bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Healthy Environment Project: Promoting sustainable change in early childhood education settings
Authors: Farewell Charlotte V , Maiurro Emily , Powers Jamie , Puma Jini 
Published: January 2021

Objective: The Healthy Environment Project (HEP) was designed to improve familiarity with attitudes, confidence and knowledge related to health-promoting best practices, as well as the implementation of health-promoting policy, system and environment best practice change in diverse early childhood education settings. Design: Pre–post study design to assess the outcomes of the HEP intervention. Setting: Early childhood education providers representing 14 centres ( n = 117) and 30 homes ( n = 30) in Colorado, USA. Method: The Policy, System and Environment Change Process, which is an evidence-based strategic planning process based on intervention mapping, was facilitated in a professional development training format in 44 early childhood education settings. Results: Pre–post survey data ( n = 125) suggest that early childhood education providers’ familiarity with, knowledge of, and confidence related to the implementation of health-promoting policy, system and environment change significantly increased after the professional development training ( p < .05). No significant differences in these individual-level constructs were found between centre-based and home-based providers. The HEP also resulted in significant changes in environmental-level constructs; 154 total health-promoting changes (averaging 3.5 changes/setting) were implemented in 44 early childhood education settings. Conclusion: Facilitation of a strategic planning process in a professional development training format resulted in improvements in individual- and environmental-level constructs related to healthy eating and physical activity behaviours and provides a novel way to foster sustainable health-promoting environments in early childhood education centres and homes.
Pathways to severe mental illness care: A retrospective study of patients seeking psychiatric care at Department of Psychiatry, AIIMS, Delhi
Authors: Kudi Surat Ram , Khakha Deepika C , Ajesh Kumar T K , Sinha Deb Koushik 
Published: January 2021

Background and aim: Globally, very few patients with mental illness go to health care facilities to receive psychiatry treatment. This study aims to identify pathways used by patients with severe mental disorders who seek mental health care services in the psychiatry unit of AIIMS, New Delhi. Materials and methods: It is a retrospective cross-sectional study with convenience sampling technique was used, and data were collected from 123 caregivers of patients with severe mental illnesses using standardized tools like MINI, BPRS, YMRS and WHO Encounter pathway. Results: The findings revealed that 41.5% of the patients made their first contact with the faith healers, 27.6% with AYUSH medical practitioners, 14.6% with psychiatrists and 12.2% with allopathic medical practitioners. About 26% of the patients reported hallucinations as the first symptom for seeking help. In the majority of cases (96.7%), the patient’s relatives made the decision for the patient to seek treatment the first time to manage the symptoms. The psychotic symptoms (65.1%) helped the patient’s relatives to take the decision for first seek. The mean delay for seeking treatment from psychiatrists was 13.31 ± 10.6 (months). Conclusion: This study showed that a higher proportion of patients received treatment from the faith healer at the first seek, whereas only a few patients approached psychiatrist directly. Hence, there is an immense need to create awareness regarding mental illness and treatment options available.
Use of percutaneous transluminal renal angioplasty in atherosclerotic renal artery stenosis: a systematic review and meta-analysis
Authors: Chen Yonghui , Pan Hongrui , Luo Guangze , Li Peng , Dai Xiangchen 
Published: January 2021

Objective For patients with atherosclerotic renal artery stenosis (ARAS), the role of percutaneous transluminal renal angioplasty (PTRA) remains inconclusive. This study aimed to comparatively evaluate the benefits of best medical therapy (BMT) plus PTRA and BMT alone in treating ARAS. Methods We performed a systematic review and meta-analysis, and searched for all randomized, controlled trials that reported patients with ARAS. The effectiveness and safety in the BMT plus PTRA and BMT alone groups were estimated, taking into account hypertension, stroke, renal events, cardiac events, and mortality. Results Nine randomized, controlled trials involving 2309 patients were included. In the BMT plus PTRA group, the incidence of refractory hypertension was significantly lower compared with that in the BMT alone group (odds ratio 0.09; 95% confidence interval 0.01, 0.70). However, there were no significant differences in the rates of stroke, renal events, cardiac events, cardiac mortality, and all-cause mortality between the two groups. Conclusions PTRA plus BMT improves blood pressure in patients with ARAS, but there is insufficient evidence for this therapy in improving stroke, renal events, cardiac events, and cardiac and all-cause mortality.
Repairing the injured bronchus in blunt chest trauma – A case series
Authors: Riduan Anith Nadzira , Sathiamurthy Narasimman , Dharmaraj Benedict , Chai Diong Nguk , Balasubbiah Narendran 
Published: January 2021

