bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and experience of arthroscopic lateral patella retinaculum releasing through/outside synovial membrane for the treatment of lateral patellar compression syndrome
Authors: Chen Ji-Bin , Chen Dong , Xiao Ya-Ping , Chang Jian-Zhong , Li Te 
Published: November 2019

Abstract
Objective: To investigate the method and effect of arthroscopic lateral patella retinaculum releasing (LPRR) through/outside synovial membrane for the treatment of lateral patellar compression syndrome (LPCS). Methods: From September 2014 to December 2017, 125 patients with LPCS underwent arthroscopic LPRR through/outside synovial membrane combined with joint debridement. In the outside synovial membrane (OSM) group, the joint was cleaned first. The surface of lateral patella retinaculum (LPR) was created the chamber for arthroscopic operation. The LPR was released under the arthroscopy, and the synovial membrane was retained. In the through synovial membrane (TSM) group, the joint was cleaned first, and the synovial membrane, joint capsule and LPR, and superficial fascia were gradually incised from the joint cavity to the subcutaneous tissue. The synovial membrane was cut open. Active rehabilitation training was conducted after surgery. Before and after surgery, Lysholm score, patella medial shift, Kujala score, VAS score and surgical complications were evaluated and compared. Results: All patients in this study were followed up for 1.5-5 years. All patients had significant reduction in knee pain and improved function after 1 month and 1 year. The final follow-up of the Lysholm score, the distance of patella medial shift, the Kujala score, and the VAS score in the OSM group and the TSM group were significantly improved compared with those before surgery (P<0.001), but these observed targets at the last follow-up and before surgery between the two groups were compared with no statistical differences. In the TSM group, 5 patients had hemarthrosis and 3 cases joint adhesion. There were no postoperative complications in the OSM group. Conclusion: Arthroscopic closing LPRR for the treatment of LPCS can effectively improve the function and symptoms of the patellofemoral joint. It has the advantages of small trauma, good effect and rapid recovery. Among them, the hemarthrosis and joint adhesion in the TSM group were significantly higher than those in the OSM group, and arthroscopic closing LPRR outside synovial membrane was more advantageous.
The incidence of stroke among patients undergoing elective posterior lumbar fusion: a retrospective cohort study
Authors: Arena Patrick , Mo Jingping , Sabharwal Charu , Begier Elizabeth , Zhou Xiaofeng , Gurtman Alejandra , Liu Qing , Shen Rongjun , Wentworth Charles , Huang Kui 
Published: November 2019

Abstract
Background: Although stroke is an uncommon but life-threatening complication among spinal surgery patients, the recognition of this adverse event is critical given the aging population undergoing surgical procedures. The objective of this study was to estimate the incidence of stroke among adults undergoing elective posterior lumbar fusion (PLF) during post-operative risk windows and among different subgroups. Methods: A retrospective cohort study using a longitudinal electronic healthcare record (EHR) database was conducted from January 1, 2007 to June 30, 2018. Elective PLF, stroke, and select clinical characteristics were defined based on International Classification of Disease codes. Patients aged 18 to 85 years with ≥ 183 days of enrollment in the database prior to undergoing elective PLF were followed from the index date until the occurrence of stroke, death, loss to follow-up, or end of study period, whichever occurred first. Incidence proportions (IPs) and rates (IRs) of stroke were estimated in the following risk windows: index hospitalization, ≤ 30 days, ≤ 90 days, ≤ 180 days, and ≤ 365 days post-operation Results: A total of 43,063 patients were eligible for the study. The IP of stroke following elective PLF ranged from 0.29% (95% confidence interval [CI]: 0.25%, 0.35%) during index hospitalization to 1.12% (95% CI: 1.03%, 1.23%) ≤ 365 days post-operation; the IR of stroke following elective PLF per 1000 person-years decreased consistently from 229.08 (95% CI: 192.38, 272.78) during index hospitalization to 13.68 (95% CI: 12.51, 14.96) ≤ 365 days post-operation. Stratified analyses revealed that older patients had a higher incidence of stroke. Additionally, black patients had higher stroke incidences than white, Asian, or other patients. Furthermore, the incidence of post-operative stroke was higher among patients with a history of type 2 diabetes than among patients without such history. Conclusions: The incidence of stroke following elective PLF found here using an EHR database is slightly higher than that reported in the literature; however, the discrepancy is due to differences in the variable definitions, study populations, follow-up periods, and data sources between our study and those in the literature.
Usefulness of a radial applanation tonometry device in blood pressure related clinical decision making by anesthesiologists
Authors: Chen Guo , Zhou Xiaoshuang , Liu Bin , Lan Haidan , Liu Jin , Li Xiao 
Published: November 2019

