bluuebunny/crossref_metadata_2025_split huggingface dataset:
Care provided by nurses to patients with juvenile systemic lupus erythematosus
Authors: Costa Andrea A , Robba Hingrid CS , Silva Clovis A , Ferreira Juliana Caires OA 
Published: February 2022

Objectives To describe the care provided by Brazilian nurses to patients with Juvenile Systemic Lupus Erythematosus (JSLE) using a self-administered questionnaire and to evaluate the possible association of demographic data and knowledge of the disease with availability of tools for diagnosis and treatment in Brazilian pediatric services. Method This is a cross-sectional observational descriptive study that analyzed the care provided by Brazilian nurses to patients with JSLE based on the answers to a self-administered questionnaire. Questions included demographics of professionals, nursing consultation, usage of tools to assess disease activity, diagnostic criteria, general care, available practices, transition program, and practices needed for better care. Results A total of 111/373 (29.4%) questionnaires were completed, most professionals were female (90.1%). Hospitalization (45.9%) and poor medication adherence (27.9%) were the most reported problems, and lack of knowledge about the institutional transition process to adult care was mentioned by half of the professionals (50.5%). Comparisons of professionals on expected care of patients regarding the type of service, hospitalized patient care, and care provided to patients with JSLE did not reveal statistically significant differences ( p > 0.05). Nurses who care for patients with JSLE are more likely to work in a public setting (14.5% vs. 36.8%, p = 0.048) and less likely to verify vaccination records (0.12.9% vs. 36.8%, p = 0.038). Nurses who worked in the inpatient setting with patients with JSLE were less likely to address pain concerns (11.7% vs. 61.6%, p < 0.0001) compared to nurses who didn’t work with JSLE patients. However, they were more likely to discuss sunscreen use (54.9% vs. 25%, p < 0.05) and be part of a multi-disciplinary team (84.3 vs. 50%, p < 0.0001). Conclusions This study demonstrates that the care provided by nurses to patients with JSLE does not consider all the resources available to assess the disease and occurs differently in the inpatient versus outpatient settings. Future research should address this gap in care. Lack of JSLE awareness was commonly reported among professionals, confirming the need for greater knowledge about JSLE, its treatment, and ways to improve adherence.
Cariprazine: A new partial dopamine agonist with a familiar profile
Authors: Hope Judy , Keks Nicholas A 
Published: February 2022

Objective Cariprazine is the third partial dopamine agonist now available in Australia. This paper will review the properties, evidence and likely clinical place of cariprazine. Conclusion Cariprazine is a partial agonist with high affinity at dopamine D2 and D3 receptors, partial agonism at 5HT1a receptors, moderate 5HT2a and H1 antagonism and no anticholinergic activity. It is rapidly absorbed, is unaffected by food, achieves a peak plasma level in 4–8 hours and has high bioavailability. The half-life of cariprazine and its metabolites is long (7–8 days); steady state occurs in 4–8 weeks. It is hepatically metabolized via 3A4 cytochrome enzymes. Cariprazine is an effective antipsychotic in acute schizophrenia in both short and longer placebo-controlled studies. Cariprazine appears to have small advantages in negative symptoms of schizophrenia. While not approved for bipolar disorder, cariprazine is effective in mania and mixed states but requires doses higher than current maximums recommended. Cariprazine causes more akathisia than aripiprazole or brexpiprazole but is less prone to insomnia, weight gain and sedation. Risks for hyperprolactinaemia and QTc prolongation are low. Cariprazine is another ‘metabolically-friendly’ antipsychotic for schizophrenia, with advantages for those with negative symptoms, mood symptoms or problems with adherence.
Ill-defined: Concepts of mental health and illness are becoming broader, looser, and more benign
Authors: Jackson Henry J. , Haslam Nick 
Published: February 2022

Objectives We argue that mental health-related concepts have become degraded within professional circles and in the wider community. We identify three trends: concept creep, the rise of broad umbrella concepts (e.g. distress and trauma), and the conflation of mental health with well-being, which marginalises serious mental illness. We speculate on the causes of these trends, including cultural shifts towards greater sensitivity to harm and the rise of wellness industries. Contributing factors within psychiatry include overdiagnosis, dimensional models and transdiagnostic perspectives. Conclusions These trends may lead to inflated demands on services from those at the milder end of the psychopathological spectrum. We set out seven measures that mental health professionals can take to resist trends towards broad concepts of mental illness and limit some of their adverse consequences.
Racial Disparities in Social Workers’ Licensing Rates
Authors: Kim Joy Jeounghee 
Published: February 2022

