bluuebunny/crossref_metadata_2025_split huggingface dataset:
County-Level Socioeconomic Disparities in Use of Medical Services for Management of Infections by Medicare Beneficiaries With Diabetes—United States, 2012
Authors: Chang Man-Huei , Beckles Gloria L. , Moonesinghe Ramal , Truman Benedict I. 
Published: October 2018

Objective:
To assess county-level socioeconomic disparities in medical service usage for infections among Medicare beneficiaries with diabetes (MBWDs) who had fee-for-service health insurance claims during 2012.

Design:
We used Medicare claims data to calculate percentage of MBWDs with infections.

Setting:
Medicare beneficiaries.

Participants:
We estimated the percentage of MBWDs who used medical services for each of 3 groups of infections by sex and quintiles of the prevalence of social factors in the person's county of residence: anatomic site-specific infections; pathogen-specific infections; and HHST infections (human immunodeficiency virus/acquired immunodeficiency syndrome, viral hepatitis, sexually transmitted diseases, and tuberculosis).

Main Outcome Measures:
Using quintiles of county-specific socioeconomic determinants, we calculated absolute and relative disparities in each group of infections for male and female MBWDs. We also used regression-based summary measures to estimate the overall average absolute and relative disparities for each infection group.

Results:
Of the 4.5 million male MBWDs, 15.8%, 25.3%, and 2.7% had 1 or more site-specific, pathogen-specific, and HHST infections, respectively. Results were similar for females (n = 5.2 million). The percentage of MBWDs with 1 or more infections in each group increased as social disadvantage in the MBWDs' county of residence increased. Absolute and relative county-level socioeconomic disparities in receipt of medical services for 1 or more infections (site- or pathogen-specific) were 12.9 or less percentage points and 65.5% or less, respectively. For HHST infections, percentage of MBWDs having 1 or more HHST infections for persons residing in the highest quintile (Q5) was 3- to 4-fold higher (P < .001) than persons residing in the lowest quintile (Q1).

Conclusions:
Infection burden among MBWDs is generally associated with county-level contextual socioeconomic disadvantage, and the extent of health disparities varies by infection category, socioeconomic factor, and quintiles of socioeconomic disadvantage. The findings imply ongoing need for efforts to identify effective interventions for reducing county-level social disparities in infections among patients with diabetes.
Rehabilitation Approach After Surgical Repair of Spontaneous Bilateral Quadriceps Tendon Rupture in a Healthy Mason
Authors: Portugal Diogo Manuel , Capelo João A. , Martins Bárbara Dantas , Ribeiro Inês M. , Ataíde Sofia R. , Vera-Cruz Carla V. 
Published: October 2018

Abstract
Quadriceps tendon rupture is a rare lesion, occurring most frequently in males older than 60 yrs after a fall or trauma and associated with systemic diseases and risk factors. Bilateral injury is even more uncommon and disabling. The authors report a case of spontaneous bilateral quadriceps tendon rupture, nonsimultaneous (8 days apart), in a healthy 54-yr-old black male mason, that may be work related. The patient was included in a 6-mo rehabilitation program after surgical repair. Pain control and gait reacquisition were particularly difficult. Following the customized and phased rehabilitation program, the patient achieved the 6-mo functional outcomes reported for unilateral rupture. The authors highlight the rehabilitation specificities and challenges of the bilateral lesion and discuss the pathophysiological role of prolonged periods of working in repetitive quadriceps overuse postures on quadriceps tendon rupture.
The Effectiveness of Group-Based Physiotherapy-Led Behavioral Psychological Interventions on Adults With Chronic Low Back Pain
Authors: Zhang Qi , Jiang Shujun , Young Lufei , Li Feng 
Published: October 2018

