bluuebunny/crossref_metadata_2025_split huggingface dataset:
Otolaryngology Consult Protocols in the Setting of COVID-19: The University of Pittsburgh Approach
Authors: Dharmarajan Harish , Belsky Michael A. , Anderson Jennifer L. , Sridharan Shaum 
Published: March 2021

Objective: To analyze trends in otolaryngology consultations and provide algorithms to guide management during the COVID-19 pandemic. Methods: A retrospective cohort study at a single institution tertiary care hospital. A total of 95 otolaryngology consultations were performed from March 1, 2020 to April 26, 2020 (COVID-era) and 363 were performed from September 1, 2019 to February 29, 2020 (pre-COVID-era) at the UPMC Oakland campus. Data collected included patient demographics, COVID-19 status, reason for consult, location of consult, type of consult, procedures performed, need for surgical intervention, length of hospital stay and recommended follow up. Results: Patient populations in the pre-COVID-era and COVID-era were similar in terms of their distribution of demographics and chief complaints. Craniofacial trauma was the most common reason for consultation in both periods, followed by vocal fold and airway-related consults. We saw a 21.5% decrease in the rate of consults seen per month during the COVID-era compared to the 6 months prior. Review of trends in the consult workflow allowed for development of several algorithms to safely approach otolaryngology consults during the COVID-19 pandemic. Conclusions: Otolaryngology consultations provide valuable services to inpatients and patients in the emergency department ranging from evaluation of routine symptoms to critical airways. Systematic otolaryngology consult service modifications are required in order to reduce risk of exposure to healthcare providers while providing comprehensive patient care.
Kids and Diabetes in Schools (KiDS) intervention in India: Participants’ perspectives
Authors: Rawal Tina , Bhaumik Soumyadeep , Shrivastav Radhika , Nazar Gaurang P , Tandon Nikhil , Arora Monika 
Published: March 2021

Objectives: The purpose of this study was to assess the experience and satisfaction of teachers and parents of children with and without diabetes, with the Kids and Diabetes in School (KiDS) intervention. Project KiDS aimed to foster a safe and supportive school environment to encourage the management of type 1 diabetes and prevention of type 2 diabetes. Design: This qualitative evaluation involved semi-structured, face-to-face, in-depth interviews with a purposive sample of 35 respondents, including teachers and parents of children with and without diabetes attending the selected schools at 1 and 3 months post-intervention implementation. In total, n = 5 schools (3 government and 2 private) were selected out of 15 schools in which the KiDS project was implemented. Methods: In total, 65 interviews were conducted in two rounds. The sample comprised teachers ( n = 20 in round 1; n = 18 in round 2), parents of children with diabetes ( n = 3 in both the rounds) and parents of children without diabetes ( n = 15 in round 1; n = 6 in round 2) attending five schools. Data were analysed using the thematic framework method. Results: Teachers reported gaining new knowledge as a result of the KiDS intervention. They felt more confident in assisting children with diabetes. Suggestions to strengthen the KiDS resource pack were the inclusion of case studies and audio-visual aids. Parents of children with diabetes reported that the project reinforced information and improved diabetes management skills. Their suggestions for strengthening KiDS materials included the provision of additional technical information. The parents of children without diabetes reported that the resource pack aided a better understanding of diabetes and clarified myths and misconceptions. Suggestions for strengthening the pack included the regular reinforcement of information on diabetes among children. Conclusion: Findings support the upscaling of KiDS work elsewhere in India through the engagement of multiple stakeholders to promote the management and prevention of diabetes in school.
Incorporating the Biological Bases of Behavior Throughout Introduction to Psychology: A Review and Application of 7½ Lessons About the Brain
Authors: Williamson Manda J. 
Published: March 2021

