bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microvascular reconstruction for maxillofacial defects: a retrospective analysis of outcomes and complications in 121 consecutive cases
Authors: Kim SeongRyoung , Lee Dong-Hun , Ahn Kang-Min 
Published: August 2020

Abstract
Background
Microvascular reconstruction is the treatment of choice after oral cancer ablation surgery. There are few published studies of free flap survival among Korean populations. This study aimed to determine the survival rate after 121 consecutive cases of maxillofacial microvascular reconstruction and to analyze the complications associated with microsurgery.

Methods
This study included consecutive patients who underwent microsurgical reconstruction with free flaps, from January 2006 through September 2019, performed by a single surgeon at the oral and maxillofacial surgery department of a tertiary medical center. A total of 121 cases were reviewed retrospectively. The flap survival rate, flap type, radiotherapy history, complications, and treatment results were analyzed.

Results
Four different flap types were used for microvascular reconstruction: radial forearm (n = 65), fibula (n = 34), latissimus dorsi (n = 21), and serratus anterior muscle with rib bone free flap (n = 1). Total necrosis of the flap was found in four cases (two latissimus dorsi flaps and two fibular flaps). The free flap survival rate was 97.5%. Nineteen patients received radiotherapy before surgery, and none of them experienced flap failure. The mean operation time was 334 ± 83.1 min, and the mean ischemic time was 48.9 ± 12.7 min.

Conclusions
The success rate was reliable and comparable with previous studies. The success rate was not affected by radiation therapy. Free flaps can be safely used even after radiation treatment.
Novel genetic alteration in congenital melanocytic nevus: MAP2K1 germline mutation with BRAF somatic mutation
Authors: Zou Yun , Sun Yi , Zeng Xiaojing , Liu Yun , Cen Qingqing , Gu Hao , Lin Xiaoxi , Cai Ren , Chen Hui 
Published: August 2020

AbstractCongenital melanocytic nevus (CMN) represent a benign proliferative skin disease in the epidermis and dermis. CMN are historically known to be associated with activating NRAS or BRAF mutations. Melanoma frequently harbors the BRAF p.Val600Glu mutation, which is also commonly found in benign nevi. A recent study reported mutation of MAP2K1, a downstream effector of the RAS-RAF-MEK pathway, in melanoma with an overall frequency of 8%. Later, in 2019, Jansen P detected one activating MAP2K1 mutation in acral nevi. However, it is unknown whether MAP2K1 mutations are common in CMN, and how MAP2K1 contributes to the pathogenesis of CMN remains to be determined.In this study, we report one patient clinically and histologically diagnosed with CMN, with the MAP2K1 germline mutation and a BRAF p.Val600Glu somatic hit in the lesion. To the best of our knowledge, this is the first report of the coexistence of mutated BRAF and MAP2K1 in CMN, which may suggest that MAP2K1 mutations contribute to the occurrence and development of nevus expanding our knowledge of the genetics of CMN.
How does moulage contribute to medical students’ perceived engagement in simulation? A mixed-methods pilot study
Authors: Stokes-Parish Jessica B. , Duvivier Robbert , Jolly Brian 
Published: August 2020