Introduction Traumatic bronchial injury (TBI) is uncommon, difficult to diagnose and often missed. The incidence of TBI among blunt trauma patients is estimated to be around 0.5–2%. Bronchoplastic surgery is indicated in most cases to repair the tracheobronchial airway and preserve lung capacity. There is limited existing literature addressing the management of this condition in view of its rarity. The comprehensive management and outcomes of these patients are discussed. Methods The case notes of all patients who presented with persistent lung collapse due to trauma since July 2017 were reviewed retrospectively. Those patients requiring surgical intervention were included in the review. The mode of injury, clinical, radiological and bronchoscopy findings, concurrent injuries, type of surgery, length of stay (LOS) and operative outcomes were reviewed. Results Out of 11 patients who presented with persistent lung collapse post-blunt trauma, four (36%) were found to have structural bronchial disruption. All of them underwent successful repair of the injured bronchus, without the need of a pneumonectomy. The other seven patients were successfully treated conservatively. Conclusion The repair of the injured bronchus is essential in improving respiratory function and to prevent a pneumonectomy. Routine bronchoscopic evaluation should be performed for all suspected airway injuries as recommended in our management algorithm. Delayed presentations should not hinder urgent referral to thoracic centers for tracheobronchial reconstruction.
Real-life prognosis of 5041 bone-only metastatic breast cancer patients in the multicenter national observational ESME program
Authors: Bertho Marion , Fraisse Julien , Patsouris Anne , Cottu Paul , Arnedos Monica , Pérol David , Jaffré Anne , Goncalves Anthony , Lebitasy Marie-Paule , D’Hondt Véronique , Dalenc Florence , Ferrero Jean-Marc , Levy Christelle , Dabakuyo Sandrine , Rouzier Roman , Penault-Llorca Frédérique , Uwer Lionel , Eymard Jean-Christophe , Breton Mathias , Chevrot Michaël , Thureau Sébastien , Petit Thierry , Simon Gaëtane , Frénel Jean-Sébastien 
Published: January 2021

Background: Bone-only (BO) metastatic breast cancer (MBC) is considered a more favorable entity than other MBC presentations. However, only few retrospective series and data from selected randomized controlled trials have been reported so far. Methods: Using the French national multicenter ESME (Epidemiological Strategy and Medico Economics) Data Platform, the primary objective of our study was to compare the overall survival (OS) of patients with BO versus non-BO MBC at diagnosis, with adjustment on main prognostic factors using a propensity score. Secondary objectives were to compare first-line progression-free survival (PFS1), describe treatment patterns, and estimate factors associated with OS. Results: Out of 20,095 eligible women, 5041 (22.4%) patients had BO disease [hormone-receptor positive (HR+)/human epidermal growth-factor-receptor-2 negative (HER2−), n = 4 102/13,229 (31%); HER2+, n = 644/3909 (16.5%); HR−/HER2−, n = 295/2 957 (10%)]. BO MBC patients had a better adjusted OS compared with non-BO MBC [52.1 months (95% confidence interval (CI) 50.3–54.1) versus 34.7 months (95% CI 34.0–35.6) respectively]. The 5-year OS rate of BO MBC patients was 43.4% (95% CI 41.7–45.2). They also had a better PFS1 [13.1 months (95% CI 12.6–13.8) versus 8.5 months (95% CI 8.3–8.7), respectively]. This observation could be repeated in all subtypes. BO disease was an independent prognostic factor of OS [hazard ratio 0.68 (95% CI 0.65–0.72), p < 0.0001]. Results were concordant in all analyses. Conclusion: BO MBC patients have better outcomes compared with non-BO MBC, consistently, through all MBC subtypes.
Network Pharmacology Integrated Molecular Docking Reveals the Anti-COVID-19 and SARS Mechanism of Fufang Banlangen Keli
Authors: Cheng Li , Wang Fei , Zhang Shun Bo , You Qiu Yun 
Published: January 2021

