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Impact of High-Deductible Health Plans on Medication Use Among Individuals With Bipolar Disorder.

Psychiatr Serv 2021 May 11:appips202000362. Epub 2021 May 11.

Department of Population Medicine, Division of Health Policy and Insurance Research, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Lu, Zhang, Madden, Callahan, LeCates, Wallace, Soumerai, Ross-Degnan, Wharam); McLean Hospital, Belmont, Massachusetts, and Department of Health Care Policy, Harvard Medical School, Boston (Busch); Department of Pharmacy and Health Systems Sciences, Northeastern University Bouvé College of Health Sciences, Boston (Madden); Depression and Bipolar Support Alliance, Chicago (Foxworth).

Objective: High-deductible health plans (HDHPs) require substantial out-of-pocket spending for most services, although medications may be subject to traditional copayment arrangements. This study examined effects of HDHPs on medication out-of-pocket spending and use and quality of care among individuals with bipolar disorder.

Methods: This quasi-experimental study used claims data (2003-2014) for a national sample of 3,532 members with bipolar disorder, ages 12-64, continuously enrolled for 1 year in a low-deductible plan (≤$500) and then for 1 year in an HDHP (≥$1,000) after an employer-mandated switch. Read More

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Cooking with biomass fuels increased the risk for cognitive impairment and cognitive decline among the oldest-old Chinese adults (2011-2018): A prospective cohort study.

Environ Int 2021 May 4;155:106593. Epub 2021 May 4.

Department of Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China. Electronic address:

Backgrounds: While the pernicious effects of outdoor air pollution on cognitive ability have been previously examined, evidence regarding household air pollution is scarce.

Methods: Using data from the Chinese Longitudinal Healthy Longevity Survey, we explored the relationship between cooking with biomass fuel and cognitive impairment and cognitive decline using a Cox proportional hazards model. We further assessed the correlation of biomass fuels and cognitive score using a generalized estimating equation. Read More

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Tenofovir Alafenamide for Drug-Resistant Hepatitis B: A Randomized Trial for Switching from Tenofovir Disoproxil Fumarate.

Clin Gastroenterol Hepatol 2021 May 4. Epub 2021 May 4.

Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address:

Background & Aims: It remains unknown whether tenofovir alafenamide (TAF) could replace tenofovir disoproxil fumarate (TDF) in patients with drug-resistant hepatitis B virus (HBV).

Methods: In this multi-center randomized non-inferiority trial, 174 patients with HBV resistant to multiple drugs (lamivudine, entecavir, and/or adefovir) under TDF monotherapy for ≥96 weeks were randomized 1:1 to switch to TAF (n=87) or continue TDF (n=87) for 48 weeks. The primary endpoint was proportion of patients with HBV DNA<60 IU/mL at week 48. Read More

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Integrated trajectories of the maternal metabolome, proteome, and immunome predict labor onset.

Sci Transl Med 2021 May;13(592)

Department of Surgery, Stanford University School of Medicine, Palo Alto, CA 94305, USA.

Estimating the time of delivery is of high clinical importance because pre- and postterm deviations are associated with complications for the mother and her offspring. However, current estimations are inaccurate. As pregnancy progresses toward labor, major transitions occur in fetomaternal immune, metabolic, and endocrine systems that culminate in birth. Read More

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Long-term outcome after the arterial switch operation: 43 years of experience.

Eur J Cardiothorac Surg 2021 May;59(5):968-977

Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands.


Objectives: The objective of this study was to assess our 43-year experience with arterial switch operation (ASO) for transposition of the great arteries (TGA) by analysing cardiac outcome measures (hospital and late mortality, reoperations and catheter interventions, significant coronary artery obstruction) and to identify risk factors for reoperation and catheter interventions.

Methods: A total of 490 patients who underwent ASO for TGA from 1977 to 2020 were included in this retrospective, single-centre study. Data on reoperation and catheter intervention of hospital survivors were estimated by the Kaplan-Meier method and compared using a long-rank test. Read More

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Toward a neuroprotective shift: eight weeks of high intensity interval training reduces the neurotoxic kynurenine activity concurrently to impulsivity in emotionally impulsive humans - A randomized controlled trial.

