bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differentiation of autism spectrum disorder and mood or anxiety disorder
Authors: Wittkopf Sarah , Stroth Sanna , Langmann Anika , Wolff Nicole , Roessner Veit , Roepke Stefan , Poustka Luise , Kamp-Becker Inge 
Published: August 2021

Autism spectrum disorder shares many symptoms with other mental health disorders, and comorbid disorders such as mood and anxiety disorders are common, making the diagnostic process challenging. We aimed to explore the diagnostic accuracy of two standard autism spectrum disorder diagnostic instruments and to identify those behavioral items that best differentiate between autism spectrum disorder and mood and anxiety disorder in a naturalistic sample of patients utilizing autism spectrum disorder specialist services. The study included data of 847 participants (5–65 years of age, n = 586 with autism spectrum disorder, n = 261 with mood and anxiety disorder) all evaluated with the Autism Diagnostic Observation Schedule in the context of the diagnostic process. Data of the Autism Diagnostic Interview–Revised were available for 428 participants (5–51 years of age, n = 367 with autism spectrum disorder, n = 61 with mood and anxiety disorder). By means of binominal logistic regressions and an ensemble feature selection, we identified a subset of items that best differentiated between autism spectrum disorder and mood and anxiety disorder. Overall, the results indicate that a combination of communicational deficits and unusual and/or inappropriate social overtures differentiates autism spectrum disorder and mood and anxiety disorder. Aspects of social cognition are also relevant. Limitations of the current study and implications for research and practice are discussed. Lay abstract Symptoms of mood and anxiety disorders overlap with symptoms of autism spectrum disorder, making the diagnostic process challenging. This study found that a combination of communicational deficits and unusual and/or inappropriate social overtures facilitates differentiation between autism spectrum disorder and mood and anxiety disorders. Furthermore, the results confirm the essential need of a behavioral observation with the Autism Diagnostic Observation Schedule in combination with a full Autism Diagnostic Interview–Revised to support diagnostic decisions.
Positive correlation of serum indoxyl sulfate level with peripheral arterial disease in hemodialysis patients
Authors: Chiu Liang-Te , Lin Lin , Lin Huei-Jhen , Lai Yu-Hsien , Hsu Bang-Gee 
Published: August 2021

Objectives Indoxyl sulfate, known for its cardiovascular toxicity, is associated with vascular and coronary artery diseases and increased mortality. Peripheral arterial disease, defined by low ankle–brachial index, is associated with increased mortality in patients on hemodialysis. The present study aimed to determine the relationship between the serum indoxyl sulfate level and peripheral arterial disease in patients on maintenance hemodialysis. Methods The present cross-sectional, single-center study included 75 patients on maintenance hemodialysis. Serum indoxyl sulfate levels were determined by high-performance liquid chromatography–mass spectrometry. Ankle–brachial index values were measured using an automated oscillometric device. Patients with ankle–brachial indexes of < 0.9 were categorized into the low ankle–brachial index group. Results In the study cohort, 12 of the 75 patients (16.0%) had low ankle–brachial indexes. The rates of diabetes mellitus ( p = 0.010) as well as the serum levels of C-reactive protein ( p < 0.001) and indoxyl sulfate ( p < 0.001) were higher in the low ankle–brachial index group than the normal ankle–brachial index group. The multivariable logistic regression analysis revealed that serum levels of indoxyl sulfate (odds ratio = 1.123, 95% confidence interval 1.011–1.249, p = 0.031) and C-reactive protein (each 0.1 mg/dL increase, odds ratio = 1.169, 95% confidence interval 1.018–1.343, p = 0.027) were independently associated with peripheral arterial disease in patients on maintenance hemodialysis. Conclusions Serum indoxyl sulfate levels were associated with peripheral arterial disease in patients on maintenance hemodialysis.
The impact of coronavirus disease 2019 pandemic on working dynamics of junior and middle grade doctors in the United Kingdom: Learning from their experience requires immediate improvement in health care planning and management—An outcome analysis of a nationwide survey
Authors: Abbas Madiha , Ghazanfar Abbas 
Published: August 2021

