bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity of the Italian algorithm for the attribution of neuropsychiatric events in systemic lupus erythematosus: a retrospective multicentre international diagnostic cohort study
Authors: Bortoluzzi Alessandra , Fanouriakis Antonis , Appenzeller Simone , Costallat Lilian , Scirè Carlo Alberto , Murphy Elana , Bertsias George , Hanly John , Govoni Marcello 
Published: May 2017

ObjectiveTo validate the Italian algorithm of attribution of neuropsychiatric (NP) events to systemic lupus erythematosus (SLE) in an external international cohort of patients with SLE.MethodsA retrospective cohort diagnostic accuracy design was followed. SLE patients attending three tertiary care lupus clinics, with one or more NP events, were included. The attribution algorithm, applied to the NP manifestations, considers four weighted items for each NP event: (1) time of onset of the event; (2) type of NP event (major vs minor), (3) concurrent non-SLE factors; (4) favouring factors. To maintain blinding, two independent teams of assessors from each centre evaluated all NP events: the first provided an attribution diagnosis on the basis of their own clinical judgement, assumed as the ‘gold standard’; the second applied the algorithm, which provides a probability score ranging from 0 to 10. The performance of the algorithm was evaluated by calculating the area under curve (AUC) of thereceiver operating characteristic curve.ResultsThe study included 243 patients with SLE with at least one NP manifestation, for a total of 336 events. 285 (84.8%) NP events involved the central nervous system and 51 (15.2%) the peripheral nervous system. The attribution score for the first NP event showed good accuracy with an AUC of 0.893 (95% CI 0.849 to 0.937) using dichotomous outcomes for NPSLE (related vs uncertain/unrelated). The best single cut-off point to optimise classification of a first NPSLE-related event was≥7 (sensitivity 87.9%, specificity 82.6%). Satisfactory accuracy was observed also for subsequent NP events.ConclusionsValidation exercise on an independent international cohort showed that the Italian attribution algorithm is a valid and reliable tool for the identification of NP events attributed to SLE.
Untargeted antifungal therapy in adult patients with complicated intra-abdominal infection: protocol for a systematic review with meta-analysis
Authors: Petersen Marie Warrer , Perner Anders , Sjövall Fredrik , Møller Morten Hylander 
Published: May 2017

IntroductionIntra-abdominal infections are the second most frequent cause of sepsis. In a recent cohort, fungal specimens were found in 51.9% of all patients with sepsis and peritonitis. Current systematic reviews comparing untargeted antifungal treatment with placebo or no treatment in patients who are critically ill have provided conflicting results, and clinical equipoise exists. Accordingly, we aim to assess patient-important benefits and harms of untargeted antifungal therapy versus placebo or no treatment in adult patients with complicated intra-abdominal infection.Methods and analysisWe will conduct a systematic review with meta-analysis and trial sequential analysis of randomised clinical trials assessing any untargeted antifungal therapy compared with placebo or no treatment in adult patients with complicated intra-abdominal infections. The primary outcome is all-cause mortality, and secondary outcomes include adverse events, duration of mechanical ventilation and inotropic support, need for renal replacement therapy, emergence of antibiotic resistance and intensive care unit and hospital length-of-stay. Conventional meta-analysis, including sensitivity and subgroup analyses, and assessment of the risk of systematic (bias) and random errors will be conducted. The review will be prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, the Cochrane methodology and the Grading of Recommendations, Assessment, Development and Evaluation.Ethics and disseminationEthical approval is not required as this systematic review only includes previously published data. We aim to publish the review in an international peer-reviewed journal.Trial registration numberInternational Prospective Register of Systematic Reviews registration number: CRD42016053508.
The Multifarious Nature of Care
Authors: gaskin keyon 
Published: May 2017

A limited rumination on the practice of swaddling in relation to my general infatuation with death—as release, the only actual possibility of freedom for the spirit, allure of the unknown, comfort of inevitability, caring for others, catharsis of mourning, the possibilities in endings, generative destruction… keyon gaskin prefers not to contextualize their art with their credentials.
Learning Recruits Neurons Representing Previously Established Associations in the Corvid Endbrain
Authors: Veit Lena , Pidpruzhnykova Galyna , Nieder Andreas 
Published: May 2017

