bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonadherence to antihypertensive medications is related to pill burden in apparent treatment-resistant hypertensive individuals
Authors: Lawson Alexander J. , Hameed Mohammed Awais , Brown Roger , Cappuccio Francesco P. , George Stephen , Hinton Thomas , Kapil Vikas , Lenart Jane , Lobo Melvin D. , Martin Una , Menon Madhavan , Nightingale Angus , Rylance Paul B. , Webb David J. , Dasgupta Indranil 
Published: March 2020

Objective:
Nonadherence to medication is present in at least 50% of patients with apparent treatment-resistant hypertension. We examined the factors associated with nonadherence as detected by a liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based urine antihypertensive drug assay.

Methods:
All urine antihypertensive test results, carried out for uncontrolled hypertension (BP persistently >140/90 mmHg) between January 2015 and December 2016 at a single toxicology laboratory were analysed. Drugs detected were compared with the antihypertensive drugs prescribed. Patients were classified as adherent (all drugs detected), partially nonadherent (at least one prescribed drug detected) or completely nonadherent (no drugs detected). Demographic and clinical parameters were compared between the adherent and nonadherent groups. Binary logistic regression analysis was performed to determine association between nonadherence and demographic and clinical factors.

Results:
Data on 300 patients from nine hypertension centres across the United Kingdom were analysed. The median age was 59 years, 47% women, 71% Caucasian, median clinic BP was 176/95 mmHg and the median number of antihypertensive drugs prescribed was four. One hundred and sixty-six (55%) were nonadherent to prescribed medication with 20% of these being completely nonadherent. Nonadherence to antihypertensive medication was independently associated with younger age, female sex, number of antihypertensive drugs prescribed, total number of all medications prescribed (total pill burden) and prescription of a calcium channel blocker.

Conclusion:
This LC-MS/MS urine analysis-based study suggests the majority of patients with apparent treatment-resistant hypertension are nonadherent to prescribed treatment. Factors that are associated with nonadherence, particularly pill burden, should be taken into account while treating these patients.
The Protective Effect of an Eye Wash Solution on the Ocular Surface Damage Induced by Airborne Carbon Black Exposure
Authors: Li Xiangzhe , Kang Boram , Eom Youngsub , Lee Hyung Keun , Kim Hyo Myung , Song Jong Suk 
Published: March 2020

Purpose:
To investigate the effects of an eye wash solution on the ocular surface damage induced by airborne carbon black (CB) exposure.

Methods:
Sprague–Dawley rats were exposed to ambient CB for 5 days. During the 5 days, a commercial eye wash solution (Eyebon-W) was used for irrigation twice daily on CB-exposed rat eyes; normal saline was used as the vehicle control. Lactic dehydrogenase (LDH) activity and matrix metallopeptidase (MMP)-9, histamine, and lactoferrin levels were measured in tears. The expression of inflammatory cytokines in the anterior segment of the eyeball was measured by Western blot analysis.

Results:
The ocular surface staining scores, tear LDH activity, tear MMP-9, histamine, and lactoferrin concentrations, and the expression of interleukin-4 and interferon-γ in the eye were significantly increased in the CB group versus the normal control group. When compared with CB group, the Eyebon-W eye wash treatment significantly reversed these elevations induced by CB, including ocular staining scores, tear LDH activity, histamine and MMP-9 concentrations in the tear fluid, and the expression of interleukin-4 in the eye. On the other hand, saline irrigation only reduced the concentrations of histamine and MMP-9 in tear fluid and the expression of interferon-γ in the eye.

Conclusions:
Both Eyebon-W eye wash treatment and saline irrigation reversed CB-induced ocular surface injury, but the efficacy of Eyebon-W was more significant than that of the saline solution when compared with CB group. The use of an eye wash solution seems to play a protective role for the ocular surface when exposed to airborne particulate matter.
Vascular elastic fiber heterogeneity in health and disease
Authors: Halabi Carmen M. , Kozel Beth A. 
Published: March 2020

Purpose of review
Elastin has historically been described as an amorphous protein that functions to provide recoil to tissues that stretch. However, evidence is growing that elastin's role may not be limited to biomechanics. In this minireview, we will summarize current knowledge regarding vascular elastic fibers, focusing on structural differences along the arterial tree and how those differences may influence the behavior of affiliated cells.

