bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Spindle Cell Population in a Case of Primary Osteoma Cutis With GNAS Mutation
Authors: Beatty Colleen , Zinn Zachary , Schultz Charles , Lynch Michael C.
Published: January 2020

Primary osteoma cutis is a rare condition belonging to a spectrum of related genetic disorders, including progressive osseous heteroplasia, plate-like osteoma cutis, and Albright hereditary osteodystrophy, which share identical histologies with cutaneous intramembranous ossification and mutations in GNAS. We report a case of a 15-week-old girl who presented with an enlarging, indurated subcutaneous lesion on her right flank. CT scan showed an extensive subcutaneous sheet of calcification. Histologic evaluation revealed heterotopic calcification and intramembranous ossification within the dermis and mature bone largely replacing the subcutaneous fat compatible with osteoma cutis. Molecular testing was performed and identified an inactivating GNAS mutation. Unique to this case is a dermal proliferation of bland spindle cells that blended with deposited osteoid material. This has not been reported in association with primary osteoma cutis previously. These spindle cells were positive for CD44, Bcl-2, muscle-specific actin, and smooth muscle actin while negative for CD34. We hypothesize that these cells are immature mesenchymal cells, representing an early cellular phase of ossification. We favor these cells provide the background in which ossification is occurring, supporting the theory of osteoblastic metaplasia in the etiology of this condition.
Is the Association of Early Day Care Attendance with Childhood Asthma Explained by Underlying Susceptibility?
Authors: Rantala Aino K. , Magnus Maria C. , Karlstad Øystein , Stigum Hein , Håberg Siri E. , Nafstad Per , Nystad Wenche , Jaakkola Jouni J. K.
Published: January 2020

Background:

Previous studies of early day care attendance and asthma development are inconsistent, which may be explained by inadequate control of confounding and effect modification. We examined the effect of early day care on the risk of asthma taking into account the underlying susceptibility to asthma.

Methods:

The study included 55,404 children participating in the Norwegian Mother, Father and Child Cohort Study. Asthma at age 7 was defined by dispensed asthma medications in the Norwegian Prescription Database. We defined a disease risk score (DRS) to account for an underlying susceptibility to asthma including a range of hereditary and nonhereditary predictors of asthma. We assessed confounding and modifying effects of DRS on the association between day care and asthma.

Results:

Day care before 18 months was associated with a lower risk of asthma by age 7 (adjusted risk ratio [RR] = 0.85; 95% confidence interval [CI] = 0.78, 0.92) when compared with home care. DRS modified the estimated effect of day care on asthma risk. Among the 80% of children with DRS between 0.03 and 0.16, day care was associated with a reduced asthma risk (RRs between 0.79 and 0.87), whereas among 0.5% of children with a high DRS (above 0.28), estimated effect of day care on asthma increased gradually (RR for the highest DRS 2.2; 1.0–4.9).

Conclusions:

In our study, among most children, early day care was associated with reduced asthma risk at 7 years, and increased risk in a small group of children with very high underlying susceptibility to asthma.
Predicting fetoplacental mosaicism during cfDNA-based NIPT
Authors: Neofytou Maria
Published: January 2020

Purpose of review

Cell-free DNA-based noninvasive prenatal testing (cfDNA-based NIPT) using maternal blood is highly sensitive for detecting fetal trisomies. However, false-positive and false-negative results can occur, which prevents NIPT from being a diagnostic test. Fetoplacental mosaicism is one of the main reasons for discordant test results. It is therefore important to understand this phenomenon to enable more comprehensive and appropriate genetic counselling. The present review aims to summarize the current knowledge of fetoplacental mosaicism ascertained during cfDNA-based NIPT and refers to the development of recent analytical pipelines for its detection during pregnancy.

Recent findings

Publications are emerging demonstrating that genome-wide approaches to analyzing cfDNA can detect chromosomal aneuploidy other than the common trisomies. Despite the high accuracy of current cfDNA-based NIPT, a substantial number of false-positive and false-negative test results remain. Biological causes, such as fetal or (confined) placental mosaicism have been identified using advanced bioinformatics algorithms. Fetoplacental mosaicism can occur as part of normal pregnancy development, hence clinical practice standards recommend confirmation of positive NIPT results with a diagnostic karyotype or microarray study.

cfDNA-based NIPT for fetal chromosomal aneuploidies is not diagnostic because of false-positive and false-negative test results. Recently, novel algorithms have been described that identify pregnancies with an increased risk of fetoplacental mosaicism. Reporting the presence of fetoplacental mosaicism during pregnancy can influence risk estimation and improve genetic counseling.
Analysis of Chest Masculinization Surgery Results in Female-to-Male Transgender Patients: Demonstrating High Satisfaction beyond Aesthetic Outcomes Using Advanced Linguistic Analyzer Technology and Social Media
Authors: Black Cara K. , Fan Kenneth L. , Economides James M. , Camden Rachel C. , Del Corral Gabriel A.
Published: January 2020

Background:

Satisfaction rates are reported as high after subcutaneous mastectomy for chest masculinization. We examined patient satisfaction based on linguistic analysis of social media posts showing postoperative results and compared them to aesthetic quality ratings from plastic surgeons.

Methods:

Fifty publicly available images of subcutaneous mastectomy postoperative results of female-to-male gender transition patients were selected from Instagram. The photograph’s corresponding post and comments were then analyzed for sentiment through the IBM Watson tone analyzer, which rated the presence of joy on a continuous scale from 0 to 1. Three plastic surgeons rated aesthetic quality on an ordinal scale of 1 to 10. Results of both analyses were then compared.

