bluuebunny/crossref_metadata_2025_split huggingface dataset:
A narrative synthesis of research with 5-MeO-DMT
Authors: Ermakova Anna O , Dunbar Fiona , Rucker James , Johnson Matthew W 
Published: October 2021

Background: 5-Methoxy- N,N-dimethyltryptamine (5-MeO-DMT) is a naturally occurring, short-acting psychedelic tryptamine, produced by a variety of plant and animal species. Plants containing 5-MeO-DMT have been used throughout history for ritual and spiritual purposes. The aim of this article is to review the available literature about 5-MeO-DMT and inform subsequent clinical development. Methods: We searched PubMed database for articles about 5-MeO-DMT. Search results were cross-checked against earlier reviews and reference lists were hand searched. Findings were synthesised using a narrative synthesis approach. This review covers the pharmacology, chemistry and metabolism of 5-MeO-DMT, as well epidemiological studies, and reported adverse and beneficial effects. Results: 5-MeO-DMT is serotonergic agonist, with highest affinity for 5-HT1A receptors. It was studied in a variety of animal models, but clinical studies with humans are lacking. Epidemiological studies indicate that, like other psychedelics, 5-MeO-DMT induces profound alterations in consciousness (including mystical experiences), with potential beneficial long-term effects on mental health and well-being. Conclusion: 5-MeO-DMT is a potentially useful addition to the psychedelic pharmacopoeia because of its short duration of action, relative lack of visual effects and putatively higher rates of ego-dissolution and mystical experiences. We conclude that further clinical exploration is warranted, using similar precautions as with other classic psychedelics.
Estimating Treatment-Switching Bias in a Randomized Clinical Trial of Ovarian Cancer Treatment: Combining Causal Inference with Decision-Analytic Modeling
Authors: Kuehne Felicitas , Rochau Ursula , Paracha Noman , Yeh Jennifer M. , Sabate Eduardo , Siebert Uwe 
Published: October 2021

Background Bevacizumab is efficacious in delaying ovarian cancer progression and controlling ascites. The ICON7 trial showed a significant benefit in overall survival for bevacizumab, whereas the GOG-218 trial did not. GOG-218 allowed control group patients to switch to bevacizumab upon progression, which may have biased the results. Lack of data on switching behavior prevented the application of g-methods to adjust for switching. The objective of this study was to apply decision-analytic modeling to estimate the impact of switching bias on causal treatment-effect estimates. Methods We developed a causal decision-analytic Markov model (CDAMM) to emulate the GOG-218 trial and estimate overall survival. CDAMM input parameters were based on data from randomized clinical trials and the published literature. Overall switching proportion was based on GOG-218 trial information, whereas the proportion switching with and without ascites was estimated using calibration. We estimated the counterfactual treatment effect that would have been observed had no switching occurred by denying switching in the CDAMM. Results The survival curves generated by the CDAMM matched well with the ones reported in the GOG-218 trial. The survival curve correcting for switching showed an estimated bias such that 79% of the true treatment effect could not be observed in the GOG-218 trial. Results were most sensitive to changes in the proportion progressing with severe ascites and mortality. Limitations We used a simplified model structure and based model parameters on published data and assumptions. Robustness of the CDAMM was tested and model assumptions transparently reported. Conclusions Medical-decision science methods may be merged with empirical methods of causal inference to integrate data from other sources where empirical data are not sufficient. We recommend collecting sufficient information on switching behavior when switching cannot be avoided.
Expression of 34βE12 may be an independent predictor of survival in breast cancer
Authors: Wang Chuchu , Wei Jiangguo , Huang Liming , Xu Chaoyang 
Published: October 2021

