bluuebunny/crossref_metadata_2025_split huggingface dataset:
What interventions are performed in daily practice to prevent surgical site infections in neurosurgical patients? Findings from an explorative survey
Authors: Moreale Renzo , Doretto Mara , Maccherozzi Milena , Marangone Rosj , Noacco Massimo , Paiani Alex , Razzini Cristina , Rizzi Giulia , Romano Alessia , Sbrizzai Quinto , Simeoni Irene , Palese Alvisa 
Published: June 2018

Aim The primary aim of the study was to describe the perioperative care ensured on a daily basis to prevent surgical site infection in Italian neurosurgeries; the secondary aim was to explore surgical site infections 30 days after the surgical procedures. Methods Patients cared for in 16 neurosurgical units who (a) were ≥18 years of age, (b) underwent neurosurgical procedures, and (c) were willing to participate in the study were taken into account. Results A total of 383 patients were included. A preoperative shower was performed in 332 cases (86.7%), shaving in 318 (83%) cases, and antibiotic prophylaxis was administered in 293 (76.5%) cases. Surgical site disinfection was performed mainly with povidone–iodine (344; 89.8%). A surgical site dressing was applied in 376 (98.2%) cases and was changed on average after 37.8h for shaved and 39h for non-shaved patients. Postoperative shampooing was performed only in 74 (19.3%) cases. Surgical site infection at 30 days occurred in three (0.8%) patients. Discussion and conclusions: Perioperative care aimed at preventing surgical site infections is variable across Italian neurosurgical units. More studies aimed at developing evidence capable of supporting decision-making processes in neurosurgery care are strongly recommended.
Combined walking outcome measures identify clinically meaningful response to prolonged-release fampridine
Authors: Sola-Valls Núria , Blanco Yolanda , Sepúlveda María , Llufriu Sara , Martínez-Lapiscina Elena H. , Zubizarreta Irati , Pulido-Valdeolivas Irene , Montejo Carmen , Villoslada Pablo , Saiz Albert 
Published: June 2018

Background: Gait impairment is common in multiple sclerosis (MS) and negatively impacts patients’ health-related quality of life (HRQoL). Prolonged-release fampridine (PR-fam) improves walking speed, but it is unclear which walking measures are the most suitable for identifying treatment response. Our aim was to assess the effect of PR-fam and the outcome measures that best identify short- and long-term clinically meaningful response. Methods: We conducted a prospective study in 32 MS patients treated with PR-fam for a year. The assessments at 2 weeks, 3, 6 and 12 months included: timed 25-foot walk (T25FW), 6-minute walk test (6MWT), MS Walking Scale-12 (MSWS-12), a five-level version of the EuroQoL-5 dimensions, and accelerometry. PR-fam response was defined as an improvement in T25FW ⩾20%. Results: Twenty-five (78%) patients were considered responders after 2 weeks of PR-fam and improved significantly in all measures. Responders to T25FW and MSWS-12 ( n = 19) showed a significant improvement in HRQoL and accelerometer data compared with responders only to T25FW ( n = 6). At 1 year, 15/20 (75%) patients remained responders, but only those with permanent response to T25FW and MSWS-12 ( n = 8; 53%) showed a significant improvement in 6MWT and HRQoL. Conclusion: The combination of T25FW and MSWS-12 identify better those patients with a clinically significant benefit of PR-fam.
Muscle-sparing pedicled transverse rectus abdominis myocutaneous flaps for breast reconstruction: Combining benefits of both worlds
Authors: Wu Yijun , Ho Samuel Yew Ming 
Published: June 2018

