bluuebunny/crossref_metadata_2025_split huggingface dataset:
Speech Recognition Outcomes in Adults With Slim Straight and Slim Modiolar Cochlear Implant Electrode Arrays
Authors: MacPhail Margaret E. , Connell Nathan T. , Totten Douglas J. , Gray Mitchell T. , Pisoni David , Yates Charles W. , Nelson Rick F. 
Published: August 2021

ObjectiveTo compare differences in audiologic outcomes between slim modiolar electrode (SME) CI532 and slim lateral wall electrode (SLW) CI522 cochlear implant recipients.Study DesignRetrospective cohort study.SettingTertiary academic hospital.MethodsComparison of postoperative AzBio sentence scores in quiet (percentage correct) in adult cochlear implant recipients with SME or SLW matched for preoperative AzBio sentence scores in quiet and aided and unaided pure tone average.ResultsPatients with SLW (n = 52) and patients with SME (n = 37) had a similar mean (SD) age (62.0 [18.2] vs 62.6 [14.6] years, respectively), mean preoperative aided pure tone average (55.9 [20.4] vs 58.1 [16.4] dB; P =. 59), and mean AzBio score (percentage correct, 11.1% [13.3%] vs 8.0% [11.5%]; P =. 25). At last follow‐up (SLW vs SME, 9.0 [2.9] vs 9.9 [2.6] months), postoperative mean AzBio scores in quiet were not significantly different (percentage correct, 70.8% [21.3%] vs 65.6% [24.5%]; P =. 29), and data log usage was similar (12.9 [4.0] vs 11.3 [4.1] hours; P =. 07). In patients with preoperative AzBio <10% correct, the 6‐month mean AzBio scores were significantly better with SLW than SME (percentage correct, 70.6% [22.9%] vs 53.9% [30.3%]; P =. 02). The intraoperative tip rollover rate was 8% for SME and 0% for SLW.ConclusionsCochlear implantation with SLW and SME provides comparable improvement in audiologic functioning. SME does not exhibit superior speech recognition outcomes when compared with SLW.
Feminization Laryngoplasty: 17‐Year Review on Long‐Term Outcomes, Safety, and Technique
Authors: Nuyen Brian A. , Qian Z. Jason , Campbell Ross D. , Erickson‐DiRenzo Elizabeth , Thomas James , Sung C. Kwang 
Published: August 2021

ObjectivesTransfeminine patients can experience significant gender dysphoria in vocal communication. Feminization laryngoplasty (FL) is a gender‐affirming surgery developed to elevate speaking vocal range, as well as alter vocal resonance and laryngeal cosmesis. The purpose here was to appraise FL’s long‐term voice outcomes across a 17‐year review period.Study DesignLevel III, retrospective study and description of technique.SettingA single‐institution transfeminine voice clinic.MethodsVoice data (speaking fundamental frequency [F0], lowest F0, highest F0, F0 range in both Hertz and semitones, and maximum phonation time [MPT]) were collected and assessed. Self‐assessment of voice femininity and complications were documented.ResultsThe 162 patients, all transfeminine women, had a mean age of 40 years with 36‐month mean follow‐up. There were significant increases in mean speaking F0 (Δ = 50 ± 30 Hz, Δ = 6 ± 3 semitones; P <. 001) and mean change in lowest F0 (Δ = 58 ± 31 Hz, Δ = 8 ± 4 semitones; P <. 001). There was no significant difference in mean change in highest F0 or MPT. There was significant improvement (Δ = 60% ± 39%; P <. 001) in perceptual self‐assessment of vocal femininity. There was a 1.2% rate of major postoperative complications requiring inpatient admission or operative intervention. There were no differences in vocal outcomes between those patients who had less than 1‐year follow‐up and those who had 5‐year follow‐up.ConclusionFL in this cohort was a safe and effective technique for increasing mean speaking F0, mean lowest F0, and voice gender perception over a prolonged follow‐up period. These findings add to the possible treatments aimed at addressing the morbid dysphoria related to voice and communication for our transfeminine patients.
Relative Efficacy of Intra-articular Injections in the Treatment of Knee Osteoarthritis: A Systematic Review and Network Meta-analysis
Authors: Singh Harsh , Knapik Derrick M. , Polce Evan M. , Eikani Carlo K. , Bjornstad Amanda H. , Gursoy Safa , Perry Allison K. , Westrick Jennifer C. , Yanke Adam B. , Verma Nikhil N. , Cole Brian J. , Chahla Jorge A. 
Published: August 2021

