bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global Typhoid Fever Incidence: A Systematic Review and Meta-analysis
Authors: Marchello Christian S , Hong Chuen Yen , Crump John A 
Published: December 2018

AbstractBackgroundContemporary incidence estimates of typhoid fever are needed to guide policy decisions and control measures and to improve future epidemiological studies.MethodsWe systematically reviewed 3 databases (Ovid Medline, PubMed, and Scopus) without restriction on age, country, language, or time for studies reporting the incidence of blood culture–confirmed typhoid fever. Outbreak, travel-associated, and passive government surveillance reports were excluded. We performed a meta-analysis using a random-effects model to calculate estimates of pooled incidence, stratifying by studies that reported the incidence of typhoid fever and those that estimated incidence by using multipliers.ResultsThirty-three studies were included in the analysis. There were 26 study sites from 16 countries reporting typhoid cases from population-based incidence studies, and 17 sites in 9 countries used multipliers to account for underascertainment in sentinel surveillance data. We identified Africa and Asia as regions with studies showing high typhoid incidence while noting considerable variation of typhoid incidence in time and place, including in consecutive years at the same location. Overall, more recent studies reported lower typhoid incidence compared to years prior to 2000. We identified variation in the criteria for collecting a blood culture, and among multiplier studies we identified a lack of a standardization for the types of multipliers being used to estimate incidence.ConclusionsTyphoid fever incidence remains high at many sites. Additional and more accurate typhoid incidence studies are needed to support country decisions about typhoid conjugate vaccine adoption. Standardization of multiplier types applied in multiplier studies is recommended.
The hospital results and 1-year outcomes of transcatheter aortic valve-in-valve procedures and transcatheter aortic valve implantations in the native valves: the results from the Swiss-TAVI Registry
Authors: Ferrari Enrico , Stortecky Stefan , Heg Dik , Muller Olivier , Nietlispach Fabian , Tueller David , Toggweiler Stefan , Noble Stéphane , Maisano Francesco , Roffi Marco , Jeger Raban , Grünenfelder Jürg , Huber Christoph , Windecker Stephan , Wenaweser Peter 
Published: December 2018

Abstract

OBJECTIVES
The SwissTAVI Registry includes all consecutive patients undergoing transcatheter aortic valve implantation (TAVI) and valve-in-valve (VinV) procedures for a failed bioprosthesis in Switzerland. We report the real world, all-comers, 30-day and 1-year outcomes of patients undergoing VinV and standard TAVI procedures.

METHODS
Prospectively collected data from the 2 groups (VinV and standard TAVI patients) were retrospectively analysed. In an adjusted analysis, in-hospital and 1-year outcomes of VinV patients were compared with those of patients undergoing TAVI for native aortic valve disease in the same registry. A subanalysis of VinV procedures in stenotic or regurgitant bioprosthesis was also performed.

RESULTS
Between February 2011 and December 2016, 4599 and 157 consecutive patients underwent TAVI in native aortic valves and VinV procedures in degenerate bioprosthesis, respectively. VinV patients were younger (78 ± 9.1 years vs 82.2 ± 6.3 years; P < 0.001) but at a higher risk for surgery (the logistic EuroSCORE: 28.48 ± 15.3% vs 18.2 ± 13.6%; P < 0.001; the Society of Thoracic Surgery (STS) score: 6.4 ± 5% vs 5.5 ± 4.3%; P = 0.008). Valve predilatation was less frequently performed during VinV procedures (22.9% vs 69.1%; P < 0.001), and the hospital stay was shorter after VinV procedure (8.46 ± 4.2 days vs 9.83 ± 6 days; P = 0.005). VinV patients showed higher predischarge transvalvular mean gradients (14.14 ± 7.9 mmHg vs 8.42 ± 5.0 mmHg; P < 0.001), smaller mean valve surface area (1.54 ± 0.7 cm2 vs 1.83 ± 0.5 cm2; P < 0.001) and a lower risk of moderate/severe paravalvular leak (1.3% vs 5%). Post-procedural kidney injury (1.3% vs 4.8%; P = 0.06) and new pacemakers for conduction abnormalities (3.3% vs 18.5%; P < 0.001) were higher after TAVI. All-cause mortality and cardiovascular mortality at 30 days were similar between the 2 groups (1.9% vs 3.8%; P = 0.242 and 1.9% vs 3.4%; P = 0.321), whereas after 1 year, all-cause mortality was lower for VinV patients (6.8% vs 13%; P = 0.035). The bioprosthetic valve size correlated inversely with postoperative gradients after VinV procedures.

