bluuebunny/crossref_metadata_2025_split huggingface dataset:
Migraine genetics: Status and road forward
Authors: Harder Aster VE , Terwindt Gisela M. , Nyholt Dale R , van den Maagdenberg Arn MJM 
Published: February 2023

Background Migraine is considered a multifactorial genetic disorder. Different platforms and methods are used to unravel the genetic basis of migraine. Initially, linkage analysis in multigenerational families followed by Sanger sequencing of protein-coding parts (exons) of genes in the genomic region shared by affected family members identified high-effect risk DNA mutations for rare Mendelian forms of migraine, foremost hemiplegic migraine. More recently, genome-wide association studies testing millions of DNA variants in large groups of patients and controls have proven successful in identifying many dozens of low-effect risk DNA variants for the more common forms of migraine with the number of associated DNA variants increasing steadily with larger sample sizes. Currently, next-generation sequencing, utilising whole exome and whole genome sequence data, and other omics data are being used to facilitate their functional interpretation and the discovery of additional risk factors. Various methods and analysis tools, such as genetic correlation and causality analysis, are used to further characterise genetic risk factors. Findings We describe recent findings in genome-wide association studies and next-generation sequencing analysis in migraine. We show that the combined results of the two most recent and most powerful migraine genome-wide association studies have identified a total of 178 LD-independent ( r2 < 0.1) genome-wide significant single nucleotide polymorphisms (SNPs), of which 99 were unique to Hautakangas et al., 11 were unique to Choquet et al., and 68 were identified by both studies. When considering that Choquet et al. also identified three SNPs in a female-specific genome-wide association studies then these two recent studies identified 181 independent SNPs robustly associated with migraine. Cross-trait and causal analyses are beginning to identify and characterise specific biological factors that contribute to migraine risk and its comorbid conditions. Conclusion This review provides a timely update and overview of recent genetic findings in migraine.
Update in the understanding of new daily persistent headache
Authors: Peng Kuan-Po , Rozen Todd D 
Published: February 2023

Background Accumulating evidence suggests various specific triggers may lead to new daily persistent headache (NDPH)-like presentations, suggesting that new daily persistent headache is a heterogenous syndrome, and challenging the concept that new daily persistent headache is a primary headache disorder. Method We searched the PubMed database up to August 2022 for keywords including persistent daily headache with both primary and secondary etiologies. We summarized the literature and provided a narrative review of the clinical presentation, diagnostic work-ups, possible pathophysiology, treatment response, and clinical outcomes. Results and conclusion New daily persistent headache is a controversial but clinically important topic. New daily persistent headache is likely not a single entity but a syndrome with different etiologies. The issue with past studies of new daily persistent headache is that patients with different etiologies/subtypes were pooled together. Different studies may investigate distinct subsets of patients, which renders the inter-study comparison, both positive and negative results, difficult. The identification (and removal) of a specific trigger might provide the opportunity for clinical improvement in certain patients, even when the disease has lasted for months or years. Nonetheless, if there is a specific trigger, it remains unknown or unidentified for a great proportion of the patients. We need to continue to study this unique headache population to better understand underlying pathogenesis and, most importantly, to establish effective treatment strategies that hopefully resolve the continuous cycle of pain.
Effect of trigger point acupuncture on pain and functional activity in patients with chronic non-specific low back pain: a randomised controlled trial
Authors: Liu Hong , Li Ya-Ping , Hou Mei-Jin , Huang Wu-Jie , Chen Xiao-Lin , Gao Zhen , Jiang Zheng 
Published: February 2023

