bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using a community-based participatory research approach to meaningfully engage those with lived experience of diabetes and homelessness
Authors: Campbell David J T , Campbell Rachel B , DiGiandomenico Anna , Larsen Matthew , Davidson Marleane A , McBrien Kerry , Booth Gillian L , Hwang Stephen W 
Published: September 2021

IntroductionParticipatory research is a study method that engages patients in research programs, ideally from study design through to dissemination. It is not commonly used in diabetes health services research. Our objectives were to describe the process and challenges of conducting a participatory research project and to highlight the experiences of both patient co-researchers and academic researchers.Research design and methodsWe recruited people with lived experience of homelessness (PWLEH) and diabetes in Toronto, Canada to become patient co-researchers. They were asked to commit to attending biweekly meetings. We undertook two major research projects: concept mapping to choose a research focus; and photovoice to explore accessing healthy food while homeless. We used a convergent mixed-methods design to evaluate their experience.ResultsA diverse group of eight PWLEH had an average attendance of 82% over 21 meetings—despite this success, we encountered a number of challenges of conducting this research: funding, ethics approval and recruitment were particularly difficult. Group members reported that participation improved their ability to self-advocate in their diabetes care and provided them with tangible skills and social benefits. Group members stated that they valued being involved in all aspects of the research, in particular knowledge translation activities, including advocating for nutritious food at shelters; presenting to stakeholders; and meeting with policymakers.ConclusionsThe use of participatory research methods enables academic researchers to support community members in pursuing research that is pertinent to them and which has a positive impact. In our study, co-researchers contributed in meaningful ways and also valued the experience.
Reactions of non-abused children aged 3–9 years to the Sexual Knowledge Picture Instrument: an interview-based study
Authors: van Ham Kirsten , van Delft Sanne , Brilleslijper-Kater Sonja N , van Rijn Rick R , van Goudoever Johannes B , van der Lee Johanna H , Teeuw Arianne H 
Published: September 2021

BackgroundThe Sexual Knowledge Picture Instrument (SKPI) is a child-friendly picture book that was developed as a diagnostic tool for sexual abuse in young children and is currently being validated. The aim of the current study was to explore the verbal and non-verbal reactions of non-abused Dutch children, aged 3–9 years, to the SKPI and to assess differences in reactions between genders and age groups.Methods and analysisSubject recruitment took place at preschools and primary schools. All children underwent a recorded video semi-structured interview with the SKPI. Interview recordings were scored by an independent rater who used scoring lists for verbal and non-verbal reactions. Non-parametric tests were used in statistical analyses.ResultsOf the 90 children (median age 5 years) participating in the study, most correctly named the genitals and their non-sexual functions. Only 34 showed an understanding of the picture depicting adult sexuality, with just one child describing a sexual function. Girls (n=45) gave more correct answers (median 87%) than boys (n=45, median 78%; p=0.006). Giggling was the most frequently observed non-verbal reaction, with a total of 186 instances in 54 children.ConclusionNon-abused children up to 9 years of age showed only limited knowledge of the sexual function of the genitals and hardly any insight into adult sexuality.
Circulating tumour cells and circulating cell-free DNA in patients with lung cancer: a comparison between thoracotomy and video-assisted thoracoscopic surgery
Authors: Katopodis Periklis , Anikin Vladimir , Kishore Uday , Carter Thomas , Hall Marcia , Asadi Nizar , Polychronis Andreas , Karteris Emmanouil 
Published: September 2021