Abstract
Purpose: Radial artery tonometry (AT) can continuously measure arterial blood pressure (ABP) noninvasively. This study aimed to evaluate AT for continuous ABP monitoring during anesthesia and compared AT to invasive (IBP) and non-invasive (NIBP) ABP measurements at clinical decision-making moments. Methods: 243 patients undergoing elective surgery were prospectively included in the study and AT was applied on the right or left arm while IBP and NIBP were recorded simultaneously. At moments when the IBP signal required a clinical decision by the anesthesiologist for situations of hyper- or hypotension, comparison was made whether AT and NIPB signals would require a clinical decision as well. Agreement/discrepancy of clinical decision-making was analyzed, additionally bias, precision, and percentage error of AT was compared to IBP at these moments. Results: 513 clinical decision moments were recorded. Decision moments based on AT signal did not differ significantly from decision moments based on IBP (1 vs. 1; IQR, 1 – 2 vs. 0 – 3, P = 0.06), while NIBP based decision moments showed significant differences (0 vs. 1; IQR, 0 – 2 vs. 0 – 3, P＜0.001). Subgroup analysis of patients divided by age, BMI and surgery time also showed no significant differences between IBP and AT. Conclusions: ABP measurement using AT is feasible and safe. AT provides relevant and efficient information to anesthesiologists; at moments when IBP called for action, AT called for action as well, but not NIBP. AT also showed clinically satisfactory agreement with IBP at moments of hypo- and hypertension.
Use of peripheral vascular access in the prehospital setting: is there room for improvement?
Authors: Gonvers Erin , Spichiger Thierry , Albrecht Eric , Dami Fabrice 
Published: November 2019

Abstract
Background: Previous studies have shown that prehospital-insertion of peripheral vascular access is highly variable. The aim of this study is to establish the rate of peripheral vascular access placement and its use with regard to both the severity of cases and the main problem suspected by the paramedics involved. Over-triage was considered to have taken place where peripheral vascular access was placed but unused and these cases were specifically analysed in order to evaluate the possibility of improving current practice. Methods: This is a one-year retrospective study conducted throughout one state of Switzerland. Data were extracted from the state’s public health service database, collected electronically by paramedics on RescueNet® from Siemens. The following data were collected and analyzed: sex, age, main diagnosis suspected by paramedics and the National Advisory Committee for Aeronautics score (NACA) to classify the severity of cases. Results: A total of 33 055 missions were included, 29 307 (88.7%) with a low severity. A peripheral vascular access was placed in 8 603 (26.0%) cases, of which 5 678 (66.0%) were in patients with low severity. In 3 948 (45.9%) cases peripheral vascular access was set but unused with 2 626 (66.5%) of these cases being patients with low severity. Opiates represent 48.3% of all medications given. The most frequent diagnosis among unused peripheral vascular access were: respiratory distress (12.7%), neurological deficit without coma or trauma (9.6%), cardiac condition with thoracic pain and without trauma or loss of consciousness (9.6%) and decreased general condition of the patient (8.5%). Conclusions: Peripheral vascular access was set in 26% of patients, nearly half of which were unused. To reduce over-triage, special attention should be dedicated to cases defined by EMS on site as low severity, as they do not require placement of a peripheral vascular access as a precautionary measure. Alternative routes, such as the intra-nasal route, should be promoted, particularly for analgesia, whose efficiency is well documented. Emergency medical services medical directors may also consider modifying protocols of acute clinical situations when data show that mandatory peripheral vascular access, in stroke cases for example, is almost never used.
Identifying predictive patients’ characteristics in case of High Flow Nasal Cannula failure when used for post-extubation failure
Authors: Terstappen Afra L.E. , Haas Lenneke E.M. , Seumeren Esther S.E. van , Balzereit Anja , Endeman Henrik 
Published: November 2019

