bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Surgical Posterior Nasal Nerve Cryoablation on Symptoms and Disease-Specific Quality of Life in Patients With Chronic Rhinitis
Authors: Virani Farrukh R. , Wilson Machelle D. , Beliveau Angela M. , Gill Amarbir S. , Strong E. Bradley , Steele Toby O. 
Published: June 2021

Objective: Preliminary data have demonstrated long-term efficacy of posterior nasal nerve (PNN) cryoablation in reducing rhinitis symptoms for patients with allergic rhinitis (AR) and nonallergic rhinitis (NAR). We sought to evaluate the impact of procedural cryoablation of the PNN on quality of life (QOL) in patients with AR and NAR. Methods: Adult patients undergoing PNN cryoablation for AR or NAR after appropriate medical therapy were included for analysis. Demographics, medical therapies, baseline rhinitis symptom (total nasal symptom score [TNSS]), and disease-specific QOL (mini-rhinoconjunctivitis quality of life questionnaire [mini-RQLQ]) were recorded. The Wilcoxon signed-rank test was used to test for significant changes in baseline test scores posttreatment. Absolute and relative improvement in outcomes was determined for each participant. Secondary outcomes were assessed with univariate and multivariate analyses. Results: Fourteen patients were enrolled with a mean follow-up of 16.5 weeks. The TNSS and mini-RQLQ scores significantly improved after PNN cryoablation (median δs [interquartile range]: −4 [3] and −1.61 [1.08], respectively; both P = .0002). The minimal clinically important difference for the TNSS and mini-RQLQ was obtained in 92.9% of patients in each category. Relative mean percentage (%) improvement after PNN cryoablation in the TNSS and mini-RQLQ was 40.7% and 40.5% (standard deviation = 24.9 and 29.5, respectively), respectively, for all patients. Patients with NAR (n = 10) reported mean improvement of 41.3% (29.1) as measured by the TNSS and 49.6% (25.9) by mini-RQLQ. Patients with AR reported mean percentage improvement in TNSS and mini-RQLQ scores of 39.5% (12.1) and 24.6% (28.5), respectively. Patients who had been prescribed a nasal anticholinergic for management prior to PNN cryoablation had statistically significantly increased improvement in mini-RQLQ scores from pre- to post-procedure ( P = .0387). Conclusion: Surgical cryoablation of the PNN significantly improves both symptoms and disease-specific QOL in majority of patients with AR and NAR.
Assessing the Applicability of the TALK Score: A Modification for Concurrent Tobacco Use During Treatment
Authors: Johnson Mason , Porterfield James Zachary , Kejner Alexandra Eva 
Published: June 2021

ObjectiveThe previously described TALK score (T‐stage, Albumin, Liquor, Karnofsky Performance Status) has been proposed as a method to predict laryngectomy‐free survival (LFS) in patients undergoing definitive chemoradiation (CRT). This study assesses its use as well as a modification to include continued tobacco use.Study DesignRetrospective chart review.SettingAcademic institution from 2004 to 2020.MethodsPatients diagnosed with larynx or hypopharynx cancer undergoing CRT were reviewed. Clinically relevant variables were collected (TALK), which were dichotomized per previously set cutoffs. Concurrent tobacco use was evaluated and also dichotomized as 0 or 1. Multivariate analysis was conducted to determine which factors were most predictive of the key outcomes of survival and LFS.ResultsA total of 2514 patient charts were evaluated. Patients treated for larynx cancer with primary CRT with complete data were included, ultimately totaling 300. Of these, 78 patients required salvage total laryngectomy (TL). Multivariate analysis demonstrated that LFS was best predicted by tobacco use during treatment (odds ratio [OR] 0.3465, 95% confidence interval [CI] 0.1862‐0.6300) and Karnofsky Performance Status (OR 0.1646, 95% CI 0.0673‐0.3662). Tobacco use during treatment was also strongly predictive of survival. Excluding T4 tumors, the utilization of tobacco in place of T‐stage improved the accuracy of the predictive model in this cohort.ConclusionGiven that a T‐stage of 4 is typically treated with total laryngectomy, modification of the TALK score to include tobacco use during treatment (tALK) for patients with T < 4 can be used to improve prediction of 3‐year LFS and overall survival.
A prospective study to establish the minimal clinically important difference of the Mini-BESTest in individuals with stroke
Authors: Beauchamp Marla K , Niebuhr Rudy , Roche Patricia , Kirkwood Renata , Sibley Kathryn M 
Published: June 2021

