bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer pain: Results of a prospective study on prognostic indicators of pain intensity including pain syndromes assessment
Authors: Shkodra Morena , Brunelli Cinzia , Zecca Ernesto , Infante Gabriele , Miceli Rosalba , Caputo Mariangela , Bracchi Paola , Lo Dico Silvia , Kaasa Stein , Caraceni Augusto 
Published: September 2022

Background: Pain is a prevalent symptom in patients with advanced cancer. Recognition of prognostic factors associated with pain intensity, could help provide better assessment, leading to better pain management. Aim: identifying prognostic factors which could guide improvements on cancer pain classification. Design: a prospective observational study on chronic cancer pain, exploring the association between average mean pain intensity during a 28 days study follow-up and patients’ clinical and pain-related characteristics, including pain syndromes. To evaluate these associations, a mixed model was built. Setting/participants: Patients attending a Palliative Care and Pain Outpatient Clinic from May 2015 to June 2019 were screened. Patients with moderate to severe cancer pain who were already receiving or needed treatment with third step WHO ladder opioids were enrolled in the study. Data from 342 patients with at least one follow-up visit were analyzed. Results: Pain intensity decreased significantly for all patients during time ( p < 0.001). Age, sex, emotional distress, pain duration and neuropathic pain presence evaluated by the Douleur Neuropathique 4 Questions (DN4) questionnaire were not significantly associated to pain intensity. Breakthrough/episodic pain was associated with higher pain intensity during follow-up ( p < 0.001). The diagnosis of pain syndrome was overall significantly associated with mean pain intensity during follow-up ( p = 0.016). Particularly, the concurrent presence of visceral and soft ( p = 0.026) or soft and nervous tissue pain ( p = 0.043) were significantly related to worse outcome, whereas pain due to only soft tissue damage with better outcome ( p = 0.032). Conclusions: The recognition of specific pain syndromes may help to better classify cancer pain.
Feasibility of monitoring the resolution of acute pulmonary embolism with non-contrast-enhanced magnetic resonance imaging at one day, one week, one, three, and six months
Authors: Medson Koshiar , Westerlund Eli , Paris Roberto Vargas , Fyrdahl Alexander , Vidovic Nina , Nyren Sven , Lindholm Peter 
Published: September 2022

Background Pulmonary embolism (PE) is a common cause of death with an incidence of approximately 1–2 cases per 1000 inhabitants in Europe and the United States. Treatment for PE is the administration of anticoagulants for at least three months. Purpose To assess the feasibility of following the resolution rate of PE over time using repeated imaging with a non-contrast-enhanced magnetic resonance imaging (MRI) protocol. Material and Methods Patients (n = 18) diagnosed with acute PE via computed tomography pulmonary angiography (CTPA) underwent non-contrast-enhanced MRI at two tertiary hospitals. The first MRI was performed within 36 h of CTPA, with follow-up at one week, one, three, and six months. The MRI sequence used was a non-contrast-enhanced standard two-dimensional steady-state free precession under free-breathing and without respiratory or cardiac gating. All MRI scans were then compared to the initial CTPA. The emboli were assessed visually for location and size, and clot burden was calculated using the Qanadli score. Results MRI revealed complete resolution in seven cases at one week, in five cases at one month, and in three cases at three months. The most significant resolution of emboli occurred within the first few weeks, with only 10% of the diagnosed emboli persisting at the one-month examination. Conclusion The use of MRI imparts the ability to visualize PE without radiation and thus allows multiple examinations to be made, for example in studies investigating the resolution of PE or the evaluation of drug effect in clinical trials.
Differences in Cerebellar Volume as a Diagnostic and Prognostic Biomarker in Children and Adolescents With Epilepsy of Unknown Etiology
Authors: Glutig Katja , Lange Luisa , Krüger Paul-Christian , Gräger Stephanie , de Vries Heike , Brandl Ulrich , Gaser Christian , Mentzel Hans-Joachim 
Published: September 2022

