bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smaller but more frequent dosing of cefepime in the treatment of febrile neutropenia
Authors: Okubo Lindsay , Andrick Benjamin , Rampulla Ricky , Leri Frederick 
Published: February 2022

Background Generally national guidelines for febrile neutropenia recommend treatment with cefepime 2 g every 8 h. Due to beta-lactam’s time dependent killing effects, it is hypothesized smaller doses given more frequently might be non-inferior. The objective of this study is to retrospectively evaluate the efficacy of cefepime 1 g every 6 h versus 2 g every 8 h in cancer patients with febrile neutropenia. Methods This retrospective, single-center, cohort study included patients with a diagnosis of febrile neutropenia treated with cefepime during an inpatient encounter. Patients were grouped based on receipt of cefepime 2 g every 8 h (high dose cohort) versus cefepime 1 g every 6 h (low dose cohort). The primary outcome compared the time to defervescence after cefepime initiation between the two dosing strategies. A subgroup analysis of the primary endpoint was conducted in patients who received both cefepime and vancomycin. Results Ninety-seven patients were included in the high dose cohort, and seventy-six patients were included in the low dose cohort. Baseline characteristics were similar between cohorts with the exception of race. The time to defervescence between the high dose cohort and low dose cohort were comparable between groups (49.2 vs. 46.7 h). The time to defervescence in subgroup analysis of patients who received empiric vancomycin and cefepime was 65.7 versus 59.7. Conclusion Patients who received cefepime 1 g every 6 h were found to have similar trends in achieving time to defervescence compared to 2 g every 8 h.
Improved home management of oral pediatric anticancer drugs as a result of an intervention comprising practical training, written instructions and movie clips: A pilot study
Authors: Akkawi El Edelbi Ranaa , Eksborg Staffan , Ekman Jennie , Lindemalm Synnöve 
Published: February 2022

Background Long term treatment of pediatric patients with oral anticancer drugs (OADs) requires the parents/caregivers to prepare the drug at home. The handling procedures in the home setting are, however, not regulated by Swedish law and the parents are often left without guidance on how to handle OADs in a safe way. Aim The aim of this study was to increase understanding of how OADs are handled by parents/caregivers in the home setting before and after an intervention. Methods Parents of pediatric cancer patients were observed and videotaped during their handling of OADs in the home setting before and after the intervention. During the intervention, the parents were provided with written instructions, movie clips and practical training on handling the OADs. Four checklists were used to compare and score the four handling procedures (measuring an oral suspension, cutting tablets, dissolving tablets, and opening capsules) for each parent before and after the intervention. Results The intervention significantly improved the OAD handling procedures among the studied parents. The median score for correct handling was 19% (IQR: 3.6 to 30%) before the intervention and 89.5% (IQR: 71.5 to 94.5%) after the intervention (p < 0.0001). Conclusions An intervention comprising practical training and information presented in different forms improved the handling of OADs at home by parents. There is an urgent need to implement this method in all oncology centers in Sweden, educate HCPs to standardize the presentation of information. There is also a great need to provide parents with age-appropriate oral drug formulations from the local hospital pharmacies in Sweden.
Visual outcomes of photorefractive keratectomy in non-children with anisometropic amblyopia: One-year Follow-up Outcomes
Authors: Etezad-Razavi Mohammad , Tafaghodi-Yousefi Bahar , Eslampour Alireza , Kiarudi Mohammad Yaser , Najjaran Marzieh , Momeni-Moghaddam Hamed , Alio Jorge L. 
Published: February 2022

