bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parent‐Reported Outcome Questionnaire for Swallowing Dysfunction in Healthy Infants and Toddlers: Construction and Content Validation
Authors: Baqays Abdulsalam , Johannsen Wendy , Rashid Marghalara , Jaffal Hussein , Hicks Anne , Jeffery Caroline , Seikaly Hadi , El‐Hakim Hamdy 
Published: December 2020

ObjectivesThere is limited epidemiological information on swallowing dysfunction (SwD) in otherwise healthy infants and toddlers (OHITs). Cost, invasiveness, expertise, and resources constrain the repeatability and utility of instrumental diagnostic tests. A parent‐reported outcomes (PRO) tool has the potential to mitigate these disadvantages. Hence, we set out to develop and validate a novel PRO tool to assess SwD in OHITs.Study DesignA mixed‐method study.SettingTertiary pediatric center.MethodsWe recruited parents of OHITs with SwD and excluded those with a confounding diagnosis (syndromes or neurological impairment). Interviews were conducted and thematically analyzed to extract the relevant domains and items. A similar analytical method was performed on the reports from a systematic review and literature search. Four verification sessions of parents and experts were conducted to maintain rigor. A panel of experts assessed and established the content validity of the items using a modified Delphi technique.ResultsWe achieved information saturation after interviewing 10 parents and generated 7 domains with 72 items. Over the course of 3 rounds of modified Delphi content validation, the domains were reduced to 3 (swallowing, breathing, and illness) containing 21 items; a content validity index of 82.1% was achieved.ConclusionWe validated the content of a new PRO instrument to assess SwD in OHITs. The instrument is composed of 3 primary domains representing 21 items. This tool has the potential to screen for swallowing dysfunction and can assess management outcomes specifically for this population at a community level.
Effects of Fractional CO2 Laser Treatment on Subglottic Scar in a Rabbit Model
Authors: Marvin Kastley , Schwartz Isaac , Utz Edward , Wilson Justin , Johnson Christopher , Gaudreau Philip 
Published: December 2020

ObjectiveThe objective of this study was to investigate the effects of fractional CO2 laser on subglottic scar.Study DesignRandomized controlled animal study.SettingAcademic medical center.MethodsSubglottic scar was induced in 12 New Zealand white rabbits via an endoscopic brush technique. This was followed by an open airway surgery that included vertical division of the cricoid and proximal trachea. Eight rabbits underwent fractional CO2 laser treatment of the scar via a Lumenis Ultrapulse Deep FX handpiece. Four rabbits underwent the open surgical approach without laser treatment. Bronchoscopy was performed at weeks 1, 2, 4, and 8. The animals were euthanized and laryngotracheal complexes harvested 12 weeks postsurgery. Immunohistochemistry was performed to determine the collagen composition of treated and untreated scars.ResultsAll 12 subjects survived to the study endpoint with no significant respiratory complications, despite 10 of 12 developing some degree of lateral tracheal narrowing. The median ratio of type I collagen to type III collagen in the laser group (1.57) was significantly more favorable than that of the untreated group (2.84; P =. 03).ConclusionTreatment with fractional CO2 laser appears to have similar effects on subglottic scars as with cutaneous scars, improving the ratio of type I to type III collagen. Additionally, we developed an open airway approach in the rabbit model to deliver fractional CO2 laser treatment to the subglottis without introducing respiratory complications or compromising survival.
A methodological evaluation of the published consensus statements, recommendations and guidelines about surgical management in the course of coronavirus disease pandemic
Authors: Bertolaccini Luca , Iacono Giorgio Lo , Mazzella Antonio , Prisciandaro Elena , Sedda Giulia , Spaggiari Lorenzo 
Published: December 2020

