bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Pilot Randomized Clinical Trial of Remote Varenicline Sampling to Promote Treatment Engagement and Smoking Cessation
Authors: Carpenter Matthew J , Gray Kevin M , Wahlquist Amy E , Cropsey Karen , Saladin Michael E , Froeliger Brett , Smith Tracy T , Toll Benjamin A , Dahne Jennifer 
Published: November 2020

Abstract

Introduction
Medication sampling is a clinically useful tool to engage smokers in the quitting process. Whether varenicline is suitable for sampling purposes is unclear. The purpose of this study was to examine the feasibility, uptake, and preliminary outcomes of varenicline sampling.

Methods
Smokers (N = 99), both motivated to quit and not, were recruited and randomized to varenicline sampling versus not, with 12 week follow-up. The intervention consisted of mailing one-time samples of varenicline (lasting 2–4 wks), with minimally suggestive guidance on use.

Results
Uptake of varenicline was strong, at 2 weeks (54% any use, 66% daily use) and 4 weeks (38%, 46%), with 58% of medication users seeking additional medication. Most users followed conventional titration patterns, self-titrating from 0.5 mg to 2 mg. Relative to control, varenicline sampling increased motivation (p = 0.006) and confidence to quit (p = 0.02), and decreased cigarette smoking (p = 0.02). Smokers receiving varenicline samples were significantly more likely to achieve 50% reduction in cigarettes per day (CPD), both immediately following the sampling exercise (Adjusted Odds Ratio [AOR] = 4.12; 95% CI: 1.39 to 12.17) and at final follow-up (AOR = 4.50; 95% CI: 1.56 to 13.01). Though cessation outcomes were not statistically significant, there was a 1.5 to 3-fold increase in quit attempts and abstinence from varenicline sampling throughout follow-up. These outcomes were comparable among smokers motivated to quit and not.

Conclusions
Unguided, user-driven sampling of varenicline sampling is a concrete behavioral exercise that is feasible to do and seems to suggest clinical utility. Sampling is a pragmatic clinical approach to engage more smokers in quitting.

Implications
Use of evidence-based pharmacotherapies for smoking cessation is low. Medication sampling is a pragmatic behavioral exercise that allows smokers to experience the benefits of using them, while promoting positive downstream effects towards quitting. While previous studies have shown that nicotine replacement therapy (NRT) sampling is viable and effective, whether this extends to varenicline is unclear. Results from this trial demonstrate that varenicline sampling is feasible, safe, and suggestive of clinically important steps toward quitting, deserving of a larger trial.

Clinical Trial Registration
NCT #03742154.
Use of injectable collagen in partial-thickness tears of the supraspinatus tendon: a case report
Authors: Corrado Bruno , Bonini Ilenia , Alessio Chirico Vincenzo , Rosano Nicola , Gisonni Pietro 
Published: November 2020

ABSTRACT
Management of partial-thickness rotator cuff tears is actually controversial. We treated a patient with a partial-thickness tear of the supraspinatus tendon by a series of four type I porcine collagen ultrasound-guided injections, at weekly intervals. At the same time the patient underwent physical therapy, consisting of motor re-education and proprioceptive exercises. The patient was assessed before the treatment and up to 18 months after the last injection by the Constant–Murley score, the Disability of Arm, Shoulder and Hand questionnaire and ultrasonography. Shoulder pain and functional limitation progressively improved and they almost completely disappeared at the last follow-up. Ultrasonography showed a gradual healing of the partial-thickness tear and a regeneration of the tendon structure. This is the first study on ultrasound-guided injections of type I porcine collagen for the treatment of partial-thickness rotator cuff tears. Future research should confirm the excellent result achieved in this case report.
Percutaneous Peripheral Nerve Stimulation of the Medial Branch Nerves for the Treatment of Chronic Axial Back Pain in Patients After Radiofrequency Ablation
Authors: Deer Timothy R , Gilmore Christopher A , Desai Mehul J , Li Sean , DePalma Michael J , Hopkins Thomas J , Burgher Abram H , Spinner David A , Cohen Steven P , McGee Meredith J , Boggs Joseph W 
Published: November 2020

Abstract

Objective
Lumbar radiofrequency ablation is a commonly used intervention for chronic back pain. However, the pain typically returns, and though retreatment may be successful, the procedure involves destruction of the medial branch nerves, which denervates the multifidus. Repeated procedures typically have diminishing returns, which can lead to opioid use, surgery, or implantation of permanent neuromodulation systems. The objective of this report is to demonstrate the potential use of percutaneous peripheral nerve stimulation (PNS) as a minimally invasive, nondestructive, motor-sparing alternative to repeat radiofrequency ablation and more invasive surgical procedures.

