bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of diffusion and perfusion MRI mismatch on the admission blood glucose and blood pressure values measured in the first 12 hours of acute stroke
Authors: Gür-Özmen Selen , Güngör–Tunçer Özlem , Krespi Yakup 
Published: June 2019

Abstract
Patients with severe stroke and salvageable brain tissue at admission, who have higher glycaemic and blood pressure levels, may have a risk of iatrogenic hypoglycemia/iatrogenic hypotension. In this study, we examined the relationship between the presence of diffusion-weighted imaging (DWI)/perfusion-weighted imaging (PWI) mismatch, admission blood glucose level, and admission blood pressure level in patients who were admitted in the first 12 hours after onset. We studied 212 patients who were prospectively and consecutively registered to the stroke unit from 2006 to 2009. Correlations between mismatch and admission blood pressure level (ABPL) and admission blood glucose level (ABGL) were analyzed using multivariate logistic regression. Mismatch (P = .064, adjusted OR = 2.297, 95% CI, 0.953–5.536) was not associated with a high ABGL in the whole group. However, after excluding patients with diabetes mellitus (DM) (n = 67, 35%), mismatch (P = .033, adjusted OR = 3.801, 95% CI, 1.110–13.015), an impaired level of consciousness, use of anti-DM medication, glycated hemoglobin levels, and cardioembolic aetiology were independent predictors of a high ABGL. The presence of mismatch or proximal vessel occlusion was not associated with ABPL. Female sex (P = .048) and total anterior circulation stroke (P = .008) were independent predictors associated with a higher ABPL. We conclude that patients with hyperacute ischemic stroke with PWI/DWI mismatch are more likely to have hyperglycemia.
Intervention for burnout among English education undergraduates: implications for curriculum innovation
Authors: Igbokwe Uche Lebechi , Nwokenna Edith Nwakaego , Eseadi Chiedu , Ogbonna Chimaobi Samuel , Nnadi Ekwutosi Monica , Ololo Kennedy Okechukwu , Enyoghasim Oguwuike Michael , Otu Otu Akanu , Uma Kalu Ebi , Onuora Theresa Ngozi , Onwube Onyebuchi , Ogbuagu Anuli Regina 
Published: June 2019

Abstract

Background/Objective:
The present study investigated the effect of Rational Emotive Behavior Therapy (REBT) intervention on burnout among English education undergraduates in southeastern Nigeria.

Method:
The study adopted a randomized controlled trial design. A total of 96 English education undergraduates with high burnout symptoms in the participating universities took part in the study. These were randomly assigned to groups – intervention group (n = 48) and control group (n = 48). The Oldenburg Burnout Inventory for students (OLBI-S) was used for data collection. The collected data were analyzed using 2-way mixed repeated measure ANOVA at .05 probability level.

Result:
Results showed that the REBT program significantly reduced the burnout level among English education undergraduates in the intervention group compared to the students in the no-intervention control group as measured by the OLBI-S subscales. Also, the students who benefited from the REBT program maintained reduced burnout levels when the researchers conducted a follow-up.

Conclusion:
Given the present finding, the REBT program is an effective intervention for preventing and managing burnout among students. The present study has important curriculum innovation implications as far as English education is concerned especially in the Nigerian context. This intervention program can be included in the students’ curriculum activities so as to equip the students with necessary therapeutic skills to manage burnout symptoms presently and in the future.
Radiofrequency neurotomy in chronic lumbar and sacroiliac joint pain
Authors: Chen Chia-Hsien , Weng Pei-Wei , Wu Lien-Chen , Chiang Yueh-Feng , Chiang Chang-Jung 
Published: June 2019

Abstract

Background:
Effective treatment of low back pain (LBP) originating in the lumbar and sacroiliac joints is difficult to achieve. The objective of the current study was to compare the clinical effectiveness of radiofrequency (RF) neurotomy versus conservative nonsurgical approaches for the management of chronic lumbar and sacroiliac joint pain.

Methods:
The PICOS framework was adhered to (P [population]: patients with a history of chronic function-limiting lumbar and sacroiliac joint pain lasting at least 6 months; I [intervention]: RF neurotomy; C [comparator]: other nonsurgical treatments; O [outcomes]: the Oswestry Disability Index (ODI), measurement for pain, and a quality of life (QoL) questionnaire; S [study design]: meta-analysis). Two trained investigators systematically searched Medline, Cochrane, EMBASE, and ISI Web of Knowledge databases for relevant studies published in English through March 2019.

