bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment strategies and safety of rechallenge in the setting of immune checkpoint inhibitors-related myositis: a national multicentre study
Authors: Weill Amandine , Delyon Julie , Descamps Vincent , Deschamps Lydia , Dinulescu Monica , Dupuy Alain , Célérier Philippe , Nardin Charlee , Aubin François , Le Corre Yannick , Heidelberger Valentine , Maubec Eve , Malissen Nausicaa , Longvert Christine , Machet Laurent , Gounant Valérie , Brosseau Solenne , Bonniaud Bertille , Jeudy Géraldine , Psimaras Dimitri , Doucet Ludovic , Lebbe Céleste , Zalcman Gérard , De Masson Adèle , Baroudjian Barouyr , Leonard-Louis Sarah , Hervier Baptiste , Brunet-Possenti Florence 
Published: March 2021

Abstract

Objectives
The occurrence of immune-related myositis (irM) is increasing, yet there are no therapeutic guidelines. We sought to analyse the current therapeutic strategies of irM and evaluate the outcomes of immune checkpoint inhibitors (ICIs) rechallenge.

Methods
We conducted a nationwide retrospective study between April 2018 and March 2020 including irM without myocardial involvement. Depending on the presence of cutaneous signs or unusual histopathological features, patients were classified into two groups: typical or atypical irM. Therapeutic strategies were analysed in both groups. The modalities and outcomes of ICI rechallenge were reviewed.

Results
Among the 20 patients, 16 presented typical irM. Regardless of severity, most typical irM were treated with steroid monotherapy (n = 14/16) and all had a complete response within ≤3 weeks. The efficacy of oral steroids for non-severe typical irM (n = 10) was the same with low-dose (≤0.5 mg/kg/day) or high-dose (1 mg/kg/day). Severe typical irM were successfully treated with intravenous methylprednisolone. Atypical irM (n = 4) had a less favourable evolution, including one irM-related death, and required heavy immunosuppression. ICIs were safely reintroduced in nine patients presenting a moderate (n = 6) or a severe (n = 3) irM.

Conclusion
Our data highlight that steroid monotherapy is an effective treatment for typical irM, either with prednisone or with intravenous methylprednisone pulses depending on the severity. The identification of unusual features is important in determining the initial therapeutic strategy. The outcomes of rechallenged patients are in favour of a safe reintroduction of ICI following symptom resolution and creatin kinase (CK) normalization in moderate and severe forms of irM.
What is the incidence of methotrexate or leflunomide discontinuation related to cytopenia, liver enzyme elevation or kidney function decline?
Authors: Nakafero Georgina , Grainge Matthew J , Card Tim , Mallen Christian D , Zhang Weiya , Doherty Michael , Taal Maarten W , Aithal Guruprasad P , Abhishek Abhishek 
Published: March 2021

Abstract

Objectives
To examine incidence of treatment changes due to abnormal blood-test results and, to explore rates of treatment changes due to liver, kidney and haematological blood-test abnormalities in autoimmune rheumatic diseases (AIRD) treated with low-dose MTX or LEF.

Methods
Data for people with AIRDs prescribed MTX or LEF were extracted from the Clinical Practice Research Datalink. Participants were followed-up from first prescription of MTX or LEF in primary care. Primary outcome of interest was drug discontinuation, defined as a prescription gap of ≥90 days following an abnormal (or severely abnormal) blood-test result. Dose reduction was examined between consecutive prescriptions. Incidence rates per 1000 person-years were calculated.

Results
15, 670 and 2,689 participants contributing 46, 571 and 4,558 person-years follow-up were included in MTX and LEF cohorts, respectively. The incidence of MTX and LEF discontinuation with abnormal (severely abnormal) blood-test was 42.24 (6.16) and 106.53 (9.42)/1000 person-years in year 1, and 22.44 (2.84) and 31.69 (4.40)/1000 person years, respectively, thereafter. The cumulative incidence of MTX and LEF discontinuation with abnormal (severely abnormal) blood tests was 1 in 24 (1 in 169), 1 in 9 (1 in 106) at 1 year; and 1 in 45 (1 in 352), 1 in 32 (1 in 227) per-year, respectively, thereafter. Raised liver enzymes were the commonest abnormality associated with drug discontinuation. MTX and LEF dose reduction incidence were comparable in year 1, however, thereafter MTX dose was reduced more often than LEF [16.60 (95% CI 13.05, 21.13) vs 8.10 (95% CI 4.97, 13.20)/1000 person-years].

