bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lumbar Laminectomy in the Outpatient Setting Is Associated With Lower 30-Day Complication Rates
Authors: Karukonda Teja R. , Mancini Nickolas , Katz Austen , Cote Mark P. , Moss Isaac L. 
Published: May 2019

Study Design: Retrospective cohort study. Objectives: To compare the incidence of complications in patients undergoing single-level and 2-level lumbar laminectomy in either the inpatient or outpatient settings. Methods: Patients who underwent single-level and 2-level lumbar laminectomy were identified in the ACS NSQIP database from the years 2006 to 2015. Independent patient variables were recorded, including demographics and preoperative health characteristics. Logistic regression was used to determine the risk of postoperative complications for both a 1- and 2-level lumbar laminectomy as well as to identify independent risk factors for a complication. Comparisons were made between 2 groups: (1) inpatient and (2) outpatient as determined by billing data. Results: A total of 18 076 single- and 2-level lumbar laminectomy cases were identified with 10 743 (59.4%) inpatient procedures and 7333 (40.6%) outpatient procedures. The incidence of any postoperative complication was significantly lower in the outpatient group than in the inpatient group among all cohorts including 1-level lumbar laminectomy (1.9% vs 6.7%), 2-level lumbar laminectomy (3.17% vs 7.38%), as well as in the combined cohort of 1- and 2-level laminectomies (2.47% vs 7.01%). Significant independent risk factors for complications after lumbar laminectomy were identified, including body mass index (BMI) >30 kg/m2, age ≥55 years, a functional status of partially dependent, chronic obstructive pulmonary disease (COPD), chronic steroid use, American Society of Anesthesiologists (ASA) class 3 or 4, and operative time >90 minutes. Conclusions: This study reports a lower overall complication rate in the 30-day postoperative period following 1- and 2-level lumbar laminectomy performed in an outpatient versus inpatient setting. Significant risk factors for complications included BMI >30 kg/m2, age ≥55 years, a functional status of partially dependent, COPD, chronic steroid use, ASA class 3 or 4, and operative time >90 minutes.
An Analysis Between Search Engine Optimization Versus Social Media Marketing Affecting Individual Marketer’s Decision--Making Behavior
Authors: Bhandari Ravneet Singh , Bansal Sanjeev 
Published: May 2019

Purpose The research intended to reveal real behavioural inclination of marketer for SEO and SMM usage. This approach was developed to provide a constructive model for established marketers as well as emerging start up marketers. Design/methodology/approach The investigation was designed based on literature review followed by quantitative analysis of the collected data with appropriate statistical techniques based on random surveys of end users from the National Capital Region of India. Findings A new conceptual model is being proposed i.e. Marketer decision model, enabling a comparative framework which encourages more effective and result oriented decision-making techniques which ends up in developing better online marketing techniques. Internet users have different behavioural patterns based upon demographic profiles. The evidence based on the statistical analysis suggests that the consumer behavioural patterns need to take into consideration by online marketers while targeting and designing SEO and SMM strategies. Research limitations/implications The following research was based on a selected samples only but not the entire population of target consumers and there were cases where samples perhaps inaccurately representing the population. Originality/value The survey conducted on diversified demographic profiles, thereby providing few rich perspectives regarding online behavioural pattern.
Can Type 2 Diabetes Sufferers Actually Estimate Serum Glucose Level From Interstitial Fluid Glucose Level: A Diabetes Patient’s Experience
Authors: Fried Dennis A , Fried Robert 
Published: May 2019

Introduction: The general assumption is that blood glucose (BG) and interstitial fluid glucose (IntFG) are practically the same. We aimed to determine whether the typical patient with type 2 diabetes can use IntFG to estimate BG. Description: The study was conducted on an 83-year-old white male with type 2 diabetes. One hundred pairs of IntFG and BG observations mg/dL (n = 50 simultaneous; n = 50 with 15-minute lag) were made over a 10-day period. We used paired t tests, correlation coefficients, and linear regression to predict relationships between IntFG and BG. Results: There were significant ( P < .0001) mean differences between IntFG and BG (simultaneous: 53.8 mg/dL; 15-minute time lag: 46.4 mg/dL). There were significant ( P < .0001) positive correlations between IntFG and BG (simultaneous: r = 0.641; 15-minute time lag: r = 0.712). Linear regression revealed that increased IntFG was significantly ( P < .0001) associated with declines in mean predicted BG. Conclusion: The typical type 2 diabetes patient cannot use IntFG level to estimate BG.
Neutrophilic inflammation in asthma and defective epithelial translational control
Authors: Ravi Abilash , Chowdhury Saheli , Dijkhuis Annemiek , Bonta Peter I. , Sterk Peter J. , Lutter René 
Published: May 2019