AbstractIntroductionMoulage is used frequently in simulation, with emerging evidence for its use in fields such as paramedicine, radiography and dermatology. It is argued that moulage adds to realism in simulation, although recent work highlighted the ambiguity of moulage practice in simulation. In the absence of knowledge, this study sought to explore the impact of highly authentic moulage on engagement in simulation.MethodsWe conducted a randomised mixed-methods study exploring undergraduate medical students’ perception of engagement in relation to the authenticity moulage. Participants were randomised to one of three groups: control (no moulage, narrative only), low authenticity (LowAuth) or high authenticity (HighAuth). Measures included self-report of engagement, the Immersion Scale Reporting Instrument (ISRI), omission of treatment actions, time-to-treat and self-report of authenticity. In combination with these objective measures, we utilised the Stimulated Recall (SR) technique to conduct interviews immediately following the simulation.ResultsA total of 33 medical students participated in the study. There was no statistically significant difference between groups on the overall ISRI score. There were statistically significant results between groups on the self-reported engagement measure, and on the treatment actions, time-to-treat measures and the rating of authenticity. Four primary themes ((1) the rules of simulation, (2) believability, (3) consistency of presentation, (4) personal knowledge ) were extracted from the interview analysis, with a further 9 subthemes identified ((1) awareness of simulating, (2) making sense of the context (3) hidden agendas, (4) between two places, (5) dismissing, (6) person centredness, (7) missing information (8) level of training (9) previous experiences).ConclusionsStudents rate moulage authenticity highly in simulations. The use of high-authenticity moulage impacts on their prioritisation and task completion. Although the slower performance in the HighAuth group did not have impact on simulated treatment outcomes, highly authentic moulage may be a stronger predictor of performance. Highly authentic moulage is preferable on the basis of optimising learning conditions.
Can corrections spread misinformation to new audiences? Testing for the elusive familiarity backfire effect
Authors: Ecker Ullrich K. H. , Lewandowsky Stephan , Chadwick Matthew 
Published: August 2020

AbstractMisinformation often continues to influence inferential reasoning after clear and credible corrections are provided; this effect is known as the continued influence effect. It has been theorized that this effect is partly driven by misinformation familiarity. Some researchers have even argued that a correction should avoid repeating the misinformation, as the correction itself could serve to inadvertently enhance misinformation familiarity and may thus backfire, ironically strengthening the very misconception that it aims to correct. While previous research has found little evidence of such familiarity backfire effects, there remains one situation where they may yet arise: when correcting entirely novel misinformation, where corrections could serve to spread misinformation to new audiences who had never heard of it before. This article presents three experiments (total N = 1718) investigating the possibility of familiarity backfire within the context of correcting novel misinformation claims and after a 1-week study-test delay. While there was variation across experiments, overall there was substantial evidence against familiarity backfire. Corrections that exposed participants to novel misinformation did not lead to stronger misconceptions compared to a control group never exposed to the false claims or corrections. This suggests that it is safe to repeat misinformation when correcting it, even when the audience might be unfamiliar with the misinformation.
High frequency of methotrexate intolerance in longstanding rheumatoid arthritis: using the methotrexate intolerance severity score (MISS)
Authors: Amaral Jéssica Martins , Brito Maria José Menezes , Kakehasi Adriana Maria 
Published: August 2020

Abstract
Background
Methotrexate (MTX) intolerance is frequent, and its early identification may impact treatment, leading to timely changes in medication that may promote patient compliance and better control of rheumatoid arthritis (RA). The objective of this study was to identify the frequency of, and risk factors for, MTX intolerance using the Brazilian Portuguese version of the Methotrexate Intolerance Severity Score (MISS) questionnaire in patients with RA.

Methods
This cross-sectional study was performed between April 2018 and April 2019 and enrolled patients with RA in regular use of oral or subcutaneous MTX for at least 3 months. Patients were invited to answer the Brazilian Portuguese version of the MISS questionnaire, and MTX intolerance was defined by a score ≥ 6 points. Age, sex, disease duration, time of MTX use, dose, route of administration, concomitant medications, comorbidities, smoking, and Disease Activity Score for 28joint (DAS28) data were collected from institutional medical records.

Results
Among 120 patients, 103 (85.8%) were female, the mean age was 61 (±12.5) years, the mean duration of disease was 16 (±10.3) years, and the average duration of MTX use was 7 (±5.5) years. The frequency of MTX intolerance was 21.6%. The most frequent symptoms reported after the use of MTX were nausea (92.3%), abdominal pain (46.1%), and vomiting (30.7%). Behavioral symptoms occurred in 96.1% of patients with MTX intolerance, the most frequent being restlessness and irritability. Patients who used corticosteroids were more likely to develop MTX intolerance than those not using corticosteroids (odds ratio = 2.73; 95% confidence interval, 1.06 to 7.06; p = 0.038). Conversely, increasing age showed marginally significant association with decreased risk of MTX intolerance (p = 0.059).

