bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary care physicians' participation in the Medicare shared savings program and preventive services delivery: Evidence from the first 7 years
Authors: Huang Huang , Zhu Xi , Wehby George L. 
Published: July 2022

AbstractObjectiveTo evaluate whether primary care physicians' participation in the Medicare Shared Savings Program (MSSP) is associated with changes in their preventive services delivery.Data SourcesMedicare Provider Utilization and Payment Physician and Other Supplier Public Use File and MSSP Accountable Care Organizations (ACO) Provider‐Level Research Identifiable File from 2012 to 2018.Study DesignThe design was a two‐way fixed effects model estimating within‐provider changes in preventive services delivery over time controlling for provider time‐invariant characteristics, national time trends, and characteristics of served patients. The following preventive services were evaluated: influenza vaccination, pneumococcal vaccination, clinical depression screening, colorectal cancer screening, breast cancer screening, Body Mass Index (BMI) screening and follow‐up, tobacco use assessment, and annual wellness visits. Both the likelihood of providing services and the volume of services delivered were evaluated.Data Collection/Extraction MethodsSecondary data linked at the provider level.Principal FindingsMSSP participation was associated with an increase in the likelihood of providing influenza vaccination (0.7 percentage‐points), pneumococcal vaccination (2.0 percentage‐points), clinical depression screening (2.1 percentage‐points), tobacco use assessment (0.3 percentage‐points), and annual wellness visits (4.1 percentage‐points). A similar increase was found for the volume of services delivered per 100 patients for several preventive services: influenza vaccination (0.18), pneumococcal vaccination (0.56), clinical depression screening (0.46), and annual wellness visits (1.52). MSSP participation was associated with a decrease in the likelihood (−0.4 percentage‐points) and the volume of colorectal cancer screening (−0.03).ConclusionsPrimary care physicians' participation in MSSP was associated with an increase in the likelihood and the volume of several preventive services.
Presumptive eligibility for pregnancy Medicaid and timely prenatal care access
Authors: Eliason Erica L. , Daw Jamie R. 
Published: July 2022

AbstractObjectiveTo assess the association between the adoption of presumptive eligibility for pregnancy Medicaid in Kansas in 2016 and timely prenatal care access.Data Source2012–2019 National Center for Health Statistics natality files.Study DesignWe used difference‐in‐differences to compare outcomes before (2012–2015) and after (2017–2019) presumptive eligibility in Kansas relative to seven control group states overall and stratified by maternal education. Outcomes included first‐trimester prenatal care, the month of first prenatal visit, and adequate prenatal care.Data Collection/Extraction MethodsAll live births among adults aged 20 or older in Kansas, Idaho, Missouri, Nebraska, Tennessee, Utah, Wisconsin, and Wyoming.Principal FindingsAmong all births, we found no evidence that presumptive eligibility in Kansas resulted in changes in prenatal care use. Among individuals with high school education or less, presumptive eligibility was associated with a 1.92 percentage‐point increase (95% CI: 0.64, 4.35) in first‐trimester prenatal care, driven by earlier month of first prenatal care visit.ConclusionsPresumptive eligibility in Medicaid non‐expansion states may lead to small improvements in early prenatal care among individuals with lower education, but other interventions may be needed.
Feasibility and effectiveness of deprescribing benzodiazepines and Z‐drugs: systematic review and meta‐analysis
Authors: Soni Anisha , Thiyagarajan Arun , Reeve Joanne 
Published: July 2022