Results:

Joy was rated as a mean value of 0.74 (±0.13) in posts and 0.81 (±0.13) in comments. The mean ratings of results were found to be chest contour 6.1 of 10 (±1.7), scar position 5.3 of 10 (±1.8), scar quality 4.8 of 10 (±1.9), nipple position 5.2 of 10 (±1.9), and nipple quality 5.1 of 10 (±2.0). A positive relationship was found between post joy and nipple quality (r = 0.33, P = 0.0169). There were no other associations detected between level of joy and the ratings of results by plastic surgeons (P > 0.05).

Conclusions:

Despite wide variety in surgical appearance, there is a high level of satisfaction and community support. This is in contrast to the low-quality ratings by plastic surgeons. The results demonstrate the strong psychological and functional underpinnings chest masculinization has for patients. However, surgical results can be improved through a variety of techniques such that patients have both excellent surgical results and high satisfaction.
Comparative Analysis of Two Automated Fat-processing Systems
Authors: An Yang , Panayi Adriana C. , Mi Bobin , Fu Siqi , Orgill Dennis P.
Published: January 2020

Background:

Plastic surgeons desire more efficient methods of processing lipoaspirate when performing fat grafting procedures. We compared, in a preclinical study, the quantity and quality of lipoaspirate processed by a novel Poloxamer Wash, Absorption, mesh filtration System (PWAS) to a frequently used Ringer’s Lactate wash, Decant, and mesh filtration System (RLDS).

Methods:

Lipoaspirate from 10 patients was processed with the RLDS and PWAS systems. The processed lipoaspirate from each device was centrifuged to quantify the amount of fat, free oil, and aqueous components remaining in the fat graft. A trypan blue dye exclusion test assessed cell viability. The processing time for the lipoaspirate was also measured.

Results:

The 10-patient average fat volume processed and available for grafting was similar using both systems. The adipose volume fraction of PWAS was greater (89% ± 3%) than RLDS (76% ± 10%, P = 0.02). The trypan blue exclusion values and processing time were similar for both systems. Oil was efficiently removed from the lipoaspirate, and both systems processed fat efficiently.

Conclusion:

The PWAS effectively cleans lipoaspirate with increased fat concentration.
Mid-Term Outcome after Selective Neurotization of the Infraspinatus Muscle in Patients with Brachial Plexus Birth Injury
Authors: Grahn Petra M. , Sommarhem Antti J. , Lauronen Leena M. , Nietosvaara A. Yrjänä
Published: January 2020

Background:

Active shoulder external rotation in adduction can be restored by selective neurotization of the infraspinatus muscle with the spinal accessory nerve in select patients with brachial plexus birth injury. Does the improved shoulder external rotation stand the test of time?

Methods:

Fourteen consecutive brachial plexus birth injury patients with active shoulder external rotation in adduction of ≤ 0 degrees and active shoulder elevation ≥ 90 degrees underwent selective neurotization of the infraspinatus muscle at mean 2 years of age between 2012 and 2016. All 14 patients had congruent shoulders joints with passive external rotation in adduction of 30 degrees. Pre-and postoperative electromyography was done to seven patients. Shoulder function and the subjective outcome was assessed after a mean follow-up of 3.8 years.

Results:

Shoulder external rotation in adduction improved by a mean 57 degrees in the 12 children who did not develop shoulder internal rotation contracture. Shoulder external rotation in abduction and shoulder abduction increased in all 14 patients. Reinnervation of the supraspinatus muscle was evident in all seven children who underwent postoperative EMG. Thirteen patients’ parents were satisfied with the outcome.

Conclusions:

Functionally significant shoulder external rotation can be restored and maintained by reinnervation of the infraspinatus muscle in brachial plexus birth injury patients with congruent shoulder joints, if internal rotation contracture does not develop.
Exploration of Robotic Direct to Implant Breast Reconstruction
Authors: Parcells Alexis , Spiro Scott
Published: January 2020

Breast reconstruction has undergone significant innovation over the past 50 years. Both the development of nipple sparing mastectomy and the use of acellular dermal matrices have facilitated the concept of direct to implant (DTI) reconstruction. The next step in this evolution is further limiting the length of incisions as well as placing access in a more remote location. A robot-assisted surgical approach for DTI reconstruction (R-DTI) with an acellular dermal matrix scaffold is feasible and addresses limitations with open approaches and ergonomics. The authors performed a cadaveric exploration to demonstrate proof of concept and feasibility for an R-DTI following a robot-assisted nipple sparing mastectomy. Tremor stabilization, direct visualization, endo-wristed robotic instrumentation, and exposure were noted as key benefits over existing open DTI reconstruction techniques. Additionally, the ability to have a more remote access to entry at the perimeter of the breast eliminated incisional tension which can jeopardize reconstructive results. Further exploration and procedure refinements are warranted.
Uncertainty Analysis of Consequence Management Data Products
Authors: Cochran Lainy D. , Eckert Aubrey C. , Hunt Brian , Kraus Terry
Published: January 2020