Objectives This study aimed at examining how racial disparities in social workers’ licensing rates are explained by the major sources of the disparities: racial differences in educational eligibilities, the field of practice, and demographic vulnerabilities of social workers. Methods Drawing a nationally representative sample of 3990 social workers from the Current Population Survey, this study tested how the probabilities of their licensing were explained by the major sources of racial disparities. Results For master’s level social workers, African American–White differences in the field of practice and the type of employers explained away the disparity in required licensing rates. The Hispanic–White and other race–White disparities were largely due to non-White social workers’ limited educational eligibilities and the states of residence that might have imposed varying occupational regulations. Conclusions As licensing disparities reflect socioeconomic injustice that confronts many non-White social workers, they call for more purposeful research and interventions within the profession.
Evaluation of a pediatric pre-chemotherapy rapid hydration protocol: A quality assurance project
Authors: McKinnon Krista , Tran Tracey , Lewis Victor 
Published: February 2022

Introduction Intravenous hydration may be utilized to prevent nephrotoxicity and facilitate drug elimination in patients receiving high-dose chemotherapy. Prolonged hydration protocols may lead to delayed initiation and completion of therapy, lengthening hospital admissions. Rapid hydration protocols have been implemented to reduce the time required for patients to meet parameters for chemotherapy administration. This study aims to evaluate a rapid hydration protocol implemented at the Alberta Children's Hospital (ACH). Methods Starting January 2018 through May 2018, data was prospectively collected for pediatric oncology acute care and ambulatory patients at ACH receiving methotrexate (MTX), cisplatin, cyclophosphamide, or ifosfamide. The primary outcome was the time to achieve pre-determined urine parameters prior to chemotherapy administration. Secondary outcomes included the proportion of cycles that achieved urine parameters and the efficacy of each rapid hydration step. Results A total of 22 cycles were included, 13 for MTX and 9 for non-MTX chemotherapy. Median time to meet all urine parameters was 120 min (range 30–600 min). Two cycles (15%) failed rapid hydration in the MTX group, while no cycles required further hydration in the non-MTX group. Adverse events potentially attributable to hydration were mild and did not require intervention. Conclusion The ACH rapid hydration protocol resulted in reduced time to meet target urine parameters. The results of this quality assurance review support the continued use of rapid hydration prior to chemotherapy administration.
Management of acute exacerbation of chronic obstructive pulmonary disease under a tiered medical system in China
Authors: Liu Xiaojing , Du Chunling , Hu Fuying , Zhao Yunfeng , Zhou Jintao , Wang Qian , Mu Yutong , Lu Jinchang , Gao Lei , Cui Bo , Ma Yuan , Sun Tieying , Qian Feng , Chen Zhihong 
Published: February 2022

Background: The Chinese government has promoted the ‘tiered medical services’ policy in which diseases are classified by severity, mode of onset and difficulty of treatment since 2015 to optimize medical resources. We evaluated the diagnosis and treatment of acute exacerbation (AE) of chronic obstructive pulmonary disease (AECOPD) under the tiered system. Methods: We conducted a cross-sectional study. COPD characteristics and treatments were compared among hospitals in different tiers. Associations were examined by univariate and multivariable logistic regression analysis. In addition, multivariate logistic regression was performed to identify the possible influencing factors of antibiotics, glucocorticoids and anticoagulant usages. Results: Eligible COPD patients ( n = 432) were consecutively recruited from eight hospitals in different tiers in China. Patients in the countryside preferred the community hospitals, whereas patients in cities preferred second-tier and teaching hospitals when they suffer from AECOPD. It indicates most COPD patients are likely to treat their disease locally. The severity of COPD AE increased with tiers of hospitals ( p < 0.001). However, our results clearly show that most community hospitals can only deal with mild exacerbation of COPD. Approximately 90% of AE patients received antibiotics. We speculated that antibiotics abuse might exist in the three tiers of hospitals. Multivariate analysis demonstrated that long-term antibiotics usage (⩾14 days) was associated with moderate exacerbation [odds ratio (OR): 5.295, 95% confidence intervals (CI) 2.248–12.473, p < 0.001], radiographic progression (OR: 2.176, 95% CI: 1.047–4.522, p = 0.037), positive sputum etiology (OR: 3.073, 95% CI: 1.477–6.394, p = 0.003) and increased white blood cells (OR: 2.470, 95% CI: 1.190–5.126, p = 0.015). The proportion of glucocorticoids increased with the hospital hierarchy (18.6% versus 45.6% versus 69.2%, p < 0.001). The proportions of severe cases in the second-tier hospitals were 26.9%; however, non-invasive positive pressure ventilation (NPPV) rate was only 14.7%. Anticoagulant is not commonly used in AECOPD, and the community hospitals had the lowest proportion of anticoagulation regimen (1.7% versus 14.3% versus 20.5%, p = 0.002). Conclusions: The ‘tiered medical services’ policy in AECOPD management has been unsatisfactory in the past years. Irrational treatment strategies in different hospitals were still found when comparing with international guideline. Further reform of the policy is still needed to optimize the management of AECOPD in China.
In-hospital blood collection increases the rate of indeterminate results in interferon-gamma release assays
Authors: Osakabe Yuki , Yamaguchi Fumihiro , Suzuki Ayako , Kitano Haruka , Hiraiwa Mina , Shiratori Yo , Onozaki Shota , Nakamoto Mari , Kawamura Saori , Kosuge Miku , Atarashi Kenji , Cho Hidekazu , Shimizu Shohei , Fujishima Akira , Shikama Yusuke 
Published: February 2022

