bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between Depression and Anxiety Symptoms of Adult PWE and Caregivers in a Tertiary Center
Authors: João Rafael Batista , Nogueira Mateus Henrique , Morita-Sherman Márcia Elisabete , Alvim Marina Koutsodontis Machado , Johnny Steven , Pereira Haryton , Pinheiro Hildete Prisco , Cendes Fernando , Yasuda Clarissa Lin 
Published: March 2022

BackgroundAlthough several studies have emphasized the association between epilepsy and psychiatric disorders, fewer have investigated the impact of epilepsy on caregivers' emotional status, mainly in adult people with epilepsy (PWE). Here we investigated depressive symptoms, suicidal ideation, and anxiety symptoms in a large group of adult PWE and their caregivers.MethodsWe analyzed symptoms of depression [with the Beck Depression Inventory-II (BDI-II)], suicidal ideation (with BDI-II item 9), and anxiety symptoms (with the Beck Anxiety Inventory) in a large group of adult PWE [N = 548 (60% women; median age 41)] and caregivers [N = 191 (72% women; median age 47)] from a Brazilian tertiary center, considering sociodemographic and clinical aspects. We also applied the Liverpool Adverse Events Profile to assess anti-seizure drugs adverse events.ResultsWhile the presence (p = 0.026) (and intensity, p = 0.007) of depressive symptoms and suicidal ideation (p = 0.02) were higher in PWE compared to caregivers, the proportion of clinical anxiety symptoms (p = 0.32) (and the intensity, p = 0.13) was similar in both groups. Although the rates of suicidal ideation were higher in focal epilepsy (20%), both generalized genetic epilepsy and caregivers also presented elevated frequencies (11%) of suicidal ideation. The analyses of 120 patient-caregiver dyads revealed that the intensity of depressive symptoms in PWE (but not anxiety) correlated with the intensity of depressive (r = 0.35; p &lt; 0.001) and anxiety (r = 0.25; p = 0.01) symptoms in their caregivers. In the multivariate analyses of PWE, focal epilepsy (compared to GGE) was associated with clinical depressive symptoms (odds ratio, OR 2.1) and suicidal ideation (OR 3.2), while recurrent seizures (compared to the seizure-free group) were associated with suicidal ideation (OR 2.6) and anxiety symptoms (OR 2.1). Also, caregivers with anxiety symptoms were 8 times more likely to exhibit depressive symptoms, and those with depressive symptoms were 8 times more likely to present anxiety symptoms.ConclusionOur study suggests that specific attention for the caregivers' mental health is as essential as PWE. There is an urgent need for more studies involving caregivers to identify their emotional distress and provide adequate treatment.
A Systematic Review of Mobile Stroke Unit Among Acute Stroke Patients: Time Metrics, Adverse Events, Functional Result and Cost-Effectiveness
Authors: Chen Jieyun , Lin Xiaoying , Cai Yali , Huang Risheng , Yang Songyu , Zhang Gaofeng 
Published: March 2022

BackgroundMobile stroke unit (MSU) is deployed to shorten the duration of ischemic stroke recognition to thrombolysis treatment, thus reducing disability, mortality after an acute stroke attack, and related economic burden. Therefore, we conducted a comprehensive systematic review of the clinical trial and economic literature focusing on various outcomes of MSU compared with conventional emergency medical services (EMS).MethodsAn electronic search was conducted in four databases (PubMed, OVID Medline, Embase, and the Cochrane Controlled Register of Trials) from 1990 to 2021. In these trials, patients with acute stroke were assigned to receive either MSU or EMS, with clinical and economic outcomes. First, we extracted interested data in the pooled population and conducted a subgroup analysis to examine related heterogeneity. We then implemented a descriptive analysis of economic outcomes. All analyses were performed with R 4.0.1 software.ResultsA total of 22,766 patients from 16 publications were included. In total 7,682 (n = 33.8%) were treated in the MSU and 15,084 (n = 66.2%) in the conventional EMS. Economic analysis were available in four studies, of which two were based on trial data and the others on model simulations. The pooled analysis of time metrics indicated a mean reduction of 32.64 min (95% confidence interval: 23.38–41.89, p &lt; 0.01) and 28.26 minutes (95% CI: 16.11–40.41, p &lt; 0.01) in the time-to-therapy and time-to-CT completion, respectively in the MSU. However, there was no significant difference on stroke-related neurological events (OR = 0.94, 95% CI: 0.70–1.27, p = 0.69) and in-hospital mortality (OR = 1.11, 95% CI: 0.83–1.50, p = 0.48) between the MSU and EMS. The proportion of patients with modified Ranking scale (mRS) of 0–2 at 90 days from onset was higher in the MSU than EMS (p &lt; 0.05). MSU displayed favorable benefit-cost ratios (2.16–6.85) and incremental cost-effectiveness ratio ($31,911 /QALY and $38,731 per DALY) comparing to EMS in multiple economic publications. Total cost data based on 2014 USD showed that the MSU has the highest cost in Australia ($1,410,708) and the lowest cost in the USA ($783,463).ConclusionA comprehensive analysis of current research suggests that MUS, compared with conventional EMS, has a better performance in terms of time metrics, safety, long-term medical benefits, and cost-effectiveness.
Cerebral Blood Flow Pattern Changes in Unilateral Sudden Sensorineural Hearing Loss
Authors: Chen Yue , Li Haimei , Liu Bing , Gao Wenwen , Yang Aocai , Lv Kuan , Xia Hui , Zhang Wenwei , Yu Hongwei , Liu Jian , Liu Xiuxiu , Wang Yige , Han Honglei , Ma Guolin 
Published: March 2022