An interlaboratory effort has developed a probabilistic framework to characterize uncertainty in data products that are developed by the US Department of Energy Consequence Management Program in support of the Federal Radiological Monitoring and Assessment Center. The purpose of this paper is to provide an overview of the probability distributions of input variables and the statistical methods used to propagate and quantify the overall uncertainty of the derived response levels that are used as contours on data products due to the uncertainty in input parameters. Uncertainty analysis results are also presented for several study scenarios. This paper includes an example data product to illustrate the potential real-world implications of incorporating uncertainty analysis results into data products that inform protective action decisions. Data product contours that indicate areas where public protection actions may be warranted can be customized to an acceptable level of uncertainty. The investigators seek feedback from decision makers and the radiological emergency response community to determine how uncertainty information can be used to support the protective action decision-making process and how it can be presented on data products.
A Mixed-methods Approach for Improving Radiation Safety Culture in Open-source University Laboratories
Authors: Root Caitlin M. , DeVol Timothy A. , Sinclair Robert R. , Martinez Nicole E.
Published: January 2020

The radiation safety culture of those working in university open-source radioactive material laboratories was assessed by conducting both surveys and behavioral observations. Baseline results (n = 82, 89% response rate) of assessed safety culture categories indicated safety practices and safety compliance were the most in need of improvement. Specific training based on these results was provided to laboratory members at Princeton University, with creative signage and a safety newsletter posted in and around laboratories for reinforcement, in a targeted effort to improve the radiation safety culture. Signage posted utilized pop cultural memes and other engaging graphics designed to raise awareness of appropriate safety practices and the minimum laboratory attire expected while working in radioactive material laboratories. Postintervention results (n = 38, 43% response rate) indicated improvement in 4 out of the 10 safety culture indicators considered as well as fewer instances of improper safety practices. Collaborative techniques and increased communication between researchers and radiation safety staff appear to have initiated an improvement in the radiation safety culture in open-source radioactive material laboratories at Princeton University.
Dupilumab-Associated Conjunctivitis in Patients With Atopic Dermatitis
Authors: Liberman Paulina , Shifera Amde Selassie , Berkenstock Meghan
Published: January 2020

Purpose:

To report the occurrence of conjunctivitis associated with the use of dupilumab in patients with atopic dermatitis.

Methods:

A retrospective small case series.

Results:

The first case was a 56-year-old man who developed conjunctivitis 2 weeks after starting dupilumab. The second case was a 19-year-old man who developed blepharoconjunctivitis 3 months after staring dupilumab. The ocular inflammation in both cases resolved rapidly and remained controlled with topical steroid drops without necessitating the discontinuation of dupilumab. However, the second patient had already developed conjunctival cicatrization in 1 eye at the time of presentation.

Conclusions:

The pathophysiology and the risk factors for the development of conjunctivitis in patients who take dupilumab for atopic dermatitis are not completely understood. However, topical steroid treatment halts the inflammation effectively without discontinuation of dupilumab therapy.
Shared liability to pain, common mental disorders, and long-term work disability differs among women and men
Authors: Narusyte Jurgita , Ropponen Annina , Mittendorfer-Rutz Ellenor , Svedberg Pia
Published: January 2020

Knowledge of factors involved in the associations between pain, common mental disorders, and future work incapacity is still scarce. The aim of this study was to examine the overlap between genetic and environmental factors contributing to depression/anxiety, pain, and future long-term sickness absence (SA) and disability pension (DP) among women and men. The study sample included 47,995 twins born in Sweden 1935 to 1985. Information on self-reported depression/anxiety and back, neck, and shoulder pain was obtained from surveys conducted 1998 to 2002 and 2004 to 2005. Data on long-term SA (>365 days) and DP due to mental and/or musculoskeletal disorders until 2013 were obtained from the National Social Insurance Agency. Shared genetic and environmental influences on depression/anxiety, pain, and SA/DP were estimated by applying structural equation modeling. The prevalence of depression/anxiety was 27% and 14% among women and men, for pain 24% and 19%, and for SA/DP due to mental and musculoskeletal diagnoses 7% and 4%, respectively. Multivariate biometric analyses revealed different patterns of covariation between the 3 phenotypes among women and men. For women, a latent-shared liability to all 3 phenotypes could be identified, mainly attributable to genetic factors (66%). For men, no shared underlying liability was observed. The variation in SA/DP was explained by genetic factors in common with depression/anxiety by 27% and in common with pain by 9%. Common mental disorders, pain, and SA/DP tend to covariate in different ways among women and men. The results may have clinical implications as strategies preventing SA/DP may be different among women and men.
Mechanism of aseptic inflammation upon the inner ear injury
Authors: Wang Yanmei , Ren Dongdong
Published: January 2020

Many factors can cause inner ear injury, such as noise exposure, chemicals, viral infection, and radiation. The main pathological manifestations of inner ear injury are local hypoxia-ischemia, micro-trauma, and an increased level of reactive oxygen species and inflammatory mediators. The contribution of the inflammatory response to the mediation of cochlear and vestibular pathologies has received increasing attention in recent years. Aseptic inflammation can devastate audition and balance, which can lead to many typical clinical inner ear diseases. In this review, we will discuss the most pertinent and recent research on inflammatory mechanisms in inner ear injury. We will also discuss the pathophysiology of some common and significant ear diseases, such as sudden sensorineural hearing loss, age-related hearing loss, noise-induced hearing loss, and Meniere’s disease.
The recent progress and therapy in endometriosis-associated ovarian cancer
Authors: Su Kuo-Min , Wang Peng-Hui , Yu Mu-Hsien , Chang Chia-Ming , Chang Cheng-Chang
Published: January 2020

