bluuebunny/crossref_metadata_2025_split huggingface dataset:
Residual symptoms after natural remission of insomnia: associations with relapse over 4 years
Authors: Ji Xiaowen , Ivers Hans , Savard Josée , LeBlanc Mélanie , Morin Charles M 
Published: June 2019

Abstract

Study Objectives
Chronic insomnia tends to “wax and wane” over lifetime. The presence of residual insomnia symptoms is common, especially among naturally remitted individuals. This study aims to examine the features of these residual symptoms and their potential association with future relapse.

Methods
A population-based data set on the natural history of insomnia was used for this secondary analysis. Residual insomnia symptoms were investigated in those who had insomnia symptoms/syndrome at baseline and achieved full remission (according to predetermined diagnostic algorithm) within the following 1 year. Cox regressions were used to determine the hazard ratio (HR) of each residual symptom for predicting relapse in the next 4 years. The nature and severity of residual symptoms were examined with an extended version of the Insomnia Severity Index (ISI), which incorporates additional items on sleep quality and specific sleep-related daytime impairments (on daytime fatigue, cognitive functioning, mood, interpersonal relationship, and daily activities). In addition, the presence of depressive symptoms and medical conditions were controlled for in investigating risks of insomnia relapse.

Results
A total of 434 participants were included in this study (age ranges from 18 to 94; 65.9% female); 248 of them had relapsed within 4 years. The response rate ranged from 78% to 83%. The most frequently reported residual symptoms with at least moderate severity (ISI items ≥2 on 0–4 ISI item scale) were poor “Quality of sleep” (39.2 %), followed by “difficulty maintaining sleep” (DMS; 27%). The most common residual daytime impairments related to insomnia were fatigue (24.7 %), mood disturbances (23%) and cognitive disturbances (22.6%). After controlling for baseline insomnia and depression severity and concurrent physical diseases, impairments of cognition (HR = 1.46), poor quality of sleep (HR = 1.43), disturbed mood (HR = 1.39), being female (HR = 1.36), DMS (HR = 1.35), and fatigue (HR = 1.24) were significantly associated with insomnia relapse in the next 4 years. Moreover, residual poor sleep quality and daytime insomnia symptoms were independent of DMS in predicting relapse. Subgroup regressions according to sex showed that for male participants, residual cognition impairments (HR = 1.98) was the most significant predictors of future relapse, whereas residual DMS (HR = 1.46) significantly predicted relapse for women only.

Conclusion
A wide range of residual symptoms exists in individuals with naturally remitted insomnia. Notably, residual DMS is the most common residual nighttime symptom and the only nighttime symptom associated with insomnia relapse. Additionally, perceived poor sleep quality and cognitive, mood, and somatic impairments attributed to sleep disturbances are also related to future relapse. Attention to these residual symptoms when initiating insomnia treatment is warranted to minimize future relapse.
Effects of extended-release eprinomectin on fescue toxicosis, performance, and reproduction on fall-calving beef cows
Authors: Volk Mareah J , Krause Taylor R , Stokes Rebecca S , Ireland Frank A , Shike Daniel W 
Published: June 2019