AbstractBackground and AimsA total of 2.4 million adults in England were dispensed a benzodiazepine or Z‐drug (BZRA) in 2017/18, and more than 250 000 patients in the UK take BZRAs beyond the recommended duration. Deprescribing is a clinician‐guided process of withdrawing inappropriate drugs. This review aimed to evaluate the evidence base supporting the feasibility and clinical effectiveness of all forms of deprescribing initiatives used to discontinue long‐term (≥ 4 weeks) BZRAs.MethodSystematic review of randomized controlled trials evaluating BZRAs deprescribing among adults in community, primary or outpatient settings. MEDLINE, Embase and PsycINFO were searched from inception to February 2021. Primary outcomes were successful discontinuation in the short (< 4 weeks) or long term (≥ 4 weeks) and the occurrence of withdrawal symptoms, behavioural or psychological symptoms. Studies were categorized as pharmacological or non‐pharmacological supported interventions. Study quality was assessed using the Cochrane risk‐of‐bias tool. Where appropriate, risk ratios (RRs), mean differences and 95% confidence intervals (CIs) were calculated, and Mantel–Haenszel methods using the random‐effect meta‐analysis was undertaken to calculate summary effect estimates.ResultsTen studies were included (n = 1431 participants). Heterogeneity in study design and effect was observed. Benzodiazepines were successfully deprescribed when gradually tapered with non‐pharmacological support compared with gradual tapering alone in the short term (n = 124; RR = 2.02; 95% CI = 1.41, 2.89) and long term (n = 123; RR = 2.45; 95% CI = 1.56, 3.85). Benzodiazepine deprescribing was more successful when supported by non‐pharmacological methods versus routine care (n = 189; RR = 3.26; 95% CI = 2.36, 4.51). Quality of evidence reporting effectiveness was very low to low.ConclusionsIt may be feasible to deprescribe benzodiazepines depending on the process and support mechanisms employed.
Secukinumab treatment demonstrated high drug survival and sustained effectiveness in patients with severe chronic plaque psoriasis: 21‐month analysis in Australian routine clinical practice (SUSTAIN study)
Authors: Foley Peter , Manuelpillai Nick , Dolianitis Con , Cains Geoffrey D. , Mate Eric , Tronnberg Rebecca , Baker Christopher 
Published: July 2022

AbstractBackgroundDrug survival measures the rate and duration of adherence to a given therapeutic agent and evaluates its long‐term effectiveness, safety, and real‐world utility. The SUSTAIN study sought to establish the drug survival and effectiveness of secukinumab for patients with severe chronic plaque psoriasis (CPP) in the Australian clinical setting.MethodsData of all patients (aged ≥18 years) from Australasian Psoriasis Registry (APR) treated with secukinumab were analysed. The primary objective was to describe the drug survival of secukinumab at 9 months. Key secondary objectives included drug survival of secukinumab at 3, 6, 15, and 21 months, stratified by biologic‐naïve vs biologic‐experienced patients; proportion of patients achieving Psoriasis Area and Severity Index (PASI) 75/90/100 responses; and changes in health‐related quality of life over time utilising the Dermatology Life Quality Index (DLQI).ResultsOf 294 patients included in this analysis, 110 (37.4%) were biologic‐naïve and 184 (62.6%) biologic‐experienced. Kaplan–Meїer drug survival rates in biologic‐naïve vs biologic‐experienced patients were 0.92 vs. 0.86 (9 months) and 0.82 vs. 0.68 (21 months), respectively. The proportion of patients with PASI 75/90/100 responses for biologic‐naïve vs. biologic‐experienced was 100/87.7/38.4 vs 98.5/61.5/27.2 (9 months) and 100/81.0/41.7 vs. 98.4/62.0/24.2 (21 months), respectively. The mean (standard deviation [SD]) DLQI in biologic‐naïve vs. experienced patients was 2.2 (4.1) vs. 3.1 (5.2) (9 months) and 1.4 (2.5) vs. 3.1 (5.3) (21 months). No new safety signals were observed.ConclusionsSecukinumab demonstrated high drug survival and sustained effectiveness in Australian real‐world setting, in biologic‐naïve and biologic‐experienced patients with severe CPP.
Acute myocardial infarction with normal electrocardiogram and biomarkers of cardiac injury: A case report
Authors: Zha Ke‐Lan , Wen Chen  , Qiang Ye  
Published: July 2022

AbstractPatients with AMI usually present with the specific changes for electrocardiogram (ECG) and biomarkers of cardiac injury. Here, we present a rare case with chest pain and normal ECG and biomarkers of cardiac injury. Emergent coronary angiography revealed an occlusion of proximal left anterior descending coronary artery. The patient was diagnosed with AMI, and his symptom relieved after implantation of drug‐eluting stents. Caution should be exercised for the exclusion of AMI in patients with chest pain and both normal ECG and biomarkers of cardiac injury.
A sacred plant of neuronal effect: the use of ibogaine in addiction treatments in Brazil
Authors: Gomes Bruno Ramos , Tofoli Luis Fernando 
Published: July 2022

