bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Dexmedetomidine in children undergoing general anaesthesia with sevoflurane: a meta-analysis and systematic review
Authors: Tang Wen , He DongWei , Liu YuLin 
Published: June 2020

Objective The sedative effects of dexmedetomidine (Dex) are similar to natural sleep, with easy wakening following Dex administration, and Dex has minor effects on breathing, reducing emergence agitation in children. The aim of this study was to systematically evaluate the effects of Dex on recovery quality in children following general anaesthesia with sevoflurane, to aid clinical decision making. Methods Relevant randomized controlled trials published before August 2019 were searched and selected from databases. Two researchers independently screened the literature, extracted data, and assessed included studies for bias risk. Meta-analysis was performed using Stata 14.0 software. Results The study included 24 publications. Following general anaesthesia by sevoflurane, Dex was associated with reduced occurrence of emergence agitation (odds ratio [OR] 0.16, 95% confidence interval [CI] 0.11, 0.25) and nausea and vomiting (OR 0.40, 95% CI 0.24, 0.60), along with shortened eye-opening time (standardized mean difference [SMD] 0.72, 95% CI 0.41, 1.03), shortened extubation time (SMD 0.54, 95% CI 0.28, 0.81), and reduced duration of post-anaesthesia care unit (PACU) stay (SMD 0.29, 95% CI 0.08, 0.51) versus placebo. Conclusion Dexmedetomidine has positive effects on recovery quality in children undergoing general anaesthesia with sevoflurane.
Evaluation of LY573144 (lasmiditan) in a preclinical model of medication overuse headache
Authors: Rau Jill C , Navratilova Edita , Oyarzo Janice , Johnson Kirk W , Aurora Sheena K , Schwedt Todd J , Dodick David W , Porreca Frank 
Published: June 2020

Background Medication overuse is a significant issue that complicates the treatment of headache disorders. The most effective medications for the acute treatment of migraine all have the capacity to induce medication overuse headache (MOH). Novel acute migraine-specific treatments are being developed. However, because the mechanism(s) underlying medication overuse headache are not well understood, it is difficult to predict whether any particular acute medication will induce MOH in susceptible individuals. LY573144 (lasmiditan), a 5-HT1F receptor agonist, has recently been shown to be effective in the acute treatment of migraine in phase 3 trials. The aim of this study is to determine whether frequent administration of lasmiditan induces behaviors consistent with MOH in a pre-clinical rat model. Methods Sprague Dawley rats were administered six doses of lasmiditan (10 mg/kg), sumatriptan (10 mg/kg), or sterile water orally over 2 weeks and cutaneous allodynia was evaluated regularly in the periorbital and hindpaw regions using von Frey filaments. Testing continued until mechanosensitivity returned to baseline levels. Rats were then submitted to bright light stress (BLS) or nitric oxide (NO) donor administration and were again evaluated for cutaneous allodynia in the periorbital and hindpaw regions hourly for 5 hours. Results Both lasmiditan and sumatriptan exhibited comparable levels of drug-induced cutaneous allodynia in both the periorbital and hindpaw regions, which resolved after cessation of drug administration. Both lasmiditan and sumatriptan pre-treatment resulted in cutaneous allodynia that was evoked by either BLS or NO donor. Conclusions In a pre-clinical rat model of MOH, oral lasmiditan, like sumatriptan, induced acute transient cutaneous allodynia in the periorbital and hindpaw regions that after resolution could be re-evoked by putative migraine triggers. These results suggest that lasmiditan has the capacity to induce MOH through persistent latent peripheral and central sensitization mechanisms.
Osteochondritis Dissecans of the Knee: An Interrater Reliability Study of Magnetic Resonance Imaging Characteristics
Authors: Fabricant Peter D. , Milewski Matthew D. , Kostyun Regina O. , Wall Eric J. , Zbojniewicz Andrew M. ,   The Research in Osteochondritis of the Knee (ROCK) Study Group, Albright Jay C. , Bauer Kathryn L. , Carey James L. , Chambers Henry G. , Edmonds Eric W. , Ellis Henry B. , Ganley Theodore J. , Green Daniel W. , Grimm Nathan L. , Heyworth Benton E. , Kocher Mininder S. , Krych Aaron J. , Lyon Roger M. , Mayer Stephanie W. , Nepple Jeffrey J. , Nissen Carl W. , Pennock Andrew T. , Polousky John D. , Saluan Paul , Shea Kevin G. , Tompkins Marc A. , Weiss Jennifer , Clifton Willimon S. , Wilson Philip L. , Wright Rick W. , Myer Gregory D. 
Published: June 2020

