bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful management of the supraclavicular artery island flap combined with a sternohyoid muscle flap for hypopharyngeal and laryngeal reconstruction
Authors: Wang Qinying , Chen Ruixiang , Zhou Shuihong 
Published: October 2019

AbstractThis retrospective study evaluated operative outcomes when using a supraclavicular artery island flap (SAIF) combined with a sternohyoid muscle flap (SHMF) to reconstruct defects after hypopharyngeal carcinoma resection. Reconstructive surgery for hypopharyngeal and laryngeal defects was performed with the SAIF + SHME combination in 6 patients during 2016 to 2018. Within 14 to 16 days after the surgery, all 6 patients could ingest food and block the tube (avoiding aspiration), with no pharyngeal fistulas. They then underwent irradiation up to a total of 60.5 Gy during the 4 weeks postoperatively. All 6 flaps survived, and there were no donor-site complications except minor dehiscence in 1 patient. Thus, the SAIF + SHMF combination can be used to reconstruct hypopharyngeal and laryngeal defects after hemi-laryngectomy in patients with hypopharyngeal carcinoma involving the unilateral larynx. This technique effectively preserved the swallowing function and phonation of the patients, thereby improving their quality of life.
Age-specific reference values for cerebrospinal fluid protein concentrations in children in southern China
Authors: Liu Zhigang , Jia Deqin , Dai Jieming , Zhou Xing , Qin Zhoulian , Chen Liang , Zhang Jieyan , Chen Guohua , He Xiaocheng , Wan Ruipin , Ye Xingguang 
Published: October 2019

Abstract
Cerebrospinal fluid (CSF) protein values decline over the first few months of life as the infant's blood-CSF barrier matures. However, published studies have not reported CSF protein reference values of Chinese infants and differ in the reported rate, timing, and magnitude of this decline. The objective of this study was to determine reference intervals for CSF protein using available data of children in southern China. This retrospective study included infants who had a lumbar puncture (LP) performed in the Department of Pediatrics of Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan of an urban tertiary care children's hospital between January 1, 2008 and May 31, 2018. Infants with conditions suspected or known to cause elevated CSF protein concentrations were excluded. Of 3712 infants undergoing LP, 1043 (28.1%) met inclusion criteria. Results showed that there is an age-related decline in CSF protein concentration. The median CSF protein value was 62 mg/dL [interquartile range (IQR): 47–81 mg/dL] in infants aged 0 to 56 days (group 1). The 95th percentile values were 116 mg/dL for infants 0 to 28 days and 80 mg/dL for infants 29 to 56 days. The 95th percentile values by age category were as follows: ages 0 to 14 days, 117 mg/dL; ages 15 to 28 days, 107 mg/dL; ages 29 to 42 days, 96 mg/dL; and ages 43 to 56 days, 74 mg/dL. The median CSF protein value was 21 mg/dL (IQR: 16–31 mg/dL) in infants aged 2 months to <3 years (group 2). The 95th percentile values were 57 mg/dL for infants 2 to <6 months and 34 mg/dL for infants 6 to ≤24 months. The 95th percentile values by age category were as follows: ages 2 to <3 months, 66 mg/dL; ages 3 to <4 months, 52 mg/dL; ages 4 to <5 months, 53 mg/dL; and ages 5 to <6 months, 42 mg/dL. We quantify the age-related decline in CSF protein concentrations among infants 2 years of age and younger and provide age-specific reference values. The values reported here can be used to interpret the results of LP in infants ≤2 years of age.
Benefit of small dose antidepressants for functional dyspepsia
Authors: Luo Liang , Du Lijun , Shen Jinhua , Cen Mengsha , Dai Ning 
Published: October 2019

Abstract

Background:
Traditional treatment of functional dyspepsia (FD) is unsatisfactory in a subgroup of patients with FD, and the potential role of antidepressant medications also has not been definitely clarified. To provide more evidence for future optimal practice recommendations, we reviewed a 1-year clinical database of antidepressant agents applied in outpatients with FD.

Methods:
Clinical presentations, treatment course, and outcomes were determined by chart review of patients referring to the functional gastrointestinal disorders specialist clinic. One hundred thirty patients with FD were included for further analysis.