Introduction: Research suggests benefits for incorporating popular press books into courses to encourage critical thinking and student-instructor interactions about concepts. Objective: This article offers a summary and critique of 7 ½ Lessons about the Brain by Lisa Feldman-Barrett along with pedagogical strategies for integrating the book within Introduction to Psychology courses. Teaching Implications: This popular press book affords an opportunity to incorporate a biopsychology thematic approach to Introduction to Psychology. Several pedagogical strategies using active learning and collaboration are provided. Conclusion: Choosing to include a popular press book in class to supplement student learning may benefit critical thinking about many concepts presented within Introduction to Psychology.
Mitral valve replacement through mini sternotomy after long ECMO course: Case report
Authors: Abdalghafoor Tamer , Sarhan Hatem , Kindawi Ali 
Published: March 2021

Introduction: Mitral regurgitation (MR) is defined as an abnormal reversal of blood flow from the left ventricle to the left atrium (LA). It is caused by disruption in any part of the mitral valve apparatus. Surgical intervention remains the mainstay of management for severe cases. Case summary: We are reporting a case of pneumonia with severe sepsis, that had a complicated hospital course. The patient developed multi-organ failure. Echocardiography on admission showed severe mitral regurgitation. He required early mechanical ventilation and then Veno-venous Extracorporeal Membrane Oxygenation (VV-ECMO) over 29 days. He might be the first case of Coronavirus Disease 2019 (COVID-19) in our hospital. Mitral valve replacement was done after stabilization of the patient and weaning from the ECMO. Discussion: Our report demonstrates that the use of a long term VV-ECMO as a bridge for stabilization, facilitates management of the critically ill respiratory failure patient with severe MR and patient outcomes. Still the long-term results and the optimal timing of intervention need more research to define. Conclusion: Our report demonstrates that the use of a long term VV ECMO facilitates management of patients with respiratory failure associated with severe MR. Future studies focusing on stabilizing such patients, might help to define the optimal timing for intervention in these patients and the long-term outcome.
Cannabis-induced oceanic boundlessness
Authors: Earleywine Mitch , Ueno Luna F , Mian Maha N , Altman Brianna R 
Published: March 2021

Background: Despite tetrahydrocannabinol (THC)’s reputation for creating dramatic effects at high doses, empirical work rarely addresses cannabis’s impact on subjective responses common to the tryptamine psychedelics. We focused on these effects because they have preceded and covaried with the therapeutic impact of psilocybin in previous work. Aims: The current study examined if self-reported responses to cannabis products might parallel those found in clinical trials of psilocybin administration. We also investigated if measures of demographics and cannabis use might correlate with these responses. Methods: Participants reported the subjective effect of their highest THC experience using 27 items that assess oceanic boundlessness, a correlate of mystical experiences. They also answered infrequency items and questions on demographics and cannabis consumption. Results: In an effort to address concerns about replication, we divided respondents who passed infrequency items into two random samples. Self-reported “breakthrough” experiences were significantly greater than zero but significantly lower than those reported in randomized clinical trials of psilocybin (17–19% vs. 59%). Total scores covaried with perceived dosages of THC, but only in one sample. Heavier users of cannabis reported lower scores. Conclusions: Self-report data suggest that high doses of cannabis can create subjective effects comparable to those identified in trials of psilocybin that precede relief from cancer-related distress, treatment-resistant depression, alcohol problems, and cigarette dependence. Given the disparate mechanisms of action, comparing THC-induced to psilocybin-induced effects might improve our understanding of the mechanisms underlying subjective experiences. This work might also support the development of a cannabis-assisted psychotherapy comparable to psilocybin-assisted psychotherapy.
Effects of hydrocortisone and yohimbine on selective attention to emotional cues
Authors: Metz Sophie , Chae Woo R , Deuter Christian E , Otte Christian , Wingenfeld Katja 
Published: March 2021