Background: Breast reconstruction plays a vital role in the restoration of form post-mastectomy. Autologous breast reconstructions using both free as well as pedicled flaps form the bulk of the breast reconstruction in our centre. Objective: This study seeks to evaluate the muscle-sparing modification of the pedicled transverse rectus abdominis myocutaneous (MS-TRAM) flaps against conventional transverse rectus abdominis myocutaneous (TRAM) flaps, in an attempt to marry the benefits of both and minimise the drawbacks of each technique. Patients and methods: A retrospective analysis of 20 women, 10 of whom had undergone unilateral immediate breast reconstruction with pedicled MS-TRAM flaps after skin-sparing mastectomy (MS group), and 10 who had undergone the conventional pedicled TRAM flap (control group) by the same surgeon (S. Ho) over a two-year period from 2013 to 2015 was performed. Patients’ records were reviewed, assessing patient demographics including age, smoking status and evaluating the operative time, time to ambulation, length of hospital stay, pain scores and abdominal bulge rates. Results: Mean operative time was not significantly longer in the MS group. Pain scores were lower in the MS group. The length of hospital stay was not significantly different between the two groups. Abdominal bulge rates at 24 months postoperatively were 0% in the MS group patients and 10% in the control group. Conclusion The pedicled MS-TRAM flap is an excellent breast reconstruction option that is comparable to the conventional TRAM flap. It preserves innervated muscle in the donor site that reduces time to ambulation and postoperative pain. It does not add significantly to surgical time and does not require microvascular anastomosis.
Surgical Correction of Spinopelvic Instability in Children With Caudal Regression Syndrome
Authors: Vissarionov Sergei , Schroder Josh E. , Kokushin Dmitrii , Murashko Vladislav , Belianchikov Sergei , Kaplan Leon 
Published: June 2018

Study Design: Retrospective cohort. Objective: To analyze the outcome of surgical correction of children with caudal regression syndrome. Methods: The study included 12 patients aged 1.5 to 9 years with caudal regression syndrome. In order determine the type of caudal regression, the Renshaw Classification was used. The surgery included correction and stabilization of the kyphotic deformity at the unstable lumbosacral region, with reconstruction of the sagittal balance using a bony block constructed from allograft. Short- and long-term outcomes were evaluated. The study was approved by the local institutional review board. Results: Children with types III and IV caudal regression syndrome underwent spinal-pelvic fusion, with 100% fusion rate, which allows sufficient stabilization of the lumbopelvic segment permitting patient mobilization and standing in type III patients. There were 5 complications needing additional care. Conclusion: Multilevel pedicular screw fixation in combination with spinopelvic fusion with cortical allografts allows reconstruction of the sagittal alignment with solid bony fusion improving the quality of life for these patients.
A Comparison of Two Ovine Lumbar Intervertebral Disc Injury Models for the Evaluation and Development of Novel Regenerative Therapies
Authors: Daly Chris D. , Ghosh Peter , Badal Tanya , Shimmon Ronald , Jenkin Graham , Oehme David , Cooper-White Justin , Sher Idrees , Chandra Ronil V. , Goldschlager Tony 
Published: June 2018

Study Design: Large animal research. Objective: Lumbar discectomy is the most commonly performed spinal surgical procedure. We investigated 2 large animal models of lumbar discectomy in order to study the regenerative capacity of mesenchymal stem cells following disc injury. Methods: Twelve adult ewes underwent baseline 3-T magnetic resonance imaging (MRI) followed by lumbar intervertebral disc injury by either drill bit (n = 6) or annulotomy and partial nucleotomy (APN) (n = 6). Necropsies were performed 6 months later. Lumbar spines underwent 3-T and 9.4-T MRI prior to histological, morphological and biochemical analysis. Results: Drill bit-injured (DBI) and APN-injured discs demonstrated increased Pfirrmann grades relative to uninjured controls ( P < .005), with no difference between the 2 models. Disc height index loss was greater in the APN group compared with the DBI group ( P < .005). Gross morphology injury scores were higher in APN than DBI discs ( P < .05) and both were higher than controls ( P < .005). Proteoglycan was reduced in the discs of both injury models relative to controls ( P < .005), but lower in the APN group ( P < .05). Total collagen of the APN group disc regions was higher than DBI and control discs ( P < .05). Histology revealed more matrix degeneration, vascular infiltration, and granulation in the APN model. Conclusion: Although both models produced disc degeneration, the APN model better replicated the pathobiology of human discs postdiscectomy. We therefore concluded that the APN model was a more appropriate model for the investigation of the regenerative capacity of mesenchymal stem cells administered postdiscectomy.
Clinical Outcomes After the Nonoperative Management of Lateral Patellar Dislocations: A Systematic Review
Authors: Moiz Munim , Smith Nick , Smith Toby O. , Chawla Amit , Thompson Peter , Metcalfe Andrew 
Published: June 2018

