bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential Risk of Peptic Ulcer Among Users of Antidepressants Combined With Nonsteroidal Anti-inflammatory Drugs
Authors: Shin Ju-Young , Song Inmyung , Lee Jin-Ho , Yoon Jong Lull , Kwon Jun Soo , Park Byung-Joo 
Published: February 2017

Abstract

Background
Selective serotonin reuptake inhibitors (SSRIs) have been reported to have an increased risk of gastrointestinal adverse events, and the risk may be further increased by combined use of nonsteroidal anti-inflammatory drugs (NSAIDs). However, little has been known about the risk of peptic ulcer associated with other classes of antidepressants or individual antidepressants combined with NSAIDs.

Methods
We conducted a retrospective cohort study to define the risk of peptic ulcer associated with combined use of antidepressants and NSAIDs, as compared with use of antidepressants alone. Using the Korean Health Insurance Review and Assessment Service database, we identified a total of 1,127,622 patients who began receiving antidepressants between 2009 and 2012. Propensity-based matching and Cox proportional hazards models were used to compare the risk of peptic ulcer between antidepressant users with NSAIDs and those without NSAIDs matched in a 1:1 ratio, for a total of 768,850 patients.

Results
The risk of peptic ulcer did not increase with combined use of overall antidepressants and NSAIDs, as compared with antidepressant use alone (hazard ratio [HR], 1.02; 95% confidence interval [CI], 0.99–1.06). A slightly increased risk was observed for combined use of NSAIDs with tricyclic antidepressants (HR, 1.15; 95% CI, 1.09–1.21) and with SSRIs (HR, 1.08; 95% CI, 1.01–1.16).

Conclusion
We found that although concomitant use of NSAIDs and antidepressants was not associated with an increased risk of peptic ulcer for antidepressants in general, it was so for some specific classes including tricyclic antidepressants and SSRIs. However, we cannot rule out the possibility that the increased risk was solely due to NSAID use.
Effects of an 8-Week Aerobic Dance Program on Health-Related Fitness in Patients With Schizophrenia
Authors: Cheng Shu-Li , Sun Huey-Fang , Yeh Mei-Ling 
Published: February 2017

ABSTRACT

Background:
Both psychiatric symptoms and the side effects of medication significantly affect patients with schizophrenia. These effects frequently result in a sedentary lifestyle and weight gain, which increase the risk of cardiovascular disease and premature death.

Purpose:
This study developed an aerobic dance program for patients with schizophrenia and then evaluated the effect of this program on health-related fitness outcomes.

Methods:
An experimental research design was used. Sixty patients with schizophrenia were recruited from a daycare ward and rehabilitation center at a psychiatric hospital in Taiwan. Paticipants were assigned randomly into an experimental group, which received the 8-week aerobic dance program intervention, and a control group, which received no intervention. All of the participants were assessed in terms of the outcome variables, which included bodyweight, body mass index, muscular endurance, flexibility, and cardiorespiratory endurance. These variables were measured before the intervention (pretest) as well as at 8 weeks (posttest) and 12 weeks (follow-up) after the intervention. This study used a generalized linear model with a generalized estimating equation method to account for the dependence of repeated measurements and to explore the effects of the intervention on health-related fitness outcomes.

Results:
Twenty-six participants were in the experimental group, and 28 were in the control group. Significant between-group differences were observed at posttest and in the follow-up for all of the health-related fitness outcomes with the exception of muscular endurance.

Conclusions/Implications for Practice:
This study suggests that an 8-week aerobic dance program may be an effective intervention in patients with schizophrenia in terms of improving bodyweight, body mass index, flexibility, and cardiorespiratory endurance for a period of at least 4 months. Furthermore, although muscular endurance was postively affected during the short-term period, the benefits did not extend into the follow-up examination. On the basis of these findings, aerobic dance is recommended as a nonpharmacological intervention for patients with schizophrenia who are in daycare or rehabilitation settings.
Automatic Cochlear Duct Length Estimation for Selection of Cochlear Implant Electrode Arrays
Authors: Rivas Alejandro , Cakir Ahmet , Hunter Jacob B. , Labadie Robert F. , Zuniga M. Geraldine , Wanna George B. , Dawant Benoit M. , Noble Jack H. 
Published: February 2017

Hypothesis:
Cochlear duct length (CDL) can be automatically measured for custom selection of cochlear implant (CI) electrode arrays.

