bluuebunny/crossref_metadata_2025_split huggingface dataset:
Congenital defects and early childhood outcomes following in-utero exposure to antihypertensive medication
Authors: Fitton Catherine A. , Fleming Michael , Aucott Lorna , Pell Jill P. , Mackay Daniel F. , McLay James S. 
Published: October 2020

Background:
Hypertensive disorders during pregnancy are an important risk to mother and fetus, frequently necessitating antihypertensive treatment. Data describing the safety of in-utero exposure to antihypertensive treatment is conflicting with many studies suffering from significant methodological issues.

Method:
We conducted a retrospective cohort study using linked routinely collected healthcare records for 268 711 children born 2010–2014 in Scotland to assess outcomes following in-utero exposure to antihypertensive medication.

Results:
We identified a cohort of 265 488 eligible mother–child pairs born over the study period; of which, 2433 were exposed in utero to antihypertensive medication, 4391 exposed to treated late-onset hypertension and 6066 exposed to untreated hypertension during pregnancy. In-utero antihypertensive exposure was associated with an increased risk of circulatory defects (aOR 2.29; 99% CI 1.14–4.59) compared with normal controls and the untreated hypertensive group. We report no increased odds of any developmental outcomes at 2.5 years of age following exposure to antihypertensive medication during pregnancy, untreated hypertension or late-onset hypertension.

Conclusion:
Although circulatory defects may be associated with antihypertensive medication exposure during pregnancy, the mechanisms underlying this process are unclear.
Regression of left ventricular hypertrophy in primary aldosteronism after adrenalectomy: a meta-analysis of echocardiographic studies
Authors: Cuspidi Cesare , Tadic Marijana , Sala Carla , Quarti-Trevano Fosca , Gherbesi Elisa , Mancia Giuseppe , Grassi Guido 
Published: October 2020

Aim:
Available evidence on regression of left ventricular (LV) hypertrophy in patients with primary aldosteronism after unilateral adrenalectomy is scanty. We performed a systematic meta-analysis of echocardiographic studies to provide an updated and comprehensive information on this issue.

Methods:
The PubMed, OVID-MEDLINE and Cochrane library databases were analyzed to search English-language articles published from 1 January 1990 up to 30 June 2020. Studies were identified by using MeSH terms and crossing the following search items: ‘primary aldosteronism’ ‘Conn's syndrome’ ‘adrenalectomy’, with ‘cardiac damage’, ‘hypertensive heart disease’ ‘left ventricular mass’, ‘left ventricular hypertrophy’, ‘left ventricular hypertrophy regression’, ‘echocardiography’.

Results:
A total of 629 hypertensive patients with primary aldosteronism (mean age 49 years, 45% men) were included in 14 studies. Baseline and postintervention pooled mean LV mass/BSA values were 134 ± 4 and 108 ± 3 g/m2 [standard means difference (SMD) −0.42 ± 0.05, confidence interval (CI) −0.52/−0.32, P < 0.0001]; corresponding values for LV mass/h2.7 were 56 ± 2 and 49 ± 1 g/h2.7 (SMD −0.45 ± 0.06, CI −0.52/−0.36, P < 0.0001). Adrenalectomy, followed by a marked decrease in blood pressure, was associated with a decrease in relative wall thickness (SMD −0.17 ± 0.06, CI −0.31/−0.03, P < 0.01) as well as in the number of antihypertensive drugs (SMD −0.45 ± 0.04, CI −0.50–0.32, P < 0.0001).

Conclusion:
The present meta-analysis suggests that adrenalectomy in patients with primary aldosteronism exerts a beneficial effect on LV structure and geometry by reducing the burden of LV hypertrophy and LV concentric geometry.
Bruch Membrane Opening Minimum Rim Width Changes During Scleral Lens Wear
Authors: Samaha Dan , Michaud Langis 
Published: October 2020

Objective:
The purpose of this study was to evaluate the change in Bruch membrane opening minimum rim width (BMO-MRW) during scleral lens (SL) wear.