Endometriosis-associated ovarian cancers (EAOCs) including endometrioid and clear cell ovarian carcinoma are subgroups of epithelial ovarian carcinomas (EOCs), which is generally acknowledged as the most lethal gynecological malignancy. Endometriosis (ES), a common clinical disease among women, presents with clinical symptoms of pelvic pain, infertility, or adnexal masses with the formation of endometrioma. It has long been considered to be a potential risk factor for developing EOCs, mainly of endometrioid and clear cell subtypes. Here, we compiled data from previous researches on deregulated molecular functions among ES and EOCs using gene set–based integrative analysis to decipher molecular and genetic relationships between ovarian ES and EOCs, especially EAOCs. We conclude that epidermal growth factor receptor (ERBB) and Phosphoinositide 3-kinases (PI3K)-related pathways are important in the carcinogenesis of type I EOCs, including clear cell, endometrioid, and mucinous ovarian carcinoma. Dysfunctional molecular pathways, such as deregulated oxidoreductase activity, metabolism, hormone activity, inflammatory response, innate immune response, and cell–cell signaling, played key roles in the malignant transformation of EAOCs. Nine genes related to inflammasome complex and inflammasome-related pathway were identified, indicating the importance of inflammation/immunity in EAOC transformation. We also collect progressive treatments of EAOC focused on targeted therapies and immunotherapy so far. This summarized information can contribute toward effective detection and treatment of EAOCs in the future.
Networks Among Racial and Ethnic Minority Men Who Have Sex With Men in HIV Research in the United States: A Concept Analysis
Authors: Bonett Stephen
Published: January 2020

In the past 10 years, research has proliferated investigating the effects of sexual and social networks on the transmission of HIV, especially among racial/ethnic minority men who have sex with men (MSM). This research, however, has been inconsistent in its application of social network theory leading to variations in the measurement of networks and a lack of clarity in the interpretation of results from studies of network data. Efforts to delineate how networks are defined, measured, and interpreted are needed to advance the science of HIV prevention and promote health equity. The aims of this article are to review the literature around networks among racial/ethnic minority MSM, use concept analysis methods to clarify the definition and scope of the concept of networks, and to develop a network typology that can be used to guide measurement and interpretation of networks for HIV research with racial/ethnic minority MSM.
Changes in Health-Related Quality of Life for Older Persons With Cognitive Impairment After Hip Fracture Surgery: A Systematic Review
Authors: WANTONORO Wantonoro , KUO Wen-Yu , SHYU Yea-Ing Lotus
Published: January 2020

Background

Hip fractures in persons with cognitive impairments represent a major public health issue in older populations that often results in poor health-related quality of life (HRQoL).

Purpose

The aim of this systemic review was to examine the changes in HRQoL in older, cognitively impaired patients with hip fracture who had received surgical treatment.

Methods

A literature search of PubMed, Scopus, MEDLINE, PsycINFO, and CINAHL (EBSCO) databases was conducted for studies published up to July 2018 that addressed the issue of HRQoL in cognitively impaired patients with hip fracture after surgery. Studies that met the following criteria were included: Patients with hip fracture were over 60 years old and had cognitive impairment or dementia, patients had undergone hip fracture repair surgery, HRQoL was determined using standardized questionnaires, a descriptive or interventional methodology was used, and the full-text article was available in English.

Results

A primary search of databases yielded 1,528 studies, 621 duplicates were removed, and the remaining 907 abstracts were screened. Thirty-four full-text articles were deemed relevant for full review; of these, 10 articles met the criteria for inclusion in the review. Cognitive impairment was found to impact negatively on the patients' HRQoL after hip fracture surgery (n = 809). Severity of cognitive impairment was correlated with deterioration in HRQoL after hospital discharge. When compared with prefracture measures of HRQoL, the greatest deterioration in HRQoL postsurgery occurred during the first 4 months after discharge. Impacts on HRQoL for patients with cognitive impairment at later time points differed depending on type of hip fracture and type of surgical treatment. However, for most of the patients, HRQoL remained relatively unchanged at 6, 12, and 24 months postdischarge.

Conclusions

We recommend nursing care interventions for older persons with cognitive impairment be initiated immediately after surgery for hip fracture to prevent a significant decline in HRQoL. Further examination of interventions that are effective in maintaining HRQoL for these patients such as interdisciplinary care is necessary. In addition, the influences of hip fracture type and surgical approach on changes in HRQoL suggest a need for further investigations to determine what contributed to the observed inconsistencies in the outcomes.
Sex Differences and Reporting of SCAT-5 Concussion Symptoms in Adolescent Athletes
Authors: Bunt Stephen C. , Didehbani Nyaz , Tarkenton Tahnae , Rossetti Heidi , Hicks Cason , Vargas Bert , Silver Cheryl , Nakonezny Paul , Bell Kathleen , Batjer Hunt , Cullum C. Munro
Published: January 2020

Objective:

To elucidate specific symptoms that may differ between adolescent female and male athletes after a sports-related concussion (SRC) and identify symptoms that may require greater clinical attention by medical and athletic staff.

Design:

Prospective.

Setting:

This study is part of a larger research project conducted at clinics in the North Texas Concussion Network (ConTex) Registry.

Participants:

Subjects (N = 491) aged 12 to 18 years who sustained a diagnosed SRC within 30 days of clinic visit.

Independent Variables:

Sex (female vs male). Covariates included age, race, current mood (anxiety and depression), learning disability/ADHD, and time to clinic.

