bluuebunny/crossref_metadata_2025_split huggingface dataset:
Favorable effects of peritoneal dialysis in patients with refractory heart failure and overhydration
Authors: Papasotiriou Marios , Liakopoulos Vassilios , Kehagias Ioannis , Vareta Georgia , Ntrinias Theodoros , Papachristou Evangelos , Goumenos Dimitrios S 
Published: November 2020

Background: Patients with refractory to optimal pharmacological treatment heart failure (HF) require frequent hospitalization. Peritoneal dialysis (PD) has been part of the management of such patients mainly for promoting ultrafiltration and management of overhydration independently of kidney function. The aim of this study was to evaluate the efficacy of PD, especially the use of icodextrin solutions and intermittent PD, in the hospitalization rate and cardiac functional status of patients with HF. Methods: We conducted a retrospective study involving patients with New York Heart Association (NYHA) class IV HF and preserved renal function (estimated glomerular filtration rate (eGFR) > 25 ml/min), who were refractory to conservative treatment. Clinical data on weight loss, hospitalization rate before and after PD initiation, cardiac functional status, and technique complications during a 6-month observational period were analyzed. Results: PD treatment was performed in 32 patients with a mean age of 63.8 ± 11.9 years and a follow-up of 20.78 ± 14.24 months. Hospitalizations were significantly reduced from 20.7 ± 13.7 to 7.7 ± 8.9 days/patients at 6 months. All patients showed improvement in NYHA class as well as in left ventricular ejection fraction. Overall, eGFR showed a significant decrease but only six patients reached end-stage renal disease. Complications included 18 cases of peritonitis. PD was well tolerated and no patient dropped out of the method. Survival rate reached 72% at 12 months but mortality rate was high with 23 patients dying at 16.65 ± 12.3 months after the initiation of treatment. Patients survival was not influenced by the type of PD modality or weight reduction achieved. Conclusions: PD showed to be a viable option for the treatment of patients with refractory HF leading to a better cardiac functional status and diminishing the number of hospital admissions.
Satralizumab for the Treatment of Neuromyelitis Optica Spectrum Disorders
Authors: Gao Yanli , Zhang Baoqi , Yang Junyi 
Published: November 2020

Objective To review the pharmacological characteristics, clinical evidence, and place in therapy of satralizumab for the treatment of neuromyelitis optica spectrum disorders (NMOSDs). Data Sources A comprehensive literature search was conducted in PubMed (January 2000 to October 15, 2020). Key search terms included satralizumab and neuromyelitis optica spectrum disorders. Other sources were derived from product labeling and ClinicalTrials.gov. Study Selection and Data Extraction All English-language articles identified from the data sources were reviewed and evaluated. Phase I, II, and III clinical trials were included. Data Synthesis NMOSD is an autoimmune disease characterized by inflammatory lesions in the optic nerves and spinal cord. Interleukin-6 is involved in the pathogenesis of the disorder. Satralizumab is a humanized monoclonal antibody targeting the interleukin-6 receptor. Phase III trials showed that protocol-defined relapse was 30% for satralizumab and 50% for placebo ( P = 0.018) when patients with NMOSD were treated with satralizumab monotherapy; protocol-defined relapse was 20% for satralizumab and 43% for placebo ( P = 0.02) when satralizumab was added to immunosuppressant treatment. Satralizumab is generally well tolerated, with common adverse effects including injection-related reaction. Relevance to Patient Care and Clinical Practice Satralizumab has the potential to become a valuable treatment option for patients with NMOSD. Conclusion Satralizumab appears to be safe and effective as monotherapy or in combination with an immunosuppressant for patients with NMOSD and has the potential to become a valuable treatment option for these patients.
Implementing a Substance Use Screening Protocol in Rural Federally Qualified Health Centers
Authors: Reddick Blake , Foli Karen J. , Coddington Jennifer A. , Hountz Diane 
Published: November 2020

