bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of central adiposity with psoriasis, psoriatic arthritis and rheumatoid arthritis: a cross-sectional study of the UK Biobank
Authors: Ferguson Lyn D , Brown Rosemary , Celis-Morales Carlos , Welsh Paul , Lyall Donald M , Pell Jill P , McInnes Iain B , Siebert Stefan , Sattar Naveed 
Published: April 2019

AbstractObjectivesTo determine the independent association of central adiposity, assessed by waist circumference, with odds of psoriasis, PsA and RA prevalence after controlling for general adiposity (BMI).MethodsA cross-sectional study of UK Biobank participants aged 40–70 years was performed. Logistic regression was used to calculate the odds of psoriasis, PsA and RA occurrence compared with controls without these conditions by waist circumference, adjusting for covariates: age, sex, smoking status, socioeconomic deprivation and self-reported physical activity (Model 1), followed additionally by BMI (Model 2).ResultsA total of 502 417 participants were included; 5074 with psoriasis (1.02%), 905 with PsA (0.18%), 5532 with RA (1.11%) and 490 906 controls without these conditions. Adjusted odds ratios (ORs) (Model 1) for psoriasis, PsA and RA, per s.d. (13.5 cm) higher waist circumference were 1.20 (95% CI 1.16, 1.23), 1.30 (95% CI 1.21, 1.39) and 1.21 (95% CI 1.17, 1.24), respectively (all P < 0.001). These ORs remained significant after further adjustment for BMI (Model 2) in psoriasis [OR 1.19 (95% CI 1.12, 1.27), P < 0.001] and RA [OR 1.19 (95% CI 1.12, 1.26), P < 0.001], but not in PsA [OR 1.11 (95% CI 0.95, 1.29), P = 0.127].ConclusionCentral adiposity as measured by waist circumference is associated with greater odds of psoriasis and RA prevalence after adjustment for confounders and for BMI. Our findings add support for central adiposity as a long-term clinically relevant component of these conditions.
ANNUAL EFFECTIVE DOSE ASSESSMENT DUE TO RADON AND THORON PROGENIES IN DWELLINGS OF KILIMAMBOGO, KENYA
Authors: Nyambura C , Tokonami S , Hashim N O , Chege M W , Suzuki T , Kudo H , Hosoda M 
Published: April 2019

Abstract
Human beings are continuously exposed to ionising radiation originating from natural or artificial sources. Uranium-238 and Thorium-232 found in building materials are important sources of radon and thoron in the indoor environment. The concentration levels of radon, thoron and thoron progeny were measured in mud-walled, metallic or iron sheet-walled and stone-walled modern houses in Kilimambogo region, Kenya for 3 months. Radon and thoron concentration levels were measured using passive radon–thoron discriminative monitors (RADUET), while thoron progeny concentrations as the equilibrium equivalent thoron concentration (EETC) were measured using thoron progeny monitors. The mean radon concentration levels in mud, metallic and stone-walled dwellings were 67 ± 11, 60 ± 10 and 75 ± 10 Bq m−3, respectively. The mean thoron concentration levels in the corresponding dwellings were 195 ± 36, 71 ± 24 and 161 ± 31 Bq m−3, respectively, while EETCs were 12 ± 2, 3 ± 1 and 7 ± 1 Bq m−3, respectively. The annual effective doses for radon were 1.3 ± 0.2, 1.1 ± 0.1 and 1.4 ± 0.2 mSv y−1 in mud, metallic and stone-walled houses while those from thoron estimated from EETC were 2.4 ± 0.4, 0.5 ± 0.1 and 1.5 ± 0.2 mSv y−1 in the corresponding houses, respectively.
A Feasibility Study to Attribute Patients to Primary Interns on Inpatient Ward Teams Using Electronic Health Record Data
Authors: Schumacher Daniel J. , Wu Danny T.Y. , Meganathan Karthikeyan , Li Lezhi , Kinnear Benjamin , Sall Dana R. , Holmboe Eric , Carraccio Carol , van der Vleuten Cees , Busari Jamiu , Kelleher Matthew , Schauer Daniel , Warm Eric 
Published: April 2019

Purpose
To inform graduate medical education (GME) outcomes at the individual resident level, this study sought a method for attributing care for individual patients to individual interns based on “footprints” in the electronic health record (EHR).

