bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors and prognostic stratification for lupus low disease activity state: results from a prospective clinical trial
Authors: Zhang Kai , An Yuan , Zhao Peng , Huang Bo , Wang Yifan , Zhou Xingyu , Cheng Gong , Xing Xiaoyan , Wang Naidi , Feng Ruiling , Yu Siyue , Li Min , He Jing , Li Zhanguo 
Published: July 2022

AbstractObjectiveTo identify predictors for lupus low disease activity state (LLDAS), early-achieved LLDAS and long-term disease activity, and to refine a prognostic stratification tool for use in active SLE patients.MethodA total of 245 active SLE patients were enrolled, followed up quarterly from 2014 to 2016. LLDAS-50 was defined as the maintenance of LLDAS for ≥50% of the observed time. LLDAS at 3 months after cohort entry (LLDAS-3mo) was considered an early-achieved LLDAS. Multivariate analysis was performed to identify predictors for LLDAS, early-achieved LLDAS and long-term disease activity. Based on the factors associated with LLDAS, a prognostic stratification tool for LLDAS was established.ResultsThe 2-year probability of achieving LLDAS was 62.9% (154/245). Multivariate analysis-determined renal involvement, haematological involvement and hypocomplementaemia were negative predictors for achieving LLDAS and LLDAS-50. In multivariate logistic analysis, antiphospholipid antibodies positivity, hypocomplementaemia, renal involvement and haematological involvement were identified as negative predictors for achieving LLDAS-3mo. LLDAS-3mo (P &lt; 0.0001; risk ratio: 47.694; 95% CI: 13.776, 165.127) was a strong predictor for LLDAS-50. The probability of achieving LLDAS, LLDAS-50 and LLDAS-3mo were 88.9% (32/36), 69.4% (25/36) and 41.7% (15/36) in the low-risk group, 65% (65/100), 51.0% (51/100) and 32.0% (32/100) in intermediate-risk group, and 52.8% (57/108), 27.8% (30/108) and 13.0% (14/108) in high-risk group respectively. Significant differences (P &lt; 0.0001) were observed in the LLDAS Kaplan–Meier estimates for the three risk groups based on the identified risk factors.ConclusionRenal involvement, haematological involvement and hypocomplementaemia were negative predictors of LLDAS achievement and maintenance. LLDAS-3mo was a positive predictor for the long-term sustainment of LLDAS.
A phase 2 trial investigating the effects of the angiotensin II type 2 receptor agonist C21 in systemic sclerosis-related Raynaud’s
Authors: Herrick Ariane L , Batta Rohit , Overbeck Kamilla , Raud Johan , Manning Joanne , Murray Andrea , Dinsdale Graham , Tornling Göran 
Published: July 2022

Abstract

Objective
Our main aim was to investigate the effect of a single oral dose of C21, a selective angiotensin II type 2 receptor agonist, on cold-induced vasoconstriction in SSc-related RP.

Methods
This was a phase IIa, randomized, double-blind, cross-over, single-dose, placebo-controlled, single-centre study. Twelve female patients with SSc (median age 58.5 years, median duration of RP 19.0 years) attended on four occasions: screening, treatment visits 1 and 2 (separated by 3–7 days) and follow-up. At the first treatment visit, patients were randomized to receive either a single oral dose of C21 (200 mg) or placebo, then the opposite treatment on the second visit. Forty min after each treatment, each patient underwent a standard hand cold challenge. The primary end point was the area under the curve (AUC) for rewarming for each finger (eight fingers) over 15 min. Secondary end points included the maximum finger temperature after rewarming (MAX). Statistical analyses were performed by multiplicative ANCOVA models.

Results
For all eight fingers combined, mean AUC for rewarming was higher after treatment with C21 than after placebo (geometric mean 20 046°C*s vs 19 558°C*s), but not significantly (P = 0.380) and MAX (at 15 min) was also higher (geometric mean 23.5°C vs 22.5°C; P = 0.036). C21 was well tolerated.

Conclusion
Despite the small trial size, a signal emerged suggesting that even in patients with established SSc, C21 may confer benefit for RP and deserves further investigation.