Background:
CI electrode array selection can be influenced by measuring the CDL, which is estimated based on the length of the line that connects the round window and the lateral wall of the cochlea when passing through the modiolus. CDL measurement remains time consuming and inter-observer variability has not been studied.

Methods:
We evaluate an automatic approach to directly measure the two-turn (2T) CDL using existing algorithms for localizing cochlear anatomy in computed tomography (CT). Pre-op CT images of 309 ears were evaluated. Two fellowship-trained neurotologists manually and independently measured CDL. Inter-observer variability between measurements across expert and automatic observers is assessed. Inter-observer differences for choice of electrode type are also investigated.

Results:
Manual measurement of CDL by experts tends to underestimate cochlea size and has high inter-observer variability, with mean absolute differences between expert CDL estimations of 1.15 mm. Our results show that this can lead to a large number of cochleae for which a different electrode array type would be selected by different observers, depending on the specific threshold value of CDL used to decide between array type.

Conclusion:
Choosing the best CI electrode array is an important task for optimizing hearing outcomes. Manual cochleae length measurements are user-dependent, and errors impact upon the CI electrode array choice for certain patients. Measuring cochlea length automatically is less time consuming and generates more repeatable results. Our automatic approach could make use of CDL for patient-customized treatment more clinically adoptable.
The Role of Rho/Rho-Kinase Pathway in the Pathogenesis of Cholesteatoma
Authors: Yeşilova Mesut , Görür Kemal , Ismi Onur , Özcan Cengiz , Büyükafşar Kansu 
Published: February 2017

Objective:
To assess the role of Rho/Rho-kinase pathway in the pathogenesis of cholesteatoma.

Materials and Methods:
Thirty-eight patients with cholesteatoma, who had gone mastoidectomies were enrolled in this prospective study. Cholesteatomas matrix (CM) and a piece of the external ear canal skin (EECS as control) were taken and transferred to the liquid nitrogen and kept at −86 °C for Rho A and Rho-kinase (ROCK) analysis with Western blotting and commercial ELISA kits (Cell Biolabs Inc., San Diego, CA). The tissues were homogenized by an appropriate ice-cold lysis buffer. Following centrifugation, the supernatant was taken and total protein amount was detected by the Bradford method. Thereafter, tissue homogenates were subjected to sodium dodecyl sulphate (SDS)-polyacrylamide gel electrophoresis electrophoresis then transferred to nitrocellulose membrane where it was treated with specific monoclonal primary antibody against to ROCK-2 and HRP-conjugated seconder antibody, respectively. The protein blots were visualized with commercial x-ray film and dansitometrically analyzed by the Scion Image Program (Cell Biolabs Inc., San Diego, CA). In another series of experiments, Rho-kinase activities were assessed by ROCK-2 ELISA kits.

Results:
There were no statistical differences in Rho A translocation between CM and EECS. However, ROCK activity was found to be lower in CM than EECS as detected by ELISA kits. Furthermore, ROCK protein expression was also significantly lower in CM than EECS as demonstrated by Western blotting.

Conclusion:
Given Rho-kinase could take essential roles in cell differentiation, the results of this study implicate that down-regulated Rho-kinase could be responsible for the keratinocyte undifferentiation seen in cholesteatoma pathogenesis.
Intraoperative Bleeding and the Risk of Residual Cholesteatoma: A Multivariate Analysis
Authors: le Nobel Gavin J. , Cushing Sharon L. , Papsin Blake C. , James Adrian L. 
Published: February 2017

Objective:
Residual cholesteatoma most frequently occurs where visualization and surgical access are restricted by anatomic constraints. Other factors that compromise surgical field visualization might also increase rates of residual cholesteatoma. We evaluated whether impaired surgical field clarity from bleeding increases rates of residual cholesteatoma.

Study Design:
Prospective cohort study.

Setting:
Tertiary care hospital.

Patients:
Consecutive series of children having intact canal wall surgery for cholesteatoma.

Interventions:
Impact of bleeding on surgical field clarity was assessed intraoperatively on a six-point scale.

Main Outcome Measures:
Presence of residual cholesteatoma was established at follow up clinical encounters, second stage procedures, and with magnetic resonance imaging. Multiple logistic regression was used to determine the influence of surgical field clarity and other factors on rates of residual cholesteatoma.

Results:
Surgery was completed on 232 ears and residual cholesteatoma found in 45 (19%) ears. Multivariate regression analysis of cases completed with atticotomy or tympanoplasty demonstrated that surgical field clarity was a significant predictor of residual cholesteatoma (OR [odds ratio] 4, 95%CI 1.05–15; p = 0.04). Cholesteatoma extent was the most significant predictor of residual cholesteatoma when including cases requiring combined approach tympanomastoidectomy (OR 2.2, 95%CI 1.4–3.3; p < 0.001).

