bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuing Medical Education in the Time of Social Distancing: The Case for Expanding Podcast Usage for Continuing Education
Authors: Tarchichi Tony R. , Szymusiak John 
Published: December 2020

Abstract:
The COVID-19 pandemic is forcing society to re-evaluate how it educates learners of all levels, from medical students to faculty. Travel restrictions and limits on large public gatherings have necessitated the cancelling of numerous regional and national conferences as well as local grand rounds at many academic centers. Podcasting provides a potential solution for providing CME in a safe, socially distant way as an alternative to these more traditional CME sources for health care professionals. Using a popular CME podcast for pediatric hospitalists as an example, this article describes the many advantages that podcasting poses over more traditional CME methods, outlines some of the methodological and technological considerations that go into creating a high-quality podcast, and describes how podcasting can be leveraged during a global pandemic. Finally, we identify areas for further research regarding podcasting, including effective ways to virtually replace the more social and community building aspects of traditional conferences and grand rounds.
Knowledge of Glaucoma Among Patients Attending Virtual and Face-to-Face Glaucoma Clinics
Authors: Tatham Andrew J. , Ali Ameer M. , Hillier Niamh 
Published: December 2020

Precis:
No significant difference in knowledge of glaucoma was found among patients attending virtual and face-to-face glaucoma clinics. Gaps in knowledge were identified in both groups highlighting the importance of incorporating patient education into glaucoma services.

Purpose:
To examine knowledge of glaucoma among patients attending virtual compared with face-to-face glaucoma clinics.

Materials and Methods:
A survey was conducted of 105 patients with glaucoma, including 50 attending virtual and 55 attending face-to-face clinics. Participants were asked to complete a glaucoma knowledge assessment using the National Eye Health Education Program Eye-Q test. All participants had a comprehensive eye examination and completed standard automated perimetry. Knowledge of glaucoma was compared between groups and the effect of potential confounders, including age, sex, education level, and standard automated perimetry mean deviation, was explored using regression analyses. The relationship between test scores and self-perception of knowledge of glaucoma was also examined.

Results:
There was no significant difference between knowledge scores between patients attending virtual and face-to-face clinics with mean scores of 5.6±1.0 and 6.0±1.6 (P=0.762) respectively. More patients attending the virtual clinic could correctly identify the type of glaucoma they had (74% vs. 52.7%, P=0.005). Regression analyses found education level and patients’ correct knowledge of their type of glaucoma were significantly associated with Eye-Q scores. Patients with university qualifications scored significantly higher than those with no or basic school qualifications (P=0.003) and higher-level school qualifications (P=0.038). Most patients desired to know more about their condition.

Conclusions:
Patients attending virtual glaucoma clinics demonstrated similar knowledge of glaucoma compared with those attending face-to-face clinics but gaps in knowledge were identified in both groups. Patient education should be incorporated into the design of all glaucoma services.
Long-term Efficacy of Mitomycin C Augmented Trabeculectomy in a Mixed Pediatric Glaucoma Cohort
Authors: Gurney Sam P. , Ahmad Mohammad , Makanjuola Taiwo , Ramm Laura , Parulekar Manoj V. 
Published: December 2020

Precis:
This paper reports a retrospective consecutive case series investigating the efficacy of Mitomycin C-augmented trabeculectomy in the treatment of primary and secondary pediatric glaucoma in a mixed etiology, multiethnic cohort of patients.

Purpose:
To evaluate the long-term efficacy and safety of Mitomycin C-augmented trabeculectomy in a mixed, tertiary-referral, pediatric glaucoma cohort.

Methods:
Retrospective consecutive review of all children (37 eyes) undergoing Mitomycin C-augmented trabeculectomy by a single surgeon between 2008 and 2016. Seventeen eyes (45.9%) had primary congenital glaucoma, and 20 eyes (54.1%) had secondary glaucoma. The median age at surgery was 11 months (range, 2 to 146). The mean follow-up was 69.2±4.7 months (range, 3.5 to 107.9).

