bluuebunny/crossref_metadata_2025_split huggingface dataset:
When Is It Safe to Proceed With Pancreaticoduodenectomy Without Biliary Decompression?
Authors: Mosquera Catalina , Mitsakos Anastasios T. , Guyton Rodney L. , Fitzgerald Timothy L. , Zervos Emmanuel E. 
Published: November 2020

Background An absolute bilirubin level where preoperative biliary decompression (PBD) is indicated before pancreaticoduodenectomy has been elusive. Our goal was to identify a total bilirubin level whereby biliary decompression provides clear benefit, despite associated expenses and potential complications. Materials and Methods We reviewed a prospectively collected database of patients undergoing pancreaticoduodenectomy at the Vidant Medical Center between 2007 and 2016. Patients were arbitrarily subdivided into 3 groups based on presenting bilirubin level (≤10 mg/dL, 10.1-14.9 mg/dL, and ≥15 mg/dL) to determine the presence of overall complications, severe complications (Clavien-Dindo classification ≥3), prolonged length of stay (>1 SD), readmissions, or mortality. Results Common bile duct stenting independently predicted a higher incidence of complications in patients presenting with bilirubin ≤10 mg/dL ( P = .03) vs. those patients going directly to surgery. No differences were observed for patients with bilirubin between 10.1 mg/dL and 14.9 mg/dL. Biliary decompression in patients with bilirubin ≥15 mg/dL independently predicted fewer overall (73.8% vs. 100%, P = .0082) and less severe complications (14.3% vs. 44.5%, P = .03) and lower readmission rates (15.8% vs. 55.6%, P = .03) vs. those going directly to surgery. Patients not undergoing biliary decompression underwent pancreaticoduodenectomy sooner than those decompressed (4.7 days vs. 17.2 days, P = .01). Discussion All patients presenting with bilirubin ≥15 mg/dL should undergo PBD, while those with bilirubin ≤10 mg/dL should forego stent placement to avoid stent-related complications. The decision to stent between 10.1 and 14.9 mg/dL should be made on a case-by-case basis keeping in mind timeliness to definitive cancer treatment.
Non-vascularized Fibular Cortex Grafts with Osteocutaneous Free Fibula Transfer: A Novel Technique in Midface Reconstruction
Authors: Perez Paloma I. , Sloneker Del R. , Bloom Ashlie G. , Vincent Aurora G. , Hohman Marc H. , Harsha Wayne J. , Anderson Kelly G. 
Published: November 2020

Objectives: To present a method to reconstruct the midface using the fibula as both a microvascular free flap and as a free cortex graft. Methods: 22-year-old male presented with bilateral maxillary odonotogenic myxoma. Bilateral total maxillectomy defects were reconstructed using an osteocutaneous fibula free flap. The nasomaxillary buttresses were augmented using free cortex grafts to provide additional soft tissue projection and lateral nasal support. Results: The patient received dental implants at 10 months postoperatively and resumed a normal diet. His midface height, nasal and maxillary projection were adequate. At 36 months post-treatment he has no evidence of disease recurrence or resorption of the free bone grafts. Conclusion: The fibula free flap can be used to provide additional support to a patient’s reconstruction by means of free cortex grafts. The patient has had successful restoration of pyriform aperture, nasal projection, mastication, and dental restoration using a single donor site.
Correlation of serum myonectin concentrations with the presence and severity of obstructive sleep apnoea syndrome
Authors: Zou Huili , Yang Weiyi , Liu Yan 
Published: November 2020

