.

Methods:
This study includes 3,654 deliveries to Emory physicians at Grady Memorial Hospital in Atlanta, Georgia, between 2016 and 2018. We linked information abstracted from the medical record to ICD-10 diagnosis codes for gestational and pregestational diabetes during the delivery hospitalization. Using the medical record as the gold standard, we calculated sensitivity, specificity, positive predictive value, and negative predictive value for each.

Results:
For both pregestational and gestational diabetes, ICD-10 codes had a high-negative predictive value (>99%, Table 3) and specificity (>99%). For pregestational diabetes, the sensitivity was 85.9% (95% CI = 78.8, 93.0) and positive predictive value 90.8% (95% CI = 85, 97). For gestational diabetes, the sensitivity was 95% (95% CI = 92, 98) and positive predictive value 86% (95% CI = 81, 90).

Conclusions:
In a large public hospital, ICD-10 codes accurately identified cases of pregestational and gestational diabetes with low numbers of false positives.
Assessing the Efficacy of Certificate of Need Laws Through Total Joint Arthroplasty
Authors: Schultz Olivia A. , Shi Lewis , Lee Michael 
Published: November 2020

ABSTRACT
Lawmakers suggest Certificate of Need (CON) laws' main goals are increasing access to healthcare, increasing quality of healthcare, and decreasing healthcare costs. This retrospective database study aims to evaluate the effectiveness of CON through analysis of total knee, hip, and shoulder arthroplasty (TKA, THA, and TSA, respectively). A review was performed using the Humana Insurance PearlDiver national database from 2007 to 2015. Access to care was approximated by the rates of total joint arthroplasty (TJA) in patients diagnosed with arthritis to the corresponding joint. The quality of care was assessed using complication rates after TJA. The total cost of TJA was approximated from average reimbursement to the healthcare facility per procedure. Patients in states without CON programs received TKA, THA, and TSA more frequently (p < .0001, p = .250, p = .019). No significant difference was found in studied complication rates between CON and non-CON states. Similarly, there was no trend found when comparing the cost of each procedure in CON versus non-CON states. These findings are consistent with other recent studies detailing the impact of CON regulation on THA and TKA. The apparent nonsuperiority of CON states in achieving their purported goals may call into question the effectiveness of additional bureaucracy and regulation, suggesting a need for further examination.
The Experiences and Evaluation of a Complex Intervention for Couples Coping With Stroke
Authors: Ramazanu Sheena , Lim Chiang Vico Chung , Valimaki Maritta 
Published: November 2020

ABSTRACT

BACKGROUND: Globally, stroke is a leading cause of death and disability. With a strong sense of filial responsibility, Asian caregivers are committed to caring for their ill family members. In response, the 3H (Head, Heart, Hands) intervention was developed and implemented in Singapore to support couples in their coping after a stroke. The purpose of this study is to explore the experiences of the participants taking part in the 3H intervention and evaluate the intervention after they had participated in it. METHODS: An interpretive descriptive design was used. Semistructured qualitative interviews were conducted with 7 patients and 7 spousal caregivers. Data were analyzed using conventional content analysis. RESULTS: The participants' experience was described as one of becoming more prepared to face the storm. The “storm” resulted from a stroke, where the participants were worried and uncertain about their future. After participating in the intervention, the couples' coping processes had improved. They coped by breaking the silence and engaging in conversations, cultivating a sense of support, and conveniently fulfilling their educational needs. It was evaluated that extending the 3H intervention for community nursing is necessary to strengthen the care transition of couples from the hospital to home. CONCLUSION: New knowledge has been gained that the 3H intervention is useful and may be implemented in a clinical context before a patient's discharge from hospital. As a result of participating in the 3H intervention, effective coping was evident where participants engaged in conversations, cultivated a sense of support, and fulfilled their educational needs. Primary healthcare professionals should pay more attention to the difficulties and needs of this group of people, provide more resources to support them, and improve their quality of life.
AIMS65 predicts prognosis of patients with duodenal ulcer bleeding; a comparison with other risk-scoring systems
Authors: Hirai Ryosuke , Shimodate Yuichi , Minami Mariko , Ishikawa Sho , Kanadani Takafumi , Takezawa Rio , Doi Akira , Nishimura Naoyuki , Mouri Hirokazu , Matsueda Kazuhiro , Yamamoto Hiroshi , Mizuno Motowo 
Published: November 2020

Background and aim
Duodenal ulcer bleeding has a higher risk of mortality than bleeding from other portions of the gastrointestinal tract. AIMS65 is an effective risk-scoring system to predict prognosis of upper gastrointestinal bleeding and can be easily calculated without endoscopic findings. In this study, we investigate the usefulness of AIMS65 to predict prognosis of patients with duodenal ulcer bleeding.

Methods
Two hundred and fifty-five patients with endoscopically diagnosed duodenal ulcer bleeding at Kurashiki Central hospital from July 2007 to June 2017 were studied. We compared AIMS65, Glasgow Blatchford score (GBS), admission Rockall, and full Rockall scoring systems for predicting in-hospital mortality by calculating area under the receiver operating characteristic curve (AUROC).

