bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the Patient Experience of “as-Required” Medication in a Hospice In-Patient Unit
Authors: Phippen Alison , Murray Barbara , Pickard Jennie , Ahamed Ashique , Kay Samantha , Waterman David 
Published: February 2021

Background: Timely administration of ‘as-required’ medication is important for managing patients’ symptoms in palliative care. There are no national or local standards around the maximum length of time for the process to administer ‘as-required’ medication and little in the literature to inform practice. Our aim was to understand the patient experience of receiving these medications in the in-patient setting of a hospice. Methods: A survey of hospice patients who had been on the ward at least seven days was conducted over a fifteen-week period looking at current practice, the patient experience of requesting medication and how long it took to be administered. Results: Thirty-one responses were obtained. Patients made their requests in a variety of ways but 33% did not use their call bell. When looking at their most recent ‘as-required’ medication request, 87% of patients estimated that they received it within ten minutes. When considering their longest wait, 16% of patients reported waiting longer than twenty minutes. Conclusion: This survey highlights the importance of there being a variety of ways for patients to request ‘as-required’ medication and staff being proactive with patients to facilitate these requests. Patients perceive nursing staff to be busy and do not want to bother them. Although usually patients get their medication within ten minutes, patients can be waiting more than twenty minutes. There is a need for national standards on time to administer as-required medication within a healthcare setting and a need for more data to inform such a standard.
Dental Subphenotypes in Infants With Orofacial Clefts—A Longitudinal Population-Based Retrospective Radiographic Study of the Primary and Secondary Dentitions
Authors: Yow Mimi , Hermann Nuno V. , Wei Yuan , Karsten Agneta , Kreiborg Sven 
Published: February 2021

Objectives: To determine the developmental patterns of primary and secondary dentitions in infants with orofacial clefts. Design: Retrospective, longitudinal, population-based cohort study. Materials: Longitudinal records and radiographs of 192 nonsyndromic Northern European infants with isolated unilateral cleft lip (UCL, n = 111) and isolated cleft palate (CP, n = 81). Methods: Radiographic assessments of primary and secondary dentition anomalies and dental maturation, by gender and cleft severity for comparisons between the groups and with historical controls. Results: In infants with UCL, the frequencies of dental anomalies were high in both primary (38.7%) and secondary (18.0%) dentitions. Primary and secondary dentition anomalies were not observed in infants with CP and different in the UCL group ( P = .003). Risk differences involved primary supernumerary teeth ( P = .0001) and talon cusp formation ( P = .0001), and secondary tooth agenesis ( P = .001) of the maxillary lateral incisor on the side of the cleft lip. Delayed primary and secondary dental maturation occurred in the UCL and CP groups, greater in infants with UCL ( P < .0001). Primary and secondary dental maturation featured sexual dimorphism with greater delay in males (UCL, P < .0001; CP, .0001 > P = .001). The effect of cleft severity on dental maturation was significant in infants with UCL ( P = .0361) and CP ( P = .0175) in the primary but not in the secondary dentition. Conclusions: There were different dental anomalies in the primary and secondary dentitions in operated infants with UCL and no dental anomalies in unoperated infants with CP. Dental maturation was delayed in infants with UCL and CP with greater delay in males compared to females.
Reduction Glossectomy for Macroglossia in Beckwith-Wiedemann Syndrome: Is Post-Op Intubation Necessary?
Authors: Geisler Emily L. , Jeffers Jeremiah , Salhi Saoussen , Perlyn Chad A. 
Published: February 2021

