bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns and predictors of conversion to bipolar disorder in 91 587 individuals diagnosed with unipolar depression
Authors: Musliner K. L. , Østergaard S. D. 
Published: March 2018

ObjectiveConversion from unipolar depression (UD) to bipolar disorder (BD) is a clinically important event that should lead to treatment modifications. Unfortunately, recognition of this transition is often delayed. Therefore, the objective of this study was to identify predictors of diagnostic conversion from UD to BD.MethodHistorical prospective cohort study based on 91 587 individuals diagnosed with UD in Danish hospital psychiatry between 1995 and 2016. The association between a series of potential predictors and the conversion from UD to BD during follow‐up (702 710 person‐years) was estimated by means of Cox regression with death as competing risk.ResultsDuring follow‐up, 3910 individuals with UD developed BD. The cumulative incidence of conversion was slightly higher in females (8.7%, 95% CI: 8.2–9.3) compared to males (7.7%, 95% CI: 7.0–8.4). The strongest predictor of conversion from UD to BD was parental history of BD (adjusted hazard ratio (aHR) = 2.60, 95% CI: 2.20–3.07)). Other predictors included psychotic depression at the index UD episode (aHR = 1.73, 95% CI: 1.48–2.02), a prior/concomitant non‐affective psychosis (aHR = 1.73, 95% CI: 1.51–1.99), and in‐patient treatment at the index episode (aHR = 1.76, 95% CI: 1.63–1.91).ConclusionDiagnostic conversion from UD to BD is predicted by severe depression requiring in‐patient treatment, psychotic symptomatology, and parental history of BD.
Strong opioid prescription in cancer patients in their final year of life: A population‐based analysis using a Taiwanese health insurance database
Authors: Lin Yu‐Lin , Hsieh Ruey Kuen , Tang Chao‐Hsiun 
Published: March 2018

AbstractAimPain assessment and management have been important criteria in hospital accreditation in Taiwan since 2007. We used a Taiwanese health insurance database to determine factors influencing patterns of strong opioid use in cancer patients in their final 12 months of life.MethodsData from patients with cancer in Taiwan outpatient clinics with cancer‐related deaths between 2008 and 2011 were included in the analysis. Strong opioid prescription data from the last 12 months of each patient's life, as well as patient, physician, and hospital characteristics, were collected from the National Health Insurance Research Database.ResultsAmong 162 679 patients, more were male (63.6%) than female (36.4%) and almost half (49.3%) were ≥70 years old. Most (44.9%) patients had gastrointestinal cancer. More than one‐third (35.4%) of patients were prescribed strong opioids during the 12 months before death, and more than half (53.2%) of those prescribed opioids received them in the 3 months before death. Median duration of strong opioid use was 81 days before death. Patients with head/neck cancer (52.8%) or who were treated in hematology and oncology departments (45.8%) were most likely, and patients with gastrointestinal cancer (hazard ratio = 0.65; 95% confidence interval, 0.64–0.67) or treated in gastroenterology departments (hazard ratio = 0.88; 95% confidence interval, 0.84–0.93) were least likely to be prescribed strong opioids.ConclusionStrong opioid prescriptions varied among patients with different cancer diagnoses and physicians. Information from this study can guide efforts to improve patient and physician education about cancer pain management.
Outcomes of Australian patients receiving non‐funded anti‐PD‐1 immune checkpoint inhibitors for non‐melanoma cancers
Authors: Tiu Crescens , Wong Annie , Herschtal Alan , Mileshkin Linda 
Published: March 2018

