bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temperature Measurements of the Semicircular Canal During Green Laser Irradiation of the Canal: A Preliminary Study
Authors: Nogaki Taketoshi , Nomura Yasuya , Shimatani Yuichi , Kobayashi Hitome 
Published: June 2020

Background: Laser irradiation of the semicircular canal (SCC) is a good treatment for intractable benign paroxysmal positional vertigo. However, there were few reports on the temperature changes during laser irradiation. Objective: To measure the internal temperature of the SCC and vestibule during green laser irradiation of the SCC and investigate morphologic changes using human temporal bones. Methods: After the lateral SCC was blue-lined, a thermocouple was inserted into the SCC through a hole made in the canal wall. Another thermocouple was inserted into the vestibule through the oval window. Green laser was irradiated to the lateral canal wall. After the irradiation, the tissues were inspected as paraffin using HE staining. Result: The internal temperature of the SCC rose from 33 ° to 52 °C by a single laser irradiation of 1.5 W × 2 seconds and 82 °C by a single laser irradiation of 1.7 W × 3 seconds to the canal wall with a black spot. Continuous laser irradiation of 1.5 W × 3 seconds, 10 times resulted in a temperature rise of 92 °C from 33 °C. Throughout the whole experiments, temperatures within the vestibule were unchanged. Histopathology showed that the irradiated areas of the lateral canal wall were partially deficient with or without carbonization after single irradiation. By continuous laser irradiations, the SCC bony wall showed a peroration of 40 µm in diameter with carbonized edges. Conclusions: Green laser irradiation of the SCC produced char formation with perforation in the canal wall. High temperatures within the SCC were recorded for a short period of less than 30 seconds. However, the vestibule didn’t show temperature changes.
Outcome of Balloon Eustachian Tuboplasty in SCUBA Divers
Authors: Ungar Omer J. , Cavel Oren , Yahav Oron , Tsur Nir , Handzel Ophir 
Published: June 2020

Objectives: Good Eustachian tube (ET) function is necessary in order to equalize middle ear (ME) pressure with ambient pressures and avoid barotrauma among divers. Since placement of ventilation tubes is not compatible with diving, balloon eustachian tuboplasty is a potential surgical solution for divers with ET dysfunction (ETD). This is the first report of the outcome of balloon tuboplasty for ETD among divers. Methods: A retrospective analysis of medical records and clinical examinations of adult divers treated in a single tertiary medical center. Results: Four male divers (age range 21-71 years, 5 ETs) underwent balloon tuboplasty for ETD. None had identifiable risk factors for ETD. Symptom duration ranged from 2 to 5 years and was restricted to diving in 3 patients. The most common symptom was difficulties in equalizing air pressure during descent and ascent, followed by aural fullness and hearing loss. The validated Hebrew version of ETD-7 questionnaire (ETDQ-7H) results were normal in 3 ears and pathological (2.9 and 3.3) in 2 ears. The averaged postoperative ETDQ-7H score was 1.2 points, significantly better than the preoperative score ( P < .05). While diving, pressure-equalizing sensation improved in all ears. Conclusion: Balloon eustachian tuboplasty is a safe method for treating diving-induced baro-challenge ETD. This procedure can improve symptoms and enable the patient to resume diving.
Management of life-threatening aortoesophageal fistula: experiences learned from eight patients
Authors: Chen Chengshi , Kim Jong Woo , Shin Ji Hoon , Kwon Yohan , Kim Jinoo , Lee In Joon 
Published: June 2020

Background Aortoesophageal fistula (AEF) is a rare but fatal condition causing massive upper gastrointestinal bleeding. Purpose To report our experiences in the management of life-threatening AEF. Material and Methods A total of eight patients (seven men, one woman; mean age = 59.4 years; age range = 43‒76 years) presenting with AEF between 2005 and 2018 were recruited from three different Korean hospitals. The medical records of these patients were reviewed for patient demographics, clinical features, diagnostic and therapeutic modalities, and outcomes. Results Two patients died as a result of massive hemorrhage before endovascular or surgical treatment could be undertaken. Of the six patients who were treated, five underwent endovascular interventions: embolization of the fistula using n-butyl cyanoacrylate (NBCA) and subsequent thoracic endovascular aortic repair (TEVAR) in two patients; TEVAR alone in two patients; and NBCA embolization alone in one patient. Among them, three patients who received TEVAR with or without NBCA embolization in a timely fashion recovered and were discharged. One patient who received delayed TEVAR died of disseminated intravascular coagulation, and one who received NBCA embolization alone died of hemorrhagic shock, both dying within three days of treatment. The remaining patient who underwent surgical aortic repair is alive after 13 years. Conclusion Rapid identification and surgical treatment are necessary to increase the likelihood of survival, if emergency surgery is feasible. TEVAR in a timely fashion facilitates hemodynamic stabilization by rapidly controlling hemorrhage and saves the patient’s life.
Brucellar reproductive system injury: A retrospective study of 22 cases and review of the literature
Authors: Zhou Yan , Xie Songsong , Zheng Rongjiong , Dai Qinqi , Xu Zheng , Zuo Weize , Ding Jianbing , Zhang Yuexin 
Published: June 2020

