bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of peritoneal dialysis-related peritonitis on PD discontinuation and mortality: A population-based national cohort study
Authors: Chung Mu-Chi , Yu Tung-Min , Wu Ming-Ju , Chuang Ya-Wen , Muo Chih-Hsin , Chen Cheng-Hsu , Huang Shih-Ting , Li Chi-Yuan , Shieh Jeng-Jer , Hung Peir-Haur , Chung Chi-Jung 
Published: June 2021

Background: The impact of peritoneal dialysis-associated peritonitis (PD peritonitis) on long-term outcomes is uncertain. This nationwide retrospective study was conducted in Taiwan to understand the incidence, risk factors and long-term outcomes of PD peritonitis. Methods: A total of 11,202 incident adult peritoneal dialysis (PD) patients from 2000 to 2010 were collected from a Longitudinal Health Insurance Database and followed up until the end of 2011. Definition of peritonitis, the primary outcome, simultaneously met the diagnosis of peritonitis (International Classification of Diseases, Ninth Revision, Clinical Modification 567) and antibiotic use. Secondary outcomes included the impact of peritonitis on PD discontinuation and survival. Cox proportional hazards models with and without time-dependent variables were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: There were 7634 peritonitis episodes in 4245 patients during the follow-up period. The overall incidence of peritonitis was 0.18 episodes per patient-year. Peritonitis-associated risk factors included older age, female gender, chronic heart failure, cerebrovascular disease, liver cirrhosis and lower monthly income. In an adjusted Cox hazard proportional regression with the time-dependent model, peritonitis patients had a higher risk of PD discontinuation (HR 2.71, 95% CI 2.52–2.92) and mortality (HR 1.68, 95% CI 1.57–1.81) compared to patients without peritonitis. The adjusted HRs for mortality increased with each prior episode: one episode, two episodes and more than two episodes (all p < 0.05). The adjusted HRs for PD discontinuation also increased with the frequency of peritonitis. These negative effects were greatest during the first year and persisted significantly after 5 years. In a sensitivity analysis in which peritonitis within 30 days of death or PD discontinuation was excluded, peritonitis patients still had significantly increased risk of PD discontinuation and mortality compared to patients without peritonitis. Conclusions: Although peritonitis incidence was low, our findings reveal that peritonitis carried acute and long-term sequelae of higher PD discontinuation and lower patient survival.
Non-Spousal Support, Marital Status, and Mortality Risk
Authors: Roth Adam R. , Peng Siyun 
Published: June 2021

Objective To investigate whether the association between non-spousal support and mortality risk differs by marital status. Methods Using data from the National Social Life, Health, and Aging Project (N = 2460), we estimate a series of logistic regression models to assess how non-spousal support moderates the relationship between marital status and mortality across a 5-year period. Results Never married respondents who had minimal perceived access to non-spousal support had a greater probability of death compared to married respondents with similar levels of non-spousal support. The disparity in mortality risk between these two groups disappeared when non-spousal support was high. Discussion Although family and friends play an important role in mortality risk in later life, these findings suggest that never married older adults exhibit a heightened dependence on support from non-spousal sources. Future research and policies should explore ways in which never married older adults can be integrated into a supportive social environment.
Long-Term Outcome of Sciatic Nerve Regeneration Using Bio3D Conduit Fabricated from Human Fibroblasts in a Rat Sciatic Nerve Model
Authors: Ando Maki , Ikeguchi Ryosuke , Aoyama Tomoki , Tanaka Mai , Noguchi Takashi , Miyazaki Yudai , Akieda Shizuka , Nakayama Koichi , Matsuda Shuichi 
Published: June 2021

