bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency presentation of new onset versus recurrent undiagnosed seizures: A retrospective review
Authors: Holper Sarah , Foster Emma , Chen Zhibin , Kwan Patrick 
Published: December 2019

AbstractObjectivesTo identify clinical factors that may assist emergency physicians to delineate between patients with new onset seizures (NOS) versus patients with recurrent undiagnosed seizures (RUS) among those presenting with apparent ‘first seizures’ to EDs. In addition, to provide a summary of current evidence‐based guidelines regarding the workup of seizure presentations to ED.MethodsThis retrospective cohort study included patients aged over 17 years who presented to a tertiary hospital ED between 1 January 2008 and 30 November 2016 with seizure‐related ICD‐10‐AM discharge codes. Exclusion criteria included pre‐existing epilepsy and non‐seizure diagnoses. Medical records were reviewed and relevant data extracted.ResultsSeventy‐five patients had NOS (54.7% [41/75] female, median age 71 years) and 22 patients had RUS (59.1% [13/22] female, median age 64 years). Non‐motor index seizures were more than four times as common among RUS patients (27.3% [6/22] RUS vs 6.7% [5/75] NOS; P = 0.015). 95.5% (21/22) of RUS patients met epilepsy diagnostic criteria compared to 44.0% (33/75) of NOS patients (P < 0.001). No differences in patient demographics, seizure aetiology or seizure risk factors were identified.ConclusionsEmergency physicians should be wary of patients presenting with non‐motor ‘first seizures’: they are more likely to have experienced prior seizures (the ‘recurrent untreated seizure’ group), and thus meet epilepsy diagnostic criteria. Almost half of those with actual NOS may also meet epilepsy criteria, largely driven by abnormal neuroimaging. Distinguishing RUS from NOS patients in the ED allows accurate prognostication and timely initiation of appropriate therapy.
Gastric duplication cyst fistulized with the colon in an adult: A case report
Authors: Berri Toufik , Mazouzi Slimane 
Published: December 2019

AbstractGastric duplication cyst is uncommon congenital malformation rarely seen in the adult population. Although complications related to duplication such as infection, haemorrhage, obstruction, and fistula formation with neighbouring structures had been previously reported, fistulization into the colon in adult has been previously never described to our knowledge. In this study, we present the case of a 36‐year‐old male patient with moderate mental retardation who presented with 10 months history of progressive abdominal pain, nausea, vomiting, and important weight loss. Clinical assessment and radiological investigations demonstrated the presence of non‐communicating gastric duplication cyst inserted on the greater curvature of the antrum and fistulized into the transverse colon. At laparotomy, the cyst was completely excised and the colon containing the fistula was resected with colo‐colonic anastomosis. Pathology confirmed gastric duplication and demonstrated that the inner surface of the cyst was lined by gastric type mucosa. The patient had an uneventful recovery and after 3 months of follow‐up, all symptoms disappeared. Also, he gained 11 kg in weight. This case highlights, therefore, the fact that all gastric duplication cysts should be removed in order to avoid the risk of serious complications.
Comparison of the circulatory effects of continuous renal replacement therapy using AN69ST and polysulfone membranes in septic shock patients: A retrospective observational study
Authors: Shibata Mami , Miyamoto Kyohei , Kato Seiya 
Published: December 2019

AbstractThe acrylonitrile‐co‐methallyl sulfonate surface‐treated (AN69ST) membrane is expected to improve hemodynamics in patients with sepsis through cytokine adsorption. However, the clinical literature on AN69ST membranes is very limited. We aimed to compare the circulatory effects of continuous renal replacement therapy (CRRT) between patients using the AN69ST membrane and polysulfone (PS) membrane (a nonadsorbing membrane). This retrospective observational study enrolled 38 patients with septic shock, as defined by Sepsis‐3 criteria, who required CRRT from April 2013 to March 2018. Those who died within 24 hours after CRRT initiation and received polymyxin B‐immobilized fiber column direct hemoperfusion, extracorporeal membrane oxygenation, and CRRT using other membranes were excluded. The primary outcome was the vasopressor dependency index during the 12 hours after CRRT initiation, which was calculated as (inotropic score)/(mean arterial pressure). Of 38 patients analyzed, 16 underwent CRRT with an AN69ST membrane and 22 with a PS membrane. The median patient age was 68 years, and the median Acute Physiology and Chronic Health Evaluation (APACHE) II score at intensive care unit admission was 29.5. The vasopressor dependency index decreased significantly during the 12 hours after CRRT initiation in both groups (AN69ST: from 0.50 ± 0.43 to 0.33 ± 0.27 [P < .05], PS: from 0.34 ± 0.30 to 0.21 ± 0.22 [P < .05]). The time course of the vasopressor dependency index during the 12 hours did not differ between the two groups (P = .11). The vasopressor dependency index decreased significantly after CRRT initiation in both groups. The time course of the vasopressor dependency index did not differ between the groups.
Development of a validated Chinese version of the inflammatory bowel disease disability index
Authors: Zhang Jing Jing , Lou Dan Na , Ma Han , Yu Chao Hui , Chen Li Hua , Li You Ming 
Published: December 2019

