bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pap smear outcomes in elderly women living with HIV and HIV-negative matched controls
Authors: Klein Kylie L , Goron Abby R , Taylor Gregory H , Roque Dana M 
Published: August 2022

Objectives To describe risk factors/incidence of abnormal cervical/vaginal cytology/histology and cancer among women living with human immunodeficiency virus (WLHIV) ≥65 years compared to HIV-negative matched controls Study Design Retrospective cohort of patients who underwent Pap screening at the University of Maryland 01/2003-04/2019. Results WLHIV and HIV-negative controls ( n = 70 each) underwent 140/151 Pap tests, respectively. Among WLHIV, 29% exhibited abnormal results and were less likely than HIV-negative women with normal Paps to have had serially negative Pap tests prior to age 65 ( p = .03). In both groups, 1.4% developed cervical cancer. Abnormal Paps were more frequent in WLHIV than in HIV-negative women (31% vs 10%, p < .0001, RR:3.2, 95%CI1.9–5.4) as was HRHPV (high-risk human papillomavirus) status (43% vs 19%, p = .0233, RR:2.3, 95%CI1.2–4.6). The RR for an abnormal Pap was 2.6 (95% CI:1.1–4.2) for VL >1000 copies/mL and 0.4 (95% CI:0.2–0.7) for CD4 count of >200 cells/μL. No individual with an initially normal Pap experienced an abnormal result over a mean of 42.5 and 43.5 months in the HIV-positive and HIV-negative groups, respectively. Conclusions HIV status was associated with a higher rate of abnormal Pap/HRHPV; however, no significant difference in cervical/vaginal cancer. Elevated VL/low CD4 count were associated with greater risk for an abnormal Pap.
A Case of Central Nervous System Post-Transplant Lymphoproliferative Disorder Following Haploidentical Stem Cell Transplantation in a Patient With Acute Lymphoblastic Leukemia
Authors: Zhu Haibo , Li Qing , Liu Yunyang , Feng Xuequan , Deng Qi 
Published: August 2022

We present a differential diagnosis of an intracranial lesion following haploidentical stem cell transplantation (haplo-SCT) in a female patient with acute lymphoblastic leukemia (ALL). This patient received an anti-CD19-chimeric antigen receptor (CAR) T-cell therapy for refractory B-cell ALL and obtained minimal residual disease (MRD)-positive (0.03%) complete remission (CR). Then the patient received a bridging therapy of haplo-SCT. After bridging therapy, the patient maintained MRD-negative and full donor chimerism in bone marrow (BM) and was negative for Epstein–Barr virus (EBV)-DNA copy in peripheral blood. At 91 days after haplo-SCT, the patient presented with dizziness and fatigue and magnetic resonance imaging (MRI) demonstrated an intracranial lesion. The diagnosis of isolated extramedullary relapse (IEMR) was temporarily considered. Then next-generation sequencing (NGS) identified positive EBV-DNA in the cerebrospinal fluid, although EBV-DNA in the peripheral blood was negative. Furthermore, the positive EBV-DNA by NGS and complete donor chimerism in the brain tissue confirmed the diagnosis of central nervous system post-transplant lymphoproliferative disorder (CNS-PTLD). However, the EBV-encoded small RNAs (EBERs) in situ hybridization was sparsely positive. The patient was subsequently treated with anti-CD22-CAR T cells in combination with Zanubrutinib, but the disease progressed quickly and died. Donor chimerism examination of focal biopsy provides important evidence for diagnosing PTLD. Furthermore, NGS detection of EBV-DNA in local lesions is more valuable for diagnosing PTLD than detection of EBV-DNA in the peripheral blood. Trial registration: The patient was enrolled in a clinical trial of ChiCTR1800019622 and ChiCTR1800019298.
“What if We Explore…” Promoting Engaged Learning and Collaboration with MOUNTAIN RESCUE
Authors: Bressler Denise M. , Tutwiler M. Shane , Siebert-Evenstone Amanda , Annetta Leonard A. , Chen Jason A. 
Published: August 2022