Conclusions:
Impaired surgical field clarity from intraoperative bleeding is associated with increased risk of residual cholesteatoma in surgery for meso/epitympanic cholesteatoma. These findings are of particular significance for endoscopic ear surgery in which management of bleeding can be more difficult and support the use of techniques, such as hypotensive general anesthesia, that minimize surgical site bleeding and improve surgical field visualization.
Operative Mortality Rates of Acoustic Neuroma Surgery: A National Cancer Database Analysis
Authors: McClelland Shearwood , Kim Ellen , Murphy James D. , Jaboin Jerry J. 
Published: February 2017

Introduction:
Optimal acoustic neuroma (AN) management involves choosing between three treatment modalities: microsurgical excision, radiation, or observation with serial imaging. The reported in-hospital mortality rate of surgery for AN in the United States is 0.5%. However, there has yet to be a nationwide examination of the AN surgery mortality rate encompassing the period beyond initial hospital discharge.

Methods:
The National Cancer Data Base (NCDB) from 2004 to 2013 identified AN patients receiving surgery. Multivariate logistic regression assessed 30-day operative mortality, adjusting for several variables including patient age, race, sex, income, geographic region, primary payer for care, tumor size, and medical comorbidities.

Results:
Ten thousand one hundred thirty six patients received surgery as solitary treatment for AN. Mortality at 30 days postoperatively occurred in 49 patients (0.5%); only a Charlson/Deyo score of 2 (odds ratio [OR] = 6.6;95% confidence interval [CI] = 2.6–16.6; p = 0.002) was predictive of increased mortality. No other patient demographic including African–American race, minimum age of 65 or government insurance was predictive of 30-day operative mortality.

Conclusions:
The 30-day mortality rate following surgery for AN is 1 of 200 (0.5%), equivalent to the established in-hospital operative mortality rate, and 2.5 times higher than the cumulative assessment from single-center studies. No patient demographic other than increasing medical comorbidities reached significance in predicting 30-day operative mortality. The nearly identical rates of 30-day and in-hospital mortality from separate nationwide analyses indicate that nearly all of the operative mortality occurs before initial postoperative discharge from the hospital. This mortality rate provides a framework for comparing the true risks and benefits of surgery versus radiation or observation for AN.
Brief Report: Low-Dose Hydrocortisone Has Acute Enhancing Effects on Verbal Learning in HIV-Infected Men
Authors: Rubin Leah H. , Phan K. Luan , Keating Sheila M. , Weber Kathleen M. , Maki Pauline M. 
Published: February 2017

Objective:
Glucocorticoids are released in response to stress and alter cognition and brain function through both rapid nongenomic and slow genomic mechanisms. Administration of glucocorticoids in the form of hydrocortisone enhances aspects of learning and memory in individuals with PTSD but impairs these abilities in healthy individuals. We examine the time-dependent effects of glucocorticoids on cognition in HIV-infected men.

Methods:
In a double-blind placebo-controlled crossover study, we examined the time-dependent effects of a single low dose of hydrocortisone [10 mg; low-dose hydrocortisone (LDH)] on cognition in 45 HIV-infected men. Participants were randomized to receive either LDH or placebo and one month later, were given the opposite treatment. At each intervention session, cognition was assessed 30 minutes (assessing nongenomic effects) and 4 hours (assessing genomic effects) after pill administration. Self-reported stress/anxiety and cortisol/cytokines in saliva were measured throughout each session.

Results:
Compared with placebo, LDH doubled salivary cortisol levels. Cortisol returned to baseline 4 hours postadministration. At the 30-minute assessment, LDH enhanced verbal learning compared with placebo. Greater increases in cortisol were associated with greater enhancements in verbal learning. LDH did not affect subjective stress/anxiety or any other cognitive outcomes at the 30-minute or 4-hour time point.

