bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Positron Emission Tomography for the Management of Sinonasal Malignancies: A Systematic Review
Authors: El-Adem David , Yang Nathan , Gudis David A. 
Published: May 2023

Background Positron emission tomography (PET) scan is a valuable imaging modality widely used in the management of cancers. Its usage is well defined for most head and neck malignancies. However, there is a lack of consensus regarding the utility of PET scan for sinonasal malignancies. This is highlighted by the latest international consensus statement on endoscopic skull base surgery. Objective This systematic review aims to clarify the role of PET scan in the management of sinonasal malignancies. Methods We conducted a comprehensive literature search using PubMed, MEDLINE, EMBASE, Web of Science, CINAHL, and Cochrane databases for research studies of interest. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) updated statement was used to guide the review. Results In total, 1807 articles were assessed for eligibility. Thirty-nine original papers, published between 2004 and 2021, met inclusion criteria. Seven articles focused on the role of PET scan for inverted papilloma, 23 for sinonasal carcinoma, 4 for melanoma, and 3 for lymphoma, and finally, 3 articles focused on the use of specific PET scan tracers for sinonasal malignancies. Qualitative summaries for each potential role of PET scans were provided. In general, included studies were retrospective in nature with low level of evidence. Conclusions In general, and across all types of sinonasal malignancies, PET scan yielded positive results regarding detection and initial staging. It was also considered as the modality of choice for detection of distant metastases, except in the case of sinonasal lymphoma. PET scan's main limit resides in its inability to detect lesions in or close to the metabolic activity of the brain.
Medicinal cannabis for pain: Real-world data on three-month changes in symptoms and quality of life
Authors: O’Brien Kylie , Beilby Justin , Frans Michelle , Lynskey Michael , Barnes Michael , Jayasuriya Mihindu , Athanasiou-Fragkouli Alkyoni , Blair Philip , Nutt David 
Published: May 2023

Background Internationally, one of the most common conditions for which people seek medicinal cannabis (MC) is chronic pain. However, relatively little is known about the effectiveness of cannabis for reducing pain in Australia. Medicinal cannabis was made legally available in Australia in 2016. Project Twenty21 Australia is an observational study that follows patients prescribed MC for chronic pain, anxiety, PTSD and multiple sclerosis for up to 12 months. It commenced recruitment in February 2022. This paper describes some preliminary findings for a cohort of patients with chronic pain. Method Participants seeking treatment for chronic pain are prescribed MC from within a Project Formulary, and complete questionnaires at baseline then three monthly for up to 12 months. Pain severity and interference are assessed using the Brief Pain Index while standardised measures of quality of life, mood and sleep quality are also applied. Results By 30 November 2022, 55 participants with chronic pain had completed the first three-month follow-up. Patients reported a low quality of life and high levels of co-morbidity. Three-month data indicate that MC use was associated with significant reductions in self-reported pain intensity and pain interference (Effect sizes = 0.66 [95% CI = 0.34–0.98] and 0.56 [0.24–0.88], respectively). Additionally, there were significant improvements in quality of life, general health, mood/depression and sleep (Effect sizes = 0.53–0.63). One adverse reaction was reported which was mild in nature. Conclusions Preliminary evidence suggests that MC may be effective in reducing both pain severity and pain interference while also improving quality of life, general health, mood and sleep in patients with chronic pain. Increasing uptake of MC coupled with growing evidence of both the effectiveness and safety of these medications indicate a need both to make MC more widely available and to reduce financial costs associated with its use.
Prediction of therapeutic value of new drugs approved by health Canada from 2011−2020: A cross-sectional study
Authors: Lexchin Joel 
Published: May 2023

Objectives To examine whether a combination of three characteristics of new drugs – review type, outcome of premarket trials (surrogate or clinical) and first-in-class is associated with significant therapeutic value. Design Cross-sectional analysis of new drugs approved by Health Canada from January 1, 2011 to December 31, 2020. Setting Canada. Participants New drugs approved by Health Canada for which therapeutic evaluations, trial outcomes and first-in-class status was available. Main outcome measures Distribution of therapeutic value (major, moderate, little to no) depending on how many of the three characteristics were present for each drug. Results Health Canada approved 340 drugs of which 243 had data available for analysis. If all three characteristics were present 10 out of the 20 drugs had a major therapeutic rating. Conversely if none were present only 2 drugs out of 37 had a major therapeutic rating. Conclusion This study introduces a new evaluation method for determining whether new drugs will have major therapeutic value that appears to be more successful than relying only on the type of review that drugs receive.
Investigating information needs and preferences regarding digital mental health services among medical and psychology students in Germany: A qualitative study
Authors: Braun Pia , Schwientek Ann-Kathrin , Angerer Peter , Guthardt Lisa , Icks Andrea , Loerbroks Adrian , Apolinário-Hagen Jennifer 
Published: May 2023

