bluuebunny/crossref_metadata_2025_split huggingface dataset:
Morphine produces better thermal analgesia in young Huntington mice and are associated with less neuroinflammation in spinal cord
Authors: Liu Yuan-Yuarn , Lin Ya-Chi , Hsiao Hung-Tsung , Wang Jeffery Chi-Fei , Liu Yen-Chin 
Published: November 2020

Background:
Huntington’s disease (HD) is an inherited disease characterized by both mental and motor dysfunctions. Our previous studies showed that HD mice demonstrate a diminished pain response. However, few studies have focused on the relationship between HD and morphine analgesia. The purpose of this study is to investigate and compare the analgesic effects of morphine in HD and wild-type (WT) mice.

Methods:
We used clinically similar transgenic HD mice (7-10 weeks of age with motor dysfunction at 8-9 mo of age) carrying a mutant Huntington CAG trinucleotide repeats to evaluate morphine analgesia. The morphine (10 mg/kg subcutaneously) analgesia was evaluated with a tail-flick in hot water (52°C). Mice spinal cords were harvested at the end of the analgesia studies. An immunofluorescence assay and western blotting were used to identify changes in the cells and cytokines.

Results:
Our data demonstrate that preonset young HD mice exhibited a better analgesic response to morphine than the WT mice. Western blotting and an immunohistological examination of the lumbar spinal cord tissue indicated less activation of glial cells and astrocytes in the HD mice compared with the WT mice. The production levels of tumor necrosis factor α and interleukine-1β were also lower in the young HD mice.

Conclusion:
Our data demonstrate better morphine analgesic and less pain-related cytokine responses at the spinal cord level for HD mice. Further studies are needed to determine the morphine analgesia mechanism in HD.
Physician decision support system for idiopathic sudden sensorineural hearing loss patients
Authors: Liao Wen-Huei , Cheng Yen-Fu , Chen Yen-Chi , Lai Ying-Hui , Lai Feipei , Chu Yuan-Chia 
Published: November 2020

Background:
Idiopathic sudden sensorineural hearing loss (ISSNHL) is an emergency disease, and its pathogenesis is still largely unknown, making it difficult to diagnose and develop a therapeutic strategy. To predict the treatment outcomes and further customize the treatment strategy, we used a physician decision support system that incorporates complex information from electronic health records. We first developed the infrastructure of the physician decision support system, including an integrated data warehouse and an automatic data de-identification workflow.

Methods:
We next conducted a cohort study to evaluate the treatment outcomes of 757 ISSNHL patients using the modified Siegel’s criteria. The complete recovery (<25 dB) as a hearing outcome for ISSNHL patients was compared based on pretreatment hearing grades and disease onset with adjusted for age and sex after treatment initiation.

Results:
The results showed that a complete recovery hearing outcome based on pretreatment hearing grades and disease onset in consideration of age and sex was associated with a low risk of pretreatment hearing Grade 2 (26-45 dB) (adjusted odds ratio 12.3, 95% confidence interval [CI]: 4.8-31.3) and disease onset ≤7 days (adjusted odds ratio 13.9, 95% CI: 4.2-45.8), respectively. Hearing recovery outcomes among complete recovery and noncomplete recovery (>25 dB) subjects according to pretreatment hearing grades were 32.9% (Grade 2 or 26-45 dB HL), 25.4% (Grade 3 or 46-75 dB HL), 31.1% (Grade 4 or 76-90 dB), and 4.5% (Grade 5, or >90 dB HL) (p < 0.0001). Patients with pretreatment hearing Grade 2 who received treatment within ≤7 days of disease onset had the highest rate of complete recovery (32.9%, 23/70).

Conclusion:
In summary, using the physician decision support system, we successfully identified two predictors, the pretreatment hearing Grade 2 (26-45 dB) and treatment within ≤7 days of disease onset, associated with the highest odds of achieving complete recovery (<25 dB) of hearing in patients with ISSNHL.
Impact of the COVID-19 pandemic on the use of advance care planning services within the veterans administration system in Taiwan
Authors: Lin Ming-Hwai , Hsu Jo-Lan , Chen Tzeng-Ji , Hwang Shinn-Jang 
Published: November 2020

Background:
The aim of this study is to investigate the effect of COVID-19 on the outpatient advance care planning (ACP) services provided by veterans hospitals in Taiwan.

Methods:
This study adopted a retrospective data analysis. We investigated ACP services provided by 15 veterans hospitals in Taiwan from 2019 to June 2020. We also conducted a statistical analysis on the ACP services provided by the Taipei Veterans General Hospital.

