bluuebunny/crossref_metadata_2025_split huggingface dataset:
Penoscrotal Decompression—Promising New Treatment Paradigm for Refractory Ischemic Priapism
Authors: Fuchs Joceline S. , Shakir Nabeel , McKibben Maxim J. , Mathur Shawn , Teeple Sloan , Scott Jeremy M. , Morey Allen F. 
Published: March 2018

Abstract

Background
For prolonged ischemic priapism, outcomes after distal shunt are poor, with only 30% success for priapic episodes lasting longer than 48 hours.

Aim
To present a novel, glans-sparing approach of corporal decompression through a penoscrotal approach for cases of refractory ischemic priapism (RIP) after failed distal shunt procedures.

Methods
We describe the technique and present our initial experience with penoscrotal decompression (PSD) for treatment of RIP after failed distal shunt. We compared outcomes of patients with RIP undergoing surgical management using PSD or malleable penile prosthesis (MPP) placement after failed distal penile shunt procedures (2008–2017).

Outcomes
Our initial experience showed favorable outcomes with PSD compared with early MPP placement in patients with RIP whose distal shunt failed.

Results
Of 14 patients with RIP undergoing surgical management after failed distal penile shunt procedures, all patients presented after a prolonged duration of priapism (median = 61 hours) after which the priapism was refractory to multiple prior treatments (median = 3, range = 1–75) including at least 1 distal shunt. MPP was inserted in 8 patients (57.1%), whereas the most recent 6 patients (42.9%) underwent PSD. All patients with PSD (6 of 6, 100%) were successfully treated with corporal decompression without additional intervention and noted immediate relief of pain postoperatively. In contrast, 37.5% of patients (3 of 8) undergoing MPP after failed distal shunt procedures required a total of 8 revision surgeries during a median follow-up of 41.5 months. The most common indications for revision surgery after MPP placement included distal (4 of 8, 50%) and impending lateral (2 of 8, 25%) extrusion.

Clinical Implications
PSD is a simple, effective technique in the management of RIP after failed distal shunt procedures with fewer complications than MPP placement.

Strengths and Limitations
Although PSD is effective in the management of RIP after failed distal shunt procedures, long-term assessment of erectile function and ease of future penile prosthetic implantation is needed.

Conclusion
Corporal decompression resolves RIP through a glans-sparing approach and avoids the high complication rate of prosthetic insertion after failed distal shunt procedures.
Functional Outcomes of an Interdisciplinary Outpatient Rehabilitation Program for Patients with Malignant Brain Tumors
Authors: Shahpar Samman , Wong Alex W.K. , Keeshin Susan , Eickmeyer Sarah M. , Semik Patrick , Kocherginsky Masha , McCarty Stacy 
Published: March 2018

AbstractBackgroundMalignant brain tumors cause significant impairments in function because of the nature of the disease. Nevertheless, patients with malignant brain tumors can make functional gains equivalent to those with stroke and traumatic brain injury in the inpatient rehabilitation setting. However, the efficacy of outpatient rehabilitation in this population has received little study.ObjectiveTo determine if an interdisciplinary outpatient rehabilitation program will improve functional outcomes in patients with malignant brain tumors.DesignNonrandomized prospective longitudinal study.SettingSix affiliated outpatient sites of one institution.PatientsForty‐nine adults with malignant brain tumors were enrolled.MethodsPatients received interdisciplinary therapy services, with duration determined by the therapist evaluations. The therapists scored the Day Rehabilitation Outcome Scale (DayROS) and Disability Rating Scale (DRS) on admission and discharge. The caregivers filled out the DRS at discharge, 1 month, and 3 months after discharge.Main Outcome MeasurementsThe primary study outcome measure was the DayROS, which is a functional measure similar to the Functional Independence Measure. DRS was another functional outcome measure assessing basic self‐care, dependence on others, and psychosocial adaptability.ResultsForty‐six of 49 enrolled patients (94%) completed the day rehabilitation program. The average length of stay was 76.9 days. There was a significant improvement in total DayROS (P < .001), mobility (P < .001), Activities of Daily Living (P < .001), and communication (P < .001) DayROS subscores from admission to discharge. There were no significant changes over time in the DRS scores. Women had higher DayROS gains (P = .003) and better therapist DRS scores from admission to discharge than men (P = .010).ConclusionsPatients with malignant brain tumors can make functional gains in an interdisciplinary outpatient rehabilitation program. This level of care should be considered in this patient population.Level of EvidenceII
Rhythmic Neck Muscle Spasms and Upper Limb Muscle Myoclonic Jerks as an Unusual Initial Presentation of Posttraumatic Cervicothoracic Syringomyelia: A Case Report
Authors: Lin Hsin‐Chin , Tsai Yu‐Lin , Tsai Wen‐Chung 
Published: March 2018

