bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Innovative Individual-Level Socioeconomic Measure Predicts Critical Care Outcomes in Older Adults: A Population-Based Study
Authors: Barwise Amelia , Wi Chung-Il , Frank Ryan , Milekic Bojana , Andrijasevic Nicole , Veerabattini Naresh , Singh Sidhant , Wilson Michael E. , Gajic Ognjen , Juhn Young J. 
Published: June 2020

Background: Little is known about the impact of socioeconomic status (SES) as a key element of social determinants of health on intensive care unit (ICU) outcomes for adults. Objective: We assessed whether a validated individual SES index termed HOUSES (HOUsing-based SocioEconomic status index) derived from housing features was associated with short-term outcomes of critical illness including ICU mortality, ICU-free days, hospital-free days, and ICU readmission. Methods: We performed a population-based cohort study of adult patients living in Olmsted County, Minnesota, admitted to 7 intensive care units at Mayo Clinic from 2011 to 2014. We compared outcomes between the lowest SES group (HOUSES quartile 1 [Q1]) and the higher SES group (HOUSES Q2-4). We stratified the cohort based on age (<50 years old and ≥50 years old). Results: Among 4134 eligible patients, 3378 (82%) patients had SES successfully measured by the HOUSES index. Baseline characteristics, severity of illness, and reason for ICU admission were similar among the different SES groups as measured by HOUSES except for larger number of intoxications and overdoses in younger patients from the lowest SES. In all adult patients, there were no overall differences in mortality, ICU-free days, hospital-free days, or ICU readmissions in patients with higher SES compared to lower SES. Among older patients (>50 years), those with higher SES (HOUSES Q2-4) compared to those with lower SES (HOUSES Q1) had lower mortality rates (hazard ratio = 0.72; 95% CI: 0.56-0.93; adjusted P = .01), increased ICU-free days (mean 1.08 days; 95% CI: 0.34-1.84; adjusted P = .004), and increased hospital-free days (mean 1.20 days; 95% CI: 0.45-1.96; adjusted P = .002). There were no differences in ICU readmission rates (OR = 0.74; 95% CI: 0.55-1.00; P = .051). Conclusion: Individual-level SES may be an important determinant or predictor of critical care outcomes in older adults. Housing-based socioeconomic status may be a useful tool for enhancing critical care research and practice.
Identification of Possible Causative Agents in a Polymedicated Patient Presenting With Toxic Epidermal Necrolysis
Authors: Khazaka Michael , Laverdière Jeanne , Bouchard Audrey , Ferreira Victor , Mathieu Alexandre 
Published: June 2020

Purpose: To present the pharmacological evaluation process in a case of a polymedicated patient presenting with toxic epidermal necrolysis (TEN). Summary: A 75-year-old Caucasian polymedicated woman had been treated for hip pain with nonsteroidal anti-inflammatory drugs and pregabalin in the months preceding the apparition of an expanding papulo-erythematous rash. She had also started using new medicated eye drops for glaucoma. She presented to the emergency department of a regional hospital where all of her medications were stopped. The patient was transferred and admitted to a tertiary-care teaching hospital’s specialized burn unit for significant cutaneous detachment. It was estimated that 70% to 80% of the body surface area was affected. Skin biopsy showed keratinocyte necrosis with a partial detachment of the epidermis leading to a diagnosis of TEN. The reaction ceased to progress 2 days after the discontinuation of her medications. A complete reepithelialization was objectified after 10 days. A series of steps were followed by the hospital pharmacist to determine which drugs were the most probable culprits. A complete pharmacological history was obtained and a timeline for medication use in the 3 months preceding rash apparition was established. A review of the literature was done to determine the drugs’ relationships to Steven-Johnson syndrome or TEN. Using the algorithm of drug causality for epidermal necrolysis (ALDEN) score, it was determined that naproxen, pregabalin, and brinzolamide–timolol drops were all possible culprits. Conclusion: A systematic method for pharmacological evaluation of a polymedicated patient with TEN is presented. Naproxen, pregabalin, and brinzolamide–timolol drops were all retained as possible culprits.
Growth and Convergence of Social Sectors’ Expenditure in Indian States: Upshots from Neoclassical Growth and Panel Unit Roots Models
Authors: Das Ramesh Chandra , Ivaldi Enrico 
Published: June 2020