Objective We aimed to describe the clinical characteristics and prognosis of 22 patients with Brucella-induced reproductive system injury. Methods We assessed 22 patients with reproductive system injury between 2010 and 2018 at The First Affiliated Hospital of Xinjiang Medical University. Results The disease is predominant in men. Male patients had orchitis, erectile dysfunction, prostatitis, and urethral stricture, while female patients had vaginitis and cervicitis. Some patients had laboratory abnormalities and liver injury. Patients received combination therapy of rifampicin and doxycycline. Doxycycline combined with levofloxacin or moxifloxacin was administered to patients with rifampicin intolerance. All patients had received antibiotic therapy for at least 6 weeks. One patient was lost to follow-up, one patient relapsed because of osteoarthropathy, and one patient had dysuria resulting from chronic prostatitis. The clinical symptoms resolved in the other patients, and the overall patient prognosis was good. Conclusion Clinicians should pay attention to brucellosis-induced reproductive system damage. The two-drug regimen of rifampicin+doxycycline is recommended for these patients. Doxycycline combined with levofloxacin or moxifloxacin should be used in patients with brucellosis-induced reproductive system damage who have rifampicin intolerance. The treatment course should be at least 6 weeks.
Burden of vertigo at home: Risks for patients with vertigo
Authors: Kimura Yuri , Tsunoda Atsunobu , Tanaka Kumiko , Anzai Takashi , Ikeda Katsuhisa , Tsunoda Reiko , Terasaki Omi 
Published: June 2020

Objective We aimed to clarify the burden of vertigo in patients’ homes. Methods This was a questionnaire survey among patients with vestibular vertigo. Four main questions were prepared. Q1: Where did you first notice vertigo? Q2: Where have you had the most difficulty with vertigo in your home? Q3: Where do you have difficulty at present? Q4: What household equipment have you used as a countermeasure to prevent further problems with vertigo? Results Sixty patients completed the questionnaire. Benign paroxysmal positional vertigo (BPPV) was most common among respondents, followed by Ménière’s disease. Q1: Most patients with BPPV first noticed vertigo in the bedroom; patients with other diseases first noticed vertigo in the living room. Q2: Both groups previously had the most difficulty with vertigo in the same locations as in Q1; these differences were significant between Q1 and Q2. Q3: Both groups had the most difficulty on stairs. Q4: Handrails were the most often used equipment for vertigo in both groups. There was no significant difference between Q3 and Q4. Conclusion Our data revealed that the locations of risks differ among patients with vestibular disorders. Handrails were considered the most important equipment to prevent problems with vertigo.
Natural compounds attenuate heavy metal-induced PC12 cell damage
Authors: Yang Lina , Shen Keshu , Ji Dongping 
Published: June 2020

Objectives To investigate the neuroprotective effects of six natural compounds (caffeine, gallic acid, resveratrol, epigallocatechin gallate [EGCG], L-ascorbic acid and alpha tocopherol [Vitamin E] on heavy metal-induced cell damage in rat PC12 cells. Methods In this in vitro experiment, rat PC12 cells were exposed to four heavy metals (CdCl2, HgCl2, CoCl2 and PbCl2) at different concentrations and cell apoptosis, necrosis and oxidative stress were assessed with and without the addition of the six natural compounds. Results The metals decreased cell viability but the natural compounds attenuated their effects on apoptosis, necrosis and reactive oxygen species (ROS) levels. Mitochondrial protein changes were involved in the regulation. Conclusion Overall, the natural compounds did provide protection against the metal-induced PC12 cell damage. These data suggest that natural compounds may have therapeutic potential against metal-induced neurodegenerative disease.
Comparison of plasma exchange, double plasma molecular adsorption system, and their combination in treating acute-on-chronic liver failure
Authors: Guo Xiju , Wu Fengqing , Guo Weibo , Zhang Jiachang , Yang Yan , Lu Yajing , Yin Congbo , Fan Hongxing , Xu Juan , Liao Mingmei 
Published: June 2020