IntroductionThe type of lung cancer surgery impacts on tumour manipulation during surgery and may drive dissemination of cancer cells into the vasculature, thus facilitating metastatic spread. The aim of this study was to investigate the impact of surgically induced trauma using peripheral blood from preoperative and postoperative patients with non-small cell lung cancer (NSCLC) undergoing thoracotomy or video-assisted thoracoscopic surgery (VATS) resection.MethodsImaging flow cytometry was used to measure circulating cancer-associated cells (CCs). Circulating cell-free DNA (ccfDNA) isolation was performed using Promega dsDNA HS Assay Kit. DNA integrity measurements were calculated by the ALU247 to ALU115 ratio and cytokine levels measured using the Luminex screening assay.ResultsCCs were increased in postoperative blood samples in 54 patients with NSCLC. Patients who underwent thoracotomy instead of VATS had higher numbers of EpCAM (p=0.004) and PanCK-labelled (p=0.03) CCs postoperatively. ccfDNA and DNA integrity index were also significantly increased in postoperative samples (p=0.0009 and p=0.04), with concomitant increase in interleukin 6 and interleukin 10 levels in the same cohorts (p=0.0004 and p=0.034, respectively).ConclusionsIn this study we have shown the potential clinical utility of several biomarkers from liquid biopsies to guide perioperative management, as well as provide a snapshot of the type of surgical resection in terms of circulating tumour cell release. Obtaining reliable readouts from blood can provide crucial information for disease progression, as well as being of prognostic value monitoring patients’ response to treatment.
Discontinuation of nucleot(s)ide analogue therapy in HBeAg-negative chronic hepatitis B: a meta-analysis
Authors: Hall Samuel Anthony Lachlan , Vogrin Sara , Wawryk Olivia , Burns Gareth S , Visvanathan Kumar , Sundararajan Vijaya , Thompson Alexander 
Published: September 2021

Background and aimsSustained virological suppression and hepatitis B surface antigen (HBsAg) loss have been described after nucleot(s)ide analogue (NA) discontinuation for patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB). We performed a meta-analysis of the clinical outcomes after NA discontinuation for HBeAg-negative CHB.MethodsStudies involving NA cessation in HBeAg-negative CHB individuals with a median follow-up of ≥12 months were included. Participants were HBeAg-negative at the time of NA initiation. Random effects meta-analyses were performed for the following clinical outcomes: (1) virological relapse (VR) at 6 and 12 months; (2) clinical relapse (CR) at 6 and 12 months and (3) HBsAg loss. Effect of other variables was estimated using subgroup analysis and meta-regression. Studies including patients stopping entecavir (ETV) and/or tenofovir disoproxil fumarate (TDF) were considered separately to studies including patients stopping older generation NA.ResultsN=37 studies met inclusion criteria. Cumulative incidence of VR and CR after stopping ETV/TDF was 44% and 17% at 6 months and 63% and 35% at 12 months. Similar relapse rates were observed after stopping older NAs. Among patients stopping ETV/TDF, TDF cessation was associated with increased CR rates at 6 months versus ETV. There was an association between follow-up ≥4 years and HBsAg loss rates when stopping older NAs. Hepatic decompensation and hepatocellular carcinoma were rare but occurred more frequently in studies including cirrhotic individuals.ConclusionVR is common after NA discontinuation, however, CR was only seen in one-third of patients at 12 months. Stopping NA therapy can be followed by HBsAg clearance, and rates are higher with longer follow-up.
Association between annual household income and adverse outcomes in patients who had ischaemic stroke
Authors: Zang Yuhan , Zhu Zhengbao , Shi Mengyao , Wang Aili , Xie Xuewei , Xu Tan , Peng Yanbo , Yang Pinni , Li Qunwei , Ju Zhong , Geng Deqin , Chen Jing , Liu Liping , Zhang Yonghong , He Jiang 
Published: September 2021

Background and purposeThe association between annual household income and prognosis of ischaemic stroke remains debatable. We aimed to prospectively investigate the relationship between annual household income and prognosis at 3 months after ischaemic stroke.MethodsWe included 3975 participants from the China Antihypertensive Trial in Acute Ischemic Stroke. All participants were categorised into three groups according to annual household income per capita: <¥10 000 (Chinese Yuan Renminbi (RMB)), ¥10 000–19 999 and ≥¥20 000. The primary outcome was a composite outcome of death and major disability (modified Rankin Scale score ≥3) at 3 months after stroke onset, and secondary outcomes included major disability, death, and vascular events. A meta-analysis was conducted to incorporate the results of the current study and previous studies on the association of income level with outcomes after stroke.ResultsWithin 3 months after ischaemic stroke, 1002 participants (25.20%) experienced primary outcome (880 major disabilities and 122 deaths). After multivariate adjustment, low annual household income level was associated with increased risk of the primary outcome (OR 1.60; 95% CI: 1.12 to 2.31; Ptrend=0.034) when two extreme groups were compared. The meta-analysis confirmed the significant association between income level and death or major disability after stroke (pooled relative risk for lowest vs highest income level, 1.31 (95% CI: 1.18 to 1.45)).ConclusionsLow annual household income per capita was significantly associated with increased risks of adverse clinical outcomes at 3 months after ischaemic stroke, independently of established risk factors. Further studies from other samples are needed to replicate our findings due to a reason for excluding some patients who had a severe stroke in this study.Trial registration numberClinicalTrials.gov (http://wwwclinicaltrialsgov) Registry (NCT01840072).
Preprocedural Hypertension Is Not a Risk Factor for Postoperative Bleeding following Image-Guided Core Needle Breast Biopsy
Authors: Salastekar Ninad , Saunders Alexis , Patel Kushal , Willer Katherine 
Published: September 2021

