bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endogenous glucocorticoids may serve as biomarkers for migraine chronification
Authors: Woldeamanuel Yohannes W. , Sanjanwala Bharati M. , Cowan Robert P. 
Published: July 2020

Aims: The aims of this study were to: (a) identify differences in serum and cerebrospinal fluid (CSF) glucocorticoids among episodic migraine (EM) and chronic migraine (CM) patients compared with controls; (b) determine longitudinal changes in serum glucocorticoids in CM patients; and (c) determine migraine-related clinical features contributing to glucocorticoid levels. Methods: Serum and CSF levels of cortisol and corticosterone were measured using liquid chromatography-mass spectrometry among adult patients with EM, CM, and controls. Serum and CSF samples were collected from 26 and four participants in each group, respectively. Serum glucocorticoids were measured at a second timepoint after 2 years among 10 of the CM patients, six of whom reverted to EM while four persisted as CM. Receiver operating characteristic (ROC) analysis was made to assess the migraine diagnostic performance of glucocorticoids. Regression analysis was conducted to determine the link between glucocorticoid levels and migraine-related clinical variables. Results: CM patients exhibited significantly elevated serum and CSF levels of cortisol and corticosterone compared with controls and EM patients (age, sex, body mass index adjusted; Kruskal–Wallis p < 0.05). ROC showed area-under-curve of 0.89 to differentiate CM from EM. CM patients with remission had their serum glucocorticoids return to control or near EM levels ( p < 0.05). Persistent CM showed unremitting serum glucocorticoids. Migraine frequency and disability contributed to increased cortisol, while pain self-efficacy predicted lower cortisol levels ( p < 0.005). Conclusion: Endogenous glucocorticoids may be biomarkers for migraine progression and for monitoring treatment response. Improving pain self-efficacy skills may help optimize endogenous glucocorticoid levels, which in turn may prevent migraine attacks.
Online paediatric chronic pain management: assessing the needs of UK adolescents and parents, using a cross-sectional survey
Authors: Hurley-Wallace Anna , Schoth Daniel E , Lilley Suzanne , Williams Glyn , Liossi Christina 
Published: July 2020

Background: Adolescent chronic pain is prevalent, and interdisciplinary treatment is recommended. Although it is well known that technology is a key part of adolescents’ daily lives, there have not been any online, interdisciplinary interventions developed for adolescents with chronic pain in a UK healthcare context. Little is known about how adolescents currently use online resources to manage chronic pain, or what guidance they seek. Methods: Ninety-five participants from the community answered this mixed-methods, online survey (adolescent n = 54, parent n = 41), which assessed the needs of UK-based adolescents for a new online chronic pain management resource. Results: Findings indicated that, at the time of the survey, adolescents frequently used social media platforms, such as Instagram, for chronic pain management. Desired techniques for a new interdisciplinary resource for adolescents included ‘advice on explaining chronic pain to others’ (86.7% of adolescents) and sleep hygiene (82.2% of adolescents), though access to a range of pain management techniques was desired. Qualitative results indicated endorsement of a new programme by adolescents and parents. Conclusions: Adolescents and parents had a positive outlook towards the development of a UK-specific online resource to help manage chronic pain. Such an intervention should aim to be made accessible via the National Health Service. Adolescent use of social media platforms to seek support for chronic pain requires further exploration in future research.
Single-stage urethroplasty: An eight-year single-centre experience and its associated factors for urethrocutaneous fistula
Authors: Satjakoesoemah Adistra Imam , Situmorang Gerhard Reinaldi , Wahyudi Irfan , Rodjani Arry 
Published: July 2020

