bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tapering duodenoplasty: a beneficial adjunct in the treatment of congenital duodenal obstruction
Authors: Dewberry Lindel C. , Hilton Sarah A , Vuille-dit-Bille Raphael N. , Liechty Kenneth W. 
Published: July 2019

Objective Congenital duodenal obstruction is typically treated by duodenoduodenostomy. Tapering of the dilated segment has been indicated to reduce duodenal dysmotility. The purpose of this study was to review the outcomes between these two approaches. Methods We retrospectively reviewed cases of duodenal obstruction repair performed at a quaternary care referral pediatric hospital from 2007 to 2017. The length of stay, time to full enteral feeding, and complications were compared between patients who underwent duodenoduodenostomy with and without tapering duodenoplasty (n=4 and n=35, respectively). Results Both groups had similar times to initial enteral feeding (7 days) and full enteral feeding (14 vs. 15 days). Among the 35 patients who underwent duodenoduodenostomy alone, 6 (17%) required a return to the operating room; in contrast, no patients who underwent tapering required a return to the operating room. Of those who returned to the operating room, two underwent tapering at that time because of duodenal dilation and feeding intolerance. Conclusions Although limited by the small sample size, this study suggests that patients undergoing tapering duodenoplasty may have a slightly shorter time to full enteral feeding and a lower rate of complications than patients undergoing duodenoduodenostomy alone.
Parapharyngeal space tumors: a serial case study
Authors: Lien Kuang-Hsu , Young Chi-Kuang , Chin Shy-Chyi , Liao Chun-Ta , Huang Shiang-Fu 
Published: July 2019

Objective Primary parapharyngeal space (PPS) tumors are one of the most challenging head and neck tumors to diagnose and treat. We analyzed our experience in patients with PPS tumors who were treated in our hospital over 13 years. Methods We retrospectively reviewed 16 patients with PPS tumors between 2006 and 2018. The study included clinical symptoms, histological types, surgical approaches, adjuvant therapies, postoperative complications, and prognosis. Results The mean age of the patients was 49.63 ± 17.03 years. A palpable neck mass (56.3%) was the most common symptom. In our series, 78.6% of the tumors were benign, and of these, schwannomas were the most common (6/14, 42.9%). Three surgical approaches were used in our patients, including transmandibular (57.1%), transcervical (21.4%) and transparotid (21.4%) approaches. Few complications were reported, including hoarseness and numbness. Adjuvant therapy was administered depending on pathological parameters of the tumors. No recurrence was observed during a mean follow-up of 60.6 months in patients with malignant tumors. Conclusions Radiological studies of PPS tumors are essential for diagnosis and surgical planning. Excision of PPS tumors using appropriate surgical approaches provides good outcomes.
Adenoid cystic carcinoma of the Bartholin’s gland: a case report and literature review
Authors: Chang Yanan , Wu Wang , Chen Hong 
Published: July 2019

Objective The present study was performed to explore the clinical features, diagnosis, and treatment of adenoid cystic carcinoma of the Bartholin’s gland. Methods The clinical data of a case of adenoid cystic carcinoma of the Bartholin’s gland were examined, and the clinical manifestation, diagnosis, and treatment were analyzed. Results Adenoid cystic carcinoma of the Bartholin’s gland has a low incidence. The main clinical manifestations are vulvar lumps, dyspareunia, pain, itching, and bleeding. The diagnosis is based on gynecological examination and pathological biopsy, and the treatment is mainly surgical excision. Conclusion Adenoid cystic carcinoma of the Bartholin’s gland is rare and lacks specificity. Pathological biopsy is the gold standard for diagnosis, and surgical resection should be performed for treatment.
Operative hysteroscopy platform at a university teaching hospital: a retrospective study
Authors: Al-Husban Naser , Abu Rokbeh Rana 
Published: July 2019

