bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative dynamic quantitative sensory testing in remote pain-free areas is associated with axial pain after posterior cervical spinal surgeries
Authors: Chen Kaiwen , Yu Jie , Nie Cong , Zhu Yu , Jiang Jianyuan , Lei Wei , Xia Xinlei , Zheng Chaojun 
Published: May 2022

Abstract
Background
Postoperative axial pain (PAP), characterized by pain and/or stiffness around the posterior neck, periscapular areas and/or shoulder region, is a vexing complication affecting 5–60% of patients undergoing posterior cervical decompression. Given its relatively high frequency and negative impact on patients’ physical and mental status, efforts preoperatively to confirm patients at risk of developing PAP to offer more efficient pain management to minimize this complication have a high priority. The aim of this study is to investigate the role of preoperative dynamic quantitative sensory testing (QST) in predicting the PAP after posterior cervical decompression.

Methods
This longitudinal observational study included 122 patients with degenerative cervical myelopathy undergoing laminoplasty or laminectomy. Preoperatively, all patients underwent the assessment of pressure pain thresholds (PPTs) at local and remote pain-free areas and both temporal summation (TS) and conditioned pain modulation (CPM) at remote pain free-areas. These patients underwent further pain-related, psychosocial and clinical function assessments before and/or after operation.

Results
In the present study, 21 patients (21/122, 17.2%) developed PAP, and the 6-month postoperative follow-up demonstrated that 8 of these 21 patients developed chronic PAP (CPAP). All preoperative covariates with significant differences between the PAP and non-PAP groups were subjected to multivariate logistic regression, and the presence of preoperative axial pain, surgical plan including C2 decompression, total international physical activity questionnaire score (cutoff value [CV]: 2205.5, sensitivity: 82.4%; specificity: 61.1%) and TS value (CV: 2.5, sensitivity: 42.9%; specificity: 83.2%) were independently associated with PAP (P < 0.05). Logistic regression further revealed that the presence of preoperative axial pain, TS value (CV: 2.5, sensitivity: 62.5%; specificity: 83.2%) and CPM value (CV: 0.65, sensitivity: 87.5%; specificity: 61.4%) were significant predictors of CPAP (P < 0.05).

Conclusions
The findings of this study support the hypothesis that preoperative endogenous pain modulation efficiency may be associated with axial pain after posterior cervical decompression. Clinically, preoperative estimation of both TS and CPM in remote pain-free areas may provide additional useful information for identifying patients who may be at risk of developing both PAP and CPAP, which may be beneficial in enabling stratification in the perioperative period of patients based on individual vulnerabilities to avoid/reduce this complication.
Comparison of the serum brain-derived neurotrophic factor (BDNF) between fibromyalgia and nociceptive pain groups; and effect of duloxetine on the BDNF level
Authors: Bidari Ali , Ghavidel-Parsa Banafsheh , Gharibpoor Faeze 
Published: May 2022

Abstract
Background
The primary objective was to compare the serum brain-derived neurotrophic factor (BDNF) level in the patients with two types of pain: fibromyalgia (FM) and non-FM nociceptive pain (non-FM NP). The secondary objective was to investigate the effect of duloxetine on serum BDNF in FM patients and assess the direction of BDNF changes’ relation to clinical parameters’ alterations.
Methods: This is a study on 73 patients (50 FM and 23 non-FM chronic non-inflammatory pain patients). Serum BDNF was first compared between both groups. Patients with FM, then prospectively, underwent standardized FM treatment with duloxetine maximized to 60 mg/day. The Revised Fibromyalgia Impact Questionnaire (FIQR), Short-Form Health Survey (SF-12), pain visualized analog scale (pain VAS), Beck Depression Inventory-II (BDI-II), polysymptomatic distress scale (PSD) and serum BDNF were measured and compared at baseline and 4 weeks after treatment in FM group.