Previously, we developed a Bio3D conduit fabricated from human fibroblasts and reported a significantly better outcome compared with artificial nerve conduit in the treatment of rat sciatic nerve defect. The purpose of this study is to investigate the long-term safety and nerve regeneration of Bio3D conduit compared with treatments using artificial nerve conduit and autologous nerve transplantation. We used 15 immunodeficient rats and randomly divided them into three groups treated with Bio3D ( n = 5) conduit, silicon tube ( n = 5), and autologous nerve transplantation ( n = 5). We developed Bio3D conduits composed of human fibroblasts and bridged the 5 mm nerve gap created in the rat sciatic nerve. The same procedures were performed to bridge the 5 mm gap with a silicon tube. In the autologous nerve group, we removed the 5 mm sciatic nerve segment and transplanted it. We evaluated the nerve regeneration 24 weeks after surgery. Toe dragging was significantly better in the Bio3D group (0.20 ± 0.28) than in the silicon group (0.6 ± 0.24). The wet muscle weight ratios of the tibial anterior muscle of the Bio3D group (79.85% ± 5.47%) and the autologous nerve group (81.74% ± 2.83%) were significantly higher than that of the silicon group (66.99% ± 3.51%). The number of myelinated axons and mean myelinated axon diameter was significantly higher in the Bio3D group (14708 ± 302 and 5.52 ± 0.44 μm) and the autologous nerve group (14927 ± 5089 and 6.04 ± 0.85 μm) than the silicon group (7429 ± 1465 and 4.36 ± 0.21 μm). No tumors were observed in any of the rats in the Bio3D group at 24 weeks after surgery. The Bio3D group showed significantly better nerve regeneration and there was no significant difference between the Bio3D group and the nerve autograft group in all endpoints.
Nurses’ self-assessed moral courage and related socio-demographic factors
Authors: Hauhio Nora , Leino-Kilpi Helena , Katajisto Jouko , Numminen Olivia 
Published: June 2021

Background: Nurses need moral courage to ensure ethically good care. Moral courage is an individual characteristic and therefore it is relevant to examine its association with nurses’ socio-demographic factors. Objective: To describe nurses’ self-assessed level of moral courage and its association with their socio-demographic factors. Research design: Quantitative descriptive cross-sectional study. The data were collected with Nurses’ Moral Courage Scale and analyzed statistically. Participants and research context: A total of 482 registered nurses from a major university hospital in Southern Finland completed the Finnish language version of Nurses’ Moral Courage Scale in autumn 2017. Ethical considerations: Ethical approval was obtained from the university ethics committee and permission for the data collection from the participating hospital. Ethical principles and scientific guidelines were followed throughout the research process. Findings: Nurses’ self-assessed level of moral courage was rather high. On Visual Analogy Scale (0–10), the mean value was 8.20 and the mean score of the four dimensional, 21-item Nurses’ Moral Courage Scale was 4.09 on a 5-point Likert-type scale. Respondents’ gender, present work role, ethical knowledge base, additional ethics education, self-study as a means to acquire ethical knowledge, and frequency of work situations needing moral courage were statistically significantly associated with nurses’ moral courage. Discussion: Strongest association was found between nurses’ higher moral courage level and formal and informal ethics education. Honesty and patient’s humane and dignified encounter received the highest scores indicating respondents’ internalization of the core values of nursing. Conclusion: Although nurses were fairly morally courageous, moral courage should be a part of nurses’ basic and continuing education thus covering its theoretical and practical learning. Since moral courage is a virtue that can be taught, learnt, and practiced, education is a relevant way to maintain and further strengthen nurses’ moral courage.
Global Green New Deal: A Global South perspective
Authors: Chen Ying , Li An 
Published: June 2021

Most proposed solutions in the Global Green New Deal literature involve finance and technology transfers to address the imbalance between the Global North and Global South, while providing little discussion of the internal socioeconomic structures within countries in the Global South. This article uses China as a case study to show that without addressing the issue of domestic informality, the potential benefits of a Global Green New Deal are less likely to be fully realised in the Global South. We use the Input-Output method and our originally constructed data on formal and informal employment to calculate the informal employment share in two exemplary renewable energy sectors: solar and wind. We find that more than half of the jobs created in the solar and wind energy sectors, with a given level of spending, will be in the informal economy, and hence are associated with low wages and little social welfare protection. The results imply that, without addressing informality, both renewable energy sectors perpetuate the informal structure in the broader economy. We also question the capitalist nature of ‘green jobs’ created by the Green New Deal. Based on the results, we call for a more organic integration of a Global South perspective in the studies of a Global Green New Deal. JEL Codes: Q01, E26, N55
Long-term Patient-Reported Outcome Measures Following Particulated Juvenile Allograft Cartilage Implantation for Treatment of Difficult Osteochondral Lesions of the Talus
Authors: Manzi Joseph , Arzani Artine , Hamula Mathew J. , Manchanda Kshitij , Dhanaraj Dinesh , Chapman Cary B. 
Published: June 2021

