bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiphase abdomen-pelvis CT in women of childbearing potential (WOCBP)
Authors: Al Naemi Huda , Aly Antar , Kharita Mohamad Hassan , Hilli Shatha Al , Al Obadli Amal , Singh Ramandeep , Rehani Madan M. , Kalra Mannudeep K. 
Published: January 2020

Abstract
To assess justification and radiation doses of abdomen-pelvis CT in women of childbearing potential (WOCBP) scanned in 2 tertiary hospitals in Qatar.
The local ethical committee approved retrospective study of 451 WOCBP (14–55 years) who underwent abdomen-pelvis CT examinations. Patients’ age, clinical indications for ordered CT, scanner types and vendors, number and type of scan phases (non-contrast, arterial, portal venous, and/or delayed phases), and radiation dose descriptors (CT dose index volume - CTDIvol and dose length product- DLP) were recorded. Patients undergoing simultaneous chest-abdomen-pelvis CT were excluded. We classified the clinical indications for all 451 CT into indicated and unindicated based on the ACR Appropriateness Criteria. Information regarding the date of last menstrual period, likelihood of pregnancy, and if available, results of the pregnancy test were recorded. Data were analyzed with descriptive statistics (median and inter-quartile range) and analysis of variance (ANOVA).
None of the patients were pregnant at the time of their scanning. Amongst the 673 phases acquired for multiphase abdomen-pelvis CT in 451 patients, the 47% unindicated phases (315/673) included non-contrast (122/673, 18%), arterial (33/673, 5%), portal venous (125/673, 19%) and delayed (35/673, 5%) phases. The respective median DLP for indicated and unindicated phases were 266 and 758 mGy.cm (P < .0001).
Multiphase abdomen-pelvis CT exams are frequent but seldom justified in WOCBP. They lead to a substantial increase in unindicated radiation dose compared to a single-phase CT.
Effectiveness of Tocilizumab in juvenile patients with refractory Takayasu arteritis
Authors: Asano Tomoyuki , Sato Shuzo , Temmoku Jumpei , Fujita Yuya , Furuya Makiko Yashiro , Matsuoka Naoki , Kobayashi Hiroko , Suzuki Eiji , Watanabe Hiroshi , Migita Kiyoshi 
Published: January 2020

Abstract

Rationale:
Takayasu arteritis (TA) is a systemic large-vessel vasculitis which can be accompanied by the symptoms associated with vascular stenosis.

Patient concerns:
We describe 2 female juveniles with TA who presented with progressive intermittent claudication.

Diagnosis:
Contrast-enhanced computed tomography (CT) revealed the stenosis of femoral arteries and increased levels of C-reactive protein (CRP), and serum amyloid A (SAA) were noted in both patients. According to European league against rheumatism consensus criteria for the diagnosis of TA was confirmed in both patients.

Interventions:
Both patients had shown resistance to glucocorticoids and treated with tocilizumab (TCZ) (subcutaneous injections, 162 mg/week).

Outcomes:
These treatments improved claudication symptoms. Follow-up imaging by enhanced CT revealed restoration of advanced stenosis of the femoral arteries in both patients. They achieved normalization of levels of the acute-phase reactants CRP and SAA. Serum levels of interleukin-6 were increased transiently after TCZ injection, but declined to within normal ranges at 12 weeks.

Lessons:
Juvenile patients with TA presenting with advanced stenosis of the femoral arteries are not rare. The clinical courses of our patients suggested the beneficial effects of TCZ against the progressive vascular stenosis observed in refractory TA.
Study protocol for a pilot randomized controlled trial on a smartphone application-based intervention for subthreshold depression
Authors: Kato Yudai , Kageyama Kaito , Mesaki Takanori , Uchida Hiroyuki , Sejima Yoshiyuki , Marume Risako , Takahashi Kana , Hirao Kazuki 
Published: January 2020

Abstract

Introduction:
Interventions aimed at addressing subthreshold depression (StD) are important to prevent the onset of major depressive disorder. Our video playback application (SPSRS) is designed to reduce depressive symptoms by presenting positive words in videos, shedding new light on the treatment of StD. However, no randomized controlled trial (RCT) has utilized this video playback application for the treatment of individuals with StD. Therefore, a pilot RCT was designed to determine the feasibility of a full-scale trial. We herein present a study protocol for investigating the utility of a video playback application intervention for individuals with StD.

