Miracle-dz/UniFAR-FTUs huggingface dataset:
A Letter to the Editor regarding "Fusion or Not for Degenerative Lumbar Spinal Stenosis: A Meta-Analysis and Systematic Review".

We read with interest the systematic review of Shen et al (1) on “Fusion or Not for Degenerative Lumbar Spinal Stenosis: A Meta-Analysis and Systematic Review. ” The authors have systematically reviewed the published literature on the subject of the clinical outcomes of spinal decompression with or without spinal fusion for degenerative lumbar spinal stenosis (DLSS) to compare the efficacy of decompression alone and spinal fusion (1). They conducted a systematic electronic search from March 1976 to August 2016. The search analyzed a total of 5 randomized controlled trials (RCTs) (2-6) assessing the comparison between decompression and fusion surgery for DLSS, and 19 articles have been included in the reference list. On the basis of the results of Shen et al’s study (1), additional fusion surgery seems unlikely to result in better outcomes for patients with DLSS, but it may increase additional risks and costs. We would like to voice some concerns regarding the methodology and results of this review. It seems that the objective of the current systematic review, published in 2018, is the duplication of what has been reported in an article published by Wu et al (7) in 2016 in the Journal of Evidence Based Medicine. Surprisingly, Shen et al (1) have reviewed the findings of 5 RCTs (2-6). Of these 5 studies (2-6), the findings of 4 studies, including Grob et al (3), Hallett et al (4), Ghogawala et al (5), Försth et al (6), had been already reported by Wu et al (7) in a commentary entitled “A Rethink of Fusion Surgery for Lumbar Spinal Stenosis”, and the only study (2) which had not been reported by Wu et al (7) was an old study published in 1991 on “Degenerative lumbar spondylolisthesis with spinal stenosis. A prospective study comparing decompression with decompression and intertransverse process arthrodesis. ” How to choose decompression alone or decompression plus fusion has been an old and persistent issue (3,4,8). Bae et al (9) in 2013 and Jancuska et al (10) in 2016 reported that the rate of decompression alone for lumbar stenosis was decreased, whereas the rate of decompression plus fusion was increased (9,10). However, these findings are in contrast to the findings A Letter to the Editor Regarding “Fusion or Not for Degenerative Lumbar Spinal Stenosis: A Meta-Analysis and Systematic Review”
In Vivo Anti-Inflammatory, Anti-Bacterial and Anti-Diarrhoeal Activity of Ziziphus Jujuba Fruit Extract

BACKGROUND: Ziziphus jujuba belongs to family Rhamnaceae widely distributed in subtropical and tropical countries. It is used traditionally for several pharmacological purposes including anti-inflammation, antidiarrhoeal and antibacterial, as well as tonic and sometimes as hypnotic (sedative). AIM: To determine the in vivo antidiarrhoeal, antibacterial and anti-inflammatory activities of Z. jujuba fruit ethanolic extract. METHOD: The fruit was macerated and extracted by 95% (v/v) ethanol. The antidiarrhoeal activity was evaluated using castor oil and Escherichia coli induced diarrhoea mouse model. The antidiarrhoeal and antibacterial activity was investigated at graded doses (400-1200 mg/kg). The anti-inflammatory effects were tested using the carrageenan-induced paw oedema in female Wistar rats. Rat’s treatment groups received tragacanth, 100 mg/kg diclofenac sodium, 800 mg/kg, 1200 mg/kg or 1600 mg/kg of an ethanolic extract of Z. jujuba (EEZJ). All treatment groups were fed with the compounds one hour before carrageenan injection at of rat’s paw. Also, the EEZJ was further analysed by HPLC-PDA system for identification of the presence of betulinic acid and quercetin. RESULTS: EEZJ different doses did not show inhibitory activity against castor oil induced diarrhoea except for the higher (1200 mg/kg) dose. However, the frequency of defecation of stools and watery stool were reduced significantly when compared to control group (P ≤ 0.05 and P ≤ 0.01 respectively), resulted in overall 67% inhibition of diarrhoea. Our anti-inflammatory results demonstrated that EEZJ was able to inhibit the carrageenan-induced paw oedema in rats to a significant degree (p ≤ 0.05) and the paw volume and thickness of both left and right paw were affected compared to the negative control group. CONCLUSION: EEZJ possesses antidiarrhoeal and antibacterial activity in a dose depending manner and may provide a pharmacological basis for its clinical use in diarrheal diseases. The activity may partially be due to the presence of betulinic acid and quercetin.
Strategies for non‐EEG seizure detection and timing for alerting and interventions with tonic–clonic seizures

