bluuebunny/crossref_metadata_2025_split huggingface dataset:
Consumer Use of Provider Quality Report Cards
Authors: Bhandari Neeraj , Scanlon Dennis P. , Shi Yunfeng , Smith Rachel A. 
Published: December 2019

Objective:
The objective of this study was to measure the dissemination of comparative provider quality information (CPQI) and evaluate its impact on consumers’ awareness and use of CPQI.

Data Sources:
Two-period, random-digit-dial panel survey of chronically ill consumers residing in 14 regions of the United States; summaries of CPQI dissemination activities of regional multistakeholder alliances; and the LexisNexis Academic and Access World News databases.

Study Design/Methods:
Fixed effects regression to isolate the effect of CPQI producers’ dissemination activities and the print media’s CPQI coverage on chronically ill consumers’ self-reported awareness and use of CPQI.

Principal Findings:
Direct CPQI dissemination had no overall effect on either awareness or use of CPQI. One unit increase in the media coverage of an Aligning Forces for Quality (AF4Q) multistakeholder alliance report increased consumer awareness and use of CPQI by 1.4 percentage points (P=0.049) and 1.1 percentage points (P=0.009), respectively. Similar increases for the Centers for Medicare and Medicaid Services (CMS) CPQI and for the nonalliance, non-CMS CPQI improved CPQI use by 1.6 percentage points (P<0.001) and 0.2 percentage points (P=0.041), respectively.

Conclusion:
Even though CPQI producers’ direct dissemination efforts had little impact, the small but significant consumer impacts of CPQI’s limited press coverage suggests that limited use of media in the dissemination of report cards may be a significant factor behind low consumer awareness and use.
Activities of Intellectual Disability Clinical Nurse Specialists in Ireland
Authors: Doody Owen , Slevin Eamonn , Taggart Laurence 
Published: December 2019

Purpose/Aim:
The aim of this study was to identify the contribution of Irish intellectual disability clinical nurse specialists (ID CNSs) to service delivery.

Design:
A nonexperimental descriptive design was selected to survey ID CNSs presently working in Ireland. The questionnaire was developed based on focus group interviews, available literature, and expert panel views.

Methods:
Ethical approval and access were granted to all ID CNSs in Ireland. Thirty-two responded (33.68% response rate) from all work areas (voluntary organizations or health service executive) practicing within residential, community, or school services. Respondents were surveyed across a range of areas (demographic details and support to client, staff, family, organization, community, other agencies, and professional development).

Results:
Findings identify that ID CNSs are active in all aspects of their roles as clinical specialist, educator, communicator, researcher, change agent, and leader, thus supporting person-centered care and improving service delivery.

Conclusions:
To meet changing healthcare demands, promote person-centered care, and improve service delivery, the CNS role in ID should be developed and supported. The findings merit a further study on ID CNS role activity, possible variables influencing role activity, and team members' views.
Development and Pilot Implementation of a Search Protocol to Improve Patient Safety on a Psychiatric Inpatient Unit
Authors: Abela-Dimech Frances , Johnston Kim , Strudwick Gillian 
Published: December 2019

Purpose/Objective:
A mental health organization in Ontario, Canada, noted an increase in unsafe items entering locked inpatient units. The purpose of this project was to develop and implement a search protocol to improve patient, staff, and visitor safety by preventing unsafe items from entering a locked inpatient unit.

Description of the Project:
Under the guidance of a clinical nurse specialist, an interprofessional team used the Failure Mode and Effects Analysis framework to identify what items were considered unsafe, how these unsafe items were entering the unit, and what strategies could be used to prevent these items from entering the unit. A standardized search protocol was identified as a strategy to prevent items from entering the unit.

Outcome:
The standardized search protocol was developed and piloted on 1 unit. To support the search protocol, an interprofessional team created a poster using a mnemonic aid to educate patients, staff, and visitors about which items could not be brought onto the unit. Educational sessions on the search protocol were provided for staff. The difference between the number of incidents before and after the implementation of the search protocol was statistically significant.

Conclusions:
Safety on an inpatient unit was increased as incidents of unsafe items entering the unit decreased.
Age does not affect sex effect of conditioned pain modulation of pressure and thermal pain across 2 conditioning stimuli
Authors: Riley Joseph L. , Cruz-Almeida Yenisel , Staud Roland , Fillingim Roger B. 
Published: December 2019

Abstract

Introduction:
Conditioned pain modulation (CPM) is a laboratory test resulting in pain inhibition through activation of descending inhibitory mechanisms. Older adults consistently demonstrate reduced CPM compared with younger samples; however, studies of sex differences in younger cohorts have shown mixed results.

