bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of Ischemic Stroke in Patients With Atrial Fibrillation After Extracranial Hemorrhage
Authors: Zhou Eric , Lord Aaron , Boehme Amelia , Henninger Nils , de Havenon Adam , Vahidy Farhaan , Ishida Koto , Torres Jose , Mistry Eva A. , Mac Grory Brian , Sheth Kevin N. , Gurol M. Edip , Furie Karen , Elkind Mitchell S.V. , Yaghi Shadi 
Published: October 2020

Background and Purpose:
Anticoagulation therapy not only reduces the risk of ischemic stroke in atrial fibrillation (AF) but also predisposes patients to hemorrhagic complications. There is limited knowledge on the risk of first-ever ischemic stroke in patients with AF after extracranial hemorrhage (ECH).

Methods:

We conducted a retrospective study using the California State Inpatient Database including all nonfederal hospital admissions in California from 2005 to 2011. The exposure variable was hospitalization with a diagnosis of ECH with a previous diagnosis of AF. The outcome variable was a subsequent hospitalization with acute ischemic stroke. We excluded patients with stroke before or at the time of ECH diagnosis. We calculated adjusted hazard ratios for ischemic stroke during follow-up and at 6-month intervals using Cox regression models adjusted for pertinent demographics and comorbidities. In subgroup analyses, subjects were stratified by primary ECH diagnosis, severity/type of ECH, age, CHA
2
DS
2
-VASc score, or the presence/absence of a gastrointestinal or genitourinary cancer.

Results:
We identified 764 257 patients with AF (mean age 75 years, 49% women) without a documented history of stroke. Of these, 98 647 (13%) had an ECH-associated hospitalization, and 22 748 patients (3%) developed an ischemic stroke during the study period. Compared to patients without ECH, subjects with ECH had ≈15% higher rate of ischemic stroke (overall adjusted hazard ratio, 1.15 [95% CI, 1.11–1.19]). The risk appeared to remain elevated for at least 18 months after the index ECH. In subgroup analyses, the risk was highest in subjects with a primary admission diagnosis of ECH, severe ECH, gastrointestinal-type ECH, with gastrointestinal or genitourinary cancer, and age ≥60 years.

Conclusions:
Patients with AF hospitalized with ECH may have a slightly elevated risk for future ischemic stroke. Particular consideration should be given to the optimal balance between the benefits and risks of anticoagulation therapy and the use of nonanticoagulant alternatives, such as left atrial appendage closure in this vulnerable population.
An Efficient Bi-Gaussian Ensemble Kalman Filter for Satellite Infrared Radiance Data Assimilation
Authors: Chan Man-Yau , Anderson Jeffrey L. , Chen Xingchao 
Published: October 2020

AbstractThe introduction of infrared water vapor channel radiance ensemble data assimilation (DA) has improved numerical weather forecasting at operational centers. Further improvements might be possible through extending ensemble data assimilation methods to better assimilate infrared satellite radiances. Here, we will illustrate that ensemble statistics under clear-sky conditions are different from cloudy conditions. This difference suggests that extending the ensemble Kalman filter (EnKF) to handle bi-Gaussian prior distributions may yield better results than the standard EnKF. In this study, we propose a computationally efficient bi-Gaussian ensemble Kalman filter (BGEnKF) to handle bi-Gaussian prior distributions. As a proof-of-concept, we used the 40-variable Lorenz 1996 model as a proxy to examine the impacts of assimilating infrared radiances with the BGEnKF and EnKF. A nonlinear observation operator that constructs radiance-like bimodal ensemble statistics was used to generate and assimilate pseudoradiances. Inflation was required for both methods to effectively assimilate pseudoradiances. In both 800- and 20-member experiments, the BGEnKF generally outperformed the EnKF. The relative performance of the BGEnKF with respect to the EnKF improved when the observation spacing and time between DA cycles (cycling interval) are increased from small values. The relative performance then degraded when observation spacing and cycling interval become sufficiently large. The BGEnKF generated less noise than the EnKF, suggesting that the BGEnKF produces more balanced analysis states than the EnKF. This proof-of-concept study motivates future investigation into using the BGEnKF to assimilate infrared observations into high-order numerical weather models.
Adapting Personal Therapies Using a Mobile Application for Tinnitus Rehabilitation: A Preliminary Study
Authors: Abouzari Mehdi , Goshtasbi Khodayar , Sarna Brooke , Ghavami Yaser , Parker Erica M. , Khosravi Pooya , Mostaghni Navid , Jamshidi Shahrnaz , Saber Tina , Djalilian Hamid R. 
Published: October 2020