In a world of having large part suffering from the inadequacies of basic needs and inter-class and inter-regional income disparities, investing upon the development of different social sectors from the state exchequers have been one of the top agendas of the policymakers. It is not a different issue for the states and provinces of the developing countries like India. Besides having positive roles on economic betterment, spending on social expenditures sometimes work in favour of the ruling political parties to gain confidence from the voters. The states thus compete in this area. Under this background, the present study attempts to examine whether the states of India are converging in social sector’s expenditure for the period 1980–81 to 2017–18. Applying the neoclassical growth and panel unit roots models the study observes unambiguously that there are absolute and conditional β convergence and σ convergence in per capita social expenditure among the states. JEL Classification: H72, O470, C23, O530
New Zealand community mental healthcare provider experience in schizophrenia management with 3-monthly paliperidone palmitate
Authors: Cassidy Cathal , Miles Wayne 
Published: June 2020

Objectives: To understand the impact of 3-monthly treatment with paliperidone palmitate on patient management, including non-adherence and relapse, from a psychiatrist and nurse perspective for 73 patients enrolled in a patient familiarisation programme (PFP) in New Zealand. Methods: An online questionnaire was sent to clinicians with at least 6 months of regular interaction with PFP patients. Questions addressed treatment effectiveness and patient management changes. Analyses are descriptive only and do not represent patient or carer perspectives. Results: Seven psychiatrists, representing 58 of 73 (79.5%) of patients, and 17 nurses responded to the survey. Psychiatrists were satisfied with efficacy and tolerability and relapse prevention. Treatment goals were either ‘met’ (2/7; 28.6%) or ‘exceeded’ (5/7; 71.4%). The focus on adherence issues decreased and the focus on life areas and recovery goals increased. Conclusions: From the clinician perspective, 3-monthly paliperidone palmitate offers patients the potential to remain adherent and improve social functioning.
When should we image our patients? Appropriate use of imaging in inpatient psychiatry
Authors: Forbes Malcolm , Somasundaram Arjuna , Jagadheesan Karuppiah , Stuckey Stephen 
Published: June 2020

Objective: Injudicious use of medical imaging may be associated with harm to patients and increased downstream healthcare costs. Guidance on the use of imaging in common psychiatric inpatient scenarios is inconsistent or absent. This paper explores three common clinical scenarios facing adult psychiatrists and provides guidance about the appropriate use of imaging. Conclusion: Psychiatrists and their junior colleagues would benefit from considering both pre- and post-test probability in each presentation.
Exploring Family Caregiver Communication Difficulties and Caregiver Quality of Life and Anxiety
Authors: Wittenberg Elaine , Kerr Anna M. , Goldsmith Joy 
Published: June 2020

Background: When family caregivers are involved in patient care, both patients and caregivers experience better clinical outcomes. However, caregivers experience communication difficulties as they navigate a complex health care system and interact with health care providers. Research indicates that caregivers experience a communication burden that can result in topic avoidance and distress; however, little is known about how burden stemming from communication difficulties with health care providers relates to caregiving outcomes. Objectives: To investigate how family caregiver communication difficulties with health care providers influence caregiver quality of life and anxiety. Methods: Data were collected in a cross-sectional online survey of 220 caregivers with communication difficulties resulting from caregiver avoidance of caregiving-related topics, inadequate reading and question-asking health literacy, and low communication self-efficacy. Results: Caregiver outcomes were not affected by reading health literacy level but did differ based on question-asking health literacy level. Adequate question-asking health literacy was associated with lower anxiety and a higher quality of life. Caregivers who avoided discussing caregiving topics reported higher anxiety and lower quality of life and caregivers with increased communication self-efficacy reported a higher quality of life. Conclusion: Involvement of family caregivers in care is likely to require tailored approaches that address caregiver communication and health literacy skills. Findings from this study suggest that hospice and palliative care providers should identify and provide support for caregiver communication difficulties in order to positively influence caregiver quality of life and anxiety.
Four-year outcomes of aflibercept treatment for neovascular age-related macular degeneration: Results from real-life setting
Authors: Lukic Marko , Eleftheriadou Maria , Hamilton Robin D , Rajendram Ranjan , Bucan Kajo , Patel Praveen J 
Published: June 2020

