bluuebunny/crossref_metadata_2025_split huggingface dataset:
Binge Eating Disorders in Antipsychotic-Treated Patients With Schizophrenia
Authors: de Beaurepaire Renaud 
Published: February 2021

Abstract

Background
Excessive energy intake likely favors metabolic dysfunction in patients with schizophrenia and may be, in part, the consequence of antipsychotic treatments. However, previous studies on the prevalence of bulimia and binge eating symptoms in antipsychotic-treated patients are contradictory and not sufficiently informative.

Methods
The prevalence of bulimia nervosa, binge eating disorder, and subsyndromal binge eating disorder was studied using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria in 156 patients with schizophrenia or schizoaffective disorder treated with antipsychotic monotherapy. The effects of different antipsychotics were compared.

Results
The prevalence of full syndromal binge eating disorder was 4.4% and that of subsyndromal binge eating disorder was 18.7% in patients (23.1% for binge eating spectrum disorder), and there were no cases of bulimia nervosa. Compared with the whole sample, binge eating spectrum disorders were significantly more prevalent in clozapine- and olanzapine-treated patients. Comparisons of patients having undergone treatment for 2 years or less with patients treated for more than 2 years showed that binge eating spectrum disorders decrease significantly over time, the difference being significant in clozapine- and olanzapine-treated patients. Night eating, simply assessed by a single question, showed a prevalence of 30% and was more prevalent in women treated with clozapine and olanzapine, with no significant change over time.

Conclusions
Binge eating disorders should be considered as important factors involved in the development of weight gain and metabolic syndrome in antipsychotic-treated patients with schizophrenia. The difficulty to reliably assess binge eating spectrum disorders in patients with psychosis is highlighted.
Subepidermal Autoimmune Bullous Disease Associated With Monoclonal Gammopathy of Unknown Significance and Unexpected Positive Direct Nikolsky Phenomenon: A Case Report
Authors: Taş-Aygar Gamze , Gönül Müzeyyen , Gökçe Aysun , Çağın Münire 
Published: February 2021

Abstract

Introduction:
Numerous dermatoses associated with monoclonal gammopathy have been reported in the literature. Subepidermal autoimmune bullous diseases (SABD) are one of them which were not common.
Here we report a case of SABD associated with MGUS who had a severe mucosal involvement and unexpected positive direct Nikolsky phenomenon.

Case presentation:
A 68-year-old male patient was admitted to our clinic with erosions on the oral mucosa, tense blisters, erosions, and ulcers on the trunk and extremities. Subepidermal vesicle formation was detected in the skin biopsy. Clinical examination revealed positivity for the Nikolsky phenomenon. The disease was unresponsive to conventional treatments and dysphagia and hoarseness occurred. The patient was screened for malignancy due to his unresponsiveness to the treatments and his severe oral mucosal involvement. Ig-G MGUS was detected in the patient.

Discussion:
The Nikolsky sign is an indicator of acantholysis and is known as a specific finding for pemphigus. However, when we look at gammopathy-associated autoimmune bullous dermatoses, skin fragility has been reported in cases. However, the meaning of fragility is not explained. The diagnosis of all these patients was Ig-M MGUS. Our patient was presented because of non-IgM MGUS, direct Nikolsky positivity, and severe mucosal involvement.

Conclusion:
Nikolsky positivity may be a clue for gammopathy-related subepidermal autoimmune bullous diseases.
Postoperative Telehealth Visits Reduce Emergency Department Visits and 30-Day Readmissions in Elective Thoracic Surgery Patients
Authors: Tham Elwin , Nandra Kulvir , Whang Sung E. , Evans Nathaniel R. , Cowan Scott W. 
Published: February 2021

ABSTRACT

Background:
Preventing postoperative 30-day readmissions requires an investment in patient care. The use of postdischarge telehealth visits to prevent potential adverse events or hospital visits has been shown in previous studies.

Purpose:
We aim to determine the impact of postoperative telehealth visits (PTV) on reducing emergency department visits (EDV) and readmissions within 30 days postdischarge (30DR).

Methods:
All elective thoracic surgery patients opted-in or opted-out of PTV. Postoperative telehealth visits assessed patients' overall health status and addressed patient concerns. Patients were also seen at their postoperative clinic follow-up. Emergency department visits and 30DR were recorded.

