bluuebunny/crossref_metadata_2025_split huggingface dataset:
New insights into 5α-reductase type 2 deficiency based on a multi-centre study: regional distribution and genotype–phenotype profiling ofSRD5A2in 190 Chinese patients
Authors: Gui Baoheng , Song Yanning , Su Zhe , Luo Fei-Hong , Chen Linqi , Wang Xiumin , Chen Ruimin , Yang Yu , Wang Jin , Zhao Xiu , Fan Lijun , Liu Xia , Wang Yi , Chen Shaoke , Gong Chunxiu 
Published: June 2019

BackgroundThe 5α-reductase type 2 (5α-RD2) deficiency caused by mutations in the steroid 5α-reductase 2 (SRD5A2) gene results in variable degrees of undervirilisation in patients with 46,XY disorders of sex development. This study aims to profile the regional distribution and phenotype–genotype characteristics ofSRD5A2in a large Chinese 5α-RD2 deficiency cohort through multi-centre analysis.Methods190 subjects diagnosed with 5α-RD2 deficiency were consecutively enrolled from eight medical centres in China. Their clinical manifestations and genetic variants were analysed.ResultsHypospadias (isolated or combined with microphallus and/or cryptorchidism) was fairly common in the enrolled subjects (66.32%). 42 variants, including 13 novel variants, were identified inSRD5A2. Homozygous and compound heterozygous mutations presented in 38.42% and 61.58% of subjects, respectively, and predominated in exons 1, 4 and 5. The most prevalent variant was c.680G > A (52.37%), followed by c.16C > T, (10.79%), c.607G > A, (9.21%) and c.737G > A, (8.95%). However, their distributions were different: c.680G > A was more common in South China than in North China (62.62% vs 39.16%, p < 0.001), whereas the regional prevalence of c.16C > T was reversed (6.07% vs 16.87%, p = 0.001). Furthermore, c.680G > A prevailed in cases with normal meatus (68.75%) or distal hypospadias (66.28%), compared with those with proximal hypospadias (35.54%, p < 0.001). However, cases with proximal hypospadias showed a higher frequency of c.16C > T (20.48%) than those with normal meatus (3.13%) or distal hypospadias (3.49%, p < 0.001).ConclusionsThis study profiled variable phenotypic presentation and wide mutational spectrum ofSRD5A2,revealing its distinctive regional distribution in Chinese patients and further shaping the founder effect and genotype–phenotype correlation ofSRD5A2.
Switchable second-order nonlinear optical response of platinum-sensitized dithienylethenes
Authors: Liu Xiao-Yun , Shi Zhi-Yuan , Ye Jin-Ting , Wang Hui-Ying , Wang Hong-Qiang , Qiu Yong-Qing 
Published: June 2019

The electronic structure and the nonlinear optical (NLO) properties of a series of platinum-sensitized dithienylethenes (DTEs) were investigated by using the density functional theory (DFT) method. DFT calculations reveal that the second-order NLO properties of complexes significantly increase with the DTE ligand being directly linked with terpyridine–Pt(II) complexes. Due to the good [Formula: see text]-conjugated characteristics, closed-ring complexes possess much larger second-order NLO properties than the corresponding open-ring complexes. The computational [Formula: see text] values are in the order of 3c ([Formula: see text] esu) [Formula: see text] 3o ([Formula: see text] esu) [Formula: see text] 4c ([Formula: see text] esu) [Formula: see text] 4o ([Formula: see text] esu) [Formula: see text] 1 ([Formula: see text] esu) [Formula: see text] 2c ([Formula: see text] esu) [Formula: see text] 2o ([Formula: see text] esu). Among all calculated platinum-sensitized dithienylethenes, 3c has the largest second-order NLO properties. The 4c and 4o have almost the same [Formula: see text] values and the [Formula: see text] value of 4o is slightly larger than that of 2o because the ether bonds can significantly prevent charge transfer within the complexes.
General Anesthesia Versus Conscious Sedation for Intracranial Mechanical Thrombectomy: A Systematic Review and Meta‐analysis of Randomized Clinical Trials
Authors: Zhang Yu , Jia Lu , Fang Fang , Ma Lu , Cai Bowen , Faramand Andrew 
Published: June 2019

Background
Endovascular therapy is the standard of care for severe acute ischemic stroke caused by large‐vessel occlusion in the anterior circulation, but there is uncertainty regarding the optimal anesthetic approach during this therapy. Meta‐analyses of observational studies suggest that general anesthesia increases morbidity and mortality compared with conscious sedation. We performed a systematic review and meta‐analysis of randomized clinical trials to examine the effect of anesthetic strategy during endovascular treatment for acute ischemic stroke.