Objective Our objective was to compare the effectiveness of nonbiological artificial liver (NBAL) support, particularly short-term (28-day) survival rates, in patients who underwent treatment using double plasma molecular adsorption system (DPMAS), plasma exchange (PE), or combined PE+DPMAS, in addition to comprehensive physical treatment for different stages of acute-on-chronic liver failure (ACLF). Methods We retrospectively reviewed clinical data of 135 patients with ACLF who received NBAL treatment between November 2015 and February 2019. The patients were categorized into PE, DPMAS, and PE+DPMAS groups. Short-term effectiveness of treatment was assessed and compared based on selected clinical findings, laboratory parameters, and liver function markers. Results Coagulation function improved significantly in all groups after treatment. In the PE and PE+DPMAS groups, prothrombin time decreased to different degrees, whereas plasma thromboplastin antecedent increased significantly after treatment. White blood cell counts increased and platelet counts decreased in all groups after treatment. The model for end-stage liver disease score, Child–Pugh grade, systematic inflammatory syndrome score, and sepsis-related organ failure score decreased in all three groups after treatment. Conclusions PE, DPMAS, and PE+DPMAS improved disease indicators in all patients with ACLF. The combined treatment improved the short-term effectiveness of treatment, especially in patients with mild ACLF.
Combined Correction of Tibial Torsion and Tibial Tuberosity–Trochlear Groove Distance by Supratuberositary Torsional Osteotomy of the Tibia
Authors: Jud Lukas , Singh Sarvpreet , Tondelli Timo , Fürnstahl Philipp , Fucentese Sandro F. , Vlachopoulos Lazaros 
Published: June 2020

Background: Increased external tibial torsion and tibial tuberosity–trochlear groove distance (TTTG) affect patellofemoral instability and can be corrected by tibial rotational osteotomy and tibial tuberosity transfer. Thus far, less attention has been paid to the combined correction of tibial torsion and TTTG by supratuberositary osteotomy. Purpose: To quantify the effect of a supratuberositary torsional osteotomy on TTTG. Study Design: Descriptive laboratory study. Methods: Seven patients who underwent supratuberositary osteotomy to treat patellofemoral instability and an additional 13 patients with increased TTTG were included (N = 20). With 3-dimensional (3D) surface models, supratuberositary rotational osteotomies were simulated with predefined degrees of rotation. Concomitant 3D TTTG was measured by a novel and validated measurement method. In addition, all operated patients underwent 2-dimensional (2D) radiographic evaluation with pre- and postoperative computed tomography data. Absolute differences among simulated, predicted, and achieved postoperative corrections were compared. Results: A total of 500 supratuberositary osteotomies were simulated. The linear regression estimate yielded a change of −0.68 mm (95% CI, −0.72 to −0.63; P < .0001) in 3D TTTG per degree of tibial rotation, and 2D and 3D TTTG measurements in the operated patients were comparable in pre- and postoperative measurements (preoperative, 19.8 ± 2.5 mm and 20.0 ± 2.4 mm; postoperative, 13.6 ± 3.8 mm and 14.6 ± 3.4 mm, respectively). Postoperative 2D TTTG deviated in absolute terms from predicted (regression) and simulated TTTG by 1.4 ± 1.0 mm and 1.5 ± 0.6 mm. Inter- and intrarater reliability (intraclass correlation coefficient) for radiological and simulated measurements ranged between 0.883 and 0.996 and were almost perfect. Conclusion: In supratuberositary osteotomy, TTTG changes by −0.68 mm per degree of internal tibial rotation. The absolute mean difference between postoperative predicted TTTG and 2D TTTG was only 1.4 mm. Thus, TTTG correction can be successfully predicted by the degree of tibial rotation. Clinical Relevance: TTTG correction can be successfully predicted by the degree of tibial rotation. Therefore, in selected cases, tibial torsional deformity and TTTG can be corrected by 1 osteotomy. However, isolated rotations have been performed, and unintended translational movements during tibial rotation may alter the postoperative results.
Effect of titanium dioxide nanoparticles administered during pregnancy on depression-like behavior in forced swimming and tail suspension tests in offspring mice
Authors: Tarlan Mitra , Sajedianfard Javad , Fathi Mazyar 
Published: June 2020