Results
The mean of adjusted BDNF level in the FM group had no significant difference than the non-FM NP group ((5293.5 ± 2676.3 vs. 6136.3 ± 4037.6; P value = 0.77). Using linear mixed model, we showed that duloxetine reduced BDNF level significantly in FM patients, even after adjusting for depression, pain and severity of the disease (P < 0.01). The FIQR, BDI-II, PSD, and pain VAS improved significantly after duloxetine treatment.

Conclusions
Non-significant BDNF level difference between FM and non-FM nociceptive pain suggested that peripheral BDNF is not a pathophysiological feature of FM. The decreased BDNF level parallel with improvement of PSD/pain scores after duloxetine treatment indicates BDNF alteration in the pain modulation process, regardless of cause and effect.
An evaluation of three-dimensional facial changes after surgically assisted rapid maxillary expansion (SARME): an observational study
Authors: Zupan Jurij , Ihan Hren Nataša , Verdenik Miha 
Published: May 2022

Abstract
Background
The abnormal facial features in maxillary transverse deficiency (MTD) are minimal and limited to a deficiency of the middle facial third, narrow nares and nasal base, and deepened nasolabial folds. The surgical expansion of the narrow maxilla has most obvious effects on widening of the maxillary dental arch and expansion of the maxillary and palatal structures in the transverse plane, however sagittal changes also occurs. The purpose of this observational study was to evaluate the three-dimensional (3D) facial soft tissue changes following surgically assisted rapid maxillary expansion (SARME).

Methods
In 15 skeletally mature patients with severe maxillary transverse deficiency, the planned maxillary expansion (on average 8.8 mm ± 2.3 mm) was achieved with a bone-borne palatal distractor. The 3D optical scans of the facial surface were obtained before and six months after SARME. In the first part, we defined different anatomical landmarks on both scans and compared cephalometric measurements. In the second part, we registered both 3D scans in the same workplace using the regional best-fit method (forehead, supraorbital and nasal root regions were selected for the superimposition) and conducted surface analysis.

Results
The largest differences between the pre- and post-operation scans were observed in the paranasal and cheek area (1.4 ± 1.0 mm). Significant differences occurred for an increased nasal width, a decreased upper-face height with an unchanged lower height, an increased vertical philtrum height and an increased nasolabial angle. A significant increase in the facial profile angle was also observed, resulting in an increased facial convexity and anterior displacement of the upper-lip area.

Conclusions
The widening of the nose and increased projection in the cheek and paranasal area in the lateral direction after maxillary expansion were confirmed; moreover, facial convexity increases, reflecting the underlying advancement of the maxilla.
Cancer patients spend more time at home and more often die at home with advance care planning conversations in primary health care: a retrospective observational cohort study
Authors: Driller Bardo , Talseth-Palmer Bente , Hole Torstein , Strømskag Kjell Erik , Brenne Anne-Tove 
Published: May 2022

Abstract
Background
Spending time at home and dying at home is advocated to be a desirable outcome in palliative care (PC). In Norway, home deaths among cancer patients are rare compared to other European countries. Advance care planning (ACP) conversations enable patients to define goals and preferences, reflecting a person’s wishes and current medical condition.

Method
The study included 250 cancer patients in the Romsdal region with or without an ACP conversation in primary health care who died between September 2018 and August 2020. The patients were identified through their contact with the local hospital, cancer outpatient clinic or hospital-based PC team.

Results
During the last 90 days of life, patients who had an ACP conversation in primary health care (N=125) were mean 9.8 more days at home, 4.5 less days in nursing home and 5.3 less days in hospital. Having an ACP conversation in primary health care, being male or having a lower age significantly predicted more days at home at the end of life (p< .001). Patients with an ACP conversation in primary health care where significantly more likely to die at home (p< .001) with a four times higher probability (RR=4.5). Contact with the hospital-based PC team was not associated with more days at home or death at home. Patients with contact with the hospital-based PC team were more likely to have an ACP conversation in primary health care.

