bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study on Normal Laryngeal Electromyography of Thyroarytenoid Muscle, Cricothyroid Muscle, and Posterior Cricoarytenoid Muscle
Authors: Xu Xinlin , Yang Pan , Zhuang Peiyun , Yanchao Jiao , Yanli Ma , Schrof Colin , Jiang Jack J. 
Published: September 2018

Objective: The aim of this study was to investigate the physiological activity of intrinsic laryngeal muscle under different functional states of larynx by measuring the normal laryngeal electromyography parameters. Methods: Laryngeal electromyography (EMG) was performed in 112 patients with unilateral vocal cord movement disorder. The duration and amplitude of the motor unit potential (MUP) of the thyroarytenoid muscle (TA), posterior cricoarytenoid muscle (PCA), and cricothyroid muscle (CT) were measured when patients were asked to make a deep inspiration and phonate /i/. The normal side of the patients’ vocal chords was used as the research object. Results: (1) The motor unit potential of TA, CT, and PCA were measured when inspiration and phonating /i/. Waveforms were normal. (2) There were significant differences in duration of TA between inspiration and phonating /i/ in comfortable tone. (3) When comparing the duration and amplitude of any 2 of TA, CT, and PCA during inspiration and phonating /i/, there were significant differences in duration between CT and PCA when phonating /i/ only. There were no significant differences in any other comparisons. Conclusions: Under either deep inspiration or pronunciation, the TA, CT, and PCA muscles were activated. The TA may play a major role in phonating. The PCA may play a major role in the action of deep inspiration.
Mobile Applications for Allergic Rhinitis
Authors: Zhou Albert H. , Patel Varesh R. , Baredes Soly , Eloy Jean Anderson , Hsueh Wayne D. 
Published: September 2018

Objective: To study and review the currently available mobile applications relating to allergic rhinitis. Methods: The Apple and Google mobile app stores were queried with search terms relating to allergic rhinitis. Apps were assigned to categories and analyzed based on description and characteristics such as popularity, reviews, cost, platform, and physician involvement in development. Results: A total of 72 apps related to allergic rhinitis were identified. Fifty-four apps were unique, with 18 apps found on both operating systems. Forty (55.5%) apps were available in the Apple App store, and 32 (44.4%) apps were available in the Google Play app store. They were grouped into the following categories: patient education (18; 25%), journals (15; 20.8%), symptom tracking (14; 19.4%), clinical/private practice (13; 18.1%), pollen forecast (7; 9.7%), medical education (4; 5.6%), and other (1; 1.4%). The majority of apps were free of charge (67; 93.1%), with paid apps ranging from $1.47 to $4.99. Apps that were reviewed had an average rating of 3.9 out of 5. Physicians were involved in the development of 37 (51.4%) apps. Conclusions: The collection of mobile apps developed for allergic rhinitis includes those for both educational and clinical use. Mobile apps may have an increasing role in otolaryngic allergy and rhinology practices in the future. Thus, continued research is warranted to determine the best way to ensure the accuracy and quality of app content as well as the extent mobile apps can benefit allergic rhinitis patients.
Palliative esophagectomy in unexpected metastatic disease: sense or nonsense?
Authors: Depypere Lieven P , Moons Johnny , Lerut Toni E , Coosemans Willy , Van Veer Hans , Nafteux Philippe R 
Published: September 2018

Background Despite integrated positron emission tomography and computed tomography screening before and after neoadjuvant treatment in patients with locally advanced esophageal cancer, unexpected metastatic disease is still found in some patients during surgery. Should then esophagectomy be aborted or is there a place for palliative resection? Methods Between 2002 and 2015, 681 patients with potentially resectable esophageal cancer were sheduled for neoadjuvant therapy and subsequent esophagectomy. In 552 patients, a potentially curative esophagectomy was performed. In 12 patients, unexpected disease was discovered during surgery but esophagectomy was performed with synchronous resection of metastases; 10 of them had oligometastatic disease (≤4 single-organ metastases). Esophagectomy was not performed in 117 patients (because of disease progression in 50); 14 were also single-organ oligometastatic. Data of 10 single-organ oligometastatic patients who underwent esophageal resection (group 1) were compared those of 10 non-resected but treated counterparts (group 2) and with 228 patients who underwent potentially curative esophagectomy with persistent pathological lymph nodes (group 3). Results Five oligometastatic esophagectomy patients had lung metastases: 1 peritoneal, 2 adrenal, 1 pleural, and 1 pancreatic. Two oligometastatic non-resected patients had lung, 5 liver, and 3 brain metastases. Median overall survival was 21.4, 12.1, and 20.2 months in the respective groups (group 1 vs. group 2  p = 0.042; group 2 vs. group 3  p = 0.002; group 1 vs. group 3  p = 0.88). Conclusions Survival is longer in patients undergoing palliative esophagectomy with unexpected single-organ oligometastatic disease and comparable to survival in patients with persistent pathological lymph nodes. Palliative resection in these patients seems to be justified.
Predictors of surgical outcome in isolated prosthetic mitral valve endocarditis
Authors: Nagy Mohamad , Alkady Hesham , Abo Senna Waleed , Abdelhay Soliman 
Published: September 2018