Background: Trigger point (TrP) acupuncture is commonly used to treat chronic non-specific low back pain (CNLBP). Evidence for the efficacy of most TrP acupuncture modalities is weak or lacking. Objective: To assess the effect of TrP acupuncture on pain, disability, gait and muscle activation in patients with CNLBP. Methods: From May 2019 to February 2020, a randomised, single-blind clinical trial was carried out involving 33 participants with CNLBP, divided into one of two intervention groups or a control group ( n = 11 per group). The intervention groups received TrP acupuncture or traditional acupuncture treatment three times a week for 4 weeks, and the control group remained on a waiting list and received no treatment. Pain, disability, gait and muscle activation were assessed at baseline and at 4 and 8 weeks of follow-up. Results: At baseline, the three groups showed no significant differences in age, gender, height, weight, body mass index (BMI) or disease course ( p ⩾ 0.05). At 4 weeks, pain was relieved (measured by visual analogue scores, p = 0.036) and disability was improved (reflected by lower Oswestry disability index scores, p = 0.029) in TrP acupuncture versus waiting list groups. Moreover, lumbar extension range of motion was increased in TrP acupuncture versus both traditional acupuncture and waiting list groups ( p = 0.029 and p = 0.027, respectively). At 8 weeks, there were no significant differences in any parameter between the three groups ( p > 0.05). Conclusion: TrP acupuncture had a significant short-term effect on pain relief and disability in patients with CNLBP, but there was no evidence of a long-term influence (at 8 weeks following the intervention). Further high-quality randomised controlled trials are needed for verification in the future. Trial registration number: ChiCTR1900022838 (Chinese Clinical Trial Registry)
Overcoming barriers: Modelling the effect of potential future changes of organized breast cancer screening in Italy
Authors: Zielonke Nadine , Senore Carlo , Ponti Antonio , Csanadi Marcell , de Koning Harry J , Heijnsdijk Eveline A M , van Ravesteyn Nicolien T 
Published: February 2023

Objectives Organized breast cancer screening may not achieve its full potential due to organizational and cultural barriers. In Italy, two identified barriers were low attendance in Southern Italy and, in Italy as a whole, underscreening and overscreening in parts of the eligible population. The objective of this study was to identify potential changes to overcome these barriers and to quantify their costs and effects. Methods To assess the impact of potential measures to improve breast cancer screening in Italy, we performed an evaluation of costs and effects for increasing adherence for Southern Italy and harmonizing screening intervals (biennial screening) for the whole of Italy, using an online tool (EU-TOPIA evaluation tool) based on the MIcrosimulation SCreening ANalysis (MISCAN) model. Results Increasing adherence in Southern Italy through investing in mobile screening units has an acceptable cost-effectiveness ratio of €9531 per quality-adjusted life year gained. Harmonizing the screening interval by investing in measures to reduce opportunistic screening and simultaneously investing in mobile screening units to reduce underscreening is predicted to gain 1% fewer life-years, while saving 19% of total screening costs compared to the current situation. Conclusions Increasing adherence in Southern Italy and harmonizing the screening interval could result in substantial improvements at acceptable costs, or in the same benefits at lower costs. This example illustrates a systematic approach that can be easily applied to other European countries, as the online tools can be used by stakeholders to quantify effects and costs of a broad range of specific barriers, and ways to overcome them.
A Review of the Use of Buccal Fat Pad in Cleft Palate Repair
Authors: Adekunle Adegbayi Adeola , James Olutayo , Olanbiwonnu Aliyah Oluwabusayo , Adeyemo Wasiu Lanre 
Published: February 2023

Objective To review the available evidence on the use of the Buccal Fat Pad in primary and secondary Cleft Palate repair. Methods This is a narrative review. A computerized literature search was conducted for articles published till February 2022 using the Mesh phrases buccal fat pad AND cleft palate, Bichat's Fat pad AND cleft palate, buccal fat pad OR Bichats Fat pad AND cleft palate. Results A total of 35 articles were included in this review based on the set eligibility criteria. Most of the studies were retrospective case reviews (n  =  16, 45.7%), and the aggregate number of patients from all included studies was 666. Reported uses of the buccal fat pad (BFP) in association with cleft palate repair include the closure of central cleft palate defect and nasal floor in primary cleft palate repair, oronasal fistula repair following primary repair of cleft palate, and closure of relieving incision defect in primary repair of cleft palate. Complications reported were 24 cases of Oronasal Fistula (ONF), 2 dehiscences, and 4 transient mucosal defects. Conclusion The high success rate, vascularity, ease of tissue harvest, and low donor site morbidity all support its use as an adjunct flap in cleft palate repair, especially in the closure of wide palatal clefts, to prevent post-palatal repair fistula, wound contracture, and subsequently velopharyngeal insufficiency and possibly midface hypoplasia.
Regulation of oxidized LDL-induced proliferation and migration in human vascular smooth muscle cells by a novel circ_0007478/miR-638/ROCK2 ceRNA network
Authors: Guan Zeyu , Lu Ran , Sun Yong , Wang Xiaogao , Yu Chaowen , Song Tao 
Published: February 2023

