bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression in Patients with Tinnitus: A Systematic Review
Authors: Salazar James W. , Meisel Karl , Smith Eric R. , Quiggle Aaron , McCoy David B. , Amans Matthew R. 
Published: March 2019

ObjectiveTinnitus is a condition that causes distress and impairment across cognitive, functional, and psychiatric spectra. In the psychiatric realm, tinnitus has long been associated with depression. To better characterize the co‐occurrence of depression and tinnitus, we performed a systematic review of the prevalence of depression among patients with tinnitus.Data SourcesWe comprehensively examined original studies reporting the prevalence of depression in adult populations with tinnitus, as indexed in the PubMed and Web of Science databases and published from January 2006 to August 2016.Review MethodsAll identified articles were reviewed independently by 2 researchers, with a third reviewer for adjudication. Included studies were evaluated for threats to validity across 3 domains—representativeness, response rate, and ascertainment of outcome—on a 4‐point modified Newcastle‐Ottawa Quality Assessment Scale.ResultsTwenty‐eight studies were included, representing 15 countries and 9979 patients with tinnitus. Among the included studies, the median prevalence of depression was 33%, with an interquartile range of 19% to 49% and an overall range of 6% to 84%. Studies were high quality overall, with a mean score of 3.3 (SD = 0.76), and 89% utilized a validated tool to ascertain depression.ConclusionsWe conducted one of the largest contemporary comprehensive reviews, which suggests a 33% prevalence of depression among patients with tinnitus. Our review reaffirms that a substantial proportion of patients with tinnitus have depression, and we recommend that all who treat tinnitus should screen and treat their patients for depression, if present.
Does Clearance of Positive Margins Improve Local Control in Oral Cavity Cancer? A Meta‐analysis
Authors: Bulbul Mustafa G. , Tarabichi Osama , Sethi Rosh K. , Parikh Anuraag S. , Varvares Mark A. 
Published: March 2019

ObjectivesTo compare local recurrence‐free survival (LRFS) in early oral cavity cancer (OCC) patients with positive/close frozen section (FS) cleared with further resection (R1 to R0) or positive FS not cleared (R1) to those with negative margins on initial FS analysis (R0).Data SourcesPubMed, EMBASE, and Cochrane.Review MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) for reporting in our study. Only English‐language articles that included patients with OCC and local recurrence (LR) comparisons between R0 and initially R1 to final R0 or final R1 groups were included. We requested the raw data from the corresponding authors of eligible studies and performed an individual participant data (IPD) meta‐analysis of LRFS outcomes across groups.ResultsPooled LRFS data from 8 studies showed that patients in the R1 to R0 group had worse LRFS compared to the R0 group (hazard ratio [HR] = 2.897, P <. 001). Patients in the R1 group were also found to have worse LRFS compared to the R0 group (HR = 3.795, P <. 001). When compared to final R1 group, the initially R1 to final R0 only showed a trend toward better LRFS.ConclusionMargin revision of initially positive margins to “clear” based on FS guidance does not equate to an initially negative margin and does not significantly improve local control. These findings call into question the effectiveness of the current methodology of intraoperative FS in OCC resections and call for a prospective study to determine what system of resected specimen analysis best predicts completeness of resection.
Ipsilateral atrophy of the mammillary body and fornix after thalamic stroke: evaluation by MRI
Authors: Kinoshita Fumiko , Kinoshita Toshibumi , Toyoshima Hideto , Shinohara Yuki 
Published: March 2019

Background A focal brain lesion influences the function and morphology in the connected intact regions remote from it. However, it is not well documented that thalamic stroke may induce secondary degeneration of the mammillary body (MB) or the fornix (Fx). Purpose To investigate transneuronal degeneration (TND) in the MB and Fx following thalamic stroke on magnetic resonance imaging (MRI) and to assess the time course of these findings using serial MRI after stroke. Material and Methods Conventional T2-weighted axial MR images were retrospectively evaluated in 24 cases of thalamic infarction or hemorrhage involving the anterior thalamic nucleus and/or mammillothalamic tract (MTT). We recorded any change in size and/or shape of the MB and Fx after the infarction and the days on which those structural changes occurred. Results Ipsilateral atrophy of the MB was shown in 9/20 patients (45.0%). MRI revealed MB atrophy as a small round shape in almost half of the patients and was too small to visualize in one-third of them on axial planes. Ipsilateral atrophy of the Fx was found in 2/23 patients (8.7%) and was observed as a thin lined shape on MRI. The atrophy was observed on follow-up MRI scans dated 356–1779 days (mean = 910 ± 516 days) after onset. Conclusion Damage to the anterior thalamic nucleus and/or MTT caused TND in the ipsilateral MB and/or Fx resulted in atrophy and asymmetry in less than half of patients studied, mostly within three years.
Comparison of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio in patients with thyroiditis and papillary tumors
Authors: Ari Aziz , Gunver Feray 
Published: March 2019

