bluuebunny/crossref_metadata_2025_split huggingface dataset:
Imatinib plasma levels in patients with chronic myeloid leukaemia under routine clinical practice conditions
Authors: Del Rosario García Betel , González García Iris , Viña Romero María Micaela , González García Jonathan , Ramos Díaz Ruth , Mourani Padrón Ivette , Lakhwani Lakhwani Sunil , Nazco Casariego Gloria Julia , Gutiérrez Nicolás Fernando 
Published: October 2021

Introduction The addition of imatinib to the therapeutic arsenal for chronic myeloid leukaemia (CML) has changed the natural course of the disease, in such a way that it is now considered a chronic pathology. However, to achieve therapeutic success, it is necessary to reach adequate plasma concentrations to ensure efficacy and safety. In this study, we aimed to evaluate the plasma concentration of imatinib, analysing its influence on effectiveness and safety in patients with CML. Methods We performed a descriptive, multicentre study in which imatinib plasma levels from patients diagnosed with CML between 2019–2020 were analysed. An optimal therapeutic range of 750–1500 ng/mL was established for the stratification of patients, according to their minimum plasma concentrations measured at steady state (Cssmin). Results A total of 28 patients were included, of whom only 39.3% (n = 11) showed Cssmin within the therapeutic range. 100% of patients with Cssmin >750 ng/mL achieved an optimal molecular response, while only 50% of patients with Cssmin <750 ng/mL achieved an optimal molecular response ( p = 0.0004). The toxicity rate was 36.4% for patients with Cssmin >1500 ng/mL and 5.9% for those with Cssmin <1500 ng/mL ( p = 0.039). Conclusions This study aimed to describe the correlation between the toxicity and effectiveness of imatinib according to its Cssmin in routine clinical practice conditions. Based on our findings, it would be certainly justified to monitor patient plasma concentrations of imatinib on a daily routine basis in our hospitals.
Vision loss in a pregnant woman with nephrotic syndrome
Authors: Tsani Zoi , Ntafos Antonios , Toumanidou Victoria , Dastiridou Anna , Ploumi Ioanna , Androudi Sofia 
Published: October 2021

Purpose To report acute visual acuity loss in a pregnant woman with nephrotic syndrome. Case Report A 34-year-old pregnant woman was referred to our service for acute, bilateral visual impairment, associated with bilateral below knee edema (BKE). Best-corrected visual acuity (BCVA) was hand motion in the right eye and 20/200 in the left eye. Dilated fundus exam disclosed multiple pigment epithelium detachments involving the macula in both eyes. After consultation with a nephrologist a diagnosis of nephrotic syndrome was made. Unfortunately, a week later she lost the fetus. At follow-up evaluation, 20 days after the miscarriage, BCVA improved to 20/25 in both eyes with near normal restoration of the retinal anatomy. Conclusion In nephrotic syndrome, sequestration of interstitial fluids, which leads to classic generalized edema, could be the origin of interstitial accumulation of fluids in the retinal and subretinal layers. Increased awareness by the gynaecologists and prompt treatment may prevent fetus miscarriage.
‘The English language enables me to visit my pain’. Exploring experiences of using a later-learned language in the healing journey of survivors of sexuality persecution
Authors: Cook Sally Rachel , Dewaele Jean-Marc 
Published: October 2021

Aims and objectives: This qualitative study explores the experience of using a later-learned language, English (ELX), in the therapeutic journey of refugee survivors of sexuality persecution to enhance understanding of the role of language in their rehabilitation. Design/methodology/approach: This is a multiple case study of three refugees, persecuted in their home country because of their sexual orientation, who are regular attendees of a therapeutic community, Room to Heal, based in London. A qualitatively driven mixed-method research design using Interpretative Phenomenological Analysis (IPA) and ethnography was employed. Data and analysis: Data were gathered through semi-structured interviews with the first author. They consisted of questions about the relationship between the participants’ languages, emotions and sense of self. Findings/conclusions: Participants shared common positive experiences characterised by feelings of the ELX being a liberating tool that empowered them and enabled them to bear witness to their trauma, express their same-sex love more easily and be more self-accepting, and contributed to the (re)invention and performance of a ‘new’ self. Originality: The originality resides first in the unique profile of the participants – victims of persecution because of their sexual orientation; second in the unique context – a therapeutic community supporting refugees; and third in the methodology – a qualitatively driven mixed-method design combining IPA and ethnography. Significance/implications: The findings support an embodied perspective of languages and highlight the need for therapists to be aware of multilingualism and its effects. The reduced emotional resonance of a later-learned language may offer its users a way to access trauma and build a new self within the therapeutic process.
The Hip Center Rule Can be Used to Decide if Measured Pelvic Incidence is Accurate
Authors: Fisk Felicity , Oitment Colby , Taliaferro Kevin , Pahuta Markian A. 
Published: October 2021

