bluuebunny/crossref_metadata_2025_split huggingface dataset:
To image or not in noncyclic breast pain? A systematic review
Authors: Martín-Díaz Manuel , Maes-Carballo Marta , Khan Khalid Saeed , Bueno-Cavanillas Aurora 
Published: September 2017

Purpose of review
Investigation of noncyclic mastalgia in women without signs or risk factors for cancer is controversial. An initial imaging strategy can diagnose breast cancer early, potentially leading to better treatment and survival. However, cancer diagnosis is very uncommon in these cases, and this approach can be harmful, as false positives or suspicion results will lead to unneeded interventions and follow-up. The purpose of this review is to analyse the trade-offs between desirable and undesirable consequences of initial imaging tests against clinical follow-up.

Recent findings
We found seven relevant studies, all observational, with some methodological limitations and very low-quality evidence. They showed low breast cancer prevalence (around 1–2%, increasing with age), high sensitivity to rule out disease but moderate specificity to rule it in using mammography and echography, and lacked evidence on follow-up and final outcomes.

Summary
There is a low prevalence of breast cancer in patients with painful breast with negative physical examination, and very little research to inform about the effect of performing or avoiding initial imaging test on outcomes of interest. With such limited evidence, only a weak recommendation to reinforce shared decision making about what should be done in the primary care setting can be made, with the backup of a specialized breast unit.
Evaluation of the Reliability and Repeatability of Scheimpflug System Measurement in Keratoconus
Authors: de Luis Eguileor Beatriz , Escudero Argaluza Julene , Pijoán Zubizarreta Jose Ignacio , Santamaria Carro Alaitz , Etxebarria Ecenarro Jaime 
Published: September 2017

Purpose:
To assess the reliability and repeatability of the parameters obtained using a Scheimpflug system (Pentacam HR—high resolution) for monitoring progression in eyes with keratoconus.

Methods:
A prospective study was conducted based on measurements taken with the Pentacam HR in 82 eyes with keratoconus. We calculated the intraclass correlation coefficient (ICC) and the repeatability limit for topographic and aberrometric parameters.

Results:
All the parameters analyzed had excellent ICCs, above 0.95 in all cases, except for the measurement of the anterior best-fit sphere, for which the ICC was 0.873. The key repeatability limits for the parameters analyzed were as follows: 1.54 diopters (D) for the maximum keratometry in the central cornea, 1.08 D for maximum keratometry, 32.6 degrees for the axis of corneal astigmatism, 11.9 degrees for the coma axis, and 14.2 μm for thinnest corneal thickness.

Conclusions:
The level of repeatability of the measurements obtained with a Pentacam HR confirms the usefulness of this system for the diagnosis of keratoconus. Nevertheless, it has certain limitations for monitoring individual progression of keratoconus and planning intrastromal corneal ring segment insertion.
Nasopharyngeal Pneumococcal Colonization and Impact of a Single Dose of 13-Valent Pneumococcal Conjugate Vaccine in Indian Children With HIV and Their Unvaccinated Parents
Authors: Arya Bikas K. , Bhattacharya Sangeeta Das , Sutcliffe Catherine G. , Ganaie Feroze , Bhaskar Arun , Bhattacharyya Subhasish , Niyogi Swapan Kumar , Moss William J. , Panda Samiran , Ravikumar Kadahalli Lingegowda , Das Ranjan Saurav , Mandal Sutapa 
Published: September 2017

Background:
Human immunodeficiency virus (HIV) infection increases risk of invasive disease from Streptococcus pneumoniae. Pneumococcal conjugate vaccines (PCV) prevent invasive disease and acquisition of vaccine type (VT) pneumococcus in the nasopharynx.

Objective:
To look at the safety and impact of one dose of PCV13 on acquisition of VT pneumococcal carriage in Indian children with HIV.

Method:
We conducted a cohort study in families of HIV-infected children (CLH) and families of HIV-uninfected children (HUC) in West Bengal. All children received one dose of PCV13. Nasopharyngeal swabs were collected from children and parents at baseline and 2 months after vaccination.

