bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predominant patterns of β-lactam hypersensitivity in a single German Allergy Center: exanthem induced by aminopenicillins, anaphylaxis by cephalosporins
Authors: Schrüfer Philipp , Brockow Knut , Stoevesandt Johanna , Trautmann Axel 
Published: November 2020

Abstract
Background
Penicillins and other β-lactam antibiotics are the most common elicitors of allergic drug reaction. However, data on the pattern of clinical reaction types elicited by specific β-lactams are scarce and inconsistent. We aimed to determine patterns of β-latam allergy, i.e. the association of a clinical reaction type with a specific β-lactam antibiotic.

Methods
We retrospectively evaluated data from 800 consecutive patients with suspected β-lactam hypersensitivity over a period of 11 years in a single German Allergy Center.

Results
β-lactam hypersensitivity was definitely excluded in 595 patients, immediate-type (presumably IgE-mediated) hypersensitivity was diagnosed in 70 and delayed-type hypersensitivity in 135 cases. Most (59 out of 70, 84.3%) immediate-type anaphylactic reactions were induced by a limited number of cephalosporins. Delayed reactions were regularly caused by an aminopenicillin (127 out of 135, 94.1%) and usually manifested as a measles-like exanthem (117 out of 135, 86.7%). Intradermal testing proved to be the most useful method for diagnosing β-lactam allergy, but prick testing was already positive in 24 out of 70 patients with immediate-type hypersensitivity (34.3%). Patch testing in addition to intradermal testing did not provide additional information for the diagnosis of delayed-type hypersensitivity. Almost all β-lactam allergic patients tolerated at least one, usually several alternative substances out of the β-lactam group.

Conclusions
We identified two patterns of β-lactam hypersensitivity: aminopenicillin-induced exanthem and anaphylaxis triggered by certain cephalosporins. Intradermal skin testing was the most useful method to detect both IgE-mediated and delayed-type β-lactam hypersensitivity.
Altered synaptic ultrastructure in the prefrontal cortex of Shank3-deficient rats
Authors: Jacot-Descombes Sarah , Keshav Neha U. , Dickstein Dara L. , Wicinski Bridget , Janssen William G. M. , Hiester Liam L. , Sarfo Edward K. , Warda Tahia , Fam Matthew M. , Harony-Nicolas Hala , Buxbaum Joseph D. , Hof Patrick R. , Varghese Merina 
Published: November 2020

AbstractBackgroundDeletion or mutations ofSHANK3lead to Phelan–McDermid syndrome and monogenic forms of autism spectrum disorder (ASD).SHANK3encodes its eponymous scaffolding protein at excitatory glutamatergic synapses. Altered morphology of dendrites and spines in the hippocampus, cerebellum, and striatum have been associated with behavioral impairments in Shank3-deficient animal models. Given the attentional deficit in these animals, our study explored whether deficiency ofShank3in a rat model alters neuron morphology and synaptic ultrastructure in the medial prefrontal cortex (mPFC).MethodsWe assessed dendrite and spine morphology and spine density in mPFC layer III neurons inShank3-homozygous knockout (Shank3-KO), heterozygous (Shank3-Het), and wild-type (WT) rats. We used electron microscopy to determine the density of asymmetric synapses in mPFC layer III excitatory neurons in these rats. We measured postsynaptic density (PSD) length, PSD area, and head diameter (HD) of spines at these synapses.ResultsBasal dendritic morphology was similar among the three genotypes. Spine density and morphology were comparable, but more thin and mushroom spines had larger head volumes inShank3-Het compared to WT andShank3-KO. All three groups had comparable synapse density and PSD length. Spine HD of total and non-perforated synapses inShank3-Het rats, but notShank3-KO rats, was significantly larger than in WT rats. The total and non-perforated PSD area was significantly larger inShank3-Het rats compared toShank3-KO rats. These findings represent preliminary evidence for synaptic ultrastructural alterations in the mPFC of rats that lack one copy ofShank3and mimic the heterozygous loss ofSHANK3in Phelan–McDermid syndrome.LimitationsTheShank3deletion in the rat model we used does not affect all isoforms of the protein and would only model the effect of mutations resulting in loss of the N-terminus of the protein. Given the higher prevalence of ASD in males, the ultrastructural study focused only on synaptic structure in maleShank3-deficient rats.ConclusionsWe observed increased HD and PSD area inShank3-Het rats. These observations suggest the occurrence of altered synaptic ultrastructure in this animal model, further pointing to a key role of defective expression of the Shank3 protein in ASD and Phelan–McDermid syndrome.
Three distinct hematological malignancies from a single germ cell tumor: a case report
Authors: Spencer Chapman M. , May P. C. , Olavarria E. , Nadal Melsio E. 
Published: November 2020

