bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population pharmacokinetics of mycophenolic acid in Mexican patients with lupus nephritis
Authors: Romano-Aguilar Melissa , Reséndiz-Galván Juan Eduardo , Medellín-Garibay Susanna Edith , Milán-Segovia Rosa del Carmen , Martínez-Martínez Marco Ulises , Abud-Mendoza Carlos , Romano-Moreno Silvia 
Published: June 2020

Background Mycophenolic acid (MPA) is an effective oral immunosuppressive drug used to treat lupus nephritis (LN), which exhibits large pharmacokinetic variability. This study aimed to characterize MPA pharmacokinetic behaviour in Mexican LN patients and to develop a population pharmacokinetic model which identified factors that influence MPA pharmacokinetic variability. Methods Blood samples from LN patients treated with mycophenolate mofetil (MMF) were collected pre dose and up to six hours post dose. MPA concentrations were determined by a validated ultra-performance liquid chromatography tandem mass spectrometry technique. Patients were genotyped for polymorphisms in enzymes (UGT1A8, 1A9 and 2B7) and transporters (ABCC2 and SLCO1B3). The anthropometric, clinical, genetic and co-medication characteristics of each patient were considered as potential covariates to explain the variability. Results A total of 294 MPA concentrations from 40 LN patients were included in the development of the model. The data were analysed using NONMEM software and were best described by a two-compartment linear model. MPA CL, Vc, Vp, Ka and Q were 15.4 L/h, 22.86 L, 768 L, 1.28 h−1 and 20.3 L/h, respectively. Creatinine clearance and prednisone co-administration proved to have influence on clearance, while body weight influenced Vc. The model was internally validated, proving to be stable. MMF dosing guidelines were obtained through stochastic simulations performed with the final model. Conclusions This is the first MPA population pharmacokinetic model to have found that co-administration of prednisone results in a considerable increase on clearance. Therefore, this and the other covariates should be taken into account when prescribing MMF in order to optimize the immunosuppressant therapy in patients with LN.
Mapping relationship between dynamic responses of high-speed trains and additional bridge deformations
Authors: Gou Hongye , Liu Chang , Hua Hui , Bao Yi , Pu Qianhui 
Published: June 2020

Deformations of high-speed railways accumulate over time and affect the geometry of the track, thus affecting the running safety of trains. This article proposes a new method to map the relationship between dynamic responses of high-speed trains and additional bridge deformations. A train–track–bridge coupled model is established to determine relationship between the dynamic responses (e.g. accelerations and wheel–rail forces) of the high-speed trains and the track deformations caused by bridge pier settlement, girder end rotation, and girder camber. The dynamic responses are correlated with the track deformation. The mapping relationship between bridge deformations and running safety of trains is determined. To satisfy the requirements of safety and riding comfort, the suggested upper thresholds of pier settlement, girder end rotation, and girder camber are 22.6 mm, 0.92‰ rad, and 17.2 mm, respectively. This study provides a method that is convenient for engineers in evaluation and maintenance of high-speed railway bridges.
Educational needs of oncology pharmacists: A survey by the International Society of Oncology Pharmacy Practitioners
Authors: Patel Himanshu , Tan Chia Jie , Toh Yi Long , Danilak Melanie , Alexander Marliese 
Published: June 2020