Conclusion
Palliative cancer patients with an ACP conversation in primary health care spent more days at home and more frequently died at home. Data suggest it is important that ACP conversations are conducted in primary health care setting.
A case management model for patients with granulomatous mastitis: a prospective study
Authors: Deng Yuan , Xiong Ying , Ning Ping , Wang Xin , Han Xiao-Rong , Tu Guo-Fang , He Pei-Yu 
Published: May 2022

Abstract
Background
Granulomatous mastitis (GM) is a chronic inflammatory mastitis disease that requires long-term treatment and has a high recurrence rate. Case management has been proven to be an effective mechanism in assisting patients with chronic illness to receive regular and targeted disease monitoring and health care service. The aim of this study was to investigate the application of a hospital-to-community model of case management for granulomatous mastitis and explore the related factors associated with its recurrence.

Methods
This was a prospective study on patients with granulomatous mastitis based on a case management model. Data on demographic, clinical and laboratory information, treatment methods, follow-up time, and recurrence were collected and analyzed. The eight-item Morisky Medication Adherence Scale (MMAS-8) was used to investigate patients' adherence to medications. Logistic regression models were built for analysis of risk factors for the recurrence of granulomatous mastitis.

Results
By October 2021, a total of 152 female patients with a mean age of 32 years had undergone the entire case management process. The mean total course of case management was 24.54 (range 15–45) months. Almost all the patients received medication treatment, except for one pregnant patient who received observation therapy, and approximately 53.9% of the patients received medication and surgery. The overall recurrence rate was 11.2%, and “high” medication adherence (RR = 0.428, 95% CI 0.224–0.867, P = 0.015) was significantly associated with a lower rate of recurrence, while the rate of recurrence with a surgical procedure + medication was higher than that with medication alone (RR = 4.128, 95% CI 1.026–16.610, P = 0.046).

Conclusion
A case management model for patients with granulomatous mastitis was applied to effectively monitor changes in the disease and to identify factors associated with disease recurrence. “Low” medication adherence was a significant risk factor for the recurrence of granulomatous mastitis. Patients treated with medication and surgery were more likely to experience recurrence than those treated with medication alone. The optimal treatment approach should be planned for granulomatous mastitis patients, and patient medication adherence should be of concern to medical staff.
Factors influencing medical students’ attitudes towards substance use during pregnancy
Authors: Richelle Lou , Dramaix-Wilmet Michèle , Roland Michel , Kacenelenbogen Nadine 
Published: May 2022

Abstract
Background
People with substance use disorder, and pregnant women especially, are subject to a lot of stigmas, which can prevent optimal accessibility and quality of care. In this survey, we investigated attitudes of final year medical students regarding substance use during pregnancy and identified the factors that influence these attitudes.

Method
This cross-sectional study was conducted in 2019 and 2020 in Belgium using the short version of the “Substance Abuse Attitude Survey” questionnaire. We focused on two items regarding punishment of substance use during pregnancy. We analysed the concordance between these two, their correlation with other items (e.g. stereotyping, morality, forced withdrawal, low treatment optimism) and the association between respondents’ opinion on punishment and their sociodemographic data.

Results
The response rate was 65.2% (370/567 online and face-to face questionnaires). 19.2% of respondents were in favour of punishment for alcohol use (n = 353) and 15.1% for drug use (n = 356) during pregnancy. The agreement analysis between the two items showed that 14.3% of students were in favour of punishing both pregnant women who use drugs and those using alcohol. Respondents tended to be more in favour of punishment if they were male students, older, their mothers’ had a lower education level or had no personal or family history of substance use. Attitudes appeared to be more punitive among students with limited contact with people with substance use disorder (i.e. none or limited to hospital). Students intending to specialise in internal medicine were more in favour of punishment of women whereas none of those intending to specialise in psychiatry were in favour.

