bluuebunny/crossref_metadata_2025_split huggingface dataset:
Owner evaluation of quality of life and mobility in osteoarthritic cats treated with amantadine or placebo
Authors: Shipley Hilary , Flynn Kristi , Tucker Laura , Wendt-Hornickle Erin , Baldo Caroline , Almeida Daniel , Allweiler Sandra , Guedes Alonso 
Published: October 2020

Objectives The aim of the study was to determine if amantadine improves owner-identified mobility impairment and quality of life associated with osteoarthritis in cats. Methods Using a blinded, placebo-controlled, randomized, crossover design, 13 healthy client-owned cats with clinical and radiographic evidence of osteoarthritis and owner-identified mobility impairment were studied. Cats received 5 mg/kg amantadine or placebo q24h PO for 3 weeks each with no washout period in between. Locomotor activity was continuously assessed with a collar-mounted activity monitor system, and owners chose and rated two mobility-impaired activities using a client-specific outcome measures (CSOM) questionnaire on a weekly basis. Locomotor activity on the third treatment week was analyzed with two-tailed paired t-tests. The CSOM scores were analyzed using a mixed-effect model and the Bonferroni post-hoc test. Owner-perceived changes in quality of life were compared between treatments using the χ2 test. Statistical significance was set at P <0.05. Results Mean ± SD activity counts during the third week of each treatment were significantly lower with amantadine (240,537 ± 53,880) compared with placebo (326,032 ± 91,759). CSOM scores assigned by the owners were significantly better with amantadine on the second (3 ± 1) and third (3 ± 1) weeks compared with placebo (5 ± 2 and 5 ± 1, respectively). A significantly greater proportion of owners reported improvement in quality of life with amantadine compared with placebo. Conclusions and relevance Amantadine significantly decreased activity, but improved owner-identified impaired mobility and owner-perceived quality of life in cats with osteoarthritis. Amantadine appears to be an option for the symptomatic treatment of osteoarthritis in cats.
Use of ultra-wide field retinal imaging and optical coherence tomography angiography in the diagnosis of incomplete Susac syndrome
Authors: Alba-Linero Carmen , Liscombe-Sepúlveda John Paul , Llorenç Victor , GiraltJosa Joan , Adán Alfredo 
Published: October 2020

Purpose: To describe clinical findings through ultra-wide field (UWF) images and optical coherence tomography angiography (OCT-A), in Susac’s syndrome (SS). Methods: SS patients were retrospectively analyzed in a single center. Clinical features, ultra-wide-field retinographies (UWF-PR), UWF fluorescein angiographies (UWF-FA), and optical coherence tomography angiography & en face (OCT-A/EF) were reviewed. Results: Twelve eyes from six patients with a mean follow-up of 35.66 months ± SD 36.88 were included. UWF-PR showed areas of retinal whitening and cotton-wool spots in all the eyes after acute attack. Segmentary mid peripheral arteriolitis could be observed in five eyes by UWF-FA in acute and convalescent stages. OCT-A revealed capillary density changes in all of the affected eyes. During the acute phase there was a well-preserved superficial capillary network, while deep retinal plexus showed a lower density in the affected areas. OCT-A/EF revealed deep retinal plexus drop-out and surrounding edematous retina in acute attacks, becoming atrophic over time. Conversely, superficial plexus was much less affected. Perifoveal reperfusion was seen in seven eyes after the acute attack. Conclusions: UWF-PR/FA and OCT-A/EF might be helpful to stablish an early diagnosis and to monitor SS progression.
Pterygium Surgery with Conjunctival Autograft Fixation Using Bipolar Electrocauterization
Authors: Costa Fernando Quadros , Costa Ricardo Quadros , Barbosa José Bonifácio , Gomes José Álvaro Pereira 
Published: October 2020

