bluuebunny/crossref_metadata_2025_split huggingface dataset:
Artificially Elevated Tacrolimus Concentrations Obtained From a Venous Catheter Previously Used for Tacrolimus Administration in a Pediatric Patient
Authors: Marschner Magda N. , Chandran Mary M. , Colyer Lindsay G. 
Published: June 2022

Intravenous (IV) administration of calcineurin inhibitors, cyclosporine (CsA) and tacrolimus (TAC), has been associated with spuriously high serum concentrations collected from central venous catheters (CVCs) used for medication administration, secondary to reversible adsorption of medication to the catheter. Thus, therapeutic drug monitoring of IV CsA and TAC via CVCs previously exposed to these agents should be interpreted cautiously and ideally avoided. The duration of this effect is poorly characterized and the risk for extension of this effect to unexposed lumens of the same central catheter remains uncertain. We describe a case of a pediatric patient with artificially elevated serum TAC concentrations obtained from previously exposed and unexposed lumens of a central catheter, 27 days after last IV TAC administration.
Living in the wrong time zone: Elevated risk of traffic fatalities in eccentric time localities
Authors: Gentry Jeffery , Evaniuck Jayson , Suriyamongkol Thanchira , Mali Ivana 
Published: June 2022

Chronobiology research has uncovered a host of maladies linked to social jetlag (SJL), the sleep-disrupting disconnect between solar time and social time. This interdisciplinary study applies chronobiology theory to the potential effect of misaligned time zones on motor-vehicle deaths. In the U.S. 53 million residents live in counties located outside their official time zones’ standard 15° span of longitude, based on degrees west of the prime meridian. We refer to these counties as eccentric time localities (ETLs), all of which lie west of their time zones’ standard western border in the U.S. In contrast, counties within 7.5° of their time zone’s standard geographic center are what we call solar zones. Solar zones do not vary more than 30 minutes from true solar time. ETL residents are forced to rise before dawn, possibly restricting their sleep-time and suppressing both morning and evening zeitgebers that would support their circadian entrainment. Hypothesizing that living in ETLs amplifies social jetlag, data on 417,399 traffic fatalities in the U.S. between 2006 and 2017 from the Fatality Analysis Reporting System (FARS) census were analyzed via GIS mapping and population-data statistics. Road fatalities among residents of solar zones were compared to those living in ETLs within the same official time zone. ETL residents across the U.S. indicated 21.8% higher fatality-rates than solar residents, with a mean of 1286 additional (i.e., unexpected) deaths-per-year. Results support circadian entrainment theory and are consistent with the SJL construct. The socio-political ramifications of these findings are discussed, as well as the subject of best practices when analyzing whole-population data. The authors conclude that the unquestioned rhetoric of time-zone boundaries should be reconsidered in social policy.
Labour market flexibilisation in Lithuania: Outcomes and impacts on gender differences in work arrangements
Authors: Juska Arunas , Navicke Jekaterina 
Published: June 2022

AbstractThis paper evaluates the impacts of 2017’s labour law liberalisation on labour market flexibility in Lithuania. While employment did grow rapidly in 2017–2019, there was little change in labour market flexibility. Against expectations, part-time employment declined as labour relations continued to be administered under path-dependent institutional inertia inherited from previous decades. The prevalence of full-time, dual-earner employment was shaped by the country’s socialist legacy and was reflected in high employment rates and permanent open-ended contracts for both men and women. Analysis also showed that the revised labour law lowered the probability for women with family care responsibilities to be hired. Once hired, they were offered permanent employment albeit with the reduced protections that such contracts now provide. Impacts of the new labour law on shaping what is considered to be ‘men’s work’ and ‘women’s work’ in Lithuania are discussed.
Mobile-CEA – A Novel Surveillance Method for Patients with Colorectal Cancer
Authors: Pakarinen Sakari , Varpe Pirita , Carpelan Anu , Koivisto Mari , Huhtinen Heikki 
Published: June 2022

