bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Safe Do Dying People Feel at Home? Patients’ Perception of Safety While Receiving Specialist Community Palliative Care
Authors: Pedrosa Carrasco Anna J , Bezmenov Alexandra , Sibelius Ulf , Berthold Daniel 
Published: November 2022

Background There is a research gap regarding safety concerns of patients at the end of life. The aim of this study was, therefore, to explore whether patients under specialist community palliative care feel safe at home and which factors affect the perceived safety. Furthermore, we investigated if perception of safety is associated with different aspects of subsequent care. Methods Using a standardized questionnaire, a cross-sectional survey was conducted among 100 specialist community palliative care patients. Logistic regression was used to examine the strength of the association between clinical and socio-demographic variables and the perception of safety. After a 6-month follow-up period, we analyzed differences in various care-related outcomes between patients with unaffected and impaired perceptions of safety. Results In our study, one in five patients receiving specialist community palliative care expressed safety concerns. Subdomains of safety that were reported most frequently were physical disability (60%), physical symptoms (30%), psychological symptoms (26%), and side effects/complications of drug therapy (19%). Of the participants surveyed after the initial COVID-19 lockdown, 35.1% reported that they felt their safety had been adversely affected by the pandemic. Compromised safety perception was associated with higher levels of palliative care-related problems, and proximity to death. Conclusions Our study uncovered relevant safety concerns of palliative care patients receiving specialist community palliative care. The insights gained into patient-reported problems may help healthcare professionals to identify situations where patients feel unsafe. Further research should address primary and secondary prevention measures to improve the quality of end-of-life care in the home environment.
Anti-Tumor Efficacy of Anti-PD-1/PD-L1 Antibodies in Combination With Other Anticancer Drugs in Solid Tumors: A Systematic Review and Meta-Analysis
Authors: Inoue Takashi , Narukawa Mamoru 
Published: November 2022

Background The clinical efficacy of immune checkpoint inhibitors (CPIs) has been proven; however, it is also known that their efficacy as monotherapy is limited, with a response rate of 20% or less in solid tumors. The combination of CPIs and anticancer agents has been actively attempted in solid tumors area. In this systematic review and meta-analysis, we aimed to find favorable combination therapies of programmed death 1 (PD-1) or programmed death ligand 1 (PD-L1) inhibitors in terms of anti-tumor efficacy in clinical settings. Methods An electronic database search was performed using ClinicalTrials.gov , PubMed, and ASCO/ESMO annual meeting libraries. We included randomized or non-randomized trials designed to evaluate the efficacy and safety of combination therapies of PD-1/PD-L1 inhibitors and other anticancer drug-containing therapies. All clinical studies selected were solid tumors with objective response rate (ORR) data. The quality of the evidence was assessed with the Cochrane risk of bias tool or the Newcastle-Ottawa Scale. Meta-analysis used random effects models to pool results. Results Sixteen studies involving 3793 patients were included in the primary analysis. These studies have a monotherapy group with PD-1/PD-L1 inhibitors as the control group or the in-study arm/cohort (1863 patients in the combination group with PD-1/PD-L1 inhibitors and 1930 patients in PD-1/PD-L1 inhibitor monotherapy). The pooled results showed that the combination of PD-1/PD-L1 inhibitors and other anticancer drugs significantly improved the ORR (relative risk [RR] = 1.79, 95% confidence interval [CI] 1.46, 2.20). In the subgroup analysis, PD-1/PD-L1 inhibitor plus DNA-synthesis or microtubule inhibitor led to a statistically significant improvement in the ORR compared to PD-1/PD-L1 inhibitor alone. Conclusions It was suggested that combinations of PD-1/PD-L1 inhibitors and potential immunogenic cell death (ICD) inducers improve the clinical anti-tumor efficacy, although updated meta-analyses based on the results of ongoing clinical trials are further needed.
Letermovir and tacrolimus interaction effects in hematopoietic cell transplantation recipients receiving moderate cytochrome P450 3A4 inhibitors for antifungal prophylaxis
Authors: Malespini Jack , Lei Matthew , Tavares Erica , Hammond Sarah P , Chen Yi-Bin , Luk Samantha O , DeFilipp Zachariah 
Published: November 2022