Conclusion
MTX and LEF were discontinued for blood-test abnormalities after year 1 of treatment, however, discontinuations for severely abnormal results were uncommon.
Effects of ractopamine hydrochloride on nutrient digestibility and nitrogen excretion of finishing beef cattle
Authors: Harsh Bailey N , Klatt Brady J , Volk Mareah J , Green-Miller Angela R , McCann Joshua C 
Published: March 2021

Abstract
The objective was to quantify the effects of the beta-adrenergic agonist (β-AA) ractopamine hydrochloride (Actogain, Zoetis, Parsippany, NJ) on nitrogen excretion and nutrient digestibility in feedlot cattle. In experiment 1, 12 Simmental × Angus steers were blocked by bodyweight (531 ± 16 kg) and used in a randomized complete block design. Dietary treatments included: 1) a control without β-AA (CON) or 2) 400 mg/steer/d ractopamine hydrochloride (RAC) for 35 d before slaughter. Diets contained (DM basis) 55% dry-rolled corn, 20% corn silage, 15% modified wet distillers grains with soluble, and 10% supplement. For each block, total collection of feed, orts, feces, and urine were conducted for two 5 d sampling periods during week 2 and 4 of RAC supplementation. No interaction (P &gt; 0.21) between treatment and collection period was observed for any parameter evaluated. Dietary treatment had no effect (P = 0.51) on DMI, but RAC had decreased fecal DM output (P = 0.04) compared with CON. Thus, RAC had greater apparent total tract DM digestibility (77.2 vs. 73.5%; P &lt; 0.01), N digestibility (72.4 vs. 69.4%; P = 0.01), and NDF digestibility (65.6 vs. 60.2%; P &lt; 0.01) than CON. Although treatment did not affect nitrogen intake (P = 0.52), RAC tended to reduce total nitrogen excretion (113.3 vs. 126.7 g/d; P = 0.10) compared with CON due to a tendency for decreased fecal nitrogen output (53.9 vs. 61.3 g/d; P = 0.10). However, dietary treatment had no effect (P = 0.53) on urinary nitrogen output or percentage of urinary nitrogen excreted as urea (P = 0.28). Experiment 2 was an in vitro experiment conducted to validate the effects of RAC on nutrient digestibility using Simmental × Angus heifers (451 ± 50 kg). Rumen fluid was collected individually by stomach tube from CON- (n = 9) and RAC-fed (n = 10) heifers to inoculate bottles containing a CON or RAC-containing substrate in a split–plot design. No interaction between rumen fluid source and in vitro substrate was observed. Greater IVDMD (P = 0.01) was observed in rumen fluid from RAC-fed heifers compared with rumen fluid from CON-fed heifers. The inclusion of RAC in the in vitro substrate increased IVDMD (P &lt; 0.01). Overall, feeding RAC increased microbial digestion of the dry-rolled corn-based finishing diet to increase total tract dry mater digestion by 5% and reduce nitrogen excretion by 10.6% in the 35 d period prior to slaughter.
Evaluation of an herbal therapy to alleviate acute pain and stress of disbudded dairy calves under organic management1
Authors: Phillips Hannah N , Heins Bradley J 
Published: March 2021