Background: To assess long-term structural and functional outcomes of intravitreal aflibercept (Eylea®) treatment for neovascular macular degeneration (nAMD) in a real-word setting. Design and methods: This was a retrospective, single-centre, non-randomized interventional cohort analysis. Data from treatment-naive patients with nAMD funded for treatment with intravitreal aflibercept in the period between 1 September 2013 and 28 February 2014 and who finished 4-year follow-up entered the analysis. Epidemiological data, visual acuity (VA) measured on ETDRS charts and injection numbers were recorded. Spectral domain optical coherence tomography (SD-OCT) data including presence or absence of macular fluid and automated central subfield macular thickness (CSMT) at year 1, 2, 3 and 4 were also recorded. Results: Ninety-four eyes of 89 patients finished 4-year follow-up. The mean number of aflibercept injections received over 4 years was 19.3. At baseline, the mean VA (SD) (Snellen) was 54.1 ± 15.5 (20/100) ETDRS letters whilst the mean CSM (SD) was 296 ± 81 µm. At 4 years, the mean VA (SD) (Snellen) was 60.4 ± 20.0 (20/63) ETDRS letters ( p < 0.0001). Mean CSMT (SD) was 218 ± 79 μm ( p < 0.0001). Thirty-three percent of eyes gained ⩾15 ETDRS letters at end of 4 years, and 66 (70%) eyes had no macular fluid at the end of the follow-up. Conclusion and relevance: The results suggest that good long-term morphological and functional treatment outcomes can be achieved using intravitreal aflibercept for nAMD in a real-life clinical setting.
Association of teledermatology workflows with standardising co-management of rashes by primary care physicians and dermatologists
Authors: Dusendang Jennifer R , Marwaha Sangeeta , Alexeeff Stacey E , Crowley Eileen , Haiman Michael , Pham Ngoc , Tuerk Melanie J , Wudka Danny , Hartmann Michael , Herrinton Lisa J 
Published: June 2020

Introduction For patients with a rash, the effect of teledermatology workflow on utilization has not been defined. We compared utilization across four teledermatology workflows in patients with a rash. Methods The observational longitudinal cohort study included 28,857 Kaiser Permanente Northern California members with a new rash diagnosis seen in primary care and with dermatology advice obtained using teledermatology. The workflows differed in camera and image quality; who took the picture; how the image was forwarded; and synchronicity and convenience. Results On average, 23% of patients had a follow-up office visit in dermatology within 90 days of their primary care visit. In multivariable analysis, the four technologies differed substantially in the likelihood of a follow-up dermatology office visit. In contrast, the likelihood was only negligibly related to medical centre or primary care provider. Discussion Technologies and workflows that offer the mobility of a smartphone with a high level of synchronicity in communication were associated with standardised co-management of rashes.
Decrease of peripheral resistance after intraoperative administration of iloprost in patients with and without type 2 diabetes mellitus and with peripheral arterial occlusive disease
Authors: Hirsch Kornelia , Säemann Marcus , Walter Corinna , Taher Fadi , Edda Skrinjar , Mlekusch Irene , Jäger Heidrun , Assadian Afshin , Falkensammer Jürgen 
Published: June 2020

Background: In many cases, Ilomedin® infusions are applied as part of a perioperative measure in patients with peripheral arterial occlusive disease because it makes a relevant vasodilatatory effect in patients with type 2 diabetes mellitus and with/without peripheral neuropathy. Aims: A prospective case–control study was performed to investigate the effect of prostanoids on peripheral resistance in patients with type 2 diabetes mellitus and patients without type 2 diabetes mellitus, as well as the role of peripheral neuropathy in patients undergoing arterial reconstruction. Methods: Sixty patients undergoing arterial reconstruction were enrolled. Sufficient data were collected on 38 patients. Prior to surgery, peripheral nerve conduction velocity was measured. Blood flow volume at the common femoral artery was assessed intraoperatively using a Doppler flowmeter at four time points: at baseline before arterial reconstruction (T0), after reconstruction (T1), after 5 (T2) and 10 min (T3) after intra-arterial application of 3000 ng of Ilomedin. Peripheral resistance units were calculated as a function of mean arterial pressure and flow volume using the following formula: peripheral resistance unit = mean arterial pressure (mm Hg) / flow volume (mL/min). Results: Ilomedin produced an immediate and significant drop of peripheral resistance in patients without type 2 diabetes mellitus as well as in patients with type 2 diabetes mellitus. Patients with peripheral neuropathy showed a less pronounced effect to Ilomedin compared to individuals with normal nerve conduction velocity.
Resilience of Emerging Adults After Adverse Childhood Experiences: A Qualitative Systematic Review
Authors: Leung Doris Y. L. , Chan Athena C. Y. , Ho Grace W. K. 
Published: June 2020

