bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of oxycodone controlled release use in older people with cancer following public subsidy of oxycodone/naloxone formulations: An Australian population‐based study
Authors: Daniels Benjamin , Luckett Tim , Holliday Simon , Liauw Winston , Lovell Melanie , Phillips Jane , Rowett Debra , John Toby Newton , Tervonen Hanna , Pearson Sallie‐Anne 
Published: September 2020

AbstractAimPublic subsidy of the oxycodone/naloxone controlled release (CR) combination in December 2011 expanded the overall market for oxycodone CR in the general public in Australia; we evaluate its impact in people with cancer.MethodsWe used Repatriation Pharmaceutical Benefits dispensing data linked with the NSW Cancer Registry for Department of Veterans’ Affairs (DVA) healthcare card holders 65 years and older residing in NSW between 2004 and 2013 to identify clients with cancer and their opioid dispensings. We used interrupted time series analysis to model changes in monthly rates of oxycodone CR tablets dispensed and initiations. We performed a retrospective cohort study to examine changes in client characteristics and opioid utilization over time by comparing clients initiating oxycodone CR before and after subsidy.ResultsThe rate of oxycodone CR tablets dispensed/month increased by 20% from December 2011, due to uptake of the oxycodone/naloxone CR combination; monthly initiations increased immediately by 17%. Initiations of buprenorphine, fentanyl, and morphine declined from December 2011. DVA healthcare card holders were significantly more likely to initiate the 5 mg oxycodone CR formulation; more likely to use immediate release oxycodone in the 90 days following initiation; and less likely to use a weak opioid in the 90 days preceding oxycodone CR initiation following December 2011 than they were prior to that time.ConclusionsThe public subsidy of the oxycodone/naloxone CR formulation expanded the overall oxycodone CR market for DVA healthcare card holders with cancer. Our findings highlight the need for updated guidelines around risk management for opioid treatment in patients with cancer.
Cutaneous manifestations of viral outbreaks
Authors: Bothra Atul , Maheswari Anshu , Singh Mehak , Pawar Manoj , Jodhani Kirti 
Published: September 2020

AbstractAs the world tries to grapple with the COVID‐19 pandemic, dermatologists are left in a lurch as there is a lacuna in dermatologic literature as well as training regarding the cutaneous manifestations of varied viral agents capable of causing epidemics/pandemics or the potential to be bio‐weaponised. Such outbreaks have the potential to become a pandemic given this age of globalisation. The quote by George Santayana stands true ‘Those who cannot remember the past are condemned to repeat it’. Thus, this article lends a perspective to the recent viral outbreaks and is aimed at summarising these agents and their clinical features to serve as a quick reference for dermatologists.
Evaluation of the efficacy of cysteamine cream compared to hydroquinone in the treatment of melasma: A randomised, double‐blinded trial
Authors: Nguyen Jennifer , Remyn Laura , Chung In Young , Honigman Anthony , Gourani‐Tehrani Shima , Wutami Ilycia , Wong Celestine , Paul Eldho , Rodrigues Michelle 
Published: September 2020

AbstractBackground/ObjectiveMelasma is a commonly acquired disorder of hyperpigmentation that often poses a therapeutic challenge for dermatologists. Recently, cysteamine cream has shown promising results compared to placebo. This study aims to determine the efficacy of cysteamine cream compared to hydroquinone cream in the treatment of melasma.MethodsA randomised, double‐blinded, single‐centre trial was conducted in Victoria, Australia. 20 recruited participants were given either cysteamine cream or hydroquinone cream for 16 weeks. The primary outcome measure was a change in the modified Melasma Area and Severity Index (mMASI). Quality of life at baseline and week 16 as well as standard digital photography at each follow‐up visit was assessed as secondary outcome measures.ResultsAt week 16, 14 participants completed the study with 5 participants in the cysteamine group and 9 patients in the hydroquinone group. In the intention to treat analysis, there was a 1.52 ± 0.69 (21.3%) reduction in mMASI for the cysteamine group and a 2.96 ± 1.15 (32%) reduction in the hydroquinone group. The difference between groups was not statistically significant (P = 0.3). Hydroquinone cream was generally better tolerated that cysteamine cream.ConclusionOur study suggests that topical cysteamine may have comparable efficacy to topical hydroquinone. Cysteamine thus provides a possible alternative to patients and clinicians who wish to avoid or rotate off topical hydroquinone. While side effects were more common for participants using cysteamine compared with hydroquinone, these were mild and reversible. Larger studies comparing cysteamine and hydroquinone are required to support these findings.
The Dictator's Power‐Sharing Dilemma: Countering Dual Outsider Threats
Authors: Paine Jack 
Published: September 2020

