bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Interplay of Parent and Child Coping Responses in Understanding Child Functioning in the Context of Living With a Parent With or Without Chronic Pain
Authors: Van Lierde Elke , Goubert Liesbet , Lammens Tim , Ben Brahim Lamia , Van den Bussche Eva , Vervoort Tine 
Published: January 2020

Objectives:
Pain disorders tend to run in families, and children of individuals with chronic pain have been found to report lower functioning. Drawing upon a social learning perspective, the current study examined how diverse maternal pain coping responses (ie, pain catastrophizing and distraction) may, via corresponding child pain coping responses, act as a vulnerability or protective factor for child functioning in the context of parental chronic pain (CP).

Methods:
A cross-sectional study was conducted in mothers with CP and their pain-free child (N=100) and mothers without CP and their pain-free child (N=74). Moderated mediation analyses were performed to test whether associations between maternal coping responses and child functioning (ie, somatic symptoms, physical functioning, and psychosocial health) were mediated by corresponding child coping responses and whether these associations were moderated by the presence or absence of maternal CP.

Results:
Maternal pain catastrophizing was indirectly related to more somatic symptoms, lower physical functioning, and lower psychosocial health in their child via child pain catastrophizing. Relationships were moderated by the presence or absence of maternal CP, such that mediated relationships were only found in mothers without CP and their child. No (in)direct relationships between maternal distraction, child distraction, and child functioning were observed.

Discussion:
The current findings demonstrated that child functioning was associated with maternal and child pain catastrophizing, but only in children of mothers without CP. No evidence was found in support of maternal pain coping responses as vulnerability or protective factors in the context of parental CP.
Age Affects Speech Understanding and Multitask Costs
Authors: Devesse Annelies , Wouters Jan , van Wieringen Astrid 
Published: January 2020

Objectives:
We examined the effect of age on speech understanding and multitask costs in the ecologically relevant “Audiovisual True-to-Life Assessment of Auditory Rehabilitation”-paradigm (AVATAR).

Design:
Twenty-nine normal-hearing middle-aged adults completed AVATAR, which combines an auditory-visual speech-in-noise task with three secondary tasks on auditory localization or visual short-term memory in different dual-, triple-, and quadruple-task combinations. Performance decrements on the secondary tasks were considered to reflect the cognitive resources allocated during listening. Self-reported hearing difficulties were administered via a questionnaire. Results were compared with scores of 35 young normal-hearing adults.

Results:
Middle-aged adults performed consistently worse than young adults on speech understanding and, in the triple- and quadruple-task combinations only, on secondary task performance. Furthermore, middle-agers reported higher levels of daily listening concentration and more difficulties with speech understanding.

Conclusions:
This study demonstrated the adverse effect of age on speech-in-noise understanding and the amount of allocated cognitive resources during challenging listening situations realized in AVATAR.
More Than 10-year Follow-up After Laminoplasty and Pedicle Screw Fixation for Cervical Myelopathy Associated With Athetoid Cerebral Palsy
Authors: Demura Satoru , Kato Satoshi , Shinmura Kazuya , Yokogawa Noriaki , Yonezawa Noritaka , Shimizu Takaki , Oku Norihiro , Kitagawa Ryo , Handa Makoto , Annen Ryohei , Murakami Hideki , Kawahara Norio , Tsuchiya Hiroyuki 
Published: January 2020

Study Design.
Retrospective case series.

Objective.
The aim of this study was to investigate the clinical outcomes >10 years following laminoplasty and pedicle screw fixation for cervical myelopathy associated with athetoid cerebral palsy (CP).

Summary of Background Data.
Surgery for cervical myelopathy associated with CP remains a challenge because of perioperative instrumentation failure and adjacent segment problems due to patients’ repetitive involuntary neck movements with deformity of the cervical spine.

Methods.
A single-center series of 14 patients were reviewed. The patients comprised seven women and seven men with a mean age of 52 years at the time of surgery. The mean follow-up period was 12.5 years. The Barthel index (BI), which shows independence in activities of daily life, and Japanese Orthopaedic Association (JOA) score were assessed. Radiographic evaluation included changes of the C2–C7 angle in the sagittal plane, fusion rate, adjacent segment degeneration, and instrument failure.

