bluuebunny/crossref_metadata_2025_split huggingface dataset:
Next-generation sequencing for the management of sarcomas with no known driver mutations
Authors: Vyse Simon , Thway Khin , Huang Paul H. , Jones Robin L. 
Published: April 2021

Purpose of review
Next-generation sequencing (NGS) has enabled fast, high-throughput nucleotide sequencing and has begun to be implemented into clinical practice for genomic-guided precision medicine in various cancer types. This review will discuss recent evidence that highlights opportunities for NGS to improve outcomes in sarcomas that have complex genomic profiles with no known driver mutations.

Recent findings
Global genomic signatures detectable by NGS including tumour mutational burden and microsatellite instability have potential as biomarkers for response to immunotherapy in certain sarcoma subtypes including angiosarcomas. Identification of hallmarks associated with ‘BRCAness’ and homologous recombination repair defects in leiomyosarcomas and osteosarcomas may predict sensitivity to poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors. Lastly, the use of NGS for evaluating cancer predisposition in sarcomas may be useful for early detection, screening and surveillance.

Summary
Currently, the implementation of NGS for every sarcoma patient is not practical or useful. However, adopting NGS as a complementary approach in sarcomas with complex genomics and those with limited treatment options has the potential to deliver precision medicine to a subgroup of patients, with novel therapies such as immune checkpoint and PARP inhibitors. Moving forward, molecular tumour boards incorporating multidisciplinary teams of pathologists, oncologists and genomic specialists to interpret NGS data will complement existing tools in diagnosis and treatment decision making in sarcoma patients.
Virtual Synchronous Motivational Interviewing Training for Geographically Dispersed Interprofessional Learners
Authors: Bryan Jennifer L. , Saxon LaDonna C. , Mesidor Marie M. , Asghar-Ali Ali A. 
Published: April 2021

Introduction:
Behavioral health and other preventable factors account for nearly half of all premature deaths in the United States. Motivational interviewing (MI) is effective for engaging ambivalent patients in behavior change. However, many clinicians report barriers to receiving MI training, including time, cost, and travel. This study examined the effect of a 2-day virtual MI training built around didactic and real-play learning activities.

Methods:
Thirty interprofessional clinicians from eight Veterans Affairs medical centers and their community-based outpatient clinics across 4 US states attended a 2-day virtual MI training. Participants completed a posttraining evaluation and a 3-month posttraining evaluation.

Results:
Participants reported that they learned new knowledge and skills, and they would be able to apply these to their practice (M > 4).They reported high satisfaction with the training and platform and found the technology easy to use (M > 4). In the 3-month posttraining survey, participants reported that they were using MI in their practice (M = 4.19) and that they would like additional support, such as additional reading (n = 8).

Discussion:
This study demonstrates the effect of a 2-day virtual MI training built around didactic and real-play learning activities. Virtual training particularly enhances training opportunities in rural settings. Our training removed travel and payment as barriers to participation.
A Meta-analysis of Clinical Trials Evaluating the Impact of Bivalirudin-based Anticoagulation for Primary Percutaneous Coronary on Long-Term Mortality
Authors: Jagadish Pooja S. , Le Francis K. , Labroo Ajay , Nasr Abrar , Rashid Abdul , Khan Babar , Shah Rahman 
Published: April 2021

Abstract:
Bivalirudin and heparin are the principal anticoagulants used during primary percutaneous coronary intervention (PCI) for patients experiencing ST-elevation myocardial infarctions. Based on previous meta-analyses, bivalirudin improves 30-day mortality rates compared with heparin, especially when vascular access is predominantly femoral. However, no meta-analysis has yet reported whether this mortality benefit with bivalirudin persists beyond 30 days. Scientific databases and websites were searched to find randomized controlled trials, and risk ratios (RRs) were calculated using random effect models. Data from 4 trials were analyzed. Compared with heparin ± glycoprotein IIb/IIIa inhibitors, bivalirudin decreased all-cause mortality [RR, 0.81; 95% confidence interval (CI), 0.69–0.94; P = 0.008], cardiac mortality (RR, 0.72; 95% CI, 0.60–0.88; P = 0.001), and net adverse clinical events (RR, 0.83; 95% CI, 0.72–0.97; P = 0.016) at 1 year. In conclusion, a bivalirudin-based anticoagulation strategy during primary percutaneous coronary intervention significantly decreases the 1-year risks for all-cause mortality, cardiac mortality, and net adverse clinical events compared with heparin ± glycoprotein IIb/IIIa inhibitor.
Thrombocytopenia and clear corneal incision cataract surgery
Authors: Reilly Grace R. , Tipton Caroline W. , Armbrust Karen R. , Boyd Kelly , Murray Jared J. , Kopplin Laura J. , Berkenstock Meghan K. 
Published: April 2021