Objective: Macroglossia is a characteristic feature of Beckwith-Wiedemann syndrome (BWS), commonly treated with reduction glossectomy to restore form and function. There exists no consensus on the perioperative management of these patients undergoing tongue reduction surgery, including anecdotal information regarding how long postoperative intubation should be maintained. The aim of this study is to evaluate the necessity of prolonged postoperative intubation in patients receiving tongue reduction surgery via the surgical and anesthetic management methods at our center. Design: Retrospective case series. Setting: Institutional care at Level I Children’s Hospital. Participants: All children less than 18 years old with BWS and congenital macroglossia who underwent tongue reduction surgery over 5 consecutive years at our center (N = 24). Interventions: Tongue reduction surgery via the “W” technique. Main Outcome Measures: Success of immediate postoperative extubation and related surgical complications. Results: Immediate, uncomplicated postoperative extubation was successfully performed in all patients who received tongue reduction surgery for congenital macroglossia. Conclusions: Prolonged postoperative intubation for tongue reduction surgery may not be necessary as immediate, uncomplicated postoperative extubation was achieved in 100% of patients who received tongue reduction surgery at our center.
Recent progress in immunotherapy of breast cancer targeting the human epidermal growth factor receptor 2 (HER2)
Authors: Seyedmirzaei Homa , Keshavarz-Fathi Mahsa , Razi Sepideh , Gity Masoumeh , Rezaei Nima 
Published: February 2021

Objective Breast cancer is responsible for most of the cancer-induced deaths in women around the world. The current review will discuss different approaches of targeting HER2, an epidermal growth factor overexpressed in 30% of breast cancer cases. Data sources We conducted a search on Pubmed and Scopus databases to find studies relevant to HER2+ breast cancers and targeting HER2 as means of immunotherapy. Out of 1043 articles, 105 studies were included in this review. Data summary As well as the introduction of HER2 and breast cancer subtypes, we discussed various aspects of HER2-targeting immunotherapy including monoclonal antibodies, Antibody-drug conjugates (ADCs), Chimeric Antigen Receptor (CAR) T-cells and vaccines. Conclusions Despite several ways of controlling breast cancer, the need to investigate new drugs and approaches seems to be much significant as this cancer still has a heavy burden on people’s health and survival.
McIsaac score for group A streptococcal infection: Comparison of electronic visits versus face-to-face visits
Authors: Miller Nathaniel E , Jensen Teresa B , Nigon Leah M , Penza Kristine S , Murray Martha A , Kronebusch Beckie J , Pecina Jennifer L 
Published: February 2021

Introduction Acute sore throat is a common complaint traditionally completed with an in-person visit. However, non-face-to-face telemedicine visits offer greater access at reduced cost. We evaluated patient/caregiver asynchronous text-based electronic visits (eVisits) for acute sore throat and whether there was concordance for individual components and total McIsaac score compared to a clinician’s assessment. eVisits were completed by patients and/or their caregivers via a secure patient portal. Methods In this retrospective study, we manually reviewed charts between February 2017 and July 2019 of patients who had an eVisit, in-person visit and group A streptococcal (GAS) test performed on the same day for an acute sore throat. We calculated a McIsaac score for eVisits and in-person visits, and compared each component and total score using Cohen’s kappa agreement statistic. Results There were 320 instances of patients who had an eVisit, in-person visit and GAS testing done on the same day. Approximately a third of eVisits were missing at least one McIsaac component, with the physical examination elements missing most commonly. Individual score congruence was moderate for cough (0.41), fair for fever (0.34) and slight for tonsillar swelling/exudate and lymphadenopathy (0.17 and 0.08, respectively), with total congruence being slight to fair (0.09–0.37). A McIsaac score of ≤1 showed moderate agreement (0.44). Visits with complete individual score components demonstrated improved congruence: substantial for cough (0.64), moderate for fever (0.57), fair for tonsillar swelling (0.3) and slight for lymphadenopathy (0.13). Discussion Overall agreement for individual score components was better for symptoms than it was for examination components, and was improved when data were complete. A McIsaac score of 1 or 0 had moderate agreement and thus could reasonably be safely used to exclude patients from GAS testing.
Brain-Computer Interfaces for Communication: Preferences of Individuals With Locked-in Syndrome
Authors: Branco Mariana P. , Pels Elmar G. M. , Sars Ruben H. , Aarnoutse Erik J. , Ramsey Nick F. , Vansteensel Mariska J. , Nijboer Femke 
Published: February 2021

