bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaginal Progesterone Is as Effective as Cervical Cerclage to Prevent Preterm Birth in Women With a Singleton Gestation, Previous Spontaneous Preterm Birth, and a Short Cervix: Updated Indirect Comparison Meta-analysis
Authors: Conde-Agudelo Agustin , Romero Roberto , Da Fonseca Eduardo , O'Brien John M. , Cetingoz Elcin , Creasy George W. , Hassan Sonia S. , Erez Offer , Pacora Percy , Nicolaides Kypros H. 
Published: December 2018

(Abstracted from Am J Obstet Gynecol 2018;219(1):10–25)
It is widely accepted that preterm birth is a syndrome caused by several pathological processes such as infection, vascular and decidual disorders, uterine overdistension, breakdown of maternal fetal tolerance, a decline in progesterone action, and cervical disease. A previous spontaneous preterm birth is a well-known risk factor for recurrent spontaneous preterm delivery.
Repeat Antenatal Betamethasone and Cardiometabolic Outcomes
Authors: Cartwright Robert D. , Harding Jane E. , Crowther Caroline A. , Cutfield Wayne S. , Battin Malcolm R. , Dalziel Stuart R. , McKinlay Christopher J. D. 
Published: December 2018

(Abstracted from Pediatrics 2018;142(1):e20180522)
Antenatal corticosteroid therapy is one of the most effective interventions for preterm birth, resulting in rapid maturation of fetal organ systems. The Australasian Collaborative Trial of Repeat Doses of Steroids (ACTORDS) revealed that neonatal benefit is greatest when antenatal corticosteroids are administered in repeat doses, which can be used to reduce the incidence and severity of preterm lung disease and other serious neonatal morbidity, with absolute benefits similar to that of an initial course of antenatal corticosteroids.
Radiation Prophylaxis for Hip Salvage Surgery in Cerebral Palsy: Can We Reduce the Incidence of Heterotopic Ossification?
Authors: Davis Eric , Williams Kathryn , Matheney Travis H. , Snyder Brian , Marcus Karen J. , Shore Benjamin J. 
Published: December 2018

Background:
Heterotopic ossification (HO) is a well-recognized complication of proximal femoral resection (PFR) surgery in children with cerebral palsy (CP). Although single-dose radiation prophylaxis (SDRP) has been shown to be effective at lowering the rates of HO following adult total hip arthroplasty; there has been limited study examining the efficacy of SDRP for HO prevention in children with CP undergoing PFR. The purpose of this study was to assess the efficacy of SDRP in children with CP undergoing PFR.

Methods:
This retrospective case control series identified all patients from one tertiary children's hospital undergoing PFHR. Patients were dichotomized into (1) SDRP and (2) non-SDRP groups. In SDRP, radiation was delivered preoperatively at a dose of 7.5 Gy utilizing a 6 MV photon beam. The incidence of HO in the SDRP cohort was compared to historic data using binomial testing. The size of HO lesions was compared using Wilcoxon signed-rank test. McCarthy, Brooker, and Anatomic Classifications of HO were compared using repeated measures logistic regression.

Results:
Twenty-three patients (mean age, 15.5) and 35 hips (17 SDRP, 18 Non-SDRP) were included in the analysis. There were 17 females and 6 males in the cohort with the majority classified as GMFCS V, 21/23 (91%). HO was seen in 6 of the SDRP cohort (6/17, 35%) and 15 of the non-SDRP cohort (15/18, 83%) (P=0.015). The average size of HO at maturity was 282.7 mm2 in the SDRP cohort compared with 1221.5 mm2 in the Non-SDRP cohort (P=0.026). Radiation treatment was associated with a 938.9 mm2 decrease in HO size at maturity (P= 0.026). Multivariate repeated measures logistic regression analysis found that non-SDRP hips had 13 times higher odds of developing HO (P=0.015). There were no significant differences in infection rates between the 2 cohorts and there were no radiation-associated complications.

Conclusions:
Short-term follow up demonstrates that SDRP is a safe and efficacious intervention in decreasing the incidence and size of HO in children with CP undergoing PFR.