Method
Primary interns caring for patients on an internal medicine inpatient service were recorded daily by five attending physicians of record at University of Cincinnati Medical Center in August 2017 and January 2018. These records were considered gold standard identification of primary interns. The following EHR variables were explored to determine representation of primary intern involvement in care: postgraduate year, progress note author, discharge summary author, physician order placement, and logging clicks in the patient record. These variables were turned into quantitative attributes (e.g., progress note author: yes/no), and informative attributes were selected and modeled using a decision tree algorithm.

Results
A total of 1,511 access records were generated; 116 were marked as having a primary intern assigned. All variables except discharge summary author displayed at least some level of importance in the models. The best model achieved 78.95% sensitivity, 97.61% specificity, and an area under the receiver-operator curve of approximately 91%.

Conclusions
This study successfully predicted primary interns caring for patients on inpatient teams using EHR data with excellent model performance. This provides a foundation for attributing patients to primary interns for the purposes of determining patient diagnoses and complexity the interns see as well as supporting continuous quality improvement efforts in GME.
Vestibular Function Modulates the Benefit of Hearing Aids in People With Hearing Loss During Static Postural Control
Authors: Maheu M. , Behtani L. , Nooristani M. , Houde M. S. , Delcenserie A. , Leroux T. , Champoux F. 
Published: April 2019

Objectives:
To evaluate the influence of auditory cues on postural sway in normal-hearing (NH) individuals, hearing-impaired individuals with vestibular impairment (HIVL), or hearing-impaired (HI) individuals without vestibular impairment.

Design:
Thirty-two participants received a hearing and a vestibular evaluation (vHIT, oVEMP, cVEMP) and then were separated in to three groups (NH, HI, HIVL). All participants had to stand on a force platform in four postural conditions (A: EO/firm, B: EC/firm, C: EO/Foam, D: EC/Foam) under two auditory conditions, with or without auditory cues.

Results:
Results revealed that first, there was a significant difference between HIVL and both HI and NH groups in conditions C and D without auditory cues. Second, greater improvement for HIVL compared to NH and HI groups in condition C and D was observed with auditory cues. Finally, somatosensory reliance significantly decreased for the HIVL participants using hearing aids compared to NH and HI.

Conclusions:
Our results suggest that hearing aids benefit for postural control may be modulated by vestibular function.
The Fear of Tinnitus Questionnaire: Toward a Reliable and Valid Means of Assessing Fear in Adults with Tinnitus
Authors: Fuller Thomas E. , Cima Rilana F. F. , Van den Bussche Eva , Vlaeyen Johan W. S. 
Published: April 2019

Objectives:
The purpose of this study was to assess the factor structure, reliability, and validity of the Fear of Tinnitus Questionnaire (FTQ); a brief self-report measure of people’s fears about potential cognitive, emotional, behavioral, and social consequences of living with tinnitus.

Design:
Five hundred eighty-eight Dutch-speaking adults with tinnitus completed an online battery of questionnaires measuring tinnitus-related distress, fear, catastrophizing, and quality of life. The sample was randomly split into two to perform exploratory and Bayesian confirmatory factor analyses. A subsample of participants (n = 144) completed the battery of questionnaires a second time after a 2-week interval to calculate test-retest reliability and conduct a Bland-Altman analysis. Convergent and concurrent validity of the FTQ was assessed with the complete data set and measures of tinnitus-related distress as the outcome.

Results:
Exploratory factor analyses indicated that single- and three-factor FTQ models were both valid solutions. Posterior predictive p values for the Bayesian confirmatory factor analyses ranged between 0.51 and 0.53 indicating that the respective models were an excellent fit for the data. The FTQ showed excellent test-retest reliability (average value intraclass correlation coefficient (ICC) = 0.92; 95% confidence interval, 0.89–0.95) and in the Bland-Altman analysis, satisfactory agreement between participants’ scores after a 2-week interval. Furthermore, the FTQ demonstrated good internal reliability (α = 0.83, 95% confidence interval, 0.81–0.85) and added statistically significant amounts of variance to models predicting tinnitus-related distress and interference in daily life.

