bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of drug formulation on outcomes of pharmaceutical poisoning in children aged 7 years or younger
Authors: Ko Yura , Jeon Woochan , Choi Yoo Jin , Yang Heewon , Lee Jisook 
Published: October 2021

Abstract
Pharmaceutical poisoning in children is almost unintentional and there are various types of drug out of curiosity. Understanding the attractive features and formulation of drugs related to poisoning in younger children may be helpful in treatment and prevention of poisoning. To investigate the impact of drug formulation on outcomes of pharmaceutical poisoning in young children.
We retrospectively reviewed the data of pharmaceutical exposures among children who were registered in a Korean 23-center, emergency department (ED) based registry from 2011 to 2016. Our study was conducted on preschool children aged 0 to 7 years. According to the formulation and category of the ingested drugs, the exposures were divided into the “tablet and capsule (TAC)” and “syrup” groups. In the TAC group, we additionally recorded data on the shape, color, and size of the drugs. The ED outcomes, such as hospitalization and length of stay, were compared between the 2 groups.
Among the 970 enrolled exposures, 674 (69.5%) were classified into the TAC group. In this group, hormones/hormone antagonists (18.5%) were the most commonly ingested, followed by central nervous system drugs (17.1%). In the syrup group, antihistamines (28.4%) were the most commonly ingested, followed by respiratory drugs (24.3%). The TAC group showed a higher hospitalization and transfer rate to tertiary centers than the counterpart (TAC, 18.0% vs syrup, 11.5%, P = .03) without a significant difference in the length of stay (TAC, 173.5 minutes [interquartile range, 95.0–304.0] vs syrup, 152.5 [77.5–272.0]; P = .08). No in-hospital mortality occurred in the exposures. Round-shaped and chromatic TACs, accounting for 91.7% (618) and 56.1% (378), respectively, were more commonly ingested. The median size of the TACs was less than 1.0 cm.
Young children who visited the ED ingested TACs more frequently than syrups, particularly small, round-shaped, or chromatic drugs, leading to a higher hospitalization rate. Our findings can contribute to prevention strategies and safety education on childhood drug poisoning.
Factors associated with the appropriate use of ultra-broad spectrum antibiotics, meropenem, for suspected healthcare-associated pneumonia
Authors: Kirsch Nathan , Ha Jane , Kang Hee-Taik , Frisch Tina , Yoo Ji Won , Grossman Craig , Oroomchi Neema , Shigemitsu Hidenobu , Cross Chad L. , Kioka Mutsumi John 
Published: October 2021

Abstract
Pneumonia is a common disease-causing hospitalization. When a healthcare-associated infection is suspected, antibiotics that provide coverage for multi-drug resistant (MDR) or extended-spectrum beta-lactamase (ESBL) bacteria are frequently prescribed. Limited data is available for guidance on using meropenem as a first-line empiric antimicrobial in hospitalized patients with risk factors for MDR/ESBL bacterial infections.
This was a single-center, retrospective study designed and conducted to identify factors associated with positive cultures for MDR/ESBL pathogens in hospitalized patients with suspected healthcare-associated pneumonia.
Of the 246 patients, 103 patients (41%) received meropenem. Among patients prescribed meropenem, MDR/ESBL pathogens were detected in only 20 patients (13%). Patients admitted from a skilled nursing facility/long-term acute care (SNF/LTAC) or with a history of a positive culture for MDR/ESBL pathogens were significantly associated with positive cultures of MDR/ESBL pathogens during the hospitalization (odds ratio [95% confidence intervals], 31.40 [5.20–189.6] in SNF/LTAC and 18.50 [2.98–115.1] in history of culture-positive MDR/ESBL pathogen). There was no significant difference in mortality between the 3 antibiotic groups.
Admission from a SNF/LTAC or having a history of cultures positive for MDR/ESBL pathogens were significantly associated with a positive culture for MDR/ESBL pathogens during the subsequent admission. We did not detect significant association between meropenem use as a first-line drug and morbidity and mortality for patients admitted to the hospital with suspected healthcare-associated pneumonia, and further prospective studies with larger sample size are needed to confirm our findings.
Has the COVID-19 pandemic influenced the oral health and nutritional status of elderly patients with digestive cancer?
Authors: Matsuda Shinpei , Yoshida Hisato , Yoshimura Hitoshi , Goi Takanori , Yoshida Yoshio , Iwasaki Hiromichi 
Published: October 2021

Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected various aspects, including socioeconomic status and health. This retrospective study aimed to investigate the influence of the COVID-19 pandemic on oral health based on the number of teeth that contribute to mastication, and the nutritional status of elderly patients with digestive cancers.
The authors defined the before and during COVID-19 periods in this study as January 2019 to December 2019 and January 2020 to December 2020, respectively. Patients with digestive cancer who underwent general, laboratory, and orthopantomograph examinations for preoperative oral health assessment before general anesthesia participated in this study. The authors investigated the following general characteristics: (1) sex, (2) age, and (3) the organ affected by disease and scheduled for surgery under general anesthesia. The authors collected information about (4) the number of teeth that could contribute to mastication as a clinical oral health parameter. The parameters: (5) body mass index, (6) serum total protein levels, and (7) serum albumin levels were used to indicate the nutritional status.
A total of 233 elderly patients with digestive cancer participated in this study. There was no significant difference between the age of the patients with digestive cancer. There was also no significant difference in the number of teeth that could contribute to mastication. Additionally, there was no significant difference in nutritional status as indicated by the body mass index, serum total protein levels, and serum albumin levels.
This study showed that the COVID-19 pandemic during 2020 did not have a significant influence on the oral health and nutritional status of elderly patients with digestive cancer. However, the influence of COVID-19 on community oral health may become apparent in the future. Thus, dental professionals should continue further research regarding the effects of COVID-19 on oral health.
The association between lesion tracer uptake on 68Ga-DOTATATE PET with morphological response to 177Lu-DOTATATE therapy in patients with progressive metastatic neuroendocrine tumors
Authors: Metser Ur , Eshet Yael , Ortega Claudia , Veit-Haibach Patrick , Liu Amy , K.S. Wong Rebecca 
Published: October 2021

Purpose
To determine in a group of patients with progressive metastatic neuroendocrine tumors (PM-NETs) treated with 177Lu-DOTATATE whether a correlation exists between somatostatin receptor (SSTR)-2 expression in various tumors on baseline 68Ga-DOTATATE PET and their response to therapy. A secondary aim was to determine whether an association exists between tumor product of diameter (POD) and PET-derived Krenning score.

Materials & methods
Patients treated PM-NETs who had SSTR-2 overexpression (SSTR-RADS 5) on screening 68Ga-DOTATATE PET and CT at baseline and 3 months after therapy completion were included. Marker lesions on baseline CT were reassessed on CT after therapy using adapted Southwest Oncology Group solid tumor evaluation criteria. For each lesion, bidimensional diameter on CT and SSTR expression on PET (SSTR-RADS uptake score & PET-derived Krenning score) were recorded. Logistic regression models fitted through generalized estimating equations were used to assess for an association between SSTR expression and response to therapy, or lesion’s POD.

Results
Forty-one patients with SSTR-RADS 5 PM-NETs treated with 177Lu-DOTATATE were included. There were 135 marker lesions (mean 3.2 lesions/patient) with Krenning score of 4 (n = 74), 3 (n = 44) or 2 (n = 17). There was no association found between SSTR-2 expression, as determined by SSTR-RADS uptake score or PET-derived Krenning score, and POD or response to therapy.

Conclusion
In patients with SSTR-RADS 5 PM-NETs treated with 177Lu-DOTATATE, there was similar response to therapy for all lesions with PET-generated Krenning score ≥2. No correlation was found between lesion’s POD and level of tracer uptake.
Management of familial hypercholesterolemia in pregnancy
Authors: Graham Dorothy F. , Raal Frederick J. 
Published: October 2021

Purpose of review
To highlight quandaries and review options for the management of familial hypercholesterolemia (FH) during pregnancy.

