bluuebunny/crossref_metadata_2025 huggingface dataset:
Cheap Lodging-Houses
Authors: Mayhew Henry
Published: December 2020

I now come to the class of cheap lodging-houses usually frequented by the casual labourers at the docks.

On my first visit, the want and misery that I saw were such, that, in consulting with the gentleman who led me to the spot, it was...
London Omnibus-Drivers and Conductors
Authors: Mayhew Henry
Published: December 2020

Omnibus Drivers

The omnibus drivers have been butchers, farmers, horsebreakers, cheesemongers, old stage-coachmen, broken-down gentlemen, turfmen, gentlemen’s servants, grooms, and a very small sprinkling of mechanics. Nearly all can read and write, the exception being described to me as a singularity; but there are such...
Thieves and Swindlers
Authors: Mayhew Henry
Published: December 2020

The Sneaks, or Common Thieves

The common thief is not distinguished for manual dexterity and accomplishment, like the pickpocket or mobsman, nor for courage, ingenuity, and skill, like the burglar, but is characterized by low cunning and stealth—hence he is termed the Sneak,...
Diagnostic yield from routine metabolic screening tests in evaluation of global developmental delay and intellectual disability
Authors: Vallance Hilary , Sinclair Graham , Rakic Bojana , Stockler-Ipsiroglu Sylvia
Published: December 2020

Global developmental delay and intellectual disability (GDD/ID) affect 3% of the paediatric population. Although inborn errors of metabolism (IEM) are not a common cause of GDD/ID, early therapeutic intervention can improve neurodevelopmental manifestations. In 2012, a first-tier test panel, including specialized metabolic and routine chemistry tests, was piloted to community-based paediatricians in British Columbia with aims to achieve earlier diagnosis of treatable IEM.

Objective

The aim of this retrospective review was to evaluate the diagnostic yield from these first-tier tests in the 7 years before (2006 to 2012) and after (2013 to 2019) implementation at the community paediatrician level.

Results

Prior and postimplementation diagnostic yield of an IEM from first-tier metabolic testing was 9 out of 986 (0.91%) and 11 out of 4,345 children (0.25%), respectively. Disorders of creatine metabolism and organic acidurias were the most frequently established diagnoses in both time periods. No diagnoses were established through acylcarnitine copper/ceruloplasmin, lactate, or ammonia testing. Twenty out of 24 patients had specific neurological or other red flag signs in addition to GDD/ID. Four boys diagnosed with an x-linked creatine transporter defect (CTD) had speech-language delay as the most prominent finding.

Conclusions

The expansion of first-tier metabolic testing to community-based paediatricians in BC did not yield an increase in IEM diagnoses. A modified first-tier test panel should be offered to patients with GDD/ID, neurologic, and/or red flag signs. Urine creatine testing in boys with speech-language delay warrants consideration to detect CTD.
Knowledge, attitudes and anxiety toward COVID-19 among domestic and overseas Chinese college students
Authors: Yang Haojun , Chen Zhuohui , Fan Yishu , Hu Xinhang , Wu Tong , Kang Shuntong , Xiao Bo , Zhang Mengqi
Published: December 2020

Background

To investigate the knowledge, attitudes and anxiety toward COVID-19 among Chinese college students studying in China and abroad.

Method

A structured questionnaire, comprised of demographic characteristics, knowledge and attitudes toward COVID-19 and the State–Trait Anxiety Inventory (STAI), was used to collect data for 566 domestic students and 126 students studying abroad.

Results

Domestic students were better than students abroad in knowledge of epidemiology and manifestations. Domestic students showed a significant higher enthusiasm for voluntary services than students abroad, including medical science popularization, community services, traffic dispersion, logistics transportation and being volunteers for vaccine trials. The scores (Mean ± SD) of S-AI and T-AI among students abroad were 59.48 ± 8.63 and 54.10 ± 7.20, respectively, which were significantly higher than those of domestic students (39.46 ± 8.16 and 39.25 ± 7.72).

Conclusions

Our study showed a better understanding of knowledge, more positive attitudes and less anxiety toward COVID-19 among domestic students, compared with students studying abroad. In light of this information, more attention and appropriate psychological and social intervention should be paid to college students with anxiety, especially those studying abroad.
Intraoperative Radiographs in Single-level Lateral Lumbar Interbody Fusion Can Predict Radiographic and Clinical Outcomes of Follow-up 2 Years After Surgery
Authors: Jung Jong-myung , Chung Chun Kee , Kim Chi Heon , Yang Seung Heon , Ko Young San , Choi Yunhee
Published: December 2020

Mini

Some of the improvements in DH, FH, and SLL achieved intraoperatively during lateral lumbar interbody fusion surgery were lost by the postoperative 1-week follow-up. An intraoperative radiograph can predict radiographic and clinical outcomes of the 2-year follow-up. The difference between preoperative DH and intraoperative DH should be >4.18 mm.

Study Design.

Retrospective cohort study

Objective.

The aim of this study was to evaluate whether the intraoperatively estimated parameters, as calculated on a cross-table lateral radiograph, are maintained in an upright position at discharge and at 2 years postoperatively and to identify the appropriate disc height (DH) to achieve substantial clinical benefit.

Summary of Background Data.

The amount of correction retained following lateral lumbar interbody fusion (LLIF) surgery had not been reported.

Methods.