Abstract
Crows quickly learn arbitrary associations. As a neuronal correlate of this behavior, single neurons in the corvid endbrain area nidopallium caudolaterale (NCL) change their response properties during association learning. In crows performing a delayed association task that required them to map both familiar and novel sample pictures to the same two choice pictures, NCL neurons established a common, prospective code for associations. Here, we report that neuronal tuning changes during learning were not distributed equally in the recorded population of NCL neurons. Instead, such learning-related changes relied almost exclusively on neurons which were already encoding familiar associations. Only in such neurons did behavioral improvements during learning of novel associations coincide with increasing selectivity over the learning process. The size and direction of selectivity for familiar and newly learned associations were highly correlated. These increases in selectivity for novel associations occurred only late in the delay period. Moreover, NCL neurons discriminated correct from erroneous trial outcome based on feedback signals at the end of the trial, particularly in newly learned associations. Our results indicate that task-relevant changes during association learning are not distributed within the population of corvid NCL neurons but rather are restricted to a specific group of association-selective neurons. Such association neurons in the multimodal cognitive integration area NCL likely play an important role during highly flexible behavior in corvids.
Summits Where Souls Gather
Authors: Dahl Shayne A.P. 
Published: May 2017

Rituals have played a vital role in the wake of the earthquake, tsunami, and nuclear disasters that struck northeastern Japan on 11 March 2011 (subsequently referred to as “3.11”). Rituals have enabled survivors to differentiate social order from the immediate chaos of disaster, to mourn, to overcome grief, and to exorcise the spirits of the disaster dead. Yet, much remains to be learned about the transformative potential of ritual after 3.11. The significance of pilgrimage, for instance, which is a prominent aspect of religious practice in Japan, has received minimal attention. In this article, I draw on ethnographic fieldwork carried out in Dewa Sanzan, a sacred mountain range in Yamagata Prefecture, to discuss mountain pilgrimage for post-disaster memorialization. I argue that the event of 3.11 expanded the ontological meaning of the summit of Gassan 月山 (Mount Moon), thought to be an axis between the world of the living and that of the ancestral dead. Pilgrimage to the peak of Gassan has become a path of remembrance and overcoming, a formula for posthumous care, and an act of hope in post-disaster Japan.
Analysis of National Weather Service Stage Forecast Errors
Authors: Zalenski Grace , Krajewski Witold F. , Quintero Felipe , Restrepo Pedro , Buan Steve 
Published: May 2017

Abstract
This paper explores the skill of river stage forecasts produced by the National Weather Service (NWS). Despite the importance of the verification process in establishing a reference that allows advancement in river forecast technology, there is relatively little literature on this topic. This study aims to contribute to this subject. The study analyzed the North Central River Forecast Center’s river stage forecasts for 51 gauges in eastern and central Iowa between 1999 and 2014. The authors explored forecast skill dependence characteristics such as upstream area, water travel time, and the number of gauges located upstream of each forecasting point. They also assessed the influence of rainfall uncertainty on stage error by examining the relationship between the forecast skill and its antecedent 24-h observed rainfall. The results show that when using persistence as a reference for comparison with NWS actual forecasts, the NWS forecasts are better for predictions below and above flood stage. The difference in root-mean-square error (RMSE) between the actual and persistence forecasts ranges between 0.04 and 1.24 ft, and it increases with lead time. Locations with fewer upstream gauges exhibit greater variation in forecast skill than locations that are well gauged, especially at high flood levels. Strong predictive relationships between the physical characteristics of a basin (travel time, upstream drainage area), rainfall quantities, and forecast skill have not been identified.
Image-Guided Endoscopic Orbital Decompression for Graves' Orbitopathy
Authors: Dubin Marika R. , Tabaee Abtin , Scruggs Jennifer T. , Kazim Michael , Close Lanny Garth 
Published: May 2017