Recent findings
Regional heterogeneity, including differences in elastic lamellar number, density and cell developmental origin, plays an important role in vessel health and function. These differences impact cell–cell communication, proliferation and movement. Perturbations of normal cell–matrix interactions are correlated with human diseases including aneurysm, atherosclerosis and hypertension.

Summary
Although classically described as a structural protein, recent data suggest that differences in elastin deposition along the arterial tree have important effects on heterotypic cell interactions and human disease.
Characteristics of Anorectal Malformations in Children at the United States‐Mexico Border
Authors: Rosas‐Blum Eduardo D. , Reddy Ajay , Shaban Mohamed A. , Aziz Sandra , Do Ailinh , Spurbeck William , Francis Denease 
Published: March 2020

ABSTRACTBackground:Anorectal malformations (ARMs) are a group of congenital malformations affecting the lower gastrointestinal, urogenital, and/or gynecological systems. They occur in approximately 1 in 5000 live births, with a slight male predominance. ARMs can appear in isolation or in association with other anomalies. The literature contains little information about the characteristics of ARMs in United States Hispanic populations.Methods:An institutional review board–approved chart review was conducted in all patients with ARMs seen at a single institution in El Paso, Texas, from January 2012 to December 2015. Data regarding demographics, types of ARMs, associated syndromes, and long‐term complications were recorded using the Krickenbeck classification system.Results:Of the 37 patients included in the study, 20 were boys and 17 were girls. The most common ARMs were rectoperineal fistula (46%), rectourethral fistula, and cloacal malformation. Constipation was the most common long‐term complication, especially in patients with recto‐perineal fistula.Conclusion:Children in the Borderland community may have a higher percentage of recto‐perineal fistula than previously reported. Postoperative complications in Hispanic children with ARM were comparable to those reported in other populations.
Optimizing Antitumor Necrosis Factor Treatment in Pediatric Inflammatory Bowel Disease With Therapeutic Drug Monitoring
Authors: Pinto Pais Isabel , Espinheira Maria C. , Trindade Eunice , Amil Dias Jorge 
Published: March 2020

ABSTRACTBiological agents have revolutionized inflammatory bowel disease treatment but primary nonresponse and secondary loss of response are common with resulting adverse outcomes. Clinical trials demonstrated an association between serum drug concentrations, as well as the presence of antidrug antibodies, and loss‐of‐response. Therapeutic drug monitoring (TDM), defined as the evaluation of drug concentrations and antidrug antibodies, is appearing as a strategy to optimize treatment and take full advantage from these drugs. TDM appears to be a promising tool in clinical practice, especially in pediatric patients, who have pronounced fluctuations in the pharmacokinetics of the drugs.The authors present a literature review about antitumor necrosis factor therapy optimization based on personalized treatment strategies according to TDM and possible strategies to recapture loss of response, including an algorithm for practical management.
The Effect of Imputation of Pao 2/Fi o 2 From Spo 2/Fi o 2 on the Performance of the Pediatric Index of Mortality 3*
Authors: Slater Anthony , Straney Lahn , Alexander Janet , Schell David , Millar Johnny 
Published: March 2020

Objectives:
To investigate if the performance of Pediatric Index of Mortality 3 is improved by including imputed values for the Pao
2/Fio
2 ratio where measurements of Pao
2 or Fio
2 are missing.

Design:
A prospective observational study.

Setting:
A bi-national pediatric intensive care registry.

Patients:
The records of 37,983 admissions of children less than 16 years old admitted to 19 ICUs.

Interventions:
None.

Measurements and Main Results:
Seven published equations describing an association between Pao
2/Fio
2 and oxygen saturation measured by pulse oximetry (Spo
2)/Fio
2 were used to derive an alternative variable d100 × Fio
2/Pao
2 for the Pediatric Index of Mortality 3 variable 100 × Fio
2/Pao
2. Six equations exclude Spo
2/Fio
2 values if Spo
2 is greater than 96–98%. 100 × Fio
2/Pao
2 was missing in 72% of patient records primarily due to missing Pao
2, d100 × Fio
2/Pao
2 was missing in 71% of patient records if values of Spo
2greater than 97% were excluded or in 17% of patient records if all measurements of Spo
2 were included. Univariable analysis supported the inclusion of Spo
2 values greater than 97%. Compared to the standard Pediatric Index of Mortality 3 model, two alternative models imputing 100 × Fio
2/Pao
2 from d100 × Fio
2/Pao
2 only if 100 × Fio
2/Pao
2 was missing, or using d100 × Fio
2/Pao
2 values exclusively, resulted in a small but statistically significant improvements in discrimination of Pediatric Index of Mortality 3 (area under the receiver operator curve 0.9068 [0. 8965–0. 9171]; 0.9083 [0.8981–0.9184]; 0.9087 [0.8987–0.9188], respectively).

