bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corticosteroid dose and the risk of opportunistic infection in a national systemic lupus erythematosus cohort
Authors: Yang S-C , Lai Y-Y , Huang M-C , Tsai C-S , Wang J-L 
Published: August 2018

Objective This study investigated whether the incidence of opportunistic infection differed in systemic lupus erythematosus patients who received different doses of corticosteroids. Methods We included patients with diagnosed systemic lupus erythematosus from 1997 to 2010 using Taiwan national health insurance data. The index day for systemic lupus erythematosus patients was 3 months after the systemic lupus erythematosus diagnosis. A non-steroid cohort was matched 4:1 with the steroid cohort according to age, sex and index day. The end of the follow-up period was the day of opportunistic infection diagnosis, 1 year after the index day, or death. Results The overall cumulative incidence of opportunistic infection was 136-fold higher in the steroid cohort than in the non-steroid cohort. The adjusted hazard ratio for developing mycobacterium infection in the steroid cohort was 11, and the adjusted hazard ratio for developing herpes zoster was 43.6 compared to the non-steroid cohort after adjusting for immunosuppressive agents and comorbidities. The adjusted hazard ratio value for opportunistic infection was 1.40 (95% confidence interval (CI) 0.78–2.51) for a daily prednisone-equivalent dose of 7.5–15 mg, 1.72 (95% CI 1.02–2.91) for 15–30 mg, 1.96 (95% CI 1.17–3.28) for 30–60 mg and 2.24 (95% CI 1.26–4.00) for over 60 mg compared with low-dose steroids (<7.5 mg). Conclusion This study confirmed that the risk of opportunistic infection is higher in systemic lupus erythematosus patients treated with steroids in the first 3 months after diagnosis versus those not treated with steroids. Medium and high doses were associated with a higher risk of opportunistic infection compared with low doses. However, there was no controlling for disease activity, making it hard to know if increases in infection were due to disease itself or corticosteroids.
Comparison of medical and/or surgical management of 23 cats with intracranial empyema or abscessation
Authors: Martin Sophie , Drees Randi , Szladovits Balazs , Beltran Elsa 
Published: August 2018

Objectives Feline intracranial abscessation or empyema is infrequently reported in the veterinary literature. To date, the largest study is based on a population of 19 cats with otogenic infection. The aim of this study was to review a larger population of cats with intracranial empyema from multiple aetiologies and document their signalment, imaging findings, treatment protocols (including medical and/or surgical management) and to compare outcomes. Methods Cases presenting to a single referral centre over a 10 year period with compatible history, neurological signs and imaging findings consistent with intracranial abscessation and empyema were reviewed retrospectively. Results Twenty-three cats met the inclusion criteria. Advanced imaging (CT and/or MRI) was performed in 22/23 cats; one case was diagnosed via ultrasound. Ten cases underwent medical and surgical management combined, 10 underwent solely medical management and three were euthanased at the time of diagnosis. Short-term outcome showed that 90% of surgically managed and 80% of medically managed cats were alive at 48 h post-diagnosis. Long-term survival showed that surgically managed cases and medically managed cases had a median survival time of 730 days (range 1–3802 days) and 183 days (range 1–1216 days), respectively. No statistical significance in short- or long-term survival ( P >0.05) was found between medically and surgically managed groups. Conclusions and relevance Feline intracranial abscessation and empyema are uncommon conditions that have historically been treated with combined surgical and medical management. This study documents that, in some cases, intracranial abscessation and empyema can also be successfully treated with medical management alone.
Relationship between preoperative patient-reported outcomes and hospital length of stay: a prospective cohort study of general surgery patients in Vancouver, Canada
Authors: Sutherland Jason , Liu Guiping , Crump Trafford , Bair Matthew , Karimuddin Ahmer 
Published: August 2018