AbstractDictators face a power‐sharing dilemma: Broadening elite incorporation mitigates prospects for outsider rebellions (by either elites excluded from power or the masses), but it raises the risk of insider coups. This article rethinks the theoretical foundations of the power‐sharing dilemma and its consequences. My findings contrast with and provide conditionalities for a “conventional threat logic,” which argues that large outsider threats compel dictators to create broader‐based regimes, despite raising coup risk. Instead, I analyze a game‐theoretic model to explain why the magnitude of the elite outsider threat ambiguously affects power‐sharing incentives. Dictators with weak coup‐proofing institutions or who face deeply entrenched elites take the opposite actions predicted by the conventional logic. An additional outsider threat from the masses can either exacerbate or eliminate the power‐sharing dilemma with elites, depending on elite affinity toward mass rule. Examining the elite‐mass interaction also generates new implications for how mass threats affect the likelihood of coups and regime overthrow.
Long‐term outcomes after plaque incision and grafting for Peyronie’s disease: comparison of porcine dermal and bovine pericardium grafts
Authors: Fiorillo Alessandro , Droghetti Matteo , Palmisano Franco , Bianchi Lorenzo , Piazza Pietro , Sadini Paolo , Masetti Martina , Molinaroli Enrico , Gentile Giorgio , Vagnoni Valerio , Franceschelli Alessandro , Colombo Fulvio 
Published: September 2020

AbstractBackgroundPlaque incision and grafting (PEG) is one of the mainstays in surgical therapy for severe penile curvature in Peyronie’s disease (PD). Different kinds of grafts are available for covering albugineal defects during PEG, both allografts and xenografts. However, to date, none of these proved superior to others.ObjectivesTo compare two different types of xenograft, porcine dermal matrix and bovine pericardium matrix in PEG for PD.Materials and methodsFrom 2010 to 2019, 63 patients with PD underwent PEG, using porcine dermal (n = 25; Group 1) and bovine pericardium (n = 38; Group 2) grafts. Long‐term outcomes were evaluated through multi‐disciplinary questionnaires administration by phone interview. The following items were considered: correction of penile bending, quality of erection, intercourse ability, penile shortening, and sensitiveness. Overall satisfaction and impact of surgery on sexual activity and quality of life were also investigated.ResultsPlaque median (IQR) size was 29 (22‐33) mm and was smaller in Group 1 (27.5 vs. 31 mm; P = .03). Complete follow‐up data were available for 53 patients (84%). Considering post‐operative outcomes, no differences were found when considering ED rates, penile shortening, sensitiveness, complications, and penile straightening (all P > .1). Patients in Group 2 were more likely to have palpable penile nodules at follow‐up (20.6 vs. 0%; P = .03). However, patient’s post‐operative sexual life satisfaction was consistent between the two groups, with just 1 (5.3) and 8 (23.5) patients in Group 1 and 2 respectively referring a worsening in sexual life satisfaction (P = 0.2). At follow‐up, 84.9% of patients that would still undergo surgery for PD, with no statistical difference between the two groups (P = .4).ConclusionsCorporoplasty with PEG is an effective treatment for men with PD. Porcine dermal and bovine pericardium xenografts seem to have similar long‐term outcomes.
Prolonged ECG with a novel recorder utilizing electrode belt and mobile device in patients with recent embolic stroke of undetermined source: A pilot study
Authors: Lumikari Tuomas Jussi , Pirinen Jani , Putaala Jukka , Sibolt Gerli , Kerola Anne , Pakarinen Sami , Lehto Mika , Nieminen Tuomo 
Published: September 2020

