bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Unfolding of Cognitive Effort During Sentence Processing: Pupillometric Evidence From People With and Without Aphasia
Authors: Chapman Laura Roche , Hallowell Brooke 
Published: November 2021

Purpose:
Arousal and cognitive effort are relevant yet often overlooked components of attention during language processing. Pupillometry can be used to provide a psychophysiological index of arousal and cognitive effort. Given that much is unknown regarding the relationship between cognition and language deficits seen in people with aphasia (PWA), pupillometry may be uniquely suited to explore those relationships. The purpose of this study was to examine arousal and the time course of the allocation of cognitive effort related to sentence processing in people with and without aphasia.

Method:
Nineteen PWA and age- and education-matched control participants listened to relatively easy (subject-relative) and relatively difficult (object-relative) sentences and were required to answer occasional comprehension questions. Tonic and phasic pupillary responses were used to index arousal and the unfolding of cognitive effort, respectively, while sentences were processed. Group differences in tonic and phasic responses were examined.

Results:
Group differences were observed for both tonic and phasic responses. PWA exhibited greater overall arousal throughout the task compared with controls, as evidenced by larger tonic pupil responses. Controls exhibited more effort (greater phasic responses) for difficult compared with easy sentences; PWA did not. Group differences in phasic responses were apparent during end-of-sentence and postsentence time windows.

Conclusions:
Results indicate that the attentional state of PWA in this study was not consistently supportive of adequate task engagement. PWA in our sample may have relatively limited attentional capacity or may have challenges with allocating existing capacity in ways that support adequate task engagement and performance. This work adds to the body of evidence supporting the validity of pupillometric tasks for the study of aphasia and contributes to a better understanding of the nature of language deficits in aphasia.

Supplemental Material

https://doi.org/10.23641/asha.16959376
The Role of Talker Variability in Nonnative Phonetic Learning: A Systematic Review and Meta-Analysis
Authors: Zhang Xiaojuan , Cheng Bing , Zhang Yang 
Published: November 2021

Purpose:High-variability phonetic training (HVPT) has been found to be effective on adult second language (L2) learning, but results are mixed in regards to the benefit of multiple talkers over single talker. This study provides a systematic review with meta-analysis to investigate the talker variability effect in nonnative phonetic learning and the factors moderating the effect.Method:We collected studies with keyword search in major academic databases including EBSCO, ERIC, MEDLINE, ProQuest Dissertations & Theses, Elsevier, Scopus, Wiley Online Library, and Web of Science. We identified potential participant-, training-, and study-related moderators and conducted a random-effects model meta-analysis for each individual variable.Results:On the basis of 18 studies with a total of 549 participants, we obtained a small-level summary effect size (Hedges'g= 0.46, 95% confidence interval [CI; 0.08, 0.84]) for the immediate training outcomes, which was greatly reduced (g= −0.04, 95% CI [−0.46, 0.37]) after removal of outliers and correction for publication bias, whereas the effect size for immediate perceptual gains was nearly medium (g= 0.56, 95% CI [0.13, 1.00]) compared with the nonsignificant production gains. Critically, the summary effect sizes for generalizations to new talkers (g= 0.72, 95% CI [0.15, 1.29]) and for long-term retention (g= 1.09, 95% CI [0.39, 1.78]) were large. Moreover, the training program length and the talker presentation format were found to potentially moderate the immediate perceptual gains and generalization outcomes.Conclusions:Our study presents the first meta-analysis on the role of talker variability in nonnative phonetic training, which demonstrates the heterogeneity and limitations of research on this topic. The results highlight the need for further investigation of the influential factors and underlying mechanisms for the presence or absence of talker variability effects.Supplemental Materialhttps://doi.org/10.23641/asha.16959388
Interprofessionelles Wissens- und Skillstraining der PEG-Anlage an Simulatoren – Entwicklung und Testung eines nationalen Curriculums für Ärzte und spezialisierte Pflegende
Authors: Engelke Monika , Grund Karl Ernst , Schilling Dieter , Beilenhoff Ulrike , Kern-Waechter Elisabeth , Engelke Olaf , Stebner Ferdinand , Kugler Christiane 
Published: November 2021

