bluuebunny/crossref_metadata_2025_split huggingface dataset:
Employment and Unemployment Rates of People Who Are Blind or Visually Impaired: Estimates from Multiple Sources
Authors: McDonnall Michele C. , Sui Zhen 
Published: November 2019

Introduction: We examined four sources of data to evaluate the employment status of people with visual impairments, including their current status and a comparison with previous years. Methods: Data from the American Community Survey (ACS) and three other nationally representative surveys were utilized to determine employment and unemployment rates for people with visual impairments and to determine whether employment rates have changed over time. Data from ACS were used to compare this population’s employment and unemployment rates to people without disabilities and to people with other types of disabilities. Results: Unemployment rates for people with visual impairments ranged from a low of 4% (in 1994–1995) to a high of 19.8% (in 2011). Employment rates ranged from a low of 36.3% (in 2011) to a high of 44.2% (in 2017), based on ACS estimates. Estimates from all other data sources fall within this range. Based on ACS estimates, employment rates for people with visual impairments have not significantly increased over time. Large gaps in the employment and unemployment rates of people with visual impairments and those without disabilities exist, but these gap have significantly decreased over time. The smaller gaps in these rates for people with visual impairments and those with other disabilities have significantly increased over time. Discussion: These results indicate consistent employment rates for people with visual impairments across time and across different measurement methods and questions. The lowest employment rate, and highest unemployment rate, were recorded following the great recession, and these rates have been improving since 2012. Information for practitioners: Approximately 44% of the U.S. population with a visual impairment is employed, while 10% of people with a visual impairment (who are in the labor force) are unemployed. The remaining 50.9% of the U.S. population with visual impairments are not in the labor force.
Approximate Weight of 1:1000 Topical Epinephrine on Wrung‐Out Epinephrine‐Soaked Pledgets
Authors: Kuhar Hannah N. , Han Xiaoxia , Penning Donald H. , Craig John R. 
Published: November 2019

ObjectiveTopical 1:1000 epinephrine solution is commonly applied intranasally with cottonoid pledgets in endoscopic sinonasal surgery for local vasoconstriction and hemostasis. Pledgets are typically submerged in epinephrine solution and applied without measurement. Hemodynamic complications have been reported when pledgets have been saturated and not wrung out. The amount of epinephrine absorbed per pledget has not been studied methodically. The purpose of this study was to determine the amount of topical 1:1000 epinephrine remaining on a cottonoid pledget after wringing out the pledget, to simulate intraoperative application.Study DesignCohort study.SettingTertiary care center.Subjects and MethodsSixty 0.5‐in × 3‐in cottonoid pledgets were submerged in canisters filled with 1:1000 epinephrine solution (1 mg/mL). Weights of the epinephrine‐filled canisters were measured before submerging the pledgets and then after removing and wringing out the pledgets. Measurements were recorded for each pledget after being submerged for 0, 1, and 5 minutes and then wrung out. Mean weights were calculated and compared between the submersion durations.ResultsThe mean overall weight of epinephrine on a wrung‐out pledget was 0.931 mg. Mean weights of epinephrine absorbed onto wrung‐out pledgets after submersion for 0, 1, and 5 minutes were 0.914, 0.913, and 0.967 mg, respectively. There were no significant differences in weights based on submersion duration (P =. 296).ConclusionApproximately 1 mg of epinephrine was absorbed onto 0.5‐in × 3‐in cottonoid pledgets when pledgets were wrung out after being submerged in 1:1000 epinephrine, whether being removed from solution immediately or after up to 5 minutes.
Association between Smoking and 30‐Day Outcomes in Otologic Surgery
Authors: Kay‐Rivest Emily , Mascarella Marco , Sewitch Maida J. , Cloutier François , Mijovic Tamara 
Published: November 2019

