bluuebunny/crossref_metadata_2025_split huggingface dataset:
Videographic Assessment of Pediatric Tracheal Intubation Technique During Emergency Airway Management
Authors: Shiima Yuko , Hsieh Ting-Chang , Long Andrew , Donoghue Aaron 
Published: December 2017

Objectives:
To examine technical aspects of pediatric tracheal intubation using video recording and to determine the association between tracheal intubation technique and procedural outcomes.

Design:
Prospective observational study.

Setting:
Emergency department resuscitation bay in single tertiary pediatric center.

Patients:
Children undergoing emergent tracheal intubation under videorecorded conditions.

Interventions:
None.

Measurements and Main Results:
A published scoring tool for characterizing patient positioning, intubator kinematics, and adjunctive maneuvers during tracheal intubation was applied to videorecorded pediatric resuscitations when tracheal intubation was performed. Procedural outcomes were measured from video review. Seventy-one children underwent 109 tracheal intubation attempts with an overall first attempt success rate of 69% and a median laryngoscopy duration of 34 seconds (interquartile range, 24–47 s). A significant subset of tracheal intubation attempts were made with the patient’s bed at a height below the level of intubator’s umbilicus (61%), the patient in a supine position without head elevation (55%), the intubator bent at the waist to greater than 45° (66%), less than 1 cm of mouth opening by the intubator’s right hand prior to laryngoscopy (46%), and with the intubator’s face less than 12 inches away from the patient’s mouth (65%). Adjunctive maneuvers were used in a minority of attempts (cricoid pressure 48%, external laryngeal manipulation 11%, retraction of the right corner of the patient’s mouth 26%). On multivariate analysis, including controlling for patient age category and intubator background, retraction of the right corner of the patient’s mouth by an assistant showed an independent association with successful tracheal intubation. No other technical aspects were associated with tracheal intubation success.

Conclusions:
Intubators commonly exhibited suboptimal technique during tracheal intubation such as bending deeply at the waist, having their eyes close to the patient’s mouth, failing to widely open the patient’s mouth, and not elevating the occiput in older children. Retraction of the right corner of the patient’s mouth by an assistant during laryngoscopy and intubation was associated with TI success.
Lean Mass and Functional Recovery in Men With Hip Fracture
Authors: Di Monaco Marco , Castiglioni Carlotta , Di Carlo Silvia 
Published: December 2017

Objective
The aim of the study was to assess the capability of different definitions of low appendicular lean mass (aLM) to predict the short-term functional recovery in men with hip fracture.

Design
We investigated 80 of 95 men with hip fracture admitted consecutively to a rehabilitation hospital. Body composition was assessed by dual-energy x-ray absorptiometry. Functional recovery after inpatient rehabilitation was evaluated using Barthel Index scores.

Results
The patients with aLM above the cutoff value of 19.75 kg indicated by the Foundation for the National Institutes of Health (FNIH) had significantly higher Barthel Index scores than those with aLM below the cutoff value (P = 0.002). Patients' categorization according to the same threshold (aLM = 19.75 kg) was significantly associated with a Barthel Index score of 85 or higher after adjustment for age, cognitive impairment, hip fracture type, co-morbidities, and medications (odds ratio = 7.17, 95% confidence interval = 1.43–35.94, P = 0.017). Conversely, patients' categorization according to neither Baumgartner's cutoff value (7.26 kg/m2) for aLM/height2 nor Foundation for the National Institutes of Health cutoff value (0.789) for aLM divided by body mass index was significantly associated with the Barthel Index scores.

Conclusions
Categorization according to the Foundation for the National Institutes of Health threshold for aLM, but not to the Foundation for the National Institutes of Health threshold for aLM/body mass index or Baumgartner's threshold for aLM/height2, was associated with the short-term recovery in activities of daily living after a hip fracture in men.
Impact of Racial Discrimination and Hostility on Adrenergic Receptor Responsiveness in African American Adults
Authors: Hill LaBarron K. , Sherwood Andrew , McNeilly Maya , Anderson Norman B. , Blumenthal James A. , Hinderliter Alan L. 
Published: December 2017

