bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Regular Versus After Hours Admissions to a 24-hour Opioid Treatment Program
Authors: Sherrick Robert C. 
Published: November 2022

Abstract

Objectives
October of 2017 marked the opening of the first US Opioid Treatment Program (OTP) that was staffed 24 hours a day, 7 days a week, with admissions on demand, both during normal OTP working hours and outside the hours when most OTPs are able to accept new patients. This article compares demographic and treatment outcomes for those patients admitted during normal working hours with those admitted after hours or on weekends.

Methods
All admissions to the 24-hour OTP between January 2018 and December 2020 who were new to treatment at this OTP and started on methadone were included. An internal database of patient demographics and dosing events was collected during the normal treatment process. These data were examined regarding initial demographics, dosing, and treatment outcomes, comparing patients admitted during normal working hours with those admitted when most OTPs would be closed and unable to admit new patients.

Results
A total of 7,334 admissions were included, 2,631 during normal working hours, and 4,703 after hours or on weekends. After-hours patients were comparable in age but were more likely to be male (56.0% vs. 52.5%, P < 0.01), employed (24.1% vs. 22.1%, P < 0.05), and White versus non-White (56.2% vs. 51.5%, P < 0.001) compared with working-hour admissions. Outcomes of first-day dose, 30th-day dose, and 30-day treatment attendance did not differ between the 2 groups.

Conclusions
In this situation where patients could be admitted at any time, the majority presented after hours. Patients who were admitted after-hours did not have worse treatment outcomes than those who were admitted during working hours. These findings suggest that offering OTP admission after-hours and on weekends will not result in attracting patients with low motivation and poorer outcomes than those who are admitted during working hours. Extending OTP admission hours has the potential to improve medication for opioid use disorder access and treatment outcomes.
Cardiovagal baroreflex sensitivity, blood pressure and blood pressure variability – the Maastricht study
Authors: Zhou Tan Lai , Reulen Jos P.H. , Van Der Staaij Hilde , Stehouwer Coen D.A. , Van Greevenbroek Marleen , Henry Ronald M.A. , Kroon Abraham A. 
Published: November 2022

Objective:
Low baroreflex sensitivity (BRS) has been hypothesized to underlie high blood pressure (BP) and greater BP variability on the longer term, but evidence is scarce. In addition, these associations may differ by sex and (pre)diabetes. Therefore, we investigated whether cardiovagal BRS is associated with short- to mid-term mean BP and BP variability, and differs according to sex and (pre)diabetes.

Methods:
Cross-sectional data from the population-based Maastricht study (age 60 ± 8 years, 52% men), where office (n = 2846), 24-h (n = 2404) and 7-day BP measurements (n = 2006) were performed. Spontaneous BRS was assessed by cross-correlating systolic BP and instantaneous heart rate. We used linear regression with adjustments for age, sex, BP or BP variability, and cardiovascular risk factors.

Results:
With regard to BP, 1-SD (standard deviation) lower BRS (−5.75 ms/mmHg) was associated with higher office, 24-h and 7-day systolic BP (2.22 mmHg [95% confidence interval [CI]: 1.59; 2.80], 0.95 mmHg [0.54; 1.36], and 1.48 mmHg [0.99; 1.97], respectively) and diastolic BP (1.31 mmHg [0.97; 1.66], 0.57 mmHg [0.30; 0.84], and 0.86 mmHg [0.54; 1.17], respectively). Per 1-SD lower BRS, these associations were stronger in women (0.5–1.5 mmHg higher compared to men), and weaker in those with type 2 diabetes (1–1.5 mmHg lower compared to normal glucose metabolism). With regard to BP variability, BRS was not consistently associated with lower BP variability.

Conclusions:
Lower cardiovagal BRS is associated with higher mean BP from the short- to mid-term range, and not consistently with BP variability. The associations with mean BP are stronger in women and weaker in those with type 2 diabetes.
Antihypertensive medication classes and the risk of dementia over a decade of follow-up
Authors: Schroevers Jakob L. , Eggink Esmé , Hoevenaar-Blom Marieke P. , Van Dalen Jan Willem , Van Middelaar Tessa , Van Gool Willem A. , Richard Edo , Moll Van Charante Eric P. 
Published: November 2022

Introduction:
Use of angiotensin II (ATII)-stimulating antihypertensive medication (AHM), including angiotensin receptor blockers (ARBs) and dihydropyridine calcium channel blockers (CCBs), has been associated with lower dementia risk. Previous studies had relatively short follow-up periods. The aim of this study is to investigate if these effects are sustained over longer periods.

