bluuebunny/crossref_metadata_2025_split huggingface dataset:
Procedural (In)Justice as Inclusivity and Marginalization: Evidence from a Longitudinal Sample of Mexican-American Adolescents
Authors: Thompson Andrew J. , Wilson Theodore 
Published: March 2021

Objectives: Treatment by law enforcement officers, as representatives of the state that interact with individual citizens, may signal to individuals their political and social inclusion within society. Hispanics, as the largest minority group in the country that oftentimes must navigate two cultural identities, may be especially sensitive to the treatment of police. We test the group engagement model’s implication that procedural justice—or lack thereof—may promote or hinder attachment to the United States and/or Mexico among Latino/a adolescents and young adults. Methods: Using a fixed effects panel design with a subsample of Mexican Americans from the Pathways to Desistance Study, we examine whether changes in subjective procedural justice evaluations of the police are related to changes in National identification. Results: Changes in procedural justice perceptions are significantly related to changes in Mexican identification, whereas procedural justice is not related to changes in Anglo identification. Although, consistent with segmented assimilation theory, the relationships between changes in procedural justice and Mexican/Anglo identification may be stronger among participants born in the United States. Conclusions: The findings are generally consistent with the group engagement model of procedural justice and suggest procedural injustice may alienate Hispanics.
A new risk-scoring system to predict Xp11.2 translocation renal cell carcinoma in adults
Authors: Shi Qiancheng , Liu Ning , Zhu Yiqi , Qu Feng , Xu Linfeng , Li Xiaogong , Zhang Gutian , Guo Hongqian , Li Dongmei , Gan Weidong 
Published: March 2021

Objective The objective was to derive and validate a practical scoring system for preoperative diagnosis of Xp11.2 translocation renal cell carcinoma (RCC) in adults. Methods Epidemiology, symptomatology, and imaging methods were correlated between patients with common RCC and those with Xp11.2 translocation RCC using a derivation study (N = 6352) and a validation study (N = 127). Univariate analysis of risk factors was performed to derive a scoring system to predict the occurrence of Xp11.2 translocation RCC in adults. The Hosmer–Lemeshow goodness-of-fit test and receiver operating characteristic (ROC) curve were used to validate the scoring system. Results Based on odd ratios, three low-risk factors (sex, gross haematuria, and intratumoural calcification) and three high-risk factors (age, unenhanced computed tomography density, and enhancement pattern) were given weighted scores of 1 and 2, respectively. Patients who scored 3 to 5 points underwent an additional magnetic resonance imaging examination. The final scoring system had a sensitivity of 81.0% and a specificity of 98.0%. Conclusion We established a practical scoring system for the preoperative diagnosis of Xp11.2 translocation RCC in adults, which can be optimised through further clinical findings in the future.
Clinical features of cardiac lymphoma: an analysis of 37 cases
Authors: Zhao Yu , Huang Sai , Ma Chao , Zhu Haiyan , Bo Jian 
Published: March 2021

Objective To summarize the clinical and pathological features of patients with cardiac lymphoma. Methods The general conditions, clinical features, pathological types, and prognostic indices of 37 patients with cardiac lymphoma treated in our hospital were analyzed. Results Among the 37 patients, only one had primary cardiac lymphoma, and the other 36 patients had secondary cardiac lymphoma. The cardiac manifestations were mainly chest tightness, shortness of breath, increased heart rates, and electrocardiographic abnormality caused by pericardial effusion, but myocardial enzyme levels were normal in all patients. Only three patients displayed solid heart-occupying manifestations. These lesions were mainly located in the right atrium, and the masses were all larger than 5 cm. The pathological type was diffuse large B cell lymphoma that did not arise from the germinal center in all three patients. Conclusions Cardiac lymphoma was mostly secondary, and pericardial effusion was the primary objective sign. Moreover, cardiac lymphoma was characterized by a high international prognostic index, late stage, and high rates of T and NK cell lymphoma. Most cases were accompanied by serous cavity effusion, extranodal involvement of important organs, elevated lactate dehydrogenase levels, hypoalbuminemia, and normal myocardial enzyme levels.
Role of the ratio of NSE serum concentration in evaluating the therapeutic effect on metastatic neuroendocrine neoplasms of the liver
Authors: Kan Jingbao , Tian Ye , Shao Yun , Xu Haicheng , Li Xiaolin , Tang Qiyun 
Published: March 2021