ObjectiveThe inflammatory bowel disease disability index (IBD‐DI) has been used to evaluate functional status for patients with inflammatory bowel diseases (IBD). The study aimed to develop a reliable Chinese version of IBD‐DI (C‐IBD‐DI).MethodsConsecutive patients with IBD and healthy controls were recruited from June 2016 to July 2017 in the First Affiliated Hospital, College of Medicine, Zhejiang University (Hangzhou, Zhejiang Province, China) to complete an inflammatory bowel disease questionnaire‐32 (IBDQ‐32), Hamilton's anxiety rating scale (HAMA) and Hamilton's depression rating scale‐24 items (HAMD‐24). The validation process included item reduction, reliability and validity tests.ResultsAltogether 122 patients with IBD completed the validation process. Factor analysis reduced the C‐IBD‐DI to 13 items. Cronbach's α coefficient was 0.90. The C‐IBD‐DI scores were correlated with IBDQ‐32 score (r = −0.79, P < 0.001), HAMA (r = 0.78, P < 0.001) and HAMD‐24 (r = 0.81, P < 0.001). The total score of C‐IBD‐DI was significantly higher in patients with active IBD than in those in remission. The intraclass correlation coefficient was 0.83 in the stable IBD group, representing a good test–retest reliability. Those with improved disease activity had a significantly lower C‐IBD‐DI score at the follow‐up visit than at baseline. Patients with IBD had worse disability levels and quality of life than the controls, and were more likely to be anxious and depressed, especially those with active IBD.ConclusionsThe validated C‐IBD‐DI comprising 13 questions has highly acceptable reliability and validity. Multicenter studies including large sample sizes are needed to further confirm our results.
Prognostic value of a new score using serum alkaline phosphatase and pleural effusion lactate dehydrogenase for patients with malignant pleural effusion
Authors: Shi Xin‐Yu , Yi Feng‐Shuang , Wang Zheng , Qiao Xin , Zhai Kan 
Published: December 2019

AbstractBackgroundThe objective of our study was to analyze the prognostic value of the combination of serum ALP and pleural effusion LDH (AL score) for malignant pleural effusion (MPE) patients.MethodsThis study includes retrospective, descriptive and observational research from 1 June 2006 to 1 December 2017, which aimed to identify prognostic factors related to MPE patients. We analyzed the association of various clinical features, routinely tested markers from peripheral blood and MPE at diagnosis and overall survival (OS). All MPE patients were assigned to three groups according to their AL score. The impact of the AL score and other prognostic factors were evaluated with multivariable regression.ResultsAccording to their AL score, 193 patients were assigned to three groups with 25 in group 0 (sALP < 65 U/L and pLDH < 155 U/L), 121 in group 1 (sALP > 65 U/L or pLDH > 155 U/L) and 47 (sALP > 65 U/L and pLDH > 155 U/L) in group 2. For groups 0, 1 and 2, median survival times (MST) were 23, 15 and 7 months, respectively. Among the three groups, MST, serum albumin level, C reactive protein, erythrocyte sedimentation rate, the ratios of platelet‐to‐lymphocyte, neutrophil‐to‐lymphocyte showed significant differences. The counts of neutrophils, monocytes, platelets and AL score (0 vs. 1, P = 0.038, hazard ratio [HR]: 1.858, 95% confidence interval [CI]: [1.034, 3.339]; 0 vs. 2, P = 0.001, HR: 2.993, 95% CI: [1.556, 5.531]) were independent prognostic indicators for OS of MPE patients.ConclusionAL score is a promising indicator which can be used to predict the prognosis of MPE patients. It can assist physicians in the selection of patients for appropriate palliative treatment.Key pointsTo our knowledge, this paper is the first study that combined two enzymes (sALP and pLDH) from serum and pleural effusion and studied the prognostic value for MPE patients. It has been proved to be a promising indicator to assist physicians select patients for appropriate palliative treatment.
Tracheal intubation in patients at risk for cervical spinal cord injury: A systematic review
Authors: Cabrini Luca , Baiardo Redaelli Martina , Filippini Martina , Fominskiy Evgeny , Pasin Laura , Pintaudi Margherita , Plumari Valentina P. , Putzu Alessandro , Votta Carmine D. , Pallanch Ottavia , Ball Lorenzo , Landoni Giovanni , Pelosi Paolo , Zangrillo Alberto 
Published: December 2019