Objective: To determine the minimal clinically important difference of the Mini-BESTest in individuals’ post-stroke. Design: Prospective cohort study. Setting: Outpatient stroke rehabilitation. Subjects: Fifty outpatients with stroke with a mean (SD) age of 60.8 (9.4). Intervention: Outpatients with stroke were assessed with the Mini-BESTest before and after a course of conventional rehabilitation. Rehabilitation sessions occurred one to two times/week for one hour and treatment duration was 1.3–42 weeks (mean (SD) = 17.4(10.6)). Main measures: We used a combination of anchor- and distribution-based approaches including a global rating of change in balance scale completed by physiotherapists and patients, the minimal detectable change with 95% confidence, and the optimal cut-point from receiver operating characteristic curves. Results: The average (SD) Mini-BESTest score at admission was 18.2 (6.5) and 22.4 (5.2) at discharge (effect size: 0.7) ( P = 0.001). Mean change scores on the Mini-BESTest for patient and physiotherapist ratings of small change were 4.2 and 4.3 points, and 4.7 and 5.3 points for substantial change, respectively. The minimal detectable change with 95% confidence for the Mini-BESTest was 3.2 points. The minimally clinical importance difference was determined to be 4 points for detecting small changes and 5 points for detecting substantial changes. Conclusions: A change of 4–5 points on the Mini-BEST is required to be perceptible to clinicians and patients, and beyond measurement error. These values can be used to interpret changes in balance in stroke rehabilitation research and practice.
Development and validation of a prediction model of poor performance status and severe symptoms over time in cancer patients (PROVIEW+)
Authors: Seow Hsien , Tanuseputro Peter , Barbera Lisa , Earle Craig C , Guthrie Dawn M , Isenberg Sarina R , Juergens Rosalyn A , Myers Jeffrey , Brouwers Melissa , Tibebu Semra , Sutradhar Rinku 
Published: June 2021

Background: Predictive cancer tools focus on survival; none predict severe symptoms. Aim: To develop and validate a model that predicts the risk for having low performance status and severe symptoms in cancer patients. Design: Retrospective, population-based, predictive study Setting/Participants: We linked administrative data from cancer patients from 2008 to 2015 in Ontario, Canada. Patients were randomly selected for model derivation (60%) and validation (40%). Using the derivation cohort, we developed a multivariable logistic regression model to predict the risk of an outcome at 6 months following diagnosis and recalculated after each of four annual survivor marks. Model performance was assessed using discrimination and calibration plots. Outcomes included low performance status (i.e. 10–30 on Palliative Performance Scale), severe pain, dyspnea, well-being, and depression (i.e. 7–10 on Edmonton Symptom Assessment System). Results: We identified 255,494 cancer patients (57% female; median age of 64; common cancers were breast (24%); and lung (13%)). At diagnosis, the predicted risk of having low performance status, severe pain, well-being, dyspnea, and depression in 6-months is 1%, 3%, 6%, 13%, and 4%, respectively for the reference case (i.e. male, lung cancer, stage I, no symptoms); the corresponding discrimination for each outcome model had high AUCs of 0.807, 0.713, 0.709, 0.790, and 0.723, respectively. Generally these covariates increased the outcome risk by >10% across all models: lung disease, dementia, diabetes; radiation treatment; hospital admission; pain; depression; transitional performance status; issues with appetite; or homecare. Conclusions: The model accurately predicted changing cancer risk for low performance status and severe symptoms over time.
The Neighborhood Environment and Hispanic/Latino Health
Authors: Heredia Natalia I. , Xu Tianlin , Lee MinJae , McNeill Lorna H. , Reininger Belinda M. 
Published: June 2021