Trial registration
ClinicalTrials.gov, https://clinicaltrials.gov, NCT04388176.
3Disability Studies
Authors: DiLodovico Amanda 
Published: July 2022

Abstract
This review of literature examines the disability-centered experiences of Covid-19 in disability studies scholarship published in 2021. Under such examination, four main points of synthesis emerge as ways to make sense of the first full year of disability studies scholarship in the pandemic. This chapter, then, proceeds in four sections. First, a focus on the primary methods used in the literature under review as forms of sense-making and conversation that radically engage with the present. Second, a consideration of the eruption of disability politics that emerged in the wake of mask-mandates throughout the United States of America. Third, an observation of the spaces throughout the pandemic in which crip culture served, or had the potential to serve, as an epistemology in changing a seemingly unfamiliar global landscape. Lastly, a movement through the calls to action made by and through the scholarship under review.
Reasons Washington State Women Use Marijuana During Pregnancy/Breastfeeding, Their Trusted Information Sources, and Communication Strategies for Informed Decision-Making
Authors: Macario Everly , Thomas Rosita M. 
Published: July 2022

Objective:
To understand reproductive-aged women's marijuana use beliefs and attitudes.

Methods:
Qualitative research (10 focus groups and 2 bulletin boards) with 95 Washington State women, aged 18 to 44 years, segmented by marijuana-using pregnant/breastfeeding; marijuana-using not-pregnant/breastfeeding; and nonmarijuana users. Participants completed up to 10 survey questions. We used deductive and inductive coding to analyze findings.

Results:
Marijuana-using pregnant/breastfeeding participants use marijuana to manage physical/mental pain and because of stigma, feel guilty, and sometimes hide use. Medicines have failed to address symptoms. Participants perceived marijuana safer than alcohol, tobacco, and illicit substances. Participants believed in the legitimacy of marijuana for health maintenance and want others to take their personally experienced benefits seriously. Participants interpreted lack of conclusive research as marijuana use not being unsafe. They want more information. All segments preferred hearing from other women about marijuana use experiences, with the marijuana-using pregnant/breastfeeding segment feeling strongest about this.

Conclusions:
Personal experiences with, and anecdotes from family/friends about, the effects of marijuana use during pregnancy/breastfeeding influence marijuana-using participants' decision making.

Nursing Implications:
It is important to speak with perinatal patients in a nonjudgmental/nonthreatening manner that acknowledges why reproductive-aged women may use marijuana and that conveys validation of patients' positive experiences with marijuana and a harm-reduction goal.
Outcomes of Cannabis Use During Pregnancy Within the American Association of Birth Centers Perinatal Data Registry 2007-2020
Authors: Joseph-Lemon Lodz , Thompson Heather , Verostick Lori , Shizuka Oura Haley , Jolles Diana R 
Published: July 2022

Background:
Healthcare providers require data on associations between perinatal cannabis use and birth outcomes.

Methods:
This observational secondary analysis come from the largest perinatal data registry in the United States related to the midwifery-led birth center model care (American Association of Birth Centers Perinatal Data Registry; N = 19 286). Births are planned across all birth settings (home, birth center, hospital); care is provided by midwives and physicians.

Results:
Population data show that both early and persistent self-reports of cannabis use were associated with higher rates of preterm birth, low-birth-weight, lower 1-minute Apgar score, gestational weight gain, and postpartum hemorrhage. Once controlled for medical and social risk factors using logistic regression, differences for childbearing people disappeared except that the persistent use group was less likely to experience “no intrapartum complications” (adjusted odds ratio [aOR] = 0.49; 95% confidence interval [CI], 0.32-0.76; P < .01), more likely to experience an indeterminate fetal heart rate in labor (aOR = 3.218; 95% CI, 2.23-4.65; P < .05), chorioamnionitis (aOR = 2.8; 95% CI, 1.58-5.0; P < .01), low-birth-weight (aOR = 1.8; 95% CI, 1.08-3.05; P < .01), and neonatal intensive care unit (NICU) admission (aOR = 2.4; 95% CI, 1.30-4.69; P < .05).

Conclusions:
Well-controlled data demonstrate that self-reports of persistent cannabis use through the third trimester are associated with an increased risk of low-birth-weight and NICU admission.
Urinary extracellular vesicles: does cargo reflect tissue?
Authors: van Heugten Martijn H. , Hoorn Ewout J. , Fenton Robert A. 
Published: July 2022

Purpose of review
To review recent developments in urinary extracellular vesicles (uEVs) to study kidney physiology and disease.

