bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Simplified Prediction Model for Lower Extremity Long Bone Stress Injuries in Male Endurance Running Athletes
Authors: Carbuhn Aaron F. , Sanchez Zack , Fry Andrew C. , Reynolds Matthew R. , Magee Lawrence M. 
Published: August 2018

Objective:
Develop a prediction model for lower extremity long bone injuries (LBIs) in male endurance running athletes using dual-energy x-ray absorptiometry (DEXA).

Design:
Retrospective.

Setting:
Sports medicine department in a university athletic setting.

Participants:
National Collegiate Athletic Association (NCAA) Division 1 white male endurance athletes (n = 27).

Independent Variables:
Backward stepwise elimination was used to achieve a model that predicts LBI, by removing noncontributory variables (P > 0.10), using binary logistic regression. Independent prediction variables analyzed for model were as follows: (1) height (cm), body mass index (BMI) (kg/m−2), and total mass (kg); and (2) regional and total lean mass, fat mass, and bone density assessed using DEXA.

Main Outcome Measures:
Dichotomous dependent variable was LBI.

Results:
Final constructed model predicted 96.3% of athletes with and without LBI. Prediction model were as follows: predict lower extremity long bone stress injury = 23.465 − 0.896 BMI + 1.043 (total upper-body mass) TUB − 34.536 leg bone mineral density (BMD). Predict lower extremity long bone stress injury is the LBI prediction, and TUB (kg) is total fat, muscle, and bone weight in trunk and arms.

Conclusions:
These preliminary data suggest that Division 1 white male endurance running athletes are at risk of LBI with higher relative TUB and lower BMI in combination with a lower leg BMD.
Return to Competition After Surgery for Herniated Lumbar Disc in Professional Football Players
Authors: Tencone Fabrizio , Minetto Marco Alessandro , Tomaello Luca , Giannini Alessandro , Roi Giulio Sergio 
Published: August 2018

Objective:
To investigate the prevalence and outcomes of surgery for lumbar disc herniation in professional football players.

Design:
Retrospective case series.

Setting:
Sports rehabilitation center.

Participants:
A period of 10 seasons of the Italian Football First League (Serie A) was retrospectively investigated. Thirty-three teams (for a total of 1960 players) took turns in the 10 seasons, and 42 team doctors were requested to provide information about the number of players who underwent surgery for lumbar disc herniation.

Intervention:
Survey distributed to team doctors.

Main Outcome Measures:
Prevalence and match incidence of the lumbar discectomy, proportion of players returning to competition after surgery, recovery time and preintervention and postintervention number of appearances in official matches were analyzed.

Results:
Eleven players underwent the surgical intervention during the considered period. The prevalence of the surgical treatment was 0.6%, whereas the match incidence was 0.09 cases/1000 match hours. All players returned to competitions 6.0 (3.5-7.7) months after surgery, with no significant difference between different roles. The number of appearances in official matches was comparable during the seasons before and after surgery.

Conclusions:
The lumbar discectomy must be considered a rare surgical procedure performed in professional football players. All players returned to competitions after surgery. The postintervention number of appearances in official matches was comparable with the preintervention one.
Prevalence of Anal Squamous Intraepithelial Lesions in HIV-1–Infected Young Men Who Have Sex With Men and Transwomen
Authors: Thompson Amelia B. , Gillespie Scott E. , Mosunjac Marina B. , Hussen Sophia A. , Flowers Lisa C. , Camacho-Gonzalez Andres F. 
Published: August 2018

Objective
Anal cancer rates are increasing among HIV-infected persons. Although an efficacious human papillomavirus (HPV) vaccine is available, HPV vaccination rates remain low. Therefore, providers perform anal cancer screening, but there is no consensus on the optimal methods or timing of screening. This study was performed to determine the prevalence of and factors associated with anal squamous intraepithelial lesions in sexually active HIV-infected young men who have sex with men and transgender women.

Materials and Methods
We performed a single-center, retrospective study of sexually active HIV-infected young men who have sex with men and transgender women aged 13 to 24 years at an HIV clinic in Atlanta GA from 2009 to 2016. We used analysis of variance and χ2 tests of independence to evaluate bivariate associations and identify demographic, behavioral, and clinical risk factors.

