bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utility of serum beta-trace protein as a tool for estimating residual kidney function in peritoneal dialysis patients
Authors: See Yong Pey , Htay Htay , Teixeira-Pinto Armando , Pascoe Elaine M , Hawley Carmel , Cho Yeoungjee , Zhao Eileen , Johnson David W 
Published: August 2020

Background: Beta-trace protein (BTP) is a novel marker for residual kidney function (RKF) without need for urinary collection. We aimed to examine its utility as a tool for estimating RKF in incident peritoneal dialysis (PD) patients. Methods: This was a post hoc analysis of incident PD patients from the balANZ trial cohort. The outcomes evaluated were trends of serum BTP concentration with time, factors associated with change in BTP using mixed-effect multilevel linear regression and correlation of BTP with mean urinary urea and creatinine clearances (measured glomerular filtration rate (GFR)). Performances of two BTP-derived equations (Shafi-Eqn and Steubl-Eqn) to estimate GFR were evaluated by reporting bias (median difference between estimated and measured GFR), precision (interquartile range of median bias), accuracy (±2 mL/min of measured GFR) and P30 (percentage estimates within 30% of measured GFR) with confidence intervals (CIs) generated by bootstrapping 2000 replicates. The agreement between BTP-estimated GFR and measured GFR was also plotted graphically on Bland–Altman analysis. Results: The study included 161 PD patients. BTP concentration increased with dialysis vintage and was inversely correlated with measured GFR ( r = −0.64). Larger increases in BTP were associated with longer PD vintage and higher dialysate glucose exposure. Biases of BTP-estimated GFRs (Shafi-Eqn and Steubl-Eqn) were 1.2 mL/min/1.73 m2 (95% CI 1.0–1.3 mL/min/1.73 m2) and 0.4 mL/min/1.73 m2 (95% CI 0.2–0.6 mL/min/1.73 m2), respectively. Both BTP-estimated GFRs had poor precision (3.2 mL/min/1.73 m2 (95% CI 2.9–3.5 mL/min/1.73 m2) and 2.8 mL/min/1.73 m2 (95% CI 2.5–3.2 mL/min/1.73 m2), respectively) and accuracy of estimates (55% (95% CI 52–60%) and 59% (95% CI 55–63%), respectively). The mean difference of BTP-estimated GFR (Shafi-Eqn and Steubl-Eqn) and measured GFR were −1.14 mL/min/1.73 m2 and −0.42 mL/min/1.73 m2, respectively, with large limit of agreement on Bland–Altman plot. Conclusions: Serum BTP level was inversely related to RKF but neither BTP-estimated GFR equations were sufficiently accurate for routine use in PD patients.
Ophthalmologic manifestations in primary antiphospholipid syndrome patients: A cross-sectional analysis of a primary antiphospholipid syndrome cohort (APS-Rio) and systematic review of the literature
Authors: Franco Adriana M de M , Medina Flavio Mac Cord , Balbi Gustavo Guimarães Moreira , Levy Roger Abramino , Signorelli Flavio 
Published: August 2020