Objective The neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) have recently been introduced as prognostic markers of thyroid cancer and strong inflammatory markers. The study was performed to investigate the association of the PLR and NLR with thyroid inflammation and papillary cancer. Methods Patients with thyroiditis and patients with papillary carcinomas were compared with sex-, age-, and body mass index-matched healthy controls. The NLR and PLR were calculated and compared among the three groups. Results The NLR was significantly higher in patients with thyroiditis and non-significantly higher in patients with papillary cancer than in healthy controls. The PLR was significantly higher in both patients with thyroiditis and papillary cancer than in healthy controls. Like the NLR, the PLR was not different between patients with thyroiditis and papillary cancer. The NLR was significantly and positively associated with the PLR and white blood cell count. Conclusion The PLR and NLR showed similar results in both thyroid inflammation and cancer. It seems difficult to obtain clear results in separating cancer from inflammatory events using these parameters. We suggest using them as supportive parameters of thyroid papillary cancer or inflammation.
A Retrospective Analysis of Nonocclusive Mesenteric Ischemia in Medical and Surgical ICU Patients: Clinical Data on Demography, Clinical Signs, and Survival
Authors: Stahl Klaus , Busch Markus , Maschke Sabine K. , Schneider Andrea , Manns Michael P. , Fuge Jan , Wiesner Olaf , Meyer Bernhard C. , Hoeper Marius M. , Hinrichs Jan B. , David Sascha 
Published: March 2019

Background: To analyze demography, clinical signs, and survival of intensive care patients diagnosed with nonocclusive mesenteric ischemia (NOMI) and to evaluate the effect of a local intra-arterial prostaglandin therapy. Methods: Retrospective observational study screening 455 intensive care patients with acute arterial mesenteric perfusion disorder in a tertiary care hospital within the past 8 years. Lastly, 32 patients with NOMI were enrolled, of which 11 received local intra-arterial prostaglandin therapy. The diagnosis of NOMI was based on the clinical presentation and established biphasic computed tomography criteria. Clinical and biochemical data were obtained 24 hours before, at the time, and 24 hours after diagnosis. Results: Patients were 60.5 (49.3-73) years old and had multiple comorbidities. Most of them were diagnosed with septic shock requiring high doses of norepinephrine (NE: 0.382 [0.249-0.627] μg/kg/min). The Sequential Organ Failure Assessment (SOFA) score was 18 (16-20). A decrease in oxygenation (Pao 2/Fio 2), pH, and bicarbonate and an increase in international normalized ratio, lactate, bilirubin, leucocyte count, and NE dose were early indicators of NOMI. Median SOFA score significantly increased in the last 24 hours before diagnosis of NOMI (16 vs 18, P < .0001). Overall, 28-day mortality was 75% (81% nonintervention vs 64% intervention cohort; P = .579). Median SOFA scores 24 hours after intervention increased by +5% in the nonintervention group and decreased by 5.5% in the intervention group ( P = .0059). Conclusions: Our data suggest that NOMI is a detrimental disease associated with progressive organ failure and a high mortality. Local intra-arterial prostaglandin application might hold promise as a rescue treatment strategy. These data encourage future randomized controlled trials are desirable.
Rose Angina Questionnaire: Validation in emergency department to detect myocardial infarction in a tertiary hospital of eastern Nepal
Authors: Poudel Masum , Bhandari Rabin , Malla Gyanendra , Baral Dharanidhar , Uprety Samyog , Chaudhary Ritesh , Sharma Sanjib Kumar 
Published: March 2019