Introduction: Facial expressions contain important affective information, and selective attention to facial expression provides an advantage in the face of loss, stress and danger. In addition, the sympathetic nervous system and hypothalamus-pituitary-adrenal axis mediate the organism’s response to loss and danger. Here, we aimed at investigating the influence of sympathetic nervous system and hypothalamus-pituitary-adrenal axis activation on selective attention to affective facial stimuli. Methods and materials: One hundred-and-four healthy men between 18–35 years old (mean (standard deviation) age: 24.1 (3.5) years) participated in the study. We used a randomised, double-blind, placebo-controlled design. Participants received either: (a) yohimbine, (b) hydrocortisone, (c) yohimbine and hydrocortisone or (d) placebo only and participated in a dot-probe task with sad, happy and neutral faces. We collected salivary samples to measure cortisol and alpha amylase activity in addition to measurements of blood pressure and heart rate. Salivary cortisol served as correlate of hypothalamus-pituitary-adrenal axis activation and salivary alpha amylase activity, blood pressure and heart rate as correlates of sympathetic nervous system activation. Measurements were carried out before and after drug administration. Results: We did not find a main effect or interaction effect of hydrocortisone or yohimbine administration on selective attention to happy faces. However, we found an interaction of yohimbine and hydrocortisone on selective attention to sad faces. Post-hoc t-test revealed an attentional bias away from sad stimuli and towards neutral faces in the hydrocortisone-only group. Discussion: Only hydrocortisone administration led to an attentional bias away from sad faces. Future studies should investigate these effects in major depression disorder, as this disorder is characterised by glucocorticoid resistance and increased processing of sad stimuli.
Histopathological and Radiographic Features of Osteolysis After Fixation of Osteochondral Fragments Using Poly-L-Lactic Acid Pins for Osteochondral Lesions of the Talus
Authors: Ikuta Yasunari , Nakasa Tomoyuki , Sumii Junichi , Nekomoto Akinori , Adachi Nobuo 
Published: March 2021

Background: Fixation of osteochondral fragments is a potential option for treating an osteochondral lesion of the talus (OLT) involving large lesions in the remaining articular cartilage surface. Bioabsorbable devices, especially those made of poly-L-lactic acid (PLLA), can be used for the fixation of an OLT. Postoperative osteolysis surrounding the PLLA pins is occasionally observed; however, the significance of osteolysis remains unknown. Purpose: To elucidate the association between osteolysis surrounding the PLLA pins, histopathological findings in subchondral bone, and preoperative Hounsfield unit (HU) values at the pin fixation site. Study Design: Case Series; Level of evidence, 4. Methods: This retrospective analysis included 20 patients with OLT (11 men and 9 women; mean age, 20.9 years; 1 bilateral case). Tissue from the osteochondral fragment was collected intraoperatively using a bone biopsy needle for histological evaluation. The fragment was fixed through the biopsy hole using a PLLA pin. Osteolysis surrounding the PLLA pin was assessed at 1 year postoperatively using magnetic resonance imaging (MRI). Histopathological scores were assigned based on trabecular bone loss, empty lacunae, inflammatory granulation tissue, cartilage-like tissue, and the presence of osteoclasts. The HU values around the pin insertion site, detected on the postoperative MRI scans, were measured using the region of interest based on the preoperative coronal and sagittal computed tomography (CT) images. Results: Osteolysis was observed postoperatively in 9 ankles (42.9%). Histopathological evaluation revealed that the osteolysis group had a significantly higher pathological score than the nonosteolysis group (10.2 vs 6.3; P < .001). Lower HU values were identified in the osteolysis group on preoperative coronal and sagittal CT images ( P < .05). The histopathological score negatively correlated with preoperative HU values (Pearson r = −0.46; P = .037). Conclusion: Intraoperative biopsy of the OLT allowed for histopathological evaluation of the same site as that of the PLLA pin fixation. Our findings suggest that preoperative subchondral trabecular deterioration is associated with the incidence of postoperative osteolysis surrounding the PLLA pin. Additionally, low preoperative HU values in subchondral bone under OLT may serve as a predictor of osteolysis surrounding the PLLA pin.
Spontaneous urinary bladder perforation: An unusual presentation of well-differentiated papillary peritoneum mesothelioma
Authors: Serao Armando , Ambrosini Francesca , Cavallone Barbara , Borra Tiziana , Di Stasio Andrea 
Published: March 2021