ABSTRACTObjectiveRacial discrimination is increasingly recognized as a contributor to increased cardiovascular disease (CVD) risk among African Americans. Previous research has shown significant overlap between racial discrimination and hostility, an established predictor of CVD risk including alterations in adrenergic receptor functioning. The present study examined the associations of racial discrimination and hostility with adrenergic receptor responsiveness.MethodsIn a sample (N= 57) of young to middle-aged African American adults (51% female) with normal and mildly elevated blood pressure, a standardized isoproterenol sensitivity test (CD25) was used to evaluate β-AR responsiveness, whereas the dose of phenylephrine required to increase mean arterial pressure by 25 mm Hg (PD25) was used to assess α1-AR responsiveness. Racial discrimination was measured using the Perceived Racism Scale and hostility was assessed using the Cook-Medley Hostility Scale.ResultsIn hierarchical regression models, greater racial discrimination, but not hostility, emerged as a significant predictor of decreased β-adrenergic receptor responsiveness (β = .38,p= .004). However, moderation analysis revealed that the association between racial discrimination and blunted β-adrenergic receptor responsiveness was strongest among those with higher hostility (β = .49, 95% confidence interval = .17–.82,p= .004). In addition, hostility, but not racial discrimination, significantly predicted α1-AR responsiveness.ConclusionsThese findings suggest racial discrimination was associated with blunted β-adrenergic receptor responsiveness, providing further evidence of the potential contribution of racial discrimination to increased CVD risk among African Americans. The adverse effects of discrimination on cardiovascular health may be enhanced in individuals with higher levels of hostility.
Rapid Serological Tests Ineffectively Screen for HIV Exposure in HIV-Positive Infants
Authors: Urick Brittany , Fong Youyi , Okiira Christopher , Nabukeera-Barungi Nicolette , Nansera Denis , Ochola Emmanuel , Nteziyaremye Julius , Bigira Victor , Ssewanyana Isaac , Olupot-Olupot Peter , Peter Trevor , Ghadrshenas Anisa , Vojnov Lara , Kiyaga Charles 
Published: December 2017

Background:
Data on the performance and utility of rapid serological tests in infants to determine HIV exposure are unclear and in some instances contradictory. This study sought to understand the performance of rapid serological tests in high HIV burden, high Option B+ coverage settings to be used as an HIV exposure screening tool.

Methods:
A total of 3600 infants up to 24 months of age at 4 regional hospitals in Uganda were systematically enrolled and tested simultaneously using both HIV rapid serological and nucleic acid–based tests.

Results:
Only 58 of the 94 HIV-positive infants who received both rapid serological and nucleic acid–based tests were positive with the rapid serological test (sensitivity: 61.7%; 95% confidence interval: 51.1 to 71.5). Using rapid serological tests to screen infants for exposure to HIV and follow-up nucleic acid-based testing would have missed 38.3% (36 of 94) of HIV-positive infants. Finally, several HIV-positive infants who were negative by rapid serological test presented to well-child entry points and were considered healthy. All 3 HIV-positive infants presenting to outreach and immunization were negative by rapid serological testing and 73% (8 of 11) presenting to outpatient.

Conclusions:
These data suggest that the use of rapid serological tests may have inadequate performance as an indicator of exposure and potential HIV infection among infants presenting at both well-child (immunization and community outreach) and sick-infant (nutrition and inpatient) entry points. To improve the identification of HIV-positive infants, nucleic acid–based testing should instead be considered in infants aged younger than 18 months.
Brief Report: Assessing the Association Between Changing NRTIs When Initiating Second-Line ART and Treatment Outcomes
Authors: Rohr Julia K. , Ive Prudence , Horsburgh Charles Robert , Berhanu Rebecca , Hoffmann Christopher J. , Wood Robin , Boulle Andrew , Giddy Janet , Prozesky Hans , Vinikoor Michael , Mwanza Mwanza wa , Wandeler Gilles , Davies Mary-Ann , Fox Matthew P. 
Published: December 2017

Background:
After first-line antiretroviral therapy failure, the importance of change in nucleoside reverse transcriptase inhibitor (NRTI) in second line is uncertain due to the high potency of protease inhibitors used in second line.

Setting:
We used clinical data from 6290 adult patients in South Africa and Zambia from the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Southern Africa cohort.

Methods:
We included patients who initiated on standard first-line antiretroviral therapy and had evidence of first-line failure. We used propensity score-adjusted Cox proportional-hazards models to evaluate the impact of change in NRTI on second-line failure compared with remaining on the same NRTI in second line. In South Africa, where viral load monitoring was available, treatment failure was defined as 2 consecutive viral loads >1000 copies/mL. In Zambia, it was defined as 2 consecutive CD4 counts <100 cells/mm3.

