bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Face Mask Wearing in Northern Vermont in Response to the COVID-19 Pandemic
Authors: Beckage Brian , Buckley Thomas E. , Beckage Maegan E. 
Published: April 2021

Objectives Information on the prevalence of face mask use to reduce the spread of SARS-CoV-2 is needed to model disease spread and to assess the effectiveness of policies that encourage face mask use. We sought to (1) estimate the prevalence of face mask use in northern Vermont and (2) assess the effect of age and sex on the likelihood of face mask use. Methods We monitored the entrances to public businesses and visually assessed age, sex, and face mask use. We collected 1004 observations during May 16-30, 2020. We calculated estimates of overall face mask use and odds ratios (ORs) for effects by age and sex. Results Of 1004 observations, 758 (75.5%) sampled people used a face mask. Our census-weighted estimate was 74.1%. A higher percentage of females than males wore face masks (83.8% vs 67.6%). The odds of face mask use were lower among males than among females (OR = 0.52; 95% CI, 0.37-0.73). Face mask use generally decreased with decreasing age: 91.4% among adults aged >60, 70.7% among adults aged 26-60, 74.8% among people aged 15-25, and 53.3% among people aged ≤14. The OR of an adult aged >60 wearing a face mask was 14.70 times higher, for young people aged 15-25 was 2.72 times higher, and for adults aged 26-60 was 2.99 times higher than for people aged ≤14. Females aged >60 had the highest percentage of face mask use (96.3%) and males aged ≤14 had the lowest (43.8%). Conclusions Educational efforts promoting the use of face masks should be targeted at males and younger age groups to limit the spread of SARS-CoV-2.
Targeted Wellness Initiatives Are Most Effective for Reducing Otolaryngology Resident Burnout
Authors: Acevedo Joseph R. , Schlacter Jamie A. , Chambers Tamara N. , Jacobson Lia K. , Yalamanchili Ronica , Clark Bhavishya , Pan Dorothy , Kokot Niels C. , Johns Michael M. 
Published: April 2021

Objective: Investigate the effect of a targeted wellness program on burnout in Otolaryngology residents. Methods: Residents and faculty collaboratively developed a program aimed at improving resident wellness. Program implementation began in July of 2018 and after 1 year, residents evaluated the program’s effects on burnout. We used the Maslach Burnout Inventory (MBI) and a Likert scale to evaluate the effects of the program. Results: After 1 year of the resident wellness program, the MBI results showed an increase in the number of residents in the “engaged” category and a decrease in those rated as “burnout.” Residents rated favorably initiatives grouped into the following themes: time away from work, faculty engaging with residents outside of the hospital environment, efforts to enhance residents’ self-efficacy, fostering a positive culture among residents, and providing easy access to physical activity. The majority of initiatives were targeted to the “culture of wellness” domain, as defined by the Stanford Well MD framework. Our program targeted to a lesser extent the other 2 domains, “efficiency of practice” and “personal resilience.” Conclusion: After 1 year, the wellness program resulted in a trend toward improving burnout. Future efforts should be focused on targeting the multidimensional drivers of burnout as defined by established wellness frameworks. Realizing new stressors brought on by the COVID-19 pandemic will also be an area of active effort and research.
Cochlear Implantation Following Explorative Tympanotomy in Patients With Sudden Sensorineural Hearing Loss: Surgical Features and Audiological Outcomes
Authors: Rupp Robin , Hornung Joachim , Balk Matthias , Sievert Matti , Müller Sarina , Hoppe Ulrich , Iro Heinrich , Gostian Antoniu-Oreste 
Published: April 2021

