bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences Between Moderate to Severely Cognitively Impaired Fallers Versus Nonfallers in Nursing Homes
Authors: Galik Elizabeth , Holmes Sarah , Resnick Barbara 
Published: March 2018

Introduction: The purpose of this study was to test differences in psychotropic medication, function, physical activity, agitation, resistiveness to care, comorbidities, and depression among moderate to severely cognitively impaired nursing home residents who were fallers versus nonfallers. Methods: This was a secondary data analysis using baseline data from a randomized controlled trial testing the Function and Behavior Focused Care intervention across 12 nursing homes. The sample included 336 older adults, the majority of whom were female and white. Results: There was a significant difference in the total number of comorbidities, agitation, the total number of psychotropic medications, depressive symptoms, and physical activity between those who fell and those who did not fall (Pillai-Bartlett trace = 4.91; P < .001). Discussion: Findings support prior work except with regard to medication use, cognition, and function. Due to inconsistent findings, additional research is recommended particularly with regard to the use of specific drug groups and medications.
Automatic Adaptation of Basal Insulin Using Sensor-Augmented Pump Therapy
Authors: Herrero Pau , Bondia Jorge , Giménez Marga , Oliver Nick , Georgiou Pantelis 
Published: March 2018

Background: People with insulin-dependent diabetes rely on an intensified insulin regimen. Despite several guidelines, they are usually impractical and fall short in achieving optimal glycemic outcomes. In this work, a novel technique for automatic adaptation of the basal insulin profile of people with diabetes on sensor-augmented pump therapy is presented. Methods: The presented technique is based on a run-to-run control law that overcomes some of the limitations of previously proposed methods. To prove its validity, an in silico validation was performed. Finally, the artificial intelligence technique of case-based reasoning is proposed as a potential solution to deal with variability in basal insulin requirements. Results: Over a period of 4 months, the proposed run-to-run control law successfully adapts the basal insulin profile of a virtual population (10 adults, 10 adolescents, and 10 children). In particular, average percentage time in target [70, 180] mg/dl was significantly improved over the evaluated period (first week versus last week): 70.9 ± 11.8 versus 91.1 ± 4.4 (adults), 46.5 ± 11.9 versus 80.1 ± 10.9 (adolescents), 49.4 ± 12.9 versus 73.7 ± 4.1 (children). Average percentage time in hypoglycemia (<70 mg/dl) was also significantly reduced: 9.7 ± 6.6 versus 0.9 ± 1.2 (adults), 10.5 ± 8.3 versus 0.83 ± 1.0 (adolescents), 10.9 ± 6.1 versus 3.2 ± 3.5 (children). When compared against an existing technique over the whole evaluated period, the presented approach achieved superior results on percentage of time in hypoglycemia: 3.9 ± 2.6 versus 2.6 ± 2.2 (adults), 2.9 ± 1.9 versus 2.0 ± 1.5 (adolescents), 4.6 ± 2.8 versus 3.5 ± 2.0 (children), without increasing the percentage time in hyperglycemia. Conclusion: The present study shows the potential of a novel technique to effectively adjust the basal insulin profile of a type 1 diabetes population on sensor-augmented insulin pump therapy.
High-frequency spinal cord stimulation causing cardiac paresthesias after lead migration: a case report
Authors: Majmundar Neil , Spinazzi Eleonora Francesca , Doran Joseph , Mammis Antonios 
Published: March 2018

Introduction: High-frequency (HF) spinal cord stimulation (SCS), a relatively new form of spinal cord stimulation, provides stimulation frequencies of up to 10 kHz and allows for paresthesia-free pain relief, an advantage that distinguishes it from traditional stimulation therapy. Without paresthesias, patients with HF SCS do not experience position-dependent painful stimulation and do not have to experience treatment interruption during sleep. Lead migration is a well-known complication of conventional spinal cord stimulation and usually results in a loss of efficacy along with other unpleasant sensory symptoms. In this case report, we present an incidence of lead migration in HF SCS that resulted in paresthesias, a symptom not expected to occur in this novel therapy. Case: The patient, a 60-year-old female with post-laminectomy syndrome, underwent a trial of HF SCS with standard lead placement at T8-T9. She initially had pain relief, but returned to the office on post-operative day 2 complaining of left chest wall and cardiac paresthesias, without frank pain or palpitations, in addition to loss of efficacy for her back and leg pain. Imaging showed that the leads had migrated, with one lead reaching the levels of T1-T3. Conclusion: While HF SCS has emerged as an effective paresthesia-free means of reducing back and leg pain, we provide the first report of paresthesias occurring with the HF SCS system as a result of cephalad lead migration. As HF SCS is only now being utilized as a treatment modality, we must remain cautious of potential adverse outcomes in patients, in particular above T8.
Metal versus plastic stents for drainage of pancreatic fluid collection: A meta‐analysis
Authors: Yoon Seung Bae , Lee In Seok , Choi Myung-Gyu 
Published: March 2018

