bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sutureless “Contact Lens Sandwich” Technique for Amniotic Membrane Therapy of Central Corneal Ulcers
Authors: Luccarelli Saverio V. , Villani Edoardo , Lucentini Stefano , Bonsignore Francesco , Sacchi Matteo , Martellucci Cecilia Acuti , Nucci Paolo 
Published: October 2021

Purpose To describe a new technique for sutureless and glue-free amniotic membrane transplantation (AMT) and to investigate its effectiveness to treat corneal persistent epithelial defects (PEDs), compared to bandage contact lens (BCL) application alone. Methods We performed AMT with “contact lens sandwich technique” (CLS-AMT) in 8 consecutive patients with central/para-central (up to 4.00 mm from the geometrical centre) PED/ulceration and we retrospectively compared the results with 11 BCL procedures. Results The procedures were performed successfully with no complications. CLS-AMT showed significantly shorter healing time than BCL (24.0  ±  19.1 vs 42.9  ±  14.6 days; P < 0.05, Mann-Whitney test). Recurrence rates were 12% and 27% for CLS-AMT and BCL, respectively. Conclusion CLS-AMT technique, based on the suction effect due to the superposition of a bandage contact lens on the AM-ring complex, represents a quick, low cost, easy to perform and nearly non-invasive AMT technique. This approach is able to provide adequate fixation of AM, and it seems to be a safe and effective treatment for patients with PEDs.
Preemptive interventions for infants and toddlers with a high likelihood for autism: A systematic review and meta-analysis
Authors: Hampton Lauren H , Rodriguez Elizabeth M 
Published: October 2021

Understanding the impact of preemptive interventions on development for those with a high likelihood for autism is a critical step in building a transdiagnostic model of optimized intervention. The purpose of this systematic review and meta-analysis is to examine the impact of preemptive autism interventions on parent outcomes and child developmental outcomes. A total of 345 unique records were assessed for eligibility yielding 13 unique studies with 715 total infant/toddlers with a high likelihood for autism. There was a significant association between the early interventions on parent implementation of intervention strategies immediately following the intervention. However, there was no significant association between the early interventions and child developmental outcomes. The studies reporting moderator and/or mediator analyses suggest a meaningful association between parent implementation and long-term child social communication outcomes. Taken together, these findings suggest that parent-mediated interventions are associated with improved parent use of strategies, and although these results do not translate into immediate or short-term child developmental outcomes, there is evidence that parents with the greatest implementation facilitate later improved communication outcomes for their children. There is an urgent need to develop a nuanced intervention approach during a time of ever-changing concern about child development. Lay abstract Interventions to address core symptoms for young children on the autism spectrum have a strong and growing evidence base. Adapting and delivering evidence-based interventions to infants and toddlers with a high likelihood for autism is a logical next step. This systematic review and meta-analysis summarize the association between infant and toddler interventions and developmental and family outcomes. Results indicate that these early interventions are effective for improving parent implementation of core strategies, yet the effects do not readily translate to child outcomes. However, key studies demonstrate conditional results that indicate that parent implementation is associated with child outcome. Implications for research and practice toward building adaptive interventions that respond to parent implementation and changing child characteristics are discussed.
A 10-Year Single-Center Experience With the GORE TAG Conformable Thoracic Stent Graft in the Treatment of Thoracic Aortic Disease
Authors: Skrypnik Denis , Bischoff Moritz S. , Meisenbacher Katrin , Kronsteiner Dorothea B. , Böckler Dittmar 
Published: October 2021

