bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical suspicion of spondylodiscitis with equivocal MRI findings: does diffusion-weighted imaging prove helpful here?
Authors: Henkelmann Jeanette , Bremicker Kristina , Denecke Timm , Hoffmann Karl-Titus , Henkelmann Ralf , Heyde Christoph-Eckhard , Sabri Osama , Purz Sandra 
Published: May 2020

Background Despite the high sensitivity of magnetic resonance imaging (MRI), early detection of spondylodiscitis (SpD) remains challenging due to its low specificity. Purpose To assess the diagnostic value of diffusion-weighted imaging (DWI) in suspected cases of SpD with ambiguous early MRI findings in the differentiation of degenerative disorders (DD). Material and Methods In this prospective study, 52 patients suspected of having SpD underwent a whole-spine 3-T MRI scan comprising sagittal DWI. Of 58 conspicuous, T2-weighted, signal increased discs, 39 were successfully evaluated using DWI. Apparent diffusion coefficient (ADC) values and ADC maps were blindly analyzed using the region of interest of the conspicuous disc and a normal adjacent reference disc. Intraindividual ratios (conspicuous disc: reference disc) were calculated. Results All conspicuous discs showed increased absolute ADC values, which did not differ significantly between SpD (n = 22) and DD (n = 17). However, ADC ratio was significantly higher in SpD vs. DD ( P < 0.05). In receiver operating characteristic curve analysis, an ADC ratio threshold of 1.6 resulted in 45% sensitivity and 88% specificity (area under the curve = 0.69) for SpD diagnosis. Conclusion The absolute ADC value does not provide a reliable diagnosis of SpD. Increased diffusivity can be an indication of infection but should always be discussed in the context of existing disc degeneration.
The use of mind mapping in health education in extended care for children with caries
Authors: Yang Hua , Gao Xue-Bin , Li Ming-He , Ye Qiang , Sun Yue , Huang Yang 
Published: May 2020

Objective To investigate the application of mind mapping-based health education in extended care for children with caries. Methods This was a prospective study of 159 eligible children with caries. Participants were randomly assigned to an observation group and a control group, and received extended health education and guidance. Patients in the observation group received health education with mind mapping. In the third month after the first visit, a questionnaire survey was conducted to assess knowledge of extended caries diagnosis and treatment in children and their parents. Children also underwent a bacterial plaque test. Results Caries knowledge was significantly greater in the observation group than in the control group. There was no significant between-group difference in debris index on the bacterial plaque test. The observation group had a significantly greater number of follow-up visits in 12 months than the control group. Conclusions Mind mapping was effective in the implementation of extended care. Mind mapping information was more accessible to children and their parents, increasing their compliance with health education. Thus, mind mapping is an appropriate health education tool for use in extended care for children with caries.
Association between low-fat enteral nutrition after esophagectomy and a lower incidence of chyle leakage: A call for more and better evidence
Authors: Zhang Chu , Gong Longbo , Wu Wenbin , Zhang Miao , Zhang Hui , Zhao Chen 
Published: May 2020

Objective Reliable methods to prevent chyle leakage after esophagectomy are needed. This retrospective study was performed to evaluate the correlation between low-fat nutrition and the incidence of chyle leakage after esophagectomy. Methods This multicenter retrospective case–control study involved patients who underwent Ivor Lewis esophagectomy from December 2012 to August 2017. Tube feeding was started on postoperative day 1 with a normal fat-containing formula (control group, 203 patients) or low fat-containing formula (241 patients). Results The patients in the control group and low-fat group had a similar incidence of chyle leakage (7 [3.4%] vs. 19 [9.4%], respectively) and anastomotic leakage (4 [2.0%] vs. 11 [5.4%], respectively). The multivariate logistic regression indicated that high-volume surgeon experience (performance of ≥100 esophagectomies per year) was correlated with a lower incidence of chyle leakage (odds ratio, 0.280; 95% confidence interval, 0.110–0.712), whereas low-fat nutrition was correlated with an increased risk of anastomotic leakage (odds ratio, 5.995; 95% confidence interval, 1.201–29.925). Conclusion Prophylactic low-fat enteral nutrition following esophagectomy might not decrease the risk of chyle leakage. More and better evidence is needed.
Conspiracism: Archaeology and morphology of a political myth
Authors: Giry Julien 
Published: May 2020