Background The International Society of Oncology Pharmacy Practitioners (ISOPP) is committed to providing educational resources to members for their continuous learning and professional development. This survey was conducted to explore the educational needs of International Society of Oncology Pharmacy Practitioners members for the purpose of developing resources to support future learning relevant to the diverse global pharmacy practitioner membership of our society. Methods A cross-sectional survey of International Society of Oncology Pharmacy Practitioners membership was conducted between 10 December 2018 and 15 January 2019. The survey contained 17 questions and consisted of four sections: (1) respondents’ demographics, (2) common challenges/barriers faced by members in accessing oncology pharmacy education, (3) areas within oncology pharmacy where members need education and (4) preferred methods of education delivery. Descriptive statistics were utilized to summarize survey results. Results The survey was completed by 62 out of 363 International Society of Oncology Pharmacy Practitioners members (17% response rate). Respondents were from 19 different countries, representing all the habitable continents. Most respondents were practicing in North America (21%), Oceania (21%) and Asia (16%). The majority of respondents worked in inpatient cancer units (60%), ambulatory tertiary cancer centres (31%) and academia (26%). Reported barriers to accessing education relevant to oncology pharmacy practice included lack of financial support (44%), time spent travelling to attend educational activities (39%), limited learning opportunities in their country of practice (34%) and limited growth of the oncology pharmacy discipline in their country of practice (32%). The content areas of greatest demand included pharmacotherapy of various cancers followed by oncology pharmacy research, International Society of Oncology Pharmacy Practitioners oncology pharmacy practice standards, supportive care and medication safety. Among educational activities offered by International Society of Oncology Pharmacy Practitioners, respondents valued annual International Society of Oncology Pharmacy Practitioners symposia and Journal of Oncology Pharmacy Practice the most. Most respondents (87%) indicated webinars as an effective educational tool. Conclusion Among an international oncology pharmacist cohort, we identified practice areas prioritized by pharmacists for continuing and professional development. Time and cost were common barriers to education, both in developing and developed countries. These survey findings may help to guide future education initiatives of International Society of Oncology Pharmacy Practitioners and other providers of pharmacist oncology education.
Synchronous detection of multiple myeloma and acute myeloid leukemia: A diagnostic and therapeutic challenge
Authors: Maral Senem , Albayrak Murat , Sahin Osman , Ozturk Hacer Berna Afacan , Han Unsal , Falay Mesude 
Published: June 2020

Introduction Synchronous detection of multiple myeloma and acute myeloid leukemia in a single patient is a rare coincidence. Treatment of these patients is still unclear, mostly based on acute myeloid leukemia strategies combined with bortezomib. Case report A 72-year-old male with no medical history was investigated for pancytopenia. On medical examination, he was complicated with a wide and severe skin infection on arm. On examination of bone marrow aspirate, 25% myeloblasts infiltration and additional 10% plasma cells were seen. Acute myeloid leukemia was diagnosed and plasma cell proliferation was attributed to reactive plasmacytosis due to skin infection. However, flowcytometric studies and immunohistochemical examination revealed two different cell populations with 30–40% atypical plasma cells and >20% myeloblasts. Serum M-protein detected by serum electrophoresis test and immunofixation test revealed a monoclonal IgG lambda band. He was diagnosed with concurrent acute myeloid leukemia and multiple myeloma without history of chemotherapy. Management and outcome: The patient was initially treated with bortezomib and dexamethasone for the myeloma. Subsequently, azacitidine was administered subcutaneously for the acute myeloid leukemia treatment. The tru-cut biopsy of the lesion on his arm revealed suppurative inflammatory findings and no malign cells detected. Antibiotherapy was started according to susceptibility. He expired after three months of survival. Discussion The synchronous occurrence of these two different clonal hematological malignancies is rare in hematology practice. Patient-based prospective studies and case series are needed to guide diagnosis and treatment strategies. Furthermore, this report highlights the importance of ruling out reactive plasmacytosis in patients with hematological malignancy who developed severe infections.
Ti-6Al-4V fretting wear and a quantitative indicator for fretting regime evaluation
Authors: Wang Jianfei , Duan Deli , Xue Weihai , Gao Siyang , Li Shu 
Published: June 2020

