bluuebunny/crossref_metadata_2025_split huggingface dataset:
Super early cranial repair improves the prognosis of patients with craniocerebral injury
Authors: Jiang Hong-sheng , Wang Yan-zhou 
Published: September 2020

Objective Craniocerebral injury has high disability and mortality rates. The timing of cranioplasty has an important impact on patients’ prognosis. This study was performed to compare the functional prognosis between super early repair and conventional repair. Methods This observational study included 60 patients who underwent cranioplasty after surgical treatment of severe craniocerebral trauma. The patients were divided into two groups according to the time of cranial repair after the surgical treatment of craniocerebral injury: the super early group and the conventional repair group. Sex, age, Karnofsky performance status (KPS) score, Zubrod performance status (ZPS) score, psychological function score, quality of life score, and complications were recorded. Results The KPS score, ZPS score, psychological function score, and quality of life score were significantly related to the intervention period. Each of these scores had a clear correlation with the performance of super early treatment. Conclusion Super early cranial repair does not increase the incidence of surgical complications, and it can improve the postoperative KPS, ZPS, and quality of life scores.
Private practice metropolitan telepsychiatry in larger Australian states during the COVID-19 pandemic: an analysis of the first 2 months of new MBS telehealth item psychiatrist services
Authors: Looi Jeffrey CL , Allison Stephen , Bastiampillai Tarun , Pring William 
Published: September 2020

Objective: Private practice psychiatry in Australia was largely office-based until the Commonwealth Government introduced new psychiatrist Medicare Benefits Schedule (MBS) telehealth items in response to the first wave of the COVID-19 pandemic. We investigate the uptake of (1) video and telephone telehealth consultations in April–May 2020, and (2) the overall changing rates of consultation, i.e. total telehealth and in-person consultations across the larger states of Australia. Method: MBS item service data were extracted for COVID-19 psychiatrist video- and telephone-telehealth item numbers and compared with a baseline of the 2018−2019-financial-year monthly average of in-person consultations for New South Wales, Queensland, Victoria, and Western Australia. Results: Total psychiatry consultations (telehealth and in-person) rose during the first wave of the pandemic by 10%−20% compared to the previous year. The majority of private practice was conducted by telehealth in April but was lower in May as new COVID-19 case rates fell. Most telehealth provision was by telephone for short consultations of ⩽15−30 min. Video consultations increased from April into May. Conclusions: For large states, there has been a rapid adoption of the MBS telehealth psychiatrist items, followed by a trend back to face-to-face as COVID-19 new case rates reduced. There was an overall increased consultation rate (in-person plus telehealth) for April−May 2020.
Novel Therapies in Acute Migraine Management: Small-Molecule Calcitonin Gene-Receptor Antagonists and Serotonin 1F Receptor Agonist
Authors: Joyner Kayla Rena , Morgan Kelsey Woods 
Published: September 2020

Objective To review the efficacy, safety, and cost of 3 newly approved agents—ubrogepant, lasmiditan, and rimegepant—representing 2 therapeutic classes, calcitonin gene-related peptide (CGRP) receptor antagonist and serotonin 1F (5-HT1F) agonists, for the acute treatment of migraine with or without aura. Data Sources The Institute of Health US National Library of Medicine Clinical Trials, PubMed, and Cochrane databases were queried. Abstracts, journal articles, and other relevant sources published or present were reviewed. Search terms included the following: ubrogepant, MK-1602, Ubrelvy®, rimegepant, Nurtec®, BHV-3000, BMS-927711, lasmiditan, Reyvow®, LY573144. Study Selection and Data Extraction Relevant English-language articles from June 30, 2010, to August 31, 2020, were evaluated and included in the narrative. Data Synthesis CGRP receptor antagonists, ubrogepant and rimegepant, achieved 2-hour pain freedom and freedom from the most bothersome migraine symptom (MBS) at 2 hours. Both agents were well tolerated, with adverse effects similar to placebo. Lasmiditan, a 5-HT1F receptor antagonist, also improved 2-hour pain freedom and freedom from the MBS at 2 hours. Lasmiditan is associated with dizziness, paresthesia, somnolence, nausea, fatigue, and lethargy. Relevance to Patient Care and Clinical Practice Ubrogepant, rimegepant, and lasmiditan represent a new and exciting chapter in acute migraine therapy. To date, no head-to-head studies have compared these agents with the triptans. Ubrogepant and lasmiditan are effective in triptan nonresponders. None of the 3 agents is contraindicated in cardiovascular disease, unlike the triptans. Conclusions Based on available data, ubrogepant, rimegepant, and lasmiditan should be reserved as second-line therapy and may be safe in patients with cardiovascular risk. Lasmiditan’s adverse effect profile may limit its use.
Geointerpretation: The Interpretive Potential of Maps
Authors: Bailey Heidi , Smaldone David , Elmes Gregory , Burns Robert 
Published: September 2020

