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Rural Stroke Surveillance and Establishment of Acute Stroke Care Pathway Using Frontline Health Workers in Rural Northwest India: The Ludhiana Experience.

Neuroepidemiology 2021 May 5:1-9. Epub 2021 May 5.

Department of Neurology, Christian Medical College and Hospital, Ludhiana, India.

Background And Purpose: The role of community health workers (CHWs) in stroke surveillance and in establishing the stroke care pathway has not been studied. The aim of the study was to evaluate the feasibility of using CHWs in the public health system to identify stroke patients for population-based stroke registration and to study the establishment of acute stroke care pathway in rural areas of Ludhiana, Punjab, Northwest India.

Methods: Two rural blocks in Ludhiana district, comprising 164 villages and a population of 259,778, were selected. Read More

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Associations of clinical frailty with severity of limb threat and outcomes in chronic limb-threatening ischaemia.

Ann Vasc Surg 2021 May 2. Epub 2021 May 2.

Department of Cardiovascular Sciences, University of Leicester, UK; Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, UK; National Institute for Health Research Leicester Biomedical Research Centre - The Glenfield Hospital, Leicester, UK.

Objective: Investigate the relationship of frailty and severity of chronic limb-threatening ischaemia (CLTI), and their comparative associations with one-year outcomes, in patients presenting to a vascular limb salvage (VaLS) clinic.

Methods: This retrospective cohort study utilised data collected from a prospectively maintained VaLS clinic database. Patients aged ≥50 presenting to the VaLS clinic with CLTI between February 2018 and April 2019 were included. Read More

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A 4-year Longitudinal Neuroimaging Study of Cognitive Control using Latent Growth Modeling: Developmental Changes and Brain-Behavior Associations.

Neuroimage 2021 May 2:118134. Epub 2021 May 2.

Department of Psychology, Virginia Tech, Blacksburg, VA 24061, U.S.A.; Fralin Biomedical Research Institute at VTC, Roanoke, VA 24016, U.S.A.

Despite theoretical models suggesting developmental changes in neural substrates of cognitive control in adolescence, empirical research has rarely examined intraindividual changes in cognitive control-related brain activation using multi-wave multivariate longitudinal data. We used longitudinal repeated measures of brain activation and behavioral performance during the multi-source interference task (MSIT) from 167 adolescents (53% male) who were assessed annually over four years from ages 13 to 17 years. We applied latent growth modeling to delineate the pattern of brain activation changes over time and to examine longitudinal associations between brain activation and behavioral performance. Read More

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Anatomical Location of Initial and Repeat Mandible Fractures: A 5-Year, Multi-Institution Retrospective Study.

J Oral Maxillofac Surg 2021 Mar 27. Epub 2021 Mar 27.

Professor and Reichmann Chair, Department of Oral and Maxillofacial Surgery, University of Oklahoma, Oklahoma City, OK.

Purpose: The purpose of the present study was to investigate new fracture patterns resulting from low velocity mechanisms in subjects who had previously fractured their mandible and had been treated with open reduction and internal fixation (ORIF) or closed reduction.

Methods And Materials: A multi-institutional retrospective cohort study was designed to analyze subjects presenting at 2 tertiary care centers with mandibular fractures with specific interest in subjects who had repeat mandible fractures. Variables recorded included demographic (age, sex, etc) data, fracture location of all fractures treated, and the location of previous fracture. Read More

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The Progression of Stargardt Disease using Volumetric Hill of Vision Analyses Over 24 Months: ProgStar Report No.15.

Am J Ophthalmol 2021 May 2. Epub 2021 May 2.

Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland; Department of Ophthalmology, University of Basel, Switzerland. Electronic address:

Purpose: To report the yearly rate of change in macular function in patients with Stargardt disease type 1 (STGD1) over 24 months and to establish a new volumetric visual function index for use in clinical trials investigating the efficacy on retinal sensitivity.