Introduction Letermovir inhibits cytomegalovirus replication and is approved for the prevention of cytomegalovirus infection in cytomegalovirus seropositive hematopoietic cell transplantation recipients. Studies have found that letermovir coadministration has minimal effect on tacrolimus levels prior to the start of voriconazole, a strong cytochrome P450 (CYP) 3A4 inhibitor. However, data are lacking for hematopoietic cell transplantation recipients receiving letermovir and tacrolimus with moderate CYP 3A4 inhibitors as antifungal prophylaxis. Methods In this retrospective single-center analysis, we reviewed the charts of 92 consecutive adult allogeneic hematopoietic cell transplantation recipients receiving letermovir, tacrolimus, and moderate CYP3A4 inhibitors for antifungal prophylaxis. Results Tacrolimus concentration/dose (C/D) ratios were evaluated for the first 7 days pre-letermovir and for the first and second 7-day periods after letermovir. The tacrolimus mean C/D ratios [(ng/mL)/(mg/kg/day)] increased significantly with the addition of letermovir: 172.99 (95% confidence interval (CI): 158.2–187.78) pre-letermovir, 268.66 (95% CI: 244.34–292.98) first-week letermovir, and 312.19 (95% CI: 279.39–344.99) second-week letermovir ( P < 0.001). The average dosages (mg/kg) of tacrolimus also decreased significantly across the three-time intervals ( P < 0.001). Only four patients experienced clinically significant cytomegalovirus reactivation which required systemic treatment. Conclusion These results demonstrate a reduction in tacrolimus dosing requirements for patients receiving tacrolimus and letermovir with concomitant moderate CYP3A4 inhibitors. The results of this interaction suggest that frequent monitoring of tacrolimus trough levels is warranted when starting letermovir and that empiric reduction of tacrolimus dosing upon letermovir initiation should be considered.
Combined Use of ECMO, Prone Positioning, and APRV in the Management of Severe COVID-19 Patients
Authors: Ong Stephanie L , Tantawy Hossam , Assi Roland , Chichra Astha , Treggiari Miriam M 
Published: November 2022

Background Severe COVID-19-associated Acute Respiratory Distress Syndrome (ARDS) may warrant extracorporeal membrane oxygenation (ECMO). We evaluated the safety and physiologic changes in oxygenation and hemodynamic profile during ECMO, prone positioning, and the two modalities combined in patients receiving veno-venous (VV) ECMO. Methods Cohort study of consecutive adult patients with COVID-19-associated ARDS requiring VV-ECMO, classified into three groups: ECMO support only; Prone positioning only; and Prone positioning during ECMO. We collected hemodynamic, respiratory and ventilation variables as follows: pre-treatment, 1, 6, and 24 h post-treatment, and documented treatment-related complications. On-treatment variables were compared with pre-treatment using one-sample paired t-test with Bonferroni correction. Results Fourteen patients (mean age 48.1 [SD 9.3] years, male [100%]) received VV-ECMO. Of those, 10 patients had data during prone positioning alone and seven had data while proned on ECMO. While on ECMO, patients had improvement in oxygen saturation, PaO2/FiO2 ratio, and minute ventilation up to 24 h post-treatment. Vasopressor requirements increased with ECMO at 1 h and 24 h post-treatment. Prone positioning was not associated with clinically significant hemodynamic or respiratory changes, either alone or during ECMO support. All patients sustained deep tissue injuries, but only those on the face or chest were related to prone positioning. Three patients required cannula replacement. In-hospital mortality was 43%. Conclusions VV-ECMO and prone positioning in patients with COVID-19 ARDS was overall well-tolerated; however, physiologic improvements were marginal, and patients sustained deep tissue injuries. Although this was a selected population with high mortality, our data call into question the benefits of these management modalities in this severe COVID-19 population.
Telemedicine utilization and perceived quality of virtual care among pregnant and postpartum women during the COVID-19 pandemic
Authors: Davis Ann , Bradley Dani 
Published: November 2022