Objective. To evaluate the association between preprocedural hypertension and the risk of prolonged bleeding following image-guided core needle breast biopsy in nonpregnant/nonlactating women. Methods. A single institution-based, retrospective cohort study of 400 women who underwent image-guided core needle breast biopsy was conducted. Males and pregnant and lactating women were excluded. Preprocedural systolic or diastolic blood pressure greater than 140 or 90 mm of Hg, respectively, was defined as hypertension. Prolonged bleeding was defined >15 minutes of local, manual pressure required to achieve hemostasis following the biopsy. Severe bleeding complications defined as clinical significant hematoma formation, prolonged bleeding requiring an ER visit, hospitalization, or surgical intervention were also recorded. Results. The difference in the mean time for which manual pressure was held after biopsy for patients with and without preprocedural hypertension was not statistically significant (13 ± 7 vs. 13 ± 8 minutes, respectively,

P

= 0.856). There was no difference in the number of patients requiring manual postoperative pressure >15 minutes between those with preprocedural hypertension and the normotensive patients (13% vs. 12%, respectively,

P

= 0.765). Bivariate analysis demonstrated statistically significant association between prolonged bleeding and current antithrombotic or antiplatelet medication use (

P

= 0.010), the use of stereotactic guidance (

P

= 0.019), and a tethered vacuum-assisted device (

P

= 0.045). The use of a tethered vacuum-assisted biopsy device was the only variable associated with prolonged bleeding in the multivariate model (

P

= 0.044). Conclusion. Preprocedural hypertension is not a risk factor for prolonged bleeding following image-guided core needle breast biopsies in nonpregnant/nonlactating women.
Postoperative Pain After Endoscopic vs Microscopic Otologic Surgery: A Systematic Review and Meta‐analysis
Authors: Toulouie Sara , Block‐Wheeler Nikolas R. , Rivero Alexander 
Published: September 2021

ObjectiveEquivalent outcomes, such as procedural safety and audiometry, have been reported between endoscopic ear surgery (EES) and microscopic ear surgery (MES). This study aims to determine if EES leads to decreased postoperative pain when compared with MES.Data SourcesPubMed, OVID MEDLINE, Scopus, Web of Science, and Cochrane Central from 2000 to 2020.Review MethodsA systematic review in accordance with the PRISMA guidelines and standardized bias assessment was performed. Studies containing original data on postoperative pain following EES and MES were included.ResultsFourteen studies fulfilled eligibility: 7 retrospective studies, 6 randomized controlled trials, and 1 case series. Studies included surgery for cholesteatoma (n = 3), tympanoplasty/myringoplasty (n = 6), and stapedotomy (n = 5), pooling data from 974 patients. Postoperative pain was quantitatively described through a variety of numeric pain scores. Meta‐analysis was performed on 11 studies. Among the 7 studies utilizing the numeric rating scale or visual analog scale, postoperative pain in the EES cohort was significantly lower than that of the MES cohort (standardized mean difference = −1.45 [95% CI, −2.05 to −0.85], P <. 001). Similarly, pain scores were lower in the EES cohort among the 4 studies utilizing the Three Grades Pain Scale (odds ratio = 0.2 [95% CI, 0.09‐0.45], P <. 001). Additional qualitative strengths identified in EES included significant improvements in visualization, operative time, postoperative complications, and decreased need for canalplasty. Quality assessment indicated low to moderate risk of bias for all studies.ConclusionMeta‐analysis confirms that EES results in significantly less postoperative pain when compared with MES. This surgical approach should be considered in the armamentarium of otologic surgeons, allowing for improved outcomes.
Sinogenic Intracranial Suppuration in Children: Systematic Review and Meta‐analysis
Authors: Milinis Kristijonas , Thompson Nathan , Atsmoni Smadar Cohen , Sharma Sunil Dutt 
Published: September 2021