CONCLUSIONS
VinV aortic procedures showed favourable 30-day and 1-year clinical outcomes compared with TAVI procedures for the native aortic valve disease. Despite higher transvalvular mean gradients following VinV implants, this appears not to impact the early clinical outcomes.
The effect of interactions between proteinuria, activity of fibroblast growth factor 23 and serum phosphate on renal progression in patients with chronic kidney disease: a result from the KoreaN cohort study for Outcome in patients With Chronic Kidney Disease study
Authors: Kim Hyoungnae , Park Jimin , Nam Ki Heon , Jhee Jong Hyun , Yun Hae-Ryong , Park Jung Tak , Han Seung Hyeok , Chung Wookyung , Oh Kook-Hwan , Park Sue Kyung , Kim Soo Wan , Kang Shin-Wook , Choi Kyu Hun , Ahn Curie , Yoo Tae-Hyun 
Published: December 2018

Abstract

Background
Recent experimental study reported that proteinuria increases serum phosphate by decreasing biologic activity of fibroblast growth factor 23 (FGF-23). We examined this relationship in a large chronic kidney disease (CKD) cohort and evaluated the combined effect of proteinuria, FGF-23 activity and serum phosphate on CKD progression.

Methods
The activity of FGF-23, measured by the fractional excretion of phosphate (FEP)/FGF-23 ratio, was compared according to the degree of proteinuria in 1909 patients with CKD. Primary outcome was CKD progression defined as ≥50% decline of estimated glomerular filtration rate, doubling of serum creatinine and start of dialysis.

Results
There was a negative relationship between 24-h urine protein (24-h UP) and FEP/FGF-23 ratio (γ −0.07; P = 0.005). In addition, after matching variables associated with serum phosphate, patients with more proteinuria had higher serum phosphate (P &lt; 0.001) and FGF-23 (P = 0.012), and lower FEP/FGF-23 ratio (P = 0.007) compared with those with less proteinuria. In the matched cohort, low FEP/FGF-23 ratio was an independent risk factor for CKD progression (hazard ratio 0.87 per 1 log increase; 95% confidence interval 0.79–0.95; P = 0.002), and there was significant interaction between 24-h UP and FEP/FGF-23 ratio (P = 0.039). Furthermore, 24-h UP and serum phosphate also had a significant interaction on CKD progression (P &lt; 0.001).

Conclusions
Proteinuria is associated with decreased biologic activity of FGF-23 and increased serum phosphate. Furthermore, diminished activity of FGF23 is an independent risk factor for renal progression in proteinuric CKD patients.
Limited Dorsal Myeloschisis: Reconsideration of its Embryological Origin
Authors: Kim Joo Whan , Wang Kyu-Chang , Chong Sangjoon , Kim Seung-Ki , Lee Ji Yeoun 
Published: December 2018

ABSTRACT

BACKGROUND
Limited dorsal myeloschisis (LDM) is postulated to be a result of incomplete dysjunction in primary neurulation. However, clinical experience of LDM located below the first-second sacral (S1-S2) vertebral level, which is formed from secondary neurulation (S2-coccyx), suggested that LDM may not be entirely explained as an error of primary neurulation.

OBJECTIVE
To elucidate the location and characteristics of LDM to investigate the possible relation of its pathoembryogenesis to secondary neurulation.

METHODS
Twenty-eight patients were surgically treated for LDM from 2010 to 2015. Since the level where the LDM stalk penetrates the interspinous ligament is most clearly defined on the preoperative MRI and operative field, this level was assessed to find out whether the lesions can occur in the region of secondary neurulation.

