bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medication Adherence Among Patients With Corneal Diseases
Authors: Khan Mariam , Michelson Sarah , Newman-Casey Paula Anne , Woodward Maria A. 
Published: March 2021

Purpose:
Medication nonadherence is a ubiquitous problem. However, the adherence of patients to medications to manage corneal conditions is unknown. A prospective cohort study investigated the patterns of eye drop adherence among patients with corneal conditions.

Methods:
Patients older than or equal to 18 years taking prescription eye medications were recruited from an academic center's corneal clinic. Data collected included age, sex, total doses of eye medications, and category of primary corneal diagnosis. Participants completed adapted versions of the 12-question Adherence to Refills and Medications Scale (ARMS) and the 3-question Voils' Medication Adherence Scale (VMAS). Survey data were dichotomized as “adherent” and “nonadherent,” and subscales reported for reasons of nonadherence. Logistic regression analyses were used to test associations with adherence.

Results:
A total of 199 participants were surveyed from February to March 2019 (95% response rate). Participants were aged 19 to 93 years with a mean age of 59 years (SD 17.8). The percent of participants considered nonadherent was 72% by the ARMS and 33% by the VMAS. Older age was associated with higher adherence by the ARMS (odds ratio = 1.48, 95% confidence interval, 1.14–1.93, P = 0.004) and by the VMAS (odds ratio = 1.24, confidence interval, 1.04–1.48, P = 0.012). Adherence was not significantly associated with race, sex, education, total doses of eye medications, or primary cornea diagnosis.

Conclusions:
Medication adherence was lower than expected, particularly on the ARMS scale that asks more detailed questions. Clinicians should engage in conversations about adherence, especially with younger patients, if they are not seeing an expected clinical response.
Kingella kingae Displaced S. aureus as the Most Common Cause of Acute Septic Arthritis in Children of All Ages
Authors: Gouveia Catarina , Duarte Mariana , Norte Susana , Arcangelo Joana , Pinto Margarida , Correia Cristina , Simões Maria João , Canhão Helena , Tavares Delfin 
Published: March 2021

Background:
Acute septic arthritis (SA) still remains a challenge with significant worldwide morbidity. In recent years, Kingella kingae has emerged and treatment regimens have become shorter. We aim to analyze trends in SA etiology and management and to identify risk factors for complications.

Methods:
Longitudinal observational, single center study of children (<18 years old) with SA admitted to a tertiary care pediatric hospital, from 2003 to 2018, in 2 cohorts, before and after implementation of nucleic acid amplification assays (2014). Clinical, treatment and disease progression data were obtained.

Results:
A total of 247 children were identified, with an average annual incidence of 24.9/100,000, 57.9% males with a median age of 2 (1–6) years. In the last 5 years, a 1.7-fold increase in the annual incidence, a lower median age at diagnosis and an improved microbiologic yield (49%) was noticed. K. kingae became the most frequent bacteria (51.9%) followed by MSSA (19.2%) and S. pyogenes (9.6%). Children were more often treated for fewer intravenous days (10.7 vs. 13.2 days, P = 0.01) but had more complications (20.6% vs. 11.4%, P = 0.049) with a similar sequelae rate (3.7%). Risk factors for complications were C-reactive protein ≥80 mg/L and Staphylococcus aureus infection, and for sequelae at 6 months, age ≥4 years and CRP ≥ 80 mg/L.

Conclusions:
The present study confirms that K. kingae was the most common causative organism of acute SA. There was a trend, although small, for decreasing antibiotic duration. Older children with high inflammatory parameters might be at higher risk of sequelae.
Mesial Temporal Sclerosis as Late Consequence of Posterior Reversible Encephalopathy Syndrome in Pediatric Hemato-oncologic Patients
Authors: Faraci Maura , Nobile Giulia , Nobili Lino , Masetti Riccardo , Cordelli Duccio , Toni Francesco , Giardino Stefano , Morana Giovanni , Mancardi Maria M. 
Published: March 2021

Objectives:
Drug resistant epilepsy has rarely been reported following posterior reversible encephalopathy syndrome (PRES), with few cases of mesial temporal sclerosis (MTS). The aim of this study was to report clinical and neuroimaging features of MTS subsequent to PRES in hemato-oncologic/stem cell transplanted children.

Materials and Methods:
Among 70 children treated in 2 pediatric hemato-oncologic Italian centers between 1994 and 2018 and presenting an episode of PRES, we retrospectively identified and analyzed a subgroup of patients who developed epilepsy and MTS.