Conclusion
Our study shows that about 20% of surveyed medical students favoured punishing substance-using pregnant women. Awareness and training work seems to be necessary to ensure adequate care and support for this already vulnerable population.
Travelling to die: views, attitudes and end-of-life preferences of Israelis considering receiving aid-in-dying in Switzerland
Authors: Sperling Daniel 
Published: May 2022

Abstract
Background
Following the increased presence of the Right-to-Die Movement, improved end-of-life options, and the political and legal status of aid-in-dying around the globe, suicide tourism has become a promising alternative for individuals who wish to end their lives. Yet, little is known about this from the perspective of those who engage in the phenomenon.

Methods
This study applied the qualitative research approach, following the grounded theory tradition. It includes 11 in-depth semi-structured interviews with Israeli members of the Swiss non-profit Dignitas who contemplated traveling to Switzerland for aid-in-dying.

Results
Seven themes emerged from the data analysis, including health and functioning; feelings regarding survivorship and existence; interacting with the health sector; attitudes regarding death and dying; suicide; choosing death; and choosing suicide tourism. A significant portion of the participants had experienced suicidal thoughts and had even previously attempted suicide, some more than once. Most of them referred to chronic illnesses, functional disability, and social isolation. They understand suffering within the subjective dimension, namely only by the person who is actually subjected to the disease, ailments, and disability. Participants regarded aid-in-dying in Switzerland as positive thanks to its guaranteed outcome: "beautiful death", compared to "disadvantaged dying" which places a burden on the participants' loved ones throughout the prolonged dying. Most of them do not necessarily want to have their loved ones beside them when they die, and they see no significant meaning in dying in a foreign country to which they have no emotional or civil attachment.

Conclusion
The desirable approval or tragic refusal by Dignitas to participants' requests for suicide tourism enhances the paradox between the perception of aid-in-dying as a mechanism for fulfilling controlled death and its bureaucratic and materialistic characteristics specifically reflected in a paid, formalized approach to aid-in-dying that cultivate dependency and collaboration.
Smartphone-based mobile applications for adverse drug reactions reporting: global status and country experience
Authors: Fukushima Ayako , Iessa Noha , Balakrishnan Madhava Ram , Pal Shanthi Narayan 
Published: May 2022

Abstract
Background
Smartphone technology can support paperless reporting of adverse drug reactions (ADRs). The aims of this study were to systematically assess smartphone ADR-reporting applications, understand their qualitative and quantitative impact on ADR reporting, and garner key lessons from owners and developers.

Methods
This study had three components: (1) An assessment of ADR-reporting apps, (2) an online survey on the impact of app implementation on ADR reporting and the experiences of app developers and owners, and (3) a search of VigiBase, the World Health Organization global database of individual case safety reports (ICSRs), to observe trends in the number of ADR reports targeting countries where the apps were implemented.

Results
Twenty-two apps were included. Eight out of the 22 apps were for countries in the WHO African region. Features observed included E2B data elements (E stands for efficacy) and functions supporting reporting and user engagement. Seventeen app developers and owners answered to the survey and reported overall positive experiences with app features, and post-launch increases in the total number of ICSRs. User type and user environment were cited as factors influencing app use: Respondents said younger people and/or those with an inclination to use technology were more likely to use apps compared to older or more technology-averse people, while respondents in countries with limited internet connectivity reported persistent difficulties in app use.

Conclusions
Smartphone apps for reporting ADRs offer added value compared to conventional reporting tools. Reporting tools should be selected based on interface features and factors that may influence app usage.
Prediction of unplanned 30-day readmission for ICU patients with heart failure
Authors: Pishgar M. , Theis J. , Del Rios M. , Ardati A. , Anahideh H. , Darabi H. 
Published: May 2022

Abstract
Background
Intensive Care Unit (ICU) readmissions in patients with heart failure (HF) result in a significant risk of death and financial burden for patients and healthcare systems. Prediction of at-risk patients for readmission allows for targeted interventions that reduce morbidity and mortality.

