bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Survival Outcomes of Pancreatic Cancer and Intraductal Papillary Mucinous Neoplasms
Authors: Yamada Suguru , Fujii Tsutomu , Hirakawa Akihiro , Takami Hideki , Suenaga Masaya , Hayashi Masamichi , Niwa Yukiko , Hattori Norifumi , Iwata Naoki , Kanda Mitsuro , Tanaka Chie , Kobayashi Daisuke , Nakayama Goro , Koike Masahiko , Fujiwara Michitaka , Kodera Yasuhiro 
Published: July 2018

Objectives
The aims of the study were to compare survival outcomes between patients with pancreatic ductal adenocarcinoma (PDAC) and invasive intraductal papillary mucinous neoplasms (IPMN) and to determine candidates for adjuvant chemotherapy.

Methods
A total of 579 consecutive patients, including 375 PDAC and 204 IPMN patients, were reviewed. Stage-matched comparisons of survival data were conducted using the Cox proportional hazards model and propensity analysis. To evaluate prognostic factors, univariate and multivariate Cox regression analyses were performed.

Results
The overall survival for invasive IPMN was significantly longer than that for PDAC (hazard ratio, 2.34; P = 0.0001). When the analysis was limited to stage I patients, the 5-year overall survival rate of invasive IPMN patients was significantly better than that of PDAC patients (100% vs 74.1%, P = 0.0092); however, no difference was observed between stage II patients with invasive IPMN and PDAC (hazard ratio, 1.49; P = 0.09). The Cox proportional hazards model and propensity analysis demonstrated no difference in stage-matched survival. Multivariate analysis revealed that only T (≥3) was an independent prognostic factor for invasive IPMN.

Conclusions
Stage-matched analysis did not show a significant survival difference between invasive IPMN and PDAC patients, and T3 or higher was an independent prognostic factor for invasive IPMN.
In‐hospital Pediatric Endoscopic Retrograde Cholangiopancreatography Is Associated With Shorter Hospitalization for Children With Choledocholithiasis
Authors: Bonasso Patrick C. , Gurien Lori A. , Staszak Jessica , Gowen Marie E. , Troendle David M. , Odiase Eliane , Lazar Lauren , Ruan Wenly , Barth Bradley A. , Williams Regan F. , Dassinger Melvin S. 
Published: July 2018

ABSTRACTObjectives:Children with choledocholithiasis are frequently managed at tertiary children's hospitals that do not have available endoscopic retrograde cholangiopancreatography (ERCP) proceduralists. We hypothesized that patients treated at hospitals without ERCP proceduralists would have a longer hospital length of stay (LOS) than those with ERCP proceduralists.Methods:Charts were reviewed for patients who underwent cholecystectomy and ERCP at 3 tertiary children's hospitals over 10 years. Trauma and complicated pancreatitis patients were excluded. Comparisons between patients requiring and not requiring transfer for ERCP were made using Wilcoxon rank‐sum tests for continuous variables and Fisher's exact tests for categorical variables.Results:One hundred and sixty‐four children underwent ERCP for suspected choledocholithiasis: 79 (48%) in the transfer group and 85 (52%) in the no transfer group.Median LOS was longer for patients requiring transfer (7 vs 5 days, P < 0.0001). One‐third (34%) of the transfer patients had magnetic resonance cholangiopancreatography compared to only 7% that did not require transfer (P < 0.0001). Among the 123 patients who underwent ERCP before cholecystectomy, 53% required (66/123) transfer and 47% (57/123) did not. Transfer group patients had longer median hospital LOS (P < 0.0001), more days between admission and ERCP (P < 0.0001), and more days between ERCP and surgery (P = 0.0004).Conclusions:Overall median LOS was significantly shorter for patients who underwent ERCP at the admitting facility. Patients who underwent ERCP before cholecystectomy at hospitals without available ERCP proceduralists incurred longer LOS. There is a need for more pediatric proceduralists appropriately trained to perform ERCP in children.
Supernatural Explanations of Neurological and Psychiatric Disorders Among Health Care Professionals at an Academic Tertiary Care Hospital in Saudi Arabia
Authors: Tayeb Haythum , Khayat Alaa , Milyani Haneen , Alsawwaf Yousef , Alzaben Faten , Koenig Harold G 
Published: July 2018