Objectives:
This study tested for sex differences in CPM within samples of younger and older adults.

Methods:
Participants were 67 younger adults (mean age = 25.4 years) and 50 older adults (66.4 years). Study conditioning paradigms were the cold-pressor test and contact heat pain administered in separate sessions. Pressure pain threshold and ramping suprathreshold heat were the test stimuli across three time points after presentation of the conditioning stimuli (CS).

Results:
Significant inhibition was observed during both testing sessions. The hypothesis for sex differences across both age cohorts was supported only for ∆PPTh. However, sex differences did not reach significance for either paradigm using ascending suprathreshold heat as the test stimuli. The overall trend was that younger males experienced the strongest CPM and older females the weakest. From a methodological perspective, duration differences were seen in CPM, with inhibition decaying more quickly for PPTh than for suprathreshold heat pain. Furthermore, there were no differences in inhibition induced by cold-pressor test and contact heat pain as CS.

Conclusion:
Sex differences were similar across both age cohorts with males experiencing greater inhibition than females. Cross-sectional associations were also demonstrated between CPM inhibition and measures of recent pain, further supporting CPM as an experimental model with clinical utility.
Mouth Corner Lift with Botulinum Toxin Type A and Hyaluronic Acid Filler
Authors: Jeong Tae-Kwang 
Published: December 2019

Summary:
An upturned mouth corner is associated with brightness, optimism, and friendliness, whereas a downturned mouth corner not only conveys negative feelings such as sadness, depression, and tiredness, but also makes a person appear years older than they are. Surgical approaches to the correction of a downturned mouth corner can result in predictable and long-lasting results. However, because of their fear of postsurgical scars and long downtimes, many patients are reluctant to undergo surgery involving the mouth corner. As a consequence, minimally invasive procedures have become increasingly popular in recent years. Among these, botulinum toxin type A and injectable fillers play a significant role. The author uses botulinum toxin type A and hyaluronic acid filler injections as complementary procedures for lifting flat or downturned mouth corners in young patients. This method has produced reliable and consistent outcomes without severe complications such as necrosis or infection in over 100 patients, as reflected in high patient satisfaction. The combination of botulinum toxin type A and hyaluronic acid filler provides excellent results in young patients who desire an uplifted mouth corner and are reluctant to undergo surgery.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, V.
Comparison of the Wide-Awake Approach and Conventional Approach in Extensor Indicis Proprius–to–Extensor Pollicis Longus Tendon Transfer for Chronic Extensor Pollicis Longus Rupture
Authors: Hong JungJun , Kang Ho-Jung , Whang Jong-ick , Sung Seung-Yong , Kim Sung-Hoon , Shin Sung-Chul , Kim Si-Nae , Kim Ji-Sup 
Published: December 2019

Background:
The wide-awake approach enables surgeons to perform optimal tensioning of a transferred tendon intraoperatively. The authors hypothesized that the extensor indicis proprius–to–extensor pollicis longus tendon transfer using the wide-awake approach would yield better results than conventional surgery.

Methods:
A retrospective analysis was performed of the prospectively collected data of 29 consecutive patients who underwent extensor indicis proprius–to–extensor pollicis longus tendon transfer. Patients were treated with the wide-awake approach (group A, n = 11) and conventional surgery under general anesthesia (group B, n = 18). The groups were compared retrospectively for thumb interphalangeal and metacarpophalangeal joint motion, grip and pinch strength, specific extensor indicis proprius–to–extensor pollicis longus evaluation method (SEEM), and Disabilities of the Arm, Shoulder and Hand questionnaire score at 6 weeks and 2, 4, 6, and 12 months postoperatively.

Results:
Group A showed significantly better interphalangeal joint flexion and total arc of motion at 6 weeks and 2, 4, and 6 months, and significantly better metacarpophalangeal joint flexion and total arc of motion at all time points. Interphalangeal and metacarpophalangeal joint extension showed no difference at all time points. Group A showed significantly better specific extensor indicis proprius–to–extensor pollicis longus evaluation method scores at 2 and 4 months, and Disabilities of the Arm, Shoulder and Hand questionnaire scores at 4, 6, and 12 months. Grip and pinch strength showed no difference at all time points. The complication rate and duration until return to work were not different between groups.

