bluuebunny/crossref_metadata_2025_split huggingface dataset:
Family Support for Adolescent Girls and Young Women Living With HIV in Zambia: Benefits, Challenges, and Recommendations for Intervention Development
Authors: Roberts Sarah T. , Edwards Patrick , Mulenga Drosin , Chelwa Nachela , Nyblade Laura , Brander Caila , Musheke Maurice , Mbizvo Michael , Subramanian Sujha 
Published: December 2020

Abstract
Lack of family involvement is barrier to antiretroviral therapy adherence among adolescent girls and young women (AGYW). This study assessed family support for AGYW's engagement along the HIV care continuum to inform the design of a family-focused intervention in Lusaka, Zambia. We conducted 16 in-depth interviews and four focus group discussions with 40 AGYW living with HIV. Three strategies were identified to strengthen family support. First, emotional and instrumental support are highly valued by AGYW and should be further developed or reinforced. Second, AGYW wanted more informational support and open discussion of HIV from family, and an intervention should aim to enhance these types of support. Third, existing appraisal support reinforced anticipated stigma among AGYW and discouraged disclosure, yet participants wished for more interactions with peers living with HIV. Appraisal support should therefore be reframed to help AGYW decide to whom they should disclose and how to do so safely.
Transcanal Endoscopic Management of Glomus Tympanicum: Multicentric Case Series
Authors: Fermi Matteo , Ferri Gaetano , Bayoumi Ebaied Tamer , Alicandri-Ciufelli Matteo , Bonali Marco , Badr El-Dine Mohamed , Presutti Livio 
Published: December 2020

Objective:
The aim of this study was to report a multicentric surgical experience in the exclusive endoscopic management of glomus tympanicum (GT).

Study Design:
Retrospective case series review at two institutions.

Setting:
Tertiary referral centers.

Patients:
The study included 30 patients who underwent exclusive transcanal excision of GT between 2010 and 2017 at the two referral centers.

Interventions:
Exclusive endoscopic transcanal excision of GT type A1, A2, and B1 (modified Fisch-Mattox classification). All surgical procedures were performed by two senior surgeons (L.P.; M.B.).

Main Outcome Measures:
For each procedure, intraoperative features of the disease, postoperative complications, and functional outcomes were evaluated. Recurrent or residual diseases were clinically and radiologically assessed during the follow-up period.

Results:
None of the patients treated with transcanal endoscopic approach (TEA) experienced intraoperative complications, nor required conversion to microscopic approach. Gross total resection (GTR) was obtained in 90% of the cases, while a near total resection was advocated when the residual pathology had a close relationship with the internal carotid artery. Mean hospitalization time was 1.6 (±0.8 SD) days and no postoperative complications were reported. No recurrences were reported in the GTR group after a mean follow-up period of 38.1 (±28.7 SD) months.

Conclusions:
Middle ear paragangliomas with no mastoid involvement (Class A1, A2, and B1) can be safely managed by means of a transcanal endoscopic approach. Low rate of postoperative complications, short hospitalization, and high rate of gross total resection demonstrate that TEA is a safe and effective procedure.
Measurement Properties of the Hearing Environments and Reflection of Quality of Life (HEAR-QL) 28-item Questionnaire in Cholesteatoma
Authors: Leonard Colin G. , Dixon Peter R. , Cushing Sharon , Papsin Blake C. , Gordon Karen A. , James Adrian L. 
Published: December 2020

Objective:
We sought to assess the reliability and construct validity of the Hearing Environments and Reflection on Quality of Life Adolescent (HEAR-QL 28) quality of life measure (QoL) in cholesteatoma.

Study Design:
Observational.

Setting:
Tertiary referral center.

Patients:
One hundred seventeen patients with a diagnosis or history of cholesteatoma completed HEAR-QL 28. In addition to patients within the age range recommended for HEAR-QL 28 (13–18 yr), patients under 13 years old who were able to complete HEAR-QL 28 without parental assistance were included.