Main Outcome Measures:

Twenty-two individual postconcussion symptoms as measured by the Post-Concussion Symptom Scale from the Sport Concussion Assessment Tool-5 (SCAT-5).

Results:

Girls endorsed higher levels of anxiety and depression symptoms at initial clinic visit. analysis of covariance results revealed that girls had significantly greater symptom severity of headache, dizziness, sensitivity to light, sensitivity to noise, pressure in the head, feeling slowed down, fatigue, and drowsiness than boys. Ordinal logistic regression results also revealed that girls had significantly greater predicted odds of higher symptom severity on these 8 symptoms and in trouble concentrating than boys.

Conclusions:

Closer examination of specific symptoms with attention to patients' current levels of anxiety and depression symptoms may better inform medical and athletic staff to anticipate and address symptoms that may present greater challenges for adolescent girls than boys.
Audiometric Predictors of Bothersome Tinnitus in a Large Clinical Cohort of Adults With Sensorineural Hearing Loss
Authors: Lewis Rebecca M. , Jahn Kelly N. , Parthasarathy Aravindakshan , Goedicke William B. , Polley Daniel B.
Published: January 2020

Objective:

To identify demographic and audiometric predictors of bothersome tinnitus within a large clinical cohort.

Study Design:

Retrospective chart review.

Setting:

Tertiary care hospital.

Patients:

51,989 English-speaking patients between 18 and 80 years of age that received initial audiometric evaluations at the Massachusetts Eye and Ear Infirmary between the years 2000 and 2016.

Main Outcome Measures:

Patients were categorized according to whether or not tinnitus was the primary reason for their visit. The likelihood of tinnitus as a primary complaint (TPC) was evaluated as a function of age, sex, and audiometric configuration. Patient-reported tinnitus percepts were qualitatively assessed in relation to audiometric configuration.

Results:

Approximately 20% of adults who presented for an initial hearing evaluation reported TPC. The prevalence of TPC increased with advancing age until approximately 50 to 54 years, and then declined thereafter. In general, men were significantly more likely to report TPC than women. TPC was statistically associated with specific audiogram configurations. In particular, TPC was most prevalent for notched and steeply sloping hearing losses, but was relatively uncommon in adults with flat losses. Patients with frequency-restricted threshold shifts often reported tonal tinnitus percepts, while patients with asymmetric configurations tended to report broadband percepts.

Conclusions:

The probability of seeking audiological evaluation for bothersome tinnitus is highest for males, middle-aged patients, and those with notched or high-frequency hearing losses. These findings support the theory that tinnitus arises from sharp discontinuities in peripheral afferent innervation and cochlear amplification, which may induce topographically restricted changes in the central auditory pathway.
A Mouse Model of Tinnitus Using Gap Prepulse Inhibition of the Acoustic Startle in an Accelerated Hearing Loss Strain
Authors: Park So Young , Kim Min Jung , Park Jung Mee , Park Shi Nae
Published: January 2020

Hypothesis:

To develop a mouse model for temporary and persistent tinnitus using the gap startle paradigm.

Background:

Behavioral animal models for tinnitus are classified into conditioning- and reflex-based types. Gap prepulse inhibition of the acoustic startle (GPIAS) is based on the acoustic startle modification by a silent gap and gap detection deficit caused by tinnitus gap filling.

Methods:

We used C57BL/6J mice inherently susceptible to hearing loss and potentially predisposed to tinnitus. They were divided into the control, salicylate-induced tinnitus, and noise-induced tinnitus groups. Mice were tested with the auditory brainstem response at four frequencies (8, 16, 24, and 32 kHz) and GPIAS in three carrier conditions, 16 and 24 kHz narrow band noises (NBNs) and broadband noise, at multiple time points before and after treatment. The ratio between the gap startle and no-gap startle amplitudes was analyzed by a repeated measures design. In addition, the number of tinnitus-positive mice meeting a specified criterion was counted.

Results:

Salicylate/unilateral noise trauma resulted in temporary/permanent tinnitus evidenced by GPIAS reduction. GPIAS reduction was the most significant at 16 kHz NBN among the three carriers in both tinnitus groups. Control mice also showed good gap detection performance at 16 kHz NBN, which is in the most sensitive hearing range in mice.

Conclusion:

The GPIAS test in C57BL/6J mice was very reliable at 16 kHz NBN. This tinnitus model developed in the mouse strain of accelerated hearing loss can be used with two options of temporary and persistent tinnitus.
Piezosurgery in Translabyrinthine-Approach Exposure of the Internal Auditory Canal
Authors: Lyutenski Stefan , Bloching Marc
Published: January 2020

Objective:

To assess the applicability of the piezoelectric device in translabyrinthine-approach exposure of the internal auditory canal.

Methods:

In three cases with vestibular schwannoma, the bone around the internal auditory canal was completely removed by means of piezosurgery. Evaluation was performed by an experienced surgeon, and a second relatively inexperienced surgeon.

Results:

Irrespective of surgical experience, piezosurgery proved to be a safe method for exposure of the internal auditory canal. Compared with the conventional procedure it provides an improved surgical view and more precise bone removal in a narrow operating field. This novel technique has the characteristics to reduce the corresponding risk of accidental slipping with consequent thermal and mechanical injury to the dura and neurovascular structures. The major disadvantage of piezosurgery is the longer time required for bone removal.