ObjectiveTo determine the effect of current smoking status on 30‐day postoperative adverse events in patients undergoing otologic surgery.Study DesignRetrospective cohort study.SettingDatabase of the American College of Surgeons National Surgical Quality Improvement Program from 2006 to 2016.Subjects and MethodsAdult patients undergoing middle ear and mastoid surgery were included. Preoperative smoking status was determined, and adverse events within 30 days of surgery were recorded. Descriptive statistics were used to characterize the study sample. Multivariable logistic regression was performed to identify the association between sociodemographic and clinical variables and postoperative adverse events. Population‐attributable fractions were then calculated.ResultsA total of 10,684 patients who underwent otologic surgery were included, of whom 2036 (19.1%) were smokers. The most commonly performed surgery was tympanoplasty with and without ossicular chain reconstruction, followed by canal wall up tympanomastoidectomy. Adverse events occurred in 221 (2.1%) patients; the most common was superficial wound infections (n = 99, 0.9%). In smokers, the odds ratio for any adverse event was 1.97 (95% CI, 1.42‐2.71). The odds ratios (95% CIs) for superficial wound infections, wound dehiscence, and 30‐day readmission among smokers were 1.89 (1.32‐2.86), 3.92 (1.26‐11.60), and 1.84 (1.15‐2.87), respectively. The population‐attributable fraction for any adverse event in smokers was 15.5%.ConclusionsIn patients undergoing otologic surgery, smokers are more likely than nonsmokers to have postoperative adverse events—in particular, wound infections, wound dehiscence, and readmission to hospital.
Effect of hyperthermic intraperitoneal chemotherapy for gastric cancer patients: a meta-analysis of the randomized controlled trials
Authors: Liu Yan-Wen , Du Ying , Chen Bao-An 
Published: November 2019

Objective To determine the effectiveness and safety of hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with advanced gastric cancer and peritoneal metastases. Methods PubMed®, CNKI, Web of Science, VIP and WANFANG databases were searched to identify randomized controlled trials (RCTs) that examined the effect of HIPEC on survival, clinical response and adverse events. Patients with advanced gastric cancer and peritoneal metastases were divided into an experimental group and a control group. The statistical results are presented as relative ratio (RR), mean difference (MD) and 95% confidence interval (CI). Results Twenty-one RCTs met the inclusion criteria ( n = 1674 patients). Meta-analysis showed that the 3-year survival rate was significantly higher in the HIPEC group than in the control group (RR 1.61; 95% CI 1.43, 1.82) and the complete response rate was significantly higher in the HIPEC group than in the control group (RR 2.35; 95% CI 1.67, 3.31). HIPEC was also beneficial in terms of decreased CEA (MD −1.79; 95% CI −2.22, −1.35). There was no significant difference in the rate of adverse reactions (RR 1.00; 95% CI 0.87, 1.14). Conclusions HIPEC had a beneficial effect on 3-year survival rate and complete response in patients with advanced gastric cancer and peritoneal metastases.
Process of ectopic tooth formation in the maxillary sinus: follow-up observation of one case
Authors: Liu Jinfeng , Zhou Mo , Liu Qitong , He Xiaolin , Wang Ningyu 
Published: November 2019

Objective This study was performed to investigate the process of ectopic tooth formation. Methods A patient with an ectopic tooth was followed for 6 years. The tooth size and mineralization were evaluated by paranasal sinus computed tomography every 3 years. Results The ectopic tooth was present in the nasal crest of the maxilla and did not change significantly during the 6-year follow-up period. However, the patient developed a new ectopic tooth in the maxillary sinus (ETm). This tooth, located in the posterior wall of the left maxillary sinus, initially appeared as a small region of soft tissue on computed tomography. After 3 years, the area of mixed density had significantly increased, and some of it had significantly mineralized to form an ETm. After 6 years, the ETm had further mineralized and enlarged in situ. The width between the left and right sides of the ETm in 2018 (9.08 ± 2.09 mm) was significantly larger than that in 2015 (7.51 ± 2.18 mm), indicating that ETm formation is a gradual process of mineralization. Conclusion Ectopic teeth can gradually form by in situ mineralization after adolescence, suggesting that ectopic teeth are genetically regulated and result from a programmed formation process occurring at a specific time point.
On the validity of single tests, two-test combinations and the full Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in detecting patients with cognitive impairment
Authors: Baetge Sharon Jean , Filser Melanie , Renner Alina , Ullrich Sebastian , Lassek Christoph , Penner Iris-Katharina 
Published: November 2019

