bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of clinical use of intravenous iron: Utilization, efficacy, and safety in the management of cancer and chemotherapy-induced anemia in GI oncology.
Authors: Rostamnjad Leila , Leblebjian Houry , Falb Jennifer , Dolan Meghan , Sommer Karen A. , McCleary Nadine Jackson 
Published: September 2022

359 Background: National Comprehensive Cancer Network recommends intravenous (IV) iron therapy for management of cancer and chemotherapy induced anemia without mentioning agent preference. Currently at Dana-Farber Cancer Institute (DFCI), all IV iron formulations can be utilized in management of iron deficiency anemia. This study was performed to evaluate the utilization, efficacy, and safety of IV iron formulations in management of cancer and chemotherapy induced iron deficiency anemia in patients with gastrointestinal (GI) cancer. Methods: Retrospective chart review was performed on DFCI patients with GI cancer undergoing palliative or adjuvant chemotherapy who received ferric gluconate, ferumoxytol, or iron sucrose between January 2021 and January 2022. Patients were identified using electronic medical record reports. Data was collected on cancer diagnosis, chemotherapy regimen, total IV iron dose and frequency, infusion reactions, laboratory values including hemoglobin, mean corpuscular volume (MCV), and iron status parameters (serum iron, ferritin, transferrin, iron-binding capacity, transferrin saturation) at baseline and 4-6 weeks after the last dose. The primary outcome was to assess the utilization of different IV iron formulations. Secondary outcomes were efficacy defined as mean absolute change from baseline in Hemoglobin levels and safety defined as incidence of hypersensitivity reactions. Results: 102 patients were evaluated of which 61 received ferumoxytol, 36 ferric gluconate and 5 iron sucrose. All patients had baseline hemoglobin (≤11 g/dL) and MCV collected. 89 patients had baseline iron status parameters (serum iron, ferritin, transferrin, iron-binding capacity, transferrin saturation). Most patients (N = 70) had diagnosis of colorectal cancer and received chemotherapy every 2 weeks. All patients received recommend total dose of IV iron on days of chemotherapy which was outside the recommended schedule of the IV iron formulations. A gradual increase in Hemoglobin concentrations in patients treated with IV iron was observed. Conclusions: Ferumoxytol and Ferric Gluconate were the most utilized IV iron formulation at DFCI GI oncology patients. All patients received recommended IV iron dosing but did not follow the recommended schedule. All patients had hemoglobin and MCV checked before each IV iron therapy. IV iron therapy was well tolerated and effective in treatment of iron-deficiency anemia in patients with gastrointestinal cancer undergoing chemotherapy.[Table: see text]
The Together, Equitable, Accessible, Meaningful (TEAM) cancer care for sexual and gender minority (SGM) patients: A pilot training evaluation.
Authors: Pratt-Chapman Mandi L. , Shirima Sylvia 
Published: September 2022

366 Background: SGM persons face barriers to health care which may contribute to disparities in cancer outcomes. SGM-specific health coverage in healthcare professional schools is minimal and inconsistent. The TEAM SGM Training aimed to address the unique health care needs of SGM people diagnosed with cancer by improving healthcare professional knowledge and clinical preparedness and changing in-clinic behaviors as well as organizational policies. Methods: Seven teams of healthcare professionals (n = 28) were invited to participate in the pilot. Each team participated in a 13-week, 17.5-hour training curriculum and developed an action plan and progress was assessed at three- and six-months post-training. Change in provider confidence, attitudes, knowledge, and behaviors were measured using an investigator-created and validated survey. Paired sample t-tests were used to examine differences from baseline to post-training learner assessment. Teams participated in entrance and exit interviews to identify drivers and barriers to implementation. Independent samples t-tests were used to examine differences in patient experiences at baseline in each organization and at 26 weeks post baseline data collection. Results: Of the 28 learners who started the training, 27 learners completed the training. All learners (n = 28) completed baseline assessments, and n = 22 completed post-intervention assessments. Statistically significant improvements were found in four of five factors: Environmental Cues ( t(21) = 2.56, p =.018), Knowledge ( t(21) = 2.15, p =.043), Clinical Preparedness ( t(7) = 3.89, p =.006), and Clinical Behaviors (t(21) = 2.48, p =.022). For patient experience, n = 90 baseline surveys and n = 187 post-intervention surveys were collected across two healthcare settings. Results were null. All teams made progress at six months on action plans. Facilitators and barriers included; resources and buy-in from leadership and limited staff engagement respectively. Conclusions: Synchronized standardized training can improve knowledge, clinical preparedness, and clinical behaviors for SGM-affirming care. While realistic goals are critical to early success, ongoing technical assistance and supportive institutional structures are important for successful organizational change.
Racial/ethnic differences in telemedicine utilization and satisfaction among patients with breast cancer during the COVID-19 pandemic.
Authors: Freeman Jincong , Zhao Fangyuan , Nanda Rita , Olopade Olufunmilayo I. , Huo Dezheng 
Published: September 2022

