bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental health of unaccompanied asylum-seeking adolescents previously held in British detention centres
Authors: Ehntholt Kimberly A , Trickey David , Harris Hendriks Jean , Chambers Hannah , Scott Mark , Yule William 
Published: March 2018

Aim: To investigate whether the mental health of unaccompanied asylum-seeking children (UASC) was negatively affected by having their ages disputed and being detained. Method: Participants within this cross-sectional study were 35 UASC, aged between 13 and 17 when they were detained. Some years later, a team of child mental health professionals interviewed them to assess their current mental health and to determine, as far as possible, the impact that having their age disputed and being detained may have had on their mental health. The Structured Clinical Interview for DSM-IV (SCID-IV), Reactions of Adolescents to Traumatic Stress (RATS), Stressful Life Events (SLE) and Detention Experiences Checklist–UK version (DEC-UK) were administered. Results: The vast majority of UASC reported being negatively affected. Based on diagnostic interviews using the SCID-IV, self-report measures and contemporaneous records, the professionals reported a diagnosis of post-traumatic stress disorder (PTSD) developing in 29% ( n = 10), PTSD exacerbated in 51% ( n = 18), major depressive disorder (MDD) developing in 23% ( n = 8) and MDD exacerbated in 40% ( n = 14). A total of 3 years post-detention, 89% ( n = 31) met diagnostic criteria for psychiatric disorders and reported high PTSD symptoms. Conclusion: There was a high prevalence of psychiatric disorder. The additional stress of age dispute procedures and detention was judged to have been harmful.
Sexual Responses Are Facilitated by High-Order Contextual Cues in Females but Not in Males
Authors: Ponseti Jorge , Dähnke Kim , Fischermeier Leona , Gerwinn Hannah , Kluth Amelie , Müller Jens , Vogel Susanne , Stirn Aglaja 
Published: March 2018

Sexual responses are thought to be controlled by a brain module called the sexual module. Sexual strategies of males and females vary to a great extent, and sexual responses of males and females may be affected by their sexual strategies. However, the current view of the sexual module is that of a unisex module. This might be questionable since brain modules are defined as evolved cognitive mechanisms to solve adaptive problems which are different for males and females. We hypothesize that the sexual module responds differently in the presence of complex (high-order) contextual cues that are related to gender-dimorphic sexual strategies in males and females. We conducted a priming experiment in which stimuli related to sexual strategies were disentangled from their sexual meaning. Nonsexual priming pictures related to either economic resources or social interactions preceded a sexual-target picture in order to test whether the primes were able to modulate the subjective sexual response to the sexual target. In a control condition, priming pictures without relation to mating preferences but with similar emotional impact were presented. In males, sexual responses were similar in the experimental and control conditions. In females, however, primes related to economic resources or social interactions modulated sexual arousal significantly more than the control primes. Our findings suggest that brain modules dedicated to process the experimental primes were functionally connected with the sexual module in females more than in males, making females’ sexual responses more prone to the impact of high-order cultural cues than males’ sexual responses. A gender-dimorphic connectivity of the sexual module may be the way in which gender-dimorphic sexual strategies are implemented in the human mind.
Surgical site infection after trans urethral resection of the prostate (TURP): 2008–2013 French national SSI surveillance ISO-RAISIN
Authors: Bruyère Franck , Perennec-Olivie Marion , Tanguy Juliette , Aupee Martine , Astagneau Pascal , Jarno Pascal , Malavaud Sandra 
Published: March 2018