Recent findings
Women with FH face barriers to effective care and consequently face significant disease related long term morbidity and mortality.
Pregnancy includes major maternal physiological changes resulting in exacerbation of maternal hypercholesterolemia compounded by the current practice of cessation or reduction in the dose of lipid-lowering therapy during pregnancy and lactation that may impact short and long term cardiac morbidity and mortality. Although lipoprotein apheresis is the treatment of choice for high- risk FH patients, reassuring safety evidence for the use of statins during pregnancy is mounting rapidly. However, it will be some time before subtle effects on the development of the offspring can be definitively excluded. Women with homozygous FH or with an established atherosclerotic vessel or aortic disease should be offered therapy with statins during pregnancy if lipoprotein apheresis is not readily available. Pregnancy outcomes tend to be favourable in women with FH. We have reviewed the currently available evidence regarding the risks and benefits of treatment options for FH during pregnancy.
Implementing regulations and policies for uterus transplantation
Authors: Johnson Nicole , Wall Anji , Johannesson Liza 
Published: October 2021

Purpose of review
Policy development for uterus transplantation (UTx) is in its infancy. Understanding current oversight of UTx programmes can inform further development.

Recent findings
Currently, the United States has the most comprehensive regulations for UTx. Much of the policy outside the USA is focused on candidate selection. In the USA, UTx is categorized as, and follows policies of, a vascular composite allograft. Some considerations for UTx have not yet been addressed in policy, including the need for candidates to have a viable embryo before listing and transplantation, additional factors that may be warranted in organ allocation and the need to report data on the infant as well as the recipient.

Summary
Oversight of UTx falls within the governance of solid organ transplantation with unique aspects to be considered. Guidelines for multidisciplinary care, transplant-focused infrastructure and defined outcome metrics found in other solid organ transplant programmes provide a useful framework for UTx programmes.
Neonatal PT Improves Neurobehavior and General Movements in Moderate to Late Preterm Infants Born in India: An RCT
Authors: Khurana Sonia , Rao Bhamini Krishna , Lewis Leslie E. , Kumaran Senthil D , Kamath Asha , Einspieler Christa , Dusing Stacey C. 
Published: October 2021

Purpose:
To examine whether a structured neonatal physical therapy program (SNP) improves neurobehavior and general movements in moderate to late preterm (MLP) infants.

Methods:
Sixty MLP infants participated in this clinical trial. After baseline assessment using the Neurobehavioral Assessment of Preterm Infant (NAPI) and Prechtl General Movements (GMs) Assessment, infants were randomly allocated to a usual care (n = 30) or an SNP group (n = 30) and continued receiving usual care. The SNP group received intervention for 90 minutes/day, 6 days/week until discharge. Changes in neurobehavior and GMs were assessed at hospital discharge.

Results:
Changes in scores on scarf sign and motor development and vigor clusters of NAPI document an improvement in the SNP group. The proportion of infants with poor repertoire GMs also decreased more in the SNP group than in the usual care group.

Conclusion:
The SNP may be effective in improving some aspects of neurobehavior and quality of GMs in MLP infants.

What this adds to the evidence:
The addition of a structured neonatal physical therapy program to usual care can promote neurobehavioral organization and improve the quality of general movements in moderate and late preterm infants in India.
Oncological Safety and Potential Cost Savings of Routine vs Selective Histopathological Examination After Appendectomy
Authors: Bastiaenen Vivian P. , de Jonge Joske , Corten Bartholomeus J.G.A. , de Savornin Lohman Elise A.J. , Kraima Anne C. , Swank Hilko A. , van Vliet Jaap L.P. , van Acker Gijs J.D. , van Geloven Anna A.W. , in ‘t Hof Klaas H. , Koens Lianne , de Reuver Philip R. , van Rossem Charles C. , Slooter Gerrit D. , Tanis Pieter J. , Terpstra Valeska , Dijkgraaf Marcel G.W. , Bemelman Willem A. ,   for the Dutch Snapshot Research Group
Published: October 2021

Objective:
To investigate the oncological safety and potential cost savings of selective histopathological examination after appendectomy.

