bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decline of common mental disorders over time in public primary care tuberculosis patients in South Africa
Authors: Peltzer Karl 
Published: June 2016

Objective The relationship between tuberculosis and common mental disorders over time is under researched. The aim of this investigation was to estimate the prevalence of common mental disorders and its predictors among tuberculosis patients over a period of six months. Methods A longitudinal investigation was carried out with new tuberculosis and tuberculosis retreatment patients systematically selected from 40 primary health care facilities and had screened positive for hazardous or harmful alcohol use in South Africa. Common mental disorders were measured with the Kessler-10 scale and the Primary Care Posttraumatic Stress Disorder Screen at baseline and at six months. Results At six months, 710 tuberculosis patients had completed the follow up. At baseline, 34.1% had severe psychological distress with a higher cut-off score (≥28), 81.1% had moderate psychological distress with a lower cut-off score (≥16), and 29.4% had posttraumatic stress disorder symptoms (two or more). At the six-month follow-up, severe psychological stress significantly reduced by 12.3%, moderate psychological distress reduced by 24.9%, and PTSD reduced by 20.0%. Multivariate logistic regression analysis using generalized estimation equation modeling across the three mental conditions found that moderate psychological distress and PTSD symptoms but not severe psychological distress significantly reduced over time. Having chronic conditions, including HIV, and sociodemographic factors (lower education and poverty) were associated with common mental disorders. Conclusion The prevalence of moderate psychological distress and posttraumatic stress disorder symptoms significantly reduced over a period of six months. Mental health services should be integrated into tuberculosis treatment programs.
Biologic effects of stress and bonding in mother–infant pairs
Authors: Spratt Eve G , Marsh Courtney , Wahlquist Amy E , Papa Carrie E , Nietert Paul J , Brady Kathleen T , Herbert Teri Lynn , Wagner Carol 
Published: June 2016

Objective Maternal stress in humans influences behavior of children and can be assessed using biological markers. Mothers and their one-month-old infants were recruited from an existing study to examine baseline maternal serum oxytocin and hypothalamic-pituitary-adrenal axis response to infant blood heel stick stress as measured by salivary cortisol in the dyads. Objectives were to explore (1) relationships between mother and infant cortisol levels, (2) gender differences in infant biologic cortisol response, and (3) the association of cortisol levels in the dyads and maternal oxytocin levels Methods Forty-two mother–infant dyads provided biologic samples and self-report data. Maternal oxytocin samples were obtained. Initial salivary cortisol was assessed in both the mother and infant, followed by a heel stick blood draw. Twenty minutes later, salivary cortisol was collected again from dyads. Results Self-report measures were negative for depression and risk for childhood neglect. Although oxytocin and baseline cortisol in the infants was higher in mothers that did some breast-feeding, there was no statistically significant difference ( p = 0.2 and p = 0.1, respectively). Analyses showed (a) higher baseline cortisol in mothers was related to higher baseline cortisol in infants ( p ≤ 0.0001), (b) following the stressor, female infants had a larger positive change in cortisol, after adjusting for baseline cortisol ( p = 0.045), and (c) there was no relationship between dyad cortisol levels and maternal oxytocin. Conclusions Maternal and infant biologic stress measures are related. Female infants have a larger hypothalamic-pituitary-adrenal response to a blood draw stressor as measured by salivary cortisol than male infants.
Validating screening tools for depression in stroke and transient ischemic attack patients
Authors: Prisnie Joey C , Fiest Kirsten M , Coutts Shelagh B , Patten Scott B , Atta Callie AM , Blaikie Laura , Bulloch Andrew GM , Demchuk Andrew , Hill Michael D , Smith Eric E , Jetté Nathalie 
Published: June 2016

