bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cochlear Implant Electrode Tip Fold-Over: Our Experience With Long and Flexible Electrode
Authors: Högerle Catalina , Englhard Anna , Simon Florian , Grüninger Ivo , Mlynski Robert , Hempel John-Martin , Müller Joachim 
Published: October 2021

Objective:
The aim of this study was to retrospectively investigate if there is any incidence of electrode tip fold-over with 31.5 mm long and flexible lateral wall electrodes implanted in two high-volume Cochlear Implant (CI) centers in Germany. In addition, a detailed literature review was performed to capture all the peer-reviewed publications reporting on tip fold-over with CI electrodes from different CI brands for comparison.

Methods:
Post-operative X-ray images of FLEX SOFT electrode from MED-EL in Stenver's view were retrospectively investigated for the presence of electrode tip fold-over from 378 consecutive cases in two high-volume CI centers in Germany. All patients were implanted between 2010 and 2018 by three individual experienced CI surgeons using round window and extended round window approach for CI electrode insertion. A literature review was performed following a thorough PubMed (https://www.ncbi.nlm.nih.gov/pubmed/) search using the keywords “cochlear implant electrode tip fold-over” or “cochlear implant electrode tip roll-over” to capture articles that were published until December 2020 in English language only. Articles selection was based on electrode-related issues investigated only in-patient cases applying imaging modality. Those studies investigated tip fold-over in cadaveric temporal bones and cases with inner-ear malformation excluded.

Results:
No single case of tip fold-over was clinically detected from the retrospective investigation of post-operative X-ray images from 378 consecutive cases. The electrode angular insertion depth as measured applying the cochlear coordinate system, varied from a minimum of 560° to a maximum of 720°. The literature review on the tip fold-over issue resulted in 24 peer-reviewed published articles in total. Tip fold-over with pre-curved modiolar-hugging electrodes was reported in 85 cases out of 1,606 implantations making an incidence rate of 5.3%. With the straight lateral wall electrodes, the tip fold-over was reported in four cases out of 398 implantations making an incidence rate of 1%, not including the number of implantations reported in the current study. Otherwise it would be 0.5%.

Conclusion:
Electrode tip fold-over with 31.5 mm long flexible lateral wall electrodes is highly exceptional and this can be generalized to any of the straight lateral wall electrodes from any CI brand. The literature review on tip fold-over revealed an incidence rate of 5.3% with pre-curved or modiolar-hugging electrodes and 1% with straight lateral wall electrodes from CI brands. Including this series of 0% tip fold-over, the incidence rate of electrode tip fold-over with LW electrode type would be 0.5%.
The effect of glucocorticoids on mortality in severe COVID-19 patients
Authors: Yu Guang-Qing , Jiang Zhong-Hui , Yang Zhong-Bin , Jiang Shi-Qin , Quan Xiao-Qing 
Published: October 2021

Abstract

Background:
Since the start of the coronavirus disease 2019 (COVID-19) pandemic, there is an urgent need for effective therapies for patients with COVID-19. In this study, we aimed to assess the therapeutic efficacy of glucocorticoids in severe COVID-19.

Methods:
A systematic literature search was performed across PubMed, Web of Science, EMBASE, and the Cochrane Library (up to June 26, 2021). The literature investigated the outcomes of interest were mortality and invasive mechanical ventilation.

Results:
The search identified 13 studies with 6612 confirmed severe COVID-19 patients. Our meta-analysis found that using glucocorticoids could significantly decrease COVID-19 mortality (hazard ratio (HR) 0.60, 95% confidence interval (CI) 0.45–0.79, P < .001), relative to non-use of glucocorticoids. Meanwhile, using glucocorticoids also could significantly decrease the risk of progression to invasive mechanical ventilation for severe COVID-19 patients (HR = 0.69, 95% CI 0.58–0.83, P < .001). Compared with using dexamethasone (HR = 0.68, 95% CI 0.50–0.92, P = .012), methylprednisolone use had a better therapeutic effect for reducing the mortality of patients (HR = 0.35, 95% CI 0.19–0.64, P = .001).