Introduction: This study aimed to describe single-stage urethroplasty and to determine factors associated with urethrocutaneous fistula after the procedure at our institution. Methods: All hypospadias patients without any prior surgery who underwent single-stage urethroplasty from July 2010 to January 2018 were included. In total, 179 patients were followed for at least one year postoperatively. Information on types of hypospadias, operation techniques, chordee degree, preoperative pyuria (urine white blood cell count >5/HPF), urethral defect length and urethrocutaneous fistula formation was collected. Results: We obtained 103 cases of posterior (57.5%), middle (57 cases) and anterior (19 cases) hypospadias on whom onlay preputial island flap (71 cases), tubularized incised plate (46 cases) and Duckett’s transverse preputial island flap (35 cases) were conducted. After 47.1±25.8 months of follow-up, urethrocutaneous fistula were found in 23 (12.8%) patients associated with posterior hypospadias occurrence ( p=0.025), longer urethral defect ( p=0.007) and preoperative pyuria ( p<0.001). Chordee degree ( p=0.886) and age ( p=0.187) were not significant factors associated with urethrocutaneous fistula formation. Conclusion: Single-stage urethroplasty is a versatile procedure for various hypospadias cases, with a urethrocutaneous fistula rate of 12.8%. Posterior hypospadias, preoperative pyuria and longer urethral defect were associated with urethrocutaneous fistula formation. Level of evidence Level 2B.
Short-changed during the bacillus Calmette–Guérin shortages?
Authors: MacKenzie Kenneth R , Parker Sidney D , Watson Dawn , Cresswell Joanne 
Published: July 2020

Objective: Intravesical bacillus Calmette–Guérin (BCG) is the first-line treatment of choice for high-risk non-muscle-invasive bladder cancer (NMIBC). Our aim was to evaluate the long-term impact of BCG shortages on oncological outcomes. Methods: All patients undertaking an initial course of intravesical BCG for intermediate or high risk NMIBC at a single UK cancer centre between August 2012 and August 2014 were evaluated. Compliance was defined as completing 12 doses of BCG within the first year following diagnosis. Results: Due to BCG shortages, 25/114 (22%) patients were compliant with planned maintenance treatment. Compared to the compliant cohort, the non-compliant due to BCG shortages cohort had a higher rate of disease recurrence (35.3% vs. 24%), required more additional intravesical treatments (14.7% vs. 12%) and had a higher rate of radical cystectomy (11.8% vs. 4%). Disease-free survival was superior in the compliant cohort at two years (88% vs. 79.5%) and at 4.5 years (72% vs. 56.1%). There was no statistically significant difference, likely due to the sample size. Conclusions: The consequences of undertreatment due to BCG shortages can impact long-term cancer outcomes. Increased vigilance, robust long-term surveillance and alternative treatment strategies are required for NMIBC patients affected by shortages in BCG supplies. Level of evidence: Level 2b
How does the use of digital consulting change the meaning of being a patient and/or a health professional? Lessons from the Long-term Conditions Young People Networked Communication study
Authors: Sturt Jackie , Huxley Caroline , Ajana Btihaj , Gainty Caitjan , Gibbons Chris , Graham Tanya , Khadjesari Zarnie , Lucivero Federica , Rogers Rebecca , Smol Annie , Watkins Jocelyn A , Griffiths Frances 
Published: July 2020

Background While studies have examined the impact of digital communication technology on healthcare, there is little exploration of how new models of digital care change the roles and identities of the health professional and patient. The purpose of the current study is to generate multidisciplinary reflections and questions around the use of digital consulting and the way it changes the meaning of being a patient and/or a health professional. Method We used a large pre-existing qualitative dataset from the Long-term Conditions Young People Networked Communication (LYNC) study which involved interviews with healthcare professionals and a group of 16–24 years patients with long-term physical and mental health conditions. We conducted a three-stage mixed methods analysis. First, using a small sample of interview data from the LYNC study, we identified three key themes to explore in the data and relevant academic literature. Second, in small groups we conducted secondary analysis of samples of patient and health professional LYNC interview data. Third, we ran a series of rapid evidence reviews. Findings We identified three key themes: workload/flow, impact of increased access to healthcare and vulnerabilities. Both health professionals and patients were 'on duty' in their role more often. Increased access to healthcare introduced more responsibilities to both patients and health professionals. Traditional concepts in medical ethics, confidentiality, empathy, empowerment/power, efficiency and mutual responsibilities are reframed in the context of digital consulting. Conclusions Our collaboration identified conflicts and constraints in the construction of digital patients and digital clinicians. There is evidence that digital technologies change the nature of a medical consultation and with it the identities and the roles of clinicians and patients which, in turn, calls for a redefinition of traditional concepts of medical ethics. Overall, digital consulting has the potential to significantly reduce costs while maintaining or improving patient care and clinical outcomes. Timely study of digital engagement in the National Health Service is a matter of critical importance.
Complications and Readmissions After Total Hip Replacement in Octogenarians and Nonagenarians
Authors: Yohe Nicholas , Weisberg Miriam D. , Ciminero Matthew , Mannino Angelo , Erez Orry , Saleh Ahmed 
Published: July 2020