ABSTRACTThis research qualitatively investigated four treatments for addiction in Brazil that use ibogaine as the main tool in the process. Ibogaine is a substance derived from an African plant, Tabernanthe iboga, traditionally used in its region of origin and which leads to intense sensations during its acute effects and also different experiences of oneself and the surrounding world in the period after its use. It’s considered a non‐typical psychedelic. We visited the clinics and interviewed professionals and patients of these places. In this article, we focus on how ibogaine is used for addiction and depression treatment and how its effect is understood. There is variation in patient screening and preparation, how the ibogaine is determined, and the care practices proposed after the treatment. These variations seem to be influenced by the context where ibogaine is inserted and their practices. We identified three different contexts that influence ibogaine use in Brazil: the market of addiction treatment clinics, the Brazilian urban religious use of ayahuasca, and the medical context of ibogaine use developed by Howard Lotsof.
Review article: Follow‐up of coeliac disease
Authors: Tye‐Din J. A. 
Published: July 2022

SummaryCoeliac disease is a lifelong immune‐mediated enteropathy with systemic features associated with increased morbidity and modestly increased mortality. Treatment with a strict gluten‐free diet improves symptoms and mucosal damage but is not curative and low‐level gluten intake is common despite strict attempts at adherence. Regular follow‐up after diagnosis is considered best‐practice however this is executed poorly in the community with the problem compounded by the paucity of data informing optimal approaches. The aim of dietary treatment is to resolve symptoms, reduce complication risk and improve quality of life. It follows that the goals of monitoring are to assess dietary adherence, monitor disease activity, assess symptoms and screen for complications. Mucosal disease remission is regarded a key measure of treatment success as healing is associated with positive health outcomes. However, persistent villous atrophy is common, even after many years of a gluten‐free diet. As the clinical significance of asymptomatic enteropathy is uncertain the role for routine follow‐up biopsies remains contentious. Symptomatic non‐responsive coeliac disease is common and with systematic follow‐up a cause is usually found. Effective models of care involving the gastroenterologist, dietitian and primary care doctor will improve the consistency of long‐term management and likely translate into better patient outcomes. Identifying suitable treatment targets linked to long‐term health is an important goal.
Association of childhood maltreatment with subsequent dating violence: An analysis of revictimization among the Korean population
Authors: Yoon Yoewon , Song Ahyoung 
Published: July 2022

AbstractChildhood maltreatment is a universal issue impacting developmental outcomes, including the likelihood of experiencing violence in later life. Although previous works have focused on the cycle of abuse, the cycle of revictimization and neglect is less well‐understood. In the current study, childhood exposure to maltreatment (physical abuse, emotional abuse, and neglect) are examined as potential risk factors for dating relationships in adulthood. A group of 1200 adults (mean age = 46.60 years; range: 20–84 years) were recruited from the registered residential population of the Ministry of Public Administration and Security. Logistic regression analyses were conducted and revealed that childhood physical abuse was associated with physical, emotional, and financial violence in dating relationships. In addition, childhood emotional abuse exposure was associated with physical and sexual dating violence. Although childhood exposure to neglect did not explain any types of adulthood dating violence, it appears that experiencing abuse during childhood is highly related to dating violence in adulthood. Our findings revealed the importance of understanding the different types of childhood maltreatment, especially in terms of how they relate to violence victimization in the context of dating in adulthood. Interventions should address the various types of childhood victimization by family members to help prevent dating violence in adulthood.
Toxic and nutritional factors trigger Leber hereditary optic neuropathy due to a mitochondrial tRNA mutation
Authors: Vela‐Sebastián Ana , López‐Gallardo Ester , Emperador Sonia , Hernández‐Ainsa Carmen , Pacheu‐Grau David , Blanco Ignacio , Ros Andrea , Pascual‐Benito Ester , Rabaneda‐Lombarte Neus , Presas‐Rodríguez Silvia , García‐Robles Pilar , Montoya Julio , Ruiz‐Pesini Eduardo 
Published: July 2022

AbstractLeber hereditary optic neuropathy is a mitochondrial disease mainly due to pathologic mutations in mitochondrial genes related to the respiratory complex I of the oxidative phosphorylation system. Genetic, physiological, and environmental factors modulate the penetrance of these mutations. We report two patients suffering from this disease and harboring a m.15950G > A mutation in the mitochondrial DNA‐encoded gene for the threonine transfer RNA. We also provide evidences supporting the pathogenicity of this mutation.
Identification of genetic variants of the IL‐22 gene in association with an altered risk of COPD susceptibility
Authors: Wang Yan , Zhou Qipeng , Chen Lingzhu , Dong Lian , Xiong Mingmei , Xie Xiaohui , Zhao Li , Xu Jingyi , Zheng Zeguang , Wang Jian , Lu Wenju 
Published: July 2022