Methods and Results

Systematic review and meta‐analysis according to
PRISMA
(Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) guidelines has been registered with the PROSPERO (International Prospective Register of Ongoing Systematic Reviews) (
CRD
42018103684). Medline, EMBASE, and
CENTRAL
databases were searched through August 1, 2018. Meta‐analyses were conducted using a random‐effects model to pool odds ratio with corresponding 95%
CI
. The primary outcome was 90‐day functional independence (modified Rankin Scale 0–2). In the results, 3 trials with a total of 368 patients were selected. Among patients with ischemic stroke undergoing endovascular therapy, general anesthesia was significantly associated with higher odds of functional independence (odds ratio 1.87, 95%
CI
1.15–3.03, I
2
=17%) and successful recanalization (odds ratio 1.94, 95%
CI
1.13–3.3) compared with conscious sedation. However, general anesthesia was associated with a higher risk of 20% mean arterial pressure decrease (odds ratio 10.76, 95%
CI
5.25–22.07). There were no significant differences in death, symptomatic intracranial hemorrhage, anesthesiologic complication, intensive care unit length of stay, pneumonia, and interventional complication.

Conclusions
Moderate‐quality evidence suggests that general anesthesia results in significantly higher rates of functional independence than conscious sedation in patients with ischemic stroke undergoing endovascular therapy. Large randomized clinical trials are required to confirm the benefit.
A review of the asilid (Diptera) fauna from Hispaniola with six genera new to the island, fifteen new species, and checklist
Authors: SCARBROUGH AUBREY G. , PEREZ-GELABERT DANIEL E. 
Published: June 2019

The robber fly fauna of the 6 subfamilies Apocleinae, Asilinae, Laphrinae, Ommatiinae, Stenopogoninae, and Trigonomiminae of Hispaniola with special reference to the Dominican Republic is reviewed in light of new collections. This paper reports 6 genera (Cerotainia Schiner, Eumecosoma Schiner, Holcocephala Jaennicke, Pilica Curran, Proctacanthella Bromley, and Rhopalogaster Macquart) new to the island, increasing the number to 20. Within the West Indies, Eumecosoma, Holcocephala, Pilica, and Proctacanthella are only known from Hispaniola. Also, 33 species are reported, including 15 new species (Atomosia anacaona, A. ciguaya, A. jagua, A. jimagua, A. yurabia, Cerotainia sola, Eumecosoma caerulum, Holcocephala indigena, Ommatius geminus, O. laticrus, O. maculosus, O. praelongus, Proctacanthella taina, Plesiomma simile, and Rhopalogaster albidus), increasing the number to 62 species plus 2 species in Dominican amber. The male of O. cinnamomeus Scarbrough & females of Plesiomma inflatum and Proctacanthus darlingtoni Curran are reported for the first time. The Ommatius lucidatus species group is established with 8 extant and 2 fossil species. Plesiomma angustum (Macquart) and Atoniomyia mikii (Williston) are rediscovered and redescribed. Plesiomma lineata (Fabricius) is removed from the distribution list for Cuba and Jamaica and Neophoneus is removed from the list of West Indies asilids because of an error in identification. Neophoneus flavotibis Bigot tentatively diagnosed as belonging to the genus Efferia. Plesiomma macra Loew is removed from synonymy. Significant structures of most species are illustrated and keys to selected species are included. At least one species of Atoniomyia and Pilica remain undescribed from this survey. New distribution records for most species and a checklist of the Hispaniolan fauna are also included.
Three new species of free-living nematodes from the South-East Atlantic Abyss (DIVA I Expedition)
Authors: TCHESUNOV ALEXEI V. 
Published: June 2019