Purpose:
To investigate complications and outcomes of clear corneal incision cataract surgery in patients with thrombocytopenia.

Setting:
1 veterans hospital and 2 academic medical centers.

Design:
Multicenter retrospective chart review.

Methods:
All eyes of thrombocytopenic patients that underwent clear corneal incision cataract surgery with a platelet count of 100 × 103/μL or less measured within 30 days prior to surgery were included. Subject demographics, intraoperative complications, use of pupillary expansion devices, use of local anesthetic injections, and change in corrected distance visual acuity were recorded.

Results:
3 sites recorded 40 113 clear corneal incision cataract surgeries, of which 196 eyes (0.49%) of 150 thrombocytopenic patients were recorded. The mean platelet count in the study subjects was 73.0 ± 20.5 × 103/μL. Two cases of intraoperative iris hemorrhage that were readily and controlled occurred in conjunction with pupillary expansion. There were no bleeding complications associated with retrobulbar, peribulbar, or sub-Tenon anesthetic injections. There was a statistically significant improvement (P < .0001) in visual acuity post-operatively.

Conclusions:
Clear corneal incision cataract surgery with pupillary expansion devices and local anesthetic injections can be safely performed in patients with thrombocytopenia.
Frequency of Workplace Controls and Associations With Safety Perceptions Among a National Sample of US Food Retail Workers During the COVID-19 Pandemic
Authors: Ceryes Caitlin , Robinson Joelle , Biehl Erin , Wirtz Andrea L. , Barnett Daniel J. , Neff Roni 
Published: April 2021

Objectives:
Explore workplace control frequencies and factors associated with US food retail workers’ safety perceptions during COVID-19.

Methods:
An online, cross-sectional survey captured working conditions and safety perceptions among a large, national sample of US food retail workers from July to October 2020.

Results:
Overall, 40.3% reported feeling “not so” or “not protected” by COVID-19 controls. Administrative controls were more commonly reported (56.8% reported ≥5 controls) than engineering (19.5% reported ≥3). Fomite-related controls were more common than those reducing interpersonal contact. After adjustment, organizational safety climate (prevalence ratio (PR): 1.53, 95% CI: 1.24, 1.89), and perceived strict prevention measure enforcement (PR: 0.60, 95% CI: 0.46, 0.78) were associated with safety perceptions.

Conclusions:
Many workers do not feel well-protected by COVID-19 controls. Safety climate and control enforcement are associated with workers’ COVID-19 safety perceptions.
Determining the Costs of Low-Back Pain Associated Sick Leave in the Dutch Workforce in the Period 2015 to 2017
Authors: van der Wurf Cas , Speklé Erwin , Schaafsma Frederieke , Coenen Pieter 
Published: April 2021

Objective:
To investigate the costs of low-back pain associated sick leave of workers in the Netherlands from 2015 to 2017.

Methods:
We used longitudinal data form a large occupational health service regarding sick leave (registered by occupational physicians). Costs of sick leave due to low-back pain were estimated using the human capital approach, considering society and company perspectives.

Results:
A total of 7901 low-back pain episodes from 7161 unique workers were analyzed. We estimated an average episode of low-back pain sick leave was 129.42 days in duration and costed €16,191. The total extrapolated sick leave costs were estimated to be €244.7 million in 2017.

