bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of tocilizumab versus hemoadsorption combined with tocilizumab in patients with SARS-CoV-2 pneumonia: Preliminary results
Authors: Berlot Giorgio , Pintacuda Stefania , Moro Edoardo , Paluzzano Giacomo , Scamperle Alice , Chillemi Antonino , Longo Irene , Dattola Roberto , Roman-Pognuz Erik , Tomasini Ariella 
Published: February 2021

Objective: To assess the variations of Interleukin-6 (IL-6) in patients with SARS-CoV-2 infection treated with Tocilizumab (TCZ) alone or in association with hemoadsorption (HA). Design: Retrospective. Setting: An Intensive Care Unit (ICU) admitting mechanically ventilated patients with SARS-CoV-2 pneumonia. Patients: Four adult patients. Interventions: We compared the blood values of IL-6, C-reactive protein (CRP) and of other biochemical variables including the PaO2/FiO2 in two patients who received TCZ alone and in other 2 in whom it was associated with the HA (TCZ-HA) due to the presence of impending or established organ failures other than the lung. All variables were measured before, during and after the treatment. Main results: In all patients, the IL-6 increased during the treatment; after its termination, its values sharply decreased only in those treated also with HA; conversely, the CRP decreased in all patients; the PaO2/FiO2 increased in three patients and remained stable in the remaining one. Both the TCZ and the HA were well tolerated; all patients were weaned from the mechanical ventilation and discharged from the hospital. Limitations: Although the limited number of patients does not allow to draw firm conclusions, the increase of the IL-6 of can be ascribed to its displacement from cellular and soluble receptors, whereas its decrease is likely due to the scavenging effect exerted by the HA. Although the association TCZ-HA could be valuable in the treatment of the Cytokine Release Storm (CRS) associated with the SARS-CoV-2, the HA could be more effective as it neutralizes a wider panel of inflammatory mediators.
Nephron sparing surgery for the treatment of renal masses: A single center experience
Authors: Zazzara Michele , Carando Roberto , Nazaraj Arjan , Scarcia Marcello , Romano Michele , Ludovico Giuseppe Mario 
Published: February 2021

Background: Nowadays, the partial nephrectomy (PN) not only is considered oncological equivalent to radical nephrectomy as renal tumor’s treatment, but has also give benefits in quality of life and overall survival of patients. Objectives: The primary objective of the present study was to report our single center experience with NSS, predominantly performed by a robot assisted access, in a high-volume center with large experience with minimally invasive surgery. Methods: Between June 2018 and January 2020, a consecutive series of 109 patients (pts) with a renal mass suspicious of renal cell carcinoma, feasible of NSS, detected by ultrasound and abdominal computed tomography (CT), underwent NSS and they were included in a prospectively maintained institutional database. Baseline demographics and clinical characteristics, perioperative and postoperative parameters, pathological data were recorded. Results: The mean clinical maximum CT tumor diameter was 37.3 ± 19.6 mm (median 31.5 mm; interquartile range 25–45 mm). PADUA risk was low in 54 pts (49.5%), intermediate in 48 pts (44.0%), high in seven pts (6.4%). The clinical T stage was mostly pT1a (70.6%). NSS was performed by open surgery in nine pts (8.3%), laparoscopy in one pts (0.9%) and was robot assisted in 99 pts (90.8%). A simple enucleation was performed in 67 pts (61.5%), an enucleoresection was performed in 37 pts (33.9%) and a partial nephrectomy was performed in five pts (4.6%). Warm ischemia was performed in 41 pts (37.6%), with a mean warm ischemia time of 5.1 ± 7.1 min. The mean pathological maximum tumor diameter was 35.5 ± 21.7 mm (median 30 mm; interquartile range 22–40 mm). Overall PSM rate was 11.9% (13 pts). In 78% of cases no complication was recorded. No major complications (grade III-IV-V) were noted. Conclusion: Our findings suggest that NSS is a safe, reproducible and minimally invasive approach as treatment of small renal masses. NSS permits to achieve a fine oncological management without any worsening of renal function.
Unexpected hematologic malignancies after prostatectomy: Case report and literature review
Authors: Karademir Barış , Kısa Erdem , Özbilen Mert Hamza , Bildirici Çağdaş , Karabacakoğlu Burak , Süelözgen Tufan , İlbey Yusuf Özlem , Küçük Ülkü , Olgun Aybüke 
Published: February 2021