AbstractAimTo characterize the outcomes of patients with nonmelanoma solid tumors receiving anti‐PD‐1 immunotherapy not funded by the Australian Pharmaceutical Benefits Scheme.MethodsMedical records of patients with metastatic nonmelanoma tumor diagnoses treated with anti‐PD‐1 (self‐funded pembrolizumab or nivolumab through an access program) from January 1, 2014, to December 31, 2016, at Peter MacCallum Cancer Centre, were retrospectively reviewed. Events after December 31, 2016, were censored.ResultsOf 47 patients identified, 27 (57%) had lung cancer. Twenty‐six had compassionate access to nivolumab (24 lung, one renal, one gastroesophageal with possible new lung primary). Median overall survival was 5.7 months. Eleven (23%) achieved a partial response; none had complete response. Twenty (43%) had disease progression on first imaging; 16 (48%) of these continued treatment beyond radiological progression, with three achieving subsequent partial responses. Ten (21%) were not re‐staged mostly due to rapid deterioration or death. At 6 and 12 months, nine (20%) and two (4%) remained on treatment, respectively. Five (12%) discontinued treatment due to immune‐related toxicities. Of 34 patients who died, 71% received treatment within the last month of life; 38% died in an acute hospital. None of 25 patients with poor Eastern Cooperative Oncology Group performance scores of 2–4 responded.ConclusionThe response rates and overall survival of patients with NSCLC, renal carcinoma and triple negative breast cancer of good performance status receiving anti‐PD‐1 therapy outside of a clinical trial are consistent with clinical trial data. However, patients with poor ECOG performance status are unlikely to respond. Careful patient selection and counseling about the potential outcomes of self‐funding treatment in this setting is needed.
The Africa Yoga Project and Well‐Being: A Concept Map of Students’ Perceptions
Authors: Giambrone Carla A. , Cook‐Cottone Catherine P. , Klein Jessalyn E. 
Published: March 2018

BackgroundConcept mapping methodology was used to explore the perceived impact of practicing yoga with the Africa Yoga Project (AYP)—an organisation created to increase health and well‐being by providing community‐based yoga classes throughout Kenya. AYP's mission fit with theoretical models of well‐being is discussed. Anecdotal evidence and initial qualitative research suggested the AYP meaningfully impacted adult students.MethodsOf the hundreds of AYP's adult students, 56 and 82 students participated in Phases I and II, respectively. Phase I brainstorming resulted in 94 student‐generated statements about their perceived change. Phase II participants sorted and rated statements in terms of importance. Multidimensional scaling and hierarchical cluster analysis of sort data was utilised to map and group statements into clusters.ResultsBased on statistical and interpretive criteria, a five‐cluster solution with the following concepts was identified as the best model of students’ change: Personal Growth; Interpersonal Effectiveness (lowest importance); Physical and Social Benefits; Emotional Resiliency; and Improved Self‐Concept (highest importance).ConclusionsOverall, students reported positive perceptions of the AYP. Additional research is needed to quantify students’ change, and to compare the AYP outcomes to those of other programs aimed at poverty‐related stress reduction and well‐being.
β‐2 Agonists as Misusing Drugs? Assessment of both Clenbuterol‐ and Salbutamol‐related European Medicines Agency Pharmacovigilance Database Reports
Authors: Milano Giulia , Chiappini Stefania , Mattioli Francesca , Martelli Antonietta , Schifano Fabrizio 
Published: March 2018

AbstractA recent years’ increase in misusing levels of image‐ and performance‐ enhancing drugs (IPEDs) has been observed. Out of these drugs, beta‐2 agonists have recently emerged for their potential of misuse, especially for slimming and bodybuilding purposes. To this perspective, clenbuterol (‘the size zero pill’) has been reported as being both popular and widely available from the illegal market. All clenbuterol and salbutamol misuse/abuse/dependence/withdrawal/overdose/off‐label spontaneous reports (2006–2016) from the European Medicines Agency (EMA) EudraVigilance (EV) database were collected and analysed by age range, gender, concomitant therapies and source of information. From the EV database, 55 of a total number of 920 ‘suspect’ misuse/abuse/dependence/withdrawal/overdose/off‐label ADRs (e.g. 5.97%; corresponding to 25 of 138 individuals) and 1310 of 62,879 ADRs (e.g. 2.08%; corresponding to 474 of 6923 individuals) were, respectively, associated with clenbuterol (typically ingested in combination with a range of anabolic steroids) and salbutamol. Proportional reporting ratio (PRR) value for misuse/abuse ADRs was higher (PRR = 18.38) for clenbuterol in comparison with salbutamol. Clenbuterol misuse/abuse could be a cause for major concern, especially in vulnerable individuals.
Understanding mothers’ decision‐making needs for autopsy consent after stillbirth: Framework analysis of a large survey
Authors: Schirmann Anne , Boyle Frances M. , Horey Dell , Siassakos Dimitrios , Ellwood David , Rowlands Ingrid , Flenady Vicki 
Published: March 2018