Brain Behav Immun 2021 Apr 28. Epub 2021 Apr 28.

Clinical Exercise-Neuroimmunology Group, Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany; Department for Performance and Health (Sports Medicine), Institute for Sport and Sport Science, Technical University Dortmund, Dortmund, Germany.

Background: Previous findings suggest that impulsivity is related to a chronic low-grade inflammation. Inflammation is known to trigger the kynurenine pathway to a pathological level in various impulsivity-related disorders. Nonetheless, murine models and recent human studies have shown that physical exercise, in particular High Intensity Interval Training (HIIT), could counterbalance the negative effects of inflammation on the kynurenine pathway. Read More

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Determinants of Switch to Pediatric Second-Line Antiretroviral Therapy after First-Line Failure in Cameroon.

Trop Med Int Health 2021 Apr 27. Epub 2021 Apr 27.

Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Yaounde, Cameroon.

Objective: With scale-up of antiretroviral therapy (ART) children, treatment failure and switch to subsequent ART regimens is common. Our objectives were to evaluate switching practices and identify factors associated among children and adolescents failing their first-line ART.

Methods: A facility-based survey study was conducted in a cohort of children living with HIV experiencing virological failure (VF) at the Essos Hospital Centre of Yaounde, Cameroon. Read More

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Changes in alanine aminotransferase levels after switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) in HIV-positive people without viral hepatitis in the Swiss HIV Cohort Study.

HIV Med 2021 Apr 20. Epub 2021 Apr 20.

Division of Infectious Diseases and Hospital Epidemiology, University Hospital, University of Zurich, Zurich, Switzerland.

Objectives: We previously demonstrated an association between tenofovir disoproxil fumarate (TDF) and chronic liver enzyme elevation in the D:A:D study. The objective of the study was to assess changes in alanine aminotransferase (ALT) levels after switching from TDF to tenofovir alafenamide (TAF).

Methods: We included Swiss HIV Cohort Study participants who switched from TDF to TAF with two or more ALT values in the 24 months before and two or more values in the 24 months after replacing TDF with TAF. Read More

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Robust Sampled-Data Control for Switched Complex Dynamical Networks With Actuators Saturation.

IEEE Trans Cybern 2021 Apr 20;PP. Epub 2021 Apr 20.

In this article, an aperiodic sampled-data control problem is investigated for polytopic uncertain switched complex dynamical networks subject to actuator saturation. Due to the constraint on the upper bound of the sampling interval being no greater than the dwell time, the issue concerning the asynchronization between the sampled-data controller mode and the system mode is hence considered to be caused by subsystems that may switch in a sampling interval. By considering the sampling interval without switching and the sampling interval with switching, the parameters-dependent loop-based Lyapunov functionals are constructed, respectively. Read More

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Cycling of tumor necrosis factor inhibitors switching to different mechanism of action therapy in rheumatoid arthritis patients with inadequate response to tumor necrosis factor inhibitors: a Bayesian network meta-analysis.

Ther Adv Musculoskelet Dis 2021 29;13:1759720X211002682. Epub 2021 Mar 29.

Worldwide Health Economics & Outcomes Research, Bristol Myers Squibb, Princeton, NJ, USA.

Introduction: For patients with rheumatoid arthritis (RA) with an inadequate response to tumor necrosis factor inhibitors (TNFi), main options include cycling onto a different TNFi or switching to a biologic/targeted synthetic disease-modifying antirheumatic drug with a different mechanism of action (MOA). This network meta-analysis (NMA) assessed comparative clinical efficacy of cycling switching.

Methods: We conducted a literature search in MEDLINE, Embase, and Cochrane Library. Read More

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Multiple Sclerosis Patients Treated With Diroximel Fumarate in the Real-World Setting Have High Rates of Persistence and Adherence.

Neurol Ther 2021 Apr 12. Epub 2021 Apr 12.

Biogen, 225 Binney St, Cambridge, MA, 02142, USA.

Introduction: Persistence to multiple sclerosis (MS) disease-modifying therapy is fundamental for maximal treatment outcomes. Diroximel fumarate (DRF) is approved in the USA for relapsing MS. Following oral administration, DRF is metabolized to monomethyl fumarate, the active metabolite of dimethyl fumarate (DMF). Read More

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The role of depression in the prediction of a "late" remission in first-episode psychosis: An analysis of the OPTiMiSE study.