Intervention (s):
Completion of HEAR-QL 28 QoL measure.

Main Outcome Measure (s):
HEAR-QL 28 score, four tone average pure tone audiogram hearing threshold and categorical classification of hearing loss as mild, moderate, and severe.

Results:
HEAR-QL 28 did not demonstrate discriminative ability on the basis of audiometric threshold, but did discriminate between participants hearing normally (four tone average pure tone audiogram <30 dB HL) (HEAR-QL 86/100) after cholesteatoma surgery from those with unilateral hearing loss (HEAR-QL 73/100) (p < 0.001). Those with unilateral loss could in turn be differentiated from those with bilateral loss (HEAR-QL 60/100) (p < 0.006).

Conclusion:
HEAR-QL 28 is valid measure of QoL in cholesteatoma with no evidence of redundancy and excellent internal consistency. The importance of considering QoL impact of cholesteatoma is highlighted by 17% of participants reporting the normality or abnormality of their hearing differently from their audiometric threshold. The HEAR-QL 28 provides insight into the ability to cope with their hearing environment in a specific environment.
Diagnostic and therapeutic challenges of chronic obstructive pulmonary disease in the elderly
Authors: Allen Brian , Aboussouan Loutfi S. 
Published: December 2020

Purpose of review
Chronic obstructive pulmonary disease (COPD) imposes a large burden on the global population and even more so for the elderly who face significant obstacles in the diagnosis, management, and psychosocial effects of the disease. This review describes the current challenges and key points in the management of COPD in the elderly.

Recent findings
Lower limit rather than fixed cut off of the FEV1/FVC ratio can improve the diagnosis and better predict COPD mortality. High relative to standard dose influenza vaccination reduces confirmed cases of influenza overall and reduces hospitalizations in older nursing home residents. Simple interventions that include electronic health record tracking can significantly improve vaccination rates. Although many inhaler and nebulized medications are available for the elderly, the final regimen is usually determined by a combination of expense, issues with proper device use (from difficulty with coordination, hand grip, inspiratory flows or cognitive function) and the side effect profile. Fortunately, the switch to cheaper or better covered alternatives can be well tolerated with improvement in adherence and exacerbations of COPD. Finally, caution should be made against ageism, which may be a factor in the recommendation of rehabilitation or palliative care in the elderly COPD patient, as both are underused despite evidence of benefit.

Summary
Although care for the elderly COPD patient can be difficult, we summarize key points that the physician should be cognizant of to provide comprehensive care.
Association of malnutrition with postoperative complication risk after curative surgery for oral cancer
Authors: Tsai Yao-Te , Lai Chia-Hsuan , Huang Tzu-Hao , Hsieh Ching-Chuan , Huang Ethan I. , Lee Yi-Chan , Yeh Hsuan-Keng , Tsai Ming-Shao , Chang Geng-He , Hsu Cheng-Ming 
Published: December 2020

Abstract
Malnutrition is common among patients who have oral cavity squamous cell carcinoma (OSCC), but its effect on the incidence of postoperative complications remains uncertain. Validated nutrition and complication assessment tools were used to evaluate the effects of nutrition on the likelihood of postoperative complications after curative surgery for OSCC.
A retrospective study that spanned January 2014 to December 2018 enrolled 70 patients who received curative surgery for OSCC. Nutritional status before surgery was evaluated with the scored Patient-Generated Subjective Global Assessment (PG-SGA), and patients were classified as either well-nourished (rating A) or malnourished (ratings B and C). Complications 30 days after the operation were graded using Clavien-Dindo classification. The perioperative clinicopathological characteristics of the groups were compared, and risk factors for postoperative complications were identified through logistic regression.
A total of 44 (62.8%) patients formed the malnourished group, and they tended to be older (P = .03), weigh less (P = .001), have lower Body Mass Index (P = .003), higher PG-SGA scores (P < .001), higher neutrophil-to-lymphocyte ratio (P = .034), more postoperative complications (P < .001), and longer hospital stays (P = .021). Major complications (Clavien–Dindo classification ≥ IIIa) were experienced by 18.5% (n = 13) of patients and were more common in the malnourished group (P = .007). Multivariate logistic regression demonstrated that PG-SGA score ≥4 was an independent risk factor for postoperative complications (hazard ratio = 4.929, P = .008).
Malnutrition defined using the PG-SGA is an independent risk factor for postoperative complications of curative surgery in patients with OSCC. More prospective studies are warranted to confirm our findings.
Decreased albumin is associated with elevated N-terminal pro-brain natriuretic peptide and poor long-term prognosis in patients with chronic heart failure
Authors: Yi Sheng , Chen Menghua 
Published: December 2020