Abstract
The objective of this experiment was to evaluate effects of extended-release eprinomectin on fescue toxicosis and impacts on performance and reproduction in fall-calving beef cows. Fall-calving Angus × Simmental multiparous cows [n = 335; age = 5.8 ± 2.1 yr; 586.5 ± 6.0 kg body weight (BW); 5.48 ± 0.05 body condition score (BCS)] were stratified by BW, age, and BCS and randomly assigned to one of three treatments. Treatments included a spring injection of extended-release eprinomectin (SERE) on day 0, a fall injection of extended-release eprinomectin injection (FERE) on day 84, and a saline control (CON). All treatments were administered at a rate of 1 mL/50 kg BW. Prior to the experiment, all cows were treated with oral fenbendazole to minimize parasite load. Cows grazed endophyte-infected tall fescue. Hair coat score (HCS), BW, and BCS were recorded on all cattle. Fecal egg count (FEC), respiration rate (RR), horn fly and tick count, hematocrit (% packed cell volume, PCV), and serum prolactin were analyzed on a subset of cows (35/treatment). On day 194, cows were artificially inseminated (AI) and 11 d following AI were exposed to bulls for 51 d. Milk production was estimated on day 210 on a subset of 85 cow–calf pairs (28–29/treatment). There was a tendency for a treatment × time interaction (P = 0.07) for FEC likely driven by an increase in FEC of the CON cattle at day 126 compared to SERE and FERE. There was a tendency for a treatment × time interaction (P = 0.06) for cow BW, largely driven by time differences; however, there was no effect of treatment (P = 0.84) on BW. There was no difference (P ≥ 0.13) in cow PCV, fly and tick count, BCS, HCS, RR, and serum prolactin throughout the experiment. Additionally, there was no difference (P ≥ 0.46) in Julian calving date, calf birth BW, or milk production between treatments. Interestingly, heifer calves born to FERE dams tended to have greater (P = 0.06) weaning BW compared to heifer calves born to CON dams. In addition, there was no difference (P ≥ 0.17) in heat patch scores, AI conception rates, or overall pregnancy rates between treatments. Extended-release eprinomectin did not impact cow growth performance, reproductive performance or fescue toxicity symptoms when grazing endophyte-infected tall fescue; however, calf weaning BW tended to be improved.
Effects of Absence of Constitutive Androstane Receptor (CAR) on Bile Acid Homeostasis in Male and Female Mice
Authors: Lickteig Andrew J , Zhang Youcai , Klaassen Curtis D , Csanaky Iván L 
Published: June 2019

AbstractAccumulation of bile acids (BAs) in hepatocytes has a role in liver disease and also in drug-induced liver injury. The constitutive androstane receptor (CAR) has been shown to protect against BA-induced liver injury. The polymorphism of CAR has recently been shown to modify the pharmacokinetics and pharmacodynamics of various drugs. Thus, it was hypothesized that polymorphism of CAR may also influence BA homeostasis. Using CAR-null and WT mice, this study modeled the potential consequences of CAR polymorphism on BA homeostasis. Our previous study showed that chemical activation of CAR decreases the total BA concentrations in livers of mice. Surprisingly the absence of CAR also decreased the BA concentrations in livers of mice, but to a lesser extent than in CAR-activated mice. Neither CAR activation nor elimination of CAR altered the biliary excretion of total BAs, but CAR activation increased the proportion of 6-OH BAs (TMCA), whereas the lack of CAR increased the excretion of taurocholic acid, TCDCA, and TDCA. Serum BA concentrations did not parallel the decrease in BA concentrations in the liver in either the mice after CAR activation or mice lacking CAR. Gene expression of BA synthesis, transporter and regulator genes were mainly similar in livers of CAR-null and WT mice. In summary, CAR activation decreases primarily the 12-OH BA concentrations in liver, whereas lack of CAR decreases the concentrations of 6-OH BAs in liver. In bile, CAR activation increases the biliary excretion of 6-OH BAs, whereas absence of CAR increases the biliary excretion of 12-OH BAs and TCDCA.
Effect of Short-Term Morbidities, Risk Factors and Rate of Growth Failure in Very Low Birth Weight Preterms at Discharge
Authors: Yapicioglu Yildizdas Hacer , Simsek Huseyin , Ece Umit , Ozlu Ferda , Sertdemir Yasar , Narli Nejat , Satar Mehmet 
Published: June 2019

Abstract

Background
Very low birth weight (VLBW) infants often demonstrate postnatal growth failure (PGF). We aimed to analyze incidence and risk factors for PGF in surviving VLBW infants hospitalized more than 28 days.

Materials and Methods
Fenton growth chart (2013) was used for Z-scores for birth weight (BW) and discharge weight. Infants with a decrease in their Z-scores at discharge >1 were considered as ‘PGF group’ and with a decrease >2 were considered as ‘severe PGF group’.

Results
One hundred and forty-one of 148 (95.3%) infants had PGF, 88 of 141 (62.4%) had severe PGF. There were significant differences in gestational age, birth and discharge weight, and days to regain BW, age of first and full enteral feeding, duration of parenteral nutrition, lipid emulsions, intubation and hospitalization between groups (p < 0.05). Vasopressor treatment, nosocomial infection, patent ductus arteriosus and bronchopulmonary dysplasia rates were significantly higher in severe PGF group (p < 0.05).

