bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case Report: Corneal perforation secondary to orbital cellulitis caused by Streptococcus pseudoporcinus infection
Authors: Dong Yuli , Tian Mingxia 
Published: April 2022

Introduction This report described a rare case of corneal perforation secondary to orbital cellulitis caused by Streptococcus pseudoporcinus (S. pseudoporcinus) infection. To the best of our knowledge, only six cases of S. pseudoporcinus infection have been reported. This case report suggested that S. pseudoporcinus infection was contagious and potentially life threatening. The report emphasized the value of managing infections early to avoid serious consequences. Case description A patient with orbital cellulitis, which progressed to corneal perforation was admitted to the hospital for right facial swelling, pain, and decreased vision in his right eye. S. pseudoporcinus infection was found after bacterial culture of pus puncture. After aggressive anti-infection and surgical treatment, the infection was eliminated, and the patient was discharged. However, the patient had sustained permanent vision loss. Conclusions This case suggested the potential risk of corneal perforation and orbital cellulitis caused by S. pseudoporcinus infection in humans. The specific biological changes and mode of action of S. pseudoporcinus are unclear and need further investigation.
Surgical outcomes in only eye cataract surgery
Authors: Doyle Jennifer MM , Haq Aaminah S , Aslam Sher A 
Published: April 2022

Introduction Performing cataract surgery in the setting of only one seeing-eye has significant benefits but also potential negative consequences for both patient and surgeon. This study investigates the surgical outcomes in patients undergoing cataract surgery on their only seeing-eye. Methods A retrospective analysis was conducted in a single tertiary centre of all adult patients who had undergone cataract surgery on their only eye, where the fellow eye had a vision of 1.0 LogMAR or worse. Complication rates and visual outcomes were compared against data from the National Ophthalmology Database (NOD) Audit. Results 918 patients underwent cataract surgery on their only seeing-eye and had their postoperative visual acuity recorded. The overall unadjusted complication rate was 4.0% (versus 2.5% from NOD data) with the rate of posterior capsule rupture (PCR) being 1.9% (versus 1.14% from NOD data). 72.5% (versus 91.5% from NOD data) of patients attained a post-operative visual acuity of 0.3 LogMAR or better. The grade of surgeon performing the surgery did not have a statistically significant effect on the risk of complications. Discussion In this cohort of only-eye patients undergoing cataract surgery, there was a small increased risk of operative complications including an increased, unadjusted risk of PCR, and fewer eyes achieved 0.3 LogMAR vision post-operatively compared to the NOD audit data. Grade of surgeon did not have an impact on the complication rate, indicating that with appropriate supervision, trainee surgeons may gain experience in only-eye surgery without additional risk to the patient. Further multicentre studies are recommended to assess reproducibility across units.
Preparation of spunlaced viscose/PANI-ZnO/GO fiber membrane and its performance of photocatalytic decolorization
Authors: Liu Suo , Hu Jinyan , Wu Dingsheng , Zeng Haiao , Zhou Tang , Yang Maohuan , Feng Quan 
Published: April 2022

In order to solve the increasingly serious problem of printing and dyeing wastewater pollution, a kind of novel, efficient, and reusable spunlaced viscose/polyaniline-ZnO/GO fibrous membrane was fabricated in this work. Specifically, spunlaced viscose/polyaniline conductive fibrous membrane was firstly prepared by in-situ growth method, followed with the growth of zinc oxide (ZnO) and graphene oxide (GO) via the hydrothermal route to obtain spunlaced viscose/PANI-ZnO/GO fibrous membrane (SV@PANI-ZnO/GO membrane). The results show that the decolorization rate of SV@PANI-ZnO/GO membrane for methylene blue (5.0 mg/L) was 97.4% within 120 min, and the decolorization rate remained above 76.7% after five cycles. Moreover, the reaction process conformed to a quasi-first order kinetic model with the apparent rate constant of 0.0209 min–1. Meanwhile, the free radical capture experiment revealed that the main reactive species in the decolorization process was .OH. This work may provide a new method for designing photocatalytic materials for environmental applications.
PaxlovidTM Information From FDA and Guidance for AES Members
Authors: Cokley Jon A. , Gidal Barry E. , Keller Joy A. , Vossler David G. ,   Reviewed and approved by the AES Treatments Committee and Council on Clinical Activities
Published: April 2022