Abstract
Group-based physiotherapy-led behavioral psychological interventions (GPBPIs) are an emerging treatment for chronic low back pain, but the efficacy of these interventions is uncertain. A review of relevant randomized controlled trials and a meta-analysis was conducted to evaluate the effectiveness of GPBPIs on pain relief in adults with chronic low back pain. Literature databases, Google Scholar, bibliographies, and other relevant sources were searched. Thirteen intervention studies (13) published from 1998 to 2013 were included. The meta-analysis was conducted using RevMan software in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. In reviewing the short- (<6 mos), intermediate- (≥6 and <12 mos), and longer-term (≥12 mos) effects of GPBPIs, long-term follow-up evaluations showed large and significant effect sizes (standardized mean difference = −0.25, 95% confidence interval = −0.39 to −0.11, I
2 = 38%, P < 0.01). Subgroup analysis indicated that patients from GPBPIs group had the greater short-, intermediate-, and long-term pain reduction than patients on waiting listing or usual care group. Compared with other active treatments, GPBPIs showed a small but significant long-term pain reduction in patients with chronic low back pain (standardized mean difference = −0.18, 95% confidence interval = −0.35 to −0.01, I
2 = 32%, P = 0.04). In general, GPBPIs may be an acceptable intervention to relieve pain intensity.
Detectability of Brain Metastases by Using Frequency-Selective Nonlinear Blending in Contrast-Enhanced Computed Tomography
Authors: Bongers Malte N. , Bier Georg , Schabel Christoph , Fritz Jan , Horger Marius 
Published: October 2018

Purpose
The aim of this study to evaluate the role of frequency-selective nonlinear blending (FS-NLB) for the detectability of brain metastases with contrast-enhanced computed tomography (CECT) using magnetic resonance imaging (MRI) as standard of reference.

Materials and Methods
A retrospective patient data search at our institution yielded 91 patients who underwent both brain CECT and MRI for screening of brain metastases (n = 173) between 2014 and 2016 (mean time interval, 29 ± 37 [malignant: 15 ± 16/benign: 42 ± 47] days). A recently introduced FS-NLB postprocessing technique was applied to CECT images. Two readers interpreted all CT images in an independent fashion. The conventional, linear blending (LB) CT images were evaluated first. After a washout period, the same readers evaluated the FS-NLB CT images. The standard of reference was established by a consensus interpretation of the brain MRI studies. Outcome variables included determination of best performing FS-NLB settings, region of interest (ROI)–based calculation of contrast-to-noise ratios (CNRs), size, and number of brain metastases. Based on the number of metastases, we classified patients in 5 therapeutically relevant categories (0, no metastasis; 1, singular metastasis; 2, less than 4 metastases; 3, >4 and <10 metastases; 4, >10 metastases). Statistical comparison and diagnostic performance tests were applied.

Results
A center of 47 Hounsfield units (HU), delta of 5 HU, and slope of 5 resulted in the best delineation of hyperdense brain metastases, whereas for hypodense brain metastases, a center of 32 HU, delta of 5 HU, and slope of 5 showed best delineation. Frequency-selective nonlinear blending significantly increased CNR in hyperdense cerebral metastases (CECT: 9.11 [6.9–10.9], FS-NLB: 18.1 [11.9–22.8]; P < 0.0001) and hypodense cerebral metastases (CECT: 6.3 [5.2–8], FS-NLB: 17.8 [14.5–19.7]; P < 0.0001). Sensitivity, specificity, negative predictive values, positive predictive values, and accuracy for LB, and FS-NLB were 40%, 98%, 99%, 31%, and 52%, and 62%, 94%, 97%, 40%, and 69%, respectively. Magnetic resonance imaging, LB, and FS-NLB classification of metastatic patients were group 0 (47, 47, 46), group 1 (14, 8, 11), group 2 (16, 12, 15), group 3 (8, 7, 8), and group 4 (6, 4, 6).

Conclusions
Frequency-selective nonlinear blending postprocessing of CECT significantly increases the detection of brain metastases over conventional CECT; however, the sensitivity remains lower than MRI. Frequency-selective nonlinear blending is slightly inferior in the categorization of patients into therapeutically relevant groups, when compared with MRI.
Epithelioid Hemangioma of the Face
Authors: Sedran Luca , Bonaso Mila , Mettus Arianna , Roccia Fabio 
Published: October 2018

Abstract
An epithelioid hemangioma is a very rare lesion arising from vascular structures. We encountered 2 cases in atypical locations, one in the orbital and the other in the nasal region. We performed preoperative angiography in addition to the diagnostic imaging recommended in the literature. Angiography highlighted the lesions well, and in one case, it was possible to embolize the arterial trunk of a high-flow lesion. Angiography underscored how such lesions may differ from the vascular perspective, emphasizing the importance of histology in correct diagnosis. Management of both hemangiomas yielded good functional and cosmetic outcomes with no disease recurrence.
Optic Disc Deformation and Orbital Bone Erosion Secondary to a Huge Neglected Orbital Cavernous Hemangioma
Authors: Bagheri Abbas , Shahraki Kourosh , Tavakoli Mehdi 
Published: October 2018