Objective There is a broad spectrum of eye involvement in antiphospholipid syndrome (APS). The majority of descriptions are presented as case reports that include mostly APS patients secondary to systemic lupus erythematosus (SLE), with no compelling evidence in primary APS (PAPS). This study aimed to describe ocular manifestations in our well-defined PAPS cohort (APS-Rio) and then perform a systematic literature review (SLR) of ocular manifestations in patients with APS or positivity to aPL without SLE. Methods We retrospectively analyzed PAPS patients followed at our outpatient clinics. All patients fulfilled Sydney APS classification criteria (2006). We evaluated them for ocular symptoms and previous ocular diagnoses. Antiphospholipid antibodies and clinical APS manifestations were compared between patients with and without ocular manifestations. For the SLR, electronic databases were searched up to November 2019. Results We studied 105 PAPS patients; 90.5% were female and 56.2% were Caucasian. We found ocular manifestations in 37.1% of our cohort. Thrombosis was the main criteria manifestation (95.2%) and lupus anticoagulant was the most prevalent antibody. Ophthalmologic diagnoses were present in 7 patients, with 5 having retinal vessels thromboses. Amaurosis fugax was the leading complaint, present in 30 patients. In the univariate analysis, amaurosis fugax was related to livedo (p = 0.005), Raynaud’s phenomenon (p = 0.048) and the presence of anticardiolipin antibody (≥40 GPL/MPL) (p = 0.041). Hemianopia was associated with arterial hypertension (p = 0.049). In the multivariate analysis, the only association found was between livedo and amaurosis fugax (OR 4.09, 95%CI 1.5–11.11, p = 0.006). Our SLR incorporated 96 articles of ocular manifestations in patients with PAPS or positivity to aPL without SLE. Ocular findings varied from 5 to 88%, including anterior and posterior segments, orbital and neuro-ophthalmologic changes. Conclusion There is little evidence on ocular manifestations in PAPS. We described an association between livedo and amaurosis fugax. Prospective studies are needed to promote the best treatment and avoid blindness in PAPS patients.
Impact of Caring for Terminally Ill Children on Physicians: A Systematic Scoping Review
Authors: Ngiam Lisa Xin Ling , Ong Yun Ting , Ng Jun Xuan , Kuek Joshua Tze Yin , Chia Jeng Long , Chan Natalie Pei Xin , Ho Chong Yao , Abdurrahman Ahmad Bin Hanifah Marican , Kamal Nur Haidah Ahmad , Cheong Clarissa Wei Shuen , Ng Cheng Han , Tan Xiu Hui , Tan Lorraine Hui En , Chin Annelissa Mien Chew , Mason Stephen , Jumat Muhammad Raihan , Chiam Min , Krishna Lalit Kumar Radha 
Published: August 2020

Introduction: Caring for terminally ill children influences nurses’ and allied health provider’s quality of life, ability to provide personalized, dignified and empathetic care and even their concepts of personhood. In the absence of data this review utilizes the Ring Theory of Personhood (RToP) to evaluate how a physician’s concept of personhood is affected caring for terminally ill children in order to better support them holistically. Methods: Using PRISMA Guidelines, 14 researchers carried out independent searches of PubMed, CINAHL, PsycINFO, Cochrane Library and gray literature databases for articles published between 2000 to 2019. Concurrent and independent employment of content and thematic analysis (Split Approach) was used to enhance the trustworthiness of the analysis. Results: 13,424 titles and abstracts were retrieved, 188 full texts were evaluated, and 39 articles were included and analyzed. Identical categories and themes identified using the Split Approach suggest that caring for dying children in PPC impacts the physician’s professional identity, clinical decision making, personal well-being and relationships. The data also suggests that the magnitude of these effects depends on the presence of protective and risk factors. Conclusion: Aside from providing a novel insight into the upon the physician, this review proffers a unique approach to accounting for the presence, magnitude and influence of incoming catalysts, resultant conflicts, and protective and risk factors upon the physician’s personhood. Further studies into the changes in personhood are required. Design of a personalized assessment tool based on the RToP will help direct timely, appropriate and personalized support to these physicians.
Evaluation of Nasal Patency Among Patients With Unilateral Cleft Lip and Palate: Cleft Versus Non-Cleft Side
Authors: Banari Ashwina S. , Datana Sanjeev , Agarwal S. S. , Bhandari S. K. 
Published: August 2020