Results:
Nine of 70 patients (12.8%) developed post-PRES persistent seizures with magnetic resonance imaging evidence of MTS. One patient died few months after MTS diagnosis, because of hematologic complications; the remaining 8 patients showed unprovoked seizures over time leading to the diagnosis of epilepsy, focal in all and drug resistant in 4. At PRES diagnosis, all patients with further evidence of epilepsy and MTS suffered of convulsive seizures, evolving into status epilepticus in 3. In 3 patients a borderline cognitive level or intellectual disability were diagnosed after the onset of epilepsy, and 2 had behavioral problems impacting their quality of life.

Conclusions:
MTS and long-term focal epilepsy, along with potential cognitive and behavioral disorders, are not uncommon in older pediatric patients following PRES.
68Ga-FAPI PET/CT in Thyroid Cancer With Thyroglobulin Elevation and Negative Iodine Scintigraphy
Authors: Fu Hao , Fu Jie , Huang Jingxiong , Su Xinyi , Chen Haojun 
Published: March 2021

Abstract
Differentiated thyroid cancer with thyroglobulin elevation and negative iodine scintigraphy (TENIS) syndrome is a diagnostic and therapy dilemma. In this study, we present a case of TENIS with detectable metastases in the larynx and lung on the CT scan. 68Ga-fibroblast activation protein inhibitor (FAPI) PET/CT was performed for further detection of tumor recurrence and metastases, which showed intense 68Ga-FAPI activity in the metastatic lesions. To the best of our knowledge, this is the first case of TENIS presenting with FAPI-avid metastatic lesions, demonstrating its usefulness for localizing recurrent or metastatic lesions in patients with TENIS.
Rescue Protocol to Improve the Image Quality of 18F-FDG PET/CT Myocardial Metabolic Imaging
Authors: Sun Xiao-Xin , Li Shuheng , Wang Yawen , Li Wei , Wei Hongxing , He Zuo-Xiang 
Published: March 2021

Purpose

18F-FDG PET myocardial metabolic imaging is used to estimate myocardial viability. However, poor image quality can affect the accurate quantification of viable myocardium. We assessed the feasibility of a rescue protocol that reinjected low-dose 18F-FDG with simultaneous 1 to 2 U of insulin injection and oral administration of 10 g of glucose to improve the image quality of 18F-FDG PET myocardial metabolic imaging.

Patients and Methods
Fifty-one consecutive patients with poor quality to uninterpretable 18F-FDG PET/CT myocardial metabolic images received the rescue protocol immediately after the initial image acquisition. The postrescue image acquisition was performed 1 hour later. The rescue image quality was compared with the initial image. The qualitative visual estimation of the images was graded as follows: grade 0, homogeneous, minimal uptake; grade 1, predominantly minimal or mild uptake; grade 2, moderate uptake; and grade 3, good uptake. The myocardium–to–blood pool activity ratio (M/B) was measured to assess the image quality quantitatively.

Results
The grades of 0 to 3 were observed in 24 (47%), 27 (53%), 0 (0%), and 0 (0%) patients, respectively, for the initial imaging, and in 0 (0%), 3 (5.9%), 4 (7.8%), and 44 (86.3%) patients for the rescue imaging (P < 0.001). The rescue M/B was significantly higher than the initial M/B (3.4 ± 1.4 vs 1.6 ± 0.6, respectively; P < 0.001).

Conclusions
The rescue protocol successfully and rapidly improved the quality of myocardial 18F-FDG metabolic imaging.
FDG PET Findings Post–COVID Vaccinations
Authors: Moghimi Saba , Wilson Don , Martineau Patrick 
Published: March 2021

Abstract
Vaccinations can cause hypermetabolic axillary lymphadenopathy on FDG PET. We present the case of a 71-year-old man who underwent FDG PET/CT for melanoma staging 6 days following a COVID (coronavirus disease) vaccination. Imaging showed a prominent intramuscular mass at the vaccination site, in addition to extensive axillary lymphadenopathy. The mass was compatible with a hematoma at the vaccination site, and the lymphadenopathy was most likely reactive. This case demonstrates unconventional findings in response to a routine vaccination event—findings that, in light of current world events, are likely to be routinely encountered on PET imaging and that should be recognized reactive rather malignant.
Ambulatory EEG Usefulness in Epilepsy Management
Authors: Hasan Tasneem F. , Tatum William O. 
Published: March 2021