AbstractBackgroundExperiencing stillbirth is devastating and leaves parents searching for causes. Autopsy is the gold standard for investigation, but deciding to consent to this procedure is very difficult for parents. Decision support in the form of clear, consistent, and parent‐centered information is likely to be helpful. The aims of this study were to understand the influences on parents’ decisions about autopsy after stillbirth and to identify attributes of effective decision support that align with parents’ needs.MethodsFramework analysis using the Decision Drivers Model was used to analyze responses from 460 Australian and New Zealand (ANZ) mothers who took part in a multi‐country online survey of parents’ experiences of stillbirth. The main outcomes examined were factors influencing mothers’ decisions to consent to autopsy after stillbirth.ResultsFree‐text responses from 454 ANZ mothers referenced autopsy, yielding 1221 data segments for analysis. The data confirmed the difficult decision autopsy consent entails. Mothers had a strong need for answers coupled with a strong need to protect their baby. Four “decision drivers” were confirmed: preparedness for the decision; parental responsibility; possible consequences; and role of health professionals. Each had the capacity to influence decisions for or against autopsy. Also prominent were the “aftermath” of the decision: receiving the results; and decisional regret or uncertainty.ConclusionsThe influences on decisions about autopsy are diverse and unpredictable. Effective decision support requires a consistent and structured approach that is built on understanding of parents’ needs.
Children's emotion understanding in relation to attachment to mother and father
Authors: Psychogiou Lamprini , Nath Selina , Kallitsoglou Angeliki , Dimatis Konstantinos , Parry Elizabeth , Russell Abigail Emma , Yilmaz Merve , Kuyken Willem , Moberly Nicholas J. 
Published: March 2018

Although attachment plays a key role in children's socio‐emotional development, little attention has been paid to the role of children's attachment to their father. This study examined whether insecure attachment to each parent was associated with reduced emotion understanding in children and whether children showed consistent attachments to their mother and father. We measured children's attachment to each parent using the Manchester Child Attachment Story Task and child emotion understanding using the Test of Emotion Comprehension (children's Mage = 5.64 years, SD = 0.84). The results indicated that insecure father–child attachment and insecure mother–child attachment were each associated with lower emotion understanding in children after controlling for parent's depressive symptoms and children's age. There was significant concordance of child attachment to mother and father. The findings provide support for convergence of children's attachment across parents and suggest that father–child attachment is an important factor to consider when examining children's emotion understanding.
Statement of contribution

What is already known on this subject

Secure mother–child attachment is positively associated with children's emotional competence.

Children form similar representations of attachment to their mother and father.

What the present study adds

Both mother–child and father–child attachment are associated with children's emotion understanding.

The study's findings highlight the importance of father–child attachment in their children's emotion understanding.

The study provides support for concordance of children's attachment across parents.
Dental follicle mesenchymal stem cells down‐regulate Th2‐mediated immune response in asthmatic patients mononuclear cells
Authors: Genç D. , Zibandeh N. , Nain E. , Gökalp M. , Özen A. O. , Göker M. K. , Akkoç T. 
Published: March 2018