Background: In younger patients and those without severe degenerative changes, the efficacy of intra-articular (IA) injections as a nonoperative modality for treating symptomatic knee osteoarthritis (OA)–related pain while maintaining function has become a subject of increasing interest. Purpose: To assess and compare the efficacy of different IA injections used for the treatment of knee OA, including hyaluronic acid (HA), corticosteroids (CS), platelet-rich plasma (PRP), and plasma rich in growth factors (PRGF), with a minimum 6-month patient follow-up. Study Design: Meta-analysis of randomized controlled trials; Level of evidence, 1. Methods: A systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the following databases: PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar. Mean or mean change from baseline and standard deviation for outcome scores regarding pain and function were recorded at the 6-month follow-up and converted to either a 0 to 100 visual analog scale score for pain or a 0 to 100 Western Ontario and McMaster Universities Osteoarthritis Index score for function. A frequentist network meta-analysis model was developed to compare the effects of HA, CS, PRP, PRGF, and placebo on patient-reported outcomes. Results: All IA treatments except CS were found to result in a statistically significant improvement in outcomes when compared with placebo. PRP demonstrated a clinically meaningful difference in function-related improvement when compared with CS and placebo due to large effect sizes. Studies evaluating outcomes of PRGF reported significant improvement when compared with placebo due to large effect sizes, whereas a potential clinically significant difference was detected in the same comparison parameters in pain evaluation. With regard to improvements in pain, function, and both combined, PRP was found to possess the highest probability of efficacy, followed by PRGF, HA, CS, and placebo. Conclusion: PRP yielded improved outcomes when compared with PRGF, HA, CS, and placebo for the treatment of symptomatic knee OA at a minimum 6-month follow-up. Further investigations evaluating different IA and other nonoperative treatment options for patients with knee OA are warranted to better understand the true clinical efficacy and long-term outcomes of nonsurgical OA management.
Anterior “W” Tongue Reduction for Macroglossia in Beckwith-Wiedemann Syndrome
Authors: Ainuz Bar Y. , Geisler Emily L. , Hallac Rami R. , Perez Jeyna K. , Seaward James R. , Kane Alex A. 
Published: August 2021

Introduction Macroglossia occurs in 80% to 99% of patients with Beckwith-Wiedemann syndrome (BWS) and a variety of surgical techniques for tongue reduction are offered by surgeons. The purpose of this study is to evaluate the postoperative outcomes of the anterior “W” tongue reduction technique in patients with BWS. Methods A retrospective review was conducted of all patients diagnosed with BWS that underwent an anterior “W” tongue reduction for macroglossia in the past 7 years, performed by 2 surgeons. Demographics, procedural characteristics, perioperative outcomes, and complications were assessed. Results A total of 19 patients met inclusion criteria consisting of 8 male and 11 female patients. The mean age at the time of surgery was 405 days, mean surgeon operating time was 1.06 h, and mean length of follow-up was 467 days. Postoperative oral competence was observed in 100% of patients. There was no reported history of sleep apnea or airway compromise. Speech delay was seen in 4 patients pre- and postoperatively. Feeding issues decreased from 7 patients preoperatively to 1 patient postoperatively. Preoperative prevalence of class III malocclusion (53%) and isolated anterior open bite (26%) decreased postoperatively to 37% and 16%, respectively. The only reported complications were superficial tip wound dehiscence in 3 patients treated with nystatin antifungal therapy. None of the patients required revisional surgery. Conclusion Patients treated with the anterior “W” tongue reduction technique had low rates of perioperative complications and significant improvements in oral competence. Anterior “W” tongue reduction is safe and effective for the correction of macroglossia in patients with BWS.
Nasal Reconstruction of a Frontonasal Dysplasia via Septal L-Strut Reconstruction Using Costal Cartilage
Authors: Kim Yong Bae , Nam Seung Min , Park Eun Soo , Choi Chang Yong , Cha Han Gyu , Kim Jun Hyun 
Published: August 2021