Abstract
At present, the association between albumin, N-terminal pro-brain natriuretic peptide (NT-proBNP) and long-term prognosis in patients with chronic heart failure (CHF) is unclear. Therefore, the purpose of this study is to explore the relationship between albumin, NT-proBNP and all-cause mortality in CHF patients.
Three hundred fifty two CHF patients were recruited in our study, and patients were divided into 2 groups according to the mean (37.16 g/L) of albumin concentration [low group (albumin < 37.16 g/L) and high group (albumin≥37.16 g/L)]. Differences between groups was compared by odds ratio (OR) and 95% confidence interval (CI).
NT-proBNP in the high group was significantly lower than that in the low group at baseline [1811.50 (698.75–4037.00) vs 3479.50 (1538.50–7824.25), P < .001]. Spearman correlation analysis showed that there was a negative correlation between albumin and NT-pro BNP log10 transform (ρ= −0.217, P < .001). Furthermore, curve fitting further confirmed that albumin was negatively correlated with NT-proBNP. After a median follow-up of 1726 days, 90 patients in the high group occur all-cause mortality, and 98 patients in the low group occur all-cause mortality (46.88% vs 61.25%, OR = 0.29, 95% CI: 0.08–0.50). After adjusting for the selected confounding covariates by multivariate regression analysis, decreased albumin was still associated with increased all-cause mortality (high group vs low group: OR = 0.62, 95% CI: 0.39–0.97).
Decreased albumin is associated with elevated NT-ProBNP and poor long-term prognosis in CHF patients. Clinicians need to pay enough attention to the nutritional status of CHF patients.
Dietary interventions and irritable bowel syndrome – what really works?
Authors: Surdea-Blaga Teodora , Cozma-Petrut Anamaria , Dumitraşcu Dan Lucian 
Published: December 2020

Purpose of review
The review examines the latest research on the use of dietary interventions in the management of irritable bowel syndrome (IBS) in order to understand what is the evidence supporting the efficacy of a dietary approach in this disorder.

Recent findings
A general dietary advice should be offered to all IBS patients. Psyllium supplementation is recommended in IBS with both constipation and diarrhea predominance. There is increasing evidence showing the beneficial effects of a low fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) diet (LFD) on IBS symptoms. FODMAPs that are well tolerated should be reintroduced in daily diet, to increase acceptability of the diet, and limit potentially harmful effects. The benefits observed with the gluten-free diet seem determined by the reduction of FODMAPs rather than gluten. Modulation of gut microbiota using probiotics shows promising results, but there are unanswered questions regarding the optimal strains, dose and duration of treatment. Additional evidence is also needed for the role of prebiotics and synbiotics in IBS.

Summary
Food is both trigger of IBS symptoms and therapeutic tool. Recent studies demonstrated the beneficial effects of LFD on symptom control, as well as the role of probiotics, which seem to contribute to gut health and function.
Bone loss in patients with inflammatory bowel disease: cause, detection and treatment
Authors: Bravenboer Nathalie , Oostlander Angela E. , van Bodegraven Adriaan A. 
Published: December 2020

Purpose of review
Inflammatory bowel disease (IBD) is associated with bone loss leading to osteoporosis and increased fracture risk. Bone loss is the result of changes in the balanced process of bone remodeling. Immune cells and cytokines play an important role in the process of bone remodeling and it is therefore not surprising that cytokines as observed in IBD are involved in bone pathology. This review discusses the role of cytokines in IBD-associated bone loss, including the consequences for treatment.

