bluuebunny/crossref_metadata_2025_split huggingface dataset:
First Pediatric Experience With a Novel, Adhesive Adapter Retained, Bone Conduction Hearing Aid System
Authors: Osborne Max Sallis , Child-Hymas Anne , Gill Jaspreet , Lloyd Mark Sheldon , McDermott Ann Louise 
Published: August 2019

Objectives:
To assess the audiological outcomes, practicalities, and impact on quality of life of a new, nonimplantable, adhesive retained bone conduction hearing aid in children.

Study design:
A prospective, single-subject repeat measure, cohort study.

Setting:
Community and in pediatric assessment center.

Patients:
Twenty-one children aged between 5 and 15 years with a conductive hearing loss of >/=25 dB HL in the better hearing ear.

Intervention:
Audiological comparisons were made using pure-tone thresholds; unaided, with a softband aid, and with the new adhesive retained bone conducting system.

Main Outcome Measures:
Comparison of hearing threshold levels. Data analysis via paired t-testing, significance set at p value <0.01. Quality of life was assessed via the Glasgow Children's Benefit Inventory and a 10 cm linear analogue scale. A hearing aid review questionnaire provided insight into practical use.

Results:
Statistically significant improvement in thresholds of 7.3 dB HL (p=0.0001) was demonstrated with the adhesive system as compared with softband aids. After 4 weeks of usage, the mean hearing thresholds for the adhesive hearing system improved from 55 dB HL ± 2.4 to 31 dB HL± 7.9 in unaided and aided conditions.
Improvements in QOL were demonstrated with LAS and GCBI. Four children reported mild skin reactions. Eighty-six percent reported improved self-confidence.

Conclusion:
The adhesive aid produces comparable audiological results to the commercial softband hearing aids. It provides an excellent alternative in the treatment of conductive hearing loss without the possible complications and costs of a surgical intervention. Furthermore, it preserves skin envelope over the mastoid for those who wish to proceed with an autologous pinna reconstruction in the future.
Differences in edge artifacts between 68Ga- and 18F-PET images reconstructed using point spread function correction
Authors: Amakusa Shinji , Matsuoka Koki , Baba Shingo , Yoshida Tsuyoshi , Sasaki Masayuki 
Published: August 2019

Objective
Edge artifacts have been reported on in relation to 18F-PET using point spread function correction algorithms. The positron range of 68Ga is longer than 18F, and this difference is thought to result in different edge artifacts. The purpose of this study is to clarify the difference in edge artifacts in PET images using point spread function correction in 68Ga- and 18F-PET.

Methods
We used a National Electrical Manufacturers Association International Electrotechnical Commission body phantom. The phantom was filled severally with 68Ga and 18F solution. The PET data were obtained over a 90 minutes period using a True Point Biograph 16 scanner. The images were then reconstructed with the ordered subset expectation maximization with point spread function correction. The phantom image analyses were performed by a visual assessment of the PET images and profiles, and an absolute recovery coefficient, which was the ratio of the maximum radioactivity of any given hot sphere to its true radioactivity.

Results
The ring-like edge artifacts of 68Ga-PET were less prominent than those in 18F-PET. The relative radioactivity profiles of 68Ga-PET showed low overshoots of the maximum radioactivity although high overshoots did appear in 18F-PET. The absolute recovery coefficients of 68Ga-PET were smaller than those of 18F-PET.

Conclusion
The edge artifacts of 68Ga-PET were less prominent than those of 18F-PET, and their overshoots were smaller. The difference in the positron range between 68Ga and 18F may possibly result in the difference in edge artifacts of images reconstructed using the point spread function correction algorithm.
Comparison of diagnostic precision for bone metastasis of primary breast cancer between BONENAVI version 1 and BONENAVI version 2
Authors: Okada Yukinori , Matsushita Shoichiro , Nakajima Yasuo , Yamaguchi Keiichiro , Okuda Itsuko , Kojima Yasuyuki , Tsugawa Koichiro 
Published: August 2019

Objective
The aim of this study was to compare the diagnostic precision of bone scintigraphy with BONENAVI version 1 and BONENAVI version 2 in bone metastasis of primary breast cancer.