Methods:
Twenty young white subjects were enrolled (10 women and 10 men); preliminary evaluation consisted of serial measurements of intraocular pressure (IOP) using a dynamic noncontact tonometer (Corvis, Oculus), which also yielded a corneal biomechanical index and central corneal thickness, and BMO-MRW using optical coherence tomography imaging (OCT) imaging (Spectralis, Heidelberg) through 6 hrs to establish normative diurnal curves. The next day, participants were fitted with a 16-mm SL on one eye, and OCT measurements were repeated over the same time span. Statistical analysis was carried out with a two-way analysis of variance. Multiple linear regressions were used to identify significant associations.

Results:
The average diurnal variation for BMO-MRW without lenses was −4.65 μm (95% confidence interval [CI], 0.52–8.77) after 6 hours, whereas it decreased by 8 μm (95% CI, 3.87–12.12; P<0.001) after 6 hours of SL wear. The difference between variations after 6 hours was then −3.35 μm (P=0.029). Variation of the BMO-MRW did not significantly correlate with corneal rigidity (CR), central corneal thickness (CCT), and refractive error (r=−0.224, −0.054 and −0.085, respectively).

Conclusion:
Scleral lens wear induces a statistically significant decrease in BMO-MRW that could potentially be attributed to a change in IOP. The change in BMO-MRW was not affected by CR, CCT, or refractive error. Further studies are needed to better understand the significance of the observed changes at the optic nerve head during scleral lens wear.
Metabolic Changes Associated With the Use of Integrase Strand Transfer Inhibitors Among Virally Controlled Women
Authors: Summers Nathan A. , Lahiri Cecile D. , Angert Christine D. , Aldredge Amalia , Mehta C. Christina , Ofotokun Ighovwerha , Kerchberger Anne M. , Gustafson Deborah , Weiser Sheri D. , Kassaye Seble , Konkle-Parker Deborah , Sharma Anjali , Adimora Adaora A. , Bolivar Hector , Cocohoba Jennifer , French Audrey L. , Golub Elizabeth T. , Sheth Anandi N. 
Published: October 2020

Background:
Integrase strand transfer inhibitors (INSTIs) have been associated with weight gain among women living with HIV. We aimed to investigate the association between INSTIs and change in cardiometabolic risk indicators.

Setting:
Retrospective cohort.

Methods:
Data from 2006 to 2017 were analyzed from women living with HIV enrolled in the longitudinal Women's Interagency HIV Study who were virally controlled on antiretroviral therapy (ART) for ≥5 consecutive semiannual visits. Women who switched/added an INSTI to ART (INSTI group) were compared with women who remained on non-INSTI ART (non-INSTI group). Outcomes included changes in fasting lipids and glucose, hemoglobin A1c (HbA1c), blood pressure (BP), and incident diabetes, hypertension, and insulin resistance. Outcomes were measured 6–12 months before and 6–18 months after INSTI switch/add in the INSTI group with comparable visits in the non-INSTI group. Longitudinal linear regression models compared change over time in each outcome by the study group.

Results:
One thousand one hundred eighteen participants (234 INSTI, 884 non-INSTI) were followed for a median 2.0 (Q1 1.9, Q3 2.0) years. Participants were median age 49 years, 61% Black, and 73% overweight or obese (body mass index ≥25 kg/m2). Compared with non-INSTI, the INSTI group experienced greater increases in HbA1c (+0.05 vs. −0.06 mg/dL, P = 0.0318), systolic BP (+3.84 vs. +0.84 mm Hg, P = 0.0191), and diastolic BP (+1.62 vs. −0.14 mm Hg, P = 0.0121), with greatest change in HbA1c among women on INSTIs with ≥5% weight gain.

Conclusions:
INSTI use was associated with unfavorable changes in HbA1c and systolic and diastolic BP during short-term follow-up. Further research is needed to understand long-term cardiometabolic effects of INSTI use.
The current state of immunization against Gram-negative bacteria in children: a review of the literature
Authors: Broad Jonathan , Le Doare Kirsty , Heath Paul T. , Hallchurch Philippa , Whelan Isabelle , Boyd Hannah , Carruthers Elspeth , Sharland Mike , Ladhani Shamez 
Published: October 2020

Purpose of review
Gram-negative bacteria (GNB) are a major cause of infection worldwide and multidrug resistance in infants and children. The major pathogens include Klebsiella pneumoniae, Escherichia coli, Enterobacter spp., Pseudomonas aeruginosa and Acinetobacter baumannii. With new antibiotic options limited, immunization is likely to play a critical role in prevention. This review discusses their epidemiology, the current state of vaccine research and potential immunization strategies to protect children. A comprehensive review of the literature, conference abstracts along with web searches was performed to identify current and investigational vaccines against the major GNB in children.