Objectives As an aging population drives more demand for elective inpatient surgery, one approach to reducing length of stay is enhanced evaluation of patients’ preoperative health status. The objective of this research was to determine whether patient-reported outcome measures collected preoperatively can identify patients at risk for longer lengths of stay. Methods This study was based on a prospectively recruited cohort of patients who were scheduled for elective inpatient general surgery in Vancouver, Canada. All participants completed a number of patient-reported outcome measures preoperatively, including the EQ-5D for general health status, the Patient Health Questionnaire (PHQ-9) for depression, and the pain intensity (P), interference with enjoyment of life (E), and interference with general activity (G), known as the PEG, for pain. Patient-reported outcome data were linked to hospital discharge summaries. Multivariate regression was performed to estimate risk of longer lengths of stay, adjusting for patient and clinical characteristics. The primary outcome was length of stay and its associated cost. Data collection took place between October 2012 and November 2016. Results Participation among the population of 2307 eligible patients was 50.5%, providing 1165 participants. Preoperative patient-reported outcomes were not concordant with hospital reported diagnoses of depression or pain. Patients’ preoperative depression and pain scores were independently positively associated with longer length of stay after adjusting for patient-level characteristics. Patients whose PHQ-9 score was 10, representing clinically significant depression, were estimated to have a 1.53 day longer hospitalization, which was associated with an estimated incremental hospital cost of $1667. Conclusions Preoperative self-reported assessment of depression and pain can assist with identifying patients at higher risk of longer lengths of stay. Patient’s self-reported preoperative measures of depression and pain should be incorporated into patient pathways. They provide opportunities for improving management of general surgery patients and possibly play a role in aligning hospital funding with patients’ needs.
Reproducibility, longitudinal validity and interpretability of the Disease Burden Morbidity Assessment in people with chronic disease
Authors: Tyack Zephanie , Kuys Suzanne , Cornwell Petrea , Frakes Kerrie-Anne , McPhail Steven M 
Published: August 2018

Objective To evaluate the reproducibility, longitudinal validity, and interpretability of the disease burden morbidity assessment in people with chronic conditions including multimorbidity. Methods The study was conducted using a longitudinal cohort design. A large consecutive sample of adult patients at an Australian community-based rehabilitation service was included with testing at baseline and three-month follow-up (testing longitudinal validity and interpretability). A smaller subsample of patients completed a one-week test–retest (testing reproducibility). Outcome measures included the Disease Burden Morbidity Assessment and 36-item Short-Form Health Survey. Participants in the study received tailored, interdisciplinary intervention between baseline, and three-month follow-up but did not typically receive intervention between baseline and retest. Results The longitudinal validity and interpretability sample included 351 participants and the reproducibility sample included 56 participants. Longitudinal validity and interpretability were generally supported with hypotheses supported or partly supported and a small percentage of lowest total scores for impact on daily activities (0.6% at baseline, 1.3% at three-month follow-up). Reproducibility parameters were acceptable for the total score measuring impact on daily activities (e.g. ICC = 0.76). Discussion Reproducibility, longitudinal validity, and interpretability of the disease burden morbidity assessment were generally supported for community-based chronic disease patients.
Glycated LDL-C and glycated HDL-C in association with adiposity, blood and atherogenicity indices in metabolic syndrome patients with and without prediabetes
Authors: Al Saudi Rawan Mohammad , Kasabri Violet , Naffa Randa , Bulatova Nailya , Bustanji Yasser 
Published: August 2018