Results:
Patients were treated with different antidepressant drugs according to individual symptoms. The most commonly used drugs were flupenthixol melitracen and fluoxetine. Improvement and complete remission occurred in 93.8% and 54.6% of patients, respectively. There was a trend toward superior outcome for citalopram compared to sulpiride and mirtazapine in overall analysis. Meanwhile, regimens containing fluoxetine had significant increased remission rate compared to any other antidepressant regimens in postprandial distress syndrome subgroup analysis. Furthermore, older patients were more likely to achieve remission. However, sex and symptom duration were not associated with symptom remission. Finally, 11.5% of patients experienced adverse events.

Conclusions:
This retrospective cohort study indicated that small dose antidepressant therapy, especially citalopram and fluoxetine, is an effective and well tolerated treatment option for refractory FD.
Choropleth map legend design for visualizing the most influential areas in article citation disparities
Authors: Chien Tsair-Wei , Wang Hsien-Yi , Hsu Chen-Fang , Kuo Shu-Chun 
Published: October 2019

Abstract

Background:
Disparities in health outcomes across countries/areas are a central concern in public health and epidemiology. However, few authors have discussed legends that can be complemental to choropleth maps (CMs) and merely linked differences in outcomes to other factors like density in areas. Thus, whether health outcome rates on CMs showing the geographical distribution can be applied to publication citations in bibliometric analyses requires further study. The legends for visualizing the most influential areas in article citation disparities should have sophisticated designs. This paper illustrates the use of cumulative frequency (CF) map legends along with Lorenz curves and Gini coefficients (GC) to characterize the disparity of article citations in areas on CMs, based on the quantile classification method for classes.

Methods:
By searching the PubMed database (pubmed.com), we used the keyword “Medicine” [journal] and downloaded 7042 articles published from 1945 to 2016. A total number of 41,628 articles were cited in Pubmed Central (PMC). The publication outputs based on the author's x-index were applied to plot CM about research contributions. The approach uses two methods (i.e., quantiles and equal total values for each class) with CF legends, in order to highlight the difference in x-indices across geographical areas on CMs. GC was applied to observe the x-index disparities in areas. Microsoft Excel Visual Basic for Application (VBA) was used for creating the CMs.

Results:
Results showed that the most productive and cited countries in Medicine (Baltimore) were China and the US. The most-cited states and cities were Maryland (the US) and Beijing (China). Taiwan (x-index = 24.38) ranked behind Maryland (25.97), but ahead of Beijing (16.9). China earned lower disparity (0.42) than the US (0.49) and the rest of the world (0.53) when the GCs were applied.

Conclusion:
CF legends, particularly using the quantile classification for classes, can be useful to complement CMs. They also contain more information than those in standard CM legends that are commonly used with other classification methods. The steps of creating CM legends are described and introduced. Bibliometric analysts on CM can be replicated in the future.
Where are we in patient safety in the ED in Turkey?
Authors: Aksu Nalan M. , Akkaş Meltem 
Published: October 2019

Abstract
Near misses and unsafe conditions have become more serious for patients in emergency departments (EDs). We aimed to search the near misses and unsafe conditions that occurred in an ED to improve patient safety.
This was a retrospective analysis of a 10-year observational period from January 1, 2007 to December 31, 2016. We gained access to the adverse event notification forms (AENFs) sent to the hospital quality department from the ED. Patient age, sex, and date of presentation were recorded. The near misses and unsafe conditions were classified into 7 types: medication errors, falls, management errors, penetrative-sharp tool injuries, incidents due to institution security, incidents due to medical equipment, and forensic events. The outcome of these events was recorded.
A total of 220 AENF were reported from 294,673 ED visits. The median age of the 166 patients was 60 (21–95) years. Of these, 57.1% of the patients were females and 47.9% were males. The most commonly reported events were medication errors (32.7%) and management errors (27.3%). The median age of falling patients was 67.5 years. The nurse–patient ratio between 2007 to 2011 and 2011 to 2016 were 1/10 and 1/7, respectively. We found that when this ratio increased, the adverse events results were less significant (P < .003).
This was the 1st study investigating the adverse events in ED in Turkey. The reporting ratio of 0.07% for the total ED visits was too low. This showed that adverse events were under-reported.
Percutaneous endoscopic thoracic discectomy via posterolateral approach
Authors: Liu Wei , Yao Liyu , Li Xingchen , Tian Zhisen , Ning Cong , Yan Ming , Wang Yuanyi 
Published: October 2019

Abstract

Rationale:
Minimally invasive surgeries for thoracic disc herniation (TDH) evolved rapidly in recent years, and multiple approaches have been put forward. Thoracic discectomy via percutaneous spine endoscopy (PSE) is inadequately documented because of the low prevalence of TDH and the high difficulty of thoracic spine endoscopy techniques. Herein, we present a TDH case who underwent percutaneous endoscopic thoracic discectomy.