Abstract
Cavernous hemangioma (CH) is the most common benign tumor of the orbit which can expand the bony orbit by gradual growth of a large tumor. In this article, the authors report a 28-year-old man presented with a longstanding unilateral proptosis secondary to a huge orbital CH which also caused optic disc deformation and bone erosions in the adjacent orbital walls. The optic disc deformities resolved after the tumor removal.
Evaluation of a Sample of Patients With Unilateral Cleft Lip and Palate Treated With a Two-Stage Protocol
Authors: Brusati Roberto , Meazzini Maria Costanza , Rezzonico Angela , Biglioli Federico , Garattini Giovanna , Battista Valeria Marinella Augusta , Autelitano Luca 
Published: October 2018

Abstract
The aim of this paper was to assess growth, speech, and aesthetic results at the completion of growth in patients with unilateral cleft lip and palate treated with the 2 stages Milan surgical protocol.
Craniofacial growth was evaluated with cephalometric analysis and a theoretical need for orthognathic surgery.
Nasolabial appearance was qualitatively assessed using the Asher McDade Aesthetic Index.
Speech was assessed using the Gos.Sp.Ass ’98 modified for Italian language scoring system.
Burden of care was recorded in terms of number of secondary surgical procedures. All of the patients were treated and evaluated at San Paolo Hospital, Smile House, Milan.
Fifty-two consecutive patients treated by the same surgeon were recalled, 12 patients did not come for assessment.
The first surgical step (average age of 6 months) was cheilorhinoplasty (Millard modified Delaire technique) and soft palate rapair (Pigott). The second step (average age of 35 months) was hard palate and alveolar repair performed simultaneously with an early secondary gengivo alveolo plasty. Fifty-six percent of the patients did not need further surgery after the 2-stage surgery protocol.
The 2-stage surgical protocol of Milano, Smile House, seems to be effective for treatment of unilateral cleft lip and palate, with good results in terms of speech, labial appearance, and alveolar cleft management. Nevertheless, maxillary growth was moderately impaired by the protocol.
Can Volumetric and Morphological Variants of Sphenoid Sinuses Influence Sinuses Opacification?
Authors: Gibelli Daniele Maria , Cellina Michaela , Gibelli Stefano , Schiavo Paolo , Oliva Antonio Giancarlo , Termine Giovanni , Ferrario Virgilio F. , Dolci Claudia , Sforza Chiarella 
Published: October 2018

Abstract
Improvements in computed tomography and in functional endoscopic sinus surgery have recently increased interest toward paranasal sinus anatomy and anatomic variations that can be observed in patients affected by sinusitis. Isolated sphenoid sinusitis is a relatively rare pathology, often related to nonspecific symptoms, therefore making diagnosis difficult. The correlation between this type of sinusitis and anatomical variants remains unclear.
The authors’ aim was to retrospectively revise paranasal sinuses computed tomography scans of patients affected by sphenoid sinusitis, compared with a control group, analyzing the types of sphenoid sinus and the presence of aberrant pneumatization, and performing a segmentation of the sphenoid sinuses to calculate the volumes.
Sphenoid sinuses of 60 patients affected by sinus opacification, compared with a control group, were segmented. Type of sinus (sellar, presellar, postsellar) and presence of aberrant pneumatization were assessed as well. Possible statistically significant differences in volumes according to sex and group were assessed through 2-way ANOVA test (P < 0.05). Post-hoc test was assessed through Student t test. χ
2 test was applied in order to verify the statistically significance of differences in frequency of different types of sinus pneumatization variants (P < 0.05).
Average volume of sphenoid sinuses in males was of 7.672 cm3 and of 7.751 cm3 in females within the group of patients; statistically significant differences in volume were found according to sex (P: 0.342), but not between the patients and control group (P: 0.0929). Post-hoc test verified that males affected by sinus opacification showed smaller volumes in comparison with the control males (P < 0.05). In addition, patients by affected sinus opacification showed more frequently the postsellar type and were less affected by pneumatization variants of the sphenoid bone than the control group (P < 0.05).
This study first suggests the possible protective role of variants of pneumatization in the development of sphenoid sinus opacification.
Novel Application of Platelet-Rich Fibrin as a Wound Healing Enhancement in Extraction Sockets of Patients Who Smoke
Authors: Asmael Huda Moutaz , Jamil Firas A. , Hasan Ali Mohammed 
Published: October 2018