Objectives To investigate the relationship between high-molecular-weight cytokeratin (34βE12) and clinicopathological parameters (including HER-2, Ki67 and steroid receptors) in breast cancer to determine its usefulness as a prognostic marker. Methods In this retrospective study, the expression level 34βE12 was assessed in surgically resected breast cancer specimens by immunohistochemical staining. Data were correlated with the patients’ clinicopathological parameters. Results Of the 348 breast cancer tissue samples, 232 (67%) showed positive expression of 34βE12. There were statistically significant differences between the positive and negative 34βE12 expression groups in tumour size, lymph node involvement, oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2) status. There were no differences between groups in age, tumour grade, or Ki67 status. In addition, patients who were positive for 34βE12 had significantly extended overall survival. In multivariate analysis, the expression level of 34βE12 was found to be a significant independent prognostic factor. Conclusion These results suggest that positive 34βE12 expression is associated with a favourable outcome in breast cancer and so may be a useful prognostic factor. Further studies are required to confirm these results.
Return to Sports After Total Hip Arthroplasty: An Umbrella Review for Consensus Guidelines
Authors: Sowers Christopher B. , Carrero Alberto C. , Cyrus John W. , Ross Jeremy A. , Golladay Gregory J. , Patel Nirav K. 
Published: October 2021

Background: Current recommendations on safe return to sports (RTS) after total hip arthroplasty (THA) are subjective and based on studies of varying quality. Purpose: The aim of this study was to synthesize systematic reviews and meta-analyses on post-THA RTS to propose practice guidelines identifying which sports can be resumed, when they can be resumed, and what risks are present. Study Design: Systematic review; Level of evidence, 4. Methods: This umbrella review followed the Joanna Briggs Institute (JBI) protocol and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Embase, Medline, and Cochrane databases were searched. Included studies were either systematic reviews or meta-analyses addressing primary or secondary outcomes. Outcomes of interest included safe sports after THA, time to RTS, prognostic indicators of RTS, reasons patients do not RTS, percentage of patients who RTS, implant complications, and objective classification of sports by impact level. Included reviews had data extracted and were assessed for methodological quality using the JBI protocol. The authors defined RTS as “returning to a sport the patient participated in at any point preoperatively.” Results: Patients demonstrated a trend toward lower-impact sports postoperatively. Sports were classified as low (eg, walking), moderate (eg, downhill skiing), or high impact (eg, soccer). A total of 82% (range, 55%-104%) of patients were able to RTS at a mean time of 6 months (range, 4-7 months). The best prognostic indicator for RTS was previous experience in that sport. The main reason patients did not RTS was surgeon recommendation. Aseptic loosening was the most cited complication after RTS. Conclusion: Most patients are able to return to preoperative levels of low- (eg, walking) and moderate-impact (eg, hiking) sports between 7 and 12 months after THA. Patients planning a return to high-impact (eg, singles tennis) sports should be counseled on the possible risks of traumatic injuries and aseptic loosening and monitored closely.
Indigenous Women’s Experiences of Smoking and Quitting Smoking in Pregnancy: A Phenomenological Study
Authors: Small Sandra P. , Porr Caroline 
Published: October 2021

Background Maternal smoking during pregnancy (MSDP) is an important public health concern because of potential adverse health effects to the woman, fetus, and child after birth. Prevalence rates are high among groups with socioeconomic disadvantage, including Indigenous women. Purpose This study was conducted to understand experiences of MSDP for Indigenous women. Methods The study was conducted using phenomenology. Data were collected through interviews with 15 pregnant and postnatal Indigenous women who had smoked during pregnancy. The data were analyzed for themes using phenomenological methods. Results The women's narratives revealed four experiences: quitting smoking during pregnancy to protect the unborn baby from harm; quitting smoking during pregnancy because of personal adverse health effects; cutting down smoking during pregnancy and feeling remorse for not quitting; and keeping on smoking during pregnancy and not planning to try to quit. The women's experiences also indicated several impediments to quitting smoking. Conclusions There is need for health care policy to ensure adequate smoking cessation services and support for Indigenous women who smoke in pregnancy. Health care professionals should provide individualized interventions that take into account the challenges to quitting that pregnant women experience and that are in accordance with clinical practice guidelines for MSDP.
Frequency of Cerebral Venous Thrombosis in Dubai, UAE–A Multicenter, Retrospective Study
Authors: Sarathchandran Pournamy , Farooq Saba , Dar Javeed , Khan Maria , AlRukn Suhail 
Published: October 2021