Neutrophilic inflammation in asthma is associated with interleukin (IL)-17A, corticosteroid-insensitivity and bronchodilator-induced forced expiratory volume in 1 s (FEV1) reversibility. IL-17A synergises with tumour necrosis factor (TNF)-α in the production of the neutrophil chemokine CXCL-8 by primary bronchial epithelial cells (PBECs).We hypothesised that local neutrophilic inflammation in asthma correlates with IL-17A and TNF-α-induced CXCL-8 production by PBECs from asthma patients.PBECs from most asthma patients displayed an exaggerated CXCL-8 production in response to TNF-α and IL-17A, but not to TNF-α alone, and which was also insensitive to corticosteroids. This hyperresponsiveness of PBECs strongly correlated with CXCL-8 levels and neutrophil numbers in bronchoalveolar lavage from the corresponding patients, but not with that of eosinophils. In addition, this hyperresponsiveness also correlated with bronchodilator-induced FEV1% reversibility. At the molecular level, epithelial hyperresponsiveness was associated with failure of the translational repressor T-cell internal antigen-1 related protein (TiAR) to translocate to the cytoplasm to halt CXCL-8 production, as confirmed by TiAR knockdown. This is in line with the finding that hyperresponsive PBECs also produced enhanced levels of other inflammatory mediators.Hyperresponsive PBECs in asthma patients may underlie neutrophilic and corticosteroid-insensitive inflammation and a reduced FEV1, irrespective of eosinophilic inflammation. Normalising cytoplasmic translocation of TiAR is a potential therapeutic target in neutrophilic, corticosteroid-insensitive asthma.
Diagnosis and outcome of acute respiratory failure in immunocompromised patients after bronchoscopy
Authors: Bauer Philippe R. , Chevret Sylvie , Yadav Hemang , Mehta Sangeeta , Pickkers Peter , Bukan Ramin B. , Rello Jordi , van de Louw Andry , Klouche Kada , Meert Anne-Pascale , Martin-Loeches Ignacio , Marsh Brian , Socias Crespi Lorenzo , Moreno-Gonzalez Gabriel , Buchtele Nina , Amrein Karin , Balik Martin , Antonelli Massimo , Nyunga Martine , Barratt-Due Andreas , Bergmans Dennis C.J.J. , Spoelstra-de Man Angélique M.E. , Kuitunen Anne , Wallet Florent , Seguin Amelie , Metaxa Victoria , Lemiale Virginie , Burghi Gaston , Demoule Alexandre , Karvunidis Thomas , Cotoia Antonella , Klepstad Pål , Møller Ann M. , Mokart Djamel , Azoulay Elie 
Published: May 2019

ObjectiveWe wished to explore the use, diagnostic capability and outcomes of bronchoscopy added to noninvasive testing in immunocompromised patients. In this setting, an inability to identify the cause of acute hypoxaemic respiratory failure is associated with worse outcome. Every effort should be made to obtain a diagnosis, either with noninvasive testing alone or combined with bronchoscopy. However, our understanding of the risks and benefits of bronchoscopy remains uncertain.Patients and methodsThis was a pre-planned secondary analysis of Efraim, a prospective, multinational, observational study of 1611 immunocompromised patients with acute respiratory failure admitted to the intensive care unit (ICU). We compared patients with noninvasive testing only to those who had also received bronchoscopy by bivariate analysis and after propensity score matching.ResultsBronchoscopy was performed in 618 (39%) patients who were more likely to have haematological malignancy and a higher severity of illness score. Bronchoscopy alone achieved a diagnosis in 165 patients (27% adjusted diagnostic yield). Bronchoscopy resulted in a management change in 236 patients (38% therapeutic yield). Bronchoscopy was associated with worsening of respiratory status in 69 (11%) patients. Bronchoscopy was associated with higher ICU (40%versus28%; p<0.0001) and hospital mortality (49%versus41%; p=0.003). The overall rate of undiagnosed causes was 13%. After propensity score matching, bronchoscopy remained associated with increased risk of hospital mortality (OR 1.41, 95% CI 1.08–1.81).ConclusionsBronchoscopy was associated with improved diagnosis and changes in management, but also increased hospital mortality. Balancing risk and benefit in individualised cases should be investigated further.
Factors influencing behavioural intention to use a smart shoe insole in regionally based adults with diabetes: a mixed methods study
Authors: Macdonald Emma M. , Perrin Byron M. , Hyett Nerida , Kingsley Michael I. C. 
Published: May 2019