Objective The follow-up of the increasing number of cancer survivors threatens to overload the health care system. While short message system (SMS)–based communication is widely used in other areas of the health care system, there are no studies of its appliance in cancer surveillance. The aim of the current study was to analyze the acceptability, convenience and impact of a novel mobile phone messaging -based system (Mobile-CEA) on health personnel contacts in patients with colorectal cancer (CRC) during 2 years of follow-up. Methods The follow-up data of 52 curatively treated patients with CRC (22 Mobile-CEA-, 30 standard surveillance) was collected retrospectively from the electronic archives. Mobile-CEA patient satisfaction was measured by a tailored non-validated questionnaire. Health personnel satisfaction was assessed by personal interviews. Results Mobile-CEA surveillance group had less health personnel contacts than the standard surveillance group: median 3 (min 0–max 7) vs 5 (min 4–max 7) and 77.2% of the Mobile-CEA group had less than 4 contacts (minimum with the standard surveillance) to health personnel. There were no recurrences in either group. Mobile-CEA patients were satisfied with this novel follow-up method. Health personnel considered it as a practical and safe tool in CRC surveillance. Conclusion Mobile-CEA surveillance seems to be a promising and effective follow-up method for curatively treated patients with CRC. Further studies and experiences are needed.
Utilization of Personal Protective Equipment and Its Associated Factors Among Large Scale Factory Workers in Debre Berhan Town, Ethiopia
Authors: Baye Birara Fekadie , Baye Minale Fekadie , Teym Abraham , Derseh Behailu Tariku 
Published: June 2022

Background: Personal protective equipment (PPE) is one of the safeguards to protect workers from occupational risks. The aim of this study was to assess the utilization of PPE and associated factors among large-scale factory workers in Debre Berhan city administration, Ethiopia. Methods: An institutional-based cross-sectional study was conducted using stratified sampling among large-scale factory workers in the Debre Berhan city administration. Four hundred thirty-two employees were interviewed using a stratified sampling technique from 7 large-scale factories. Logistic regression analysis was used to identify factors affecting the utilization of PPE. The strength of association between variables was measured using the odds ratio with 95% confidence intervals at a P-value of .05. Results: A total of 413 respondents were included in the study, with a response rate of 95.6%. Two hundred and eighty-two (68.3%) of the participants were males. The mean age of the respondents was 28.37 ± 7.33 years. The PPE utilization was 35.43% (95% CI: 0.31, 0.40). Accordingly on job training (AOR = 8.85; 95% CI: 5.52, 14.28), previous history of injury (AOR = 0.23; 95% CI: 0.14, 0.36), workplace supervision (AOR = 14.08; 95% CI: 7.87, 25.0), and availability of guideline (AOR = 4.62; 95% CI: 2.51, 8.49) were statistically significant with utilization of PPE among large scale factory workers at a P-value <.05. Conclusion: Utilization of PPE is low. Previous history of injuries, on-the-job training, supervision, and the availability of guidelines were all independent predictors of PPE utilization. As a result, job training, workplace supervision, root-cause learning, and the availability of guidelines should all be considered.
The experience of being a spouse of a person with dementia in respect to their marital relationship in Japan
Authors: Musgrave-Takeda Mika , Ishibashi Miyuki , Masaki Harue 
Published: June 2022

Background and Purpose While the marital relationship with partners with dementia has an impact on spousal carers’ well-being, the spousal understandings or expectations of their marital relationship have not been fully identified. As the marital relationship is formed by individual backgrounds including society, culture and psychological status, the aim of this study was to identify the experience of being the spouse of a person with dementia in the context of their marital relationship. The study was conducted in Japan. Research Design To identify spousal experience of being, Heideggerian perspectives of interpretive phenomenology were applied. Study Sample Seven couples aged over 65 years, each comprising one partner with dementia who received home nursing, and their spouse participated in this study. Data Collection The couples were observed, and semi-structured interviews were conducted. Data Analysis Interpretive data analysis based on the Hermeneutic circle of Heideggerian perspectives was applied. Results In the findings, the experience of being a spouse, contextualised by spousal understandings of marital relationship, was formed through seven themes. The main context for spousal understanding of their marital relationship was helping each other as husband and wife, and this relationship was seen as natural and unchanging. It reflected on spousal potentiality of being, that is, living together indefinitely as before. Spouses tried to provide suitable care for their partners using memories while preserving a sense of identity, maintaining external relationships and accepting unanticipated internal responsibility. Conclusions In conclusion, fulfilling unmet needs could help spouses to ease intense care load, which re-acknowledges their own and their partner’s identity, and their relationship by reminiscing their past.
Comparison of the Clinical Outcome of Carotid Artery Stenting Between Institutions With a Treatment Strategy Based on Risk Factors and Those With First-Line Treatment
Authors: Ito Yoshiro , Ishikawa Eiichi , Sato Masayuki , Marushima Aiki , Hayakawa Mikito , Maruo Kazushi , Takigawa Tomoji , Kato Noriyuki , Tsuruta Wataro , Uemura Kazuya , Matsumaru Yuji 
Published: June 2022