Design: International, multicenter, prospective cohort study with five study visits every 6 months over 24 months.

Participants And Main Outcome Measures: A total of 233 individuals with genetically confirmed STGD1 (≥ 1 disease-causing ABCA4 variant). Read More

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Individuals aged 1-64 years with documented congenital heart defects at healthcare encounters, five U.S. surveillance sites, 2011-2013.

Am Heart J 2021 May 2. Epub 2021 May 2.

Department of Epidemiology, Colorado School of Public Health, University of Colorado | Anschutz Medical Campus, Aurora, Colorado.

Background: Many individuals born with CHD survive to adulthood. However, population estimates of CHD beyond early childhood are limited in the U.S. Read More

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Non-operative management of biliary complications after Liver Transplantation in pediatric patients: A 30-year experience.

Pediatr Transplant 2021 May 5:e14028. Epub 2021 May 5.

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.

Background: To evaluate the efficacy of percutaneous and endoscopic therapeutic interventions for biliary strictures and leaks following LT in children.

Methods: Retrospective analysis of 49 consecutive pediatric liver transplant recipients (27 girls, 22 boys, mean age at transplant 3.9 years) treated at our institution from 1989 to 2019 for biliary leak and/or biliary stricture was performed. Read More

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Axial length targets for myopia control.

Ophthalmic Physiol Opt 2021 May 5. Epub 2021 May 5.

College of Optometry, University of Houston, Houston, USA.

Purpose: Both emmetropic and myopic eyes elongate throughout childhood. The goals of this study were to compare axial elongation among untreated progressing myopes, progressing myopes treated with a myopia control contact lens and emmetropes, in order to place axial elongation in the context of normal eye growth in emmetropic children, and to consider whether normal physiological eye growth places limits on what might be achieved with myopia control.

Methods: Axial elongation data were taken from the 3-year randomised clinical trial of a myopia control dual-focus (MiSight® 1 day) contact lens. Read More

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The molecular and phenotypic spectrum of CLCN4-related epilepsy.

Epilepsia 2021 May 5. Epub 2021 May 5.

Institute of Chemistry and Biochemistry, Berlin Free University, Berlin, Germany.

Objective: This study was undertaken to expand the phenotypic and genetic spectrum of CLCN4-related epilepsy and to investigate genotype-phenotype correlations.

Methods: We systematically reviewed the phenotypic and genetic spectrum of newly diagnosed and previously reported patients with CLCN4-related epilepsy. Three novel variants identified in four patients reported in this study were evaluated through in silico prediction and functional analysis by Western blot, immunofluorescence, and electrophysiological measurements. Read More

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Changes in health and functioning of care home residents over two decades: what can we learn from population-based studies?

Age Ageing 2021 May;50(3):921-927

Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK.

Background: Care home residents have complex care and support needs. There is a perception that the needs of residents have increased, but the evidence is limited. We investigated changes in health and functioning of care home residents over two decades in England and Wales. Read More

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Dysphagia due to necrotizing otitis externa.

Age Ageing 2021 May;50(3):1004-1005

University of Nottingham School of Health Sciences, Nottingham, UK.

An 88-year-old man presented with delirium, and subsequently developed hoarseness and oropharyngeal dysphagia. This was due to skull-based osteomyelitis from necrotizing otitis externa (NOE), causing lower cranial nerve (X, XII) palsies and venous sinus thrombosis. Diagnosis was delayed as the patient reported no otalgia, had an almost normal looking external auditory canal and was not diabetic. Read More

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Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis.

Age Ageing 2021 May;50(3):733-743

School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.

Objective: Detection of delirium in hospitalised older adults is recommended in national and international guidelines. The 4 'A's Test (4AT) is a short (<2 minutes) instrument for delirium detection that is used internationally as a standard tool in clinical practice. We performed a systematic review and meta-analysis of diagnostic test accuracy of the 4AT for delirium detection. Read More

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Breast cancer survival and its prognostic factors in the United Arab Emirates: A retrospective study.