Recent findings
Phase I--III vaccine trials have been undertaken for the major Gram-negative bacteria but not in infants or children. E. coli is a common infection in immune-competent children, including neonatal sepsis. Several vaccines are in late-phase clinical trials, with some already licensed for recurrent urinary tract infections in women. Klebsiella spp. causes community-acquired and hospital-acquired infections, including sepsis in neonates and immunocompromised children although no vaccine trials have extended beyond early phase 2 trials. P. aeruginosa is a common pathogen in patients with cystic fibrosis. Phase 1--3 vaccine and monoclonal antibody trials are in progress, although candidates provide limited coverage against pathogenic strains. Enterobacter spp. and A. baumannii largely cause hospital-acquired infections with experimental vaccines limited to phase 1 research.

Summary
The current immunization pipelines for the most prevalent GNB are years away from licensure. Similar to incentives for new antibiotics, global efforts are warranted to expedite the development of effective vaccines.
A Model to Assess the Outcomes Associated With Dementia With Lewy Bodies
Authors: Espinosa Robert , Davis Matthew , Johnson Scott , Cline Stephanie , Weintraub Daniel 
Published: October 2020

Background:
Research investigating outcomes associated with dementia with Lewy bodies (DLB) disease progression is scarce. Developing models of DLB disease progression will provide information on the burden of disease and facilitate the evaluation of treatments for DLB from a clinical and cost perspective.

Methods:
Longitudinal, cognitive evaluation data were utilized in order to identify distinct health states for DLB and to estimate transition probabilities across the DLB disease continuum. These probabilities were applied to a health state transition model to evaluate disease progression and associated outcomes for a closed cohort over a fixed time horizon. The effect of a reduction in the risk of disease progression on outcomes was assessed.

Results:
Estimated transition probabilities indicate that a patient >60 years of age with mild DLB has a 54%, 30%, 4%, and 12% chance of remaining mild, progressing to severe DLB, being institutionalized, and dying after 1 year, respectively. Reducing the annual risk of transitioning from mild to severe DLB by 40% decreased time institutionalized and increased time to death.

Conclusions:
This study used real-world longitudinal data to create a clinically relevant DLB disease progression model. Reducing the rate of disease progression resulted in meaningful benefits with potentially significant public health implications.
Cross-cultural applicability of ICD-11 and DSM-5 personality disorder
Authors: Ayinde Olatunde O. , Gureje Oye 
Published: October 2020

Purpose of review
This review explores recent literature on the applicability of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and International Classification of Disease, 11th Revision (ICD-11) personality disorder classification systems across countries and cultural contexts.

Recent findings
Several studies examining the cultural validity and utility of DSM-5 and ICD-11 personality disorder have been conducted in a number of language and cultural groups that are different from those in which the tools were originally developed. These studies, using quantitative methods, have largely supported the applicability of the new dimensional and trait approaches to classifying personal disorders. Studies qualitatively exploring the views of service users and clinicians on the development or operationalization of DSM-5 and ICD-11 personality disorder report that a lay summary of diagnostic constructs that
reflect concern about language of diagnostic criteria as well the lived experience of service users would be found useful. Clinicians found the dimensional system of ICD-11 slightly more useful than the categorical system of ICD-10 on several utility scales, but the studies on ICD-11 have been much less in view of its latter appearance.