Objective: To describe surgical site infection (SSI) after transurethral resection of prostate (TURP) from the French national database. Methods: A national SSI surveillance system was implemented in 1999. Each year, the network included urology departments that included at least two months plus one month follow-up, or at least 100 consecutive targeted surgical procedures. A dataset of patients who underwent urology procedures during the six-year period 2008–2013 was made available. SSI diagnosis was made according to standardised CDC criteria. Descriptive analyses were performed using SAS software version 9.4. Results: A total of 12,897 TURPs were performed by 89 urology departments. The crude incidence SSI rate was 2.43 (95% confidence interval = 2.16–2.79). The mean delay for diagnosis was 11.9 ± 8.9 days. The treatment of the SSI required a new surgical intervention in 1.35%. In the multilevel multivariate analysis, ASA score and duration of follow-up were the only parameters correlated with the SSI rate. Conclusions: On more than 12,000 TURPs surveyed, the SSI rate was 2.43. ASA score and duration of follow-up were the only parameters correlated with the SSI rate.
Adaptive and Personalized Plasma Insulin Concentration Estimation for Artificial Pancreas Systems
Authors: Hajizadeh Iman , Rashid Mudassir , Samadi Sediqeh , Feng Jianyuan , Sevil Mert , Hobbs Nicole , Lazaro Caterina , Maloney Zacharie , Brandt Rachel , Yu Xia , Turksoy Kamuran , Littlejohn Elizabeth , Cengiz Eda , Cinar Ali 
Published: March 2018

Background: The artificial pancreas (AP) system, a technology that automatically administers exogenous insulin in people with type 1 diabetes mellitus (T1DM) to regulate their blood glucose concentrations, necessitates the estimation of the amount of active insulin already present in the body to avoid overdosing. Method: An adaptive and personalized plasma insulin concentration (PIC) estimator is designed in this work to accurately quantify the insulin present in the bloodstream. The proposed PIC estimation approach incorporates Hovorka’s glucose-insulin model with the unscented Kalman filtering algorithm. Methods for the personalized initialization of the time-varying model parameters to individual patients for improved estimator convergence are developed. Data from 20 three-days-long closed-loop clinical experiments conducted involving subjects with T1DM are used to evaluate the proposed PIC estimation approach. Results: The proposed methods are applied to the clinical data containing significant disturbances, such as unannounced meals and exercise, and the results demonstrate the accurate real-time estimation of the PIC with the root mean square error of 7.15 and 9.25 mU/L for the optimization-based fitted parameters and partial least squares regression-based testing parameters, respectively. Conclusions: The accurate real-time estimation of PIC will benefit the AP systems by preventing overdelivery of insulin when significant insulin is present in the bloodstream.
Trends in Tracheostomy After Stroke: Analysis of the 1994 to 2013 National Inpatient Sample
Authors: Chatterjee Abhinaba , Chen Monica , Gialdini Gino , Reznik Michael E. , Murthy Santosh , Kamel Hooman , Merkler Alexander E. 
Published: March 2018

Background: Real-world data on long-term trends in the use of tracheostomy after stroke are limited. Methods: Patients who underwent tracheostomy for acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH) were identified from the 1994 through 2013 releases of the National Inpatient Sample using previously validated International Classification of Diseases, Ninth Revision, Clinical Modification codes. Survey weights were used to report nationally representative estimates. Our primary outcome was the trend in tracheostomy use during the index stroke hospitalization over the last 20 years. Additionally, we evaluated trends in in-hospital mortality, timing of placement, and discharge disposition among patients who received a tracheostomy. Results: We identified 9.9 million patients with AIS, ICH, or SAH in the United States from 1994 to 2013, of which 170 255 (1.7%; 95% confidence interval [CI]: 1.6%-1.8%) underwent tracheostomy. Among all patients with stroke, tracheostomy use increased from 1.2% (95% CI: 1.1%-1.4%) in 1994 to 1.9% (95% CI: 1.8%-2.1%) in 2013, with similar trends across stroke types. From 1994 to 2013, the timing of tracheostomy decreased from 16.5 days (95% CI: 14.9-18.1 days) to 10.3 days (95% CI: 9.9-10.8 days) after mechanical ventilation. In-hospital mortality decreased from 32.6% (95% CI: 29.1%-36.1%) to 13.8% (95% CI: 12.3%-15.3%) among tracheostomy patients; however, discharge to a nonacute care facility increased from 42.9% (95% CI: 38.0%-47.8%) to 83.3% (95% CI: 81.6%-85.0%) and home discharge declined from 9.3% (95% CI: 7.3%-11.3%) to 2.9% (95% CI: 2.1%-3.7%). Conclusion: Over the past 2 decades, tracheostomy use has increased among patients with stroke. This increase was associated with earlier placement, reduced in-hospital mortality, and lower rates of home discharge.
Conversion from insulin glargine U-100 to insulin glargine U-300 or insulin degludec and the impact on dosage requirements
Authors: Pearson Scott M. , Trujillo Jennifer M. 
Published: March 2018

