bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lunar cycle, seasonal variation, and prevalence of emergency urological presentations: correlation or coincidence?—A preliminary report
Authors: Akinpelu Tosin S. , Laher Abdullah E. , Chen Andrew , Adam Ahmed 
Published: April 2021

Abstract

Objective:
The objective of this study was to conduct a pilot study to determine the prevalence and patterns of emergency urological presentations and to evaluate their relationship with the lunar cycle and seasonal variation.

Methods:
Medical records of subjects that presented with urological pathology to the Emergency Department during the 2017 calendar year were retrospectively reviewed. The data extracted included demographic details, date and day of presentation, presenting complaints, investigations, radiological findings, and final diagnosis. Associations between emergent presentations and the lunar phase and seasonal variation were determined.

Results:
A total of 199 subjects were enrolled. The median participant age was 49 (interquartile range 31–64) years with the majority (n = 136, 68.3%) being male. Cystitis (n = 55, 27.6%), prostate cancer (n = 30, 15.1%), benign prostatic hypertrophy (n = 29, 14.6%), and urolithiasis (n = 29, 14.6%) were the most common clinical diagnosis. There were 96 (48.2%) patients who presented during the waxing moon phase, whereas 85 (42.7%) presented during the waning moon phase, 11 (5.6%) presented on the day of full moon, and 7 (3.5%) patients presented on the day of the new moon. Most patients presented during the summer months (n = 61, 30.7%). There was no significant association between the lunar cycle and emergent urological presentations (p = 0.99).

Conclusion:
In this pilot study, there was no significant association between the lunar cycle and emergent urological presentations. However, during the summer months more urology-related emergency presentations to the Emergency Department were observed.
A prospective study of the effect of testosterone escape on preradiotherapy prostate-specific antigen kinetics in prostate cancer patients undergoing neoadjuvant androgen deprivation therapy
Authors: Christie David R.H. , Mitina Natalia , Sharpley Christopher F. 
Published: April 2021

Abstract

Introduction:
Prostate-specific antigen (PSA) kinetic patterns during neoadjuvant androgen deprivation therapy have been shown to predict unfavorable long-term outcomes.

Objective:
To investigate the effect of testosterone escape (TE) on these kinetic patterns, as this had not been previously reported.

Methods:
There were 50 consecutive prostate cancer patients who received 6 months of triptorelin prior to definitive radiotherapy (RT). Testosterone and PSA levels were measured at baseline and every 6 weeks. Clinical factors were tested for their ability to predict for TE and unfavorable PSA kinetic patterns. The effects of TE, at both 1.7 and 0.7 nmol/L levels, were analyzed.

Results:
TE occurred in at least one reading for 14% and 34% of the patients at the 1.7 and 0.7 nmol/L levels, respectively. No baseline factors predicted TE. The median PSA halving time was 25 days and the median pre-RT PSA level was 0.55 ng/mL. The only factor significantly associated with a higher pre-RT PSA level was a higher baseline PSA level. The only factor that significantly predicted a longer PSA halving time was TE at the 1.7 nmol/L level.

Conclusions:
TE and higher baseline PSA levels may adversely affect PSA kinetics and other outcomes for patients undergoing neoadjuvant hormone therapy prior to radiotherapy. Studies investigating the tailoring of neoadjuvant therapy by extending the duration in those patients with a higher baseline PSA level or by the addition of anti-androgens in those demonstrating TE, should be considered.
Bladder preservation versus radical cystectomy in transitional cell carcinoma and squamous cell carcinoma muscle invasive bladder cancer
Authors: Mohamed Dalia O. , Sayed Mona M. , Abdelkawi Islam F. , Elshoieby Mahmoud H. , Khallaf Salah M. , Khallaf Lamia M. , Fouad Doaa M. 
Published: April 2021

Abstract

Background:
Randomizing patients to bladder preservation or radical cystectomy (RC) for the treatment of bladder cancer has not been practical, due to patient and physician preferences. Therefore, continually comparing the 2 treatment modalities is needed, in order to make the proper choice for each patient.

Patients and methods:
The records of T1–4N0M0 bladder cancer patients, who presented to the South Egypt Cancer Institute between 2007 and 2017 and were treated by either bladder preservation or RC were reviewed.