ObjectiveThis study analyzed the differences in the cerebral blood flow (CBF) between unilateral Sudden Sensorineural Hearing Loss (SSNHL) patients and healthy controls (HCs). We also investigated CBF differences in auditory-related areas in patients with left- and right-sided SSNHL (lSSNHL and rSSNHL) and HCs. We further explore the correlation between unilateral SSNHL characteristics and changes in the CBF.Methods36 patients with unilateral SSNHL (15 males and 21 females, 40.39 ± 13.42 years) and 36 HCs (15 males and 21 females, 40.39 ± 14.11 years) were recruited. CBF images were collected and analyzed using arterial spin labeling (ASL). CereFlow software was used for the post-processing of the ASL data to obtain the CBF value of 246 subregions within brainnetome atlas (BNA). The Two-sample t-test was used to compare CBF differences between SSNHL patients and HCs. One-way ANOVA or Kruskal-Wallis test was used to compare the CBF difference of auditory-related areas among the three groups (lSSNHL, rSSNHL, and HCs). Then, the correlation between CBF changes and specific clinical characteristics were calculated.ResultsThe SSNHL patients exhibited decreased CBF in the bilateral middle frontal gyrus (MFG, MFG_7_1 and MFG_7_3), the contralateral precentral gyrus (PrG, PrG_6_3) and the bilateral superior parietal lobule (SPL, bilateral SPL_5_1, SPL_5_2, and ipsilateral SPL_5_4), p &lt; 0.0002. Compared with HCs, unilateral SSNHL patients exhibited increased rCBF in the bilateral orbital gyrus (OrG, OrG_6_5), the bilateral inferior temporal gyrus (ITG, contralateral ITG_7_1 and bilateral ITG_7_7), p &lt; 0.0002. lSSNHL showed abnormal CBF in left BA21 caudal (p = 0.02) and left BA37 dorsolateral (p = 0.047). We found that the CBF in ipsilateral MFG_7_1 of SSNHL patients was positively correlated with tinnitus Visual Analog Scale (VAS) score (r = 0.485, p = 0.008).ConclusionOur preliminary study explored CBF pattern changes in unilateral SSNHL patients in auditory-related areas and non-auditory areas, suggesting that there may exist reduced attention and some sensory compensation in patients with SSNHL. These findings could advance our understanding of the potential pathophysiology of unilateral SSNHL.
Effects of Preserving the Pulmonary Vagus Nerve Branches on Cough After Pneumonectomy During Video-Assisted Thoracic Surgery
Authors: Gu Shaorui , Wang Wenli , Wang Xishi , Wu Kaiqin , Zhang Xin , Xie Shiliang , Zhou Yongxin 
Published: March 2022