Background: We wanted to determine whether basal insulin requirements change when patients transition from insulin glargine U-100 (Gla-100) to insulin glargine U-300 (Gla-300) or insulin degludec. Methods: This study involved subjects seen in the University of Colorado Health Endocrine Clinic who were transitioned from Gla-100 to either Gla-300 ( n = 95) or insulin degludec ( n = 39). The primary outcome was the difference between baseline Gla-100 dose and dose of Gla-300 or insulin degludec prescribed after first follow-up visit within 1–12 months. Secondary outcomes included changes in glycemic control and empiric dose conversion from Gla-100 to Gla-300 or insulin degludec on the day of transition. Wilcoxon rank sum tests evaluated changes in insulin doses, and paired t tests assessed changes in glycemic control using GraphPad statistical software. Results: Median daily basal insulin dose increased for individuals transitioned from Gla-100 to Gla-300 from 30 [19–60 interquartile range (IQR)] units at baseline to 34.5 (19–70 IQR) units after follow up ( p = 0.01). For patients transitioned to insulin degludec, dose changes from baseline to follow up were not significantly different ( p = 0.56). At the time of transition, the prescribed dose of Gla-300 or insulin degludec did not significantly differ from the previous dose of Gla-100 ( p = 0.73 and 0.28, respectively), indicating that empiric dose adjustments were not routinely prescribed. Conclusions: Patients who transitioned from Gla-100 to Gla-300 had increased basal insulin requirements between visits, while basal insulin requirements for those transitioned from Gla-100 to insulin degludec were not significantly different.
Non‐invasive tests for the detection of oesophageal varices in compensated cirrhosis: systematic review and meta‐analysis
Authors: Sami Sarmed S. , Harman David , Ragunath Krish , Böhning Dankmar , Parkes Julie , Guha Indra Neil 
Published: March 2018

IntroductionConclusive data on the accuracy and clinical applicability of non‐invasive screening tests for oesophageal varices (OV) in patients with compensated cirrhosis remain lacking. We conducted this study to identify currently available tests, estimate their diagnostic performance and then exemplify how these could be utilized in clinical practice.Materials and methodsA systematic literature search was performed to identify all primary studies that reported accuracy using oesophagogastroduodenoscopy (OGD) as the gold standard. Sources searched included Ovid MEDLINE, Ovid EMBASE and The Cochrane Library databases.ResultsTwenty‐one studies with a total of 2471 patients were identified. Several tests were evaluated in more than three studies. Platelet count/spleen diameter ratio (PSR) had the highest summary area under the curve for detection of any size OV of 0.85 (95% confidence interval 0.78–0.92). At a cut‐off of 909 (n = 4 studies) and prevalence rates of 10, 20, 30, 40 and 50% for OV, PSR screening correctly avoided the need for OGD in 70, 62, 55, 47 and 39% of patients, respectively.ConclusionsPSR appears to be the most accurate and validated non‐invasive screening test for OV in patients with compensated cirrhosis. At a cut‐off of 909, PSR could be clinically useful to avoid OGDs in a significant proportion of patients.
Risk factors for peri-traumatic distress and appearance concerns in burn-injured inpatients identified by a screening tool
Authors: Oaie Ecaterina , Piepenstock Emma , Williams Lisa 
Published: March 2018

Introduction: Psychosocial screening of burn-injured patients is a National Burn Care Guideline and is increasingly used to identify individuals most in need of support. It can also generate data that can inform our understanding of patient reported concerns following a burn injury. Method: As part of routine care, 461 patients admitted to a burns unit were screened soon after admission using a psychosocial screen designed by the service. The questionnaire included items on pre-existing social support, coping, emotional and psychological difficulties, as well as current trauma symptoms and current level of concern about changed appearance following the burn. Results: Overall, patients reported low levels of appearance concerns (mean 3.7/10) and trauma symptoms (18% reporting flashbacks) in the initial days following a burn injury. In those who did report concerns, there were some significant associations with demographic and other variables. Patients who experienced flashbacks were younger and had a larger total body surface area (TBSA) burn. Higher levels of appearance concern were associated with younger women, larger TBSA and facial burns. However, the relationships found were weak and frequently confounded by other factors. Conclusion: Overall, the findings indicate that initial trauma symptoms and appearance concerns are not inevitable in this group and there is no substitute for screening in identifying who is most at risk.
Spontaneous cutaneous endometriosis of the mons pubis: Diagnosis, treatment, and review of the literature
Authors: Lo Lydia , Lee Rebecca 
Published: March 2018

