bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Risk Factors for Postoperative Urinary Retention in Elective Thoracolumbar Spinal Fusion Patients
Authors: Strickland Ashley R. , Usmani M. Farooq , Camacho Jael E. , Sahai Amil , Bruckner Jacob J. , Buraimoh Kendall , Koh Eugene Y. , Gelb Daniel E. , Ludwig Steven C. 
Published: February 2020

Study Design: Retrospective case series. Objectives: Postoperative urinary retention (POUR) represents a common postoperative complication of all elective surgeries. The aim of this study was to identify demographic, comorbid, and surgical factors risk factors for POUR in patients who underwent elective thoracolumbar spine fusion. Methods: Following institutional review board approval, patients who underwent elective primary or revision thoracic and lumbar instrumented spinal fusion in a 2-year period in tertiary and academic institution were reviewed. Sex, age, BMI, preoperative diagnosis, comorbid conditions, benign prostatic hyperplasia, diabetes, primary or revision surgery status, narcotic use, and operative factors were collected and analyzed between patients with and without POUR. Results: Of the 217 patients reviewed, 54 (24.9%) developed POUR. The average age for a patient with POUR was 67 ± 9, as opposed to 59 ± 10 for those without ( P < .0001). Single-level fusions were associated with a 0% incidence of POUR, compared with 54.5% in 6 or more levels. The average hospital stay was increased by 1 day for those who had POUR (5.8 ± 3.3 vs 4.9 ± 3.9 days). There was no significant association with other demographic variables, comorbid conditions, or surgical factors. Conclusions: POUR was a common complication in our patient cohort, with an incidence of 24.9%. Our findings demonstrate that patients who developed POUR are significantly older and have larger constructs. Patients who developed POUR also had longer in-hospital stays. Although our study supports other findings in the spine literature, more prospective data is needed to define diagnostic criteria of POUR as well as its management.
Cytomegalovirus Retinal Necrosis With Occlusive Vasculopathy Secondary to Steroid Immunosuppression for Giant Cell Arteritis
Authors: Zeng Anne , Strauss Ron , Goglin Sarah E. , Gonzales John , Pawar Varun K. , Imes Richard K. , Jung Jesse J. 
Published: February 2020

Purpose: This case report discusses an atypical case of cytomegalovirus (CMV) retinal necrosis with panretinal occlusive vasculopathy in a 77-year-old man who was immunosuppressed following treatment for giant cell arteritis (GCA). Methods: A case report is presented. Results: Clinical examination demonstrated a central retinal artery occlusion and pale disc suspicious for arteritic ischemic optic neuropathy in the right eye. Biopsy-proven GCA prompted treatment with oral prednisone. While on glucocorticoid immunosuppression, the patient suffered vision loss in the left eye from CMV-necrotizing retinitis with occlusive vasculopathy. Treatment controlled the CMV infection but tapering of his steroids resulted in worsening GCA, requiring a steroid-sparing treatment, tocilizumab. Conclusions: Corticosteroid immunosuppression for GCA may lead to immune dysfunction allowing for an atypical occlusive vasculitis with retinal necrosis from CMV. Early identification and treatment are essential to adjust the level of immunosuppression and consider alternate therapies to control the GCA and prevent worsening of this opportunistic infection.
Economic burden of migraine in Singapore
Authors: Ong Jonathan Jia Yuan , Patnaik Devanshi , Chan Yee Cheun , Simon Oliver , Finkelstein Eric A 
Published: February 2020