Introduction: Even as children experience adversity, they can become resilient adults, in large part due to their social supports as emerging adults. Objective: Authors examine constructs of social support applied to the concept of resilience among emerging adults having experienced adverse childhood experiences (ACE). Method: Authors conducted a meta-ethnography with six databases between January 1998 and October 2019. Inclusion criteria were as follows: (i) original peer-reviewed qualitative or mixed-method studies, (ii) sampling adults aged 18–35 years, (iii) reporting at least one ACE as defined by the World Health Organization, (iv) focused on resilience, and (v) in English. Data were collected from six electronic databases (MEDLINE, EMBASE, CINAHL, PsychINFO, Web of Science, and Google Scholar). Studies were appraised using the Critical Appraisal Skills Program Qualitative Checklist. Analysis drew on Bourdieu’s constructs of capital following Noblit and Hare’s methods. Results: Thirteen studies of 277 emerging adults, aged 18–35 years old (mean 23 years), from six countries, reported resilience as “self-righting” appraisals. These were interdependent of their social supports and within a culturally determined sense of self-reliance. Self-reliance appeared to be a precursor shaping resilience of emerging adults with ACE. Self-reliance may deter self-compassion and, as a self-righting appraisal/capacity, may inhibit accessing social support. Conclusion: This review emphasizes the life stage of emerging adulthood regarding the development of self-righting appraisal skills, which, when enabled with reliance, others help to transform ACEs and allow resilience to grow.
A Novel Immune-Related Prognostic Signature for Thyroid Carcinoma
Authors: Xue Yuanbo , Li Jing , Lu Xiubo 
Published: June 2020

Background: Recent studies have confirmed that immune-associated genes perform a crucial function in recurrence and metastasis of thyroid carcinoma. A reliable immune-related prognostic signature for patients with thyroid cancer is needed. This study constructed a novel immune-related prognostic signature for thyroid cancer and evaluated its prognostic value by bioinformatics analysis. Methods: In this study, we anatomized differentially expressed immune-associated genes from The Cancer Genome Atlas database. The samples from The Cancer Genome Atlas database were randomly divided into training set and test set. A novel immune-related prognostic signature for thyroid cancer was developed by least absolute shrinkage and selection operator and Cox regression analysis: Risk score = (0.6846 × expression value of C-X-C motif chemokine ligand 5 [CXCL5]) + (1.1556 × expression value of Azurocidin 1 [AZU1]) + (−0.3156 × expression value of nucleotide binding oligomerization domain containing 1 [NOD1] + (0.0542 × expression value of TNF Receptor Superfamily Member 11b [TNFRSF11B]) + (0.0952 × expression value of VGF nerve growth factor inducible [VGF]). The established prognostic signature was evaluated based on training set and test set by survival curves, receiver–operator characteristic curves, risk score, survival status, heatmap, and independent prognostic analysis. Meanwhile, we appraised the correlation between target immune-associated genes and clinical stage, tumor-infiltrating immune cells respectively. Results: Five immune-associated genes were used for constructing an immune-related prognostic signature by least absolute shrinkage and selection operator, univariate, and multivariate analysis. Survival curves, receiver–operator characteristic curves, and independent prognostic analysis showed the signature had significant prediction value. Clinical and immune cell correlation analyses indicated that target immune-associated genes may participate in tumor immune infiltration and tumor progression. Conclusions: We constructed a novel 5 immune-associated genes signature for predicting the prognosis of patients with thyroid cancer, which may help clinical workers evaluate individualized therapy and prognosis.
The role of chest computed tomography in the management of COVID-19: A review of results and recommendations
Authors: Wong Molly D , Thai Theresa , Li Yuhua , Liu Hong 
Published: June 2020