Abstract
Background: High Flow Nasal Cannula (HFNC) is a relatively new but broadly used type of oxygen therapy. Hence, not much is known about HFNC in the setting of post-extubation failure. Aim of this study is to identify patients’ characteristics that predict failure of HFNC when used for post-extubation failure. Methods: This retrospective, observational study was conducted in a Dutch ICU. Between 2008 and 2014 all subjects aged 18 and older who started with HFNC due to respiratory failure within 2 to 72 hours after extubation were included. Primary outcome was patient characteristics predicting failure of HFNC. Failure was defined as reintubation or death following HFNC. Success was defined as the opportunity to stop HFNC after a non-specified time. Secondary outcome was the difference in length of stay (LOS) and mortality between the success and failure group. Results: A total of 246 subjects were included; in 135 (55%) cases HFNC failed. The success and failure group were comparable in terms of age, primary diagnosis and duration of mechanical ventilation prior to extubation. HFNC was started 19 ± 15 hours (mean ± SD) after extubation. Significant differences were found for breathing frequency (success: 22 ± 7/min vs. failure: 24 ± 7/min, p=0.009) and the presence of acute kidney injury (51% vs. 79%, p=0.003). There was a non-significant difference in pH (7.43 ± 0.07 vs. 7.40 ± 0.08, p=0.08). After logistic breathing frequency (p=0.02) and pH (p=0.01) remained independent predictors of HFNC failure. LOS at the ICU after starting HFNC differed (success: 181 ± 177 hours vs. failure: 405 ± 519 hours, p<0.001). ICU and hospital mortality were not significantly different between groups. Conclusion: In more than half of the patients HFNC failed when used for post-extubation failure. Breathing frequency and pH were predictors of HFNC failure.
Postoperative Pulmonary Complications in Complex Paediatric and Adult Spine Deformity: A Retrospective Review of Consecutive Patients Treated at SRS GOP Site in Ghana
Authors: Wulff Irene , Duah Henry Ofori , Tutu Henry Osei , Ofori-Amankwah Gerhard , Yankey Kwadwo Poku , Owiredu Mabel Adobea , Yahaya Halima Bidemi , Akoto Harry , Oteng-Yeboah Audrey , Group FOCOS Spine Research , Boachie-Adjei Oheneba 
Published: November 2019

Abstract
Background Pulmonary complications are important cause of morbidity and mortality in patients following spinal surgeries. There is paucity of literature on pulmonary complications following complex spine deformity surgery in underserved regions. This study sought to assess the incidence and risk factors of pulmonary complication following complex spine deformity surgery Methods Data of 276 complex spine deformity patients aged 3-25yrs who were consecutively treated at a single site were retrospectively reviewed. Data was analyzed using Stata 14 software. Patients were labelled into two groups: Grp 1: patients with pulmonary complications(N=17) vs Grp 2: patients with no pulmonary complications (N=259). Comparative analysis for risk factors included independent t-test and chi square test for independence. Multivariate logistic regression analysis was also performed. Results The incidence proportion of pulmonary complication was 17/276 (6.1%) (Grp 1) whiles 259 pts had no pulmonary events (Grp 2). There were 8M/9F for Grp 1 vs 100M/159F Grp 2, p=0.48. BMI was similar in both groups (17.2 vs 18.4km -2 , p=0.15). Average pre-op sagittal cobb (90.6 vs 88.7deg, p=0.87.), coronal cobb (95 vs 88.5deg, p=0.43), Pre-Op FVC (45.3 vs 62.0%, p=0.02), Pre-Op FEV1 (41.9% vs 63.1, p<0.001), Grp 1 vs Grp 2, respectively. EBL, OR time and Surgery Levels were similar in both Grps. Thoracoplasty was performed in 41.18% vs 21.57%, p=0.06, SPO 47.06% vs 42.31%, p=0.04 and VCR 5.88% vs 20.31%, p=0.145, Grp 1 vs Grp 2, respectively. Multivariate logistic regression showed that every unit increase in pre-Op FVC (%) decreases the odds of pulmonary complication by 5% (OR=0.95, 95% CI 0.90 to 0.99, p=0.045). Conclusion The observed 6.1% incidence of pulmonary complications is comparable to reported series. Only pre-Op FVC was an independent predictor of pulmonary complications. The observed case fatality rate (17%) following pulmonary complications highlights the need for thorough preoperative evaluation to identify high risk patients. Key words: Complex spine deformity; Pulmonary complications; late presentation; Forced Vital Capacity; Halo Gravity Traction; FVC; pediatric deformity; scoliosis; Pulmonary function tests; PFT; complications; Preoperative management.
Misdiagnosis rate of the prolonged disorders of consciousness on a clinical consensus compared with a repeated Coma-Recovery Scale-Revised assessment
Authors: Wang Jing , Hu Xiaohua , Hu Zhouyao , Sun Ziwei , Laureys Steven , Di Haibo 
Published: November 2019