Objective: Despite the high prevalence and disabling nature of migraine, studies evaluating its economic burden in Singapore remain scant. This study aims to quantify the per capita and aggregate economic cost of episodic migraine (EM; ≤14 monthly headache days) without aura among full-time employees in Singapore. Methods: We administered a cross-sectional online survey to full-time employees in Singapore who met the International Classification of Headache Disorders (third edition, 2018) criteria for EM without aura. Eligible participants were classified by the frequency of monthly migraine days (MMDs): lower end episodic migraine (LEM; ≤3 MMDs) and upper end episodic migraine (UEM; 4–14 MMDs). The survey captured per capita healthcare resource utilization and lost work productivity (absenteeism and presenteeism) for each subgroup. Healthcare costs were obtained by multiplying unit costs by healthcare utilization. Finally, per capita (patient) costs of each subgroup were then imputed and multiplied by prevalence data to quantify the aggregate burden of migraine in Singapore. Results: Of the 606 participants who completed the survey, 81% experienced ≤3 MMDs. Total annual per capita costs were SGD4925 (USD 3620; 95% confidence interval (CI): SGD 4438–5411) and SGD14,476 (USD 10,639; 95% CI: SGD 11,908–17,045) for the LEM and UEM subgroup, respectively. Healthcare costs on average accounted for 17.6% of per capita costs, of which was driven primarily by diagnostic tests (33.6%), followed by consultations (17.1%), medications (16.7%), alternative medications (16.6%) and hospitalizations (14.8%). Lost productivity accounted for 82.4% of costs, chiefly attributable to absenteeism in the LEM group (38.2%), followed by presenteeism in the UEM group (26.0%), absenteeism in the UEM group (18.8%) and presenteeism in the LEM group (17.1%). The total cost to Singapore for EM in 2018 was approximately SGD 1 billion (USD 0.75 billion; SGD 1.00 = USD 0.74). Conclusion: Overall, EM imposes a substantial economic burden on society in Singapore. Total migraine cost per capita is greater in the UEM (4–14 MMDs) as compared to the LEM subgroup. Majority of the overall costs result from missed workdays and lost work productivity. Future research should determine the extent to which optimized migraine treatments could improve productivity, and by extension, mitigate the staggering costs of this disorder.
A multifocal electroretinography study to evaluate risk of developing macular hole in the fellow eye of patients suffering with unilateral macular hole
Authors: Dalan Daleena , Jaisankar Durgasri , Mani Karthiga , Madhu Abinaya , Ratra Dhanashree 
Published: February 2020

Background: Visual outcome of eyes has often been found to be unsatisfactory even after successful closure of a macular hole, owing to factors like persistent metamorphopsia, scotoma, and reduced sensitivity. Therefore, it becomes critical to evaluate and study the probability and risk of developing a macular hole in the fellow eyes of the patient. This study analyzed the multifocal electroretinographic responses to help predict the risk of macular hole development in fellow eyes. Methods: In total 26 fellow eyes, 26 eyes with macular hole, and 50 eyes of 25 controls were enrolled prospectively. The retinal responses from the different rings were compared in the three groups. Optical coherence tomography was done to rule out macular pathology or vitreomacular traction in the fellow eyes. Results: All the fellow eyes under observation showed significantly reduced mean amplitudes of retinal response densities, in all rings as compared with controls (31.45 ± 10.38 versus 48.87 ± 7.55, p = 0.00). Three of the fellow eyes developed a macular hole during the 24 months observation period. The prevalence of fellow eye involvement was 11.5%. Relative risk of developing macular hole in the fellow eye ranged from 25 to 75. Conclusion: All the fellow eyes, including those that did not develop a macular hole, showed significantly reduced responses on multifocal electroretinogram. This indicates that macular hole may not be a focal disease. It may have widespread functional deficit which is bilateral in nature and suggestive of a degenerative or ischemic insult.
Subglottic secretion drainage for preventing ventilator-associated pneumonia: an overview of systematic reviews and an updated meta-analysis
Authors: Pozuelo-Carrascosa Diana P. , Herráiz-Adillo Ángel , Alvarez-Bueno Celia , Añón Jose Manuel , Martínez-Vizcaíno Vicente , Cavero-Redondo Iván 
Published: February 2020

Although several guidelines recommend subglottic secretion drainage as a strategy for prevention of ventilator-associated pneumonia (VAP), its use is not widespread. With the aim to assess the effectiveness of subglottic secretion drainage for preventing VAP and to improve other outcomes such as mortality, duration of mechanical ventilation and length of stay in the intensive care unit (ICU) or hospital, an electronic search of the Cochrane Library, MEDLINE, Web of Science and Embase was undertaken. Nine systematic reviews with meta-analysis (in the overview of reviews) and 20 randomised controlled trials (in the updated meta-analysis) were included.In the overview of reviews, all systematic reviews with meta-analysis included found a positive effect of subglottic secretion drainage in the reduction of incidence of VAP. In the updated meta-analysis, subglottic secretion drainage significantly reduced VAP incidence (risk ratio (RR) 0.56, 95% CI 0.48–0.63; I2=0%, p=0.841) and mortality (RR 0.88, 95% CI 0.80–0.97; I2=0%, p=0.888).This is the first study that has found a decrease of mortality associated with the use of subglottic secretion drainage. In addition, subglottic secretion drainage is an effective measure to reduce VAP incidence, despite not improving the duration of mechanical ventilation and ICU and/or hospital length of stay.
Equilibrium, kinetic and thermodynamic studies on the adsorption of atrazine in soils of the water fluctuation zone in the Three-Gorges Reservoir
Authors: Yu Haiyan , Liu Yongfeng , Shu Xingquan , Fang Han , Sun Xiaojing , Pan Yuwei , Ma Limin 
Published: February 2020

Abstract
Background
Environmental behavior of pesticide in soils is a key current research focus. Studying the adsorption characteristics of pesticides in soils as a parameter for evaluating the risk of groundwater pollution by pesticides is commonly applied in agriculture.