A single-center, consecutive series of patients who underwent single-level LLIF with at least 2 years of follow-up were retrospectively reviewed. Upright standardized preoperative, 1-week, and 2-year postoperative radiographs, as well as intraoperative lateral radiographs, were analyzed for DH, foraminal height (FH), and segmental lumbar lordosis (SLL) at the index level. Clinical outcomes were compared between preoperatively and 1 week and 2 years postoperatively.

Results.

In total, 89 patients were evaluated (mean follow-up, 42.8 months [range, 24–83 months]). DH decreased from 12.5 ± 2.7 mm intraoperatively to 11.7 ± 3.1 mm at 1 week postoperatively, FH decreased from 15.9 ± 3.6 mm to 15.1 ± 3.6 mm, and SLL decreased from 13.6° ± 1.7° to 12.4° ± 1.7°. A linear correlation between intraoperative and 2-year postoperative parameters was found (R
2 = 0.552, 0.518, and 0.616, respectively). Clinical outcomes, including back pain, leg pain, and Oswestry Disability Index (ODI), significantly improved 2 years postoperatively. The optimal cutoff point for substantial clinical benefit thresholds for the ODI was a 4.18 mm increase in DH (sensitivity, 64.3%; specificity, 80.3%; area under the curve, 0.793; 95% confidence interval, 0.642–0.855).

Conclusion.

Some of the improvements in DH, FH, and SLL achieved intraoperatively during LLIF surgery were lost by the postoperative 1-week follow-up. An intraoperative radiograph can predict radiographic and clinical outcomes of the 2-year follow-up. The difference between preoperative DH and intraoperative DH should be >4.18 mm.

Level of Evidence: 4
Fibrous Connection Between Cervical Nerve and Zygapophysial Joint and Implication of the Cervical Spondylotic Radiculopathy
Authors: Kagawa Eiichiro , Nimura Akimoto , Nasu Hisayo , Kato Ryuichi , Akita Keiichi
Published: December 2020

Study Design

Observational, anatomical, cadaveric study.

Objective

We anatomically investigated the fibrous connection between the cervical nerves and the zygapophysial joint capsules.

Summary of Background Data

Cervical spondylotic radiculopathy is caused by the compression of the cervical nerves as the static factor and head and neck movements as the dynamic factor. To understand the dynamic pathology of cervical spondylotic radiculopathy, the anatomic relationship between the cervical nerves and the zygapophysial joints needs to be investigated in detail.

Methods

In 11 cadavers, we dissected both sides from the C5 to C7. For macroscopic examination, we observed structures connecting the cervical nerves and the zygapophysial joints in 18 cervical nerves from three cadavers. In 14 sides of eight cadavers, we histologically analyzed the fibrous structures and their attachments.

Results

Macroscopically, the fibrous band connected the cranial surface of the cervical nerve to the lateral and inferior aspects of the transverse process. In four of 18 nerves, the fibrous bands were divided into two fascicles by loose connective tissues. In addition, the fibrous bands extended along the dorsal aspect of the posterior tubercle of the transverse process and attached to the zygapophysial joint capsule. Histologically, densely stained fibrous tissues overlaid the zygapophysial joint capsule and extended to the recess between the posterior tubercle and inferior articular process on the cranial vertebral body.

Conclusion

We macroscopically and histologically clarified the fibrous bands connecting the cervical nerve to the zygapophysial joint capsule. The fibrous bands may help clarify the pathology of cervical spondylotic radiculopathy associated with the zygapophysial joints as dynamic factors.

Level of Evidence: N/A
The Effectiveness of Matrix Rhythm Therapy in Patients with Chronic Low Back Pain
Authors: Özcan Nadir Tayfun , Çalık Bilge Başakçı , Kabul Elif Gür
Published: December 2020

Study Design.

Randomized clinical study.

Objective

Our study was planned to determine the effect of matrix rhythm therapy (MRT) on pain, level of disability, and quality of life in chronic low back pain.

Summary of Background Data.

Low back pain is a complex and heterogeneous disorder. Different therapy options can be applied in the treatment of low back pain. In the literature, there are very few studies showing the effect of MRT in patients with chronic low back pain.

Methods.

A total of 32 participants with a mean age of 36.41 ± 8.91 years were randomly divided into two groups (intervention group and control group). Each participant was treated with ten sessions a combined physiotherapy program (hot pack, transcutaneous electrical nerve stimulation, therapeutic ultrasound, home exercise and patient education program). Additionally, intervention group received six sessions of MRT. Pain (McGill Pain Questionnaire), level of disability (Oswestry Disability Index) and quality of life (Short Form-36) were measured before and after the treatment programme.

Results.

When pre- and post-treatment results were compared in the intervention group, a statistically significant difference was found in total pain level, disability level, and all subdimensions except the “Emotional Role” subdimension of Short Form-36 (SF-36) and total SF-36 scores (P ≤ 0.05). In the control group, statistically significant differences were found in disability level, the “Vitality” and “Bodily Pain” subdimensions of SF-36 and total SF-36 scores (P ≤ 0.05). When the delta values were compared between groups, there was a statistically significant difference only in the “general health perceptions” subdimension of SF-36 (P ≤ 0.05) in favor of the intervention group.

Conclusion.

It was determined that both the combined physiotherapy program and the MRT application in addition to the combined physiotherapy program have a positive effect on pain, disability level, and quality of life in patients with chronic low back pain.