Methods:
This 5-week, single-blind, 2-arm, parallel-group, pilot RCT will determine the effectiveness of the video playback application by comparing individuals who had and had not been exposed to the same. A total of 32 individuals with StD will be randomly assigned to the experimental or control group at a 1:1 ratio. The experimental group will receive a 10-minute intervention containing the video playback application per day, whereas the control group will receive no intervention. The primary outcome will include changes in the Center for Epidemiologic Studies Depression Scale score after the 5-week intervention, while secondary outcomes will include changes in the Kessler Screening Scale for psychological distress and the generalized anxiety disorder 7-item scale score after the 5-week intervention. Statistical analysis using linear mixed models with the restricted maximum likelihood estimation method will then be performed.

Discussion:
This pilot RCT will have been the first to explore the utility of SPSRS application interventions that display positive words in videos for individuals with StD. The results of this pilot trial are expected to help in the design and implementation of a full-scale RCT that investigates the effects of SPSRS applications among individuals with StD.

Trial registration:
ClinicalTrials.gov Identifier: NCT04136041
Cost‐effectiveness Analysis of Feeding Guidelines for Infants Following Intestinal Surgery
Authors: Shores Darla R. , Mogul Douglas , Allen Julia , Delarmente Benjo A. , Padula William 
Published: January 2020

ABSTRACTObjective:The aim of the study was to determine the cost‐effectiveness of postoperative feeding guidelines to reduce complications in infants with intestinal surgery compared to standard feeding practices.Methods:Using outcomes from a cohort study, Markov models from health care and societal perspectives simulated costs per hospitalization among infants fed via guidelines versus standard practice. Short‐term outcomes included intestinal failure–associated liver disease, necrotizing enterocolitis after feeding, sepsis, and mortality. Effectiveness was measured as length of stay. The incremental cost‐effectiveness ratios (ICER) compared cost over length of stay. Univariate and multivariate probabilistic sensitivity analyses with 10,000 Monte Carlo Simulations were performed. A second decision tree model captured the cost per quality‐adjusted life years (QALYs) using utilities associated with long‐term outcomes (liver cirrhosis and transplantation).Results:In the hospital perspective, standard feeding had a cost of $31,258,902 and 8296 hospital days, and the feeding guidelines had a cost of $29,295,553 and 8096 hospital days. The ICER was $−9832 per hospital stay with guideline use. More than 90% of the ICERs were in the dominant quadrant. Results were similar for the societal perspective. Long‐term costs and utilities in the guideline group were $2830 and 0.91, respectively, versus $4030 and 0.90, resulting in an ICER of $−91,756/QALY.Conclusion:In our models, feeding guideline use resulted in cost savings and reduction in hospital stay in the short‐term and cost savings and an increase in QALYs in the long‐term. Using a systematic approach to feed surgical infants appears to reduce costly complications, but further data from a larger cohort are needed.
Do Histological Features of Eosinophilic Esophagitis in Children Correlate With Peripheral Eosinophils?
Authors: Choudhury Shelly , Kozielski Rafal , Hua Jia , Wilding Gregory E. , Baker Susan 
Published: January 2020

ABSTRACTAim:Eosinophilic esophagitis (EoE) is a chronic, relapsing inflammatory disease of the esophagus. We investigate whether peripheral eosinophils can be a good indicator of esophageal eosinophilia and whether they correlate with histological findings, such as basilar hyperplasia, spongiosis, microabscesses, number of lymphocytes, and number of neutrophils.Methods:A retrospective chart review was conducted with EoE patients ages <18 years after obtaining IRB approval. Biopsies obtained from 57 EoE patients were analyzed. Patient demographics, symptoms; complete blood count with differentials obtained at the time of endoscopies or within a month of the procedure, were documented.Results:A significant correlation was observed between peripheral absolute eosinophil count (AEC) and peak esophageal eosinophil count (P value: 0.0009). Subjects with biopsies suggestive of ongoing disease activity or active status had a higher mean of AEC at 577.41 ± 202.60 compared with subjects with inactivity with mean of 305.26 ± 526.67. However, when the subjects were broadly divided with 500 AEC as a cut off (<500 and >500 AEC), it was found that, out of 27 EoE inactive patients, 24 had AEC count less than or equal to 500 and out of 66 EoE active patients, 32 had AEC more than 500.Conclusion:Active EoE status meant a higher mean of AEC compared with inactive status; but AEC was not found to be a sensitive tool for detecting active EoE.
Pathological Narcissism and Symptoms of Major Depressive Disorder Among Psychiatric Outpatients
Authors: Kealy David , Laverdière Olivier , Pincus Aaron L. 
Published: January 2020