Abstract
Saudi society is one of many where supernatural explanations for neurological and psychiatric disorders are prevalent among lay persons. The frequency of such beliefs among health care professionals in this country, however, is unknown. The frequency of supernatural explanations for neurological and psychiatric disorders was assessed in 126 health care professionals at an academic medical center in Jeddah. A high frequency of belief in supernatural factors as a cause for neurological and psychiatric illness, including the evil eye, divine testing and punishment, and sorcery, was found. Younger age and more junior level of training were associated with a higher likelihood of belief in supernatural causation. A surprisingly high prevalence of supernatural explanations was found among these health care professionals, 80% of whom were attending physicians or physicians in training. Future studies should focus on the potential impact of these beliefs on clinical practice.
Single Versus Multiple Suicide Attempts
Authors: Kochanski Kristen M. , Lee-Tauler Su Yeon , Brown Gregory K. , Beck Aaron T. , Perera Kanchana U. , Novak Laura , LaCroix Jessica M. , Lento Rene M. , Ghahramanlou-Holloway Marjan 
Published: July 2018

AbstractIndividuals with multiple suicide attempts have a greater risk for eventual suicide death. We investigated clinical differences in participants with single versus multiple suicide attempts. Individuals with multiple attempts were more likely to have severe depressive symptoms, drug use disorder, and a higher wish to die. Borderline personality disorder traits and drug use disorder were significant predictors of multiple attempts when adjusting for other psychiatric disorders. Participants with multiple attempts sustained higher suicidal ideation–worst and wish to die/wish to live–worst scores during the 3-month assessment period. Clinical differences between individuals with multiple versus single attempts point to the need of tailored suicide prevention efforts.
Care and Discharge Outcome of Acute Stroke in Lebanon
Authors: Lahoud Nathalie , Salameh Pascale , Hosseini Hassan , Saleh Nadine , Rizk Elias , Hallit Souheil , Abbas Marie Helene , Gebeily Souheil 
Published: July 2018

Abstract
The present study was conducted to assess stroke care and outcomes in two Lebanese hospitals. Patients admitted in 2012 and 2013 were retrospectively selected. Data were extracted from medical records for time to hospital arrival, stroke severity, management, and discharge outcomes. A Cox regression analysis was then conducted to predict time to in-hospital death. A total of 201 patients were included (mean age = 69.2 years), among whom 50% arrived within a delay of 3.75 hours. Half underwent brain imaging in the first hour, and nine patients received an acute intervention. Forty-four patients died at the hospital; 142 were discharged home, among whom 98 patients were dependent in their daily activities. Stroke severity on admission and time from onset to arrival were found to be significantly associated to the time to in-hospital death (adjusted hazard ratio [HRa] = 1.13 and HRa = 0.98 respectively; p < 0.05). The study sheds light on high case fatality and dependency rates at discharge among stroke patients in Lebanese hospitals.
The Emerging Imperative for a Consensus Approach Toward the Rating and Clinical Recommendation of Mental Health Apps
Authors: Torous John , Firth Joseph , Huckvale Kit , Larsen Mark E. , Cosco Theodore D. , Carney Rebekah , Chan Steven , Pratap Abhishek , Yellowlees Peter , Wykes Til , Keshavan Matcheri , Christensen Helen 
Published: July 2018

Abstract
With over 10,000 mental health– and psychiatry-related smartphone apps available today and expanding, there is a need for reliable and valid evaluation of these digital tools. However, the updating and nonstatic nature of smartphone apps, expanding privacy concerns, varying degrees of usability, and evolving interoperability standards, among other factors, present serious challenges for app evaluation. In this article, we provide a narrative review of various schemes toward app evaluations, including commercial app store metrics, government initiatives, patient-centric approaches, point-based scoring, academic platforms, and expert review systems. We demonstrate that these different approaches toward app evaluation each offer unique benefits but often do not agree to each other and produce varied conclusions as to which apps are useful or not. Although there are no simple solutions, we briefly introduce a new initiative that aims to unify the current controversies in app elevation called CHART (Collaborative Health App Rating Teams), which will be further discussed in a second article in this series.
High Completion Rate for 12 Weekly Doses of Isoniazid and Rifapentine as Treatment for Latent Mycobacterium tuberculosis Infection in the Federal Bureau of Prisons
Authors: Schmit Kristine M. , Lobato Mark N. , Lang Simona G. , Wheeler Sherri , Kendig Newton E. , Bur Sarah 
Published: July 2018

Context:
Correctional facilities provide unique opportunities to diagnose and treat persons with latent tuberculosis infection (LTBI). Studies have shown that 12 weekly doses of isoniazid and rifapentine (INH-RPT) to treat LTBI resulted in high completion rates with good tolerability.