Summary
DSM-5 and ICD-11 personality disorder have shown a preliminary evidence of improved utility across cultures. More studies, including those reflecting the views of service users, are needed to confirm this early observation across many more cultural and linguistic groups.
Political and commercial prospects for inertial fusion energy
Authors: Holland Andrew 
Published: October 2020

Fusion energy holds the prospect of an energy source that is clean, safe, affordable and limitless. It will transform the global energy system. Today, around $1.5 billion in private capital has been invested in companies that are working on transformative approaches to fusion. Annually, even more than that is spent on fusion research by governments around the world. However, just achieving a scientific demonstration of fusion power will not be enough on its own to transition the global energy system. It will require innovations in the legal, regulatory, commercial and political spheres to support the massive deployment of fusion power that we know will be necessary to meet the global challenges of climate change and energy scarcity.
This article is part of a discussion meeting issue ‘Prospects for high gain inertial fusion energy (part 1)'.
An Innovative Non-Pharmaceutical Intervention to Mitigate SARS-CoV02 Spread: Probability Sampling to Identify and Isolate Asymptomatic Cases
Authors: Williams Nathalie E. , Yao Xiaozheng , Pal Ankita , Qian Xiaolu , Rathod Mansi , Xu Chang , Dobra Adrian 
Published: October 2020

AbstractStudies estimate that a substantial proportion of SARS-CoV-2 transmission occurs through individuals who do not exhibit symptoms. Mitigation strategies test only those who are moderately to severely symptomatic, excluding the substantial portion of cases that are asymptomatic yet still infectious and likely responsible for a large proportion of the virus’ spread (1-8). While isolating asymptomatic cases will be necessary to effectively control viral spread, these cases are functionally invisible and there is no current method to identify them for isolation. To address this major omission in COVID-19 control, we develop a strategy, Sampling-Testing-Quarantine (STQ), for identifying and isolating individuals with asymptomatic SARS-CoV-2 in order to mitigate the epidemic. STQ uses probability sampling in the general population, regardless of symptoms, then isolates the individuals who test positive along with their household members who are high probability for asymptomatic infections. To test the potential efficacy of STQ, we use an agent-based model, designed to computationally simulate the epidemic in the Seattle with infection parameters, like R0 and asymptomatic fraction, derived from population data. Our results suggest that STQ can substantially slow and decrease the spread of COVID-19, even in the absence of school and work shutdowns. Results also recommend which sampling techniques, frequency of implementation, and population subject to isolation are most efficient in reducing spread with limited numbers of tests.Significance StatementA substantial portion of SARS-CoV-2 infections are spread through asymptomatic carriers. Until a vaccine is developed, research indicates an urgent need to identify these asymptomatic infections to control COVID-19, but there is currently no effective strategy to do so. In this study, we develop such a strategy, a procedure called Sampling-Testing-Quarantine (STQ), that combines techniques from survey methods for sampling from the general population and testing and isolation techniques from epidemiology. With computational simulations, we demonstrate that STQ procedures can dramatically decrease and slow COVID-19 spread, even in the absence of widespread work, school, and community lockdowns. We also find particular implementation strategies (including sampling techniques, frequencies of implementation, and people who are subject to isolation) are most efficient in mitigating spread.
One size fits all?: Modeling face-mask fit on population-based faces
Authors: Solano Tomas , Mittal Rajat , Shoele Kourosh 
Published: October 2020

AbstractThe use of face masks by the general population during viral outbreaks such as the COVID-19 pandemic, although at times controversial, has been effective in slowing down the spread of the virus. The fit of simple cloth masks on the face as well as the resulting perimeter leakage and face mask efficacy are expected to be highly dependent on the type of mask and facial topology. However, this effect has to date, not been examined and quantified. Here, we study the leakage of a rectangular cloth mask on a large virtual population of subjects with diverse facial features, using computational mechanics modeling. The effect of weight, age, gender, and height on the leakage is studied. The Centers for Disease Control and Prevention (CDC) recommended mask size was used as a basis for comparison and was found not to be the most effective design for all subjects. Thin, feminine, and young faces benefit from mask sizes smaller than that recommended by the CDC. The results show that side-edge tuck-in of the masks could lead to a larger localized gap opening in many face categories, and is therefore not recommended for all. The perimeter leakage from the face mask worn by thin/feminine faces is mostly from the leakage area along the bottom edge of the mask and therefore, a tuck-in of the bottom edge of the mask or a mask smaller than the CDC recommended mask size are proposed as a more effective design. The leakage from the top edge of the mask is determined to be largely unaffected by mask size and tuck-in ratio, meaning that other mechanical alterations such as a nose wire strip are necessary to reduce the leakage at this site.
Bangla Technique of Laparoscopic Cholecystectomy: a Novel, Safe and Cost-effective modification of American and French Techniques
Authors: Hannan Md Jafrul , Parveen Mosammat Kohinoor , Nandy Alak Kumar 
Published: October 2020

