bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge Toward Cervical Cancer and Its Determinants Among Women Aged 30-49 in Jimma Town, Southwest Ethiopia
Authors: Nigussie Tadesse , Asefa Adane , Nigusse Aderajew , Admassu Bitiya 
Published: December 2020

Background: Cervical cancer is one of the common causes of premature death and disability in women worldwide. It is preventable through vaccination, and screening for precancerous lesions and early treatment. However, screening service uptake and treatment for cervical cancer face significant challenges in low-income countries due to poor information systems. The aim of this study was to assess knowledge of cervical cancer and its determinants among women aged 30-49 years living in Jimma Town, Southwest Ethiopia. Methods: A community-based cross-sectional study was undertaken from March 20 to April 15, 2017. The data were collected using a structured interviewer-administered questionnaire and analyzed by SPSS version 21. Multivariable logistic regression anaysis was done and variables with a p-value < 0.05 were considered statistically significant. Results: Of the interviewed women, only 321(43.6%) had adequate knowledge about cervical cancer and screening. Attending secondary school or above (AOR = 2.42, 95% CI: 1.24-4.74), using modern contraceptives (AOR = 6.31, 95% CI: 2.86-13.89), knowing somebody with cervical cancer (AOR = 2.24, 95% CI: 1.35-3.71) and knowing someone screened for cervical cancer (AOR = 2.23, 95% CI: 1.30-3.80) were associated with knowledge of cervical cancer. Conclusion: Knowledge of cervical cancer is low in the current study area even if appropriate knowledge regarding the disease is important in decreasing the incidence and prevalence of cervical cancer through screening and human pappiloma virus vaccination. Increasing awereness regarding the disease and prevention strategies are the key issue.
Acute cytokine release syndrome after a first dose of pembrolizumab as second-line treatment for metastatic, programmed death-ligand 1-positive, non-small-cell lung cancer
Authors: Normand Clément V , Zender Hervé O , Staehli Dominique M , Chouiter-Djebaili Amina Faiza , John Gregor 
Published: December 2020

Introduction The use of programmed death-ligand 1 (PD-L1) checkpoint inhibitor therapy is expanding, although its adverse effects are not completely known. We report on a rare case of acute cytokine release syndrome related to pembrolizumab use in a patient with lung cancer. Case report A 79-year-old man with metastatic, PD-L1-positive, non-small-cell lung cancer developed a febrile condition associated with a systemic inflammatory response syndrome and suffered haemodynamic compromise four hours after the first intravenous administration of pembrolizumab. A thorough medical workup found no alternative cause and a grade 2 cytokine release syndrome (CRS) was diagnosed. Management and outcome: Aggressive fluid resuscitation and supportive therapy led to restitutio ad integrum. Discussion Acute CRS after the administration of a PD-L1 inhibitor is infrequent but could be a fatal condition. Supportive treatment and, if necessary, corticosteroids should be considered.
OCTA-guided navigated laser therapy for advanced macula neovascularization secondary to age related macular degeneration
Authors: Amoroso Francesca , Souied Eric H , Cohen Salomon Yves , Pedinielli Alexandre , Astroz Polina , Blanco Garavito Rocio , Capuano Vittorio , Querques Giuseppe , Miere Alexandra 
Published: December 2020

Introduction: To evaluate the effects of the Navilas system guided by optical coherence tomography angiography for advanced macular neovascularization (MNV) secondary to age-related macular degeneration (AMD). Methods: Prospective case-series including nine eyes presenting with advanced MNV with persistence of exudative signs, no longer responding to anti-VEGF therapy, best-corrected visual acuity at least of 1.3 logMar. All patients were treated with Navilas guided by overlaid optical coherence tomography angiography (OCTA) images at the site of branching large neovascular trunks. Results: Occlusion of large neovascular trunks successfully occurred in all nine included patients. OCTA analysis revealed, at 1 month follow up, MNV total area decreasing from 6.2 ± 3.1 to 2.6 ± 3.4 mm2. At 6 months follow up, mean MNV area was 3.3 ± 3.4 mm2 ( p = 0.008). Conclusion: This preliminary study showed that Navilas treatment guided by OCTA may represent an attractive therapeutic option in advanced neovascular lesions secondary to AMD.
A case of bilateral unusual retinal hemorrhages in a COVID-19 patient
Authors: Monferrer-Adsuara Clara , Castro-Navarro Verónica , González-Girón Nuria , Remolí-Sargues Lidia , Ortiz-Salvador Miguel , Montero-Hernández Javier , Cervera-Taulet Enrique 
Published: December 2020

