bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of COVID-19 pandemic on acute pancreatitis presentations, management, and in-hospital outcomes: a single-center, retrospective observational study from the northeast of China
Authors: Du Zu-Chao , Zhang Jian , Li Xin-Jian , Zhang Zhan-Tian , Bai Kai-Song , Wang Zi-Min , Xu Yan , Bai Xue-Wei , Sun Bei 
Published: December 2022

Background: Since initially detected in late December 2019, the novel coronavirus disease 2019 (COVID-19) outbreak rapidly swept the world, which has profoundly affected healthcare system and clinical practice in the management of gastrointestinal diseases. Objectives: We aimed to evaluate the impact of COVID-19 pandemic on the pattern of hospital admissions and healthcare services for acute pancreatitis (AP). Design: We conducted a retrospective observational cohort study using the anonymized electronic medical records. Methods: This single-center, retrospective observational study from a regional medical center in the northeast of China included all consecutively admitted patients with AP from 23 January to 10 June 2020 (during the COVID-19 outbreak in Harbin), compared with the equivalent period of the previous year, in terms of demographics, clinical characteristics, and in-hospital outcomes. Results: In this article, we observed a reduction in AP admissions after the beginning of COVID-19 outbreak. With the prolonged time from symptom onset to hospitalization [32.0 (22.0–72.0) versus 18.0 (12.0–24.0) h; p < 0.001], a higher proportion of AP patients developed acute renal failure (14.0% versus 7.4%, p = 0.004) and acute necrotic collection (16.5% versus 11.2%; p = 0.038) in the COVID-19 era. The percentage of alcohol etiology significantly decreased after the implementation of social restriction measures (11.5% versus 20.4%; p = 0.002), whereas biliary etiology was numerically more common amidst the COVID-19 era (41.6% versus 32.6%; p = 0.014). No significant differences were found in the rates of intensive care unit admission and mortality between the two groups. Conclusion: This study preliminarily demonstrated the descending trend and delay in hospital presentations for AP during the outbreak of COVID-19. Given that the pandemic may persist for several years, adjustments of medical services according to the varying degrees of local breakouts are imperative to provide appropriate care for AP patients and diminish the risk of viral transmission. Registration: ClincialTrials.gov number ChiCTR2100043350.
Predictive value of vascular endothelial growth factor polymorphisms for maintenance bevacizumab efficacy in metastatic colorectal cancer: an ancillary study of the PRODIGE 9 phase III trial
Authors: de Rauglaudre Bernadette , Sibertin-Blanc Camille , Fabre Aurélie , Le Malicot Karine , Bennouna Jaafar , Ghiringhelli François , Taïeb Julien , Boige Valérie , Bouché Olivier , Chatellier Thierry , Faroux Roger , François Eric , Jacquot Stéphane , Genet Dominique , Mulot Claire , Olschwang Sylviane , Seitz Jean-François , Aparicio Thomas , Dahan Laetitia 
Published: December 2022