Conclusions:
The FTQ has good psychometric properties and can be used to assess people’s fear of tinnitus in research or clinical settings. Further work to establish the reliability and validity should be conducted and include an examination of a version of the FTQ that uses Likert-type response scales which might offer improved sensitivity.
The Use of Static and Dynamic Cues for Vowel Identification by Children Wearing Hearing Aids or Cochlear Implants
Authors: Hedrick Mark , Thornton Kristen E. T. , Yeager Kelly , Plyler Patrick , Johnstone Patti , Reilly Kevin , Springer Cary 
Published: April 2019

Objective:
To examine vowel perception based on dynamic formant transition and/or static formant pattern cues in children with hearing loss while using their hearing aids or cochlear implants. We predicted that the sensorineural hearing loss would degrade formant transitions more than static formant patterns, and that shortening the duration of cues would cause more difficulty for vowel identification for these children than for their normal-hearing peers.

Design:
A repeated-measures, between-group design was used. Children 4 to 9 years of age from a university hearing services clinic who were fit for hearing aids (13 children) or who wore cochlear implants (10 children) participated. Chronologically age-matched children with normal hearing served as controls (23 children). Stimuli included three naturally produced syllables (/ba/, /bi/, and /bu/), which were presented either in their entirety or segmented to isolate the formant transition or the vowel static formant center. The stimuli were presented to listeners via loudspeaker in the sound field. Aided participants wore their own devices and listened with their everyday settings. Participants chose the vowel presented by selecting from corresponding pictures on a computer screen.

Results:
Children with hearing loss were less able to use shortened transition or shortened vowel centers to identify vowels as compared to their normal-hearing peers. Whole syllable and initial transition yielded better identification performance than the vowel center for /ɑ/, but not for /i/ or /u/.

Conclusions:
The children with hearing loss may require a longer time window than children with normal hearing to integrate vowel cues over time because of altered peripheral encoding in spectrotemporal domains. Clinical implications include cognizance of the importance of vowel perception when developing habilitative programs for children with hearing loss.
Establishing Consensus on the Best Practice Guidelines for Use of Halo Gravity Traction for Pediatric Spinal Deformity
Authors: Roye Benjamin D. , Campbell Megan L. , Matsumoto Hiroko , Pahys Joshua M. , Welborn Michelle Cameron , Sawyer Jeffrey , Fletcher Nicholas D. , McIntosh Amy L. , Sturm Peter F. , Gomez Jaime A. , Roye David P. , Lenke Lawrence G. , Vitale Michael G. 
Published: April 2019

Background:
Although halo gravity traction (HGT) has been used to treat children with severe spinal deformity for decades, there is a distinct lack of high-quality evidence to speak to its merits or to dictate ideal manner of implementation. In addition, no guidelines exist to drive research or assist surgeons in their practice. The aim of this study was to establish best practice guidelines (BPG) using formal techniques of consensus building among a group of experienced pediatric spinal deformity surgeons to determine ideal indications and implementation of HGT for pediatric spinal deformity.

Methods:
The Delphi process and nominal group technique were used to formally derive consensus among leaders in pediatric spine surgery. Initial work identified significant areas of variability in practice for which we sought to garner consensus. After review of the literature, 3 iterative surveys were administered from February through April 2018 to nationwide experts in pediatric spinal deformity. Surveys assessed anonymous opinions on ideal practices for indications, preoperative evaluation, protocols, and complications, with agreement of 80% or higher considered consensus. Final determination of consensus items and equipoise were established using the Nominal group technique in a facilitated meeting.

Results:
Of the 42 surgeons invited, responses were received from 32, 40, and 31 surgeons for each survey, respectively. The final meeting included 14 experts with an average 10.5 years in practice and average 88 annual spinal deformity cases. Experts reached consensus on 67 items [indications (17), goals (1), preoperative evaluations (5), protocols (36), complications (8)]; these were consolidated to create final BPG in all categories, including statements to help dictate practice such as using at least 6 to 8 pins under 4 to 8 lbs of torque, with a small, tolerable starting weight and reaching goal weight of 50% TBW in ∼2 weeks. Nine items remained items of equipoise for the purposes of guiding future research.

Conclusions:
We developed consensus-based BPG for the use and implementation of HGT for pediatric spinal deformity. This can serve as a measure to help drive future research as well as give new surgeons a place to begin their practice of HGT.

Level of Evidence:
Level V—expert opinion.
Prevalence of Hip Dysplasia and Associated Conditions in Children Treated for Idiopathic Early-onset Scoliosis—Don’t Just Look at the Spine
Authors: Talmage Matthew S. , Nielson Alexandra N. , Heflin John A. , D’Astous Jacques L. , Fedorak Graham T. 
Published: April 2019

Background:
Hip dysplasia, congenital muscular torticollis, plagiocephaly, and metatarsus adductus are known to be associated. The etiology of infantile idiopathic scoliosis and its association with the aforementioned conditions is unknown. This study reviews a series of infantile scoliosis patients to address this gap.