Methods
The subjects were 56 consecutive patients (all women, mean age 59 ± 12.7 years) who underwent bone scintigraphy with 99mTc-MDP and were diagnosed with bone metastasis of primary breast cancer from January 2012 to November 2014. Bone scintigraphy was performed with BONENAVI version 1 and BONENAVI version 2 to calculate artificial neural network (ANN), bone scan index (BSI), and hot-spot values, with ANN ≥ 0.5 considered to reflect bone metastasis for the calculation of sensitivity. Mean ANN, BSI, hot-spot values, and sensitivity were compared between BONENAVI version 1 and BONENAVI version 2, with P < 0.05 considered a significant difference.

Results
With BONENAVI version 1, mean ANN was 0.73 ± 0.29, BSI was 1.47 ± 1.85, the hot-spot value was 12.4 ± 12.5, and sensitivity was 76.8% (43/56). With BONENAVI version 2, the mean ANN was 0.86 ± 0.19, BSI was 1.53 ± 2.09, hot-spot value was 12.9 ± 15.6, and sensitivity was 94.6% (53/56). BONENAVI version 2 yielded significantly better ANN and sensitivity than BONENAVI version 1 (both P < 0.01).

Conclusion
BONENAVI version 2 has improved sensitivity for detecting bone metastasis of primary breast cancer compared to BONENAVI version 1.
Are superior cervical sympathetic ganglia avid on whole body 68Ga-PSMA-11 PET/magnetic resonance?: a comprehensive morphologic and molecular assessment in patients with prostate cancer
Authors: Bialek Ewa J. , Malkowski Bogdan 
Published: August 2019

Objectives
Recent reports warn against erroneous mistaking of celiac and stellate sympathetic ganglia for metastatic lymph nodes on multimodal prostate-specific membrane antigen (PSMA)-ligand PET imaging. The aim was to check the intensity of 68Ga-PSMA-11 uptake and magnetic resonance (MR) features of superior cervical ganglia (SCG) on PET/MR imaging.

Methods
In 89 patients 106 SCG were reliably identified on 68Ga-PSMA-11 PET/MR. For each SCG, qualitative assessment (visual subjective avidity, diffusion restriction, shape, and the presence of central hypointensity) and quantitative measurements [dimensions, maximal standardized uptake value (SUVmax), mean apparent diffusion coefficient (ADC)] were performed.

Results
Mean SUVmax in SCG amounted to 1.88 ± 0.63 (range: 0.87–4.42), with considerable metabolic activity (SUVmax ≥ 2) in 37.7% of SCG; mean thickness was 3.18 ± 1.08 mm. In subjective visual evaluation, SCG avidity was classified as mistakable or potentially mistakable with underlying malignancy in 32.1% of cases. Mean ADC values amounted 1749.83 ± 428.83 × 10−6 mm2/s. In visual assessment, 74.5% of ganglia showed moderate to high diffusion restriction. An oval or longitudinal shape on transverse MR plane was presented by 59.4% of SCG. The central hypointensity was detected on MR T2-weighted images only in 10.4% of SCG.

Conclusion
SCG, similar to other sympathetic ganglia, show 68Ga-PSMA-11 uptake. SCG avidity may be of significance, especially in view of frequently occurring SCG oval or longitudinal shape, and moderate to high diffusion restriction in visual assessment, potentially suggesting malignancy on transverse MR plane. Diagnostic imaging specialists and clinicians should be aware of the above.
Informal Dance Intervention Improves BMI and Functional Gait in an Adolescent With Cerebral Palsy: A Case Report
Authors: Owens Meghan , Silkwood-Sherer Debbie 
Published: August 2019

Purpose:
This case study examined the effects of incorporating Informal Dance Intervention into traditional therapy sessions on body mass index and functional walking in an adolescent girl with cerebral palsy.

Case Description:
A 15-year-old adolescent girl, Gross Motor Function Classification System Level II, participated in Informal Dance Intervention twice weekly in 2, 16 session phases. Sixty-minute sessions focused on waltzing, contra dancing, square dancing, and belly dancing to improve timing, endurance, vestibular functioning, and core strength.