Results:
Patients treated with RF neurotomy (n = 528) had significantly greater improvement in ODI scores, pain scores and QoL measured by EQ-5D compared with controls (n = 457); however, significant heterogeneity was observed when data were pooled from eligible studies. In subgroup analyses, patients who received RF neurotomy had a significantly greater improvement in ODI scores compared with those with sham treatment. Patients treated with RF achieved significantly greater improvement in pain scores compared with controls who received sham treatment or medical treatment. In a subgroup analysis of pain in the sacroiliac joint and in lumbar facet joints, the RF neurotomy group achieved a significantly greater improvement in ODI score and pain scores compared with the control group. The ODI score and pain score were improved after 2 months of follow up in the analyses stratified by follow-up duration.

Conclusions:
Use of RF neurotomy as an intervention for chronic lumbar and sacroiliac joint pain led to improved function; however, larger, more directly comparable studies are needed to confirm this study's findings.
Comparison of urinary TIMP-2 and IGFBP7 cut-offs to predict acute kidney injury in critically ill patients
Authors: Zhang Dongquan , Yuan Yuan , Guo Longfei , Wang Quanhong 
Published: June 2019

Abstract

Background:
Tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) are recently identified urinary biomarkers of acute kidney injury (AKI) in critically ill patients. Because their predictive accuracies vary widely, a meta-analysis was performed to evaluate the accuracy of previously reported urinary TIMP-2 and IGFBP7 cut-offs for predicting AKI.

Methods:
This meta-analysis was reported following the guideline of PRISMA. Four databases, PubMed, the Cochrane Library, the ISI Web of Knowledge, and Embase, were systematically searched from inception to June 2018 by 2 investigators, who independently selected studies, extracted relevant data, and evaluated study quality. A bivariate model was used to calculate the pooled estimates.

Results:
The search identified 5 studies with 1619 critically ill patients. Urinary TIMP-2 and IGFBP7 cut-off points of 0.3 (ng/ml)2/1000 had a sensitivity of 0.89 [95% confidence interval (CI) 0.85–0.93], a specificity of 0.48 (95% CI 0.45–0.51) and a diagnostic odds ratio (DOR) of 8.33 (95% CI 5.55–12.52). The area under the curve (AUC) estimated by the summary receiver operating characteristic (SROC) curve was 0.748. Based on 891 critically ill patients from 4 studies, urinary TIMP-2 and IGFBP7 cut-off points of 2.0 (ng/ml)2/1000 had a sensitivity of 0.45 (95% CI 0.37–0.53), a specificity of 0.93 (95% CI 0.91–0.95) and a DOR of 11.43 (95% CI 7.43–17.57). The AUC estimated by SROC was 0.844.

Conclusion:
Cut-off values around 0.3 (ng/ml)2/1000 (high sensitivity) and 2.0 (ng/ml)2/1000 (high specificity) could be accurate surrogate biomarkers predicting AKI in critically ill patients. The urinary TIMP-2 and IGFBP7 cut-off point of 2.0 (ng/mL)2/1000 appears to have the highest overall accuracy.

Trial registration:
PROSPERO registration number 2018: CRD42018084457 Registered on 11 February 2018.
Difficulties in tracheal extubation due to phrenic nerve injury during massive mediastinal tumor resection
Authors: Wang Kui-Rong , Liu Fan-Fan , Zhou Yan-Feng 
Published: June 2019

Abstract

Rationale:
Massive mediastinal tumors present a major challenge for surgery and anesthesia management due to possible perioperative circulation and respiratory dysfunction.

Patient concerns:
A 36-year-old female underwent difficulty with tracheal extubation and required mechanical ventilation for 3 months after resection of a massive mediastinal tumor.

Diagnoses:
Postoperative B-ultrasound examination of diaphragmatic motor weakness and electrophysiological examination indicated respiratory failure due to phrenic nerve injury.

Interventions:
The patient failed tracheal extubation several times after the operation and finally a tracheotomy was performed. Mechanical ventilation, anti-infective treatment, and systemic supportive treatment were provided.

Outcomes:
The patient recovered well after tracheotomy and approximately 3 months of ventilation support.

