bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic Evaluation of the Upper Airway in a Sample Population
Authors: Soares Oliveira Maria Claudia , Tufik Sergio , Louise Martinho Haddad Fernanda , Santos‐Silva Rogerio , Gregório Luis Carlos , Bittencourt Lia 
Published: March 2015

ObjectivesTo investigate the anatomy of the upper airway (UA) of a representative sample of the adult population of São Paulo city, Brazil, and to identify factors associated with the presence of obstructive sleep apnea syndrome (OSAS), as confirmed using full‐night polysomnography (PSG).Study DesignCross‐sectional study.SettingPopulation‐based sample.MethodsA 3‐stage sampling procedure was used to proportionally recruit adult residents of São Paulo city according to gender, age, and socioeconomic status. A complete evaluation was performed, including a systematic evaluation of the UA prior to conducting PSG.ResultsNine‐hundred ninety‐three (90.2%) of the participants were seen by an ear, nose, and throat (ENT) specialist. Individuals who were diagnosed with OSAS (32.9%) presented a higher frequency of nasal symptoms and structural abnormalities (both nasal and oropharyngeal) compared with those without OSAS. No anatomical differences were observed in the facial skeleton. An abnormal nasal structure visible via anterior rhinoscopy was the only UA factor predicting OSAS after adjustments for the other common OSAS risk factors (male sex, aging, obesity, and increased neck circumference).ConclusionThis is the first study in which a systematic evaluation of the UA was followed by a sleep study in a population‐based sample. In a sample of the general population that had not previously been screened for OSAS, having an abnormal nasal structure was found to be a risk factor for OSAS, in conjunction with other well‐established clinical and demographic factors, such as male gender, increased age, increased neck circumference, and body mass index.
Public Awareness of Human Papillomavirus as a Causative Factor for Oropharyngeal Cancer
Authors: Williams Michael U. , Carr Michele M. , Goldenberg David 
Published: March 2015

ObjectiveTo assess the public’s awareness of human papillomavirus (HPV) as a causative factor for oropharyngeal cancer.Study DesignTwenty‐three‐item survey.SettingLocal shopping malls and Maxwell Air Force Base in 2012.MethodsRespondents were randomly chosen to participate in 23‐item survey at various local shopping malls and at Maxwell Air Force Base in 2012. The χ2 test was used in statistical analysis.ResultsThe majority of respondents (n = 319) were civilians; 158 were military officer trainees (MOTs). All MOTs had a bachelor’s degree or higher, while 37% of civilian respondents had a bachelor’s degree or higher. Most MOTs (82%) were aware of oropharyngeal cancer, and 53% of civilians had not heard of oropharyngeal cancer (P <. 0001). Most respondents (73% civilian and 91% military) were aware of the association between HPV and cervical cancer. Conversely, 75% of civilian population and 49% of MOTs were not aware of the association between HPV and oropharyngeal cancer (P <. 0001). The majority of respondents (61% military and 81% civilian) did not know that both sexes were eligible for HPV vaccine (P <. 0001).ConclusionsMost respondents were aware that HPV is a causative agent of cervical cancer. However, the majority were not aware of the association between oropharyngeal cancer and HPV. Furthermore, many respondents were not aware that HPV equally affects males and females and that the vaccine is available for both sexes. This underscores the need to educate the public on the availability of HPV vaccine and the association between HPV and oropharyngeal cancer.
Does the addition of specific acupuncture to standard swallowing training improve outcomes in patients with dysphagia after stroke? a randomized controlled trial
Authors: Xia Wenguang , Zheng Chanjuan , Zhu Suiqiang , Tang Zhouping 
Published: March 2015

