bluuebunny/crossref_metadata_2025 huggingface dataset:
Speech Audiometrical Results Before and After Reimplantation of Cochlear Implants
Authors: Öz Okan , De Ceulaer Geert , Govaerts Paul J.
Published: October 2021

Objectives:

This study aimed to compare the audiological outcomes of cochlear reimplantation with those of the first cochlear implant (CI).

Design:

A retrospective analysis was performed on the data of all CI recipients who received the first CI at the age of 8 years or above and who were subsequently reimplanted on the same side. All participants who received their first implant after January 1, 2000, and who were reimplanted before January 1, 2021, were included. CI recipients who were unable to perform an open-set of Flemish monosyllable speech audiometry were excluded. The participants’ clinical files were reviewed in terms of the cause of hearing loss, age at the first and second implantation, device types, the time between the first and second surgery, speech reception scores before and after reimplantation, and the reason for reimplantation.

Results:

Reimplantation was due to device failure in 19 out of 22 patients, performance decrement in two patients, and medical reasons in one patient. The interval between the first and second CI ranged from 8 to 218 mo. Within-subject analysis showed the speech reception performance with the second CI to be significantly better than that with the first CI at all follow-up time points, with average within-patient gains of 17%, 16%, 12%, and 15% at 3 mo, 9 mo, 3 years, and the highest scores achieved, respectively. After reimplantation, the performance was better than the last results before reimplantation, and this was significant from 9 mo after reimplantation onwards. Three patients (14%) had a performance degradation with the second CI, which was probably owing to (1) difficulties in reimplantation surgery leading to a reduced number of active channels, (2) insufficient experience with the second CI as the reimplantation has been performed recently, and (3) advanced fenestral and retrofenestral otosclerosis.

Conclusions:

The present study shows that speech reception performance after reimplantation yields faster and better results than the first implant. It takes a couple of months to get better results than those before the reimplantation. Only in a minority of participants, a small deterioration may be observed. It seems that soft failures in the absence of measurable technical abnormalities call for caution with regard to reimplantation.
Effectiveness and Safety of Inelastic Versus Elastic Lumbosacral Orthoses on Low Back Pain Prevention in Healthy Nurses
Authors: Hu Jianzhong , Jiang Liyuan , Cao Yong , Qu Jin , Lu Hongbin
Published: October 2021

Study Design.

A randomized controlled trial.

Objective.

To evaluate the effects of inelastic and elastic lumbosacral orthoses (LSOs) on the prevention of low back pain (LBP) in healthy nurses.

Summary of Background Data.

Over 80% of people experience LBP during their lifetime. LSOs, as a device used to maintain lumbar stability, were widely used in LBP management. The effects of inelastic LSOs (iLSOs) and elastic LSOs (eLSOs) on the prevention of LBP are controversial.

Methods.

A randomized clinical trial recruiting healthy nurses was conducted from November 2011 to June 2013 at a tertiary hospital in China. A total of 300 eligible participants aged 20 to 25 years were randomly assigned to iLSO, eLSO, or control groups. The intervention period was 6 months, and follow-ups were continued for an additional 6 months. Participants in both iLSO and eLSO groups were required to wear LSOs daily. Outcomes included the incidence of LBP, changes in trunk muscle endurance, and spinal range of motion assessed at baseline, 6months, and 12 months from the starting date. The incidence of LBP among groups was analyzed by ANOVA. Wilcoxon rank-sum test, Kruskal-Wallis H test, etc. were used for secondary outcomes comparison across groups.

Results.

Two hundred seventy-eight out of 300 participants (92.7%) completed the trial. No statistically significant differences were observed in LBP incidence among the three groups. No difference was observed in abdominal/back muscle endurance among groups at 6 months. In secondary outcome analysis regarding spinal range of motion, flexion and extension improved in iLSO groups at 12 months compared with that at baseline (flexion, P 
= 0.01; extension, P 
= 0.01), whereas only extension motion improved at 12 months in the eLSO group (P 
= 0.00).

Conclusions.

Six-month wearing of LSO showed neither a significant difference in preventing LBP nor causing adverse effects to participants.

Level of Evidence: 1
Quantifying the impacts of human mobility restriction on the spread of coronavirus disease 2019: an empirical analysis from 344 cities of China
Authors: Tan Jing , Zhao Shao-Yang , Xiong Yi-Quan , Liu Chun-Rong , Huang Shi-Yao , Lu Xin , Thabane Lehana , Xie Feng , Sun Xin , Li Wei-Min
Published: October 2021

Background:

Since the outbreak of coronavirus disease 2019 (COVID-19), human mobility restriction measures have raised controversies, partly because of the inconsistent findings. An empirical study is promptly needed to reliably assess the causal effects of the mobility restriction. The purpose of this study was to quantify the causal effects of human mobility restriction on the spread of COVID-19.

Methods:

Our study applied the difference-in-difference (DID) model to assess the declines of population mobility at the city level, and used the log–log regression model to examine the effects of population mobility declines on the disease spread measured by cumulative or new cases of COVID-19 over time after adjusting for confounders.

Results:

The DID model showed that a continual expansion of the relative declines over time in 2020. After 4 weeks, population mobility declined by −54.81% (interquartile range, −65.50% to −43.56%). The accrued population mobility declines were associated with the significant reduction of cumulative COVID-19 cases throughout 6 weeks (ie, 1% decline of population mobility was associated with 0.72% [95% CI: 0.50%–0.93%] reduction of cumulative cases for 1 week, 1.42% 2 weeks, 1.69% 3 weeks, 1.72% 4 weeks, 1.64% 5 weeks, and 1.52% 6 weeks). The impact on the weekly new cases seemed greater in the first 4 weeks but faded thereafter. The effects on cumulative cases differed by cities of different population sizes, with greater effects seen in larger cities.