Background A project to benchmark the consensus statements, guidelines, and recommendations on surgical management in the course of the COVID-19 pandemic was developed to assess the methodology used. Standard and practical approaches for COVID-19 management in surgical patients to date are not accessible, despite the magnitude of the pandemic. A plethora of consensus statements, guidelines, and recommendations on surgical management in the course of COVID-19 epidemic have been rapidly published in the last three months. Methods Each manuscript was scored on a seven-point scale in the different items and domains with the Appraisal of Guidelines for Research and Evaluation II. Results Nine guidelines that met the inclusion criteria were assessed. Transnational cooperation produced only one guideline. Multivariable analysis showed that improved scores of stakeholders’ involvement were related to internationally developed guidelines. Clarity of presentation was related to the contribution of scientific societies due to greater rigor of development. The rigor of development produced guidelines with a high overall value. Higher healthcare expenses did not produce superior guidelines. Conclusions Evaluated by the Appraisal of Guidelines for Research and Evaluation II, the methodological characteristic of consensus statements, guidelines, and recommendations on surgical management during COVID-19 pandemic was relatively low. International development should be recommended as a model for the development of best methodological quality guidelines.
Dyadic trust as a mediator in the association between posttraumatic stress symptoms and relationship distress in community couples
Authors: Barden Eileen P. , Wang Binghuang A. , Sternberg Julia A. , Poole Leanna Z. , Balderrama-Durbin Christina M. 
Published: December 2020

Background: Trust is an important component in romantic relationships. However, posttraumatic stress symptoms (PTSS) can alter an individual’s appraisal of others resulting in difficulties with interpersonal trust. Indeed, prior literature has established associations between PTSS and trust, and relations between trust and relationship distress. Even so, there is a dearth of research examining the association between PTSS and trust specifically within ones’ romantic relationship as well as how dyadic trust may help explain the relation between PTSS and overall relationship distress. Method: This study examined a sample of 57 opposite-sex adult community couples where at least one partner had a lifetime history of trauma-exposure. Mediated actor-partner interdependence modeling (APIMeM) examined the intraindividual and interpersonal pathways in the association between PTSS and relationship distress as well as potential sex differences. Results: Findings demonstrated actor and partner effects between dyadic trust and relationship distress; however, males’ dyadic trust was only marginally associated with their female partners’ relationship distress. Sex differences were demonstrated in the relation between PTSS and dyadic trust whereby females’ dyadic trust was related to their own and their partners’ PTSS. There was a partner effect between females’ PTSS on their male partners’ relationship distress but not from males’ PTSS to females’ relationship distress. Finally, females’ dyadic trust was supported as a full mediator between PTSS and relationship distress for all pathways in the model. Conclusion: There is a unique effect of females’ dyadic trust on the relation of PTSS and relationship distress. Future directions and clinical implications are discussed.
Effects of repeated adolescent exposure to cannabis smoke on cognitive outcomes in adulthood
Authors: Hernandez Caesar M , Orsini Caitlin A , Blaes Shelby L , Bizon Jennifer L , Febo Marcelo , Bruijnzeel Adriaan W , Setlow Barry 
Published: December 2020

Background: Cannabis (marijuana) is the most widely used illicit drug in the USA, and consumption among adolescents is rising. Some animal studies show that adolescent exposure to delta 9-tetrahydrocannabinol or synthetic cannabinoid receptor 1 agonists causes alterations in affect and cognition that can persist into adulthood. It is less clear, however, whether similar alterations result from exposure to cannabis via smoke inhalation, which remains the most frequent route of administration in humans. Aims: To begin to address these questions, a rat model was used to determine how cannabis smoke exposure during adolescence affects behavioral and cognitive outcomes in adulthood. Methods: Adolescent male Long-Evans rats were assigned to clean air, placebo smoke, or cannabis smoke groups. Clean air or smoke exposure sessions were conducted daily during adolescence (from P29–P49 days of age ) for a total of 21 days, and behavioral testing began on P70. Results: Compared to clean air and placebo smoke conditions, cannabis smoke significantly attenuated the normal developmental increase in body weight, but had no effects on several measures of either affect/motivation (open field activity, elevated plus maze, instrumental responding under a progressive ratio schedule of reinforcement) or cognition (set shifting, reversal learning, intertemporal choice). Surprisingly, however, in comparison to clean air controls rats exposed to either cannabis or placebo smoke in adolescence exhibited enhanced performance on a delayed response working memory task. Conclusions: These findings are consistent with a growing body of evidence for limited long-term adverse cognitive and affective consequences of adolescent exposure to relatively low levels of cannabinoids.
Nitric oxide-mediated defensive and antinociceptive responses organised at the anterior hypothalamus of mice are modulated by glutamatergic inputs from area 24b of the cingulate cortex
Authors: Falconi-Sobrinho Luiz Luciano , dos Anjos-Garcia Tayllon , Coimbra Norberto Cysne 
Published: December 2020