Background: Neuron-specific enolase (NSE) is one of the biomarkers of neuroendocrine neoplasms (NEN). Its level of evidence is significantly lower than some other biomarkers. However, the ratio of NSE serum concentration (NSE ratio) before and after the treatment cycle may be a good tool for evaluating the therapeutic effect of metastatic neuroendocrine neoplasms of the liver (MNENOL). Methods: We collected clinical cases of NEN with liver metastases, calculating the ratio of NSE in each case before and after the treatment cycle, using thin-slice computed tomography or magnetic resonance imaging as a reference to evaluate the therapeutic effect. We analyzed the correlation between NSE ratio and NSE serum concentration and curative effect, and then compared the evaluation performance of the two. Results: We found that increase in the NSE ratio is a risk factor for the progression of MNENOL. Compared with NSE, NSE ratio has a greater advantage in evaluating the effect of MNENOL. NSE ratio is related to the curative effect of NEN, and the correlation is better than that of NSE. When judging whether NEN has new metastasis, the NSE ratio shows a similar effect to NSE, and there is no significant difference between the two. Conclusion: NSE ratio is more effective than NSE in evaluating the therapeutic effect of MNENOL, but it is not significantly different from NSE in terms of predicting new metastases.
Resource Over-Utilization in Hospitalized Patients With Uncomplicated Skin and Soft Tissue Infections
Authors: Venugopalan Veena , Crawford Robert , Ho Kennedy , Garg Mahek , Park Haesuk , Premraj Sasha , Klinker Kenneth , Cherabuddi Kartikeya , DeSear Kathryn 
Published: March 2021

Background: Inpatient management of SSTIs utilizes considerable healthcare resources. The CREST+SEWS score categorizes patients with SSTIs into 4 severity classes. Hospitalizations can be avoided in Class I as they are treated as outpatients with oral antibiotics, whereas Class IV require hospitalization for intravenous antibiotics. Objective: The purpose of this study was to perform a budget impact analysis on CREST+SEWS Class 1 patients, to compare the medical costs of current treatment, in the inpatient setting with intravenous antibiotics, with a proposed alternative of using oral antibiotics in the outpatient setting. Further, resource utilization in Class I was evaluated. Methods: This was a retrospective study of adult patients hospitalized in 2015 for SSTIs who received >24 hours of antimicrobials. The CREST+SEWS scoring system was used to stratify patients into Class I to IV. Pharmacy and medical costs and resources associated with inpatient management of Class I SSTIs were derived from the itemized discharge records. Results: Of the 252 patients who met the inclusion criteria, 61 (24%) were classified as Class I. The total cost of treating Class I SSTI patients in the inpatient setting was $281,816 (cost per patient: $4,619) in 2015 USD. In the hypothetical situation of treatment with oral antibiotics in the outpatient setting, the cost savings were estimated to be $4,398 per patient. Fifty-three percent of patients had blood cultures, and on average, each patient received 2 radiographic tests. Conclusions: Identifying outpatient candidates, and avoiding tests with low diagnostic can reduce the economic burden of SSTIs.
An Academic-Community Collaboration to Deliver Medication Therapy Management (MTM) Services to Patients Living in Rural Counties of a Southwestern State in the United States
Authors: Axon David Rhys , Johnson Melissa , Abeln Brittany , Forbes Stephanie , Anderson Elizabeth J. , Taylor Ann M. , Aseret-Manygoats Teresa , Warholak Terri , Hall-Lipsy Elizabeth 
Published: March 2021

