bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Update to Changing Patterns of Anal Carcinoma in the United States
Authors: Mahal Amandeep R. , Johung Kimberly L. , Mahal Brandon A. , Nguyen Paul L. , Yu James B. 
Published: October 2019

Objectives:
Approximately 8,300 new cases of anal carcinoma will be diagnosed in the United States in 2019. Anal squamous cell carcinoma (SCC) accounts for about 70% of all anal cancers. As cancer prevention and treatments have evolved over time, medical management of human immunodeficiency virus has improved, and sexual behaviors have changed, anal carcinoma incidence rates (IRs) may have also changed.

Methods:
The 9 oldest Surveillance, Epidemiology, and End Results registries were used to identify and determine IR of carcinoma in situ (CIS) and invasive SCC for 9757 patients below 65 years diagnosed with anal SCC/CIS from 1973 to 2014. Joinpoint regression models identified time points at which incidence trends changed.

Results:
The incidence of CIS decreased since 2010 (age-adjusted IR annual percent change [APC]: −5.65, 95% CI: −10.0 to −1.1), especially for men (APC: −8.30, 95% CI: −12.6 to −3.8). In contrast, the incidence of SCC increased since 2007 (APC: 2.59, 95% CI: 0.1-5.2). During 2010-2014, men were more likely to present with CIS (incidence rate ratio [IRR]: 3.234, 95% CI: 3.000-3.489) but less likely to present with localized (IRR: 0.827, 95% CI: 0.754-0.906), regional (IRR: 0.603, 95% CI: 0.537-0.676), and distant SCC (IRR: 0.751, 95% CI: 0.615-0.915) compared with women.

Conclusions:
The previously observed rise in anal SCC/CIS incidence slowed in 2010, largely due to a decline in CIS rates. Patients were more likely to present with CIS than SCC at any stage. Future studies are necessary to determine if this decline in CIS precedes a decline in invasive SCC.
Multimorbidity patterns in people with HIV
Authors: De Francesco Davide , Sabin Caroline A. , Reiss Peter 
Published: October 2019

Purpose of review
With the progressive aging of populations of people with HIV (PWH), multimorbidity is increasing. Multimorbidity patterns, that is groups of comorbidities that are likely to co-occur, may suggest shared causes or common risk factors. We review the literature regarding multimorbidity patterns identified with data-driven approaches and discuss the methodology and potential implications of the findings.

Recent findings
Despite the substantial heterogeneity in the methods used to identify multimorbidity patterns, patterns of mental health problems, cardiovascular diseases, metabolic disorders and musculoskeletal problems are consistently reported in the general population, with patterns of mental health problems, cardiovascular diseases or metabolic disorders commonly reported in PWH. In addition to these, patterns of lifestyle-related comorbidities, such as sexually transmitted diseases, substance use (alcohol, recreational drugs and tobacco smoking) or their complications, seem to occur among PWH.

Summary
Multimorbidity patterns could inform the development of appropriate guidelines for the prevention, monitoring and management of multiple comorbidities in PWH. They can also help to generate new hypotheses on the causes underlying previously known and unknown associations between comorbidities and facilitate the identification of risk factors and biomarkers for specific patterns.
Serum uric acid and fatal myocardial infarction: detection of prognostic cut-off values: The URRAH (Uric Acid Right for Heart Health) study
Authors: Casiglia Edoardo , Tikhonoff Valérie , Virdis Agostino , Masi Stefano , Barbagallo Carlo M. , Bombelli Michele , Bruno Bernardino , Cicero Arrigo F.G. , Cirillo Massimo , Cirillo Pietro , Desideri Giovambattista , D’Elia Lanfranco , Ferri Claudio , Galletti Ferruccio , Gesualdo Loreto , Giannattasio Cristina , Iaccarino Guido , Lippa Luciano , Mallamaci Francesca , Maloberti Alessandro , Mazza Alberto , Muiesan Maria Lorenza , Nazzaro Pietro , Palatini Paolo , Parati Gianfranco , Pontremoli Roberto , Quarti-Trevano Fosca , Rattazzi Marcello , Rivasi Giulia , Salvetti Massimo , Tocci Giuliano , Ungar Andrea , Verdecchia Paolo , Viazzi Francesca , Volpe Massimo , Grassi Guido , Borghi Claudio 
Published: October 2019