Fretting wear between titanium alloy components in aero engine is prevailing in the blade dovetail, the blade crown, and the damping shoulders. In this study, the fretting wear behavior of Ti-6Al-4V alloy was investigated by changing the load and displacement under a high frequency (100 Hz). To simulate the actual working conditions in aero engines, both the ball and flat samples were Ti-6Al-4V alloy. It was found that as the load increased, or as the applied displacement decreased, the fretting regime changed from gross slip regime to partial slip regime. The coefficient of friction/traction at steady stage decreased as load increased. Wear scar morphologies varied with fretting running conditions. In gross slip regime, the central area was higher than the rest region of the wear scar. In the mixed slip regime, large material accumulation could be found at both ends of the reciprocating motion. In partial slip regime, a nearly original fretting sample surface was observed in the central area and wear occurred in the edge area. Furthermore, considering the wear of the paired samples, a method based on the fretting wear scar diameter was proposed to evaluate the fretting running conditions.
Implantable Agents for Fecal Incontinence: An Age-Matched Retrospective Cohort Analysis of GateKeeper versus SphinKeeper
Authors: Grossi Ugo , Brusciano Luigi , Tolone Salvatore , Del Genio Gianmattia , Di Tanna Gian Luca , Gambardella Claudio , Docimo Ludovico 
Published: June 2020

Background. We aim to evaluate morphofunctional changes of the sphincter complex after GateKeeper (GK) and SphinKeeper (SK) procedures and correlate these with symptom improvement. Methods. Ten consecutive females undergoing SK implant were age-matched with a cohort of 10 females who previously underwent the GK procedure. Patients in the SK and GK groups underwent implantation of 10 and 6 prostheses, respectively. Muscle tension ( Tm), expressed in millinewtons per centimetre squared, mN (cm2)−1, was calculated using the equation Tm = P( r i)( tm)−1, where P is the average maximum squeeze pressure and r i and tm the inner radius and thickness of the external anal sphincter, respectively. The pre- and postimplant changes in Tm and Cleveland Clinic Fecal Incontinence Score (CCFIS) were tested by linear and Poisson regression models, respectively. Results. The CCFIS significantly improved in both groups at 12-month postimplantation. Although not reaching statistical significance, symptom improvement after SK was 33% above that observed after GK ( P = .088). Compared to the baseline, a significant increase in Tm was observed in both groups at 12 months (GK, 508.1 [478.8-568.0] vs 864.4 [827.0-885.8] mN (cm2)−1; SK, 528.0 [472.7-564.0] vs 858.6 [828.0-919.6] mN (cm2)−1, P = .005). Compared to the GK group, Tm was significantly higher in patients after SK implant (158.3 mN (cm2)−1 [95% confidence interval, 109.6-207.0]; P < .001), after controlling for baseline values, at 12-month postimplantation. Conclusions. GK and SK are safe and effective treatments for FI with good short-term clinical outcomes. Comparative analysis showed superiority of SK over GK in terms of gain in Tm, with borderline significantly better improvement in symptoms. Larger studies are needed to confirm these findings.
Development, implementation and participant evaluation of combining text messaging and peer group support in a weight management programme for African-American women
Authors: Lee Sohye , Lindquist Ruth , Schorr Erica , Chi Chih-Lin , Treat-Jacobson Diane J 
Published: June 2020

Background Development of highly accessible interventions that are effective in reducing body weight, preventing weight gain, and maintaining weight loss is urgently needed to solve the current obesity epidemic, especially among African-American women. Aims The purpose of this paper is to describe the development, implementation, and participant evaluation processes of a combined text messaging and peer support group programme to enhance weight management skills among African-American women. Methods The programme’s conceptual framework and operational model were developed to enhance the research design and protocol to support the study rationale and to lay a solid theoretical base for programme implementation. The programme curriculum and schedule were established and embedded into the programme protocol. Results The 16-week text messaging and peer support group intervention was implemented from September 2014 to March 2015. In total, 2089 messages were sent using an online text messaging application. Eight support group sessions were held in the participant’s community centre or community church bi-weekly for approximately one hour. Conclusions This paper provides a blueprint of the methodological aspects and insights from participants’ evaluation of a combined weight management intervention that can be used or adapted by public health nurses and other community health professionals in their work to develop weight management skills among African-American women.
Salvage of advanced carpal collapse: proximal row carpectomy with pyrocarbon resurfacing of the capitate versus four-corner arthrodesis
Authors: Ferrero Matteo , di Summa Pietro G. , Giacalone Francesco , Senesi Letizia , Sapino Gianluca , Battiston Bruno 
Published: June 2020