Summary:
Long-term video-EEG monitoring has been the gold standard for diagnosis of epileptic and nonepileptic events. Medication changes, safety, and a lack of recording EEG in one's habitual environment may interfere with diagnostic representation and subsequently affect management. Some spells defy standard EEG because of ultradian and circadian times of occurrence, manifest nocturnal expression of epileptiform activity, and require classification for clarifying diagnostic input to identify optimal treatment. Some patients may be unaware of seizures, have frequent events, or subclinical seizures that require quantification before optimal management. The influence on antiseizure drug management and clinical drug research can be enlightened by long-term outpatient ambulatory EEG monitoring. With recent governmental shifts to focus on mobile health, ambulatory EEG monitoring has grown beyond diagnostic capabilities to target the dynamic effects of medical and nonmedical treatment for patients with epilepsy in their natural environment. Furthermore, newer applications in ambulatory monitoring include additional physiologic parameters (e.g., sleep, detection of myogenic signals, etc.) and extend treatment relevance to patients beyond seizure reduction alone addressing comorbid conditions. It is with this focus in mind that we direct our discussion on the present and future aspects of using ambulatory EEG monitoring in the treatment of patients with epilepsy.
Left/right asymmetry disruptions and mirror-image reversals to behavior and brain anatomy inCiona
Authors: Kourakis Matthew J. , Bostwick Michaela , Zabriskie Amanda , Smith William C. 
Published: March 2021

ABSTRACTBackgroundLeft-right asymmetries are a common feature of metazoan nervous systems. This is particularly pronounced in the comparatively simple larval central nervous system (CNS) of the tunicateCiona, whose swimming tadpole larva shows a clear chordate ground plan. While common pathway elements for specifying the left-right axis are found in the chordates, particularly a requirement for Nodal signaling,Cionadiffers from its vertebrate cousins by specifying its axis at the neurula stage, rather than at gastrula. Additionally,Ciona, and other ascidians, have a requirement for an intact chorionic membrane for proper left/right specification.ResultsWe present here results showing that left-right asymmetry disruptions caused by removal of the chorion (dechorionation) are highly variable and present throughout theCionalarval nervous system. While previous studies have documented disruptions to the conspicuously asymmetric sensory systems in the anterior brain vesicle, we document asymmetries in seemingly symmetric structures such as the posterior brain vesicle and motor ganglion. Moreover, defects caused by dechorionation include misplaced or absent neuron classes, loss of asymmetric gene expression, aberrant synaptic connectivity, and abnormal behaviors. In the motor ganglion, a brain structure that has been equated with the vertebrate hindbrain, we find that despite the apparent left/right symmetric distribution of interneurons and motor neurons, AMPA receptors are expressed exclusively on the left side, which equates with asymmetric swimming behaviors. We also find that within a population of dechorionated larvae, there is a small percentage with apparently normal left-right specification, and approximately equal population with inverted (mirror-image) asymmetry. We present a method based on a behavioral assay for isolating these larvae. When these two classes of larvae (normal and inverted) are assessed in a light dimming assay they display mirror-image behaviors, with normal larvae responding with counterclockwise swims, while inverted larvae respond with clockwise swims.ConclusionsOur findings highlight the importance of left-right specification pathways not only for proper CNS anatomy, but also for correct synaptic connectivity and behavior.
Impact of the Asian gall waspDryocosmus kuriphiluson the radial growth of the European chestnutCastanea sativa
Authors: Marcolin Enrico , Pividori Mario , Colombari Fernanda , Manetti Maria Chiara , Pelleri Francesco , Conedera Marco , Gehring Eric 
Published: March 2021

AbstractThe invasion of the Asian chestnut gall waspDryocosmus kuriphilus(ACGW) in Europe has caused serious biological and economic impacts on chestnut stands that have been partially solved with the introduction of the biological control agentTorymus sinensis. However, information concerning tree‐ring growth during the ACGW epidemic has been lacking so far.Using dendrochronology techniques, we analysed the impact of the ACGW on tree‐ring growth and the capacity of the chestnut tree to recover when biocontrol was achieved in seven sites covering the area of first detection and subsequent spread of the ACGW in Europe. In each site, a non‐target control species (i.e. trees not attacked by the ACGW) has been included as a reference in the analysis.Results show a reduction in the tree‐ring increment by 60% on average during the ACGW epidemic. Such effects were higher in the magnitude and longer in the duration when compared to other stresses such as insect defoliation or extreme summer droughts.Synthesis and applications. Marked reductions in radial growth were evident in the years of ACGW attack regardless of the age of the chestnut coppices. Since most of the trees only recovered to an almost normal growth rate after 3–4 years of biocontrol byT. sinensis, an immediate release of the antagonist at the first ACGW appearance is highly recommended. The consequences and perspectives of ACGW's attacks on the quality of the timber produced are also discussed.
Did Medicaid slow declines in access to health care during the great recession?
Authors: Benitez Joseph A. , Perez Victoria E. , Chen Jie 
Published: March 2021