Study Design Simulation study. Objective Pelvic incidence (PI) should be considered during surgical planning. The ideal patient position with both hip centers perfectly aligned for a lateral radiograph is rarely obtained. It has been suggested that a radiograph with axial and coronal rotation up to 20° is acceptable to obtain a measured PI within 6 degrees of the actual PI. We seek to: (1) evaluate the effect of variations in PI and patient malpositioning on measured vs true PI, and (2) determine whether the presence of one hip center within the bony acetabular rim of the contralateral hip can serve as a simple clinical decision rule on the accuracy of measured PI. Methods Published anthropometric three-dimensional pelvic landmark coordinates were used in this study. Radiographic projections were generated using linear algebra for combinations of axial and coronal rotation from −20° to +20°. True and measured PIs were compared. Results Rotation to 20° cannot be uniformly accepted as decision rule. Pelvises with higher PIs are more sensitive to malpositioning with greater PI deviation with smaller amounts of rotation. Diagnostic performance of the hip center rule demonstrated a sensitivity of 25.58% and a specificity of 100.00%. Conclusions Rather than assessing the quality of radiographs for PI measurement by magnitude of malpositioning, we recommend clinicians use the “hip center rule.” As long as at least one hip center is contained within the bony acetabular rim of the contralateral hip, there is high confidence that measured PI will be within 6° of true PI.
Standard Error of the Mean and Minimal Detectable Change of Gait Speed in Older Adults Using Japanese Long-Term Care Insurance System
Authors: Takada Yui , Tanaka Shigeharu 
Published: October 2021

Evaluation of motor function, such as gait ability, can accurately predict the subsequent occurrence of disability in older adults. There are no reports of standard error of the mean (SEM) or minimal detectable change (MDC) with respect to gait in Japanese long-term care insurance-certified individuals. The purpose of this study was to investigate the values of preferred gait, fast gait, and the timed up and go (TUG) test. This study included 46 participants using the Japanese long-term care insurance system. (age 86.5 ± 6.6 years, 12 men, 34 women). The duration of three gait were measured twice using a stopwatch. The SEM was 0.07 for preferred gait, 0.09 for fast gait and 2.59 for TUG. The MDC was 0.19 for preferred gait, 0.26 for fast gait, and 7.17 for TUG. The SEM and MDC values of preferred gait, fast gait, and TUG in this study corroborated with those of previous studies, whereas others were different. Considering that gait speed differs with the country, it may be difficult to compare it among different population groups. We obtained the results of gait speed of Japanese long-term care insurance-certified individuals, which is a new finding
Biomechanical Analysis of Single Interference Screw vs Interference Screw With Cortical Button for Flexor Hallucis Longus Transfer
Authors: Neary Kaitlin C. , McClish Sarah J. , Khoury Anthony N. , Denove Nicholas , Konicek John , Wijdicks Coen A. 
Published: October 2021

