bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of ICU Diaries on Psychological Outcomes and Quality of Life of Survivors of Critical Illness and Their Relatives: A Systematic Review and Meta-Analysis
Authors: McIlroy Philippa A. , King Rebecca S. , Garrouste-Orgeas Maité , Tabah Alexis , Ramanan Mahesh 
Published: November 2018

Objectives:
To evaluate the effect of ICU diaries on posttraumatic stress disorder symptoms in ICU survivors and their relatives. Secondary objectives were to determine the effect on anxiety, depression, and health-related quality of life in patients and their relatives.

Data Sources:
We searched online databases, trial registries, and references of relevant articles.

Study Selection:
Studies were included if there was an ICU diary intervention group which was compared with a group without a diary.

Data Extraction:
Titles, abstracts, and full-text articles were reviewed independently by two authors. Data was abstracted using a structured template.

Data Synthesis:
Our search identified 1,790 articles and retained eight studies for inclusion in the analysis. Pooled results found no significant reduction in patients’ posttraumatic stress disorder symptoms with ICU diaries (risk ratio, 0.75 [0.3–1.73]; p = 0.5; n = 3 studies); however, there was a significant improvement in patients’ anxiety (risk ratio, 0.32 [0.12, 0.86]; p = 0.02; n = 2 studies) and depression (risk ratio, 0.39 [0.17–0.87]; p = 0.02; n = 2 studies) symptoms. Two studies reported significant improvement in posttraumatic stress disorder symptoms of relatives of ICU survivors; however, these results could not be pooled due to reporting differences. One study reported no significant improvement in either anxiety (risk ratio, 0.94; 95% [0.66–1.33]; p = 0.72) or depression (risk ratio, 0.98; 95% [0.5–1.9]; p = 0.95) in relatives. There was a significant improvement in health-related quality of life of patients with a mean increase in the Short Form-36 general health score by 11.46 (95% CI, 5.87–17.05; p ≤ 0.0001; n = 2 studies). No studies addressed health-related quality of life of relatives.

Conclusions:
ICU diaries decrease anxiety and depression and improve health-related quality of life, but not posttraumatic stress disorder among ICU survivors and may result in less posttraumatic stress disorder among relatives of ICU patients. Multicenter trials with larger sample sizes are necessary to confirm these findings.
Histopathological Study on the Proposed Pathogenesis of Intratarsal Keratinous Cysts
Authors: Tang Tina , Brownstein Seymour , Chen Henry , Jordan David R. , Iacob Codrin E. , Blanco Paula , Farmer James 
Published: November 2018

Purpose:
Intratarsal keratinous cysts (IKCs) are a recently described entity that is frequently misdiagnosed clinically as chalazia and mislabeled in the literature as “intratarsal epidermal inclusion cysts” or “epidermoid cysts.” It is important to accurately diagnose IKCs and distinguish them from chalazia because IKCs require a complete surgical excision and can exhibit multiple recurrences following curettage. The authors performed a retrospective case series to further elucidate the pathogenesis of IKCs and to determine the diagnostically optimal panel of stains for diagnosis.

Methods:
A study group of 8 specimens of IKCs and control specimens of epidermal inclusion cysts were obtained from their pathology laboratories. The authors compared the histological and immunohistochemical profile of IKCs and epidermal inclusion cysts by staining sections from each specimen with hematoxylin and eosin, periodic acid-Schiff, Masson trichrome, cytokeratin 5, cytokeratin 17, carcinoembryonic antigen, and epithelial membrane antigen. The immunoreactivity data were then analyzed using a 2-tailed Mann-Whitney test, assuming a nonparametric population (p < 0.05 is significant).

Results:
Histopathologically, IKCs are embedded in the tarsus lined by stratified squamous epithelium with an inner undulating cuticle filled with a compact keratinous-appearing material. The authors demonstrate that IKCs develop progressively from dilated meibomian ducts to the formation of complete cysts with their markers. The most valuable immunochemical stains to diagnose IKC were cytokeratin 17, carcinoembryonic antigen, and epithelial membrane antigen (p < 0.05 with each).