Methods and results
We presented a process mining/deep learning approach for the prediction of unplanned 30-day readmission of ICU patients with HF. A patient’s health records can be understood as a sequence of observations called event logs; used to discover a process model. Time information was extracted using the DREAM (Decay Replay Mining) algorithm. Demographic information and severity scores upon admission were then combined with the time information and fed to a neural network (NN) model to further enhance the prediction efficiency. Additionally, several machine learning (ML) algorithms were developed to be used as the baseline models for the comparison of the results.

Results
By using the Medical Information Mart for Intensive Care III (MIMIC-III) dataset of 3411 ICU patients with HF, our proposed model yielded an area under the receiver operating characteristics (AUROC) of 0.930, 95% confidence interval of [0.898–0.960], the precision of 0.886, sensitivity of 0.805, accuracy of 0.841, and F-score of 0.800 which were far better than the results of the best baseline model and the existing literature.

Conclusions
The proposed approach was capable of modeling the time-related variables and incorporating the medical history of patients from prior hospital visits for prediction. Thus, our approach significantly improved the outcome prediction compared to that of other ML-based models and health calculators.
Cost of illness of chronic kidney disease in Lebanon: from the societal and third-party payer perspectives
Authors: Aoun Mabel , Helou Elie , Sleilaty Ghassan , Zeenny Rony M. , Chelala Dania 
Published: May 2022

Abstract
Background
Chronic kidney disease (CKD) is the 12th leading cause of death worldwide. Cost-of-illness studies of CKD are scarce in developing countries. This study aims to estimate the cost of illness of all stages of CKD in Lebanon, from early stages until dialysis and kidney transplantation. The secondary objective is to identify factors related to the highest financial burden.

Methods
This is a cross-sectional study of CKD patients who presented to two nephrology clinics during November 2020. Their medical and administrative records were reviewed for collection of demographics, CKD characteristics, direct medical costs (medications, diagnostic tests, hospitalizations, inpatient care, outpatient care), direct non-medical costs (transportation) and indirect costs (productivity losses) for one year. Kruskal Wallis test was used to compare the costs between different CKD stages and categories. Logistic regression analysis was used to evaluate risk factors associated with costs.

Results
The sample included 102 non-dialysis CKD patients, 40 hemodialysis, 8 peritoneal dialysis and 10 transplant patients. Their mean age was 66.74 ± 15.36 years, 57.5% were males and 42.5% diabetics. The total median cost per year of CKD across all categories was assessed to be 7,217,500 Lebanese Pounds (3,750,000–35,535,250; 1 $USD = 1515 LBP in 2019) from the societal perspective and 5,685,500 LBP (2,281,750- 32,386,500) from the third-party payer perspective. Statistical analysis showed a higher total cost in hemodialysis (p < 0.001), higher cost of medications in transplant (p < 0.001) and higher cost in technique modality in peritoneal dialysis (p < 0.001). In a sub-analysis of hemodialysis patients, dialysis vintage negatively correlated with total societal cost (r = -0.391, p = 0.013); the regression analysis found diabetes as a risk factor for higher cost (OR = 2.3; 95%CI: 0.638,8.538; p = 0.201). In the subcategory of CKD-ND patients, age correlated with total societal cost (r = 0.323, p = 0.001); diabetes and coronary artery disease were significantly associated with higher total cost (OR = 2.4; 95%CI: 1.083,5.396; p = 0.031; OR = 3.7; 95%CI: 1.535,8.938; p = 0.004).

Conclusions
This cost of illness study showed a high burden of hemodialysis and peritoneal dialysis cost compared to transplant and non-dialysis CKD patients. It revealed a significantly higher cost of medications in transplant patients. Health policies should target interventions that prevent end-stage kidney disease and encourage kidney transplantation.