In this retrospective study we report on two comparable groups of patients with advanced carpal arthritis treated with either proximal row carpectomy combined with a pyrocarbon resurfacing of the capitate (31 patients) or a four-corner arthrodesis and dorsal plating (26 patients). Follow-up time was 46 months (24–118). Except for a modestly higher radial wrist deviation in the patients treated with four-corner arthrodesis, there were no significant differences in outcomes between the groups. Asymptomatic progression of osteoarthritis in the lunate fossa was observed in four cases in both groups. Two cases were converted to a total wrist arthrodesis in the pyrocarbon group compared with one case in the four-corner arthrodesis group. Although four-corner arthrodesis remains the reference standard in the treatment of wrist osteoarthritis with involvement of the midcarpal joint, proximal row carpectomy combined with pyrocarbon resurfacing of the capitate is an alternative option. It can even be used in selected cases with erosion of the lunate fossa. Level of evidence: III
Lung under attack by COVID-19-induced cytokine storm: pathogenic mechanisms and therapeutic implications
Authors: Pelaia Corrado , Tinello Caterina , Vatrella Alessandro , De Sarro Giovambattista , Pelaia Girolamo 
Published: June 2020

The lung is a key target of the cytokine storm that can be triggered by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), responsible for the widespread clinical syndrome known as coronavirus disease 2019 (COVID-19). Indeed, in some patients, SARS-CoV-2 promotes a dysfunctional immune response that dysregulates the cytokine secretory pattern. Hypercytokinemia underlies the hyperinflammatory state leading to injury of alveolar epithelial cells and vascular endothelial cells, as well as to lung infiltration sustained by neutrophils and macrophages. Within such a pathogenic context, interleukin-6 (IL-6) and other cytokines/chemokines play a pivotal pro-inflammatory role. Therefore, cytokines and their receptors, as well as cytokine-dependent intracellular signalling pathways can be targeted by potential therapies aimed to relieve the heavy burden of cytokine storm. In particular, the anti-IL-6-receptor monoclonal antibody tocilizumab is emerging as one of the most promising pharmacologic treatments. The reviews of this paper are available via the supplemental material section.
A Narrative Review of Theories of Wayfinding Within the Interior Environment
Authors: Jamshidi Saman , Pati Debajyoti 
Published: June 2020

Purpose: The aim of this article is to provide a narrative overview of theories that are available in the published literature on wayfinding in interior environments. Background: Wayfinding is an issue in healthcare facilities, and it has been documented that wayfinding problems have negative impacts on patients, visitors, caregivers’ time, and the organization’s bottom line. This issue can be more challenging for people with illness, low vision, cognitive disorders, and limited physical mobility. Wayfinding is a complex phenomenon depending on a variety of cognitive processes and behaviors. Methods: This article is a part of a broader literature review that searched for empirical studies on interior wayfinding. Four databases were systematically searched—PsychINFO, JSTOR, ProQuest, and EBSCO. A total of 81 articles satisfied all inclusion criteria for the broader study. Each article included in the broader study was reviewed to identify theory or theories, if any, that a study was founded on. Results: After an in-depth review of the theories, the authors proposed four categories of theories relating to human wayfinding. The four classes and the specific theories in those are articulated in this article, including major changes during their evolution. The four classes of theories explain four facets of wayfinding: (1) theories of perception, (2) theories of spatial knowledge development, (3) theories of mental representation of spatial knowledge, and (4) theories of spatial cognition. Conclusion: Since wayfinding is essentially a cognitive/problem-solving phenomenon, understanding the theoretical underpinnings of wayfinding may result in more meaningful and impactful design decisions.
Patterns in hospital readmissions after ischaemic stroke – An observational study from the Swedish stroke register (Riksstroke)
Authors: Sennfält Stefan , Petersson Jesper , Ullberg Teresa , Norrving Bo 
Published: June 2020