Background: The international standard to screen for cognitive impairment in multiple sclerosis (MS) is BICAMS (Brief International Cognitive Assessment for MS). However, with an application time of approximately 20 minutes, the battery might be too time consuming from a pragmatic perspective of a routine examination. Objectives: To examine the relative sensitivity and specificity of a BICAMS short version and its validity compared to the total battery. Methods: The German BICAMS version was applied comprising the Symbol Digit Modalities Test (SDMT), the Brief Visuospatial Memory Test–Revised (BVMT-R) and the Rey Auditory Verbal Learning Test (RAVLT; German VLMT). Single tests and two-test combinations were compared regarding conformity with the total battery. Results: Examining 1320 MS patients, the two-test combination of SDMT-BVMT-R was the most sensitive (92.7%) to impairment and showed the strongest agreement with the total battery (κ = 0.95). Performing binary logistic regression analyses, this combination was also validated by its association with employment status. Conclusion: Application of the total BICAMS battery should be the goal to strive for. However, in time-restricted clinical settings, the combined application of SDMT and BVMT-R is a recommendable alternative with an application time of 10 minutes, while single tests alone are not sufficiently sensitive.
Familial Success in Allergen Desensitization
Authors: Rowane Marija , Shilian Ryan , Jhaveri Devi K. , Tcheurekdjian Haig H. , Sher Theordore H. , Hostoffer Robert 
Published: November 2019

Introduction Allergic rhinitis (AR) is a widely prevalent immunoglobulin E-mediated inflammatory nasal condition resulting from reexposure to an allergen in a sensitized individual. The genetic associations behind AR and other allergic conditions have been studied. However, familial success with AR therapies, specifically allergen desensitization through subcutaneous immunotherapy (SCIT), has never been reported in the literature. Pharmocogenetics has been gradually applied to link heritable genetic variants with drug responses, such as intergenic region variants APOBEC3B and APOBEC3C and β2-adrenergic receptor and glycoprotein ADAM33 polymorphisms as predictive biomarkers for biologic treatment response in asthma. We provide the first reported survey of familial success with SCIT. Methods We administered a month-long, institutional review board-approved (20190493) questionnaire to 200 adult patients receiving SCIT in a suburban allergy/immunology practice. The anonymous survey inquired about demographics, target allergens for their SCIT, current symptom improvement on SCIT, and family history of allergies and SCIT management. Results Twenty-six percent (52 of 200, 26%) SCIT patients reported familial success with the same allergy treatment modality. AR diagnosis and symptom improvement from SCIT was similar among previous/same (18 of 52, 38%; 26 of 52, 54%) and subsequent (10 of 52, 21%; 19 of 52, 40%) generations of family members. A combination of seasonal and perennial allergies was most prevalent (81%) among this population. Conclusion In a subpopulation of SCIT patients, there appears to be a familial success rate with this allergen desensitization treatment. This is the first reported pharmocogenetic evidence of assessing hereditary influence on effective AR therapy. Understanding pharmacogenetic associations involved with SCIT may improve allergists’ recommendations for this treatment option.
The Prevalence of Bacterial Infection in Patients Undergoing Elective ACDF for Degenerative Cervical Spine Conditions: A Prospective Cohort Study With Contaminant Control
Authors: Bivona Louis J. , Camacho Jael E. , Usmani Farooq , Nash Alysa , Bruckner Jacob J. , Hughes Meghan , Bhandutia Amit K. , Koh Eugene Y. , Banagan Kelley E. , Gelb Daniel E. , Ludwig Steven C. 
Published: November 2019

