bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of body mass index on 90-day warfarin requirements: a retrospective chart review
Authors: Soyombo Bolanle M. , Taylor Ashley , Gillard Christopher , Wilson Candice , Bailey Wheeler Janel 
Published: June 2021

Background: Rates of obesity continue to rise worldwide as evidenced in the 2017 Centers for Disease Control and Prevention (CDC) report that indicated over 35% of United States (US) citizens are obese, with Louisiana ranked as the fifth most obese state in America. Since large clinical trials tend to exclude obese patients, health care providers are faced with concerns of under- or overdosing these patients on warfarin. Methods: This retrospective chart review evaluated patients who reported to a community anticoagulation clinic for warfarin management between 1 June 2017 and 30 September 2017. Along with baseline demographics, chronic use of drugs that have clinically significant interactions with warfarin, social activity such as tobacco use and alcohol consumption, were collected. Body mass indexes (BMI) were collected and categorized according to the World Health Organization definitions as follows: Normal (BMI 18–24.9 kg/m2), Overweight (25–29.9 kg/m2), Obesity Class I (30–34.9 kg/m2), Obesity Class II (35–39.9 kg/m2), Obesity Class III (⩾40 kg/m2). The primary outcome was the mean 90-day warfarin dose required to maintain “intermediate control” or “good control” of international normalized ratio (INR), stratified by BMI classifications. The secondary outcome was the time in therapeutic range (TTR) stratified by BMI classifications. Results: A total of 433 patient encounters were included in this study. There was a total of 43 encounters in the Normal BMI category, 111 Overweight encounters, 135 Obesity Class I encounters, 45 Obesity Class II encounters, and 99 Obesity Class III encounters. Approximately 63% of the study population were male, and over 90% the patients were African American. The Obesity Class I and Obesity Class II class required an average of 11.47 mg and 17.10 mg more warfarin, respectively, to maintain a therapeutic INR when compared with the Normal BMI category. These findings were statistically significant with p values of 0.007 and <0.001, respectively. Additionally, upon comparing the Overweight BMI category with the Obesity Class II category, there was a mean warfarin dose difference of 11.22 mg ( p = 0.010) more in Obesity Class II encounters to maintain a therapeutic INR. In the secondary analysis of TTR, Overweight category encounters had the highest TTR, whereas encounters in the Normal BMI category had the lowest TTR. Conclusion: As BMI increases, there is an increased chronic warfarin requirement to maintain “intermediate control” or “good control” of INR between 2 and 3 in an ambulatory care setting.
Inconsistencies in Overdose Suicide Death Investigation Practice and Potential Remedies Using Technology: A Centers for Disease Control and Prevention Consultation Meeting Summary
Authors: Mercado Melissa C. , Stone Deborah M. , Kokubun Caroline W. , Trudeau Aimée-Rika T. , Gaylor Elizabeth , Holland Kristin M. , Bartholow Brad N. 
Published: June 2021

Introduction: It is widely accepted that suicides—which account for more than 47 500 deaths per year in the United States—are undercounted by 10% to 30%, partially due to incomplete death scene investigations (DSI) and varying burden-of-proof standards across jurisdictions. This may result in the misclassification of overdose-related suicides as accidents or undetermined intent. Methods: Virtual and in-person meetings were held with suicidologists and DSI experts from five states (Spring-Summer 2017) to explore how features of a hypothetical electronic DSI tool may help address these challenges. Results: Participants envisioned a mobile DSI application for cell phones, tablets, or laptop computers. Features for systematic information collection, scene description, and guiding key informant interviews were perceived as useful for less-experienced investigators. Discussion: Wide adoption may be challenging due to differences in DSI standards, practices, costs, data privacy and security, and system integration needs. However, technological tools that support consistent and complete DSIs could strengthen the information needed to accurately identify overdose suicides.
Application of [18F]FLT‐PET in pulmonary arterial hypertension: a clinical study in pulmonary arterial hypertension patients and unaffected bone morphogenetic protein receptor type 2 mutation carriers
Authors: Botros Liza , Jansen Samara M.A. , Ashek Ali , Spruijt Onno A. , Tramper Jelco , Noordegraaf Anton V. , Aman Jurjan , Harms Hans , de Man Frances S. , Huisman Marc C. , Zhao Lan , Bogaard Harm J. 
Published: June 2021