Interpretive centers are well-known sources of geographic information—providing visitors with maps and facts about noteworthy places. Yet research on the effectiveness of interpretation in conveying geographic information is limited. Managing natural and cultural resources creates a need to communicate to the public about these places at both small and large scales. This raises the question of how people perceive different types of spaces and how they learn geographic and spatial information. This paper reviews the literature on spatial cognition, providing a theoretical and empirical basis to suggest strategies for interpretation. The recommendations of this paper are to: 1) design geographic interpretation around the three components of spatial knowledge; 2) create interpretive maps by blending the principles of map and exhibit design; and 3) provide visitors with multiple opportunities to learn about a geographic setting. Maps have considerable potential as tools for connecting visitors to the meaning of places.
Free-Choice Family Learning: A Literature Review for the National Park Service
Authors: Bourque Colleen M. , Houseal Ana K. , Welsh Kate M. , Wenger Matthew 
Published: September 2020

Grand Valley State University Learning in national parks often occurs in the context of family groups. Understanding the motivations, needs, and outcomes of family groups is critical to engaging a substantial portion of the National Park Service (NPS) audience. This literature review was prompted by an NPS initiative to improve lifelong learning. It explores research about the nature of family learning, factors that influence it, and recommendations for enhancing it. This review uses Falk and Dierking's (2000) Contextual Model of Learning as a framework for understanding personal, sociocultural, and physical factors that contribute to family learning outcomes in free-choice settings. Recommendations for improving family learning include: tapping into the motivations of family visits, helping families converse to construct meaning, and creating physical spaces for visitors of many ages to interact. The NPS can enhance visitors’ connections to parks if park programs, exhibits, and interpretive media are effectively and deliberately designed to engage families. National parks and similar sites need to thoughtfully design education programs and exhibits to engage learners of all ages in meaningful, relevant, and memorable ways.
Treatment of feline gastrointestinal intermediate- or large-cell lymphoma with lomustine chemotherapy and 8 Gy abdominal cavity radiation therapy
Authors: Gieger Tracy L , Seiler Gabriela S , Nolan Michael W 
Published: September 2020

Objectives The goal of this study was to document the outcomes and toxicity of a novel multimodality treatment protocol for feline gastrointestinal intermediate- or large-cell lymphoma (FGL) in which cats were treated at 21-day intervals. Methods This was a prospective, single-arm study. Twelve client-owned cats with cytologically diagnosed FGL were treated with a combination of abdominal cavity radiation therapy (RT; 8 Gy total dose administered in two 4 Gy fractions, 21 days apart), lomustine chemotherapy (approximately 40 mg/m2, administered orally at 21-day intervals for four treatments), prednisolone (5 mg PO q24h) and cobalamin (250 µg/week SC). Results Three cats were euthanized prior to the second treatment and it was difficult to discern treatment-associated toxicity from progressive disease. Four of the remaining cats developed cytopenias, resulting in 7–14-day lomustine treatment delays and/or dose reductions. Six cats had a partial response to treatment and three had stable disease based on ultrasound at day 21 (50% overall response rate). Three of these six cats completed the study and lived >240 days; one died of refractory diabetes mellitus with no clinical evidence of FGL, and the other two died as a result of FGL. The median overall survival time was 101 days (95% confidence interval [CI] 9–240). The median progression-free survival time was 77 days (95% CI 8–212). Necropsies were performed in eight cats, which revealed multifocal lymphoma throughout the gastrointestinal tract and other organs. Conclusions and relevance Oncological outcomes reported herein are comparable to those achieved with multiagent injectable chemotherapy (eg, CHOP). Treatment was seemingly well tolerated in most cats and was relatively cost-effective. It is therefore plausible that improved disease control may be achievable through continued optimization and intensification of the combinatorial chemoradiotherapy protocol.
Needling revision with marking maneuver to locate the scleral flap
Authors: Gutiérrez-Ortiz Consuelo , Rodrigo-Rey Sara 
Published: September 2020

