bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceived discrimination, health, and well-being among adults with and without pain: a prospective study
Authors: Scott Whitney , Jackson Sarah E. , Hackett Ruth A. 
Published: June 2021

Abstract
Discrimination negatively influences health and well-being in the general population, but its impact on people with pain is unclear. This study assessed discrimination, health, and well-being in people with and without pain. Data were from 5871 participants from the English Longitudinal Study of Ageing. Experiences of discrimination were reported in 2010 to 2011. Pain, self-rated health, depressive symptoms, quality of life, life satisfaction, and loneliness were assessed in 2010 to 2011 and 2016 to 2017. A quarter (26%, n = 1524) of the sample reported pain at baseline. Participants with pain were more likely to report discrimination than those without pain (odds ratio [OR] = 1.28, 95% confidence interval [CI] 1.13-1.46). Cross-sectionally, those with pain who perceived discrimination had poorer self-rated health (OR = 1.28, 95% CI 1.02-1.61), greater depressive symptoms (OR = 1.90, 95% CI 1.48-2.45), were more likely to be lonely (β = 0.21, 95% CI 0.15-0.26), and had lower quality of life (β = −4.01, 95% CI −4.88 to −3.14), and life satisfaction (β = −1.75, 95% CI −2.45 to −1.06) than those with pain who did not perceive discrimination. Prospectively, discrimination in those with pain was associated with greater depression (OR = 1.67, 95% CI 1.19-2.34) and loneliness (β = 0.11, 95% CI 0.05-0.17), adjusting for baseline values. In those without pain in 2010 to 2011, discrimination predicted pain in 2016 to 2017, controlling for covariates (OR = 1.29, 95% CI 1.06-1.56). People with pain are more likely to report discrimination than those without pain, and this experience is associated with increased depression and loneliness. Discrimination was predictive of incident pain in pain-free adults. These findings highlight the need to tackle discrimination to improve well-being in those with pain and to potentially reduce the risk of pain onset.
Enhanced mindfulness-based stress reduction in episodic migraine—effects on sleep quality, anxiety, stress, and depression: a secondary analysis of a randomized clinical trial
Authors: Burrowes Shana A.B. , Goloubeva Olga , Stafford Kristen , McArdle Patrick F. , Goyal Madhav , Peterlin B. Lee , Haythornthwaite Jennifer A. , Seminowicz David A. 
Published: June 2021

Abstract
Patients with migraine suffer from high morbidity related to the repeated headache attacks, characteristic of the disorder, poor sleep, and a high prevalence of comorbid psychosocial disorders. Current pharmacological therapies do not address these aspects of migraine, but nonpharmacological treatments such as mindfulness-based stress reduction (MBSR) have been shown to improve both pain and psychological well-being. In this secondary analysis, we examined the change over time in sleep quality and psychosocial outcomes from the magnetic resonance imaging outcomes for mindfulness meditation clinical trial and assessed how these mediated treatment response (50% reduction in headache frequency postintervention). We also examined the relationship between baseline values and treatment response. The trial (primary outcomes previously reported) included 98 patients with episodic migraine randomized to either enhanced MBSR (MBSR+) or stress management for headache. They completed psychosocial questionnaires and headache diaries at baseline (preintervention), midintervention (10 weeks after baseline), and postintervention (20 weeks after baseline). There was a significant improvement in sleep quality from baseline to postintervention (P = 0.0025) in both groups. There were no significant changes from baseline or between groups in anxiety, depression, and stress. There was also no significant association between baseline scores and treatment response. Mediation analysis showed a significant indirect effect of 6% for sleep: In other words, small improvements in sleep may have contributed to the efficacy of MBSR+.
Trial registration: NCT02133209.
Impact of rescue medication in placebo-controlled trials of pharmacotherapy for neuropathic pain and low back pain
Authors: Grøvle Lars , Hasvik Eivind , Haugen Anne Julsrud 
Published: June 2021