Results
Of 314 subjects with a mean (SD) age of 20.4 (2.1) years at initial anal cytology testing, 5% had completed the HPV vaccine series at or before the time that cytology was obtained. Ninety-five percent of the anal cytology tests obtained were abnormal, and 72 (29%) of those subjects returned for diagnostic testing either by intraoperative biopsy or high-resolution anoscopy. Fifty-seven percent of those who underwent biopsy had histologic high-grade squamous intraepithelial lesions including 2 cases of carcinoma in situ. A history of greater than 20 lifetime sexual partners was associated with abnormal histology (probability < 0.001, p = .017).

Conclusions
Our study highlights the value of early, standardized screening to avoid missing anal dysplasia or cancer, particularly in unvaccinated persons with high numbers of sexual partners.
How People with Low Vision Achieve Magnification in Digital Reading
Authors: Granquist Christina , Wu Yueh-Hsun , Gage Rachel , Crossland Michael D. , Legge Gordon E. 
Published: August 2018

SIGNIFICANCE
Digital reading displays provide opportunities for enhancing accessibility of text for low vision. How are these displays used by people in their daily lives?

PURPOSE
Subjects responded to an online survey concerning their vision history, reading technology, display preferences, and reading habits. Here, we report on findings concerning acuity and magnification.

METHODS
The survey asked subjects to arrange a text passage for typical reading and to report viewing distance, screen dimensions, and the number of characters per line. Seventy-five adult subjects (most with early-onset low vision, few with central field loss) completed all survey questions relevant to the analysis of acuity and magnification. Mean acuity was .92 logMAR (range, 0.1 to 1.6), and mean age was 44.8 years (range, 18 to 71 years). Twelve normally sighted controls reported the same information while viewing the passage on cell phones, tablets, and computers.

RESULTS
The controls had a mean viewing distance of 38.7 cm and a mean x-height of 1.38 mm. For all three types of devices, angular x-height was 0.21° (close to laboratory estimates of the critical print size for reading). Low vision subjects showed decreasing viewing distance and increasing print size with larger values of logMAR acuity. Most of the low vision subjects achieved their desirable magnification by a combination of reduced viewing distance and increased physical letter size. The majority (54 of 75) relied more on letter-size magnification. Relative to the controls, regression analysis revealed that a typical low vision subject with logMAR acuity of 1.0 reduced viewing distance by a factor of 2.8 and enlarged physical print size by a factor of 6.

CONCLUSIONS
Our survey shows that people with a wide range of acuities are engaged in digital reading. Our subjects achieved desirable magnification primarily by enlarging physical character size and to a lesser extent by reducing viewing distance.
Preliminary Evaluation of a Wearable Camera-based Collision Warning Device for Blind Individuals
Authors: Pundlik Shrinivas , Tomasi Matteo , Moharrer Mojtaba , Bowers Alex R. , Luo Gang 
Published: August 2018

SIGNIFICANCE
This work describes a preliminary evaluation of a wearable collision warning device for blind individuals. The device was found to provide mobility benefit in subjects without (or deprived of) vision. This preliminary evaluation will facilitate further testing of this developmental stage device in more naturalistic conditions.

PURPOSE
We developed a wearable video camera–based device that provided tridirectional collision warnings (right, center, and left) via differential feedback of two vibrotactile wristbands. We evaluated its mobility benefit in blind and normally sighted (NS) blindfolded individuals in indoor mobility courses.

METHODS
Three evaluation experiments were conducted. First, the ability of the device to provide warnings for hanging objects not detected by a long cane was evaluated in eight NS and four blind subjects in an obstacle course with and without the device. Second, the accuracy of collision warning direction assignment was evaluated in 10 NS subjects as they walked toward a hanging object at random offsets and verbally reported the obstacle offset position with respect to their walking path based on the wristbands' vibrotactile feedback. Third, the mobility benefit of collision warning direction information was evaluated by 10 NS and 4 blind subjects when walking with and without differential wristband feedback.

RESULTS
In experiment 1, collisions reduced significantly from a median of 11.5 without to 4 with the device (P < .001). Percent preferred walking speed reduced only slightly from 41% without to 36% with the device (P = .04). In experiment 2, the most likely reported relative obstacle positions were consistent with the actual positions. In experiment 3, subjects made more correct navigational decisions with than without the collision warning direction information (91% vs. 69%, P < .001).