Purpose: To report a variation of the classical needle revision maneuver with an external marking of the scleral flap, augmented with mitomycin C (MMC) in failed non penetrating deep sclerectomy (NPDS). Method: This observational prospective pilot study included five consecutive patients who underwent an MMC needling revision of failed NPDS with the external marking of the scleral flap. All participants underwent a complete ophthalmologic examination and data were collected preoperatively as well as 1 day, 1 week and 1 month after the surgery. The surgical site was also evaluated during the procedure. Results: A significant reduction of IOP and antiglaucomatous medication from preoperative levels was detected at the end of the follow-up period. Regarding the surgical site, we succeed in locating the scleral flap and observing the bleb formation in all cases. No significant subconjunctival bleeding was detected. Conclusion: This variation of the classical needling technique seems to improve intrasurgical visualization and reduces complications, which might lead to an improvement in surgical success.
Paracentral acute middle maculopathy (PAMM) associated with ulcerative colitis and coexisting hyperhomocysteinemia: A case report
Authors: Alkabes Micol , Vujosevic Stela , Muraca Andrea , De Cillà Stefano 
Published: September 2020

Introduction: Paracentral acute middle maculopathy (PAMM) is a tomographic finding of a retinal occlusive vascular disorders with different aetiologies. Despite the well documented triple association among hyper-homocysteine, retinal vein occlusion and PAMM, up to date no reports exist on the development of PAMM in young patients affected by ulcerative colitis (UC). Case description: A multimodal imaging study, including fundus photographs, optical coherence tomography (OCT) B-scans, OCT angiography (OCT-A) and fluorescein and indocyanine green angiography, was performed in a 32-years-old male complaining of acute-onset paracentral scotoma in the right eye. Fundus images demonstrated the typical dark gray area of retinal capillary ischemia, corresponding on OCT B-scans to the hyper-reflective plaques in the INL, and consistent with PAMM lesions.The deep capillary plexus (DCP) was normal on OCT-A. Fluorescein angiography revealed a concurrent branch retinal vein preocclusion and showed capillary drop out parafoveally. Patient’s anamnesis was negative except for a 15-years history of UC and use of acetylsalicylic acid (ASS). At the time of presentation, UC was quiescent, but new blood tests revealed concomitant high values of homocysteinemia requiring oral vitamin B12 and folate supplementation. Two months later PAMM lesions had disappeared on OCT B-scans and a retinal thinning at the level of the inner nuclear layer (INL) was visible. The DCP on OCT-A remained unchanged without any sign of capillary ischemia. Conclusions: Although no definitive evidence directly links UC with PAMM, the latter should be suspected in young patients affected by IBD with coexisting hyper-homocysteinemia and unexplained visual symptoms.
Efficacy of a WeChat-based intervention for adherence to secondary prevention therapies in patients undergoing coronary artery bypass graft in China: A randomized controlled trial
Authors: Wang Jinwen , Zeng Zhechun , Dong Ran , Sheng Juanjuan , Lai Yongqiang , Yu Jianbo , Zuo Huijuan 
Published: September 2020

Introduction We assessed whether the social media-based (WeChat) intervention integrated with follow-up care could improve adherence to drugs, lifestyle changes and clinical risk markers in patients undergoing coronary artery bypass graft (CABG) in China. Methods We randomized patients at hospital discharge following CABG to intervention group or control care in China. The intervention is a structured programme of cardiac health education, medication reminders and cardiologist-based follow-up service using WeChat platform. The control group maintains a routine practice pattern. The primary outcome is adherence to cardioprotective medications measured for 12 months after discharge. We also evaluated the lifestyle modifications and clinical risk markers at 12 months. Results A total of 164 participants completed the trial for analysis. The intervention group had significantly greater adherence to statins use 98.6% vs. 75.0% ( p < 0.01), beta-blockers 93.4% vs. 69.3% ( p < 0.01) and aspirin 98.8% vs. 87.8% ( p < 0.001). The intervention group had significantly greater adherence to regular physical activity (64.2% vs. 48.2%; p < 0.039). Furthermore, intervention versus standard group at 12 months had significantly lower mean systolic blood pressure and low-density lipoprotein cholesterol ( p < 0.05). Discussion A WeChat-based intervention strategy in post-CABG patients improved adherence to medications, including statin, aspirin and beta-blockers, and regular physical activity and resulted in an improvement in systolic blood pressure and low-density lipoprotein cholesterol level.
The Munich Valsalva Implantation Technique (MuVIT) for Cardiac Output Reduction During TEVAR: Vena Cava Occlusion With the Valsalva Maneuver
Authors: Tsilimparis Nikolaos , Abicht Jan-Michel , Stana Jan , Konstantinou Nikolaos , Rantner Barbara , Banafsche Ramin , Fernandez Prendes Carlota 
Published: September 2020

