bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-term effectiveness and tolerability of carbon dioxide laser for anal high-grade squamous intraepithelial lesions in individuals living with HIV
Authors: Fuertes Irene , Chivite Iván , Cranston Ross D , Sánchez Emilia , Cordón Encarna , Rodríguez-Carunchio Leonardo , Blanco José L 
Published: May 2022

Background: Ablative treatment of intra-anal high-grade squamous intraepithelial lesions (HSIL) reduces the risk of progression to anal squamous cell carcinoma. Our objective was to assess the short-term effectiveness and tolerability of the carbon dioxide laser for treating intra-anal HSIL in patients at high risk of anal cancer. Methods: This is an exploratory, pilot, single-arm, clinical trial of treatment response for anal HSIL in people living with HIV diagnosed with ≤3 not previously treated HSILs. Individuals were treated with one carbon dioxide laser treatment session. Clinical assessment by high resolution anoscopy and systematic recording of adverse events was performed. Results: Fifty-two patients with 72 HSILs were included. Response to treatment was assessed in 48 (92.3%) patients; in the per-protocol population analysis, complete, partial, and no response was seen in 50% ( n = 24), 20.8% ( n = 10) and 29.1% ( n = 14), respectively. Being older than 40 years and having a CD4 T-cell count lower than 200 cells/μL at diagnosis of HSIL were significantly associated with a poor response to treatment. Data on adverse events was recorded for 49 patients and 69.4% ( n=34) reported no symptoms after the procedure. Conclusions: Carbon dioxide laser ablation is a promising and well tolerated treatment for intra-anal HSIL.
Evaluating specimen pooling for Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium screening in asymptomatic men who have sex with men
Authors: Moran Angelica , Gipson Monique , Hazra Aniruddha , Tesic Vera 
Published: May 2022

Background Screening for Neisseria gonorrhoeae and Chlamydia trachomatis is recommended for individuals at high-risk for sexually transmitted infections (STIs), while the role of Mycoplasma genitalium screening is still unclear. We evaluated whether specimen pooling is an effective alternative for sexually transmitted infection testing during resource shortages. Methods This 2-year prospective study enrolled 135 asymptomatic patients from a community outreach site who identified as men who have sex with men. Oropharyngeal, urine, and/or rectal swab specimens were pooled and tested using the Aptima Combo 2 assay for Neisseria gonorrhoeae and Chlamydia trachomatis. The Aptima Mycoplasma genitalium assay was performed on 34 patients whose specimens had sufficient sample volume for additional testing. Results from pooled specimens were compared to results obtained by individual-site testing. Results The positive percent agreement (PPA) between pooled testing and individual-site testing was 93.8% and negative percent agreement (NPA) was 100% for Neisseria gonorrhoeae. For Chlamydia trachomatis, the PPA was 85.7% and NPA was 99.2%. A PPA of 72.7% and NPA of 95.7% were observed for Mycoplasma genitalium. Discrepancy analysis revealed the majority of false-negative pools were from failure to detect positive rectal samples. Conclusions Specimen pooling reduces sensitivity of the Aptima assays for Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium and thus should be used with caution.
Factors associated with non-use of condoms among heterosexually-active single people in Germany: Results from the first representative, population-based German health and sexuality survey (GeSiD)
Authors: Cerwenka Susanne , Wiessner Christian , Mercer Catherine H , Matthiesen Silja , Pietras Laura , von Rüden Ursula , Dekker Arne , Briken Peer 
Published: May 2022

Background: Against the backdrop of rising STI incidence among the heterosexual population, sexually active single people are at particularly high STI transmission risk. Gaining insight into circumstances related to condoms non-use in this population is therefore important for developing effective health interventions. Methods: The nationally-representative survey, GeSiD (German Health and Sexuality Survey) undertaken 2018–2019, interviewed 4,955 people aged 18–75 years. A total of 343 heterosexually-active single participants answered a question about condom use at last sex. Data on sociodemographic characteristics, sexual behaviours and circumstances of last sex were analysed to identify independently associated factors. Results: Condom non-use at last sex was reported more commonly by participants aged >35 years than by younger participants (48.5 vs 33.7%, respectively) and more likely among longer relationships (adjusted odds ratio [AOR]: 2.43) or early loving relationships (AOR: 3.59) than in one-night-stands. It was also associated with not discussing using condoms before sex (AOR: 6.50) and with reporting non-use of condoms at sexual debut (AOR: 4.75). Conclusions: Non-use of condoms is a common STI risk behaviour among heterosexually-active single people in Germany and so needs promoting from sexual debut throughout the life course, regardless of relationship type and age, but particularly among middle-aged and older people.
Feasibility and Burden of Lay Caregivers Providing Daily Massages to Patients With Cancer Receiving Hospice and Palliative Care
Authors: Moosvi Karen , Schoppee Tasha M. , Xavier Stacy , Henderson Kristen , Suarez Marie L. , Yao Yingwei , Wilkie Diana J. 
Published: May 2022