Results:
Overall, trabeculectomy was successful in 80.6% of eyes at 12 months, 60.5% at 3 years, and 57.5% at 5 years. 45.9% cases (17 eyes) required further laser or surgery for uncontrolled intraocular pressure (IOP) and were therefore deemed as failures. The time to failure ranged from 0.4 to 65.1 months (mean, 22.2±5.1 mo). The proportion of children achieving visual acuity of 1.0 LogMAR equivalent or better increased from 43.2% preoperatively to 63.6% at 1 year and 68% at 5 years. The mean IOP reduced from 24.85±0.88 mm Hg preoperatively to 15.14±0.94 mm Hg at 3 months (39% reduction) and 17.42±1.08 mm Hg at 5 years (30% reduction). IOP-lowering medication requirement reduced from 4.14±0.20 agents preoperatively to 0.84±0.22 at 3 months (80% reduction) and 1.78±0.36 at 5 years (57% reduction). There were no sight-threatening complications such as hyphaema, bleb leak, chronic hypotony, endophthalmitis, retinal detachment, or loss of light perception.

Conclusions:
This study provides valuable evidence that Mitomycin C-augmented trabeculectomy is safe and effective as a treatment of primary or secondary pediatric glaucoma, with particularly encouraging results in cases of secondary glaucoma. Trabeculectomy offers the potential for delaying or avoiding glaucoma drainage device surgery in a significant proportion of children.
The Effect of Add-on Buprenorphine to Matrix Program in Reduction of Craving and Relapse Among People With Methamphetamine Use Disorder
Authors: Kheirabadi Gholam Reza , Bahrami Mabobeh , Shariat Ali , Tarrahi Mohammadjavad 
Published: December 2020

Abstract

Background
Methamphetamine addiction is a global issue. Buprenorphine might have beneficial roles in reducing craving to methamphetamine use via altering neurotransmission signaling and dopaminergic system-related reward mechanisms.

Procedures
This clinical trial was performed in 2019 to 2020 in Khorshid Hospital, Isfahan, Iran. The study was conducted on patients with methamphetamine use disorder. The intervention group received sublingual buprenorphine for 8 weeks, and the other group also received placebo tablets. Patients were followed up and visited every month for the next 4 months. Both groups were treated simultaneously by matrix program for 2 months and observed for the next 4 months. Patients filled out the Cocaine Craving Questionnaire-Brief (CCQ-Brief) every week during intervention time (first 2 months) and every month during follow up visits (4 months). The Depression Anxiety Stress Scale (DASS-21) was also filled out before and after interventions for all of the patients. Data were analyzed using SPSS software using χ2, independent t test and repeated-measure analysis of variance tests.

Results
Our data indicated significantly lower CCQ-Brief scores in the intervention group compared with the placebo group (P < 0.05). It was also indicated that changes in CCQ-Brief scores were also significant among both groups (P < 0.001). We also showed that the anxiety, depression, and stress scores reduced significantly after interventions (P < 0.001). These scores were also significantly lower in the intervention group compared with placebo group (P < 0.05).

Conclusions
Buprenorphine may be effective and may have positive potential roles in reducing methamphetamine craving. This drug is also helpful in reducing the anxiety, depression, and stress of patients with methamphetamine use disorders.
Prolactin and Estrogen Levels in Postmenopausal Women Receiving Aripiprazole Augmentation Treatment for Depression
Authors: Rahman Tahir , Patrick Cory , Ma Cynthia , Nicol Ginger E. , Reynolds Charles F. , Mulsant Benoit H. , Hartz Sarah M. , Yingling Michael , Lenze Eric J. 
Published: December 2020

Abstract

Background
Antipsychotic drugs are well established to alter serum prolactin levels, often resulting in adverse effects including amenorrhea, galactorrhea, osteoporosis, and loss of libido. There is growing preclinical evidence that prolactin-elevating drugs can instigate the progression of precancerous lesions to breast cancer and that genes activated by prolactin are associated with the development and proliferation of breast cancer. Current guides advise a cautious approach (weighing risks and benefits) to the administration of prolactin-elevating antipsychotic drugs in women with a previously detected breast cancer. Aripiprazole is known to be a prolactin-sparing antipsychotic; however, data regarding its effects on prolactin and estrogens in postmenopausal women are lacking.

