bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disparities in Access to Medications for Opioid Use Disorder in the Veterans Health Administration
Authors: Finlay Andrea K. , Harris Alex H. S. , Timko Christine , Yu Mengfei , Smelson David , Stimmel Matthew , Binswanger Ingrid A. 
Published: August 2020

Objectives:
A variety of patients – including women, older, racial/ethnic minority, rural, homeless, and justice-involved patients – are vulnerable to experiencing poor healthcare access and quality, such as lower quality substance use disorder treatment, than other populations. The current study examined receipt of medications for opioid use disorder by vulnerable populations within Veterans Health Administration (VHA) facilities to determine whether there are patient and facility factors that are associated with disparities in care.

Methods:
Using national VHA clinical/administrative data from Fiscal Year 2017, we calculated receipt of medications for opioid use disorder using the American Society for Addiction Medicine quality measure specifications. A mixed-effects logistic regression model tested whether patient vulnerability (ie, women, older age, racial/ethnic minority, rural residence, homeless, and justice-involved) and facility (eg, regional location, availability of a methadone clinic) characteristics were associated with medication receipt.

Results:
Among the 53,568 veterans at VHA facilities diagnosed with opioid use disorder in Fiscal Year 2017, vulnerable populations – including women, older, Black, rural, homeless, and justice-involved veterans – had lower odds of receiving medications for opioid use disorder than their nonvulnerable counterparts. Veterans had higher odds of receiving medications at facilities with a higher proportion of patients with opioid use disorder, but lower odds of receiving medications at facilities in the Southern region compared to the Northeast region of the United States.

Conclusions:
Quality improvement efforts targeted at vulnerable populations are needed at the VHA to ensure these groups receive the same quality of substance use disorder treatment as other veterans.
Revisiting Risk-stratified Whiplash-exposed Patients 12 to 14 Years After Injury
Authors: Rasmussen Martin K. , Kongsted Alice , Carstensen Tina , Jensen Troels S. , Kasch Helge 
Published: August 2020

Objective:
The objective of this study was to evaluate the long-term predictive value of the Danish Whiplash Group Risk Assessment Score (DWGRAS) with 7 risk strata.

Design:
E-questionnaire-based follow-up study (n=927) combining 2 cohorts of whiplash-injured patients, 1 observational (n=187) and 1 interventional randomized controlled trial (n=740).

Methods:
Nine hundred twenty-seven previously healthy persons exposed to acute whiplash injury during motor vehicle collision were sent letter by postal service asking the addressee if they would respond to an E-questionnaire. Outcome measures were: whiplash-related disability, pain, use of medication/nonmedical treatment, work capacity.

Results:
The response rate was 37%. Fifty-five percent reported whiplash-related disability. Fourteen percent reported daily symptoms. A strong relationship was found between risk strata and impact of event and between risk strata and disabling symptoms.

Conclusions:
Internal and long-term validation of DWGRAS was performed, but a low response rate indicates that results should be interpreted with caution. Furthermore, external validation needs to be done in long-term studies. An receiver operating characteristics curve of 0.73 (95% confidence interval 0.67; 0.79) predicting daily or weekly whiplash-related disability after 12 to 14 years was found using the DWGRAS risk score.
A precision medicine approach to management of acute myeloid leukemia in older adults
Authors: Upadhyay Banskota Shristi , Khanal Nabin , Bhatt Vijaya Raj 
Published: August 2020

Purpose of review
Therapy selection in older adults with acute myeloid leukemia (AML) can be challenging because of a higher incidence of high-risk cytogenetic and molecular features conferring chemoresistance and poor functional status leading to increased treatment-related toxicities. The purpose of this review is to highlight the recent advances in precision medicine in AML that have shown promise to improve outcomes of older adults.

Recent findings
The utilization of next generation sequencing to identify and target actionable mutations can influence therapy selection in one-third of patients and can result in higher response rates as well as survival compared with those who do not receive targeted therapy. Oral targeted agents are available for AML with IDH 1, IDH2, or FLT3 mutations. Low-intensity venetoclax-based regimens have shown high rates of responses in AML, particularly among those with NPM1 and IDH2 mutations; responses are often durable and associated with minimal residual disease (MRD) negativity. Multiple studies have demonstrated the prognostic significance of flow cytometric MRD, with potential implications for subsequent therapy.

