bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Intermittent Peritoneal Dialysis in Critically Ill COVID-19 Patients with Renal Failure: Saviour or Succourer
Authors: Varghese Benoy , Rajagopalan Arul , Arunachalam Jegan , Prasath Arun , Durai Rakesh 
Published: April 2022

Background:
The COVID-19 pandemic has led to an increase in critically ill patients with renal failure, with many requiring renal replacement therapies. Unfortunately, many of them are too critically ill to tolerate intermittent hemodialysis. In the setting of limited resources, we did bedside acute intermittent peritoneal dialysis for critically ill COVID-19 patients with hemodynamic instability with or without ventilator support admitted to our intensive care unit.

Objective:
The aim of the study was to determine the outcome of intermittent peritoneal dialysis in critically ill COVID-19 patients.

Methods:
Our retrospective observational study included 91 patients with critically ill SARS-CoV2 infection and renal failure admitted to the intensive care unit of our hospital from July 2020 to September 2021, who underwent acute intermittent peritoneal dialysis.

Results:
The demographic, laboratory, and treatment parameters were compared between survivors and non-survivors. Variables, like increased mean age (49.88 vs. 59.07 years), presence of diabetes mellitus (36.4% vs. 63.8%), increased lung involvement (57.3% vs. 75.0%), mechanical ventilation (15.2% vs. 70.7%), systolic (84.3 vs. 77.5 mm of Hg) and diastolic (59.09 vs. 42.93 mm of Hg) blood pressures, were associated with poor outcomes. The use of hypertonic PD (63.6% vs. 37.9%), better urea reduction ratios (44.33 vs. 39.84), and increased PD cycles (66.52 vs. 44.26) were associated with a better outcome. Complications, like haemorrhage and peritonitis, occurred in 10.9%.

Conclusion:
PD is a cost-effective bedside RRT that can be considered an effective option in critically ill COVID-19 patients. Good urea clearance, hemodynamic stability, and minimal resource requirements are also the features that favour peritoneal dialysis.
Stress, Depression, Anxiety, and Burnout among Healthcare Workers during the COVID-19 Pandemic: A Cross-sectional Study in a Tertiary Centre
Authors: Jaber Mohammad J. , AlBashaireh Ahmad M. , AlShatarat Mohammad H. , Alqudah Ola M. , Du Preez Susanna E. , AlGhamdi Khalid S. , AlTmaizy Hind M. , Abo Dawass Mohammad A. 
Published: April 2022

Background:Healthcare workers have been known to suffer from depression, anxiety, and other mental health issues as a result of their profession. Healthcare professionals were already vulnerable to mental health issues prior to the COVID-19 pandemic, but now they are even more prone to stress and frustration.Objective:The study aimed to assess stress, depression, anxiety, and burnout among healthcare workers during the COVID-19 pandemic. Moreover, it assessed the relationship between stress, depression, anxiety, burnout, and COVID-19 related stress.Methods:A cross-sectional, descriptive, and correlative design was adopted to assess stress, depression, anxiety, and burnout among healthcare workers and determine the relationship among these variables during the COVID-19 pandemic.Results:The response rate was 87.6% (831 out of 949), the majority of the participants were nurses (87.4%), and 38.4% were working in inpatient settings. The means of COVID-19 related anxiety (17.38 ± 4.95) and burnout (20.16 ± 6.33) were high and tended to be in the upper portion of the total scores. Participants reported moderate to extremely severe levels of stress (26.5%), anxiety (55.8%), and depression (37.2%). Males reported a higher level of stress (16.59 ± 10.21vs.13.42 ± 9.98, p = 0.002) and depression (14.97 ± 10.98vs.11.42 ± 10.56, p = 0.001). COVID-19 related anxiety was significantly correlated with participants’ professions (p = 0.004). Burnout (p = 0.003) and depression (p = 0.044) were significantly correlated with the participants’ working area. Significant positive correlations were found between stress, depression, anxiety, burnout, and COVID-19 related stress.Conclusion:Healthcare workers may experience considerable psychologic distress as a result of the COVID-19 pandemic due to providing direct patient care, quarantine, or self-isolation. Healthcare workers who were at high risk of contracting COVID-19 appeared to have psychological distress, burnout, and probably, chronic psychopathology. Frontline staff, especially nurses, were at higher risk of showing higher levels of psychological and mental health issues in the long term.
A Review of Computational Approaches Targeting SARS-CoV-2 Main Protease to the Discovery of New Potential Antiviral Compounds
Authors: Castillo-Garit Juan A. , Cañizares-Carmenate Yudith , Pham-The Hai , Pérez-Doñate Virginia , Torrens Francisco , Pérez-Giménez Facundo 
Published: April 2022