This American Epilepsy Society (AES) official statement provides information and preliminary guidance to Society members related to the U.S. Food & Drug Administration (FDA) December 22, 2021 Emergency Use Authorization for Paxlovid™ for the oral treatment of mild to moderate COVID-19 in adults and children (≥12 years and weighing ≥40 kg). Paxlovid is likely to be widely prescribed, and important considerations for patients on antiseizure medications (ASMs) include key contraindications and potential toxicity or dose adjustments while taking Paxlovid. This statement highlights concerns and provides information about their pharmacologic basis. Of particular concern, concomitant use of Paxlovid with the ASMs carbamazepine, phenobarbital, phenytoin, and primidone is contraindicated, because they are strong inducers of the CYP3A4 isozyme that metabolizes Paxlovid and thereby could cause loss of virologic response and development of resistance. Alternate oral or intravenous COVID-19 treatments should be considered. A second concern is that Paxlovid may increase the plasma concentrations of many ASMs, because it inhibits the CYP3A4 isozyme. ASMs that are metabolized, at least in part, by CYP3A4 include cannabidiol, carbamazepine, clobazam, clonazepam, diazepam, ethosuximide, everolimus, felbamate, lacosamide, midazolam, oxcarbazepine, perampanel, stiripentol, tiagabine, and zonisamide. Patients receiving these medications may warrant closer monitoring while being treated with Paxlovid.
Should we adjudicate outcomes in stroke trials? A systematic review
Authors: Godolphin Peter J , Bath Philip M , Montgomery Alan A 
Published: April 2022

Background: Central adjudication of outcomes is common in randomized clinical trials in stroke. The rationale for adjudication is clear; centrally adjudicated outcomes should have less random and systematic errors than outcomes assessed locally by site investigators. However, adjudication brings added complexities to a clinical trial and can be costly. Aim: To assess the evidence for outcome adjudication in stroke trials. Summary of review: We identified 12 studies evaluating central adjudication in stroke trials. The majority of these were secondary analyses of trials, and the results of all of these would have remained unchanged had central adjudication not taken place, even for trials without sufficient blinding. The largest differences between site-assessed and adjudicator-assessed outcomes were between the most subjective outcomes, such as causality of serious adverse events. We found that the cost of adjudication could be upward of £100,000 for medium to large prevention trials. These findings suggest that the cost of central adjudication may outweigh the advantages it brings in many cases. However, through simulation, we found that only a small amount of bias is required in site investigators’ outcome assessments before adjudication becomes important. Conclusion: Central adjudication may not be necessary in stroke trials with blinded outcome assessment. However, for open-label studies, central adjudication may be more important.
Dietary patterns associated with stroke among West Africans: A case–control study
Authors: Okekunle Akinkunmi P , Asowata Osahon , Akpa Onoja M , Ovbiagele Bruce , Fakunle Adekunle , Komolafe Morenikeji , Arulogun Oyedunni , Sarfo Fred S , Akpalu Albert , Obiako Reginald , Wahab Kolawole , Osaigbovo Godwin , Owolabi Lukman , Ogbole Godwin , Akinyemi Joshua , Adeniyi Sunday , Calys-Tagoe Benedict , Aridegbe Mayowa , Adebowale Akintunde , Dambatta Hamisu , Agunloye Atinuke , Oyinloye Olalekan , Aderibigbe Adeniyi , Suleiman Isah , Adeoye Abiodun M , Akpalu Josephine , Agbogu-Ike Obiageli , Tiwari Hemant K , Arnett Donna , Akinyemi Rufus , Owolabi Mayowa O 
Published: April 2022