Background: Several studies have reported the impact of single nucleotide polymorphisms (SNPs) in vascular endothelial growth factor ( VEGF) pathway genes on the efficacy of bevacizumab in metastatic colorectal cancer (mCRC), but results are still inconsistent. The PRODIGE 9 phase III study compared bevacizumab maintenance versus observation alone after induction chemotherapy with FOLFIRI plus bevacizumab. Objective: We evaluated the impact of SNPs of VEGF-A, VEGF receptors ( VEGFR-1, VEGFR-2), and hypoxia inducible factor-1α ( HIF-1α) on tumor control duration (TCD), overall survival (OS), progression-free survival (PFS), and duration of first chemotherapy free-intervals (CFI). Patients and methods: We included 314/491 patients from PRODIGE 9 with a DNA blood sample available. Nine SNPs were genotyped on germline DNA using real-time Polymerase Chain Reaction TaqMan TM (Thermo Fisher Scientific, Waltham, MA , USA 02451). Results: In the bevacizumab arm, patients with the VEGFR-1 rs9582036 CC genotype ( n = 14) had significantly longer TCD [22.4 months (95% confidence interval (CI): 14.75-not reached)] than patients with the AA or CA genotype [14.4 months (95% CI: 11.7–17.1)] ( p = 0.036), whereas there was no significant difference in the observation arm. In the bevacizumab arm, no significant difference was found between the CC, and AA or CA genotype for OS [28.2 (95% CI: 18.1–42.8) versus 22.5 (95% CI: 18.6–24.6) months, p = 0.5], PFS [9.4 (95% CI: 7.2–11.3) versus 9.2 (95% CI: 8.71–10.1)], and duration of the first CFI [4.6 (95% CI: 1.6–13.3) versus 4.14 (95% CI: 0.5–29.0) months, p = 0.3]. Conclusion: Among mCRC patients treated with bevacizumab maintenance, those with the VEGFR-1 rs9582036 CC genotype experienced longer TCD. The presence of this genotype may thus predict a benefit of bevacizumab maintenance in mCRC.
Cost-effectiveness analysis of Oncotype DX from a Brazilian private medicine perspective: a GBECAM multicenter retrospective study
Authors: Oliveira Leandro Jonata Carvalho , Megid Thais Baccili Cury , Rosa Daniela Dornelles , Magliano Carlos Alberto da Silva , Assad Daniele Xavier , Argolo Daniel Fontes , Sanches Solange Moraes , Testa Laura , Bines José , Kaliks Rafael , Caleffi Maira , de Melo Gagliato Debora , Sahade Marina , Barroso-Sousa Romualdo , Corrêa Tatiana Strava , Shimada Andrea Kazumi , Batista Daniel Negrini , Musse Gomes Daniel , Cesca Marcelle Goldner , Gaudêncio Débora , Moura Larissa Matos Almeida , Araújo Julio Antonio Pereira de , Katz Artur , Mano Max Senna 
Published: December 2022

Background: Oncotype DX (ODX) is a validated assay for the prediction of risk of recurrence and benefit of chemotherapy (CT) in both node negative (N0) and 1–3 positive nodes (N1), hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) early breast cancer (eBC). Due to limited access to genomic assays in Brazil, treatment decisions remain largely driven by traditional clinicopathologic risk factors. ODX has been reported to be cost-effective in different health system, but limited data are available considering the reality of middle-income countries such as Brazil. We aim to evaluate the cost-effectiveness of ODX across strata of clinical risk groups using data from a dataset of patients from Brazilian institutions. Methods: Clinicopathologic and ODX information were analyzed for patients with T1–T3, N0–N1, HR+/HER2− eBC who had an ODX performed between 2005 and 2020. Projections of CT indication by clinicopathologic criteria were based on binary clinical risk categorization based on the Adjuvant! Algorithm. The ODX score was correlated with the indication of CT according to TAILORx and RxPONDER data. Two decision-tree models were developed. In the first model, low and high clinical risk patients were included while in the second, only high clinical risk patients were included. The cost for ODX and CT was based on the Brazilian private medicine perspective. Results: In all, 645 patients were analyzed; 411 patients (63.7%) had low clinical risk and 234 patients (36.3%) had high clinical risk disease. The ODX indicated low (<11), intermediate (11–25), and high (>25) risk in 119 (18.4%), 415 (64.3%), and 111 (17.2%) patients, respectively. Among 645 patients analyzed in the first model, ODX was effective (5.6% reduction in CT indication) though with an incremental cost of United States Dollar (US$) 2288.87 per patient. Among 234 patients analyzed in the second model (high clinical risk only), ODX led to a 57.7% reduction in CT indication and reduced costs by US$ 4350.66 per patient. Conclusions: Our study suggests that ODX is cost-saving for patients with high clinical risk HR+/HER2− eBC and cost-attractive for the overall population in the Brazilian private medicine perspective. Its incorporation into routine practice should be strongly considered by healthcare providers.
Hemichorea as initial presentation of newly diagnosed diabetes and acute lacunar stroke
Authors: Oo Than Zaw , Lim Wan Tin 
Published: December 2022