Background: Cutaneous endometriosis is usually associated with a preceding surgical scar; spontaneous cutaneous endometriosis is rare. We report on a case of spontaneous cutaneous endometriosis of the mons pubis as well as a review of the literature. Case: A 46-year-old woman with no surgical history presented to gynecology clinic with a 6-year history of a mass on the mons pubis causing severe cyclic pain with enlargement during menses. Initial fine needle aspiration biopsy was nondiagnostic; thus, pelvic ultrasound, magnetic resonance imaging, and a core needle biopsy were used to diagnose a mons endometrioma. The lesion was surgically excised with pathology confirming the diagnosis. The patient noted subsequent improvement in her symptoms. Conclusion: Spontaneous cutaneous endometriosis of the mons pubis can be successfully treated via surgical excision.
Meta-analysis of antibiotic prophylaxis in breast reduction surgery
Authors: Shortt Rodger , Cooper Michael J , Farrokhyar Forough , Bain James 
Published: March 2018

Background Breast reduction surgery is a very common procedure; however, there is still no consensus as to whether antibiotics should be used perioperatively. Objective To review the world literature and perform a meta-analysis of studies comparing wound infection rates with antibiotic use in breast reduction surgery. Methods A literature search was performed using the MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Database of Clinical Trials, Embase and CINAHL databases. Subject headings and relevant subheadings for “Breast”, “Breast Reduction”, “Reduction Mammaplasty”, “Mammaplasty” were combined with “Antibiotics” and “Antibacterial Agents”. The list of titles was assessed by the study's authors and abstracts were reviewed. All relevant articles were then independently reviewed by the two primary authors, and Jadad scoring was used to assess the quality of the included articles. Results From the original search, three randomized controlled trials were included in the meta-analysis of preoperative antibiotics. The meta-analysis revealed a 75% reduction in wound infections with preoperative antibiotics (OR 0.25 [95% CI 0.09 to 0.72]). Because only one randomized controlled trial analyzed postoperative antibiotics, no meta-analysis could be performed. Conclusions Preoperative antibiotics should routinely be used before breast reduction surgery. The use of postoperative antibiotics remains controversial. Additional randomized studies investigating postoperative antibiotics are needed.
Incidence of positive screening for obstructive sleep apnea in patients with isolated cleft lip and/or palate
Authors: Silvestre Jason , Tahiri Youssef , Paliga J Thomas , Taylor Jesse A 
Published: March 2018

Objective To determine the incidence of obstructive sleep apnea (OSA) in children with isolated cleft lip and/or palate (CL/P). Methods The present prospective study was performed at a pediatric tertiary care centre. Consecutive patients evaluated at the cleft clinic from January 2011 to August 2013 were identified. Patients' families prospectively completed the Pediatric Sleep Questionnaire (PSQ), a validated tool used to predict moderate to severe OSA. Patients with CL/P and an underlying syndrome or other craniofacial diagnosis were excluded. A positive OSA screen was recorded if the ratio of positive to total responses was >0.33. Risk factors associated with a positive screen were identified using the Student's t or ANOVA test. Results A total of 867 patients completed the PSQ, 489 of whom with isolated CL/P met inclusion criteria. The mean age was 8.4 years. The overall incidence of positive screening was 14.7%. The most commonly reported symptoms among positive screeners were ‘fidgets with hands or feet’ (73.6%), ‘interrupts others’ (69.4%) and ‘mouth breather during the day’ (69.4%). The most sensitive items were ‘stops breathing during the night’ and ‘trouble breathing during sleep’, with positive predictive values of 0.78 and 0.67, respectively. Sex, body mass index, ancestry and cleft type were not significantly associated with increased risk for positive screening. Conclusion One in seven children with isolated CL/P screened positively for OSA according to the PSQ. This finding highlights the potential importance of routine screening in this at-risk group.
Prevalence of brachial plexus injuries in patients with scapular fractures: A National Trauma Data Bank review
Authors: Chamata Edward , Mahabir Raman , Jupiter Daniel , Weber Robert A 
Published: March 2018