Objective Myonectin, a newly discovered myokine, enhances fatty acid uptake in cultured adipocytes and hepatocytes and suppresses circulating concentrations of free fatty acids in mice. This study is performed to evaluate the association between serum myonectin concentrations with the presence and severity of OSAS. Methods This study was performed in a population of 191 patients with OSAS and 105 control subjects. Serum myonectin concentrations were measured using enzyme-linked immunosorbent assay method. Results Lower serum myonectin concentrations were found in OSAS patients than in the controls. Serum myonectin concentrations were associated with a reduced risk of OSAS (OR: 0.988, 95% CI: 0.984–0.993, P <  0.001). Severe OSAS patients had significantly lower myonectin concentrations compared with mild and moderate OSAS patients ( P <  0.001 and P  =   0.001, respectively). There are lower serum myonectin concentrations in moderate patients compared with mild patients ( P  =   0.024). Pearson correlation analysis revealed that serum myonectin concentrations were negatively correlated with the severity of OSAS (r = −0.344, P <  0.001). Simple linear regression analysis showed that serum myonectin concentrations in OSAS patients were negatively correlated with body mass index, fasting plasma glucose, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol, low-density lipoprotein cholesterol (LDL-C) and apnoea hypopnea index. Multiple stepwise regression analysis shows that body mass index (β = −0.289, P  =   0.03), HOMA-IR (β = −0.19, P  =   0.003), total cholesterol (β = −0.155, P  =   0.016), LDL-C (β = −0.176, P  =   0.006) and apnoea hypopnea index (β = −0.263, P <  0.001) remained to be associated with serum myonectin. Conclusion Serum myonectin concentrations are inversely correlated with the presence and severity of OSAS.
Acceptability of alcohol-free dance in place of traditional alcohol-focused events
Authors: Brown Kyle , Hill Kimberley M. , Smith Joanne , Johansson Mattias , Davies Emma L. 
Published: November 2020

Objective: Alcohol misuse prevention often fails to account for or replace the pleasurable benefits of drinking such as relaxing and socialising with friends. Increasingly, alcohol-free dance music events are emerging, allowing people to gain the positive outcomes of dancing without recourse to alcohol. This study sought to explore whether conscious-clubbing would be rated as an acceptable alternative to traditional alcohol-focused events. Design/Setting: An online cross-sectional survey was completed by 281 young respondents (80.4% female; mean age = 22). Method: Health-related cognitions (attitudes, intentions), perceived acceptability towards alcohol-free dance events and the extent to which these were predicted by demographics and individual differences were assessed in the survey. Results: T-tests indicated overall positive attitudes, acceptability, support towards and intention to attend alcohol-free clubbing events regardless of drinking status, with the exception of drinkers’ intentions to attend an event. Exploratory multiple regression analyses indicated that young women and individuals who had previously attended these events held more positive attitudes. These attitudes were associated with acceptability and support, but more favourable attitudes towards alcohol consumption were inversely related to acceptability. More positive attitudes, previous attendance and lower life satisfaction associated with higher intentions to attend an event. Conclusion: Results indicate that alcohol free events may provide an alternative socialising experience, with greater potential utility for young women, non-drinkers and individuals who have previously attended these events. This is of particular importance given that recent literature highlights the need for (non-alcohol) alternatives to socialise among a growing number of individuals.
Association Between Sudden Sensorineural Hearing Loss and History of Statin Use: A Nested Case‐Control Study
Authors: Kim So Young , Wee Jee Hye , Min Chanyang , Yoo Dae Myoung , Choi Hyo Geun 
Published: November 2020

ObjectiveThe effect of statin on sudden sensorineural hearing loss (SSNHL) remains unclear. Thus, this study aimed to investigate the association between prior statin use and SSNHL.Study DesignA nested case‐control study.SettingParticipants aged ≥40 years were enrolled from the 2002‐2015 Korean National Health Insurance Service–Health Screening Cohort.MethodsA total of 5876 patients with SSNHL were matched with 23,504 control participants for age, sex, income, and region of residence. History of statin use for 2 years before SSNHL onset was investigated between the groups. The odds ratios (ORs) of the length of statin use for SSNHL stratified by age, sex, income, and region of residence were analyzed with conditional logistic regression. Dyslipidemia, total cholesterol, blood pressure, blood glucose, hemoglobin, obesity, smoking, alcohol consumption, and Charlson Comorbidity Index score were adjusted. The adjusted variables were subjected to subgroup analyses.ResultsThe SSNHL group had a longer duration of statin use than the control group (mean [SD], 81.9 [197.7] days vs 72.7 [188.0] days; P =. 001). However, statin use was not associated with SSNHL after adjusting for the confounders (adjusted OR, 1.04; 95% CI, 0.98‐1.11; P =. 245). There was a positive correlation between statin use and SSNHL in the crude model (crude OR, 1.10; 95% CI, 1.04‐1.16; P =. 001). However, there was no association between statin use and SSNHL in all subgroup analyses.ConclusionPrevious statin use was not associated with SSNHL.
Influence of Surgical Techniques on Endoscopic Dacryocystorhinostomy: A Systematic Review and Meta‐analysis
Authors: Vinciguerra Alessandro , Nonis Alessandro , Resti Antonio Giordano , Barbieri Diego , Bussi Mario , Trimarchi Matteo 
Published: November 2020

