bluuebunny/crossref_metadata_2025_split huggingface dataset:
Out-of-Pocket Payments for Delivery Care in India: Do Households face Hardship Financing?
Authors: Yadav Jeetendra , John Denny , Menon Geetha R. , Allarakha Shaziya 
Published: June 2021

Background: Present study aims to examine the socioeconomic and demographic factors that affect health care utilization, health care expenditure and financing strategies for delivery care in India. Methods: The study uses data from National Family Health Survey (NFHS-4), 2015-2016. Descriptive, bivariate and multivariate regression analysis were carried out to examine health care utilization, out of pocket expenditure and financing strategies for delivery care in India. We used hardship financing as when people resort to borrowings, or sale of property/jewelry to pay for healthcare expenditure Results: Overall, Janani Suraksha Yojana (JSY) could cover less than 40% of the delivery care expenditure across all states. One-third of the households borrowed money or sold property/jewelry for delivery care expenditure. Highest exposure to hardship financing was observed in utilisation of private healthcare facilities for delivery. Women from the higher income quintiles are less likely to experience hardship financing as compared to women from the poorest wealth quintile. Conclusions: The study results will be useful for government to ensure that financing policies for delivery such as JSY are effective to provide availability and affordability of delivery healthcare in India.
Distal Tibial Reconstruction in the Management of Primary Bone Tumors in Children and Adolescents
Authors: Raciborska Anna , Bilska Katarzyna , Malesza Iwona , Rodriguez-Galindo Carlos , Pachuta Bartosz 
Published: June 2021

Background: Distal tibial primary bone tumors are rare, and options for limb salvage surgery are limited and challenging. Importantly, local control has shown to be crucial and necessary for cure, and radical surgery is one of the most important components of therapy for some bone sarcomas. We investigated the feasibility and functional and oncological outcomes of distal tibial reconstruction using endoprosthesis in children with malignant bone tumors. Methods: Fourteen patients (median age 13.6 years) with primary bone tumors (4 Ewing sarcoma [ES], 10 osteosarcoma) of the distal tibiae were treated during 2013-2019. All patients had reconstruction using a modular (13 patients) or expandable custom-made titanium bone replacement system (1 patient). All patients received chemotherapy before and after surgery. Results: Twelve patients (85.7%) are alive with a median follow-up 20 months from diagnosis. Five-year estimates of event-free survival and overall survival were 60.6% and 76.4%, respectively. Three patients had postoperative complications requiring second surgery. Maximum dorsiflexion and plantar flexion of the foot were 20 degrees (range 0-20 degrees) and 20 degrees (range 5-20 degrees), respectively. Conclusion: For select distal tibial sarcomas, after neoadjuvant chemotherapy pretreatment and radical resection, reconstruction using an endoprosthesis as a radical surgery provides an option was associated with a low rate of short-term local complications and relatively good early function. Level of Evidence: Level IV, therapeutic study.
The use of Ologen Collagen Matrix implants to treat ocular hypotony developing after trabeculectomy: A case series
Authors: Russ Heloisa , Maestrini Heloisa Andrade , Coelho Laura Fernandes , Balbino Marcos , Seixas Regina Cele Silveira 
Published: June 2021

Purpose: Late hypotony is an undesirable and challenging complication of glaucoma surgery. We describe our use of the Ologen Collagen Matrix to treat late hypotony developing after trabeculectomy. Study design: A retrospective study performed at three eye surgery centers in Brazil. Participants: Eighteen patients who underwent 19 eye surgeries. Intervention: Subconjunctival Ologen was implanted at the trabeculectomy sites to treat over-filtering or leaking blebs in patients experiencing late hypotony after trabeculectomy (obtained 6 months after glaucoma surgery). The primary outcome was the intraocular pressure (IOP); we gathered preoperative data records from 19 Ologen treated eyes and days 1, 7, 30, 60, and 180 postoperatively. The secondary outcomes included visual acuity and macular thickness measured via optical coherence tomography; we compared preoperative data to subsequent ones up to sixth-month-evolution. Results: Over the 6-month period, the IOP rose from 2.89 ± 1.59 mmHg preoperatively to 8.21 ± 3.46 mmHg ( p = 0.0001). Visual acuity improved from 0.33 ± 0.29 to 0.21 ± 0.31 LogMar ( p = 0.0013). Macular thickness fell from 325.62 ± 58.7 to 283.08 ± 47.35 µm ( p = 0.0097). We encountered two complications: one related to suture dehiscence following an ocular trauma and one instance of transitory choroidal detachment. Conclusion: Subconjunctival Ologen implants preserved bleb function and successfully treated post-trabeculectomy hypotony as revealed by data collected at the 6-month follow-up. Longer follow-up is necessary to confirm long-term efficacy and safety. There are no financial conflicts of interest to disclose.
Involvement of Jordanian Head Nurses’ in Health Policy Development: A Cross-Sectional Study
Authors: Al Faouri Ibrahim Ghaleb , Elfaqieh Khloud , AbuAlRub Raeda 
Published: June 2021

