bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Safety Profiles of the New and Old Formulations of Levothyroxine in a First Global Introduction in France
Authors: Lehnert Hendrik , Castello-Bridoux Claire , Channaiah Bushan , Martiniere Karine , Hildemann Steven , Wémeau Jean-Louis 
Published: January 2021

Abstract
Background Levothyroxine sodium marketed in France was reformulated following a French National Agency for Medicines and Health Products Safety request for a more stringent potency specification. Despite previously established purity and bioequivalence of the new and old formulations, reports of adverse events substantially increased following reformulation. This analysis evaluated the nature and relevance of the medically confirmed safety reports.
Methods Spontaneous and solicited individual case safety reports in France were retrieved from 26 March 2015 to 30 June 2016 (old formulation) and 26 March 2017 to 30 June 2018 (new formulation). Rates of reports and adverse events were calculated for the overall patient population and for at-risk subgroups. Adverse events delineated by thyroid-stimulating hormone levels were evaluated.
Results A total of 295 and 42 775 reports for the old formulation and new formulation, respectively, were retrieved, with 149 and 5503 medically confirmed. The most common medically confirmed adverse events were consistent with the known safety profile of levothyroxine, with generally comparable rates between both formulations (range of differences, 1.8–4.1%). Most cases were not serious (old formulation, 65.8%; new formulation, 78.7%). Reporting rates were similar or higher for the old formulation within subgroups of at-risk patients. Nature/distributions of adverse events by thyroid-stimulating hormone levels as determined by both the marketing authorization holder of levothyroxine and the French National Agency for Medicines and Health Products Safety were similar.
Conclusions The new formulation safety profile aligns with the established profile of the old formulation of levothyroxine. The benefit–risk profile is unchanged, such that the benefits of using the new formulation in the approved indications outweigh the risks associated with the treatment.
Prävalenz von SARS-CoV-2 bei Mitarbeitern eines Krankenhauses der Regel-/Schwerpunktversorgung in Nordrhein-Westfalen
Authors: Platten Martin , Cranen Rita , Peters Claudia , Wisplinghoff Hilmar , Nienhaus Albert , Bach Alexander Daniel , Michels Guido 
Published: January 2021

Zusammenfassung
Hintergrund Wir erhoben die Prävalenz von SARS-CoV-2 in der Belegschaft eines Krankenhauses der Regel-/Schwerpunktversorgung in Nordrhein-Westfalen im Rahmen einer Querschnittsstudie.
Methode Allen 1363 Mitarbeiter wurden ein nasopharyngealer Abstrich sowie eine Serologie auf SARS-CoV-2 angeboten. Zudem wurde ein Fragebogen zu Vorerkrankungen, Kontakten zu SARS-CoV-2-positiven Personen und COVID-19-typischen Symptomen vorgelegt.
Ergebnisse 1212 MitarbeiterInnen nahmen teil. 19 von 1363 (1,4 %) Mitarbeitern waren PCR-positiv (3 während der Studie, 16 vorher). Bei 40 (3,3 %) bzw. 105 (8,6 %) Mitarbeitern wurde IgG bzw. IgA nachgewiesen, bei 32 (2,6 %) IgG und IgA. Damit wurden insgesamt 47 Mitarbeiter positiv für SARS-CoV-2 getestet. In dieser Gruppe waren die häufigsten Symptome Kopfschmerzen (56 %), Müdigkeit (49 %), Halsschmerzen (49 %) und Husten (46 %), Fieber wurde in 33 % berichtet. Positiv getestete Mitarbeiter gaben häufiger Kontakt zu einem COVID-19-Fall an (60,5 % vs. 37,3 %; p = 0,006). Mitarbeiter mit isoliertem IgA-Nachweis gaben seltener Symptome an.
Schlussfolgerung 3,9 % der Mitarbeiter eines Krankenhauses der Regel-/Schwerpunktversorgung wurden zwischen dem 27.04. und 20.05.2020 positiv auf SARS-CoV-2 getestet. Der Anteil war geringer als erwartet; mögliche Gründe sind die geringe Durchseuchung der Bevölkerung und die umfangreichen, einheitlichen hausinternen Präventionsmaßnahmen.
Artocarpus lacucha Extract and Oxyresveratrol Inhibit Glucose Transporters in Human Intestinal Caco-2 Cells
Authors: Wongon Matusorn , Limpeanchob Nanteetip 
Published: January 2021