AbstractBackgroundThe association between non seminomatous germ cell tumors (GCTs) and hematological malignancies of rare lineage has been described in the literature. In some of these cases there is evidence that the leukemia derives from a pluripotent primitive clone present in the original germ cell tumor.Case presentationWe present a highly unusual case of a 23-year-old man of South Asian origin with a history of Klinefelter’s syndrome who initially developed mediastinal non seminomatous GCT. Following treatment with surgery and standard chemotherapy he went on to develop three different hematological malignancies of distinct lineages in sequential fashion over a short time period. Despite treatment with multiple intensive chemotherapy regimens and a matched unrelated donor allogeneic stem cell transplant, he died 41 months after initial diagnosis of his GCT and 10 months after the first diagnosis of hematological malignancy.ConclusionsThis is an extreme case that highlights the pluripotency and aggressiveness of these GCT-derived hematological malignancies, and the need for novel therapeutic approaches.
Interactions of multiple rhythms in a biophysical network of neurons
Authors: Gelastopoulos Alexandros , Kopell Nancy J. 
Published: November 2020

AbstractNeural oscillations, including rhythms in the beta1 band (12–20 Hz), are important in various cognitive functions. Often neural networks receive rhythmic input at frequencies different from their natural frequency, but very little is known about how such input affects the network’s behavior. We use a simplified, yet biophysical, model of a beta1 rhythm that occurs in the parietal cortex, in order to study its response to oscillatory inputs. We demonstrate that a cell has the ability to respond at the same time to two periodic stimuli of unrelated frequencies, firing in phase with one, but with a mean firing rate equal to that of the other. We show that this is a very general phenomenon, independent of the model used. We next show numerically that the behavior of a different cell, which is modeled as a high-dimensional dynamical system, can be described in a surprisingly simple way, owing to a reset that occurs in the state space when the cell fires. The interaction of the two cells leads to novel combinations of properties for neural dynamics, such as mode-locking to an input without phase-locking to it.
Seeking international consensus on approaches to primary tumour treatment in Ewing sarcoma
Authors: Gerrand Craig , Bate Jessica , Seddon Beatrice , Dirksen Uta , Randall R. Lor , van de Sande Michiel , O’Donnell Paul , Tuckett John , Peake David , Jeys Lee , Saifuddin Asif , Grainger Mel , Whelan Jeremy 
Published: November 2020

Abstract
Background
The local treatment of Ewing sarcoma of bone involves surgery, radiotherapy or both. The selection of treatment depends on the anatomical extent of the tumour, the effectiveness of the proposed treatment, its morbidity, and the expectation of cure. However, not only are there variations in the approach to local treatment between individual patients, but also between treatment centres and countries. Our aim was to explore variation in practice and develop consensus statements about local treatment.

Methods
A three stage modified Delphi technique was used with international collaborators. This involved an expert panel to identify areas of controversy, an online survey of international collaborators and a consensus meeting in London, UK in June 2017. In the consensus meeting, teams of clinicians discussed the local management of selected cases and their responses were collected with electronic voting.

Results
Areas of greater or less consensus were identified. The lack of evidence underpinning different approaches was noted and areas for collaborative research became apparent.

