bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences between sexes in patients who underwent total arch replacement and frozen elephant trunk procedures for acute dissection
Authors: Wang Zeling , Xue Yuan , Qian Sichong , Liu Yongmin , Zhu Junming , Sun Lizhong , Zhang Hongjia , Li Haiyang 
Published: August 2022

Objective To analyze the effect of sex on the short-time prognosis in two different age subgroups (≤55 years old and >55 years old). Methods From January 2009 to 2019, 1522 patients with DeBakey I acute aortic dissection (AAD) underwent frozen elephant trunk and total arch replacement at a Tertiary Center in China were divided into female group ( n = 324) and male group ( n = 1198). The demographic characteristics, clinical presentation, management, short-term outcomes were described in the different sex groups. The risk factors of 30-days mortality for females and males were identified by univariate and multivariable logistic regression analysis. Then, random Forest regression was used to analyze the association between age and 30-days mortality in the different sexes groups. The cut-off age for 30-days mortality in females was then identified as 55 years. The patients were divided into two subgroups: young patients (≤55 years old) and elderly patients (>55 years old). Clinical prognosis between different sex groups was further compared in the age subgroups. Results Approximately four-fifths of the patients were males. Males with DeBakey I AAD were younger than females (47 vs 52 years; p < 0.01). The proportion of males gradually declined with age. The cut-off age for 30-days mortality in females and males was identified as 55 years old and 63 years old, respectively. In young patients (≤55 years old), the 30-days mortality rate for females was lower than males (hazard ratio [HR, 2.02, p < 0.05). Following adjustment using the multivariable Cox regression analysis, females were identified as an independent protective factor for 30-days mortality (HR, 2.24, p = 0.03). Conclusions Our study showed that females present with DeBakey I AAD less frequently than males and they tend to present with DeBakey AAD later in life. In young patients, females had better early outcomes despite similar time for symptom onset to diagnosis and surgical technique than males.
When Socialism Comes One Country at a Time
Authors: Hahnel Robin Eric 
Published: August 2022

What should a country that has rejected capitalism and is beginning to build a socialist economy do with regard to international trade and investment in today’s world where other countries still have capitalist economies, and there are very large differences in levels of economic development? Hoping to stimulate discussion, this article explores dilemmas such a country will face, and proposes concrete answers in the form of rules such a country might follow to (a) take advantage of opportunities that international trade and investment provide but (b) avoid undermining fundamental principles that are the backbone of its socialist economy. JEL Classification: F10, F13, F21, P21, P23
Structural Stigma and Sexual Minority Victimization Across 28 Countries: The Moderating Role of Gender, Gender Nonconformity, and Socioeconomic Status
Authors: Bränström Richard , Fellman Daniel , Pachankis John 
Published: August 2022

Objective: Country-level structural stigma toward sexual minority individuals (i.e., discriminatory laws and policies and prejudicial attitudes) shows robust associations with sexual minority individuals’ mental health and individual-level stigma processes, such as identity concealment. Whether structural stigma is also associated with interpersonal-level stigma processes, such as victimization, is rarely studied. Whether the association between structural stigma and sexual minority individuals’ interpersonal mistreatment varies across gender, gender nonconformity, and socioeconomic status also remains to be determined. Methods: In 2012, sexual minority adults ( n = 86,308) living in 28 European countries responded to questions assessing past-12-month victimization experiences (i.e., physical or sexual attack or threat of violence). Country-level structural stigma was objectively indexed as an aggregate of national laws, policies, and population attitudes negatively affecting sexual minority individuals Results: Country-level structural stigma was significantly associated with victimization (adjusted odds ratios [AOR]: 1.13, 95% confidence interval [CI]: 1.04–1.22; p = .004). However, this effect varied by gender, gender nonconformity, and socioeconomic status. For both sexual minority men and women, gender nonconformity and lower socioeconomic status were associated with increased risk of victimization. The strongest association between country-level stigma and victimization was found among gender nonconforming men with lower socioeconomic status (AOR: 1.32, 95% CI: 1.14–1.52; p < .001). Conclusions: A much larger proportion of sexual minorities living in higher stigma countries reports victimization than those living in lower stigma countries. At the same time, the association between country-level structural stigma and victimization is most heavily concentrated among gender nonconforming men with lower socioeconomic status.
Effects of Maternal Adjustment Enhancement Program Using Mobile-Based Education for Chinese Immigrant Women in Korea: A Quasi-Experimental Study
Authors: Song Ju-Eun , Roh Eun Ha , Kim Youn-Jeong , Ahn Jeong-Ah 
Published: August 2022

