bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacterial etiology and antimicrobial resistance trends in ocular infections: A 30-year study, Turin area, Italy
Authors: Grandi Giuseppe , Bianco Gabriele , Boattini Matteo , Scalabrin Simona , Iannaccone Marco , Fea Antonio , Cavallo Rossana , Costa Cristina 
Published: December 2019

Purpose: Bacterial ocular infections can result in loss of all or part of the ocular structures, contributing to a high disability charge. Local surveillance of etiology and susceptibility patterns is crucial for an appropriate empiric management of ocular infections. The aim of this study was to analyze of bacterial spectrum in culture-proven ocular infections and trends of antimicrobial susceptibility patterns. Methods: A monocentric retrospective study was performed including ocular infection cases diagnosed at the Microbiology Unit of Turin Ophthalmic Hospital between 1988 and 2017. Spectrum of pathogens that caused bacterial culture-proven ocular infections and trends of antimicrobial susceptibility patterns were analyzed. Results: A total of 15,517 culture-positive isolates were identified as causative agents of ocular infections. Gram-positive bacteria were deemed to cause infection in 73.5% of cases. Staphylococcus spp. and Pseudomonas spp., coagulase-negative staphylococci, Staphylococcus aureus were the leading causative pathogens of keratitis, endophthalmitis, and conjunctivitis, respectively. Statistically significant changes in temporal trends were observed for all analyzed microorganism groups except for Enterobacteriaceae group. Overall, fluoroquinolones and chloramphenicol demonstrated to be the most effective antimicrobials in vitro toward bacterial ocular infections, followed by tetracycline, ampicillin, and aminoglycosides. Enterobacteriaceae isolates showed higher multi-drug resistance rate, followed by coagulase-negative staphylococci. Analysis of resistance rates over time highlighted increasing resistance trend for aminoglycosides among Gram-negative and for both aminoglycosides and fluoroquinolones among Gram-positive pathogens, especially for S. aureus. Conclusion: This study provided a 30-year assessment of bacterial ocular infections in an urban area of Italy, giving support to epidemiological consciousness and guiding empiric antimicrobial therapy.
Primary total hip arthroplasty: mid-term outcomes of dual-mobility cups in patients at high risk of dislocation
Authors: Assi Chahine , Barakat Hanane , Mansour Jad , Samaha Camille , Yammine Kaissar 
Published: December 2019

Introduction: Dual-mobility cups (DMC) are currently used in patients having risk factors of instability. Most of the studies report the use of DMC in patients having a single high-risk variable. The aim of the study was to analyse a continuous series of patients treated with primary total hip arthroplasty (THA) and DMC with different high risk for dislocation. Methods: This is a retrospective study analysing the outcomes of primary THA with DMC in patients at high-risk of dislocation. The sample consisted of 215 patients having 1 of 3 aetiologies or risk factors: (1) young subjects (<55 years); (2) osteonecrosis of the femoral head (ONFH); and (3) femoral neck fracture (FNF). Results: With a mean follow-up duration of 70 ± 24.7 months, the findings showed the following: 2 patients had dislocated their hip following motor vehicle accidents; 1 patient had a traumatic femoral peri-prosthetic fracture; and 1 patient had an acute infection. No intra-prosthetic dislocation or aseptic loosening were encountered. No radiolucent lines were observed on the acetabular side. The mean modified Hip Harris Score was 96.6 ± 7.4%. Out of 186 patients, 170 (90.1%) would label their operated hip as a “forgotten hip”. 78 out of the 84 patients (92.8%) who used to practice oriental sitting and/or ablution for prayers were able to return to their usual daily activities of extreme hip position and 74 out of the 84 patients (88%) described their operated hip as “a forgotten hip”. No correlation was found between any of the studied variables. Discussion: The findings of this series of patients at high risk of dislocation showed excellent clinical and radiological results with very few complications. The use of DMC seems to counteract the impact of some aetiologies/risk factors that could lead to higher instability. Most patients practising extreme hip positions resumed their usual practices.
Balancing welfare and market logics: Procurement regulations for social and health services in four Nordic welfare states
Authors: Stenius Kerstin , Storbjork Jessica 
Published: December 2019