Abstract
Rescue medication (RM) consumption is commonly used as a secondary outcome in placebo-controlled trials of chronic pain, but its validity has yet to be established. If participants randomized to placebo take more RM than those randomized to an active drug, the difference in pain between the 2 groups may be reduced, potentially masking effects of the active drug. This study assessed proportional RM consumption in the placebo and active groups according to results of 42 randomized controlled trials of neuropathic pain (NeP), and 29 trials of low back pain, which were included in 2 systematic reviews and meta-analyses. Trial results were assessed based on effect size, statistical significance, and whether the drug was recommended as first-line treatment by the systematic reviews. In trials indicating effect of the investigational drug, RM consumption was generally higher in the placebo groups than in the active groups. In trials reporting a small or a medium effect size of the investigational drug, subjects receiving placebo consumed 17% to 30% more RM than subjects receiving active drug, potentially leading to underestimation of the effects of the investigational drugs. Few trials reported a large effect size. Differences in RM consumption between participants receiving placebo and those receiving active drug were seldom taken in account by the individual trials and not at all by the systemic reviews when making treatment recommendations for NeP or low back pain. Elaboration on analytical methods to assess treatment effects in chronic pain trials using RM is warranted.
Oral squamous cell carcinoma–released brain-derived neurotrophic factor contributes to oral cancer pain by peripheral tropomyosin receptor kinase B activation
Authors: Grayson Max , Arris Dominic , Wu Ping , Merlo Jaclyn , Ibrahim Tarek , Fang-Mei Chang , Valenzuela Vanessa , Ganatra Shilpa , Ruparel Shivani 
Published: June 2021

Abstract
Oral cancer pain is debilitating and understanding mechanisms for it is critical to develop novel treatment strategies treatment strategies. Brain-derived neurotrophic factor (BDNF) signaling is elevated in oral tumor biopsies and is involved with tumor progression. Whether BDNF signaling in oral tumors contributes to cancer-induced pain is not known. The current study evaluates a novel peripheral role of BDNF-tropomyosin receptor kinase B (TrkB) signaling in oral cancer pain. Using human oral squamous cell carcinoma (OSCC) cells and an orthotopic mouse tongue cancer pain model, we found that BDNF levels were upregulated in superfusates and lysates of tumor tongues and that BDNF was expressed by OSCC cells themselves. Moreover, neutralization of BDNF or inhibition of TrkB activity by ANA12, within the tumor-bearing tongue reversed tumor-induced pain-like behaviors in a sex-dependent manner. Oral squamous cell carcinoma conditioned media also produced pain-like behaviors in naïve male mice that was reversed by local injection of ANA12. On a physiological level, using single-fiber tongue-nerve electrophysiology, we found that acutely blocking TrkB receptors reversed tumor-induced mechanical sensitivity of A-slow high threshold mechanoreceptors. Furthermore, single-cell reverse transcription polymerase chain reaction data of retrogradely labeled lingual neurons demonstrated expression of full-form TrkB and truncated TrkB in distinct neuronal subtypes. Last but not the least, intra-TG siRNA for TrkB also reversed tumor-induced orofacial pain behaviors. Our data suggest that TrkB activities on lingual sensory afferents are partly controlled by local release of OSCC-derived BDNF, thereby contributing to oral cancer pain. This is a novel finding and the first demonstration of a peripheral role for BDNF signaling in oral cancer pain.
Muscle function, quality, and relative mass are associated with knee pain trajectory over 10.7 years
Authors: Pan Feng , Tian Jing , Scott David , Cicuttini Flavia , Jones Graeme 
Published: June 2021

Abstract
Periarticular muscle plays an important role in the pathogenesis of musculoskeletal pain. We recently reported that pain population consists of distinct subgroups of which the causes and mechanisms may differ. This study aimed to examine the association of lean mass, muscle strength, and quality with 10.7-year pain trajectory. Nine hundred forty-seven participants from a population-based cohort study were analysed. Dual-energy X-ray absorptiometry was used to assess lean and fat mass. Leg strength, knee extensor strength, and lower-limb muscle quality were measured/calculated. Knee pain was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index pain questionnaire. Radiographic knee osteoarthritis was assessed by X-ray. Three distinct pain trajectories were identified: “Minimal pain” (53%), “Mild pain” (34%), and “Moderate pain” (13%). Higher total and lower-limb lean mass were associated with an increased risk of “Mild pain” and “Moderate pain” trajectories relative to the “Minimal pain” trajectory group, but these associations became nonsignificant after further adjustment for fat mass. Total lean mass percentage was associated with a lower risk of “Mild pain” (relative risk ratio [RRR]: 0.95, 95% confidence interval 0.92-0.98) and “Moderate pain” trajectory (RRR: 0.92, 95% confidence interval 0.87-0.96). Greater leg and knee extensor strength and muscle quality were associated with “Mild pain” and “Moderate pain” trajectories (RRR: 0.52-0.65, all P < 0.05). Similar results were found in those with radiographic knee osteoarthritis. Higher lower-limb muscle strength and quality, and relative lean mass, are associated with a reduced risk of severe knee pain trajectories, suggesting that improving muscle function and composition may protect against persistent unfavourable knee pain courses.
Printing a static progressive orthosis for hand rehabilitation
Authors: Huang Li-Ying , Wang Tien-Hsiang , Chang Bao-Chi , Huang Chia-I , Chou Li-Wei , Wang Shyh-Jen , Chen Wei-Ming 
Published: June 2021