384 Background: Telemedicine utilization has increased in recent years, with widespread adoption during the COVID-19 pandemic. Literature has documented benefits of telemedicine in cancer care and symptom management; patients (pts) report satisfaction with telemedicine. Data on telemedicine utilization is lacking, and racial/ethnic differences in utilization and satisfaction are unknown among breast cancer pts. Methods: Two surveys, conducted in 2020 and 2021, collected data on telemedicine utilization and satisfaction among breast cancer pts enrolled in the Chicago Multiethnic Epidemiologic Breast Cancer Cohort. Telemedicine utilization (e.g., telephone call or video conference) during the COVID-19 pandemic was per self-report. Satisfaction was assessed using a 5-point Likert scale. Mixed-effects (ME) binary logistic regression was used to model utilization, and ME proportional odds regression was used to model satisfaction. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated. Results: Of 1,260 respondents in 2020, 57.6% were ages 40-65, 72.2% were White, 22.3% were Black, 75.1% had private insurance, and 99% had early-stage breast cancer. Of 1,299 respondents in 2021, 58.6% were ages 40-65, 71.4% were White, 21.9% were Black, 77.6% had private insurance, and 98.9% had early-stage breast cancer. In 2020, 59.1% reported using telemedicine, while in 2021, 64.9% did. Black pts were most likely to have used telemedicine, followed by Asian, Hispanic, and White pts. In the adjusted ME models, Black pts were more likely than White pts to have used telemedicine (AOR 2.9, 95% CI: 1.6-5.4), while no differences in utilization were observed between Asian and White (AOR 2.1, 95% CI: 0.6-7.4) or Hispanic and White (AOR 1.7, 95% CI: 0.5-6.3) pts over time. In 2020, 90.3% reported somewhat to extreme satisfaction with telemedicine, and in 2021, 91.2% did. There were no racial/ethnic differences in satisfaction between Black and White (AOR 1.1, 95% CI: 0.7-1.7), Asian and White (AOR 0.4, 95% CI: 0.2-1.1), or Hispanic and White (AOR 0.5, 95% CI: 0.2-1.4) pts over time. Conclusions: In this multiethnic cohort of breast cancer pts, telemedicine utilization and satisfaction were high over time and across racial/ethnic groups. Furthermore, racial/ethnic minorities were more likely to have used telemedicine. Our findings suggest an important role for telemedicine in reducing barriers to care and promoting health equity in breast cancer pts.
Real-world treatment patterns among patients with non-muscle invasive bladder cancer (NMIBC) treated with intravesical Bacillus Calmette-Guerin (BCG).
Authors: Kumar Neela , Balaji Hiremagalur parthasarathy , Emond Bruno , Manceur Ameur M , Ghelerter Isabelle , Pilon Dominic , Lefebvre Patrick , Imran Nida Shafaat , Ellis Lorie 
Published: September 2022

