bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐Term Hearing Outcomes following Total Ossicular Reconstruction with Titanium Prostheses
Authors: Wood C. Burton , Yawn Robert , Lowery Anne Sun , O'Connell Brendan P. , Haynes David , Wanna George B. 
Published: February 2019

Objective(1) Characterize a large cohort of patients undergoing total ossicular chain reconstruction with titanium prosthesis. (2) Analyze long‐term hearing outcomes of the same cohort.Study DesignCase series with chart review.SettingTertiary care center.Subject and MethodsThis study reviews patients who underwent total ossicular chain reconstruction (OCR) with titanium prostheses (TORPs) at a single tertiary care center from 2005 to 2015. Patient charts were reviewed for demographic data, diagnosis, and operative details. Patients were included in statistical analysis if length of follow‐up was 2 years or more. Evaluation of hearing improvement was made by comparing preoperative air‐bone gap (ABG) and ABG at follow‐up at 2 years.ResultsIn total, 153 patients were identified who met inclusion criteria. The mean age of included patients was 40 years (range, 6‐89 years). Sixty patients (39%) had a history of OCR, and 120 patients (78%) had a diagnosis of cholesteatoma at the time of OCR. Preoperatively, the mean ABG was 36 ± 12, whereas the mean ABG at 2‐year follow‐up improved to 26 ± 13. This was statistically significant (P <. 0001) using a Wilcoxon matched‐pairs signed rank test. Twelve patients (8%) required revision OCR. Two revisions were performed due to prosthesis extrusion (<1%).ConclusionTitanium prostheses lead to significant improvement in hearing over long periods. The results are sustained as far out as 5 years following surgery. In addition, rates of revision surgery with titanium TORPs are low. Based on this series, there are no readily identifiable predictors for outcomes following total OCR.
Epistaxis Risk Associated with Intranasal Corticosteroid Sprays: A Systematic Review and Meta‐analysis
Authors: Wu Eric L. , Harris William C. , Babcock Casey M. , Alexander Bailin H. , Riley Charles A. , McCoul Edward D. 
Published: February 2019

ObjectiveIntranasal corticosteroids (INCSs) are widely utilized for the treatment of allergic rhinitis. Epistaxis is a known adverse effect of INCSs, but it is not known if the risk of epistaxis differs among INCSs.Data SourcesSystematic review of primary studies identified through Medline, Embase, Web of Science, PubMed Central, and Cochrane databases.Review MethodsSystematic review was conducted according to the PRISMA standard. English‐language studies were queried through February 1, 2018. The search identified randomized controlled trials of INCSs for treatment of allergic rhinitis that reported incidence of epistaxis. An itemized assessment of the risk of bias was conducted for each included study, and meta‐analysis was performed of the relative risk of epistaxis for each INCS.ResultsOf 949 identified studies, 72 met the criteria for analysis. Meta‐analysis demonstrated an overall relative risk of epistaxis of 1.48 (95% CI, 1.32‐1.67) for all INCSs. The INCSs associated with the highest risk of epistaxis were beclomethasone hydrofluoroalkane, fluticasone furoate, mometasone furoate, and fluticasone propionate. Beclomethasone aqueous, ciclesonide hydrofluoroalkane, and ciclesonide aqueous were associated with the lowest risk of epistaxis. Conclusions about epistaxis with use of budesonide, triamcinolone, and flunisolide are limited due to the low number of studies and high heterogeneity.ConclusionsWhile a differential effect on epistaxis among INCS agents is not clearly demonstrated, this meta‐analysis does confirm an increased risk of epistaxis for patients using INCSs as compared with placebo for treatment of allergic rhinitis.
Primary or secondary Bentall-De Bono procedure: are the outcomes worse?
Authors: Kaskar Ameya , Bohra Deepak V , Rao K Rahul , Shetty Varun , Shetty Devi 
Published: February 2019