Background: The interferon (IFN)-γ release assay (IGRA) has recently been established as a method to evaluate the infection status of tuberculosis instead of the tuberculin skin test. However, indeterminate results can create challenges to interpretation. The IGRA has been available in Japan since 2005, including the recently launched QuantiFERON-TB Gold Plus (QFT-plus) assay. Objectives: The aim of this study was to investigate the clinical features and predictors of indeterminate results by the QFT-plus test in routine practice. Methods: This was a cross-sectional study of 1258 patients. Multivariate logistic regression models were employed to investigate the clinical factors related to indeterminate results by the QFT-plus. Results: Overall, 91.8% of results were found to be conclusive and 8.2% were indeterminate. The QFT-plus indeterminate results were predominantly due to a low level of IFN-γ production by mitogens. Multivariate analysis indicated that an indeterminate result was significantly associated with age, sex, corticosteroid use, autoimmune disease, and inpatient setting. Conclusion: Certain types of individuals are at higher risk of an indeterminate IGRA result. The QFT-plus test for hospitalized patients should be avoided as much as possible, and it is better to perform the test for those patients in outpatient settings.
Effect of Lateral Retinacular Release on Medial Patellofemoral Ligament Reconstruction
Authors: Gallagher Brian W. , Mistretta Katherine L. , Abbasi Pooyan , Levine Richard G. 
Published: February 2022

Background: When performing a medial patellofemoral ligament (MPFL) reconstruction, surgeons may place the MPFL graft under higher than anatomic tension to minimize the chance of recurrent instability. Purpose: To investigate whether a lateral retinacular release (LRR) significantly decreases patellofemoral contact pressures after an overtensioned (OT) MPFL reconstruction. Study Design: Controlled laboratory study. Methods: Mean and peak pressure across the patellofemoral joint at 30°, 45°, and 60° of flexion was assessed in 14 cadaveric knee specimens with intact MPFL, transected MPFL, reconstructed MPFL with graft OT, and OT MPFL with LRR. The Wilcoxon signed rank test was used to determine differences across states, with W and C values calculated when possible. Results: Mean pressure decreased significantly after MPFL transection compared with intact at 30° (456.9 ± 116.8 vs 410.9 ± 109.4 N, P = .006, W < 7) and 45° (404.9 ± 91.7 vs 369.4 ± 85.3 N, P = .005, W < 5) and increased significantly from intact to OT graft at 30° (456.9 ± 116.8 vs 563.0 ± 11.2 N, P = .003, W < 7), 45° (404.9 ± 91.7 vs 481.4 ± 14.8 N, P = .005, W < 5), and 60° (272.9 ± 139.0 vs 367.0 ± 53.7 N, P = .007, W < 3). Peak pressure increased significantly between intact and OT graft at 30° (1364.0 ± 478.2 vs 2094.4 ± 619.8 N, P = .002, W < 9), 45° (1224.7 ± 491.5 vs 1676.7 ± 779.1 N, P = .005, W < 5), and 60° (1117.7 ± 566.8 vs 1604.2 ± 772.9 N, W < 3). In knees with significantly increased mean pressure after overtensioning, mean pressure increased by 23.3% (11/14 knees) at 30°, 18.3% (10/14 knees) at 45°, and 35.0% (10/14 knees) at 60°. Peak pressure increased significantly by 35.3% (30°), 25.2% (45°), and 29.3% (60°). A significant decrease in mean pressure, toward but not to baseline, was observed between the OT and LRR states at 30° (563.0 ± 11.2 vs 501.5 ± 9.3 N, W < 7) and 60° (367.0 ± 53.7 vs 302.0 ± 13.8 N, W < 5) and a decrease in peak pressure at 30° (2094.4 ± 619.8 vs 1886.5 ± 655.3 N; W < 9). Conclusion: LRR led to a statistically significant decrease in pressure across the patellofemoral joint in knees that demonstrated increased contact pressures after an OT MPFL graft. Clinical Relevance: LRR after an MPFL reconstruction in which the MPFL graft has been OT may help reduce patellofemoral contact pressures at the time of surgery.
Common Characteristics and Clinical Management Recommendations for Juvenile Recurrent Parotitis: A 10‐Year Tertiary Center Experience
Authors: Benaim Ezer , Fan Timothy , Dash Anwesh , Gillespie M. Boyd , McLevy‐Bazzanella Jennifer 
Published: February 2022