Background: The aim of the study was to compare and correlate glycated high-density lipoprotein (GHDL-C) and glycated low-density lipoprotein (GLDL-C) plasma levels with adiposity indices [weight/hip ratio (WHR) and body adiposity index (BAI)], lipid ratios and hematological indices [platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR)]. Methods: This was a cross-sectional study of 30 nondiabetic metabolic syndrome (MetS) patients, 30 prediabetic or type 2 diabetes mellitus (T2DM) patients and 30 normoglycemic controls. Results: Remarkably both GHDL-C and GLDL-C levels lacked any intergroup statistically significant discrepancy in either MetS or MetS-pre/T2DM versus control ( p > 0.05). Unlike GLDL-C/LDL-C ratios for either MetS groups; there were highly significant intergroup differences in the means of GHDL-C/HDL-C ratios when comparing both nondiabetic MetS and MetS-pre/T2DM groups versus controls ( p = 0.001). In MetS patients; GHDL-C and GLDL-C proportionally correlated with WHR ( p < 0.05). Also, MetS GHDL-C correlated inversely with MLR and monocytes ( p < 0.05). In MetS-pre/T2DM; GLDL-C directly correlated with BAI, platelet count and PLR ( p < 0.05). Conclusion: GLDL-C and GHDL-C are dysfunctional glucolipotoxicity lipoproteins and may present putatively surrogate biomarkers for prediction/prevention of metabolic disturbances.
The predictive factors of primary head and neck cancer stage at presentation and survival in a developing nation’s tertiary hospital
Authors: Adoga Adeyi A , Kokong Daniel D , Ma’an Nuhu D , Mugu Joyce G , Mgbachi Chukwunonso J , Dauda Ayuba M 
Published: August 2018

Background: Stage of head and neck cancers at presentation is a strong determinant of outcomes. Objective: To evaluate predictors of stage of head and neck cancers at presentation and survival in a Nigerian tertiary hospital. Patients and methods: Health records that met the inclusion criteria for head and neck cancers were retrieved using the International Classification of Diseases, 10th revision and analyzed with associations between variables modeled using logistic regression analysis. Results: From a record of 487 head and neck neoplasms, 129 (26.5%) were malignant of which 122 health records met the criteria for analysis consisting of 83 (68.0%) males and 39 (32.0%) females aged 13–85 years (mean = 51 years; standard deviation = ±16 years). Alcohol (odds ratio = 1.99; 95% confidence interval = 1.08–3.69; p = 0.02) and tobacco exposure (odds ratio = 3.07; 95% confidence interval = 1.32–7.16; p = 0.01) were associated with increased odds for advanced tumor stage at presentation. Stage IV cancer (hazard ratio = 1.44; 95% confidence interval = 1.80–2.59), alcohol (hazard ratio = 2.19; 95% confidence interval = 1.18–4.10) and tobacco use (hazard ratio = 3.40; 95% confidence interval = 1.22–8.74) were associated with increased hazards for death. Conclusion: Alcohol, tobacco use and smoke from cooking wood are predictive factors for advanced HNC stage at presentation. Stage IV cancer, alcohol and tobacco use were associated with an increased hazard for death.
Can the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score Be Reliably Administered Over the Phone? A Randomized Study
Authors: Erickson Brandon J. , Chalmers Peter N. , Newgren Jon , Malaret Marissa , O’Brien Michael , Nicholson Gregory P. , Romeo Anthony A. 
Published: August 2018

Background: The Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow outcome score is a functional assessment tool for the upper extremity of the overhead athlete, which is currently validated for administration in person. Purpose/Hypothesis: The purpose of this study was to validate the KJOC score for administration over the phone. The hypothesis was that no difference will exist in KJOC scores for the same patient between administration in person versus over the phone. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Fifty patients were randomized to fill out the KJOC questionnaire either over the phone first (25 patients) or in person first (25 patients) based on an a priori power analysis. One week after the patients completed the initial KJOC on the phone or in person, they then filled out the score via the opposite method. Results were compared per question and for overall score. Results: There was a mean ± SD of 8 ± 5 days between when patients completed the first and second questionnaires. There were no significant differences in the overall KJOC score between the phone and paper groups ( P = .139). The intraclass correlation coefficient comparing paper and phone scores was 0.802 (95% CI, 0.767-0.883; P < .001), with a Cronbach alpha of 0.89. On comparison of individual questions, there were significant differences for questions 1, 3, and 8 ( P = .013, .023, and .042, respectively). Conclusion: The KJOC questionnaire can be administered over the phone with no significant difference in overall score as compared with that from in-person administration.
Reclaiming Glory of Shehr-i-Khas, Srinagar—Revitalization of Ali Kadal-Maharaj Ganj Area
Authors: Shah Purva Harish , Kaderi Ali Iqbal , Malani Nandan Somnath , Suryavanshi Amol Subhashchandra 
Published: August 2018

