bluuebunny/crossref_metadata_2025_split huggingface dataset:
Airway wall thickness and airflow limitations in asthma assessed in quantitative computed tomography
Authors: Patyk Mateusz , Obojski Andrzej , Sokołowska-Dąbek Dąbrówka , Parkitna-Patyk Martyna , Zaleska-Dorobisz Urszula 
Published: January 2020

Background: Asthma is a frequent chronic disease of the airways. In spite of the fact that symptoms of asthma are well known, the pathogenesis has not yet been fully understood. Quantitative computed tomography (qCT) of the lung allows for the measurment of a set of parameters. The aim of this study was to evaluate the usefulness of quantitative computed tomography in the assessment of airway wall thickness in asthma. Methods: The prospective study was performed on a group of 83 patients with well-defined, long-term asthma between 2016 and 2018. The control group was composed of 30 healthy volunteers. All examined subjects were non-smokers. All computed tomography (CT) studies were performed using a 128 multi-slice CT scanner with no contrast, following a chest scanning protocol in the supine position, at full inspiration and breath-holds. Results: Quantitative bronchial tree measurements were obtained from the third up to the ninth generation of the posterior basal bronchi (B10) of the right lung in a blinded fashion. The value of the wall thickness in patients with asthma was significantly higher in all measured generations of the bronchial tree (third to ninth generation). The lumen area and the inner diameter significantly correlated with the lung function tests and were substantially smaller in the examined group from the seventh to the ninth generation of the bronchi ( p < 0.05). Conclusions: We conclude that airway remodelling occurs in most patients with long-term asthma and is associated mainly with the medium and small airways. Imaging techniques, especially qCT can be useful in the diagnosis and management of asthma. The reviews of this paper are available via the supplemental material section.
Nasal Symptoms Following Laryngectomy: A Cross-sectional Analysis
Authors: Ayoub Noel , Kearney Ann , Sayyid Zahra N. , Erickson-DiRenzo Elizabeth , Jeffrey Caroline , Hwang Peter H. 
Published: January 2020

Background After total laryngectomy, the severe reduction in nasal airflow alters the function and physiology of the nasal cavity. These anatomic and physiologic changes may in turn impact sinonasal quality of life. Objective This study sought to characterize the degree of postoperative sinonasal symptoms experienced by laryngectomees. Methods Two groups of subjects were recruited in this cross-sectional analysis: patients who previously underwent laryngectomy with or without chemoradiation for laryngeal or hypopharyngeal cancer and a comparison group treated with radiation but not laryngectomy. Patients underwent assessment of sinonasal symptoms using the Reflective Total Nasal Symptom Score (rTNSS), 22-item Sinonasal Outcome Test (SNOT-22), and visual analog scales (VASs). Patients also underwent nasal endoscopy recorded and graded by blinded reviewers using the Modified Lund–Kennedy (MLK) scale. Results Thirty-six laryngectomees and 12 controls were enrolled. The total SNOT-22 was similar between the 2 groups (27.3 vs 20.3, P = .16), but the laryngectomy cohort had higher rhinologic ( P < .01), extranasal ( P = .01), and ear/face ( P = .01) subdomain scores. VAS scores were worse in the laryngectomy group for nasal congestion ( P < .01), rhinorrhea ( P < .01), postnasal drip ( P < .01), and smell ( P < .01) but not for nasal fullness ( P = .11). rTNSS (4.7 vs 2.8, P = .04) and MLK scores (2.8 vs 0.8, P < .01) were higher in the laryngectomy group. In addition, 44% and 83% of patients in the laryngectomy and nonlaryngectomy groups, respectively, subjectively reported well-controlled nasal symptoms. Conclusion Laryngectomees are likely to experience a higher degree of subjective and objective nasal disease than nonlaryngectomized patients. Postlaryngectomy nasal dysfunction may be an important aspect of quality of life impairment in the laryngectomee population.
Demographics of traumatic brain injury and outcomes of continuous chain of early rehabilitation in Singapore
Authors: Lui Siew Kwaon , Fook-Chong Stephanie Man Chung , Teo Qiao Qi 
Published: January 2020

