bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corticosteroid Exposure in the Treatment of Severe COPD Exacerbations
Authors: George Jamie , Ganoff Michelle , Lipari Melissa 
Published: September 2020

Background: Recent literature and guidelines support treatment of severe acute exacerbation of COPD (AECOPD) with prednisone 40 mg (or equivalent) for 5 days. Objective: The purpose of this study was to determine whether systemic corticosteroids were being prescribed at the appropriate dose and duration in the treatment of severe AECOPD at a large academic medical institution. Methods: This was a single-center, retrospective, observational study conducted to evaluate corticosteroid prescribing patterns for adults admitted for severe AECOPD from March to May 2019 at a large academic medical institution. Appropriate therapy was defined as: prednisone 40 mg (or equivalent) for 5 days. The primary outcome was to determine the frequency of appropriate dose and duration. The secondary outcomes were to identify the frequency of appropriate dose or duration, compare the prevalence of adverse effects, such as new/worsening hyperglycemia or hypertension, and compare 30- and 90-day readmission rates. Results: Of the 190 patients included, 16 (8.4%) had an appropriate duration and 8 (4.2%) an appropriate dose. Only 4 patients (2.1%) had both appropriate corticosteroid dose and duration. New/worsening hyperglycemia occurred in 96 (50.5%), and hypertension developed in 13 (6.8%). Thirty-day readmission occurred in 46 (24.2%) and 90-day readmission in 78 (41.1%). These were more likely in those without appropriate dose and duration. Conclusion: Systemic corticosteroids for the treatment of severe AECOPD are not prescribed in accordance with evidence-based recommendations at this institution. This might result in a greater incidence of adverse effects and readmissions.
Do implementation contexts for the Positive Parenting Program improve child and parental well-being?
Authors: Garcia Antonio R , Kim Minseop , Myers Christina , Trinh Xuan 
Published: September 2020

Summary While previous studies have offered insight into evidence-based practices that are effective in promoting safety and well-being, the underlying contextual implementation conditions that influence these outcomes in child welfare agencies are less understood. To address this gap, this study relied on organizational survey data collected from child welfare workers and supervisors during the process of implementing an evidence-based practice—the Positive Parenting Program—and merged those data with data gathered by the Parents' Assessment of Protective Factors survey. Findings Results showed a significant increase between baseline and termination of services in social connections and overall protective factors index scores. Parents who received services from organizations inclusive of supportive leadership experienced greater increases in social connections. Lower protective factors index scores were associated with workers’ perception that evidence-based practices were required; however, scores increased as supportive leadership increased. Parents who identified as African American experienced lower protective factors index scores compared to parents in other racial categories. Parents who were engaged with workers who felt evidence-based practices were appealing were likely to experience greater increases in protective factors index scores. Applications Intended client outcomes are more likely to be achieved when agency leaders (1) provide workers support to learn and use evidence-based practices and (2) rely on methods to increase evidence-based practice appeal rather than mandate implementation. Future research is needed to (1) understand why the implementation contexts or Positive Parenting Program itself are not as effective for African Americans as they are for oteher racial/ethnic groups and (2) validate findings in other agency contexts and with other evidence-based practices.
Increased rupture risk in small intracranial aneurysms associated with methamphetamine use
Authors: Noblett Dylan , Hacein-Bey Lotfi , Waldau Ben , Ziegler Jordan , Dahlin Brian , Chang Jennifer 
Published: September 2020