ObjectiveJuvenile recurrent parotitis (JRP) is a rare disease that may adversely affect normal development and quality of life. The objective of this study was to report on the demographics, characteristics, and treatment outcomes of JRP and to offer evidence‐based management recommendations.Study DesignRetrospective review.SettingA single tertiary care pediatric teaching hospital.MethodsMedical records, imaging studies, and laboratory findings over a 10‐year period were retrospectively collected and reviewed, resulting in 41 patients with JRP between the ages of 8 months and 16 years.ResultsBlack males aged 2 to 8 years were most commonly affected by JRP. Overall, 18 (44%) patients received ≥3 antibiotics, and 17 (42%) underwent sialendoscopy for treatment. Over 75% of patients had no JRP recurrences after 3 sialendoscopies. The most common imaging approach was computed tomography (42%), and the most frequent laboratory results were elevated amylase (83%) and C‐reactive protein (82%). Atopy (61%) and excess weight (42%) were routinely associated with JRP, especially in severe cases.ConclusionJRP workup and treatment plans should begin with the least burdening modalities, including over‐the‐counter analgesics, minimal laboratory studies in the acute phase, and ultrasonography over computed tomography. Clindamycin is an effective initial antibiotic of choice, and severe recurrences may be controlled with sialendoscopy. Optimizing the health of patients with JRP includes managing comorbidities, especially of atopic and overweight origins, which are associated with more severe cases.
Defects in mucosal immunity and nasopharyngeal dysbiosis in HSC-transplanted SCID patients with IL2RG/JAK3 deficiency
Authors: Goncalves Pedro , Doisne Jean-Marc , Eri Toshiki , Charbit Bruno , Bondet Vincent , Posseme Celine , Llibre Alba , Casrouge Armanda , Lenoir Christelle , Neven Bénédicte , Duffy Darragh , Fischer Alain , Di Santo James P. 
Published: February 2022

AbstractBoth innate and adaptive lymphocytes have critical roles in mucosal defense that contain commensal microbial communities and protect against pathogen invasion. Here we characterize mucosal immunity in patients with severe combined immunodeficiency (SCID) receiving hematopoietic stem cell transplantation (HSCT) with or without myeloablation. We confirmed that pretransplant conditioning had an impact on innate (natural killer and innate lymphoid cells) and adaptive (B and T cells) lymphocyte reconstitution in these patients with SCID and now show that this further extends to generation of T helper 2 and type 2 cytotoxic T cells. Using an integrated approach to assess nasopharyngeal immunity, we identified a local mucosal defect in type 2 cytokines, mucus production, and a selective local immunoglobulin A (IgA) deficiency in HSCT-treated SCID patients with genetic defects in IL2RG/GC or JAK3. These patients have a reduction in IgA-coated nasopharyngeal bacteria and exhibit microbial dysbiosis with increased pathobiont carriage. Interestingly, intravenous immunoglobulin replacement therapy can partially normalize nasopharyngeal immunoglobulin profiles and restore microbial communities in GC/JAK3 patients. Together, our results suggest a potential nonredundant role for type 2 immunity and/or of local IgA antibody production in the maintenance of nasopharyngeal microbial homeostasis and mucosal barrier function.
Metalloproteinase inhibition reduces AML growth, prevents stem cell loss, and improves chemotherapy effectiveness
Authors: Pirillo Chiara , Birch Flora , Tissot Floriane S. , Anton Sara Gonzalez , Haltalli Myriam , Tini Valentina , Kong Isabella , Piot Cécile , Partridge Ben , Pospori Constandina , Keeshan Karen , Santamaria Salvatore , Hawkins Edwin , Falini Brunangelo , Marra Andrea , Duarte Delfim , Lee Chiu Fan , Roberts Edward , Lo Celso Cristina 
Published: February 2022