Background: Previous studies suggested that Cg1 area of the cingulate cortex of rats controls glutamate-mediated fear-induced defensive behaviour and antinociception organised at the posterior hypothalamus. In turn, microinjection of the nitric oxide donor SIN-1 into the anterior hypothalamus of mice produced defensive behaviours and fear-induced antinociception. However, it remains unknown whether Cg1 also modulates the latter mechanisms in mice. Aims: The present study examined the influence of Cg1 on SIN1-evoked fear-induced defensive behaviour and antinociception organised at the anterior hypothalamus of mice. Methods: The fear-like behavioural and antinociceptive responses to the microinjection of SIN-1 (300 nmol) into the anterior hypothalamus were evaluated after the microinjection of either N-methyl-D-aspartic acid receptor agonist (0.1, 1 and 10 nmol) or physiological saline into the cingulate cortex of C57BL/6 male mice. In addition, neurotracing and immunohistochemistry were used to characterise Cg1-anterior hypothalamus glutamatergic pathways. Results: The data showed that activation of Cg1 N-methyl-D-aspartic acid receptors increased escape while reducing freezing and antinociceptive responses to SIN-1 microinjections into the anterior hypothalamus. Anterograde neural tract tracer co-localised with VGLUT2-labelled fibres suggests these responses are mediated by glutamatergic synapses at the anterior hypothalamus. Conclusions: In contrast with previous studies showing that Cg1 facilitates both escape and antinociception to chemical stimulation of the posterior hypothalamus in rats, the present data suggest that Cg1 facilitates escape while inhibiting defensive antinociception produced by the microinjection of SIN-1 in the anterior hypothalamus of mice. Accordingly, Cg1 may have opposite effects on antinociceptive responses organised in the anterior and posterior hypothalamus of mice and rats, respectively.
Distribution of pressure on the breast in mammography using flexible and rigid compression plates: implications on patient handling
Authors: Dustler Magnus , Förnvik Daniel , Timberg Pontus , Zackrisson Sophia , Muller Serge 
Published: December 2020

Background Breast compression in mammography is important but is a source of discomfort and has been linked to screening non-attendance. Reducing compression has little effect on breast thickness, and likely little effect on image quality, due to force being absorbed in the stiff juxta thoracic area instead of in the central breast. Purpose To investigate whether a flexible compression plate can redistribute force to the central breast and whether this affects perceived pain. Material and Methods Twenty-eight women recalled from mammography screening were compressed with flexible and rigid plates while retaining force and positioning, 15 in the craniocaudal (CC) view and 13 in the mediolateral oblique (MLO) view. Pressure distribution was continuously measured using pressure sensors. Results The flexible plate showed greater mean breast pressure in both views: 2.8 versus 2.3 kPa for CC (confidence interval [CI] = 0.2–0.8) and 1.0 versus 0.5 kPa for MLO (CI = 0.2–0.6). The percentage of applied force distributed to the breast was significantly higher with the flexible plate, both on CC (36% vs. 22%, CI = 1–11) and MLO (30% vs. 14%, CI = 4–13). Conclusion The flexible plate redistributes pressure to the central breast, achieving a better compression, particularly in the MLO view, though much applied force is still applied to the juxta thoracic region.
Expression patterns and prognostic values of the cyclin-dependent kinase 1 and cyclin A2 gene cluster in pancreatic adenocarcinoma
Authors: Jiang Peng , Zhang Ming , Gui Liangliang , Zhang Kai 
Published: December 2020