ObjectiveEndoscopic endonasal dacryocystorhinostomy (END‐DCR) has increased as a valid alternative to the classic external approach to treat distal lacrimal obstruction. Different surgical varieties of the END‐DCR approach have been proposed with no clear understanding of the best surgical technique.Data SourceA comprehensive research was performed in PubMed, Embase, SCOPUS, and Cochrane databases with a final search on March 2020.Review MethodsThe aim of this search was to identify relevant END‐DCR procedures performed with mechanical (Mecn‐END‐DCR) and powered (Pow‐END‐DCR) approaches to compare their functional success rate. In addition, the influence of mucosal flaps was evaluated. Articles were selected only if they were published later than 2000 and had at least 50 single‐clinician surgical procedures performed. Excluded articles included acute infections, cancers, mixed cohort study, and revision cases.ResultsA total of 11,445 publications were identified and 2741 reviewed after screening; 15 articles were included after full‐text review (0.6% of the initial articles reviewed). The mean success rate was 91.34% (95% CI, 87.1%‐94.3%) for Pow‐END‐DCR and 89.5% (95% CI, 86.5%‐91.9%) for Mecn‐END‐DCR with no significant difference between the surgical approaches (P =. 43). For mucosal flaps performed during END‐DCR, the mean success rate was 89% (95% CI, 86%‐91%) if mucosal flaps were used and 92% (95% CI, 88%‐95%) if they were not used, with no statistical difference present (P =. 14).ConclusionsOur analyses suggest that there are no differences in outcomes between mechanical and powered approaches in END‐DCR and that mucosal flap preservation is not essential to achieve a superior END‐DCR outcome.
High‐Risk Human Papillomavirus–Related Oropharyngeal Squamous Cell Carcinoma Among Non‐Indigenous and Indigenous Populations: A Systematic Review
Authors: Ju Xiangqun , Canfell Karen , Smith Megan , Sethi Sneha , Garvey Gail , Hedges Joanne , Logan Richard M. , Antonsson Annika , Jamieson Lisa M. 
Published: November 2020

ObjectiveTo estimate the prevalence of oral high‐risk human papillomavirus (hr‐HPV) infection and the proportion of hr‐HPV–related oropharyngeal squamous cell carcinoma (OPSCC) among Indigenous and non‐Indigenous populations.Data SourceElectronic database searches of PubMed, PubMed Central, Embase, MEDLINE, Scope, and Google Scholar were conducted for articles published from January 2000 until November 2019.Review MethodsStudies were included with a minimum of 100 cases assessing hr‐HPV infection in either population samples or oropharyngeal cancer tumor series. The objective was to conduct meta‐analyses to calculate the pooled prevalence of oral hr‐HPV infection by adjusting for age group or sex in primary studies, the incidence of OPSCC, and the proportion of hr‐HPV–related OPSCC in Indigenous people and non‐Indigenous/general populations.ResultsWe identified 47 eligible studies from 157 articles for meta‐analyses. The pooled prevalence of oral hr‐HPV infection was 7.494% (95% CI, 5.699%‐9.289%) in a general population, with a higher prevalence among men (10.651%) than women (5.176%). The pooled incidence rate was 13.395 (95% CI, 9.315‐17.475) and 7.206 (95% CI, 4.961‐9.450) per 100,000 person‐years in Indigenous and non‐Indigenous populations, respectively. The overall pooled proportion of hr‐HPV–related OPSCC was 50.812% (95 CI, 41.656%‐59.969%). The highest proportion was in North America (60.221%), while the lowest proportion was in the Asia‐Pacific (34.246%).ConclusionOur findings suggest that in the general population, the prevalence of oral hr‐HPV infection is lower among females and those in younger age groups. The incidence of OPSCC was higher among Indigenous than non‐Indigenous populations, with the proportion being highest in North America.
Maternal Infection During Pregnancy and Risk of Cerebral Palsy in Children: A Systematic Review and Meta-analysis
Authors: Ayubi Erfan , Sarhadi Saeedeh , Mansori Kamyar 
Published: November 2020