Design
Prospective, multicenter trial.

Methods
Individuals with a return of chronic axial pain after radiofrequency ablation underwent implantation of percutaneous PNS leads targeting the medial branch nerves. Stimulation was delivered for up to 60 days, after which the leads were removed. Participants were followed up to 5 months after the start of PNS. Outcomes included pain intensity, disability, and pain interference.

Results
Highly clinically significant (≥50%) reductions in average pain intensity were reported by a majority of participants (67%, n = 10/15) after 2 months with PNS, and a majority experienced clinically significant improvements in functional outcomes, as measured by disability (87%, n = 13/15) and pain interference (80%, n = 12/15). Five months after PNS, 93% (n = 14/15) reported clinically meaningful improvement in one or more outcome measures, and a majority experienced clinically meaningful improvements in all three outcomes (i.e., pain intensity, disability, and pain interference).

Conclusions
Percutaneous PNS has the potential to shift the pain management paradigm by providing an effective, nondestructive, motor-sparing neuromodulation treatment.
A reconciling hypothesis centred on brain-derived neurotrophic factor to explain neuropsychiatric manifestations in rheumatoid arthritis
Authors: Pedard Martin , Quirié Aurore , Tessier Anne , Garnier Philippe , Totoson Perle , Demougeot Céline , Marie Christine 
Published: November 2020

Abstract
Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disease characterized by synovitis leading to joint destruction, pain and disability. Despite efficient antirheumatic drugs, neuropsychiatric troubles including depression and cognitive dysfunction are common in RA but the underlying mechanisms are unclear. However, converging evidence strongly suggests that deficit in brain-derived neurotrophic factor (BDNF) signalling contributes to impaired cognition and depression. Therefore, this review summarizes the current knowledge on BDNF in RA, proposes possible mechanisms linking RA and brain BDNF deficiency including neuroinflammation, cerebral endothelial dysfunction and sedentary behaviour, and discusses neuromuscular electrical stimulation as an attractive therapeutic option.
WOOF AND BREW LTD’S TRADE MARK APPLICATION
Authors:   Appointed Person (Trade Marks)
Published: November 2020

Abstract
H1 Trade Marks – Opposition proceedings – PAWSECCO – Edible pet treats – Pet beverages – Whether use in the UK prohibited by any enactment or provision of EU law – Protected denominations of origin – PROSECCO – Scope of protection – Assessing evocation – Surrounding context – Circumstances suggestion visual and phonetic similarities not fortuitous – Freedom of speech – Parody defences – Appeal to Appointed Person
Comparative Performance of Popular Methods for Hybrid Detection using Genomic Data
Authors: Kong Sungsik , Kubatko Laura S 
Published: November 2020

