bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of taurolidine citrate and unfractionated heparin on inflammatory state and dialysis adequacy in hemodialysis patients
Authors: Ezzat Haitham , Elsharkawy Magdy , Rezk Khaled , Mohsen Reem , Mansour Amr , Emara Ahmed 
Published: June 2021

Background and aim: HD patients using dialysis catheters have been associated with chronic inflammatory state. In Egypt 6.6% of HD patients use catheters, of which short term catheters represent 59.6% and 40.4% with long-term catheters. In this study, we aimed to assess the effect of Taurolidine citrate and unfractionated heparin combination (Taurolock-hep500™) as a lock solution compared to unfractionated heparin alone on inflammatory markers, incidence of catheter related blood stream infections (CRBSI) and dialysis adequacy in HD patients with temporary HD catheters only, for 4 weeks duration. Methods: Sixty ESRD patients from hemodialysis units in Ain-Shams University hospitals (ASUH) at the time of catheter insertion we enrolled in our study. They were randomized into two groups: Group 1: Thirty patients received Taurolock-hep500™ as a catheter lock solution at the end of each hemodialysis session. Group 2: Thirty patients received unfractionated heparin as a catheter lock solution. hsCRP and IL-6 were measured at baseline and 1 month after using the lock solutions. Blood cultures were done in patients who developed symptoms of catheter related infections. Results: At the end of the study, Inflammatory markers were significantly higher in group 2 ( p-value: 0.045, 0.001, and 0.018 for WBCs, hsCRP and IL-6, respectively). Group 1 had better dialysis adequacy assessed by URR ( p-value: 0.007 and 0.001, respectively). CRBSI were demonstrated in nine patients in group 2 (30%) in contrast to one patient only in group 1(3.3%) ( p-value: 0.006) with pseudomonas being the most common isolated organism (27.7%). Conclusion: Use of (Taurolock-hep500™) for temporary hemodialysis catheters was associated with lower levels of inflammation markers and lower incidence of CRBSI and better catheter performance.
Validation of growth standards and growth references: A review of literature
Authors: Marume Anesu , Archary Moherndran , Mahomed Saajida 
Published: June 2021

The World Health Organization (WHO) growth standards provide the most recognized and widely accepted way of assessing child growth. To ensure its applicability, accuracy, and reliability, studies have validated WHO growth standards against local populations and other internationally recognized growth references. We reviewed outcomes of evaluations done on WHO growth standards and assess the appropriateness of using these growth standards on a global level. We undertook a systematic quantitative review of studies published from 2011 to 2020 from multiple databases. Studies were included if they considered children aged 59 months and below and reported on validation of growth standards. There was an agreement in studies that validated WHO growth standards against international growth references of its superiority in identifying stunted, overweight, and obese children. However, they were less likely to identify underweight children. None of the studies reviewed reported similar growth trajectories to WHO standards in all indicators considered. Regional differences in child growth were observed in comparison to WHO growth standards. Adoption of regional-specific standards increases the sensitivity of identifying children with adverse nutrition outcomes.
CBE: A Framework to Guide the Application of Marketing to Behavior Change
Authors: Rundle-Thiele Sharyn , Dietrich Timo , Carins Julia 
Published: June 2021