Background: The relationship of diet with stroke risk among Africans is not well understood. Aim: The aim of this study was to investigate the association between dietary patterns and stroke risk among West Africans. Methods: In this multi-center case–control study, 3684 stroke patients matched (for age and sex) with 3684 healthy controls were recruited from Nigeria and Ghana. Food consumption was assessed using a food frequency questionnaire, and dietary patterns were summarized using principal component analysis. Stroke was defined using predefined criteria primarily on clinical evaluation following standard guidelines. Conditional logistic regression was applied to compute odds ratio (OR) and 95% confidence interval (CI) for stroke risk by tertiles of dietary patterns adjusting for relevant confounders. Results: Overall, mean age was 59.0 ± 13.9 years, and 3992 (54.2%) were males. Seven dietary patterns were identified. Multivariable-adjusted OR (95% CI) for risk of stroke by second and third tertiles (using the lowest and first tertile as reference) of dietary patterns was 1.65 (1.43, 1.90) and 1.74 (1.51, 2.02), for “poultry product and organ meat”; 1.69 (1.47, 1.96) and 1.51 (1.31, 1.75) for “red meat”; 1.07 (0.92, 1.23) and 1.21 (1.04, 1.40) for “fried foods and sweetened drinks”; 0.69 (0.60, 0.80) and 0.45 (0.39, 0.53) for “vegetables”; 0.84 (0.72, 0.97) and 0.81 (0.70, 0.93) for “whole-grain and fruit drinks”; and 0.97 (0.84, 1.12) and 0.85 (0.73, 0.98) for “fruits” respectively ( p < 0.05). Conclusion: These data suggest that plant-based diets are associated with a lower risk of stroke and might be a beneficial dietary recommendation for the primary prevention of stroke among Africans.
European minimum wage: A Swedish perspective on EU’s competence in social policy in the wake of the proposed directive on adequate minimum wages in the EU
Authors: Sjödin Erik 
Published: April 2022

The question of whether there can, may, and should be a lowest price for work performed by a human can be discussed from different perspectives. The President of the European Commission, Ursula von der Leyen, has unambiguously made it clear that the EU must take measures with regard to minimum wages. On October 28 2020, the Commission presented a proposal for a Directive on adequate minimum wages in the European Union. The article is structured as follows. It begins with a brief description of the history of the proposal and a short presentation of its material content. This is followed by a discussion of the chosen legal basis in the Treaty and of whether the EU has the competence to adopt the proposal. I shall then analyse how it can be determined whether Sweden has transferred competence to the EU to adopt legislation regarding minimum wages. The article concludes with some comments on future developments as a result of the proposal for a Directive on adequate minimum wage in the European Union.
Theoretical model and measurement of shared decision making in web-based pharmaceutical care consultation
Authors: Chen Haihong , Xiong Yuqi , Zhang Zinan , Zhou Qian , Wang Dan , Wang Xuemei , Zhang Xinping 
Published: April 2022

ObjectivesWe aimed to construct a theoretical model and an observer-based measurement of shared decision making (SDM) in web-based pharmaceutical care consultation.MethodsWe first constructed a theoretical model through analysis of SDM models and interviews with 24 key informants. Then, the initial measurement was formulated, and the content was evaluated by 16 key informants alone. A cross-sectional study was executed, where 300 provider-patient encounters were collected at the online platform ‘Good Doctor Website’, for reliability and validity assessment. Content validity was evaluated by appropriateness score, that is the median of 7–9 and without disagreement. Interrater reliability was evaluated by Spearman correlation coefficient using 30 out of 300 samples. Single indicator validity was tested by Pearson correlation analysis, and convergent validity was evaluated by the Multiple Indicators Multiple Causes (MIMIC) model using 300 samples.ResultsTheoretical model constructed included four elements: ‘comprehensive understanding of the patient's condition’, ‘exchanging ideas on medication options’, ‘achieving a medication plan’, and ‘providing decision support’. Measurement constructed included four dimensions and 19 items, and four dimensions were in accordance with four elements of the theoretical model. We found median scores of these dimensions and items were 7–9 and without disagreement, indicating good content validity. Spearman correlation coefficients of 19 items were greater than 0.750, suggesting good interrater reliability. Pearson coefficients between 19 items and their external variables were significant ( p < 0.001), and MIMIC model results showed that the R2values of dimensions 1–4 were over 0.5, indicating good single indicator validity and convergent validity.ConclusionsCharacteristics of web-based pharmaceutical care consultation, highlighting the importance of medication history, medication regimen, and detailed medication plan, were observed in the theoretical model. Measurement constructed had good reliability and validity and may be used by health policymakers to improve the quality of pharmaceutical care consultation online.
Medial and Lateral Posterior Tibial Slope in the Skeletally Immature: A Cadaveric Study
Authors: Anchustegui Nicolas , Grimm Nathan L. , Milbrandt Todd A. , Rustad Audrey , Shea Cooper , Troyer Stockton , Dingel Aleksei B. , Ganley Theodore J. , Fabricant Peter D. , Shea Kevin G. 
Published: April 2022