Introduction: As the US population ages, the need for total hip arthroplasty (THA) is predicted to increase by 174% by 2030. The purpose of our study was to examine the rate and risks of 30-day complications and unplanned readmission in patients over the age of 80 years old. Materials and Methods: The National Surgical Quality Improvement Project database for the years 2008 to 2014 was queried for patients over the age of 80 undergoing THA. The risks of major complications, minor complications, bleeding occurrences, unplanned readmissions, and deaths over a 30-day period were examined using univariate and multivariate analyses. Results: A total of 7730 patients were included for analysis; 324 (4.2%) patients experienced a major complication, 1944 (25.1%) patients experienced a minor complication, 1776 (22.9%) patients had a bleeding occurrence requiring transfusion, and 376 (4.9%) patients experienced an unplanned readmission to the hospital within 30 days. A total of 33 (0.4%) patient deaths were recorded within 30 days postoperatively. Patients with congestive heart failure were at increased risk for developing a major complication, odds ratio (OR) 3.618 (1.052-12.437), and postoperative death, OR 11.920 (1.362-104.322). Patients with an American Society of Anesthesiologists >2, OR: 1.351 (1.131-1.613), and an operative time greater than 120 minutes, OR: 1.346 (1.084-1.670), had increased risks of minor complications. Patients with a body mass index greater than 30 had reduced rates of minor complications, OR: 0.609 (0.486-0.763). Increased risk of unplanned readmission was seen in patients with chronic obstructive pulmonary disease, OR: 2.403 (1.324-4.359). Discussion/Conclusion: Elderly patients undergoing THA have high complication and readmission rates. Surgeons should convey these increased risk factors and rates of complications in elective THAs to their elderly patients and work with primary care physicians to mitigate these risks.
The microfoundations of organizational ambidexterity: A systematic review of individual ambidexterity through a multilevel framework
Authors: Pertusa-Ortega Eva M , Molina-Azorín José F , Tarí Juan José , Pereira-Moliner Jorge , López-Gamero María D 
Published: July 2020

The analysis of ambidexterity at the individual level may help to open the black box of organizational ambidexterity and to address the microfoundations of the exploration/exploitation dilemma in order to know how it can be achieved. The purpose of this article is to examine the main characteristics, antecedents, and consequences of individual ambidexterity, highlighting several key theoretical and methodological issues. Through a systematic literature review, we synthesize and integrate knowledge about individual ambidexterity, identifying opportunities and challenges for future research. We propose a multilevel framework that includes antecedents, consequences, and contingent effects of individual ambidexterity and their relationships. This multilevel framework may help to overcome the micro–macro divide in the management field. We also provide a synthesis of future research proposals. JEL CLASSIFICATION: M10
A Psychometric Network Analysis of OHIP-14 across Australian and Brazilian Populations
Authors: Soares G.H. , Santiago P.H.R. , Werneck R.I. , Michel-Crosato E. , Jamieson L. 
Published: July 2020

Objectives: The aim of this study was to assess the structural validity of the Oral Health Impact Profile–14 (OHIP-14) instrument in Indigenous and non-Indigenous populations from Australia and Brazil using a network analysis approach. Methods: Cross-sectional data collected using OHIP-14 were obtained for Indigenous and non-Indigenous populations from Australia and Brazil. Networks were estimated using the Gaussian graphical model. Items of the OHIP-14 instrument are represented as nodes and the partial correlations between items as edges. Dimensionality was assessed using exploratory graph analysis. Structural consistency and item stability were computed using a bootstrap sampling method. Standardized node strength across each dimension was also calculated. Results: Four dimensions were identified across all samples, although the item arrangement of most dimensions presented variation. Similarities with the theoretical domains of the instrument were found. Items from the conceptually derived OHIP-14 domains formed separated clusters or blended with other items in a single dimension. Most dimensions across all samples showed an acceptable structural consistency. Item stability revealed some discrepancies among items of dimensions of both Indigenous networks. Conclusion: The psychometric network perspective adopted in this study provides validation of the OHIP-14 structure in Indigenous and non-Indigenous populations. The structural consistency and item stability analyses showed that both Indigenous networks present a higher number of cross-domain items and less defined boundaries between dimensions. These findings indicate that OHIP-14 does not measure attributes in the same extent among different cultures. Knowledge Transfer Statement This study demonstrates a new analytical framework from which to conceptualize and interpret the construct oral health–related quality of life using the Oral Health Impact Profile (OHIP-14). Network graphs facilitate knowledge translation of findings to professionals with no expertise in psychometric methods. OHIP-14 is a valuable tool to oral health research and clinical practice. Differences in conceptions of health may influence the extent that the instrument measures oral health impacts. Consequently, dimension scores do not always provide appropriate measures and should be avoided in research reports and assessments of treatment outcomes.
Bilateral Placoid Choroiditis in an HIV-Positive Patient With Cryptococcus neoformans Meningitis and Disseminated Cryptococcal Disease
Authors: Larochelle Ryan D. , Larochelle Marissa B. , Aung Yee Yee , Linn Thinzar , Heiden David , Vitale Albert T. 
Published: July 2020

