bluuebunny/crossref_metadata_2025 huggingface dataset:
Do Tamil newspapers educate the public about suicide? Content analysis from a high suicide Union Territory in India
Authors: Menon Vikas , Kaliamoorthy Charanya , Sridhar Vivekanandhan Kavanoor , Varadharajan Natarajan , Joseph Rini , Kattimani Shivanand , Kar Sujita Kumar , Arafat SM Yasir
Published: June 2020

Background:

Responsible media reporting of suicide is a key population-level suicide prevention strategy. Thus far, there has been no systematic analysis of media reporting of suicide in Puducherry, a consistently high suicide burden state in India.

Aim:

To evaluate the adherence of media reports of suicide against the World Health Organization (WHO) guidelines in Puducherry.

Method:

We conducted a year-round content analysis of all suicide-related reports in the two most widely read vernacular dailies of Puducherry. We used a pre-defined data extraction form and coded each item based on the WHO reporting guidelines.

Results:

A total of 318 suicide reports were retrieved. Harmful reporting practices such as mentioning the method of suicide (99.1%), description of the steps involved (68.2%) and location of suicide (86.5%), monocausal explanations (91.8%), and inciting life events (52.5%) were common. Helpful practices such as mentioning warning signs (1.3%), recognizing links with mental health disorders (3.8%) and effects on bereaved persons (2.2%) were rare. Only one article (0.31%) included any content related to educational/preventive aspects of suicide.

Conclusion:

Media reporting of suicide in Puducherry, India, does not adhere to reporting guidelines and there is very little focus on educating the public about preventive aspects of suicide. Urgent efforts are warranted to improve the quality of media reporting which should include the development of national guidelines on suicide reporting and collaborative efforts that take into account barriers and perspectives of media professionals.
National Trends in Surgical Resection of Vestibular Schwannomas
Authors: Ren Yin , Sethi Rosh K. V. , Stankovic Konstantina M.
Published: June 2020

Objective

To characterize the national trend for surgical resection of vestibular schwannoma (VS) and to assess changes in demographics, length of stay (LOS), discharge patterns, and hospital charges.

Study Design

Population‐based inpatient registry analysis.

Setting

National Inpatient Sample and SEER database (Surveillance, Epidemiology, and End Results).

Patients and Methods

Retrospective review of the US National Inpatient Sample and the SEER database from 2001 to 2014 of all patients who underwent resection of VS.

Results

A total of 24,380 VS resections were performed. While the annual incidence of VS remained stable at 1.38 per 100,000, surgical volume declined by 36.1%, from 2807 in 2001 to 1795 in 2014 (R2 = 0.58). Total hospital charges more than doubled, from $52,475 in 2001 to $115,164 in 2014 ($4478 per year, R2 = 0.96). While most procedures were performed at large‐sized hospitals, this decreased from 89% in 2002 to 75.8% in 2014. Average LOS remained stable at 5.2 days during the study period. The number of discharges to a nursing facility increased from 113 (5.5%) in 2002 to 245 (13.6%) in 2014 (P =. 0002).

Conclusion

VS resection has evolved in the United States. While the incidence remained stable, surgical volume decreased by 36%, and hospital charges more than doubled. More cases are being performed at smaller hospitals. Although LOS did not vary significantly, there is an increase in nonroutine discharges. These data may guide future research in resource utilization in neurotology.
The Role of Age and Merkel Cell Polyomavirus in Oral Cavity Cancers
Authors: Windon Melina , Fakhry Carole , Rooper Lisa , Ha Patrick , Schoppy David , Miles Brett , Koch Wayne , Vosler Peter , Eisele David , D’Souza Gypsyamber
Published: June 2020

The incidence of oral tongue cancer, the majority subsite of oral cavity cancer, is rising among young people with less exposure to tobacco and alcohol. Viral causes have been proposed, including Merkel cell polyomavirus (MCPyV). We evaluated patient and tumor characteristics among 126 incident oral cavity cancers (OCCs). Consistent with generational norms, younger patients had less exposure to tobacco and a greater number of oral sexual partners than older OCCs. In addition, younger patients were more likely to present at an earlier stage and with cancer arising from the oral tongue (each P <. 05). A subset of 44 cases was centrally tested for MCPyV large T antigen expression by immunohistochemistry. In the presence of controls, none of the tumors expressed MCPyV. These findings exclude consideration of MCPyV as an etiologic factor in OCC and may generate hypotheses for future examinations of the factors underlying the rise in oral tongue cancers.
Augmentation of Scarred Vocal Folds With Centrifuged and Emulsified Autologous Fat Grafts
Authors: Salmerón‐González Enrique , García‐Vilariño Elena , Llópez‐Carratalá Ignacio , Collado‐Martin Diego , María Perolada‐Valmaña José , Armengot‐Carceller Miguel
Published: June 2020

Objective

To review the results of a series of patients with glottic insufficiency caused by scarred vocal folds who underwent injection laryngoplasty with centrifuged and emulsified autologous fat.

Study Design

Prospective cohort.

Setting

Single center, tertiary institution.

Subjects and Methods

Examination of the medical records of 21 patients operated on through injection laryngoplasty with fat grafts for the treatment of dysphonia was performed. All patients were operated on between January of 2015 and September of 2019. The voice variables measured were the GRABS (Grade, Roughness, Breathiness, Asthenia, Strain) scale, the Voice Handicap Index–10 (VHI‐10), maximum phonation time, jitter, shimmer, and harmonic/noise ratio before surgery and 8 months later.