Professional massages reduce symptoms experienced by cancer patients, but are costly. A cost-effective way to include this therapy routinely in hospice care is to teach family caregivers to give massages as part of their caregiving activities. However, the burden on caregivers is unknown and might offset patient benefits or cost savings. The pilot study aim was to explore feasibility issues related to licensed massage therapists training caregivers to give massages at home, the burden of giving four daily massages to hospice patients, and feedback about the training and massage delivery. In this pretest/posttest study, caregivers completed the Caregiver Reaction Assessment (CRA), received training on standardized massage techniques from a licensed massage therapist who evaluated their proficiency the following day. Caregivers gave daily massages for 3 days and afterward completed the CRA. Then a researcher interviewed the dyad for feedback about the training and massage delivery. We used paired t tests to evaluate CRA scores and content analysis of interview data. Thirty-nine caregivers (mean age = 46 years, 69% female) completed the study. After training, all but three caregivers provided daily massages. Some caregivers reported minor logistical challenges in massage delivery and documentation, mutual satisfaction, relaxation, and tender moments ranging from laughter and story sharing to closure activities. Mean CRA scores were not significantly different pretest to posttest. We conclude that repeated-dose massages by caregivers to patients dying of cancer is feasible and is worthy of further study to determine the benefits of massage therapy, caregiver and patient experiences, and caregiver burden.
The Impact of Metabolic Syndrome on Quality of Life Among Individuals With Knee Osteoarthritis Living in Egypt
Authors: Samaan Sara F. , Taha Sara I. 
Published: May 2022

Background: Several studies have linked metabolic syndrome (MetS) to osteoarthritis (OA), but they have not looked into how MetS can affect the health-related quality of life (HRQOL) of OA individuals. Objectives: We aimed to assess the association of MetS and its components, including obesity, hypertension, hyperglycemia, and dyslipidemia, with HRQOL among Egyptians with knee OA. Methods: This cross-sectional study comprised 116 adult Egyptian participants with knee OA. They were divided into 2 groups based on whether or not they had the MetS. All participants were subjected to a thorough medical history taking and a detailed medical examination. The Kellgren and Lawrence (K/L) scale evaluated OA in all individuals using anteroposterior knee radiographs. The Health Assessment Questionnaire-Disability Index (HAQ-DI) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to assess participants’ HRQOL; their higher scores indicate more disability. Spearman rank and Pearson’s correlation analyses were used to assess the association between variables. Results: Diabetes, hypertension, dyslipidemia, and obesity were significantly associated with the OA + MetS group with a prevalence of 77.6%, 82.8%, 77.6%, and 50.0%, respectively. According to the K/L scale, 70.7% of the OA + MetS group had grade IV knee affection. The HAQ-DI and WOMAC scores were significantly ( P < .001) higher among the OA + MetS individuals compared with the OA individuals. Interleukin (IL)-6 serum levels were also significantly higher in the OA + MetS group ( P = .036) and increased significantly with the more serious radiological damage and functional disability. We found significant positive correlations between HAQ-DI and WOMAC with waist circumference ( P = .004, .001), as well as triglycerides ( P = .006, .008), cholesterol ( P = .041, .048), fasting blood sugar ( P < .001, < .001) and significant negative correlations with high-density lipoprotein levels ( P = .628, .002). Conclusions: Individuals with knee OA with MetS showed more significant radiological damage, severe functional disability, and poor HRQOL. They also had higher levels of IL-6, which correlated significantly with the degree of disability, promoting it as a significant therapeutic target.
Comparative study of stator current-based and vibration-based methods for railway traction motor bearing cage fault diagnosis at high-speed condition
Authors: Sun Qi , Chen Chunjun , Liu Xinchang 
Published: May 2022