BackgroundAlthough metal stents are increasingly being used for endoscopic transmural drainage of pancreatic fluid collection (PFC), the advantages of metal stents in comparison with plastic stents are not clear.ObjectiveThe aim of this study is to compare the clinical outcomes and adverse events between patients receiving endoscopic transmural drainage of PFCs through metal or plastic stents.MethodsWe performed a systematic literature search to identify all published manuscripts comparing metal and plastic stents for PFC drainage. The primary outcome was clinical success, and the secondary outcomes were technical success, procedure time, overall cost, adverse events, and recurrence.ResultsSeven studies were considered to be appropriate for this meta‐analysis. Metal stents showed a higher clinical success rate (odds ratio (OR) 3.39, 95% confidence interval (CI) 2.05–5.60) and a lower overall adverse event rate (OR 0.37, 95% CI 0.21–0.66) than plastic stents. In subgroup analyses, metal stents showed higher clinical success rates than plastic stents both for pseudocyst (OR 5.35, 95% CI 1.35–21.19) and walled‐off necrosis (OR 3.37, 95% CI 1.89–5.99).ConclusionsMetal stents are superior to plastic stents for endoscopic transmural drainage of PFC because they have a higher clinical success rate and lower rate of adverse events.
Liver disease in adults with α1‐antitrypsin deficiency
Authors: Mandorfer Mattias , Bucsics Theresa , Hutya Veronika , Schmid-Scherzer Karin , Schaefer Benedikt , Zoller Heinz , Ferlitsch Arnulf , Peck-Radosavljevic Markus , Trauner Michael , Ferenci Peter , Kneussl Meinhard , Reiberger Thomas 
Published: March 2018

BackgroundThe natural history of adult liver disease due to α1‐antitrypsin deficiency (A1AD) remains poorly understood.ObjectiveWe investigated whether heterozygosity for the Z‐allele predisposes for the development of clinically significant portal hypertension (CSPH). Moreover, we aimed to non‐invasively assess the prevalence of liver fibrosis and hepatic steatosis in adults with A1AD treated by pulmonologists.MethodsSERPINA1 rs28929474 (Z‐allele) was genotyped in 315 patients with CSPH (hepatic venous pressure gradient ≥10 mmHg; cases) and 248 liver donors (controls). In addition, 31 adults with A1AD (Pi*ZZ/Pi*SZ) and 11 first‐degree relatives (Pi*MZ/Pi*MS) underwent liver stiffness and controlled attenuation parameter (CAP) measurement.ResultsHeterozygosity for the Z‐allele was observed in 6.7% of patients with CSPH and 2.8% of liver donors. Thus, harboring the Z‐allele was associated with increased odds of CSPH (odds ratio: 2.47; 95% confidence interval: 1.03–5.9; P = 0.042). Among Pi*ZZ/Pi*SZ patients, 23%/3% had liver stiffness values indicative of liver fibrosis ( ≥F2/ ≥F3). Interestingly, 65%/52% of Pi*ZZ/Pi*SZ patients had CAP values indicative of hepatic steatosis ( ≥S1/ ≥S2).ConclusionsHeterozygosity for the Z‐allele predisposes for the development of CSPH, confirming its role as a genetic (co)factor in liver disease. Pi*ZZ/SZ patients rarely develop liver fibrosis ≥F3 during adulthood; however, liver fibrosis ≥F2 is common. Elevated CAP values hint at underlying hepatic steatosis, which might promote liver fibrosis progression.
Athletes do better after FAI arthroscopic treatment in male population
Authors: Przybyl M , Walenczak K , Domzalski ME 
Published: March 2018

