bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined Spinal Epidural Technique for Labor Analgesia Does Not Delay Recognition of Epidural Catheter Failures
Authors: Booth Jessica M. , Pan Joshua C. , Ross Vernon H. , Russell Gregory B. , Harris Lynne C. , Pan Peter H. 
Published: July 2016

Abstract

Background
It is unclear whether recognition of epidural catheter failures is delayed with combined spinal epidural technique (CSE) compared to traditional epidural technique (EPID) when used for labor analgesia. The authors hypothesized that recognition of failed catheters is not delayed by CSE.

Methods
Anesthetic, obstetric, and quality assurance records from 2,395 labor neuraxial procedures (1,440 CSE and 955 EPID) performed at Forsyth Medical Center (Winston-Salem, North Carolina) between June 30 and December 31, 2012, were retrospectively analyzed. The primary outcome was catheter survival (failure-free) time during labor analgesia. A proportional hazards model with the counting method was used to assess relationships between the techniques and survival (failure-free) time of catheters, while controlling for subjects’ body mass index and providers’ level of training in the final best-fit multivariable regression model.

Results
Cumulative incidence of epidural catheter failures was 6.6% for CSE and 11.6% for EPID (P = 0.001). In the multivariable regression model, catheters placed with CSE versus epidural were less likely to fail (hazard ratio, 0.58; 95% CI, 0.43 to 0.79; P = 0.0002) for labor analgesia. Among the catheters that failed, there was no overall difference in failure time course between the techniques (hazard ratio, 1.17; 95% CI, 0.89 to 1.54; P = 0.26) even though more failed catheters with CSE (48.4%) than with EPID (30.6%) were recognized within the first 30 min of placement (P = 0.009).

Conclusions
In this cohort, CSE has a significantly lower risk of overall epidural catheter failures than EPID and does not delay recognition of epidural catheter failures. Choice of CSE versus EPID should be based on overall risk of failure, efficacy, and side effects.
Cognitive Spare Capacity as an Index of Listening Effort
Authors: Rudner Mary 
Published: July 2016

Everyday listening may be experienced as effortful, especially by individuals with hearing loss. This may be due to internal factors, such as cognitive load, and external factors, such as noise. Even when speech is audible, internal and external factors may combine to reduce cognitive spare capacity, or the ability to engage in cognitive processing of spoken information. A better understanding of cognitive spare capacity and how it can be optimally allocated may guide new approaches to rehabilitation and ultimately improve outcomes. This article presents results of three tests of cognitive spare capacity:
1. Sentence-final Word Identification and Recall (SWIR) test
2. Cognitive Spare Capacity Test (CSCT)
3. Auditory Inference Span Test (AIST)
Results show that noise reduces cognitive spare capacity even when speech intelligibility is retained. In addition, SWIR results show that hearing aid signal processing can increase cognitive spare capacity, and CSCT and AIST results show that increasing load reduces cognitive spare capacity. Correlational evidence suggests that while the effect of noise on cognitive spare capacity is related to working memory capacity, the effect of load is related to executive function. Future studies should continue to investigate how hearing aid signal processing can mitigate the effect of load on cognitive spare capacity, and whether such effects can be enhanced by developing executive skills through training. The mechanisms modulating cognitive spare capacity should be investigated by studying their neural correlates, and tests of cognitive spare capacity should be developed for clinical use in conjunction with developing new approaches to rehabilitation.
Shelf acetabuloplasty in Perthes disease: comparison with nonoperative treatment
Authors: Parmentier Charles , Madoki Alexandre , Mercier Pierrick , Docquier Pierre-Louis 
Published: July 2016

Background:
The purpose of this study was to compare radiographic results between operatively and nonoperatively treated hips in patients with Perthes disease.

Methods:
Eighty children (88 hips) treated for Perthes disease were retrospectively reviewed with focus on the radiographic result at a mean follow-up of 6.3 yr (range 2.0 to 12.9 yr). Forty-seven hips had shelf acetabuloplasty, and 41 hips were treated nonoperatively. The radiographs were evaluated at the time of diagnosis, at 4 wk and 3 yr postoperatively (for the shelf group) and finally at latest follow-up for both groups.