Levels of Evidence:
Level III—Case control cohort study.
Benefit of Mohs Micrographic Surgery Over Wide Local Excision for Melanoma of the Head and Neck: A Rational Approach to Treatment
Authors: Demer Addison M. , Vance Karl K. , Cheraghi Nikoo , Reich Hilary C. , Lee Peter K. 
Published: December 2018

BACKGROUND
There are limited published data comparing wide local excision (WLE) with Mohs micrographic surgery (MMS) for the treatment of melanoma.

OBJECTIVE
To describe a novel treatment algorithm for the surgical management of head and neck melanoma and compare rates of local recurrence for tumors treated with either MMS using immunohistochemistry or WLE.

MATERIALS AND METHODS
A 10-year retrospective chart review including all in situ and invasive melanomas of the head and neck treated at one institution from January 2004 to June 2013.

RESULTS
Among 388 patients with melanoma, MMS was associated with decreased rates of local recurrence (p = .0012). However, patient and tumor characteristics varied significantly, and WLE subgroup was largely composed of higher stage and risk tumors. Subgroup analysis found that patients with in situ or thin invasive tumors (<0.8 mm) treated with MMS had improved local recurrence outcomes (p = .0049), despite more frequent tumor location on high risk anatomic sites (e.g., central face). In addition, MMS was associated with a favorable delay in time to local recurrence among in situ tumors (HR = 31.8; p = .0148).

CONCLUSION
These findings further support the use of MMS for treatment of melanoma of the head and neck and help to validate our proposed clinical decision tree.
A Survey of Mohs Tissue Tracking Practices
Authors: Dietert Jessica B. , MacFarlane Deborah F. 
Published: December 2018

BACKGROUND
There are little data regarding error within the multistep process of Mohs micrographic surgery (MMS).

OBJECTIVE
A survey of Mohs surgeons was performed to evaluate variation in tissue handling and processing within the MMS process.

METHODS AND MATERIALS
A 9-question electronic survey was distributed to members of the American College of Mohs Micrographic Surgery. A total of 97 responses were analyzed.

RESULTS
Most surgeons personally transport the tissue (71.1%), most frequently in a specimen container (54.6%). Method of tissue identification during transportation varied significantly. Most surgeons personally hand-draw the map (77.1%). A diagram was most commonly used to convey tissue orientation to the histotechnician (65.4%). Only 31.3% of histotechnicians used labeling of blocks to identify tissue within the cryostat. Most respondents (72.2%) are the only surgeon processing tissue in the laboratory at one time; however, 28.9% reported performing 10 or more cases per day.

CONCLUSION
Most respondents are responsible for tissue transport and mapping, which likely reduces potential error. However, the method of transport and labeling, as well as identification by the histotechnician, was more variable. Ultimately, having a consistent process and clear communication with personnel will help reduce potential error during Mohs surgery.
Mammary Analogue Secretory Carcinoma Arising in the Parotid Gland of Child
Authors: Shigeta Rie , Orgun Doruk , Mizuno Hiroshi , Hayashi Ayato 
Published: December 2018

Summary:
Mammary analogue secretory carcinoma (MASC) of salivary glands is a newly recognized tumor entity. We report a child who was initially diagnosed with lymphangioma and referred to our institute for sclerotherapy, only to find out that the tumor was in fact MASC after excision. This case of MASC is in a 7-year-old boy, the youngest case so far reported. He referred to his primary care physician with a infra-auricular swelling, and it was diagnosed as lymphatic malformation he was referred to our institution for sclerotherapy. For Doppler and ultrasound magnetic resonance imaging, there was a distinct cystic lesion with a heterogeneous solid lesion inside. Minimally invasive treatment such as sclerotherapy was thought to be more desirable due to a pediatric case, the risk of postoperative facial paralysis and scar. However, even the successful treatment of cystic lesion with sclerotherapy, solid lesion of the tumor could be remained without pathological findings. Otolaryngologist also thought the importance of pathological diagnosis, and we finally chose surgical excision. The tumor was ultimately diagnosed as MASC considering histological and genetic findings. For child case, we tend to treat patient less invasively, and it might bring a risk of MASC being incorrectly treated nonsurgically such as with sclerotherapy. This could lead to tumor progression and wider radical excision at last. We believe that histological diagnosis should become the priority in similar cases of mixed solid and cystic tumors to avoid incorrect treatment, and we need to choose surgical excision by understanding the character of salivary gland tumor occurring in childhood.
Beyond 30 Days: A Risk Calculator for Longer Term Outcomes of Prosthetic Breast Reconstruction
Authors: Blough Jordan T. , Vu Michael M. , Qiu Cecil S. , Mlodinow Alexei S. , Khavanin Nima , Fine Neil A. , Kim John Y. S. 
Published: December 2018