Conclusion:

The micro-oscillating piezoelectric device is a useful adjunct to the rotating burr during removal of the bone around the internal auditory canal in translabyrinthine approach. It could reduce the risk of injury to neurovascular structures at the bone-to-soft tissue interface.
Comprehensive application of high tibial osteotomy, chronic distraction tissue regeneration, and computer-assisted external fixation in the treatment of severe knee osteoarthritis
Authors: Zhang Weiye , Wan Chunyou , Zhang Tao , Wang Mingjie , Liu Zhao , Zhang Ningning , Zhao Yuanhang
Published: January 2020

Rationale

Knee osteoarthritis (KOA) is a common disease. It has long been believed that the main causes of KOA are knee degenerative diseases, trauma, overwork, and labor habits. However, long-term deformity leads to uneven stress on the surface of the knee joint, and the cause of lower limb force line damage has not been taken seriously. Comprehensive application of high tibial osteotomy (HTO), chronic distraction tissue regeneration, and computer-assisted external fixation for the treatment of severe KOA has many advantages over total knee arthroplasty, such as lasting and thorough orthopedic effects, a lower cost, and a faster recovery.

Patient concerns

The patient was a 48-year-old male with KOA caused by long-term genu varus, resulting in pain in both knees, especially in the right knee. The right knee pain had been aggravated for 2 years, and he was admitted to the hospital for left knee pain for 1 month.

Diagnoses

X-ray: The patient has right KOA and varus deformity

Interventions

Comprehensive application of HTO, chronic distraction tissue regeneration technology, and computer-assisted external fixation technology has a good therapeutic effect for patients with KOA and varus.

Outcomes

The patient's severe genu varus was corrected, the bone and soft tissue regeneration was good, the lower limb force line was improved, lower limb function was restored well, and the treatment was satisfactory.

Conclusion

For the treatment of KOA patients with genu varus, the combination of HTO, chronic distraction tissue regeneration, and computer-assisted adjustment of external fixation technology have a good effect on the correction of genu varus deformity and the recovery of the lower limb force line. This treatment method is also conducive to preventing postoperative infection and avoiding secondary trauma caused by the removal of internal fixation plates.
Extremity fractures in patients presenting with traumatic spinal fractures and spinal cord injury
Authors: Wang Hongwei , Wu Deluo , Xu Weijie , Zhu Yunpeng , Liu Huan , Li Changqing , Liu Jun , Ou Lan , Xiang Liangbi
Published: January 2020

Clinical features of extremity fractures (EFs) in patients presenting with traumatic spinal fractures (TSFs) and spinal cord injury (SCI) have not been investigated. To investigate the clinical features and risk factors for EFs in patients presenting with TSFs and SCI.

Data from 1392 patients presenting with TSFs and SCI in our hospitals between 2001 and 2010 were retrospectively reviewed, among which 165 patients (129 males and 36 females, 37.5 ± 10.6 years old) presented with EFs. The clinical features of EFs have been investigated.

The frequencies of upper limb fractures were significantly higher in the motor vehicle collisions (MVCs) group than in the high-fall group (P = .012) and the struck-by-object group (P = .002). The frequencies of lower limb fractures were significantly higher in the struck-by-object group (P = .019) and the high-fall group (P = .011) than the MVCs group. Univariate logistic regression analysis show that being in the 19 to 39 age group (P = .001), having a lumbar spinal fracture (P < .001) and experiencing a high fall (P < .001) were risk factors for EFs. Multivariate logistic regression analysis showed that we should focus on the factors that having a lumbar spinal fracture and experiencing a high fall.

High fall and MVCs were the most common aetiologies for EFs. Having a lumbar spinal fracture and experiencing a high fall were significant risk factors for EFs. We should make early diagnoses and initiate timely treatment according to different patterns of extremity fractures in patients with TSFs and SCI.
Intraocular infiltration of Philadelphia chromosome-positive acute lymphoblastic leukemia diagnosed by polymerase chain reaction from the aqueous humor
Authors: Hiraoka Miki , Ohguro Hiroshi , Ikeda Hiroshi , Furuya Daisuke , Takahashi Satoshi
Published: January 2020

Rationale:

Intraocular manifestation of hematopoietic tumors is rare and often difficult to distinguish from inflammation. We report a patient with acute lymphoblastic leukemia (ALL) who developed intraocular infiltration during the remission period.

Patient concerns:

A 40-year-old man presented with hypopyon in his right eye. Three months later, extensive subretinal infiltration and the elevation of intraocular pressure were observed. Fourteen months prior to this, he had been diagnosed with Philadelphia chromosome-positive ALL, and had received chemotherapy and bone marrow transplantation that resulted in complete remission.

Diagnosis:

The breakpoint cluster region-Ableson (BCR/ABL) chimera was detected by polymerase chain reaction (PCR) analysis in the patient's aqueous humor. Additionally, a high expression of WT1 (Wilms tumor gene) mRNA in the aqueous humor was discovered. A bone marrow examination yielded a high expression of BCR/ABL fusion gene, and it was determined the patient had experienced a relapse of ALL.

Interventions:

The dasatinib was administered orally to the patient.

Outcomes:

The intraocular infiltration disappeared, and intraocular pressure was normalized.