INTRODUCTION: In 2018, nearly 20% of Americans aged 12 years and older reported using illicit substances, with higher rates in rural areas. Federally Qualified Health Centers (FQHCs) provide health care to one in five rural Americans. However, estimates suggest that only 13.6% of patients in rural FQHCs receive substance use (SU) screening compared with 42.6% of patients in urban FQHCs. AIMS: This quality improvement (QI) project aimed to improve patient quality and safety and meet Health Resources and Services Administration reporting requirements. These aims were achieved through the design and implementation of a new SU screening protocol in four FQHCs in rural Indiana. METHOD: Deming’s plan–do–study–act model was used to implement QI interventions to increase SU screening rates. A new SU screening tool, the National Institute on Drug Abuse –Modified Alcohol, Smoking, and Substance Involvement Screening Testwas implemented, and staff were trained on its use. the screening, brief intervention, and referral to treatment model was used as a guiding framework. Outcome measures included a comparison of SU screening rates from the first quarter of 2019 to the first quarter of 2020, as well a pretest–posttest designed to measure staff knowledge and attitudes regarding SU. RESULTS: Baseline SU screening rate in 2019 was 0.87%. This increased to 24.8% by March 2020. Additionally, posttest results demonstrated improvement from staff on all indices, and an approval rating of 77% of the new SU screening practices. CONCLUSIONS: This project demonstrated that a low-cost QI intervention can increase SU screening rates in rural FQHCs, as well as improve staff knowledge and attitudes regarding SU.
Optical coherence tomography angiography of choroidal neovascularization in immune choroiditis following acute retinal necrosis
Authors: Nakamura Shun , Nakao Shintaro , Shiose Satomi , Kohno Ri-ichiro , Hasegawa Eiichi , Sonoda Koh-Hei 
Published: November 2020

Purpose: To report optical coherence tomography angiography (OCTA) findings in a case of immune choroiditis following contralateral acute retinal necrosis (ARN) with choroidal neovascularization (CNV) during anti-vascular endothelial growth factor (VEGF) therapy. Case report: A 64-year-old woman with immune choroiditis following contralateral ARN and secondary CNV presented with decreased visual acuity. Fundus examination revealed macular and peripheral yellowish lesions in the right eye. Inflammatory cells were observed in the anterior chamber and the vitreous. OCT revealed retinal exudative changes and subretinal lesions suggestive of CNV. OCTA detected an abnormal vascular net in the outer retina as well as choriocapillaris, corresponding to type 2 CNV, that reduced following intravitreous anti-VEGF therapy. Two weeks after treatment, OCTA showed re-dilated choroidal neovasculature at the outer retina despite no exudative recurrence in OCT. Six weeks after treatment, OCT detected exudative changes around the neovascular lesion. Conclusion: This case discusses the use of OCTA detection of CNV in a case of immune choroiditis following contralateral ARN. During anti-VEGF therapy for inflammatory CNV-related diseases, OCTA may be useful not only for CNV detection but also for the follow-up of CNV activity.
T-STAT for detecting autism spectrum disorder in toddlers aged 18–24 months
Authors: Wu Chin-Chin , Chiang Chung-Hsin , Chu Ching-Lin , Iao Lai-Sang , Hou Yuh-Ming 
Published: November 2020

