bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing Core Competencies for Pharmacy Graduates: The Lebanese Experience
Authors: Sacre Hala , Hallit Souheil , Hajj Aline , Zeenny Rony M. , Akel Marwan , Raad Elie , Salameh Pascale 
Published: October 2020

Background: In the absence of a national qualification framework for health professionals, the Lebanese Order of Pharmacists (OPL) took the initiative of developing a pharmacy competency framework to standardize pharmacy education in all universities. The objective of this manuscript is to describe the steps that led to the Lebanese Pharmacy Core Competencies Framework. Methods: Based on a primer developed by a group of academic instructors, following international reference documents from different parts of the world, the Academic board appointed by the OPL, reviewed, streamlined, and validated the suggested primer using the Delphi technique over three rounds, to come up with the final framework. Results: The framework encompassed competencies distributed over 7 domains: fundamental knowledge, professional practice, personal skills, supply of medications, safe and rational use of medications, pharmaceutical public health competencies, and organization and management competencies. Its structure was similar to that of the International Pharmaceutical Federation (FIP), with cultural and legal adaptations and the addition of some behaviors related to OPL specific practice and research projects. Conclusion: This work describes the elaboration of the Lebanese Pharmacy Core Competencies Framework, a project considered to be an essential step forward for the profession and a first step toward providing information on human resource planning and professional development of the pharmacy workforce. Instead of adapting existing international educational standards from resource-rich contexts, which may not meet the actual needs of Lebanon, universities can draw our findings to develop relevant programs targeting the skills needed for health workers in Lebanon.
Associations of site-specific CD4+-T-cell hypomethylation within CD40-ligand promotor and enhancer regions with disease activity of women with systemic lupus erythematosus
Authors: Vordenbäumen Stefan , Rosenbaum Anna , Gebhard Claudia , Raithel Johanna , Sokolowski Alexander , Düsing Christina , Chehab Gamal , Richter Jutta G , Brinks Ralph , Rehli Michael , Schneider Matthias 
Published: October 2020

Objective To comprehensively assess associations of site-specific CD4+-T-cell hypomethylation of the CD40-Ligand gene ( CD40L) with disease activity of women with systemic lupus erythematosus (SLE). Methods CpG-sites within the DNA of the promotor and two enhancer regions (n = 22) of CD40L were identified and numbered consecutively. The rate of methylated DNA in isolated CD4+-T-cells of women with SLE were quantified for each methylation site by MALDI-TOF. Disease activity was assessed by SLE Disease Activity Index (SLEDAI). Associations of site-specific methylation rates with the SLEDAI scores were assessed by linear regression modelling. P values were adjusted according to Bonferroni-Holm as indicated. Results 60 female SLE patients participated in the study (age 45.7 ± 11.1 years, disease duration 17.0 ± 8.3 years). Significant associations to the SLEDAI were noted for CpG22 hypomethylation of the promotor (β = −40.1, p = 0.017, adjusted p = 0.027), trends were noted for CpG17 hypomethylation of the promotor (β = −30.5, p = 0.032, adjusted p = 0.6), and for CpG11 hypermethylation of the second enhancer (β = 15.0, p = 0.046, adjusted p = 0.8). Conclusion Site-specific hypomethylation of the CD40L promotor in CD4+-T-cells show associations with disease activity in female SLE patients.
What is the value of repeat kidney biopsies in patients with lupus nephritis?
Authors: Morales Enrique , Trujillo Hernando , Bada Teresa , Alonso Marina , Gutiérrez Eduardo , Rodríguez Esther , Gutiérrez Elena , Galindo María , Praga Manuel 
Published: October 2020