Background Despite the importance of involving nurses in health policy, nurse’s involvement faces many challenges. Literature showed that there is a low level of nurses’ and nurse leaders’ involvement in health policy development. Aim The aims of this study were to examine (a) the level of Jordanian head nurses’ involvement in health policy development and their perceived benefits and barriers; (b) the relationships between level of knowledge, competence, and interest in health policy and the level of involvement in health policy development; and (c) the relationship between the level of self-efficacy (efficacy expectation and outcome expectation) and the level of involvement in health policy development. Methods A cross-sectional descriptive correlational study design was adopted in this study. A convenience sampling of 250 participants from hospitals affiliated to three health sectors in Jordan (private, governmental, and university) were recruited to complete a self-administered questionnaire. Descriptive statistics and Pearson correlation coefficient were used to answer the study questions. Results The results revealed a moderate level of involvement of head nurses in the policy development. The most frequent cited political activity was “providing written reports, consultations, research.” “Lack of time” was the most perceived barrier, while “improving the health of the public” was the most perceived benefit. Workshops or sessions at conferences is the most indicated source of knowledge. Participants had an excellent level of skills with positive relationships between the competence and both of the levels of professional and personal involvement in health policy. Participants reported a low level of confidence in performing political activities as well as the impact of such activities on health outcomes. Positive relationship was indicated between self-efficacy and the levels of professional and personal involvement in political activities. Implications: Health policies affect nurses and their practice. Overcoming the barriers and enhancing the levels of head nurses’ knowledge and competence regarding health policies can help activating their roles in health policy development process. This will help in activating nurses’ role in health policy development, which in turn will have a positive impact on health outcomes.
A comparison of endovascular versus open repair for ruptured abdominal aortic aneurysm – Meta-analysis of propensity score-matched data
Authors: Alsusa Hatim , Shahid Abbas , Antoniou George A 
Published: June 2021

Background Optimal management of ruptured abdominal aortic aneurysms (rAAA) has been heavily debated in the literature. The aim of this review is to assess comparative outcomes from propensity-matched studies of endovascular versus open for rAAA. Methods Electronic databases (MEDLINE and Embase) were searched in January 2021 using the Healthcare Databases Advanced Search interface. Eligible studies compared endovascular versus open repair for rAAA using propensity-matched cohorts. Pooled estimates of perioperative outcomes were calculated using odds ratio (OR) or mean difference (MD) and 95% confidence interval (CI) using the random-effects model. Time-to-event data meta-analysis was conducted using the inverse-variance method and reported as summary hazard ratio (HR) and associated 95% CI. The quality of evidence was graded using a system developed by the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) working group. Results Six studies published between 2010 and 2020 were selected for qualitative and quantitative synthesis, reporting a total of 6731 patients. The odds of perioperative mortality after endovascular aneurysm repair (EVAR) were significantly lower than after open surgical repair (OSR) (OR 0.52, 95% CI 0.41–0.65). The hazard of overall mortality during follow-up was lower, although not significantly, after EVAR than after OSR (HR 0.79, 95% CI 0.62–1.01). The odds of acute kidney injury and early aneurysm-related reintervention were both significantly lower after EVAR than after OSR (OR 0.34, 95% CI 0.14–0.78 and OR 0.57, 95% CI 0.33–0.98, respectively). Patients treated with EVAR stayed in hospital for significantly less time than those treated with OSR (MD −5.13, 95% CI −7.94 to −2.32). The certainty of the body of evidence for perioperative mortality was low and for overall mortality was very low. Conclusion The evidence suggests that EVAR confers a significant benefit on perioperative mortality.
Pharmacist-led sedative-hypnotic deprescribing in team-based primary care practice
Authors: Lui Eric , Wintemute Kimberly , Muraca Maria , Truong Christine , Ha Rita , Choe Albert Kee Buhm , Michell Laura , Laine-Gossin Joanne , Blankenstein Harvey , Klein Stephanie , Mayer Dana , Feder Victor , Greiver Michelle 
Published: June 2021

