bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing a Practical Tool for Predicting Wound Healing Outcomes of Patients with Diabetic Forefoot Ulcers: Focus on Vasculopathy and Infection
Authors: Moon Kyung-Chul , Cha Ji-Hwan , Han Seung-Kyu , Son Ji-Won 
Published: January 2024

ABSTRACT

OBJECTIVE
To develop a preliminary risk scoring system to predict the prognosis of patients with diabetic forefoot ulcers based on the severity of vasculopathy and infection, which are the major risk factors for amputation.

METHODS
Forefoot was defined as the distal part of the foot composed of the metatarsal bones and phalanges and associated soft tissue structures. The degree of vasculopathy was graded as V0, V1, or V2 according to transcutaneous partial oxygen tension values and toe pressure. The degree of infection was graded as I0, I1, or I2 according to tissue and bone biopsy culture results. The risk scores were calculated by adding the scores for the degree of vasculopathy and infection and ranged from 0 to 4. Wound healing outcomes were graded as healed without amputation, minor amputation, or major amputation. The authors evaluated wound healing outcomes according to risk scores.

RESULTS
As the risk score increased, the proportion of patients who underwent both major and minor amputations increased (P < .001). In the multivariate logistic analysis, the odds ratios of amputation also increased as the risk score increased. Patients with a risk score of 4 were 75- and 19-fold more likely to undergo major and minor amputations, respectively, than patients with a risk score of 0 (P = .006 and P < .001).

CONCLUSIONS
The risk score can be used as an indicator to predict the probability of amputation in patients with diabetic forefoot ulcers.
Outpatient Foot-Sparing Surgery Is Safe in Selected Patients with Diabetic Foot Infections
Authors: Aragón-Sánchez Javier , Víquez-Molina Gerardo , López-Valverde María Eugenia , Aragón-Hernández Cristina , Aragón-Hernández Javier , Rojas-Bonilla José María 
Published: January 2024

ABSTRACT

OBJECTIVE
To determine if outpatient foot-sparing surgery for patients with diabetic foot infections (DFIs) is associated with a higher rate of treatment failure or longer healing time.

METHODS
In this prospective observational study, the authors consecutively recruited a cohort of 200 patients with moderate and severe DFIs from the Diabetic Foot Unit of Hospital San Juan de Dios, Caja Costarricense de Seguro Social, San José de Costa Rica, Costa Rica from October 15, 2020 to December 15, 2021. They compared outpatients with those admitted. Cox univariate analysis was performed, with time to treatment failure and time to healing as dependent variables and outpatient management as the independent variable.

RESULTS
Seventy-one patients underwent surgery on an outpatient basis (35.5%), and 129 (64.5%) were admitted. Sixty of 111 patients (54.1%) with moderate infections were treated as outpatients versus 11 of 89 (12.4%) of those with severe infections. Twelve (16.9%) of the outpatients and 26 (20.2%) of those admitted presented failure (P = .57). The Cox univariate analysis with time to failure of treatment associated with outpatient management reported a hazard ratio of 1.26 (95% CI, 0.64–2.50; P = .50), and the analysis regarding healing time reported a hazard ratio of 0.91 (95% CI, 0.66–1.25; P = .56).

CONCLUSIONS
Foot-sparing surgery on an outpatient basis was safe in more than half the cases of moderate DFIs, especially in patients with osteomyelitis. This approach is not associated with treatment failure or a longer healing time. Patients with severe infections, penetrating injuries, necrosis, or high inflammatory response and those with peripheral arterial disease who require revascularizations should be admitted to the hospital.
The Effect of Education Via Videoconferencing at Home on Individuals’ Self-efficacy and Adaptation to Life with a Stoma: A Randomized Controlled Study
Authors: Özkaya Edanur , Harputlu Deniz 
Published: January 2024

ABSTRACT

OBJECTIVE
To determine the effect of education via videoconferencing at home on individuals’ self-efficacy and adaptation to life with a stoma.