Background: Patients living in rural communities often experience pronounced health disparities, have a higher prevalence of diabetes and hypertension, and poorer access to care compared to urban areas. To address these unmet healthcare service needs, an established, academic-based MTM provider created a novel, collaborative program to provide comprehensive, telephonic services to patients living in rural Arizona counties. Objective: This study assessed the program effectiveness and described differences in health process and outcome measures (e.g., clinical outcomes, gaps in care for prescribed medications, medication-related problems) between individuals residing in different rural-urban commuting area (RUCA) groups (urban, micropolitan, and small town) in rural Arizona counties. Methods: Subjects eligible for inclusion were 18 years or older with diabetes and/or hypertension, living in rural Arizona counties. Data were collected on: demographic characteristics, medical conditions, clinical values, gaps in care, medication-related problems (MRPs), and health promotion guidance. Subjects were analyzed using 3 intra-county RUCA levels (i.e., urban, micropolitan, and small town). Results: A total of 384 patients were included from: urban (36.7%), micropolitan (19.3%) and small town (44.0%) areas. Positive trends were observed for clinical values, gaps in care, and MRPs between initial and follow-up consultations. Urban dwellers had significantly lower average SBP values at follow-up than those from small towns (p < 0.05). A total of 192 MRPs were identified; 75.0% were resolved immediately or referred to providers and 16.7% were accepted by prescribers. Conclusion: This academic-community partnership highlights the benefits of innovative collaborative programs, such as this, for individuals living in underserved, rural areas.
Efficacy and Safety of Vancomycin Therapy After the Transition to AUC/MIC Monitoring in a Primary Facility
Authors: Eads Andrea V , Cole Jennifer L 
Published: March 2021

Background: New guidance recommends area under the curve/minimum inhibitory concentration (AUC/MIC) instead of trough-based monitoring for vancomycin therapy. While this transition has demonstrated improved safety and efficacy in large, tertiary centers, this has not been assessed in the primary hospital setting. Objective: The primary objectives were to evaluate the efficacy and safety of AUC/MIC monitoring in inpatient veterans treated with intravenous vancomycin for ≥72 hours compared to a historical cohort of trough-based monitoring. Methods: This was a retrospective, quasi-experimental study over 2 five-month study periods. Efficacy was evaluated by comparing clinical failure rates as defined by a persistent fever, clinical deterioration, or escalation of gram-positive therapy. Safety was determined by the incidence of acute kidney injury (AKI) defined by an acute increase in serum creatinine ≥0.3 mg/dL over 48 hours. Results: 25 patients met the criteria in the before group and 19 in the after group. Efficacy was equivalent between groups; no patients exhibited clinical failure of vancomycin therapy. In the before group, 2 patients (8%) met defined criteria for AKI, while none in the after group experienced AKI (P = 0.21). Total vancomycin exposure was similar between groups (P = 0.56). Conclusion: AUC-based monitoring was equally efficacious as trough-based monitoring with similarly low rates of AKI.
Dexamethasone intravitreal implant in patients with cataract and naïve diabetic macular edema
Authors: Barone Antonio , Russo Vincenzo , Maggiore Giulia , Loiodice Marco Sabino , Stella Andrea , Bux Anna Valeria , Iaculli Cristiana 
Published: March 2021

Purpose: To assess the feasibility and clinical effectiveness of dexamethasone intravitreal implant 0.7 mg (IDI) administered in diabetic patients to prevent the worsening of macular edema. Methods: Forty eyes of 40 consecutive patients with naïve macular edema secondary to diabetes mellitus who were treated with IDI administered preoperative (Group A: 20 patients) or IDI administered immediately after cataract surgery (Group B: 20 patients). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) changes were evaluated at baseline and at postoperative time points. Results: Follow-up study was 20 weeks. In Group A and B, mean BCVA improved significantly at all post-surgery time points ( p < 0.05). In Group A and B, mean CMT decreased significantly at 16 weeks ( p = 0.02 and p = 0.004, respectively). At week 20, CMT failed to reach statistical significance in both groups ( p = 0.5, group A and p = 0.15, group B). No statistical differences were noted between groups in term of BCVA (with the exception of week 4 for the presence of cataract in Group A), CMT and IOP. Conclusions: The use of intravitreal dexamethasone implant 1 month prior to scheduled cataract extraction or at the time of phacoemulsification appears to be safe and effective for at least 16 weeks after surgery.
Benign Umbilical Tumors Resembling Sister Mary Joseph Nodule
Authors: Ha Dae-Lyong , Yang Min-Young , Shin Jun-Oh , Kim Hoon-Soo , Ko Hyun-Chang , Kim Byung-Soo , Kim Moon-Bum 
Published: March 2021

