bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with treatment outcomes after intravesical hyaluronic acid therapy in women with refractory interstitial cystitis: A prospective, multicenter study
Authors: Tsai Ching-Pei , Yang Jenn-Ming , Liang So-Jung , Lin Yi-Hao , Huang Wen-Chu , Lin Tzu-Yin , Hsu Chun-Shuo , Chuang Fei-Chi , Hung Man-Jung 
Published: March 2021

Background:
Bladder instillation of hyaluronic acid (HA) is an acceptable treatment for bladder pain syndrome/interstitial cystitis (BPS/IC). The treatment is limited by a high proportion of non-responders (~30%–40%). Here, we aimed to evaluate predisposing factors associated with treatment outcomes.

Methods:
This is a prospective multicenter study. We enrolled a total of 137 (out of 140) women with refractory IC. They all underwent a standard protocol of 6-month intravesical HA therapy (initial 4 weeks, once weekly, followed by once monthly). To assess the outcomes, we used the pain Visual Analog Scale (Pain-VAS), Interstitial Cystitis Symptom and Problem Index (ICSI & ICPI), and a scaled Global Response Assessment (GRA).

Results:
The age of patients was 47.6 ± 27.5 (range 24–77) years. We found statistically significant improvement (p < 0.001) in the Pain-VAS and the ICSI & ICPI scores both after the initial 4-weekly instillations and at the end of 6-month treatment. Those who reported moderate/marked improvement on GRA at the 2 follow-up visits were considered responders: 39.4% (n = 54) at the first follow-up, and 59.9% (n = 82) at the second follow-up. No remarkable side effect was noted. After statistical analyses, treatment outcomes on GRA were positively associated with baseline functional bladder capacity and with Pain-VAS scores. The initial treatment responses optimally (p < 0.001) predicted final treatment outcomes (McNemar).

Conclusion:
Intravesical HA therapy is safe and effective for most (~60%) of our patients with refractory IC. Functional bladder capacity and Pain-VAS scores before treatment, and the early treatment responses are helpful predictors of treatment outcomes.
Role of kisspeptin on cell proliferation and steroidogenesis in luteal cells in vitro and in vivo
Authors: Chiang Chi-Ming , Chiu Hsin-Yi , Chang Chia-Sheng , Chien Ya-Yun , Jong De-Shien , Wu Leang-Shin , Chiu Chih-Hsien 
Published: March 2021

Background:
Kisspeptin (KISS1) and kisspeptin receptor (KISS1R) are essential gatekeepers of the reproductive system. The functions of KISS1 and KISS1R in corpus luteal cells remain ambiguous. The objective was to observe normal physiologic functions of corpus luteal cells in vivo and clarify the functions of KISS1 in vitro.

Methods:
We conducted an in vivo observation of cellular patterns as well as the levels of steroidogenic enzymes and KISS1/KISS1R in corpus luteal cells obtained from female crossbred Taiwan native goats in the estrous cycle; the observation was performed using hematoxylin and eosin and immunohistochemistry staining. Subsequently, we used kisspeptin-10 (Kp-10) to stimulate temperature sensitive-caprine luteal cell line (ts-CLC-D) cells to investigate the progesterone (P4) levels, steroidogenic messenger RNA (mRNA)/protein levels, cell survival rate, intracellular Ca2+ concentration, and cell proliferation-related mRNA/protein levels in the mitogen-activated protein kinase pathway in vitro by applying immunofluorescence staining, Western blotting, 2,3-bis (2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide assay, and real-time polymerase chain reaction.

Results:
We observed the presence of proteins and mRNAs for STAR, CYP11A1, HSD3B, KISS1, and KISS1R in the corpus luteal cells from goats in vivo. In vitro, the addition of Kp-10 reduced the P4 levels (p < 0.01) and increased cell proliferation (p < 0.05) of the ts-CLC-D cells. Furthermore, we found that the levels of proteins and mRNA for STAR, CYP11A1, and HSD3B decreased significantly when Kp-10 was added (p < 0.05). However, adding Kp-10 did not affect the mRNA levels for PLCG2, DAG1, PRKCA, KRAS, RAF1, MAP2K1, MAP2K2, MAPK3, MAPK1, and MAPK14.