Objective: To assess the effect of adding acupuncture to standard swallowing training for patients with dysphagia after stroke. Design: Single-blind randomized controlled trial. Setting: Inpatient and outpatient clinics. Subjects: A total of 124 patients with dysphagia after stroke were randomly divided into two groups: acupuncture and control. Interventions: The acupuncture group received standard swallowing training and acupuncture treatment. In comparison, the control group only received standard swallowing training. Participants in both groups received six days of therapy per week for a four-week period. Main measures: The primary outcome measures included the Standardized Swallowing Assessment and the Dysphagia Outcome Severity Scale. The secondary outcome measures included the Modified Barthel Index and Swallowing-Related Quality of Life, which were assessed before and after the four-week therapy period. Results: A total of 120 dysphagic subjects completed the study (60 in acupuncture group and 60 in control group). Significant differences existed in the Standardized Swallowing Assessment, Dysphagia Outcome Severity Scale, Modified Barthel Index, and Swallowing-Related Quality of Life scores of each group after the treatment ( P < 0.01). After the four-week treatment, the Standardized Swallowing Assessment (mean difference − 2.9; 95% confidence interval (CI) – 5.0 to − 0.81; P < 0.01), Dysphagia Outcome Severity Scale (mean difference 2.3; 95% CI 0.7 to 1.2; P < 0.01), Modified Barthel Index (mean difference 17.2; 95% CI 2.6 to 9.3; P < 0.05) and Swallowing-Related Quality of Life scores (mean difference 31.4; 95% CI 3.2 to 11.4; P < 0.01) showed more significant improvement in the acupuncture group than the control group. Conclusions: Acupuncture combined with the standard swallowing training may be beneficial for dysphagic patients after stroke.
Comparison between landfill gas and waste incineration for power generation in Astana, Kazakhstan
Authors: Inglezakis Vassilis J , Rojas–Solórzano Luis , Kim Jong , Aitbekova Aisulu , Ismailova Aizada 
Published: March 2015

The city of Astana, the capital of Kazakhstan, which has a population of 804,474, and has been experiencing rapid growth over the last 15 years, generates approximately 1.39 kg capita-1 day-1 of municipal solid waste (MSW). Nearly 700 tonnes of MSW are collected daily, of which 97% is disposed of at landfills. The newest landfill was built using modern technologies, including a landfill gas (LFG) collection system. The rapid growth of Astana demands more energy on its path to development, and the viability analysis of MSW to generate electricity is imperative. This paper presents a technical–economic pre-feasibility study comparing landfill including LFG utilization and waste incineration (WI) to produce electricity. The performance of LFG with a reciprocating engine and WI with steam turbine power technologies were compared through corresponding greenhouse gases (GHG) reduction, cost of energy production (CEP), benefit–cost ratio (BCR), net present value (NPV) and internal rate of return (IRR) from the analyses. Results demonstrate that in the city of Astana, WI has the potential to reduce more than 200,000 tonnes of GHG per year, while LFG could reduce slightly less than 40,000 tonnes. LFG offers a CEP 5.7% larger than WI, while the latter presents a BCR two times higher than LFG. WI technology analysis depicts a NPV exceeding 280% of the equity, while for LFG, the NPV is less than the equity, which indicates an expected remarkable financial return for the WI technology and a marginal and risky scenario for the LFG technology. Only existing landfill facilities with a LFG collection system in place may turn LFG into a viable project.
Transferability of the youth foyer model for women exiting the criminal justice system
Authors: Grace Marty , Malone Jennifer , Murphy Angela 
Published: March 2015

Summary This article reports on research with an Australian Homelessness Prevention Project, Restart, which set out to test the transferability of a Youth Foyer model for women exiting prison. The aim of the program was to prevent homelessness for this group of women by stabilising both housing and employment. The program design included a comprehensive package of services including support, housing, and assistance with finding employment. The research methods included analysis of program data, and interviews with program staff and clients. Findings The research found that while the Restart model was described as an adult foyer model, it had some characteristics of a Youth Foyer model and some characteristics of a Housing First model. The imperative to be employed within 12 months in order to be able to afford the housing prevented the program from supporting women to pursue longer-term goals such as education and training which typify youth foyers. Although the program had only limited success with assisting the women to find employment, it demonstrated that intensive assistance that includes support and housing can assist women to stabilise their lives and avoid re-offending post release. Application This research indicates that it would be worthwhile to pursue a model that provides social housing that is permanent and will be affordable in the long term, facilitates employment by establishing corporate partnerships, perhaps with social enterprises, and assists women to establish longer-term goals and undertake education and training in order to provide them with better labour market access in the future.
Outcome Following Isolated Osteochondral Allograft Transplantation of the Femoral Trochlea
Authors: Cameron James I. , Pulido Pamela , DeYoung Allison , Gortz Simon , Bugbee William 
Published: March 2015