Aim: In increasingly market-oriented welfare regimes, public procurement is one of the most important instruments for influencing who produces which services. This article analyses recent procurement regulations in four Nordic countries from the point of view of addiction treatment. The implementation of public procurement in this field can be viewed as a domain struggle between the market logic and the welfare logic. By comparing the revision of the regulations after the 2014 EU directives in Denmark, Finland, Norway, and Sweden, we identify factors affecting the protection of a welfare logic in procurement. We discuss the possible effects of different procurement regulations for population welfare and health. Data and theoretical perspective: The study is based on the recently revised procurement laws in the four countries, and adherent guidelines. The analysis is inspired by institutional logics, looking at patterns of practices, interests, actors, and procurement as rules for practices. Results: Procurement regulations are today markedly different in the four countries. The protection of welfare and public health aspects in procurement – strongest in Norway – is not solely dependent on party political support. Existing service providers and established steering practices play a crucial role. Conclusion: In a situation where market steering has become an established practice and private providers are strongly present, it can be difficult to introduce strong requirements for protection of welfare and population health in procurement of social services.
Cerebrospinal Fluid Drainage During Endovascular Aortic Aneurysm Repair: A Systematic Review of the Literature and Treatment Recommendations
Authors: Malloy Patrick C. , Raghavan Alankrita , Elder Theresa , Wright James , Wright Christina Huang , Burant Christopher , Sajatovic Martha , Hoffer Alan 
Published: December 2019

Introduction: Spinal cord injury (SCI) is a known complication of aortic aneurysm repair. Previous reports indicate that cerebrospinal fluid drainage (CSFD) may reduce incidence of SCI during open aortic aneurysm repair but its utility in endovascular repair remains poorly understood. We performed a systematic review of the literature to examine the protocols and outcomes of CSFD in patients undergoing endovascular aortic aneurysm repair. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were utilized to conduct a systematic literature review. PubMed, Scopus, Ovid, Cochrane, and EMBASE were queried for articles published since 2016 using search terms “(cerebrospinal fluid diversion OR CSF diversion OR lumbar drain OR subarachnoid drain OR spinal) AND (aortic aneurysm AND thoracic AND endovascular OR TEVAR).” Ninety-two articles were identified and screened by 2 independent reviewers, and 23 studies met criteria for full-text review after initial screening. Results: A total of 8 studies met full inclusion criteria for final analysis. Six studies reported incidence of SCI in patients with CSFD and 2 compared SCI incidence between patients with and without CSFD. Protocols for drainage most commonly included draining to a target pressure intra- and postoperatively, between 8 and 12 mm Hg. Incidence of SCI ranged from 0% to 17% in patients with CSFD, and from 0% to 50% in those without CSFD. Rates of CSFD-related complications ranged from <1% to 28%. Conclusion: There may be a protective benefit of CSFD in preventing SCI, but there remains significant variation in drain placement protocols. Significant potential bias exists in the reviewed data. Higher quality studies on the role of CSFD in endovascular aortic aneurysm repair are needed.
Knowledge, Behaviors, and Attitudes of Polish Nurses As Compared With Evidence-Based Practice in Relation to the Guidelines of the European Resuscitation Council
Authors: Ozga Dorota , Jędrzejczyk-Cwanek Marzena , Woźniak Krystyna , Niemczyk Edyta , Mędrzycka-Dąbrowska Wioletta 
Published: December 2019