Conclusions
The use of the MISS questionnaire disclosed high frequencies of anticipatory, associative, and behavioral symptoms in MTX-intolerant patients, and the use of corticosteroid increases the risk of MTX intolerance. We suggest that the MISS questionnaire be used routinely in clinical practice.
Developing cheese tourism: a local-based perspective from Valle de Roncal (Navarra, Spain)
Authors: Fusté-Forné Francesc 
Published: August 2020

AbstractThis paper aims to investigate the opinions of local cheese producers with regard to the relationships between cheese and tourism in rural areas. Based on a case study approach, data was collected through semi-structured interviews with cheesemakers and visits to cheesemaking facilities in Valle de Roncal (Roncal valley), a mountain region in northern Spain. Results of this research show that cheese producers in rural areas award tourism value to cheese by appreciating its historical linkages to land and landscapes, the rural lifestyle, and a regional communication of cheese. The originality of this paper lies on the approach to a niche tourism which is drawn from the understanding of cheese as both a local product and a tourist attraction, from the perspective of local producers in peripheries. This research informs rural tourism planners in the design of (food) tourist experiences that rely on a local-based storytelling.
Comparative analysis of restraint stress-induced depressive-like phenotypes in C57BL/6N mice derived from three different sources
Authors: Hwang Dong-Joo , Kwon Ki-Chun , Hwang Dae-Youn , Seo Min-Soo , Kim Kil-Soo , Jung Young-Suk , Cho Joon-Yong 
Published: August 2020

AbstractC57BL/6NKorl mice are a novel mouse stock recently developed by the National Institute of Food and Drug Safety Evaluation in Korea. Extensive research into the nature of C57BL/6NKorl mice is being conducted. However, there is no scientific evidence for the phenotypic response to restraint stress (RST), a stress paradigm for modeling depressive disorders, in rodents. In this study, we investigated the repeated RST-induced depressive-like phenotypes in C57BL/6 N mouse substrains (viz., C57BL/6NKorl mice from Korea, C57BL/6NA mice from the United States, and C57BL/6NB mice from Japan) obtained from different sources. The results showed that C57BL/6 N mice derived from various sources exposed to repeated RST resulted in depressive-like phenotypes reflected by a similar degree of behavioral modification and susceptibility to oxidative stress in a duration-dependent manner, except for the distinctive features (increased body weight (BW) and tolerance to the suppression of BW gain by exposure to repeated RST) in C57BL/6NKorl mice. Taken together, the duration-dependent alteration in depressive-like phenotypes by repeated exposure to RST observed in this study may provide valuable insights into the nature of C57BL/6NKorl mice as an alternative animal resource for better understanding of the etiology of depressive disorders and the mechanisms of antidepressant actions.
Congenital peritoneal encapsulation presented with small bowel obstruction
Authors: Mohamed Abdallah A. A. , Al Shuraiqi Fatma Mohammmed , Al Sarhani Salwa , Al Busaidi Sultan Ali Salim , Joodi Amer Ameen 
Published: August 2020

Abstract
Background
Congenital peritoneal encapsulation is an extremely rare condition with an etiology based on abnormal embryonic gastrointestinal development. It is characterized by congenital development of an accessory peritoneal layer partially or entirely encapsulating the small bowel. The condition is poorly understood and often discovered incidentally, either intra-operatively or during autopsy. The majority of cases are asymptomatic and rarely complicated by small bowel obstruction. The preoperative diagnosis may be impossible by plain radiographs, which are often normal or may show signs of small bowel obstruction. Computed tomography (CT) may be helpful in preoperative diagnosis of congenital peritoneal encapsulation in a patient with obstruction.

Case presentation
We report a case of a 46-year-old male patient, who presented with features of intestinal obstruction; surprisingly, CT accurately suggested the diagnosis of peritoneal encapsulation which was confirmed at surgery.