Background: Conventional methods are not suitable for difficult to treat osteochondral lesions of the talus (OCLTs). The role of particulated juvenile allograft articular cartilage implantation is not well elucidated for long-term patient outcomes. Methods: Thirteen patients with difficult-to-treat OCLTs underwent arthroscopy-assisted implantation of particulated juvenile articular cartilage graft into defects from 2010 to 2012 by the same surgeon. “Difficult to treat” was defined as having at least 3 of the following features or 2 if both variables described lesion characteristics: (1) lesions size of 107 mm2 or greater, (2) shoulder lesions, (3) patients who failed microfracture, (4) patient aged ≥40 years, or (5) patient body mass index (BMI) >25. Patients were evaluated using physical examination, patient interviews, and outcome score measures. Patients had follow-up at 2 years, 4 years, and between 6 and 10 years at their most recent follow-up. Differences in functional outcome scores were compared before and after surgery. Results: Patients (age: 46.5 ± 11.8 years, BMI: 28.5 ± 6.1) had, on average, most recent follow-up of 8.0 years (range 72-113 months). Average visual analog scale for pain score decreased for patients by 3.9 points (95% confidence interval [CI] 2.18-5.60), when compared to preoperative assessment. Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sports subscale scores also improved from 46.5 to 80.9 (95% CI 21.35-47.43), and from 18.8 to 57.9 (95% CI 21.05-57.10), respectively. Short Form–36 Health Survey physical component scores showed significant improvement by an average of 45.5 points (95% CI 32.42-58.50). American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Scale scores improved from 55.2 to 80.3 (95% CI 12.459-37.741). Conclusion: These results demonstrate positive patient-reported long-term outcomes for a cohort of patients with difficult OCLTs, followed over the course of 6-10 years after treatment with arthroscopy-assisted particulated juvenile articular cartilage implantation. Level of Evidence: Level II, prospective cohort study.
Short-term Efficacy of Ultrasonographic Guidance for Intra-articular Corticosteroid Injection in Hallux Rigidus: A Single-Blind Randomized Controlled Trial
Authors: Emami Razavi Seyede Zahra , Azadvari Mohaddeseh , Fateh Hamid R. , Ghahvechi Akbari Masood , Kazemi Shahrbanoo , Rezaee Elahe 
Published: June 2021

Background: Multiple considerations should be taken before standardizing a clinical procedure such as efficacy, safety, or the cost. The aim of this study was to compare the effects of landmark-guided vs ultrasonography-guided intra-articular injection of corticosteroid into the first metatarsophalangeal joint cavity to reduce pain and dysfunction in patients with hallux rigidus. Methods: We carried out a single-blind randomized controlled trial with 2 parallel arms in an outpatient clinic affiliated with a medical university. In total, 50 participants (35 women) with the mean (SD) age of 49.8 (10.3) years were randomly allocated to landmark-guided or ultrasonography-guided groups (each n = 25). Each patient received a single intra-articular injection of 40-mg methylprednisolone plus 1 mL lidocaine into the affected first metatarsophalangeal joint. The primary outcome was joint pain and the secondary outcome was the American Orthopaedic Foot & Ankle Society score. We measured the outcomes at baseline and 2 and 6 weeks after the intervention. Results: Six weeks after the injections, there were no statistically significant differences between the study groups in pain reduction and increase in the American Orthopaedic Foot & Ankle Society scores ( P = .131 and .241, respectively). We did not find any complications for the injections in both groups. There were statistically significant changes within each group in pain and the scores for the landmark ( P < .001, and P = .007), and ultrasonography groups (both P < .001). Conclusion: Landmark guidance is as effective as ultrasonographic guidance for intra-articular injection in patients with hallux rigidus. A single intra-articular injection of 40 mg methylprednisolone plus 1 mL lidocaine is an efficient and safe therapeutic measure for decreasing joint pain and maintaining its function, at least for 6 weeks. Level of Evidence: Level I, high-quality prospective randomized study.
Comparative Reliability of a Novel Electromechanical Device and Handheld Ruler for Measuring First Ray Mobility
Authors: Morgan Oliver J. , Hillstrom Rajshree , Turner Robert , Day Jonathan , Thaqi Ibadet , Caolo Kristin , Song Jinsup , Russell Roland , Ellis Scott , Deland Jonathan T. , Hillstrom Howard J. 
Published: June 2021