AbstractBackgroundSmart insole technologies that provide biofeedback on foot health can support foot‐care in adults with diabetes. However, the factors that influence patient uptake and acceptance of this technology are unclear. Therefore, the aim of this mixed‐methods study was to use an established theoretical framework to determine a model of psychosocial factors that best predicts participant intention to use smart insoles.MethodsFifty‐three adults with diabetes from regional Australia completed the validated Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire. Multiple regression analysis was used to determine the psychosocial factors that best predict behavioural intention to adopt a smart insole. Additionally, a focus group was conducted and thematic analysis was performed to explore barriers and enablers to adopting this technology.ResultsThe multiple regression model that best predicted intention to adopt the smart insole (adjusted R2 = 0.51, p < 0.001) identified that self‐efficacy (β = 0.67, p = 0.001) and attitude (β = 0.72, p < 0.001) were significant predictors of behavioural intention, while effort expectancy (β = − 0.52, p = 0.003) and performance expectancy (β = − 0.40, p = 0.040) were moderating factors. Thematic analysis illustrates the importance of attitude and self‐efficacy on participants' behavioural intentions, influenced by participant's belief in the device's clinical efficacy and anticipated effort expectancy.ConclusionsThis mixed‐methods study demonstrates that attitude, self‐efficacy, performance expectancy and effort expectancy combine to predict intention to adopt smart insole technology. Clinicians should consider these psychosocial factors when they prescribe and implement smart soles with patients at high risk of foot ulceration.
A novel application of strain sonoelastography can detect changes in Achilles tendon elasticity during isometric contractions of increasing intensity
Authors: Schneebeli Alessandro , Del Grande Filippo , Falla Deborah , Cescon Corrado , Clijsen Ron , Barbero Marco 
Published: May 2019

AbstractBackgroundMechanical and morphological properties of the Achilles tendon are altered in disease and in response to changes in mechanical loading. In the last few years different ultrasound based technologies have been used to detect tendon mechanical properties changes mainly in resting condition. Therefore the aim of this study was to evaluate if strain sonoelastography can identify changes in Achilles tendon elasticity during isometric contractions of increasing intensity.MethodsThis cross‐sectional study enrolled 37 healthy volunteers (19 women) with mean (±SD) age of 27.1 (±7.0) years between January and June 2017. Strain sonoelastography images of the Achilles tendon were acquired during an isometric ramp force (0 kg, 0.5 kg, 1 kg, 2 kg, 5 kg and, 10 kg). An external reference material was used to provide a comparison between the examined tissue and a material of constant elasticity. Friedman test with post hoc pairwise comparison were used to determine the correlation between the difference contraction levels.ResultsThe median and interquartile range (IQR) values for the strain ratio were 1.61 (1.5–2.9) in a relaxed state and 1.30 (1.07–2.02), 1.00 (0.76–1.66), 0.81 (0.70–1.19), 0.47 (0.39–0.73) and 0.33 (0.28–0.40) for 0.5 kg, 1 kg, 2 kg, 5 kg and 10 kg, respectively revealing increased tendon hardness with increasing contraction intensities. Friedman test revealed significant differences (p < 0.05) in the strain ratio between all contractions except between 0.5 kg – 1 kg (p = 0.41); 1 kg – 2 kg (p = 0.12) and 5 kg – 10 kg (p = 0.12).ConclusionStrain sonoelastography can detect changes in Achilles tendon elasticity between different contraction intensities. The results provide an original force‐elasticity curve for the Achilles tendon in a healthy, asymptomatic population.Trial registrationThe study was approved by the Ethics Committee of Canton Ticino.
Donor site morbidity following radial forearm free flap reconstruction with split thickness skin grafts using negative pressure wound therapy
Authors: Clark Jessica M. , Rychlik Shannon , Harris Jeffrey , Seikaly Hadi , Biron Vincent L. , O'Connell Daniel A. 
Published: May 2019