Results:
In the nonoperatively treated group, the prognosis was initially better than in the shelf group: younger age at the time of diagnosis (4.7 vs. 6.1 yr), more Herring type A and fewer Herring type C, fewer “head at risk” signs. Stulberg’s classification at the latest follow-up showed Stulberg 1, 2 or 3 in 85% and Stulberg 4 in 15% in the nonoperative group compared with 89% and 11%, respectively, in the shelf group. Acetabular depth ratio and the migration index were better in the shelf group.

Conclusions:
Despite initial worse prognostic factors, final radiographic result seemed to be better in the shelf group. The shelf procedure showed radiographic improvement in the hip in Perthes disease.
Treatment of the Dislocated Hip in Infants With Spasticity
Authors: Refakis Christian A. , Baldwin Keith D. , Spiegel David A. , Sankar Wudbhav N. 
Published: July 2016

Background:
Although many studies have separately investigated the treatment of developmental dysplasia of the hip and spastic hip disease, little data exist regarding the treatment of infants with dislocated hips and underlying spasticity. The purpose of this study was to review our results after the surgical treatment of these infants.

Methods:
We retrospectively reviewed all children below 3 years of age who underwent hip reconstruction for dislocated hips in the setting of cerebral palsy or other spastic/high-tone neuromuscular disease. Medical records were reviewed for clinical data including treatment course, complications, and need for further surgery. Preoperative and postoperative radiographs were used to determine International Hip Dysplasia Institute (IHDI) grade of dislocation, acetabular index, migration percentage, and presence of avascular necrosis according to the Salter criteria.

Results:
Eleven patients with 15 hips met our inclusion criteria with a mean age of 20±8 (range, 6 to 34) months. Preoperatively, 12 of 15 hips (80%) were IHDI grade 4 and 3 of 15 (20%) were IHDI grade 3. Mean acetabular index was 29±8 (range, 19 to 46) degrees. Patients underwent open reduction (15 hips), adductor tenotomy (14 hips), femoral osteotomy (10 hips), and pelvic osteotomy (12 hips). At a mean follow-up of 40±16 (range, 13 to 71) months, 13 of 15 hips were IHDI grade 1 (86.7%), 1 was IHDI grade 2 (6.7%), and 1 hip was IHDI grade 3 (6.7%). The mean postoperative migration index was 7%±24% (range, −30% to 46%); the mean acetabular index was 22±8 (range, 9 to 38) degrees. No patients developed radiographically significant osteonecrosis. Complications included 2 femur fractures (13.3%) and 1 symptomatic implant that required early removal. One patient underwent further reconstructive hip surgery.

Conclusions:
In this series of infants with hip dislocations and underlying spasticity, open reduction±pelvic osteotomy and/or femoral osteotomy has a nearly 90% success rate in achieving and maintaining adequate hip reduction at intermediate-term follow-up. In the unique population of infants with dislocated hips and underlying spasticity, comprehensive hip reconstruction is largely successful with an acceptable rate of complications.

Level of Evidence:
Level IV—retrospective.
Association Between Cartilage Intermediate Layer Protein and Degeneration of Intervertebral Disc
Authors: Wang Wenyu , Hao Jingcan , Zheng Shuyu , Xiao Xiao , Wen Yan , He Awen , Guo Xiong , Zhang Feng 
Published: July 2016

Study Design.
Meta-analysis to collect all eligible studies for investigating whether cartilage intermediate layer protein (CILP) gene rs2073711 polymorphism is associated with susceptibility to intervertebral disc degeneration (IVD).

Objective.
To investigate the association between CILP gene rs2073711 and IVD.

Summary of Background Data.
CILP is one of the limited genes that is being suggested to be associated with IVD. However, previous association study results of CILP and IVD are conflicted.

Methods.
The PubMed, ISI Web of Science, Science Direct Online, and China National Knowledge Infrastructure database were searched for relevant articles till November 1, 2015. The odds ratio (OR) and related 95% confidence interval (CI) were drawn out and merged to assess the strength of association by STATA version 12.0.

Results.
A total of 1551 IVD cases and 1793 controls from the 5 studies were used in this study, comprising four Asian populations and two European populations. Meta-analysis found that the CILP 2073711 polymorphism was significantly associated with IVD risk. The estimated OR of risk allele T of rs2073711 was 1.36. (95% CI = 1.18–1.55, P < 0.001). No significant heterogeneity and publication bias were observed in this study.

