bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antipsychotics Use Is Associated With Greater Adherence to Cardiometabolic Medications in Patients With Schizophrenia: Results From a Nationwide, Within-subject Design Study
Authors: Solmi Marco , Tiihonen Jari , Lähteenvuo Markku , Tanskanen Antti , Correll Christoph U , Taipale Heidi 
Published: June 2021

AbstractBackgroundPeople with schizophrenia/schizoaffective disorder (schizophrenia) die early, largely due to cardiovascular-related mortality. Antipsychotics are associated with lower mortality. We aimed to explore whether antipsychotic use can reduce discontinuation of medications for cardiovascular risk factors and diseases (“cardiometacolic drugs”), using a within-study design controlling for subject-related factors.MethodsPersons diagnosed with schizophrenia between 1972 and 2014, aged &lt;65 years at cohort entry were identified in Finnish national databases. Four subcohorts were formed based on cardiometabolic drug use during the follow-up period, 1996–2017, namely statin (n = 14,047), antidiabetic (n = 13,070), antihypertensive (n = 17,227), and beta-blocker (n = 21,464) users. To control for subject-related factors, including likelihood of adherence as a trait characteristic, we conducted a within-subject study comparing the risk of discontinuation of each cardiometabolic drug during periods on vs off antipsychotics within each subject. We also accounted for number of psychiatric and nonpsychiatric visits in sensitivity analyses.ResultsIn 52,607 subjects with schizophrenia, any antipsychotic use vs nonuse was associated with decreased discontinuation risk of antidiabetics (adjusted hazard ratio [aHR] = 0.56, 95% confidence interval [CI] = 0.47–0.66), statins (aHR = 0.61, 95%CI = 0.53–0.70), antihypertensives (aHR = 0.63, 95%CI = 0.56–0.71), and beta-blockers (aHR = 0.79, 95%CI = 0.73–0.87). Antipsychotics ranking best for discontinuation of all cardiometabolic drug categories were clozapine (aHR range = 0.34–0.55), followed by olanzapine (aHR = 0.43–0.71). For statins, aHRs ranged from aHR = 0.30 (95%CI = 0.09–0.98) (flupentixol-long-acting injectable (LAI) to aHR = 0.71 (95%CI = 0.52–0.97) (risperidone-LAI), for anti-diabetic medications from aHR = 0.37 (95%CI = 0.28–0.50) (clozapine) to aHR = 0.70 (95%CI = 0.53–0.92) (quetiapine), for antihypertensives from aHR = 0.14 (95%CI = 0.04–0.46) (paliperidone-LAI) to aHR = 0.69 (95%CI = 0.54–0.88) (perphenazine), for beta-blockers from aHR = 0.55 (95%CI = 0.48–0.63) (clozapine) to aHR = 0.76 (95%CI = 0.59–0.99) (perphenazine-LAI). The decreased risk of discontinuation associated with antipsychotic use somewhat varied between age strata. Sensitivity analyses confirmed main findings.DiscussionIn this national database within-subject design study, current antipsychotic use was associated with substantially decreased risk of discontinuation of statins, anti-diabetics, antihypertensives, and beta-blockers, which might explain reduced cardiovascular mortality observed with antipsychotics in people with schizophrenia.
The virus and the vessel, or: how we learned to stop worrying and love surveillance
Authors: Chorev Nitsan 
Published: June 2021

Abstract
This Society for the Advancement of Socio-Economics (SASE) Presidential address was given (virtually) at the annual SASE conference in July 2020. It is an early analysis of governments’ response to COVID-19, specifically governments’ attempt to reduce the spread of the virus by modifying people’s behaviors. Some of these attempts followed familiar models of power, such as discipline and governmentality. In addition, I show that a new practice of power emerged, addressing subjects who are considered ‘ungovernable’. In the first part of the lecture, I look at how states see their subjects and argue that COVID-19 reveals and normalizes a state’s view of subjects as ‘unresponsive’ and therefore ‘ungovernable’. In the second part, I look at how social media companies constitute us as ‘ungovernable’ and help reshape how states govern. Finally, I discuss instances of resistance, which might save our political agency after all.
Comparison of reproductive performance of AI- and natural service-sired beef females under commercial management
Authors: Marrella Mackenzie A , White Robin R , Dias Nicholas W , Timlin Claire , Pancini Stefania , Currin J , Clark Sherrie , Stewart Jamie L , Mercadante Vitor R G , Bradford Heather L 
Published: June 2021