Background Aneurysmal subarachnoid hemorrhage (SAH) is the most common cause of nontraumatic SAH. Current guidelines generally recommend observation for unruptured intracranial aneurysms smaller than 7 mm, for those are considered at low risk for spontaneous rupture according to available scoring systems. Objective We observed a tendency for SAH in small intracranial aneurysms in patients who are methamphetamine users. A retrospective, single center study to characterize the size and location of ruptured and unruptured intracranial aneurysms in methamphetamine users was performed. Materials and methods Clinical characteristics and patient data were collected via retrospective chart review of patients with intracranial aneurysms and a history of methamphetamine use with a specific focus on aneurysm size and location. Results A total of 62 patients were identified with at least one intracranial aneurysm and a history of methamphetamine use, yielding 73 intracranial aneurysms (n = 73). The mean largest diameter of unruptured aneurysms (n = 44) was 5.1 mm (median 4.5, SD 2.5 mm), smaller than for ruptured aneurysms (n = 29) with a mean diameter of 6.3 mm (median 5.5, SD 2.5 mm). Aneurysms measuring less than 7 mm presented with SAH in 36.5%. With regard to location, 28% (n = 42) of anterior circulation aneurysms less than 7 mm presented with rupture, in contrast to 70% (n = 10) of posterior circulation aneurysms which were found to be ruptured. Conclusions Methamphetamine use may be considered a significant risk factor for aneurysmal SAH at a smaller aneurysm size than for other patients. These patients may benefit from a lower threshold for intervention and/or aggressive imaging and clinical follow-up.
Arthroscopic ligament-specific repair for triangular fibrocartilage complex foveal avulsions: a minimum 2-year follow-up study
Authors: Liu Bo , Arianni Margareta , Wu Feiran 
Published: September 2020

This study reports the arthroscopic ligament-specific repair of the triangular fibrocartilage complex (TFCC) that anatomically restores both the volar and dorsal radioulnar ligaments into their individual foveal footprints. Twenty-five patients underwent arthroscopic ligament-specific repair with clinical and radiological diagnoses of TFCC foveal avulsions. The mean age was 28 years (range 14–47) and the mean follow-up was 31 months (range 24–47). Following arthroscopic assessment, 20 patients underwent double limb radioulnar ligament repairs and five had single limb repairs. At final follow-up, there were significant improvements in wrist flexion–extension, forearm pronation–supination and grip strength. There were also significant improvements in pain and patient-reported outcomes as assessed by the patient-rated wrist evaluation, Disabilities of the Arm, Shoulder and Hand score and modified Mayo wrist scores. Arthroscopic ligament-specific repair of the TFCC does not require specialist dedicated equipment or consumables and offers a viable method of treating these injuries. Level of evidence: IV
The subacromial spacer system for irreparable posterosuperior rotator cuff tears: A retrospective study of 47 patients with a two-year follow-up
Authors: Kaisidis Aristotelis , Pantos Panagiotis , Bochlos Dimitrios 
Published: September 2020

Background Numerous surgical options are available for the management of massive irreparable rotator cuff tears, but there are no current definitive guidelines concerning the optimal treatment modality. The purpose of this study was to evaluate the efficacy and safety of a biodegradable subacromial spacer (InSpace) implantation in patients with irreparable rotator cuff tears. Methods A retrospective study was conducted involving 47 patients treated with the InSpace balloon between 2016 and 2018. Shoulder function was assessed using Constant Score. Pain was scored using a visual analogue scale, with scores ranging from 0 to 10. Results At an average follow-up of 24.6 months (range 12–38), the Constant Score had improved from 39.4 to 71.5 points (p < 0.0001). The range of motion, a main component of Constant Score, was improved after two years, from 27.6 to 42.2 points (p < .001). The visual analogue scale score decreased from 6.32 at baseline to a mean score of 2.7 points (p < 0.0001). Discussion Arthroscopic deployment of the InSpace device was found to be a safe, reliable treatment option in patients with painful irreparable rotator cuff tears, with meaningful improvement in shoulder function without serious complications.
Dupilumab as Add-on Therapy for Chronic Rhinosinusitis With Nasal Polyposis in Aspirin Exacerbated Respiratory Disease
Authors: Mustafa S. Shahzad , Vadamalai Karthik , Scott Bryan , Ramsey Allison 
Published: September 2020