Background: The first-line treatment for patellar dislocations is often nonoperative and consists of physical therapy and immobilization techniques, with various adjuncts employed. However, the outcomes of nonoperative therapy are poorly described, and there is a lack of quality evidence to define the optimal intervention. Purpose: To perform a comprehensive review of the literature and assess the quality of studies presenting patient outcomes from nonoperative interventions for patellar dislocations. Study Design: Systematic review; Level of evidence, 4. Methods: The MEDLINE, AMED, Embase, CINAHL, Cochrane Library, PEDro, and SPORTDiscus electronic databases were searched through July 2017 by 3 independent reviewers. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Study quality was assessed using the CONSORT (Consolidated Standards for Reporting Trials) criteria for randomized controlled trials and the Newcastle-Ottawa Scale for cohort studies and case series. Results: A total of 25 studies met our inclusion criteria, including 12 randomized controlled trials, 7 cohort studies, and 6 case series, consisting of 1066 patients. Studies were grouped according to 4 broad categories of nonoperative interventions based on immobilization, weightbearing status, quadriceps exercise type, and alternative therapies. The most commonly used outcome measure was the Kujala score, and the pooled redislocation rate was 31%. Conclusion: This systematic review found that patient-reported outcomes consistently improved after all methods of treatment but did not return to normal. Redislocation rates were high and close to the redislocation rates reported in natural history studies. There is a lack of quality evidence to advocate the use of any particular nonoperative technique for the treatment of patellar dislocations.
Arthroscopic-Assisted Latissimus Dorsi Tendon Transfer for Massive Rotator Cuff Tears: A Systematic Review
Authors: Memon Muzammil , Kay Jeffrey , Quick Emily , Simunovic Nicole , Duong Andrew , Henry Patrick , Ayeni Olufemi R. 
Published: June 2018

Background: Arthroscopic-assisted latissimus dorsi tendon transfer (LDTT) has shown promising results with good outcomes in patients with massive rotator cuff tears (MRCTs), as reported by individual studies. However, to the best of the authors’ knowledge, no systematic review has been performed to assess the collective outcomes of these individual studies. Purpose/Hypothesis: The primary purpose of this study was to assess patient outcomes after arthroscopic-assisted LDTT for the management of MRCTs. The secondary objectives were to report on the management of MRCTs, including diagnostic investigations, surgical decision making, and arthroscopic techniques, as well as to evaluate the quality of evidence of the existing literature. It was hypothesized that nearly all patients were satisfied with arthroscopic-assisted LDTT and that they experienced improvements in pain symptoms, function, and strength after the procedure, with an overall complication rate of less than 10%. Study Design: Systematic review; Level of evidence, 4. Methods: The databases MEDLINE, Embase, and PubMed were searched from database inception (1946) until August 18, 2017, with titles, abstracts, and full-text articles screened independently by 2 reviewers. Inclusion criteria were English-language studies investigating arthroscopic-assisted LDTT for the management of MRCTs on patients of all ages. Conference papers, book chapters, review articles, and technical reports were excluded. The quality of the included studies was categorized by level of evidence and the Methodological Index for Non-Randomized Studies (MINORS) checklist. Results: In total, 8 studies (7 case series [median MINORS score, 7 of 16] and 1 prospective comparative study [median MINORS score, 14 of 24]) were identified; the studies included 258 patients (258 shoulders) with MRCTs treated with LDTT using arthroscopic-assisted techniques. The decision to pursue surgery was based on both clinical findings and investigations in 5 studies, investigations only in 2 studies, and clinical findings only in 1 study. Overall, 88% of patients were satisfied with the results of surgery and experienced significant improvement in their symptoms, including shoulder pain, strength, range of motion, and overall function, over a mean follow-up period of 34.3 months. Overall, there was a low rate of complications (7%) associated with the procedure. Conclusion: Arthroscopic-assisted LDTT for MRCTs provides patients with marked improvement in shoulder pain, strength, and function, and the procedure is associated with a low risk of complication. Further high-quality comparative studies are warranted to validate these findings in comparison with other operative techniques.
A case of acute myeloid leukemia with promyelocytic features characterized by expression of a novel RARG-CPSF6 fusion
Authors: Miller Christopher A. , Tricarico Christopher , Skidmore Zachary L. , Uy Geoffrey L. , Lee Yi-Shan , Hassan Anjum , O’Laughlin Michelle D. , Schmidt Heather , Tian Ling , Duncavage Eric J. , Griffith Malachi , Griffith Obi L. , Welch John S. , Wartman Lukas D. 
Published: June 2018