Background Most previous studies dealing with predictors of surgical outcome in prosthetic valve endocarditis included patients with aortic and/or mitral valve prostheses. Here, we concentrate on isolated prosthetic mitral endocarditis due to heterogeneity of epidemiological data, anatomical factors, and surgical techniques between mitral, prosthetic mitral, and aortic endocarditis between prosthetic mitral and prosthetic aortic endocarditis. Methods Data of 40 patients reoperated upon due to isolated prosthetic mitral endocarditis between July 2015 and March 2017 were retrospectively collected and analyzed. Results Independent predictors of major postoperative complications on multivariate analysis were: no blood cultures before referral (odds ratio 6.36, 95% confidence interval: 1.44–28.15), inadequate response to medical treatment (odds ratio 11.38, 95% confidence interval: 1.29–100.25), and serum creatinine ≥2.0 mg·dL−1 (odds ratio 4.56, 95% confidence interval: 1.07–19.36). Independent predictors of hospital mortality were: congestive heart failure (odds ratio 30.91, 95% confidence interval: 2.02 to 473.87), embolization (odds ratio 18.24, 95% confidence interval:1.94–171.91), peri-annular extension of infection (odds ratio 12.68, 95% confidence interval: 1.30–123.43), serum creatinine on admission > 2 mg·dL−1 (odds ratio 9.67, 95% confidence interval: 1.97–47.48), and early prosthetic valve endocarditis (odds ratio 7.80, 95% confidence interval: 1.35–45.00). EuroSCORE II > 5.93% was associated with the highest predictive value for hospital mortality (area under the curve 0.813). Conclusion Certain factors can predict morbidity and mortality in surgery for isolated mitral prosthetic valve endocarditis. EuroSCORE II has a good ability to predict hospital mortality in surgery for mitral prosthetic valve endocarditis.
Clinical relevance of reporting fatty liver on ultrasound in asymptomatic patients during routine health checkups
Authors: Mahale Ajit Ramakant , Prabhu Sonali Dattatray , Nachiappan Muthiah , Fernandes Merwyn , Ullal Sonali 
Published: September 2018

Objective Ultrasonography is an efficient technique for detecting fatty liver. Its sensitivity and specificity in detecting moderate to severe fatty liver are comparable to those of histology. Fatty liver is associated with abnormal lipid and lipoprotein metabolism and insulin resistance, metabolic syndrome, cardiovascular/renal disease, type 2 diabetes, and other conditions. This study was performed to compare the serum lipid profiles and serum glutamic pyruvic transaminase (GPT), glutamic oxaloacetic transaminase (GOT), and glycosylated hemoglobin (HbA1c) levels in patients diagnosed with fatty liver on ultrasonography versus controls without fatty liver and evaluate the clinical relevance of an ultrasound diagnosis of fatty liver in routine health checkups. Methods This hospital-based cross-sectional study included 390 patients who underwent health checkups; 226 were diagnosed with fatty liver (cases) and 164 were not (controls). The lipid profile, serum GOT and GPT levels, and HbA1c level were compared between the cases and controls. Results The cases had considerably higher levels of lipids, liver enzymes (serum GOT and GPT), and HbA1c than controls. Conclusion Ultrasonography is a noninvasive simple tool for early detection of fatty liver in asymptomatic patients and can help clinicians achieve early detection of metabolic syndrome.
Development and validation of Nurses’ Moral Courage Scale
Authors: Numminen Olivia , Katajisto Jouko , Leino-Kilpi Helena 
Published: September 2018