Objective:The Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension conceived and designed an ad-hoc study aimed at searching for prognostic cut-off values of serum uric acid (SUA) in predicting fatal myocardial infaction (MI) in women and men.Methods:The URic acid Right for heArt Health study is a nationwide, multicentre, observational cohort study involving data on individuals aged 18–95 years recruited on a regional community basis from all the territory of Italy under the patronage of the Italian Society of Hypertension with a mean follow-up period of 122.3 ± 66.9 months.Results:A total of 23 467 individuals were included in the analysis. Cut-off values of SUA able to discriminate MI status were identified by mean of receiver operating characteristic curves in the whole database (>5.70 mg/dl), in women (>5.26 mg/dl) and in men (>5.49 mg/dl). Multivariate Cox regression analyses adjusted for confounders (age, arterial hypertension, diabetes, chronic kidney disease, smoking habit, ethanol intake, BMI, haematocrit, LDL cholesterol and use of diuretics) identified an independent association between SUA and fatal MI in the whole database (hazard ratio 1.381, 95% confidence intervals, 1.096–1.758,P = 0.006) and in women (hazard ratio 1.514, confidence intervals 1.105–2.075,P < 0.01), but not in men.Conclusion:The results of the current study confirm that SUA is an independent risk factor for fatal MI after adjusting for potential confounding variables, and demonstrate that a prognostic cut-off value associated to fatal MI can be identified at least in women.
Assessment of Surgical Antibiotic Prophylaxis Compliance in Pediatrics: A Pre–post Quasi-experimental Study
Authors: Lombardi Juliana , Nguy Philippe , Robichaud Ducharme Antoine , Thompson-Desormeaux Félix , Ruo Ni , Girard Gabrielle , Schnitzer Mireille E. , Thirion Daniel J. G. , Papenburg Jesse , Longpré Audrey-Anne 
Published: October 2019

Objective:
Data from rigorous evaluations of the impact of interventions on improving surgical antibiotic prophylaxis (SAP) compliance in pediatrics are lacking. Our objective was to assess the impact of a multifaceted intervention on improving pediatric SAP compliance in a hospital without an ongoing antimicrobial stewardship program.

Study Design:
A multidisciplinary team at the Montreal Children’s Hospital performed a series of interventions designed to improve pediatric SAP compliance in June 2015. A retrospective, quasi-experimental study was performed to assess SAP compliance before and following the interventions. Our study included patients under 18 years old undergoing surgery between April and September in 2013 (preintervention) and in 2016 (postintervention). A 10-week washout period was included to rigorously assess the persistence of compliance without ongoing interventions. SAP, when indicated, was qualified as noncompliant, partially compliant (adequate agent and timing) or totally compliant (adequate agent, dose, timing, readministration, duration).

Results:
A total of 982 surgical cases requiring SAP were included in our primary analysis. The composite partial and total compliance increased from 51.4% to 55.8% [adjusted odds ratio 1.3; 95% confidence interval: 1.0–1.8; P = 0.06]. Although improvements in correct dose and readministration were significant, there was no significant improvement in correct timing, agent selection or duration.

Conclusion:
Our study demonstrated that overall SAP compliance did not significantly improve following a washout period, illustrating the importance of ongoing surveillance and feedback from an antimicrobial stewardship program. Our strict approach in evaluating the timing criterion may also explain the lack of a significant impact on SAP compliance.
Epidemiology of Respiratory Syncytial Virus–related Hospitalizations and the Influence of Viral Coinfections in Southern Austria in a 7-year Period
Authors: Resch Bernhard , Puchas Claudia , Resch Elisabeth , Urlesberger Berndt 
Published: October 2019

Objective:
The aim of this study was to determine the respiratory syncytial virus (RSV) epidemiology and to analyze the influence of risk factors and coinfections over the last years.

Methods:
Retrospectively all infants, children and adolescents hospitalized due to respiratory disease with positive RSV test [hospitalized for RSV infection (RSV-H)] between January 1, 2009, and December 31, 2015, at a tertiary care center in the southern part of Austria were included for analysis. Patients were all identified by a search via International Classification of Diseases and Related Health Problems, 10th Edition codes, and all medical data were collected from the local electronic databases called openMedocs. RSV tests had to prove true infection case definition.