Zusammenfassung
Einleitung Ein Positionspapier verschiedener Fachgesellschaften zur Delegation ärztlicher Tätigkeiten in der Gastroenterologie fordert im Abschnitt „Perkutane Punktion bei der Anlage einer perkutanen endoskopischen Gastrostomie (PEG)“ ein nationales Curriculum für Trainingskurse, die vor der Durchführung der Punktion absolviert werden sollen.Gegenstand der vorliegenden Studie ist die Entwicklung und Testung eines solchen Curriculums. Ziel ist die Vermittlung des notwendigen Wissens und der Skills zur sicheren Durchführung der PEG-Anlage für Ärzte und Pflegende.
Methoden Die Testung erfolgte im Rahmen einer nicht randomisierten, interventionellen Pilotstudie an Simulatoren. Sie umfasste (1) eine Vorbereitungsphase, (2) eine theoretische und (3) eine praktische Phase. Nach der theoretischen Phase erfolgte eine Überprüfung der kognitiven Fähigkeiten mittels Wissenstests. Am Ende der praktischen Phase wurde das Anlageprozedere jedes einzelnen Teilnehmers mehrkanalig auf Video aufgezeichnet und die sensomotorischen Fähigkeiten wurden mithilfe eines Assessmentinstruments (AS-PEG) ausgewertet. Abschließend wurde eine Evaluation mittels Fragebogen zur Zufriedenheit der Teilnehmenden durchgeführt.
Ergebnisse Sieben Ärzte und 17 Pflegende absolvierten die im Curriculum definierten Phasen und abschließenden Prüfungen. Beim Wissenstest wurden durchschnittlich 70,3 ± 3,7 (61–75) von 76 Punkten erreicht. Beim Test zu den erworbenen sensomotorischen Fähigkeiten wurden durchschnittlich 37,1 ± 2,1 (32–40) von 42 Punkten erzielt. Die Evaluation ergab eine hohe Zufriedenheit der Teilnehmenden in Bezug auf Inhalte, Lernzielerreichung und erworbene praktische Fähigkeiten.
Schlussfolgerung Eine Verbreitung des Curriculums wird als sinnvoll und notwendig erachtet, um theoretische und praktische Kenntnisse für Ärzte und Pflegende durch das strukturierte interprofessionelle Wissens- und Skillstraining zu vermitteln und den Pflegenden einen rechtlich abgesicherten Rahmen zu bieten.
Vertebro- und Kyphoplastie
Authors: Thomé Patrick , Vetter Sven 
Published: November 2021

ZusammenfassungDie Vertebroplastie und die Kyphoplastie sind minimalinvasive, perkutane Augmentationsverfahren. Sie werden meist bei schmerzhaften osteoporotischen Wirbelkörperkompressionsfrakturen des älteren Menschen eingesetzt. Durch den demografischen Wandel ist mit einem ansteigenden Versorgungsbedarf zu rechnen. In diesem Beitrag werden Indikationen, technische Prinzipien und mögliche Komplikationen beider Verfahren beleuchtet und die aktuelle Literatur dargestellt.
Pancreaticobiliary endoscopic ultrasound in England 2007 to 2016: Changing practice and outcomes
Authors: Trudgill Nigel , Oppong Kofi W. , Kamran Umair , King Dominic , Dosanjh Amandeep , Coupland Ben , Leeds John , Nayar Manu , Patel Prashant 
Published: November 2021

Abstract
Background and study aims Population-level data on the outcomes of pancreaticobiliary endoscopic ultrasound (PB-EUS) are limited. We examined national PB-EUS and fine-needle aspiration (FNA) activity, its relation to pancreatic cancer therapy, associated mortality and adverse events.
Patients and methods Adults undergoing PB-EUS in England from 2007–2016 were identified in Hospital Episode Statistics. A pancreatic cancer cohort diagnosed within 6 months of PB-EUS were studied separately. Multivariable logistic regression models examined associations with 30-day mortality and therapies for pancreatic cancer.
Results 79,269 PB-EUS in 68,908 subjects were identified. Annual numbers increased from 2,874 (28 % FNA) to 12,752 (35 % FNA) from 2007 to 2016. 8,840 subjects (13 %) were diagnosed with pancreatic cancer. Sedation related adverse events were coded in 0.5 % and emergency admission with acute pancreatitis in 0.2 % within 48 hours of PB-EUS. 1.5 % of subjects died within 30 days of PB-EUS. Factors associated with 30-day mortality included increasing age (odds ratio 1.03 [95 % CI 1.03–1.04]); male sex (1.38 [1.24–1.56]); increasing comorbidity (1.49 [1.27–1.74]); EUS-FNA (2.26 [1.98–2.57]); pancreatic cancer (1.39 [1.19–1.62]); increasing deprivation (least deprived quintile 0.76 [0.62–0.93]) and lower provider PB-EUS volume (2.83 [2.15–3.73]). Factors associated with surgical resection in the pancreatic cancer cohort included lower provider PB-EUS volume (0.44 [0.26–0.74]) and the least deprived subjects (1.33 [1.12–1.57]). 33 % of pancreatic cancer subjects who underwent EUS, did not subsequently receive active cancer treatment.
Conclusions Lower provider PB-EUS volume was associated with higher 30-day mortality and reduced rates of both pancreatic cancer surgery and chemotherapy. These results suggest potential issues with case selection in lower-volume EUS providers.
Clinical practice patterns in indirect peroral cholangiopancreatoscopy: outcome of a European survey
Authors: Stassen Pauline M.C. , de Jonge Pieter Jan F. , Webster George J.M. , Ellrichmann Mark , Dormann Arno J. , Udd Marianne , Bruno Marco J. , Cennamo Vincenzo ,   on behalf of the European Cholangioscopy Group,   and the German Spyglass User Group
Published: November 2021