Purpose: Hispanic/Latino adults on the Texas-Mexico border have high rates of chronic disease. Neighborhoods can influence health, though there is a limited research on neighborhood environment and health in Hispanics/Latinos. The purpose of this study was to assess the relation of neighborhood environment with health variables in Hispanic/Latino adults, including physical activity [PA], depression, anxiety, and lab-assessed conditions (type 2 diabetes, metabolic syndrome, and chronic inflammation). Methods: Participants were randomly-selected from a Hispanic/Latino cohort on the Texas-Mexico border. Neighborhood environment, self-reported PA, anxiety, and depression were assessed through questionnaires. Laboratory values determined Type 2 diabetes, metabolic syndrome, and C-reactive protein (CRP). We conducted multivariable linear and logistic regression analyses to assess the associations of neighborhood environment and health variables, controlling for covariates. Results: Participants (n = 495) were mostly females, without insurance. After controlling for covariates, crime (Adjusted Odds Ratio [AOR] = 1.59 (95%CI 1.06-2.38), no streetlights (AOR = 1.65, 95%CI 1.06-2.57), and traffic (AOR = 1.74, 95%CI 1.16-2.62) were all significantly associated with anxiety. Only traffic was significantly associated with depression (AOR = 1.61, 95%CI1.05-2.47). A lack of nearby shops (AOR = 0.57, 95%CI 0.38-0.84) and no one out doing PA (AOR = 0.53, 95% CI 0.34-0.83) were both significantly associated with lower odds of meeting PA guidelines. A lack of nearby shops was associated with a 26% increase in the CRP value (β = 0.26, 95%CI 0.04-0.47). Discussion: Several neighborhood environment variables were significantly associated with mental health, PA and CRP, though estimates were small. The neighborhood environment is a meaningful contextual variable to consider for health-related interventions in Hispanic/Latino adults, though more study is needed regarding the magnitude of the estimates. Trial registration: NCT01168765.
Association of Weight Loss With Type 2 Diabetes Remission Among Adults in Medically Underserved Areas: A Retrospective Cohort Study
Authors: Chen Ming , Surbhi Satya , Bailey James E. 
Published: June 2021

Purpose: To examine the association between weight loss and type 2 diabetes remission among vulnerable populations living in medically underserved areas of the Mid-Southern United States. Design: Quantitative, retrospective cohort study. Setting: 114 ambulatory sites and 5 adults’ hospitals in the Mid-South participating in a regional diabetes registry. Participants: 9,900 adult patients with type 2 diabetes, stratified by remission status, with 1 year of baseline electronic medical record data, and 1 year of follow-up data for the 2015-2018 study period. Measures: The outcomes were diabetes remissions, categorized as any remission, partial remission, and complete remission based on the guidelines of the American Diabetes Association. The exposure was weight loss, calculated by the change in the Body Mass Index (BMI) as a proxy measure. Analysis: χ2 tests, Fisher’s exact tests, and the Mann-Whitney U-test were used to examine the differences in patient characteristics by remission status across the 3 remission categories, as appropriate. Multiple multivariable logistic regressions adjusting for confounders were performed to estimate the adjusted odds ratios (aORs) for the associations between weight loss and diabetes remission. Results: Among 9,900 patients identified, a reduction of 0.3 kg/m2 (standard deviation: 2.5) in the average BMI from the baseline to the follow-up was observed. 10.8% achieved any type of remission, with 9.8% for partial and 1.0% for complete remissions. Greater weight loss was significantly associated with an increased likelihood of any (aOR = 1.07, 95% confidence interval (CI), 1.06-1.08), partial (aOR 1.06, 95% CI, 1.04-1.07), and complete diabetes remission (aOR 1.10, 95% CI, 1.07-1.13). Conclusions: Weight loss is significantly associated with diabetes remission among patients living in medically underserved areas, but complete remission is rare.
E-mental health in child psychiatry during COVID-19: an initial attitudinal study
Authors: Eapen Valsamma , Dadich Ann , Balachandran Srilaxmi , Dani Anitha , Howari Rasha , Sequeria Anupama Zeena , Singer Joel D 
Published: June 2021

