bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and Safety of Repeated Micropulse Transscleral Diode Cyclophotocoagulation in Advanced Glaucoma
Authors: Lim Edward J.Y. , Aquino Cecilia M. , Lun Katherine W.X. , Lim Dawn K.A. , Sng Chelvin , Loon Seng Chee , Chew Paul T.K. , Koh Victor T.C. 
Published: April 2021

Precis:
Repeat micropulse transscleral cyclophotocoagulation (MPTCP) has some benefit in lowering intraocular pressure (IOP). There was a small risk of loss of vision, prolonged hypotony, and phthisis bulbi.

Aim:
This study aimed to determine the efficacy and safety of repeated MPTCP for an Asian population with refractory glaucoma.

Methods:
This is a retrospective case series of 43 eyes (43 patients) with severe glaucoma which underwent repeated MPTCP. Baseline parameters were taken from the visit just before the second MPTCP session. Success was defined as IOP of 6 to 21 mm Hg or ≥20% reduction in IOP without an increase in glaucoma medication from baseline, without further glaucoma reoperation, and ≤3 total MPTCP episodes. The IOP, number of IOP-lowering medications, and best-corrected visual acuity were documented preoperatively and postoperatively. Postoperative complications were also analyzed.

Results:
The mean age±SD was 57.4±18.2 years with a mean follow-up duration of 28.9±27.5 months. Neovascular glaucoma was the most common type of glaucoma [18 eyes (41.9%)]. The success rates at postoperative years 1, 2, and 3, and the latest follow-up were 36.4%, 42.9%, 32.0%, and 39.5%, respectively. The median survival time of repeat MPTCP was 4.6 months. Compared with the preoperative mean IOP (35.2±11.0 mm Hg), the mean IOP at postoperative years 1, 2, and 3, and latest follow-up, was 27.8±13.7 mm Hg (P=0.004), 27.4±12.4 (P=0.003), 31.8±13.2 (P=0.35), and 27.1±13.8 mm Hg (P=0.002), respectively. The mean number of IOP-lowering medications was reduced from 3.3±0.9 preoperatively to 2.8±1.3 at the final follow-up (P=0.007). Postoperative complications included prolonged hypotony [3 eyes (7.0%)] and phthisis bulbi [2 eyes (4.7%)].

Conclusion:
Repeated MPTCP is at best moderately effective in lowering IOP for eyes with advanced glaucoma.
Running a cardiology consult service during a pandemic: Experiences from the front lines
Authors: Valdez-Lowe Claudia , Parikh Sachin , Kenel Kristina L. 
Published: April 2021

ABSTRACT
Millions of deaths worldwide have been attributed to the novel coronavirus (COVID-19). As case counts increased in the United States and resurgence occurred in Europe, health care systems across the country prepared for the influx of acutely ill patients. In response to this, our cardiology consult service was called to aid in the management of COVID-19 patients. We describe our experiences and the changes that were implemented.
CPAP-SAVER follow-up study to determine long-term adherence and associated factors
Authors: Shapiro April L. , Olson Joeli , Shafique Saima , Piamjariyakul Ubolrat 
Published: April 2021

ABSTRACT

Background:
Many factors contribute to continuous positive airway pressure (CPAP) nonadherence, affecting health care burden. The original CPAP-SAVER study enrolled 66 CPAP-naive participants and showed high 1-month adherence and significantly higher apnea beliefs and CPAP attitude for the intervention group.

Purpose and methods:
Thirty-three participants from the original CPAP-SAVER study were recruited for a 3-year follow-up to determine adherence, examine the intervention effect, and identify adherence-associated factors.

Results:
Adherence rates dropped to 54.5% at 3 years, with a significant decrease in CPAP use hours (t = −2.37, p = .024) and nights (t = −4.05, p < .001). Group differences in beliefs and attitude were not sustained; however, beliefs (r = 0.57) and attitude (r = 0.44) were significant factors associated with adherence. Life satisfaction was significantly higher at present compared with before wearing CPAP (t = 5.17, p < .001).

Implications for practice:
The authors recommend intervention with a focus on apnea beliefs, CPAP attitude, and long-term support to promote CPAP adherence. Focus on CPAP attitude and beliefs and enhanced support early in the obstructive sleep apnea (OSA) treatment trajectory may promote long-term adherence and subsequently reduce the health care burden of OSA disease.
Interventional treatment of acute myocardial infarction-related cardiogenic shock
Authors: Josiassen Jakob , Møller Jacob E. , Holmvang Lene , Hassager Christian 
Published: April 2021

Purpose of review
Acute revascularization is with some evidence the only intervention proven to improve the prognosis in myocardial infarction-related cardiogenic shock but several interventions are continuously being investigated in order to increase survival among these patients. In this review, several aspects related to the interventional treatment of cardiogenic shock are discussed chronologically from symptom debut to leaving the cardiac catheterization laboratory.