Background Aspirin-exacerbated respiratory disease (AERD) affects 7% of asthmatics. Usual therapies are inadequate for asthma and/or nasal polyposis, leading to decreased quality of life. Objective Our objective was to evaluate the efficacy of dupilumab in AERD patients with uncontrolled, chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods Patients 18 years and older with a physician diagnosis of AERD and sino-nasal outcome test 22 (SNOT 22) score ≥19 despite standard medical therapy were eligible for the study. Patients received one month of placebo dosing, followed by 6 months of dupilumab. Patients were blinded to the order of therapy. Wilcoxon-paired rank sum test was used to compare study outcomes at baseline and the completion of the study. Results Ten patients completed the study. The median baseline SNOT 22 score improved from 46 [IQR: 34 to 64.8] to 9.5 [IQR: 2.5 to 19] after 6 months of therapy (p = 0.0050). The median baseline Lund MacKay score improved from 21.5 [IQR: 17 to 23.3] to 4 [IQR: 1.2 to 6] after 6 months of therapy (p = 0.0050). There was also improvement in the following secondary outcomes: asthma control test (ACT), mini asthma quality of life questionnaire (AQLQ), and University of Pennsylvania Smell Identification test (UPSIT). Exhaled nitric oxide (FeNO), total serum IgE, 24-hour urinary leukotriene E4, and serum thymus and activation regulated cytokine (TARC) also decreased. There were no significant study-related adverse events. Conclusion Dupilumab was highly effective as add-on therapy for CRSwNP in AERD, improving patient-reported outcomes, sinus opacification, and markers of T2 inflammation.
LncRNA TMPO-AS1 facilitates the proliferation and metastasis of NSCLC cells by up-regulating ERBB2 via sponging miR-204-3p
Authors: Yu Xiaobo , Lin Qiang , Liu Fabing , Yang Fu , Mao Jingyu , Chen Xi 
Published: September 2020

Introduction: This study aims at probing into the expression and biological function of long non-coding RNA (lncRNA) TMPO-AS1 in non-small cell lung cancer (NSCLC), and exploring its regulatory role for miR-204-3p and erb-b2 receptor tyrosine kinase 2 (ERBB2). Methods: In this study, paired NSCLC samples were collected, and the expression levels of TMPO-AS1, miR-204-3p and ERBB2 were examined by quantitative real-time polymerase chain reaction (qRT-PCR); proliferative ability and colony formation ability were detected by CCK-8 assay and plate colony formation assay, respectively; flow cytometry was performed to detect the effect of TMPO-AS1 on apoptosis; Transwell assay was used to detect the changes of migration and invasion; qRT-PCR and Western blot were utilised to analyse the changes of miR-204-3p and ERBB2 regulated by TMPO-AS1; luciferase reporter gene assay and RNA immunoprecipitation assay were employed to determine the regulatory relationship between TMPO-AS1 and miR-204-3p. Results: We demonstrated that TMPO-AS1 was significantly up-regulated in cancerous tissues of NSCLC samples, and positively correlated with the expression of ERBB2, while negatively correlated with miR-204-3p. After transfection of TMPO-AS1 shRNAs into NSCLC cells, the malignant phenotypes of NSCLC cells were significantly inhibited, while overexpression of TMPO-AS1 had opposite effects; TMPO-AS1 was also demonstrated to regulate the expression of miR-204-3p by sponging it, and indirectly modulate the expression of ERBB2. Conclusion: Collectively, we conclude that TMPO-AS1 has the potential to be the ‘ceRNA’ to regulate the expression of ERBB2 by sponging miR-204-3p in NSCLC.
Predictive Factors of Successful Return to Work Following Discectomy
Authors: Andersen Mikkel Ø. , Ernst Carsten , Rasmussen Jesper , Ankjær Thomas , Carreon Leah Y. 
Published: September 2020

Study Design: Retrospective analysis of prospectively collected data. Objective: To identify modifiable factors associated with successful return to work 12 weeks following discectomy. Lumbar disc herniation is a common cause of sciatica and sick leave. This presents an economic burden to the individual and the society. Methods: Data from DaneSpine on a consecutive cohort of patients operated due to lumbar disc herniation during a 3-year period was identified and merged with data from the Ministry of Employment’s register on public welfare payments. Data on welfare payments 2 years prior to the date of operation and 1 year postoperative was included. Patients were considered to be on sick leave if they received welfare payments for the week. Patients are considered to have returned to work if they did not receive public welfare payments for a 4-week period. Results: Of 1134 patients meeting inclusion criteria, 98.5% had complete preoperative surgical data available. Postoperatively, 79.1% of the patients returned to the work within 12 weeks. Physically demanding jobs, low preoperative EQ5D score, and long duration of sick leave prior to surgery were associated negatively with return to work at 12 weeks. Conclusion: The results of this study indicate that patients who have a longer duration of sick leave have a physically demanding job and are in a poor health are more likely not to return to work by 12 weeks after surgery for lumbar disc herniation. Future studies are needed to determine if earlier referral to a surgeon leads to an earlier return to work.
High Altitude and Its Effects on Oral Health: A Review of Literature
Authors: Ashour Amal Adnan 
Published: September 2020

