bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chlorhexidine (di)gluconate locking device for central line infection prevention in intensive care unit patients: a multi-unit, pilot randomized controlled trial
Authors: Pook Makena , Zamir Nasim , McDonald Ellen , Fox-Robichaud Alison 
Published: July 2022

Purpose: Intensive care unit (ICU) patients are at risk for central line-associated bloodstream infection (CLABSI) with significant attributable mortality and increased hospital length of stay, readmissions, and costs. Chlorhexidine (di)gluconate (CHG) is used as a disinfectant for central line insertion; however, the feasibility and efficacy of using CHG as a locking solution is unknown. Methods: Patients with a central venous access device (CVAD) in situ were randomized to standard care or a CHG lock solution (CHGLS) within 72 hours of ICU admission. The CHG solution was instilled in the lumen of venous catheters not actively infusing. CVAD blood cultures were taken at baseline and every 48 hours. The primary outcome was feasibility including recruitment rate, consent rate, protocol adherence, and staff uptake. Secondary outcomes included CVAD colonization, bacteraemia, and clinical endpoints. Results: Of 3,848 patients screened, 122 were eligible for the study and consent was obtained from 82.0% of the patients or substitute decision makers approached. Fifty participants were allocated to each group. Tracking logs indicated that the CHGLS was used per protocol 408 times. Most nurses felt comfortable using the CHGLS. The proportion of central line colonization was significantly higher in the standard care group with 40 (29%) versus 26 (18.7%) in the CHGLS group (P=0.009). Conclusions: Using a device that delivers CHG into CVADs was feasible in the ICU. Findings from this trial will inform a full-scale randomized controlled trial and provide preliminary data on the effectiveness of CHGLS. Trial Registration: ClinicalTrials.gov Identifier NCT03309137, registered on October 13, 2017
Statins and renal disease progression, ophthalmic manifestations, and neurological manifestations in veterans with diabetes: A retrospective cohort study
Authors: Mansi Ishak A. , Chansard Matheu , Lingvay Ildiko , Zhang Song , Halm Ethan A. , Alvarez Carlos A. 
Published: July 2022

Background
Statins increase insulin resistance, which may increase risk of diabetic microvascular complications. Little is known about the impact of statins on renal, ophthalmologic, and neurologic complications of diabetes in practice. The objective of this study was to examine the association of statins with renal disease progression, ophthalmic manifestations, and neurological manifestations in diabetes.

Methods
This is a retrospective cohort study, new-user active comparator design, that included a national Veterans Health Administration (VA) patients with diabetes from 2003 to 2015. Patients were age 30 years or older and were regular users of the VA with data encompassing clinical encounters, demographics, vital signs, laboratory tests, and medications. Patients were divided into statin users or nonusers (active comparators). Statin users initiated statins and nonusers initiated H2-blockers or proton pump-inhibitors (H2-PPI) as an active comparator. Study outcomes were: 1) Composite renal disease progression outcome; 2) Incident diabetes with ophthalmic manifestations; and 3) Incident diabetes with neurological manifestations.

Results
Out of 705,774 eligible patients, we propensity score matched 81,146 pairs of statin users and active comparators. Over a mean (standard deviation) of follow up duration of 4.8 (3) years, renal disease progression occurred in 9.5% of statin users vs 8.3% of nonusers (odds ratio [OR]: 1.16; 95% confidence interval [95%CI]: 1.12–1.20), incident ophthalmic manifestations in 2.7% of statin users vs 2.0% of nonusers (OR: 1.35, 95%CI:1.27–1.44), and incident neurological manifestations in 6.7% of statin users vs 5.7% of nonusers (OR: 1.19, 95%CI:1.15–1.25). Secondary, sensitivity, and post-hoc analyses were consistent and demonstrated highest risks among the healthier subgroup and those with intensive lowering of LDL-cholesterol.