Background:
Static progressive orthosis is used for the treatment of severe joint contracture after trauma and/or surgery. However, a custom-fabricated static progressive splint would be expensive and labor intensive. Especially, owing to very limited payment under the current Taiwanese National Health Insurance, the incentives to fabricate a patient-specific splint are insufficient for a therapist. To ease splint construction, we introduced three-dimensional (3D)-printed “shark fin”-shaped device works as a static progressive orthosis for the hand rehabilitation. The aim of this study was to describe and demonstrate the newly designed device.

Methods:
This study included a 46-year male suffered from a left distal radius fracture and underwent open reduction internal fixation and a 23-year male with the right thumb flexor pollicis longus rupture, requiring tendon repair. Both subjects used this “shark fin”-shaped device to stretch for increasing range of motion (ROM) of wrist extension and the thumb.

Results:
The patient receiving ulnar shortening surgery used this device to stretch for increasing ROM of wrist extension. The active ROM of wrist extension improved from 30° to 50°. The other patient with the right thumb flexor pollicis longus rupture suffered from thumb contracture; the ROMs of the metacarpophalangeal (MCP) joint and interphalangeal (IP) joint were 40°–55° and 20°–25°, respectively. After tenolysis surgery, his ROMs of the MCP and IP joints were improved to 10°–35° and 40°–65°, respectively. Following physical therapy by applying the device, his ROMs of the MCP and IP joints were further increased to 0°–40° and 25°–70°, respectively.

Conclusion:
Incorporating the “shark fin”-shaped orthosis into hand rehabilitation increased the ROM of wrist extension for a patient with distal radius fracture and improved the ROM of the MCP and IP joints in another patient after tenolysis surgery.
Varied impacts on outpatient services among departments and divisions in the early phase of the COVID-19 pandemic: Implications for personnel mobilization and preparatory training
Authors: Chang Ya-Ting , Chiang Shu-Chiung , Lee Wui-Chiang , Chen Tzeng-Ji , Hwang Shinn-Jang 
Published: June 2021

Background:
Coronavirus disease 2019 (COVID-19) spread all over the world in 2020. In the face of the sudden pandemic, workforce mobilization has been of critical concern to medical institutions. During the pandemic, the public’s behaviors of seeking medical assistance have also changed. Using the real-world data of a large medical center in Taiwan, this study aimed to analyze the fluctuations of outpatient visits among various departments and divisions in the early phase of the COVID-19 pandemic and to provide suggestions for staff allocation in similar future events.

Methods:
Data of outpatient visits at Taipei Veterans General Hospital were obtained for analysis. The weekly fluctuations of outpatient visits among 36 departments or divisions were computed for 8 weeks from February 3 to March 29, 2020, the early phase of the pandemic. The monthly data of outpatient visits by department and division in March 2020 were also extracted for comparison with those in March 2019. A simple regression equation was used to calculate the weekly trends.

Results:
Average outpatient visits decreased by 26% in 2 months following the outbreak. Among the 36 departments or divisions, ophthalmology, orthopedics, and cardiology underwent marked declines after the outbreak; the slopes of the simple regression equation were −110.8, −100.7, and −99.2, respectively. By contrast, transfusion medicine, toxicology, transplantation surgery, pediatric surgery, chest surgery, technical aid, and oncology were divisions less influenced. In the year-over-year comparison, infection was the only department or division with positive growth (20.5%), whereas all others exhibited negative growth.

Conclusion:
In the future, we can fulfil the additional personnel needs during a pandemic by redeploying physicians from departments experiencing a reduced workload. Hospitals should also establish preparatory employee training programs to ensure that the reassigned personnel are adequately equipped to serve in their new positions.
The Effect of Clozapine on Self-reported Duration of Sleep and Its Interaction With 23 Other Medications
Authors: Fernandez-Egea Emilio , Chen Shanquan , Jenkins Christopher , Turrion Concha , Mitchell Simon P. , Dodwell David J. F. , Mann Louisa M. , Deakin Julia B. , Syed Zahoor H. , Hafizi Sepehr , Zimbron Jorge , Praseedom Asha S. , Cardinal Rudolf N. 
Published: June 2021

Abstract

Background
Sedation is a common and incapacitating clozapine adverse effect, but the factors associated with sedation and its pharmacological management remain poorly studied.

