bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combination Therapy of Long-Acting Injectable Second-Generation Antipsychotics and Oral Antipsychotics
Authors: Misawa Fuminari , Amemiya Ami , Fujii Yasuo , Takeuchi Hiroyoshi 
Published: October 2021

Abstract

Background
Although long-acting injectable antipsychotics (LAI-APs) have been considered as a monotherapeutic option in the maintenance treatment of schizophrenia, it has been recently reported that the combination therapy of LAI-APs and oral antipsychotics (OAPs) is common.

Methods
We conducted a retrospective chart review to examine the situation of the combination therapy of LAI second-generation antipsychotics (LAI-SGAs) and OAPs, and a questionnaire survey to investigate prescribers’ attitudes toward the combination therapy. We included patients who received any LAI-SGAs for 1 month or longer and classified them into monotherapy and combination therapy groups. We collected information on age, sex, primary psychiatric diagnosis, and concomitant psychotropic medications.

Results
Of the 132 patients, 39 (29.5%) received the combination therapy of LAI-SGAs and OAPs. Long-acting injectable risperidone was significantly associated with receiving the combination therapy compared with LAI aripiprazole. Olanzapine was the most common OAP in combination with LAI-SGAs. Only 8 patients (20.5%) concurrently received the same type of OAPs as LAI-SGAs. More than 60% of the patients received OAP polypharmacy before the initiation of LAI-SGAs. The psychiatrists in charge prescribed LAI-SGAs mainly because of a concern about adherence, and OAPs mainly because of insufficient dose of LAI-SGAs, to patients in the combination therapy group. They estimated that adherence to OAPs in two thirds of the patients in the combination therapy group was 80% or higher.

Conclusions
The present study showed that the combination therapy of LAI-SGAs and OAPs is often conducted in real-world clinical practice. Considering the reason for the introduction of LAI-APs, clinicians should carefully monitor patients’ adherence to OAPs concurrently used with LAI-APs.
Home-Based Telework and Presenteeism
Authors: Gerich Joachim 
Published: October 2021

Objective:
Previous research found increased sickness presenteeism (working despite sickness) associated with home-based telework. The Covid-19 pandemic offers new insights into mechanisms, as a large proportion of the workforce was forced to work from home, irrespective of organizational and individual predispositions.

Methods:
A path analysis based on survey data from a sample of teleworkers collected during the Covid-crisis was performed.

Results:
We found no general relationship between telework and sickness presenteeism. However, employees with telework experience before the pandemic use telework more often for work intensification which is associated with increased sickness presenteeism. As teleworking before the pandemic is associated with indirect work control (goal-directed management), indirect effects of such work organizations on presenteeism were confirmed.

Conclusion:
As hypothesized in prior research, indirect work control may increase self-endangering behavior which is amplified by telework.
Is a Mechanical Rotational Chair Superior to Manual Treatment Maneuvers on an Examination Bed in the Treatment of Benign Paroxysmal Positional Vertigo?
Authors: Schuricht Alexander , Hougaard Dan Dupont 
Published: October 2021

Objective:
To compare the efficacy of the TRV-chair, a mechanical rotational chair, against manual treatment maneuvers in the treatment of benign paroxysmal positional vertigo (BPPV).

Study design:
Prospective open-label block-randomized controlled clinical trial.

Setting:
Tertiary referral center.

Subjects:
Seventy-four patients referred from primary care and subsequently diagnosed with BPPV.

Intervention(s):
Patients were randomized to diagnostics and treatment with either manual treatment maneuvers on an examination table or using the TRV-chair.

Main outcomes:
The primary outcome was treatment efficacy, defined as absence of positional nystagmus (with or without concomitant vertigo), following one treatment. Secondary outcomes were number of treatments necessary for treatment success and Dizziness Handicap Inventory (DHI) scores.

Results:
61.1% of the subjects in the TRV-group and 63.2% in the manual treatment group were treated successfully (p = 0.856). The differences in the number of treatments necessary to achieve treatment success as well as pre- and post-treatment DHI-scores between the TRV-group and the manual treatment group were nonsignificant.