Conclusions:
These findings provide a better understanding of the pathogenesis and the immunohistochemical findings of this relatively new entity allowing for more appropriate diagnosis of IKCs aiming to reduce future complications from their management.
Mini-Open Surgical Fasciotomy for Chronic Exertional Compartment Syndrome of the Forearm in Professional Motorcycling Adolescents
Authors: Schiavi Paolo , Gondolini Giorgio , Gandolfi Cecilia Eugenia , Guardoli Luca , Vaienti Enrico , Zasa Michele 
Published: November 2018

Objective:
Evaluate treatment and outcome of mini-open fasciotomy (MOF) in a population of adolescent motorcycling racers affected by forearm chronic exertional compartment syndrome (CECS).

Design:
Prospective case series.

Setting:
University hospital/private practice.

Patients:
Nine professional motorcycling adolescents were diagnosed with forearm CECS. All were treated with MOF between 2007 and 2012 and followed for a minimum of 5 years (range 5–10 years). Age, sex, body mass index, laterality, and profession were recorded.

Interventions:
A MOF to obtain decompression of all compartments was performed in all patients.

Main outcome measures:
Visual analog scale; a subjective scale to measure strength; and Quick-DASH functional scores. Time to resume full riding capacities as the short-term evaluation.

Results:
A significant decrease in visual analog scale (P < 0.001) and Quick-DASH (P < 0.001) scores was observed in the first 3 months, stabilizing during follow-up (P = 0.521; P = 0.217). Average time to return to sport was 2.8 ± 1 week. No symptom recurrence was reported, but one patient suffered a minor complication. There were no cases of infection, hematoma, or peripheral nerve injury.

Conclusions:
We assess that MOF can be a valid alternative for the treatment of forearm CECS in adolescent competitive motorcycling racers, as demonstrated by the good success rate and minimal incidence of complications during follow-up.

Level of Evidence:
IV, case series.
Probiotic Yogurt for the Prevention of Antibiotic-associated Diarrhea in Adults
Authors: Velasco María , Requena Teresa , Delgado-Iribarren Alberto , Peláez Carmen , Guijarro Carlos 
Published: November 2018

Goal:
To evaluate the effect of yogurt supplemented with probiotic bacteria on the prevention of antibiotic-associated diarrhea (AAD) in hospitalized patients.

Background:
Diarrhea following antibiotic administration is a frequent clinical problem. The usefulness of probiotics for the prevention of AAD in the hospitalized adult population remains unclear.

Study:
A randomized, double-blind, placebo-controlled clinical trial was conducted in hospitalized patients who started antibiotic treatment. Patients were randomized (2:2:1) to receive a daily amount of 200 mL of placebo-yogurt (Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus), 200 mL of probiotic yogurt (previous plus Lactobacillus acidophilus La-5, Bifidobacterium animalis subsp. lactis Bb-12 and Lactobacillus casei subsp. casei Lc-01 or no yogurt (unblinded control) within 48 hours of beginning the antibiotic therapy and up to 5 days after stopping the antibiotic. Patients were followed up with for 1 month to determine occurrence of diarrhea.

Results:
We included 314 patients, mean age 76 years. The rate of diarrhea was 23.0% in the probiotic group versus 17.6% in the placebo group, absolute risk reduction −5.35% (95% confidence interval, −15.4% to 4.7%; P=0.30). Rate of diarrhea was similar in the unblinded external control and in the blinded study groups combined (20.9% vs. 20.2% respectively; P=0.91). There was no difference in the duration of diarrhea, maximum number of bowel movements or prolonged admission because of diarrhea among the groups. All-cause mortality did not differ between groups.

Conclusions:
The combined probiotic strains LA-5, BB-12, and LC-01 do not have an effect in the prevention of AAD in hospitalized patients.
The Model to Estimate Survival in Ambulatory Hepatocellular Carcinoma Patients Aids in the Decision for TACE Retreatment
Authors: Cho Young Youn , Yu Su Jong , Yoo Jung-Ju , Lee Minjong , Lee Dong Hyeon , Cho Yuri , Yoon Kyoung Wan , Cho Eun Ju , Lee Jeong-Hoon , Kim Yoon Jun , Yoon Jung-Hwan 
Published: November 2018

Background/Aims:
Transarterial chemoembolization (TACE) is a major therapeutic modality for patients with unresectable hepatocellular carcinoma, which needs repeated treatments. Model to Estimate Survival in Ambulatory Hepatocellular carcinoma patients (MESIAH) was recently developed as a model for predicting survival. We aimed to develop a novel index for TACE retreatment using MESIAH scores.