Objective To evaluate the safety, efficiency, short term stability, and sensory results of photorefractive keratectomy (PRK) in anisometropic in non-compliant children with correction. Methods Twelve eyes of 12 children with an age range: 6–17 years and anisometropic amblyopia who underwent PRK under general anesthesia to correct the dioptric difference between the eyes were included in this study. A complete ophthalmic assessment including refractive status, uncorrected and corrected distance visual acuity (UDVA & CDVA), and binocular vision status using the Worth 4-dot test and stereopsis were performed before and 1, 3, 6, and 12 months after PRK. Results The mean preoperative CDVA was 0.34 ± 0.24 LogMAR which showed a statistically significant improvement at 12 months (0.20 ± 0.19, p = 0.024) after surgery compared to the preoperative assessment. (p = 0.003) The mean preoperative UDVA was 0.63 ± 0.24 LogMAR that increased to 0.44 ± 0.24, 0.32 ± 0.16, 0.25 ± 0.19, and 0.25 ± 0.19 LogMAR at 1, 3, 6, and 12 months after PRK, respectively. One to three lines improvement in UDVA and CDVA was seen in 10 (83.4%) and 8 eyes (66.7%); while one line UDVA and CDVA loss was seen in one (8.3%) and one (8.3%) eye and unchanged UDVA and CDVA was seen in 1 (8.3%) and 3 eyes (25%), respectively. The mean preoperative stereoacuity was 341.9 ± 245.7 s of arc, which significantly improved to 166.6 ± 87.5 s of arc 12 months after PRK. (p = 0.012) Conclusion PRK was an effective surgical alternative to improve visual acuity and stereopsis in anisometropic children who did not cooperate with conventional methods of amblyopia therapy.
Effect of maternal parenting style on child behaviour and its management strategies in dental office: A pilot study
Authors: Joshi Sakshi , Garg Shalini , Dhindsa Abhishek 
Published: February 2022

Aim To evaluate the effect of maternal parenting style on child behaviour and consequent management strategies in dental office. Materials and Methods Eighty child–mother pairs were included in the study. Before the start of the treatment, Maternal parenting style was evaluated utilising Primary Caregivers Practices Report, while child behaviour along with his/her perception towards dental treatment were observed using Frankl Behaviour Rating Scale and Sound Eye Motor scale, respectively. Also the behaviour management strategy utilised for the child was noted and its correlation to both parenting style and child behaviour was evaluated. Results A statistically significant correlation ( p-value = 0.00) was observed between the maternal parenting style and child behaviour displayed during dental treatment. Also, a positive correlation ( p-value = 0.00) was observed between behaviour displayed by the children and behaviour management strategy used in the dental operatory. Conclusion The clinicians can predict the type of behaviour the child might display and the behaviour management strategy to be utilised for a specific child based on the maternal parenting style.
The long-term clinical impact of COPD exacerbations: a 3-year observational study (SHERLOCK)
Authors: Haughney John , Lee Amanda J. , Nath Mintu , Müllerová Hana , Holmgren Ulf , Nigris Enrico de , Ding Bo 
Published: February 2022

Background and Aims: Exacerbations of chronic obstructive pulmonary disease (COPD) drive disease progression and can lead to an accelerated decline in lung function and a burden on healthcare systems. The retrospective, observational cohort Study on HEalthcare Resource utiLization related to exacerbatiOns in patients with COPD (SHERLOCK; D5980R00014) evaluated the associations between exacerbation history and rates of subsequent COPD exacerbations in primary care patients from the National Health Service in Greater Glasgow and Clyde, United Kingdom. Methods: Patients were stratified into four groups according to exacerbation history in the year before the index date: Group A (no exacerbations), Group B (1 moderate exacerbation only), Group C (1 severe exacerbation only), and Group D (⩾2 moderate or severe exacerbations). The frequencies of moderate and/or severe exacerbations were recorded over 36 months of follow-up and compared with reference Group A, using generalized linear models. Results: Over 36 months of follow-up, the adjusted rate ratios (RRs, 95% confidence interval) of moderate or severe exacerbations relative to Group A were 1.60 (1.53, 1.67), 1.75 (1.50, 2.04), 1.61 (1.54, 1.68), and 3.61 (3.48, 3.74) for Groups B, C, B + C, and D, respectively. Compared with Group A, patients in Group C exhibited an increased rate of moderate (RR, 1.58 (1.35, 1.85)) and severe exacerbations (RR, 3.13 (2.20, 4.46)). Conclusion: SHERLOCK highlights that even one moderate exacerbation increases the risk for subsequent exacerbations compared with having no recent prior exacerbations. Reviewing recent exacerbation history to ascertain future exacerbation risk and inform COPD management may reduce hospitalizations and improve patient outcomes.
Effectiveness of ustekinumab in patients with refractory Crohn’s disease: a multicentre real-life study in Italy
Authors: Scribano Maria Lia , Aratari Annalisa , Neri Benedetto , Bezzio Cristina , Balestrieri Paola , Baccolini Valentina , Falasco Giuliano , Camastra Caterina , Pantanella Paolo , Monterubbianesi Rita , Tullio Alessandro , Saibeni Simone , Papi Claudio , Biancone Livia , Cosintino Rocco , Faggiani Roberto 
Published: February 2022