Background Donor site complications secondary to radial forearm free flap (RFFF) reconstruction can limit recovery. Optimizing hand and wrist function in the post-operative period may allow more efficient self-care and return to activities of daily living. Negative pressure wound dressings (NPD) may increase blood flow and perfusion as compared to static pressure dressings (SPD) designed to minimize shear forces during the healing period. This study aims to compare subjective and objective hand and wrist functional outcomes following RFFF reconstruction with split thickness skin grafts (STSG) in patients treated with NPD and SPD. Methods Adult patients undergoing RFFF with STSG were identified preoperatively and randomized to receive NPD or SPD following their RFFF reconstruction. NPD involved a single-use, portable device capable of applying 80 mmHg of negative pressure to the forearm donor site. SPD involved a volar splint. Dressings were left in place for seven days with subjective and objective function assessed at seven days, one month and three months postoperatively. The primary outcome was self-reported hand function as measured with the function subscale of the Michigan Hand Questionnaire (MHQ). Secondary outcomes included hand and wrist strength, range of motion, sensation, scar aesthetics, and skin graft complications. Results Twenty-four patients undergoing RFFF were randomized to NPD or SPD. Patients treated with NPD had improved MHQ self-reported functional scores as compared to those treated with SPD at seven days postoperatively ( P = 0.016). Flexion at seven days was improved in NPD group ( P = 0.031); however, all other strength and range of motion outcomes were similar between groups. There were no differences in rates of graft complications, scar aesthetics, or sensation. Conclusions In the immediate post-operative period, NPD was associated with improved patient-reported hand and wrist function. Wound care to optimize hand and wrist function could allow for improved patient outcomes in the immediate postoperative period.
EBV-positive mucocutaneous ulcers: a presentation of two cases and a brief literature review
Authors: Wanderlei Karolinne Correia , Quintella Danielle Carvalho , Cuzzi Tullia , D’Azambuja Ramos Denize , Morais José Carlos , Romañach Mário , Milito Cristiane Bedran 
Published: May 2019

AbstractMucocutaneous ulcers associated with the Epstein Barr virus constitute an EBV-induced B-cell lymphoproliferative disorder first described in 2010 by Stefan D. Dojcinov et al. These lesions can occur in association with a spectrum of immunosuppressive conditions, including primary immune deficiency, Human Immunodeficiency Virus (HIV) infection, post-transplantation and the use of methotrexate or tumor necrosis factor-alpha (TNF-a) antagonists. Patients clinically present with slowly developing indurated cutaneous and/or mucosal ulcers, especially in the oropharynx. Histopathology reveals circumscribed ulcers containing a mixture of lymphocytes, plasma cells, histiocytes, eosinophils and large transformed cells resembling Hodgkin and Reed-Sternberg cells. The adjacent squamous epithelium presents reactive nuclear atypia and pseudoepitheliomatous hyperplasia. The large transformed cells show positivity for CD20, CD30, Oct-2, PAX5 and EBV. These cells are also positive for MUM1, yet lack CD10 expression, with absent or focal positivity for BCL6. Despite the presence of highly atypical cells, the clinical course is indolent, without progression to disseminated disease. We report herein two cases of diagnosed EBV-positive mucocutaneous ulcers to add to the relatively few cases previously described in the literature.
Nivolumab for Newly Diagnosed Advanced-Stage Classic Hodgkin Lymphoma: Safety and Efficacy in the Phase II CheckMate 205 Study
Authors: Ramchandren Radhakrishnan , Domingo-Domènech Eva , Rueda Antonio , Trněný Marek , Feldman Tatyana A. , Lee Hun Ju , Provencio Mariano , Sillaber Christian , Cohen Jonathon B. , Savage Kerry J. , Willenbacher Wolfgang , Ligon Azra H. , Ouyang Jing , Redd Robert , Rodig Scott J. , Shipp Margaret A. , Sacchi Mariana , Sumbul Anne , Armand Philippe , Ansell Stephen M. 
Published: May 2019