Conclusions:
The rapid effects of LDH on verbal learning suggests a nongenomic mechanism by which glucocorticoids can enhance cognition in HIV-infected men. The nonenduring nature of this enhancement may limit its clinical utility but provides insight into mechanisms underlying the effects of acute glucocorticoids on learning.
Antiviral Activity, Safety, and Pharmacokinetics of Bictegravir as 10-Day Monotherapy in HIV-1–Infected Adults
Authors: Gallant Joel E. , Thompson Melanie , DeJesus Edwin , Voskuhl Gene W. , Wei Xuelian , Zhang Heather , White Kirsten , Cheng Andrew , Quirk Erin , Martin Hal 
Published: February 2017

Objective:
To evaluate antiviral activity, safety, and pharmacokinetics of short-term monotherapy with bictegravir (BIC), a novel, potent HIV integrase strand transfer inhibitor (INSTI).

Design:
Phase 1b, randomized, double-blinded, adaptive, sequential cohort, placebo-controlled study.

Methods:
HIV-infected adults not taking antiretroviral therapy were randomized to receive BIC (5, 25, 50, or 100 mg) or placebo once daily for 10 days. Primary endpoint was time-weighted average change from baseline to day 11 (DAVG11) for plasma HIV-1 RNA. HIV-1 RNA, adverse events (AEs), and laboratory assessments were evaluated through day 17.

Results:
Twenty participants were enrolled (n = 4/group). Mean DAVG11 ranged from −0.92 to −1.61 across BIC doses versus −0.01 for placebo. Significant reductions in plasma HIV-1 RNA from baseline at day 11 were observed for all BIC doses compared with placebo (P < 0.001); mean decreases were 1.45–2.43 log10 copies/mL. Increased BIC exposures correlated with increased reduction in plasma HIV-1 RNA from baseline on day 11. Three participants on BIC (50 or 100 mg) achieved plasma HIV-1 RNA <50 copies/mL by end of study. Median Tmax ranged from 1.0 to 1.8 hours (day 1, postdose) and 1.3–2.7 hours (day 10), with median t1/2 ranging from 15.9 to 20.9 hours. No participant developed primary INSTI-R substitution through day 17. BIC was well tolerated, with no discontinuations because of adverse events.

Conclusions:
BIC is a novel, potent, unboosted INSTI that demonstrated rapid, dose-dependent declines in HIV-1 RNA after 10 days of monotherapy. BIC was well tolerated, and displayed rapid absorption and a half-life supportive of once-daily therapy in HIV-infected subjects.
Physical and Sexual Violence Affecting Female Sex Workers in Abidjan, Côte d'Ivoire: Prevalence, and the Relationship with the Work Environment, HIV, and Access to Health Services
Authors: Lyons Carrie E. , Grosso Ashley , Drame Fatou M. , Ketende Sosthenes , Diouf Daouda , Ba Ibrahima , Shannon Kate , Ezouatchi Rebecca , Bamba Amara , Kouame Abo , Baral Stefan 
Published: February 2017

Background:
Violence is a human rights violation, and an important measure in understanding HIV among female sex workers (FSW). However, limited data exist regarding correlates of violence among FSW in Côte d'Ivoire. Characterizing prevalence and determinants of violence and the relationship with structural risks for HIV can inform development and implementation of comprehensive HIV prevention and treatment programs.

Methods:
FSW > 18 years were recruited through respondent driven sampling (RDS) in Abidjan, Côte d'Ivoire. In total, 466 participants completed a socio-behavioral questionnaire and HIV testing. Prevalence estimates of violence were calculated using crude and RDS-adjusted estimates. Relationships between structural risk factors and violence were analyzed using χ2 tests and multivariable logistic regression.

Results:
The prevalence of physical violence was 53.6% (250/466), and sexual violence was 43.2% (201/465) among FSW in this study. Police refusal of protection was associated with physical (adjusted Odds Ratio [aOR]: 2.8; 95% confidence interval [CI]: 1.7 to 4.4) and sexual violence (aOR: 3.0; 95% CI: 1.9 to 4.8). Blackmail was associated with physical (aOR: 2.5; 95% CI: 1.5 to 4.2) and sexual violence (aOR: 2.4; 95% CI: 1.5 to 4.0). Physical violence was associated with fear (aOR: 2.2; 95% CI: 1.3 to 3.1) and avoidance of seeking health services (aOR: 2.3; 95% CI: 1.5 to 3.8).

Conclusions:
Violence is prevalent among FSW in Abidjan and associated with features of the work environment and access to care. These relationships highlight layers of rights violations affecting FSW, underscoring the need for structural interventions and policy reforms to improve work environments, and to address police harassment, stigma, and rights violations to reduce violence and improve access to HIV interventions.
Rapid Diffusion-Weighted Magnetic Resonance Imaging of the Brain Without Susceptibility Artifacts
Authors: Merrem Andreas , Hofer Sabine , Voit Dirk , Merboldt K.-Dietmar , Klosowski Jakob , Untenberger Markus , Fleischhammer Julius , Frahm Jens 
Published: February 2017

Objective
The aim of this study was to develop a rapid diffusion-weighted (DW) magnetic resonance imaging (MRI) technique for whole-brain studies without susceptibility artifacts and measuring times below 3 minutes.