Objectives: Severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019) pandemic had an unprecedented impact on health services across the world resulting in increased demand of intensive care capacity, opening Nightingale hospitals, and mass movement of doctors across various specialities. This unplanned redeployment raised concerns among various health care workers. The objective of the current study is to explore working dynamics and experience of junior and middle grade doctors during current pandemic. Methods: We organised a nationwide cross-sectional survey of junior and middle grade doctors working in the United Kingdom. The survey was aimed to study their level of participation during coronavirus disease 2019 pandemic and its impact on their clinical practices and well-being. Results: In total, 1564 completed questionnaires with representations from all regions of the United Kingdom were included. The mean age of respondents was 30.64 years (95% confidence interval +1.025; standard deviation = 9.9057). There were 51.5% females with significantly more participants from Black, Asian, and minority ethnic group ( n = 835, p = 0.0073); 963 (61.6%, p ⩽ 0.0001) doctors were redeployed outside their primary speciality. The major redeployments were from other specialities to Intensive Therapy Units (41.8%, p ⩽ 0.001); 63.3% of respondents spend more than 8 weeks in redeployed speciality ( p ⩽ 0.0001). There was a significant impact of coronavirus disease 2019 on personal, mental, and physical well-being of doctors. The major areas requiring immediate attention include proper leadership and clinical support (64.1%), pre-redeployment planning and induction (48.5%), redeployment according to the skills and/or in familiar specialities (44.6%), and regular mental and physical well-being checks (37%). Conclusion: The outcome of the survey concluded with four major recommendations, including the need to have a named supervisor for these doctors, structured induction program, regular well-being checks, and involving them in crisis planning. These recommendations will help to shape future health care policies and management particularly when it is related to redeployment of doctors during any crisis or pandemic.
Prevalence, characteristics and predicting risk factors of adverse drug reactions among hospitalized older adults: A systematic review and meta-analysis
Authors: Yadesa Tadele Mekuriya , Kitutu Freddy Eric , Deyno Serawit , Ogwang Patrick Engeu , Tamukong Robert , Alele Paul E 
Published: August 2021

Background: Occurrence of adverse drug reactions is a major global health problem mostly affecting older adults. Identifying the magnitude and predictors of adverse drug reactions is crucial to developing strategies to mitigate the burden of adverse drug reactions. This study’s objectives were to estimate and compare the prevalences of adverse drug reactions, to characterize them and to identify the predictors among hospitalized older adults. Methods: A comprehensive systematic literature search including both prevalence and risk factors of adverse drug reactions in hospitalized older adults was conducted using PubMed, Scopus and Google Scholar, involving all articles published in English. Descriptive statistics and comparison of means was performed using SPSS version 20.0 and metaprop command was performed in STATA version 13.0. Heterogeneity was assessed using I2 statistic. Results: A total of 18 studies, involving 80,695 participants with a median age of 77 years, were included in this study. The pooled prevalence of adverse drug reaction was 22% (95% confidence interval: 17%, 28%; I2 = 99.23%). Among high-income countries, the prevalence of adverse drug reactions was 29% (95% confidence interval: 16%, 42%) as compared to 19% (95% confidence interval: 14%–25%) in low and middle-income countries ( p value = 0.176). Of the 620 adverse drug reactions categorized, most were type A (89%), which are generally predictable and preventable. Two-thirds (795, 67%) of the adverse drug reactions were probable and most (1194, 69%) were mild or moderate. The majority (60%) of the categorized adverse drug reactions were preventable and less than one-third (31%) were severe. The most consistently reported predictors of adverse drug reactions in hospitalized older patients were medication-related factors, including polypharmacy and potentially inappropriate medications followed by disease-related factors—renal failure, complex comorbidity, heart failure and liver failure. Conclusion: Almost one-quarter of all hospitalized older adults experienced at least one adverse drug reaction during their hospital stay. The majority of the adverse drug reactions were preventable. Medication-related factors were the most consistently reported predictors of adverse drug reactions followed by disease-related factors.
Attitude and self-care practice on hypertension among antihypertensive medication users in a tertiary care hospital Nepal
Authors: Shrestha Jyoti , Marasine Nirmal Raj , Lamichhane Rajendra , Marasini Nabin Raj , Sankhi Sabina 
Published: August 2021