Methods:
This post hoc observational analysis was based on data from a dementia prevention trial (preDIVA and its observational extension), among Dutch community-dwelling older adults without prior diagnosis of dementia. Differential associations between AHM classes and incident dementia were studied after 7.0 and 10.4 years, based on the median follow-up durations of dementia cases and all participants.

Results:
After 7 years, use of ATII-stimulating antihypertensives [hazard ratio = 0.68, 95% confidence interval (CI) = 0.47–1.00], ARBs (hazard ratio = 0.54, 95% CI = 0.31–0.94) and dihydropyridine CCBs (hazard ratio = 0.52, 95% CI = 0.30–0.91) was associated with lower dementia risk. After 10.4 years, associations for ATII-stimulating antihypertensives, ARBs and dihydropyridine CCBs attenuated (hazard ratio = 0.80, 95% CI = 0.61–1.04; hazard ratio = 0.75, 95% CI = 0.53–1.07; hazard ratio = 0.73, 95% CI = 0.51–1.04 respectively), but still suggested lower dementia risk when compared with use of other AHM classes. Results could not be explained by competing risk of mortality.

Conclusion:
Our results suggest that use of ARBs, dihydropyridine CCBs and ATII-stimulating antihypertensives is associated with lower dementia risk over a decade, although associations attenuate over time. Apart from methodological aspects, differential effects of antihypertensive medication classes on incident dementia may in part be temporary, or decrease with ageing.
EFFICACY OF COMBINED SYSTEMIC CORTICOSTEROID AND EARLY IMMUNOMODULATORY THERAPY WITHIN THREE MONTHS OF ONSET IN VOGT–KOYANAGI–HARADA DISEASE
Authors: Park Hyo Song , Park Hyun Young , Lee Christopher Seungkyu , Lee Sung Chul , Lee Ji Hwan 
Published: November 2022

Purpose:
To evaluate the clinical outcomes of combined systemic corticosteroid and early immunomodulatory therapy (IMT) within 3 months of onset in Vogt–Koyanagi–Harada (VKH) disease compared with conventional therapy.

Methods:
This retrospective observational case series included 73 eyes of 38 patients with VKH, categorized into the conventional (n = 41) and the early IMT (n = 32) groups. Clinical information was gathered from patients' medical records. Primary outcome measures were visual acuity, subfoveal choroidal thickness, and uveitis outcome including occurrence of sunset glow fundus.

Results:
The logarithm of minimal angle of resolution visual acuity of both groups improved, with statistically significant difference at the last follow-up (P < 0.01, Mann–Whitney U test). Their mean subfoveal choroidal thickness decreased, with no statistically significant difference at the last follow-up (P = 0.21, T-test). In the conventional and early IMT groups, 27 (65.9%) and 15 (46.9%) eyes, respectively, had chronic or chronic recurrent VKH and sunset glow fundus was observed in 33 (80.5%) and 16 (50.0%) eyes, respectively.

Conclusion:
Combined systemic corticosteroid and early IMT within 3 months of onset was superior to conventional therapy in the final visual and uveitis outcome of patients with VKH disease. Therefore, IMT may be added early in cases of VKH disease, even when under control with high-dose corticosteroid.
Associations Between Thyroid Eye Disease and Glaucoma Among Those Enrolled in the National Institutes of Health All of Us Research Program
Authors: Delavar Arash , Radha Saseendrakumar Bharanidharan , Lee Tonya C. , Topilow Nicole J. , Ting Michelle A. , Liu Catherine Y. , Korn Bobby S. , Weinreb Robert N. , Kikkawa Don O. , Baxter Sally L. 
Published: November 2022

Purpose:
To assess the association between thyroid eye disease (TED) and glaucoma.

Methods:
Patients 18 years of age and over enrolled in the NIH All of Us Research Program, a nationwide cohort, were extracted. Those with conditions relating to TED were identified and compared with 2020 US Census-matched controls without a diagnosis of TED in a 1:4 ratio. The authors used Pearson’s χ2 tests to study demographics by TED status, and logistic regression to generate odds ratios and 95% confidence intervals to evaluate the association between TED and glaucoma (any type, including glaucoma suspect), using those without TED as the reference group. Multivariable models were adjusted for age, gender, race/ethnicity, eye doctor visits, and smoking status.