Objective: The aim of this study was to report 10-year real-world single-center experience with the GORE TAG conformable thoracic aortic graft (CTAG), focusing on rupture-free survival, aortic-related reintervention, and device-related complications during midterm and long-term follow-up (FU). Methods: This retrospective study analyzes results of thoracic endovascular aortic repair (TEVAR) performed between January 2009 and December 2018. Out of 419 TEVAR procedures within this period, 194 patients (male 57.2%, 111/194), with a mean age of 65 ± 13 years, were treated with the CTAG device. Indication for TEVAR was a thoracic aortic aneurysm in 24.7% (48/194), type B aortic dissection in 32.5% (63/194), penetrating aortic ulcer 15.5% (30/194), and miscellaneous 27.3% (53/194). Emergently were operated 43.8% (85/194) patients. Median follow-up (FU) including computed tomography imaging was 43.5 months (Q1-Q3: 8.6–67.0) and was completed in 91.2% (177/194) of patients. Results: Overall survival rates were 75.8% (95% confidence interval [CI] = [0.76–0.70]) and 56.6% (95% CI = [0.57–0.50]) at 12 and 60 months, respectively. Cumulative incidence for aortic rupture was 11.9% (95% CI = [0.07–0.17]) at 60 and 90 months, respectively. Cumulative incidence for aortic-related reintervention was 27.5% (95% CI = [0.21–0.34]) at 60 and 90 months. Cumulative incidence for migration was 2.8% (95% CI = [0.004–0.05]) and 3.9% (95% CI = [0.007–0.07]) at 60 and 90 months, respectively. New endograft infections or material fatigue were not observed. Conclusions: The herein reported 10-year real-world single-center experience with the CTAG observed favorable long-term outcome. Thus, the device demonstrates appropriate persistent safety, efficacy, and clinical durability up to long-term FU in the treatment of diverse thoracic aortic pathologies.
The Benefits of a Muscle-Sparing Below Knee Amputation in the Elderly Population
Authors: Theriot Jared M. , Bhattarai Prabhat , Finlay David J. 
Published: October 2021

Background It is well accepted that good muscle coverage of the bones at the end of a below knee amputation (BKA) stump is preferable, for both weight bearing and protection against prosthesis failure. Elderly patients often have atrophy of the leg musculature secondary to age-related physiological changes and decreased use. These patients often have poor coverage and bulk in their stumps after the standard BKA. We propose a selective muscle-sparing approach to these patients, utilizing selective removal of muscle bundles with regard to their blood supply and fascial planes. The surgical method technique along with outcomes of patients undergoing the procedure is presented here. Methods A retrospective chart review was performed to identify patients who had undergone a muscle-sparing BKA from March 2008 to October 2017 by a single surgeon. Estimated blood loss, operative time, and perioperative and postoperative complications were assessed. Results Forty-six patients greater than 60 years of age underwent muscle-sparing BKA procedures. Complete healing was seen in 30 (65%) patients, while 7 (15%) were lost to follow-up and 9 (20%) required conversion to an above knee amputation (AKA). Intraoperative outcomes in our series were notable for an average estimated blood loss (EBL) of 84.3 ml, lower than the traditional BKA (average EBL 150-500 ml), with comparable operative times averaging 131 minutes and as short as 85 minutes (skin incision to dressing). No patients in the cohort required postoperative blood transfusions (day 0–4), significantly less than the reported 3–7 ml/kg body weight blood requirements in similar patient populations. Conclusions The muscle-sparing BKA technique should be considered in elderly patients, where the normally bulky posterior calf muscle mass is lacking. The selective removal of muscle bundles with regard to their blood supply leaves maximum coverage of the bone with decreased potential hematoma formation and blood loss.
Return to work following ultrasound guided thread carpal tunnel release versus open carpal tunnel release: a comparative study
Authors: Asserson Derek B. , North Taylor J. , Rhee Peter C. , Bishop Allen T. , Brault Jeffrey S. , Shin Alexander Y. 
Published: October 2021

A retrospective review of hospital employees at a single employer institution who underwent ultrasound guided thread carpal tunnel release (TCTR) or open carpal tunnel release (OCTR) between January 2018 and August 2020 was performed to ascertain differences in return-to-work status. Patient age, sex, occupation, handedness, severity of carpal tunnel syndrome, prior treatments and surgical outcomes were reviewed. A total of 18 patients underwent TCTR and 17 patients underwent OCTR. The TCTR group averaged 12 days to return to work without restrictions, as opposed to 33 days for the OCTR group. Resolution of symptoms was afforded in all patients without any complications regardless of surgical technique. While both TCTR and OCTR were effective, our data indicates that TCTR resulted in a shorter return to work. Level of evidence: III
Effects of testosterone treatment on transgender males: A single-institution study
Authors: Korpaisarn Sira , Chiewchalermsri Dararat , Arunakul Jiraporn , Chinthakanan Orawee , Poomthavorn Preamrudee , Sriphrapradang Chutintorn 
Published: October 2021