Background: When physicians see an umbilical nodule, most of them instinctively recall the Sister Mary Joseph nodule. Therefore, dermatologists need to recognize umbilical dermatoses that can be mistaken for the Sister Mary Joseph nodules. This study aimed to describe the different kinds of benign umbilical tumors as well as elucidate the factors that can be used to distinguish the Sister Mary Joseph nodule from these tumors. Methods: The “benign umbilical tumor” group included 19 patients, whereas the “Sister Mary Joseph nodule” group comprised 30 patients (2 from our department, 28 from PubMed search). We compared the clinical and dermoscopic findings between 2 groups. Results: In the “benign umbilical tumor” group, the most common diagnosis was dermatofibroma (5/19), followed by keloid (3/19), and soft fibroma (3/19). These tumors had various colors (red, brown to black, and flesh colored) and exhibit characteristic surface changes (eg, verrucous changes in epidermal nevi and verrucae). Conversely, most Sister Mary Joseph nodules have an erythematous color, oozing or ulceration on the surface, and nearby satellite lesions. Furthermore, the dermoscopic findings of Sister Mary Joseph nodules showed a polymorphous vascular pattern and a white or milky-red, amorphous area. Benign lesions showed different dermoscopic patterns: pigment networks with white areas (dermatofibromas), thrombosed capillaries (verrucae), and the “pore sign” (epidermal cysts). Conclusions: Various cutaneous tumors can be mistaken for the Sister Mary Joseph nodule when they develop on the umbilicus; the clinical and dermoscopic differences found in this study may be useful for establishing a differential diagnosis.
Vertical segmental anterior mandibular distraction to aid closure of a severe anterior open bite associated with an accentuated reverse curve of Spee
Authors: Fowler Peter , Haworth Jennifer , Steenberg Leon 
Published: March 2021

Background: The correction of severe anterior open bite is technically challenging, often requiring the use of complex orthodontic mechanics and/or orthognathic surgery and has a relatively high risk of relapse. A marked reverse curve of Spee in the lower arch presents additional challenges when correcting a severe anterior open bite. Methods and Materials: A 22.2-year-old Caucasian man presented with concerns relating to poor anterior occlusion associated with a 1.3-cm anterior open bite. There was an accentuated reverse curve of Spee to the lower arch, an increased maxillary-mandibular plane angle and increased lower face height. Multidisciplinary treatment involving the use of segmental anterior mandibular distraction to level the curve of Spee before undertaking a Le Fort I posterior maxillary impaction is described in this case report. Results: Long-term post-treatment records showed stable anterior open bite correction. Conclusions: This case report illustrates the successful use of segmental anterior mandibular vertical distraction followed by conventional Le Fort I posterior impaction surgery to correct a severe anterior open bite associated with an accentuated reverse curve of Spee and high maxillary-mandibular plane angle.
Cardiovascular events and all-cause mortality in surgically or medically treated primary aldosteronism: A Meta-analysis
Authors: Jing Ying , Liao Kangla , Li Ruolin , Yang Shumin , Song Ying , He Wenwen , Wang Kanran , Yang Jun , Li Qifu , Hu Jinbo 
Published: March 2021

Objectives: To compare the effect of surgical or medical treatment on the risk of cardiovascular diseases (CVD) and all-cause mortality in patients with established primary aldosteronism (PA). Methods: We searched PUBMED, MEDLINE and Cochrane Library for the meta-analysis. We included patients who were diagnosed with PA following guideline-supported protocols and received surgery or mineralocorticoid receptor antagonist (MRA)-based medical treatment, and age-sex matched patients with treated essential hypertension (EH). Primary endpoints were CVD incidence and all-cause mortality. Results: Compared with EH, patients with treated PA had a higher risk of CVD [odds ratio (OR) 1.79; 95% confidence interval (CI) 1.39–2.31]. This elevated risk was only observed in patients with medically treated PA [OR 2.11; 95%CI 1.88–2.38] but not in those with surgically treated PA. The risk of all-cause mortality was significantly lower in patients with treated PA [OR 0.86; 95% CI 0.77–0.95] compared to EH. The reduced risk was only observed in patients with surgically treated PA [OR 0.47; 95% CI 0.34–0.66], but not in those with medically treated PA. Conclusions: Patients with medically treated PA have a higher risk of CVD compared to patients with EH. Surgical treatment of PA reduces the risk of CVD and all-cause mortality in patients with PA.
Identifying Needs and Barriers to Engage Family Members in Transplant Candidate Care
Authors: McKinney Warren T. , Bruin Marilyn J. , Kurschner Sophie , Partin Melissa R. , Hart Allyson 
Published: March 2021