Conclusion:
We determined that KISS1 could affect the P4 levels, steroidogenesis, and cell proliferation in luteal cells. However, further research is required to clarify how KISS1 regulates proliferation and steroid production in luteal cells.
Combined Oxytocin and Cognitive Behavioral Social Skills Training for Social Function in People With Schizophrenia
Authors: Buchanan Robert W. , Kelly Deanna L. , Strauss Gregory P. , Gold James M. , Weiner Elaine , Zaranski Jennifer , Chen Shuo , Blatt Frank , Holden Jason , Granholm Eric 
Published: March 2021

Abstract

Background
A significant proportion of people with schizophrenia are characterized by impaired ability to socially engage with others. The development of effective interventions for social functioning remains a central therapeutic challenge. Cognitive-behavioral social skills training (CBSST) has been found to improve social functioning in schizophrenia, but with only medium effect sizes. Intranasal oxytocin also has prosocial effects, but also only with modest effect sizes. This study assessed whether the addition of intranasal oxytocin to CBSST can strengthen their impact on social function.

Methods
Participants (N = 62) with schizophrenia or schizoaffective disorder entered a 24-week, double-blind, placebo-controlled, randomized clinical trial with a 3-month follow-up evaluation at 2 sites: Maryland and San Diego. Participants were randomized to either intranasal oxytocin 36 IU (3 sprays) twice a day (n = 31) or intranasal placebo-oxytocin (3 sprays) twice a day (n = 31). All participants received CBSST plus a social cognition skills training module (48 total sessions).

Results
There were no significant treatment group differences in social functioning, positive symptoms, negative symptoms, defeatist beliefs, or asocial beliefs. The interpretation of treatment effects was complicated by site effects, whereby participants in San Diego began the trial with greater severity of impairments and subsequently showed greater improvements compared with participants in Maryland.

Conclusions
The results did not support the utility of add-on intranasal oxytocin to psychosocial rehabilitation interventions like CBSST for improvement in social function (ClinicalTrials.gov trial number: NCT01752712).
Transcanal Endoscopic Cartilage and Perichondrium Graft Myringoplasty for Large Tympanic Membrane Perforations
Authors: Lou Zhengcai 
Published: March 2021

Objectives:
The objective of this study was to evaluate the outcomes following transcanal endoscopic cartilage and perichondrium double-layer myringoplasty for subtotal and total tympanic membrane (TM) perforations.

Study Design:
Retrospective case review.

Setting:
Tertiary referral center.

Methods:
Adult patients who underwent transcanal endoscopic double-layer myringoplasty for subtotal and total TM perforations between January 2015 and December 2017 were included. The graft success rate, hearing outcomes, and complications were evaluated postoperatively. Temporal bone computed tomography or magnetic resonance imaging was performed at 24 months postoperatively.

Results:
The mean follow-up period was 28.2 ± 6.1 (range, 24–36) months. The graft success rate was in 95.7% (45/47) at 6 months, 93.6% (44/47) at 12 months, and 87.2% (41/47) at 24 months, respectively. The mean ABG improved from 32.89 ± 5.31 dB preoperatively to 10.89 ± 4.78 dB postoperatively 12 months (p < 0.05) for subtotal perforations; from 33.41 ± 7.41 dB preoperatively to 11.45 ± 2.41 dB postoperatively 12 months (p < 0.05) for total perforations. No graft-related complications (e.g., graft lateralization, significant blunting, graft atelectasis, graft adhesions, or effusion) were encountered during the follow-up period. Postoperative temporal bone imaging revealed a pneumatized middle ear and mastoid in all cases with no evidence of cholesteatoma.

Conclusions:
Transcanal endoscopic myringoplasty for large TM perforations using a double-layer perichondrium and cartilage graft is feasible with comparable rates of closure to more invasive approaches.
Optimizing Care Delivery by Applying an Innovative Shared Medical Appointment Model for Determination of Cochlear Implant Candidacy
Authors: Sydlowski Sarah , Donovan Cara , McNair Jordan , Hahn Katie , Petter Karen , Marks Tina , Haberkamp Tom , Nguyen-Huynh Anh , Podriznik James , Woodson Erika 
Published: March 2021

Objective:
To develop and implement an innovative group appointment with the potential to improve access to cochlear implantation (CI) while maintaining patient satisfaction and experience.

Patients:
Adult patients with advanced sensorineural hearing loss.

Intervention(s):
Implementation of novel shared medical appointment (SMA) model.

Main Outcome Measure(s):
Patient satisfaction with group visit; anecdotal description of provider efficiency and experience.