Abstract:The new pandemic caused by the coronavirus (SARS-CoV-2) has become the biggest challenge that the world is facing today. It has been creating a devastating global crisis, causing countless deaths and great panic. The search for an effective treatment remains a global challenge owing to controversies related to available vaccines. A great research effort (clinical, experimental, and computational) has emerged in response to this pandemic, and more than 125000 research re-ports have been published in relation to COVID-19. The majority of them focused on the discovery of novel drug candidates or repurposing of existing drugs through computational approaches that significantly speed up drug discovery. Among the different used targets, the SARS-CoV-2 main protease (Mpro), which plays an essential role in coronavirus replication, has become the preferred target for computational studies. In this review, we examine a representative set of computational studies that use the Mpro as a target for the discovery of small-molecule inhibitors of COVID-19. They will be divided into two main groups, structure-based and ligand-based methods, and each one will be subdivided according to the strategies used in the research. From our point of view, the use of combined strategies could enhance the possibilities of success in the future, permitting to devel-opment of more rigorous computational studies in future efforts to combat current and future pan-demics.
Magnetic Resonance Imaging Angiography of Physiological and Pathological Pregnancy Placentas Ex Vivo: Protocol for a Prospective Pilot Study
Authors: Dap Matthieu , Chen Bailiang , Banasiak Claire , Hossu Gabriela , Morel Olivier , Beaumont Marine , Bertholdt Charline 
Published: April 2022

Background
Preeclampsia (PE) and intrauterine growth restriction (IUGR) are 2 major pregnancy complications due to abnormal placental vasculogenesis. Data on whole fetoplacental vasculature are still missing; hence, these pathologies are not well understood. Ex vivo magnetic resonance imaging (MRI) angiography has been developed to characterize the human placental vasculature by injecting a contrast agent within the umbilical cord.

Objective
The primary objective of this study is to compare the placental vascular architecture between normal and pathological pregnancies. This study’s secondary objectives are to (1) compare texture features on MRI between groups (normal and pathological), (2) quantitatively compare the vascular architecture between both pathological groups (pathological IUGR, and pathological PE), (3) evaluate the quality of the histological examination in injected placentas, and (4) compare vascularization indices to histological characteristics.

Methods
This is a prospective controlled study. We expect to include 100 placentas: 40 from normal pregnancies and 60 from pathological pregnancies (30 for IUGR and 30 for PE). Ex vivo MR image acquisition will be performed shortly after delivery and with preparation by injection of a contrast agent in the umbilical cord. The vascular architecture will be quantitatively described by vascularization indices measured from ex vivo MRI angiography data. Comparisons of vascularization indices and texture features in accordance with the group and within comparable gestational age will be also performed. After MR image acquisition, placental histopathological analysis will be performed.

Results
The enrollment of women began in November 2019. In view of the recruitment capacity of our institution and the availability of the MRI, recruitment should be completed by March 2022. As of November 2021, we enrolled 70% of the intended study population.

Conclusions
This study protocol aims to provide information about the fetal side of placental vascular architecture in normal and pathological placenta through MRI.

Trial Registration
Clinicaltrials.gov NCT04389099; https://clinicaltrials.gov/ct2/show/NCT04389099

International Registered Report Identifier (IRRID)
DERR1-10.2196/35051
Integrating Hepatitis C Care for Opioid Substitution Treatment Patients Attending General Practice: Feasibility, Clinical, and Cost-Effectiveness Analysis
Authors: McCombe Geoff , Swan Davina , Lambert John S , O’Connor Eileen , Ward Zoe , Vickerman Peter , Avramovic Gordana , Crowley Des , Tinago Willard , Mafirakureva Nyashadzaishe , Cullen Walter 
Published: April 2022

Background
Hepatitis C virus (HCV) infection is common among people who inject drugs, yet well-described barriers mean that only a minority have accessed HCV treatment. Recent developments in HCV diagnosis and treatment facilitate innovative approaches to HCV care that improve access to, and uptake of, care by people who inject drugs.