BackgroundTracheal intubation in patients at risk for secondary spinal cord injury is potentially difficult and risky.ObjectivesTo compare tracheal intubation techniques in adult patients at risk for secondary cervical spinal cord injury undergoing surgery. Primary outcome was first‐attempt failure rate. Secondary outcomes were time to successful intubation and procedure complications.DesignSystematic review and meta‐analysis of randomized controlled trials (RCTs) with trial sequential analysis (TSA).Data SourcesDatabases searched up to July 2019.EligibilityRandomized controlled trials comparing different intubation techniques.ResultsWe included 18 trials enrolling 1972 patients. Four studies used the “awake” approach, but no study compared awake versus non‐awake techniques. In remaining 14 RCTs, intubation was performed under general anesthesia. First‐attempt failure rate was similar when comparing direct laryngoscopy or fiberoptic bronchoscopy versus other techniques. A better first‐attempt failure rate was found with videolaryngoscopy and when pooling all the fiberoptic techniques together. All these results appeared not significant at TSA, suggesting inconclusive evidence. Intubating lighted stylet allowed faster intubation. Postoperative neurological complications were 0.34% (no significant difference among techniques). No life‐threatening adverse event was reported; mild local complications were common (19.5%). The certainty of evidence was low to very low mainly due to high imprecision and indirectness.ConclusionsVideolaryngoscopy and fiberoptic‐assisted techniques might be associated with higher first‐attempt failure rate over controls. However, low to very low certainty of evidence does not allow firm conclusions on the best tracheal intubation in patients at risk for cervical spinal cord injury.
Twenty‐four‐hour subjective and pharmacological effects of ad‐libitum electronic and combustible cigarette use among dual users
Authors: Harvanko Arit M. , St Helen Gideon , Nardone Natalie , Addo Newton , Benowitz Neal L. 
Published: December 2019

AbstractBackground and AimsRelative pharmacological effects of e‐cigarettes and cigarettes during 24 hours of ad‐libitum use have not been described. In this study, 24‐hour blood plasma nicotine concentrations and 48‐hour subjective effects with use of cigarettes and e‐cigarettes were measured among dual users.DesignTwo‐arm within‐subject cross‐over design with preferred e‐cigarette or cigarette ad‐libitum use over 48 hours.SettingHospital research ward in San Francisco, California, USA.ParticipantsThirty‐six healthy dual users of e‐cigarettes and cigarettes (n = 8, 25% females).MeasurementsTwenty‐four‐hour blood plasma nicotine and cotinine concentrations and 48‐hour self‐reported nicotine withdrawal symptoms and rewarding effects.FindingsAnalyses used analysis of variance (ANOVA)‐based mixed models with order of product (e‐cigarette or cigarette) and product type (combustible cigarette or type of e‐cigarette) as fixed effects, and subject as a repeated effect. During a 24‐hour period, e‐cigarettes produced lower nicotine exposure than cigarettes for the majority of users, although 25% received more nicotine from e‐cigarettes, which was predicted by more frequent e‐cigarette use or greater dependence. Compared to cigarette smoking, nicotine exposure for variable‐power tank users was similar, while cig‐a‐like (t(30) = 2.71, P = 0.011, d = 0.745) and fixed‐power tank users (t(30) = 3.37, P = 0.002, d = 0.993) were exposed to less nicotine. Cigarettes were rated higher than e‐cigarettes on some desirable subjective effects (e.g. psychological reward, t(322) = 7.24 P < 0.001, d = 0.432), but withdrawal symptom reduction was comparable. No differences were found between e‐cigarette types, but Bayes factors indicate that these measures were insensitive.ConclusionsDuring a 24‐hour period in a hospital setting in the United States, nicotine exposure for dual users of e‐cigarettes and cigarettes was similar when using cigarettes or variable‐power tank devices only but was lower for those using cig‐a‐like or fixed‐power devices only. Despite lower nicotine levels, all types of e‐cigarette were effective in preventing withdrawal symptoms. E‐cigarettes were rated less rewarding than cigarettes.
Effect of alcohol use disorders and alcohol intake on the risk of subsequent depressive symptoms: a systematic review and meta‐analysis of cohort studies
Authors: Li Jiande , Wang Hongxuan , Li Mei , Shen Qingyu , Li Xiangpen , Zhang Yuanpei , Peng Jialing , Rong Xiaoming , Peng Ying 
Published: December 2019