Conclusion:
The result of this meta-analysis showed that using glucocorticoids could reduce mortality and risk of progression to invasive mechanical ventilation in severe COVID-19 patients.
The irony of the transforaminal approach
Authors: Ahn Yong , Yoo Byung Rhae , Jung Jong-myung 
Published: October 2021

Abstract
Transforaminal endoscopic lumbar discectomy (TELD) is useful for soft lumbar disc herniation (LDH). Although the transforaminal approach can reach the foraminal disc zone, the risk of exiting nerve root irritation along the path is considerable. Few studies have assessed the difficulties of TELD for foraminal LDH. The objective of this study is to compare the clinical results of TELD between foraminal or far-lateral LDH and paramedian LDH.
Between June 2016 and July 2017, 135 consecutive patients with single-level LDH were treated with TELD for 2 years. Among them, 25 patients had foraminal or far-lateral LDH (foraminal group), and the remaining 110 patients had central or subarticular LDH (paramedian group). Perioperative data and clinical outcomes were evaluated using the visual analog pain scale, Oswestry Disability Index, and modified Macnab criteria.
The foraminal group showed a higher rate of significant access pain (24.00% vs 8.19%, P < .05). The foraminal group also had a longer duration of surgery, length of hospital stay, and return to work (all P < .05). Pain scores and functional status were significantly improved in both groups. Although there were no differences in the outcomes at 2 years postoperatively, early pain and disability at 6 weeks were higher in the foraminal group.
Ironically, the early clinical results of TELD for foraminal LDH may be less favorable than those for paramedian LDH. Therefore, great care should be taken during TELD for foraminal or far-lateral LDH.
Impact of switching to tenofovir alafenamide fumarate in patients with entecavir-treated chronic hepatitis B
Authors: Kumada Takashi , Toyoda Hidenori , Yasuda Satoshi , Ito Takanori , Tanaka Junko 
Published: October 2021

Background and aims
Tenofovir alafenamide (TAF), a new tenofovir prodrug, has been developed to circumvent the less favorable safety profile of tenofovir disoproxil fumarate (TDF). We investigated reductions in hepatitis B surface antigen (HBsAg) levels in patients with HBV infection who received continuous entecavir (ETV) monotherapy or sequential therapy with ETV and TAF.

Methods:
This retrospective cohort study included 286 patients who were divided into two groups: continuous ETV monotherapy (ETV group, n = 168) and sequential therapy with ETV and TAF (ETV-TAF group, n = 108). Factors associated with a 90% reduction in HBsAg levels were analyzed by a Cox proportional hazards model using a time-dependent covariate in both groups.

Results
In the multivariate Cox proportional hazards model, the ETV-TAF group [adjusted hazard ratio (aHR) 2.750; 95% confidence interval (CI), 1.265–3.405; P = 0.0038] and BMI ≤ 25.0 kg/m2 (aHR 0.520, 95% CI, 0.308–0.875; P = 0.0139) demonstrated a 90% reduction in HBsAg levels. HBsAg levels of patients in the TAF phase in the ETV-TAF group showed greater yearly percent reductions than those in the ETV group and those in the ETV phase in the ETV-TAF group (P = 0.0361 and P = 0.0022, respectively, Steel–Dwass test).

Conclusion
HBsAg levels decreased more rapidly after patients switched from ETV to TAF. Switching to TAF may be an effective treatment option to reduce HBsAg levels.
Risk constellations, viral infections, and prophylaxis in uterine transplantation
Authors: Harris Courtney E. , Issa Nicolas C. 
Published: October 2021

Purpose of review
Uterine transplantation (UTx) is a burgeoning new category of solid organ transplantation (SOT) that is practiced at several centers worldwide (first transplantation in 2013). Although there are still relatively low numbers of transplants (<75 published in literature), they are increasing in frequency and thus we attempt to discuss the current documented infections in this population as well as theoretical infectious risks and summarize prophylaxis and treatment strategies of centers current performing these procedures.

Recent findings
The most reported posttransplantation infection is not surprisingly urinary tract infections, with other documented infections including bacterial infections at site of graft (Enterococcus), herpes simplex virus, cytomegalovirus (CMV), human papillomavirus, Candida, and reportedly posttransplant lymphoproliferative disorder. The net state of immunosuppression and host factors (host colonization and serologic status of viral exposures) plays a significant role in infectious risk and with low numbers of infections documented, much of our guidance surrounding prophylaxis is inferred from SOT literature.