PURPOSE Nivolumab, an anti–programmed death-1 monoclonal antibody, has demonstrated frequent and durable responses in relapsed/refractory classic Hodgkin lymphoma (cHL). We report results from Cohort D of the CheckMate 205 trial, which assessed nivolumab monotherapy followed by nivolumab plus doxorubicin, vinblastine, and dacarbazine (N-AVD) for newly diagnosed cHL. METHODS Patients 18 years of age or older with untreated, advanced-stage (defined as III to IV and IIB with unfavorable risk factors) cHL were eligible for Cohort D of this multicenter, noncomparative, phase II trial. Patients received nivolumab monotherapy for four doses, followed by 12 doses of N-AVD; all doses were every 2 weeks, and nivolumab was administered at 240 mg intravenously. The primary end point was safety. Efficacy end points included objective response rate and modified progression-free survival, defined as time to disease progression/relapse, death, or next therapy. Chromosome 9p24.1 alterations and programmed death-ligand 1 expression were assessed in Hodgkin Reed-Sternberg cells in evaluable patients. RESULTS A total of 51 patients were enrolled and treated. At diagnosis, 49% of patients had an International Prognostic Score of 3 or greater. Overall, 59% experienced a grade 3 to 4 treatment-related adverse event. Treatment-related febrile neutropenia was reported in 10% of patients. Endocrine immune-mediated adverse events were all grade 1 to 2 and did not require high-dose corticosteroids; all nonendocrine immune-mediated adverse events resolved (most commonly, rash; 5.9%). At the end of therapy, the objective response rate (95% CI) per independent radiology review committee was 84% (71% to 93%), with 67% (52% to 79%), achieving complete remission (five patients [10%] were nonevaluable and counted as nonresponders). With a minimum follow-up of 9.4 months, 9-month modified progression-free survival was 92%. Patients with higher-level Hodgkin Reed-Sternberg programmed death-ligand 1 expression had more favorable responses to N-AVD ( P = .041). CONCLUSION Nivolumab followed by N-AVD was associated with promising efficacy and safety profiles for newly diagnosed, advanced-stage cHL.
Efficacy of fine focal spot technique in CT angiography of neck
Authors: Oh Lawrence Chia-Wei , Lau Kenneth Kwok-Pan , Devapalasundaram Ashwini , Buchan Kevin , Kuganesan Ahilan , Huynh Minh 
Published: May 2019

Objectives:
Focal spot size partially defines spatial resolution of a CT system. Many CT tubes have two focal spot sizes, with the finer one allowing more detailed imaging at the cost of photon intensity and increased heat production. Improved X-ray technology and advancement of various generations of iterative reconstruction allow the use of fine focal spot technique in CT angiography. CT neck angiography (CTNA) has been commonly performed as part of stroke imaging or in the trauma setting. This prospective study aimed to assess the efficacy of fine focal spot scanning in vessel clarity improvement, vessel calcification and arterial pulsation artefact reduction on CTNA.

Methods and materials:
Consecutive adult patients of all ages and genders who presented for CTNA were included. All CTNA were scanned with standard focal spot size (SFSS) of 1 × 1 mm in first 4 months while the CTNA in the following 4 months with fine focal spot size (FFSS) of 0.5 × 1 mm. Vessel clarity, calcification and arterial pulsation artefact of arch of aorta, brachiocephalic, subclavian, common carotid, carotid bifurcation, internal carotid, external carotid and vertebral arteries were assessed randomly using a 5-point scale by two blinded radiologists. Results were compared.

Results:
There were 43 patients (mean age 60) with 97 calcified arterial segments in SFSS and 48 patients (mean age 62) with 113 calcified arterial segments in FFSS. 30 % of patients had &gt; 50% carotid artery stenosis. No occlusion or dissection was found in the remaining arteries. Mann-Whitney test showed FFSS performed significantly better for vessel clarity (U: 48238.50, p &lt; .001,r: 0.556) and calcification artefact reduction (U: 2040.50, p &lt; .001,r: 0.564). There was no significant reduction for arterial pulsation artefact.

Conclusion:
Fine focal spot technique improves vessel clarity and reduces calcification blooming artefact in CTNA. These benefits may potentially improve the assessment of arterial luminal stenosis and vessel wall pathology, including plaque morphology.

Advances in knowledge:
Beam hardening artefact from calcification particularly in the vessel wall can often reduce the clarity of vessel lumen thus affect accurate assessment of luminal stenosis. Fine focal spot technique has the advantages of reducing beam-hardening artefact of vessel wall calcifications and improving vessel wall clarity, thus it may potentially improve the assessment of arterial luminal stenosis and vessel wall pathology, including plaque morphology. It may become an important CT imaging technique in near future.