Introduction Recent studies with protocol biopsies have shown a mismatch between clinical and histological remission in lupus nephritis (LN). We aimed to evaluate histological changes in repeat kidney biopsies by clinical indication in patients with LN. Methods We analyzed 107 patients with LN in which a kidney biopsy was performed between 2008 and 2018. Of those, we included 26 (24.2%) who had ≥2 kidney biopsies. Classification was done according to the International Society of Nephrology/Renal Pathology Society. Results Mean time between biopsies was 71.5 ± 10.7 months. 73.1% of patients presented a change of class at repeat biopsy; 38.4% to a higher class and 34.6% to a lower class. A significant increase in glomerulosclerosis (% GS) (3.8% vs 18.7%, p = 0.006), interstitial fibrosis (3.8% vs 26.9%, p = 0.021), tubular atrophy (15.4% vs 57.7%, p = 0.001) and chronicity index (CI) (1 vs 3, p < 0.001) was observed at repeat biopsy. Subjects who developed chronic kidney disease progression had a lower rate of complete remission at 12 months (0% vs 37.5%, p = 0.02), higher % GS at first biopsy (7.9% vs 1.2%, p = 0.02) and higher CI (4 vs 2, p = 0.006), tubular atrophy (90% vs 37.6%, p = 0.008), interstitial fibrosis (50% vs 12.5%, p = 0.036) and vascular lesions (60% vs 18.8%, p = 0.031) at second biopsy. Conclusions Our major finding was that patients with LN showed a significant increase in % GS, interstitial fibrosis, tubular atrophy and vascular lesions in repeat biopsies performed by clinical indication. This suggest that a second kidney biopsy may provide valuable and useful information regarding kidney disease progression.
Interrogating Social and Solidarity Economies Following Marxian Class Focused Approach: Evidence from India
Authors: Bhowmik Manas Ranjan 
Published: October 2020

We use a class-focused Marxian approach to examine non-capitalist firms within the Social and Solidarity Economy (SSE) sector in India and draw some theoretical conclusions from it. Cooperatives, labour supply contracts, farmer producer organisations, mutuals, peoples’ credit societies, local alternative currencies—all such initiatives are covered by the umbrella term SSE. This article focuses on generating some broad-based criteria for conceptualising and assessing the successes and failures of firms within the SSE sector; maintaining non-exploitative class processes for a considerable period of time is a good measure of the success of an enterprise within the SSE sector. To this end, three case studies—a Farmer Producer organisation (FPO), handloom weavers’ cooperatives and Timbaktu Collective—have been used to show the impact on the existing class processes and non-class processes. By methodologically following overdetermined interrelationships between SSEs, trade unions and political parties, both of the importance of actual and possible avenues of intervention by way of class and non-class struggles have been pointed out towards the end. JEL: B14, P13, P16, P32
Pharmacological interventions for preventing anthracycline-induced clinical and subclinical cardiotoxicity: A network meta-analysis of metastatic breast cancer
Authors: Ghasemi Khojasteh , Vaseghi Golnaz , Mansourian Marjan 
Published: October 2020

Objective Doxorubicin- and epirubicin-induced cardiotoxicities are life threatening for those suffering from breast cancer. Comparing the effects of different strategies on the prevention of these agent-induced cardiotoxicities remains unexplored. Data sources: A comprehensive review of clinical trials was performed on the prevention of epirubicin- and/or doxorubicin-induced cardiotoxicity in HER2-positive metastatic breast cancer patients. The reduction in ejection fraction was directed at evaluating cardiac toxicity. Data summary: Fourteen articles evaluated cardiotoxicity as a condition among 2945 individuals, evaluating doxorubicin, epirubicin, Liposomal Doxorubicin (LD), Pegylated Liposomal Doxorubicin (PLD), dexrazoxane plus doxorubicin or epirubicin, and Angiotensin-Converting Enzyme Inhibitors (ACEIs) plus doxorubicin. Pooled Odds Ratio (OR) of 0.043 with a 95% credible interval (CrI) between 0.005 and 0.22 indicated that the dexrazoxane plus epirubicin reduced the number of cardiac events compared with doxorubicin. Furthermore, doxorubicin and epirubicin represented the most effective interventions with a 52% probability of success. Also, the best treatment for reducing Congestive Heart Failure (CHF) was dexrazoxane plus epirubicin with a probability of 43%. For the Left Ventricular Ejection Fraction (LVEF) reduction outcome, ACEIs plus doxorubicin was ranked first with a success probability of 61.2% and they could significantly prevent the reduction in LVEF compared with LD, epirubicin, or doxorubicin. Conclusion Our data suggested that angiotensin-converting enzyme inhibitors and dexrazoxane plus epirubicin were the most effective interventions for preventing cardiotoxicity and CHF. However, ACEIs plus doxorubicin was the best treatment for preventing LVEF reduction.
Anterior and posterior ischemic optic neuropathy following liposuction surgery in a previously healthy young woman
Authors: Abri Aghdam Kaveh , Sadeghi Ali , Soltan Sanjari Mostafa , Aghajani Ali , Gholamalizadeh Saba 
Published: October 2020

