bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic Cartilage Myringoplasty with Inside Out Elevation of a Tympanomeatal Flap for Repairing Anterior Tympanic Membrane Perforations
Authors: Lou Zhengcai 
Published: April 2020

Objective: We evaluated the graft take rate and hearing gain of endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap for repairing an anterior tympanic membrane perforation. Study design: A retrospective case series Setting: Tertiary university hospital Materials and Methods: The study population consisted of patients with an anterior perforation undergoing endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap. The primary outcome was the graft take rate at 6 months. The secondary outcomes were the air–bone gap (ABG) gain at 3 months and complications. Results: A total of 51 patients with a unilateral anterior marginal perforation were included in this study. The mean operation time was 62.2 ± 8.3 minutes. The graft success rate was 92.2% (47/51) at 6 months. The mean preoperative ABG was 28.07 ± 5.13 dB, while the mean postoperative ABG was 12.24 ± 4.89 dB ( P < .05). No patients reported sensorineural hearing loss, altered taste, facial nerve palsy, vertigo, or tinnitus. Two patients with a middle perforation developed postoperative purulent otorrhea that resulted in residual perforations. The cartilage graft was extruded into the anterior annulus in two patients with large perforations that resulted in graft lateralization in one patient and residual perforation in the other. Conclusions: Endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap is a useful procedure with a low reperforation rate for repairing anterior perforation.
Examining Referral Patterns between Otolaryngology and Gastroenterology: A Window into Potential Inter-Specialty Knowledge Gaps
Authors: Haines Adam , Kohli Nikita , Lerner Benjamin A. , Lerner Michael Z. 
Published: April 2020

Objective: The objective of this study was to examine referral patterns between otolaryngology and gastroenterology in order to delineate areas of clinical overlap, as well as to identify areas that might benefit from improved inter-specialty communication and collaboration. Methods: Montefiore’s Clinical Looking Glass tool was used to define parameters for electronic medical record data extraction from 2015 to 2018. Two cohorts were generated, one representing referrals placed by gastroenterology to otolaryngology and a second representing referrals placed by otolaryngology to gastroenterology. The ICD-10 codes in both cohorts were reviewed and 13 distinct “reason for referral” categories were defined. The rates of referral for each category were then calculated for each of the referral cohorts. Results: Otolaryngology referred to gastroenterology at a greater rate than gastroenterology referred to otolaryngology, despite seeing fewer total patients than gastroenterology. For referrals from gastroenterology to otolaryngology, the three most frequent referral reasons were oral cavity/oropharyngeal pathology (28.3%), dysphagia (28.3%), and gastroesophageal reflux disease/laryngopharyngeal reflux disease (GERD/LPRD) (11.3%). For referrals from otolaryngology to gastroenterology, the three most frequent referral reasons were GERD/LPRD (61.7%), dysphagia (18.6%), and esophageal pathology (5.3%). Conclusions: GERD/LPRD was more frequently referred out by otolaryngology than it was by gastroenterology, suggesting the need for further characterization of the discrepancy in management of a disease commonly treated by both specialties. The discrepant rates of referral for dysphagia also suggest a need to better understand what factors contribute to the differences in management of another clinical condition commonly assessed by both specialties. Level of Evidence: 4
Characterisation of the pharmacodynamic effects of the P2X7 receptor antagonist JNJ-54175446 using an oral dexamphetamine challenge model in healthy males in a randomised, double-blind, placebo-controlled, multiple ascending dose trial
Authors: Recourt Kasper , van der Aart Jasper , Jacobs Gabriel , de Kam Marieke , Drevets Wayne , van Nueten Luc , Kanhai Kawita , Siebenga Pieter , Zuiker Rob , Ravenstijn Paulien , Timmers Maarten , van Gerven Joop , de Boer Peter 
Published: April 2020

