bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exhaled nitric oxide is not a biomarker for idiopathic pulmonary arterial hypertension or for treatment efficacy
Authors: Malekmohammad Majid , Folkerts Gert , Kashani Babak Sharif , Naghan Parisa Adimi , Dastenae Zahra Habibi , Khoundabi Batoul , Garssen Johan , Mortaz Esmaeil , Adcock Ian M. 
Published: October 2019

Abstract

Background
Idiopathic pulmonary arterial hypertension (IPAH) is a fatal illness. Despite many improvements in the treatment of these patients, there is no unique prognostic variable available to track these patients. The aim of this study was to evaluate the association between fractional exhaled nitric oxide (FeNO) levels, as a noninvasive biomarker, with disease severity and treatment outcome.

Methods
Thirty-six patients (29 women and 7 men, mean age 38.4 ± 11.3 years) with IPAH referred to the outpatient’s clinic of Masih Daneshvari Hospital, Tehran, Iran, were enrolled into this pilot observational study. Echocardiography, six-minute walking test (6MWT), FeNO, brain natriuretic peptide (BNP) levels and the functional class of patients was assessed before patients started treatment. Assessments were repeated after three months. 30 healthy non-IPAH subjects were recruited as control subjects.

Results
There was no significant difference in FeNO levels at baseline between patients with IPAH and subjects in the control group. There was also no significant increase in FeNO levels during the three months of treatment and levels did not correlate with other disease measures. In contrast, other markers of disease severity were correlated with treatment effect over the three months.

Conclusion
FeNO levels are a poor non-invasive measure of IPAH severity and of treatment response in patients in this pilot study.
Can a physiotherapy student assume the role of an advanced practice physiotherapist in Orthopaedic surgery triage? A prospective observational study
Authors: Yin David , Cabana François , Tousignant-Laflamme Yannick , Bédard Sonia , Tousignant Michel 
Published: October 2019

Abstract

Background
Advanced practice physiotherapists (APP) have helped improve accessibility to orthopaedic outpatient care. Several studies have validated the APP practice model in orthopaedic care, demonstrating high agreement between APPs and orthopaedic surgeons (OS) regarding diagnosis and management. However, as APPs tend to be experienced senior physiotherapists, such a study involving physiotherapy students (PS) has not yet been explored. The objective of this study was to evaluate the agreement for orthopaedic diagnoses and surgical triage between a PS and OSs.

Methods
A prospective study involving a final year PS and seven OSs was conducted in a university hospital, after the PS had undergone a three-week intensive training. Eighty-six adult patients referred to OSs for knee osteoarthritis, hip osteoarthritis or shoulder problem were independently evaluated by the PS, and then re-evaluated by an OS. The diagnoses and surgical triage recommendations of both clinicians were analyzed for agreement using raw percent agreement and Cohen’s kappa. Patient satisfaction with the outpatient clinic experience was noted using a modified version of the Visit-Specific Satisfaction Instrument.

Results
Our sample consisted of 86 patients (mean age = 63.4 years). Reasons for consultation included shoulder problems (36%), knee osteoarthritis (52%) and hip osteoarthritis (12%). The raw percent agreement for diagnosis was 95.3%. The agreement for surgical triage was high (κ = 0.86, 95% CI: 0.74–0.98) with a raw agreement of 94.2%. Patient satisfaction was high.

Conclusions
The PS and OSs made similar diagnoses and triage recommendations suggesting that clinical experience alone is not a prerequisite for physiotherapists to help increase accessibility to orthopaedic care.
Case report and literature review: patient with gastroduodenal intussusception due to the gastrointestinal stromal tumor of the lesser curvature of the gastric body
Authors: Đokić Mihajlo , Novak Jerica , Petrič Miha , Ranković Branislava , Štabuc Miha , Trotovšek Blaž 
Published: October 2019