Results:
A total of 393 cases of TED were identified, and 1,572 US Census-matched controls. The median age of the cohort was 63 years (interquartile range: 48–73 years). Age, gender, and race/ethnicity varied by TED status (p < 0.001). Overall, 114 (29.0%) of TED cases had a diagnosis of glaucoma, compared with 94 (6.0%) of non-TED controls. On bivariate logistic regression models, those diagnosed with TED were significantly more likely to be diagnosed with glaucoma compared with controls (odds ratio: 6.42; 95% confidence interval: 4.76–8.70; p < 0.001). This trend persisted on multivariable logistic regression controlling for confounding factors (odds ratio: 3.37; 95% confidence interval: 1.85–6.20 p < 0.001).

Conclusions:
Individuals with TED were significantly more likely to be diagnosed with glaucoma. Clinicians caring for patients with TED should be aware of this elevated risk and arrange glaucoma evaluation, accordingly.
Addressing Metabolic Comorbidity in Individuals With Intellectual and Developmental Disability on Antipsychotics
Authors: Stogios Nicolette , Hahn Margaret K. , Lunsky Yona , Desarkar Pushpal , Agarwal Sri Mahavir 
Published: November 2022

Abstract

Purpose/Background
Individuals with intellectual and developmental disabilities (IDDs) are at increased risk for serious metabolic comorbidities, which is further exacerbated by the high rate of antipsychotic use in this population. There is currently a lack of literature on effective treatment options for antipsychotic-induced weight gain and metabolic abnormalities in IDD. This case series reports on the clinical use of metformin in patients with IDD on antipsychotics.

Methods/Procedures
We conducted a retrospective review of patients in a novel clinical service at the Centre for Addiction and Mental Health in Toronto, Ontario, Canada for adults with IDD experiencing antipsychotic-related weight gain and other metabolic aberrations. Charts were reviewed for weight and other metabolic outcome measures before and after commencing metformin treatment.

Findings/Results
In 11 patients referred to this clinic, the mean weight loss while on metformin treatment was 11.1 kg, with over 50% of the sample achieving clinically meaningful weight loss of >7%. Additional adaptive changes were observed for fasting glucose, glycated hemoglobin, triglyceride, and high-density lipoprotein cholesterol levels.

Implications/Conclusions
In line with its use in severe mental illness, metformin may be a safe, effective, and accessible treatment option for patients with IDD experiencing metabolic adverse effects of antipsychotic medication. Further research and randomized controlled trials are needed to examine the efficacy of metformin in this population.
Tinea Gladiatorum Detection With a Dermatophyte Test Strip
Authors: Berg Mark A. , Martin Casey 
Published: November 2022

Objective:
Determine sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and concordance of diafactory hs-TP (DTS) to detect tinea gladiatorum using direct potassium hydroxide (KOH) microscopy as the reference standard.

Design:
Prospective, comparative study.

Setting:
Seventeen Minnesota high schools during the winter wrestling season.

Patients:
Seventy-one consecutive high school wrestlers identified with a suspicious rash during skin inspection.

Interventions:
Samples were obtained from each rash for both DTS and direct KOH microscopy.

Main Outcome Measures:
Readings were recorded as positive or negative.

Results:
Direct KOH microscopy identified tinea gladiatorum in 35 of the 71 samples (46%). DTS sensitivity was 80% (95% confidence interval 63%-92%), and specificity was 82% (66%-92%). PPV was 85% (68%-95%), and NPV was 86% (72 %-91%). The DTS result was 83% concordant (72%-91%) with direct KOH microscopy.

Conclusions:
Similar to rapid Covid antigen tests, DTS required brief, basic training to perform and gave onsite results in 5 to 30 minutes. Although DTS is not approved for use in the United States by the FDA, concordance compared with direct KOH microscopy in diagnosing tinea gladiatorum was similar to results reported for DTS-TU in tinea unguium and tinea pedis. Further study comparing DTS to a reference standard using PCR plus direct microscopy is warranted.
A systematic review of epidemiology and outcomes of Crohn’s disease-related enterocutaneous fistulas
Authors: Iglay Kristy , Bennett Dimitri , Kappelman Michael D. , Reynolds Kamika , Aldridge Molly , Karki Chitra , Cook Suzanne F. 
Published: November 2022

Background:
Enterocutaneous fistulas (ECF) are rare sequelae of Crohn’s disease (CD) that occur either postoperatively or spontaneously. ECFs are associated with high morbidity and mortality. This systematic literature review assesses the disease burden of CD-related ECF and identifies knowledge gaps around incidence/prevalence, treatment patterns, clinical outcomes, healthcare resource utilization (HCRU), and patient-reported outcomes (PROs).