404 Background: Intravesical BCG is a common treatment in high-risk NMIBC patients; however supply constraints and regimen demands for patients have been reported and may impact long term patient outcomes. This study examined treatment patterns in NMIBC patients receiving intravesical BCG. Methods: Adults with NMIBC treated with intravesical BCG during any line of therapy (LOT) on or after the index date (first date for transurethral resection of the bladder tumor [TURBT] or initiation of intravesical therapy) were selected from de-identified IBM MarketScan Commercial and Medicare Supplemental Databases (1/1/2010-2/28/2021) and Multi-State Medicaid Database (1/1/2010-12/31/2019). Classification of NMIBC on the index date required that patients have no prior systemic antineoplastic therapy, radiotherapy, or cystectomy. Treatment patterns were evaluated from the index date until the end of the NMIBC phase (earliest of initiation of systemic antineoplastic therapy, cystectomy, radiotherapy, diagnosis for metastatic cancer, end of insurance eligibility, or end of data availability). Discontinuation of a LOT was defined as having a treatment gap > 180 days for BCG (90 days for other agents) or switching to a new LOT. During each LOT, adequate BCG treatment was defined as having ≥5 claims during induction (first 42 days of treatment) and ≥2 claims during maintenance (beyond the first 42 days). Results: There were 5,410 NMIBC patients treated with BCG over a mean (median) follow up of 25.5 (18.9) months. The population was 79% male; mean age was 67 years. The majority of patients only received a single LOT (76%; TABLE). The predominant first LOT was BCG (93.1% of NMIBC patients); however, the majority (69.8%) did not receive adequate BCG induction/maintenance in first LOT. Nearly half (46.4%) of first LOT patients had reassessment for disease progression by TURBT. BCG retreatment after a six-month lapse was observed as the predominant second LOT, with > 90% receiving inadequate BCG induction/maintenance. Conclusions: While intravesical BCG remains the most common therapy for NMIBC, less than a third of patients receive adequate BCG treatment in the first LOT; with this percentage further decreasing in the few patients who receive a subsequent LOT. In light of supply and demand constraints, results of this study further emphasize a need for additional treatment options that are effective, safe, and tolerable for patients with NMIBC.[Table: see text]
Hepatectomy After Conversion Therapy Using Tyrosine Kinase Inhibitors Plus Anti-PD-1 Antibody Therapy for Patients with Unresectable Hepatocellular Carcinoma
Authors: Zhu Xiao-Dong , Huang Cheng , Shen Ying-Hao , Xu Bin , Ge Ning-Ling , Ji Yuan , Qu Xu-Dong , Chen Lingli , Chen Yi , Li Mei-Ling , Zhu Jin-Jin , Tang Zhao-You , Zhou Jian , Fan Jia , Sun Hui-Chuan 
Published: September 2022

Abstract
Background
Combined treatment with tyrosine kinase inhibitors (TKI) plus anti-PD-1 antibodies showed high anti-tumor efficacy and made conversion resection possible for patients with unresectable hepatocellular carcinoma (HCC). However, long-term survival has not been reported.

Methods
A cohort of consecutive patients who received combined TKI/anti-PD-1 antibodies as first-line treatment for initially unresectable HCC at the authors’ hospital between August 2018 and September 2020 was eligible for this study. Patients who were responding to systemic therapy and met the criteria for hepatectomy underwent liver resection with curative intention. The study also investigated the association of clinical factors with successful conversion resection and postoperative recurrence.

Results
The study enrolled 101 patients including 24 patients (23.8 %) who underwent R0 resection a median of 3.9 months (interquartile range: 2.5–5.9 months) after initiation of systemic therapy. Patients with an Eastern cooperative oncology group performance status of 0, fewer intrahepatic tumors, or a radiographic response to systemic therapy were more likely to be able to receive curative resection. After a median follow-up period of 21.5 months, hepatectomy was independently associated with a favorable overall survival (hazard ratio [HR], 0.050; 95 % confidence interval [CI], 0.007–0.365; P = 0.003). For the 24 patients who underwent surgery, the 12-month recurrence-free survival and overall survival rates were respectively 75% and 95.8%. Achieving a pathologic complete response (n = 10) to systemic therapy was associated with a favorable recurrence-free survival after resection, with a trend toward significance (HR, 0.345; 95% CI, 0.067–1.785; P = 0.187).