AbstractBackgroundIntussusception in adult patient is rare. Gastroduodenal intussusception due to the gastrointestinal stromal tumors is infrequently described in the literature. Authors present a case of gastroduodenal intussusception due to the low-risk gastrointestinal stromal tumor of the lesser curvature of the gastric body with literature review.Case presentationSixty-two-year-old male was admitted to our hospital with symptoms of acute gastric outlet obstruction. Imaging studies confirmed a lesion of the gastric wall producing gastroduodenal intussusception with pylorus obstruction. Upon laparotomy a tumor mass of the lesser curvature of the gastric body that invaginated through the pylorus into the duodenum was found. Desinvagination and resection of the tumor with the adequate resection margins were performed. Histology reveled a low-risk gastrointestinal stromal tumor. Due to favorable outcome only observation was suggested by the multidisciplinary team.ConclusionsGastroduodenal intussusception due to the gastrointestinal stromal tumor of the gastric wall is a rare event. Surgical resection is the treatment of choice. In selected cases laparosopic resection of the tumor can be performed.
Using inferior epigastric vascular anatomical landmarks for anterior inguinal hernia repair
Authors: Li Weiming , Li Yijun , Ding Lili , Chen Xiongzhi , Xu Qingwen , Li Shumin , Xu Pengyuan , Sun Dali , Sun Yanbo 
Published: October 2019

Abstract

Background
Inferior epigastric vascular anatomical landmarks for anterior inguinal hernia repair is an alternative surgical procedure. We present our experience and outcome of the way.

Methods
We performed a retrospective analysis of 230 patients who received anterior tension-free hernia repair between May 2016 to May 2017. Among these cases, 120 were performed using the traditional transinguinal preperitoneal (TTIPP) technique while 100 were performed using the vascular anatomic landmark transinguinal preperitoneal (VALTIPP) technique. Between these two groups, we compared the operation time, length of hospital stay, complication rates, and the visual analog scale (VAS) for pain at 2 days, 3 months, and 6 months after surgery.

Results
Surgery was well-tolerated in both groups with no significant hemorrhage or complications. The operation times for the VALTIPP and TTIPP groups were 42.52 ± 9.15 and 53.84 ± 10.64 min (P < 0.05), respectively. Ten patients in the VALTIPP group and 17 patients in the TTIPP group reported sensations of foreign bodies (P < 0.05). The VAS pain score in VALTIPP patients at 2 days (4.0 ± 0.5), 3 months (1.0 ± 0.3), and 6 months (0.9 ± 0.3) were significantly lower when compared with those of TTIPP patients (5.3 ± 0.9 at 2 days, 1.8 ± 0.4 at 3 months, and 1.1 ± 0.1 at 6 months, p < 0.05). No statistically significant differences were found in age, gender, BMI, hernia type and location, follow-up period, incidence of post-operative seromas, recurrence rate, or length of hospital stay.

Conclusion
Anterior inguinal hernia repair using inferior epigastric vascular anatomical landmarks may lead to reduced operation times, reduced sensations of foreign bodies, and reduced post-operative pain. This technique is simple, practical, and effective in the management of inguinal hernias.
Milled versus moulded mock-ups based on the superimposition of 3D meshes from digital oral impressions: a comparative in vitro study in the aesthetic area
Authors: Cattoni Francesca , Teté Giulia , Calloni Alessandro Mauro , Manazza Fabio , Gastaldi Giorgio , Capparè Paolo 
Published: October 2019