Background: Moral courage is required at all levels of nursing. However, there is a need for development of instruments to measure nurses’ moral courage. Objectives: The objective of this study is to develop a scale to measure nurses’ self-assessed moral courage, to evaluate the scale’s psychometric properties, and to briefly describe the current level of nurses’ self-assessed moral courage and associated socio-demographic factors. Research design: In this methodological study, non-experimental, cross-sectional exploratory design was applied. The data were collected using Nurses’ Moral Courage Scale and analysed statistically. Participants and research context: The data were collected from a convenience sample of 482 nurses from four different clinical fields in a major university hospital in Finland for the final testing of the scale. The pilot comprised a convenience sample of 129 nurses. Ethical considerations: The study followed good scientific inquiry guidelines. Ethical approval was obtained from the university ethics committee and permission to conduct the study from the participating hospital. Findings: Psychometric evaluation showed that the 4-sub-scale, 21-item Nurses’ Moral Courage Scale demonstrates good reliability and validity at its current state of development showing a good level of internal consistency for a new scale, the internal consistency values ranging from 0.73 to 0.82 for sub-scales and 0.93 for the total scale, thus well exceeding the recommended Cronbach’s alpha value of >0.7. Principal component analysis and confirmatory factor analysis supported the theoretical construct of Nurses’ Moral Courage Scale. Face validity and expert panel assessments markedly contributed to the relevance of items in establishing content validity. Discussion and conclusion: Nurses’ Moral Courage Scale provides a new generic instrument intended for measuring nurses’ self-assessed moral courage. Recognizing the importance of moral courage as a part of nurses’ moral competence and its assessment offers possibilities to develop interventions and educational programs for enhancement of moral courage. Research should focus on further validation measures of Nurses’ Moral Courage Scale in international contexts.
On a Theorem due to Alan D. Taylor about Aggregation of Preferences
Authors: Lahiri Somdeb 
Published: September 2018

In this paper, we show that there does not exist any triple acyclic preference aggregation rule that satisfies Majority property, weak Pareto criterion and a version of a property due to Alan Taylor. We also show that there are non-dictatorial preference aggregation rules and in particular non-dictatorial social welfare functions which satisfy the weak Pareto criterion and Taylor’s Independence of Irrelevant Alternatives. Further, we are able to obtain analogous results for preference aggregation functionals by suitably adjusting the desired properties to fit into a framework which uses individual utility functions rather than individual preference orderings. Our final result is a modest generalisation of Sen’s version of Arrow’s impossibility theorem which is shown to hold under our mild domain restriction. JEL: D71
Supramalleolar Osteotomy Combined With an Intra-articular Osteotomy for the Reconstruction of Malunited Medial Impacted Ankle Fractures
Authors: Guo Changjun , Liu Zongbao , Xu Yangbo , Li Xingchen , Zhu Yuan , Xu Xiangyang 
Published: September 2018

Background: Malunion of a medial impacted ankle fracture may cause varus ankle deformity. This retrospective study examined the use of supramalleolar osteotomy combined with an intra-articular osteotomy in patients with malunited medial impacted ankle fractures. Methods: Twenty-four patients with malunited medial impacted ankle fracture were treated between January 2011 and December 2014. Using Weber’s classification, 10 had type A fractures and 14 had type B, and with the AO classification, 20 had 44A2 and 4 had 44B3. All of these patients had varus ankle deformity. Supramalleolar osteotomy combined with an intra-articular osteotomy was performed. The visual analog scale (VAS) for pain during daily activities, the Olerud and Molander Scale and the modified Takakura classification stage were used to determine the clinical outcomes and a radiographic analysis was performed. Results: The radiographic parameters, including the tibial ankle surface (TAS) angle and talar tilt angle (TTA), showed significant differences between the preoperative and follow-up assessments. The mean tibial lateral surface (TLS) did not show a significant change. The average Olerud and Molander Scale score improved significantly from 56.4 ± 6.21 preoperatively to 77.0 ± 6.11 at the latest follow-up ( P < .01). The mean VAS decreased significantly from 6.7 ± 0.8 preoperatively to 3.1 ± 0.6 at the latest follow-up ( P < .01). No significant difference in the modified Takakura classification stage was observed between the preoperative assessment and the last follow-up. Conclusions: The use of a supramalleolar osteotomy combined with an intra-articular osteotomy was an effective option for the treatment of malunited medial impacted ankle fractures associated with varus ankle deformity. Level of Evidence: Level IV, retrospective case series.
Risk Factors for Complications following Introduction of Radical Surgery for Colon Cancer: A Consecutive Patient Series
Authors: Furnes B. , Storli K. E. , Forsmo H. M. , Karliczek A. , Eide G. E. , Pfeffer F. 
Published: September 2018