AbstractPosttraumatic syringomyelia with an initial presentation of involuntary movement is rare. We describe a 25‐year‐old patient who sustained complete traumatic spinal cord injury at the thoracic level and presented with rhythmic neck muscle spasms and upper limb muscle myoclonic jerks 1 month after trauma. Magnetic resonance imaging revealed syrinx formation between C3 and T1. Lumbar‐peritoneal shunt and decompression were performed. The symptoms completely disappeared after surgery. This report highlights that rhythmic neck muscle spasms and upper limb muscle myoclonic jerks can be the initial and only manifestations of syringomyelia.Level of EvidenceV
Amantadine‐Induced Corneal Edema in a Pediatric Neuro‐Oncology Patient: A Case Report
Authors: Beran Maria , Okyere Britta , Vova Joshua 
Published: March 2018

AbstractAmantadine is commonly prescribed as a neurostimulant in patients with brain injuries. This is a case of a 14‐year‐old male with a history of brain tumor that developed corneal edema after initiation of amantadine, a rare but documented side effect of this medication. After discontinuation of amantadine, the corneal edema resolved within two months, but endothelial cells density remained low.Level of EvidenceV
Frailty in a Post‐Acute Care Population: A Scoping Review
Authors: Roberts Pamela S. , Goud Manoj , Aronow Harriet Udin , Riggs Richard V. 
Published: March 2018

AbstractFrailty is a complex and growing phenomenon facing health care providers throughout the continuum of care. Frailty is not well understood in post‐acute care (PAC) settings. The purpose of this scoping review was to summarize current evidence of frailty impact on outcomes and frailty mitigation initiatives in PAC. Three major publication databases were searched from January 2000 to June 2017 that identified 18 articles specifically addressing frailty in PAC. Three themes were identified: scales used to measure frailty, factors that led to an adverse outcome or diagnosis of frailty, and interventions to address frailty in PAC. Scales used to measure frailty were dominated by physical factors and scarce on nutrition and social support. Functional decline, grip strength, gait speed, polypharmacy, and nutrition were identified in the studies as factors that identify frailty and are associated with poor outcomes. All these frailty characteristics compromise patients’ ability to benefit from rehabilitation, which further establishes the importance of PAC providers to identify, prevent, and treat frailty. Intervention studies had mixed outcomes, suggesting a need for further development in this area. The findings of this scoping review highlight the need for a comprehensive multidimensional assessment of frailty risks in PAC.Level of EvidenceIV
Why the security industry should stop relying on FUD
Authors: Curry Sam 
Published: March 2018

The narrative around information security has always been much more negative than the rest of the technology sector. Discussions around cyber tend to focus on threats and consequences, rather than the optimistic emphasis on progress and opportunity found in areas such as the cloud or mobile technology. Discussions around cyber tend to focus on threats and consequences, rather than the optimistic emphasis on progress and opportunity found in areas such as the cloud or mobile technology. The security industry often gets carried away with the level of doom and gloom and all too often, we see the conversation veering into fear, uncertainty and doubt. The industry has a duty to use its knowledge and experience to guide organisations into making choices that will improve their confidentiality, integrity and availability when a security incident occurs, says Sam Curry of Cybereason.
Art and Archaeology
Authors: Spivey Nigel 
Published: March 2018