AbstractReduction of intestinal glucose absorption might result from either delayed carbohydrate digestion or blockage of glucose transporters. Previously, oxyresveratrol was shown to inhibit α-glucosidase, but its effect on glucose transporters has not been explored. The present study aimed to assess oxyresveratrol-induced inhibition of the facilitative glucose transporter 2 and the active sodium-dependent glucose transporter 1. An aqueous extract of Artocarpus lacucha, Puag Haad, which is oxyresveratrol-enriched, was also investigated. Glucose transport was measured by uptake into Caco-2 cells through either glucose transporter 2 or sodium-dependent glucose transporter 1 according to the culture conditions. Oxyresveratrol (40 to 800 µM) dose-dependently reduced glucose transport, which appeared to inhibit both glucose transporter 2 and sodium-dependent glucose transporter 1. Puag Haad at similar concentrations also inhibited these transporters but with greater
efficacy. Oxyresveratrol and Puag Haad could help reduce postprandial hyperglycemic peaks, which are considered to be most damaging in diabetics.
Entwicklung der hausärztlichen Versorgung innerhalb der letzten Jahrzehnte – eine Analyse des Basisdatensatzes der Kassenärztlichen Vereinigung Bayerns
Authors: Schäfer Merle , Donnachie Ewan , Gerlach Roman , Tauscher Martin , Schneider Antonius 
Published: January 2021

Zusammenfassung
Ziel der Studie Der Hausärztemangel in Deutschland nimmt weiterhin zu. Durch ein vertieftes Verständnis der Veränderung von hausärztlichen Kennzahlen innerhalb der letzten Jahrzehnte könnten Ansatzpunkte für eine Verbesserung der Versorgungssituation identfiziert werden. Ziel war die Analyse von hausärztlichen Kennzahlen der Kassenärztlichen Vereinigung Bayerns (KVB) im Hinblick auf die Dauer zwischen Staatsexamensabschluss und Selbstständigkeit in Form einer Praxisniederlassung seit den siebziger Jahren, die Entwicklung von Gemeinschaftspraxen und Angestelltenverhältnissen und den Erwerb von Zusatzbezeichnungen.
Methodik Als Datengrundlage für die Analyse des Zeitraums zwischen Staatsexamensabschluss und Niederlassung, Entwicklung von Gemeinschaftspraxen und Zusatzbezeichnungen dienten die Arztregisterdaten der niedergelassenen Ärzte in Bayern, aufbereitet von der KVB. Es wurden deskriptive Analysen durchgeführt.
Ergebnisse Seit den 70er Jahren kam es zu einer erheblichen Zunahme der zeitlichen Dauer von Studienabschluss bis zur Niederlassung in eigener Praxis von durchschnittlich 5 auf 12 Jahre. Es entwickelte sich ein deutlicher Trend hin zur Gemeinschaftspraxis seit den 2000er Jahren. Die Anzahl der Neuniederlassungen in eigener Praxis blieb über die letzten Jahre relativ konstant. Zudem zeichnet sich eine deutliche Tendenz zum Angestelltenverhältnis ab. Der Anteil an Zusatzbezeichnungen nimmt im zeitlichen Verlauf insbesondere im alternativmedizinischen Bereich und Sportmedizin ab.
Schlussfolgerung Es sind weiterhin Initiativen notwendig, um die Facharztweiterbildung inhaltlich und zeitlich effizient zu gestalten. Darüber hinaus müssten kontinuierlich motivationale Anreize zur Niederlassung mit eigenem KV-Sitz erfolgen, wobei gleichzeitig dem ausgeprägten Wunsch nach Anstellungsverhältnissen Rechnung getragen werden sollte.
Perrhenate Esters as Intermediates in Molecular Complexity-Increasing Reactions
Authors: Floreancig Paul E. 
Published: January 2021

AbstractAllylic alcohols form perrhenate esters upon reaction with Re2O7 or HOReO3. These species undergo nonstereospecific and nonregiospecific alcohol-transposition reactions through cationic intermediates. Sequencing these nonselective processes with reversible trapping by electrophiles results in cyclization reactions where regio- and stereocontrol are dictated by thermodynamics. The cationic intermediates can also be utilized as electrophiles in intra- or intermolecular dehydrative reactions with nucleophiles. These processes serve as the basis for applications in catalytic syntheses of a wide range of heterocyclic and carbocyclic structures that often show considerable increases in molecular complexity. This Account describes a sequence of events that started from a need to solve a problem for the completion of a natural product synthesis and evolved into a central element in the design of numerous new transformations that proceed under mild conditions from readily accessible substrates.1	Introduction2	Exploratory Studies3	Application to Spiroketal Synthesis4	Reactions with Epoxides as Trapping Agents5	Development of Dehydrative Cyclizations6	Bimolecular Reactions7	Spirocyclic Ether Formation8	Conclusions
Nickel-Catalyzed Cross-Electrophile Coupling of the Difluoromethyl Group for Fluorinated Cyclopropane Synthesis
Authors: Jarvo Elizabeth R. , Lucas Erika L. , McGinnis Tristan M. , Castro Anthony J. 
Published: January 2021