Abstract
Background: Previous studies have shown that a single Coma-Recovery Scale-Revision (CRS-R) assessment can identify high misdiagnosis rate for a clinical consensus. The aim of this study was to investigate the misdiagnosis rate of clinical consensus compared to repeated behavior scale assessments in patients with prolonged disorders of consciousness (DOC).
Methods: Patients with prolonged DOC during hospitalization were screened by clinicians, and the clinicians formed a clinical consensus diagnosis. Trained professionals also used the CRS-R to evaluate the consciousness levels of the enrolled patients for repeated times (≥5 times) within a week. After the repeated evaluation results, the enrolled patients with prolonged DOC were divided into unresponsive wakefulness syndrome (UWS), minimally conscious state (MCS), and emergence from MCS (EMCS). Furthermore, the relationship between the results of the CRS-R and the clinical consensus were analyzed.
Results: In this study, 137 patients with a clinical consensus of prolonged DOC were enrolled. After the single CRS-R behavior evaluation, it was found that the misdiagnosis rate of clinical MCS was 24.7%, while the repeated CRS-R evaluation results showed that the misdiagnosis rate of clinical MCS was 38.2%. A total of 16.7% of EMCS cases were misdiagnosed as MCS, and 1.1% of EMCS cases were misdiagnosed as UWS.
Conclusions: The current clinical consensus of the misdiagnosis rate is still relatively high. Therefore, clinicians should be aware of the importance of the bedside CRS-R behavior assessment and should apply the CRS-R tool to daily procedures.
Documentation of vaccine wastage in two different geographic contexts under the universal immunization program in India
Authors: Das Manoja Kumar , Sood Mangla , Tambe Muralidhar , Sharma Thakur Dutt , Parande M A , Surwade Jitendra B , Salunke N M , Patil S S , Pawar Bhagwan , Guleri Rajesh , Kaushal Chitra , Sindhu Monica 
Published: November 2019

Abstract
Background Government of India is introducing new and relatively costly vaccines under immunization program. Monitoring of vaccine wastage is needed to guide the program implementation and forecasting. Under pilot introduction of rotavirus vaccine in two districts both 5- and 10-doses vials were used, which was considered as an opportunity for documenting the wastage.Methods A survey conducted in two districts (Kangra, Himachal Pradesh and Pune, Maharashtra) covered 49 vaccine stores, 34 sub-centres and 34 outreach sessions collected vaccine receipt, distribution and usage data for two complete years 2016 and 2017.Results The overall wastage rates for almost all vaccines were higher in Kangra district (BCG 37.1%, DPT 32.1%, Measles 32.2%, OPV 50.8%, TT 34.1% and pentavalent 18.4%) than Pune district (BCG 35.1%, DPT 25.4%, Measles 21.7%, OPV 14.3%, TT 23.1% and pentavalent 13.2%). Wastage for pneumococcal conjugate and measles-rubella vaccines were 27% and 40.5%, respectively. With transition from 5- to 10-doses vials for rotavirus vaccine, wastage at stores levels increased in both Kangra (29% to 33.2%) and Pune (17.8% to 25.7%) districts. With transition from intramuscular to intradermal fractional inactivated polio vaccine, the wastage increased from 36.1% to 54.8% in Kangra and 18.4% to 26.9% in Pune district.Conclusions The observed vaccine wastage rates were relatively higher than program assumption for forecasting. The observed variations in the vaccine wastage indicates need for state or region based documentation and monitoring in India for appropriate programmatic action.
Monetary value of disability-adjusted-life-years lost from all causes in Mauritius
Authors: MUSANGO Laurent , Nundoochan Ajoy , Wilder Philippe Van , Kirigia Joses Muthuri 
Published: November 2019