Objective: COVID-19 propelled e-mental health within the Australian health system. It is important to learn from this to inform mental healthcare during future crises. Method: A lexical analysis was conducted of clinician reflections during COVID-19 as they delivered psychiatry services to children and families in New South Wales ( n = 6) and transitioned to e-mental health. Results: E-mental health can extend the reach of, and access to psychiatry services, particularly for individuals disadvantaged by inequity. Yet e-mental health can be problematic. It is partly contingent on technological prowess, equipment, internet access as well as space and privacy. Relatedly, e-mental health can hinder clinician capacity to conduct examinations, monitor child development as well as assess risk and the need for child protection. Conclusions: Given the benefits and limitations of e-mental health, a model that supports face-to-face mental healthcare and e-mental health may be of value. This model would require practical, yet flexible policies and protocols that protect the privacy of children and families, safeguard them from harm, and respect the needs and preferences of children, families and clinicians.
Safety Evaluation of KP-10 (Metastin 45–54) Following once Daily Intravenous Administration for 14 Days in Dog
Authors: Terse Pramod S. , Peggins James , Seminara Stephanie B. 
Published: June 2021

Kisspeptin-10 (previously referred as metastin 45–54), an active fragment of the endogenous full-length kisspeptin-145, is a potential therapeutic agent for reproductive disorders such as infertility, amenorrhea, and pubertal delay. A safety evaluation of KP-10 was conducted in dogs at the doses of 30, 100, and 1,000 μg/kg, given once daily intravenously for 14 days with a 14-day recovery period. There were no overt signs of drug-related toxicity observed in clinical signs, body weights, food consumption, clinical pathology, histopathology, urinalysis, electrocardiogram, or respiratory rate. Due to very rapid clearance of the peptide, luteinizing hormone (LH) levels were measured as a surrogate marker to demonstrate KP-10 exposure. The LH response reached a maximum concentration at 5 minutes post-dose and remained relatively unchanged for at least 30 minutes after dosing with no gender effect. LH concentrations on Day 1 were generally greater than on day 14. Vaginal cytology results indicated all dogs were in anestrous throughout the dosing period. There were also no KP-10–related findings observed in recovery animals on Day 29. In conclusion, KP-10 demonstrated favorable safety profile in dog where 1,000 μg/kg dose was considered as a no-observed-adverse-effect level dose when administered IV once daily for 14 days.
An Evaluation of the Knowledge and Perceptions of Pharmacy Staff and Pre-Registration Students of E-Cigarettes Use: A Systematic Review
Authors: Barrett Ravina , Aldamkhi Hajar 
Published: June 2021

Introduction: Pharmacy staff are a trusted source of advice on the safe and appropriate use of medicines and devices. Retail pharmacies deliver smoking cessation services and sell e-cigarettes in the UK. This review asks ‘what knowledge, experience and ability do staff have to support e-cigarette users to quit smoking’. Methods: A systematic literature search was undertaken drawn on predefined eligibility criteria and a comprehensive search strategy following the PRISMA guideline. Eligible papers reported survey-research published in English from 2015 to 2020. PubMed, Google Scholar, OVID, EMBASE and MEDLINE Databases were searched. No restrictions on study design or language were applied. Two reviewers independently screened for inclusion/exclusion and then extracted the relevant information from the articles for synthesis. Results: Of 12 potentially eligible full-text studies, 1 was a duplicate, 7 were excluded as per eligibility criteria. Four papers were finally included in this literature review. Two studies indicated that pharmacy staff are less confident in giving advice on e-cigarette use. Knowledge on the adverse effects of e-cigarettes compared to traditional smoking cessation aids remain unclear. In one study, 42% of community pharmacists did not believe that e-cigarettes could be used for smoking cessation. Three studies identified need for specific regulations and professional support. The overall certainty of the evidence is ‘low’ or ‘very low’, with moderate levels of bias. Conclusion: Pharmacists may be well placed to implement e-cigarette smoking cessation interventions, but most practitioners lacked knowledge and ability to support these customers citing unclear risk of harm. Pharmacists felt secure in recommending traditional cessation tools. Further regulation, guidelines and training is needed. Findings may be less generalizable in countries where e-cigarettes are banned. Their extent of knowledge, experience and ability to support users of e-cigarettes within their community to quit smoking is lacking.
The Toddler Autism Symptom Inventory: Use in diagnostic evaluations of toddlers
Authors: Coulter Kirsty L , Barton Marianne L , Boorstein Hilary , Cordeaux Cara , Dumont-Mathieu Thyde , Haisley Lauren , Herlihy Lauren , Jashar Dasal Tenzin , Robins Diana L , Stone Wendy L , Fein Deborah A 
Published: June 2021