Objectives: Osteochondral allograft (OCA) transplantation is a recognized treatment modality for cartilage damage in the knee. Few reports on outcomes of OCA in the patellofemoral joint and no reports on lesions isolated to the femoral trochlea are available. The goal of this study was to evaluate graft survivorship and clinical outcomes in patients who had an OCA of the femoral trochlea. Methods: Twenty-nine knees in twenty-eight patients (mean age, 30. 2 years; range 12-47 years) were treated with fresh OCA transplant limited to the femoral trochlea. There were eight females and twenty males. Minimum follow-up was 2 years. The primary outcome was graft survivorship. Pain and function were assessed by the Modified Merle d’Aubigné-Postel (18-point) scale, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Society function (KS-F), International Knee Documentation Committee (IKDC) and UCLA activity scores. The OCA patient satisfaction score (five point scale from extremely satisfied to extremely unsatisfied) was reported. Results: Mean follow-up was 7.0 years (range 2.1-19.9 years) with 65.5% of patients with more than five years of follow-up. Graft survivorship was 91.7% at a mean of 7.0 years. One patient was converted to a total knee arthroplasty at 7.6 years after allograft surgery. Mean Modified Merle d’Aubigné-Postel (18-point) scale improved from 13.0 to 16.1, mean KS-F score from 65.6 to 85.2 and mean IKDC from 38.5 to 71.9. Mean UCLA score postoperatively was 7.9 and mean KOOS QOL (quality of life) scores improved from 34.0 preoperatively to 75.1 postoperatively. Eighty-nine percent of patients were extremely satisfied or satisfied with the outcome of surgery. Conclusion: Fresh OCA transplantation appears to have good results in this cohort of patients with advanced articular cartilage damage to the femoral trochlea. The procedure resulted in improved pain and function and could delay the need for patellofemoral or total knee arthroplasty for many years.
Correlates With Injury In Youth And Adolescent Pitchers
Authors: Chalmers Peter Nissen , Sgroi Terrance , Riff Andrew Joseph , Lesniak Matthew , Sayegh Eli , Verma Nikhil N. , Cole Brian J. , Romeo Anthony A. 
Published: March 2015

Objectives: Shoulder and elbow injuries are common among youth and adolescent baseball players. While previous cross-sectional studies have identified breaking pitches as a risk factor for injury, breaking pitches have not been associated with higher shoulder and elbow torques in motion analysis. We hypothesized that pitch velocity and kinematic factors would be more important predictors of injury than breaking pitches. Methods: Demographic and kinematic data were collected on normal youth and adolescent pitchers in pre-season training using dual orthogonal high-speed video analysis. Pitching history was also collected. Players were asked whether they had ever experienced a pitching-related shoulder or elbow injury. Multivariate logistic regression analysis was performed on those variables that correlated with injury to identify the most important predictors. Results: Four hundred and twenty pitchers were included, of whom 31% had a history of a pitching related injury. After multivariate logistic regression analysis only subject height (p=0.009, R2=0.023), pitching for more than one team (p=0.019, R2=0.018), and pitch velocity (p=0.006, R2=0.194), served as independent correlates of injury status. A model constructed with these three variables could correctly predict 77% of injuries. Within our cohort, the presence of either an 8.6 inch increase in height or a 17 mile per hour increase in velocity was associated with a doubling of likelihood of history of injury. Playing for more than one team increased the likelihood of a history of injury 61%. Conclusion: Pitch velocity, pitcher height, and pitching for more than one team correlate with a history of shoulder and elbow injury. Current recommendations regarding breaking pitches may not prevent injury. Pitchers should be cautioned from pitching for more than one team. Taller pitchers and high velocity pitchers may be at risk for injury. To fully prevent injury, age-based velocity limits could be considered.
15 Year Survival Of Endoscopic Anterior Cruciate Ligament Reconstruction In Patients Aged 18 Years And Under
Authors: Pinczewski Leo A. , Morgan Matthew , Salmon Lucy J. , Waller Alison , Thompson Simon , Roe Justin P. 
Published: March 2015