Conclusions:
Traditional manual treatment maneuvers and treatment maneuvers performed with the TRV-chair are equally good at treating BPPV in patients referred directly from primary care.
Using 18F-flurodeoxyglucose and 68Ga-fibroblast activation protein inhibitor PET/CT to evaluate a new periprosthetic joint infection model of rabbit due to Staphylococcus aureus
Authors: Wang Yiqun , Liu Honghong , Yao Shulin , Guan Zhiwei , Li Qingxiao , Qi Erpeng , Li Xiang , Zhang Jinming , Tian Jiahe 
Published: October 2021

Purpose
The existing periprosthetic joint infection (PJI) models have obvious limitations, and studies of PJI on animal models using PET/computed tomography (CT) for diagnosis are still lacking. Thus, the aim of this study was to establish a new PJI model and 18F-fluorodeoxyglucose (FDG) and 68Ga-fibroblast activation protein inhibitor (FAPI) were employed to study their performance.

Methods
A novel PJI model of rabbit was developed by placing two screws in the tibia and femur. Based on bacteria concentration, the animals were divided into five groups, control, 104, 105, 106 and 107. 18F-FDG and 68Ga-FAPI PET/CT were performed continuously in next 2 weeks and maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic target volume (MTV) and total lesion glycolysis/total lesion fibrosis were calculated as the metrics.

Results
As for SUVmax, all data of 18F-FDG were larger than that of 68Ga-FAPI in the same group for both weeks. For the performance of 18F-FDG, no definitive conclusion could be drawn for SUVmax and SUVmean. As for 68Ga-FAPI, the 104 group was significantly larger than 105, 106 and 107 groups for SUVmax and SUVmean in both weeks (P < 0.05). MTV of 68Ga-FAPI was found to be almost always larger than that of 18F-FDG in the same group.

Conclusion
The mechanism of 68Ga-FAPI is totally different from 18F-FDG and this unique property of 68Ga-FAPI shows a promising prospect in detecting infection boundary and may even distinguish a small number or a large number of bacterial infections.
Outcomes of Pediatric Oncology Patients Admitted to An Intensive Care Unit in a Resource-limited Setting
Authors: Cawood Shannon , Bassingthwaighte Mairi , Naidu Gita , Murphy Susan 
Published: October 2021

Background:
Improved survival and intensified treatment protocols in pediatric oncology have resulted in an increased need for intensive care. However, in resource-constrained settings, the higher morbidity and mortality of these patients raises sensitive issues around the optimal use of limited critical care resources.

Methods:
Single-center, 10-year retrospective review of pediatric oncology patients admitted to the pediatric intensive care unit (PICU).

Results:
Of the 117 admissions, 70.1% had solid tumors, 61.5% were admitted electively, and 76.1% were admitted for noninfective indications. PICU mortality of oncology patients was 18.8% relative to the PICU mortality of all patients in the same period of 10.5%. In a multivariable analysis, factors shown to be independently associated with PICU mortality were infective indications for admission (relative risk=3.83, confidence interval: 1.16; 12.6, P=0.028) and vasoactive support (relative risk=7.50, confidence interval: 1.72; 32.8, P=0.0074).

Conclusion:
The increased mortality associated with sepsis, organ dysfunction and need for organ support underscores the need for earlier recognition of and intervention in pediatric oncology patients requiring intensive care. Further prospective studies are needed to identify the most critical areas for improvement in the referral of these children to PICU, to optimize care and improve outcomes.
Inpatient Rehabilitation Outcomes After Severe COVID-19 Infections
Authors: Abramoff Benjamin A. , Dillingham Timothy R. , Caldera Franklin E. , Ritchie Marylyn D. , Pezzin Liliana E. 
Published: October 2021

Objective
The aim of the study was to describe the characteristics and functional outcomes of patients undergoing acute inpatient rehabilitation after hospitalization for COVID-19.

Design
Using a retrospective chart review, patients were identified who were admitted to inpatient rehabilitation after COVID-19. Patient information collected included sociodemographic characteristics, comorbidities, length of stay, discharge disposition, self-care, mobility, and cognitive functioning. These patients were compared with patients (controls) without COVID-19 with similar impairment codes treated at the same facility before the COVID-19 pandemic.