Abstract
Background and aims Indirect peroral cholangiopancreatoscopy (IPOC) is a relatively new diagnostic and therapeutic tool for biliopancreatic diseases. This international survey aimed to evaluate clinical practice patterns in IPOC among endoscopists in Europe.
Methods An online survey was developed comprising 66 questions on the use of IPOC. Questions were grouped into four domains. The survey was sent to 369 endoscopists who perform IPOC.
Results 86 respondents (23.3 %) from 21 different countries across Europe completed the survey. The main indications for cholangioscopy were determination of biliary strictures (85 [98.8 %]) and removal of common bile duct or intrahepatic duct stones (79 [91.9 %]), accounting for an estimated use of 40 % (interquartile range [IQR] 25–50) and 40 % (IQR 30–60), respectively, of all cases undergoing cholangioscopy. Pancreatoscopy was mainly used for removal of pancreatic duct stones (68/76 [89.5 %]), accounting for an estimated use of 76.5 % (IQR 50–95) of all cases undergoing pancreatoscopy. Only 13/85 respondents (15.3 %) had an institutional standardized protocol for targeted cholangioscopy-guided biopsy sampling. IPOC with lithotripsy was used as first-line treatment in selected patients with bile duct stones or pancreatic stones by 24/79 (30.4 %) and 53/68 (77.9 %) respondents, respectively.
Conclusions This first European survey on the clinical practice of IPOC demonstrated wide variation in experience, indications, and techniques. These results emphasize the need for prospective studies and development of an international consensus guideline to standardize the practice and quality of IPOC.
Endoscopic duodenal mucosal resurfacing for nonalcoholic steatohepatitis (NASH): a pilot study
Authors: Hadefi Alia , Verset Laurine , Pezzullo Martina , Rosewick Nicolas , Degré Delphine , Gustot Thierry , Moreno Christophe , Devière Jacques , Trépo Eric 
Published: November 2021

Abstract
Background and study aims Nonalcoholic steatohepatitis (NASH) is a leading cause of chronic liver disease worldwide with limited treatment options. Duodenal mucosal resurfacing (DMR) has been associated with improvement in glycaemic parameters and liver function tests (LFTs) in type 2 diabetes. This study aimed to assess the effect of DMR in patients with NASH.
Patients and methods This was a single-center, open-label pilot study. Patients with definite, biopsy-proven NASH (nonalcoholic fatty liver disease activity score [NAS] ≥ 4) underwent a single DMR procedure followed by a 2-week postprocedural diet, without lifestyle intervention. The primary outcome was either resolution of NASH with no worsening of fibrosis or improvement in fibrosis (≥ 1 stage) with no worsening of NASH at 12 months. Secondary outcomes were changes in key histological parameters of NASH, surrogate markers of fibrosis, LFTs, and metabolic factors at 12 months.
Results From 2017 to 2019, 14 patients underwent successful DMR, of whom 11 were included in the analysis. After 12 months, no resolution of NASH was observed, while three patients (27 %) had marginal improvement in fibrosis with no worsening of NASH. Serious adverse events related to the procedure were reported in two patients out of 14 (14 %). Neither weight loss nor improvement in NAS score, or in the other secondary outcomes, were observed at 12 months.
Conclusions In this small and heterogenous study population, we found that DMR, in the absence of lifestyle intervention, did not induce NASH resolution and marginally improved liver fibrosis at 12 months.
Initial experience with a homemade “hybrid-tome” for needle-knife precut in patients with difficult biliary cannulation
Authors: De la Morena Madrigal Emilio J. , Rodríguez García Isabel , Galera Ródenas Ana Belén , Pérez Arellano Elena 
Published: November 2021

