bluuebunny/crossref_metadata_2025_split huggingface dataset:
Locations for noninvasive brain stimulation in treating depressive disorders: A combination of meta-analysis and resting-state functional connectivity analysis
Authors: Zhang Binlong , Liu Jiao , Bao Tuya , Wilson Georgia , Park Joel , Zhao Bingcong , Kong Jian 
Published: May 2020

Objective: Many noninvasive brain stimulation techniques have been applied to treat depressive disorders. However, the target brain region in most noninvasive brain stimulation studies is the dorsolateral prefrontal cortex. Exploring new stimulation locations may improve the efficacy of noninvasive brain stimulation for depressive disorders. We aimed to explore potential noninvasive brain stimulation locations for depressive disorders through a meta-analysis and a functional connectivity approach. Methods: We conducted a meta-analysis of 395 functional magnetic resonance imaging studies to identify depressive disorder–associated brain regions as regions of interest. Then, we ran resting-state functional connectivity analysis with three different pipelines in 40 depression patients to find brain surface regions correlated with these regions of interest. The 10–20 system coordinates corresponding to these brain surface regions were considered as potential locations for noninvasive brain stimulation. Results: The 10–20 system coordinates corresponding to the bilateral dorsolateral prefrontal cortex, bilateral inferior frontal gyrus, medial prefrontal cortex, supplementary motor area, bilateral supramarginal gyrus, bilateral primary motor cortex, bilateral operculum, left angular gyrus and right middle temporal gyrus were identified as potential locations for noninvasive brain stimulation in depressive disorders. The coordinates were: posterior to F3, posterior to F4, superior to F3, posterior to F7, anterior to C4, P3, midpoint of F7–T3, posterior to F8, anterior to C3, midpoint of Fz–Cz, midpoint of Fz–Fp1, anterior to T4, midpoint of C3–P3, and anterior to C4. Conclusion: Our study identified several potential noninvasive brain stimulation locations for depressive disorders, which may serve as a basis for future clinical investigations.
Diversity in Academic Otolaryngology: An Update and Recommendations for Moving From Words to Action
Authors: Smith Joshua B. , Chiu Alexander G. , Sykes Kevin J. , Eck Lindsey P. , Hierl Anneliese N. , Villwock Jennifer A. 
Published: May 2020

Objectives: (1) To investigate the state of diversity and inclusion initiatives in otolaryngology–head and neck surgery (OHNS) as compared to general surgery and (2) assess their effects on female representation in these programs. Methods: The websites of OHNS residency programs, general surgery residency programs, and their associated academic medical institutions were indexed for content related to diversity and inclusion (D&I) initiatives. Gender data were gathered and used as a proxy for identity diversity. Results: All programs surveyed (N = 198) have D&I programs at the institutional level and have an office of D&I (or equivalent program). However, only 18% of general surgery programs and 19% of otolaryngology programs have additional department-level D&I initiatives. There was an increase in the proportion of female residents across all residency programs if the program mentioned D&I on their website (44% vs 38%, P = .004) and if the program reported a D&I initiative (45% vs 38%, P < .001). Conclusion: Despite the ACGME’s recent emphasis on the importance of recruiting and retaining a diverse physician workforce, the minority of otolaryngology residency programs advertise any concerted, department-level efforts toward increasing D&I at their residency program. General surgery programs have a significantly higher proportion of female department chairs and higher mean proportion of female residents when compared to OHNS. Programs that mention the diversity of their residents or faculty on the program website and programs with their own D&I initiatives have a higher mean proportion of female residents.
Effects of lunch club attendance on the dietary intake of older adults in the UK: A pilot cross-sectional study
Authors: Tsofliou Fotini , Grammatikopoulou Maria G , Lumley Rosie , Gkiouras Konstantinos , Lara Jose , Clark Carol 
Published: May 2020

