bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative care in endoscopic sinus surgery: a critical review
Authors: Eloy Philippe , Andrews Peter , Poirrier Anne-Lise 
Published: November 2016

Purpose of review
Chronic rhinosinusitis with and without nasal polyps is a common disease affecting people all over the world. Functional endoscopic sinus surgery (FESS) has become the gold standard treatment for medically refractive disease. Postoperative care is recommended by international leaders as an important part of the patient's management. This article is a critical review and discussion focusing on postoperative care, which is based on expert opinion, clinical studies, randomized controlled trials and meta-analysis studies.

Recent findings
Postoperative care including nasal rinsing, topical corticosteroids, antibiotics and avoidance of nasal packing are unanimously considered to be the cornerstone of best practice following FESS. However, the effectiveness of in-office nasal debridement is still under debate.

Summary
There is a lack of consensus regarding the necessity of performing in-office nasal debridement and the majority of clinicians carry out their postoperative care according to experience and their own preference. This is often determined by the extent of surgery performed, the severity of the postoperative inflammation, as well as being dependent on the patient's discomfort, the time constraints associated with postoperative care and the costs associated with additional appointments. Ideally, nasal debridement should be performed by the operating surgeon under endoscopic control both gently and atraumatically.
Closing the growth plate: a review of indications and surgical options
Authors: Ruzbarsky Joseph J. , Goodbody Christine , Dodwell Emily 
Published: November 2016

Purpose of review
The purpose is to review the indications for epiphysiodesis in the treatment of pediatric limb length discrepancies; provide an update on current diagnostic, planning, and surgical techniques; and to introduce possible future alternatives.

Recent findings
Retrospective comparative studies have failed to demonstrate superiority of one epiphysiodesis technique over the others. EOS low-dose biplanar X-ray and smartphone growth prediction applications are improving our ability to diagnose and plan treatment for leg length discrepancy. Arthroscopically guided percutaneous epiphysiodesis and radiofrequency ablation are newer techniques that are still under investigation.

Summary
Epiphysiodesis is the treatment of choice for children with predicted leg length discrepancies between 2–5 cm, provided that the physes are open with sufficient growth remaining. The most common epiphysiodesis techniques are performed percutaneously and either ablate the physis with drills/curettes or use metal implants to tether the physis and prevent further growth. Surgical treatment is typically ambulatory in nature, and allows for early return to weight bearing. In modern series, complication rates are less than 10%, with the majority being minor complications. Further high-quality prospective research is needed to determine the optimal epiphysiodesis surgical technique.
Serum Acetaminophen Protein Adduct Concentrations in Pediatric Emergency Department Patients
Authors: Heard Kennon , Anderson Victoria , Dart Richard C. , Kile Deidre , Lavonas Eric J. , Green Jody L. 
Published: November 2016

ABSTRACTObjectives:Acetaminophen toxicity is a common cause of pediatric liver failure. The diagnosis may be limited by the short window of detection of acetaminophen in serum. Recently acetaminophen protein adducts (APAP‐CYS) have been used as a biomarker with a longer duration of detection. The objective of this study was to describe the serum concentrations of APAP‐CYS in pediatric patients with and without reported therapeutic acetaminophen exposure.Methods:A cross‐sectional study of children age 1 to <12 years presenting to a pediatric emergency department. Subjects were stratified by recent acetaminophen use and had serum APAP‐CYS measured using LC/MS.Results:One hundred patients were enrolled. All of the patients whose caregivers denied acetaminophen exposure had nondetectable APAP‐CYS. Fifty‐two percent of subjects who were reported to have taken acetaminophen in the preceding 2 weeks had detectable serum APAP‐CYS. The APAP‐CYS concentrations were positively correlated with higher overall dose and more recent ingestion.Conclusions:APAP‐CYS is detectable in the majority of children taking acetaminophen and not detected in the majority of children who are not exposed to acetaminophen.
Prevalence and Patterns of Marijuana Use in Young Adults With Inflammatory Bowel Disease
Authors: Phatak Uma P. , Rojas‐Velasquez Danilo , Porto Anthony , Pashankar Dinesh S. 
Published: November 2016