Background According to the Committee on STEM Education, K-12 science students need access to learning experiences that promote collaboration and engagement. To fill that void, we need to develop activities that stimulate engaged learning and scaffold effective collaboration. K-12 teacher candidates see value in utilizing games for this purpose. Specifically, tabletop science games can help teachers engage students in science learning and scaffold collaboration. Aim For this study, we designed a collaborative, STEM-themed card game called MOUNTAIN RESCUE and explored its capacity to promote engaged learning and collaboration. Method Four groups of STEM campers (n = 14) in a suburban Mid-Atlantic region played MOUNTAIN RESCUE. All groups had a mix of boys and girls. Play-testers ranged from 10–13 years old. The tabletop game took approximately 30-minutes. During gameplay, players embodied unique STEM roles: physicist, chemist, structural engineer, and electrical engineer. They collaborated to solve challenges related to electricity, physics, chemistry, and engineering design. Discourse was audio-recorded throughout gameplay. Immediately after gameplay, self-report survey data were collected to assess flow and perceptions of collaborative learning. Results Findings demonstrated that the game promoted engagement and collaboration. Specifically, students had a flow-like experience and felt positively about the game's value for collaborative learning. Utterances demonstrating active engagement and constructive thinking became more group-focused over time. Conclusion This study contributes to science education by demonstrating potential benefits of a well-designed, low-tech, science learning environment or—in other words—a tabletop game.
Being Normal yet Different: A Qualitative Study on the Dualistic Experience of Living With Unilateral Cleft Lip and Palate
Authors: Paganini Anna , Engström My , Mark Hans , Persson Martin 
Published: August 2022

The aim of the present study was to describe the experiences of young adults living with cleft lip and palate (CLP) and to explore potential gender differences. A descriptive qualitative study was designed involving semi-structured interviews. The interviews were analyzed using qualitative content analysis, as described by Graneheim and Lundman. A total of 9 women and 8 men, aged 22 to 26 years with UCLP. The main theme identified was: the duality of living with a cleft—being normal yet different, and 2 subcategories: “My cleft and me” and “My cleft and the World.” The participants described themselves as normal yet different, both in relation to themselves and in relation to others. They also stated that gender norms regarding appearance affected their lives and how they saw the cleft. This study adds to the growing body of qualitative research on CLP. It highlights the dualistic experiences of feeling normal and different at the same time. The interviews indicated that this dualism was based on context and gender, showing the psychological complexity of an individual. The clinical implications of this study emphasizes the need of a person-centered care approach in the cleft care setting where the clinicians are aware of the potential dualistic experience that also may differ over time that individuals with cleft can experience. This can also help clinicians better understand and help patients reduce distress and strengthen positive coping mechanisms.
Oral Cleft Related-Genes may be Involved in Root Curvature of Maxillary Lateral Incisors
Authors: Küchler Erika Calvano , de Oliveira Stroparo Jeferson Luis , Bitencourt Reis Caio Luiz , Ullrich Niklas , Olsson Bernardo , Scariot Rafaela , Matsumoto Mirian Nakane , Ribeiro Mattos Natanael Henrique , Proff Peter , Baratto-Filho Flares , Kirschneck Christian 
Published: August 2022

The maxilla is formed by the medial nasal and maxillary processes fusion. The dental lamina develops from 2 origins connecting in the lateral incisor. The maxillary lateral incisor region is often affected by dental anomalies and clefting. It is possible that genes involved in oral cleft could also be associated with a variety of phenotypic variations in the maxillary lateral incisor. In this phenotype–genotype study, we explored the association between polymorphisms in the oral-cleft-related genes BMP2 and BMP4 and root curvature of maxillary lateral incisors. Cross-sectional study. Universities and private clinics. Panoramic radiographs and DNA from 231 patients were analyzed. Schneider method (1971) was applied to estimate the degree of root curvature of the maxillary lateral incisors and to classify the root as straight (5° or less) or curved (higher than 5°). Genetic polymorphisms in BMP2 (rs235768 and rs1005464) and BMP4 (rs17563) were genotyped. Statistical analysis was performed. A total of 401 teeth (199 left and 202 right) were evaluated. Genetic analysis demonstrated trends toward association for the rs1005464 in BMP2 ( P  =  .025) in co-dominant model and in dominant model ( P  =  .026) for left incisors. The rs235768 in BMP2 showed trends toward association with the degree of root curvature in left incisors in the recessive model ( P  =  .031). rs17563 in BMP4 also showed trends toward association with the degree of the root curvature in left incisors ( P  =  .019). BMP2 (rs235768 and rs1005464) and BMP4 (rs17563) might be involved in maxillary lateral incisor root curvature.
The Cost of Von Willebrand Disease in Europe: The CVESS Study
Authors: Morgan George , Brighton Sarah , Laffan Mike , Goudemand Jenny , Franks Bethany , Finnegan Alan 
Published: August 2022