Objectives: The incidence and risk factors for further anterior cruciate ligament (ACL) injury after ACL reconstruction have been examined in adults but not in juveniles. The aim of this study was to determine the long term survival of the ACL graft and the contralateral ACL (CACL) after primary reconstruction in those 18 years and under, and to identify the factors that increase the odds of subsequent ACL injury over the long term. Methods: All patients having undergone primary ACL reconstruction at the age of 18 or less between January 1993 and December 1998 by a single surgeon in a single unit were considered. ACL reconstruction was performed using a single-incision endoscopic technique with either autologous bone-patellar tendon-bone graft (BPTB) or hamstring tendon graft (HT). Femoral tunnel drilling was performed via the anteromedial portal. Patients were contacted to complete a subjective interview by telephone or online questionnaire at a minimum of 15 years after the index surgery. Results: A total of 288 juveniles met the inclusion criteria of which 237 (82%) were reviewed at a mean of 16.6 years after ACL reconstruction. The mean age at the time of surgery was 16 years (13-18). Subsequent ACL injury occurred in 29% of juveniles. 16% of suffered an ACL graft rupture, 19% suffered a CACL rupture and 5% ruptured both the graft and CACL. Expected survival of the ACL graft after reconstruction was 93%, 89%, 87% and 85% at 2, 5, 10 and 15 years, respectively. Expected survival of the CACL was 97%, 90%, 84% and 82%, respectively. Survival of the ACL graft was less favourable in those with a positive family history (73% versus 91%, p = .001). Survival of the CACL was less favourable in males than in females (77% versus 87%, p = .05). Graft source, age at surgery and graft diameter did not significantly increase the odds of graft or CACL rupture. The mean International Knee Documentation Committee (IKDC) subjective score at 15 years was 88. Return to preinjury sport level was reported in 69% of patients and 65% were still participating in strenuous or very strenuous activities at a mean 16 years post-reconstruction. Conclusion: After ACL reconstruction in those aged 18 years or less, further ACL injury occurred to 1 in 3 over 15 years. The expected 15 year survival of the ACL graft was 85% and expected 15 year survival of the CACL was 82%. Family history of ACL rupture significantly increased the odds of ACL graft rupture. CACL injury was more common in males than females. High subjective scores and continued participation in sports were maintained over the long term after ACL reconstruction in the juvenile population.
All-Arthroscopic Suprapectoral versus Open Subpectoral Tenodesis of the Long Head of the Biceps Brachii
Authors: Gombera M. Mustafa , Kahlenberg Cynthia A. , Nair Rueben , Saltzman Matthew D. , Terry Michael A. 
Published: March 2015