Background: An increased posterior tibial slope (PTS) results in greater force on the anterior cruciate ligament (ACL) and is a risk factor for ACL injuries. Biomechanical studies have suggested that a reduction in the PTS angle may lower the risk of ACL injuries. However, the majority of these investigations have been in the adult population. Purpose: To assess the mean medial and lateral PTS on pediatric cadaveric specimens without known knee injuries. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 39 pediatric knee specimens with computed tomography scans were analyzed. Specimens analyzed were between the ages of 2 and 12 years. The PTS of each specimen was measured on sagittal computed tomography slices at 2 locations for the medial and lateral angles. The measurements were plotted graphically by age to account for the variability in development within age groups. The anterior medial and lateral tibial plateau widths were measured. The distance between the top of the tibial plateau and the physis was measured. The independent-samples t test and analysis of variance were used to analyze the measurements. Results: The mean PTS angle for the medial and lateral tibial plateaus was 5.53° ± 4.17° and 5.95° ± 3.96°, respectively. The difference between the PTS angles of the medial and lateral tibial plateaus was not statistically significant ( P > .05). When plotted graphically by age, no trend between age and PTS was identified. Conclusion: This data set offers values for the PTS in skeletally immature specimens without a history of ACL injury and suggests that age may not be an accurate predictive factor for PTS.
The Impact of an Acute Medical Unit in Internal Medicine on Resident Education
Authors: Ibrahim Halah , Mohamad Mohamad Kasem , Adi Abd Al Kareem , Kamour Ashraf M. , Harhara Thana 
Published: April 2022

Background Medical trainees are expected to provide care for increasingly sick and treatment intensive patients. To improve patient care, hospitals worldwide have developed acute medical units (AMUs), dedicated medical wards that provide care for patients during the first 24 to 72 hours of an emergency medical hospital admission. A distinguishing feature of these units is that they are supervised by senior clinicians and offer multidisciplinary patient-centered care. Little is known about the impact of AMUs on trainee supervision and education. Methods In this educational case study, we describe the evolution, process and structure of our AMU service. We also provide resident and teaching faculty perceptions of the impact of this intervention on education and supervision. Results Questionnaire results showed that residents and teaching attendings believed that supervision and education were improved on the AMU, as compared to the traditional medical ward model. Residents also felt that their knowledge and clinical skills in managing acute patients improved. Procedure skills were less impacted by the intervention. A small number of residents believed that the AMU model worsened supervision and education. Conclusion Integrating medical trainees into an AMU allowed for early evaluation and input from senior clinicians and increased opportunities to work in and learn from multidisciplinary teams, contributing to improved resident supervision and education. Future studies are needed to assess the long-term impact of the AMU on educational outcomes.
Nummular headache in children: A case series and systematic literature review
Authors: Lax Daniel N , Hershey Andrew D , Kabbouche Marielle A , Kacperski Joanne 
Published: April 2022