Abstract and KeywordsBackgroundLaparoscopic cholecystectomy (LC) can be performed by following either of the two approaches proposed by the American and the French school. The two approaches have comparable operative times, but use different arrangements for the patient’s and operators’ positions, and sites for port insertions.The aim of the present paper is to describe an alternative to the American and the French approaches, referred to as the Bangla technique, which uses a standard four port approach but requires the presence of only one assistant along with the surgeon. It is hoped that the Bangla technique will improve surgery outcomes for gallbladder disease patients and encourage healthcare professionals in resource-poor settings to adopt minimally invasive/laparoscopic approaches to surgical problems.MethodsThe sample consisted of a total of 280 gallbladder disease retrospective observational cases (of which 21 were children between 6 and 16 of age) who were treated with the Bangla technique at the South Point Hospital Chittagong, Bangladesh, between January 2018 and February 2020.ResultsSurgery data showed that using the Bangla technique, the average operating time and average operation theater time were36.25 and 45.9 minutes, respectively. Of the patients, 86% left the hospital on the same day of operation, while the remaining left the following day. In 91.7% of the cases, there were no complications, while content leakage and bleeding occurred in 6.7% and 1.4% cases, respectively.ConclusionThe proposed LC technique will benefit infection prevention and control by reducing the number of personnel in the operation theatre (one assistant and the surgeon) and, as such, reducing surgery-related expenses, which can be further decreased by using only one monitor. More so, the Bangla technique can be combined with the cystic artery sparing technique to reduce the risk of injury to the common bile duct and bleeding.Mini AbstractLaparoscopic cholecystectomy can be performed following the American or the French approach. The present paper proposes an alternative to the American and the French approaches referred to as the Bangla technique, which uses a standard four port approach but requires the presence of only one assistant along with the surgeon.
Physical health complaints among healthcare workers engaged in the care of critically ill COVID-19 patients: A single tertiary-care center prospective study from Japan
Authors: Namikawa Hiroki , Tochino Yoshihiro , Okada Akiko , Ota Keiko , Okada Yasuyo , Fujioka Kazuya , Yamada Koichi , Watanabe Tetsuya , Nakagama Yu , Kido Yasutoshi , Takemoto Yasuhiko , Mizobata Yasumitsu , Kakeya Hiroshi , Kuwatsuru Yumiko , Shibata Toshihiko , Shuto Taichi 
Published: October 2020

AbstractBackgroundHealthcare workers (HCWs) who care for patients with the novel coronavirus infectious disease (COVID-19) are at an increased risk and fear contracting the infection themselves. HCWs are chronically exposed to very intense stress, both and physically and mentally. Hospitals must reduce both the physical and mental burden of HCWs on the front lines and ensure their safety. No prospective study has focused on the physical health complaints among HCWs engaged in the care of critically ill COVID-19 patients. This study aimed to investigate the occupational risk among HCWs of experiencing physical symptoms during the current COVID-19 pandemic.MethodsA twice-weekly questionnaire targeting HCWs who care for COVID-19 patients was performed at Osaka City University Hospital from April 30 to May 31, 2020 using a shareable Research Electronic Data Capture tool. The demographic characteristics of the participants, frequency of exposure to at-risk care, and physical complaints were evaluated.ResultsA total of 35 doctors, 88 nurses, and 35 technicians were engaged in the care of these critically ill COVID-19 patients. 76 HCWs participated in this study, of whom 24 (31.6%) were doctors, 43 (56.6%) were nurses, and 9 (11.8%) were technicians. The frequency of experiencing any physical symptom was 25.0% among HCWs. Exposure to at-risk care was significantly higher among nurses than among doctors (p < 0.001); likewise, the frequency of experiencing physical symptoms was higher among nurses than among doctors (p < 0.01). The multivariate analysis revealed that nurses (odds ratio 8.29; p = 0.01) might be independently at risk of experiencing physical symptoms.ConclusionsOur results indicate that occupational health care at hospitals must be allocated to HCWs who are highly exposed to at-risk care, particularly nurses engaged in the care of COVID-19 patients.