Conclusions
Statin use in patients with diabetes was associated with modestly higher risk of renal disease progression, incident ophthalmic, and neurological manifestations. More research is needed to assess the overall harm/benefit balance for statins in the lower risk populations with diabetes and those who receive intensive statin therapy.
Impact of COVID-19 on the HIV care continuum in Asia: Insights from people living with HIV, key populations, and HIV healthcare providers
Authors: Hung Chien-Ching , Banerjee Sumita , Gilada Ishwar , Green Kimberly , Inoue Yoji , Kamarulzaman Adeeba , Leyritana Kate , Phanuphak Nittaya , Wong Timothy , Wong TinHung , Singh Shikha , Choi Jun Yong 
Published: July 2022

BackgroundThe COVID-19 pandemic has threatened continued access to public health services worldwide, including HIV prevention and care. This study aimed to evaluate the impact of the COVID-19 pandemic on HIV service access and delivery in the Asia region.MethodsA descriptive, cross-sectional, online study, conducted between October-November 2020, assessed the impact of COVID-19 on HIV prevention and care among people living with HIV (PLHIV), key populations (KPs), and healthcare providers (HCPs). The study populations were recruited across ten Asian countries/territories, covering Hong Kong, India, Japan, Malaysia, Philippines, Singapore, Korea, Taiwan, Thailand, and Vietnam.ResultsAcross the region, 702 PLHIV, 551 KPs, and 145 HCPs were recruited. Both PLHIV and KPs reported decreased or had yet to visit hospitals/clinics (PLHIV: 35.9%; KPs: 57.5%), reduced HIV RNA viral load testing (21.9%; 47.3%), and interruptions in antiretroviral therapy (ART) (22.3%) or decreased/complete stop of HIV prevention medication consumption (40.9%). Travel constraints (40.6%), financial issues (28.9%), and not receiving prescription refills (26.9%) were common reasons for interrupted ART access, whereas reduced engagements in behaviours that could increase the risks of HIV acquisition and transmission (57.7%), travel constraints (41.8%), and less hospital/clinic visits (36.7%) underlie the disruptions in HIV preventive medications. Decreased visits from PLHIV/KPs and rescheduled appointments due to clinic closure were respectively reported by 50.7%-52.1% and 15.6%-17.0% of HCPs; 43.6%-61.9% observed decreased ART/preventive medication refills. Although 85.0% of HCPs adopted telemedicine to deliver HIV care services, 56.4%-64.1% of PLHIV/KPs were not using telehealth services.ConclusionsThe COVID-19 pandemic substantially disrupted HIV prevention to care continuum in Asia at the time of the study. The findings highlighted differences in HIV prevention to care continuum via telehealth services utilisation by PLHIV, KPs, and HCPs. Efforts are needed to optimise infrastructure and adapt systems for continued HIV care with minimal disruptions during health emergency crises.
The impact of non-alcoholic fatty liver disease on sleep apnea in healthy adults: A nationwide study of Korea
Authors: Kim Namkyun , Roh Jae-Hyung , Lee Hanbyul , Kim Doyeon , Heo Sung Jae 
Published: July 2022

Background & aims
Nonalcoholic fatty liver disease (NAFLD) is one of the most common health problems worldwide. Sleep apnea (SA) causes cardiovascular and metabolic problems, as well as a significant socioeconomic burden. Although several studies have found that SA causes NAFLD, there is no evidence that NAFLD causes SA. The goal of this study was to look at the relationship between NAFLD and SA in realworld data.

Methods
We evaluated 334,334 healthy individuals without comorbidities who underwent National Health checkups in the Republic of Korea from 2009 to 2014. NAFLD was defined by a surrogate marker, the fatty liver index (FLI). The association between FLI and SA was analyzed using multivariate Cox proportional hazards regression models.