Two studies were conducted to examine the use of the Taiwanese version of the Screening Tool for Autism in Two-Year-Olds for detecting autism spectrum disorder in toddlers aged 18–24 months. Study 1 used receiver operating characteristics to select a cutoff score for the Taiwanese version of the Screening Tool for Autism in Two-Year-Olds. It involved two groups of 16 toddlers each, one group with toddlers having autism spectrum disorder and the other group with chronological and mental age-matched toddlers with developmental delay. The result suggested that a cutoff of 2.50 would yield high sensitivity and specificity. In Study 2, we recruited 136 toddlers—30 with autism spectrum disorder, 33 with mild-autism spectrum disorder, and 73 with developmental delay. Using 2.50 as the cutoff score, the concurrent agreement between Taiwanese version of the Screening Tool for Autism in Two-Year-Olds risk and clinical diagnosis and Autism Diagnostic Observation Schedule yielded high sensitivity and specificity. The results of this study indicated that the Taiwanese version of the Screening Tool for Autism in Two-Year-Olds can be used as a Level 2 autism-specific screening tool for the 18–24 months age group. Lay abstract The benefits of early intervention for young children with autism spectrum disorder highlight the importance of early diagnosis. Reliable diagnoses of autism spectrum disorder can be made before 24 months of age. However, many children are diagnosed with autism spectrum disorder at a later age. Delayed diagnosis can occur for children with less severe symptoms and lead to missed opportunities for early intervention. This current study was executed to examine the Taiwanese version of the Screening Tool for Autism in Two-Year-Olds in detecting autism spectrum disorder in toddlers between 18 and 24 months of age. One strength of this study was the inclusion of toddlers with autism spectrum disorder or mild-autism spectrum disorder using the strict and relaxed Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria for autism spectrum disorder simultaneously. The results of this study supported that diagnosis of toddlers with autism spectrum disorder could be made reliable before 24 months of age. And the Taiwanese version of the Screening Tool for Autism in Two-Year-Olds was a Level 2 autism-specific screening tool for toddlers aged from 18 to 24 months in Taiwan.
Characterizing the early vocabulary profiles of preverbal and minimally verbal children with autism spectrum disorder
Authors: Haebig Eileen , Jiménez Eva , Cox Christopher R , Hills Thomas T 
Published: November 2020

Children with autism spectrum disorder often have significant language delays. But do they learn language differently than neurotypical toddlers? We compared the lexical skills of 64 preverbal and minimally verbal children with autism spectrum disorder to 461 vocabulary-size-matched typically developing toddlers. We also examined social features of verb knowledge using a novel collection of social ratings. Children with autism spectrum disorder produced proportionally more verbs than typically developing toddlers. Children with autism spectrum disorder produced proportionally more action and food words, while typically developing toddlers produced proportionally more animal, people words, and animal sounds and sound effects. Children with autism spectrum disorder also produced “mommy” and “daddy” at lower rates. We discuss how these differences may reflect an association between lexical development and weaknesses in social communication. Lay abstract Although preverbal and minimally verbal children with autism spectrum disorder represent a significant portion of the autism spectrum disorder population, we have a limited understanding of and characterization of them. Although it is a given that their lexical profiles contain fewer words, it is important to determine whether (a) the words preverbal and minimally verbal children with autism spectrum disorder produce are similar to the first words typically developing children produce or (b) there are unique features of the limited words that preverbal and minimally verbal children with autism spectrum disorder produce. The current study compared the early word profiles of preverbal and minimally verbal children with autism spectrum disorder to vocabulary-matched typically developing toddlers. Children with autism spectrum disorder produced proportionally more verbs than typically developing toddlers. Also, children with autism spectrum disorder produced proportionally more action and food words, while typically developing toddlers produced proportionally more animal words, animal sounds and sound effects, and people words. Children with autism spectrum disorder also produced “mommy” and “daddy” at lower rates. Our findings identified several areas of overlap in early word learning; however, our findings also point to differences that may be connected to core weaknesses in social communication (i.e. people words). The findings highlight words and categories that could serve as useful targets for communication intervention with preverbal and minimally verbal children with autism spectrum disorder.
Ecstasy (MDMA): A rebellion coherent with the system
Authors: García-Montes José Manuel , Pérez-Álvarez Marino , Sánchez-Moya Miguel Ángel , Torres José Alberto Carmona , Carreno David F. , Garcelán Salvador Perona , Sánchez-Sánchez Laura del Carmen 
Published: November 2020