Background Von Willebrand disease (VWD) is one of the most common inherited bleeding disorders, imposing a substantial health impact and financial burden. The Cost of von Willebrand disease in Europe: A Socioeconomic Study (CVESS) characterises the socio-economic cost of VWD across Germany, Spain, Italy, France, and the UK. Methods A retrospective, cross-sectional design captured 12 months of patient disease management, collected from August-December 2018, for 974 patients. This enabled estimation of direct medical, direct non-medical and indirect costs, utilising prevalence estimates to extrapolate to population level. Results Total annual direct medical cost (including/excluding von Willebrand factor [VWF]) across all countries was the highest cost (€2 845 510 345/€444 446 023), followed by indirect costs (€367 330 271) and direct non-medical costs (€60 223 234). Differences were seen between countries: the UK had the highest direct medical costs excluding VWF (€159 791 064), Italy the highest direct-non medical (€26 564 496), and Germany the highest indirect cost burden (€197 036 052). Total direct medical costs per adult patient increased across VWD types with Type 1 having the lowest cost (€23 287) and Type 3 having the highest cost (€133 518). Conclusion A substantial financial burden arises from the prevalence of VWD for the European healthcare systems considered.
Assessment of Consumers’ Perception of Chicken Eggs Consumption and Associated Health Implications in the Volta Region of Ghana
Authors: Abive-Bortsi Maxwell , Baidoo Samuel Tawiah , Amiteye Samuel 
Published: August 2022

Background: Rather erroneously, eggs consumption is linked to increase in plasma cholesterol content and incidents of cardiovascular diseases, cancer, stroke, or diabetes. This misconception which is more pervasive particularly in sub-Saharan Africa, has led to very low patronage of eggs intake. In this study, egg consumption patterns, desired egg characteristics, and the extent to which the perception of eggs consumption as a health risk is entrenched among consumers in the Volta Region of Ghana, were examined. Methods: The study used primary data for the analysis and the 2-stage sampling technique was employed. First, 5 districts (Keta, Ho, Krachi East, Nkwanta South and North Tongu) were selected and afterward, a sample was randomly selected from each of the district. A well designed and pretested questionnaires were administered to the respondents. Results: It was found that cheaper price and deep yellow yolk were the most persuasive parameters that motivate consumer purchase. The relationship between educational level and awareness on cholesterol types was significant. More than half of the respondents held the view that egg intake results in an increase in serum cholesterol and leads to the incidence of serious health problems. Recommendation: This study proves the urgent need for a concerted national public education effort to raise awareness about the nutritional and health benefits of eggs intake. Success in such awareness creation will go a long way to greatly minimize acute malnutrition in the Ghana.
Outcomes of young patients following mechanical thrombectomy for stroke: A systematic review and meta-analysis
Authors: Kobeissi Hassan , Liu Michael , Ghozy Sherief , Kadirvel Ramanathan , Kallmes David F 
Published: August 2022