BackgroundCough is one of the most common complications of early-stage non-small cell lung cancer (NSCLC) after video-assisted thoracoscopic surgery (VATS). The vagus nerve plays an important role in pulmonary inflammation and the cough reflex. In this study, we attempted to reduce the incidence of postoperative chronic cough and other complications by preserving the pulmonary vagus nerve branches.Patients and MethodsThis study was a randomized controlled double-blinded trial of subjects and observers. A total of 158 NSCLC patients were enrolled. We randomly assigned 79 patients to Group A (pulmonary branch of vagus nerve preservation group) and 79 cases to Group B (conventional surgical treatment group). In the final analysis, 72 patients from Group A and 69 patients from Group B were included. The main outcome measure of the study was the occurrence of CAP or other postoperative complications within five weeks. This trial was registered with ClinicalTrials.gov (number NCT03921828).ResultsThere was no significant difference in preoperative general clinical data between the two groups. No death during the perioperative period occurred in either of the two groups. There was no significant difference between the two groups in operation time, intraoperative bleeding, number of lymph nodes sent for examination, number of cases transferred to ICU after operation, postoperative catheterization time, or postoperative hospital stay (P&gt;0.05). There was no significant difference in other pulmonary and cardiovascular complications between the two groups, including pulmonary infection (2.78% vs. 8.70%, P = 0.129), atelectasis (1.39% vs. 0%, P = 0.326), pleural effusion (2.78% vs. 1.45%, P = 0.585), persistent pulmonary leakage (2.78% vs. 2.90%, P = 0.965), arrhythmia (2.78% vs. 1.45%, P = 0.585), and heart failure (0% vs. 1.45%, P = 0.305). The incidence of CAP in Group A was significantly lower than that in Group B (13.89% vs. 30.43%, P = 0.018). The LCQ-MC scores in Group A were significantly higher than those in Group B at two and five weeks after operation (P&lt;0.05). Univariate and multivariate analysis showed that the risk factors for postoperative CAP were surgical side (right lung), surgical lung lobe (upper lobe), preservation of pulmonary branch of the vagus nerve during operation, and duration of anesthesia.ConclusionsPreserving the pulmonary vagus nerve branches during VATS in patients with stage IA1-2 NSCLC can reduce the incidence of postoperative CAP.
Parental Regret Following Decision to Revise Circumcision
Authors: Bar-Yaakov Noam , Mano Roy , Ekstein Margaret , Savin Ziv , Dekalo Snir , Ben-Chaim Jacob , Bar-Yosef Yuval 
Published: March 2022

PurposeRevision surgery for the removal of excess foreskin after circumcision is a common procedure. The decision regret scale (DRS) is a validated questionnaire which assesses regret after medical decision making. The aim was to evaluate parental regret by means of the DRS and querying about factors associated with regret about deciding to revise their child's circumcision.Patients and MethodsIncluded were all pediatric patients who underwent revision of neonatal circumcision in a single center between 2010 and 2016. Excluded were children who underwent revision for reasons other than excess foreskin, those who underwent additional surgical procedures during the same anesthetic session, and those who had undergone previous penile surgery other than circumcision. Response to the DRS questionnaire was by a telephone call with the patient's parent. Regret was classified as none (a score of 0), mild (1–25), or moderate-to-strong (26–100). Surgical and baseline demographic data were obtained from the departmental database and compared between the no regret and regret groups.ResultsOf the 115 revisions of circumcisions performed during the study period, 52 fulfilled the inclusion criteria, and the parents of 40 (77%) completed the DRS questionnaire. Regret was reported by 11/40 [28%: nine as mild (23%) and two as moderate-to-strong (5%)]. The average age of the child in the regret group was 17 months compared to 18 months in the no regret group (p = 0.27). The median weight percentile was 43% in both groups. Surgical variables, including anesthesia type (caudal vs. no block, p = 0.65), suture type (polyglactin vs. poliglecaprone, p = 0.29), operation time (28 vs. 25 min, p = 0.59), and anesthesia time (55 vs. 54 min, p = 0.57) were not significantly different between the groups.ConclusionsRegret for deciding upon revision surgery for removal of excess foreskin post-circumcision was reported by 27.5% of parents of children who underwent revision. No clinical, surgical, or demographic characteristics predicted parental decisional regret.
Public Health Graduates' Perceptions of the Educational Environment Measured by the DREEM
Authors: Xu Fang-Rong , Yang Yang 
Published: March 2022

ObjectiveStudents' perceptions of the educational environment have a significant impact on their behavior and academic progress. This study aims to measure medical graduates' perception of the educational environment within the School of Public Health at Wuhan University in China.MethodsThe survey was conducted by emails sent to 119 graduates, and 93 valid questionnaires were returned. The DREEM was used to assess the medical graduates' satisfaction with the educational environment.ResultsThe average score on the scale was 126.02 (±18.27). The scoring rate of the areas ranged between 61.06 and 67.11%. The area with the highest score was “perception of teachers.” The area with the lowest score was “academic self-perception.” No difference was found between genders. Except for “perception of atmosphere,” the total scores and other areas showed differences in graduation time.ConclusionThe educational environment at the School of Public Health at Wuhan University was satisfactory. The program contributed to the graduates' later careers. The information obtained in this study identified some areas for improvement.
Schistosomiasis Among Female Migrants in Non-endemic Countries: Neglected Among the Neglected? A Pilot Study
Authors: Roure Sílvia , Pérez-Quílez Olga , Vallès Xavier , Valerio Lluís , López-Muñoz Israel , Soldevila Laura , Torrella Ariadna , Fernández-Rivas Gema , Chamorro Anna , Clotet Bonaventura 
Published: March 2022