Level of Evidence: 2
Pediatric Emergency and Critical Care Resources and Infrastructure in Resource-Limited Settings: A Multicountry Survey*
Authors: Muttalib Fiona , González-Dambrauskas Sebastián , Lee Jan Hau , Steere Mardi , Agulnik Asya , Murthy Srinivas , Adhikari Neill K. J.
Published: December 2020

OBJECTIVES:

To describe the infrastructure and resources for pediatric emergency and critical care delivery in resource-limited settings worldwide.

DESIGN:

Cross-sectional survey with survey items developed through literature review and revised following piloting.

SETTING:

The electronic survey was disseminated internationally in November 2019 via e-mail directories of pediatric intensive care societies and networks and using social media.

PATIENTS:

Healthcare providers who self-identified as working in resource-limited settings.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Results were summarized using descriptive statistics and resource availability was compared across World Bank country income groups. We received 328 responses (238 hospitals, 60 countries), predominantly in Latin America and Sub-Saharan Africa (n = 161, 67.4%). Hospitals were in low-income (28, 11.7%), middle-income (166, 69.5%), and high-income (44, 18.4%) countries. Across 174 PICU and adult ICU admitting children, there were statistically significant differences in the proportion of hospitals reporting consistent resource availability (“often” or “always”) between country income groups (p < 0·05). Resources with limited availability in lower income countries included advanced ventilatory support, invasive and noninvasive monitoring, central venous access, renal replacement therapy, advanced imaging, microbiology, biochemistry, blood products, antibiotics, parenteral nutrition, and analgesic/sedative drugs. Seventy-seven ICUs (52.7%) were staffed 24/7 by a pediatric intensivist or anesthetist. The nurse-to-patient ratio was less than 1:2 in 71 ICUs (49.7%).

CONCLUSIONS:

Contemporary data demonstrate significant disparity in the availability of essential and advanced human and material resources for the care of critically ill children in resource-limited settings. Minimum standards for essential pediatric emergency and critical care in resource-limited settings are needed.
Bronchopleural Fistula in the Mechanically Ventilated Patient: A Concise Review
Authors: Grotberg John C. , Hyzy Robert C. , De Cardenas Jose , Co Ivan N.
Published: December 2020

Objective:

To describe the physiology of air leak in bronchopleural fistula in mechanically ventilated patients and how understanding of its physiology drives management of positive-pressure ventilation. To provide guidance of lung isolation, mechanical ventilator, pleural catheter, and endobronchial strategies for the management of bronchopleural fistula on mechanical ventilation.

Data Sources:

Online search of PubMed and manual review of articles (laboratory and patient studies) was performed.

Study Selection:

Articles relevant to bronchopleural fistula, mechanical ventilation in patients with bronchopleural fistula, independent lung ventilation, high-flow ventilatory modes, physiology of persistent air leak, extracorporeal membrane oxygenation, fluid dynamics of bronchopleural fistula airflow, and intrapleural catheter management were selected. Randomized trials, observational studies, case reports, and physiologic studies were included.

Data Extraction:

Data from selected studies were qualitatively evaluated for this review. We included data illustrating the physiology of driving pressure across a bronchopleural fistula as well as data, largely from case reports, demonstrating management and outcomes with various ventilator modes, intrapleural catheter techniques, endoscopic placement of occlusion and valve devices, and extracorporeal membrane oxygenation. Themes related to managing persistent air leak with mechanical ventilation were reviewed and extracted.

Data Synthesis:

In case reports that demonstrate different approaches to managing patients with bronchopleural fistula requiring mechanical ventilation, common themes emerge. Strategies aimed at decreasing peak inspiratory pressure, using lower tidal volumes, lowering positive end-expiratory pressure, decreasing the inspiratory time, and decreasing the respiratory rate, while minimizing negative intrapleural pressure decreases airflow across the bronchopleural fistula.

Conclusions:

Mechanical ventilation and intrapleural catheter management must be individualized and aimed at reducing air leak. Clinicians should emphasize reducing peak inspiratory pressures, reducing positive end-expiratory pressure, and limiting negative intrapleural pressure. In refractory cases, clinicians can consider lung isolation, independent lung ventilation, or extracorporeal membrane oxygenation in appropriate patients as well as definitive management with advanced bronchoscopic placement of valves or occlusion devices.
Evaluation of Electronic Health Record–Generated Work Intensity Scores and Nurse Perceptions of Workload Appropriateness
Authors: Womack Dana , Warren Cheri , Hayes Mariah , Stoyles Sydnee , Eldredge Deborah
Published: December 2020

Electronic health record–generated work intensity scores represent state-of-the art functionality for dynamic nursing workload estimation in the hospital setting. In contrast to traditional stand-alone patient classification and acuity tools, electronic health record–based tools eliminate the need for dedicated data entry, and scores are automatically updated as new information is entered into patient records. This paper summarizes the method and results of evaluation of electronic health record–generated work intensity scores on six hospital patient care units in a single academic medical center. The correlation between beginning-of-shift work intensity scores and self-reported registered nurse rating of appropriateness of patient assignment was assessed using Spearman rank correlation. A weak negative correlation (−0.09 to −0.23) was observed on all study units, indicating that nurse appropriateness ratings decrease as work intensity scores increase. Electronic health record–generated work intensity scores provide useful information that can augment existing data sources used by charge nurses to create equitable nurse-patient assignments. Additional research is needed to explain observed variation in nurses' appropriateness ratings across similar work intensity point ranges.
Efficacy and Safety of a Novel Botulinum Toxin A for Masseter Reduction: A Randomized, Double-Blind, Placebo-Controlled, Optimal Dose-Finding Study
Authors: Hong Ji Yeon , Jeong Guk Jin , Kwon Tae-Rin , Kim Jong Hwan , Li Kapsok , Kim Beom Joon
Published: December 2020

BACKGROUND

A wide lower face and a square jaw are considered esthetic problems, particularly in Asia.

