bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association of Human Milk Feeding With Short-Term Health Outcomes Among Chinese Very/Extremely Low Birth Weight Infants
Authors: Peng Wenjing , Han Junyan , Li Shujuan , Zhang Lan , Yang Chuanzhong , Guo Jinzhen , Cao Yun 
Published: March 2022

Background: There is limited evidence about the influence of human milk feeding on short-term outcomes in a large preterm infant population. Research Aims: To explore the influences of human milk feeding on the primary outcome of necrotizing enterocolitis and secondarily sepsis, bronchial pulmonary dysplasia, severe retinopathy of prematurity, death, and the time to achieve full enteral feeding at discharge in very/extremely low-birth-weight infants. Methods: This study was a retrospective, longitudinal, observational two-group comparison cohort study. A total of 4470 very/extremely low-birth-weight infants from 25 neonatal intensive care units in China, between April 2015 and May 2018, were enrolled in this study. Exclusive human milk-fed and formula-fed participants were matched using propensity scores. After matching, human milk-fed participants ( n = 1379) and formula-fed participants ( n = 1378) were included in the analyses. The likelihood of necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis, severe retinopathy of prematurity, death, and the time to achieve full enteral feeding were compared between the two groups. Results: Exclusive human milk feeding was associated with lower odds of necrotizing enterocolitis (2.90% vs. 8.42%, OR 0.33, 95% CI [0.22, 0.47]), bronchopulmonary dysplasia (15.74% vs. 20.26%, OR 0.69, 95% CI [0.56, 0.86]), severe retinopathy of prematurity (1.45% vs. 2.39%, OR 0.50, 95% CI [0.27, 0.93]), and death (6.02% vs. 10.38%, OR 0.44, 95% CI [0.32, 0.61]) compared with formula feeding. No significant differences in the time to achieve full enteral feeding or the odds of sepsis were found between the two groups. Conclusion: Exclusive human milk feeding is associated with a reduction in necrotizing enterocolitis, bronchopulmonary dysplasia, severe retinopathy of prematurity, and mortality among very/extremely low-birth-weight infants. Trial registration: Clinicaltrials.gov on November 9, 2015 (NCT02600195).
Whole-genome sequencing of Chlamydia trachomatis isolates from persistently infected patients
Authors: Pitt Rachel , Doyle Ronan , Theilgaard Christiansen Mette , Horner Paddy , Hathorn Emma , Alexander Sarah , Woodford Neil , Cole Michelle , Breuer Judith 
Published: March 2022

Background Current understanding of the causes of treatment failure in Chlamydia trachomatis is poor and antimicrobial susceptibility data are lacking. We used genome sequencing to seek evidence of antimicrobial resistance in isolates sourced from patients who were persistently infected. Methods Genomic DNA was extracted from C. trachomatis isolates cultured in McCoy cell monolayers. Sequencing libraries were prepared using the SureSelectXT Illumina paired-end protocol. Paired reads were mapped against a reference genome and single nucleotide variants (SNVs) were identified. Results Seven isolates from persistently infected patients and five isolates from successfully treated patients were sequenced. No previously reported SNVs associated with antimicrobial resistance were found. A unique SNV was identified in the gyrA gene of one treatment failure isolate but was located outside of the quinolone resistance determining region; this SNV has been previously reported in other members of the Chlamydiaceae family. Conclusion No genomic evidence was found to explain the differences in clinical outcome for our two groups of patients. A mutation unrelated to antimicrobial susceptibility was found in an isolate from a persistently infected patient. The cause of these persistent infections with C. trachomatis remains unclear.
Clinical pharmacology considerations for the approval of belimumab for the treatment of adult patients with active lupus nephritis: A regulatory perspective
Authors: Liu Tao , Neuner Rosemarie , Thompson Aliza , Pottackal Ginto , Petullo David , Liu Jiang , Nikolov Nikolay , Sahajwalla Chandrahas , Doddapaneni Suresh , Chen Jianmeng 
Published: March 2022