Introduction: Applications of engineered nanoparticles are rapidly increasing. Titanium dioxide nanoparticles (TiO2 NPs) are used in many products including those produced by pigment and cosmetic manufacturers. The objective of this study was to investigate the effects of maternal exposure during pregnancy to TiO2 NPs on depressive-like behavior in the first and second generation offspring. Materials and Methods: Forty female albino mice were placed into four groups for 2 weeks. Fertile males were then added to each cage by a ratio of two males to five females. After detection of pregnancy, the mice were transferred to separate cages. The study groups were divided into four groups: the first group, served as control, did not receive any treatment; the second group received injections of normal saline; groups 3 and 4 received, respectively, 50 and 100 µl of TiO2 NP solution injections subcutaneously on days 3, 7, 10, and 14 after mating. Behavioral tests were conducted on postnatal days 21 and 40. Findings: Subcutaneous injection of 50 and 100 µl of TiO2 NPs significantly ( p < 0.05) increased the immobility time in the forced swimming test and tail suspension test (TST). No significant difference was observed in measured variables between groups receiving 50 and 100 µl of TiO2 NPs. No significant difference was also found between male and female offspring. Depression-like behavior increased in the second generation of mice in the forced swim test and TST. Conclusion: Prenatal exposure of mothers to TiO2 NPs would increase depression-like behavior in neonatal mice.
Suicidal Behaviors Among Nurses in Canada
Authors: Stelnicki Andrea M. , Jamshidi Laleh , Angehrn Andréanne , Nicholas Carleton R. 
Published: June 2020

Background Nurses are regularly exposed to potentially psychologically traumatic events, experience high rates of burnout, and may be at an elevated risk of death by suicide. Few studies have assessed for suicidal behaviors among Canadian nurses, and factors that may increase risk for suicidal behaviors are unknown. Purpose The current study was designed to assess past-year and lifetime suicidal behavior (i.e., ideation, plans, and attempts) using a large sample of Canadian nurses. Method Participants ( n =  3969; 94.3% women) completed an online survey including measures of suicidal behavior and symptoms of mental disorders. Results Considerable proportions of participants reported past-year and/or lifetime suicidal ideation (10.5%, 33.0%), plans (4.6%, 17.0%), and attempts (0.7%, 8.0%), considerably higher than general population estimates. Significant differences were identified across age groups, years of service, marital status, regional location, and nursing type (e.g., registered psychiatric nurses, licensed practical nurses, registered nurses). Participants who screened positive for almost all measured mental disorders had significantly higher rates of suicidal behavior. Conclusions The results necessitate further research to evaluate risk factors contributing to suicidal behavior in Canadian nurses and methods to decrease the risk (e.g., developing effective monitoring and prevention measures).
Continuation of Opioid Therapy at Transitions of Care in Critically Ill Patients
Authors: Witcraft Emily J. , Gonzales Jeffrey P. , Seung Hyunuk , Watt Ian , Tata Asha L. , Yeung Siu Yan Amy , Heavner Mojdeh S. , Qato Danya M. , Gulati Mangla S. , Millstein Leah S. 
Published: June 2020

Purpose: Opioids are one of the high-risk medication classes that are administered to critically ill patients during their intensive care unit (ICU) stay. However, little attention has been given to inpatient opioid prescribing practices, especially in critically ill patients. The purpose of our study was to characterize opioid prescribing practices across 2 transitions of care during an inpatient hospital stay: medical ICU (MICU)/intermediate care unit (IMC) to floor and floor to hospital discharge and identify potential patient-specific factors that impact opioid continuation. Methods: This is a retrospective cohort study evaluating opioid-naive adult patients with new opioid therapy initiated in MICU/IMC at a tertiary care academic medical center from December 1, 2016, to November 30, 2017. Opioid continuation rate was assessed twice: transition 1 (MICU/IMC to floor) and transition 2 (floor to hospital discharge). Results: In total, 112 opioid-naive patients with initial opioid administration in the MICU/IMC were included. Opioid therapy was continued in 56.1% (37/66) at transition 1 and 56.8% of patients (21/37) at transition 2. Patients with opioids continued at transition 1 had a longer hospital length of stay compared to those not continued on opioids, 22 (interquartile range [IQR] 11-36) vs 8 (IQR 6-14; P = .0004). Among the patients continued on opioids at hospital discharge, intubation during hospital stay and cumulative opioid dosage were greater than those not continued on opioids (17 [80.9%] vs 7 [43.8%], P = .019; and 3482 mcg [IQR 1690-9530] vs 732.5 mcg [IQR 187.5-1360.9], P = .0018, respectively). Conclusions: Opioid-naive patients receiving opioid therapy in the MICU/IMC had a continuation rate of >56% during transitions of care, including hospital discharge. Factors that contributed to the continuation of opioids at transitions of care included longer hospital length of stay, intubation, and cumulative hospital opioid dosage. These findings may help to provide health systems with guidance on targeted opioid stewardship programs.
Optimal Outcomes Reporting (OOR): A New Value–Based Metric for Outcome Reporting Following Cleft Palate Repair
Authors: Meara John G. , Hughes Christopher D. , Sanchez Karl , Catallozzi Liza , Clark Roseanne , Kummer Ann W. 
Published: June 2020