Introduction: Friends and family members provide critical support to patients on the waitlist for deceased donor kidney transplantation. However, little is known about how best to support and engage them effectively to improve patient outcomes. Methods: We conducted 5 focus groups with the family members of patients on the waitlist for a deceased donor kidney (n=23) to identify individual- and group-level targets for an intervention. Discussions encouraged participants to reflect on their support roles, experiences at the transplant evaluation, interactions with providers, knowledge of transplant options and expected outcomes. Transcripts of study sessions were coded using an iterative and inductive process. Results: The thematic analysis produced two main themes related to experiences providing care to patients on the waitlist for kidney transplantation. First, participants revealed that supporting a patient on the waitlist created challenges that reverberate through their entire social structure. Family members discussed frustrations with adapting to their patient’s kidney health needs, feelings of isolation, and barriers to identifying and building effective support networks. Second, participants described multiple challenges that prevented their patient-family unit from making informed decisions about transplant care. These challenges included communication with their patient, patients resisting help, difficulty understanding the information, and feeling helpless. Conclusion: Family members providing care to patients with end-stage kidney disease require targeted support to overcome the unique challenges associated with their role in helping to meet their patient’s clinical needs. Interventions to engage friends and family members in the care of kidney transplant candidates need to effectively address these challenges.
A Narrative Review of Qualitative Studies Describing Access to Kidney Transplantation
Authors: Ranahan Molly , Dolph Beth , VonVisger Jon , Cadzow Renee , Feeley Thomas , Kayler Liise K. 
Published: March 2021

Background: This review used the Information-Motivation-Behavioral Skills (IMB) model of health behavior change to conceptualize the determinants of kidney transplant access behavior for adult patients with end-stage renal disease (ESRD). Methods: A narrative review of qualitative studies of patient access to kidney transplantation was undertaken. Only articles in English were accessed. The existing literature was critically analyzed using theoretical constructs of the IMB model and thematic synthesis was performed. Results: Results suggest patients having more information (greater transplant knowledge), more personal motivation (higher transplant outcomes expectations), more social motivation (more social and provider support), and more selfefficacy (confidence in navigating the transplant continuum) may be more likely to perform transplant access behaviors. Conclusion: Our findings provide a framework for considering patients’ levels of knowledge, motivation, and self-efficacy in future educational and behavioral interventions for ESRD patients.
Surgical Considerations in the Treatment of Axillary-Subclavian Venous Thrombosis in the Era of COVID-19
Authors: Mukherjee Dipankar , Kittner Janine 
Published: March 2021

Purpose: Traditional treatment of axillary-subclavian venous thrombosis is resource intensive due to the need for advanced nursing care and increased utilization of intensive care units for thrombolysis procedures. We recently encountered this in the management of 2 patients with effort-induced upper extremity venous thrombosis following COVID-19 infection and offer a treatment paradigm for consideration. Case Reports: A 30-year-old presented with 2 weeks of left upper extremity symptoms following COVID-19 infection. Duplex ultrasound demonstrated axillary-subclavian venous thrombosis and venogram confirmed total occlusion of the axillary and subclavian veins with profuse collaterals around the occlusion. Suction thrombectomy was performed successfully and veins remained patent at 6 month follow up. The patient declined first rib resection and stopped lifting weights. A 16-year-old presented with 4 days of right arm symptoms 1 month after testing positive for COVID-19. Duplex ultrasound revealed acute axillary and subclavian vein thrombosis and she underwent successful thrombectomy followed by balloon angioplasty with improvement in symptoms. Conclusion: The pandemic has strained health care resources such that the treatment of non-life-threatening conditions must be triaged to conserve resources. While axillary-subclavian venous occlusion is usually not life-threatening, timely treatment leads to decreased morbidity and better outcomes. Percutaneous aspiration and thrombectomy without adjunctive thrombolysis may be of benefit in reducing healthcare resource utilization while still achieving good outcomes during the COVID pandemic and beyond.