bluuebunny/crossref_metadata_2025_split huggingface dataset:
Semen quality and cigarette smoking in a cohort of healthy fertile men
Authors: Tang Qiuqin , Pan Feng , Wu Xian , Nichols Cody E. , Wang Xinru , Xia Yankai , London Stephanie J. , Wu Wei 
Published: July 2019

Background:Numerous health effects of smoking are well-known; associations with semen quality are uncertain. Most previous studies did not adjust for potential confounders and had limited information on age at smoking initiation or smoking cessation.Methods:We investigated 1,631 healthy fertile men in the Nanjing Medical University Longitudinal Investigation of Fertility and the Environment (NMU-LIFE) study. Relationships were examined using multivariable linear regression controlling for potential covariates.Results:We found a significant decrease in semen volume (β= −0.10,P= 0.001) and total sperm count (β= −0.42,P= 0.037), and significant increase in total motility (β= 6.02,P= 0.037) and progressive motility (β= 5.52,P= 0.037) in ever smokers of pack-years ≥10 compared with never smokers. We observed an inverse dose-dependent relation between smoking pack-years and semen volume (P< 0.001) and total sperm count (P= 0.010) and a positive dose-dependent relation between smoking pack-years and both total motility and progressive motility (P= 0.042 and 0.048, respectively). No significant differences in semen quality were detected among ever smokers with different ages at smoking initiation nor in former smokers compared with never smokers.Conclusions:Cigarette smoking was associated with lower semen volume and total sperm count and higher sperm motility. Smoking cessation might have a restorative effect on semen quality. This finding has important implications for public health research and for understanding the development of abnormal semen quality.
Environmental noise and sleep and mental health outcomes in a nationally representative sample of urban US adolescents
Authors: Rudolph Kara E. , Shev Aaron , Paksarian Diana , Merikangas Kathleen R. , Mennitt Daniel J. , James Peter , Casey Joan A. 
Published: July 2019

Background:Environmental noise has been linked to negative health outcomes, like poor sleep, poor mental health, and cardiovascular disease, and likely accounts for more than 1 million disability-adjusted life years annually in Western Europe. Adolescence may be a particularly sensitive period for noise exposure due to an increased need for sleep, failure to meet sleep guidelines, and increased risk for first onset of some mental health disorders. However, the potential health effects of living in high-noise environments have not been studied in US adolescents, rarely in European adolescents, and mental health outcomes studied have not corresponded to diagnoses from the Diagnostic and Statistical Manual of Mental Disorders (DSM).Methods:Using a US-based nationally representative survey of urban adolescents (N = 4,508), we estimated associations of day-night average sound levels exceeding the US Environmental Protection Agency’s 55 decibel limit with sleep outcomes and lifetime mental health DSM diagnoses. We implemented doubly robust targeted minimum loss-based estimation coupled with propensity score matching to account for numerous potential adolescent, household, and environmental confounders.Results:Living in a high- versus low-noise Census block group was associated with later bedtimes on weeknights (0.48 hours, 95% confidence interval [CI] = –0.15, 1.12) and weekend nights (0.65 hours, 95% CI = 0.37, 0.93), but not with total hours slept. Associations between living in a high- versus low-noise Census block group and mental disorders were mixed, with wide CIs, and not robust to sensitivity analyses.Conclusions:We find evidence for an association between residence in a high-noise area and later bedtimes among urban adolescents but no consistent evidence of such an association with mental health disorders.
Obturator Nerve Split for Gracilis Free-flap Double Reinnervation in Facial Paralysis
Authors: Baccarani Alessio , Starnoni Marta , Zaccaria Giovanna , Anesi Alexandre , Benanti Elisa , Spaggiari Antonio , De Santis Giorgio 
Published: July 2019