Purpose: To report a case series of pterygium surgery with conjunctival autograft fixation using bipolar electrocautery. Design: A noncomparative, retrospective, interventional case series of pterygium surgery with follow-up longer than 12 months to assess recurrence and other complication rates. Participants: Fifty-six eyes of 37 patients were treated between April 2011 and January 2018, either for primary ( n = 53 cases) or recurrent ( n = 3 cases) pterygia. Intervention: After pterygium excision, free conjunctival grafts from the inferior bulbar conjunctiva of the same eye were harvested and fixated with the use of bipolar electrocautery. Main outcome measure: Recurrence of the pterygium and complications. Results: The mean follow-up was 41 months (range 12 to 81 months). There were no intraoperative complications. Recurrence of the lesion was seen in three eyes (5.36%). There were no other postoperative complications such as graft detachment, or formation of dellen or granulomas. Conclusion: Conjunctival autograft fixation using bipolar electrocautery seems to be a fast, costly and safe procedure that can be applied in most cases of pterygium surgery.
Combining Genetic Mutation and Expression Profiles Identifies Novel Prognostic Biomarkers of Lung Adenocarcinoma
Authors: Liu Yun , Liu Fu , Hu Xintong , He Jiaxue , Jiang Yanfang 
Published: October 2020

Motivation: Although several prognostic signatures for lung adenocarcinoma (LUAD) have been developed, they are mainly based on a single-omics data set. This article aims to develop a novel set of prognostic signatures by combining genetic mutation and expression profiles of LUAD patients. Methods: The genetic mutation and expression profiles, together with the clinical profiles of a cohort of LUAD patients from The Cancer Genome Atlas (TCGA), were downloaded. Patients were separated into 2 groups, namely, the high-risk and low-risk groups, according to their overall survivals. Then, differential analysis was performed to determine differentially expressed genes (DEGs) and mutated genes (DMGs) in the expression and mutation profiles, respectively, between the 2 groups. Finally, a prognostic model based on the support vector machine (SVM) algorithm was developed by combining the expression values of the DEGs and the mutation times of the DMGs. Results: A total of 13 DEGs and 7 DMGs were recognized between the 2 groups. Their prognostic values were validated using independent cohorts. Compared with several existing signatures, the proposed prognostic signatures exhibited better prediction performance in the testing set. In addition, it is found that 1 of the 7 DMGs, GRIN2B, is mutated much more frequently in the high-risk group, showing a potential value as a therapy target. Conclusions: Combining multi-omics data sets is an applicable manner to identify novel prognostic signatures and to improve the prognostic prediction for LUAD, which will be heuristic to other types of cancers.
Unattended Mental Health Needs in Primary Care: Lebanon’s Shatila Palestinian Refugee Camp
Authors: Segal Steven P , Khoury Vicky C , Salah Ramy , Ghannam Jess 
Published: October 2020

Aims: This study examines factors potentially contributing to unattended mental health needs among primary care patients in Lebanon’s Shatila Palestinian Refugee Camp in order to understand the prevalence of such needs and improve clinical practice with refugees and other vulnerable groups. Methods: Data collection (2012-13) involved researcher administered structured surveys of primary healthcare-clinic patients (n = 254) using the K6, the PC-PTSD, and the Modified-MINI mental illness screens. Chi. Sq., ANOVA and Principal Component analysis evaluate associations and differences in sample characteristics; Logistic regression evaluates factors associated with unattended-positive-mental-health-screens. Results: The sample (n = 254) included 55% females and 45% males; aged 18 to 89, M = 40.4 (±13). About 51.6% (n = 132) screened positive for mental illness, for these individuals only 11.4% (15 of 132) spoke to their physician about mental illness or had an acknowledged record of psychological problems. Thus 88.6% (n = 117) of those who screened positive, had unattended positive-screens. Univariate tests indicated that patients with “negative-screens,” those with “attended positive-screens,” and those with “unattended positive-screens” differed in their social and psychological characteristics as well as their relationship with the primary care setting. Overall multivariable Logistic results indicated that patients with unattended positive-screens were 34% less likely to have higher SES scores for each step up in status [OR = 0.66; CI: 0.48-0.89] and 58% less likely to have access to a provider for advice or assistance [OR = 0.42; CI: 0.20-0.88]. They were 2.2 times more likely to be females [OR = 2.20; CI: 1.22-3.95], and 5.26 times more likely to attribute their mental illness to a physical illness [OR = 5.26; CI: 2.36-11.74]. Conclusion: Large numbers of patients screen positive for mental illness who do not have their mental health need addressed during their primary care visit. This seems an issue rooted in a lack of psychoeducation about what is mental versus physical illness, female specific access to care, stigma toward mental illness, and cross-SES-communication. Improved communication in primary care, especially as it serves vulnerable refugee populations might significantly reduce the prevalence of untreated mental illness.
Age-related adverse events of disease-modifying treatments for multiple sclerosis: A meta-regression
Authors: Prosperini Luca , Haggiag Shalom , Tortorella Carla , Galgani Simonetta , Gasperini Claudio 
Published: October 2020