AbstractInterspecific hybridization is an important evolutionary phenomenon that generates genetic variability in a population and fosters species diversity in nature. The availability of large genome scale data sets has revolutionized hybridization studies to shift from the observation of the presence or absence of hybrids to the investigation of the genomic constitution of hybrids and their genome-specific evolutionary dynamics. Although a handful of methods have been proposed in an attempt to identify hybrids, accurate detection of hybridization from genomic data remains a challenging task. In addition to methods that infer phylogenetic networks or that utilize pairwise divergence, site pattern frequency based and population genetic clustering approaches are popularly used in practice, though the performance of these methods under different hybridization scenarios has not been extensively examined. Here, we use simulated data to comparatively evaluate the performance of four tools that are commonly used to infer hybridization events: the site pattern frequency based methods HyDe and the $D$-statistic (i.e., the ABBA-BABA test) and the population clustering approaches structure and ADMIXTURE. We consider single hybridization scenarios that vary in the time of hybridization and the amount of incomplete lineage sorting (ILS) for different proportions of parental contributions ($\gamma$); introgressive hybridization; multiple hybridization scenarios; and a mixture of ancestral and recent hybridization scenarios. We focus on the statistical power to detect hybridization and the false discovery rate (FDR) for comparisons of the $D$-statistic and HyDe, and the accuracy of the estimates of $\gamma$ as measured by the mean squared error for HyDe, structure, and ADMIXTURE. Both HyDe and the $D$-statistic are powerful for detecting hybridization in all scenarios except those with high ILS, although the $D$-statistic often has an unacceptably high FDR. The estimates of $\gamma$ in HyDe are impressively robust and accurate whereas structure and ADMIXTURE sometimes fail to identify hybrids, particularly when the proportional parental contributions are asymmetric (i.e., when $\gamma$ is close to 0). Moreover, the posterior distribution estimated using structure exhibits multimodality in many scenarios, making interpretation difficult. Our results provide guidance in selecting appropriate methods for identifying hybrid populations from genomic data. [ABBA-BABA test; ADMIXTURE; hybridization; HyDe; introgression; Patterson’s $D$-statistic; Structure.]
Barriers, facilitators, and interventions for medication adherence across chronic conditions with the highest non-adherence rates: a scoping review with recommendations for intervention development
Authors: Konstantinou Pinelopi , Kassianos Angelos P , Georgiou Giοrgos , Panayides Andreas , Papageorgiou Alexia , Almas Ioannis , Wozniak Greta , Karekla Maria 
Published: November 2020

Abstract
Medication non-adherence (MNA) constitutes a complex health problem contributing to increased economic burden and poor health outcomes. The Medication Adherence Model (MAM) supports that numerous processes are involved in medication adherence (MA). Based on the MAM and guidelines of the World Health Organization (WHO), this scoping review aimed to identify the barriers and facilitators associated with MA, and the behavioral health interventions and techniques among chronic conditions presenting with high non-adherence rates (asthma, cancer, diabetes, epilepsy, HIV/AIDS, and hypertension). PubMed, PsycINFO, and Scopus databases were screened, and 243 studies were included. A mixed methods approach was used to collate the evidence and interpret findings. The most commonly reported barriers to MA across conditions were younger age, low education, low income, high medication cost, side effects, patient beliefs/perceptions, comorbidities, and poor patient–provider communication. Additionally, digitally delivered interventions including components such as medication and condition education, motivational interviewing (MI), and reinforcement and motivational messages led to improvements in MA. This review highlights the importance of administrating multicomponent interventions digitally and personalized to the patients’ individual needs and characteristics, responding to the adherence barriers faced. This is the first review examining and synthesizing evidence on barriers and facilitators to MA and behavioral health interventions used for improving MA across chronic conditions with the highest non-adherence rates and providing recommendations to researchers and clinicians. Stakeholders are called to explore methods overcoming barriers identified and developing effective multicomponent interventions that can reduce the high rates of MNA.
An unusual artery causing an unusual stroke
Authors: Balbi Alanna M. , Henry Kathryn A. , Van Sant Amanda A. , Maier Jessica L. , Eygnor Jessica K. , Jacoby Jeanne L. 
Published: November 2020

ABSTRACT
Bilateral thalamic infarctions are uncommon and often lead to more severe and long-lasting symptoms than unilateral thalamic infarctions. This article describes a patient with bilateral thalamic infarction caused by occlusion in the artery of Percheron, an anatomic variant thought to be present in 4% to 12% of the population.
Entrustable Professional Activities (EPAs) for Global Health
Authors: Steeb David R. , Brock Tina P. , Dascanio Sarah A. , Drain Paul K. , Squires Allison , Thumm Melissa , Tittle Robin , Haines Stuart T. 
Published: November 2020

Purpose
As global health education and training shift toward competency-based approaches, academic institutions and organizations must define appropriate assessment strategies for use across health professions. The authors aim to develop entrustable professional activities (EPAs) for global health to apply across academic and workplace settings.

