bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypopigmented mycosis fungoides: a retrospective clinicohistopathologic study
Authors: Rodney I.J. , Kindred C. , Angra K. , Qutub O.N. , Villanueva A.R. , Halder R.M. 
Published: August 2016

AbstractImportanceHypopigmented mycosis fungoides is a rare variant of mycosis fungoides with limited published clinicohistopathologic data available.ObjectiveTo characterize our patient group, to provide additional information and insight into this malignancy.DesignA 16‐year retrospective medical records review (from 1992 to 2009) was conducted of patients with a diagnosis of hypopigmented mycosis fungoides.SettingAll patients were seen in the department of dermatology at Howard University Hospital, an outpatient clinic in an urban academic institution.ParticipantsThe review comprised of 20 patients. Inclusion required presence of hypopigmented skin lesions and a skin biopsy diagnostic for hypopigmented mycosis fungoides.InterventionsTreatment modalities, including oral psoralen with UVA, narrow‐band UVB and/or topical medications such as nitrogen mustard and topical corticosteroids were employed.ResultsPatients ranged from 4 to 57 years old. Fifteen were African American, three African, one Afro‐Caribbean and one Hispanic. The interval from disease onset to diagnosis ranged from 7 months to 24 years. Patients presented at Stage 1A or 1B. Treatment included phototherapy and topical medications. In four patients with pre‐ and post‐treatment biopsies, the original histological diagnosis of hypopigmented mycosis fungoides and the subsequent complete resolution were shown. There was no associated mortality in the patients studied.Conclusions and RelevanceHypopigmented mycosis fungoides affected skin of colour patients in this study. This variant differs from classic mycosis fungoides: younger population, slower progression and the majority of patients remaining in Stage I with treatment. We observed that any repigmentation of lesions suggests an effective treatment regimen, complete repigmentation correlates with clinical and histopathologic resolution, and new hypopigmented lesions during remission suggest relapse. A limitation of this study is the small sample size. This is the first study to correlate the histological resolution of hypopigmented mycosis fungoides with clinical repigmentation of lesions.
Occupational contact sensitization in female geriatric nurses: Data of the Information Network of Departments of Dermatology (IVDK) 2005–2014
Authors: Schubert S. , Bauer A. , Molin S. , Skudlik C. , Geier J. 
Published: August 2016

AbstractBackgroundGeriatric nurses (GN) have a high risk of occupational contact dermatitis (OCD), with chronic irritant contact dermatitis predominating. However, allergic contact dermatitis is an important issue as well. Little is known whether the relevant occupational allergen spectrum reported in the 1990s, including fragrances, preservatives, rubber chemicals and ingredients of surface disinfectants to be the most common sensitizers in GN, is still valid.ObjectivesTo monitor the current allergen spectrum in GN with OCD and verify the validity of the patch test recommendations (baseline‐, preservative‐, ointment base‐, rubber‐, disinfectant, series and fragrances) in GN with suspected OCD given by the German Contact Dermatitis Research Group (DKG).MethodsRetrospective analysis of IVDK data (2005–2014) of 743 female GN with OCD, in comparison to 695 GN without OCD.ResultsGN with OCD reacted significantly more frequently to both fragrance mixes, hydroxyisohexyl 3‐cyclohexene carboxaldehyde (HICC), thiuram mix, zinc diethyldithiocarbamate and mercaptobenzothiazole than GN without OCD. Reactions to MDBGN, methylchloroisothiazolinone/methylisothiazolinone and oil of turpentine occurred substantially, but not significantly more frequently among GN with OCD. The latter may be due to former use of a special alcoholic liniment in geriatric care. Among material from the patients’ workplaces, tetrazepam was a frequent allergen, due to dust exposure from pill crushing. Furthermore, occupationally used protective gloves, body care products as well as surface disinfectants were often tested positively.ConclusionsThe general allergen spectrum in GN with OCD is unchanged, so the DKG patch test recommendations are still valid. Prevention of occupational sensitization should focus on fragrance‐free hygiene and body care products, usage of accelerator‐free protective gloves and avoidance of drug dust exposure.
Decision‐to‐delivery interval in pregnant women with intrapartum non‐reassuring fetal heart rate patterns
Authors: Boriboonhirunsarn Dittakarn , Watananirun Kanokwaroon , Sompagdee Nalat 
Published: August 2016