Background Studies investigating the prevalence of brachial plexus injuries associated with scapular fractures are sparse, and are frequently limited by small sample sizes and often restricted to single-centre experience. Objective To determine the prevalence of brachial plexus injuries associated with scapular fractures; to determine how the prevalence varies with the region of the scapula injured; and to assess which specific nerves of the brachial plexus were involved. Methods The present study was a retrospective review of data from the National Trauma Data Bank over a five-year period (2007 to 2011). Results Of 68,118 patients with scapular fractures, brachial plexus injury was present in 1173 (1.72%). In patients with multiple scapular fractures, the prevalence of brachial plexus injury was 3.12%, and ranged from 1.52% to 2.22% in patients with single scapular fractures depending on the specific anatomical location of the fracture. Of the 426 injuries with detailed information on nerve injury, 208 (49%) involved the radial nerve, 113 (26.5%) the ulnar nerve, 65 (15%) the median nerve, 36 (8.5%) the axillary nerve and four (1%) the musculocutaneous nerve. Conclusion The prevalence of brachial plexus injuries in patients with scapular fractures was 1.72%. The prevalence was similar across anatomical regions for single scapular fracture and was higher with multiple fractures. The largest percentage of nerve injuries were to the radial nerve.
Inhibitory effects of low-level laser therapy on skin-flap survival in a rat model
Authors: Baldan Cristiano S , Masson Igor Fb , Júnior Ivaldo Esteves , Baldan Alessandra Maria S , Machado Aline F P , Casaroto Raquel A , Liebano Richard E 
Published: March 2018

Background Although several studies have demonstrated the effects of low-level laser therapy (LLLT) on skin flap viability, the role of higher doses has been poorly investigated. Objective To investigate the inhibitory effect of the LLLT (λ=670 nm) on the viability of random skin flaps in a rat model using an irradiation energy of 2.79 J at each point. Methods Sixteen Wistar rats were randomly assigned into two groups: sham laser irradiation (n=8); and active laser irradiation (n=8). Animals in the active laser irradiation group were irradiated with a 670 nm diode laser with an energy of 2.79 J/point, a power output 30 mW, a beam area of 0.028 cm2, an energy density of 100 J/cm2, an irradiance of 1.07 W/cm2 for 93 s/point. Irradiation was performed in 12 points in the cranial skin flap portion. The total energy irradiated on the tissue was 33.48 J. The necrotic area was evaluated on postoperative day 7. Results The sham laser irradiation group presented a mean (± SD) necrotic area of 47.96±3.81%, whereas the active laser irradiation group presented 62.24±7.28%. There was a significant difference in skin-flap necrosis areas between groups (P=0.0002). Conclusion LLLT (λ=670 nm) increased the necrotic area of random skin flaps in rats when irradiated with an energy of 2.79 J (100 J/cm2).
Horizontal mattress technique for anastomosis of size-mismatched vessels
Authors: Odobescu Andrei , Moubayed Sami P , Daniels Eugene , Danino Michel Alain 
Published: March 2018

Objective To evaluate the horizontal mattress technique in microvascular anastomosis for size-mismatched vessels. Methods The present study involved cadaveric simulation using size-mismatched (1.5:1) Thiel-embalmed cadaveric arteries. The authors performed horizontal mattress anastomoses using 9-0 nylon suture and recorded the procedure. Vessel patency was evaluated by saline infusion. Vessels were cut open and photographed; histological slides were prepared and stained with hematoxylin and eosin. Results Four anastomoses were performed. Vessels were found to be patent in all cases, with grade 0 leaks. Intima-on-intima apposition with no intraluminal exposure of muscularis nor adventitia were observed. Conclusion The present cadaveric study supports the technical feasibility of using horizontal mattress sutures in size-mismatched end-to-end anastomoses.