Conclusion:
Compared with the conventional approach, the wide-awake approach showed significantly better results in the thumb’s range of motion and functional outcomes, especially in the early postoperative periods.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Effect of Long-Term Retention of Gadolinium on Metabolism of Deep Cerebellar Nuclei After Repeated Injections of Gadodiamide in Rats
Authors: El Hamrani Dounia , Vives Véronique , Buchholz Rebecca , Même William , Factor Cecile , Fingerhut Stefanie , Sperling Michael , Karst Uwe , Robert Philippe , Même Sandra 
Published: December 2019

Objectives
The aim of this study was to determine potential metabolism and histological modifications due to gadolinium retention within deep cerebellar nuclei (DCN) after linear gadolinium-based contrast agent injection (gadodiamide) in rats at 1 year after the last injection.

Materials and Methods
Twenty female rats received 20 doses of gadodiamide (0.6 mmol of gadolinium per kilogram each) over 5 weeks. They were followed at 1 week (M0), 6 weeks (M1), and 54 to 55 weeks (M13) postinjections to evaluate hypersignal on unenhanced T1-weighted magnetic resonance imaging and metabolic alterations by 1H magnetic resonance spectroscopy (1H-MRS). At 1 year postinjections, brains were sampled to determine the localization of gadolinium within cerebellum by laser ablation inductively coupled mass spectroscopy and to evaluate morphological changes by semiquantitative immunofluorescence analysis.

Results
There is a significant increase of the ratio DCN/brainstem for the gadodiamide group at M0 (+7.2% vs control group = 0.989 ± 0.01), M1 (+7.6% vs control group = 1.002 ± 0.018), and it lasted up to M13 (+4.7% vs control group = 0.9862 ± 0.008). No variation among metabolic markers (cellular homeostasis [creatine, choline, taurine], excitatory neurotransmitter [glutamate], and metabolites specific to a cellular compartment [N-acetyl aspartate for neurons and myo-inositol for glial cells]) were detected by 1H-MRS between gadodiamide and saline groups at M0, M1, and M13. At M13, laser ablation inductively coupled mass spectroscopy demonstrated that long-term gadolinium retention occurred preferentially in DCN. No histological abnormalities (including analysis of astrocytes, neurons, and microglial cells) were found in the rostral part of DCN.

Conclusions
Repeated administration of gadodiamide lead to a retention of gadolinium preferentially within DCN at 1 year postinjections. This retention did not lead to any detectable changes of the measured metabolic biomarkers nor histological alterations.
Randomized and Comparative Clinical Trial of Bovine Mesh Versus Polypropylene Mesh in the Repair of Inguinal Hernias
Authors: Sun Li , Chen Jie , Li Juan , Shen Yingmo 
Published: December 2019

Background:
The type of mesh (synthetic vs. biological) play integral roles in the recovery and long-term outcomes of patients undergoing hernia repair. The aim of this study was to determine whether a biological mesh from bovine pericardium is equivalent to a standard polypropylene mesh in an open inguinal hernia repair using the Lichtenstein technique.

Materials and Methods:
A prospective, randomized, double-blinded, single-center trial was conducted to evaluate the safety and efficacy of a biological mesh compared with a commonly used polypropylene mesh using Lichtenstein’s inguinal hernia repair in a 6-month study. Patients were evaluated for recurrence and complications by a blinded surgeon at 1 day, 1 week, 1 month, 3 months, and 6 months after surgery.

Results:
A total of 132 patients were randomized into experimental group receiving the bovine mesh (n=66) and control group receiving the standard polypropylene mesh (n=66). No recurrences were diagnosed in both arms within 6-month follow-up. Patients in the experimental group reported markedly less groin pain during the 3-month postoperative assessment period compared with the control group. There were no statistically significant differences in other complications, such as incision inflammation, physical limitation, testicular problems, and foreign body sensation, between the 2 groups.

Conclusions:
Biological mesh is safe and effective in repairing inguinal hernia, with comparable intraoperative and early postoperative morbidity to the synthetic mesh.
Role of Endoanal Ultrasonography in Grading Anal Sphincter Integrity in Rectal Prolapse and in Predicting Improvement in the Continence State After Surgical Treatment
Authors: Emile Sameh H. , Youssef Mohamed , Thabet Waleed , Omar Waleed , Khafagy Wael , Farid Mohamed , Abdelnaby Mahmoud 
Published: December 2019

Background:
Rectal prolapse can be associated with fecal incontinence (FI) that may not completely resolve after surgical treatment. We aimed to examine the utility of endoanal ultrasonography (EAUS) in identifying the pattern of anal sphincter injury in rectal prolapse and in predicting the improvement in continence state after surgical treatment.