Background The aim of this study was to compare the outcomes of a primary and secondary Bentall-De Bono procedure. Methods From 2008 to 2015 (8-year period), 308 patients underwent a Bentall-De Bono procedure in our institute. The mean age was 43 ± 13 years and 80% were men. Twenty-eight patients had prior cardiac surgery through a median sternotomy (group 1) and 280 underwent a primary Bentall-De Bono procedure (group 2). Various preoperative and perioperative parameters were analyzed before and after propensity-score matching. Results Before propensity-score matching, patients undergoing a secondary Bentall-De Bono procedure had a worse preoperative profile, as indicated by a higher EuroSCORE II ( p < 0.0001), with hospital mortality in group 1 of 14% (4/28) and 5% (14/280) in group 2 ( p = 0.069). After propensity-score matching, there was no significant difference in EuroSCORE II ( p = 0.922) or hospital mortality ( p = 0.729). After adjusting for the different variables, repeat sternotomy could not be identified as an independent predictor of postoperative mortality or morbidity. Survival at the end of 1 and 5 years in both groups showed no significant differences before or after propensity-score matching ( p = 0.328 and p = 0.356, respectively). In Cox multivariable regression analysis, reoperation was not identified as an independent factor for survival before ( p = 0.559) or after propensity-score matching ( p = 0.365). Conclusion A secondary Bentall-De Bono procedure can be performed with acceptable mortality and morbidity, and with midterm survival rates comparable to those of a primary Bentall-De Bono procedure.
Psychiatric hospitalization following antipsychotic medication cessation in first episode psychosis
Authors: Hayes Joseph F , Osborn David PJ , Lundin Andreas , Dalman Christina 
Published: February 2019

Background: There are questions about the risk-benefit balance of longer-term antipsychotic medication treatment following first episode psychosis, especially in relation to relapse because of dopamine supersensitivity following treatment cessation. Aim: The purpose of this study was to determine whether hospitalization rates in first episode psychosis patients are associated with length of initial oral antipsychotic medication exposure. Methods: We examined psychiatric hospitalization rates in patients experiencing first episode of psychosis from the total population of Sweden between 1 January 2007–31 December 2016 ( n=7043). We categorised patients by the length of first antipsychotic treatment (<6 months, 6 months to <1 year, 1 year to <2 years, 2 years to <5 years and ⩾5 years). Results: Compared to those treated for <6 months, individuals receiving oral antipsychotic medications for ⩾5 years had less than half the cumulative incidence of hospitalization at all times between 1–4 years after treatment cessation. Conclusion: We found no evidence that hospitalization rates increased with increasing baseline antipsychotic exposure.
Feasibility of reduced-dose CT of the head and neck with iterative reconstruction: a phantom and prospective clinical study
Authors: Chung Mi Sun , Choi Young Jun , Hwang Jae-Yeon , Yoon Dok Hyun , Seo Kyeong Jin , Lee Jeong Hyun , Baek Jung Hwan 
Published: February 2019

Background There is growing concern over computed tomography (CT)-related radiation exposure, particularly in patients requiring head and neck CT due to the proximity of radiosensitive organs. Purpose We aimed to evaluate the feasibility of reduced-dose CT of the head and neck with iterative reconstruction in a phantom and patient study. Material and Methods In the phantom study, low-contrast resolution test of the American Association of Physicists in Medicine CT performance phantom was scanned to determine the lowest acceptable tube current (mAs). In the patient study, three sets of CT images (standard-dose [200 mAs] and reduced-dose with iterative reconstruction or filtered back projection [FBP]) were prospectively obtained. The image noise, qualitative image quality, and radiation dose were compared. Results In the phantom study, 100 mAs was determined as the lowest acceptable value. In the patient study (n = 29), reduced-dose CT with FBP showed significantly higher image noise and lower qualitative image quality than reduced-dose CT with iterative reconstruction and standard-dose CT ( P < 0.05). There was no significant difference in image noise and qualitative image quality between reduced-dose CT with iterative reconstruction and standard-dose CT ( P > 0.05). The radiation dose of the reduced-dose CT was significantly lower than that of the standard-dose CT (volume CT dose index = 6.9 vs. 14.3, P < 0.001; dose-length product = 223.6 vs. 455.8, P < 0.001). Conclusions Reduced-dose CT with iterative reconstruction is a potential alternative to standard-dose CT of the head and neck, reducing radiation dose by approximately 50% while preserving image quality.
A 2-Year Prospective Study of Injury Epidemiology in Elite Australian Rugby Sevens: Exploration of Incidence Rates, Severity, Injury Type, and Subsequent Injury in Men and Women
Authors: Toohey Liam A. , Drew Michael K. , Finch Caroline F. , Cook Jill L. , Fortington Lauren V. 
Published: February 2019