Abstract
Background and study aims Current clinical guidelines recommend needle-knife precut (NKP) as the primary and best method for performing a biliary cannulation (BC) when simple techniques fail and the criteria are met for difficult BC (DBC). However, many endoscopists avoid or defer early NKP in favor of alternative, simpler techniques that have not been shown to be either safer or more effective. Our goal is to test a device that provides the needle-knife papillotome (NKPT) with traction capability and which can facilitate the learning and execution of NKP.
Patients and methods This was a descriptive bicentric observational study of a personal cohort of patients undergoing early NKP to analyse the efficacy and safety of the technique with a “hybrid-tome” (HT) built using the isolated core of a NKPT and a conventional canulotome.
Results Over a 4-year period, we performed 43 NKPs with the HT, achieving BC in one or two steps in all cases. The 100 % technical success was matched by a 95 % clinical success rate. We recorded 11 adverse events (23 %): five hemorrhages, four pancreatitis, and two cholangitis. In addition to the objective data, we confirmed that HT facilitates alignment with the duodenal papilla and the execution of pre-cutting, especially if the papilla is intradiverticular or hidden by folds.
Conclusions The HT tested seems to help trained endoscopists to perform NKP, especially in some anatomic situations, which can improve compliance with the guidelines recommended for early NKP in patients with DBC.
The feasibility and safety of disposable endoscope vs. conventional endoscope for upper gastrointestinal tract examination: a multicenter, randomized, parallel, non-inferiority trial
Authors: Li De-feng , Shi Rui-yue , Tian Yan-hui , Xu Zheng-lei , Zhou Ying-sheng , Sun Xian-jiu , Cai Jin-wei , Fang Yuan-yuan , Peng Huan , Wang Jia-min , Dong Tao , Cai Yong-de , Yao Jun , wang Li-sheng 
Published: November 2021

Abstract
Background A disposable upper gastrointestinal endoscope can effectively decrease infectious outbreaks associated with endoscope reuse. In the present study, we aimed to evaluate the feasibility and safety of a disposable endoscope for upper gastrointestinal examination.
Methods In a prospective, randomized trial, 144 upper endoscopic procedures were allocated to either the disposable endoscope group or the conventional endoscope group. The primary outcomes were rates of excellent and good image qualities and maneuverability satisfaction. The second outcome included procedure duration, endoscopic diagnosis, and adverse events.
Results A total of 144 subjects were enrolled in the present analysis and prospectively randomized to 2 study groups. Finally, 70 and 69 subjects were enrolled in the novel disposable endoscope group and the conventional endoscope group, respectively, due to the schedule cancellation of 5 subjects. The baseline characteristics of the patients were similar in both groups. The excellent and good image quality rates and maneuverability satisfaction of the novel disposable endoscope were not inferior to the conventional endoscope (p = 0.99 and p = 0.99, respectively). Moreover, no significant between-group difference was observed in the endoscopic results and adverse events (p = 0.30 and p = 1, respectively). However, the procedure duration in the novel disposable endoscope was longer compared with the conventional endoscope (8.40 ± 4.28 min vs. 5.12 ± 2.65 min, p < 0.001).
Conclusions The novel disposable endoscope was as safe, effective, and maneuverable as a conventional endoscope. However, the novel disposable endoscope was associated with a longer procedure duration.
Red urine and a red herring – diagnosing rare diseases in the light of the COVID-19 pandemic
Authors: Jud Philipp , Hackl Gerald , Reisinger Alexander Christian , Horvath Angela , Eller Philipp , Stadlbauer Vanessa 
Published: November 2021

Abstract
Background The COVID-19 pandemic has occupied the time and resources of health care professionals for more than 1 year. The risk of missed diagnoses has been discussed in the medical literature, mainly for common diseases such as cancer and cardiovascular events. However, rare diseases also need appropriate attention in times of a pandemic.
Case Report We report a 34-year-old woman with fever, pinprick sensation in her chest and thoracic spine, and dizziness after receiving the first dose of ChAdOx1 nCoV-19 vaccination. The patient’s condition worsened with abdominal pain, red urine, and hyponatremia, needing intensive care admission. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) was diagnosed. Vaccine-induced thrombocytopenia and thrombosis were ruled out. Acute hepatic porphyria was finally diagnosed, and the patient recovered completely after treatment with hemin.
Conclusion Currently, the focus of physicians is on COVID-19 and associated medical problems, such as vaccine side effects. However, it is important to be vigilant for other uncommon medical emergencies in medically exceptional situations that may shift our perception.
A Convenient On-Site Oxidation Strategy for the N-Hydroxylation of Melanostatin Neuropeptide Using Cope Elimination
Authors: Sampaio-Dias Ivo E. , Silva-Reis Sara C. , Pires-Lima Beatriz L. , Correia Xavier Cruz , Costa-Almeida Hugo F. 
Published: November 2021