Background The emphasis on Evidence-Based Practice (EBP) is taking on new importance as the profession of nursing strives to meet the challenge of defining the direction of health care, promoting optimal outcomes, and ensuring patient safety. Therefore, Evidence-Based Practice has never been more important to nursing than in the current health-care environment. Objective The study was designed to assess the knowledge, behaviors, and attitudes of nurses as compared with Evidence-Based Practice in relation to the Guidelines of the European Resuscitation Council. Methods The study covered involved a total of 236 nurses who participated in a cardiopulmonary resuscitation course over a period of 12 months. The nurses who qualified for the study followed a complete study registration procedure. Results The current findings show that the lowest score was achieved in the domain of attitude toward selected Evidence-Based Practice aspects in professional work. Detailed domain questions concerned nurses’ Evidence-Based Practice and its limitations related to procedures, the lack of equipment and personnel issues, as well as the lack of scientific evidence. Furthermore, nurses saw clinical experience as being more valuable than research findings for practical decision-making than research findings, and, according to the respondents, they presented opinions that the best way to assess the effectiveness of an action was through clinical experience. In addition, the nurses gave low scores and tended to underestimate the critical literature review aspect within the domain, along with its significance for the general professional practice, believing that search for scientific evidence alone does not apply into their professional work. Conclusions The validated Polish version of the Evidence-Based Practice profile questionnaire is a reliable instrument. The study demonstrates that nurses are facing a multitude of limitations due to procedures, the lack of equipment, and personnel issues. Currently perceived as very poor, the ability to make critical assessments and synthesize evidence should be improved. According to the nurses, clinical experience cannot be the only and the best way to assess the effectiveness of a given measure.
Factors Affecting Length of Stay Following 3-Column Spinal Osteotomies in Pediatric Patients
Authors: Kato So , Dear Taylor , Lewis Stephen J. 
Published: December 2019

Study Design: A retrospective analysis. Objectives: Length of stay (LOS) is one of the important indicators for the quality of patient care. Although perioperative complications are known to be associated with longer LOS in general, little has been understood regarding LOS after 3-column spinal osteotomy for the rigid spinal deformity in pediatric population. The main objective of the article is to identify factors affecting the LOS in pediatric patients undergoing 3-column posterior spinal osteotomies. Methods: Following research ethics approval, a retrospective review was performed of 35 consecutive posterior 3-column spinal osteotomies performed on pediatric patients in a single academic institution. Patients’ demographic data, preoperative comorbidities, details of operative procedures, intraoperative complications, and postoperative complications were investigated, and LOS was compared among the groups. Results: The mean LOS was 9.0 days, and the median LOS was 7 days (range = 4-23 days). Low body weight and syndromic deformity were associated with longer LOS. Operation time ≥6 hours and total perioperative fluid administration greater than or equal to twice the estimated blood volume were associated with longer LOS. Among postoperative complications, those with respiratory complication had prolonged stay. Conclusions: Preoperative low body weight and syndromic scoliosis had longer LOS after 3-column osteotomies. Excessive fluid administration and respiratory complications were associated with longer LOS.
External Multicenter Study of Reliability and Reproducibility for Lower Cervical Spine Injuries Classification Systems—Part 2: An Analysis of the Subaxial Cervical Spine Injury Classification and Cervical Spine Injury Severity Score Scale
Authors: Grin Andrey , Krylov Vladimir , Lvov Ivan , Talypov Aleksandr , Dzukaev Dmitriy , Kordonskiy Anton , Smirnov Vladimir , Karanadze Vasily , Abdukhalikov Boburmirzo , Khushnazarov Ulugbek , Airapetyan Artem , Dmitriev Aleksandr , Kaykov Aleksandr , Peyker Alexander , Semchenko Vitaliy , Aksenov Andrey , Borzenkov Anton , Gulyy Vladimir , Torchinov Soslan , Bagaev Sergey , Toporskiy Anton , Kalandari Alik , Kasatkin Denis , Sytnik Aleksey , Lebedev Valeriy , Epifanov Dmitry , Hovrin Dmitriy , Feniksov Victor , Choriev Daniyar 
Published: December 2019