PLoS One 2021 5;16(5):e0251118. Epub 2021 May 5.

Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.

Background: Data on breast cancer survival and its prognostic factors are lacking in the United Arab Emirates (UAE). Sociodemographic and pathologic factors have been studied widely in western populations but are very limited in this region. This study is the first to report breast cancer survival and investigate prognostic factors associated with its survival in the UAE. Read More

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Prospective estimation of the age of initiation of cigarettes among young adults (18-24 years old): Findings from the Population Assessment of Tobacco and Health (PATH) waves 1-4 (2013-2017).

PLoS One 2021 5;16(5):e0251246. Epub 2021 May 5.

Michael & Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, United States of America.

Objectives: To prospectively estimate the age of cigarette initiation among young adults (18-24 years old) who were never cigarette users at their first wave of adult study participation overall, by sex, and by race/ethnicity given recent increases in cigarette initiation occurring in young adulthood.

Methods: Secondary analyses were conducted using the PATH restricted-use adult datasets among young adult never users of cigarettes in waves 1-3 (2013-2016) with outcomes followed-up in waves 2-4 (2014-2017). Interval censoring survival methods were used to estimate the age of initiation of (i) ever, (ii) past 30-day, and (iii) fairly regular cigarette use. Read More

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Generally rare but occasionally severe weight gain after switching to an integrase inhibitor in virally suppressed AGEhIV cohort participants.

PLoS One 2021 5;16(5):e0251205. Epub 2021 May 5.

Department of Internal Medicine, Amsterdam Infection and Immunity Institute and Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Objectives: Recent studies have reported disproportionate weight gain associated with integrase strand transfer inhibitor (INSTI) initiation in antiretroviral therapy(ART)-naive people with HIV (PWH), particularly among black women. We investigated if HIV-positive AGEhIV participants with suppressed viremia switching to INSTI-containing ART experienced more weight gain compared to HIV-positive virally-suppressed non-switching and HIV-negative controls.

Methods: In the AGEhIV cohort, standardized weight measurements were performed biennially. Read More

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The association of estimated cardiorespiratory fitness with COVID-19 incidence and mortality: A cohort study.

PLoS One 2021 5;16(5):e0250508. Epub 2021 May 5.

Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.

Background: It has been suggested that cardiorespiratory fitness (CRF) may be used to identify those at greatest risk for severe COVID-19 illness. However, no study to date has examined the association between CRF and COVID-19. The objectives of this study were to determine whether CRF is independently associated with testing positive with or dying from COVID-19. Read More

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A nomogram prediction of overall survival based on lymph node ratio, AJCC 8th staging system, and other factors for primary pancreatic cancer.

PLoS One 2021 5;16(5):e0249911. Epub 2021 May 5.

Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.

Background: As a malignant tumor with poor prognosis, accurate and effective prediction of the prognosis of pancreatic cancer (PC) is crucial.

Methods: A total of 12,909 patients diagnosed with pancreatic cancer were selected from the Surveillance, Epidemiology, and End Results program between 2004 and 2016. The sex, age, ethnicity, marital status, metastasis status, radiotherapy, chemotherapy, tumor size, regional nodes examined, regional nodes positive of each patient were recorded. Read More

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Genotype-phenotype correlation in neurofibromatosis type-1: NF1 whole gene deletions lead to high tumor-burden and increased tumor-growth.

PLoS Genet 2021 May 5;17(5):e1009517. Epub 2021 May 5.

Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Neurofibromatosis type-1 (NF1) patients suffer from cutaneous and subcutaneous neurofibromas (CNF) and large plexiform neurofibromas (PNF). Whole gene deletions of the NF1 gene can cause a more severe phenotype compared to smaller intragenic changes. Two distinct groups of NF1 whole gene deletions are type-1 deletions and atypical deletions. Read More

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More popular because you're older? Relative age effect on popularity among adolescents in class.