ObjectiveTo evaluate temporal trends in the management of sinogenic intracranial suppuration and its outcomes in children.Data SourcesA systematic search of databases was performed (Medline, Embase, Cochrane, ClinicalTrials.gov).Review MethodsStudies in children (age <18 years) with sinogenic subdural empyema, extradural abscess, and intraparenchymal abscess were included. Data on treatment strategies were extracted. Primary outcome was death <90 days. Secondary outcomes were return to theater, neurologic disability at 6 months, and length of stay. Random effects meta‐analysis and meta‐regression were performed to investigate the effect of time and endoscopic sinus surgery (ESS) on these outcomes.ResultsA total of 32 retrospective observational studies involving 533 patients recruited across a 45‐year period (1975‐2020) were included. The pooled estimates for 90‐day mortality, permanent neurologic disability, and return to theater were 2.3% (95% CI, 1.1%‐3.6%; I2 = 0, P >. 99), 21.3% (95% CI, 15.3%‐27.3%; I2 = 75.2%, P <. 001), and 37.3% (95% CI, 29.5%‐45%; I2 = 71.2%, P <. 001), respectively, with no significant differences found across the study period. The pooled estimate for ESS was 58.4% (95% CI, 44.2%‐72.6%; I2 = 97.1%, P <. 001) with a significantly increasing trend in its use in the more recent years. ESS was not associated with improved mortality, reduced need for revision surgery, or neurologic disability.ConclusionThe outcomes of sinogenic intracranial complications have not changed over the last 45 years, and ESS was not associated with improved patient outcomes. Further high‐quality studies are required to determine the most appropriate treatment modalities to improve the burden of morbidity associated with sinogenic intracranial suppuration in children.
Management of Flap Failure After Head and Neck Reconstruction: A Systematic Review and Meta‐analysis
Authors: Walia Amit , Lee Jake J. , Jackson Ryan S. , Hardi Angela C. , Bollig Craig A. , Graboyes Evan M. , Zenga Joseph , Puram Sidharth V. , Pipkorn Patrik 
Published: September 2021

ObjectiveTo systematically review management of flap loss in head and neck construction with free tissue transfer as compared with locoregional flap or conservative management.Data SourcesMedline, Embase, Scopus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ClinicalTrials.gov were searched up to October 2019.Review MethodsCandidate articles were independently reviewed by 2 authors. Articles were considered eligible if they included adequate reporting of flap management after flap loss and outcomes for survival of reconstruction, length of hospitalization, and perioperative complications.ResultsA total of 429 patients had acute flap failure in the perioperative period. The overall success with a secondary free flap was 93% (95% CI, 0.89‐0.97; n = 26 studies, I2 = 12.8%). There was no difference in hospitalization length after secondary reconstruction between free tissue transfer and locoregional flaps or conservative management (relative risk of hospitalization ≥2 weeks, 96%; 95% CI, 0.80‐1.14; n = 3 studies, I2 = 0). The pooled relative risk of perioperative complications following free tissue transfer was 0.60 when compared with locoregional flap or conservative management (95% CI, 0.40‐0.92; n = 5 studies, I2 = 0).ConclusionSalvage reconstruction with free tissue transfer has a high success rate. Second free flaps following flap failure had a similar length of hospitalization and lower overall complication rate than locoregional reconstruction or conservative management. A second free tissue transfer, when feasible, is likely a more reliable and effective procedure for salvage reconstruction.
Translation and initial validation of the occupational balance questionnaire to Arabic—Occupational Balance Questionnaire-A
Authors: N Dhas Brightlin , Wagman Petra , Marji Firas A , Håkansson Carita , Carrasco Ricardo 
Published: September 2021