Objective Pancreatic adenocarcinoma (PAAD) is one of the most lethal malignant tumors worldwide. Various studies based on cell lines, preclinical mouse models, and human tissue samples have shown that cell cycle-associated proteins are involved in the tumorigenesis and progression of PAAD. Methods Herein, we analyzed the relationships between CDK1 and CCNA2 gene expression and prognosis in patients with pancreatic cancer, using information from the Oncomine, cBioportal, Kaplan–Meier Plotter, and GEPIA databases. Results Expression levels of CDK1 and CCNA2 were significantly higher in PAAD compared with control tissues, and were associated with more advanced tumor stage. Survival analyses using the Kaplan–Meier Plotter database further confirmed that increased expression levels of CDK1 and CCNA2 were associated with a poor prognosis in patients with pancreatic cancer. Conclusions The results of this study suggest that CDK1 and CCNA2 may be potential therapeutic targets and prognostic biomarkers in patients with PAAD.
Risk factors for residual dizziness in patients successfully treated for unilateral benign posterior semicircular canal paroxysmal positional vertigo
Authors: Jiang Xiuwen , He Lina , Gai Yinzhe , Jia Chengfang , Li Wenya , Hu Sunhong , Tang Jianguo , Cao Liping 
Published: December 2020

Objective The risk factors for residual dizziness (RD) after successful treatment of benign paroxysmal positional vertigo (BPPV) are poorly characterized. We determined the risk factors for RD in patients with benign unilateral posterior semicircular canal paroxysmal positional vertigo (pc-BPPV) after successful treatment. Methods We conducted a prospective study of patients diagnosed with unilateral pc-BPPV between March 2015 and January 2017. Bone mineral density (BMD) was measured by dual-energy X-ray bone mineral densitometry. Participants underwent bithermal caloric testing (C-test) using videonystagmography and a canalith repositioning procedure (CRP). The occurrence of RD was the primary outcome. The participants underwent follow-up 1 week, 1 month, and 1 year after successful CRP, consisting of outpatient visits, questionnaires, and telephone interviews. Results We assessed 115 participants with unilateral pc-BPPV (31 men and 84 women) who were 53.2 ± 8.8 years old. RD occurred in 60 (52.2%) participants. The participants who experienced RD were older, had vertigo for longer before treatment, and were more likely to show a positive C-test and significant BMD loss. Conclusions We found that a significant reduction in BMD (T-score  < −1 standard deviation), a positive C-test, and older age are independently associated with RD in patients with pc-BPPV after successful CRP.
Risk factors for tumor recurrence in patients with pT3N0M0 thoracic esophageal squamous cell carcinoma after esophagectomy
Authors: Feng Wei , Qi Zhan , Qiu Rong , Li Zhen-Sheng , Dong Shi-Lei , Li Yue-Kao , Hu Yuan-Ping , He Ming , Wang Yu-Xiang 
Published: December 2020

Objective To analyze the factors contributing to recurrence in patients with pT3N0M0 thoracic esophageal squamous cell carcinoma (ESCC). Methods Patients with pT3N0M0 thoracic ESCC who underwent esophagectomy from January 2008 to December 2012 were included retrospectively. The last date of follow-up was 1 December 2016. Multivariate proportional hazard Cox models were used to identify factors associated with total (i.e., any) recurrence (TR), locoregional recurrence (LR), and distant metastasis (DM). Results A total of 692 patients were included. The median follow-up was 53 months (range: 3–107). The 3- and 5-year TR, LR, and DM rates were 35.8% and 41.0%, 28.7% and 32.1%, and 16.8% and 21.1%, respectively. The Cox analyses showed that the tumor location, number of dissected lymph nodes, and postoperative therapies were significantly associated with LR. The subgroup analysis showed that postoperative therapies could significantly decrease LR in the mediastinum but not in the neck and upper abdomen regions. Conclusions The recurrence rate of pT3N0M0 thoracic ESCC patients was high, especially for LR in the mediastinum. Postoperative therapies can significantly reduce the incidence of mediastinal recurrence.
Nicotine: A Targeted Therapy for Epilepsy Due to nAChR Gene Variants
Authors: Fox Jordana , Thodeson Drew M. , Dolce Alison M. 
Published: December 2020