Summary
In this review, we give an overview of described infections in UTx and theoretical infectious risks, detailing how to tailor prophylaxis base on host risk, with specific focus that the goal of transplantation is completion of a successful pregnancy as the desired outcome. Special considerations should be given to pregnant recipients when managing infectious complications and further data collection and reporting regarding infectious complications is crucial to advance this field as numbers of transplantation continue to increase.
Reliability of Refraction, Keratometry, and Intraocular Pressure Measurements with an Automated All-in-one Device
Authors: Tzamalis Argyrios , Tsiampali Chara , Prousali Efthymia , Mataftsi Asimina , Ziakas Nikolaos , Kynigopoulos Myron 
Published: October 2021

SIGNIFICANCE
This study explores the reliability of TonoRef II (Nidek, Tokyo, Japan), which represents a simple tool to obtain rapid refractometry and tonometry measurements. The present device demonstrates very high repeatability of refraction and intraocular pressure (IOP) readings as compared with subjective measurements and a higher concordance of IOP readings to Goldmann application tonometry (GAT).

PURPOSE
This study aimed to evaluate the repeatability of measurements acquired with the Autorefractometer/Keratometer/Tonometer TonoRef II and assess their agreement to subjective measurements and readings of other established devices.

METHODS
In a cross-sectional study, 54 eyes of 54 healthy subjects were enrolled. Each subject underwent five measurements with the TonoRef II, three measurements with the Canon RK-F1 Autorefractor Keratometer (Canon Europe NV, Amstelveen, the Netherlands), three IOP measurements with the Canon TX-F Noncontact Tonometer (Canon Inc., Tokyo, Japan), three measurements with GAT, and a thorough subjective refraction. Repeatability coefficient (r), intraclass correlation coefficient (ICC), and Bland-Altman plots were used to evaluate repeatability of readings and agreement to the subjective values.

RESULTS
TonoRef II showed high repeatability (ICC >0.9) in all parameters tested (sphere, r = 0.157; cylinder, r = 0.196; IOP, r = 2.653). A strong correlation was found between TonoRef and Canon instruments (P < .001 in all parameters). Mean differences and limits of agreement (mean ± 1.96 standard deviation) were −0.01 ± 0.69 D, −0.11 ± 0.7 D, and 2.1 ± 3.4 mmHg for sphere, cylinder, and IOP, respectively. Both autorefractors achieved a very good to excellent agreement to the values obtained with the subjective refraction for most of the parameters tested, without any significant difference to each other (P > .05). Intraocular pressure measurements of TonoRef II showed higher agreement to the GAT values compared with those obtained with the Canon tonometer (ICC, 0.9114 and 0.7002, respectively; P < .001).

CONCLUSIONS
Intraocular pressure and refraction readings acquired with TonoRef II demonstrate very high repeatability and agreement to the subjective measurements. Regarding IOP evaluation, TonoRef II shows higher concordance to GAT compared with another established noncontact tonometer.
Evolving Trends of Button Battery Ingestion in Indian Children at a Tertiary Care Hospital
Authors: Bettadahalli Vishaka , Kumar Sunil , Shukla Indu , Nair Rohini , Kumar Poornima 
Published: October 2021

Introduction
Foreign body ingestion is a common problem encountered in the pediatric age group. Impaction of lithium batteries of greater than 20-mm diameter in the esophagus is associated with severe complications. This study aimed at analyzing the evolving trends of button battery ingestion in pediatric age groups at our tertiary care center in terms of clinical presentation, intraoperative findings, and the correlation of various clinical variables.

Methods
A retrospective observational study was done. All children younger than 18 years with impaction of a button battery of size greater than 20 mm in the esophagus between January 2015 and December 2018 were included in the study. All children underwent removal of the battery using direct laryngoscopy/rigid esophagoscopy under general anesthesia.

Results
There were 100 children included in the study with a mean age of 29.92 months having 93 children (93%) younger than 6 years. The mean duration of impaction was 34.7 hours. Increased duration of impaction was associated with an increased risk of complications and an increased difficulty in removal. There was a significant correlation between the site of impaction and the age of the patient. Complications were seen in 10% of cases with severe complications in 6 cases. No fatalities were reported in this study.