Background: Flexor hallucis longus tendon transfer (FHL) with a cortical button tension slide is an innovative addition that has not been measured against traditional methods. Methods: 12 pairs (n=24) of fresh-frozen cadaveric tibia-to-toe samples were used and randomized to receive one of the operative FHL techniques. Specimens underwent bone density analysis. Biomechanical loading was applied between 20 and 60 N at 1 Hz for 100 cycles. Post–cyclic load to failure occurred at 1.25 mm/s. Cyclic displacement, structural stiffness, and ultimate load were derived from load-displacement curves. Student t tests evaluated significant effects between both FHL techniques. Linear regression analysis assessed interactions between bone density and strength of FHL technique. Results: Average tendon diameter was 5.44±0.46 mm. Average bone density was 1.06±0.08 g/cm2. Addition of a cortical button to FHL transfer did not significantly affect cyclic displacement (0.78±0.52 mm vs 0.87±0.80 mm) or structural stiffness (162.11±43.34 N/mm vs 167.57±49.19 N/mm). Cortical button addition to FHL transfer resulted in significantly increased ultimate load (343.72±68.93 N) compared with interference screw alone (255.62±77.17 N) ( P = .0002). Linear regression analyses did not reveal any significant interactions between bone density and FHL tendon transfer technique. Conclusion: Enhanced strength can be achieved with FHL tendon transfer to calcaneus using an interference screw and cortical button tension slide technique as compared to an interference screw alone. Cortical buttons in the setting of FHL tendon transfer to the calcaneus offers an additional level of support. Clinical Relevance: Operative cases presenting with poor bone quality due to osteoporosis or osteopenia could benefit from cortical button fixation during FHL transfer. Clinical studies are needed to determine if the increased construct stability conferred from the additional use of a flip button results in fewer FHL transfer failures or better clinical outcomes. Level of Evidence: Level V, Controlled Laboratory Study.
The Cyber Avatar of Sexual Harassment at the Workplace: Media Analysis of Reports During COVID-19
Authors: Ahuja Kanika K. , Padhy Priyanka 
Published: October 2021

Background: Whether working at physical workplaces or from the seeming safety of home, women employees continue to be hounded by sexual harassment. During COVID-19, sexual harassment has taken on a cyber avatar and continues to enjoy the protections afforded by ambiguity and inept implementation. Objectives: The study explores how media reported cyber sexual harassment (CSH) during a 1-year period after COVID-19 in India. It explores the dominant discourses evident in such media reports, such as the ways in which CSH is manifested, psychosocial factors behind the same, action taken (if any), and organizational practices. Method: The present study involved content analysis of electronic print media content (newspapers and magazines) published in India, in the English language, between the period March 2020 and February 2021. A final pool of 24 articles was purposively arrived at through an Internet-based search, which was classified as news story, editorial, opinion piece, interview, column, and other. Content analysis of the articles was carried out to uncover the main themes. Within these themes, the researchers carried out open coding to identify subthemes. Results: Six broad themes emerged from the articles: manifestations of CSH, causes of CSH, outcomes of CSH, action taken by the victim, organizational practices, and barriers in seeking redressal. Manifestations included inappropriate behavior by boss/colleagues during meeting (30.6%), social media harassment (22.6%), video calls/meeting/work at odd hours (17.7%), inappropriate attire (14.5%), sexist behavior and comments (8.1%), and inappropriate jokes (6.2%). Some of the causes reported for CSH were blurring of personal and professional boundaries, lack of guidelines regarding virtual workplaces, job uncertainty, and notions of patriarchy. Only 29.2% articles highlighted any action(s) taken by the victim. Some of the barriers in seeking redressal were reported to be lack of awareness and/or clear guidelines, fear about the repercussions, difficulty in proving CSH, daunting appellate process, lack of privacy with family members around, and patriarchal culture. Conclusion: The study reiterates the need for clear and consistent communication on CSH, both in organizations and through the media. It is imperative not only to revive and modify the existing policies on CSH but also to implement them effectively. In the “new normal,” organizations need to formulate responses that are multilevel, swift, and coordinated across stakeholders, policymakers, technology specialists, and social scientists.
Arthroscopic Reverse Bankart Surgical Repair
Authors: Dean Robert S. , Gowd Anirudh K. , Bunker Carson D. , Beck Edward C. , Dennis Eric J. , Waterman Brian R. 
Published: October 2021