Background: This paper aims to extend the application of social marketing to social and environmentally beneficial behavior change providing a three-step process—Co-create-Build-Engage (CBE). The key strength social marketing brings to the social change space is the development of something of value that moves and motivates people to voluntarily change their behavior; in turn benefitting themselves, the planet and society at large. Method: Using a case study method, this paper identifies how up to eight marketing principles, initially penned to distinguish social marketing from public health, are applied in the three step CBE process, using first time program development and implementation examples. First, programs are co-created (C) with people at the heart of the problem and built (B) to create and embed lasting solutions and finally communities are engaged (E) to partake in these programs. This linear process is applied in first time program development and stages blur following first time implementation as CBE steps become continuous when programs are embedded into communities. This paper outlines four cases demonstrating when and where key marketing activities were applied to co-create, build and implement social marketing programs that achieved behavioral change. Results: Included is a roadmap of the activities that occurred in first time program development and implementation across each stage of the three step CBE process. During co-creation competition is assessed and groups are identified (segmentation). Formative research programs are theoretically underpinned and human centred (customer orientation) and solely aimed at identifying insights to guide program build and engagement. Elements of the marketing mix focus program build ensuring that a valued exchange offering is built. Engagement represents the initial implementation phase and encompasses the set of activities that focus on ensuring people are aware of and can adopt the program. Recommendations for Research or Practice: Many of the foundational techniques that distinguish social marketing from other behavioral science approaches are not widely adopted. This paper offers a roadmap to demonstrate how and when core social marketing activities can be applied to effect voluntary behavior change. Volitional change avoids stigmatization, alienation, reactance and community divides, which occur when behaviors are mandated or when people are told what to do. The CBE process provides a process, outlining social marketing’s key principles and the set of activities that are applied to build more effective marketing programs.
Is health a priority? Examining health-related support needs in adults with intellectual disability through a self-determination framework
Authors: Rinaldi Romina , Duplat Jordan , Haelewyck Marie-Claire 
Published: June 2021

Background: People with intellectual disabilities experience inequities in healthcare. Those are maintained by individual limitations as well as environmental factors. In this context, health needs are less likely to be expressed, identified and met. Method: We led a survey in 832 adults with intellectual disabilities to identify if health was set as a priority and if so, what were their major health-related support needs (in terms of physical, social and psychological health). Results: 67.1% of participants reported at least one need. Most frequently, two or more types of needs were reported with gender and living facility having an effect on whether participants would report these needs, but these did not affect which type of needs were reported. Conclusions: Health-related support needs are highly prevalent and diversified in people with intellectual disabilities. This study emphasizes the importance to consider health as a global concept as well as the relationships between health and self-determination.
A comparison of intramedullary cannulated screws versus miniplates for fixation of unstable metacarpal diaphyseal fractures
Authors: Kibar Birkan , Cavit Ali , Örs Abdullah 
Published: June 2021

We carried out a prospective randomized study to compare the clinical and radiological results of metacarpal diaphyseal fractures treated with retrograde intramedullary headless cannulated screws (IHCS) and plates. Fractures were fixed with IHCS in 34 patients (37 metacarpals) and locked miniplates in 35 patients (40 metacarpals). The mean age was 33 years (range 18–61) in the IHCS group and 32 years (range 17–68) in plate group. All patients were followed up for 1 year. All fractures in the IHCS group united but there was one nonunion in the plate group. At final follow-up, there was no significant difference between the groups in total active movement, visual analogue pain score, Disabilities of the Arm, Shoulder, and Hand score and grip strength, although the study was not sufficiently powered to exclude differences with certainty. IHCS is a safe and fast technique that is a good alternative to plate fixation in metacarpal diaphyseal fractures. Level of evidence: I
7T MRI with post-processing for the presurgical evaluation of pharmacoresistant focal epilepsy
Authors: Chen Cong , Xie Juan-Juan , Ding Fang , Jiang Ya-Si , Jin Bo , Wang Shan , Ding Yao , Li Hong , Jiang Biao , Zhu Jun-Ming , Ding Mei-Ping , Chen Zhong , Wu Zhi-Ying , Zhang Bao-Rong , Hsu Yi-Cheng , Lai Hsin-Yi , Wang Shuang 
Published: June 2021

