bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Pain and Overview or Differential Diagnoses of Nonodontogenic Orofacial Pain
Authors: Renton Tara 
Published: October 2020

Orofacial pain is defined as pain arising from the regions of the face and mouth. Dental pain is the most common inflammatory pain presenting in this region; however, chronic pain conditions presenting frequently, including temporomandibular joint disorders (TMDs), primary headaches (neurovascular), neuropathic pain and idiopathic pain conditions, can often mimic toothache. Dentists are familiar with TMDs but have no training or experience in diagnosing or treating headaches that mainly present in the first trigeminal division. The anatomical complexity of the region and the potential possible diagnoses, mean that correct diagnosis is often delayed resulting in patients often undergoing inappropriate surgical and medical treatments that themselves may complicate the presentation of the pain by changing its phenotype and further complicating diagnosis and appropriate management. Due to the variable pain presentation of toothache, it can mimic many different chronic episodic orofacial pain conditions, resulting in many inappropriately prescribed courses of antibiotics and surgical interventions. Dentists are not the only profession to fall foul of the misdiagnosis but ear, nose and throat (ENT) and maxillofacial surgeons fall into the same trap.
Effect of tobacco use on disease activity and DMT discontinuation in multiple sclerosis patients treated with dimethyl fumarate or fingolimod
Authors: Hersh Carrie M , Harris Haleigh , Ayers Malissa , Conway Devon 
Published: October 2020

Background Tobacco exposure is a modifiable risk factor for multiple sclerosis (MS). Studies evaluating the relationship between tobacco, disease activity, and disease modifying therapy (DMT) persistence yielded conflicting results. We sought to address this issue with data from clinical practice. Objective To compare 24-month disease outcomes in tobacco versus non-tobacco users treated with dimethyl fumarate (DMF) or fingolimod (FTY) in clinical practice. Methods We retrospectively identified 659 MS patients treated with DMF or FTY, stratified by patient-reported tobacco use. DMT discontinuation and measures of disease activity at 24 months were assessed using propensity score (PS) weighting. Outcome estimates were calculated as tobacco vs non-tobacco use. Results 164 tobacco users (DMF n = 101; FTY n = 63) and 495 non-tobacco users (DMF n = 294; FTY n = 201) were identified. Tobacco (39.4%) and non-tobacco (34.4%) users were equally likely to discontinue DMT (OR = 1.17, 95% CI 0.79, 1.75), but tobacco users discontinued therapy earlier (HR = 1.53, 95% CI 1.06, 2.43). There were no differences in ARR (rate ratio = 1.39, 95% CI 0.97, 1.96). However, tobacco users had decreased odds of NEDA-2 (OR = 0.61, 95% CI 0.44, 0.83). Conclusion Our findings suggest that tobacco is a negative risk factor for inflammatory disease activity and earlier DMF and FTY discontinuation.
Enlarged perivascular spaces are not associated with vascular co-morbidities, clinical outcomes, and brain volumes in people with secondary progressive multiple sclerosis
Authors: Wooliscroft Lindsey , Boespflug Erin , Hildebrand Andrea , Shangraw Kathleen , Silbermann Elizabeth , Bourdette Dennis , Spain Rebecca 
Published: October 2020

Background In secondary progressive multiple sclerosis (SPMS) significance of enlarged perivascular spaces (ePVS) is unknown. Objectives, Methods: Analysis of associations between vascular co-morbidities, clinical outcomes, and volumetrics with categorical ePVS scores in midbrain, basal ganglia (BG), and centrum semiovale (CSO) in SPMS(n-46). Results, Conclusion: In BG, advancing age (Z = 2.68) and lower Expanded Disability Status Scale (Z = −2.04) were associated with increasing ePVS score. In CSO, advancing age (Z = 2.66) and male gender (Z = 2.45) were associated with increasing ePVS score. No associations between ePVS score and vascular co-morbidities or volumetrics existed; ePVS may not be an informative marker for SPMS.
China’s Experiences in Developing Lifelong Education, 1978–2017
Authors: Wu (吴遵民) Zunmin 
Published: October 2020