AbstractThrough an empirical approach of several conspiracy theories (Knight Templars, Jesuits, Illuminati, Free-masons or Jewish conspiracy), I have noticed they develop six main characteristics. First, the conspiratorial myth points out scapegoats in a non-aleatory way. They usually belong to ethnical or religious minorities. Secondly, those scapegoats try to acquire an overwhelming power in all fields. Thirdly, to achieve this goal, they corrupt the whole society, especially on mores and sexuality. Fourthly, to set up their domination the scapegoats use the art of simulation and dissimulation. They yield a cult of secrecy. Fifthly, the scapegoats are consistently portrayed through symbolic morphological types, frequently as animals. Finally, conspiratorial myths undergo a process of hybridization and creolization. They go through transformations, alterations and medleys. Every conspiracy theories mix up into one another.
The impact of increasing general hospital admissions on Consultation–Liaison Psychiatry
Authors: Holmes Alex , Handrinos Dennis , Jones Simon , Huang Beatrice 
Published: May 2020

Objective: The objective of this study was to identify changes in patients referred to CLP at a typical inner urban teaching hospital over two decades in the context of increased hospital admissions. Method: Multivariate analyses were conducted on data collected for all referrals to CLP at Royal Melbourne Hospital between 1998 and 2017. Analyses were conducted with reason for referral, current psychiatric contact, psychiatric diagnosis, discharge destination and follow up as dependent variables, and the year and annual hospital admissions as independent variables. Results: Annual hospital admissions grew at a rate (4.6%), greater than the annual increase in beds (2.0%). Psychosis, suicide attempt, past psychiatric history and behaviour became more common reasons for referral, whilst depression and somatisation became less common. Transfers to and from mental health inpatient units increased. Conclusions: An increasing proportion of patients seen by CLP have ‘acute’ problems. Patients with somatisation and depression are seen less frequently. These findings indicate that CLP services need to provide timely assessment and work closely with other elements of the local mental health service in order to optimise patient flow and ensure continuity of care. Local strategies may be required to ensure an adequate breadth of experience for trainees.
Homeless men with psychosis are spending more time shelterless
Authors: Burton Daniel , Jones Simon , Carlisle Trevor , Holmes Alex 
Published: May 2020

Objective: The objective of this study was to determine if homeless men with psychosis in central Melbourne have spent a greater proportion of the past 12 months in homeless settings as compared with the same group 15 years previously. Method: A 12-month accommodation history was collected from all men with psychosis assessed by a homeless outreach mental health team over a 12-month period commencing 2018 and compared with data from 2006. Results: Between 2006 and 2018, the percentage of time spent homeless in the previous 12 months rose from 50% to 80% ( p = 0.0001). The mean time spent shelterless increased from 72 days to 149 days ( p = 0.0001). Conclusions: The amount of time spent homeless has increased in men with psychosis assessed in central Melbourne. This finding suggests that men with psychosis are becoming increasingly entrenched in homeless settings. Addressing this trend requires an increased emphasis on assertive outreach, greater access to acute inpatient and long-term rehabilitation units, and more low cost affordable housing, including housing first facilities.
Anosognosia and schizophrenia – a reminder
Authors: Little John D , Bell Elliot 
Published: May 2020