Study Design: A multicenter observational survey. Objective: To quantify and compare inter- and intraobserver reliability of the subaxial cervical spine injury classification (SLIC) and the cervical spine injury severity score (CSISS) in a multicentric survey of neurosurgeons with different experience levels. Methods: Data concerning 64 consecutive patients who had undergone cervical spine surgery between 2013 and 2017 was evaluated, and we surveyed 37 neurosurgeons from 7 different clinics. All raters were divided into 3 groups depending on their level of experience. Two assessment procedures were performed. Results: For the SLIC, we observed excellent agreement regarding management among experienced surgeons, whereas agreement among less experienced neurosurgeons was moderate and almost twice as unlikely. The sensitivity of SLIC relating to treatment tactics reached as high as 92.2%. For the CSISS, agreement regarding management ranged from medium to substantial, depending on a neurosurgeon’s experience. For less experienced neurosurgeons, the level of agreement concerning surgical management was the same as for the SLIC in not exceeding a moderate level. However, this scale had insufficient sensitivity (slightly exceeding 50%). The reproducibility of both scales was excellent among all raters regardless of their experience level. Conclusions: Our study demonstrated better management reliability, sensitivity, and reproducibility for the SLIC, which provided moderate interrater agreement with moderate to excellent intraclass correlation coefficient indicators for all raters. The CSISS demonstrated high reproducibility; however, large variability in answers prevented raters from reaching a moderate level of agreement. Magnetic resonance imaging integration may increase sensitivity of CSISS in relation to fracture management.
Clinical, radiological, and histological outcomes after the fibrin–matrix autologous chondrocyte implantation for chondral lesions of the knee in patients more than 50 years old: A prospective case series with minimum 2-year follow-up
Authors: Kim Myung Ku , Park Jun Sung , Jeon Yun Moon , Jeon Yoon Sang 
Published: December 2019

Background: The purpose of this study was to evaluate clinical and radiological outcomes and to analyze the histological findings of repaired cartilage in patients more than 50 years old with underwent fibrin–matrix autologous chondrocyte implantation (ACI). Methods: From January 2013 to February 2014, a prospective study was conducted on 16 patients (16 knees) who underwent fibrin–matrix ACI for International Cartilage Repair Society grade 3 or 4 chondral lesions of the knee. The major lesion was in the medial femoral condyle in all patients. The mean age of the patients was 58.1 ± 6.2 (range 51–66) years, and the minimum follow-up period was 2 years. All patients had clinical and radiological evaluations at 3 months, 6 months, 1 year, and 2 years after surgery. Twelve patients had second-look arthroscopies at 1 year after surgery, and implanted chondral biopsies were performed in 11 of these 12 patients for histological analysis. Results: Functional disability assessment scales for the knee significantly improved after fibrin–matrix ACI ( p < 0.05). The visual analog scale score significantly decreased from 6.7 ± 1.2 to 2.0 ± 1.8 ( p < 0.001). The mean modified magnetic resonance observation of cartilage repair tissue score was 83.8 ± 17.3 at 1 year after surgery and 74.0 ± 19.2 at 2 years after surgery. Repair of the tissue with hyaline cartilage was confirmed histologically. Conclusions: Satisfactory clinical and radiological outcomes were obtained from gel-type fibrin–matrix ACI technique in older patients with a cartilage defect of the knee. Histological analysis confirmed that the new repaired tissue with hyaline cartilage filled the cartilage defect area. Therefore, fibrin–matrix ACI is believed to be an applicable treatment for older patients with chondral lesions of the knee. Level of evidence: Level IV.
Acalabrutinib monotherapy in patients with relapsed/refractory chronic lymphocytic leukemia: updated phase 2 results
Authors: Byrd John C. , Wierda William G. , Schuh Anna , Devereux Stephen , Chaves Jorge M. , Brown Jennifer R. , Hillmen Peter , Martin Peter , Awan Farrukh T. , Stephens Deborah M. , Ghia Paolo , Barrientos Jacqueline , Pagel John M. , Woyach Jennifer A. , Burke Kathleen , Covey Todd , Gulrajani Michael , Hamdy Ahmed , Izumi Raquel , Frigault Melanie M. , Patel Priti , Rothbaum Wayne , Wang Min Hui , O’Brien Susan , Furman Richard R. 
Published: December 2019