Background: Lunch clubs are community-based projects where meals are offered with opportunities for social interaction, and a unique dining experience of dual commercial and communal nature. Aim: The aim of the present cross-sectional study was to assess differences in the dietary intake between lunch club and non-lunch club days among community-dwelling elderly, living in Dorset, UK. Methods: A total of 39 elderly individuals attending local lunch clubs were recruited. Socioeconomic factors were recorded, anthropometric measurements were taken and the dietary intake was assessed in lunch club and non-lunch club days via 24 hour dietary recalls. Results: For the majority of participants, having a hot meal (74.4%), meeting with friends (92.3%), dining outside home (76.9%), having a home-styled cooked meal (71.8%) and skipping cooking (43.6%) were considered as important factors for lunch club dining. Absolute energy intake, protein, fat, carbohydrate, saturated fatty acids, fibre, potassium, calcium, iron, vitamins A, C and folate and water from drinks were significantly greater on lunch club days. When intake was expressed as a percentage of the dietary reference values, all examined nutrients were consumed in greater adequacy during lunch club days, except potassium and vitamin D. Conclusions: Lunch clubs appear to be an effective means for ameliorating nutrient intake among older adults, while in parallel, offer the opportunity for socializing and sharing a hot meal with peers.
Upper endplate nonunion after transcorporeal percutaneous endoscopic cervical discectomy: A case report
Authors: Huang Zhen , Li Yuefei , Liu Hui , Sun Ning , Liu Xin , Ren Jiabin , Bi Jingwei , Sun Zhaozhong 
Published: May 2020

Background Transcorporeal percutaneous endoscopic cervical discectomy (TcPECD) destroys the integrity of the vertebral body. We herein discuss its long-term risks and avoidance measures. Case presentation: A 44-year-old woman underwent TcPECD. Although her upper limb symptoms were relieved after the operation, the bone channel did not heal and the endplate of the segment was altered. She consequently developed chronic neck and shoulder discomfort. Conclusion Careful preoperative planning is needed to avoid non-healing of the bone channel following TcPECD. The diameter of the bony channel should be as small as possible and the channel should be opened at the posterior edge of the upper endplate to avoid collapse.
Er,Cr:YSGG laser surface treatment of gamma titanium aluminide: Scanning electron microscopy–energy-dispersive X-ray spectrometer analysis, wettability and Eikenella corrodens and Aggregatibacter actinomycetemcomitans bacteria count—in vitro study
Authors: Koopaie Maryam , Kia Darbandsari Ali , Hakimiha Neda , Kolahdooz Sajad 
Published: May 2020

Dental implants play an important role in oral health. Titanium dental implants must endure the complex microflora environment of the oral cavity. Moreover, bacterial infections have been considered as one of the most important factors of implant failure. The issue of dental improvement through modification of chemical composition and surface treatment has received considerable critical attention. γ-TiAl as a novo biocompatible material revealed a slower corrosion rate in biological media rather Ti-6Al-4V. The objective of this study is to investigate the effect of Er,Cr:YSGG laser on γ-TiAl in comparison with sandblasted and acid-etched samples as the control groups and machined samples. Wettability, surface roughness, surface topography, scanning electron microscopy–energy dispersive X-ray spectrometer analysis of surface and subsurface of samples were investigated and bacteria counts of two periodontal bacterial strains ( Aggregatibacter actinomycetemcomitans and Eikenella corrodens) were evaluated on the Er,Cr:YSGG laser surface-treated sandblasted and acid-etched and machined samples. The results of this investigation show that Er,Cr:YSGG laser surface treatment affects surface roughness, surface topography, wettability, chemical composition of the surface and bacteria count. Scanning electron microscopy–energy dispersive X-ray spectrometer analysis of the sample revealed the increment of titanium and oxygen content and reduction of aluminum content in the surface and subsurface layer. A. actinomycetemcomitans and E. corrodens count were found from the lowest level to highest in the sandblasted and acid-etched samples, laser samples and machined samples, respectively. Using controlled parameters of Er,Cr:YSGG laser ensured no significant adverse alteration. The findings to emerge from this study revealed the significant correlation between microbial count and wettability. Furthermore, the contact angle strongly correlated with surface roughness.
Measuring Socio-Economic Inequality in Self-Reported Morbidity in India: Decomposition Analysis
Authors: Akhtar M.D. Azharuddin , Ahmad Nadeem , Chowdhury Indrani Roy 
Published: May 2020