Background: This is the first report of the pharmacodynamic (PD) effects of the selective, potent and brain-penetrant P2X7 receptor (P2X7R) antagonist JNJ-54175446. Activation of the P2X7R, an adenosine triphosphate-gated ion channel, leads to the production of pro-inflammatory cytokines, which have been linked to neuroinflammation and play a role in the pathogenesis of mood disorders. Previous clinical studies with JNJ-54175446 demonstrated peripheral target engagement of JNJ-54175446 by assessing ex vivo lipopolysaccharide (LPS)-stimulated cytokine production. Blood–brain barrier penetration and a clear dose–receptor occupancy relationship was demonstrated using positron emission tomography. Aims: The objectives of this double-blind, placebo-controlled, translational study were to assess the safety and tolerability of administering multiple doses of JNJ-54175446 and to explore its PD effects using a dexamphetamine challenge. Methods: Subjects ( N = 64) were randomised to either JNJ-54175446 (50–450 mg; n = 48) or placebo ( n = 16) and underwent a baseline oral 20 mg dexamphetamine challenge followed by 11 consecutive days q.d. dosing with JNJ-54175446/placebo and a randomised crossover dexamphetamine/placebo challenge. Results: At all doses tested, JNJ-54175446 was well tolerated and suppressed the ex vivo LPS-induced release of cytokines. At doses ⩾100 mg, JNJ-54175446 attenuated dexamphetamine-induced increases in locomotion and enhanced the mood-elevating effects of dexamphetamine, suggesting that a dose that is approximately twice as high is needed to obtain a central PD response compared to the dose needed for maximum peripheral occupancy. Conclusion: Overall, the observed pharmacological profile of JNJ-54175446 in the dexamphetamine challenge paradigm is compatible with a potential mood-modulating effect.
Exploring the Gender-Specific Impact of Educational Film on Maternal and Child Health Knowledge and Behavior: A Qualitative Study in Serenje District, Zambia
Authors: Mweemba Oliver , Smith Helen , Coombe Helen 
Published: April 2020

Background Educational film is a communication tool that helps to present complex information simply and clearly, keeping audiences interested for longer and helping to reinforce important learning. Medical Aid Films produces educational films targeted at communities and health workers, with a focus on maternal and child health (MCH) content. Pilot work suggests that film screenings have attracted male as well as female viewers and have started to increase male involvement in MCH care. We explored stakeholder perspectives and gender-specific responses to educational films screened in a rural district of Serenje, Zambia. Methods A qualitative study using focus group discussions and in-depth interviews with men and women who had viewed the films at least once, and key informant interviews with health workers who helped deliver the film screenings. Thematic framework analysis was used to derive themes and subthemes, and illustrative quotes are used to substantiate interpretation of the findings. Results Men’s and women’s perspectives are clustered around the influence of the films on knowledge and behavior in relation to MCH topics and male involvement and overall community responses to the films. The three themes summarizing key informant perspectives relate to their impressions of the influence of the films on male involvement in MCH and their views on using film to deliver heath information. Conclusion Educational films have the potential to improve women’s and men’s knowledge and awareness of MCH topics, including healthy nutrition and welfare of women during pregnancy, the need to seek skilled care during pregnancy and for childbirth, and the importance of male involvement in supporting the care of women and children. Before widespread implementation, decisions must be made about whether and how to integrate the films with community health education programs, the needs, values, and preferences of men and women and how to present and deliver the film content in a way that maximizes participation of men and women in MCH but does not undermine women’s rights, autonomy, or safety.
Effect of genetic liability to migraine on cognition and brain volume: A Mendelian randomization study
Authors: Daghlas Iyas , Rist Pamela M , Chasman Daniel I 
Published: April 2020

Objective To investigate potential causality between genetic liability to migraine and Alzheimer’s disease, intelligence, and brain volume using two-sample Mendelian randomization. Methods The exposure consisted of independent genetic variants associated with migraine in the largest (59,674 cases/316,078 controls) published genome-wide association study. Outcomes included Alzheimer’s disease (71,880 cases/383,378 controls), a measure of general intelligence (n = 269,867), intracranial volume (n = 11,373), and seven subcortical brain volumes (n ∼ 13,000), all with available genome-wide association study summary statistics. Mendelian randomization effects were estimated using inverse-variance weighted analysis. Results Genetic liability to migraine did not associate with Alzheimer’s disease (odds ratio [95% confidence interval] 1.01 [1.00–1.02], p = 0.07), intelligence (standardized beta [95% confidence interval] 0.01 [0.00–0.02], p = 0.13), or any brain volume measures (all p > 0.05). No individual migraine variant associated with any of the outcomes at genome-wide significance. Conclusions These data do not support a causal effect of migraine liability on Alzheimer’s disease, intelligence, or brain volume.
L2 proficiency predicts inhibitory ability in L1-dominant speakers
Authors: Hui Nga-Yan , Yuan Mingyu , Fong Manson Cheuk-Man , Wang William Shi-yuan 
Published: April 2020