Background: Circular RNAs (circRNAs) have been implicated in the pathogenesis of atherosclerosis (AS) and the migration and proliferation of vascular smooth muscle cells (VSMCs) under oxidized low-density lipoprotein (ox-LDL). Here, we defined the exact action of human circ_0007478 in VSMC migration and proliferation induced by ox-LDL. Methods: Human VSMCs (HVSMCs) were exposed to ox-LDL. Circ_0007478, microRNA (miR)-638, and rho-associated protein kinase 2 ( ROCK2) levels were gauged by quantitative real-time PCR (qRT-PCR) and western blot. Cell viability and proliferation were assessed by MTT and EdU assays, respectively. Transwell assays were used to detect cell migration and invasion. Dual-luciferase reporter and RNA immunoprecipitation (RIP) assays were used to evaluate the direct relationship between miR-638 and circ_0007478 or ROCK2. Results: Our data indicated that circ_0007478 expression was augmented in AS serum samples and ox-LDL-treated HVSMCs. Depletion of circ_0007478 attenuated HVSMC proliferation, migration, and invasion induced by ox-LDL. Mechanistically, circ_0007478 targeted miR-638 by directly pairing to miR-638. Reduction of miR-638 reversed the effects of circ_0007478 depletion on ox-LDL-evoked proliferation, migration, and invasion in HVSMCs. ROCK2 was a direct miR-638 target and miR-638-mediated inhibition of ROCK2 relieved ox-LDL-evoked HVSMC proliferation, migration, and invasion. Furthermore, circ_0007478 was identified as a competing endogenous RNA (ceRNA) for miR-638 to modulate ROCK2 expression. Conclusion: Our present study establishes an undescribed ceRNA regulatory network, in which circ_0007478 targets miR-638 to upregulate ROCK2, thereby contributing to ox-LDL-induced proliferation and migration in HVSMCs.
Lower-extremity pressure, staging, and grading thresholds to identify chronic limb-threatening ischemia
Authors: Choi Justin Chin-Bong , Miranda Jorge , Greenleaf Erin , Conte Michael S , Gerhard-Herman Marie D , Mills Joseph L , Barshes Neal R 
Published: February 2023

Introduction: The Society for Vascular Surgery Threatened Limb Classification System (‘WIfI’) is used to predict risk of limb loss and identify peripheral artery disease in patients with foot ulcers or gangrene. We estimated the diagnostic sensitivity of multiple clinical and noninvasive arterial parameters to identify chronic limb-threatening ischemia (CLTI). Methods: We performed a single-center review of 100 consecutive patients who underwent angiography for foot gangrene or ulcers. WIfI stages and grades were determined for each patient. Toe, ankle, and brachial pressure measurements were performed by registered vascular technologists. CLTI severity was characterized using Global Limb Anatomic Staging System (GLASS stages) and angiosomes. Medial artery calcification in the foot was quantified on foot radiographs. Results: GLASS NA (not applicable), I, II, and III angiographic findings were seen in 21, 21, 23, and 35 patients, respectively. A toe–brachial index < 0.7 and minimum ipsilateral ankle–brachial index < 0.9 performed well in identifying GLASS II and III angiographic findings, with sensitivity rates 97.8% and 91.5%, respectively. The diagnostic accuracy rates of noninvasive measures peaked at 74.7% and 89.3% for identifying GLASS II/III and GLASS I+ angiographic findings, respectively. The presence of medial artery calcification significantly diminished the sensitivity of most noninvasive parameters. Conclusions: The use of alternative noninvasive arterial testing parameters improves sensitivity for detecting PAD. Abnormal noninvasive results should suggest the need for diagnostic angiography to further characterize arterial anatomy of the affected limb. Testing strategies with better accuracy are needed.
Accuracy of the pedal acceleration time to diagnose limb ischemia in patients with and without diabetes using the WIfI classification
Authors: de Castro-Santos Guilherme , Gonçalves Patric Emerson Oliveira , Procópio Ricardo Jayme , Dardik Alan , Navarro Túlio Pinho 
Published: February 2023