Background: Imaging characteristics of osteochondritis dissecans (OCD) lesions quantified by magnetic resonance imaging (MRI) are often used to inform treatment and prognosis. However, the interrater reliability of clinician-driven MRI-based assessment of OCD lesions is not well documented. Purpose: To determine the interrater reliability of several historical and novel MRI-derived characteristics of OCD of the knee in children. Study Design: Cohort study (diagnosis); Level of evidence, 3 Methods: A total of 42 OCD lesions were evaluated by 10 fellowship-trained orthopaedic surgeons using 31 different MRI characteristics, characterizing lesion size and location, condylar size, cartilage status, the interface between parent and progeny bone, and features of both the parent and the progeny bone. Interrater reliability was determined via intraclass correlation coefficients (ICCs) with 2-way random modeling, Fleiss kappa, or Krippendorff alpha as appropriate for each variable. Results: Raters were reliable when the lesion was measured in the coronal plane (ICC, 0.77). Almost perfect agreement was achieved for condylar size (ICC, 0.93), substantial agreement for physeal patency (ICC, 0.79), and moderate agreement for joint effusion (ICC, 0.56) and cartilage status (ICC, 0.50). Overall, raters showed significant variability regarding interface characteristics (ICC, 0.25), progeny (ICC range, 0.03 to 0.62), and parent bone measurements and qualities (ICC range, –0.02 to 0.65), with reliability being moderate at best for these measurements. Conclusion: This multicenter study determined the interrater reliability of MRI characteristics of OCD lesions in children. Although several measurements provided acceptable reliability, many MRI features of OCD that inform treatment decisions were unreliable. Further work will be needed to refine the unreliable characteristics and to assess the ability of those reliable characteristics to predict clinical lesion instability and prognosis.
Ageing and Alcohol: Drinking Typologies among Older Adults
Authors: Roche Ann M. , Harrison Nathan J. , Chapman Janine , Kostadinov Victoria , Woodman Richard J. 
Published: June 2020

Objectives: Alcohol consumption and harms among older people are increasing. We examined different demographic characteristics and drinking patterns among an older population. Methods: Secondary analyses of nationally representative Australian data; subjects aged 50+ years ( N = 10,856). Two-step cluster analysis was performed to identify demographic groups and alcohol consumption behaviours. Results: Three groups were identified: Group 1 (older, unmarried, and lived alone): >65 years, moderate drinkers, poorest health, psychological distress, social disadvantage, smokers, illicit drug users, and more frequent previous alcohol treatment. Group 3 (older married): >65 years, good health, low psychological distress, less likely to drink at risky levels, and one in five drank daily. Group 2 (younger married): 50–64 years, mostly employed, highest proportion of risky drinkers and of 5+ standard drinks per session, and liberal drinking attitudes with most concern from others about their drinking. Discussion: These demographic typologies can inform targeted prevention efforts for an estimated 1.3 million adults older than 50 years drinking at risky levels.
Lupus nephritis: correlation of immunohistochemical expression of C4d, CD163-positive M2c-like macrophages and Foxp3-expressing regulatory T cells with disease activity and chronicity
Authors: Allam Maram , Fathy Hanan , Allah Dina Abd , Salem Mona Abd Elkader 
Published: June 2020