Results:
During a 7-year study period, 745 infants, children and adolescents exhibited RSV-H. Main diagnosis was bronchiolitis (70%). Nearly half of all cases (44%) were born during the first half of the RSV season (November–January), and seasonal peak of RSV-H was in January. Predominant underlying condition was history of prematurity in 15% followed by neurologic impairment (3.5%) and hemodynamically significant congenital heart disease (2.95%). Age ≤2 months and underlying conditions/morbidities were associated with more severe disease. The majority of cases (96%) had an age below 24 months, and 91% below 12 months. Viral coinfection (most common influenza virus, adenovirus and rhinovirus) was diagnosed in 37 cases (5%) resulting in a more severe course of disease. Main risk factors of coinfection were siblings and crowding. Mortality was 0.27% (2/745). Both children had coinfection with influenza A virus and were multihandicapped (15 and 20 years of age, respectively).

Conclusions:
Prematurity and underlying morbidities play a marked role in RSV-H. Viral coinfections aggravated disease with death in 2 multihandicapped adolescents.
The Shared Subjective Frames of Interdisciplinary Practitioners Involved in Function-Focused Care in a Nursing Home: Q-Methodology
Authors: KIM Mi So , KIM Gyu-Tae , LEE Su Jung , PARK Min Sun , JEONG Eun-hye , CHANG Sung Ok 
Published: October 2019

ABSTRACT

Background
An interdisciplinary team-based approach in nursing homes has been suggested in the literature as a strategy for delaying functional decline in residents. Function-focused care is a philosophy-based approach in which interdisciplinary practitioners assess functional capacity and help older adults to optimize and maintain their remaining abilities.

Purpose
This study explored and described the shared subjective frames of interdisciplinary practitioners as regards function-focused care for nursing home residents.

Methods
Q-methodology was used to analyze the subjectivity of each factor of function-focused care for nursing home residents. Data were collected from August to September 2016. Thirty-four Q-statements were selected and scored by the 30 interdisciplinary practitioners on a 9-point scale with a normal distribution. Data were analyzed using the PQ Method 2.33 program.

Results
The results revealed four factors of function-focused care, including (a) using a wait-and-see approach to encourage self-care, (b) maintaining interactive communications to identify and respond to changes, (c) reinforcing residents' inner and outer strengths for homeostasis, and (d) using a tailored approach based on comparisons between the past and the present. Shared subjectivity may provide an important collaborative framework to identify and solve complex problems related to the functional needs of nursing home residents.

Conclusions
The results of this study elucidate the subjectivities of interdisciplinary practitioners and better enable their provision of effective care in support of the remaining functional abilities of older adults living in nursing homes. The findings may be used as a reference to establish communication methods and shared documentation for interdisciplinary practitioners in nursing homes and construct interdisciplinary function-focused care practice guidelines.
Work Productivity Losses and Associated Risk Factors Among University Employees in the CAMMPUS Wellness Program
Authors: Zhang Wei , Li Kathy H. , Gobis Barbara , Zed Peter J. , Lynd Larry D. 
Published: October 2019

Objective:
The aim of this study was to comprehensively measure work productivity losses of employees enrolled in a pharmacist-led wellness program and assess associated risk factors.

Methods:
The study sample was employees at least 18 years old with a Framingham Risk Score (FRS) at least 10% or 1+ medication-modifiable cardiovascular risk factor (196 participants at baseline and 166 at 12-month endpoint). Total work hour losses (WHL) were measured using the Valuation of Lost Productivity questionnaire. The factors anticipated to be associated with WHL included work habits, FRS, body mass index (BMI), physical activity, and health-related quality of life (HRQoL).

Results:
Sedentary work habits, higher BMI, and lower HRQoL were significantly associated with more WHL for males. Among females, only a lower HRQoL was significantly associated with more WHL.

Conclusions:
Our findings help identify employees at greater risk for WHL and provide insights on how workplace wellness programs can be modified.
Preadmission Exposure to Air Pollution and 90-Day Mortality in Critically ill Patients
Authors: Im Chami , Kim Dong Hyun , Oh Tak Kyu 
Published: October 2019

Objective:
We investigated the association between preadmission exposure to air pollutants and 90-day mortality in critically ill patients.