Introduction: Voiding symptoms, storage symptoms and post-voiding symptoms together constitute lower urinary tract symptoms (LUTS). Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. The most common finding is lymphadenomegaly. Although infrequent, extranodal sites of involvement such as prostate can be detected. Mantle cell lymphoma (MCL) is a subtype of B cell non-Hodgkin lymphomas. Extranodal involvement findings such as prostate may be observed. In this case report, we will present a case in which we performed an open suprapubic prostatectomy (Freyer’s) and had CLL as a result of pathology, and a case whose pathology was MCL after transurethral resection of the prostate. Case 1: A 60-year-old male patient with LUTS for 6 years. Open suprapubic prostatectomy (Freyer’s) was performed on the patient. The pathology result of the prostatectomy material was compatible with CLL involvement. Case 2: A 62-year-old male patient with LUTS for 4 years. Transurethral resection of the prostate (TUR-P) was performed on the patient. The pathology result of the prostate was compatible with MCL involvement. Discussion and Conclusion: There are limited number of cases have been reported about CLL pathology after prostatectomy due to benign prostatic obstruction (BPO). There is no study indicating how often CLL pathology is seen after open prostatectomy or TUR-P due to BPO. In patients with CLL pathology after RRP, open prostatectomy, TUR-P, the need for additional surgery, the difference in prognosis or the difference between the treatment have not been shown in the studies. It should be kept in mind that patients with leukocytosis, lymphocytosis, cytopenias, and LUTS in their clinical presentation and who have not yet been diagnosed with CLL and other hematological malignancies such as mantle cell lymphoma may also have prostate gland involvement and can be diagnosed incidentally by any prostatic intervention.
Understanding Components of Duration of Untreated Psychosis and Relevance for Early Intervention Services in the Canadian Context: Comprendre les Composantes de la Durée de la Psychose Non Traitée et la Pertinence de Services D’intervention Précoce Dans le Contexte Canadien
Authors: Malla Ashok , Dama Manish , Iyer Srividya , Joober Ridha , Schmitz Norbert , Shah Jai , Issaoui Mansour Bilal , Lepage Martin , Norman Ross 
Published: February 2021

Background: Clinical, functional, and cost-effectiveness outcomes from early intervention services (EIS) for psychosis are significantly associated with the duration of untreated psychosis (DUP) for the patients they serve. However, most EIS patients continue to report long DUP, while a reduction of DUP may improve outcomes. An understanding of different components of DUP and the factors associated with them may assist in targeting interventions toward specific sources of DUP. Objectives: To examine the components of DUP and their respective determinants in order to inform strategies for reducing delay in treatment in the context of an EIS. Methods: Help-seeking (DUP-H), Referral (DUP-R), and Administrative (DUP-A) components of DUP, pathways to care, and patient characteristics were assessed in first episode psychosis ( N = 532) patients entering an EIS that focuses on systemic interventions to promote rapid access. Determinants of each component were identified in the present sample using multivariate analyses. Results: DUP-H (mean 25.64 ± 59.00) was longer than DUP-R (mean = 14.95 ± 45.67) and DUP-A (mean 1.48 ± 2.55). Multivariate analyses showed that DUP-H is modestly influenced by patient characteristics (diagnosis and premorbid adjustment; R 2 = 0.12) and DUP-R by a combination of personal characteristics (age of onset and education) and systemic factors (first health services contact and final source of referral; R 2 = 0.21). Comorbid substance abuse and referral from hospital emergency services have a modest influence on DUP-A ( R 2 = 0.08). Patients with health care contact prior to onset of psychosis had a shorter DUP-H and DUP-R than those whose first contact was after psychosis onset (F(1, 498) = 4.85, P < 0.03 and F(1, 492) = 3.34, P < 0.07). Conclusions: Although much of the variance in DUP is unexplained, especially for help-seeking component, the systemic portion of DUP may be partially determined by relatively malleable factors. Interventions directed at altering pathways to care and promote rapid access may be important targets for reducing DUP. Simplifying administrative procedures may further assist in reducing DUP.
COVID-19: Are Non-Communicable Diseases Risk Factors for Its Severity?
Authors: Bello Bashir , Useh Ushotanefe 
Published: February 2021