AbstractBackgroundParoxysmal atrial fibrillation (pAF) is a major risk factor for ischemic stroke, but challenging to detect with routine short‐term monitoring methods. In this pilot study, we present a novel method for prolonged ECG and screening for pAF in patients with a recent embolic stroke of unknown source (ESUS).MethodsFifteen patients aged ≥ 50 years with a recent ESUS were assigned to wear an external electrode belt‐based 1‐lead ECG device (Beat2Phone) continuously for 2 weeks (wear time). The device was operated via a mobile phone application in nonhospital conditions. The primary outcome was patient adherence to monitoring. Secondary outcomes were incidence of new pAF, quality‐wise comparison to Holter, and usability of the novel ECG monitoring method with Systems Usability Scale (SUS). We also performed a 24‐ to 48‐hr comparison between simultaneous Beat2Phone ECG and a standard Holter in 6 patients.ResultsWear time of Beat2Phone device was over 80% in 5 (33.3%) patients, 50%–80% in 7 (46.6%) patients, and less than 50% in 3 (20%) patients. We detected pAF ≥ 30 s in 1 patient (6.7%). In the simultaneous monitoring with Beat2Phone and Holter, there were a total of 817 (out of 1979) analyzable periods of sinus rhythm or premature atrial or ventricular beats (Cohen's Kappa coefficient 0.92 ± 0.02 between Beat2Phone and Holter), and no pAF events. Beat2Phone ECG showed remarkable SUS scores in user evaluations (average score: 81.4 out of 100 on SUS).ConclusionsBeat2Phone device was easy to use among ESUS patients and in optimal conditions provided high‐quality 1‐lead ECG signal for diagnosing pAF.Clinical trial registrationThe study was not registered, as it was a nonrandomized single‐arm pilot study.
The role of chromosomal microarray analysis among fetuses with normal karyotype and single system anomaly or nonspecific sonographic findings
Authors: Hui Annie Sy , Chau Matthew Hoi Kin , Chan Yiu Man , Cao Ye , Kwan Angel Hw , Zhu Xiaofan , Kwok Yvonne K. , Chen Zihan , Lao Terence T. , Choy Kwong Wai , Leung Tak Yeung 
Published: September 2020

AbstractIntroductionChromosomal microarray analysis is recommended as the first‐tier test for the evaluation of fetuses with structural anomalies. This study aims to investigate the incremental diagnostic yield of chromosomal microarray over conventional karyotyping analysis in fetuses with anomalies restricted to one anatomic system and those with nonspecific anomalies detected by sonography.Material and methodsThis is a retrospective cohort analysis of 749 fetuses undergoing prenatal diagnosis for abnormal ultrasound findings isolated to one anatomic system and normal karyotype, utilizing chromosomal microarray. Overall, 495 (66%) fetuses had anomalies confined to one anatomic system and 254 (34%) had other nonspecific anomalies including increased nuchal translucency (≥3.5 mm), cystic hygroma, intrauterine growth restriction and hydrops fetalis.ResultsFetuses with ultrasound anomalies restricted to one anatomic system had a 3.0% risk of carrying a pathogenic copy number variant; the risk varied dependent on the anatomic system affected. Fetuses with confined anomalies of the cardiac system had the highest diagnostic yield at 4.6%, but there were none in the urogenital system. Fetuses with nonspecific ultrasound anomalies had the highest diagnostic yield in fetuses with an intrauterine growth restriction at 5.9%. Overall, fetuses with a nonspecific ultrasound anomaly were affected with pathogenic copy number variants in 1.6% in the cases.ConclusionsThe diagnostic yield of chromosomal microarray in fetuses with normal karyotype and ultrasound abnormality confined to a single anatomic system was highest if it involved cardiac defects or intrauterine growth restriction. This diagnostic yield ranges from 0% to 4.6% depending on the anatomic system involved. Chromosomal microarray has considerable diagnostic value in these pregnancies.
Characteristics and short‐term obstetric outcomes in a case series of 67 women test‐positive for SARS‐CoV‐2 in Stockholm, Sweden
Authors: Remaeus Katarina , Savchenko Julia , Brismar Wendel Sophia , Brusell Gidlöf Sebastian , Graner Sophie , Jones Elin , Molin Johanna , Saltvedt Sissel , Wallström Tove , Pettersson Karin 
Published: September 2020