Background: We aimed to evaluate the diagnostic yield of seven-tesla (7T) magnetic resonance imaging (MRI) with post-processing of three-dimensional (3D) T1-weighted (T1W) images by the morphometric analysis program (MAP) in epilepsy surgical candidates whose 3T MRI results were inconclusive or negative. Methods: We recruited 35 patients with pharmacoresistant focal epilepsy. A multidisciplinary team including an experienced neuroradiologist evaluated their seizure semiology, video-electroencephalography data, 3T MRI and post-processing results, and co-registered FDG-PET. Eleven patients had suspicious lesions on 3T MRI and the other 24 patients were strictly MRI-negative. 7T MRI evaluation was then performed to aid clinical decision. Among patients with pathologically proven focal cortical dysplasia (FCD) type II, signs of FCD were retrospectively evaluated in each MRI sequence (T1W, T2W, and FLAIR), and positive rates were analyzed in each MAP feature map (junction, extension, and thickness). Results: 7T MRI evaluation confirmed the lesion in nine of the 11 (81.8%) patients with suspicious lesions on 3T MRI. It also revealed new lesions in four of the 24 (16.7%) strictly MRI-negative patients. Histopathology showed FCD type II in 11 of the 13 (84.6%) 7T MRI-positive cases. Unexpectedly, three of the four newly identified FCD lesions were located in the posterior quadrant. Blurred gray–white boundary was the most frequently observed sign of FCD, appearing on 7T T1W image in all cases and on T2W and FLAIR images in only about half cases. The 7T junction map successfully detected FCD (10/11) in more cases than the extension (1/11) and thickness (0/11) maps. The 3D T1W images at 7T exhibited superior cerebral gray–white matter contrast, more obviously blurred gray–white boundary of FCD, and larger and brighter positive zones in post-processing than 3T T1W images. Conclusion: 7T MRI with post-processing can enhance the detection of subtle epileptogenic lesions for MRI-negative epilepsy and may optimize surgical strategies for patients with focal epilepsy.
A multicenter analysis of treatment patterns and clinical outcomes of subsequent therapies after progression on palbociclib in HR+/HER2− metastatic breast cancer
Authors: Li Yi , Li Wei , Gong Chengcheng , Zheng Yabin , Ouyang Quchang , Xie Ning , Qu Qing , Ge Rui , Wang Biyun 
Published: June 2021

Introduction: Endocrine therapy and cyclin-dependent kinase (CDK) 4/6 inhibitors (CDK4/6i) are standard treatment options for hormone receptor positive (HR+)/human epidermal growth factor receptor 2 negative (HER2–) metastatic breast cancer (MBC). However, the efficacy of standard subsequent therapies after CDK4/6i-based treatment is unclear. This study aimed to examine physician practice patterns and treatment outcomes of subsequent therapies administered after progression on palbociclib therapy in clinical practice. Methods: The study included 200 patients with HR+/HER2– MBC who underwent subsequent treatments after progressing on palbociclib-based regimens in five Chinese institutions between August 2017 and April 2020. The treatment pattern, progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) were reported. Results: A total of 200 patients were included, of whom 147 (73.5%) and 53 (26.5%) received subsequent chemotherapy and endocrine therapy, respectively. The frequently used monochemotherapy regimens were taxane ( n = 29), capecitabine ( n = 21), and vinorelbine ( n = 17), while the endocrine therapy regimens were chidamide plus exemestane ( n = 16) and everolimus plus exemestane ( n = 9). The overall median PFS (mPFS) was 5.5 months, with no significant difference in mPFS between the chemotherapy and endocrine therapy groups ( p = 0.669). However, among patients not sensitive to prior palbociclib treatment, those administered chemotherapy had significantly longer PFS than those administered endocrine therapy ( p = 0.006). The mPFS with endocrine therapy after first-, second-, and subsequent-line palbociclib was 13.4, 3.1, and 4.1 months, respectively ( p = 0.233); in contrast, the mPFS with chemotherapy was 7.2, 6.5, and 4.9 months after first-, second-, and subsequent-line palbociclib, respectively ( p = 0.364). The median OS was not achieved. The ORR was 10.6% among the 198 patients included in the analysis. Conclusions: Physicians prefer chemotherapy over endocrine therapy for the treatment of patients with HR+/HER2– MBC who develop progression on palbociclib. Sensitivity to previous palbociclib treatment might be one of the indicators for predicting response to subsequent treatment. ClinicalTrials.gov identifier: NCT04517318
Inspecting Insulin Products Using Water Proton NMR. I. Noninvasive vs Invasive Inspection
Authors: Taraban Marc B. , Wang Yilin , Briggs Katharine T. , Yu Yihua Bruce 
Published: June 2021