Results

Twenty‐six injection laryngoplasties were performed in 21 patients during the reviewed period. Seventeen were men, and 4 were women. Mean age was 57.2 (range, 18‐80) years. Mean (SD) follow‐up time was 20.7 (9.3) months. Etiology of dysphonia was scarring after tumor resection in 17 patients and sulcus vocalis in 4. Five patients received an additional injection laryngoplasty. Statistically significant improvements were observed in all the parameters evaluated (P <. 05).

Conclusions

Injection laryngoplasty with fat grafts processed through centrifugation and emulsification is an effective technique for the treatment of dysphonia caused by glottic insufficiency related to scarred vocal folds, with minimal complication rates.
Narrowband Imaging for p16+ Unknown Primary Squamous Cell Carcinoma Prior to Transoral Robotic Surgery
Authors: Al‐Mulki Kareem , Hamilton James , Kaka Azeem S. , Boyce Brian J. , Baddour H. Michael , El‐Deiry Mark , Solares C. Arturo , Magliocca Kelly , Summers Kelly , Aiken Ashley , Saba Nabil F. , Beitler Jonathan J. , Patel Mihir R.
Published: June 2020

Our purpose was to assess the potential utility of narrowband imaging (NBI) as a tool in diagnosing and treating unknown primary oropharyngeal squamous cell carcinoma (OPSCC) in patients prior to diagnostic resection with transoral robotic surgery (TORS). Between 2016 and March 2019, 29 patients with carcinoma of unknown primary meeting inclusion criteria were identified and treated with TORS. NBI was used preoperatively in 9 of 29 patients. A suspected tumor site was delineated by NBI in 8 of 9 patients (89%). Of the patients imaged with NBI, 8 of 9 (89%) patients had a pathologically confirmed tumor following TORS, corresponding to the same 8 suspected tumor sites identified with NBI. In contrast, a primary tumor was localized following TORS in 15 of 20 (75%) patients not evaluated with NBI. Thus, we see NBI as a potentially useful tool for the diagnosis and management of p16+ carcinoma of unknown primary.

Level of Evidence: IIb
The Difficult Airway and Aerosol‐Generating Procedures in COVID‐19: Timeless Principles for Uncertain Times
Authors: Smith Joshua D. , Chen Michelle M. , Balakrishnan Karthik , Sidell Douglas R. , di Stadio Arianna , Schechtman Samuel A. , Brody Robert M. , Kupfer Robbi A. , Rassekh Christopher H. , Brenner Michael J.
Published: June 2020

The impact of the COVID‐19 pandemic on otolaryngology practice is nowhere more evident than in acute airway management. Considerations of preventing SARS‐CoV‐2 transmission, conserving personal protective equipment, and prioritizing care delivery based on acuity have dictated clinical decision making in the acute phase of the pandemic. With transition to a more chronic state of pandemic, heightened vigilance is necessary to recognize how deferral of care in patients with tenuous airways and COVID‐19 infection may lead to acute airway compromise. Furthermore, it is critical to respect the continuing importance of flexible laryngoscopy in diagnosis. Safely managing airways during the pandemic requires thoughtful multidisciplinary planning. Teams should consider trade‐offs among aerosol‐generating procedures involving direct laryngoscopy, supraglottic airway use, fiberoptic intubation, and tracheostomy. We share clinical cases that illustrate enduring principles of acute airway management. As algorithms evolve, time‐honored approaches for diagnosis and management of acute airway pathology remain essential in ensuring patient safety.
Effectiveness of progressive and resisted and non-progressive or non-resisted exercise in rotator cuff related shoulder pain: a systematic review and meta-analysis of randomized controlled trials
Authors: Naunton Josh , Street Gabrielle , Littlewood Chris , Haines Terrence , Malliaras Peter
Published: June 2020

Objective:

Synthesize evidence regarding effectiveness of progressive and resisted or non-progressive and non-resisted exercise compared with placebo or no treatment, in rotator cuff related pain.

Data sources:

English articles, searched in Cochrane CENTRAL, MEDLINE, EMBASE and CINAHL databases up until May 19, 2020.

Methods:

Randomized controlled trials in people with rotator cuff related pain comparing either progressive and resisted exercise or non-progressive and non-resisted exercise, with placebo or no treatment were included. Data extracted independently by two authors. Risk of bias appraised with the Cochrane Collaboration tool.

Results:

Seven trials (468 participants) were included, four trials (271 participants) included progressive and resisted exercise and three trials (197 participants) included non-progressive or non-resisted exercise. There was uncertain clinical benefit for composite pain and function (15 point difference, 95% CI 9 to 21, 100-point scale) and pain outcomes at >6 weeks to 6 months with progressive and resisted exercise compared to placebo or no treatment (comparison 1). For non-progressive or non-resisted exercise there was no significant benefit for composite pain and function (4 point difference, 95% CI −2 to 9, 100-point scale) and pain outcomes at >6 weeks to 6 months compared to placebo or no treatment (comparison 2). Adverse events were seldom reported and mild.

