bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of Ipratropium Bromide for the Treatment of Pediatric Sialorrhea: A Retrospective Clinical Case Series
Authors: Tunio Suhaima , Strychowsky Julie E. , Dzioba Agnieszka , You Peng , Madou Edward , Chen Breanna A. 
Published: March 2024

Objective: This retrospective review documents the experience of ipratropium bromide use among pediatric patients with sialorrhea at our multidisciplinary sialorrhea clinic at Children’s Hospital at London Health Sciences Centre (LHSC). Methods: A retrospective chart review of patients diagnosed with sialorrhea at our multidisciplinary clinic between January 2015 and June 2021 was completed. Data on patient demographics, comorbidities, clinical presentation, previous interventions, quality of life, and medication adverse side effects was collected. Drooling Frequency and Severity Scale (DFSS) scores were reviewed to compare sialorrhea management pre- and post-treatment with topical 0.03% ipratropium bromide nasal solution. A descriptive analysis and Wilcoxon signed rank tests were conducted to compare pre- versus post-treatment DFSS scores. Results: A total of 12 patients presented for follow-up and were included in the final analysis. At the pre-treatment visit, the median DFSS score was 4 for frequency and 5 for severity. Post-treatment, median DFSS score was 3 for frequency and 4.5 for severity, ( P = .020 and .129, respectively). Minimal adverse effects were encountered. Conclusions: Ipratropium bromide provided a statistically significant benefit for drooling frequency in the patients studied and may present an additional topical medical option for pediatric sialorrhea with limited adverse effects.
Using Longitudinal Surveillance of Unemployment Claims During Public Health Emergencies to Provide Timely and Granular Data on the Social Determinants of Health
Authors: Acosta Joie D. , Faherty Laura J. , Weden Margaret M. 
Published: March 2024

Objective: Employment is a well-documented social determinant of physical and mental health and can be used to determine who is disproportionately affected by public health emergencies. We examined trends in unemployment overall and by gender, by race or ethnic group, and by their interaction for 2 public health emergencies (the COVID-19 pandemic and the 2020 California wildfires). Methods: We obtained summary data files on the number of initial unemployment insurance (IUI) claims made in all 58 California counties from January 2018 through December 2021. We fit fixed-effects Poisson regression models to county data on weekly IUI claims cross-classified by gender and race or ethnic group. We used models to evaluate the overall effect of COVID-19, whether this effect changed over time increasing under compounding emergencies, and whether the overall and compounding effects of COVID-19 differed by gender and race or ethnic group. Results: During the COVID-19 pandemic, weekly IUI claims rates increased to as much as 10 times their prepandemic level. The increase in IUI claims for COVID-19 weeks, compared with weeks from the same month in the 2 years prior, was greater for women than for men of all race or ethnic groups, except for Black women. The higher rates of IUI claims for most women during COVID-19 entailed a reversal of prepandemic gender differences in claims that persisted through 2021. Conclusion: Public health officials should consider using IUI claims for surveillance of social determinants of health, particularly in the context of emergencies, which we show can have a persisting effect on the social patterning of social determinants. Future research is needed to forecast these affects and inform public health and policy mitigation and prevention strategies.
Psychiatric risks for worsened mental health after psychedelic use
Authors: Marrocu Alessia , Kettner Hannes , Weiss Brandon , Zeifman Richard J , Erritzoe David , Carhart-Harris Robin L 
Published: March 2024