Background:
The necessity of routine histopathological examination after appendectomy has been questioned, but prospective studies investigating the safety of a selective policy are lacking.

Methods:
In this multicenter, prospective, cross-sectional study, inspection and palpation of the (meso)appendix was performed by the surgeon in patients with suspected appendicitis. The surgeon's opinion on additional value of histopathological examination was reported before sending all specimens to the pathologist. Main outcomes were the number of hypothetically missed appendiceal neoplasms with clinical consequences benefiting the patient (upper limit two-sided 95% confidence interval below 3:1000 considered oncologically safe) and potential cost savings after selective histopathological examination.

Results:
Seven thousand three hundred thirty-nine patients were included. After a selective policy, 4966/7339 (67.7%) specimens would have been refrained from histopathological examination. Appendiceal neoplasms with clinical consequences would have been missed in 22/4966 patients. In 5/22, residual disease was completely resected during additional surgery. Hence, an appendiceal neoplasm with clinical consequences benefiting the patient would have been missed in 1.01:1000 patients (upper limit 95% confidence interval 1.61:1000). In contrast, twice as many patients (10/22) would not have been exposed to potential harm due to re-resections without clear benefit, whereas consequences were neither beneficial nor harmful in the remaining seven. Estimated cost savings established by replacing routine for selective histopathological examination were €725,400 per 10,000 patients.

Conclusions:
Selective histopathological examination after appendectomy for suspected appendicitis is oncologically safe and will likely result in a reduction of pathologists' workload, less costs, and fewer re-resections without clear benefit.
The association between personality traits and hoarding behaviors
Authors: Dozier Mary E. , DeShong Hilary L. 
Published: October 2021

Purpose of review
Hoarding is a behavior that occurs across a variety of disorders, including hoarding disorder, obsessive-compulsive disorder (OCD), and schizophrenia. Hoarding is also a normative human behavior within certain contexts, including the recent coronavirus disease 2019 pandemic, when individuals became panicked about the availability of products such as toilet paper and antibacterial wipes. Previous research suggests that personality traits and personality disorder symptoms may be linked with hoarding behaviors. The purpose of this review is to provide a snapshot of recent research on hoarding and personality.

Recent findings
Most recent research on this topic has focused on hoarding behaviors as the action of stockpiling goods during a pandemic. Research on this area was mixed with regard to extraversion and openness but was strongly suggestive of a link between stockpiling behaviors and increased neuroticism. Hoarding in the context of OCD was linked with lower levels of both extraversion and conscientiousness. Patients with hoarding disorder almost universally have clinically elevated levels of personality disorder traits.

Summary
The directions of observed associations between five-factor model personality traits and hoarding behaviors differ across diagnostic and geographic contexts. Additional research is needed with participants who meet diagnostic criteria for hoarding disorder.
Minimal exposures reveal visual processing priorities
Authors: Lanfranco Renzo C. , Canales-Johnson Andrés , Rabagliati Hugh , Cleeremans Axel , Carmel David 
Published: October 2021

ABSTRACTHuman vision can detect a single photon, but the minimal exposure required to extract meaning from stimulation remains unknown. This requirement cannot be cha racterised by stimulus energy, because the system is differentially sensitive to attributes defined by configuration rather than physical amplitude. Determining minimal exposure durations required for processing various stimulus attributes can thus reveal the system’s priorities. Using a tachistoscope enabling arbitrarily brief displays, we established minimal durations for processing human faces, a stimulus category whose perception is associated with several well-characterised behavioural and neural markers. Neural and psychophysical measures showed a sequence of distinct minimal exposures for stimulation detection, object-level detection, face-specific processing, and emotion-specific processing. Resolving ongoing debates, face orientation affected minimal exposure but emotional expression did not. Awareness emerged with detection, showing no evidence of subliminal perception. These findings inform theories of visual processing and awareness, elucidating the information to which the visual system is attuned.
The matrisome contributes to the increased rigidity of the bovine ovarian cortex and provides a source of new bioengineering tools to investigate ovarian biology
Authors: Henning Nathaniel F.C. , Laronda Monica M. 
Published: October 2021