Background: Evidence shows that early initiation of a continuous chain of rehabilitation is associated with better functional outcomes in traumatic brain injured patients. The Department of Rehabilitation Medicine initiated early screening and review of patients with all traumatic brain injury (TBI) severity within 72 hours of acute admission, followed by direct transfer of suitable patients to acute inpatient rehabilitation (AIR). Objectives: This study aim to document the demographics and clinical characteristics of all TBI patients admitted to the local acute hospital; determine the characteristics of patients with TBI who are directly transferred to AIR following early screening and review; and determine clinical predictors affecting functional outcomes of patients of all TBI severity. Methods: A total of 491 patients were screened and reviewed; 116 patients were directly transferred to AIR. Results: The median age of the screened cohort was 67.0 years (interquartile range 50.0–77.0 years). Falls were the leading mechanism of TBI. Infection (odds ratio (OR)=2.95, 95% confidence interval (CI) 1.59–5.49) and neurosurgical intervention (OR=2.18, 95% CI 1.24–3.81) increased the odds of transfer to AIR. The Functional Independence Measure (FIM) gain after receiving AIR was significant ( p<0.001). Increased age, complications, high motor admission FIM (AFIM) and long rehabilitation length of stay (RLOS) were negatively associated with FIM gain and FIM efficiency. Conclusions: Our study demonstrated that falls were the leading mechanism of TBI, with the majority of patients being older. Infection and neurosurgical intervention increased the likelihood of transfer to AIR. There was functional improvement after AIR. Age, complications, motor AFIM and RLOS were negatively associated with FIM gain and FIM efficiency. Further local research is warranted to confirm these findings.
Awareness about radiation hazards and knowledge about radiation protection among healthcare personnel: A quaternary care academic center–based study
Authors: Khamtuikrua Chaowanan , Suksompong Sirilak 
Published: January 2020

Background: The use of medical radiation in diagnosis and procedural and surgical treatment is increasing. Therefore, healthcare personnel should be adequately aware and knowledgeable about radiation hazards to protect themselves and their patients from its adverse effects. The objective of this study was to examine awareness about radiation hazards and knowledge about protection methods among the anesthesia personnel and surgical subspecialists of a quaternary care academic center. Methods: A validated questionnaire was completed by anesthetic personnel and surgical subspecialists. It consisted of questions that required demographic information and assessed awareness about radiation hazards. In addition, 15 multiple-choice questions assessed knowledge about radiation across the following domains: the main principle of radiation protection, personal annual radiation dose, personal protection equipment, safe distance from an X-ray machine, and susceptible organs. Results: A total of 270 potential participants were emailed and invited to respond to an online questionnaire, and the response rate was 79.3%. Of the 214 participants, 69.2% were women; the mean age of the sample was 34.8 years. Most of the participants (63.1%) considered radiation exposure that occurs as a part of daily work to be very harmful; 86.4% and 78.5% reported that they always wore a lead apron and a thyroid shield when working in an environment that entails radiation exposure, respectively. The mean score for knowledge about radiation hazards and protection was 6.4 ± 2.0 (maximum possible score = 15) Therefore, there is a need to improve anesthetic personnel and surgical subspecialists’ knowledge about radiation protection, especially with regard to the use of lead goggles and harmful doses of radiation. Conclusion: The present findings suggest that there is a reasonable level of awareness but a relative lack of knowledge about radiation hazards and protection among anesthesia personnel and surgical subspecialists. Therefore, continuing medical education on radiation hazards and protection must be mandated.
Personal and societal costs of multiple sclerosis in the UK: A population-based MS Registry study
Authors: Nicholas Richard S , Heaven Martin L , Middleton Rodden M , Chevli Manoj , Pulikottil-Jacob Ruth , Jones Kerina H , Ford David V 
Published: January 2020

Objectives To investigate through survey and data linkage, healthcare resource use and costs (except drugs), including who bears the cost, of multiple sclerosis in the United Kingdom by disease severity and type. Methods The United Kingdom Multiple Sclerosis Register deployed a cost of illness survey, completed by people with multiple sclerosis and linked this with data within the United Kingdom Multiple Sclerosis Register and from their hospital records. Resource consumption was categorised as being medical or non-medical and costed by National Health Service and social services estimates for 2018. Results We calculated £509,003 in non-medical costs over a year and £435,488 in medical costs generated over 3 months. People with multiple sclerosis reported self-funding 75% of non-medical costs with non-medical interventions having long-term potential benefits. Costs increased with disability as measured by patient-reported Expanded Disability Status Score and Multiple Sclerosis Impact Scale, with Multiple Sclerosis Impact Scale physical being a more powerful predictor of costs than the patient-reported Expanded Disability Status Score. Two distinct groups were identified: medical and non-medical interventions ( n = 138); and medical interventions only ( n = 399). The medical and non-medical group reported increased disease severity and reduced employment but incurred 80% more medical costs per person than the medical-only group. Conclusions The importance of disability in driving costs is illustrated with balance between medical and non-medical costs consistent with the United Kingdom health environment. People with multiple sclerosis and their families fund a considerable proportion of non-medical costs but non-medical interventions with longer term impact could affect future medical costs.
Effects of tourniquet application on enhanced recovery after surgery (ERAS) and ischemia-reperfusion post-total knee arthroplasty: Full- versus second half-course application
Authors: Cao Qinggang , He Zhiwei , Fan Yongfei , Meng Jia , Yuan Tao , Zhao Jianning , Bao Nirong 
Published: January 2020