RESULTS
Eleven patients (39%) with typical morphology of the stalk had interspinous defect levels lower than S1-S2. These patients were not different from 17 patients with classic LDMs at a level above or at S1-S2. This result shows that other than the low level of the interspinous level, 11 patients had lesions that could be defined as LDMs

CONCLUSION
By elucidating the location of LDM lesions (in particular, the interspinous level), we propose that LDM may be caused by errors of secondary neurulation. The hypothesis seems more plausible due to the supportive fact that the process of separation between the cutaneous and neural ectoderm is present during secondary neurulation. Hence, incomplete disjunction of the two ectoderms during secondary neurulation may result in LDM, similar to the pathomechanism proposed during primary neurulation.
Carcass traits and consumer acceptability of striploin steaks from band-castrated, intratesticular zinc-injected, or sexually intact beef cattle1
Authors: Ball Jase J , Kegley Elizabeth B , Lawrence Ty E , Roberts Shelby L , Powell Jeremy G , Richeson John T 
Published: December 2018

Abstract
One hundred and eighty beef bulls (BW = 337 ± 10.9 kg) were blocked by BW (6 blocks) and assigned randomly to one of three treatments on day 0: 1) INJ; received 1 mL (100 mg Zn) of a Zn solution in each testis, 2) BAN; received blood-restrictive rubber band placed upon the dorsal aspect of the scrotum, and 3) BUL; bulls with testicles remaining intact. Cattle were grouped by weight block in a randomized complete block design (three treatment pens/block and 10 cattle/pen) and harvested by block on three separate dates when blocks reached similar BW and visual subcutaneous fat thickness depth. Striploins were removed from the left carcass sides, vacuum packaged and aged for 14 d, and then frozen at −20 °C. Frozen striploins were sliced into 2.54-cm-thick steaks and remained frozen until analyses. Steaks (n = 3/animal) were used to assess consumer acceptability via consumer taste panel (n = 152 panelists), Warner-Bratzler shear force, percentage cook loss, and cooked color values. Data were analyzed using mixed model procedures; pen was the experimental unit for all dependent variables. Hot carcass weights and LM area were greater (P &lt; 0.01) for the INJ and BUL treatments compared with BAN. Mean yield grade did not differ between treatments (P = 0.12), although BAN carcasses had smaller LM area (P &lt; 0.01) than BUL or INJ carcasses. Percentage of USDA Choice or better carcasses was greater (P &lt; 0.01) for BAN than INJ and BUL treatments. Consumer panelists detected a difference in perceived tenderness; BAN steaks had greater (P = 0.02) tenderness scores than BUL steaks, whereas INJ steaks were intermediate. Panelists rated juiciness of BAN steaks greater (P &lt; 0.01) than either BUL or INJ steaks. Panelists rated beef flavor greater (P = 0.01) for BAN and BUL steaks than INJ steaks. Overall acceptability was greater (P &lt; 0.01) for BAN compared with INJ steaks, whereas BUL steaks were intermediate. Percentage cook loss of striploin steaks (P = 0.47) and Warner-Bratzler shear force values (P = 0.11) did not differ. Cooked color lightness (L*) and redness (a*) values were not affected (P ≥ 0.23) by treatment. Striploin steaks from BAN and BUL treatments had greater (P = 0.02) yellowness values (b*) than INJ steaks. The ratio of red-to-brown (630:580 nm) of cooked striploin steaks was greater (P = 0.05) for INJ than either BAN or BUL treatments. Carcass and palatability outcomes of INJ were more similar to BUL than BAN, suggesting limited efficacy of INJ in mature beef bulls at feedlot entry.
Discussions about contralateral prophylactic mastectomy among surgical oncology providers and women with sporadic breast cancer: a content analysis
Authors: D’Agostino Thomas A , Brewster Abenaa M , Peterson Susan K , Bedrosian Isabelle , Parker Patricia A 
Published: December 2018

Abstract
Rates of contralateral prophylactic mastectomy (CPM) have risen substantially, yet little is known about how and to what extent CPM is discussed within surgical oncology visits at the time of treatment decision-making. We examined CPM discussions in naturally occurring interactions between sporadic breast cancer patients and their surgical oncology providers. Women with early-stage unilateral disease were recruited before their first surgical visit and completed brief questionnaires to determine study eligibility and interest in treatment options. After their visits, enrolled patients and their providers completed questionnaires assessing discussion of and interest in CPM. Audio-recorded visits from 36 unique patients were randomly selected, transcribed, and analyzed. A CPM discussion was present in 28 transcripts. Approximately half of CPM discussions were initiated by the patient or the oncology provider. The topic of CPM was most frequently introduced while reviewing available treatment options. Patients were most interested in pursuing CPM to reduce the risk of future breast cancer. Providers most frequently responded by offering information (e.g., about risk of contralateral disease). A high level of agreement was found among patient, provider, and observer ratings of whether or not CPM was discussed. CPM discussions were consistently present within our sample. Results can be used to build providers' skills and bring provider–patient communication more in line with best practices and recommendations from leading professional medical societies.
Vascular Anatomy of the Medial Femoral Neck and Implications for Surface Plate Fixation
Authors: Putnam Sara M. , Collinge Cory A. , Gardner Michael J. , Ricci William M. , McAndrew Christopher M. 
Published: December 2018