Results.
The 10-year BI and JOA score significantly improved at 36% and 31%, respectively. The preoperative Cobb angle of the sagittal plane from C2–C7 measured 11.9° of kyphosis, which improved to 0.8° of lordosis. In the radiographic analysis, 35% (proximal) and 21% (distal) of the adjacent segment showed progression in degeneration of more than one grade after 10 years. More than 90% of the patients who underwent magnetic resonance imaging showed progressive disc degeneration on either side after 10 years. Autofusion inside the disc or anterior vertebral bony bridging was observed in 86% of intervertebral levels without anterior procedures.

Conclusion.
The procedure showed favorable initial stability and maintained favorable clinical outcomes in patients with CP. More than 90% of the patients showed disc degeneration on either side. The rate of proximal adjacent segment degeneration was higher than that of distal segments with or without symptoms at the >10-year follow-up.

Level of Evidence: 4
Role of serum cystatin C in the prediction of contrast-induced nephropathy after intra-arterial interventions
Authors: Wang Zheng-Yu , Wang Yong-Li , Wei Jian , Jin Long , Wang Zhen-Chang 
Published: January 2020

Abstract

Background
The diagnosis of contrast-induced nephropathy (CIN) is usually based on changes in serum creatinine (sCr). However, sCr has poor sensitivity as a biomarker of kidney injury. The aim of this study was to investigate the usefulness of serum cystatin C (sCysC) to predict CIN after intra-arterial interventions.

Methods
A total of 360 consecutive patients underwent intra-arterial procedures using digital subtraction angiography. SCr, sCysC, and estimated glomerular filtration rate were measured at 1 to 2 days before and at 48, 72 h, and 7 days after the procedure.

Results
Thirty-one patients (8.61%) developed CIN. Receiver operating characteristic (ROC) curve analysis showed that pre-operative sCysC levels had good discriminatory power (area under the curve [AUC] = 0.634; 95% confidence interval [CI] = 0.526–0.743) for evaluating the risk of CIN after an endovascular procedure, with a sensitivity of 53.33% and specificity of 73.70%. ROC analysis showed that sCysC at 48 h after contrast medium administration was predictive of CIN after an endovascular procedure (AUC = 0.735; 95% CI = 0.647–0.822) with satisfactory sensitivity of 74.20% and specificity of 63.90%. Diabetes mellitus was an independent risk factor for CIN (odds ratio = 2.778; 95% CI = 1.045–7.382; P = 0.040).

Conclusions
SCysC is an appropriate biomarker to predict the occurrence of CIN. Baseline sCysC before an intervention is useful to obtain a preliminary estimate of the risk of CIN. A 48-h cut-off value of sCysC of 0.99 mg/L after an endovascular procedure may help to rule out patients at lower risk of CIN.
Effectiveness and safety of different doses of pioglitazone in psoriasis: a meta-analysis of randomized controlled trials
Authors: Zhang Jing-Zhan , Ding Yuan , Xiang Fang , Yu Shi-Rong , Zhang De-Zhi , Guan Meng-Meng , Kang Xiao-Jing 
Published: January 2020

Abstract

Background:
Pioglitazone may be beneficial in the treatment of psoriasis. However, based on the effectiveness and safety considerations, it has not been widely used. To fully evaluate the strength of evidence supporting psoriasis treatment with pioglitazone, we conducted a meta-analysis of existing published studies.

Methods:
PubMed, Ovid, Cochrane Library, Google Scholar, and Web of Science databases were systematically searched before February 2019. Randomized controlled trials (RCTs) of pioglitazone administration compared with placebo, administered to patients with psoriasis for at least 10 weeks, and published in English were included. Quality of the included RCTs was identified by the modified Jadad scale. The quality of evidence for each outcome was evaluated using the GRADEpro Guideline Development Tool online software. Primary outcomes were proportion of patients showing psoriasis area and severity index (PASI) score improvement (>75%) and the mean percent change in PASI score from baseline to the end of treatment. Dichotomous data were analyzed using odds ratios (ORs) corresponding to the 95% confidence interval (CI), whereas continuous variables, expressed as mean and standard deviation, were analyzed using the mean differences (MD) with the 95% CI.