Objective The best screening questionnaires for detecting post-stroke depression have not been identified. We aimed to validate four commonly used depression screening tools in stroke and transient ischemic attack patients. Methods Consecutive stroke and transient ischemic attack patients visiting an outpatient stroke clinic in Calgary, Alberta (Canada) completed a demographic questionnaire and four depression screening tools: Patient Health Questionnaire (PHQ)-9, PHQ-2, Hospital Anxiety and Depression Scale (HADS-D), and Geriatric Depression Scale (GDS-15). Participants then completed the Structured Clinical Interview for DSM-IV (SCID), the gold-standard for diagnosing major depression. The questionnaires were validated against the SCID and sensitivity and specificity were calculated at various cut-points. Optimal cut-points for each questionnaire were determined using receiver-operating curve analyses. Results Among 122 participants, 59.5% were diagnosed with stroke and 40.5% with transient ischemic attack. The point prevalence of SCID-diagnosed current major depression was 9.8%. At the optimal cut-points, the sensitivity and specificity for each screening tool were as follows: PHQ-9 (sensitivity: 81.8%, specificity: 97.1%), PHQ-2 (sensitivity: 75.0%, specificity: 96.3%), HADS-D (sensitivity: 63.6%, specificity: 98.1%), and GDS-15 (sensitivity: 45.5%, specificity: 84.8%). Areas under the receiver operating characteristic curves were as follows: PHQ-9 86.6%, PHQ-2 86.7%, HADS-D 85.9%, and GDS-15 66.3%. Conclusions The PHQ-2 and PHQ-9 are both suitable depression screening tools, taking less than 5 minutes to complete. The HADS-D does not appear to have any advantage over the PHQ-based scales, even though it was designed specifically for medically ill populations. The GDS-15 cannot be recommended for general use in a stroke clinic based on this study as it had worse discrimination due to low sensitivity.
Proprotein convertase subtilisin/kexin type 9 levels and aortic valve calcification: A prospective, cross sectional study
Authors: Wang Wen-guang , He Yong-feng , Chen Yuan-li , Zhao Fu-mei , Song Yan-qiu , Zhang Hong , Ma Yan-he , Guan Xin , Zhang Wen-ya , Chen Xiao-lin , Liu Chao , Cong Hong-liang 
Published: June 2016

Objective To investigate the possible association between plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) and the incidence and severity of calcific aortic valve disease (CAVD). Methods This prospective, cross sectional study involved patients with and without (controls) aortic valve calcification diagnosed by transthoracic echocardiography and dual source computed tomography (DSCT) scan. Aortic valves calcification scores were calculated from DSCT scans and patients were graded: grade 1, no calcification; grade 2, mildly calcified; grade 3, moderately calcified; grade 4, heavily calcified. Plasma PCSK9 levels were measured using an enzyme-linked immunosorbent assay. Results Forty patients were grade 1 (controls), 32 were grade 2, 48 were grade 3 and 32 were grade 4. Plasma levels of PCSK9 were significantly different between the four groups and the highest value was observed in the patients with grade 2 calcification. Only low-density lipoprotein cholesterol and lipoprotein (Lp)(a) were associated with the severity of CAVD. Regression analysis showed that age, Lp(a) and PCSK9 were independent predictors of CAVD. Conclusion Data from this cross sectional study in a small sample of patients showed that plasma PCSK9 was correlated with the presence of CAVD but not its severity.
Distance from Dura mater to spinal cord at the thoracic vertebral level: An introductory study on local subdural geometry for thoracic epidural block
Authors: Park Jin-Woo , Bae Seung-Kil , Huh Jin 
Published: June 2016

Objective To evaluate the anatomical safety margins in relation to thoracic epidural block by analysing magnetic resonance (MR) images. Methods This retrospective study identified consecutive patients who underwent MR imaging of the thoracic vertebral spine. The distance from the dura mater to the spinal cord (DTC) was measured at different thoracic intervertebral levels using three different pathways as references: the ‘U’, ‘L’ and ‘M’ lines. Results A total of 346 patients provided MR images for analysis. The vertical DTC was the longest at the T5/6 intervertebral level (mean ± SD: 4.22 ± 1.43 mm) and the shortest at the T11/12 intervertebral level (mean ± SD: 2.51 ± 0.87 mm). The DTC was the longest on the ‘L’ line at the T1/2 and T5/6 intervertebral levels and on the ‘U’ line at the T10/11 intervertebral level. The difference in DTC between the ‘U’ and ‘L’ lines was the greatest at the T5/6 intervertebral level. Conclusion Differences in the DTC were observed among the thoracic intervertebral levels. The variability of the safety margin according to the angle of needle insertion was the largest at the T5/6 intervertebral level.
Schistosomus Reflexus Syndrome in Olive Ridley Sea Turtles (Lepidochelys olivacea)
Authors: Bárcenas-Ibarra A. , Rojas-Lleonart I. , Lozano-Guzmán R. I. , García-Gasca A. 
Published: June 2016