Objective: To remind the clinical and legal practitioner that anosognosia is a recognised facet of schizophrenia with implications for capacity assessment and for relating effectively with people who experience it. Conclusions: The term anosognosia emphasises that, in schizophrenia, lack of capacity is the result of a neurological deficit. Under-appreciation of this may place that person at risk of a preventable harm.
Placing rehabilitation at the core of assertive community treatment
Authors: Siskind Dan , Dark Frances , Carney Kylie , Gore-Jones Victoria , Kar Ray Manaan , Steginga Anne , Suetani Shuichi , Kisely Stephen 
Published: May 2020

Objectives: Assertive community treatment (ACT) teams are increasingly being adapted to suit the needs of consumers who have never experienced long-term institutional care yet struggle to retain community tenure and quality of life due to residual functional disabilities associated with severe mental illness. Support needs can be provided by the growing disability support sector but recovery-orientated rehabilitation services delivered by specialist rehabilitation clinicians are also required. The Mobile Intensive Rehabilitation Team (MIRT) within the Metro South Addiction and Mental Health Service has adapted the ACT model to deliver assertive outreach that aims to work collaboratively with the person and their chosen supports to improve their function and their sense of self-efficacy in illness self-management. We described the characteristics of the consumers referred to MIRT over a 20-month time period, and reported on on their discharge location. Conclusion: After two years with MIRT, half the participants were discharged out of case-management. Being on clozapine was a barrier to discharge from case-management despite functional improvement. Psychiatric hospitalisations predicted longer duration working with MIRT.
Head-to-Head Comparison of p63 and p40 in Non-Neuroendocrine Carcinomas of the Tubal Gut
Authors: Bakhshwin Ahmed M. , Gordon Ilyssa O. , Brown Kathryn Bock , Liu Xiuli , Allende Daniela S. 
Published: May 2020

Objectives. With targeted agents, characterizing carcinomas of the gastrointestinal (GI) tract has become more important. We aim to determine the usefulness of p40 in classifying GI tract carcinomas. Methods. Seventy-five GI carcinomas including 28 squamous cell carcinomas (SCC), 2 adenosquamous carcinomas (ASCA), 21 poorly differentiated carcinomas (PDCA), and 24 adenocarcinomas (AdCA; control group) were stained for p40, p63, and CK5/6. Tumors were scored from 0 to 5 based on extent of staining and marked as positive (score >2) or negative. Results. p63 was positive in 100% of SCC/ASCA and 12.5% of AdCA. p40 was positive in 92.5% of SCC/ASCA and 4.1% of AdCA. In the PDCA subset, a panel including p63, p40, and MOC31 was the best way to accurately classify most cases. Conclusions. p63 and CK5/6 are more sensitive but less specific than p40 for SCC/ASCA in GI carcinomas. In PDCA, a panel approach including p63, CK5/6, and p40 may be best in classifying these cases.
Submucosal Supernumerary Smooth Muscle Coat: A Common Histologic Finding in Mowat–Wilson Syndrome With or Without Hirschsprung Disease
Authors: Suchi Mariko , Calkins Casey M , Chogle Ashish , Bond Jesse Steffan , Kapur Raj P 
Published: May 2020

Background Mowat–Wilson syndrome (MWS) is a multiorgan system disorder caused by ZEB2 (zinc finger E-box-binding homeobox 2) mutations or deletions. One common manifestation is constipation, and approximately half of the patients have Hirschsprung disease (HSCR). In addition to classic histologic features of HSCR, an unusual supernumerary intestinal muscle coat was recently reported in a patient of MWS with HSCR. A similar smooth muscle alteration, segmental additional circular muscle coat, had been described in the specimens from patients with intestinal pseudo-obstruction without MWS or HSCR. Method Rectal biopsies and rectosigmoidectomy specimens from MWS patients were identified by retrospective reviews of surgical pathology records. Routinely prepared glass slides were examined to determine whether any smooth muscle structural alteration was present. Clinical information was obtained by chart review. Results Six MWS patients were identified. A supernumerary smooth muscle coat in the submucosa was present in 3 of them, including 2 of the 4 patients with HSCR. Conclusion The structural anomaly, termed submucosal supernumerary smooth muscle coat, is not a syndrome-specific pathological feature. However, it appears to be more common than expected in MWS and is consistent with contemporary models for the roles of ZEB2 and related cell signaling pathways in the patterning of intestinal musculature during embryonic development.
Subthreshold micropulse yellow laser for the management of refractory cystoid macular edema consequent to complicated cataract surgery
Authors: Verdina Tommaso , Ferrari Cecilia , Valerio Edoardo , Brombin Alberto , Lazzerini Andrea , Mastropasqua Rodolfo , Cavallini Gian Maria 
Published: May 2020