BackgroundSchistosomiasis among migrant populations in Europe is an underdiagnosed infection, yet delayed treatment may have serious long-term consequences. In this study we aimed to characterize the clinical manifestations of Schistosoma infection among migrant women, and the degree of underdiagnosis.MethodsWe carried out a prospective cross-sectional study among a migrant population living in the North Metropolitan Barcelona area and coming from schistosomiasis-endemic countries. We obtained clinical, laboratory and socio-demographic data from electronic clinical records, as well as information about years of residence and previous attendance at health services. Blood sample was obtained and schistosomiasis exposure was assessed using a specific ELISA serological test.ResultsFour hundred and five patients from schistosomiasis-endemic regions were screened, of whom 51 (12.6%) were female. Seropositivity prevalence was 54.8%, but considering women alone we found a prevalence of 58.8% (30 out of 51). The median age of the 51 women was 41.0 years [IQR (35–48)] and the median period of residence in the European Union was 13 years [IQR (10–16)]. Schistosoma-positive women (N = 30) showed a higher prevalence of gynecological signs and symptoms compared to the seronegative women (96.4 vs. 66.6%, p = 0.005). Among seropositive women, the median number of visits to Sexual and Reproductive Health unit prior to diagnosis of schistosomiasis was 41 [IQR (18–65)].ConclusionThe high prevalence of signs and symptoms among seropositive women and number of previous visits suggest a high rate of underdiagnosis and/or delayed diagnosis of Schistosoma infection, particularly female genital schistosomiasis, among migrant females.
The Value(s) of Vaccination: Building the Scientific Evidence According to a Value-Based Healthcare Approach
Authors: Calabro' Giovanna Elisa , Carini Elettra , Tognetto Alessia , Giacchetta Irene , Bonanno Ester , Mariani Marco , Ricciardi Walter , de Waure Chiara 
Published: March 2022

ObjectivesTo provide a new value-based immunization approach collating the available scientific evidence on the topic.MethodsFour value pillars (personal, allocative, technical, and societal) applied to vaccination field were investigated. A systematic literature review was performed querying three database from December 24th, 2010 to May 27th, 2020. It included studies on vaccine-preventable diseases (VPDs) that mentioned the term value in any part and which were conducted in advanced economies. An in-depth analysis was performed on studies addressing value as key element.ResultsOverall, 107 studies were considered. Approximately half of the studies addressed value as a key element but in most of cases (83.3%) only a single pillar was assessed. Furthermore, the majority of papers addressed the technical value by looking only at classical methods for economic assessment of vaccinations whereas very few dealt with societal and allocative pillars.ConclusionsEstimating the vaccinations value is very complex, even though their usefulness is certain. The assessment of the whole value of vaccines and vaccinations is still limited to some domains and should encompass the wider impact on economic growth and societies.
Pulpitis of Primary Teeth. Diagnostics and Clinic
Authors: Рубникович С.П. , Андреева В.А. , Бинцаровская Г.В. , Валеева З.Р. , Кузьменко Е.В. 
Published: March 2022

Пульпиты временных зубов занимают важное место в структуре стоматологической заболеваемости в Республике Беларусь, что связано с высокой распространенностью и интенсивностью кариеса во временном прикусе, анатомо-физиологическими особенностями строения пульпы и твердых тканей временных зубов у детей, а также поздней обращаемостью за стоматологической помощью.Клиническое течение воспалительного процесса в пульпе имеет свои особенности, обусловленные ее анатомо-физиологическим строением, и зависит от стадии развития корня на этапах его формирования или резорбции.
Pulpitis of primary teeth has a significant place in the structure of dental morbidity in the Republic of Belarus, which is due to the high prevalence and intensity of caries in primary dentition, anatomical and physiological characteristics of pulp and hard tissue structure of primary teeth, as well as overdue dental treatment appealability.The clinical picture of the inflammatory process in primary teeth has certain characteristics due to the anatomical and physiological structure of the pulp and depends on the stage of root development, namely on its formation or resorption phase.
Modern Pathogenetic and Clinical-Diagnostic Aspects of IgG4-Associated Disease of the Salivary Glands
Authors: Людчик Т.Б. , Артюшкевич А.С. , Гурбанов Т.В. , Степанова Ю.И. , Насибянц Н.В. , Юрага Т.М. 
Published: March 2022