AbstractA convenient synthetic protocol for the unprecedented N-hydroxylation of proline residue in Melanostatin (MIF-1) neuropeptide is reported. This methodology is grounded on the incorporation of N-(cyanoethyl)prolyl residue followed by on-site oxidation by Cope elimination with m-chloroperbenzoic acid, exploring the unrecognized dual role of the cyanoethyl group as an effective N-protecting group under peptide synthesis conditions and as a suitable leaving group during the chemoselective on-site N-oxidation. Following this protocol N-hydroxy-MIF-1 is obtained in 78% global yield from N-(cyanoethyl)-l-proline. This synthetic approach opens a new avenue for access to N-hydroxylated Melanostatin analogues with direct application in neurochemistry and Parkinson’s research.
A Chiral Sulfoxide-Based C–H Acid
Authors: List Benjamin , Höfler Denis , Kaupmees Karl , Leito Ivo 
Published: November 2021

AbstractWe report the design and synthesis of a strong, chiral, enantiopure sulfoxide-based C–H acid. Single-crystal X-ray analysis confirms the proposed structure and its absolute configuration. The new motif shows a high acidity and activity in Brønsted and Lewis acid catalyzed transformations. So far, only little to no enantioselectivities were achieved.
The Prognostic Potential of Growth Differentiation Factor-15 on Bleeding Events and Patient Outcome after Cardiac Surgery—A Prospective Cohort Study
Authors: Kazem Niema , Hammer Andreas , Koller Lorenz , Hofer Felix , Steinlechner Barbara , Laufer Günther , Hengstenberg Christian , Wojta Johann , Sulzgruber Patrick , Niessner Alexander 
Published: November 2021

Abstract
Background GDF-15 (growth/differentiation factor 15) is induced by myocardial stretch, volume overload, inflammation, and oxidative stress. Its expression is tightly linked with cardiovascular events as well as the risk for major bleeding and all-cause mortality. The present study aimed to elucidate the prognostic potential of GDF-15 in patients after cardiac surgery.
Methods A total of 504 patients undergoing elective cardiac valve and/or coronary artery bypass graft surgery were prospectively enrolled. GDF-15 levels were measured prior to surgery to evaluate the impact on bleeding events, thromboembolic events, and mortality.
Results Preoperative GDF-15 was associated with the primary endpoint of intra- and postoperative red blood cell transfusion (for bleeding risk factors adjusted [adj] OR [odds ratio] per 1-SD [standard deviation] of 1.62 [95% confidence interval [CI]: 1.31–2.00]; p < 0.001). Higher concentrations of GDF-15 were observed in patients reaching the secondary endpoint of major or clinically relevant minor bleeding (for bleeding risk factors adj. OR per 1-SD of 1.70 [95% CI: 1.05–2.75]; p = 0.030) during the first postoperative year, but not for thromboembolic events. GDF-15 was a predictor for cardiovascular mortality (for comorbidities adj. HR [hazard ratio] per 1-SD of 1.67 [95% CI: 1.23–2.27]; p = 0.001) and all-cause mortality (for comorbidities adj. HR per 1-SD of 1.55 [95% CI: 1.19–2.01]; p = 0.001). A combined risk model of GDF-15 and EuroSCORE II outperformed the EuroSCORE II alone for long-term survival (C-index: 0.75 [95% CI: 0.70–0.80], p = 0.046; net reclassification improvement: 33.6%, p < 0.001).
Conclusion Preoperative GDF-15 concentration is an independent predictor for intra- and postoperative major bleeding, major bleeding during the first year, and for long-term cardiovascular or all-cause mortality after cardiac surgery.
Indicated Opioids in Pregnancy: Guidance on Providing Comprehensive Care
Authors: Cleary Erin M. , Smid Marcela C. , Bokat Christina , Costantine Maged M. , Rood Kara M. 
Published: November 2021

In modern obstetric practice, providers will encounter patients for whom opioid use in pregnancy is reasonable or even necessary. A “one-size-fits-all” approach to the counseling and management of such patients is misguided. Understanding indications for ongoing opioid use in pregnancy is essential to patient-centered care. Specifically, recognition of the nuanced differences between opioid dependence and opioid use disorder is crucial for appropriate diagnosis, screening for common concurrent conditions, adequately counseling about individualized maternal and perinatal risks, and accurate documentation of diagnoses and medical decision-making. In this paper, we explore the current typical scenarios in which opioid use in pregnancy may be encountered, ongoing opioid prescribing should be considered, and provide a guide for the obstetric provider to navigate the antepartum, intrapartum, and postpartum periods.
Key Points