bluuebunny/crossref_metadata_2025_split huggingface dataset:
Macrophage activation syndrome triggered by systemic lupus erythematosus flare: successful treatment with a combination of dexamethasone sodium phosphate, intravenous immunoglobulin, and cyclosporine: a case report
Authors: Gouda Wesam , Alsaqabi Faisal , Moshrif Abdelhfeez , Abbas Awad S. , Abdel-Aziz Tarek M. , Islam Md Asiful 
Published: October 2021

Abstract
Background
Macrophage activation syndrome is classified as a secondary form of hemophagocytic lymphohistiocytosis. It is a hyperinflammatory complication observed to be comorbid with a variety of autoimmune diseases, including adult-onset Still’s disease and systemic juvenile idiopathic arthritis. Macrophage activation syndrome is less commonly detected in adult patients with systemic lupus erythematosus, which, if untreated, can be fatal, though determining the optimum treatment strategy is still a challenge.

Case presentation
Herein, we report a case of macrophage activation syndrome in a 33-year-old Egyptian female as an unusual complication of a systemic lupus erythematosus flare in adult patients. Our patient was initially treated with a combination of intravenous methylprednisolone pulse therapy and intravenous immunoglobulin therapy, which was followed by a course of oral prednisolone and oral cyclosporine with little response. Switching from oral prednisone to intravenous dexamethasone sodium phosphate showed a more favorable clinical and biochemical response.

Conclusion
Macrophage activation syndrome is less commonly detected in adult patients with systemic lupus erythematosus. Our case demonstrates that dexamethasone sodium phosphate can be a successful alternative treatment for patients with systemic lupus erythematosus complicated by macrophage activation syndrome in whom the response to pulse methylprednisolone was inadequate to manage their illness, proving to be remarkably effective in a relatively short time frame.
Retinal artery occlusion as a probable idiosyncratic reaction to topical minoxidil: a case report
Authors: Venkatesh Ramesh , Pereira Arpitha , Reddy Nikitha Gurram , Yadav Naresh Kumar 
Published: October 2021

Abstract
Background
Minoxidil hair formulation is commonly used for the treatment of male or female androgenic alopecia. This over-the-counter product is considered safe, but should be used with caution. Ocular side effects following topical minoxidil use are rarely reported. In this paper, we report a rare case of inferior hemiretinal artery occlusion possibly caused by topical 5% minoxidil treatment.

Case description
A 21-year-old Asian Indian male presented to the retina clinic with sudden onset blurring of vision and superior visual field loss in the right eye since morning. He was diagnosed with androgenic alopecia and was on treatment with topical 5% minoxidil spray twice a day for the last 3 years. On examination, his corrected distance visual acuity was 6/6, N6 in both eyes. Anterior segment examination and intraocular pressure in both eyes and left eye fundus were within normal limits. Right eye fundus examination showed features suggestive of inferior hemiretinal artery occlusion, which were confirmed on fluorescein angiography and optical coherence tomography. A detailed systemic evaluation and investigations (blood pressure, random blood sugar, hematological and coagulation profile, serum homocysteine level, Mantoux test, chest x-ray, cardiac two-dimensional echography, thyroid function test, and immunological profile) did not detect any abnormalities. The ocular condition and its visual prognosis were explained to the patient, and he was asked to review after 4 weeks.

Conclusion
Though there is no definite cause–outcome relationship between topical minoxidil use and retinal artery occlusion development, this possibility should be kept in mind when observing retinal vascular occlusion cases with concurrent use of topical minoxidil.
The establishment of serum 25-hydroxyvitamin D reference intervals in children aged 0–14 years in Zigong area, China
Authors: Yu Jianhong , He Xiaoping , Huang Shengwei 
Published: October 2021

Abstract
Objective
To establish the reference interval of serum 25-hydroxyvitamin D (25(OH)D) in apparently healthy children in Zigong, China, using an indirect method to provide a basis for proper clinical diagnosis and treatment.