Objective: To verify the hypothesis of an age-dependent increase of infections and neoplasms in patients with multiple sclerosis (MS) under disease-modifying treatments (DMTs) with different mechanisms of action. Methods: We extracted relevant data from 45 randomized clinical trials (RCTs) on currently licensed DMTs. We fitted inverse-variance weighted meta-regressions with random-effects models to estimate whether age and/or mechanism of action (immunomodulatory, sequestrating, and depletive) of currently licensed DMTs influenced the difference between experimental arm and control arm in the incidence of specific adverse events, namely, overall infections, opportunistic infections, and neoplasms. Results: A higher incidence of overall infections was observed in RCTs with depletive DMTs (event-rate ratio = 1.25, p < 0.001). Herpetic infections were more frequently observed in RCTs with both depletive (event-rate ratio = 3.51, p < 0.001) and, to a lesser extent, sequestrating DMTs (event-rate ratio = 1.52, p = 0.078). The interaction of age with depletive DMTs was associated with higher incidence of neoplasms ( p = 0.017), especially above 45 years of age. Discussion: Our study supports a detrimental effect of age on the safety profile of depletive DMTs, with an increased incidence of neoplasms especially over 45 years of age. We failed to demonstrate an age-related increased incidence of infections, possibly due to latency in their occurrence.
Ettore’s song: The hero who had the courage to fight Achilles
Authors: Giordano Filippo , Rutigliano Chiara , Muggeo Paola , Fusaro Tommaso , Santoro Nicola 
Published: October 2020

End-of-life accompaniment requires even greater care of the patient and their family by the multi-disciplinary team, which requires a clear, wellorganized interdisciplinary and interprofessional approach. Musictherapy (MT) is often use as a complementary approach to improve a person’s quality of life by helping to relieve symptoms, addressing psychological needs, offering support and comfort, facilitating communication, and meeting spiritual needs. Through songwriting, Ettore, a teenager was able to make choices and act on his own will. Songwriting represented a channel for effective and powerful communication and expression. The song became the means by which the relationship with the team was maintained and deepened; it became something tangible, a product with its own consistency, a further bond that unites Ettore to his family to this day.
Insomnia subtypes and clinical impairment in hospitalized children with autism spectrum disorder
Authors: Taylor Briana J , Reynolds Charles F , Siegel Matthew 
Published: October 2020

