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Acute effect of particulate matter pollution on hospital admissions for stroke among patients with type 2 diabetes in Beijing, China, from 2014 to 2018.

Ecotoxicol Environ Saf 2021 Apr 7;217:112201. Epub 2021 Apr 7.

School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China. Electronic address:

Background: The health effect of particulate matter pollution on stroke has been widely examined; however, the effect among patients with comorbid type 2 diabetes (T2D) in developing countries has remained largely unknown.

Methods: A time-series study was conducted to investigate the short-term effect of fine particulate matter (PM) and inhalable particulate matter (PM) on hospital admissions for stroke among patients with T2D in Beijing, China, from 2014 to 2018. An over-dispersed Poisson generalized additive model was employed to adjust for important covariates, such as weather conditions and long-term and seasonal trends. Read More

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Comparative study on anticancer drug access times between FDA, EMA and the French temporary authorisation for use program over 13 years.

Eur J Cancer 2021 Apr 7;149:82-90. Epub 2021 Apr 7.

ANSM Agence Nationale de Sécurité des Médicaments Direction Onco-hématologie et Thérapie Cellulaire, 147 Boulevard Anatole France, Saint-Denis, France; Avec Groupe Hospitalier Mutualiste de Grenoble - Institut Daniel Hollard, 8, Rue Docteur Calmette, 38028 Grenoble cedex 1, France. Electronic address:

Introduction: The cancer incidence continues to rise worldwide. Medical innovation has a major impact on patient survival, but within drug development, it can take more than 10 years to obtain marketing authorisation (MA). The time required for access to therapeutic innovation remains critical, so France has developed a specific expanded access program named ATU, which allows the administration of drugs before the European Medicines Agency (EMA) approval. Read More

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Sex-related patterns of the gut-microbiota-brain axis in the neuropsychiatric conditions.

Brain Res Bull 2021 Apr 7. Epub 2021 Apr 7.

Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil. Electronic address:

Sex differences are often observed in psychiatric patients, especially major depressive disorders (MDD), schizophrenia, and developmental disorders, including autism spectrum disorders (ASDs). The prevalence rates between males and females seem variate according to the clinical condition. Although the findings are still incipient, it is suggested that these differences can involve neuroanatomical, neurochemical, and physiological sex differences. Read More

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Fast hybrid Bayesian integrative learning of multiple gene regulatory networks for type 1 diabetes.

Biostatistics 2021 Apr;22(2):233-249

Department of Statistics, Purdue University, West Lafayette, IN, USA.

Motivated by the study of the molecular mechanism underlying type 1 diabetes with gene expression data collected from both patients and healthy controls at multiple time points, we propose a hybrid Bayesian method for jointly estimating multiple dependent Gaussian graphical models with data observed under distinct conditions, which avoids inversion of high-dimensional covariance matrices and thus can be executed very fast. We prove the consistency of the proposed method under mild conditions. The numerical results indicate the superiority of the proposed method over existing ones in both estimation accuracy and computational efficiency. Read More

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Clinical evaluation of a novel subcutaneous lactate monitor.

J Clin Monit Comput 2021 Apr 10. Epub 2021 Apr 10.

Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, USA.

Lactate levels are commonly used as an indirect measure to assess metabolic stress in clinical conditions like sepsis. Dynamic lactate measurements are recommended to assess and guide treatment in patients with shock and other critical care conditions. A minimally invasive, continuous lactate monitor has potential to improve clinical decisions and patient care. Read More

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Value of influenza vaccines in cancer patients during the coronavirus (COVID-19) pandemic: a cross-sectional study.

Support Care Cancer 2021 Apr 10. Epub 2021 Apr 10.

Department of Biostatics and Epidemiology, Shahid Sadoughi University of Medical Science, Yazd, Iran.