Objective: To investigate the anatomical status of the round window niche and hearing outcome of cochlear implantation (CI) after explorative tympanotomy (ExT) with sealing of the round window membrane in patients with sudden sensorineural hearing loss at a tertiary referral medical center. Methods: Between January 1, 2007, and July 30, 2020, 1602 patients underwent CI at our department. Out of these, all patients previously treated by ExT with sealing of the round window membrane because of unilateral sudden hearing loss were included in the study. A retrospective chart review was conducted concerning method of round window membrane sealing, intraoperative findings during CI, postoperative imaging, and hearing results. Results: Twenty one patients (9 females; 8 right ears; 54.3 years [± 12.9 years]) underwent ExT with sealing of the round window membrane with subsequent CI after 26.6 months (± 32.9 mo) on average. During CI, in 76% of cases (n = 16), the round window niche was blocked by connective tissue due to the previous intervention but could be removed completely in all cases. The connective tissue itself and its removal had no detrimental effects on the round window membrane. Postoperative computed tomography scan showed no electrode dislocation. Mean postoperative word recognition score after 3 months was 57.4% (± 17.2%) and improved significantly to 73.1% (± 16.4%, P = .005) after 2 years. Conclusion: Performing CI after preceding ExT, connective tissue has to be expected blocking the round window niche. Remaining tissue can be removed safely and does not alter the round window membrane allowing for a proper electrode insertion. Short- and long-term hearing results are satisfactory. Consequently, ExT with sealing of the round window membrane in patients with sudden sensorineural hearing loss does not impede subsequent CI that can still be performed safely.
Laryngeal Chondrosarcoma Characteristics and Survival Analysis in the National Cancer Database
Authors: Talati Vidit M. , Urban Matthew J. , Patel Tirth R. , Wojcik Christopher , Tajudeen Bobby A. , Stenson Kerstin , Bhayani Mihir K. , Al‐Khudari Samer , Husain Inna A. 
Published: April 2021

ObjectiveTo highlight various patient, tumor, diagnostic, and treatment characteristics of laryngeal chondrosarcoma (LC) as well as elucidate factors that may independently affect overall survival (OS) for LCs.Study DesignRetrospective cohort study.SettingNational Cancer Database (NCDB).MethodsAll LC cases from 2004 to 2016 were extracted from the NCDB. Several demographic, diagnostic, and treatment variables were compared between LC subgroups using χ2 and analysis of variance tests. Univariate and multivariate survival analyses were performed for LCs using univariate Kaplan‐Meier analysis and Cox proportional hazards regression models.ResultsThere were 348 LCs included in the main cohort. LCs were predominantly non‐Hispanic white males with similar rates of private and government insurance (49.4% vs 45.4%). Most LCs (81.6%) underwent primary surgery, particularly partial and total laryngectomy. The 1‐, 5‐, and 10‐year survivals for LC were 95.7%, 88.2%, and 66.3%, respectively. On multivariate analysis, lack of insurance (P =. 019; hazard ratio [HR], 8.21; 95% CI, 1.40‐48.03), high grade (P =. 001; HR, 13.51; 95% CI, 3.08‐59.26), and myxoid/dedifferentiated histological subtypes (P =. 0111; HR, 10.74; 95% CI, 1.71‐67.33) correlated with worse OS. No difference in OS was found between partial and total laryngectomy.ConclusionThis is the first multivariate survival analysis and largest single cohort study of LCs in the literature. Overall, LCs enjoy an excellent prognosis, with insurance status, grade, and histology as the main predictors of survival.
Human Papillomavirus in Patients With Hypopharyngeal Squamous Cell Carcinoma
Authors: Patel Evan J. , Oliver Jamie R. , Jacobson Adam S. , Li Zujun , Hu Kenneth S. , Tam Moses , Vaezi Alec , Morris Luc G. T. , Givi Babak 
Published: April 2021

ObjectiveAssess the testing rates and prognostic significance of human papilloma virus (HPV) status in hypopharynx malignancies.Study DesignHistorical cohort study.SettingNational Cancer Database.MethodsReview of the National Cancer Database was conducted between 2010 and 2017 for squamous cell carcinomas (SCCs) of the hypopharynx. We investigated how often the tumors were tested for HPV and whether it was associated with survival outcomes.ResultsA total of 13,269 patients with hypopharynx malignancies were identified. Most cases were not tested for HPV status (n = 8702, 65.6%). Of those tested, 872 (19.1%) were positive for HPV and 3695 (80.9%) were negative. The proportion of nonoropharyngeal SCCs tested for HPV increased nearly every year during the study, with roughly one‐third of cases (31.9%) being tested in 2017. In the facilities classified as high‐testing centers of nonoropharyngeal SCCs of the head and neck, 18.7% of hypopharyngeal tumors were HPV positive. HPV‐negative status was associated with worse survival on multivariable analysis. In propensity score–matched analysis controlling for all factors significant in multivariable regression, 2‐year survival remained higher in the HPV‐positive cohort (77.7% vs 63.1%, P <. 001).ConclusionsHPV‐positive tumors constitute a sizable minority of hypopharynx tumors and are associated with improved survival. Expansion of HPV testing to hypopharynx malignancies may be warranted.
Adverse Events Associated With Corticosteroid‐Eluting Sinus Stents: A MAUDE Database Analysis
Authors: Narwani Vishal , Torabi Sina J. , Kasle David A. , Patel Rahul A. , Lerner Michael Z. , Manes R. Peter 
Published: April 2021