AbstractHerein, we report a new strategy for fluorinated cyclopropane synthesis. Photocatalytic olefin difluoromethylation is coupled with a nickel-catalyzed intramolecular cross-electrophile coupling (XEC) reaction between a difluoromethyl moiety and a benzylic ether. To the best of our knowledge, this is the first example of a XEC reaction employing a difluoromethyl group as an electrophile. A plausible mechanism is highlighted, and DFT calculations are included to support the observed stereochemical outcome.
Surgical Treatment Alternatives to Sacral Neuromodulation for Fecal Incontinence: Injectables, Sphincter Repair, and Colostomy
Authors: Ivatury Srinivas Joga , Wilson Lauren R. , Paquette Ian M. 
Published: January 2021

AbstractFecal incontinence is a prevalent health problem that affects over 20% of healthy women. Many surgical treatment options exist for fecal incontinence after attempts at non-operative management. In this article, the authors discuss surgical treatment options for fecal incontinence other than sacral neuromodulation.
Cost-Effectiveness of Emergent MRI during Stroke Alert to Diagnose Stroke Mimics: Single-Center Experience
Authors: Kapoor Nidhi , Sharma Rohan , Iser Courtney , Chaudhari Kaustubh , Nalleballe Krishna , Brown Aliza , Veerapaneni Poornachand , Sheng Sen , Elkhider Hisham , Veerapaneni Karthika , Onteddu Sanjeeva , Sidorov Evgeny 
Published: January 2021

Abstract

Objective The aim of this article was to assess the role of emergent magnetic resonance imaging (MRI) for stroke mimics during a stoke alert (within 45 minutes) in reducing direct cost of management and duration of inpatient stay.

Methods We did a retrospective chart review of all the patients who received emergent MRI brain during a stroke alert to help make decision about intravenous tissue-type plasminogen activator (IV tPA) administration from January 2013 to December 2015. Using the patient financial resource data and with the help of billing department, we calculated the approximate money saved in taking care of the patients who may have received IV tPA if emergent MRI brain was not available to diagnose stroke mimics as they presented with acute neurologic deficit within IV tPA time window.

Results Ninety seven out of 1,104 stroke alert patients received emergent MRI. Of these only 17 (17.5%) were diagnosed with acute ischemic stroke (AIS), and 80 (82.5%) as stroke mimics. By doing emergent MRI for suspected stroke mimics, our study showed an approximate total saving of $1,005,720 to $1,384,560, that is, $12,571 to $17,307 per patient in medical expenditure.

Discussion We suggest modification of stroke pathway from current algorithm “CT+CTA≥IV-tPA/neurointervention≥MRI” to “MRI+MRA≥IV-tPA/neurointervention” for possible stroke mimics, which can reduce the cost, radiation exposure, and duration of hospital stay for stroke mimics.

Conclusion Emergent MRI is a cost-effective tool to evaluate IV-tPA eligibility for suspected stroke mimics during a stroke alert.
Role of Cardiac Biomarkers in the Assessment of Acute Cerebrovascular Accident
Authors: Radhakrishnan Srinivasan , Moorthy Swathy , Gadde Sudish , Madhavan Krishnaswamy 
Published: January 2021

Abstract

Background Stroke (cerebrovascular accident) has for long been a global burden in terms of its morbidity and mortality. Serum levels of cardiac enzymes such as creatine kinase-MB (CK-MB) component, troponin T, and brain natriuretic peptide have been found to be elevated among the patients with stroke and also serve to prognosticate these patients. The serum levels of these enzymes correlate directly to the severity of stroke in these patients.

Objective Elevated cardiac enzymes among patients with acute cerebrovascular accidents are not uncommon despite the patients not having any cardiac problems. We aimed to identify the occurrence of elevated cardiac enzymes among patients with acute stroke and their correlation with the severity of stroke.