Conclusion
This has demonstrated that there is an international consensus around many aspects of the local treatment of Ewing sarcoma of bone, including the use of specialist MultiDisciplinary Team (MDT) meetings with access to all appropriate treatments. However, considerable variation remains including the use of different staging investigations, decision making, definitions of response, and radiotherapy doses and timing. Further collaborative work should be undertaken to determine the impact of these variations in order to define best practice.
Appropriateness of psychotropic medication use in a cohort of adolescents with intellectual disability in Queensland, Australia
Authors: Song Menghuan , Ware Robert S. , Doan Tan N. , McPherson Lyn , Trollor Julian N. , Harley David 
Published: November 2020

Background
Psychotropic medications are sometimes used off-label and inappropriately. This may cause harm to adolescents with intellectual disability. However, few studies have analysed off-label or inappropriate prescribing to this group.

Aims
To examine the appropriateness of psychotropic prescribing to adolescents with intellectual disability living in the community in south-east Queensland, Australia.

Method
Off-label medication use was determined based on whether the recorded medical condition treated was approved by the Australian Therapeutic Goods Administration. Clinical appropriateness of medication use was determined based on published guidelines and clinical opinion of two authors who specialise in developmental disability medicine (J.N.T. and D.H.).

Results
We followed 429 adolescents for a median of 4.2 years. A total of 107 participants (24.9%) were prescribed psychotropic medications on at least one occasion. Of these, 88 (82.2%) were prescribed their medication off-label or inappropriately at least once. Off-label or inappropriate use were most commonly associated with challenging behaviours.

Conclusions
Off-label or inappropriate use of psychotropic medications was common, especially for the management of challenging behaviours. Clinical decision-making accounts for individual patient factors and is made based on clinical experience as well as scientific evidence, whereas label indications are developed for regulatory purposes and, although appropriate at a population level, cannot encompass the foregoing considerations. Education for clinicians and other staff caring for people with intellectual disability, and a patient-centred approach to prescribing with involvement of families should encourage appropriate prescribing. The effect of the National Disability Insurance Scheme on the appropriateness of psychotropic medication prescribing should be investigated.
Clinical utility of the parent-reported Strengths and Difficulties Questionnaire as a screen for emotional and behavioural difficulties in children and adolescents with intellectual disability
Authors: Murray Caitlin A. , Hastings Richard P. , Totsika Vasiliki 
Published: November 2020

SummaryWe assessed the clinical utility of the parent-reported Strengths and Difficulties Questionnaire (SDQ) as a screen for emotional and behavioural difficulties in 626 children and young people with intellectual disability. Using the Developmental Behavior Checklist (DBC2-P) to determine clinical caseness, the area under the curve for the SDQ total difficulties score was 0.876 (95% CI 0.841–0.911), indicating that it is a good measure for identifying significant emotional and behavioural difficulties requiring further investigation. Analyses supported the use of the same SDQ cut-off for those with and without intellectual disability, which may assist with consistent and comparable assessment in clinical practice.
MvhB-type Polyferredoxin as an Electron-transfer Chain in Putative Redox-enzyme Complexes
Authors: Watanabe Tomohiro , Shima Seigo 
Published: November 2020

Abstract
Ferredoxin is a type of electron carrier protein involved in many biological redox reactions and also incorporated as an electron transfer domain and subunit in redox enzyme complexes. MvhB-type polyferredoxin is an iron-sulphur protein composed of three to seven 2[4Fe-4S]-ferredoxin domains. In this short review, we introduce the structure and function of MvhB-type polyferredoxin modules in methanogenic enzymes and then discuss the possible physiological function of the putative MvhB-like polyferredoxins identified in microbial genomes.
Accuracy of high-resolution ultrasound (US) for gingival soft tissue thickness mesurement in edentulous patients prior to implant placement
Authors: Sönmez Gül , Kamburoğlu Kıvanç , Gülşahı Ayşe 
Published: November 2020