AbstractThe incidence of chronic obstructive pulmonary disease (COPD) is related to the interaction between environmental exposure and genetic factors. Far more than 15% of smokers eventually develop COPD. In addition to smoking, genetic susceptibility may be another factor in the development of COPD. IL‐22 and its receptors are increased in human and experimental COPD and contribute to pathogenesis. Here, we conducted a case–control study to evaluate the association between IL‐22 tag‐single nucleotide polymorphisms (SNPs) and COPD risk. Four tag‐SNPs (rs2227478, rs2227481, rs2227484 and rs2227485) were identified according to linkage disequilibrium (LD) analysis in 30 healthy controls. A total of 513 COPD cases and 504 controls were recruited to perform an association study between these four tag‐SNPs and COPD risk. We found that the “C” allele of rs2227478T>C and the “T” allele of rs2227481C>T were obviously related to decreased COPD susceptibility. Genetic model analysis showed that rs2227478T>C and rs2227481C>T were significantly associated with a decreased risk of COPD under dominant models after adjusting for the above factors. In the recessive model, rs2227485T>C was obviously associated with decreased COPD risk. Our data showed that only rs2227485T>C was associated with a decreased COPD risk after Bonferroni correction. The eQTL analysis showed that rs2227485T>C was significantly associated with IL‐22 expression. The pGL4‐rs2227485‐C gene reporter had a higher promoter activity than pGL4‐rs2227485‐T. In our study, rs2227485T>C, located in the promoter region of IL‐22, was associated with a decreased risk of COPD and increased IL‐22 promoter activity, suggesting that this variant might modulate COPD susceptibility.
Metastatic lung carcinoma in thyroid aspirates: A case series and literature review illustrating diagnostic challenges
Authors: Ng Joanna Ka Man , Li Joshua Jing Xi 
Published: July 2022

AbstractBackgroundPapillary thyroid carcinoma (PTC) is the most common primary malignant thyroid neoplasm and malignant diagnosis in thyroid aspirates. Metastatic adenocarcinoma of the lung is an under‐recognised mimicker which overlaps cytomorphologically and immunocytochemically with PTC. This case series reviews thyroid aspirates of metastatic lung carcinomas, aiming to address the similarities and methods of differentiating this entity from PTC.MethodsThyroid aspirates of metastatic lung carcinomas were obtained by a computerised search. Clinico‐cytological features and ancillary test results were reviewed. A literature review was performed for published cases of metastatic lung carcinomas in thyroid aspirates.ResultsA total of 14 cases were found, including nine adenocarcinomas, three TTF1‐positive non‐small cell lung carcinomas (NSCLCs), one small cell carcinoma and one squamous cell carcinoma. The adenocarcinomas and TTF1‐positive NSCLCs displayed PTC‐like features including papillae/papillary‐like fronds (n = 6/12, 50%), nuclear grooves (n = 5/12, 41.7%) and inclusions (n = 1/12, 8.3%), chromatin clearing (n = 3/12, 25%), calcifications (n = 3/12, 25%) and multinucleated giant cells (n = 2/12, 16.7%). Useful distinguishing features observed were prominent nucleoli, coarse chromatin, mitosis, and necrosis. TTF‐1 immunocytochemistry was positive in most cases (n = 5/6, 83.3%), while PAX8 and thyroglobulin were consistently negative. EGFR exon 19 deletion was detected on cell block preparation in a single case, corresponding to its lung primary. The literature search yielded 84 cases of metastatic malignancies, with lung carcinomas comprising of 3.6%–33.3% in case series of metastatic malignancies.ConclusionMetastatic adenocarcinoma of lung and PTC share significant cytomorphological and immunocytochemical similarities. A high degree of caution, meticulous clinico‐cytological assessment and prudent use of ancillary techniques is necessary to avoid potential misdiagnosis.
Labour market perspectives for PhD graduates in Europe
Authors: Hnatkova Eva , Degtyarova Iryna , Kersschot Margaux , Boman Julia 
Published: July 2022

AbstractAn increase in the number of PhD candidates in the last decades has changed the landscape of employment and the nature of what it means to be a PhD holder. Embarking on a career in academia is a challenging endeavour for early‐career researchers while they are confronted with a limited number of job opportunities in academia. Taking into account that knowledge based societies need highly skilled professionals beyond the academic environment, it is important to understand what is the role and value of a PhD for the labour market; and what the current labour market perspectives are for PhD holders. To answer these questions, the authors analysed the available data on PhD holders' employment and conducted semi‐structured interviews with European experts on doctoral education and career development. The data and expert interviews point to different contexts across European countries. The numbers of researchers and PhDs employed in sectors outside higher education varies to a great extent—in business enterprises, government, and private non‐profit sectors. The article maps out different factors which need to be considered when assessing the labour market perspectives of PhD holders, such as the geographic area or country and its economic development, the sector of employment, type of work and the field of research.
Predictive parameters of early respiratory decline in amyotrophic lateral sclerosis
Authors: Michels Sebastian , Widmann Paul , Rapp Daniel , Willkomm Frank , Ludolph Albert C. , Dorst Johannes 
Published: July 2022