Objective:
To evaluate completion rates and clinical signs or reported symptoms associated with discontinuation of 12 weekly doses of INH-RPT for LTBI treatment.

Setting/Participants:
During July 2012 to February 2015, 7 Federal Bureau of Prisons facilities participated in an assessment of 12 weekly doses of INH-RPT for LTBI treatment among 463 inmates.

Main Outcome Measures:
Fisher exact test was used to assess the associations between patient sociodemographic characteristics and clinical signs or symptoms with discontinuation of treatment.

Results:
Of 463 inmates treated with INH-RPT, 424 (92%) completed treatment. Reasons for discontinuation of treatment for 39 (8%) inmates included the following: 17 (44%) signs/symptoms, 9 (23%) transfer or release, 8 (21%) treatment refusal, and 5 (13%) provider error. A total of 229 (49.5%) inmates reported experiencing at least 1 sign or symptom during treatment; most frequently reported were fatigue (16%), nausea (13%), and abdominal pain (7%). Among these 229 inmates, signs/symptoms significantly associated with discontinuation of treatment included abdominal pain (P < .001), appetite loss (P = .02), fever/chills (P = .01), nausea (P = .03), sore muscles (P = .002), and elevation of liver transaminases 5× upper limits of normal or greater (P = .03).

Conclusions:
The LTBI completion rates were high for the INH-RPT regimen, with few inmates discontinuing because of signs or symptoms related to treatment. This regimen also has practical advantages to aid in treatment completion in the correctional setting and can be considered a viable alternative to standard LTBI regimens.
Psychometric properties of the brief pain inventory modified for proxy report of pain interference in children with cerebral palsy with and without cognitive impairment
Authors: Barney Chantel C. , Stibb Stacy M. , Merbler Alyssa M. , Summers Rebekah L.S. , Deshpande Supreet , Krach Linda E. , Symons Frank J. 
Published: July 2018

Abstract

Introduction:
Cerebral palsy (CP) is the most common cause of physical disability in children and is often associated with secondary musculoskeletal pain. Cerebral palsy is a heterogeneous condition with wide variability in motor and cognitive capacities. Although pain scales exist, there remains a need for a validated chronic pain assessment tool with high clinical utility for use across such a heterogeneous patient population with and without cognitive impairment.

Objectives:
The purpose of this study was an initial assessment of several psychometric properties of the 12-item modified brief pain inventory (BPI) pain interference subscale as a proxy-report tool in a heterogeneous sample of children with CP with and without cognitive impairment.

Methods:
Participants (n = 167; 47% male; mean age = 9.1 years) had pain assessments completed through caregiver report in clinic before spasticity treatment (for a subgroup, the modified BPI was repeated after procedure). To measure concurrent validity, we obtained pain intensity ratings (Numeric Rating Scale of pain) and pain intensity, duration, and frequency scores (Dalhousie Pain Interview).

Results:
Modified BPI scores were internally consistent (Cronbach α = 0.96) and correlated significantly with Numeric Rating Scale intensity scores (rs = 0.67, P < 0.001), Dalhousie Pain Interview pain intensity (rs = 0.65, P < 0.001), pain frequency (rs = 0.56, P = 0.02), and pain duration scores (rs = 0.42, P = 0.006). Modified BPI scores also significantly decreased after spasticity treatment (pretest [scored 0–10; 3.27 ± 2.84], posttest [2.27 ± 2.68]; t (26) = 2.14, 95% confidence interval [0.04–1.95], P = 0.04).