AbstractBackgroundAesthetic porcelain veneers proved to be a long-term reliable prosthetic solution, ensuring minimal invasiveness. The use of veneers requires an adhesive cementation technique, so maintaining as much enamel as possible is to ensure lasting success. A diagnostic mock-up is a key tool that allows a preview of the outcome of the aesthetic restoration: it is obtainable both in an analog and digital way. With the recent developments in impression technology and the ever so fast growing use of CAD-CAM technologies it is useful to understand the pros and cons of either one of these techniques (analog and digital) in order to identify the easier and more convenient workflow in aesthetic dentistry.MethodsAfter taking pictures and impressions of the dental arcs of a patient in need of aesthetic rehabilitation, 52 resin models were produced and a digital drawing of the smile was outlined. Both an analog and a digital wax-up were obtained from two of the 52 models: the latter was obtained using digital impressions and a dedicated software. The analog wax-up was then used to produce 25 matrices that have later been used to mould 25 resin mock-ups using a traditional moulding protocol (Control Group - CG). The digital wax-up was used to mill 25 PMMA mock-ups. Each mock-up, both milled and moulded (total 50), was then laid on the other 50 resin models as a digital impression of it was taken. The STL. files of the milled mock-ups were compared with the 3D CAD wax-up made using a specific software. The STL. files of the analog printed mock-ups were compared with the traditional wax-up design. A statistical analysis was carried out to evaluate the difference between the groups.ResultsThe statistical analysis showed a significant difference (P > 0.01) between the mean value of the distance between the points of the overlapping STL. meshes in GC (0.0468 mm) and in TG (Test Group - TG) (0,0109 mm).ConclusionsThe study showed a difference in accuracy between traditional moulded and milled mock-ups compared to their original wax-up. The data analysis reports that the digital method allows for greater accuracy. Within the limitations of this study, a fully digital workflow is to considered more reliable when it come to creating an esthetic mockup: the digital procedure has been shown to be more accurate than the one made manually which is much more operator dependent and it brings an increase to the chance of error, and that could ultimately affect the final result.
First characterization of methanogens in oral cavity in Malian patients with oral cavity pathologies
Authors: Sogodogo Elisabeth , Doumbo Ogobara , Aboudharam Gérard , Kouriba Bourema , Diawara Ousseynou , Koita Hapssa , Togora Souleymane , Drancourt Michel 
Published: October 2019

Abstract

Background
The oral cavity of humans is inhabited by several hundreds of bacterial species and other microorganisms such as fungi and archaeal methanogens. Regarding methanogens, data have been obtained from oral cavity samples collected in Europe, America and Asia. There is no study published on the presence of methanogens in the oral cavity in persons living in Africa. The objective of our study was to bring new knowledge on the distribution of oral methanogens in persons living in Mali, Africa.

Methods
A total of 31 patients were included in the study during a 15-day collection period in September. Bacterial investigations consisted in culturing the bacteria in 5% sheep blood–enriched Columbia agar and PolyViteX agar plates. For archaeal research, we used various methods including culture, molecular biology and fluorescent in situ hybridization (FISH).

Results
Eight of 31 (26%) oral samples collected in eight patients consulting for stomatology diseases tested positive in polymerase chain-reaction (PCR)-based assays for methanogens including five cases of Methanobrevibacter oralis and one case each of Methanobrevibacter smithii, Methanobrevibacter massiliense and co-infection Methanobrevibacter oralis and Methanobrevibacter massiliense.

Conclusions
In this pilot study, we are reporting here the first characterization of methanogens in the oral cavity in eight patients in Mali. These methanogen species have already been documented in oral specimens collected from individuals in Europe, Asia, North America and Brazil.
How do Lebanese patients perceive the ideal doctor based on the CanMEDS competency framework?
Authors: Aoun Mabel , Sleilaty Ghassan , Abou Jaoude Simon , Chelala Dania , Moussa Ronald 
Published: October 2019

AbstractBackgroundDuring their training, Lebanese medical students develop a high medical expertise but are not focusing on other competencies such as communication, collaboration, erudition, professionalism, leadership and health promotion. There is also insufficient data about patients’ preference for these skills. This study describes the different weights patients attribute to these physician’s competencies.MethodsThis is a cross-sectional study based on a questionnaire distributed to 133 Lebanese patients. It included 15 questions assessing how patients prioritize the physician’s competencies, with open-ended questions asking them to define “the good doctor”. Krippendorff’s alpha coefficient was used to analyze the reliability of the competencies’ classification.ResultsOne hundred twenty five patients completed the questionnaire in this cross-sectional study. Their mean age was 48 ± 16.76 years. When classifying competencies, 73.6% opted for medical expertise as first choice and 48% put communication as second. Based on the Krippendorff’s coefficient, we identified a moderate agreement for the seven choices (alpha = 0.44). In open-ended questions, patients defined the good doctor in 325 answers: 64.3% mentioned medical expertise, 34.1% high ethics and 26.2% communication.ConclusionsThis patient-centered study concurs well with the worldwide practice that puts medical expertise at the center of medical education. However Lebanese patients don’t perceive equally other competencies and favor professionalism and communication that should be integrated in priority in students’ curricula.
Atrial fibrillation classification based on convolutional neural networks
Authors: Lee Kwang-Sig , Jung Sunghoon , Gil Yeongjoon , Son Ho Sung 
Published: October 2019