Results
To provide a theoretical basis for environment risk assessment and pollution remediation, the thermodynamics and kinetics of the equilibrium of atrazine adsorption in the Three-Gorges Reservoir area were assessed and analyzed via batch experiments. Results showed that the sorption of atrazine was an exothermic and spontaneous process at temperatures of 298–318 K. Atrazine was more easily adsorbed by soils at concentrations of 0–30 mg L−1, with low-temperature adsorption being more effective than high-temperature adsorption. The adsorption of atrazine to the two assessed soils was well fitted by the Freundlich and Langmuir models. The adsorption kinetics of atrazine in soils were consistent with the quasi-second-order kinetic model and intraparticle diffusion was found not to be the only control step. The monolayer adsorption occurred with non-uniform energy distribution on the soil surface, indicating that the adsorption of atrazine by the two kinds of soil was controlled by internal diffusion surface adsorption and liquid film diffusion, leading to the complexity of its adsorption kinetics. The values of standard free energy $$\Delta rG_{m}^{0}$$ΔrGm0 < 0, indicated that the adsorption of atrazine in soils was spontaneous and dominated by physical adsorption. Changes in standard enthalpy ($$\Delta {\text{r}}H_{m}^{0}$$ΔrHm0) indicated that the adsorption was exothermic.

Conclusions
Atrazine exhibited a weak adsorption capacity in both soils, indicating it is highly mobile in the soil–water environment and can easily cause groundwater pollution. Therefore, much attention should be paid to the environmental behavior of pesticide soil moisture fluctuations, potentially leading to the broad transfer and spread of pollution.
Quantifying photosynthetic performance of phytoplankton based on photosynthesis–irradiance response models
Authors: Yang Xiaolong , Liu Lihua , Yin Zhikai , Wang Xingyu , Wang Shoubing , Ye Zipiao 
Published: February 2020

Abstract
Background
Clarifying the relationship between photosynthesis and irradiance and accurately quantifying photosynthetic performance are of importance to calculate the productivity of phytoplankton, whether in aquatic ecosystems modelling or obtaining more economical production.

Results
The photosynthetic performance of seven phytoplankton species was characterized by four typical photosynthesis–irradiance (P–I) response models. However, the differences were found between the returned values to photosynthetic characteristics by different P–I models. The saturation irradiance (Isat) was distinctly underestimated by model 1, and the maximum net photosynthetic rate (Pnmax) was quite distinct from its measured values, due to the asymptotic function of the model. Models 2 and 3 lost some foundation to photosynthetic mechanisms, that the returned Isat showed significant differences with the measured data. Model 4 for higher plants could reproduce the irradiance response trends of photosynthesis well for all phytoplankton species and obtained close values to the measured data, but the fitting curves exhibited some slight deviations under the low intensity of irradiance. Different phytoplankton species showed differences in photosynthetic productivity and characteristics. Platymonas subcordiformis showed larger intrinsic quantum yield (α) and lower Isat and light compensation point (Ic) than Dunaliella salina or Isochrysis galbana. Microcystis sp., especially M. aeruginosa with the largest Pnmax and α among freshwater phytoplankton strains, exhibited more efficient light use efficiency than two species of green algae.

Conclusions
The present work will be useful both to describe the behavior of different phytoplankton in a quantitative way as well as to evaluate the flexibility and reusability of P–I models. Meanwhile we believe this research could provide important insight into the structure changes of phytoplankton communities in the aquatic ecosystems.
Help-seeking intention and associated factors towards mental illness among residents of Mertule Mariam town, East Gojam Zone, Amhara Region, Ethiopia: a mixed-method study
Authors: Yeshanew Berhanu , Belete Asmare , Necho Mogesie 
Published: February 2020

Abstract
Background
About 76% and 85% of people in low and middle-income countries with severe mental illness did not get management because of fear of expected discrimination. Studying the intention to seek help for mental illness will, therefore, help to know their intended plan for help that would have a vital role to access patients with mental illness. Despite this, literature is limited in the area and community-based studies are scarce in Africa in general and Ethiopia in particular concerning help-seeking intention towards mental illness and its associated factors. Therefore, we assessed the pattern of intention to seek help and associated factors for mental illness among residents of Mertule Mariam town that would fill the gap in evidence and serve as baseline information for public health intervention.