Conclusions:
Waist circumference decreased, walking speed increased on the 6-Minute Walk Test and Timed Up and Down Stairs, balance confidence increased per the Activities-specific Balance Confidence Scale, and vestibular functioning improved per changes in the Functional Gait Assessment.

Recommendations for Clinical Practice:
Incorporating Informal Dance Intervention, in conjunction with therapy, may be motivating and improve overall health for adolescents with cerebral palsy to combat their tendency of increased sedentary lifestyle.
Our Experience Managing Difficult Accidental Chainsaw Trauma
Authors: Cascino Flavia , Pini Niccolò , Giovannoni Maria Elisa , Aboh Ikenna Valentine , Gabriele Guido , Niccolai Gianluca , Zerini Federico , Amadi Jude Ugochukwu , Gennaro Paolo 
Published: August 2019

Background:
Chainsaw and circular-saw injuries represent a rare condition within the maxillofacial region. The purpose of this clinical report is to describe the injuries and the clinical and surgical management of these rare traumas.

Methods:
In this clinical report, 11 patients presenting themselves to the emergency room in the hospital “Policlinico Le Scotte,” Siena, from March 2016 to September 2017 with severe chainsaw and circular-saw injuries, were included. All of the patients underwent general anesthesia and surgical treatment. This study describes 3 of the 11 patients with saw injuries.

Results:
No complications occurred during surgeries and a good primary closure of the wound margins were achieved in all patients. However, after surgery, the authors experienced some complications in 2 patients: the 1st one displayed chewing problems due to extensive local edema; the 2nd one developed a total loss of vision in his left eye, even though there was no damage inflected to the eye ball during the trauma or surgery.

Conclusion:
All the patients were followed during the 1st year after surgery. The authors evaluated the patients at 3 months, 6 months, and after 1 year, and none of them developed complications or alterations related to the trauma. However, 1 patient is still experiencing loss of vision and he is under constant specialized follow-up.
Relationship Between Lacrimal Bone Thickness and Lacrimal Sac in Chronic Dacryocystitis
Authors: Bulgurcu Suphi , Idil Mehmet , Pekçevik Yeliz , Cukurova Ibrahim 
Published: August 2019

Background:
Chronic inflammation in the lacrimal sac may lead to thickening of the surrounding bony tissues. This study aimed to assess the thickness of lacrimal bone surrounding the lacrimal sac, and the thickness of maxilla, based on the presence of purulent secretion in the lacrimal sac in patients who underwent EDCR.

Material and Methods:
Lacrimal bone thickness and the maximum and midpoint maxillary bone thickness of 70 patients (mean age of 49.07 years) who underwent EDCR, were assessed along 3 planes (upper, middle, and lower) using CT of the paranasal sinus. The patients were divided into 2 groups: the 1 who had purulent secretion in the lacrimal sac during the intraoperative period (Group 1) and another who did not have purulent secretion (Group 2).

Results:
No significant difference was detected between the 2 groups in terms of maximum and midpoint maxillary bone thickness. The increase in the thickness of lacrimal bone in Group 1 was statistically significant in all the 3 planes as compared to that in Group 2. Cutoff values for the thickness of the upper, middle, and lower plane of lacrimal bone were detected to be 0.710 mm, 0.685 mm, and 0.675 mm, respectively.

Conclusion:
The presence of purulent secretion in the lacrimal sac, along with the detected increase in the thickness of the lacrimal bone, as assessed by CT, offers an insight on the lacrimal sac before the surgery.
The Utility of an Open-Access Surgical Simulator to Enhance Surgeon Training
Authors: Volk Angela S. , Eisemann Bradley S. , Dibbs Rami P. , Perdanasari Aurelia T. , Braun Tara L. , Marsack Kristina P. 
Published: August 2019

Background:
Smile Train, an international children's charity committed to improving cleft care around the world, empowers local medical professionals in developing countries to provide quality comprehensive cleft care in their own communities. As part of their sustainable model, Smile Train developed a web-based, interactive virtual simulator to improve surgical training of cleft procedures for surgeons around the world, replicating the anatomical and technical steps involved in cleft surgery. This study evaluated the simulator as a tool for enhancing surgical training.