Abstract
Research is scarce regarding the mechanisms by which pathological narcissism––consisting of narcissistic grandiosity and vulnerability––is linked with depression. The present study examined whether impaired emotional processing would mediate relations between pathological narcissism domains and depressive symptoms in a sample of 99 psychiatric outpatients. A significant indirect effect was found for narcissistic vulnerability on depressive symptoms, through unprocessed emotion as a mediator. Findings suggest that narcissistic vulnerability contributes to persistent and intrusive negative feelings, which in turn contribute to depressive symptom severity.
Vaginal Bromocriptine Improves Pain, Menstrual Bleeding, and Quality of Life in Women With Adenomyosis: A Pilot Study
Authors: Andersson Johanna K. , Khan Zaraq , Weaver Amy L. , Vaughan Lisa E. , Gemzell-Danielsson Kristina , Stewart Elizabeth A. 
Published: January 2020

(Abstracted from Acta Obstet Gynecol Scand 2019;98:1341–1350)
Animal models suggest that increased uterine prolactin concentration is a risk factor for adenomyosis. Prolactin is produced in the human endometrium, myometrium, and the pituitary gland and acts as a smooth muscle cell mitogen in vitro.
Comparing Radiotherapy to Prostatectomy for High-Risk Prostate Cancer
Authors: Greenberger Benjamin A. , Taylor James M. , Chen Victor E. , Den Robert B. 
Published: January 2020

Abstract
There is currently a lack of level 1 evidence regarding the relative efficacy of radical prostatectomy compared with radiotherapy combined with androgen deprivation therapy for high-risk prostate cancer. There has recently been an improved optimization of treatment, achieving superior biochemical outcomes and cancer-specific mortality through the use of combined modality therapy strategies. Combined modality therapies have also increasingly incorporated brachytherapy boost. Although available observational data must be interpreted with caution because of the effects of potential residual confounding, we present here a narrative review of recent advances in understanding the relative efficacy of the principal combined modality approaches for treating high-risk prostate cancer. As the trend has demonstrated approaching equivalence between well-selected combined modality therapies, an increasing emphasis should be placed on selecting therapy tailored toward a patient's goals regarding quality of life. We present here an outline of efforts to date to understand the implications of treatment on functional outcomes and quality-of-life endpoints.
Brief Report: Recurrence of Anal High-Grade Squamous Intraepithelial Lesions Among Women Living With HIV
Authors: Stier Elizabeth A. , Abbasi Wafaa , Agyemang Amma F. , Valle Álvarez Eduardo Amílkar , Chiao Elizabeth Y. , Deshmukh Ashish A. 
Published: January 2020

Background:
Women living with HIV (WLHIV) have a high risk of developing invasive anal cancer. Anal cancer may be prevented with early detection and treatment of anal histologic high-grade squamous intraepithelial lesions (HSIL). However, there are limited data on the efficacy of anal HSIL treatment in WLHIV.

Study design:
We conducted a retrospective study of WLHIV treated for anal HSIL under high-resolution anoscopy (HRA) guidance from January 1, 2007 to December 31, 2017 with at least one post-treatment visit at an urban tertiary care hospital.

Results:
Forty-five WLHIV women with at least 1 follow-up evaluation after treatment for anal HSIL were identified. The median age was 46 years (range 35–66 years), 63% were African American, 27% were Hispanic/Latino, and 53% were current smokers. The mean absolute CD4+ T-cell count was 516 cells/mm3; 50% and 24% of the cohort had a history of cervical or vulvar HSIL respectively. The cumulative probability of anal HSIL recurrence was 29% at 12 months, 52% at 24 months, and 79% at 36 months post-treatment.