Objectives:
To describe the inferior retinacular artery (IRA) as encountered from an anterior approach, to define its intraarticular position, and to define a safe zone for buttress plate fixation of femoral neck fractures.

Methods:
Thirty hips (15 fresh cadavers) were dissected through an anterior (Modified Smith-Petersen) approach after common femoral artery injection (India ink, blue latex). The origin of the IRA from the medial femoral circumflex artery and the course to its terminus were dissected. The IRA position relative to the femoral neck was described using a clock-face system: 12:00 cephalad, 3:00 anterior, 6:00 caudad, and 9:00 posterior.

Results:
The IRA originated from the medial femoral circumflex artery and traveled within the Weitbrecht ligament in all hips. The IRA positions were 7:00 (n = 13), 7:30 (n = 15), and 8:00 (n = 2). The IRA was 0:30 anterior to (n = 24) or at the same clock-face position (n = 6) as the lesser trochanter. The mean intraarticular length was 20.4 mm (range 11–65, SD 9.1), and the mean extraarticular length was 20.5 mm (range 12–31, SD 5.1).

Conclusions:
The intraarticular course of the IRA lies within the Weitbrecht ligament between the femoral neck clock-face positions of 7:00 and 8:00. A medial buttress plate positioned at 6:00 along the femoral neck is anterior to the location of the IRA and does not endanger the blood supply of the femoral head. The improved understanding of the IRA course will facilitate preservation during intraarticular approaches to the femoral neck and head.
Bundled Payment Initiative for Hip Fracture Arthroplasty Patients: One Institution's Experience
Authors: Lott Ariana , Haglin Jack M. , Belayneh Rebekah , Konda Sanjit , Egol Kenneth A. 
Published: December 2018

Objectives:
To analyze the effectiveness of a Bundled Payments for Care Improvement (BPCI) initiative at a large urban medical center for hip fracture patients included in the bundle payment program with respect to improving patient outcomes and reducing cost.

Design:
Retrospective cohort.

Setting:
Single Academic Institution.

Patients/Participants:
Patients discharged with the diagnosis-related group codes 469–470 performed for hip fractures between July 2011 and September 2014 were evaluated. A BPCI initiative focused on optimizing care coordination, patient education, expectations, and minimizing postacute facility and resource utilization was initiated in October 2013. Patient outcomes before the introduction of the BPCI initiative were compared with those who participated in the initiative.

Intervention:
Application of BPCI principles.

Main Outcome Measures:
Length of stay, location of discharge, readmission within 90 days, and 90-day episode of care costs.

Results:
Sixty-one patients received care before the initiative, and 44 patients were treated with the initiative. The mean length of stay decreased from 6.8 to 5.3 days and the percentage of patients discharged home increased by nearly 10% with the introduction of the BPCI initiative (6.6% vs. 15.9%). There was a 13.1% reduction in total 90-day episode of care cost ($57,546 vs. $49,993, P = 0.210) on introduction of the initiative. There was no significant difference in readmission rate between the 2 cohorts.

Conclusions:
This study demonstrates the success of one such program for hip fracture arthroplasty patients aimed at care coordination and minimizing postacute hospitalization facility care both with respect to improved patient outcomes and substantial cost reduction.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Follicle-stimulating hormone is associated with lipids in postmenopausal women
Authors: Serviente Corinna , Tuomainen Tomi-Pekka , Virtanen Jyrki , Witkowski Sarah , Niskanen Leo , Bertone-Johnson Elizabeth 
Published: December 2018

Abstract

Objective:
The purpose of this study was to evaluate the relation between FSH and lipid levels in postmenopausal women from the Kuopio Ischaemic Heart Disease Risk Factor Study.