Conclusion
PGF remains a serious problem in our unit. All VLBW preterm infants should be followed for PGF.
25-Hydroxyvitamin D Deficiency: Impacting Deep-Wound Infection and Poor Healing Outcomes in Patients With Diabetes
Authors: Smart Hiske , AlGhareeb Ahmed Mohamed , Smart Sally-Anne 
Published: June 2019

ABSTRACT

BACKGROUND
The Kingdom of Bahrain has a high incidence of diabetes and associated foot complications. Simultaneously, low 25-hydroxyvitamin D (25[OH]D) levels are common in this population and may be associated with the traditional clothing used in desert climates.

METHODS
This investigation compared 25(OH)D levels and glycemic control with quantifiable wound healing parameters in a prospective, analytic, nonexperimental, cross-sectional pilot study. Consecutive consenting adult patients (N = 80) who presented to the regional wound care unit in January 2016 with either an existing or new wound were included. Collected data included three-dimensional wound photography, NERDS and STONEES criteria, and an X-ray with a positive probe-to-bone test. Blood values for 25(OH)D and hemoglobin A1c (HbA1c) were collected simultaneously.

RESULTS
Diabetes mellitus (types 1 and 2) was present in 90% of the sample patients. No patient had sufficient 25(OH)D levels; 15% had insufficient levels (30–50 ng/mL), and deficiency (levels <#20 ng/mL) was found in 85% of the sample. Males were slightly less affected by 25(OH)D deficiency compared with females (82.4% vs 91.3%). Poor glycemic control (HbA1c levels >#6.8%) was found in 69.4% (n = 50) of the persons with diabetes included in the sample. Those with both diabetes mellitus and a 25(OH)D deficiency (76.3%; n = 61) were more likely to demonstrate healing difficulty (40.9%; n = 25) or present with a stalled or deteriorating wound (44.2%, n = 27). A 3° F or higher periwound surface temperature elevation over a mirror image site was present in 82.5% of all wounds. Exposed bone in the ulcer base was found in 50% of the cases. For persons with diabetes, general linear modeling statistical analysis (adjusted R
2 value = 47.9%) linked poor wound healing with three studied variables: 25(OH)D deficiency, poor glycemic control, and an exposed bone in the wound bed.

CONCLUSIONS
Vitamin D may be an overlooked factor in the pathophysiology of diabetic foot ulcer development and subsequent delay in wound healing outcomes. The authors recommend adding 25(OH)D deficiency to the list of multifactorial aggravating factors providers should consider correcting in this subgroup of patients.
Understanding Professional Identity Formation in Early Clerkship: A Novel Framework
Authors: Jarvis-Selinger Sandra , MacNeil Kimberley A. , Costello Gregory R.L. , Lee Kenneth , Holmes Cheryl L. 
Published: June 2019

Purpose
Medical educators should foster students’ professional attitudes because individuals are more likely to act in accordance with medicine’s professional values if these values have been internalized. Still, there is much to be learned about how students examine and negotiate their emerging identities. This study examined third-year medical students’ experiences of professional identity formation (PIF) during clinical clerkship.

Method
The authors relied on an interpretivist perspective, informed by a grounded theory approach, to analyze data, which were collected from a pilot course designed to support medical students’ efforts to “unhide” the hidden curriculum in relation to their development as medical students and emerging professionals.

Results
Twelve third-year medical students engaged in 10 collaborative discussions with 3 faculty members, a resident, and a fourth-year student (2015–2016). Discussions facilitated students’ reflection on their professional journeys. Analysis of transcribed discussions resulted in a conceptual framework useful for exploring and understanding students’ reflections on their PIF. Through analyzing students’ experiences, the authors identified 4 components that constituted PIF stories: context, focus, catalyst, process.

Conclusions
The analysis resulted in the development of a conceptual framework and distinct identity formation themes. Discrete reflections focused on either students’ current identity (being) or their sense of future self (becoming). The study identified catalysts that sparked participants’ introspection about, or their processing of, identity. The moments that generate profound feelings of awareness in students are often moments that would not be recognizable (even post hoc) as remarkable by others.
Complement, infection, and autoimmunity
Authors: Conigliaro Paola , Triggianese Paola , Ballanti Eleonora , Perricone Carlo , Perricone Roberto , Chimenti Maria Sole 
Published: June 2019

Purpose of review
Complement system dysfunction in terms of upregulation, downregulation, or dysregulation can create an imbalance of both host defense and inflammatory response leading to autoimmunity. In this review, we aimed at describing the role of complement system in host defense to inflection and in autoimmunity starting from the evidence from primary and secondary complement system deficiencies.