Recent findings
Many studies have been conducted that showed the effect of a single cytokine on bone cells in vitro, including interleukin (IL)-1β, IL-6, IL-8, IL-12/IL-23, IL-17, IL-18, IL-32 and interferon-γ. Recently new members of the IL-1 family (IL-1F) have been related to IBD but the consequences for bone health remain uncertain.

Summary
Overall, patients have to deal with a cocktail of cytokines, present in their serum. The combination of cytokines can affect bone cells differently compared to the effects of a single cytokine. This implicates that treatment, focused on reducing the inflammation could work best for bone health as well. Vitamin D might also play a role in this.
Diagnosis and Management of Gestational Trophoblastic Disease: A Comparative Review of National and International Guidelines
Authors: Tsakiridis Ioannis , Giouleka Sonia , Kalogiannidis Ioannis , Mamopoulos Apostolos , Athanasiadis Apostolos , Dagklis Themistoklis 
Published: December 2020

Importance
Gestational trophoblastic disease (GTD) is associated with increased mortality and morbidity in women of reproductive age, if managed in a suboptimal way, left untreated, or diagnosed after the development of extensive metastases.

Objective
The aims of this study were to review and compare the recommendations from published guidelines on these tumors of placental origin.

Evidence Acquisition
A descriptive review of guidelines from the Royal College of Obstetricians and Gynecologists, the International Federation of Gynecology and Obstetrics, the European Society for Medical Oncology, and the Royal Australian and New Zealand College of Obstetricians and Gynecologists on GTD was carried out.

Results
All the guidelines agree that suction evacuation is the optimal management for hydatidiform molar pregnancy and that chemotherapy, either single-agent (for low risk) or multiagent (for high risk), is the preferred treatment modality for choriocarcinoma. There is also a consensus that a future pregnancy should be avoided during follow-up; therefore, an effective contraception method should be used. All medical societies recommend the registration of such patients to GTD screening centers, endorse the use of International Federation of Gynecology and Obstetrics 2000 scoring system, and mention that the diagnosis of gestational trophoblastic neoplasia (GTN) should be based on the clinical presentation (from the genital tract and the metastatic sites) and the human chorionic gonadotropin evaluation. Additionally, all 4 medical societies recommend the surgical management of placental site trophoblastic tumors or epithelioid trophoblastic tumors, as chemotherapy is less effective in these cases. However, there is controversy regarding the appropriate follow-up after the treatment of hydatidiform mole, the administration of anti-D immunoglobulin, the time of oxytocin infusion, and the salvage regimens that may be used in cases of resistant or recurrent GTN.

Conclusions
There is need for consistent international practice protocols, which will lead to an earlier diagnosis and eventually to a more effective management of GTD worldwide and decrease in the recurrence rate and in the associated morbidity and mortality.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After participating in this activity, the learner should be better able to assess the diagnostic aspects of GTD; evaluate treatment options for hydatidiform mole and GTN; and describe the appropriate follow-up options for cases complicated with GTD.
123I Scan With Whole-Body Retention Measurement at 48 Hours for Simplified Dosimetry Before 131I Treatment of Metastatic Thyroid Cancer
Authors: Durski Jolanta M. , Hruska Carrie B. , Bogsrud Trond V. , Ryder Mabel , Johnson Geoffrey B. 
Published: December 2020