Background: Quantifying first ray mobility is crucial to understand aberrant foot biomechanics. A novel device (MAP1st) that can perform measurements of first ray mobility in different weightbearing conditions, foot alignments, and normalization was tested. The reliability of these measurement techniques was assessed in comparison to a handheld ruler considered representative of the common clinical examination. Methods: The study included 25 participants (50 feet). Two independent raters performed baseline, test-retest, and remove-replace measurements of first ray mobility with MAP1st and the handheld device. The effects of non-, partial, and full weightbearing in subtalar joint neutral and the resting calcaneal stance position were assessed. Measurement normalization relative to foot size was also investigated. Intra- and interclass correlation coefficients (ICCs) were calculated for each device between the 2 raters. In addition, Bland-Altman plots were constructed to determine if fixed biases or substantial outliers were present. Results: Similar intrarater ICC values were found for both devices (≥0.85). However, interrater ICC values were substantially improved by MAP1st compared with the handheld device (0.58 vs 0.06). Bland-Altman plots demonstrated biases of 1.27 mm for the handheld ruler, and 2.88 to 0.05 mm and −1.16 to 0.00 for linear and normalized MAP1st measurements, respectively. Improved reliability was achieved with MAP1st for normalized assessments of first ray mobility while the foot was placed in partial- and full-weightbearing resting calcaneal stance positions. Conclusion: MAP1st provided reliable assessments of partial- and full-weightbearing first ray mobility. It should help investigators to explore the potential relationships between first ray function and aberrant foot biomechanics in future research. Level of Evidence: Level II, prospective cohort study.
Real-world evidence for carfilzomib dosing intensity on overall survival and treatment progression in multiple myeloma patients
Authors: Raje Noopur , Medhekar Rohan , Panjabi Sumeet , Hines Dionne M , Wang Xin , Iskander Karim , Welliver Tim , Wade Rolin L , Ailawadhi Sikander 
Published: June 2021

Introduction Carfilzomib dosing as a single agent or in combination with dexamethasone (Kd) has evolved from the initial 27 mg/m2 twice-weekly (legacy dose), to more recently approved doses of 56 mg/m2 twice-weekly and 70 mg/m2 once-weekly (optimized doses). The objective of this study was to evaluate the overall survival (OS), and time to next treatment (TTNT) among multiple myeloma patients treated with Kd optimized vs legacy doses. Methods A retrospective analysis of patients receiving Kd between 01/01/2013–07/31/2017 was conducted using IQVIA’s oncology electronic medical records database. Kd dose was estimated based on body surface area. OS was measured from the Kd-initiation date until death. TTNT was defined as the time from Kd-initiation until the start of subsequent treatment. Kaplan-Meier analysis and Cox models were used to evaluate OS and TTNT. Results Of the 1,469 patients evaluated, 129 (8.8%) received optimized dose and 1,340 (91.2%) received legacy dose. Risk of mortality was 64% lower for patients receiving the optimized doses (HR: 0.36, 95% CI: 0.178–0.745). Patients receiving the optimized doses had significantly longer TTNT compared to patients receiving the legacy dose (median TTNT: 17.5 months [95% CI: 14.8-NE] and 13.2 months, [95% CI: 12.4–14.4], respectively; p = 0.023), and 33% lower risk of progressing to the subsequent treatment (HR: 0.67, 95% CI: 0.48–0.93). Conclusions Patient outcomes could be improved if eligible MM patients are treated with the optimized, recently approved Kd doses (56 mg/m2 twice-weekly and 70 mg/m2 once-weekly).
A retrospective observational study of a low fixed-dose rasburicase protocol for the treatment of tumor lysis syndrome in adults
Authors: Hossain Shahrier , Naber Martha , Yacobucci Matthew J 
Published: June 2021