Objective Frontonasal dysplasia (FND) is a rare congenital condition. Its major features include hypertelorism, a large and bifid nasal tip, and a broad nasal root. We present our technique of septal L-strut reconstruction using costal cartilage. Design Retrospective review from June 2008 and August 2017. Methods Under general anesthesia, 6 patients with FND underwent septal reconstruction using costal cartilage via open rhinoplasty. We reconstructed the nasal and septal cartilaginous framework by placing columellar struts and cantilever-type grafts. Results The patients ranged in age from 6 to 13 years old. All were female. The follow-up period ranged from 8 months to 2 years; we encountered no postoperative complications (infection, nasal obstruction, or recurrence). All patients were satisfied with their nasal appearance. Conclusions Although the results were not entirely satisfactory from an esthetic point of view, we found that FND can be treated via septal reconstruction with costal cartilage and that the clinical outcomes are reliable and satisfactory. Our approach is a useful option for FND patients.
The Development of an Interdisciplinary and Integrated Model of Occupational Safety
Authors: Lagoe Carolyn , Newcomer Derek , Fico Ashley 
Published: August 2021

Background: Occupational safety and health professionals facilitate safer workplaces through the development and implementation of interventions. Empirically validated theories can enhance the likelihood that an intervention will be successful in achieving the desired outcome; however, occupational safety interventions are often devoid of theory or utilize frameworks that fail to take a comprehensive approach to conceptualizing occupational safety processes. Focus of the Article: The current paper seeks to address these gaps by proposing an interdisciplinary and integrated model of occupational safety (IIMOS). Importance to the Social Marketing Field: IIMOS takes an interdisciplinary approach, examining the combined influence of concepts from psychology, social marketing, and occupational safety on behavioral change. This model accounts for the influence that threat appraisal, coping appraisal, and customer service factors can have on safety behaviors’ initiation/adoption and maintenance. Recommendations for Research and Practice: IIMOS may inform the design, implementation, and evaluation of occupational safety and health programs. Although future empirical work must still test the model’s propositions, the model’s in-depth application of social marketing techniques is a novel addition to the field. This model can encourage practitioners to develop innovative products, build relationships with consumers, and design upstream efforts to support program adoption.
Endovascular Treatment of Transplant Renal Artery Stenosis: A Systematic Review and Meta-analysis
Authors: Hinojosa-Gonzalez David Eugenio , Salgado-Garza Gustavo , Torres-Martinez Mauricio , Villegas-De Leon Sergio Uriel , Bueno-Gutierrez Luis Carlos , Herrera-Carrillo Francisco Eugenio , Gonzalez-Urquijo Mauricio , Segura Ibarra Victor , Fabiani Mario Alejandro , Flores-Villalba Eduardo 
Published: August 2021