Background: Resurgent psychedelic research has largely supported the safety and efficacy of psychedelic therapy for the treatment of various psychiatric disorders. As psychedelic use and therapy increase in prevalence, so does the importance of understanding associated risks. Cases of prolonged negative psychological responses to psychedelic therapy seem to be rare; however, studies are limited by biases and small sample sizes. The current analytical approach was motivated by the question of whether rare but significant adverse effects have been under-sampled in psychedelic research studies. Methods: A “bottom margin analysis” approach was taken to focus on negative responders to psychedelic use in a pool of naturalistic, observational prospective studies ( N = 807). We define “negative response” by a clinically meaningful decline in a generic index of mental health, that is, one standard error from the mean decrease in psychological well-being 4 weeks post-psychedelic use (vs pre-use baseline). We then assessed whether a history of diagnosed mental illness can predict negative responses. Results: We find that 16% of the cohort falls into the “negative responder” subset. Parsing the sample by self-reported history of psychiatric diagnoses, results revealed a disproportionate prevalence of negative responses among those reporting a prior personality disorder diagnosis (31%). One multivariate regression model indicated a greater than four-fold elevated risk of adverse psychological responses to psychedelics in the personality disorder subsample ( b = 1.425, p < 0.05). Conclusion: We infer that the presence of a personality disorder may represent an elevated risk for psychedelic use and hypothesize that the importance of psychological support and good therapeutic alliance may be increased in this population.
Biomarker cystatin B expression correlates with pathogenesis in cervical cancer
Authors: Ye Danjuan , Duan Xiaoling , Guan Bin , Yuan Jia , Zhu Yan , Shi Jimin , Lu Qi , Xu Guoxiong 
Published: March 2024

Objective Cervical cancer (CC) is one of the most common gynecologic malignancies worldwide. Although rapid improvements have been made regarding its prevention and treatment, little is known about disease pathogenesis and the clinical relevance of reliable biomarkers. The present study evaluated the expression of cystatin B (CSTB) as a potential biomarker of CC. Methods Tissue microarray analysis and immunohistochemical staining were performed to detect CSTB expression, while CSTB mRNA and protein expression levels of freshly isolated CC tissue were measured by quantitative real-time PCR and western blot, respectively. Bioinformatics were used to analyze the CSTB co-expression network and functional enrichments. Results We observed high CSTB mRNA and protein expression levels in CC tissues, which was confirmed by tissue microarray in a comparison with paired adjacent non-cancerous cervical tissue samples. CSTB gene enrichments and associations with co-expressed genes were also observed. Further analysis showed that elevated CSTB expression was associated with pathological progress in CC. Conclusion Our data demonstrate that CSTB has the potential to be used as a tissue biomarker with clinical value in patients with CC, which may aid the development of intervention strategies.
Reduced plasma calcitonin gene-related peptide level identified in cluster headache: A prospective and controlled study
Authors: Petersen Anja Sofie , Lund Nunu , Meßlinger Karl , Christensen Sarah Louise , Barloese Mads , Jørgensen Niklas Rye , Kogelman Lisette , Jensen Rigmor Højland 
Published: March 2024

Background The role of calcitonin gene-related peptide (CGRP) in the cyclic pattern of cluster headache is unclear. To acquire biological insight and to comprehend why only episodic cluster headache responds to CGRP monoclonal antibodies, we examined whether plasma CGRP changes between disease states (i.e. bout, remission and chronic) and controls. Methods The present study is a prospective case–control study. Participants with episodic cluster headache were sampled twice (bout and remission). Participants with chronic cluster headache and controls were sampled once. CGRP concentrations were measured in plasma with a validated radioimmunoassay. Results Plasma was collected from 201 participants diagnosed with cluster headache according to the International Classification of Headache Disorders, 3rd edition, and from 100 age- and sex-matched controls. Overall, plasma CGRP levels were significantly lower in participants with cluster headache compared to controls ( p < 0.05). In episodic cluster headache, CGRP levels were higher in bout than in remission (mean difference: 17.1 pmol/L, 95% confidence interval = 9.8–24.3, p < 0.0001). CGRP levels in bout were not different from chronic cluster headache ( p = 0.266). Conclusions Plasma CGRP is unsuitable as a diagnostic biomarker of cluster headache or its disease states. The identified reduced CGRP levels suggest that CGRPs role in cluster headache is highly complex and future investigations are needed into the modulation of CGRP and its receptors.
Periareolar Mastopexy: A Historical Appraisal of Technique and Further Technical Refinements Toward Reliable, Lasting, and Reproducible Results
Authors: Lie Kwok Hao , Hodgkinson Darryl J. 
Published: March 2024