Background: There is a clear need to transition from batch-level to vial/syringe/pen-level quality control of biologic drugs, such as insulin. This could be achieved only by noninvasive and quantitative inspection technologies that maintain the integrity of the drug product. Methods: Four insulin products for patient self-injection presented as prefilled pens have been noninvasively and quantitatively inspected using the water proton NMR technology. The inspection output is the water proton relaxation rate R2(1H2O), a continuous numerical variable rather than binary pass/fail. Results: Ten pens of each product were inspected. R2(1H2O) displays insignificant variation among the 10 pens of each product, suggesting good insulin content uniformity in the inspected pens. It is also shown that transferring the insulin solution out of and then back into the insulin pen caused significant change in R2(1H2O), presumably due to exposure to O2 in air. Conclusions: Water proton NMR can noninvasively and quantitatively inspect insulin pens. wNMR can confirm product content uniformity, but not absolute content. Its sensitivity to sample transferring provides a way to detect drug product tampering. This opens the possibility of inspecting every pen/vial/syringe by manufacturers and end-users.
Frailty Severity and Hospitalization After Dialysis Initiation
Authors: Clark David , Matheson Kara , West Benjamin , Vinson Amanda , West Kenneth , Jain Arsh , Rockwood Kenneth , Tennankore Karthik 
Published: June 2021

Background: Frailty is associated with hospitalization and mortality among dialysis patients. To now, few studies have considered the degree of frailty as a predictor of hospitalization. Objective: We evaluated whether frailty severity was associated with hospitalization after dialysis initiation. Design: Retrolective cohort study. Setting: Nova Scotia, Canada. Patients: Consecutive adult, chronic dialysis patients who initiated dialysis from January 1, 2009 to June 30, 2014, (last follow-up June, 2015). Methods: Frailty Severity, as determined by the 7-point Clinical Frailty Scale (CFS, ranging from 1 = very fit to 7 = severely frail), was measured at dialysis initiation and treated as continuous and in categories (CFS scores of 1-3, 4/5, and 6/7). Hospitalization was characterized by cumulative time admitted to hospital (proportion of days admitted/time at risk) and by the joint risk of hospitalization and death. Time at risk included time in hospital after dialysis initiation and patients were followed until transplantation or death. Results: Of 647 patients (mean age: 62 ± 15), 564 (87%) had CFS scores. The mean CFS score was 4 (“corresponding to “vulnerable”) ± 2 (“well” to “moderately frail”). In an adjusted negative binomial regression model, moderate-severely frail patients (CFS 6/7) had a >2-fold increased risk of cumulative time admitted to hospital compared to the lowest CFS category (IRR = 2.18, 95% confidence interval [CI] = 1.31-3.63). In the joint model, moderate-severely frail patients had a 61% increase in the relative hazard for hospitalization (hazard ratio [HR] = 1.61, 95% CI = 1.29-2.02) and a 93% increase in the relative hazard for death compared to the lowest CFS category (HR = 1.93, 95% CI = 1.16-3.22). Limitations: Potential unknown confounders may have affected the association between frailty severity and hospitalization given observational study design. The CFS is subjective and different clinicians may grade frailty severity differently or misclassify patients on the basis of limited availability. Conclusions: Among incident dialysis patients, a higher frailty severity as defined by the CFS is associated with both an increased risk of cumulative time admitted to hospital and joint risk of hospitalization and death.
Perceived Adequacy of Tangible Support during Stay-at-Home Orders in Chicago and New York
Authors: O’Conor Rachel , Opsasnick Lauren , Pack Allison , Yoshino Benavente Julia , Curtis Laura M. , Lovett Rebecca M. , Luu Han , Wismer Guisselle , Kwasny Mary J. , Federman Alex D. , Bailey Stacy C. , Wolf Michael S. 
Published: June 2021

