bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of covariates on heterogeneity in Hamilton Anxiety Scale ratings in placebo-controlled trials of benzodiazepines in generalized anxiety disorder: Systematic review and meta-analysis
Authors: Gale Chris , Glue Paul , Guaiana Giuseppe , Coverdale John , McMurdo Maeve , Wilkinson Sam 
Published: January 2019

Background: Generalized anxiety disorder is a common psychiatric condition that is associated with decreased quality of life and significant disability. Benzodiazepines are anti-anxiety drugs used widely in the treatment of generalized anxiety disorder. This study examines the influence of several variables on benzodiazepine efficacy in generalized anxiety disorder. Method: We performed a systematic review of placebo-controlled randomized controlled trials with benzodiazepines in generalized anxiety disorder. Fifty-eight studies were deemed eligible to include in the meta-analysis. The studies dated from 1977 to 2013 and included over 5400 participants. From each paper, we extracted: benzodiazepine name and dose, dosing regimen, baseline Hamilton Anxiety Scale (HAM-A) score, change in HAM-A score at study endpoint, drop-out rate, year of study publication, diagnostic criteria used, study size, study duration, location, any conflicts of interest and side-effect profile. We then assessed the influence, direct and indirect, of individual variables on the primary outcome (mean difference at endpoint, HAM-A score). Results: Three factors were shown to be associated statistically with change in HAM-A; baseline HAM-A for benzodiazepine arm, baseline HAM-A for the placebo arm, and duration of the study. A higher baseline HAM-A in both arms was associated with a greater mean difference in HAM-A. A shorter study length was also associated with a greater mean difference. Discussion: The major factors determining benzodiazepine response was baseline anxiety level for the benzodiazepine arm and study duration. In any design of further meta-analyses and clinical trials for generalized anxiety disorder we suggest that these should be considered these as confounding factors.
Partial Meniscectomy for Degenerative Medial Meniscal Root Tears Shows Favorable Outcomes in Well-Aligned, Nonarthritic Knees
Authors: Lee Bum-Sik , Bin Seong-Il , Kim Jong-Min , Park Min-Ho , Lee Sang-Min , Bae Kun-Hyung 
Published: January 2019

Background: Arthroscopic meniscectomy has been commonly performed for persistent pain caused by degenerative medial meniscal posterior root tears (MMPRTs). However, risk factors that affect long-term outcomes and joint survivorship after meniscectomy are unclear. Purpose: To identify the risk factors associated with end-stage osteoarthritis after arthroscopic meniscectomy for degenerative MMPRT for middle-aged or elderly patients and to determine the joint survivorship according to the identified risk factors. Study Design: Case-control study; Level of evidence, 3. Methods: Data from 288 patients (24 male and 264 female), followed for at least 5 years after arthroscopic meniscectomy for degenerative MMPRTs performed between 1999 and 2010, were examined retrospectively. The modified Lysholm score was used for clinical evaluation. Cox proportional hazards regression analysis was used to assess factors that affect joint survivorship when conversion to total knee arthroplasty (TKA) was taken as the endpoint; these factors were age, sex, body mass index (BMI), preoperative tibiofemoral alignment (varus [<2° valgus] vs well-aligned [2°-10° valgus]), preoperative Kellgren-Lawrence grade (0 or 1 vs 2 or 3), and the modified Outerbridge grade of the medial compartment. Kaplan-Meier survival analysis and the log-rank test were used to compare overall survivorship with respect to each significant risk factor. Results: Mean age at the time of surgery was 58.9 years (range, 43-78 years). Sixty (20.8%) patients underwent TKA at 7.0 ± 3.6 years (range, 1.1-14.4 years) postoperatively. The mean follow-up time for those who did not undergo TKA was 8.9 ± 2.9 years (range, 4.5-16.5 years). The overall modified Lysholm score improved from 64.4 to 81.3 ( P < .001), but progression of radiographic arthritis was noted in 156 (61.9%) patients ( P < .001) at 2 years postoperatively. Age (hazard ratio [HR] = 1.049), BMI (HR = 1.092), varus alignment (HR = 2.283), and Kellgren-Lawrence grade 2 or higher (HR = 2.960) were significant risk factors for end-stage arthritis requiring TKA. Well-aligned nonarthritic knees (n = 131, 45.5%) survived significantly longer before requiring TKA than did knees with varus alignment or radiographic arthritis ( P < .05). The 5- and 10-year survival rates in these low-risk groups were 97.7% (95% CI, 95.2%-100.2%) and 89.1% (95% CI, 82.4%-95.8%), respectively. Conclusion: Arthroscopic meniscectomy is an effective treatment for degenerative MMPRTs, with favorable long-term survival in well-aligned nonarthritic knees. However, meniscectomy should be undertaken cautiously in patients with varus alignment and preoperative radiographic osteoarthritis.
Analyzing and Critiquing the Concepts of Professional Autonomy and Accountability through the Prisms of Decentralization and Constructivist Theory
Authors: Shapiro Arthur , Koren Andrej 
Published: January 2019