Objective This study was performed to investigate the prevalence, indications, effectiveness, outcomes, and complications of operative hysteroscopy in gynecological patients with an emphasis on the need for further training and equipping facilities as performed by consultant gynecologists. Methods This was a retrospective descriptive study of operative hysteroscopic procedures from 19 September 2016 to 31 December 2018. Results In total, 1919 hysteroscopic procedures were performed [1829 (95.3%) diagnostic and 90 (4.7%) operative hysteroscopies]. The patients’ mean age was 42.4 years (range, 20–69 years). The most common operative procedure was hysteroscopic fibroid polypectomy in 31 patients (34.4%), followed by transcervical resection of the endometrium in 23 (25.6%) and endometrial polypectomy in 16 (17.8%). The most common indication was menorrhagia in 57 patients (63.33%), followed by recurrent miscarriages in 9 (10.00%) and primary infertility in 5 (5.56%). Sixty-six patients (73.33%) were treated under general anesthesia and 24 (26.67%) under spinal anesthesia. Fifteen fibroids (48.4%) were 3 to 4 cm in size and 11 (35.5%) were >4 cm. Eight polyps (50%) were 3 to 4 cm. The mean uterine size and endometrial thickness were 8.9 ± 2.16 weeks and 11.1 ± 3.01 mm, respectively. The mean preoperative hemoglobin level was 10.9 g/dL and the mean estimated blood loss was 65.9 ± 48.7 mL (range, 10–200 mL). Thirty-eight patients (60.3%) with heavy bleeding improved with no need for further medical or surgical intervention. Eleven patients (44%) with reproductive issues conceived or regained their normal menstrual pattern. Two patients (2.2%) had excessive fluid absorption and one (1.1%) had uterine perforation. Conclusions Operative hysteroscopy was an effective and safe option in certain uterine pathologies. Specific training in operative hysteroscopy should be promoted to make this type of surgery an integral part of gynecological services in the developing world.
Nalbuphine versus dexmedetomidine for treatment of combined spinal-epidural post-anesthetic shivering in pregnant women undergoing cesarean section
Authors: Sun Jing , Zheng Zhao , Li Yi-Lu , Zou Li-Wei , Li Ge-Hui , Wang Xiao-Guang , She Bao-Zuan , Huang Xiao-Lei , Li Yuan-Tao 
Published: July 2019

Objective This study aimed to compare the clinical efficacy and side effects of nalbuphine and dexmedetomidine for treatment of combined spinal-epidural anesthetic shivering in women after cesarean section. Methods A total of 120 pregnant women, who underwent elective cesarean section under combined spinal-epidural anesthesia, were enrolled in a double-blind, randomized study. These women were randomized into three groups of 40 pregnant women each to receive either saline (group C), nalbuphine 0.07 mg/kg (group N), or dexmedetomidine 0.5 µg/kg (group D) for treatment of shivering after anesthesia. The main outcome measure was a significant reduction in the time required for shivering after intervention. Results The mean time to cessation of shivering in groups N and D was significantly shorter than that in group C (3.5±2.7 and 4.2±3.7 versus 14.5±1.4 minutes). The success rate of shivering treatment and Observer’s Assessment of Alertness/Sedation scores in groups N and D were significantly higher than those in group C, while the recurrence rate was lower than that in group C. Conclusion Nalbuphine 0.07 mg/kg can be used safely and effectively for shivering in pregnant women under combined spinal-epidural anesthesia.
Intervention for depression among chemistry education undergraduates in a Nigerian university
Authors: Ezeudu Florence Obiageli , Eya Ngozi M. , Nwafor Stephen Chinedu , Ogbonna Chimaobi Samuel 
Published: July 2019

Objective We assessed the efficacy of a rational-emotive behaviour therapy psycho-educational programme in reducing depression among chemistry education undergraduates in a Nigerian university. Methods Twenty-three chemistry education undergraduates with major depressive disorder were randomised to a treatment group (12) or control group (11). Students were scored using Beck’s Depression Inventory three times (pre-test, post-treatment, and follow-up). An evidence-based protocol for combating depression was used in the treatment. Controls received counselling. Data were evaluated using univariate analysis of variance and two-way mixed analysis of variance. Results Mean depression scores did not differ between groups prior to the intervention. Rational-emotive behaviour therapy was effective in reducing depression scores. Conclusion Rational-emotive behaviour therapy is an effective tool in assisting university undergraduates (of chemistry education) to manage depression.
Class Discrimination? Evidence from Jamaica: A Racially Homogeneous Labor Market
Authors: Spencer Nekeisha , Urquhart Mikhail-Ann , Whitely Patrice 
Published: July 2019