Result:
One hundred and fifteen CLH and 47 HUC received one dose of PCV13. Fifty-eight percent of CLH were on antiretroviral therapy (ART), and the median nadir CD4 count was 287. There were no significant adverse events in either group. HUC had more VT colonization than CLH—55% versus 23% of all pneumococcal isolates. HIV infection doubled the risk of nonvaccine serotype colonization (P = 0.03). There was no difference in acquisition of VT isolates in CLH (4.4%) and HUC (4.5%) post-PCV13; however, older CLH (>5 years) had decreased clearance of VT strains. ART made no difference in pneumococcal colonization at baseline or after PCV13; however, CLH with higher nadir CD4 counts before starting ART were less likely to have VT colonization post-PCV13 (prevalence ratio, 0.2; 95% confidence interval: 0.1–0.5).

Conclusion:
While there was no difference in acquisition of VT nasopharyngeal carriage of pneumococcus in CLH and HUC after one dose of PCV13, earlier access to ART may impact response to PCV13 in CLH.
The CALI-9: A brief measure for assessing activity limitations in children and adolescents with chronic pain
Authors: Holley Amy Lewandowski , Zhou Chuan , Wilson Anna C. , Hainsworth Keri , Palermo Tonya M. 
Published: September 2017

Abstract
Pain-related functional limitations represent an important outcome domain to assess in children and adolescents with chronic pain. The aim of this study was to extend the empirical support of the 21-item Child Activity Limitations Interview (CALI-21), a well-validated measure of activity limitations, using a large, multisite sample and to develop a brief form of the measure with more interpretable scoring. A sample of 1616 youth and 1614 parents completed the CALI-21 at an initial appointment in 1 of 3 pain specialty clinics in the Midwest or Northwest United States, or as part of a research study after this initial visit. All youth also reported on usual pain intensity. The CALI-21 data from 1236 youth and parents were used in analyses. Results of the exploratory and confirmatory factor analyses supported a common 2-factor structure (Active and Routine factors) for both child- and parent-report versions. Using item reduction, the 9-item measure (CALI-9) was developed with both child and parent versions showing good internal consistency and high cross-informant reliability. Initial validity was shown by the ability of the CALI-9 to distinguish by level of pain intensity. Findings suggest that the CALI-9 is a promising brief tool for the evaluation of pain-related activity limitations in youth with chronic pain and for proxy report by parents. Advantages of the shortened scale include the revised 0 to 100-point scale, which increases interpretability, and further validation of the subscale scoring to assess specific limitations in Active and Routine physical functioning domains.
Nonalcoholic Steatohepatitis is the Most Rapidly Increasing Indication for Liver Transplantation in Young Adults in the United States
Authors: Doycheva Iliana , Issa Danny , Watt Kymberly D. , Lopez Rocio , Rifai Ghassoub , Alkhouri Naim 
Published: September 2017

Goals:
To analyze the frequency and trend of liver transplantation (LT) for nonalcoholic steatohepatitis (NASH) cirrhosis in young adults aged 18 to 40 years and to assess post-LT outcomes in this age group.

Background:
NASH is currently the fastest-growing indication for LT in US adults. It is believed that NASH is a rare indication for LT among young adults.

Study:
Using the United Network for Organ Sharing database, we performed a retrospective cohort analysis of all LTs in young adults between 2002 and 2012. Incidence rate ratio was calculated for each indication.

Results:
A total of 5157 young adults underwent LT over the study period—54% were male, 23% obese. Mean (±SD) age and body mass index were 31.6±6.7 years and 26.3±6.1 kg/m2, respectively. The incidence of LTs performed for NASH cirrhosis increased from 0.53% in 2002 to 4.46% in 2012. NASH was the most rapidly growing indication for LT among all other etiologies with a 14% increment per year (incidence rate ratio, 1.14; 95% confidence interval, 1.09-1.20, P<0.001). The 5-year post-LT outcomes were comparable between NASH and non-NASH recipients, but graft survival was lower and retransplantation cumulative rates were higher in NASH recipients compared with those with other metabolic liver diseases (63.5% vs. 81.4%, P=0.003 and 12.7% vs. 4.2%, P=0.046, respectively).

Conclusions:
NASH is the fastest-growing indication for LT among young US adults aged 18 to 40 years and now accounts for almost 5% of all LTs in this age group.
Predictors of No-show Rate in the GI Endoscopy Suite at a Safety Net Academic Medical Center
Authors: Shuja Asim , Harris Ciel , Aldridge Petra , Malespin Miguel , de Melo Silvio W. 
Published: September 2017

Background/Objectives:
Noncompliance with physician and procedure appointments is associated with poor disease control and worse disease outcomes. This also impacts the quality of care, decreases efficiency, and affects revenue. Studies have shown that no-show rates are higher in clinics caring for underserved populations and may contribute to poorer health outcomes in this group.