METHODS
A randomized controlled experimental study was conducted between November 2021 and July 2022 in an education and research hospital (face-to-face) and at the homes of individuals with a stoma (online). The study sample consisted of 60 individuals with a stoma: 30 in the experimental group and 30 in the control group. Study data were collected using the Individuals with Stoma Identification Form, Stoma Self-efficacy Scale (SSES), and Ostomy Adjustment Inventory-23 (OAI-23). After discharge, participants in the experimental group received educational booklets and education on stoma care in four video conference sessions. The authors analyzed the data using frequency and percentage distributions, χ
2 analyses, independent-sample t tests, Wilcoxon tests, and Mann-Whitney U tests.

RESULTS
There was a significant difference between the median pretest SSES and OAI-23 scores and the median posttest SSES and OAI-23 scores in the experimental group. At the end of the study, more individuals in the experimental group cared for their own stoma.

CONCLUSIONS
The education provided to individuals with a stoma significantly increased their self-efficacy and stoma adaptation scores. Hence, providing structured, continuous education on stoma care by nurses and using videoconferencing as an education method are recommended.
A Novel and Reproducible Classification of Cervical Dumbbell Tumors to Inform Surgical Approach and Reconstruction Techniques
Authors: Yang Minglei , Zhong Nanzhe , Lou Yan , Jiang Dongjie , Liu Yujie , Dai Zeyu , Wan Wei , Jiao Jian , Yang Xinghai , Xiao Jianru 
Published: January 2024

Study Design.
A retrospective case series.

Objective.
This study developed a novel classification system based on imaging and anatomy to select optimal surgical approaches and reconstruction strategies to achieve total resection of cervical dumbbell tumors and restore spinal stability.

Summary of Background Data.
Total resection is necessary to decrease the recurrence rate of cervical dumbbell tumors. Previous cervical dumbbell tumor classifications are insufficient for determining surgical strategies, therefore, a practical classification is needed.

Methods.
This study included 295 consecutive patients with cervical dumbbell tumors who underwent total surgical resection. A novel classification of cervical dumbbell tumors was developed based on magnetic resonance imaging and computed tomography. Continuous variables were expressed as mean±standard deviation (SD) and were compared using an unpaired two-tailed Student’s t‑test. The χ2 test or Fisher’s exact test was used for categorical variables. Kendall’s W test assessed three independent raters’ inter- and intra-rater reliabilities on 140 cervical dumbbell tumors.

Results.
The inter-rater and intra-rater consistency coefficient was 0.969 (χ2=404.3, P<0.001) and 0.984 (χ2=273.7, P<0.001). All patients with type I and II tumors underwent single-posterior surgeries to achieve total resection. Of the patients in this study, 86.1%, 25.9%, 75.9%, and 76.9% underwent posterior surgeries for types IIIa, IIIb, IVa, and V tumors, respectively. All patients with type IVb tumors underwent a combined anterior and posterior approach. Posterior internal fixation was used for all patients in posterior surgery. Anterior reconstruction was applied for patients with type IVb tumors (20/20, 100%) and some with Type V tumors (3/13, 23.1%). The mean follow-up duration was 93.6±2.6 months. Recurrence was observed in 19 (6.4%) patients.

Conclusion.
We describe a novel classification system that is of practical use for planning the complete resection of cervical dumbbell tumors.
Related health burden with the improvement of air quality across China
Authors: Xu Huaiyue , Wang Qing , Zhu Huanhuan , Zhang Yayi , Ma Runmei , Ban Jie , Liu Yiting , Chen Chen , Li Tiantian 
Published: January 2024

Abstract

Background:
Substantial progress in air pollution control has brought considerable health benefits in China, but little is known about the spatio-temporal trends of economic burden from air pollution. This study aimed to explore their spatio-temporal features of disease burden from air pollution in China to provide policy recommendations for efficiently reducing the air pollution and related disease burden in an era of a growing economy.

Methods:
Using the Global Burden of Disease method and willingness to pay method, we estimated fine particulate matter (PM2.5) and/or ozone (O3) related premature mortality and its economic burden across China, and explored their spatio-temporal trends between 2005 and 2017.