Lessons:

Intraocular infiltration in leukemia patients may be an indication of relapse regardless of systemic conditions. Analyzing mRNA expression of BCR/ABL and WT1 of ocular fluid in patients with hypopyon is beneficial in diagnosing topical relapses in leukemia.
A systematic review protocol of Tuina for children with acute bronchitis
Authors: Feng Huichao , Rong Jiao , Pei Ke , Jing Fushi , Zhuang Qian , Lu Tianjiao , Jing Fujie , Yang Jiguo
Published: January 2020

Background:

Acute bronchitis (AB) is a common cause of childhood morbidity. Tuina, a kind of Chinese massage, is frequently used for the treatment of AB in children by traditional Chinese medicine doctors. However, there is no relevant systematic review show its effectiveness and safety. The study aims to evaluate the effectiveness and safety of Tuina for children with AB.

Methods:

The following electronic databases will be searched from the respective dates of database inception to January 1st, 2020: The Cochrane Library, Web of Science, the World Health Organization International Clinical Trials Registry Platform, Springer, EMBASE, MEDLINE, China National Knowledge Infrastructure, the Chinese Biomedical Literature Database, Wanfang database, the Chinese Scientific Journal Database, and other sources. All published randomized controlled trials and blinded researches that are relevant to the subject of interest only will be contained. Two independent researchers will operate article retrieval, duplication removing, screening, quality evaluation, and data analyses by Review Manager (V.5.3.5). Meta-analyses, subgroup analysis and/or descriptive analysis will be performed based on the included data conditions.

Results:

High-quality synthesis and/or descriptive analysis of current evidence will be provided from the bronchitis severity score, symptom, and quality-of-life questionnaires, the questionnaire of clinical symptoms of cough and sputum, Patient Satisfaction Scale and adverse reactions.

Conclusion:

This study will provide the evidence of whether Tuina is an effective and safe intervention for children with AB.

PROSPERO registration number:

CRD42019140667.
Duration of Bisphosphonate Drug Holidays and Associated Fracture Risk
Authors: Curtis Jeffrey R. , Saag Kenneth G. , Arora Tarun , Wright Nicole C. , Yun Huifeng , Daigle Shanette , Matthews Robert , Delzell Elizabeth
Published: January 2020

Background:

Discontinuation of bisphosphonates (BP) or a “drug holiday” after several years of treatment is increasingly common. However, the association of drug holiday duration with future fracture risk is unclear.

Objectives:

We evaluated the rate of fracture in relation to various lengths of drug holidays among women receiving long-term BP therapy.

Research Design:

Observational cohort study using US Medicare data 2006–2016. Incidence rates (IRs) and Cox proportional hazards models were used to evaluate the rate and adjusted hazard ratios (aHRs) controlling for potential confounders.

Subjects:

Women aged 65 years and above enrolled in fee-for-service Medicare who had been adherent (≥80%) to alendronate, risedronate, or zoledronate for ≥3 years.

Measures:

Hip, humerus, distal forearm, and clinical vertebral fracture.

Results:

Among 81,427 eligible women observed for a median (interquartile range) of 4.0 (2.5, 5.3) years, 28% of women underwent a drug holiday. In the alendronate cohort (73% overall), the IR of hip fracture among women who discontinued BP for >2 years was 13.2 per 1000 person-years. Risk was increased (aHR=1.3, 1.1–1.4) versus continuing therapy (IR=8.8, referent). Rates were elevated for humerus fracture with discontinuation >2 years (aHR=1.3, 1.1–1.66) and for clinical vertebral fracture with discontinuation >2 years (aHR=1.2, 1.1–1.4). Results were similar for risedronate, zoledronate, and ibandronate for hip and clinical vertebral fracture.

Conclusion:

Discontinuing alendronate beyond 2 years was associated with increased risk of hip, humerus, and clinical vertebral fractures.
Treatment of Children With Cancer and/or Hematopoietic Stem Cell Transplantation in the Intensive Care Unit: Experience at a Large European Pediatric Cancer Center
Authors: Barking Catharina T.M.M. , Masjosthusmann Katja , Rellensmann Georg , Ehlert Karoline , Zöllner Stefan , Jocham Sophie , Kremer Almut , Potratz Jenny , Rieger-Fackeldey Esther , Groll Andreas H.
Published: January 2020

Pediatric cancer treatment and hematopoietic stem cell transplantation (HSCT) carry considerable risks of morbidity. We conducted a single-center retrospective analysis of intensive care unit (ICU) admissions in unselected children and adolescents treated for cancer or undergoing HSCT. In a 10-year time period, 140 patients had 188 ICU admissions for a life-threatening condition. Main reasons for ICU admission were respiratory or cardiovascular insufficiency and sepsis. Mortality in the ICU was 19.1% and related to organ failure or acute complications in 77.8% and progress of the underlying malignancy in 22.2%. Mortality rates at 30, 100, and 365 days after discharge from the ICU were 24.5%, 30.9%, and 39.9%. Kaplan-Meier survival probabilities at 5 and 10 years were 46.4% and 39.8%, respectively. Multivariable analysis revealed the number of failed organ systems, the number of prior ICU stays, and days spent in the ICU as parameters independently associated with death. Taken together, the outcome of pediatric cancer and/or HSCT patients admitted to the ICU for life-threatening conditions was not as dismal as reported elsewhere. Most patients benefitted from ICU care, and survival was predominantly compromised by the evolution of complications.
Disruptive Innovation: Impact for Practice, Policy, and Academia
Authors: Nelson-Brantley Heather V. , Bailey K. David , Batcheller Joyce , Caramanica Laura , Lyman Bret , Snow Francine
Published: January 2020