Materials and Methods
The proposed method combines a DW spin-echo module with a single-shot stimulated echo acquisition mode MRI sequence. Previous deficiencies in image quality due to limited signal-to-noise ratio are compensated for (1) by radial undersampling to enhance the flip angle and thus the signal strength of stimulated echoes; (2) by defining the image reconstruction as a nonlinear inverse problem, which is solved by the iteratively regularized Gauss-Newton method; and (3) by denoising with use of a modified nonlocal means filter. The method was implemented on a 3 T MRI system (64-channel head coil, 80 mT · m gradients) and evaluated for 10 healthy subjects and 2 patients with an ischemic lesion and epidermoid cyst, respectively.

Results
High-quality mean DW images of the entire brain were obtained by acquiring 1 non-DW image and 6 DW images with different diffusion directions at b = 1000 s · mm. The achievable resolution for a total measuring time of 84 seconds was 1.5 mm in plane with a section thickness of 4 mm (55 sections). A measuring time of 168 seconds allowed for an in-plane resolution of 1.25 mm and a section thickness of 3 mm (54 sections). Apparent diffusion coefficient values were in agreement with literature data.

Conclusions
The proposed method for DW MRI offers immunity against susceptibility problems, high spatial resolution, adequate signal-to-noise ratio and clinically feasible scan times of less than 3 minutes for whole-brain studies. More extended clinical trials require accelerated computation and online reconstruction.
Incidentally Found Postoperative Spindle Cell Nodule of the Breast 6 Months After Ultrasound-Guided Vacuum-Assisted Excision
Authors: Kim Yeo Jin , Seo Mirinae , Sohn Yu-Mee , Shin So Youn 
Published: February 2017

Abstract
Postoperative spindle cell nodule (PSCN) is a very rare pathologic complication that can occur in association with a recent core needle biopsy, surgery, or trauma. Cases of PSCN have been reported in the lower genitourinary tract, endometrium, and thyroid but are rare in the breast. Herein, we report an ultrasound-guided biopsy-proven PSCN after ultrasound-guided vacuum-assisted excision in the breast.
Response Adjusted for Days of Antibiotic Risk (RADAR): evaluation of a novel method to analyze antibiotic stewardship interventions
Authors: Schweitzer Valentijn A. , van Smeden Maarten , Postma Douwe F. , Oosterheert Jan Jelrik , Bonten Marc J.M. , van Werkhoven Cornelis H. 
Published: February 2017

ABSTRACTOBJECTIVESThe Response Adjusted for Days of Antibiotic Risk (RADAR)-statistic was proposed to improve efficiency of antibiotic stewardship trials. We studied the behavior of RADAR in a non-inferiority trial in which a beta-lactam monotherapy strategy (BL, n=656) was non-inferior to fluoroquinolone monotherapy (FQL, n=888) for moderately-severe community-acquired pneumonia (CAP) patients.METHODSPatients were ranked according to clinical outcome, using five or eight categories, and antibiotic use. RADAR was calculated as the probability that the BL group had a more favorable ranking than the FQL group. To investigate the sensitivity of RADAR to detrimental clinical outcome we simulated increasing rates of 90-day mortality in the BL group and performed the RADAR and non-inferiority analysis.RESULTSThe RADAR of the BL-group compared to the FQL group was 60.3% (95% confidence interval 57.9%-62.7%) using five and 58.4% (95% CI 56.0%-60.9%) using eight clinical outcome categories, all in favor of BL. Sample sizes for RADAR were 250 and 580 patients per study arm using five or eight clinical outcome categories, respectively, reflecting 38% and 89% of the original non-inferiority sample size calculation. With simulated mortality rates, loss of non-inferiority of the BL-group occurred at a relative risk of 1.125 in the conventional analysis, whereas using RADAR the BL-group lost superiority at a relative risk of mortality of 1.25 and 1.5, with eight and five clinical outcome categories, respectively.CONCLUSIONSRADAR favored BL over FQL therapy for CAP. Although RADAR required fewer patients than conventional non-inferiority analysis, the statistic was less sensitive to detrimental outcomes.