Introduction The aim of this research was to examine the association between perceived quality of care during the COVID-19 pandemic and the modality of maternity care visits, virtual or in-person. Methods This study utilized an online nationwide survey about experiences in prenatal and postpartum care between 18 April and 6 August 2020. Perceived quality of care was categorized into worse care, better, or the same care as compared to before the pandemic. Barriers were categorized into five groups: (1) concern for the privacy of health information, (2) not having a private or quiet place, (3) lack of physical exam or measurements, (4) quality of care, and (5) technology issues. Data analyses included bivariate analyses and multivariate logistic regression. Results The majority (75.3%) of modified visits utilized telemedicine. Over half of the women took at-home measurements and the majority were successful. Barriers to care included a lack of a quiet or private space to conduct their visit. Women expressed concerns about a lack of measurements and a lower quality of care. Women who received telemedicine visits perceived worse care as compared to women who received in-person care visits (OR = 5.62; 95% CI 5.01–6.31). Discussion Previous studies have shown that pregnant patients are generally satisfied with virtual care during the pandemic. This study provides insight from a large nationwide sample of women and geographic variation in satisfaction and perceived quality. These findings highlight barriers and potential solutions to improving patients’ perceived quality of virtual maternity care, and thus future uptake of high-quality, virtual care.
The economic evaluation of an Internet-based parental wellbeing intervention
Authors: Lee Peter , Sanders Davina , Milgrom Jeannette , Kavanagh David J , Scuffham Paul A 
Published: November 2022

Background Internet-based parental programmes may improve parental wellbeing and mitigate the burden of mental health issues during the perinatal period. However, few studies have explored the cost and clinical impacts of such interventions. In the present study, we sought to evaluate the cost-effectiveness associated with an online cognitive behaviour therapy intervention ( Baby Steps Wellbeing) to an information-only programme (Baby Care). Methods An alongside-trial cost-effectiveness analysis was undertaken using data from a randomised clinical trial comparing the Baby Steps Wellbeing intervention to Baby Care. Direct healthcare costs, as well as indirect costs attributed to income loss, were considered. The Assessment of Quality of Life-8 Dimensions multi-attribute utility instrument was used to estimate participant utilities, and subsequently calculate quality-adjusted life years (QALYs). Incremental cost-effectiveness ratios were calculated to assess the cost-effectiveness of the intervention. The economic evaluation adopted a societal perspective. Results In total, 496 parents were randomised to either the Baby Steps Wellbeing intervention or the Baby Care control arm. No significant differences in costs (−$27, 95% confidence interval (CI): −$1189–$1134) or QALYs (0.051, 95% CI: −0.097–0.200) were identified. Bootstrapped results showed that the Baby Steps Wellbeing programme was cost-saving and health improving in 38% of simulations and cost-effective in another 37% of simulations. Conclusions The Baby Steps Wellbeing programme was slightly cost-saving with slightly improved health outcomes compared with Baby Care. Bootstrapped results indicate the Baby Steps Wellbeing was cost-effective in 75% of simulations. Overall, the Baby Steps Wellbeing programme is an online programme that is cost-effective. Trial registration Australian & New Zealand Clinical Trials Registry: ANZCTR12614001256662.
Cardiopulmonary Exercise Test With Comorbidity Index Before Allogeneic Hematopoietic Stem Cell Transplantation
Authors: Yeon Sang Hoon , Lee Myung-Won , Thuy Duong Pham Thi , Kang Sora , Jee Sungju , Ahn So-Young , Ryu Hyewon , Lee Hyo-Jin , Kwon Jung Hye , Yun Hwan-Jung , Jo Deog-Yeon , Song Ik-Chan 
Published: November 2022

Purpose: To evaluate the role of the cardiopulmonary exercise test (CPET) with comorbidity index as a predictor of overall survival (OS) and non-relapse mortality (NRM) in patients with hematological malignancies who undergo allogeneic hematopoietic stem cell transplantation (HSCT). Methods: We retrospectively analyzed consecutive adult patients with hematological malignancies who underwent HLA-matched donor-HSCT at Chungnam National University Hospital (Daejeon, South Korea) between January 2014 and December 2020. Maximal oxygen consumption (VO2max) was classified using the recommendations of the Mayo Clinic database. Results: Of 72 patients, 38 (52.8%) had VO2max values lower than the 25th percentile (VO2max ≤ 25th) of an age- and sex-matched normal population. Patients with VO2max ≤ 25th had no significant differences both OS and NRM (30 month OS 29.8% vs 41%, P = .328; and 30 month NRM 16% vs 3.3%, P = .222), compared with other patients. VO2max ≤ 25th was assigned a weight of 1 when added to the Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI) to form a composite comorbidity/CPET index (HCT-CI/CPET). Patients with HCT-CI/CPET scores of 0 to 1 demonstrated significantly better OS and NRM than did patients with HCT-CI/CPET scores ≥2 [median OS not reached vs 6 months, P < .001 and 30 month NRM 7.4% vs 33.3%, P = .006]. An HCT-CI/CPET score ≥2 was the only adverse risk factor for NRM on multivariate analysis [hazard ratio (HR) of NRM 10.36 (95% CI 1.486-2.25, P = .018)]. Conclusion: The composite HCT-CI/CPET score can predict the survival and mortality of patients with hematological malignancies who undergo allogeneic HSCT.
Technical and clinical success after venous sinus stenting for treatment of idiopathic intracranial hypertension using a novel guide catheter for access: Case series and initial multi-center experience
Authors: Zyck Stephanie , Malik Muhammad , Webb Matthew , Mohammed Marwa , Powers Ciaran J , Birnbaum Lee , Hawk Harris , Brinjikji Waleed , Nimjee Shahid M. 
Published: November 2022