Pulmonary arterial hypertension is a heterogeneous group of diseases characterized by vascular cell proliferation leading to pulmonary vascular remodelling and ultimately right heart failure. Previous data indicated that 3′‐deoxy‐3′‐[18F]‐fluorothymidine (18FLT) positron emission tomography (PET) scanning was increased in pulmonary arterial hypertension patients, hence providing a possible biomarker for pulmonary arterial hypertension as it reflects vascular cell hyperproliferation in the lung. This study sought to validate 18FLT‐PET in an expanded cohort of pulmonary arterial hypertension patients in comparison to matched healthy controls and unaffected bone morphogenetic protein receptor type 2 mutation carriers. 18FLT‐PET scanning was performed in 21 pulmonary arterial hypertension patients (15 hereditary pulmonary arterial hypertension and 6 idiopathic pulmonary arterial hypertension), 11 unaffected mutation carriers and 9 healthy control subjects. In‐depth kinetic analysis indicated that there were no differences in lung 18FLT k3 phosphorylation among pulmonary arterial hypertension patients, unaffected bone morphogenetic protein receptor type 2 mutation carriers and healthy controls. Lung 18FLT uptake did not correlate with haemodynamic or clinical parameters in pulmonary arterial hypertension patients. Sequential 18FLT‐PET scanning in three patients demonstrated uneven regional distribution in 18FLT uptake by 3D parametric mapping of the lung, although this did not follow the clinical course of the patient. We did not detect significantly increased lung 18FLT uptake in pulmonary arterial hypertension patients, nor in the unaffected bone morphogenetic protein receptor type 2 mutation carriers, as compared to healthy subjects. The conflicting results with our preliminary human 18FLT report may be explained by a small sample size previously and we observed large variation of lung 18FLT signals between patients, challenging the application of 18FLT‐PET as a biomarker in the pulmonary arterial hypertension clinic.
Acupuncture (superficial dry-needling) as a treatment for chronic postherpetic neuralgia – a randomized clinical trial
Authors: Sollie Martin , Pind Robert , Madsen Christoffer Bing , Sørensen Jens Ahm 
Published: June 2021

Background: Postherpetic neuralgia is a painful condition where finding sufficient treatment poses a great challenge. Acupuncture is often used as an alternative treatment for these pains, yet no randomized trials, using a sham-placebo have been performed to confirm its effect. Our objective was to investigate the efficacy of acupuncture compared to sham-acupuncture when treating chronic postherpetic dermal pain. Methods: We performed a sham-controlled double-blinded randomized clinical trial (RCT) with two arms. The intervention group received superficial dry-needling, and the control group received sham acupuncture using blunted needles. Twenty-six patients received two treatments. They filled out questionnaires at baseline and 1 month after treatment: (1) average and maximum pain (Numeric Rating Scale), (2) neuropathic pain (Neuropathic Pain Scale Inventory) and (3) Quality of Life (QoL) (Short-form 36). Results: Thirteen patients were allocated to the intervention group and 15 to the control group. We did not detect any significant changes in levels of pain and neuropathic pain. One QoL parameter, regarding emotional problems, reached a level of statistical significance. The sham-blinding was successful. This is the first RCT on the effect of acupuncture (superficial dry-needling) on postherpetic neuralgia (PHN), using a sham procedure as control. We observed no significant changes or tendencies in the measured levels of pain. One QoL parameter had significant improvement in the intervention group compared to the control group. Conclusion: In conclusion, acupuncture was not superior to treatment with sham acupuncture. Though individual patients may experience some pain relief from acupuncture, our results do not support the routine use of this type of acupuncture to treat PHN.
Satisfaction with dental condition and oral health–related quality of life of school-age children with dental pain in Ibadan, Nigeria
Authors: Lawal Folake Barakat , Oke Gbemisola Aderemi 
Published: June 2021