Patients and Methods:
From 2005 to 2008, 783 patients with hepatocellular carcinoma who had undergone 1 previous TACE procedure were enrolled. We calculated their pre-TACE and post-TACE-MESIAH and calculated the MESIAH ratio by dividing the post-TACE by pre-TACE score. The discriminatory abilities of the MESIAH ratio and post-TACE-MESIAH were compared with ART and ABCR scores.

Results:
Among 783 patients, 355 (45.3%) received a second TACE (test set), and 195 (24.9%) patients received a third TACE treatment (validation set). In the test set, patients with a MESIAH ratio <0.9 obtained longer overall survival than patients with a MESIAH ratio ≥0.9 [26.0 vs. 9.0 mo, respectively; hazard ratio 1.66 (1.29-2.14)], and patients with a post-TACE-MESIAH<4.5 showed longer overall survival than patients with a post-TACE-MESIAH≥4.5 [38.0 vs. 7.0 mo, respectively; hazard ratio, 3.17 (2.45-4.09)]. The post-TACE-MESIAH [C-index 0.663 (0.628-0.697)] was better than the ART [C-index 0.596 (0.554-0.638)] and ABCR scores [C-index 0.576 (0.536-0.617)] at estimating prognosis. Our results were confirmed by the validation set.

Conclusions:
A MESIAH score ≥4.5 after TACE identifies patients with a poor prognosis. Randomized studies are needed to establish whether additional TACE may affect survival.
Current First-line Therapy for Ovarian Cancer: A Comprehensive Review
Authors: Pierce Stuart R. , Clark Leslie H. 
Published: November 2018

Importance
Ovarian, fallopian tube, and primary peritoneal cancers constitute the deadliest gynecologic malignancies. After primary cytoreductive surgery, there are several standard first-line cytotoxic treatments for providers to consider. Newer molecular targeted therapies are becoming more common and may have a role as first-line therapy in the future.

Objective
This article provides an evidence-based review of all approved standard therapies for first-line treatment of advanced-stage, high-grade serous ovarian cancer. Treatment schedules, dose modifications, and drug substitutions are reviewed. Ongoing trials and pending approvals for newer molecular therapies are discussed.

Evidence Acquisition
A comprehensive primary literature review was performed using MEDLINE, the Cochrane Collaborative Database, and PubMed. Guidelines from the National Comprehensive Cancer Network and the Society for Gynecologic Oncology were also reviewed.

Results
Seven different approved first-line regimens for high-grade serous ovarian cancer are available based on literature review. These vary in route of administration, dose intensity, drug combinations, and treatment schedules. Molecular targeted therapies, including antiangiogenic drugs and poly(ADP-ribose) polymerase inhibitors, have also been studied in multiple randomized controlled trials in the first-line setting.

Conclusions and Relevance
Cytotoxic regimens remain the foundation of first-line treatment for high-grade serous ovarian cancer. Choosing which regimen is best for a patient depends on both patient and disease factors. Molecular therapies in first-line treatment are a promising and exciting possibility, with regulatory approval pending.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After completing this activity, the learner should be better able to compare the 7 approved up-front cytotoxic regimens for high-grade serous ovarian cancer; choose a regimen based on patient and disease factors; and distinguish 3 molecular therapies that are in clinical trials that may be incorporated into up-front therapy.
Telementoring Demonstration in Craniofacial Surgery With HoloLens, Skype, and Three-Layer Facial Models
Authors: Mitsuno Daisuke , Hirota Yuka , Akamatsu Jun , Kino Hiromi , Okamoto Toyoko , Ueda Koichi 
Published: November 2018

Background:
Telementoring is the technology for providing surgical instruction from a remote place via a network. To demonstrate the use of telementoring in craniofacial surgery, Skype and a mixed reality device HoloLens were adopted, and 3-layer facial models had been developed.

Methods:
A resident in hospital A used the model surgery under remote guidance by a mentor surgeon in hospital B 4 times on different dates. The straight-line between hospitals A and B is 250 km. The mentor gave the resident guidance via Skype and HoloLens, communicating by voice, and video of the surgical field, and providing reference data.