Patient concerns:
A 28-year-old male suffered backpain and partial paralysis in lower extremities.

Diagnoses:
Magnet resonance imaging demonstrated T11-12 TDH, with cranially migrated disc fragment.

Interventions:
The patient underwent percutaneous endoscopic thoracic discectomy via posterolateral approach with the assistance of endoscopic reamer in the procedure of foramino-laminaplasty.

Outcomes:
The patient's muscle force improved immediately, and the backpain relieved after 5 days post-surgery. In the 6-month follow-up, he had normal muscle force without paresthesia in lower limbs.

Lessons:
The innovative design of endoscopic reamer provides effective plasty and access establishment with lower risk and difficulty, which ensures the vision and the operating space of the procedure of decompression. With this technique, the indications of thoracic PSE were broadened to both ventral and dorsal thoracic stenosis.
Predrainage and Postdrainage Prognostic Nomograms to Predict Outcome of Percutaneous Drainage for Infected Pancreatic and Peripancreatic Necrotic Collections
Authors: Gupta Rajesh , Kulkarni Aditya A. , Babu Raghavendra , Shenvi Sunil , Gupta Rahul , Sharma Gopal , Kang Mandeep , Sharma Vishal , Singh Harjeet , Kumar-M Praveen , Rana Surinder 
Published: October 2019

Objectives
This study aimed to identify factors affecting outcome of percutaneous catheter drainage (PCD) in management of infected pancreatic necrosis treated with step-up approach.

Methods
This was a single-center retrospective cohort study that included patients with infected necrosis undergoing PCD as initial intervention. Patients who did not respond underwent necrosectomy. Predictors of PCD failure (ie, mortality or need for necrosectomy) were analyzed. Models were constructed for predrainage and postdrainage use and were internally validated.

Results
Of 304 patients included, catheter drainage was successful in 59.8%, with overall mortality of 22%. Predrainage model consisted of Acute Physiologic and Chronic Health Evaluation II score at admission, early organ failure, and pancreatic necrosis of greater than 50%. Postdrainage model consisted of Acute Physiologic and Chronic Health Evaluation II at first PCD, early organ failure, pancreatic necrosis of greater than 50%, sepsis reversal within 1 week of PCD and Escherichia coli in PCD culture. Both models were internally validated with area under receiver operating characteristics curve of 71.2% for pre-PCD and 81.2% for post-PCD model. Prognostic nomograms were constructed using the models.

Conclusions
Percutaneous catheter drainage alone was successful in 59.8% with mortality of 22%. The nomograms can help in guiding treatment strategy and referral of high-risk cases.
A Study on the Effect of Patient Characteristics, Geographical Utilization, and Patient Outcomes for Total Pancreatectomy Alone and Total Pancreatectomy With Islet Autotransplantation in Patients With Pancreatitis in the United States
Authors: Lara Luis F. , Bellin Melena D. , Ugbarugba Emmanuel , Nathan Jaimie D. , Witkowski Piotr , Wijkstrom Martin , Steel Jennifer L. , Smith Kerrington D. , Singh Vikesh K. , Schwarzenberg Sarah J. , Pruett Timothy L. , Naziruddin Bashoo , Long-Simpson Leslie , Kirchner Varvara A. , Gardner Timothy B. , Freeman Martin L. , Dunn Ty B. , Chinnakotla Srinath , Beilman Gregory J. , Adams David B. , Morgan Katherine A. , Abu-El-Haija Maisam A. , Ahmad Syed , Posselt Andrew M. , Hughes Michael G. , Conwell Darwin L. 
Published: October 2019

Objectives
A selective therapy for pancreatitis is total pancreatectomy and islet autotransplantation. Outcomes and geographical variability of patients who had total pancreatectomy (TP) alone or total pancreatectomy with islet autotransplantation (TPIAT) were assessed.

Methods
Data were obtained from the Healthcare Cost and Utilization Project National Inpatient Sample database. Weighed univariate and multivariate analyses were performed to determine the effect of measured variables on outcomes.