Objectives: The aim of the study was to determine the association between oral health–related quality-of-life domains and satisfaction with dental condition of school-age children with dental pain in Ibadan, Nigeria. Methods: This cross-sectional study was conducted among 1006 pupils aged 9–12 years who attended 18 randomly selected primary schools in Ibadan, Nigeria. An interviewer-administered questionnaire, Child Oral Impact on Daily Performances inventory in addition to oral examination was used to obtain data. Analysis was done with SPSS 23 and STATA 14 and p-value set at <0.05. Results: The prevalence of self-reported dental pain was 10.2%. The mean Child Oral Impact on Daily Performances inventory score was 2.6(±7.2) overall and 9.8(±12.4) for pupils with pain. There was a greater impact on oral health–related quality of life of respondents who reported dental pain than in others (mean rank = 749.54 vs 475.4, U = 21,162, p < 0.001) compared to those with clinically assessed pain (mean rank = 541.21 vs 502.97, U = 6416, p = 0.489). Those who reported dental pain were more dissatisfied with their dental condition (odds ratio = 7.7, 95% confidence interval = 5.0–12.0, p < 0.001) compared to those with clinically assessed dental pain (odds ratio = 1.3, 95% confidence interval = 0.4–4.9, p = 0.687). The direct effect of pain on satisfaction with dental condition and Child Oral Impact on Daily Performances inventory was β = 0.74 (standard error = 0.12, 95% confidence interval = 0.50–0.97, p < 0.001) and β = 0.53 (standard error = 0.05, 95% confidence interval = 0.44–0.63, p < 0.001), respectively. The indirect effect was β = 0.12 (standard error = 0.039, 95% confidence interval = 0.05–0.20, p = 0.001) and the total effect was β = 0.86 (standard error = 0.11, 95% confidence interval = 0.64–1.08, p < 0.001); R2 = 0.21. Conclusion: Self-reported dental pain significantly impacted the quality of life of the pupils to cause dissatisfaction with dental condition when compared to clinically assessed pain.
Efficacy and safety of non-vitamin K antagonist oral anticoagulants for venous thromboembolism: a meta-analysis
Authors: Zhuang Yan , Dai Lin-feng , Chen Ming-qi 
Published: June 2021

Objective Several trials had compared the efficacy and safety between non-vitamin K antagonist oral anticoagulants and warfarin for acute venous thromboembolism, but the results were incomplete. This updated review comprehensively assessed the efficacy and safety of non-vitamin K antagonist oral anticoagulants for venous thromboembolism. Design Meta-analysis of randomised control trials. Six databases were searched from January 2000 to December 2018. Setting Adult patients had got non-vitamin K antagonist oral anticoagulants or warfarin for venous thromboembolism. Participants Randomised control trials that compared the efficacy and safety between non-vitamin K antagonist oral anticoagulants and warfarin. Main outcome measures The efficacy and safety of non-vitamin K antagonist oral anticoagulants . Results Seven studies involving 29,879 cases were included, among which 14,943 cases were assigned to non-vitamin K antagonist oral anticoagulants group and 14,936 cases to warfarin group. Meta-analysis showed that compared with warfarin, recurrent venous thromboembolism (odds ratio 0.94 [95% confidence interval 0.81 to 1.11]), death related to venous thromboembolism or fatal pulmonary embolism (odds ratio 1.00 [95% confidence interval 0.63 to 1.60]), symptomatic deep-vein thrombosis (odds ratio 0.88 [95% confidence interval 0.72 to 1.09]), symptomatic nonfatal pulmonary embolism (odds ratio 1.03 [(95% confidence interval 0.82 to 1.30]) and all deaths (odds ratio 0.92 [95% confidence interval 0.76 to 1.12]) are similar in non-vitamin K antagonist oral anticoagulants group, but major bleeding event (odds ratio 0.61 [95% confidence interval 0.50 to 0.75]) and clinically relevant non-major bleeding event (odds ratio [95% confidence interval 0.53 to 0.85]) are less in non-vitamin K antagonist oral anticoagulants group.  Conclusions For the treatment of venous thromboembolism, non-vitamin K antagonist oral anticoagulants is as effective as warfarin, and has a better safety profile than warfarin.
Understanding Home Hemodialysis Patient Attrition: A Cohort Study
Authors: Paterson Bailey , Fox Danielle E. , Lee Chel Hee , Riehl-Tonn Victoria , Qirzaji Elena , Quinn Rob , Ward David , MacRae Jennifer M. 
Published: June 2021