Conclusions:

Persistent population mobility restrictions are well deserved. Implementation of mobility restrictions in major cities with large population sizes may be even more important.
Prenatal Gene Therapy
Authors: Schwab Marisa E. , MacKenzie Tippi C.
Published: October 2021

Prenatal gene therapy could provide a cure for many monogenic diseases. Prenatal gene therapy has multiple potential advantages over postnatal therapy, including treating before the onset of disease, the ability to induce tolerance and cross the blood-brain barrier. In this chapter, we will describe in utero gene therapy and its rationale, clinical trials of postnatal gene therapy, preclinical studies of in utero gene therapy, and potential risks to the mother and fetus.
An Introduction: Prenatal Screening, Diagnosis, and Treatment of Single Gene Disorders
Authors: Wapner Ronald J. , Norton Mary E.
Published: October 2021

Increasing ability to diagnose fetal single gene disorders has changed the prenatal diagnostic paradigm. As fetal sequencing advances, the genomic information obtained can lead to improved prognostic counseling, and elucidation of recurrence risk and future prenatal diagnosis options. For some of these disorders, postnatal molecular therapy, including gene therapy, is available or being studied in clinical trials. Most of the initial research and clinical trials have involved children and adults, but there are potential benefits to treating conditions before birth. Many clinical studies are underway exploring the potential for in utero gene therapy.
Economics and laboratory efficiency of atrial fibrillation ablation
Authors: Kowalski Marcin , Shah Rina , Akhrass Philippe , Parikh Valay
Published: October 2021

Purpose of review

Atrial fibrillation is a growing public health problem and is associated with an increased risk of comorbidities with enormous socioeconomic implications. This review article focuses on fiscal burden of atrial fibrillation on the healthcare system and economic value of atrial fibrillation ablations brought to the patient and the payers by improvement in outcomes and reduction in treatment costs.

Recent findings

This article summarizes the recently published studies evaluating the economic impact of atrial fibrillation treatment. Catheter ablation have shown to be the most successful strategy for treatment of defibrillation. However, repeat ablation is associated with higher costs, over and above any subsequent procedural costs, compared with a single ablation procedure for atrial fibrillation. Cryoballoon ablation has been shown to have fewer repeat ablations than radiofrequency ablations, which resulted in overall cost reduction. Improvement in laboratory efficiency, better utilization of laboratory resources and same-day discharge strategy can lead to further healthcare savings and increase in value to all stakeholders.

The value of healthcare delivery for patient with atrial fibrillation can be improved by advancement in technology that demonstrates cost reduction to the health system and outcomes improvements. Implementation of tactics that decrease cost and improve outcomes can alleviate some of the financial strain on healthcare systems, which is of extreme importance in the current climate.
Efficacy of the Systane iLux Thermal Pulsation System for the Treatment of Meibomian Gland Dysfunction After 1 Week and 1 Month: A Prospective Study
Authors: Schanzlin David , Owen James P. , Klein Steve , Yeh Thao N. , Merchea Mohinder M. , Bullimore Mark A.
Published: October 2021

Objectives:

To assess 1-week and 1-month efficacy of Systane iLux thermal pulsation treatment for meibomian gland dysfunction (MGD).

Methods:

This prospective, nonrandomized, open-label, multicenter study enrolled 30 adult patients (60 eyes) who had a Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire score greater than 6 and total meibomian gland secretion (MGS) score equal to or less than 12 in each eye. All participants received thermal pulsation treatment bilaterally. Primary efficacy measures included MGS score (sum of grades for 15 glands graded on a scale of 0–3; 0 [no secretion], 1 [inspissated], 2 [cloudy], and 3 [clear liquid]) and tear breakup time (TBUT). Secondary efficacy measures were SPEED and Ocular Surface Disease Index (OSDI) scores.

Results:

The mean age of patients was 52.9±11.9 years. After 1 week, the mean MGS score improved significantly from 4.1±3.1 to 15.8±7.1 (right eye, OD) and 3.7±3.1 to 16.7±7.6 (left eye, OS); mean TBUT improved significantly from 4.9±4.1 to 8.4±3.6 (OD) and 5.2±4.2 to 8.9±3.9 (OS); and mean SPEED and OSDI scores improved significantly from 16.1±5.3 to 7.2±6.1 and 45.2±21.3 to 19.0±16.8, respectively (all P<0.001). After 1 month, the mean MGS score improved to 18.3±8.2 (OD) and 18.6±7.3 (OS); mean TBUT improved to 9.7±3.8 (OD) and 9.6±3.5 (OS); and mean SPEED and OSDI scores improved to 7.0±5.6 and 16.7±14.5, respectively (all P<0.001). No adverse events were reported.

Conclusions:

Systane iLux thermal pulsation treatment for MGD resulted in a statistically significant increase in meibomian gland secretion, improvement in tear film stability, and reduction in dry eye symptoms as early as both 1 week and 1 month.
Unilateral Dry Eye Due to Possible Isolated Parasympathetic Denervation of the Lacrimal Gland in a Woman With Hypothyroidism
Authors: Singh Swati , Basu Sayan
Published: October 2021

Purpose:

The aim of this study was to report a unique case of unilateral neurogenic dry eye disease (DED) secondary to isolated parasympathetic denervation of the lacrimal gland along with a literature review.