Key Points
Novel RARG-CPSF6 fusion in an AML case with promyelocytic features and no evidence of PML-RARA or X-RARA fusion. Gene fusions involving RARG can initiate AML with promyelocytic morphological features.
Reporting data analysis methods in high-impact respiratory journals
Authors: Nieminen Pentti , Toljamo Tuula , Vähänikkilä Hannu 
Published: June 2018

Data analysis methods play an important role in respiratory research. We evaluated the application and complexity of data analytical methods in high-impact respiratory journals and compared the statistical reporting in these respiratory articles with reports published in other eminent medical journals.This study involved a total of 160 papers published in 2015 in theEuropean Respiratory Journal, American Journal of Respiratory and Critical Care Medicine, ChestandThorax, and 680 papers published between 2007–2015 in other medical journals including theLancetandNew England Journal of Medicine. We manually reviewed the articles to determine the way in which they reported the methods applied in data analysis.The statistical intensity in the respiratory journals was equal to that in eminent medical journals. Traditional ways of testing statistical significance were widely used in respiratory articles. Statistical procedures were not always described in sufficient detail, and the prominent respiratory journals did not display different profiles with respect to their statistical content.Readers of the prominent respiratory journals need to possess a substantial level of statistical expertise if they wish to critically evaluate the design, methodology, data analysis and interpretation of the findings published in these journals.
Chest ultrasonography to assess the kinetics and efficacy of talc pleurodesis in a model of pneumothorax: an experimental animal study
Authors: Tazi-Mezalek Rachid , Frankel Diane , Fortin Marc , Kaspi Elise , Guinde Julien , Assolen Alexandra , Laroumagne Sophie , Robaglia Andree , Dutau Herve , Roll Patrice , Astoul Philippe 
Published: June 2018

Talc pleurodesis is used to avoid recurrences in malignant pleural effusions or pneumothorax. The lack of lung sliding detected by chest ultrasonography (CUS) after talc application is indicative of the effectiveness of pleurodesis. The objective of our study was to explore, in an animal model, the capacity of CUS to predict the quality of a symphysis induced by talc poudrage (TP) and talc slurry (TS).We induced an artificial pneumothorax in six healthy pigs prior to talc application. TP was performed on one hemithorax, followed by TS on the other side 1 week later. 108 points on the chest were marked and evaluated by ultrasonography during the study.TP showed higher sonographic scores compared to TS starting from 72 h after talc administration. At autopsy, a higher grade of symphysis was observed for TP, and a high correlation rate was registered between CUS and macroscopic findings. Histological analysis also showed a higher grade of pleural symphysis for TP.CUS is a reliable tool to assess talc pleurodesis. The quality and kinetics of the pleural symphysis are also evaluable by ultrasonography. Pleurodesis by TP is more effective than TS in this experimental model of pneumothorax.
To what extent do mesophotic coral ecosystems and shallow reefs share species of conservation interest? A systematic review
Authors: Laverick Jack H. , Piango Shanice , Andradi-Brown Dominic A. , Exton Dan A. , Bongaerts Pim , Bridge Tom C. L. , Lesser Michael P. , Pyle Richard L. , Slattery Marc , Wagner Daniel , Rogers Alex D. 
Published: June 2018