Background: Rose Angina Questionnaire (RAQ) is a useful screening questionnaire for ischemic heart disease validated in different settings; however, its diagnostic ability to predict myocardial infarction (MI) in the emergency is less clear. Objectives: To find out the usefulness of RAQ to predict MI in patients presenting to the emergency. Methods: A cross-sectional study was conducted at the BP Koirala Institute of Health Sciences (BPKIHS), a teaching hospital in eastern Nepal from 1 January to 30 March 2017, after ethical clearance from the Institutional Review Committee. Informed consent was obtained from the patients for their anonymised information to be published in this study The samples were collected from 100 patients with chest pain aged 40 to 70 years presenting to the emergency. RAQ was applied and its performance to detect MI was compared with emergency and cardiologist diagnosis of MI. Sensitivity, specificity, positive predictive value and negative value were calculated along with descriptive analysis. Results: A total of 100 patients were analysed with the mean age of 63.78 years (SD 11.60) and male to female ratio of 1.94. RAQ detected 58 cases (63.8%) with emergency department (ED) diagnosis of MI (true positive) and identified 3 (33.3%) cases with non-MI (true negative). The true positive rate for RAQ to detect MI after cardiologist consultation was 71.6%. RAQ had a sensitivity of 84.91% (95% confidence interval (CI) 72.41% –93.25%) to detect positive troponin, 63.74% (52.99–73.56) to detect positive electrocardiogram (ECG) and 71.60% (95% CI 60.5% to 81.07%) to detect final diagnosis of MI. Conclusion: RAQ is a good screening tool to detect MI in the emergency that can be used in isolation or in combination with other diagnostic modalities to detect it early.
Incorporating Older Adults as “Trained Patients” to Teach Advance Care Planning to Third-Year Medical Students
Authors: Nussbaum Sarah E. , Oyola Sonia , Egan Mari , Baron Aliza , Wackman Shewanna , Williams Shellie , Benson Janice , Limaye Seema , Levine Stacie 
Published: March 2019

Background: Advance care planning (ACP) is a critical component of end-of-life (EoL) care, yet infrequently taught in medical training. Objective: We designed a novel curriculum that affords third-year medical students (MS3s) the opportunity to practice EoL care discussions with a trained older adult in the patient’s home. Design: Volunteers were instructed as trained patients (TPs) to evaluate MS3s interviewing and communication skills. The MS3s received a didactic lecture and supplemental material about ACP. Pairs of MS3s conducted ACP interviews with TPs who gave verbal and written feedback to students. Student evaluations included reflective essays and pre/postsurveys in ACP skills. Settings and Participants: A total of 223 US MS3s participated in the curriculum. Results: Qualitative analysis of reflective essays revealed 4 themes: (1) students’ personal feelings, attitudes, and observations about conducting ACP interviews; (2) observations about the process of relationship building; (3) learning about and respecting patients’ values and choices; and (4) the importance of practicing the ACP skills in medical school. Students’ confidence in skills significantly improved in all 7 domains ( P < .001): (1) introduce subject of EoL; (2) define advance directives; (3) assess values, goals, and priorities; (4) discuss prior experience with death; (5) assess expectations about treatment and hospitalization; (6) explain cardiopulmonary resuscitation and outcomes; and (7) deal with own feelings about EoL and providers’ limitations. Conclusions: The use of older adults as TPs in an ACP curriculum provides students an opportunity to practice skills and receive feedback in the nonmedical setting, thereby improving comfort and confidence in approaching these conversations for future patients.
A survey of feeding practices and use of food puzzles in owners of domestic cats
Authors: Delgado Mikel , Bain Melissa J , Buffington CA Tony 
Published: March 2019