PLoS One 2021 5;16(5):e0249336. Epub 2021 May 5.

Department of Sociology, Utrecht University, Utrecht, Netherlands.

Previous studies have found a significant effect of pupil's month of birth on their school- and sports performances. The current study investigates whether this so-called relative age effect also exists in a rather unexplored domain, namely popularity among adolescents in school classes. Whereas prior studies examined relative age related to the cut-off date at primary school entry, we also study possible relative age effects regarding the age composition within pupils' current school class. Read More

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Clinical implication of homocysteine in premature acute coronary syndrome female patients: Its distribution and association with clinical characteristics and major adverse cardiovascular events risk.

Medicine (Baltimore) 2021 May;100(18):e25677

Department of Cardiology, Cangzhou Teaching Hospital of Tinjin Medical University, Cangzhou Central Hospital, Cangzhou, China.

Abstract: Homocysteine (Hcy) is a risk factor for the presence of atherosclerotic vascular disease and hypercoagulability states, which is associated with increased risk of cardiovascular events in cardiovascular disease patients. Whereas the role of Hcy in premature acute coronary syndrome (ACS) female patients is still obscure. Hence, we aimed to explore the relationship of Hcy with clinical features, and more importantly, to probe its predictive value for major adverse cardiovascular events (MACE) risk in premature ACS female patients. Read More

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Analysis of related risk factors of lung metastasis after laparoscopic radical hysterectomy of cervical cancer.

Medicine (Baltimore) 2021 May;100(18):e24480

Department of Gynecology and Obstetrics, Traditional Chinese Medicine Hospital, Chongqing, China.

Abstract: To explore the risk factors of lung metastasis in patients after laparoscopic radical hysterectomy (LRH) of cervical cancer (CC).The clinical data of CC patients with clinical stage of IA1-IIA2 diagnosed in our hospital from April 2007 to October 2015 were collected. According to the situation of metastasis, the patients were divided into lung metastasis (n = 73) and non-lung metastasis group (n = 2076). Read More

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Multisite Veno-Venous Cannulation for Neonates and Nonambulatory Children.

Pediatr Crit Care Med 2021 May 4. Epub 2021 May 4.

Department of Paediatric Intensive Care, Evelina London Children's Hospital, London, United Kingdom. Department of Cardiothoracic Surgery, Evelina London Children's Hospital, London, United Kingdom. Department of Paediatric Neuroscience, Faculty of population health King's College London, Evelina London Children's Hospital, London, United Kingdom. Department of Perfusion Department, Evelina London Children's Hospital, London, United Kingdom.

Objectives: Neonates with respiratory failure are ideally supported with veno-venous rather than veno-arterial extracorporeal membrane oxygenation due to the reduced rate of neurologic complications. However, the proportion of neonates supported with veno-venous extracorporeal membrane oxygenation is declining. We report multisite veno-venous extracorporeal membrane oxygenation, accessing the neck, returning to the inferior vena cava via the common femoral vein in neonates and children less than 10 kg. Read More

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Silicone Adenopathy and Intractable Axilary Pain after Breast Implant Augmentation - Case Report.

Chirurgia (Bucur) 2021 Mar-Apr;116(2):248-253

Silicone lymphadenophaty (siliconoma) is a rare complication secondary to breast implant augmentation or breast reconstruction surgery. Although it is usually linked to the age of the implant, the predominant etiology is multifactorial. Herein, we report a case of extensive siliconoma in the axilla in the hope that our experience will contribute to clinical decision making. Read More

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Association between the discontinuation of substance use inpatient treatment and the risk of committing a crime leading to imprisonment: A Finnish registry-based 5-year follow-up.

Crim Behav Ment Health 2021 May 5. Epub 2021 May 5.

A-Clinic Foundation, Helsinki, Finland.

Background: Discontinuation of substance use inpatient treatment is common, generally due to dropout and rule breaking. In turn, this is associated with worse long-term substance use outcomes.