Purpose: Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are recommended based on certain risk factors. The volume of an institution’s treatment experience may be associated with good clinical outcomes. There is a dilemma between the treatment strategy based on risk factors and the experience volume. Therefore, we investigated the clinical outcomes of CAS performed at institutions that selected the treatment strategy based on risk factors and those that performed CAS at the first-line treatment. Materials and Methods: Patients who underwent CAS at 5 institutions were included in this retrospective case-control study. We defined CEA/CAS institutions as those that selected the treatment option based on risk factors, and CAS-first institutions as those that performed CAS as the first-line treatment. We investigated cases of ischemic stroke, hemorrhagic stroke, myocardial infarction, and deaths within 30 days of the intervention between the CEA/CAS- and CAS-first institution groups. One-to-one propensity score matching was performed to compare rates of ischemic and hemorrhagic strokes within 30 days of the intervention. Results: A total of 239 and 302 patients underwent CAS at the CEA/CAS institutions and CAS-first institutions, respectively; ischemic stroke occurred in 12 (5.0%) and 7 patients (2.3%), respectively (p=0.09). No differences in major ischemic strokes (0.8% vs 1.3%; p=0.59), hemorrhagic strokes (0.4% vs 0.3%; p=0.87), or deaths (0.0% vs 0.7%; p=0.21) were observed. Myocardial infarction did not occur in either group. Propensity score analysis showed that ischemic stroke (odds ratio: 1.845, 95% confidence interval: 0.601–5.668, p=0.28) and hemorrhagic stroke (odds ratio: 1.000, 95% confidence interval: 0.0061–16.418, p=1.00) were not significantly associated with either institution group. Conclusions: The CAS-specific treatment strategies for CAS can achieve the same level of outcomes as the treatment strategy based on risk factors. The CAS performed based on risk factors in CEA/CAS institutions and the treatment of more than 30 patients/year/institution in CAS-first institutions were associated with good clinical outcomes.
Effect of physical training on cytokine expression in CD4+ T lymphocytes in subjects with stable COPD
Authors: Uzeloto Juliana S. , de Toledo-Arruda Alessandra C. , Silva Bruna S.A. , Braz Aline M.M. , de Lima Fabiano F. , Grigoletto Isis , Ramos Dionei , Golim Marjorie A. , Ramos Ercy M.C. 
Published: June 2022

Introduction: Although evidence suggests that physical exercise reduces systemic inflammation, at the plasma level, there are still contradictions in chronic obstructive pulmonary disease (COPD). In this sense, analysis of intracellular cytokines could clear off the effect of physical exercise on the inflammatory profile of these subjects. Aim: The aim was to evaluate the effect of physical training on cytokine expression in CD4+ T lymphocytes from subjects with COPD. Methods: This is a randomized controlled trial. Subjects with stable COPD were grouped into two groups, exercise and control. In total, 23 subjects with stable COPD were evaluated, of which 15 underwent aerobic strength training [physical exercise group (PEG)] and 8 underwent breathing exercises [respiratory physiotherapy group (RPG)]. Intracellular cytokines [interleukin (IL)-8, IL-13, IL-17, IL-6, IL-2, IL-10, and tumor necrosis factor alpha (TNF-α)] from CD4+ T lymphocytes were analyzed from peripheral blood through flow cytometry, before and after 8 weeks of intervention. Results: The PEG and RPG groups had a mean age of 68 ± 5.96 and 72.25 ± 6.86 years and predicted forced expiratory volume in the first second (FEV1) of 58.6 ± 15.99% and 39.75 ± 10.39%, respectively. It was possible to detect a significant reduction in IL-8 ( p = 0.0125) and an increase in IL-13 ( p = 0.0014) and an increase in TNF-α ( p < 0.001) in both groups. Conclusion: Eight weeks of physical training, both peripheral and respiratory, were able to reduce concentrations of IL-8 and to increase IL-13, and TNF-α in CD4+ T lymphocytes in subjects with stable COPD. The findings reinforce the benefits of interventions in subjects with COPD, revealing data not previously investigated.
SARS-CoV-2-inactivated vaccine hesitancy and the safety in inflammatory bowel disease patients: a single-center study
Authors: Cao Yubin , Feng Jiaming , Duan Shihao , Yang Yi , Zhang Yan 
Published: June 2022