Conclusions:
Imputation of the Pao
2/Fio
2 ratio in cases where arterial sampling was not performed resulted in a large reduction in the rate of missing data if all values of Spo
2 were included. The imputation technique improved the discrimination of Pediatric Index of Mortality 3; however, the magnitude of the increment in overall model performance was small. A possible benefit of the approach is reducing the potential for bias resulting from variation in practice for invasive monitoring of oxygenation.
Noninvasive Brain Stimulation in Epilepsy
Authors: VanHaerents Stephen , Chang Bernard S. , Rotenberg Alexander , Pascual-Leone Alvaro , Shafi Mouhsin M. 
Published: March 2020

Summary:
Neurostimulation in epilepsy is a long standing established concept, and through experimental and clinical uses, our understanding of neurostimulation and neuromodulation has grown substantially. Noninvasive brain stimulation techniques use electromagnetic principles to noninvasively modulate brain activity in a spatiotemporally targeted manner. This review focused on the two predominant forms of noninvasive neurostimulation: transcranial magnetic stimulation (TMS) and transcranial direct current stimulation, and their current applications in the diagnosis and management of epilepsy. A number of small randomized sham-controlled studies suggest that both TMS and transcranial direct current stimulation may have a beneficial effect in decreasing seizure frequency in patients with medically refractory epilepsy, without significant side effects. Small pilot studies also suggest that TMS in combination with EEG may be used to develop quantitative biomarkers of cortical hyperexcitability in patients with epilepsy. Furthermore, TMS is already Food and Drug Administration-cleared for presurgical mapping of eloquent cortex, and preliminary studies suggest that navigated TMS represents a highly valuable clinical supplement for preoperative functional planning. Transcranial magnetic stimulation and transcranial direct current stimulation have shown great potential benefit for patients with epilepsy; however, further large multicenter randomized sham-controlled studies are needed to better optimize stimulation settings and protocols, define mechanisms of action, assess long-term effects, and clearly define roles and determine efficacy.
Transcranial Magnetic Stimulation–Induced Motor Evoked Potentials in Hirayama Disease: Systematic Review of the Literature
Authors: Bembenek Jan P. , Kłysz Bożena , Kurkowska-Jastrzębska Iwona 
Published: March 2020

Purpose:
Hirayama disease (HD) is a rare motor disorder mainly affecting young men, characterized by atrophy and unilateral weakness of forearm and hand muscles corresponding to a C7-T1 myotome distribution. The progression is self-limited. The etiology of HD is unclear. The usefulness of motor evoked potentials (MEPs) in pyramidal tracts damage evaluation still appears to be somehow equivocal.

Methods:
We searched PubMed for original articles, evaluating the use of transcranial magnetic stimulation elicited MEPs in HD using keywords “motor evoked potentials Hirayama” and “transcranial magnetic stimulation Hirayama.”

Results:
We found seven articles using the above keywords that met inclusion criteria. The number of participants was small, and diagnostic procedures varied. There were also differences in methodology. Abnormal central motor conduction time was found in 17.1% of patients in one study, whereas it was normal in two other studies. Peripheral motor latency was evaluated in one study, which found abnormally increased peripheral motor latencies in at least one tested muscle in 16 of 41 HD patients (39.0%). Abnormal MEP parameters were found in three studies in 14.3% to 100% patients. In one study they were not evaluated, in three other studies they were normal, and in one they were normal also in standard and flexed neck position In one study, inconsistent results were found in MEP size after neck flexion in patients after treatment with neck collar.

Conclusions:
Although MEP parameters may be abnormal in some HD patients, these have not been thoroughly assessed. Further studies are indispensable to evaluate their usefulness in assessing pyramidal tract damage in HD.
Quantitative EEG Changes Correlate With Post-Clamp Ischemia During Carotid Endarterectomy
Authors: Kamitaki Brad K. , Tu Bin , Wong Stephen , Mendiratta Anil , Choi Hyunmi 
Published: March 2020

Introduction:
EEG monitoring is a critical tool for identifying cerebral ischemia during carotid endarterectomy (CEA). Quantitative EEG can be used to supplement visual EEG review, but which measures best predict post-clamp ischemia is unclear.