Background:
Despite growing use of surgical risk calculators, many are limited to 30-day outcomes due to the constraints of their underlying datasets. Because complications of breast reconstruction can occur well beyond 30 days after surgery, we endeavored to expand the Breast Reconstruction Risk Assessment (BRA) Score to prediction of 1-year complications after primary prosthetic breast reconstruction.

Methods:
We examined our prospective intrainstitutional database of prosthetic breast reconstructions from 2004 to 2015. Patients without 1-year follow-up were excluded. Pertinent patient variables include those enumerated in past iterations of the BRA Score. Outcomes of interest include seroma, surgical site infection (SSI), implant exposure, and explantation occurring within 1 year of tissue expander placement. Risk calculators were developed for each outcome using multivariate logistic regression models and made available online at www.BRAScore.org. Internal validity was assessed using C-statistic, Hosmer-Lemeshow test, and Brier score.

Results:
Nine-hundred three patients met inclusion criteria. Within 1-year, 3.0% of patients experienced seroma, 6.9% infection, 7.1% implant exposure, and 13.2% explantation. Thirty-day, 90-day, and 180-day windows captured 17.6%, 39.5%, and 59.7% of explantations, respectively. One-year risk calculators were developed for each complication of interest, and all demonstrated good internal validity: C-statistics for the 5 models ranged from 0.674 to 0.739, Hosmer-Lemeshow tests were uniformly nonsignificant, and Brier scores ranged from 0.027 to 0.154.

Conclusions:
Clinically significant complications of prosthetic breast reconstruction usually occur beyond the 30-day window following tissue expander placement. To better reflect long-term patient experiences, the BRA Score was enhanced with individualized risk models that predicted 1-year complications after prosthetic reconstruction (BRA Score XL). All models performed as well as, if not better than, the original BRA Score models and other popular risk calculators such as the CHA2DS2VASc Score. The patient-friendly BRA Score XL risk calculator is available at www.brascore.org to facilitate operative decision-making and heighten the informed consent process for patients.
NEW PROPOSAL FOR THE PATHOPHYSIOLOGY OF TYPE 3 NEOVASCULARIZATION AS BASED ON MULTIMODAL IMAGING FINDINGS
Authors: Spaide Richard F. 
Published: December 2018

Purpose:
To investigate the imaging characteristics of early Type 3 neovascularization and propose a new pathophysiologic sequence for early disease.

Methods:
Patients were evaluated with a comprehensive ophthalmologic examination to include fundus photography, optical coherence tomography, optical coherence tomography angiography, fluorescein angiography, and volume-rendered optical coherence tomography angiography. Relevant literature was also reviewed.

Results:
There were 10 eyes of 9 patients who had a mean age of 87 (range 79–93) years and 7 were women. The patients were seen to have distributed areas of cystoid macular edema, not necessarily contiguous with areas of fluorescein or optical coherence tomography angiographic evidence of neovascularization, which colocalized with each other. Areas of hemorrhage were not necessarily contiguous with observed neovascularization. In some patients, massive amounts of edema were imaged, although the associated neovascular invasion was small and did not reach deeper portions of the retina. These findings were readily responsive to intravitreal injections of anti–vascular endothelial growth factor (VEGF) medication. Review of published literature showed conflicting pathophysiologic proposals, which did not abide with contemporaneous imaging findings.

