bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nuances and Management of Hilar Submandibular Sialoliths With Combined Transoral Robotic Surgery–Assisted Sialolithotomy and Sialendoscopy
Authors: Wen Christopher Z. , Douglas Jennifer E. , Elrakhawy Mohamed , Paul Ellen A. , Rassekh Christopher H. 
Published: December 2020

ObjectiveTo describe the management, technical nuances, and success rates of transoral robotic surgery (TORS)–assisted sialolithotomy.Study DesignRetrospective database review.SettingQuaternary academic medical center.MethodsBetween the months of January 2015 and May 2019, patients with hilar submandibular gland stones underwent 2 main variations of TORS‐assisted sialolithotomy and sialendoscopy: (1) TORS followed by sialendoscopy for patients with palpable predominantly single stones and (2) either sialendoscopy followed by TORS and sialendoscopy or sialendoscopy followed by TORS only for patients with nonpalpable or multiple stones. Clinical charts were reviewed to collect data, including stone size (imaging review, intraoperative measurement), palpability, duration of operation, TORS variation, operative challenges, symptom improvement, gland preservation rate, and complications.ResultsThirty‐seven patients were identified. Patients were 26 to 80 years old (mean, 57.2 years), and 40.5% were female. Twenty‐four patients (64.9%) underwent TORS followed by sialendoscopy; 10 (27.0%), sialendoscopy followed by TORS and sialendoscopy; and 3 (8.1%), sialendoscopy followed by TORS only. The mean stone size was 12.4 mm (range, 4‐28 mm). Eleven patients had multiple stones with a mean 4 stones per patient (range, 2‐9). Procedural success was 91.9% (34/37) at a mean follow‐up of 34.2 weeks (range, 1.4‐262.1), and the gland preservation rate was 97.3% (36/37). No patients reported symptoms of lingual nerve injury at 3‐month follow‐up.ConclusionTORS combined with sialendoscopy for hilar submandibular gland sialolithiasis allows for improved visualization of critical anatomy, tissue manipulation, and operative flexibility. In our experience, the operative success rate is high, and duration of surgery compares favorably with conventional combined hilar approaches.
Return to work following total knee arthroplasty: A multiple case study of stakeholder perspectives
Authors: Coutu Marie-France , Gaudreault Nathaly , Major Marie-Eve , Nastasia Iuliana , Dumais Réjean , Deshaies Annie , Pettigrew Sara , Labrecque Marie-Elise , Desmeules François , Maillette Pascale 
Published: December 2020

Objective: The study’s aim was to gain insights into factors influencing sustainable return to work following total knee arthroplasty (TKA). Design: A descriptive multiple-case design was used. A case was defined as a worker’s following TKA work disability situation. Settings: The cases came from public hospitals in urban and semi-urban areas in Quebec (Canada) and involved mostly non-work-related TKAs. Subjects: Workers had to be between 6 and 12 months post-TKA, have physical/manual jobs and currently employed. Their rehabilitation professionals and workplace representatives (employer and/or union) were also recruited, based on the work disability paradigm. Main measures: Semi-structured interviews, questionnaires on pain, physical work demands (workers only), and observation of the work activities of those workers back at work were used. Cases were compared and categorized for worker-perceived levels of difficulty in returning to or staying at work: little or no difficulty ( n = 8); some difficulty ( n = 5); not back at work due to excessive difficulty with their knee ( n = 4). Results: A total of 17 cases were constituted. In only one case, the worker benefitted from an interdisciplinary work rehabilitation approach. Results highlight the interplay among these factors: (1) the workers’ perceptions of their residual symptoms and ability to manage them, (2) the interaction between work adjustments and tools offered by the employers and the workers’ own strategies, and (3) perceptions of the workers’ physical capacities. Conclusion: Workers’ who face high levels of work demands/difficulties and who have limited access to work adjustments and tools should be referred for work rehabilitation.
Factors Influencing Clinical Success Following Endovascular Treatment of Type II Endoleaks
Authors: Hamidizadeh Ramin , Nzekwu Emeka , Halliwell Oliver 
Published: December 2020