Purpose:
To determine which quantitative EEG parameters reliably detect intraoperative ischemia during CEA.

Methods:
The authors identified patients who underwent carotid endarterectomy at Columbia University Medical Center from 2007 to 2014 with intraoperative EEG monitoring. Two masked physicians reviewed these EEGs retrospectively and determined whether there was post-clamp ischemia, categorizing patients into (1) ischemic-change and (2) no-ischemic-change groups. The authors then studied the performance of a battery of quantitative EEG measures (alpha, beta, theta, and delta power bands, alpha–delta ratio, beta–delta ratio, amplitude-integrated EEG, and 90% spectral edge frequency) against physician review as the gold standard.

Results:
Of 118 patients, 15 were included in the ischemic-change group and 103 in the no-ischemic-change group. Ipsilateral post-clamp trough values of all the quantitative EEG measures assessed were significantly decreased for patients in the ischemic-change group. Decreases in alpha, beta, and theta power of 52.1%, 41.6%, and 36.4% or greater, respectively, were most predictive of post-clamp ischemia.

Conclusions:
Quantitative EEG monitoring during carotid endarterectomy, in addition to visual EEG monitoring, may improve the detection of cerebral ischemia and thus result in fewer perioperative strokes.
Predictors of Nonconvulsive Seizure and Their Effect on Short-term Outcome
Authors: Singh Jaysingh , Thakur Gaurav , Alexander Jonathan , Rayi Appaji , Peng Juan , Bell William , Britton Jeffrey 
Published: March 2020

Introduction:
Nonconvulsive seizures (NCSs) are common in critically ill adult patients with acute neurologic conditions. However, the effect of NCSs on patient outcome remains unclear. In this study, we aimed to determine the effect of NCSs on short-term outcome and to assess the clinical and EEG factors associated with NCSs.

Methods:
We retrospectively identified 219 adult patients from the EEG reporting system who underwent continuous EEG (cEEG) monitoring between January 2018 and June 2018. Patients with anoxic brain injury were excluded from the study. Clinical, laboratory, and EEG data were reviewed to determine potentially predictive factors of NCSs. The impact of NCSs on in-hospital mortality, length of stay, and disability on discharge was measured; an modified Rankin scale of three or greater was considered disabled.

Results:
Of the 219 patients included in our study, a total of 14% (n = 31) had NCSs on continuous EEG, of which 42% (n = 13) had their first seizure discharge recorded during the first hour of continuous EEG monitoring. The presence of clinical seizures before continuous EEG (odds ratio = 1.787; 95% confidence interval = 1.197–2.667, P = 0.0045), history of epilepsy (odds ratio = 1.508; 95% confidence interval = 1.027–2.215, P = 0.035), and comatose state (29 vs. 16%; P = 0.0006) were associated with NCSs. Among EEG characteristics, the presence of interictal epileptiform discharges (P < 0.0001), lateralized rhythmic delta activity (P = 0.02), and lateralized periodic discharges (P < 0.0001) were associated with NCSs. Nonconvulsive seizures were significantly associated with longer in-hospital stay (23.68 ± 24.84 vs. 17.14 ± 20.52; P = 0.036) and disability on discharge (87% [n = 27] vs. 13% [n = 4], P = 0.02). However, there was no significant association between NCS and in-hospital mortality (9.6% [n = 3] vs. 10.6% [n = 20]; P = 0.1).

Conclusions:
Nonconvulsive seizures are associated with longer in-hospital stay and disability on discharge but not with in-hospital mortality in adult patients.
Clinical and Laboratory Profiles of 75 Hospitalized Patients with Novel Coronavirus Disease 2019 in Hefei, China
Authors: Zhao Zonghao , Xie Jiajia , Yin Ming , Yang Yun , He Hongliang , Jin Tengchuan , Li Wenting , Zhu Xiaowu , Xu Jing , Zhao Changcheng , Li Lei , Li Yi , Mengist Hylemariam Mihiretie , Zahid Ayesha , Yao Ziqin , Ding Chengchao , Qi Yingjie , Gao Yong , Ma Xiaoling 
Published: March 2020

