bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospitalization in patients with systemic lupus erythematosus at Tawam Hospital, United Arab Emirates (UAE): Rates, causes, and factors associated with length of stay
Authors: Aldarmaki Reem , Al Khogali Hiba I , Al Dhanhani Ali M 
Published: January 2021

Introduction Systemic lupus erythematosus (SLE) is a relapsing and remitting multiorgan disease associated with significant morbidity and mortality. The survival rate of patients with SLE has recently improved, which was associated with increased morbidity and hospitalization rates. Therefore, this study aimed to examine the rate and causes of hospitalization in patients with SLE and explore factors associated with increased length of stay (LOS). Methods Patients who visited rheumatology clinics (Tawam hospital, United Arab Emirates (UAE)) and fulfilled the American College of Rheumatology (ACR) SLE criteria were identified. Retrospective charts were reviewed to determine previous admissions. Demographic data, reason for hospitalization, duration of hospitalization, intensive care unit (ICU) admission, number of specialist consultations, medications used, and SLE characteristics at time of admission were collected. The hospitalization rate was calculated as the number of hospitalized patients divided by the total number of patients with the disease. We performed multivariable regression analysis for factors associated with increased LOS. Results A total of 91 patients with SLE (88 women and 3 men) met the inclusion criteria with a mean disease duration of 10.2 years (SD 5.5). A total of 222 admissions were identified, and 66 of 91 patients were admitted at least once. The mean crude hospitalization rate calculated was 29.8%. The primary reason for admission was pregnancy (29%), SLE activity (24%), and infection (20%). When combining primary and secondary reasons, the proportion of admissions due to SLE activity increased to 32%. The mean LOS was 5.9 (SD 6.0) days. About 7% of admitted patients required ICU admission. In multivariable analysis, patients with lupus nephritis, complications during hospitalization, and increased number of specialists consultations and who were admitted to ICU and started new medication were all associated with increased LOS. Conclusion A significant proportion of patients with SLE were hospitalized during their disease course. The hospitalization rate in this study appears to be higher than those reported elsewhere. Disease flare is the leading cause of admission in patients with SLE in this relatively young cohort. Lupus nephritis has been found to be significantly related to longer LOS. Measurements taken to reduce the incidence and severity of flares would likely decrease hospitalization rate and LOS in patients with SLE.
Identification and stratification of systemic lupus erythematosus patients into two transcriptionally distinct clusters based on IFN-I signature
Authors: Shobha Vineeta , Mohan Anu , Malini AV , Chopra Puneet , Karunanithi Preethi , Subramani Thulasingam Siva , Selvam Sabariya , Deyati Avisek , Srivastava Ratika , Basavanthappa Sushma , Lemos Nadine , Sunitha S Margaret , Mazumder Tagore Debarati , Anand Amit , Pant Saumya , Jayaswal Vivek , Ramarao Manjunath , Dudhgaonkar Shailesh 
Published: January 2021

Objective Despite the significant advancement in the understanding of the pathophysiology of systemic lupus erythematosus (SLE) variable clinical response to newer therapies remain a major concern, especially for patients with lupus nephritis and neuropsychiatric systemic lupus erythematosus (NPSLE). We performed this study with an objective to comprehensively characterize Indian SLE patients with renal and neuropsychiatric manifestation with respect to their gene signature, cytokine profile and immune cell phenotypes. Methods We characterized 68 Indian SLE subjects with diverse clinical profiles and disease activity and tried to identify differentially expressed genes and enriched pathways. To understand the temporal profile, same patients were followed at 6 and 12-months intervals. Additionally, auto-antibody profile, levels of various chemokines, cytokines and the proportion of different immune cells and their activation status were captured in these subjects. Results Multiple IFN-related pathways were enriched with significant increase in IFN-I gene signature in SLE patients as compared to normal healthy volunteers (NHV). We identified two transcriptionally distinct clusters within the same cohort of SLE patients with differential immune cell activation status, auto-antibody as well as plasma chemokines and cytokines profile. Conclusions Identification of two distinct clusters of patients based on IFN-I signature provided new insights into the heterogeneity of underlying disease pathogenesis of Indian SLE cohort. Importantly, patient within those clusters retain their distinct expression dynamics of IFN-I signature over the time course of one year despite change in disease activity. This study will guide clinicians and researchers while designing future clinical trials on Indian SLE cohort.
Wargaming as a Methodology: The International Crisis Wargame and Experimental Wargaming
Authors: Schechter Benjamin , Schneider Jacquelyn , Shaffer Rachael 
Published: January 2021