Methods:
The medical records of all patients treated with casting for early-onset scoliosis (EOS) from 2001 to 2016 were retrospectively reviewed. Inclusion criteria were a diagnosis of idiopathic EOS and age below 4 years at the time of the first cast. Demographic information, comorbid conditions, and radiographic measurements including Cobb angle and acetabular index (AI) were collected. The first acceptable anteroposterior pelvis radiograph for each patient was measured. An AI≥30 degrees was defined as hip dysplasia. A measurement between 25 and 30 degrees was defined as a “hip at risk.”

Results:
Between 2001 and 2016, 142 patients were treated with casting. Eighty-one patients met the inclusion criteria. The mean age at the first cast was 19.3 (±7.5) months and the mean Cobb angle was 53.6 (±18.8) degrees. There was no significant correlation between Cobb angle and AI. Nine patients met radiographic criteria for hip dysplasia (11.1%), only 4 of whom had been previously diagnosed. Thirty-six patients (44.4%) met the criteria of having at least 1 hip “at risk” of hip dysplasia. Ten patients (12.3%) had been diagnosed with torticollis and 13 patients (16.0%) with plagiocephaly. Three patients (3.7%) had been diagnosed with metatarsus adductus or clubfoot. In total, 30.9% of patients (25/81) had at least one of the above comorbid conditions.

Conclusions:
In a large group of children treated for idiopathic EOS, we found a high prevalence of commonly associated conditions—hip dysplasia, torticollis, plagiocephaly, metatarsus adductus, and clubfoot. In 6.2% of our sample, a diagnosis of hip dysplasia was not made in a timely manner despite routine radiographic spine follow-up. With increasing subspecialization within pediatric orthopaedics, surgeons need to maintain vigilance in assessing the entire child.

Level of Evidence:
Level IV.
Biomechanical Comparison of Pronator Quadratus Repair Techniques in the Modified Henry Approach for Distal Radius Fracture
Authors: Marmen Andreanne , Lepine Josianne , Leblanc Elisabeth , Balg Frederic 
Published: April 2019

Background:
Open reduction and volar plate fixation of distal radius fracture frequently involve detaching the pronator quadratus muscle. Repair maybe difficult due to friable muscle fascia or bulky plate. This study evaluates the strength of 3 repair techniques.

Methods and Results:
Repair with separate Simple Sutures, Continuous Suture, or Suture Anchors was tested on 3 groups of 6 cadaver forearms. A distraction load was applied to all repairs on a traction simulator until there was a failure of either the suture, the muscle or the anchor. Simple Suture group could resist 20.7 N, the Continuous Suture group 33.3 N, and the Suture Anchors group 42.5 N. The load to displacement were, respectively, 20.0, 25.9, and 34.6 N. The mode of failure was noted.

Conclusions:
This cadaveric study shows that if deemed necessary for soft tissue coverage or for biological aid in fracture healing, suture anchor is the strongest repair choice for pronator quadratus. This conclusion must be weighed against the fact that no in vivo tensile strength value sustained by the pronator quadratus is known in the literature and that simple suture could be sufficient to hold the repaired muscle while the wrist is immobilized postoperatively.
The Association of Premorbid Metformin Exposure With Mortality and Organ Dysfunction in Sepsis: A Systematic Review and Meta-Analysis
Authors: Tan Kaiquan , Simpson Andrew , Huang Stephen , Tang Benjamin , Mclean Anthony , Nalos Marek 
Published: April 2019

Objectives:
To examine the association between premorbid metformin exposure and mortality, hyperlactatemia, and organ dysfunction in sepsis.

Data Sources:
PubMed and EMBASE (with Medline via Ovid) databases were searched for all studies of premorbid metformin exposure and sepsis published between January 1974 and August 2018.

Study Selection:
Studies of at least 20 patients with sepsis that reported data on metformin use, mortality, and/or organ dysfunction were independently selected.

Data Extraction:
Two reviewers abstracted data on study design, settings, study quality, participants, metformin exposure, mortality, initial lactate levels, and organ dysfunction. Risk of bias was independently assessed.