A common concern in audit studies of racial discrimination is that names assigned to a particular race may also proxy for socioeconomic status. We conduct a correspondence study in Jamaica, a predominantly black middle-income country, and find that these concerns may be valid. The evidence from sending out over 1,000 résumés suggests employers prefer applicants perceived to be from high-income backgrounds. While qualifications are not independently important, those with names preferred by employers have a lower chance of being selected if they have high-quality résumés. The results suggest that class discrimination may matter as much as race discrimination. JEL Classification: I31, J71, J64
Effect of Coopetitive Activity on Innovation and Management Performances in the Structural Context
Authors: Cho Yongrae , Lee Choonghyun 
Published: July 2019

This study intends to demonstrate whether firms’ cooperative activities, particularly ‘coopetition’, affect business performances. Coopetition, which is cooperation with competitors, is a strategic concept that suggests competition and cooperation between firms can exist simultaneously. More specifically, in order to investigate cooperation as a part of innovation mechanism, this study analysed the mediating effects of product and process innovation performances in between cooperative activities and management performances. For this purpose, we applied a structural equation model (SEM) by integrating a regression model and a logistic regression model. The former analysed the effects of cooperation and innovation on management performances, whereas the latter studied influence of cooperation on innovation performances. For empirical analysis, we utilised data from Korea Innovation Survey (KIS), which incorporates information on Korean firm’s innovation activities and their relevant performances. The results from this study can be applied to addressing and diagnosing issues in Korean industries by analysing relationships among cooperative activities, innovation outcomes and management performances in the structural context. The analysis showed that coopetition, compared to other types of cooperation, has enhanced the performance of process innovation. Furthermore, the analysis demonstrated that cooperation related positively to management performances. This study, however, also addresses the problem that Korean firms have limitations in linking these innovation performances to actual management performances of financial growth. The results highlight the significance of strategic openness and flexibility, even to competitors, as the business environment and technology market may change drastically. Coopetition strategy can work as a facilitator in providing windows of opportunity for sustainable growth through field-based innovation.
Estimated Cardiovascular Risk and Guideline-Concordant Primary Prevention With Statins: Retrospective Cross-Sectional Analyses of US Ambulatory Visits Using Competing Algorithms
Authors: Fairman Kathleen A. , Romanet David , Early Nicole K. , Goodlet Kellie J. 
Published: July 2019

Introduction: The 2013 pooled cohort equations (PCE) may misestimate cardiovascular event (CVE) risk, particularly for black patients. Alternatives to the original PCE (O-PCE) to assess potential statin benefit for primary prevention—a revised PCE (R-PCE) and US Preventive Services Task Force (USPSTF) algorithms—have not been compared in contemporary US patients in routine office-based practice. Methods: We performed retrospective, cross-sectional analysis of a nationally representative, US sample of office visits made from 2011 to 2014. Sampling criteria matched those used for PCE development: aged 40 to 79 years, black or white race, no cardiovascular disease. Original PCE, R-PCE, and USPSTF algorithms were applied to biometric and demographic data. Outcomes included estimated 10-year CVE risk, percentage exceeding each algorithm’s statin-treatment threshold (>7.5% risk for O-PCE and R-PCE, and >10% O-PCE plus >1 risk factor for USPSTF), and percentage prescribed statin therapy. Results: In 12 556 visits (representing 285 330 123 nationwide), 10.8% of patients were black, 27.1% had diabetes, and 15.7% were current smokers. Replacing O-PCE with R-PCE decreased mean (95% confidence interval [CI]) estimated CVE risk from 12.4% (12.0%-12.7%) to 8.5% (8.2%-8.8%). Significant ( P < 0.05) racial disparity in the rate of CVE risk >7.5% was identified using O-PCE (black and white patients [95% CI], respectively: 58.8% [54.6%-62.9%] vs 52.8% [51.1%-54.4%], P = .006) but not R-PCE (41.6% [37.6%-45.7%] vs 39.9% [38.3%-41.5%], P = .448). Revised PCE and USPSTF recommendations were concordant for 90% of patients. Significant racial disparity in guideline-concordant statin prescribing was found using O-PCE (black and white patients, respectively, 35.0% [30.5%-39.9%] vs 41.8% [39.9%-44.4%], P = .013), but not R-PCE (40.6% [35.0%-46.6%] vs 43.0% [40.0%-45.9%], P = .482) or USPSTF recommendations (39.0% [33.8%-44.5%] vs 44.4% [41.5%-47.5%], P = .073). Conclusions: Use of an alternative to O-PCE may reduce racial disparity in estimated CVE risk and may facilitate shared decision-making about primary prevention.
Age-related decreases in relapses among adults with relapsing-onset multiple sclerosis
Authors: Schwehr Natalie A , Kuntz Karen M , Butler Mary , Enns Eva A , Shippee Nathan D , Kingwell Elaine , Tremlett Helen , Carpenter Adam F ,   The BeAMS Study Group
Published: July 2019