Materials and Methods Our study included 100 patients of acute stroke with no previous history of cardiac ailments. Serum levels of troponin I and CK-MB were analyzed among these patients using enzyme-linked immunosorbent assay method within the first 2 hours of admission. Patients outcome during the hospital stay were analyzed. Stroke severity was assessed using the National Institute of Health Stroke score (NIHS score) and the modified Rankin Score (mRS). The cardiac enzyme levels were correlated with these scores.

Results Twenty-eight percent of patients had elevated troponin I, while 72% patients had normal levels with the mean values of 10.36 to 106.54 ng/mL and 0.00 to 0.02 ng/mL, respectively. CK-MB levels were found elevated among 14% patients and normal among 86% patients with mean values of 5.8 to 124.36 and 0.0 to 4.3 ng/mL, respectively. Among the six patients who succumbed to death, three patients had increased troponin I and four had elevated CK-MB. NIHS scores of 21.0357±6.79 and 105.277±5.564 were seen in patients with elevated and normal troponin I, whereas NIHS scores of 20.4285±8.658 and 11.8721±9.273 were seen among patients with increased and normal CK-MB, respectively. The mRS scores were 4.3214±0.367, 2.4305±1.374, 4.2143±1.412, and 2.756±1.749 ng/mL among the patients with elevated and normal troponin I and CK-MB, respectively.

Conclusion The mean values of cardiac enzymes troponin I and CK-MB were higher among patients with higher scores of NIHS and mRS. Among them, troponin I was very significant and it may serve as an early biomarker for the severity of stroke and hint on early cardiac evaluation among these patients.
Factors Associated with Poor Antiepileptic Drugs Adherence in Below Poverty Line Persons with Epilepsy: A Cross-Sectional Study
Authors: Govil Nikhil , Chahal Savita , Gupta Nishu , Kaloti Amandeep Singh , Nadda Anuradha , Singh Parmal 
Published: January 2021

Abstract

Background Adherence to antiepileptic drugs (AED) is essential for adequate seizure control in epilepsy. People with low socioeconomic status are more vulnerable to poor adherence to AED. The present study aimed to explore factors associated with poor adherence to antiepileptic drugs in below poverty line (BPL) persons with epilepsy (PWE).

Methods The research had a cross-sectional design with inclusion of persons aged 18 to 65 years and an established diagnosis of epilepsy. Holding a BPL card (Yellow card) was taken as a measure for BPL criteria. Adherence to antiepileptic drugs was assessed using medication adherence rating scale (MARS). Univariate analysis with Chi-square test was used to determine the association between various variables and AED adherence, while the predictors of adherence were identified using multivariate logistic regression analysis.

Results There was a total of 88 BPL PWE. The mean age of male and female patients was 35.0 ± 15.0 & 32.0 ± 10.1 years, respectively. Adherence for drugs were found to be 30.7% and nonadherence to be 44.3%. Low (illiterate or primary) education (OR 0.041 [0.01–0.21]), polytherapy (OR 0.088 [0.02–0.40]), and substance abuse (OR 0.05 [0.01–0.58]) were found to have significant association with nonadherence to AEDs. Age, gender, marital status, family composition, occupation, rural urban background, distance from health care facility, duration of epilepsy, and side effects of AED were not found to have significant association with adherence.

Conclusion There is a need for psychoeducational programs for the people having low education status and polytherapy to form positive beliefs in AEDs. Substance abuse should also be addressed while treating them.
Effects of Long Durations of RF–Magnetron Sputtering Deposition of Hydroxyapatite on Titanium Dental Implants
Authors: Safi Ihab Nabeel , Hussein Basima Mohammed Ali , Aljudy Hikmat J. , Tukmachi Mustafa S. 
Published: January 2021

Abstract
Objectives Dental implant is a revolution in dentistry; some shortages are still a focus of research. This study use long duration of radiofrequency (RF)–magnetron sputtering to coat titanium (Ti) implant with hydroxyapatite (HA) to obtain a uniform, strongly adhered in a few micrometers in thickness.
Materials and Methods Two types of substrates, discs and root form cylinders were prepared using a grade 1 commercially pure (CP) Ti rod. A RF–magnetron sputtering device was used to coat specimens with HA. Magnetron sputtering was set at 150 W for 22 hours at 100°C under continuous argon gas flow and substrate rotation at 10 rpm. Coat properties were evaluated via field emission scanning electron microscopy (FESEM), scanning electron microscopy–energy dispersive X-ray (EDX) analysis, atomic force microscopy, and Vickers hardness (VH). Student’s t-test was used.
Results All FESEM images showed a homogeneous, continuous, and crack-free HA coat with a rough surface. EDX analysis revealed inclusion of HA particles within the substrate surface in a calcium (Ca)/phosphorus (P) ratio (16.58/11.31) close to that of HA. Elemental and EDX analyses showed Ca, Ti, P, and oxygen within Ti. The FESEM views at a cross-section of the substrate showed an average of 7 µm coat thickness. Moreover, these images revealed a dense, compact, and uniform continuous adhesion between the coat layer and the substrate. Roughness result indicated highly significant difference between uncoated Ti and HA coat (p-value < 0.05). A significant improvement in the VH value was observed when coat hardness was compared with the Ti substrate hardness (p-value < 0.05).
Conclusion Prolonged magnetron sputtering successfully coat Ti dental implants with HA in micrometers thickness which is well adhered essentially in excellent osseointegration.
Peripartum Hysterectomies over a Fifteen-year Period
Authors: Dorigon Alessandra , Martins-Costa Sérgio Hofmeister , Ramos José Geraldo Lopes 
Published: January 2021

