bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pain and Opioid Analgesic Use After Otorhinolaryngologic Surgery
Authors: Kim Matthew , Kacker Ashutosh , Kutler David I. , Tabaee Abtin , Stewart Michael G. , Kjaer Klaus , Sclafani Anthony P. 
Published: July 2020

ObjectiveTo quantify pain and opioid use after otorhinolaryngologic surgery. To determine the effect of patient and surgical factors on primary outcomes.Study DesignProspective cohort.SettingTertiary academic hospital.Subjects and MethodsPatients undergoing elective otorhinolaryngologic surgery were prospectively enrolled. Patients completed demographic surveys and psychometric questionnaires assessing attitudes toward pain and baseline anxiety and depression before surgery. After surgery, patients documented peak pain levels (0‐100 mm, visual analog scale) and daily prescription and nonprescription analgesic requirements over a 2‐week period. Average daily and cumulative pain and opioid use were calculated and compared among patient cohorts stratified by procedure and preoperative factors.ResultsA total of 134 patients were enrolled. Total tonsillectomy was associated with significantly higher pain scores and opioid consumption, as compared to all other procedures. There was moderate correlation between average cumulative pain and opioid use. Older patients required significantly fewer doses of opioids. There was no effect of sex, marital status, or education level on postoperative pain or opioid use. Psychometric instrument scores and chronic pain or analgesic use were not associated with significant differences in pain or opioid requirements. Most patients were prescribed substantially more opioids than they actually required.ConclusionPostoperative pain following elective otorhinolaryngologic surgery decreases dramatically within the first week and requires only few days of opioid analgesia, with the exception of tonsillectomy. Almost all patients required fewer than 15 doses of opioids.
Factors Influencing the Development of Pneumonia in Patients With Head and Neck Cancer: A Meta‐analysis
Authors: Reddy Priyanka D. , Yan Flora , Nguyen Shaun A. , Nathan Cherie‐Ann O. 
Published: July 2020

ObjectiveThe aim of this study was to identify factors that are associated with the occurrence of pneumonia in patients with head and neck cancer (HNC) after treatment.Data SourcesPubMed, Scopus, OVID, and Cochrane Library from inception to November 26, 2019.Review MethodsA systematic review in accordance with the PRISMA guidelines and an assessment of bias were performed. Included studies reported on the risk factors of pneumonia development after HNC treatment via odds ratios and subdistribution hazard ratios from regression analysis.ResultsFifteen studies were included, comprising 30,962 patients with a mean age of 70 years (range, 19‐95 years). Of these, 71.6% are male. The results of our study indicate that the following were independent risk factors contributing to the development of pneumonia: male sex, habitual alcohol consumption, poor oral hygiene before treatment, pretreatment dysphagia, hypopharynx and nasopharynx tumor sites, use of radiotherapy with or without chemotherapy versus surgery alone, addition of chemotherapy to radiotherapy, reirradiation, neck dissection, increased duration of tracheotomy, and use of sedatives for sleeping.ConclusionMultiple patient‐, tumor‐, and treatment‐specific risk factors were identified in predicting pneumonia. Recognition of these risk factors early on may help prevent or at least detect pneumonia in this vulnerable group of patients.
MicroRNA Profiling as a Methodology to Diagnose Ménière’s Disease: Potential Application of Machine Learning
Authors: Shew Matthew , Wichova Helena , Bur Andres , Koestler Devin C. , St Peter Madeleine , Warnecke Athanasia , Staecker Hinrich 
Published: July 2020