Introduction: Evaluation of limb hemodynamics using the ankle–brachial index (ABI) may be difficult due to skin lesions, extensive necrosis, and obesity, such as commonly present in patients with diabetes with chronic limb-threatening ischemia (CLTI). We hypothesized that the pedal acceleration time (PAT) correlates with ABI and Wound, Ischemia, and foot Infection (WIfI) scores in patients with diabetes to serve as a new modality to accurately stage CLTI. Methods: A single-center, cross-sectional study included patients with and without diabetes > 18 years with CLTI. Limbs were categorized in three grades of ischemia based on the ABI (ABI < 0.8, < 0.6, and < 0.4) and in two classes based on WIfI stages of amputation risk. Receiver operator characteristic (ROC) curves were used to determine PAT sensitivity, specificity, and accuracy to predict lower-limb ischemia. Results: A total of 141 patients (67 nondiabetic and 74 diabetic) and 198 lower limbs (94 nondiabetic and 104 diabetic) met the inclusion criteria. In patients without diabetes, the accuracy of PAT for detecting an ABI < 0.8 was 85%; for detecting an ABI < 0.6 was 85%; and for detecting an ABI < 0.4 was 87%. In patients with diabetes, the accuracy of PAT in detecting an ABI < 0.8 was 91%; for detecting an ABI < 0.6 was 79%; and for detecting an ABI < 0.4 was 88%. In patients without diabetes, the accuracy for detecting WIfI stages of moderate and high amputation risk was 77% and for patients with diabetes was also 77%. Conclusions: PAT shows high correlation with the ABI as well as with the WIfI stages of amputation risk and the grades of ischemia, with high accuracy.
Reliability of WhatsApp images of plain radiographs to diagnose fractures of the hand and wrist
Authors: Khoo Saw Sian , Guruseelan Nishand , Gunasagaran Jayaletchumi , Shamsul Shams Amir , Razak Izzati , Ahmad Tunku Sara 
Published: February 2023

We assessed the reliability of plain radiographs interpreted through WhatsApp messaging system in orthopaedic hand trauma consultation in a large teaching hospital. Plain radiographs of 25 hand fractures and five normal radiographs were captured from a picture archiving and communication system using iPhone XS smartphone, anonymized and sent to 53 orthopaedic residents’ and consultants’ personal smartphones. The participants independently assessed the images and answered questions on fracture identification and characteristics, diagnostic confidence, further imaging and surgical inclination. The study was repeated after a 1-month washout period using the picture archiving and communication system on the hospital desktop. The results showed good (0.60 < ƙ < 0.80) intraobserver agreement on fracture identification and characteristics. The overall diagnostic accuracy for hand fractures was 95% on WhatsApp and 99% on the desktop. In conclusion, images of plain radiographs transmitted via WhatsApp were reliable for interpretation in orthopaedic hand trauma consultation. Level of evidence: IV
A qualitative assessment of provider satisfaction and experiences with a COVID-19 community mobile health clinic outreach model in underserved Baltimore neighborhoods
Authors: Cadet Kechna , Baker David R , Brown Annice 
Published: February 2023

Objective: Although previous studies have assessed provider perceptions about telehealth, no prior studies have qualitatively assessed the experiences and satisfaction of health-care providers with a community mobile health clinic model within underserved urban settings. Methods: This study draws on the views expressed by community health workers ( n = 4), registered nurses ( n = 2), Grace Medical Center outreach specialists ( n = 2), and physician assistants staffing LifeBridge Health’s virtual hospital ( n = 3) to understand their satisfaction and experiences with a COVID-19 community mobile health clinic in underserved Baltimore neighborhoods. Thematic analysis of the interviews was used to extract themes and subthemes of our health-care providers’ experiences with the community mobile health clinic model. Results: These individuals shared their experiences addressing social determinants of health, the perceived impact of community mobile health clinic, satisfaction with and limitations of the pilot project, as well as future implications for the community mobile health clinic model. Finally, ideas for how the model can fit into the existing healthcare delivery framework are suggested. Conclusion: The context surrounding the COVID-19 pandemic has provided a unique opportunity to critically address healthcare frameworks and models. The LifeBridge community mobile health clinic served as an initiative to truly bridge together community outreach and health access. Among the many themes, health-care providers on the team applauded the model for its potential to bring preventative health care to the patient with the goal of improving patient health outcomes.
Resolution of urethral obstruction using temporary urethral stents in two female cats
Authors: Aubrecht Alex M , Lulich Jody P 
Published: February 2023