Hemichorea is one of the spectrums of involuntary, continuous, non-purposeful movement of one side of the body, a choreiform disorder. Hemichorea causes vary and include various inherited or acquired systemic conditions. There might be overlapping pathophysiology where the synergistic effects of uncontrolled hyperglycemia and vascular insufficiency cause an incomplete transient dysfunction of the striatum, leading to hemichorea. We herein describe a patient who presented with hemichorea triggered by hyperglycemia and was incidentally found to have an acute lacunar stroke. She was initiated on insulin with good glycemic control. Secondary stroke prevention therapy with aspirin and statin was also started. Her symptoms improved inpatient after stable glycemic control was achieved. After 3 months, her symptoms had completely resolved. Hemichorea is an unusual initial presentation for newly diagnosed diabetes mellitus or stroke. Hence, recognizing and diagnosing this uncommon disease entity is pertinent to make a timely and accurate diagnosis, which can lead to a rapid clinical response.
Clozapine for treatment resistance in early psychosis: a survey of UK clinicians’ training, knowledge and confidence
Authors: Oloyede Ebenezer , Mantell Bethany , Williams Julie , Lai Serena , Jauhar Sameer , Taylor David , MacCabe James H. , Harland Robert , McGuire Philip , Blackman Graham 
Published: December 2022

Background: Clozapine is the only medication licenced for patients with psychosis that is resistant to conventional antipsychotic treatment. However, despite its effectiveness, it remains widely underutilised. One contributory factor for this may be clinicians’ lack of confidence around the management of clozapine. Objective: We conducted a survey of clinicians working in Early Intervention in Psychosis (EIP) services to determine their training needs for clozapine management in EIP services. Methods: An electronic survey was made available to all clinicians working in EIP services in England. The survey assessed confidence and training needs regarding managing clozapine in patients with treatment-resistant psychosis. Quantitative data were analysed using total mean scores and the Mann–Whitney U test. Results: In all, 192 (27%) of approximately 700 clinicians from 35 EIP services completed the survey. Approximately half (54%) had not received training on treatment with clozapine. Experience of training was higher in prescribers than non-prescribers, and among medical than non-medical clinicians. Previous training was associated with significantly higher confidence in offering clozapine and managing treatment-resistant psychosis ( p < 0.001). Confidence levels with managing treatment-resistant psychosis and clozapine were relatively high (mean = 4 out of 5, SD = 1). Respondents were most confident about monitoring mental health response to treatment (mean = 5, SD = 1). Participants were least confident about how to discontinue clozapine treatment safely (mean = 3, SD = 1). Conclusion: Most clinicians working in EIP have not received training on the use of clozapine. This may account, in part, for the underutilisation of clozapine in EIP services. The provision of training in the identification of treatment-resistant psychosis and the use of clozapine will likely improve the detection and management of treatment resistance in the early phase of psychosis.
Clinical outcome and associated factors of respiratory distress syndrome among preterm neonates admitted to the neonatal intensive care unit of Adama Hospital and Medical College
Authors: Bacha Lensa Tamiru , Hailu Wase Benti , Tesfaye Geta Edosa 
Published: December 2022

Objective: Aim of the study was to assess the clinical outcome and associated factors of respiratory distress syndrome among preterm neonates admitted to the neonatal intensive care unit of Adama Hospital and Medical College. Methods: Hospital-based cross-sectional study was conducted using 242 randomly selected medical records of preterm neonates admitted to Adama comprehensive specialized hospital. Clinical outcome was categorized as poor if the neonate died or left against advice and good if discharged after improvement. Data were coded, entered into Epidata v.7.4.2 and exported to SPSS v.27 for analysis. After initial bi-variable logistic regression analysis, predictor variables with p-value of <0.2 were included in multivariable analysis. Significant association of factors with clinical outcome was claimed at p-value <0.05 and calculated 95% adjusted odds ratio. Results: Majority of admissions were male (63.2%), mean birth weight of 1440.3 g (+321.2 SD) and sepsis (82%), hypothermia (73%), and apnea (21.5%) were leading comorbidities. One hundred fifty-two (62.8%) of preterm neonates had poor outcomes. Neonates born singleton were 47% less likely to develop poor clinical outcomes (adjusted odds ratio 0.53 (0.48–0.94). The odds of poor clinical outcomes were higher during the first 3 days of admission (adjusted odds ratio 3.83 (3.28–14.77). Extremely preterm neonates (adjusted odds ratio 4.16 (4.01–12.97), extremely low birth weight preterm neonates had higher odds of poor clinical outcome. Conclusion: The study found higher poor clinical outcome among preterm neonates admitted with respiratory distress syndrome. Poor outcome was higher in lower gestational age, lower birth weight, twins and majority of it happened during 3 days of their life. Effective preventive care and initiation of low-cost, life-saving interventions including heated humidified high-flow nasal cannula and surfactant administration could significantly improve the clinical outcome of the neonates.
Verification, analytical validation and clinical validation (V3) of wearable dosimeters and light loggers
Authors: Spitschan Manuel , Smolders Karin , Vandendriessche Benjamin , Bent Brinnae , Bakker Jessie P , Rodriguez-Chavez Isaac R , Vetter Céline 
Published: December 2022