This analysis and synthesis explores constructs of professional autonomy and accountability using constructivist theory and practice to examine the organizational dynamics of centralization/decentralization, particularly as applied to educational organizations. Major schools of constructivist thought are explored to shed light on centralization/decentralization dynamics, which then are used to explore constructs of professional autonomy and accountability. Oldroyd's comparison of the United States and United Kingdom's heavy focus on “education for results,” or accountability, is compared with Scandinavia's preference for “education for learning.” The former results in centralization and accountability; the latter emphasizes the local locus of control, thus supporting autonomy. The overwhelming consensus as the twentieth century closed has been that knowledge is constructed. —D. C. Phillips, Constructivism in Education (2000, p. viii)
Head and Bottle Angles Achieved by Patients During High-Volume Sinonasal Irrigations
Authors: Griggs Zachary H. , Williams Amy M. , Craig John R. 
Published: January 2019

Background Certain head positions can optimize topical irrigation distribution to specific sinuses. No studies have assessed whether patients attain these positions when irrigating. Objective The purpose of this study was to assess head and bottle angles achieved when patients irrigate based on instructions from an irrigation device or from a Rhinologist. Methods Study approval was obtained from Henry Ford Health System’s Institutional Review Board (10604). Forty-two patients with various rhinologic conditions were equally divided into groups based on irrigation instruction type: pictoral instructions from an irrigation device or written/verbal instructions from a Rhinologist. Both groups’ instructions directed nose-to-floor head positioning. Simulating home irrigations, patients irrigated 120 mL of saline into each naris using 240 mL squeeze bottles. Frontal and lateral views were captured using video cameras. On frontal view, angles were measured between (1) nasal dorsum (ND) and bottle tip (BT; n = 84) and (2) ND and vertical (V; n = 84). On lateral view, angles were measured between (1) line from nasion-to-pogonion (NTP) and horizontal (H) (n = 73) and (2) NTP and BT (n = 73). Results On lateral view, average angle between NTP and H was 20.0° (standard deviation [SD] = 13.1, 95% confidence interval [CI] = 17.0–23.0) and between NTP and BT was 59.4° (SD = 15.8, 95% CI = 55.8–63.1). On frontal view, average angle between ND and V was 9.5° (SD = 19.5, 95% CI = 5.3–13.6) and between ND and BT was 24.5° (SD = 12.0, 95% CI = 21.9–27.0). There were no significant angle differences between sides or instruction types. Conclusion When instructed to irrigate in the nose-to-floor head position, patients achieved a head position uprotated 20° on lateral view and vertex rotated 10° away from the side of irrigation on frontal view.
Single Questions for the Screening of Anxiety and Depression in Hemodialysis
Authors: Collister David , Rodrigues Jennifer C. , Mazzetti Andrea , Salisbury Kelsi , Morosin Laura , Rabbat Christian , Brimble K. Scott , Walsh Michael 
Published: January 2019