OBJECTIVE

To investigate the optimal dose of a novel botulinum toxin (prabotulinum toxin A) for treating masseteric hypertrophy.

METHODS

Ninety subjects with masseteric hypertrophy were randomly divided into 5 groups and treated with placebo (A, normal saline) or prabotulinum toxin A (B: 24, C: 48, D: 72, and E: 96 units). Photography, ultrasonography, and 3-dimensional imaging were performed before and after injection at baseline and at 4, 8, 12, and 16 weeks after treatment. The participants also rated their satisfaction.

RESULTS

Masseter thickness significantly reduced in all groups at 12 weeks, compared with that in the placebo group. A dose-dependent reduction in masseter thickness was observed at the resting and maximal clenching positions. Sonography and 3-dimensional imaging revealed a gradual reduction in masseter thickness and volume, respectively, during the first 12 weeks. Despite being slightly effective, a dose of 24 units might be insufficient for resolving square face problems. Patients in Group E reported discomfort during jaw movement.

CONCLUSION

Prabotulinum toxin A could effectively improve lower face contour without major complications, with an optimal dose of 48 to 72 units, followed by reinjection after 12 weeks.
Optimizing Care Preconception for Women With Diabetes and Obesity
Authors: WILKIE GIANNA , LEFTWICH HEIDI K.
Published: December 2020

The prevalence of diabetes in reproductive age women has been reported to be as high as 6.8%, with pregestational diabetes affecting 2% of all pregnancies. As cases of diabetes in children and adolescents rise, more patients will be entering reproductive age and pregnancy with diagnoses of obesity, prediabetes, type 2 diabetes. Early interventions of diet modification and exercise to maintain healthy weights can delay or even prevent these complications. It is critical for health care providers to emphasize the importance of preconception counseling in this high-risk patient population to reduce the morbidities associated with obesity and diabetes in pregnancy.
Effect of Hemodialysis on Peripapillary Choroidal Thickness Measured by Swept-Source Optical Coherence Tomography
Authors: Lee Won June , Hong Rimkyung , Kang Min Ho , Cho Heeyoon , Han Sang-Woong , Yi Joo-Hark , Shin Yong Un , Seong Mincheol
Published: December 2020

Purpose:

The aim was to investigate the effects of hemodialysis (HD) on peripapillary choroidal thickness (PCT) by swept-source optical coherence tomography and on other ophthalmologic parameters in patients with end-stage kidney disease.

Materials and Methods:

This was a prospective observational study. The authors evaluated 29 patients who underwent HD for end-stage kidney disease. Detailed ophthalmologic examinations and swept-source optical coherence tomography were performed immediately before and after HD. PCT was measured using the modification tool in the built-in OCT image viewer program. Changes in PCT before and after HD were statistically analyzed.

Results:

The average PCT significantly decreased from 127.3±49.2 μm before HD to 117.1±50.9 μm after HD (P<0.001). A significant correlation was found between changes in PCT and macular choroidal thickness (ρ=0.547, P=0.002). Changes in mean ocular perfusion pressure did not significantly correlate with changes in PCT (ρ=−0.049, P=0.803).

Conclusions:

PCT significantly decreased after HD. HD could influence the optic nerve head and its surrounding structures.
Did the OCT Show Progression Since the Last Visit?
Authors: Hood Donald C. , Melchior Bruna , Tsamis Emmanouil , Liebmann Jeffrey M. , De Moraes Carlos G.
Published: December 2020

Identifying progression is of fundamental importance to the management of glaucoma. It is also a challenge. The most sophisticated, and probably the most useful, commercially available clinical tool for identifying progression is the Guided Progression Analysis (GPA), which was initially developed to identify progression using 24-2 visual field tests. More recently, it has been extended to retinal nerve fiber layer (RNFL) and ganglion cell+inner plexiform layer thicknesses measured with optical coherence tomography (OCT). However, the OCT GPA requires a minimum of 3 tests to determine “possible loss (progression)” and a minimum of 4 tests to determine if the patient shows “likely loss (progression).” Thus, it is not designed to answer a fundamental question asked by both the clinician and the patient, namely: Did damage progress since the last visit? Some clinicians use changes in summary statistics, such as global/average circumpapillary RNFL thickness. However, these statistics have poor sensitivity and specificity due to segmentation and alignment errors. Instead of relying on the GPA analysis or summary statistics, one needs to evaluate RNFL and ganglion cell+inner plexiform layer probability maps and circumpapillary OCT B-scan images. In addition, we argue that the clinician can make a better decision about suspected progression between 2 test days by topographically comparing the changes in the different OCT maps and images, in addition to topographically comparing the changes in the visual field with the changes in OCT probability maps.
Influence of Different Antidepressants on Ocular Surface in Patients With Major Depressive Disorder
Authors: Işik-Ulusoy Selen , Ulusoy Mahmut Oğuz
Published: December 2020

Purpose

Several studies have previously reported the association between dry eye and depression along with the treatment of depression. The aim of this study was to investigate the effects of different antidepressant drugs on tear parameters in patients with major depressive disorder.