Purpose: To report the safety and efficacy of subthreshold micropulse yellow laser of 577 nm for a complex case of refractory pseudophakic cystoid macular edema. Methods: A retrospective chart review of an interventional case report of three subthreshold micropulse yellow laser interventions for refractory pseudophakic cystoid macular edema. Patient: A 77-year-old healthy female underwent pseudoexfoliative cataract surgery complicated by posterior capsule rupture and sulcus intraocular lens implantation. After 3 months, she required a scleral fixation of the same lens, due to a lack of capsular support and decentration of the intraocular lens. One month later, she experienced a severe pseudophakic cystoid macular edema (foveal thickness of 399 µm and best-corrected visual acuity of 20/80 Snellen). The condition was refractory to conventional treatments prior to subthreshold micropulse yellow laser interventions, including non-steroidal anti-inflammatory eye drops, topical steroids, oral indomethacin and three sub-Tenon’s triamcinolone injections, attempted over a 14-month period. Results: Subthreshold micropulse yellow laser treatment was performed and immediate resolution was achieved and maintained for 2 months. Two cases of edema relapse were observed at 3 months from initial laser treatment and again at 4 months from the second laser treatment. Final patient’s follow-up at 6 months from the third laser treatment evidenced the absence of edema, improved visual acuity (foveal thickness of 265 µm/best-corrected visual acuity of 20/30 Snellen) and the absence of complications. Conclusions: Subthreshold micropulse yellow laser seems to be a safe and effective treatment for short-term resolution of refractory pseudophakic cystoid macular edema after complicated cataract surgery and represents a useful alternative to expensive and invasive therapies. A trend towards a longer duration of edema resolution with every subthreshold micropulse yellow laser repetition was observed.
The Fit Between Spatial Configuration and Idealized Flows: Mapping Flows in Surgical Facilities as Part of Case Study Visits
Authors: Machry Herminia , Joseph Anjali , Wingler Deborah 
Published: May 2020

Purpose: This study proposes a flow mapping approach for surgical facilities that can be implemented by design teams as a component of case study tours. Background: The provision of healthcare services involves simultaneous and closely coupled flows of people, objects, and information, and the efficiency of these flows is influenced by the spatial configuration of the buildings where these services are housed. Many architecture firms conduct case study tours to inform their design process. However, these tours often lack a structured way of documenting different flows and interpreting observations. A structured approach is needed during the design process to understand the impact of spatial configuration on healthcare flows. Method: Site tours were conducted at four surgery centers to develop and test an evidence-based flow mapping approach. Idealized flows within surgical facilities were first identified from the literature, followed by the development of a data collection tool aimed at documenting these flows in each case study through a pre-assessment questionnaire, a physical assessment, and interviews with staff. Results: The flow mapping tool kit was effective in allowing the design team to systematically understand the physical configuration of surgical flows across case studies. The tool also allowed the team to identify spatial configuration characteristics acting as barriers and facilitators to idealized flows. Conclusions: The flow mapping approach was able to provide structure for conducting these short tours more effectively via observations and staff inquiry, enabling design teams to draw more meaningful conclusions from case study tours and conduct comparisons between healthcare facilities visited.
Does Smoking Affect Short-Term Patient-Reported Outcomes After Lumbar Decompression?
Authors: Goyal Dhruv K. C. , Divi Srikanth N. , Bowles Daniel R. , Mujica Victor E. , Kaye I. David , Kurd Mark F. , Woods Barrett I. , Radcliff Kris E. , Rihn Jeffrey A. , Anderson D. Greg , Hilibrand Alan S. , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D. 
Published: May 2020