Results
There were 43 patients who were admitted to the inpatient rehabilitation hospital after COVID-19 infection and 247 controls. Patients who had COVID-19 were significantly more likely to be African American and to have been admitted to a long-term acute care hospital. They also had a longer length of rehabilitation stay. The groups did not differ by age, sex, or insurance. Functionally, although presenting with significantly worse mobility, self-care, and motor scores, the patients previously infected with COVID-19 had similar functional outcomes at time of discharge to the control group.

Conclusions
Although patients with a history of COVID-19 had worse function at time of admission to acute rehabilitation, inpatient rehabilitation significantly improved their function to comparable levels as patients who did not have COVID-19.

To Claim CME Credits
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME

CME Objectives
Upon completion of this article, the reader should be able to: (1) Identify how characteristics of patients with COVID-19 admitted to acute rehabilitation differ from those with similar admission codes but without COVID-19; (2) Describe changes in functional measures at admission and discharge of COVID-19 patients compared with patients without COVID-19; and (3) Recognize how inpatient rehabilitation may help reduce inequities in outcomes after severe COVID-19 infection.

Level
Advanced

Accreditation
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Associations Between the Gut Microbiota and Internalizing Behaviors in Preschool Children
Authors: van de Wouw Marcel , Wang Yanan , Workentine Matthew L. , Vaghef-Mehrabani Elnaz , Dewey Deborah , Reimer Raylene A. , Tomfohr-Madsen Lianne , Giesbrecht Gerald F. 
Published: October 2021

ABSTRACT

Objective
Emerging evidence points toward a connection between mental health and the gut microbiota and its metabolites (e.g., short-chain fatty acids). It is unknown whether the gut microbiota is associated with the development of mental health problems (e.g., internalizing or externalizing behaviors) in preschool children. The objective of this study was to evaluate associations between the gut microbiota and internalizing and externalizing behaviors in preschool-aged children.

Methods
A community sample of 248 typically developing children (3–5 years of age) provided a stool sample for gut microbiota and SCFA analysis. Parents reported child internalizing and externalizing behaviors using the Child Behavior Checklist. Associations between child behaviors and gut microbiota measures were analyzed using Spearman correlations followed by an adjustment for multiple testing, with subanalysis conducted in children clinically “at risk” for behavioral problems compared with those who were not.

Results
There was a correlation between Shannon alpha diversity with internalizing behaviors (r
s = −0.134, p = .035) and its subscale somatic complaints (r
s = −0.144, p = .023). In addition, children clinically “at risk” for internalizing problems had decreased alpha diversity (U = 551, p = .017). Internalizing behaviors correlated with valerate and isobutyrate (r
s = −0.147, p = .021; r
s = −0.140, p = .028, respectively). Furthermore the somatic complaints subscale additionally correlated with acetate and butyrate (r
s = −0.219, p = .001; r
s = −0.241, p < .001, respectively). These findings were also present in children “at risk” for internalizing problems (U = 569, p = .026; U = 571, p = .028) and somatic complaints (U = 164, p = .004; U = 145, p = .001).

Conclusions
These analyses reveal novel associations between internalizing behaviors and the gut microbiota in preschool children. Furthermore, a relationship between somatic complaints and acetate and butyrate was identified, indicating that interventions that increase SCFA production warrant future investigation.
Evaluating the Costs of Nurse Burnout-Attributed Turnover: A Markov Modeling Approach
Authors: Muir K. Jane , Wanchek Tanya N. , Lobo Jennifer M. , Keim-Malpass Jessica 
Published: October 2021

Objective
Burnout is a public health crisis that impacts 1 in 3 registered nurses in the United States and the safe provision of patient care. This study sought to understand the cost of nurse burnout-attributed turnover using hypothetical hospital scenarios.

Methods
A cost-consequence analysis with a Markov model structure was used to assess nurse burnout-attributed turnover costs under the following scenarios: (1) a hospital with “status quo” nurse burnout prevalence and (2) a hospital with a “burnout reduction program” and decreased nurse burnout prevalence. The model evaluated turnover costs from a hospital payer perspective and modeled a cohort of nurses who were new to a hospital. The outcome measures were defined as years in burnout among the nurse cohort and years retained/employed in the hospital. Data inputs derived from the health services literature base.