Conclusion:
Most WLHIV treated for anal HSIL recurred within 3 years, suggesting need for continued surveillance after treatment. Our data contribute to the information needed to develop effective anal cancer prevention guidelines in WLHIV.
Diffuse Hepatosplenic 99mTc-Pyrophosphate Activity Caused by Amyloidosis
Authors: Ren Jingyun , Ren Chao , Huo Li , Li Fang , Zhang Shuyang 
Published: January 2020

Abstract
A 46-year-old man underwent 99mTc-pyrophosphate scan to evaluate possible infiltrative myocardiopathy revealed by echocardiography. The images did not show abnormal cardiac activity. However, diffuse abnormal activity in the liver and spleen was noted. Pathological examination from the specimen acquired from hepatic biopsy demonstrated amyloidosis, light chain type.
Radioguided Surgery for Meckel Diverticulum
Authors: Medaer Eva , Miserez Marc , De Hertogh Gert , Van Laere Koen , Deroose Christophe M. 
Published: January 2020

Abstract
We present the case of a 13-year-old boy with bleeding complications from a Meckel diverticulum (MD), which was scintigraphically confirmed. A first exploratory laparoscopy was unsuccessful in identifying the diverticulum. A new 99mTc-pertechnetate scintigraphy (including SPECT/CT), 3 years later, suggested the anatomical location and was helpful during the surgical exploration for the MD by radioguided surgery. Radioguidance is helpful in pathologies characterized by small size or variable anatomical location. A MD with ectopic gastric mucosa can be distinguished from the rest of the small bowel based on selective 99mTc-pertechnetate uptake in the gastric mucosa, with limited background activity.
A Modified Procedure for Blepharoplasty: Physiological Structure Reconstruction of Upper Eyelids
Authors: Wang Yuting , Cao Yong , Xie Aiguo 
Published: January 2020

Background:
Double eyelid operation has become the most popular cosmetic procedure in China, while how to make sure the acquired double eyelids the same as congenital ones is still a problem.

Objective:
This study aimed to explore a design and operation procedure to obtain natural and dynamic double eyelids, which are accordant with the congenital double eyelids both in appearance and movement.

Methods:
The authors conducted a retrospective review of 352 patients who underwent our operation from October 2012 to October 2018. The procedures were performed by one senior surgeon. First, design the incision line 7 to 8 mm distance parallel to the ciliary margin. Then, cut down the skin and orbicularis muscle, and dissect the orbicularis myocutaneous flap from the anterior surface of the tarsal plate. Next, expose the orbital septum transversely in the lowest site from lateral to medial direction, and dispose of the fat tissue herniated spontaneously. Subsequently, suture the upper margin of pretarsal orbicularis myocutaneous flap to the levator aponeurosis. Finally, the skin edge of incision was closed interruptedly. The patients were followed up from 6 to 30 months after surgery by 2 surgeons to evaluate the long-term results.

Results:
A total of 352 patients with 704 eyes were operated on and followed up in our study. There were 29 patients (8.2%) that showed slight asymmetry, and 7 eyes (2.0%) showed shallow creases. Besides that, all the creases were symmetry, parallel and natural. Just as congenital double eyelids, when opening eyes there was no sausagelike appearance, and when closing eyes there were no depressed scars.

Conclusions:
By reconstructing the physiological structure of upper eyelids, our double eyelid operation creates dynamic double eyelids, which are accordant with the congenital ones both in appearance and movement.
The Efficacy and Safety of Submandibular Transcatheter Perfusion Anesthesia in Submandibular Gland Surgery
Authors: Lu Ruohuang , Xiao Zhiqiang , Guo Xincheng , Gan Pingping 
Published: January 2020

Abstract
The present study aims to evaluate the feasibility, safety, and effects of the combined use of submandibular transcatheter perfusion with lingual nerve block and subcutaneous infiltration for anesthetic purposes during submandibular gland surgery. A total of 38 patients with benign tumors, who had undergone resection by submandibular gland surgery were randomly divided into 2 groups. Patients in group A were administered with submandibular anesthesia through catheter perfusion, lingual nerve block, and subcutaneous infiltration anesthesia. Patients in the group B were only treated with lingual nerve block and subcutaneous infiltration anesthesia. The submandibular gland surgery was performed within 5 minutes following anesthesia administration, after which the numerical rating scale (NRS) was evaluated before surgery, during skin incision (T
1), during the pulling process of the submandibular gland (T
2), during the removal of the submandibular gland (T
3), and at 2, 6, 12, and 24 hours post-surgery. The dosage of analgesic drugs was also measured after surgery. The findings revealed no significant difference in NRS before surgery, at T
1, 6, 12, and 24 hours after surgery (P > 0.01) while NRS was much lower in group A patients as observed at T
2, T
3, and 2 hours after surgery when compared with group B (P < 0.01). The combined application of submandibular transcatheter perfusion with lingual nerve block and subcutaneous infiltration can be used as an effective anesthetic method during submandibular gland surgery.
Perceptions of Family Physicians About Fall Risk Screening, Fall Risk Assessment, and Referral Practices for Fall Prevention in Malaysia
Authors: Jaafar Mohamad Hasif , Mat Sumaiyah , Mackenzie Lynette , Tan Maw Pin 
Published: January 2020

Purpose:
This study aimed to identify factors that influence the implementation of fall prevention programs from the perspectives of the family physician (FP).