On 16 December 2020, FDA approved Benlysta® (belimumab) for both the intravenous (IV) and subcutaneous (SC) administration routes for the treatment of adult patients with active lupus nephritis (LN) who are receiving standard therapy. This approval represents the first FDA approved treatment of patients with active LN. The approved IV dosing regimen (10 mg/kg dose Q2W for three doses, then 10 mg/kg Q4W thereafter) was based on a randomized double-blind placebo controlled clinical trial in adult patients with LN. For the approval of the SC dosing regimen (400 mg dose QW for four doses, then 200 mg QW thereafter), efficacy was supported solely by pharmacokinetics (PK) modeling and simulation which estimated a matched steady state average concentration and higher trough concentrations for the SC administration route, for bridging to the efficacy of IV belimumab in adults with LN. The safety and immunogenicity profile of the SC administration route has been assessed in the SLE studies. In a population PK analysis, higher proteinuria was associated with greater belimumab clearance and lower belimumab exposure. In an exposure response analysis, the efficacy of belimumab as evaluated by renal response was mainly driven by patients with lower proteinuria at baseline regardless of other baseline characteristics (e.g. baseline renal function, renal biopsy classification), induction therapies, or belimumab exposure levels (within 10 mg/kg dosing regimen), etc. However, post hoc analyses showed that belimumab had activity in LN patients with higher proteinuria at baseline. There is no adequate information to suggest that a higher dose would provide additional benefit for patients with lower exposure (e.g. higher proteinuria).
Adoption of Digital Innovations: A Special Referenceto Routinised Incremental Innovations
Authors: Dutta Dorothy , Sarma Mrinmoy K. 
Published: March 2022

The study’s main purpose is to determine the adoption of digital innovations in a developing country that is continuously introduced on different service platforms. A quantitative approach is taken in the research where structured questionnaires based on the unified theory of acceptance and use of technology (UTAUT) model have been used to collect primary data. A total of 821 responses were selected for analysis using structural equation modelling. The findings suggest that the UTAUT model indicates a good fit for determining the behavioural intention to adopt incremental innovations in digital platforms. The model as a whole explains 31.6% of the total variance in the behavioural intention to adopt. Out of the four variables in the UTAUT model, social influence (SI) is seen to have no significant relationship with that of behavioural intention. However, the other three factors, namely performance expectancy (PE), effort expectancy (EE) and facilitating conditions (FC), do have a significant impact on the behavioural intention to adopt incremental innovations. FC has the greatest influence on the behavioural intention, followed by PE and EE. But important factors like age, gender, internet experience and voluntariness to use that are considered moderators are not seen to impact this aspect. Research focussing on radical innovations is quite abundant in past literature; however, those focusing on incremental innovations are quite scarce. This research, focussing on the adoption of incremental innovation in digital platforms in a developing country with a digital divide situation, is indeed a novel attempt. JEL Classification: O1, O2, O320
How peer review groups support learning and wellbeing in psychiatrists
Authors: Nash Louise , Karageorge Aspasia , Lancaster Jeanette , Prager Shirley 
Published: March 2022

Objective To explore the self-reported value of Peer Review Groups (PRGs) by Australian psychiatrists, focussing on learning and wellbeing. Methods A cross-sectional mixed-methods online survey of psychiatrists registered with the NSW Branch Royal Australian and New Zealand College of Psychiatrists (RANZCP) who had attended a PRG in the previous 12 months. Results Respondents described PRG participation as supportive to their learning and to their professional wellbeing by sharing professional experiences, emotional support for the inherent stresses of practice, the provision of a space for debriefing and the amelioration of professional isolation. Difficulties or challenges in group functioning were reported rarely and included new group member selection and limitations to individual support provided by the group. Conclusions The PRG form of Continuing Professional Development (CPD) is unique, popular and highly valued by psychiatrists. In addition to supporting learning, PRGs provide a collegial space for processing of emotional aspects of practice that in turn supports wellbeing. Other healthcare professionals might benefit from similar self-directed, self-selected small group peer contact for CPD.
Cost Analysis of Developing, Implementing, and Evaluating a Multi-Disciplinary Teaching Kitchen
Authors: Bonnet Jonathan P. , Rastorguieva Krystyna , Moore Miranda A. , Munroe Dominique , Bergquist Sharon H. 
Published: March 2022

Introduction: Teaching kitchens have emerged as strategies to deliver lifestyle medicine principles and practices. However, a better understanding of their implementation, delivery cost, and potential benefits are needed. This article provides a comprehensive analysis of the costs associated with the development, deployment, and evaluation of the Emory Healthy Kitchen Collaborative (EHKC) teaching kitchen clinical trial. Methods: The actual number of hours spent and costs incurred to develop and deploy the EHKC teaching kitchen were recorded and broadly categorized into 1 of 4 areas: program development, course delivery, research, and optional enhancements. Costs of each item were assigned as fixed or variable, enabling calculation of the marginal per participant program cost. Results: Total costs were US$123,898, with 3/4 incurred for program development, research, and optional enhancements. Delivery of the course alone (not including program development costs, research, or any optional enhancements) cost US$30,194. The total cost per participant for the course was US$755, with a marginal participant cost of US$141. Conclusion: Teaching kitchens represent viable options to deliver lifestyle medicine interventions. However, more research and cost analyses are needed to better understand the value teaching kitchens provide to determine if they are an effective and economical way to deliver lifestyle medicine.
Incorporating Lifestyle Medicine Into Primary Care Practice: Perceptions and Practices of Family Physicians
Authors: Bharati Rajani , Kovach Kevin A. , Bonnet Jonathan P. , Sayess Polina , Polk Elizabeth , Harvey Keisha , Vorbeck Lauren 
Published: March 2022