Methods
We examined serum hormone levels in n = 66 women who participated in a randomized, double-blind, placebo-controlled, multicenter trial of aripiprazole (high and low doses) added to an antidepressant in adults older than 60 years. Aripiprazole or placebo tablets were administered for 12 weeks as an augmentation strategy in venlafaxine-treated women. The primary outcomes were the difference in prolactin and estrogen levels.

Results
There was no significant effect of aripiprazole treatment on prolactin or estrogen levels, including in models that divided groups into low and high doses: prolactin (P = 0.075), estrone (P = 0.67), and estradiol (P = 0.96).

Conclusions
Aripiprazole addition to an antidepressant did not alter serum estrogens or prolactin. These findings may be relevant in the treatment of some postmenopausal women with depression.
Clinical Genomics for the Diagnosis of Monogenic Forms of Inflammatory Bowel Disease
Authors: Uhlig Holm H. , Charbit‐Henrion Fabienne , Kotlarz Daniel , Shouval Dror S. , Schwerd Tobias , Strisciuglio Caterina , de Ridder Lissy , van Limbergen Johan , Macchi Marina , Snapper Scott B. , Ruemmele Frank M. , Wilson David C. , Travis Simon P.L. , Griffiths Anne M. , Turner Dan , Klein Christoph , Muise Aleixo M. , Russell Richard K. ,   Paediatric IBD Porto group of ESPGHAN
Published: December 2020

ABSTRACTBackground:It is important to identify patients with monogenic IBD as management may differ from classical IBD. In this position statement we formulate recommendations for the use of genomics in evaluating potential monogenic causes of IBD across age groups.Methods:The consensus included paediatric IBD specialists from the Paediatric IBD Porto group of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and specialists from several monogenic IBD research consortia. We defined key topics and performed a systematic literature review to cover indications, technologies (targeted panel, exome and genome sequencing), gene panel setup, cost‐effectiveness of genetic screening, and requirements for the clinical care setting. We developed recommendations that were voted upon by all authors and Porto group members (32 voting specialists).Results:We recommend next‐generation DNA‐sequencing technologies to diagnose monogenic causes of IBD in routine clinical practice embedded in a setting of multidisciplinary patient care. Routine genetic screening is not recommended for all IBD patients. Genetic testing should be considered depending on age of IBD‐onset (infantile IBD, very early‐onset IBD, paediatric or young adult IBD), and further criteria, such as family history, relevant comorbidities, and extraintestinal manifestations. Genetic testing is also recommended in advance of hematopoietic stem cell transplantation. We developed a diagnostic algorithm that includes a gene panel of 75 monogenic IBD genes. Considerations are provided also for low resource countries.Conclusions:Genomic technologies should be considered an integral part of patient care to investigate patients at risk for monogenic forms of IBD.
The Use and Effect of the Health Storylines mHealth App on Female Childhood Cancer Survivors’ Self-efficacy, Health-Related Quality of Life and Perceived Illness
Authors: Cantrell Mary Ann , Ruble Kathy , Mensinger Janell , Birkhoff Susan , Morris Amanda , Griffith Patricia , Adams Jared 
Published: December 2020

Background
mHealth apps have been not been well tested among childhood cancer survivors (CCSs) to track physical and psychosocial functioning for improved self-management of post-treatment needs.

Objectives
This pilot study had 3 aims: (1) assess the usage of the Health Storylines mHealth app; (2) examine its effect in improving self-efficacy in managing survivorship healthcare needs, health-related quality of life, and perceived illness; and (3) determine if app usage moderated the effects on the above patient-reported outcome measures among female CCSs.

Methods
Study participants accessed the Health Storylines mHealth app on their own personal device. This single-group, pilot study included 3 measurement points: baseline and 3 and 6 months after initiation of using the app.

