bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and facilitators to influenza and pneumococcal vaccine hesitancy in rheumatoid arthritis: a qualitative study
Authors: Colmegna Inés , Valerio Valeria , Gosselin-Boucher Vincent , Lacoste Guillaume , Labbe Sara , Lavoie Kim L , Hazel Elizabeth , Ward Brian , Hudson Marie , Peláez Sandra 
Published: June 2021

AbstractObjectivesImmunization is an essential component of RA care. Nevertheless, vaccine coverage in RA is suboptimal. Contextual, individual and vaccine-related factors influence vaccine acceptance. However, barriers and facilitators of vaccination in RA are not well defined. The aim of this study was to assess perspectives of RA patients and healthcare professionals (HCPs) involved in RA care of barriers and facilitators regarding influenza and pneumococcal vaccines.MethodsEight focus groups (four with RA patients and four with HCPs) and eight semi-structured open-ended individual interviews with vaccine-hesitant RA patients were conducted. Data were audio recorded, transcribed verbatim and imported to MAXQDA software. Analysis using the framework of vaccine hesitancy proposed by the Strategic Advisory Group of Experts on Immunization was conducted.ResultsRA patients and HCPs reported common and specific barriers and facilitators to influenza vaccination that included contextual, individual and/or group and vaccine- and/or vaccination-specific factors. A key contextual influence on vaccination was patients’ perception of the media, pharmaceutical industry, authorities, scientists and the medical community at large. Among the individual-related influences, experiences with vaccination, knowledge/awareness and beliefs about health and disease prevention were considered to impact vaccine acceptance. Vaccine-related factors including concerns about vaccine side effects such as RA flares, the safety of new formulations, the mechanism of action, access to vaccines and costs associated with vaccination were identified as actionable barriers.ConclusionAcknowledging RA patients’ perceived barriers to influenza and pneumococcal vaccination and implementing specific strategies to address them might increase vaccination coverage in this population.
Maternal sensitivity and infant neural response to touch: an fNIRS study
Authors: Mateus Vera , Osório Ana , Miguel Helga O , Cruz Sara , Sampaio Adriana 
Published: June 2021

AbstractThe mother’s attunement to her infant’s emotional needs influences her use of touching behaviors during mother–infant interactions. Moreover, maternal touch appears to modulate infants’ physiological responses to affective touch. However, little is known about the impact of maternal sensitivity on infants’ touch processing at a brain level. This study explored the association between maternal sensitivity when infants (N = 24) were 7 months old and their patterns of cortical activation to touch at 12 months. Brain activation was measured using functional near-infrared spectroscopy. Changes in oxy-hemoglobin (HbO2) and deoxy-hemoglobin (HHb) concentrations were measured in the left somatosensory cortex and right temporal cortex while infants received two types of tactile stimulation—affective and discriminative touch. Results showed that a lower maternal sensitivity was associated with a higher HbO2 response for discriminative touch over the temporal region. Additionally, infants of less sensitive mothers tended to present a higher response in HbO2 for affective touch over the somatosensory region. These findings suggest that less sensitive interactions might result in a lower exposure to maternal touch, which can be further related to infants’ neural processing of touch.
Paraquat but not diquat induces TGF-β expression and thus activates calcium-NFAT axis for epithelial–mesenchymal transition
Authors: Yang Wenyu , Ma Xinrun , Zhu Yong , Meng Xiaoxiao , Tian Rui , Yang Zhengfeng 
Published: June 2021