Results:
Survey data were collected from 166 adults who participated in a group CI candidacy appointment from September 2017 to February 2020 as part of a quality improvement initiative. Provider time is anecdotally optimized by accommodating more patients in a shorter timeframe while effectively triaging those candidates most likely to meet candidacy criteria for a full CI evaluation. Most importantly, patient feedback has been positive which suggests that patients find value in this novel format.

Conclusions:
The current climate of healthcare demands that providers maximize the efficacy and efficiency of patient care. Our large CI program has determined that using an SMA format as an entry point for CI candidacy evaluation offers many benefits. The group appointment improves patient throughput and also provides a positive patient experience. Group visits offer a viable solution for increasing patient access to CI while maintaining quality in a busy academic medical center setting.
Virtual Reality for Vestibular Rehabilitation: A Systematic Review
Authors: Xie Michael , Zhou Kelvin , Patro Nivedh , Chan Teffran , Levin Marc , Gupta Michael K. , Archibald Jason 
Published: March 2021

Introduction:
Vertigo is a debilitating symptom, leading to increased healthcare utilization and lost patient productivity. Vestibular rehabilitation is used to manage the symptomatic manifestations of vestibular disease. However, vestibular rehabilitation is limited by accessibility and time commitment. Recently, virtual reality has been described as a vestibular rehabilitation tool that may circumvent these barriers to treatment. Despite this, the efficacy of virtual reality for vestibular rehabilitation remains unclear. This study aims to review and summarize the current literature on the effectiveness of virtual reality-based vestibular rehabilitation.

Methods:
A systematic review of the MEDLINE, EMBASE, and Alternative and Complementary Medicine databases was conducted for prospective studies describing virtual reality-based vestibular rehabilitation.

Results:
Our search identified 382 unique articles. Six randomized controlled trials and four other studies were ultimately included. Study sample sizes ranged from 13 to 70 participants and varied in diagnoses from any unilateral peripheral vertigo to specific pathologies. Different virtual reality interventions were used. Comparator groups ranged from supervised vestibular rehabilitation to independent Cawthorne-Cooksey exercises. Outcomes consisted of validated questionnaires, objective clinical tests, and measurements of balance or reflexes.

Conclusion:
The studies reviewed in this study are preliminary evidence to suggest the benefit of virtual reality-based vestibular rehabilitation. However, these studies are limited by their inclusion criteria, heterogeneity, comparator design, and evidence-based clinical outcomes. Further research should address these limitations.
Current and future treatment options for adrenal insufficiency
Authors: Arshad Muhammad Fahad , Debono Miguel 
Published: March 2021

Purpose of review
Patients with adrenal insufficiency (AI) irrespective of being on glucocorticoid replacement therapy still suffer from increased morbidity and mortality. A major contributing factor is an inability of conventional glucocorticoid treatment to mirror the physiological cortisol rhythm. Novel strategies to replicate the cortisol rhythm using hydrocortisone infusion pumps and oral modified release hydrocortisone have now been developed and confirmed to offer benefits to patients.

Recent findings
In the DREAM study, when compared to multiple daily dosing of glucocorticoids Plenadren reduced weight, was less immunosuppressive and resulted in a better quality of life besides reducing infections. Chronocort that provides the early morning rise in cortisol improves androgen concentrations compared to conventional glucocorticoid treatments in congenital adrenal hyperplasia (CAH). Physiological hydrocortisone infusion pumps improve cortisol profiles with better adrenocorticotrophic hormone, glucose control, and quality of life (QOL) with androgen levels better controlled in CAH.

Summary
Advances in glucocorticoid replacement for patients with AI are ongoing. Novel approaches to managing AI, enabled by this armamentarium of drug formulations, aims to improve patient health. Currently, their use should be reserved for patients with metabolic complications, very poor QOL and difficult-to-treat CAH. Larger studies based on outcomes are essential to understand to what extent these strategies can replace conventional treatments.
Inequities in Access to Care and Health Care Spending for Asian Americans With Cancer
Authors: Park Sungchul , Chen Jie , Ma Grace X. , Ortega Alexander N. 
Published: March 2021

Background:
Asian Americans have lower cancer screening rates than non-Latino “Whites,” suggesting inequities in cancer prevention among Asian Americans. Little is known about inequities in cancer treatment between Whites and Asian Americans with cancer.

Methods:
Using the 2002–2017 Medical Expenditure Panel Survey, we examined inequities in access to care and health care spending between Whites and Asian Americans with and without cancer. Our outcomes included 3 measures of access to care and 3 measures of health care spending. We used multivariable regressions while adjusting for predisposing, enabling, and need factors and estimated the mean adjusted values of the outcomes for each group. We then examined the differences in these adjusted mean outcomes among Asian Americans relative to Whites.