Abstract
The objective of this experiment was to evaluate a herbal therapy used in place of standard synthetic analgesia to mitigate disbudding pain of dairy calves. For this experiment, 54 calves were randomly assigned to one of three treatments: 1) local anesthetic lidocaine given as a cornual nerve block before cautery disbudding (AD); 2) sham disbudding (SD); or 3) herbal tincture (Dull It, Dr. Paul’s Lab, Mazomanie, WI) composed of white willow (Salix alba L.) bark, St. John’s wort (Hypericum perforatum L.), chamomile (Matricaria recutita L.), arnica (Arnica montana L.), and fennel (Foeniculum vulgare Mill.) administered orally before and after cautery disbudding (TD). Behaviors were assessed during disbudding, and behaviors and blood plasma cortisol concentrations were assessed following disbudding. Tail wag, head movement, forcing ahead, and kick rates recorded during disbudding were similar among treatments. When averaged across the 360-min observation period following disbudding, injury-directed behavioral rates of head jerks, head shakes, horn bud scratches, and head rubs were greater (P ≤ 0.03) for calves in the AD group than calves in the SD group, calves in the TD group had greater (P &lt; 0.01) horn bud scratch and head rub rates compared to calves in the SD group, and calves in the AD group had a greater (P &lt; 0.01) horn bud scratch rate than calves in the TD group. Calves in the AD group took 1.6 [95% confidence interval (CI) = 1.0 to 2.4, P = 0.03] times longer to lie down after disbudding compared to calves in the TD group. Serum cortisol concentrations were greater (P ≤ 0.01) for calves in the TD group compared to calves in the SD group at 10, 30, and 90 min after disbudding. At 30 min after disbudding, calves in the AD group had 5.8 ng/mL (95% CI = −1.1 to 12.7 ng/mL, P = 0.02) greater serum cortisol compared to calves in the SD group, while calves in the TD group had 14.3 ng/mL (95% CI = 1.5 to 27.1 ng/mL, P &lt; 0.01) greater serum cortisol than calves in the AD group. In conclusion, neither the local anesthetic lidocaine nor the orally administered herbal tincture attenuated both acute injury-directed behaviors and blood plasma cortisol concentrations in disbudded calves, and the tincture was clearly less effective at mitigating cortisol; therefore, additional analgesic may be required to properly manage disbudding pain effectively.
Effects of voluntary removal of ractopamine hydrochloride (Optaflexx) on live performance and carcass characteristics of beef steers
Authors: Rincker Phillip J , Allen Janet B , Edmonds Matt , Brown Michael S , Kube John C 
Published: March 2021

Abstract
There is a lack of consistency across the globe in how countries establish tissue ractopamine residue limits and which residue limits are applied to various tissues, particularly for edible noncarcass tissues. Therefore, some U.S. beef slaughter organizations have recommended a 48-h voluntary removal of ractopamine before slaughter to meet residue requirements of specific export countries and maintain international trade. Our objective was to assess the impact of voluntary removal of ractopamine hydrochloride (Optaflexx; Elanco, Greenfield, IN) up to 8 d before slaughter on growth performance and carcass characteristics. Crossbred beef steers (60 pens of 10 animals/pen) with an initial shrunk body weight (BW) of 611.8 ± 10 kg SEM were fed one of six treatments over 42 d. Treatments included a control that did not receive ractopamine, on-label use of ractopamine (0-d withdrawal), and 2, 4, 6, or 8 d of voluntary removal of ractopamine from feed before slaughter. The start of ractopamine feeding (30.1 mg/kg of diet dry matter for 32 d) was staggered, so that blocks could be slaughtered on the same day. Dry matter intake was decreased by 0.5 kg/d when ractopamine was fed with a 0-d withdrawal (P = 0.04) compared with the control, but was not altered (P = 0.56) as the duration of ractopamine removal increased from 0 to 8 d. Final BW, total BW gain, and average daily BW gain were increased by feeding ractopamine with a 0-d withdrawal (P = 0.09) compared with the control, but these variables decreased in a linear manner (P = 0.10) as the duration of removal increased from 0 to 8 d. Gain efficiency was improved by 15% (P &lt; 0.01) by feeding ractopamine with a 0-d withdrawal compared with the control, and gain efficiency decreased linearly (P = 0.06) as the duration of ractopamine removal increased. Approximately 2/3 of the increase in gain efficiency remained after 8 d of removal. Hot carcass weight was increased by 6 kg (P = 0.02) by feeding ractopamine with a 0-d withdrawal compared to the control. Measured carcass characteristics were not altered by ractopamine feeding or by removal before slaughter (P ≥ 0.24). The consequences of voluntary removal of ractopamine up to 8 d before slaughter were a linear decrease in live BW gain (0.64 kg/d), poorer gain efficiency, and numerically lighter carcass weight.
COVID-19 pandemic response behaviors: a Singapore experience of the “circuit breaker”
Authors: Chew Han Shi Jocelyn , Chng Samuel 
Published: March 2021