The rapid and dramatic increase in confirmed cases of COVID-19 has led to a global pandemic. Early detection and containment are currently the most effective methods for controlling the outbreak. A positive diagnosis is determined by laboratory real-time reverse transcriptase polymerase chain reaction (rRT-PCR) testing, but the use of chest computed tomography (CT) has also been indicated as an important tool for detection and management of the disease. Numerous studies reviewed in this paper largely concur in their findings that the early hallmarks of COVID-19 infection are ground-glass opacities (GGOs), often with a bilateral and peripheral lung distribution. In addition, most studies demonstrated similar CT findings related to the progression of the disease, starting with GGOs in early disease, followed by the development of crazy paving in middle stages and finally increasing consolidation in the later stages of the disease. Studies have reported a low rate of misdiagnosis by chest CT, as well as a high rate of misdiagnosis by the rRT-PCR tests. Specifically, chest CT provides more accurate results in the early stages of COVID-19, when it is critical to begin treatment as well as isolate the patient to avoid the spread of the virus. While rRT-PCR will probably remain the definitive final test for COVID-19, until it is more readily available and can consistently provide higher sensitivity, the use of chest CT for early stage detection has proven valuable in avoiding misdiagnosis as well as monitoring the progression of the disease. With the understanding of the role of chest CT, researchers are beginning to apply deep learning and other algorithms to differentiate between COVID-19 and non-COVID-19 CT scans, determine the severity of the disease to guide the course of treatment, and investigate numerous additional COVID-19 applications. Impact statement The impact of the COVID-19 pandemic has been worldwide, and clinicians and researchers around the world have been working to develop effective and efficient methods for early detection as well as monitoring of the disease progression. This minireview compiles the various agency and expert recommendations, along with results from studies published in numerous countries, in an effort to facilitate the research in imaging technology development to benefit the detection and monitoring of COVID-19. To the best of our knowledge, this is the first review paper on the topic, and it provides a brief, yet comprehensive analysis.
Diclofenac reduces the risk of Alzheimer’s disease: a pilot analysis of NSAIDs in two US veteran populations
Authors: Stuve Olaf , Weideman Rick A. , McMahan Danni M. , Jacob David A. , Little Bertis B. 
Published: June 2020

Background: Our aim was to determine whether specific nonsteroidal anti-inflammatory (NSAID) agents are associated with a decreased frequency of Alzheimer’s disease (AD). Materials and methods: Days of drug exposure were determined for diclofenac, etodolac, and naproxen using US Department of Veterans Affairs (VA) pharmacy transaction records, combined from two separate VA sites. AD diagnosis was established by the International Classification of Diseases, ninth revision (ICD-9)/ICD-10 diagnostic codes and the use of AD medications. Cox regression survival analysis was used to evaluate the association between AD frequency and NSAID exposure over time. Age at the end of the study and the medication-based disease burden index (a comorbidity index) were used as covariates. Results: Frequency of AD was significantly lower in the diclofenac group (4/1431, 0.28%) compared with etodolac (328/14,646, 2.24%), and naproxen (202/12,203, 1.66%). For regression analyses, naproxen was chosen as the comparator drug, since it has been shown to have no effect on the development of AD. Compared with naproxen, etodolac had no effect on the development of AD, hazard ratio (HR) 1.00 [95% confidence interval (CI): 0.84–1.20, p = 0.95]. In contrast, diclofenac had a significantly lower HR of AD compared with naproxen, HR 0.25 (95% CI: 0.09–0.68, p <0.01). After site effects were controlled for, age at end of the study (HR = 1.08, 95% CI: 1.07–1.09, p <0.001) was also found to influence the development of AD, and the medication-based disease burden index was a strong predictor for AD, HR 5.17 (95% CI: 4.60–5.81) indicating that as comorbidities increase, the risk for AD increases very significantly. Conclusion: Diclofenac, which has been shown to have active transport into the central nervous system, and which has been shown to lower amyloid beta and interleukin 1 beta, is associated with a significantly lower frequency of AD compared with etodolac and naproxen. These results are compelling, and parallel animal studies of the closely related fenamate NSAID drug class.