Methods

We recruited 132 patients who were using different antidepressants and 58 healthy controls. Venlafaxine, duloxetine, escitalopram, and sertraline were used by 34, 28, 36, and 34 patients, respectively. The participants filled out and completed the Beck Depression Scale. We recorded Schirmer test, tear breakup time (TBUT) and corneal staining values of the participants. The Ocular Surface Disease Index was completed by the participants. In addition, we evaluated the tear meniscus parameters by using anterior segment optical coherence tomography.

Results

All conventional dry eye tests and tear meniscus parameters were significantly lesser in the depression group than in the control group (Schirmer test, 11.41 ± 6.73 mm and 22.53 ± 4.98 mm; TBUT, 5.29 ± 2.92 seconds and 13.38 ± 1.72; Corneal staining, tear meniscus area, 0.026 ± 0.012 mm2 and 0.11 ± 0.025 mm2; tear meniscus depth, 182.75 ± 78.79 μm and 257.48 ± 90.1 μm; tear meniscus height, 290.3 ± 133.63 μm and 459.78 ± 180.26 μm, in patients and controls, respectively). The tear parameters of the duloxetine group were lowest among the drug groups and Schirmer test, and TBUT of the venlafaxine group was statistically significantly different from the duloxetine group (P = 0.028 and P = 0.017, respectively). Ocular Surface Disease Index score of the depression group was significantly higher than the control group (31.12 ± 21.15 and 17.43 ± 11.75 in depression and control group, respectively.)

Conclusions

We found that the usage of selective serotonin reuptake inhibitors and serotonin noradrenaline reuptake inhibitors affects the ocular surface by a mechanism other than the anticholinergic system. Besides serotonin blockage, the noradrenaline blockade of serotonin noradrenaline reuptake inhibitors may increase the dry eye findings on the ocular surface.
No Effect of Coenzyme Q10 on Cognitive Function, Psychological Symptoms, and Health-related Outcomes in Schizophrenia and Schizoaffective Disorder
Authors: Maguire Áine , Mooney Christina , Flynn Grainne , Ferguson Yolande , O'Keane Veronica , O'Rourke Doreen , McMonagle Tom , Heaton Robert , Phillips Suzannah , Hargreaves Iain , Gill Michael , Hargreaves April
Published: December 2020

Background

Cognitive impairments, negative symptoms, affective symptoms, and low energy are highly prevalent features of schizophrenia. Mitochondrial dysfunction has been hypothesized as one of the numerous factors to underlie the manifestation of these symptoms. The objective of this study was to evaluate whether Coenzyme Q10 (CoQ10) has a role in the treatment of schizophrenia and schizoaffective disorder.

Methods

A double-blind, randomized, placebo-controlled trial was conducted to assess the effects of CoQ10 supplementation (300 mg/day) on the co-primary outcomes of attention and working memory performance after 3 and 6 months. Secondary outcomes included plasma CoQ10 levels, mitochondrial function, energy, depression, anxiety, negative symptoms, and quality oflife.

Findings

In total, 72 patients were randomized to intervention groups. Overall, there was no effect of CoQ10 supplementation on the primary outcome measures at 3 or 6 months. Further, with the exception of plasma CoQ10 levels, CoQ10 supplementation also had no effect on the secondary outcomes. At 3 months, CoQ10 concentration was significantly higher in the CoQ10 group (3.85 μg/mL) compared with placebo (1.13 μg/mL); this difference was not present at 6 months.

Conclusions

The results of the study suggest that CoQ10 supplementation at 300 mg/day for 6 months is unlikely to be beneficial for cognitive, psychological and health-related outcomes in schizophrenia and schizoaffective disorder. However, a number of limitations including low adherence, modest sample size, and attrition, likely reduce estimates of effects. As such, results should be considered preliminary.
The Application of the Theory Coding Scheme to Interventions in Occupational Health Psychology
Authors: Horan Kristin A. , Streit Jessica M.K. , Beltramo Jenna M.D. , Post Marissa
Published: December 2020

Objective:

There is a need to understand how and to what extent theory is used to inform occupational health psychology (OHP) interventions. This study examines the utility of Michie and Prestwich
1
theory coding scheme (TCS) to examine the theoretical base of OHP interventions.

Methods:

We applied the TCS to a systematically derived sample of 27 papers that reported evaluation data for work-related interventions seeking to improve employee sleep quantity or quality.

Results:

Results indicated that the original TCS was largely applicable to OHP sleep interventions. After several minor modifications to its evaluative criteria, the TCS successfully accommodates a range of OHP intervention designs.

Conclusions:

The revised TCS for OHP interventions allows for a more detailed understanding of the role and use of theory in OHP interventions and may prove to be a valuable tool for OHP researchers and practitioners.
Risk Factors for Bacteremia After Endoscopic Procedures in Hospitalized Patients With a Focus on Neutropenia
Authors: Isenberg Yoni , Zamstein Noa , Horesh Nurit , Chowers Yehuda , Bar-Yoseph Haggai
Published: December 2020

Background:

The risk for bacteremia following endoscopic procedures varies among studies. A low neutrophil count is considered as a risk factor.

Objective:

To assess risk factors for bacteremia following endoscopic procedures, focusing on neutropenia.