Background C4d, which is a serum complement cleavage product of the activated complement component C4, was found to be an accurate indicator of lupus activity compared to complement levels. Recently, macrophages have been considered to be pivotal members in the pathogenesis of lupus nephritis (LN). M2c-like macrophages have anti-inflammatory functions and promote fibrosis. Multiple studies have detected that LN is associated with an imbalance between the regulatory T cell (Treg) population and the inflammatory T helper subtypes. Methods We evaluated and scored the immunohistochemical expression of C4d, CD163-positive M2C-macrophages and Foxp3-expressing Tregs in 53 renal biopsies of LN. Their expression was scored and correlated with clinical and histological disease activity and chronicity. Results Class IV was the most prevalent class (50.9%), followed by class III (17%). PTC-C4d intensity score, CD163% of positive M2c macrophages and FOXP3% of positive Tregs were significantly correlated with chronicity index ( rs = 0.292, p = 0.034; rs = 0.407, p = 0.003; and rs = 0.296, p = 0.031, respectively). Also, FOXP3% of positive Tregs was significantly correlated with LN class ( rs = 0.31, p = 0.024). Conclusion C4d-PTC, CD163-positive M2c macrophages and FOXP3-positive Tregs are markers that significantly correlated with chronicity in LN. Further studies are needed to evaluate their prognostic value.
Distinct Expression of miR-378 in Nonsyndromic Cleft Lip and/or Cleft Palate: A Cogitation of Skewed Sex Ratio in Prevalence
Authors: Xu Yuzi , Xie Binbin , Shi Jue , Li Jia , Zhou Chuan , Lu Wei , Xu Fengqin , He Fuming 
Published: June 2020

Objective: Nonsyndromic cleft lip and/or cleft palate (NSCL/P) is an isolated phenotype of orofacial clefts with skewed sex ratio in prevalence. This study aims to identify differentially expressed genes (DEGs) and microRNAs (DEMs) of NSCL/P by integrated bioinformatics analysis, revealing mechanisms for sexual dimorphism in prevalence. Materials and Methods: First, we downloaded the expression profile data from Gene Expression Omnibus database to identify DEGs and DEMs. Second, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses performed DEGs’ functions. Then, clustered DEGs were identified through protein–protein interaction networks. Combining clustered DEGs with key genes searched in GeneCards enlarged NSCL/P-related genes. Moreover, the genes were linked by transcription factors (TFs). Subsequently, connected by the above TFs, DEMs and genes were used to establish the miRNA-TF-messenger RNA (mRNA) regulatory networks. Results: The DEGs in sex-ignored group, female-only group, and male-only group were obtained, respectively. Among the DEMs, miR-378 was downregulated in females but upregulated in males. In female-only group, the miRNA-TF-mRNA regulatory networks showed miR-378-SP1-POLE2/CDK6/EZR regulatory axis was found to be key candidates of NSCL/P. Conclusions: Our findings suggest that different expression of miR-378 is consistent with the skewed sex ratio in the prevalence of NSCL/P.
Comparison of Doppler ultrasonic and oscillometric devices (with or without proprietary optimisations) for non-invasive blood pressure measurement in conscious cats
Authors: Cerna Petra , Archontakis Panos E , Cheuk Hester OK , Gunn-Moore Danièlle A 
Published: June 2020

Objectives This study compared Doppler and oscillometric (PetMAP+) devices (with or without proprietary optimisations) for the non-invasive measurement of blood pressure in conscious cats. Methods Twenty-three cats were enrolled; however, five were excluded as fewer than five measurements were obtained for each assessment. All measurements were obtained according to American College of Veterinary Internal Medicine consensus guidelines. Oscillometric device modes A and B were operated according to the manufacturer’s guidelines. Doppler and oscillometric devices were used alternately as the first device. Results Systolic arterial blood pressure (SAP) measurements were obtained by Doppler (SAPd) and oscillometry; the mean of each set of five values was used for statistical analysis. There was a significant difference between SAPd and SAP measurements in oscillometric modes A ( P <0.001) and B ( P <0.001). While both modes measured SAP higher than SAPd, B had a smaller bias (+15.72 mmHg) and narrower limits of agreement (LOA). There was also a significant difference between SAPd and mean arterial pressure (MAP) on oscillometric modes A ( P = 0.002) and B ( P <0.001). Both modes’ MAP readings were lower than SAPd and oscillometric A MAP was closer to SAPd (–14.94 mmHg), with a smaller bias and narrower LOA. Conclusions and relevance The findings support that Doppler and oscillometric devices cannot be used interchangeably, with or without proprietary optimisations. Methodology should always be taken into account and reference intervals (RIs) need to be defined for the different methodologies. Until methodology-specific RIs are published, definitive diagnosis of hypertension and sub-staging of patients with kidney disease according to the International Renal Interest Society guidelines remains challenging.
A novel in-home digital treatment to improve processing speed in people with multiple sclerosis: A pilot study
Authors: Bove Riley , Rowles William , Zhao Chao , Anderson Annika , Friedman Samuel , Langdon Dawn , Alexander Amber , Sacco Simone , Henry Roland , Gazzaley Adam , Feinstein Anthony , Anguera Joaquin A 
Published: June 2020