Results:
Six RCTs were analyzed. Meta-analysis showed that pioglitazone reduced the PASI scores in patients with psoriasis compared with the control group when administered at 30 mg per day (P < 0.001, MD = –3.82, 95% CI = –5.70, –1.93) and at 15 mg per day (P = 0.04, MD = –3.53, 95% CI = –6.86, –0.20). The PASI-75 of the pioglitazone group was significantly higher than that of the control group at 30 mg per day (P < 0.001, OR = 8.30, 95% CI = 3.99, 17.27) and at 15 mg per day (P = 0.03, OR = 2.96, 95% CI = 1.08, 8.06). No statistically significant differences in total adverse events were observed between the groups. There were no significant differences in common adverse reactions such as weight gain and elevated liver enzymes between the two pioglitazone groups.

Conclusions:
Use of pioglitazone in the current treatment of psoriasis is beneficial. The therapeutic effect of the daily 30 mg dose may be greater than that of the 15 mg dose per day with no significant change in the frequency of adverse reactions.
Data-science-based subgroup analysis of persistent pain during 3 years after breast cancer surgery
Authors: Lötsch Jörn , Ultsch Alfred , Kalso Eija 
Published: January 2020

BACKGROUND
Persistent pain extending beyond 6 months after breast cancer surgery when adjuvant therapies have ended is a recognised phenomenon. The evolution of postsurgery pain is therefore of interest for future patient management in terms of possible prognoses for distinct groups of patients to enable better patient information.

OBJECTIVE(S)
An analysis aimed to identify subgroups of patients who share similar time courses of postoperative persistent pain.

DESIGN
Prospective cohort study.

SETTING
Helsinki University Hospital, Finland, between 2006 and 2010.

PATIENTS
A total of 763 women treated for breast cancer at the Helsinki University Hospital.

INTERVENTIONS
Employing a data science approach in a nonredundant reanalysis of data published previously, pain ratings acquired at 6, 12, 24 and 36 months after breast cancer surgery, were analysed for a group structure of the temporal courses of pain. Unsupervised automated evolutionary (genetic) algorithms were used for patient cluster detection in the pain ratings and for Gaussian mixture modelling of the slopes of the linear relationship between pain ratings and acquisition times.

MAIN OUTCOME MEASURES
Clusters or groups of patients sharing patterns in the time courses of pain between 6 and 36 months after breast cancer surgery.

RESULTS
Three groups of patients with distinct time courses of pain were identified as the best solutions for both clustering of the pain ratings and multimodal modelling of the slopes of their temporal trends. In two clusters/groups, pain decreased or remained stable and the two approaches suggested/identified similar subgroups representing 80/763 and 86/763 of the patients, respectively, in whom rather high pain levels tended to further increase over time.

CONCLUSION
In the majority of patients, pain after breast cancer surgery decreased rapidly and disappeared or the intensity decreased over 3 years. However, in about a tenth of patients, moderate-to-severe pain tended to increase during the 3-year follow-up.
Frailty predicts 30-day mortality in intensive care patients
Authors: De Geer Lina , Fredrikson Mats , Tibblin Anna O. 
Published: January 2020

BACKGROUND
Frailty is a multidimensional syndrome characterised by a loss of reserve and an increased risk of adverse outcomes.

OBJECTIVE
To study the impact of frailty on mortality in unselected intensive care patients, and to compare its discriminatory ability to an established model for outcome prediction in intensive care.

DESIGN
A prospective study with a comparison of two prediction models.

SETTING
A tertiary mixed ICU, from January 2017 to June 2018.

PATIENTS AND MAIN OUTCOME MEASURES
Data on premorbid frailty (clinical frailty scale; CFS), severity of illness (the simplified acute physiology score, third version; SAPS3), therapeutic procedures, limitations of care and outcome were collected in 872 adult ICU patients. A cut-off level of CFS for predicting death within 30 days was identified and unadjusted and adjusted analyses were used to evaluate the association of frailty to outcome.