Abstract
Paraquat (PQ) and diquat (DQ), two highly efficient herbicides sharing similar chemical backbone, both induce reactive oxygen species and are highly toxic to humans and livestock, however, PQ but not DQ poisoning result in pulmonary fibrosis, the leading cause of high mortality rate in patients suffering PQ toxicity. Understanding the unique mechanism of PQ different from DQ therefore would provide potential strategies to reduce PQ-induced pulmonary fibrosis. Here, we identified that PQ but not DQ continuously upregulates TGF-β expression in alveolar type II (AT II) cells. Importantly, such high expression of TGF-β increases cytosolic calcium levels and further promotes the activation of calcineurin-NFAT axis. TGF-β mainly activates NFATc1 and NFATc2, but not NFATc3 or NFATc4. Administration of the inhibitors targeting cytosolic calcium or calcineurin largely reverses PQ-induced epithelial–mesenchymal transition (EMT), whereas DQ has little effects on activation of NFAT and EMT. Ultimately, PQ poisoned patients exhibit significantly reduced blood calcium levels compared to DQ poisoning, possibly via the large usage of calcium by AT II cells. All in all, we found a vicious cycle that the upregulated TGF-β in PQ-induced EMT further aggravates EMT via promotion of the calcium–calcineurin axis, which could be potential drug targets for treating PQ-induced pulmonary fibrosis.
A Core Outcome Set for Research in Patients on Extracorporeal Membrane Oxygenation
Authors: Hodgson Carol L. , Fulcher Bentley , Mariajoseph Frederick P. , Burrell Aidan J. C. , Pellegrino Vincent , Brodie Daniel , Fan Eddy 
Published: June 2021

OBJECTIVES:
A core set of outcomes have been identified and published, which are essential to include in all clinical research evaluating the use of extracorporeal membrane oxygenation in critically ill patients, particularly regarding safety and adverse events. The purpose of this international modified Delphi study was to determine which measurement tools and the timing of measurement should be selected for the core outcome set for research evaluating patients receiving extracorporeal membrane oxygenation.

DESIGN:
This was a two-round international, multidisciplinary web-based, modified Delphi study.

PATIENTS:
Participants were identified from the International Extracorporeal Membrane Oxygenation Network and the Extracorporeal Life Support Organization, including consumers, multidisciplinary clinicians, researchers and industry partners.

MEASUREMENTS:
Measurement tools and the timing of measurement were identified from a systematic review of the literature and clinical trials registrations. The primary outcome was the percentage of respondents who completed each survey and indicated that a measurement tool as well as the timing of the measurement should “always” be included in a core outcome set.

MAIN RESULTS:
Participant response rates were 46 of 65 (71%) and 40 of 46 (87%) for rounds one and two, respectively, with participants representing, researchers, consumers, and industry partners from 15 countries over five continents. Seven measurement tools were identified for the core outcome set of patients on extracorporeal membrane oxygenation.

CONCLUSIONS:
This study has identified appropriate measurement instruments and the timing of measurement to include in the core outcome set for research evaluating patients receiving extracorporeal membrane oxygenation. This was an important final step to standardize and synthesize research efforts internationally.
Transient Cardiac Injury in Adolescents Receiving the BNT162b2 mRNA COVID-19 Vaccine
Authors: Snapiri Ori , Rosenberg Danziger Chen , Shirman Nina , Weissbach Avichai , Lowenthal Alexander , Ayalon Itay , Adam Dganit , Yarden-Bilavsky Havatzelet , Bilavsky Efraim 
Published: June 2021

Background:
Vaccines are paramount in the effort to end the coronavirus disease 2019 global epidemic. BNT162b2 is approved for the vaccination of adolescents over 16 years of age. Systemic adverse events were scarce though the pretested cohort of this age group was relatively small. The aim of the current study is to raise awareness for potential adverse reactions.

Methods:
This is a case series of patients diagnosed with perimyocarditis following vaccination. Patients were compiled from 3 pediatric medical centers in Israel through a network of pediatricians and data regarding those cases was collected. In addition, incidence of perimyocarditis during the vaccination period was compared with previous years.

Results:
All patients were males 16–18 years old, of Jewish descent, who presented with chest pain that began 1–3 days following vaccination (mean, 2.1 days). In 6 of the 7 patients, symptoms began following the 2nd dose and in 1 patient following the 1st dose. All cases were mild and none required cardiovascular or respiratory support. The incidence of perimyocarditis during the vaccination period was elevated in comparison to previous years.