The core areas of Indian cities present a unique case of survival and degradation co-existing. Once the pulse of Srinagar city, Ali Kadal-Maharaj Ganj area struggles for its existence today. Although the historic urban structure of the city prevails, almost in its authentic form; it lacks the pulse it must have had in medieval period, while it demonstrates potential for tourism with its heritage reserve. This research derives traces from urban analytical studies of the area to re-invent them for effective modern use. The design effort is to intervene least while upgrading the area to its past glory. The finding of the whole process concludes to an understanding that it may not be restored to its original format; the urban life can revolve around tourism, promotion of local arts and crafts and heritage and suggests relevant design interventions. However, these need to be investigated for public and stakeholder’s opinions.
Understanding the Relationship between Component and Attribute of Cultural Landscapes: Case of Indian Music and Cultural Landscapes
Authors: Venkatachary Balaji , Kawathekar Vishakha 
Published: August 2018

The widely recognized definition of ‘Cultural Landscape’ in current practice is borrowed from UNESCO as Combined works of Nature and of Man.1 They are complex entities consisting of multiple layering of built-unbuilt components including intangible cultural aspects. These components are interrelated and interdependent. The landscape evolves together through combined natural and cultural processes. In current discourse and practice of heritage management, value-based assessment is a widely accepted approach. Evaluation of cultural landscapes for its Significance and Value is a complex process that requires an understanding of interwoven layers of components and attributes.2 Systematic understanding of such relationships between components and attributes is still in its infancy. Amongst various such identified intangible agencies, this study chooses to explore music. A study of secondary sources was undertaken. Cultural landscapes nominated as World Heritage Sites and identified Indian sites were systematically examined to understand various components and attributes. Using the indicators from this study and the theoretical framework of sociomusicology, a research design was prepared. Recognizing the historical association of music with the sites on the Kaveri river basin in peninsular India, a reconnaissance study was undertaken for onsite validation. Musical associations were spatially mapped for analysis and the findings are presented. Systematic understanding of the relationships between components of a cultural landscape and intangible cultural traditions is still in its infancy. The undertaken study is an exploratory work that focuses on understanding the relationship between components of a cultural landscape and ‘intangible attributes’, especially music. A study of secondary sources was undertaken in two parts. In the first part, concept of cultural landscape has been explored. Cultural landscapes nominated as World Heritage Sites were systematically examined to understand various components and attributes. The knowledge helped in formation of indicators for evaluation of cultural landscapes. In the second part of the study, selected case studies of Indian cultural landscapes were studies with the developed indicators. Musical traditions existing in these sites were theoretically reduced to basic components and mapped for analysis.
Two robust imaging methodologies for challenging environments: Wave-equation dispersion inversion of surface waves and guided waves and supervirtual interferometry + tomography for far-offset refractions
Authors: Li Jing , Lu Kai , Hanafy Sherif , Schuster Gerard 
Published: August 2018

Two robust imaging technologies are reviewed that provide subsurface geologic information in challenging environments. The first one is wave-equation dispersion (WD) inversion of surface waves and guided waves (GW) for the shear-velocity (S-wave) and compressional-velocity (P-wave) models, respectively. The other method is traveltime inversion for the velocity model, in which supervirtual refraction interferometry (SVI) is used to enhance the signal-to-noise ratio of far-offset refractions. We have determined the benefits and liabilities of both methods with synthetic seismograms and field data. The benefits of WD are that (1) there is no layered-medium assumption, as there is in conventional inversion of dispersion curves. This means that 2D or 3D velocity models can be accurately estimated from data recorded by seismic surveys over rugged topography, and (2) WD mostly avoids getting stuck in local minima. The liability is that WD for surface waves is almost as expensive as full-waveform inversion (FWI) and, for Rayleigh waves, only recovers the S-velocity distribution to a depth no deeper than approximately 1/2 to 1/3 wavelength of the lowest-frequency surface wave. The limitation for GW is that, for now, it can estimate the P-velocity model by inverting the dispersion curves from GW propagating in near-surface low-velocity zones. Also, WD often requires user intervention to pick reliable dispersion curves. For SVI, the offset of usable refractions can be more than doubled, so that traveltime tomography can be used to estimate a much deeper model of the P-velocity distribution. This can provide a more effective starting velocity model for FWI. The liability is that SVI assumes head-wave first arrivals, not those from strong diving waves.
Electroconvulsive therapy and later stroke in patients with affective disorders
Authors: Rozing Maarten Pieter , Jørgensen Martin Balslev , Osler Merete 
Published: August 2018