Results:
From 2019 to June 2020, 15 veterans hospitals in Taiwan provided ACP services to 2493 individuals. The outpatient ACP services declined significantly after January 2020, decreasing from a national average of 206.2 ± 29.2 declarants per month to 106.2 ± 30.8 declarants per month in the 6 months immediately following the COVID-19 pandemic outbreak (p < 0.001). From the official implementation of the ACP in January 2019 to the end of June 2020, a total of 1126 declarants accepted ACP services at the Taipei Veterans General Hospital. When the COVID-19 pandemic was prevalent, the declarants who received ACP services were younger (i.e., 60.1 ± 15.2 vs 65.5 ± 16.3 years; p < 0.001). After the variables had been adjusted, the changes in the characteristics of the declarants receiving ACP services when the COVID-19 pandemic was prevalent were as follows: a significant increase in the percentage of hospital staff receiving ACP services (odds ratio [OR]: 5.460, 95% confidence interval [CI]: 2.378–12.536); An increase in the percentage of declarants who paid for the ACP services received at their own expense (OR: 3.417, 95% CI: 1.591–7.339); and an increase in the percentage of declarants who received the consultations with three or more people (OR: 2.017, 95% CI: 1.278–3.182).

Conclusion:
COVID-19 severely changed outpatient ACP services provided by hospitals. The results obtained by this study offer valuable insight regarding the provision of outpatient ACP services.
Prospective Study of Disease-Specific Quality-of-Life in Sporadic Vestibular Schwannoma Comparing Observation, Radiosurgery, and Microsurgery
Authors: Carlson Matthew L. , Barnes Jason H. , Nassiri Ashley , Patel Neil S. , Tombers Nicole M. , Lohse Christine M. , Van Gompel Jamie J. , Neff Brian A. , Driscoll Colin L. W. , Link Michael J. 
Published: November 2020

Background:
Previous cross-sectional studies analyzing quality of life (QOL) outcomes in patients with sporadic vestibular schwannoma (VS) have shown surprisingly little difference among treatment modalities. To date, there is limited prospective QOL outcome data available comparing baseline to posttreatment scores.

Study Design:
Prospective longitudinal study using the disease-specific Penn Acoustic Neuroma Quality of Life (PANQOL) scale.

Setting:
Large academic skull base center.

Patients:
Patients diagnosed with unilateral VS who completed a baseline survey before treatment and at least one posttreatment survey.

Main Outcome Measures:
Change in PANQOL scores from baseline to most recent survey.

Results:
A total of 244 patients were studied, including 78 (32%) who elected observation, 118 (48%) microsurgery, and 48 (20%) stereotactic radiosurgery. Patients who underwent microsurgery were younger (p < 0.001) and had larger tumors (p < 0.001) than those who underwent observation or radiosurgery; there was no significant difference in duration of follow-up among management groups (mean 2.1 yrs; p = 0.28). When comparing the total PANQOL score at baseline to the most recent survey, the net change was only –1.1, –0.1, and 0.3 points on a 100-point scale for observation, microsurgery, and radiosurgery, respectively (p = 0.89). After multivariable adjustment for baseline features, there were no statistically significant changes when comparing baseline to most recent scores within each management group for facial function, general health, balance, hearing loss, energy, and pain domains or total score. However, the microsurgical group experienced a 10.8-point improvement (p = 0.002) in anxiety following treatment, compared with 1.5 (p = 0.73) and 5.3 (p = 0.31) for observation and radiosurgery, respectively.

Conclusions:
In this prospective longitudinal study investigating differences in QOL outcomes among VS treatment groups using the disease-specific PANQOL instrument, treatment did not modify QOL in most domains. Microsurgery may confer an advantage with regard to patient anxiety, presumably relating to the psychological benefit of “cure” from having the tumor removed.
Nomogram for predicting the risk of gastroesophageal varices after primary endoscopic prophylaxis for variceal hemorrhage in patients with cirrhosis
Authors: Zhang Shuo , Song Weiping , Chang Yizhong , Wang Shenglan , Yang Li , Yang Changqing 
Published: November 2020

Background and aims
The aim of this study was to identify predictors of non-high-risk gastroesophageal varices and evaluate the probability of the residual high-risk varices in cirrhosis patients after the primary endoscopic treatment.

Patients and methods
Medical records of the patients with cirrhosis admitted for primary endoscopic prophylaxis gastroesophageal varices hemorrhage were retrospectively analyzed. The patients were divided into high-risk varices and non-high-risk varices groups according to the endoscopy. A nomogram was developed based on the results of multivariate Cox analyses. Accuracy of this model was validated by the concordance index (Harrell’s c-index) and calibration curve.