Methods
We conducted a retrospective cohort study based on deidentified electronic clinical records of clozapine-treated patients from the secondary mental health care provider for Cambridgeshire and Peterborough, United Kingdom. We first evaluated cross-sectionally the influence of clozapine dose, clozapine, and norclozapine plasma levels on self-reported hours slept, as a proxy for sedation, using bivariate correlation and then the longitudinal effect of changes in clozapine dose and other 23 medications using linear mixed effect models. We followed 241 clozapine-treated patients for 56 months on average, with 2237 face-to-face assessments in total.

Results
Patients slept for a mean of 9.35 h/d, with 46% reporting 10 h/d or more. Cross-sectionally, sleep duration did not correlate with clozapine dose (r = 0.14, P = 0.106), but with clozapine plasma levels (r = 0.38, P < 0.0001) and norclozapine plasma levels (r = 0.25, P = 0.005). Longitudinally, the final mixed-effects model revealed 4 pharmacological variables that had a significant impact on hours slept: clozapine, risperidone augmentation, and atenolol were associated with increased sleep, whereas aripiprazole augmentation was associated with decreased sleep. We found that 20 other psychotropic medications measured were not associated with changes in sleep when added to clozapine. Excess sleep is a clozapine level-dependent adverse effect.

Conclusions
The impact of different augmentation strategies might help clinicians decide on the most adequate strategy, albeit further studies should confirm our results.
Crisis Management of Hysteroscopic Surgical Complications in the Office Setting
Authors: Roman Robert A. , Roberts Carey C. , Booth Rachel , Nezhat Camran , Bhagavath Bala , Lindheim Steven R. 
Published: June 2021

Importance
As health care providers are increasingly motivated to perform office procedures, there is marginal training and attention related to crisis management (CM).

Objective
We review the CM in office gynecology and illustrate the value of applying the STOP (stop, think, observe, plan) mental framework to acute management of office hysteroscopy complications.

Evidence Acquisition
We performed a literature review on crisis management in gynecology.

Results
Concepts of team leadership, simulation training, awareness of human error, and panic control are implemented in CM.

Conclusions
Health care providers need to be cognizant of the importance of CM for optimizing patient safety and quality improvement and consider its application on office-based procedures.

Relevance
Crisis management has become increasingly relevant in the outpatient setting, seeking to better equip physicians with the skills to manage adverse outcomes while performing office-based procedures.

Target Audience
Obstetricians and gynecologists, family physicians

Learning Objectives
At the completion of this article, physicians should be better able to describe the benefits and risks of office hysteroscopy; evaluate CM principles of human error, simulation training, leadership, and panic control; and assess the STOP mental framework for CM.
Cervical Cancer Screening in the United States: Challenges and Potential Solutions for Underscreened Groups
Authors: Fuzzell Lindsay N. , Perkins Rebecca B. , Christy Shannon M. , Lake Paige W. , Vadaparampil Susan T. 
Published: June 2021

(Abstracted from Prev Med 2021;144:106400)
Every year, approximately 13,000 cases and 4000 deaths are attributed to cervical cancer, making it the leading cause of cancer death for women worldwide. Nearly all cases of cervical cancer are caused by human papillomavirus (HPV), making HPV vaccination and screening programs critical for reducing mortality.
Long-Term Physical Activity Levels and Physical Functioning Outcomes After Midurethral Sling
Authors: Shinnick Julia K. , Raker Christina A. , Sung Vivian W. 
Published: June 2021

(Abstracted from Female Pelvic Med Reconstr Surg 2021;27:51–56)
Urinary incontinence (UI) affects approximately 15.7% of women and can impact physical activity (PA), often due to a fear of urinary leakage. Studies have reported >60% of women with daily urine leakage reporting a diminished physical functioning (PF), and this is especially predominant in women with stress urinary incontinence (SUI) in their fifth or sixth decades of life.
Associations Between Consumption of Coffee and Caffeinated Soft Drinks and Late Stillbirth—Findings From the Midland and North of England Stillbirth Case-Control Study
Authors: Heazell Alexander E. P. , Timms Kate , Scott Rebecca E. , Rockliffe Lauren , Budd Jayne , Li Minglan , Cronin Robin , McCowan Lesley M. E. , Mitchell Edwin A. , Stacey Tomasina , Roberts Devender , Thompson John M. D. 
Published: June 2021