AbstractThe outbreak of the novel coronavirus disease 2019 (COVID-19) infection began in December 2019 in Wuhan, and rapidly spread to many provinces in China. The number of cases has increased markedly in Anhui, but information on the clinical characteristics of patients is limited. We reported 75 patients with COVID-19 in the First Affiliated Hospital of USTC from Jan 21 to Feb 16, 2020, Hefei, Anhui Province, China. COVID-19 infection was confirmed by real-time RT-PCR of respiratory nasopharyngeal swab samples. Epidemiological, clinical and laboratory data were collected and analyzed. Of the 75 patients with COVID-19, 61 (81.33%) had a direct or indirect exposure history to Wuhan. Common symptoms at onset included fever (66 [88.0%] of 75 patients) and dry cough (62 [82.67%]). Of the patients without fever, cough could be the only or primary symptom. The most prominent laboratory abnormalities were lymphopenia, decreased percentage of lymphocytes (LYM%), decreased CD4+ and CD8+ T cell counts, elevated C-reactive protein (CRP) and lactate dehydrogenase (LDH). Patients with elevated interleukin 6 (IL-6) showed significant decreases in the LYM%, CD4+ and CD8+ T cell counts. Besides, the percentage of neutrophils, CRP, LDH and Procalcitonin levels increased significantly. We concluded that COVID-19 could cause different degrees of hematological abnormalities and damage of internal organs. Hematological profiles including LYM, LDH, CRP and IL-6 could be indicators of diseases severity and evaluation of treatment effectiveness. Antiviral treatment requires a comprehensive and supportive approach. Further targeted therapy should be determined based on individual clinical manifestations and laboratory indicators.
Preliminary epidemiological analysis on children and adolescents with novel coronavirus disease 2019 outside Hubei Province, China: an observational study utilizing crowdsourced data
Authors: Henry Brandon Michael , de Oliveira Maria Helena Santos 
Published: March 2020

ABSTRACTBackgroundThe outbreak of coronavirus disease 2019 (COVID-19) continues to expand across the world. Though both the number of cases and mortality rate in children and adolescents is reported to be low in comparison to adults, limited data has been reported on the outbreak with respect to pediatric patients. To elucidate information, we utilized crowdsourced data to perform a preliminary epidemiologic analysis of pediatric patients with COVID-19MethodsIn this observational study, data was collected from two open-access, line list crowdsourced online databases. Pediatric cases of COVID-19 were defined as patients ≤19 years of age with a laboratory confirmed diagnosis. The primary outcomes were case counts and cumulative case counts. Secondary outcomes included days between symptoms onset and first medical care and days between first medical care and reporting. Tertiary outcomes were rate of travel to Wuhan, rate of infected family members and rates of symptoms.ResultsA total of 82 patients were included. The median age was 10 [IQR: 5-15] years. Patients from mainland China (outside Hubei) accounted for 46.3% of cases, while the remaining 53.7% of cases were international. Males and females accounted for 52.4% and 32.9% of cases, respectively, with the remaining 14.6% being designated as unknown. A male skew persisted across subgroup analyses by age group (p=1.0) and location (inside/outside China) (p=0.22). While the number of reported international cases has been steadily increasing over the study period, the number of reported cases in China rapidly decreased from the start point. The median reporting delay was 3 [IQR: 2-4.8] days. The median delay between symptom onset and first seeking medical care was 1 [IQR: 0-3.25] day. In international cases, time to first seeking medical care was a median of 2.5 days longer than in China (p=0.04). When clinical features were reported, fever was the most common presentation (68.0%), followed by cough (36.0%).ConclusionsThe number of reported international pediatric COVID-19 cases is rapidly increasing. COVID-19 infections are, to-date, more common in males than females in both the children and adolescent age groups. Additionally, this male predominance remains the case both inside and outside of China. Crowdsourced data enabled early analysis of epidemiologic variables in pediatric patients with COVID-19. Further data sharing is required to enable analyses that are required to understand the course of this infection in children.
Preliminary estimating the reproduction number of the coronavirus disease (COVID-19) outbreak in Republic of Korea from 31 January to 1 March 2020
Authors: Zhuang Zian , Zhao Shi , Lin Qianying , Cao Peihua , Lou Yijun , Yang Lin , Yang Shu , He Daihai 
Published: March 2020

AbstractThe novel coronavirus disease 2019 (COVID-19) outbreak in Republic of Korea has caused 3736 cases and 18 deaths by 1 March 2020. We modeled the transmission process in Republic of Korea with a stochastic model and estimated the basic reproduction numberR0as 2.6 (95%CI: 2.3-2.9) and 3.2 (95%CI: 2.9-3.5), under the assumption that the exponential growth starting 31 January and 5 February, 2020, respectively. Estimates of dispersion term (k) were larger than 10 significantly, which implies few super-spreading events..