Results
During a median followup of 5.3 years, 1,351 patients (0.4%) were newly diagnosed with SA. Subjects were categorized into quartile groups according to FLI (range: Q1, 0–4.9; Q2, 5.0–12.5; Q3, 12.6–31.0; Q4, >31.0). Subjects with higher FLIs had a significantly higher cumulative incidence of SA than those with lower FLIs (Q1, 119 [0.1%]; Q2, 210 [0.3%]; Q3, 339 [0.4%]; Q4, 683 [0.8%]; P < 0.001). Adjusted hazard ratios (HRs) revealed that a higher FLI was independently associated with an increased risk of SA (HR between Q4 and Q1, 4.03; 95% confidence interval, 3.22–5.05; P < 0.001). This association remained statistically significant after further adjustment for Body mass index (BMI) (HR between Q4 and Q1, 2.19; 95% confidence interval, 1.69–2.83; P < 0.001). FLI was significantly associated with an increased risk of new-onset SA regardless of baseline characteristics.

Conclusion
This study demonstrated that NAFLD, assessed by FLI, was independently associated with increased risk for SA in the healthy Korean population.
Initial experience with AI Pathway Companion: Evaluation of dashboard-enhanced clinical decision making in prostate cancer screening
Authors: Henkel Maurice , Horn Tobias , Leboutte Francois , Trotsenko Pawel , Dugas Sarah Gina , Sutter Sarah Ursula , Ficht Georg , Engesser Christian , Matthias Marc , Stalder Aurelien , Ebbing Jan , Cornford Philip , Seifert Helge , Stieltjes Bram , Wetterauer Christian 
Published: July 2022

Purpose
Rising complexity of patients and the consideration of heterogeneous information from various IT systems challenge the decision-making process of urological oncologists. Siemens AI Pathway Companion is a decision support tool that provides physicians with comprehensive patient information from various systems. In the present study, we examined the impact of providing organized patient information in comprehensive dashboards on information quality, effectiveness, and satisfaction of physicians in the clinical decision-making process.

Methods
Ten urologists in our department performed the entire diagnostic workup to treatment decision for 10 patients in the prostate cancer screening setting. Expenditure of time, information quality, and user satisfaction during the decision-making process with AI Pathway Companion were recorded and compared to the current workflow.

Results
A significant reduction in the physician’s expenditure of time for the decision-making process by -59.9% (p < 0,001) was found using the software. System usage showed a high positive effect on evaluated information quality parameters completeness (Cohen’s d of 2.36), format (6.15), understandability (2.64), as well as user satisfaction (4.94).

Conclusion
The software demonstrated that comprehensive organization of information improves physician’s effectiveness and satisfaction in the clinical decision-making process. Further development is needed to map more complex patient pathways, such as the follow-up treatment of prostate cancer.
Comparison of reduced field-of-view DWI and full field-of view DWI for the differentiation between non-muscle invasive bladder cancer and muscle invasive bladder cancer using VI-RADS
Authors: Juri Hiroshi , Higashiyama Akira , Yamamoto Kiyohito , Narumi Yoshifumi , Azuma Haruhito , Yamamoto Kazuhiro , Osuga Keigo 
Published: July 2022

Purpose
To evaluate whether reduced field-of-view (rFOV) DWI sequence improves the differentiation between non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC) using VI-RADS.

Material and methods
Eighty-nine patients underwent bladder MRI with full field-of-view (fFOV) DWI and rFOV DWI sequence. Images were independently evaluated by 2 radiologists. The sensitivities, specificities, accuracies, and areas under the curve (AUCs) for the differentiation between NMIBC and MIBC with fFOV DWI and with rFOV DWI sequence were calculated using VI-RADS. Apparent diffusion coefficients (ADC) values were measured for each patient and averaged.