Method:

This is a case report and literature review on neurogenic DED discussing its clinical presentation, etiology, and treatment options.

Results:

A 32-year-old woman with hypothyroidism presented with pain and a burning sensation in her left eye and dry nares for 1 week. Ocular examination revealed conjunctival congestion and inferior superficial punctate fluorescein staining in the left eye. Her unanesthetized Schirmer values were 24 and 01 mm in the right and left eyes, respectively, with no secretory activity noted in the left lacrimal gland on direct assessment. A detailed neurologic examination, autoimmune panel, and neuroimaging were unremarkable except for the dry left nasal cavity. She is currently using lubricants and did not consent to pilocarpine therapy. Her lacrimal gland activity was unchanged till 3 months of follow-up. The most common cause of neurogenic DED is idiopathic, followed by trauma. Pilocarpine therapy, in oral, topical, or combined form, has improved tear secretion in 63% of neurogenic DED seen in animal cohort.

Conclusions:

Unilateral neurogenic DED can occur as an isolated parasympathetic denervation of the lacrimal glands. Pilocarpine therapy has shown some efficacy in animal cohort of neurogenic DED; however, it needs to be explored for human eyes.
Retroprosthetic Membrane Formation in Boston Keratoprosthesis Type 1: Incidence, Predisposing Factors, Complications, and Treatment
Authors: Khair Diana , Daoud Roy , Harissi-Dagher Mona
Published: October 2021

Purpose:

The purpose of this study was to evaluate the incidence, rate of formation, and risk factors of retroprosthetic membrane (RPM) after Boston type 1 keratoprosthesis (BKPro) as well as identify secondary complications linked to its formation and describe its treatment.

Methods:

This was a retrospective cohort study. One hundred thirty-three eyes of 115 patients who underwent BKPro implantation at the Centre Hospitalier de l'Université de Montréal from 2008 to 2017 were included with at least 1-year follow-up. Charts were reviewed, and data were collected, including incidence of RPM formation, preoperative and intraoperative risk factors, postoperative complications, and treatment modalities.

Results:

The mean follow-up was 5.5 years, and 39% (n = 52) of eyes developed RPM. No etiologies were found to be significantly associated with RPM development. Simultaneous lensectomy and simultaneous intraocular lens extraction were respectively positively and negatively correlated with RPM development [odds ratio (OR): 0.3590, 95% CI: 0.1629–0.7570, P = 0.0097; OR = 2.646, 95% CI: 1.273–5.585, P = 0.0086, respectively]. As for postoperative complications, the strongest correlation was between RPM and retinal detachment (OR = 6.16, 95% CI: 2.14–16.14; P = 0.0004). RPM development was also positively associated with the development of hypotony and corneal melt. Nd:YAG membranectomy was the most common treatment, performed in 83% of eyes with RPM (n = 24), with 58% resolution.

Conclusions:

More than one third of patients who undergo BKPro will develop RPM, requiring close monitoring for retinal detachment. Simultaneous intraocular lens extraction seems protective, whereas simultaneous lens extraction increases the rate of RPM formation significantly. Nd:YAG membranectomy can be used as an initial noninvasive approach.
Nurse-Sensitive Indicators in the Care of Individuals With Opioid Use Disorder
Authors: Bernhardt Jean M.
Published: October 2021

Patients with opioid use disorder (OUD) seek care in primary care settings where nurses support the provision of medication-assisted treatment. Office-based opioid treatment (OBOT) that includes buprenorphine hydrochloride administration under the supervision of a nurse for stabilization and maintenance therapy has the potential to improve outcomes for patients with OUD in primary care settings. However, the first step is to determine if OBOT nurses provide nurse-sensitive care, which consists of activities that have been shown to make a difference in patient outcomes. Content analysis of 368 nursing notes from 100 patients enrolled in an OBOT program in an urban hospital-based primary care clinic was conducted. Data were analyzed descriptively according to quantity and qualitatively according to the content. Entries indicative of care coordination and transition management were extracted. Seven content categories within care coordination were identified, including harm reduction, medication management, symptom management, communication between providers, promoting adherence, self-management goal setting, and patient education. Four areas within transition management were identified including supporting connections to resources, referrals for care, medication reconciliation, and communication with other facilities. Care coordination was documented more frequently than transition management. The presence of nurse-sensitive indicators provides evidence for and distinguishes the role of the nurse in OUD care.
Anisocoria Correlates With Injury Severity and Outcomes After Blunt Traumatic Brain Injury
Authors: Nyancho Daniel , Atem Folefac D. , Venkatachalam Aardhra M. , Barnes Arianna , Hill Michelle , Traylor Jeffrey I. , Stutzman Sonja E. , Bedros Nicole , Aiyagari Venkatesh , Aoun Salah G.
Published: October 2021