Purpose: To compare long-term outcomes of transarterial (TA) and translumbar (TL) embolization of type II endoleaks (T2E) following EVAR, as well as factors that predict clinical success. Methods: 129 (mean age, 71.4y; range, 53-95) with T2E referred for embolization from August-2003 to December-2017 were retrospectively reviewed. One-hundred-eighty procedures were performed via TA (n = 139) and TL (n = 41) approaches, with 37 patients undergoing 51 reinterventions. Clinical success was defined as absence of endoleak and/or absence of aneurysm sac enlargement on follow-up imaging. Medical comorbidities, procedural data, embolic agents used, presence of successful sac embolization, and 30-day morbidity and mortality data were collected. Results: TL approaches had higher technical success (41/41 vs.122/139, p = .014). Clinical success rates were 52% (N = 58/111) and 62% (N = 23/37) for TA and TL procedures respectively ( p = .34). Looking at all procedures, sac embolization using n-butyl cyanoacrylate glue had higher clinical success compared to other embolic agents ( p = .017-.037). Successful sac access was a strong predictor of success for TA procedures (46/78 vs.12/33, p = .0379). 30-day complication rates were similar between TA (5.8%) and TL (4.9%) approaches. There was 1 death secondary to graft infection following TA embolization. Conclusions: Overall clinical success of TA and TL embolization when considering re-interventions is high. n-butyl cyanoacrylate glue had significantly higher success than other embolic agents ( p = .017-.037). Successful sac access was associated with success for TA procedures.
Representation of seafarers’ occupational safety and health: Limits of the Maritime Labour Convention
Authors: Graham Carolyn AE , Walters David 
Published: December 2020

This article assesses the regulatory steer provided by the Maritime Labour Convention 2006, against the research evidence as to what works in making for effective worker representation and consultation on occupational safety and health. Based on the testimony of seafarers and regulatory agencies, it demonstrates that the Maritime Labour Convention provisions lack the necessary elements for an effective regulatory steer. This is because the conditions shown to support this form of representation are absent from or underdeveloped in the shipboard work environment. The article concludes with some suggested ways to enhance the Convention’s provisions to achieve a more positive effect for seafarers.JEL Codes: J28, J53, J83
Evaluation of efficacy and safety of pegfilgrastim when given less than two weeks from dose-dense chemotherapy regimens
Authors: Umoru Godsfavour O , Zaghloul Hanna , El-Rahi Cynthia , Ensor Joe E 
Published: December 2020

Introduction In clinical practice, waiting 14 days between the administration of pegfilgrastim and subsequent chemotherapy cycle (as recommended by the prescribing information) is sometimes not feasible with multi-cycle dose-dense regimens. This study evaluated the practice related to the use of pegfilgrastim in oncology patients at a multi-hospital health system. Methods Patients who received pegfilgrastim as primary prophylaxis following dose-dense chemotherapy scheduled every 14 days were included. The primary endpoint was the impact of <14 elapsed days between pegfilgrastim administration and next chemotherapy cycle on the change in mean absolute neutrophil counts (ANC). A generalized linear mixed-effects model with fixed effects for pegfilgrastim delivery method, elapsed days between pegfilgrastim and chemotherapy (fixed categorical effect for 12, 13, 14 days), and ANC at subsequent cycle was fitted to the change in ANC between chemotherapy cycles. Results One hundred and sixty four patients with breast cancer who received pegfilgrastim support for dose dense doxorubicin and cyclophosphamide (ddAC) qualified for the model. The mean age was 52 ± 12 years. Eighty-eight percent received pegfilgrastim on-body injector while 13% received pegfilgrastim injection. The mean number of elapsed days between pegfilgrastim and subsequent chemotherapy was 13 ± 0.5 days. The method of pegfilgrastim delivery and elapsed days between pegfilgrastim and chemotherapy administration had no significant effect on the change in ANC (p = 0.8663 and p = 0.8434 respectively); however, patient’s age (p = 0.0125) had a significant effect on the change in ANC. Conclusion The study findings suggest safety and efficacy when chemotherapy is administered 12–14 days from pegfilgrastim.
Ten-Year Clinical Characteristics and Early Outcomes of Type B Aortic Dissection Patients With Thoracic Endovascular Aortic Repair
Authors: Huang Lihong , Kan Yuanqing , Zhu Ting , Chen Bin , Xu Xin , Dong Zhihui , Guo Daqiao , Si Yi , Fu Weiguo 
Published: December 2020