Background. Wargaming has a long history as a tool for understanding the complexity of conflict. Although wargames have shown their relevance across topics and time, the immersive nature of wargames and the guild-like communities that surround them have often resisted the social scientific advances that occurred alongside the evolution of warfare. However, recent work raises new possibilities for integrating wargaming practices and social scientific methods. Purpose. Develop the experimental wargaming method and practice. Prioritizing the focus on iteration, control, and generalizability within experimental design can provide new opportunities for wargames to answer broader questions about decision-making, crisis behaviors, and patterns of outcomes. Method. The International Crisis Wargame developed in 2018 demonstrates the viability of experimental wargaming, and models the process of theorizing, designing, developing, and executing these wargames. It also identifies what makes games more or less experimental and details how experimental design influenced choices in the game. Conclusion. Experimental wargames are a promising new tool for both the social science and the wargaming communities. A proposed new research agenda for experimental design within wargames would support this nascent method
Registry-Based Study of Prevalence of Cleft Lip/Palate in Thailand from 2012 to 2015
Authors: Fuangtharnthip Pornpoj , Chonnapasatid Wannapong , Thiradilok Sasipa , Manopatanakul Somchai , Jaruratanasirikul Somchit 
Published: January 2021

Objective: Two main objectives were established. First objective was to determine the prevalence of the cleft lip and/or cleft palate (CL/P) in Thailand from 2012 to 2015 using the orofacial clefts (OFCs) registry and civil registration. Second objective was to conduct a quality control of this OFC registry especially for the Birth Defects Registration (BDR). Design: Registry-based survey. Setting: Analyzing data from the Thailand National Health Security Office. Participants: Registered patients with CL/P in Thailand from 2012 to 2015. Intervention: None Main Outcome Measure: Duplicated records were verified using National Identity Number (Thai ID#) and date of birth. The prevalence of CL/P and specific phenotypes was then calculated. From this prevalence estimate method, quality assurance of the OFCs registry was possible. Results: For the main outcome, the population-weighted pool prevalence of CL/P was 2.14 per 1000 live births (95% confidence interval of 2.08-2.20). Thai ID# and expense reimbursement systems were the main factors driving this cases capturing. However, this OFCs registration still requires active case finding with clinical verification, improvement of staff training and databases networking. Conclusions: This study reported a very high CL/P prevalence of Thailand. Strengths and limitations of these OFCs registry and BDR were described.
The Association of Fetal Congenital Cardiac Defects and Placental Vascular Malperfusion
Authors: Ozcan Tulin , Kikano Sandra , Plummer Sarah , Strainic James , Ravishankar Sanjita 
Published: January 2021

