bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance determinants of fixed gear cycling during criteriums
Authors: Babault Nicolas , Poisson Maxime , Cimadoro Guiseppe , Cometti Carole , Païzis Christos 
Published: June 2018

AbstractNowadays, fixed gear competitions on outdoor circuits such as criteriums are regularly organized worldwide. To date, no study has investigated this alternative form of cycling. The purpose of the present study was to examine fixed gear performance indexes and to characterize physiological determinants of fixed gear cyclists. This study was carried out in two parts. Part 1 (n = 36) examined correlations between performance indexes obtained during a real fixed gear criterium (time trial, fastest laps, averaged lap time during races, fatigue indexes) and during a sprint track time trial. Part 2 (n = 9) examined correlations between the recorded performance indexes and some aerobic and anaerobic performance outputs (VO2max, maximal aerobic power, knee extensor and knee flexor maximal voluntary torque, vertical jump height and performance during a modified Wingate test). Results from Part 1 indicated significant correlations between fixed gear final performance (i.e. average lap time during the finals) and single lap time (time trial, fastest lap during races and sprint track time trial). In addition, results from Part 2 revealed significant correlations between fixed gear performance and aerobic indicators (VO2max and maximal aerobic power). However, no significant relationship was obtained between fixed gear cycling and anaerobic qualities such as strength. Similarly to traditional cycling disciplines, we concluded that fixed gear cycling is mainly limited by aerobic capacity, particularly criteriums final performance. However, specific skills including technical competency should be considered.
Different Effects of Social Support on Adolescent Smoking and the Mediation by Smartphone Dependence
Authors: Dancoine Pierre-François , Gentina Elodie 
Published: June 2018

Background and aims:
This study examines the relationship between social support (from parents and peers) and cigarette use, through the mediating effect of smartphone dependence, among adolescents.

Study design:
Prospective cohort study.

Methods:
A survey, conducted among 472 adolescents (average age = 16.2 years) attending classes in 3 schools in Lille, France, provides the data. The theoretical model features social support (parental and peer) and cigarette use, with smartphone dependence as a mediator, such that the authors simultaneously examine direct (support → cigarette use) and indirect (eg, peer support → smartphone dependence → cigarette use) paths.

Results:
The results illustrate that both parental support and peer support discourage cigarette use, but the indirect effect through smartphone dependence is positive. That is, smartphone dependence mediates the relationship between peer support and cigarette use. Parental support and peer support shape adolescents’ cigarette use and smartphone dependence differently, depending on the adolescents’ gender.

Conclusions:
Policy makers should acknowledge the positive effects of social support, the negative effect of smartphone dependence, and the importance of gender when developing anti-smoking policies and campaigns.
Percutaneous Versus Open Treatment of Posterior Pelvic Ring Injuries: Changes in Practice Patterns Over Time
Authors: Gire Jacob D. , Jiang Sam Y. , Gardner Michael J. , Bishop Julius A. 
Published: June 2018

Objective:
To determine how the utilization of open versus percutaneous treatment of posterior pelvic ring injuries in early-career orthopaedic surgeons has changed over time.

Methods:
Case log data from surgeons testing in the trauma subspecialty for part II of the American Board of Orthopaedic Surgery examination from 2003 to 2015 were evaluated. Current procedural terminology codes for percutaneous fixation (27216) and open fixation (27218) of the posterior pelvic ring were evaluated using a regression analysis.

Results:
A total of 377 candidates performed 2095 posterior ring stabilization procedures (1626 percutaneous, 469 open). Total case volume was stable over time [β = −1.7 (1.1), P = 0.14]. There was no significant change in the number of posterior pelvic ring fracture surgery cases performed per candidate per test year [β = 0.1 (0.1), P = 0.50]. The proportion of posterior pelvic ring cases performed percutaneously increased significantly from 49% in 2003 to 79% in 2015 [β = 1.0 (0.4), P = 0.03]. There was a significant decrease in the number of open cases reported per candidate [β = −0.07 (0.03), P = 0.008].