Objective
This study aims to examine feasibility, acceptability, likely clinical effectiveness, and cost-effectiveness of an integrated model of HCV care for patients receiving opioid substitution treatment in general practice.

Methods
A pre- and postintervention design with an embedded economic analysis was used to establish the feasibility, acceptability, and clinical and cost-effectiveness of a complex intervention to optimize HCV identification and linkage to HCV treatment among patients prescribed methadone in primary care. The “complex intervention” comprised general practitioner (GP)/practice staff education, nurse-led clinical support, and enhanced community-based HCV assessment of patients. General practices in North Dublin were recruited from the professional networks of the research team and from GPs who attended educational sessions.

Results
A total of 135 patients from 14 practices participated. Follow-up data were collected 6 months after intervention from 131 (97.0%) patients. With regard to likely clinical effectiveness, among patients with HCV antibody positivity, there was a significant increase in the proportions of patients who had a liver FibroScan (17/101, 16.8% vs 52/100, 52.0%; P<.001), had attended hepatology/infectious diseases services (51/101, 50.5% vs 61/100 61.0%; P=.002), and initiated treatment (20/101, 19.8% vs 30/100, 30.0%; P=.004). The mean incremental cost-effectiveness ratio of the intervention was €13,255 (US $13,965.14) per quality-adjusted life-year gained at current full drug list price (€39,729 [US $41,857.48] per course), which would be cost saving if these costs are reduced by 88%.

Conclusions
The complex intervention involving clinical support, access to assessment, and practitioner education has the potential to enhance patient care, improving access to assessment and treatment in a cost-effective manner.
Technology Acceptance and Usability of a Mobile App to Support the Workflow of Health Care Aides Who Provide Services to Older Adults: Pilot Mixed Methods Study
Authors: Miguel Cruz Antonio , Lopez Portillo Hector Perez , Daum Christine , Rutledge Emily , King Sharla , Liu Lili 
Published: April 2022

Background
Health care aides are unlicensed support personnel who provide direct care, personal assistance, and support to people with health conditions. The shortage of health care aides has been attributed to recruitment challenges, high turnover, an aging population, the COVID-19 pandemic, and low retention rates. Mobile apps are among the many information communication technologies that are paving the way for eHealth solutions to help address this workforce shortage by enhancing the workflow of health care aides. In collaboration with Clinisys EMR Inc, we developed a mobile app (Mobile Smart Care System [mSCS]) to support the workflow of health care aides who provide services to older adult residents of a long-term care facility.

Objective
The purpose of this study was to investigate the technology acceptance and usability of a mobile app in a real-world environment, while it is used by health care aides who provide services to older adults.

Methods
This pilot study used a mixed methods design: sequential mixed methods (QUANTITATIVE, qualitative). Our study included a pre– and post–paper-based questionnaire with no control group (QUAN). Toward the end of the study, 2 focus groups were conducted with a subsample of health care aides (qual, qualitative description design). Technology acceptance and usability questionnaires used a 5-point Likert scale ranging from disagree (1) to agree (5). The items included in the questionnaires were validated in earlier research as having high levels of internal consistency for the Unified Theory of Acceptance and Use of Technology constructs. A total of 60 health care aides who provided services to older adults as part of their routine caseloads used the mobile app for 1 month. Comparisons of the Unified Theory of Acceptance and Use of Technology constructs’ summative scores at pretest and posttest were calculated using a paired t test (2-tailed). We used the partial least squares structural regression model to determine the factors influencing mobile app acceptance and usability for health care aides. The α level of significance for all tests was set at P≤.05 (2-tailed).

Results
We found that acceptance of the mSCS was high among health care aides, performance expectancy construct was the strongest predictor of intention to use the mSCS, intention to use the mSCS predicted usage behavior. The qualitative data support the quantitative findings and showed health care aides’ strong belief that the mSCS was useful, portable, and reliable, although there were still opportunities for improvement, especially with regard to the mSCS user interface.