Results:
Three hundred fourty-one patients were included—295 and 46 patients opted-in and opted-out of PTV. Opting-out of PTV, being discharged with chest tubes or drains, and the inability to perform activities of daily living at their postoperative follow-up were associated with increased EDV (OR = 8.7, 5.3, 6.3; p ≤ .05) and 30DR (OR = 5.1, 6.3, 7.1; p ≤ .05).

Conclusion:
Postoperative telehealth visits were able to reduce EDV and 30DR in our study, although further studies establishing the range of interventions that can be feasibly provided remotely should be performed to identify limitations of these PTV.

Implications:
Telehealth could be used postoperatively to reduce EDV and 30DR, improving quality and cost-effectiveness of healthcare delivery to patients.
Defining a Research Agenda for Youth Sport Specialization in the United States: The AMSSM Youth Early Sport Specialization Summit
Authors: Kliethermes Stephanie A. , Marshall Stephen W. , LaBella Cynthia R. , Watson Andrew M. , Brenner Joel S. , Nagle Kyle B. , Jayanthi Neeru , Brooks M. Alison , Tenforde Adam S. , Herman Daniel C. , DiFiori John P. , Beutler Anthony I. 
Published: February 2021

Abstract:
Sport specialization is becoming increasingly common among youth and adolescent athletes in the United States and many have raised concern about this trend. Although research on sport specialization has grown significantly, numerous pressing questions remain pertaining to short- and long-term effects of specialization on the health and well-being of youth, including the increased risk of overuse injury and burnout. Many current elite athletes did not specialize at an early age. Methodological and study design limitations impact the quality of current literature, and researchers need to prioritize pressing research questions to promote safe and healthy youth sport participation. The American Medical Society for Sports Medicine hosted a Youth Early Sport Specialization Summit in April 2019 with the goal of synthesizing and reviewing current scientific knowledge and developing a research agenda to guide future research in the field based on the identified gaps in knowledge. This statement provides a broad summary of the existing literature, gaps and limitations in current evidence, and identifies key research priorities to help guide researchers conducting research on youth sport specialization. Our goals are to help improve the quality and relevance of research on youth sport specialization and to ultimately assure that opportunities for healthy and safe sport participation continue for all youth.
Three-Dimensional Modeling and Measurement of the Human Cochlear Hook Region: Considerations for Tonotopic Mapping
Authors: Helpard Luke , Li Hao , Rohani Seyed A. , Rask-Andersen Helge , Ladak Hanif M. , Agrawal Sumit 
Published: February 2021

Hypothesis:
Measuring the length of the basilar membrane (BM) in the cochlear hook region will result in improved accuracy of cochlear duct length (CDL) measurements.

Background:
Cochlear implant pitch mapping is generally performed in a patient independent approach, which has been shown to result in place-pitch mismatches. In order to customize cochlear implant pitch maps, accurate CDL measurements must be obtained. CDL measurements generally begin at the center of the round window (RW) and ignore the basal-most portion of the BM in the hook region. Measuring the size and morphology of the BM in the hook region can improve CDL measurements and our understanding of cochlear tonotopy.

Methods:
Ten cadaveric human cochleae underwent synchrotron radiation phase-contrast imaging. The length of the BM through the hook region and CDL were measured. Two different CDL measurements were obtained for each sample, with starting points at the center of the RW (CDLRW) and the basal-most tip of the BM (CDLHR). Regression analysis was performed to relate CDLRW to CDLHR. A three-dimensional polynomial model was determined to describe the average BM hook region morphology.

Results:
The mean CDLRW value was 33.03 ± 1.62 mm, and the mean CDLHR value was 34.68 ± 1.72 mm. The following relationship was determined between CDLRW and CDLHR: CDL

HR

= 1.06(CDL

RW
)-0.26 (R

2

= 0.99).