Discussion and Conclusion:
Early-career orthopaedic surgeons are performing more percutaneous fixation of the posterior pelvic ring and less open surgery. The impact of this change in volume on surgeon proficiency is unknown and warrants additional research.
A Prospective Study Investigating Fistula Rate Following Primary Palatoplasty Using Acellular Dermal Matrix
Authors: Gilardino Mirko S. , Aldekhayel Salah , Govshievich Alexander 
Published: June 2018

Background:
Acellular dermal matrix (ADM) has been described as an adjunct in primary cleft palate repair to reduce the fistula rate in several retrospective studies (level III or lower); however, current data are insufficient to definitively conclude its efficacy for this purpose. The goal of the present study was to provide prospective, higher level of evidence data investigating the effect of ADM on fistula rate following primary palatoplasty.

Methods:
A prospective clinical trial was conducted in which ADM was used uniformly in all primary cleft palate repairs that met inclusion criteria. For comparison, a matched control group was identified (retrospectively) from the same center/surgeon’s database. Primary outcome was the rate of palatal fistula formation. Secondary outcomes included bleeding, infection, and delayed healing.

Results:
A total of 130 patients were included in the analysis consisting of 65 in both the study and control groups. There were no statistically significant differences in patient demographics or cleft /surgical characteristics. The results demonstrated a fistula rate of 1.5% in the study group versus 12.3% in the control group (P = 0.03). The other complications (infection, bleeding, delayed healing) were similar between the groups.

Conclusion:
The study provides the highest level of evidence currently available (level II, prospective data) investigating the effect of ADM on fistula rate following primary palatoplasty. The results demonstrate a low overall fistula rate (1.5%) and suggest there may be a clinically significant reduction in fistula formation associated with the routine use of ADM in all primary palate repairs.
Aortic Valve-in-Valve in Externally Mounted Bioprosthesis
Authors: Cheung Anson W. , Ye Jian , Dvir Danny , Wood David A. , Webb John G. 
Published: June 2018

Objective Aortic valve-in-valve implantation for prosthetic valve dysfunction is a good alternative to reoperative valve replacement. There are some limitations to this approach including the risk of coronary occlusion, patient prosthesis mismatch, and valve malposition. The incidence of coronary occlusion is higher in aortic valve-in-valve than de novo aortic stenosis cases. Multiple factors can contribute to this complication, and the type of bioprosthesis has been implicated. Methods We examined our experience of 80 aortic valve-in-valve cases with internally and externally mounted leaflet valves. Results Procedural success was achieved in 95% of cases with an overall 30-day mortality of 1.3%. Clinical and procedural outcomes were similar in the both cohorts. Conclusions Our data suggest that aortic valve-in-valve implantation can be safely performed in carefully selected patient with internally and externally mounted leaflet bioprosthesis.
Homograft versus Conventional Prosthesis for Surgical Management of Aortic Valve Infective Endocarditis
Authors: Yanagawa Bobby , Mazine Amine , Tam Derrick Y. , Jüni Peter , Bhatt Deepak L. , Spindel Stephen , Puskas John D. , Verma Subodh , Friedrich Jan O. 
Published: June 2018

Objective Surgical management of aortic valve infective endocarditis (IE) with cryopreserved homograft has been associated with lower risk of recurrent IE, but there is equipoise with regard to the optimal prosthesis. This systematic review and meta-analysis were performed to compare outcomes between homograft and conventional prosthesis for aortic valve IE. Methods We searched MEDLINE database to September 2017 for studies comparing homograft versus conventional prosthesis. The main outcomes were all-cause mortality, recurrent IE, and reoperation. Results There were 18 included comparative observational studies with 2232 patients (median follow up = 5 [interquartile range: 2–7] years, 30% prosthetic valve endocarditis); four studies were adjusted for baseline differences. There were no differences in perioperative mortality or stroke despite a greater proportion of staphylococcal endocarditis, abscess, and root replacements but less multivalve involvement in the homograft group. Long-term outcomes of all-cause mortality [incidence rate ratio (IRR) = 1.03, 95% confidence interval (CI) = 0.81–1.31, P = 0.83, for unmatched, and IRR = 0.82, 95% CI = 0.36–1.84, P = 0.63, for matched studies], recurrent endocarditis (IRR = 1.01, 95% CI = 0.53–1.93, P = 0.96, for unmatched, and IRR = 1.04, 95% CI = 0.49–2.19, P = 0.92, for matched studies), and reoperation (IRR = 1.60, 95% CI = 0.80–3.21, P = 0.18, for unmatched, and IRR = 3.17, 95% CI = 0.52–19.44, P = 0.21, for matched studies) were not different comparing homograft versus conventional prosthesis. There was a significantly increased need for reoperation with homograft versus mechanical prosthetic valves, but this comparison was based on limited data. Conclusions Homografts and conventional prostheses offer similar survival and freedom from recurrent endocarditis and reoperation for aortic valve IE. Homografts may be associated with greater risk of reoperation compared with mechanical valves.
Maintenance Ketamine Therapy for Treatment-Resistant Depression
Authors: Archer Shaina , Chrenek Carson , Swainson Jennifer 
Published: June 2018