Background: Arthroscopic surgery is becoming popular in the management of hip pathologies. There are numerous studies describing the outcomes of the treatment of athletes with this method. These outcomes are generally found to be excellent. Yet there are little data in the literature with respect to the arthroscopic treatment of nonathletes. The objective of our study is to compare the outcomes of the femoroacetabular impingement (FAI) treatment between athletes and nonathletes using arthroscopy, using two popular scales. Methods: The study involved a total of 129 male patients operated at our departments between 2009 and 2013. The subjects were divided into two groups: athletes and nonathletes. The results were assessed using the Nonarthritic Hip Score (NAHS) and Modified Harris Hip Score (MHHS). In addition, the length of postoperative hospitalization was evaluated. Results: Analyses revealed that athletes performed better in NAHS over each period under analysis (prior to the operation, 12 and 24 months after the operation). As regards MHHS in these periods, the results in both groups were comparable. In addition, it was found that the length of postoperative hospitalization was similar in athletes and nonathletes. Conclusions: Arthroscopic treatment of FAI is an effective method producing visible effects in athletes as well as nonathletes but quicker recovery in male athletic population. In the examined population, NAHS was a better measurement tool than MMHS, showing differences between the athlete and nonathlete population.
Surveying Dentists’ Perceptions of Caregiver Refusal of Topical Fluoride
Authors: Chi D.L. , Basson A.A. 
Published: March 2018

The objective of this study was to assess dentists’ perceptions of caregiver topical fluoride refusal behaviors. We administered an 8-item survey in 2015 and 2016 ( N = 582) and asked dentists about the extent to which fluoride refusal is a problem, refusal trends, comfort talking to caregivers who refuse, and perceived reasons why caregivers refuse. To examine geographic variation, we ran χ2 tests between dentists’ location (US West vs. non-West) and the first 3 perception measures (α = 0.05). Nearly 80% of dentists believed fluoride refusal was a problem, and 42.3% believed it was a growing problem. A significantly larger proportion of dentists who saw fluoride refusal as a problem also believed refusal was a growing problem compared to those who thought refusal was not a problem (89.6% and 41.2%, respectively; P < 0.0001). Caregiver characteristics perceived to be associated with fluoride refusal included immunization refusal (41.3%), White race (37.6%), and high income (33.7%). Thirty-seven percent of surveyed dentists were uncomfortable talking to caregivers who refused. There were no geographic differences in perceptions of fluoride refusal as a problem ( P = 0.52). A significantly larger proportion of non-West dentists believed fluoride refusal has gotten worse (non-West: 65.5%, West: 41.2%; P < 0.0001), but more dentists from the West were uncomfortable talking to caregivers who refused (West: 86%, non-West: 67.4%; P < 0.0001). Caregiver refusal of topical fluoride may be a growing problem, and many dentists are uncomfortable talking to caregivers who refuse. Additional interdisciplinary research is needed to identify the reasons why caregivers refuse fluoride, which is an important next step in developing chairside interventions that address fluoride refusal behaviors. Knowledge Transfer Statement: The results of this study can be used by researchers to develop chairside strategies to help dentists identify and manage fluoride refusal behaviors in clinical settings. This could help preserve topical fluoride as an evidence-based preventive therapy and address a growing public health problem.
Feature extraction via similarity search: application to atom finding and denoising in electron and scanning probe microscopy imaging
Authors: Somnath Suhas , Smith Christopher R. , Kalinin Sergei V. , Chi Miaofang , Borisevich Albina , Cross Nicholas , Duscher Gerd , Jesse Stephen 
Published: March 2018

AbstractWe develop an algorithm for feature extraction based on structural similarity and demonstrate its application for atom and pattern finding in high-resolution electron and scanning probe microscopy images. The use of the combined local identifiers formed from an image subset and appended Fourier, or other transform, allows tuning selectivity to specific patterns based on the nature of the recognition task. The proposed algorithm is implemented in Pycroscopy, a community-driven scientific data analysis package, and is accessible through an interactive Jupyter notebook available on GitHub.
The Montgomery ruling, individual values and shared decision-making in psychiatry
Authors: Hughes Julian C. , Crepaz-Keay David , Emmett Charlotte , Fulford K. W. M. 
Published: March 2018