Methods:
This retrospective cohort study analyzed the medical records of adult patients (more than or equal to 18 years) admitted to the intensive care unit of a tertiary academic hospital from 2015 to 2016.

Results:
Four air pollutants were not significantly associated with 90-day mortality and pulmonary disease-related 90-day mortality (P > 0.05). In patients with preadmission chronic obstructive lung disease (COPD), a 1 ppm increase in ozone (O3) and carbon monoxide (CO) was associated with a 1.04-fold and 5.99-fold increase in pulmonary disease-related 90-day mortality, respectively.

Conclusions:
Preadmission exposure to air pollution was not associated with 90-day mortality in critically ill patients. However, a higher concentration of CO and O3 was associated with an increase in pulmonary disease-related 90-day mortality in patients with preadmission COPD.
Barriers to Weight Management Among Overweight and Obese Firefighters
Authors: Muegge Carolyn M. , Zollinger Terrell W. , Song Yiqing , Wessel Jennifer , Monahan Patrick O. , Moffatt Steven M. 
Published: October 2019

Objective:
To examine barriers to weight management among firefighters.

Methods:
Health risk data collected on 2373 overweight firefighters were used for this cross-sectional study. Barriers to weight management were the dependent variables and demographic characteristics, readiness for change, and health risk factors were the correlates in the multivariate-adjusted logistic models.

Results:
Overweight firefighters who were ready to begin a weight management program were more likely to identify “lack of knowledge about weight management,” “lack of access to exercise opportunities,” and “eating helps me cope with stress” and report a greater number of barriers toward weight management. Older firefighters were less likely to identify or report one or more barriers to weight management.

Conclusion:
Understanding barriers, readiness for change, and age may be useful in planning interventions to help firefighters better manage their weight.
Effectiveness of a Short Education Series to Reduce Anxiety for Health Professions Graduate Students: A Pilot Study
Authors: Shearin Staci M. , Brewer-Mixon Karen 
Published: October 2019

Abstract.
In college and graduate programs across the United States, educators have become aware that the psychological well-being of the current generation of students (often referred to as “Millennials”) needs to be an important area of focus. In 2007, 50.7% of American college students met the clinical criteria for a depressive or anxiety disorder. In the 2010 American College Health Survey, 48% of college and university respondents felt overwhelming anxiety at least once in the preceding year. These data make it clear that there is a need for effective interventions to help students reduce the emotional distress they experience. This pilot study examined the effects of an educational intervention on anxiety in graduate students. The intervention included cognitive behavioral therapy (CBT) and mindfulness training, in addition to education about lifestyle health behaviors and study habits. First year graduate students in the UT Southwestern School of Health Professions were recruited for the pilot study. The study design included 4 educational sessions to provide education/training in CBT, mindfulness, lifestyle, and study habits. Subjects completed outcome measures before and after the intervention including the Depression Anxiety Stress Scale-21 (DASS-21) and a survey about subjects' behaviors in the domains targeted in the study. Results indicated a decrease in student distress in DASS-21 overall and individual subtest scores. The results suggest that a comprehensive intervention was successful in impacting the depression, anxiety, and overall stress levels of the involved students.
Ultrasound Evaluation of Hemidiaphragm Function Following Thoracentesis
Authors: Skaarup Søren H. , Lonni Sara , Quadri Federico , Valsecchi Alberto , Ceruti Paolo , Marchetti Giampietro 
Published: October 2019

Background:
Dyspnea is the major symptom caused by pleural effusion. The pathophysiological pathways leading to dyspnea are poorly understood. Dysfunction of respiratory mechanics may be a factor. We aimed to study the change in diaphragmatic function following thoracentesis.

Methods:
Patients undergoing thoracentesis at a highly specialized pleural center, underwent ultrasound evaluation of hemidiaphragm movement, before and after thoracentesis was performed. The change was compared to the reduction of dyspnea measured at the modified Borg scale.

Results:
Thirty-two patients were included. Dyspnea was reduced from 5.01 [95% confidence interval (CI): 4.12-6.04] to 2.6 (95% CI: 1.87-3.4, P<0.0001). Low hemidiaphragmatic movement before thoracentesis on the side of pleural effusion was improved by 17.4 cm2 (95% CI: 13.04-21.08), equalizing movement to the side without pleural effusion. On average, 1283 mL (SD: 469) fluid was drained. Multiple linear regression analysis showed that prethoracentesis ultrasound evaluation of hemidiaphragmatic function was correlated with successful thoracentesis.