Conclusion.
Our results confirm the positive association between CILP and IVD, providing novel clues for clarifying the role of CILP in the development of IVD.

Level of Evidence: 2
Antibody drug conjugates: the future of chemotherapy?
Authors: Borcoman Edith , Le Tourneau Christophe 
Published: July 2016

Purpose of review
The current review describes the rationale and current clinical development of antibody drug conjugates (ADCs), along with their perspectives for the future.

Recent findings
Trastuzumab emtansine was the first ADC approved by the U.S. Food and Drug Administration for the treatment of human epidermal growth factor receptor 2 positive metastatic breast cancer in the second-line setting, with a high efficacy and a favorable safety profile. ADC represents an exciting new class of cancer therapeutics that combines a targeted approach for delivering cytotoxic agents. About 30 new ADCs are currently under investigation in oncology.

Summary
ADCs are empowered antibodies designed to exploit the targeting ability of monoclonal antibodies (mAbs) by linking them to cytotoxic agents, giving them higher tumor selectivity, and potentially an increased therapeutic window, as compared with cytotoxic agents alone. The key components of ADCs include a mAb, a stable linker and a cytotoxic agent. In linking mAbs with cytotoxic agents, the aim is to optimize the properties of both components, bringing their complementary features together. Trastuzumab emtansine has been the first ADC to be marketed in human epidermal growth factor receptor 2 positive metastatic breast cancer. Current clinical development of ADCs includes a variety of targets, as well as combinations with other therapeutic agents, such as chemotherapy, radiotherapy, targeted therapies, and immune checkpoint inhibitors.
Bedtime Electronic Media Use and Sleep in Children with Autism Spectrum Disorder
Authors: Mazurek Micah O. , Engelhardt Christopher R. , Hilgard Joseph , Sohl Kristin 
Published: July 2016

ABSTRACT:

Objectives:
The purpose of this study was to better understand the use of screen-based media at bedtime among children with autism spectrum disorder (ASD). The study specifically examined whether the presence of media devices in the child's bedroom, the use of media as part of the bedtime routine, and exposure to media with violent content just before bedtime were associated with sleep difficulties.

Methods:
Parents of 101 children with ASD completed questionnaires assessing their children's sleep habits, bedroom media access (including television, video game devices, and computers), and patterns of nighttime media use (including timing of media exposure and violent media content).

Results:
Children with ASD who used media as part of the bedtime routine showed significantly greater sleep onset latency than those who did not (39.8 vs 16.0 minutes). Similarly, children who were exposed to media with violent content within the 30-minute period before bedtime experienced significantly greater sleep onset delays and shorter overall sleep duration. In contrast, the mere presence of bedroom media was not associated with either sleep onset latency or sleep duration.

Conclusion:
Overall, these findings indicate that incorporating television and video games into the bedtime routine is associated with sleep onset difficulties among children with ASD. Exposure to violent media before bed is also associated with poor sleep. Families of children with ASD should be encouraged to regulate and monitor the timing and content of television and video game use, whether or not such devices are physically present in the child's bedroom.
The Effect of Bilingual Exposure on Executive Function Skills in Preterm and Full-Term Preschoolers
Authors: Loe Irene M. , Feldman Heidi M. 
Published: July 2016

ABSTRACT:

Objective:
To evaluate the effects of bilingual exposure on executive function (EF) skills, measured by parent-rating and performance-based instruments, in preterm and full-term preschoolers.

Method:
Children age 3 to 5 years (mean 4.4) born preterm (PT; n = 82) and full term (FT; n = 79) had monolingual (PT-M, n = 51; FT-M, n = 53) or bilingual (PT-B, n = 31; FT-B, n = 26) language exposure. Groups were similar in age, gender and race, but PT children had lower socioeconomic status (SES) than FT children. Parents completed a language questionnaire and diary and a standardized parent rating of EF skills. Children completed EF tasks that tap response inhibition, working memory, and cognitive flexibility. ANCOVA and logistic regression examined effects on EF of birth group (PT/FT), language status (M/B), and birth group by language status interaction, controlling for age and SES.

Results:
Compared to children born FT, children born PT had significantly higher parent-rated EF scores and poorer performance on all but one EF task, both indicating more EF problems. No main effects of language status and no birth group by language status interactions were significant.