This paper assesses socio-economic inequalities in self-reported morbidities (SRMs) among households in India. Particularly, we addressed two questions. Is socio-economic-related inequality in SRMs significantly pro-rich or pro-poor? What are the major socio-economic and regional determinants contributing to inequality? This study is based on National Sample Survey 71st round (2014). We calculated equity ratio and concentration index (CI) to assess socio-economic-related inequality. Further, we applied probit regression and decomposition of CI to identify the major factors contributing to inequality. The finding suggests that SRMs and hospital admission have significantly pro-rich distribution, and accessibility to healthcare is a constraint against poor households. After adjusting the inequality, the unjust inequality due to socio-economic gradient is still found to be significant. Overall, income and regional differences are observed to be inflating factors, while education and insurance are observed to be deflating factors in socio-economic inequality in SRMs. High out-of-pocket expenditure with high proportion of transportation cost indicates high burden of accessing healthcare, which acts as a deterrent for poor in seeking healthcare. The government targets of investing 2.5 per cent of the Gross Domestic Product in the healthcare sector and running an ambitious programme like Universal Health Coverage are necessary efforts in the presence of income and health inequalities.
Sciatic Nerve Structural and Functional Recovery with Extract of Phyllanthus amarus and Esculetin in STZ-Induced Hyperglycemic Rats
Authors: Srilatha Kota , Reddy Karnati Pratap 
Published: May 2020

Background: Diabetes-instigated nerve damage is a chronic complication including impaired peripheral nerve function with lowered nerve conduction velocity (NCV), demyelination of nerve fibres and alterations in the behaviour. Many clinical and experimental studies have proved that Phyllanthus amarus and esculetin have potential effects against various diseases. Purpose: The aim of this study is to assess the neuroprotective role of hydro-ethanolic extract of Phyllanthus amaras (PAE) and esculetin (ESC) on NCV, metabolism, behavioural and structural changes in diabetic rats. Methods: The extent of protection using PAE and ESC in diabetic rats was determined by checking the HbA1c, NO, myeloperoxidase (MPO), total calcium, protein content, Na+-K+ ATPase activity, acetylcholine content and behavioural alterations using rotarod and maze learning tests on 7, 14 and 21 days. NCV was measured on the 21st day. Results: The diabetic rats showed increased HbA1c, nitrite, MPO, calcium and decreased protein, Na+-K+ ATPase activity, NCV, acetylcholine, behavioural alterations and morphological changes of sciatic nerve so that diabetic peripheral neuropathy (DPN) is manifested. Continuous treatment for three weeks with Phyllanthus amarus and esculetin significantly minimized the damage to axons and myelin sheath and enhanced the sciatic NCV by reversing all the mentioned parameters. Conclusion: Phyllanthus amarus and esculetin showed the anti-diabetic as well as anti-inflammatory characteristics by prevention of initiation of adverse processes of the sciatic nerve morphology, internal cell functions leading to improved coordination, behavioural and physiological functions in STZ-induced diabetic rats. PAE has shown similar effects with the ESC. However, further studies are essential to confirm their detailed therapeutic effects.
The Development and Implementation of a Cardiac Home Hospice Program: Results of a RE-AIM Analysis
Authors: Jordan Lizeyka , Russell David , Baik Dawon , Dooley Frances , Masterson Creber Ruth M. 
Published: May 2020

Background: Use of hospice has grown among patients with heart failure; however, gaps remain in the ability of agencies to tailor services to meet their needs. Aim: This study describes the implementation of a cardiac home hospice program and insights for dissemination to other hospice programs. Design: We conducted a multimethod analysis structured around the Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) framework. Settings/Participants: We used electronic medical records for our quantitative data source and interviews with hospice clinicians from a not-for-profit hospice agency (N = 32) for our qualitative data source. Results: Reach—A total of 1273 participants were enrolled in the cardiac home hospice program, of which 57% were female and 42% were black or Hispanic with a mean age was 86 years. Effectiveness—The cardiac home hospice program increased hospice enrollment among patients with heart failure from 7.9% to 9.5% over 1 year (2016-2017). Adoption—Institutional factors that supported the program included the acute need to support medically complex patients at the end of life and an engaged clinical champion. Implementation—Program implementation was supported by interdisciplinary teams who engaged in care coordination. Maintenance—The program has been maintained for over 3 years. Conclusion: The cardiac home hospice program strengthened hospice clinicians’ ability to confidently provide care for patients with heart failure, expanded awareness of their symptoms among clinicians, and was associated with increased enrollment of patients with heart failure over the study period. This RE-AIM evaluation provides lessons learned and strategies for future adoption, implementation, and maintenance of a cardiac home hospice program.
An Innovative Assessment of the Dynamics of Facial Movements in Surgically Managed Unilateral Cleft Lip and Palate Using 4D Imaging
Authors: Gattani Shyam , Ju Xiangyang , Gillgrass Toby , Bell Aileen , Ayoub Ashraf 
Published: May 2020