Introduction: Lifestyle medicine (LM) uses therapeutic lifestyle behavior change to address the root causes of chronic diseases. The purpose of this study was to assess family physicians’ perceptions and utilization of LM principles in their primary care practices, as well as identify reported barriers to implementation. Methods: A survey was administered to 5770 family physicians registered with the American Academy of Family Physicians (AAFP). The survey questions assessed the gap between perception and practice of LM core competencies and the 6 domains of LM. Results: The responses from 447 family physicians were included in the study. Respondents’ perceived importance and reported practice was higher for clinical skills compared to the community partnerships and advocacy. There was a substantial gap in the reported comfort with and practice of certain LM domains, such as sleep (47%) and relationships (39.4%). However, LM board-certified physicians had a significantly higher frequency of practice in these domains. The majority of participants identified both difficulty with changing patient behavior (89%) and having limited time (81%) as major barriers to incorporate LM into their practice. Conclusion: Lifestyle medicine concepts resonate strongly with family physicians although gaps exist surrounding engaging in community partnerships, advocacy, and certain domains of LM. This study assesses family physicians’ perceptions and utilization of LM principles in their primary care practices, and identifies reported barriers to implementation.
A Multi-Site Evaluation of A National Employee Wellness Initiative at the Department of Veterans Affairs
Authors: Shah Freny , Sells Joanna R. , Werthman Jennifer , Abraham Corrine , Ali Asma M. , Callaway-Lane Carol 
Published: March 2022

Background The Department of Veterans Affairs (VA) seeks to transform its health care delivery from disease-centered, episodic care to a holistic and patient-centered model known as the Whole Health System (WHS) of care. Employee engagement and buy-in are crucial to this cultural transformation. The VA aspires to provide employees with opportunities to experience whole health in their personal and professional lives through a national Employee Whole Health (EWH) program. Although there are national recommendations, different local facilities may have unique strategies and challenges as they implement this program. Objective This study aimed to conduct a program evaluation of EWH at three different VA facilities across the United States in order to identify facilitators and barriers to the implementation of EWH. Methods The team used the RE-AIM framework to develop an interview guide to assess various domains of implementation. Quantitative data on whole health offerings at each site were gauged using a national employee education platform. Standardized employee-related metrics at each site were assessed using the annual, national VA employee survey. Results EWH has had variable implementation at the three sites. Sites noted main facilitators as employee interest as well as available skills and expertise for delivering complementary and integrative care to employees. Limited staffing for EWH and a lack of dedicated employee time were cited as barriers. The infrastructure to perform local program evaluations to demonstrate effectiveness and impact were missing. Conclusion Employee engagement in whole health activities has the potential to support the VA’s mission to transform its health care delivery model. Currently, the use of EWH and its potential impact are difficult to discern based on available information. Local sites need guidance to conduct program evaluations and find creative solutions to enhance employee participation. A robust measurement system to demonstrate effectiveness is paramount to ensure the success of this initiative.
Cemented Lateral Unicompartmental Knee Replacement: A retrospective single centre independent series
Authors: Hefny Mamdouh H. , Smith Nick A. , Waite Jon 
Published: March 2022

Background Unicompartmental knee replacement (UKR) has functional and economic benefits when compared with total knee replacement, however it is technically demanding and may be associated with higher failure rates. The primary aim of this independent series study was to evaluate the survival of lateral UKRs implanted in our institution and their clinical outcomes. The secondary outcome was to compare the results of mobile and fixed-bearing prostheses. Methods This is a retrospective series study of 183 cemented lateral UKRs implanted in 170 patients, for advanced isolated lateral compartment arthritis, under the care of two senior surgeons. Fixed or mobile-bearing prostheses were used according to the surgeon's preference. Kaplan Meier analysis was used to evaluate prosthesis survival with the endpoint being revision for any reason. A subgroup analysis of survival was also done for each bearing type. Functional outcomes were evaluated using the Oxford knee score (OKS) at final follow-up. Results This series included 103 Fixed-bearing and 80 mobile-bearing prostheses. Median follow-up was 6.9 years. 9 knees required revision. The commonest reason for revision was progression of arthritis to the medial compartment. Dislocation was the commonest cause of revision in the mobile-bearing group. Survival at 10 years was 91.9% with no significant difference ( p = 0.083) between bearing types (fixed-bearing 93.8% and mobile-bearing 90.6%). The OKS were comparable in both groups, the mean OKS was 44/48. Conclusion Good survival and functional outcomes can be achieved using cemented lateral UKRs with both bearing types. There was a trend towards superior outcomes in the fixed-bearing group.
Patient-Specific Implants in Maxillofacial Reconstruction: A Case Report
Authors: Mukul Sailesh Kumar , Mishra Madan , Singh Gaurav , Singh Abhishek , Das Manthan Kumar 
Published: March 2022