The olive ridley sea turtle ( Lepidochelys olivacea), considered the most abundant sea turtle species, is listed as vulnerable on the International Union for Conservation of Nature Red List. The most important nesting areas are located in the Eastern Pacific, and congenital malformations have been previously reported in this species. The present study was conducted in a single population at El Verde beach, one of the most important nesting beaches for the species in the northwestern Mexican Pacific. The study was based on embryos that had been incubated in a controlled environment. Schistosomus reflexus syndrome (SRS) was observed in 124 of 20 257 olive ridley embryos (0.6%), comprising 124 of 400 (31%) cases of congenital malformations over a 7-month period. Affected embryos had malformations of the carapace, bridge, or plastron, resulting in exposure of the abdominal or thoracic viscera, as well as spinal malformation and abnormal positioning of limbs adjacent to the head with subsequent ankylosis. SRS phenotypes (although lethal) varied from mild to severe, although most cases were severe. SRS was mostly associated with congenital malformations in the neck (short neck, 80%), tail (anury, 38%), and flippers (different types of dysmelias, 53%). In most cases of severe SRS, ankyloses were present. Documenting these findings could be important to identify the cause of the developmental defects, and identification of the cause of the defects may be of significance to the population and to our efforts to manage this and other populations at risk.
Ibuprofen Differentially Affects Supraspinatus Muscle and Tendon Adaptations to Exercise in a Rat Model
Authors: Rooney Sarah Ilkhanipour , Baskin Rachel , Torino Daniel J. , Vafa Rameen P. , Khandekar Pooja S. , Kuntz Andrew F. , Soslowsky Louis J. 
Published: June 2016

Background: Previous studies have shown that ibuprofen is detrimental to tissue healing after acute injury; however, the effects of ibuprofen when combined with noninjurious exercise are debated. Hypothesis: Administration of ibuprofen to rats undergoing a noninjurious treadmill exercise protocol will abolish the beneficial adaptations found with exercise but will have no effect on sedentary muscle and tendon properties. Study Design: Controlled laboratory study. Methods: A total of 167 male Sprague-Dawley rats were divided into exercise or cage activity (sedentary) groups and acute (a single bout of exercise followed by 24 hours of rest) and chronic (2 or 8 weeks of repeated exercise) response times. Half of the rats were administered ibuprofen to investigate the effects of this drug over time when combined with different activity levels (exercise and sedentary). Supraspinatus tendons were used for mechanical testing and histologic assessment (organization, cell shape, cellularity), and supraspinatus muscles were used for morphologic (fiber cross-sectional area, centrally nucleated fibers) and fiber type analysis. Results: Chronic intake of ibuprofen did not impair supraspinatus tendon organization or mechanical adaptations (stiffness, modulus, maximum load, maximum stress, dynamic modulus, or viscoelastic properties) to exercise. Tendon mechanical properties were not diminished and in some instances increased with ibuprofen. In contrast, total supraspinatus muscle fiber cross-sectional area decreased with ibuprofen at chronic response times, and some fiber type–specific changes were detected. Conclusion: Chronic administration of ibuprofen does not impair supraspinatus tendon mechanical properties in a rat model of exercise but does decrease supraspinatus muscle fiber cross-sectional area. This fundamental study adds to the growing literature on the effects of ibuprofen on musculoskeletal tissues and provides a solid foundation on which future work can build. Clinical Relevance: The study findings suggest that ibuprofen does not detrimentally affect regulation of supraspinatus tendon adaptations to exercise but does decrease muscle growth. Individuals should be advised on the risk of decreased muscle hypertrophy when consuming ibuprofen.
Quantifying Head Impacts in Collegiate Lacrosse
Authors: Reynolds Bryson B. , Patrie James , Henry Erich J. , Goodkin Howard P. , Broshek Donna K. , Wintermark Max , Druzgal T. Jason 
Published: June 2016