AbstractBackground and AimsAlcohol use disorders (AUD) are often comorbid with depressive symptoms. Cohort studies on the association between AUD and subsequent depressive symptoms have produced inconsistent results. Moreover, regarding alcohol intake, the risk of developing depressive symptoms might vary with alcohol intake level. We aimed to investigate the association between AUD, alcohol intake and subsequent depressive symptoms.Design and SettingWe conducted a systematic search in PubMed, Embase and PsycINFO for cohort studies on the association between AUD or alcohol intake and subsequent depressive symptoms.ParticipantsWe included 338 426 participants from 42 studies. Six and four studies analyzed only females and males, respectively.MeasurementsWe combined risk estimates for developing depressive symptoms using a random‐effects model. We divided alcohol intake into abstinence, light (0–84 g/week), moderate (85–168 g/week) and heavy drinking (> 168 g/week or > 48 g/day at least weekly). We conducted a categorical analysis to compare the risk of depressive symptoms between abstinence and different intake categories. Further, we conducted a dose–response analysis to investigate the alcohol–depression association.FindingsWe analyzed 42 studies (follow‐up time: 1–40 years). AUD was associated with significantly increased risk of subsequent depressive symptoms [relative risk (RR) = 1.57, 95% confidence interval (CI) = 1.41–1.76]. Regarding alcohol intake, heavy drinking had an increased risk of depressive symptoms; however, the association was only significant when controls were limited to non‐heavy drinkers (RR = 1.13, 95% CI = 1.05–1.22). Taking into consideration the possibility of publication bias and confounding factors made the association non‐significant. We observed J‐shaped associations in both categorical and dose–response analyses where light‐moderate drinking had a significantly decreased risk of depression, while heavy drinking did not show a significant association with depressive symptoms compared with non‐drinkers.ConclusionAlcohol use disorders are associated with increased the risk of subsequent depressive symptoms. Heavy drinking does not significantly predict occurrence of depressive symptoms after adjusting for potential confounders.
Trained Identities: Exploring Emergent Identities Aboard One Slow‐Moving Train
Authors: Leggett William H. 
Published: December 2019

SummaryThis article explores processes of identity negotiation through talk and body language among a small community of travelers aboard a cross‐country train. I explore the emergent and contingent nature of narrative as well as the role of body language and silence in the construction of self and other in a space separate from the usual social networks that inform our senses of self. I argue that aboard the train we were able to invent ourselves anew, making of ourselves what we wanted with the understanding that we would never meet again and that our stories could go largely unchecked. At the same time, I note the importance of structural identity markers in our storytelling and place‐making actions.
Forbidden Fieldwork: The Affair as Research Method
Authors: Rice Kathleen 
Published: December 2019

SummaryThis creative nonfiction essay is both a reflection about a complex intimate relationship that developed during doctoral fieldwork and a commentary on what anthropologists are socialized to compartmentalize, silence, and refuse for the sake of academic credibility. Grounded in the author’s personal experience of having an affair in the field, it explains that pursing a course of action that the author was trained and socialized to eschew had the unexpected outcome of advancing the author’s anthropological research.
Comparison of biosynthetic versus synthetic mesh in clean and contaminated ventral hernia repairs
Authors: Keogh Kandice , Slater Kellee 
Published: December 2019