Conclusions
The presence of physical signs such as asymmetrical and fixed abdominal distension can help the clinician to raise the suspicion of peritoneal encapsulation; however, CT in the right settings can confirm the diagnosis.
Predicting short-term suicide risk: allowing for ongoing variation in severity of intent
Authors: Morgan Gethin 
Published: August 2020

SummaryThis article considers the role that assessment of suicidal ideation may have in short-term prediction of suicide. Suicide risk assessment is a multifactorial process and it is assumed that assessment of suicidal ideation is one component. Denial that suicidal ideation has any useful role in risk assessment fails to allow for the marked ongoing short-term variability in severity of intent, which is a common feature of the suicidal state of mind. It is concluded that the assessment of suicidal ideation, provided it is carried out correctly and applied appropriately, should continue to be regarded as a central component of the overall prediction process. A ‘two-take’ approach to short-term risk assessment and mitigation is proposed that takes variability in severity of intent into account and includes anticipatory treatment planning for any problems that may occur in the near future.
Psychological impact of COVID-19 in the Swedish population: Depression, anxiety, and insomnia and their associations to risk and vulnerability factors
Authors: McCracken Lance M. , Badinlou Farzaneh , Buhrman Monica , Brocki Karin C. 
Published: August 2020

AbstractBackground:The 2019 coronavirus disease (COVID-19) pandemic, with its associated restrictions on daily life, is like a perfect storm for poor mental health and wellbeing. The purpose of this study was therefore to examine the impacts of COVID-19 on mental health and wellbeing during the ongoing pandemic in Sweden.Method:Standardized measures of depression, anxiety, and insomnia as well as measures of risk and vulnerability factors known to be associated with poor mental health outcomes were administered through a national, online, cross-sectional survey (n = 1,212; mean age 36.1 years; 73% women).Result:Our findings show significant levels of depression, anxiety, and insomnia in Sweden, at rates of 30%, 24.2%, and 38%, respectively. The strongest predictors of these outcomes included poor self-rated overall health and a history of mental health problems. The presence of COVID-19 symptoms and specific health and financial worries related to the pandemic also appeared important.Conclusions:The impacts of COVID-19 on mental health in Sweden are comparable to impacts shown in previous studies in Italy and China. Importantly, the pandemic seems to impose most on the mental health of those already burdened with the impacts of mental health problems. These results provide a basis for providing more support for vulnerable groups, and for developing psychological interventions suited to the ongoing pandemic and for similar events in the future.
The molecular and cellular features of 2-cell-like cells: a reference guide
Authors: Genet Marion , Torres-Padilla Maria-Elena 
Published: August 2020

ABSTRACT
Currently, two main cell culture models predominate pluripotent stem cell research: embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs). Thanks to their ability to contribute to and form all tissues within the body, ESCs and iPSCs have proven invaluable in understanding pluripotent states, early embryonic development and cell differentiation, as well as in devising strategies for regenerative medicine. Comparatively little is known about totipotency – a cellular state with greater developmental potential. In mice, only the zygote and the blastomeres of the 2-cell-stage embryo are truly totipotent, as they alone can develop to form the embryo and all of its supportive extra-embryonic tissues. However, the discovery of a rare subpopulation of cells in murine ESC cultures, possessing features of 2-cell embryo blastomeres and expanded cell fate potential, has provided a biochemically tractable model to enable the in vitro study of totipotency. Here, we summarize current known features of these 2-cell-like cells (2CLCs) in an effort to provide a reference for the community, and to clarify what we know about their identity so far.
From pluripotency to totipotency: an experimentalist's guide to cellular potency
Authors: Riveiro Alba Redó , Brickman Joshua Mark 
Published: August 2020