Sudden unexpected death in epilepsy (SUDEP) is a common cause of death in epilepsy and frequently occurs following generalized tonic–clonic seizures (GTCS). Non–electroencephalography (EEG) seizure detection systems using mobile sensor devices permit caregivers to assist patients during seizures and may reduce risks for complications of seizures such as injuries and SUDEP. We review changes in accelerometry, electrodermal activity, and heart rate associated with tonic–clonic seizures and their use in detection systems, including multimodal detectors. We reviewed current and past publications reporting data on linkage between GTCS, post‐ictal generalized EEG suppression (PGES), and ventilatory dysfunction. The timing and duration of postictal immobility and respiratory dysfunction associated with convulsions help identify which patients might benefit the most from seizure monitoring and from benchmarks for the timing of seizure detection, caregiver alerting, and interventions.
The Impact of Computing Device Design on Patient-Centered Communication: An Experimental Study

Prior research has studied the impact of use of a single computing device, such as a desktop or a tablet computer, on patient-provider communication. While some studies have considered how contextual features such as room layout and software interface design affect computer use and patient-provider interaction in the exam room, it is not known how the choice of computing device impacts patient-provider communication. We conducted a within-participant experimental study. Three physicians participated in nine simulated consultations, using a desktop computer, a tablet computer, and a tabletop computer. Consultations were video-recorded and the video data were analyzed using framework analysis. Findings reveal the choice of device impacts the extent to which the consultation is patient-centered. To better support patient-centered communication, a large adjustable horizontal screen can facilitate eye contact and patient engagement. Findings also highlight the need for design of future systems to consider the characteristics of both openness and privacy.
How different contexts of social capital are associated with self-rated health among Lithuanian high-school students

ABSTRACT Background. Adolescents’ self-rated health is related to a number of sociodemographic and socio-economic factors, health-related behaviors, and their social environment. The impact of the latter is still not well explored. An adolescent’s social environment is represented by the social capital, i.e. social resources that they can access. The relationships between various contexts of social capital (family, neighborhood, peers, and school) and self-rated health among adolescents are still unclear. Objective. This study aims to examine the relationships between various social capital contexts and self-rated health in Lithuanian adolescents. Methods. The current cross-sectional study includes a nationally representative sample of 1863 adolescents (51.4% were girls) aged 14–18 years. The indicators of self-rated health as well as indicators of social capital in family, neighborhood, and school contexts were assessed. The results of the relationships between self-rated health and contexts of social capital were calculated controlling for the following covariates: physical activity, psychological distress, gender, body mass index, and family socioeconomic status. Results. Results indicate that there are significant relationships between good self-rated health and a higher level of family support, neighborhood trust, and vertical school trust. In the final logistic regression model, while controlling for all covariates, a higher level of family support and neighborhood trust remain significant predictors of good self-rated health. Conclusions. Family support and neighborhood trust are important correlates of self-rated health in adolescents.
Self-organizing Development Teams for Innovative Nursing Care

The purpose of this study was to describe the participation of nurses and nurse leaders in self-organizing teams formed to develop innovative nursing care. The theoretical perspective combines Bondas' caritative theory on nursing leadership with Waterman's and Dolan's work on ad hoc organizations. Seven self-organizing teams participated in a 2-year action research project. Data were collected through fieldwork, formal and informal individual and group interviews, and diaries. Analytical abstraction methodology described by Miles et al was used. The metaphor “overcoming the jet lag of bureaucracy” is based on 5 themes: struggling to design the new team; investing time and self; needing research and leadership support; evolving collegial collaboration, professional growth, and pride; and growing professional security and the will to continue education as a result of learning.
Does the sex of the preterm baby affect respiratory outcomes?