Conclusions:

There is uncertain clinical benefit for all outcomes with progressive and resisted exercise and no significant benefit with non-progressive and non-resisted exercise, versus no treatment or placebo at >6 weeks to 6 months. Findings are low certainty and should be interpreted with caution.
Early Literacy Skill Growth in Spanish-Speaking Children With and At Risk for Disabilities in Early Childhood
Authors: Wackerle-Hollman Alisha K. , Durán Lillian K. , Miranda Alejandra
Published: June 2020

For young Spanish–English dual language learners (SE-DLLs), early literacy skills, including phonological awareness and alphabet knowledge in Spanish as well as English, are crucial to their reading success. However, there is a lack of research about how SE-DLLs develop early literacy skills, and how their rates of performance can inform evidence-based intervention. This article examined to what degree SE-DLLs with disabilities or at risk for later reading difficulties on early literacy skills demonstrated growth on English and Spanish measures of early literacy when compared with their typically developing peers. Hierarchical linear modeling was used to analyze growth for 325 SE-DLLs on four Individual Growth and Development Indicators that assessed phonological awareness and alphabet knowledge in English and Spanish. Results indicated that at-risk and typically developing children showed significant slopes for all measures and that at-risk children grew faster than typically developing children on Spanish alphabet knowledge measures.
Collaborative online international learning: A way to develop students’ engineering capabilities and awareness to become global citizens
Authors: Munoz-Escalona Patricia , de Crespo Zulay Cassier , Marin Mara Olivares , Dunn Meg
Published: June 2020

In the 21st century, academics must recognise the value of incorporating e-learning activities in teaching in order to provide students the opportunity to interact and engage with peers in collaborative learning. To achieve this, a Collaborative Online International Learning (COIL) activity was introduced to 2nd and 3rd year students in Mechanical and Industrial Design Engineering degrees, with the aim of enhancing aspects such as global manufacturing and reverse engineering. This activity was also used as an approach to internationalise the curriculum which is an important mechanism to promote intercultural competencies, international perspectives and ethical sensitivities, whilst also contributing to the enhancement of students’ abilities to develop as responsible global citizens. Three institutions were involved in this project, with results indicating that 93% of students felt they had a better understanding of the topic under study, 93% were satisfied with the learning experience and 90% enjoyed interacting with international peers.
TINA and alternative strategies for Polish economic transformation
Authors: Osiatyński Jerzy
Published: June 2020

The article examines the commonly shared belief that ‘there was no alternative’ (the TINA hypothesis) regarding the transformation strategy in Poland in 1989–1990. This belief is shown to be incorrect, with evidence that an alternative was contemplated. Following a visit in Stockholm in January 1989 of high-ranking experts of the Consultative Economic Council (a government think-tank established shortly after martial law was introduced on 13 December 1980), the Council produced a report on the Swedish Model. The report was hoped to provide foundations for shifting the still centrally planned Polish economy towards economic efficiency and the social welfare standards of the Nordic countries. After the 1989 parliamentary elections and the appointment of the non-communist government of Tadeusz Mazowiecki, the political environment changed radically and the priority of the new government was to swiftly establish a truly liberal market economy in Poland. The article shows, however, that notwithstanding those revolutionary changes, a high-level debate took place only a few weeks after the new government came to power to discuss an option of a more gradual strategy of Poland’s economic transformation that at the same time would be of a more social democratic nature. An insider account of that debate and of its external and internal constraints is given in the subsequent sections of the article.
World Cleft Coalition International Treatment Program Standards
Authors: Kassam Serena N. , Perry Jamie L. , Ayala Ruben , Stieber Erin , Davies Gareth , Hudson Nan , Hamdan Usama S.
Published: June 2020

Objective:

To present preliminary efforts to establish an internationally agreed set of minimum core practice and best practice guidelines, along with overarching principles to promote safe and comprehensive cleft care globally.

Design:

Representatives from 6 national and international organizations collaborated to form a World Cleft Coalition. Representatives met monthly/bimonthly to compile standards for safe, comprehensive, and sustainable cleft care. Outcomes were circulated within each organization and to a small subset of external constituents for feedback.

Results:

A series of overarching principles were established for those involved in International Cleft Treatment Programs, based on the experience of participating organizations. The overarching principles are followed by a structured and detailed Recommended Practice for Ensuring Safe, Comprehensive and Sustainable Cleft Care, which includes minimum core and best practice for the following areas: surgical safety, quality control, patient education, patient selection, patient follow-up, comprehensive care, partnership with the host nations and professionals, training and exchanges for sustainability, and local capacity building.

Conclusions:

Outcomes aimed to provide a working document to define core principles for safe comprehensive cleft care, while balancing various levels of resources, geographic locations, appropriately trained health care professional specialists, and training limitations. The study highlights the process and benefits to a collaborative international working group not only to establish best practice but also to solicit and engage others in discussion of their experiences with building and supporting safe, high-quality, comprehensive, sustainable, worldwide cleft care.
A Systematic Review of Newer Antidiabetic Agents in the Treatment of Nonalcoholic Fatty Liver Disease
Authors: Dougherty John A. , Guirguis Erenie , Thornby Krisy-Ann
Published: June 2020

Objective:

To evaluate glucagon-like peptide 1 receptor agonists (GLP-1 RAs), dipeptidyl-peptidase IV (DPP-4) inhibitors, and sodium-glucose cotransporter 2 (SGLT) inhibitors to treat nondiabetic and type 2 diabetes mellitus (T2DM) nonalcoholic fatty liver disease (NAFLD) as it relates to improvement in hepatosteatosis (HS) or steatohepatitis (SH).