Purpose Fufang Banlangen Keli (FBK) has been recommended for its clinical treatment of Coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS), but the mechanism of action is unclear. So, using network pharmacology and molecular docking, we studied the active components and mechanism of FBK in the treatment of COVID-19 and SARS. Methods The Encyclopedia of Traditional Chinese Medicine and Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform were used to screen the active components by oral bioactivity and drug likeness. Then, PharmMapper and SwissTargetPrediction databases were used to screen potential target genes of active components; the related target genes of COVID-19 and SARS were obtained from the GeneCards database. The intersection of the active components and disease-related targets was performed by the Venny2.1.0 database. The DAVID6.8 database and KOBAS3.0 database were used to get gene ontology (GO) function enrichment and Kyoto Encyclopedia of Genes and Genomes pathway annotation of gene targets. The “components-targets-pathways (C-T-P)” network of FBK was conducted by Cytoscape3.6.1 software. The top active components, angiotensin-converting enzyme 2 (ACE2) and SARS-CoV-2 3 Cl, were imported into AutoDock and PyMOL for molecular docking. Results From the FBK, a total of 28 active components and 73 gene targets were screened through network pharmacology. Twenty pathways were analyzed, including pathways in cancer, nod-like receptor signaling pathway, and pancreatic cancer, etc. ( P < 0.05). A total of 337 items were obtained by GO functional enrichment analysis ( P < 0.05), including 257 items for biological process, 38 items for cell composition, and 42 items for molecular function. Furthermore, molecular docking studies were performed to study potential binding between the key gene targets and selected active components. Conclusion Based on network pharmacology and molecular docking technology, qingdainone, (2Z)-2-(2-oxoindolin-3-ylidene) indolin-3-one, sinensetin, and acacetin in FBK were verified to bind to ACE2 and SARS-COV-2 3 Cl, so as to treat COVID-19 and SARS.
Study of social disparities in pediatric laparoscopic appendectomy outcomes and cost
Authors: Burjonrappa Sathyaprasad 
Published: January 2021

Purpose: There is an increasing focus on racial and social disparities in health care. There have been several studies that have documented disparities in outcome between racial groups in the adult literature. Not much is known about disparities in outcomes after surgical procedures in children. The purpose of this study was to investigate the effect of race on complications (outcomes) and costs after laparoscopic appendectomy. Methods: This study is a single-center retrospective chart review of 248 pediatric patients who underwent appendectomies for uncomplicated acute appendicitis from 2015 to 2017. Patients were divided into minority (Africa American or Hispanic) and non-minority groups, and length of stay, preoperative and postoperative factors, and total costs were compared. Results: Of 185 eligible patients, 45.9% (n = 85) were of Hispanic or African American ethnicity and 54.1% (n = 100) were Caucasian. About 11.8% of minority patients had comorbidities and 12% of majority patients had comorbidities (p = 1). Readmission rate for minority group patients was 3.5% (n = 3) and 2% (n = 2) for majority patients (p = 0.7). The average cost of hospital stay for minority patients was $30,900 and for majority patients was $31,111 (p = 0.59). Conclusions: Standardization of care protocols has reduced social/racial disparities in surgical outcomes. In the most common pediatric surgery emergency procedure, laparoscopic appendectomy, there were no differences in outcomes or costs between minority (Hispanic/Africa American) and Caucasian ethnic groups. Level of evidence: Level III Type of study: Clinical Study
Outcomes of an Inpatient Dialysis Start in Patients With Kidney Graft Failure: A Population-Based Multicentre Cohort Study
Authors: Naylor Kyla L. , Knoll Gregory A. , McArthur Eric , Garg Amit X. , Lam Ngan N. , Field Bonnie , Getchell Leah E. , Hahn Emma , Kim S. Joseph 
Published: January 2021