Recent findings
In the randomized CULPRIT-SHOCK trial, a culprit-only revascularization strategy was reported superior to immediate complete revascularization among patients with multivessel disease. Recent large-scale observational data underline the marked prognostic importance of time from medical contact to revascularization in acute myocardial infarction-related cardiogenic shock. Moreover, studies suggest a potential beneficial effect of a transradial vascular access as well as early initialization of mechanical circulatory support in carefully selected patients. This, however, needs further validation.

Summary
Acute revascularization remains a crucial part of the initial management of acute myocardial infarction-related cardiogenic shock. Among cardiogenic shock patients presenting with multivessel disease, a culprit-only approach should be the routine strategy. Time to revascularization plays a crucial role in the setting of cardiogenic shock, why prehospital optimization and triaging may be the most important factors in order to improve prognosis in AMI-related cardiogenic shock.
Mechanical ventilation in cardiogenic shock
Authors: Tavazzi Guido 
Published: April 2021

Purpose of review
Mechanical ventilation is frequently needed in patients with cardiogenic shock. The aim of this review is to summarize and discuss the current evidence and the pathophysiological mechanism that a clinician should consider while setting the ventilator.

Recent findings
Little attention has been placed specifically to ventilatory strategies in patients with cardiogenic shock undertaking mechanical ventilation. Lung failure in patients with cardiogenic shock is associated with worsening outcome as well as a delay in mechanical ventilation institution. The hemodynamic profile and cardiogenic shock cause, considering the preload dependency of the failing heart, must be defined to adjust ventilatory setting.

Summary
Evidence is growing regarding the role of lung failure as adverse prognostic factor and beneficial effect of positive pressure ventilation as part of first-line treatment in patients with cardiogenic failure.
The evolving paradigm of precision medicine in lung cancer
Authors: Passiglia Francesco , Scagliotti Giorgio V. 
Published: April 2021

Purpose of review
In this review, we report a complete and updated summary of the most recent treatment advances in the fields of oncogene-addicted disease and provide expert perspectives on the evolving paradigm of precision medicine in lung cancer patients.

Recent findings
The advent of innovative genome sequencing technologies is rapidly increasing the number of targetable molecular alterations in advanced nonsmall cell lung cancer (NSCLC), leading to the introduction of novel selective inhibitors into the clinical arena, showing unprecedent tumor responses against rare and elusive NSCLC targets. The results of the ADAURA trial suggested that targeting EGFR pathway in the adjuvant setting is a feasible and effective strategy. The routine use of next-generation sequencing (NGS) is currently recommended as new standard approach to profile advanced NSCLC samples while recent findings suggest the potential application of a plasma-based first approach for tumor genotyping. Innovative umbrella trials provide the right infrastructure to investigate the role of precision medicine in advanced NSCLC, but failed to show clinical benefit.

Summary
Implementing NGS-based molecular screening, increasing patients’ access to biomarker driven-clinical trials, ensuring equal access to molecular testing and innovative treatments, overcoming disparities and preserve health systems’ financial sustainability represents the main challenges of precision medicine worldwide.
Brief Report: COVID-19 Testing, Characteristics, and Outcomes Among People Living With HIV in an Integrated Health System
Authors: Chang Jennifer J. , Bruxvoort Katia , Chen Lie H. , Akhavan Bobak , Rodriguez Janelle , Hechter Rulin C. 
Published: April 2021

Background:
Understanding the attributes of COVID-19 clinical severity among people living with HIV (PLWH) compared with those in HIV-uninfected patients is critical for risk stratification and treatment strategies.

Methods:
We conducted a retrospective study at Kaiser Permanente Southern California among PLWH aged 18 years or older. We compared the incidence of SARS-CoV-2 molecular testing, COVID-19 diagnosis, and COVID-19 hospitalization among PLWH and HIV-uninfected adults. A chart review was conducted for PLWH with COVID-19 to examine viral suppression of HIV and most recent CD4+ counts in the year before COVID-19 diagnosis, known exposures to COVID-19, and clinical presentation.