Introduction: Since its first description in 1976, periareolar mastopexy has attained a negative perception due to perceived high rates of unsatisfactory outcomes. The 2 main reported problems are (1) periareolar scar widening and (2) poor breast shaping. It is the author’s experience that with appropriate refinements in surgical technique based on sound anatomical and surgical underpinnings, good breast shaping and areolar aesthetics can be reliably achieved. This article describes innovations in the technique to improve outcomes, followed by a description of our own technique and refinements over the senior author’s 40-year journey. Materials and methods: A literature review of technical refinements in periareolar mastopexy surgical technique was undertaken. Suggested refinements from various authors were then placed in the context of the senior author’s own clinical experience and evolution of technique over 40 years. Representative case studies from the author’s personal series are then presented to illustrate technical pearls and results. Results: Four illustrative cases are discussed, along with a comprehensive description of the senior author’s technique and underlying principles. Discussion: Early techniques of periareolar mastopexy were plagued by poor breast shaping and areolar distortion. Progressive refinements in technique over the last 50 years have steadily improved surgical outcomes. Conclusion: By combining various published refinements into a single operation, it is now possible to reliably achieve good aesthetic outcomes and avoid previous problems, as shown by the author’s own case series.
Insights into ocular syphilis in Nepal
Authors: Sharma Sadhana , Kharel Ranju , Parajuli Sanket , Shrestha Ruchi , Tiwari Shradha , Singh Maskey Himang 
Published: March 2024

Purpose This study aims to elucidate the demographic characteristics, clinical features, diagnostic approaches, and medical management of patients with ocular syphilis, known as ‘the great masquerader,’ at a tertiary eye care center in Nepal. Methods We conducted a retrospective review involving 15 eyes from ten patients with ocular syphilis treated at a uveitis referral center between 2020 and 2022. Lumbar puncture was performed if neurosyphilis was suspected. Treatment success was defined as the absence of ocular inflammation in both eyes and a decrease in Veneral disease research laboratory (VDRL) titres after completing therapy. Results A total of 15 eyes of 10 patients were diagnosed with syphilitic uveitis based on positive treponemal and non-treponemal serological tests. The mean age of the patient was 39.9 years (range 22-54 years) with an equal distribution between males and females. HIV coinfection was not found in any of the patients. Syphilitic uveitis was the primary presentation in nine patients (90%), while one patient presented with recurrent nodular scleritis. Ocular involvement was bilateral in 50% (5 patients). The mean duration between the initial symptom and the first presentation was 8.7 weeks (range: 4 days to 24 weeks). The most common ocular findings was panuveitis (6 eyes). Eight patients with early syphilis received weekly intramuscular injections of benzathine penicillin G for 3 weeks whereas 2 patients with neurosyphilis were treated with intravenous ceftriaxone 1 gm twice a day for 14 days. Signs and symptoms of majority of patients improved with systemic therapy for syphilis. Conclusions Syphilitic uveitis should be included in the differential diagnosis of any form of ocular inflammation.
Gamified Intervention for Health Promotion of Families in Child Health Clinics — A Cluster Randomised Trial
Authors: Selänne Laura , Pasanen Miko , Aslan Funda , Pakarinen Anni 
Published: March 2024

Objectives This study aimed to evaluate the effectiveness of the digital and gamified WellWe intervention on parental self-efficacy for healthy behaviours and mindfulness in parenting at the comprehensive health checks of 4-year-old children. Methods Two-arm cluster, randomised, controlled trial with a 4-month follow-up.The data were collected from parents of 4-year-old children. Cluster randomisation was done at the municipality level. Fifteen child health clinics within 4 municipalities located in Southwest Finland were randomly allocated to either an intervention (WellWe intervention) or a control group (usual care). The outcome measures included the Parental Self-Efficacy for Healthy Behaviours (PDAP) and Mindfulness in Parenting (MIPQ) questionnaires. Data were collected at baseline, after the intervention and at the 4-month follow-up. Results Initially a total of 110 parents (50 in the intervention and 60 in the control group) participated in the study. At the end of the study, there were 33 parents involved, with 12 in the intervention group and 21 in the control group. Parental self-efficacy and mindfulness in parenting showed no statistically significant difference between the groups or within the groups at the different time points. Conclusions The results of the study showed no difference between the intervention and the usual care. The commitment of the subjects was lower than expected. The intervention could be improved by placing a greater focus on engaging and motivating both families and public health nurses (PHNs). Therefore, when refining the intervention further, it's important to involve the target group more actively in the design of both content and delivery.
Sociodemographic Factors Predict Long-Term Attrition from Multidisciplinary Cleft Clinic
Authors: Wagner Connor S , Barnett Sarah L , Romeo Dominic , Morales Carrie Z , Salinero Lauren K , Barrero Carlos E , Pontell Matthew E , McKenna Rachel A , Folsom Nancy , Taylor Jesse A , Swanson Jordan W 
Published: March 2024