Results:
Among patients in South Africa initiated on zidovudine (AZT), the adjusted hazard ratio for second-line virologic failure was 0.25 (95% confidence interval: 0.11 to 0.57) for those switching to tenofovir (TDF) vs. remaining on AZT. Among patients in South Africa initiated on TDF, switching to AZT in second line was associated with reduced second-line failure (adjusted hazard ratio = 0.35 [95% confidence interval: 0.13 to 0.96]). In Zambia, where viral load monitoring was not available, results were less conclusive.

Conclusions:
Changing NRTI in second line was associated with better clinical outcomes in South Africa. Additional clinical trial research regarding second-line NRTI choices for patients initiated on TDF or with contraindications to specific NRTIs is needed.
Quality and Safety in Health Care, Part XXXIV
Authors: Harolds Jay A. 
Published: December 2017

Abstract
The PINNACLE (Practice INNovation And Clinical Excellence) program was started in 2008 by the American College of Cardiology and its National Cardiovascular Data Registry. This was the first and now the largest countrywide prospective registry to improve care quality for cardiac outpatients. The registry focuses on reporting about the adherence to guidelines in treating individuals with high blood pressure, atrial fibrillation, coronary artery disease, and/or cardiac failure.
Quality and Safety in Health Care, Part XXXIV
Authors: Harolds Jay A. 
Published: December 2017

Abstract
There is an important opportunity for improvement in the care of cardiology outpatients by having greater compliance with published guidelines, and the PINNACLE (Practice Innovation and Clinical Excellence) Registry seeks to do that. One of the major areas studied by this registry is the use of secondary prevention medications for patients with coronary artery disease. Appropriate use of these medications decreases later myocardial infarctions and death from a cardiac cause.
Dilated Internal Thoracic Vertebral Venous Plexus Simulating Bone Metastases on FDG PET/CT
Authors: Hod Nir , Anconina Reut , Levin Daniel , Ezroh Kazap Dina , Lantsberg Sophie 
Published: December 2017

Abstract
A 42-year-old woman with a newly diagnosed malignant thymoma underwent FDG PET/CT, which demonstrated an increased uptake in anterior mediastinal tumor and several pleural masses in the right hemithorax, compatible with “drop metastases.” In addition, contrast-enhanced CT images showed hyperdense abnormality in T2 vertebral body, congruent with intensely increased FDG uptake, raising suspicion of skeletal metastasis. This is a rare but important potential pitfall either in CT and FDG PET/CT—a “false-positive” bony lesion not attributed to skeletal metastasis but to dilated internal thoracic vertebral venous plexus associated with collateral circulation due to superior vena cava syndrome.
Imaging of Acquired Demyelinating Syndrome With 18F-FDG PET/CT
Authors: Malo-Pion Caroline , Lambert Raymond , Décarie Jean-Claude , Turpin Sophie 
Published: December 2017

Abstract
Acquired demyelinating syndromes include acute disseminated encephalomyelitis, transverse myelitis and may progress to multiple sclerosis (MS). Acute disseminated encephalomyelitis is characterized by impairment of level of consciousness and multifocal neurological deficits and transverse myelitis by back pain, weakness and sphincter dysfunction. Only a few cases of acquired demyelinating syndrome have been imaged with 18F-FDG PET/CT. We present two such cases.
A Novel Technique to Measure the Intensity of Abnormality on GI Bleeding Scans
Authors: Farhat Rami , Kim Derek T. , French T. Dustin , Bechhofer Dov , Kranz Anca-Oana , Hoffmann Jason C. 
Published: December 2017

Purpose
Develop a technique to quantify intensity of lower gastrointestinal bleeding (LGIB) on 99mTc-labeled red blood cell (RBC) scintigraphy, correlate with angiography, and determine the tool’s predictive value.

Materials and Methods
An IRB-approved, single institution database query of GI bleeding scans performed between January 2013 and December 2015. Reports from all studies and imaging from all positive studies were reviewed. A technique was developed for scan analysis, allowing for calculation of percent increase of activity in the region of interest (ROI, area of bleeding) and ROI in the aorta and liver (controls). Database query determined which patients underwent angiography, and which had positive angiograms. Median ROI percent increase in patients with positive scintigraphy and positive angiography was compared to those with positive scintigraphy and negative angiography.