Conclusion:
Hemidiaphragm function is reduced on the side of pleural effusion, and thoracentesis restores function. Improvement in diaphragm movement is related to a reduction in dyspnea.
Machine Learning and Cochlear Implantation—A Structured Review of Opportunities and Challenges
Authors: Crowson Matthew G. , Lin Vincent , Chen Joseph M. , Chan Timothy C. Y. 
Published: October 2019

Objective:
The use of machine learning technology to automate intellectual processes and boost clinical process efficiency in medicine has exploded in the past 5 years. Machine learning excels in automating pattern recognition and in adapting learned representations to new settings. Moreover, machine learning techniques have the advantage of incorporating complexity and are free from many of the limitations of traditional deterministic approaches. Cochlear implants (CI) are a unique fit for machine learning techniques given the need for optimization of signal processing to fit complex environmental scenarios and individual patients’ CI MAPping. However, there are many other opportunities where machine learning may assist in CI beyond signal processing. The objective of this review was to synthesize past applications of machine learning technologies for pediatric and adult CI and describe novel opportunities for research and development.

Data Sources:
The PubMed/MEDLINE, EMBASE, Scopus, and ISI Web of Knowledge databases were mined using a directed search strategy to identify the nexus between CI and artificial intelligence/machine learning literature.

Study Selection:
Non-English language articles, articles without an available abstract or full-text, and nonrelevant articles were manually appraised and excluded. Included articles were evaluated for specific machine learning methodologies, content, and application success.

Data Synthesis:
The database search identified 298 articles. Two hundred fifty-nine articles (86.9%) were excluded based on the available abstract/full-text, language, and relevance. The remaining 39 articles were included in the review analysis. There was a marked increase in year-over-year publications from 2013 to 2018. Applications of machine learning technologies involved speech/signal processing optimization (17; 43.6% of articles), automated evoked potential measurement (6; 15.4%), postoperative performance/efficacy prediction (5; 12.8%), and surgical anatomy location prediction (3; 7.7%), and 2 (5.1%) in each of robotics, electrode placement performance, and biomaterials performance.

Conclusion:
The relationship between CI and artificial intelligence is strengthening with a recent increase in publications reporting successful applications. Considerable effort has been directed toward augmenting signal processing and automating postoperative MAPping using machine learning algorithms. Other promising applications include augmenting CI surgery mechanics and personalized medicine approaches for boosting CI patient performance. Future opportunities include addressing scalability and the research and clinical communities’ acceptance of machine learning algorithms as effective techniques.
Anxiety and depression predict unfavorable survival in acute myeloid leukemia patients
Authors: Ding Ting , Wang Xin , Fu Adan , Xu Liwen , Lin Jing 
Published: October 2019

Abstract
This study aimed to investigate the prevalence/severity of anxiety and depression, and also their correlations with clinical characteristics and survival profiles in acute myeloid leukemia (AML) patients.
In all, 208 AML patients and 200 age and sex-matched healthy controls (HCs) were recruited in this study. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS) in AML patients before initiating therapy and in HCs after being enrolled. Treatment response was assessed, and event-free survival (EFS), and also the overall survival (OS) were calculated.
The HADS-anxiety score (P < .001), anxiety prevalence (P < .001), and anxiety severity (P < .001) were increased in AML patients than those in HCs. The HADS-depression score (P < .001), depression prevalence (P < .001), and also depression severity (P < .001) were higher in AML patients compared with HCs. No correlation of anxiety or depression with clinical characteristics was found in AML patients (all P > .05). Moreover, the anxiety (P = .178) and depression (P = .512) rates were similar between complete remission (CR) patients and non-CR patients. Additionally, the EFS was worse in anxiety patients compared with nonanxiety patients (P = .013). The OS was shorter in anxiety patients compared with nonanxiety patients (P = .015) and was also worse in depression patients compared with nondepression patients (P = .007).
Anxiety and depression are much more frequent and severe in AML patients compared to HCs, and both of them predict unfavorable survival profiles in AML patients.