CONCLUSIONS
Substantial mobility benefit of the device was seen in detection of aboveground collision threats missed by a long cane and in enabling better navigational decision making based on the tridirectional collision warning information.
A Global Public Health Perspective: Facilitating Access to Assistive Technology
Authors: du Toit Rènée , Keeffe Jill , Jackson Jonathan , Bell Diane , Minto Hasan , Hoare Philip 
Published: August 2018

SIGNIFICANCE
Clinicians should not overlook vulnerable populations with limited access to assistive technology (AT), the importance of collaboration in multidisciplinary teams, advocacy for enabling environments, and supportive health systems. Resources, a model of care, and recommendations can assist clinicians in contributing to changing attitudes, expanding knowledge, and improving the lives of many.
The increasing availability of innovative advances in AT can immeasurably enhance the quality of life of people with disabilities. Clinicians will undoubtedly welcome the prospect of having cutting-edge AT available to prescribe to individuals who consult them. Arguably, though, the development of innovative strategies to improve access to AT, especially to underserved people “left behind,” is equally urgent. Current efforts are inadequate, with millions of people with disabilities not being reached. Particularly at risk are women, children, and the elderly, as well as poorer people who live in resource-poor and remote areas, especially in low- and middle-income countries. Not only must physical access be facilitated, but also quality services must be available. Good-quality, affordable AT, which is appropriate and acceptable to the user, would ideally be provided by competent personnel, working in multidisciplinary teams, offering comprehensive, person-centered services, including rehabilitation, fully integrated into the various levels of the health system. Clinicians can contribute to improving access to quality services, participate in initiatives aiming to increase the knowledge of health personnel and the public, engage in advocacy to change attitudes, influence legislation, and raise awareness of universal health coverage—ultimately facilitating access to AT for all.
Recommendations on RBC Transfusion in Critically Ill Children With Nonlife-Threatening Bleeding or Hemorrhagic Shock From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative
Authors: Karam Oliver , Russell Robert T. , Stricker Paul , Vogel Adam M. , Bateman Scot T. , Valentine Stacey L. , Spinella Philip C. 
Published: August 2018

Objectives:
To present the recommendations and supporting literature for RBC transfusions in critically ill children with bleeding developed by the Pediatric Critical Care Transfusion and Anemia Expertise Initiative.

Design:
Consensus conference series of international, multidisciplinary experts in RBC transfusion management of critically ill children.

Methods:
The panel of 38 experts developed evidence-based and, when evidence was lacking, expert-based clinical recommendations as well as research priorities for RBC transfusions in critically ill children. The bleeding subgroup included five experts. Electronic searches were conducted using PubMed, EMBASE, and Cochrane Library databases from 1980 to May 2017. Agreement was obtained using the Research and Development/UCLA Appropriateness Method. Results were summarized using the Grading of Recommendations Assessment, Development, and Evaluation method.

Results:
Transfusion and Anemia Expertise Initiative Consensus Conference experts developed a total of six recommendations focused on transfusion in the critically ill child with acute bleeding. In critically ill children with nonlife-threatening bleeding, we recommend giving a RBC transfusion for a hemoglobin concentration less than 5 g/dL, and be considered for a hemoglobin concentration between 5 and 7 g/dL. In critically ill children with hemorrhagic shock, we suggest that RBCs, plasma and platelets transfusion ratio between 2:1:1 to 1:1:1 until the bleeding is no longer life-threatening. We recommend future studies to develop physiologic and laboratory measures to indicate the need for RBC transfusions, and to determine if goal directed hemostatic resuscitation improves survival. Finally, we recommend future studies to determine if low titer group O whole blood is more efficacious and safe compared with reconstituted whole blood in children with hemorrhagic shock.