Purpose: There have been anecdotal reports of ocular manifestations in the Coronavirus Disease 2019 (COVID-19). As the pandemic is spreading and the whole picture is yet unknown, ophthalmologists should be aware of unusual ocular presentations of COVID-19 since they could precede the development of severe respiratory distress. Methods: We report here the first case of a patient with bilateral unusual dot-blot retinal hemorrhages and retinal venous dilation who presented shortly thereafter a PCR-proven COVID-19. Case report: A 59-year-old woman presented with a 7 days history of blurred vision in both eyes. Fundus examination revealed bilateral venous stasis and dot and blot intra-retinal hemorrhages preceding the diagnosis of COVID-19 in a patient with mild respiratory symptoms that progressed within a few days to a severe respiratory distress. After 1 month of the COVID-19 treatment, fundus examination improved and fluorescein angiography demonstrated no diabetic retinopathy signs, no retinal vasculitis and no significant delay in arterial or venous filling. Conclusion: Intraretinal hemorrhages similar to those found in the retinopathy associated to blood dyscrasias could be an association with SARS-CoV-2 in the context of a coagulopathy induced by the infection.
Ventricular Assist Device Technology and Black-White Disparities on the Heart Transplant Wait List
Authors: Frech Adrianne , Tarrence Jake , Natale Ginny , Tumin Dmitry 
Published: December 2020

Introduction: Heart transplantation is the definitive treatment for end-stage heart failure. Left ventricular assist devices (LVADs) are a continually improving technology that extends life for some candidates on the heart transplant waiting list. Research Questions: Our objective is to compare Black-White differences in LVAD implantation and heart transplant outcomes during a period of technological innovation when the pulsatile flow LVAD was largely replaced by the continuous flow LVAD between 1999-2014. Design: We used transplant registry data from the United Network for Organ Sharing (N = 5,550) to identify Black and White patients with heart failure who used an LVAD as a bridge-to-transplant (BTT). Using logistic regression, we compared Black-White differences in access to newer LVAD technology and timing of implantation relative to wait listing for heart transplantation. We used competing-risks event history models to predict transplant outcomes across race, LVAD type, and timing of LVAD implantation. Results: Black and White candidates were equally likely to receive newer continuous flow LVADs, but Black candidates received LVADs later in the disease course (i.e. after transplant listing). This later timing of technological intervention contributed to poorer wait list outcomes among black transplant candidates, including lower likelihood of receiving a heart transplant and greater likelihood of being removed from the wait list due to worsening health. Discussion: Delayed LVAD implantation is more common among Black patients and is associated with poorer transplant outcomes.
Analysis of Linguistically and Culturally Tailored Initiatives in Websites of Kidney Transplant Programs in the United States Between 2013-2018
Authors: Caicedo Juan Carlos , Carbunaru Samuel , Brooks Joseph Tyler , Ortiz Christopher Chiodo , Ortiz Alejandro Chiodo , Benavides Xiomara , Niño Laura , Ortiz Jorge , Locke Jayme E. 
Published: December 2020