SUMMARYThis article starts with a brief review of the UK Supreme Court's decision in the Montgomery case. Although much of the focus in discussing the case has been on the disclosure of risk, an important aspect of the model of consent contained in the judgment is that of dialogue. The model of informed consent set out in Montgomery suggests shared decision-making as the norm. Central to shared decision-making, however, is an awareness of values and of how values can vary between people. We introduce values-based practice as an approach that is entirely in keeping with the precepts of the Montgomery judgment. We go on to review how values-based practice and shared decision-making are relevant to psychiatric practice, using as examples recovery practice and compulsory detention under the Mental Health Act 1983.LEARNING OBJECTIVES•Appreciate that a new test of consent has been established as of a result of the UK Supreme Court's Montgomery ruling•Learn about the role of values-based practice as a partner to evidence-based practice in implementing Montgomery•Understand how values-based practice and Montgomery together support shared decision-making in psychiatryDECLARATION OF INTERESTNone.
How to carry out a literature search for a systematic review: a practical guide
Authors: Atkinson Lauren Z. , Cipriani Andrea 
Published: March 2018

SUMMARYPerforming an effective literature search to obtain the best available evidence is the basis of any evidence-based discipline, in particular evidence-based medicine. However, with a vast and growing volume of published research available, searching the literature can be challenging. Even when journals are indexed in electronic databases, it can be difficult to identify all relevant studies without an effective search strategy. It is also important to search unpublished literature to reduce publication bias, which occurs from a tendency for authors and journals to preferentially publish statistically significant studies. This article is intended for clinicians and researchers who are approaching the field of evidence synthesis and would like to perform a literature search. It aims to provide advice on how to develop the search protocol and the strategy to identify the most relevant evidence for a given research or clinical question. It will also focus on how to search not only the published but also the unpublished literature using a number of online resources.LEARNING OBJECTIVES•Understand the purpose of conducting a literature search and its integral part of the literature review process•Become aware of the range of sources that are available, including electronic databases of published data and trial registries to identify unpublished data•Understand how to develop a search strategy and apply appropriate search terms to interrogate electronic databases or trial registriesDECLARATION OF INTERESTNone.
Against the Stream: Generalised anxiety disorder (GAD) – a redundant diagnosis
Authors: Tyrer Peter 
Published: March 2018

SummaryThe diagnosis of generalised anxiety disorder is a distraction of no value. It is highly unreliable, co-occurring with many other disorders of firmer diagnostic status, and has intrinsic connections to personality dysfunction. It is argued that classification would be heartily relieved to rid itself of this unnecessary appendage and for the symptom of anxiety to remain as a descriptive term only.Declaration of interestNone.
Distinct Phenotypic Clusters of Glioblastoma Growth and Response Kinetics Predict Survival
Authors: Rayfield Corbin A. , Grady Fillan , De Leon Gustavo , Rockne Russell , Carrasco Eduardo , Jackson Pamela , Vora Mayur , Johnston Sandra K. , Hawkins-Daarud Andrea , Clark-Swanson Kamala R. , Whitmire Scott , Gamez Mauricio E. , Porter Alyx , Hu Leland , Gonzalez-Cuyar Luis , Bendok Bernard , Vora Sujay , Swanson Kristin R. 
Published: March 2018

PurposeDespite the intra- and intertumoral heterogeneity seen in glioblastoma multiforme (GBM), there is little definitive data on the underlying cause of the differences in patient survivals. Serial imaging assessment of tumor growth allows quantification of tumor growth kinetics (TGK) measured in terms of changes in the velocity of radial expansion seen on imaging. Because a systematic study of this entire TGK phenotype—growth before treatment and during each treatment to recurrence —has never been coordinately studied in GBMs, we sought to identify whether patients cluster into discrete groups on the basis of their TGK.Patients and MethodsFrom our multi-institutional database, we identified 48 patients who underwent maximally safe resection followed by radiotherapy with imaging follow-up through the time of recurrence. The patients were then clustered into two groups through a k-means algorithm taking as input only the TGK before and during treatment.ResultsThere was a significant survival difference between the clusters ( P = .003). Paradoxically, patients among the long-lived cluster had significantly larger tumors at diagnosis ( P = .027) and faster growth before treatment ( P = .003) but demonstrated a better response to adjuvant chemotherapy ( P = .048). A predictive model was built to identify which cluster patients would likely fall into on the basis of information that would be available to clinicians immediately after radiotherapy (accuracy, 90.3%).ConclusionDichotomizing the heterogeneity of GBMs into two populations—one faster growing yet more responsive with increased survival and one slower growing yet less responsive with shorter survival—suggests that many patients who receive standard-of-care treatments may get better benefit from select alternative treatments.
Symptom Burden in the First Year After Cancer Diagnosis: An Analysis of Patient-Reported Outcomes
Authors: Bubis Lev D. , Davis Laura , Mahar Alyson , Barbera Lisa , Li Qing , Moody Lesley , Karanicolas Paul , Sutradhar Rinku , Coburn Natalie G. 
Published: March 2018