Summary:
The use of a double-powered free muscle transfer for facial reanimation has been reported by several authors with different types of nerve coaptation. A new nerve coaptation strategy is presented herein. We performed a 1-stage double-powered free gracilis muscle flap transfer in a patient with long-standing facial paralysis by splitting the obturator nerve and anastomosing the 2 free ends to the contralateral facial nerve (through a sural graft) and to the masseteric nerve. Voluntary movement of the transferred muscle with teeth clenching was observed at 6 months after the operation and a symmetric smile with bilateral elevation of the mouth angle at 10 months. Our limited experience suggests that in case of a large cross-section of the obturator nerve, the latter can be split and sutured to the ipsilateral masseteric nerve and to the contralateral facial nerve with a sural graft by double end-to-end anastomosis.
Unique Uses of SPY: Revision Rhinoplasty
Authors: Amirlak Bardia , Dehdashtian Amir , Sanneic Kyle , Lu Karen B. , Cheng Jonathan 
Published: July 2019

Summary:
Inadequate tissue perfusion is a serious complication following reconstructive surgeries. Skin flap necrosis, especially in the head and neck area, may have significant cosmetic consequences. Although clinical exam is the mainstay in evaluating perfusion, it may not always predict ischemic problems. The SPY Elite laser angiographic system, which has been widely used to analyze tissue perfusion in postmastectomy skin flaps, has been shown to be able to evaluate tissue perfusion objectively. We describe a revision rhinoplasty case where hypoperfusion of the nasal tip was seen following placement of structural grafts to the nasal tip, and before the grafts being removed SPY, angiography was used to evaluate if topical nitroglycerin alone could correct hypoperfusion of the nasal tip rather than removal of structural grafts. A SPY angiography was performed to evaluate the hypoperfusion to the nasal tip. Repeat imaging was then performed following treatment with topical nitroglycerin alone. Perfusion of the nasal tip was restored and confirmed by SPY angiography system. The objective findings from the SPY angiography allowed the grafts to remain in place and lead to optimal cosmetic result. Due to the critical information SPY angiography provided in this case, we recommend the use of technology when evaluating reconstructive cases in which the viability of the tissue may be difficult to deduce from clinical exam.
Three-dimensional Camera Imaging in Postoperative Evaluation of Distraction Osteogenesis
Authors: Hirota Yuka , Ueda Koichi , Otsuki Yuki , Fuse Asuka , Mitsuno Daisuke 
Published: July 2019

Summary:
Distraction osteogenesis needs to be regularly assessed in some way to monitor the degree of advancement. X-ray is used for the general evaluation of osteotomy. However, radiation exposure should be avoided. The purpose of this study is to evaluate 3-dimensional (3D) camera imaging for postoperative evaluation. Three patients who underwent Le Fort I or III advancement osteotomy using rigid external distraction and internal distraction were observed in this study. The degrees of the distractions were evaluated using VECTRA H1 3D imaging in addition to computed tomographic (CT) scans. In the VECTRA 3D imaging, the tilt and size of the faces were corrected using the dedicated software for imaging. The preoperative and postoperative images were superimposed, and the distances of motion between the landmarks were measured. In CT scans, the bone distances between osteotomy points of the pterygomaxillary junction were analyzed. As the VECTRA 3D imaging can be compared by overlaying previous photographs, it served as a good tool to evaluate the distractions. However, both the soft-tissue movement measured by VECTRA and CT bony measurements did not match the total amount of movement for the internal distraction devices. The bony advancements were less than the amount of distraction. The soft tissues shrank after the distraction was completed in all cases. Three-dimensional camera imaging is considered to be a useful tool for the evaluation of distraction osteogenesis.
Nonsurgical Rhinoplasty: A Graft-based Technique
Authors: Segreto Francesco , Marangi Giovanni Francesco , Cerbone Vincenzo , Alessandri-Bonetti Mario , Caldaria Erika , Persichetti Paolo 
Published: July 2019

Background:
Nonsurgical rhinoplasty with hyaluronic acid (HA) has gained popularity due to its efficacy and minimal downtime. From a structural standpoint, it is like performing a tridimensional reshaping where only enhancement by grafts is allowed. To date, indications, technique, and products are still debated. The aim of this study is to describe the author’s experience with nonsurgical nasal reshaping, focusing on the indications and maneuvers to safely achieve, by mean of HA, the grafts previously described for surgical rhinoplasty.

Materials and Methods:
A total of 70 consecutive patients underwent nonsurgical rhinoplasty using the same type of HA. The rhinoplasty module of FACE-Q was administered to all patients before treatment and 15 days posttreatment. Statistical analysis was performed.