ObjectiveDiagnosis and treatment of Ménière’s disease remains a significant challenge because of our inability to understand what is occurring on a molecular level. MicroRNA (miRNA) perilymph profiling is a safe methodology and may serve as a “liquid biopsy” equivalent. We used machine learning (ML) to evaluate miRNA expression profiles of various inner ear pathologies to predict diagnosis of Ménière’s disease.Study DesignProspective cohort study.SettingTertiary academic hospital.Subjects and MethodsPerilymph was collected during labyrinthectomy (Ménière’s disease, n = 5), stapedotomy (otosclerosis, n = 5), and cochlear implantation (sensorineural hearing loss [SNHL], n = 9). miRNA was isolated and analyzed with the Affymetrix miRNA 4.0 array. Various ML classification models were evaluated with an 80/20 train/test split and cross‐validation. Permutation feature importance was performed to understand miRNAs that were critical to the classification models.ResultsIn terms of miRNA profiles for conductive hearing loss versus Ménière’s, 4 models were able to differentiate and identify the 2 disease classes with 100% accuracy. The top‐performing models used the same miRNAs in their decision classification model but with different weighted values. All candidate models for SNHL versus Ménière’s performed significantly worse, with the best models achieving 66% accuracy. Ménière’s models showed unique features distinct from SNHL.ConclusionsWe can use ML to build Ménière’s‐specific prediction models using miRNA profile alone. However, ML models were less accurate in predicting SNHL from Ménière’s, likely from overlap of miRNA biomarkers. The power of this technique is that it identifies biomarkers without knowledge of the pathophysiology, potentially leading to identification of novel biomarkers and diagnostic tests.
Olfactory Dysfunction in COVID‐19 Patients: Prevalence and Prognosis for Recovering Sense of Smell
Authors: D’Ascanio Luca , Pandolfini Manlio , Cingolani Cristina , Latini Gino , Gradoni Paolo , Capalbo Maria , Frausini Gabriele , Maranzano Massimo , Brenner Michael J. , Di Stadio Arianna 
Published: July 2020

While olfactory dysfunction associated with coronavirus disease 2019 (COVID‐19) has attracted considerable interest, few studies have tracked outcomes at serial time points or beyond 2 weeks. Furthermore, data are conflicting regarding whether COVID‐19 severity correlates with degree of olfactory dysfunction. This prospective case‐control study analyzed prevalence and severity of subjective loss of smell in outpatients (n = 23) and inpatients (n = 20) with confirmed severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection vs healthy controls (n = 25). Olfactory dysfunction was reported more commonly in COVID‐19 patients than in healthy controls (P <. 001), and outpatients paradoxically reported loss of smell more commonly than inpatients (P =. 02). Headaches were present in 52% of patients with olfactory dysfunction. Anosmia or hyposmia persisted beyond 5 days but most of the patients recovered by 30 days, suggesting favorable prognosis for olfaction. Differences between inpatients and outpatients are potentially reflective of timeline of olfactory symptoms and contextual factors, underscoring the importance of corroborative objective testing, coupled with careful tracking of temporal relationships.
Matching the Symptom Profile of Adolescent Disaster Survivors with Changing Diagnostic Criteria of Posttraumatic Stress Disorder: Focus on ICD-11
Authors: Kar Nilamadhab , Sharma Asmita 
Published: July 2020

Background: Considering recent changes in the diagnostic guidelines for posttraumatic stress disorder (PTSD), it has become imperative to review their influence, especially on the symptoms related to children and adolescent victims of disasters. We intended to assess the profile of posttraumatic stress symptoms (PTSS) of adolescents following an earthquake, especially the gender differences, in relation to the changing diagnostic guidelines, particularly ICD-11. Methods: In a cross-sectional study, PTSS and functional impairments were evaluated in school-going adolescents in Nepal, one year after the 2015 earthquake, using the Child Posttraumatic Stress Scale (CPSS). Results: A considerable proportion of adolescent survivors of the earthquake had PTSS. Most common ones were intrusive thoughts (46.7%), avoiding thoughts, conversations and feelings about the disaster (44.2%), decreased interest in activities (40.0%), distress with reminders (35.6%), and concentration problems (35.6%). Females had a higher prevalence for all the PTSS compared with males, except for avoiding thought, conversations, feelings, and being overly careful/vigilant. Proportion of adolescents who met symptomatic criteria for PTSD diagnosis in different systems ranged from 14.7% in DSM-5 to 15.6% in ICD-11 three-factor model, and 22.2% in DSM-IV and 31.7% in ICD-10. Inclusion of the criterion of significant functional impairment changed the proportions to 10.0%, 10.3%, 12.8%, and 16.4%, respectively. In all of the diagnostic systems, higher proportions of females had possible PTSD. Conclusion: Adolescent females had a higher prevalence for most of the PTSS and at the diagnostic level. It appears that for adolescents, diagnosis of PTSD in ICD-11 has become more robust with a focus on core symptoms and having a functional impairment criterion.
Psychological Health Among Armed Forces Doctors During COVID-19 Pandemic in India
Authors: Gupta Simmi , Kohli Kinshuk , Padmakumari P , Dixit Prashant Kumar , Prasad Ajay Shankar , Chakravarthy Bharath Seshadri , Shukla Rajat , Ghana Parthasarathi , Mahapatra Debasish , Varadaraj G 
Published: July 2020