Methods:
English language articles published in PubMed and Embase in the past 10 years that provided data and insight into the disease burden of CD-related ECF (PROSPERO Registration number: CRD42020177732) were identified. Prespecified search and eligibility criteria guided the identification of studies by two reviewers who also assessed risk of bias.

Results:
In total, 582 records were identified; 316 full-text articles were assessed. Of those, eight studies met a priori eligibility criteria and underwent synthesis for this review. Limited epidemiologic data estimated a prevalence of 3265 persons with ECF in the USA in 2017. Clinical response to interventions varied, with closure of ECF achieved in 10% to 62.5% of patients and recurrence reported in 0% to 50% of patients. Very little information on HCRU is available, and no studies of PROs in this specific population were identified.

Conclusion:
The frequency, natural history, and outcomes of ECF are poorly described in the literature. The limited number of studies included in this review suggest a high treatment burden and risk of substantial complications. More robust, population-based research is needed to better understand the epidemiology, natural history, and overall disease burden of this rare and debilitating complication of CD.
Disseminated fusarium infection after allogeneic hematopoietic stem cell transplantation after CART: A case report
Authors: Fei Hairong , Liu Xiaodan , Sun Lingjie , Shi Xue , Wang Wei , Zhao Hongguo , Zhao Chunting 
Published: November 2022

Background:
Fusarium is a conditional pathogen that can cause invasive infection in patients with hematological diseases under immune function.

Methods:
A case of recurrent and refractory Philadelphia chromosome-positive acute lymphoblastic leukemia was treated with allogeneic hematopoietic stem cell transplantation after chimeric antigen receptor-modified T cells treatment.

Results:
During transplantation, disseminated Fusarium infection occurred, involving the skin, liver, spleen and central nervous system, and the patient eventually died.

Conclusions:
Early identification of Fusarium infection based on the characteristic rash and timely antifungal treatment can improve the cure rate.
Effectiveness and safety of electroacupuncture for ankylosing spondylitis: A protocol for a systematic reviews and meta-analysis
Authors: Liu Shenghui , Zheng Jiangxia , Wen Xiuzhen , Fang Qun , Zhang Xifeng 
Published: November 2022

Introduction:
Ankylosing spondylitis (AS) is a type of autoimmune disease commonly characterized by joint pain and stiffness. This disease progression can exhibit common deformities and other activities with limited symptoms and significantly impacts people’s work and life. Electroacupuncture (EA) as a traditional Chinese therapy, showing several advantages (e.g., safety, economy, and less side effects), has been extensively used to treat AS. However, its curative effect is supported by limited evidence. Accordingly, the present study aims to comprehensively assess the reliability of EA in AS treatment.

Methods and analysis:
The study will conduct a systematic review and meta-analysis. Seven databases, including the Embase, Cochrane Library, Pubmed, SinoMed, CNKI, VIP, and Wanfang Data, will be searched using predefined search terms to identify relevant studies. The primary outcomes will be the clinical efficiency, the Bath AS Disease Activity Index, and the Visual Analog Scale. Eligible studies should report at least 1 of these primary outcomes. Eligible studies designed as randomized controlled trials will be included for meta-analysis, while other related clinical studies will be reviewed. The methodological quality of the included studies will be assessed with a previously established checklist. The Cochrane Collaboration’s bias risk tool will be used for assessing the bias of included randomized controlled trials. Stata 17.0 software is used for meta-analysis.

Results:
The protocol will be used to assess the efficacy and safety of EA in AS treatment.

Conclusion:
This review reliably evidences whether EA is a reliable method for the intervention of AS.
Sensory neuronopathy in a patient with neurofibromatosis type 1: A case report
Authors: Kang You-Ri , Hong Seong-Min , Choi Jong-Hee , Lee Seung-Jin , Kim Jae-Myung , Wook Kang Kyung , Nam Tai-Seung 
Published: November 2022

Rationale:
Neurofibromatosis type 1 (NF-1) can manifest with various neurological symptoms. However, sensory ataxia has not been reported.

Patient concerns:
A 44-year-old man with NF-1 presented with several weeks of unsteady gait. He was diagnosed with gastric neuroendocrine tumor with multiple hepatic metastases 6 years ago and received palliative chemotherapy. Neurological examination revealed ataxia veering to the right side with no motor weakness.

Diagnoses:
Clinical manifestations and electrodiagnostic studies suggested the dysfunction of the thoracic dorsal column (DC). Initial magnetic resonance imaging showed a lateral thoracic meningocele (LTM) located in the right paravertebral area at the T3-T4 vertebral level, but the spinal cord was unremarkable. Gait disturbance worsened after 9 months, and follow-up magnetic resonance imaging showed high signal intensity involving the right DC at the level adjacent to the LTM and spinal cord atrophy distal to the DC lesion. Tests for well-characterized paraneoplastic antibodies were negative. Ultimately, the patient was assumed to have sensory neuronopathy due to compressive damage to the dorsal root ganglia within the intervertebral foramina by LTM.