Objective Endovascular treatment through either percutaneous transluminal angioplasty (PTA) alone or stenting has been previously used as a treatment for transplant renal artery stenosis (TRAS). This review aimed to investigate the results of endovascular treatment for renal artery stenosis in transplanted kidneys as compared with the outcomes of interventions, medical management, and graft survival in non-TRAS patients. Methods A systematic review of PubMed, Google Scholar, Cochrane, and Scopus was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in which studies that reported outcomes of the treatment of TRAS via the endoluminal approach were identified, and their results were meta-analyzed. Results Fifty-four studies with a total of 1522 patients were included. A significant reduction of serum creatinine level was found, favoring the stenting group, with a mean difference of 0.68 mg/dL (95% confidence interval (CI), 0.17–1.19; Z=2.60, p=0.0009). Comparison of pre- and post-intervention values of any intervention revealed a significant decrease in overall serum creatinine level (0.65 mg/dL; 95% CI, 0.40–0.90; Z=5.09, p=0.00001), overall blood pressure, with a mean difference of 11.12 mmHg (95% CI, 7.29–14.95; Z=5.59, p=0.00001), mean difference in the use of medications (0.77; 95% CI, 0.29–1.24; p=0.002), and peak systolic velocity (190.05; 95% CI, 128.41–251.69; p<0.00001). The comparison of serum creatinine level between endovascular interventions and best medical therapy favored endovascular intervention, with a mean difference of 0.23 mg/dL (95% CI, 0.14–0.32; Z=5.07, p<0.00001). Graft survival was similar between the treated patients and those without TRAS (hazard ratio, 0.98; 95% CI, 0.75–1.28; p=0.091). The overall pooled success rate was 89%, and the overall complication rate was 10.4%, with the most prevalent complication being arterial dissection. Conclusion The endovascular treatment of TRAS improves graft preservation and renal function and hemodynamic parameters. PTA + stenting appears to be a more effective option to PTA alone in the stabilization of renal function, with additional benefits from decreased restenosis rates. Further high-quality studies could expand on these findings.
Social-emotional problems of children with mild intellectual disabilities having parents with mental health concerns: A quantitative comparison study
Authors: Riemersma I , Van Santvoort F , Van Doesum KTM , Hosman CMH , Janssens JMAM , Weeland M , Otten R 
Published: August 2021

Introduction: Children of parents with mental health concerns are at-risk for social-emotional problems. In this study, we assessed whether children with a mild intellectual disability and parents with mental health concerns are particularly at-risk. Method: Strengths and Difficulties Questionnaire (SDQ) reports of children with a mild intellectual disability (N = 55) and their parents with mental health concerns (N = 45) were compared to two comparison groups. The first group included children with average intelligence (N = 13) and their parents with mental health concerns (N = 56), the second group included children with mild intellectual disability (N = 44) and their parents (N = 36). Results: Children with a mild intellectual disability and a parent with mental health concerns show higher total SDQ problem scores and more internalizing and externalizing problems as compared to children in the two other groups. Discussion: Children having mild intellectual disability and parents with mental health concerns are particularly at risk for developing social-emotional problems.
Association of the rate of bilirubin decrease with major morbidity in patients undergoing preoperative biliary drainage before pancreaticoduodenectomy
Authors: Rungsakulkij Narongsak , Thongchai Varinthip , Suragul Wikran , Vassanasiri Watoo , Tangtawee Pongsatorn , Muangkaew Paramin , Mingphruedhi Somkit , Aeesoa Suraida 
Published: August 2021

Objective: The objective of this study was to examine the relationship between the rate of bilirubin decrease following preoperative biliary drainage before pancreaticoduodenectomy and postoperative morbidity. Methods: Records of patients who underwent pancreaticoduodenectomy at the Department of Surgery in Ramathibodi Hospital between January 2008 and December 2019 were retrospectively reviewed. The patients were classified into either an adequate or inadequate drainage rate groups according to the bilirubin decrease rate. Major morbidity was defined as higher than grade II in the Clavien-Dindo classification. Risk factors for major morbidity were analyzed by logistic regression analysis. Results: In total, 166 patients were included in the study. Major morbidity was observed in 36 patients (21.6%). Adequate biliary drainage rate was observed in 39 patients (23.4%). Patients who had major morbidity were less likely to have come from the adequate biliary drainage rate group than the inadequate group (38.9% vs. 61.1%). However, through multivariate logistic analysis, only body mass index, operative time, and pancreatic duct diameter were independent factors associated with major morbidity, whereas the bilirubin decrease rate was not. Conclusions: Bilirubin decrease rate following preoperative biliary drainage has no significant association with major postoperative morbidity after pancreaticoduodenectomy.
Melatonin ameliorates hepatic steatosis by inhibiting NLRP3 inflammasome in db/db mice
Authors: Yu Yongxiang , Chen Dongru , Zhao Yuhua , Zhu Jianjun , Dong Xiaohui 
Published: August 2021