Background: A pandemic poses a significant challenge to the healthcare staff and infrastructure. We studied the prevalence of anxiety and depressive symptoms among armed forces doctors in India during the COVID-19 pandemic and the factors that contribute to these symptoms. Methods: The study was conducted from March 30, 2020, to April 2, 2020, using a self-administered questionnaire questionnaire using the hospital anxiety and depression scale (HADS), which was sent through Google Forms. Responses were received from 769 respondents. Data were analyzed for demographic details and HADS scores using the chi-square test and backward logistic regression. Results: Anxiety and depressive symptoms were seen in 35.2% and 28.2% of the doctors, respectively. In doctors with anxiety symptoms, significant associations were observed with age (20–35 years, 39.4%, P = 0.01), gender (females, 44.6%, P < 0.001), duration of service (0–10 years, 38%, P = 0.03), and clinical versus non-clinical specialties (non-clinical, 41.3%, P < 0.001) as opposed to marital status, education level, and current department of work. In doctors with depressive symptoms, significant associations were observed with age (P = 0.04), clinical versus non-clinical specialties (P < 0.001), duration of service (0–10 years, 30.1%, P = 0.03), and doctoral degree (P = 0.04) as opposed to gender, marital status, education level, and current working department. Conclusion: The study revealed a high prevalence of anxiety and depressive symptoms among armed forces doctors. The main contributing factors are female gender, young age group, non-clinical specialties, and having a doctoral degree.
Dual-task training on gait, motor symptoms, and balance in patients with Parkinson’s disease: a systematic review and meta-analysis
Authors: Li Zhenlan , Wang Tian , Liu Haoyang , Jiang Yan , Wang Zhen , Zhuang Jie 
Published: July 2020

Objective: The aim of the present study was to systematically evaluate and quantify the effectiveness of dual-task training on gait parameters, motor symptoms and balance in individuals diagnosed with Parkinson’s disease. Data resources: A systematic review of published literature was conducted until May 2020, using PubMed, EMBASE, Cochrane Library, Web of Science, EBSCO and CNKI databases. Methods: We included randomized controlled trials (RCTs) and non-RCTs to evaluate the effects of dual-task training compared with those of non-intervention or other forms of training. The measurements included gait parameters, motor symptoms and balance parameters. Methodological quality was assessed using the PEDro scale. Outcomes were pooled by calculating between-group mean differences using fixed- or random-effects models based on study heterogeneity. Results: A total of 11 RCTs comprising 322 subjects were included in the present meta-analysis. Results showed that dual-task training significantly improved gait speed (standardized mean difference [SMD], −0.23; 95% confidence interval [CI], −0.38 to −0.08; P = 0.002), cadence (SMD, −0.25; 95% CI, −0.48 to −0.02; P = 0.03), motor symptoms (SMD, 0.56; 95% CI, 0.18 to 0.94; P = 0.004) and balance (SMD, −0.44; 95% CI, −0.84 to −0.05; P = 0.03). However, no significant changes were detected in step length or stride length. Conclusion: Dual-task training was effective in improving gait performance, motor symptoms and balance in patients with Parkinson’s disease relative to other forms of training or non-intervention.
Scapular exercise combined with cognitive functional therapy is more effective at reducing chronic neck pain and kinesiophobia than scapular exercise alone: a randomized controlled trial
Authors: Javdaneh Norollah , Letafatkar Amir , Shojaedin Sadredin , Hadadnezhad Malihe 
Published: July 2020