Objective: To evaluate the nasal patency using acoustic rhinometry (AR) in patients with unilateral cleft lip and palate (UCLP) and to ascertain the rhinological importance of the same. Methods: Eccovision Acoustic Rhinometer system was used for assessment of nasal cross-sectional area (CSA) and volume in 15 patients with UCLP. The CSA1, CSA2, and CSA3, which represent the CSA at the nasal valve area and anterior end of the inferior turbinate, the anterior half of the inferior turbinate and the anterior end of the middle turbinate, and the region of middle portion of middle turbinate, respectively, were compared on the cleft and non-cleft side. Results: The mean ± SD of CSA1, CSA2, and CSA3 as well as the overall nasal CSA were significantly higher on non-cleft side compared to cleft side ( P value < .001). The mean ± SD of nasal volume was also significantly higher in non-cleft side compared to cleft side ( P value < .001). Conclusions: The nasal patency among patients with UCLP demonstrates a range of impairments that can be objectively measured using acoustic rhinometry. The orthodontic, orthopedic, or orthosurgical management of maxillary deficiency in these patients can affect the nasal area and volume and can have an impact on breathing, speech, and sleep. The pretreatment assessment may be useful to identify patients who are at potential risk of deterioration of nasal patency and airway post-intervention. Taking into consideration the multiple diagnostic procedures in the course of long-term multidisciplinary treatment of patients with cleft lip and palate, a noninvasive investigation technique such as AR may be the preferred mode of investigation to ascertain nasal patency.
Impact of Telehealth Interventions on Medication Adherence for Patients With Type 2 Diabetes, Hypertension, and/or Dyslipidemia: A Systematic Review
Authors: Bingham Jennifer M. , Black Melissa , Anderson Elizabeth J. , Li Yawen , Toselli Natalie , Fox Shawna , Martin Jennifer R. , Axon David R. , Silva-Almodóvar Armando 
Published: August 2020

Objective: To describe telehealth interventions and determine their effect on medication adherence for patients with type 2 diabetes, hypertension, and/or dyslipidemia. Data Sources: PubMed/MEDLINE, EMBASE, Cochrane, CINAHL Plus, PsycINFO, Academic Search Ultimate, International Pharmaceutical Abstracts, Scopus, Web of Science, WHO Global Index Medicus, association websites, and gray literature were searched from January 1, 1998, to December 31, 2019. Study Selection and Data Extraction: Eligible studies reported eHealth, mobile health, and telehealth interventions for adult patients prescribed medications for chronic condition management (eg, type 2 diabetes, hypertension, and/or dyslipidemia). Studies were required to evaluate medication adherence outcomes (eg, medication possession ratio [MPR], proportion of days covered (PDC)]. Randomized controlled trials, cohort studies, and controlled before-and-after studies were included. Multiple reviewers independently extracted data and evaluated risk of bias. Data Synthesis: Of 8693 studies identified, 13 reported either an MPR or PDC and were included in the systematic review. The systematic review demonstrated that electronic health (eHealth) and telehealth interventions were successful at improving medication adherence, whereas mobile health interventions did not improve medication adherence. Relevance to Patient Care and Clinical Practice: This systematic review highlighted the available research and findings of studies assessing interventions to improve medication nonadherence among patients with type 2 diabetes, hypertension, and/or dyslipidemia. The evaluated findings lend support to the need for targeted medication adherence interventions based on patient population and practice settings. Conclusions: Telehealth modalities include telephonic outreach and specialized tools designed to increase health literacy. eHealth and telehealth medication adherence interventions were associated with improved MPR and/or PDC rates.
Perturbations in Endocytotic and Apoptotic Pathways Are Associated With Chemotherapy-Induced Nausea
Authors: Singh Komal , Cao Huangshen , Miaskowski Christine , Conley Yvette P. , Hammer Marilyn , Wright Fay , Levine Jon D. , Kober Kord M. 
Published: August 2020

Background: While vomiting is well controlled with current antiemetic regimens, unrelieved chemotherapy-induced nausea (CIN) is a significant clinical problem. Perturbations in endocytotic and apoptotic pathways in the gut can influence the functioning of the microbiome-gut-brain-axis and the occurrence of gastrointestinal (GI) symptoms. However, limited information is available on the mechanisms that underlie unrelieved CIN. Objectives: The purpose of this study was to evaluate for perturbed biological pathways associated with endocytosis and apoptosis in oncology patients who did (n = 353) and did not (n = 275) report CIN prior to their second or third cycle of chemotherapy (CTX). Methods: Oncology patients (n = 735) completed study questionnaires in the week prior to their second or third cycle of CTX. CIN occurrence was evaluated using the Memorial Symptom Assessment Scale. Pathway impact analyses (PIA) were performed in 2 independent samples using RNA-sequencing (sample 1, n = 334) and microarray (sample 2, n = 294) methodologies. Fisher’s combined probability method was used to identify signaling pathways related to endocytotic and apoptotic mechanisms that were significantly perturbed between the 2 nausea groups across both samples. Results: CIN was reported by 63.6% of the patients in sample 1 and 48.9% of the patients in sample 2. Across the 2 samples, PIA identified 4 perturbed pathways that are involved in endocytosis (i.e., endocytosis, regulation of actin cytoskeleton) and apoptosis (i.e., apoptosis, PI3K/Akt signaling). Conclusions: Our findings suggest that CTX-induced inflammation of the GI mucosa, that results in the initiation of endocytotic and apoptotic processes in the gut, is associated with the occurrence of CIN.
Race-Conscious Career Development: Exploring Self-Preservation and Coping Strategies of Black Professionals in Corporate America
Authors: Sisco Stephanie 
Published: August 2020