Background: According to the recommendation of the Centers for Disease Control and Prevention (CDC), getting influenza vaccines during the coronavirus (COVID-19) pandemics is especially important for people with certain underlying medical conditions, like cancer. Due to the similarities between the symptoms of influenza and COVID-19, receiving the flu vaccine in suspicious cases can be helpful because it will make it easier to request a medical test and diagnosis. In this study, the value of influenza vaccination in the cancer population was investigated. Read More

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Investigation of motor self-monitoring deficits in schizophrenia with passivity experiences using a novel modified joint position matching paradigm.

Eur Arch Psychiatry Clin Neurosci 2021 Apr 10. Epub 2021 Apr 10.

Department of Psychiatry, Li Ka Shing Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, 222 New Clinical Building, 102 Pokfulam Road, Hong Kong SAR, China.

Numerous studies have identified deficits in the self-monitoring system that are associated with schizophrenia. However, the tasks used in the few previous studies generally involved complex cognitive processes and rarely compared between patients with and without passivity experiences (PE). Here, we examined the deficits in internal motor predictive representation in patients with and without PE, and in healthy controls using a novel paradigm which involved minimal cognitive processes. Read More

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Circadian rhythm and gestational diabetes: working conditions, sleeping habits and lifestyle influence insulin dependency during pregnancy.

Acta Diabetol 2021 Apr 10. Epub 2021 Apr 10.

Department of Obstetrics, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.

Objective: Management of gestational diabetes (GDM) is currently changing toward a more personalized approach. There  is a growing number of GDM patients requiring only a single dose of basal insulin at night to achieve glucose control. Well-known risk factors like obesity, parity and family history have been associated with GDM treatment requirements. Read More

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Innovations and paradigm shifts in atrial fibrillation ablation.

Europace 2021 Apr;23(Supplement_2):ii23-ii27

Department of Cardiology, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.

Treatment of symptomatic atrial fibrillation has seen important changes in the past decades. Advancements have especially been made in the field of non-pharmacological treatment of this disease. Patients in whom a rhythm control strategy is chosen the place of catheter ablation has become more frontline therapy in the past years. Read More

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Early atrial fibrillation detection and the transition to comprehensive management.

Europace 2021 Apr;23(Supplement_2):ii46-ii51

Department of Cardiology, Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, The Netherlands.

Current atrial fibrillation (AF) guidelines recommend screening for AF in individuals above 65 years or with other characteristics suggestive of increased stroke risk. Several mobile health (mHealth) approaches are available to identify AF. Although most wearables or ECG machines include algorithms to detect AF, an ECG confirmation of AF is necessary to establish a suspected diagnosis of AF. Read More

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Cryotherapy for long-standing drug-induced lip pigmentation: A fast, safe and inexpensive procedure.

Clin Exp Dermatol 2021 Apr 10. Epub 2021 Apr 10.

Department of Dermatology, Karabuk Training and Research Hospital, Karabuk, Turkey.

In dermatological practice, removal of macular discoloration in the skin or mucosa is difficult to treat.Topical products often become insufficient to penetrate the skin or mucosa. Surgical removal is also not very reasonable due to the potential risk of scarring. Read More

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NB-UVB phototherapy is associated with a reduction in topical corticosteroid and clinical improvement in atopic dermatitis - a historical inception cohort study.

Clin Exp Dermatol 2021 Apr 10. Epub 2021 Apr 10.

University of Dundee, Medical School, Dundee, Scotland, UK.

Background: Despite decades of use, the magnitude of efficacy of narrowband-ultraviolet B phototherapy (NB-UVB) for atopic dermatitis (AD) outwith industry-sponsored trials remains unclear.

Objective: To evaluate the clinical efficacy of NB-UVB in AD under real-world conditions.

Methods: We conducted a historical inception cohort study using automated recording of drug dispensed to provide an objective treatment outcome in a large population catchment of 420,000 over 15 years. Read More

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Reinduction chemotherapy regimen involved decitabine and cladribine improves the prognosis of patients with relapsed or refractory acute myeloid leukemia: a preliminary study.

Int J Cancer 2021 Apr 9. Epub 2021 Apr 9.

Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Relapsed/refractory acute myeloid leukemia (R/R-AML) is characterized by a high incidence, short survival and poor prognosis. Presently, no unified effective reinduction chemotherapy regimen has been developed. Therefore, the use of reinduction chemotherapy regimens before allogeneic hematopoietic stem cell transplantation (allo-HSCT) is controversial. Read More

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The Effect of Geometric and Hemodynamic Parameters on Blood Flow Efficiency in Repaired Tetralogy of Fallot Patients.

Ann Biomed Eng 2021 Apr 9. Epub 2021 Apr 9.

Institute of Biomedical Engineering, University of Toronto, Toronto, Canada.

Surgical repair of Tetralogy of Fallot (TOF) involves a series of steps to remove right ventricular outflow tract and pulmonary artery obstruction. However, the large degree of anatomic variability among preoperative TOF patients may impact the effectiveness of different repair strategies and, subsequently, different geometric modifications for different patients. This study investigates the relationships between geometric and hemodynamic parameters and mechanical energy efficiency for a patient-specific dataset of 16 postoperative TOF repairs, using morphometric and statistical shape analyses, as well as computational fluid dynamics simulations with physiologically-relevant inlet and outlet boundary conditions. Read More

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An economic analysis of a wearable patient sensor for preventing hospital-acquired pressure injuries among the acutely ill patients.

Int J Health Econ Manag 2021 Apr 9. Epub 2021 Apr 9.

Department of Nursing, San Joaquin Valley College, Bakersfield, CA, USA.

More than 2.5 million people in the United States develop pressure injuries annually, which are one of the most common complications occurring in hospitals. Despite being common, hospital-acquired pressure injuries (HAPIs) are largely considered preventable by regular patient turning. Read More

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Chronotropic effects and mechanisms of long-chain omega-3 polyunsaturated fatty acids on heartbeat: the latest insights.

Weiguo Zhang

Nutr Rev 2021 Apr 9. Epub 2021 Apr 9.

W. Zhang is with the Las Colinas Institutes, Irving, Texas, USA.

The roles of the resting heart rate (RHR) have been actively investigated and increasingly recognized in recent decades, because of the growing evidence that fast RHR is associated with and predicts the risk of developing cardiovascular and metabolic disorders, as well as all-cause mortality. Long-chain omega-3 polyunsaturated fatty acids (PUFAs) (eg, eicosapentaenoic acid and docosahexaenoic acid) have been shown to have chronotropic effects on heartbeat in both healthy people and patients with various disease conditions. The aims of this review are (1) to briefly summarize the importance of elevated RHR in disease pathogenesis and mortality; (2) to provide an update on the negative chronotropic effect of omega-3 PUFAs on the heart; (3) to highlight how omega-3 PUFAs regulate heart rate through the autonomic nervous system - a central control mechanism; and (4) to highlight how omega-3 PUFAs modulate the trans-membrane ionic channels in cardiomyocytes - a fundamental mechanism of cardiac automaticity. Read More

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Chronic breathlessness in advanced cardiorespiratory disease: patient perceptions of opioid use.

BMJ Support Palliat Care 2021 Apr 9. Epub 2021 Apr 9.

The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia

Objective: Low-dose oral opioids may improve severe chronic breathlessness in advanced cardiorespiratory diseases. Prescription of opioids for breathlessness occurs infrequently however, with little known about patients' attitudes towards their use in this setting. The aim of this qualitative study was to explore patients' perceptions regarding opioids for the management of severe chronic breathlessness in people with advanced cardiorespiratory disease. Read More

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Could social prescribing contribute to type 2 diabetes prevention in people at high risk? Protocol for a realist, multilevel, mixed methods review and evaluation.

BMJ Open 2021 Apr 9;11(4):e042303. Epub 2021 Apr 9.

Centre for Primary Care and Mental Health. Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry. Queen Mary University of London, London, UK.

Introduction: Social prescribing is an innovation being widely adopted within the UK National Health Service policy as a way of improving the management of people with long-term conditions, such as type 2 diabetes (T2D). It generally involves linking patients in primary care with non-medical community-based interventions. Despite widespread national support, evidence for the effectiveness of social prescribing is both insufficient and contested. Read More

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Incidental diagnosis of situs inversus totalis: a perspective from an emergency department attendance.