Objectives: To develop a smartphone application providing sound therapy and cognitive behavioral therapy (CBT) for treating tinnitus and performing a proof-of-concept pilot study evaluating its potential efficacy. Methods: An interactive smartphone application available on iOS and Android platforms was developed, which provided an 8-week tinnitus-specific CBT and personalized and frequency-matched sound therapy. Included patients presented to our tertiary clinic between 2017 and 2018, while those waitlisted were regarded as controls. Three surveys were administrated: Tinnitus Handicap Inventory (THI), Generalized Anxiety Disorder 7-item (GAD-7), and Perceived Stress Scale (PSS). Results: A total of 30 patients enrolled in this study consisting of 20 treatment and 10 control patients and mean age was 55.4 ± 11.6 years. Treatment and control patients had similar age, sex, and pre-enrolment GAD and PSS (all P > .05). Baseline THI scores were also similar between treatment and control cohorts (50.1 ± 21.9 vs 62.0 ± 20.7; P = .15). After 8 weeks, though changes in GAD and PSS scores were similar ( P > .05), the treatment group reported a significantly greater improvement in THI scores (17.7 ± 15.8 vs 5.3 ± 10.5, P = .04). Conclusions: This pilot study demonstrated potentially promising efficacy of a smartphone-based CBT and sound therapy platform for treating tinnitus and encourages future randomized controlled trials on this treatment modality.
A Non-inferiority Trial: Safety and Efficacy of Topical 1:1000 versus 1:10 000 Epinephrine in Sino-nasal Surgeries
Authors: Dow Cassie L. , Sideris Anders W. , Singh Ravjit , Giles Mitchell H. , Banks Catherine , Meller Catherine , Choroomi Sim , Havas Thomas E. 
Published: October 2020

Objective: This study aimed to test the non-inferiority of topical 1:1000 epinephrine compared to topical 1:10 000 with regard to intraoperative hemodynamic stability, and to determine whether it produced superior visibility conditions. Methods: A single-blinded, prospective, cross-over non-inferiority trial was performed. Topical 1:1000 or topical 1:10 000 was placed in 1 nasal passage. Hemodynamic parameters (heart rate, systolic and diastolic blood pressures, and mean arterial pressure) were measured prior to insertion then every minute for 10 minutes. This was repeated in the contralateral nasal passage of the same patient with the alternate concentration. The surgeon graded the visualization of each passage using the Boezaart Scale. The medians of the greatest absolute change in parameters were compared using a Wilcoxon Rank-Signed test and confidence intervals were calculated using a Hodges-Lehman test. The non-inferiority margin was pre-determined at 10 bpm for heart rate and 10 mmHg for blood pressures. A Wilcoxon Rank-Signed test was used to assess superiority in visualization. Results: Thirty-two patients were enrolled and after exclusions, nineteen were assessed (mean age = 35.63 ± 12.49). Differences in means of greatest absolute change between the 2 concentrations were calculated (heart rate = 2.49 ± 1.20; systolic = −1.51 ± 2.16; diastolic = 2.47 ± 1.47; mean arterial pressure = 0.07 ± 1.83). In analyses of medians, 1:1000 was non-inferior to the 1:10 000. There was a significant difference (–0.58 ± 0.84; P = .012) in visualization in favor of topical 1:1000. Conclusion: Topical 1:1000 epinephrine provides no worse intraoperative hemodynamic stability compared to topical 1:10 000 but affords superior visualization and should be used to optimize surgical conditions.
Derivation and Demonstration of a New Metric for Multitasking Performance
Authors: Fox Elizabeth L. , Houpt Joseph W. , Tsang Pamela S. 
Published: October 2020