Purpose: Pneumatic tourniquets are used in total knee arthroplasty (TKA) for surgical field visualization and improved cementation; however, their use is controversial. This study aimed to assess the effects of tourniquet application on enhanced recovery post-TKA. Methods: A prospective randomized single-blinded trial assessed tourniquet’s effects on postoperative pain, swelling, and early outcome in TKA. One-hundred and two patients with knee osteoarthritis were randomized to full-course (FC) and second half-course (SHC) application ( n = 51/group). Tumor necrosis factor-alpha (TNF-α), C-C motif chemokine ligand 2(CCL-2), pentraxin-3 (PTX-3), prostaglandin E-2 (PGE-2), superoxide dismutase-1 (SOD-1), and myoglobin (Mb) were assessed by enzyme-linked immunosorbent assay, while the visual analog scale (VAS), range of motion (ROM), and thigh circumference growth rate were recorded. Results: Average tourniquet duration significantly differed between the SHC (37.5 ± 5.1 min) and FC (66.4 ± 7.2 min) groups ( p < 0.01); VAS and thigh circumference growth rate in the SHC group were much lower compared with the FC group, while ROM was higher within 48 h of tourniquet removal ( p < 0.01). Blood TNF-α, PTX3, CCL2, PGE2, SOD-1, and Mb were lower in the SHC group than the FC group ( p < 0.01). Additionally, intraoperative blood loss was significantly elevated in the SHC group than the FC group ( p < 0.01), with lower postoperative blood loss in the drain ( p = 0.001). Postoperative drainage volume was reduced in the SHC group compared with the FC group ( p < 0.01); five and two patients in the FC and SHC groups required blood transfusion, respectively ( p = 0.025). Hospital stay tended to be shorter in the SHC group ( p = 0.023), and no tourniquet-related complications were recorded. Conclusion: Improved therapeutic outcome was observed in the SHC group, indicating patients should routinely undergo TKA with SHC tourniquet application.
Influence of Occupational Factors on the Job Satisfaction Among Licensed Periodontist in Kingdom of Saudi Arabia: A Cross-Sectional Study
Authors: Al-Shibani Nouf , Labban Nawaf , Alshehri Fahad Ali , Al-Kattan Reem , Al-Otaibi Hanan , Alfadda Sara , Albarakati Sahar Faisal 
Published: January 2020

Aim: To evaluate the overall job satisfaction among periodontists, highlighting the significance of intrinsic and extrinsic factors and their satisfaction level with patients, facilities, and workplace when working in the Kingdom of Saudi Arabia. Materials and Methods: An interview-type questionnaire-based cross-sectional study was formulated and consisted of total 38 questions in 8 domains. Contact details of registered periodontists were taken and a weblink containing details of the questionnaire using the tool SurveyMonkey was sent to periodontist from the office of Saudi Dental Society. A single investigator was done to minimize bias evaluated with all the responses. Statistical Package for the Social Sciences software version 21 (SPSS Inc., Chicago, IL, USA) was used for tabulation of descriptive analysis. Standard deviation, percentages and means were calculated. Results: Out of the total 75 emails sent to the periodontists, 65 (86%) responses were received. 63 (96.9%) of the respondents were Saudi nationals, whereas the rest 2 (3.1%) were non‑Saudis. 40 (61.5%) respondents were males, whereas 25 (38.5%) were females. Majority of the respondents were dentists 43 (66.2%). 32.3% reported better professional growth as the main reason for choosing periodontal profession. However, a vast majority of the respondents, 56.9% stated that working as a periodontist was their first choice. 49.3% of the respondents affirmed that they were pleased with the working environment as it was conductive and professional. Approximately, 73.9% of the periodontist were of the view that they had good relations with their patients. Conclusion: Job satisfaction among periodontists working in the Kingdom of Saudi Arabia was adequate as majority of them displayed a positive attitude toward working environment, their profession, peers, and intrinsic and extrinsic factors related to periodontal profession. Clinical Significance: Job satisfaction plays a vital role in delivering standard quality health care. Dissatisfaction in job may lead to stress, anxiety, and/or depression leading to compromised health care facilities and patient satisfaction.
Hip and Groin Injuries in National Collegiate Athletic Association Women’s Soccer Players
Authors: Ralston Bridget , Arthur Jaymeson , Makovicka Justin L. , Hassebrock Jeff , Tummala Sailesh , Deckey David G. , Patel Karan , Chhabra Anikar , Hartigan David 
Published: January 2020