Purpose To demonstrate a physiologically induced alternative to the typical methods of reducing cardiac output during deployment of stent-grafts in the aortic arch and proximal aorta. Technique A modified Valsalva maneuver, the Munich Valsalva implantation technique (MuVIT), to raise the intrathoracic pressure, minimize backflow, and reduce the cardiac output is illustrated in a patient undergoing a triple-branch thoracic endovascular aortic repair (TEVAR). During manual mechanical ventilation, the adjustable pressure-limiting valve is carefully closed to 25 mm Hg, creating “manual bloating” of the lungs and sustained apnea. The increased intrathoracic pressure causes compression of the vena cava and pulmonary veins, reducing the venous backflow and gradually decreasing the arterial pressure. Once the desired pressure is obtained, the stent-graft is accurately deployed. The airway pressure is thereupon slowly reduced, and the patient is taken back to normal ventilation. The procedure is then finished following standard practice. Conclusion The MuVIT is a simple, noninvasive technique for cardiac output reduction during aortic arch TEVAR, eliminating the need for other invasive techniques.
LncRNA growth arrest-special 5 polymorphisms and predisposition to cancer: A meta-analysis
Authors: Cai Hairong , Xu Wenyan , Zhang Xian 
Published: September 2020

Aim: The lncRNA growth arrest-special 5 ( GAS5) is a critical tumor suppressor lncRNA, and its expression level has been found to be decreased in many types of cancers. So GAS5 polymorphisms are also likely to influence predisposition to many types of malignant diseases. Nevertheless, the relationships between GAS5 polymorphisms and cancer are still controversial. Thus, the authors designed this meta-analysis to get a more statistically reliable conclusion. Methods: The authors searched PubMed, Embase, and Web of Science for eligible studies. A total of 12 eligible studies involving 8693 cancer cases and 10,805 controls were pooled and analyzed in this meta-analysis. Results: Among GAS5 polymorphisms, only GAS5 rs145204276 insertion/deletion polymorphism could be analyzed in a meta-analysis with regard to predisposition to cancer since no any other GAS5 polymorphisms were explored by at least two individual genetic association studies. All eligible studies were found to be of Asian origin. Although the overall pooled meta-analysis results did not show any significant associations between rs145204276 insertion/deletion polymorphism and a predisposition to cancer, rs145204276 insertion/deletion polymorphism was demonstrated to be significantly associated with a predisposition to gastric cancer (dominant comparison: P<0.0001; recessive comparison: P=0.005; over-dominant comparison: P=0.0003; over-dominant comparison: P<0.0001) in Asians in further subgroup analyses. Conclusions: This meta-analysis demonstrated that GAS5 rs145204276 insertion/deletion polymorphism was associated with a predisposition to gastric cancer in Asians. Nevertheless, considering that this positive finding was only based on three eligible studies from the same area, future studies with larger sample sizes in other populations are still warranted to test the robustness of our findings.
Sex differences in risk factors, treatment, and prognosis in acute stroke
Authors: Dahl Solveig , Hjalmarsson Clara , Andersson Björn 
Published: September 2020