Conclusions:
This case series describes a time association between coronavirus disease 2019 vaccine and perimyocarditis in adolescents. All cases were mild, although only long-term follow-up can reveal the true impact of this cardiac injury. While it seems that the incidence of perimyocarditis during the vaccination campaign period is increased, a more comprehensive data collection on a wider scale should be done. We hope this report will serve as a reminder to report events and allow for analysis of potential adverse reactions.
Comparison of effective corneal refractive centration to the visual axis: LASIK vs SMILE, a contralateral eye digitized comparison of the postoperative result
Authors: Vingopoulos Filippos , Zisimopoulos Athanasios , Kanellopoulos Anastasios John 
Published: June 2021

Purpose:
To define and compare the centration of the ablation effect in laser in situ keratomileusis (LASIK) with the corresponding effect in small-incision lenticule extraction (SMILE), in myopic laser vision correction to possibly explain the refractive performance differences noted between the two procedures in a contralateral eye study.

Setting:
Private ambulatory eye surgery unit.

Design:
Prospective randomized contralateral eye study.

Methods:
In 22 consecutive patients (44 eyes), 1 eye was prospectively randomized to undergo myopic topography-guided LASIK treatment and the contralateral eye to undergo SMILE; digital image analysis of the achieved centration to the aimed corneal vertex was assessed for both procedures on perioperative Scheimpflug tangential curvature maps, using a proprietary digitized methodology.

Results:
The radial displacement measured in micrometers in the above treated 44 eyes, between the attempted centration point on the corneal vertex vs the center of the measured effective anterior corneal curvature flattening was on average 130 ± 62 mm in the 22 eyes of LASIK group and 313 ± 144 mm in the 22 contralateral eyes of the SMILE group (P < .001).

Conclusions:
In this contralateral eye study, topography-guided myopic LASIK was found to achieve significantly better effective centration compared with myopic SMILE, in regard to digitally measured decentration of the effective refractive change achieved in the anterior corneal curvature from the corneal vertex. This may explain the previously reported superior visual outcomes in the LASIK group eyes when compared with the contralateral SMILE group eyes.
Color LED reflection topography: validation of equivalent keratometry reading for IOL power calculation in eyes with previous corneal myopic refractive surgery
Authors: Fernández-Rosés Joaquim , Lamarca José , Hoffer Kenneth J. , Beltrán-Saiz Antonio , Barraquer Rafael I. , Savini Giacomo 
Published: June 2021

Purpose:
To compare the accuracy of the equivalent keratometry reading (EKR) from a color LED corneal topographer (Cassini) with that of other no-history formulas for intraocular lens (IOL) power calculation in eyes with previous myopic excimer laser surgery.

Setting:
Centro de Oftalmología Barraquer, Barcelona, Spain.

Design:
Retrospective case series.

Methods:
The refractive outcomes of the Cassini EKR entered into the Haigis formula were compared with those of the Barrett True-K, Haigis-L, and Shammas-PL formulas and the Triple-S method combined with the Haigis formula. Optimized lens constants for virgin eyes were used. The mean prediction error (PE), the median absolute error (MedAE), and the percentage of eyes with a PE within ±0.25 diopter (D), ±0.50 D, ±0.75 D, and ±1.00 D were calculated.

Results:
The study comprised 37 patients (37 eyes). The Haigis-L, Shammas-PL, and Barrett True-K no-history methods produced a myopic mean PE that was significantly different from zero (P < .001, P < .001 and P = .004, respectively), whereas the mean PEs of Cassini EKR and the Triple-S combined with the Haigis formula were not different from zero (P > .05). Repeated-measures analysis of variance disclosed a significant difference among the PE of all methods (P < .0001). The MedAE of the Cassini EKR, Barrett True-K, Haigis-L, Shammas-PL, and Triple-S was, respectively, 0.34 D, 0.34 D, 0.49 D, 0.48 D, and 0.31 D (P = .0026).