Background Since 2020, physicians and psychotherapists in Germany can prescribe digital mental health services (dMHSs). However, even future healthcare professionals (HCPs), such as medical and psychology students, remain reluctant to use dMHSs, although they are a risk group for mental health issues themselves. Reasons include scepticism and lacking awareness of dMHSs, which can be addressed by acceptance-facilitating interventions (AFIs) such as information strategies. To date, though, little is known about their information needs. Methods Semi-structured interviews with n = 21 students were conducted between August and September 2021. Students of legal age studying psychology or medicine at a German university could participate. Interview recordings were transcribed verbatim and content-analyzed according to Mayring, using deductive and inductive coding. Results Most students reported having little experience with dMHSs. Digital health has barely been raised in their study, even though it was perceived as crucial for personal needs as well as in preparation for their work as HCPs. Students favoured receiving information on and recommendations for dMHSs from their university via, e.g. social media or seminars. Among others, information about data safety, scientific evidence base and application scope were preferred. Additionally, information on costs as well as user reviews seemed to be essential components of information strategies because students were concerned that high costs or low usability would hinder uptake. Conclusions The results give first insights on how future HCPs would like to be informed on dMHSs. Future research should focus on systematic variations of AFIs' components mimicking real-world decision scenarios to increase the adoption of dMHSs.
The “Lazio ADVICE” telemedicine platform: First results of general practitioners’ usage, facilitators and barriers in the Local Health Authority Roma 1
Authors: Barbara Andrea , Villani Leonardo , Lombardo Paolo , Parente Paolo , Gemma Antonella , Angeletti Debora , Chiriaco Tiziana , Mastromattei Antonio , Akselrod Svetlana , Goletti Mauro , Rosa Enrico Di , De Vito Corrado 
Published: May 2023

Background Telemedical approaches represent a valuable tool for the management of coronavirus disease 2019 patients, allowing daily clinical assessment, monitoring of vital parameters, remote visits, and prescription of treatment or hospitalization in case of clinical worsening. This cross-sectional study aims to evaluate the use, barriers and facilitators of the “Lazio ADVICE” telemedical platform, a regional system for remote assistance for coronavirus disease 2019 patients at home, according to General Practitioners and Family Pediatricians of the Local Health Authority Roma 1, during the coronavirus disease 2019 pandemic. Methods An interview-based survey was performed between December 2020 and January 2021. The survey investigated the demographic information of General Practitioner and Family Pediatricians, the knowledge of the platform, frequency of utilization, usefulness, strengths and weaknesses, and hypothesis of future implementation proposed. Results We interviewed 214 physicians and 89 (41.6%) were classified as users and 125 (58.4%) as non-users. Older age and working in District 1, 14 and 15 (vs. District 13) significantly reduced the probability of using the platform physician. Among the 89 users, 19 (21.3%) used the platform every day or even several times a day, 40 (44.9%) several times a week but less than one access per day, 30 (33.7%) used the platform several times a month up to one entry per week. Most of them (92.3%) consider the platform useful. Barriers were poor integration with software and work routine (76.4%), and usability issues (53.9%). Among the 125 non-users, 14 (11.2%) didn’t know the existence of the platform, 60 (48.0%) never tried it and 51 (40.8%) tried to use it. Reported reasons for the interruption of use were not very user-friendly (45.1%), perceived useless (37.3%), non-optimal functioning (23.5%), and lack of time (19.6%). Conclusion The pandemic accelerated the implementation of telemedicine services around Lazio Region, starting a positive and continuous exchange of experiences, activities and best practices among physicians.
Management and Outcome of Elderly Patients With Patellar Fracture Treated With Novel Modified Cerclage Wiring
Authors: Li Lin , Zhang Qing , Tao Fulin , Wang Dawei , Dong Jinlei , Zhou Dongsheng , Song Wenhao 
Published: May 2023

Introduction The purpose of this study is to assess the efficacy and security of a fixation method for fixing patellar fractures in elderly patients utilizing modified cerclage wire. Methods From January 2015 to December 2020, 31 cases (age≥65 years old) of closed patellar fracture were treated by modified cerclage wiring. Patients in these instances ranged in age from 65 to 87 (73.7 ± 7.2 years), with 15 men and 16 women. 4 instances were type 34-C1 (transverse fracture) according to the AO/OTA classification, 27 cases (87%) were comminuted fractures, including 11 cases that were type 34-C2 (3 fragments), and 16 cases that were type 34-C3 (more than 3 fragments). Postoperative problems such as fragment re-displacement, nonunion, internal fixation loosening, infection, and internal fixation rupture were evaluated. The clinical grading systems of Böstman were used to assess the postoperative clinical outcomes. Results Thirty one patients in all were monitored for 14 to 31 months (22.2 ± 4.5 months). After the procedure, the fracture took 2.5-3.5 months (2.92 ± .25 months) to heal. There were no postoperative issues like infection, dislocation, implant breakage, uncomfortable hardware, or post-traumatic osteoarthritis. According to the clinical grading scales of Böstman, the average score of the final follow-up was 28.6 ± 1.1 (range 26-30). 29 (94%) of the patients had excellent results, whereas just 2 (6%) had good results. The patient’s knee flexion activity ranged from 110 to 140°, making for a favorable prognosis. Conclusion Most patella fractures in the elderly are comminuted. Elderly patients with patellar fractures may be successfully treated with modified cerclage wire, with good results and no noticeable side effects.
Opioid Use After Knee Arthroscopy in Adolescent Patients: A Prospective Evaluation
Authors: Steinmetz R. Garrett , Hamilton John M. , Moritz Brandon W. , Algan Sheila M. 
Published: May 2023