Conclusions
Selected patients with initially unresectable HCC can undergo hepatectomy after systemic therapy with combined TKI/anti-PD-1 antibodies. In this study, conversion resection was associated with a favorable prognosis.
Mortality and re-revision following single-stage and two-stage revision surgery for the management of infected primary knee arthroplasty in England and Wales
Authors: Lenguerrand Erik , Whitehouse Michael R. , Kunutsor Setor K. , Beswick Andrew D. , Baker Richard P. , Rolfson Ola , Reed Michael R. , Blom Ashley W. ,   On behalf of the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man
Published: September 2022

Aims We compared the risks of re-revision and mortality between two-stage revision surgery and single-stage revision surgery among patients with infected primary knee arthroplasty. Methods Patients with a periprosthetic joint infection (PJI) of their primary knee arthroplasty, initially revised with a single-stage or a two-stage procedure in England and Wales between 2003 and 2014, were identified from the National Joint Registry. We used Poisson regression with restricted cubic splines to compute hazard ratios (HR) at different postoperative periods. The total number of revisions and re-revisions undergone by patients was compared between the two strategies. Results A total of 489 primary knee arthroplasties were revised with single-stage procedure (1,390 person-years) and 2,377 with two-stage procedure (8,349 person-years). The adjusted incidence rates of all-cause re-revision and for infection were comparable between these strategies (HR overall five years, 1.15 (95% confidence interval (CI) 0.87 to 1.52), p = 0.308; HR overall five years, 0.99 (95% CI 0.70 to 1.39), p = 0.949, respectively). Patients initially managed with single-stage revision received fewer revision procedures overall than after two-stage revision (1.2 vs 2.2, p < 0.001). Mortality was lower for single-stage revision between six and 18 months postoperative (HR at six months, 0.51 (95% CI 0.25 to 1.00), p = 0.049 HR at 18 months, 0.33 (95% CI 0.12 to 0.99), p = 0.048) and comparable at other timepoints. Conclusion The risk of re-revision was similar between single- and two-stage revision for infected primary knee arthroplasty. Single-stage group required fewer revisions overall, with lower or comparable mortality at specific postoperative periods. The single-stage revision is a safe and effective strategy to treat infected knee arthroplasties. There is potential for increased use to reduce the burden of knee PJI for patients, and for the healthcare system. Cite this article: Bone Joint Res 2022;11(10):690–699.
Cost analysis of registrar training in hip and knee arthroplasty before COVID-19
Authors: Ting J , Garikapati V , Muir R 
Published: September 2022

Introduction Hospitals often face competing pressures to deliver surgical tuition and provide a service that meets performance targets. However, there are sparse data on the costs of training orthopaedic registrars to carry out procedures compared with consultants. The aim of this study was to evaluate the short-term financial, time and morbidity cost of training registrars in hip and knee joint arthroplasty in our trust. Methods All patients undergoing elective primary hip and knee arthroplasty over a 12-month period in our unit were reviewed retrospectively. Data recorded included grade of primary surgeon, patient demographics, operative time, length of stay, readmission and reoperation within 30 days, and 12-month mortality. Results A total of 889 patients were identified for inclusion in the study. For primary hip arthroplasty performed by registrars, the mean operative time was 126 minutes (standard deviation [SD]: 22 minutes) compared with 98 minutes (SD: 29 minutes) for consultant operations (p < 0.001). The mean length of stay was 5.1 days (SD: 4.3 days) for trainees versus 4.3 days (SD: 2.8 days) for consultants (p = 0.19). For primary knee arthroplasty, the mean trainee operative time was 114 minutes (SD: 20 minutes) compared with 100 minutes (SD: 25 minutes) for consultant operations (p < 0.001). The mean length of stay was 4.0 days (SD: 2.7 days) for trainees versus 4.5 days (SD: 3.5 days) for consultants (p = 0.16). No significant differences were found in complications, readmissions, reoperations or mortality. Conclusions Our study demonstrates no increased morbidity cost to patients following arthroplasty carried out by registrars and the major cost for training was in the increase in operative time associated with registrar performed procedures. With this in mind, careful planning of operating lists can maximise training opportunities while maintaining the efficiency of the unit as a whole.
Ultra-broadband nanowire metamaterial absorber
Authors: Wang Baoqing , Ma Cuiping , Yu Peng , Govorov Alexander O. , Xu Hongxing , Wang Wenhao , Besteiro Lucas V. , Jing Zhimin , Li Peihang , Wang Zhiming 
Published: September 2022