Purpose: We report a presumptive case of bilateral placoid choroiditis secondary to disseminated Cryptococcus neoformans infection and review the literature on choroidal involvement of C neoformans. Methods: A case report is presented. Results: A 35-year-old HIV-positive man presented with disseminated cryptococcal infection. Cryptococcal meningitis was confirmed by lumbar puncture, and skin involvement was confirmed by microscopy of scrapings from a papular, umbilicated, ulcerated lesion. Ophthalmologic examination revealed intact visual acuity, clear vitreous, and multiple yellowish, placoid-appearing choroidal lesions in the posterior pole bilaterally. Conclusions: Multifocal choroiditis caused by C neoformans is an uncommon manifestation of disseminated infection, and placoid yellowish choroidal lesions are an unusual variant. These findings must be differentiated from choroidal tuberculosis and other infections. Multifocal choroiditis typically occurs in AIDS patients and may precede the presentation of meningitis. In such patients, choroidal lesions warrant investigation for systemic, life-threatening opportunistic infections.
Recombinant vs plasma-derived von Willebrand factor to prevent postpartum hemorrhage in von Willebrand disease
Authors: Machin Nicoletta , Ragni Margaret V. 
Published: July 2020

Abstract
von Willebrand disease (VWD) is a congenital bleeding disorder characterized by deficient or defective von Willebrand factor (VWF). Among women with VWD, postpartum hemorrhage (PPH) is common. Treatment options at delivery include plasma-derived VWF (pdVWF) and recombinant VWF (rVWF). However, limited data are available regarding their efficacy. We conducted a retrospective observational study comparing PPH in women with VWD treated at the Hemophilia Center of Western Pennsylvania between 1 February 2017 and 31 January 2018 with either rVWF or pdVWF. We compared postpartum outcomes, including PPH frequency and estimated blood loss (EBL) at delivery. There were a total of 12 deliveries, 7 vaginal and 5 cesarean. At delivery and for 3 days postpartum, 6 women received 80 IU/kg of rVWF and 6 received 80 IU/kg of pdVWF, based on prepregnancy weight, insurance, and/or patient choice. Treatment groups had similar demographics, including median age (32.0 vs 27.0 years; P = .075), bleeding scores (3.0 vs 3.5; P = .734), and prepregnancy body mass index (29.0 vs 29.2 kg/m2; P = .691). PPH occurred in 3 (25.0%) of 12 deliveries, with no difference by treatment group (2 of 6 rVWF vs 1 of 6 pdVWF; P = 1.000) and no difference in EBL by treatment group (685 vs 462 mL; P = .384) or delivery type (vaginal, P = .722 vs cesarean, P = .531). In summary, PPH occurred in one-fourth of the deliveries in women with VWD, despite a higher dose (80 IU/kg) of rVWF or pdVWF. Future trials are needed to develop and assess novel strategies to prevent PPH in VWD.
Hysteroscopic view with targeted biopsy in the assessment of endometrial carcinoma. What is the rate of underestimatated diagnosis? The results of a multicenter Italian trial
Authors: Garuti Giancarlo , Angioni Stefano , Mereu Liliana , Calzolari Stefano , Mannini Luca , Scrimin Federica , Casadio Paolo , Alberti Davide De , Nappi Luigi , Busato Enrico , Leone Francesco P. G. , Perrini Gaetano , Cela Vito , Luerti Massimo 
Published: July 2020

Abstract
Objective
In the last two decades, many reports demonstrated the unreliability of endometrial biopsy pathology showing an AH (atypical hyperplasia) to exclude a synchronous EEC (endometrioid endometrial carcinoma), with an underestimation of EEC in up to 50% of women. Hysteroscopy is now considered the standard diagnostic tool for endometrial pathology. However, a recent meta-analysis showed that hysteroscopically guided biopsy provides a high rate of failure with respect to dilatation and curettage (D&C) and endometrial resection, in underestimating AH instead of concurrent EC. The aim of this study was to assess the sensitivity of hysteroscopy view and hysteroscopic sampling in diagnosing EEC.