Objectives: Data regarding gender-affirming hormone therapy in the Asian population are sparse. We aimed to evaluate the efficacy and safety of testosterone therapy in transgender men. Methods: A retrospective study chart review was conducted in a single university-based transgender clinic. Transgender men aged >18 years who newly started testosterone therapy during January 2015 to October 2019 were recruited. Physical changes, laboratory results, and adverse events, including cancer, thromboembolism, cardiovascular events, and death after masculinizing hormone therapy, were evaluated. Results: A total of 39 transgender men (mean age: 27.8 ± 6.0 years) were included. All individuals were treated with intramuscular testosterone injection with a mean follow-up of 25.2 ± 12.9 months. The most common maintenance regimen was testosterone enanthate 250 mg every 4 weeks. Masculinizing effects developed in all transgender men. There were no changes in body weight, and systolic and diastolic blood pressure. Hematocrit levels were 12% significantly increased from 39.9 ± 3.3% to 48.9 ± 2% (p < 0.001). Ten individuals (25.6%) had hematocrit >50%. Significant changes were found in decreased fasting plasma glucose, increased creatinine, and increased uric acid levels. A non-significantly increased alanine aminotransferase, increased low-density lipoprotein cholesterol, and decreased high-density lipoprotein cholesterol were observed. No thromboembolism, cancer, stroke, or coronary artery disease occurred. Conclusions: Gender-affirming hormone therapy is an effective and safe short-term treatment in Thai transgender men. Apart from the standard recommendation, uric acid, plasma glucose, and creatinine level evaluation before and during masculinizing hormone therapy are rational practices. An intramuscular testosterone enanthate 250 mg every 4 weeks is an alternative masculinizing regimen with decent efficacy and safety profile.
Self-injury and Smartphone Addiction: Age and gender differences in a community sample of adolescents presenting self-injurious behavior
Authors: Mancinelli Elisa , Sharka Ona , Lai Tatiana , Sgaravatti Eleonora , Salcuni Silvia 
Published: October 2021

This study aimed to identify the variables (i.e., internalizing, and externalizing problems, self-control, emotion dysregulation, and alexithymia) relevant for Smartphone Addiction and non-suicidal self-injury (NSSI), conceptualized as emotion-regulation strategies, also assessing age and gender differences. Based on power analysis, N = 78 Italian adolescents (11–19 years; Mage = 14.24; SD = 1.56; 73.1% females) were considered. Step-wise multivariate linear regressions evidence a mutual association between NSSI and Smartphone Addiction, particularly relevant in pre-adolescence. Low self-control is significantly associated with the Smartphone Addiction, while emotion dysregulation and alexithymia with NSSI. This study supports NSSI and Smartphone Addiction conceptualization as emotion-regulation strategies and the importance of prevention interventions.
Correlation of Multiple Acromion Morphological Parameters on Radiographs in a Geriatric Chinese Population and Its Clinical Significance
Authors: Yu Mingyang , Zhu Xiaoming , Zhang Yao , Guo Lin , Li Dongyi , Tian Fengde , An Ning , Hao Ruihu , Wang Changcheng 
Published: October 2021

Introduction Previous clinical studies have reported associations between the acromion index, lateral acromion angle, and critical shoulder angle and the occurrence of rotator cuff tears. The objective of this study was to analyze the correlations of these different anatomic parameters in geriatric Chinese Population. Methods Healthy geriatric Chinese participants (n = 66) and geriatric Chinese patients with rotator cuff tears (n = 70) identified between January 2019 and October 2020 were included in this study. Standardized true anteroposterior radiographs were used to measure the acromion index, lateral acromion angle, and critical shoulder angle in each study participant. Results The mean acromion index was significantly larger, the mean lateral acromion angle was significantly smaller, and the mean critical shoulder angle was significantly larger in geriatric patients with full-thickness rotator cuff tears compared with geriatric healthy participants. Conclusion There were a negative linear relationship between the acromion index and lateral acromion angle and a positive linear relationship between the acromion index and critical shoulder angle in geriatric patients with rotator cuff tear and geriatric healthy participants; we termed this phenomenon “Hypothesis of Acromion Index.” The acromion index, lateral acromion angle, and critical shoulder angle are independent predictors of rotator cuff tears in a geriatric Chinese population.
Lower Extremity Musculoskeletal Injury in US Military Academy Cadet Basic Training: A Survival Analysis Evaluating Sex, History of Injury, and Body Mass Index
Authors: Hearn Darren W. , Kerr Zachary Y. , Wikstrom Erik A. , Goss Donald L. , Cameron Kenneth L. , Marshall Stephen W. , Padua Darin A. 
Published: October 2021

