bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Carbapenems Compared With Noncarbapenem Broad-Spectrum Beta-Lactam Antibiotics as Initial Antibiotic Therapy Against Sepsis: A Nationwide Observational Study*
Authors: Umemura Yutaka , Yamakawa Kazuma , Tanaka Yoshihiro , Yoshimura Jumpei , Ogura Hiroshi , Fujimi Satoshi 
Published: May 2023

OBJECTIVES:
As causative pathogens are not usually identified at the time of initiating antibiotics in sepsis, carbapenems are commonly used as an initial treatment. To reduce indiscriminate use of carbapenems, the efficacy of alternative empiric regimens, such as piperacillin–tazobactam and the fourth-generation cephalosporins, should be elucidated. This study aimed to evaluate survival effect associated with carbapenems as initial therapy for sepsis compared with these antibiotics.

DESIGN:
Multicenter retrospective observational study.

SETTING:
Tertiary hospitals in Japan.

PATIENTS:
Adult patients diagnosed as having sepsis from 2006 to 2019.

INTERVENTIONS:
Administration of carbapenems as initial antibiotic therapy.

MEASUREMENTS AND MAIN RESULTS:
This study used data of adult patients with sepsis extracted from a large-scale database in Japan. Patients were divided into two groups as follows: patients receiving carbapenems and patients receiving noncarbapenem broad-spectrum beta-lactam antibiotics as initial treatment. In-hospital mortality was compared between the groups by a logistic regression model adjusted by an inverse probability treatment weighting using propensity scores. To evaluate heterogeneity of effects according to patient characteristics, we also fitted logistic models in several subgroups. Among 7,392 patients with sepsis, 3,547 patients received carbapenems, and 3,845 patients received noncarbapenem agents. The logistic model showed no significant association between carbapenem therapy and lower mortality (adjusted OR 0.88, p = 0.108). Subgroup analyses suggested that there were significant survival benefits associated with carbapenem therapy in patients with septic shock, in ICUs, or with mechanical ventilation (p for effect modifications: < 0.001, 0.014, and 0.105, respectively).

CONCLUSIONS:
Compared with the noncarbapenem broad-spectrum antibiotics, carbapenems as an initial therapy for sepsis were not associated with significantly lower mortality.
PROSPECT guideline for haemorrhoid surgery
Authors: Bikfalvi Alexis , Faes Charlotte , Freys Stephan M. , Joshi Girish P. , Van de Velde Marc , Albrecht Eric 
Published: May 2023

BACKGROUND
Haemorrhoidectomy is associated with moderate-to-severe postoperative pain.

OBJECTIVE
The aim of this systematic review was to assess the available literature and update previous PROSPECT (procedure specific postoperative pain management) recommendations for optimal pain management after haemorrhoidectomy.

DESIGN AND ELIGIBILITY CRITERIA
A systematic review utilising PROSPECT methodology was undertaken.

DATA SOURCES
Randomised controlled trials published in the English language from January 1, 2016 to February 2, 2022 assessing postoperative pain using analgesic, anaesthetic, and surgical interventions were identified from MEDLINE, EMBASE and Cochrane Database.

RESULTS
Of the 371 randomized controlled trials (RCTs) identified, 84 RCTs and 19 systematic reviews, meta-analyses met our inclusion criteria (103 publications). Interventions that improved postoperative pain relief included: paracetamol and nonsteroidal anti-inflammatory drugs or cyclo-oxygenase-2 selective inhibitors, systemic steroids, pudendal nerve block, topical metronidazole, topical diltiazem, topical sucralfate or topical glyceryl trinitrate, and intramuscular injection of botulinum toxin.

DISCUSSION
This review has updated the previous recommendations written by our group. Important changes are abandoning oral metronidazole and recommending topical metronidazole, topical diltiazem, topical sucralfate, topical glyceryl trinitrate. Botulinum toxin can also be administered. Contemporary publications confirm the analgesic effect of bilateral pudendal nerve block but invalidate recommendations on perianal infiltration. The choice of the surgery is mostly left to the discretion of the surgeons based on their experience, expertise, type of haemorrhoids, and risk of relapse. That said, excisional surgery is more painful than other procedures.
Experiences and perspectives of adults on using opioids for pain management in the postoperative period
Authors: Aljohani Dalia Mohammed , Almalki Nabat , Adam Rosalind , Forget Patrice 
Published: May 2023

OBJECTIVE
To identify and examine the available studies regarding adult perceptions and experiences of postoperative opioid pain management.