Background: Concussion and repetitive head impact in sports has increased interest and concern for clinicians, scientists, and athletes. Lacrosse is the fastest growing sport in the United States, but the burden of head impact in lacrosse is unknown. Purpose: The goal of this pilot study was to quantify head impact associated with practicing and playing collegiate lacrosse while subjects were fitted with wearable accelerometers. Study Design: Descriptive epidemiology study. Methods: In a single year, a collegiate cohort of 14 women’s and 15 men’s lacrosse players wore mastoid-patch accelerometers to measure the frequency and severity of head impacts during official practices and games. Average impact severity, mean number of impacts, and cumulative acceleration were evaluated, stratified by sport and event type. Results: Men’s and women’s collegiate lacrosse players did not significantly differ in the number of head impacts received during games (11.5 for men vs 9.2 for women) or practices (3.1 vs 3.1). Men’s lacrosse players had significantly higher average head acceleration per impact during games compared with women (21.1 g vs 14.7 g) but not during practices (21.3 g vs 18.1 g). For both men and women, more impacts occurred during games than during practices (men, 11.5 vs 3.1; women, 9.2 vs 3.1), but impact severity did not significantly differ between events for either sport (men, 21.1 g vs 21.3 g; women, 14.7 g vs 18.1 g). Conclusion: The study data suggest a higher impact burden during games compared with practices, but this effect is driven by the quantity rather than severity of impacts. In contrast, sex-based effects in impact burden are driven by average impact severity rather than quantity. Data collected from larger multisite trials and/or different age groups could be used to inform ongoing debates, including headgear and practice regulations, that might appreciably affect the burden of head impacts in lacrosse. Clinical Relevance: While most head impacts do not result in a clinical diagnosis of concussion, evidence indicates that subconcussive head impacts may increase susceptibility to concussion and contribute to long-term neurodegeneration.
The Medial Stitch in Transosseous-Equivalent Rotator Cuff Repair
Authors: Montanez Anthony , Makarewich Christopher A. , Burks Robert T. , Henninger Heath B. 
Published: June 2016

Background: Despite advances in surgical technique, rotator cuff repair retears continue to occur at rates of 10%, 22%, and 57% for small, medium, and large tears, respectively. A common mode of failure in transosseous-equivalent rotator cuff repairs is tissue pullout of the medial mattress stitch. While the medial mattress stitch has been studied extensively, no studies have evaluated a vertical mattress pattern placed near the musculotendinous junction in comparison with a horizontal mattress pattern. Hypothesis: Vertical mattress stitches will have higher load to failure and lower gapping compared with horizontal mattress stitches in a transosseous-equivalent rotator cuff repair. Study Design: Controlled laboratory study. Methods: Double-row transosseous-equivalent rotator cuff repairs were performed in 9 pairs of human male cadaveric shoulders (mean age ± SD, 58 ± 10 years). One shoulder in each pair received a medial-row suture pattern using a vertical mattress stitch, and the contralateral shoulder received a horizontal mattress. Specimens were mounted in a materials testing machine and tested in uniaxial tensile deformation for cyclic loading (500 cycles at 1 Hz to 1.0 MPa of effective stress), followed by failure testing carried out at a rate of 1 mm/s. Construct gapping and applied loads were monitored continuously throughout the testing. Results: Vertical mattress sutures were placed in 5 right and 4 left shoulders. Peak cyclic gapping did not differ between vertical (mean ± SD, 2.8 ± 1.1 mm) and horizontal mattress specimens (3.0 ± 1.2 mm) ( P = .684). Vertical mattress sutures failed at higher loads compared with horizontal mattress sutures (568.9 ± 140.3 vs 451.1 ± 174.3 N; P = .025); however, there was no significant difference in failure displacement (8.0 ± 1.6 vs 6.0 ± 2.1 mm; P = .092). Failure stiffness did not differ between the suture patterns ( P = .204). Conclusion: In transosseous-equivalent rotator cuff repairs near the musculotendinous junction, a vertical mattress suture used as the medial stitch has a higher load to failure but no difference in gapping compared with a horizontal mattress pattern. Clinical Relevance: A vertical mattress suture may offer enhanced strength of repair for transosseous-equivalent repairs.
Mechanical Ventilation Outcomes in Patients With Pulmonary Hypertension in the United States: A National Retrospective Cohort Analysis
Authors: Rush Barret , Biagioni Bradly J. , Berger Landon , McDermid Robert 
Published: June 2016