Introduction and Objective Epilepsy is one of the most common brain diseases during childhood and adolescence. Atrophy in different brain areas is possible during epilepsy. This study aimed to verify whether cerebellar volume differences could be detected by volume analysis using magnetic resonance imaging (MRI) in children with epilepsy. Method In this retrospective study, 41 children (3.1-18.8 years) with epilepsy of unknown etiology were included (duration of epilepsy 1.9 ± 3 years). A cranial MRI with a volumetric 3-dimensional, T1-weighted sequence was used for volume analysis. The MRIs of 26 patients with headache (5.3-17.1 years) were analyzed for comparison. A volume analysis of the cerebellum was performed using region-based morphometry. Total cerebellar volume, total white and gray matter volume, and 48 regional lobules (L), separated into white and gray matter, were calculated. Cerebellar volumes are presented in relative ratios as the volume fraction of cerebellar volume to total intracranial volume: CV/TIV. Results The ratio of overall white matter volume was significantly lower in the case group (23.93 × 10−3, P = .039). A significantly lower ratio of regional white matter volume was detected in LV right ( P = .031) and left ( P = .014), in LVIIIB right ( P = .011) and left ( P = .019), and in LVIIIA left ( P = .009). Conclusion Our results emphasize that volume analysis of the total cerebellar volume alone is insufficient to characterize cerebellar differences in children with epilepsy. Rather, in specific cerebellar region volume analysis using region-based morphometry, children with epilepsy showed significantly lower regional volumes of lobules, which are important for sensorimotor function (LV, LVIII) and higher cognitive function (crus I).
Mental Health Benefits and Detriments of Caregiving Demands: A Nonlinear Association in the Canadian Longitudinal Study on Aging
Authors: Bierman Alex , Lee Yeonjung , Penning Margaret J. 
Published: September 2022

Objectives This study examines whether the association between caregiving demands and mental health is non-linear and also, whether this non-linear association is contingent on the marital status of the caregiver. Methods We analyze the data from the Canadian Longitudinal Study on Aging, applying OLS regression and quadratic interaction terms. Results A lower level of demands is salubriously associated with symptoms of depression and life satisfaction, but this association becomes deleterious at higher levels of demands. Moreover, a connection to a marital partner extends the benefits of caregiving demands and stems the adverse consequences. Discussion This research shows that acts of caregiving may not themselves be detrimental. Instead, the degree and way in which caregiving relates to mental health may vary by both the extent of the demands of the caregiving role and familial relationships in which caregivers are embedded.
Intraoperative midflexion medial laxity using navigation affects patient expectations following posterior stabilized total knee arthroplasty
Authors: Hasegawa Masahiro , Tone Shine , Naito Yohei , Sudo Akihiro 
Published: September 2022

Background Patient satisfaction and expectations are now recognized as an outcome measure for successful total knee arthroplasty (TKA). The purpose of this study was to determine which factors including soft tissue balance during surgery affect patient satisfaction and expectations after TKA. Methods A total of 135 patients (157 knees) with knee osteoarthritis who underwent primary TKA with a posterior stabilized design were studied. After implantation of all components, varus/valgus laxity of the knee was measured intraoperatively with the knee at 0°, 30°, 60°, 90°, and 120° guided by an image-free navigation system. Factors that affected patient satisfaction and expectations, including lateral and medial laxities, were evaluated using the 2011 Knee Society score. Results The mean intraoperative lateral laxity was 1.1°, 1.6°, 0.9°, 1.3°, and 1.7° with the knee at 0°, 30°, 60°, 90°, and 120°, respectively. The mean intraoperative medial laxity was 1.1°, 1.4°, 1.1°, 1.1°, and 1.7° with the knee at 0°, 30°, 60°, 90°, and 120°, respectively. Patient satisfaction after TKA correlated positively with symptom (R = 0.61, p < 0.01) and functional activity (R = 0.47, p < 0.01) scores. Patient expectations after TKA weakly positively correlated with symptom (R = 0.29, p < 0.01) and functional activity (R = 0.20, p = 0.01) scores, and weakly negatively with medial laxity at 30° (R = −0.21, p < 0.01). Conclusion Midflexion medial laxity was associated with worse patient expectations after TKA. Avoiding medial laxity could be one of the important techniques during TKA.
Comparison of the characteristics of patients treated with sublingual vs. long-acting injectable buprenorphine formulations for treatment of opioid use disorder: A retrospective cohort study
Authors: Nayer Carmen , Sveticic Jerneja , Abeysundera Hesitha , Bui Tuan Anh 
Published: September 2022