Results
The sensitivity, specificity, accuracy, and AUC by reader 1 were 92%, 78%, 82% and 0.905 with fFOV DWI, and 92%, 86%, 88% and 0.916 with rFOV DWI sequence, respectively. The sensitivity, specificity, accuracy and AUC by reader 2 were 96%, 76%, 82% and 0.900 with conventional DWI, and 96%, 81%, 85% and 0.907 with rFOV DWI sequence, respectively. The specificity and accuracy of reader 1 were significantly better with rFOV DWI sequence than with fFOV DWI, in contrast there was no significant difference for the others. The average of ADC values of fFOV DWI and rFOV DWI sequence were 1.004×10−6 mm2/s and 1.003×10−6 mm2/s, respectively.

Conclusion
The diagnostic ability of rFOV DWI sequence may be better than that of fFOV DWI using VI-RADS for the differentiation between NMIBC and MIBC regardless of image-reading experience, it is controversial.
Hierarchical improvement of regional tissue oxygenation after packed red blood cell transfusion
Authors: Balegar V. Kiran Kumar , Jayawardhana Madhuka , Martin Andrew J. , de Chazal Philip , Nanan Ralph Kay Heinrich 
Published: July 2022

Background
It is well established that counter-regulation to hypoxia follows a hierarchical pattern, with brain-sparing in preference to peripheral tissues. In contrast, it is unknown if the same hierarchical sequence applies to recovery from hypoxia after correction of anemia with packed red blood cell transfusion (PRBCT).

Objective
To understand the chronology of cerebral and splanchnic tissue oxygenation resulting after correction of anemia by PRBCT in preterm infants using near-infrared spectroscopy (NIRS).

Design
Prospective cohort study.

Setting
Neonatal intensive care.

Patients included
Haemodynamically stable infants: <32 weeks gestation, <37weeks postmenstrual age, <1500 grams birth weight; and ≥120 mL/kg/day feeds tolerated.

Intervention
PRBCT at 15 mL/Kg over 4 hours.

Main outcome measures
Transfusion-associated changes were determined by comparing the 4-hour mean pre-transfusion cerebral and splanchnic fractional tissue oxygen extraction (FTOEc0; FTOEs0) with hourly means during (FTOEc1-4; FTOEs1-4) and for 24 hours after PRBCT completion (FTOEc5-28; FTOEs5-28).

Results
Of 30 enrolled infants, 14[46.7%] male; median[IQR] birth weight, 923[655–1064]g; gestation, 26.4[25.5–28.1]weeks; enrolment weight, 1549[1113–1882]g; and postmenstrual age, 33.6[32.4–35]weeks, 1 infant was excluded because of corrupted NIRS data. FTOEc significantly decreased during and for 24 hours after PRBCT (p < 0.001), indicating prompt improvement in cerebral oxygenation. In contrast, FTOEs showed no significant changes during and after PRBCT (p>0.05), indicating failure of improvement in splanchnic oxygenation.

Conclusion
Improvement in regional oxygenation after PRBCT follows the same hierarchical pattern with a prompt improvement of cerebral but not splanchnic tissue oxygenation. We hypothesise that this hierarchical recovery may indicate continued splanchnic hypoxia in the immediate post-transfusion period and vulnerability to transfusion-associated necrotizing enterocolitis (TANEC). Our study provides a possible mechanistic underpinning for TANEC and warrants future randomised controlled studies to stratify its prevention.
Applied Theatre and Sexual Health Communication: Apertures of Possibility, Katharine E. Low (2020)
Authors: Hahn Matthew 
Published: July 2022

Review of: Applied Theatre and Sexual Health Communication: Apertures of Possibility, Katharine E. Low (2020)
London: Palgrave Macmillan, 323 pp.,
ISBN 978-1-34995-975-4, ebook, $69.99
ISBN 978-1-34995-974-7, h/bk, $89.99
Ozanimod Maintenance Therapy After Cyclosporine Induction in Acute Severe Ulcerative Colitis
Authors: Cohen Nathaniel A. , Dalal Sushila R. , Choi David , Rubin David T. 
Published: July 2022