Objectives: We studied the efficacy and safety of image-guided balanced orbital decompression for Graves' orbitopathy. Methods: The data of 24 patients (45 orbits) were reviewed for demographics, ophthalmologic outcomes, and complications in regard to image-guided (18 orbits) versus non-image-guided surgery (27 orbits). Results: Overall, all patients had a reduction in proptosis (mean reduction, 6.2 mm in proptosis) as measured by Hertel exophthalmometry. There was improvement in the visual acuity of all 12 orbits with preoperative acuity of 20/40 or worse and either complete resolution (38%) or improvement (62%) in the 16 orbits with optic neuropathy. These measures reached statistical significance. Despite subjective improvement in surgeon confidence, the use of image guidance did not result in a statistically significant difference in postoperative ophthalmologic outcomes. Medical and sinonasal complications were experienced by 11.1% and 18.5% of patients who underwent image-guided and non-image-guided orbital decompression, respectively. Conclusions: Image guidance may be a useful adjunct to balanced orbital decompression for Graves' orbitopathy, but it was not associated with a statistically significant improvement in outcomes in this study.
Change of External Auditory Canal pH in Acute Otitis Externa
Authors: Kim Jin Kook , Cho Jae Hoon 
Published: May 2017

Objectives We investigated 1) the correlation between the degree of acute otitis externa (AOE) and a change of pH and 2) the recovery of pH after acidification compared to an antibiotic otic solution in AOE. A change of pH in the external auditory canal (EAC) is very important for the pathogenesis of otitis externa. Therefore, not only an antibiotic otic solution, but also acidification, is known to be a good treatment for AOE. However, pH has only been investigated in chronic otitis externa, and not in AOE. Methods This was a prospective randomized control study. Forty adult patients (56 ears) with AOE and 40 normal control subjects (80 ears) participated in this study. The severity of disease was graded as mild, moderate, or severe. The pH of each EAC was then measured. The patients were randomly assigned into 2 groups: one for vinegar irrigation and the other for topical antibiotics. The pH of the diseased ears was measured at 1 and 2 weeks after the treatment. Results The mean (±SD) pH for the normal control subjects was 5.4 ± 0.48, and the EAC lost its acidity proportionately to the degree of disease (p < 0.05). For both the vinegar irrigation and topical antibiotic groups, the acidity was restored dramatically (p < 0.05) at 1 and 2 weeks for the moderate and severe grades of otitis, but not for the mild grade. There was no difference in recovery between the 2 groups. Conclusions The EAC lost its acidity proportionately to the degree of disease in AOE. Vinegar irrigation and topical antibiotics were equally effective for restoration of pH.
Hearing Loss Progression and Contralateral Involvement in Children with Unilateral Sensorineural Hearing Loss
Authors: Uwiera Trina C. , Dealarcon Alessandro , Meinzen-Derr Jareen , Cohen Aliza P. , Rasmussen Brian , Shott Gordon , Greinwald John 
Published: May 2017

Objectives We undertook this study to determine the rate of hearing loss progression in the affected ear of children with unilateral sensorineural hearing loss and without an enlarged vestibular aqueduct, and the rate of new-onset hearing loss in the contralateral ear. Methods We searched the database at our pediatric tertiary care center to identify patients who met the inclusion criteria, examining demographic variables, audiometric data, and presumptive causes. Results We identified 198 patients. At presentation, they showed slight left-sided and male predominances. Of 142 patients who had sufficient audiometric follow-up for us to evaluate progression, 21% showed ipsilateral progression and 10.6% developed new-onset hearing loss in the contralateral ear. Isolated high-frequency loss was identified in 11 patients (5.6%), 8 of whom had sufficient follow-up for us to identify progression. Two showed progression; 4 others with progression in the ipsilateral ear developed new-onset high-frequency loss in the contralateral ear. Temporal bone anomalies were identified in 26 children (13%), and these children were more likely to have profound hearing loss than were those without temporal bone anomalies (46% versus 23%). Conclusions The findings suggest that unilateral sensorineural hearing loss may not always be a unilateral process, but that it may be the initial manifestation of bilateral auditory dysfunction.
Predictors of Aspiration Pneumonia following Radiotherapy for Head and Neck Cancer
Authors: Purkey Michael T. , Levine Marc S. , Prendes Brandon , Norman M. Frank , Mirza Natasha 
Published: May 2017