Materials and methods
A multicenter, retrospective, observational trial was conducted between January 2012 and December 2018 in 14 Italian gynecological units (university-affiliated or public hospitals). Eligible patients were identified as those women in whom either a pathologic report of EEC was found on hysterectomy specimen and a preoperative hysteroscopy assessment with endometrial biopsy targeted under vision had been performed. As primary outcome, we calculated the sensitivity of hysteroscopy view and biopsy pathology on hysteroscopically driven sampling in the diagnostic workup of EC.

Results
Nine hundred forty-eight patients (age 65.83 ± 10.43) resulted eligible for analysis. Hysteroscopy view showed a sensitivity of 54.2%, a specificity of 47.2%, and an accuracy of 54% in the diagnosis of EC. Moreover, hysteroscopic view was significantly able to distinguish carcinoma from hyperplasia (p < 0.001). We evidenced an important difference of the results comparing the centers involved. Hysteroscopy-driven biopsy presented a sensitivity of 76.2%, a specificity of 52.8%, and an accuracy of 75.3%. AH pathology was reported in 19% of the cases.

Conclusion
Our study showed that EEC diagnosis via hysteroscopy diagnosis could be improved through the implementation of operator training. Hysteroscopy-driven biopsies have excellent sensitivity and accuracy in the diagnosis of EEC, and the advantages of using hysteroscopy for making a diagnosis can improve the management of the patients with EEC. While it seems reasonable that hysteroscopy is the preferred technique for diagnosing and treating a benign pathology of the uterus, it could play a major role even in the diagnosis of a malignancy.
Development of type 2 diabetes mellitus quality indicators in general practice by a modified Delphi method in Beijing, China
Authors: Jin Guanghui , Wei Yun , Liu Yanli , Wang Feiyue , Wang Meirong , Zhao Yali , Du Juan , Cui Shuqi , Lu Xiaoqin 
Published: July 2020

Abstract
Background
The service capacity of primary care has improved in China. General practice also takes growing responsibility in the management of type 2 diabetes mellitus, but there are concerns about the paucity of evidence of the quality of care delivered. And there is an absence of systematic quality indicators of type 2 diabetes mellitus in general practice in China. This study aimed to develop a set of type 2 diabetes mellitus quality indicators to facilitate quality measurement in general practice in China.

Methods
Preliminary quality indicators were generated and refined by literature review and an expert consultation meeting. Two rounds of email-based Delphi survey and a consensus meeting were carried out to identify quality indicators. Delphi questionnaires with 43 indicators were sent to 30 participants in the first round. There were 16 general practitioners and 10 community health service center leaders from primary care, 3 endocrinologists and a primary care researcher in the first round. And 27 out of the 30 participants participated in the second round. The consensus meeting was held among 9 participants to refine the indicators and a last round of rating was carried out in the meeting. The indicators were rated in terms of importance and feasibility. The agreement criteria were defined as median ≥ 7.0 and ≥ 85.0% of ratings in the 7–9 tertile for importance; median ≥ 7.0 and ≥ 65.0, 70.0, 75.0% of ratings in the 7–9 tertile for feasibility respectively in the three rounds of rating.

Results
After 2 rounds of Delphi survey and the consensus meeting, total 38 indicators achieved consensus for inclusion in the final set of indicators. The final set of indicators were grouped into 7 domains: access (5 indicators), monitoring (12 indicators), health counseling (7 indicators), records (2 indicators), health status (7 indicators), patient satisfaction (2 indicators) and self-management (3 indicators).

Conclusions
A set of 38 potential quality indicators of type 2 diabetes mellitus in general practice were identified by an iterative Delphi process in Beijing, China. Preliminary approach for measurement and data collection were described. However, the indicators still need to be validated by testing in a further study.