Results:
In 2017, we estimated that the premature mortality and economic burden related to the two pollutants were RMB 0.94 million (68.49 per 100,000) and 1170.31 billion yuan (1.41% of the national gross domestic product [GDP]), respectively. From 2005 to 2017, the total premature mortality was decreasing with the air quality improvement, but the economic burden was increasing along with the economic growth. And the economic growth has contributed more to the growth of economic costs than the economic burden decrease brought by the air quality improvement. The premature mortality and economic burden from O3 in the total loss from the two pollutants was substantially lower than that of PM2.5, but it was rapidly growing. The O3-contribution was highest in the Yangtze River Delta region, the Fen-Wei Plain region, and some western regions. The proportion of economic burden from PM2.5 and O3 to GDP significantly declined from 2005 to 2017 and showed a decreasing trend pattern from northeast to southwest.

Conclusion:
The disease burden from O3 is lower than that of PM2.5, the O3-contribution has a significantly increasing trend with the growth of economy and O3 concentration.
Prevention and Treatment of Burn Scar Contracture: A Practical Review
Authors: Raborn Layne N. , Janis Jeffrey E. 
Published: January 2024

Summary:
Burn contracture affects close to one-third of all burn patients, leading to significant functional impairment and costs. Effective prevention and treatment strategies are necessary to decrease morbidity and unnecessary costs. This scoping review aimed to summarize prevention and treatment strategies used for management of burn scar contractures published in the literature since 2000. A comprehensive PubMed review was performed in October 2022 to identify methods of burn contracture prevention and treatments. Non-English, duplicate, and unavailable articles were excluded. Data were extracted including publication year, techniques, and outcomes. A total of 327 publications met criteria for inclusion. Most articles were published in 2011 (n = 22). Treatment strategies were discussed in 82.9% of studies, prevention in 16.5%, and both in 0.6%. The most common areas discussed included the upper extremity (n = 127) and neck (n = 102). Flaps were the most frequently used method (n = 208), followed by autografts (n = 89). Most preventative therapies were still in early stages of development. Burn contracture management requires a highly individualized approach with many available reconstructive techniques available. Further research is needed to improve prevention techniques and decrease morbidity and cost to patients.
Injection-related Visual Compromise
Authors: Santiago Díaz Alejandra , Montes José Raúl , Nieves Martinez Ileana 
Published: January 2024

Summary:
The global market for hyaluronic acid (HA)-based dermal fillers has experienced substantial growth, providing patients with an effective nonsurgical cosmetic option. According to the global market report, the HA dermal fillers market size is expected to grow to $8.5 billion in 2027 at an annual growth rate (CAGR) of 8.9%. However, despite their popularity, HA injections are not free of complications. Vascular occlusion, particularly involving the central retinal artery, represents a significant risk. This case report presents a 60-year-old woman who presented with binocular vertical diplopia after HA filler injection in the right tear trough area. Upon evaluation, the patient exhibited right hypertropia, suggesting right inferior rectus paresis due to vascular injury of the infraorbital artery. Prompt management with hyaluronidase and oral steroids resulted in the resolution of double vision. This case highlights the importance of recognizing potential complications during HA filler injections and emphasizes the need for early intervention to minimize adverse effects.
Postsurgical Pyoderma Gangrenosum Requiring Plastic Surgical Intervention: A Practical Review
Authors: Guliyeva Gunel , Janis Jeffrey E. 
Published: January 2024

Summary:
Pyoderma gangrenosum is a neutrophilic dermatosis characterized by immune dysfunction and pathergy. Thus, it is frequently seen in patients with underlying systemic illnesses or postoperatively. For the performance of the debridement or closure of the resultant defect, plastic surgeons are often involved in the care of pyoderma patients. However, both procedures may exacerbate the injury. Therefore, plastic surgeons must be familiar with the presentation of postsurgical pyoderma to avoid further damage and safely repair related soft tissue defects. A systematic search of the PubMed/Medline database was performed using the following keywords: “pyoderma gangrenosum” and “surgery.” This online database search has identified 656 studies published between 1958 and 2022. Only reconstructed cases of postsurgical pyoderma gangrenosum were selected. Twenty-eight patients who developed pyoderma after dermatologic, plastic, orthopedic, cardiovascular, general, or obstetric surgery were included in this study. The average time to the PG presentation and diagnosis was 5.5 and 17 days, respectively. Diagnostic scoring tools were not used, and the diagnosis was primarily based on histopathology after repeated treatment failures. The patients received split- or full-thickness skin grafts, local, pedicled, and free flaps. An estimated 82.1% underwent skin grafting, whereas 42.9% underwent flap reconstruction. In addition, 21.4% got both the graft and flap. Accurate diagnosis of PSPG, prevention of further surgical injury, and timely medical management are vital for improving patient outcomes. Reconstruction can be performed, if required. However, despite the availability of different reconstructive techniques, there is no standard approach to the management of the PSPG.
Comparison of disc position stability and condylar bone remodeling between two open disc repositioning surgeries: a retrospective single-center cohort study
Authors: Lu Chuan , Zhao Jieyun , Zhang Xiaoyu , Fan Xingda , Nie Xin , Yu Chuangqi , Yang Chi , He Dongmei 
Published: January 2024