Recent findings
Proteomic analysis in rats showed significant correlations between kidney and uEV protein abundances. Consistent with uEV biogenesis, these correlations were stronger for membrane-associated proteins than for e.g. soluble kinases or E3 ubiquitin ligases. When challenged with a high potassium diet, the physiologically predicted protein changes occurred both in kidney and uEVs, suggesting that analysis of uEVs might be utilized as a proxy or even replacement for tissue analysis. Although kidney–uEV correlations are more difficult to obtain in humans, analysis of uEV cargo from patients with inherited tubulopathies or with primary aldosteronism were also consistent with the predicted changes at the tissue level. The kidney appears to be the main source of uEVs, with a recent study showing that nephron mass determines uEV excretion rate. Therefore, a measure of nephron mass should be included for between-subject comparisons.

Summary
The overall good correlation between kidney and uEV protein abundances renders uEVs an attractive noninvasive source of biomarkers for studying kidney physiology or disease. However, differences in per-protein kidney–uEV correlations and per-person uEV excretion rates should be considered in uEV biomarker studies.
Defining improvement in chronic kidney disease: regression and remission
Authors: Taal Maarten W. 
Published: July 2022

Purpose of review
International definitions exist for chronic kidney disease (CKD) progression and kidney failure but despite evidence that kidney function may improve, there are no agreed definitions for regression and remission of CKD. In the light of recent novel kidney protective therapies and the promise of regenerative medicine to reverse kidney damage, it is time to critically examine these neglected aspects of CKD epidemiology.

Recent findings
We propose that CKD regression is viewed as a process of improvement defined as a sustained increase in glomerular filtration rate (GFR) by ≥25% and an improvement in GFR category or increase in GFR of 1≥ml/min/year, whereas remission is considered a category of improvement defined as GFR ≥60 ml/min/1.73m2 and urine albumin to creatinine ratio <30 mg/g. Several recent studies have reported improvement in kidney function in populations with CKD, even in the absence of specific therapy. Regression and remission of CKD are associated with increased likelihood of sustained improvement in kidney function as well as improved survival.

Summary
Further research is warranted to validate the proposed definitions and investigate associated mechanisms. We look to a future in which the goal of therapy is not merely to slow CKD progression but to improve kidney function and seek a cure.
Pediatric Delirium and All-Cause PICU Readmissions Within 1 Year*
Authors: Pilato Tara C. , Mauer Elizabeth A. , Gerber Linda M. , Traube Chani 
Published: July 2022

Objectives:
Delirium in critically ill children is associated with increased in-hospital morbidity and mortality. Little is known about the lingering effects of pediatric delirium in survivors after hospital discharge. The primary objective of this study was to determine whether children with delirium would have a higher likelihood of all-cause PICU readmission within 1 calendar year, when compared with children without delirium.

Design:
Retrospective cohort study.

Setting:
Tertiary care, mixed PICU at an urban academic medical center.

Patients:
Index admissions included all children admitted between September 2014 and August 2015. For each index admission, any readmission occurring within 1 year after PICU discharge was captured.

Intervention:
Every child was screened for delirium daily throughout the PICU stay.

Measurements and Main Results:
Among 1,145 index patients, 166 children (14.5%) were readmitted at least once. Bivariate analyses compared patients readmitted within 1 year of discharge with those not readmitted: complex chronic conditions (CCCs), increased severity of illness, longer PICU length of stay, need for mechanical ventilation, age less than 6 months, and a diagnosis of delirium were all associated with subsequent readmission. A multivariable logistic regression model was constructed to describe adjusted odds ratios for readmission. The primary exposure variable was number of delirium days. After controlling for confounders, critically ill children who experienced greater than 2 delirium days on index admission were more than twice as likely to be readmitted (adjusted odds ratio, 2.2; CI, 1.1–4.4; p = 0.023). A dose-response relationship was demonstrated as children with longer duration of delirium had increased odds of readmission.