Objective: Palatoplasty outcome measurements vary widely among institutions. A standardized outcome metric would help provide quality benchmarks. Design: Retrospective review of primary palatoplasty patients from 2007 to 2013. Setting: Tertiary care children’s hospital. Main Outcome Measures: We created a novel conceptual quality metric called “OOR” (Optimal Outcome Reporting). Optimal Outcome Reporting is designed to reflect the percentage of patients with cleft palate who experience the best outcomes: one operation, velar competence by age 5 years, and no unintended palatal fistula. Results: Optimal Outcome Reporting was 72.3% (68/94). Eight patients had “suboptimal” outcomes for having undergone more than one operation. Eighteen patients failed for velar incompetence. No additional patients fell out of the algorithm for fistula. A significantly higher proportion of nonsyndromic patients demonstrated an “optimal” result compared to syndromic patients (61/80, 76.3% vs 7/14, 50.0%; P = .04). Patients who required more than one procedure had significantly more clinic visits (32.6 vs 14.9; P < .01) and accrued higher costs compared to “optimal” patients (US$34 019.88 vs US$15 357.25; P < .01). Conclusions: Optimal Outcome Reporting represents a novel quality metric that can provide meaningful information for patients with cleft palate. Optimal Outcome Reporting utilization can help cleft centers adopt changes that matter to patients and their families. By allowing for cross-institutional comparisons in a clear and objective manner, OOR can promote competition, innovation, and value in cleft palate care.
Validation of the low anterior resection syndrome score in finnish patients: preliminary results on quality of life in different lars severity groups
Authors: Carpelan Anu , Elamo Eeva , Karvonen Jukka , Varpe Pirita , Elamo Sami , Vahlberg Tero , Grönroos Juha , Huhtinen Heikki 
Published: June 2020

Background and Aims: Low anterior resection syndrome is common after anterior resection for rectal cancer. Its severity can be tested with the low anterior resection syndrome score. We have translated the low anterior resection syndrome score to Finnish, and the aim of this study is to validate the translation. Materials and Methods: The translated Finnish low anterior resection syndrome score and European Organisation for Research and Treatment of Cancer quality-of-life questionnaire-C30 and QLQ-CR29 questionnaires were sent to 159 surviving patients operated with anterior resection for rectal adenocarcinoma between 2007 and 2014 in a tertiary referral center. Psychometric properties of the translation were evaluated in comparison to quality-of-life scales and in different risk factor groups. Results: In the study, 104 (65%) patients returned the questionnaires. Of these, 56 (54%) had major low anterior resection syndrome, 26 (25%) had minor low anterior resection syndrome, and 22 (21%) had no low anterior resection syndrome. Patients with major low anterior resection syndrome had a significantly lower quality of life and more defecatory symptoms as assessed with the European Organisation for Research and Treatment of Cancer questionnaires compared with those with no low anterior resection syndrome. Patients operated with total mesorectal excision had significantly higher low anterior resection syndrome scores compared with those operated with partial mesorectal excision (median/interquartile range 32/15 and 29/11, respectively, p = 0.037). The test–retest validity of the translation was good with an intraclass correlation coefficient of 0.77 (95% confidence interval 0.51–0.90). Conclusions: The Finnish low anterior resection syndrome score is a valid test in the assessment of postoperative bowel function and its impact on the quality of life. It can be implemented to use during regular follow-up visits of Finnish-speaking rectal cancer patients.