Results
In-hospital mortality due to duodenal ulcer bleeding occurred in 17 (6.7%). Scores of all scoring systems were significantly higher in patients with in-hospital mortality than in patients without it. AUROC values for predicting in-hospital mortality was 0.83 in AIMS65, 0.74 in GBS, 0.76 in admission Rockall score, and 0.82 in full Rockall score, a statistically insignificant difference among the systems. In AIMS65, score more than or equal to 2 was an optimal value to predict in-hospital mortality, with sensitivities of 88.2% and specificities of 59.7%, respectively.

Conclusions
AIMS65 predicted in-hospital mortality of patients with duodenal ulcer bleeding as accurately as did other scoring systems. Given its simplicity of calculation, AIMS65 may be a more clinically practical system in the management of bleeding duodenal ulcer patients.
Pre-hospitalization proton pump inhibitor use and clinical outcomes in COVID-19
Authors: Ramachandran Preethi , Perisetti Abhilash , Gajendran Mahesh , Jean-Louis Farla , Bansal Pardeep , Dwivedi Alok Kumar , Goyal Hemant 
Published: November 2020

Introduction
Severe acute respiratory syndrome coronavirus-2 may escape the inactivation by gastric acid because of hypochlorhydria caused by proton pump inhibitors (PPIs), which could predispose the patients to severe COVID-19.

Methods
We studied the association between prehospitalization PPI exposure and clinical outcomes among hospitalized COVID-19 patients.

Results
A total of 295 hospitalized COVID-19 patients were included in the study. 15.6% of hospitalized COVID-19 patients were on PPIs at home. Mortality among PPI-users was 2.3 times higher than non-users, along with 2.3 times higher risk of acute respiratory distress syndrome after adjusting for confounding variables.

Conclusion
We found that prehospitalization PPI-exposure is independently associated with worse clinical outcomes, including mortality in COVID-19 patients, regardless of the presence of cardiovascular comorbidities.
Assessment of the mass casualty triage during the November 2015 Paris area terrorist attacks: towards a simple triage rule
Authors: James Arthur , Yordanov Youri , Ausset Sylvain , Langlois Matthieu , Tourtier Jean-Pierre , Carli Pierre , Riou Bruno , Raux Mathieu 
Published: November 2020

Backround
Triage is key in the management of mass casualty incidents.

Objective
The objective of this study was to assess the prehospital triage performed during the 2015 Paris area terrorist attack.

Design setting and participant
This was a retrospective cohort study that included all casualties of the attacks on 13 November 2015 in Paris area, France, that were admitted alive at the hospital within the first 24 h after the events. Patients were triaged as absolute emergency or relative emergency by a prehospital physician or nurse. This triage was then compared to the one of an expert panel that had retrospectively access to all prehospital and hospital files.

Outcomes measures and analysis
The primary endpoints were the rate of overtriage and undertriage, defined as number of patients misclassified in one triage category, divided by the total number of patients in this triage category.

Main result
Among 337 casualties admitted to the hospital, 262 (78%) were triaged during prehospital care, with, respectively, 74 (28%) and 188 (72%) as absolute and relative emergencies. Among these casualties, the expert panel classified 96 (37%) patients as absolute emergencies and 166 (63%) as relative emergency. The rate of undertriage and overtriage was 36% [95% confidence interval (CI), 27–47%] and 8% (95% CI, 4–13%), respectively. Among undertriaged casualties, 8 (23%) were considered as being severely undertriaged. Among overtriaged casualties, 10 (77%) were considered as being severely overtriaged.

Conclusion
A simple prehospital triage for trauma casualties during the 13 November terrorist attack in Paris could have been performed triaged in 78% of casualties that were admitted to the hospital, with a 36% rate of undertriage and 8% of overtriage. Qualitative analysis of undertriage and overtriage indicate some possibilities for further improvement.
Radium-223 therapy for metastatic castration-resistant prostate cancer: survival benefit when used earlier in the treatment pathway
Authors: Jarvis Peter , Ho Adrian , Sundram Francis 
Published: November 2020

Background
Radium-223 dichloride (Ra-223) therapy improves overall survival in bony metastatic castration-resistant prostate cancer (mCRPC) patients. Recent guidance change recommends Ra-223 following at least two prior therapies for mCRPC. We evaluated how this change affects overall survival and the optimal timing of Ra-223 in the mCRPC treatment pathway.

Methods
Retrospective analysis of all mCRPC patients receiving Ra-223 therapy at a single UK centre over a 70-month period. Overall survival, number of prior lines of therapy commenced before Ra-223 initiation and number of Ra-223 therapy cycles completed were identified.

Results
One hundred ninety-one mCRPC patients received Ra-223 therapy during the study period. One hundred twenty-one (63%) received one prior therapy (group 1) and 70 (37%) received two prior therapies (group 2). Median survival in group 1 was significantly improved, compared to group 2 (448 days vs. 341 days (P = 0.03). Subgroup analysis of 111/191 (58%) patients that completed the recommended six Ra-223 therapy cycles showed additional improved survival. Median survival in group 1 was incrementally significantly improved, compared to group 2 within these patients (665 days vs. 552 days; P = 0.05). There was no difference in the number of patients completing the recommenced six cycles of therapy between the groups [72/121 (59%) vs. 39/70 (56%); P = 0.61].