Background: There is a relative paucity of literature on how to best treat postoperative pain after knee arthroscopy in the adolescent population. Purpose: To evaluate the use of opioid medication after knee arthroscopy in adolescent patients. Study Design: Case series; Level of evidence, 4. Methods: We prospectively enrolled 50 patients aged 10 to 18 years who underwent 1 of the following procedures: diagnostic arthroscopy; plica excision; loose body removal; debridement; chondroplasty; meniscal repair; and/or partial meniscectomy. Patients already taking chronic pain medication and those undergoing revision knee arthroscopy, ligamentous reconstruction, or bony osteotomy procedures were excluded. Postoperatively, the patients were prescribed 15 tablets of hydrocodone/acetaminophen (5 mg/325 mg) every 6 hours as needed for pain. The patients were given a diary to record the number of postoperative opioid pills taken, days the pills were taken, pain level, and nonopioid pills taken. The data were collected and used to identify the mean number of opioid pills needed as well as the number of days opioid medication was needed postoperatively. Results: Of the 50 enrolled patients, 35 patients adequately completed the diary and were included in the study. The mean age in this cohort was 14.2 years. The total number of pills taken ranged from 0 to 14, with an overall mean of 5.41. Therefore, on average, patients utilized 36% of their postoperative prescriptions. In our cohort, 74.3% of patients had stopped taking opioids by postoperative day 3, with a mean of 3.8 pills, and 97.1% of patients had stopped taking opioids by postoperative day, 5 with a mean of 5.3 pills. No postoperative refills of opioid medication were necessary. Conclusion: After knee arthroscopy, the adolescents in our study consumed a mean of 5.41 opioid pills postoperatively, and over 97% of patients stopped opioid use by postoperative day 5. The results of this study should help in guiding physicians to avoid overprescribing opioid medication while treating postoperative pain after knee arthroscopy in this vulnerable patient population.
The US Immigration Courts, Dumping Ground for the Nation’s Systemic Immigration Failures: The Causes, Composition, and Politically Difficult Solutions to the Court Backlog
Authors: Kerwin Donald , Millet Evin 
Published: May 2023

The US immigration court system seeks to “fairly, expeditiously, and uniformly administer and interpret US immigration laws” (DOJ 2022a). It represents the first exposure of many immigrants to due process and the rule of law in the United States, and occupies an integral role in the larger US immigration system. Yet it labors under a massive backlog of pending cases that undermines its core goals and objectives. The backlog reached 1.87 million cases in the first quarter of FY 2023 (Straut-Eppsteiner 2023, 6). This paper attributes the backlog to systemic failures in the broader immigration system that negatively affect the immigration courts, such as: Visa backlogs, United States Citizen and Immigration Services (USCIS) application processing delays, and other bottlenecks in legal immigration processes. The immense disparity in funding between the court system and the Department of Homeland Security (DHS) agencies that feed cases into the courts. The failure of Congress to pass broad immigration reform legislation that could ease pressure on the enforcement and court systems. The lack of standard judicial authorities vested in Immigration Judges (IJs), limiting their ability to close cases; pressure parties to “settle” cases; and manage their dockets. The absence of a statute of limitations for civil immigration offenses. Past DHS failures to establish and adhere to enforcement priorities and to exercise prosecutorial discretion (PD) throughout the removal adjudication process, including in initial decisions to prosecute. The location of the Executive Office for Immigration Review (EOIR), which oversees US immigration courts, within the nation’s preeminent law enforcement agency, the Department of Justice (DOJ). The misconception of many policymakers that the court system should primarily serve as an adjunct to DHS. A past record of temporary judge reassignments and government shutdowns. The paper supports a well-resourced and independent immigration court system devoted to producing the right decisions under the law. Following a short introduction, a long section on “Causes and Solutions to the Backlog” examines the multi-faceted causes of the backlog, and offers an integrated, wide-ranging set of recommendations to reverse and ultimately eliminate the backlog. The “Conclusion” summarizes the paper’s topline findings and policy proposals.
A Qualitative Examination of the Preferred Language for Patients Discussing Genital Psoriasis With the Physician
Authors: Moumen Mohammed , Zaino Mallory L. , Salisbury Katherine R. , Pichardo Rita O. , Feldman Steven R. 
Published: May 2023