Schizophr Res 2021 Apr 7;231:100-107. Epub 2021 Apr 7.

Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain.

Objective: The identification of predictors of psychosis remission could guide early clinical decision-making for treatment of first-episode schizophrenia (FES).

Methods: We analyzed two non-independent subsamples of patients with FES ages 18-40 years from the OPTiMiSE study dataset to investigate the demographic and clinical factors that might help to differentiate "late" remitters (i.e. Read More

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Real world effectiveness of standard of care triple therapy versus two-drug combinations for treatment of people living with HIV.

PLoS One 2021 8;16(4):e0249515. Epub 2021 Apr 8.

Hospital General Universitario Gregorio Marañón, Madrid, Spain.

Background: Since 1996, the standard of care (SOC) therapy for HIV treatment has consisted of a backbone of two nucleoside analogue reverse transcriptase inhibitors (NRTI) paired with a third agent. Use of two-drug combinations (2DC) has been considered for selected patients to avoid toxicities associated with the use of NRTIs. This study aimed to compare the real-world outcomes of integrase strand transfer inhibitor (INSTI)-containing triple therapy (TT) to dolutegravir- (DTG) and/or boosted protease inhibitor (bPI)-based 2DC in a large Spanish cohort of HIV patients. Read More

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Evaluation of Switch-to-Brand Rates as a Potential Signal for Therapeutic Equivalency of Generic Antidepressants: A Real-World Retrospective Cohort Study.

Clin Pharmacol Ther 2021 Apr 2. Epub 2021 Apr 2.

Center for Translational Medicine, School of Pharmacy, University of Maryland, Baltimore, Maryland, USA.

Negative clinical outcomes after switching from brand to generic antidepressants have raised concerns regarding therapeutic equivalency. This research aims to estimate the prevalence of switching and to identify predictors for generic to brand switching for various antidepressants. This retrospective cohort study utilized data from a 10% random sample of enrollees in the IQVIA PharMetrics Plus claims database from 2007-2015. Read More

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Switch Strategy from Direct Aspiration First Pass Technique to Solumbra Improves Technical Outcome in Endovascularly Treated Stroke.

Int J Environ Res Public Health 2021 03 6;18(5). Epub 2021 Mar 6.

Department of Diagnostic, UOC of Neuroradiology and Interventional Neuroradiology, San Camillo-Forlanini Hospital, 00152 Rome, Italy.

Background: The major endovascular mechanic thrombectomy (MT) techniques are: Stent-Retriever (SR), aspiration first pass technique (ADAPT) and Solumbra (Aspiration + SR), which are interchangeable (defined as switching strategy (SS)). The purpose of this study is to report the added value of switching from ADAPT to Solumbra in unsuccessful revascularization stroke patients.

Methods: This is a retrospective, single center, pragmatic, cohort study. Read More

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Prognostic value of neurofilament light chain in chronic inflammatory demyelinating polyneuropathy.

Brain Commun 2021 9;3(1):fcab018. Epub 2021 Mar 9.

Department of Neurosciences, Laboratory for Molecular Neurobiomarker Research, Leuven Brain Institute, KU Leuven, Leuven 3000, Belgium.

Chronic inflammatory demyelinating polyneuropathy is a neuroinflammatory disorder with considerable variation in clinical phenotype, disease progression and therapy response among patients. Recently, paranodal antibodies associated with poor response to intravenous immunoglobulin therapy and more aggressive disease course have been described in small subsets of patients, but reliable serum-based prognostic biomarkers are not yet available for the general population. In current retrospective longitudinal study, we utilized logistic regression models to investigate the associations of serum neurofilament light chain levels with 1-year disease progression and therapy response during follow-up in chronic inflammatory demyelinating polyneuropathy. Read More

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Internal consistency and test-retest reliability of an affective task-switching paradigm.

Emotion 2021 Apr 1. Epub 2021 Apr 1.

Department of Psychology, Goethe University Frankfurt.