Objective: The outcome of patients with pulmonary arterial hypertension (PAH) who undergo mechanical ventilation is not well known. Methods: The Nationwide Inpatient Sample for 2006 to 2012 was used to isolate patients with a diagnosis of PAH who also underwent invasive (MV) and noninvasive (NIMV) mechanical ventilation. The primary outcome was in-hospital mortality. Results: The hospital records of 55 208 382 patients were studied, and there were 21 070 patients with PAH, of whom 1646 (7.8%) received MV and 834 (4.0%) received NIMV. Those receiving MV had higher mortality (39.1% vs 12.6%, P < .001) and longer hospital stays (11.9 days, interquartile range [IQR] 6.1-22.2 vs 6.7 days, IQR 3.4-11.9, P < .001) than those undergoing NIMV. Of the patients treated with MV, 4.4% also used home oxygen therapy and had similar overall mortality to those who did not use home oxygen (35.3% vs 39.1%, P = .46). Similarly, there was no relationship between home oxygen use and mortality in patients treated with NIMV (10.6% vs 12.6%, P = .48). Notably, more patients treated with NIMV used home oxygen than those treated with MV (14.4% vs 4.4%, P < .001). Conclusion: Patients with PAH who undergo invasive mechanical ventilation have an in-hospital mortality of 39.1%. Future work may help identify the types of patients who benefit most from advanced respiratory support in a critical care setting.
Precarious work and precarious workers: Towards an improved conceptualisation
Authors: Campbell Iain , Price Robin 
Published: June 2016

AbstractDiscussion of the implications of precarious work for individual workers remains hesitant and often confused. A clear conceptualisation would separate out five analytical levels: precariousness in employment, precarious work, precarious workers individually and as an emerging class, and precarity as a general condition of social life. To illustrate the need to avoid slippage between the concepts of precarious work and precarious workers, we present one ‘theory-relevant’ example – full-time secondary school students in Australia who hold part-time jobs in the retail sector. Their part-time jobs are indeed precarious but the negative effects on the student-workers are modest, both because participation in precarious work is limited (moderate weekly hours and intermittent work within the framework of a brief stage of the life course) and because many (though not all) of the associated risks are cushioned by structural forces such as access to alternative income sources and career paths. At the same time, however, a longitudinal perspective reveals that the same group of student-workers faces major risks in the future, as a result of increasingly insecure labour markets. Reflections on this example help to identify conceptual tools that can be applied to a wide range of other examples of precarious work.
Cost of Medications Recommended by Canadian Acne Clinical Practice Guidelines
Authors: Czilli Tiffany , Tan Jerry , Knezevic Sanja , Peters Colin 
Published: June 2016

Background: Acne affects a large proportion of the Canadian population and has psychosocial and financial consequences. Objective: We provide cost information for treatments recommended by the Canadian acne guidelines. Methods: Highest level recommendations were selected for 3-month usage cost. Results: Three-month estimated treatment costs were as follows: topical retinoids ($14.40-$73.80), benzoyl peroxide (BPO; $6.75), fixed-dose BPO-clindamycin ($40.95-$44.10) and BPO-adapalene ($73.80), oral antibiotics ($25.20 for tetracycline 250 mg qid; $52.20 and $52.74 for doxycycline 50 mg bid and 100 mg od, respectively), and hormonal therapy ($26.46-$37.80 for ethinyl estradiol [EE] 0.030 mg/drospirenone 3mg and $75.60-108.99 for EE 0.035 mg/cyproterone acetate 2 mg). Oral isotretinoin 3-month costs ranged from $393.96 to $478.80. Conclusions: Awareness of costs of recommended treatments may facilitate improved outcomes by increasing procurement and adherence.