Although symptoms of autism are present early in life and early diagnosis can lead to better outcomes, there is a dearth of validated caregiver-report interviews designed for children under the age of 3 years. We developed the Toddler Autism Symptom Inventory, a semi-structured interview designed to assess the presence and absence of skills and symptoms in children aged 12–36 months. Reliability and validity of items and a cutoff score for likelihood of autism spectrum disorder were established. Specificity and sensitivity of this cutoff were confirmed with a cross-validation sample. The Toddler Autism Symptom Inventory effectively identified most children with autism without excessive false positives. The Toddler Autism Symptom Inventory is a developmentally appropriate caregiver interview for use in diagnostic evaluations of children under age 3 years that offers clearly operationalized diagnostic criteria and a cutoff for autism likelihood for very young children. Lay abstract Determining whether a young child has an autism spectrum disorder requires direct observation of the child and caregiver report of the child’s everyday behaviors. There are few interviews for parents that are specifically designed for children under 3 years of age. The Toddler Autism Symptom Inventory is a new interview that asks caregivers of children age 12–36 months about symptoms of possible autism spectrum disorder. The Toddler Autism Symptom Inventory uses a cutoff score to indicate likelihood for autism spectrum disorder; this cutoff score appears to accurately identify most children who are diagnosed with autism spectrum disorder without identifying too many who do not have autism spectrum disorder. The Toddler Autism Symptom Inventory interview can help clinicians to determine whether a young child shows symptoms suggestive of an autism spectrum disorder.
Preschool teachers’ selection of social communication interventions for children with autism: An application of the theory of planned behavior
Authors: Hugh Maria L , Johnson LeAnne D , Cook Clayton 
Published: June 2021

Early Childhood Special Education teachers select practices to use to promote social communication development for their students with autism spectrum disorder. Understanding what evidence-based practices teachers select and why can inform the development of dissemination and implementation supports at the critical Adoption-Decision stage of implementation. The researchers used discrete choice analysis to examine and test the effects of Early Childhood Special Education teachers’ beliefs (self-efficacy, attitude, subjective norms; Theory of Planned Behavior) about key evidence-based practices on their practice selections. To assess malleable determinants of practice selection, this study addressed these aims: (1) assess Early Childhood Special Education teachers’ beliefs (attitudes, subjective norms, and self-efficacy) about key evidence-based practices, (2) describe which evidence-based practices teachers selected, and (3) examine whether teachers’ beliefs predicted practice selections. A web-based survey gathered responses from 222 Early Childhood Special Education teachers. Participants had the most favorable beliefs about naturalistic intervention and the least about discrete trial teaching and scripting. These beliefs aligned with the frequencies with which these practices were selected, and teachers’ beliefs predicted which practices they selected. Together, these findings suggest that beliefs serve as determinants of Early Childhood Special Education teachers’ practice selections that can be acted on to tailor pre-implementation supports and improve implementation from the start. Lay abstract Preschool special educators’ are more likely to choose an educational practice to teach a young child with autism a social communication skill if they have positive beliefs about it. We asked preschool special educators to read a description of an autistic student and their social communication goal and imagine they were the student’s teacher. We then asked them to pick one of five practices to teach the student. We also asked them questions to understand their attitudes about, confidence in their ability to use, and their perception of their coworkers’ support of each practice. There are many research-based practices that a teacher could use to help children learn, and preschool teachers often make these decisions for their students. Teachers’ beliefs varied in how supportive they were of each practice, and research shows people are more likely to do something that their beliefs support. In this study, they had more supportive beliefs and were more likely to use some practices, like naturalistic intervention, than other practices, like discrete trial teaching. By knowing this, researchers can help teachers use practices that their beliefs support and help change teachers’ beliefs to be supportive of a practice they may need to use.