The Problem Corporations have maintained a history of operating as racialized social systems that contribute to racial divisions and inequities in the workplace. Despite this reality, there have been high-achieving Black men and women who have overcome limitations and unfavorable circumstances. In this study, resilience to racial bias in corporate America is explored through the lived experience of Black professionals by using a phenomenological research method. The Solution Race, racism, and workplace incivility are discussed in a conceptual framework to examine how racial bias still exists in the workplace and to contextualize the participants’ experiences. As a result of the findings, self-preservation and coping strategies are identified to provide insight into how the participants overcame social and racial barriers that influence their professional identities and career development in corporate America. The Stakeholders This research is intended to inform organizational leaders and career development researchers and specialists who are invested in the advancement of Black professionals and the communities they represent. This study also has implications for human resource developers and researchers who seek to minimize racial bias against Black professionals through racial discourse and race-conscious research.
High School Students’ Knowledge, Attitude and Preventive Practice of Dementia Care in Macao
Authors: Lo Iek Long , Zeng Wen , Lei Chin Ion , Lam Chong , Lou Hong Lei 
Published: August 2020

Objective: To investigate knowledge, attitude and preventive practice of dementia care among high school students in Macao. Methods: Questionnaires was developed and distributed to 10 randomly selected high schools in Macao and 586 valid questionnaires were returned. Results: Knowledge, attitude and preventive practice of dementia care were 56.27 ± 24.90, 73.97 ± 7.72 and 68.34 ± 14.05. There were positive relationships between preventive practice and attitude, and knowledge. The students of 2 high schools had participated or organized lectures or events related to dementia scored higher knowledge, attitude and preventive practice than those hadn’t. Knowledge and attitude of female students were significantly higher than male students. Knowledge and preventive practice of the high school students were significantly lower than primary health professionals in Macao. Conclusion: Most high school students in Macao had insufficient knowledge and inappropriate preventive practice of dementia care. Enhanced dementia education should be a strong agenda for high school students in Macao.
The Double Threshold: Consequences for Identifying Low-Dose Radiation Effects
Authors: Waltar Alan , Feinendegen Ludwig 
Published: August 2020

Prior to observing low-dose-induced cell signaling and adaptive protection, radiogenic stochastic effects were assumed to be linearly related to absorbed dose. Now, abundant data prove the occurrence of radiogenic adaptive protection specifically at doses below ∼ 200 mGy (with some data suggesting such protection at a dose even higher than 200 mGy). Moreover, cells do not thrive properly when deprived of radiation below background dose. Two threshold doses need be considered in constructing a valid dose-response relationship. With doses beginning to rise from zero, cells increasingly escape radiation deprivation. The dose at which radiation-deprived cells begin to function homeostatically provides dose Threshold A. With further dose increase, adaptive protection becomes prominent and then largely disappears at acute doses above ∼ 200 mGy. The dose at which damage begins to override protection defines Threshold B. Thresholds A and B should be terms in modeling dose-response functions. Regarding whole-body responses, current data suggest for low-LET acute, non-chronic, irradiation a Threshold B of about 100 mGy prevails, except for leukemia and probably some other malignancies, and for chronic, low dose-rate irradiation where the Threshold B may well reach 1 Gy per year. A new Research and Development Program should determine individual Thresholds A and B for various radiogenic cell responses depending on radiation quality and target.
Anti-Thrombotic Therapy to Ameliorate Complications of COVID-19 (ATTACC): Study design and methodology for an international, adaptive Bayesian randomized controlled trial
Authors: Houston Brett L , Lawler Patrick R , Goligher Ewan C , Farkouh Michael E , Bradbury Charlotte , Carrier Marc , Dzavik Vlad , Fergusson Dean A , Fowler Robert A , Galanaud Jean-Phillippe , Gross Peter L , McDonald Emily G , Husain Mansoor , Kahn Susan R , Kumar Anand , Marshall John , Murthy Srinivas , Slutsky Arthur S , Turgeon Alexis F , Berry Scott M , Rosenson Robert S , Escobedo Jorge , Nicolau Jose C , Bond Lindsay , Kirwan Bridget-Anne , de Brouwer Sophie , Zarychanski Ryan 
Published: August 2020