Lessons:
Weaning difficulty caused by phrenic nerve injury seriously affected patient postoperative rehabilitation. To reduce the occurrence of similar problems, intraoperative phrenic nerve electrophysiological monitoring should be conducted.
Efficacy of amlodipine besylate and Valsartan for the treatment of mild to moderate hypertension
Authors: Wang Xiao-ou , Tian Wen 
Published: June 2019

Abstract

Background:
Clinical researchers found that Amlodipine besylate and Valsartan (ABVS) can effectively treat mild to moderate hypertension (MMH). However, no study has systematically investigated its efficacy and safety for patients with MMH. Thus, present study will systematically assess the efficacy and safety of ABVS for patients with MMH.

Methods:
MEDICINE, Cochrane Library, EMBASE, Ovid, PsycINFO, Web of Science, Allied and Complementary Medicine Database, and China National Knowledge Infrastructure will be searched for literatures related to the topic from inception to the present without language limitations. All randomized controlled trials that assess the efficacy and safety of ABVS for patients with MMH will be considered for inclusion. Two researchers will independently select study, extract data, and assess risk of bias for all eligible studies.

Results:
The primary outcome includes the change of seated diastolic blood pressure. The secondary outcomes consist of the change of seated systolic blood pressure, health-related quality of life, and the tolerability.

Conclusions:
The results of this study will summarize the latest evidence on ABVS for the treatment of MMH.

Ethics and dissemination:
This study does not need ethical approval, because it will not use individual data. The results of this study are expected to be published at peer-reviewed journals.

PROSPERO registration number:
PROSPERO CRD42019133123.
Acupuncture for lumbar myofascial pain Protocol for a systematic review of randomized controlled trials
Authors: Chen Yupei , Li Xiaohong , Xu Jing , Chen Jie , Huo Zejun , Zhang Li 
Published: June 2019

Abstract

Background:
Lumbar myofascial pain is a major contributor to chronic low back pain. Acupuncture has been applied as an effective treatment for chronic low back pain worldwide. However, few critical systematic reviews focus on the effect of acupuncture on chronic low back pain caused by lumbar myofascial pain have been published. The study aims to evaluate the current evidence on the efficacy of acupuncture for chronic low back pain caused by lumbar myofascial pain.

Methods:
A total of 7 databases will be searched from their inception to March 2019, including PubMed, Medline, Embase, the Cochrane Central Register of Controlled Trials, the Chinese National Knowledge Infrastructure database, the Chinese Biomedical database, and the Wanfang database. Randomized controlled trials (RCTs) that compared the effect of acupuncture for lumbar myofascial pain will be included. The primary outcomes will be reduction of lumbar myofascial pain assessed by Visual Analog Scale (VAS). Secondary outcomes are questionnaires to evaluate the effects of treatment on patients’ daily life activities and psychological status; and adverse events. The primary and secondary outcomes will be assessed before (0 day) treatment and at 0, 7, 30, and 90 days after treatment. Data synthesis will be computed by RevManV.5.3.5 software when a data-analysis is allowed. Methodological quality will be evaluated with the risk of bias according to Cochrane Handbook.

Results:
The results of this study will be published in a peer-reviewed journal.

Conclusion:
The study will provide evidence to illustrate acupuncture is an effective therapeutic intervention for chronic low back pain caused by lumbar myofascial pain.

Trial registration number:
PROSPERO CRD42019129735
Infracardiac total anomalous pulmonary venous return in a patient with Williams syndrome
Authors: Zou Yanqiang , Wu Jie , Wang Guohua , Zhou Cheng , Dong Nianguo 
Published: June 2019

Abstract

Rationale:
Total anomalous pulmonary venous return (TAPVR) is a rare condition, accounting for 1% of all congenital heart diseases, and an atypical cardiovascular abnormality in Williams syndrome (WS). Here, we report a rare case of WS combined with infracardiac TAPVR.

Patient concerns:
A female newborn presented shortness of breath and purpura after crying at the age of 10 days.

Diagnosis:
Based on clinical symptoms and laboratory and echocardiographic findings, the patient was diagnosed with infracardiac TAPVR.

Interventions:
We performed infracardiac total anomalous pulmonary venous connection repair surgery.

Outcomes:
The operation was successful and the patient was discharged from the hospital uneventfully after 2 months of treatment. However, we diagnosed the patient with WS in addition to infracardiac TAPVR 6 months postoperatively.

