bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Virtual Exercise Rehabilitation In-Home Therapy Compared with Traditional Care After Total Knee Arthroplasty
Authors: Prvu Bettger Janet , Green Cynthia L. , Holmes DaJuanicia N. , Chokshi Anang , Mather Richard C. , Hoch Bryan T. , de Leon Arthur J. , Aluisio Frank , Seyler Thorsten M. , Del Gaizo Daniel J. , Chiavetta John , Webb Laura , Miller Vincent , Smith Joseph M. , Peterson Eric D. 
Published: November 2019

Background:
Financial burden for patients, providers, and payers can reduce access to physical therapy (PT) after total knee arthroplasty (TKA). The purpose of the present study was to examine the effect of a virtual PT program on health-care costs and clinical outcomes as compared with traditional care after TKA.

Methods:
At least 10 days before unilateral TKA, patients from 4 clinical sites were enrolled and randomized 1:1 to the virtual PT program (involving an avatar [digitally simulated] coach, in-home 3-dimensional biometrics, and telerehabilitation with remote clinician oversight by a physical therapist) or to traditional PT care in the home or outpatient clinic. The primary outcome was total health-care costs for the 12-week post-hospital period. Secondary (noninferiority) outcomes included 6 and 12-week Knee injury and Osteoarthritis Outcome Score (KOOS); 6-week knee extension, knee flexion, and gait speed; and 12-week safety measures (patient-reported falls, pain, and hospital readmissions). All outcomes were analyzed on a modified intent-to-treat basis.

Results:
Of 306 patients (mean age, 65 years; 62.5% women) who were randomized from November 2016 to November 2017, 290 had TKA and 287 (including 143 in the virtual PT group and 144 in the usual care group) completed the trial. Virtual PT had lower costs at 12 weeks after discharge than usual care (median, $1,050 compared with $2,805; p < 0.001). Mean costs were $2,745 lower for virtual PT patients. Virtual PT patients had fewer rehospitalizations than the usual care group (12 compared with 30; p = 0.007). Virtual PT was noninferior to usual PT in terms of the KOOS at 6 weeks (difference, 0.77; 90% confidence interval [CI], −1.68 to 3.23) and 12 weeks (difference, −2.33; 90% CI, −4.98 to 0.31). Virtual PT was also noninferior to usual care at 6 weeks in terms of knee extension, knee flexion, and gait speed and at 12 weeks in terms of pain and hospital readmissions. Falls were reported by 19.4% of virtual PT patients and 14.6% of usual care patients (difference, 4.83%; 90% CI, −2.60 to 12.25).

Conclusions:
Relative to traditional home or clinic PT, virtual PT with telerehabilitation for skilled clinical oversight significantly lowered 3-month health-care costs after TKA while providing similar effectiveness. These findings have important implications for patients, health systems, and payers. Virtual PT with clinical oversight should be considered for patients managed with TKA.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
The effect of temperature on childhood hand, foot and mouth disease in Guangdong Province, China, 2010-2013: A multicity study
Authors: Xu Zece , Hu Wenqi , Jiao Kedi , Ren Ci , Jiang Baofa , Ma Wei 
Published: November 2019

Abstract
Background Hand, foot and mouth disease (HFMD) is a serious infectious disease, which has become a public health problem. Previous studies have shown that temperature may influence the incidence of HFMD, but most only focus on single city and the results are highly heterogeneous. Therefore, a multicity study was conducted to explore the association between temperature and HFMD in different cities and search for modifiers that influence the heterogeneity. Methods We collected daily cases of childhood HFMD (aged 0-5 years) and meteorological factors of 21 cities in Guangdong Province in the period of 2010-2013. Distributed lag non-linear model (DLNM) with quasi-Poisson was adopted to quantify the effects of temperature on HFMD in 21 cities. Then the effects of each city were pooled by multivariate meta-analysis to obtain the heterogeneity among 21 cities. Potential city-level factors were included in meta-regression to explore effect modifiers. Results A total of 1,048,574 childhood cases were included in this study. There was a great correlation between daily childhood HFMD cases and temperature in each city, which was non-linear and lagged. High heterogeneity was showed in the associations between temperature and HFMD in 21 cities. The pooled temperature-HFMD association was peaking at the 79th percentile of temperature with relative risk (RR) of 2.474(95%CI: 2.065-2.965) as compared to the median temperature. Latitude was the main modifier for reducing the heterogeneity to 69.28% revealed by meta-analysis. Conclusions There was a strong non-linear and lagged correlation between temperature and HFMD. Latitude was strongly associated with the relationship between temperature and HFMD. Meanwhile, it had an effect on modifying the relationship. These findings can conducive to local governments developing corresponding preventive measures.
The Clinicopathological Features and Survival Outcomes of Patients with Different Metastatic Sites in Stage IV Breast Cancer
Authors: Wang Ru , Zhu Yayun , Liu Xiaoxu , Liao Xiaoqin , He Jianjun , Niu Ligang 
Published: November 2019