Background: Depression and anxiety are common and underrecognized in end-stage renal disease (ESRD), are associated with poor outcomes and reduced health-related quality of life, and are potentially treatable. Simple, accurate screening tools are needed. Objective: We examined the operating characteristics of single questions for anxiety and depression from the Edmonton Symptom Assessment System (ESAS) in hemodialysis. Design: Cross-sectional study. Setting: Two outpatient hemodialysis units (1 tertiary, 1 community) in Hamilton, Canada. Patients: Adult prevalent hemodialysis patients. Measurements: ESAS and Hospital Anxiety and Depression Scale (HADS). Methods: Participants were asked the degree to which they experienced anxiety and depression using the ESAS. ESAS single questions for anxiety and depression were compared with the reference standard of the HADS using dialysis population specific cutoffs (HADS anxiety subscale ≥6 and HADS depression subscale ≥7). Logistic regression was used to create receiver operating characteristics (ROC) curves. Results: We recruited 50 participants with a mean age of 64 (SD = 12.4) years, of whom 52% were male and 96% were on ≥3× weekly hemodialysis. Using the reference standards, 28 (56%) had a diagnosis of anxiety and 27 (54%) had a diagnosis of depression. Areas under the ROC curves were 0.83 for anxiety and 0.81 for depression using ESAS scores of ≥2. Limitations: Sample size and the lack of a reference gold standard. Conclusions: The ESAS single questions for anxiety and depression have reasonable discrimination in a hemodialysis population. The use of more complex and time-consuming screening instruments could be reduced by adopting the ESAS questions for anxiety and depression in hemodialysis.
Nonoperative Treatment for Partial Ruptures of the Lateral Collateral Ligament Occurring in Combination With Complete Ruptures of the Anterolateral Ligament: A Common Injury Pattern in Brazilian Jiu-Jitsu Athletes With Acute Knee Injury
Authors: Temponi Eduardo Frois , Saithna Adnan , de Carvalho Lúcio Honório , Teixeira Bruno Presses , Sonnery-Cottet Bertrand 
Published: January 2019

Background: Combined partial lateral collateral and complete anterolateral ligament (PLCCALL) injuries are a specific injury pattern seen in Brazilian jiu-jitsu (BJJ) because of the knee varus-flexion mechanism that frequently occurs during grappling. Purpose/Hypothesis: The purpose of this study was to evaluate the incidence of this injury pattern in a series of BJJ athletes with an acute knee injury and to evaluate clinical and functional outcomes after nonoperative management at a minimum follow-up of 1 year. Our hypotheses were that PLCCALL injuries are common in BJJ and that nonoperative treatment is associated with excellent clinical outcomes and return to the preinjury level of sport. Study Design: Case series; Level of evidence, 4. Methods: All BJJ athletes who presented with an acute knee injury between July 2013 and June 2017 and who underwent magnetic resonance imaging (MRI) of the knee were included. A specific emphasis was placed on identifying those whose imaging demonstrated PLCCALL injury. Clinical evaluation included physical examination as well as Lysholm and International Knee Documentation Committee (IKDC) scores. Results: Of the 27 patients analyzed, 7 (25.9%) had MRI-proven PLCCALL injuries. The mean follow-up after nonoperative management was 41.3 months. The mean IKDC and Lysholm scores were 94 and 92 before the injury, 26 and 36 at the initial assessment after the injury, and 83 and 78 at 12-month follow-up, respectively ( P < .00001). All 7 patients had returned to their preinjury level of sports by the 12-month follow-up. The mean time between injury and return to competition level was 4.7 months (range, 4-6 months). Conclusion: PLCCALL injury is a specific but infrequent injury pattern in BJJ. The prognosis of this injury after nonoperative treatment appears to be excellent. Improved functional scores (IKDC and Lysholm) and changes on MRI demonstrated that the anterolateral ligament has intrinsic healing potential, as the images showed complete healing of the previously documented rupture of the anterolateral ligament from its proximal attachment.
Comparison of prostate delineation on multimodality imaging for MR-guided radiotherapy
Authors: Pathmanathan Angela U , McNair Helen A , Schmidt Maria A , Brand Douglas H , Delacroix Louise , Eccles Cynthia L , Gordon Alexandra , Herbert Trina , van As Nicholas J , Huddart Robert A , Tree Alison C 
Published: January 2019