Objective: The aim of this study was to compare the effectiveness of scapular exercises alone and combined with cognitive functional therapy in treating patients with chronic neck pain and scapular downward rotation impairment. Design: Single-blind randomized controlled trial. Setting: Outpatient. Subjects: A total of 72 patients (20–45 years old) with chronic neck pain were studied. Intervention: Allocation was undertaken into three groups: scapular exercise ( n = 24), scapular exercise with cognitive functional therapy ( n = 24) and control ( n = 24) groups. Each programme lasted three times a week for six weeks. Main outcomes: The primary outcome measure was pain intensity measured by the visual analogue scale scores. The secondary outcome measures included kinesiophobia and muscles activity. Results: Statistically significant differences in pain intensity were found when multidisciplinary physiotherapy group including a cognitive functional approach was compared with the scapular exercise alone group at six weeks (effect size (95% CI) = −2.56 (−3.32 to −1.80); P = 0.019). Regarding kinesiophobia, a significant between-group difference was observed at six-week (effect size (95% CI) = −2.20 (−2.92 to −1.49); P = 0.005), with the superiority of effect in multidisciplinary physiotherapy group. A significant between-group differences was observed in muscle activity. Also, there were significant between-group differences favouring experimental groups versus control. Conclusion: A group-based multidisciplinary rehabilitation programme including scapular exercise plus cognitive functional therapy was superior to group-based scapular exercise alone for improving pain intensity, kinesiophobia and muscle activation in participants with chronic neck pain.
Starting lithium in patients with compromised renal function – is it wise?
Authors: Golic Mihaela , Aiff Harald , Attman Per-Ola , Ramsauer Bernd , Schön Staffan , Steingrimsson Steinn , Svedlund Jan 
Published: July 2020

Background: Little is known of the risks involved for patients who, at the start of lithium treatment, already have compromised renal function. Aims: To assess the risk of developing severe renal impairment (chronic kidney disease (CKD) 4–5) among those patients and to explore predictors for the progression. Methods: A retrospective longitudinal cohort study using data from Sahlgrenska University Hospital’s laboratory database 1981–2017. We compared the risk of developing CKD 4–5 in two patient cohorts: an exposed cohort of 83 patients who had high serum creatinine prior to start of lithium and a reference cohort of 83 patients with normal serum creatinine, matched by gender, duration of lithium treatment and age at the start of lithium treatment. The patients’ medical charts were reviewed and the Swedish Renal Registry was used to identify patients with renal replacement therapy. Results: There were no significant differences between the exposed and reference cohorts with respect to our matching criteria. Almost half the patients in the exposed cohort versus only 10% of the reference patients progressed to CKD 4–5 (HR 6.7, 95%CI 3.1–14.3, p < 0.001) during a mean observation time of more than 10 years. The progressors were older at the start of lithium treatment and were characterised by a higher burden of comorbid somatic diseases, in particular cardiovascular diseases. Conclusions: Compromised renal function prior to initiating lithium treatment increases the risk of developing severe renal impairment. Monitoring of renal function should include somatic comorbidity among older patients.
Health Beliefs and Breast Cancer Screening Practices Among African American Women in California
Authors: Davis Claudia M. 
Published: July 2020

Background African American women continue to have higher mortality rates of breast cancer when compared to other women, and evidence suggests that early detection of breast cancer can lead to favorable outcomes, yet there remains a paucity of literature about health beliefs and the utilization of three screening practices, namely breast self-examination, clinical breast examination and mammography in California, a state that currently has one of the highest breast cancer mortality rates among African American women. Purpose To investigate the relationship between health beliefs and three breast cancer detection practices, e.g. breast self-examination, clinical breast examination, and mammography in a cohort of African American women. Methods Using a descriptive correlational design, a convenience sample of two hundred and eighty-two (n = 282) self-identified women from six regional chapters of a national Black women’s political organization in California, completed a Demographic Data Questionnaire and Champion’s Health Belief Model Scale which assessed the hypothesized relationships of health beliefs and breast cancer detection practices. Results Among this culturally diverse group of women (49.8% American, 28.8% African, 21.4% West Indian), health motivation was positively related to the practice of BSE and annual physician visitation for clinical breast examinations. Health locus of control was positively related to the practice of BSE. Having relatives and friends who were diagnosed with breast cancer was strongly associated with having a mammogram and annual physician visitation for clinical breast examinations. Conclusion These findings may be used to target and develop interventions that are tailored to the unique characteristics of these diverse women.
Weighted or internal rotation radiographs are not useful in the classification of acromioclavicular joint dislocations
Authors: Nordin Jonas S , Mogianos Felicia , Hauggaard Anders , Lunsjö Karl 
Published: July 2020