Objective Long-acting injectable buprenorphine (LAI-BPN) was introduced in recent years as a novel treatment for opioid use disorder. Despite growing evidence-base of its effectiveness, there is limited research on the relationship between this treatment and patient characteristics. Methods This descriptive, retrospective cohort study compared sociodemographic and clinical variables between patients treated with SL-BPN and those treated with LAI-BPN at a large metropolitan health service in Queensland, Australia. Results Patients that transitioned to LAI-BPN were more likely to be single, have a comorbid mental illness, untreated hepatitis C infection and longer duration of unsanctioned opioid use. Patients continuing treatment with SL-BPN were more likely to fail to attend appointments and have urine drug screen results positive for gabapentinoids. Conclusions The results of this study contribute to currently limited literature on this novel treatment option in an Australian context, highlighting factors which may influence patient and prescriber treatment choices. Clinicians may be more inclined to prescribe LAI-BPN to patients with higher psychosocial comorbidity to facilitate engagement in treatment.
Psychiatrist and trainee burnout: Commentary and recommendations on management
Authors: Looi Jeffrey CL , Allison Stephen , Bastiampillai Tarun , Brazel Matthew , Kisely Stephen R , Maguire Paul A 
Published: September 2022

Objective To comment upon the evidence-base regarding psychiatrist and trainee burnout and provide recommendations on management. Conclusions Burnout has been conceptualised as a specific stress-related response, primarily related to work. There is a high prevalence of burnout amongst both trainees and psychiatrists internationally, with substantial consequences for personal and family wellbeing, organisational efficiency and patient care. We summarise the evidence on organisational and individual approaches to addressing burnout.
Engine noise cancellation with optimum array of speakers inside vehicle enclosures
Authors: Porghoveh Mojtaba , Shirazi Kourosh Heidari , Yildizdag M. Erden 
Published: September 2022

In this study, a computational optimization framework is presented to identify active noise control systems for vehicle enclosures. The adopted optimization approach determines optimum configuration of an array of secondary sound sources to suppress noises with low frequency (under 500 Hz) due to engine performance. The overall framework is conducted via a particle swarm optimization algorithm coupled with a modified modal interaction method developed to estimate sound field inside enclosures. The applicability of the proposed optimization approach has been examined with two enclosures of different size by considering 1-speaker and 2-speaker array options as a secondary sound source. The numerical investigation shows that, with the determined optimum configurations, a significant noise reduction may be obtained in vehicle enclosures.
Combination of available topical beta-blockers and antibiotic ointment for epidermal growth factor receptor tyrosine kinase inhibitor-induced paronychia and pseudopyogenic granulomas in Taiwan
Authors: Liu Hui-Lin , Chuang Cheng-Hao , Chen Chin-Ling , Wei Po-Ju , Yang Chih-Jen 
Published: September 2022

Background Painful paronychia and pseudopyogenic granuloma (PG) are common adverse drug reactions (ADRs) associated with the use of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) to treat non-small cell lung cancer (NSCLC). Multiple local management approaches have been tested with unsatisfactory results. We have introduced an occlusion therapy technique through which available topical drugs for longer than 2 years. Methods Based on the cancer registry and case management system of our hospital, from July 2019 to July 2020, we retrospectively enrolled patients with NSCLC who were treated with EGFR-TKIs and received applications of 0.5% timolol ophthalmic solution (TIMOPTOL XE 0.5%®) combined with a neomycin/tyrothricin ointment ( Biomycin®) using the occlusion method to treat paronychia or PG. Results A total of 22 patients were enrolled, with a mean age of 66.5 years, most of whom were women (72.7%). Periungual lesion-related pain was reported by all patients, and periungual bleeding and PG were reported in 14% (3/22) and 64% (14/22) of patients, respectively. After the occlusion therapy application of timolol ophthalmic solution combined with neomycin/tyrothricin ointment twice daily, the overall response rate was 83.3%, including complete response in 18% (4/22) of cases and partial response in 68% (15/22) of cases. Conclusion We presented an occlusion method using available topical beta-blockers and antibiotic ointment for EGFR-TKI-induced paronychia and PG in Taiwan. The result is favorable. Further randomized control trial is urgent to validate our findings
Radiation recall myositis with pazopanib in a patient with soft tissue sarcoma
Authors: Varan Melike Pekyürek , Turna Hande , Öner Dinçbaş Fazilet 
Published: September 2022