Methods:
We performed a 17-month retrospective observational cohort study of patients scheduled for outpatient procedures in the Gastroenterology endoscopy suite at the University of Florida Health, Jacksonville. Multivariate logistic regression analysis was performed to evaluate associations between attendance and predictors of no-show.

Results:
In total, 6157 patients were scheduled to undergo different GI procedures during the study period. A total of 4388 (71%) patients completed their procedure, whereas 2349 (29%) failed to attend their appointment and were considered “no-show”. There was a significant relationship between the visit attendance and race, insurance, gender, and marital status. Males had a higher no-show rate compared with females (30% vs. 28%; P<0.05). African Americans had the highest no-show rate (32%; P<0.05) amongst different races. Patients scheduled for surveillance colonoscopy (ie, history of polyps, IBD, Colon cancer) were more likely to show (78%) than those obtaining initial colorectal cancer screening (74%) or other indications (71%) (P<0.05).
In the logistic regression model, patients with commercial insurance are more likely to show for their appointments than those with noncommercial insurance (eg, Medicare, Medicaid, City contract etc) [odds ratio (OR), 2.6; 95% confidence interval (CI), 2.2-3.0]. The odds of showing up are 1.7 times higher for married men compared with single men (OR, 1.7; 95% CI, 1.3-2.0). Similarly, married females are more likely to show up for appointment than single females (OR, 1.1; 95% CI, 0.9-1.3). We did not find significant association between the type of GI procedure (eg, colonoscopy vs. esophagogastroduodenoscopy vs. advanced endoscopic procedures) (P>0.05).

Conclusions:
Predictors of no-shows for endoscopic gastrointestinal procedures included unpartnered or single patients, African American race and noncommercial insurance providers. Patients scheduled for surveillance colonoscopy had better adherence than initial screening. Further studies are required to better characterize these factors and improve adherence to the outpatient appointments based on the identified predictors.
Utility of post-liver transplantation MELD and delta MELD in predicting early and late mortality
Authors: Zakareya Talaat , Abbasy Mohammed , Abdel-Razek Wael , Elsiesy Hussein , Abal Khail Faisal , Al Sebayel Mohammed , Waked Imam 
Published: September 2017

Introduction
The performance of early post-liver transplantation (post-LT) model for end-stage liver disease (MELD) or even its dynamic changes over time (ΔMELD) in predicting the mortality after LT is still controversial.

Aim
The aim of this study was to assess the ability of absolute and ΔMELD calculated at days 7 and 30 after LT to predict 1- and 5-year mortality.

Patients and methods
Data of 209 consecutive patients who underwent LT in two centers were reviewed. Patients who received LT for hepatocellular carcinoma were excluded, as well as those who did not survive for at least 1 month. MELD and ∆MELD were calculated for each patient at 7 and 30 days after LT.

Results
One hundred fifty-six patients were included, mostly male [104 (66.7%)] with a mean age of 51.9±8.8 years. The main indications for transplantation were decompensated hepatitis C virus-related liver cirrhosis [138 (88.5%)] and hepatitis C and B virus co-infection [10 (6.4%)]. Grafts were obtained from 104 living donors and 52 deceased donors. Survival at 1 and 5 years was 89.7 and 85.9%, respectively, with a mean survival of 52.3±1.5 months. In univariate analysis, both absolute and ΔMELD at postoperative days 7 and 30 significantly predicted 1- and 5-year post-LT mortality. In multivariate analysis, MELD at postoperative day 30 was significantly associated with 1- (odds ratio: 1.24, 95% confidence interval: 1.14–1.35, P<0.0001) and 5-year mortality (odds ratio: 1.23, 95% confidence interval: 1.14–1.33, P<0.0001). The area under the curve for MELD at 30 days post-LT in the prediction of mortality was 0.823 (P=0.01) at 1 year and 0.812 (P<0.001) at 5 years. A cutoff of post-LT day 30 MELD less than 10 could predict mortality with a sensitivity and specificity of 90 and 68.1% at 1 year and 81.3 and 69.7% at 5 years, respectively.