Three new nematode species were found in the Angola Basin (south-east Atlantic Ocean) at depths of about 5500 m. Paracyatholaimus diva sp. nov. (Cyatholaimidae) is characterised by outer labial and cephalic setae of about 3–5 μm, multispiral amphidial fovea with six turns in males and four turns in females situated at the level of the dorsal tooth, buccal cavity armoured with only one prominent dorsal tooth, tail consisting of anterior conical and posterior slender cylindrical half portions, and six preanal midventral setose supplementary organs. Paracyatholaimus diva sp. nov. is most similar to Paracyatholaimus rotundus Gerlach, 1964 but differs by slightly longer body (936–1176 μm versus 705 μm), tail shape (with clearly narrowed posterior half versus conical), six versus four supplementary organs of different shape. The genus Paracyatholaimus Micoletzky, 1923 is briefly reviewed. The genus now includes twenty-four valid species. Five species are considered as species inquirendae, mainly because of inadequate type material lacking adult stages and/or incomplete descriptions. A pictorial guide for identification of the valid species of Paracyatholaimus is provided. Pomponema proximamphidum sp. nov. shares subapical position of the amphidial fovea and distinct lateral differentiation of the somatic cuticle with five Pomponema species: P. concinnum Wieser, 1954, P. corniculata Gourbault, 1980, P. mirabile Cobb, 1917, P. multipapillatum Filipjev, 1922 and P. stomachor Wieser, 1954 but differs from them by tail length, longer posterior cylindrical portion of the tail, relative width of the amphidial fovea, position of the ventral pore and lesser number of supplementary organs. Desmodora striatocephala sp. nov. is well characterized by a combination of very large amphidial fovea occupying nearly the entire lateral surface of the cephalic capsule and thickened midventral preanal cuticle with a few supplementary papillae inserted therein in males. D. striatocephala sp. nov. differs from related species D. cuddlesae Inglis, 1963 and to some lesser degree with D. inflexa Wieser, 1954 with shorter body, relative tail length, bigger size of the amphidial fovea and lesser number of supplementary papillae.
Evaluation of Cumulus and Microphysics Parameterizations in WRF across the Convective Gray Zone
Authors: Jeworrek Julia , West Gregory , Stull Roland 
Published: June 2019

Abstract
This study evaluates the grid-length dependency of the Weather Research and Forecasting (WRF) Model precipitation performance for two cases in the Southern Great Plains of the United States. The aim is to investigate the ability of different cumulus and microphysics parameterization schemes to represent precipitation processes throughout the transition between parameterized and resolved convective scales (e.g., the gray zone). The cases include the following: 1) a mesoscale convective system causing intense local precipitation, and 2) a frontal passage with light but continuous rainfall. The choice of cumulus parameterization appears to be a crucial differentiator in convective development and resulting precipitation patterns in the WRF simulations. Different microphysics schemes produce very similar outcomes, yet some of the more sophisticated schemes have substantially longer run times. This suggests that this additional computational expense does not necessarily provide meaningful forecast improvements, and those looking to run such schemes should perform their own evaluation to determine if this expense is warranted for their application. The best performing cumulus scheme overall for the two cases studies here was the scale-aware Grell–Freitas cumulus scheme. It was able to reproduce a smooth transition from subgrid- (cumulus) to resolved-scale (microphysics) precipitation with increasing resolution. It also produced the smallest errors for the convective event, outperforming the other cumulus schemes in predicting the timing and intensity of the precipitation.
Variations in Stapes Surgery Cost within a Multihospital Network
Authors: Casazza Geoffrey C. , Thomas Andrew J. , Dewey Jesse , Gurgel Richard K. , Shelton Clough , Meier Jeremy D. 
Published: June 2019