SummaryBackgroundAsthma is a chronic inflammatory disease in which inflammatory responses have the polarisation of CD4+ T cells to Th2 cells. Dental follicle mesenchymal stem cells (DFSCs) have strong anti‐inflammatory properties comparable to other mesenchymal stem cells.ObjectiveWe investigated the immunomodulatory effects of DFSCs on CD4+ T helper cell responses of asthmatic patients and compared the results with those obtained with asthmatic subjects on immunotherapy and with healthy individuals.MethodPeripheral blood mononuclear cells (PBMC) were isolated from immunotherapy naïve asthmatics, asthmatics on subcutaneous Der p1 immunotherapy and from healthy individuals. PBMC were pre‐conditioned with anti‐CD3/anti‐CD28 mAbs, Der p1 or IFN‐γ in the presence and absence of DFSCs and analysed for T cell viability and proliferation, CD4+CD25+FOXP3+ regulatory T cell frequencies, cytokine expression, and GATA3, T bet and FoxP3 expressions. Neutralisation of TGF‐β and blockade of IDO and PGE2 pathways were performed to determine suppressive signalling pathways of DFSCs.ResultsDental follicle mesenchymal stem cells suppressed proliferative responses of CD4+ T lymphocytes and increased the frequency of Treg cells. DFSCs decreased effector and effector memory CD4+ T cell phenotypes in favour of naïve T cell markers. DFSCs decreased IL‐4 and GATA3 expression and increased IFN‐γ, T‐bet and IL‐10 expression in asthmatics. Costimulatory molecules were suppressed in monocytes with DFSCs in the cocultures. DFSCs down‐regulated inflammatory responses via IDO and TGF‐β pathways in asthmatic patients.ConclusionDental follicle mesenchymal stem cells suppressed allergen‐induced Th2‐cell polarisation in favour of Th1 responses and attenuated antigen‐presenting cell co‐stimulatory activities. These studies suggest that DFSC‐based cell therapy may provide pro‐tolerogenic immunomodulation relevant to allergic diseases such as asthma.
Accuracy of intraocular lens power calculation formulas in long eyes: a systematic review and meta‐analysis
Authors: Wang Qiwei , Jiang Wu , Lin Tiao , Zhu Yi , Chen Chuan , Lin Haotian , Chen Weirong 
Published: March 2018

AbstractImportanceVisual outcome after intraocular lens (IOL) implantation in long eyes is considerably affected by IOL power calculation. Various formulas have been designed to achieve an accurate IOL power prediction. However, controversy about the accuracy remains.BackgroundTo evaluate the accuracy of IOL power calculation formulas in long eyes.DesignMeta‐analysis.ParticipantsPatients with ocular axial length (AL) over 24.5 mm.MethodsA comprehensive search in PubMed, EMBASE, Cochrane Data Base of Systematic Reviews and the Cochrane Central Register of Controlled Trials were conducted by September, 2017. The weighted mean differences of mean absolute errors (MAE) and the odds ratio of percentage of eyes within ±0.50D of prediction error among formulas were analysed.Main Outcomes MeasuresBetween‐group differences of MAE among formulas.ResultsEleven observational studies, involving 4047 eyes, were enrolled. Six formulas for IOL power calculation were compared: Barrett Universal II, Haigis, Holladay 2, SRK/T, Hoffer Q and Holladay 1. The MAE of Barrett Universal II was statistically lower than that of Holladay 2 (mean difference, MD = −0.04D, P = 0.0002), SRK/T (MD = −0.05D, P < 0.00001), Hoffer Q (MD = −0.07D, P < 0.00001) and Holladay 1 (MD = −0.07D, P < 0.00001). Barrett Universal II yielded significantly higher percentage of eyes within ±0.50D of the prediction error than the other formulas. The heterogeneity was minimized through dividing eyes into two groups by the AL of 26 mm.Conclusions and RelevanceThis study demonstrates the superiority of Barrett Universal II over Holladay 2, SRK/T, Hoffer Q and Holladay 1 in predicting IOL power in long eyes.
Evidence‐based knowledge on the aesthetics and maintenance of peri‐implant soft tissues: Osteology Foundation Consensus Report Part 2—Effects of hard tissue augmentation procedures on the maintenance of peri‐implant tissues
Authors: Schwarz Frank , Giannobile William V. , Jung Ronald E. ,   on behalf of the Groups of the 2nd Osteology Foundation Consensus Meeting
Published: March 2018

AbstractObjectivesOne task of Working Group 1 at the 2nd Consensus Meeting of the Osteology Foundation was to comprehensively assess the effects of hard tissue augmentation procedures on peri‐implant health or disease.Materials and methodsOne systematic review and meta‐analysis on the effects of hard tissue augmentation procedures included a total of eight studies (n = 12 publications). Consensus statements, clinical recommendations, and implications for future research were based on structured group discussions and plenary session approval.ResultsAfter 1–10 years of follow‐ up, lateral bone augmentation procedures were associated with peri‐implant tissue stability, as evidenced by minimal and non‐significant changes in bleeding on probing, probing depth, and marginal bone levels. Case definitions based on clinical and radiographic parameters to differentiate peri‐implant health from disease have been inconsistently employed in the studies investigated.ConclusionsLateral bone augmentation procedures are associated with peri‐implant tissue stability on short‐term (1–3 years) and midterm follow‐ups to long‐term (>3 years) follow‐ups.
Effects of soft tissue augmentation procedures on peri‐implant health or disease: A systematic review and meta‐analysis
Authors: Thoma Daniel S. , Naenni Nadja , Figuero Elena , Hämmerle Christoph H. F. , Schwarz Frank , Jung Ronald E. , Sanz‐Sánchez Ignacio 
Published: March 2018