The 2019 Association for Leadership Science in Nursing International Conference, Disruptive Innovation, was held in Los Angeles, California, with attendees from 30 US states, Canada, Brazil, and China. Presenters discussed the need for nurse leaders to advocate for health equity, lead evidence-based innovation, how robots and other technology are generating disruptive innovations in healthcare, and building strong academic-practice partnerships to address nursing workforce challenges. This article will report on these important insights.
Increasing Nursing Scholarship Through Dedicated Human Resources: Creating a Culture of Nursing Inquiry
Authors: Whalen Madeleine , Baptiste Diana-Lyn , Maliszewski Barbara
Published: January 2020

As the role of nursing grows in healthcare, the engagement of frontline nurses in evidence-based practice, quality improvement, and research is becoming the expectation and no longer the exception. Clinical nurses are in a unique position to inform and implement scholarly projects. The purpose of this staff development and capacity-building project was to increase the output of scholarly work among frontline nurses through the formalization of nursing inquiry support via designated nursing inquiry project coordinators.
Could HIV-1 RNA Testing be an Option as the Second Step in the HIV Diagnostic Algorithm?
Authors: Masciotra Silvina , Luo Wei , Rossetti Rebecca , Smith Tara , Ethridge Steven , Delaney Kevin P. , Wesolowski Laura G. , Owen S. Michele
Published: January 2020

Background

There is benefit to early HIV-1 diagnosis and treatment, but there is no Food and Drug Administration–approved quantitative assay with a diagnostic claim. We compared the performance of the Hologic Aptima HIV-1 Quant (APT-Quant) and Aptima HIV-1 Qual (APT-Qual) assays for diagnostic use and the performance of a diagnostic algorithm consisting of Bio-Rad BioPlex 2200 HIV Ag-Ab assay (BPC) followed by APT-Quant (2-test) compared with BPC followed by Geenius HIV-1/2 supplemental assay (Geenius) with reflex to APT-Qual (3-test).

Methods

Five hundred twenty-four plasma, which included 419 longitudinal specimens from HIV-1 seroconverters (78 were after initiating antiretroviral therapy [ART]) and 105 from ART-naive persons with established HIV-1 infections, were used to evaluate APT-Quant performance for diagnostic use. Specimens from 200 HIV-negative persons were used to measure specificity. For the algorithm comparison, BPC-reactive specimens were evaluated with the 2-test or 3-test algorithm. McNemar’s test was used to compare performance.

Results

The APT-Quant detected more samples early in infection compared with APT-Qual. The APT-Quant specificity was 99.8%. Before ART initiation, the algorithms performed similarly among samples from different stages of infection. After ART initiation, the 3-test algorithm performed significantly better (P = 0.0233).

Conclusions

The APT-Quant has excellent performance for diagnostic use. The 2-test algorithm works well in ART-naive samples, but its performance decreases after the IgG response is elicited and with ART-induced suppressed viremia. Providing confirmation and viral load assay with 1 test result could be advantageous for patient care. However, additional factors and challenges associated with the implementation of this 2-test algorithm, such as cost, specimen type, and collection need further evaluation.
Radiotherapy in the Management of Metastatic Hormone-Sensitive Prostate Cancer
Authors: Deek Matthew P. , Phillips Ryan , Tran Phuoc T.
Published: January 2020

Systemic therapy has historically been the backbone of treatment for patients with metastatic disease. However, recent evidence suggests metastasis-directed therapy in those with oligometastatic disease (≤5 lesions) may improve progression-free and overall survival. Within prostate cancer–specific cohorts, metastasis-directed therapy also appears to delay the time to initiation of androgen deprivation therapy while also generally being associated with a mild toxicity profile and has thus garnered interest as a means to delay systemic therapy. Here we review the evidence surrounding the use of radiation therapy to metastatic sites in patients with metastatic hormone-sensitive prostate cancer.
Safety Checklist Implementation Did Not Reduce Central Venous Catheter Duration in Pediatric Cardiac ICU Patients
Authors: Sahulee Raj , Ramirez Michelle M. , Al-Qaqaa Yasir M. , Chakravarti Sujata B. , McKinstry Jaclyn
Published: January 2020

Introduction:

The Center for Disease Control recommends prompt removal of nonessential central venous catheters (CVCs) to reduce the risk for central line–associated bloodstream infections. Safety checklists have been trialed to reduce nonessential CVC days, but pediatric studies are lacking. Our specific aim was to detect >10% reduction in mean CVC duration after implementation of a safety checklist addressing CVCs in our unit.

Methods:

All patients admitted to the Congenital Cardiovascular Care Unit at New York University Langone Medical Center who had a CVC placed between January 1, 2012, and December 31, 2017, were included. We implemented a checklist addressing CVC use in our unit on June 7, 2013, and modified it on March 10, 2016. We analyzed quarterly mean CVC duration and postsurgical CVC duration over the study period using statistical process control charts.

Results:

We placed 778 CVCs for 7,947 CVC days during the study period. We noted special cause variation from Q4 2013 to Q2 2014 and a centerline shift in mean CVC duration from 8.91 to 11.10 days in Q1 2015. In a subgroup analysis of the 657 lines placed in surgical patients, there was a centerline shift in mean CVC duration from 6.48 to 8.86 days in Q4 2013.

Conclusions:

Our study demonstrated an unexpected increase in mean CVC duration after the implementation of a safety checklist designed to decrease nonessential CVC days. Additional studies are needed to identify the ideal method to detect and remove nonessential CVCs and reduce the risk of preventable harm.