If asked to cite a single image as symbolic of Athenian democracy, many Classicists would probably suggest the Tyrannicides group. It seems the obvious choice. Yet while no one would deny the ideological value given to the statue(s) raised in commemoration of the event, there are some well-known historical reasons for being sceptical about any democratic ideals harboured by Harmodius and Aristogeiton when they assassinated Hipparchus in 514 bc. In that sense, the Tyrannicides group is inappropriate. So what alternatives come to mind? Here is one possibility, which was once visible, like the Tyrannicides, in the Athenian agora: a fourth-century bc marble relief showing several figures engaged in making footwear (Agora inv. I 7396). The piece carries an inscription, worth quoting:
Dionysios the son of [Sim?]on, the cobbler, and the children dedicated this to Heros Kallistephanos. Having seen a divine vision in his sleep, Dionysios adorns the hero and the children of Kallistephanos; do you give in return for these things wealth and happy health.
Tackling rarity and sample bias with large-scale biodiversity monitoring: a case study examining the status, distribution and ecology of the lichen Cladonia rei in Alberta, Canada
Authors: HAUGHLAND Diane L. , HILLMAN Ashley , AZERIA Ermias T. 
Published: March 2018

AbstractSpecies conservation depends on accurate data, but for many lichens existing collections are geographically biased and contain many taxonomic errors. It is unclear whether ‘non-expert’, systematic monitoring schemes can address these sources of error, particularly for taxonomically challenging lichens (e.g. species requiring chemistry for accurate identification). In this case study we use the Alberta Biodiversity Monitoring Institute (ABMI), a large-scale, systematic, multi-taxon monitoring programme, to better understand the ecology and distribution of a putative rare species, Cladonia rei. Collections of C. rei from Alberta dating from 1947 suggested the species was broadly distributed but rare, with seven accessioned specimens. We used comparative morphology, thin-layer chromatography and habitat modelling to compare historical records against more recent material from ABMI surveys. Contrary to the historical collections, ABMI samples suggest C. rei is almost entirely limited to the dry mixed grassland, northern fescue grassland and aspen parkland natural regions, and that within these ecosystems it is relatively common. The typical ecotype exhibited included a persistent primary thallus, podetia with a persistent basal cortex, and secondary squamules; typically they lacked cups, well-developed apothecia and fumarprotocetraric acid, and ramifications were sparse. Cladonia rei was consistently found in pastures and undisturbed grasslands that hosted relatively rich communities of epigeic lichens, thus it does not appear to act as a pioneer in Alberta or to commonly occupy the anthropogenic niches documented elsewhere. In summary, large-scale, systematic, non-targeted monitoring employing novices redressed issues of sample bias through almost 300 C. rei collections, simultaneously improving the ecological understanding of a putative rare species.
The cost-effectiveness of follow-up strategies after cancer treatment: a systematic literature review
Authors: Barbieri M , Richardson G , Paisley S 
Published: March 2018

Abstract

Introduction
The cost of treatment and follow-up of cancer patients in the UK is substantial. In a budget-constrained system such as the NHS, it is necessary to consider the cost-effectiveness of the range of management strategies at different points on cancer patients’ care pathways to ensure that they provide adequate value for money.

Sources of data
We conducted a systematic literature review to explore the cost-effectiveness of follow-up strategies of patients previously treated for cancer with the aim of informing UK policy. All papers that were considered to be economic evaluations in the subject areas described above were extracted.

Areas of agreement
The existing literature suggests that intensive follow-up of patients with colorectal disease is likely to be cost-effective, but the opposite holds for breast cancer.

Areas of controversy
Interventions and strategies for follow-up in cancer patients were variable across type of cancer and setting. Drawing general conclusions about the cost-effectiveness of these interventions/strategies is difficult.

Growing points
The search identified 2036 references but applying inclusion/exclusion criteria a total of 44 articles were included in the analysis. Breast cancer was the most common (n = 11) cancer type followed by colorectal (n = 10) cancer. In general, there were relatively few studies of cost-effectiveness of follow-up that could influence UK guidance. Where there was evidence, in the most part, NICE guidance broadly reflected this evidence.