Background: Nummular headache is a rare primary headache disorder potentially disabling and refractory to treatment. Of over 300 reported cases, only 9 are children. Design/Methods: We searched our institutional database and PubMed for “nummular headache” and synonyms and evaluated select articles from reference lists of substantial reviews. Results: Seven children were identified from our institution and nine from 107 unique publications. Mean age at onset was 9.7 and 11.9 years in our cohort and the literature, respectively, with a female:male ratio of 2:1. Location and quality varied, and allodynia was reported in five. Frequency ranged from every other week to continuous. Imaging was normal except in four cases. Migraine was often comorbid. Published cases were frequently refractory to treatment whereas four of our cohort improved with therapy for comorbid migraine. Conclusions: Nummular headache is rarely reported in children. We describe characteristics of seven new and nine previously published pediatric cases.
Up to 8-year follow-up from RESONATE-2: first-line ibrutinib treatment for patients with chronic lymphocytic leukemia
Authors: Barr Paul M. , Owen Carolyn , Robak Tadeusz , Tedeschi Alessandra , Bairey Osnat , Burger Jan A. , Hillmen Peter , Coutre Steve E. , Dearden Claire , Grosicki Sebastian , McCarthy Helen , Li Jian-Yong , Offner Fritz , Moreno Carol , Zhou Cathy , Hsu Emily , Szoke Anita , Kipps Thomas J. , Ghia Paolo 
Published: April 2022

Abstract
We report long-term follow-up from the RESONATE-2 phase 3 study of the once-daily Bruton’s tyrosine kinase inhibitor ibrutinib, which is the only targeted therapy with significant progression-free survival (PFS) and overall survival (OS) benefit in multiple randomized chronic lymphocytic leukemia (CLL) studies. Patients (≥65 years) with previously untreated CLL, without del(17p), were randomly assigned 1:1 to once-daily ibrutinib 420 mg until disease progression/unacceptable toxicity (n = 136) or chlorambucil 0.5-0.8 mg/kg ≤12 cycles (n = 133). With up to 8 years of follow-up (range, 0.1-96.6 months; median, 82.7 months), significant PFS benefit was sustained for ibrutinib vs chlorambucil (hazard ratio [HR], 0.154; 95% confidence interval [CI], 0.108-0.220). At 7 years, PFS was 59% for ibrutinib vs 9% for chlorambucil. PFS benefit was also observed for ibrutinib- vs chlorambucil-randomized patients with high-risk genomic features: del(11q) (HR, 0.033; 95% CI, 0.010-0.107) or unmutated immunoglobulin heavy chain variable region (HR, 0.112; 95% CI, 0.065-0.192). OS at 7 years was 78% with ibrutinib. Prevalence of adverse events (AEs) was consistent with previous 5-year follow-up. Ibrutinib dosing was held (≥7 days) for 79 patients and reduced for 31 patients because of AEs; these AEs resolved or improved in 85% (67 of 79) and 90% (28 of 31) of patients, respectively. With up to 8 years of follow-up, 42% of patients remain on ibrutinib. Long-term RESONATE-2 data demonstrate sustained benefit with first-line ibrutinib treatment for CLL, including for patients with high-risk genomic features. These trials were registered at www.clinicaltrials.gov as #NCT01722487 and #NCT01724346.
Impact of connected and autonomous vehicle dedicated lane on the freeway traffic efficiency
Authors: He Shanglu , Ding Fan , Lu Chaoru , Qi Yong 
Published: April 2022

Abstract
Background
The imminent emergence of connected and autonomous vehicles (CAVs) highlights the need for preparing the road infrastructure for traffic flows mixed with CAVs and human-driven vehicles. A dedicated lane (DL) for CAVs is one of the practical and potential ways to upgrade the road infrastructure for the mixed traffic.

Methods
This paper proposes a theoretical method to discuss the influence of implementing a CAV DL policy on the freeway traffic efficiency. In detail, the impact was measured by capacity and throughput. The calculation methods of these efficiency measurements under different CAV DL policies were proposed.

Experiments
Numerical experiments were conducted under various compositions of CAV DL policies and traffic conditions. More specifically, the relationship between the traffic conditions (i.e., traffic demand, market penetration rate (MPR) of CAVs, platoon intensity of CAVs, willingness of CAVs using the CAV DL) and the CAV DL policies (i.e., lane configuration, DL access control policy) were discussed.

Results and Conclusion
The results have led to some interesting findings, including the critical values of MPR that are valuable to guide an appropriate implementation of a CAV DL policy under a specific traffic condition.