BACKGROUND: Automated infrared pupillometry (AIP) has been shown to be helpful in the setting of aneurysmal subarachnoid hemorrhage and stroke as an indicator of imminent irreversible brain injury. We postulated that the early detection of pupillary dysfunction after light stimulation using AIP may be useful in patients with traumatic brain injury (TBI). METHODS: We performed a retrospective review of the Establishing Normative Data for Pupillometer Assessment in Neuroscience Intensive Care database, a prospectively populated multicenter registry of patients who had AIP measurements taken during their intensive care unit admission. The primary eligibility criterion was a diagnosis of blunt TBI. Ordinal logistic modeling was used to explore the association between anisocoria and daily Glasgow Coma Scale scores and discharge modified Rankin Scale scores from the intensive care unit and from the hospital. RESULTS: Among 118 subjects in the who met inclusion, there were 6187 pupillometer readings. Of these, anisocoria in ambient light was present in 12.8%, and that after light stimulation was present in 9.8%. Anisocoria after light stimulation was associated with worse injury severity (odds ratio [OR], 0.26 [95% confidence interval (CI), 0.14–0.46]), lower discharge Glasgow Coma Scale scores (OR, 0.28 [95% CI, 0.17–0.45]), and lower discharge modified Rankin Scale scores (OR, 0.28 [95% CI, 0.17–0.47]). Anisocoria in ambient light showed a similar but weaker association. CONCLUSION: Anisocoria correlates with injury severity and with patient outcomes after blunt TBI. Anisocoria after light stimulation seems to be a stronger predictor than does anisocoria in ambient light. These findings represent continued efforts to understand pupillary changes in the setting of TBI.
Discharge Transition Experience for Lumbar Fusion Patients: A Qualitative Study
Authors: Kim Jeoung Hee , Shin Yong Soon
Published: October 2021

BACKGROUND: Support should be provided to individuals who are ready to be discharged; however, quantitative research is lacking in understanding the challenges of postsurgery lumbar fusion patients' discharge and transition. This article delves into the in-depth experience of lumbar fusion patients with discharge transitions. METHODS: We conducted semistructured individual interviews with 11 patients who had lumbar fusion surgery at one of Korea's most equipped general hospitals. These interviews focused on the patients' discharge transition experiences. The data were analyzed using phenomenological analysis. RESULTS: Lumbar fusion patients' experiences of discharge transition fit into 4 categories: anticipation of surgical transition, the process of transition to discharge, the difficult process of recovery, and recovery strategy. CONCLUSION: To further expedite the discharge process and make better use of cooperative hospital resources, conducting preoperative treatment planning, identifying family and social support systems, and sharing treatment procedures are all required. Furthermore, thorough health information services and step-by-step courses on predicted problems and everyday living after surgery should be considered for postoperative education. It is critical to broadening the scope of preoperative and postoperative education programs, as well as assistance for the social support system, such as the family-based support system and cooperative hospitals.
The Mindful Lawyer
Authors: Nielsen Emily G. , Minda John Paul
Published: October 2021

Objectives:

Two studies were conducted to determine whether mindfulness meditation could be an effective tool for improving well-being among legal professionals—a population plagued by high rates of depression, anxiety, and stress.

Methods:

Study 1. Legal professionals completed questionnaires before and after an 8-week mindfulness program. Study 2. Lawyers were randomly assigned to either an experimental or waitlist condition. Questionnaires were administered at the beginning of the study and after experimental participants had completed a 30-day intervention.

Results:

Study 1. Participants reported significant improvements in mood, resilience, trait mindfulness, stress, anxiety, and depression over time. Study 2. Post-intervention, experimental participants reported better mood, lower levels of stress, and higher levels of non-reactivity and observing than waitlist participants.

Conclusions:

Mindfulness and meditation may effectively improve well-being among legal professionals.
Employer-Led Strategies to Improve the Value of Health Spending: A Systematic Review
Authors: Weinmeyer Richard M. , McHugh Megan , Coates Emma , Bassett Sarah , O’Dwyer Linda C.
Published: October 2021

Objective:

To systematically review studies that evaluated the impact of employer-led efforts in the United States to improve the value of health spending, where employers have implemented changes to their health benefits to reduce costs while improving or maintaining quality.

Methods:

We included all studies of employer-led health benefit strategies that reported outcomes for both employer health spending and employee health outcomes.

Results:

Our search returned 44 studies of employer health benefit changes that included measures of both health spending and quality. The most promising efforts were those that lowered or eliminated cost sharing for primary care or medications for chronic illnesses. High deductible health plans with a savings option appeared less promising.

Conclusions:

More research is needed on the characteristics and contexts in which these benefit changes were implemented, and on actions that address employers’ current concerns.
Determination of Cardiovascular Risk in 56,262 Spanish Construction Workers
Authors: López-González Ángel Arturo , Riutord Sbert Pere , Arroyo Bote Sebastiana , González San Miguel Hilda , Vidal Real Carmen , Ramirez-Manent José Ignacio
Published: October 2021

Objective:

To evaluate different cardiovascular risk scales in construction workers.

Methods:

A descriptive, cross-sectional study was carried out in 56,262 Spanish construction workers. Scales of obesity and fatty liver, metabolic syndrome, atherogenic indices, and cardiovascular risk scales, among others, were assessed.

Results:

In women, 19.6% were obese, 18.2% hypertensive, 12.6% had metabolic syndrome, 12% were at high risk of non-alcoholic fatty liver disease, and 4.3% were at moderate or high risk on the SCORE scale. In men, 20.1% were obese, 30.1% hypertensive, 17.5% had metabolic syndrome, and 27.6% had high or moderate risk on the SCORE scale.

Conclusions:

Knowing the cardiovascular risk of a large number of construction workers by means of a large number of scales may be of great interest to occupational health professionals, as it may enable them to establish prevention strategies.
What Are Work-Related Predictors of Post-COVID-19 Home and Family Work Roles? A Cross-Sectional Survey
Authors: Dabbagh Armaghan , Seens Hoda , Fraser James , MacDermid Joy C.
Published: October 2021

Objective:

To determine the extent to which pre-and post-COVID-19 work-related factors can explain post-COVID-19 home and family work roles.