AbstractThe objective of this study was to assess differences in reproductive performance of natural service and artificial insemination (AI) sired beef females based on pregnancy outcomes, age at first calving, and calving interval. Data were sourced from 8,938 cows sired by AI bulls and 3,320 cows sired by natural service bulls between 2010 and 2017. All cows were in a commercial Angus herd with 17 management units located throughout Virginia and represented spring and fall calving seasons. All calves were born to dams managed with estrus synchronization. Pregnancy was analyzed with generalized linear mixed models and other reproductive measures with linear mixed models in R. Six models were evaluated with the dependent variables of pregnancy status at the first diagnosis, pregnancy status at the second diagnosis, pregnancy type (AI or natural service) at the first diagnosis, pregnancy type at the second diagnosis, calving interval, and age at first calving. Independent variables differed by model but included sire type of the female (AI or natural service), prebreeding measures of age, weight, and body condition score, postpartum interval, sex of the calf nursing the cow, and management group. No differences were observed between AI- and natural service-sired females based on pregnancy status at first and second pregnancy diagnosis (P &gt; 0.05). Sire type was only found to be significant for age at first calving (P &lt; 0.05) with AI-sired females being 26.6 ± 1.6 d older at their first calving, which was expected because AI-sired females were born early in the calving season making them older at breeding. Surprisingly, age and body condition score were not significant predictors of pregnancy (P &gt; 0.05). Body weight at breeding was not significant for pregnancy (P &gt; 0.05) but was significant for age at first calving (P &lt; 0.05). These data suggested that lighter heifers calved earlier which contradicts our original hypothesis. Overall, commercial Angus females sired by AI or natural service bulls had similar reproductive performance. Factors that were commonly associated with reproductive success were not significant in this commercial Angus herd managed with estrus synchronization. Given the size of these data, the importance of body condition, age, and weight should be reassessed in modern genetics and management practices.
Perception of Medical Student Mistreatment: Does Specialty Matter?
Authors: O’Brien Kevin E. , Mechaber Alex J. , Ledford Cynthia H. , Klocksieben Farina A. , Fagan Mark J. , Harrell Heather E. , Kaib Susan , Elnicki Mike , Van Deusen Reed , Moerdler Scott , Jagsi Reshma , Frank Erica ,   the Perceived Abuse of Medical Students (PAMS) Investigators
Published: June 2021

Purpose
Medical student mistreatment is pervasive, yet whether all physicians have a shared understanding of the problem is unclear. The authors presented professionally designed trigger videos to physicians from 6 different specialties to determine if they perceive mistreatment and its severity similarly.

Method
From October 2016 to August 2018, resident and attending physicians from 10 U.S. medical schools viewed 5 trigger videos showing behaviors that could be perceived as mistreatment. They completed a survey exploring their perceptions. The authors compared perceptions of mistreatment across specialties and, for each scenario, evaluated the relationship between specialty and perception of mistreatment.

Results
Six-hundred fifty resident and attending physicians participated. There were statistically significant differences in perception of mistreatment across specialties for 3 of the 5 scenarios: aggressive questioning (range, 74.1%–91.2%), negative feedback (range, 25.4%–63.7%), and assignment of inappropriate tasks (range, 5.5%–25.5%) (P ≤ .001, for all). After adjusting for gender, race, professional role, and prior mistreatment, physicians in surgery viewed 3 scenarios (aggressive questioning, negative feedback, and inappropriate tasks) as less likely to represent mistreatment compared with internal medicine physicians. Physicians from obstetrics–gynecology and “other” specialties perceived less mistreatment in 2 scenarios (aggressive questioning and negative feedback), while family physicians perceived more mistreatment in 1 scenario (negative feedback) compared with internal medicine physicians. The mean severity of perceived mistreatment on a 1 to 7 scale (7 most serious) also varied statistically significantly across the specialties for 3 scenarios: aggressive questioning (range, 4.4–5.4; P < .001), ethnic insensitivity (range, 5.1–6.1; P = .001), and sexual harassment (range, 5.5–6.3; P = .004).