Objective We proposed and demonstrate a theory-driven, quantitative, individual-level estimate of the degree to which cognitive processes are degraded or enhanced when multiple tasks are simultaneously completed. Background To evaluate multitasking, we used a performance-based cognitive model to predict efficient performance. The model controls for single-task performance at the individual level and does not depend on parametric assumptions, such as normality, which do not apply to many performance evaluations. Methods Twenty participants attempted to maintain their isolated task performance in combination for three dual-task and one triple-task scenarios. We utilized a computational model of multiple resource theory to form hypotheses for how performance in each environment would compare, relative to the other multitask contexts. We assessed if and to what extent multitask performance diverged from the model of efficient multitasking in each combination of tasks across multiple sessions. Results Across the two sessions, we found variable individual task performances but consistent patterns of multitask efficiency such that deficits were evident in all task combinations. All participants exhibited decrements in performing the triple-task condition. Conclusions We demonstrate a modeling framework that characterizes multitasking efficiency with a single score. Because it controls for single-task differences and makes no parametric assumptions, the measure enables researchers and system designers to directly compare efficiency across various individuals and complex situations. Application Multitask efficiency scores offer practical implications for the design of adaptive automation and training regimes. Furthermore, a system may be tailored for individuals or suggest task combinations that support productivity and minimize performance costs.
Identifying user-centered content, design, and features for mobile health apps to support long-term assessment, behavioral intervention, and transitions of care in neurological rehabilitation: An exploratory study
Authors: Osborne Candice L , Juengst Shannon B , Smith Emily E 
Published: October 2020

Introduction The use of mobile health technology has the potential to increase healthcare accessibility, promote self-management, provide education materials, and support self-monitoring of biometrics. This may be of particular benefit to those living in the community with chronic neurological conditions. The purpose of this research was to characterize perspectives of individuals with brain injury or stroke, their care partners, and neuro-rehabilitation clinicians to inform the design of mobile health app-based interventions that address the need for ongoing community-based health-related professional support. Methods Individuals with stroke or traumatic brain injury, their care partners, and clinicians were recruited from a large university hospital with a specialized neuro-rehabilitation program. Data were collected via semi-structured focus groups and were examined using descriptive statistics and content analysis. Results Five consistent themes emerged: (a) all-in-one app with customized features; (b) communication with healthcare providers; (c) cognitive strategies; (d) app accessibility; and (e) user education. The clinician focus group reiterated these consumer focus group themes, with one additional theme: (f) logistics of clinician time and effort to provide effective app-based services to patients. Conclusions Results have directly informed the ongoing development of a community-based mobile health app intervention, and may also inform the content and design of future mHealth technological development in this population.
Evaluation of different Jaipur foot–ankle assemblies using infrared thermography
Authors: Olaya Mira Natali , Viloria Barragán Carolina , Plata Jesus Alberto 
Published: October 2020

Background:
Mechanical behavior is difficult to monitor in experimental environments, usually because of geometric or technology implementation limitations. Nevertheless, thermography has been shown to overcome these issues.

Objectives:
The aim of this study was to evaluate four types of assemblies between a Jaipur foot and a polyethylene tube using infrared thermography in order to find the best mechanical configuration in terms of thermal behavior.

Study Design:
Mechanical testing.

Technique:
An infrared camera captured short videos every 5 min over 10 h in six different positions (three in the back and three in front of the Jaipur foot) around a prosthesis subjected to repetitive stresses (axial force 980 N) simulating kinematic variables like joint angles. We established a region of interest around the foot–ankle assemblies and calculated maximum temperatures and thermographic indices.

Results:
In this study, the best foot–ankle assembly used epoxy adhesive because it presented the lowest temperature in the six positions and the lowest thermal index.

Conclusions:
Thermographic techniques can be used to study mechanical behaviors in complex experimental situations.
The Clinical Value of the Faux Pas Test for Diagnosing Behavioral-Variant Frontotemporal Dementia
Authors: Delbeuck Xavier , Pollet Marianne , Pasquier Florence , Bombois Stéphanie , Moroni Christine 
Published: October 2020

Objective: We studied the clinical value of the faux pas test to diagnose behavioral-variant frontotemporal dementia. Methods: The faux pas test was administered to patients referred to a memory clinic in a context of behavioral disturbances. The diagnosis of behavioral-variant frontotemporal dementia (n = 14) or not (n = 25) was confirmed after a 3 years follow-up. Results: The faux pas test displayed a high sensitivity for behavioral-variant frontotemporal dementia (.83) however its specificity was only moderate (.64). Conclusions: Our results confirm that the FPT capture’s specific cognitive impairments in patients with behavioral-variant frontotemporal dementia. However, some patients with psychiatric disease or other neurological diseases may also show impaired scores.
Changes in Self- and Informant-Reported Frontal Behaviors in Parkinson’s Disease: A Longitudinal Study
Authors: Pluim Celina F. , Nakhla Marina Z. , Split Molly , Filoteo J. Vincent , Litvan Irene , Moore Raeanne C. , Lessig Stephanie , Schiehser Dawn M. 
Published: October 2020