Results:
We observed evidence of inequities that Asian Americans without cancer experienced limited access to care due to a lack of a usual source of care. The likelihood of having a usual source of care was lower among Asian Americans without cancer than Whites without cancer. Inequities were not observed among Asian Americans with cancer. Compared with Whites with cancer, Asian Americans with cancer had similar or better levels of access to care. No or marginal differences in health care spending were detected between Whites and Asian Americans with cancer. These findings were consistent in both nonelderly and elderly groups.

Conclusion:
While Asian Americans without cancer have unmet medical needs due to limited access to care, access to care and spending are relatively equitable between Whites and Asian Americans with cancer.
Procedural mechanical support for lung transplantation
Authors: Schwarz Stefan , Hoetzenecker Konrad , Klepetko Walter 
Published: March 2021

Purpose of review
The use of procedural mechanical support during lung transplantation (LTx) varies between centers and the optimal support strategy is still controversially discussed. The two main questions are if cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO) should be preferred and whether mechanical support should be reserved for specific patient groups or a routine use can be recommended.

Recent findings
Recent cohort studies have consistently shown that LTx on CPB leads to inferior outcomes when compared to venoarterial (va)-ECMO. Thus, ECMO should be preferred in lung transplantation except for special indications. Despite its higher invasiveness, ECMO offers some pivotal advantages over off-pump lung transplantation. It has been shown to remarkably reduce rates of primary graft dysfunction, supporting the concept of a routine intraoperative ECMO use in LTx.

Summary
Although randomized-controlled trials addressing this question are still lacking, current evidence appears to favor the routine use of ECMO support during lung transplantation.
The Quality of End-of-Life Care for Women Deceased From Metastatic Breast Cancer
Authors: Brazee Rachel L. , Nugent Bethany D. , Sereika Susan M. , Rosenzweig Margaret 
Published: March 2021

Metastatic breast cancer (MBC) carries unique disease burdens with potential for poor-quality end-of-life (EOL) care. It is the purpose of this article to explore the association of poor-quality EOL care indicators according to key tumor, demographic, social, and clinical factors.
End-of-life quality indicators were based on Emanuel and Emanuel's good death model in conjunction with Earle et al (2003). A single-institution retrospective chart review of women deceased from MBC between November 2016 and November 2019 with double-verification chart review was completed. Data were analyzed with descriptive, correlative, and comparative statistics.
Total sample was N = 167 women, with 14.4% (n = 24) Black and 85.6% (n = 143) White. Mean (SD) age was 55.3 (11.73) years. Overall, MBC survival was 3.12 years (SD, 3.31): White women, 41.2 months (3.4 years), and Black women, 19 months (1.6 years). A total of 64.1% (n = 107) experienced 1 or more indicators of poor-quality EOL care. Patients more likely to experience poor-quality EOL care were older (P = .03), estrogen negative (P = .08), human epidermal growth factor receptor 2 negative (P = .07), from more deprived neighborhoods (P = .02), married (P = .05), and with physical (P = .001) and mental (P = .002) comorbidities.
Understanding sociodemographic and clinical factors associated with poor EOL MBC care may be useful for proactive patient navigation.
A Case of Clutter and Chaos
Authors: Sivakanthan Archadhaa , Basu Arnabh , Jacob Theresa 
Published: March 2021

Abstract
Hoarding disorder is a chronic disorder defined as the persistent difficulty in parting with possessions and the need to save items, regardless of their actual value. Severe hoarding has largely been a hidden clinical problem, and awareness has mostly been limited to voyeuristic depictions of the plight of hoarders in popular media. Approximately 28% to 32% of individuals with attention deficit hyperactivity disorder (ADHD), especially the inattentive subtype, have been reported to have clinically significant hoarding. It has been hypothesized that patients with ADHD initially acquire objects impulsively and later develop emotional attachments or intrinsic meaning, resulting in a perpetuating cycle of reliance on hoarding as a coping mechanism. Treatment focused on impaired attention has shown improved prognosis, which further signifies the relationship between inattentive ADHD and hoarding. We discuss the case of a patient with ADHD (inattentive type), major depressive disorder, and hoarding traits.
Patients With Neuropathic Pain Have Poor Sleep Quality
Authors: Guntel Murat , Huzmeli Esra Dogru , Melek Ismet 
Published: March 2021