Objective: To assess whether a videogame-like digital treatment is superior to a control in improving processing speed in adults with multiple sclerosis (MS). Methods: Adults with MS and baseline Symbol Digit Modalities Test (SDMT) z-scores between −2 and 0 were enrolled in a double-blind randomized controlled clinical trial. After completing a baseline in-clinic evaluation (Visit 1), they were randomized to complete an in-home, tablet-based videogame-like digital treatment (AKL-T03) or control word game (AKL-T09) for up to 25 minutes/day, 5 days/week, for 6 weeks. A repeat in-clinic evaluation occurred at 6 weeks (Visit 2), and again 8 weeks later to determine persistence of effects (Visit 3). The pre-specified primary outcome was change in SDMT score between Visits 1 and 2. Results: SDMT increased at Visit 2 for participants randomized to both AKL-T03 ( p < 0.001) and AKL-T09 ( p = 0.024). These respective mean improvements were +6.10 and +3.55 (comparison p = 0.21). At Visit 3, 70% of participants randomized to AKL-T03 maintained a clinically meaningful 4+-point increase in SDMT above their baseline, compared with 37% for AKL-T09 ( p = 0.038). Conclusion: This in-home digital intervention resulted in substantial and durable improvements in processing speed. A larger randomized controlled clinical trial is planned. Trial Registration: This trial is registered on ClinicalTrials.gov under “NCT03569618,” https://clinicaltrials.gov/ct2/show/NCT03569618 .
A corpus study of child heritage speakers’ Spanish gender agreement
Authors: Goebel-Mahrle Thomas , Shin Naomi L. 
Published: June 2020

Objectives: This study investigates (a) whether child heritage speakers produce more gender mismatches in Spanish ( un piedra “a-masc. stone-fem.”) than monolingual children, (b) whether older child heritage speakers mismatch more than younger ones, and (c) linguistic contexts in which mismatches occur. Methodology: 3893 agreement forms were extracted from corpora of Spanish spoken by six monolingual children, ages 5–6 years, and three groups of US child heritage speakers: ten 5–6-year-olds, fifteen 7–8-year-olds, and twenty-one 9–11-year-olds. Data and analysis: Logistic regressions measured the impact of agreement form type, noun gender, noncanonical noun ending, and noun frequency on gender matching. One regression included 5–6-year-olds only (monolingual and heritage); the second included child heritage speakers only (5–11-year-olds). Findings: There were no significant differences between monolingual and heritage 5–6-year-olds; for these children, adjectives, direct object clitics, noncanonical nouns, and feminine nouns increased the likelihood of mismatches. Among the 5–11-year-old heritage speakers, direct object clitics referring to feminine nouns and noncanonical nouns increased the likelihood of mismatches. The 9–11-year-olds produced more gender mismatches referring to feminine nouns than the younger child heritage speakers, especially with direct object clitics. Originality: This corpus study provides evidence for high rates of gender matching and clarifies the contexts that increase the likelihood that children will mismatch. Implications: Gender matching remains an intact part of child heritage speakers’ Spanish grammars. The distribution of mismatches found provides evidence of a strong article–noun association and a weaker noun–direct object clitic association. The oldest child heritage speakers’ use of masculine clitic lo to refer to feminine nouns may reflect an association between English “it” and Spanish lo. More generally, the finding that mismatches tend to involve masculine forms referring to feminine nouns supports the idea that masculine is the default, unmarked form in Spanish.
Long-term outcomes of major trauma with unstable open pelvic fractures: A population-based cohort study
Authors: Gabbe Belinda J , Stewart Ian , Veitch William , Beck Ben , Cameron Peter , Russ Matthias , Bucknill Andrew , Steiger Richard de , Esser Max 
Published: June 2020