Background: Injuries are common in rugby sevens, but studies to date have been limited to short, noncontinuous periods and reporting of match injuries only. Purpose: To report the injury incidence rate (IIR), severity, and burden of injuries sustained by men and women in the Australian rugby sevens program and to provide the first longitudinal investigation of subsequent injury occurrence in rugby sevens looking beyond tournament injuries only. Study Design: Descriptive epidemiology study. Methods: Ninety international rugby sevens players (55 men and 35 women) were prospectively followed over 2 consecutive seasons (2015-2016 and 2016-2017). All medical attention injuries were reported irrespective of time loss. Individual exposure in terms of minutes, distance, and high-speed distance was captured for each player for matches and on-field training, with the use of global positioning system devices. The IIR and injury burden (IIR × days lost to injury) were calculated per 1000 player-hours, and descriptive analyses were performed. Results: Seventy-three players (81.1%) sustained 365 injuries at an IIR of 43.2 per 1000 player-hours (95% CI, 38.8-47.8). As compared with male players, female players experienced a lower but nonsignificant IIR (incidence rate ratio, 0.91; 95% CI, 0.73-1.12). Female players also sustained a higher proportion of injuries to the trunk region (relative risk, 1.75; 95% CI, 1.28-2.40) but a lower number to the head/neck region (relative risk, 0.58; 95% CI, 0.37-0.93; P = .011). The majority (80.7%) of subsequent injuries were of a different site and nature than previous injuries. A trend toward a reduced number of days, participation time, distance, and high-speed distance completed before the next injury was observed after successive injury occurrence. Conclusion: A trend for a lower IIR was observed for female players compared with male players, with variation of injury profiles observed between sexes. With a surveillance period of 2 years, subsequent injuries account for the majority of injuries sustained in rugby sevens, and they are typically different from previous types of sustained injuries. After each successive injury, the risk profile for future injury occurrence appears to be altered, which warrants further investigation to inform injury prevention strategies in rugby sevens.
The impact of different classes of lupus nephritis on maternal and fetal outcomes: a cohort study of 147 pregnancies
Authors: Rodrigues B Costa , Lacerda M Ignacchiti , Ramires de Jesús G R , Cunha dos Santos Flávia , Ramires de Jesús N , Levy R A , Klumb E Mendes 
Published: February 2019

Objective To analyze the impact of different classes of lupus nephritis as risk variables for maternal and fetal adverse outcomes in a cohort of pregnant lupus patients. Methods This is a cohort study with retrospective and prospective data collection, conducted at the University Hospital of State University of Rio de Janeiro, Brazil, from 2011 to 2016. A total of 147 pregnancies of 137 systemic lupus erythematosus patients of whom 66 had lupus nephritis were included. Demographic and clinical features, as well as maternal and fetal outcomes were observed for each nephritis histological class among systemic lupus erythematosus patients and compared with those without nephritis. Categorical variables were expressed as absolute and relative frequencies and numerical variables as means and standard deviation. The chi-square test with Fisher's correction and Student's t-test were used for statistical analysis. A pvalue < 0.05 was considered statistically significant. Results Systemic lupus erythematosus patients with proliferative nephritis (classes III/IV, n = 54) presented more frequent disease flares ( p = 0.02), continuous active disease during pregnancy and puerperium ( p = 0.006), hospitalization due to systemic lupus erythematosus ( p < 0.001), hospitalization not directly associated to systemic lupus erythematosus ( p = 0.04), higher frequency of cesarean delivery ( p = 0.03) and preeclampsia ( p = 0.01) than patients without nephritis. Permanent damage measured by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index was more frequent in classes III/IV than among the other patients. The frequency of adverse fetal outcomes such as prematurity and admission to neonatal intensive care unit were not different among systemic lupus erythematosus patients with or without nephritis. However, perinatal deaths were more frequent in patients with all classes of nephritis ( p = 0.003). Conclusion Systemic lupus erythematosus patients with proliferative nephritis (classes III/IV) have a higher frequency of adverse maternal outcomes. This is probably due to the major impact of proliferative forms of nephritis on women's global heath, which is corroborated by the higher Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index findings, although we cannot exclude the negative influence of disease activity for the maternal adverse events. The findings indicate a need for further lupus nephritis classification beyond the nonspecific term nephritis in the context of lupus pregnancy as the impact on maternal and fetal outcomes varies according to histological class.
Derotation of the Talus and Arthrodesis Treatment of Stages II-V Müller-Weiss Disease: Midterm Results of 36 Cases
Authors: Yuan Chengjie , Wang Chen , Zhang Chao , Huang Jiazhang , Wang Xu , Ma Xin 
Published: February 2019