Conclusions:
Low-back pain remains to be a persistent problem in the working population, as it causes workers to take sick leave for considerable periods of time with considerable associated economic consequences.
How Should We Organize Care for Patients With Human Immunodeficiency Virus and Comorbidities? A Multisite Qualitative Study of Human Immunodeficiency Virus Care in the United States Department of Veterans Affairs
Authors: Bokhour Barbara G. , Bolton Rendelle E. , Asch Steven M. , Dvorin Kelly , Fix Gemmae M. , Gifford Allen L. , Hyde Justeen K. , McInnes D. Keith , Parker Victoria A. , Richardson Kelly , Skolnik Avy A. , Vaughan-Sarrazin Mary S. , Wu Juliet , Ohl Michael E. 
Published: April 2021

Background:
With human immunodeficiency virus (HIV) now managed as a chronic disease, health care has had to change and expand to include management of other critical comorbidities. We sought to understand how variation in the organization, structure and processes of HIV and comorbidity care, based on patient-centered medical home (PCMH) principles, was related to care quality for Veterans with HIV.

Research Design:
Qualitative site visits were conducted at a purposive sample of 8 Department of Veterans Affairs Medical Centers, varying in care quality and outcomes for HIV and common comorbidities. Site visits entailed conduct of patient interviews (n=60); HIV care team interviews (n=60); direct observation of clinic processes and team interactions (n=22); and direct observations of patient-provider clinical encounters (n=45). Data were analyzed using a priori and emergent codes, construction of site syntheses and comparing sites with varying levels of quality.

Results:
Sites highest and lowest in both HIV and comorbidity care quality demonstrated clear differences in provision of PCMH-principled care. The highest site provided greater team-based, comprehensive, patient-centered, and data-driven care and engaged in continuous improvement. Sites with higher HIV care quality attended more to psychosocial needs. Sites that had consistent processes for comorbidity care, whether in HIV or primary care clinics, had higher quality of comorbidity care.

Conclusions:
Provision of high-quality HIV care and high-quality co-morbidity care require different care structures and processes. Provision of both requires a focus on providing care aligned with PCMH principles, integrating psychosocial needs into care, and establishing explicit consistent approaches to comorbidity management.
Deciphering transcriptional and functional heterogeneity in hematopoiesis with single-cell genomics
Authors: Martin-Rufino Jorge D. , Sankaran Vijay G. 
Published: April 2021

Purpose of review
Single-cell genomic approaches have uncovered cell fate biases and heterogeneity within hematopoietic subpopulations. However, standard single-cell transcriptomics suffers from high sampling noise, which particularly skews the distribution of lowly expressed genes, such as transcription factors (TFs). This might preclude the identification of rare transcripts that define cell identity and demarcate cell fate biases. Moreover, these studies need to go hand in hand with relevant functional assays to ensure that observed gene expression changes represent biologically meaningful alterations.

Recent findings
Single-cell lineage tracing and functional validation studies have uncovered cell fate bias within transcriptionally distinct hematopoietic stem and progenitor subpopulations. Novel markers identified using these strategies have been proposed to prospectively isolate functionally distinct subpopulations, including long-term hematopoietic stem cells for ex vivo applications. Furthermore, the continuous nature of hematopoiesis has prompted the study of the relationship between stochastic transcriptional noise in hematopoietic TFs and cell fate determination.

Summary
An understanding of the limitations of single-cell genomic approaches and follow-up functional assays is critical to discern the technical and biological contribution of noise in hematopoietic heterogeneity, to identify rare gene expression states, and to uncover functionally distinct subpopulations within hematopoiesis.

Supplementary video

http://links.lww.com/COH/A23
Clinical Significance of MicroRNA-29a and MicroRNA-100 Gene Expression in Pediatric Acute Myeloid Leukemia
Authors: Said Fadwa , Tantawy Marwa , Sayed Ahmed , Ahmed Sonia 
Published: April 2021

Aim:
The aim of this study was to evaluate the diagnostic and prognostic performance of miRNA-29a and miRNA-100 in pediatric acute myeloid leukemia (AML).

Patients and Methods:
In all, 73 children with diagnosed pediatric AML (based on standard morphologic, cytochemical, cytogenetic, immunologic, and molecular workup, and the French-American British classification) admitted to Children’s Cancer Hospital Egypt (CCHE-57357), and 9 healthy age-matched and sex-matched controls were recruited for a case-control study. Gene expression levels of miRNA-29a and miRNA-100 were assessed using real-time quantitative RT-PCR.