AbstractObjectiveTo review the dental literature in terms of soft tissue augmentation procedures and their influence on peri‐implant health or disease in partially and fully edentulous patients.MethodsA MEDLINE search from 1966 to 2016 was performed to identify controlled clinical studies comparing soft tissue grafting versus no soft tissue grafting (maintenance) or two types of soft tissue grafting procedures at implant sites. The soft tissue grafting procedures included either an increase of keratinized tissue or an increase of the thickness of the peri‐implant mucosa. Studies reporting on the peri‐implant tissue health, as assessed by bleeding or gingival indices, were included in the review. The search was complemented by an additional hand search of all selected full‐text articles and reviews published between 2011 and 2016. The initial search yielded a total number of 2,823 studies. Eligible studies were selected based on the inclusion criteria (finally included: four studies on gain of keratinized tissue; six studies on gain of mucosal thickness) and quality assessments conducted. Meta‐analyses were applied whenever possible.ResultsSoft tissue grafting procedures for gain of keratinized tissue resulted in a significantly greater improvement of gingival index values compared to maintenance groups (with or without keratinized tissue) [n = 2; WMD = 0.863; 95% CI (0.658; 1.067); p < .001]. For final marginal bone levels, statistically significant differences were calculated in favor of an apically positioned flap (APF) plus autogenous grafts versus all control treatments (APF alone; APF plus a collagen matrix; maintenance without intervention [with or without residual keratinized tissue]) [n = 4; WMD = −0.175 mm; 95% CI: (−0.313; −0.037); p = .013]. Soft tissue grafting procedures for gain of mucosal thickness did not result in significant improvements in bleeding indices over time, but in significantly less marginal bone loss over time [WMD = 0.110; 95% CI: 0.067; 0.154; p < .001] and a borderline significance for marginal bone levels at the study endpoints compared to sites without grafting.ConclusionsWithin the limitations of this review, it was concluded that soft tissue grafting procedures result in more favorable peri‐implant health: (i) for gain of keratinized mucosa using autogenous grafts with a greater improvement of bleeding indices and higher marginal bone levels; (ii) for gain of mucosal thickness using autogenous grafts with significantly less marginal bone loss.
Syncope as a subject of the risk assessment of pulmonary thromboembolism to be used for: A cross‐sectional study
Authors: Ozyurt Songul , Ozsu Savas , Erbay Muge , Oztuna Funda , Gumus Aziz , Sahin Unal 
Published: March 2018

AbstractIntroductionSyncope is infrequent in pulmonary thromboembolism (PTE) yet might be indicative of haemodynamic instability. The prognostic role of syncope in PTE has not been well documented.ObjectivesIn this study, the association between risk classification of the European Society of Cardiology and syncope was investigated in the normotensive PTE patients.MethodsWe retrospectively screened electronic medical records of patients who were admitted in 2 tertiary care hospital and diagnosis of PTE with computed tomography pulmonary angiography. Patients with hypotension (high risk) at the time of admission were excluded from the study.ResultsOf 5% patients (16/322) had syncope with the proportion of 81.3% (13/16) in the intermediate high risky group, 18.7% (3/16) in intermediate low risk group and 0% in low risk group. Mortality rate was higher in subjects with syncope (25% vs 11.1%) although it was not it was not statistically significant (P = NS). In those with syncope, the central venous thrombus was more frequent than those without it (78.6% vs 30.1%, P = .008). Only heart rate and intermediate high‐risk group were retained as independent predictors of syncope selection in the multivariate logistic regression.ConclusionAlthough syncope is positively correlated with the severity of PTE, it does not predict the prognosis alone. Nonetheless, syncope in patients with PTE can be considered as an important alarming stimulus for clinical course.