Abstract
Background
The features and survival of stage IV breast cancer patients with different metastatic sites are poorly understood. This study aims to examine the clinicopathological features and survival of stage IV breast cancer patients according to different metastatic sites.
Methods
Using the Surveillance, Epidemiology, and End Results database, we restricted our study population to stage IV breast cancer patients diagnosed between 2010 to 2015. The clinicopathological features were examined by chi‐square tests. Breast cancer‐specific survival (BCSS) and overall survival (OS) were compared among patients with different metastatic sites by the Kaplan‐Meier method with log‐rank test. Univariable and multivariable analyses were also performed using the Cox proportional hazard model to identify statistically significant prognostic factors.
Results
A total of 18,322 patients were identified for survival analysis. Bone-only metastasis accounted for 39.80% of patients, followed by multiple metastasis (33.07%), lung metastasis (10.94%), liver metastasis (7.34%), other metastasis (7.34%), and brain metastasis (1.51%). The Kaplan‐Meier plots showed that patients with bone metastasis had the best survival, while patients with brain metastasis had the worst survival in both BCSS and OS ( p < 0.001, for both). Multivariable analyses showed that age, race, marital status, grade, tumor subtype, tumor size, surgery of primary cancer, and a history of radiotherapy or chemotherapy were independent prognostic factors.
Conclusion
Stage IV breast cancer patients have different clinicopathological characteristics and survival outcomes according to different metastatic sites. Patients with bone metastasis have the best prognosis, and brain metastasis is the most aggressive subgroup.
Direct qPCR is a sensitive approach to detect Mycoplasma contamination in U937 cell cultures
Authors: Baaity Zain , Breunig Sven , Önder Kamil , Somoyvári Ferenc 
Published: November 2019

Abstract
Objective In order to make the Mycoplasma contamination monitoring task easier, we optimized a commercially available quantitative PCR (qPCR)-based detection kit to detect Mycoplasma DNA without DNA purification in a U937 suspension cell culture. We compared the sensitivities of the direct qPCR and the qPCR with the purified DNA template.

Results Our findings indicate that qPCR worked optimally with a 6 ml sample volume and a 52 o C annealing-extension temperature. We were able to decrease the annealing-extension step time from 60 sec to 20 sec without any major decrease in the reaction sensitivity. The total cycle time of the optimized direct qPCR was 65 minutes. The optimized qPCR protocol was used to detect Mycoplasma DNA directly and after DNA purification. Our findings indicate that the direct qPCR had a higher sensitivity compared to the regular qPCR. The Ct levels produced by the direct qPCR with 6 ml templates were almost identical to the Ct levels produced by the regular qPCR with DNA purified from a 60 ml cell culture sample (23.42 vs 23.49 average Ct levels respectively). The optimized direct qPCR protocol was successfully applied to monitor the elimination of Mycoplasma contamination from the U937 cell cultures.
Primary Prophylaxis to Prevent Tuberculosis Infection in Prison Inmates:A Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Oliveira Roberto Dias de , Santos Andrea da Silva , Reis Cassia Barbosa , Leite Alessandra de Cássia , Sacchi Flávia Patussi Correia , Araujo Rafaele Carla Piveta de , Santos Paulo Cesar Pereira dos , Rolla Valeria Cavalcanti , Martinez Leonardo , Andrews Jason , Croda Julio 
Published: November 2019