ABSTRACTObjectives:Recent studies in adults report symptom relief with marijuana use in patients with inflammatory bowel disease (IBD). We assessed the prevalence, pattern, effects, and adverse effects of marijuana use in young adults with IBD.Methods:We conducted a prospective questionnaire survey study at a pediatric IBD clinic. All patients (18–21 years of age) answered anonymous questionnaires about demographics, IBD, medications, and marijuana use.Results:Fifty‐three patients (mean age 18.7 years, 32 boys) were enrolled. Thirty‐seven patients (70%) reported using marijuana currently or in the past. There was no statistically significant difference between the users and nonusers of marijuana regarding demographics, disease activity, or medications. Despite prolonged use of marijuana, 70% of patients did not discuss it with their gastroenterologists. Twenty‐four patients used marijuana medicinally for IBD symptoms in addition to medical therapy. Although majority found marijuana to be moderately/very helpful, complete relief of symptoms such as abdominal pain, poor appetite, nausea, and diarrhea was seen in 29%, 37%, 14%, and 10% of patients, respectively. Only half of patients reported knowledge of possible adverse effects of marijuana and 19% of patients reported mild neuropsychiatric adverse effects. Overall, 98% of patients supported legalization of marijuana and 85% were interested in using medical marijuana if it became legally available.Conclusions:We found a high rate of marijuana use in our cohort of young adults with IBD. Majority of users report symptom improvement but do not inform physicians. Future well‐controlled studies are necessary to assess role of marijuana in IBD therapy.
The potential role of Wolbachia in controlling the transmission of emerging human arboviral infections
Authors: Kamtchum-Tatuene Joseph , Makepeace Benjamin L. , Benjamin Laura , Baylis Matthew , Solomon Tom 
Published: November 2016

Purpose of review

Wolbachia is a genus of Gram-negative intracellular bacteria that is naturally found in more than half of all arthropod species. These bacteria cannot only reduce the fitness and the reproductive capacities of arthropod vectors, but also increase their resistance to arthropod-borne viruses (arboviruses). This article reviews the evidence supporting a Wolbachia-based strategy for controlling the transmission of dengue and other arboviral infections.

Recent findings
Studies conducted 1 year after the field release of Wolbachia-infected mosquitoes in Australia have demonstrated the suppression of dengue virus (DENV) replication in and dissemination by mosquitoes. Recent mathematical models show that this strategy could reduce the transmission of DENV by 70%. Consequently, the WHO is encouraging countries to boost the development and implementation of Wolbachia-based prevention strategies against other arboviral infections. However, the evidence regarding the efficacy of Wolbachia to prevent the transmission of other arboviral infections is still limited to an experimental framework with conflicting results in some cases. There is a need to demonstrate the efficacy of such strategies in the field under various climatic conditions, to select the Wolbachia strain that has the best pathogen interference/spread trade-off, and to continue to build community acceptance.

Summary

Wolbachia represents a promising tool for controlling the transmission of arboviral infections that needs to be developed further. Long-term environmental monitoring will be necessary for timely detection of potential changes in Wolbachia/vector/virus interactions.
Efficacy of Endoscopic Submucosal Excavation for Gastrointestinal Stromal Tumors in the Cardia
Authors: Wang Shanshan , Shen Lei 
Published: November 2016

Objective:
Our goal was to estimate the feasibility and efficacy of endoscopic submucosal excavation (ESE) for the treatment of gastrointestinal stromal tumors (GISTs) in the cardia.

Materials and Methods:
We analyzed the clinical data of 30 patients who were diagnosed with GISTs after ESE in the cardia at the Endoscopy Center of Renmin Hospital of Wuhan University (China) from June 2009 to 2015. We evaluated the operative and postoperative conditions and long-term follow-up of these patients.