Methods

A total of 1851 apparently healthy children of the Children’s Health Care Department in Zigong First People’s Hospital between January 2016 and December 2020 were included in the study. The Kolmogorov–Smirnov test was used to analyze the data for normality, and the non-normally distributed data were transformed into approximately normal distribution by Blom's normal rank transformation, and the transformed data were excluded from outliers by the quartile spacing method, and the data were stratified and analyzed according to sex, age, and season. The data were stratified according to sex, age, and season, and the area between the 2.5% and 97.5% percentile points was used as the reference interval.

Results
The serum 25(OH)D data were non-normally distributed. The data were normally distributed after Blom’s normality rank transformation, and 92 cases of outliers were excluded from the transformed data according to the interquartile spacing method. The differences in serum 25(OH)D levels between sex were not statistically significant (P > 0.05), and there was no need to establish reference intervals based on sex. There was no statistically significant difference in serum 25-hydroxyvitamin D levels between winter and spring, and also no difference between summer and autumn (P > 0.05), and the levels were lower in winter-spring than in summer-autumn. Comparison between age groups showed that there was no statistically significant difference in serum 25(OH)D levels between the < 6 months group and the 6 ~ 11 months group, and between the 6 ~ 9 years group and the 10 ~ 14 years group (P > 0.05); serum 25(OH)D levels decreased with increasing age. There was an interactive effect of season and age group on 25(OH)D levels, and the corresponding reference intervals were established according to different seasons and age groups. In summer and autumn, the reference intervals of serum 25(OH)D for < 1 year, 1 ~ 2 years, 3 ~ 5 years, and 6 ~ 14 years were 39.86 ~ 151.43, 31.54 ~ 131.65, 22.05 ~ 103.75, and 15.36 ~ 85.53 ng/ml and 24.42 ~ 144.20, 31.54 ~ 131.65, 16.80 ~ 165.68, and 15.46 ~ 85.54 ng/ml in winter and spring, respectively.

Conclusion
Reference intervals for serum 25(OH)D in children of different seasons and ages in Zigong, China, were established to provide a reference for clinical disease diagnosis, treatment, and prognosis determination.
Psychological consequences for family caregivers of patients receiving hemodialysis: threat or opportunity?
Authors: Ebadi Abbas , Sajadi Seyedeh Azam , Moradian Seyed Tayeb , Akbari Roghayeh 
Published: October 2021

Abstract
Background
Family caregivers of patients receiving hemodialysis experience physical and psychological disorders. They are unfortunately neglected. The aim of this study was to explain the psychological consequences for family caregivers of patients receiving hemodialysis.

Methods
This qualitative inductive conventional content analysis research approach was conducted in Tehran, Iran. Nineteen hemodialysis patient caregivers were enrolled via purposive sampling. Data collection was conducted through in-depth and semi-structured interviews until reaching data saturation. All interviews were recorded, transcribed, imported into the Open Code Software, and analyzed using the Graneheim and Lundman methods.

Results
The results included two main categories: (1) threats to the psychological integrity; (2) development of capabilities. The first main category comprised the sub-categories of “care-related negative feelings and emotions,” care-related stress and its behavioral impacts on care, “psychological disorders arising from care provision,” and “impaired quality and quantity of sleep.” The second main category comprised of the sub-categories of “care-related positive feelings and emotions” and “coping strategies.”

Conclusions
The present study showed that though caring for hemodialysis patients threatens the caregiver’s psychological integrity, it provides the opportunity of development capabilities.
The story of critical care in Asia: a narrative review
Authors: Phua Jason , Lim Chae-Man , Faruq Mohammad Omar , Nafees Khalid Mahmood Khan , Du Bin , Gomersall Charles D. , Ling Lowell , Divatia Jigeeshu Vasishtha , Hashemian Seyed Mohammad Reza , Egi Moritoki , Konkayev Aidos , Mat-Nor Mohd Basri , Shrestha Gentle Sunder , Hashmi Madiha , Palo Jose Emmanuel M. , Arabi Yaseen M. , Tan Hon Liang , Dissanayake Rohan , Chan Ming-Cheng , Permpikul Chairat , Patjanasoontorn Boonsong , Son Do Ngoc , Nishimura Masaji , Koh Younsuck ,   for the Asian Critical Care Clinical Trials Group
Published: October 2021