Conclusion:
Type 3 neovascularization likely grows in response to increased cytokine levels, particularly VEGF, in a permissive environment. Elevated levels of VEGF have been shown to cause hemorrhage, edema, and telangiectasis in the macula, suggesting some of the manifestations of Type 3 neovascularization are related to increased tissue VEGF levels and not necessarily to the neovascularization alone. A proposal based on imaging and histopathologic findings and known physiologic effects of VEGF is presented.
Fourier Analysis of Corneal Irregular Astigmatism Due to the Anterior Corneal Surface in Dry Eye
Authors: Koh Shizuka , Maeda Naoyuki , Ogawa Mai , Asonuma Sanae , Takai Yoshihiro , Maruyama Kazuichi , Klyce Stephen D. , Nishida Kohji 
Published: December 2018

Objectives:
To evaluate corneal irregular astigmatism due to the anterior corneal surface using Fourier harmonic analysis with a Placido ring–based corneal topographer (Placido-based topographer) and three-dimensional anterior segment optical coherence tomography (OCT) in dry eyes.

Methods:
Forty-four eyes of 44 subjects with dry eye and 20 eyes of 20 normal control subjects were enrolled. Corneal topographic data were obtained using a Placido-based topographer and OCT. Dioptric data from the central 3-mm zone of the anterior corneal surface were decomposed using Fourier harmonic analysis. Spherical, regular astigmatism, and irregular astigmatism (asymmetry and higher-order irregularity) refractive error components of the cornea from the two imaging modalities were compared.

Results:
Both asymmetry and higher-order irregularity values were significantly greater in dry eyes than in control eyes for both the Placido-based topographer and OCT measurements (all P<0.05). In dry eyes, measured values of asymmetry and higher-order irregularities were significantly smaller when obtained with OCT than with the Placido-based topographer (both P<0.001). By contrast, these parameters were not significantly different between the two devices in control eyes. In dry eyes, severity of superficial punctate keratopathy in the central corneal region was correlated with irregular astigmatism.

Conclusions:
The amount of corneal irregular astigmatism, quantified using Fourier harmonic analysis, was significantly higher in dry eyes than in normal eyes. Measurements obtained with OCT and the Placido-based topographer differed in subjects with dry eyes. Therefore, caution should be practiced when trying to use these measurements interchangeably.
Economic Science in Lower-Limb Prosthetic Rehabilitation: The Consumer’s Perspective
Authors: Richmond Jack 
Published: December 2018

ABSTRACT
Prosthetic care for people living with limb loss has proved to be one of the most rehabilitative technologies in medicine. Many who have received lower-limb prosthetic care are living lives considered to be completely ordinary to highly extraordinary.
From the consumer’s perspective, the question of the economic value of prosthetic care is, “To what degree will this prosthetic care help to restore my mobility, my confidence, and my ability to live my life as I choose?”
Developing the tools that will provide better answers to this value question is not easy, but it is essential to the future of prosthetic care in an era of rapidly increasing technology and health care cost. Multiple tools to measure outcomes already exist; the key is adapting them to patient-centric models that identify value to patients, providers, and payers.
The purpose of this article is to present the consumer’s perspective on the economic value of prosthetic care through a better understanding of patient expectations and to encourage more patient-centered over device-centered research.
Economic Value of Prosthetic Services among Medicare Beneficiaries: A Claims-Based Retrospective Cohort Study
Authors: Dobson Allen , El-Gamil Audrey , Shimer Matt , DaVanzo Joan E. 
Published: December 2018

ABSTRACT

Context
There are few studies of the economic impact or value of lower extremity prosthetic services. Results from this study can inform the value proposition concerning prosthetic services within military health, where over 40,000 Veterans with limb-loss receive care for their amputations through the Veterans Administration health care system.

Purpose
To determine the extent to which Medicare patients who received selected prosthetic services had less health care utilization, lower Medicare payments, and/or fewer negative outcomes compared to matched patients not receiving these services.