Abstract

Background
Previous studies have demonstrated ketamine to have a rapid antidepressant effect in some patients with treatment-resistant depression (TRD), but the effect is unfortunately not sustained in the long term. In this study, we report on the clinical use of ongoing maintenance ketamine infusions in a group of patients with TRD, beyond an acute course of 6 to 8 ketamine infusions.

Methods
This retrospective case series reports on 11 patients with TRD who received maintenance ketamine infusions, defined as treatments beyond an initial series of up to 8 infusions. Charts were reviewed to collect data on response to treatment and side effects.

Results
All 11 patients in this case series were noted to have a reduction in their Beck Depression Inventory II (BDI-II) score after an acute course of treatment and a lower median BDI-II during their maintenance treatments than their baseline BDI-II. At the study end point, 4 patients were continuing maintenance ketamine and 1 patient had transitioned to maintenance intranasal ketamine. Four patients discontinued ketamine due to loss of effect and 1 due to side effects, and the reason for discontinuation was not noted for the remaining 2 patients. No major adverse events were noted in these patients receiving maintenance treatments, and it was well tolerated overall.

Conclusions
Maintenance ketamine treatments may be an effective way of maintaining treatment response in some ketamine responders. Future research is required to determine optimal length of treatment in those who respond to ketamine and to track adverse effects over a longer time.
Idiopathic Sudden Sensorineural Hearing Loss Is Not a Sentinel Event for Acute Myocardial Infarction
Authors: Crowson Matthew G. , Mulder Hillary , Cyr Derek D. , Langman Alan W. , Lee Walter T. , Parham Kourosh , Pynnonen Melissa A. , Schulz Kristine , Shin Jennifer J. , Witsell David , Vambutas Andrea 
Published: June 2018

Objective:
Given ongoing debate about the suggested association, the primary objective was to determine if idiopathic sudden sensorineural hearing loss (ISSNHL) was a sentinel event for acute myocardial infarction (AMI) in adults.

Study Design:
Case-control study.

Setting:
United States MarketScan administrative health claims database.

Patients:
Aged 18 years or older, had a diagnosis of ISSNHL on or after January 1st, 2011 and had sufficient follow-up data available to assess for AMI occurrence.

Intervention:
N/A.

Main Outcome Measures:
Incidence rates (per 1,000 patient years) of AMI for cases and controls were computed. Adjusted and unadjusted Cox proportional hazards models were created to explore possible associations between ISSNHL and initial AMI.

Results:
A total of 10,749 ISSNHL cases and 10,749 matched controls were included. There were no significant differences in the incidence rate of AMI between ISSNHL cases (8.29 events/1,000 person-years) and controls (9.25 events/1,000 person-years), nor were there differences within age groups, sex, or comorbidity status (overall incidence rate ratio 0.90; 95% confidence interval [CI] 0.70–1.15 p = 0.39). The unadjusted and adjusted Cox proportional hazards models did not demonstrate an association between ISSNHL and initial AMI (hazard ratio [HR]: 0.90, 95% CI: 0.70–1.15; HR: 0.86, 95% CI: 0.67–1.10, respectively).