Objective:With increasing incorporation of MRI in radiotherapy, we investigate two MRI sequences for prostate delineation in radiographer-led image guidance.Methods:Five therapeutic radiographers contoured the prostate individually on CT, T 2 weighted (T 2W) and T 2* weighted (T 2*W) imaging for 10 patients. Contours were analysed with Monaco ADMIRE (research v. 2.0) to assess interobserver variability and accuracy by comparison with a gold standard clinician contour. Observers recorded time taken for contouring and scored image quality and confidence in contouring.Results:There is good agreement when comparing radiographer contours to the gold-standard for all three imaging types with Dice similarity co-efficient 0.91–0.94, Cohen’s κ 0.85–0.91, Hausdorff distance 4.6–7.6 mm and mean distance between contours 0.9–1.2 mm. In addition, there is good concordance between radiographers across all imaging modalities. Both T 2W and T 2*W MRI show reduced interobserver variability and improved accuracy compared to CT, this was statistically significant for T 2*W imaging compared to CT across all four comparison metrics. Comparing MRI sequences reveals significantly reduced interobserver variability and significantly improved accuracy on T 2*W compared to T 2W MRI for DSC and Cohen’s κ. Both MRI sequences scored significantly higher compared to CT for image quality and confidence in contouring, particularly T 2*W. This was also reflected in the shorter time for contouring, measuring 15.4, 9.6 and 9.8 min for CT, T 2W and T 2*W MRI respectively.Conclusion:Therapeutic radiographer prostate contours are more accurate, show less interobserver variability and are more confidently and quickly outlined on MRI compared to CT, particularly using T 2*W MRI.Advances in knowledge:Our work is relevant for MRI sequence choice and development of the roles of the interprofessional team in the advancement of MRI-guided radiotherapy.
Natural Wolbachia infections in malaria vectors in Kayin state, Myanmar
Authors: Sawasdichai Sunisa , Chaumeau Victor , Dah Tee , Kulabkeeree Thithiworada , Kajeechiwa Ladda , Phanaphadungtham Monthicha , Trakoolchengkaew Muesuwa , Kittiphanakun Praphan , Akararungrot Yanada , Oo Kyi , Delmas Gilles , White Nicholas J. , Nosten François H. 
Published: January 2019

Background: Natural Wolbachia infections in malaria mosquitoes were recently reported in Africa, and negatively correlated with the development of Plasmodium falciparum in the vectors. The occurrence and effects of Wolbachia infections outside Africa have not been described and may have been underestimated. Methods: Mosquitoes were collected by human-landing catch during May and June 2017 in ten villages in Kayin state, Myanmar. Closely related species of malaria vectors were identified with molecular assays. Wolbachia infection rates were assessed by quantitative real-time PCR. Results: Malaria vectors were identified in the Funestus, Maculatus and Leucosphyrus Groups. Wolbachia were detected in 6/6 Anopheles species and in 5/10 villages. Mean prevalence of Wolbachia infection was 2.7% (95%CI= [1.3; 4.9]). The median Wolbachia load was seven orders of magnitude less in naturally infected malaria vectors than in artificially infected laboratory-reared Aedes aegypti. Phylogenetic analysis based on 16S rRNA sequences revealed a high diversity of Wolbachia strains and identified lineages different from those described in Africa. Conclusion: Natural Wolbachia infections are common and widespread in malaria vectors in Kayin state, Myanmar. Their effects on Anopheles mosquitoes and malaria transmission is yet to be determined.
Mit – umysł – rzeczywistość. Kognitywne uwarunkowania archaicznych form narracyjnych na przykładzie mitu
Authors: Czeremski Maciej 
Published: January 2019

The article discusses the cognitive conditions of mythical narratives, especially their relationship with the architecture of the human mind and the processes of its evolutionary formation. The analyzed features are: a) a permanent arrangement of events (monomyth); b) a semiosis based on bricolage, and c) a counter-intuitive supernaturalism. The stability of the system of mythical events is related to the subjective significance of the elements of the chain of basic biological activities. The proposed explanation for bricolage is the embodied nature of the human mind. In combination with the archaic character of the myth, it translates tendency to code abstraction in specific objects. The presence of counter-intuitiveness in the myth is explained by the interaction between innate knowledge about ontological categories and cognitive fluidity, which allows to deformed them and the influence of what is counter-intuitiveness on the effectiveness of the cultural transmission of narrative containing it.
In vitro and in vivo evaluation of colon cancer targeted epichlorohydrin crosslinked Portulaca-alginate beads
Authors: Asnani Geet P. , Kokare Chandrakant R. 
Published: January 2019