Results
Of 194 bleeding scans performed during the study period, 71 were positive for active LGIB, 37 had angiography, and 9 had active contrast extravasation. The new tool was used to analyze the 37 cases with positive nuclear scans sent for angiography. Median percent increase in ROI activity was 50% in those with positive scan and positive angiogram and 26.8% in those with positive scan but negative angiogram. Using ROI percent change quartiles, we observed a statistically significant association between percent increase in ROI activity from baseline and the probability of having a positive angiogram (Cochran-Armitage trend test, P = 0.01), such that there are no positive angiogram cases when ROI change was <20% and a majority of the positive angiogram cases (67%) in the highest quartile.

Conclusions
Utilization of processing protocol to determine percent increase in activity from baseline within ROI of active LGIB on scintigraphy has predictive value in determining which patients will not benefit from conventional angiography.
The Effect of Midface Advancement Surgery on Obstructive Sleep Apnoea in Syndromic Craniosynostosis
Authors: Saxby Clair , Stephenson Kate A. , Steele Katherine , Ifeacho Sonna , Wyatt Michelle E. , Samuels Martin 
Published: December 2017

Background:
Children with syndromic craniosynostosis frequently suffer from obstructive sleep apnoea (OSA). The aim of the authors’ study was to investigate if midface advancement surgery for patients with SC improved the severity of OSA by examining the results of sleep studies before and after surgery.

Methods:
A retrospective comparison of the pre and postoperative sleep study data of children undergoing midface advancement surgery at Great Ormond Street Hospital between 2007 and 2016.

Results:
A total of 65 children underwent midface advancement surgery between 2007 and 2016 at Great Ormond Street Hospital and had recorded pre- and postoperative sleep studies. Thirteen patients were excluded from the analysis as their sleep study techniques before and after surgery were not comparable (e.g., different conditions with prong/continuous positive airway pressure use). Fifty-six percent of the patients were treated by monobloc surgery and the remainder with bipartition surgery. A greater proportion of patients had a normal OSA grading following midface advancement (42.3% postoperatively vs. 23.1% preoperatively, P = 0.059) although no statistically significant categorical changes in OSA grade were observed. Seventy-one percent of the patients had a decrease in Apnoea-Hypopnoea Index after surgery (21 patients 2011 onward). Similarly, there was no significant change in median oxygen desaturation index or in oxygen saturation nadir following surgery.

Conclusion:
The authors report one of the largest reviews of the effects of midface advancement surgery on sleep study parameters. Most patients showed improvements in Apnoea-Hypopnoea Index and OSA grading, although measures of oxygenation showed no consistent change.
Effect Evaluation of Modified Uvulopalatopharyngoplasty With Low-Temperature Plasma and Selective Nasal Cavity Vasodilatation With Tongue Volume Reduction in Patients With Obstructive Sleep Apnea Hypopnea Syndrome
Authors: Huai De , Ju Lixian , Wang Shoufeng , Wu Hong , Xu Min , Cao Ying 
Published: December 2017

Objective:
To compare the clinical effects of modified uvulopalatopharyngoplasty (UPPP) with low-temperature plasma with selective nasal cavity vasodilatation with tongue volume reduction for obstructive sleep apnea/hypopnea syndrome (OSAHS).

Methods:
A retrospective analysis based on 156 patients with serious OSAHS was used for the evaluation. These patients were divided into 2 groups according to surgery methods according to 1:1.s. The patients in observation group accepted modified UPPP with low-temperature plasma and selective nasal cavity vasodilatation with tongue root volume reduction on the basis of fully preparation for surgery, while the patients in the control group accepted normal treatment. The clinic effects, operative complications, postoperative relapse, and other indexes were compared.

Result:
After 6 months of follow-up visit, the general effective rates of the observation group and control groups were 80.77% and 61.54%, the difference was statistically significant (P < 0.05). Besides, the rate complication occurrence in the observation group was also lower than that in the control group.

Conclusion:
The effect of modified UPPP with low-temperature plasma and selective nasal cavity vasodilatation with tongue volume reduction is satisfactory for patients with moderate and severe OSAHS after enough preparation.
Effect of Septoplasty on the Heart Rate Variability in Patients With Nasal Septum Deviation
Authors: Celiker Metin , Cicek Yuksel , Tezi Suat , Ozgur Abdulkadir , Polat Hatice Beyazal , Dursun Engin 
Published: December 2017

Background:
Nasal septum deformities (NSD) are one of the most common causes of upper airway obstruction. Heart rate variability (HRV) is a physiologic parameter that is affected by the balance between the sympathetic and parasympathetic tonus.