Background: Hypertension a “silent killer” is a serious global health problem, whose prevalence is increasing in Nepal. Objective: This study aimed to determine the attitude and practice of hypertension among anti-hypertensive medication users in a tertiary care teaching hospital in western Nepal. Methodology: A hospital-based cross-sectional study design was used among 136 hypertensive patients under medication, aged ⩾ 30 years, and visiting medical outpatient department, medical ward, and geriatric ward, using a non-probability convenience sampling technique. Semi-structured questionnaires were used for data collection through interviews. Descriptive and inferential statistics were used, and a p value < 0.05 was considered statistically significant. Results: Most of the patients were male (56.6%), mean ± standard deviation age was 56.74 ± 12.58. Majority of them were Hindu (69.9%), upper caste people (29.4%), illiterate (22.1%), and house maker (27.2%). Half of the patients (50.7%) had a positive attitude and more than half (52.2%) had performed adequate self-care practice. Selected variables such as educational status and dietary pattern and attitude were significantly associated, whereas no association was found between sociodemographic variables and self-care practice. Attitude and self-care practices were found strongly associated with one another (p = 0.002). Conclusion: Our study found that half of the study population had positive attitude, and more than half of them had performed adequate self-care practice. Hence, educational interventions and awareness programs on dietary aspects should be focused for improving the attitude and practice of all the patient groups.
Risk factors associated with cat parasites in a feline medical center
Authors: Iturbe Cossío Tamara Libertad , Montes Luna Azucena Danae , Ruiz Mejia Magdalena , Flores Ortega Ariadna , Heredia Cárdenas Rafel , Romero Núñez Camilo 
Published: August 2021

Objectives The present study was carried out to evaluate the risk factors for and presence of intestinal parasites in cats at the feline hospital ‘CEME Gatos’, Mexico City. Methods In total, 528 fecal samples from domestic cats were collected and analyzed in order to diagnose enteroparasites. Results The parasite with the highest prevalence was Giardia species (21.97%), followed by Cryptosporidium species (7%), Toxocara cati (6.45%), Cystoisospora species (5.11%) and Dipylidium caninum (0.76%). One hundred and twenty-one cats (55.50%) were infected with a single parasite, 80 (36.69%) were infected with two and 17 (14.04%) were infected with three parasites. The results of the prevalence study showed that a liquid consistency of feces was associated with the presence of Giardia species, whereas age <7 months and mucus in the stool were factors associated with the prevalence of Cystoisospora species. Regarding T cati, the associated risk factors were age <7 months, being male, contact with other animal species and access to the outdoors. The last factor was strongly associated with the presence of T cati (eight times more likely) in outdoor cats’ feces. Brushing frequency was also an associated factor: T cati was present in cats that were never brushed. The results of the analysis of cats infected with D caninum showed that interaction with other species was a risk factor for infection. Conclusions and relevance Age <7 months, mucus in feces, living with other animal species, outdoor access and frequency of brushing are risk factors for the presence of parasites.
Perilunate Dislocation Above the Age of 65 Years: Case Series and Review of Literature
Authors: Rubin Guy , Eliyahu Amir , Grinbaum Erez , Rozen Nimrod 
Published: August 2021

Introduction Perilunate and fracture dislocations predominantly follow a high-energy mechanism. Perilunate dislocations have an incidence of 0.5/105 individuals/year, occurring at a mean age of 26 years and are frequently seen in men. This study aimed to describe the characteristics of this injury in elderly population of patients using literature review and our experience with four cases aged >65 years. Materials and Methods We treated four patients with perilunate dislocation aged >65 years. All the patients’ medical records were reviewed retrospectively. A literature review for case studies of perilunate dislocation was conducted with the purpose of finding cases including patients aged >65 years. Results Three of our patients had injuries that were missed in the first visit in the emergency department. The mechanism of injury was high energy in only two patients. Two patients had posterior perilunate dislocation, while the other two had transradial perilunate dislocation. Three patients were available for follow-up. The overall outcome was satisfaction according the Mayo wrist score and minimal disability according to the Disabilities of the Arm, Shoulder and Hand score. All patients reported that pain was absent and they were able to return to their regular activities. The literature review found only seven papers documenting treatment of patients aged >65 years. Discussion Perilunate dislocation is extremely rare in the population aged >65 years. Although the rate of missed diagnosis in our cohort was extremely high, the overall satisfaction and return to function was high. Conclusions This case series and literature review highlight the unique characteristics of this injury in the age group of patients aged >65 years. Although perilunate dislocation in patients aged >65 years is rare, clinicians should be aware of the presentation of this condition in the elderly.
Epithelioid sarcoma: A single-institutional retrospective cohort study of 36 cases
Authors: Zhang Shuguang , Jing Changyou , Liu Huanmei , Zhao Zhenguo , Zhang Xinxin , Liu Ting , Xu Songfeng , Xu Libin , Yu Shengji 
Published: August 2021