Conclusion:
Overall, the modified BPI produced scores with strong internal consistency and that had concurrent validity as a proxy-report tool for children with CP.
Effectiveness of Cognitive Behavioral Therapy for Depression and Anxiety in Patients With Cardiovascular Disease: A Systematic Review and Meta-Analysis
Authors: Reavell James , Hopkinson Michael , Clarkesmith Danielle , Lane Deirdre A. 
Published: July 2018

ABSTRACT

Objective
Depression and anxiety are highly prevalent in patients with cardiovascular disease (CVD) and influence their mental well-being and CVD prognosis. The primary objective was to assess the effectiveness of cognitive behavioral therapy (CBT) for depression and anxiety in patients with CVD. Secondary objectives were to assess the impact of CBT on cardiovascular mortality, cardiovascular events, patient satisfaction, and quality of life.

Methods
MEDLINE, PsycINFO, CINAHL, CENTRAL, and alternative sources were searched for randomized controlled trials and observational studies with a control. Studies were required to assess CBT in coronary heart disease, acute coronary syndrome, atrial fibrillation, or postmyocardial infarction patients, with anxiety and/or depression. Studies were independently screened by two reviewers and critically appraised using the Cochrane Risk of Bias tool. The random-effects model was used to pool standardized mean differences (SMD).

Results
Twelve randomized controlled trials were included. At follow-up, depression (SMD = −0.35, 95% confidence interval [CI] = −0.52 to −0.17, p < .001, I
2 = 59%) and anxiety (SMD = −0.34, 95% CI = −0.65 to −0.03, p = .03, I
2 = 71%) scores were significantly lower in CBT patients compared with controls. Change in mental health quality of life (SF-12) was also significantly greater for CBT patients, compared with controls (mean difference = 3.62, 95% CI = 0.22 to 7.02, p = .04, I
2 = 0%). No differences in patient satisfaction or cardiovascular events were evident between CBT and control groups. Among the study reports included in this meta-analysis, data specific to cardiovascular mortality were not reported.

Conclusions
Cognitive behavioral therapy seems to be an effective treatment for reducing depression and anxiety in patients with CVD and should be considered in standard clinical care.
Split-Skin-Graft Wrapped Conformer to Treat Severe Contracted Sockets
Authors: Hasan Sultan Al , Galindo-Ferreiro Alicia , Bigethi Carolina , Meneghim Roberta L.S.F. , Shaikh Osama Al , Schellini Silvana A. 
Published: July 2018

Abstract
This case series present the surgical management of cases with severe contracted sockets using a split-skin-graft wrapped conformer. Eight patients with severely contracted anophthalmic sockets underwent surgery. The surgical technique is described and a chart review was performed to collect patient data pre- and postoperatively. Preoperatively, all patients had grade 3 or 4 contracted sockets with shallow or obliterated fornices and patients were unable to retain an external prosthesis in place. Donor material was harvested from the supraclavicular area. The split-skin-graft was successfully performed in all cases without fornix-deepening sutures. All patients underwent a significant improvement of socket contracture enabling retention of the prosthesis and were satisfied with the outcomes. The split-skin-graft wrapped conformer is a rapid and less surgically challenging option to correct severe contracted anophthalmic sockets.
Tourniquet use is not associated with limb loss following military lower extremity arterial trauma
Authors: Kauvar David S. , Miller Diane , Walters Thomas J. 
Published: July 2018

BACKGROUND
The effect of battlefield extremity tourniquet (TK) use on limb salvage and long-term complications following vascular repair is unknown. This study explores the influence of TK use on limb outcomes in military lower extremity arterial injury.

METHODS
The study database includes cases of lower extremity vascular injury from 2004 to 2012 with data recorded until discharge from military service. We analyzed all limbs with at least one named arterial injury from the femoral to the tibial level. Tourniquet (TK) and no TK (NTK) groups were identified. Univariate analyses were performed with significance set at p ≤ 0.05.

RESULTS
A total of 455 cases were included, with 254 (56%) having a TK for a median of 60 minutes (8–270 minutes). Explosive injuries (53%) and gunshot wounds (26%) predominated. No difference between TK and NTK was present in presence of fracture, level of arterial injury, type of arterial repair, or concomitant venous injury. More nerve injuries were present in the TK group, and Abbreviated Injury Scale extremity and Mangled Extremity Severity Score tended toward greater injury severity. Amputation and mortality rates did not differ between groups, but the incidence of severe edema, wound infection, and foot drop was higher in the TK group. Vascular above-knee amputation, arterial repair complication, and severe edema were higher in the TK group also (p = 0.10). Tourniquet duration of 60 minutes or longer was not associated with increased amputations, but more rhabdomyolysis was present.