Background: Relapsing-onset multiple sclerosis (MS) typically starts in early- to mid-adulthood, yet the trajectory of disease activity over the subsequent lifetime remains poorly defined. Previous studies have not quantified the age-specific portion of decreases in annualized relapse rates (ARR). Objective: The aim of this article is to determine, under a range of disease-related assumptions, the age-specific component of decreases in ARR over time among adults with relapsing-onset MS. Methods: We used a simulation modeling approach to examine a range of assumptions about changes in ARR due to age versus disability status. Scenarios included variations in initial ARR and rate of worsening on the Expanded Disability Status Scale. Model parameters were developed through analysis of MS patients in British Columbia, Canada, and literature review. Results: We found a substantial age-specific decrease in ARR in all simulated scenarios, independent of disability worsening. Under a range of clinically plausible assumptions, 88%–97% of the decrease was attributed to age and 3%–13% to disability. The age-specific decrease ranged from 22% to 37% per 5 years for a wide range of initial ARR (0.33–1.0). Conclusion: Decreases in ARR were due mostly to age rather than disability status. To facilitate informed decision making in MS, it is important to quantify the dynamic relationship between relapses and age.
High Mortality from Major Vascular Trauma in Traffic Accidents: A Population-Based Study
Authors: Johannesdottir B. K. , Johannesdottir U. , Jonsson T. , Lund S. H. , Mogensen B. , Gudbjartsson T. 
Published: July 2019

Background and Aims: Injuries involving major arteries are an important cause of mortality and morbidity, most often from road traffic accidents. Our aim was to study the outcome of major vascular trauma from traffic accidents in an entire population, including patients who die at the scene and those who reach hospital alive. Materials and Methods: This was a retrospective analysis of all patients who sustained major vascular trauma in traffic accidents in Iceland from 2000 to 2011. Patient demographics, mechanism, and location of vascular injury and treatment were registered. Injury scores were calculated and overall survival estimated. Results: There were 62 individuals (mean age 44 years, 79% males) with 95 major vascular traumas, giving an incidence of 1.69/100,000 inhabitants (95% confidence interval: 1.27–2.21). A total of 33 died at the scene and 8 during transportation to hospital but 21 (34%) reached hospital alive. Most patients who succumbed had thoracic major vascular traumas (76%) or abdominal major vascular traumas (23%). Mean new injury severity score for the 21 admitted patients was 44. A total of 18 were operated with vascular repair, 3 with endovascular stent graft insertion. The mean hospital stay for discharged patients was 34 days. Altogether, 15 of the 62 patients (24%) survived to discharge from hospital, with a 5-year survival of 86% for discharged patients. Conclusion: Every other patient with major vascular trauma following traffic accidents died at the scene and a further 13% died during transportation to hospital, most of whom sustained major vascular trauma to the thoracic aorta. However, one-third of the patients reached hospital alive and 71% of them survived to discharge, with excellent long-term survival.
Association Between Individual Components of Metabolic Syndrome and Cognitive Function in Northeast Rural China
Authors: Wang Xue , Luan Dechun , Xin Shimeng , Liu Yang , Gao Qian 
Published: July 2019