Abstract
Acute myeloid leukemia (AML) is a blood cancer of the myeloid lineage. Its prognosis remains poor, highlighting the need for new therapeutic and precision medicine approaches. AML symptoms often include cytopenias linked to loss of healthy hematopoietic stem and progenitor cells (HSPCs). The mechanisms behind HSPC decline are complex and still poorly understood. Here, intravital microscopy (IVM) of a well-established experimental model of AML allows direct observation of the interactions between healthy and malignant cells in the bone marrow (BM), suggesting that physical dislodgment of healthy cells by AML through damaged vasculature may play an important role. Multiple matrix metalloproteinases (MMPs), known to remodel extracellular matrix, are expressed by AML cells and the BM microenvironment. We reason MMPs could be involved in cell displacement and vascular leakiness; therefore, we evaluate the therapeutic potential of MMP pharmacological inhibition using the broad-spectrum inhibitor prinomastat. IVM analyses of prinomastat-treated mice reveal reduced vascular permeability and healthy cell clusters in circulation and lower AML infiltration, proliferation, and cell migration. Furthermore, treated mice have increased retention of healthy HSPCs in the BM and increased survival following chemotherapy. Analysis of a human AML transcriptomic database reveals widespread MMP deregulation, and human AML cells show susceptibility to MMP inhibition. Overall, our results suggest that MMP inhibition could be a promising complementary therapy to reduce AML growth and limit HSPC loss and BM vascular damage caused by MLL-AF9 and possibly other AML subtypes.
Mass spectrometry vs immunofixation for treatment monitoring in multiple myeloma
Authors: Puig Noemí , Contreras María-Teresa , Agulló Cristina , Martínez-López Joaquín , Oriol Albert , Blanchard María-Jesús , Ríos Rafael , Martín Jesús , Iñigo María-Belén , Sureda Anna , Hernández Miguel-Teodoro , de la Rubia Javier , González-Calle Verónica , Krsnik Isabel , Cabañas Valentín , Palomera Luis , Moraleda José-María , Bargay Joan , Cedena María-Teresa , Paiva Bruno , Rosiñol Laura , Bladé Joan , San Miguel Jesús , Lahuerta Juan-José , Mateos María-Victoria 
Published: February 2022

Abstract
Monitoring of the monoclonal protein (M-protein) by electrophoresis and/or immunofixation (IFE) has long been used to assess treatment response in multiple myeloma (MM). However, with the use of highly effective therapies, the M-protein becomes frequently undetectable, and more sensitive methods had to be explored. We applied IFE and mass spectrometry (EXENT&FLC-MS) in serum samples from newly diagnosed MM patients enrolled in the PETHEMA/GEM2012MENOS65 obtained at baseline (n = 223), and after induction (n = 183), autologous stem cell transplantation (n = 173), and consolidation (n = 173). At baseline, the isotypes identified with both methods fully matched in 82.1% of samples; in the rest but 2 cases, EXENT&FLC-MS provided additional information to IFE with regards to the M-protein(s). Overall, the results of EXENT&FLC-MS and IFE were concordant in &gt;80% of cases, being most discordances due to EXENT&FLC-MS+ but IFE− cases. After consolidation, IFE was not able to discriminate 2 cohorts with different median progression-free survival (PFS), but EXENT&FLC-MS did so; furthermore, among IFE− patients, EXENT&FLC-MS identified 2 groups with significantly different median PFS (P = .0008). In conclusion, compared with IFE, EXENT&FLC-MS is more sensitive to detect the M-protein of patients with MM, both at baseline and during treatment, and provides a more accurate prediction of patients’ outcome. This trial was registered at www.clinicaltrials.gov as #NCT01916252.