Data Synthesis:
Eight observational studies fulfilled our criteria, comprising 4,144 patients with sepsis including 562 diabetics on metformin. Premorbid metformin exposure was associated with reduced mortality in sepsis (odds ratio, 0.57; 95% CI, 0.40–0.80). Between studies heterogeneity was low (i
2 = 43%; τ2 = 0.1; p = 0.09). Premorbid metformin exposure was not significantly associated with initial lactate levels (mean difference, 0.39 [–0.50 to 1.28]; i
2 = 72%; p = 0.39).

Conclusions:
The meta-analysis suggests that premorbid metformin exposure is associated with decreased mortality in sepsis but not with hyperlactatemia. What are the potential mechanisms and whether there is any effect on organ dysfunction remain unclear.
Corneal Tomography Changes and Refractive Outcomes After Descemet Stripping Without Endothelial Keratoplasty
Authors: Davies Emma , Pineda Roberto 
Published: April 2019

Purpose:
To investigate corneal tomography changes and refractive outcomes after Descemetorhexis without endothelial keratoplasty (DWEK).

Methods:
Retrospective chart review of 25 eyes from 16 patients with Fuchs corneal endothelial dystrophy that underwent successful DWEK combined with cataract surgery.

Results:
There was no significant change in anterior corneal curvature on tomography maps. However, all tomography maps demonstrated an increase in central posterior float and all but one demonstrated a decrease in pachymetry after DWEK. Only 7 of 25 eyes had increased irregular astigmatism on tomography after DWEK, of which 57% had preexisting irregular astigmatism before the procedure. The mean difference between the targeted and outcome refraction was +0.65 diopters (D) at the time of corneal clearance, but this improved to +0.38 D 1 month after corneal clearance. Postoperative refraction was within 1 D of target refraction for 92% of cases (23 eyes) but within 0.5 D of target refraction for only 48% of cases (12 eyes). The differences between expected and actual refractive outcomes were correlated with change in posterior corneal curvature and pachymetry.

Conclusions:
DWEK induces an increased central posterior float localized to the site of Descemet membrane stripping, confirming the need for centralized stripping. Irregular astigmatism can occur after DWEK but is typically minimal and occurs more commonly in the setting of preoperative irregular astigmatism. DWEK induces about a 0.5 D hyperopic shift, which should be considered when determining intraocular lens power with simultaneous surgery.
Expressible Meibomian Glands Have Occult Fixed Obstructions: Findings From Meibomian Gland Probing to Restore Intraductal Integrity
Authors: Maskin Steven L. , Alluri Sreevardhan 
Published: April 2019

Purpose:
To describe and quantify findings of intraductal obstruction during probing expressible and nonexpressible meibomian glands (MGs) in patients with obstructive meibomian gland dysfunction using a 1-mm intraductal MG probe.

Methods:
A retrospective study of probe findings from 108 consecutive patients. Nonparametric tests using SPSS software 25.0 to explore relationships between expressibility and probe findings.

Results:
Of 11,776 probed glands of 404 lids, 84% showed mechanical resistance (MR) and 16% showed no resistance (NR). Fixed, firm, focal unyielding resistance (FFFUR) occurred in 79.5% of obstructed glands, and nonfixed, nonfocal easily yielding soft resistance (SFT) in 20.4%. FFFUR was characterized by an audible and tactile “firm pop” (FP) or “firm gritty” (FG) sensation. No significant difference in MR and FFFUR for lids between 0% and >90% gland expressibility was observed. FP correlated with increased expressibility (P = 0.011), lid tenderness (P = 0.045), and complete proximal obstruction (P = 0.037), whereas SFT correlated with reduced expressibility (P = 0.016). Upper lids showed greater incidence of MR (P < 0.001), FFFUR (P < 0.001), and FG (P < 0.001), whereas lower lids showed greater expressibility (P < 0.001) and NR (P < 0.001).

Conclusions:
FFFUR was the most common probe finding in a large series of consecutively probed MGs, with an incidence of 67% of glands and 80% of obstructed glands. FFFUR was independent of gland expressibility, demonstrating expressible glands harbor FFFUR deep to at least one acinus. FP was associated with expressible gland occult obstruction and lid tenderness. SFT correlated with reduced expressibility, perhaps related to altered duct/duct contents. Upper lids correlated with increased MR, FFFUR, and FG and lower lids with increased expressibility and NR, possibly reflecting contrasting anatomy and blink-related microtrauma.