Results:
No complication was experienced. Two (2.8%) patients required a retouch after 15 days for further dorsal correction. There was a statistically significant difference between preoperative and postoperative values in all domains and overall scores of the rhinoplasty module of FACE-Q.

Conclusions:
The graft-based technique proved to be safe, effective, and reliable. It may allow correction of selected nasal defects with reduced cost and minimal downtime.
A Cross-sectional Study of the Association between Homelessness and Facial Fractures
Authors: Nguyen Audrey B. , Grimes Barbara , Neuhaus John , Pomerantz Jason H. 
Published: July 2019

Background:
Little is known about the risk factors for facial fractures among homeless patients. We investigated the association between homelessness, mechanism of injury, and type of facial fracture in patients treated at an urban trauma center.

Methods:
Data for 2,221 adults with facial fractures were obtained retrospectively from a standardized registry of trauma patients at Zuckerberg San Francisco General Hospital from 2011 to 2016. Associations between homelessness and mechanism of injury, facial fracture type, and surgical repair type were evaluated with multivariate multinomial logistic regression analysis.

Results:
Among 2,221 patients with facial fractures, 12% were homeless and, compared with housed patients, more likely to be male, black, and test positive for drug and alcohol use (all P < 0.0001). They had lower injury severity scores but longer hospital stays and were more likely to be discharged to the community than to a rehabilitation facility (all P < 0.0001). After adjusting for confounding variables, homeless patients with facial fractures were nearly 3-fold more likely to have been assaulted than housed patients (OR = 2.8, 95% CI = 1.9–4.1, P < 0.0001) and twice as likely to have mandible fractures (OR = 2.0, 95% CI = 1.3–3.0, P = 0.0030) and to have surgery for these fractures (OR = 2.1, 95% CI = 1.2–3.7, P = 0.0110).

Conclusions:
Our novel results demonstrate that homeless patients with facial fractures are at much higher risk than the general population for being assaulted, suffering mandible fractures, and requiring surgery for these fractures. Further investigations could guide identification, treatment, and prevention efforts.
Medial Upper Lip Vermillion Reconstruction with a Labial Artery-based Cross-lip Vermillion Flap
Authors: Sowa Yoshihiro , Inafuku Naoki , Kodama Takuya , Morita Daiki , Numajiri Toshiaki 
Published: July 2019

Summary:
A defect of the central upper lip vermillion generally requires “like for like” reconstruction because this part of the upper lip can attract attention and has a unique structure and color. In this article, we report use of a labial artery-based horizontal long cross-lip flap for central upper lip vermillion reconstruction. In the first stage of surgery, a horizontal long vermillion flap from the lower lip starting at the left commissure with a vascular pedicle containing an inferior labial artery was raised and transposed to the upper vermillion defect. In the second stage, 12 days later, the pedicle was divided to complete the reconstruction. There were no postoperative complications in articulation or eating, and the patient was satisfied with the esthetic outcome. This surgical technique reduces microstomia and inconvenience in eating and speaking compared with a common horizontal cross-lip flap and provides better color- and texture-matched tissue compared to reconstruction using a tongue flap or mucosal flap. The technique is simple, requires a relatively short surgical time, has minimum donor-site morbidity and permits good esthetic and functional reconstruction of the central upper lip vermillion for a relatively small defect.
Clinical Characteristics of Primary HHV-6B Infection in Children Visiting the Emergency Room
Authors: Hattori Fumihiko , Kawamura Yoshiki , Kozawa Kei , Miura Hiroki , Miyake Misa , Yoshikawa Akiko , Ihira Masaru , Yoshikawa Tetsushi 
Published: July 2019

Objective:
This cohort study, based on the design of a prior study in the United States, was conducted to elucidate the clinical features of primary human herpesvirus-6B (HHV-6B) infection.

Methods:
Between June 2014 and May 2016, febrile children younger than 5 years who visited the emergency room (ER) and underwent blood examination were enrolled in this study.