Background: The effectiveness of ustekinumab in patients with refractory Crohn’s disease (CD) has been investigated in several real-world studies. However, very few data concerning the real-life experience in Italy have been reported. Therefore, this study assessed the effectiveness of ustekinumab in a large cohort of Italian patients with refractory CD. Methods: All patients who had started on ustekinumab after failure of or intolerance to antitumour necrosis factor-α (TNF-α) treatment at five tertiary centres between November 2018 and February 2020 were retrospectively enrolled. The coprimary outcome was corticosteroid-free clinical remission, defined as a Harvey–Bradshaw Index (HBI) score of ⩽4, at weeks 26 and 52. The secondary outcomes were changes in the HBI and C-reactive protein (CRP) values at weeks 8, 26, and 52 from baseline and the normalization of CRP in patients with initially abnormal values. Results: Totally, 140 patients who had previously received at least one anti-TNF-α agent were enrolled; 40.0% received two anti-TNF-α agents and 20.0% received vedolizumab. At baseline, 108 patients (77.1%) had HBI scores of >4; of these, 56.5% and 58.3% achieved corticosteroid-free clinical remission at weeks 26 and 52, respectively. Significant decreases in HBI and CRP values were observed at weeks 8, 26, and 52 in the entire study cohort (all p < 0.0001). The CRP values were normalized in 34.9%, 37.8%, and 49.3% of the patients by weeks 8, 26, and 52, respectively. The baseline HBI score of ⩾8 was a negative predictor of corticosteroid-free clinical remission at week 52 (odds ratio: 0.21, 95% confidence interval: 0.08–0.56, p = 0.002). The probability of remaining on ustekinumab after 52 weeks was 92.1%. Eleven (7.9%) patients discontinued ustekinumab (three for adverse events). Conclusion: Our study findings confirm the effectiveness and safety of ustekinumab in patients with CD after failure of or intolerance to anti-TNF-α therapy.
Stereotactic radiotherapy for soft tissue and bone sarcomas: real-world evidence
Authors: Spałek Mateusz Jacek , Teterycz Paweł , Borkowska Aneta , Poleszczuk Jan , Rutkowski Piotr 
Published: February 2022

Introduction: Selected patients with locally advanced or metastatic soft tissue and bone sarcomas (STBS) may benefit from intensive local treatment, such as stereotactic radiotherapy (SRT). This study aimed to summarize the utilization and outcomes of SRT in STBS and to identify predictive factors for progression and survival. Materials and methods: Consecutive patients with advanced STBS who underwent STBS in a sarcoma tertiary center were identified. We collected tumor- and treatment-related factors. Endpoints comprised time to local progression (TTLP), local progression-free survival (LPFS), time to progression, progression-free survival, and overall survival (OS). The Cox proportional-hazards model was used to identify prognostic factors. Results: We identified 141 patients who underwent 233 SRTs. Median follow-up was 21 months. Local and distant progression occurred after 19 and 163 SRTs, respectively. SRT for lung metastases was predictive for better TTLP and LPFS (hazard ratio, HR = 0.12, p = 0.007 and HR = 0.42, p = 0.002, respectively). Bone sarcoma (HR for TTLP = 3.18, p = 0.043; HR for LPFS = 1.99, p = 0.028) and lower administered dose (HR for TTLP = 0.98, p = 0.007; HR for LPFS = 0.99, p = 0.012) were predictive for worse TTLP and LPFS. SRT for oligometastases (HR = 0.46, p = 0.021) and lung metastases (HR = 0.55, p = 0.046) was predictive for better OS, whereas diagnosis of bone sarcoma (HR = 2.05, p = 0.029) was predictive for worse OS. Conclusion: SRT provides excellent local control in STBS patients without significant toxicity. Patients with oligometastatic disease, lung metastases, and soft tissue sarcomas benefit the most from SRT. The dose escalation moderately enhances local control; however, it does not translate into better survival.
Selection of X-ray versus magnetic resonance imaging as a first-line imaging modality for diagnosing axial spondyloarthritis
Authors: Chan Kwon Oh , Park Min-Chan 
Published: February 2022