Introduction: Minority patients constitute the majority of the kidney transplant waiting list, yet they suffer greater difficulties in listing and longer wait times to transplantation. There is a lack of information regarding targeted efforts by transplant centers to improve transplant care for minority populations. Research Question: Our aim was to analyze all kidney transplant websites in the United States to identify changes over a 5-year period in the number of multilingual websites, reported culturally targeted initiatives, and center and provider diversity. Design: Surveys were developed to analyze center websites of all transplant programs in the United States. Those with incomplete information about their nephrology or surgical teams were excluded, resulting in 174 (73%) sites in 2013 and 185 (76%) in 2018. Results: Few websites were available in a language other than English, 6.3% in 2013 and 9.7% in 2018 (P = 0.24). Only 3 websites (1.3%) in 2013 and 7 (3.7%) in 2018 reported any evidence of a culturally targeted initiative (P = 0.23). In 2018, 35% of centers employed a Hispanic transplant physician, 77% had a transplant physician who spoke a language other than English, and 39% had a transplant physician who spoke Spanish. Discussion: Although minority patients are expected to grow in the United States, decreased access to transplantation continues to vex the transplant community. Very little progress has been made in the development of multilingual websites and culturally targeted initiatives.
Factors Influencing Emergency Department Utilization and Hospital Re-Admissions in a Predominantly Obese, Racially Diverse Urban Renal Transplant Population
Authors: Lichvar Alicia B. , Patel Alisha , Pierce Dana , Gimbar Renee Petzel , Tzvetanov Ivo , Benedetti Enrico , Campara Maya 
Published: December 2020

Introduction: Early emergency department and hospital re-admissions are common in renal transplant recipients, but data are lacking in unique populations. Study Aim: The purpose of this study was to identify patient risk factors for multiple acute care utilization events within the first year of renal transplantation. Design: This was a single-center, retrospective cohort study of adult renal transplant recipients between 9/2013-9/2016. Patients were compared across number of emergency department visits and by hospital re-admissions. Diagnoses were categorized. Univariate and multivariate logistic regression was used to assess risk for multiple acute care utilization events within the first 12 months post-transplant. Results: A total of 216 patients were analyzed and were on average 50.5 (SD 13.9) years old, redominantly Black (49.77%) with an average body mass index of 33.33 (9.8) and were recipients of deceased donor renal transplants (61.11%). A total of 105 (48.6%) patients visited the emergency epartment and 119 (55.1%) patients had a hospital readmission. Patients having a body mass index >35 kg/m2 did not differ across emergency department visit or hospitalization groups. Delayed graft function (OR 2.86, 95% CI 1.07-7.65) and previous renal transplant (OR 2.77, 95% CI 1.04-7.39) were significantly associated with multiple acute care utilizations. Discussion: Acute care utilization following renal transplantation was similar to previously reported experiences. Obesity did not impact use of acute care resources or patient outcomes. Strategies addressing potential preventable emergency visits and hospital re-dmissions should be promoted.
Identifiable Patterns of Trait, State, and Experience in Chronic Stroke Recovery
Authors: Duncan E. Susan , Shereen A. Duke , Gentimis Thanos , Small Steven L. 
Published: December 2020

Background Considerable evidence indicates that the functional connectome of the healthy human brain is highly stable, analogous to a fingerprint. Objective We investigated the stability of functional connectivity across tasks and sessions in a cohort of individuals with chronic stroke using a supervised machine learning approach. Methods Twelve individuals with chronic stroke underwent functional magnetic resonance imaging (fMRI) seven times over 18 weeks. The middle 6 weeks consisted of intensive aphasia therapy. We collected fMRI data during rest and performance of 2 tasks. We calculated functional connectivity metrics for each imaging run, then applied a support vector machine to classify data on the basis of participant, task, and time point (pre- or posttherapy). Permutation testing established statistical significance. Results Whole brain functional connectivity matrices could be classified at levels significantly greater than chance on the basis of participant (87.1% accuracy; P < .0001), task (68.1% accuracy; P = .002), and time point (72.1% accuracy; P = .015). All significant effects were reproduced using only the contralesional right hemisphere; the left hemisphere revealed significant effects for participant and task, but not time point. Resting state data could also be used to classify task-based data according to subject (66.0%; P < .0001). While the strongest posttherapy changes occurred among regions outside putative language networks, connections with traditional language-associated regions were significantly more positively correlated with behavioral outcome measures, and other regions had more negative correlations and intrahemispheric connections. Conclusions Findings suggest the profound importance of considering interindividual variability when interpreting mechanisms of recovery in studies of functional connectivity in stroke.
Exploring the Impact of Home-Schooling on the Psychological Wellbeing of Irish Families During the Novel Coronavirus (COVID-19) Pandemic: A Qualitative Study Protocol
Authors: O’Sullivan Katriona , McGrane Amy , Clark Serena , Marshall Kevin 
Published: December 2020