RESULTS
The receiver operating curve, area under the curve of CFS [0.74 (95% confidence interval, 0.69 to 0.79)] did not differ significantly from that of SAPS3 [0.79 (0.75 to 0.83), P = 0.53], whereas combining the two resulted in an improved discriminatory ability [area under the curve = 0.82 (0.79 to 0.86), CFS + SAPS3 vs. SAPS3 alone, P = 0.02]. The correlation of CFS to SAPS3 was moderate (r = 0.4). A cut-off level was identified at CFS at least 5, defining 43% (n=375) of the patients as frail. Frail patients were older with higher SAPS3 and more comorbidities. Treatment in the ICU was more often withheld or withdrawn in frail patients, and mortality was higher. After adjustment for SAPS3, comorbidities, limitations of treatment, age and sex, frailty remained a strong predictor of death within 30 days [hazard ratio 2.12 (95% confidence interval, 1.44 to 3.14), P < 0.001].

CONCLUSION
Premorbid frailty was common in general ICU patients and was an independent predictor of death. Our study suggests that frailty could be a valuable addition in outcome prediction in intensive care.
What Are the Predictors for Achieving Therapeutic Levetiracetam Serum Concentrations in Adult Neurological Patients?
Authors: Cotta Menino O. , Abdul-Aziz Mohd H. , Frey Otto R. , Sime Fekade B. , Roberts Jason A. , Roehr Anka C. 
Published: January 2020

Background:
Emerging studies suggest that levetiracetam pharmacokinetics can be difficult to predict in certain special patient populations, including the elderly, critically ill patients, and pregnant women.

Objective:
To determine clinical characteristics that predict the attainment of target serum concentrations in a heterogeneous group of patients prescribed levetiracetam.

Methods:
A retrospective observational study was conducted in adult neurological patients prescribed levetiracetam for the treatment or prophylaxis of seizures. Serum samples were collected after steady-state was reached, with a trough/steady-state serum concentration between 6 and 20 mg/L considered therapeutic. Logistic regression was used to identify significant predictors associated with the attainment of therapeutic concentrations.

Results:
One-hundred thirty patients (63 male) were included. The median (interquartile ranges) serum trough/steady-state concentration (Cmin/ss) was 16.2 (9.8–26.1) mg/L. The dose-normalized median (interquartile range) Cmin/ss was 11.5 (7.0–16.5) mg/L. The coefficient of variation of Cmin/ss and dose-normalized Cmin/ss were 69.4% and 64.2%, respectively. A weak correlation was observed between levetiracetam Cmin/ss and patient age (r = 0.21; P = 0.020), creatinine clearance (r = −0.26; P = 0.004), and daily dose (r = 0.42; P < 0.001). Logistic regression analysis identified age and daily levetiracetam dose as significant factors predicting target Cmin/ss attainment. The influence of concomitant antiepileptic therapy was not determined.

Conclusions:
Age and daily dose were the most significant predictors of levetiracetam target-concentration attainment and should be considered in further investigations to develop a dosing algorithm for optimal levetiracetam therapy.
Role of Axial Split Osteotomy of Free Fibula Flap in Mandibular Reconstruction and Dental Rehabilitation
Authors: Bolzoni Alessandro Remigio , Baj Alessandro , Sweed Ahmed Hassan , Giannì Aldo Bruno , Montrasio Edoardo Francesco , Beltramini Giada Anna 
Published: January 2020

Summary:
The fibula free flap (FFF) is regarded as the gold standard in mandibular reconstruction. Dental rehabilitation is important to improve the health-related quality of life of patients undergoing mandibular reconstruction. FFF provides adequate cortical bone osseous tissue for use in dental implantation. The application of “axial split osteotomy” via a double-barrel fibula graft may enable discrepancies between the native mandible and FFF to be avoided, thereby improving the likelihood of early and successful dental rehabilitation.
Gene expression and growth factor analysis in early nerve regeneration following segmental nerve defect reconstruction with a mesenchymal stromal cell-enhanced decellularized nerve allograft
Authors: Rbia Nadia , Bulstra Liselotte F. , Friedrich Patricia F. , Bishop Allen T. , Nijhuis Tim H.J. , Shin Alexander Y. 
Published: January 2020

Background:
The purpose of this study was to evaluate the molecular mechanisms underlying nerve repair by a decellularized nerve allograft seeded with adipose-derived mesenchymal stromal cells (MSCs) and compare it to the unseeded allograft and autograft nerve.