Background Psoriasis is a chronic inflammatory disease that may affect the genitalia in up to 60% of patients. This is a significant concern to patients; however, they may be too embarrassed to report genital involvement or seek help for it spontaneously. Information on preferred language that would put patients more at ease discussing disease in sensitive areas is lacking. Objective To address language as a barrier to care in patients with psoriasis by identifying preferred terminology when discussing genital involvement of the disease with physicians. Methods A qualitative study was performed that consisted of one-on-one interviews with patients with psoriasis; thematic analysis was used to analyze the data. Results Themes included (1) personal experience with genital psoriasis; (2) timespan between genital psoriasis symptom onset and diagnosis; (3) patient–provider communication; (4) patient–provider preference, and (5) patient terminology preference. Conclusion Our study highlights providers’ failure to ask psoriasis patients about genital involvement of the disease and variation in patient response on preferred language when discussing sensitive topics. Dermatologists may need to be cognizant of the patient’s comfort level using verbal and nonverbal communication and tailor their approach to the individual.
Management of bloodborne pathogen exposures in primary care: A quality improvement project
Authors: Hewitt Sarah E. , Southard Erik P. 
Published: May 2023

Background Exposure to bloodborne pathogens poses a serious risk to healthcare workers. As more primary care providers are being asked to perform occupational health services, the evaluation and treatment of bloodborne pathogen (BBP) exposures can be overwhelming. Lack of knowledge about how to handle these encounters can lead to poor outcomes, including conversion to human immunodeficiency virus (HIV) and hepatitis B virus if not handled properly. To assist providers with understanding best practices for the management of exposures, a detailed protocol and targeted education were developed. The protocol addressed the importance of evaluating the source patient for HIV, hepatitis B virus, and hepatitis C virus; injured workers were assessed for the same items, tetanus status, and the need for post-exposure prophylaxis (PEP). Methods A retrospective chart review for 12 months before the implementation of the protocol and eight months after implementation was completed to assess compliance with five evidence-based criteria and the appropriate use of PEP when indicated. Findings Variables of interest included (a) correct identification of the source patient, (b) accuracy of source patient labs, (c) completion of same-day employee labs, (d) accuracy of employee labs, and (e) evaluation of the employee's tetanus status. The rate of completion of these categories ranged from 14% to 43% in pre-protocol cases ( n = 7), and 100% in post-protocol cases ( n = 7). Conclusions The combination of targeted education and a detailed protocol for evaluating and treating BBP exposures resulted in increased compliance with best-practice care; the project also improved employee satisfaction.
Neuropeptide Y in the medial habenula alleviates migraine-like behaviors through the Y1 receptor
Authors: Yang Chunxiao , Gong Zihua , Zhang Xiaochen , Miao Shuai , Li Bozhi , Xie Wei , Wang Tao , Han Xun , Wang Liang , Dong Zhao , Yu Shengyuan 
Published: May 2023

Abstract
Background
Migraine is a highly disabling health burden with multiple symptoms; however, it remains undertreated because of an inadequate understanding of its neural mechanisms. Neuropeptide Y (NPY) has been demonstrated to be involved in the modulation of pain and emotion, and may play a role in migraine pathophysiology. Changes in NPY levels have been found in patients with migraine, but whether and how these changes contribute to migraine is unknown. Therefore, the purpose of this study was to investigate the role of NPY in migraine-like phenotypes.

Methods
Here, we used intraperitoneal injection of glyceryl trinitrate (GTN, 10 mg/kg) as a migraine mouse model, which was verified by light-aversive test, von Frey test, and elevated plus maze test. We then performed whole-brain imaging with NPY-GFP mice to explore the critical regions where NPY was changed by GTN treatment. Next, we microinjected NPY into the medial habenula (MHb), and further infused Y1 or Y2 receptor agonists into the MHb, respectively, to detect the effects of NPY in GTN-induced migraine-like behaviors.

Results
GTN effectively triggered allodynia, photophobia, and anxiety-like behaviors in mice. After that, we found a decreased level of GFP+ cells in the MHb of GTN-treated mice. Microinjection of NPY attenuated GTN-induced allodynia and anxiety without affecting photophobia. Furthermore, we found that activation of Y1—but not Y2—receptors attenuated GTN-induced allodynia and anxiety.

Conclusions
Taken together, our data support that the NPY signaling in the MHb produces analgesic and anxiolytic effects through the Y1 receptor. These findings may provide new insights into novel therapeutic targets for the treatment of migraine.

Graphical Abstract