ABSTRACT
Ozanimod has recently received US Food and Drug Administration approval for moderate-to-severe ulcerative colitis. Treatment of acute severe colitis remains a clinical challenge, and although many patients respond to cyclosporine therapy, there remains a relative paucity of maintenance options. This case report describes the first reported, successful use of ozanimod after hospitalization for acute severe ulcerative colitis and in tandem with cyclosporine. Although a longer follow-up is required, this report shows the feasibility of ozanimod in this clinical setting.
A Community-Based Pancreatic Cancer Screening Study in High-Risk Individuals: Preliminary Efficacy and Safety Results
Authors: Kandiah Jonathan , Lo Tammy , Jin Dugho , Melchior Landon , Krebs Thorsten L. , Anand Naveen , Ingram Susan , Krumholtz Pramila , Pandya Deep , Trinidad Antolin , Dong Xiang (Eric) , Seshadri Ramanathan , Bauman James , Lee Ronald , Frank Richard C. 
Published: July 2022

INTRODUCTION:
Pancreatic cancer (PC) screening recommendations have been based on studies performed solely at high-volume academic centers. To make PC screening more widely available, community-based efforts are essential. We implemented a prospective PC screening study in the community of Fairfield County, CT, and report our early safety and efficacy results.

METHODS:
Eligible individuals were enrolled into an investigator-initiated study and underwent a baseline and 3 annual magnetic resonance imagings/magnetic resonance cholangiopancreatographies (MRIs/MRCPs) with gadolinium, biannual blood donations for biobanking, and assessments for anxiety and depression. All MRIs were presented at a multidisciplinary board to determine whether further investigation was warranted.

RESULTS:
Seventy-five individuals have been enrolled and 201 MRIs performed over a 2.6-year average length of follow-up. Abnormal pancreatic findings (predominantly small cysts) were detected in 58.7% of the participants. Among these, 6.7% underwent endoscopic ultrasound, with 1 case complicated by postprocedural pancreatitis. One surgical resection was performed on a 4.7-cm intraductal papillary mucinous neoplasm with a focus on low-grade pancreatic intraepithelial neoplasia. One incidental finding of fibrosing mediastinitis was detected. Anxiety and depression scores decreased over the course of this study from 21.4% to 5.4% and 10.7% to 3.6%, respectively.

DISCUSSION:
This preliminary report supports the feasibility of performing MRI/magnetic resonance cholangiopancreatographies-based PC screening as part of a clinical trial in a community setting. A longer follow-up is needed to better assess safety and efficacy. To the best of our knowledge, this is the first report from a community-based PC screening effort (clinicaltrials.gov ID: NCT03250078).
Diagnostic accuracy of calf circumference for decreased muscle mass in older adults with sarcopenia
Authors: Pusparini Novi Diah , Probosari Enny , Murbawani Etisa Adi , Muis Siti Fatimah , Christianto Febe 
Published: July 2022

Background: Increasing number of the older adults population results in increasing sarcopenia, a geriatric problem that may lead to poor quality of life, susceptibility to disease, malnutrition, and even death. Muscle mass is an important sarcopenia parameter that can be measured by Bioelectrical Impedance Analysis (BIA). Detection of decreased muscle mass can be done by measuring calf circumference, it is expected to provide an early diagnose of sarcopenia so that early intervention can be given and improve the quality of life of the older adults.Objective: To analyze the diagnostic accuracy of calf circumference for decreased muscle mass in older adults to provide simple way in diagnosing sarcopenia.Methods: This study involved 126 older adults, consisted of 57 men and 69 women aged 60-80 years in the community who met the inclusion criteria. Criteria of sarcopenia were defined based on the Asian Working Group for Sarcopenia (AWGS) Consensus, consisted of three components; muscle mass, handgrip strength, and walking speed. This study analyze the diagnostic accuracy of calf circumference for decreased muscle mass measured by single- frequency BIA and calf circumference was measured using a measuring tape. The analysis was carried out according to the receiver operating characteristic (ROC) curve to determine the cut-off point along with the sensitivity (Se) and specificity (Sp) values, positive and negative predictive values (PPV and NPV) of calf circumference as an indicator for low muscle mass.Results: Optimal cut-off point of calf circumference to indicate low muscle mass is 32.9 cm in women (Se 80.8%, Sp 79.1%, PPV 75.9%, NPV 87.5%) and 33.5 cm in men (Se 78.6%, Sp 74.4%, PPV 50%, NPV 91.4%). PPV in men is lower than women. This is due to a lower prevalence of decreased muscle mass in men than women. There were 49 participants with the calf circumference below cut-off point and 40 (31.7%) of the 126 participants had sarcopenia.Conclusion: Calf circumference has a diagnostic accuracy to find decreased muscle mass in sarcopenia.
Actualizing Learning English Grammar Strategy Using New Inventory for University Students
Authors: Syafryadin Syafryadin 
Published: July 2022