Background: Home hemodialysis (HHD) offers a flexible, patient-centered modality for patients with kidney failure. Growth in HHD is achieved by increasing the number of patients starting HHD and reducing attrition with strategies to prevent the modifiable reasons for loss. Objective: Our primary objective was to describe a Canadian HHD population in terms of technique failure and time to exit from HHD in order to understand reasons for exit. Our secondary objectives include the following: (1) determining reasons for training failure, (2) reasons for early exit from HHD, and (3) timing of program exit. Design: A retrospective cohort study of incident adult HHD patients between January 1, 2013—June 30, 2020. Setting: Alberta Kidney Care South, AKC-S HHD program. Participants: Patients who started training for HHD in AKC-S. Methods: A retrospective, cohort study of incident adult HHD patients with primary outcome time on home hemodialysis, secondary outcomes include reason for train failure, time to and reasons for technique failure. Cox-proportional hazard model to determine associations between patient characteristics and technique failure. The cumulative probability of technique failure over time was reported using a competing risks model. Results: A total of 167 patients entered HHD. Training failure occurred in 20 (12%), at 3.1 [2.0, 5.5] weeks; these patients were older ( P < .001) and had 2 or more comorbidities ( P < .001). Reasons for HHD exit after training included transplant (35; 21%), death (8; 4.8%), and technique failure (24; 14.4%). Overall, the median time to HHD exit, was 23 months [11, 41] and the median time of technique failure was 17 months [8.9, 36]. Reasons for technique failure included: psychosocial reasons (37%) at a median time 8.9 months [7.7, 13], safety (12.5%) at 19 months [19, 36], and medical (37.5%) at 26 months [11, 50]. Limitations: Small patient population with quality of data limited by the electronic-based medical record and non-standardized definitions of reasons for exit. Conclusions: Training failure is a particularly important source of patient loss. Reasons for exit differ according to duration on HHD. Early interventions aimed at reducing train failure and increasing psychosocial supports may help program growth.
Social Determinants of Health Challenges Are Prevalent Among Commercially Insured Populations
Authors: Pera Megan F. , Cain Mary M. , Emerick Ashleigh , Katz Stephanie , Hirsch Nicole A. , Sherman Bruce W. , Bravata Dena M. 
Published: June 2021

Objectives: To evaluate the prevalence of social determinants of health (SDoH) factors in a large commercially-insured population and to characterize the prevalence of common conditions (eg, diabetes, behavioral health issues) and addressable health services utilization concerns (eg, lack of preventive care) for which employers offer no- and low-cost benefit programs. Methods: We identified groups with SDoH challenges within a commercially-insured population of 5.1 M through administrative data and self-report. Using medical claims and health assessment data, we identified populations with SDoH needs who had common conditions for which employers often provide no- or low-cost benefit programs (ie, diabetes, behavioral health conditions, high-risk pregnancy, overweight/obesity). Additionally, we sought populations with common addressable health services utilization concerns such as avoidable emergency room visits, lack of preventive care services, or non-adherence to medications. We used univariate analyses to describe the prevalence of SDoH risks in the population of interest. Results: Twenty-seven percent of this commercially-insured population live in a zip code where the median income is at or below 200% of the Federal Poverty Line. Respondents identified cost (55%) and family, school, or work responsibilities (26%) as key barriers to care. ER overutilization rates are higher in lower income zip codes than wealthier zip codes (34% vs 9%) as is the prevalence of diabetes, overweight/obesity, and behavioral issues, and decreased use of preventive services. Fifteen percent of the study population live in a low-access food area. There is considerable variability in access to employer-sponsored resources to address these needs (70% of employers provide behavioral health programs; 63% provide telehealth programs, but only 1% offer healthy food programs and less than 0.5% offer either child care or transportation support programs). Conclusions: Commercially insured populations could benefit from employer-sponsored programs or benefits that address key SDoH barriers such as financial support, healthy food programs, child-care, and transportation.
In Vivo biomechanical evaluations of suture anchors for repairing grade 3 superficial medial collateral ligament injury in a porcine model
Authors: Takahashi Tsuneari , Takeshita Katsushi 
Published: June 2021