Being born very preterm is associated with later deficits in lung function and an increased rate of respiratory symptoms compared with term-born children. The rates of early respiratory infections are higher in very preterm-born subjects, which may independently lead to deficits in lung function in later life. As with very preterm-born children, deficits in lung function, increased respiratory symptoms and an increased risk of respiratory infections in early life are observed in late preterm-born children. However, the rates of respiratory symptoms are lower compared with very preterm-born children. There is some evidence to suggest that respiratory outcomes may be improving over time, although not all the evidence suggests improvements. Male sex appears to increase the risk for later adverse respiratory illness. Although not all studies report that males have worse long-term respiratory outcomes than females. It is essential that preterm-born infants are followed up into childhood and beyond, and that appropriate treatment for any lung function deficits and respiratory symptoms is prescribed if necessary. If these very preterm-born infants progress to develop chronic obstructive airway disease in later life then the impact, not only on the individuals, but also the economic impact on healthcare services, is immense. Educational aims To report the effect of the sex of the preterm baby on respiratory outcomes. To explore the short- and long-term respiratory outcomes of preterm birth. Preterm birth is associated with adverse long-term respiratory outcomes. Males appear to have increased risk for later adverse respiratory illness compared to females, although not all studies agree. http://ow.ly/bRmj30jvn4g
Evaluation of 230 patients with relapsed/refractory deletion 17p chronic lymphocytic leukaemia treated with ibrutinib from 3 clinical trials

Patients with chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) with deletion 17p [del(17p)] have poor outcomes with chemoimmunotherapy. Ibrutinib is indicated for the treatment of CLL/SLL, including del(17p) CLL/SLL, and allows for treatment without chemotherapy. This integrated analysis was performed to evaluate outcomes in 230 patients with relapsed/refractory del(17p) CLL/SLL from three ibrutinib studies. With a median of 2 prior therapies (range, 1–12), 18% and 79% of evaluable patients had del(11q) or unmutated IGHV, respectively. With a median follow‐up of 28 months, overall response rate was 85% and estimated 30‐month progression‐free and overall survival rates were 57% [95% confidence interval (CI) 50–64] and 69% (95% CI 61–75), respectively. Patients with normal lactate dehydrogenase or no bulky disease had the most favourable survival outcomes. Sustained haematological improvements in haemoglobin, platelet count and absolute neutrophil count occurred in 61%, 67% and 70% of patients with baseline cytopenias, respectively. New onset severe cytopenias and infections decreased in frequency over time. Progression‐free and overall survival with ibrutinib surpass those of other therapies for patients with del(17p) CLL/SLL. These results provide further evidence of the robust clinical activity of ibrutinib in difficult‐to‐treat CLL/SLL populations.
Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder in Patients with Chronic Pain

Aims: To investigate rates of attention-deficit hyperactivity disorder (ADHD) in patients with chronic pain attending a pain clinic, the effects of a screening measure for ADHD in patients with chronic pain, and the effects of ADHD drugs on both pain and ADHD symptoms. Methods: We retrospectively surveyed 110 patients with chronic pain visiting the Anesthesiology and Pain Relief Center at the University of Tokyo in Japan, who had also consulted a psychiatrist, between April 2012 and July 2015. Results: Of the total of 110 patients with chronic pain, 35 (31.8%) were also diagnosed with ADHD, and the average Wender Utah Rating Scale (WURS) score among the ADHD patients was 39.0 ± 22.1 (n = 25). Only 36.0% of these patients exceeded the cutoff value, suggesting that 64.0% of the patients with ADHD were not identified by screening with the WURS. Twenty-six patients initiated treatment with ADHD medication, with dosage adjustment completed in 21. Of these 21 patients 20 (95.0%) had improved ADHD symptoms. Improved pain symptoms were observed in 14 patients (66.6%), with a reduction in the pain numerical rating scale of 64.7% ± 30.1%. Conclusions: This is the first study investigating the comorbidity of ADHD and chronic pain at pain clinics showing a high level of comorbidity and amelioration of pain and ADHD symptoms with treatment. Careful interpretation is required when the WURS is used to screen patients with chronic pain.
Structural Magnetic Resonance Imaging Correlates of Aggression in Psychosis: A Systematic Review and Effect Size Analysis