Objective:
The aim of this study was to evaluate the effects of a septoplasty operation on HRV parameters as assessed by 24 hours ambulatory Holter recordings in patients with NSD.

Methods:
The prospective study involved 54 consecutive patients (16 women and 38 men) who underwent septoplasty due to a marked C- or S-shaped NSD. Twenty-four-hour Holter monitoring was performed to all patients pre- and 2 months postseptoplasty operation. For the HRV analyses, the definitions of evaluated parameters were made according to the Task Force of European Society of Cardiology and the North American Society of Pacing and Electrophysiology on HRV.

Results:
Low-frequency norm () (73 [68–86] versus 78 [70–81], P = 0.039) values were significantly increased after septoplasty whereas changes in other parameters were not statistically significant.

Conclusion:
The authors’ study showed that low-frequency norm values were significantly increased after septoplasty operation in patients with NSD which may be interpreted as a decreased sympathetic tone.
Optimal Conditions for Absorbable Fixation of Hydroxyapatite Ceramic Implants
Authors: Sakamoto Yoshiaki , Kishi Kazuo 
Published: December 2017

Abstract
Synthetic hydroxyapatite (HAP) implants are common in craniofacial surgery; the major problem with HAP implants is fixation instability. An ultrasound-assisted pinned resorbable fixation system has recently been introduced. The authors hypothesized that this resorbable system could be used to fix HAP implants. The authors evaluated the optimal HAP porosity and resorbable pin using the pull-out test and microscopic analysis. Hydroxyapatite blocks were synthesized with 0% (dense type), 35% (fine pore type), and 50% (large pore type) porosity. Bioabsorbable pins of 4 sizes were tested: diameters of 1.6 or 2.1 mm and lengths of 4 or 7 mm. Among the 1.6 mm diameter pins, the 7-mm length pins showed higher pull-out strength (large pore, 6.5 ± 1.2 kgf; fine pore, 4.1 ± 0.7 kgf; dense, 2.4 ± 0.4 kgf) than the 4-mm length pins (large pore, 2.1 ± 1.0 kgf; fine pore, 1.3 ± 0.4 kgf; dense, 1.5 ± 0.9 kgf) with all 3 HAP types (P < 0.01). Among 2.1-mm diameter pins, all were removed from the large and fine pore HAP types without any resistance. Only three of seven 2.1 × 7 mm pins inserted into the dense type HAP showed pull-out strength (3.9 ± 2.1 kgf). Among all conditions, the 7-mm length, 1.6-mm diameter pin in large pore type HAP showed the highest pull-out strength. Microscopically, the large pore type HAP showed the liquefying pin flowing into the large pore adjacent to the pilot hole. By contrast, the fine pore and dense pore types of HAP did not allow flow, and the pins did not change in structure 3-dimensionally. The authors found that pull-out strength depends on HAP porosity, and pin length and diameter.
Computer-Aided Freehand Maxillary Repositioning
Authors: Lin Xiaozhen , Sun Yi , Han Xiaodong , Wang Jing , Zhang Ming , Liang Limin 
Published: December 2017

Abstract
The authors aimed to test the hypothesis that in orthognathic surgery the maxilla could be repositioned using spatial distances from Glabella to 3 maxillary dental landmarks as references. An asymmetric skeletal Class 3 malocclusion patient was involved and bimaxillary orthognathic surgery was planned. Virtual surgery was simulated and spatial distances from Glabella to midpoint of the upper dentition (U0) and bilateral medial-buccal cusp of the first molar (6L and 6R) were measured. These distances were used as the repositioning references and were imported intraoperatively into a digital caliper after the maxilla was mobilized, the repositioning of maxilla was manipulated till all the true spatial distances reached the references. Postoperative computed tomography head model were superimposed onto the planned head model, the maxillary repositioning error was assessed using spatial distances between the pre- and postoperative dental landmarks. The asymmetric skeletal Class 3 malocclusion was corrected through bimaxillary surgery and the errors at U0, 6R and 6L was 1.37, 1.79, and 1.45 mm. The maxilla could be repositioned using spatial distances from Glabella to 3 maxillary dental landmarks as references.