Conclusions
Overall, these results support the assertion that mSCS technology acceptance and usability are high among health care aides. In other words, health care aides perceived that the mSCS assisted them in addressing their workflow issues.
Do Firms Modify Investments in Tax Planning to Manage Earnings?
Authors: Wang Yangmei , Cook Kirsten A. 
Published: April 2022

SYNOPSIS
We examine whether suspect firms (that precisely meet or narrowly beat earnings benchmarks) decrease investments in tax planning to manage earnings; we refer to this strategy as the direct method of modifying discretionary tax fees to increase net income. We analyze investments in tax planning by suspect firms and find that most suspect firms increase earnings by curtailing these investments. Thus, suspect firms appear to prefer this direct method to the indirect method that prior studies have examined, in which firms increase investments in tax planning to reduce tax expense and, in turn, increase net income. We next examine the association between investments in tax planning by suspect firms and tax avoidance. Our findings suggest that suspect firms that increase investments in tax planning experience reductions in ETRs during the same period. In contrast, suspect firms that decrease investments in tax planning do not experience symmetric increases in ETRs.
A Pilot Program of Interprofessional Care for the Patient with a History of Injectable Drug Use Requiring Intravenous Medication
Authors: Hawes Michelle L. 
Published: April 2022

Highlights

Abstract

Background:
The use of injectable drugs and alcohol increased during the months of lockdown and continual uncertainty of the worldwide response to the COVID-19 virus and its variants. As the world adjusts to living with multiple transmissible viruses, the health care system needs a comprehensive approach to care for people who inject drugs. Although the problem of injectable drug use is wide-ranging, this article will focus on the intersection of the person who injects drugs and the health care system.

Methods & Findings:
After an initial case involving a person who injects drugs requiring 42 days of intravenous antibiotics, the hospital began to develop plans to care for this patient population. Finding gaps in the research, a team at the hospital developed a Substance Use Risk Reduction Program that included a risk assessment scale, an interprofessional communication plan, and a set of protocols, then trialed these components between 2017 and 2019. The program successfully screened and collaborated care for patients with a history of injectable drug use. The goals to increase safety were addressed through the protocols that included tamper-evident technology and frequent observations by the staff. The risks of blood stream infection and overdose while a patient was in the hospital were reduced by using the risk reduction protocols. In addition, repudiated costs were decreased by thousands of dollars because of early planning for transfer from inpatient to outpatient, skilled nursing facility, or long-term acute care for the completion of intravenous therapy.
Low-Dose Dasiglucagon Versus Oral Glucose for Prevention of Insulin-Induced Hypoglycemia in People With Type 1 Diabetes: A Phase 2, Randomized, Three-Arm Crossover Study
Authors: Laugesen Christian , Ranjan Ajenthen G. , Schmidt Signe , Nørgaard Kirsten 
Published: April 2022

OBJECTIVE
To compare the efficacy of low-dose subcutaneous dasiglucagon with oral glucose for prevention of insulin-induced hypoglycemia in people with type 1 diabetes.

RESEARCH DESIGN AND METHODS
Twenty adults with type 1 diabetes using multiple daily injection or insulin pump therapy completed a phase 2, randomized, three-arm crossover study. On each study visit, an individualized subcutaneous insulin bolus was administered aiming for a plasma glucose (PG) concentration of 3.0 mmol/L (54 mg/dL). When a PG concentration of 4.5 mmol/L (81 mg/dL) was reached, 15 g oral glucose (CHO) from dextrose tablets, 80 µg dasiglucagon (D80), or 120 µg dasiglucagon (D120) was administered. PG was measured frequently for the following 180 min.

RESULTS
Hypoglycemia (&lt;3.9 mmol/L [70 mg/dL]) occurred in 10 participants after CHO, in 5 after D80, and in 4 after D120 (CHO vs. D80, P = 0.096; CHO vs. D120, P = 0.034). Time spent in hypoglycemia (&lt;3.9 mmol/L [70 mg/dL]) was 14%, 7%, and 6% for CHO, D80, and D120, respectively (P = 0.273). The median time (95% CI) from intervention to first increase in PG of 1.1 mmol/L (20 mg/dL) was 30 (25–50), 15 (15–20), and 15 (15–20) minutes for CHO, D80, and D120, respectively (CHO vs. D80, P = 0.006; CHO vs. D120, P = 0.003). Episodes of nausea were numerically, but not significantly, higher after dasiglucagon administration. No significant differences in visual analog scale-assessed adverse effects were observed between interventions.