Study Design: Retrospective cohort study. Objective: The goal of this study was to determine how smoking status influences patient-reported outcome measurements (PROMs) in patients undergoing lumbar decompression surgery. Methods: Patients undergoing lumbar decompression between 1 to 3 levels at a single-center, academic hospital were retrospectively identified. Patients <18 years old, and those undergoing surgery for infection, trauma, tumor, or revision, with less than 12 months of follow-up were excluded. Patients were divided into 3 groups: (1) never smokers (NSs); (2) current smokers (CSs); and (3) former smokers (FSs). PROMs analyzed included the Physical Component Score and Mental Component Score of the Short Form-12 Health Survey, the Oswestry Disability Index, and Visual Analogue Scale Back and Leg pain scores. One-way ANOVA was used to compare preoperative and postoperative scores between smoking groups, and multiple linear regression analysis was performed to determine whether smoking status predicted change in each outcome score, controlling for factors such as age, sex, body mass index, and other clinical variables. A P value <.05 was considered to be significant. Results: A total of 195 patients were included in the final cohort, with 121 (62.1%) patients in the NS group, 22 (11.3%) in the CS group, and 52 (26.6%) in the FS group. There were no significant differences between groups at baseline or postoperatively. Smoking status was also not a significant predictor of change in any outcome scores over time on multivariate analysis. Conclusion: These results suggest that smoking status does not significantly affect short-term complications or outcomes in patients undergoing lumbar decompression surgery.
Acquisition of coronal alignment according to the degree of varus deformity in total knee arthroplasty using computer-assisted navigation
Authors: Song Suk Kyoon , Cho Myung Rae , Lee Seo Ho , Kim Hee Chan , Kang Dae won , Choi Won-Kee 
Published: May 2020

Purpose: We have analyzed the surgical outcomes of primary total knee arthroplasty (TKA) using computer-assisted navigation that were performed by a single surgeon in terms of postoperative coronal alignment depending on preoperative varus deformity. Methods: We conducted a retrospective study of patients who have undergone navigated primary TKA from January 2016 through December 2019. Two hundred and fifty-six cases with varus deformity of 10° or less were assigned to group 1, and 216 cases with varus deformity of more than 10° were assigned to group 2. The postoperative mechanical hip–knee–ankle (mHKA) angle was measured from scanograms which were taken preoperatively and 3 months after surgery. The postoperative mHKA angle was targeted to be 0°, and the appropriate range of coronal alignment was set as 0 ± 3°. Results: The Pearson correlation showed a significant correlation with the degree of preoperative varus deformity and with the absolute error of postoperative mHKA ( p = 0.01). Among all patients, 64 cases (13.6%) were detected as outliers (mHKA > 0° ± 3°) at 3 months after surgery. Of the 64 cases, 25 cases (9.8%) were affiliated to group 1 and 39 cases (18.1%) were affiliated to group 2. Group 2 showed significantly higher occurrence of outliers than group 1 ( p = 0.01). Multiple variables logistic regression analysis, which analyzed the difference in the occurrence rate of outliers (mHKA > 0° ± 3°), showed that the occurrence rate of group 2 was 2.04 times higher than group 1. After adjusting for patient’s age, gender, and body mass index, the occurrence rate of outliers in group 2 was 2.01 times higher than group 1. Conclusion: The benefit of computer-assisted navigation during TKA in obtaining coronal alignment within 0 ± 3° may be lessened when the preoperative varus deformity is severely advanced.