AbstractBackgroundAsia has more critically ill people than any other part of our planet. The aim of this article is to review the development of critical care as a specialty, critical care societies and education and research, the epidemiology of critical illness as well as epidemics and pandemics, accessibility and cost and quality of critical care, culture and end-of-life care, and future directions for critical care in Asia.Main bodyAlthough the first Asian intensive care units (ICUs) surfaced in the 1960s and the 1970s and specialisation started in the 1990s, multiple challenges still exist, including the lack of intensivists, critical care nurses, and respiratory therapists in many countries. This is aggravated by the brain drain of skilled ICU staff to high-income countries. Critical care societies have been integral to the development of the discipline and have increasingly contributed to critical care education, although critical care research is only just starting to take off through collaboration across groups. Sepsis, increasingly aggravated by multidrug resistance, contributes to a significant burden of critical illness, while epidemics and pandemics continue to haunt the continent intermittently. In particular, the coronavirus disease 2019 (COVID-19) has highlighted the central role of critical care in pandemic response. Accessibility to critical care is affected by lack of ICU beds and high costs, and quality of critical care is affected by limited capability for investigations and treatment in low- and middle-income countries. Meanwhile, there are clear cultural differences across countries, with considerable variations in end-of-life care. Demand for critical care will rise across the continent due to ageing populations and rising comorbidity burdens. Even as countries respond by increasing critical care capacity, the critical care community must continue to focus on training for ICU healthcare workers, processes anchored on evidence-based medicine, technology guided by feasibility and impact, research applicable to Asian and local settings, and rallying of governments for support for the specialty.ConclusionsCritical care in Asia has progressed through the years, but multiple challenges remain. These challenges should be addressed through a collaborative approach across disciplines, ICUs, hospitals, societies, governments, and countries.
Clinical evaluation of periodontal pathogen levels by real-time polymerase chain reaction in peri-implantitis patients
Authors: Ito Taichi , Mori Gentaro , Oda Yukari , Hirano Tomoki , Sasaki Hodaka , Honma Shinya , Furuya Yoshitaka , Yajima Yasutomo 
Published: October 2021

Abstract
Objective
The mechanisms underlying the onset and progression of peri-implantitis are similar to those of periodontitis, and the causative bacteria are believed to similar. Previous studies support an association between peri-implantitis and periodontal pathogen. Thus, we investigated the bacterial flora of peri-implantitis patients in comparison to those of healthy implant and periodontitis patients.

Materials and methods
In total, 70 patients visiting Tokyo Dental College Chiba Hospital were divided into four groups: healthy, periodontitis, healthy implant, and peri-implantitis. For each group, the following five periodontal pathogens were detected using real-time polymerase chain reaction: Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Treponema denticola, and Prevotella intermedia.

Results
The average copy number of total bacteria was significantly higher in the periodontitis group than in the other groups. P. gingivalis was detected in the periodontitis and peri-implantitis groups at levels as high as 18.92% and 12.29%, respectively, and P. intermedia was found in the peri-implantitis group at a rate of 2.06%. Nevertheless, periodontal pathogens were generally detected at lower levels in the peri-implantitis group than in the periodontitis group.