Methods:
A cross-sectional survey was conducted with all 1800 members of the Academy of Family Medicine, Malaysia.

Results:
Sixty (54%) and 75 (67%) FPs did not routinely ask older people about falls and fear of falling, respectively. Seventy-nine FPs (71%) reported being unfamiliar with any guidelines for screening for fall risk.

Conclusion:
Our study revealed major gaps in the delivery of evidence-based fall prevention in practice by Malaysian FPs.
Effect of Textured and Prefabricated Insole Use With Medical or Sports Shoes on Dynamic Postural Control in Elderly People
Authors: Kiaghadi Adele , Bahramizadeh Mahmood , Hadadi Mohammad 
Published: January 2020

Background:
Evidence suggests that orthotic intervention can alter dynamic balance in elderly people. This study compared the effect of textured and prefabricated insoles on dynamic postural control in older adults.

Methods:
Thirty elderly people were tested with prefabricated and textured insoles in combination with medical and sports shoes. Reach distance of participants was measured in anteromedial, medial, and posteromedial directions of the Star Excursion Balance Test.

Results:
Significant footwear-dependent differences were seen in all reach directions. The reach distance was longer for barefoot than for other conditions in the 3 evaluated directions (P < .015).

Conclusions:
The use of prefabricated and textured insoles with 2 different shoes significantly reduced reach distance compared with when barefoot.
The Impact of Direct-acting Antivirals on Overall Mortality and Tumoral Recurrence in Patients With Hepatocellular Carcinoma Listed for Liver Transplantation: An International Multicenter Study
Authors: Gorgen Andre , Galvin Zita , Huang Annsa C. , Vinaixa Carmen , O’Rourke Joanne M. , Francoz Claire , Hansen Bettina E. , Durand François , Elsharkawy Ahmed M. , Shah Tahir , Berenguer Marina , Rubin Angel , Calatayud David , Mehta Neil , Terrault Norah A. , Lilly Les B. , Selzner Nazia , Sapisochin Gonzalo 
Published: January 2020

Background.
There is a lack of data on the use of direct-acting antivirals (DAA) on the risk of death and tumoral recurrence in patients with hepatitis C virus (HCV) and hepatocellular carcinoma (HCC) listed for liver transplantation (LT). We aimed to assess the impact of antiviral treatment on mortality and HCC recurrence patients with HCC-HCV.

Methods.
This was a retrospective multicenter study of patients with HCC-HCV listed for LT from 2005 to 2015. Patients were divided according to the antiviral treatment received after HCC diagnosis: DAA, interferon (IFN), or no antiviral. Intention-to-treat overall survival and HCC recurrence incidence were compared by the Kaplan-Meier method. Multivariable regression analysis was performed to identify risk factors for outcomes.

Results.
A total of 1012 HCV-HCC patients were listed for LT during the study period. The median follow-up was 4.0 (interquartile range = 2.3–6.7) years. Mortality was 5.6 (95% confidence interval [CI], 4.3-7.2), 13.1 (95% CI, 11.0-15.7), and 6.2 (95% CI, 5.4-7.2) deaths per 100 person-year among patients treated with DAA, IFN, and antiviral naïve, respectively (P < 0.001). Of the 875 HCV-HCC transplant recipients, the 5-year recurrence-free survival was 93.4%, 84.8%, 73.9% for the pre-LT DAA, pre-LT IFN, and antiviral naïve groups, respectively (P < 0.001). After multivariable regression, the use of pre-LT DAA was not associated to risk of recurrence (hazard ratio = 0.44 [95% CI, 0.19-1.00]). Post-LT DAA was not related to increased risk of recurrence (hazard ratio = 0.62 [95% CI, 0.33-1.16]).

Conclusions.
In this multicenter intent-to-treat study, DAA therapy was not found to be a risk factor for mortality or HCC recurrence after adjusting for potential confounders.