Abstract
The objectives of this study were to assess the potential of platelet-rich fibrin (PRF) on acceleration of soft tissue healing after tooth extraction and to evaluate its effectiveness in reducing the prevalence of dry socket among smoker patients. Twenty smoker male patients aged (18–72) years with multiple teeth extraction were participated in this clinical research. They underwent trans-alveolar extraction of 40 teeth. The extraction sockets were divided in each patient into 2 groups: the study group in which extraction sockets were treated with PRF and the control group: in which extraction sockets left to heal naturally without PRF. Platelet-rich fibrin enhanced soft tissue healing and reduced inflammatory process within the study group compared with control group as the 2-tailed P value equaled 0.0035 which was very statistically significant. Pain level according to visual analog scale in control group had average of (1.8), while in the study group had average of (0.65) and the P value equaled 0.1511 which was not statistically significant. Degree of epithelization was recorded by dental caliper for both groups and the 2-tailed P value equaled 0.7134 which was insignificant. The results from this study showed that PRF enhanced the quality of soft tissue healing of extraction socket among smoker patients but it did not show significant difference regarding pain reduction, dry socket prevention, and socket closure. Future clinical trials are required to clearly identify the effectiveness of PRF regarding this subject.
Huge Extra Cranial Arteriovenous Malformation Presenting as Fluctuant Mass in Scalp
Authors: Ogul Hayri , Keskin Emine 
Published: October 2018

Abstract
Arteriovenous malformation (AVM) of the scalp is an uncommon condition. Clinical manifestations usually include local pain, pulsatile mass, headache, numbness, tinnitus; and less frequently, necrosis and hemorrhage. This study discusses and illustrates an unusual case of AVM in scalp with its radiologic appearance and clinical features.
Intra- and Postoperative Complications of Le Fort I Maxillary Osteotomy
Authors: Eshghpour Majid , Mianbandi Vajiheh , Samieirad Sahand 
Published: October 2018

Background:
The Le Fort I maxillary osteotomy is a versatile and simple procedure, which has gained popularity nowadays, to correct a wide range of malocclusion and maxillofacial deformities. This procedure is often associated with significant but rare postoperative complications. The aim of this study was to evaluate the types and frequencies of intra- and perioperative complications related to Le Fort I osteotomies in noncleft Iranian patients.

Materials and Methods:
In this prospective study, all the healthy systemic patients, (ASA I, II) with the age range of 18 to 30 years from both genders, who had the skeletal class II or III deformities and required only isolated 1-piece maxillary Le Fort I osteotomy, were included in this study. These patients had no craniofacial cleft history and were candidates for orthognathic surgery in Maxillofacial Surgery Department of Qaem Hospital of Mashhad (Iran), 2015 to 2017. All of the operations were carried out or supervised by a single surgeon and anesthesiologist using the same protocol. The patients were monitored for occurrence of intra- or postoperative complications till 6 months. The t-test, Chi-squared test, and Fisher exact test were performed for data analysis using SPSS version 16 (SPSS Inc, Chicago, IL).

Results:
In the present study, a total of 114 consecutive patients with the average age of 22 ± 5 years from October 2015 to November 2017 were recruited. About 77 (67.54%) patients were presented skeletal class III deformity and 37 (32.46%) were class II. The most prevalent maxillary movement after Le Fort I osteotomy was identified to be isolated maxillary advancement in 51 (44.75%) patients. Only 10 (8.77%) of all 114 patients confronted surgical complications. Hemorrhagic complication (arterial bleeding from descending palatine artery and epistaxis) and anatomic complications (septal deviation and bad fracture) would be the most prevalent complications with the frequency of 5.25% and 3.5% in total. Maxillary setback with impaction presented the highest rate (36.4%) of complications compared to other maxillary movement types. On balance, there was a significant association between Le Fort I surgery complications and maxillary movement types in our research (P = 0.002).