INTRODUCTION
The opioid crisis has been acknowledged as a significant clinical and social problem in many countries. Opioids are often initiated after surgery and may be continued on hospital discharge. There is no consensus on the optimal strategy for integrating patients’ views in postoperative opioid prescribing. The aim of this review is to explore the literature on adults’ experiences with postoperative opioid pain management.

INCLUSION CRITERIA
This review will consider all qualitative studies and mixed-method studies with qualitative approaches that explored adults’ opinions or concerns on opioids and/or opioid reduction, and adults’ satisfaction with pain control in this context. Participants in the studies should be adults who had undertaken any type of surgery and have had opioid prescriptions for pain management.

METHODS
This scoping review will be carried out in accordance with the Joanna Briggs Institute (JBI) methodology and will utilise the Preferred Reporting Items for Systematic Reviews and Meta Analyses extension for scoping reviews (PRISMA-ScR) reporting guideline and checklist. Searches will be conducted in Ovid MEDLINE, PsycInfo, EMBASE and CINAHL (EBSCO). Studies published in the English language will be included with no time limit. The screening and selection of studies will be carried out independently by three reviewers. Then data extraction process will be conducted by the main reviewer and the reviewer's supervisors independently. A descriptive qualitative content analysis will be utilised for data synthesis. The final report will contain a methodological quality assessment, with the findings being presented, including the knowledge gaps and recommendations for research.
Study on myocardial infarction based on nationwide inpatient sample database: a bibliometric analysis from 2000 to 2022
Authors: Zhang Tianyi , Yang Xue , Zhuang Qian , Liu Yuhua , Bai Huajuan , Liu Jianchao , Ye Zhouheng 
Published: May 2023

Abstract

Background
Studies on myocardial infarction (MI) based on large medical databases have become popular in recent years. The influence of the National Inpatient Sample (NIS), the largest collection of administrative healthcare data across the United States, on the field of MI has not been well investigated. This study aimed to quantify the contribution of NIS to MI research using bibliometric methods.

Methods
We searched the Web of Science Core Collection database to identify publications on MI using NIS from 2000 to 2022. Bibliometric indicators, such as the number of publications, citations, and Hirsch index (H-index), were summarized by years, authors, organizations, and journals. VOSviewer and CiteSpace software were used to analyze the keywords and trends of the hot spots.

Results
A total of 342 articles on MI based on NIS were included. A significant growth in outputs related to MI using the NIS from 2000 to 2020 was observed. The publications were mainly from the United States. The Mayo Clinic was the most prolific institution and had the most citations and the highest H-index. The American Journal of Cardiology ranked first among journals with the highest number of publications, citations, and H-index. Mortality and healthcare management are the main focuses of this field. Personalized risks and care are receiving increased attention.

Conclusion
This study suggests that NIS significantly contributes to high-quality output in MI research. More efforts are needed to improve the impact of knowledge gained from the NIS on MI.
Hirudotherapy for Venous Congestion in an Almost Completely Avulsed Earlobe without Microsurgical Repair
Authors: Vargas Nikoletta , Lieberman Benn , Hwang Lyahn , Badner Victor 
Published: May 2023

Summary:
Venous congestion is a frequent and challenging complication after re-attachment or replantation of avulsed tissues, body parts, and flaps. It is often the reason for failure. One of the successful therapies to prevent and/or treat venous congestion is the use of medicinal leeches. There is sound evidence for its efficacy in plastic and reconstructive surgery for avulsed body parts or flaps. However, there is not enough evidence for its use in ear reconstruction or replantation, especially regarding the fragile tissue of the earlobes. The current study is the first in the literature to describe the use of hirudotherapy for venous congestion in an almost completely avulsed earlobe without microsurgical blood vessel repair, as a last resort in an otherwise healthy 38-year-old male patient who sustained trauma due to physical assault.
Risk of Major Malformations in Infants After First-Trimester Exposure to Stimulants
Authors: Szpunar Mercedes J. , Freeman Marlene P. , Kobylski Lauren A. , Rossa Ella T. , Gaccione Peter , Chitayat David , Viguera Adele C. , Cohen Lee S. 
Published: May 2023

Abstract

Purpose/Background
The prevalence of attention-deficit/hyperactivity disorder in adult females is 3% to 4%. Attention-deficit/hyperactivity disorder is highly comorbid with other psychiatric disorders such as mood, anxiety, and substance use disorders. For reproductive-aged women, the treatment of attention-deficit/hyperactivity disorder with stimulant medications may be considered during pregnancy or breastfeeding, although historically, data are lacking to inform these decisions. The aim of this investigation was to determine the risk of major malformations in infants after first-trimester prescription stimulant exposure in a small but rigorously characterized sample.