Purpose: This study systematically reviews the China’s progress in lifelong education (LLE) policies, theories, and practices in the 40 years since its reform and opening-up and provides several guidelines for developing LLE going forward. Design/Approach/Methods: This study analyzes the characteristics of LLE in China through a review of its developmental process and prospects at the policy, theoretical, and practical levels. Findings: While following the goals of LLE set by the United Nations Educational, Scientific, and Cultural Organization, China has developed and implemented LLE with distinctly Chinese characteristics. The development of LLE in China has focused on protecting citizens’ learning rights, improving civic literacy, and enhancing human resources. This study reveals four aspects of China’s experiences of LLE development. First, as the primary actor in promoting LLE, the government took responsibility for providing guidance and leadership in the development and implementation of LLE. Second, the people’s enthusiastic response to and expectation of the further enhancement of their spiritual cultivation and quality of life established LLE’s practical status. Third, the socioeconomic and political context consolidated the value foundation of LLE development. Fourth, the positive responses of the academic community and follow-up studies promoted policy-oriented processes and practice-based scientific development. Originality/Value: In addition to suggestions for the creation of an LLE system with Chinese characteristics, this study reveals several core theoretical topics of LLE development in China that warrant further research.
Effect of Tobacco Cessation on Weight in a Veteran Population
Authors: Zhou Crystal , Tran Nicole G. , Chen Timothy C. 
Published: October 2020

Introduction/Objectives: Weight gain concerns remain a barrier to tobacco cessation. Literature suggests that weight gain can occur after stopping tobacco, but continuing tobacco can have far worse outcomes. Limited information is available regarding weight gain in military personnel. The objective of this study was to evaluate weight change in veterans that stopped tobacco for a minimum of 12 months enrolled in a pharmacist managed telephone tobacco cessation clinic (PMTTCC). Methods: A retrospective analysis of veterans who had been tobacco-free for 12 months enrolled in a PMTTCC were included in this analysis. Primary outcomes were change in weight (kg) and body mass index (BMI) from baseline. Descriptive data were utilized where appropriate and paired t-tests were utilized for the primary outcomes. Results: Seventy-seven patients were screened and 10 were excluded. Sixty-seven veterans met inclusion criteria and were mostly male (91%, n = 61) and Caucasian (74.6%, n = 50). At 12 months post cessation, the mean weight gain was (1.81 kg ± 6.83, P = .03) and BMI (0.51 ± 2.23 kg/m2, P = .06). Conclusions: Veterans appeared to have minimal weight gain despite statistical significance and no statistical change with BMI after 12 months of being tobacco-free. Results suggest that the long-term weight gain is minimal, and a comprehensive tobacco cessation program can be helpful to improve weight outcomes.
Can We Agree What Skilled Mindfulness-Based Teaching Looks Like? Lessons From Studying the MBI:TAC
Authors: S Crane Rebecca , Hecht Frederick M , Brewer Judson , Griffith Gemma M , Hartogensis Wendy , Koerbel Lynn , Moran Patricia , Sansom Sophie , Yiangou Alison , Kuyken Willem 
Published: October 2020

Background The Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) is a widely used tool for assessing fidelity in mindfulness-based program (MBP) research and training. It also supports MBP teacher reflective and skill development. MBI:TAC assessors review MBP teaching and rate the teaching on 6 domains. The MBI:TAC yields individual domain and overall scores, using 6 levels of competence. Although the MBI:TAC is widely used in MBP research and training, research is at an early stage. Objective We developed and tested a method of training MBI:TAC assessors to use the tool reliably and examined interrater reliability of the tool. Methods A total of 31 international senior MBP teachers were recruited to join an online training to build their skills in using the MBI:TAC. The training systematically and iteratively built familiarity and skills in assessing the 6 MBI:TAC domains. Qualitative and quantitative data on trainee’s experience of the training were gathered. Interrater reliability in using the tool was tested each week of the training. At the end of the training, interrater reliability was tested by asking trainees to individually assess videos that they had not previously seen. Their ratings were compared to benchmark assessments, which had been established via consensus agreement between 4 expert users of the MBI:TAC. Results The training was well received and appreciated, with some challenges experienced in applying the assessment methodology. Participants’ ratings became progressively more in line with one another and the benchmark ratings during the training. At the end, interrater reliability was high (ranging from 0.67 to 1.0). Conclusion It is possible for senior MBP trainers, coming from different regions in the world, to align toward common understandings of the elements of MBP teaching competence and program integrity. An assessor training methodology was tested, and the learning from this project has led to refinements for future delivery.
A bibliometric analysis of multimorbidity from 2005 to 2019
Authors: Ahmed Mohamed Ali Ag , Almirall José , Ngangue Patrice , Poitras Marie-Eve , Fortin Martin 
Published: October 2020