Objectives Abnormal early angiogenesis appears to impact both placental disorders and fetal congenital heart defects (CHD). We sought to assess the association of placental perfusion defects (PPD) and fetal (CHD). Methods Singleton pregnancies with isolated severe fetal CHD were compared to controls without congenital anomalies or maternal malperfusion (MVM) risk factors. CHD was categorized into group 1: single left ventricle morphology and transposition of the great vessels (TGA) and group 2: single right ventricle and two ventricle morphology. Malperfusion was defined as fetal vascular malperfusion (FVM), MVM, and both FVM and MVM. Results PPD was increased for all CHD (n = 47), CHD with or without risk factors, and CHD groups compared to controls (n = 92). Overall CHD cases and CHD with risk factors had an increased risk of FVM (30% and 80% vs 14%), and MVM (43% and 50% vs 21%), respectively. MVM rates were similar in CHD with and without maternal risk factors. FVM (38% vs 14%) and MVM (44% vs 21%) were increased in Group 1. MVM (42% vs 21%) and both FVM and MVM (16% vs 3%) were increased in Group 2. Conclusions PPD risk is increased in severe isolated fetal CHD. The highest risk is seen in fetal CHD with maternal risk factors.
Are there anthropometric and body composition differences between children with autism spectrum disorder and children with typical development? Analysis by age and spectrum severity in a school population
Authors: Esteban-Figuerola Patricia , Morales-Hidalgo Paula , Arija-Val Victoria , Canals-Sans Josefa 
Published: January 2021

Overweight and obesity have been reported to be more prevalent in populations with autism spectrum disorder than in children with typical development. The aim of this study was to compare the anthropometric status of children with autism spectrum disorder (diagnosed and subclinical) and children with typical development and analyse which variables can affect the anthropometric and health status of children with autism spectrum disorder. We present a two-phase epidemiological study in a school population of two age groups which assesses autism spectrum disorder diagnosis, anthropometric data and bioelectrical impedance analysis. From an initial sample of 3,713 children, 79 with autism spectrum disorder, 42 with subclinical autism spectrum disorder and 350 with typical development participated in the study. Pre-schoolers with autism spectrum disorder were taller than pre-schoolers with typical development. School-age children with autism spectrum disorder showed a significantly higher body mass index and rate of overweight/obesity than children with typical development (63.4% vs 46.3%). No significant differences were found for bioelectrical impedance analysis, but school-age children with autism spectrum disorder showed a significantly higher waist circumference, waist/height ratio and cardiovascular risk than children with typical development. The quality of the diet was lower in children with autism spectrum disorder than in children with typical development. Multiple regression analyses showed that having autism spectrum disorder and internalizing psychological problems were associated with waist/height ratio and high cardiovascular risk in school-age children. Lay abstract This study makes a comparison between the growth status of pre-school and school-age children with autism spectrum disorder and typical development children. Pre-schoolers with autism spectrum disorder were taller than children with typical development. School-age children with autism spectrum disorder were more overweight/obese, had more body fat and a greater waist circumference and waist/height ratio than children with typical development. The presence of autism spectrum disorder and internalizing problems was associated with cardiovascular risk in school-age children.
Window on the weather: a case study in multi-platform visual communication design, with a relationship to Design Thinking
Authors: Macdonald Iain 
Published: January 2021

In February 2018, after three years of design and development work, the British Broadcasting Corporation (BBC) Weather launched its redesigned service across multiple platforms. The project involved new ways of cross-disciplinary communication design working across broadcast and digital services. This research examines these innovations and considers the transcorporeality of our relationship with weather forecasting. BBC Weather developed an iconography in the mid-1970s that has been integral to its brand identity and which has survived the changes in television graphics technology from magnetised acrylic symbols to digital systems. Satellite imagery, advanced computer weather modelling, mobile interaction, and weather on the move in realtime, have become integral to presenting different layers of visual sophistication and information that require translation and editing to communicate the weather across multiple platforms and formats. An ethnographic study of the leading participants in the design project mapped out the creative process and highlighted reflexive points where design practice was modified and adapted by the interdisciplinarity of the team. Their approach to design anthropology and service design approaches are revealed in the context of Design Thinking, and how the domestication of digital services is linked to a relationship to the weather for a UK and Irish audience.
The International Society for Minimally Invasive Cardiothoracic Surgery Expert Consensus Statement on Transcatheter and Surgical Aortic Valve Replacement in Low- and Intermediate-Risk Patients: A Meta-Analysis of Randomized and Propensity-Matched Studies
Authors: Thourani Vinod H. , Edelman J. James , Holmes Sari D. , Nguyen Tom C. , Carroll John , Mack Michael J. , Kapadia Samir , Tang Gilbert H. L. , Kodali Susheel , Kaneko Tsuyoshi , Meduri Christopher U. , Forcillo Jessica , Ferdinand Francis D. , Fontana Gregory , Suwalski Piotr , Kiaii Bob , Balkhy Husam , Kempfert Joerg , Cheung Anson , Borger Michael A. , Reardon Michael , Leon Martin B. , Popma Jeffrey J. , Ad Niv 
Published: January 2021