Purpose: To clarify the biomechanical and radiological outcomes of superficial medial collateral ligament (sMCL) repair using suture anchors in a large animal model. Methods: The right sMCLs of nine male castrated pigs was completely detached at the femoral attachment. sMCL repair surgery was performed using two suture anchors. The same skin incision, sMCL exposure, and immediate wound closure were made at the left knee as a sham surgery. Magnetic resonance imaging was performed preoperatively and 4 weeks after surgery. The structural properties (upper yield load, maximum load, linear stiffness, and elongation at failure) of the femur-sMCL-tibia complex were determined. Results: During tensile testing, all the repaired sMCLs avulsed from the femoral attachment. There were no significant differences in the upper yield load, maximum load, linear stiffness, or elongation at failure between the groups 4 weeks after surgery or in the MRI-derived signal-to-noise quotients (SNQs) at the mid and tibial sMCL. The SNQs differed significantly at the femoral (2.7 ± 1.2 vs 0.3 ± 0.7; P = 0.00064) portions between groups. Conclusion: The injured sMCLs biomechanically recovered after surgery using suture anchors even though the SNQs were higher than those with native contralateral sMCLs. For clinical relevance, sMCL repair of grade 3 sMCL injuries using suture anchors was both safe and successful with less tissue dissection.
An Inquiry into the Persistence of Holiday Effect on Stock Markets in India: Insights and Perspectives on a Seasonal Anomaly
Authors: Tadepalli Meher Shiva , Jain Ravi Kumar , Metri Bhimaraya 
Published: June 2021

Asset pricing is a key area of literature in analysing and evaluating the stock market efficiency. Though various pricing models made efforts to explain the behaviour of the stocks, the existence of seasonal anomalies in the stock markets creates an opportunity for the investors to generate abnormal returns. The present article emphasizes one of such market anomalies namely, the holiday effect using indices belonging to Indian stock exchanges. Thorough research is performed by including all the prime market-capital and sectoral indices of the National Stock Exchange and the Bombay Stock Exchange. The ARIMAX methodology is adopted to observe the anomaly by considering exogenous variables representing the trading days before the exchange-mandated holidays. Further, the strength of the anomaly is analysed with the incorporation of various stock market reforms and observed to be significantly persistent among most of the Indian market indices (including both the sectoral and the market-capital based indices).
Simultaneous improvement of microgeometry and surface quality of spur and straight bevel gears by abrasive flow finishing process
Authors: Petare Anand , Jain Neelesh Kumar , Palani I. A. 
Published: June 2021

This article reports on influence of extrusion pressure, abrasive particle size and volumetric concentration on simultaneous reduction of surface roughness and microgeometry errors of spur and straight bevel gear by abrasive flow finishing (AFF) process. A vertical configured experimental apparatus was developed for two-way AFF and developed fixtures for finishing gears. Experimental investigations were conducted to identify optimum parametric combination, using response surface methodology, based on Box–Behnken design approach. Results revealed that higher values of abrasive particle size and volumetric concentration yield more percentage decrease in surface roughness and microgeometry error. Roughness profile, bearing area curve, microhardness, surface morphology, and wear resistance of the gear having best quality finishing were studied. Surface morphology analysis of the flank regions of the best finished spur and straight bevel gears found them to be smooth and free from cracks and burrs. Reciprocating wear test results revealed higher wear resistance of the AFF finished gears as compared to the unfinished gears. AFF also enhanced microhardness of the finished gears, which would enhance their operating performance and service life. This study shows that AFF is a flexible, economical, productive, easy to operate, and sustainable nontraditional process for precision finishing of gear that can simultaneously improve microgeometry, surface finish, microhardness, surface morphology, wear resistance, and residual stresses of the finished gears. Gear manufacturers and users will be benefited by the outcome of this study. JEL codes: C00, C20