Context: Multimorbidity is frequently seen in primary care. We aimed to identify and analyze publications on multimorbidity, including those that most influenced this field. Method: A bibliometric analysis of publications from 2005 to 2019 in the PubMed database containing “multimorbidity” or “multi-morbidity” identified with the tool iCite. We analyzed the number of publications, total citations, the article-level metric Relative Citation Ratio (RCR), type of study, and journals with the most cited articles. Results: The number of publications using “multimorbidity” has continuously increased since 2005 (2005–2009: 138; 2010–2014: 823; 2015–2019: 3068). The median number of total citations per article was 3. The median RCR was 1.04. Articles with RCR at or above the 97th percentile (RCR = 7.43) were analyzed in detail (n = 104). In 34 publications of this subgroup (33%), the word multimorbidity was used but was not the subject of study. The remaining top 70 publications included 32 observational studies, 22 reviews, five guideline statements, three analysis papers, two randomized trials, three qualitative studies, two measurement development reports, and one conceptual framework development report. The publications were produced by authors from 32 countries. They were published in 37 different journals, ranging from one to four articles in the same journal. Conclusions: We found a continuous increase in the number of publications about multimorbidity since 2005. However, our study suggests that the numbers should be considered only a general trend because multimorbidity was not the main subject in 33% of publications in a subgroup of 104 analyzed in detail.
Risk factors of dysphagia in patients with ossification of the anterior longitudinal ligament
Authors: Nishimura Hirosuke , Endo Kenji , Aihara Takato , Murata Kazuma , Suzuki Hidekazu , Matsuoka Yuji , Takamatsu Taichiro , Maekawa Asato , Sawaji Yasunobu , Tsuji Hanako , Yamamoto Kengo 
Published: October 2020

Introduction: Cervical ossification of the anterior longitudinal ligament (OALL) occasionally leads to dysphagia by the anterior osteophyte. A recent report explained that the dysphagia after an occipito-cervical fusion is caused by the narrowing of pharyngeal space due to the cranio-cervical malalignment. The purpose of this study was to evaluate the cranio-cervical alignment in patients with OALL complaining of the dysphagia. Subjects and methods: The subjects were 11 cases with complaining of dysphagia due to cervical OALL who underwent anterior cervical OALL resection and as control, age-matched 12 cases without dysphagia who have diffuse idiopathic skeletal hyperostosis in cervical spine. All subjects were male, and the mean age was 59.5 ± 9.1 years. The subjects were divided into two groups according to the symptoms of dysphagia (dysphagia, group A; control, group B). The O–C2 angle, C2–C7 angle, and the maximum thickness of OALL and the cranio-cervical alignment (pharyngeal inlet angle; PIA) and swallowing line (S-line) were measured before and after the operation on the lateral cervical radiogram at the sitting position. Results: Group A showed significantly large maximum thickness of OALL, small cervical range of motion, small O–C2 angle, large C2–C7 angle, and small PIA. The S-line crossed the anterior apex of cervical osteophyte in group A. After OALL resection, dysphagia had improved, PIA had increased, and the S-line uncrossed the apex of cervical vertebrae in all cases. Conclusion: The prevalence of dysphagia in patients with cervical OALL was influenced by the thickness of osteophyte, cervical mobility, and cranio-cervical alignment.
Prospective Frontal Plane Angles Used to Predict ACL Strain and Identify Those at High Risk for Sports-Related ACL Injury
Authors: Bates Nathaniel A. , Myer Gregory D. , Hale Rena F. , Schilaty Nathan D. , Hewett Timothy E. 
Published: October 2020