Background and aim: The association between maternal infection during pregnancy and the risk of cerebral palsy has been previously reported. However, their results were relatively inconsistent. This systematic review and meta-analysis were carried out to investigate the association between maternal infection during pregnancy and the risk of cerebral palsy in children. Methods: PubMed, Scopus, and Web of Sciences databases were searched from inception to October 28, 2019. Heterogeneity was assessed using the I2 value. In case of substantial heterogeneity (I2 > 50%), a random effects model was applied, otherwise, a fixed effects model was used. The pooled associations were expressed as relative risks (RRs) and 95% confidence intervals (CIs). Publication bias and quality of studies included in the systematic review were checked using the Egger’s regression test and Newcastle-Ottawa Scale (NOS), respectively. Results: Thirty-seven studies were included in the systematic review. Among them, 21 studies were eligible for the meta-analysis. The pooled RR of cerebral palsy risk was 2.50 (95% CI 1.94, 3.21; I2 = 88.7%, P < .001) among children born to mothers who had any infection during pregnancy. The risk was increased to 2.85 (95% CI 1.96, 4.15; I2 = 75.9%, P < .001) when the mother was diagnosed with chorioamnionitis. Publication bias tests suggested no evidence of potential publication bias and 76% of the studies included in the meta-analysis were of high quality (NOS ≥ 6). Conclusion: This systematic review and meta-analysis provides evidence that maternal infection during pregnancy may be associated with an increased risk of cerebral palsy in children.
Questioning the Hope in Science and Schooling
Authors: Dores António Pedro de Andrade 
Published: November 2020

The succession of extraordinary traumatic events, such as the poles defrosting, the fires in Australia and Amazon, the COVID-19 pandemic, the financial global crises revival, the Black Lives Matter movement, seems to call for science (to solve problems) and schooling (to make time to the unemployed) for help. Science and schooling are some of the big successes of post-modern culture and states. Given these successes, questions remain. Why do they not deliver hope? We are left to ponder (a) why these extreme events takes us by surprise; (b) why those who have been afforded the best education ever are so anxious, so frozen; (c) why is it that our best policies, science, and minds continue to fail us when it comes to solving the problems associated with the environment, this pandemic, capitalism, and racism; and (d) given the promise of science, why are we so in need of solutions?
A comparative analysis of two alternative programmes to counter stigma and discrimination associated with mental illness delivered to medical students
Authors: Gordon Sarah E , Kininmonth Leah A , Newton-Howes Giles , Purdie Gordon L , Gardiner Tracey 
Published: November 2020

Objective: To assess and compare attitudes of medical students in response to two service-user-led anti-stigma and discrimination education programmes. Method: Two programmes, consistent with the key elements of effective contact-based anti-stigma and discrimination education programmes for healthcare providers, were delivered to medical students in their penultimate and final year: a more intensive version of the programme in 2015/2016 and a briefer programme in 2016/2017. Attitudes were assessed using the Recovery Attitudes Questionnaire (RAQ) and the Opening Minds Stigma Scale for Health Care Providers (OMS-HC-20) at the beginning and end of their final year. Results: There were no significant differences between the years in initial scores on either scale. Both cohorts showed statistically significant reductions in scores on both scales after completion of the programme, indicating overall improvements in students’ attitudes with reductions in stigma, and more positive attitudes towards recovery of those in mental distress. The more intensive programme led to significantly greater improvement in reductions in stigma than the less intensive programme. Conclusion: Findings support the need for contact-based anti-stigma and discrimination education programmes for medical students that are both intensive and repeated over time.
Comparison of consumer-based methodologies for optimizing the development of new products: A case study with probiotic chocolate flavored milk
Authors: Oliveira Denize , Deliza Rosires 
Published: November 2020