Aims and Objectives: Bilinguals reportedly perform better in tasks that require the suppression of interference because of the constant practice in linguistic inhibition. However, previous literature was largely based on comparisons of pure monolinguals and balanced bilinguals. Those in between the two extremes were rarely examined. This project aimed at studying whether the population who primarily speak in a first language with a different level of second language proficiency also enjoy bilingual advantage. Methodology: Twelve monolingual and 38 bilingual Hong Kong older adults were recruited to perform the Stroop task and the second language (English) proficiency tests. The subjects were all frequent first language (Cantonese) speakers with various levels of second language proficiency. Data and Analysis: Pearson correlation and multiple regression analyses were used to identify the relationship between inhibition ability (Stroop score) and demographic and language background variables (including proficiency in and frequency of exposure to their second language). Findings: Both correlation and multiple regression analysis showed that the subjects with higher proficiency in a second language performed significantly better in the Stroop task. The results suggested that higher second language proficiency leads to higher difficulty in suppressing it, thus the training of inhibition is more effective. Originality: This study expanded the literature on bilingual advantage from a dichotomous comparison between monolingual and bilingual to the more continuous spectrum of bilinguals with different levels of second language proficiency. This study aimed at showing a fuller picture of bilingualism in the world. Significance/Implications: This study proposed that with high proficiency in a second language, frequent first language speakers could also enjoy cognitive advantages brought by bilingualism. Our study provides further evidence for the bilingual advantage hypothesis.
A preliminary evaluation of a client-centred prompting tool for supporting everyday activities in individuals with mild to moderate levels of cognitive impairment due to dementia
Authors: Harris Nigel , Boyd Hazel , Evans Nina , Cheston Richard , Noonan Krist , Ingram Thomas , Jarvis Aron , Ridgers Jessica 
Published: April 2020

Objectives Technology-based prompting has the potential to support people with dementia to complete multistep tasks in the home. However, these devices can be complex to use. This paper reports a feasibility trial of a personalised touchscreen digital prompter designed for home use. Methodology: A tablet-based prompter suitable for people living with dementia was developed, along with a detailed guidance manual. Carers loaded instructions for completing the task onto the prompter, and the person with dementia then used the tablet independently to complete a task. Eleven couples used the prompter ‘out-of-the-box’ with no support other than a guidance manual. Results The majority of participants with dementia could follow the steps on the prompter, and carers were able to breakdown and load tasks onto the prompter. Eight couples used the prompter successfully to complete goals that they had identified in advance. These included preparing simple snacks and using a TV remote control. Successfully achieving goals was associated with more frequent use of the prompting screen on more days, but not higher levels of editing or previewing of tasks. Conclusion The study provides the preliminary evidence that family caregivers can use a touchscreen tablet, software and manual package to identify specific tasks and break these down into steps and that people living with dementia can then follow the prompts to complete the tasks. This potentially represents an important advance in dementia care. Further testing is required to establish efficacy and to identify any factors that impact on outcomes.
IL-25/IL-33/TSLP contributes to idiopathic pulmonary fibrosis: Do alveolar epithelial cells and (myo)fibroblasts matter?
Authors: Xu Xuefeng , Zhang Jinglan , Dai Huaping 
Published: April 2020