Objective: Assess facial asymmetry during maximum smile in patients with surgically managed unilateral cleft lip and palate (UCLP), using a dynamic 3-dimensional (3D) imaging (4-dimensional) system. Design: Prospective 2 cohort comparative study. Methods: Twenty-five surgically managed UCLP cases and 75 controls at 8 to 10 years of age were recruited. Facial movements during maximum smile were recorded using video stereophotogrammetry at a rate of 60 3D facial images per second. Maximum smile took approximately 3 seconds and generated 180 3D facial images for the analysis. A generic facial mesh which consists of more than 7000 quasi landmarks was used for the assessment of facial asymmetry at 5 key 3D frames representing the pattern of maximum smile. Results: Statistically significant differences were seen regarding the magnitude of facial asymmetry between the UCLP group and the noncleft controls. Higher average asymmetry in the UCLP group was seen in the 3D frame midway between maximum smile and rest (frame 4) followed by the frame at peak expression of maximum smile (frame 3). The average magnitude of nasolabial asymmetry of the control group was within 0.5 mm in comparison with the UCLP cases which was about 1.8 mm. Conclusion: This study provided for the first time, an objective tool for analysis of the dynamics of muscle movements which provided an unprecedented insight into the anatomical basis of the residual dysmorphology. The research demonstrates the limitations of the primary lip repair in achieving symmetrical results and underpins the required refinements to improve the quality of surgical repair of cleft lip.
Utility of Volumetric Measurement via Weight-Bearing Computed Tomography Scan to Diagnose Syndesmotic Instability
Authors: Bhimani Rohan , Ashkani-Esfahani Soheil , Lubberts Bart , Guss Daniel , Hagemeijer Noortje C. , Waryasz Gregory , DiGiovanni Christopher W. 
Published: May 2020

Background: Weight-bearing computed tomography (WBCT) allows evaluation of the distal syndesmosis under physiologic load. We hypothesized that WBCT volumetric measurement of the distal syndesmosis would be increased on the injured as compared to the contralateral uninjured side and that these 3-dimensional (3D) calculations would be a more sensitive determinant than 2-dimensional (2D) methodology among patients with syndesmotic instability. Methods: Twelve patients with unilateral syndesmotic instability requiring operative fixation who underwent preoperative bilateral foot and ankle WBCT were included in the study group. The control group consisted of 24 patients without ankle injury who underwent similar imaging. On WBCT scan, 2D measurements of the syndesmosis joint were first measured 1 cm above the joint line in the axial plane via syndesmotic area and distances between the anterior, middle, and posterior quadrants. Thereafter, comparative 3D volumetric measurements of the syndesmotic joint were also calculated: (1) from the tibial plafond extending until 3 cm proximally, (2) 5 cm proximally, and (3) 10 cm proximally. Results: In patients with unilateral syndesmotic instability, all 3 weight-bearing volumetric measurements were significantly larger on the injured side as compared to the contralateral, uninjured side ( P < .001). In the control group, there was no difference between syndesmotic volumes at any level. Of these 3 anatomic reference points, the 3D measurement spanning from the tibial plafond to a level 5 cm proximally had the highest relative volumetric ratio between the injured and uninjured side, suggesting it is the most sensitive in distinguishing between stable and unstable syndesmotic injury ( P < .001). Notably, this 3D volumetric measurement was also more sensitive than 2D measurements ( P = .001). Conclusion: 3D volumetric measurement of the syndesmosis joint appears to be the most effective way to diagnose syndesmotic instability, compared with more traditional 2D syndesmosis measurement. Level of Evidence: Level III, retrospective comparative study.
Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors and Ezetimibe on Risk of New-Onset Diabetes: A Systematic Review and Meta-Analysis of Large, Double-Blinded Randomized Controlled Trials
Authors: Chiu Sarah W. , Pratt Cristina M. , Feinn Richard , Chatterjee Saurav 
Published: May 2020