Background and Objective:
Open suturing (OSu) and Mini-screw Anchor (MsA) are two commonly used open disc repositioning surgeries for anterior disc displacement (ADD) of the temporomandibular joint (TMJ). This study assesses the differences in disc position stability (DPS) and condylar bone remodeling (CBR) between these two surgical procedures in a single center.

Methods:
A retrospective cohort study using magnetic resonance imaging (MRI) scans (preoperation, 1 week and 12 mo postoperation) of all patients who had open TMJ disc repositioning surgery from January 2016 to June 2021 at one center through two surgical techniques (OSu and MsA) was performed. The predictor variable was technique (OSu and MsA). Outcome variables were DPS and CBR. During follow-up, DPS was rated as good, acceptable and poor, and CBR was graded as improved, unchanged, and degenerated. Multivariate analysis was used to compare the DPS and CBR at 12 months after adjusting 5 factors including age, sex, Wilkes stage, preoperative bone status (normal, mild/moderate abnormal) and the degree of disc repositioning (normal, overcorrected, and posteriorly repositioned). Relative risk (RR) for DPS and CBR was calculated by multivariate logistic regression.

Results:
385 patients with 583 joints were included in the study. MRIs at 12 months showed that 514 joints (93.5%) had good DPS, and 344 joints (62.5%) had improved CBR. Multivariate analysis revealed that OSu had higher DPS (RR=2.95; 95% confidence interval [CI], 1.27 to 6.85) and better CBR (RR=1.58; 95%CI, 1.02 to 2.46) than MsA. Among the factors affecting DPS, females had better results than males (RR=2.63; 95%CI, 1.11 to 6.26) and overcorrected or posteriorly repositioned discs were more stable than normally-repositioned discs (RR=5.84; 95%CI, 2.58 to 13.20). The improvement in CBR decreased with age increasing (RR=0.91; 95%CI, 0.89 to 0.93). Preoperative mild/moderate abnormal bone status had a higher probability of improved CBR compared to normal preoperative bone status (RR=2.60; 95%CI, 1.76 to 3.83).

Conclusion:
OSu had better DPS and CBR than MsA. Sex and the degree of disc repositioning impacted DPS, while age and preoperative bone status affected CBR.
Influence of the Spread of the Electric Field on Speech Recognition in Cochlear Implant Users
Authors: Kopsch Anna C. , Rahne Torsten , Plontke Stefan K. , Wagner Luise 
Published: January 2024

Objective
To investigate the correlation of word recognition with cochlear implant (CI) and spread of the electric field.

Study Design
Prospective, noninterventional, experimental study.

Setting
A tertiary referral center.

Patients
Thirty-eight adult CI users with poor (n = 11), fair (n = 13), and good (n = 16) word recognition performance.

Main Outcome Measure
Transimpedances were measured after 37 μs. Word recognition score was recorded at 65 dB SPL for German monosyllables in quiet. Transimpedance half widths were calculated as a marker for spread of the electric field.

Results
Narrow and broad spread of the electric field, i.e., small and large half widths, were observed in all word recognition performance groups. Most of the transimpedance matrices showed a pattern of expansion along the diagonal toward the apical electrode contacts. Word recognition was not correlated with transimpedance half widths.