Conclusion:
PT status was clearly associated with poorer EF skills, similar to many other studies. In this sample, bilingual exposure conferred neither an advantage nor disadvantage in the FT and PT group. This information may prove useful in counseling families of both PT and FT children about the impact of bilingual exposure on their children's cognitive skills.
Ablative Fractional Laser–Assisted Topical Fluorouracil for the Treatment of Superficial Basal Cell Carcinoma and Squamous Cell Carcinoma In Situ: A Follow-Up Study
Authors: Hsu Sarah H. , Gan Stephanie D. , Nguyen Bichchau T. , Konnikov Nellie , Liang Christine A. 
Published: July 2016

BACKGROUND
The authors previously reported the safety and short-term efficacy of ablative fractional laser (AFXL)–assisted delivery of topical fluorouracil in the treatment of superficial basal cell carcinoma (sBCC) and squamous cell carcinoma in situ (SCCis).

OBJECTIVE
This follow-up study was conducted to assess whether tumor clearance was sustained in this cohort of patients at >9 months post-treatment.

METHODS
Thirty primary sBCC or SCCis <2 cm on the trunk or extremities were treated with AFXL and a single application of topical 5-fluorouracil 5% under occlusion for 7 days. Among the 26 patients who achieved tumor clearance at 4 to 8 weeks post-treatment, 20 patients presented for this follow-up study and underwent shave biopsy to confirm histologic clearance. Mean follow-up time was 15 months.

RESULTS
Considering those who had persistent tumor at 4 to 8 weeks post-treatment and those who presented for follow-up at >9 months post-treatment, overall treatment success was 79% (95% confidence interval: 67%–96%), with 92% (11/12) for SCCis and 67% (8/12) for sBCC. Neither the tumor location nor size significantly impacted treatment outcome (p = .96 and 0.87, respectively).

CONCLUSION
Ablative fractional laser–assisted topical fluorouracil is a reasonable noninvasive treatment option for primary SCCis and sBCC, especially for lesions located in areas where self-application is not possible, or when clinician-administered therapy is preferred.
Emerging Points of the Supraorbital and Supratrochlear Nerves in the Supraorbital Margin With Reference to the Lacrimal Caruncle: Implications for Regional Nerve Block in Upper Eyelid and Dermatologic Surgery
Authors: Shin Kang-Jae , Shin Hyun Jin , Lee Shin-Hyo , Song Wu-Chul , Koh Ki-Seok , Gil Young-Chun 
Published: July 2016

BACKGROUND
Blocking the supraorbital nerve (SON) and supratrochlear nerve (STN) by injecting anesthetic distal to the surgical site has the advantage in upper eyelid surgery that avoids obscuring the surgical landmarks and compromising the levator function.

OBJECTIVE
To identify the emerging points of the SON and STN in the supraorbital margin with reference to the lacrimal caruncle.

METHODS
Forty-nine orbits from 27 embalmed Korean cadavers were dissected. The lacrimal caruncle and facial midline were used as landmarks. The emerging points of the SON and STN in the supraorbital margin were determined.

RESULTS
The emerging points of the SON and STN were, respectively, located at 3.0 mm lateral and 3.3 mm medial to the vertical line through the apex of the lacrimal caruncle along the supraorbital margin. The horizontal distances from the facial midline to the emerging points of the SON and STN were 22.8 and 15.2 mm, respectively.

CONCLUSION
The optimum sites for achieving SON and STN block are, respectively, located approximately 3 mm lateral and 3 mm medial to the vertical line through the apex of lacrimal caruncle along the supraorbital margin. This knowledge will help the surgeon achieve an easy and accurate approach for regional nerve block.
Is Sterile Better Than Aseptic? Comparing the Microbiology of Acellular Dermal Matrices
Authors: Klein Gabriel M. , Nasser Ahmed E. , Phillips Brett T. , Gersch Robert P. , Fourman Mitchell S. , Lilo Sarit E. , Fritz Jason R. , Khan Sami U. , Dagum Alexander B. , Bui Duc T. 
Published: July 2016

Introduction:
Postoperative infections are a major complication associated with tissue-expander-based breast reconstruction. The use of acellular dermal matrix (ADM) in this surgery has been identified as a potential reservoir of infection, prompting the development of sterile ADM. Although aseptic and sterile ADMs have been investigated, no study has focused on the occurrence and clinical outcome of bacterial colonization before implantation.