Methods:

This study was a cross-sectional survey. The primary outcome measure was the Home and Family Work Roles Questionnaire. Descriptive statistical methods and multiple regression analyses were run. The significant predictors were further probed in a one-way analysis of covariance (ANCOVA) model with a Tukey posthoc correction.

Results:

In our sample of 1447 participants, the two significant predictors of post-COVID-19 home and family work roles were pre-pandemic paid job status (F [3, 1401] = 5.66, P < 0.001), and pre-COVID-19 home and family work roles (F [1, 1401] = 2509.26, P < 0.001).

Conclusion:

Greater pre-pandemic home and family role responsibilities, full-time and part-time employment pre-COVID-19 were associated with greater post-COVID-19 home and family responsibilities.
COVID-19 Prevalence and Prevention Behaviors Among US Certified Organic Producers
Authors: Rosero Daisy V. , Soto Mas Francisco , Sebastian Rachel , Guldan Steve , Casanova Vanessa , Nervi Laura
Published: October 2021

Objective:

There is a scarcity of data on the impact of the pandemic in farmers.

Methods:

Cross-sectional survey of certified organic producers through a 28-item self-reported paper or electronic survey. Analysis included descriptive statistics, Cronbachαto measure the internal consistency of a six-item prevention scale, and correlation and regression analyses.

Results:

A total of 344 records were computed. Infection rate among producers was 6.4%. Sex and farm size were the most statistically significant predictors of prevention behaviors. Women reported more use of prevention methods (β = 0.333,P < 0.001) and those with 50 or more certified organic acres reporting less use of prevention methods (β = –0.228,P < 0.001). Mask wearing was significantly related to lower COVID-19 prevalence.

Conclusions:

Determining prevalence and understanding how farmers follow prevention behaviors is essential for health care and public health interventions and policies.
Cochlear Implant Electrode Tip Fold-Over: Our Experience With Long and Flexible Electrode
Authors: Högerle Catalina , Englhard Anna , Simon Florian , Grüninger Ivo , Mlynski Robert , Hempel John-Martin , Müller Joachim
Published: October 2021

Objective:

The aim of this study was to retrospectively investigate if there is any incidence of electrode tip fold-over with 31.5 mm long and flexible lateral wall electrodes implanted in two high-volume Cochlear Implant (CI) centers in Germany. In addition, a detailed literature review was performed to capture all the peer-reviewed publications reporting on tip fold-over with CI electrodes from different CI brands for comparison.

Methods:

Post-operative X-ray images of FLEX SOFT electrode from MED-EL in Stenver's view were retrospectively investigated for the presence of electrode tip fold-over from 378 consecutive cases in two high-volume CI centers in Germany. All patients were implanted between 2010 and 2018 by three individual experienced CI surgeons using round window and extended round window approach for CI electrode insertion. A literature review was performed following a thorough PubMed (https://www.ncbi.nlm.nih.gov/pubmed/) search using the keywords “cochlear implant electrode tip fold-over” or “cochlear implant electrode tip roll-over” to capture articles that were published until December 2020 in English language only. Articles selection was based on electrode-related issues investigated only in-patient cases applying imaging modality. Those studies investigated tip fold-over in cadaveric temporal bones and cases with inner-ear malformation excluded.

Results:

No single case of tip fold-over was clinically detected from the retrospective investigation of post-operative X-ray images from 378 consecutive cases. The electrode angular insertion depth as measured applying the cochlear coordinate system, varied from a minimum of 560° to a maximum of 720°. The literature review on the tip fold-over issue resulted in 24 peer-reviewed published articles in total. Tip fold-over with pre-curved modiolar-hugging electrodes was reported in 85 cases out of 1,606 implantations making an incidence rate of 5.3%. With the straight lateral wall electrodes, the tip fold-over was reported in four cases out of 398 implantations making an incidence rate of 1%, not including the number of implantations reported in the current study. Otherwise it would be 0.5%.

Conclusion:

Electrode tip fold-over with 31.5 mm long flexible lateral wall electrodes is highly exceptional and this can be generalized to any of the straight lateral wall electrodes from any CI brand. The literature review on tip fold-over revealed an incidence rate of 5.3% with pre-curved or modiolar-hugging electrodes and 1% with straight lateral wall electrodes from CI brands. Including this series of 0% tip fold-over, the incidence rate of electrode tip fold-over with LW electrode type would be 0.5%.
The effect of glucocorticoids on mortality in severe COVID-19 patients
Authors: Yu Guang-Qing , Jiang Zhong-Hui , Yang Zhong-Bin , Jiang Shi-Qin , Quan Xiao-Qing
Published: October 2021

Background:

Since the start of the coronavirus disease 2019 (COVID-19) pandemic, there is an urgent need for effective therapies for patients with COVID-19. In this study, we aimed to assess the therapeutic efficacy of glucocorticoids in severe COVID-19.

Methods:

A systematic literature search was performed across PubMed, Web of Science, EMBASE, and the Cochrane Library (up to June 26, 2021). The literature investigated the outcomes of interest were mortality and invasive mechanical ventilation.