Summary
Novel approaches for AML risk-stratification, MRD assessment, and a precision medicine approach offer significant promise to improve survival and quality of life of older adults.
Percutaneous Coronary Intervention Compared with Coronary Artery Bypass Graft Surgery for Patients With 3-vessel Disease: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant Systematic Review and Meta-analysis
Authors: Zhao Hengyi , Zhang Daimin 
Published: August 2020

Objectives:
Previous investigations showed inconsistent results for comparison in clinical outcomes between patients with 3-vessel disease (3VD) treated with percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery. A systematic review and meta-analysis is essential to compare the clinical outcomes of PCI with CABG surgery for patients with 3VD.

Methods:
We systematically searched on PubMed and Web of Science for articles which compared PCI with CABG for patients with 3VD and published from January 1989 to January 2020. We computed the hazard ratios (HRs) and 95% confidence intervals (CIs) for individual clinical outcomes.

Results:
This study indicated that the PCI group was associated with a 1.51-fold higher risk of all-cause mortality compared with the CABG group in patients with 3VD (HR 1.51, 95% CI 1.38–1.65). In addition, the PCI group showed a 3.08-fold and 2.94-fold higher risk compared with the CABG group in risks of myocardial infarction (MI) and target-vessel revascularization (TVR), respectively (MI: HR 3.08, 95% CI 2.61–3.63; TVR: HR 2.94, 95% CI 1.94–4.46).

Conclusions:
In conclusion, in patients with 3VD, PCI was consistently associated with higher rates of all-cause mortality, MI, and TVR, compared with CABG.
Long Noncoding RNA OIP5-AS1 Contributes to the Progression of Atherosclerosis by Targeting miR-26a-5p Through the AKT/NF-κB Pathway
Authors: Ren Mingming , Wang Tao , Han Zhen , Fu Pengcheng , Liu Zigang , Ouyang Chun 
Published: August 2020

Abstract:
Atherosclerosis (AS) is a cardiovascular disease caused by multiple factors, leading to high mortality and morbidity in aged people. Some long noncoding RNAs have been reported to be associated with AS progression. However, the roles of OIP5-AS1 in AS development are still little known. In this study, the levels of OIP5-AS1 and miR-26a-5p in oxidized low-density lipoprotein (ox-LDL)-treated human umbilical vein endothelial cells (HUVECs) were determined by quantitative real-time polymerase chain reaction. Cell proliferation and apoptosis were evaluated by Cell Counting Kit-8 assay and flow cytometric analysis, respectively. The protein levels of proliferating cell nuclear antigen, B-cell lymphoma-2, cleaved caspase 3, inflammatory cytokines (IL-6 and IL-1β), protein kinase B (AKT), p-AKT, p65, p-p65, IκBα, and p-IκBα were detected by Western blot analysis. The targeting relationship between OIP5-AS1 and miR-26a-5p was verified by dual-luciferase reporter assay, RNA immunoprecipitation assay, and RNA pull-down assay. As a result, the expression of OIP5-AS1 was upregulated and miR-26a-5p was downregulated in ox-LDL–treated HUVECs. MiR-26a-5p was identified as a direct target of OIP5-AS1. OIP5-AS1 knockdown reversed the inhibitory effect on cell proliferation and the promotional effects on apoptosis and inflammation induced by ox-LDL treatment in HUVECs. Interestingly, the effects caused by OIP5-AS1 knockdown were further attenuated by miR-26a-5p inhibition. Furthermore, OIP5-AS1 knockdown blocked the AKT/NF-κB pathway by regulating miR-26a-5p expression. In conclusion, OIP5-AS1 knockdown promoted cell proliferation and suppressed apoptosis and inflammatory response in ox-LDL–treated HUVECs by targeting miR-26a-5p through blocking the AKT/NF-κB pathway, indicating a promising strategy for AS treatment.
Additive association of knowledge and awareness on control of hypertension: a cross-sectional survey in rural India
Authors: Ragavan Rathina Srinivasa , Joshi Rohina , Evans Roger G. , Riddell Michaela A. , Thankappan Kavumpurathu R. , Chow Clara K. , Oldenburg Brian , Mahal Ajay S. , Kalyanram Kartik , Kartik Kamakshi , Suresh Oduru , Thomas Nihal , Mini Gomathyamma K. , Srikanth Velandai K. , Maulik Pallab K. , Alim Mohammed , Guggilla Rama K. , Busingye Doreen , Thrift Amanda G. 
Published: August 2020

Objective:
To determine whether there is an interaction between knowledge about hypertension and awareness of hypertension on the treatment and control of hypertension in three regions of South India at different stages of epidemiological transition (see Video, Supplemental Digital Content 1, http://links.lww.com/HJH/B426).