Abstract
Background. In many low- and middle-income countries, tuberculosis incidence in prisons is high, exposing incarcerated populations to an elevated risk of tuberculosis infection. Methods. We conducted a randomized, double-blind, placebo-controlled trial among HIV-negative male inmates of a high tuberculosis burden prison to determine whether twice-weekly isoniazid (900 mg) for 12 months prevents tuberculosis infection. The primary outcome was QuantiFERON–TB Gold Plus (QFT) conversion to ≥0.35 IU/ml at 6 months; the secondary outcome was conversion at any time point. Alternative QFT positivity thresholds (≥0.7, ≥2.0, and ≥4.0 IU/ml) were investigated as exploratory endpoints. Results. In total, 467 participants were randomly assigned to isoniazid (N=258) or placebo (N=209). In an interim analysis of participants who had completed six months of follow-up (N=171), QFT conversion occurred in 20.7% (19/92) and 21.5% (17/79) of participants in isoniazid and placebo arms (efficacy: 4.0%; P=0.88). The trial was then stopped for futility, and the remaining participants underwent QFT testing. Among all participants with a second QFT test at 6-months, conversion occurred in 19.7% (26/132) and 30.3% (37/122) of participants in isoniazid and placebo arms (efficacy: 35.1%; P=0.04). Protection was also seen among all individuals with a follow-up QFT (5/132 [3.8%] vs 14/122 [11.5%]; efficacy: 67.0%, P=0.01). In exploratory analyses, the isoniazid arm had significantly lower rates of conversion at ≥2.0 IU/ml (67.0% efficacy, P=0.01), but not at other cutoff values. Discontinuations and losses to follow-up were high in both arms (isoniazid, 126/258 [48.8%]; placebo, 87/209 [41.6%]; P=0.14), due to elective withdrawal (24.0% vs 21.5%; P=0.60) and transfer or release from prison (19.0% vs 18.2%; P=0.92). Conclusions. Our results suggest that 900 milligrams of isoniazid given twice weekly may confer partial protection against QFT conversion in high exposure environments; however, discontinuation rates in both arms were high, which would limit the clinical benefits of this prevention method.
Factors Influencing Post-Graduate Career Decisions of Ophthalmology Residents
Authors: Chen Xinyi , Zafar Sidra , Srikuma Divya , Boland Michael V. , Johnson Thomas V. , Green Laura , Ramanathan Saras , Pettey Jeff , Gedde Steven J. , Singman Eric L. , Woreta Fasika A 
Published: November 2019

Abstract
Background: To identify factors that influence ophthalmology residents’ decisions to pursue fellowship training or to practice comprehensive ophthalmology after residency. Methods: An anonymous survey was sent to ophthalmology residents in the U.S. from the graduating Class of 2018 and Class of 2019. The main outcome measure was the decision on whether to seek fellowship training or to practice comprehensive ophthalmology. Information on demographics, residency program characteristics and factors influencing career choices were collected. Results: The overall response rate was 16.4% (153/931). Among the 153 respondents, 117 (76.5%) matched into subspecialty training. Residents pursuing fellowships had more first-author publications (4.4 vs. 1.2, P < 0.001), were more likely to plan to practice in an academic setting (47.0% vs. 8.3%, P < 0.001) and in an urban location (48.7% vs. 25.0%, P < 0.001). In a multivariable analysis, factors predictive of fellowship training included a desire to acquire special skills (OR=3.01; 95% CI, 1.34–6.77), working with new technology (OR=2.67; 95% CI, 1.14-6.24) and mentorship (OR=2.30; 95% CI, 1.02-5.17). Factors that predicted a career in comprehensive ophthalmology were being married (OR=0.11; 95% CI, 0.02-0.74), lifestyle considerations (OR=0.19; 95% CI, 0.07-0.56), educational debt (OR=0.31; 95% CI, 0.15-0.68) and a decreased interest in an academic career (OR=0.38; 95% CI, 0.17-0.86). Gender, prestige or perceived favorable job market were not significant factors. Conclusions: The majority of U.S. ophthalmology residents responding to this survey matched into fellowships. Various factors including mentorship, lifestyle considerations, educational debt and interest in an academic career influenced the post-graduate career choices.
Inflammatory diseases of ENT organs and purulentseptic intracranial complications associated with them in the Kabardino-Balkarian Republic
Authors: Shardanov Z. N. , Artyushkin S. A. , Krivopalov A. A. , Shnayder N. A. , Shcherbuk A. Yu. , Shcherbuk Yu. A. , Krasikova A. I. 
Published: November 2019