Objective: To identify and describe the mechanisms of lifestyle characteristics—obesity, DM, hypertension and physical inactivity—that may lead to the severity of illness among individuals with COVID-19. Data Source: A scoping review was conducted by searching electronic databases of PubMed and Scopus from December 2019 to August 2020. Inclusion/Exclusion Criteria: inclusion criteria were studies that explicitly describe the mechanism of COVID—19 in relationship with either hypertension, type 2 diabetes mellitus type 2 (DM), obesity and/or physical inactivity. Studies of epidemiological background, descriptive surveys and interventional studies were excluded. Data Extraction: study characteristics were tabulated according to purpose, type of non-communicable diseases (NCDs), the hypothesis on the mechanism of infestation (MOI) and conclusion. Data Synthesis: NCDs were categorized according to type and hypothesis on mechanisms of infestation. The interplay between COVID—19, type of NCDs and MOI leading to the severity of the disease was appraised. Results: Twenty-four (24) studies were identified from 357 unique records. Eight studies postulated the mechanism of infestation and interaction between COVID 19 illness severity and Obesity, while 7 studies described COVID—19 and DM. Five studies highlighted the interaction between COVID—19 and hypertension with 4 studies showing how physical activity restriction suppresses immunity. Conclusion: The current review, identified and explicitly described the mechanisms of the lifestyle characteristics that may increase the severity of illness among people with COVID-19.
Randomized Clinical Trial of a Prenatal Breastfeeding and Mental Health Mixed Management Intervention
Authors: Zhao Ying , Lin Qiping , Zhu Xinli , Wang Jing 
Published: February 2021

Background The continuity of maternal depressive symptoms throughout the perinatal period and breastfeeding problems have adverse influences on breastfeeding. Research aim To compare the feeding patterns and breastfeeding experiences, maternal health and mental health, and breastfeeding self-efficacy between women with depressive symptoms who participated in a prenatal individualized mixed management intervention and those who received usual care. Methods Chinese primigravida ( N = 182) with an Edinburgh Postnatal Depression Scale score ≥ 9 in late pregnancy (≥ 28 weeks and < 35 weeks) were randomly assigned to the intervention group ( n = 84) or the control group ( n = 84). Intervention group participants received four sessions of individualized mixed management combining psycho-education and breastfeeding education. Breastfeeding self-efficacy, feeding patterns, maternal depression, and health status were evaluated in both groups. Results Significant differences were noted between the groups in breastfeeding self-efficacy at 42 days postpartum ( p < .05) and feeding patterns at 3 months and 6 months postpartum ( p < .05). Repeated measures analysis of variance showed significant differences in the EPDS scores between groups at three postpartum time points ( p < .05). The intervention group had significantly lower postpartum depression as diagnosed by the MINI ( p < .05). Conclusions A prenatal individualized mixed management intervention holds promise as an effective prevention and health promotion program addressing breastfeeding outcomes and maternal mental health. This RCT was registered (ChiCTR-IOR-17013761) with Chinese Clinical Trial Registry, http://www.chictr.org.cn/enIndex.aspx on 12/7/2017.
Reliability of Markers for Breast Hypoplasia in the Early Postpartum Period
Authors: Kam Renee L. , Cullinane Meabh , Vicendese Don , Amir Lisa H. 
Published: February 2021