Methods/Procedures
The Massachusetts General Hospital National Pregnancy Registry for Psychiatric Medications systematically ascertains information from pregnant females including demographic information, medical and psychiatric history, use of prescription medications, and other information relevant to fetal outcomes. Participants provide verbal informed consent and are interviewed twice during gestation and again at approximately 3 months postpartum. The primary outcome of interest is the presence of a major malformation identified within 6 months after birth. Redacted cases of major malformations are reviewed by a dysmorphologist blinded to medication exposure.

Findings/Results
A total of N = 1988 women were eligible for this analysis, including the following exposures: n = 173 to mixed amphetamine salts; n = 40 to lisdexamfetamine; n = 45 to methylphenidate; n = 3 to dexmethylphenidate; and n = 1755 controls. The odds ratio of a major malformation among infants after first-trimester exposure to any stimulant was 0.39 (95% confidence interval, 0.09–1.61) compared with controls. There were no major malformations observed in infants exposed to lisdexamfetamine, methylphenidate, or dexmethylphenidate.

Implications/Conclusions
Although preliminary, this analysis from an ongoing pregnancy registry provides reassurance that these stimulants do not appear to have major teratogenic effects.

Trial Registration

ClinicalTrials.gov identifier: NCT01246765.
The Continuum of Severity of Functional Impairment Due to Indoor Air Symptoms
Authors: Eidstø Einar , Selinheimo Sanna , Lampi Jussi , Salmela Anniina , Pekkanen Juha 
Published: May 2023

Objective
The aim of the study is to study functional impairment due to indoor air–related symptoms and associated characteristics.

Methods
A questionnaire survey of a random sample of Finnish people aged 25 to 64 years. Analyses were done using multivariate multinomial logistic regression.

Results
A total of 23.1% reported indoor air–related symptoms, 1.8% severe functional impairment due to symptoms, 5.3% moderate, 11.1% mild, and 4.9% reported no impairment. Those with severe functional impairment showed the strongest associations with comorbid diseases, for example, asthma and irritable bowel syndrome, perceived sensitivities to several environmental factors, like chemicals, and likelihood of having symptoms in multiple organs, while those with no or little functional impairment showed weak or even inverse associations. Similar results emerged with severity of indoor air–related symptoms.

Conclusions
Individuals with indoor air–related symptoms are a very heterogeneous group. This should be better considered in future research and clinical practice.
Dose Escalations Among Workers’ Compensation Claimants Using Opioid Medications—An 8 Year Postinjury Follow up Study
Authors: Lavin Robert A. , Yuspeh Larry , Kalia Nimisha , Tsourmas Nicholas F. , Leung Nina , Hunt Dan L. , Green-McKenzie Judith , Bernacki Edward J. , Tao Xuguang (Grant) 
Published: May 2023

Objective
The aim of the study is to determine the morphine equivalent dose in milligrams (MED)/day escalation trend after initial utilization.

Methods
A total of 25,108 lost time claims filed between 1998 and 2007 were followed for 8 years from injury date. Claims were stratified by initial MED/day at 3 months after injury into four groups (0, 1 to < 15, 15 to < 30, and ≥30 MED/day). The slopes in MED/year of opioid dose escalation were determined for each initial MED/day group.

Results
The slopes of MED/day escalation by initial MED categories were similar (P ≥ 0.05) ranging from 5.38 to 7.76 MED annually. On average, MED/day increased in a liner pattern with a slope at 6.28 MED/year (P < 0.01).