Aims The aims of this study were to describe the profile and longer-term outcomes of major trauma patients with unstable open pelvic fractures. Patients and methods An observational study was performed using data from the population-based Victorian State Trauma Registry. Adult (≥16 years) major trauma patients who had sustained an unstable open pelvic fracture between 1 July 2010 and 30 June 2017 in Victoria (Australia) were included. Patient demographics, injury event, severity and management data were extracted. Patients were followed up at 6, 12 and 24 months post-injury to collect information about health status, function and return to work. Results There were 67 patients. The mean (SD) age was 41.4 (18.3) years, and 66% were male. Seventy-six per cent were road traffic injuries, 96% were managed at Level 1 trauma centres and all were multi-trauma patients. A third were Tile C fractures and 80% underwent surgical stabilisation of the pelvic injury. Eighty per cent were admitted to intensive care. The in-hospital mortality rate was 9%. Most (89%) survivors were discharged to an inpatient rehabilitation facility. The proportion classified as ‘severe disability’ on the Glasgow Outcome-Scale Extended declined from 38% at 6 months to 19% at 24 months. The overall three-level EuroQoL five-dimensional instrument score increased with time indicating better health status, and 50% of patients returned to work by 24 months. Conclusions Major trauma with unstable, open pelvic fracture is rare. Low in-hospital mortality was observed. Most survived to hospital discharge and outcomes improved with time post-injury, but 75% of patients experienced persistent pain and ongoing mobility and activity restrictions.
Fetal bradyarrhythmia causing hydrops fetalis: A journey from fetal echo to autopsy
Authors: Agarwal Arjit , Agarwal Shubhra , Lalwani Astha , Najam Rehana , Kumar Ashutosh 
Published: June 2020

Introduction Non-immune hydrops fetalis is a condition with poor fetal prognosis. The incidence of this clinical condition is increasing as compared to its iso-immune variant. The diagnosis of hydrops fetalis is straightforward; however, delineating the primary cause of non-immune hydrops fetalis requires a holistic approach and background knowledge of the entity. Case report We present a case of non-immune hydrops fetalis due to a rare functional cardiac disorder demonstrated by features of cardiac failure in the form of clinically significant tricuspid regurgitation detected on echocardiography. Fetal autopsy supported the diagnosis by excluding any structural anomaly. Discussion Non-immune hydrops fetalis may be due to structural and non-structural cardiac anomalies. Meticulous work-up is required to establish the diagnosis in such cases. Conclusion The case also highlights the systematic approach as well as the series of investigations required for the early diagnosis and management of such cases.
Expert opinion on the use of cladribine tablets in clinical practice
Authors: Sørensen Per Soelberg , Centonze Diego , Giovannoni Gavin , Montalban Xavier , Selchen Daniel , Vermersch Patrick , Wiendl Heinz , Yamout Bassem , Salloukh Hashem , Rieckmann Peter 
Published: June 2020

Background: Gaps in current product labels and a lack of detailed clinical guidelines leaves clinicians’ questions on the practical management of patients receiving cladribine tablets for the treatment of relapsing multiple sclerosis (MS) unanswered. We describe a consensus-based programme led by international MS experts with the aim of providing recommendations to support the use of cladribine tablets in clinical practice. Methods: A steering committee (SC) of nine international MS experts led the programme and developed 11 clinical questions concerning the practical use of cladribine tablets. Statements to address each question were drafted using available evidence, expert experiences and perspectives from the SC and an extended faculty of 33 MS experts, representing 19 countries. Consensus on recommendations was achieved when ⩾75% of respondents expressed an agreement score of 7–9, on a 9-point scale. Results: Consensus was achieved on 46 out of 47 recommendations. Expert-agreed practical recommendations are provided on topics including: the definition of highly active disease; patterns of treatment response and suboptimal response with cladribine tablets; management of pregnancy planning and malignancy risk, infection risk and immune function, and switching to and from cladribine tablets. Conclusion: These expert recommendations provide up-to-date relevant guidance on the use of cladribine tablets in clinical practice.