Aim: This study attempts to demonstrate the relevance of the socio-cultural model of drugs in explaining the impressive development of ecstasy in the last 45 years. Method: First the study describes the use of ecstasy by groups which have left their imprint on the substance: university students, gays, yuppies and the “New Age” movement. Then the link between ecstasy and techno music led to the socially integrated “club” phenomenon, and the “rave”, which began as a rupturing, nonconformist phenomenon. Findings: According to this argument, in spite of its clearly counterculture beginnings, the “rave” movement and its most characteristic drug, ecstasy, have gradually become integrated into mainstream culture, somehow reinforcing the functioning of capitalist postmodernity. Our study explains ecstasy’s history in reference to the cultural contradictions of capitalism and the functions that it currently fulfils for young people. Based on this analysis, the implications of the cultural perspective are discussed as a paradigm of research in drug use, stressing notions of subculture, myths and rituals. It also proposes a harmonious articulation of academic and common knowledge as the most appropriate method for their study. Conclusion: A cultural approach to drug use could assist in unblocking a field so in need of conceptual and empirical revision.
Safety and Feasibility of No.12a Lymph Node Dissection by Portal Vein Approach in Radical Laparoscopic Gastrectomy for Gastric Cancer
Authors: Huang Hai-Peng , Xiong Wen-Jun , Peng Yao-Hui , Zheng Yan-Sheng , Luo Li-Jie , Li Jin , Cui Zi-Ming , Zhu Xiao-Feng , Wan Jin , Wang Wei 
Published: November 2020

Background: Traditional laparoscopic No.12a lymph node dissection in radical gastrectomy for gastric cancer may damage the peripheral blood vessels, and is not conducive to the full exposure of the portal vein and the root ligation of the left gastric vein. We recommend a new surgical procedure, the portal vein approach, to avoid these problems. Methods: 25 patients with advanced gastric cancer underwent radical laparoscopic gastrectomy and No.12a lymph node were dissected by portal vein approach, including 7 cases with total gastrectomy, 18 cases with distal gastric resection, 14 males and 11 females. Operative time, intraoperative blood loss, time to first flatus, postoperative hospital stay, number of total lymph node dissection and No.12a lymph node dissection, No.12a lymph node metastasis rate and postoperative complications were statistically observed. Results: All the patients were operated successfully and No.12a lymph node were cleaned by portal vein approach. A total of 683 lymph nodes were dissected, with the average number of lymph nodes dissection and positive lymph nodes were (27.3 ± 12.7) and (3.8 ± 5.6) respectively. The average number of No.12a lymph node dissection was (2.4 ± 1.95) and the metastasis rate of No.12a lymph node was 16% (4/25). The average operation time of radical laparoscopic distal and total gastrectomy were (239.2 ± 51.4) min and (295.1 ± 27.7) min respectively. The mean intraoperative blood loss was (134.0 ± 65.7) ml, and postoperative first anal exhaust time was (2.24 ± 0.86) d. The mean time to fluid intake was (4.2 ± 1.7) d, and postoperative hospitalization time was (9.6 ± 5.0) d. Without portal vein injure, anastomotic leakage, gastrointestinal bleeding, intestinal obstruction and other complications were observed in all patient. Conclusion: Our results show that the laparoscopic No.12a lymph node dissection by portal vein approach for gastric cancer is safe, feasible and has certain clinical application value.
Long-term outcomes of endovascular treatment of isolated subclavian artery aneurysms
Authors: Fang Gang , Fang Yuan , Xu Xin , Yang Jue , Zhu Ting , Yue Jianing , Fu Weiguo , Dong Zhihui 
Published: November 2020

Objectives The aim of the present study was to review our institutional experience of endovascular treatment for isolated subclavian artery aneurysms and evaluate the long-term outcomes. Methods A retrospective review of all patients with isolated subclavian artery aneurysms who underwent endovascular treatment between March 2008 and March 2020 was performed. The demographics, aneurysmal characteristics, treatment strategies, and in-hospital and follow-up outcomes were recorded and then analyzed. Results From March 2008 to March 2020, 35 isolated subclavian artery aneurysms were endovascularly treated at our institution. Atherosclerosis was the most common cause of aneurysms in this series. Most aneurysms were intrathoracic (91.4%) and located at the right side (77.1%). There were 26 true aneurysms, seven pseudoaneurysms, and two ruptured isolated subclavian artery aneurysms. Five types of endovascular strategies were performed. Covered stent placement across the aneurysm was the most (54.3%) commonly used method. Technical success was achieved in all patients. The median postoperative in-hospital stay was 4.0 days (range, 1–15 days). One patient died after discharge but within 30 days of surgery due to myocardial infarction. The median follow-up time was 62.0 months (range, 3–132 months). No death, stroke, stent fractures, or severe upper limb ischemia developed during the follow-up period. The cumulative survival rate at five years was 97.1%. The overall complication rate was 25.7% and one-third of complications (8.6%) required reinterventions. Conclusions Endovascular treatment for isolated subclavian artery aneurysms is safe, effective and technically achievable in most patients. Short- and long-term outcomes are promising. Reasonable and flexible use of covered stents can also get satisfactory outcomes in some complicated lesions such as isolated subclavian artery aneurysms located at the origin of the right subclavian artery, avoiding the huge surgical trauma caused by conventional open repair.
Factors affecting the acceptance of integrated electronic personal health records in Saudi Arabia: The impact of e-health literacy
Authors: Alsahafi Yaser A , Gay Valerie , Khwaji Adel A 
Published: November 2020