Background Brain-computer interfaces (BCIs) have been proposed as an assistive technology (AT) allowing people with locked-in syndrome (LIS) to use neural signals to communicate. To design a communication BCI (cBCI) that is fully accepted by the users, their opinion should be taken into consideration during the research and development process. Objective We assessed the preferences of prospective cBCI users regarding (1) the applications they would like to control with a cBCI, (2) the mental strategies they would prefer to use to control the cBCI, and (3) when during their clinical trajectory they would like to be informed about AT and cBCIs. Furthermore, we investigated if individuals diagnosed with progressive and sudden onset (SO) disorders differ in their opinion. Methods We interviewed 28 Dutch individuals with LIS during a 3-hour home visit using multiple-choice, ranking, and open questions. During the interview, participants were informed about BCIs and the possible mental strategies. Results Participants rated (in)direct forms of communication, computer use, and environmental control as the most desired cBCI applications. In addition, active cBCI control strategies were preferred over reactive strategies. Furthermore, individuals with progressive and SO disorders preferred to be informed about AT and cBCIs at the moment they would need it. Conclusions We show that individuals diagnosed with progressive and SO disorders preferred, in general, the same applications, mental strategies, and time of information. By collecting the opinion of a large sample of individuals with LIS, this study provides valuable information to stakeholders in cBCI and other AT development.
P2Y12 inhibitors in neuroendovascular surgery: An opportunity for precision medicine
Authors: Rosengart Axel , Collins Malie K , Hendrix Philipp , Uber Ryley , Sartori Melissa , Jain Abhi , Mao Jennifer , Goren Oded , Schirmer Clemens M , Griessenauer Christoph J 
Published: February 2021

Introduction Dual antiplatelet therapy (DAPT), primarily the combination of aspirin with a P2Y12 inhibitor, in patients undergoing intravascular stent or flow diverter placement remains the primary strategy to reduce device-related thromboembolic complications. However, selection, timing, and dosing of DAPT is critical and can be challenging given the existing significant inter- and intraindividual response variations to P2Y12 inhibitors. Methods Assessment of indexed, peer-reviewed literature from 2000 to 2020 in interventional cardiology and neuroendovascular therapeutics with critical, peer-reviewed appraisal and extraction of evidence and strategies to utilize DAPT in cardio- and neurovascular patients with endoluminal devices. Results Both geno- and phenotyping for DAPT are rapidly and conveniently available as point-of-care testing at a favorable cost-benefit ratio. Furthermore, systematic inclusion of a quantifying clinical risk score combined with an operator-linked, technical risk assessment for potential adverse events allows a more precise and individualized approach to new P2Y12 inhibitor therapy. Conclusions The latest evidence, primarily obtained from cardiovascular intervention trials, supports that combining patient pharmacogenetics with drug response monitoring, as part of an individually tailored, precision medicine approach, is both predictive and cost-effective in achieving and maintaining individual target platelet inhibition levels. Indirect evidence supports that this gain in optimizing drug responses translates to reducing main adverse events and overall treatment costs in patients undergoing DAPT after intracranial stent or flow diverting treatment.
505(b) (2) - A smart pathway to differentiate from competitive, low margin environment of generics
Authors: Rathee Pooja , Tripathy Swagat , Khatter Sahil , Patra BP , Murthy PN , Dureja Harish 
Published: February 2021

Purpose 505(b) (2) application is one of the advantageous ways of regulatory submission. This submission approach can lead to fast-track approval for wide-ranging products, exclusively for those that exemplify a limited change from formerly approved drug. Safety and efficacy evidence in terms of non-clinical and clinical portion of the Reference Listed Drug (RLD), are trusted upon. Additionally, supplementary data essentially required to establish comparability with the RLD, are presented in the dossier. Methods This retrospective analysis is to understand the FDA's expectations and avoid errors in terms of data support approval for a new product submitted under the 505 (b) (2) route. The current script is an analysis on how to architect 505(b) (2) regulatory strategy by developing a different set of documents/information. Results The ultimate goal of this review is to allow drug developers to easily navigate through various 505 (b) (2) submissions and defense strategies for registration processes available to the new drug manufacturers and to understand an effective, safer filing route by facilitating early market launch with a prospect of lower cost. Conclusion Before considering option 505 (b) (2), general companies should have a good understanding of product’s potential productivity, scalability, patent infringement, expensive clinical studies and/or non-clinical studies to appropriately strategize scientific and commercial opportunities. This leverage will potentially quicken the development program and will definitely lower the clinical and regulatory risk of new product entrants.
Return to Sport Composite Test After Anterior Cruciate Ligament Reconstruction (K-STARTS): Factors Affecting Return to Sport Test Score in a Retrospective Analysis of 676 Patients
Authors: Franck Florent , Saithna Adnan , Vieira Thais Dutra , Pioger Charles , Vigne Gregory , Le Guen Meven , Rogowski Isabelle , Fayard Jean-Marie , Thaunat Mathieu , Sonnery-Cottet Bertrand 
Published: February 2021