Results
Altogether 117 patients were enrolled between March 2014 and April 2018. The multivariate Cox analyses identified spleen length <140 mm [odds ratio (OR) = 2.715; P = 0.037), small or medium size of esophageal varices (OR = 4.412; P = 0.017), unaccompanied with gastric varices (OR = 7.025; P = 0.003) and frequency of endoscopic variceal ligation ≥one time per 4 months (OR = 3.834; P = 0.034) as independent factors of non-high-risk varices. All significant predictors were incorporated into a nomogram to predict the residual high-risk varices, which showed a notable accuracy with the concordance index (0.833).

Conclusion
The nomogram-based prediction of residual high-risk varices can be used for risk stratification in cirrhosis patients with gastroesophageal varices.
The Relationship Between the Implicit Rationing of Nursing Care and Emotionally Intelligent Leadership Style
Authors: Blizzard Linda , Woods Stephanie L. 
Published: November 2020

OBJECTIVE
The study examined relationships between nurses' perceptions of implicit rationing of nursing care and leadership style in the nursing work environment.

BACKGROUND
Nurses' perceptions of higher amounts of implicit rationing of nursing care relate to perceptions of lower quality of care and poorer patient outcomes. This study was the 1st to examine leadership style and implicit rationing of nursing care.

METHODS
Using a cross-sectional survey study design, 35 039 RNs were randomly sampled during September 2017 to March 2018.

RESULTS
Findings support an association between nurses' perceptions of an emotionally intelligent leadership style and lower amounts of implicit rationing of nursing care.

CONCLUSION
Implicit rationing of nursing care in the nursing work environment is significantly associated with emotionally intelligent leadership style. Nurse executives, and nursing faculty in administrative-focused graduate programs, can provide development and education in emotionally intelligent leadership skills.
Primary Intrathoracic Sarcomas: A Review of Cross-sectional Imaging and Pathology
Authors: Chahal Anurag , Manapragada Padma Priya , Singh Satinder Pal , Winokur Thomas S. , Sonavane Sushilkumar K. 
Published: November 2020

Abstract
The most common sarcomas in the thorax are metastasis from an extrathoracic primary malignancy. Primary intrathoracic sarcomas are rare albeit aggressive malignancies that are diagnosed on histopathology. Although a few imaging characteristics have been described that are common to sarcomas, it is still a diagnosis of exclusion as other tumors are much more common. Like elsewhere, primary thoracic sarcomas are also classified according to their histologic features. They are a rare group of tumors that can arise from the mediastinal structures, lung, pleura, or chest wall. On imaging, differentiating these from more common malignancies like lung cancer is difficult and often requires multimodality workup and tissue sampling. A few sarcomas are very specific to their locations, such as angiosarcoma in the right atrium, leiomyosarcoma in the pulmonary artery, where imaging has high accuracy for the diagnosis. Despite being nonspecific in a majority of cases, imaging plays a pivotal role in determining the organ of origin, tumor extent, invasion of adjacent structures, and thus help to assess the surgical resectability. Although sarcomas arising from chest wall are the most common primary sarcomas in the chest, they are excluded from this review to focus only on primary intrathoracic sarcomas. The article provides a comprehensive imaging and pathology review of the rare primary intrathoracic sarcomas, including but not limited to angiosarcoma, Kaposi sarcoma, fibrosarcoma, malignant transformation of fibrous tumor of pleura, sarcomatoid mesothelioma, leiomyosarcoma, and malignant small round blue cell tumors.
Key points:
Primary intrathoracic sarcomas are rare but clinically important.
Imaging helps to determine local extent, invasion, metastases and appropriate site/mode of biopsy.
Role of pathology is paramount in diagnosis and guiding treatment based on immunogenetic/molecular typing.
Feasibility and Safety of Laparoscopic Complete Mesocolic Excision (CME) for Right-sided Colon Cancer
Authors: Di Buono Giuseppe , Buscemi Salvatore , Cocorullo Gianfranco , Sorce Vincenzo , Amato Giuseppe , Bonventre Giulia , Maienza Elisa , Galia Massimo , Gulotta Leonardo , Romano Giorgio , Agrusa Antonino 
Published: November 2020

Objective:
The aim of this prospective clinical study is to compare short-term outcome of laparoscopic right hemicolectomy using the Complete Mesocolic Excision (CME group) with patients who underwent conventional right-sided colonic resection (NCME group).