Background: National implementation of electronic personal health record (ePHR) systems is of vital importance to governments worldwide because this type of technology promises to promote and enhance healthcare. Although there is widespread agreement as to the advantages of ePHRs, the level of awareness and acceptance of this technology among healthcare consumers has been low. Objective: The aim of this study was to identify the factors that can influence the acceptance and use of an integrated ePHR system in Saudi Arabia. Method: The unified theory of acceptance and use of technology model was extended in this study to include e-health literacy (e-HL) and tested using structural equation modelling. Data were collected via a questionnaire survey, resulting in 794 valid responses. Results: The proposed model explained 56% of the variance in behavioural intention (BI) to use the integrated ePHR system. Findings also highlighted the significance of performance expectancy, effort expectancy, social influence (SI) and e-HL as determinants of Saudi healthcare consumers’ intentions to accept and use the integrated ePHR system. Additionally, assessment of the research model moderators revealed that only gender had a moderating influence on the relationship between SI and BI. Finally, findings showed a low level of awareness among Saudi citizens about the national implementation of an integrated ePHR system, suggesting the need to promote a greater and more widespread awareness of the system and to demonstrate its usefulness. Conclusion: Findings from this study can assist governments, policymakers and developers of health information technologies and systems by identifying important factors that may influence the diffusion and use of integrated ePHRs.
Impact of Covid-19 on Stroke Code Activations, Process Metrics, and Diagnostic Error
Authors: Velez Faddi G. Saleh , Alvarado-Dyer Ronald , Brutto Victor J. Del , Carrión-Penagos Julián , Bulwa Zachary , Prabhakaran Shyam 
Published: November 2020

Background and Purpose: In a comprehensive stroke center, we analyzed the stroke code activations (SCA), assessed the impact of Covid-19, and the measures taken by the local government to lessen the spread of the disease. Methods: We retrospectively reviewed SCA and classified them into 2 groups: pre-pandemic activations (February 15 to March 10) and Covid-19 pandemic activations (March 11 to April 30). The primary outcome was the ratio of true positive diagnoses of stroke relative to the total number of SCA in the 2 time periods. Results: Among the 212 SCA, 83 (39.2%) were from the pre-pandemic period, whereas 129 (60.8%) were from the pandemic period, 147 (69.3%) in the Emergency Department (ED) versus 65 (30.7%) in the inpatient service. In the ED cohort, a rapid decrease in the number of SCA at the beginning of the pandemic was followed by a gradual increase to pre-pandemic levels and a significant increase in the number of true positive strokes over time (44.2% vs 61.1%, p = 0.037). An increase in door-to-CT time (p = 0.001) and an increase in the rate of diagnostic error in patients admitted from the ED (p = 0.016) were also seen. The in-hospital cohort had a sustained decrease in the number of SCA following the pandemic declaration, with no difference in the rate of true positive stroke. Conclusions: We observed a rapid decline and slow recovery in ED SCA with a shift toward increased true positive cases following the Covid-19 pandemic. Also, delays in obtaining CT and diagnostic error was increased, however, no difference in early clinical outcomes were seen between groups.