Background: Aggression in psychoses is of high clinical importance, and volumetric MRI techniques have been used to explore its structural brain correlates. Methods: We conducted a systematic review searching EMBASE, ScienceDirect, and PsycINFO through September 2017 using thesauri representing aggression, psychosis, and brain imaging. We calculated effect sizes for each study and mean Hedge's g for whole brain (WB) volume. Methodological quality was established using the PRISMA checklist (PROSPERO: CRD42014014461). Results: Our sample consisted of 12 studies with 470 patients and 155 healthy controls (HC). After subtracting subjects due to cohort overlaps, 314 patients and 96 HC remained. Qualitative analyses showed lower volumes of WB, prefrontal regions, temporal lobe, hippocampus, thalamus and cerebellum, and higher volumes of lateral ventricles, amygdala, and putamen in violent vs. non-violent people with schizophrenia. In quantitative analyses, violent persons with schizophrenia exhibited a significantly lower WB volume than HC (p = 0.004), and also lower than non-violent persons with schizophrenia (p = 0.007). Conclusions: We reviewed evidence for differences in brain volume correlates of aggression in persons with schizophrenia. Our results point toward a reduced whole brain volume in violent as opposed to non-violent persons with schizophrenia. However, considerable sample overlap in the literature, lack of reporting of potential confounding variables, and missing research on affective psychoses limit our explanatory power. To permit stronger conclusions, further studies evaluating structural correlates of aggression in psychotic disorders are needed.
Stem Cell Factor in Combination with Granulocyte Colony-Stimulating Factor reduces Cerebral Capillary Thrombosis in a Mouse Model of CADASIL

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) is a cerebral small vascular disease caused by NOTCH3 mutation-induced vascular smooth muscle cell (VSMC) degeneration, leading to ischemic stroke and vascular dementia. Our previous study has demonstrated that repeated treatment with a combination of stem cell factor (SCF) and granulocyte colony-stimulating factor (G-CSF) reduces VSMC degeneration and cerebral endothelial cell (EC) damage and improves cognitive function in a mouse model of CADASIL (TgNotch3R90C). This study aimed to determine whether cerebral thrombosis occurs in TgNotch3R90C mice and whether repeated SCF+G-CSF treatment reduces cerebral thrombosis in TgNotch3R90C mice. Using the approaches of bone marrow transplantation to track bone marrow-derived cells and confocal imaging, we observed bone marrow-derived blood cell occlusion in cerebral small vessels and capillaries (thrombosis). Most thrombosis occurred in the cerebral capillaries (93% of total occluded vessels), and the thrombosis showed an increased frequency in the regions of capillary bifurcation. Degenerated capillary ECs were seen inside and surrounding the thrombosis, and the bone marrow-derived ECs were also found next to the thrombosis. IgG extravasation was seen in and next to the areas of thrombosis. SCF+G-CSF treatment significantly reduced cerebral capillary thrombosis and IgG extravasation. These data suggest that the EC damage is associated with thrombosis and blood–brain barrier leakage in the cerebral capillaries under the CADASIL-like condition, whereas SCF+G-CSF treatment diminishes these pathological alterations. This study provides new insight into the involvement of cerebral capillary thrombosis in the development of CADASIL and potential approaches to reduce the thrombosis, which may restrict the pathological progression of CADASIL.
Clinical trial design and dissemination: comprehensive analysis of clinicaltrials.gov and PubMed data since 2005