Objectives Food puzzles may provide enrichment to domestic cats. The purpose of our survey was to determine: (1) how respondents fed their cat (type[s] of food, amount and mode of delivery); (2) how many people used food puzzles to provide food for their cats; and (3) owner attitudes about food puzzles. Methods We conducted an online survey from January to April of 2018 to ask cat owners (n = 3192) questions related to their cat feeding practices and use of food puzzles. Results Most cat owners fed their cats dry food, with half of those owners offering it ad libitum. Thirty percent of participants offered food puzzles to their cats; another 18% had tried food puzzles but were no longer using them. The remaining participants had never used a food puzzle with their cat. Reasons for not using food puzzles included perceptions about the cat (eg, being too lazy), multiple pets in the home, pets fed different diets, health issues and feeding an exclusively wet food diet. Many participants did not know how to choose or introduce a food puzzle to their cat, and many non-users saw no need or benefit to their cat. Conclusions and relevance This survey provided information about the feeding habits of cat owners and why they do and do not use food puzzles with their cats. Because of the scarcity of empirical evidence about the effects of food puzzles on pet cat welfare, more research is needed to determine the role of food puzzles as part of an overall enrichment plan.
In Silico Analyses of Burial Codon Bias Among the Species of Dipterocarpaceae Through Molecular and Phylogenetic Data
Authors: Biswas Raju , Panja Anindya Sundar , Bandopadhyay Rajib 
Published: March 2019

Introduction: DNA barcode, a molecular marker, is used to distinguish among the closely related species, and it can be applied across a broad range of taxa to understand ecology and evolution. MaturaseK gene ( matK) and rubisco bisphosphate carboxylase/oxygenase form I gene ( rbcL) of the chloroplast are highly conserved in a plant system, which are used as core barcode. This present endeavor entails the comprehensive examination of the under threat plant species based on success of discrimination on DNA barcode under selection pressure. Result: The family Dipterocarpaceae comprising of 15 genera is under threat due to some factors, namely, deforestation, habitat alteration, poor seed, pollen dispersal, etc. Species of this family was grouped into 6 clusters for matK and 5 clusters and 2 sub-clusters for rbcL in the phylogenetic tree by using neighbor-joining method. Cluster I to cluster VI of matK and cluster I to cluster V of rbcL genes were analyzed by various codon and substitution bias tools. Mutational pressure guided the codon bias which was favored by the avoidance of higher GC content and significant negative correlation between GC12 and GC3 (in sub-cluster I of cluster I [0.03 <  P], cluster I [0.00001 <  P], and cluster II [0.01 <  P] of rbcL, and cluster IV [0.013 <  P] of matK). After refining the results, it could be speculated that the lower null expectation values ( R = 0.5 or <0.5) were less divergent from the evolutionary perspective. Apart from that, the higher null expectation values ( R = >0.85) also showed the same result, which possibly could be due to the negative impact of very high and low transition rate than transversion. Conclusion: Through the analysis of inter-generic, inter/intra-specific variation and phylogenetic data, it was found that both selection and mutation played an important role in synonymous codon choice in these genes, but they acted inconsistently on the genes, both matK and rbcL. In vitro stable proteins of both matK and rbcL were selected through natural selection rather than mutational selection. matK gene had higher individual discrimination and barcode success compared with rbcL. These discriminatory approaches may describe the problem related to the extinction of plant species. Hence, it becomes very imperative to identify and detect the under threat plant species in advance.
Predictors of Infant Care Competence Among Mothers With Postpartum Depression
Authors: Jones Debbie , Letourneau Nicole , Leger Linda Duffett 
Published: March 2019

Background/objective: Postpartum depression is linked to decreased quality mother-infant interactions and long-term negative impacts on children’s behavior and health. Infant care competence may be reduced by postpartum depression and other maternal or environmental variables. Thus, the objective of this study was to explain factors that contribute to perceived infant care competence among mothers with postpartum depression. Methods: Multiple regression analysis and correlational analysis were conducted to study associations between the predictors (depression severity, social support, child development, family functioning) and the outcome of perceived infant care competence among a peer support intervention study for mothers with postpartum depression (n = 55). Results: Child development, specifically communication ( P = .04), gross ( P = .00) and fine ( P = .00) motor skills, problem solving ( P = .00), and personal-social development ( P = .01), explained maternal perceptions of responsiveness, an aspect of infant care competence. The best-fit model was obtained for the responsiveness subscale, in which 37% of the variance was explained by mothers’ reports of infants’ fine motor skills ( P = .000) and nurturance ( P = .039) as an aspect of social support and family functioning ( P = .078). Conclusions: Recognition of the importance of infant development to perceived infant care competence, particularly mothers’ perceptions of infant responsiveness, may offer targets for intervention. Helping mothers identify infant cues and milestones that signal infant responsiveness may be beneficial. Moreover, social support and family functioning may be targets for intervention to promote perceived infant care competence in mothers affected by postpartum depression.
Subacute Combined Spinal Cord Degeneration by Recreational Laughing Gas (N2O) Use
Authors: Onrust Marthe R , Frequin Stephan TFM 
Published: March 2019