Affective flexibility refers to the flexible adaptation of behavior or thought given emotionally relevant stimuli, tasks, or contexts, and has been associated with the efficiency of emotion regulation and dealing with stress and adversity. Experimentally, individual differences in affective flexibility have been measured as behavioral costs (response times, errors rates) of switching between affective and neutral tasks. However, behavioral task measures can only be treated as trait-like characteristics if they have sufficient psychometric quality. Read More

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Switching from zoledronic acid to denosumab increases the risk for developing medication-related osteonecrosis of the jaw in patients with bone metastases.

Cancer Chemother Pharmacol 2021 Jun 31;87(6):871-877. Epub 2021 Mar 31.

Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.

Purpose: Switch from zoledronic acid (ZA) to denosumab may increase the risk of medication-related osteonecrosis of the jaw (MRONJ) owing to the additive effect of denosumab on the jawbone and residual ZA activities. We evaluated the risk of developing MRONJ in patients who received ZA, denosumab, or ZA-to-denosumab for the treatment of bone metastases.

Methods: The medical charts of patients with cancer who received denosumab or ZA for bone metastases were retrospectively reviewed. Read More

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Comparison of outcomes of cyclosporine A and infliximab for steroid-refractory acute severe ulcerative colitis.

J Gastroenterol Hepatol 2021 Mar 29. Epub 2021 Mar 29.

Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.

Background And Aim: Data comparing the outcomes of cyclosporin A (CsA) and infliximab (IFX) as rescue therapy for steroid-refractory acute severe ulcerative colitis (SR-ASUC) among Asians are scarce.

Methods: In this single-center study, we retrospectively reviewed 121 patients with SR-ASUC according to the Truelove and Witts' criteria who received CsA or IFX as rescue therapy between 1995 and 2015. The cumulative rates of treatment failure and colectomy at 3 months were compared. Read More

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Component processes underlying voluntary task selection: Separable contributions of task-set inertia and reconfiguration.

Cognition 2021 Mar 26;212:104685. Epub 2021 Mar 26.

Department of Psychological and Brain Sciences, 4235 TAMU, College Station, TX 77843, USA; Texas A&M Institute for Neuroscience, 3474 TAMU, College Station, TX 77843, USA. Electronic address:

Most theories describing the cognitive processes underlying task switching allow for contributions of active task-set reconfiguration and task set inertia. Manipulations of the Cue-to-Stimulus-Interval (CSI) are generally thought to influence task set reconfiguration, while Response-to-Cue (RCI) manipulations are thought to influence task set inertia. Together, these intervals compose the Response-to-Stimulus (RSI) interval. Read More

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Reduced flexibility of cognitive control: reactive, but not proactive control, underpins the congruency sequence effect.

Psychol Res 2021 Mar 29. Epub 2021 Mar 29.

Cognitive and Affective Psychophysiology Laboratory, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.

The congruency sequence effect (CSE) refers to facilitated conflict processing following incongruent than congruent trials, and reflects enhanced cognitive control during conflict processing. Although this effect is mostly conceived as being reactive, proactive control can also unlock it under specific circumstances according to previous studies (e.g. Read More

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Disability improvement as a clinically relevant outcome in clinical trials of relapsing forms of multiple sclerosis.

Mult Scler 2021 Mar 26:13524585211000280. Epub 2021 Mar 26.

Research Center for clinical Neuroimmunology and Neuroscience Basel (RC2NB) and MS Center, Departments of Medicine, Clinical Research, Biomedicine, and Biomedical Engineering, University Hospital, University of Basel, Basel, Switzerland.

Background: Disease-modifying therapies (DMTs) can reduce the risk of disability worsening in patients with relapsing forms of multiple sclerosis (RMS). High-efficacy DMTs can lead to confirmed or sustained disability improvement (CDI and SDI).

Objective And Methods: Post hoc analyses of data from the TRANSFORMS, FREEDOMS, and FREEDOMS II trials and their extensions assessed the effects of fingolimod (0. Read More

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The association of ketamine induction with blood pressure changes in paramedic rapid sequence intubation of out-of-hospital traumatic brain injury.

Acad Emerg Med 2021 Mar 24. Epub 2021 Mar 24.