Abstract
Background
Globally, shallow-water coral reef biodiversity is at risk from a variety of threats, some of which may attenuate with depth. Mesophotic coral ecosystems (MCEs), occurring from 30 to 40 m and deeper in tropical locations, have been subject to a surge of research this century. Though a number of valuable narrative reviews exist, a systematic quantitative synthesis of published MCE studies is lacking. We conducted a systematic review to collate mesophotic research, including studies from the twentieth century to the present. We highlight current biases in research effort, regarding locations and subject matter, and suggest where more attention may be particularly valuable. Following a notable number of studies considering the potential for mesophotic reefs to act as refuges, it is important to know how comprehensive these sources of recruits and organisms capable of moving to shallow water reefs may be.

Methods
We search seven sources of bibliographic data with two search strings, as well as personal libraries. Articles were included if they contained species presence data from both shallower and deeper than 30 m depth on tropical coral reefs. Studies were critically appraised based on the number of species identified and balanced sampling effort with depth. Maximum and minimum depths per species were extracted from each study, along with study region and taxon. We quantified the degree of community overlap between shallow tropical reefs (< 30 m) and reefs surveyed at the same locations below 30 m. Proportions of shallow species, across all studied taxa, observed deeper than 30 m were used to generate log odds ratios and passed to a mixed-effects model. Study location and taxon were included as effect modifiers. Funnel plots, regression tests, fail safe numbers, and analysis of a high validity subgroup contributed to sensitivity analyses and tests of bias.

Results
Across all studies synthesised we found two-thirds of shallow species were present on mesophotic reefs. Further analysis by taxon and broad locations show that this pattern is influenced geographically and taxonomically. Community overlap was estimated as low as 26% and as high as 97% for some cases.

Conclusions
There is clear support for the hypothesis that protecting mesophotic reefs will also help to conserve shallow water species. At the same time, it is important to note that this study does not address mesophotic-specialist communities, or the ecological forces which would permit refuge dynamics. As we limit our analysis to species only present above 30 m it is also possible diversity found exclusively deeper than 30 m warrants protection in its own right. Further research into relatively ignored taxa and geographic regions will help improve the design of protected areas in future.
Sheltering archaeological sites in Malta: lessons learnt
Authors: Cassar JoAnn , Cefai Shirley , Grima Reuben , Stroud Katya 
Published: June 2018

Abstract
The purpose of this paper is to review the performance of the protective shelters installed over three archaeological sites in Malta over the past decade, and to draw some key lessons learnt that may be useful to others when considering whether to adopt a similar solution. The conservation threats to the Megalithic Temples of Malta are introduced and defined—these range from material issues (loss of surface) to structural issues (cracking and dislodgement of stones leading to structural instability and collapses). Causes identified specifically included fluctuating environmental conditions: wetting and drying cycles and thermal fluctuations, combined with the salt-laden Mediterranean island environment. The recognition during the late twentieth century of these issues as key factors in the deterioration of these structures, and the strategy that was developed in response, are outlined. A key component of this strategy was the installation of protective shelters over three of the main megalithic sites. The process through which the design requirements for the shelters were defined is reviewed. The performance of the shelters is then examined, through a critical review of unpublished reports and published studies. An evidence-based summary of the beneficial effects of the shelters is provided, and the possibility of any harmful effects discussed. A number of lessons learnt through this process are then identified. One key lesson is that the microenvironment in a newly-sheltered site is at a transitional stage that does not necessarily reflect longer-term trends, which therefore require long-term monitoring to be understood. The choice and number of environmental parameters to be monitored need to be informed by a careful consideration of their sustainability, both in terms of equipment and human resources. Any monitoring programme, however well-designed, needs to be open to re-evaluation and revision where needed. As more experience and data are accumulated from different sheltering projects, it will become more feasible to establish performance indicators in advance of a sheltering intervention, on the basis of which to evaluate its performance. The experience of these projects is then used to inform a checklist of key considerations for anyone considering whether to shelter an archaeological site. The foremost consideration is that every site requires a site-specific strategy tailored to its needs. The decision whether a shelter is desirable, and what its performance requirements should be, may only be taken in the context of such a strategy. This paper should help define the parameters for such a decision to take place.