Conclusions
Button batteries impacted in the esophagus can lead to severe complications including death. There has been an increasing trend in the ingestion of button batteries over the last 4 years. A prompt diagnosis and emergent removal of the battery are crucial to minimize the rate of complications. Symptoms of stridor and dysphagia must be given more attention, and these children are prioritized because they are more prone to have complications. Furthermore, primary prevention and caregiver education should be emphasized, and the need for a legislation to change the policies for securing the batteries in their products must be endorsed.
Longitudinal Relationship Between Tibiofemoral Contact Stress at Baseline and Worsening of Knee Pain Over 84 Months in the Multicenter Osteoarthritis Study
Authors: Rabe Kaitlin G. , Stockman Tyler J. , Kern Andrew M. , Wirth Wolfgang , Eckstein Felix , Sharma Leena , Lynch John A. , Nevitt Michael C. , Anderson Donald D. , Segal Neil A. 
Published: October 2021

Objective
The aim of the study was to determine whether tibiofemoral contact stress predicts risk for worsening knee pain over 84 ms in adults aged 50–79 yrs with or at elevated risk for knee osteoarthritis.

Design
Baseline tibiofemoral contact stress was estimated using discrete element analysis. Other baseline measures included weight, height, hip-knee-ankle alignment, Kellgren-Lawrence grade, and Western Ontario and McMaster Universities Osteoarthritis Index pain subscale. Logistic regression models assessed the association between baseline contact stress and 84-mo worsening of Western Ontario and McMaster Universities Osteoarthritis Index pain subscale.

Results
Data from the dominant knee (72.6% Kellgren-Lawrence grade 0/1 and 27.4% Kellgren-Lawrence grade ≥ 2) of 208 participants (64.4% female, mean ± SD body mass index = 29.6 ± 5.1 kg/m2) were analyzed. Baseline mean and peak contact stress were 3.3 ± 0.9 and 9.4 ± 4.3 MPa, respectively. Forty-seven knees met the criterion for worsening pain. The highest tertiles in comparison with the lowest tertiles of mean (odds ratio [95% confidence interval] = 2.47 [1.03–5.95], P = 0.04) and peak (2.49 [1.03–5.98], P = 0.04) contact stress were associated with worsening pain at 84 mos, after adjustment for age, sex, race, clinic site, and baseline pain. Post hoc sensitivity analyses including adjustment for body mass index and hip-knee-ankle alignment attenuated the effect.

Conclusions
These findings suggest that elevated tibiofemoral contact stress can predict the development of worsening of knee pain.
Comparison of the Effect of Ultrasound-Guided Injection of Botulinum Toxin Type A and Corticosteroid in the Treatment of Chronic Plantar Fasciitis
Authors: Ahadi Tannaz , nik Sasan Sadeghi , Forogh Bijan , Madani Seyed Pezhman , Raissi Gholam Reza 
Published: October 2021

Objective
The aim of the study was to compare the efficacy of ultrasound-guided injection of botulinum toxin type A with corticosteroid in patients with chronic plantar fasciitis (PF).

Design
This randomized controlled trial was conducted on 35 patients with chronic plantar fasciitis. Participants were randomly allocated into two groups: one group received methylprednisolone in to the plantar fascia (n = 18) and the other group received botulinum toxin type A injection into the flexor digitorum brevis and quadratus plantae (n = 17). All injections were performed under ultrasound guidance. Patients were evaluated using the Visual Analog Scale, Foot and Ankle Ability Measures, and plantar fascia thickness before the intervention, 3 wks, 12 wks, and 6 mos after the treatment.

Results
In both groups, patients’ pain and function improved significantly up to 3 wks after injection. In the botulinum toxin type A group, morning Visual Analog Scale improved significantly at 12 wks after intervention and the improvement was sustained for another 3 mos. In the botulinum toxin type A group, Foot and Ankle Ability Measures–sports subscale improved in all evaluated points, whereas in the corticosteroid group, the improvement was significant only when comparing follow-ups values to baseline.

Conclusions
Both ultrasound-guided botulinum toxin type A and corticosteroid injection were effective in the treatment of plantar fasciitis. Our study showed that the effects of botulinum toxin type A injection last longer than those of steroid injection.
18F-FDG PET/CT in a Patient With Matrix-Producing Carcinoma of the Breast
Authors: Chen Xueqi , Chen Guoqian , Fu Zhanli , Li Qian 
Published: October 2021

Abstract
A 47-year-old woman presented with a large mass in the upper inner quadrant of the left breast. 18F-FDG PET/CT revealed a low-density left breast mass with heterogeneous ring-like 18F-FDG uptake. Core needle biopsy of the tumor revealed a rare subtype of metaplastic breast carcinoma, matrix-producing carcinoma. The tumor size slightly decreased after 6 cycles of neoadjuvant chemotherapy with docetaxel and epirubicin. The left breast was entirely resected subsequently, and the matrix-producing carcinoma of the breast was ultimately diagnosed.
Impressive Rapid Complete Response on FDG PET/CT to BRAF Inhibitors in a Metastatic Melanoma With Massive Tumor Burden
Authors: Abgral Ronan , Salaun Pierre-Yves , Sassolas Bruno 
Published: October 2021