Background: Posterior glenoid labrum lesions occur in only 2% to 10% of all cases of shoulder instability, yet these injuries may cause significant shoulder dysfunction in an athletic population. Moreover, these injuries frequently require surgical intervention and present a unique surgical challenge. Indications: Indications for arthroscopic posterior labral repair include symptomatic posterior labral tears identified on magnetic resonance imaging with or without contrast, that failed nonsurgical management (ie, lifestyle modification, nonsteroidal anti-inflammatory drug, and physical therapy). Patients may present with a positive posterior load and shift or positive posterior apprehension test. Technique Description: With the patient in the lateral decubitus position, use a standard posterior superior portal, an ancillary anterior superior portal, a posterior-inferior, and the portal of Wilmington. After portal placement and diagnostic arthroscopy, the torn labrum is debrided. The torn portion of the posterior labrum is then mobilized from approximately the 6 o’clock to 10 o’clock positions, and a curette and shaver are used to produce a bleeding margin for fixation. Two double-loaded 2.4-mm suture anchors are placed, passed, and tied; one at the 6:30 o’clock position and the other at the 8 o’clock position. A cinch stich configuration using a 2.9-mm pushlock anchor can be used at the 10 o’clock position. A polydioxanone suture is used to assist with capsular plication and to close the posterior portal. Results: The literature suggests that 90% to 94% of patients are able to return to their desired sport with 5% to 10% reporting recurrent instability by 2 years after operation. Two out of 3 patients report no limitations at 2 years. Discussion/Conclusion: Arthroscopic repair of posterior labral tears with suture anchors can be an effective surgical option for patients with reverse Bankart lesions. Using advanced imaging to identify concomitant pathologies, meticulous surgical technique, direct visualization of the anatomy and anchor placement, and a dedicated rehabilitation program, greater than 90% of patients can expect to return to sport.
Impaired formation of neutrophil extracellular traps in patients with MDS
Authors: Brings Carolin , Fröbel Julia , Cadeddu Patrick , Germing Ulrich , Haas Rainer , Gattermann Norbert 
Published: October 2021

Abstract
Neutrophil extracellular traps (NETs) are networks of extracellular fibers primarily composed of DNA and histone proteins, which bind pathogens. We investigated NET formation in 12 patients with myelodysplastic syndrome (MDS) and 15 age-adjusted normal controls after stimulation with phorbol-12-myristate-13-acetate (PMA). Histones and neutrophil elastase were visualized by immunostaining. Since NET formation is triggered by reactive oxygen species (ROS), mainly produced by reduced NADP-oxidase and myeloperoxidase (MPO), ROS were analyzed by flow cytometry using hydroethidine, 3’-(p-aminophenyl) fluorescein, and 3’-(hydroxyphenyl) fluorescein. On fluorescence microscopy, PMA-stimulated MDS neutrophils generated fewer NETs than controls (stimulated increase from 17% to 67% vs 17% to 85%) (P = .02) and showed less cellular swelling (P = .04). The decrease in mean fluorescence intensity (MFI) of 4’,6-diamidino-2-phenylindole, indicating chromatin decondensation, was significantly less in MDS neutrophils than controls (ΔMFI 3467 vs ΔMFI 4687, P = .03). In addition, the decrease in MFI for fluorescein isothiocyanate, indicating release of neutrophil elastase from cytoplasmic granules, was diminished in patients with MDS (P = .00002). On flow cytometry, less cell swelling after PMA (P = .02) and a smaller decrease in granularity after H2O2 stimulation (P = .002) were confirmed. PMA-stimulated ROS production and oxidative burst activity did not reveal significant differences between MDS and controls. However, inhibition of MPO activity was more easily achieved in patients with MDS (P = .01), corroborating the notion of a partial MPO defect. We conclude that NET formation is significantly impaired in MDS neutrophils. Although we found abnormalities of MPO-dependent generation of hypochloride, impaired ROS production may not be the only cause of deficient NETosis in MDS.
Effects of age on sugammadex reversal of neuromuscular blockade induced by rocuronium in Chinese children: a prospective pilot trial
Authors: Zhang Ruidong , Hu Jie , Li Shengde , Xue Bin , Wang Lu , Bai Jie , Zheng Jijian 
Published: October 2021

Abstract
Background
Sugammadex reverses neuromuscular blockade induced by steroidal relaxants. We compared the recovery for neuromuscular blockade reversal with sugammadex in children aged 1–12 years.

Methods
From August 2019 to August 2020, patients who received 2.0 mg·kg− 1 sugammadex for neuromuscular blockade reversal after surgery were recruited. The primary outcome was the time for the train-of-four ratio (TOFR) to recover to 0.9; secondary outcomes included the incidence of the TOFR < 0.9, extubation time, length of stay at the post-anesthesia care unit, and adverse events. Hemodynamic parameters before and 5 min after sugammadex administration and vital signs in the recovery room were also recorded.

Results
Eighty-six children were recruited (1 to < 3 years, n = 23; 3 to < 5 years, n = 33; 5 to ≤12 years, n = 30). Intergroup differences in the recovery of the TOFR to 0.9 were not statistically significant (F = 0.691, p = 0.504). Recurrence of the TOFR < 0.9 was not observed in any group. Five minutes after sugammadex administration, the heart rates of patients aged 3 to < 5 and 5 to ≤12 years were significantly lower than those at baseline (p < 0.05). Extubation time was similar in patients aged 1 to ≤12 years. Length of stay and end-tidal capnography at the post-anesthesia care unit as well as adverse events did not differ significantly.