Aim: To investigate whether people who discontinued voluntary inpatient substance use treatment have a higher risk of imprisonment for a crime within 5 years of discontinuance than those who completed treatment. Read More

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Medium to Long Term Follow-Up of Treated Hypertensive Mediated Heart Disease.

High Blood Press Cardiovasc Prev 2021 May 5. Epub 2021 May 5.

Cardiology Institute of the Sanatorio Britanico de Rosario, Jujuy 1540, Floor 5th, 2000, Rosario, Argentina.

Introduction: Hypertensive mediated heart disease is the consequence of anatomical and functional changes in cardiovascular system. The benefits on left ventricular (LV) diastolic impairment and remodeling of hypertension treatment are well established.

Aim: To evaluate LV structure, systolic and diastolic function of treated hypertensive patients on a medium to long term follow-up. Read More

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The Economic Burden of Adults with Major Depressive Disorder in the United States (2010 and 2018).

Pharmacoeconomics 2021 May 5. Epub 2021 May 5.

Harvard Medical School, Boston, MA, USA.

Background: The incremental economic burden of US adults with major depressive disorder (MDD) was estimated at $US210.5 billion in 2010 (year 2012 values).

Objective: Following a similar methodology, this study updates the previous findings with more recent data to report the economic burden of adults with MDD in 2018. Read More

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Two-year change in 18F-sodium fluoride uptake in major arteries of healthy subjects and angina pectoris patients.

Int J Cardiovasc Imaging 2021 May 5. Epub 2021 May 5.

Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.

To examine 2-year changes in carotid and aortic F-sodium fluoride (NaF) uptake in both healthy controls and angina pectoris patients. Twenty-nine healthy subjects and 20 angina pectoris patients underwent 90-min NaF-PET/CT twice 2 years apart. The carotids and three sections of the aorta (arch, thoracic, abdominal) were manually segmented. Read More

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The role of sex genotype in paediatric CNS tumour incidence and survival.

Childs Nerv Syst 2021 May 5. Epub 2021 May 5.

School of Medicine, University of Leeds, Leeds, LS2 9JT, UK.

Purpose: Evidence exists, in CNS germinomas and medulloblastomas (MB), that patient sex significantly influences incidence and outcome. The role of sex genotype in other paediatric CNS tumours remains unclear. This study sought to examine the role of sex genotype in CNS tumour incidence and overall survival (OS). Read More

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Effects of Growth Hormone treatment on sleep-related parameters in adults with Prader-Willi syndrome.

J Clin Endocrinol Metab 2021 May 5. Epub 2021 May 5.

Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.

Background: Prader-Willi Syndrome (PWS) is a rare, genetic, multi-symptom, neurodevelopmental disease, due to lack of the expression of the paternal genes in the q11-q13 region of chromosome 15. The main characteristics of PWS are muscular hypotonia, hyperphagia, obesity, behavioral problems, cognitive disabilities and endocrine deficiencies, including growth hormone (GH) deficiency. Sleep apnea and abnormal sleep patterns are common in PWS. Read More

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Trends in Incidence of Intracerebral Hemorrhage and Association With Antithrombotic Drug Use in Denmark, 2005-2018.

JAMA Netw Open 2021 May 3;4(5):e218380. Epub 2021 May 3.

Research Unit for Neurology, Odense University Hospital, Odense, Denmark.

Importance: Spontaneous (nontraumatic) intracerebral hemorrhage (ICH) is the most severe complication of antithrombotic drug use.

Objectives: To estimate the strength of association between use of antithrombotic drugs and risk of ICH and to examine major changes in the incidence of ICH in the general population.

Design, Setting, And Participants: This case-control study of patients with a first-ever ICH from January 1, 2005, to December 31, 2018, matched by age, sex, and calendar year with general population controls (1:40 ratio), assessed case and control patients 20 to 99 years of age in population-based nationwide registries in Denmark (population of 5. Read More

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