Introduction Radiation recall reaction is an acute inflammatory reaction confined to previously irradiated areas that are most commonly triggered by the administration of anti-cancer agents after radiotherapy. Radiation recall myositis is a relatively rare form of radiation recall reaction. Case report Here we report a 29-year-old female patient who suffered from metastatic monophasic synovial sarcoma. 8.5 months after post-operative radiotherapy of the right thigh region, the patient suffered pain, edema, redness, and increased temperature locally on the right thigh. Physical exam showed red fixed skin, rigidity and severe tenderness of region, and thigh magnetic resonance imaging revealed dense edema areas at the addiction, semimembranous-semitendinous muscle, and superior part of the biceps femoris and vastus lateralis isointense on T1AG, hyperintense T2AG images. Based on these findings, the patient was diagnosed with pazopanib-induced radiation recall myositis. Management & outcome Pazopanib was stopped and pentoxifylline (2  × 400 mg), Vitamin E (3  × 400 mg), and methylprednisolone (2  × 8 mg) were prescribed. After 1 month, complete relief of thigh pain and marked recovery of rigidity, as well as erythema, were achieved and no recurrence of radiation recall reaction-related symptoms was observed after the pazopanib rechallenge. Discussion Myositis is a relatively rare presentation of radiation recall reaction and physicians must be aware of the symptoms of the patients who are treated by radiotherapy and pazopanib.
Clinical outcomes of Descemet membrane endothelial keratoplasty performed in eyes with keratoconus and corneal endothelial dysfunction
Authors: Dockery Philip W. , Parker Jack S. , Birbal Rénuka S. , Tong C. Maya , Parker John S. , Joubert Katelyn P. , Melles Gerrit R.J. 
Published: September 2022

Purpose To evaluate the clinical outcome of Descemet membrane endothelial keratoplasty (DMEK) performed in eyes with comorbid keratoconus (KCN) and corneal endothelial dysfunction. Methods Twenty-five consecutive eyes of 14 patients with comorbid stable KCN underwent DMEK for corneal endothelial dysfunction; best spectacle corrected visual acuity (BSCVA), maximum corneal curvature (Kmax), maximum corneal power (Pmax), central corneal thickness (CCT), and intra- and postoperative complications were assessed. Results Excluding eyes requiring re-transplantation for primary graft failure (n = 3), all eyes showed improvement in BSCVA, reaching ≥ 20/40 (0.5) in 86%, ≥ 20/25 (0.8) in 55%, and ≥ 20/20 (1.0) in 27% by one month postoperatively; 90%, 76%, and 48% by 6 months postoperatively; and 88%, 76%, and 47% by 12 months postoperatively. CCT decreased from 571μm preoperatively to 485μm at 1 month (p < 0.001) and 481μm at 12 months (p < 0.001). Kmax decreased by a median of 1.4 diopters (D) at 1 month (p = 0.003) and 3.1 D at 12 months (p = 0.021), and every eye with a preoperative Kmax ≥ 46 D demonstrated flattening. Pmax decreased by 2.1 D at 1 month (p = 0.001) and 4.0 D at 12 months (p = 0.016). Conclusion DMEK is technically feasible in eyes with comorbid KCN and may give excellent outcomes visual and refractive outcomes, including significant corneal flattening, which may potentially create a visually significant hyperopic shift in patients with severely ectatic corneas.
Evaluation of neurotrophic factor secreting mesenchymal stem cells in progressive multiple sclerosis
Authors: Cohen Jeffrey A , Lublin Fred D , Lock Christoper , Pelletier Daniel , Chitnis Tanuja , Mehra Munish , Gothelf Yael , Aricha Revital , Lindborg Stacy , Lebovits Chaim , Levy Yossef , Motamed Khorasani Afsaneh , Kern Ralph 
Published: September 2022