Conclusions
The half width of the spread of the electric field showed no correlation with word recognition scores in our study population.
A Novel Diagnostic and Treatment Algorithm for Acute Mastoiditis in Children Based on 109 Cases
Authors: Häußler Sophia Marie , Peichl Jonathan , Bauknecht Christian , Spierling Katja , Olze Heidi , Betz Christian , Stölzel Katharina 
Published: January 2024

Background
Acute mastoiditis (AM) is a potentially life-threatening condition primarily affecting children. To date, there are no consistent criteria or valid guidelines for the diagnosis and treatment of pediatric AM. Therefore, this study evaluates the clinical course of AM in terms of clinical signs and treatment. In addition, a novel classification scheme for the disease and a treatment algorithm is being proposed.

Methods
Patient records over a 12-year period from a single center were reviewed to identify confirmed cases of AM in children. Data collected included clinical signs, body temperature, and infection parameters during the disease, as well as radiological imaging, antibiotics, and surgical as well as conservative treatment. In addition, a classification of the AM stages was established in accordance with the findings described and practical experience, consisting of four stages (1, mastoidal irritation; 2, mild AM; 3, advanced AM; 4, advanced AM and additional complications) with corresponding treatment recommendations. In the retrospective cohort, those AM cases that were treated alongside the classification were compared with the rest concerning clinical course and outcome.

Results
A total of 109 patients (mean age, 3.8 ± 3.8 years) were included. The main symptoms at hospital admission were auricular protrusion (n = 73; 67.0%), fever (n = 56; 51.4%) with a mean temperature of 38.3 ± 1.1°C, and otalgia (n = 28; 25.7%). The mean laboratory-tested levels of leukocytes and C-reactive protein at the time of hospital admission were 15.96 ± 8.7/nl and 59.6 ± 54.0 mg/L, respectively. During winter, there was a higher prevalence of AM, with peak hospital admissions in April (n = 22). The most common pathogen was Streptococcus pyogenes (32 cases). Treatment was purely conservative in four cases, whereas the remaining cases underwent surgery (41× grommet insertion, 64× plus mastoidectomy). The outcome was generally good, but in eight patients a second surgical procedure had to be performed as they showed signs of clinical deterioration. A total of 101 patients were treated according to the proposed algorithm, and all of which had a good outcome without the need for further interventions.

Conclusion
Based on clinical experience in a large cohort of pediatric AM patients, a novel diagnostic and treatment algorithm has been developed and successfully tested in a retrospective cohort for AM in children to prevent further complications and to ease its management by pediatricians and otorhinolaryngologists in the emergency setting.
Localization of Low- and High-Frequency Sounds in Cochlear Implant Recipients Using a Contralateral Hearing Aid
Authors: Zelger Philipp , Zorowka Patrick , Schmutzhard Joachim , Galvan Oliver , Rossi Sonja , Stephan Kurt , Seebacher Josef 
Published: January 2024

Background and Objectives
The ability to localize sounds is partly recovered in patients using a cochlear implant (CI) in one ear and a hearing aid (HA) on the contralateral side. Binaural processing seems effective at least to some extent, despite the difference between electric and acoustic stimulation in each ear. To obtain further insights into the mechanisms of binaural hearing in these listeners, localization of low- and high-frequency sounds was tested.

Study Design
The study used a within-subject design, where participants were tasked with localizing sound sources in the horizontal plane. The experiment was conducted in an anechoic chamber, where an array of seven loudspeakers was mounted along the 24 azimuthal angle span from −90° to +90°. Stimuli were applied with different frequencies: broadband noise and high- and low-frequency noise.

Subjects
Ten CI recipients participated in the study. All had an asymmetric hearing loss with a CI in the poorer ear and an HA on the contralateral side.

Main Outcome Measures
Accuracy of sound localization in terms of angular error and percentage of correct localization scores.

Results
The median angular error was 40° in bimodal conditions for both broadband noise and high-frequency noise stimuli. The angular error increased to 47° for low-frequency noise stimuli. In the unilaterally aided condition with an HA, only a median angular error of 78° was observed.

Conclusions
Irrespective of the frequency composition of the stimuli, this group of bimodal listeners showed some ability to localize sounds. Angular errors were larger than those reported in the literature for bilateral CI users or single-sided deaf listeners with a CI. In the unilateral listening condition with HA, only localization of sounds was not possible for most subjects.