ObjectiveTo identify costs and operative times for stapedotomy and evaluate factors influencing cost variation.Study DesignCase series with cost analysis.SettingMultihospital network.Subjects and MethodsA multihospital network’s standardized activity‐based accounting system was used to determine costs and operative times of all patients undergoing stapedotomy from 2013 to 2017. Subjects with additional procedures were excluded. Correlations between variable factors and cost were calculated by Spearman correlation coefficients. Audiometric and cost data were compared with a Mann‐Whitney U test.ResultsThe study cohort included 176 stapedotomies performed by 23 surgeons at 10 hospitals. Mean ± SD patient age was 44.3 ± 17.4 years. Mean cut‐to‐close time was 61.1 ± 23.55 minutes. Mean total encounter cost was $3542.14 ± $1258.78 (US dollars). Significant factors correlating with increased total encounter cost were surgical supply cost (r = 0.74, P <. 0001) and cut‐to‐close time (r = 0.66, P <. 0001). Laser utilization ($563.37 ± $407.41) was the highest‐cost surgical supply, with the carbon dioxide laser being significantly more costly than the potassium titanyl phosphate (KTP; $852.60 vs $230.55, P <. 001). Additionally, the carbon dioxide laser was associated with a significantly higher mean total encounter cost than the KTP laser ($4645.43 vs $2903.00, P <. 001) and cases where no laser was used ($4645.43 vs $2932.47, P <. 001). There was no difference in mean total encounter cost between the KTP laser and cases of no laser use ($2903.00 vs $2932.47, P =. 75).ConclusionsSignificant cost variation exists in stapes surgery. Surgical supply cost, specifically laser use, may be associated with significantly increased costs. Reducing variation in costs while maintaining outcomes may improve health care value.
The Impact of Post‐thyroidectomy Paresis on Quality of Life in Patients with Nodular Thyroid Disease
Authors: Sorensen Jesper Roed , Printz Trine , Iwarsson Jenny , Grøntved Ågot Møller , Døssing Helle , Hegedüs Laszlo , Bonnema Steen Joop , Godballe Christian , Mehlum Camilla Slot 
Published: June 2019

ObjectiveTo investigate the impact of postoperative paresis on disease‐specific quality of life (DSQoL) after thyroidectomy in patients with benign nodular thyroid disease.Study DesignObservational study.SettingUniversity hospital.Subjects and MethodsPatients were evaluated before and 3 weeks and 6 months after surgery in an individual prospective cohort study using videolaryngostroboscopy (VLS), voice range profile, voice handicap index (VHI), multidimensional voice program, maximum phonation time (MPT), and auditory perceptual evaluation. Changes in DSQoL were assessed by the Thyroid‐specific Patient‐Reported Outcome measure. Cohen’s effect size was used to evaluate changes.ResultsSixty‐two patients were included, 55 of whom completed all examinations. Three weeks after surgery, a blinded VLS examination showed signs of paresis of either the recurrent laryngeal nerve or the external branch of the superior laryngeal nerve (RLN/EBSLN) in 13 patients (24%). A paresis corresponded to a 12 ± 28 point increase in VHI (P =. 002) and was associated with a significant 4.3 ± 7.5 semitone decrease in the maximum fundamental frequency (P <. 001) and a 5.3 ± 8.2 dB reduction in maximum intensity. Further, it was associated with a 4.5 ± 11.2 second reduction in MPT (P =. 001) and an increase of 0.40 ± 1.19 in grade, 0.42 ± 1.41 in roughness, and 0.36 ± 1.11 in breathiness. Signs of postoperative RLN/EBSLN paresis correlated with an 11.0‐point (P =. 02) poorer improvement in goiter symptoms at both 3 weeks and 6 months after surgery.ConclusionSigns of RLN/EBSLN paresis after thyroidectomy were associated with less pronounced improvement in goiter symptoms in patients with thyroid nodular disease. However, thyroidectomy was associated with an overall improved DSQoL by 6 months after surgery.
Music Therapy for Pain and Anxiety Management in Nasal Bone Fracture Reduction: Randomized Controlled Clinical Trial
Authors: Ortega Alvaro , Gauna Felipe , Munoz Daniel , Oberreuter Gerardo , Breinbauer Hayo A. , Carrasco Loreto 
Published: June 2019