Summary Background Data:
Although CME with central vascular ligation in laparoscopic right hemicolectomy is associated with a significant decrease in local recurrence rates and improvements in cancer-related 5-year survival, there may be additional risks associated with this technique because of increased surgical complications. As a result, there is controversy surrounding its use.

Methods:
In this randomized controlled trial, several primary endpoints (operative time, intraoperative blood loss, other complications, conversion rate, and anastomotic leak) and secondary endpoints (overall postoperative complications) were evaluated. In addition, we evaluated histopathologic data, including specimen length and the number of lymph nodes harvested, as objective signs of the quality of CME, related to oncological outcomes.

Results:
The CME group had a significantly longer mean operative time than the NCME group (216.3 minutes vs 191.5 minutes, P = 0.005). However, the CME group had a higher number of lymph nodes (23.8 vs 16.6; P < 0.001) and larger surgical specimens (34.3 cm vs 29.3 cm; P = 0.002). No differences were reported with respect to intraoperative blood loss, conversion rate, leakage, or other postoperative complications.

Conclusions:
In this study laparoscopic CME were a safe and feasible technique with improvement in lymph nodes harvesting and length of surgical specimens with no increase of surgical intraoperative and postoperative complications.
Wound Pain and Wound Healing Biomarkers From Wound Exudate
Authors: Goto Taichi , Saligan Leorey N. 
Published: November 2020

PURPOSE:Effective management of wound pain is essential for optimal wound healing. Nevertheless, the outcomes of wound pain interventions are based on subjective measures, which can prove problematic in patients with cognitive impairment. Identification of biomarkers associated with wound pain and wound healing can be used to more objectively estimate wound pain and contribute to the development of precise management options to reduce wound pain and promote wound healing. This scoping review aimed to identify wound pain and wound healing biomarkers from wound exudates and to describe different wound collection methods to identify these biomarkers.METHODS:We searched the literature (PROSPERO database registration number: CRD42018103843) via a scoping review.SEARCH STRATEGY:The PubMed database was searched for articles that explored relationships between cutaneous wound pain, wound healing, and biomolecules. Inclusion criteria were articles that reported original data, used adult human samples, and were published in English.FINDINGS:Twenty-one articles were retrieved: 17 investigated molecules from wound exudate associated with wound healing status, and 4 reported molecules associated with wound pain. The most frequently observed wound pain biomarkers were proinflammatory cytokines; the most frequently observed wound healing biomarkers were proteases including those in the matrix metalloproteinase family. Six wound exudate collection methods were identified to extract potential wound pain and wound healing biomarkers from wound exudate.IMPLICATIONS:The results can guide future wound exudate research to validate these wound pain and wound healing biomarkers and to develop therapies targeting these biomarkers to reduce wound pain and promote wound healing.
Prevalence of Anxiety and Depression in Persons With Ostomies
Authors: Moraes Juliano Teixeira , Borges Eline Lima , Santos Carolina Fernandes , da Silva Magda Eva , de Sá Francisco dos Santos 
Published: November 2020

PURPOSE:
The purpose of this study was to measure the prevalence of anxiety and depression in adults with ostomies and to identify associated factors.

DESIGN:
A descriptive cross-sectional study.

SUBJECTS AND SETTING:
The sample comprised 120 adults; all reside in a health region in the state of Minas Gerais in southeastern Brazil.

METHODS:
Participants responded to a questionnaire designed for purposes of this study. The questionnaire included 2 validated instruments—the Beck Depression Inventory and the Beck Anxiety Inventory. In addition to measuring the prevalence of depression and anxiety, we used logistic regression models to identify factors associated with depression and anxiety. A backward method was adopted and the goodness-of-fit of the model was evaluated through the Hosmer and Lemeshow goodness-of-fit test. An odds ratio (OR) with a 95% confidence interval (95% CI) was used to measure the effect size of these associations.

RESULTS:
The prevalence of depression in our sample was 26.7% (n = 32; 95% CI, 18.6-34.6). Slightly more than half of respondents (53.1%, n = 17) had mild depression, 34.3% (n = 11) had moderate depression, and 12.6% (n = 4) had had severe depression. The prevalence of anxiety in our sample was 52.5% (n = 63; 95% CI, 43.4-61.5). Slightly less than half 47.6% (n = 30) had mild anxiety; 36.5% (n = 23) reported moderate and 15.9% (n = 10) reported severe anxiety. The final multiple logistic regression model indicated that respondents with less supportive family relationships were more likely to have depression than respondents with greater family support (OR, 3.83; 95% CI, 1.30-11.25). Similarly, respondents with anxiety were more likely to experience depression when compared to individuals reporting no anxiety (OR, 6.32; 95% CI, 2.26-17.65).