Methods:

This was a retrospective analysis of all inpatients undergoing endoscopic procedures between 2005 and 2018 with neutrophil count taken within 72 hours before the procedure in a tertiary center in Israel. The primary outcome was positive blood culture within 48 hours following the procedure of bacteria that was not cultured before. Risk factors for bacteremia were assessed and multivariate logistic regression models were built. In neutropenic patients, comparator groups were used to assess the risk related to the procedure and neutropenia.

Results:

Of 13,168 patients included, postprocedural bacteremia was recorded in 103 (0.8%). Neutropenia, low albumin level, male gender, older age, preprocedure fever, and admitting department were associated with increased risk for bacteremia in both univariate and multivariate analyses. A multivariate model including these factors was found to be predictive of bacteremia (area under the curve 0.82; 95% confidence interval, 0.78-0.88). In neutropenic patients, the risk of postendoscopic bacteremia (4.2%) was not significantly different compared with neutropenic patients undergoing bronchoscopy (1.8%, P=0.14) or from the rate of bacteremia-to-neutropenic episodes (“background risk”) in neutropenic patients in general (6.3%, P=0.33).

Conclusions:

Postendoscopic bacteremia is a rare event among inpatients. Although neutropenia was found to be a risk factor for bacteremia, it was not higher than the background risk in these patients. Models highly predictive of bacteremia were developed and should be validated.
Associations of Duration, Intensity, and Quantity of Smoking With Risk of Gastric Intestinal Metaplasia
Authors: Thrift Aaron P. , Jove Andre G. , Liu Yan , Tan Mimi C. , El-Serag Hashem B.
Published: December 2020

Goal:

Determine whether various dimensions of smoking increase risk for gastric intestinal metaplasia.

Background:

Cigarette smoking has been implicated in the etiology of gastric cancer, but it is not clear if smoking is a risk factor for gastric intestinal metaplasia, a precursor lesion of gastric cancer.

Materials and Methods:

We compared data from 385 gastric intestinal metaplasia cases and 1577 controls without gastric intestinal metaplasia recruited into a cross-sectional study at the Michael E. DeBakey VA Medical Center in Houston, Texas. All participants completed standardized questionnaires and underwent a study endoscopy with gastric mapping biopsies. Gastric intestinal metaplasia cases included participants with intestinal metaplasia on any noncardia gastric biopsy. We calculated odds ratios and associated 95% confidence intervals using multivariable logistic regression models.

Results:

Compared with never smokers, current smokers had 2-fold increased risk for gastric intestinal metaplasia (odds ratio, 2.05; 95% confidence interval, 1.47-2.85). Among ever smokers, increasing duration and total dose were significantly associated with increased risk for gastric intestinal metaplasia (P-trend, 0.004 and 0.01, respectively). Among former smokers, risk for gastric intestinal metaplasia decreased over time and was no different to never smokers after 15 years smoking cessation. Cases with gastric intestinal metaplasia were more likely than controls to have Helicobacter pylori infection (53.2% vs. 21.7%); however, smoking effect on gastric intestinal metaplasia was not different by H. pylori infection status.

Conclusions:

Cigarette smoking is a risk factor for gastric intestinal metaplasia. Risk of gastric intestinal metaplasia among former smokers remained significantly elevated until 15 years postcessation.
Incidence of Depression and Anxiety in a Cohort of Adolescents With Nonalcoholic Fatty Liver Disease
Authors: Noon Sheila L. , D'Annibale Danielle A. , Schwimmer Melanie H. , Shiels Jacqueline , Arin Jennifer , Durelle Janis , Newton Kimberly P. , Goyal Nidhi P. , Schwimmer Jeffrey B.
Published: December 2020

Objectives:

To determine the incidence of clinically diagnosed depression and anxiety in adolescents with nonalcoholic fatty liver disease (NAFLD).

Methods:

This was a prospective, longitudinal cohort study between January 1, 2012 and July 1, 2018 conducted in a Children's Hospital Pediatric Gastroenterology Clinic. Participants included adolescents 12 to 17 years old at baseline with biopsy‐confirmed NAFLD. The primary outcomes were having depression and/or anxiety based upon a clinical diagnosis established by a physician or psychologist. The rates of depression and anxiety were measured at baseline and longitudinally throughout follow‐up.

Results:

A total of 160 adolescents with NAFLD were followed for a mean of 3.8 years. At baseline, 8.1% had a diagnosis of depression. During follow‐up, an additional 9.5% (95% confidence interval, 4.7–14.3) developed depression. The incidence density of depression was 27 new cases per 1000 person‐years at risk. In adolescents with NAFLD, 6.3% had anxiety at baseline and 6.7% (95% confidence interval, 2.6–10.7) developed anxiety during follow‐up. The incidence density of anxiety was 18 new cases per 1000 person‐years at risk. The change in alanine aminotransferase was significantly worse for adolescents with NAFLD who developed depression compared to those who did not develop depression (P < 0.01).

Conclusions:

Adolescents with NAFLD had a high incidence of clinically diagnosed depression and anxiety. The rates were higher than expected relative to the available data in the general population. Addressing this mental health burden will require efforts at both the patient level and the systems level.
Current Physical Therapy Practice in Norway for Children With Cerebral Palsy
Authors: Størvold Gunfrid Vinje , Jahnsen Reidun Birgitta
Published: December 2020

Purpose:

To investigate to what degree functional physical therapy approaches are implemented in Norway when promoting gross motor skill acquisition in children with cerebral palsy.