(Abstracted from Eur J Obstet Gynecol Reprod Biol 2021;256:471–477)
The prevention of stillbirth is an enduring problem. Identifying risk factors and developing strategies to minimize their effect can help to reduce the prevalence of stillbirth.
The Role of HLA-B27 in Argentinian Axial Spondyloarthritis Patients
Authors: García-Salinas Rodrigo , Ruta Santiago , Chichande Jessica Torres , Magri Sebastian 
Published: June 2021

Background
The prevalence of human leukocyte antigen B27 (HLA-B27) is variable around the world. Our objectives were to estimate the frequency of HLA-B27 in an Argentinian cohort of axial spondyloarthritis (axSpA), to evaluate the differences between HLA-B27–positive and HLA-B27–negative patients, and to analyze its performance as a diagnostic biomarker.

Methods
Observational study including patients older than 18 years, with axSpA diagnosis assessed in a fast track program (Reuma-Check SpA). All patients underwent the following: blood tests, HLA-B27, sacroiliac images, and enthesitis ultrasound. Sociodemographic data and SpA symptoms were also collected. The clinical assessor was blinded to complementary studies. For the sensitivity and specificity analysis, patients with chronic low back pain without axSpA who performed the same circuit in the same period were used as control, paired 1:1 (sex and age).

Results
One hundred fifty patients were included, 75 axSpA and 75 controls. The frequency of HLA-B27 was 43% (95% confidence interval [CI], 30–53). The differences between HLA-B27–positive and HLA-B27–negative patients were observed in age of low back pain onset (36 vs 46 years), BASFI (Bath Ankylosing Spondylitis Functional Index) (4 vs 5), and extra-articular SpA features such as uveitis and inflammatory bowel disease (29% vs 50%). When this frequency was compared (low back pain control group), the difference was 43% versus 9% (odds ratio, 7.7; 95% CI, 2.8–24), and HLA-B27 had a sensitivity of 43%, specificity of 91%, positive predictive value of 85%, negative predictive value of 58%, and likelihood ratio of 4.9 (95% CI, 3–8).

Conclusions
The frequency of HLA-B27 in axSpA was 43%; positive patients had an earlier age of onset (36), a higher BASFI, and more SpA features. For the diagnosis of SpA, HLA-B27 had a good specificity but low sensitivity.
Discontinuation of Continuation or Maintenance Electroconvulsive Therapy Caused by the COVID-19 Pandemic
Authors: Van de Velde Nele , Geerts Pieter-Jan , Tandt Hannelore , Vanderhasselt Marie-Anne , Titeca Koen , Lemmens Gilbert 
Published: June 2021

Background
Continuation or maintenance electroconvulsive therapy (C/M-ECT) is recommended to reduce relapse rates of patients with major depressive disorder. During the ongoing COVID-19 pandemic, ECT services have come under pressure or needed to close because of redirected resources and safety reasons. We investigated the impact of C/M-ECT discontinuation on relapse in patients with unipolar depressive disorder in Flanders, Belgium.

Methods
Between March 30 and June 18, 2020, all patients receiving C/M-ECT in 2 ECT centers were included. Continuation or maintenance electroconvulsive therapy was discontinued in 33 patients and continued in 4 patients. Relapse was defined as the need to restart ECT or the need for hospitalization. Depressive symptoms were assessed every 3 weeks using the Patient Health Questionnaire, the Clinical Global Impression Scale, and 2 additional patient-rated questions.

Results
Relapse in the discontinuation group was 60.6%. All 4 patients who continued ECT remained remitted. Kaplan-Meier survival analysis showed significantly shorter relapse rates for patients receiving bitemporal and/or frequent C/M-ECT (1- to 2-week intervals). Patients older than 60 years showed longer survival rates.

Conclusions
Our results confirm earlier prospective and retrospective data regarding the efficacy and importance of C/M-ECT as relapse prevention. After treatment discontinuation, close monitoring of early warning signs for relapse is crucial, especially in the first few months. With the COVID-19 pandemic continuing, our data provide an indication of the necessity to ensure adequate care and access to ECT not only for the acutely ill but also for the vulnerable patients who are depending on C/M-ECT.