Conclusion
We found lower bacterial counts in the peri-implantitis group relative to the periodontitis group. Our results suggest that the peri-implant tissue is less resistant to bacteria, so even a small number of bacteria can be a risk factor for peri-implantitis and the causative agent of peri-implantitis can be bacteria other than periodontal pathogen.
Communicating the Information Needed for Treatment Decision Making Among Patients With Pancreatic Cancer Receiving Preoperative Therapy
Authors: Lee Howard J. , Qian Carolyn L. , Landay Sophia L. , O'Callaghan Deirdre , Kaslow-Zieve Emilia , Azoba Chinenye C. , Fuh Charn-Xin , Temel Brandon , Ufere Nneka , Petrillo Laura A. , Fong Zhi Ven , Greer Joseph A. , El-Jawahri Areej , Temel Jennifer S. , Traeger Lara , Nipp Ryan D. 
Published: October 2021

PURPOSE: Preoperative therapy for pancreatic cancer represents a new treatment option with the potential to improve outcomes for patients, yet with complex risks. By not discussing the potential risks and benefits of new treatment options, clinicians may hinder patients from making informed decisions. METHODS: From 2017 to 2019, we conducted a mixed-methods study. First, we elicited clinicians' (n = 13 medical, radiation, and surgery clinicians), patients' (n = 18), and caregivers' (n = 14) perceptions of information needed for decision making regarding preoperative therapy and generated a list of key elements. Next, we audio-recorded patients' (n = 20) initial multidisciplinary oncology visits and used qualitative content analyses to describe how clinicians discussed this information and surveyed patients to ask if they heard each key element. RESULTS: We identified 13 key elements of information patients need when making decisions regarding preoperative therapy, including treatment complications, alternatives, logistics, and potential outcomes. Patients reported hearing infrequently about complications (eg, hospitalizations [n = 3 of 20]) and alternatives (n = 8 of 20) but frequently recalled logistics and potential outcomes (eg, likelihood of surgery [n = 19 of 20]). Clinicians infrequently discussed complications (eg, hospitalizations [n = 7 of 20]), but frequently discussed alternatives, logistics, and potential outcomes (eg, likelihood of surgery [n = 20 of 20]). No overarching differences in clinician discussion content emerged to explain why patients did or did not hear about each key element. CONCLUSION: We identified key elements of information patients with pancreatic cancer need when considering preoperative therapy. Patients infrequently heard about treatment complications and alternatives, while frequently hearing about logistics and potential outcomes, underscoring areas for improvement in educating patients about new treatment options in oncology.
Optical Field and Chemical Environment Near the Surface Modified Gold Nanoparticle Assembly Revealed by Two-Photon Induced Photoluminescence and Surface Enhanced Raman Scattering
Authors: Jimbo Atsuko , Nishikado Yui , Imura Kohei 
Published: October 2021

Abstract
Gold nanoparticle assemblies significantly enhance optical fields and have been applied for nano-optical devices, biosensing, and chemical reactions. The optical properties of the assembly are, however, less controllable once the assemblies are fabricated on a solid substrate. An assembly prepared at the water-organic solvent interface overcomes this restriction and provides flexible photochemical reaction fields. Additionally, the physical and chemical properties of the assembly can be controlled by modification of the nanoparticle surface. In this study, we investigated the optical properties of the assembly using two-photon-induced photoluminescence and surface-enhanced Raman scattering, and demonstrated that the optical field enhancement and chemical environment near the gold nanoparticle assembly can be finely controlled by surface-modification of the gold nanoparticles.
A phenomenological study on experiences of cancer stigma amongst selected people living with cancer in rural and urban Zimbabwe
Authors: Mandizadza Enock , Moyo Stanzia 
Published: October 2021

Background: Cancer is a highly stigmatized illness associated with profound adverse impact on communities, families and diagnosed individuals. Notwithstanding extensive theorizing since Erving Goffman’s classical contributions, health stigma is well explicated in context-specific and situated analysis. The current study explored the manifestations of self and enacted stigma among 20 selected people diagnosed with cancer from rural and urban Zimbabwe, who sought quaternary level of health care services in the capital, Harare. Methods: Phenomenological methodology was enlisted to capture intimate expressions of stigma as expressed about, and by people diagnosed with cancer. Data collection methods used includes semi-structured interviews, key informant interviews and focus group discussions. A semi-structured in-depth interview guide, focus group discussion guide and a key informant interview guide were the tools used to collect the data. Results: The study identified five themes of stigma, indicating pronounced, complex and multiple catalogues of stigma embedded in the existing socio-cultural milieu. Conclusions: This study stands to offer invaluable conceptual schemas and empirical insights on health-related stigma, and may aid in nursing and in the design of educational programs meant to combat health stigma.
Shaping and delivering services in primary care: benzodiazepine and opiate withdrawal service
Authors: Fernandez Jeff 
Published: October 2021