Areas timely to develop research
In terms of future research around the timing, frequency and composition of follow-ups, this is dependent on the type of cancer being considered. Nevertheless, across most cancers, the possibility of remote follow-up (or testing) by health professionals other than hospital consultants in other settings appears to warrant further work.
European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on arrhythmias and cognitive function: what is the best practice?
Authors: Dagres Nikolaos , Chao Tze-Fan , Fenelon Guilherme , Aguinaga Luis , Benhayon Daniel , Benjamin Emelia J , Bunch T Jared , Chen Lin Yee , Chen Shih-Ann , Darrieux Francisco , de Paola Angelo , Fauchier Laurent , Goette Andreas , Kalman Jonathan , Kalra Lalit , Kim Young-Hoon , Lane Deirdre A , Lip Gregory Y H , Lubitz Steven A , Márquez Manlio F , Potpara Tatjana , Pozzer Domingo Luis , Ruskin Jeremy N , Savelieva Irina , Teo Wee Siong , Tse Hung-Fat , Verma Atul , Zhang Shu , Chung Mina K ,   ESC Scientific Document Group, Bautista-Vargas William-Fernando , Chiang Chern-En , Cuesta Alejandro , Dan Gheorghe-Andrei , Frankel David S , Guo Yutao , Hatala Robert , Lee Young Soo , Murakawa Yuji , Pellegrini Cara N , Pinho Claudio , Milan David J , Morin Daniel P , Nadalin Elenir , Ntaios George , Prabhu Mukund A , Proietti Marco , Rivard Lena , Valentino Mariana , Shantsila Alena 
Published: March 2018

Abstract
The benefits of health information exchange: an updated systematic review
Authors: Menachemi Nir , Rahurkar Saurabh , Harle Christopher A , Vest Joshua R 
Published: March 2018

AbstractObjectiveWidespread health information exchange (HIE) is a national objective motivated by the promise of improved care and a reduction in costs. Previous reviews have found little rigorous evidence that HIE positively affects these anticipated benefits. However, early studies of HIE were methodologically limited. The purpose of the current study is to review the recent literature on the impact of HIE.MethodsWe used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to conduct our systematic review. PubMed and Scopus databases were used to identify empirical articles that evaluated HIE in the context of a health care outcome.ResultsOur search strategy identified 24 articles that included 63 individual analyses. The majority of the studies were from the United States representing 9 states; and about 40% of the included analyses occurred in a handful of HIEs from the state of New York. Seven of the 24 studies used designs suitable for causal inference and all reported some beneficial effect from HIE; none reported adverse effects.ConclusionsThe current systematic review found that studies with more rigorous designs all reported benefits from HIE. Such benefits include fewer duplicated procedures, reduced imaging, lower costs, and improved patient safety. We also found that studies evaluating community HIEs were more likely to find benefits than studies that evaluated enterprise HIEs or vendor-mediated exchanges. Overall, these finding bode well for the HIEs ability to deliver on anticipated improvements in care delivery and reduction in costs.
External Ventricular Drain and Hemorrhage in Aneurysmal Subarachnoid Hemorrhage Patients on Dual Antiplatelet Therapy: A Retrospective Cohort Study
Authors: Hudson Joseph S , Prout Benjamin S , Nagahama Yasunori , Nakagawa Daichi , Guerrero Waldo R , Zanaty Mario , Chalouhi Nohra , Jabbour Pascal , Dandapat Sudeepta , Allan Lauren , Ortega-Gutierrez Santiago , Samaniego Edgar A , Hasan David 
Published: March 2018

Abstract

BACKGROUND
Stenting and flow diversion for aneurysmal sub arachnoid hemorrhage (aSAH) require the use of dual antiplatelet therapy (DAPT).

OBJECTIVE
To investigate whether DAPT is associated with hemorrhagic complication following placement of external ventricular drains (EVD) in patients with aSAH.

METHODS
Rates of radiographically identified hemorrhage associated with EVD placement were compared between patients who received DAPT for stenting or flow diversion, and patients who underwent microsurgical clipping or coiling and did not receive DAPT by way of a backward stepwise multivariate analysis.

RESULTS
Four hundred forty-three patients were admitted for aSAH management. Two hundred ninety-eight patients required placement of an EVD. One hundred twenty patients (40%) were treated with stent-assisted coiling or flow diversion and required DAPT, while 178 patients (60%) were treated with coiling without stents or microsurgical clipping and did not receive DAPT. Forty-two (14%) cases of new hemorrhage along the EVD catheter were identified radiographically. Thirty-two of these hemorrhages occurred in patients on DAPT, while 10 occurred in patients without DAPT. After multivariate analysis, DAPT was significantly associated with radiographic hemorrhage [odds ratio: 4.92, 95% confidence interval: 2.45-9.91, P = .0001]. We did not observe an increased proportion of symptomatic hemorrhage in patients receiving DAPT (10 of 32 [31%]) vs those without (5 of 10 [50%]; P = .4508).