AbstractRationale, aims and objectivesIt has been proposed that delivery should be accomplished within 30 minutes after diagnosis of fetal distress. The objective of this study was to determine the decision‐to‐delivery interval (DDI) in emergency caesarean delivery for non‐reassuring fetal heart rate (FHR).MethodsA total of 272 term, singleton pregnant women who underwent an emergency caesarean section for non‐reassuring FHR were included. Patient characteristics and clinical data were reviewed. The timing of the decision‐to‐delivery process was reviewed.ResultsThe mean age was 28.7 years; the mean gestational age at delivery was 38.4 weeks; and 93.7% were in FHR category 2. The decision for emergency caesarean delivery was made during normal office hours in 31.6%. Median time for decision‐to‐operating room, decision‐to‐incision and decision‐to‐delivery was 42.3, 48.5 and 56 minutes, respectively. Only 6.6% of women had a DDI of <30 minutes, whereas 30.5% had a DDI of >75 minutes. Significantly shorter intervals were observed for every endpoint among patients in FHR category 3, and they were significantly more likely to deliver within 30 minutes than were those in FHR category 2 (41.2% vs. 4.3%, P < 0.001). Similar results were observed for cases that occurred during normal and after hours. Neonatal outcomes were comparable among different DDI categories.ConclusionOnly 6.6% of women with non‐reassuring FHR achieved the 30‐minute goal for caesarean delivery (median 56 minutes). Better performance was observed among patients in FHR category 3 regardless of diagnosis time, with 41.2% of these patients having a DDI of <30 minutes.
Slick scripts: impact on patient flow targets of pharmacists preparing discharge prescriptions in a hospital with an electronic prescribing system
Authors: Tran Tim , Hardidge Andrew , Heland Melodie , Taylor Simone E , Garrett Kent , Mitri Elise , Elliott Rohan A 
Published: August 2016

AbstractRationale, aims and objectivesInpatient bed access decreases when ward discharge is delayed. This contributes to prolonged emergency department (ED) length of stay (LOS) which has been associated with increased hospital LOS and mortality. Delays in preparation of discharge medication prescriptions by ward doctors may contribute to delayed ward discharge. This project aimed to evaluate the effect on patient flow of having a pharmacist collaborate with ward doctors to prepare discharge prescriptions at a hospital with an electronic prescribing system.MethodEight‐week pre‐ and post‐intervention study on two surgical wards at a major metropolitan Australian hospital. During the intervention, a project pharmacist (PP) electronically prepared discharge prescriptions, in consultation with ward doctors, which were reviewed by the regular ward pharmacist before being dispensed. Outcome measures, based on hospital performance indicators, included:

Percentage of patients transferred to wards from ED within four and six hours of presentation;
Median time (minutes) past 9 am that patients were discharged from the wards;
Percentage of patients discharged from wards by 9 am;
Staff satisfaction.
ResultsPre‐ and post‐intervention, there were 259 and 246 patients transferred from ED to the study wards, respectively. The percentage of patients transferred within four and six hours of presentation did not change. There were 320 and 341 patients discharged, pre‐ and post‐intervention, respectively, who required a discharge prescription. The PP prepared 273 (80%) prescriptions during the post‐intervention period. Patients were discharged 57 minutes earlier with the intervention (median 211 vs. 154 minutes past 9 am, P = 0.01). The percentage of patients discharged before 9 am increased from 6% to 12% (P = 0.01). All 26 health‐professional respondents (79% response rate) were satisfied with the service and recommended its continuation.ConclusionsPharmacist collaboration with doctors to prepare discharge prescriptions did not impact upon ED access targets, but resulted in patients being discharged earlier.
Adherence to guidelines in monitoring amiodarone‐induced thyroid dysfunction
Authors: Huang Chun‐Jui , Tseng Chi‐Lung , Chu Chia‐Huei , Huang De‐Feng , Huang Chin‐Chou , Lin Liang‐Yu 
Published: August 2016