ObjectiveTo evaluate whether listening to music through binaural headphones contributes to the perception of pain and anxiety in patients undergoing closed nasal bone fracture reductions.Study DesignRandomized controlled trial.Subjects and MethodsWe recruited patients from San Juan de Dios Hospital with displaced nasal fractures who required a reduction and assigned them to a control group or a music group. For both groups, a protocolized closed reduction of the nasal fracture with local anesthesia was performed. The music group heard music through headphones during the pre‐, intra‐, and postprocedural periods of the intervention. Physiological variables (blood pressure and heart rate) were measured. An anxiety survey (State‐Trait Anxiety Inventory) and the visual analog scale for measuring pain were also applied.ResultsThe music group exhibited significantly lower levels of systolic blood pressure (P =. 0001), anxiety (P <. 0001), and pain (P =. 0004) than the control group.ConclusionListening to music through headphones—a safe and low‐cost intervention—appears to aid in pain and anxiety management associated with procedures that are usually uncomfortable, such as the reduction of nasal bone fractures with local anesthesia. We believe that this effect is achieved by the modulation of pain and anxiety on an emotional‐affective dimension at a central level. Given its safety, feasibility, and low cost, music therapy should be considered a complementary treatment for pain and anxiety management for nasal fracture reduction performed with local anesthesia, as well as for other medical procedures of similar pain levels conducted without general anesthesia.
Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence
Authors: Anderson Rebecca J , Bloch Steven , Armstrong Megan , Stone Patrick C , Low Joseph TS 
Published: June 2019

Background: Effective communication between healthcare professionals and relatives of patients approaching the end-of-life is vital to ensure patients have a ‘good death’. To improve communication, it is important to first identify how this is currently being accomplished. Aim: To review qualitative evidence concerning characteristics of communication about prognosis and end-of-life care between healthcare professionals and relatives of patients approaching the end-of-life. Design: Qualitative systematic review (PROSPERO registration CRD42017065560) using thematic synthesis. Peer-reviewed, English language articles exploring the content of conversations and how participants communicated were included. No date restrictions were applied. Quality of included studies was appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Data sources: An electronic database search of CINAHL, MEDLINE, PsycINFO and EMBASE was performed. Results: Thirty-one papers were included. Seven themes were identified: highlighting deterioration; involvement in decision-making, post-decision interactional work, tailoring, honesty and clarity, specific techniques for information delivery and roles of different healthcare professionals. Varied levels of family involvement in decision-making were reported. Healthcare professionals used strategies to aid understanding and collaborative decision-making, such as highlighting the patient’s deterioration, referring to patient wishes and tailoring information delivery. Doctors were regarded as responsible for discussing prognosis and decision-making, and nurses for providing individualized care. Conclusion: Findings suggest training could provide healthcare professionals with these strategies to improve communication. Interventions such as question prompt lists could help relatives overcome barriers to involvement in decision-making. Further research is needed to understand communication with relatives in different settings and with different healthcare professionals.
Modelling the Mediating Effect of Health Care Healing Environment on Core Health Care Delivery and Patient Satisfaction in Ghana
Authors: Amankwah Oti , Weng-Wai Choong , Mohammed Abdul Hakim 
Published: June 2019

Objective: The multifaceted nature of health care delivery has led to the need to incorporate strategies that will help to enhance performance and maintain the quality of the health care environment. However, even though dedicated health care staffs contribute to patients’ satisfaction of health care delivery, the health care environment must ensure the safety and well-being of patients. Like most developing countries, many public hospitals in Ghana are faced with challenges in the area of health care healing environment. Therefore, this article investigates the mediating effect of health care healing environment between health care core business and patients’ satisfaction. Method: This is a cross-sectional study involving adult patients of Komfo Anokye Teaching Hospital, Tamale Teaching Hospital, and Cape Coast Teaching Hospital in Ghana. A questionnaire survey based on the ‘A Staff and Patient Environment Calibration Toolkit (ASPECT)’ dimensions and health care core service dimensions was used to collect data from 622 patients. SmartPLS was used to analyse the data collected. Results: The findings of the study show that the quality of health care healing environment mediates the relationship between patients’ satisfaction and all of the constructs under the core health care delivery. Conclusion: Stakeholders of the Ghanaian health care sector should take initiatives to constantly improve the quality of health care healing environment as it has an influence on patient satisfaction of the overall core health care delivery.