Introduction: This study aimed to develop a maternal adjustment program for Chinese immigrant primiparous women in Korea and to investigate its effectiveness. Methodology: Forty-five Chinese immigrant women with newborns were recruited and conveniently assigned into experimental and control groups. A maternal adjustment enhancement program was initiated to the experimental group using a mobile-based education regarding cultural intimacy for 4 weeks. Results: In the follow-ups, the experimental group showed significantly higher knowledge of childcare and parenting efficacy. Both the experimental and control groups showed an improvement in social support and a decrease in childcare stress without between-group differences. Discussion: The maternal adjustment enhancement program can be utilized as an effective approach to improve knowledge of childcare and reinforce parenting efficacy of Chinese immigrant women in Korea. Strategies to reduce language barrier and to provide education with culturally friendly manners should be utilized for successful transition to motherhood among immigrant mothers.
Effectiveness and Safety of Enoxaparin Versus Unfractionated Heparin as Thromboprophylaxis in Hospitalized COVID-19 Patients: Real-World Evidence
Authors: AlLehaibi Lina H. , Alomar Mukhtar , Almulhim Abdulaziz , Al-Makki Sarah , Alrwaili Nazar R. , Al-Bassam Shahad , Alsultan Semat , Al Saeed Jenan , Alsheef Mohammad , Abraham Ivo , Alamer Ahmad 
Published: August 2022

Background: Coronavirus 2019 (COVID-19) patients are at risk of thrombosis. Literature that compares the effectiveness of enoxaparin to unfractionated heparin (UFH) in COVID-19 patients is scarce. Objective: We aimed to evaluate the effectiveness and safety of enoxaparin compared with UFH when used at their standard/intermediate dosing in COVID-19 patients. Methods: This was a retrospective study conducted at a large COVID-19 center located in Eastern Province, Saudi Arabia. Confirmed COVID-19 cases (≥18 years old) admitted between January and December 2020 were randomly screened for inclusion. Exclusion criteria were patients receiving therapeutic anticoagulation, on chronic anticoagulation, had active bleeding, a platelet count <25 × 109/L, or an incomplete electronic file. The primary endpoint was the occurrence of any thrombotic event (pulmonary embolism, deep venous thrombosis, stroke, or myocardial infarction) or mortality. Secondary endpoints were major or minor bleeding. We applied inverse propensity score weighting (IPTW) with survival analysis to analyze the primary endpoint. Logistic regression was used for the secondary endpoint. Results: A total of 980 patients were included (enoxaparin, n = 470 and UFH, n = 510) with a mean age (±SD) of 47.7 (± 12.3) for the enoxaparin arm and 52 (±13.9) for the UFH arm. There was a statistically significant difference in the primary endpoint with an adjusted hazard ratio (aHR) of 0.46 (95%CI: 0.22 to 0.96, P = 0.039) in favor of the enoxaparin arm. There was no statistically significant difference in major or minor bleeding rates between the two arms. Conclusion and Relevance: When compared with UFH, enoxaparin was associated with a significant reduction in thrombotic events or mortality among COVID-19 patients. The results need confirmation from randomized controlled trials.
Safety and Efficacy of Ceftriaxone in the Treatment of Methicillin-Susceptible Staphylococcus aureus Bloodstream Infections: A Noninferiority Retrospective Cohort Study
Authors: Ganguly Anisha , de la Flor Carolina , Alvarez Kristin , Brown L. Steven , Mang Norman S. , Smartt Jillian , King Helen , Perl Trish M. , Filizola Hector , Bhavan Kavita P. 
Published: August 2022