Introduction Venous sinus stenting is a well established alternative to cerebrospinal fluid diversion for the treatment of idiopathic intracranial hypertension (IIH) with associated venous sinus stenosis. During this procedure, distal guide catheter placement within the venous sinuses may be desirable to facilitate stent delivery. We report our initial experience using the TracStar LDP™ (Imperative Care, Campbell, USA, 0.088-inch inner diameter) as the guide catheter for intracranial access during venous sinus stenting. Methods A multi-institutional retrospective chart review of a prospectively maintained IRB-approved database was performed. Consecutive patients who underwent venous sinus stenting from 1/1/2020-9/6/2021 for IIH were included. Patient characteristics, procedural details, TracStar distal reach, outcomes, and complications were collected and analyzed. Results Fifty-eight patients were included. The mean age was 33.8 years and 93.1% of patients were female. Visual changes prompted evaluation in 86.2% of patients. Stent placement was successful in all patients. The TracStar LDP catheter was advanced to the location of stent placement in 97.9% of cases in which it was attempted. The large 0.088-inch inner diameter lumen enabled compatibility with all desired stent sizes ranging from six to 10 millimeters. Gradient pressure across transverse sinus stenosis dropped from an average of 19.5 mmHg pre-procedure to 1.7 mmHg post-stent placement (p < 0.001). Clinical improvement was achieved in 87.9% (51/58) of patients. There were no catheter-related complications. Conclusion The TracStar LDP is a safe and effective access platform for reaching treatment locations in patients who present with idiopathic intracranial hypertension and who are candidates for venous sinus stent placement.
First case of relining an aortic bifurcated bypass graft with the Altura endograft to treat anastomotic aneurysms
Authors: Georgakarakos Efstratios , Dimitriadis Konstantinos , Georgiadis George S 
Published: November 2022

Objective Use of classic bifurcated endografts for relining of bifurcated aortic bypass grafts with aneurysms is usually precluded by the short distance between the lowermost renal artery and the aneurysmatic bifurcation, rendering their management challenging. Methods We present the use of the Altura endograft in a case of a 75-year old male with large anastomotic aneurysms in the proximal and the left iliac amastomosis of a bifurcated aortic bypass graft. The Altura endograft consists of two separate components with a proximal D-shaped design. Its braided nitinol endoskeleton is attached only at the proximal and distal ends of the inner surface of the polyester fabric and results in adjustable lengths of the components according to the vessel diameters where they are deployed. Results A 24 mm Altura sealed successfully at the native infarenal aortic segment covering the entire distance between the lowermost renal artery and the upper end of external iliac artery, providing successful exclusion of the aneurysms. No iliac extensions were used. The completion angiography showed no endoleaks. Conclusions The unique design of Altura makes it ideal for treatment of anastomotic aneurysms of bifurcated bypass grafts, overcoming anatomic limitations. To the best of our knowledge, this is the first report addressing this crucial issue.
The ipsilateral olecranon tip is a suitable anatomic autograft for unrepairable coronoid fractures: A comparative three-dimensional mapping analysis
Authors: Putman Stephen A , Farooq Hassan , Chauhan Aakash , Jiang Feifei , Chen Jie , Hastings Hill , Merrell Gregory A 
Published: November 2022