AbstractObjectiveWe examine whether broadened access to Medicaid helped insulate households from declines in health coverage and health care access linked to the 2007‐2009 Great Recession.Data Source2004‐2010 Behavioral Risk Factor Surveillance System (BRFSS).Study DesignFlexible difference‐in‐difference regressions were used to compare the impact of county‐level unemployment on health care access in states with generous Medicaid eligibility guidelines versus states with restrictive guidelines.Data Collection/Extraction MethodsNonelderly adults (aged 19‐64) in the BRFSS were linked to county unemployment rates from the Bureau of Labor Statistics’ Local Area Unemployment Statistics Program. We created a Medicaid generosity index by simulating the share of a nationally representative sample of adults that would be eligible for Medicaid under each state's 2007 Medicaid guidelines using data from the 2007 Current Population Survey's Annual Social and Economic Supplement.Principal FindingsA percentage point (PPT) increase in the county unemployment rate was associated with a 1.3 PPT (95% CI: 0.9‐1.6, P < .01) increase in the likelihood of being uninsured and a 0.86 PPT (95% CI: 0.6‐1.1, P < .01) increase in unmet medical needs due to cost in states with restrictive Medicaid eligibility guidelines. Conversely, a one PPT increase in unemployment was associated with only a 0.64 PPT (P < .01) increase in uninsurance among states with the most generous eligibility guidelines. Among states in the fourth quartile of generosity (ie, most generous), rises in county‐level unemployment were associated with a 0.68 PPT (P < .10) increase in unmet medical needs due to cost—a 21% smaller decrease relative to states with the most restrictive Medicaid eligibility guidelines.ConclusionsIncreased access to Medicaid during the Great Recession mitigated the effects of increased unemployment on the rate of unmet medical need, particularly for adults with limited income.
Preoperative plasmapheresis in patients with Graves' disease intolerant to antithyroid drugs
Authors: Apaydin Tugce , Gogas Yavuz Dilek 
Published: March 2021

AbstractAntithyroid drugs (ATDs) are the mainstay of treatment for Graves' disease with possible detrimental adverse effects. Surgery or radioactive iodine (RAI) ablation is the second choice among the treatment options in cases of non‐remission. Normalization of serum thyroid hormone levels as much as possible is required before surgery or RAI to prevent thyrotoxic crisis in patients with uncontrolled Graves' disease. In recent decades, therapeutic plasma exchange (TPE) has been used in the treatment of thyroid storm, drug‐induced hepatotoxicity and agranulocytosis, or patients with hyperthyroidism scheduled for emergency surgery. TPE is an effective method to reduce serum FT3, FT4, and TRAB levels in severe hyperthyroid conditions. Although TPE‐related complications are rare, the risk of bleeding needs to be taken into consideration in patients who were scheduled for surgery within 24 h after TPE. In terms of reducing intraoperative bleeding, patients can be referred to surgery 24–48 h after TPE, or fresh frozen plasma transfusion can be the preferred treatment for emergency cases.
Oxycodone/naloxone prolonged‐release tablets in patients with moderate‐to‐severe, chronic cancer pain: Challenges in the context of hepatic impairment
Authors: Le Brian H , Aggarwal Ghauri , Douglas Carol , Green Michael , Nicoll Amanda , Ahmedzai Sam 
Published: March 2021