Conclusions
Specialty was associated with differences in the perception of mistreatment and rating of its severity. Further investigation is needed to understand why these perceptions of mistreatment vary among specialties and how to address these differences.
Updated evidence-based recommendations for cervical cancer screening in France
Authors: Hamers Françoise F. , Poullié Anne-Isabelle , Arbyn Marc 
Published: June 2021

Introduction
A national organized cytology-based cervical cancer screening program was launched in 2018 and rollout is ongoing. Concomitantly, the High Authority for Health (HAS) recently assessed new evidence on primary HPV testing to update screening recommendations.

Methods
The HAS commissioned systematic reviews and meta-analyses to evaluate the effectiveness of primary HPV screening; accuracy of HPV testing on self-samples; effectiveness of self-sampling to reach underscreened women; and triage strategies to manage HPV-positive women. Recommendations developed by the HAS were reviewed by a multidisciplinary group.

Results
Compared with cytology screening, HPV screening is more sensitive to detect precancers but less specific. In women aged ≥30, if the test is negative, HPV screening greatly reduces the risk of developing precancer and cancer for at least 5 years. HPV testing, using validated PCR-based assays, is as sensitive and slightly less specific on self-samples than on clinician-taken samples. Self-sampling is more effective to reach underscreened women than sending invitations to have a specimen taken by a clinician. Two-time triage strategies ensure a sufficiently high risk if triage-positive to justify referral and low risk if triage-negative allowing release to routine screening.

Conclusions
The HAS recommends three-yearly cytology screening for women aged 25–29 and HPV screening for those aged 30–65 with an extension of the screening interval to 5 years if the HPV test is negative. Self-sampling should be offered to underscreened women aged ≥30. HPV-positive women should be triaged with cytology. Those with abnormal cytology should be referred for colposcopy and those with normal cytology re-tested for HPV 12 months later. Recommendations for implementation of HPV-based screening in the organized program are provided.
A Pilot Study of Preoperative Vandetanib on Markers of Proliferation and Apoptosis in Breast Cancer
Authors: Spanheimer Philip M. , Bashir Amani , Lorenzen Allison W. , Beck Anna C. , Liao Junlin , Lizarraga Ingrid M. , Erdahl Lillian M. , Sugg Sonia L. , Karwal Mark W. , Weigel Ronald J. 
Published: June 2021

Introduction:
Preclinical data supports antitumor activity of tyrosine kinase inhibitor vandetanib with Ret as the therapeutic target in breast cancer. We investigated the effect of preoperative vandetanib on markers of proliferation and apoptosis in breast cancer.

Methods:
Patients with invasive breast cancer were randomly assigned vandetanib 300 mg or placebo PO daily for 2 weeks before operative resection from January 2014 to June 2017. Pretreatment and posttreatment specimens were analyzed by immunohistochemistry for Ki-67, TUNEL, and p-ERK with stratification by Ret expression by immunohistochemistry.

Results:
Ten patients were enrolled. There was no statistically significant difference in ERK activation compared with placebo (P=0.45); however, ERK activation was reduced 74% compared with pretreatment biopsy with vandetinib treatment (P=0.005) without a significant reduction in the placebo group (−29%, P=0.55). Mean change in Ki-67 after vandetanib treatment was +0.3% compared with +2.0% in placebo treated patients, P=0.72. Mean change in TUNEL was +0.48 apoptotic nuclei per HPF in the vandetanib arm compared with +1.02 in the placebo arm, P=0.32. In vandetanib treated patients, Ki-67 was reduced 0.3% in RET-positive tumors compared with increased 1.0% in RET-negative tumors, P=0.43 and TUNEL was increased 0.77 in RET-positive tumors and 0.2 in RET-negative tumors, P=0.21.

Conclusions:
In this pilot study, no statistically significant differences on prespecified markers were seen with vandetanib compared with placebo. In accordance with the investigational hypothesis, there was a nonsignificant trend with vandetanib treatment of reduction in p-ERK and increased effects in Ret expressing tumors.
Racism as an Adverse Childhood Experience: An Interactive Workshop to Train Pediatricians to Address Racism in Clinical Care
Authors: Loe Irene M. , Froehlich Tanya E. , Edrees Hanein H. , Spinks-Franklin Adiaha ,   the R.A.C.E. C.A.R.D. Collaborative
Published: June 2021

ABSTRACT:

Objective:
The objective of this study was to address critical gaps in pediatric medical education by developing and evaluating an interactive educational workshop on racism as an adverse childhood experience (ACE).