Broadband absorbers generally consist of plasmonic cavities coupled to metallic resonators separated by a dielectric film, and they are vertically stacking configurations. In this work, we propose an ultra-broadband nanowire metamaterial absorber composed of an array of vertically aligned dielectric nanowires with coaxial metallic rings. The absorber shows strong absorption from 0.2 to 7 μm with an average absorption larger than 91% due to the excitation of gap surface plasmon polariton modes in Fabry–Perot-like resonators. Moreover, a refractory dielectric cladding can be added to improve the thermal stability of the absorber, showing a negligible impact on its absorption performance. The proposed absorber may find potential applications in solar energy harvesting, infrared imaging and spectroscopy, and optoelectronic devices.
Alternating hemiplegia of childhood: An electroclinical study of sleep and hemiplegia
Authors: Poole Josephine , Zagaglia Sara , Demurtas Rita , Farrell Fiona , Walker Matthew C. , Sisodiya Sanjay M. , Balestrini Simona , Vivekananda Umesh 
Published: September 2022

Objective
Alternating Hemiplegia of Childhood (AHC) is characterised by paroxysmal hemiplegic episodes and seizures. Remission of hemiplegia upon sleep is a clinical diagnostic feature of AHC. We investigated whether: 1) Hemiplegic events are associated with spectral EEG changes 2) Sleep in AHC is associated with clinical or EEG spectral features that may explain its restorative effect.

Methods
We retrospectively performed EEG spectral analysis in five adults with AHC and twelve age-/gender-matched epilepsy controls. Five-minute epochs of hemiplegic episodes and ten-minute epochs of four sleep stages were selected from video-EEGs. Arousals were counted per hour of sleep.

Results
We found 1) hemispheric differences in pre-ictal and ictal spectral power (p = 0.034), during AHC hemiplegic episodes 2) 22% reduced beta power (p = 0.017) and 26% increased delta power (p = 0.025) during wakefulness in AHC versus controls. There were 98% more arousals in the AHC group versus controls (p = 0.0003).

Conclusions
There are hemispheric differences in spectral power preceding hemiplegic episodes in adults with AHC, and sleep is disrupted.

Significance
Spectral EEG changes may be a potential predictive tool for AHC hemiplegic episodes. Significantly disrupted sleep is a feature of AHC.
Barriers to healthcare access and healthcare seeking for childhood illnesses among childbearing women in Burundi
Authors: Ahinkorah Bright Opoku , Seidu Abdul-Aziz , Hagan John Elvis , Budu Eugene , Mohammed Aliu , Adu Collins , Ameyaw Edward Kwabena , Adoboi Faustina , Schack Thomas 
Published: September 2022

Introduction
Poor health seeking behaviour continues to be major challenge in accessing healthcare in sub-Saharan Africa despite the availability of effective treatment for most childhood illnesses. The current study investigated the barriers to healthcare access and health seeking for childhood illnesses in Burundi.

Methods
The study utilized data from the 2016–17 Burundi Demographic and Health Survey (BDHS). A total of 2173 children under five of childbearing women were included in our study. The outcome variable for the study was healthcare seeking for childhood illnesses (diarrhea and fever/cough). Barriers to healthcare access were the explanatory variables and maternal and child factors were the control variables. Chi-square test of independence and a binary logistic regression modelling were carried out to generate the results.

Results
Overall, less than 50% of children in Burundi who were ill two weeks before the survey obtained healthcare. We found that children of mothers who perceived getting money for medical care for self as a big problem [aOR = 0.75; CI = 0.60–0.93] and considered going for medical care alone as a big problem [aOR = 0.71; CI = 0.55–0.91] had lower odds of getting healthcare, compared to those of mothers who considered these indicators as not a big problem. The results also showed that children of mothers who had three [aOR = 1.48; 1.02–2.15] and four [aOR = 1.62; 1.10–2.39], children were more likely to get healthcare for childhood illnesses compared to those whose mothers had one child. Children of mothers with single birth children were less likely to get healthcare compared to those whose mothers had multiple births.

Conclusion
Findings of the low prevalence of healthcare for childhood illnesses in Burundi suggest the need for government and non-governmental health organizations to strengthen women’s healthcare accessibility for child healthcare services and health seeking behaviours. The Burundian government through multi-sectoral partnership should strengthen health systems for maternal health and address structural determinants of women’s health by creating favourable conditions to improve the status of women and foster their overall socioeconomic well-being. Free child healthcare policies in Burundi should be strengthened to enhance the utilization of child healthcare services in Burundi.