Objective: Genetic variants of the neuronal nicotinic acetylcholine receptor (nAChR) cause autosomal dominant sleep-related hypermotor epilepsy. Approximately 30% of autosomal dominant sleep-related hypermotor epilepsy patients are medically intractable. In preclinical models, pathogenic nAChR variants cause a gain of function mutation with sensitivity to acetylcholine antagonists and agonists. Nicotine modifies the activity of nAChRs and can be used as targeted therapy. Methods: We reviewed next-generation sequencing epilepsy panels from a single laboratory (GeneDx) from patients at Children’s Medical Center Dallas between 2011 and 2015 and identified patients with nAChR variants. Retrospective review of records included variant details, medical history, neuroimaging findings, and treatment history. Results: Twenty-one patients were identified. Four patients were prescribed nicotine patches for intractable seizures. Three of 4 patients had a clinical response, with >50% seizure reduction. Conclusions: Treatment with a nicotine patch can be an effective therapy in epilepsy patients with nAChR gene variants. We propose consideration of transdermal nicotine treatment in intractable epilepsy with known nAChR variants as an experimental therapy. Further clinical trials are needed to fully define therapeutic effects.
Topical capsaicin versus topical ibuprofen in acute musculoskeletal injuries: A randomized, double-blind trial
Authors: Akgol Gur Sultan Tuna , Dogruyol Sinem , Kocak Abdullah Osman , Sanalp Menekse Tugba , Akbas Ilker , Betos Kocak Meryem , Cakir Zeynep 
Published: December 2020

Background: Acute musculoskeletal pain is one of the common causes of emergency admissions. Topical analgesics are an easily tolerated option in the treatment of these pains. Objective: This study aimed to compare the efficacy of topical capsaicin and topical non-steroidal anti-inflammatory drugs in acute musculoskeletal injuries. Methods: In this prospective, randomized, controlled, double-blinded study, patients were allocated to two groups—the topical non-steroidal anti-inflammatory drug (n = 60) and topical capsaicin (n = 59). For both groups, the first dose treatment was applied as a thin layer in the emergency department to a maximum area of 5 × 5 cm. The remaining doses were administered at home by the patients for 72 h. The initial visual analog scale scores were compared with the 60th and 120th minute as well as the 24th and 72nd hour values. Differences between the visual analog scale scores, clinical response to the treatment, and side effects were evaluated. Results: The proportional reduction in visual analog scale scores for topical capsaicin was significantly higher, especially at 36 and 72 h. These rates were 0.75 (95% confidence interval: 0.77–1.42; p = 0.029) and 9.08 (95% confidence interval: 1.02–17.14; p = 0.028) at 36 h, respectively. At 72 h, they were 1.27 (95% confidence interval: 0.48–2.05; p = 0.002) and 17.07 (95% confidence interval: 8.39–25.76; p < 0.001), respectively. In the topical capsaicin group, the clinical response to treatment was significantly higher (p = 0.001). Treatment-related systemic side effects were experienced only in the topical non-steroidal anti-inflammatory drug group (1.7%). Conclusion: Topical capsaicin can be used safely in patients presenting to the emergency department with acute pain with its high analgesic efficacy and absence of systemic side effects.
Life in 90 words: opportunities for person-centred care amidst COVID-19
Authors: Theodoros Theo , Wyder Marianne , Lombardo Chiara , Dark Frances , Joseph Anup M , Steginga Anne , Locke Sharon , Kinsella Kieran , Kar Ray Manaan 
Published: December 2020

Objective: Coronavirus disease 2019 and the consequent public health and social distancing measures significantly impacted on service continuity for mental health patients. This article reports on contingency planning initiative in the Australian public sector. Methods: Ninety-word care synopses were developed for each patient. These formed the basis for guided conversations between case managers and consultant psychiatrists to ensure safe service provision and retain a person-centred focus amidst the threat of major staffing shortfalls. Results: This process identified vulnerable patient groups with specific communication needs and those most at risk through service contraction. The challenges and opportunities for promoting safety and self-management through proactive telehealth came up repeatedly. The guided conversations also raised awareness of the shared experience between patients and professionals of coronavirus disease 2019. Conclusion: There is a parallel pandemic of anxiety which creates a unique opportunity to connect at a human level.