Background Light exposure is an important driver and modulator of human physiology, behavior and overall health, including the biological clock, sleep-wake cycles, mood and alertness. Light can also be used as a directed intervention, e.g., in the form of light therapy in seasonal affective disorder (SAD), jetlag prevention and treatment, or to treat circadian disorders. Recently, a system of quantities and units related to the physiological effects of light was standardized by the International Commission on Illumination (CIE S 026/E:2018). At the same time, biometric monitoring technologies (BioMeTs) to capture personalized light exposure were developed. However, because there are currently no standard approaches to evaluate the digital dosimeters, the need to provide a firm framework for the characterization, calibration, and reporting for these digital sensors is urgent. Objective This article provides such a framework by applying the principles of verification, analytic validation and clinical validation (V3) as a state-of-the-art approach for tools and standards in digital medicine to light dosimetry. Results This article describes opportunities for the use of digital dosimeters for basic research, for monitoring light exposure, and for measuring adherence in both clinical and non-clinical populations to light-based interventions in clinical trials.
Advancing digital patient-centered measurement methods for team-based care
Authors: Antonio Marcy G , Davis Selena , Smith Mindy , Burgener Paul , Price Morgan , Lavallee Danielle C , Fletcher Sarah , Lau Francis 
Published: December 2022

Objectives To conceptualize new methods for integrating patient-centered measurement into team-based care. Methods A standalone portal was introduced into a rural clinic to support conceptualization of new methods for integration of patient-centered measurement in team-based care. The portal housed mental health-related online resources, three patient-reported measures and a self-action plan. Six providers and four patients used the portal for four months. Our data collection techniques included clinic discussions, one-on-one interviews, workflow diagrams and data generated through the portal. Analysis was supported through coding interview transcripts, looking across multiple sources of research data and research team discussions. Results Our research team conceptualized five team-based patient-centered measurement methods through this study. Patient-centered measurement Team Mapping offfers a technique to provide greater clarity of care-team roles and responsibilities in data collected through patient-centered measurement. Longitudinal Care Alignment can guide the care-team on incorporating patient-centered measurement into ongoing provider–patient interactions. Digital Tool Exploration can be used to evaluate a team's readiness toward digital tool adoption, and the impact of these tools. Team-based quality improvement serves as a framework for engaging teams in patient-centered quality improvement. Shared learning is a method that promotes patientprovider interactions that validate patient's perspectives of their care. Conclusion The portal illuminated new methods for the integration of patient-centered measurement in team-based care. The first three proposed patient-centered measurement methods provides ways to assess how a clinic can incorporate patient-centered measurement methods into team-based care. The latter two methods focus on the aim of patient-generated data in which patient's values and perspectives are represented and quality of patient-centered care can be evaluated. Further testing is needed to assess the utility of these patient-centered measurement methods across different clinical settings and domains.
Implementation of a mobile application for outpatient care after liver transplantation
Authors: Andrä Michaela , Sibinovic Milan , Pfeiffer Karl , Kniepeiss Daniela 
Published: December 2022