Results:
Out of the 166 included patients, 81 (48.8%) patients were treated by bladder preservation and 85 (51.2%) patients had RC. For the patients treated by bladder preservation and the patients treated by RC, the 5-year overall survival (OS) was 56% and 60% (p = 0.67), the 5-year local recurrence-free survival was 69% and 73% (p = 0.69), and the 5-year disease-free survival was 45% and 53% (p = 0.16), respectively. After propensity matching analysis, the mean 5-year OS was 58% for the bladder preservation patients and 61% for the RC patients (p = 0.51). It is notable that among the bladder preservation group, 8 patients (10%) had squamous cell carcinoma (SCC) pathology and refused RC. Their OS was 56% compared to 53% for the SCC patients treated by RC (p = 0.6).

Conclusion:
Bladder preservation is a safe alternative to cystectomy in transitional cell carcinoma stages T1–4aN0M0, and its use in SCC bladder cancer should be further studied, as it could be feasible to spare them from initial cystectomy.
Activation of the dorsal, but not the ventral, hippocampus relieves neuropathic pain in rodents
Authors: Wei Xuhong , Centeno Maria Virginia , Ren Wenjie , Borruto Anna Maria , Procissi Daniele , Xu Ting , Jabakhanji Rami , Mao Zuchao , Kim Haram , Li Yajing , Yang Yiyuan , Gutruf Philipp , Rogers John A. , Surmeier D. James , Radulovic Jelena , Liu Xianguo , Martina Marco , Apkarian Apkar Vania 
Published: April 2021

Abstract
Accumulating evidence suggests hippocampal impairment under the chronic pain phenotype. However, it is unknown whether neuropathic behaviors are related to dysfunction of the hippocampal circuitry. Here, we enhanced hippocampal activity by pharmacological, optogenetic, and chemogenetic techniques to determine hippocampal influence on neuropathic pain behaviors. We found that excitation of the dorsal (DH), but not the ventral (VH) hippocampus induces analgesia in 2 rodent models of neuropathic pain (SNI and SNL) and in rats and mice. Optogenetic and pharmacological manipulations of DH neurons demonstrated that DH-induced analgesia was mediated by N-Methyl-D-aspartate and μ-opioid receptors. In addition to analgesia, optogenetic stimulation of the DH in SNI mice also resulted in enhanced real-time conditioned place preference for the chamber where the DH was activated, a finding consistent with pain relief. Similar manipulations in the VH were ineffective. Using chemo-functional magnetic resonance imaging (fMRI), where awake resting-state fMRI was combined with viral vector-mediated chemogenetic activation (PSAM/PSEM89s) of DH neurons, we demonstrated changes of functional connectivity between the DH and thalamus and somatosensory regions that tracked the extent of relief from tactile allodynia. Moreover, we examined hippocampal functional connectivity in humans and observe differential reorganization of its anterior and posterior subdivisions between subacute and chronic back pain. Altogether, these results imply that downregulation of the DH circuitry during chronic neuropathic pain aggravates pain-related behaviors. Conversely, activation of the DH reverses pain-related behaviors through local excitatory and opioidergic mechanisms affecting DH functional connectivity. Thus, this study exhibits a novel causal role for the DH but not the VH in controlling neuropathic pain–related behaviors.
A Quality Improvement Project for Monitoring Surgical Patients With Obstructive Sleep Apnea
Authors: Fotino Karen 
Published: April 2021

Introduction
Patients who have obstructive sleep apnea (OSA) are at a higher risk for opioid-induced respiratory depression postoperatively. Many patients who have OSA are not given a diagnosis before undergoing surgery and may not be monitored appropriately afterward.

Purpose
The purpose of this quality improvement project was to increase the number of preoperative patients screened for OSA and improve their postoperative monitoring through a novel OSA protocol order set through the implementation of evidence-based practices.

Methods
Screening for OSA risk is performed preoperatively using the STOP-Bang instrument. High-risk patients, as well as patients with existing OSA, are monitored postoperatively using a bundle of evidence practices to identify early respiratory compromise. If respiratory events occur, a treatment intervention will be triggered.