Conclusion
Failure of the MELD score to decline over the first postoperative month to less than 10 is a significant predictor of both early and late post-LT mortality.
Comparison of correlations between lipid profile and different computed tomography fatty liver criteria in the setting of incidentally noted fatty liver on computed tomography examinations
Authors: Jawahar Anugayathri , Gonzalez Beverly , Balasubramanian Neelam , Adams William , Goldberg Ari 
Published: September 2017

Purpose
The aim of this study was to compare the correlations between computed tomography (CT) criteria for hepatic steatosis and lipid profile values when hepatic steatosis is incidentally detected.

Participants and methods
This is an institutional Review Board-approved, HIPPA-compliant, retrospective study of abdominal CT scans in 200 randomly selected patients who had either nonenhanced CT (NECT) or contrast-enhanced CT (CECT) studies with reported fatty liver. The participants were matched for age, sex, and ethnicity with 200 patients with nonfatty liver. For NECT, four different criteria have been proposed in the literature to diagnose fatty liver: (i) liver Hounsfield Units (HU) less than 48 HU, (ii) ratio of liver to spleen HU less than 0.8, (iii) HU difference between liver and spleen less than −10, and (iv) hepatic vessel HU greater than or equal to liver HU. For CECT, the criteria was attenuation difference between liver and spleen HU, in the portal venous phase of up to −20 to −25 HU. Laboratory results (low-density lipoprotein, high-density lipoprotein, triglycerides) were documented. Matched analyses and conditional logistic regression analysis were carried out for matched variables.

Results
There were statistically significant differences in triglyceride values, between the cases and controls (P=0.02), when all criteria were considered. Also, statistically significant differences were found between cases and controls on the basis of NECT criterion 2 and high-density lipoprotein (P=0.04), as well as CECT criteria and triglyceride levels (P=0.02). In addition, the data indicate that criteria for steatosis on CECT may be more broad than traditionally utilized.

Conclusion
Incidental reporting of fatty liver on NECT/CECT should prompt consideration of clinical follow-up and lipid profile testing in an otherwise asymptomatic patient. Additional metrics for the diagnosis of steatosis in CECT exam should also be considered.
Triglyceride-lowering trials
Authors: Keech Anthony C. , Jenkins Alicia J. 
Published: September 2017

Purpose of review
We provide an overview of current evidence about the independent role of high triglyceride levels for cardiovascular risk and for acute pancreatitis.

Recent findings
Natural experiments of Mendelian randomization have given us a deeper understanding about the molecular pathways involved in triglyceride metabolism. Individuals with low-triglyceride levels generally have lower rates of cardiovascular disease (CVD). There has been a significant growth in the development of new agents that modulate enzymes involved in a variety of aspects of triglyceride packaging into VLDL or chylomicron particles, and triglyceride catabolism. Antisense inhibitors of apolipoprotein CIII are being tested, as are a variety of agents designed to increase lipoprotein lipase activity. Large-scale trials are underway with purified fatty acid (FA) formulations in over 20 000 individuals in aggregate. A large study of a new fibrate is underway.

Summary
A focus on patients with elevated triglyceride levels is a new paradigm not previously the focus of large trials. Clinical outcome data on cardiovascular risk reductions remains sparse. Some drugs are already approved for use in rare inherited disorders predisposing to severe hypertriglyceridaemia and acute pancreatitis. Safety and costs issues are critical.
The Relation Between Mastery, Anticipated Stigma and Depression Among Older Adults in a Primary Care Setting
Authors: Raeifar Elmira , Halkett Ashley , Lohman Matthew C. , Sirey Jo Anne 
Published: September 2017

Abstract
The current study evaluates the interaction between mastery, depression, and psychological barriers to care among older adults in a primary care setting, including the longitudinal effects of anticipated stigma and mastery on depressive symptoms. The sample was composed of 70 depressed older adults (age ≥ 60) who were newly recommended antidepressant treatment by their physicians. This cohort is part of a larger study examining the usefulness of the Treatment Initiation and Participation program to improve medication adherence. Anticipated stigma significantly predicted greater depression among older adults with low mastery, but not among those with high mastery. Mastery was found to moderate the relationship between anticipated stigma and depressive symptoms among older adults. Increased mastery over 28 weeks was also associated with greater reductions in depressive symptoms at follow-up, controlling for antidepressant strength and adherence. Bolstering older adults' sense of mastery in treatment could provide a source of resilience for older adults facing depression.
Bipolar Disorder and Cognitive Dysfunction
Authors: Cipriani Gabriele , Danti Sabrina , Carlesi Cecilia , Cammisuli Davide Maria , Di Fiorino Mario 
Published: September 2017