Abstract
Recent advances in the development of innovative treatments for MM (metastatic melanoma) significantly improved survival. BRAF inhibitor–targeted therapies are also indicated in stage IV BRAF-mutant melanoma, especially dabrafenib and trametinib in combination. The authors present here an impressive rapid (1 month) complete metabolic response on FDG PET/CT to BRAF inhibitors of an MM with a massive tumor burden estimated at more than 10 kg.
STOP Signs: A Population-based Interrupted Time Series Analysis of Antibiotic Duration for Complicated Intraabdominal Infection Before and After the Publication of a Landmark RCT
Authors: Ng-Kamstra Joshua S. , Soo Andrea , McBeth Paul , Rotstein Ori , Zuege Danny J. , Gregson Daniel , Doig Christopher James , Stelfox Henry T. , Niven Daniel J. 
Published: October 2021

Objective:
To determine if the STOP-IT randomized controlled trial changed antibiotic prescribing in patients with Complicated Intraabdominal Infection (CIAI).

Summary of Background Data:
CIAI is common and causes significant morbidity. In May 2015, the STOP-IT randomized controlled trial showed equivalent outcomes between four-day and clinically determined antibiotic duration.

Methods:
This was a population-based retrospective cohort study using interrupted time series methods. The STOP-IT publication date was the exposure. Median duration of inpatient antibiotic prescription was the outcome. All adult patients admitted to four hospitals in Calgary, Canada between July 2012 and December 2018 with CIAI who survived at least four days following source control were included. Analysis was stratified by infectious source as appendix or biliary tract (group A) versus other (group B).

Results:
Among 4384 included patients, clinical and demographic attributes were similar before vs after publication. In Group A, median inpatient antibiotic duration was 3 days and unchanged from the beginning to the end of the study period [adjusted median difference -0.00 days, 95% confidence interval (CI) -0.37 – 0.37 days]. In Group B, antibiotic duration was shorter at the end of the study period (7.87 vs 6.73 days; -1.14 days, CI-2.37 – 0.09 days), however there was no change in trend following publication (-0.03 days, CI –0.16 - 0.09).

Conclusions:
For appendiceal or biliary sources of CIAI, antibiotic duration was commensurate with the experimental arm of STOP-IT. For other sources, antibiotic duration was long and did not change in response to trial publication. Additional implementation science is needed to improve antibiotic stewardship.
Multicenter social media community consultation for an exception from informed consent trial of the XStat device (PhoXStat trial)
Authors: Stephens Shannon W. , Farley Paige , Collins Sean P. , Wong Monica D. , Panas Ashley B. , Dennis Bradley M. , Richmond Neal , Inaba Kenji , Brown Karen N. , Holcomb John B. , Jansen Jan O. 
Published: October 2021

INTRODUCTION
Community consultation (CC) is a key step for exception from informed consent research. Using social media to conduct CC is becoming more widely accepted but has largely been conducted by single sites. We describe our experience of a social media–based CC for a multicenter clinical trial, coordinated by the lead clinical site.

METHODS
Multicenter CC was administered by the lead site and conducted in preparation for a three-site prehospital randomized clinical trial. We used Facebook and Instagram advertisements targeted to the population of interest. When “clicked,” the advertisements directed individuals to study-specific websites, providing additional information and the opportunity to opt out. The lead institution and one other hospital relied on a single website, whereas the third center set up their own website. Site views were evaluated using Google analytics.

RESULTS
The CC took 8 weeks to complete for each site. The advertisements were displayed 9.8 million times, reaching 332,081 individuals, of whom 1,576 viewed one of the study-specific websites. There were no requests to opt out. The total cost was $3,000. The costs per person reached were $1.88, $2.00, and $1.85 for each of the three sites. A number of site-specific issues (multiple languages, hosting of study-specific websites) were easily resolved.

CONCLUSION
This study suggests that it is possible for one institution to conduct multiple, simultaneous, social media-based CC campaigns, on behalf of participating trial sites. Our results suggest that this social media CC model reaches many more potential subjects and is economical and more efficient than traditional methods.

LEVEL OF EVIDENCE
Epidemiological, level IV.