Background: Sedative-hypnotic (SH) medications are often used to treat chronic insomnia, with potentially serious long-term side effects. The objective of this study is to evaluate an interprofessional SH deprescribing program within a community team-based, primary care practice, with or without cognitive behavioural therapy for insomnia (CBT-I). Methods: Retrospective chart review for patients referred to the team pharmacist for SH deprescribing from February 2016 to June 2019. Results: A total of 121 patients were referred for SH deprescribing, with 111 (92%) patients who attempted deprescribing (average age 69, range 29-97 years) and 22 patients who also received CBT-I. Overall, 36 patients (32%) achieved complete abstinence, and another 36 patients (32%) reduced their dosage by ≥50%. For the 36 patients who achieved complete abstinence, 26 (72%) patients remained abstinent at 6 months (9 patients resumed using SH and 1 patient was lost to follow-up). The proportion of patients achieving complete abstinence or reduced dosage of ≥50% (successful tapering) was higher with CBT-I than without CBT-I but did not reach statistical significance (77% vs 62%, p = 0.22). There were also no statistically significant differences detected in the success between those who took a benzodiazepine and those who took a Z-drug (67% vs 61%, p = 0.55) or for those who took SH daily and those who took them intermittently (67% vs 44%, p = 0.09). Conclusion: Almost two-thirds of patients participating in our pharmacist-led program were able to stop or taper their SH medications by ≥50%. The role of CBT-I in SH deprescribing remains to be further elucidated. Can Pharm J (Ott) 2021;154:xx-xx.
Beyond the Crew: Hip-Hop and Professionalization in Mexico City
Authors: Green Andrew 
Published: June 2021

In recent years profesionalización – professionalization – has become an increasingly influential concept in the hip-hop scene in Mexico City. This term can refer to a variety of changing practices relating to artistic presentation, the organization of hip-hop events, and the hip-hop scene’s model of creative production. The influence of professionalization relates to the rising specialization of hip-hop production and the increasing importance of the digital circulation of music and images; increasingly, success is made on YouTube and Spotify. It also relates to new sources of income, such as freestyle rap battles with corporate sponsorship, and to nascent spaces for hip-hop within adult education. Above all, professionalization relates to a series of structural changes connected to the declining influence of crews, oriented around something akin to Spillman’s ‘non-strategic solidarity’: fraternity, informality, and shared identity. In some cases, crews are giving way to more formal ‘teams’, oriented around the solo artists that now dominate the hip-hop scene. This article builds on ongoing ethnographic research since 2012 and a series of interviews with over 40 local hip-hop artists, to explore professionalism and professionalization as emergent, negotiated values within Mexico City’s hip-hop scene. It offers a frame through which different ideas of the ‘professional’ may be considered: object-forming (relating to the creation of a ‘professional’ music object) and subject-forming (relating to the formation of a ‘professional’ subject). Profesionalización cannot be understood in a functionalist sense, nor may the hip-hop ‘professional’ be conceptualized as a straightforward antonym of ‘amateur’. This article instead shows different ways that ‘object-forming’ and ‘subject-forming’ professionalization both incorporate and texture the ‘non-strategic’ and distinguish hip-hop ‘professionalism’ from the same texture the ‘non-strategic’, and distinguish hip-hop professionalism from it.
Determination and clinical significance of bone pseudoprogression in hormone receptor-positive metastatic breast cancer
Authors: Lin Mingxi , Jin Yizi , Yang Ziyi , Hu Xichun , Zhang Jian 
Published: June 2021