Abstract
Preventive health behaviors such as hand hygiene are crucial amidst pandemics like COVID-19 but reports on nonadherence persist. This could be due to the lack of Consideration of Future Consequences (CFC), a cognitive-motivational construct known to improve health-related behaviors. Therefore, we examined the relationship between CFC and five behaviors—mask-wearing, social distancing, hand hygiene, excessive necessities buying, and COVID-19 information searching using an internet-based Singapore-wide survey conducted from April 20 to May 4, 2020. Behavioral differences 2 weeks before and after the state-wide confinement were examined using paired t-tests. Relationships between CFC and COVID-19 behaviors were examined using regression analyses adjusted for depression and anxiety. Participants were regrouped into three categories—increased behavior performance, maintained high performance, and maintained low performance where mean differences were analysed using MANOVA. Three hundred and thirty-six participants completed the survey (mean age, SD = 32.9 years [SD = 12.6]; 38.7% males). CFCfuture predicted mask wearing (B = 0.16; p &lt; .05), social distancing (B = 0.0.19; p &lt; .01), hand hygiene (B = 0.17; p &lt; .01), and information searching (B = 0.21; p &lt; .001). CFCimmediate predicted hand hygiene (B = 0.09; p &lt; .05), excessive necessities buying (B = 0.07; p &lt; .05) and information searching (B = 0.08; p &lt; .05). Anxiety predicted excessive buying (B = 0.08; p &lt; .05) and hand hygiene (B = 0.13; p &lt; .01). Post-hoc test showed significantly higher CFCfuture (p &lt; .01) in participants who increased and maintained high behavioral performance.
Local Water Quality, Diarrheal Disease, and the Unintended Consequences of Soda Taxes
Authors: Gutierrez Emilio , Rubli Adrian 
Published: March 2021

Abstract
Could taxing sugar-sweetened beverages in areas where clean water is unavailable lead to increases in diarrheal disease? An excise tax introduced in Mexico in 2014 led to a significant 6.6 percent increase in gastrointestinal disease rates in areas lacking safe drinking water throughout the first year of the tax, with evidence of a diminishing impact in the second year. Suggestive evidence of a differential increase in the consumption of bottled water by households without access to safe water two years post-tax provides a potential explanation for this declining pattern. The costs implied by these results are small, particularly compared to tax revenues and the potential public health benefits. However, these findings inform the need for accompanying soda taxes with policy interventions that guarantee safe drinking water for vulnerable populations.
Vaginal Hysterectomy Rates Before and After Implementation of a Multiple-Tier Intervention
Authors: Crouss Tess , Sharma Shefali , Smith Devon , Hunter Krystal , Perry Robin , Lipetskaia Lioudmila 
Published: March 2021

OBJECTIVE:
To assess a multiple-tier intervention to increase vaginal hysterectomy rates.

METHODS:
We performed a cohort study assessing hysterectomy performance before and after implementation of a multiple-tier intervention to increase vaginal hysterectomy rates at a single tertiary care medical center. This intervention involved resident and attending education and simulation, professional development, design of a clinical pathway to assist in hysterectomy decision making, and development of a surgical mentorship program.

RESULTS:
Data from 698 hysterectomies (253 preintervention and 445 postintervention) were included. The preintervention time period extended from January 1, 2016, to December 31, 2017 (24 months), and the postintervention period from January 1, 2018, to February 28, 2020 (26 months). The intervention was implemented over the month of December 2017 but was not complete until January 1, 2018. The preintervention and postintervention cohorts were similar in most demographic and clinical aspects. Postintervention, the proportion of vaginal hysterectomies was higher (26.5% vs 5.5%, odds ratio 6.2, 95% CI 3.52–11.35), including in those performed for reasons other than prolapse (6.8% vs 0%, P<.001). Logistic regression revealed that prolapse, uterine weight less than 250 g, and surgery during the postintervention cohort were significantly associated with vaginal hysterectomy. Operative complications did not differ significantly by hysterectomy type.

CONCLUSION:
Implementation of a multiple-tier intervention was associated with an increase in vaginal hysterectomies.
Long-Term Outcomes in Complex Abdominal Wall Reconstruction Repaired With Absorbable Biologic Polymer Scaffold (Poly-4-Hydroxybutyrate)
Authors: Buell Joseph F. , Flaris Alexandros N. , Raju Sukreet , Hauch Adam , Darden Michael , Parker Geoff G. 
Published: March 2021

Introduction:
After promising early outcomes in the use of absorbable biologic mesh for complex abdominal wall reconstruction, significant criticism has been raised over the longevity of these repairs after its 2-year resorption profile.