Abstract

Background
The global age-adjusted mortality rate related to atrial fibrillation (AF) registered a rapid growth in the last four decades, i.e., from 0.8 to 1.6 and 0.9 to 1.7 per 100,000 for men and women during 1990–2010, respectively. In this context, this study uses convolutional neural networks for classifying (diagnosing) AF, employing electrocardiogram data in a general hospital.

Methods
Data came from Anam Hospital in Seoul, Korea, with 20,000 unique patients (10,000 normal sinus rhythm and 10,000 AF). 30 convolutional neural networks were applied and compared for the diagnosis of the normal sinus rhythm vs. AF condition: 6 Alex networks with 5 convolutional layers, 3 fully connected layers and the number of kernels changing from 3 to 256; and 24 residual networks with the number of residuals blocks (or kernels) varying from 8 to 2 (or 64 to 2).

Results
In terms of the accuracy, the best Alex network was one with 24 initial kernels (i.e., kernels in the first layer), 5,268,818 parameters and the training time of 89 s (0.997), while the best residual network was one with 6 residual blocks, 32 initial kernels, 248,418 parameters and the training time of 253 s (0.999). In general, the performance of the residual network improved as the number of its residual blocks (its depth) increased.

Conclusion
For AF diagnosis, the residual network might be a good model with higher accuracy and fewer parameters than its Alex-network counterparts.
Post-stroke pathway analysis and link with one year sequelae in a French cohort of stroke patients: the PAPASePA protocol study
Authors: Broussy S. , Rouanet F. , Lesaine E. , Domecq S. , Kret M. , Maugeais M. , Aly F. , Dehail P. , Bénard A. , Wittwer J. , Salamon R. , Sibon I. , Saillour-Glenisson F. 
Published: October 2019

Abstract

Background
Stroke is a health problem with serious consequences, both in terms of mortality, and after-effects affecting patient quality of life. Stroke requires both urgent and chronic management involving the entire health care system. Although large variability in the management of stroke patients have been noticed, knowledge of the diversity and the scalability of post-stroke pathways, whether it is the care pathway or the life pathway, is currently not sufficient. Moreover the link between post-stroke pathways and patients sequelae have not been yet clearly defined. All this information would be useful to better target the needs to improve stroke patient management.
The purposes are to identify the post-stroke life pathways components associated with sequelae (activity limitations – main purpose, cognitive disorders, anxio-depressive disorders, fatigue, participation restrictions) at 3 months and 1 year post-stroke, to define a typology of life pathways of patients during the post-stroke year and to analyze the social and geographical inequalities in the management of stroke.

Methods
Design: a prospective multicenter comparative cohort study with a follow up to 1 year after the acute episode.
Participant centers: 13 hospitals in the Aquitaine region (France).
Study population: patients diagnosed with a confirmed ischemic or hemorrhagic stroke included in the Aquitaine Observatory of Stroke (ObA2) cohort and voluntary to participate.
Data sources are existing databases (ObA2 database and the French National Health Data System - SNDS) to collect information about care pathways, patient characteristics and stroke characteristics and Ad hoc surveys to collect information about life pathways and post-stroke sequelae. The endpoints of the study are post-stroke activity limitations evaluated by the modified Rankin score, other post-stroke sequelae (Cognitive disorders, anxio-depressive disorders, fatigue, restriction of participation) assessed by standardized and validated scales and Clusters of patients responding to pathways with common or similar characteristics.;

Discussion
By integrating a longitudinal dimension and relying on a large cohort, the project will make it possible to identify the sources of disturbances and the factors favorable to the outcome of the life pathways, important for the planning of the offer and the management of the public policies concerning stroke pathways.