Background: Return to sport (RTS) to the preinjury level is the main purpose after anterior cruciate ligament (ACL) reconstruction but the factors affecting the RTS are not completely known. Knee Santy Athletic Return to Sport (K-STARTS) is a composite test designed to assess readiness for RTS after ACL reconstruction. Purpose: To determine the key factors that influence K-STARTS scores in a large cohort of patients after ACL reconstruction. Study Design: Case-control study. Level of Evidence: Level 3. Methods: A retrospective analysis of prospectively collected data was undertaken. All patients who underwent ACL reconstruction surgery between March 2016 and May 2017 and also had a K-STARTS assessment at 6 months postoperatively were included. To identify factors influencing the K-STARTS score, an analysis of variance was performed. Age, sex, sports level, delay between injury and surgery, concomitant lesions, graft type, additional lateral tenodesis procedure, and participation in the RTS program were analyzed to identify factors influencing the K-STARTS score. Results: A total of 676 patients were included in the study. The K-STARTS score was significantly higher in male patients than in female patients (13.9 vs 12.4; P < 0.001), in younger patients (those aged <30 years vs older patients; 14.2 vs 12; P < 0.001), ACL reconstructions performed with hamstring tendon autografts compared with bone–patellar tendon–bone (13.5 vs 13.1; P = 0.03) and in those who completed a specific RTS program in addition to standard rehabilitation, compared with those who did not participate (17.1 vs 13.1; P < 0.001). However, the only factor that significantly influenced the K-STARTS score beyond the minimal detectable change threshold was the completion of the additional RTS program. The preinjury frequency of sports participation, whether the dominant limb was injured, time from injury to surgery, the presence of associated meniscal injuries, and whether a lateral tenodesis was performed did not significantly influence the K-STARTS score. Conclusion: Completion of a specific RTS program, in addition to standard rehabilitation, was the most important factor influencing the K-STARTS composite functional and psychological RTS test score at 6 months after ACL reconstruction. Clinical Relevance: This study shows that the completion of a specific RTS program affects positively the RTS test score at 6 months after ACL reconstruction.
The use of eHealth interventions among persons experiencing homelessness: A systematic review
Authors: Polillo Alexia , Gran-Ruaz Sophia , Sylvestre John , Kerman Nick 
Published: February 2021

Objective eHealth interventions are being developed to meet the needs of diverse populations. Despite these advancements, little is known about how these interventions are used to improve the health of persons experiencing homelessness. The aim of this systematic review was to examine the feasibility, effectiveness, and experience of eHealth interventions for the homeless population. Methods Following PRISMA guidelines, a systematic search of PsycINFO, PubMed, Web of Science, and Google Scholar was conducted along with forward and backward citation searching to identify relevant articles. Results Eight articles met eligibility criteria. All articles were pilot or feasibility studies that used modalities, including short message service, mobile apps, computers, email, and websites, to deliver the interventions. The accessibility, flexibility, and convenience of the interventions were valued by participants. However, phone retention, limited adaptability, a high level of human involvement, and preference for in-person communication may pose future implementation challenges. Conclusions eHealth interventions are promising digital tools that have the potential to improve access to care and service delivery. eHealth interventions are feasible and usable for persons experiencing homelessness. These interventions may have health benefits by augmenting existing services and if implementation challenges are addressed. Further evaluation of the effectiveness of eHealth interventions is needed before widespread implementation. Those with lived experience should also be engaged in developing and evaluating these interventions.
Chest computed tomographic findings of patients with COVID-19-related pneumonia
Authors: Tiryaki Şaban , Dabeşlim Hakan , Aksu Yusuf 
Published: February 2021