Background: The frequency and outcomes of starting maintenance dialysis in the hospital as an inpatient in kidney transplant recipients with graft failure are poorly understood. Objective: To determine the frequency of inpatient dialysis starts in patients with kidney graft failure and examine whether dialysis start status (hospital inpatient vs outpatient setting) is associated with all-cause mortality and kidney re-transplantation. Design: Population-based cohort study. Setting: We used linked administrative healthcare databases from Ontario, Canada. Patients: We included 1164 patients with kidney graft failure from 1994 to 2016. Measurements: All-cause mortality and kidney re-transplantation. Methods: The cumulative incidence function was used to calculate the cumulative incidence of all-cause mortality and kidney re-transplantation, accounting for competing risks. Subdistribution hazard ratios from the Fine and Gray model were used to examine the relationship between inpatient dialysis starts (vs outpatient dialysis start [reference]) and the dependent variables (ie, mortality or re-transplant). Results: We included 1164 patients with kidney graft failure. More than half (55.8%) of patients with kidney graft failure, initiated dialysis as an inpatient. Compared with outpatient dialysis starters, inpatient dialysis starters had a significantly higher cumulative incidence of mortality and a significantly lower incidence of kidney re-transplantation ( P < .001). The 10-year cumulative incidence of mortality was 51.9% (95% confidence interval [CI]: 47.4, 56.9%) (inpatient) and 35.3% (95% CI: 31.1, 40.1%) (outpatient). After adjusting for clinical characteristics, we found inpatient dialysis starters had a significantly increased hazard of mortality in the first year after graft failure (hazard ratio: 2.18 [95% CI: 1.43, 3.33]) but at 1+ years there was no significant difference between groups. Limitations: Possibility of residual confounding and unable to determine inpatient dialysis starts that were unavoidable. Conclusions: In this study we identified that most patients with kidney graft failure had inpatient dialysis starts, which was associated with an increased risk of mortality. Further research is needed to better understand the reasons for an inpatient dialysis start in this patient population.
Suprascapular Nerve Block Is an Effective Pain Control Method in Patients Undergoing Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial
Authors: Kim Jung Youn , Kang Min Wook , Lee Ho Won , Noh Kyu Cheol 
Published: January 2021

Background: Effective pain control in patients who have undergone arthroscopic rotator cuff surgery improves functional recovery and early mobilization. Interscalene blocks (ISBs), a widely used approach, are safe and provide fast pain relief; however, they are associated with complications. Another pain management strategy is the use of a suprascapular nerve block (SSNB). Hypothesis: We hypothesized that indwelling SSNB catheters are a more effective pain control method than single-shot ISBs. We also hypothesized that indwelling SSNB catheters will reduce the level of rebound pain and the demand for opioid analgesics. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Included in this study were 93 patients who underwent arthroscopic rotator cuff surgery between May 2012 and January 2019. These patients were assigned to either the indwelling SSNB catheter group, the single-shot ISB group, or the control (sham/placebo) group (31 patients per group). Level of pain was measured with a visual analog scale (VAS; 0 to 10 [worst pain]) on the day of the operation. The preoperative VAS score was recorded at 6 AM on the day of operation, and the postoperative scores were recorded at 1, 8, and 16 hours after surgery and then every 8 hours until postoperative day 3. Results: The VAS pain scores were lower in the SSNB and ISB groups than in the control group up to postoperative hour (POH) 8, with the most significant difference at POH 8. At POH 1 and POH 8, the mean VAS scores for each group were 2.29 and 1.74 (SSNB), 2.59 and 2.50 (ISB), and 3.42 and 4.48 (control), respectively. VAS scores in the SSNB and ISB groups were consistently <3, compared with a mean VAS score of 3.1 ± 1.58 in the control group ( P < .001). Compared with the ISB group, the SSNB group had significantly fewer side effects such as rebound pain duration as well as lower VAS scores ( P < .001). Conclusion: VAS scores were the lowest in the indwelling SSNB catheter group, with the most pronounced between-group difference in VAS scores at POH 8. Severity and recurring frequency of pain were lower in the indwelling SSNB catheter group than in the single-shot ISB group.
A Comparison of Nonoperative and Operative Treatment of Type 2 Tibial Spine Fractures
Authors:   Tibial Spine Research Group, Prasad Niyathi , Aoyama Julien T. , Ganley Theodore J. , Ellis Henry B. , Mistovich R. Justin , Yen Yi-Meng , Fabricant Peter D. , Green Daniel W. , Cruz Aristides I. , McKay Scott , Kushare Indranil , Schmale Gregory A. , Rhodes Jason T. , Jagodzinski Jason , Sachleben Brant C. , Sargent M. Catherine , Lee R. Jay 
Published: January 2021