Background and Purpose Cerebral venous thrombosis (CVT), also known as cerebral dural venous thrombosis, is not a very common cause of stroke. It has a diverse clinical presentation, with multiple predisposing factors and imaging findings. The incidence of CVT varies in different studies. We hypothesized that the incidence of CVT in Dubai is more than that reported in the West owing to dehydration caused by the high atmospheric temperature. Methods We retrospectively reviewed the medical records of all patients aged more than 13 years with appropriate International Classification of Diseases, 9th Revision, codes for the diagnosis of CVT from January 1, 2010 to December 31, 2018 from three major hospitals with an acute stroke service in Dubai, United Arab Emirates. Results We identified 138 patients who presented with CVT. The average frequency of CVT was 6.6 per 100,000 population. Fifty percent of the patients presented between May and September, which are considered the hottest months in the UAE. Headache was the most common presentation, followed by seizures. The most important risk factors were the use of oral contraceptive pills, anemia, and polycythemia. Our study showed a higher incidence of anemia, polycythemia, thrombophilia, and abnormal CT brain findings. Conclusion In our study, CVT was more common during the months of summer. Anemia and polycythemia were strongly associated with CVT. Public awareness about CVT, its higher incidence during summer months and strategies to avoid dehydration might be considered to reduce the incidence of CVT in summer months. However, larger studies are needed to confirm definite associations.
Assessing febrile neutropenia outcomes in patients receiving primary versus secondary prophylactic G-CSF treatment therapy with intermediate neutropenic risk chemotherapy regimens
Authors: Goodin Claire , Ratliff Patrick , Cottingham Lauren , Shely Ryan 
Published: October 2021

Background Prophylaxis with granulocyte colony-stimulating factors (G-CSFs) reduce the severity and duration of chemotherapy-induced neutropenia. Currently, the use of G-CSF prophylactic treatment to prevent neutropenia and its complications varies widely in clinical practice with no standardization for intermediate-risk chemotherapy regimens. Objective The purpose of this study was to assess neutropenic outcomes in patients receiving intermediate-risk chemotherapy regimens who receive primary versus secondary prophylactic G-CSFs. Methods This is a retrospective, multicenter cohort study of patients who received intermediate risk chemotherapy regimens and at least one dose of G-CSF therapy. 121 patients were included and were divided into primary (n = 76) or secondary prophylaxis (n = 45) groups. The primary outcome for this study was the incidence of neutropenic episodes per course of treatment. The secondary outcomes included the percentage of patients who experienced delays in chemotherapy doses, the number of chemotherapy dose reductions, and the number of subsequent treatment delays. Results The incidence of neutropenic episodes over the course of therapy was 0.42 episodes in the primary group compared to 1.52 episodes in the secondary group (p < 0.05). 10.5% of patients in the primary group versus 54.3% of patients in the secondary group experienced chemotherapy dose delays (p < 0.05). There were no statistically significant differences in chemotherapy dose reductions or in the average number of FN risk factors between groups. Conclusion This retrospective, cohort study determined that patients receiving intermediate risk chemotherapy regimens should receive primary prophylaxis, regardless of risk factors in order to decrease episodes of neutropenia and chemotherapy dose delays.
Self-Reported Smoking Status 10-Months After a Single Session Intervention Including an Education Conference About Smoking Harms and Announcement of Spirometric Lung-Age
Authors: Derbel Khansa , Maatoug Chiraz , Mchita Amira , Mabrouk Khaoula Hadj , Saad Helmi Ben 
Published: October 2021