Traction motor’s rolling element bearings are one of the most critical components for the structural health monitoring of high-speed train vehicles. Most structural health monitoring techniques for railway rolling element bearings are using vibration signal. However, the vibration characteristic of cage defect is difficult to be transmitted to external monitoring point owing to the location of cage in bearing. Hence, the cage defect of Railway Traction Motor Bearing (RTMB) is usually difficult to be recognized with motor housing vibration acceleration signal. Considering Induction Motor (IM) itself a sensor, the mechanical imbalance of bearing cage defect can reflect in stator current through the motor gap magnetic field rather than a solid transmission path. A novel strategy with stator current for monitoring the traction motor bearing cage health status in High-Speed Train (HST) is proposed in this paper. This method requires no additional sensor in the practical application. To prove the strategy is feasible and more effective than vibration-based method for the cage fault diagnosis of RTMB, a comprehensive experiment investigation with a real railway traction motor of a HST is completed. Artificial cage defects are processed on bearings at both ends of the induction motor, respectively. Three high-speed (≥250 km/h) conditions are observed. The data analysis results show that vibration-based method is almost invalid at high-speed condition and the proposed current-based method is feasible and effective for the fault diagnosis of high-speed railway traction motor bearing cage.
Contrast Enhanced Computed Tomography in the Diagnosis of Acute Pyogenic Flexor Tenosynovitis
Authors: Myers Devon M. , Goubeaux Craig , Skura Brian , Warmoth Patrick J. , Taylor Benjamin C. 
Published: May 2022

Background: The diagnosis of infectious flexor tenosynovitis (FTS) has historically been made based on physical exam using Kanavel’s signs. The specificity of these findings has come into question. We looked to evaluate the use of contrast-enhanced computed tomography (CT) in increasing the successful diagnosis of FTS. Methods: Two adult cohorts were formed, one of patients with FTS confirmed in the operating room and the second of patients with ICD.10 identified finger cellulitis (FC), without concomitant FTS. Demographics, laboratory values, CT scans, and examination findings were evaluated. Axial CTs were evaluated in the coronal and sagittal planes and tendon sheath/tendon width were measured. The tendon sheath/tendon was recorded as a ratio in the coronal (CR) and sagittal (SR) planes. Continuous and dichotomous variables were analyzed and measures of sensitivity, specificity, and predictivity were calculated. Seventy patients were included, 35 in the FTS cohort and 35 with FC. Result: A higher number of Kanavel signs were present in the FTS group (2.9 vs. 0.5, P < .05), with CR and SR both being significantly larger in the FTS group ( P < .05). CR and SR cutoffs ≥ 1.3 provided high sensitivity, specificity, and positive predictive value (PPV) for FTS. Likelihood of FTS increased 5.9% and 5.5% for every 0.1 increase in CR and SR, respectively, with a 14% increase for every additional Kanavel sign. Conclusion: In conclusion, CT ratios are useful in identifying FTS; and when used on their own or in combination with Kanavel’s signs, CR and SR objectively improve the diagnosis of FTS.
Cross-cultural adaptation and reliability of the Arabic version of Children’s Hand-use Experience Questionnaire (CHEQ)
Authors: Amer Ahmed , Alomari Mahmoud A. , Jarl Gustav , Ajarmeh Majd M , Migdadi Fathi , Eliasson Ann-Christin , Hermansson Liselotte 
Published: May 2022

Background Validated outcome measures are essential for assessment and treatment of children with disabilities. The Children’s Hand-use Experience Questionnaire (CHEQ) was developed and validated for use in Western countries for children with unilateral hand dysfunction. This study aimed to perform a cross-cultural adaptation and investigate reliability for the Arabic CHEQ. Methods Translation and cross-cultural adaptation were performed in four phases: (i) forward-translation and reconciliation with feedback from parents and typically developing children from Jordan ( n = 14); (ii) backward-translation and review; (iii) cognitive debriefing with parents and/or their children with unilateral hand dysfunction ( n = 17); and (iv) review and proofreading. In the psychometric analyses, 161 children from Jordan (mean age [SD] 10y 8 m [5y 8 m]; 88 males) participated. Internal consistency was evaluated with Cronbach’s alpha. Test-retest reliability was evaluated in 39 children with intraclass correlation coefficient (ICC) and weighted kappa (κ). Results Synonyms of four words were added to accommodate for different Arabic dialects. On average, 93% of children with unilateral hand dysfunction and their parents understood the CHEQ items. One response alternative, ‘ Get help’, to the opening question was unclear for 70% of the respondents and need further explanation. Two items about using a knife and fork were difficult to comprehend and culturally irrelevant. High internal consistency was demonstrated (Cronbach’s alphas 0.94- 0.97) and moderate to excellent ICC (0.77–0.93). For 18 individual items, κ indicated poor to good agreement (κ between 0.28 and 0.66). Conclusions After the suggested minor adjustments, the Arabic CHEQ will be comprehensible, culturally relevant and reliable for assessing children with unilateral hand dysfunction in Jordan.
Effects of oral glibenclamide versus subcutaneous insulin on perinatal outcome of patients with gestational diabetes mellitus: A randomized clinical trial
Authors: Faraji Azam , Tahamtani Lida , Maharlouei Najmeh , Asadi Nasrin 
Published: May 2022