Results:
Between March 1, 2020, and May 31, 2020, the incidence of SARS-CoV-2 molecular testing, COVID-19 diagnosis, and COVID-19 hospitalization was 551.2, 57.0, and 9.3 per 10,000 PLWH, respectively, compared with 268.4, 34.6, and 5.3 per 10,000 HIV-uninfected individuals, respectively. Among those with COVID-19, the distribution of race/ethnicity, smoking status, and comorbidities was similar in PLWH and HIV-uninfected patients; however, PLWH were mostly men, younger, and less obese than HIV-uninfected individuals. Health care utilization regarding emergency care and hospitalizations in the year before COVID-19-related hospitalization was similar between the groups. Overall, HIV was virologically suppressed in >95% of PLWH with COVID-19, and HIV viral load and CD4+ status did not differ between hospitalized and nonhospitalized patients.

Conclusions:
In this population of patients with well-controlled HIV infection, the incidence of testing, diagnosis, and hospitalization for COVID-19 was higher in PLWH than that in HIV-uninfected patients.
Barriers, benefits and interventions for improving the delivery of telemental health services during the coronavirus disease 2019 pandemic: a systematic review
Authors: Siegel Ashley , Zuo Yushen , Moghaddamcharkari Nika , McIntyre Roger S. , Rosenblat Joshua D. 
Published: April 2021

Purpose of review
To reduce the spread of infection from the coronavirus disease 2019 (COVID-19), mental healthcare facilities were forced to make the rapid transition from face-to-face services to virtual care. This systematic review aims to synthesize the extant literature reporting on barriers of telemental health (TMH) during the COVID-19 pandemic and how facilities have worked to overcome these barriers, to inform best practices for TMH delivery.

Recent findings
Most recent findings came from case studies from mental health professionals which reported on barriers related to institutional, provider and patient factors, and how these barriers were overcome. Common barriers identified in the literature include: technological difficulties; issues regarding safety, privacy and confidentiality; therapeutic delivery and the patient-provider relationship; and a loss of sense of community. Studies also reported on the benefits to TMH interventions/tools, as well as suggestions for improvements in the delivery of TMH services.

Summary
As the COVID-19 pandemic evolves, mental healthcare providers continue to find creative and feasible solutions to overcome barriers to the delivery of TMH. Dissemination of these solutions is imperative to ensure the best quality of mental healthcare for patients across the globe.
Gulf War veterans exhibit broadband sleep EEG power reductions in regions overlying the frontal lobe
Authors: Moffet Eric W. , Jones Stephanie G. , Snyder Theodore , Riedner Brady , Juergens Timothy 
Published: April 2021

AbstractAimsNearly a third of U.S. veterans who deployed in support of the 1990-1991 Persian Gulf War are affected by Gulf War illness (GWI). Here we aimed to characterize whether subjective sleep complaints in GWI veterans are associated with objective sleep EEG disturbances relative to healthy veterans and controls; and whether Gulf War veterans show alterations in neural activity during sleep that differentiate them from healthy subjects.Main methodsWe used high-density EEG (HDEEG) to assess regional patterns of rapid eye movement (REM) sleep and non-REM (NREM) sleep between three groups: Gulf War male veterans with fatigue and GWI, Gulf War male veterans without fatigue or GWI, and control males. The groups were matched relative to age, sex and obstructive sleep apnea. Topographic comparisons of nocturnal NREM and REM sleep were made between groups for all frequency bands.Key findingsTopographic analysis revealed a broadband reduction in EEG power in a circumscribed region overlying the frontal lobe in both groups of Gulf War veterans, regardless of GWI and fatigue. This frontal reduction in neural activity was present, to some extent, across all frequency bands in NREM and REM sleep.SignificanceGiven that our findings were observed in all Gulf War veterans, it appears unlikely that frontal sleep HDEEG power reductions prove wholly responsible for fatigue symptoms. These results provide avenues for research and underpin the importance of maintaining a high index of suspicion when providing clinical care to formerly deployed veterans of the Persian Gulf War.
Global cognition is related to upper-extremity motor skill retention in individuals with mild-to-moderate Parkinson disease
Authors: VanGilder Jennapher Lingo , Lopez-Lennon Cielita , Paul Serene S. , Dibble Leland E. , Duff Kevin , Schaefer Sydney Y. 
Published: April 2021