Background: Few studies have focused on the correlation between the clinical variables and the survival in Epithelioid Sarcoma (ES). The aim of this study was to investigate the relevant clinical variables influencing the survival of ES patients. Methods: From March 2000 to April 2018, 36 patients (median age, 38 years, range 22–61 years) with ES were evaluated, treated, and followed up. Results: All 36 patients underwent resection in our hospital. Among them, the 2 and 5 years local recurrence rates were 32.0% and 45.1%, respectively, with a better prognosis in patients with R0 resection margin. Distant metastasis rates for the 33 patients with M0 after 2 and 5 years were 51.5% and 70.8%, respectively. Overall survival rates at 2 and 5 years for 36 patients were 74.8% and 43.3%, respectively. Tumor size (>5 cm) and M1 were significantly associated with a poor overall survival. But the R0 resection margin was the only prognostic factor for influencing the LRFS and DMFS. Conclusions: The R0 resection margin and small tumor size were critical for a better prognosis.
Association Between Tobacco Consumption and Self-Reported Visual Impairment in Adults of High-Altitude Andean Communities of Peru
Authors: Paitan-Quispe Emilyn N. , Pérez-Castillo Kathleen H. , Camacho-Caballero Kiara , Rodriguez-Cuba Maria Alejandra , Runzer-Colmenares Fernando M. , Parodi Jose F. 
Published: August 2021

To determine the association between tobacco consumption and self-reported visual impairment. We performed a cross-sectional study based on an original cohort study. A non-probabilistic sampling was performed to invite 413 patients of 60 years or more from 11 high-altitude Andean communities (altitude higher than 1500 m above sea level) of Peru between 2013 and 2017. Demographic data and information on tobacco consumption were collected. Associations were determined using a Poisson regression model with 95% confidence intervals (CI). Of the 413 participants, 141 (34.14%) were men and 49 (11.86%) were tobacco users. In the adjusted model, tobacco users presented a high probability of visual impairment with a prevalence ratio of 1.32 (95% CI: 1.18–1.97). We also found that having two or more comorbidities 2.19 (95% CI: 1.53–3.15), receiving health assistance in a pharmacy 3.75 (95% CI: 1.97–7.16), and coffee consumption 1.67 (95% CI: 1.26–2.21) were factors significantly associated with self-reported visual impairment. We determined that in Peruvian high-altitude Andean communities, visual impairment was more frequent in individuals reporting tobacco consumption, taking alternative medicine, going directly to a drug store without primary care physician consultation, having more than one comorbidity, and coffee consumption.
Cilioretinal Artery Occlusion as the Presenting Manifestation of Left Atrial Myxoma
Authors: Mir Tahreem A. , Megalla Marez M. , Sinard John H. , Wang Jay C. 
Published: August 2021

Purpose: This work reports a case of left atrial myxoma presenting with cilioretinal artery occlusion. Methods: A case report is discussed. Results: A 57-year-old man was referred for acute vision loss in the left eye after a workup including electrocardiogram, magnetic resonance imaging of the brain without contrast, computed tomography angiography of the head and neck, erythrocyte sedimentation rate, and C-reactive protein had negative results. Examination revealed cilioretinal artery occlusion with visible emboli. Because an echocardiogram was not performed, the patient was referred to the emergency department. Echocardiogram revealed a large left atrial mass prolapsing into the left ventricle. The mass was excised, and pathology showed myxoma. Conclusions: This is the first case to our knowledge of isolated cilioretinal artery occlusion as the initial presentation of an atrial myxoma. Thorough and complete workup was crucial to averting further morbidity and mortality.
Cranial suture headache: An extracranial head pain syndrome originating in the cranial sutures of the skull
Authors: Rozen Todd D 
Published: August 2021