Outcome
Postintervention chart reviews demonstrated 100% of the qualifying patients had OSA screening completed before surgery. The OSA protocol was ordered in 28 of the 100 charts reviewed. Patient harm may have been avoided through the implementation of the protocol's standing order for continuous positive airway pressure, which was triggered by respiratory events.

Conclusion
It is important to identify these high-risk patients before surgery through preoperative screening. These patients should be monitored closely postoperatively to identify early respiratory compromise.
Pain Quality Among Hospitalized Postcraniotomy Brain Tumor Patients
Authors: Foust Winton Rebecca E. , Draucker Claire B. , Von Ah Diane 
Published: April 2021

Purpose/Aims
The aim of this study was to describe how persons given a diagnosis of a brain tumor who have had a craniotomy describe the quality of their pain after surgery.

Design
A qualitative descriptive design was used.

Methods
Qualitative descriptive methods as described by Sandelowski guided this study. Semistructured interviews were conducted with patients hospitalized on a neurological step-down unit in an urban teaching hospital in the Midwestern United States. Interviews focused on the quality of participants' pain after surgery. Narratives were analyzed using standard content analysis.

Results
Twenty-seven participants were interviewed. Most were White and female. Most underwent a craniotomy using an anterior approach with sedation. Participants described the quality of their pain with 6 different types of descriptors: pain as pressure, pain as tender or sore, pain as stabbing, pain as throbbing, pain as jarring, and pain as itching.

Conclusions
Participants' descriptions of their pain quality after surgery provide a different understanding than do numerical pain ratings. Clinicians should use questions to explore patients' individual pain experiences, seeking to understand the quality of patients' pain and their perceptions.
Lumbar Bracing for Chronic Low Back Pain
Authors: Annaswamy Thiru M. , Cunniff Kegan J. , Kroll Mitchell , Yap Lori , Hasley Matthew , Lin Chung-Kuang , Petrasic Jason 
Published: April 2021

PurposeWe performed this study to evaluate the effect of back bracing to treat patients with chronic low back pain.MethodsThis was a prospective, unblinded, randomized controlled trial of 61 adults with uncomplicated chronic low back pain (>12 wks) and imaging findings of degenerative spondylosis, to assess the effectiveness of a semirigid back brace. All study participants received back school instruction. The treatment group also received a lumbar orthosis and was instructed to wear it as needed for symptom relief. At baseline, 6 wks, 12 wks, and 6 mos after intervention, we collected: Numerical Rating Scale to measure pain intensity, Pain Disability Questionnaire, Patient-Reported Outcome Measurement Information System, and EuroQol 5-Dimension (EQ-5D) to measure patient-reported function and quality of life.ResultsAn interim analysis at the halfway point in enrollment (61 of 120 planned participants) revealed the Pain Disability Questionnaire, Patient-Reported Outcome Measurement Information System, and EQ-5D scores in the treatment group to be worse than in the control group, but no significant group differences in Numerical Rating Scale scores. Outcome differences between groups analyzed over time revealed (effect [P]): Pain Disability Questionnaire = 0.84 (0.04); Patient-Reported Outcome Measurement Information System = 0.78 (0.005); EQ-5D = 0.06 (0.01); and Numerical Rating Scale = 0.02 (0.6). We halted the study because continuation was unlikely to produce significant changes to the results.ConclusionsIn patients with uncomplicated chronic low back pain, a back brace when combined with education and exercise instruction did not provide any pain relief compared with education and exercise instruction alone.To Claim CME CreditsComplete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCMECME ObjectivesUpon completion of this article, the reader should be able to: (1) Describe the effect of lumbar back bracing on pain intensity in patients with chronic low back pain; (2) Discuss the effects of lumbar back bracing on pain-related disability, function, and quality of life in patients with chronic low back pain; and (3) Understand the role of lumbar back bracing in the treatment of patients with chronic low back pain.LevelAdvancedAccreditationThe Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
The Moderating Effects of Genetic Variations on Changes in Physical Activity Level and Cardiorespiratory Fitness in Response to a Life-Style Intervention: A Randomized Controlled Trial
Authors: Lee Harold H. , McGeary John E. , Dunsiger Shira , Baker Laura , Balasubramanyam Ashok , Knowler William C. , Williams David M. 
Published: April 2021

ABSTRACT

Objective
Prior studies identified single nucleotide polymorphisms (SNPs) associated with physical activity (PA) level in a natural environment and intervention study: rs978656-DNAPTP6, rs10887741-PAPSS2, rs7279064-C18orf2, and rs6265-BDNF. Using the four SNPs’ polygenic score (PGS), we examined whether PGS moderates a life-style intervention’s effect on changes in PA level and cardiorespiratory fitness (CRF).