Methods:
Undifferentiated MSCs were seeded onto decellularized nerve allografts and used to reconstruct a 10 mm gap in a rat sciatic nerve model. Gene expression profiles of genes essential for nerve regeneration and immunohistochemical staining (IHC) for PGP9.5, NGF, RECA-1, and S100 were obtained 2 weeks postoperatively.

Results:
Semi-quantitative RT-PCR analysis showed that the angiogenic molecule VEGFA was significantly increased in seeded allografts, and transcription factor SOX2 was downregulated in seeded allografts. Seeded grafts showed a significant increase in immunohistochemical markers NGF and RECA-1, when compared with unseeded allografts.

Conclusions:
MSCs contributed to the secretion of trophic factors. A beneficial effect of the MSCs on angiogenesis was found when compared with the unseeded nerve allograft, but implanted MSCs did not show evidence of differentiation into Schwann cell-like cells.
The effects of antihypertensive class on gout in older adults: secondary analysis of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial
Authors: Juraschek Stephen P. , Simpson Lara M. , Davis Barry R. , Shmerling Robert H. , Beach Jennifer L. , Ishak Anthony , Mukamal Kenneth J. 
Published: January 2020

Objectives:
Gout is a common complication of blood pressure management and a frequently cited cause of medication nonadherence. Little trial evidence exists to inform antihypertensive selection with regard to gout risk.

Methods:
The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) was a randomized clinical trial on the effects of first-step hypertension therapy with amlodipine, chlorthalidone, or lisinopril on fatal coronary heart disease or nonfatal myocardial infarction (1994–2002). Trial participants were linked to CMS and VA gout claims (ICD9 274.XX). We determined the effect of drug assignment on gout with Cox regression models. We also determined the adjusted association of self-reported atenolol use (ascertained at the 1-month visit for indications other than hypertension) with gout.

Results:
Claims were linked to 23 964 participants (mean age 69.8 ± 6.8 years, 45% women, 31% black). Atenolol use was reported by 928 participants at the 1-month visit. Over a mean follow-up of 4.9 years, we documented 597 gout claims. Amlodipine reduced the risk of gout by 37% (hazard ratio 0.63; 95% CI 0.51--0.78) compared with chlorthalidone and by 26% (hazard ratio 0.74; 95% CI 0.58--0.94) compared with lisinopril. Lisinopril nonsignificantly lowered gout risk compared with chlorthalidone (hazard ratio 0.85; 95% CI 0.70--1.03). Atenolol use was not associated with gout risk (adjusted hazard ratio 1.18; 95% CI 0.78--1.80). Gout risk reduction was primarily observed after 1 year of follow-up.

Conclusion:
Amlodipine lowered long-term gout risk compared with lisinopril or chlorthalidone. This finding may be useful in cases where gout risk is a principal concern among patients being treated for hypertension.

This trial is registered at clinicaltrials.gov, number: NCT00000542.
Eckardt Forceps Tip Widening for the Removal of Posterior Intraocular Foreign Bodies Bigger Than 1 mm
Authors: Vastarella Paola , Bratu Adriana , Sinisi Fabrizio 
Published: January 2020

Purpose:
To propose a new technique with an “old” tool to allow for better intraocular foreign body (IOFB) grasping and manipulation during mininvasive vitreoretinal surgery.

Methods:
The authors report herein their technique on seven eyes, diagnosed with posterior IOFBs, in which the surgery consisted of a 23-gauge vitrectomy, using, for IOFB grasping, a Grieshaber DSP 23-gauge Eckardt forceps, properly modified intraoperatively. Such result was achieved by enlarging the forceps opening bite, according to the IOFB size.

Results:
In all patients, IOFBs were removed using the modified 23-gauge Grieshaber Eckardt forceps. In 6 cases, a combined phacovitrectomy was performed, and the IOFB expressed through the corneal phacoincision; in one phakic patient, the removal was performed through the sclerotomy, extended just as needed.

Conclusion:
The Grieshaber Eckardt forceps commonly used in MIVS can be used in IOFB surgery for a scleral or corneal removal. In case of IOFB bigger than 1 mm, enlarging the forceps bite according the IOFB size provides a firm and safe grip, allowing the surgeon to complete the surgery without switching to bigger and more traumatic instrumentation, reducing collateral damage and shortening the surgery time.