Trial registration
ClinicalTrials.gov ID: NCT03865173, March 6th, 2019.
Cancer treatment and the risk of cancer death among Aboriginal and non-Aboriginal South Australians: analysis of a matched cohort study
Authors:   for the CanDAD Aboriginal Community Reference Group and other CanDAD Investigators, Banham David , Roder David , Eckert Marion , Howard Natasha J. , Canuto Karla , Brown Alex 
Published: October 2019

Abstract

Background
Aboriginal and Torres Strait Islander Australians have poorer cancer outcomes than other Australians. Comparatively little is known of the type and amount of cancer treatment provided to Aboriginal and Torres Strait Islander people and the consequences for cancer survival. This study quantifies the influence of surgical, systemic and radiotherapy treatment on risk of cancer death among matched cohorts of cancer cases and, the comparative exposure of cohorts to these treatments.

Methods
Cancers registered among Aboriginal South Australians in 1990–2010 (N = 777) were matched with randomly selected non-Indigenous cases by sex, birth and diagnostic year, and primary site, then linked to administrative cancer treatment for the period from 2 months before to 13 months after diagnosis. Competing risk regression summarised associations of Indigenous status, geographic remoteness, comorbidities, cancer stage and treatment exposure with risk of cancer death.

Results
Fewer Aboriginal cases had localised disease at diagnosis (37.2% versus 50.2%) and they were less likely to: experience hospitalisation with cancer diagnosis, unadjusted odds ratio (UOR) = 0.76; 95%CI = 0.59–0.98; have surgery UOR = 0.65; 95%CI = 0.53–0.80; systemic therapies UOR = 0.64; 95%CI = 0.52–0.78; or radiotherapy, UOR = 0.76; 95%CI = 0.63–0.94. Localised disease carried lower risk of cancer death compared to advanced cases receiving surgery or systemic therapies, SHR = 0.34; 95%CI = 0.25–0.47 and SHR = 0.35; 95%CI = 0.25–0.48. Advanced disease and no treatment carried higher risk of cancer death, SHR = 1.82; 95%CI = 1.26–2.63.

Conclusion
The effects of treatment did not differ between Aboriginal and non-Indigenous cohorts. However, comparatively less exposure to surgical and systemic treatments among Aboriginal cancer cases further complicated the disadvantages associated with geographic remoteness, advanced stage of disease and co-morbid conditions at diagnosis and add to disparities in cancer death. System level responses to improving access, utilisation and quality of effective treatments are needed to improve survival after cancer diagnosis.
Parents’ experiences of a health dialogue in the child health services: a qualitative study
Authors: Håkansson Linda , Derwig Mariette , Olander Ewy 
Published: October 2019

Abstract

Background
The Child Health Services in Sweden is a well-attended health promoting setting, and thereby has an important role in promoting healthy living habits in families with young children. Due to lack of national recommendations for health dialogues, a Child Centred Health Dialogue (CCHD) model was developed and tested in two Swedish municipalities. The aim of this study was to explore parents’ experiences of health dialogues based on the CCHD model focusing on food and eating habits during the scheduled child health visit at four years of age.

Methods
A qualitative design with purposeful sampling was used. Twelve individual interviews with parents were conducted and analysed with qualitative content analysis.

Results
The analysis resulted in three categories: The health dialogue provides guidance and understanding; Illustrations promote the health dialogue; and Space for children and parents in the health dialogue. In addition, analysis of the latent content resulted in a single theme reflecting the parents’ voice on the importance of having a health dialogue on food and eating habits. The health dialogue, promoted by illustrations, provided guidance and understanding, and gave space for children’s and parents’ involvement.

Conclusions
The results indicate that health dialogues using the CCHD- model create supportive conditions for family members’ active participation in the visits, which may strengthen empowerment and health literacy. The study provides knowledge and guidance for further development, evaluation and implementation of the model.