Objectives: Pathology of the long head of the biceps tendon is a recognized source of shoulder pain in adults that can be treated with tenotomy or tenodesis when non-operative measures are not effective. It is not clear whether arthroscopic or open biceps tenodesis has a clinical advantage. To date, we are not aware of any studies that directly compare clinical outcomes between an arthroscopic and an open technique for tenodesis of the long head of the biceps brachii. The purpose of this study was to determine whether a difference in outcomes and complications exists between matched cohorts after biceps tenodesis utilizing an open subpectoral versus an all-arthroscopic suprapectoral technique. Methods: A prospective database was reviewed for patients undergoing an all-arthroscopic suprapectoral or open subpectoral biceps tenodesis. Adult patients with a minimum 18-month follow-up were included. Patients undergoing a concomitant rotator cuff or labral repair were excluded. The groups were matched to age within 3 years, sex, and time to follow-up within 3 months. Pain improvement, development of a popeye deformity, muscle cramping, post-operative ASES scores, satisfaction scores, and complications were evaluated. Results: Forty-six patients (23 all-arthroscopic, 23 open) patients with an average age of 57.2 years (range, 45-70) were evaluated at a mean 28.7 months (range, 18-42) follow-up. No patients in either group developed a popeye deformity or complained of arm cramping. There was no significant difference in mean ASES scores between the open and all-arthroscopic groups (92.7 vs. 88.9, P = 0.42, Table 1). Similarly, there was no significant difference between patient satisfaction scores (8.9 vs. 9.1, P = 0.73). Eighteen patients (78.3%) in the arthroscopic cohort and sixteen patients (69.6%) in the open cohort fully returned to athletic activity (P = 0.50). There were no complications in the all-arthroscopic group. There were two complications in the open group (superficial incisional erythema, and brachial plexopathy) that resolved by final follow-up. Conclusion: Biceps tenodesis is a reliable treatment option for pathology of the long head of the biceps that may avoid arm cramping and a cosmetic “popeye” deformity that can occur following tenotomy. Open subpectoral and all-arthroscopic suprapectoral are two commonly used techniques to reattach the biceps tendon distal to the bicipital groove. In this study, patients undergoing an all-arthroscopic tenodesis experienced similar pain relief, shoulder function, and return to athletic activity as patients undergoing an open tenodesis. An open subpectoral technique may increase the risk of complications secondary to a larger incision and increased surgical dissection. Larger studies with longer follow-up would help delineate the long-term effects and potential differences between an all-arthroscopic suprapectoral and open subpectoral biceps tenodesis.
Characterizing Patterns In Patellar Maltracking On Dynamic Kinematic CT Imaging
Authors: Tanaka Miho Jean , Williams Ariel , Elias John J. , Demehri Shadpour , Cosgarea Andrew J. 
Published: March 2015

Objectives: Patellar maltracking has been traditionally difficult to assess due to its dynamic component. Unlike the assessment of malalignment, which relies on static radiographic measurements, maltracking is a dynamic phenomenon described subjectively with the J sign. The advent of dynamic, kinematic computed tomographic imaging (DKCT) has allowed for the dynamic assessment of the patellofemoral joint. We used DKCT to visualize and quantify patterns of patellar maltracking and correlated these findings with the presence or absence of symptoms of patellar instability. Methods: 76 knees in 38 subjects were analyzed using DKCT. Measurements of bisect offset at 10° intervals of knee flexion were performed for each knee during active flexion/extension cycles. Patterns in bisect offset were assessed and graded in terms of 1, 2 or 3 quadrants of lateral patellar motion, based on 75-100, 100-125, and >125% bisect offset. The presence or absence of symptomatic patellar instability were recorded for each knee, and ratios of patients with symptoms were calculated for J sign tracking patterns of grades 1, 2 and 3. Differences in ratios between Grades 1, 2 and 3 were calculated using chi squared analysis. Results: 76 knees were available for analysis, of which 51 had symptomatic patellar instability. 9 knees demonstrated normal patterns of tracking. 58 knees demonstrated increased lateral translation in extension. 7 knees showed persistent lateralization of the patella throughout range of motion, and 2 knees showed increased translation in flexion. In the 58 knees that showed maximal lateral translation in extension (J sign), the J sign was graded as 1(N=24), 2 (N=20) and 3 (N=14). The sensitivities of J sign grades in predicting patellar instability were 45.8% (J1), 80% (J2), and 92.9% (J3) (p<0.01), with statistically significant differences between Grades 1 and 2/3 (0=0.018). Conclusion: On DKCT imaging, we noted additional patterns of patellar maltracking besides the standard J sign. Of those with maltracking in extension (J sign), Grade 2 and 3 J signs with > 2 quadrants of patellar lateralization in extension were predictive of symptomatic patellar instability. Further understanding of patellar maltracking patterns can provide the clinician with information regarding the pathoanatomy and pathophysiology of patellar instability, and allow us to better plan for surgical stabilization.