Method
In 2019, the authors invited 55 global health experts from medicine, nursing, pharmacy, and public health to participate in a multiround, online Delphi process; 30 (55%) agreed. Experts averaged 17 years of global health experience, and 12 (40%) were from low- to middle-income countries. In round one, participants listed essential global health activities. The authors used in vivo coding for round one responses to develop initial EPA statements. In subsequent rounds, participants used 5-point Likert-type scales to evaluate EPA statements for importance and relevance to global health across health professions. The authors elevated statements that were rated 4 (important/relevant to most) or 5 (very important/relevant to all) by a minimum of 70% of participants (decided a priori) to the final round, during which participants evaluated whether each statement represented an observable unit of work that could be assigned to a trainee. Descriptive statistics were used for quantitative data analysis. The authors used participant comments to categorize EPA statements into role domains.

Results
Twenty-two EPA statements reached at least 70% consensus. The authors categorized these into 5 role domains: partnership developer, capacity builder, data analyzer, equity advocate, and health promoter. Statements in the equity advocate and partnership developer domains had the highest agreement for importance and relevance. Several statements achieved 100% agreement as a unit of work but achieved lower levels of agreement regarding their observability.

Conclusions
EPAs for global health may be useful to academic institutions and other organizations to guide the assessment of trainees within education and training programs across health professions.
Cybersecurity Challenges and the Academic Health Center: An Interactive Tabletop Simulation for Executives
Authors: Maggio Lauren A. , Dameff Christian , Kanter Steven L. , Woods Beau , Tully Jeffrey 
Published: November 2020

Problem
Academic health centers (AHCs) face cybersecurity vulnerabilities that have potential costs to an institution’s finances, reputation, and ability to deliver care. Yet many AHC executives may not have sufficient knowledge of the potential impact of cyberattacks on institutional missions such as clinical care, research, and education. Improved cybersecurity awareness and education are areas of opportunity for many AHCs.

Approach
The authors developed and facilitated a tabletop cybersecurity simulation at an international conference for AHC leaders in September 2019 to raise awareness of cybersecurity issues and threats and to provide a forum for discussions of concerns specific to CEOs and C-suite–level executives. The 3.5-hour interactive simulation used an evolving, 3-phase case study describing a hypothetical cyberattack on an AHC with a ransomware demand. The approximately 70 participants, from AHCs spanning 25 states and 11 countries, worked in teams and discussed how they would react if they held roles similar to their real-life positions. The authors provide the full scenario as a resource.

Outcomes
The exercise was well received by the participants. In the postsession debrief, many participants noted that cybersecurity preparedness had not received the level of institutional attention given to threats such as epidemics or natural disasters. Significant variance in teams’ courses of action during the simulation highlighted a lack of consensus with regard to foundational decisions. Participants identified this as an area that could be remedied by the development of guidelines or protocols.

Next Steps
As health care cybersecurity challenges persist or grow in magnitude, AHCs will have increased opportunities to lead in the development of best practices for preparedness and response. AHCs are well positioned to work with clinicians, security professionals, regulators, law enforcement, and other stakeholders to develop tools and protocols to improve health care cybersecurity and better protect patients.
Outcomes after primary reverse total shoulder arthroplasty in patients with comorbid anxiety and depressive disorders: a retrospective cohort study
Authors: Moore A. Ryves , Brolin Tyler J. , Smith Richard A. , Azar Frederick M. , Throckmorton Thomas W. 
Published: November 2020

Background:
Current literature generally indicates that anxiety and depressive disorders have negative effects on the outcomes of orthopaedic procedures. We studied a patient population with primary reverse total shoulder arthroplasty (RTSA) to evaluate the effect of these disorders on 2-year outcomes.

Methods:
Patients were classified as having depression or anxiety by documentation of such in the chart or the use of a prescription mood-stabilizing drug. Pain and function were evaluated with visual analog scale (VAS) and American Shoulder and Elbow Surgeons (ASES) scores, respectively. Data for complications, reoperations, and readmissions were also compiled, and radiographs were assessed for loosening or component failure at the most recent follow-up.