Introduction While acute treatment and secondary prevention in stroke have undergone major improvements, hospital readmission after index stroke remains high. However, there are few reports on long-term readmission patterns. Patients and methods For this prospective observational study, data on demographics, functional status and living conditions were obtained from the Swedish Stroke Register (Riksstroke). Data on comorbidity and hospital readmissions up to five years post-index stroke were obtained from the Swedish National Patient Register. Patients were grouped based on number of readmissions: low (0–1) intermediate (2–4), high (5–9) or very high (≥10). Results Of the 10,092 patients included, 43.7% had been readmitted within 12 months and 74.0% within 5 years. There was an average of three readmissions per individual during the five-year interval. A small group of patients with a high-comorbidity burden accounted for the majority of readmissions: approximately 20% of patients accounted for 60% of readmissions, and 5% of patients accounted for 25%. Circulatory conditions were the most common cause followed by infectious disease, stroke, trauma and diseases of the nervous system other than stroke. The proportion of readmissions due to stroke decreased sharply in the first six months. Conclusion A small number of patients with a high degree of comorbidity accounted for the majority of hospital readmissions after index stroke. Our results highlight the need for further development of strategies to support high-risk comorbid stroke patients in the community setting. Further research describing characteristics and healthcare utilisation patterns in this group is warranted.
Laparoscopic-assisted myomectomy with uterine artery occlusion at a freestanding ambulatory surgery center: a case series
Authors: MacKoul Paul , Danilyants Natalya , Touchan Faraj , van der Does Louise Q. , Haworth Leah R. , Kazi Nilofar 
Published: June 2020

Abstract
Background
Non-hysteroscopic myomectomy is infrequently performed in a freestanding ambulatory setting, in part due to risks of intraoperative hemorrhage. There are also concerns about increased surgical risks for morbidly obese patients in this setting. The purpose of this study is to report the surgical outcomes of a series of laparoscopic-assisted myomectomy (LAM) cases at a freestanding ambulatory surgery center (ASC), including a comparative analysis of outcomes in morbidly obese patients (BMI > 40 kg/m2).

Methods
A retrospective comparative analysis was performed of 969 women, age 18 years or older, non-pregnant, who underwent LAM by one of two high volume, laparoscopic gynecologic surgical specialists at a freestanding ambulatory surgery center serving the Washington, DC area, between October 2013 and February 2019. Reversible occlusion was performed laparoscopically by placing a latex-based rubber catheter as a tourniquet around the isthmus of the uterus, causing a temporary occlusion of the bilateral uterine arteries. Permanent occlusion was performed laparoscopically via retroperitoneal dissection and uterine artery ligation at the origin of the anterior branch of the internal iliac artery. Minilaparotomy was performed for specimen removal in all cases. No power morcellation was used. Postoperative complications were graded using the Clavien-Dindo Classification system. Outcomes were compared across BMI categories using Pearson Chi-Square.

Results
Average myoma weight and size were 422.7 g and 8.3 cm, respectively. Average estimated blood loss (EBL) was 192.1 mL; intraoperative and grade 3 postoperative complication rates were 1.4% and 1.6%, respectively. While EBL was significantly higher in obese and morbidly obese patients, this difference was not clinically meaningful, with no significant difference in blood transfusion rates. There were no statistically significant intraoperative or postoperative complication rates across BMI categories. There was a low rate of hospital transfers (0.7%) for all patients.

Conclusion
Laparoscopic-assisted myomectomy can be performed safely in a freestanding ambulatory surgery setting, including morbidly obese patients. This is especially important in the age of COVID-19, as elective surgeries have been postponed due to the 2020 pandemic, which may lead to a dramatic and permanent shift of outpatient surgery from the hospital to the ASC setting.