Results:
The success rate and the complete resection rate were both 100%. The maximum diameter of the tumor ranged from 1.0 to 3.5 cm (2.2±0.2 cm). The operation time was 20 to 120 min (50±5 min). During ESE, bleeding occurred in all cases (100%) with a mean blood loss of 50 mL, and perforation in 6 (20%), including 2 full-thickness resections. GIST was confirmed by pathology in all cases. Follow-up included endoscopy at 1, 3, and 6 months, and at 1 year. At 1 month, ulcer was detected in 23 cases (76.67%), titanium clips remained in 17 cases (56.67%), and scar tissues were observed in the remainder. No recurrence was found with gastroscopy.

Conclusions:
The cardia is a unique anatomic location for GISTs, which often requires complex surgeries prone to complications. ESE for GISTs of the cardia is a challenging, but safe and effective procedure.
Laparoscopic Repair of Intrathoracic Stomach: Clinical and Health-related Quality of Life Outcomes
Authors: Karim Muhammad A. , Maloney Jay , Ali AbdulMajid 
Published: November 2016

Background:
This study aims to evaluate the clinical and quality of health outcomes in patients undergoing laparoscopic repair of intrathoracic stomach with or without gastric volvulus.

Materials and Methods:
From January 2007 to December 2013, a prospectively maintained data, of patients undergoing surgical repair of intrathoracic stomach, with or without gastric volvulus, was reviewed. Patient demographics, ASA grade, diagnostic technique, semiurgent/emergency status, type of volvulus if present, details of surgery and perioperative complications were recorded. Validated SF-36 questionnaires were completed by patients to record preoperative and postoperative quality of life (QoL) status. Patients managed by nonoperative measures were excluded from the study.

Results:
Thirty patients were identified with intrathoracic stomach. Fourteen patients had gastric volvulus. Twenty-seven patients (10 emergency, 17 semiurgent) underwent laparoscopic repair of intrathoracic stomach and were included in the study. Mean operating time was 156 (SD, 37.5; range, 105 to 230) minutes. All 27 operations were completed by laparoscopic approach. There was no conversion to open procedure or mortality at 30 days. Mean hospital stay was 5.2 (range, 1 to 15) days. There were 3 (11%) early postoperative complications. One (3.7%) patient developed recurrence at 2 years which required reoperation. Mean follow-up was 10.5 (range, 1 to 36) months. ASA grade and operative time determined the postoperative hospital stay (P=0.001, 0.001, respectively), whereas body mass index and age were shown to have no influence. Patient-reported QoL scores improved across all scales of the health questionnaire after surgery especially bodily pain, social functioning, and physical functioning.

Conclusions:
Laparoscopic surgery is a safe and effective treatment option for intrathoracic stomach, with or without gastric volvulus. It is associated with low rates of complications and recurrence. Self-reported patient data shows significant improvement to overall QoL after surgery for intrathoracic stomach.
Decreased Incidence of Postoperative Delirium in Robot-assisted Thoracoscopic Esophagectomy Compared With Open Transthoracic Esophagectomy
Authors: Jeong Dae Myoung , Kim Jie Ae , Ahn Hyun Joo , Yang Mikyung , Heo Burn Young , Lee Soo Hee 
Published: November 2016

Background:
Postoperative delirium (POD) is one of messy complications related with increased mortality and hospital costs. Patients undergoing esophagectomy are more in danger of delirium than other kinds of surgeries. We investigated the impact of robot-assisted thoracoscopic esophagectomy on the incidence of POD compared with open transthoracic esophagectomy.

Materials and Methods:
A retrospective review was completed for the patients who underwent esophagectomy from December 2, 2012 and April 15, 2015 (n=529). POD was assessed using Confusion Assessment Method for the Intensive Care Unit. The comparison of group differences between the robotic esophagectomy group (R group) and the open esophagectomy group (O group) was conducted with and without propensity score (PS) matching method. Univariate model was used for 247 PS-matched patients to calculate the odds ratio of potential risk factors of POD.

Results:
The incidence rate of POD was significantly lower among R group patients than O group (30% vs. 42%; P=0.035) after PS matching method. The risk of POD in R group was 0.55-fold lower than that of O group. Operative time and intraoperative blood loss were also significantly lower in R group patients.