Objectives: To evaluate and compare the accuracy of high-resolution ultrasound (US) with two different cone beam CT (CBCT) units and clinical assessment for measuring gingival soft tissue thickness in edentulous patients prior to implant placement. Methods and materials: The study consisted of 40 maxillary implant sites of 40 healthy patients (20 females, 20 males; mean age, 47.88 years). We prospectively evaluated labial/buccal gingival thickness in 40 implant regions (16 anterior and 24 posterior) by using limited field of view (FOV) CBCT images and US images in comparison to gold standard transgingival probing measurements. One-way analysis of variance (ANOVA) was used to compare mean measurements obtained from CBCT (Morita and Planmeca), US, and transgingival probing. Interclass correlation coefficient (ICC) estimates were calculated based on means with two-way mixed and absolute-agreement model. Bland Altman plot was used to describe agreement between clinical vs US and CBCT measurements by constructing limits of agreement. Statistical significance was set at p < 0.05. Results: There was no significant difference between methods used according to mean gingival thickness measurements obtained from the top (p = 0.519) and bottom (p = 0.346) of the alveolar process. US and CBCT measurements highly correlated with clinical measurements for both top and bottom alveolar process gingival thickness (p < 0.001). Distribution of differences between clinical measurements and both CBCT measurements showed statistically significant differences according to 0 (p < 0.05). Distribution of differences between clinical measurements and US measurements did not show statistically significant difference (p > 0.05). Conclusion: High-resolution US provided accurate information for the measurement of gingival soft tissue thickness in edentulous patients prior to implant placement.
Comparison of Resident, Advanced Practice Clinician, and Hospitalist Teams in an Academic Medical Center: Association With Clinical Outcomes and Resource Utilization
Authors: Johnson Stacy A , Ciarkowski Claire E , Lappe Katie L , Kendrick David R , Smith Adrienne , Reddy Santosh P 
Published: November 2020

BACKGROUNDAcademic medical centers have expanded their inpatient medicine services with advanced practice clinicians (APCs) or nonteaching hospitalists in response to patient volumes, residency work hour restrictions, and recently, COVID‐19. Reports of clinical outcomes, cost, and resource utilization differ among inpatient team structures.OBJECTIVEDirectly compare outcomes among resident, APC, and solo hospitalist inpatient general medicine teams.DESIGNRetrospective cohort study using multivariable analysis adjusted for time of admission, interhospital transfer, and comorbidities that compares clinical outcomes, cost, and resource utilization.SUBJECTSPatients 18 years or older discharged from an inpatient medicine service between July 2015 and July 2018 (N = 12,716).MAIN MEASURESLength of stay (LOS), 30‐day readmission, inpatient mortality, normalized total direct cost, discharge time, and consultation utilization.KEY RESULTSResident teams admitted fewer patients at night (32.0%; P < .001) than did APC (49.5%) and hospitalist (48.6%) teams. APCs received nearly 4% more outside transfer patients (P = .015). Hospitalists discharged patients 26 minutes earlier than did residents (mean hours after midnight [95% CI], 14.58 [14.44‐14.72] vs 15.02 [14.97‐15.08]). Adjusted consult utilization was 15% higher for APCs (adjusted mean consults per admission [95% CI], 1.00 [0.96‐1.03]) and 8% higher for residents (0.93 [0.90‐0.95]) than it was for hospitalists (0.85 [0.80‐0.90]). No differences in LOS, readmission, mortality, or cost were observed between the teams.CONCLUSIONWe observed similar costs, LOS, 30‐day readmission, and mortality among hospitalist, APC, and resident teams. Our results suggest clinical outcomes are not significantly affected by team structure. The addition of APC or hospitalist teams represent safe and effective alternatives to traditional inpatient resident teams.
Performance of Pediatric Readmission Measures
Authors: Auger Katherine A , Ponti‐Zins Michael C , Statile Angela M , Wesselkamper Kris , Haberman Beth , Hanke Samuel P 
Published: November 2020