Methods:
Using a cross-sectional design, we randomly selected villages within each of rural Trivandrum, West Godavari, and Chittoor. Sampling was stratified by age group and sex. We measured blood pressure and administered a questionnaire to determine knowledge and awareness of hypertension. Logistic regression was used to assess associations of awareness and knowledge about hypertension with its treatment and control in participants with hypertension, while examining for statistical interaction.

Results:
Among a total of 11 657 participants (50% male; median age 45 years), 3455 had hypertension. In analyses adjusted for age and sex, both knowledge score [adjusted odds ratio (aOR) 1.14 [95% confidence interval (CI) 1.12--1.17)] and awareness [aOR 104 (95% CI 82--134)] were associated with treatment for hypertension. Similarly, both knowledge score [aOR 1.10; 95% CI (1.08--1.12)] and awareness [aOR 13.4; 95% CI (10.7--16.7)], were positively associated with control of blood pressure in those with hypertension, independent of age and sex. There was an interaction between knowledge and awareness on both treatment and control of hypertension (P of attributable proportion <0.001 for each).

Conclusion:
Health education to improve knowledge about hypertension and screening programs to improve awareness of hypertension may act in an additive fashion to improve management of hypertension in rural Indian populations.
Placental lipid metabolism in preeclampsia
Authors: Khaire Amrita A. , Thakar Shivani R. , Wagh Girija N. , Joshi Sadhana R. 
Published: August 2020

Objectives:
The current study examines the placental and maternal lipid profile and expression of genes involved in placental lipid metabolism in women with preeclampsia.

Methods:
The current study includes normotensive control women (n = 40) and women with preeclampsia (n = 39). Preeclampsia women were further classified into women delivering at term preeclampsia (T-PE; n = 15) and preterm preeclampsia (PT-PE; n = 24).

Results:
There were no significant differences in maternal lipid profile between the T-PE and normotensive control groups. Maternal plasma VLDL (P < 0.05) and ratios of total cholesterol : HDL (P < 0.05), atherogenic index [log (triglycerides/HDL)] (P < 0.01) and apolipoprotein B : apolipoprotein A (P < 0.05) were higher in the PT-PE group as compared with the normotensive control group. Placental total cholesterol and HDL levels were higher (P < 0.05) in the T-PE as compared with the normotensive control group. Higher placental triglycerides (P < 0.05) were observed in PT-PE group compared with T-PE group. Placental mRNA levels of peroxisome proliferator activated receptor α, carnitine palmitoyl transferase-1, cluster of differentiation 36 and lipoprotein lipases were lower (P < 0.05) in the PT-PE than normotensive control group. A negative association of mRNA levels of peroxisome proliferator activated receptor α (r = −0.246, P = 0.032; r = −0.308, P = 0.007, respectively), carnitine palmitoyl transferase-1 (r = −0.292, P = 0.011; r = −0.366, P = 0.001), lipoprotein lipases (r = −0.296, P = 0.010; r = −0.254, P = 0.028) with SBP and DBP was observed. There was a positive association of placental triglycerides (r = 0.244, P = 0.031) with DBP.

Conclusion:
Women with preeclampsia exhibit higher lipid : lipoprotein ratios suggesting an atherogenic state particularly in women delivering preterm. Lower expression of genes involved in placental fatty acid oxidation and transport was also observed in preeclampsia.
SELF-DESIGNATION OF THE TREATED EYE BEFORE INTRAVITREAL INJECTIONS
Authors: Mimouni Michael , Naftali Ben Haim Liron , Rozenberg Eldad , Shapira Yinon , Beiran Itzchak , Zayit-Soudry Shiri 
Published: August 2020

Purpose:
To identify risk factors for incorrect self-identification of the treatment eye before intravitreal injections.

Methods:
This prospective study included consecutive patients who were asked to designate the eye for which the intravitreal injection was intended and were subsequently divided into two groups according to whether or not they identified the correct eye.