Results:
Database search identified 112 patients (114 shoulders) with primary RTSA and a minimum of 2-year clinical and radiographic follow-up. Thirty-one patients were categorized as having depression and/or anxiety, and 81 (83 shoulders) did not have these disorders. Significantly more women than men were in the anxiety and depression group (P=0.007). There were no significant differences in other patient demographics or VAS, ASES score, range of motion, or strength at 2-year follow-up (all P>0.05). Three complications occurred in the anxiety/depression group, and 16 occurred in the group without these disorders (P=0.34).

Conclusions:
Contrary to most current literature, these results suggest that patients with anxiety and/or depression can expect similar outcomes as those of patients without these disorders after primary RTSA.

Level of Evidence:
Level III.
Accuracy of imageless navigation for functional cup positioning and restoration of leg length in total hip arthroplasty: a matched comparative analysis
Authors: Meftah Morteza , Siddappa Vinay Hosuru , Muir Jeffrey M. 
Published: November 2020

Background:
Computer-assisted navigation has the potential to improve the accuracy of cup positioning during total hip arthroplasty (THA) and prevent leg-length discrepancy (LLD). The purpose of this study was to compare acetabular cup position and postoperative LLD after primary THA using posterolateral approach.

Methods:
Between August 2016 to December 2017, 57 THAs using imageless navigation were matched with 57 THA without navigation, based on age, gender, and BMI. Postoperative weight-bearing radiographs were assessed for anteversion, inclination, and LLD. Functional LLD was measured in comparison to the contralateral side. The proportion of cups within Lewinnek’s safe zone and LLD greater than 5 mm were assessed.

Results:
The mean age was 54.9±9.6 yr and 57.6±12.5 yr in control and navigated groups, respectively. Mean cup orientation in the navigated group was 20.6±3.3 degrees (17 to 25) of anteversion and 41.9±4.8 degrees (30 to 51) of inclination, versus 25±11.1 degrees (10 to 31) and 45.7±8.7 degrees (29 to 55) in the control group; these were statistically significant (P=0.005 and P<0.001, respectively). In the navigated group, significantly more acetabular cups were placed within Lewinnek’s safe zone (anteversion: 77% vs. 47%, P=0.005; inclination: 91% vs. 67%, P<0.001). There was no significant difference in mean LLD in the navigation and control groups (3.2±1.5 mm vs. 4.6±3.4 mm, P=0.36), although fewer LLDs of greater than 5 mm were reported in the navigated group (7.1%) than in the control group (31.6%, P=0.007).

Conclusions:
The use of imageless computer-assisted navigation improved the accuracy of acetabular cup components and LLD.

Level of Evidence:
Level III.
EFFECTS OF GLYCEMIC VARIABILITY ON THE PROGRESSION OF DIABETIC RETINOPATHY AMONG PATIENTS WITH TYPE 2 DIABETES
Authors: Park Jae Yong , Hwang Je Hyung , Kang Min Ji , Sim Ha Eun , Kim Jae Suk , Ko Kyung Soo 
Published: November 2020

Purpose:
To evaluate the effects of glycemic variability on the progression of diabetic retinopathy (DR) among individuals with Type 2 diabetes and to test the hypothesis that consistent glycemic control delays the progression of DR.

Methods:
This retrospective study included 1,125 participants with a follow-up period of more than 5 years and more than 20 glucose laboratory test results. The hazard ratio of ≥3 steps of progression on the Early Treatment Diabetic Retinopathy Study person scale and progression to proliferative DR were assessed.

Results:
An increase in the HbA1c SD was associated with a higher risk of ≥3 step progression (P < 0.001) and progression to proliferative DR (P < 0.001). Not only mean HbA1c, but also HbA1c SD was associated with a lower risk of ≥3 steps of progression (P < 0.001), and progression to proliferative DR (P < 0.001).

Conclusion:
Achievable and consistent glycemic control may contribute to the delay in DR progression.

Clinical Trial Registration Number:
Institutional review board of Inje University (No. 202003014).