Conclusions
Opioid MED/day increased in a linear pattern, regardless of initial MED/day dose.
Recurring Themes in Prosthetic and Orthotic Education: A Narrative Review of Prosthetic and Orthotic Education Summit Meetings
Authors: Spaulding Susan E. , Utay Joshua B. , Sachs Sheryl N. 
Published: May 2023

ABSTRACT

Introduction
Prosthetic and orthotic (P&O) education summits and strategic planning meetings have been held periodically since 1970 to review the current state of practice and education and to advance the profession. These meetings typically included a panel of acknowledged experts from the ranks of educators, researchers, consumers, industry representatives, and practitioners.

Materials and Methods
A narrative review of education summit and strategic planning meeting reports was performed. The authors defined concrete aims and specific questions before conducting the review. The authors independently reviewed the reports to identify the purpose of each meeting and the perceived challenges of the time. Lastly, the authors performed a qualitative thematic analysis to clarify the findings.

Results
The recurring themes identified from the five education summit reports, joint task force report, and three National Commission on Orthotic and Prosthetic Education (NCOPE) strategic planning meeting reports include 1) workforce shortages, 2) continuous development and oversight of uniform, recognized, national academic standards, 3) sustainability of P&O academic programs, 4) development and oversight of uniform, recognized, national residency standards, 5) communication with stakeholders, including related health professionals, and 6) data collection and usage.

Conclusions
Recurring themes and challenges that existed previously in P&O education still exist today. Communication between academic programs and community partners (e.g., clinical practitioners, paraprofessionals, patients, payers, and interdisciplinary professionals) is a continuing priority to clarify the expectations of P&O professionals and to advance the profession. Use of a systematic approach could help map the patterns and needs of the profession to demonstrate progress over time and to facilitate future strategic planning.

Clinical Relevance
P&O education is designed to meet the needs of practitioners and paraprofessionals who implement P&O services (i.e., fitting, fabrication, and patient management). Maintaining communication between academia and its community partners is critical to advancing the profession.
Influence of the Electrode Montage to Detect Ocular Vestibular Evoked Myogenic Potentials
Authors: Mat Quentin , Deggouj Naïma , Duterme Jean-Pierre , Tainmont Sophie , Lelubre Christophe , Manto Mario 
Published: May 2023

Objective
To compare ocular vestibular evoked myogenic potentials (oVEMPs) obtained with three different electrode montages (infra-orbital vs belly-tendon vs chin) in a group of healthy subjects. To assess the electrical activity recorded at the level of the reference electrode in the belly-tendon and chin montages.

Study Design
Prospective study.

Setting
Tertiary referral center.

Patients
Twenty-five healthy adult volunteers.

Intervention(s)
Each ear was tested separately via air-conducted sound (500 Hz Narrow Band CE-Chirps at 100 dB nHL) for recording contralateral myogenic responses. Recording conditions were randomized.

Main Outcome Measure(s)
n1-p1 amplitudes values, interaural amplitude asymmetry ratios (ARs) and response rates.

Results
The belly-tendon electrode montage (BTEM) produced larger amplitudes than the chin (p = 0.008) and the IOEM (infra-orbital electrode montage; p < 0.001). The chin montage displayed larger amplitudes than the IOEM (p < 0.001). The interaural amplitude asymmetry ratios (ARs) were not affected by the different electrode montages (p = 0.549). In 100% of cases, oVEMPs were detected bilaterally with the BTEM which is higher than with the chin and the IOEM (p < 0.001; p = 0.020, respectively). We did not record any VEMP when placing the active electrode on the contralateral internal canthus or the chin and the reference electrode on the dorsum of the hand.

Conclusions
The BTEM increased the amplitudes recorded and response rate in healthy subjects. No positive or negative reference contamination was observed with the belly-tendon or chin montages.
Myringoplasty for Eosinophilic Otitis Media
Authors: Kikuchi Saori , Yoshida Saeko , Sugiyama Tomonori , Iino Yukiko 
Published: May 2023

Objective
Surgical intervention of eosinophilic otitis media (EOM) has been considered contraindicated because middle ear surgery is associated with a risk of deafness. Myringoplasty is believed to be less invasive. Therefore, we analyzed the surgical results of myringoplasty for perforated eardrums in patients with EOM treated by biological drugs (biologics).

Study Design
Retrospective chart review.

Setting
Tertiary referral center.

Patients
Nine ears of seven patients with EOM with eardrum perforation associated with bronchial asthma were treated with add-on biologics; myringoplasty was then performed. The controls comprised 17 ears of 11 patients with EOM treated by myringoplasty without biologics.