Conclusion:
The length and morphology of the hook region was determined. Current measurements underestimate CDL in the hook region and can be corrected using the results herein.
Prevalence of masked hypertension evaluated by home blood pressure monitoring in a large sample of patients with office blood pressure <140/90 mmHg
Authors: Magalhães Jéssica A. , Lins-Filho Ozéas de L. , de Couto Tarcya L.G. , Silva Marcus V de F P , Lustosa Thais C. , Barroso Weimar K.S. , Brandão Andréa A. , Miranda Roberto D. , Barbosa Eduardo C.D. , Gomes Marco A.M. , Nadruz Wilson , Feitosa Audes D.M. , Pedrosa Rodrigo P. 
Published: February 2021

Aim
Patients with masked hypertension have a higher incidence of target organ damage, including increased left ventricular mass and carotid atherosclerosis and cardiovascular events when compared with normotensive patients. The adverse cardiovascular risks are even greater in patients already taking antihypertensive medication.

Objective
To identify the prevalence and clinical characteristics of masked hypertension in a large multicenter Brazilian sample that underwent office and home blood pressure monitoring.

Methods
This was an observational cross-sectional analytical study based on secondary data from the teleMRPA online platform, which included 32 cities from 15 states in the five regions of Brazil. The database included 3704 outpatient participants with office blood pressure <140/90 mmHg who performed home blood pressure monitoring for diagnostic investigation (diagnosis group; n = 1819) or treatment (treatment group; n = 1885) of hypertension in 2018.

Results
The prevalence of masked hypertension was 18.0% in the whole studied population and 15.4% and 20.4% in the diagnostic and treatment group, respectively. Masked hypertension was more frequently detected in patients with office blood pressure classified as high normal [systolic blood pressure (SBP) = 130–139 mmHg or diastolic blood pressure (DBP) = 85–89 mmHg], followed by those classified as normal (SBP = 120–129 mmHg or DBP = 80–84 mmHg) and optimal (SBP < 120 mmHg and DBP < 80 mmHg), with respective prevalence of 28.3, 13.4 and 4.4% in the diagnostic group and 30.8, 18.8 and 7.1% in the treatment group.

Conclusion
Masked hypertension has a significant prevalence among individuals with office blood pressure <140/90 mmHg, which is greater with patients with high normal office blood pressure and even higher in patients already using antihypertensive medication.
Comparison of the Effect of Holder Pasteurization and High-Pressure Processing on Human Milk Bacterial Load and Bioactive Factors Preservation
Authors: Dussault Nathalie , Cayer Marie-Pierre , Landry Patricia , de Grandmont Marie-Joëlle , Cloutier Marc , Thibault Louis , Girard Mélissa 
Published: February 2021

ABSTRACT

Objectives:
This project aims at comparing the impact of Holder pasteurization (HoP) and high-pressure processing (HPP) on bacterial load and retention of immunological components in human milk.

Methods:
Human milk samples discarded by the Public Mothers’ milk bank (Montreal, Canada) for bacterial purpose were pooled (n = 6) and pasteurized either by heating in a water bath (62.5°C, 30 minutes) or by HPP treatment (425 MPa, four cycles of 6 minutes, initial milk temperature of 4°C or 37°C). Bacterial load, lysozyme activity, and levels of immunoglobulins, lactoferrin, lipase, and 26 cytokines were analyzed. Untreated milk samples from same pools served as control.

Results:
HPP treatment of milk allows a similar elimination of bacteria than HoP; bacterial counts were under the detection limit [<3 colony-forming units (CFU)/mL] in 50% of milk pools after HPP treatment, compared to 17% for HoP. With initial heating of samples to 37°C before HPP treatment, inactivation to an extent under the detection limit was reached in 67% of pools. There is no significant difference in IgA, lysozyme, and cytokines concentrations between untreated milk and all treatment methods. While no significant difference was observed in the amount of lipase (P > 0.07) and IgG (P > 0.11) between untreated milk and HPP-treated milk samples, HoP seems to be damaging for these factors (P < 0.04). IgM is well preserved in HPP-4°C samples compared to untreated milk (P = 0.07) whereas a decrease is observed for this immunoglobulin levels in HPP-37°C and HoP samples (P < 0.01). Lactoferrin activity, is well maintained in HPP-37°C milk samples in comparison to untreated milk samples (P = 0.52). A decrease in activity of this molecule is noted for samples treated with HPP at 4°C (P = 0.02) and this decrease is even more pronounced for HoP samples (P = 0.004).