CONCLUSIONS:
Anxiety and depression are prevalent in adults living with an ostomy; anxiety was more prevalent than depression. Respondents with less support from their family and those with anxiety were more likely to experience depression.
Outcomes of a Smartphone-based Application with Live Health-Coaching Post-Percutaneous Coronary Intervention
Authors: Paruchuri Kaavya , Finneran Phoebe , Marston Nicholas A , Healy Emma W , Andreo John , Lynch Ryan , Blood Alexander J , Jones-O’Connor Maeve , Lander Bradley , Kelly Noreen , Vivaldi Maria T. , Traynor Kate , Wiviott Stephen , Natarajan Pradeep 
Published: November 2020

ABSTRACTBackgroundThe interval between inpatient hospitalization for symptomatic coronary artery disease (CAD) and post-discharge office consultation is a vulnerable period for adverse events.MethodsContent was customized on a smartphone app-based platform for hospitalized patients receiving PCI which included education, tracking, reminders and live health coaches. We conducted a single-arm open-label pilot study of the app at two academic medical centers in a single health system, with subjects enrolled 02/2018-05/2019 and 1:3 propensity-matched historical controls from 01/2015-12/2017. To evaluate feasibility and efficacy, we assessed 30-day hospital readmission (primary), outpatient cardiovascular follow-up, and cardiac rehabilitation (CR) enrollment as recorded in the health system. Outcomes were assessed by Cox Proportional Hazards model.Findings118 of 324 eligible (36·4%) 21-85 year-old patients who underwent PCI for symptomatic CAD who owned a smartphone or tablet enrolled. Mean age was 62.5 (9·7) years, 87 (73·7%) were male, 40 of 118 (33·9%) had type 2 diabetes mellitus, 68 (57·6%) enrolled underwent PCI for MI and 59 (50·0%) had previously known CAD; demographics were similar among matched historical controls. No significant difference existed in all-cause readmission within 30 days (8·5% app vs 9·6% control, ARR -1.1% absolute difference, 95% CI -7·1-4·8, p=0·699) or 90 days (16·1% app vs 19·5% control, p=0.394). Rates of both 90-day CR enrollment (HR 1·99, 95% CI 1·30-3·06) and 1-month cardiovascular follow up (HR 1·83, 95% CI 1·43-2·34) were greater with the app. Weekly engagement at 30- and 90-days, as measured by percentage of weeks with at least one day of completion of tasks, was mean (SD) 73·5% (33·9%) and 63·5% (40·3%). Spearman correlation analyses indicated similar engagement across age, sex, and cardiovascular risk factors.InterpretationsA post-PCI smartphone app with live health coaches yielded similarly high engagement across demographics and safely increased attendance in cardiac rehabilitation. Larger prospective randomized controlled trials are necessary to test whether this app improves cardiovascular outcomes following PCI.FundingNational Institutes of Health, Boston Scientific.Clinical Trial RegistrationNCT03416920 (https://clinicaltrials.gov/ct2/show/NCT03416920).
Detection of COVID-19 Disease from Chest X-Ray Images: A Deep Transfer Learning Framework
Authors: Sakib Shadman , Siddique Md. Abu Bakr , Rahman Khan Mohammad Mahmudur , Yasmin Nowrin , Aziz Anas , Chowdhury Madiha , Tasawar Ihtyaz Kader 
Published: November 2020

AbstractWorld economy as well as public health have been facing a devastating effect caused by the disease termed as Coronavirus (COVID-19). A significant step of COVID-19 affected patient’s treatment is the faster and accurate detection of the disease which is the motivation of this study. In this paper, implementation of a deep transfer learning-based framework using a pre-trained network (ResNet-50) for detecting COVID-19 from the chest X-rays was done. Our dataset consists of 2905 chest X-ray images of three categories: COVID-19 affected (219 cases), Viral Pneumonia affected (1345 cases), and Normal Chest X-rays (1341 cases). The implemented neural network demonstrates significant performance in classifying the cases with an overall accuracy of 96%. Most importantly, the model has shown a significantly good performance over the current research-based methods in detecting the COVID-19 cases in the test dataset (Precision = 1.00, Recall = 1.00, F1-score = 1.00 and Specificity = 1.00). Therefore, our proposed approach can be adapted as a reliable method for faster and accurate COVID-19 affected case detection.