CONCLUSIONS
Low-dose dasiglucagon safely and effectively prevented insulin-induced hypoglycemia with a faster glucose-elevating profile than oral glucose.
The Importance of Office Blood Pressure Measurement Frequency and Methodology in Evaluating the Prevalence of Hypertension in Children and Adolescents With Type 1 Diabetes: The SWEET International Database
Authors: Vazeou Andriani , Tittel Sascha R. , Birkebaek Niels H. , Kordonouri Olga , Iotova Violeta , Piccini Barbara , Saboo Banshi , Pundziute Lyckå Auste , Seget Sebastian , Maahs David M. , Stergiou George 
Published: April 2022

OBJECTIVE
The prevalence of hypertension is higher in children and adolescents with type 1 diabetes (T1D) compared with those without. This retrospective analysis of a large cohort of children and adolescents with T1D from the SWEET (Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) international consortium of pediatric diabetes centers aimed to 1) estimate the prevalence of elevated office blood pressure (BP) and hypertension and 2) investigate the influence of BP measurement methodology on the prevalence of hypertension.

RESEARCH DESIGN AND METHODS
A total of 27,120 individuals with T1D, aged 5–18 years, were analyzed. Participants were grouped into those with BP measurements at three or more visits (n = 10,440) and fewer than 3 visits (n = 16,680) per year and stratified by age and sex. A subgroup analysis was performed on 15,742 individuals from centers providing a score indicating BP measurement accuracy.

RESULTS
Among participants with BP measurement at three or more visits, the prevalence of hypertension was lower compared with those with fewer than three visits (10.8% vs. 17.5% P &lt; 0.001), whereas elevated BP and normotension were higher (17.5% and 71.7% vs. 15.3% and 67.1%, respectively; both P &lt; 0.001). The prevalence of hypertension and elevated BP was higher in individuals aged ≥13 years than in younger ones (P &lt; 0.001) and in male than female participants (P &lt; 0.001). In linear regression models, systolic and diastolic BP was independently determined by the BP measurement methodology.

CONCLUSIONS
The estimated prevalence of elevated BP and hypertension in children and adolescents with T1D is ∼30% and depends on the BP measurement methodology. Less frequent BP evaluation may overestimate the prevalence of hypertension.
Botulinum Injection into the Proximal Intestinal Wall of Diet-induced Obese Mice Leads to Weight Loss and Improves Glucose and Fat Tolerance
Authors: Sundaresan Sinju , Antoun Joseph , Banan Babak , Adcock Jamie , Johnson Connor , Claire Brendan , Dixon Kala , Flynn Joyce , Shibao Cyndya A. , Abumrad Naji 
Published: April 2022

<p>Botulinum neurotoxin (available commercially as BOTOX®) has been used successfully for treatment of several neuromuscular disorders including blepharospasm, dystonia, spasticity, and cerebral palsy in children. Our data demonstrate that injection of BOTOX® into the proximal intestinal wall of diet-induced obese (DIO) mice induces weight loss and reduces food intake. This was associated with amelioration of hyperglycemia, hyperlipidemia, and significant improvement of glucose tolerance without alteration of energy expenditure. We also observed accelerated gastrointestinal transit and significant reductions in glucose and lipid absorption which may account at least, in part to the observed weight loss and robust metabolic benefits, although possible systemic effects occurring as a consequence of central and/or peripheral signaling cannot be ignored. The observed metabolic benefits were found to be largely independent of weight loss as demonstrated by pair-feeding experiments. Effects lasted until about 8 weeks, for as long as the half-life of Botox as reported in prior rodent studies. These results have valuable clinical implications. If the observed effects are translatable in humans this approach could lay the foundation for therapeutic approaches geared toward robust and sustained weight loss, mimicking some of the benefits of bariatric surgeries without its cost and complications. </p>