Conclusions:
In this cohort, delirium duration was an independent risk factor for readmission in critically ill children. Future research is needed to determine if decreasing prevalence of delirium during hospitalization can decrease need for PICU readmission.
Calcium Administration During Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest in Children With Heart Disease Is Associated With Worse Survival—A Report From the American Heart Association’s Get With The Guidelines-Resuscitation (GWTG-R) Registry*
Authors: Dhillon Gurpreet S. , Kleinman Monica E. , Staffa Steven J. , Teele Sarah A. , Thiagarajan Ravi R. ,   for the American Heart Association’s Get With The Guidelines - Resuscitation (GWTG-R) Investigators
Published: July 2022

Objectives:
IV calcium administration during cardiopulmonary resuscitation (CPR) for pediatric in-hospital cardiac arrest (IHCA) is associated with worse survival. We evaluated survival to hospital discharge in children with heart disease (HD), where calcium is more frequently administered during CPR.

Design:
Retrospective study of a multicenter registry database.

Setting:
Data reported to the American Heart Association’s (AHA) Get With The Guidelines-Resuscitation registry.

Patients:
Children younger than 18 years with HD experiencing an index IHCA event requiring CPR between January 2000 and January 2019. Using propensity score matching (PSM), we selected matched cohorts of children receiving and not receiving IV calcium during CPR and compared the primary outcome of survival to hospital discharge.

Interventions:
None.

Measurements and Main Results:
We included 4,556 children with HD experiencing IHCA. Calcium was administered in 1,986 (44%), more frequently in children younger than 1 year old (65% vs 35%; p < 0.001) and surgical cardiac (SC) compared with medical cardiac patients (51% vs 36%; p < 0.001). Calcium administration during CPR was associated with longer duration CPR (median 27 min [interquartile range (IQR): 10–50 min] vs 5 min [IQR, 2–16 min]; p < 0.001) and more frequent extracorporeal-CPR deployment (25% vs 8%; p < 0.001). In the PSM cohort, those receiving calcium had decreased survival to hospital discharge (39% vs 46%; p = 0.02) compared with those not receiving calcium. In a subgroup analysis, decreased discharge survival was only seen in SC cohorts.

Conclusions:
Calcium administration during CPR for children with HD experiencing IHCA is common and is associated with worse survival. Administration of calcium during CPR in children with HD should be restricted to specific indications as recommended by the AHA CPR guidelines.
“Surgical treatment of peripheral nerve neuromas – a systematic review and meta-analysis”
Authors: Langeveld Mirte , Hundepool Caroline A. , Duraku Liron S. , Power Dominic M. , Rajaratnam Vaikunthan , Zuidam J. Michiel 
Published: July 2022

Background:
Despite many treatment options available, no consensus on the optimal surgical management of symptomatic peripheral nerve neuroma has been reached. The aim of this systematic review and meta-analysis was to evaluate effectiveness of different surgical techniques in treating painful neuromas and to help guide surgeons in electing optimal treatment.

Methods:
Five databases (Embase, MEDLINE, web of science, and Cochrane Central) were searched. Studies that reported either numerical (VAS/NRS) or non-numerical postoperative pain scores after surgical treatment of peripheral neuroma were identified.

Results:
Thirty-two articles met the eligibility criteria and were analyzed for qualitative review. Thirty studies were included in qualitative analysis for a total of 1150 neuromas. Surgical treatment of peripheral neuroma achieved good postoperative results in 70% of treated neuromas (95% CI; 64-77). Proportions between techniques ranged between 60%-92%. In a post-hoc analysis, Targeted Muscle Reinnervation (82%, 95% CI; 73-92) performed significantly better than neurectomy (p = 0.024).

Conclusions:
The choice of surgical management in treating symptomatic peripheral neuroma is challenging, yet surgical intervention achieves significant pain relief in the majority of cases. Targeted Muscle Reinnervation is promising for the management of painful neuromas.
Piloting GETCare
Authors: Einerson Jackie , Cardell Beth , Majersik Jennifer J. , Reblin Maija , Richards Lorie Gage , Terrill Alexandra L. 
Published: July 2022

Abstract

Purpose
Many individuals with stroke require informal caregiver support. These caregivers are often unprepared and overwhelmed. This study assesses the feasibility and acceptability of GETCare, a remote Goal-based Education and skills Training program for Caregivers caring for an individual poststroke.

Design
Single-arm mixed-methods pilot trial was performed.