Background: Hip and groin injuries are common in competitive soccer players and have been shown to be significant sources of time loss. There are few studies describing the epidemiology of hip and groin injuries in female National Collegiate Athletic Association (NCAA) soccer players. Purpose: To describe the epidemiology of hip and groin injuries in women’s collegiate soccer players. Study Design: Descriptive epidemiology study. Methods: The NCAA Injury Surveillance System/Program (ISS/ISP) was analyzed from 2004 through 2014 for data related to hip and groin injuries in female collegiate soccer players. Injuries and athlete-exposures (AEs) were reported by athletic trainers. Data were stratified by time of season, event type, injury type, treatment outcome, time loss, and player field position. Results: Between 2004 and 2014, there were 439 recorded hip or groin injuries in female soccer players and an overall rate of injury of 0.57 per 1000 AEs. Injuries were 12.0 times more likely to occur during the preseason (4.41/1000 AEs) as opposed to during the regular season (0.37/1000 AEs) (injury rate ratio [IRR], 12.01; 95% confidence interval [CI], 9.92-14.55) or postseason (0.38/1000 AEs) (IRR, 11.55; 95% CI, 7.06-18.91). Rates of injury were similar during the regular season and postseason (IRR, 0.96; 95% CI, 0.59-1.58). Rates of injury were higher during competition (0.69/1000 AEs) than during practice (0.52/1000 AEs) (IRR, 1.33; 95% CI, 1.08-1.63). Most injuries were new (87.5%; n = 384) and unlikely to recur (12.5%; n = 55). Conclusion: Hip and groin injuries in female NCAA soccer players are uncommon, and fortunately, most players return to play quickly without recurrence. Future prospective studies should evaluate the effectiveness of strength and conditioning programs in preventing these injuries.
Virtual Reality Relaxation to Decrease Dental Anxiety: Immediate Effect Randomized Clinical Trial
Authors: Lahti S. , Suominen A. , Freeman R. , Lähteenoja T. , Humphris G. 
Published: January 2020

Introduction: Dental anxiety is common and causes symptomatic use of oral health services. Objectives: The aim was to study if a short-term virtual reality intervention reduced preoperative dental anxiety. Methods: A randomized controlled single-center trial was conducted with 2 parallel arms in a public oral health care unit: virtual reality relaxation (VRR) and treatment as usual (TAU). The VRR group received a 1- to 3.5-min 360° immersion video of a peaceful virtual landscape with audio features and sound supporting the experience. TAU groups remained seated for 3 min. Of the powered sample of 280 participants, 255 consented and had complete data. Total and secondary sex-specific mixed effects linear regression models were completed for posttest dental anxiety (Modified Dental Anxiety Scale [MDAS] total score) and its 2 factors (anticipatory and treatment-related dental anxiety) adjusted for baseline (pretest) MDAS total and factor scores and age, taking into account the effect of blocking. Results: Total and anticipatory dental anxiety decreased more in the VRR group than the TAU group (β = −0.75, P < .001, for MDAS total score; β = −0.43, P < .001, for anticipatory anxiety score) in patients of a primary dental care clinic. In women, dental anxiety decreased more in VRR than TAU for total MDAS score (β = −1.08, P < .001) and treatment-related dental anxiety (β = −0.597, P = .011). Anticipatory dental anxiety decreased more in VRR than TAU in both men (β = −0.217, P < .026) and women (β = −0.498, P < .001). Conclusion: Short application of VRR is both feasible and effective to reduce preoperative dental anxiety in public dental care settings (ClinicalTrials.gov NCT03993080). Knowledge Transfer Statement: Dental anxiety, which is a common problem, can be reduced with short application of virtual reality relaxation applied preoperatively in the waiting room. Findings of this study indicate that it is a feasible and effective procedure to help patients with dental anxiety in normal public dental care settings.
A telehealth approach to improving clinical trial access for infants with tuberous sclerosis complex
Authors: Hyde Carly , Pizzano Maria , McDonald Nicole M. , Nelson Charles A. , Kasari Connie , Thiele Elizabeth A. , Jeste Shafali S. 
Published: January 2020