Introduction Occupational balance (OB) is related to many health indicators, including quality of life. The Occupational Balance Questionnaire (OBQ11) was developed to measure OB, and to date, no Arabic translations of the questionnaire exist. The aim of the study was to describe the translation process of OBQ11 to Arabic and to evaluate its content validity, internal consistency, construct validity, and convergent validity. Methods OBQ11 was translated to Arabic (OBQ11-A) following standard guidelines. Content validity feedback was obtained from ten Arabic-speaking occupational therapists and in a cognitive debriefing with seven volunteers. In addition, OBQ11-A and the Family Quality of Life Survey-2006 were administered to 67 Arabic-speaking participants from a larger study about OB among parents. Results High level of agreement was found on the content of OBQ11-A from the occupational therapists. Cognitive debriefing interviews indicated that OBQ11-A was easy to understand. Cronbach’s alpha for the total OBQ11-A score was 0.864 indicating good internal consistency. Exploratory factor analysis showed acceptable factor loadings for all items. The total scores showed positive statistically significant associations with Family Quality of Life Scores ( r = 0.561, p < 0.001). Conclusions OBQ11-A may prove useful for assessing OB in Arabic-speaking populations. Further research is needed to establish its reliability.
Clinically Oriented Target Contour Evaluation Using Geometric and Dosimetric Indices Based on Simple Geometric Transformations
Authors: Xian Lixun , Li Guangjun , Xiao Qing , Li Zhibin , Zhang Xiangbin , Chen Li , Hu Zhenyao , Bai Sen 
Published: September 2021

Purpose: In radiotherapy, geometric indices are often used to evaluate the accuracy of contouring. However, the ability of geometric indices to identify the error of contouring results is limited primarily because they do not consider the clinical background. The purpose of this study is to investigate the relationship between geometric and clinical dosimetric indices. Methods: Four different types of targets were selected (C-shaped target, oropharyngeal cancer, metastatic spine cancer, and prostate cancer), and the translation, scaling, rotation, and sine function transformation were performed with the software Python to introduce systematic and random errors. The transformed contours were regarded as reference contours. Dosimetric indices were obtained from the original dose distribution of the radiotherapy plan. The correlations between geometric and dosimetric indices were quantified by linear regression. Results: The correlations between the geometric and dosimetric indices were inconsistent. For systematic errors, and with the exception of the sine function transformation (R2: 0.023-0.04, P > 0.05), the geometric transformations of the C-shaped target were correlated with the D98% and Dmean (R2: 0.689-0.988), 80% of which were P < 0.001. For the random errors, the correlations obtained by the all targets were R2 > 0.384, P < 0.05. The Wilcoxon signed-rank test was used to compare the spatial direction resolution capability of geometric indices in different directions of the C-shaped target (with systematic errors), and the results showed only the volumetric geometric indices with P < 0.05. Conclusions: Clinically, an assessment of the contour accuracy of the region-of-interest is not feasible based on geometric indices alone. Dosimetric indices should be added to the evaluations of the accuracy of the delineation results, which can be helpful for explaining the clinical dose response relationship of delineation more comprehensively and accurately.
Ascending Aortoiliac Bypass for One-Stage Repair of Adult Aortic Coarctation With Concomitant Cardiac Lesions
Authors: Peng Zhan , Qiu Juntao , Wang De , Yang Xiubin , Yu Cuntao , Zhang Liang 
Published: September 2021

Background To evaluate the efficacy and safety of ascending aortoiliac bypass surgery for one-stage repair of adult coarctation of the aorta (CoA) and concomitant cardiac disease. Methods From March 2012 to October 2018, 51 consecutive CoA patients were treated with ascending aorta to bilateral iliac artery bypass concomitant with and cardiac surgerical procedures performed for a variety of reasons. A Y-shaped graft was used for the bypass procedure. We evaluated early outcomes, including postoperative death, systolic blood pressure and differences between upper and lower limb blood pressure. Results The average age was 41 years and 64.7% of patients were men. Simultaneous cardiac procedures included aortic valve replacement, ventricular septal defect repair, Bentall procedures and Wheat procedures. No deaths occurred in the early postoperative period. Three patients had delayed healing at the site of the abdominal lower quadrant incisions. The average systolic pressure in the upper limb and the average difference between the upper- and lower-limb blood pressure decreased significantly after surgery (162.7 ± 13.4 mmHg vs 128.4 ± 6.7 mmHg, P = .000; 69.6 ± 15.6 mmHg vs 8.7 ± 7.6 mmHg, P = .000, respectively); The systolic blood pressure in the lower limb increased after bypass surgery (93.1 ± 6.2 mmHg vs 119.6 ± 7.7 mmHg, P = .000). The follow-up rate was 100%, with an average follow-up time of 61 months. Six patients (11.8%) had graft stenosis or occlusion. Three patients (5.9%) underwent endovascular embolectomy. Conclusions In our small series, ascending aortoiliac bypass for one-stage repair of CoA with concomitant cardiac lesions appears safe and efficacious in effectively reduceing differences between upper and lower limb systolic blood pressure. Further study with larger sample size and longer follow-up is needed.