Objective/Background: This study examined the 10-year hospitalization characteristics, economic patterns and early clinical outcomes of type B aortic dissection (TBAD) patients that underwent thoracic endovascular aortic repair (TEVAR) in one high-volume hospital in China. Methods: We performed a population-based retrospective analysis based on electronic medical record system data provided by Zhongshan Hospital Fudan University from 2009 to 2018. Results: We identified 1,367 cases of TBAD patients with TEVAR over the past decade. The total incidence of in-hospital complications was 7.6% (104 of 1,367), among which acute kidney injury (AKI) had the highest incidence (3.1%, 42 of 1,367). Aortic-related reintervention was performed in 7 patients (0.5%). The overall aortic-related in-hospital mortality rate was 2.7% (37 of 1,367) and had no significant time-varying trend ( P = 0.2). Among these, 27% of in-hospital deaths were caused by retrograde type A dissection (RTAD). Chronic TBAD had a higher risk of in-hospital death versus acute TBAD, with a risk ratio of 2.69 (95% confidence interval [CI]: 1.19-6.09). Patients with hypertension (risk ratio 4.63, 95% CI: 1.38, 15.54) also had a higher in-hospital death risk. These 2 factors were also the predictive factors for the composite endpoint of in-hospital adverse events (risk ratio 2.17, 95% CI: 1.43, 3.29 and risk ratio 4.83, 95% CI: 1.90, 12.28, respectively), in addition to Marfan syndrome (risk ratio 4.05, 95% CI: 1.61, 10.19). The average length of hospitalization significantly declined during the past decade (annual percentage change -6.3%, 95% CI -8.2 to -4.3), and the stent-grafts (SGs) cost was the main expenditure of the total hospitalization costs. Conclusion: Our study showed a favorable early outcome of TEVAR over the past decade. Greater attention should be paid to certain risk factors in order to reduce the in-hospital adverse events. SG expenditure is still the primary economic burden on Chinese TBAD patients.
Methods to Integrate Natural Language Processing Into Qualitative Research
Authors: Abram Marissa D. , Mancini Karen T. , Parker R. David 
Published: December 2020

Background: Qualitative methods analyze contextualized, unstructured data. These methods are time and cost intensive, often resulting in small sample sizes and yielding findings that are complicated to replicate. Integrating natural language processing (NLP) into a qualitative project can increase efficiency through time and cost savings; increase sample sizes; and allow for validation through replication. This study compared the findings, costs, and time spent between a traditional qualitative method (Investigator only) to a method pairing a qualitative investigator with an NLP function (Investigator +NLP). Methods: Using secondary data from a previously published study, the investigators designed an NLP process in Python to yield a corpus, keywords, keyword influence, and the primary topics. A qualitative researcher reviewed and interpreted the output. These findings were compared to the previous study results. Results: Using comparative review, our results closely matched the original findings. The NLP + Investigator method reduced the project time by a minimum of 120 hours and costs by $1,500. Discussion: Qualitative research can evolve by incorporating NLP methods. These methods can increase sample size, reduce project time, and significantly reduce costs. The results of an integrated NLP process create a corpus and code which can be reviewed and verified, thus allowing a replicable, qualitative study. New data can be added over time and analyzed using the same interpretation and identification. Off the shelf qualitative software may be easier to use, but it can be expensive and may not offer a tailored approach or easily interpretable outcomes which further benefits researchers.
Abiraterone in patients with recurrent epithelial ovarian cancer: principal results of the phase II Cancer of the Ovary Abiraterone (CORAL) trial (CRUK – A16037)
Authors: Banerjee Susana , Tovey Holly , Bowen Rebecca , Folkerd Elizabeth , Kilburn Lucy , McLachlan Jennifer , Hall Marcia , Tunariu Nina , Attygalle Ayoma , Lima Joao Paulo Da Silveira Nogueira , Perry Sophie , Chatfield Peter , Hills Margaret , Kaye Stan , Attard Gert , Dowsett Mitch , Bliss Judith M. 
Published: December 2020