Background: Knee abduction moment during landing has been associated with anterior cruciate ligament (ACL) injury. However, accurately capturing this measurement is expensive and technically rigorous. Less complex variables that lend themselves to easier clinical integration are desirable. Purpose: To corroborate in vitro cadaveric simulation and in vivo knee abduction angles from landing tasks to allow for estimation of ACL strain in live participants during a landing task. Study Design: Descriptive laboratory study. Methods: A total of 205 female high school athletes previously underwent prospective 3-dimensional motion analysis and subsequent injury tracking. Differences in knee abduction angle between those who went on to develop ACL injury and healthy controls were assessed using Student t tests and receiver operating characteristic analysis. A total of 11 cadaveric specimens underwent mechanical impact simulation while instrumented to record ACL strain and knee abduction angle. Pearson correlation coefficients were calculated between these variables. The resultant linear regression model was used to estimate ACL strain in the 205 high school athletes based on their knee abduction angles. Results: Knee abduction angle was greater for athletes who went on to develop injury than for healthy controls ( P < .01). Knee abduction angle at initial contact predicted ACL injury status with 78% sensitivity and 83% specificity, with a threshold of 4.6° of knee abduction. ACL strain was significantly correlated with knee abduction angle during cadaveric simulation ( P < .01). Subsequent estimates of peak ACL strain in the high school athletes were greater for those who went on to injury (7.7-8.1% ± 1.5%) than for healthy controls (4.1-4.5% ± 3.6%) ( P < .01). Conclusion: Knee abduction angle exhibited comparable reliability with knee abduction moment for ACL injury risk identification. Cadaveric simulation data can be extrapolated to estimate in vivo ACL strain. Athletes who went on to ACL injury exhibited greater knee abduction and greater ACL strain than did healthy controls during landing. Clinical Relevance: These important associations between the in vivo and cadaveric environments allow clinicians to estimate peak ACL strain from observed knee abduction angles. Neuromuscular control of knee abduction angle during dynamic tasks is imperative for knee joint health. The present associations are an important step toward the establishment of a minimal clinically important difference value for ACL strain during landing.
Sleep and the Gut Microbiome in Psoriasis: Clinical Implications for Disease Progression and the Development of Cardiometabolic Comorbidities
Authors: Myers Bridget , Reddy Vidhatha , Brownstone Nicholas , Chan Stephanie , Thibodeaux Quinn , Chang Hsin-Wen , Bhutani Tina , Liao Wilson 
Published: October 2020

Background: Sleep dysfunction and sleep disorders are important comorbidities of psoriasis. Not only do these sleep comorbidities contribute to reduced quality of life, but they may also lead to worsening psoriasis and increased susceptibility to cardiometabolic diseases. While psoriasis and sleep dysfunction are thought to be linked by itch, depression, and immune system dysregulation, the relationship between psoriasis and sleep dysfunction is not yet fully understood. Objective: We sought to compare previous studies characterizing the gut microbiome in psoriasis and sleep dysfunction and examine the potential relevance of shared findings on cardiometabolic and overall health. Methods: We performed literature searches of PubMed and Embase databases to find studies evaluating the gut microbiome in psoriasis, sleep dysfunction, and cardiometabolic diseases. Results: Studies characterizing the gut microbiome in psoriasis and sleep dysfunction reveal shared findings, specifically an increased Firmicutes to Bacteroidetes ratio and reduced abundance of short-chain fatty acid–producing bacteria. These dysbiotic features have also been shown to promote systemic inflammation and cardiometabolic disease. Conclusion: In favoring an increased Firmicutes to Bacteroidetes ratio and reduced abundance of short-chain fatty acid–producing bacteria, sleep dysfunction could be contributing to worsening psoriasis and cardiometabolic comorbidities through intestinal dysbiosis. Future studies are needed to determine whether gut- and sleep-targeting interventions could be therapeutic in patients with psoriasis having poor sleep.
Development of Sexual Orientation Scale
Authors: Sagayaraj K. , Gopal C. N. Ram 
Published: October 2020