Interventions:
Empirical treatment with vitamin B12 supplementation and corticosteroids failed to improve his condition. The patient underwent decompressive laminectomy and excision of the meningocele with dura repair.

Outcomes:
The patient temporarily improved to walk with assistance postoperatively. However, he developed dyspnea and hypotension 5 weeks later. Carcinoid heart disease confined the patient to the bed. The patient died of pneumonia 3 months after the operation.

Lessons:
This case with NF-1 shows asymmetric sensory ataxia of subacute progression. LTM may contribute to the development of sensory neuronopathy by damaging sensory neurons of the dorsal root ganglia. The comorbidities of the patient, including gastric neuroendocrine tumor and LTM, made it challenging to investigate the pathomechanism.
A Bayesian network analysis of immunotherapy and taxane chemotherapy as second- or later-line treatments in non-small cell lung cancer
Authors: Liu Xin-Xiu , Lin Guo-He , Wang Bi-Cheng 
Published: November 2022

Background:
Taxane chemotherapy represents the standard of care in the second-line setting for non-small cell lung cancer (NSCLC) patients, but immunotherapy agents pose great challenges. Whether immunotherapy/chemotherapy alone or combination therapy has more benefits remains controversial. In this study, we provided comparisons to integrate the efficacy of immunotherapy and taxane chemotherapy as second- or later-line treatments in advanced NSCLC.

Methods:
PubMed, Web of Science, Embase, and Cochrane Central Register of Controlled Trials were systematically searched from inception to September 1, 2020. Randomized controlled trials comparing immunotherapy and taxane chemotherapy were enrolled in the Bayesian network analysis. Overall survival (OS) and progression-free survival (PFS) with hazard ratios (HRs) were investigated.

Results:
Eight trials in 13 studies with 4398 patients comparing seven treatments were identified. Pembrolizumab 10 mg/kg was associated with the best improved OS, with significant differences versus docetaxel (HR 0.81, 95% credible interval [CrI] 0.74‐0.88), avelumab (HR 0.84, 95% CrI 0.75‐0.95), and pembrolizumab 200 mg plus docetaxel (HR 0.75, 95% CrI 0.56‐1.00). Although pembrolizumab 200 mg plus docetaxel ranked the last in terms of OS, the combination therapy showed the most favorable PFS. Additionally, the anti-programmed death-ligand 1 (PD-L1) agent, avelumab, was associated with the least improvement in PFS.

Conclusion:
As second- or later-line therapeutic strategies, pembrolizumab 10 mg/kg provided the largest OS benefits and pembrolizumab 200 mg plus docetaxel improved PFS to the greatest extent. Considering that immunotherapy has been recommended to the first-line setting of NSCLC, advanced patients who have not received immunotherapy previously might be the suitable population for our findings.
Coexistence of condyloma acuminatum and extramammary Paget’s disease on penis and scrotum: A rare case report
Authors: Kang Inho , Lee Joon Ho , Lee Jong Im , Hong Joon Shik , Mo Young Woong , Jung Gyu Yong 
Published: November 2022

Rationale:
Extramammary Paget’s disease (EMPD) is a rare skin cancer that commonly occurs in sites rich in apocrine glands, such as perineum, vulva, axilla, scrotum, and penis. On the other hand, condyloma acuminatum (CA; also referred to as anogenital warts) is a common benign neoplasm caused by human papillomavirus. Few cases of coexistent EMPD and CA have been reported because of the rarity of the condition.

Patient concerns and diagnosis:
A 72-year-old man with a genital mass, which appeared to be composed of multiple papillomatous masses, was referred for surgical resection. The lesion was first noticed 6 months previously and grew rapidly. CO2 ablative laser therapy was performed twice at a primary clinic, but the mass recurred.

Intervention and outcomes:
Excisional biopsy revealed the presence of coexistent EMPD and CA. Additional wide excision was performed, and postoperative biopsy confirmed no residual tumor. Two years after surgery, no recurrence had occurred.

Lessons:
CA can co-occur with several types of skin malignancies, and a skin malignancy coexisting with CA is difficult to diagnose visually. Therefore, even if a skin lesion in the genital region is considered to be CA, we recommend punch biopsy before treatment because it can benefit prognosiss.