Methods:
A pre-test and questionnaire addressing cleft care, surgical knowledge, and confidence level was administered to surgeons-in-training at an academic institution. Participants completed 3 simulator modules followed by a post-test and questionnaire to measure changes in knowledge and confidence levels.

Results:
Sixteen surgeons-in-training participated in this study. The mean score on the knowledge examination increased after reviewing the modules for both junior residents (33.1%–64.4%) and senior residents (46.9%–70.8%). Reviewing the modules increased participants’ confidence in the knowledge of cleft anatomy, understanding of surgical procedures, and ability to follow along meaningfully while assisting in operations.

Conclusions:
The Smile Train Virtual Surgery Simulator increased knowledge and reported surgeon confidence in understanding and assisting in cleft lip surgery, signifying its usefulness as a training tool for surgeons-in-training. Virtual simulation is a valuable resource for improving understanding and competence of the craniofacial surgeon while serving as an educational resource to other members of the comprehensive cleft care team, patients, and families.
Effects of Septoplasty on Tp-e Interval and Tp-e/QT Ratio in Patients With Nasal Septal Deviation
Authors: Taşolar Hakan , Karataş Mehmet , Demiröz Aslan Duygu 
Published: August 2019

Objectives:
There are multiple nasal airway pathologies leading to upper airway obstruction, and one of the most common ones is nasal septum deviation (NSD). Our study aimed to evaluate the effect of nasal septal surgery in patients with NSD on ventricular arrhythmogenesis using the novel electrocardiographic parameters, Tp-e interval, and Tp-e/QT ratio.

Methods:
This retrospective cross-sectional study included 102 consecutive patients diagnosed with NSD. All participants completed a validated outcomes instrument (the NOSE scale), echocardiographic and electrocardiographic evaluation before and 3 months after septoplasty. The degree of nasal septal deviation was evaluated with the Dreher classification.

Results:
All of the electrocardiography parameters (except heart rate and QTmin) were significantly decreased with the septoplasty operation. Electrocardiographic parameters have significantly decreased especially in marked NSD patients. (Δ = difference between the preoperative and postoperative values) ΔNOSE was positively correlated both ΔcTp-e (r = 0.348, P < .001) and ΔcTp-e/QT values (r = 0.536, P < .001).

Conclusion:
Consequently, marked NSD was associated with increased risk of arrhythmogenesis, which were too much improved after septoplasty. So, treatment of especially marked NSD not only reduces otolaryngological complaints, but also leads to improvement of ventricular repolarization parameters.
Factors associated with organ donation by trauma patients in Nova Scotia
Authors: Hetherington Alexandra , Erdogan Mete , Cameron Adam , Lanteigne Sara , Beed Stephen D. , Green Robert S. 
Published: August 2019

BACKGROUND
Trauma patients represent a significant pool of potential organ donors (PODs), and previous research suggests that this population is underutilized for organ donation (OD). Our objective was to assess factors associated with OD in the trauma population.

METHODS
We retrospectively analyzed OD in Nova Scotia over a 7-year period (2009–2016) using data from the Nova Scotia Trauma Registry and Nova Scotia Legacy of Life Donor Registry. All trauma patients who died in the hospital were included. Multiple logistic regression was used to assess factors associated with donation. We also evaluated characteristics, donation types, and reasons for nondonation among trauma PODs.

RESULTS
There were 689 trauma-related deaths in all hospitals in NS during the study period, of which 39.8% (274 of 689) met the Nova Scotia Trauma Registry definition of a POD. Data on OD were available for 108 of these patients who were referred to the Legacy of Life Program. The conversion rate was 84%. Compared with nondonors, organ donors were significantly younger, had a higher Abbreviated Injury Scale head score and a lower scene Glasgow Coma Scale score, were more likely to suffer ischemia from drowning or asphyxia and to require air transport, and were less likely to have comorbidities. Regression analysis showed that donation was associated with younger age (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.95–0.99) and lower Glasgow Coma Scale score at the scene (OR, 0.76; 95% CI, 0.66–0.88). Odds of donation were increased with air transport compared with land ambulance (OR, 8.27; 95% CI, 2.07–33.08) and injury within Halifax Regional Municipality compared with injury outside Halifax Regional Municipality (OR, 4.64; 95% CI, 1.42–15.10). Among the 60 referred PODs who did not donate, family refusal of consent was the most common reason (28 [46.7%] of 60).