Background Young patients experience acute ischemic stroke (AIS) at much lower rates than their older counterparts. We performed a systematic review and meta-analysis to assess the question regarding outcomes and clinical characteristics of young stroke patients who underwent mechanical thrombectomy for AIS. Methods Following PRISMA guidelines, a systematic review of the literature was conducted using the databases PubMed, MEDLINE, and Embase. The primary outcome of interest was 90-day modified Rankin Scale (mRS) 0–2. Secondary outcome variables included rate of successful reperfusion (TICI 2b/3), symptomatic intracerebral hemorrhage (sICH), and mortality. Using R software version 4.1.2, we calculated pooled event rates and their corresponding 95% confidence intervals (CI) for all outcomes. Results Our analysis included eight studies with a total of 1903 patients. Definitions of young patients included age ranges of 18–49/50 years, 18–54/55 years, and 18–64/65 years. Functional independence was achieved in 62.0% of the patients, with an overall mortality of 9.0%. Moreover, successful reperfusion was achieved in 82.0% of the patients with sICH rates of 5.7%. There was significant heterogeneity among different analyses, which could not be attributed to the differences of the definition of young patients. Conclusions Following mechanical thrombectomy for AIS, patients aged 18–65 years achieved relatively high rates of functional independence and successful reperfusion and low rates of mortality and sICH. Clinical Perspective In this systematic review and meta-analysis of eight studies, we examined outcomes in young stroke patients, aged 18–65 years old, following mechanical thrombectomy for acute ischemic stroke. We found that young patients achieved high rates of functional independence, high rates of successful reperfusion, and low rates of mortality and symptomatic intracerebral hemorrhage. While there have been several papers examining outcomes following mechanical thrombectomy for acute ischemic stroke in young patients, the results of these studies have yet to be pooled together in a meta-analysis. Our results indicate that young patients have good outcomes following mechanical thrombectomy. Further studies that examine these outcomes are warranted so that a higher-powered analysis can be performed to better informed clinicians regarding outcomes in this patient age-group cohort.
Nursing Staff Mortality During the Covid-19 Pandemic, Scoping Review
Authors: Vera-Alanis Yuliana , Aranda-Sanchez Daysi , Cano-Verdugo Guillermo , Gonzalez-Angulo Pedro , Rueda-Sanchez Cynthia Berenice , Rojas-Martinez Augusto 
Published: August 2022

Introduction In a pandemic, the risk of infection and mortality for nurses can increase substantially. This study analyzes the information reported on the mortality of nursing personnel from different countries due to COVID-19. Methods We performed a scoping review by searching information available in PubMed, Scielo, and Google Scholar databases using concepts related to nursing, mortality, COVID-19, etc. The studies were searched from September 1 to October 30, 2021. This review included 12 articles were selected among 73 identified for the scope search because they included nurses. Results Nursing personnel presented a high mortality rate after physicians and health personnel. The average age of the deceased nurses was 43 years, being higher in men than in women. Higher mortality rates were reported in services attending COVID-19, nursing homes, and psychiatric centers. Conclusion Contagion and deaths are attributed to lack of planning and inadequate personal protective equipment.
Inlay Patellofemoral Arthroplasty: A Readily Reproducible Technique
Authors: Hevesi Mario , Berlinberg Elyse J. , Patel Harsh H. , Ramos Pablo , Forsythe Brian 
Published: August 2022

Background: Patients with recalcitrant anterior knee pain and isolated patellofemoral osteoarthritis (PFOA) may benefit from patellofemoral arthroplasty. Arthroplasty with an inlay implant may be beneficial given recreation of native biomechanics and potentially avoiding anterior overstuffing. Indications: Patellofemoral arthroplasty is indicated in patients with anterior knee pain from isolated PFOA in patients with neutral alignment and intact menisci and ligaments. To highlight these indications, we present a 32-year-old female with severe anterior knee pain from PFOA, not resolved by conservative measures. Preoperative imaging demonstrated full-thickness chondral loss of the lateral patellar facet and trochlea, with neutral alignment and no significant trochlear dysplasia. Technique Description: This technique utilized the HemiCap Wave Implant manufactured by Anika Therapeutics (Franklin, MA, USA). A standard midline approach and medial parapatellar arthrotomy is performed. The patella is everted, and the trochlea is exposed. A guide pin is placed perpendicular to the trochlear bony surface and centrally in the defect. The pin is advanced, and the surrounding area is reamed. A guide block is placed over the pin in the trochlea and over-reamed. The area is prepared and centrally drilled, then tapped. A taper post is implanted. The trochlear implant is then secured to the taper post with an impactor and mallet. On the patellar side, a guide pin is placed in the center of the patella. Consideration is given to medialization of the button to decrease Q-angle. The patella is reamed to the diameter of an appropriately sized patellar button. A trial button is used to ensure satisfactory tracking. A real patellar implant is then cemented into place. Standard closure is performed. Results: Overall outcomes following inlay patellofemoral arthroplasty have been positive, with up to 89% of patients engaging in sports at 2 years status post surgery and 83% survival free of total knee arthroplasty at 5 years postoperatively. Discussion/Conclusion: Patellofemoral arthroplasty can provide good satisfaction and high rates of return to sport in patients with symptomatic, isolated patellofemoral arthritis. The surgical technique video presented provides reproducible steps, tips, and tricks for performing this procedure.
Randomised controlled trial of first-line tyrosine-kinase inhibitor (TKI)versusintercalated TKI with chemotherapy forEGFR-mutated nonsmall cell lung cancer
Authors: Gijtenbeek Rolof G.P. , van der Noort Vincent , Aerts Joachim G.J.V. , Staal-van den Brekel Jeske A. , Smit Egbert F. , Krouwels Frans H. , Wilschut Frank A. , Hiltermann T. Jeroen N. , Timens Wim , Schuuring Ed , Janssen Joost D.J. , Goosens Martijn , van den Berg Paul M. , de Langen A. Joop , Stigt Jos A. , van den Borne Ben E.E.M. , Groen Harry J.M. , van Geffen Wouter H. , van der Wekken Anthonie J. 
Published: August 2022