Several studies have reported that most new products do not achieve satisfactory results when launched on the market. There is a need to increase the efficiency of the methodologies used in the development of new products to increase success rates. Rapid sensory methodologies named Polarized Sensory Positioning (PSP), Check-all-that-apply (CATA), Projective mapping (PM) or Napping were applied to obtain sensory and hedonic information of a new product, probiotic-added chocolate flavored milk, aiming at determining preference guides that can be used to obtain a high overall liking level. It was possible to develop a probiotic chocolate flavored milk with general positive overall liking. The preferred sample was formulated with high content of sugar and chocolate, concluding that these characteristics are preference guides. The results supplied by the consumers using different methodologies were consistent, although the methodologies differed in their ability for sample differentiation. CATA methodology allowed better discrimination between samples than the other methodologies, followed by Projective Mapping, PSP with scales and triadic PSP. We could confirm that those rapid methodologies of sensory characterization are efficient when applied to product development. Practical applications  Using those methodologies, it was possible to develop a probiotic chocolate flavored milk that meets both, consumer’s expectations in relation to nutrition and taste and functionality. The methodologies proved to be efficient in characterizing consumer preference guides, and therefore fundamental to the development of a product with higher overall liking.
Hummelsheim procedure combined with medial rectus recession in complete sixth nerve palsy and esotropic Duane Retraction Syndrome
Authors: Bagheri Abbas , Veisi Amirreza , Tavakoli Mehdi 
Published: November 2020

Purpose: To evaluate the effect of half tendon vertical rectus muscle transposition (HVRT) combined with medial rectus muscle recession (MRrec) in complete sixth nerve palsy (CSNP) and esotropic Duane Retraction Syndrome (eDRS). Methods: A retrospective study of patients with unilateral CSNP or eDRS who underwent HVRT combined with medial rectus recession over the course of 18 years. The patients with previous strabismus surgery and follow up less than 3 months were excluded. Overcorrection was defined as any amount of exotropia, and undercorrection was defined as residual esotropia of ⩾10 prism diopter (PD). Results: A total of 39 patients were enrolled including 22 CSNP and 17 eDRS patients. Esotropia improved from 45.8 ± 22 and 22.5 ± 6.4 PD to 0.8 ± 2.5 and 0.3 ± 1 PD in CSNP group and eDRS group respectively. The angle of face turn improved from 34.3 ± 8.4° and 26.5 ± 9° to 0.6 ± 2.4° and 0.8 ± 1.6° in the CSNP group and eDRS group respectively. Abduction limitation improved from −4.5 ± 0.5 and −4 ± 0 units to −2.9 ± 0.5 and −2.7 ± 0.5 units in CSNP group and eDRS group respectively. No patient developed a new vertical deviation. An overcorrection occurred in one patient of the eDRS group who improved after botulinum toxin injection in the ipsilateral lateral rectus muscle. Undercorrection was seen in two patients. Conclusion: HVRT combined with MRrec is an effective procedure to improve esotropia, face turn, and abduction limitation in CSNP and eDRS.
Knowledge, attitudes and practice of self-medication among university students in Portugal: A cross-sectional study
Authors: Alves Regina Ferreira , Precioso José , Becoña Elisardo 
Published: November 2020

Aims: To describe the knowledge, attitudes and practices of self-medication in college students and to analyse the predicting factors for the engagement in that behaviour. Design: This is a cross-sectional study involving students ( n = 840) from a Portuguese university, selected through stratified and proportional sampling. Data were collected using a self-administered questionnaire containing, in addition to sociodemographic issues, a scale measuring knowledge about self-medication (α = .488), a scale measuring attitudes towards self-medication (α = .708) and questions about the patterns of self-medication practices (α = .445). Differences between outcomes and sociodemographics were analysed through independent t-tests and ANOVA. A generalised linear model was calculated to determine the predictive variables of self-medication. Results: Over half of the respondents ( 54.3%, n = 434) had used some form of self-medication during the preceding year. Students revealed poor knowledge about the referred practice, correctly answering 1.60 ( SD = 0.936) questions in a total of 3, and favourable attitudes towards self-medication ( M = 2.17, SD = 0.950, range 1–5). Attending engineering sciences (β = .718, 95% CI: 1.373–3.069, p < .001), being female (β = .866, 95% CI: 1.700–3.327, p < .001) and having negative attitudes towards self-medication (β = .367, 95% CI: 1.227–1.698, p < .001) predict the adoption of those practices. Conclusions: Self-medication is a common practice among university students, the level of self-medication knowledge is low and the low score of the level of attitudes revealed that students tended to have a correct positioning towards self-medication. Therefore, the recommendation to develop campaigns or educational programmes becomes obvious, in order to inform about the adverse effects of the use of non-prescribed medicine.