Results:

The search identified 13 studies with 6612 confirmed severe COVID-19 patients. Our meta-analysis found that using glucocorticoids could significantly decrease COVID-19 mortality (hazard ratio (HR) 0.60, 95% confidence interval (CI) 0.45–0.79, P < .001), relative to non-use of glucocorticoids. Meanwhile, using glucocorticoids also could significantly decrease the risk of progression to invasive mechanical ventilation for severe COVID-19 patients (HR = 0.69, 95% CI 0.58–0.83, P < .001). Compared with using dexamethasone (HR = 0.68, 95% CI 0.50–0.92, P = .012), methylprednisolone use had a better therapeutic effect for reducing the mortality of patients (HR = 0.35, 95% CI 0.19–0.64, P = .001).

Conclusion:

The result of this meta-analysis showed that using glucocorticoids could reduce mortality and risk of progression to invasive mechanical ventilation in severe COVID-19 patients.
The irony of the transforaminal approach
Authors: Ahn Yong , Yoo Byung Rhae , Jung Jong-myung
Published: October 2021

Transforaminal endoscopic lumbar discectomy (TELD) is useful for soft lumbar disc herniation (LDH). Although the transforaminal approach can reach the foraminal disc zone, the risk of exiting nerve root irritation along the path is considerable. Few studies have assessed the difficulties of TELD for foraminal LDH. The objective of this study is to compare the clinical results of TELD between foraminal or far-lateral LDH and paramedian LDH.

Between June 2016 and July 2017, 135 consecutive patients with single-level LDH were treated with TELD for 2 years. Among them, 25 patients had foraminal or far-lateral LDH (foraminal group), and the remaining 110 patients had central or subarticular LDH (paramedian group). Perioperative data and clinical outcomes were evaluated using the visual analog pain scale, Oswestry Disability Index, and modified Macnab criteria.

The foraminal group showed a higher rate of significant access pain (24.00% vs 8.19%, P < .05). The foraminal group also had a longer duration of surgery, length of hospital stay, and return to work (all P < .05). Pain scores and functional status were significantly improved in both groups. Although there were no differences in the outcomes at 2 years postoperatively, early pain and disability at 6 weeks were higher in the foraminal group.

Ironically, the early clinical results of TELD for foraminal LDH may be less favorable than those for paramedian LDH. Therefore, great care should be taken during TELD for foraminal or far-lateral LDH.
Impact of switching to tenofovir alafenamide fumarate in patients with entecavir-treated chronic hepatitis B
Authors: Kumada Takashi , Toyoda Hidenori , Yasuda Satoshi , Ito Takanori , Tanaka Junko
Published: October 2021

Background and aims

Tenofovir alafenamide (TAF), a new tenofovir prodrug, has been developed to circumvent the less favorable safety profile of tenofovir disoproxil fumarate (TDF). We investigated reductions in hepatitis B surface antigen (HBsAg) levels in patients with HBV infection who received continuous entecavir (ETV) monotherapy or sequential therapy with ETV and TAF.

Methods:

This retrospective cohort study included 286 patients who were divided into two groups: continuous ETV monotherapy (ETV group, n = 168) and sequential therapy with ETV and TAF (ETV-TAF group, n = 108). Factors associated with a 90% reduction in HBsAg levels were analyzed by a Cox proportional hazards model using a time-dependent covariate in both groups.

Results

In the multivariate Cox proportional hazards model, the ETV-TAF group [adjusted hazard ratio (aHR) 2.750; 95% confidence interval (CI), 1.265–3.405; P = 0.0038] and BMI ≤ 25.0 kg/m2 (aHR 0.520, 95% CI, 0.308–0.875; P = 0.0139) demonstrated a 90% reduction in HBsAg levels. HBsAg levels of patients in the TAF phase in the ETV-TAF group showed greater yearly percent reductions than those in the ETV group and those in the ETV phase in the ETV-TAF group (P = 0.0361 and P = 0.0022, respectively, Steel–Dwass test).

Conclusion

HBsAg levels decreased more rapidly after patients switched from ETV to TAF. Switching to TAF may be an effective treatment option to reduce HBsAg levels.
Risk constellations, viral infections, and prophylaxis in uterine transplantation
Authors: Harris Courtney E. , Issa Nicolas C.
Published: October 2021

Purpose of review

Uterine transplantation (UTx) is a burgeoning new category of solid organ transplantation (SOT) that is practiced at several centers worldwide (first transplantation in 2013). Although there are still relatively low numbers of transplants (<75 published in literature), they are increasing in frequency and thus we attempt to discuss the current documented infections in this population as well as theoretical infectious risks and summarize prophylaxis and treatment strategies of centers current performing these procedures.

Recent findings

The most reported posttransplantation infection is not surprisingly urinary tract infections, with other documented infections including bacterial infections at site of graft (Enterococcus), herpes simplex virus, cytomegalovirus (CMV), human papillomavirus, Candida, and reportedly posttransplant lymphoproliferative disorder. The net state of immunosuppression and host factors (host colonization and serologic status of viral exposures) plays a significant role in infectious risk and with low numbers of infections documented, much of our guidance surrounding prophylaxis is inferred from SOT literature.

In this review, we give an overview of described infections in UTx and theoretical infectious risks, detailing how to tailor prophylaxis base on host risk, with specific focus that the goal of transplantation is completion of a successful pregnancy as the desired outcome. Special considerations should be given to pregnant recipients when managing infectious complications and further data collection and reporting regarding infectious complications is crucial to advance this field as numbers of transplantation continue to increase.
Reliability of Refraction, Keratometry, and Intraocular Pressure Measurements with an Automated All-in-one Device
Authors: Tzamalis Argyrios , Tsiampali Chara , Prousali Efthymia , Mataftsi Asimina , Ziakas Nikolaos , Kynigopoulos Myron
Published: October 2021

SIGNIFICANCE

This study explores the reliability of TonoRef II (Nidek, Tokyo, Japan), which represents a simple tool to obtain rapid refractometry and tonometry measurements. The present device demonstrates very high repeatability of refraction and intraocular pressure (IOP) readings as compared with subjective measurements and a higher concordance of IOP readings to Goldmann application tonometry (GAT).