Methods:
Records of patients of rectal prolapse who underwent surgical treatment and were evaluated with EAUS before surgery were screened. According to the degree of anal sphincter injury preoperative EAUS, 4 grades of anal sphincter injury were recognized (0 to III). The preoperative patient characteristics and outcome of surgery in each group were compared.

Results:
Fifty-nine patients (33 male), mean age 36.2 years, were included in the study. Forty-four (74.5%) patients complained of FI preoperatively. There were 12 (20.3%) patients with grade 0 injury, 29 (49.1%) with grade I, 7 (11.8%) with grade II, and 11 (18.6%) with grade III. Patients with grade III presented more with external rectal prolapse had a significantly longer duration of symptoms and had undergone previous surgery for rectal prolapse significantly more than the patients of the other 3 grades. Patients with grade II and grade III anal sphincter injury had significantly higher incontinence scores and lower anal pressures than grade 0 and grade I patients.

Conclusion:
Preoperative EAUS is a useful tool for the assessment of anal sphincter injury in patients with rectal prolapse and for predicting improvement in FI after surgical treatment as higher grades of sphincter injury were associated with less improvement in continence than lower grades.
Experience of Using Adrenocorticotropic Hormone in the Treatment of Patients With Acute Neuromyelitis Optica Who Failed Systemic Steroids: A Case Series
Authors: Berkovich Regina 
Published: December 2019

Objectives
Neuromyelitis optica (NMO) has a complex pathology. Clinical symptoms, derived from damage to optic nerves and spinal cord, cause optic neuritis and/or longitudinally extensive myelitis. Treatment options are limited. We assessed adrenocorticotropic hormone (ACTH) use in patients developing exacerbations on systemic steroid treatment and declining other treatments.

Methods
Patients with NMO who initiated intravenous methylprednisolone (IVMP) for exacerbations and experienced a subsequent exacerbation on monthly IVMP or had inadequate response to IVMP received ACTH 80 U/d intramuscularly for 7 days (for acute relapse), followed by 80 U every 2 weeks (for long taper down/maintenance). Every 1 to 3 months, relapse, Expanded Disability Status Scale, laboratory, and adverse event assessments were performed.

Results
Six patients (mean age: 48.6 years; NMO-suggestive clinical/imaging presentations; cerebral spinal fluid revealing no oligoclonal bands; aquaporin-4 positive [n = 5]) were identified: 5 experiencing subsequent exacerbations with monthly IVMP and 1 with inadequate response to IVMP. No relapses occurred during ACTH treatment or taper-down period, laboratory values indicated no safety concerns, and annual follow-up magnetic resonance imagings were stable. Adverse events were generally characterized as improved or unchanged versus with IVMP, although 1 patient reported transient edema (lower extremities) only during ACTH treatment. Potential treatment-related AEs included edema, acne, urinary tract infection, and insomnia and were reportedly less severe with ACTH treatment than IVMP.

Conclusions
Adrenocorticotropic hormone treatment for acute NMO was associated with clinical improvement, suggesting that ACTH could have a role in treating acute NMO patients failing IVMP and declining other treatments. Fewer/less severe AEs were observed with ACTH versus IVMP. Larger, controlled clinical studies are needed.
miR-16-5p and miR-19b-3p prevent amyloid β-induced injury by targeting BACE1 in SH-SY5Y cells
Authors: Zhang Nan , Li Wei-Wei , Lv Chun-Mei , Gao Yi-Wen , Liu Xiao-Liang , Zhao Li 
Published: December 2019

Purpose:
Alzheimer’s disease is the most common neurodegenerative disease, characterized by accumulation of amyloid β peptides. MicroRNAs have been identified as significant regulators and therapeutic targets of Alzheimer’s disease. However, the roles of miR-16-5p and miR-19b-3p and their mechanisms in Alzheimer’s disease progression remain largely unknown.