Background: Antistaphylococcal penicillins and cefazolin are the treatments of choice for methicillin-susceptible Staphylococcus aureus (MSSA) infections, requiring multiple doses daily. At Parkland, eligible uninsured patients with MSSA bloodstream infections (BSI) receive self-administered outpatient parenteral antimicrobial therapy (S-OPAT). Ceftriaxone was used in a cohort of S-OPAT patients for ease of once-daily dosing. Objective: A retrospective study was conducted to evaluate clinical outcomes for patients discharged with ceftriaxone versus cefazolin to treat MSSA BSI. Methods: A retrospective cohort noninferiority study design was used to assess treatment efficacy of ceftriaxone versus cefazolin among Parkland S-OPAT patients treated from April 2012 to March 2020. Demographic, clinical, and treatment-related adverse events data were collected. Clinical outcomes included treatment failure as defined by repeat positive blood culture or retreatment within 6 months, all-cause 30-day readmission rates, and central line–associated bloodstream infection (CLABSI) rates. Results: Of 368 S-OPAT patients with MSSA BSI, 286 (77.7%) received cefazolin, and 82 (22.3%) received ceftriaxone. Demographics and comorbidities were similar for both groups. There were no treatment failures in the ceftriaxone group compared with 4 (1%) in the cefazolin group ( P = 0.58). No difference in 30-day readmission rate between groups was found. The CLABSI rates were lower in ceftriaxone group (2%) compared with cefazolin (11%; P = 0.02). Limitations include retrospective cohort design. Conclusions: Ceftriaxone was found to be noninferior to cefazolin in this study. Our findings suggest that ceftriaxone is a safe and effective treatment of MSSA BSI secondary to osteoarticular or skin and soft tissue infections when used in the S-OPAT setting. Poster abstract: OFID on 2018 Nov; 5(Suppl 1): S316: doi: 10.1093/ofid/ofy210.894.
Difelikefalin: A New κ-Opioid Receptor Agonist for the Treatment of Hemodialysis-Dependent Chronic Kidney Disease–Associated Pruritus
Authors: Fugal Justin , Serpa Sister Michaela 
Published: August 2022

Objective: To review data for difelikefalin (Korsuva) intravenous solution for management of moderate-to-severe pruritus in hemodialysis (HD) patients. Data Sources: Literature search of PubMed (January 1946-May 2022) and SCOPUS (January 1946-May 2022) was performed using the terms: Korsuva, CR845, and difelikefalin. Additional information sources include ClinicalTrials.gov, prescribing information, meeting posters, and references of identified articles. Study Selection and Data Extraction: Clinical trials and articles evaluating difelikefalin for chronic kidney disease–associated pruritis (CKD-aP) in HD patients. Data Synthesis: Difelikefalin is a peripherally acting κ-opioid receptor agonist with antipruritic effects for HD patients with moderate-to-severe CKD-aP. A phase 3 study showed significant improvement of patient itch intensity and itch-related quality of life (QOL) when compared with placebo. More patients had decreased pruritus on the 24-hour Worst Itch Intensity Numerical Rating Scale with difelikefalin (49.1%) compared with placebo (27.9%, P < 0.001). A positive effect was seen with or without use of additional antipruritic agents. Common adverse events include diarrhea, dizziness, and vomiting; there were no signs of physical dependence or centrally acting opioid effects (euphoria, hallucinations). Relevance to Patient Care and Clinical Practice: Difelikefalin reduced itch intensity and improved QOL for patients with CKD-aP. Whether the benefit is continued long-term as well as how it compares with other effective agents is currently unknown. Conclusion: Difelikefalin is the only Food and Drug Administration–approved treatment for moderate-to-severe CKD-aP with additional research into its benefit in this and other types of pruritus ongoing.
Takedown of Ankle Fusions and Conversion to Total Ankle Replacements
Authors: Lundeen Anna L. , Raduan Fernando C. , Stone McGaver Rebecca , Seiffert Kayla J. , Fritz Jacquelyn E. , Giveans M. Russell , Coetzee J. Chris 
Published: August 2022