Conclusion
A moderate (TOF count two) rocuronium-induced neuromuscular blockade can be effectively and similarly reversed with sugammadex 2 mg·kg− 1 in Chinese children aged 1–12 years.

Trial registration
Chinese Clinical Trial Registry: ChiCTR1900023715 (June 8, 2019).
Clinical outcomes of endoscopic removal of foreign bodies from the upper gastrointestinal tract
Authors: Yoo Dong Ryeol , Im Chang Bin , Jun Baek Gyu , Seo Hyun Il , Park Jong Kyu , Lee Sang Jin , Han Koon Hee , Kim Young Don , Jeong Woo Jin , Cheon Gab Jin , Na Hee Kyong , Lee Jeong Hoon , Choi Kee Don , Jung Kee Wook , Kim Do Hoon , Song Ho June , Lee Gin Hyug , Jung Hwoon-Yong , Gong Eun Jeong , Ahn Ji Yong 
Published: October 2021

Abstract
Background
Ingested foreign objects frequently require emergency removal. This study aimed to investigate the clinical outcomes of endoscopic removal of foreign bodies from the upper gastrointestinal tract and the risk factors for adverse events.

Methods
Adults (> 18 years) who underwent endoscopic management of ingested foreign bodies at two centers, one inland and one on the coast, between January 2008 and December 2017 were eligible. Clinical characteristics and procedure-related outcomes were retrospectively reviewed. Patients were divided into two groups, based on whether the foreign bodies were sharp or blunt in shape.

Results
A total of 853 patients aged 19–96 years were analyzed. Ingestion of fish bones was more common in the coastal area, whereas ingestion of food boluses was more common in the inland area. The duration of impaction ranged from 1 h to over 1 month and was significantly longer in patients who ingested blunt than sharp foreign bodies (15 vs. 5 h, p < 0.001). Most (98.9%) foreign bodies were successfully removed. Adverse events occurred in 31.2 % of patients, including ulcers (4.0%) and perforations (3.3 %). Multivariate analysis showed that age (odds ratio [OR] 1.015, p = 0.012), sharp foreign bodies (OR 5.133, p < 0.001), location in the esophagus (OR 2.723, p = 0.018), and duration of impaction (OR 1.431, p < 0.001) were factors associated with adverse events.

Conclusions
Early recognition and timely endoscopic removal of ingested foreign bodies, particularly in elderly patients and those with sharp foreign bodies, may improve clinical outcomes.
Management of preoperative pain in elderly patients with moderate to severe cognitive deficits and hip fracture: a retrospective, monocentric study in an orthogeriatric unit
Authors: Ruel Mathilde , Boussat Bastien , Boudissa Mehdi , Garnier Virginie , Bioteau Catherine , Tonetti Jérôme , Pailhe Régis , Gavazzi Gaëtan , Drevet Sabine 
Published: October 2021

Abstract
Background
Patients with cognitive deficits are 3 times more likely to suffer a hip fracture than geriatric patients of the same age group without cognitive deficits. The persistence of perioperative pain following hip fracture is a risk factor for the occurrence of delirium, poor functional prognosis, and the development of secondary chronic pain. Patients with cognitive deficits receive 20 to 60% less analgesics than those without cognitive deficits. Our retrospective descriptive monocentric study was performed in an orthogeriatric unit on a cohort of elderly patients hospitalized for hip fracture. The aim of the study was to compare the quantity of strong opioids delivered in a morphine sulfate equivalent daily during the preoperative period after a hip fracture between cognitively intact patients and those with cognitive deficits.

Results
Our total population of 69 patients had a median age of 90 years old, and 46% of these patients had moderate or severe cognitive deficits. During the preoperative period, the same quantity of strong opioids was administered to both groups of patients (13.1 mg/d versus 10.8 mg/d (p = 0.38)). Patients with moderate to severe cognitive deficits more often experienced delirium during their hospitalization (p < 0.01) and received more psychotropic drugs in the first 3 postoperative days (p = 0.025).

Conclusions
We reported that with standardized pain management in an orthogeriatric unit, patients aged 75 years and older received the same daily average quantity of strong opioids during the preoperative period regardless of the presence of cognitive deficits.