BACKGROUNDReadmission rates are frequently used as a hospital quality metric; yet multiple measures exist to evaluate pediatric readmission rates. We sought to assess how four different measures of pediatric readmission compare with assessment of both preventable and unplanned readmission.METHODSClinicians on hospital medicine, cardiology, neonatology, and neurology teams reviewed medical records for 30‐day readmissions using an abstraction tool with high interrater reliability for preventability assessment. Readmissions between July 2014 and June 2016 were classified separately as preventable or not preventable and planned or unplanned. We compared the classifications to four existing readmission metrics: all‐cause readmission, unplanned readmission/time flag classification, the pediatric all‐condition readmission, and potentially preventable readmission. We calculated sensitivity and specificity for all readmission metrics.RESULTSAmong 30‐day readmissions considered, 1,643 were eligible for medical record review; 1,125 reviews were completed by the clinical teams (68%). On medical record review, the majority of readmissions were determined not preventable (85%). Only 15% were classified as unplanned and preventable. None of the four readmission measures had appropriate sensitivity or specificity for identifying preventable readmission. The unplanned readmission/time flag classification had the highest sensitivity (95%) and specificity (90%) in identifying unplanned readmissions.CONCLUSIONNone of the existing pediatric readmission measures can reliably determine preventability. The unplanned readmission/time flag measure performed best in identifying unplanned readmissions.
<strong>New records of Noctuid moths (Lepidoptera, Noctuidae) from India, Bhutan and China</strong>
Authors: P.R. SHASHANK , BENEDEK BALÁZS 
Published: November 2020

The five species, Harutaeographa brumosa Yoshimoto, 1994, Nyctycia asymmetrica Hreblay & Ronkay, 1998, Hemiglaea costigera Hreblay & Ronkay, 1998, Owadaglaea barna Hreblay & Ronkay, 1998, and O. triangulifera Hreblay & Ronkay, 1998 are reported for the first time from the Himalayan region of India, Bhutan and China. For two species, N. asymmetrica and H. costigera, the females are described for the first time. Male and female genitalia of all species are illustrated and new distributional data is provided. Key words: Biodiversity, Distribution, Himalaya, New record
Cascaded metamaterial polarizers for the visible region
Authors: Bootpakdeetam Pawarat , Hemmati Hafez , Magnusson Robert 
Published: November 2020

Polarizers serve many application fields such as imaging, display technology, and telecommunications. Focusing on the visible spectral region, we provide the design and fabrication of compact high-efficiency resonant polarizers in the crystalline silicon-on-quartz material system. We experimentally verify the improved efficiency attained by a cascaded dual-module polarizer assembled with building blocks of elemental subwavelength grating structures. We obtain a measured extinction ratio (ER) of

∼

3000

in a 2 mm thick stacked prototype device across a bandwidth of

∼

110

n
m

in the 570–680 nm spectral domain. The ridge width of the constituent nanograting is

∼

84

n
m

. Computed results show a high ER in spite of the lossy nature of crystalline silicon in the visible region, enabling cascaded metasurfaces while preserving high transmission.
Wide-range optical carrier recovery via broadened Brillouin filters
Authors: Zarifi Atiyeh , Merklein Moritz , Liu Yang , Choudhary Amol , Eggleton Benjamin J. , Corcoran Bill 
Published: November 2020

Stimulated Brillouin scattering has great potential for wide-wavelength-range optical carrier recovery, as it can act as a parametrically defined narrowband gain filter. However, due to the dispersion of the Brillouin frequency shift, prior demonstrations have been limited in wavelength range. Here, we demonstrate that frequency modulating the pump light for a gain filter based on stimulated Brillouin scattering enables optical carrier recovery for a broad range of input wavelengths. We demonstrate highly selective (

bandwidth) amplification for optical carriers over an 18 nm wide wavelength range in the optical communications C-band, an

improvement over using an unmodulated pump. Measurements of the noise properties of these spectrally broadened gain filters, in both amplitude and phase, indicate the noise performance and SNR are maintained over a wide wavelength range. Our technique provides a potential solution for highly selective, wavelength agnostic optical carrier recovery.