Methods
The GETCare program is a 5-week remote, individually administered program for informal stroke caregivers that includes education, skills training, guided goal setting, and resource recommendations. Quantitative data were analyzed using descriptive statistics and qualitative data via a deductive approach.

Results
Twenty-eight caregivers were recruited with 18 caregivers completing the program. These 18 caregivers reported high satisfaction, and over 75% reported program content was at least quite helpful. Caregivers suggested that the length of the program was appropriate, indicated that weekly check-ins were helpful, and supported this program for informal caregivers across the time trajectory poststroke. Eight of 10 caregivers who dropped out of the program were caring for someone 0–4 months poststroke.

Conclusions
Caregivers positively received the GETCare program, which was uniquely structured to provide resources and skills for this high-need population. This pilot study provides valuable insight for future remote interventions poststroke.

Clinical Relevance to Practice of Nursing
Results provide foundational knowledge in how to better support caregivers through guided goal setting and individualized education.
Benign Meningioma With Rare Radiological and Behavioral Features
Authors: Wen Donghui , Xu Dan , Wang Lu , Chen Yili , Ou Changjiang 
Published: July 2022

Background:
Meningiomas are usually dura-based primary nonmalignant neoplasms of the central nervous system. It is extremely rare that a meningioma is located at the convexity of the brain, but shows no dura attachment and causes osteolysis of the skull.

Case Presentation:
A 57-year-old woman presented with an incidentally discovered scalp lump on the head. Neurological deficits were not found. Radiological examination revealed a localized osteolytic lesion in the right parietal bone, which was initially diagnosed as a bone tumor and was surgically resected. At surgery, a tumor mass was found located at the brain convexity without dura attachment. It was tightly attached to the brain parenchyma and had no distinct boundary from the brain. The mass was rather small, but resulted in significant osteolysis of the skull and destruction of the dura. Simpson grade I resection of the tumor was performed. Histological and immunohistochemical results indicated a meningothelial meningioma.

Conclusions:
Both preoperative and intraoperative diagnoses are difficult for this case. Knowledge of this case is crucial for clinicians to be aware of this entity because it can be easily confused with bone tumors. Further research on the relationship between meningioma and bone metabolism is required to investigate the mechanism of osteolysis.
The Role of Pelvic Floor Muscle Training on Low Anterior Resection Syndrome
Authors: Asnong Anne , D’Hoore André , Van Kampen Marijke , Wolthuis Albert , Van Molhem Yves , Van Geluwe Bart , Devoogdt Nele , De Groef An , Guler Caamano Fajardo Ipek , Geraerts Inge 
Published: July 2022

Background and Objective:
Total mesorectal excision (TME) for rectal cancer (RC) often results in significant bowel symptoms, commonly known as low anterior resection syndrome (LARS). Although pelvic floor muscle training (PFMT) is recommended in noncancer populations for treating bowel symptoms, this has been scarcely investigated in RC patients. The objective was to investigate PFMT effectiveness on LARS in patients after TME for RC.

Methods:
A multicenter, single-blind prospective randomized controlled trial comparing PFMT (intervention; n=50) versus no PFMT (control; n=54) 1 month following TME/stoma closure was performed. The primary endpoint was the proportion of participants with an improvement in the LARS category at 4 months. Secondary outcomes were: continuous LARS scores, ColoRectal Functioning Outcome scores, Numeric Rating Scale scores, stool diary items, and Short Form 12 scores; all assessed at 1, 4, 6, and 12 months.

Results:
The proportion of participants with an improvement in LARS category was statistically higher after PFMT compared with controls at 4 months (38.3% vs 19.6%; P=0.0415) and 6 months (47.8% vs 21.3%; P=0.0091), but no longer at 12 months (40.0% vs 34.9%; P=0.3897). Following secondary outcomes were significantly lower at 4 months: LARS scores (continuous, P=0.0496), ColoRectal Functioning Outcome scores (P=0.0369) and frequency of bowel movements (P=0.0277), solid stool leakage (day, P=0.0241; night, P=0.0496) and the number of clusters (P=0.0369), derived from the stool diary. No significant differences were found for the Numeric Rating Scale/quality of life scores.

Conclusions:
PFMT for bowel symptoms after TME resulted in lower proportions and faster recovery of bowel symptoms up to 6 months after surgery/stoma closure, justifying PFMT as an early, first-line treatment option for bowel symptoms after RC.