Background: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine is thought to be the most effective preventive method of controlling the coronavirus disease 2019 (COVID-19) epidemic. Some patients with immune-related diseases, including inflammatory bowel disease (IBD) patients, however, may hesitate to be vaccinated for various reasons. Although several guidelines recommend vaccinating all IBD patients with inactivated SARS-CoV-2 vaccines, there is still a lack of real-world data on the safety of inactivated SARS-CoV-2 vaccines and COVID-19 vaccination rate in IBD patients. In this study, we investigated the reasons for hesitancy in COVID-19 vaccination, the COVID-19 vaccination rate, and the safety of SARS-CoV-2-inactivated vaccination in patients with IBD. Methods: This was a retrospective study. A total of 418 participants with IBD were enrolled to calculate the vaccination rates. A total of 232 patients with IBD who did not receive SARS-CoV-2 vaccination were recruited to investigate the reasons for hesitation. A follow-up survey of 151 IBD patients and 188 healthy participants who had received the SARS-CoV-2-inactivated vaccination was conducted to analyze adverse reactions. Results: The COVID-19 vaccination rate was 49.3% and almost half of the participants were ‘Concerned about the safety of the vaccine (such as adverse reactions) due to IBD’. After SARS-CoV-2 vaccination, adverse reactions were mild or moderate. The adverse reactions in the IBD and non-IBD populations were roughly the same, and IBD medications did not increase the risk of adverse reactions. Conclusion: SARS-CoV-2-inactivated vaccination rates in IBD patients are still low and a significant proportion of patients are hesitant about the vaccine because of safety concerns. SARS-CoV-2-inactivated vaccination in patients with IBD appears to be safe.
Lipoaspiration and Processing to Create Microfragmented Adipose Tissue
Authors: McGee Cally , Baria Michael R. , Gatewood Corey , Tiwari Maneesh , Vasileff W. Kelton , Lavender Chad 
Published: June 2022

Background: Orthobiologics are increasingly used to treat musculoskeletal (MSK) conditions. Adipose may be a useful source of autologous cells for orthobiologic interventions. The lipoaspiration and processing techniques necessary to obtain these cells are not traditionally taught in most orthopedic training programs. Therefore, the goal of this video is to review the technique for adipose harvest and preparation to create microfragmented adipose tissue (MFAT). Indications: Currently, all MFAT applications are off-label. In practice, this is most commonly used for osteoarthritis and tendon disease. Technique Description: After local anesthesia is administered, a 17-gauge trochar is inserted into the subcutaneous adipose, and tumescent solution is injected. After a 5-minute waiting period, a separate 17-gauge harvest trochar is attached to the Autopose double-syringe (Arthrex; Naples, Florida) and is inserted into the subcutaneous adipose. Lipoaspiration is performed by moving the harvest device back and forth in a fan-like pattern. After 20 mL of lipoaspirate has been harvested from the first site, the lipoaspiration process is repeated on the contralateral side. After 40 mL of lipoaspirate has been harvested, the device is removed and decanted for 3 to 5 minutes. Then, 10 mL of sterile saline solution is injected into the device using the Luer lock attachment. This rinse process is repeated a second time. Once the excess fluid has been removed, the device is capped, and the outer syringe is slowly pushed down to move the tissue through the resizing filter. The inner syringe is removed and contains the final MFAT product. Discussion/Conclusion: Lipoaspirate is a simple technique that can be performed in the clinic or operating room to create MFAT. This provides a unique population of autologous cells that may be beneficial for treating MSK pathology.
Hemodynamic changes associated with neuraxial anesthesia in pregnant women with covid 19 disease: a retrospective case-control study
Authors: Sangroula D. , Maggard B. , Abdelhaleem A. , Furmanek S. , Clemons V. , Marsili B. , Stikes R. , Hill M. , Sigdel A. , Clifford S. P. , Huang J. , Akca O. , Logsdon M. C. 
Published: June 2022

Abstract
Background
Neuraxial blocks is the recommended mode of analgesia and anesthesia in parturients with Coronavirus 19 (COVID-19). There is limited data on the hemodynamic responses to neuraxial blocks in COVID-19 patients. We aim to compare the hemodynamic responses to neuraxial blocks in COVID-19 positive and propensity-matched COVID-19 negative parturients.