Conclusions:
In conclusion, robotic thoracoscopic esophagectomy lowers the incidence of POD 0.55-fold compared with open transthoracic esophagectomy.
Endoscopic Stenting With the Over-The-Scope Technique: Our Experience With 11 Consecutive Patients
Authors: Mutignani Massimiliano , Dokas Stefanos , Forti Edoardo , Pugliese Francesco , Manta Raffaele , Dioscoridi Lorenzo 
Published: November 2016

Background:
Endoscopic stenting is widely used to manage benign and malignant strictures, postoperative stenoses, or anastomotic leaks and fistulas.

Materials and Methods:
However, Over the Wire delivery systems are generally short and quite stiff, and therefore, cannot reach distal parts of the gastrointestinal tract or cross severely angulated strictures. In such cases, we used the Over-the-Scope stenting (OTSS) technique to deliver and deploy endoscopically large-bore fully covered stents. We present herein a series of 11 patients treated with the OTSS technique for a variety of indications. To our knowledge, this is the largest series of OTSS cases published.

Results:
The stents were correctly deployed in 10 cases. In one case, the stent was dislocated during scope withdrawal and Through the Scope stenting was performed with a smaller diameter uncovered stent instead. Predilation of the stricture was necessary in 5 patients. Clinical success was achieved in all patients.

Conclusions:
Our results encourage the use of the OTSS technique in cases where standard Over the Wire delivery systems of large-bore stents cannot reach or cross distal or tortuous strictures. The technique can also be used to reinsert migrated stents or misplaced braided-suture release mechanism (Ultraflex) stents.
The World's Youngest Cadaveric Kidney Transplant: Medical, Surgical and Ethical Issues
Authors: Daar Abdallah S. , Al Lawati Nabil Mohsin 
Published: November 2016

Background
We report here the first successful transplant from a preterm cadaveric donor. This was performed in November 1994. The donor, who had been born at about 33 weeks of gestation, was diagnosed as having agenesis of the corpus callosum. The transplant was carried out 10 days after the donor's birth. The recipient was a 17-month-old boy with a diagnosis of Denys-Drash syndrome (WT1 mutation).

Method
We describe and analyze the ethical, social, cultural, medical and surgical issues encountered and how these were addressed. The major issue of determining death in a beating heart, very young donor was dealt with in the absence of worldwide experience and guidelines.

Results
The transplanted recipient has lived with the grafted pair of kidneys for more then 22 years. He has led a relatively normal life.

Conclusions
It is possible for immature preterm deceased donor kidneys to be transplanted into a 17-month-old recipient and for the grafted kidneys to grow with the recipient and function for 22 years. There were challenges in ethically determining the death of the donor, in surgical techniques to obviate potential surgical complications, and in postoperative care of the recipient, but these were managed successfully.
The opportunities and ethics of big data: practical priorities for a national Council of Data Ethics
Authors: Varley-Winter Olivia , Shah Hetan 
Published: November 2016

In order to generate the gains that can come from analysing and linking big datasets, data holders need to consider the ethical frameworks, principles and applications that help to maintain public trust. In the USA, the National Science Foundation helped to set up a Council for Big Data, Ethics and Society, of which there is no equivalent in the UK. In November 2015, the Royal Statistical Society convened a workshop of 28 participants from government, academia and the private sector, and discussed the practical priorities that might be assisted by a new Council of Data Ethics in the UK. This article draws together the views from that meeting. Priorities for policy-makers and others include seeking a public mandate and informing the terms of the social contract for use of data; building professional competence and due diligence on data protection; appointment of champions who are competent to address public concerns; and transparency, across all dimensions. For government data, further priorities include improvements to data access, and development of data infrastructure. In conclusion, we support the establishment of a national Data Ethics Council, alongside wider and deeper engagement of the public to address data ethics dilemmas.
This article is part of the themed issue ‘The ethical impact of data science’.
The ethics of data and of data science: an economist's perspective
Authors: Cave Jonathan 
Published: November 2016