Background: With ankle replacements gaining credibility, there is a small subset of patients who might benefit from a conversion of an ankle fusion to a replacement. The objective of this study is to present clinical and radiographic results of patients who had their ankle fusion converted to total ankle arthroplasty (TAA). Methods: Patients presented to the senior author with ongoing ankle pain following fusion or increasing pain after a period of relative comfort after an ankle fusion. Outcomes were evaluated preoperatively and postoperatively with the Veterans Rand Health Survey (VR-12), Ankle Osteoarthritis Scale (AOS), and visual analog scale (VAS) pain scale. A patient satisfaction survey was also distributed. Results: All ankle fusion conversions between April 2010 and December 2019 were included. Fifty-one patients (30 females) with the mean age of 62.6 (range, 37-83) years were followed. Mean follow-up was 4.2±2.3 (range, 2-11.5) years. Two patients were lost to follow-up (1 is deceased). Pre- and postoperative mean patient-reported outcome scores were all significantly different between groups except VR-12 mental subscale scores. VR-12 physical scores improved from 28.7±8.9 preoperatively to 38.9±9.9 ( P < .001) postoperatively; VR-12 mental score was stable. AOS pain and disability subscales similarly improved: 55.9±24.4 to 27.9±25.4 ( P < .001) and 61.7±21.1 to 31.1±25.7 ( P < .001), respectively. VAS pain improved from a mean of 64.5±27.3 to 29.4±27.7 ( P < .001). There was no tibiotalar dorsiflexion or plantarflexion with the ankle fusion. Initial postoperative visit revealed that average dorsiflexion was 10.9±5.93 degrees and average plantarflexion was 14.1±5.22 degrees. At the latest follow-up, dorsiflexion improved significantly to 15.5±6.33 degrees ( P < .001), with no significant improvement in plantarflexion ( P = .980). Conclusion: In this single-surgeon longitudinal study of 51 patients with a painful, malaligned, or nonhealed ankle fusion treated with an ankle replacement, we found highly satisfactory functional outcomes at an average of 4.2 years. Continued long-term follow-up will reveal whether the longevity of these replacements is comparable to primary replacements.
Perceptions and prevalence of marijuana use among cancer patients managed at an outpatient department in Zimbabwe: A brief report
Authors: Manyau Maudy CP , Changadzo Kudzanai P , Mudziti Tinashe 
Published: August 2022

Background Globally, marijuana is becoming an acceptable complementary medicine for symptom management in cancer. At the time that the study was conducted, Zimbabwean laws only allowed for the cultivation of marijuana for medical and scientific use. As of 18 July 2022, the national medicines regulator released a circular allowing the licensing, distribution, and use of cannabidiol-based products. Anecdotes indicate there is medical marijuana use among Zimbabwean patients with cancer. We sought to determine the prevalence, patterns of use and perceptions of medical marijuana among patients with cancer. Methods A cross-sectional survey was used to determine patterns and perceptions of marijuana use among outpatient patients with cancer. The study included adults attending the outpatient oncology clinic at Parirenyatwa Hospital Radiotherapy Treatment Center. Results Fifty participants with a median age of 50.5 years (IQR: 41–58) completed the questionnaire, and 28.0% of them were male. The prevalence of marijuana use in the sample was 24.0% (95% CI 13.9–38.2). Most marijuana users were male (83.3%, p < 0.001). The rate of medical marijuana use among users was 66.7%. Participants were generally neutral concerning the benefits of marijuana and how it should be regulated. Just under 50% indicated that they would be open to using it if it were legal. Conclusions and recommendations The prevalence of marijuana use in the sample was comparable to other jurisdictions. Perceptions toward medical marijuana were generally neutral. Consequently, for medical marijuana and/or cannabidiol-based products to become acceptable in the Zimbabwean context, there is need for the dissemination of evidence-based information on their benefits.
Effects of Smoking on SARS-CoV-2 Positivity: A Study of a Large Health System in Northern and Central California
Authors: Li Jiang , Martinez Meghan C , Frosch Dominick L , Matt Georg E 
Published: August 2022

Introduction COVID-19 continues to impact vulnerable populations disproportionally. Identifying modifiable risk factors could lead to targeted interventions to reduce infections. The purpose of this study is to identify risk factors for testing positive for SARS-CoV-2. Methods Using electronic health records collected from a large ambulatory care system in northern and central California, the study identified patients who had a test for SARS-CoV-2 between 2/20/2020 and 3/31/2021. The adjusted effect of active and passive smoking and other risk factors on the probability of testing positive for SARS-CoV-2 were estimated using multivariable logistic regression. Analyses were conducted in 2021. Results Of 556 690 eligible patients in our sample, 70 564 (12.7%) patients tested positive for SARS-CoV-2. Younger age, being male, racial/ethnic minorities, and having mild major comorbidities were significantly associated with a positive SARS-CoV-2 test. Current smokers (adjusted OR: 0.69, 95% CI: 0.66-0.73) and former smokers (adjusted OR: 0.92, 95% CI: 0.89-0.95) were less likely than nonsmokers to be lab-confirmed positive, but no statistically significant differences were found when comparing passive smokers with non-smokers. The patients with missing smoking status (25.7%) were more likely to be members of vulnerable populations with major comorbidities (adjusted OR ranges from severe: 2.52, 95% CI = 2.36-2.69 to mild: 3.28, 95% CI = 3.09-3.48), lower income (adjusted OR: 0.85, 95% CI: 0.85-0.86), aged 80 years or older (adjusted OR: 1.11, 95% CI: 1.07-1.16), have less access to primary care (adjusted OR: 0.07, 95% CI: 0.07-0.07), and identify as racial ethnic minorities (adjusted OR ranges from Hispanic: 1.61, 95% CI = 1.56-1.65 to Non-Hispanic Black: 2.60, 95% CI = 2.5-2.69). Conclusions Our findings suggest that the odds of testing positive for SARS-CoV-2 were significantly lower in smokers compared to nonsmokers. Other risk factors include missing data on smoking status, being under 18, being male, being a racial/ethnic minority, and having mild major comorbidities. Since those with missing data on smoking status were more likely to be members of vulnerable populations with higher smoking rates, the risk of testing positive for SARS-CoV-2 among smokers may have been underestimated due to missing data on smoking status. Future studies should investigate the risk of severe outcomes among active and passive smokers, the role that exposure to tobacco smoke constitutes among nonsmokers, the role of comorbidities in COVID-19 disease course, and health disparities experienced by disadvantaged groups.
The RANGER II superficial femoral artery trial: 1-year results of the long lesion cohort
Authors: Schroë Herman , Sachar Ravish , Keirse Koen , Soga Yoshimitsu , Brodmann Marianne , Rao Vikram , Werner Martin , Holden Andrew , Lopez Louis , Krishnan Prakash , Diaz-Cartelle Juan 
Published: August 2022