Actuality. The growth of inflammatory diseases of ENT organs and associated purulent-septic intracranial complications is an urgent problem of modern otorhinolaryngology. Severe complications associated with sepsis and inflammatory lesions of the membranes and brain matter are life-threatening conditions for otorhinolaryngological patients.Objective. To study the epidemiological situation of inflammatory diseases of the ENT organs and associated purulent-septic intracranial complications in the Kabardino-Balkarian Republic.Materials and methods. Data of official statistics, electronic databases, statistical reports of the Ministry of Health of the KabardinoBalkan Republic, data of outpatient’s medical records and hospital medical records of multidisciplinary medical and preventive institutions, data on the prevalence of diseases of ENT organs in the Kabardino-Balkarian Republic from 2011 to 2018 among adults and children.Results and conclusions. The results obtained reflect a significant increase in inflammatory diseases of the ENT organs in the Kabardino-Balkarian Republic from 2011 to 2018. both in the number of reported cases and in the primary incidence. Despite the decrease in the number of inpatient ENT beds in the Republic in 2013, the number of patients treated increased. The reduction of ENT beds entailed an increase in hospital mortality, which is represented exclusively by ENT-associated intracranial complications. Today, the Republic has a rather high level of ENT-associated intracranial complications associated with low prevention and diagnosis of inflammatory ENT diseases, which dictates the importance of using a multidisciplinary approach (ENT doctor, neurologist, ophthalmologist, resuscitator, therapist, neurosurgeon), the need for review management tactics, development of algorithms for the diagnosis and optimal treatment of patients with ENT-associated HFD.
Rhinosinusitis with nasal polyps: main aspects of anti-relapse therapy and recovery of nasal breathing
Authors: Ryazantsev S. V. , Budkovaya M. A. , Artemyeva E. S. , Khamgushkeeva N. N. 
Published: November 2019

Objective. This study was conducted to increase effectiveness of anti-relapse therapy of chronic rhinosinusitis with polyps to create a stable long-term remission in the long-term postoperative period.Patients and research methods. 60 patients with total spread of polyposis process in the nasal cavity and paranasal sinuses were examined. All patients underwent endoscopic polysinusotomy and 3 weeks after surgery, basic anti-relapse therapy of PRS in the form Of nasonex intranasal spray of 400 mcg/day for 6 months in combination with irrigation with isotonic salt solutions was prescribed. At the same time, 30 patients 1.5 months after polysinusotomy were additionally given a short course of systemic corticosteroid therapy with Methylprednisolone, starting at 20 mg/day in combination with Omeprazole at 20 mg /day for 14 days. Subjective assessment of the patients ‘condition was carried out by questionnaire, for objective diagnosis acoustic rhinometry and CT of the paranasal sinuses were used.Results. Simultaneous administration of a short course of corticosteroid therapy in combination with prolonged intranasal use of Nasonex spray in patients with nasal polyps in the postoperative period contributed to the most rapid subjective improvement of nasal breathing. The combined scheme in 27 (90%) subjects showed a statistically significant improvement in intra-nasal aerodynamics (p<0.05) 2 months after polysinusotomy according to the results of acoustic rhinometry, the average MPPS1 was 0.67 ± 0,04 cm2 before and after the decongestant test. In 13 patients (44,3%) who received only intranasal corticosteroids reactive edema from the nasal mucosa were more pronounced, which contributed to the formation of zones of pathological narrowing of the nasal flow and a decrease in МППС1 to 0.43 ± 0,04см2 to test with decongestant. 2 years after surgical treatment in patients undergoing a combined course of corticosteroid therapy in relation to patients receiving only monotherapy with intranasal corticosteroids, there was no recurrence of polyposis in 86.7% of cases (26 patients), against 66.7% (20 patients), receiving only intranasal corticosteroids.
The Efficacy and Safety of Bilastine in the Treatment of Perennial Allergic Rhinitis in Patients with Moderate and Severe Forms of the Disease. Comparison of bilastine 20 mg with desloratadine 5 mg Сергей
Authors: Ryazantsev S. , Gogunska I. , Lymar I. , Romanyuk L. , Bil B. , Pukhlik S. , Pravdyva V. , Lapshyn V. , Koshlia V. 
Published: November 2019