Conclusions:
ISSNHL is not a predictor of an initial AMI in adult patients from the United States. Considerable inconsistencies in associations between cardiovascular risk factors and ISSNHL exist in the literature. Further work is needed to confirm or refute direct associations between cardiovascular disease risk factors and ISSNHL before definitive mechanistic conclusions can be made.
Inadequate Hepatocellular Carcinoma Screening in Patients With Nonalcoholic Steatohepatitis Cirrhosis
Authors: Aby Elizabeth , Phan Jennifer , Truong Emily , Grotts Jonathan , Saab Sammy 
Published: June 2018

Background:
Nonalcoholic steatohepatitis (NASH) is a common cause of liver disease which can progress to cirrhosis and hepatocellular carcinoma (HCC). American Association for the Study of Liver Diseases (AASLD) guidelines recommend abdominal ultrasound, with or without serum alpha-fetoprotein, every 6 months for HCC surveillance in cirrhotic patients.

Goals:
Describe HCC surveillance rates in NASH cirrhosis compared with hepatitis C (HCV) cirrhosis and the impact of surveillance on tumor size, treatment, and mortality.

Study:
Adults with NASH and HCV cirrhosis diagnosed with HCC from 2009 to 2016 were retrospectively evaluated. Patients were categorized into 3 mutually exclusive disease screening groups based on abdominal imaging with or without serum alpha-fetoprotein testing before HCC diagnosis.

Results:
In total, 99 patients with NASH cirrhosis and 162 patients with HCV cirrhosis were evaluated. In total, 51.5% of NASH cirrhosis patients and 25.9% of HCV cirrhosis patients had no screening before HCC diagnosis. Patients with HCV cirrhosis were significantly more likely to undergo surveillance compared with patients with NASH cirrhosis (P=0.002). NASH cirrhosis patients who underwent complete screening had smaller tumors compared with those with incomplete screening and no screening (P=0.006). There were no differences in number of tumors at diagnosis or mortality between screening groups in patients with NASH cirrhosis (P=0.281 and 0.468, respectively).

Conclusions:
There is suboptimal HCC surveillance in NASH and HCV cirrhotic patients, with a greater proportion of patients with NASH cirrhosis not undergoing surveillance. Patients with NASH cirrhosis who had complete surveillance had smaller tumors at diagnosis, but there were no differences in treatment outcomes or mortality.
Role of Cholecystectomy After Endoscopic Sphincterotomy in the Management of Choledocholithiasis in High-risk Patients
Authors: Khan Muhammad Ali , Khan Zubair , Tombazzi Claudio R. , Gadiparthi Chiranjeevi , Lee Wade , Wilcox C. Mel 
Published: June 2018

Background:
Endoscopic retrograde cholangiography and endoscopic sphincterotomy (ES) with subsequent cholecystectomy is the standard of care for the management of patients with choledocholithiasis. There is conflicting evidence in terms of mortality reduction, prevention of complications specifically biliary pancreatitis and cholangitis with the use of early cholecystectomy particularly in high-risk surgical and elderly patients.

Aims:
We conducted this systematic review and meta-analysis of randomized controlled trials to compare the early cholecystectomy versus wait and watch strategy after ES.

Methods:
We searched Medline, Scopus, Web of Science, and Cochrane database for randomized controlled trials comparing the 2 strategies in the management of choledocholithiasis after ES. Our primary outcome of interest was difference in mortality. We evaluated several secondary outcomes including difference in development of acute pancreatitis, biliary colic and cholecystitis, cholangitis and recurrent jaundice, nonbiliary adverse events, and length of hospital stay. Risk ratios (RR) were calculated for categorical variables and difference in means was calculated for continuous variables. These were pooled using random effects model.

Results:
Seven studies with 916 patients (455 cholecystectomy group and 461 wait and watch group) were included in the meta-analysis. Pooled RR with 95% confidence interval for mortality was 1.43 (0.93-2.18), I
2=9%. In the high-risk patient group, pooled RR was 1.39 (0.64-3.03) and in low-risk population pooled RR was 1.53 (0.79-2.96). Pooled RR for acute pancreatitis was 1.64 (0.46-5.81) with no heterogeneity. There was no difference in the rate of acute pancreatitis patients based on high-risk versus low-risk patients. Pooled RR for occurrence of biliary colic and cholecystitis during follow-up was 9.82 (4.27-22.59), I
2=0%. Pooled RR for cholangitis and recurrent jaundice was 2.16 (1.14-4.07), I
2=0%. However, there was no difference in the rate of cholangitis between the 2 groups in low-risk patients. Length of stay was shorter in the wait and watch group with a pooled mean difference was −2.70 (−4.71, −0.70) with substantial heterogeneity.