Insomnia subtypes have not been characterized in severely affected youth with autism spectrum disorder. We examined indices of clinical impairment (i.e. length of hospital stay, autism severity, nonverbal intelligence quotient, and adaptive and maladaptive behaviors) across insomnia subtypes in 427 psychiatrically hospitalized children with autism spectrum disorder (mean age = 12.8 ± 3.4; 81.3% male). Multivariate analysis with Bonferroni adjustment tested for differences in clinical impairment across insomnia subtypes adjusting for age and sex. Per parent report, 60% (n = 257) of children had at least one form of insomnia. The distribution of subtypes was sleep onset (26.1%, n = 67), sleep maintenance (24.9%, n = 64), early morning waking (4.3%, n = 11), and combined (44.7%, n = 115). There was a significant multivariate effect of insomnia subtypes on clinical impairment (Pillai’s Trace = 0.25, F = 2.78, p < 0.001). Sleep maintenance and early morning waking were associated with longer hospital stays. Early morning waking was also associated with greater autism symptom severity. In general, children with sleep-maintenance or combined insomnias scored lower on adaptive behaviors and higher on maladaptive behaviors. Sleep-maintenance and combined insomnias appear to be more indicative of or consequential for impaired behavioral functioning. Lay abstract Insomnia subtypes are not well understood in the most severely affected children with autism spectrum disorder. We examined length of hospital stay, autism severity, nonverbal intelligence quotient, and behavioral functioning across insomnia subtypes in 427 psychiatrically hospitalized children with autism spectrum disorder (mean age = 12.8 ± 3.4; 81.3% male). Per parent report, 60% (n = 257) of children had at least one type of insomnia. The distribution of subtypes was difficulty falling asleep (26.1%, n = 67), difficulty staying asleep (24.9%, n = 64), early morning awakening (4.3%, n = 11), and multiple insomnia symptoms (44.7%, n = 115). Difficulty staying asleep and early morning awakenings were associated with longer hospital stays. Early morning awakening was also associated with higher autism symptom severity. In general, children with difficulty staying asleep or multiple insomnia symptoms scored lower on adaptive behaviors (e.g. communication, self-care, socialization) and higher on maladaptive behaviors (e.g. irritability, hyperactivity, emotional reactivity, and emotional dysphoria). Difficulty staying asleep or having multiple insomnia symptoms appears to be most strongly related to impaired behavioral functioning. Conversely, early morning awakenings may be more closely tied with autism spectrum disorder itself. Further research is needed regarding insomnia subtypes at the severe end of the autism spectrum.
Regional variations in the treatment of gallstone disease may affect patient outcome: a large, population-based register study in sweden
Authors: Lindqvist Lisa , Sandblom Gabriel , Nordin Pär , Hemmingsson Oskar , Enochsson Lars 
Published: October 2020

Background: The lack of studies showing benefit from surgery in patients with symptoms of gallstone disease has led to a divergence in local practices and standards of care. This study aimed to explore regional differences in management and complications in Sweden. Furthermore, to study whether population density had an impact on management. Methods: Data were collected from the Swedish National Register for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks). Cholecystectomies undertaken for gallstone disease between January 2006 and December 2017 were included. Age, sex, American Society of Anesthesiologists (ASA) classification, intra- and post-operative complications, and the proportion of patients with acute cholecystitis who underwent surgery within 2 days of hospital admission were analyzed. The 21 different geographical regions in Sweden were compared, and each variable was analyzed according to population density. Results: A total of 139,444 cholecystectomies cases were included in this study. There were large differences between regions regarding indications for surgery and intra- and post-operative complications. In the analyses, there were greater divergences than would be expected by chance for most of the variables analyzed. Age of the cholecystectomized patients correlated with population density of the regions (R2 = 0.310; p = 0.0088). Conclusions: There are major differences between the different regions in Sweden in terms of the treatment of gallstone disease and outcome, but these did not correlate to population density, suggesting that local routines are more likely to have an impact on treatment strategies rather than demographic factors. These differences need further investigation to reveal the underlying causes.
Effects of Cystatin C on Cognitive Impairment in Older Chinese Adults
Authors: Cui Zhizhen , Cao Guizhen , Wang Youyi , Ma Qinghua , Wang Congju , Xu Yong , Sun Hongpeng , Ma Yana 
Published: October 2020

Objective: To find a suitable dividing value to classify cystatin C and evaluate the association between cognition and levels of cystatin C. Methods: Using data from the China Health and Retirement Longitudinal Study, We conducted a longitudinal analysis of a prospective cohort of 6,869 middle-aged and older Chinese without cognitive impairment at baseline. Levels of cystatin C were categorized into 2 groups by method of decision tree. Logistic regression models evaluated whether cystatin C was related to cognitive impairment. Results: Respondents were categorized as lower levels of cystatin C and higher levels of cystatin C, cut-point was 1.11 mg/L. Higher levels of cystatin C was associated with the odds of cognitive impairment (OR, 1.56; 95% CI, 1.10-2.22) after multivariable adjustment. Respondents with higher levels of cystatin C had worse cognition scores. Conclusions: We found a suitable dividing value of cystatin C in middle-aged and older Chinese.
Feasibility of Beans/Bran Enriching Nutritional Eating For Intestinal Health & Cancer Including Activity for Longevity: A Pilot Trial to Improve Healthy Lifestyles among Individuals at High Risk for Colorectal Cancer
Authors: Leach Heather J. , Baxter Bridget A. , Beale Melanie N. , Smith Hillary V. , Rao Sangeeta , Hibbs-Shipp Sarah , Ryan Elizabeth P. 
Published: October 2020