Background: Previous meta-analyses have shown that statins may cause incident diabetes. This article reviews randomized controlled trials using proprotein convertase subtilisin/kexin 9 inhibitors (PCSK9i) or ezetimibe on the risk of new-onset diabetes. Methods: Eight trials involving PCSK9i and 3 trials of ezetimibe were selected for review. PubMed, Cochrane Central Register of Controlled Trials, and Clinicaltrials.gov were thoroughly searched for relevant trials. Inclusion criteria included at least 100 patients per treatment arm, follow-up of at least 52 weeks, and at least double-blinded study design. Exclusion criteria included patients with previously diagnosed diabetes, nonrandomized, placebo-controlled, open-label, and crossover trials. The primary outcome was the number of incident diabetes cases. A random effects model was used. Heterogeneity in effect sizes was measured with I 2 parameter and the Q statistic was used to test for excessive between-study heterogeneity. Results: A total of 52 214 participants for the PCSK9i and a total of 20 084 for the ezetimibe meta-analyses were included. Participants randomized to PCSK9i did not differ from the control patients in diabetes incidence (risk ratio [RR] = 0.99, P = .87, 95% CI = 0.92-1.07). Participants randomized to ezetimibe did not differ from the control patients in diabetes incidence (RR = 1.05, P = .37, 95% CI = 0.95-1.15). Discussion: The use of PCSK9i and ezetimibe does not appear to impact the risk of incident diabetes mellitus when added to guideline-directed medical therapy.
Short- and Midterm Adherence to Platelet P2Y12 Receptor Inhibitors After Percutaneous Coronary Intervention With Drug-Eluting Stents
Authors: Morita Fernando , Wajngarten Mauricio , Katz Marcelo , Fernandes-Silva Miguel Morita , Caixeta Adriano , Franken Marcelo , Lemos Pedro A. , Pesaro Antonio E. 
Published: May 2020

Introduction/Objectives: In patients who have undergone recent percutaneous coronary intervention (PCI), poor adhesion to antiplatelet agents may increase the risk of stent thrombosis and death. We aimed to investigate the adherence to different P2Y12 receptor inhibitors after PCI with drug-eluting stent in stable and unstable patients and to evaluate the factors associated with low adherence. Method: In a prospective study conducted between 2014 and 2018, the 8-item Morisky scale was applied at 30 days and 6 months post-PCI to measure P2Y12 receptor inhibitors adherence. Also, we describe the characteristics of patients using different platelet receptor P2Y12 inhibitors. Regression models were used to identify predictors of poor adherence. Results: A total of 214 patients were included (65 ± 12 years, 81% man, 61% acute coronary syndromes). Patients in the clopidogrel group were older than those in the prasugrel (68 ± 12 vs 59 ± 11 years, P < .01, respectively) or ticagrelor group (68 ± 12 vs 62 ± 12 years, P < .01). Patients with low/moderate adherence at 30 days and 6 months represented, respectively, 19.8% and 27.5% of our sample. Current smokers and preexisting cardiovascular disease at presentation were associated with lower adherence at 30 days. Conclusions: We found substantial rates of moderate and low adherence to P2Y12 receptor inhibitors early after PCI. Current smokers and preexisting cardiovascular disease at presentation were associated with a lower likelihood of adherence. These results highlight the need of monitoring adherence to medical treatment after PCI.
Structural damage detection in plates using a deep neural network–couple sparse coding classification ensemble method
Authors: Bokaeian Vahid , Khoshnoudian Faramarz , Fallahian Milad 
Published: May 2020

The present study aims at identifying damages in plate structures by applying a pattern recognition–based damage detection technique using the frequency response function. The large number of degrees of freedom is one of the crucial obstacles in the way of accurately identifying damages in plate structures. On the other hand, frequency response functions include many details that dramatically lower the computing speed and enlarge the memory needed for storing data, hampering the application of this method. Furthermore, this study performs principal component analysis as an authoritative feature extraction method with the purpose of reducing the dimensions of the measured frequency response function data and generating distinct feature patterns. Also, because there has been no individual optimal classifier applicable to all problems, an ensemble comprising two powerful classifiers containing couple sparse coding classification and deep neural networks is used to predict the structure damage. This study evaluates the accuracy of damage detection by the proposed method in square-shaped structural plates with the lengths of 1 m and 2 m under different damage scenarios, namely, single and multiple element.