Background: 99mTechnetium labeled methylene diphosphonate bone scans (BSs) are commonly used to monitor disease progression in bone for patients with metastatic breast cancer (MBC). However, new BS lesions may represent osteoblastic bone healing, which we now define as bone pseudoprogression. In this study, we aimed to assess the clinical significance and determination methods of bone pseudoprogression. Methods: This retrospective analysis was conducted among 48 patients with hormone receptor-positive MBC treated with first-line endocrine therapy. Four months after initiating therapy, all the participants did not show extraosseous disease progression. Participants were divided into two groups according to the presence of new BS lesions. All the patients continued on treatment until explicit disease progression (extraosseous disease progression or progressive lysis on bone lesions). Explicit progression-free survival (PFS) and extraosseous objective response rate were analyzed between the two groups. Results: New BS lesions were observed in 11 of 48 (22.9%) patients. All the new BS lesions appeared as osteoblastic bone lesions on computed tomography. For patients with new BS lesions, the median PFS was 26.57 months [95% confidence interval (CI) 15.46–37.68], which was similar to that (29.57 months; 95% CI 19.24–39.90) in patients without new BS lesions [hazard ratio: 1.098 (95% CI 0.482–2.503), p = 0.818]. Notably, 82.9% of patients without new BS lesions showed an extraosseous objective response, whereas 85.7% of patients with new BS lesions demonstrated an extraosseous objective response [odds ratio: 0.806 (95% CI 0.061–5.682), p = 0.999]. The median interval between bone pseudoprogression and true disease progression was 21.26 months (95% CI 10.11–32.42). Conclusions: Osteoblastic new BS lesions detected on follow-up BSs may represent bone pseudoprogression. Clinicians should raise awareness of bone pseudoprogression, thereby avoiding premature discontinuation of therapy and maximizing the opportunity to benefit from endocrine therapy. Due to the small sample size and retrospective nature of the study, large prospective clinical trials are needed to confirm our findings.
Intramuscular neridronate for the treatment of complex regional pain syndrome type 1: a randomized, double-blind, placebo-controlled study
Authors: Varenna Massimo , Braga Vania , Gatti Davide , Iolascon Giovanni , Frediani Bruno , Zucchi Francesca , Crotti Chiara , Nannipieri Fabrizio , Rossini Maurizio 
Published: June 2021

Background: Complex regional pain syndrome type-1 (CRPS-1) is a severely disabling painful disease challenging to treat. This multicenter, randomized, double-blind placebo-controlled trial examined the efficacy of intramuscular (i.m.) neridronate in CRPS-1 patients. Methods: A total of 78 patients diagnosed with CRPS-1 (aged 59.5 ± 10.3, 66.7% female) were randomly assigned to 25 mg (i.m.) neridronate ( N = 41) given once daily for 16 consecutive days or placebo control ( N = 37). Efficacy was assessed after 30 days using a visual analogue scale (VAS) pain score and the number of patients achieving ⩾50% reduction in VAS score. Change in clinical signs and symptoms, quality of life (QoL) using Short Form Health Survey (SF-36) and the McGill Pain Questionnaire were also assessed. Results: After 30 days, VAS score decreased significantly to a greater extent in neridronate-treated patients versus placebo (31.9 ± 23.3 mm versus 52.3 ± 27.8 mm, p = 0.0003). Furthermore, the proportion of patients achieving a VAS reduction of ⩾50% was greater in the neridronate group (65.9% versus 29.7%, p = 0.0017). Clinical signs and symptoms were improved significantly in the neridronate group versus placebo for edema (72.5% versus 79.9%, p = 0.03), pain during motion (70% versus 83.3%, p = 0.0009), allodynia (20% versus 63.3%, p = 0.0004), and hyperalgesia (20% versus 56.7%, p = 0.0023). Whereas no difference was observed for QoL measures using the SF-36 questionnaire, three of the four pain variables using the McGill Pain Questionnaire improved significantly in the neridronate group. No serious drug-related adverse events were reported during the study. Conclusion: In patients with acute CRPS-1, i.m. injections of 25 mg neridronate were associated with clinically relevant benefit compared with placebo controls. Trial registration: EU Clinical Trials Register: https://www.clinicaltrialsregister.eu/ctr-search/search?query=2014-001156-28
Cross-echelon managerial design competencies: Relational coordination in organizational learning and growth performance
Authors: Hernaus Tomislav , Juras Ana , Matic Ivan 
Published: June 2021