В обзорной статье на основе всестороннего анализа научной литературы за последние 15 лет систематизирована информация, посвященная патогенетическим и клинико-диагностическим аспектам новой нозологической единицы в стоматологии – IgG4-связанного заболевания слюнных желез. Описаны основные этиопатогенетические механизмы формирования и клиническая картина IgG4-связанных сиалоаденитов, а также представлены современные принципы дифференциальной диагностики воспалительных поражений слюнных желез. Обоснована необходимость разработки алгоритма дифференциальной диагностики IgG4-связанного заболевания слюнных желез с другими аутоиммунными системными патологическими процессами и онкологическими заболеваниями с использованием современных методов лабораторной и инструментальной диагностики.
In a review article it has been presented information, based on a comprehensive analysis of scientific literature over the past 15 years and devoted to the pathogenetic, clinical and diagnostic aspects of a new nosological unit in dentistry – IgG4-associated disease of the salivary glands. The main etiopathogenetic mechanisms of the formation and clinical picture of IgG4-associated sialoadenitis are discussed, and modern principles of differential diagnosis of inflammatory lesions of the salivary glands are presented. The need to develop an algorithm for the differential diagnosis of IgG4- associated diseases of the salivary glands with other autoimmune systemic pathological processes and oncological diseases using modern methods of laboratory and instrumental diagnostics is substantiated.
Detection of Intraocular Foreign Bodies of the Lens by Non-Invasive Infrared Transpalpebral Transillumination
Authors: Коган М.Б. 
Published: March 2022

Травматическое повреждение глазного яблока является одной из основных причин слепоты у лиц трудоспособного возраста. Лидирующее место среди всей посттравматической патологии, которая приводит к инвалидизации, занимает проникающее ранение глазного яблока, которое в 41% случаев сопровождается наличием внутриглазного инородного тела (ВИТ). Целью нашей работы было изучить возможность визуализации внутриглазных инородных тел в хрусталике способом инфракрасной транспальпебральной диафаноскопии. Под наблюдением находилось 11 человек (11 глаз) с проникающим ранением глазного яблока и наличием ВИТ в хрусталике. Во всех случаях были выполнены: рентгендиагностика в прямой и боковой проекциях, ультразвуковое сканирование заднего отдела глазного яблока, металлодетекция, а также транспальпебральная инфракрасная диафаноскопия (ИКТД). При помощи ИКТД у всех исследуемых пациентов удалось зарегистрировать ВИТ, расположенные в проекции хрусталика при набухающих, мутных хрусталиковых массах и помутнениях роговицы. Также при диафаноскопии глаза хорошо визуализировались дефекты радужной оболочки. Были визуализированы не только рентген-позитивные, но и рентген-негативные ВИТ. Способ ИКТД у пациентов с проникающим ранением глазного яблока позволяет неинвазивно визуализировать внутриглазные инородные тела, расположенные в переднем отделе глаза, а именно хрусталике. Требуются дальнейшие исследования, которые позволят оценить возможности предложенного способа и определить его значение в диагностике внутриглазных инородных тел.
Traumatic damage of the eyeball is one of the main causes of blindness in people of working age. The leading place among the entire post-traumatic pathology that leads to disability is occupied by the penetrating wound of the eyeball, which in 41% of cases is accompanied by the presence ofan intraocular foreign body (IOFB). The purpose was to study the possibility of intraocular foreign bodies imaging in the lens with infrared transpalpebral transillumination. Under observation were 11 people (11 eyes) with a penetrating wound of the eyeball and the presence of IOFB in the lens. In all cases, the following tests were performed: X-ray diagnostics in the direct and lateral projection, ultrasound scanning of the posterior segment of the eyeball, metal detection, as well as transpalpebral infrared transillumination (IRTT). Using IRTT, in all patients, it was possible to detect IOFB located in the lens with swelling, cloudy lens masses and corneal opacities. Also, with IRTT, iris defects were well visualized. Not only X-ray-positive, but also X-ray-negative IOFB were visualized. The IRTT method in patients with a penetrating wound of the eyeball allows non-invasive imaging of intraocular foreign bodies located in the anterior segment of the eye, exactly in the lens. Further studies are required that will allow us to evaluate the capabilities of the proposed method and determine its value in the diagnosis of intraocular foreign bodies.