Background: Injury incidence for physically active populations with a high volume of physical load can exceed 79%. There is little existing research focused on timing of injury and how that timing differs based on certain risk factors. Purpose/Hypothesis: The purpose of this study was to report both the incidence and timing of lower extremity injuries during cadet basic training. We hypothesized that women, those with a history of injury, and those in underweight and obese body mass index (BMI) categories would sustain lower extremity musculoskeletal injury earlier in the training period than men, those without injury history, and those in the normal-weight BMI category. Study Design: Cohort study; Level of evidence, 2. Methods: Cadets from the class of 2022, arriving in 2018, served as the study population. Baseline information on sex and injury history was collected via questionnaire, and BMI was calculated from height and weight taken during week 1 at the United States Military Academy. Categories were underweight (BMI <20), middleweight (20-29.99), and obese (≥30). Injury surveillance was performed over the first 60 days of training via electronic medical record review and monitoring. Kaplan-Meier survival curves were used to estimate group differences in time to the first musculoskeletal injury. Cox proportional hazard regression was used to estimate hazard ratios (HRs). Results: A total of 595 cadets participated. The cohort was 76.8% male, with 29.9% reporting previous injury history and 93.3% having a BMI between 20 and 30. Overall, 16.3% of cadets (12.3% of male cadets and 29.7% of female cadets) experienced an injury during the follow-up period. Women experienced significantly greater incident injury than did men ( P < .001). Separation of survival curves comparing the sexes and injury history occurred at weeks 3 and 4, respectively. Hazards for first musculoskeletal injury were significantly greater for women versus men (HR, 2.63; 95% CI, 1.76-3.94) and for those who reported a history of injury versus no injury history (HR, 1.76; 95% CI, 1.18-2.64). No differences were observed between BMI categories. Conclusion: Female cadets and those reporting previous musculoskeletal injury demonstrated a greater hazard of musculoskeletal injury during cadet basic training. This study did not observe an association between BMI and injury.
Physical Constraint in Pediatric Dentistry: The Lived Experience of Parents
Authors: Malik P. , Ferraz dos Santos B. , Girard F. , Hovey R. , Bedos C. 
Published: October 2021

Background: The use of physical constraint in pediatric dentistry is highly controversial. Papoose boards in particular, which envelop and immobilize children during treatment procedures, have been described as barbaric devices even though their goal is to protect the patient. In this debate, the voice of parents is important but still missing in the scientific literature. Aim: To understand how parents or caregivers experienced physical constraint and the use of the papoose board on their children during regular dental treatment. Design: We conducted qualitative research rooted in interpretive phenomenology. Accordingly, we performed in-depth individual interviews with a purposive sample of 7 parents or caregivers. The interviews took place in Montréal, Canada, after the children had been treated with a papoose board for nonemergency dental treatments. The discussions were audio recorded, transcribed, and thematically analyzed. Results: Two perspectives emerged among participants. Some explained that the papoose board calmed their children, helped the dentist to complete the procedures, and made their experience less stressful. For others, the papoose board was a horrible and traumatizing experience, leading to feelings of guilt toward their children. They expressed anger toward the dentists for not allowing them enough time to decide and for imposing use of the device. Conclusion Our study raises serious ethical concerns about this practice. We believe that using a papoose board should remain an extraordinary measure and, more generally, that dental professionals should reflect on the place of children and their families in clinical encounters. Knowledge Transfer Statement: The findings of this study should encourage policy makers, dental professionals and ethicists to consider the following points: 1) the traumatizing experiences described by parents raise serious ethical concerns about the use of papoose boards; 2) the dental profession should reflect on the place of children and their families in the clinical encounter and grapple with the importance of consent and how to ensure consent in encounters involving children and their parents.
Differences in adverse drug events and medication errors among pediatric inpatients aged <3 and ≥3 years: The JADE study
Authors: Takeuchi Jiro , Sakuma Mio , Ohta Yoshinori , Ida Hiroyuki , Morimoto Takeshi 
Published: October 2021