Background: Recurrent epithelial ovarian cancer (EOC) remains difficult to treat, with an urgent need for more therapy options. Androgens bind to the androgen receptor (AR), commonly expressed in EOC. CYP17 inhibitor abiraterone irreversibly inhibits androgen biosynthesis. The Cancer of the Ovary Abiraterone (CORAL) trial was designed to evaluate the clinical activity of abiraterone in EOC. Patients & Methods: CORAL was a multi-centre, open-label, non-randomised, 2-stage phase II clinical trial. Eligible patients had progression within 12 months of last systemic therapy and no prior hormonal anti-cancer agents. Patients received abiraterone 1000 mg daily plus 5 mg prednisone until progression. The primary endpoint was objective response rate (ORR) according to combined Response Evaluation Criteria in Solid Tumours/Gynaecological Cancer Intergroup (RECIST/GCIG) criteria at 12 weeks. Secondary endpoints included clinical benefit rate (CBR) at 12 weeks. Results: A total of 42 patients were recruited; median age 65 (range 34–85) years; 37 (88.1%) had high-grade serous tumours; 20 (48%) had at least three prior lines of therapy; 29/40 (72.5%) were AR+. In stage 1, 1/26 response was observed (in an AR+, low-grade serous EOC); response lasted 47 weeks. Overall, 12 week ORR was 1/42 (2%), CBR was 11/42 (26%) (8/29 (28%) in AR+ patients). Disease control was ⩾6 months for 4/29 (14%). One patient (AR+, low-grade serous) had a RECIST response at 82 weeks. Four (10%) had grade ⩾3 hypokalaemia; 11 (26%) had dose delays. Conclusions: CORAL represents the first trial of an AR targeted agent in ovarian cancer. While responses were rare, a subset of patients achieved sustained clinical benefit. Targeting AR in EOC including low-grade serous cancer warrants further investigation. Trial registration: CORAL is registered on the ISRCTN registry: ISRCTN63407050; http://www.isrctn.com/ISRCTN63407050
Methotrexate at middle and high accumulative doses might be associated with lower risk of new-onset cancers in patients with rheumatoid arthritis: a nationwide population-based cohort study
Authors: Perng Wuu-Tsun , Hung Yao-Min , Chang Renin , Lin Cheng-Li , Chiou Jeng-Yuan , Chen Huang-Hsi , Kao Chia-Hung , Wei James Cheng-Chung 
Published: December 2020

Background: We investigated whether taking methotrexate (MTX) is associated with a lower risk of new-onset cancers in patients with rheumatoid arthritis (RA). Methods: We conducted a 12-year retrospective cohort study from a population-based National Health Insurance Research Database in Taiwan. A total of 21,699 patients with newly diagnosed RA were enrolled during 2000–2009. The overall cancer rate was compared between 10,352 new users of MTX and 11,347 non-users. We used the WHO Defined Daily Dose (DDD) as a tool to assess drug exposure. Cox proportional hazard regression models were used to estimate the hazard ratio (HR) of disease after controlling for demographics and other comorbidities. Results: After adjusting for age, sex, cancer-related comorbidities, and RA-combined medication, the HR of cancer risk was 0.87 (95% CI = 0.74–1.02) for the MTX user group compared with the MTX non-user group. The cumulative incidence of cancer in the MTX non-user group was significantly higher than that of the MTX user group (log-rank test p < 0.001). In the low accumulative dose group [cumulative dose <1125 mg, cumulative defined daily dose (cDDD) <450], the HR of cancer risk for MTX users was 1.20 (95% CI = 1.01–1.42) compared with the MTX-non-user group. However, the adjusted HR of cancer risk was reduced to 0.66 (95% CI = 0.49–0.87) in MTX middle-dose users (cumulative dose 1125–2250 mg, cDDD: 450–899) and 0.33 (95% CI = 0.23–0.48) for the MTX high-dose group (cumulative dose ⩾2250 mg, cDDD ⩾900), respectively ( p for trend < 0.0001). Conclusion: MTX at middle and high accumulative doses might be associated with lower risk of new-onset cancers in patients with RA.
Hypomagnesemia in persons with type 1 diabetes: associations with clinical parameters and oxidative stress
Authors: van Dijk Peter R. , Waanders F. , Qiu Jiedong , de Boer Hannah H. R. , van Goor H. , Bilo H. J. G. 
Published: December 2020