Methods
This retrospective cohort analysis using Medicare claims data (2007–2010) and propensity score matching techniques to control for observable selection bias based on etiological diagnosis, comorbidities, patient characteristics, and historical health care utilization one year before the etiological diagnosis. Findings: Patients who received lower extremity prostheses had comparable Medicare episode payments ($6,099 per-member-per-month for study group, $6,015 per-member-per-month for comparison group) and better outcomes than patients who did not receive prostheses. Study group patients were more likely to receive extensive outpatient therapy than comparison group patients ( P < 0.05). Receiving physical therapy is associated with fewer hospitalizations and emergency room visits, and less facility-based care ( P < 0.05), essentially offsetting the cost of the prosthetic over a 12-month time frame.
Postural Control Deficits After Repetitive Soccer Heading
Authors: Caccese Jaclyn B. , Buckley Thomas A. , Tierney Ryan T. , Rose William C. , Glutting Joseph J. , Kaminski Thomas W. 
Published: December 2018

Objective:
To determine the acute effects of repetitive soccer heading on postural control.

Design:
Prospective study; participants were divided into 2 groups: a soccer heading group and a control group.

Setting:
Biomechanics laboratory.

Participants:
One hundred sixty participants, including youth (age = 13.0 ± 0.8 years), high school (age = 17.2 ± 1.0 years), and collegiate (age = 20.2 ± 1.3 years) male and female soccer players, participated in this study.

Interventions:
Participants in the soccer heading group performed 12 soccer headers (initial velocity = 11.2 m/s). Postural control testing was performed both before (PRE) and immediately after (POST) the purposeful soccer headers. Control participants performed postural control testing PRE and POST a 15-minute wait period. During postural control testing, participants were asked to stand on the MobileMat (Tekscan Inc, Boston, Massachusetts) for two 2-minute intervals with their hands on their hips and their feet together with one eyes-open and one eyes-closed trial.

Main Outcome Measures:
Using the center-of-pressure data, 95% area, sway velocity, and ApEn were calculated. Multilevel linear models were used to analyze the effects of age, sex, group, condition, and concussion history simultaneously.

Results:
Participants in the soccer heading group had significantly higher sway velocity POST than participants in the control group after controlling for age, sex, concussion history, condition, and PRE (t = −3.002; P = 0.003; 95% confidence interval, −0.482 to −0.100). There were no significant differences from PRE to POST for 95% area, M/L ApEn, and A/P ApEn.

Conclusions:
Repetitive soccer heading does not affect most postural control measures, even among youth athletes. However, sway velocity increased after heading relative to control participants independent of age, sex, and concussion history.
Effective But Not Adhered to: How Can We Improve Adherence to Evidence-Based Hamstring Injury Prevention in Amateur Football?
Authors: van der Horst Nick , Hoef Sander van de , Otterloo Paul van , Klein Milan , Brink Michel , Backx Frank 
Published: December 2018

Objectives:
To investigate adherence to a Nordic hamstring exercise (NHE) program in a real-world context of male amateur football, and the perceptions of end users (players) and intervention deliverers (coaches and medical staff) about adherence to this proven effective program.

Design:
Retrospective cohort study.

Setting:
Dutch amateur football.

Participants:
Two hundred sixty-four players, 23 coaches, and 29 medical staff from Dutch amateur football teams that participated in a national randomized controlled trial 2 years earlier.

Independent Variables:
Nordic hamstring exercise program.

Main Outcome Measures:
Nordic hamstring exercise program adherence during 2014 and 2015. Intervention or control group allocation during the trial, transfers, and personal perception about adherence to the program were also examined.

Results:
Of all players, 69% reported never, 16% sometimes, 6% frequently, 5% often, and 4% always performing exercises of the NHE program. Adherence to the NHE program was higher among players who had been in the NHE arm of the previous trial and among players who had not been transferred to another club compared with players who had been transferred. Key factors in stimulating players to adhere to the NHE program were knowledge of the NHE and personal motivation. Coaches and medical staff members also mentioned personal motivation and consensus with team staff as key factors to encourage NHE adherence.

Conclusions:
Among high-level male amateur football players, adherence to an evidence-based hamstring injury-prevention program was very low. It is essential to recognize factors that stimulate or limit adherence to injury-prevention programs for effective programs to actually lead to a reduction in hamstring injuries in a real-world context.