Background In December 2019, pneumonia cases of unknown cause were announced in Wuhan, China. The causative agent of pneumonia was identified as coronavirus 2 (SARS-CoV-2), and the disease was named coronavirus disease 2019 (COVID-19). Purpose To evaluate the usefulness of computed thoracic tomography (CT) and postero anterior (PA) thoracic radiography in patients with COVID-19. Material and Methods Between March and June 2020, the patients who arrived at our hospital with suspicion of COVID-19 were retrospectively analyzed. Thorax CT findings of the 281 patients (142 females and 139 males; age range 3–91 years) with positive PCR tests were evaluated. Lesions in the lung parenchyma were examined according to their number, localization, and distribution. PA chest radiograms were classified into two groups, positive and negative for the lung parenchymal lesions. Results Of the total 281 patients with PCR-positive COVID-19, CT examinations were normal in 107 (38.1%), and positive CT findings for pneumonia were found in 174 patients (61.9%). Bilateral involvement was observed in 100 (57.5%) of the 174 patients with positive CT findings, and unilateral involvement was observed in 74 (42.5%) of them. According to the localization of the lesions, peripheral subpleural distribution occurred in 160 of the 174 patients (91.9). The most common lesion was the ground glass opacities (GGO). In 77 of 281 PCR-positive patients (27.4), pulmonary lesions were found on PA chest radiograms. Conclusion The presence of bilateral posterior subpleural GGO, nodule, and consolidation in thoracic CT are significant in terms of COVID-19 pneumonia.
Effect of Prophylactic Knee Bracing on Anterior Cruciate Ligament Agonist and Antagonist Muscle Forces During Perturbed Walking
Authors: Haddara Raneem , Harandi Vahidreza Jafari , Lee Peter Vee Sin 
Published: February 2021

Background: Anterior cruciate ligament (ACL) injuries most commonly occur after a perturbation. Prophylactic knee braces (PKBs) are off-the-shelf braces designed to prevent and reduce the severity of knee injuries during sports, yet their effectiveness has been debated. Purpose: To identify differences in ACL agonist and antagonist muscle forces, during braced and unbraced conditions, while walking with the application of unexpected perturbations. Study Design: Controlled laboratory study. Methods: A total of 20 recreational athletes were perturbed during walking at a speed of 1.1 m/s, and motion analysis data were used to create patient-specific musculoskeletal models. Static optimization was performed to calculate the lower-limb muscle forces. Statistical parametric mapping was used to compare muscle forces between the braced and unbraced conditions during the stance phase of the perturbed cycle. Results: The brace reduced muscle forces in the quadriceps (QUADS), gastrocnemius (GAS), and soleus (SOL) but not in the hamstrings. The peak QUADS muscle force was significantly lower with the brace versus without at 49% to 60% of the stance phase (28.9 ± 12.98 vs 14.8 ± 5.06 N/kg, respectively; P < .001) and again at 99% of the stance phase (1.7 ± 0.4 vs 3.6 ± 0.13 N/kg, respectively; P = .049). The SOL muscle force peak was significantly lower with the brace versus without at 25% of the stance phase (1.9 ± 1.7 vs 4.6 ± 3.4 N/kg, respectively; P = .031) and at 39% of the stance phase (1.9 ± 1.4 vs 5.3 ± 5.6 N/kg, respectively; P = .007). In the GAS, there were no significant differences between conditions throughout the whole stance phase except between 97% and 100%, where the braced condition portrayed a smaller peak force (0.23 ± 0.13 vs 1.4 ± 1.1 N/kg for unbraced condition; P = .024). Conclusion: These findings suggested that PKBs that restrict knee hyperextension and knee valgus/varus motion can alter neuromuscular patterns, which result in a reduction of QUADS force. Clinical Relevance: Understanding the way PKBs alter muscle function and knee mechanics can provide invaluable information that will help in making decisions about their use. Further studies should investigate different types of braces and perturbations to evaluate the effectiveness of PKBs.