ObjectiveCorticosteroid‐eluting stents (CESs) are increasingly used after endoscopic sinus surgery to reduce the need for revision surgery, but their use is not without risks. The objective of this study is to describe adverse events related to CESs.Study DesignRetrospective cross‐sectional study.SettingThe US Food and Drug Administration’s MAUDE database (2011‐2020; Manufacturer and User Facility Device Experience).MethodsThe MAUDE database was queried for reports of adverse events involving the use of CESs approved by the Food and Drug Administration, including Propel, Propel Mini, Propel Contour, and Sinuva (Intersect ENT).ResultsThere were 28 reported adverse events in total, with all events being related to the Propel family of stents and none related to Sinuva stents. Overall, 22 were categorized as patient‐related adverse events and 6 as device‐related events. The most common adverse event was related to postoperative infection, accounting for 39% (n = 11) of all complications. Four of these patients developed periorbital cellulitis, and 5 developed a fungal infection. The second‐most common adverse event was migration of the stent, representing 21% of all complications (n = 6). Overall, 8 patients (29%) in our cohort required reintervention in the operating room, with subsequent removal of the CES.ConclusionThe most commonly reported adverse events were postoperative infection, including multiple cases of fungal infection, followed by migration of the stent. An increased awareness of the complications associated with CESs can be used to better inform patients during the consenting process as well as surgeons in their surgical decision making.
Healthcare professionals’ views of the use of oral morphine and transmucosal diamorphine in the management of paediatric breakthrough pain and the feasibility of a randomised controlled trial: A focus group study (DIPPER)
Authors: Jamieson Liz , Harrop Emily , Johnson Margaret , Liossi Christina , Mott Christine , Oulton Kate , Skene Simon S. , Wong Ian CK , Howard Richard F 
Published: April 2021

Background: Oral morphine is frequently used for breakthrough pain but the oral route is not always available and absorption is slow. Transmucosal diamorphine is administered by buccal, sublingual or intranasal routes, and rapidly absorbed. Aim: To explore the perspectives of healthcare professionals in the UK caring for children with life-limiting conditions concerning the assessment and management of breakthrough pain; prescribing and administration of transmucosal diamorphine compared with oral morphine; and the feasibility of a comparative clinical trial. Design/ participants: Three focus groups, analysed using a Framework approach. Doctors, nurses and pharmacists ( n = 28), caring for children with life-limiting illnesses receiving palliative care, participated. Results: Oral morphine is frequently used for breakthrough pain across all settings; with transmucosal diamorphine largely limited to use in hospices or given by community nurses, predominantly buccally. Perceived advantages of oral morphine included confidence in its use with no requirement for specific training; disadvantages included tolerability issues, slow onset, unpredictable response and unsuitability for patients with gastrointestinal failure. Perceived advantages of transmucosal diamorphine were quick onset and easy administration; barriers included lack of licensed preparations and prescribing guidance with fears over accountability of prescribers, and potential issues with availability, preparation and palatability. Factors potentially affecting recruitment to a trial were patient suitability and onerousness for families, trial design and logistics, staff time and clinician engagement. Conclusions: There were perceived advantages to transmucosal diamorphine, but there is a need for access to a safe preparation. A clinical trial would be feasible provided barriers were overcome.
Different chest CT scoring systems in patients with COVID-19: could baseline CT be a helpful tool in predicting survival in patients with matched ages and co-morbid conditions?
Authors: Dilek Okan , Demirel Emin , Akkaya Hüseyin , Belibagli Mehmet Cenk , Soker Gokhan , Gulek Bozkurt 
Published: April 2021