Data Sources:

MEDLINE and CINAHL were searched from inception through May 1, 2020. Search terms included nonalcoholic steatohepatitis, nonalcoholic fatty liver disease, fatty liver, dipeptidyl-peptidase IV inhibitors, glucagon-like peptide-1 receptor agonists, and sodium-glucose transporter 2 inhibitors.

Study Selection and Data Extraction:

Full-text observational and randomized controlled studies in English were included. Patients diagnosed with NAFLD, treated with GLP-1 RAs, DPP-4 inhibitors, and SGLT2 inhibitors, with measures to evaluate HS or SH were evaluated.

Data Synthesis:

Eight GLP-1 RA trials were reviewed; 7 GLP-1 RA trials showed improvement in HS. Two studies demonstrated improvement in liver histology in patients with SH. Seven SGLT2 inhibitor studies were reviewed; 6 studies demonstrated improvements in NAFLD. Five studies showed improvements in HS, whereas 1 displayed improvement in liver histology in NASH. Six studies that included DPP-4 inhibitors were evaluated, and only 2 demonstrated improvement in NASH.

Relevance to Patient Care and Clinical Practice:

Based on evidence reviewed, GLP-1 RAs and SGLT2 inhibitors decreased HS and SH in NAFLD patients, whereas DPP-4 inhibitor therapy was not effective for patients with HS.

Conclusions:

Based on study data utilizing imaging studies and biopsy results, GLP-1 RAs or SGLT2 inhibitors can benefit NAFLD T2DM patients. Clinical trials with larger patient populations may augment these results.
Effect of total hip arthroplasty on brake reaction time and braking force
Authors: Bäcker Henrik C , Krüger David , Spies Sophie , Perka Carsten , Kirschbaum Stephanie M , Hardt Sebastian
Published: June 2020

Introduction:

The correct moment for return to driving after total hip arthroplasty (THA) remains unclear. Until today no uniform recommendation exists on the ability to perform an emergency brake. The aim of this prospective study was to investigate the braking ability of patients before and after THA implantation based on brake reaction time in milliseconds (BRT) and braking force in N (BF).

Methods:

In total, 25 patients (15 men, 10 women, mean age 51.3 ± 10.1 years) were treated with THA on the right side. Inclusion criteria consisted of a valid driving licence, frequent road participation and at least 2 years of driving experience. Exclusion criteria were underlying neurological disorders as well as severe complaints in the lumbar spine and the right knee joint. The brake ability was evaluated for emergency braking with a car simulator and a measuring sole. Measurements were performed preoperatively, 6 days, 2, 4 and 6 weeks after surgery.

Results:

Preoperatively, the mean BRT was 671.3 ± 123.5 ms and the BF 455.4 ± 185.0 N. Significant differences were observed at 6 days and 2 weeks after surgery, (BRT 836.4 ± 219.7 ms, respectively, BRT 735.0 ± 186.7 ms, and BF 302.6 ± 154.9 N, respectively, BF 375.5 ± 149.3 N, p < 0.05). Only 4 weeks after, no significant differences were seen compared to pre-operative with a BRT of 647.0 ± 91.9ms ( p = 0.354) and BF of 435.9 ± 177.4 ( p = 0.843). Furthermore, the BRT improved significantly after 6 weeks (607.4 ± 87.6; p = 0.005).

Conclusions:

The braking force is significantly reduced, and the brake reaction time is prolonged directly after surgery for at least 2 weeks. After 4 weeks, no statistically significant differences were measured, although special care should still be taken during return to activity.
Performance of fiber metal laminate composites embedded with AL and CU wire mesh
Authors: Krishnasamy Prabu , Rajamurugan G , Thirumurugan M
Published: June 2020

This work was investigated that the effect of aluminium (Al) and copper (Cu) wire mesh embedded as a structural reinforcement on jute epoxy hybrid composite. The hybrid composites were prepared by epoxy LY556 with HY951 hardener as a matrix; jute and wire mesh as reinforcements using the compression molding technique. In hybrid composites, the aluminium wire mesh (AWM) and copper wire mesh (CWM) were embedded as 45° & 90° orientation to the jute fiber (AWM45/90 and CWM45/90). The performance of the fabricated hybrid composites was studied by conducting various mechanical, thermal, and dynamic characterizations. The test results were shown that the tensile strength of the fabricated composite was improved by 14.12% in AWM45 and 9.28% in CWM45 compared to AWM90 and CWM90 composites respectively. The TGA result expressed that the thermal stability of the CWM45 composite was enhanced with the residue of 18.33% at 800 °C due to the influence of Cu-wire mesh. In the transition region, the 45° oriented wire mesh improved the loss modulus (E″) peaks about 31.74% in CWM and 11.49% in AWM composite to 90° oriented mesh.
Examining and Expanding Latinx General Strain Theory
Authors: Isom Scott Deena A. , Whiting Serita , Grosholz Jessica M.
Published: June 2020

Since the initial articulation of general strain theory (GST), Agnew has suggested strains may function differently—in type, response, and impact—for different groups. We build upon Pérez and colleagues’ foundational arguments for a Latinx GST by investigating the role of the ethnically specific strains they propose in addition to other strains argued to disproportionately impact people of Color. Furthermore, we examine the protective role of positive ethnic identity against the negative effects of strainful experiences for Latinxs. Using a sample of Latinx youth from the Project on Human Development in Chicago Neighborhoods, we highlight not only the unique strains faced by Latinxs in America, but how they distinctly experience and respond to criminogenic strains.
Abnormal pathology seen on appendectomy in patients with predominant right-sided pelvic pain
Authors: Cai Catherine W , Sisler Katelin E , Gavard Jeffrey A , Eugenio-Colon Jose D , Yeung Patrick P
Published: June 2020

Introduction:

Previous studies have linked chronic pelvic pain (CPP) to appendix pathologies. However, few studies have investigated appendix pathology specifically in the context of CPP that is right-side predominant (R-CPP). We hypothesized that women with R-CPP have higher rates of appendix pathology compared with women with CPP that is not right-side predominant (N-CPP).