Introduction: Well-differentiated papillary mesothelioma (WDPM) is a very rare neoplasm. Most of WDPM are asymptomatic and are often incidentally detected during surgery. This report describes a case of WDPM of the peritoneum unexpectedly diagnosed in a male with a spontaneous intraperitoneal bladder rupture. Case presentation: A 65-year-old male presented to our Emergency Department in November 2019 with a two-day history of anuria, abdominal pain, distention, and sepsis. The CT scan reported a large amount of extra and intraperitoneal free fluid. The CT cystogram showed bladder perforations on the dome and on the left lateral wall which was repaired through exploratory laparotomy. Intraoperatively, we encountered extensive suppurative peritonitis with large fibrino-purulent exudation. The purulent perivesical peritoneum was dissected and sent for histopathological examination which unexpectedly resulted in WDPM of the peritoneum. Conclusion: Although we can’t affirm with certainty, this case would seem to suggest that WDPM had played a role in patient’s clinical presentation. However, further research is necessary to draw stronger conclusion.
Pharmacogenomics in Pain Management: A Review of Relevant Gene-Drug Associations and Clinical Considerations
Authors: Brandl Emily , Halford Zachery , Clark Matthew D. , Herndon Chris 
Published: March 2021

Objective: To provide an overview of clinical recommendations regarding genomic medicine relating to pain management and opioid use disorder. Data Sources: A literature review was conducted using the search terms pain management, pharmacogenomics, pharmacogenetics, pharmacokinetics, pharmacodynamics, and opioids on PubMed (inception to February 1, 2021), CINAHL (2016 through February 1, 2021), and EMBASE (inception through February 1, 2021). Study Selection and Data Extraction: All relevant clinical trials, review articles, package inserts, and guidelines evaluating applicable pharmacogenotypes were considered for inclusion. Data Synthesis: More than 300 Food and Drug Administration–approved medications contain pharmacogenomic information in their labeling. Genetic variability may alter the therapeutic effects of commonly prescribed pain medications. Pharmacogenomic-guided therapy continues to gain traction in clinical practice, but a multitude of barriers to widespread pharmacogenomic implementation exist. Relevance to Patient Care and Clinical Practice: Pain is notoriously difficult to treat given the need to balance safety and efficacy when selecting pharmacotherapy. Pharmacogenomic data can help optimize outcomes for patients with pain. With improved technological advances, more affordable testing, and a better understanding of genomic variants resulting in treatment disparities, pharmacogenomics continues to gain popularity. Unfortunately, despite these and other advancements, pharmacogenomic testing and implementation remain underutilized and misunderstood in clinical care, in part because of a lack of health care professionals trained in assessing and implementing test results. Conclusions: A one-size-fits-all approach to pain management is inadequate and outdated. With increasing genomic data and pharmacogenomic understanding, patient-specific genomic testing offers a comprehensive and personalized treatment alternative worthy of additional research and consideration.
Outcomes of Simultaneous Bilateral vs Unilateral Distal Chevron Metatarsal Osteotomy in Hallux Valgus Patients Aged ≥60 Years
Authors: Seo Jae Hyeon , Lee Ho Seong , Choi Young Rak , Park Seung Hwan , Lee Jae Hyung , Chun Hannah 
Published: March 2021