Results
Between 2002 and 2013, there were 1006 TP and 825 TPIAT in patients with a diagnosis of chronic pancreatitis, and 1705 TP and 830 TPIAT for any diagnosis of pancreatitis. The majority of the TP and TPIAT were performed in larger urban hospitals. Costs were similar for TP and TPIAT for chronic pancreatitis but were lower for TPIAT compared with TP for any type of pancreatitis. The trend for TP and TPIAT was significant in all geographical areas during the study period.

Conclusions
There is an increasing trend of both TP and TPIAT. Certain groups are more likely to be offered TPIAT compared with TP alone. More data are needed to understand disparities and barriers to TPIAT, and long-term outcomes of TPIAT such as pain control and glucose intolerance need further study.
The Effect of Neuromuscular Electrical Stimulation During Walking on Muscle Strength and Knee Pain in Obese Women With Knee Pain
Authors: Matsuse Hiroo , Segal Neil A. , Rabe Kaitlin G. , Shiba Naoto 
Published: October 2019

Objective
The aim of the study was to assess the effectiveness of a hybrid training system with walking that simultaneously applies electrical stimulation to the knee extensors/flexors during walking in obese women with knee pain.

Design
This is a randomized, single-blind (assessor), controlled trial. Twenty-eight obese women with knee pain were randomized to 12 weeks of biweekly walking with either hybrid training system with walking or with transcutaneous electrical nerve stimulation (control). Primary outcomes (maximum isokinetic knee extensor torque and maximum isokinetic knee flexor torque) and secondary outcomes (20-m walk time, chair-stand time, stair-climb time, knee pain, and knee-related quality life) were evaluated. Change-point regression analyses were used to model the interaction for the primary outcomes. Two-sample t tests were used on pre-post change scores in secondary outcomes.

Results
Knee extensor torque increased significantly more in the hybrid training system with walking group than the control group when baseline knee extensor torque was greater than 57.2 Nm (P = 0.0033). When baseline knee flexor torque was at 30 or 50 Nm, there was a trend toward greater increase in the hybrid training system with walking group than the control group (P = 0.0566, P = 0.0737, respectively). There were no significant differences between groups in secondary outcomes.

Conclusions
These results suggest that hybrid training system with walking is effective for improving knee extensor torque in obese women with knee pain. However, the superiority of hybrid training system with walking may vary depending on baseline knee muscle strength.
The Effect of Therapeutic Exercises on Balance, Quality of Life, and Pain in Patients Who Were Receiving Neurotoxic Chemotherapy
Authors: Bahar-Ozdemir Yeliz , Akyuz Gulseren , Kalkandelen Melihat , Yumuk Perran Fulden 
Published: October 2019

Objective
The aim of the study was to evaluate the effect of lower limb strengthening and balance exercises on balance, quality of life and neuropathic pain of the cancer patients receiving neurotoxic chemotherapy.

Design
Patients who were planning to receive neurotoxic chemotherapy agents were included in the first group. They were trained before the neurotoxic chemotherapy sessions with the 10-wk home-based exercise program including lower limb strengthening and balance exercises. The second group of patients who had received the third cycle of neurotoxic chemotherapy had no exercise program. Both groups were evaluated after the third cycle. Neurocom Balance Master and Berg Balance Scale were used to evaluate balance. The neuropathic pain was questioned by PainDETECT questionnaire and the quality of life was assessed with the European Organization for Research and Treatment of Cancer’s Quality of Life Questionnaire.

Results
Sixty patients were admitted to this study. Twenty-four patients were in the exercise group (F = 14, M = 10) and 36 patients were in the control group (F = 17, M = 19). Sociodemographic and clinical data of both groups were similar. Berg Balance Scale (P = 0.005), European Organization for Research and Treatment of Cancer’s Quality of Life Questionnaire global quality of life, physical function, and emotional status were higher, and symptom scores and PainDETECT questionnaire score were lower in the exercise group (P < 0.05). Balance tests were different between the groups.