SummaryThe long-term effects of electroconvulsive therapy (ECT) on the risk of stroke are unknown. We examined the association between ECT and risk of incident or recurrent stroke. A cohort of 174 534 patients diagnosed with affective disorder between 2005 and 2016 in the Danish National Patient Registry were followed for stroke until November 2016. The association between ECT and stroke was analysed using Cox regression with multiple adjustment and propensity-score matching on sociodemographic and clinical variables. In 162 595 patients without previous stroke, 5781 (3.6%) were treated with ECT. The total number of patients developing stroke during follow-up was 3665, of whom 165 had been treated with ECT. In patients <50 years, ECT was not associated with stroke (adjusted hazard ratio (HR) = 1.29, 95% CI 0.87–1.93). In patients ≥50, ECT was associated with a lower risk of stroke (adjusted HR = 0.69, 95% CI 0.57–0.89), but this estimate was likely influenced by competing mortality risk. Of 11 939 patients with a history of stroke, 228 (1.9%) were treated with ECT. During follow-up, 2330 (19.5%) patients had a recurrence, of which 26 were patients treated with ECT. ECT was not associated with risk of a new event (HR = 0.69, 95% CI 0.46–1.00; P = 0.05). ECT is not associated with an elevated risk of incident or recurrent stroke.Declaration of interestNone.
Serum Biomarker Signature-Based Liquid Biopsy for Diagnosis of Early-Stage Pancreatic Cancer
Authors: Mellby Linda D. , Nyberg Andreas P. , Johansen Julia S. , Wingren Christer , Nordestgaard Børge G. , Bojesen Stig E. , Mitchell Breeana L. , Sheppard Brett C. , Sears Rosalie C. , Borrebaeck Carl A.K. 
Published: August 2018

Purpose Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, with a 5-year survival of < 10% because of diffuse symptoms leading to late-stage diagnosis. That survival could increase significantly if localized tumors could be detected early. Therefore, we used multiparametric analysis of blood samples to obtain a novel biomarker signature of early-stage PDAC. The signature was derived from a large patient cohort, including patients with well-defined early-stage (I and II) PDAC. This biomarker signature was validated subsequently in an independent patient cohort. Patients and Methods The biomarker signature was derived from a case-control study, using a Scandinavian cohort, consisting of 16 patients with stage I, 132 patients with stage II, 65 patients with stage III, and 230 patients with stage IV PDAC, and 888 controls. This signature was validated subsequently in an independent case-control cohort in the United States with 15 patients with stage I, 75 patients with stage II, 15 patients with stage III, and 38 patients with stage IV PDAC, and 219 controls. An antibody microarray platform was used to identify the serum biomarker signature associated with early-stage PDAC. Results Using the Scandinavian case-control study, a biomarker signature was created, discriminating samples derived from patients with stage I and II from those from controls with a receiver operating characteristic area under the curve value of 0.96. This signature, consisting of 29 biomarkers, was then validated in an independent case-control study in the United States. The biomarker signature could discriminate patients with stage I and II PDAC from controls in this independent patient cohort with a receiver operating characteristic area under the curve value of 0.96. Conclusion This serum biomarker signature might represent a tenable approach to detecting early-stage, localized PDAC if these findings are supported by a prospective validation study.