IntroductionPrevious studies have shown interference between epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors and chemotherapy in the cell cycle, thus reducing efficacy. In this randomised controlled trial we investigated whether intercalated erlotinib with chemotherapy was superior compared to erlotinib alone in untreated advanced EGFR-mutated nonsmall cell lung cancer (NSCLC).Materials and methodsTreatment-naïve patients with an activatingEGFRmutation, ECOG performance score of 0–3 and adequate organ function were randomly assigned 1:1 to either four cycles of cisplatin-pemetrexed with intercalated erlotinib (day 2–16 out of 21 days per cycle) followed by pemetrexed and erlotinib maintenance (CPE) or erlotinib monotherapy. The primary end-point was progression-free survival (PFS). Secondary end-points were overall survival, objective response rate (ORR) and toxicity.ResultsBetween April 2014 and September 2016, 22 patients were randomised equally into both arms; the study was stopped due to slow accrual. Median follow-up was 64 months. Median PFS was 8.8 months (95% CI 4.2–18.8) for CPE and 10.3 months (95% CI 7.1–15.5; hazard ratio (HR) 0.78, 95% CI 0.32–1.91) for erlotinib monotherapy; when compensating for number of days receiving erlotinib, PFS of the CPE arm was superior (HR 0.32, 95% CI 0.10–1.01; p=0.02). ORR was 64% for CPEversus55% for erlotinib monotherapy. Median overall survival was 30.9 months (95% CI 18.5–61.9 months) for CPE compared to 17.2 months (95% CI 11.5–45.5 months) for erlotinib monotherapy (HR 0.66, 95% CI 0.27–1.65 months). Patients treated with CPE had higher rates of treatment-related fatigue, anorexia, weight loss and renal toxicity.ConclusionIntercalating erlotinib with cisplatin-pemetrexed provides a longer PFS compared to erlotinib alone inEGFR-mutated NSCLC at the expense of more toxicity.
Underweight children are agile but lack power
Authors: Verbecque Evi , Coetzee Dané , Smits-Engelsman Bouwien 
Published: August 2022

AbstractGiven the knowledge gap in literature on the impact of undernutrition on muscular power and agility in school-aged children, the aim of this study was to compare physical fitness in such underweight- and normal weight children. In this cross-sectional study, 853 children were included (459 boys; mean age: 9.2 (1.8) years). The children were grouped according to their BMI-for-age-and-sex: normal weight (− 1 ≤ z-score < 2) and underweight (z-score < − 1). Within the underweight group, three thinness subgroups were composed: grade 1 (− 2 ≤ z-score < − 1), grade 2 (− 3 ≤ z-score < − 2) and grade 3 (z-score < − 3). Their agility, muscular endurance and power were assessed with the Performance and Fitness test battery (PERF-FIT). Regardless the country they lived in, the underweight children showed better agility (p = 0.012) and muscular endurance (p = 0.004) than those with normal weight. They presented with lower muscular power than the normal weight group, shown by significantly shorter overhead throwing distances (p = 0.017) and less standing long jump peak power (p < 0.001). The standing long jump peak power decreased further with increasing thinness grade (p = 0.027).Conclusion: Underweight children are more agile, but have lower muscular power compared to their normal weight peers. Its relationship with motor competence and physical activity, necessitates attention for tackling muscular strength deficiencies in these children, enabling them to meet the basic requirements for a healthy lifestyle later in life.