Lessons:
This case demonstrates that patients with WS can have associated infracardiac TAPVR. The postoperative growth patterns and changes in the diameters of the aorta and pulmonary arteries were related closely to our early diagnosis of TAPVR associated with WS.
High Quality of Care Persists With Shifting Depression Services From VA Specialty to Integrated Primary Care
Authors: Leung Lucinda B. , Escarce José J. , Yoon Jean , Sugar Catherine A. , Wells Kenneth B. , Young Alexander S. , Rubenstein Lisa V. 
Published: June 2019

Background/Objective:
Offering depression collaborative care services in primary care (PC) settings can reduce use of nonintegrated mental health care resources and improve mental health care access, particularly for vulnerable PC patients. Tests of effects on depression care quality, however, are needed. We examined overall quality of depression care and tested whether increasing clinic engagement in Veterans Affairs (VA)’s Primary Care-Mental Health Integration (PC-MHI) services was associated with differences in depression care quality over time.

Methods:
We conducted a retrospective longitudinal cohort study of 80,136 Veterans seen in 26 Southern California VA PC clinics (October 1, 2008–September 30, 2013). Using multilevel regression models adjusting for year, clinic, and patient characteristics, we predicted effects of clinic PC-MHI engagement (ie, percent of PC patients receiving PC-MHI services) on 3 VA-developed longitudinal electronic population-based depression quality measures among Veterans newly diagnosed with depression (n=12,533).

Results:
Clinic PC-MHI engagement rates were not associated with significant depression care quality differences. Across all clinics, average rates of follow-up within 84 or 180 days were, 66.4% and 74.5%, respectively. Receipt of minimally appropriate treatment was 80.5%. Treatment probabilities were significantly higher for vulnerable PC patients (homeless: 4.5%, P=0.03; serious mental illness: 15.2%, P<0.001), than for otherwise similar patients without these characteristics.

Conclusions/Policy Implications:
Study patients treated in PC clinics with greater PC-MHI engagement received similarly high quality depression care, and even higher quality for vulnerable patients. Findings support increasing use of PC-MHI models to the extent that they confer some advantage over existing services (eg, access, patient satisfaction) other than quality of care.
Perceived Patient Safety Culture in Nursing Homes Associated With “Nursing Home Compare” Performance Indicators
Authors: Li Yue , Cen Xi , Cai Xueya , Temkin-Greener Helena 
Published: June 2019

Background:
The safety and quality of care provided to nursing home residents is a significant concern. Little is known whether fostering patient safety culture helps improve the safety and quality of nursing home care.

Methods:
This study determined the associations of nursing home patient safety culture performance, as reported by administrators, directors of nursing, and unit leaders in a large national sample of free-standing nursing homes, with several “Nursing Home Compare” performance indicators. We conducted the survey in 2017 using the Agency for Healthcare Research and Quality Survey on Patient Safety Culture for nursing homes to collect data on 12 core domains of safety culture scores. Survey data were linked to other nursing home files for multivariable regression analyses.

Results:
Overall, 818 of the 2254 sampled nursing homes had at least 1 completed survey returned for a response rate of 36%. After adjustment for nursing home, market, and state covariates, every 10 percentage points increase in overall positive response rate for safety culture was associated with 0.56 fewer health care deficiencies (P=0.001), 0.74 fewer substantiated complaints (P=0.004), reduced fines by $2285.20 (P=0.059), and 20% increased odds of being designated as 4-star or 5-star (vs. 1 to 3 star) facilities (odds ratio roughly=1.20, P<0.05).

Conclusions:
Efforts to improve nursing home performance in patient safety culture have the potential to improve broad safety and quality of care measures encapsulated in the Nursing Home Compare publication.
Evaluation of a Novel Educational Tool in Adolescents With Inflammatory Bowel Disease
Authors: Vaz Karla K.H. , Carmody Julia K. , Zhang Yue , Denson Lee A. , Hommel Kevin A. 
Published: June 2019

ABSTRACTObjectives:Among adolescents with inflammatory bowel disease (IBD), nonadherence rates are 50 to 88% across medications. Improving education in adults with IBD has been shown to improve coping and adherence to treatment in adults with IBD. Therapeutic patient education (TPE) has been used in patients with chronic diseases to train patients in skills to support treatment adaptation and condition management. This study tested the feasibility and preliminary efficacy of a novel TPE intervention in adolescents with IBD.Methods:In this pilot, mixed‐methods study, we evaluated the feasibility and preliminary efficacy of TPE with the IBD Pocket Guide on medication adherence, IBD knowledge, and transition readiness in adolescents ages 11 to 18 years. Medication adherence was monitored using a MedMinder Pill Dispensing system. Participants who were <90% adherent during a 4‐week pre‐intervention monitoring period were randomized to either a usual care group or an educational intervention (EI) group. Participants were followed for an additional 4 weeks after intervention.Results:Trends were found in the EI group indicating improved medication adherence and IBD knowledge compared with the usual care group, though differences between groups did not reach statistical significance. Qualitative data showed that participants perceived that they had improved knowledge after the educational intervention.Conclusions:Therapeutic patient education may be beneficial for improving patient medication adherence and IBD knowledge. Future directions include testing the effects of the intervention with a larger sample.
Does Depressive-Type Schizophrenia Exist? How Do We Prove It?
Authors: Huang Jianjie , Zhuo Chuanjun , Song Xueqin , Li Yachen , Jing Rixing , Tian Hongjun , Wang Lina , Mao Fuqiang , Li Shen , Jiang Ronghuan , Chen Suling 
Published: June 2019