Health deterioration at high altitudes is related to many pathophysiological processes. The literature contains much evidence describing the multiple factors responsible for this deterioration, including hypoxia, decreased oxygen saturation, and decreased barometric pressure. An increase in the levels of oxidative stress at high altitudes can lead to many serious health events, although the human body may be able to adapt to such changes in the case of people who are accustomed to living at a high altitude. The pathophysiological processes at high altitudes also have adverse effects on oral tissue health. The aim of this review is to summarize the major published findings about oral health deterioration of living in and travelling to high-altitude areas. Most studies have noted the adverse effects of prolonged exposure to hypoxia at high altitudes on oral tissues, including the salivary gland, periodontal tissue, gingival crevicular fluids, and jawbone. These changes include increases in the levels of inflammatory mediators and periodontal inflammation parameters. In addition, the incidence and severity of dental fluorosis is higher in residents of high-altitude areas. Abrupt changes in barometric pressure in people who travel to high altitudes may cause dental barotrauma and appear to increase sensitivity to pain (barodontalgia). In conclusion, it is important to consider that travelling to and living in high-altitude areas is a possible risk factor for multiple oral diseases.
Free-Text Documentation of Dementia Symptoms in Home Healthcare: A Natural Language Processing Study
Authors: Topaz Maxim , Adams Victoria , Wilson Paula , Woo Kyungmi , Ryvicker Miriam 
Published: September 2020

Background: Little is known about symptom documentation related to Alzheimer’s disease and related dementias (ADRD) by home healthcare (HHC) clinicians. Objective: This study: (1) developed a natural language processing (NLP) algorithm that identifies common neuropsychiatric symptoms of ADRD in HHC free-text clinical notes; (2) described symptom clusters and hospitalization or emergency department (ED) visit rates for patients with and without these symptoms. Method: We examined a corpus of −2.6 million free-text notes for 112,237 HHC episodes among 89,459 patients admitted to a non-profit HHC agency for post-acute care with any diagnosis. We used NLP software (NimbleMiner) to construct indicators of six neuropsychiatric symptoms. Structured HHC assessment data were used to identify known ADRD diagnoses and construct measures of hospitalization/ED use during HHC. Results: Neuropsychiatric symptoms were documented for 40% of episodes. Common clusters included impaired memory, anxiety and/or depressed mood. One in three episodes without an ADRD diagnosis had documented symptoms. Hospitalization/ED rates increased with one or more symptoms present. Conclusion: HHC providers should examine episodes with neuropsychiatric symptoms but no ADRD diagnoses to determine whether ADRD diagnosis was missed or to recommend ADRD evaluation. NLP-generated symptom indicators can help to identify high-risk patients for targeted interventions.
An assessment of annual procedure volumes and therapy adoption of transcatheter closure of patent foramen ovale in four European countries
Authors: Pietzsch Jan B , Geisler Benjamin P , Daniels Matthew J , Busca Rachele M , Tarantini Giuseppe , Søndergaard Lars , Kasner Scott E 
Published: September 2020