Background Perform computed tomography (CT) three-dimensional (3D) mapping analysis of the ipsilateral olecranon tip to determine its suitability as an autograft for unrepairable coronoid fractures. Methods CT was evaluated using Mimics 13.0 and 3-matic software (Materialise, Inc., Leuven, Belgium). Coronoid fracture fragment was measured from the medial sublime tubercle to the halfway point of the proximal radioulnar joint. Ipsilateral olecranon tip graft was measured at the equivalent height of the coronoid fragment and the angle of graft “cut” necessary to match the coronoid fragment was measured. The overall width of each graft site was measured in thirds and the congruity of surface geometry was measured by overlapping both fragments. The ipsilateral olecranon tip lateral facet which rotates to become the coronoid medial facet was also measured. Results The olecranon tip and coronoid fragments were similar in average maximum height and width. The average angle of graft cut needed to match the coronoid fragment was 86°. The average difference between the medial facet of the coronoid and lateral facet of the olecranon was <2 mm. Discussion The ipsilateral olecranon tip can be harvested through the same surgical incision and function as a local autograft during reconstruction of unrepairable coronoid fractures.
COVID-19 smart surveillance: Examination of Knowledge of Apps and mobile thermometer detectors (MTDs) in a high-risk society
Authors: Sayibu Muhideen , Chu Jianxun , Tosin Yinka Akintunde , Rufai Olayemi Hafeez , Shahani Riffat , Jin MA 
Published: November 2022

Background Technological innovations gained momentum and supported COVID-19 intelligence surveillance among high-risk populations globally. We examined technology surveillance using mobile thermometer detectors (MTDs), knowledge of App, and self-efficacy as a means of sensing body temperature as a measure of COVID-19 risk mitigation. In a cross-sectional survey, we explored COVID-19 risk mitigation, mobile temperature detectable by network syndromic surveillance mobility, detachable from clinicians, and laboratory diagnoses to elucidate the magnitude of community monitoring. Materials and Methods In a cross-sectional survey, we create in-depth comprehension of risk mitigation, mobile temperature Thermometer detector, and other variables for surveillance and monitoring among 850 university students and healthcare workers. An applied structural equation model was adopted for analysis with Amos v.24. We established that mobile usability knowledge of APP could effectively aid in COVID-19 intelligence risk mitigation. Moreover, both self-efficacy and mobile temperature positively strengthened data visualization for public health decision-making. Results The algorithms utilize a validated point-of-center test to ascertain the HealthCode scanning system for a positive or negative COVID-19 notification. The MTD is an alternative personal self-testing procedure used to verify temperature rates based on previous SARS-CoV-2 and future mobility digital health. Personal self-care of MTD mobility and knowledge of mHealth apps can specifically manage COVID-19 mitigation in high or low terrestrial areas. We found mobile usability, mobile self-efficacy, and app knowledge were statistically significant to COVID-19 mitigation. Additionally, interaction strengthened the positive relationship between self-efficacy and COVID-19. Data aggregation is entrusted with government database agencies, using natural language processing and machine learning mechanisms to validate and analyze. Conclusion The study shows that temperature thermometer detectors, mobile usability, and knowledge of App enhanced COVID-19 risk mitigation in a high or low-risk environment. The standardizing dataset is necessary to ensure privacy and security preservation of data ethics.
The Relationship of Family and School Environments with Depression, Anxiety, and Stress Among Jordanian Students: A Cross-Sectional Study
Authors: Rayan Ahmad , Harb Alaa Mohamad , Baqeas Manal Hassan , Al.Khashashneh Osama Zuhair , Harb Eman 
Published: November 2022

Introduction Depression, anxiety, and stress are highly prevalent among adolescents. The role of impaired family and school environments in adolescents’ depression, anxiety, and stress in Jordan has yet to be established. Objective The purpose of this study was to explore the association of family and school environments with the depression, anxiety, and stress of adolescents in Jordan. Methods A cross-sectional correlational survey was used. A sample of 220 adolescents aged 12–18 years completed the study. Data were collected about family and school environments and adolescents’ depression, anxiety, and stress. Results School climate had a strong significant relationship with both general family functioning ( r = .53, p < 0.01) and family process ( r  = .58, p  < 0.01). General family functioning and school climate were uniquely associated with stress, anxiety, and depression ( Β = −.280 or higher), p < 0.05, controlling for demographics. Conclusion The general family functioning and overall school climate were shown to play important role in adolescents’ depression, anxiety, and stress. School nurses and psychiatric nurses may want to respond to the needs of adolescents with depression, anxiety, and stress through campaigns, lectures, and conferences and encourage them to access professional psychological counseling.