CONCLUSION
Patients with aSAH who receive stent-assisted coiling or flow diversion are at higher risk for radiographic hemorrhage associated with EVD placement. The timing between EVD placement and DAPT initiation does not appear to be of clinical significance. Stenting and flow diversion remain viable options for aSAH patients.
Response Changes During Insertion of a Cochlear Implant Using Extracochlear Electrocochleography
Authors: Giardina Christopher K. , Khan Tatyana E. , Pulver Stephen H. , Adunka Oliver F. , Buchman Craig A. , Brown Kevin D. , Pillsbury Harold C. , Fitzpatrick Douglas C. 
Published: March 2018

Objectives:
Electrocochleography is increasingly being utilized as an intraoperative monitor of cochlear function during cochlear implantation (CI). Intracochlear recordings from the advancing electrode can be obtained through the device by on-board capabilities. However, such recordings may not be ideal as a monitor because the recording electrode moves in relation to the neural and hair cell generators producing the responses. The purposes of this study were to compare two extracochlear recording locations in terms of signal strength and feasibility as intraoperative monitoring sites and to characterize changes in cochlear physiology during CI insertion.

Design:
In 83 human subjects, responses to 90 dB nHL tone bursts were recorded both at the round window (RW) and then at an extracochlear position—either adjacent to the stapes or on the promontory just superior to the RW. Recording from the fixed, extracochlear position continued during insertion of the CI in 63 cases.

Results:
Before CI insertion, responses to low-frequency tones at the RW were roughly 6 dB larger than when recording at either extracochlear site, but the two extracochlear sites did not differ from one another. During CI insertion, response losses from the promontory or adjacent to the stapes stayed within 5 dB in ≈61% (38/63) of cases, presumably indicating atraumatic insertions. Among responses which dropped more than 5 dB at any time during CI insertion, 12 subjects showed no response recovery, while in 13, the drop was followed by partial or complete response recovery by the end of CI insertion. In cases with recovery, the drop in response occurred relatively early (<15 mm insertion) compared to those where there was no recovery. Changes in response phase during the insertion occurred in some cases; these may indicate a change in the distributions of generators contributing to the response.

Conclusions:
Monitoring the electrocochleography during CI insertion from an extracochlear site reveals insertions that are potentially atraumatic, show interaction with cochlear structures followed by response recovery, or show interactions such that response losses persist to the end of recording.
Costs and Complications of Single-Stage Fixation Versus 2-Stage Treatment of Select Bicondylar Tibial Plateau Fractures
Authors: Virkus Walter W. , Caballero Jesse , Kempton Laurence B. , Cavallero Matthew , Rosales Rich , Gaski Greg E. 
Published: March 2018

Objectives:To determine the differences in costs and complications in patients with bicondylar tibial plateau (BTP) fractures treated with 1-stage definitive fixation compared with 2-stage fixation after initial spanning external fixation.Design:Retrospective cohort study.Setting:Level 1 Trauma Center.Patients/Participants:Patients with OTA/AO 41-C (Schatzker 6) BTP fractures treated with open reduction internal fixation.Intervention:Definitive treatment with open reduction internal fixation either acutely (1 stage) or delayed after initial spanning external fixation (2 stage).Main Outcome Measures:Wound healing complications, implant costs, hospital charges, Patient-Reported Outcomes Measurement Information System (PROMIS), reoperation, nonunion and infection.Results:One hundred five patients were identified over a three-year period, of whom 52 met the inclusion criteria. There were 28 patients in the 1-stage group and 24 patients in the 2-stage group. Mean follow-up was 21.8 months, and 87% of patients had at least 12 months of follow-up. The mean number of days to definitive fixation was 1.2 in the 1-stage group and 7.8 in the 2-stage group. There were no differences between groups with respect to wound healing or any other surgery-related complications. Functional outcomes PROMIS were similar between groups. Mean implant cost in the 2-stage group was $10,821 greater than the 1-stage group, mostly because of the costs of external fixation. Median hospital inpatient charges in the 2-stage group exceeded the 1-stage group by more than $68,000 for all BTP fractures and by $61,000 for isolated BTP fractures.Conclusions:Early single-stage treatment of BTP fractures is cost-effective and is not associated with a higher complication rate than 2-stage treatment in appropriately selected patients.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.