Objective: Frontal behaviors (i.e., executive dysfunction, disinhibition, apathy) are common in Parkinson’s disease (PD). However, it is unclear if patient and informant reports of patient frontal behaviors are in agreement over time. Method: Sixty-two PD patients without dementia and their informants (87% spouses/partners) completed the self- and informant-versions of the Frontal Systems Behavior Scale at baseline and 2-year follow-up. Dyad ratings were compared and predictors of behavior ratings were examined. Results: Patient and informant reports at baseline and follow-up were in agreement, with significant increases in overall frontal behaviors, executive dysfunction, and apathy. Higher levels of baseline patient depression and caregiver burden predicted decrements in patient-reported executive function; worse patient cognition at baseline predicted worsening apathy as rated by informants. Conclusions: PD patients and their informants are concordant in their ratings of worsening frontal behaviors over time. Targeting patient depression, cognition, and caregiver burden may improve decrements in frontal behaviors (executive dysfunction and apathy) in PD.
Serrated Lesions in Inflammatory Bowel Disease: Genotype-Phenotype Correlation
Authors: Brcic Iva , Dawson Heather , Gröchenig Hans Peter , Högenauer Christoph , Kashofer Karl 
Published: October 2020

Background Patients with inflammatory bowel disease (IBD) and hyperplastic/serrated polyposis have an increased risk of colorectal cancer. The aim of our study was to elucidate the nature of serrated lesions in IBD patients. Materials and Methods Sixty-five lesions with serrated morphology were analyzed in 39 adult IBD patients. Lesions were classified according to the WHO 2019 criteria or regarded as reactive, and molecular analysis was performed. Results 82.1% of patients had ulcerative colitis, 17.9% had Crohn’s disease; 51.3% were female, and the mean age was 54.5 years. The duration of IBD varied significantly (16.7 ± 11.4 years). Endoscopy showed polypoid lesions in 80.3%; the size ranged from 2 to 20 mm. A total of 21.6% of the lesions were located in the right colon. Five lesions were classified as inflammatory pseudopolyps, 28 as hyperplastic polyp, 21 and 2 as sessile serrated lesion without and with dysplasia, respectively, and 9 as traditional serrated adenoma with low-grade dysplasia. Analysis of all true serrated lesions revealed 31 mutations in KRAS and 32 in BRAF gene. No mutations were identified in inflammatory pseudopolyps. In the right colon BRAF mutations were more frequent than KRAS (16 vs 3), while KRAS mutations prevailed on the left side (28 vs 16, P < .001). One patient with traditional serrated adenomas progressed to an adenocarcinoma after 61 months. Conclusion The molecular analysis could help discriminate true serrated lesions (IBD-associated or not) from reactive pseudopolyps with serrated/hyperplastic epithelial change. These should help in more accurate classification of serrated lesions.
Pemetrexed-induced Sweet Syndrome: First case report in the medical literature
Authors: Korkmaz Mustafa , Eryılmaz Melek Karakurt , Karaağaç Mustafa , Demirkıran Aykut , Araz Murat , Artaç Mehmet 
Published: October 2020

Introduction Sweet Syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory disease characterized by the sudden emergence of painful, edematous, and erythematous papules, plaques, or nodules on the skin, which usually fully responsive to systemic corticosteroids. Skin lesions are often accompanied by fever and leukocytosis. Here we present a case of Sweet Syndrome caused by pemetrexed in metastatic lung adenocarcinoma. Case report A 52-year-old patient with metastatic lung adenocarcinoma received multiple lines of chemotherapy. The patient presented with extensive skin lesions after performing of pemetrexed chemotherapy. He had a fever and elevations in blood levels of C-reactive protein (CRP), sedimentation, leucocytes, and neutrophils. Neutrophil predominant perivascular and interstitial dermatitis, focal micropustule formation, and severe neutrophilic dermatosis were reported in skin biopsy. Topical steroid and oral antihistamine treatment were started as initial treatment. Discussion and conclusions: Cutaneous side effects related to pemetrexed are often reported as ‘skin rash,' which is a non-specific term. Therefore, the diagnosis of Sweet Syndrome must be confirmed by skin biopsy. It is essential to exclude the presence of an infection and medication history. Recovery in drug-induced Sweet Syndrome occurs after the drug that caused it was discontinued. Systemic corticosteroids are the first-line treatment for most cases.
A pharmacist’s review of the treatment of systemic light chain amyloidosis
Authors: Hughes David M. , Staron Andrew , Sanchorawala Vaishali 
Published: October 2020