Results
The expected model results demonstrated that at status quo, a hospital spends an expected $16,736 per nurse per year employed on nurse burnout-attributed turnover costs. In a hospital with a burnout reduction program, such costs were $11,592 per nurse per year employed. Nurses spent more time in burnout under the status quo scenario compared with the burnout reduction scenario (1.5 versus 1.1 y of employment) as well as less time employed at the hospital (2.9 versus 3.5 y of employment).

Conclusions
Given that status quo costs of burnout are higher than those in a hospital that invests in a nurse burnout reduction program, hospitals should strongly consider proactively supporting programs that reduce nurse burnout prevalence and associated costs.
Unexpected Retrosternal Goiter Interpreted as Hyperfunctioning Metastasis on the Posttherapeutic 131I SPECT/CT
Authors: Hou Li-ying , Luo Quan-yong , Qiu Zhong-ling 
Published: October 2021

Abstract
We present a 38-year-old man who underwent total thyroidectomy with radical right neck dissection due to papillary thyroid cancer was referred for 131I treatment. The patient was in subclinical hypothyroidism with remarkable stimulated Tg level after 4 weeks of l-thyroxine withdrawal before 131I treatment, which indicated hyperfunctioning metastasis. Posttherapeutic 131I whole-body scan combined with 131I SPECT/CT performed on day 3 after 131I administration revealed an elevated 131I uptake mass in cervicothoracic region. To our surprise, the mass was histologically confirmed to be a retrosternal goiter.
Multiple Delayed Complications at Different Time Points After AQUAfilling Filler Injection for Facial Rejuvenation
Authors: Kong Tae Hyun , Chung Kyu Jin 
Published: October 2021

Abstract
Delayed inflammatory and infectious complications occurred in a 63-year-old woman after receiving AQUAfilling filler injection in the forehead and nasolabial folds. The complications were idiopathic and occurred at different time points at different sites. Her condition improved after the removal of the injected materials and capsule, and administration of intravenous antibiotics. Although injection sites differ, inflammation can occur at any site at different time points. The possibility of inflammation at other injection sites should always be considered during periodic follow-up, even if the filler injection site initially shows no signs of complications.

Level of Evidence: Level IV
Pseudomonas Aeruginosa Theft Biofilm Require Host Lipids of Cutaneous Wound
Authors: Sinha Mithun , Ghosh Nandini , Wijesinghe Dayanjan S. , Mathew-Steiner Shomita S. , Das Amitava , Singh Kanhaiya , El Masry Mohamed , Khanna Savita , Inoue Hiroyuki , Yamazaki Katsuhisa , Kawada Manabu , Gordillo Gayle M. , Roy Sashwati , Sen Chandan K. 
Published: October 2021

Objective:
This work addressing complexities in wound infection, seeks to test the reliance of bacterial pathogen Pseudomonas aeruginosa (PA) on host skin lipids to form biofilm with pathological consequences.

Background:
PA biofilm causes wound chronicity. Both CDC as well as NIH recognizes biofilm infection as a threat leading to wound chronicity. Chronic wounds on lower extremities often lead to surgical limb amputation.

Methods:
An established preclinical porcine chronic wound biofilm model, infected with PA or Pseudomonas aeruginosa ceramidase mutant (PA∆Cer), was used.

Results:
We observed that bacteria drew resource from host lipids to induce PA ceramidase expression by three orders of magnitude. PA utilized product of host ceramide catabolism to augment transcription of PA ceramidase. Biofilm formation was more robust in PA compared to PA∆Cer. Downstream products of such metabolism such as sphingosine and sphingosine-1-phosphate were both directly implicated in the induction of ceramidase and inhibition of peroxisome proliferator-activated receptor (PPAR)δ, respectively. PA biofilm, in a ceram-idastin-sensitive manner, also silenced PPARδ via induction of miR-106b. Low PPARδ limited ABCA12 expression resulting in disruption of skin lipid homeostasis. Barrier function of the wound-site was thus compromised.