Results:
There was no delay in voice communication and a delay of <0.5 seconds in the video. The resident was able to confirm the main landmarks of the surgical field and to grasp the situation without problems. The mentor could send appropriate instructions by voice, could point out a specific part by telestration function, and could draw lines on the 2-dimentional images pasted on the operator's field of vision.

Discussion:
With the use of HoloLens, Skype, and the 3-layer models, it was possible to demonstrate telementoring. The risk of personal information leakage due to data interception seems to be very low because its data communication is encrypted with advanced encryption standard.

Conclusion:
This telementoring system has various advantages and many improvable aspects in the field of craniofacial surgery.
Personal Computer-Based Cephalometric Landmark Detection With Deep Learning, Using Cephalograms on the Internet
Authors: Nishimoto Soh , Sotsuka Yohei , Kawai Kenichiro , Ishise Hisako , Kakibuchi Masao 
Published: November 2018

Background:
Cephalometric analysis has long been, and still is one of the most important tools in evaluating craniomaxillofacial skeletal profile. To perform this, manual tracing of x-ray film and plotting landmarks have been required. This procedure is time-consuming and demands expertise. In these days, computerized cephalometric systems have been introduced; however, tracing and plotting still have to be done on the monitor display. Artificial intelligence is developing rapidly. Deep learning is one of the most evolving areas in artificial intelligence. The authors made an automated landmark predicting system, based on a deep learning neural network.

Methods:
On a personal desktop computer, a convolutional network was built for regression analysis of cephalometric landmarks’ coordinate values. Lateral cephalogram images were gathered through the internet and 219 images were obtained. Ten skeletal cephalometric landmarks were manually plotted and coordinate values of them were listed. The images were randomly divided into 153 training images and 66 testing images. Training images were expanded 51 folds. The network was trained with the expanded training images. With the testing images, landmarks were predicted by the network. Prediction errors from manually plotted points were evaluated.

Results:
Average and median prediction errors were 17.02 and 16.22 pixels. Angles and lengths in cephalometric analysis, predicted by the neural network, were not statistically different from those calculated from manually plotted points.

Conclusion:
Despite the variety of image quality, using cephalogram images on the internet is a feasible approach for landmark prediction.
Approaches for Excision of Intramasseteric Nodules
Authors: Aizawa Tetsushi , Kubo Satoshi , Azuma Ryuichi , Kiyosawa Tomoharu 
Published: November 2018

Abstract
Developmental lesions, including benign or malignant tumors, rarely arise in the masseteric region. This retrospective study was performed to evaluate the adequacy of different surgical approaches in a series of patients with lesions in the masseteric region. The surgical methods, postoperative complications, pathological diagnosis, and aesthetic outcome were compared in 4 patients who underwent excision of intramasseteric mass lesions. A flap was elevated in 3 patients and direct incisional resection was performed in 1 patient. Two patients underwent incisional biopsy to exclude malignancy before the total excision was performed. The final diagnosis was hemangioma in 3 patients and schwannoma in 1 patient. All patients were satisfied with the aesthetic results and there were no major complications. In conclusion, surgery with skin flap elevation was concluded to be the best approach based on overall assessment of technical considerations, complications, and the cosmetic outcome. However, the surgeon should not hesitate to perform direct incisional biopsy when malignancy needs to be excluded.
A factorial cluster-randomised controlled trial combining home-environmental and early child development interventions to improve child health and development: rationale, trial design and baseline findings
Authors: Hartinger Stella M , Nuño Nestor , Hattendorf Jan , Verastegui Hector , Ortiz Mariela , Mäusezahl Daniel 
Published: November 2018