Background: Sexual orientation is a continuing amorous pattern of attraction toward the opposite sex (heterosexual), same sex (homosexual), or both sexes (bisexual) or it is lack of sexual desire toward anyone (asexual). Psychosocial and biological explanations regarding the development of an individual’s sexual orientation are related to life incidents, parenting patterns, psychological attributes of the individual, or may also be related to an imbalance in sex hormones. There is no strong evidence-based scientific research revealing the exact causes for one’s sexual orientation for it is not static but dynamic in nature. Aim: The purpose of the study is to develop a psychological assessment scale which identifies an individual’s sexual orientation, particularly when he/she denies to reveal his/her sexual preference in the marital life. Methodology: A tool with 32 items was developed by conducting focus group discussion, interviewing the experts in the relevant fields and reviewing the literature. Test-retest and split half reliability were established with Cronbach’s alpha to analyze the internal consistency. Both logical-based validity (face, content, and focus group) and empirical-based validity (criterion, concurrent, convergent, and divergent) were established. These methodologies were standardized by a sample of 506 participants (217 males and 289 females) between the age range of 18 and 50 years. Results: The test-retest reliability was found to be r = 0.96, Spearman-Brown and Guttman split half reliability was 0.73, and Cronbach’s alpha ranged from (α) 0.71 to 0.88. Implications: This scale would be beneficial for premarital counselors and mental health professionals to understand the sexual orientation of their clients explicitly.
Naive T-cell depletion in stem cell transplantation
Authors: Bleakley Marie 
Published: October 2020

Abstract
Allogeneic hematopoietic stem cell transplantation (HCT) is curative in many patients with advanced hematopoietic malignancies. Donor T cells not only facilitate engraftment and protect against opportunistic pathogens and residual disease, but can also cause graft-versus-host disease (GVHD), with significant morbidity and mortality. Complete T-cell depletion can not only substantially reduce GVHD rates but can also delay immune reconstitution and increase rates of opportunistic infections and relapse. Murine models have shown that naive T cells (TNs) consistently cause severe GVHD, whereas memory T cells cause milder or no GVHD and have critical graft-versus-tumor function. Informed by experiments performed in murine models of HCT, clinical trials are being conducted to evaluate TN-depleted peripheral blood stem cell (PBSC) grafts. These trials are showing very low rates of chronic GVHD and of serious acute GVHD in the HLA-matched HCT setting, with lower frequencies of opportunistic infections than after fully T-cell–depleted HCT and no apparent increase in relapse rates. Randomized clinical trials are ongoing, comparing standard unselected HCT with TN-depleted PBSCs and other promising GVHD-reduction strategies. Correlative laboratory studies will clarify how antitumor function is retained in TN-depleted HCT and inform strategies to further augment graft-versus-leukemia in patients at a high risk of relapse. TN depletion of donor lymphocyte infusions and of haploidentical stem cell grafts is also being investigated.
Comparison between traditional and nontraditional add-on devices used with pressurised metered-dose inhalers
Authors: Nicola Mina , Soliman Youssef M.A. , Hussein Raghda , Saeed Haitham , Abdelrahim Mohamed 
Published: October 2020

Add-on devices that are attached to metered-dose inhalers (MDIs) were introduced to improve aerosol delivery. The objective of this study was to determine the efficacy of drug delivery from an MDI when attached to different add-on devices at different inhalation volumes.The total emitted dose (TED) of salbutamol was estimated for the MDI alone and the MDI connected to five different add-on devices (Able valved holding chamber, Tips-haler valved holding chamber, Aerochamber plus flow Vu valved holding chamber, Dolphin chamber, and a handmade water bottle spacer), at inhalation flow of 28.3 L·min−1with flow volume of 1, 2 and 4 L, assuming young child (aged <6 years), old child (>6 years) and adult inhalation volumes, respectively.The TED% ranged between 84.1% and 87.2% at all inhalation volumes from the MDI alone, which was significantly greater than all MDI add-on device combinations (p<0.05). The TED% delivered to MDI sampling apparatus by a homemade water bottle spacer and Dolphin chamber, as non-antistatic add-on devices, ranged between 30.5% and 35.3%. However, washing these non-antistatic add-on devices with a light detergent before use improved their TED to range between 47.6% and 51.2%. Non-antistatic add-on devices had significantly lower TED (p<0.05) than that delivered by most antistatic add-on devices, which ranged from 51.3% to 71.6%.This study suggests that antistatic add-on devices delivered much more aerosol than non-antistatic add-on devices. However, it may be advised to still use a non-antistatic add-on device, for the sake of solving the coordination problem, and wash it with light detergent before use to improve TED.