Background: Various operative procedures have been reported for the treatment of Müller-Weiss disease (MWD). This study reports the midterm operative treatment results for stages II to V MWD with derotation of the talus and arthrodesis. Methods: Thirty-four patients (36 feet) with MWD were treated by talonavicular (TN) or talonavicular-cuneiform (TNC) arthrodesis in our center from 2008 to 2015. The affected feet were staged according to the Maceira staging system (stage II: 9; stage III: 10; stage IV: 9; stage V: 8). The American Orthopaedic Foot & Ankle Society (AOFAS) midfoot scale, the visual analog scale (VAS), and relative radiologic parameters were evaluated preoperatively and also during follow-up. The mean follow-up duration was 38.2 (range, 25-113 months). Results: The final follow-up showed satisfactory outcomes. Overall, the AOFAS scores improved from 41.5 (range, 20-56) to 85.3 (range, 68-100) points ( P <.001), and the VAS score decreased from 5.7 (range, 3-8) to 0.9 (range, 0-4) points ( P <.001). The Tomeno-Méary angle decreased from −6.7 (range, −26.4 to 17.7) to 0.7 (range, −5.3 to 7) degrees ( P=.001). The calcaneal pitch angle increased from 13.7 (range, 4.1-26.2) to 22.0 (range, 13.3-28.9) degrees ( P < .001). The anteroposterior (AP) talar–first metatarsal angle decreased from −15.8 (range, −30.1 to −13.7) to −7.0 (range, −25.9 to −8.9) degrees ( P < .001), and the AP talocalcaneal angle increased from 14.7 (range, 4.7-22.3) to 22.1 (range, 13.4-29.5) degrees ( P=.005). The AP talonavicular coverage angle decreased from −27.0 (range, −40.4 to −13.3) to −7.8 degrees (range, −20.7 to −1.8) degrees ( P < .001). Conclusion: The midterm results found that the TN or TNC joint fusion could achieve a favorable clinical and radiologic outcome for patients with MWD. Even for the patients with severe deformities (stages IV-V), this treatment strategy could also achieve satisfactory deformity correction and functional improvement. Intraoperative restoration of talus rotation was the key to normal alignment of the subtalar joint/TN joint. Level of Evidence: Level IV, retrospective case series.
Open Defecation Practices in Lodwar, Kenya: A Mixed-Methods Research
Authors: Busienei Phylis Jepkorir , Ogendi George Morara , Mokua Millicent A 
Published: February 2019