Abstract
A previously published model (Atkins) allows for calculation of 131I maximum tolerated activity on the basis of 48-hour whole-body retention of 131I on a pretherapy diagnostic scan. Our practice uses iodine 123I for diagnostic imaging of metastatic thyroid cancer for staging before 131I therapy, with images typically acquired 24 hours after administration of the radiopharmaceutical. We explored the feasibility of an additional 123I whole-body scan and retention measurement at 48 hours, with application of the model to estimate maximum tolerated activity of radioiodine before 131I treatment of metastatic thyroid cancer.
De-implementation of Axillary Dissection in Women With Breast Cancer is Largely Driven By Site-level Contextual Effects
Authors: Gleisner Ana L. , Moss Angela , Friedman Chloe , Suresh Krithika , Grunwald Gary , Torphy Robert J. , Leonard Laura D. , Colborn Kathryn , Ahrendt Gretchen , Tevis Sarah , Christian Nicole , Abud Viviane L. , de Araujo Thiago B. , Beaty Laurel E. , Thieu Daniel , Glorioso Thomas J. , Kim Simon , Daugherty Stade 
Published: December 2020

Objective:
To assess the contribution of unknown institutional factors (contextual effects) in the de-implementation of cALND in women with breast cancer.

Summary of Background Data:
Women included in the National Cancer Database with invasive breast carcinoma from 2012 to 2016 that underwent upfront lumpectomy and were found to have a positive sentinel node.

Methods:
A multivariable mixed effects logistic regression model with a random intercept for site was used to determine the effect of patient, tumor, and institutional variables on the risk of cALND. Reference effect measures
were used to describe and compare the contribution of contextual effects to the variation in cALND use to that of measured variables.

Results:
By 2016, cALND was still performed in at least 50% of the patients in a quarter of the institutions. Black race, younger women and those with larger or hormone negative tumors were more likely to undergo cALND. However, the width of the 90% reference effect measures range for the contextual effects exceeded that of the measured site, tumor, time, and patient demographics, suggesting institutional contextual effects were the major drivers of cALND de-implementation. For instance, a woman at an institution with low-risk of performing cALND would have 74% reduced odds of having
a cALND than if she was treated at a median-risk institution, while a patient at a high-risk institution had 3.91 times the odds.

Conclusion:
Compared to known patient, tumor, and institutional factors, contextual effects had a higher contribution to the variation in cALND use.
Algibacillus agarilyticus gen. nov., sp. nov., isolated from the surface of the red algae Gelidium amansii
Authors: Meng Xue , Chang Ya-Qi , Wang Huan , Du Zong-Jun 
Published: December 2020

A novel Gram-stain-negative, strictly aerobic, coccoid and agar-hydrolysing bacterium, designated RQJ05T, was isolated from the marine red algae Gelidium amansii collected from the coastal area of Rizhao, PR China. Cells of strain RQJ05T were approximately 0.8–1.0×1.3–3.0 µm in size and motile by means of a polar flagellum. Growth occurred at 4–33 °C (optimum, 25–30 °C), pH 7.0–8.5 (optimum, pH 7.5–8.0) and in the presence of 1.0–7.0 % (w/v) NaCl (optimum, 2.0–3.0 %). Strain RQJ05T showed oxidase-positive and catalase-negative activities. Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain RQJ05T formed a phylogenetic lineage with members of the family

Alteromonadaceae

and exhibited 16S rRNA gene sequence similarities of 92.6, 91.3, 90.2 and 90.1 % to

Catenovulum maritimum

Q1T,

Catenovulum agarivorans

YM01T,

Paraphotobacterium marinum

NSCS20N07DT and

Algicola sagamiensis

B-10-31T, respectively. The major cellular fatty acids of strain RQJ05T were summed feature 3 (C16 : 1
ω7c and/or C16 : 1
ω6c), C16 : 0 and summed feature 8 (C18 : 1
ω7c and/or C18 : 1
ω6c). The major polar lipids of strain RQJ05T were phosphatidylethanolamine, phosphatidylglycerol and two aminophospholipids. Strain RQJ05T contained Q-8 as the major respiratory quinone. The genomic DNA G+C content was 39.0 mol%. On the basis of genotypic, phenotypic and phylogenetic evidence, strain RQJ05T is presented as a representative of a novel species in a new genus, for which the name Algibacillus agarilyticus gen. nov., sp. nov. is proposed. The type strain is RQJ05T (=KCTC 62846T=MCCC 1H00352T).