Objective Identify and describe factors associated with retention and attrition of patients during longitudinal follow-up at multidisciplinary cleft clinic. Design Retrospective cohort study. Setting Single, tertiary care center. Patients, Participants Patients born between 1995 and 2007 with a diagnosis of cleft palate with or without cleft lip attending multidisciplinary cleft clinic. Interventions None tested, observational study. Main Outcome Measure(s) Age at last clinical appointment with a multidisciplinary cleft team provider. Attrition was defined as absence of an outpatient appointment following 15 years of age. Results Six hundred seventy-eight patients were included. The average age at last appointment across the entire cohort was 13.1 years (IQR 6.6–17.2). Patients who were Black (HR 1.60, 95% CI 1.10–2.32, p = 0.014) and other races (HR 1.90, 95% CI 1.22–2.98, p = 0.004) were more likely to be lost to follow-up compared to white patients. Publicly insured patients were more likely to experience attrition than those who were privately insured (HR 1.30, 95% CI 1.03–1.65, p = 0.030). Estimated income was not significantly associated with length of follow-up (p = 0.259). Those whose residence was in the fourth quartile of driving distance from our center experienced loss to follow-up significantly more than those who lived the closest (HR 2.04, 95% CI 1.50–2.78, p < 0.001). Conclusions There is a high degree of follow-up attrition among patients with cleft lip and palate. Race, insurance status, and driving distance to our center were associated with attrition in a large, retrospective cohort of patients who have reached the age of cleft clinic graduation.
Nomogram for Predicting Postoperative Pulmonary Metastasis in Hepatocellular Carcinoma Based on Inflammatory Markers
Authors: Zhou Huanjie , Zheng Haiping , Wang Ying , Lao Ming , Shu Hong , Huang Meifang , Ou Chao 
Published: March 2024

Background Uncertainty surrounds the usefulness of inflammatory markers in hepatocellular carcinoma (HCC) patients for predicting postoperative pulmonary metastasis (PM). The purpose of this study was to assess the predictive value of inflammatory markers as well as to create a new nomogram model for predicting PM. Methods Cox regression was utilized to identify independent prognostic variables and to create a nomogram that predicted PM for comparison with a validation cohort and other prediction systems. We retrospectively analyzed a total of 1109 cases with HCC were included. Results The systemic inflammatory response index (SIRI) and aspartate aminotransferase-to-platelet ratio index (APRI) were independent risk factors for PM, with a concordance index of .78 (95% CI: .74-.81) for the nomogram. The areas under the curve of the nomograms for PM predicted at 1-, 3-, and 5-year were .82 (95% CI: .77-.87), .82 (95% CI: .78-.87) and .81 (95% CI: .75-.86), respectively, which were better than those of Barcelona Clinic Liver Cancer and China liver cancer stage. Decision curve analyses demonstrated a broader range of nomogram threshold probabilities. Conclusion A nomogram based on SIRI and APRI can accurately predict postoperative PM in HCC.
Platelet rich plasma for primary macular hole: A case series
Authors: Parisi Guglielmo , Gelormini Francesco , Ricardi Federico , Borrelli Enrico , Parisi Francesca , Belluardo Giuseppe , Azzaro Laura , Marolo Paola , D’antico Sergio , Salafia Marika , Reibaldi Michele 
Published: March 2024