Objectives: Stroke is a major cause of long-term disability and death worldwide. Several studies have shown that women in general have more severe symptoms at arrival to hospital and are less likely to return home and independent living. Our aim with the present study was to update previous results concerning sex differences in baseline characteristics, stroke management, and outcome in a population study from Sahlgrenska University Hospital, Gothenburg, Sweden. Methods: This study included patients with acute ischemic and hemorrhagic stroke in 2014 at Sahlgrenska University Hospital. All data were collected from The Swedish National Stroke Registry (Riksstroke). Results: The study population consisted of 1453 patients, with 46.7% females. Women were 5 years older than men. There was no sex difference in acute stroke severity. Frequency of revascularization was equal between men and women. The stroke mortality rate was the same between the sexes. At 3-months follow-up, women had a worse functional outcome and a higher frequency of depression and post-stroke fatigue. Conclusion: Our results show that there are no sex differences in management of acute stroke. However, the cause of worse functional outcome in women at 3-months follow-up, independent of other risk factors, is not clear and warrants further investigations.
Pulmonary pathology of infection by SARS-CoV-2, what we have learnt through post-mortem studies and pathophysiological considerations
Authors: Takano Angela M 
Published: September 2020

Background: Since the declaration of Coronavirus Disease 2019 (COVID-19) caused the by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a pandemic, millions of people throughout the world have contracted the disease and more than 500,000 have died. While this terrible disease has brought devastation to many countries, it has also generated the fastest growing amount of research output that science has seen during the last decades. Objectives: The objectives of this work were to review the pulmonary pathology from post-mortem studies and case reports of patients who succumbed to COVID-19, perform clinicopathologic correlation and hypothesize about pathogenetic mechanisms, and translate this understanding into better prevention, management and outcomes in the battle against COVID-19. Method: I performed a literature search through PubMed. Results: The main histopathologic findings in COVID-19 pneumonia are diffuse alveolar damage, organizing pneumonia, acute fibrinous and organizing pneumonia, interstitial pneumonia, endotheliitis, thromboembolism that correlates with respiratory failure and manifestations of thrombotic microangiopathy and hypercoagulable state. Immunohistochemical and transmission electron microscopic studies demonstrate viral proteins and viral structures within epithelial and endothelial cells. Reverse transcriptase polymerase chain reaction demonstrates the presence of viral RNA in nasopharynx and lung tissue post-mortem. Conclusions: SARS-CoV-2 is a respiratory virus that infects cells by binding to angiotensin-converting enzyme II (ACE2) receptors, produces cell death and ACE2 downregulation, which, in conjunction with dysregulated immune response, orchestrates a proinflammatory and prothrombic state that results in respiratory and multiple organ failure.
Comparison of reliability of magnetic resonance imaging using cartilage and T1-weighted sequences in the assessment of the closure of the growth plates at the knee
Authors: Kvist Ola FT , Dallora Ana Luiza , Nilsson Ola , Anderberg Peter , Berglund Johan Sanmartin , Flodmark Carl-Erik , Diaz Sandra 
Published: September 2020

Background Growth development is traditionally evaluated with plain radiographs of the hand and wrist to visualize bone structures using ionizing radiation. Meanwhile, MRI visualizes bone and cartilaginous tissue without radiation exposure. Purpose To determine the state of growth plate closure of the knee in healthy adolescents and young adults and compare the reliability of staging using cartilage sequences and T1-weighted (T1W) sequence between pediatric and general radiologists. Material and Methods A prospective, cross-sectional study of MRI of the knee with both cartilage and T1W sequences was performed in 395 male and female healthy subjects aged between 14.0 and 21.5 years old. The growth plate of the femur and the tibia were graded using a modified staging scale by two pediatric and two general radiologists. Femur and tibia were graded separately with both sequences. Results The intraclass correlation was overall excellent. The inter- and intra-observer agreement for pediatric radiologists on T1W was 82% (κ  = 0.73) and 77% (κ  = 0.65) for the femur and 90% (κ  = 0.82) and 87% (κ  = 0.75) for the tibia. The inter-observer agreement for general radiologists on T1W was 69% (κ  = 0.56) for the femur and 56% (κ  = 0.34) for the tibia. Cohen’s kappa coefficient showed a higher inter- and intra-observer agreement for cartilage sequences than for T1W: 93% (κ  = 0.86) and 89% (κ  = 0.79) for the femur and 95% (κ = 0.90) and 91% (κ  = 0.81) for the tibia. Conclusion Cartilage sequences are more reliable than T1W sequence in the assessment of the growth plate in adolescents and young adults. Pediatric radiology experience is preferable.