AbstractIntroductionThe Stockholm region was the first area in Sweden to be hit by the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). The national guidelines on the care of women with a positive test for SARS‐CoV‐2 (detection with polymerase chain reaction [PCR]) recommend individualized antenatal care, mode of delivery based on obstetric considerations, and no routine separation of the mother and the newborn. Breastfeeding is encouraged, and although there is no specific recommendation regarding wearing a face mask to prevent viral transmission to the newborn while nursing, instructions are given to keep high hygiene standards. All studies based on cases tested on hospital admission will capture more women with pregnancy complications than in the general population. Our aim was to describe the clinical characteristics of SARS‐CoV‐2‐positive women and their neonates, and to report short‐term maternal and neonatal outcomes.Material and methodsA retrospective case series with data from medical records including all test‐positive women (n = 67) who gave birth to 68 neonates from 19 March to 26 April 2020 in Stockholm, Sweden. Means, proportions and percentages were calculated for clinical characteristics and outcomes.ResultsThe mean age was 32 years, 40% were nulliparous and 61% were overweight or obese. Further, 15% had diabetes and 21% a hypertensive disease. Seventy percent of the women had a vaginal birth. Preterm delivery occurred in 19% of the women. The preterm deliveries were mostly medically indicated, including two women who were delivered preterm due to severe coronavirus disease 19 (COVID‐19), corresponding to 15% of the preterm births. Four women (6%) were admitted to the intensive care unit postpartum but there were no maternal deaths. There were two perinatal deaths (one stillbirth and one neonatal death). Three neonates were PCR‐positive for SARS‐CoV‐2 after birth.ConclusionsIn this case series of 67 women testing positive for SARS‐CoV‐2 with clinical presentations ranging from asymptomatic to manifest COVID‐19 disease, few women presented with severe COVID‐19 illness. The majority had a vaginal birth at term with a healthy neonate that was negative for SARS‐CoV‐2.
Intrapartum zigzag pattern of fetal heart rate is an early sign of fetal hypoxia: A large obstetric retrospective cohort study
Authors: Tarvonen Mikko , Hovi Petteri , Sainio Susanna , Vuorela Piia , Andersson Sture , Teramo Kari 
Published: September 2020

AbstractIntroductionThe aim of the present study was to identify possible associations of fetal heart rate (FHR) patterns during the last 2 hours of labor with fetal asphyxia expressed by umbilical artery acidemia at birth and with neonatal complications in a large obstetric cohort.Material and methodsCardiotocographic recordings from 4988 singleton term childbirths over 1 year were evaluated retrospectively and blinded to the pregnancy and neonatal outcomes in a university teaching hospital in Helsinki, Finland. Umbilical artery pH, base excess and pO2, low Apgar scores at 5 minutes, need for intubation and resuscitation, early neonatal hypoglycemia, and neonatal encephalopathy were used as outcome variables. According to the severity of the neonatal complications at birth, the cohort was divided into three groups: no complications (Group 1), moderate complications (Group 2) and severe complications (Group 3).ResultsOf the 4988 deliveries, the ZigZag pattern (FHR baseline amplitude changes of >25 bpm with a duration of 2‐30 minutes) occurred in 11.7%, late decelerations in 41.0%, bradycardia episodes in 52.9%, reduced variability in 36.7%, tachycardia episodes in 13.9% and uterine tachysystole in 4.6%. No case of saltatory pattern (baseline amplitude changes of >25 bpm with a duration of >30 minutes) was observed. The presence of the ZigZag pattern or late decelerations, or both, was associated with cord blood acidemia (odds ratio [OR] 3.3, 95% confidence interval [CI] 2.3‐4.7) and severe neonatal complications (Group 3) (OR 3.3, 95% CI 2.4‐4.9). In contrast, no significant associations existed between the other FHR patterns and severe neonatal complications. ZigZag pattern preceded late decelerations in 88.7% of the cases. A normal FHR preceded the ZigZag pattern in 90.4% of the cases, whereas after ZigZag episodes, a normal FHR pattern was observed in only 0.9%.ConclusionsZigZag pattern and late decelerations during the last 2 hours of labor are significantly associated with cord blood acidemia at birth and neonatal complications. The ZigZag pattern precedes late decelerations, and the fact that normal FHR pattern precedes the ZigZag pattern in the majority of the cases suggests that the ZigZag pattern is an early sign of fetal hypoxia, which emphasizes its clinical importance.
Is sleep deficit associated with infertility and recurrent pregnancy losses? Results from a prospective cohort study
Authors: Stocker Linden Jane , Cagampang Felino Ramon , Lu Shilong , Ladyman Tom , Cheong Ying Chin 
Published: September 2020