Background: Tibial spine fractures (TSFs) are typically treated nonoperatively when nondisplaced and operatively when completely displaced. However, it is unclear whether displaced but hinged (type 2) TSFs should be treated operatively or nonoperatively. Purpose: To compare operative versus nonoperative treatment of type 2 TSFs in terms of overall complication rate, ligamentous laxity, knee range of motion, and rate of subsequent operation. Study Design: Cohort study; Level of evidence, 3. Methods: We reviewed 164 type 2 TSFs in patients aged 6 to 16 years treated between January 1, 2000, and January 31, 2019. Excluded were patients with previous TSFs, anterior cruciate ligament (ACL) injury, femoral or tibial fractures, or grade 2 or 3 injury of the collateral ligaments or posterior cruciate ligament. Patients were placed according to treatment into the operative group (n = 123) or nonoperative group (n = 41). The only patient characteristic that differed between groups was body mass index (22 [nonoperative] vs 20 [operative]; P = .02). Duration of follow-up was longer in the operative versus the nonoperative group (11 vs 6.9 months). At final follow-up, 74% of all patients had recorded laxity examinations. Results: At final follow-up, the nonoperative group had more ACL laxity than did the operative group ( P < .01). Groups did not differ significantly in overall complication rate, reoperation rate, or total range of motion (all, P > .05). The nonoperative group had a higher rate of subsequent new TSFs and ACL injuries requiring surgery (4.9%) when compared with the operative group (0%; P = .01). The operative group had a higher rate of arthrofibrosis (8.9%) than did the nonoperative group (0%; P = .047). Reoperation was most common for hardware removal (14%), lysis of adhesions (6.5%), and manipulation under anesthesia (6.5%). Conclusion: Although complication rates were similar between nonoperatively and operatively treated type 2 TSFs, patients treated nonoperatively had higher rates of residual laxity and subsequent tibial spine and ACL surgery, whereas patients treated operatively had a higher rate of arthrofibrosis. These findings should be considered when treating patients with type 2 TSF.
A New Clinical Sign for Diagnosing Medial Meniscus Posterior Root Tear
Authors: Akmese Ramazan , Malatyalı Batu , Kocaoglu Hakan , Akkaya Zehra , Kalem Mahmut 
Published: January 2021

Background: In the presence of medial meniscus posterior root tear (MMPRT), there is a possibility of reduced compression of meniscal tissue in hyperflexion as the intra-articular mobility of the meniscus increases. This phenomenon can be mimicked during clinical examination. Purpose: To describe, evaluate, and validate the diagnostic performance of a new clinical indicator, the Akmese sign, for the diagnosis of an MMPRT. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: In this study, we prospectively enrolled patients aged 18 to 55 years who were scheduled for arthroscopic surgery after a diagnosis of medial meniscal lesion at a single institution between January 2016 and January 2018. All of the patients underwent preoperative examination for the Akmese sign. All surgeries were performed by a single surgeon with more than 5 years of experience in sports injury surgery, who was blinded to the Akmese sign results. Results: A total of 273 patients with a mean age of 42.4 ± 5.3 years met the study criteria. The Akmese sign was identified as positive in 33 patients, and MMPRT was confirmed during arthroscopy in 36 cases. The performance parameters of the Akmese sign were a sensitivity of 86.1%, specificity of 99.1%, Youden index of 0.85, and kappa index of 0.88. Conclusion: This study showed that the Akmese sign is a useful new physical examination test that can help clinicians distinguish MMPRTs from other meniscal medial meniscal pathology.