Results:
Overall, 349 eyes (n = 349) were included, and 8.6% (n = 30) designated the incorrect eye or did not know which eye was intended for treatment. Incorrect designation was associated with diabetic macular edema (odds ratio [OR] = 0.33 [0.15–0.75]), first injection in the intended eye or ≥1 year since previous injection (OR = 0.34 [0.14–0.87]), Arabic native tongue (OR = 0.48 [0.22–1.01]), previous injection to the fellow eye (OR = 0.26 [0.10–0.64]), and concurrent treatment of both eyes (OR = 0.35 [0.16–0.74]). Multivariate analysis showed the first injection or ≥1 year since last injection in the treatment eye (R2 = 2.24%, P = 0.004, OR = 0.20 [0.07–0.57]) and previous injection in the fellow eye (R2 = 6.55%, P < 0.001, OR = 0.20 [0.07–0.52]) as significant independent predictors of incorrect identification.

Conclusion:
Several factors are associated with a greater probability for incorrect patient's self-identification of the eye laterality intended for intravitreal injections. These findings may help identify patients with a higher risk of such potential errors.
Risks and Benefits of Surgical Excision of Orbital Cavernous Venous Malformations (So-Called Cavernous Hemangioma): Factors Influencing the Outcome
Authors: Strianese Diego , Bonavolontà Giulio , Iuliano Adriana , Mariniello Giuseppe , Elefante Andrea , Liuzzi Raffaele 
Published: August 2020

Purpose:
To assess risks and benefits associated with surgical excision of orbital cavernous venous malformation and analyze factors influencing the outcome.

Methods:
Design: cohort study. Participants: 164 consecutive patients undergoing surgical removal of orbital cavernous venous malformation. Intervention: lateral or anterior orbitotomy. Outcome measures: visual acuity, visual field, pupillary function, ocular motility, and fundus examination. Influence of the mass volume and tumor location on the outcome was evaluated. The threshold value and risk group for the volume were evaluated using the receiver operating characteristic analysis; 8 orbital different quadrants, extraconal/intraconal position, and orbital apex extension were considered as variables to evaluate the location.

Results:
Postoperatively overall visual acuity (p = 0.0084), visual field (p < 0.0001), diplopia (p < 0.0001), proptosis (p < 0.0001), ocular motility (p = 0.02), ptosis (p = 0.033), choroidal fold (p < 0.0001), disk edema (p = 0.0004) were significantly improved. The commonest location was the lateral quadrant (28%). Choroidal folds were associated with tumor greater than 1100 mm3 (p = 0.001). Visual loss occurred in 2 patients (1.2%) and tonic pupil in 5 (3%,) Visual deterioration was associated with the apical extension (p = 0.001). Pupil efferent defect was associated with lateral quadrant location (p = 0.011) and apical extension (p = 0.05).

Conclusions:
Surgical removal of orbital cavernous venous malformation is a useful treatment modality, particularly for large size tumors. Removal of cavernous venous malformations located at the lateral aspect of the orbit carries an increased risk of permanent tonic pupil. Postoperative blindness is rarely seen and is often associated with the apical extension. Tailoring the surgical approach, depending on the relative position to the optic nerve, may have an important bearing on outcome.
Tarsal Epithelial Cysts: Prevalence, Case Series, and Synthesis of Existing Literature
Authors: Ahmad Meleha , Chen Hung-Chang , Chang Jessica R. , Hodgson Nickisa , McDonnell Emma C. , Henderson Amanda D. , Siadati Sepideh , Eberhart Charles G. , McCulley Timothy J. 
Published: August 2020

Purpose:
Tarsal epithelial cysts (TECs) are squamous epithelial-lined lesions of the eyelid that are often mistaken for chalazia or epidermal inclusion cysts. They remain poorly described in the literature. This study is designed to characterize the prevalence and clinical features of TEC.

Methods:
We conducted a single-center retrospective review of adult patients with a diagnosis of eyelid neoplasm, eyelid cyst, hordeolum, stye, or chalazion between January 1, 2011 and July 1, 2017. Among this cohort, we identified patients with a histopathologic diagnosis of TEC. We also conducted a PubMed literature review and synthesis of existing clinical data of patients reported to have TEC, noting common clinical and histopathological features.