A previously healthy 28-year-old female developed bilateral painless vision loss, more prominent in the right eye than in the left, following abdominoplasty and liposuction surgery. Laboratory studies showed severe peri- and post-operative anemia. Over a 5-month follow-up, visual function remained decreased but stable in the right eye and improved in the left eye. This is the second reported case of anterior ischemic optic neuropathy in one eye and posterior ischemic optic neuropathy in the other eye after liposuction. Level of evidence: Level VI, case report study.
Evaluation of retinochoroidal tissues in third trimester pregnants: An optical coherence tomography angiography study
Authors: Yildirim Abdulmutalip , Kurt Emin , Altinisik Muhammed , Uyar Yildiz 
Published: October 2020

Introduction: The structural and vascular changes in the retina and choroid in women in the third trimester of pregnancy were analyzed using optical coherence tomography angiography (OCTA). Methods: Forty women in the third trimester of uncomplicated pregnancy and 40 age-matched healthy women were included. Vascular density (VD) in the superficial and deep capillary plexuses (SCP/DCP), foveal density (FD), and foveal avascular zone (FAZ) area and perimetry measured with OCTA, as well as OCT measurements of central macular thickness (CMT) and choroidal thickness (CT) were compared between the groups. Correlations between structural OCT parameters and vascular OCTA metrics were analyzed. Results: The mean gestational age was 34 (28–41) weeks. Mean age was comparable in the groups ( p = 0.732). The pregnant women had significantly higher parafoveal DCP-VD ( p = 0.015), FAZ area ( p = 0.044), and FD ( p = 0.002). Mean subfoveal CT was 21 µm higher in pregnant women but was not significant ( p = 0.472). There was no difference in CMT ( p = 0.448). FAZ metrics were positively correlated with CT in pregnants and with CMT in the control group ( p < 0.05). Parafoveal VD was negatively correlated with CT in the control group ( p < 0.05). After adjusting for CT and CMT, the significant difference in VD and FD persisted ( p < 0.05), while the difference in FAZ area lost significance ( p > 0.05). Conclusions: Considering the effects of the probable covariant factors CMT and CT, systemic changes in pregnant women in their third trimester may cause an increase in VD in the macula and parafoveal DCP.
Stand up! Are normal weight-bearing forces sufficient for a 12/14 Morse taper locking in total hip arthroplasty?
Authors: Qurashi Suleman , Pelletier Matthew H , Wang Tian , Bramich Nicholas , Chinnappa Jason , Walsh William R 
Published: October 2020

Background: The aim of this study was to investigate total hip arthroplasty (THA) Morse taper pull-off strengths after impaction prior to cyclical loading compared to cyclical loading alone. The practical relevance of the experiment is to provide a perspective on what may be clinically satisfactory taper assembly given the spectrum of head tapping patterns used by surgeons, as well as compare traditional impaction performed in standard THA with alternate methods of taper engagement such as ‘ in situ assembly’ used in micro-invasive techniques. Methods: 36 taper constructs utilising a combination of cobalt-chrome alloy and ceramic-titanium alloy junctions were investigated in vitro in wet and dry conditions with cyclical loading of the constructs. Taper disengagement strengths with and without impaction were compared. Secondary investigation of the surface roughness of the heads and tapers was also assessed. Results: An impaction to a wet taper resulted in a greater pull off force compared to a dry taper with a CoCr head and taper combination. Impacting the head and dryness of the taper did not affect pull off forces of a ceramic femoral head on titanium taper. Pulling a head off a taper significantly alters the head surface roughness. Conclusion: Impaction of a taper does not provide any benefit over cyclical loading of a taper assembly alone for pull-off strength.
Enhanced Recovery With Paravertebral and Transversus Abdominis Plane Blocks in Microvascular Breast Reconstruction
Authors: Guffey Ryan , Keane Grace , Ha Austin Y , Parikh Rajiv , Odom Elizabeth , Zhang Li , Myckatyn Terence M 
Published: October 2020