Results:
Fifty-nine (12%) of the 491 patients were diagnosed with primary HHV-6B infection. The rates of both simple and complex febrile seizure were significantly higher in patients with primary HHV-6B infection than in those without (P < 0.001 and P = 0.008, respectively). The median age at primary HHV-6B infection was 15 months. Forty-seven (79.7%) of the 59 patients with primary HHV-6B infection were younger than 2-year-old. Clinical features were compared between HHV-6B–infected patients older and younger than 2 years. The frequency of apparent infection (exanthema subitum) was significantly higher in the younger patients (P = 0.01). The median leukocyte (P = 0.01) and lymphocyte (P < 0.001) counts in the patients older than 2 years were significantly lower than those in the younger patients.

Conclusions:
Primary HHV-6B infection accounted for 12% of ER visits. Secondary febrile seizures, in particular the complex type, were considered to be a major contributor to the disease burden of primary HHV-6B infection. The timing of primary HHV-6B infection occurred at older ages than in past reports, and the frequency of inapparent infection was higher in older patients.
Causes of Pediatric Meningitis in Botswana: Results From a 16-Year National Meningitis Audit
Authors: Mitchell Hannah K. , Mokomane Margaret , Leeme Tshepo , Tlhako Nametso , Tsholo Katlego , Ramodimoosi Chandapiwa , Dube Bonno , Mokobela Kelebeletse O. , Tawanana Ephraim , Chebani Tony , Setlhake Pretty , Pilatwe Tlhagiso , Hurt William J. , Molefi Mooketsi , Mullan Paul C. , Steenhoff Andrew P. , Mine Madisa , Jarvis Joseph N. , Tenforde Mark W. 
Published: July 2019

Background:
Central nervous system infections are an important cause of childhood morbidity and mortality in high HIV-prevalence settings of Africa. We evaluated the epidemiology of pediatric meningitis in Botswana during the rollout of antiretroviral therapy, pneumococcal conjugate vaccine and Haemophilus influenzae type B (HiB) vaccine.

Methods:
We performed a cross-sectional study of children (<15 years old) evaluated for meningitis by cerebrospinal fluid (CSF) examination from 2000 to 2015, with complete national records for 2013–2014. Clinical and laboratory characteristics of microbiologically confirmed and culture-negative meningitis were described and incidence of Streptococcus pneumoniae, H. influenzae and cryptococcal meningitis was estimated for 2013–2014.

Results:
A total of 6796 unique cases were identified. Median age was 1 year [interquartile range 0–3]; 10.4% (435/4186) of children with available HIV-related records were known HIV-infected. Overall, 30.4% (2067/6796) had abnormal CSF findings (positive microbiologic testing or CSF pleocytosis). Ten percent (651/6796) had a confirmed microbiologic diagnosis; including 26.9% (175/651) Cryptococcus, 18.9% (123/651) S. pneumoniae, 20.3% (132/651) H. influenzae and 1.1% (7/651) Mycobacterium tuberculosis. During 2013–2014, national cryptococcal meningitis incidence was 1.3 cases per 100,000 person-years (95% confidence interval, 0.8–2.1) and pneumococcal meningitis incidence 0.7 per 100,000 person-years (95% confidence interval, 0.3–1.3), with no HiB meningitis diagnosed.

Conclusions:
Following HiB vaccination, a marked decline in microbiologically confirmed cases of H. influenzae meningitis occurred. Cryptococcal meningitis remains the most common confirmed etiology, demonstrating gaps in prevention-of-mother-to-child transmission and early HIV diagnosis. The high proportion of abnormal CSF samples with no microbiologic diagnosis highlights limitation in available diagnostics.
General pediatric care for a patient after heart transplant: what the practitioner needs to know
Authors: Chatfield Kathryn , Nakano Stephanie J. , Everitt Melanie D. 
Published: July 2019

Purpose of review
The scope of this review is to discuss aspects of general pediatric care which significantly impact the outcome of children after heart transplant. The general practitioner (GP) often serves as the frontline for prevention and early detection of common problems after heart transplant.