Background: As of the year 2014, about 2.5 billion people globally lacked access to improved sanitation. The situation is even worse in the sub-Saharan African countries including Kenya. The practice of open defecation (OD) peaks beyond 72% of the population in Turkana County, Kenya, despite various interventions to end it. Methods: This article reports on both qualitative and quantitative aspects of a cross-sectional study. A partially mixed sequential dominant (quantitative) status was used to understand various socioeconomic factors associated with OD practice in Lodwar’s human settlements, Turkana County. Simple random sampling technique was chosen to select participants for this study with the sample drawn from various administrative units of Lodwar. Standardized questionnaires, focus group discussions, and key informant interviews were used to collect data. Results: The quantitative findings revealed that culture was the leading factor as to why people practiced OD with a frequency of 44%. The findings further revealed that poverty was the major influencing factor for latrine ownership among the households (frequency 27%). Pearson χ2 tests revealed that there was a significant association between latrine presence and education level of the household head (χ2 = 107.317; P < .05), latrine sharing (χ2 = 403; P < .05), and occupation of the household head (χ2 = 74.51; P < .05). The quantitative findings showed that culture was by far the most common factor that contributed to the OD practice with a theme intensity of 31.1%. Further analyses identified 5 major cultural aspects that were associated with OD practice. This included sexual immorality, OD as a common habit, nomadic pastoralism, bride’s dignity and mixing of feces. Open defecation as a common habit among the respondents was the most cited factor that contributed to its rampant practice (theme intensity 31.3%) followed closely by nomadic pastoralism kind of life among the residents that limit latrine construction (theme intensity 28.1%). Conclusions: In addition to cultural aspects, high poverty levels influence latrine adoption and consequently OD practices. Future sanitation interventions addressing OD should assess and factor in these cultural aspects in such communities to come up with appropriate eradication measures which have otherwise been difficult to solve through poverty eradication and sanitation campaigns that have been in existence.
A generalist approach to forensic social work: A qualitative analysis
Authors: Naessens Liesbeth , Raeymaeckers Peter 
Published: February 2019

Summary Forensic social work is often portrayed as a specialized area within the field of social work. Nevertheless, the target group of forensic social work is confronted with a variety of problems in different life domains. The literature reveals the importance of generalist social work to address the complex needs of vulnerable target groups. However, little has been written or studied about what generalist social work should entail in the field of forensic social work. This article addresses the value of generalist social work for the practice of forensic social work. We conduct 14 interviews with social workers affiliated with forensic social work organizations in Brussels, the capital of Belgium. Findings The results show that generalist social work plays a pivotal role in forensic social work. A generalist approach is indispensable to meeting the complex problems of the vulnerable target group of offenders. Our study makes a distinction between five different roles adopted by generalist social workers affiliated with forensic social work organizations when providing services and support to the target group of offenders. In addressing the needs of this target group, they act as a broker, a mediator, a key figure, a safety net and as an advocate. Applications Despite some specific needs and skills required in the field of forensic social work, a generalist approach is critical to a more responsive social work approach towards the target group of offenders.
Choline transport for phospholipid synthesis: An emerging role of choline transporter-like protein 1
Authors: Hedtke Vera , Bakovic Marica 
Published: February 2019

This review provides a summary of recent discoveries in choline transport and the proteins mediating it with a specific focus on the choline transporter-like proteins (CTL)/solute carriers 44 A (SLC44A) and their role in phospholipid metabolism. Since its initial cloning, particularly, the CTL1/SLC44A1 transporter has been investigated further and its ubiquitous expression characterized in various cells and tissues of mouse, rat, and human origin. We describe the role of this choline transporter both in the plasma membrane and in the mitochondria and summarize novel aspects of choline transport regulation in the muscle, nervous system, and cancer.Impact statementThis review will provide a summary of recent advances in choline transport research and highlight important novel areas of focus in the field.
Experience of nail bed injuries at a tertiary hand trauma unit: a 12-month review and cost analysis
Authors: Yildirimer Lara , Brewster Colin T , Aziz Hina , Unluer Zeynep , Jemec Barbara , De Leo Anna 
Published: February 2019

The aim of this study was to analyse the management of nail bed injuries from a clinical and economic perspective. We carried out a retrospective analysis of nail bed injuries treated operatively at a tertiary Plastic Surgery Hand Trauma Unit during 2016. The National Schedule of Reference Costs (2015–2016) was used to estimate the costs of treating 630 patients. The most common mechanism was a crush injury in a door (33%). Fifty-five per cent of patients had an associated tuft fracture. The minimum cost per annum for patients treated for nail bed injuries in our unit was calculated to be £511,560 (€573,362; US$666,664). Many nail bed injuries are preventable and because they present a very high financial burden on the National Health Service, targeted prevention strategies should be considered. Level of evidence: IV