Objectives Aspiration following radiotherapy for head and neck cancer (HNC) is a common event, but not all patients with aspiration will develop pneumonia. Our aim was to identify predictors of pneumonia in patients with aspiration following radiotherapy for HNC. Methods We performed a retrospective study of 52 patients referred for modified videofluoroscopic barium swallow (MVBS) testing at our institution from 2003 to 2007 in order to identify clinical variables associated with the diagnosis of aspiration pneumonia. Results Independent risk factors for the development of pneumonia were tracheobronchial aspiration on MVBS testing (odds ratio [OR], 5.0; 95% confidence interval [CI], 1.2 to 20.5; p = 0.025), malnutrition (OR, 4.4; 95% CI, 1.3 to 14.7; p = 0.018), and smoking history (OR, 1.04 per pack-year; 95% CI, 1.01 to 1.07; p = 0.011). Through logistic regression analysis, we developed a bivariate predictive model with a sensitivity of 58%, a specificity of 90%, a positive predictive value of 79%, and a negative predictive value of 77% for the development of aspiration pneumonia in our patient population. Conclusions Depth of aspiration on MVBS testing, malnutrition, and smoking history were strongly associated with the development of aspiration pneumonia in our patient population. The use of clinical variables to determine the risk of aspiration pneumonia is feasible and may help identify high-risk patients.
Review of Floor of Mouth Dysontogenic Cysts
Authors: Macneil S. Danielle , Moxham J. Paul 
Published: May 2017

Objectives We report the common surgical approaches, incidence of sinus tracts, and recurrence rates of floor of mouth dysontogenic (epidermoid, dermoid, and teratoid) cysts in the pediatric population. Methods Data were derived from PubMed, Medline, Embase, Google Scholar, and manual searches. Three cases from the senior author's (J.P.M.) practice were included. All English-language studies consisting of floor of mouth dysontogenic cysts were included. Case reports of tongue dysontogenic cysts, mandibular dysontogenic cysts, maxillary dysontogenic cysts, and dysontogenic cysts in the neck below the hyoid bone were excluded. Results There are 198 case reports, including those presented here, of floor of mouth dysontogenic cysts. They are more common in male patients (55.1%), and the most common location is in the sublingual space (104 or 52.5%). Most floor of mouth dysontogenic cysts can be excised by an intraoral approach. There are 5 reported cases in the literature of recurrent dysontogenic cysts and 11 cases of multiple floor of mouth dysontogenic cysts. Conclusions Floor of mouth dysontogenic cysts most commonly present in the sublingual space, and most can be excised by an intraoral approach. Multiple dysontogenic cysts often require a combination of intraoral and extraoral approaches. Recurrence of a dysontogenic cyst may be secondary to a tract not identified at the time of surgery.
Actinomycosis of the Temporal Bone and Brain: Case Report and Review of the Literature
Authors: Budenz Cameron L. , Tajudeen Bobby A. , Roehm Pamela C. 
Published: May 2017

Objectives Actinomycosis is a rare disease with a typically indolent course in the head and neck. During the modern era, only 12 cases within the ear and temporal bone and 75 intracranial cases have been reported. We present a case of actinomycosis of the petrous apex that led to meningitis and encephalitis. Methods The patient was a 12-year-old girl who presented with mental status changes. After 48 hours of treatment with empiric antibiotics for meningitis without improvement, imaging revealed an enhancing mass in the right petrous apex, destruction of the cochlea, meningeal enhancement, and left temporoparietal encephalitis. Results The initial therapy included broad-spectrum antibiotic, antifungal, and antiviral agents, as well as myringotomy and tympanostomy tube placement. When the patient's clinical status worsened, she underwent subtotal petrosectomy with drainage of the petrous apex. The final pathologic findings were consistent with actinomycosis. Conclusions Actinomycosis is a rare infection in the temporal bone and central nervous system that can have a high mortality risk if not treated appropriately. Often, these bacteria do not grow well in culture, and diagnosis must be made on the basis of histopathologic features. Good clinical outcomes can be obtained with surgical debridement followed by long-term antibiotic treatment.
Bioactive Glass S53P4 in the Filling of Cavities in the Mastoid Cell Area in Surgery for Chronic Otitis Media
Authors: Stoor Patricia , Pulkkinen Jaakko , Grénman Reidar 
Published: May 2017