Conclusions:
Although we found no difference in mortality between the 2 strategies after ES, laparoscopic cholecystectomy should be recommended as it is associated with lower rates of subsequent recurrent cholecystitis, cholangitis, and biliary colic down the road even in high-risk surgical patients.
Assessing Quality of Precut Sphincterotomy in Patients With Difficult Biliary Access
Authors: Chen Jie , Wan Jian Hua , Wu Dang Yan , Shu Wen Qing , Xia Liang , Lu Nong Hua 
Published: June 2018

Background:
It is generally accepted that precut sphincterotomy during endoscopic retrograde cholangiopancreatography (ERCP) increases the risk of pancreatitis. However, patients with difficult biliary access may be different. We implemented a meta-analysis to explore the effects of early and delayed precut sphincterotomy on post-ERCP pancreatitis in patients with difficult biliary access.

Methods:
We searched studies in PubMed, EMBASE, and the Cochrane Central Register of Randomized Controlled Trials for meeting requirement in which precut sphincterotomy was compared with persistent standard cannulation during ERCP. The primary outcomes included the overall cannulation success rate and the incidence of post-ERCP pancreatitis. The secondary outcomes included primary cannulation success and the overall complication rate.

Results:
Six studies (898 patients) were included. The present meta-analysis found no significant difference in overall cannulation success rate and overall complication rate between early precut sphincterotomy and persistent standard cannulation. However, early precut sphincterotomy not only increased the primary cannulation success rate [Mantel Haenszel test relative risk, 1.87; 95% confidence interval (CI), 1.15-3.04] but also decreased the overall risk of pancreatitis (Peto odds ratio, 0.49; 95% CI, 0.30-0.80). For persistent standard cannulation, no significant difference was observed in the pancreatitis rate between no salvage precut and delayed salvage precut sphincterotomy (Peto odds ratio, 0.96; 95% CI, 0.49-1.85).

Conclusions:
Compared with persistent standard cannulation, an early precut sphincterotomy exhibited a reduced risk of pancreatitis. In addition, a delayed precut sphincterotomy after persistent attempts did not increase the occurrence of pancreatitis and this is the first meta-analysis to present this conclusion.
Factors Associated With Adenoma Detection in Propofol-sedated Patients
Authors: Jia Hui , Koo Malcolm , Hsieh Yu-Hsi , Tseng Chih-Wei , Hu Chi-Tan , Zhang Linhui , Dong Tao , Pan Yanglin , Leung Felix W. 
Published: June 2018

Goals:
To assess the factors associated with adenoma detection in propofol-sedated patients.

Backgrounds:
Low adenoma detection rate (ADR) are linked to increased risk of interval cancer and related deaths. Compared with air insufflation (AI) colonoscopy, the method of water exchange (WE) significantly decreased insertion pain and increased ADR in unsedated patients. Deep sedation with propofol has been increasingly used in colonoscopy. One report suggested that WE significantly increased ADR in propofol-sedated patients, but the factors associated with adenoma detection were not analyzed.

Study:
Post hoc multiple logistic regression analyses were performed based on pooled data from 2 randomized controlled trials to assess the factors associated with adenoma detection in propofol-sedated patients.

Results:
Propofol-sedated patients (n=510) were randomized to AI and WE. The baseline characteristics were comparable. Multiple logistic regression analyses show that age, withdrawal time, indications (screening vs. diagnostic), and WE were significantly and independently associated with higher ADR. WE had fewer patients with inadequate Boston Bowel Preparation Scale score of <6. Despite a significantly shorter inspection time, WE had significantly higher overall ADR than AI, especially in those with adequate Boston Bowel Preparation Scale of ≥6. Right colon ADR (17.5% vs. 10.5%), flat ADR (32.3% vs. 19.4%), combined advanced and sessile serrated ADR (13.1% vs. 7.4%) of WE were significantly higher than those of AI.

Conclusions:
WE enhanced quality of colonoscopy in propofol-sedated patients by significantly improving colon cleanliness and overall ADR. Colonoscopists with patients under propofol sedation might consider evaluating WE method for performance improvement.