Study Design: Prospective cohort study. Objectives: To determine the prevalence of bacterial infection, with the use of a contaminant control, in patients undergoing anterior cervical discectomy and fusion (ACDF). Methods: After institutional review board approval, patients undergoing elective ACDF were prospectively enrolled. Samples of the longus colli muscle and disc tissue were obtained. The tissue was then homogenized, gram stained, and cultured in both aerobic and anaerobic medium. Patients were classified into 4 groups depending on culture results. Demographic, preoperative, and postoperative factors were evaluated. Results: Ninety-six patients were enrolled, 41.7% were males with an average age of 54 ± 11 years and a body mass index of 29.7 ± 5.9 kg/m2. Seventeen patients (17.7%) were considered true positives, having a negative control and positive disc culture. Otherwise, no significant differences in culture positivity was found between groups of patients. However, our results show that patients were more likely to have both control and disc negative than being a true positive (odds ratio = 6.2, 95% confidence interval = 2.5-14.6). Propionibacterium acnes was the most commonly identified bacteria. Two patients with disc positive cultures returned to the operating room secondary to pseudarthrosis; however, age, body mass index, prior spine surgery or injection, postoperative infection, and reoperations were not associated with culture results. Conclusion: In our cohort, the prevalence of subclinical bacterial infection in patients undergoing ACDF was 17.7%. While our rates exclude patients with positive contaminant control, the possibility of contamination of disc cultures could not be entirely rejected. Overall, culture results did not have any influence on postoperative outcomes.
Syphilitic hepatitis: a case report and review of the literature
Authors: Huang Jiaofeng , Lin Su , Wang Mingfang , Wan Bo , Zhu Yueyong 
Published: November 2019

Abstract
Background
Syphilis is a common disease that has been researched and focused on for many years, however, syphilitic hepatitis has not been well-recognized. We report this case of syphilitic hepatitis with intrahepatic cholestasis and liver granulomas to make a deeper impression.

Case presentation
A 47-year-old male was admitted with jaundice and rashes. The laboratory examination showed abnormal liver enzymes with significant increases in ALP and GGT but mild increases in ALT and AST. His HBV surface antigen was weakly positive, with negative HIV antibody, HCV antibody, and undetectable HBV DNA. The rapid plasma reagin test and the Treponema pallidum particle assay tests for Syphilis were both positive. Abdominal ultrasonography and magnetic resonance cholangiopancreatography revealed the normal biliary tract, liver, and spleen. The liver pathological examination showed cholangiocyte inflammation and micro-granulomas with coagulation necrosis. After 2 months of benzathine penicillin treatment, his liver enzyme decreased rapidly and remained normal after 1-year of follow-up.

Conclusions
Increased liver enzymes, intrahepatic cholestasis and liver granulomas with well-response to antibiotics may provide clues for the diagnosis of syphilitic hepatitis.
Colorectal endoscopic mucosal resection with submucosal injection of epinephrine versus hypertonic saline in patients taking antithrombotic agents: propensity-score-matching analysis
Authors: Yamaguchi Daisuke , Yoshida Hisako , Ikeda Kei , Takeuchi Yuki , Yamashita Shota , Jubashi Amane , Yukimoto Takahiro , Takeshita Eri , Yoshioka Wataru , Fukuda Hiroko , Tominaga Naoyuki , Tsuruoka Nanae , Morisaki Tomohito , Ario Keisuke , Tsunada Seiji , Fujimoto Kazuma 
Published: November 2019

Abstract
Background
Endoscopic mucosal resection (EMR) to remove colon polyps is increasingly common in patients taking antithrombotic agents. The safety of EMR with submucosal saline injection has not been clearly demonstrated in this population.

Aims
The present study aimed to evaluate the efficacy and safety of submucosal injection of saline–epinephrine versus hypertonic saline in colorectal EMR of patients taking antithrombotic agents.

Methods
This study enrolled 204 patients taking antithrombotic agents among 995 consecutive patients who underwent colonic EMR from April 2012 to March 2018 at Ureshino Medical Center. Patients were divided into two groups according to the injected solution: saline–epinephrine or hypertonic (10%) saline (n = 102 in each group). Treatment outcomes and adverse events were evaluated in each group and risk factors for immediate and post-EMR bleeding were investigated.