Background Weighted radiographs are performed to classify acromioclavicular joint dislocations; however, the evidence regarding their usefulness is conflicting. Laboratory studies suggest that internal rotation views can replace weighted radiographs, but this has not been clinically evaluated. Purpose To evaluate whether weighted or internal rotation radiographs uncovers more high-grade acromioclavicular joint dislocations than non-weighted radiographs. Material and Methods A total of 162 patients with acromioclavicular joint dislocations were prospectively included. After applying exclusion criteria, 140 remained. Three panorama radiographs, including both coracoclavicular intervals, were completed of each participant: first, a weighted radiograph with 5-kg weights suspended from the wrists; second, a non-weighted radiograph; and third, an internal rotation radiograph. The coracoclavicular intervals were measured by two radiologists independently, and measurements were translated into Rockwood classifications. The classifications and measurements derived from the different radiographic views were compared. Results Weighted radiographs caused no significant changes in classification. For the internal rotation views, there was a significant change in classification for radiologist 2; however, the reason was that more injuries were downgraded compared to the non-weighted views. Relative to the non-weighted radiographs, the mean increase of the coracoclavicular interval on the injured side in the weighted view was 0.5 mm (95% confidence interval [CI] 0.37–0.65) and in the internal rotation view 0.2 mm (95% CI 0.04–0.33). While these changes were statistically significant, they were small and not clinically important. Conclusion This study does not support the use of weighted and internal rotation radiographs in the classification of acromioclavicular joint dislocations.
Comparison of three FLAIR vascular hyperintensities methodologies in patients with acute ischemic stroke
Authors: Jing Lina , Sui Binbin , Shen Mi , Qin Haiqiang , Ke Dena , Gao Peiyi 
Published: July 2020

Background Multiple methods have been used to analyze fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVHs) which may represent collaterals in patients with acute ischemic stroke (AIS); however, there is no consensus between methods. Purpose To compare three frequently used FVH methods for predicting early infarct volume and clinical outcome in patients with AIS. Material and Methods Patients with AIS in middle cerebral artery territory were recruited. FVHs were evaluated using extensive FVHs, FVH-diffusion-weighted imaging (DWI) mismatch, and FVH-in/out-DWI. Infarct volume at baseline and day 7 were measured. Early neurological improvement (ENI) was assessed. Good outcomes were defined by modified Rankin Scale scores of 0–2 at 90 days. Results Fifty-one patients were included. ENI was 55.6% in patients with extensive FVHs and 23.3% in those without ( P = 0.024). Patients with extensive FVHs had smaller infarct volume growth at seven days than those without ( P = 0.041). ENI was 48.3% in patients with FVH-DWI mismatch and 15.8% in those without ( P = 0.021). Patients with FVH-DWI mismatch had smaller infarct volumes at seven days than those without ( P = 0.038). Patients with FVH-out-DWI had smaller baseline infarct volumes, smaller seven-day volumes, and smaller infarct growth than those with FVH-in-DWI ( P<0.001, P<0.001, and P = 0.031, respectively). In multivariate logistic regression analysis, the infarct growth at seven days negatively independently predicted ENI (OR = 0.737, 95% CI 0.593–0.915, P = 0.006). However, none of the FVH classifications could predict a good 90-day outcome. Conclusion Patients with extensive FVHs or FVH-DWI mismatch tend to have early favorable clinical outcome. FVH-out-DWI being associated with smaller infarct growth may also indicate early favorable clinical outcome.