Purpose Improvement in the quality of life of patients with cancer requires attention to symptom burden across the continuum of care, with the use of patient-reported outcomes key to achieving optimal care. Yet there have been few studies that have examined symptoms in the early postdiagnosis period during which suboptimal symptom control may be common. A comprehensive analysis of temporal trends and risk factors for symptom burden in newly diagnosed patients with cancer is essential to guide supportive care strategies. Methods A retrospective observational study was performed of patients who were diagnosed with cancer between January 2007 and December 2014 and who survived at least 1 year. Patient-reported Edmonton Symptom Assessment System scores, which are prospectively collected at outpatient visits, were linked to provincial administrative health care data. We described the proportion of patients who reported moderate-to-severe symptom scores by month during the first year after diagnosis according to disease site. Multivariable logistic regression models were constructed to identify risk factors for moderate-to-severe symptom scores. Results Of 120,745 patients, 729,861 symptom assessments were recorded within 12 months of diagnosis. For most symptoms, odds of elevated scores were highest in the first month, whereas nausea had increased odds of elevated scores up to 6 months after diagnosis. On multivariable analysis, cancer site, younger age, higher comorbidity, female sex, lower income, and urban residence were associated with significantly higher odds of elevated symptom burden. Conclusion A high prevalence of moderate-to-severe symptom scores was observed in cancers of all sites. Patients are at risk of experiencing multiple symptoms in the immediate postdiagnosis period, which underscores the need to address supportive care requirements early in the cancer journey. Patient subgroups who are at higher risk of experiencing moderate-to-severe symptoms should be targeted for tailored supportive care interventions.
Type 2 Diabetes and Adiposity Induce Different Lipid Profile Disorders: A Mendelian Randomization Analysis
Authors: Wang Ningjian , Cheng Jing , Ning Zhiyuan , Chen Yi , Han Bing , Li Qin , Chen Chi , Zhao Li , Xia Fangzhen , Lin Dongping , Guo Lixin , Lu Yingli 
Published: March 2018

Abstract

Context
Type 2 diabetes and obesity often coexist, so it is difficult to judge whether diabetes or obesity induce certain types of hyperlipidemia due to mutual confounds and reverse causation. We used Mendelian randomization analyses to explore the causal relationships of diabetes and adiposity with lipid profiles.

Design, Setting, and Main Outcome Measures
From 23 sites in East China, 9798 participants were enrolled during 2014 to 2016. We calculated two weighted genetic risk scores as instrumental variables for type 2 diabetes and body mass index (BMI). These scores were used to measure the causal relationships of diabetes and BMI with lipid profiles that included total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TGs).

Results
The causal regression coefficients (βIV) of genetically determined diabetes for the total cholesterol, LDL-C, and log10TG were 0.130 [95% confidence interval (CI): 0.020, 0.240; P = 0.014], 0.125 (96% CI: 0.041, 0.209; P = 0.001), and 0.019 (95% CI: –0.001, 0.039; P = 0.055), respectively. The βIV for HDL-C was –0.008 (95% CI: –0.032. 0.016), which was not significant (P = 0.699). The causal regression coefficients of a genetically determined 10 kg/m2 increase in BMI for HDL-C and log10TG were –0.409 (96% CI: –0.698, –0.120; P = 0.004) and 0.227 (95% CI: 0.039, 0.415; P = 0.026), respectively. The βIVs for TGs and LDL-C were not significant.

Conclusions
This study has provided evidence for the biologically plausible causal effects of diabetes and adiposity by BMI on different elements of the lipid profile using Mendelian randomization analyses.