BMJ Case Rep 2021 Apr 9;14(4). Epub 2021 Apr 9.

Emergency Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE

A 30-year-old man of African origin presented to our emergency department (ED) with subjective fever and abdominal pain which started on the day of attendance. Vital signs and systemical examination were within normal limits. As part of his evaluation in ED, a 12-lead electrocardiogram was performed which showed features consistent with dextrocardia later confirmed on a chest X-ray as well. Read More

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Therapeutic plasma exchange: A potential management strategy for critically ill MIS-C patients in the pediatric intensive care unit.

Transfus Apher Sci 2021 Apr 1:103119. Epub 2021 Apr 1.

Ankara Yıldırım Beyazıt University, Ankara Children's Hospital, Department of Pediatric Surgery, Ankara, Turkey. Electronic address:

This study aimed to evaluate the effectiveness and the role of therapeutic plasma exchange (TPE) in treatment of children with severe MIS-C. In addition, we assessed demographic data, clinical features, laboratory abnormalities, underlying conditions, treatments, and outcomes. Patients with severe MIS-C who were admitted to the pediatric intensive care unit (PICU) between September 01 and October 05, 2020 were included in this observational, descriptive, retrospective study. Read More

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The impact of different preanalytical methods related to CA 15-3 determination in frozen human blood samples: a systematic review.

Syst Rev 2021 Apr 9;10(1):102. Epub 2021 Apr 9.

IRCCS SDN, Via E. Gianturco, 80143, Naples, Italy.

Background: The determination of CA 15-3 is useful for monitoring breast cancer patients. Several retrospective studies determined CA 15-3 levels in frozen samples to evaluate the sensitivity and specificity of novel biomarkers in relation to breast cancer; however, freeze-thaw cycles, as well as preanalytical variables before sample storage, are not always reported. Here, we analyzed the current scientific literature to identify possible critical aspects related to CA 15-3 determination in frozen-stored human serum/plasma samples. Read More

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Unsupervised phenotyping of sepsis using nonnegative matrix factorization of temporal trends from a multivariate panel of physiological measurements.

BMC Med Inform Decis Mak 2021 Apr 9;21(Suppl 5):95. Epub 2021 Apr 9.

Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.

Background: Sepsis is a highly lethal and heterogeneous disease. Utilization of an unsupervised method may identify novel clinical phenotypes that lead to targeted therapies and improved care.

Methods: Our objective was to derive clinically relevant sepsis phenotypes from a multivariate panel of physiological data using subgraph-augmented nonnegative matrix factorization. Read More

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Which nurses are victims of bullying: the role of negative affect, core self-evaluations, role conflict and bullying in the nursing staff.

BMC Nurs 2021 Apr 9;20(1):57. Epub 2021 Apr 9.

Health Education and Promotion, Health School, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

Background: Bullying among nurses is a universally recognized problem that has important consequences for nurses, patients and health institutions. This research was conducted with the aim of studying the relationship between role conflict, negative affect and core self-evaluations with bullying in nurses.

Methods: In this cross-sectional study, 329 nurses were selected by census method. Read More

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Person-centred care in osteoarthritis and inflammatory arthritis: a scoping review of people's needs outside of healthcare.

BMC Musculoskelet Disord 2021 Apr 9;22(1):341. Epub 2021 Apr 9.

Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.

Background: Arthritis, regardless of cause, has significant physical, social and psychological impacts on patients. We aimed to identify the non-healthcare needs perceived by patients with inflammatory arthritis (IA) and osteoarthritis (OA), and to determine if these differ.

Methods: We electronically searched MEDLINE, PsycINFO, EMBASE and CINAHL (1990-2020) systematically to identify non-healthcare-related needs of people with IA or OA. Read More

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Distinct clinical phenotypes for Crohn's disease derived from patient surveys.