Learning grammar strategies have been explored by students and teachers. Moreover, research on this issue has been done by several researchers. However, new inventory to measure learning English grammar strategy has been developed and not implemented to identify students’ learning strategy. Thus, the present study aimed to implement and identify the students’ English learning grammar strategy by using new inventory. Besides, this study also wanted to know the challenges of students in implementing those strategies. This study used Mixed method with sequential explanatory. The participants of this research were 30 students of English Language Department in one of the universities in Bengkulu. The instrument of this study used questionnaire of Grammar Learning Strategy Inventory (GLSI) and the interview guideline. Those instruments have been validated by two expert judgments and tried out to another class. The quantitative data were analysed by using simple statistic calculation and using percentage for every learning strategy type. However, the qualitative data analysis comprised several steps namely data collection, data condensation, data display, and conclusion. The result shows that students used all strategies in learning grammar, but the dominant one is cognitive strategy, while the least one is social strategy. The challenges in implementing learning strategy or in learning grammar were poor knowledge of grammar, ineffective time management, less group work, and less sociable because of Covid-19.
PERANCANGAN DAN PENGENDALIAN MANIPULATOR ROBOT 4-DOF DENGAN GRIPPER BERBASIS INVERSE KINEMATICS DAN TRAJECTORY PLANNING DENGAN ROS
Authors: Setiyadi Ahmad Didik , Setiawan Iwan , Afrisal Hadha 
Published: July 2022

Penyebaran virus korona terjadi dari manusia ke manusia melalui droplet dan udara, kontak fisik atau jarak dekat manusia ke manusia merupakan penyebab utama penularan virus korona meskipun dengan penggunaan alat perlindungan diri (APD), ini dibutktikan dengan meninggalnya lebih dari 1400 tenaga medis karena terpapar COVID-19 per tanggal Juli 2021 di Indonesia. Penelitian ini dirancang robot manipulator 4 DOF (RPRR) dengan sistem ROS menggunakan penggerak motor stepper Nema 17 serta dengan sistem pengendalian inverse kinematics dan trajectory planning dengan fungsi sigmoid yang bekerja pada joint space. Untuk mengurangi osilasi pada pergerakan robot ditambah kontrol proporsional dengan nilai KP=10 yang dihasilkan dengan metode trial and error. Robot dirancang untuk memindahkan tabung reaksi. Dari hasil rancangan robot yang dibangun robot dapat melakukan pergerakan dengan presisi ditunjukan dengan pengujian kinematika balik dengan galat rata-rata pada sumbu x sebesar 0,62 mm, pada sumbu y sebesar 0,55 mm, dan pada sumbu z sebesar 0,36 mm. Performa dari trajectory planning pada joint space saat mencapai koordinat tujuan joint 1 memiliki galat 0,20º, joint 2 sebesar 0,20º, pada joint 3 sebesar 0,17º, dan pada joint 4 sebesar 0.18º. Robot manipulator 4 DOF saat melakukan tugas pick and place tabung reaksi memiliki galat rata-rata 1,46 mm.