Data collection and modelling are increasingly important in social science and science-based policy, but threaten to crowd out other ways of thinking. Economists recognize that markets embody and shed light on human sentiments. However, their ethical consequences have been difficult to interpret, let alone manage. Although economic mechanisms are changed by data intensity, they can be redesigned to restore their benefits. We conclude with four cautions: if data are good, more may not be better; scientifically desirable data properties may not help policy; consent is a double-edged tool; and data exist only because someone thought to capture and codify them.This article is part of the themed issue ‘The ethical impact of data science’.
Privacy is an essentially contested concept: a multi-dimensional analytic for mapping privacy
Authors: Mulligan Deirdre K. , Koopman Colin , Doty Nick 
Published: November 2016

The meaning of privacy has been much disputed throughout its history in response to wave after wave of new technological capabilities and social configurations. The current round of disputes over privacy fuelled by data science has been a cause of despair for many commentators and a death knell for privacy itself for others. We argue that privacy’s disputes are neither an accidental feature of the concept nor a lamentable condition of its applicability. Privacy is essentially contested. Because it is, privacy is transformable according to changing technological and social conditions. To make productive use of privacy’s essential contestability, we argue for a new approach to privacy research and practical design, focused on the development of conceptual analytics that facilitate dissecting privacy’s multiple uses across multiple contexts.
This article is part of the themed issue ‘The ethical impact of data science’.
Locating ethics in data science: responsibility and accountability in global and distributed knowledge production systems
Authors: Leonelli Sabina 
Published: November 2016

The distributed and global nature of data science creates challenges for evaluating the quality, import and potential impact of the data and knowledge claims being produced. This has significant consequences for the management and oversight of responsibilities and accountabilities in data science. In particular, it makes it difficult to determine who is responsible for what output, and how such responsibilities relate to each other; what ‘participation’ means and which accountabilities it involves, with regard to data ownership, donation and sharing as well as data analysis, re-use and authorship; and whether the trust placed on automated tools for data mining and interpretation is warranted (especially as data processing strategies and tools are often developed separately from the situations of data use where ethical concerns typically emerge). To address these challenges, this paper advocates a participative, reflexive management of data practices. Regulatory structures should encourage data scientists to examine the historical lineages and ethical implications of their work at regular intervals. They should also foster awareness of the multitude of skills and perspectives involved in data science, highlighting how each perspective is partial and in need of confrontation with others. This approach has the potential to improve not only the ethical oversight for data science initiatives, but also the quality and reliability of research outputs.This article is part of the themed issue ‘The ethical impact of data science’.
Facilitating the ethical use of health data for the benefit of society: electronic health records, consent and the duty of easy rescue
Authors: Porsdam Mann Sebastian , Savulescu Julian , Sahakian Barbara J. 
Published: November 2016

Advances in data science allow for sophisticated analysis of increasingly large datasets. In the medical context, large volumes of data collected for healthcare purposes are contained in electronic health records (EHRs). The real-life character and sheer amount of data contained in them make EHRs an attractive resource for public health and biomedical research. However, medical records contain sensitive information that could be misused by third parties. Medical confidentiality and respect for patients' privacy and autonomy protect patient data, barring access to health records unless consent is given by the data subject. This creates a situation in which much of the beneficial records-based research is prevented from being used or is seriously undermined, because the refusal of consent by some patients introduces a systematic deviation, known as selection bias, from a representative sample of the general population, thus distorting research findings. Although research exemptions for the requirement of informed consent exist, they are rarely used in practice due to concerns over liability and a general culture of caution. In this paper, we argue that the problem of research access to sensitive data can be understood as a tension between the medical duties of confidentiality and beneficence. We attempt to show that the requirement of informed consent is not appropriate for all kinds of records-based research by distinguishing studies involving minimal risk from those that feature moderate or greater risks. We argue that the duty of easy rescue—the principle that persons should benefit others when this can be done at no or minimal risk to themselves—grounds the removal of consent requirements for minimally risky records-based research. Drawing on this discussion, we propose a risk-adapted framework for the facilitation of ethical uses of health data for the benefit of society.
This article is part of the themed issue ‘The ethical impact of data science’.