Conclusions:
The performance of the combination of standard Haigis formula with Cassini EKR was comparable to other no-history formulas in eyes with previous myopic excimer laser surgery.
Cognitive therapy, mindfulness-based stress reduction, and behavior therapy for the treatment of chronic pain: randomized controlled trial
Authors: Burns John W. , Jensen Mark P. , Thorn Beverly , Lillis Teresa A. , Carmody James , Newman Andrea K. , Keefe Francis 
Published: June 2021

Abstract
Trials of cognitive therapy (CT), mindfulness-based stress reduction (MBSR), and behavior therapy (BT) suggest that all 3 treatments produce reductions in pain and improvements in physical function, mood, and sleep disturbance in people with chronic pain conditions. Fewer studies have compared the relative efficacies of these treatments. In this randomized controlled study, we compared CT, MBSR, BT, and treatment as usual (TAU) in a sample of people with chronic low back pain (N = 521). Eight individual sessions were administered with weekly assessments of outcomes. Consistent with the prior work, we found that CT, MBSR, and BT produced similar pretreatment to posttreatment effects on all outcomes and revealed similar levels of maintenance of treatment gains at 6-month follow-up. All 3 active treatments produced greater improvements than TAU. Weekly assessments allowed us to assess rates of change; ie, how quickly a given treatment produced significant differences, compared with TAU, on a given outcome. The 3 treatments differed significantly from TAU on average by session 6, and this rate of treatment effect was consistent across all treatments. Results suggest the possibility that the specific techniques included in CT, MBSR, and BT may be less important for producing benefits than people participating in any techniques rooted in these evidence-based psychosocial treatments for chronic pain.
Pain by mistake: investigating a link between error-related negativity and pain avoidance behavior
Authors: Traxler Juliane , von Leupoldt Andreas , Vlaeyen Johan W.S. 
Published: June 2021

Abstract
Pain can be considered as a signal of “bodily error”: errors put organisms at danger and activate behavioral defensive systems. If the error is of physical nature, pain is the warning signal that motivates protective action such as avoidance behavior to safeguard our body's integrity. Interestingly, an important component of neural error processing, the error-related negativity (ERN), has been found to be related to avoidance in anxiety disorders. The present study is the first to extend these findings to pain and investigate the relationship between ERN and pain-related avoidance behavior. It was hypothesized that individuals with larger ERN amplitudes would show more pain-related avoidance behavior and would be more persistent in their avoidance despite changes in the environment. Fifty-three healthy individuals performed the Eriksen flanker task during which their brain activity on correct and erroneous motor responses was recorded by means of high-density electroencephalography. Avoidance behavior was assessed with an arm reaching task using the HapticMaster robot arm. The results showed that, in contrast to our hypothesis, avoidance was not related to ERN amplitudes. Surprisingly, persons with elevated ERN amplitudes showed low levels of avoidance specifically during early acquisition trials. In contrast to earlier findings in anxiety disorders, individuals with elevated ERN amplitudes did not engage in more pain-related avoidance behavior. In fact, the opposite pattern was found at the start of acquisition: individuals with higher compared with lower ERN amplitudes were slower in learning to avoid pain. Replications and future studies on the relationship between ERN and avoidance behavior are needed.
The causal-effect of bed rest and post-dural puncture headache in patients receiving diagnostic lumbar puncture: A prospective cohort study
Authors: Tai Chien-Shu , Wu Shang-Liang , Lin Shao-Yu , Liang Ying , Wang Shuu-Jiun , Chen Shih-Pin 
Published: June 2021

Background:
Post-dural puncture headache (PDPH) is the most common complication of lumbar puncture. Patients who received lumbar puncture were previously suggested to remain in bed for a certain time to prevent PDPH; however, this concept was challenged by recent studies. We aimed to investigate whether ambulation instead of resting supine following lumbar puncture could increase the risk of PDPH.

Methods:
The study used a prospective cohort design, applying convenience sampling among patients who received diagnostic lumbar puncture between January and September 2018 in the neurology ward of a tertiary medical center. The patients who fulfilled the inclusion criteria were informed that the current practice suggests lying supine for 6 to 8 hours after lumbar puncture, but they were allowed to either follow the suggestion or ambulate by their wills. The timing of bed rest was recorded, in addition to other possible risk factors of PDPH. The study endpoint is the presence or absence of PDPH within 48 hours of lumbar puncture.

Results:
A total of 137 patients who received lumbar puncture were enrolled, including 103 with bed rest following lumbar puncture and 34 without. There was no difference in demographics between the two groups. PDPH was found in 21 patients, with a total follow-up period of 5959 person-hours and an incidence density of 0.35%. There was no significant difference between the incidence of PDPH between the two groups (non-bed rest group 5.9% vs bed rest group 18.4%; p = 0.078), nor was incidence density (non-bed rest group 0.13% vs bed rest group 0.43%, p = 0.113). The results remained the same after adjusting for age.