Idiopathic pulmonary fibrosis is a relentless fibrotic disease with largely unknown etiologies. Currently, the crosstalk between alveolar epithelial cells and lung-resident mesenchymal cells (especially [myo]fibroblasts) is considered to be the central pathogenesis to initiate and propagate the fibrotic process. Unfortunately, the master switch hidden in the profibrotic milieu that mediates pathogenic epithelial-mesenchymal interactions is still not well elucidated. Thus, the definite treatment target that can block and cure idiopathic pulmonary fibrosis is now lacking. Based on the previous studies, we proposed the notion that epithelium-derived triple type 2 cytokines, i.e. interleukin (IL)-25, IL-33, and thymic stromal lymphopoietin (TSLP) are important pro-fibrotic mediators in idiopathic pulmonary fibrosis via two possible mechanisms: (1) paracrine pathway: directly acting on (myo)fibroblast. There may exist a structural and functional axis of (IL-25/IL-33/TSLP)+alveolar epithelial cells-(IL-25R/IL-33R/TSLPR)+(myo)fibroblasts in fibroblastic foci of idiopathic pulmonary fibrosis patients. The crosstalk between alveolar epithelium and the adjacent mesenchymal compartment is well established by the binding of IL-25/IL-33/TSLP expressed on alveolar epithelial cells with their corresponding receptors (i.e. IL-17BR/sT2L/TSLPR) expressed on (myo)fibroblasts; (2) autocrine pathway: directly acting on alveolar epithelial cells. Alveolar epithelial cells may act as both cellular sources and targets of IL-25/IL-33/TSLP. Autocrine IL-25/IL-33/TSLP causes salient injury and phenotypic changes of alveolar epithelial cells. Thus, epithelium-derived IL-25/IL-33/TSLP may be the novel promising treatment target for the cure of idiopathic pulmonary fibrosis.Impact statementWe suggest a novel modality in terms of IL-25/IL-33/TSLP’s pro-fibrotic role in IPF. First, IL-25/IL-33/TSLP fully activates (myo)fibroblasts in fibroblastic foci (FF) in a paracrine-dependent manner. (IL-25/IL-33/TSLP)+alveolar epithelial cells-(IL-25R/IL-33R/TSLPR)+(myo)fibroblasts axis may contribute greatly to the abnormal epithelial-mesenchymal crosstalk and lung fibrosis. Second, IL-25/IL-33/TSLP causes significant injury and phenotypic changes of alveolar epithelial cells in an autocrine-dependent manner. By acting directly on the two most important cells in the fibrotic process, i.e. alveolar epithelial cells and (myo)fibroblasts, we support the notion that biological therapies targeting IL-25/IL-33/TSLP will shed new light on the cure of IPF patients.
Incidence and risk factors for stroke following percutaneous coronary intervention
Authors: Dawson Luke P , Cole Justin A , Lancefield Terase F , Ajani Andrew E , Andrianopoulos Nick , Thrift Amanda G , Clark David J , Brennan Angela L , Freeman Melanie , O'Brien Jessica , Sebastian Martin , Chan William , Shaw James A , Dinh Diem , Reid Christopher M , Duffy Stephen J ,   on behalf of the Melbourne Interventional Group (MIG) Investigators, CCRE Therapeutics, Monash University, Melbourne Victoria, Australia
Published: April 2020

Background Stroke rates and risk factors may change as percutaneous coronary intervention practice evolves and no data are available comparing stroke incidence after percutaneous coronary intervention to the general population. Aims This study aimed to identify the incidence and risk factors for inpatient and subsequent stroke following percutaneous coronary intervention with comparison to age-matched controls. Methods Data were prospectively collected from 22,618 patients undergoing percutaneous coronary intervention in the Melbourne Interventional Group registry (2005–2015). The cohort was compared to the North-East Melbourne Stroke Incidence Study population-based cohort (1997–1999) and predefined variables assessed for association with inpatient or outpatient stroke. Results Inpatient stroke occurred in 0.33% (65.3% ischemic, 28.0% haemorrhagic, and 6.7% cause unknown), while outpatient stroke occurred in 0.55%. Inpatient and outpatient stroke were associated with higher rates of in-hospital major adverse cardiovascular outcomes ( p < 0.0001) and mortality ( p < 0.0001), as well as 12-month mortality ( p < 0.0001). Factors independently associated with inpatient stroke were renal impairment, ST-elevation myocardial infarction, previous stroke, left ventricular ejection fraction 30–45%, and female sex, while those associated with outpatient stroke were previous stroke, chronic lung disease, previous myocardial infarction, rheumatoid arthritis, female sex, and older age. Compared to the age-standardized population-based cohort, stroke rates in the 12 months following discharge were higher for percutaneous coronary intervention patients <65 years old, but lower for percutaneous coronary intervention patients ≥65 years old. Conclusions Risk of inpatient stroke following percutaneous coronary intervention appears to be largely associated with clinical status at presentation, while outpatient stroke relates more to age and chronic disease. Compared to the general population, outpatient stroke rates following percutaneous coronary intervention are higher for younger, but not older, patients.
Happy Hookers: findings from an international study exploring the effects of crochet on wellbeing
Authors: Burns P , Van Der Meer R 
Published: April 2020