Methods:

We conducted a retrospective case–control study of 220 women who underwent diagnostic laparoscopy and planned or incidental appendectomy for CPP and suspected endometriosis between January 2015 and December 2018 at a tertiary care center in Saint Louis, MO.

Results:

No significant difference in abnormal appendix pathology was found between women with R-CPP and women with N-CPP (30.9% vs 34.5%, p = 0.74, odds ratio = 0.85, 95% CI: (0.44, 1.62)). Gross abnormalities of the appendix were documented in 40 of 220 patients (18.2%), with the most common abnormal gross findings being adhesions (8.2%), followed by abnormal lesions (7.3%).

Conclusion:

In this study, the presence of abnormal pathology within the appendix did not correlate with R-CPP, indicating triage based on predominant pain location cannot help identify patients with underlying appendix pathology. However, consistent with previous studies, we identified a high rate of abnormal appendix pathology overall, supporting the practice of many surgeons to perform routine appendectomy in women with CPP.
Are There Harmful Effects of Preoperative Mild Lateral or Patellofemoral Degeneration on the Outcomes of Open Wedge High Tibial Osteotomy for Medial Compartmental Osteoarthritis?
Authors: Kim Dong Hyun , Kim Seong Chan , Yoon Ji Soo , Lee Yong Seuk
Published: June 2020

Background:

Early osteoarthritis of the knee joint mostly affects the medial compartment, making osteotomy a rational approach to slow the progression of the disease. However, some patients show asymptomatic mild degeneration in the lateral or patellofemoral compartment.

Purpose:

To evaluate the effect of asymptomatic mild lateral or patellofemoral degeneration on the outcomes of medial open wedge high tibial osteotomy (OWHTO) by assessing the outcomes according to the preoperative status of the lateral or patellofemoral degenerative changes.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 114 patients (121 knees) who underwent biplanar OWHTO with second-look arthroscopic surgery and postoperative magnetic resonance imaging (MRI) were retrospectively enrolled. Patients were categorized into 4 groups according to the Osteoarthritis Research Society International (OARSI) and MRI Osteoarthritis Knee Score (MOAKS) classification systems. The International Cartilage Repair Society (ICRS) grade was used to evaluate the preoperative and postoperative cartilage status. Clinical outcomes were assessed by the American Knee Society (AKS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 36-item Short Form Health Survey (SF-36).

Results:

No degenerative changes in the lateral and patellofemoral compartments of knees (group I) were identified in 51.2% of cases (62 knees). Asymptomatic degenerative changes only in the lateral compartment (group II: OARSI grades 1-3 and MOAKS grades 1-3) were identified in 15.7% of cases (19 knees), changes only in the patellofemoral compartment (group III: OARSI grades 1-3 and MOAKS grades 1-3) were identified in 10.7% of cases (13 knees), and changes in both the lateral and the patellofemoral compartments (group IV) were identified in 22.3% of cases (27 knees). In the medial compartment, there was no significant difference in the improvement of MOAKS and ICRS grades among all groups ( P = .813 and .985, respectively). In the lateral and patellofemoral compartments, there was no significant difference in the decline of MOAKS ( P = .649 and .421, respectively) and ICRS grades ( P = .927 and .676, respectively) among all groups.

Conclusion:

The presence of mild lateral or patellofemoral degenerative changes did not affect the MRI, arthroscopic, and clinical outcomes of OWHTO. However, long-term observations are necessary to draw definitive conclusions as to whether OWHTO can be indicated in such patients without harmful effects.
Introducing a Supportive Care Team for Advance Directive Education in a Neurological and Neurosurgical Patient Population
Authors: Henke Charlotte , Mroz Emily , Le Ngoc Anh , Gregory Hannah M , Ghiaseddin Ashley , McFarland Nikolaus R , Baron-Lee Jacqueline
Published: June 2020

Background:

Patient-centered care includes delineation of patient treatment values (ie, advance care planning [ACP]). Advance care planning often includes advance directive (AD) completion and is underutilized, particularly among neurology and neurosurgery patients. Implementation of a supportive care team (SCT) in outpatient clinic settings may offer opportunities for AD education and completion.

Objective:

This study assesses the effectiveness of an integrative SCT composed of hospice volunteers and undergraduate quality improvement interns in their efforts to provide ACP education in neurological and neurosurgical outpatient clinics. Assessment includes a description of different types of SCT-patient encounters, as well as patient interest in and completion of ADs after interacting with the SCT.

Results:

Across the data collection period, 2770 encounters were initiated. The majority of encounters resulted in patient ACP education. Some patients completed ADs during their SCT encounter (3.45%) or after their SCT encounter (10.18%).