Purpose: We have shown previously that a preoperative paravertebral nerve block is associated with improved postoperative recovery in microvascular breast reconstruction. The purpose of this study was to compare the outcomes of a complete enhanced recovery after surgery (ERAS) protocol with complete regional anesthesia coverage to our traditional care with paravertebral block. Patients and methods: This was a retrospective cohort study of 83 patients who underwent autologous breast reconstruction by T.M.M. between May 2014 and February 2018 at a tertiary academic center. Patients in the ERAS group were additionally administered acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), gabapentin, a transversus abdominis plane block (liposomal or plain bupivacaine), and primarily oral opioids postoperatively. The patients were mobilized earlier with more rapid diet progression. All patients received a preoperative paravertebral block. Results: Forty-four patients in the ERAS cohort were compared with 39 retrospective controls. The 2 groups were similar with respect to demographics and comorbidities. The ERAS cohort required significantly less opioids (291 vs 707 mg oral morphine equivalent, P < .0001) with unchanged postoperative pain scores and a shorter time to oral only opioid use (16.0 vs 78.2 hours, P < .0001). Median length of stay (3.20 vs 4.62, P < .0001) and time to independent ambulation (1.86 vs 2.88, P < .0001) were also significantly decreased in the ERAS cohort. Liposomal bupivacaine use did not significantly affect the results ( P ⩾ .2). Conclusions: Implementation of a robust enhanced recovery protocol with complete regional anesthesia coverage was associated with significantly decreased opioid use despite unchanged pain scores, with improved markers of recovery including length of stay, time to oral only narcotics, and time to independent ambulation.
Comparison of in-person and telegeriatric follow-up consultations
Authors: Betkus Georgia , Freeman Shannon , Martin-Khan Melinda , Lau Shell , Flood Frank , Hanlon Neil , Banner-Lukaris Davina 
Published: October 2020

Introduction Telehealth has the potential to support the care of older adults and their desire to age at home by providing a videoconferencing connection to specialist geriatric care. However, more information is needed to determine how telehealth services affect the care of older adults, and how telehealth services for older adults compare to traditional in-person methods of care provision. The aim of this study was to compare telegeriatric and in-person geriatric consultation methods with respect to outcomes and costs. Methods This was a retrospective chart analysis of consultation letters from patients’ first follow-up appointment with a geriatric specialist during the 2017/2018 fiscal year ( N = 95) in a health jurisdiction of a Western Canadian province. Results Patients seen through telehealth and in person were similar in mean age ( M = 79.1 and 78.1 years, respectively) and were predominately female. Telegeriatric consultations resulted in more requests for further testing and screening ( p = 0.003), new diagnoses ( p = 0.002), medication changes ( p = 0.009) and requests for follow-up ( p = 0.03) compared to in-person consultations. An average one-day clinic with one geriatric specialist providing consultations through telehealth cost Can$1684–$1859 less than an equivalent in-person clinic. Discussion Although additional research is needed to explain the differences in outcomes further between telehealth and in-person consultations found in this work, telehealth consultations cost substantially less than in-person consultations and are a promising way to improve access to geriatric care for older adults in underserved areas.
Long-Term Effectiveness of a Drug-Eluting Stent for Femoropopliteal In-Stent Restenosis: Subanalysis of the Zilver PTX Japan Post-Market Surveillance Study
Authors: Sugimoto Masayuki , Komori Kimihiro , Yokoi Hiroyoshi , Ohki Takao , Kichikawa Kimihiko , Nakamura Masato , Nanto Shinsuke , O’Leary Erin E. , Lottes Aaron E. , Saunders Alan T. , Dake Michael D. 
Published: October 2020