AbstractThe aim of this study was to formulate a novel dual crosslinked hydrogel bead using Portulaca mucilage for colon-targeted delivery of 5-fluorouracil (5-FU) and evaluate its safety, specificity and efficacy. The ionotropic gelation technique was employed to prepare the hydrogel beads of Portulaca mucilage. For this, the mucilage was initially crosslinked with alginate and calcium ions. Epichlorohydrin was employed as a crosslinker in the second crosslinking step. The formulation was subjected to in vitro and in vivo studies to evaluate morphology, size, cytotoxicity, and organ distribution. Human HT-29 colon cancer cell-line was used for in vitro assays and in vivo studies were performed in Wistar rats to assess the usefulness and effectiveness of the formulation for colon cancer therapy. Microsphere sizes ranged from 930 to 977μm and possessed a high level of drug encapsulation efficiency (ca. 78% w/w). Compared with 5-FU solution (Tmax = 1.2 h, mean resident time: MRT = 3.3h) the dual crosslinked Portulaca microspheres exhibited sustained drug release after oral administration to rats (Tmax = 16h, MRT = 14h). The relative bioavailability of 5-FU solution and the microspheres were 100 and 93.6% respectively. Tissue distribution studies indicated high concentration of 5-FU in colon. In-vitro anticancer assay demonstrated IC50 value of 11.50 μg/ml against HT-29 colon cancer cell line. The epichlorohydrin cross-linked Portulaca microspheres prepared in this study provided sustained release of 5-FU up to 16h in the colonic region and enhanced the antitumor activity of the neoplastic drug. The formulation is hence an ideal carrier system for colon-targeted drug delivery.
Prescribed opioid analgesic use developments in three Nordic countries, 2006–2017
Authors: Muller Ashley Elizabeth , Clausen Thomas , Sjøgren Per , Odsbu Ingvild , Skurtveit Svetlana 
Published: January 2019

Abstract

Background and aims
While the Nordic countries have considerably stricter controls on opioid prescribing for chronic non-cancer pain than other countries, previous research has warned that prescription of strong opioids is increasing. This study examines consumption of and developments in dispensed prescribed opioids to individuals receiving ambulatory care from 2006 to 2017, using publicly available data from each of three Nordic countries’ national prescription registries.

Methods
Repeated, cross-sectional design. One-year prevalence of all dispensed prescribed opioids in ATC N02A group were reported for Norway, Denmark, and Sweden in the period 2006–2017 by gender. One-year prevalence of the weak opioids tramadol and codeine and the strong opioid oxycodone were then reported separately over this period for each country. The mean defined daily dose (DDD) per user per year, an estimate of the amount of opioids prescribed, was reported for each of the three opioids in 2016.

Results
Patterns of dispensed prescribed opioids differ greatly between 2006 and 2017 and between countries, with tramadol increasing in Norway, codeine declining across the board, and oxycodone increasing in all three countries. Norway exceeded Sweden and Denmark in prevalence of all dispensed prescribed opioids, with 12.1% of the female Norwegian population and 9.2% of the male Norwegian population dispensed at least one prescribed opioid as an outpatient in 2016. Norway’s high overall prevalence rates are tempered by dispensing the lowest mean doses of both weak opioids compared to Sweden. Similarly, Sweden dispenses the lowest mean doses of oxycodone but to the largest proportion of its population (3.0%).

Conclusions
Significant shifts have occurred in the dispensing of prescribed opioids in Norway, Sweden, and Denmark over the past 12 years. The increasing prevalence of oxycodone in all three countries should continue to be monitored. Prescription registries provide a wealth of publicly available data that can be used to monitor and to guide prescribing policies in a more knowledge-based direction.