ABSTRACTBackground and PurposeCognitive impairment has been linked to poor motor learning and rehabilitation outcomes in older adult and stroke populations, but this remains unexplored in individuals with Parkinson disease (PD). The purpose of this secondary data analysis from a recent clinical trial (NCT02600858) was to determine if global cognition was related to nine-day skill retention after upper-extremity motor training in individuals with PD.MethodsTwenty-three participants with idiopathic PD completed three consecutive days of training on an upper-extremity task. For the purposes of the original clinical trial, participants trained either “on” or “off” their dopamine replacement medication. Baseline, training, and shorter-term (48-hour) retention data have been previously published. Global cognition was evaluated using the Montreal Cognitive Assessment (MoCA). Participant age, baseline performance, MoCA score, and group (medication “on”/”off”) were included in a multivariate linear regression model to predict longer-term (nine day) follow-up performance. Baseline and follow-up performance were assessed for all participants while “on” their medication.ResultsMoCA score was positively related to follow-up performance, such that individuals with better cognition performed better than those with poorer cognition. Participant age, baseline performance, and medication status were unrelated to follow-up performance.Discussion and ConclusionsResults of this secondary analysis align with previous work that suggest cognitive impairment may interfere with motor learning in PD, and that assessing cognition could provide prognostic information about an individual’s responsiveness to motor rehabilitation for a number of clinical populations.
SARS-CoV-2 Vaccination Uptake in a Correctional Setting
Authors: Berk Justin , Murphy Matthew , Chan Philip A. , Kane Kimberly , Rich Jody , Brinkley-Rubinstein Lauren 
Published: April 2021

AbstractBetween December 2020 and February 2021, the Rhode Island Department of Corrections offered SARS-CoV-2 vaccination to all correctional staff and sentenced individuals incarcerated in the state. During this initial campaign, 76.4% (1106 / 1447) of sentenced individuals and 68.4% (1008 / 1474) of correctional staff accepted and received the vaccine. This study demonstrates the feasibility and efficiency of vaccine implementation in a carceral setting.
Genetic Susceptibility Of Cytotoxic T Lymphocyte-Associated Antigen 4 Gene Polymorphism In The Onset Of Arthritis
Authors: Mukhtar Maryam , Sheikh Nadeem , Suqaina Saira Kainat , Saleem Tayyaba , Mehmood Rabia , Khawar Muhammad Babar 
Published: April 2021

ABSTRACTCytotoxic T lymphocyte-associated antigen 4 (CTLA-4) gene plays a vital role in the activation of T-cells as a down regulator. CTLA-4 gene polymorphisms have implicated a potential risk factor for autoimmune disorders like arthritis. Therefore the current study was designed to determine the association of CTLA-4 gene polymorphism in the onset of rheumatoid and osteoarthritis in Pakistani individuals. Genotyping was performed on 300 RA, 316 OA, and 412 control subjects by direct sequencing method as well as polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. It was observed that allelic and genotypic frequency of rs5742909, rs231775, rs4553808, rs733618, and rs3087243 were significantly varied among patients and controls and considered as a significant risk factor in the onset of RA as well as OA. However, no mutation was identified on the rs11571317 polymorphic site. Haplotype CAGTCA and CAG TCG act as a protectant against disease onset whereas CAACCG was significant in disease onset. Mutation on rs231775 polymorphic site lead to the change of threonine into alanine It was concluded that CTLA-4 gene polymorphism is a significant risk factor in the onset of RA as well as OA. Large scale survey is required for the screening of the genetic markers for pre-diagnosis of the disease.SUMMARY STATEMENTThe study summarized that CTLA-4 gene polymorphism plays a key role in the arthritis onset in Pakistani population.
A triangulated study on non-pharmacological management of Alzheimer’s disease in Mauritius
Authors: Dorkhy Geeta Devi , Smita Goorah , Ameenah Sorefan 
Published: April 2021