Conclusions:
HPP is a promising alternative to HoP for treatment of human milk intended to preterm babies. Our results demonstrate that HPP treatment of human milk provides safe milk with less detrimental effects on the biochemically and immunologically active milk components than HoP.
Therapeutic Drug Monitoring of Adalimumab During Long‐term Follow‐up in Paediatric Patients With Crohn Disease
Authors: Kim Mi Jin , Kim Eunsil , Kang Ben , Choe Yon Ho 
Published: February 2021

ABSTRACTObjectives:We investigated the therapeutic drug monitoring of adalimumab (ADL) on clinical remission (CR) and mucosal healing (MH) rates in paediatric patients with Crohn disease (CD). Furthermore, long‐term treatment efficacy of ADL in paediatric CD was evaluated through 3‐year follow‐up.Methods:We conducted a prospective study of 31 patients with CD who received ADL maintenance therapy and underwent endoscopic evaluation of MH and pharmacokinetic analysis. Patients in CR were identified based on Paediatric Crohn Disease Activity Index (PCDAI) scores less than 10. Patients with MH were identified based on Simple Endoscopic Scores for Crohn Disease (SES‐CD) of less than 2.Results:At 4 months and 1 year of ADL treatment, 28 and 26 patients, respectively, were under CR; 13 and 17 patients, respectively, achieved MH. The median trough levels (TLs) of ADL were higher in patients in CR (7.6 ± 3.5 μg/mL) than in patients with active disease (5.1 ± 2.2 μg/mL). ADL TLs were significantly higher in patients who achieved MH than in those who did not (14.2 ± 7.6 vs 7.8 ± 5.2 μg/mL). The optimal cut‐point for predicting MH at 1 year of ADL treatment was 8.18 μg/mL. During long‐term follow‐up, ADL TLs were stably maintained over 10 μg/mL; not only CR and MH but also histologic remission was obtained at a high rate. ADL administration maintained a positive effect on growth during the maintenance period.Conclusions:ADL TLs were significantly higher in paediatric patients with CD who achieved CR or MH. ADL treatment showed long‐term stable efficacy and positive effects on growth indicators.
Extragenital Screening of Chlamydia trachomatis and Neisseria gonorrhoeae Among Women in the College Health Setting
Authors: Huxta Rebecca A. , Soniyi Omotoyosi , Halbritter Ashlee , Nguyen Giang T. 
Published: February 2021

Background
Despite high frequencies of oral and receptive anal intercourse among young women, the Centers for Disease Control and Prevention does not recommend routine oropharyngeal or anorectal screening for CT and GC. Risk-based extragenital screening of women has not been adopted at the majority of college health centers, and existing research has not focused on the female or college population.

Methods
We examined health records of women at a college health center in a large urban university for 3 years to evaluate the effectiveness of CT and GC screening. We also evaluated the proportion of CT and GC infections that would have been missed if risk-based extragenital screening was not performed. Decisions to screen at extragenital sites were based on patient-reported risk behavior.

Results
For 8027 unique chlamydia screens and 7907 unique gonorrhea screens, approximately 20% of the visits used extragenital screening in response to self-reported risk behaviors. More than 44% of patients were non-Hispanic White, and approximately 48% fell within the 20- to 24-year age group. The case positivity rates for CT were 2.85% with urogenital-only screening and 1.30% with risk-prompted extragenital screening (1.1% throat, 4.3% rectal). The case positivity rates for GC were 0.11% with urogenital-only screening and 0.37% with risk-prompted extragenital screening (0.37% throat, 0% rectal). If the college health center had relied solely on urogenital screening rather than adding risk-based extragenital screening, 4.41% of CT infections would have been missed and 28.57% of GC infections would have been missed.