AbstractIntroductionBiological rhythms, the innate cycle of changes in the body’s physiological functions, are circadian if they have a 24‐hour period. It is known that sleep is a key feature of human circadian rhythm but the relation between sleep and female fertility is largely unknown. This paucity of research is surprising given that circadian rhythms are paramount to human physiology and sleep is related to major female reproductive events. This study was designed to investigate whether there is a difference between the sleep and activity parameters of women with poor reproductive outcome compared with healthy, fertile parous women (comparator group) using subjective (questionnaires) and objective (actigraphy and light exposure) measures.Material and methodsA prospective cohort study in a tertiary in vitro fertilization referral center in the UK; composed of three study groups: women diagnosed with recurrent implantation failure, women with recurrent miscarriage (RM) and a comparison group (fertile women without endometrial pathology). Comparison women were selected gynecology patients without endometrial disease (ie perineal complaints or altruistic egg donors). Primary outcome was differences in objective length of sleep in each of the participant groups using actigraphy. Secondary outcomes were subjective sleep quality and quantity, using participant questionnaires, light exposure, and the feasibility of machine learning in activity‐pattern interpretation.ResultsWomen with recurrent implantation failure slept daily on average for 7 hours 35 minutes (± 57 min), 53 minutes less than the comparison group (P = .03), although quality of their objective sleep, and quantity of their subjective sleep, were not significantly different. Women with recurrent miscarriage slept less that the comparison women (36 minutes less/night) but more than women with recurrent implantation failure (17 minutes more/night). No difference in light exposure was found between recurrent miscarriage and the recurrent implantation failure and comparison groups.ConclusionsThis study demonstrates an objective observation of sleep time reduction in women with subfertility, although it is not yet clear if this association is casual. Given our increased understanding of the internal body clock and circadian rhythm on fertility, our observation warrants further investigation.
Three cases of Charles Bonnet Syndrome in patients with advanced glaucomatous visual field loss but preserved visual acuity
Authors: Lomo Trine , Singh Amardeep , Peters Dorothea 
Published: September 2020

AbstractPurposeTo describe three cases of Charles Bonnet syndrome (CBS) in glaucoma patients with preserved visual acuity.MethodsThree glaucoma patients who had taken part in a recent CBS study were interviewed about their hallucinations. The patients underwent macular optical coherence tomography (OCT) of both eyes. The visual function was evaluated with visual field measurement (Humphrey visual field analyser) and visual acuity testing (Snellen scale).ResultsAll three patients had preserved visual acuity (≥0.5 in both eyes) and at least one eye with advanced visual field defect (Mean Deviation worse than −12.00 decibel). They all reported vivid visual hallucinations with insight into the unreal nature of the hallucinations.ConclusionCharles Bonnet syndrome can occur in glaucoma despite preserved visual acuity. Awareness of this relation is desirable among clinicians, as it will improve communication with patients.
Prevalence and risk factors for depressive symptoms in patients with neovascular age‐related macular degeneration who present for anti‐VEGF therapy
Authors: Vu Kim Van , Mitchell Paul , Dharamdasani Detaram Harshil , Burlutsky George , Liew Gerald , Gopinath Bamini 
Published: September 2020

AbstractPurposeTo examine the prevalence and risk factors for depressive symptoms in patients with neovascular age‐related macular degeneration (nAMD) presenting for anti‐vascular endothelial growth factor (anti‐VEGF) therapy.MethodsIn a clinic‐based cohort of 547 patients with nAMD who presented for treatment, the Centre of Epidemiological Studies Depression 10‐point scale (CES‐D‐10) and Mental Health Index (MHI) component of the 36‐item Short Form Survey were administered to assess for the presence of depressive symptoms. Logistic regression analyses were used to calculate odds ratios and 95% confidence intervals for factors associated with an increased likelihood of depressive symptoms.ResultsThe prevalence of depressive symptoms was 42.04% and 31.78% as per the CES‐D‐10 and MHI scales, respectively. Poor self‐rated health (SRH) is associated with increased odds of depressive symptoms [multivariable‐adjusted OR: 3.00 (95% CI 1.90–4.73) for CES‐D‐10; OR: 2.67 (95% CI 1.67–4.28) for MHI]. Impaired activities of daily living (ADLs) [multivariable‐adjusted OR: 2.62 (95% CI 1.56–4.38) for CES‐D‐10; OR: 3.59 (95% CI 2.10–6.15) for MHI] and a visual function score within the two lowest quartiles were also associated with increased odds of depressive symptoms using both scales.ConclusionA high prevalence of depressive symptoms was observed among nAMD patients presenting for treatment. Poorer SRH, ADL impairment and reduced visual function were associated with increased odds of depressive symptoms.