AbstractBackground and purposeRespiratory insufficiency is a common symptom during the course of amyotrophic lateral sclerosis (ALS). The diagnostic workup may be challenging and includes a wide array of diagnostic measures. In this study, the aim was to analyze the relationship between hypercapnia‐associated symptoms, blood gas parameters and pulmonary function tests.MethodsIn total, 109 patients (56 women, 53 men, 62.4 ± 11.9 years) with definite, possible or probable ALS according to El Escorial criteria were included. All patients received either arterial blood gas analysis, nocturnal capnometry or both. Pulmonary function was assessed by spirometry and peak cough flow. Clinical symptoms potentially indicating hypercapnia were assessed using 17 dichotomous (yes/no) items.ResultsOf 109 ALS patients, 40 had hypercapnia. The highest accuracy and specificity for predicting hypercapnia was observed for dyspnea at rest (Youden's index 17%, 95% confidence interval [CI] 2%–34%; sensitivity 23%, 95% CI 9%–38%; specificity 95%, 95% CI 88%–100%). Daytime fatigue yielded the highest sensitivity of 58% (95% CI 40%–76%). Logistic regression for all assessed symptoms combined yielded an area under the receiver operating charteristic curve of 0.8 (95% CI 0.7–0.9). Compared to the clinical symptoms, forced vital capacity and peak cough flow showed higher sensitivity (70% and 87%, respectively) but lacked specificity (33% and 20%).ConclusionEvaluation of the presence of hypercapnic symptoms can be utilized to predict incipient respiratory insufficiency and should complement pulmonary function tests. Further studies are needed to validate specific questionnaires in this regard. No single hypercapnia‐associated symptom or pulmonary function test on its own seems sufficient to safely predict hypercapnia.
Impact of relative cerebral blood volume reduction on early neurological improvement in extensive ischemic stroke
Authors: Broocks Gabriel , Haupt Wolfgang , McDonough Rosalie , Elsayed Sarah , Flottmann Fabian , Bechstein Matthias , Schön Gerhard , Kniep Helge , Kemmling Andre , Zeleňák Kamil , Fiehler Jens , Hanning Uta , Meyer Lukas 
Published: July 2022

AbstractBackground and purposeThe benefit of endovascular treatment (EVT) for patients with low Alberta Stroke Program early computed tomography score (ASPECTS) is still ambiguous and is currently being investigated in randomized trials. Computed tomography (CT) perfusion, used to estimate infarct extent and progression, might predict early neurological improvement (ENI) after EVT. We hypothesized that the degree of relative cerebral blood volume (rCBV) reduction is directly associated with ENI in low ASPECTS patients undergoing EVT.MethodsIschemic stroke patients with ASPECTS ≤ 5 who received multimodal CT and underwent thrombectomy were analyzed. rCBV reduction was defined as the ratio of cerebral blood volume (CBV), measured in the ischemic lesion to contralateral CBV. Complete reperfusion was defined as an expanded Thrombolysis in Cerebral Infarction score 2c‐3. The clinical endpoint was ENI at 24 h, defined continuously (National Institutes of Health Stroke Scale [NIHSS] score change from baseline to 24 h) and binarized (NIHSS score at 24 h ≤ 8).ResultsA total of 102 patients were included. Lower rCBV reduction and complete EVT were independently associated with ENI (−11.4 NIHSS points, p = 0.04; −7.3 points, p < 0.0001, respectively). The effect of complete EVT on ENI was directly linked to the degree of rCBV reduction: the probability for binary ENI was +34.6% (p = 0.004) in patients with low rCBV reduction versus +8.2% (p = 0.28) in patients with high rCBV reduction).ConclusionIn patients with ischemic stroke with low ASPECTS, ENI was directly linked to the degree of rCBV reduction, a potential indicator of ischemia depth in extensive baseline infarction. Lower rCBV reduction was associated with higher probability of ENI after complete reperfusion, suggesting less pronounced lesion progression despite its large extent and hence, a higher susceptibility to EVT.