AbstractDementia is a neurodegenerative disease, with more than 50 million people worldwide. Nearly 60% are living in the low and middle-income countries [1]. Mauritius has a rising population of elderly people, of 7.5% above 65 years [2]. Currently 14,000 people with Alzheimer’s disease (AD), show very modest improvements with pharmacological therapies. Alzheimer’s Association in Mauritius, the only NGO, which assist person with AD and offer multiple non-pharmacological therapies (NPT).ObjectivesThe main study aim is to find the outcomes of NPT in the management of AD and the correlation of data in mixed studies.SettingThe participants were recruited from Alzheimer’s Association Mauritius, the only NGO. The center provides NPT such as cognitive training, reminiscence therapy, socialization and group interactive games.Primary and secondary outcome measuresBoth quantitative and qualitative studies were triangulated to find similarities (matched) and unsimilar (unmatched) results.ResultQuantitative data (n=42) analysis showed a direct statistical decline in higher function (IADL) with respect to decreasing cognition. Qualitative study (n=20) emerged with 7 main themes among which ‘dependency in AD’ was a main theme. Mixed study results showed 6 out of 7 main themes were linked to/ matching to statistical results after triangulation.ConclusionNPT is an effective tool in the management of AD in Mauritius. Triangulated studies allowed in depth analysis of the patient.Strengths and limitations of the studyMixed study provides in depth analysisData speaks for itself, it is lived experienceMixed studies complement each otherHowever, it is a time consuming processParticipant unwillingness to participate
Clinical manifestations of hospitalized COVID-19 patients in Bangladesh: a 14-day observational study
Authors: Shaha Modhusudon , Islam Md. Azizul , Huq Faizul , Roy Bithi , Kabir Ashraful , Salimullah Md. , Mamun-Al-Mahtab  , Fazle Akbar Sheikh Mohammad 
Published: April 2021

AbstractObjectivesSevere acute respiratory coronavirus-2 (SARS-CoV-2) is currently a significant public health concern and causing a pandemic in the world. Despite of immense attention to the coronavirus disease-2019 (COVID-19), very little attention has been given to the kinetics of disease progression in infected patients. Therefore, in this study, we present a 14-day clinical observation of hospital-admitted COVID-19 patients.MethodsAfter recording the demography of 42 COVID-19 patients on day 1, we observed the clinical progression for 14 days by investigating the hematological and biochemical responses of patients blood and serum, respectively.ResultsApproximately 62% of the hospital-admitted COVID-19 patients presented cough, followed by fever (approximately 52%). The top comorbidities of these patients were hypertension (30%) and diabetes mellitus (19%). The average blood hemoglobin level was slightly low among the patients in early days of infection and went up to the normal level on the latter days. A substantial increase in the level of ALT/SGPT (up to 106 units/L; SEM: 12.64) and AST/SGOT (up to 64.35 units/L; SEM: 5.013) in COVID-19 patients was observed, which may suggest that infection with CoV-2019 is associated with the functionality of other organs of COVID-19 patients.ConclusionThis 14-day observational study may help clinicians to decide the choice of treatment of COVID-19 patients.
Quantitative Gradient Echo MRI Identifies Dark Matter as a New Imaging Biomarker of Neurodegeneration that Precedes Tissue Atrophy in Early Alzheimer Disease
Authors: Kothapalli Satya V.V.N. , Benzinger Tammie L. , Aschenbrenner Andrew. J. , Perrin Richard. J. , Hildebolt Charles. F. , Goyal Manu. S. , Fagan Anne. M. , Raichle Marcus. E. , Morris John. C. , Yablonskiy Dmitriy. A. 
Published: April 2021

AbstractBackgroundCurrently, brain tissue atrophy serves as in vivo MRI biomarker of neurodegeneration in Alzheimer Disease (AD). However, postmortem histopathological studies show that neuronal loss in AD exceeds volumetric loss of tissue and that loss of memory in AD begins when neurons and synapses are lost. Therefore, in vivo detection of neuronal loss prior to detectable atrophy in MRI is essential for early AD diagnosis.ObjectiveTo apply a recently developed quantitative Gradient Recalled Echo (qGRE) MRI technique for in vivo evaluation of neuronal loss in human hippocampus.MethodsSeventy participants were recruited from the Knight Alzheimer Disease Research Center, representing three groups: Healthy controls [Clinical Dementia Rating® (CDR®)=0, amyloid β (Aβ)-negative), n=34]; Preclinical AD (CDR=0, Aβ-positive, n=19); and mild AD (CDR=0.5 or 1, Aβ-positive, n=17).ResultsIn hippocampal tissue, qGRE identified two types of regions: one, practically devoid of neurons, we designate as “Dark Matter”, the other, with relatively preserved neurons - “Viable Tissue”. Data showed a greater loss of neurons than defined by atrophy in the mild AD group compared with the healthy control group - neuronal loss ranged between 31% and 43% while volume loss ranged only between 10% and 19%. The concept of Dark Matter was confirmed with histopathological study of one participant who underwent in vivo qGRE 14 months prior to expiration.Conclusionin vivo qGRE method identifies neuronal loss that is associated with impaired AD-related cognition but is not recognized by MRI measurements of tissue atrophy, therefore providing new biomarkers for early AD detection.