Conclusion:
The rate of intra- and postoperative complications following Le Fort I osteotomy for healthy noncleft adults in our center was low. Therefore, it can be concluded that this technique is safe and reliable. The maxillofacial surgeon should pay more attention for prevention or even management of the risk of intra- and perioperative complications in patients with anatomic irregularities (previous craniofacial cleft or trauma history) and those who required maxillary setback concomitant with impaction movements.
Does the incidence of thoracic aortic injury warrant the routine use of chest computed tomography in children?
Authors: Arbuthnot Mary , Onwubiko Chinwendu , Osborne Michele , Mooney David P. 
Published: October 2018

BACKGROUND
Thoracic aortic injury is a potentially life-threatening injury associated with rapid deceleration mechanisms. Diagnosis is made by chest computed tomography (CT), which is associated with a risk of radiation-induced malignancy. We sought to determine the incidence of aortic injuries in the pediatric population to weigh against the risk of CT imaging.

METHODS
The Pediatric Health Information Systems was queried for children ≤18 years with discharge diagnosis code of thoracic aortic injury (901.0) between December 2004 and 2014. Data abstracted included patient age, gender, diagnosis and procedure codes, and discharge disposition, where available. We also queried for imaging codes to determine what type of chest imaging the child received.

RESULTS
Between December 2004 and 2014, 311,850 children were admitted to Pediatric Health Information Systems hospitals with traumatic injury. Of these patients, 46 (0.015%) were coded with a thoracic aortic injury and an accompanying E-code. Twenty-seven patients (58.7%) were male, and the median age was 13 years. The most common mechanism of injury was motor vehicle collision (63%, n = 29). Eighteen hospitals (41.9%) had no patients with a thoracic aortic injury in the 10-year period. In children with a thoracic aortic injury, the mortality rate was 11% (n = 5) and 22 (47.8%) underwent a chest CT during their hospitalization. Forty percent (124,909) of all trauma patients underwent chest CT, with a positive rate for aortic injury of 1.8/10,000. The reported estimated cancer risk from a chest CT scan is 25/10,000 for girls and 7.5/10, 000 in boys, greater than the positive CT rate.

CONCLUSION
Thoracic aortic injuries are rare in children in the United States. The risk of cancer associated with screening chest CT is greater than the likelihood of identifying an aortic injury. Therefore, screening chest CT scans are unwarranted in injured children.

LEVEL OF EVIDENCE
Therapeutic/Care Management, level IV.
Label-free Identification of Antibody-mediated Rejection in Cardiac Allograft Biopsies Using Infrared Spectroscopic Imaging
Authors: Uraizee Imran , Varma Vishal K. , Sreedhar Hari , Gambacorta Francesca , Nazeer Shaiju S. , Husain Aliya , Walsh Michael J. 
Published: October 2018

Background.
Antibody-mediated rejection (AMR) in cardiac allograft recipients remains less well-understood than acute cellular rejection, is associated with worse outcomes, and portends a greater risk of developing chronic allograft vasculopathy. Diffuse immunohistochemical C4d staining of capillary endothelia in formalin-fixed, paraffin-embedded right ventricular endomyocardial biopsies is diagnostic of immunopathologic AMR but serves more as a late-stage marker. Infrared (IR) spectroscopy may be a useful tool in earlier detection of rejection. We performed mid-IR spectroscopy to identify a unique biochemical signature for AMR.

Methods.
A total of 30 posttransplant formalin-fixed paraffin-embedded right ventricular tissue biopsies (14 positive for C4d and 16 negative for C4d) and 14 native heart biopsies were sectioned for IR analysis. Infrared images of entire sections were acquired and regions of interest from cardiomyocytes were identified. Extracted spectra were averaged across many pixels within each region of interest. Principal component analysis coupled with linear discriminant analysis and predictive classifiers were applied to the data.

Results.
Comparison of averaged mid-IR spectra revealed unique features among C4d-positive, C4d-negative, and native heart biopsies. Principal component analysis coupled with linear discriminant analysis and classification models demonstrated that spectral features from the mid-IR fingerprint region of these 3 groups permitted accurate automated classification into each group.

Conclusions.
In cardiac allograft biopsies with immunopathologic AMR, IR spectroscopy reveals a biochemical signature unique to AMR compared with that of nonrejecting cardiac allografts and native hearts. Future study will focus on the predictive capabilities of this IR signature.