AbstractRationale, aims and objectivesBaseline thyroid function testing and regular follow‐up of thyroid function under amiodarone usage was recommended by guidelines. Little is known about the status of amiodarone monitoring in real‐world clinical care in Taiwan. The objective was to determine the rate of thyroid monitoring and to assess the clinical and physicians' characteristics associated with adequate monitoring in a tertiary referral centre for arrhythmia.MethodsWe reviewed the medical records of patients receiving amiodarone during the period 2008–2009 at Taipei Veterans General Hospital. The rate of baseline and follow‐up thyroid function monitoring during amiodarone therapy were calculated. Factors associated with guideline adherence to monitoring were analysed.ResultsAmong the 1319 enrolled cases, 36.4% (n = 480) underwent baseline thyroid function testing and 1.1% (n = 15) received measurement of anti‐thyroid peroxidase antibody before amiodarone initiation. Regular follow up of thyroid function under amiodarone usage occurred in only 8.6% (n = 114) of cases. Baseline thyroid function was more likely to be present in patients of younger age (P < 0.001), female sex (P = 0.01), and in those who received amiodarone therapy from cardiologists (P < 0.001) or electrophysiologists (P < 0.001) with fewer years of service (P < 0.001). Upon multivariate analysis, only physicians' expertise (cardiologist versus non‐cardiologist, OR = 5.67, 95% CI: 2.44–13.16) and years of service (OR = 0.97, 95% CI: 0.95–0.998) were significantly associated with adequate thyroid monitoring.ConclusionsThe rate of thyroid monitoring with amiodarone therapy had been suboptimal. Strategies to enhance guideline adherence are needed.
Primary care and chronic disease: the intersection of comfort and specialty involvement – a cross‐sectional study
Authors: Schreiner Andrew , Simpson Kit 
Published: August 2016

AbstractBackgroundPrimary care referrals to specialty physicians play an integral role in patient care and health care costs. Multiple factors play into the primary care physician's decision to refer, including comfort managing particular conditions. As the burden of chronic disease climbs, the relationship between patients, primary care physicians and specialists in accurately diagnosing, managing and treating chronic conditions needs clarity. The objective of this study is to assess the relationship between specialty physician involvement and the care of three chronic conditions: diabetes mellitus (DM), chronic kidney disease (CKD) and systemic lupus erythematosus (SLE).MethodsTo achieve this objective, we performed a cross‐sectional study of 2013 MarketScan data (875 million billing records) for three chronic medical conditions. Participants were identified in the dataset by having received a diagnosis code for DM, CKD or SLE in an outpatient care setting during 2013. The study compared proportions of outpatient visits with specialty physicians in endocrinology, nephrology and rheumatology for patients with DM, CKD and SLE respectively.ResultsData included 1 615 609 visits with the diagnosis of DM, 158 424 visits with the diagnosis of CKD and 103 910 visits with SLE. Diabetic patients met endocrinologists (10.2%) at a smaller proportion of their visits than patients with CKD saw nephrologists (41.2%, P < 0.0001). Further, CKD patients met with nephrologists (41.2%) at a significantly fewer proportion of outpatient visits than SLE patients saw rheumatologists (51.8%, P < 0.0001).ConclusionsDifferences in primary care physicians' comfort with diagnosis, therapy and adherence to published guidelines affect the rate with which primary care providers seek specialty consultation.
Low socio‐economic status is a newly identified independent risk factor for poor vitamin D status in severely obese adults
Authors: Léger‐Guist'hau J. , Domingues‐Faria C. , Miolanne M. , Peyrol F. , Gerbaud L. , Perreira B. , Minet‐Quinard R. , Sapin V. , Walrand S. , Boirie Y. 
Published: August 2016

AbstractBackgroundHypovitaminosis D is very prevalent, especially in the obese population. However, the degree of severity and the parameters involved in vitamin D deficiency in this population are still unclear. The present study aimed to identify, from among the factors known to influence vitamin D status in a healthy population, those impacting the same parameter in obese population.MethodsSerum 25‐OH‐D concentration was measured in 564 patients with class III obesity [i.e. severe and morbid obesity; mean (SD) body mass index (BMI) 42.04 (6.92) kg m–2] and their demographic, clinical, biological, anthropometric, dietary and socio‐economic data were collected.ResultsWe observed that 96% of the obese patients had serum 25‐OH‐D lower than 30 ng mL−1. Severe vitamin D deficiency (serum 25‐OH‐D concentration <10 ng mL−1) affected 35% of this population. We found an inverse relationship between 25‐OH‐D levels and BMI (P = 0.012), fat mass (P = 0.041), metabolic syndrome (P < 0.0001), fasting blood glucose (P = 0.023), homeostasis model assessment for insulin resistance (P = 0.008), waist circumference (P = 0.001), and fasting blood triglycerides (P = 0.002) and C‐reactive protein (P = 0.005). Low socio‐economic status independently increased the risk of severe vitamin D deficiency [odds ratio (OR) = 1.98; 95% confidence interval (CI) 1.25–3.13], especially in the autumn–winter season (OR = 2.94; 95% CI 1.98–4.36), morbid obesity (OR = 3.19; 95% CI 1.49–6.82), metabolic syndrome (OR = 1.6; 95% CI 1.06–2.42) and inflammation (OR = 1.03; 95% CI 1.01–1.06).ConclusionsVitamin D deficiency is extremely common among obese patients, and the prevalence of severe deficiency is high. The association of adiposity, high body mass index, metabolic syndrome and inflammation with vitamin D status is marked, whereas low socio‐economic status appears to be a major risk factor for severe vitamin D deficiency, suggesting that vitamin D deficiency may at least in part be responsible for the greater health vulnerability of populations with low socio‐economic status.
Efficient three‐phase reconstruction of heterogeneous material from 2D cross‐sections via phase‐recovery algorithm
Authors: HASANABADI ALI , BANIASSADI MAJID , ABRINIA KAREN , SAFDARI MASOUD , GARMESTANI HAMID 
Published: August 2016