Methods
This is a secondary analysis of Look AHEAD, a multicenter randomized controlled trial designed to test the health benefits of a life-style intervention among 2675 participants with overweight/obesity and type 2 diabetes (ages, 45–76 years). Using linear mixed-effects models, level of PA (Paffenbarger PA questionnaire) and treadmill-assessed CRF were each regressed on four SNPs’ PGS, study time (baseline, year 1, and year 4), intervention arm, and interactions between the three. Models adjusted for age, sex, body mass index, ancestry principal components (population stratification), and study sites, with Bonferroni corrections for multiple testing (α < .005). Effect modification by age was examined.

Results
PGS was not predictive of change in CRF or PA level in response to intervention. In analyses without PGS by intervention by time, the relationships between PGS and PA phenotypes were modified by age (p interaction = .048 for CRF and .058 for PA), such that a 1-unit increase in PGS was associated with 24 kcal · wk−1 more in moderate-intensity PA and 0.004 MET higher CRF only among older groups (age >55 years for CRF, >60 years for PA level).

Conclusions
The effects of the intervention on PA and CRF were not moderated by the four SNPs. Future studies with extended SNP list should confirm the findings on effect modification by age.
Prevalence and Risk Factors for Anxiety and Depression in Patients With COVID-19 in Wuhan, China
Authors: Li Tao , Sun Siwei , Liu Bao , Wang Jing , Zhang Yalan , Gong Cheng , Duan Jun 
Published: April 2021

ABSTRACT

Objective
Infectious diseases can cause psychological changes in patients. This study aimed to evaluate the prevalence and related risk factors for anxiety and depression in patients with COVID-19.

Methods
A cross-sectional study was performed on patients with COVID-19 admitted to the Sino-French New City branch of Wuhan Tongji Hospital from January to February 2020. The Zung Self-Rating Anxiety and Depression Scales were used to evaluate the prevalence of anxiety and depression. Demographic, clinical, and sociological data were also collected. Multivariable logistic regression analysis was used to identify independent risk factors of anxiety and depression in patients with COVID-19.

Results
In the current study, 183 patients were enrolled (mean age = 53 ± 9 years; 41.1% women). The prevalences of anxiety and depression were 56.3% and 39.3%, respectively. Logistic regression analysis revealed that older age, female sex, being divorced or widowed, COVID-19 disease duration, renal disease, and depression were identified as independent risk factors for anxiety in patients with COVID-19. Factors that were associated with depression were female sex, being widowed, COVID-19 disease duration, and anxiety.

Conclusions
This study demonstrates a high prevalence of anxiety and depression in patients with COVID-19 at the peak of the epidemic in Wuhan, China. The identification of demographic, clinical, and social factors may help identify health care professionals to provide psychological care as part of treatment for patients with COVID-19 and other life-threatening infectious diseases.
Evaluation of the Clinical Effectiveness of Shear Wave Elastography in Pediatric Cases With Acute Appendicitis
Authors: Isik İshak Abdurrahman , Ozkan Mehmet Burak 
Published: April 2021

Abstract
To determine sensitivity and specificity of shear wave elastography in pediatric patients diagnosed with acute inflammation of the appendix. Forty-eight patients who were referred for abdominal pain, with 18 volunteers recruited for the evaluation. Alvarado scores were calculated on the patients. The elasticity and stiffness of the inflamed appendix tissues of patients and controls were measured using shear wave elastography. The anterior, posterior, and medial parts of the appendix tissue were measured, calculating the highest elasticity values in kPa. In the end, 32 patients with Alvarado scores between 7 and 9 (group 1) underwent surgery, whereas 3 of them had pathological specimens reporting as normal. Eight of the patients whose Alvarado scores were between 4 and 6 and had inflammatory conditions of the appendix (group 2), plus the control group totaled 16 patients (group 3). The median shear wave value was found to be significantly higher in group 1 (14.7 kPa) than in either group 2 (12.7 kPa) or group 3 (9.3 kPa) (P < 0.01). In the evaluation of the receiver operating characteristic curve, the cutoff value was discovered to be 14.3 kPA (95% CI: 0.753–0.995) in the acute appendicitis group, with a 100% sensitivity and 79.17% specificity. Shear wave elastography examination is not considered an invasive method and is an easily accessible diagnostic tool that can be used to differentiate between inflamed and noninflamed tissue in children. The quantitative measurement for flexibility of the appendix contributes to the diagnosis.
Estimating the strength of selection for new SARS-CoV-2 variants
Authors: van Dorp Christiaan H. , Goldberg Emma E. , Hengartner Nick , Ke Ruian , Romero-Severson Ethan O. 
Published: April 2021