Aims: With rising rates of mental health disorders being reported globally, it is imperative that we investigate economical and accessible ways to increase relaxation and reduce stress. While there is a plethora of anecdotal evidence as to the positive effects of domestic crafts on mental wellbeing, there is little empirical research in this area. As such, we aimed to explore perceived links between crochet and wellbeing. Methods: An online survey was developed and piloted, based on an existing tool that explored knitting and wellbeing. The final survey was promoted through social media, over a 6-week period, resulting in valid responses from 8391 individuals. Results: Most respondents were female (99.1%), aged between 41 and 60 years (49.5%) and living in 87 different countries. Many respondents reported crocheting for between 1 and 5 years (42.6%). The three most frequent reasons reported for crocheting were: to be creative (82.1%), to relax (78.5%) and for a sense of accomplishment (75.2%). Respondents reported that crochet made them feel calmer (89.5%), happier (82%) and more useful (74.7%). There was a significant improvement in reported scores for mood before crocheting (M = 4.19, SD = 1.07) and mood after crocheting (M = 5.78, SD = 0.82); z = −69.86, p < .001, r = −0.56. Content analysis of free-text responses identified five major themes: (1) health benefits, (2) process of crochet, (3) personal connection, (4) crochet as contribution and (5) online crochet communities. Conclusion: The data suggests that crochet offers positive benefits for personal wellbeing with many respondents actively using crochet to manage mental health conditions and life events such as grief, chronic illness and pain. Crochet is a relatively low-cost, portable activity that can be easily learnt and seems to convey all of the positive benefits provided by knitting. This research suggests that crochet can play a role in promoting positive wellbeing in the general population, adding to the social prescribing evidence base.
Perioperative Dexmedetomidine for outpatient cataract surgery: a systematic review
Authors: Jones James Harvey , Aldwinckle Robin 
Published: April 2020

AbstractBackgroundCataract surgery is one of the most common procedures performed worldwide in the elderly. Various medications can provide effective anesthesia and analgesia for cataract surgery, but undesirable side effects limit the utility of each medication or combination of medications. Dexmedetomidine may serve as an anesthesia adjunct for outpatient cataract surgery in the elderly.MethodsSearches were conducted in Cochrane, Embase, and PubMed for randomized clinical trials investigating the use of dexmedetomidine in adult patients undergoing outpatient, or ambulatory, cataract surgery with sedation and topical or peribulbar block. Ninety-nine publications were identified, of which 15 trials satisfied the inclusion criteria. A total of 914 patients were included in this review. The following data were collected: American Society of Anesthesiologists’ (ASA) physical status and age of study patients; method of blinding and randomization; medication doses and routes of administration; and intraoperative levels of sedation. We also recorded statistically significant differences between dexmedetomidine and other study medications or placebo with respect to the following outcomes: hemodynamic and respiratory parameters; pain; sedation; post-operative nausea and vomiting (PONV); discharge from post-anesthesia care unit (PACU) or recovery times; patient satisfaction; surgeon satisfaction; and effects on intraocular pressure (IOP).ResultsHypotension with or without bradycardia was reported following bolus doses of dexmedetomidine ranging from 0.5–1.0 mcg/kg with or without a continuous dexmedetomidine infusion. Delayed PACU discharge times were associated with the use of dexmedetomidine, but no clear association was identified between delayed recovery and higher levels of intraoperative sedation. Better analgesia and higher patient satisfaction were commonly reported with dexmedetomidine as well as reductions in IOP.ConclusionsOverall, this review demonstrates better analgesia, higher patient satisfaction, and reduced IOP with dexmedetomidine for outpatient cataract surgery when compared to traditional sedatives, hypnotics, and opioids. These benefits of dexmedetomidine, however, must be weighed against relative cardiovascular depression and delayed PACU discharge or recovery times. Therefore, the utility of dexmedetomidine for outpatient cataract surgery should be considered on a patient-by-patient basis.