Purpose To present a subgroup analysis of patients from a large real-world study evaluating the safety and effectiveness of the Zilver PTX drug-eluting stent (DES) for treating femoropopliteal in-stent restenosis (ISR). Materials and Methods This study examined patients enrolled in the Zilver PTX Japan Post-Market Surveillance Study ( ClinicalTrials.gov identifier NCT02254837), a prospective, multicenter registry of 904 symptomatic patients with 1082 femoropopliteal lesions treated with the DES at 95 institutions in Japan. Five-year outcomes, including mortality, stent radiography, freedom from target lesion revascularization (TLR), and clinical benefit, were evaluated for 177 patients (mean age 74.2±8.3 years; 118 men) with 204 ISR lesions treated with the Zilver DES. Over half of the patients (108, 61.0%) were diabetic. Mean lesion length was 17.8±10.4 cm, and a third (72, 35.3%) were total occlusions. Outcome measures were all-cause mortality, thrombosis, freedom from TLR, and clinical benefit, defined as freedom from persistent or deteriorating ischemic symptoms. Results No device-related or procedure-related deaths or paclitaxel-related adverse events were reported. All-cause mortality was 25.1% at 5 years. Stent fracture was observed in 5 stents through 5 years. The 5-year rate of freedom from clinically-driven TLR was 73.4%, and the rate of clinical benefit was 63.6%. Improvement in Rutherford category and ankle-brachial index was sustained through 5 years. Conclusion The safety and effectiveness of the Zilver PTX stent for the treatment of femoropopliteal ISR lesions demonstrated that this device provides a favorable treatment option in this difficult-to-treat subgroup.
Outcomes of Surgical Management of Intraosseous Ganglia of the Carpal Bones: A Case Series
Authors: Zelenski Nicole A. , Corona Jacqueline , Bishop Allen T. , Shin Alexander Y. 
Published: October 2020

Background Intraosseous ganglia of the carpal bones are uncommon with sparse publications to guide treatment. The purpose of this study was to review a single-institution experience to determine the outcomes of patients with surgically treated intraosseous carpal ganglia. Methods Skeletally mature patients with intraosseous carpal ganglia between 1995 and 2016 treated operatively were identified. Demographic information, clinical data, and radiographic studies were evaluated. Results Thirty-three ganglia in 31 patients were identified. Intraosseous ganglia were located in the lunate (23), scaphoid (9), and trapezoid (1). Patients who presented with pathologic fracture or collapse had larger intraosseus ganglia than those presenting with pain alone. Surgery significantly improved pain. Patients treated with debridement with autograft bone graft had a higher consolidation rate compared with allograft bone but no difference in pain. Conclusions Patients with large or symptomatic lesions can be treated successfully with curettage and debridement, which leads to relief of pain. The use of bone grafting remains controversial.
Dose-Response Analysis of Exposure to Arsenic in Drinking Water and Risk of Skin Lesions: A Systematic Review of the Literature
Authors: Boffetta Paolo , Zunarelli Carlotta , Borron Claire 
Published: October 2020

Background: Exposure to high arsenic concentrations in drinking water has been associated with skin lesions. Our goal was to conduct a systematic review of studies on skin lesions and arsenic exposure, with emphasis on results at low level of exposure. Methods: We conducted a systematic review of studies reporting estimates of either prevalence or risk of skin lesions associated with exposure to more than 2 levels of arsenic in drinking water. We reviewed and abstracted the relevant results, with the aim of conducting a dose-response meta-analysis. Results: Nine studies of skin lesions were reviewed. Strong heterogeneity in the results did not meet the criteria for performing a meta-analysis. The relative risks for an increase of 10 μg/L arsenic in drinking water ranged from 1.002 to 1.140 (p-value of heterogeneity < 0.0001). Protection from bias and confounding was inadequate in most studies. Conclusion: Current studies are inadequate to conduct meta-analysis on dose-response relationship between exposure to arsenic in drinking water and skin lesions. Studies with complete exposure histories indicate skin lesions are associated with arsenic exposure in excess of 50 µg/L or higher.