Abstract
Background
Research in rare genetic syndromes associated with ASD is often hampered by the wide geographic distribution of families and the presence of medical comorbidities, such as epilepsy, that may preclude travel to clinical sites. These challenges can limit the sample size and generalizability of the cohorts included in both natural history studies and clinical trials. Tuberous sclerosis complex (TSC) is a rare genetic syndrome that confers an elevated risk for autism spectrum disorder (ASD), with social communication delays identified in this population as early as 12 months of age. Early identification of risk necessitates parallel testing of early intervention, prompting the first randomized controlled clinical trial of behavioral intervention for infants with TSC (NCT03422367). However, considerable early recruitment challenges have mandated the systematic identification of enrollment barriers followed by modification of the study design to address these barriers.

Methods
Caregivers were interviewed regarding barriers to enrollment (phase 1). Adaptations to the intervention were made to address these barriers (phase 2). Outcomes based on this modification to the study design were defined by enrollment rate and participant demographics.

Results
Qualitative reports from caregivers indicated that distance and time were the primary barriers to clinical trial enrollment. The intervention was then modified to a remote model, with at-home, parent-delivered intervention, and weekly video conferencing with interventionists at the study sites. Enrollment increased 10-fold (from 3 to 30 participants) within 1 year and included a more diverse and clinically representative cohort of infants.

Conclusion
The design and implementation of more scalable methods to disseminate research remotely can substantially improve access to clinical trials in rare neurodevelopmental disorders. The lessons learned from this trial can serve as a model for future studies not only in rare conditions, but in other populations that lack adequate access, such as families with limited financial or clinical resources. Continued efforts will further refine delivery methods to enhance efficiency and ease of these delivery systems for families.
Abnormal cisatracurium pharmacodynamics and pharmacokinetics among patients with severe aortic regurgitation during anesthetic induction
Authors: Huang Xiaocong , Chen Lei , Cai Yujing , Wei Jinfeng , Lin Lina , Sun Jie , Peng Xuemei , Wang Sheng 
Published: January 2020

AbstractBackgroundThis study was designed to examine whether severe aortic regurgitation will affect the pharmacodynamics (PD) and pharmacokinetics (PK) of cisatracurium during anesthetic induction.MethodsA total of 32 patients were divided into two groups: the AR group (n = 16) and the control group (n = 16). Arterial blood samples were drawn before and at 1, 2, 4, 6, 8, 10, 16 and 20 min after intravenous injection of 0.15 mg/kg cisatracurium. TOF tests were applied to determine the onset time of maximal muscle relaxation. The concentration of cisatracurium in plasma was determined by high-performance liquid chromatography.ResultsThe onset time to maximal neuromuscular block was prolonged from 2.07 ± 0.08 min to 4.03 ± 0.14 min, which indicated that the PD responses to cisatracurium were significantly delayed in the AR group (P < 0.05) compared to the control group.A conventional two-compartment PK model showed a higher plasma concentration of cisatracurium among the AR group with markedly reduced intercompartment transfer rate (K12 = 0.19 ± 0.02 and K21 = 0.11 ± 0.01 in the AR group vs. K12=0.26 ± 0.01 and K21 = 0.19 ± 0.01 in the control group,P < 0.01) compared to the control group.ConclusionBackward blood flow during diastole in severe AR impaired distribution of cisatracurium from the central compartment to the peripheral compartment, which accounted for the lagged PD responses.Findings in this study underlie the importance of muscular blockade monitoring among patients with severe aortic regurgitation during anesthetic induction.RegistrationName of the registry: Abnormal Cisatracurium Pharmacodynamics and Pharmacokinetics among Patients with Severe Aortic Regurgitation during Anesthetic Induction. Trial registration number:ChiCTR1800019654. Date of registration: November 20th 2018.