Conclusion
We found a significant survival benefit when Ra-223 was used earlier in the mCRPC treatment pathway, with additional survival advantage seen in those patients completing all six Ra-223 cycles. Our results support the use of Ra-223 earlier in the treatment pathway.
Health Professionals’ Views on Lifestyle Advice Delivery to Teenage and Young Adult Cancer Patients
Authors: Pugh Gemma , Petrella Anika , Pabary Akshay , Cross Aaron , Hough Rachael , Soanes Louise , Sabiston Catherine , Fisher Abigail 
Published: November 2020

Background
Many health professionals working with teenage and young adult cancer patients (TYA-HPs) do not provide advice on physical activity, dietary intake, smoking cessation, and alcohol consumption as part of routine cancer care.

Objective
The aim of this study was to understand TYA-HPs’ perspectives on the provision of health behavior advice and preferences on an intervention to help develop their health promotion skills.

Methods
In-depth, semistructured interviews were conducted with 26 TYA-HPs (12 nurses, 8 clinicians, and 6 allied health professionals) whose average time working with teenage and young adult (TYA) cancer patients was 8 years. Each interview followed the same semistructured guide, which was based upon constructs of the COM-B model of behavior change (capability, physical opportunity, social opportunity, reflective motivation, and automatic motivation), transcribed verbatim, and analyzed using the Framework analysis.

Results
Overall, TYA-HPs recognized the value and importance of promoting health behaviors but felt that their capability to provide health behavior advice was limited by the availability of, and access to, good-quality evidence linking health behavior to cancer outcomes. The TYA-HPs expressed confusion over professional responsibility to provide choices.

Conclusions
The TYA-HPs recognize health behavior promotion to be a core part of TYA cancer care but feel ill-equipped to provide such advice to patients.

Implications for practice
Mapped to constructs of the COM-B model of behavior, these findings suggest that TYA-HPs would benefit from cross–multidisciplinary team support for improved access to TYA-specific resources covering key health behaviors and skills-based training on delivering lifestyle advice.
Magnetic Resonance Imaging of the Brain in the Pediatric Emergency Department
Authors: Lee-Jayaram Jannet J. , Goerner Lee N. , Yamamoto Loren G. 
Published: November 2020

AbstractEmergent imaging of the brain is often required to diagnose and manage serious and life-threatening conditions for children presenting to the emergency department. In an effort to reduce children's exposure to ionizing radiation, the use of magnetic resonance imaging (MRI) as an alternative to computed tomography (CT) is increasing. In some conditions, an urgent MRI rather than CT is critical for making management decisions. The purpose of this review is to highlight 3 emergency medical conditions—acute stroke, traumatic brain injury, and hydrocephalus—in which timely MRI of the brain is required for diagnosis and management. Another aim will be to guide providers in determining when and what limited MRI sequences of the brain can be used in lieu of CT in these emergency medical conditions.
The utility of olfactory function in distinguishing early-stage Alzheimer's disease from HIV-associated neurocognitive disorders
Authors: Sundermann Erin E. , Fields Adam , Saloner Rowan , Gouaux Ben , Bharti Ajay , Murphy Claire , Moore David J. 
Published: November 2020

Objectives:
Given the rising number of older people with HIV (PWH) and the overlap in cognitive dysfunction profiles in HIV-associated neurocognitive disorders (HAND) and Alzheimer's disease and its precursor, amnestic mild cognitive impairment (aMCI), methods are needed to distinguish aMCI/Alzheimer's disease from HAND. As an early indicator of Alzheimer's disease, we examined whether olfactory dysfunction could help to distinguish between aMCI/Alzheimer's disease and HAND among PWH.

Design:
An observational cohort study.

Methods:
Eighty-one older (≥50 years) PWH (83% men, 65% white) from the California NeuroAIDS Tissue Consortium completed the University of Pennsylvania Smell Identification Test (UPSIT; higher scores = better smell identification) and a comprehensive seven-domain neuropsychological test battery and neuromedical evaluation. HAND was classified via Frascati criteria. High aMCI risk was defined as impairment (>1.0 SD below normative mean) on two of four delayed recall or recognition outcomes (at least one recognition impairment required) from the Hopkins Verbal Learning Test-Revised and the Brief Visuospatial Memory Test-Revised. We examined UPSIT scores in relation to aMCI risk and HAND status, and continuous memory scores considering adjustments for demographics and relevant clinical or HIV disease characteristics.

Results:
Fifty-seven participants were classified with HAND (70%) and 35 participants were classified as high aMCI risk (43%). UPSIT scores were lower (worse) in the high versus low aMCI risk group [F (1,76) = 10.04, P = 0.002], but did not differ by HAND status [F (1,76) = 0.62, P = 0.43]. UPSIT scores positively correlated with all memory outcomes (Ps < 0.05).

Conclusion:
Olfactory assessments may help in detecting early aMCI/Alzheimer's disease among PWH and allow for appropriate and early disease intervention.