Conclusions:
The Transfusion and Anemia Expertise Initiative Consensus Conference developed pediatric specific recommendations regarding RBC transfusion management in the critically ill child with acute bleeding, as well as recommendations to help guide future research priorities.
Recommendations on RBC Transfusions for Critically Ill Children With Nonhemorrhagic Shock From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative
Authors: Muszynski Jennifer A. , Guzzetta Nina A. , Hall Mark W. , Macrae Duncan , Valentine Stacey L. , Bateman Scot T. , Spinella Philip C. 
Published: August 2018

Objectives:To present the recommendations and supporting literature for RBC transfusions in critically ill children with nonhemorrhagic shock developed by the Pediatric Critical Care Transfusion and Anemia Expertise Initiative.Design:Consensus conference series of international, multidisciplinary experts in RBC transfusion management of critically ill children.Methods:The panel of 38 experts developed evidence-based, and when evidence was lacking, expert-based clinical recommendations as well as research priorities for RBC transfusions in critically ill children. The nonhemorrhagic shock subgroup included five experts. Electronic searches were conducted using PubMed, EMBASE, and Cochrane Library databases from 1980 to May 2017. Agreement was obtained using the Research and Development/UCLA Appropriateness Method. Results were summarized using the Grading of Recommendations Assessment, Development, and Evaluation method.Results:Transfusion and Anemia Expertise Initiative Consensus Conference experts developed and voted on a total of four clinical and four research recommendations focused on RBC transfusion in the critically ill child with nonhemorrhagic shock. All recommendations reached agreement (> 80%). Of the four clinical recommendations, three were based on consensus panel expertise, whereas one was based on weak pediatric evidence. In hemodynamically stabilized critically ill children with a diagnosis of severe sepsis or septic shock, we recommend not administering a RBC transfusion if the hemoglobin concentration is greater than or equal to 7 g/dL. Future studies are needed to determine optimum transfusion thresholds for critically ill children with nonhemorrhagic shock undergoing acute resuscitation.Conclusions:The Transfusion and Anemia Expertise Initiative Consensus Conference developed pediatric-specific clinical and research recommendations regarding RBC transfusion in the critically ill child with nonhemorrhagic shock. Although agreement among experts was strong, available pediatric evidence was scant—revealing significant gaps in the existing literature.
Lactic Acidosis in a Critically Ill Patient
Authors: Schuh Abigail M. , Leger Kasey Joanne , Summers Corinne , Uspal Neil G. 
Published: August 2018

Abstract
Lactic acidosis in the emergency department and other hospital settings is typically due to tissue hypoxia with sepsis being the most common cause. However, in patients with persistently elevated lactate without evidence of inadequate oxygen delivery, type B lactic acidosis should be considered. We report the case of a 12-year-old boy with relapsed and refractory pre–B-cell acute lymphoblastic leukemia who presented in distress with tachycardia, history of fever, and diffuse abdominal tenderness. The patient had severe metabolic acidosis with elevated lactate upon arrival to the emergency department. Despite aggressive fluid resuscitation and intravenous antibiotics, the patient's acidosis worsened. Serial blood cultures were negative, and he was eventually diagnosed with type B lactic acidosis secondary to relapsed acute lymphoblastic leukemia.
Heterogeneous Knee Effusions on Point-of-Care Ultrasound in a Toddler Diagnosed With Juvenile Idiopathic Arthritis
Authors: Rizvi Munaza B. , Rabiner Joni E. 
Published: August 2018

Abstract
Point-of-care musculoskeletal ultrasound can provide information about joint effusions and the quality of the effusion. This case report describes the findings of a previously healthy pediatric patient with acute onset of knee swelling and abnormal gait. After point-of-care ultrasound demonstrated bilateral knee effusions with complex, heterogeneous material, subsequent workup revealed a diagnosis of juvenile idiopathic arthritis (JIA). We review the ultrasound technique, sonographic findings, and literature regarding point-of-care ultrasound for knee effusions and JIA.
Hepatic Portal Venous Gas
Authors: Liang Keng-Wei , Huang Hsin-Hui , Tyan Yeu-Sheng , Tsao Teng-Fu 
Published: August 2018

Abstract
Ultrasonography (US) is believed to be the most available method of detecting hepatic portal venous gas (HPVG) with real-time imaging capability. Hepatic portal venous gas has characteristic image appearances in various ultrasound modes such as bright mode, Doppler mode, and even motion (M) mode. In this article, we give a comprehensive review of the image appearances of HPVG among different modes of US with a special focus on the M mode US. Hepatic portal venous gas was recognized as linear echogenicities in various oblique directions (the meteor shower sign) on the M mode US. This specific sign may expand some potential of HPVG detection by US.
Fronto-naso-orbital Reconstructions
Authors: Chen Shih-Heng , Ko An-Ta , Chen Hung-Chi , Roan Tyng-Luen , Tang Yueh-Bih 
Published: August 2018

Background
Significant defects at the fronto-naso-orbital area always present with severe facial disfigurement for the afflicted individuals. It may occur after tumor ablations, compound comminuted fractures, or craniofacial surgeries at this area.