AbstractThe aim of this article was to describe the current evidence regarding phenomenon of cognitive functioning and dementia in bipolar disorder (BD). Cochrane Library and PubMed searches were conducted for relevant articles, chapters, and books published before 2016. Search terms used included “bipolar disorder,” “cognitive dysfunction,” and “dementia.” At the end of the selection process, 159 studies were included in our qualitative synthesis. As result, cognitive impairments in BD have been previously considered as infrequent and limited to the affective episodes. Nowadays, there is evidence of stable and lasting cognitive dysfunctions in all phases of BD, including remission phase, particularly in the following domains: attention, memory, and executive functions. The cause of cognitive impairment in BD raises the question if it subtends a neurodevelopmental or a neurodegenerative process. Impaired cognitive functioning associated with BD may contribute significantly to functional disability, in addition to the distorted affective component usually emphasized.
Classification of Thinness, Overweight, and Obesity as a Function of the Body Mass Index and Fat Percentiles in Preschool and Primary School Children
Authors: Rodrigues Jessica , Rocha Ada 
Published: September 2017

IntroductionPortugal is one of the European countries showing an increase in mortality and morbidity associated with chronic diseases, presenting one of the highest prevalence rates of overweight and obesity among children.ObjectiveThe aim of this study was to evaluate the prevalence of thinness, overweight, and obesity as a function of the body mass index (BMI) and fat percentiles in preschool and primary school children in a municipality of the center region of Portugal.MethodsA total of 901 children were evaluated between November 2014 and March 2015. Evaluation included weight, height, waist circumference, and body fatness (total and trunk). Nutritional status was classified based on the Centers for Disease Control and Prevention, BMI percentile by age and gender, and the International Obesity TaskForce (IOTF) cutoff values of BMI.ResultsOf the children evaluated, according to the Centers for Disease Control and Prevention cutoff values, 32.3% were overweight or obese, and from those, 16.2% were obese. According to the fat percentile, the prevalence of overweight was 18.0%, corresponding 6.6% to obese children. Total body fat percentage and trunk fat percentage were 23.5% and 17.8%, respectively.ConclusionThe prevalences found were quite different depending on the method used. To allow comparisons and more accurately determine prevalence rates of thinness, overweight, and obesity in children, it is necessary to standardize methodologies between studies and between countries.
Effects of Lens-Care Solutions on Hydrogel Lens Performance
Authors: Kitamata-Wong Britney , Yuen Tiffany , Li Wing , Svitova Tatyana , Zhou Yixiu , Lin Meng C. 
Published: September 2017

SIGNIFICANCELens care multipurpose solutions (MPSs) can have varying effects on contact lens (CL) surface properties and the corneal epithelium.PURPOSEThe aim of this study was to investigate the short-term effects of newer MPS on CL comfort and dryness, prelens tear-film stability, and ocular-surface health.In vitrostudy was also performed to assess the effect of MPSs on CL surface properties.METHODSAcuvue 2 CLs were soaked in control solution, Clear Care (CC), or test solutions: PureMoist, Biotrue, RevitaLens (RL), or saline solution (SS). Over four visits, subjects were exposed to control solution in one eye and to test solution in the contralateral eye for 2 hours using presoaked CLs. Contact lens comfort and dryness, ocular-surface health assessment, prelens noninvasive tear breakup time, and corneal epithelial permeability measured with fluorometry were assessed. Captive-sessile bubble technique evaluated CL wettability and viscous dragin vitro.RESULTSAt 10 minutes, mean comfort ± SD with PureMoist (76 ± 22) was lower than CC (86 ± 15,P= .02), Biotrue (92 ± 9,P< .005), RL (90 ± 13,P< .005), and SS (90 ± 14,P< .005). No other difference in comfort or dryness was noted. RevitaLens was associated with greater corneal epithelial permeability than CC (P= .020) and increased corneal staining compared with all MPSs (P< .005 for all). RevitaLens was also associated with longer prelens noninvasive tear breakup than CC (P< .005).In vitroresults agreed with clinical findings of tear-film stability as RL reduced viscous drag. Contact lens surface wettability was enhanced by all MPSs in comparison to SS.CONCLUSIONSDifferences of MPSs on the ocular surface were foundin vivoandin vitro. RL caused the greatest corneal epithelium disruption but also associated with higher tear-film stability. The effect of MPSs on CL surface propertiesin vitroseems to reflect how MPSs altered prelens tear stability.