Case summary The management of urethral obstructions is well documented in male cats but is less established for females. These cases describe two female cats that presented with non-dissolvable urocystoliths. Urocystoliths were removed by laser lithotripsy and basket retrieval. Following urolith removal, urethral obstruction occurred in both cats. Both cats were successfully managed using temporary urethral stents in lieu of indwelling urethral catheters permitting outpatient, spontaneous recovery of the urethra. Relevance and novel information Use of temporary urethral stents has not been described in cats. These novel stents are constructed from materials available in most veterinary facilities, placed without advanced imaging and reside entirely within the urethra and vestibule. Temporary stents are used to bypass urethral disease, facilitating outpatient recovery, and are easily removed when no longer needed. For these reasons, temporary stents are a cost-efficient alternative to permanent stents or indwelling urinary catheters attached to closed urine-collection systems.
Ignorance as a Method: Rethinking Academic Burden in an Accelerated Society
Authors: Lin (林小英) Xiaoying 
Published: February 2023

Purpose This study applies “ignorance” as a theoretical lens to understand students’ academic burden in China as well as the value of free time in social acceleration. Design/Approach/Methods The article argues that students’ learning gradually became alienated in different times and spaces. It uses Rosa's social acceleration theory to analyze the logical paradox of the burden reduction policy in China and Benner's plasticity and self-activity principles to highlight the pedagogical value of leisure and free activities. Findings The findings suggest the need to maintain the “necessary ignorance” in leisure activities and intervene less in student learning. In this respect, “ignorance” can be viewed as a cognitive method to protect leisure time and rebuild a spontaneous order in learning, which can close the gap caused by the impossible synchronization of specific parties in the education system. Ignorance opens the door to learned spaces, providing more opportunities to reduce academic burden in an accelerated society and stimulate the imagination of education. Originality/Value This study reveals the plasticity and self-activity that students develop in free leisure time and space, and reworks the key concept of “inevitable ignorance” expounded by Friedrich Hayek into “necessary ignorance” with pedagogical and ethical meanings. The reconceptualization of academic burden opens up new ways of thinking about educational policy and educational practice.
Increasing Identification and Follow-Up of Older Adult Depression in Primary Care
Authors: Uomoto Keirstin E. 
Published: February 2023

Introduction: Depression is a common mental health disorder faced by older adults that can go undetected and untreated. It was determined that the project site was not screening for depression among their older patient population. Aims: The purpose of this quality improvement project was to determine if the implementation of the Geriatric Depression Scale-15 (GDS-15) would impact the identification of risk factors for depression and follow-up among adults 65 and older. Methods: Implementation started in June 2021 in a primary care office in Southern California. Data was collected for this project over a total of 8 weeks. This project was a quality improvement project designed to implement routine depression screening among older adult patients using the GDS-15. Depressive symptoms were identified, and follow-up and treatment for depression in primary care was initiated if indicated by GDS-15 scores. Data were obtained from the project site’s electronic medical record on a total sample size of 443 patients (n = 252 in the comparison group and n = 191 in the implementation group). Results: A chi-square test indicated a clinical and statistically significant improvement in the identification rate of depression, X2 (1, N = 443) = 49.76, P < .0001; and follow-up rate X2 (1, N = 70) = 23.94, P < .0001. Clinical significance was found with an increase in the identification of depression and follow-up of older adults in primary care. Demographic variables were also compared for the QI intervention group patients according to those who scored <5 (n = 134) and patients who scored 5 or greater on the GDS-15 (n = 57) again using chi-square tests. The results showed significant differences between gender ( P = .016) and primary diagnosis ( P = .006). Conclusions: Findings of this project suggest all older adults should receive a depression screening routinely in primary care to increase the recognition of depression as well as follow-up and treatment.