Department of Epidemiology and Preventive Medicine and Department of Paramedicine, Ambulance Victoria, Research and Evaluation, Monash University, Melbourne, Victoria, Australia.

Introduction: Rapid sequence intubation (RSI) is used to secure the airway of traumatic brain injury (TBI) patients, with ketamine frequently used for induction. Studies show that ketamine-induction RSI might cause lower blood pressures when compared to etomidate. It is not clear if the results from that research can be extrapolated to systems that use different dosing regimens for ketamine RSI. Read More

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Time-Based Transition Expectancy in Task Switching: Do We Need to Know the Task to Switch to?

J Cogn 2021 Mar 10;4(1):19. Epub 2021 Mar 10.

Cognition, Action, and Sustainability Unit, Department of Psychology, University of Freiburg, Freiburg im Breisgau, DE.

Recent research has shown that humans are able to implicitly adapt to time-transition contingencies in a task-switching paradigm, indicated by better performance in trials where the task transition (switch vs. repetition) is validly predicted by the pre-target interval compared to trials with invalidly predicted transitions. As participants switched between only two different tasks, not only the transition, but also the specific task was predictable; at least indirectly when taking into account the temporally predicted transition in the current trial together with the task in the previous trial. Read More

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Preoperative Anemia and Outcomes After Corrective Surgery in Neonates With Dextro-Transposition of the Great Arteries.

J Cardiothorac Vasc Anesth 2021 Feb 17. Epub 2021 Feb 17.

Department of Congenital Heart Disease/Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany; German Center for Cardiovascular Research (DZHK), Congenital Heart Diseases, Partner Site Berlin, Berlin, Germany.

Objectives: The authors aimed to assess whether untreated preoperative anemia was associated with increased risk for adverse outcomes after the arterial switch operation in neonates with dextro-transposition of the great arteries (d-TGA).

Design: Retrospective cohort study.

Setting: Single cardiac surgery center. Read More

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February 2021

First-line treatment of advanced epidermal growth factor receptor (EGFR) mutation positive non-squamous non-small cell lung cancer.

Cochrane Database Syst Rev 2021 03 18;3:CD010383. Epub 2021 Mar 18.

Institute of Translational Medicine, University of Liverpool, Bebington, UK.

Background: Epidermal growth factor receptor (EGFR) mutation positive (M+) non-small cell lung cancer (NSCLC) is an important subtype of lung cancer comprising 10% to 15% of non-squamous tumours. This subtype is more common in women than men, is less associated with smoking, but occurs at a younger age than sporadic tumours.

Objectives: To assess the clinical effectiveness of single-agent or combination EGFR therapies used in the first-line treatment of people with locally advanced or metastatic EGFR M+ NSCLC compared with other cytotoxic chemotherapy (CTX) agents used alone or in combination, or best supportive care (BSC). Read More

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The irrelevancy of the inter-trial interval in delay-discounting experiments on an animal model of ADHD.

Behav Brain Res 2021 Jun 13;408:113236. Epub 2021 Mar 13.

Departamento de Psicología Básica I, Universidad Nacional de Educación a Distancia (UNED), C/ Juan del Rosal 10, Madrid, 28040, Spain. Electronic address:

Delay discounting involves choosing between a small, immediate reward, and a larger but delayed one. As the delay between choice and large reward gets longer, people with ADHD tend to become impulsive faster than controls, indicated by a switch in preference from the large to the smaller reward. Choosing the smaller reward when the larger is considered reward maximizing is labeled impulsive behaviour. Read More

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Outcomes associated with treatment change from tenofovir disoproxil fumarate to tenofovir alafenamide in HIV-1-infected patients: a real-world study in Japan.

HIV Med 2021 Mar 15. Epub 2021 Mar 15.

Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan.

Objectives: To investigate the impact of switching from tenofovir disoproxil fumarate (TDF)- to tenofovir alafenamide (TAF)-containing regimens on bone, kidney, serum lipids and body weight among Asian patients.

Methods: A prospective, multicentre, observational cohort study was conducted at three centres for HIV infection in Japan during 2017-2019. HIV-infected adults previously treated with TDF-containing regimens and scheduled to switch to TAF-containing regimens were included. Read More

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