Background: The purpose of this study was to compare radiographic outcomes of simultaneous bilateral and unilateral distal chevron metatarsal osteotomy (DCMO) in hallux valgus patients aged ≥60 years. Methods: This retrospective study analyzed consecutive outcomes of simultaneous bilateral DCMO and unilateral DCMO performed between June 2010 and August 2018 in 90 feet of 60 patients. Thirty patients underwent simultaneous bilateral DCMO, and 30 underwent unilateral DCMO. Comparative analysis of radiographic and clinical parameters between a simultaneous bilateral DCMO group (SB) and a unilateral DCMO group (U) was performed. Results: Mean age at surgery (65.7±4.8 vs 65.2±5.2 years), mean length of follow-up period (20.0 vs 18.6 months), and preoperative radiographic parameters were similar between the 2 groups (SB vs U). Mean hallux valgus angle (HVA) improved from 34.2 to 5.4 degrees (correction angle SB 28.8 vs U 28.8 degrees). Mean first-to-second intermetatarsal angle improved from 15.8 to 6.8 degrees (correction angle SB 8.9 vs U 8.9 degrees). Hallux varus deformity was observed in 4 feet (SB 3 vs U 1), and mechanical instability with callus formation in 1 foot in the unilateral group. Conclusion: DCMOs in patients aged ≥60 years were radiographically effective and safe, even performed in one stage bilaterally. Radiographic parameters were similar in patients who underwent simultaneous bilateral and unilateral DCMO. Level of Evidence: Level III, retrospective cohort study.
Students’ experiences and learning of social inclusion in team activities in physical education
Authors: Hovdal Dag Ove G , Haugen Tommy , Larsen Inger Beate , Johansen Bjørn Tore 
Published: March 2021

Physical education (PE) can be a context in which students are ‘educated through the physical’, which includes the possibility to learn social inclusion as an important life skill and contributor to the greater good of society. A key goal in the Norwegian educational system is that such positive life skills become internalised in students. The aims of this study were to understand students’ experiences of and behaviour towards social inclusion – such as passing the ball – in team activities and how the teacher facilitated the learning of social inclusion. We use Dewey’s pedagogical perspective on education, and Johnson and Johnson’s cooperative learning model to discuss possible consequences and implications of our findings. The participants consisted of two secondary classes from two state schools in Norway, where one class was investigated in depth. Methods comprised written narratives, interviews, observation and video recordings of PE lessons. Data creation was triangulated, and thematic analysis was conducted. The results highlighted a paradox between students’ experiences of and behaviour towards social inclusion in team activities. Students disliked socially exclusive behaviours, but they often provided positive feedback when the behaviour was seen as successful in the context of a game; furthermore, students could themselves behave in a socially exclusive manner. Although the teacher could ‘teach by telling’ the students to pass the ball or by having rules, passing the ball did not become internalised in students. We discuss a model of ‘learning through experiences and reflections’, according to which students may learn to become socially inclusive beings.
DSM-5 symptom expression in toddlers
Authors: Coulter Kirsty L , Barton Marianne L , Robins Diana L , Stone Wendy L , Fein Deborah A 
Published: March 2021

Although the early behaviors associated with autism spectrum disorder have been well characterized, many behaviors are also commonly observed in young children with other developmental delays and even in those with typical development. Therefore, consideration must be given to whether a child demonstrates sufficient autism spectrum disorder symptoms to warrant this diagnosis. Using the Toddler Autism Symptom Inventory, we examined caregiver endorsement of specific behaviors in three groups of toddlers referred for autism spectrum disorder risk: those who received a best-estimate diagnosis of autism spectrum disorder, those with another developmental disorder, and those who showed slight or no developmental delays and did not meet criteria for any disorder. The results revealed significant differences in symptoms among the three diagnostic groups, as well as low frequency of some DSM-5, ASD criteria, especially insistence on sameness, for those with ASD. These findings have important implications for applying the DSM-5, diagnostic criteria to toddlers. Lay abstract Children with autism show more social-communication symptoms and repetitive behaviors than children with typical development or those diagnosed with other developmental disorders; however, non-autistic children often show some behaviors that are associated with autism. We compared the behavioral reports from caregivers of children in these three groups to identify the behaviors that were specific to autism. Children with autism were found to show more of these behaviors, and behaviors that are particularly indicative of autism were identified. These behaviors included social symptoms (approaching others to interact, showing things, looking back while showing, responding to an approaching child, spontaneous imitation) and repetitive behavior symptoms (specific, inflexible play, unusual body movements, strong specific interest, carrying around an unusual object, sensory seeking, and sensory hyper-reactivity). These findings may aid professionals in determining the most appropriate diagnosis for a child between the ages of 12 and 36 months.