Patients and Methods
Reconstructions of 11 patients with this problem had been performed by the authors, with follow-up for 3 to 25 years. The modes of reconstruction involved carved cartilage block with fascia grafts in 3 patients, split calvarial bone grafting covered with fascia grafts in 2 patients, drilled bone chips harvested from outer table of calvarial bone encased with fascia for smaller defects in 2 patients, 3-dimensional computed tomographic reconstruction and reformation of replica to replace the destroyed framework in 4 patients.

Results
Patients in this series all achieved good results, with symmetric face, acceptable facial contour, and being willing to attend social activities with deliberate evaluation and planning, selection of proper method, with proficient skills in reconstruction. One patient who received cartilage block grafting came back for refining facial contour 18 years later.

Conclusions
Midline fronto-naso-orbital defects could be reconstructed with carved cartilage graft or bone graft, overlaid with fascia graft, intricate asymmetric defects can be reconstructed with the aid of 3-dimensional computed tomographic image reconstruction and reformation of the defect replica to achieve symmetric esthetic result with individualized approaches.
How to Get Started Performing Supermicrosurgical Lymphaticovenular Anastomosis to Treat Lymphedema
Authors: Chen Wei F. 
Published: August 2018

Abstract
Recent advancements in microsurgery and supermicrosurgery have made effective lymphedema treatment a surgical reality. When comparing the 2 currently available procedures, lymphaticovenular anastomosis (LVA) and vascularized lymph node transfer, vascularized lymph node transfer is more frequently performed owing to technical unfamiliarity with supermicrosurgery and uncertainty in patient selection, technical execution, and procedural outcome. To date, the author has performed more than 250 cases of supermicrosurgical LVAs. In this article, the author shares his approach in technical acquisition, how to get over the learning curve using a simulation model, patient selection, LVA-specific technical pearls, outcome assessment, and finally how to team up with other lymphedema-related specialists. After reading this paper, the readers should have enough knowledge to get started building a surgical lymphedema program.
Could Nasal Surgery Affect Multilevel Surgery Results for Obstructive Sleep Apnea?
Authors: El-Anwar Mohammad Waheed , Amer Hazem S. , Askar Sherif M. , Elsobki Ahmed , Awad Ali 
Published: August 2018

Objective:
To study the role of nasal surgery as a part of multilevel surgery for management of obstructive sleep apnea (OSA).

Methods:
All patients underwent multilevel surgery for relieving OSA symptoms and they were classified according to type of surgical intervention into: group A (20 patients), who underwent hyoid suspension (Hyoidthyroidpexy), tonsillectomy, suspension (El-Ahl and El-Anwar) sutures and nasal surgery (inferior turbinate surgery). Group B (20 patients), who underwent hyoid suspension (Hyoidthyroidpexy), tonsillectomy and suspension sutures. Pre and postoperative sleep study, Epworth sleepiness scale, snoring score were reported and compared.

Results:
Apnea hypoapnea index (AHI) dropped significantly in both groups. The mean preoperative AHI was significantly less in patients who had no nasal obstruction (P = 0.0367), while the difference in postoperative values was nonsignificant (P = 0.7358).
The mean Epworth sleepiness scale improved significantly in both groups, but the difference between pre and postoperative values in both groups was nonsignificant. The lowest oxygen saturation elevated significantly in both groups, but the difference between pre and postoperative values in both groups was nonsignificant. As regards snoring scores, they dropped significantly in both groups. The preoperative snoring score was reported to be significantly more in patients who had associated nasal obstruction (group A) (P = 0.0113). But after surgery the difference in postoperative values was nonsignificant (P = 0.1296).

Conclusion:
Treatment of nasal obstruction should be considered a crucial component in the comprehensive management plan for OSA patients as it has significant impact on the patients’ AHI and snoring.