Background Adverse drug events (ADEs) are defined as any injuries due to medication use. We hypothesized that the incidences of ADEs and medication errors (MEs) could be associated with linguistic skills of pediatric patients. Methods We analyzed data from the Japan Adverse Drug Events study on pediatric inpatients. This study included inpatients aged one months and older and less than seven years old. We compared the primary outcome of ADEs and MEs between patients aged under three years and three years and older as children typically do not acquire sufficient linguistic skills until around three years of age. Results This study included 639 patients; 412 (64%) patients aged under three years and 227 (36%) patients aged three years and older. We identified 241 ADEs in 639 patients; 152 ADEs among patients aged under three years (37 ADEs per 100 patients) and 89 ADEs among those aged three years and older (39 ADEs per 100 patients). ADEs among patients aged under three years were less likely to be found (49 ADEs) during their hospital stay than those aged three years and older (20 ADEs) ( P = 0.02). Among 172 MEs identified in 639 patients, 25 MEs (15%) resulted in ADEs; 23 (92%) occurred to those aged under three years and two (8%) occurred to those aged three years and older ( P = 0.0008). Conclusion ADEs were less likely to be found and MEs resulted in ADEs more frequently in patients under three years old, and these differences could be explained by differences in their linguistic skill levels.
DINOSAUR: an integrated cognitive-behavioral treatment for anxiety in young children with ASD
Authors: Keefer Amy , Vasa Roma A. 
Published: October 2021

Abstract
Background
Anxiety disorders are highly prevalent in children and adolescents with autism spectrum disorder and often emerge before the age of 6 years. Yet, only a few studies have examined anxiety treatment for this group. Preliminary evidence from these studies suggests that utilizing cognitive behavioral therapy (CBT) as well as strategies to target intolerance of uncertainty (IU) and parental accommodation, known mechanistic and maintaining factors of anxiety may improve anxiety and optimize outcomes in this age group.

Main body
To meet this need, we developed an integrated treatment called DINO Strategies for Anxiety and intolerance of Uncertainty Reduction (DINOSAUR), a 12-week group telehealth treatment for 4- to 6-year-old children with ASD. DINOSAUR works with young children and their parents to deliver CBT along with interventions targeting IU and parental accommodation. In this paper, we first discuss the rationale for developing this treatment and then describe a pilot study of its feasibility and preliminary efficacy.

Conclusions
There is a great need to develop anxiety treatments for young children with ASD. We proposed a novel integrated treatment approach that aims to alter the way young children and parents respond to fear, which could potentially improve short- and long-term mental health outcomes for this age group.

Trial registration
ClinicalTrials.govNCT04432077 on June 03, 2020
Is orchiectomy avoidable in testicular tuberculosis mimicking malignancy? A case report
Authors: Kharbach Youssef , Retal Youssef , Khallouk Abdelhak 
Published: October 2021

Abstract
Background
Isolated testicular tuberculosis (TB) is extremely uncommon. It has non-specific presentation; thus, diagnosis is challenging and is often discovered on pathology examination after orchiectomy.

Case presentation
We report herein the case of a 73-year-old male, with no significant medical or family history, who presented with left scrotal swelling, physical examination revealed a left testicular firm mass measuring 3 cm and ultrasound was suggestive of testicular tumor. Left inguinal orchiectomy was performed and the pathologic examination revealed testicular TB. The presentation was typically mimicking a testicular cancer with no evocative evidence of TB; this can lead to a dilemma and highlights the need to consider TB in differential diagnosis of testicular tumor, especially in areas endemic for the disease.

Conclusions
The aim of our presentation is to argue if orchiectomy was avoidable. It also illustrates the probable hematogenous or lymphatic spread of Mtb to the testicle.