Background Computed tomography (CT) gives an idea about the prognosis in patients with COVID-19 lung infiltration. Purpose To evaluate the success rates of various scoring methods utilized in order to predict survival periods, on the basis of the imaging findings of COVID-19. Another purpose, on the other hand, was to evaluate the agreements among the evaluating radiologists. Material and Methods A total of 100 cases of known COVID-19 pneumonia, of which 50 were deceased and 50 were living, were included in the study. Pre-existing scoring systems, which were the Total Severity Score (TSS), Chest Computed Tomography Severity Score (CT-SS), and Total CT Score, were utilized, together with the Early Decision Severity Score (ED-SS), which was developed by our team, to evaluate the initial lung CT scans of the patients obtained at their initial admission to the hospital. The scans were evaluated retrospectively by two radiologists. Area under the curve (AUC) values were acquired for each scoring system, according to their performances in predicting survival times. Results The mean age of the patients was 61 ± 14.85 years (age range = 18–87 years). There was no difference in co-morbidities between the living and deceased patients. The survival predicted AUC values of ED-SS, CT-SS, TSS, and Total CT Score systems were 0.876, 0.823, 0.753, and 0.744, respectively. Conclusion Algorithms based on lung infiltration patterns of COVID-19 may be utilized for both survival prediction and therapy planning.
Effectiveness of intratympanic dexamethasone for the treatment of vertigo attacks in patients with Ménière’s disease compared with betahistine pharmacotherapy
Authors: Molnár András , Maihoub Stefani , Tamás László , Szirmai Ágnes 
Published: April 2021

Objective This study analyzed the possible effects of intratympanic steroid (ITS) therapy in the symptomatic treatment of vertigo attacks in patients with Ménière’s disease. Methods Thirty-five patients treated with ITS (dexamethasone) plus betahistine (Group A) and 35 patients treated with betahistine alone (Group B) were enrolled in this investigation. Complaints were analyzed using medical records and vertigo diaries. Statistical analysis was conducted using IBM SPSS V24 software. Results Based on the analysis, there were no significant differences in baseline features between the two groups. When the occurrence of vertigo attacks was compared using the Kaplan–Meier method, no significant difference was detected between Groups A and B (odds ratio [OR] = 1.051, 95% confidence interval [CI] = 0.965–1.067; p = 0.972). In addition, no difference in the incidence of vertigo attacks was noted in group A between the periods of treatment with betahistine alone and betahistine plus ITS when the groups were analyzed via logistic regression (OR = 1.07, 95% CI = 0.065–1.467; p = 0.614). Conclusion It can be concluded that the addition of ITS therapy to betahistine did not improve outcomes in patients with Ménière’s disease. Further prospective studies should be conducted to analyze the results in a more detailed manner.
Comparative evaluation of the bispectral index (BIS) and BISpro during propofol anaesthesia
Authors: Li Zhitao , Cai Jiachun , Li Jiexiong , Xu Xianghui , Zheng Limin 
Published: April 2021

Objective To compare the accuracy, correlation and agreement between the bispectral index (BIS) and BISpro during propofol anaesthesia. Methods The BIS, BISpro, heart rate, target-concentration of propofol and Observer’s Assessment of Alertness and Sedation (OAA/S) score were recorded every 30 s in female patients scheduled for hysteroscopic surgery. Propofol anaesthesia was induced by an initial target-controlled concentration (1.0 μg/ml) followed by a stepwise increase (0.5 μg/ml) until the patient was unresponsive. Spearman’s correlation coefficient and prediction probability were calculated for the association between sedation levels and the above parameters. The ability of investigated parameters to distinguish between OAA/S scores was analysed. Bland–Altman analysis was used to compare the agreement between BIS and BISpro. The BIS and BISpro cut-off values for lost response were also determined. Results Out of 30 patients in total, a high correlation was found between BIS and BISpro, and both correlated well with OAA/S score. Only BIS was able to distinguish all investigated OAA/S states accurately, but the ability to predict OAA/S score 5 to loss of response was comparable between BIS and BISpro. The calculated cut-off values were 68 for BIS and 70 for BISpro. Conclusion BISpro and BIS are reliable monitors of general anaesthesia during sedation. Trial registration number: Chinese Clinical Trial Registry (URL: www.chictr.org.cn ): ChiCTR1900024037 (retrospectively registered).
Clinical predictors for biochemical failure in patients with positive surgical margin after robotic-assisted radical prostatectomy
Authors: Su Shih-Huan , Chang Ying-Hsu , Huang Liang-Kang , Chu Yuan-Cheng , Kan Hung-Cheng , Liu Chung-Yi , Lin Po-Hung , Yu Kai-Jie , Wu Chun-Te , Pang See-Tong , Chuang Cheng-Keng , Shao I-Hung 
Published: April 2021