Conclusion:

The SCT effectively enhances ACP education in this patient population. The utilization of trained interns to assist with ACP is beneficial and practical in clinic workflow.
Combination of Size-Exclusion Chromatography and Ultracentrifugation Improves the Proteomic Profiling of Plasma-Derived Small Extracellular Vesicles
Authors: Wei Rui , Zhao Libo , Kong Guanyi , Liu Xiang , Zhu Shengtao , Zhang Shutian , Min Li
Published: June 2020

Background

Circulating small extracellular vesicles (sEVs) and its associated proteins are of great interest in the early detection of many diseases. However, there is no gold standard for plasma sEVs isolation, especially for proteomic profiling which could be largely affected by contamination such as lipoproteins and plasma proteins. Previous studies suggested combinations of different sEVs isolation methods could improve the yield and purity of the isolated fractions. Nevertheless, there is no systematic evaluation of size-exclusion chromatography (SEC), ultracentrifugation (UC), and their combination in a proteomic perspective.

Results

Plasma samples were collected from healthy individuals, and sEVs were separated by one-step SEC, one-step UC, and combining SEC with UC, respectively. Here we exhibited that the purity of sEVs was improved by SEC in contrast to traditional UC. Furthermore, by conducting a SEC procedure followed by UC, we separated sEVs with the highest purity. In the proteomic analysis, 992 protein species were identified in the plasma sEVs isolated by our novel separation method, of which several proteins are sEVs-associated proteins but hitherto never been identified in the previous studies and database, much more than plasma sEVs isolated by UC (453) or SEC (682) alone. As compared to Vesiclepedia and Exocarta databases, plasma sEVs isolated by the new procedure kept 584 previously identified sEVs-associated proteins and 360 other proteins that have not been detected before. Detailed analysis suggested that more kinds of sEVs biomarkers, such as CD9, ALIX, and FLOT1, could be identified in plasma sEVs isolated by the novel isolation method as compared to one-step UC/SEC. Furthermore, the lower abundance ranks of common contaminants, such as lipoproteins and IgG chains, in the sEVs fractions obtained by our new method as compared to one-step UC/SEC also demonstrated the purity of sEVs had been improved.

Conclusions

Combining SEC with UC could significantly improve the performance of mass spectrometry-based proteomic profiling in analyzing plasma-derived sEVs.
Minor surgery in general practice in Ireland- a report of workload and safety
Authors: ní Riain Ailís , Maguire Niall , Collins Claire
Published: June 2020

Background

The provision of minor surgical services is an established part of the task profile of general practitioners (GPs) in many countries in Europe and elsewhere. This study aimed to collect data on the clinical process and outcomes for specified minor surgical procedures undertaken in Irish general practice by GPs experienced in minor surgery in order to document the scope and safety of minor surgery being undertaken.

Methods

Over a six-month period, 24 GPs in 20 practices recorded data on a pre-determined list of procedures undertaken in adults (aged 18 and older); procedures for ingrown toenails were also recorded for those aged 12–18 years. Clinical data were rendered fully anonymous by the participating GPs, entered onto the Excel database template and returned to the project team monthly.

Results

On average, each practice undertook 212 procedures in a six-month period. The four most frequent procedures include two relatively non-invasive procedures (cryosurgical ablation of skin lesions and aspiration and/or injection of joints) and two more invasive procedures (full thickness excision of skin lesion and shave, punch or incisional biopsy). Overall, 83.8% of relevant specimens were submitted for histology. Combining benign and malignant cases, there was an overall 87% clinical and histological concordance; 85% of malignancies were suspected clinically. A complication was recorded in 0.9% after 1 month.

Conclusions

Irish GPs with experience in minor surgery can provide a range of surgical services in the community safely.
Do Polish primary care physicians meet the expectations of their patients? An analysis of Polish QUALICOPC data
Authors: Krztoń-Królewiecka Anna , Oleszczyk Marek , Windak Adam
Published: June 2020

Background

Meeting the expectations of patients is one of the most crucial criteria when assessing the quality of a healthcare system. This study aimed to compare the expectations and experiences of patients of primary care in Poland and to identify key patient characteristics affecting these outlooks.

Methods

The study was performed within the framework of the international Quality and Costs of Primary Care in Europe (QUALICOPC) cross-sectional, questionnaire-based study. In Poland, a nationally representative sample of 2218 patients were recruited to take part in the study. As a study tool, we used data from two of four QUALICOPC questionnaires: “Patient Experience” and “Patient Values”.

Results

Patients’ expectations were fulfilled in all study areas: accessibility, continuity, quality of care, and equity. We observed that the highest-met expectations indexes were in the area of quality of care, while the lowest, but still with a positive value, were in the area of accessibility. Patient-doctor communication was the aspect most valued by study participants. Elements of the patient’s own level of engagement during the consultation were ranked as less essential.

Conclusions

Comparing patient experiences to their values allows us to identify areas for improvement that are prioritized by patients. Accessibility is recognized as the most important area by Polish patients, simultaneously showing the highest level of patient-perceived improvement potential. Interpersonal care is another domain, in which the needs of patients are satisfied but are also relatively high. Strong clinician-patient relationships seem to be a priority in patients’ expectations. The continuous efforts in interpersonal communication skills training for primary care physicians should be upgraded.
Comparison of the touch-screen and traditional versions of the Corsi block-tapping test in patients with psychosis and healthy controls
Authors: Siddi Sara , Preti Antonio , Lara Elvira , Brébion Gildas , Vila Regina , Iglesias Maria , Cuevas-Esteban Jorge , López-Carrilero Raquel , Butjosa Anna , Haro Josep Maria
Published: June 2020

Background

Working memory (WM) refers to the capacity system for temporary storage and processing of information, which is known to depend on the integrity of the prefrontal cortex. Impairment in working memory is a core cognitive deficit among individuals with psychotic disorders. The Corsi block-tapping test is a widely-used instrument to assess visuospatial working memory. The traditional version is composed of 9 square blocks positioned on a physical board. In recent years, the number of digital instruments has increased significantly; several advantages might derive from the use of a digital version of the Corsi test.