Background: Rectal cancer surgery is standardized, resulting in improved survival. Colon cancer has fallen behind and therefore more radical surgical techniques have been introduced. One technique is complete mesocolic excision. The aim of this article was to study the complications after the introduction of standardized complete mesocolic excision in a single center. Methods: Complete mesocolic excision was introduced in 2007, and data were collected from 286 patients prior to surgery (2007–2010). The surgeon decided on open or laparoscopic surgery. Follow-up information was recorded until 31 December 2015. Complications were classified according to a modified Clavien–Dindo classification. Results: Complications occurred in 47%, severe complications (grade III and IV) in 15%. In-hospital mortality was 3.5%. A total of 142 patients (49.7%) were operated by open surgery. Logistic regression revealed anemia (p = 0.001), open surgery (p < 0.001), and long operating time (p < 0.001) as significant factors for complications in general. Multinomial logistic regression revealed that severe complications occurred more often in males (odds ratio: 2.56; 95% confidence interval: 0.98–6.68), patients with anemia (odds ratio: 3.49; 95% confidence interval: 1.27–9.60), elevated body mass index (odds ratio: 1.14; 95% confidence interval: 1.02–1.28), and in open surgery (odds ratio: 9.95; 95% confidence interval: 2.58–38.35). Age was not associated with severe complications. Survival was not significantly influenced by complications. Overall survival (5 years) was 90% among patients with complications and 92% among those without complications. Conclusion: Severe complications following the introduction of complete mesocolic excision are patient dependent and related to open surgery. Patients selected for laparoscopy had less number of complications; therefore, introducing complete mesocolic excision by laparoscopy is justified. Identification of these factors can improve selection of appropriate surgical approach and postoperative patient safety.
Effects of depression and exercise on health-related quality of life in patients with Parkinson's disease
Authors: Koutsouras George W , Levine Kimberly , Duroseau Nathalie , Ciraco Christina , Chan Vivian , Pergament Kathleen , Chan Thomas , Mancini Jayme D , Leder Adena N , Krishnamachari Bhuma 
Published: September 2018

Objectives There is limited literature describing the effect exercise may have on depression and an individual’s health-related quality of life (HRQoL) in Parkinson’s Disease (PD). We aim to quantify this effect. Methods A cross-sectional questionnaire was administered to 60 PD subjects. The Parkinson’s Disease Questionnaire-39 (PDQ-39) summary index and the Geriatric Depression Scale-30 were used to quantify HRQoL and depression, respectively. Data were obtained on exercise habits. ANOVA and multivariate linear regression analysis were used to calculate mean differences in HRQoL. Results Depression was consistently related to HRQoL ( p < 0.05). Of those who exercised as an adult before PD diagnosis, 49.02% ( n = 25) reported depression as compared to 88.89% ( n = 8) of those who did not report adult exercise ( p = 0.03). Those who exercised frequently as an adult prior to PD diagnosis had a better PDQ-39 Cognitive Index ( p = 0.03). Those who were not depressed and were currently exercising had a significantly higher HRQoL than those who were depressed and did not exercise ( p < 0.01). Discussion Exercising and depression may interact to affect HRQoL. Thus, coordination of mental health evaluation and exercise regimens in persons with PD may improve HRQoL.
Underdiagnosis of psychiatric disorders in people with intellectual disabilities: Differences between psychiatric disorders and challenging behaviour
Authors: Peña-Salazar Carlos , Arrufat Francesc , Santos Josep Manel , Fontanet Abel , González-Castro Gretel , Más Silvia , Roura-Poch Pere , Valdés-Stauber Juan 
Published: September 2018