Objective To evaluate the anatomical and functional macular results and rate of complications following surgical treatment of primary macular hole (MH) with autologous platelet rich plasma (a-PRP) use. Design retrospective, interventional, non-randomized case series Partecipants and methods A cohort of 9 consecutive patients from January 1, 2019 to August 31, 2021 who underwent vitrectomy with a-PRP use for primary MH were included. Anatomical results based on spectral domain- optical coherence tomography (SD-OCT) and visual acuity were analyzed. Results 10 pseudophakic eye of 9 patients were enrolled. Six patients were female and three patients were male. The mean age was 69.9 years ± 1.48. The baseline MH minimum diameter was 486.1 μm ± 37.1, and mean pre operative best-corrected visual acuity (BCVA) was 0.91 ± 0.03 logMAR (Snellen equivalent 20/160). Mean 1 month post operative BCVA was 0.81 ± 0.57 logMAR (Snellen equivalent 20/130; p = 1.000); mean 3 month post operative BCVA was 0.66 ± 0.04 logMAR (Snellen equivalent 20/90; p = 0.006); mean 6 month post operative BCVA was 0.6 ± 0.04 logMAR (Snellen equivalent 20/80; p < 0.001). In all eyes, 10/10 (100%), there was a complete MH closure at 6 months follow up: 5 eyes (50%) with a U-type closure pattern, 4 eyes (40%) with a V-type pattern and 1 eye (10%) with an irregular foveal contour closure at 6 month follow-up. No ocular and systemic complications were reported. Conclusion The a-PRP use is a successful and promising vitreoretinal surgical technique option for primary MH
Efficacy and safety results after >3.5 years of treatment with the Bruton’s tyrosine kinase inhibitor evobrutinib in relapsing multiple sclerosis: Long-term follow-up of a Phase II randomised clinical trial with a cerebrospinal fluid sub-study
Authors: Montalban Xavier , Piasecka-Stryczynska Karolina , Kuhle Jens , Benkert Pascal , Arnold Douglas L , Weber Martin S , Seitzinger Andrea , Guehring Hans , Shaw Jamie , Tomic Davorka , Hyvert Yann , Harlow Danielle E , Dyroff Martin , Wolinsky Jerry S 
Published: March 2024

Background: Evobrutinib – an oral, central nervous system (CNS)-penetrant, and highly selective Bruton’s tyrosine kinase inhibitor – has shown efficacy in a 48-week, double-blind, Phase II trial in patients with relapsing MS. Objective: Report results of the Phase II open-label extension (OLE; up to week 192 from randomisation) and a cerebrospinal fluid (CSF) sub-study. Methods: In the 48-week double-blind period (DBP), patients received evobrutinib 25 mg once-daily, 75 mg once-daily, 75 mg twice-daily or placebo (switched to evobrutinib 25 mg once-daily after week 24). Patients could then enter the OLE, receiving evobrutinib 75 mg once-daily (mean (± standard deviation (SD)) duration = 50.6 weeks (±6.0)) before switching to 75 mg twice-daily. Results: Of 164 evobrutinib-treated patients who entered the OLE, 128 (78.0%) completed ⩾192 weeks of treatment. Patients receiving DBP evobrutinib 75 mg twice-daily: annualised relapse rate at week 48 (0.11 (95% confidence interval (CI) = 0.04-0.25)) was maintained with the OLE twice-daily dose up to week 192 (0.11 (0.05–0.22)); Expanded Disability Status Scale score remained stable; serum neurofilament light chain fell to levels like a non-MS population ( Z-scores); T1 gadolinium-enhancing lesion numbers remained low. No new safety signals were identified. In the OLE, evobrutinib was detected in the CSF of all sub-study patients. Conclusion: Long-term evobrutinib treatment was well tolerated and associated with a sustained low level of disease activity. Evobrutinib was present in CSF at concentrations similar to plasma.
SUNCT syndrome secondary to multiple sclerosis: Not only trigeminal neuralgia
Authors: Giuliani Giada , Zilli Chiara , Caramia Francesca , Di Piero Vittorio , Altieri Marta 
Published: March 2024

Background: Facial pain in multiple sclerosis is often due to trigeminal neuralgia but atypical pictures can be observed. Case presentation: A man with primary progressive multiple sclerosis developed severe unilateral facial pain in the right orbital region. Spontaneous and triggered attacks were associated with ipsilateral conjunctival injection and lacrimation. A diagnosis of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing was made, and symptoms significantly improved with lamotrigine. Conclusion: Pain is poorly investigated in multiple sclerosis, with a dramatic impact on patients’ life quality. In this light, standardized evaluation of pain is needed to improve patient management.