Objective There is an increasing amount of evidence supporting use of transcatheter aortic valve replacement (TAVR) for treatment of aortic stenosis in patients at low or intermediate risk for surgical aortic valve replacement (SAVR). TAVR is now approved for use in all patient cohorts. Despite this, there remains debate about the relative efficacy of TAVR compared with SAVR in lower-risk cohorts and various subgroups of patients. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) and propensity-matched trials to guide a consensus among expert cardiologists and surgeons. Methods Studies comparing TAVR and SAVR in low- and intermediate-risk patients were identified by a thorough search of the major databases. Mortality, stroke, and other perioperative outcomes were assessed at 30 days and 1 year. Results Early mortality was lower in TAVR compared to SAVR in RCTs, but not propensity-matched studies in low-risk cohorts (0.66% vs 1.5%; odds ratio [OR] = 0.44, 95% confidence interval [CI] 0.20 to 0.98, I2 = 0%). No difference in mortality between TAVR and SAVR was identified in intermediate-risk patients at early or later time points. Incidence of perioperative stroke in 3 low-risk RCTs was significantly lower in TAVR (0.4%) than SAVR (1.4%; OR = 0.33, 95% CI 0.13 to 0.81, I2 = 0%). There was no difference in stroke for intermediate-risk patients between TAVR and SAVR. The expert panel of cardiologists and cardiac surgeons provided recommendations for TAVR and SAVR in various clinical scenarios. Conclusions In RCTs comparing TAVR and SAVR in low-risk patients, early mortality and stroke were lower in TAVR, but did not differ at 1 year. There was no difference in mortality and stroke in intermediate-risk patients. The Multidisciplinary Heart Team must consider individual patient characteristics and preferences when recommending TAVR or SAVR. The decision must consider the long-term management of each patient’s aortic valve disease.
Treatment of Nonreplantable Total Thumb Amputation at the CMC Level Using Index Finger Pollicization
Authors: Dickey Ryan M. , Meade Anna E. , Agnew Sonya P. , Zhang Andrew Y. 
Published: January 2021

Background Pollicization of the index finger is a rarely performed reconstructive option for patients with total thumb amputations with nonsalvageable carpometacarpal (CMC) joint and thenar muscles. Successful pollicization can provide basic grasp and pinch to help patients carry out activities of daily living. We present a retrospective review of 4 patients who underwent index finger pollicization for traumatic total thumb amputations. Methods A retrospective review of 4 cases of pollicization using an injured index finger for traumatic thumb amputation was performed. Patients available for follow-up were contacted for functional assessment. Outcomes including range of motion (ROM), grip strength, key pinch, 2-point discrimination, and Disabilities of the Arm, Shoulder, and Hand score were obtained. Functional thenar muscle and the CMC joint were absent in all cases. Injury mechanism was firework in 2 patients and crush in 2 patients. Results The time from injury to pollicization ranged from 8 days to 17 months. Follow-up time ranged from 10 weeks to 3 years. Three patients regularly used the pollicized thumb in activities of daily living such as writing. Tip pinch and lateral pinch along with grip strength were weak in all cases; the best recorded pinch strength was 24% and grip strength was 25% compared with the contralateral hand. The ROM of the pollicized thumb was limited. Conclusions Index finger pollicization following total thumb amputation can be a viable last-resort option for patients. The pollicized digit acts as a sensate post and avoids further morbidity from the traumatized extremity.
Randomized controlled trial of an education-based intervention to improve medication adherence: Design considerations in the medication adherence in glaucoma to improve care study
Authors: Rosdahl Jullia A , Hein Aaron M , Bosworth Hayden B , Woolson Sandra , Olsen Maren , Kirshner Miriam , Hung Anna , Muir Kelly W 
Published: January 2021