Methods:
A team of developmental-behavioral pediatrics professionals used a best-practice curriculum development model of Kern's 6 steps to develop the workshop curriculum. Based on a targeted needs assessment, goals and objectives to address the topics of race and racism in clinical practice were developed. A variety of educational strategies (e.g., audience polls, videos, didactic presentations, experiential activities, and peer-guided case-based discussion and practice) were used to appeal to varied learning styles. Selection of strategies was guided by self-determination theory, an adult learning model that addresses the needs of autonomy, competence, and relatedness. The workshop was implemented at 2 national pediatric meetings and evaluated using participant polls and written program evaluation.

Results:
The workshop curriculum was well-received. Participants endorsed improvements in comfort level in talking about race/racism and demonstrated a significant change in preparation or comfort level for skills-based activities, including counseling families and offering resources to address experiences with racism, postworkshop. Participants endorsed intent to change clinical practice by discussing the issues of race and indicated a desire to receive additional training.

Conclusion:
An interactive educational workshop on racism as an ACE was effective in improving pediatric professionals' comfort level and self-rated skills. Desire for a longer educational session suggests receptivity to longitudinal approaches. Replication and refinement of the educational workshop could clarify effective components of this approach. We advocate for longitudinal training curricula that incorporate observable behavior change and skills to increase and further evaluate the impact. Health care provider education and training to implement antiracism efforts in clinical encounters with patients and families can serve as an entry point to the complex process of addressing racism at multiple levels in health care.
Adolescent Chronic Health Conditions and School Disconnectedness
Authors: James Christine , Corman Hope , Noonan Kelly , Reichman Nancy E. , Jimenez Manuel E. 
Published: June 2021

Abstract:

Objective:
The objective of this study was to examine associations between chronic health conditions and school disconnectedness, trouble getting along with others at school, and peer victimization at age 15.

Method:
We conducted a secondary analysis of population-based data from the Fragile Families and Child Wellbeing birth cohort to investigate associations between chronic developmental/behavioral and physical health conditions and school disconnectedness, trouble getting along with others at school, and peer victimization of adolescents using mother-reported child health conditions and youth-reported relationships/experiences at school ascertained from standardized scales. Associations were examined using linear and logistic regression models adjusting for confounding factors.

Results:
Of the 2874 adolescents included, more than one-third had at least 1 chronic health condition. Compared with those with no chronic health conditions, adolescents with developmental/behavioral health conditions felt more disconnected from school (by 0.22 SDs), had more trouble getting along with others at school (0.22 SD), and were more victimized by peers at school (0.20 SD). Teens with physical health conditions also felt more disconnected from school (0.10 SD), had more trouble getting along with others at school (0.12 SD), and were more victimized by peers (0.12 SD). One noteworthy difference was that adolescents with developmental/behavioral conditions were more likely than those with no conditions to report trouble getting along with teachers, but adolescents with physical health conditions were not.

Conclusion:
Chronic health conditions were associated with disconnectedness from school and negative school social interactions in this study of US urban youth, suggesting that targeted resources and interventions for this population are needed.
TWENTY-FIVE AND TWENTY-SEVEN-GAUGE SUTURELESS INTRASCLERAL FIXATION OF INTRAOCULAR LENSES
Authors: Patel Kishan G. , Yazdani Ava , Abbey Ashkan M. 
Published: June 2021

Purpose:
To describe the clinical outcomes and surgical technique in transconjunctival sutureless intrascleral fixation of intraocular lenses, including the effectiveness of haptic flanging and peripheral iridotomy.

Method:
Retrospective series of patients who underwent sutureless intrascleral fixation of three-piece intraocular lenses by a single surgeon.

Results:
A total of 488 eyes were included in this study. Mean follow-up was 444 days. Mean preoperative best-corrected visual acuity was 20/355, and mean postoperative best-corrected visual acuity was 20/39 (P < 0.001). Intraocular lens dislocation occurred during the postoperative period in 67 (13.7%), with the majority (65.7%) occurring within 3 months after surgery. Dislocation occurred in 13 of 196 (6.6%) flanged haptics versus 54 of 292 (18.5%) unflanged haptics (P < 0.001). Reverse pupillary block occurred in 7 of 231 eyes (3.0%) without intraoperative peripheral iridotomy but only in 1 of 257 eyes (0.4%) with iridotomy (P = 0.0297). Other complications included haptic exposure (1.2%), retinal detachment (1.0%), and endophthalmitis (0.4%).