Methods:
Postmenopausal women (n = 588) aged 53 to 73 years and not using hormone therapy were included. The relation between FSH and total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TGs) was evaluated using linear regression, adjusting for estradiol, body mass, smoking, and other hormonal and lifestyle factors. The relation between FSH, dyslipidemia, and abnormal lipid levels were also evaluated.

Results:
FSH was positively and linearly associated with TC (P = 0.001) and LDL-C (P = 0.01) in all participants, with stronger relations seen in younger compared with older postmenopausal women. FSH was less strongly associated with HDL-C and TG. FSH was not associated with dyslipidemia; however, higher FSH was associated with increased risk of high TC (P = 0.02) and high LDL-C (P = 0.03).

Conclusions:
These data suggest that higher FSH in postmenopausal women is related to higher levels of both TC and LDL-C.
Vaginal ring pessary use for pelvic organ prolapse: continuation rates and predictors of continued use
Authors: Manonai Jittima , Sarit-apirak Sirirat , Udomsubpayakul Umaporn 
Published: December 2018

Abstract

Objectives:
The aim of the study was (1) to evaluate continuation rates of vaginal ring pessary for pelvic organ prolapse (POP), and (2) to identify predictors for continued pessary use.

Methods:
This retrospective chart review study was conducted in a tertiary center. Women who had a ring with support pessary successfully fitted between January 2009 and December 2013 and had completed up to 3 years of follow-up care were included in the analysis. Demographic and obstetric data, body weight, pelvic organ prolapse stage, and associated symptoms were evaluated. All the women were followed until February 28, 2017, unless surgery to correct POP surgery was required, pessary use was discontinued, or the women died.

Results:
A total of 289 women with symptomatic POP (stages II, III, and IV) were evaluated. The median age was 71 years (range 34-83 y), and the median parity was 3 (range 0-8). Among the women with a successful initial fitting, the failure rate was 5.88% (17/289) at 6 months with most of these women choosing to have surgical intervention. This analysis indicates that the probability of the successful continuation of pessary use after 1, 2, 3, 4, and 5 years was 83.0%, 78.2%, 71.3%, 65.3%, and 61.7%, respectively, reported using a Kaplan–Meier plot. The main cause for discontinuation of pessary use before 3 years was the election for surgical intervention. With regard to predictors for continued pessary use, self-care was the only factor that influenced compliance rates after treatment of 3 years.

Conclusion:
A ring with support pessary can be used successfully to alleviate symptoms of advanced stage prolapse for 3 years or longer. In addition, proper self-management was found to be a strong predictor for prolonged pessary use.
Conduit-based Nerve Repairs Provide Greater Resistance to Tension Compared with Primary Repairs: A Biomechanical Analysis on Large Animal Samples
Authors: Rasappan Kumaran , Rajaratnam Vaikunthan , Wong Yoke-Rung 
Published: December 2018

Background:
When primary repair of transected peripheral nerves is not possible due to large gaps, nerve grafts or repair using conduits are other options to bridge the gap such that the nerve is repaired without tension. When nerve gaps are repaired primarily, there is a worry about tension, failure, and poor healing. In this biomechanical study comparing nerves repaired primarily versus those repaired with conduits, we hypothesized that conduit repair provided greater mechanical breaking strength.

Methods:
We dissected fresh cadaveric sheep hooves and transacted their peripheral nerves. Subsequently, we divided these transacted nerves into 2 groups: primary repair versus repair using a nerve conduit. After repair using a standardized technique, we tensioned each of these repairs via a load tester and recorded the force required till repair failure occurred.

Results:
Six nerves using primary nerve repair and 6 nerves repaired with a nerve conduit (10 mm length × 2.5 mm diameter) were studied. The average breaking strength of the nerves repaired with the nerve conduit was 0.92 N and that using the primary nerve repair technique was 0.46 N (P = 0.001). All the nerves repaired using nerve conduit repair had an additional 5 mm added to their total length as compared with the nerves in the other group.

Conclusions:
Nerve repair using a nerve conduit ensures a higher breaking strength and potentially a greater tension-free repair as compared with primary nerve repairs in a sheep model. This study supports the use of conduits in the bridging of nerve gaps.