AbstractOpioids such as oxycodone are recommended in the management of moderate‐to‐severe, chronic cancer pain. All opioids can potentially cause constipation, which may be a significant barrier to their use. Multiple randomised clinical trials have shown that the use of naloxone as a peripherally acting mu‐opioid receptor antagonist, in combination with oxycodone can prevent or reduce opioid‐induced constipation while having equivalent analgesic efficacy to oxycodone alone. However, clinical experience has shown that unexpected events may occur in some patients when unrecognized liver impairment is present. We describe the underlying biological reasons and propose simple, but effective steps to avoid this unusual but potentially serious occurrence. In healthy individuals, naloxone undergoes extensive hepatic first pass metabolism resulting in low systemic bioavailability. However, in patients with hepatic impairment, porto‐systemic shunting can increase systemic bioavailability of naloxone, potentially compromising the analgesic efficacy of oral naloxone–oxycodone combinations. This reduced first pass effect can occur in a range of settings that may not always be apparent to the treating clinician, including silent cirrhosis, non‐cirrhotic portal hypertension and disruption of liver internal vasculature by metastases. Hepatic function test results correlate poorly with presence and extent of liver disease, and are not indicative of porto‐systemic shunting. Presence of hepatic impairment should thus be considered when medication‐related outcomes with oxycodone–naloxone combination are not as expected, even if liver function test results are normal.
Allergenic components of the mRNA‐1273 vaccine for COVID‐19: Possible involvement of polyethylene glycol and IgG‐mediated complement activation
Authors: Klimek Ludger , Novak Natalija , Cabanillas Beatriz , Jutel Marek , Bousquet Jean , Akdis Cezmi A. 
Published: March 2021

AbstractFollowing the emergency use authorization of the mRNA‐1273 vaccine on the 18th of December 2020, two mRNA vaccines are in current use for the prevention of coronavirus disease 2019 (COVID‐19). For both mRNA vaccines, the phase III pivotal trials excluded individuals with a history of allergy to vaccine components. Immediately after the initiation of vaccination in the United Kingdom, Canada, and the United States, anaphylactic reactions were reported. While the culprit trigger requires investigation, initial reports suggested the excipient polyethylene glycol 2000 (PEG‐2000)—contained in both vaccines as the PEG‐micellar carrier system—as the potential culprit. Surface PEG chains form a hydrate shell to increase stability and prevent opsonization. Allergic reactions to such PEGylated lipids can be IgE‐mediated, but may also result from complement activation‐related pseudoallergy (CARPA) that has been described in similar liposomes. In addition, mRNA‐1273 also contains tromethamine (trometamol), which has been reported to cause anaphylaxis to substances such as gadolinium‐based contrast media. Skin prick, intradermal and epicutaneous tests, in vitro sIgE assessment, evaluation of sIgG/IgM, and basophil activation tests are being used to demonstrate allergic reactions to various components of the vaccines.
Estimating benefits: Proposed national paid family and medical leave programs
Authors: Hartmann Heidi I. , Hayes Jeffrey 
Published: March 2021

AbstractUsing a sophisticated simulation model to estimate worker leave access, eligibility, and usage behaviors, this study examines the distributional impact of program design elements across four programs that could provide paid family and medical leave insurance to American workers. Overall, paid family and medical leave benefits are well targeted to low wage workers, compared with moderate and higher wage workers, under all potential national programs whose effects are simulated here. Workers at all earnings and income levels would gain access to new leave benefits. Suggestions for improving the benefits to low wage workers are also discussed.
CDK4/6 and PI3K inhibitors: A new promise for patients with HER2‐positive breast cancer
Authors: Agostinetto Elisa , Debien Véronique , Marta Guilherme Nader , Lambertini Matteo , Piccart‐Gebhart Martine , de Azambuja Evandro 
Published: March 2021

AbstractBackgroundHER2‐positive (HER2+) breast cancer represents a heterogeneous breast cancer subtype, including both oestrogen receptor (ER) positive and negative tumours. A deeper understanding of the crosstalk between ER and HER2 receptor pathways has led to the development of treatment strategies consisting of a simultaneous blockade of both signalling pathways, as a reasonable approach to prevent the onset of mechanisms of resistance.MethodsThis review was based on the material searched on PubMed, MEDLINE and Embase databases and on conference proceedings from major oncology conferences up to 15 December 2020. The search strategy included the following keywords: ‘HER2‐positive breast cancer’, ‘CDK4‐6 inhibitors’ and ‘PI3K inhibitors’, and was adapted for use with different bibliographic databases.ResultsCDK4/6 and PI3K inhibitors are two classes of agents already approved in patients with hormone receptor positive, HER2‐negative breast cancer. Recently, promising data with their use have been also shown in HER2+ disease. Results from preclinical and clinical studies are shedding light on the role of these classes of agents in HER2+ breast cancer, and are paving the road for a forthcoming change in clinical practice.ConclusionsTreatment landscape for HER2+ breast cancer is rapidly changing, and CDK4/6 and PI3K inhibitors represent a new promising strategy to improve patients’ outcomes.