Methods
A community-based cross-sectional study design was conducted from May to June 2017 at Mertule Mariam town. General Help-Seeking Questionnaire (GHQ) was used to assess the intention of help sought. Focus group discussion had also been employed to obtain qualitative data. A multi-stage sampling technique was used to obtain a total sample of 964 participants. Data were fed into Epi Info 7 and analyzed using SPSS version 21. The binary logistic regression method was used and an odds ratio with its 95% confidence interval was computed. Variables in multi-variable logistic regression were considered as an independent predictor of help-seeking intention to mental illness if their P value was less than 0.05.

Result
About 81.5% of respondents had the intent to seek help from healthcare workers. But 44.6% of participants had the intention to seek from traditional healers. Variables that had an association with help-seeking intention were having an idea that mental illness needs treatment (AOR = 3.42, 95% CI 1.1–10.55), age group of 25–34 years (AOR = 1.46, 95% CI 1.02–2.09), mild social support (AOR = 1.85, 95% CI 1.25–2.72), and perceived severity of mental illness.

Conclusion
Community help-seeking intent for mental health problems was still inadequate. So strengthening to deliver information about mental illness through media like radio and television to advance help-seeking intention of the community was mandatory.
Comparison of T-piece and pressure support ventilation as spontaneous breathing trials in critically ill patients: a systematic review and meta-analysis
Authors: Li Yuting , Li Hongxiang , Zhang Dong 
Published: February 2020

Abstract
Background
The effect of alternative spontaneous breathing trial (SBT) techniques on extubation success and other clinically important outcomes is uncertain. A systematic review and meta-analysis was performed to clarify the preferable SBT (T-piece or pressure support ventilation [PSV]).

Methods
We searched the PubMed, Cochrane, and Embase databases for randomized controlled trials (RCTs) from inception to the 31st of July 2019. We included RCTs involving adult patients (> 18 years) who underwent at least two different SBT methods. All authors reported our primary outcome of successful extubation rate and clearly compared PS versus T-piece with clinically relevant secondary outcomes (rate of reintubation, ICU and hospital length of stay, and ICU and hospital mortality). Results were expressed as odds ratio (OR) and mean difference (MD) with accompanying 95% confidence interval (CI).

Results
Ten RCTs including 3165 patients were included. The results of this meta-analysis showed that there was no significant difference in the successful extubation rate between the T-piece group and PS group (odds ratio [OR] = 0.91; 95% CI, 0.78–1.07; P = 0.27; I2 = 79%). In addition, compared with the PS group, the T-piece group showed no significant difference in the rate of reintubation (odds ratio [OR] = 0.99; 95% CI, 0.78–1.26; P = 0.95; I2 = 5%), ICU mortality (odds ratio [OR] = 1.22; 95% CI, 0.83–1.80; P = 0.30; I2 = 0%), hospital mortality (odds ratio [OR] = 1.36; 95% CI, 0.99–1.87; P = 0.06; I2 = 19%), ICU length of stay (mean difference = − 0.10; 95% CI, − 0.59 to 0.39; P = 0.69; I2 = 13%), and hospital length of stay (mean difference = − 0.82;95% CI, − 2.2 to 0.55; P = 0.24; I2 = 0%).

Conclusions
T-piece and PSV as SBTs are considered to have comparable predictive power of successful extubation in critically ill patients. The analysis of secondary outcomes also shows no significant difference in the rate of reintubation, ICU and hospital length of stay, and ICU and hospital mortality between the two groups. Further randomized controlled studies of SBTs are still required.
Application of Marte Meo® counselling with people with behavioural variant frontotemporal dementia and their primary carers (AMEO-FTD) – a non-randomized mixed-method feasibility study
Authors: Berwig Martin , Dinand Claudia , Becker Ursula , Halek Margareta 
Published: February 2020

Abstract
Background
One of the core symptoms of behavioural variant frontotemporal dementia (bvFTD) is the early loss of social cognitive abilities, which has a deteriorating impact on everyday interaction and the quality of dyadic relationships. Marte Meo® (MM) counselling is a video-based intervention that aims to maintain or improve the quality of dyadic relationships. This non-randomized mixed-method study aimed to evaluate the feasibility of the intervention in practice with primary carers of persons with bvFTD as well as the feasibility of a future confirmatory trial.