Results
Use of the mHealth app ranged from 0 times to 902 times. Every study participant who used the app (n = 26) also used the mental health app component of the Health Storylines app. Generalized estimating equations were fit to examine the effect of the mHealth app use on self-efficacy, perceived illness, and health-related quality of life, between baseline, 3-month follow-up, and 6-month follow-up. No statistically significant changes were evident, on average, from baseline to 3- or 6-month follow-up on any outcome. Subsequent testing of effect moderation showed differential trends for high versus low users.

Conclusions
Studies are needed among this clinical population to determine who will benefit and who will perceive the app as a useful aspect of their survivorship care.

Implications for Practice
Sharing mental health functioning tracked on mhealth apps with healthcare providers may inform needed interventions for young adult female CCSs.
Rejuvenation of Aged Human Skin by Injection of Cross-linked Hyaluronic Acid
Authors: Cui Yilei , Wang Frank , Voorhees John J. , Fisher Gary J. 
Published: December 2020

Background:
Dermal injection of chemically cross-linked hyaluronic acid (CL-HA) is a common procedure to smooth wrinkles and add fullness to the face. Due to its physical properties, CL-HA both fills space and exerts mechanical forces within the dermis. Dermal fibroblasts produce the collagen-rich extracellular matrix (ECM), which comprises the bulk of skin. Attachment to the ECM allows fibroblasts to achieve a stretched, morphology, which confers a functional phenotype that maintains collagen production. In aged/photoaged skin, collagen fibril fragmentation impairs fibroblast attachment, resulting in a collapsed morphology and reduced collagen production. This article describes investigations of the impact of CL-HA injection on fibroblast morphology and function in the aged/photoaged human skin.

Methods:
Fifty-three subjects, age 70 years or older, received a single injection of saline (vehicle control) and CL-HA (0.5 ml each) in separate adjacent skin sites on photodamaged forearm or sun-protected buttock skin. Full-thickness punch biopsies were obtained from injected skin sites at various times and analyzed for molecular and cellular changes.

Results:
Injected CL-HA forms discreet pockets that localize to areas of the dermis that contain fragmented, loosely organized collagen fibrils. These CL-HA pockets fill space and apply mechanical forces on adjacent ECM that induce stretching of fibroblasts. This stretching is associated with increased collagen gene expression and deposition of mature collagen fibril bundles, which resemble those observed in young skin.

Conclusions:
CL-HA injected into aged/photoaged human dermis acts by both filling space and inducing production of collagen by dermal fibroblasts. Deposition of mature collagen, which remains in the skin for decades, likely confers long-term benefits. Reduced collagen production in aged/photoaged skin is an adaptive response of fibroblasts to ECM fragmentation, rather than inherent cellular aging mechanisms.
Prediction of Facial Aging Using the Facial Fat Compartments
Authors: Rohrich Rod J. , Avashia Yash J. , Savetsky Ira L. 
Published: December 2020

Summary:
Facial aging is a multifactorial process governed by both intrinsic and extrinsic factors that impart a change to each component of the facial anatomy. Our understanding of the science of aging has evolved over the years. A recent and valuable addition to our understanding is the knowledge of both the superficial and deep facial fat compartments. The deep compartments provide structural support to the midface and the superficial fat compartments. Understanding the anatomy and the spectrum of their changes helps to tailor management options for facial rejuvenation. The authors present a review on facial aging as it relates to these fat compartments and provide a management algorithm based on the longitudinal changes seen during aging.
Surgical Treatment of Upper Extremity Gunshot Injures
Authors: Meade Anna , Hembd Austin , Cho Min-Jeong , Zhang Andrew Y. 
Published: December 2020

Introduction
Firearm morbidity and mortality have been increasing in recent years, and with this, the demand for medical personnel firearm injury treatment knowledge. Extremities contribute to a majority of firearm injuries, with these injuries being particularly complex because of neurovascular proximity within a confined space. Knowledge of firearm mechanism of injury and treatment management options is important for any trauma hand surgeon. Many factors play vital roles in the treatment of complex upper extremity (UE) gunshot wounds (GSWs). The aim of our review and case illustrations is to provide hand surgeons with an up-to-date guide for initial emergent management, soft tissue, bony, and nerve repair and reconstruction.