Objectives: Physical distancing precautions during the COVID-19 pandemic may challenge the provision of tangible support many middle age and older adults receive in managing their health. We examined the association between unmet tangible support needs and self-management behaviors and mental health status during the stay-at-home orders in Chicago and New York. Methods: We used data from the COVID-19 & Chronic Conditions study collected between May 1st and May 22nd, 2020. A total of 801 middle age and older adults with ≥1 chronic condition in Chicago and New York City completed the telephone interview. Adequacy of tangible social support was measured using a brief, validated scale that determined whether an individual needed assistance managing his or her health, and if yes, whether this need was met. Participants reported their level of difficulty engaging in self-management behaviors using 2 discrete items; they also self-reported medication adherence using the ASK-12 medication adherence scale. Mental health status was measured using the depression and anxiety PROMIS short-form instruments. Results: Participants’ mean age was 63 years; 30% identified as Black, 26% identified as Latino, and 12% identified unmet support needs. Inadequacy of tangible support was associated with greater difficulty managing one’s health and accessing medications due to COVID-19, as well as poorer medication adherence, increased anxiety and depressive symptoms, and poorer overall well-being ( P’s < .05). Conclusions: Perceived unmet support needs during stay-at-home orders were associated with greater difficulty engaging in self-management behaviors and poorer overall well-being. Two brief items quickly identified individuals with unmet support needs.
COVID-19 Recurrence Without Seroconversion in a Patient With Mannose-Binding Lectin Deficiency
Authors: Hayes Breanne , Stanley Jonathan , Peppers Brian P. 
Published: June 2021

Introduction The SARS-CoV-2 virus has infected more than 63,000,000 people worldwide after emerging from Wuhan, China in December 2019. This outbreak was declared a Public Health Emergency in January 2020, and a pandemic in March. While rare, reinfection with the virus has been reported on multiple occasions. Case Presentation We present a case report of an individual with mannose binding lectin deficiency who tested positive on two separate occasions, months apart, and did not develop IgG antibodies to SARS-CoV-2. This patient Is a 30- year-old female healthcare worker with a past medical history of ITP, pancreatitis, GERD, anxiety and recurrent pneumonia. She presented in March 2020 with fever, nasal congestion, and dry cough. She was diagnosed with COVID-19 in March 2020, via PCR through employee health. She was treated with a course azithromycin and hydroxychloroquine. Symptoms resolved, however in June 2020, SARS-CoV-2 IgG antibodies were negative. Seven months later in October, she once again developed symptoms which were milder. She was found to have a decreased level of mannose binding lectin, normal immunoglobulin levels, and normal streptococcus pneumonia IgG antibodies. On immune work-up after recovery, she was found to have a decreased level of mannose binding lectin (<50 ng/mL), normal immunoglobulin levels, and protective Streptococcus pneumoniae IgG antibodies with appropriate vaccine response. Her SARS-CoV-2 IgG returned back as positive 8 weeks after her second infection. Discussion This case illustrates that patients with mannose binding lectin deficiency may be at greater risk of re-infection than the general population.
A case series of intra-articular diffuse pigmented villonodular synovitis of the knee: Prognosis of complete synovectomy under arthroscopic surgery
Authors: Cheng You-Hung , Lin Yi-Hsuan , Tseng I-Chuan , Chan Yi-Sheng 
Published: June 2021

Purpose: The purpose of this study is to evaluate the outcome and prognosis of complete synovectomy performed under arthroscopic surgery in the treatment of diffuse pigmented villonodular synovitis (DPVNS) of the knee. Methods: We retrospectively reviewed 7 cases (6 female and 1 male) diagnosed with diffuse pigmented villonodular synovitis (DPVNS) of knee from 2013 to 2017. All of these cases were treated with knee arthroscopy-assisted complete synovectomy. The follow-up period ranged from 36 months to 60 months (average: 48.0 months). The pain score, range of motion and functional outcome of the knee joint were evaluated after surgery. Symptoms and signs were monitored and magnetic resonance imaging (MRI) were routinely requested to note for possible recurrence during clinical follow up. Results: During and after the surgeries of complete synovectomy under arthroscope by the same surgeon, no complications were noted in the ward or the clinic. Significant improvements were achieved in terms of the range of motion and Lysholm knee function score. There was no recurrence of DPVNS observed in our patients during a follow-up of 4 years. Conclusions: Intra-articular DPVNS of the knee can successfully be treated by complete synovectomy under arthroscope. This case series emphasized the technique of multiple portals and cycling different shavers to achieve satisfactory outcomes.