Background: The COVID-19 pandemic has placed severe restrictions on people’s behavior worldwide with school closures in many countries. These closures have shifted education from the classroom to the home. This change is unprecedented, and home-schooling has placed substantial stress on families across the world. As of 9 April 2020, 1.57 billion children were being educated by families that had little or no experience of protracted home-schooling. An essential but neglected issue related to COVID-19 is the psychological impact of home-schooling on family wellbeing, especially considering the other stressors they are experiencing including social isolation, fears of infection, frustration, boredom, inadequate information, and financial stress. This study explores the impact of home-schooling on family psychological wellbeing during COVID-19. These findings will help develop supports and interventions for this population. Methods: An exploratory qualitative study will be conducted using semi-structured interviews with a convenience sample of families (at least one parent and one child). Participants will be recruited using social media outlets, contacts of academic members and snowball sampling. Interviews will take place using Microsoft Teams and via telephone and recorded for transcription purposes. These transcripts will be analyzed using interpretative phenomenological analysis (IPA). Ethical approval has been granted by the Social Research Ethics Subcommittee (SRESC) Maynooth University (2407411). The Science Foundation Ireland (SFI) has funded the research with the COVID-19 rapid response grant. The dissemination of findings will be through open access journal publications, distribution of lay summaries, press release and policy papers. Discussion: The research findings will discuss the impact that home-schooling has had on family psychological wellbeing. It will examine how parents are managing their children’s education and learning while handling the other stresses associated with COVID-19. A deeper understanding of the impact of school closures and home-schooling on family processes is essential if the psychological wellbeing of families is to be protected and supported during challenging times such as health-related disasters.
ATR and p-ATR are emerging prognostic biomarkers and DNA damage response targets in ovarian cancer
Authors: Feng Wenlong , Dean Dylan C. , Hornicek Francis J. , Wang Jinglu , Jia Yanyan , Duan Zhenfeng , Shi Huirong 
Published: December 2020

Background: Although ataxia-telangiectasia and Rad3 related (ATR) has an established role in the DNA damage response of various cancers, its clinical and prognostic significance in ovarian cancer remains largely unknown. The aims of this study were to assess the expression, function, and clinical prognostic relationship of ATR and phospho-ATR ser428 (p-ATR) in ovarian cancer. Methods: We confirmed ATR and p-ATR expression by immunohistochemistry (IHC) in a unique ovarian cancer tissue microarray constructed of paired primary, recurrent, and metastatic tumor tissues from 26 individual patients. ATR-specific small interfering RNA (siRNA) and ATR inhibitor VE-822 were applied to determine the effects of ATR inhibition on ovarian cancer cell proliferation, apoptosis, and DNA damage. ATR expression and the associated proteins of the ATR/Chk1 pathway in ovarian cancer cell lines were evaluated by Western blotting. The clonogenicity was also examined using clonogenic assays. A three dimensional (3D) cell culture model was performed to mimic the in vivo ovarian cancer environment to further validate the effects of ATR inhibition on ovarian cancer cells. Results: We show recurrent ovarian cancer tissues express higher levels of ATR and p-ATR than their patient-matched primary tumor counterparts. Additionally, higher expression of p-ATR correlates with decreased survival in ovarian cancer patients. Treatment of ovarian cancer cells with ATR specific siRNA or ATR inhibitor VE-822 led to significant apoptosis and inhibition of cellular proliferation, with reduced phosphorylation of Chk1 (p-Chk1), Cdc25c (p-Cdc25c), Cdc2 (p-Cdc2), and increased expression of cleaved PARP and γH2AX. Inhibition of ATR also suppressed clonogenicity and spheroid growth of ovarian cancer cells. Conclusion: Our results support the ATR and p-ATR pathway as a prognostic biomarker, and targeting the ATR machinery is an emerging therapeutic approach in the treatment of ovarian cancer.
Anthropometric Evaluation of Photographic Images Before and After Functional Nasal Surgery in Patients With Deviated Noses
Authors: Lindemann Joerg , Stupp Franziska , Scheithauer Marc , Schmadl Anna , Goldberg-Bockhorn Eva , Halbig Anna-Sophia , Hoffmann Thomas K. , Sommer Fabian 
Published: December 2020