SummaryDigital reconstruction of a complex heterogeneous media from the limited statistical information, mostly provided by different imaging techniques, is the key to the successful computational analysis of this important class of materials. In this study, a novel approach is presented for three‐dimensional (3D) reconstruction of a three‐phase microstructure from its statistical information provided by two‐dimensional (2D) cross‐sections. In this three‐step method, first two‐point correlation functions (TPCFs) are extracted from the cross‐section(s) using a spectral method suitable for the three‐phase media. In the next step, 3D TPCFs are approximated for all vectors in a representative volume element (RVE). Finally, the 3D microstructure is realized from the full‐set TPCFs obtained in the previous step, using a modified phase‐recovery algorithm. The method is generally applicable to any complex three‐phase media, here illustrated for an SOFC anode microstructure. The capabilities and shortcomings of the method are then investigated by performing a qualitative comparison between example cross‐sections obtained computationally and their experimental equivalents. Finally, it is shown that the method almost conserves key microstructural properties of the media including tortuosity, percolation and three‐phase boundary length (TPBL).
Cement Thickness of Inlay Restorations Made of Lithium Disilicate, Polymer‐Infiltrated Ceramic and Nano‐Ceramic CAD/CAM Materials Evaluated Using 3D X‐Ray Micro‐Computed Tomography
Authors: Uzgur Recep , Ercan Ertuğrul , Uzgur Zeynep , Çolak Hakan , Yalçın Muhammet , Özcan Mutlu 
Published: August 2016

AbstractPurposeTo evaluate the marginal and internal cement thicknesses of inlay restorations made of various CAD/CAM materials using 3D X‐ray micro‐computed tomography (micro‐CT) technique.Materials and MethodsCaries‐free extracted mandibular molars (N = 30) with similar size were randomly assigned to three groups (N = 10 per group). Mesio‐occlusal‐distal (MOD) cavities were prepared, and inlay restorations were obtained by milling out CAD/CAM materials namely, (a) IPS: monolithic lithium disilicate (control), (b) VE: polymer‐infiltrated ceramic, and (c) CS: nano‐ceramic using a CAM unit. Marginal and internal cement thicknesses were measured using 3D micro‐CT. Data were analyzed using 1‐way ANOVA and Tukey's tests (alpha = 0.05).ResultsThe mean marginal and internal cement thickness were not significant in all inlay materials (p > 0.05). Mean marginal cement thickness (μm) was the lowest for the IPS group (67.54 ± 10.16) followed by VE (84.09 ± 3.94) and CS (95.18 ± 10.58) (p > 0.05). The internal cement thickness (μm) was the lowest in the CS group (54.85 ± 6.94) followed by IPS (60.58 ± 9.22) and VE (77.53 ± 12.13) (p > 0.05).ConclusionMarginal and internal cement thicknesses of MOD inlays made of monolithic lithium disilicate, polymer‐infiltrated ceramic, and nano‐ceramic CAD/CAM materials were similar and all less than 100 μm, which could be considered clinically acceptable.Clinical significanceMOD inlays made of different CAD/CAM materials presented similar cement thickness, less than 100 μm.
Health Insurance Benefit Mandates and Firm Size Distribution
Authors: Bailey James , Webber Douglas 
Published: August 2016