Methods:
Samples of aseptic AlloDerm, sterile Ready-To-Use AlloDerm, and AlloMax were taken before implantation. These samples were incubated in Tryptic soy broth overnight before being streaked on Trypticase soy agar, MacConkey agar, and 5% blood agar plates for culture and incubated for 48 hours. Culture results were cross-referenced with patient outcomes for 1 year postoperatively.

Results:
A total of 92 samples of ADM were collected from 63 patients. There were 15 cases of postoperative surgical site infection (16.3%). Only 1 sample of ADM (AlloMax) showed growth of Escherichia coli, which was likely a result of contamination. That patient did not develop any infectious sequelae. Patient outcomes showed no difference in the incidence of seroma or infection between sterile and aseptic ADMs.

Conclusions:
This study evaluates the microbiology of acellular dermal matrices before use in breast reconstruction. No difference was found in the preoperative bacterial load of either aseptic or sterile ADM. No significant difference was noted in infection or seroma formation. Given these results, we believe aseptic processing used on ADMs is equivalent to sterile processing in our patient cohort in terms of clinical infection and seroma occurrence postoperatively.
Video Capture of Perforator Flap Harvesting Procedure with a Full High-definition Wearable Camera
Authors: Miyamoto Shimpei 
Published: July 2016

Summary:
Recent advances in wearable recording technology have enabled high-quality video recording of several surgical procedures from the surgeon’s perspective. However, the available wearable cameras are not optimal for recording the harvesting of perforator flaps because they are too heavy and cannot be attached to the surgical loupe. The Ecous is a small high-resolution camera that was specially developed for recording loupe magnification surgery. This study investigated the use of the Ecous for recording perforator flap harvesting procedures. The Ecous SC MiCron is a high-resolution camera that can be mounted directly on the surgical loupe. The camera is light (30 g) and measures only 28 × 32 × 60 mm. We recorded 23 perforator flap harvesting procedures with the Ecous connected to a laptop through a USB cable. The elevated flaps included 9 deep inferior epigastric artery perforator flaps, 7 thoracodorsal artery perforator flaps, 4 anterolateral thigh flaps, and 3 superficial inferior epigastric artery flaps. All procedures were recorded with no equipment failure. The Ecous recorded the technical details of the perforator dissection at a high-resolution level. The surgeon did not feel any extra stress or interference when wearing the Ecous. The Ecous is an ideal camera for recording perforator flap harvesting procedures. It fits onto the surgical loupe perfectly without creating additional stress on the surgeon. High-quality video from the surgeon’s perspective makes accurate documentation of the procedures possible, thereby enhancing surgical education and allowing critical self-reflection.
Solely Penile Skin for Neovaginal Construction in Sex Reassignment Surgery
Authors: Sigurjonsson Hannes , Rinder Johan , Lindqvist Ebba K. , Farnebo Filip , Lundgren T. Kalle 
Published: July 2016

Background:
Gender reassignment surgery due to transsexualism (International Classification of Diseases, Tenth Revision: F64.0) is a procedure becoming increasingly common worldwide as a result of a significant increase in diagnostic incidence. Several methods have been described for this complex surgery, but no internationally agreed upon gold standard exists, in particular with regard to which methods allow for creating a sufficient neovaginal depth.

Methods:
We use a 2-stage technique using solely penile skin for creating a neovaginal cavity and present the long-term outcome in terms of measured neovaginal depth. Eighty patients were included. Patients’ neovaginal depth was measured in a standardized fashion 6 months or more after initial surgery. Results were compared with published data on female anatomy.

Results:
The average neovaginal depth achieved was 10.2 cm. Having had a postoperative complication and noncompliance to neovaginal dilatation were both negatively correlated with neovaginal depth, whereas higher body mass index was not. Most patients received a neovaginal depth sufficient for penetrative intercourse and within the range for biological women.

Conclusions:
Using solely penile skin for the vaginal lining is a satisfactory surgical method to achieve adequate vaginal depth, provided that the postoperative dilatation regimen is followed. This holds true regardless of age or body mass index.