Abstract
Objective To determine the indications and outcomes of peripartum hysterectomies performed at Hospital de Clínicas de Porto Alegre (a university hospital in Southern Brazil) during the past 15 years, and to analyze the clinical characteristics of the women submitted to this procedure.
Methods A cross-sectional study of 47 peripartum hysterectomies from 2005 to 2019.
Results The peripartum hysterectomies performed in our hospital were indicated mainly due to placenta accreta or suspicion thereof (44.7% of the cases), puerperal hemorrhage without placenta accreta (27.7%), and infection (25.5%). Total hysterectomies accounted for 63.8% of the cases, and we found no difference between total versus subtotal hysterectomies in the studied outcomes. Most hysterectomies were performed within 24 hours after delivery, and they were associated with placenta accreta, placenta previa, and older maternal age.
Conclusion Most (66.0%) patients were admitted to the intensive care unit (ICU). Those who did not need it were significantly older, and had more placenta accreta, placenta previa, or previous Cesarean delivery.
Is it Possible to Predict Massive Bleeding in Nulliparous Women with Placenta Previa?
Authors: Orgul Gokcen , Ayhan Sule Goncu , Saracoglu Gulhan Cetinkaya , Yucel Aykan 
Published: January 2021

Abstract
Objective We evaluated risk factors to determine if there were specific risk factors that could predict massive bleeding in nulliparous women with placenta previa.
Methods The participants were classified into two groups. Women with a calculated blood loss ≥ 1,000 mL were included in the massive bleeding group. Women without any signs or symptoms related with hypovolemia or with a calculated bleeding volume < 1,000 mL were categorized into the non-massive bleeding group.
Results There were 28 patients (40.6%) with massive bleeding and 41 cases (59.4%) with non-massive bleeding. The calculated blood loss and number of cases that required red cell transfusions were statistically different between the groups (< 0.005 and 0.002, respectively). There were no statistically significant differences in terms of maternal or fetal factors, placental location, or delivery characteristics between the two groups.
Conclusion We could not determine the predictive features for massive hemorrhage based on clinical features, delivery features, or placental location.
Evaluation of Bone–Implant Interface Stress and Strain Using Heterogeneous Mandibular Bone Properties Based on Different Empirical Correlations
Authors: Hussein Mostafa Omran , Alruthea Mohammed Suliman 
Published: January 2021

AbstractObjectives The purpose of this study was to compare methods used for calculating heterogeneous patient-specific bone properties used in finite element analysis (FEA), in the field of implant dentistry, with the method based on homogenous bone properties.Materials and Methods In this study, three-dimensional (3D) computed tomography data of an edentulous patient were processed to create a finite element model, and five identical 3D implant models were created and distributed throughout the dental arch. Based on the calculation methods used for bone material assignment, four groups—groups I to IV—were defined. Groups I to III relied on heterogeneous bone property assignment based on different equations, whereas group IV relied on homogenous bone properties. Finally, 150 N vertical and 60-degree-inclined forces were applied at the top of the implant abutments to calculate the von Mises stress and strain.Results Groups I and II presented the highest stress and strain values, respectively. Based on the implant location, differences were observed between the stress values of group I, II, and III compared with group IV; however, no clear order was noted. Accordingly, variable von Mises stress and strain reactions at the bone–implant interface were observed among the heterogeneous bone property groups when compared with the homogenous property group results at the same implant positions.Conclusion Although the use of heterogeneous bone properties as material assignments in FEA studies seem promising for patient-specific analysis, the variations between their results raise doubts about their reliability. The results were influenced by implants’ locations leading to misleading clinical simulations.