Background Breast hypoplasia is one reason for insufficient milk supply. Case reports use wide intra-mammary width and certain breast appearances as markers of breast hypoplasia. However, the reliability of these variables has not been determined. Research aims To test the (i) interrater and intrarater reliability of intra-mammary width measurement and interrater reliability of categorizing women’s breasts into breast types, and (ii) feasibility and acceptability of study procedures for the participants. Methods This was a prospective, longitudinal, non-experimental design with survey and observational components of a convenience sample of early postpartum women ( N = 31). Interrater and intrarater reliability were measured using intraclass correlation coefficient for agreement for intra-mammary width measurements. Interrater reliability was measured using weighted kappa for agreement for categorizing breast type. Feasibility and acceptability of study procedures were collected 1 month later. Results Excellent intrarater and interrater reliability for the intra-mammary width measurement (ICC = 0.99, 95% CI [0.99, 0.997] and ICC = 0.88, 95% CI [0.74, 0.94], respectively) and fair interrater reliability for breast type categorization (k = 0.35, 95% CI [−0.05, 0.75]) with high level of agreement between raters (97%) were achieved. Proportions of participants agreeing to breast photography and acceptability of study procedures were 68% (21/31) and 100% (28/28) respectively. Conclusion The excellent reliability for the intra-mammary width measurement means it provides a useful measure for future research. Since the “fair” reliability of categorizing breast type was due to lack of breast shape range in our sample, future research could assess the breasts of women with different medical profiles.
Postpartum Marijuana Use, Perceptions of Safety, and Breastfeeding Initiation and Duration: An Analysis of PRAMS Data From Seven States, 2017
Authors: Coy Kelsey C. , Haight Sarah C. , Anstey Erica , Grant Althea M. , Ruffo Nan , Ko Jean Y. 
Published: February 2021

Background Little is known about breastfeeding initiation and duration in the context of postpartum marijuana use and safety beliefs. Research Aims (1) To describe characteristics of women who used marijuana postpartum; (2) to evaluate the relationship between postpartum marijuana use and breastfeeding behaviors; and 3) to assess, among women who used marijuana postpartum, how safety perceptions are associated with breastfeeding behaviors. Methods Data from the cross-sectional Pregnancy Risk Assessment Monitoring System, a United States national governmental survey, 2017, were analyzed for participants with infants aged ≥ 12 weeks (seven states, unweighted N = 4604). Chi-square tests were used to compare characteristics and counseling for postpartum marijuana use. For participants with postpartum use, adjusted prevalence ratios (aPR) were calculated to evaluate relationships between safety perceptions and breastfeeding initiation and duration. Results Overall, 5.5% (95% CI [4.6, 6.6]) of participants reported postpartum marijuana use; among these women, 47.2% (CI [37.6, 56.9]) were breastfeeding at the time of the survey. Overall, 25.7% of participants indicated that they had been advised, by their prenatal care provider, against marijuana use while breastfeeding. Breastfeeding initiation or duration did not differ by postpartum marijuana use. Among participants with postpartum use, those who perceived marijuana was safe for breastfeeding women to use were more likely to have breastfed (aPR = 1.22, CI [1.04, 1.43]) and have a breastfeeding duration > 12 weeks (aPR = 1.57, CI [1.08, 2.27]) compared to those who perceived it to be unsafe. Conclusions Understanding maternal safety beliefs and provider education about the latest evidence and guidance related to postpartum marijuana use may improve clinical care.
Proactive Lactation Care is Associated With Improved Outcomes in a Referral NICU
Authors: Hoban Rebecca , McLean Laura , Sullivan Samantha , Currie Caroline 
Published: February 2021

Background Mother’s milk improves outcomes. Referral neonatal intensive care units face unique lactation challenges with maternal–infant separation and maternal pump dependency. Little is known about lactation resource allocation in this high-risk population. Research Aims To determine differences in human milk outcomes, (1) the proportion of infants fed exclusive or any mother’s milk and (2) recorded number and volume of pumped mothers’ milk bottles, between two models of lactation care in a referral neonatal intensive care unit. Methods This retrospective, longitudinal, two-group comparison study utilized medical record individual feeding data for infants admitted at ≤ Day 7 of age and milk room storage records from reactive and proactive care model time periods (April, 2017–March, 2018; May, 2018–April, 2019). The reactive care model ( n = 509 infants, 58% male, median birth weight and gestational age of 37 weeks,) involved International Board Certified Lactation Consultant referral for identified lactation problems; whereas, the proactive model ( n = 472 infants, 56% male, median birth weight and gestational age 37 weeks) increased International Board Certified Lactation Consultant staffing, who then saw all admissions. Comparisons were performed using chi square, Mann Whitney, and t-tests. Results A proactive lactation approach was associated with an increase in the receipt of any mother’s milk from 74.3% to 80.2% ( p = .03) among participants in the proactive model group. Additionally, their milk room mean monthly bottle storage increased from 5153 ( SD 788) to 6620 ( SD 1314) bottles ( p < .01). Conclusions In this retrospective study at a tertiary referral neonatal intensive care unit, significant improvement inhuman milk outcomes suggests that increased resources for proactive lactation care may improve mother’s milk provision for a high-risk population.
Positioning school business practitioners in the English school system
Authors: Creaby Fiona 
Published: February 2021