Objective: To define a new type of head pain syndrome termed “cranial suture headache” which is a localized headache originating along the cranial suture lines of the skull. Background: Well localized headaches maybe extracranial in origin. As trigeminal nociceptors are localized within the cranial sutures of the skull, these fibrous joints maybe the source of head pain for some patients. Methods: Case series. To diagnose cranial suture headache, the patient’s pain had to be localized to the skull and elicited/mimicked by mild to moderate palpation over one or more distinct cranial suture lines. Results: Ten cases are presented. Most of the patients were women (9/10). The headache started daily from onset in all cases. Range of age of headache onset was 32–64 years. Headache was one sided, unless confined to the midline and typically lacked any migrainous and/or cranial autonomic symptoms. Most cranial suture headaches localized to either the sagittal, coronal or squamosal suture lines. Headache duration prior to diagnosis was on average 8.5 years. Triggering events: three began immediately after head trauma, two had very remote head trauma, one was post infectious, one was post craniotomy, while three patients had no known triggering event. All patients were treatment refractory failing at least three preventive medications. All improved with localized anesthetic injection to the suture line(s) and/or onabotulinum toxin A injection only to the cranial sutures. Discussion: Without the recognition of cranial suture-based pain, patients may have unremitting headaches that can last years to decades. The observation that “cranial suture” headache improves with localized treatment only to the cranial sutures would seem to suggest the extracranial origin of the pain.
Measurable residual disease does not preclude prolonged progression-free survival in CLL treated with ibrutinib
Authors: Wang Xin Victoria , Hanson Curtis A. , Tschumper Renee C. , Lesnick Connie E. , Braggio Esteban , Paietta Elisabeth M. , O’Brien Susan , Barrientos Jacqueline C. , Leis Jose Francisco , Zhang Cong Christine , Coutre Steven E. , Barr Paul M. , Cashen Amanda F. , Mato Anthony R. , Singh Avina K. , Mullane Michael P. , Erba Harry , Stone Richard , Litzow Mark R. , Tallman Martin S. , Shanafelt Tait D. , Kay Neil E. 
Published: August 2021

Abstract
E1912 was a randomized phase 3 trial comparing indefinite ibrutinib plus 6 cycles of rituximab (IR) to 6 cycles of fludarabine, cyclophosphamide, and rituximab (FCR) in untreated younger patients with CLL. We describe measurable residual disease (MRD) levels in E1912 over time and correlate them with clinical outcome. Undetectable MRD rates (&lt;1 CLL cell per 104 leukocytes) were 29.1%, 30.3%, 23.4%, and 8.6% at 3, 12, 24, and 36 months for FCR, and significantly lower at 7.9%, 4.2%, and 3.7% at 12, 24, and 36 months for IR, respectively. Undetectable MRD at 3, 12, 24, and 36 months was associated with longer progression-free survival (PFS) in the FCR arm, with hazard ratios (MRD detectable/MRD undetectable) of 4.29 (95% confidence interval [CI], 1.89-9.71), 3.91 (95% CI, 1.39-11.03), 14.12 (95% CI, 1.78-111.73), and not estimable (no events among those with undetectable MRD), respectively. In the IR arm, patients with detectable MRD did not have significantly worse PFS compared with those in whom MRD was undetectable; however, PFS was longer in those with MRD levels &lt;10−1 than in those with MRD levels above this threshold. Our observations provide additional support for the use of MRD as a surrogate end point for PFS in patients receiving FCR. In patients on indefinite ibrutinib-based therapy, PFS did not differ significantly by undetectable MRD status, whereas those with MRD &lt;10−1 tended to have longer PFS, although continuation of ibrutinib would very likely be necessary to maintain treatment efficacy.