Abstract
Background The Republic of Mauritius lost a total of 402,565 disability-adjusted-life-years (DALY) from all causes in 2017. The objectives of this study were (a) to estimate the monetary value of DALY lost in 2017, and projected to be lost from all causes in Mauritius in 2030; and (b) to estimate the monetary value of DALY savings in year 2030, if the country would attain the United Nations Sustainable Development Goal 3 (SDG3) targets 3.1, 3.2, 3.3, 3.4 and 3.6.Methods Human capital approach is used to monetarily value DALY lost from 293 causes in 2017. The monetary value of DALY lost in 2017 from each cause is equal to the Mauritius net gross domestic product (GDP) per capita multiplied by the number of DALY lost from a specific cause. The percentage reductions implied in the five SDG3 targets were used in the projections of the monetary values of DALY expected in 2030. The potential savings equals monetary value of DALY lost in 2017 minus monetary value of DALY expected in 2030. The DALY data was obtained from the Institute of Health Metrics and Evaluation Global Burden of Disease Study 2017 database; the current health expenditure per capita data was from the WHO Global Health Expenditure Database; and the per capita GDP data was obtained from the IMF outlook database.Results The DALY lost in 2017 had a total monetary value of Int$9,564,741,771. Of which, 82.9% resulted from non-communicable diseases; 10.2% from communicable, maternal, neonatal and nutritional diseases; and 6.9% from injuries. Full attainment of the five SDG 3 targets would avert DALY losses with a value of Int$2,986,241,156.Conclusions Diseases and injuries causes a significant DALY lost per year with a substantive monetary value. Full achievement of the SDG3 targets 3.1, 3.2, 3.3, 3.4 and 3.6 might potentially save the country about 9.351% of the total GDP of Mauritius in 2019. In order to achieve such savings, the country require to further strengthen the national health system, the other systems that tackle social determinants of health, and the national health research system.
The prevalence and correlates of burnout among Chinese preschool teachers
Authors: Li Shen , Li Yibo , Lv Hao , Jiang Rui , Zhao Peng , Zheng Xin , Wang Lili , Li Jie , Mao Fuqiang 
Published: November 2019

Abstract
Background: A series of studies have suggested that teachers are likely to experience professional burnout in various regions around the world. To date, no known research has been conducted to investigate the prevalence and correlates of burnout among preschool teachers in China. Objective: This study examined the level of self-reported burnout and correlates of burnout among Chinese preschool teachers. Methods: A cross-sectional study was conducted among1795 preschool teachers in Tianjin, China, during August 2018- October 2018. The validated Chinese version of the 15-item Maslach Burnout Inventory was used to assess burnout. A self-administered questionnaire collected the sociodemographic factors. The psychological factors were collected by the Chinese version of the 20-item Center for Epidemiologic Studies Depression Scale (CES-D) and the Perceived Stress Scale-14. Results: The prevalence of burnout in Chinese preschool teachers was 53.2% ( 95% CI：51%─56%). Burnout rate was significantly decreased in overweight (P=0.001, OR=0.58, 95% CI: 0.42-0.79) and obesity (P=0.048, OR=0.75, 95% CI: 0.56-1.00) teachers compared with teachers with normal weight. The type of school (P=0.007, OR=1.45, 95% CI: 1.11-1.91), income satisfaction (P=0.001, OR=0.67, 95% CI: 0.53-0.86), depression (P<0.001, OR=3.08, 95% CI: 2.34-4.05) and perceived stress (P<0.001, OR=1.15, 95%CI: 1.13-1.18) were significantly associated with burnout. Conclusions: The prevalence of burnout among preschool teachers in Tianjin, China, is high. Burnout was significantly associated with BMI, the type of school, income satisfaction, depression and perceived stress among Chinese preschool teachers. Keywords: Burnout, Stress, Preschool teachers, Depression
An Infodemiology Approach to Assess the Impact of the Great Recession on Anxiety and Depression in France.
Authors: Ramos-Gomez Ariadna , Perez-Escatel Aldo , Villaseñor-Garcia Elio Atenogenes , Ramos-Remus Cesar 
Published: November 2019

Abstract
Background: The global financial crisis of 2008 and subsequent sovereign debt crisis in Europe had a profound multidimensional impact on developed economies, including on the construct of health. Mental health is a key factor for productivity and an indicator of the general well-being of the population. France poses mental health and public policies characteristics that differentiated it from other countries of the European Union. This study aimed to assess whether depression and anxiety increased throughout the course of the 2008 debt crisis in France.
Methods: This is an ecological study using an infodemiology approach. The search terms for depression and anxiety were extended with related words according to culture to form a distress index. Google Trends was used to mine the distress index search terms in a period before the debt crisis (2004) until 2018, using open source libraries, and pandas to merge information. Diverse economic- and employment-related datasets for France were used as covariates in multiple linear regression analyses, and the expected seasonal variability as a dummy variable.
Results: The results showed that for each additional demand for unemployment benefits, search traffic for the distress index was expected to increase by 0.09% (p< 0.001, r2 0.89), even after controlling for the expected seasonal variations in the distress index. However, there was no significant association with unemployment rate.
Conclusions: Contrary to reports from other countries, the mild effect of demand for unemployment benefits on the distress index may be explained by aspects of social protection policies in France.