Background: Autologous mesenchymal stem cell neurotrophic factor–secreting cells (NurOwn®) have the potential to modify underlying disease mechanisms in progressive multiple sclerosis (PMS). Objective: This open-label phase II study was conducted to evaluate safety/efficacy of three intrathecal cell treatments. Methods: Eighteen participants with non-relapsing PMS were treated. The primary endpoint was safety. Secondary endpoints included: cerebrospinal fluid (CSF) biomarkers; timed 25-foot walk speed, nine-hole peg test (9-HPT), low-contrast letter acuity, symbol digit modalities test, and 12-item multiple sclerosis (MS) walking scale. Seventeen participants received all treatments. Results: No deaths/adverse events related to worsening of MS, clinical/magnetic resonance imaging (MRI) evidence of disease activation, and clinically significant changes in safety lab results were reported. Two participants developed symptoms of low back and leg pain, consistent with a diagnosis of arachnoiditis, occurring in one of three intrathecal treatments in both participants. Nineteen percent of treated participants achieved pre-specified ⩾ 25% improvements in timed 25-foot walk speed/nine-HPT at 28 weeks compared to baseline, along with consistent efficacy signals for pre-specified response criteria across other secondary efficacy outcomes. CSF neuroprotective factors increased, and inflammatory biomarkers decreased after treatment, consistent with the proposed mechanism of action. Conclusion: Based on these encouraging preliminary findings, further confirmation in a randomized study is warranted.
Leptomeningeal enhancement under different MS immunotherapies: A monocentric retrospective cohort study of 214 patients
Authors: Friedli Christoph , Wagner Franca , Hammer Helly Noemi , Kamber Nicole , Wiest Roland , Diem Lara , Chan Andrew , Salmen Anke , Hoepner Robert 
Published: September 2022

Background: Leptomeningeal inflammation in patients with multiple sclerosis (MS) mainly affects meningeal B-cell follicle-like structures linked to cortical and subpial lesions and can be visualized as leptomeningeal enhancement (LME). Objective: To evaluate the evolution of LME under different MS immunotherapies. Methods: A total of 214 MS patients treated with anti-CD20 therapies or fingolimod at the university hospital Bern were screened for LME. Magnetic resonance imaging (MRI) and medical records were retrospectively evaluated, and comparative statistics were applied. Results: We compared MS patients treated with anti-CD20 therapies (128 patients (59.8%)) or fingolimod (86 patients (40.2%)). Of 128 anti-CD20-treated patients, 108 (84.4%) had no LME, 11 (8.6%) had persistent LME, and 9 (7.0%) showed resolution of LME. Of 86 fingolimod-treated MS patients, 81 (94.2%) had no LME and 5 (5.8%) persistent LME. Patients with LME persistence were older than those without or resolution of LME ( p = 0.039). Resolution of LME was more frequent during anti-CD20 compared with fingolimod treatment ( p = 0.019). Conclusion: We observed LME resolution under treatment with anti-CD20 therapies. As LME might play an important role in cerebral gray matter pathology in MS, further investigations including extensions to higher field strengths, correlation with clinical phenotypes, and comparison with other immunotherapies are needed.
Immersion in dual-language programs does not impede children’s native language processing
Authors: Neveu Anne , Gangopadhyay Ishanti , Ellis Weismer Susan , Kaushanskaya Margarita 
Published: September 2022

Aims and Objectives: The benefits of dual-language immersion (DLI) versus English-only classrooms for minority-language speakers’ acquisition of English have been well documented. However, less is known about the effect(s) of DLI on majority-language speakers’ native English skills. Prior studies largely used accuracy-focused measures to index children’s language skills; it is possible that processing-based tasks are more sensitive to the effects of DLI experience. Methodology: Thirty-three monolingual native English-speaking children attending English-only classrooms and thirty-three English-speaking children attending English-Spanish DLI matched in age, gender, nonverbal IQ, and socio-economic status were tested twice, 1 year apart, on standardized and processing-based measures of English vocabulary and morphosyntax. Analysis: We ran linear mixed-effects models to examine the extent to which group and time would predict scores on knowledge-based measures of vocabulary and morphosyntactic knowledge, as well as accuracy and reaction times on processing-based measures of English vocabulary and morphosyntax. Findings: Results revealed comparable levels of growth in English for both groups. A subtle effect of DLI was observed on a lexical-decision task: bilinguals were slower in Year 1 but both groups were equally efficient in Year 2. These results indicate that DLI programs have minimal impact on majority-language speakers’ native-language skills in the age-range tested. Originality: This study is the first to longitudinally examine processing-based native language outcomes in bilingual children in DLI classrooms. Significance: We do not find evidence that DLI exposure carries a cost to native language development, even when indexed by processing measures. This should reassure parents, educators, and policymakers in that there are no downsides to DLI.