Introduction: To determine the cut-off values for age and symptom duration that could be used in selecting preferential first-line imaging modality of sacroiliac joints [X-ray versus magnetic resonance imaging (MRI)] for diagnosing axial spondyloarthritis (axSpA). Methods: This retrospective cohort study included 388 patients newly diagnosed with axSpA. Patients were classified into radiographic axSpA (n = 322) and non-radiographic axSpA (n = 66) groups according to the fulfilment of modified New York criteria by X-ray. Patient characteristics of the two groups were compared. Receiver operating characteristic (ROC) curve analysis was conducted to determine the cut-off values for age and symptom duration that best distinguish non-radiographic axSpA from radiographic axSpA. Results: Compared with patients with radiographic axSpA, those with non-radiographic axSpA were younger at diagnosis (35.7 ± 11.3 years versus 26.8 ± 7.8 years, p < 0.001) and had shorter symptom duration [5.1 (2.1–12.0) years versus 1.0 (0.5–3.2) years, p < 0.001]. ROC analysis showed that age > 33.5 years at diagnosis [area under the curve (AUC): 0.734] and symptom duration > 4.1 years (AUC: 0.787) were the cut-off values that best discriminate radiographic axSpA from non-radiographic axSpA. Conclusion: The best cut-off values for age and symptom duration for predicting radiographic sacroiliitis are 33.5 and 4.1 years, respectively. It is reasonable to use X-ray as a first-line imaging modality in patients older than 33.5 years with a symptom duration longer than 4.1 years, and use MRI as a first-line imaging in patients younger than 33.5 years with a symptom duration less than 4.1 years.
Do Prophylactic Inferior Vena Cava Filters Affect the Rates of Venous Thromboembolism and Pulmonary Embolism in Patients Undergoing Major Spine Surgery?
Authors: Woodward Chase C. , Eby Michael , Gandhi Rikesh , Plachta Stephen M. , Baldwin Keith , Holderread Brendan M. , Smith Harvey E. , Arlet Vincent , Saifi Comron 
Published: February 2022

Study Design Retrospective Analysis Background Venous thromboembolism (VTE) represents a significant cause of morbidity and mortality in major spine surgery. Placement of prophylactic inferior vena cava filters (IVCF) in patients undergoing major spine surgery was previously adopted at our institution. This study reports our experience and compares VTE rates between patients with and without preoperative IVCF placement. Methods A Retrospective comparative study was conducted on adult patients who underwent IVCF placement and those who did not prior to their spinal fusion procedure, between 2013 and 2016. Thoracolumbar fusions (anterior and/or posterior) of 7 or more levels, spinal osteotomies, and a minimum of a 3-month follow-up were included. Traumatic, oncologic, and cervical pathology were excluded. Primary outcomes measured included the incidence of overall VTE (DVT/PE), death, IVCF related complications, and IVCF retrieval. Results 386 patients who underwent major spine surgery, 258 met the eligibility criteria. Of those patients, 105 patients (40.7%) had prophylactic IVCF placement. All patients had postoperative SCDs and chemoprophylaxis. The presence of an IVCF was associated with an increased rate of overall VTE (14.3% vs 6.5%, P ≤ .05) and DVT episodes (8.6% vs 2.6%, P = .04). The rate of PE for the IVCF group and non-IVCF group was 8.6% and 4.6%, respectively, which was not statistically significant ( P = .32). The all-cause mortality rate overall of 2.3% was statistically similar between both groups ( P = 1.0). The IVCF group had higher rates of hematoma/seroma vs the non-IVCF group (12.4% vs 3.9%, P ≤ .05). 99 IVCFs were retrievable designs, and 85% were successfully retrieved. Overall IVCF-related complication rate was 11%. Conclusions No statistical difference in PE or mortality rates existed between the IVCF and the control group. Patients with IVCF placement experienced approximately twice the rate of VTE and three times the rate of DVT compared to those without IVCF. The IVCF-related complication rate was 11%. Based on the results of this study, the authors recommend against the routine use of prophylactic IVCFs in adults undergoing major spine surgery. Level of Evidence III.
Marking Pen Bacterial Contamination During Shoulder Surgery
Authors: Magone Kevin , Ristow Jacob , Root Kyle , Atkinson Theresa , Sardelli Matthew 
Published: February 2022