Conclusions
Strengthening and balance exercises have a valuable effect on balance, quality of life, and neuropathic pain in patients receiving neurotoxic chemotherapy.
Significantly Increased Accumulation of 18F-FDG Throughout the Left Middle Cerebral Artery Territory Corresponding to Acute-Phase Infarction
Authors: Okuyama Chio , Nakae Takuro , Oka Satoshi , Nohara Jun , Yamauchi Hiroshi 
Published: October 2019

Abstract
A 70-year-old woman had spontaneous resolution of an embolism in her right middle cerebral artery (MCA) (day 1); another embolism occurred in her left MCA (day 3), which was promptly removed. On day 5, 18F-FDG PET/CT performed for staging mediastinal lymphoma showed marked FDG accumulation in the left MCA territory, whereas a defect was seen in the right insular region. Eventually, bilateral lesions developed irreversible infarction. Anaerobic metabolism and/or inflammation in acute-phase infarction were the supposed mechanism for the increased accumulation of FDG in her left MCA territory.
Antimicrobial resistance gene prevalence in a population of patients with advanced dementia is related to specific pathobionts
Authors: Rowan-Nash Aislinn D. , Araos Rafael , D’Agata Erika M.C. , Belenky Peter 
Published: October 2019

ABSTRACTBackgroundThe issue of antimicrobial resistance continues to grow worldwide, and long-term care facilities are significant reservoirs of antimicrobial-resistant organisms, in part due to high frequency of antimicrobial use. Patients with advanced dementia are particularly vulnerable to multidrug-resistant organism acquisition and antimicrobial overuse, which has negative consequences for the gut microbiome and can contribute to the selection and propagation of antimicrobial resistance genes. In this study, we longitudinally examined a group of advanced dementia patients treated with the fluoroquinolone antimicrobial levofloxacin, finding a correlation between abundance of pathogens and antimicrobial resistance genes, which we confirmed in a larger cohort of subjects with advanced dementia.ResultsWe observed significant inter- and intra-subject heterogeneity in the composition of the microbiota of the longitudinal levofloxacin cohort, suggesting temporal instability. Within this dataset, we did not find significant impacts of levofloxacin on the diversity, composition, function, or resistome of the gut microbiota of this population. However, we were able to link the antimicrobial resistance gene burden in a sample with the relative abundance of several pathobionts – particularlyEscherichia coli,Proteus mirabilis, andEnterococcus faecalis, as well as less-prevalent species includingProvidencia stuartiiandStaphylococcus haemolyticus. Furthermore, we used metagenomic assembly and binning to demonstrate that these species had higher genomic resistance gene levels than common gut commensals, and we were able to predict antimicrobial resistance gene burden from the relative abundances of these species in a separate, larger cohort from the same population.ConclusionsWe found that the relative abundances of several pathobionts were correlated with and were even predictive of the level of antimicrobial resistance genes in corresponding samples, and that these species carried high levels of resistances genes in their assembled genomes. In order to test this observation, we utilized a larger metagenomics dataset from a similar population and confirmed the association between pathobiont abundance and antimicrobial resistance genes. Given the high frequency with which these species were found at high levels in this population and the underlying vulnerability to infection with multidrug resistant organisms of advanced dementia patients, attention to microbial blooms of these species may be warranted. Additionally, in this study, we were able to utilize genomic assembly from metagenomic data to more definitively associate antimicrobial resistance gene levels with specific assembled species; as this technology continues to develop, assembly could prove to be a valuable method to monitor both specific resistance genes and blooms of multidrug-resistant organisms.
Serotonin depletion amplifies distinct human social emotions as a function of individual differences in personality
Authors: Kanen Jonathan W , Arntz Fréderique E , Yellowlees Robyn , Cardinal Rudolf N , Price Annabel , Christmas David M , Apergis-Schoute Annemieke M , Sahakian Barbara J , Robbins Trevor W 
Published: October 2019

AbstractSerotonin is involved in a wide range of mental capacities essential for navigating the social world, including emotion and impulse control. Much recent work on serotonin and social functioning has focused on decision-making. Here we investigated the influence of serotonin on human emotional reactions to social conflict. We used a novel computerised task that required mentally simulating social situations involving unjust harm and found that depleting the serotonin precursor tryptophan – in a double-blind randomised placebo-controlled design – enhanced emotional responses to the scenarios in a large sample of healthy volunteers (n = 73), and interacted with individual differences in trait personality to produce distinctive human emotions. Whereas guilt was preferentially elevated in highly empathic participants, annoyance was potentiated in those high in trait psychopathy, with medium to large effect sizes. Our findings show how individual differences in personality, when combined with fluctuations of serotonin, may produce diverse emotional phenotypes. This has implications for understanding vulnerability to psychopathology, determining who may be more sensitive to serotonin-modulating treatments, and casts new light on the functions of serotonin in emotional processing.