Introduction Tumor lysis syndrome is an oncologic emergency characterized by hyperuricemia. Previous studies have demonstrated that a fixed-dose strategy of rasburicase is as effective as the FDA approved weight-based dose. Albany Medical Center employs rasburicase 1.5 mg in patients with a uric acid (UA) between 8 and 12 mg/dL and 3 mg for UA above12 mg/dL.We aimed to evaluate the UA lowering effectiveness and provider adherence to the institutional protocol, as well as the cost-efficiency of this dosing strategy. Methods This is a single center, retrospective, cohort study. The electronic medical record was used to identify patients receiving rasburicase and to collect baseline demographic and laboratory data. The fixed-dose strategies of rasburicase 1.5 mg and 3 mg were compared in their degree of UA reduction and clinical outcomes. Cost-savings of fixed-dosing was compared to the FDA-approved weight-based dose. Results Mean UA reduction in the 1.5 mg group (n = 49) from baseline to 24 hours was 2.88 ± 0.88 mg/dL (p < 0.0001) and 4.83 ± 1.39 mg/dL (p < 0.0001) in the 3 mg group (n = 105). A subgroup analysis of patients who received per protocol initial doses of rasburicase showed a mean reduction in UA from baseline to 24 hours of 2.83 ± 0.62 mg/dL in the 1.5 mg group (n = 42) and 6.12 ± 1.87 mg/dL in the 3 mg group (n = 42). Using a low fixed-dose approach resulted in a cost-savings of $138,077.30 annually. Conclusion Low fixed-dose rasburicase was an effective treatment, with a dose of 1.5 mg being sufficient to reach a goal UA of less than 8 mg/dL for serum UA levels below 12 mg/dL, while a 3 mg dose is appropriate for levels above 12 mg/dL. Cost analysis indicates this strategy is more cost-efficient than the FDA-approved weight-based dose.
Effects of plasma atherogenic index and plasma osmolality on arteriovenous fistula patency in hemodialysis patients
Authors: Güven Cengiz , Pala Arda Aybars , Urcun Yusuf Salim 
Published: June 2021

Background: The purpose of the present study was to investigate the effects of Plasma atherogenic index (AIP) and plasma osmolality (PO) values on arteriovenous fistula (AVF) patency in patients with chronic renal failure. Methods: The patients with primary AVF between December 2012 and March 2020 with the diagnosis of end-stage renal disease in our clinic were included in the study. The patient data were collected retrospectively in digital medium. Diabetic patients were not included in the study. The Triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), sodium (Na), fasting blood glucose, and blood urea nitrogen (BUN) values were found and recorded from the files. AIP and PO were calculated with special formulas. Fistula patency rate in 6th, 12th, and 24th months were evaluated in 2-year follow-ups. Results: According to the results of two-year follow-ups of the 162 patients, who underwent primary AVF, 21 (13%) patients were found to have thrombosis in the 6th month, 33 (20.4%) patients in the 12th month; however,141 (87%) and 129 (79.6%) patients actively used AVF in the 6th and 12th months, respectively. The AIP and PO values that were calculated in the patient group with AVF thrombosis were significantly higher ( p = 0.001, p < 0.001; respectively). In the multivariate logistic regression analysis, Na, BUN, and HDL-C variables were found to be independent predictive factors for AVF thrombosis (OR (Odds Ratio): 1.169, 95% CI (Confidence interval)): 1.056–1.294, p = 0.003; OR: 1.108, 95% CI: 1.043–1.176, p = 0.001; OR: 0.874, 95% CI: 0.820–0.932, p < 0.001; respectively). It was also found that the patency rate was 64.2% (104 patients) in the 24th month. Conclusion: AIP, PO, Na, and BUN values are positively associated with AVF thrombosis. Checking AIP, Na, and BUN values will be useful in patients with end-term renal failure, who already have difficulties in renal replacement methods and vascular access.