Abstract
Although sleep disorders have been studied many times in neuropathic pain (NP), the effect of pain level, depression, and quality of life (QOL) on sleep quality in NP has been rarely investigated. In the present study, we aimed to investigate associations between possible quality of sleep (QOS) impairment and pain level, depression, and QOL. Average daily pain intensity, QOL, QOS, and depression status of the patients were evaluated using a 100-mm visual analog scale (VAS), the RAND 36-Item Health Survey 1.0, the Pittsburgh Sleep Quality Index, and Beck Depression Inventory (BDI), respectively. In 83.1% of patients QOS was found to be poor. We found that there was a significant difference between good and poor QOS in BDI, VAS, and RAND 36-Item Health Survey 1.0 scale's parameters, and patients with NP have poor sleep quality. Depression status is the main predictor for QOS, so pain level and QOL affect the QOS in NP. Physicians who aim healthy QOS must evaluate all characteristics of pain, depression status, and QOL in patients with NP.
Barriers to and Facilitators of Human Papillomavirus Vaccination Among People Aged 9 to 26 Years: A Systematic Review
Authors: Zheng Luyan , Wu Jie , Zheng Min 
Published: March 2021

Background
Cervical and oropharyngeal cancers are associated with human papillomavirus (HPV) infection, which can be prevented with the vaccines. However, uptake of the HPV vaccine remains low in many countries. There is a need to better understand the barriers to and facilitators of HPV vaccination from young people's perspectives.

Methods
Five electronic databases were searched for original publications (dated January, 2006–December, 2019) reporting barriers to and facilitators of HPV vaccination among young people. All articles were screened against prespecified eligibility criteria, and data were extracted against prespecified form.

Results
A total of 13 studies that were published in international peer-reviewed journals and met the stated eligibility criteria were identified. The barriers reported were centralized around lack of knowledge about HPV and the HPV vaccine, fear about the safety and efficacy of the HPV vaccine, fear about not being able to pay for the HPV vaccine, and discrimination regarding to the HPV vaccine. The facilitators reported were centralized around trust in the efficacy and safety of the HPV vaccine, discounted price of vaccination, positive recommendations from others, perceived risk of HPV infection, and benefits of vaccine.

Conclusions
After their introduction 14 years ago, knowledge deficiency of the HPV vaccine is still a critical barrier to vaccination. Educational initiatives aimed at adolescents and young adults were urgently needed. Understanding factors that arbitrate in early HPV vaccination is critical for improving the HPV vaccination rate.
Human Papillomavirus Vaccination Trends and Disparities in the United States: Who Is Getting Left Behind?
Authors: Chan John K. , Mann Amandeep K. , Lee Danny , Rohatgi Atharva , Chan Chloe , Abel Mary Kathryn , Argueta Chris , Kapp Daniel S. 
Published: March 2021

Background
United States guidelines recommend human papillomavirus (HPV) vaccination for males and females up to 26, with more recent extended coverage for those 27 to 45 years based on discussion with patients' clinician. This study seeks to assess trends and disparities of vaccination in the United States based on demographic characteristics.

Methods
Data were obtained from the National Health and Nutrition Examination Survey between 2007 and 2016. χ2 Analyses were used for statistical methods.

Results
Of 12,844 participants (median age, 22 years; range, 9–36 years), 2711 (21.3%) initiated HPV vaccination, of which 1358 (56.3%) completed the 3-dose vaccination series. Vaccination rates were higher in females compared with males (24.6% vs 13.0%; P < 0.001) and in Whites compared to Mexican Americans (22.6% vs 19.4%; P = 0.02). The uninsured had lower vaccination rates than private insurance and Medicaid (12.5% vs 22.4% vs 28.5%; P < 0.001). We divided the 10 year study into five separate periods (2007–2008, 2009–2010, 2011–2012, 2013–2014, and 2015–2016) to analyze trends. Vaccine initiation increased from 19.6% to 49.6% for 14–19-year olds (P < 0.001), 10.4% to 35.5% for females (P < 0.001), and 8.5% to 32.9% for Blacks (P < 0.001). Although on trend analyses, the vaccination rates with the highest proportional increase were found in those: older than 25 to 29 years (4.56-fold), Mexican Americans (4.56 fold), below high school education (2.32 fold), and low income group (2.90 fold) over time.

Conclusions
The HPV vaccination rates in Mexican Americans increased nearly 5-fold over the last 10 years. However, their vaccination rates continue to lag behind Whites and Blacks.