Background The surgical repair and reconstruction of defects in the craniomaxillofacial region can be exigent because of complex anatomy, sensitivity of the involved systems, and uniqueness of each defect. The need to reconstruct the defect in the most precise way for the surgical procedure is of crucial importance to surgeons for enhancing patient outcomes and well-being. Autogenous grafts are considered the gold standard for reconstruction but are associated with an unpredictable resorption and donor site morbidity. The introduction of 3-dimensional printing in the biomedical field has led to the utilization of patient-specific implants (PSIs) in the surgical repair of maxillofacial defects, which occur congenitally, posttraumatically, or postsurgically. PSI fit quickly with greater accuracy with the added benefit of shorter rehabilitation time. Material and Method A 21-year-old male with a history of left zygomatico–orbital–maxillary complex fracture presented complaining of secondary deformity as a result of facial trauma. He underwent zygomatic osteotomy and repositioning followed by PSI reconstruction of the left zygoma, left orbital floor with titanium implants. A hemicoronal, subcilliary, and maxillary vestibular approaches were used. Result Good esthetic results with no postoperative complications are obtained. Conclusion The use of PSI for the reconstruction of oral and craniomaxillofacial defects should be considered an accurate alternative to noncustom-made implants. Automation allows for the application of safe, time-effective procedures not requiring specialized, and software-specific knowledge. The major drawback of PSI is its high cost, but many advantages of using PSI outweigh this disadvantage.
CAR T cells as a second-line therapy for large B-cell lymphoma: a paradigm shift?
Authors: Westin Jason , Sehn Laurie H. 
Published: March 2022

Abstract
The standard of care treatment strategy for patients with relapsed or refractory large B-cell lymphoma (LBCL) has been high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) if chemotherapy sensitive in suitable patients. Because of treatment intensity, this approach has only been feasible in half of patients and because of chemotherapy resistance has only been successful in a quarter of transplant-eligible patients. Chimeric antigen receptor (CAR) T-cell therapy, using genetically modified autologous T cells targeting CD19, has been approved for third-line therapy of LBCL and has been associated with durable remissions in a proportion of patients. In this review, we interpret the design and results of 3 randomized phase 3 trials comparing CAR T-cell therapy and ASCT and their implications for CAR T-cell therapy as a potential new standard of care for second-line treatment in appropriate patients with refractory or early relapsing LBCL.
Innovative computational approaches shed light on genetic mechanisms underlying cognitive impairment among children born extremely preterm
Authors: Liu Weifang , Sun Quan , Huang Le , Bhattacharya Arjun , Wang Geoffery W. , Tan Xianming , Kuban Karl C. K. , Joseph Robert M. , O’Shea T. Michael , Fry Rebecca C. , Li Yun , Santos Hudson P. 
Published: March 2022

Abstract
Background
Although survival rates for infants born extremely preterm (gestation < 28 weeks) have improved significantly in recent decades, neurodevelopmental impairment remains a major concern. Children born extremely preterm remain at high risk for cognitive impairment from early childhood to adulthood. However, there is limited evidence on genetic factors associated with cognitive impairment in this population.

Methods
First, we used a latent profile analysis (LPA) approach to characterize neurocognitive function at age 10 for children born extremely preterm. Children were classified into two groups: (1) no or low cognitive impairment, and (2) moderate-to-severe cognitive impairment. Second, we performed TOPMed-based genotype imputation on samples with genotype array data (n = 528). Third, we then conducted a genome-wide association study (GWAS) for LPA-inferred cognitive impairment. Finally, computational analysis was conducted to explore potential mechanisms underlying the variant x LPA association.

Results
We identified two loci reaching genome-wide significance (p value < 5e-8): TEA domain transcription factor 4 (TEAD4 at rs11829294, p value = 2.40e-8) and syntaxin 18 (STX18 at rs79453226, p value = 1.91e-8). Integrative analysis with brain expression quantitative trait loci (eQTL), chromatin conformation, and epigenomic annotations suggests tetraspanin 9 (TSPAN9) and protein arginine methyltransferase 8 (PRMT8) as potential functional genes underlying the GWAS signal at the TEAD4 locus.

Conclusions
We conducted a novel computational analysis by utilizing an LPA-inferred phenotype with genetics data for the first time. This study suggests that rs11829294 and its LD buddies have potential regulatory roles on genes that could impact neurocognitive impairment for extreme preterm born children.