Introduction: Type 2 diabetes mellitus (T2DM) is commonly accompanied by obesity and non-alcoholic fatty liver disease (NAFLD), yet the mechanism underlying diabetes-related NAFLD is not fully understood. It has been reported that melatonin can regulate glucose and lipid metabolism. This study aims to investigate the actions and mechanisms of melatonin toward the development of diabetes-related NAFLD. Methods: Melatonin (bid, 30 mg/kg/day, i.p.) was administrated to db/db mice for 8 weeks, while saline was administrated to db/m mice. The metabolic parameters of mice were measured using an automatic biochemistry analyzer. The oxidative stress indexes and mitochondrial membrane potential (MMP) were determined with kits. Pathological assessment in liver tissues was used to analyze the effects of melatonin on hepatic steatosis. The levels of IL-1β and IL-18 were detected with ELISA kits. The mRNA levels of NLRP3 inflammasome were detected using quantitative real-time PCR assay, and protein expressions were estimated using Western blotting assay. Immunofluorescence staining was used to evaluate the caspase-1 expression in the liver. Results: Melatonin treatment significantly reduced blood glucose, serum insulin, body weight, related liver weight, serum lipids, and hepatic enzymes in db/db mice. Melatonin markedly corrected the NAFLD phenotypes, including lipid accumulation, steatohepatitis, fibrosis, and oxidative stress levels. Melatonin significantly improved the MMP level and decreased the serum IL-1β and IL-18 concentrations. The mRNA levels of the NLRP3 inflammasome could also be remarkably reversed by melatonin in the liver tissues. The activation of the NLRP3 inflammasome was also suppressed, evidenced by the downregulated proteins of NLRP3, caspase-1, IL-1β, and IL-18. The enhanced fluorescence intensity of caspase-1 in the liver tissues was also obviously weakened by the melatonin treatment. Conclusion: Our study concluded that melatonin could safeguard against NAFLD by improving hepatic steatosis in db/db mice, and this action could be associated with the regulation of the NLRP3 inflammasome activation.
Risk of Infection in Knee Arthroscopy Patients Undergoing Corticosteroid Injections in the Perioperative Period
Authors: Belk John W. , Keeling Laura E. , Kraeutler Matthew J. , Snow Michaela G. , Mei-Dan Omer , Scillia Anthony J. , McCarty Eric C. 
Published: August 2021

Background: Recent evidence suggests that there may be an increased risk of infection for patients undergoing a corticosteroid injection before, during, or after knee arthroscopy. Purpose: To systematically review the literature to evaluate the risk of postoperative infection in patients undergoing intra-articular corticosteroid injections (CSI) before, during, or after knee arthroscopy. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review was performed by searching the PubMed, Cochrane Library, and Embase databases to identify studies that evaluated the rate of postoperative infection in patients undergoing knee arthroscopy who received an intra-articular CSI during the perioperative period. The search phrase used was “knee AND arthroscopy AND injection AND (infection OR revision).” A subanalysis was also performed to analyze infection rates based on the timing of the corticosteroid injection in relation to arthroscopy. Results: Four studies met the inclusion criteria, representing 11,925 patients undergoing knee arthroscopy with an intra-articular CSI administered during the perioperative period (mean follow-up, 5.3 months) and 247,329 patients without a corticosteroid injection during the perioperative period (mean follow-up, 5.9 months). Patients who received an injection experienced a statistically significantly higher rate of postoperative infection (2.2%) when compared with patients who did not receive an injection (1.1%; P < .001). When analyzed by the timing of the injection, patients receiving an injection preoperatively or intraoperatively experienced a statistically significantly higher rate of postoperative infection (3% and 2.6%, respectively) when compared with patients receiving an injection postoperatively (1.4%; P = .001 for both). Conclusion: Patients undergoing knee arthroscopy who receive an intra-articular CSI during the perioperative period can be expected to experience significantly higher postoperative infection rates when compared with patients not receiving an injection. Furthermore, patients receiving a corticosteroid injection pre- or intraoperatively may experience significantly higher rates of postoperative infection when compared with patients receiving an injection postoperatively.