AbstractDepressive symptoms can occur at any point in the duration of schizophrenia. However, we are unable to predict if or when depression will occur in schizophrenic patients. Simultaneously, the standard treatment of depression in schizophrenic patients is the combination of antidepressants and antipsychotics, which has been minimally effective for most patients. Based on several studies, we hypothesized the existence of depressive-type schizophrenia and reviewed the substantial evidence supporting the hypothesis of depressive-type schizophrenia. Simultaneously, we propose technical methods to explore the neuropathology of depressive-type schizophrenia in order to identify the disease during its early stages and to predict how patients will respond to the standard treatment strategies. We believe that the new classification of depressive-type schizophrenia will differentiate it from other forms of depression. In return, this will aid in the discovery of new therapeutic strategies for combatting this disease.
Religious Belief at the Level of the Brain
Authors: Gaw Albert C. 
Published: June 2019

Abstract
This article summarizes key functional magnetic resonance imaging studies that correlate the neural substrate of religious belief and the influence of culture. I searched and updated PubMed (http://www.ncbi.nlm.nih.gov/pubmed) publications until March 2018 on religious belief and related topics. Belief, whether religious or nonreligious, is associated with greater signal in the ventromedial prefrontal cortex (vMPFC), a brain region important for self-representation, emotional associations, reward, and goal-driven behavior. However, religious belief, compared with nonreligious belief, registers greater signal in the precuneus, anterior insula, ventral striatum, anterior cingulate cortex, and posterior medial cortex—areas associated with governance of emotion, self-representation, and cognitive conflict. In contrast, nonreligious belief registers more signal in the left hemisphere memory networks (Harris et al. PLoS One 2009;4:e0007272). Moreover, cultural studies revealed self-judgment tasks in nonbelievers involved more the vMPFC, whereas Christians had significantly increased activation in the dorsomedial prefrontal cortex (Han et al. Soc Neurosci 2008;3:1–15). Consequently, the Christian belief of “surrendering to Christ” seemed to weaken neural coding of stimulus self-relatedness but enhanced neural activity underlying evaluative processes of self-referential stimuli. The findings suggest a transformation of the semantic autobiographical self to Christ's conceptual self.
Activation of Hypoxia-Inducible Factor-1α Via Succinate Dehydrogenase Pathway During Acute Lung Injury Induced by Trauma/Hemorrhagic Shock
Authors: Li Mengya , Li Guifeng , Yu Buwei , Luo Yan , Li Qifang 
Published: June 2019

ABSTRACT
Hypoxia-inducible factor (HIF)-1α is a transcription factor that is critical for tissue adaptation to hypoxia and inflammation. Previous studies had indicated that normoxic activation of HIF-1α in cancer involves inhibition or mutation of the metabolic enzyme succinate dehydrogenase (SDH). We have found that local inhibition of HIF-1α ameliorates acute lung injury (ALI) induced by trauma/hemorrhagic shock (T/HS) in rats. In this study, we found pulmonary activation of HIF-1α and inhibition of SDH during THS-induced ALI in rats and transcriptional activation of HIF-1α during ALI induced by T/HS lymph via SDH pathway in vitro. Furthermore, pharmacologic inhibition of HIF-1α attenuates lung inflammation and pulmonary edema during ALI by T/HS. Activation of HIF-1α is detrimental to ALI induced by T/HS. Thus, our data suggest that HIF-1α activation by T/HS is necessary for T/HS-induced lung injury and a critical role for SDH in the initiation of acute inflammatory response after ALI. Nevertheless, this is a preclinical work and several limitations impede translation of the findings to patients, such as uncontrolled bleeding and simultaneous treatment, and prolonged course of clinical shock on the outcome of the work, which needs to be addressed in future.