Background Numerous techniques for correction of deviated noses have been described. Nevertheless, surgical management is challenging even for experienced rhinosurgeons. Often, a “residual deformity” after functional septorhinoplasty (SRP) due to a deviated pyramid syndrome may remain. Objective Therefore, the purpose of this study was to determine how frequent functional SRP in patients with a deviated nose results in “successful” straightening of the external nose based on standardized angle measurements. Possible influences having a positive or negative effect on the surgical success were identified. Methods Photo documentation of 607 patients with deviated noses (304 women, 303 men, median age 30 years) before and after nasal surgery were retrospectively analyzed using standardized angle measurements. The pre- and postoperative photos of the faces were anthropometrically measured. The median follow-up was 6 months. Results A “straight” deviated nose (I-type) was present in 225 patients (37%), a C-shaped nose (C-type) in 382 patients (63%). More than 75% of the patients presented a facial asymmetry. Based on angle measurements alone, a total of 452 (75%) noses were straightened or postoperatively improved. 155 noses (25%) still showed a biometric deviation. The I- or C-type had no relevant influence on outcome. Conclusion A purely biometric analysis of crooked noses is difficult and its importance is limited due to commonly pre-existing facial asymmetries. The risk of a “residual deviation” after rhinoplasty in patients with deviated noses must not be underestimated. This fact should be addressed as part of the informed consent. In particular, it should be mentioned that the surgical outcome can remain well below the patient’s aesthetic expectations. Not rarely, a revision surgery may be necessary.
Reasons for initiating long-acting antipsychotics in psychiatric practice: findings from the STAR Network Depot Study
Authors: Barbui Corrado , Bertolini Federico , Bartoli Francesco , Calandra Carmela , Callegari Camilla , Carrà Giuseppe , D’Agostino Armando , Lucii Claudio , Martinotti Giovanni , Mastromo Daniele , Moretti Daniele , Monzani Emiliano , Porcellana Matteo , Prestia Davide , Ostuzzi Giovanni ,   STAR Network Investigators
Published: December 2020

Background: Long acting injectable (LAI) antipsychotics have been claimed to ensure treatment adherence and possibly reduce the daily burden of oral formulations. So far, only surveys investigating the theoretical prescribing attitudes of clinicians have been employed. On this basis, we aimed to investigate reasons for prescribing LAIs in a real-world, unselected sample of patients. Methods: The STAR Network Depot Study is an observational, multicentre study consecutively enrolling adults initiating a LAI over a 12-months period. Clinical severity was assessed with the Brief Psychiatric Rating Scale, and patient’s attitude toward medications with the Drug Attitude Inventory 10 items. Psychiatrists recorded reasons for LAI prescribing for each study participant. Responses were grouped into six non-mutually exclusive categories: aggressiveness, patient engagement, ease of drug taking, side-effects, stigma, adherence. Results: Of the 451 patients included, two-thirds suffered from chronic psychoses. Improving patient engagement with the outpatient psychiatric service was the most common reason for prescribing LAIs (almost 80% of participants), followed by increasing treatment adherence (57%), decreasing aggressiveness (54%), and improving ease of drug taking (52%). After adjusting for confounders, logistic regression analyses showed that reasons for LAI use were associated with LAI choice (e.g. first-generation LAIs for reducing aggressiveness). Conclusion: Despite the wide availability of novel LAI formulation and the emphasis on their wider use, our data suggest that the main reasons for LAI use have remained substantially unchanged over the years, focusing mostly on improving patient’s engagement. Further, clinicians follow implicit prescribing patterns when choosing LAIs, and this may generate hypotheses for future experimental studies.