Conclusions
Nearly 1 of 22 CT infections and nearly 1 of 3 GC infections would have been missed without extragenital screening in this analysis of college women. Inclusion of risk-prompted extragenital screening in asymptomatic STD screening protocols can help clinicians diagnose CT and GC infections that would be have been missed with urogenital-only screening. Although rectal GC infections among women seem to be less common, oropharyngeal testing, in particular, for GC is suggested for women based on sexual risk. However, clinicians might only identify these risks if they ask patients directly about these potential exposures. Because guidelines exist only for men, future studies should focus on extragenital screening in college women to build the evidence that this particular population of patients may benefit from this practice, given the high risk of STDs in young adults.
Pediatric Patients Brought by Emergency Medical Services to the Emergency Department
Authors: Ramgopal Sriram , Varma Selina , Janofsky Stephen , Martin-Gill Christian , Marin Jennifer R. 
Published: February 2021

Background/Objective
To describe the epidemiology of emergency department (ED) visits by pediatric patients transported from the out-of-hospital setting (ie, scene) by emergency medical services (EMS), and identify factors associated with EMS transport.

Methods
We performed a cross-sectional study of ED visits from 2014 to 2017 utilizing a nationally representative probability sample survey of visits to US EDs. We included pediatric patients (<18 years old) and compared encounters transported from the scene by EMS to those who arrived to the ED by all other means. We performed multivariable logistic regression to identify factors associated with scene EMS transport.

Results
Of 130.2 million pediatric ED encounters, 4.7 million (3.8%) arrived by EMS. Most patients were White (61.1%), non-Hispanic (77.5%), and publicly insured (52.2%). Multivariable analysis demonstrated associations with EMS transport: Black (vs White) race (adjusted odds ratio [aOR], 1.48; 95% confidence interval [CI], 1.16–1.89), ages 1 to younger than 5 years (aOR, 0.52; 95% CI, 0.37–0.72) and 5 to younger than 12 years (aOR, 0.56; 95% CI, 0.40–0.80) (vs adolescents), pediatric (aOR, 0.60; 95% CI, 0.42–0.85) and nonmetropolitan hospital status (aOR, 0.52; 95% CI, 0.35–0.78), blood testing (aOR, 2.34; 95% CI, 1.71–3.19), time to evaluation (31–60 minutes [aOR, 0.56; 95% CI, 0.39–0.80] and >60 minutes [aOR, 0.51; 95% CI, 0.33–0.77] compared with 0–30 minutes), admission (aOR, 3.20; 95% CI, 2.33–4.38), and trauma (1.80; 95% CI, 1.43–2.28).

Conclusions
Four percent of pediatric ED patients are transported to the ED by EMS from the scene. These patients receive a rapid and resource intense diagnostic evaluation, suggesting that higher acuity. Black patients, adolescents, and those with trauma were more likely to be transported by EMS.
Change in Cardiopulmonary Resuscitation Performance Over Time During Simulated Pediatric Cardiac Arrest and the Effect of Just-in-Time Training and Feedback
Authors: Duff Jonathan P. , Bhanji Farhan , Lin Yiqun , Overly Frank , Brown Linda L. , Bragg E. Alexis , Kessler David , Tofil Nancy M. , Bank Ilana , Hunt Elizabeth A. , Nadkarni Vinay , Cheng Adam ,   for the INSPIRE CPR Investigators
Published: February 2021

Objectives
Effective cardiopulmonary resuscitation (CPR) is critical to ensure optimal outcomes from cardiac arrest, yet trained health care providers consistently struggle to provide guideline-compliant CPR. Rescuer fatigue can impact chest compression (CC) quality during a cardiac arrest event, although it is unknown if visual feedback or just-in-time training influences change of CC quality over time. In this study, we attempt to describe the changes in CC quality over a 12-minute simulated resuscitation and examine the influence of just-in-time training and visual feedback on CC quality over time.

Methods
We conducted secondary analysis of data collected from the CPRCARES study, a multicenter randomized trial in which CPR-certified health care providers from 10 different pediatric tertiary care centers were randomized to receive visual feedback, just-in-time CPR training, or no intervention. They participated in a simulated cardiac arrest scenario with 2 team members providing CCs. We compared the quality of CCs delivered (depth and rate) at the beginning (0–4 minutes), middle (4–8 minutes), and end (8–12 minutes) of the resuscitation.

Results
There was no significant change in depth over the 3 time intervals in any of the arms. There was a significant increase in rate (128 to 133 CC/min) in the no intervention arm over the scenario duration (P < 0.05).

Conclusions
There was no significant drop in CC depth over a 12-minute cardiac arrest scenario with 2 team members providing compressions.