Materials and methods:
Amyloid β-treated SH-SY5Y cells were used to study Alzheimer’s disease progression in vitro. Transfection was conducted into SH-SY5Y cells using Lipofectamine 2000. The expression levels of miR-16-5p, miR-19b-3p and beta-site amyloid precursor protein cleaving enzyme 1 (BACE1) were measured by quantitative real-time PCR or western blot, respectively. Cell viability and apoptosis were detected in amyloid β-treated SH-SY5Y cells by MTT or flow cytometry, respectively. The interaction between BACE1 and miR-16-5p or miR-19b-3p was explored by luciferase reporter and RNA immunoprecipitation analyses.

Results:
The expression levels of miR-16-5p and miR-19b-3p were reduced but BACE1 protein expression was enhanced in SH-SY5Y cells after treatment of amyloid β. Overexpression of miR-16-5p or miR-19b-3p attenuated amyloid β-induced viability inhibition and apoptosis promotion in SH-SY5Y cells, while their knockdown exacerbated amyloid β-induced injury. BACE1 was confirmed as a target of miR-16-5p and miR-19b-3p and its overexpression aggravated amyloid β-induced loss of viability and production of apoptosis, while its depletion caused an opposite effect. Moreover, upregulation of BACE1 alleviated the regulatory effects of miR-16-5p and miR-19b-3p on amyloid β-induced injury.

Conclusion:
MiR-16-5p and miR-19b-3p relieved amyloid β-induced injury by targeting BACE1 in SH-SY5Y cells, indicating miR-16-5p and miR-19b-3p as protective agents for treatment of Alzheimer’s disease.
Expression of sirtuin type 3 in locus ceruleus is associated with long-term intermittent hypoxia-induced neurocognitive impairment in mice
Authors: Zhang Jing , Zhu Ying , Lai Chunliu , Du Hongchun , Tang Kejing 
Published: December 2019

Recent studies revealed that increased oxidative stress is one of the major mechanisms underlying the cognitive dysfunction induced by long-term intermittent hypoxia (LTIH). Locus ceruleus (LC) neurons, which fire at high rate across wakefulness, are essential for optimal cognitive function. The aim of this study was to investigate whether sirtuin type 3 (SirT3), a redox responses coordinator, plays a role in LTIH-induced neurocognitive impairment. Mice were subjected to LTIH or room air [normal control (NC)] for 10 weeks (10 h/day). Morris water maze test was used to detect spatial learning and memory ability. The oxidative stress was evaluated through the level of superoxide dismutase 2 (SOD2) and dihydroethidium and ethidium (DHE). Then the correlation between the number of platform crossing and SirT3 content measured by western blot was analyzed. Results showed that performance on the Morris water maze test was significantly worse for LTIH mice than for NC mice. LTIH exposure downregulated SirT3 and SOD2 in LC neurons, increasing DHE immunodensity. In addition, the SirT3 protein levels in LC neurons were positively related to the number of platform crossing. These observations suggest that SirT3-SOD2-intracellular superoxide is a key component associated with the cognitive dysfunction induced by LTIH. Moreover, they lend support to a rational basis for targeting upregulation of SirT3 in LC as a disease modifying strategy.
Video abstract:
http://links.lww.com/WNR/A577
Cholinergic circuit genes in the healthy brain are differentially expressed in regions that exhibit gray matter loss in Parkinson’s disease
Authors: Keo Arlin , Dzyubachyk Oleh , van der Grond Jeroen , Hafkemeijer Anne , van de Berg Wilma D.J. , van Hilten Jacobus J. , Reinders Marcel J. T. , Mahfouz Ahmed 
Published: December 2019

AbstractStructural covariance networks are able to identify functionally organized brain regions by gray matter volume covariance. In Parkinson’s disease, the posterior cingulate network and anterior cingulate network showed decreased gray matter and therefore we examined the underlying molecular processes of these anatomical networks in the healthy brain. Whole brain transcriptomics from post-mortem samples from healthy adults, revealed upregulation of genes associated with serotonin, GPCR, GABA, glutamate, and RAS signaling pathways in these PD-related regions. Our results also suggest involvement of the cholinergic circuit, in which genesNPPA, SOSTDC1, andTYRP1may play a protective role. Furthermore, both networks were associated with memory and neuropsychiatric disorders that overlap with Parkinson’s disease symptoms. The identified genes and pathways contribute to healthy functions of the posterior and anterior cingulate networks and disruptions to these functions may in turn contribute to the pathological and clinical events observed in Parkinson’s disease.