AbstractBackgroundAbdominal hernias are an increasingly common presentation due to obesity, ageing and prevalence of prior abdominal surgery. Mesh repair is the mainstay of treatment; however, mesh selection remains largely subjective. There are little data available to assess the performance of biosynthetic meshes against synthetic meshes across all wound types. This study assessed the 6‐month outcomes of a single surgeon's cohort of ventral hernia repairs performed with either GORE BIO‐A (BioA) or Parietex ProGrip (ProGrip).MethodsRetrospective case cohort study across two centres with patients undergoing repair by a single surgeon (KS) between January 2014 and April 2018 was conducted. All hernia repairs were performed with either BioA (n = 55) or ProGrip mesh (n = 60). Outcomes were monitored for 6 months post repair. Wounds were classified according to the Centre for Disease Control Wound Status. Outcomes measured were length of stay, general complications, wound complications and hernia recurrence.ResultsThe overall complication rate and length of stay were similar for both groups. In clean wounds, the complication rate was equivalent for BioA and ProGrip (34% versus 22%, P = 0.22). There was a significant difference in complication rates in contaminated wounds – BioA 17% versus ProGrip 100% (P = 0.004). BioA performed equivocally in clean and contaminated wounds (34% versus 17%, P = 0.178), whereas ProGrip performed worse in contaminated wounds (22% versus 100%, P = 0.016).ConclusionOur results suggest that BioA is a suitable, if not preferable, choice for contaminated hernia repair. In this cohort, BioA was also demonstrated as safe and equivalent to ProGrip mesh in clean hernia wounds.
Relationship between age, comorbidities and complications in head and neck cancer patients undergoing curative surgery
Authors: Shepherd Sally J. , Creber Nathan , Mansour Kristy , Wiesenfeld David , Iseli Tim A. , Amott Deborah 
Published: December 2019

AbstractBackgroundBoth age and comorbidity are accepted as significant prognostic factors for adverse perioperative outcomes in major surgery. Elderly patients may be overlooked for radical treatment for fear of poor perioperative outcome. We aim to assess the relationship between age, comorbidities and post‐operative outcomes in a tertiary head and neck unit.MethodsA retrospective analysis was undertaken on 651 patients who underwent surgery for head and neck cancer at a tertiary hospital between 2007 and 2014.ResultsA total of 253 (38.9%) patients were aged ≥70 years and 398 (61.1%) patients were ≤69 years. Age alone did not predict prolonged post‐operative stay, perioperative complications nor perioperative mortality. Congestive cardiac failure and/or complicated diabetes were significantly associated with poor outcomes, as was male sex.ConclusionPatients of any age with cardiac failure or complicated diabetes have a higher rate of post‐operative complications in head and neck surgery.
Expression and prognostic utility of SSX2IP in patients with nasopharyngeal carcinoma
Authors: Chang Shih‐Lun , Lee Sung‐Wei , Yang Sheau‐Fang , Chien Chu‐Chun , Chan Ti‐Chun , Chen Tzu‐Ju , Yang Ching‐Chieh , Li Chien‐Feng , Wei Yu‐Ching 
Published: December 2019

Cell adhesion affects carcinogenesis, tumor progression, and metastasis. We datamined a published transcriptome (GSE12452) of nasopharyngeal carcinoma (NPC) and identified SSX2IP as a significantly upregulated gene in NPC carcinogenesis among genes associated with cell adhesion (GO:0007155). Consequently, we assessed SSX2IP protein expression and its prognostic significance in 124 patients with NPC using immunohistochemistry and the H‐score method. The status of SSX2IP immunoexpression correlated with clinical and pathological characteristics, as well as oncological outcomes. High levels of SSX2IP expression were significantly associated with more advanced primary tumor and TNM stages. Kaplan–Meier and log‐rank analyses revealed that high levels of SSX2IP expression, and advanced tumor stage and lymph node metastasis were significantly associated with lower rates of local recurrence‐free survival (LRFS), distant metastasis‐free survival (DMeFS), and disease‐specific (DSS) survival. Multivariate analysis showed that high levels of SSX2IP expression significantly predicted DSS (hazard ratio [HR], 4.290; 95% confidence interval [CI], 2.271–8.102; p < 0.001), DMeFS (HR, 4.159’ 95% CI, 2.072–8.345; p < 0.001), and LRFS (HR, 3.007’ 95% CI,: 1.418–6.378; p = 0.004). We associated high levels of SSX2IP immunoexpression with aggressive pathological features and worse oncological outcomes, suggesting its potential therapeutic value for patients with NPC.