Background Studies investigating the effects of announcing spirometric lung-age (SLA) on the smokers’ self-reported smoking status reported conflicting results. Main objective To evaluate the effects of a single session intervention including an education conference about smoking harms and announcement of SLA on the participants’ self-reported smoking status. Methodology An interventional study was conducted in a cable factory. The intervention included four steps: PowerPoint presentation about raising smoking hazards awareness; general questionnaire; measurement of the anthropometric and spirometric data, and announcement of SLA; and evaluation of the smokers’ self-reported smoking status 10 months later (quitted smoking, decreased consumption; stable consumption, increased consumption). Results Thirty-six smokers completed the four steps. Ten months after the intervention, 11.1% of smokers quitted smoking, 52.7% decreased their consumption by 7  ±  4 cigarettes/day, 30.5% kept a stable consumption, and 5.5% increased their consumption by 9  ±  6 cigarettes/day. Conclusion Providing an education conference combined with announcing SLA motivated 64% of smokers to quit smoking or to reduce their cigarette consumption.
Mechanical behavior of electronic waste concrete columns reinforced with structural fibers and glass fiber reinforced polymer bars: Experimental and analytical investigation
Authors: Zaman Khan Qaiser uz , El Ouni Mohamed Hechmi , Raza Ali , Alomayri Thamer 
Published: October 2021

Nowadays, the improper disposal of electronic waste (E-waste) is creating environmental pollution and health problems in developing countries. Moreover, the corrosion of steel bars reduces the serviceability of reinforced concrete columns. Although many researchers studied the behavior of glass fiber reinforced polymer (GFRP) bars in concrete columns, none of the studies investigated the structural performance of structural fiber-reinforced E-waste concrete (SFEC) columns having GFRP reinforcement. The present study aims to examine the structural performance of GFRP reinforced concrete circular columns consisting of polypropylene structural fibers (GSFEC columns) under concentric and eccentric loading. Identical steel bars reinforced concrete columns (SSFEC columns) were also manufactured and tested to failure under the same loading conditions. The experimental program consisted of 18 circular columns (1200 mm × 300 mm) to measure the axial capacity (AC), axial deflections, failure modes, and cracking patterns under different eccentric loadings. The AC of SSFEC columns was larger while the ductility was lower than GSFEC columns. Both GSFEC and SSFEC columns illustrated similar damaging behavior. The eccentric loading led to similar decreases in AC for both GSFEC and SSFEC columns.
Venous Thromboembolism in Hospitalized COVID-19 Patients Treated in a Single Academic Center in Mexico: A Case Series Study
Authors: Ontiveros Narda , Becerril-Gaitan Andrea , Llausas-Villarreal Alejandro , Gonzalez-Urquijo Mauricio , Paredes-Vazquez José Gildardo , Martínez-Resendez Michel Fernando , Fabiani Mario Alejandro 
Published: October 2021

Background The increasing prevalence of venous thromboembolism (VTE) among patients with coronavirus disease 2019 (COVID-19) is a matter of concern as it contributes significantly to patients' morbidity and mortality. Data regarding the optimal anticoagulation regimen for VTE prevention and treatment remain scarce. This study describes the characteristics, treatment, and outcomes of COVID-19 patients with VTE treated in a single academic center in Mexico. Methods We conducted a retrospective study of all patients with a positive PCR test for SARS-CoV-2 hospitalized in a single academic center in Monterrey, Mexico, between March 2020 and February 2021, with a radiologically confirmed VTE, including deep venous thrombosis (DVT) and pulmonary embolism (PE). Informed consent was obtained from each patient before reviewing their medical records. Results Of the 2000 COVID-19 hospitalized patients, 36 (1.8%) developed VTE and were included in the analysis. The median age was 60 years (range 32-88 years), and up to 78% (n = 28) were males. Most patients (n = 34, 94%) had an underlying comorbidity and 47% (n = 17) had a BMI ≥ 30 kg/m2. In most cases (n=28, 78%), VTE presented as a PE, whereas the remaining 22% (n = 8) had a DVT. The median time between hospital admission and VTE was 8 days (range 0-33 days). Regarding the thromboprophylaxis regimen, 35/36 patients received low molecular weight heparin enoxaparin on admission, most commonly at a dose of 60 mg daily (n = 19, 53%). Other complications presented were superinfection (n = 19, 53%), acute kidney injury (n = 11, 31%), and septic shock (n = 5, 14%). A total of 69% of patients (n = 25) required intensive care unit admission, and patients' overall mortality was 55.6%. Conclusion VTE remains a significant cause of increased morbidity and mortality among patients with COVID-19. The strikingly high mortality among patients with VTE highlights the need for further investigation regarding the best preventive, diagnostic, and treatment approaches.
Clinical results and 10-year survivorship of the Synthes Epoca resurfacing total shoulder arthroplasty
Authors: James Karssiens Timothy , Zhou Rui , Ritchie Gill James , Paul Roberts Christopher 
Published: October 2021