Background: A few young patients were brought in with subacute combined spinal cord degeneration at the Department of Neurology in our hospital. They all have used laughing gas for recreational purposes. Case: A 30-year-old woman, known with alcohol abuse, was presented to our Department of Neurology for having paresthesia and unstable movements of arms, legs, and trunk for 9 days. She has used 50 laughing gas patterns per day. The diagnosis of laughing gas–induced combined spinal cord degeneration was evident by the low count of vitamin B12 combined with lesions shown on magnetic resonance imaging (MRI). Abstaining from the laughing gas, weekly intramuscular injections of hydroxocobalamin and revalidation, she was fully recovered in 8 weeks. Conclusions: Recreational use of laughing gas seems to be more used in our society, however, without having any knowledge of the neurological consequences. The right diagnosis and treatment can provide full recovery in these patients. Furthermore, attention for this diagnosis can help increase social awareness.
Longitudinal analysis of serum neurofilament light chain: A potential therapeutic monitoring biomarker for multiple sclerosis
Authors: Hyun Jae-Won , Kim Yeseul , Kim Gayoung , Kim Su-Hyun , Kim Ho Jin 
Published: March 2019

Objectives: Serum neurofilament light chain (sNfL) has been proposed a potential biomarker in multiple sclerosis (MS) based on mainly cross-sectional observations in Western population. To clarify clinical implication of sNfL, we longitudinally analysed sNfL levels at multiple time points in Korean MS patients undergoing alemtuzumab therapy. Methods: Between 2016 and 2018, 144 sera from 17 MS patients treated with alemtuzumab at National Cancer Centre and 35 sera from 35 age- and gender-matched healthy controls (HCs) were collected for a longitudinal study with a mean 21-month follow-up. The sera were measured for sNfL levels using single molecule array. Patients were classified into two groups: evidence of disease activity (EDA) or no evidence of disease activity (NEDA). Results: During alemtuzumab therapy, sNfL levels in EDA patients were significantly higher than those in NEDA patients and HCs ( p < 0.001). In longitudinal analysis, the sNfL levels were consistently low in NEDA patients, while it consistently increased in radiologically and/or clinically active status in EDA patients. All sNfL levels in radiologically and/or clinically active status samples were higher than those in inactive status samples. Conclusion: These results suggest that sNfL is a promising monitoring biomarker for personalized therapeutics in MS patients.
Do theatre staff use face masks in accordance with the manufacturers’ guidelines of use?
Authors: Herron Jonathan Blair Thomas , Kuht James Alan , Hussain Ammar Zahid , Gens Kamila Kinga , Gilliam Andrew Douglas 
Published: March 2019

Aim: Surgical face masks are worn by theatre staff to protect the surgical site from airborne contamination and the wearer from bodily fluid splash. This observational/audit aimed to assess whether theatre staff wear masks in accordance with manufacturers’/Centers for Disease Control and Prevention (CDC) guidelines of use. Methods: A total of 1034 surgically scrubbed staff were assessed on their technique of applying surgical face masks, compared to the CDC guidelines as manufacturers’ guidelines were not available as per Health and Safety Executive guidelines. Results: Only 18% of surgically scrubbed staff fully complied with the CDC guidelines on the application of a face mask. Compliance was worst in urology, ophthalmology and vascular surgeons, whereas orthopaedic and plastic surgeons were the most compliant. Discussion: Compliance with CDC face mask guidelines may have an impact on surgical site infections (SSI) and protection of staff from body fluid splash, but most staff do not comply with these guidelines. Conclusions: Most operating theatre staff do not apply a face mask using correct technique, outlined in CDC guidance, which may increase SSI rates. Staff are not aware of existing guidelines for donning a mask.
Roots and Branches: Comparing Child Care Policymaking in the us and Australia
Authors: Michel Sonya 
Published: March 2019

Talk presented at ANU, FaCS and University of Melbourne, July 2003 In both Australia and the United States today, child care is very much on the political and social agenda, a concern not only for working parents but also for policy-makers seeking to ‘reconcile work and family’ and, increasingly, to address issues arising from welfare reform.