Conclusions:
This work demonstrates that microbial pathogens must co-opt host skin lipids to unleash biofilm pathogenicity. Anti-biofilm strategies must not necessarily always target the microbe and targeting host lipids at risk of infection could be productive. This work may be viewed as a first step, laying fundamental mechanistic groundwork, toward a paradigm change in biofilm management.
Meta-analysis of the Connection Between Alzheimer Disease and Telomeres
Authors: Fu Jiajia , Ji Xiaoyu , Liu Jiao , Chen Xueping , Shang Huifang 
Published: October 2021

Background:
Alzheimer disease (AD) is the most common neurodegenerative disease of the central nervous system. The stability of the telomere-telomerase system is closely related to AD. A previous meta-analysis indicated that AD patients had shorter telomere length (TL) than control subjects. However, there are no consistent telomerase activity findings in AD patients, and the published telomerase studies were not meta-analyzed yet.

Methods:
We searched all the related studies that probed into TL and/or telomerase activity in AD patients based on PubMed and Embase database from the establishment to September 2020. The Chinese National Knowledge Infrastructure, Wanfang and China Science and Technology Journal Database were also utilized. The quality of the included studies was evaluated by using Newcastle-Ottawa Scale. All the statistical analyses of this meta-analysis were performed using Stata version 15.0.

Results:
Analyzing 30 TL data from 2248 AD patients and 4865 controls, AD patients had a significantly shorter TL than the controls, with a standardized mean difference of −0.70 (confidence interval: −0.95 to −0.46; P<0.05). The meta-analysis included 3 primary studies and did not find a significant difference in the telomerase activity between 233 AD patients and 132 controls, but AD patients had a trend of increased telomerase activity compared with controls (standardized mean difference: 0.47; confidence interval: −0.29 to 1.23; P>0.05).

Conclusion:
Our results showed that compared with the control group, the AD group had a shorter TL and may have higher telomerase activity.
Evolving Causes of Rapidly Progressive Dementia
Authors: Stamatelos Petros , Kontokostas Kimonas , Liantinioti Chrysoula , Giavasi Christina , Ioakeimidis Michail , Antonelou Roubina , Papathanasiou Matilda , Arvaniti Chrysa , Bonakis Anastasios , Tsivgoulis Georgios , Voumvourakis Konstantinos , Stefanis Leonidas , Papageorgiou Sokratis G. 
Published: October 2021

Background:
Rapidly progressive dementia (RPD) is a clinical syndrome developing in <1 to 2 years. Recent progress in RPD evaluation is significant, so RPD’s prevalence may change over time. The aim of our new case series was to estimate the relative frequency of RPDs’ causative entities, considering the recent advances in RPDs’ diagnosis, and compare the results with those of our previous report.

Patients and Methods:
We retrospectively reviewed the medical records of 47 patients who were referred to Attikon University Hospital during a 5-year period for a suspected RPD.

Results:
Neurodegenerative diseases were the most frequent causes (38%), followed by prion disease (19%) and autoimmune encephalopathy (AE, 17%). AE cases were by far more common than in our previous report, while other than AE secondary causes were significantly decreased. Mean time to dementia was 9 months in neurodegenerative diseases and 5 months in non-neurodegenerative. Main clinical findings across all patients were memory impairment (66%) and behavioral-emotional disturbances (48%).

Conclusions:
Neurodegenerative diseases are common causes of RPD and have a slower evolution than non-neurodegenerative. Diagnostic novelties enabled the recognition of AE, whereas more common secondary causes are probably now diagnosed in primary settings since the recognition of RPD as distinct clinical entity is continually increasing.
Inferring copy number variation from gene expression data: methods, comparisons, and applications to oncology
Authors: Boen Joseph , Wagner Joel P. , Di Nanni Noemi 
Published: October 2021

ABSTRACTCopy number variations (CNVs) are genomic events where the number of copies of a particular gene varies from cell to cell. Cancer cells are associated with somatic CNV changes resulting in gene amplifications and gene deletions. However, short of single-cell whole-genome sequencing, it is difficult to detect and quantify CNV events in single cells. In contrast, the rapid development of single-cell RNA sequencing (scRNA-seq) technologies has enabled easy acquisition of single-cell gene expression data. In this work, we employ three methods to infer CNV events from scRNA-seq data and provide a statistical comparison of the methods’ results. In addition, we combine the analysis of scRNA-seq and inferred CNV data to visualize and determine subpopulations and heterogeneity in tumor cell populations.