PURPOSE

This study aimed to evaluate the repeatability of measurements acquired with the Autorefractometer/Keratometer/Tonometer TonoRef II and assess their agreement to subjective measurements and readings of other established devices.

METHODS

In a cross-sectional study, 54 eyes of 54 healthy subjects were enrolled. Each subject underwent five measurements with the TonoRef II, three measurements with the Canon RK-F1 Autorefractor Keratometer (Canon Europe NV, Amstelveen, the Netherlands), three IOP measurements with the Canon TX-F Noncontact Tonometer (Canon Inc., Tokyo, Japan), three measurements with GAT, and a thorough subjective refraction. Repeatability coefficient (r), intraclass correlation coefficient (ICC), and Bland-Altman plots were used to evaluate repeatability of readings and agreement to the subjective values.

RESULTS

TonoRef II showed high repeatability (ICC >0.9) in all parameters tested (sphere, r = 0.157; cylinder, r = 0.196; IOP, r = 2.653). A strong correlation was found between TonoRef and Canon instruments (P < .001 in all parameters). Mean differences and limits of agreement (mean ± 1.96 standard deviation) were −0.01 ± 0.69 D, −0.11 ± 0.7 D, and 2.1 ± 3.4 mmHg for sphere, cylinder, and IOP, respectively. Both autorefractors achieved a very good to excellent agreement to the values obtained with the subjective refraction for most of the parameters tested, without any significant difference to each other (P > .05). Intraocular pressure measurements of TonoRef II showed higher agreement to the GAT values compared with those obtained with the Canon tonometer (ICC, 0.9114 and 0.7002, respectively; P < .001).

CONCLUSIONS

Intraocular pressure and refraction readings acquired with TonoRef II demonstrate very high repeatability and agreement to the subjective measurements. Regarding IOP evaluation, TonoRef II shows higher concordance to GAT compared with another established noncontact tonometer.
Evolving Trends of Button Battery Ingestion in Indian Children at a Tertiary Care Hospital
Authors: Bettadahalli Vishaka , Kumar Sunil , Shukla Indu , Nair Rohini , Kumar Poornima
Published: October 2021

Introduction

Foreign body ingestion is a common problem encountered in the pediatric age group. Impaction of lithium batteries of greater than 20-mm diameter in the esophagus is associated with severe complications. This study aimed at analyzing the evolving trends of button battery ingestion in pediatric age groups at our tertiary care center in terms of clinical presentation, intraoperative findings, and the correlation of various clinical variables.

Methods

A retrospective observational study was done. All children younger than 18 years with impaction of a button battery of size greater than 20 mm in the esophagus between January 2015 and December 2018 were included in the study. All children underwent removal of the battery using direct laryngoscopy/rigid esophagoscopy under general anesthesia.

Results

There were 100 children included in the study with a mean age of 29.92 months having 93 children (93%) younger than 6 years. The mean duration of impaction was 34.7 hours. Increased duration of impaction was associated with an increased risk of complications and an increased difficulty in removal. There was a significant correlation between the site of impaction and the age of the patient. Complications were seen in 10% of cases with severe complications in 6 cases. No fatalities were reported in this study.

Conclusions

Button batteries impacted in the esophagus can lead to severe complications including death. There has been an increasing trend in the ingestion of button batteries over the last 4 years. A prompt diagnosis and emergent removal of the battery are crucial to minimize the rate of complications. Symptoms of stridor and dysphagia must be given more attention, and these children are prioritized because they are more prone to have complications. Furthermore, primary prevention and caregiver education should be emphasized, and the need for a legislation to change the policies for securing the batteries in their products must be endorsed.
Longitudinal Relationship Between Tibiofemoral Contact Stress at Baseline and Worsening of Knee Pain Over 84 Months in the Multicenter Osteoarthritis Study
Authors: Rabe Kaitlin G. , Stockman Tyler J. , Kern Andrew M. , Wirth Wolfgang , Eckstein Felix , Sharma Leena , Lynch John A. , Nevitt Michael C. , Anderson Donald D. , Segal Neil A.
Published: October 2021

Objective

The aim of the study was to determine whether tibiofemoral contact stress predicts risk for worsening knee pain over 84 ms in adults aged 50–79 yrs with or at elevated risk for knee osteoarthritis.

Design

Baseline tibiofemoral contact stress was estimated using discrete element analysis. Other baseline measures included weight, height, hip-knee-ankle alignment, Kellgren-Lawrence grade, and Western Ontario and McMaster Universities Osteoarthritis Index pain subscale. Logistic regression models assessed the association between baseline contact stress and 84-mo worsening of Western Ontario and McMaster Universities Osteoarthritis Index pain subscale.

Results

Data from the dominant knee (72.6% Kellgren-Lawrence grade 0/1 and 27.4% Kellgren-Lawrence grade ≥ 2) of 208 participants (64.4% female, mean ± SD body mass index = 29.6 ± 5.1 kg/m2) were analyzed. Baseline mean and peak contact stress were 3.3 ± 0.9 and 9.4 ± 4.3 MPa, respectively. Forty-seven knees met the criterion for worsening pain. The highest tertiles in comparison with the lowest tertiles of mean (odds ratio [95% confidence interval] = 2.47 [1.03–5.95], P = 0.04) and peak (2.49 [1.03–5.98], P = 0.04) contact stress were associated with worsening pain at 84 mos, after adjustment for age, sex, race, clinic site, and baseline pain. Post hoc sensitivity analyses including adjustment for body mass index and hip-knee-ankle alignment attenuated the effect.