Results:
When diagnosed, patients had a significantly higher expression of miRNA-100 as against controls (median [range]: 12.99 [0.92-851.38] vs. 0.26 [0.03-2.67], P<0.001), with a significantly lower expression of miRNA-29a (2.08 [0.02-19.72] vs. 24.95 [15.48-42.54], P<0.001). Likewise, high-risk patients according to cytogenetic stratification had significantly higher miRNA-100 expression and lower miRNA-29a expression. Both miRNA-100 and miRNA-29a performed well as diagnostic markers of pediatric AML with an area under the curve of 0.977 (95% confidence interval [95% CI: 0.943-1.0]) and 0.994 (0.982-1.0) for miRNA-100 and miRNA-29a, respectively. Both miRNA-29a (odds ratio [95% CI]: 0.160 [0.054-0.474], P=0.001) and miRNA-100 (odds ratio [95% CI]: 1.997 [1.994-2.001], P=0.047) were identified as significant predictors of treatment response.

Conclusion:
The miRNA-29a and miRNA-100 expression may serve as diagnostic and prognostic markers in pediatric AML.
Implications of weight gain with newer anti-retrovirals: 10-year predictions of cardiovascular disease and diabetes
Authors: McCann Kaitlyn , Shah Shahini , Hindley Laura , Hill Andrew , Qavi Ambar , Simmons Bryony , Serenata Celicia , Sokhela Simiso , Venter Willem D.F. 
Published: April 2021

Objective:
To evaluate the long-term risks of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) secondary to weight gain and clinical obesity associated with the initiation of integrase strand transfer inhibitors and tenofovir alafenamide (TAF) in the ADVANCE trial using validated risk equation tools.

Design:
Retrospective data analysis.

Methods:
In ADVANCE, 1053 treatment-naive participants in South Africa (99% black, 59% female) were randomized to 96 weeks of TAF/emtricitabine + dolutegravir (TAF/FTC + DTG), tenofovir disoproxil fumarate/FTC + DTG (TDF/FTC + DTG), or TDF/FTC + efavirenz (TDF/FTC/EFV). The 5 and 10-year risks of CVD were calculated using D:A:D, QRISK and Framingham, and T2DM risk using QDiabetes, Cambridge Diabetes and Leicester Practice Risk scores. Participants were included in this analysis if they were above 30 years old at baseline.

Results:
A total of 217 (TAF/FTC + DTG), 218 (TDF/FTC + DTG), and 215 (TDF/FTC/EFV) participants had 96-week data available. Weight gain was +8.1, +4.2, and +2.4 kg on TAF/FTC + DTG, TDF/FTC + DTG, and TDF/FTC/EFV, respectively. Participants on TAF/FTC + DTG had greatest risk scores for CVD (using QRISK) and T2DM, driven by weight changes. Differences were statistically significant between TAF/FTC + DTG and TDF/FTC/EFV for CVD risk using the QRISK equation, equivalent to one extra case per 1000 people treated over 10 years, and between all treatment groups for T2DM risk. Six extra T2DM cases were predicted on TAF/FTC + DTG vs. TDF/FTC + DTG using QDiabetes.

Conclusion:
Obesity, especially with TAF/FTC + DTG, drove increased risk of T2DM, with some evidence of greater CVD risk. However, predictive tools have not been validated in the HIV-positive and black African population.
Reconstruction of Soft Tissue Defects on the Face, Neck, and Chest by Expanded Cervico-Acromial Flap
Authors: Chen Sen , Li Yangqun , Ma Ning , Wang Weixin , Xu Lisi , Yang Zhe 
Published: April 2021

Background:
Repairing the defects of face and neck remains a big challenge for plastic surgeons. Here we present a case series of pre-expanded cervico-acromial flaps in the repair of soft tissue defects.

Method:
This is a retrospective study that a total of 126 patients between 2001 and 2019 were included. One patient was excluded since he did not complete the treatment. All patients were followed for at least 0.5 years (range: 0.5–4 years, mean 2.50 years) after surgery.

Results:
All patients are satisfied with the appearance. The color and texture of expanded flaps were similar to surroundings. One patient (0.8%) had complete necrosis and received skin grafts. The size of cervico-acromial was 26-10 × 14-6 cm (mean, 15.389 ± 2.701× 8.341 ± 1.075 cm). The time of operation during stage 1 was 59.254 ± 9.895 minutes, 96.912 ± 18.936 minutes during stage 2, and 38.146 ± 9.478 minutes during stage 3. Surgical complication rate was 14.3%, given that 18 patients had complications following the surgery.