Results:
Of 7,516 patients, we identified 6 patients with a histopathological diagnosis of TEC, amounting to a prevalence of 0.08% amongst patients with eyelid lesions. Average age was 49.7 years (range 18–76 years), with a 1:1 male to female ratio. The most common presenting symptom was a painless eyelid mass, and the majority (66.6%) had a preoperative diagnosis of chalazion. All but 1 patient had surgical excision from the posterior approach and there was 1 recurrence in the follow-up period. On review of the literature, we identified 68 prior cases of TEC from 18 clinical studies, with clinical features mirroring our case series.

Conclusions:
TEC has stereotypical clinical and histologic features that distinguish it from other tarsal lesions. Our review identified TEC as a relatively rare cause of eyelid lesions.
Effects of sex on placebo effects in chronic pain participants: a cross-sectional study
Authors: Olson Elizabeth M. , Akintola Titilola , Phillips Jane , Blasini Maxie , Haycock Nathaniel R. , Martinez Pedro E. , Greenspan Joel D. , Dorsey Susan G. , Wang Yang , Colloca Luana 
Published: August 2020

Abstract
Sex-related differences can influence outcomes of randomized clinical trials and may jeopardize the effectiveness of pain management and other therapeutics. Thus, it is essential to understand the mechanistic and translational aspects of sex differences in placebo outcomes. Recently, studies in healthy participants have shed light on how sex-related placebo effects might influence outcomes, yet no research has been conducted in a patient population. Herein, we used a tripartite approach to evaluate the interaction of prior therapeutic experience (eg, conditioning), expectations, and placebo effects in 280 chronic (orofacial) pain patients (215 women). In this cross-sectional study, we assessed sex differences in placebo effects, conditioning as a proxy of prior therapeutic effects, and expectations evaluated before and after the exposure to positive outcomes, taking into account participant–experimenter sex concordance and hormonal levels (estradiol and progesterone assessed in premenopausal women). We used mediation analysis to determine how conditioning strength and expectations impacted sex differences in placebo outcomes. Independent of gonadal hormone levels, women showed stronger placebo effects than men. We also found significant statistical sex differences in the conditioning strength and reinforced expectations whereby reinforced expectations mediated the sex-related placebo effects. In addition, the participant–experimenter sex concordance influenced conditioning strength, reinforced expectations, and placebo effects in women but not in men. Our findings suggest that women experience larger conditioning effects, expectations, and placebo effects emphasizing the need to consider sex as a biological variable when placebo components of any outcomes are part of drug development trials and in pain management.
Hyporesponsivity to mu-opioid receptor agonism in the Wistar-Kyoto rat model of altered nociceptive responding associated with negative affective state
Authors: Ferdousi Mehnaz I. , Calcagno Patricia , Clarke Morgane , Aggarwal Sonali , Sanchez Connie , Smith Karen L. , Eyerman David J. , Kelly John P. , Roche Michelle , Finn David P. 
Published: August 2020

Abstract
Chronic pain is often comorbid with anxiety and depression, altering the level of perceived pain, which negatively affects therapeutic outcomes. The role of the endogenous mu-opioid receptor (MOP) system in pain–negative affect interactions and the influence of genetic background thereon are poorly understood. The inbred Wistar-Kyoto (WKY) rat, which mimics aspects of anxiety and depression, displays increased sensitivity (hyperalgesia) to noxious stimuli, compared with Sprague-Dawley (SD) rats. Here, we report that WKY rats are hyporesponsive to the antinociceptive effects of systemically administered MOP agonist morphine in the hot plate and formalin tests, compared with SD counterparts. Equivalent plasma morphine levels in the 2 rat strains suggested that these differences in morphine sensitivity were unlikely to be due to strain-related differences in morphine pharmacokinetics. Although MOP expression in the ventrolateral periaqueductal gray (vlPAG) did not differ between WKY and SD rats, the vlPAG was identified as a key locus for the hyporesponsivity to MOP agonism in WKY rats in the formalin test. Moreover, morphine-induced effects on c-Fos (a marker of neuronal activity) in regions downstream of the vlPAG, namely, the rostral ventromedial medulla and lumbar spinal dorsal horn, were blunted in the WKY rats. Together, these findings suggest that a deficit in the MOP-induced recruitment of the descending inhibitory pain pathway may underlie hyperalgesia to noxious inflammatory pain in the WKY rat strain genetically predisposed to negative affect.