Methods

This study aimed to compare the digital and traditional versions of the Corsi test in 45 patients with psychotic disorders and 45 healthy controls. Both groups completed a neuropsychological assessment involving attention and working memory divided into the two conditions.

Results

Results were consistent between the traditional and digital versions of the Corsi test. The digital version, as well as the traditional version, can discriminate between patients with psychosis and healthy controls. Overall, patients performed worse with respect to the healthy comparison group. The traditional Corsi test was positively related to intelligence and verbal working memory, probably due to a more significant effort to execute the test.

Conclusions

The digital Corsi might be used to enhance clinical practice diagnosis and treatment.The digital version can be administered in a natural environment in real-time. Further, it is easy to administer while ensuring a standard procedure.
Correction to: Relationship between Toxoplasma gondii seropositivity and schizophrenia in the Lebanese population: potential implication of genetic polymorphism of MMP-9
Authors: El Mouhawess Amata , Hammoud Amal , Zoghbi Marouan , Hallit Souheil , Haddad Chadia , El Haddad Kinda , El Khoury Saydeh , Tannous Jennifer , Obeid Sahar , Halabi Mohamad Adnan , Mammari Nour
Published: June 2020

An amendment to this paper has been published and can be accessed via the original article.
Should analyses of large, national palliative care data sets with patient reported outcomes (PROs) be restricted to services with high patient participation? A register-based study
Authors: Hansen Maiken Bang , Petersen Morten Aagaard , Ross Lone , Groenvold Mogens
Published: June 2020

Background

There is an increased interest in the analysis of large, national palliative care data sets including patient reported outcomes (PROs). No study has investigated if it was best to include or exclude data from services with low response rates in order to obtain the patient reported outcomes most representative of the national palliative care population. Thus, the aim of this study was to investigate whether services with low response rates should be excluded from analyses to prevent effects of possible selection bias.

Methods

Data from the Danish Palliative Care Database from 24,589 specialized palliative care admittances of cancer patients was included. Patients reported ten aspects of quality of life using the EORTC QLQ-C15-PAL-questionnaire. Multiple linear regression was performed to test if response rate was associated with the ten aspects of quality of life.

Results

The score of six quality of life aspects were significantly associated with response rate. However, in only two cases patients from specialized palliative care services with lower response rates (< 20.0%, 20.0–29.9%, 30.0–39.9%, 40.0–49.9% or 50.0–59.9) were feeling better than patients from services with high response rates (≥60%) and in both cases it was less than 2 points on a 0–100 scale.

Conclusions

The study hypothesis, that patients from specialized palliative care services with lower response rates were reporting better quality of life than those from specialized palliative care services with high response rates, was not supported. This suggests that there is no reason to exclude data from specialized palliative care services with low response rates.
ATP-sensitive potassium channels gene polymorphism rs1799858 affects the risk of macro-/micro-vascular arteriosclerotic event in patients with increased low-density lipoprotein cholesterol levels
Authors: Liu Cheng , Guan Tianwang , Lai Yanxian , Zhu Jieming , Kuang Jian , Shen Yan
Published: June 2020

Background

Plasma concentration of low-density lipoprotein cholesterol (LDL-C) is causally related to the risk of arteriosclerotic events. Whether ATP-sensitive potassium channels (KATP) genetic variants predict increased LDL-C concentration (≥1.8 mmol/L) and risk of macro-/micro-vascular arteriosclerotic event remain elusive.

Methods

A total of 320 subjects with increased LDL-C concentration (≥1.8 mmol/L) and 320 counterpart subjects (< 1.8 mmol/L) from the South China were enrolled in this study. Three KATP polymorphisms (rs1799858, rs4148671 and rs78148713) were genotyped by the Sequenom MassARRAY system. Binary logistic regression analysis was used to evaluate the association of the 3 KATP variants with increased LDL-C concentration and carotid artery stenosis (CAS) ≥50%. Two-way ANOVA was used to analyze the association of the 3 KATP variants with microalbumin in urine (MAU) and high-sensitivity C-reactive protein (HsCRP) levels. Cox proportional hazards regression analysis was used to retrospectively analyse the association of the optimal variant with the risk of new onset/recurrent acute myocardial infarction (AMI).

Results

Among the 3 studied KATP gene single nucleotide polymorphisms (SNPs), only rs1799858 (TT + CT genotype) was associated with elevated risk of LDL-C ≥ 1.8 mmol/L (adjusted OR = 2.25, 95% CI: 1.31–3.85, P = 0.003) and CAS ≥50% (adjusted OR = 2.80, 95% CI: 1.12–6.98, P = 0.028). KATP SNP rs1799858 was also associated with increased MAU (P = 0.013) and HsCRP (P = 0.027) levels. The follow-up for an average of 51.1-months revealed that participants carrying the T-allele (TT + CT) of rs1799858 was associated with high risk of new onset/recurrent AMI (adjusted HR = 2.90, 95% CI: 1.06–7.94, P = 0.038).