Abstract Objective To investigate the distribution, design characteristics, and dissemination of clinical trials by funding organisation and medical specialty. Design Cross sectional descriptive analysis. Data sources Trial protocol information from clinicaltrials.gov, metadata of journal articles in which trial results were published (PubMed), and quality metrics of associated journals from SCImago Journal and Country Rank database. Selection criteria All 45 620 clinical trials evaluating small molecule therapeutics, biological drugs, adjuvants, and vaccines, completed after January 2006 and before July 2015, including randomised controlled trials and non-randomised studies across all clinical phases. Results Industry was more likely than non-profit funders to fund large international randomised controlled trials, although methodological differences have been decreasing with time. Among 27 835 completed efficacy trials (phase II-IV), 15 084 (54.2%) had disclosed their findings publicly. Industry was more likely than non-profit trial funders to disseminate trial results (59.3% (10 444/17 627) v 45.3% (4555/10 066)), and large drug companies had higher disclosure rates than small ones (66.7% (7681/11 508) v 45.2% (2763/6119)). Trials funded by the National Institutes of Health (NIH) were disseminated more often than those of other non-profit institutions (60.0% (1451/2417) v 40.6% (3104/7649)). Results of studies funded by large drug companies and NIH were more likely to appear on clinicaltrials.gov than were those from non-profit funders, which were published mainly as journal articles. Trials reporting the use of randomisation were more likely than non-randomised studies to be published in a journal article (6895/19 711 (34.9%) v 1408/7748 (18.2%)), and journal publication rates varied across disease areas, ranging from 42% for autoimmune diseases to 20% for oncology. Conclusions Trial design and dissemination of results vary substantially depending on the type and size of funding institution as well as the disease area under study.
Differences in baseline and process variables between non-responders and responders in Internet-based cognitive behavior therapy for chronic tinnitus

Abstract Although Internet-based cognitive behavior therapy (iCBT) is an effective treatment for chronic tinnitus, several patients do not improve. In the current study, baseline and process variables were compared between non-responders and responders. Data from patients participating in two randomized controlled trials on iCBT for chronic tinnitus were re-analyzed. Based on the literature, a pre-post difference on the “Tinnitus Handicap Inventory” (THI) of less than seven points improvement was used to operationalize non-response. Associations between non-response and baseline variables (age, gender, and questionnaire scores), patient progress (THI), the process of the therapeutic alliance (“Working Alliance Inventory-Short Revised”; WAI-SR), as well as other process variables (number of logins, amount of messages sent from therapists to patients) were investigated. The results showed that non-responders had a less favorable change on the THI than responders already at mid-treatment (p < .05). The alliance (WAI-SR) during iCBT was not associated with non-response. Non-responders showed more severe sleep disturbances, logged in less in the iCBT platform, and received fewer messages from the therapists than responders, but these differences were mostly not significant anymore when correcting for multiple testing. To conclude, no symptom change in the first half of iCBT for chronic tinnitus patients is a risk factor of not benefiting from iCBT.
Agreement between home and ambulatory blood pressure measurement in non-dialysed chronic kidney disease patients in Cameroon

Introduction home blood pressure measurement (HBPM) is not entirely capable of replacing ambulatory blood pressure (BP) measurement (ABPM), but is superior to office blood pressure measurement (OBPM). Although availability, cost, energy and lack of training are potential limitations for a wide use of HBPM in Sub-Saharan Africa (SSA), the method may add value for assessing efficacy and compliance in specific populations. We assessed the agreement between HBPM and ABPM in chronic kidney disease (CKD) patients in Douala, Cameroon. Methods from March to August 2014, we conducted a cross sectional study in non-dialyzed CKD patients with hypertension. Using the same devices and methods, the mean of nine office and eighteen home (during three consecutive days) blood pressure readings were recorded. Each patient similarly had a 24-hour ABPM. Kappa statistic was used to assess qualitative agreement between measurement techniques. Results forty-six patients (mean age: 56.2 ± 11.4 years, 28 men) were included. The prevalence of optimal blood pressure control was 26, 28 and 32% for OBPM, HBPM and ABPM respectively. Compared with ABPM, HBPM was more effective than OBPM, for the detection of non-optimal BP control (Kappa statistic: 0.49 (95% CI: 0.36 - 0.62) vs. 0.22 (95%CI: 0.21 - 0.35); sensitivity: 60 vs 40%; specificity: 87 vs. 81%). Conclusion HBPM potentially averts some proportion of BP misclassification in non-dialyzed hypertensive CKD patients in Cameroon.