Objective Systemic light-chain (AL) amyloidosis is an uncommon hematologic plasma cell dyscrasia that is becoming increasingly recognized. Therapeutic agents used in AL amyloidosis overlap with those used in multiple myeloma; however, differences in disease features change treatment efficacy and tolerance. Pharmacists must be cognizant of these distinctions. Herein, this review article provides an up-to-date guide to treatment considerations for systemic AL amyloidosis in both the front-line and relapsed settings. Data sources: A comprehensive literature search was performed using the PubMed/Medline database for articles published through (June 2020) regarding treatments for AL amyloidosis. Search criteria included therapies that are FDA approved for multiple myeloma, as well as investigational agents. This review of chemotherapeutic agents reflects the current clinical practice guidelines endorsed by NCCN along with commentary based on the experience of pharmacists from a tertiary-referral center treating many patients with AL amyloidosis. Data consists of randomized controlled trials, observational cohorts, case reports, and ongoing clinical trials. Data summary: Frontline options discussed here include high-dose melphalan with autologous stem cell transplantation and bortezomib-based regimens. Regarding the relapsed setting, supporting data are compiled and summarized for: bortezomib, ixazomib, carfilzomib, lenalidomide, pomalidomide, daratumumab, elotuzumab, isatuximab, venetoclax, NEOD001, and melflufen. Conclusions The treatment platform for AL amyloidosis is expanding with novel agents traditionally used in multiple myeloma being adopted and modified for use in AL amyloidosis. The pharmacist’s familiarity with the clinical evidence base for these agents and how they fit into standard protocols for AL amyloidosis is critical as dosing and monitoring recommendations are unique from multiple myeloma.
A Diagnostic Nomogram of Pathologic Grade for Preoperative Risk Stratification in Upper Tract Urothelial Carcinoma
Authors: Ma Runzhuo , Xia Haizhui , Qiu Min , Tao Liyuan , Lu Min , Huang Rui , Lu Jian , Ma Lulin 
Published: October 2020

Background: To develop a novel nomogram to improve the preoperative diagnosis of pathological grade of upper tract urothelial carcinoma (UTUC). Methods: Retrospective study was conducted with 245 patients with UTUC treated by radical nephroureterectomy from 2002 to 2016. Of the cohort, 57.6% received ureteroscopic (URS) biopsy and 35.9% received urine cytology examination. Preoperative clinical characteristics and examination results were collected. Final pathological grade was diagnosed by postoperative pathology. Univariable and multivariable binary logistic regressions were applied to establish a preoperative predictive model for tumor grade, and significant factors were included in the nomogram. The area under curve (AUC) was used to show the predictive efficacy, and the calibration plot was drawn for validation. Results: Of the 245 patients, 72.7% were diagnosed with pathological high-grade disease. Age (odds ratio [OR] = 1.03, P = .039), sessile (OR = 3.86, P = .021), positive urinary cytology (OR = 6.87, P = .035), and biopsy high-grade result (OR = 10.85, P < .001) were independent predictors for pathological high-grade disease. The predictive nomogram containing these factors achieved an AUC of 0.78, which was significantly better than URS biopsy alone (AUC = 0.62, P = .003) in the whole cohort. In the URS biopsy subgroup, the nomogram achieved an AUC of 0.79, better than biopsy alone (AUC = 0.76), but was not statistically significant ( P = .431). When the cutoff value of the nomogram was set at 0.64, the sensitivity of detecting a high-grade lesion versus low-grade lesion was 80.3%, better than that of URS biopsy alone (sensitivity = 65.7%). Conclusions: Advanced age, sessile, positive urinary cytology, and biopsy high-grade were independent predictors of pathological high-grade disease in patients with UTUC. A nomogram containing these factors can improve diagnostic accuracy, potentially reducing the risk of “undergrading” by URS biopsy.