ABSTRACT
Embryonic stem cells (ESCs) are derived from the pre-implantation mammalian blastocyst. At this point in time, the newly formed embryo is concerned with the generation and expansion of both the embryonic lineages required to build the embryo and the extra-embryonic lineages that support development. When used in grafting experiments, embryonic cells from early developmental stages can contribute to both embryonic and extra-embryonic lineages, but it is generally accepted that ESCs can give rise to only embryonic lineages. As a result, they are referred to as pluripotent, rather than totipotent. Here, we consider the experimental potential of various ESC populations and a number of recently identified in vitro culture systems producing states beyond pluripotency and reminiscent of those observed during pre-implantation development. We also consider the nature of totipotency and the extent to which cell populations in these culture systems exhibit this property.
Multiparametric prostate MRI-based intensity-modulated radiation therapy guided by prostatic calcifications
Authors: Kao Johnny , Karwowski Pawel , Pettit Jeffrey , Barney Austin Kevin , Atalla Christopher 
Published: August 2020

Objectives: The optimal technique to administer image-guided radiation therapy for prostate cancer remains poorly defined. This study assessed outcomes after multiparametric prostate MRI-based planning was delivered with image-guided radiation therapy using prostatic calculi observed on cone beam CT (CBCT). Methods: Between January 2015 and December 2017, 94 consecutive patients were treated with CBCT-based image-guided radiation therapy (IGRT) without fiducial markers. MRI was routinely incorporated for target delineation and intraprostatic tumor nodules were boosted to allow reduced doses to normal appearing prostate. The primary endpoint was the prevalence of prostatic calcifications while toxicity and biochemical control were secondary endpoints. Results: Median follow-up was 39.7 months with 82% NCCN intermediate to very high risk. Intraprostatic calculi were noted in 68% of patients. The 3-year biochemical control, late grade ≥2 rectal toxicity and late grade ≥2 urinary toxicity rates were 96%, 3 and 7%, respectively. Biochemical control and toxicity were not significantly impacted by the presence of prostatic calculi. Conclusion: Prostatic calcifications can serve as natural fiducial markers to allow for non-invasive IGRT for prostate cancer with promising early disease control and toxicity outcomes. Advances in knowledge: Prostate calcification-guided IGRT is technically feasible.
Analgesic efficacy of intravenous nefopam after spine surgery: a randomized, double-blind, placebo-controlled trial
Authors: Eiamcharoenwit Jatuporn , Chotisukarat Haruthai , Tainil Kanjana , Attanath Nalinrat , Akavipat Phuping 
Published: August 2020

Background: The incidence of moderate to severe pain is high among patients undergoing spinal surgery. Nefopam can be used as an adjuvant analgesic postoperatively after spine surgery. The study aimed to assess the analgesic efficacy and side effects of nefopam on 24-hour postoperative morphine consumption after spine surgery. Methods: The study is a randomized, double-blinded, placebo-controlled trial. A total of 96 patients were randomized into 4 treatment groups, 24 each. In group 1, patients received normal saline before surgical incision and before the end of surgery. In group 2, patients received 30 mg nefopam before surgical incision and normal saline before the end of surgery. In group 3, patients received normal saline before surgical incision and 30 mg of nefopam before the end of surgery. In group 4, patients received 30 mg of nefopam in both timings. Patient-controlled analgesia morphine was used for the postoperative period. Outcomes were to determine 24-hour morphine consumption and incidence of side effects. Results: Of 96 patients enrolled, 21 in placebo-placebo, 22 in nefopam-placebo, 22 in placebo-nefopam and 21 in nefopam-nefopam groups completed the study. Analysis of the Kruskal-Wallis test shows no significant difference in 24-hour postoperative morphine consumption between four groups, which were 18 [IQR 13.5-29], 20 [IQR 11-28.3], 17 [IQR 11.5-28.5], 13 [IQR 8.5-18.5] mg., respectively (p = 0.223). Incidence of side effects, including tachycardia, sedation, sweating and nausea/ vomiting, did not differ. Conclusions: Adding perioperative nefopam to opioid analgesic does not improve analgesic efficacy in patients who underwent spine surgery. Registration: Thai Clinical Trials Registry ID TCTR20171115001; registered on 15 November 2017.