We followed the continuity perspective of leadership skill requirements to examine the interplay between the design competencies of different management cohorts, relational coordination, and organizational learning and growth performance outcomes. Using a two-source sample of 103 organizations, we found evidence for compensatory effects. Specifically, a conditional process analysis (moderated mediation) revealed that: (a) design competencies are a highly relevant type of managerial knowledge or skill, (b) competent middle-level managers compensate for a lack of design skills and design-related knowledge at the top management level, and (c) top- and middle-level managerial design competencies simultaneously create a cross-echelon complementarity effect on organizational learning and growth performance. JEL classification
β-elemene alleviates airway stenosis via the ILK/Akt pathway modulated by MIR143HG sponging miR-1275
Authors: Zhang Guoying , Xue Cheng , Zeng Yiming 
Published: June 2021

Abstract
Background
We have previously found that β-elemene could inhibit the viability of airway granulation fibroblasts and prevent airway hyperplastic stenosis. This study aimed to elucidate the underlying mechanism and protective efficacy of β-elemene in vitro and in vivo.

Methods
Microarray and bioinformatic analysis were used to identify altered pathways related to cell viability in a β-elemene-treated primary cell model and to construct a β-elemene-altered ceRNA network modulating the target pathway. Loss of function and gain of function approaches were performed to examine the role of the ceRNA axis in β-elemene's regulation of the target pathway and cell viability. Additionally, in a β-elemene-treated rabbit model of airway stenosis, endoscopic and histological examinations were used to evaluate its therapeutic efficacy and further verify its mechanism of action.

Results
The hyperactive ILK/Akt pathway and dysregulated LncRNA-MIR143HG, which acted as a miR-1275 ceRNA to modulate ILK expression, were suppressed in β-elemene-treated airway granulation fibroblasts; β-elemene suppressed the ILK/Akt pathway via the MIR143HG/miR-1275/ILK axis. Additionally, the cell cycle and apoptotic phenotypes of granulation fibroblasts were altered, consistent with ILK/Akt pathway activity. In vivo application of β-elemene attenuated airway granulation hyperplasia and alleviated scar stricture, and histological detections suggested that β-elemene's effects on the MIR143HG/miR-1275/ILK axis and ILK/Akt pathway were in line with in vitro findings.

Conclusions
MIR143HG and ILK may act as ceRNA to sponge miR-1275. The MIR143HG/miR-1275/ILK axis mediates β-elemene-induced cell cycle arrest and apoptosis of airway granulation fibroblasts by modulating the ILK/Akt pathway, thereby inhibiting airway granulation proliferation and ultimately alleviating airway stenosis.
Feasibility and safety of cangrelor in patients with suboptimal P2Y12 inhibition undergoing percutaneous coronary intervention: rationale of the Dutch Cangrelor Registry
Authors: Selvarajah A. , Tavenier A. H. , Bor W. L. , Houben V. , Rasoul S. , Kaplan E. , Teeuwen K. , Hofma S. H. , Lipsic E. , Amoroso G. , van Leeuwen M. A. H. , Berg J. M. ten , van ‘t Hof A. W. J. , Hermanides R. S. 
Published: June 2021

AbstractBackgroundDespite the advances of potent oral P2Y12inhibitors, their onset of action is delayed, which might have a negative impact on clinical outcome in patients undergoing percutaneous coronary intervention (PCI). Trials conducted in the United States of America have identified cangrelor as a potent and rapid-acting intravenous P2Y12inhibitor, which has the potential of reducing ischemic events in these patients without an increase in the bleeding. As cangrelor is rarely used in The Netherlands, we conducted a nationwide registry to provide an insight into the use of cangrelor in the management of patients with suboptimal platelet inhibition undergoing (primary) PCI (the Dutch Cangrelor Registry).Study designThe Cangrelor Registry is a prospective, observational, multicenter, single-arm registry with cangrelor administered pre-PCI in: (1) P2Y12naive patients with ad-hoc PCI, (2) patients with STEMI/NSTEMI with suboptimal P2Y12inhibition including (3) stable resuscitated/defibrillated patients with out-of-hospital cardiac arrest (OHCA) due to acute ischemia and (4) STEMI/NSTEMI patients with a high thrombotic burden. Primary endpoint is 48 h Net Adverse Clinical Events (NACE), which is a composite endpoint of all-cause death, recurrent myocardial infarction (MI), target vessel revascularization (TVR), stroke, stent thrombosis (ST) and BARC 2-3-5 bleeding.SummaryThe Dutch Cangrelor Registry will assess the feasibility and safety of cangrelor in patients with suboptimal P2Y12inhibition undergoing (primary) PCI in the setting of acute coronary syndrome (ACS) and stable coronary artery disease (CAD) in the Netherlands.