Aims This prospective cohort study reports the 10-year survivorship, patient-reported outcome measures and radiographic outcomes of the first series of the Epoca resurfacing head total shoulder arthroplasty. Methods From July 2008 to July 2014, 59 Epoca resurfacing head total shoulder arthroplasties were implanted in 50 patients by a single surgeon. Minimum 4.8 year and maximum 11.3 year follow-up (mean: 7.9 years) was analysed using the latest available Oxford Shoulder Score. Kaplan–Meier survivorship analysis was performed with revision as the end point. Most recent radiographs were reviewed for component radiolucency, osteolysis and proximal humeral migration. Results Two shoulders underwent revision (3.4%); one for pain with posterior subluxation following a fall, the other for pain with failure of the glenoid. Kaplan–Meier analysis revealed 10-year survivorship of 98.2% (95% confidence intervals: 88.0%–99.8%). Mean Oxford Shoulder Score improved significantly compared to pre-operative values from 18.2 (5–45) to 46.6 (36–48) ( p < 0.001). Fifty-three shoulders underwent radiographic analysis (89.8%). This revealed humeral radiolucency in two cases (3.8%), glenoid radiolucency in three cases (5.7%) and radiographic rotator cuff failure in eight cases (15.1%). Conclusion This prospective cohort study shows excellent 10-year survivorship, medium to long-term clinical and radiological results and for the Synthes Epoca resurfacing head total shoulder arthroplasty. Evidence level IV.
The appropriateness of ceftriaxone utilization in government hospitals of Eastern Ethiopia: A retrospective evaluation of clinical practice
Authors: Amare Firehiwot , Gashaw Tigist , Sisay Mekonnen , Baye Yohannes , Tesfa Tewodros 
Published: October 2021

Introduction: Drug use evaluation is a method of obtaining information to identify problems related to drug use and if properly developed, a means of correcting the problems. Ceftriaxone is among the most commonly utilized cephalosporins. Owing to a broad spectrum of activity and being used empirically, ceftriaxone has been used inappropriately posing a risk for development of antimicrobial resistance. This study is, therefore, designed to evaluate the appropriateness of ceftriaxone utilization in government hospitals in Harar town. Methods: A retrospective cross-sectional study was conducted in four government hospitals of Harar town by reviewing the medical records of 271 patients who received ceftriaxone from 1 January to 31 December 2016. Systematic random sampling was utilized to capture the medical records. Data were entered and analyzed using SPSS version 22. Results: From the 271 medical records reviewed majority of patients were from surgical ward ( n = 85, 31.4%) followed by gynecology and obstetrics ward ( n = 67, 24.7%). Demographically, the majority of the patients were female ( n = 142, 52.4%). Patients in the age group of 20–29 years were dominant ( n = 98, 36.2%). A total of 71 drugs were co-administered with ceftriaxone, the most common being metronidazole followed by tramadol. Among the co-administered drugs, unfractionated heparin ( n = 6), warfarin ( n = 5), and enoxaparin ( n = 1) were found to have a moderate drug interaction with ceftriaxone. Ceftriaxone was commonly used for post-operative prophylaxis ( n = 80, 27.5%) followed by for the management of pneumonia ( n = 62, 21.3%). The result of ceftriaxone use evaluation showed that majority ( n = 190, 70.1%) were found to be inappropriate. The inappropriate utilization was primarily due to wrong indication (indications for which ceftriaxone was not the primary option) ( n = 114, 60.0%) followed by wrong duration ( n = 54, 28.4%). Conclusion: Ceftriaxone was used inappropriately in more than two-thirds of the patients, with wrong indication and wrong duration contributing the majority. Inappropriate use of antibiotics may potentially lead to the emergence and spread of drug-resistant microorganisms and also ultimately exposes the patient to treatment failure, prolonged hospital stay, and higher cost of therapy.