Background: Mortality from COVID-19 is high among hospitalized patients and effective therapeutics are lacking. Hypercoagulability, thrombosis and hyperinflammation occur in COVID-19 and may contribute to severe complications. Therapeutic anticoagulation may improve clinical outcomes through anti-thrombotic, anti-inflammatory and anti-viral mechanisms. Our primary objective is to evaluate whether therapeutic-dose anticoagulation with low-molecular-weight heparin or unfractionated heparin prevents mechanical ventilation and/or death in patients hospitalized with COVID-19 compared to usual care. Methods: An international, open-label, adaptive randomized controlled trial. Using a Bayesian framework, the trial will declare results as soon as pre-specified posterior probabilities for superiority, futility, or harm are reached. The trial uses response-adaptive randomization to maximize the probability that patients will receive the more beneficial treatment approach, as treatment effect information accumulates within the trial. By leveraging a common data safety monitoring board and pooling data with a second similar international Bayesian adaptive trial (REMAP-COVID anticoagulation domain), treatment efficacy and safety will be evaluated as efficiently as possible. The primary outcome is an ordinal endpoint with three possible outcomes based on the worst status of each patient through day 30: no requirement for invasive mechanical ventilation, invasive mechanical ventilation or death. Conclusion: Using an adaptive trial design, the Anti-Thrombotic Therapy To Ameliorate Complications of COVID-19 trial will establish whether therapeutic anticoagulation can reduce mortality and/or avoid the need for mechanical ventilation in patients hospitalized with COVID-19. Leveraging existing networks to recruit sites will increase enrollment and mitigate enrollment risk in sites with declining COVID-19 cases.
User-centered design principles in the development of clinical research tools
Authors: Walden Anita , Garvin Lynsi , Smerek Michelle , Johnson Constance 
Published: August 2020

Background: Increasing and sustaining the engagement of participants in clinical research studies is a goal for clinical investigators, especially for studies that require long-term or frequent involvement of participants. Technology can be used to reduce barriers to participation by providing multiple options for clinical data entry and form submission. However, electronic systems used in clinical research studies should be user-friendly while also ensuring data quality. Directly involving study participants in evaluating the effectiveness and usability of electronic tools may promote wider adoption, maintain involvement, and increase user satisfaction of the technology. While developers of healthcare applications have incorporated user-centered designs, these methods remain uncommon in the design of clinical study tools such as patient-reported outcome surveys or electronic data capture digital health tools. Methods: Our study evaluated whether the clinical research setting may benefit from implementing user-centered design principles. Study participants were recruited to test the web-based form for the Measurement to Understand the Reclassification of Disease of Cabarrus/Kannapolis (MURDOCK) Study Community Translational Population Health Registry and Biorepository that would enable them to complete their study forms electronically. The study enrollment form collects disease history, conditions, smoking status, medications, and other information. The system was initially evaluated by the data management team through traditional user-acceptance testing methods. During the tool evaluation phase, a decision was made to incorporate a small-scale usability study to directly test the system. Results: Results showed that a majority of participants found the system easy to use. Of the eight required tasks, 75% were completed successfully. Of the 72 heuristics violated, language was the most frequent violation. Conclusion: Our study showed that user-centered usability methods can identify important issues and capture information that can enhance the participant’s experience and may improve the quality of study tools.