Background In the face of the Covid-19 pandemic and the need for social distancing new therapeutic tools like mobile health applications might gain in importance for outpatient care. Objective of the present study was to assess if and to what extent the implementation of a free available transplant application in a cohort of liver transplant recipients was possible. Methods Patients of the aftercare program at the Department of Transplant Surgery Graz in June 2016 were first asked to complete a survey concerning knowledge about mobile health and their management of everyday life. After using the application for 2 months a second survey evaluated whether the implementation of the application in the daily routine was achievable. Results Among 135 patients, 124 (91.9%) agreed to participate. Seventy-one (57.3%) owned a mobile device with which they could use the application, 42 patients (33.8%) decided to try it out for 2 months. The majority stated that the application supported them for therapy management and surveillance of vital parameters. Successful implementation of the application has been reached in 57.1% of patients after 2 months testing period. Conclusion The technical prerequisites are only partially met and should be improved. Older patients need extensive support and motivation.
Relationships of Nurses with Midwives in Their Working Area and Associated Factors at Jimma Medical Center, Jimma, Southwest Ethiopia
Authors: Andualem Eneyew Melkamu , Beyene Desalew Tilahun , Jemaneh Tsiyon Mekoya , Abose Diriba Wakjira 
Published: December 2022

Background Good relationships among healthcare professionals in general and nurses and midwives, in particular, are vital in creating a smooth working environment and producing the best services from these two backbones of healthcare. Unfortunately, no studies have been conducted in Ethiopia that assesses the relationship between nurses and midwives in health facilities and the possible associated factors. Thus, this study aimed to assess the relationship between nurses and midwives in their working areas and factors associated with their relationships. Methods An institution-based cross-sectional study was conducted among 358 nurses at Jimma medical center, Jimma, Southwest Ethiopia. The sample size was calculated using a single-population proportion formula, and a simple random sampling technique was used to select individual study participants. Data were collected using a semistructured self-administered questionnaire prepared in the local language. Data were entered into epi-data version 4.2, and the analysis was conducted using the statistical packages for social sciences version 23. The level of significance was declared at a p-value less than .05 in the final multivariable logistic regression model. The results are presented in a figure, tables, frequencies and percentages, and narratives. Results This study indicated that 284 (79.60%) nurses had good relationships with midwives in their work area, and the remaining 74 (20.40%) had poor relationships. The rules and regulations of the hospital ( p = .009, adjusted odds ratio [AOR] = 0.478, confidence interval [CI]: (0.274, 0.833)) and years of experience ( p = .039, AOR = 8.391, CI: (1.120, 9.845)) were found to have statistically significant associations with relationships between nurses and midwives. Conclusion It could be concluded that there is a relatively good relationship between nurses and midwives at Jimma medical center. Although there is a good relationship, it is vital to make nurses aware of the importance of good relationships. Enabling hospital rules and regulations to be helpful in fostering relationships between nurses and midwives and working with nurses with few years of experience to develop good relationships with midwives is recommended.
Organizational Commitment of Sonographers in the US Mid-Atlantic Region
Authors: Demars Yonella , Legg Jeffrey S. , Steidle Ernie F. , Cohen Timmerie F. , Reid Christine A. , Tilson Elwin R. , Adams Robert 
Published: December 2022

Objective: The objective of this study was to quantify the organizational commitment of sonographers and determine factors influencing their connection or bond with their employer. Materials and Methods: One thousand nationally credentialed sonographers and vascular technologists in the mid-Atlantic region were surveyed using a systematic sampling model. Measurement tools included the Affective, Continuance, and Normative Commitment Scales. Descriptive and inferential statistics based on stepwise regression were used to define organizational commitment levels and the impact of sociodemographic characteristics on organizational commitment. Results: Of the 1000 surveys mailed, 110 usable surveys were returned (11% response rate). Affective, continuance, and normative commitment scores were 4.30, 4.62, and 3.46 out of 7, respectively. Results showed living in Pennsylvania, years at current organization, being a registered cardiac sonographer, and being unmarried had a statistically significant impact upon the variance in sonographers’ organizational commitment scores. Conclusion: Sonographers indicated feeling little obligation to remain with the employer but may do so because of the perceived costs of leaving. As a result, sonographers’ performance, work behavior, and attendance may be affected negatively. Factors such as locale, marital status, work tenure, and registration as a cardiac sonographer impact sonographers’ organizational commitment.