Background: The objective of the RANGER II SFA long lesion cohort analysis was to evaluate the safety and effectiveness of the Ranger drug-coated balloon (DCB) in patients with lesion lengths greater than 100 mm. Methods: Patients from the RANGER II SFA randomized controlled trial and long balloon sub-study were included in the long lesion cohort if their baseline lesion measurement was > 100 mm and if they had been treated with a RANGER DCB. Patients had symptomatic lower limb peripheral artery disease and Rutherford classification 2–4 symptomatology. The endpoints of interest included the 12-month target lesion primary patency and freedom from major adverse events (MAEs).Additional patient outcomes including changes in Rutherford classification were also evaluated. Results: A total of 129 patients met the inclusion criteria and were included in the long lesion cohort. Mean lesion length was 144.5 ± 31.7 mm. Seventy-five lesions had Peripheral Arterial Calcium Scoring System (PACSS) grades 3 (33.3%, 43/129) and 4 (24.8%, 32/129). The Kaplan–Meier estimate of the primary patency rate at 12 months was 88.0%. The rate of freedom from MAEs at 12 months was 95.1% (117/123; 95% CI: 89.7%, 98.2%); all MAEs were clinically driven target lesion revascularization (4.9%, 6/123). The 12-month mortality rate was 2.4% (3/125). Conclusions: Patients with lesions > 100 mm treated with Ranger DCBs demonstrated excellent 1-year safety and efficacy results, comparable to those of the overall RANGER II SFA randomized clinical trial. This suggests that the Ranger DCB can provide consistent results regardless of lesion length. (ClinicalTrials.gov Identifier: NCT03064126)
Developing and validating a chronic obstructive pulmonary disease quick screening questionnaire using statistical learning models
Authors: Wang Xiaoyue , He Hong , Xu Liang , Chen Cuicui , Zhang Jieqing , Li Na , Chen Xianxian , Jiang Weipeng , Li Li , Wang Linlin , Song Yuanlin , Xiao Jing , Zhang Jun , Hou Dongni 
Published: August 2022

Background Active targeted case-finding is a cost-effective way to identify individuals with high-risk for early diagnosis and interventions of chronic obstructive pulmonary disease (COPD). A precise and practical COPD screening instrument is needed in health care settings. Methods We created four statistical learning models to predict the risk of COPD using a multi-center randomized cross-sectional survey database ( n = 5281). The minimal set of predictors and the best statistical learning model in identifying individuals with airway obstruction were selected to construct a new case-finding questionnaire. We validated its performance in a prospective cohort ( n = 958) and compared it with three previously reported case-finding instruments. Results A set of seven predictors was selected from 643 variables, including age, morning productive cough, wheeze, years of smoking cessation, gender, job, and pack-year of smoking. In four statistical learning models, generalized additive model model had the highest area under curve (AUC) value both on the developing cross-sectional data set (AUC = 0.813) and the prospective validation data set (AUC = 0.880). Our questionnaire outperforms the other three tools on the cross-sectional validation data set. Conclusions We developed a COPD case-finding questionnaire, which is an efficient and cost-effective tool for identifying high-risk population of COPD.