BMC Gastroenterol 2021 Apr 9;21(1):160. Epub 2021 Apr 9.

Department of Bioengineering, Stanford University, Shriram Room 209, MC: 4245, 443 Via Ortega Drive, Stanford, CA, 94305-4145, USA.

Background: Defining clinical phenotypes provides opportunities for new diagnostics and may provide insights into early intervention and disease prevention. There is increasing evidence that patient-derived health data may contain information that complements traditional methods of clinical phenotyping. The utility of these data for defining meaningful phenotypic groups is of great interest because social media and online resources make it possible to query large cohorts of patients with health conditions. Read More

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Acute gastrointestinal bleeding: results from the prospective German electronic registry of nearly 11 000 endoscopies (ALGK GI-bleeding registry).

Z Gastroenterol 2021 Apr 9. Epub 2021 Apr 9.

ALGK (Arbeitsgemeinschaft Leitende Gastroenterologische Krankenhausärzte; Working Group of Leading German Gastroenterologists in Hospitals).

Background And Study Aims:  Gastrointestinal bleeding is frequently observed in the German population. However, recent epidemiological data are not available. This study aimed to elucidate gastrointestinal bleeds under real-life conditions in 3 German hospitals. Read More

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Diffusion weighted imaging in acute ischemic stroke: A review of its interpretation pitfalls and advanced diffusion imaging application.

J Neurol Sci 2021 Apr 3;425:117435. Epub 2021 Apr 3.

Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA. Electronic address:

Diffusion weighted imaging (DWI) is a widely used imaging technique to evaluate patients with stroke. It can detect brain ischemia within minutes of stroke onset. However, DWI has few potential pitfalls that should be recognized during interpretation. Read More

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The impact of Covid-19 on patients with suspected cancer: An analysis of ED presentation and referrals to a quick diagnosis unit.

Am J Emerg Med 2021 Apr 2;48:1-11. Epub 2021 Apr 2.

Department of Internal Medicine, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain.

Purpose: Patients evaluated in the emergency department (ED) who have concerning symptoms suggestive of a cancer diagnosis are mostly referred to the quick diagnosis unit of our tertiary hospital. This study analyzed the impact of the Covid-19 pandemic on the volume, disease patterns, and accessibility to essential investigations of patients with suspected cancer referred by the ED to this unit.

Methods: Trends in referrals were analyzed from January 1 to July 8, 2020 and the corresponding dates of 2019. Read More

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Screening for HPV and dysplasia in transgender patients: Do we need it?

Eur J Obstet Gynecol Reprod Biol 2021 Mar 31;260:177-182. Epub 2021 Mar 31.

Department of Obstetrics and Gynecology, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address:

Introduction: Aim of this study was the evaluation of prevalence of HPV infection and resulting genital dysplasia to assess the necessity and reasonability of pap smears and HPV testing in transgender patients. HPV is the most common sexually transmitted infection and responsible for the majority of genital dysplasias and malignancies. However, few data exist about the prevalence of HPV and dysplasia in transgender people. Read More

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A real-life study of the positive response to DAA-based therapies for hepatitis C in Brazil.

Braz J Infect Dis 2021 Apr 6:101573. Epub 2021 Apr 6.

University of Brasília (UnB), Faculty of Medicine, Center for Tropical Medicine, Brasília, DF, Brazil; National Institute for Science and Technology for Health Technology Assessment, Porto Alegre, RS, Brazil; University of Brasília (UnB), Faculty of Ceilândia, Brasília, DF, Brazil.

A retrospective cohort of 11,308 chronic hepatitis C infected patients treated with regimens that included Sofosbuvir (SOF), Daclatasvir (DCV), Simeprevir (SMV), or an association of Ombitasvir, Veruprevir/Ritonavir and Dasabuvir (3D) with or without Ribavirin (RBV) were assessed for sustained virologic response (SVR) or viral cure after a 12-week treatment. Logistic regression analyses were used to identify factors independently associated with positive response to direct-acting antivirals (DAA)-based therapies. Overall 57. Read More

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