AbstractControlling the SARS-CoV-2 pandemic becomes increasingly challenging as the virus adapts to human hosts through the continual emergence of more transmissible variants. Simply observing that a variant is increasing in frequency is relatively straightforward, but more sophisticated methodology is needed to determine whether a new variant is a global threat and the magnitude of its selective advantage. We present three methods for quantifying the strength of selection for new and emerging variants of SARS-CoV-2 relative to the background of contemporaneous variants. These methods range from a detailed model of dynamics within one country to a broad analysis across all countries, and they include alternative explanations such as migration and drift. We find evidence for strong selection favoring the D614G spike mutation and B.1.1.7 (Alpha), weaker selection favoring B.1.351 (Beta), and no advantage of R.1 after it spreads beyond Japan. Cutting back data to earlier time horizons reveals large uncertainty very soon after emergence, but that estimates of selection stabilize after several weeks. Our results also show substantial heterogeneity among countries, demonstrating the need for a truly global perspective on the molecular epidemiology of SARS-CoV-2.
Hypsugo stubbeisp. nov., a novel cryptic bat species of the genusHypsugo(Vespertilionidae, Chiroptera, Mammalia) from Mongolia. Results of the Mongolian-German Biological Expeditions Since 1962, No. 347.
Authors: Dolch D. , Stubbe M. , Batsaikhan N. , Stubbe A. , Steinhauser D. 
Published: April 2021

AbstractThe occurrence of two members of the genusHypsugo, namelyH. alaschanicusandH. savii caucasicus, have been reported for Mongolia in the literature. Due to various taxonomic reassignments within and between genera, the number of records for the genusHypsugoin Mongolia is quite scarce and sometimes not resolved at species or subspecies level. Despite recognition of the two above-mentioned species, recent reports based on genetic analyses describe only new and further records ofH. alaschanicus. Thus, it exists a large uncertainty regarding the occurrence and distribution ofH. savii caucasicusin Mongolia. Here, our efforts in gaining a deeper understanding towards the occurrence and distribution ofHypsugospecies in Mongolia are described.A combination of genetic and morphological analyses of collected material fromHypsugospecimens revealed the existence of a genetically largely distantHypsugoclade. Therefore, a new and crypticHypsugospecies is proposed which is named after Prof. Dr. Michael Stubbe for his continuous, long-standing and significant contributions into the biological exploration of Mongolia.Hypsugo stubbeisp. nov. differs by at least 8.4 % and 9 % to the closest Western Palearctic distributedH. cf.darwiniiandH. saviias well as at least 11.3 % to the Easter Palearctic (including Mongolia) distributedH. alaschanicusbased on the first 798 nucleotides of the gene encoding the mitochondrial ND1 (subunit one of NADH dehydrogenase). Neither a close proximity species based on the gene encoding the mitochondrial COI (cytochrome oxidase subunit one) could be found in publicly accessible nucleotide databases. While the crypticH. stubbeisp. nov. reveals no obvious cranial and morphological differences, few external characteristics are dissimilar to bothH. alaschanicusandH. savii(caucasicus). Currently,Hypsugo stubbeisp. nov. was found at four different locations in Mongolia. Among the 11 specimens captured, six facilitated a genetic assignment. Based on the current scarce data records, the species seems to occur mainly in the far west of Mongolia inhabiting semi-deserts and steppes up to high mountain areas. An overlapping distribution withH. alaschanicuscannot be excluded based on the limited data currently available.