Background: Equipment used to guide surgical incisions has been shown to be a source of bacterial contamination during surgery. Purpose/Hypothesis: To compare the culture-positive rates of sterile marking pens used before and after skin preparation for shoulder surgery. It was hypothesized that there will be no difference in culture-positive rates from marking pens used after skin preparation compared with before skin preparation. Study Design: Controlled laboratory study. Methods: Overall, 43 consecutive patients undergoing elective shoulder surgery were enrolled prospectively into this study. Each patient provided 2 samples: study pens (from marking the surgical site incision after skin preparation) and positive control pens (from marking the surgical site incision before skin preparation). In addition, there were 43 negative control pens evaluated (straight from the packaging without any patient contact). Cultures were evaluated at 4 and 21 days, and all positive cultures were further evaluated for speciation, if able. Standard descriptive summaries and Fisher exact tests were used to compare the study samples. Results: The average age of the 43 patients was 54 years (range, 18-76 years). There were 29 (67%) female patients, and 30 (70%) procedures were on the right shoulder. Of the 43 procedures performed, 29 (67.4%) were arthroscopic, 12 (27.9%) were open, and 2 (4.7%) were closed. Of the 43 study pens, 1 culture was positive for Propionibacterium acnes (2.3%). Of the 43 positive control pens, 2 cultures were positive for bacterial growth (4.7%): P. acnes and Gram-positive bacilli (no speciation could be obtained). Of the 43 negative control pens, none of the cultures were positive for bacterial growth (0%). There was no statistical difference in the culture-positive rate between the study pens and the positive or negative control pens ( P ≥ .999). Conclusion: Study results indicated that sterile surgical marking pens used to plan incisions and to outline anatomic landmarks did not have a higher culture-positive rate compared with pens used on unprepared skin or pens straight from the packaging. Clinical Relevance: As a precaution, sterile surgical marking pens should be discarded after use on the skin surface and not placed on the sterile field.
Bhimrao Ramji Ambedkar’s Image and Thought as Perceived in Thailand From 1975 to 2017
Authors: Panyamanee Pittikorn 
Published: February 2022

Bhimrao Ramji Ambedkar (1891–1956), popularly known as Babasaheb Ambedkar, was an Indian jurist, economist, politician and social reformer who inspired the Dalit Buddhist movement and campaigned against social discrimination against untouchables (Dalits) while supporting the rights of women and labourers. This article examines how Ambedkar is characterized in Thai language academic and general writings published between 1975 and 2017. The paper is based on textual analysis that interprets the books and articles on Ambedkar in Thai language as primary sources for understanding his image and thought as portrayed in Thailand. Ambedkar’s forward-thinking ideas on democracy impressed Thai writers because Ambedkar attempted to dispense with the caste system and promote liberty, equality and fraternity among underprivileged communities in India. Ambedkar also served as chairman of drafting committee of Constitution and leader of the Dalit movement and community. Furthermore, Thai writers see Ambedkar’s ideas about Buddhism as qualifying him as a messiah or bodhisattva who revived a neo-Buddhist movement in India. Thai monks have served as significant intermediaries in narrating Ambedkar’s interpretation of Buddhism to the Thai Buddhist community because they have direct experience such as studying and staying in India. Academics and famous writers have also conveyed Ambedkar’s ideas about Buddhism and democracy, which qualify him as a modernist and maha manav [great man].
Lived Realities of Socio-political Negotiations by Marginalized Groups and the Inherent Rationality of Caste-Based Power Negotiations: A Study of Khap Regions of Muzaffarnagar, Uttar Pradesh
Authors: Sarvesh Tarushikha 
Published: February 2022

The article explores the lived realities of socio-political negotiations by marginalized groups and the inherent rationality of caste-based power negotiations at a micro level. It also explores the possibilities of alternate futures and alternate interpretations of the margins, through the study of caste-based negotiations and subversions in the Khap villages of western Uttar Pradesh. Stuart Hall, British Cultural theorist, draws attention to the perspective that cultural identification need not produce an essence but a positioning subject to the continuous ‘play’ of history, culture and power. B. R. Ambedkar had termed the hierarchical caste system in India as ‘graded inequality’, which resists any transformation in its oppressive framework because it gives a sense of superiority to each caste placed above the other in a descending order. Despite stiff resistance to any transformation, various forms of subversion—denting the rigid caste and cultural frames—exist in the Khap areas of western Uttar Pradesh. Ambedkar’s vision of a non-sectarian equitable new social order in combination with empirical study on the current socio-political negotiations by marginalized groups on the ground—with a hint to the possibilities of alternate futures through the efforts towards inducing a democratic environment—are explored here.