This article explores the increasing professionalisation of school business practitioners in the state school system in England. Often referred to a ‘school business managers’ or ‘school business leaders’, this cohort of the school workforce have been increasingly tasked with leading crucial site-based management functions in schools, such as finance and budgeting, human resources and school operations. As this area of practitioner activity has grown over the last two decades, ‘school business leadership’ has increasingly been positioned by education policy makers and professional bodies as a distinct field of practice within the school system. However, despite increasing recognition of the value of school business leadership within the school system, there is evidence of continued tensions around the inclusion of such practitioners in matters of leadership. Further, there is a paucity of scholarly research exploring school business activity and the increasing professionalisation of its practitioners. Therefore, this article serves to contribute to this gap by exploring the evolution of school business practitioners and their positioning within the wider field of education in England. It argues for further research in England and for knowledge exchange with other education contexts to share insight and explore future potential.
Impact of COVID-19 ‘Stay Home, Stay Healthy’ Orders on Function among Older Adults Participating in a Community-Based, Behavioral Intervention Study
Authors: Adams Leah M. , Gell Nancy M. , Hoffman Elise V. , Gibbons Laura E. , Phelan Elizabeth A. , Sturgeon John A. , Turk Dennis C. , Patel Kushang V. 
Published: February 2021

Background: Early mitigation orders for COVID-19 halted participation in community-based programs. We examined the early impact of “Stay Home, Stay Healthy” orders on functioning in older adults participating in a behavioral intervention study involving community-based exercise. Methods: A quasi-natural experiment, using mixed methods ( n = 39). Participants completed interviews and questionnaires after 3–4 weeks of the Stay Home, Stay Healthy directive. PROMIS-29 outcomes were compared to pre-COVID-19 responses. Results: Participants had a mean age of 74.1 (6.5) years, 79.5% were women, and 20.5% were racial/ethnic minorities. Compared to pre-COVID-19, there was a significant increase in anxiety and decrease in fatigue and social participation. Thematic analysis revealed five main themes related to disruption of daily life, the emotional and physical impact of stay-at-home orders, unexpected positive outcomes, and perspectives on messaging surrounding the pandemic. Conclusions: Efforts to curb the spread of COVID-19 have substantially impacted the lives of older adults participating in community-based exercise.
Comparison of cytology and human papillomavirus-based primary testing in cervical screening programs in the Nordic countries
Authors: Partanen Veli-Matti , Dillner Joakim , Tropé Ameli , Ágústsson Ágúst Ingi , Pankakoski Maiju , Heinävaara Sirpa , Sarkeala Tytti , Wang Jiangrong , Skare Gry Baadstrand , Anttila Ahti , Lönnberg Stefan 
Published: February 2021

Objective To compare primary test positivity in cytology and human papillomavirus-based screening between different Nordic cervical cancer screening programs using harmonized register data. Methods This study utilized individual-level data available in national databases in Finland, Iceland, Norway, and Sweden. Cervical test data from each country were converted to standard format and aggregated by calculating the number of test episodes for every test result for each calendar year and one-year age group and test method. Test positivity was estimated as the proportion of positive test results of all primary test episodes with a valid test result for “any positive” and “clearly positive” results. Results The age-adjusted rate ratio for any positive test results in primary human papillomavirus-based screening compared to cytology was 1.66 (95% CI 1.64–1.68). The age-adjusted rate ratio for clearly positive test results was 1.02 (95% CI 1.00–1.05). A decreasing rate ratio by age was seen in both any positive and clearly positive test results. Test positivity increased over time in Iceland, Norway, and Sweden but slightly decreased in Finland. Conclusions The probability of any positive test result was higher in human papillomavirus testing than in primary cytology, even though the cross-sectional detection of a clearly positive test result was the same. Human papillomavirus testing can still lead to an improved longitudinal sensitivity through a larger number of follow-up tests and the opportunity to identify women with a persistent human papillomavirus infection. Further research on histologically verified precancerous lesions is needed in primary as well as repeat testing.