Dependency on benzodiazepine and opiates is an increasing problem. Jeff Fernandez uses case studies to show how a nurse-led addiction service based in primary care can improve patient outcomes This article looks at the development of the benzodiazepine and opiate withdrawal service (BOWS) based in addiction services in London. The service was created to implement a manageable and sustainable model that would treat patients with benzodiazepine and codeine-based dependencies. It was envisaged the service would effectively treat patients in GP practices in two boroughs in London. The article outlines what is possible in terms of treatment for patients with issues of opioid dependency, by examining two in-depth case studies. It also illustrates what is possible for nurses in the modern NHS and can be used as a resource to shape and deliver services with positive patient outcomes. Nurses should be seen as shaping and delivering care in the NHS. This is a role that should be promoted to a greater degree, wherever possible.
Lower pelvic tilt, lower pelvic incidence, and increased external rotation of the iliac wing in patients with femoroacetabular impingement due to acetabular retroversion compared to hip dysplasia
Authors: Lerch Till Dominic , Boschung Adam , Schmaranzer Florian , Todorski Inga A. S. , Vanlommel Jan , Siebenrock Klaus A. , Steppacher Simon D. , Tannast Moritz 
Published: October 2021

AimsThe effect of pelvic tilt (PT) and sagittal balance in hips with pincer-type femoroacetabular impingement (FAI) with acetabular retroversion (AR) is controversial. It is unclear if patients with AR have a rotational abnormality of the iliac wing. Therefore, we asked: are parameters for sagittal balance, and is rotation of the iliac wing, different in patients with AR compared to a control group?; and is there a correlation between iliac rotation and acetabular version?MethodsA retrospective, review board-approved, controlled study was performed including 120 hips in 86 consecutive patients with symptomatic FAI or hip dysplasia. Pelvic CT scans were reviewed to calculate parameters for sagittal balance (pelvic incidence (PI), PT, and sacral slope), anterior pelvic plane angle, pelvic inclination, and external rotation of the iliac wing and were compared to a control group (48 hips). The 120 hips were allocated to the following groups: AR (41 hips), hip dysplasia (47 hips) and cam FAI with normal acetabular morphology (32 hips). Subgroups of total AR (15 hips) and high acetabular anteversion (20 hips) were analyzed. Statistical analysis was performed using analysis of variance with Bonferroni correction.ResultsPI and PT were significantly decreased comparing AR (PI 42° (SD 10°), PT 4° (SD 5°)) with dysplastic hips (PI 55° (SD 12°), PT 10° (SD 6°)) and with the control group (PI 51° (SD 9°) and PT 13° (SD 7°)) (p < 0.001). External rotation of the iliac wing was significantly increased comparing AR (29° (SD 4°)) with dysplastic hips (20°(SD 5°)) and with the control group (25° (SD 5°)) (p < 0.001). Correlation between external rotation of the iliac wing and acetabular version was significant and strong (r = 0.81; p < 0.001). Correlation between PT and acetabular version was significant and moderate (r = 0.58; p < 0.001).ConclusionThese findings could contribute to a better understanding of hip pain in a sitting position and extra-articular subspine FAI of patients with AR. These patients have increased iliac external rotation, a rotational abnormality of the iliac wing. This has implications for surgical therapy with hip arthroscopy and acetabular rim trimming or anteverting periacetabular osteotomy (PAO). Cite this article: Bone Jt Open 2021;2(10):813–824.