Methods
A pilot effect study with a quasi-experimental, one-group, pre-post design and double pre-measurement was conducted. Data were collected at three time points (t0, t1 after 2 weeks, and t2 after 6 weeks) using videography and several measurement instruments. Between t1 and t2, each primary carer received five MM counselling sessions. The outcomes included positive and negative affect, behavioural and psychological symptoms in dementia (BPSD), the interpersonal abilities of the person with dementia, the sensitivity and distress of the primary carers due to BPSD, the manageability of BPSD, the personal goal attainment by means of MM counselling, and the quality of the dyadic relationships. The pilot process evaluation focused on the primary carers’ and the interventionist’s perceived benefits and perceptions of the intervention process using questionnaires and interviews.

Results
Five dyads were enrolled. Regarding the feasibility of the intervention, MM counselling seems to be appropriate and useful for the target group. Although the recruitment of persons with reliable bvFTD diagnoses was very time consuming and complex, the intervention was well accepted by the dyads, and regarding goal attainment, all carers benefited as much or even more than they expected. The study also showed that the benefits of MM counselling depend on whether the primary carer has accepted his/her relative’s dementia. Regarding the feasibility of a future confirmatory trial, certain outcomes, particularly positive affect, distress due to BPSD, and the quality of the dyadic relationship, seem to be appropriate for describing possible effects.

Conclusion
Overall, the intervention seems feasible for this target group. A future confirmatory trial should be planned as a multicentre pilot trial with an extension option.

Trial registration
DRKS00014377. Registered retrospectively on April 11, 2018.
Pan-Cancer Landscape Analysis Reveals Recurrent KMT2A-MAML2 Gene Fusion in Aggressive Histologic Subtypes of Thymoma
Authors: Massoth Lucas R. , Hung Yin P. , Dias-Santagata Dora , Onozato Maristela , Shah Nikunj , Severson Eric , Duncan Daniel , Gillespie Brendan J. , Williams Nathan F. , Ross Jeffrey S. , Vergilio Jo-Anne , Harkins Shannon K. , Glomski Krzysztof , Nardi Valentina , Zukerberg Lawrence R. , Hasserjian Robert P. , Louissaint Abner , Williams Erik A. 
Published: February 2020

PURPOSE Thymomas are epithelial neoplasms that represent the most common thymic tumors in adults. These tumors have been shown to harbor a relatively low mutational burden. As a result, there is a lack of genetic alterations that may be used prognostically or targeted therapeutically for this disease. Here, we describe a recurrent gene rearrangement in type B2 + B3 thymomas. PATIENTS AND METHODS A single index case of thymoma was evaluated by an RNA-based solid fusion assay. Separately, tissues from 255,008 unique advanced cancers, including 242 thymomas, were sequenced by hybrid capture–based next-generation DNA sequencing/comprehensive genomic profiling of 186 to 406 genes, including lysine methyltransferase 2A ( KMT2A) rearrangements, and a portion were evaluated for RNA of 265 genes. We characterized molecular and clinicopathologic features of the pertinent fusion-positive patient cases. RESULTS We identified 11 patients with thymomas harboring a gene fusion of KMT2A and mastermind-like transcriptional coactivator 2 ( MAML2). Fusion breakpoints were identified between exon 8, 9, 10, or 11 of KMT2A and exon 2 of MAML2. Fifty-five percent were men, with a median age of 48 years at surgery (range, 29-69 years). Concurrent genomic alterations were infrequent. The 11 thymomas were of B2 or B3 type histology, with 1 case showing foci of thymic carcinoma. The frequency of KMT2A- MAML2 fusion was 4% of all thymomas (10 of 242) and 6% of thymomas of B2 or B3 histology (10 of 169). CONCLUSION KMT2A- MAML2 represents the first recurrent fusion described in type B thymoma. The fusion seems to be specific to type B2 and B3 thymomas, the most aggressive histologic subtypes. The identification of this fusion offers insights into the biology of thymoma and may have clinical relevance for patients with disease refractory to conventional therapeutic modalities.