Purpose: Examine the feasibility and preliminary effects of a lifestyle intervention of rice bran plus navy bean supplementation, and physical activity (PA) education on intake of fiber and whole grains, and PA levels. Design: Randomized-controlled, single-blinded. Setting: Academic institution and free-living. Subjects: Adults >18 years, with ≥1 adenomatous polyp removed within 3 years. Intervention: Participants received powder and pre-prepared meals and snacks that contained either rice bran (30 g/day) plus navy bean (30 g/day), or Fibersol-2® (10 g/day), for 12-weeks. All participants received a 1-hour (PA) education session. Measures: Feasibility was assessed by recruitment and retention rates, and compliance to the study foods and procedures. Three-day food logs were analyzed using Nutritionist Pro™ to estimate fiber intake, and the Automated Self-Administered 24-hour (ASA24®) Dietary Assessment Tool calculated Healthy Eating Index (HEI) whole grain and total scores. PA was measured using an ActivPAL™ accelerometer. Analysis: Continuous data were summarized as median, range, and percent change from baseline to post-intervention. Results: N = 20 (86.9%) completed the intervention. Compliance was 92% in the rice bran plus navy bean versus 89% in Fibersol-2®. Navy bean consumption increased from 2 g/day to 30 g/day, and rice bran from 0 g/day to 30 g/day. Fiber intake (g/day) increased by 73% versus 82%, HEI whole grain improved by 270% versus 37%, and HEI total improved by 10% versus 9.1% in rice bran plus navy bean and Fibersol-2®, respectively. Total PA (MET-hours/day) showed minimal change for intervention (+0.04%) and control (+4%). Conclusion: Findings merit a larger trial of rice bran plus navy bean and PA to evaluate efficacy for dietary and cancer prevention-related outcomes.
Clinical Correlates of Electroencephalographic Patterns in Critically Ill Patients
Authors: Nazish Saima , Zafar Azra , Shariff Erum , Shahid Rizwana , Alamri Sara , Albakr Aisha 
Published: October 2020

Objective The objective of this study was to determine the frequency and clinical correlates of different electroencephalographic patterns and their association with clinical outcomes in critically ill patients. Subjects and Methods This retrospective cross-sectional study was performed in the Neurology Department of King Fahd Hospital of the University, Kingdom of Saudi Arabia and involved a review and analysis of medical records pertaining to 179 intensive care unit patients who underwent electroencephalography (EEG) in the June to November 2018 period. Results Among the different etiologies, presence of spike and wave or sharp wave (SWs) was associated with encephalitis ( P = .01) and large artery stroke ( P = .01), whereas markedly attenuated EEG activity ( p = .04) and burst suppression ( P = .01) were associated with large artery stroke and hypoxic ischemic encephalopathy (HIE), respectively. Generalized theta activity ( P = .01) was significantly found in patients of septic encephalopathy, while generalized delta activity ( P = .02) and asymmetrical background ( P = .04) were significantly associated with traumatic brain injury. Presence of periodic discharges in EEG was significantly associated with more adverse clinical outcomes ( P = .001), whereas rhythmic delta activity (RDA) ( P = .03), persistent focal slow wave activity ( P = .01), and asymmetric background ( P = .002) were found in patients who were discharged from hospital with sequelae of current illness. Conclusion Certain EEG patterns are associated with particular underlying etiologies like SWs for encephalitis, markedly attenuated EEG activity and burst suppression with large artery stroke and HIE, respectively. Whereas few EEG patterns, including periodic discharges, RDA, persistent focal slow wave activity have some prognostic value in critically ill patients. However, they cannot be used as markers for prognostic assessment of patients without considering other clinical and diagnostic variables. Further larger prospective studies with continuous EEG monitoring with control of confounding factors are needed.