Background The first-line treatment for gestational diabetes mellitus remains insulin, but oral hypoglycemic agents are easier and cheaper to use. The aim of the current study was to compare the efficacy and safety of oral glibenclamide and subcutaneous insulin on the serum glucose control and perinatal outcome of patients with gestational diabetes mellitus. Materials and methods This randomized clinical trial was conducted during a 2-year period from 2017 to 2019 in two tertiary healthcare centers in Shiraz, Iran. We included 84 singleton pregnancies between 24 and 34 weeks of gestation diagnosed with gestational diabetes mellitus. Patients were randomly assigned to oral glibenclamide ( n = 44) or subcutaneous insulin ( n = 40) according to a standard protocol and followed until delivery. The primary endpoint was to compare the glycemic level of patients, and the secondary outcomes included pregnancy adverse events and neonatal complications such as preeclampsia, preterm and premature rupture of membranes, preterm labor, placental abruption, maternal hypoglycemia, birth weight, neonatal hypoglycemia, hyperbilirubinemia, respiratory distress syndrome, and neonatal intensive care unit admission. Results The two study groups had comparable baseline characteristics. After treatment, the two study groups were comparable regarding fasting blood glucose ( p = 0.398) and 2 h postprandial glucose ( p = 0.085). There was no significant difference between the two groups regarding the rate of preeclampsia ( p = 0.250), preterm rupture of membranes ( p = 0.998), preterm labor ( p = 0.495), hypoglycemia ( p = 0.476), and abruption ( p = 0.815). There was no significant difference between the two study groups in birth weight ( p = 0.863) and the Apgar score at 1 ( p = 0.190) and 5 min ( p = 0.055). The rates of neonatal adverse events including hypoglycemia ( p = 0.999), hyperbilirubinemia ( p = 0.160), neonatal intensive care unit admission ( p = 0.852), and respiratory distress syndrome ( p = 0.665) were comparable between the two groups. Conclusion The results of the current study demonstrate that oral glibenclamide is as effective and safe as subcutaneous insulin in glycemic control and maternal and neonatal outcomes in women with gestational diabetes mellitus. Thus, it could be used as first-line treatment of gestational diabetes mellitus.
Assessment of Healthcare Professionals’ Wellbeing During a Peak of the COVID-19 Pandemic in a Healthcare System in Ohio
Authors: Dyer Natalie L , Adan Francoise , Barnett Tyler , Dusek Jeffery A 
Published: May 2022

Objective The purpose of this cross-sectional study was to evaluate multiple indices of wellbeing in healthcare professionals during the COVID-19 pandemic. Methods Healthcare professionals were invited to participate across the University Hospitals healthcare system in Ohio, USA. Participants (N = 6397) completed online questionnaires on their wellbeing, including healthy behaviors, safety and security, mental and physical health concerns, and social support. Differences in wellbeing across demographics were also assessed. Results Overall, healthcare professionals’ mean subjective wellbeing was 7.98 (1.50) and their future health score was 3.98 (1.13). Room for improvement was noted for diet, sleep, and positive thinking. Males reported significantly higher levels of overall wellbeing and future health scores, including fruit and vegetable intake and physical activity, and alcohol use, whereas females reported higher levels of positive thinking and tobacco use. Of the three largest racial groups, White and Asian employees scored significantly higher on future health, M = 4.00 (1.17) and M = 4.10 (1.13), than Black or African American employees, M = 3.74 (1.10). Conclusions This cross-sectional study assessed the wellbeing of healthcare workers during the initial peak of the COVID-19 pandemic prior to vaccine delivery. Future work will implement strategies to improve healthcare workers’ wellbeing in an individualized way based on our findings, as well as evaluate changes in wellbeing and future health scores across time.
HLA-matching with PTCy: a reanalysis of a CIBMTR dataset with propensity score matching and donor age
Authors: Ambinder Alexander , Jain Tania , Tsai Hua-Ling , Horowitz Mary M. , Jones Richard J. , Varadhan Ravi 
Published: May 2022