Background: Bilastine is a new non-sedating H1 antihistamine approved for the symptomatic treatment of allergic rhinoconjunctivitis (ARC) and urticaria in adults and children over 12 years of age. In this paper, bilastine was compared with desloratadine in the treatment of various forms of allergic rhino-conjunctivitis classified according to the ARIA recommendations.Materials and Methods: This was an international, multi-centre, open-label, prospective randomized, parallel-group, phase III study which enrolled a total of 226 patients with ARC. The diagnosis of the allergic rhino-conjunctivitis was established on the basis of nasal and non-nasal symptoms and confirmed by the skin prick test. Patients were randomized to one of the two treatment groups: bilastine 20 mg daily or desloratadine 5 mg daily.Results: The results for the primary and secondary endpoints showed a comparable reduction in TSS, NSS, and NNSS from the baseline to the end of the treatment between the treatment groups, with slightly better effects for bilastine. Additional tests carried out in the subgroup of patients with moderate / severe persistent (MSP) ARC demonstrated comparable results for the bilastine and desloratadine groups regarding the mean change in TSS from the baseline until the 28th day, except for the sneezing score, for which bilastine showed the higher response (-1.60 ± 0.60 vs. -1.39 ± 0.63), and a statistically significant difference between the treatment groups regarding AUC for TSS ( -26.07 [95% CI: -48.6, -3.53] p = 0.024), NNSS (-10.51 [95% CI:-19.42, -1.59] p = 0.021), the sneezing score (-4.79 [95% CI:-9.06, -0.51] p = 0.028) and the ocular redness score (-5.50 [95% CI: -8.91, -2.08] p = 0.02).Conclusion: In general, bilastine and desloratadine showed a comparable efficacy profile in the treatment of ARC; however, the results obtained in the subgroup of patients with moderate / severe persistent symptoms indicate that bilastine has a stronger therapeutic effect
Experience of using herbal medicine sinupret for patients with chronic maxillary sinusitis during the post-surgery period
Authors: Ryazantsev S. V. , Budkovaya M. A. , Artemyeva E. S. 
Published: November 2019

The choice of an optimal tactic for chronic rhinosinusitis treatment is a very topical issue in otorhinolaryngology. Several pieces of existing literature report a positive impact of a herbal-based remedy Sinupret for patients in the post-rhinosurgical period. Objectives of the study: The investigation of the effect of Sinupret on patients with chronic maxillary sinusitis in the early postoperative period.Materials and methods: 15 patients with chronic rhinosinusitis were examined. The age of patients ranged from 20 to 57 years. The examination of patients was carried out right before the surgery and three months after it. The examination also included general otorhinolaryngological examination, assessment of the overall severity of the disease on the VAS scale, endoscopy of the nasal mucosa, assessment of nasal breathing function based on the analysis of the main indicators of anterior active rhinomanometry and computed tomography of the paranasal sinuses. Two days before their surgery, each patient was prescribed to take two tablets of Sinupret 3 times a day up to 14 days.Results: By day 10 of the post-surgery period, all patients reported noteworthy improvement in nasal breathing, a significant decrease in nasal discharge and no discomfort in the projection of the paranasal sinuses. There was a substantial decrease in the severity of oedema, exudation and formation of crusts, fibrin in all examined patients with rhinoscopy. According to the anterior active rhinomanometry, a statistically significant increase in the total nasal flow and a decrease in nasal resistance to physiological values were established 3 months after surgery. Conclusion: This article presents the results of Sinupret usage in the combined therapy before and after surgical treatment of patients with chronic rhinosinusitis and abnormal development of nasal structures. The results of that 14-day treatment evidenced an acceleration of epithelialization and restoration of drainage; as well as an improvement of ventilation function of the nasal cavity and paranasal sinuses. In addition to that, the chosen treatment contributed to the reduction of the rehabilitation period and the absence of relapses of chronic maxillary sinusitis was observed.