Methods:

It was a national survey about current practice among Norwegian pediatric physical therapists. The physical therapists chose between 5 predefined approaches developed through practice descriptions by a convenience sample of 55 physical therapists.

Results:

The distribution of the main approaches were: functional training based on principles of motor learning, training of body functions and structures, manual stimulation of position and movements, addressing environmental factors, and conceptual methods. Working in the North and having more experience predicted less chance of using functional approaches. Most physical therapists frequently used other approaches as a supplement to the main approach, but not conceptual methods.

Conclusions:

Functional training based on principles of motor learning has become the method of choice in Norway.
Life-threatening Upper Gastrointestinal Bleeding Due to Ruptured Gastroduodenal Artery Aneurysm in a Child
Authors: Kavitha Thondi Kandy , Madabhavi Prabhu , Takia Lalit , Awasthi Puspraj , Chaluvashetty Sreedhara B , Aneja Aradhana , Menon Prema , Nallasamy Karthi , Angurana Suresh Kumar , Lal Sadhna , Jayashree Muralidharan
Published: December 2020

Gastroduodenal artery (GDA) aneurysm is a rare cause of massive life-threatening upper gastrointestinal (UGI) bleeding in children. Prompt resuscitation with fluids, administration of large amount of blood products (massive transfusion), prompt diagnostic evaluation using computed tomography (CT) angiography or digital subtraction angiography (DSA), and therapeutic endovascular or catheter-based interventions are life-saving. In cases with failed endovascular interventions, open surgical approach to ligate aneurysm is required. We report a 10-year-male with life-threatening UGI bleed due to ruptured GDA aneurysm possibly secondary to sepsis requiring resuscitation, massive transfusion, CT angiography and DSA, endovascular intervention, and ultimately surgical management with good outcome.
Use of Negative-Pressure Wound Therapy With Instillation and Dwell Time: An Overview
Authors: Faust Elizabeth , Opoku-Agyeman Jude L. , Behnam Amir B.
Published: December 2020

The use of negative-pressure wound therapy (NPWT) has become an established therapy for wound management. There have been many advancements in the technology of NPWT including NPWT with instillation and dwell (NPWTi-d). NPWTi-d promotes wound healing by wound cleansing, irrigation, and nonexcisional debridement. NPWTi-d has been shown in comparative clinical studies to decrease the time to definitive wound healing and length of hospitalization. NPWTi-d—using a reticulated open-cell foam dressing with “through” holes (ROCF-CC)—has been postulated to facilitate solubilization, detachment, and elimination of infectious materials, such as slough and thick exudate, before or after operative debridement, and in cases where surgical debridement is not an option. The authors provide an overview on the use of NPWTi-d by reviewing the components of the system, proposed mechanism of action, clinical outcomes, and current consensus guidelines for its utilization.
Use of Negative-Pressure Wound Therapy With Instillation and Dwell in Breast Reconstruction
Authors: Constantine Thomas
Published: December 2020

The use of negative-pressure wound therapy (NPWT) has expanded over the last 3 decades, paralleled and documented by an increase in research. This article discusses the evolution and current applications of NPWT in modern breast reconstruction. Negative-pressure wound therapy with instillation and dwell (NPWTi-d) technology can be used to remove infectious material, facilitate salvaging compromised tissue, and stabilize the soft-tissue environment. Published consensus NPWTi-d guidelines can aid in treatment selection and implementation of this new technology. The therapeutic approach of simultaneously removing infectious material and actively improving mastectomy flap perfusion and thickness is a burgeoning concept, and illustrative cases are presented. NPWTi-d preliminary use has led to reconstruction salvage with reproducible early experience and outcomes, and it is hoped that it will raise interest and awareness of this promising application of the technology to improve breast reconstruction outcomes.
Sacral and Ischial Pressure Ulcer Management With Negative-Pressure Wound Therapy With Instillation and Dwell
Authors: Arowojolu Omotayo A. , Wirth Garrett A.
Published: December 2020

Background:

The addition of topical fluid instillation, a programmable “dwell” time and a novel foam-wound interface to the established wound healing benefits of negative-pressure wound therapy (NPWT) works synergistically to benefit patients with complex wounds. This engineering breakthrough for wound care has been termed NPWT with instillation and dwell (NPWTi-d), and the new foam dressings are reticulated open cell foam dressings specifically designed for use with NPWTi-d. This combined technology has shown promise in chronic, complex wounds and has potential for the management of sacral and ischial pressure wounds.

Methods:

A qualitative comprehensive review was performed analyzing articles from PubMed and Medline that reported on the use of NPWTi-d in sacral or ischial pressure ulcers. Case series and case reports were predominant, and results of cases specific to sacral and ischial pressure wounds were extracted from larger studies and summarized for presentation.

Results:

Compared with conventional NPWT alone, NPWTi-d has been shown to help irrigate the wound, remove fibrinous debris, and promote granulation tissue formation. This is associated with a decreased number of operative debridements and decreased hospital length of stay.