Introduction Patent foramen ovale closure reduces recurrence of cryptogenic ischaemic stroke compared to anti-platelet therapy. Our goal was to determine procedure volumes and closure utilisation as a proportion of candidates in four large European countries. Patients and methods National statistics were obtained for Germany, England, France, and Italy for the last available five years (2014–2018). Eligibility was aligned to the enrolment criteria of pivotal trials and current consensus documents. Stroke and transient ischaemic attack incidences were obtained from epidemiological registries and claims data. The eligible candidate pool for analysis included current year candidates plus untreated patients from the prior two years. Absolute strokes avoided assumed the hazard ratio for ischaemic stroke recurrence from a recent meta-analysis. Results In 2018, closure incidence rates were 5.64, 0.53, 2.94 and 5.26 per 100,000 in Germany, England, France and Italy, respectively. This reflects five-year increases of 128% in Germany, 462% in France and 36% in Italy ( p < 0.05 for all), and a decline of 37% in England. The proportions of treated patients versus candidates for the combined stroke and transient ischaemic attack pool were 55%, 30%, 80%, and 6%, respectively. Discussion Patent foramen ovale closure volumes increased after the 2017 announcement of positive trial results but still differ substantially across large European countries. If all closure candidates in 2018 with prior ischaemic stroke were treated, the resulting absolute reduction of recurrent ischaemic strokes, compared to anti-platelet therapy alone, would be between 782 and 2295 across the four countries over five years. Conclusion Many eligible patients at risk for a recurrent cryptogenic event might remain untreated due to regional practice variations.
Parasexual recombination enablesAspergillus fumigatusto persist in cystic fibrosis
Authors: Engel Tobias , Verweij Paul E. , van den Heuvel Joost , Wangmo Dechen , Zhang Jianhua , Debets Alfons J.M. , Snelders Eveline 
Published: September 2020

Aspergillus fumigatusis a saprobic fungus that causes a range of pulmonary diseases, some of which are characterised by fungal persistence such as is observed in cystic fibrosis (CF) patients. Creation of genetic variation is critical forA. fumigatusto adapt to the lung environment, but biofilm formation, especially in CF patients, may preclude mutational supply inA. fumigatusdue to its confinement to the hyphal morphotype. We tested our hypothesis that genetic variation is created through parasexual recombination in chronic biofilms by phenotypic and genetic analysis ofA. fumigatusisolates cultured from different origins.As diploids are the hallmark of parasex, we screened 799A. fumigatusisolates obtained from patients with CF, chronic pulmonary lung disease and acute invasive aspergillosis, and from the environment for spore size. Benomyl sensitivity, nuclear content measurements through fluorescence-activated cell sorting and scanning electron microscopy were used to confirm the diploid state of large size spores. Whole genome sequencing was used to characterise diploid-associated genetic variation.We identified 11 diploids in isolates recovered from six of 11 (55%) CF patients and from one of 24 (4%) chronic aspergillosis patients, but not in 368 isolates from patients with acuteAspergillusinfection and the environment. Diploid formation was associated with accumulation of mutations and variable haploid offspring including a voriconazole-resistant isolate.Parasexual recombination allowsA. fumigatusto adapt and persist in CF patients, and plays a role in azole resistance development. Our findings are highly significant for understanding the genetics and biology ofA. fumigatusin the human lung.
Comparison of histological and computed tomographic measurements of pig lung bronchi
Authors: Schmitt Volker H. , Schmitt Christine , Hollemann David , Mamilos Andreas , Wagner Willi , Weinheimer Oliver , Brochhausen Christoph 
Published: September 2020

AimLight microscopy is used as template in the evaluation and further development of medical imaging methods. Tissue shrinkage caused by histological processing is known to influence lung tissue dimensions. In diagnosis of COPD, computed tomography (CT) is widely used for automated airway measurement. The aim of this study was to compare histological and computed tomographic measurements of pig lung bronchi.MethodsAirway measurements of pig lungs were performed after freezing under controlled inflation pressure in a liquid nitrogen bath. The wall thickness of seven bronchi was measuredviaMicro-CT and CT using the integral-based method (IBM) and the full-width-at-half-maximum method (FWHM) automatically and histologically on frozen and paraffin sections. Statistical analysis was performed using the Wilcoxon test, Pearson's correlation coefficient with a significance level at p<0.05, scatter plots and Bland–Altman plots.ResultsBronchial wall thickness was smallest in frozen sections (median 0.71 mm) followed by paraffin sections (median 0.75 mm), Micro-CT (median 0.84 mm), and CT measurements using IBM (median 0.68 mm) and FWHM (median 1.69 mm). Statistically significant differences were found among all tested groups (p<0.05) except for CT IBM and paraffin and frozen sections and Micro-CT. There was high correlation between all parameters with statistical significance (p<0.05).ConclusionsSignificant differences in airway measurement were found among the different methods. The absolute measurements with CT IBM were closest to the histological results followed by Micro-CT, whereas CT FWHM demonstrated a distinct divergence from the other groups.