AbstractBy 2010, the average U.S. state had passed 37 health insurance benefit mandates (laws requiring health insurance plans to cover certain additional services). Previous work has shown that these mandates likely increase health insurance premiums, which in turn could make it more costly for firms to compensate employees. Using 1996–2010 data from the Quarterly Census of Employment and Wages and a novel instrumental variables strategy, we show that there is limited evidence that mandates reduce employment. However, we find that mandates lead to a distortion in firm size, benefiting larger firms that are able to self‐insure and thus exempt themselves from these state‐level health insurance regulations. This distortion in firm size away from small businesses may lead to substantial decreases in productivity and economic growth.
Treatment Outcome of Overactive Bladder Patients Receiving Antimuscarinic Therapy for More than One Year
Authors: HSIAO Sheng‐Mou , LIN Ho‐Hsiung , KUO Hann‐Chorng 
Published: August 2016

ObjectivesDetails on the therapeutic effects of long‐term antimuscarinic therapy have not been reported. Thus, the aim of this study is to evaluate the detailed long‐term therapeutic effect of antimuscarinic therapy.MethodsAll consecutive patients who visited the urologic outpatient clinics of a medical center for treatment of overactive bladder syndrome and received antimuscarinic therapy of 12 months or more were retrospectively reviewed. All medical records, including the Overactive Bladder Symptom score (OABSS), the modified Indevus Urgency Severity Scale and the International Prostate Symptoms score (IPSS) questionnaires, and uroflowmetry parameters were reviewed at each visit.ResultsA total of 140 patients had received 12 months or more of antimuscarinic therapy. Sustained therapeutic effects were observed by persistent decreases of IPSS‐storage score, IPSS‐total score and OABSS score. Moreover, the maximum flow rate did not change over time. A temporary increase in postvoid residual volume and decrease in voiding efficiency were found, but these parameters improved over long‐term visits. Side‐effects were observed in 81 patients (57.9%) and included dry mouth (n = 58, 41.4%), constipation (n = 48, 34.3%) and blurred vision (n = 4, 2.9%); all side‐effects were tolerable. Patients aged 75 years or more (n = 94) had a higher comorbidity rate (n = 46, 48.9%) before treatment but generally exhibited similar therapeutic effects as overall patients; elderly patients could also tolerate side‐effects.ConclusionSustained therapeutic effects were observed in patients who received 12 months or more of antimuscarinic therapy, even in elderly patients. In addition, side‐effects in patients receiving long‐term therapy were also common but tolerable.
Geophysical and magneto‐structural study of the Maâdna structure (Talemzane, Algeria): Insights on its age and origin
Authors: Lamali A. , Rochette P. , Merabet N. , Abtout A. , Maouche S. , Gattacceca J. , Ferrière L. , Hamoudi M. ,   ASTER Team, Meziane E.H. , Ayache M. 
Published: August 2016

AbstractThe Maâdna structure is located approximately 400 km south of Algiers (33°19′ N, 4°19′ E) and emplaced in Upper‐Cretaceous to Eocene limestones. Although accepted as an impact crater on the basis of alleged observations of shock‐diagnostic features such as planar deformation features (PDFs) in quartz grains, previous works were limited and further studies are desirable to ascertain the structure formation process and its age. For this purpose, the crater was investigated using a multidisciplinary approach including field observations, detailed cartography of the different geological and structural units, geophysical surveys, anisotropy of magnetic susceptibility, paleomagnetism, and petrography of the collected samples. We found that the magnetic and gravimetric profiles highlight a succession of positive and negative anomalies, ones that might indicate the occurrence of a causative material which is at least in part identical. Geophysical analysis and modeling suggest the presence of this material within the crater at a depth of about 100 m below the surface. Using soil magnetic susceptibility measurements, the shallowest magnetized zone in the central part of the crater is identified as a recently deposited material. Paleomagnetic and rock magnetic experiments combined with petrographic observations show that detrital hematite is the main magnetic carrier although often associated with magnetite. A primary magnetization is inferred from a stable remanence with both normal and reverse directions, carried by these two minerals. Although this is supposed to be a chemical remagnetization, its normal polarity nature is considered to be a Pliocene component, subsequent to the crater formation. The pole falls onto the Miocene‐Pliocene part of the African Apparent Polar Wander Path (APWP). Consequently, we estimate the formation of the Maâdna crater to have occurred during the time period extending from the Late Miocene to the Early Pliocene. Unfortunately, our field and laboratory investigations do not allow us to confirm an impact origin for the crater as neither shatter cones, nor shocked minerals, were found. A dissolved diapir with inverted relief is suggested as an alternative to the impact hypothesis, which can still be considered as plausible. Only a drilling may provide a definite answer.