Abstract
Therapeutic targeting of Bruton tyrosine kinase (BTK) has dramatically improved survival outcomes for patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL). Acalabrutinib is an oral, highly selective BTK inhibitor that allows for twice-daily dosing due to its selectivity. In this phase 1b/2 study, 134 patients with relapsed/refractory CLL or SLL (median age, 66 years [range, 42-85 years]; median prior therapies, 2 [range, 1-13]) received acalabrutinib 100 mg twice daily for a median of 41 months (range, 0.2-58 months). Median trough BTK occupancy at steady state was 97%. Most adverse events (AEs) were mild or moderate, and were most commonly diarrhea (52%) and headache (51%). Grade ≥3 AEs (occurring in ≥5% of patients) were neutropenia (14%), pneumonia (11%), hypertension (7%), anemia (7%), and diarrhea (5%). Atrial fibrillation and major bleeding AEs (all grades) occurred in 7% and 5% of patients, respectively. Most patients (56%) remain on treatment; the primary reasons for discontinuation were progressive disease (21%) and AEs (11%). The overall response rate, including partial response with lymphocytosis, with acalabrutinib was 94%; responses were similar regardless of genomic features (presence of del(11)(q22.3), del(17)(p13.1), complex karyotype, or immunoglobulin variable region heavy chain mutation status). Median duration of response and progression-free survival (PFS) have not been reached; the estimated 45-month PFS was 62% (95% confidence interval, 51% to 71%). BTK mutation was detected in 6 of 9 patients (67%) at relapse. This updated and expanded study confirms the efficacy, durability of response, and long-term safety of acalabrutinib, justifying its further investigation in previously untreated and treated patients with CLL/SLL. This trial was registered at www.clinicaltrials.gov as #NCT02029443.
Intellectual functioning and behavioural features associated with mosaicism in fragile X syndrome
Authors: Baker Emma K. , Arpone Marta , Vera Solange Aliaga , Bretherton Lesley , Ure Alexandra , Kraan Claudine M. , Bui Minh , Ling Ling , Francis David , Hunter Matthew F. , Elliott Justine , Rogers Carolyn , Field Michael J. , Cohen Jonathan , Maria Lorena Santa , Faundes Victor , Curotto Bianca , Morales Paulina , Trigo Cesar , Salas Isabel , Alliende Angelica M. , Amor David J. , Godler David E. 
Published: December 2019

AbstractBackgroundFragile X syndrome (FXS) is a common cause of intellectual disability and autism spectrum disorder (ASD) usually associated with a CGG expansion, termed full mutation (FM: CGG ≥ 200), increased DNA methylation of theFMR1promoter and silencing of the gene. Mosaicism for presence of cells with either methylated FM or smaller unmethylated pre-mutation (PM: CGG 55–199) alleles in the same individual have been associated with better cognitive functioning. This study compares age- and sex-matched FM-only and PM/FM mosaic individuals on intellectual functioning, ASD features and maladaptive behaviours.MethodsThis study comprised a large international cohort of 126 male and female participants with FXS (aged 1.15 to 43.17 years) separated into FM-only and PM/FM mosaic groups (90 males, 77.8% FM-only; 36 females, 77.8% FM-only). Intellectual functioning was assessed with age appropriate developmental or intelligence tests. The Autism Diagnostic Observation Schedule-2nd Edition was used to examine ASD features while the Aberrant Behavior Checklist-Community assessed maladaptive behaviours.ResultsComparing males and females (FM-only + PM/FM mosaic), males had poorer intellectual functioning on all domains (p< 0.0001). Although females had less ASD features and less parent-reported maladaptive behaviours, these differences were no longer significant after controlling for intellectual functioning. Participants with PM/FM mosaicism, regardless of sex, presented with better intellectual functioning and less maladaptive behaviours compared with their age- and sex-matched FM-only counterparts (p< 0.05). ASD features were similar between FM-only and PM/FM mosaics within each sex, after controlling for overall intellectual functioning.ConclusionsMales with FXS had significantly lower intellectual functioning than females with FXS. However, there were no significant differences in ASD features and maladaptive behaviours, after controlling for intellectual functioning, independent of the presence or absence of mosaicism. This suggests that interventions that primarily target cognitive abilities may in turn reduce the severity of maladaptive behaviours including ASD features in FXS.