CONCLUSION
Younger age, greater severity of injury, and shorter time to tertiary care were associated with OD in trauma patients.

LEVEL OF EVIDENCE
Prognostic and Epidemiological, Level III.
Where should new parkrun events be located? Modelling the potential impact of 200 new events on geographical and socioeconomic inequalities in access and participation
Authors: Schneider PP , Smith RA , Bullas AM , Bayley T , Haake SSJ , Brennan A , Goyder E 
Published: August 2019

AbstractBackgroundparkrun, an international movement which organises free weekly 5km running events, has been widely praised for encouraging inactive individuals to participate in physical activity. Recently, parkrun received funding to establish 200 new events across England, specifically targeted at deprived communities. This study aims to investigate the relationships between geographic access, deprivation, and participation in parkrun, and to inform the planned expansion by proposing future event locations.MethodsWe conducted an ecological spatial analysis, using data on 455 parkrun events, 2,842 public green spaces, and 32,844 English census areas. Poisson regression was applied to investigate the relationships between the distances to events, deprivation, and parkrun participation rates. Model estimates were incorporated into a location-allocation analysis, to identify locations for future events that maximise deprivation-weighted parkrun participation.ResultsThe distance to the nearest event (in km) and the Index of Multiple Deprivation (score) were both independently negatively associated with local parkrun participation rates. Rate ratios were 0.921 (95%CI = 0.921-0.922) and 0.959 (0.959-0.959), respectively. The recommended 200 new event locations were estimated to increase weekly runs by 6.9% (from 82,824 to 88,506). Of the additional runs, 4.1% (n=231) were expected to come from the 10% most deprived communities.ConclusionParticipation in parkrun is wide spread across England. We provide recommendations for new parkrun event location, in order to increase participation from deprived communities. However, the creation of new events alone is unlikely to be an effective strategy. Further research is needed to study how barriers to participation can be reduced.Online Map, data, and source codeAn interactive online map is available here, and the annotated R source code and all data that were used to generate the results of this study are provided on a repository.
Physician Suicide: A Scoping Review to Highlight Opportunities for Prevention
Authors: Leung Tiffany I. , Pendharkar Sima S. , Chen Chwen-Yuen Angie , Snyder Rebecca 
Published: August 2019

AbstractObjectiveThe aim of this scoping review is to map the current landscape of published research and perspectives on physician suicide. Findings could serve as a roadmap for further investigations and potentially inform efforts to prevent physician suicide.MethodsOvid MEDLINE, PsycInfo, and Scopus were searched for English-language publications from August 21, 2017 through April 28, 2018. Inclusion criteria were a primary outcome or thesis focused on suicide (including suicide completion, attempts, and thoughts or ideation) among medical students, postgraduate trainees, or attending physicians. Opinion articles were included. Studies that were non-English, or those that only mentioned physician burnout, mental health or substance use disorders were excluded. Data extraction was performed by two authors.ResultsThe search yielded 1,596 articles, of which 347 articles passed to the full-text review round. The oldest article was an editorial from 1903; 210 (60.3%) articles were published from 2000 to present. Authors originated from 37 countries and 143 (41.2%) were opinion articles. Most discussed were suicide risk factors and culture of practice issues, while least discussed themes included public health and postvention.ConclusionsConsistency and reliability of data and information about physician suicides could be improved. Data limitations partly contribute to these issues. Also, various suicide risk factors for physicians have been explored, and several remain poorly understood. Based on this scoping review, a public health approach, including surveillance and early warning systems, investigations of sentinel cases, and postvention may be impactful next steps in preventing physician deaths by suicide.