Recent findings
Complement system has a determinant role in defense against infections: deficiencies of complement components are associated with increased susceptibility to infections. Primary complement system deficiencies are rare disorders that predispose to both infections and autoimmune diseases. Secondary complement system deficiencies are the result of the complement system activation with consumption. Complement system role in enhancing risk of infective diseases in secondary deficiencies has been demonstrated in patients affected by systemic autoimmune disorders, mainly systemic lupus erythematosus and vasculitis.

Summary
The relationship between the complement system and autoimmunity appears paradoxical as both the deficiency and the activation contribute to inducing autoimmune diseases. In these conditions, the presence of complement deposition in affected tissues, decreased levels of complement proteins, and high levels of complement activation fragments in the blood and vessels have been documented.
General Health Quality of Life Instruments Underestimate the Impact of Bilateral Cochlear Implantation
Authors: McRackan Theodore R. , Fabie Joshua E. , Bhenswala Prashant N. , Nguyen Shaun A. , Dubno Judy R. 
Published: June 2019

Objective:
To determine the extent to which bilateral cochlear implantation increases patient-reported benefit as compared with unilateral implantation and no implantation.

Data Sources:
PubMed, Scopus, CINAHL, and Cochrane databases searches were performed using the keywords (“Cochlear Implant” or “Cochlear Implantation”) and (“bilateral”).

Study Selection:
Studies assessing hearing/CI-specific (CI) and general-health-related (HR) quality of life (QOL) in adult patients after bilateral cochlear implantation were included.

Data Extraction:
Of the 31 articles meeting criteria, usable QOL data were available for 16 articles (n = 355 bilateral CI recipients).

Data Synthesis:
Standardized mean difference (Δ) for each measure and weighted effects were determined. Meta-analysis was performed for all QOL measures and also independently for hearing/CI-specific QOL and HRQOL.

Conclusion:
When measured using hearing/CI-specific QOL instruments, patients reported very large improvements in QOL comparing before cochlear implantation to bilateral CI (Δ=2.07 [1.76–2.38]) and medium improvements comparing unilateral CI to bilateral CI (Δ=0.51 [0.32– 0.71]). Utilization of parallel versus crossover study design did not impact QOL outcomes (χ2 = 0.512, p = 0.47). No detectable improvements were observed in either CI transition when using HRQOL instruments (no CI to bilateral CI: Δ=0.40 [−0.02 to 0.81]; unilateral CI to bilateral CI: Δ=0.22 [−0.02 to 0.46]).
The universal nature of HRQOL instruments may render them insensitive to the medium to large QOL improvements reported by patients using hearing/CI-specific QOL instruments. Given that HRQOL instruments are used to determine the economic benefit of health interventions, these measurement differences suggest that the health economic value of bilateral cochlear implantation has been underestimated.
Prognostic significance of blood inflammatory biomarkers NLR, PLR, and LMR in cancer—A protocol for systematic review and meta-analysis
Authors: Kumarasamy Chellan , Sabarimurugan Shanthi , Madurantakam Royam Madhav , Lakhotiya Kartik , Samiappan Suja , Baxi Siddhratha , Nachimuthu Ramesh , Gothandam Kodiveri Muthukaliannan , Jayaraj Rama 
Published: June 2019

Abstract

Background:
The neutrophil-lymphocyte-ratio, platelet-lymphocyte-ratio, and monocyte-lymphocyte-ratio have been explored as a simple, inexpensive, and effective method for cancer prognosis. However, there are no studies that have investigated the comparative utility of these markers, in multiple cancers.