Conclusion:
Bed rest following lumbar puncture does not prevent PDPH, and even leads to a marginally increased risk of PDPH. Amendment to the current practice guideline post-lumbar puncture care might be needed to improve patient care.
Health care costs associated with primary care physicians versus nurse practitioners and physician assistants
Authors: Rajan Suja S. , Akeroyd Julia M. , Ahmed Sarah T. , Ramsey David J. , Ballantyne Christie M. , Petersen Laura A. , Virani Salim S. 
Published: June 2021

ABSTRACT

Background:
Significant primary care provider (PCP) shortage exists in the United States. Expanding the scope of practice for nurse practitioners (NPs) and physician assistants (PAs) can help alleviate this shortage. The Department of Veterans' Affairs (VA) has been a pioneer in expanding the role of NPs and PAs in primary caregiving.

Purpose:
This study evaluated the health care costs associated with VA patients cared for by NPs and PAs versus primary care physicians (physicians).

Methods:
A retrospective data analysis using two separate cohorts of VA patients, one with diabetes and the other with cardiovascular disease (CVD), was performed. The associations between PCP type and health care costs were analyzed using ordinary least square regressions with logarithmically transformed costs.

Results:
The analyses estimated 12% to 13% (US dollars [USD] 2,626) and 4% to 5% (USD 924) higher costs for patients assigned to physicians as compared with those assigned to NPs and PAs, after adjusting for baseline patient sociodemographics and disease burden, in the diabetes and CVD cohort, respectively. Given the average patient population size of a VA medical center, these cost differences amount to a total difference of USD 14 million/year per center and USD 5 million/year per center for diabetic and CVD patients, respectively.

Implications for practice:
This study highlights the potential cost savings associated with primary caregiving by NPs and PAs. In light of the PCP shortage, the study supports increased involvement of NPs and PAs in primary caregiving. Future studies examining the reasons for these cost differences by provider type are required to provide more scientific evidence for regulatory decision making in this area.
Rates of revascularization and PCI:CABG ratio: a new indicator predicting in-hospital mortality in acute coronary syndromes
Authors: Klein Lloyd W. , Abugroun Ashraf , Daoud Hussein 
Published: June 2021

Objective
The principal trend in acute coronary syndrome (ACS) is increasing utilization of percutaneous coronary interventions (PCI) and declining coronary artery bypass graft surgery (CABG) utilization. This study was designed to evaluate whether higher PCI:CABG ratios lead to higher in-hospital PCI or CABG mortality.

Methods
The National Readmission Database for years 2016 was queried for all hospitalized ACS patients who underwent coronary revascularization during their admission. The study population was derived from 355 US hospitals and included 103 021 patients. Hospitals were grouped based on their PCI:CABG ratio into low, intermediate, and high ratio quartiles with a median [interquartile ranges (IQR)] PCI:CABG ratio of 2.9 (2.5–3.2), 5.0 (4.3–5.9) and 8.9 (7.8–10.3), respectively multivariable logistic regression with adjustment for age, demographics and comorbidities were used to identify CABG:PCI ratio related risk for in-hospital CABG and PCI mortality.

Results
Higher PCI:CABG ratios correlated with an increased CABG mortality. There was a median (IQR) mortality of 2.5% (1.6–4.3) in the low ratio quartile; 3.1% (1.9–5.3) in the intermediate quartiles; and 5.3% (3.2–9.1) in the high ratio quartile (P < 0.001). On multivariate analysis, the PCI:CABG ratio was associated with an increased risk for CABG mortality with an adjusted odds ratio of 1.38 (95% CI, 1.14–1.67, P < 0.001) and 2.17 (95% CI, 1.70–2.80, P < 0.001) for hospitals with intermediate and high PCI:CABG ratios, respectively. There was no significant association between PCI:CABG ratio and PCI mortality.

Conclusions
The programmatic PCI:CABG ratio is a valid indicator of optimal case selection. The PCI:CABG ratio correlates with in-hospital mortality in ACS.