Objectives Chronic infection of the middle ear and cholesteatoma can be treated surgically by exenteration of the mastoid air cells behind the ear. After a procedure with the canal wall–down technique, a cavity remains that is sometimes difficult to clean, collects crust, and becomes repeatedly infected. Such problematic mastoid cavities can be eliminated by filling the created cavity surgically after thorough removal of mucous membranes and cleaning of the bone. Methods We treated 7 patients with cavities after canal wall–down surgery for the treatment of chronic suppurative otitis media or cholesteatoma by filling the difficult-to-clean cavity in the mastoid cell area with granules of bioactive glass (BAG) S53P4 to avoid further retraction formation. The area with BAG was carefully closed with a musculoperiosteal flap. Results After the canal wall–down tympanomastoidectomy, the mastoid cavities were successfully filled in all 7 patients. No biomaterial-associated infection was seen, and no disadvantages for the patients due to the BAG were observed. The cavity in the mastoid cell area decreased in size in all patients treated. Conclusions This BAG seems to be a promising material for filling mastoid cavities after canal wall–down tympanomastoidectomy.
Use of ICF in Assessing the Effects of Meniere's Disorder on Life
Authors: Levo Hilla , Stephens Dafydd , Poe Dennis , Kentala Erna , Pyykkö Ilmari 
Published: May 2017

Objectives We sought to determine the value of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) in subjects with Meniere's disorder in relation to their quality of life. Methods We asked 228 members of the Finnish Meniere Federation to report the effects that Meniere's disorder had on their lives. The replies were classified on the basis of the ICF classification and related to the EuroQol 5D score and disease-specific impact. Logistic regression and decision tree analyses were used to determine the relationships. Results Seventy percent of the patients listed impairments, 39% activity limitations, 47% participation restrictions, 16% effects on environmental contextual factors, and 28% effects on personal contextual factors. The EuroQol 5D score was explained by reported vertigo, anxiety, fatigue, restriction of life, and communication problems. The disease-specific impact was explained by episodes of vertigo, fatigue, communication problems, inability to work, restriction of life, and uncertainty of life. Both analysis models provided the same outcome variables, although the decision tree separated the results better (80%) into correct classes than did logistic regression analysis (60%). Conclusions Self-reported participation restriction, activity limitation, and personal contextual factors describe the limitations of general life in subjects with Meniere's disorder. The use of the ICF classification provides an instrument that can be used in enablement of subjects with Meniere's disorder.
Forestier Disease: Single-Center Surgical Experience and Brief Literature Review
Authors: Presutti Livio , Alicandri-Ciufelli Matteo , Piccinini Alessia , Trebbi Marco , Marchioni Daniele , Ghidini Angelo , Ruberto Marco 
Published: May 2017

ObjectivesWe describe the experience of our otolaryngology department in the treatment of Forestier disease, particularly regarding the diagnostic process, surgical treatment, and postoperative outcomes.MethodsThe charts of 12 patients who underwent surgical treatment of Forestier disease between January 1, 2003, and January 1, 2009, were analyzed. All patients were subjected to clinical, radiologic, and endoscopic evaluation that confirmed the presence of cervical osteophytes. All patients were treated by a right-sided prevascular transcervical approach to remove cervical osteophytes. A literature review on Forestier disease was also carried out.ResultsOne case of immediate postoperative hemorrhage was reported. During the postoperative follow-up, ranging from 1 to 5 years, all patients underwent cervical radiography and fiberoptic laryngoscopy that confirmed no evidence of recurrence, and all patients remained asymptomatic.ConclusionsA prevascular transcervical right-sided approach seems to be an effective treatment for surgical removal of hyperostosis in Forestier disease, with an acceptable rate of complications and recurrence.