Results
There were no differences between groups in patient or polyp characteristics. The main antithrombotic agents were low-dose aspirin, warfarin, and clopidogrel. Propensity-score matching created 80 matched pairs. Adjusted comparisons between groups showed similar en bloc resection rates (95.1% with saline–epinephrine vs. 98.0% with hypertonic saline). There were no significant differences in adverse events (immediate EMR bleeding, post-EMR bleeding, perforation, or mortality) between groups. Multivariate analyses revealed that polyp size over 10 mm was associated with an increased risk of immediate EMR bleeding (odds ratio 12.1, 95% confidence interval 2.0–74.0; P = 0.001).

Conclusions
Two tested solutions in colorectal EMR were considered to be both safe and effective in patients taking antithrombotic agents.
Mortality and comorbidity after non-operatively managed, low-energy pelvic fracture in patients over age 70: a comparison with an age-matched femoral neck fracture cohort and general population
Authors: Reito Aleksi , Kuoppala Mari , Pajulammi Hanna , Hokkinen Lasse , Kyrölä Kati , Paloneva Juha 
Published: November 2019

Abstract
Background
Research on mortality and comorbidity associated with pelvic fractures in older patients is scarce. We aimed to determine the short- and long-term mortality rates of older patients with a pelvic ring fracture compared with both an age-matched cohort of patients with a femoral neck fracture and a general population, and to investigate 30- and 60-day readmission rates after pelvic fracture.

Methods
This was a retrospective cohort study done in an emergency department of a level II/III trauma center. All patients aged over 70 years diagnosed with a pelvic or acetabular fracture between January 2010 and December 2016 in our ED were identified. Two reference populations were used: patients operated due to femoral neck fracture in our institution between 2007 and 2008 and a general population aged 70 years or more.

Results
Two hundred nineteen patients were identified. 30- and 90-day mortality was 7.3 and 11.4%, respectively. Compared to the general population, a pelvic fracture was associated with an 8.5-fold (95% CI: 5.2–13.9) and 11.0-fold (95% CI: 5.4–22.3) 90-day mortality risk in females and males, respectively. We could not observe a difference in the risk of 90-day mortality between femoral neck fracture patients and patients with a pelvic fracture. Within 30 days, 28 (12.8%) pelvic fracture patients were readmitted for in-patient care in our hospital.

Conclusions
The mortality of older patients with pelvic ring fractures resembles that after hip fracture. Although older patients with a pelvic ring fracture rarely require operative treatment, the severity of the injury should not be considered as a class apart from hip fracture.
A feminist phenomenology on the emotional labor and morality of live-in migrant care workers caring for older people in the community
Authors: HO Ken H. M. , CHIANG Vico C. L. , LEUNG Doris , CHEUNG Daphne S. K. 
Published: November 2019

AbstractBackgroundGlobal societal changes, such as increasing longevity and a shortage of family caregivers, have given rise to a popular worldwide trend of employing live-in migrant care workers (MCWs) to provide homecare for older people. However, the emotional labor and morality inherent in their interactions with older people are largely unknown. The aim of the present study is to understand the corporeal experiences of live-in migrant care workers in the delivery of emotional labor as seen in their interactions with older people by: (1) describing the ways by which they manage emotional displays with older people; and (2) exploring their morality as enacted through emotional labor.MethodsWe performed a secondary analysis drawing on feminist phenomenology to thematically analyze data from interviews with 11 female MCWs. Follow-up interviews were conducted with 10 participants. The participants had two to 15 years of experience in caring for older people in their homes in Hong Kong.ResultsPerforming emotional labor by suppressing and inducing emotions is morally demanding for live-in MCWs, who experience socio-culturally oppressive relationships. However, developing genuine emotions in their relationships with older people prompted the MCWs to protect the interests of older people. Through demonstrating both fake and genuine emotions, emotional labor was a tactic that live-in MCWs demonstrated to interact morally with older people.ConclusionsEmotional labor allowed live-in MCWs to avoid conflict with older people, and to further protect their own welfare and that of others. This study highlights the significance of empowering live-in MCWs by training them in ways that will help them to adapt to working conditions where they will encounter diverse customs and older people who will develop an increasing dependence on them. Thus, there is a need to develop culturally appropriate interventions to empower live-in MCWs to deliver emotional labor in a moral manner.