Background and purpose: The purpose of this study was to assess the level of mental disorders and challenging behaviour in individuals with intellectual disability (ID) supported by specialized services, but without a prior psychiatric diagnosis, and to compare the levels of different disorders depending on the severity of ID. Methods: This is a cross-sectional study ( N = 142) of population with ID. Inclusion criteria were the following: adult patients with ID and with no previous psychiatric diagnosis prior to this survey. The Wechsler Adults Intelligence Scale-II, the Psychiatric Assessment Schedule for Adults with Developmental Disability checklist and clinical interview, the Diagnostic Assessment for the Severely Handicapped scale and the Inventory for Client and Agency Planning were the assessment tools. Results: A previously undiagnosed mental disorder was found in 29.6% of the sample. The most prevalent mental disorders were major depressive and anxiety disorders. An association between psychiatric comorbidity and challenging behaviour was found only for mild/moderate ID, especially for affective disorders. Conclusions: The presence of a psychiatric as well as a medical comorbidity is associated with severe ID, unlike challenging behaviour. Clinical limitations of the study have been discussed.
The “one airway, one disease” concept in light of Th2 inflammation
Authors: Giovannini-Chami Lisa , Paquet Agnès , Sanfiorenzo Céline , Pons Nicolas , Cazareth Julie , Magnone Virginie , Lebrigand Kévin , Chevalier Benoit , Vallauri Ambre , Julia Valérie , Marquette Charles-Hugo , Marcet Brice , Leroy Sylvie , Barbry Pascal 
Published: September 2018

In line with the pathophysiological continuum described between nose and bronchus in allergic respiratory diseases, we assessed whether nasal epithelium could mirror the Type 2 T-helper cell (Th2) status of bronchial epithelium.Nasal and bronchial cells were collected by brushing from healthy controls (C, n=13), patients with allergic rhinitis and asthma (AR, n=12), and patients with isolated allergic rhinitis (R, n=14). Cellular composition was assessed by flow cytometry, gene expression was analysed by RNA sequencing and Th2, Type 17 T-helper cell (Th17) and interferon (IFN) signatures were derived from the literature.Infiltration by polymorphonuclear neutrophils (PMN) in the nose excluded 30% of the initial cohort. All bronchial samples from the AR group were Th2-high. The gene expression profile of nasal samples from the AR group correctly predicted the paired bronchial sample Th2 status in 71% of cases. Nevertheless, nasal cells did not appear to be a reliable surrogate for the Th2 response, in particular due to a more robust influence of the IFN response in 14 out of 26 nasal samples. The Th2 scores in the nose and bronchi correlated with mast cell count (both p<0.001) and number of sensitisations (p=0.006 and 0.002), while the Th17 scores correlated with PMN count (p=0.006 and 0.003).The large variability in nasal cell composition and type of inflammation restricts its use as a surrogate for assessing bronchial Th2 inflammation in AR patients.
Impact of intensity of post-treatment surveillance on survival in colorectal cancer.
Authors: Snyder Rebecca A , Hu Chung-Yuan , Cuddy Amanda , Francescatti Amanda B. , Schumacher Jessica R. , You Y. Nancy , Schrag Deborah , McKellar Daniel , Winchester David P , Kozower Benjamin D. , Greenberg Caprice Christian , Chang George J. 
Published: September 2018

10016 Background: The optimal strategy for CRC post-treatment surveillance is unknown. The frequency and type of testing remains controversial, and it is unclear whether surveillance impacts rates of detection or survival. The purpose of this study was to determine if the intensity of post-treatment surveillance is associated with time to recurrence detection, treatment, or overall survival (OS). Methods: Primary records of a random sample of 10,636 Stage I-III CRC patients from Commission on Cancer accredited hospitals (2006-2007) were abstracted, and detailed results of surveillance testing were reviewed. Data was merged with records in the National Cancer Database (NCDB). A predicted and observed number of imaging and CEA tests per patient were determined and clustered by hospital to categorize patients into high (HI, O/E ≥ 1) or low intensity (LI, O/E < 1) categories. Results: 6,279 patients underwent imaging or CEA surveillance in the 3 years after CRC treatment. Patients with HI imaging (50.6%) or CEA (51.2%) had a mean of 2.9 imaging studies and 4.7 CEA tests. Patients with LI imaging underwent a mean of 1.4 imaging studies and 1.6 CEA tests. 5-year recurrence rates did not differ based on intensity of surveillance. Stage II and III patients who underwent HI imaging and CEA testing had a slightly higher resection rate, but this did not translate into an improvement in 5-year OS. Conclusions: High vs. low intensity surveillance was not associated with earlier detection of recurrent disease or improved OS. HI surveillance was associated with a slightly higher resection rate, but this did not result in a survival benefit. Our findings within a national hospital registry cohort failed to demonstrate a survival benefit of HI surveillance and suggest that an effective surveillance strategy may involve less frequent testing. [Table: see text]