Conclusion:
This is the largest reported series of sutureless intrascleral fixation of intraocular lenses using trocar cannulas. This technique is an effective surgical option with low complication rates. The authors recommend that haptic flanging and peripheral iridotomy be performed in all cases.
Preoperative Criteria Predict Operative Time Variability Within Tympanoplasty Procedures
Authors: LeClair Karissa L. , Bessen Sarah Y. , Magro Isabelle L. , Kahng Peter W. , Saunders James E. 
Published: June 2021

Objective:
To identify preoperative patient and surgical parameters that predict operative time variability within tympanoplasty current procedural terminology (CPT) codes.

Study Design:
Retrospective.

Setting:
Tertiary referral center.

Patients:
One hundred twenty eight patients who underwent tympanoplasty (CPT code 69631) or tympanoplasty with ossicular chain reconstruction (69633) by a single surgeon over 3 years.

Intervention(s):
Procedures were preoperatively assigned a complexity modifier: Level 1 (small or posterior perforation able to be repaired via transcanal approach), Level 2 (large perforation or other factor requiring postauricular approach), or Level 3 (cholesteatoma or severe infection).

Main Outcome Measure(s):
Total in-room time (nonoperative time plus actual operative time).

Results:
Consideration of preoperative parameters including surgical complexity, surgical facility, use of facial nerve monitoring, laser usage, resident involvement, revision surgery, and underlying patient characteristics (American Society of Anesthesiologists [ASA] score, body mass index [BMI]) accounted for up to 69% of surgical time variance. Across both CPT codes, surgical complexity levels accurately stratified operative times (p < 0.05). Total time was longer (by 30.0 min for 69631, 55.4 min for 69633) in Level 3 procedures compared with Level 2, while Level 1 cases were shorter (27.6, 33.9 min). Resident involvement added 25 and 32 minutes to total time (p < 0.02). Nonoperative preparation times were longer (22.1, 15.4 min) in the main hospital compared with ambulatory surgical center (p < 0.001).

Conclusions:
There is significant surgical time variability within tympanoplasty CPT codes, which can be accurately predicted by the preoperative assignment of complexity level modifiers and consideration of patient and surgical factors. Application of complexity modifiers can enable more efficient surgical scheduling.
The Impact of Superior Canal Dehiscence on Power Absorbance, Otoacoustic Emissions, and Hearing in Fat Sand Rats
Authors: Attias Joseph , Rabinovics Naomi , Nageris Benny , Hilly Ohad 
Published: June 2021

Background:
Superior Semicircular Canal Dehiscence (SSCD) may lead to vestibular and auditory impairments.

Objective:
To study the effects of power absorbance (PA), Distortion Product Otoacoustic emissions (DPOAE), and hearing thresholds in normal ears of fat sand rats, after a bullotomy, creation and patching.

Methods:
SSCD was performed unilaterally in eight normal hearing animals while the contra-lateral un-operated ear was used as a control. Measures included auditory brain stem responses thresholds for air and bone conduction stimuli, DPOAEs and PA at peak pressure.

Results:
The normal PA pattern of the animals grossly resembled that of human ears. A bullotomy generated specific, large and significant (p < 0.0001) changes in PA without altering hearing thresholds. SSCD significantly decreased PA at low (p < 0.02) and increased at high frequencies (p < 0.03), but on a smaller scale than the bullotomy. SSCD, induced a mean air-bone gaps of 24.3 for clicks, and 31.2 dB for 1 kHz TB. SSCD also increased the DPOAEs levels by mean of 10.1 dB SPL (p < 0.03). Patching the dehiscence, reversed partially the PA changes, the auditory threshold shifts, and the DPOAEs levels to pre-SSCD values.

Conclusions:
SSCD affects both incoming and emitting sounds from the ear, probably due to its effect on cochlear impedance and stiffness of the middle and inner ear. The presence of DPOAEs and ABGs indicated a “third window” disease, i.e., SSCD. Due to similar PA patterns after bullotomy and SCCD, PA alone has limited diagnostic yield for patients with SCCD.