Aim: The aim of this article was to examine associations between metabolic syndrome and its individual components with cognitive function among rural elderly population in northeast China. Methods: Our study included 1047 residents aged older than 60 years in a northeast rural area. All were interviewed and data were obtained including sociodemographic and medical histories. Cognitive function was assessed by Mini-Mental State Examination. Metabolic syndrome was defined by NCEP-ATP III. Results: After adjusted for confounding factors, metabolic syndrome was inversely associated with cognitive function (odds ratio [OR] = 1.79; 95% confidence interval [CI]: 1.06-3.01) especially in participants aged less than 70 years old (OR = 2.60; 95% CI: 1.27-5.26). In addition, participants with metabolic syndrome had worse language function, which is a part of cognitive function (OR = 2.64; 95% CI: 1.39-5.00). Individual metabolic syndrome components, especially abdominal obesity and hyperglycemia, had significant association with cognitive function (OR = 0.72, 95% CI: 0.56-0.92 and OR = 1.41; 95% CI: 1.12-1.78, respectively). Conclusions: Abdominal obesity might be a protective factor for cognitive function. However, hyperglycemia might be a risk factor.
Changes in peripheral and central sensitization in patients undergoing occipital nerve stimulation
Authors: Wodehouse Theresa , Bahra Anish , Mehta Vivek 
Published: July 2019

Introduction: Central sensitization and impaired conditioned pain modulation (CPM) response have been reported to contribute to migraine progression. Migraine patients can present with allodynia possibly attributed to increased sensitivity of peripheral ends of nociceptors with both peripheral and central sensitization. Occipital nerve stimulation (ONS) works by stimulating the distal branches of C1, C2 and C3 possibly altering the nociceptive traffic to the trigemino-cervical complex, brainstem and supranuclear connections. Aims: This observational study explores peripheral and central sensitization in patients undergoing percutaneous ONS. Methods: Following local regulatory approval, 13 patients undergoing ONS with dual Octrode 90 cm leads and rechargeable implantable pulse generator (IPG) (St Jude) were recruited to have quantitative sensory testing (QST) pre- and post-procedure 2 weeks, 1, 3, 6 and 12 months. Results: Patients with intractable migraine demonstrated impaired CPM (mean baseline pressure pain thresholds (PPTs): 61.98 kPa vs 48.01 kPa cuff inflated) prior to ONS, reverting to an efficient CPM response within 2 weeks following ONS implant (68.9 kPa vs 104.5 kPa cuff inflated) and continuing positively over the next 12 months. In contrast, no statistical difference was observed in PPTs. Conclusion: This is the first reported observation highlighting the effects on central sensitization following ONS. A consistent and sustained improvement in CPM was observed in contrast to PPT’s where there was no difference. Normalisation of the CPM response following ONS indicates that the treatment may reduce central sensitization in the migraine population.
Baseline endometriosis-associated pain burden: Data from 1600+ women enrolled in elagolix clinical trials
Authors: Leyland Nicholas , Estes Stephanie J , Eichner Samantha , Soliman Ahmed M , Mai Yabing , Snabes Michael C , Taylor Hugh S , Surrey Eric S 
Published: July 2019

Background: The daily pain burden experienced by women with endometriosis has not been well studied. Objective: To characterize baseline pain among women with moderate-to-severe endometriosis-associated pain enrolled in phase 3 studies of elagolix, an oral, nonpeptide gonadotropin-releasing hormone antagonist. Study design: Data were pooled from the screening phase of two randomized, double-blind, placebo-controlled clinical trials. After cessation of endometriosis medications, patients entered the screening phase during which symptoms (dysmenorrhea, nonmenstrual pelvic pain, and dyspareunia) and rescue medication use were recorded daily in electronic diaries. Endometriosis-associated pain was also scored using the Numeric Rating Scale (range 0–10). Baseline was defined as the last 35 days during the screening period. Results: Endometriosis-associated pain was reported by the 1686 study participants on most days during the baseline interval. Pain was often moderate or severe, with a mean Numeric Rating Scale score of 5.6 ± 1.7. Women reported dysmenorrhea an average of 8.1 ± 3.0 days (97.9% ± 7.0% of menstruating days), nonmenstrual pelvic pain on 20.5 ± 5.4 days (90.3% ± 15.8% of nonmenstruating days), and dyspareunia on 8.7 ± 8.0 days (81.7% ± 29.7% of sexually active days). When they occurred, dysmenorrhea, nonmenstrual pelvic pain, and dyspareunia were frequently moderate or severe in intensity. Women were free of pelvic pain for an average of 2.4 ± 3.9 days during the 35-day evaluation interval. Conclusion: Among women with untreated moderate-to-severe endometriosis pain, the daily burden of pain was extensive, both during menstruation and on nonmenstruating days.