ABSTRACTBackgroundExposure to unhealthy environments and poor cognitive development are the main risk factors that affect children’s health and wellbeing in low- and middle-income countries. Interventions that simultaneously address several risk factors at the household level have great potential to reduce these negative effects. We present the design and baseline findings of a cluster-randomised controlled trial to evaluate the impact of an integrated home-environmental intervention package and an early child development programme to improve diarrhoea, acute respiratory infections and childhood developmental outcomes in children under 36 months of age living in resource-limited rural Andean Peru.MethodsWe collected baseline data on children’s developmental performance, health status and demography as well as microbial contamination in drinking water. In a sub-sample of households, we measured indoor and personal 24-hour air concentration levels of carbon monoxide (CO) and fine particulate matter (PM2.5).ResultsWe recruited and randomised 317 children from 40 community-clusters to four study arms. At baseline, all arms had similar health and demographic characteristics, and the developmental status of children was comparable between arms. The analysis revealed that more than 25% of mothers completed primary education, a large proportion of children were stunted and diarrhoea prevalence was above 18%. Fifty-two percent of drinking water samples tested positive for thermo-tolerant coliforms and the occurrence ofE.coliwas evenly distributed between arms. The mean levels of kitchen PM2.5and CO concentrations were 213 μg/m3and 4.8 ppm, respectively.ConclusionsThe trial arms are balanced with respect to most baseline characteristics, such as household air and water pollution, and child development. These results ensure the possible estimation of the trial effectiveness. This trial will yield valuable information for assessing synergic, rational and cost-effective benefits of the combination of home-based interventions.Trial registrationretrospectively registered on 15thJanuary 2018. SRCTN reference: 26548981
Correlation of Remodeling Brain and Phenotype Behavior in the Comorbidity of the Chronic Obstructive Pulmonary Disease and Acute Cerebral Ischemia in Animal Model
Authors: Plekhova Natalia G. , Geltser Boris I. , Zinoviev Sergey V. , Zayats Yulia V. 
Published: November 2018

AbstractCognitive impairment is one of the most common features in patients with COPD, and is associated with COPD severity and comorbidities. Development of relevant models of respiratory-cerebrovascular comorbidity in human diseases is an important task of experimental medicine. The purpose of the research consisted in determination of the morphological criteria brain condition and their correlation with behavioral phenotype of animals in the experimental comorbidity of the chronic obstructive pulmonary disease (COPD) and acute cerebral ischemia (ACI). Modeling of COPD on the basis of the combination of inducers, reproducing a proteoclastic degradation of lung tissue and systemic inflammation, and modeling of ACI by the suture middle cerebral artery occlusion with to mimic ischemia condition were used. Comparative histological study of the brain, neurological and behavioral phenotype of animals was conducted. It has been shown that in case of COPD and ACI comorbidity, formation of neurogliovascular microstructural complexes in brain is more pronounced than at animals with isolated form of disease, which was indicative of active adaptive transformation of neocortex. Significant disturbance of neurological and behavioral status of animals under the conditions of COPD and ACI comorbidity was correlated with the structural changes in the microvascular layer and neurons of brain. This study provides new insights about formation of neurogliovascular complexes with altered quantitative ratio in the vessels that was indicative of the presence of pericellular and perivascular edemas of the brain, and correlating of the these changes with the behavior of animals.
Ribosomal stress-induced senescence as a novel pro-senescence strategy for p16 positive basal-like breast cancer
Authors: Moore Madeleine , Gammon Luke , Dreger Sally , Koh James , Garbe James C , Stampfer Martha R , Philpott Michael , Jones Louise , Bishop Cleo L 
Published: November 2018

ABSTRACTRe-engaging the senescent programme represents an attractive yet underexplored strategy for cancer therapy, particularly for those tumour subtypes where targeted agents are limited or unavailable. Here, we identify a specific subset of ribosomal proteins as novel pro-senescence therapeutic targets for a highly aggressive subtype of breast cancer, p16 positive basal-like breast cancer. Mechanistically, ribosomal stress-induced senescence generates a stable cell cycle arrest, is dependent on endogenous p16 triggering a resensitisation to the p16/RB tumour suppressor axis, followed by establishment of a senescence-associated secretory phenotype, and is independent of DNA damage. Conversely, ribosomal protein knockdown in a p16 negative breast cancer model results in caspase-mediated apoptosis. Importantly, individual ribosomal protein loss is well tolerated by a panel of normal human cells. We demonstrate a reciprocal feedback loop between loss of RPS3A and RPS7 at both the transcriptional and post-transcriptional level during ribosomal stress-induced senescence. Further, our ribosomal hits are co-ordinately dysregulated in breast cancer, with elevated expression associated with a poor prognosis. Clinical relevance is demonstrated in tissue microarrays, and a RPS3AHIGHRPS7HIGHsignature is associated with an earlier disease onset and synergises with p16 to further worsen patient outcome. We conclude that dysregulation of ribosomal proteins constitutes a cancer cell-specific mechanism of senescence evasion and that engaging ribosomal stress-induced senescence may be relevant for future pro-senescence therapies.