Methods:
The preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) guidelines were used to design this meta-analysis protocol. The final study will also be conducted under the PRISMA guidelines for systematic reviews and meta-analyses. The core bibliographic database search will be carried out by 2 reviewers working individually, with each conducting an initial screening based on titles and abstracts. The shortlisted articles will be selected for review and quantitative analysis, based on predefined inclusion and exclusion criteria. Study characteristics, relevant clinicopathological characteristics, and statistical data required for meta-analysis (hazard ratios [HRs] and 95% confidence intervals [CIs]) will be extracted and compiled into a MS Excel datasheet. Meta-analysis will be performed, using a random-effects model, and the results (pooled HR and 95% CI) will be presented in the form of a forest plot. Publication bias will also be assessed by use of Egger bias indicator test and funnel plot symmetry. If statistical data from included studies is insufficient, a qualitative literature review will be pursued.
PROSPERO registration: PROSPERO CRD42019121008.
Feasibility of a craniometry in a comminuted zygomaticomaxillary complex fracture
Authors: Hsu Shao-Yun , Shih Pin-Keng 
Published: June 2019

Abstract
Few studies have reported on using craniometry for comminuted zygomaticomaxillary complex (ZMC) fracture management. We present our experiences with this procedure and a review of the related literature.
From September 2011 to October 2018, 43 patients with comminuted ZMC fracture receiving open reduction internal fixation under coronal incision were enrolled. Data on gender, age, operation time, hospital stay, duration of follow-up, vertical/horizontal differences, and complications were collected. Between-group differences (C-arm imaging vs craniometry) were evaluated using nonparametric Mann–Whitney test for continuous data and chi-square test for categorical data.
No significant difference were found between the groups regarding gender, age, hospital duration, follow-up duration, and postoperative complications, except for operation time. The averaged operation time was significantly shorter in the C-arm imaging group (4.217 h) than in the craniometry group (6.193 h). The C-arm imaging group had two cases with horizontal differences >3 mm and one case with vertical differences >3 mm. The craniometry group had four cases with horizontal differences >3 mm and four cases with vertical differences >3 mm. There were no significant differences between the two groups in horizontal differences and vertical differences.
Craniometry may achieve the same outcomes as C-arm imaging in comminuted ZMC fracture management; however, the former requires more time than the latter.
The Syntaxin-1A gene single nucleotide polymorphism rs4717806 associates with the risk of ischemic heart disease
Authors: Guerini Franca R. , Ripamonti Enrico , Costa Andrea S. , Zanzottera Milena , Agliardi Cristina , Bolognesi Elisabetta , Clerici Mario , Racca Vittorio 
Published: June 2019

AbstractIschemic heart disease (IHD) has a genetic predisposition and a number of cardiovascular risk factors are known to be affected by genetic factors. Development of metabolic syndrome and insulin resistance, strongly influenced by lifestyle and environmental factors, frequently occur in subjects with a genetic susceptibility. The definition of genetic factors influencing disease susceptibility would allow to identify individuals at higher risk and thus needing to be closely monitored.To this end, we focused on a complex of soluble-N-ethylmaleimide-sensitive factor attachment protein receptors (SNAREs), playing an important role in metabolic syndrome and insulin resistance, involved in endothelial dysfunction and heart disease. We assessed if genetic variants of the SNARE genes are associated with IHD.SNAP25 rs363050,Stx-1A rs4717806,rs2293489, andVAMP2 26bp ins/delgenetic polymorphisms were analyzed in a cohort of 100 participants who underwent heart surgery; 56 of them were affected by IHD, while 44 were not. A statistical association of plasma glycemia and insulin resistance, calculated as Triglyceride glucose (TyG) index, was observed in IHD (P < .001 andP = .03, respectively) after binomial logistic stepwise regression analysis, adjusted by age, gender, diabetes positivity, waist circumference, and cholesterol plasma level. Among genetic polymorphisms,rs4717806(A)andrs2293489(T), as well as thers4717806 – rs2293489 (A-T)haplotype were associated with higher risk for IHD (Pc = .02;Pc = .02;P = .04, respectively). Finally, a statistical association ofrs4717806(AA)genotype with higher TyG index in IHD patients (P = .03) was highlighted by multiple regression analysis considering log-transformed biochemical parameters as dependent variable and presence of coronary artery disease, age, gender, waist circumference, presence of diabetes as predictors. These results point to a role of theStx-1A rs4717806SNP in IHD, possibly due to its influence on Stx-1A expression and, as a consequence, on insulin secretion and glucose metabolism.