Patient and Methods
A literature review was conducted in the current management of UE GSW injuries, and 2 specific patient case examples were included. High-energy versus low-energy GSWs were documented and compared, as well as containment injures. Management including soft tissue, bony, and nerve injuries was explored along with patient outcome. Based on these findings, guidelines for GSW management were purposed.

Conclusion
Gunshot wounds of the UE encompass a group of highly heterogeneous injuries. High-energy wounds are more extensive, and concomitant injuries to bone, vessel, nerve, muscle, and soft tissue are common. Early treatment with adequate debridement, skeletal fixation, and soft tissue coverage is indicated for complex injuries, and antibiotic treatment in the pre-, peri-, and postoperative period is indicated for operative injuries. Soft tissue coverage options include the entire reconstructive ladder, with pattern of injury and considerations of wound characteristics dictating reconstructive choice. There are arguments to using either external or internal bony fixation techniques for bone fracture management, with choice tailored to the patient. For management of nerve injuries, we advocate earlier nerve repair and a shorter duration of observation before secondary reconstruction in selective cases. If transected nerve endings cannot be brought together, nerve autografts of shorter length are recommended to bridge nerve ending gaps. A significant number of patients with GSW fail to make necessary follow-up appointments, which adds to challenges in treatment.
Potential In Vitro Tissue-Engineered Anterior Cruciate Ligament by Copolymerization of Polyvinyl Alcohol and Collagen
Authors: Pan Zhengjun , Yin Hao , Wang Shuangli , Xiong Gaoxin , Yin Zongsheng 
Published: December 2020

Background and Purpose:
Suitable tissue-engineered scaffolds to replace human anterior cruciate ligament (ACL) are well developed clinically as the development of tissue engineering. As water-soluble polymer compound, polyvinyl alcohol (PVA) has been wildly used as the materials to replace ACL. The aim of this study was to explore the feasibility of constructing tissue-engineered ACL by the copolymerization of PVA and collagen (PVA/COL).

Methods:
PVA and COL were copolymerized at a mass ratio of 3:1. The pore size and porosity of the scaffold were observed by electron microscope. The maximum tensile strength of the scaffold was determined by electronic tension machine. The cytotoxicity of the scaffold was evaluated by MTT assay. The morphology of ACL cells cultured on the surface of the scaffold was observed by inverted microscope. The degradation of the scaffold was recorded in the rabbit model.

Results:
The average pore size of the polymer scaffold was 100 to 150 μm and the porosity was about 90%. The maximum tensile strength of the scaffold material was 8.10 ± 0.28 MPa. PVA/COL could promote the proliferation ability of 3T3 cells. ACL cells were successfully cultured on the surface of PVA/COL scaffold, with natural growth rate, differentiation, and proliferation. Twenty-four weeks after the plantation of scaffold, obvious degradations were observed in vivo.

Conclusion:
The model of in-vitro tissue-engineered ACL was successfully established by PVA/COL scaffolds.
Application of Virtual Endoscopy in Microvascular Decompression of Trigeminal Neuralgia
Authors: Wei Wenbin , Liu Zhiyang , Zhang Weijie , Wang Yiwen , Chen Minjie 
Published: December 2020

Purpose:
The main purpose of this study is to evaluate the accuracy of virtual endoscopy (VE) in microvascular decompression (MVD) for the treatment of trigeminal neuralgia (TN).

Methods:
A total of 30 TN patients aged 42 to 70 years were recruited from January 2015 to January 2019, and all patients were confirmed to have severe neurovascular compression (NVC) (≥degree 2) by magnetic resonance tomographic angiography (MRTA). Preoperative MRTA and enhanced CT were performed, and the data were imported into Stlview software for VE simulation of MVD. The reliability of VE, real endoscopy, and MRTA in evaluating the degree and position of MVD in TN patients was compared.

Results:
Virtual endoscopy is more reliable than MRTA in evaluating the degree of NVC, but both of them are reliable in determining the position of NVC in TN patients.

Conclusions:
Virtual endoscopy can be used in MVD for the treatment of TN, including preoperative diagnosis and risk evaluation, intraoperative guidance, and postoperative evaluation.