Objective: Patients with positive surgical margins (PSMs) after radical prostatectomy for localized prostate cancer have a higher risk of biochemical failure (BCF). We investigated the risk factors of BCF in patients with PSMs after robotic-assisted radical prostatectomy (RARP). Methods: We evaluated 462 patients who underwent RARP in a single medical center from 2006 through 2013. Of them, 61 with PSMs did not receive any treatment before BCF. Kaplan-Meier curve and Cox regression analysis were used to compare patients with (n = 19) and without (n = 41) BCF. Results: Overall, 13.2% of patients had PSMs, and of those, 31.7% experienced BCF during follow-up. The mean follow-up duration was 43.7 months (42.4 [non-BCF] vs 46.35 (BCF], p = 0.51). In univariant analyses, the platelet to lymphocyte ratio (6.26 [non-BCF] vs 8.02 [BCF], p = 0.04) differed statistically. When patients were grouped by pathologic grade ≦2 or ≧3 ( p = 0.004), the BCF-free survival rates differed significantly. Seminal vesicle invasion also differed significantly (5 [non-BCF] vs 7 [BCF], p = 0.005). Patients with undetectable nadir prostate-specific antigen (PSA) after RARP (BCF rate 4/34) differed statistically from those with detectable PSA after RARP (BCF rate 15/26) ( p < 0.001). In the multivariate analysis, the platelet/lymphocyte (P/L) ratio, pathologic grade, and undetectable nadir PSA remained statistically significant. Conclusions: In patients who undergo RARP and have PSMs, P/L ratio >9 preoperatively, pathologic grade ⩾3, and detectable nadir PSA after RARP should be considered adverse features. Early intervention such as salvage radiation therapy or androgen deprivation therapy should be offered to these patients.
SGLT2 inhibition does not reduce glucose absorption during experimental peritoneal dialysis
Authors: Martus Giedre , Bergling Karin , de Arteaga Javier , Öberg Carl M 
Published: April 2021

Introduction: Unwanted glucose absorption during peritoneal dialysis (PD) remains a clinical challenge, especially in diabetic patients. Recent experimental data indicated that inhibitors of the sodium and glucose co-transporter (SGLT)-2 could act to reduce glucose uptake during PD, which raises the question of whether glucose absorption may also occur via intracellular or trans-cellular pathways. Methods: We performed PD in anesthetized Sprague-Dawley rats using a fill volume of 20 mL with either 1.5% glucose fluid or 4.25% glucose fluid for 120 min dwell time to evaluate the effects of SGLT2 inhibition by empagliflozin on peritoneal water and solute transport. To assess the diffusion capacity of glucose, we developed a modified equation to measure small solute diffusion capacity, taking convective- and free water transport into account. Results: SGLT2 inhibition markedly increased the urinary excretion of glucose and lowered plasma glucose after PD compared to sham groups. Glucose absorption for 1.5% glucose was 165 mg 95% CI (145–178) in sham animals and 157 mg 95% CI (137–172) for empagliflozin-treated animals. For 4.25% glucose, absorption of glucose was 474 mg 95% CI (425–494) and 472 mg 95% CI (420–506) for sham and empagliflozin groups, respectively. No significant changes in the transport of sodium or water across the peritoneal barrier could be detected. Conclusion: We could not confirm recent findings that SGLT2 inhibition reduced glucose absorption and increased osmotic water transport during experimental PD.
Workforce Skills in Family Support: A Systematic Review
Authors: Zegarac Nevenka , Isakov Anita Burgund , Nunes Cristina , Antunes Ana 
Published: April 2021

Purpose: Skills used in the practice of family support workforce are implemented in different settings and frameworks. The conceptual assumptions and epistemological frameworks of diversity are a challenge. Various paradigms of intervention, different sectors, and disciplinary involvement indicate the need to systematize and clarify knowledge in the field. Method: Using preferred reporting items for systematic reviews and meta-analyses guidelines, a systematic review was conducted, including qualitative, quantitative, and mixed-method studies on skills in the practice of family support. Results: The literature was collected in an exhaustive search of several databases, where a set of 8,489 papers was selected. The workforce skills described were the qualities of the professionals, technical skills, and specific knowledge. Discussion: Most of the studies were literature reviews, did not define specific skills, had very small samples, and had issues with bias. We discuss implications for practice in social work as well as the gaps to be covered in further research of family support.