Conclusions:
The cercico-acromial flap is a reliable and multifunctional method for face, neck, and chest reconstruction.
Systematic review automation tool use by systematic reviewers, health technology assessors and clinical guideline developers: tools used, abandoned, and desired
Authors: Scott Anna Mae , Forbes Connor , Clark Justin , Carter Matt , Glasziou Paul , Munn Zachary 
Published: April 2021

AbstractObjectiveWe investigated the use of systematic review automation tools by systematic reviewers, health technology assessors and clinical guideline developers.Study design and settingsAn online, 16-question survey was distributed across several evidence synthesis, health technology assessment and guideline development organisations internationally. We asked the respondents what tools they use and abandon, how often and when they use the tools, their perceived time savings and accuracy, and desired new tools. Descriptive statistics were used to report the results.Results253 respondents completed the survey; 89% have used systematic review automation tools – most frequently whilst screening (79%). Respondents’ ‘top 3’ tools include: Covidence (45%), RevMan (35%), Rayyan and GRADEPro (both 22%); most commonly abandoned were Rayyan (19%), Covidence (15%), DistillerSR (14%) and RevMan (13%). Majority thought tools saved time (80%) and increased accuracy (54%). Respondents taught themselves to how to use the tools (72%), and were most often prevented by lack of knowledge from their adoption (51%). Most new tool development was suggested for the searching and data extraction stages.ConclusionAutomation tools are likely to take on an increasingly important role in high quality and timely reviews. Further work is required in training and dissemination of automation tools and ensuring they meet the desirable features of those conducting systematic reviews.
Real world evidence of calcifediol use and mortality rate of COVID-19 hospitalized in a large cohort of 16,401 Andalusian patients
Authors: Loucera Carlos , Peña-Chilet María , Esteban-Medina Marina , Muñoyerro-Muñiz Dolores , Villegas Román , Lopez-Miranda Jose , Rodriguez-Baño Jesus , Túnez Isaac , Bouillon Roger , Dopazo Joaquin , Gomez Jose Manuel Quesada 
Published: April 2021

AbstractBackgroundCOVID-19 is a major worldwide health problem because of acute respiratory distress syndrome, and mortality. Several lines of evidence have suggested a relationship between the vitamin D endocrine system and severity of COVID-19.MethodsWe present a retrospective survival study that includes all Andalusian patients hospitalized between January and November 2020 because of COVID-19 infection. Based on a central registry of electronic health records (the Andalusian Population Health Database, BPS), prescription of vitamin D or its metabolites within 15-30 days before hospitalization were recorded. The effect of treatment with vitamin D metabolites for other indication previous to the hospitalization was studied with respect to patient survival by means of Kaplan-Meyer survival curves and Log Hazard Ratios, using a propensity score to compensate the disbalance of compared classes and the confounding factors. The availability of detailed patient data in the BPS allowed to obtain Real-World Evidence (RWE) of the effects of prior use of vitamin D or its metabolites on the mortality due to COVID-19 infection.FindingsA retrospective cohort of 16.401patients was extracted from the BPS, which includes all the patients hospitalized with COVID-19 diagnosis between January and November 2020 in Andalusia, one of the largest regions in Europe with the size of an average median country. A total of 358 patients were found with cholecalciferol, and 193 with calcifediol, prescriptions 15 days before hospitalization. For a period extended to 30 days before hospitalization, the numbers increase to 416 and 210 and, respectively. Kaplan-Meyer survival curves and hazard ratios support an association between consumption of these metabolites and patient survival. Such association was stronger in calcifediol (Log Hazard Ratio, LHR = -1.27±0.32) than in cholecalciferol (LHR= -0.56±0.15), when prescribed 15 days before hospitalization This effect decreases when a larger 30 days period is considered (calcifediol LHR= -1.01±0.27 and cholecalciferol LHR= -0.27±0.12), suggesting that the closer was the treatment to the hospitalization the stronger the association.ConclusionsA significant reduction in mortality in patients hospitalized with COVID-19 is associated with the prescription of vitamin D, especially calcifediol, within 15-30 days prior to hospitalization.