Conclusions:

This technology is rapidly demonstrating expanded utilization in hospitalized patients with chronic sacral and ischial pressure ulcers. When used correctly, NPWTi-d serves as an effective “bridge to defined endpoint”: whether that is a flap reconstruction, skin grafting, or discharge home with a stable chronic wound and simplified wound care.
Mitochondrial Secrets of Youthfulness
Authors: Singh Keshav K.
Published: December 2020

The genetic basis of youthfulness is poorly understood. The aging of skin depends on both intrinsic factors and extrinsic factors. Intrinsic factors include personal genetics, and extrinsic factors include environmental exposure to solar radiation and pollution. We recently reported the critical role of the mitochondria in skin aging phenotypes: wrinkle formation, hair graying, hair loss, and uneven skin pigmentation. This article focuses on molecular mechanisms, specifically mitochondrial mechanisms underlying skin aging. This contribution describes the development of an mitochondrial DNA depleter-repleter mouse model and its usefulness in developing strategies and identifying potential agents that can either prevent, slow, or mitigate skin aging, lentigines, and hair loss. The ongoing research efforts include the transplantation of young mitochondria to rejuvenate aging skin and hair to provide youthfulness in humans.
Management of Wounds With Orthopedic Fixation Hardware Using Negative-Pressure Wound Therapy With Instillation and Dwell
Authors: Liu Jane , Crist Brett D.
Published: December 2020

Negative-pressure wound therapy with instillation and dwell (NPWTi-d) is an option for management of wounds with exposed orthopedic fixation hardware. The mechanical effect of the negative-pressure therapy works to contract the wound edges, and the instillation of solution and its subsequent removal help remove infectious material. NPWTi-d also promotes robust granulation tissue formation. In this article, we discuss the science behind NPWTi-d and its role in the treatment of wounds with indwelling orthopedic fixation hardware.
A Systematic Review of the Utility of Indocyanine Angiography in Autologous Breast Reconstruction
Authors: Parmeshwar Nisha , Sultan Steven M. , Kim Esther A. , Piper Merisa L.
Published: December 2020

Background

In the last decade, a number of studies have demonstrated the utility of indocyanine green (ICG) angiography in predicting mastectomy skin flap necrosis for immediate breast reconstruction. However, data are limited to investigate this technique for autologous breast reconstruction. Although it may have the potential to improve free flap outcomes, there has not been a large multicenter study to date that specifically addresses this application.

Methods

A thorough literature review based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines was conducted. All studies that examined the use of intraoperative ICG angiography or SPY to assess perfusion of abdominally based free flaps for breast reconstruction from January 1, 2000, to January 1, 2020, were included. Free flap postoperative complications including total flap loss, partial flap loss, and fat necrosis were extracted from selected studies.

Results

Nine relevant articles were identified, which included 355 patients and 824 free flaps. A total of 472 free flaps underwent clinical assessment of perfusion intraoperatively, whereas 352 free flaps were assessed with ICG angiography. Follow-up was from 3 months to 1 year. The use of ICG angiography was associated with a statistically significant decrease in flap fat necrosis in the follow-up period (odds ratio = 0.31, P = 0.02). There was no statistically significant difference for total or partial flap loss.

Conclusions

From this systematic review, it can be concluded that ICG angiography may be an effective and efficient way to reduce fat necrosis in free flap breast reconstruction and may be a more sensitive predictor of flap perfusion than clinical assessment alone. Future prospective studies are required to further determine whether ICG angiography may be superior to clinical assessment in predicting free flap outcomes.
Pediatric Parotidectomy
Authors: Kalmar Christopher L. , Patel Vijay A. , Taylor Jesse A.
Published: December 2020

Background

Parotid gland pathologies requiring resection present with varying effects on surrounding tissue architecture, and we hypothesize that this spectrum of indications confers different risks of adverse events. The purpose of this study is to elucidate the complication profiles of parotidectomy in children across a spectrum of pathologies requiring parotid resection.

Methods

The American College of Surgeons National Surgical Quality Improvement Program Pediatric data set was queried for parotidectomies performed from 2012 through 2017. Indications were subclassified based on International Classification of Diseases, Ninth Revision and Tenth Revision codes. Complications, readmissions, and reoperations were analyzed with appropriate statistics.

Results

Parotidectomies in children (n = 208) were mostly performed for neoplasms (47.6%), followed by inflammatory conditions (24.0%). Total parotidectomies took significantly longer (P < 0.001) and remained in the hospital significantly longer than superficial parotidectomies (P < 0.001). There was no significant difference (P = 0.417) between benign neoplasms (29.3%) and malignant neoplasms (37.9%) requiring total parotidectomy. However, there was a significant difference (P = 0.014) across various malformations, with 83.3% of lymphatic malformations requiring total parotidectomy. Although lymphatic malformations required more aggressive resection, these procedures had the lowest rate of adverse events (0%). Despite the unappreciable predilection toward total parotidectomy based on nature of neoplasms, parotidectomy performed for malignant neoplasms had a significantly increased risk of nerve injury (P < 0.001; odds ratio [OR], 3563) and medical complications (P < 0.001; OR, 67.2), whereas those performed for benign neoplasms did not have an increased risk of these complications (all P's > 0.209). Parotidectomy performed for vascular malformations had significantly increased risk of bleeding requiring transfusion (P < 0.001; OR, 14.9) and surgical complications (P < 0.001; OR, 9.2). Bleeding requiring transfusion was significantly related to longer surgical procedures (P < 0.001; 409 vs 191 minutes).

Conclusions

Parotidectomy in pediatric patients for malignant neoplasms is associated with a significantly higher risk of nerve injury compared with parotidectomy for benign neoplasms. Parotidectomy for vascular malformations has a significantly higher risk of bleeding requiring transfusion, whereas parotidectomy for lymphatic malformations is associated with the lowest risk of medical and surgical complications.