CONCLUSION
Field TK use is associated with wound infection and neurologic compromise but not limb loss. This may be due to a more severe injury profile among TK limbs. Increased TK times may predispose to systemic, but not limb, complications.

LEVEL OF EVIDENCE
Therapeutic/care management, level IV.
Improved Gray Matter Atrophy Detection in Alzheimer Disease in Chinese Populations Using Chinese Brain Template
Authors: Jia Xiuqin , Shi Lin , Qian Tianyi , Li Ying , Wang Defeng , Liang Peipeng , Li Kuncheng 
Published: July 2018

Objective:
This study aimed to test the hypothesis that the statistical Chinese brain template would be more effective to detect gray matter (GM) changes in patients with Alzheimer disease (AD) in Chinese populations.

Materials and Methods:
In total, 50 patients with AD and 50 sex-matched and age-matched healthy controls were included in this study. Chinese2020, a typical statistical Chinese brain template, and MNI152, a typical Caucasian template were used for spatial normalization respectively. The GM volume alterations in patients with AD were examined by using voxel-based morphometry with education level and total intracranial volume as nuisance variables. The GM proportions of the identified brain areas with group difference were compared.

Results:
By using Chinese2020 and MNI152, significant GM atrophies in patients with AD were commonly detected in the bilateral medial temporal lobe, lateral temporal lobe, inferior/medial frontal cortex, as well as left thalamus. However, higher GM percentages of detected regions were acquired when Chinese2020 was used rather than MNI152. Furthermore, stronger statistical powers in the detected clusters were observed using Chinese2020 than MNI152. In addition, the laterality index analysis showed the bilateral atrophies with no hemispheric laterality in the para/hippocampus when using population-specific brain atlas (ie, Chinese2020).

Conclusions:
These findings indicated that applying the population-specific brain atlas to neuroimaging studies may achieve higher accuracy in activation detection. This may have implications to the imaging study of neurodegenerative diseases.
Online Theta Frequency Transcranial Alternating Current Stimulation for Cognitive Remediation in Schizophrenia
Authors: Sreeraj Vanteemar S. , Shivakumar Venkataram , Sowmya Selvaraj , Bose Anushree , Nawani Hema , Narayanaswamy Janardhanan C. , Venkatasubramanian Ganesan 
Published: July 2018

Abstract
Transcranial alternating current stimulation (tACS), a noninvasive brain stimulation technique that uses low-intensity alternating current, has been postulated to be a potential therapeutic option in treating the cognitive deficits in schizophrenia. Transcranial alternating current stimulation synchronizes the neural oscillations to the applied stimulation frequency in the stimulated cortical regions. In this report, we have reviewed the literature pertinent to the clinical application of tACS in psychiatric disorders; in addition, we have described the clinical use of online theta tACS in a schizophrenia patient with cognitive deficits. Online theta tACS led to improvement in working memory, attention, processing speed, and emotional processing. The beneficial effect of tACS persisted during reassessment of the patient after 50 days. Transcranial alternating current stimulation, given its noninvasiveness, safety, and ease of administration, has the potential to ameliorate cognitive deficits in neuropsychiatric disorders like schizophrenia.
A different state of mind: neural activity related to volitionally up- versus downregulating cortical excitability
Authors: Ruddy Kathy , Balsters Joshua , Mantini Dante , Liu Quanying , Kassraian-Fard Pegah , Enz Nadja , Mihelj Ernest , Chander Bankim , Soekadar Surjo R. , Wenderoth Nicole 
Published: July 2018

AbstractTo date there exists no reliable method to non-invasively upregulate or downregulate the state of the resting motor system over a large dynamic range. Here we show that an operant conditioning paradigm which provides neurofeedback of the size of motor evoked potentials (MEPs) in response to transcranial magnetic stimulation (TMS), enables participants to self-modulate their own brain state. Following training, participants were able to robustly increase (by 83.8%) and decrease (by 30.6%) their MEP amplitudes. This volitional up-versus down-regulation of corticomotor excitability caused an increase of late-cortical disinhibition (LCD), a TMS derived read-out of presynaptic GABAB disinhibition, which was accompanied by an increase of gamma and a decrease of alpha oscillations in the trained hemisphere. This approach paves the way for future investigations into how altered brain state influences motor neurophysiology and recovery of function in a neurorehabilitation context.