Background: Glaucoma treatment requires patients to follow daily, often times complex, eye drop regimens, but adherence is poor for many patients, putting them at risk for irreversible vision loss. A comprehensive approach is needed to address the challenges in the self-management of glaucoma. The purpose of this study is to improve glaucoma medication adherence in Veterans with medically treated glaucoma using an education-based intervention. Methods/design: This study is a single-site randomized controlled trial enrolling 200 Veterans and their companions, if companions are involved in their care. It has two arms: an intervention group and a control group. Participants in the intervention group receive an educational session with a non-physician interventionist and are provided with an AdhereTech smart bottle with the reminder functions activated. The control group is designed as an attention control such that they have a session on general eye health and are provided with a smart bottle but without the reminder functions activated. The primary outcome is the proportion of prescribed doses taken on schedule over 6 months following randomization according to the smart bottle. Secondary outcomes include intensification of glaucoma treatment, cost of intervention delivery, and cost-effectiveness of the intervention over 12 months. Discussion: The education-based intervention that we are testing is comprehensive in scope, to encompass a variety of barriers to adherence that glaucoma patients encounter, but personalized to address issues facing individual patients. Particular attention was given to feasibility in the real-world setting, as the high throughput of patients and lack of reimbursement for educational encounters in ophthalmology would limit implementation of a resource-intensive intervention.
Social networks in patients hospitalized with preventable conditions for heart disease and diabetes in Hawai‘i by health literacy
Authors: Sentell Tetine L , Agner Joy L , Davis James , Mannem Santhosh , Seto Todd B , Valente Thomas W , Vawer May , Taira Deborah A 
Published: January 2021

Objectives Reducing potentially preventable hospitalizations (PPH) for chronic disease is a research and practice priority. Native Hawaiians and other Pacific Islanders (NHOPI) have disparities in PPH, and are understudied in both health literacy and social network research. Greater inclusion of social and familial networks can help address health disparities among people with chronic illness and enhance culturally relevant healthcare. Methods Adults hospitalized with a heart disease or diabetes-related PHH in Hawai‘i ( N = 22) were assessed for health literacy and social network membership (“alters”). Results Sixty-nine percent of respondents were NHOPI. Three respondents (14%) had no alters (“isolates”). Among non-isolates, 79% desired the participation of at least one alter in chronic disease management-related interventions. Fifty-nine percent of respondents had low health literacy. While the mean number of alters did not vary significantly by health literacy, those with lower health literacy had a trend ( p = .055) towards less interest in social network engagement. Discussion In a sample primarily comprised of NHOPI with chronic disease, many patients wished to include social network members in interventions. Engagement varied by health literacy with implications for health disparities. Not all patients were interested in social network engagement, which must be considered in intervention planning.
Plaster immobilization versus anterior plating for dorsally displaced distal radial fractures in elderly patients in Pakistan
Authors: Tahir Muhammad , Khan Zimri Faridullah , Ahmed Nadeem , Rakhio Jamali Allah , Mehboob Ghulam , Watson Katherine R. , Faraz Ahmad 
Published: January 2021

This prospective, multi-centred, randomized trial examined outcomes of 3- and 12-month follow-ups of 159 elderly participants aged more than 75 years with isolated distal radial fractures, treated by anterior locking plate or closed reduction and cast immobilization. The primary outcome was the patient-rated wrist evaluation (PRWE) score. The PRWE score at 12 months was not significantly different between the two groups; however, the radiological outcomes and complications rates were worse in the casting group. Level of evidence: III