Methods
We conducted retrospective, cross-sectional case–control study of hemodynamic changes associated with neuraxial blocks in COVID-19 positive parturients in a Tertiary care academic medical center. Fifty-one COVID-19 positive women confirmed by nasopharyngeal reverse transcription–polymerase chain reaction (RT-PCR), were compared with propensity-matched COVID negative controls (n = 51). Hemodynamic changes after neuraxial block were recorded by electronic medical recording system and analyzed using paired and unpaired T- test and Wilcoxon-Mann–Whitney Rank Sum tests. The primary outcome was ≥ 20% change in MAP and HR after neuraxial block placement.

Results
In the epidural group, 7% COVID-19 positive parturients had > 20% decrease in mean arterial pressure (MAP) from baseline compared to 15% COVID-19 negative parturients (P = 0.66). In the spinal group, 83% of COVID-19 positive parturients had a decrease in MAP more than 20% from baseline compared to 71% in control (P = 0.49). MAP drop of more than 40% occurred in 29% COVID positive parturients in the spinal group versus 17% in COVID-19 negative parturients (P = 0.5465). In COVID-19 positive spinal group, 54% required vasopressors whereas 38% in COVID-19 negative spinal group required vasopressors (P = 0.387). We found a significant correlation between body mass index (BMI) > 30 and hypotension in COVID ( +) parturient with odds ratio (8.63; 95% CI-1.93 – 37.21) (P = 0.007).

Conclusion
Incidence and severity of hypotension after neuraxial blocks were similar between COVID-19 positive and COVID-19 negative parturients. BMI > 30 was a significant risk factor for hypotension as described in preexisting literature, this correlation was seen in COVID-19 positive parturients. The likely reason for parturients with BMI > 30 in COVID negative patients not showing similar correlation, is that the sample size was small.
Clinical-pathological characteristics and prognostic factors for malignant peritoneal mesothelioma in the elderly
Authors: Pan Dan , Wang Mengyao , Liu Wencheng , Li Yan , Sang Lixuan , Chang Bing 
Published: June 2022

Abstract
Background
Malignant peritoneal mesothelioma (MPM) is a rare disease characterized by atypical symptoms, difficult diagnosis, variable course and poor prognosis, and it develops mainly in elderly individuals. The authors aimed to identify the clinical-pathological characteristics, prognosis, and prognostic factors in elderly MPM patients.

Methods
From the National Cancer Institute Surveillance Epidemiology End Results (SEER) database, 1492 patients with MPM from 1975 to 2016 were selected and divided into the elderly group (≥ 65) and the adult group (< 65). We compared the clinical-pathological characteristics and treatment methods of the elderly group (N = 665) and the adult group (N = 827). At the same time, we analysed specific selected clinicopathological parameters and prognostic factors for elderly MPM patients.

Results
Compared with the adult group, the elderly group had higher percentages of male patients (P = 0.017) and white patients (P = 0.043) and lower proportions of insured patients (P < 0.001) married patients (P < 0.001), patients with peritoneal tumours (P = 0.006) and patients who underwent surgery (P < 0.001) and chemotherapy (P < 0.001). There was a significant difference in the differentiation grade between the two groups (P = 0.003). Elderly patients had a shorter median survival time than adult patients (6 months vs. 19 months). Uninsured (hazard ratio (HR): 5.187, P = 0.005), sarcomatoid type (HR 3.913, P < 0.001), poorly differentiated (HR 3.900, P < 0.001), distant metastasis (HR 1.735, P = 0.001), no cancer-directed surgery (HR 1.733, P < 0.001), and no chemotherapy (HR 1.532, P < 0.001) were independently associated with poorer prognosis in elderly MPM patients.

Conclusion
Compared with adult patients, elderly MPM patients had a higher male ratio, poor differentiation and relatively conservative treatment. The cancer-specific survival (CSS) rate of elderly MPM patients was significantly lower than that of adult patients. Insurance status, histology type, differentiation grade, stage, surgery status, and chemotherapy status were all independent prognostic factors for elderly MPM patients.