Background: Among persons with type 1 diabetes mellitus (T1DM) low concentrations of magnesium have been reported. Previous (small) studies also suggested a relation of hypomagnesemia with (poor) glycaemic control and complications. We aimed to investigate the magnitude of hypomagnesemia and the associations between magnesium with parameters of routine T1DM care in a population of unselected outpatients. Methods: As part of a prospective cohort study, initially designed to measure quality of life and oxidative stress, data from 207 patients with a mean age of 45 [standard deviation (SD) 12] years, 58% male, diabetes duration 22 [interquartile range (IQR) 16, 31] years and glycated haemoglobin (HbA1c) of 60 (SD 11) mmol/mol [7.6 (SD 1.0)%] were examined. Hypomagnesemia was defined as a concentration below <0.7 mmol/l. Results: Mean magnesium concentration was 0.78 (SD 0.05) mmol/l. A deficiency was present in 4.3% of participants. Among these persons, mean concentration was 0.66 (SD 0.03) mmol/l. There was no correlation between magnesium and HbA1c at baseline ( r = –0.014, p = 0.843). In multivariable analysis, free thiols (reflecting the degree of oxidative stress) were significantly and negatively associated with magnesium concentrations. Conclusion: In this cohort of T1DM outpatients, the presence of hypomagnesemia was infrequent and, if present, relative mild. Magnesium was not associated with glycaemic control nor with presence of micro- and macrovascular complications. Although these results need confirmation, in particular the negative association of magnesium with free thiols, this suggests that hypomagnesemia is not a relevant topic in routine care for people with T1DM.
Epidemiology of occupational injuries in Ethiopian hotel industry in Ethiopia: A cross-sectional study
Authors: Abune Roza , Merga Hailu , Mengiste Embialle 
Published: December 2020

Introduction: An occupational injury is a global health issue, and in hotel industries, little is known about it. The aim of this study was therefore to assess the epidemiology of occupational injuries in international brand hotels. Method: An institutional cross-sectional study was conducted among 330 workers using a systematic random sampling method. Using EpiData and SPSS, respectively, data were entered and analyzed. The final results were explained and presented with the adjusted odds ratio and the 95% confidence interval, and the results of the qualitative data were triangulated with quantitative data. Results: Of the 330 study participants, 125 (37.9%; 95% confidence interval (32.7%, 43.8%)) reported having sustained an occupational injury. The study showed those who had four or less family members (adjusted odds ratio: 0.484, 95% confidence interval (0.286, 0.818)), those who had low educational background (adjusted odds ratio: 1.466, 95% confidence interval (1.098, 1.959)), those who had 2 years or less work experience (adjusted odds ratio: 1.065, 95% confidence interval (1.023, 1.108)), those who were working in shifts (adjusted odds ratio: 2.559, 95% confidence interval (1.197, 5.474)), and those who had sleep disturbance (adjusted odds ratio: 1.797, 95% confidence interval (1.025, 3.151)) were factors significantly associated with occupational injury. Conclusion: The study found that the prevalence rate was very high. Among the variables included in the analysis, having four or less family sizes, low educational background, having work experience of 2 years or less, working in shifts, and having sleep disorders/problems were statistically significant. It is therefore recommended that health and safety training and reinforcement be provided to increase awareness and understand the risk factors at the workplace.
Knowledge, Attitudes and Practices in Antibiotic Use in Family Medicine Students
Authors: Sánchez Xavier , Landázuri Andrea , Londo Paulina , Manzano Andrea , Moreno Roca Andrés , Jimbo Ruth 
Published: December 2020

Background Inappropriate prescriptions of antibiotics lead to ineffective and unsafe treatments and worsening of diseases. Medical students may have deficiencies in their prescription skills and they may need further training in the use of antibiotics for their practice. Medical skills in prescribing antibiotics can be improved through continuous medical education. The aim of this study was to assess the current levels of knowledge, attitudes, and practices (KAP) in antibiotic prescription in upper respiratory tract infections (URTI) among postgraduate family medicine students in Ecuador. Methods A cross-sectional study with an on-line survey, based on micro-curricular contents, to evaluate KAPs regarding antibiotic prescription in URTI among postgraduate family medicine students in 5 provinces of Ecuador. Results Two hundred and seventy-three physicians responded (94.1%). Most physicians treated between 1 and 5 URTI cases per day. The odds for inadequate knowledge and inappropriate practices in URTI among postgraduate family medicine students were 8.74 (95%CI, 4.94-15.46, P < .001) and 5.99, (IC95%, 2.66-13.50, P < .001) in physicians who were students of the first half of the study program. Conclusion The knowledge in URTI was limited among physicians. Nonetheless, they expressed a positive attitude toward not using antibiotics in URTI. A postgraduate program can significantly improve the knowledge and practices related to antibiotic prescriptions in URTI.