Recent findings
Multiple studies in the literature show the negative impact of preventable illness in immune compromised patients, including the appropriateness of vaccine administration. Except for live vaccines, pediatric heart transplant recipients generally follow standard childhood vaccine schedules. In addition, diagnosis of cardiac and noncardiac conditions by the practitioner can lead to earlier treatment by subspecialists. While rejection and infection are such conditions the practitioner may identify, psychological and neurocognitive conditions are common and impact both adherence to medications and quality of life.

Summary
These issues are addressed in this review of the recent literature. Through knowledge, detection, and collaboration of care, the practitioner can greatly improve the well being of pediatric heart transplant recipients.
Delay in the Diagnosis of Breast and Colorectal Cancer in People With Severe Mental Disorders
Authors: Céspedes Pedro , Sánchez-Martínez Vanessa , Lera-Calatayud Guillem , Vila-Candel Rafael , Cauli Omar , Buigues Cristina 
Published: July 2019

Background
People with severe mental disorders have a worse cancer prognosis, with higher mortality rates than the general population, and this could be partially attributed to a later detection. Breast cancer and colorectal cancer have mass population screenings in Spain, but the influence in early diagnosis is unknown in persons with severe mental disorders.

Objective
To compare the severity of breast and colorectal cancers at diagnosis in people with and without mental disorders.

Methods
This was an observational, retrospective, case-control study with 1:2 matching performed in Eastern Spain. Data were retrieved for analysis from electronic medical records.

Results
The study included 111 oncology patients (75 with breast cancer and 36 with colorectal cancer). Individuals with mental disorders had a significantly higher (P = .002) relative risk (odds ratio [OR], 3.93; 95% confidence interval [CI], 1.60–9.65) to be diagnosed with an advanced tumor stage (clinical stages IIIA, IIIB, IIIC, and IV), for both breast and colorectal cancers when analyzed separately. The variables associated with advanced cancer at the time of diagnosis were the presence of a previous mental disorder (OR, 4.67; 95% CI, 1.73–12.61) and older age (OR, 1.08; 95% CI, 1.02–1.14).

Conclusions
Individuals with severe mental disorders showed a higher risk of being diagnosed with breast and colorectal cancers at advanced stages.

Implications for Practice:
Cancer screening for earlier detection and intervention in people with severe mental disorders needs improvement. Mental health nurses, screening nurses, and oncology nurses could serve an essential role in increasing the screening adherence of this group of individuals.
Simulation to assess intelligent video camera system's actual production performance during chemotherapy preparation
Authors: Laplace Marie , Lefranc Benoit , Dalifard Benoit 
Published: July 2019

Abstract

Introduction:
DRUGCAM is a new approach to control the chemotherapy preparations with an intelligent video system to assist the pharmacy technician during compounding process. This tool is able to control all of our production (except for colored and dark anticancer drugs) with an in-process control and a posteriori inspection. We first aimed to estimate DRUGCAM's performance in real-life production by simulation and to compare it with the double human control. Furthermore, factors influencing the performance of both controls were observed and preventive solutions will be envisaged to optimize our activity.

Equipment and methods:
Each day during 30 days, between 11:30 am and 12:30 am, we controlled 20 different volumes contained in syringes, in real production conditions (clean room) both by human visual inspection then by automated video control. Working conditions have been observed and tasks disturbances and interruptions have been noted. A set of information has been collected: the syringe's model, the volume of product and the disturbances. A statistical analysis has been conducted to interpret results.

Results:
With 24 errors throughout the 600 volume controls, the error rate for the visual human control is 4%. Seven checked volumes were superior to the expected volume (overdosing) and 17 were inferior (underdosing). The error rate for DRUGCAM is 0.17%. Among the disturbance factors, the type of syringe used is responsible for errors: 13 errors have been noticed with the 1 mL syringe and 8 errors with the 10 mL syringe which represent higher error rates than with the other syringes.
The “permanent” staff members of the unit present an error rate of 5.3%, more important than the “non-permanent” ones (1.8%). More mistakes are done in the presence of a pharmacist than in its absence (13% against 4%).

Conclusion:
Our studies justify the superiority of the DRUGCAM system toward double human control. Moreover, the double human control could possibly be disturbed by external factors whereas DRUGCAM is not. Using DRUGCAM is to be considered to establish preventive measures and reduce tasks interruptions or disturbance factors thanks to video analysis.