Conclusion

The KATP SNP rs1799858 may be an optimal genetic predisposition marker for increased LDL-C concentration (≥1.8 mmol/L) and its related macro-/micro-vascular arteriosclerotic event risk. The KATP variant rs1799858 was associated with higher risk of macro-/micro-vascular arteriosclerotic events in patients with elevated serum LDL-C levels.
Phosphoproteomics of short-term hedgehog signaling in human medulloblastoma cells
Authors: Scheidt Tamara , Alka Oliver , Gonczarowska-Jorge Humberto , Gruber Wolfgang , Rathje Florian , Dell’Aica Margherita , Rurik Marc , Kohlbacher Oliver , Zahedi René P. , Aberger Fritz , Huber Christian G.
Published: June 2020

Background

Aberrant hedgehog (HH) signaling is implicated in the development of various cancer entities such as medulloblastoma. Activation of GLI transcription factors was revealed as the driving force upon pathway activation. Increased phosphorylation of essential effectors such as Smoothened (SMO) and GLI proteins by kinases including Protein Kinase A, Casein Kinase 1, and Glycogen Synthase Kinase 3 β controls effector activity, stability and processing. However, a deeper and more comprehensive understanding of phosphorylation in the signal transduction remains unclear, particularly during early response processes involved in SMO activation and preceding GLI target gene regulation.

Methods

We applied temporal quantitative phosphoproteomics to reveal phosphorylation dynamics underlying the short-term chemical activation and inhibition of early hedgehog signaling in HH responsive human medulloblastoma cells. Medulloblastoma cells were treated for 5.0 and 15 min with Smoothened Agonist (SAG) to induce and with vismodegib to inhibit the HH pathway.

Results

Our phosphoproteomic profiling resulted in the quantification of 7700 and 10,000 phosphosites after 5.0 and 15 min treatment, respectively. The data suggest a central role of phosphorylation in the regulation of ciliary assembly, trafficking, and signal transduction already after 5.0 min treatment. ERK/MAPK signaling, besides Protein Kinase A signaling and mTOR signaling, were differentially regulated after short-term treatment. Activation of Polo-like Kinase 1 and inhibition of Casein Kinase 2A1 were characteristic for vismodegib treatment, while SAG treatment induced Aurora Kinase A activity. Distinctive phosphorylation of central players of HH signaling such as SMO, SUFU, GLI2 and GLI3 was observed only after 15 min treatment.

Conclusions

This study provides evidence that phosphorylation triggered in response to SMO modulation dictates the localization of hedgehog pathway components within the primary cilium and affects the regulation of the SMO-SUFU-GLI axis. The data are relevant for the development of targeted therapies of HH-associated cancers including sonic HH-type medulloblastoma. A deeper understanding of the mechanisms of action of SMO inhibitors such as vismodegib may lead to the development of compounds causing fewer adverse effects and lower frequencies of drug resistance.
“Right-to-Try” experimental drugs: an overview
Authors: Mahant Vijay
Published: June 2020

The “Right-to-Try” experimental drugs act passed by Donald Trump in 2018 provides an opportunity of early access to experimental drugs for the treatment of life-threatening diseases and a potential boon to many young and under-capitalized biotechnology or pharmaceutical companies. The pros and cons of experimental drugs, including a number of “cutting edge” scientific, clinical, and a number of synergistic approaches such as artificial intelligence, machine learning, big data, data refineries, electronic health records, data driven clinical decisions and risk mitigation are reviewed.
Factors associated with the burden of family caregivers of elderly patients with femoral neck fracture: a cross-sectional study
Authors: Xiao Peifen , Zhou Yongchun
Published: June 2020

Background

This study aimed to study the factors associated with caregiver burden among caregivers of elderly patients with femoral neck fracture.

Methods

This cross-sectional study was based on a non-probabilistic sampling of 183 elderly postoperative patients (aged 65 years or older) with femoral neck fracture who were hospitalized in the orthopedic center in our hospital and their family caregivers. Data were collected from January 2016 to June 2019. Patients and family caregivers completed the sociodemographic questionnaire. The Social Support Rating Scale (SSRS), the General Self-Efficacy Scale (GSE), and the Chinese version of the Zarit Burden Interview (ZBI) were used to evaluate social support, self-efficacy, and caregiver burden, respectively. By analyzing the clinical data of patients and family caregivers and combining the factors that affect the caregiver burden in parallel studies, we selected the factors that affected the caregiver burden in this study and conducted a multivariate analysis of these factors.P< 0.05 was considered statistically significant.

Results

We observed 176 caregivers aged 69.28 ± 7.19 years old, among whom 52.3% were male, 58.0% lived in the city, 84.0% were spouses of the patients, and 67.0% had a primary school educational background. The ZBI score of the family caregivers was 37.8 ± 8.9, and 82.7% of the caregivers were under a moderate to severe burden. The patient’s functional status, Harris score, and pain score and the caregiver’s SSRS scores, GSE scores, and the ratio of medical expenses to monthly income per capita were factors that affected the caregiver burden.

Conclusions

Most family caregivers of elderly patients with femoral neck fracture are subject to a considerable care burden, and social support and self-efficacy intervention are conducive to reducing the caregiver burden.