Conclusions

These findings suggest that elevated tibiofemoral contact stress can predict the development of worsening of knee pain.
Comparison of the Effect of Ultrasound-Guided Injection of Botulinum Toxin Type A and Corticosteroid in the Treatment of Chronic Plantar Fasciitis
Authors: Ahadi Tannaz , nik Sasan Sadeghi , Forogh Bijan , Madani Seyed Pezhman , Raissi Gholam Reza
Published: October 2021

Objective

The aim of the study was to compare the efficacy of ultrasound-guided injection of botulinum toxin type A with corticosteroid in patients with chronic plantar fasciitis (PF).

Design

This randomized controlled trial was conducted on 35 patients with chronic plantar fasciitis. Participants were randomly allocated into two groups: one group received methylprednisolone in to the plantar fascia (n = 18) and the other group received botulinum toxin type A injection into the flexor digitorum brevis and quadratus plantae (n = 17). All injections were performed under ultrasound guidance. Patients were evaluated using the Visual Analog Scale, Foot and Ankle Ability Measures, and plantar fascia thickness before the intervention, 3 wks, 12 wks, and 6 mos after the treatment.

Results

In both groups, patients’ pain and function improved significantly up to 3 wks after injection. In the botulinum toxin type A group, morning Visual Analog Scale improved significantly at 12 wks after intervention and the improvement was sustained for another 3 mos. In the botulinum toxin type A group, Foot and Ankle Ability Measures–sports subscale improved in all evaluated points, whereas in the corticosteroid group, the improvement was significant only when comparing follow-ups values to baseline.

Conclusions

Both ultrasound-guided botulinum toxin type A and corticosteroid injection were effective in the treatment of plantar fasciitis. Our study showed that the effects of botulinum toxin type A injection last longer than those of steroid injection.
18F-FDG PET/CT in a Patient With Matrix-Producing Carcinoma of the Breast
Authors: Chen Xueqi , Chen Guoqian , Fu Zhanli , Li Qian
Published: October 2021

A 47-year-old woman presented with a large mass in the upper inner quadrant of the left breast. 18F-FDG PET/CT revealed a low-density left breast mass with heterogeneous ring-like 18F-FDG uptake. Core needle biopsy of the tumor revealed a rare subtype of metaplastic breast carcinoma, matrix-producing carcinoma. The tumor size slightly decreased after 6 cycles of neoadjuvant chemotherapy with docetaxel and epirubicin. The left breast was entirely resected subsequently, and the matrix-producing carcinoma of the breast was ultimately diagnosed.
Impressive Rapid Complete Response on FDG PET/CT to BRAF Inhibitors in a Metastatic Melanoma With Massive Tumor Burden
Authors: Abgral Ronan , Salaun Pierre-Yves , Sassolas Bruno
Published: October 2021

Recent advances in the development of innovative treatments for MM (metastatic melanoma) significantly improved survival. BRAF inhibitor–targeted therapies are also indicated in stage IV BRAF-mutant melanoma, especially dabrafenib and trametinib in combination. The authors present here an impressive rapid (1 month) complete metabolic response on FDG PET/CT to BRAF inhibitors of an MM with a massive tumor burden estimated at more than 10 kg.
STOP Signs: A Population-based Interrupted Time Series Analysis of Antibiotic Duration for Complicated Intraabdominal Infection Before and After the Publication of a Landmark RCT
Authors: Ng-Kamstra Joshua S. , Soo Andrea , McBeth Paul , Rotstein Ori , Zuege Danny J. , Gregson Daniel , Doig Christopher James , Stelfox Henry T. , Niven Daniel J.
Published: October 2021

Objective:

To determine if the STOP-IT randomized controlled trial changed antibiotic prescribing in patients with Complicated Intraabdominal Infection (CIAI).

Summary of Background Data:

CIAI is common and causes significant morbidity. In May 2015, the STOP-IT randomized controlled trial showed equivalent outcomes between four-day and clinically determined antibiotic duration.

Methods:

This was a population-based retrospective cohort study using interrupted time series methods. The STOP-IT publication date was the exposure. Median duration of inpatient antibiotic prescription was the outcome. All adult patients admitted to four hospitals in Calgary, Canada between July 2012 and December 2018 with CIAI who survived at least four days following source control were included. Analysis was stratified by infectious source as appendix or biliary tract (group A) versus other (group B).

Results:

Among 4384 included patients, clinical and demographic attributes were similar before vs after publication. In Group A, median inpatient antibiotic duration was 3 days and unchanged from the beginning to the end of the study period [adjusted median difference -0.00 days, 95% confidence interval (CI) -0.37 – 0.37 days]. In Group B, antibiotic duration was shorter at the end of the study period (7.87 vs 6.73 days; -1.14 days, CI-2.37 – 0.09 days), however there was no change in trend following publication (-0.03 days, CI –0.16 - 0.09).

Conclusions:

For appendiceal or biliary sources of CIAI, antibiotic duration was commensurate with the experimental arm of STOP-IT. For other sources, antibiotic duration was long and did not change in response to trial publication. Additional implementation science is needed to improve antibiotic stewardship.