ABSTRACTThe gonadotoxic effects of some cancers significantly increase the risk of developing infertility and cessation of ovary hormones (premature ovarian insufficiency, POI). Fertility preservation in the form of ovarian tissue cryopreservation (OTC) is offered to pediatric and adolescent cancer patients who cannot undergo oocyte retrieval and egg cryopreservation. The cryopreserved ovarian tissue can be transplanted back and has been found to restore fertility in 20 - 40% of transplants and restore hormone function for an average of 3 to 5 years. However, some individuals have primary or metastatic disease within their ovarian tissue and would not be able to transplant it back in its native form. Therefore, there is a need for additional methods for hormone and fertility restoration that would support a safe transplant with increased successful livebirths and long-term hormone restoration. To support these goal, we sought to understand the contribution of the ovarian microenvironment to its physical and biochemical properties to inform bioprosthetic ovary scaffolds that would support isolated follicles. Using atomic force microscopy (AFM), we determined that the bovine ovarian cortex was significantly more rigid than the medulla. To determine if this difference in rigidity was maintained in isolated matrisome proteins from bovine ovarian compartments, we cast and 3D printed hydrogels created from decellularized bovine ovarian cortex and medulla slices. The cast gels and 3D printed bioprosthetic ovary scaffolds from the cortex was still significantly more rigid than the medulla biomaterials. To expand our bioengineering toolbox that will aide in the investigation of how biochemical and physical cues may affect folliculogenesis, we sought to confirm the concentration of matrisome proteins in bovine ovarian compartments. The matrisome proteins, COL1, FN, EMILIN1 and AGRN were more abundant in the bovine ovarian cortex than the medulla. Whereas, VTN was more abundant in the medulla than the cortex and COL4 was present in similar amounts within both compartments. Finally, we removed proteins of interest, EMILIN1 and AGRN, from decellularized bovine ovarian cortex materials and confirmed that this specifically depleted these proteins without affecting the rigidity of cast or 3D printed hydrogels. Taken together our results indicate the existence of a rigidity gradient in the bovine ovary, that this rigidity gradient is maintained in resulting engineered materials strongly implicating a role for matrisome proteins in contributing to the physical properties of the bovine ovary. By establishing additional engineering tools we will continue to explore mechanisms behind matrisome-follicle interactions.
Dependence of Heart Rate Variability on Immersion in a Virtual Game and Change of Visual Content in the Flow of Virtual Reality
Authors: Pyatin Vasily , Videnin Arseny , Maslova Olga , Chaplygin Sergei , Rovnov Sergey 
Published: October 2021

ABSTRACTA modern person constantly changes the environment of his mental activity, moving real into an immersive environment, for example, from the surrounding reality to the information environment of a smartphone and back. This kind of transition is needed to satisfy many of the cognitive and emotional needs of people. The transition from a real physical environment to virtual reality (VR) with the help of a special headset, for example, the Oculus Rift or HTC vive, occurs less often, causing less frequent emotional state. If at the same time the emotional state of a person is investigated, then, as a rule, the manifestation of heart rate variability (HRV) is used as an indicator. However, there are relatively few studies in the literature on physiological responses using HRV during the perception of VR content. The results of such studies are extrapolated to data evoked in HRV manifestations by stimuli of real and virtual environments. We studied HRV in 55 participants while they were in the flow of VR content of different dynamics. The results were analyzed by statistically testing the hypothesis of the effect of VR immersion and the effect of transitions between realities on HRV manifestations, as well as the effect of VR flow dynamics on HRV. The results showed that the perception of the VR flow and the content transitions made in it determine the change in HRV in the form of such parameters as LF and the Baevsky Index, which can be considered as markers of immersion in VR. An increase in emotional arousal with sequential participation in virtual games in one virtual stream determines the manifestations of HRV - HR, Moda and PAR.The results contribute to understanding the possibilities of using VR technology to recognize emotions during the transition between the natural environment and VR, as well as to determine the level of emotional arousal when immersed in the changing flow of virtual content. These studies are important for the study of the psychology of emotions in the VR flow paradigm.