Methods:
This is the long-term (5-year) follow-up analysis of our initial experience with the absorbable polymer scaffold poly-4-hydroxybutyrate (P4HB) mesh compared with a consecutive contiguous group treated with porcine cadaveric mesh for complex abdominal wall reconstructions. Our clinical analysis was performed using Stata 14.2 and Excel 16.16.23.

Results:
After a 5-year follow-up period, the P4HB group (n = 31) experienced lower rates of reherniation (12.9% vs 38.1%; P = 0.017) compared with the porcine cadaveric mesh group (n = 42). The median interval in months to recurrent herniation was similar between groups (24.3 vs 20.8; P = 0.700). Multivariate logistic regression analysis on long-term outcomes identified smoking (P = 0.004), African American race (P = 0.004), and the use of cadaveric grafts (P = 0.003) as risks for complication while smoking (P = 0.034) and the use of cadaveric grafts (P = 0.014) were identified as risks for recurrence. The long-term cost analysis showed that P4HB had a $10,595 per case costs savings over porcine cadaveric mesh.

Conclusions:
Our study identified the superior outcomes in clinical performance and a value-based benefit of absorbable biologic P4HB scaffold persisted after the 2-year resorption timeframe. Data analysis also confirmed the use of porcine cadaveric grafts independently contributed to the incidence of complications and recurrences.
Chronic cluster headache: a study of the telencephalic and cerebellar cortical thickness
Authors: Demichelis Greta , Pinardi Chiara , Giani Luca , Medina Jean Paul , Gianeri Ruben , Bruzzone Maria Grazia , Becker Benjiamin , Proietti Alberto , Leone Massimo , Chiapparini Luisa , Ferraro Stefania , Nigri Anna 
Published: March 2021

AbstractPrevious studies on brain morphological alterations in chronic cluster headache revealed inconsistent findings. The present cross-sectional explorative study determined telencephalic and cerebellar cortex thickness alterations in a relatively wide sample of chronic cluster headache patients (n=28) in relation to matched healthy individuals. The combination of two highly robust state-of-the-art approaches for thickness estimation (Freesurfer and CERES) with an unbiased functional characterization of the abnormal regions, revealed two main results. First, chronic cluster headache patients show cortical thinning in the right middle cingulate cortex and the left posterior insula. This indicates abnormalities in key-regions of pain processing areas, in particular in regions belonging to the spino-thalamic-cortical tract and primarily involved in the sensory-motor aspects of nociception. Second, chronic cluster headache patients present cortical thinning in the left anterior superior temporal sulcus and the left collateral/lingual sulcus, suggesting neuroplastic maladaptations in areas possibly involved in social cognition, which may promote psychiatric comorbidity, frequently observed in these patients.
Determining the risk of developing symptomatic covid-19 infection after attending hospital for radiological examinations: controlled cohort study
Authors: Evangelou Nikos , Vaughan Sian , Hibbert Aimee , Morgan Paul S , Backx Matthijs , Berry Louise , Card Tim , Tallantyre Emma 
Published: March 2021

AbstractOBJECTIVETo determine whether brief attendance for outpatient radiological investigations is associated with increased risk of clinically significant coronavirus disease 2019 (covid-19) infection.DESIGNObservational cohort study with a historical control.SETTING2 large UK University Hospitals located in Nottingham and Cardiff.PARTICIPANTSAll 47,340 patients who attended an outpatient radiology appointment at Nottingham University Hospitals and University Hospital of Wales during the first wave of the pandemic in 2020, and 70,655 patients that comprised the control cohort who attended for outpatient radiology the same period in 2019.MAIN OUTCOME MEASURESThe risk of developing clinically significant covid-19 infection within 28-days of attending a radiological examination. Covid-19 infection rates for the 2020 cohort were compared against a control group who attended in 2019.RESULTS84 positive SARS-CoV-2 tests were temporally associated with 47,340 radiological examinations across two hospitals in 2020. This low infection rate was higher than the 2019 control cohort; OR 2.507 (1.766 – 3.559) and equates to an approximate 1 positive covid-19 infection per 1000 radiology investigations.CONCLUSIONSOur data suggests that attending hospitals for outpatient radiological investigations during the pandemic is associated with a very small absolute risk of acquiring clinically significant covid-19 infection. It is unlikely that this risk is directly attributable to radiology attendance, considering the reasons leading individuals to attend hospitals during the pandemic, the true attributable risk will likely be even lower.TRIAL REGISTRATIONClinicalTrials.govNCT04544176