Abstract
Blood or marrow transplantation (BMT) outcomes using haploidentical donors (Haplo) and posttransplant cyclophosphamide (PTCy)-based graft-versus-host disease (GVHD) prophylaxis compare favorably to HLA-matched donors using calcineurin inhibitor–based prophylaxis. A recent Center for International Blood and Marrow Transplant Research analysis of patients receiving homogenous PTCy-based prophylaxis found that, with reduced intensity conditioning, Haplo BMTs had worse outcomes than matched unrelated donor (MUD) BMTs. Due to significant differences between groups, we reanalyzed the dataset using propensity score matching and, additionally, added a donor age variable. After matching MUD BMTs to Haplo BMTs in a 1:5 ratio, no significant differences were found between groups across all measured baseline characteristics. Outcomes analyses demonstrated no significant differences in overall survival (hazard ratio [HR] of mortality with MUD vs Haplo [95% confidence interval], 0.95 [0.65-1.16], P = .75), disease-free survival (HR of relapse or death, 0.98 [0.73-1.18], P = .89), relapse rate (HR, 1.06 [0.77-1.38], P = .69), or nonrelapse mortality (NRM) (HR, 0.85 [0.42-1.13], P = .49) between groups. After stratification by conditioning intensity, MUD BMTs in the reduced-intensity cohort had lower risk of NRM (HR, 0.56 [0.14-0.99], P = .05), with no significant difference in other clinical outcomes. These results suggest the effect of HLA matching on BMT outcomes with PTCy is less meaningful than previously reported. Timely identification of a young, at least half-matched (related or unrelated) donor may be more important than finding a fully matched donor if the latter leads to a delay in BMT or use of an older donor.
Anticoagulant therapy for splanchnic vein thrombosis: an individual patient data meta-analysis
Authors: Candeloro Matteo , Valeriani Emanuele , Monreal Manuel , Ageno Walter , Riva Nicoletta , Lopez-Reyes Raquel , Peris Maria Luisa , Beyer Westendorf Jan , Schulman Sam , Rosa Vladimir , López-Núñez Juan José , Garcia-Pagan Juan-Carlos , Magaz Marta , Senzolo Marco , De Gottardi Andrea , Di Nisio Marcello 
Published: May 2022

Abstract
Robust evidence on the optimal management of splanchnic vein thrombosis (SVT) is lacking. We conducted an individual-patient meta-analysis to evaluate the effectiveness and safety of anticoagulation for SVT. Medline, Embase, and clincaltrials.gov were searched up to June 2021 for prospective cohorts or randomized clinical trials including patients with SVT. Data from individual datasets were merged, and any discrepancy with published data was resolved by contacting study authors. Three studies of a total of 1635 patients were included. Eighty-five percent of patients received anticoagulation for a median duration of 316 days (range, 1-730 days). Overall, incidence rates for recurrent venous thromboembolism (VTE), major bleeding, and mortality were 5.3 per 100 patient-years (p-y; 95% confidence interval [CI], 5.1-5.5), 4.4 per 100 p-y (95% CI, 4.2-4.6), and 13.0 per 100 p-y (95% CI, 12.4-13.6), respectively. The incidence rates of all outcomes were lower during anticoagulation and higher after treatment discontinuation or when anticoagulation was not administered. In multivariable analysis, anticoagulant treatment appeared to be associated with a lower risk of recurrent VTE (hazard ratio [HR], 0.42; 95% CI, 0.27-0.64), major bleeding (HR, 0.47; 95% CI, 0.30-0.74), and mortality (HR, 0.23; 95% CI, 0.17-0.31). Results were consistent in patients with cirrhosis, solid cancers, myeloproliferative neoplasms, unprovoked SVT, and SVT associated with transient or persistent nonmalignant risk factors. In patients with SVT, the risk of recurrent VTE and major bleeding is substantial. Anticoagulant treatment is associated with reduced risk of both outcomes.