Interventions
The EOM status of each patient of both groups was assessed using severity scores, hearing acuity, and temporal bone computed tomography scores.

Main Outcome Measures
Preoperative and postoperative changes in severity scores and hearing acuity, postoperative closure of the perforation, and relapse of EOM.

Results
Severity scores significantly decreased after the use of biologics but did not change after myringoplasty. One patient developed postoperative relapse of middle ear effusion (MEE); in the control group, however, 10 ears developed recurrence of MEE. Significant improvement of the air conduction hearing level was obtained in the biologics group. No patients showed deterioration of the bone conduction hearing level.

Conclusions
This is the first report to describe successful surgical interventions with add-on biologics for patients with EOM. In the era of biologics, surgical interventions such as myringoplasty will be indicated to improve hearing and to avoid recurrence of MEE in patients with EOM with perforated eardrums, with the use of biologics.
Anatomical Features of Children With Mondini Dysplasia: Influence on Cochlear Implantation Performance
Authors: Joo Hye Ah , Lee Dong Kyu , Lee Yun Ji , Alrehaili Bassim Mallith , AlMutawah Abdullah Ali , Kang Woo Seok , Ahn Joong Ho , Chung Jong Woo , Park Hong Ju 
Published: May 2023

Objective
To analyze the long-term auditory performance after cochlear implantation (CI) and identify anatomical features of Mondini dysplasia associated with post-CI outcomes.

Study Design
Retrospective study.

Setting
Tertiary care academic center.

Patients
We enrolled 49 ears with Mondini dysplasia who underwent CI with more than 7 years of follow-up and age at CI- and sex-matched control group with radiologically normal inner ears.

Main Outcomes and Measures
The development of auditory skills after CI was evaluated using word recognition scores (WRSs). The anatomical features were measured based on temporal bone computed tomography and magnetic resonance imaging, involving the width of the bony cochlear nerve canal (BCNC), cochlear basal turn, enlarged vestibular aqueduct, cochlear height, and diameter of the cochlear nerve (CN).

Results
CI in ears with Mondini dysplasia showed comparable benefits and improvement of auditory performance to controls during the 7 years of follow-up. In Mondini dysplasia, four (8.2%) ears showed narrow BCNC (<1.4 mm) with poorer WRS (58 ± 17%) than those with normal-sized BCNC, which had WRS (79 ± 10%) comparable to that of the control group (77 ± 14%). In Mondini dysplasia, the maximum (r = 0.513, p < 0.001) and minimum (r = 0.328, p = 0.021) CN diameters had positive correlations with post-CI WRS. The maximum CN diameter (β = 48.347, p < 0.001) and BCNC width (β = 12.411, p = 0.041) were significant factors that influence the post-CI WRS in multiple regression analysis.

Conclusions
Preoperative anatomical evaluation, especially BCNC status and CN integrity, may serve as predictive markers for post-CI performance.
Exploring the Potential of Electronic Patient-Reported Outcome Measures to Inform and Assess Care in Sarcoma Centers
Authors: Geese Franziska , Kaufmann Sabine , Sivanathan Mayuri , Sairanen Kati , Klenke Frank , Krieg Andreas H. , Müller Daniel , Schmitt Kai-Uwe 
Published: May 2023

Background
Electronic patient-reported outcome measures (ePROMs) are useful tools to assess care needs of patients diagnosed with cancer and to monitor their symptoms along the illness trajectory. Studies regarding the application of ePROMs by advanced practice nurses (APNs) specialized in sarcoma care and the use of such electronic measures for care planning and assessing quality of care are lacking.

Objective
To explore the potential of ePROMs in clinical practice for assessing the patient’s quality of life, physical functionality, needs, and fear of progression, as well as distress and the quality of care in sarcoma centers.

Methods
A multicenter longitudinal pilot study design was chosen. Three sarcoma centers with and without APN service located in Switzerland were included. The instruments EQ-5D-5L, Pearman Mayo Survey of Needs, the National Comprehensive Cancer Network Distress Thermometer, PA-F12, and Toronto Extremity Salvage Score were used as ePROMs. Data were analyzed descriptively.

Results
Overall, 55 patients participated in the pilot study; 33 (60%) received an intervention by an APN, and 22 (40%) did not. Patients in sarcoma centers with APN service reported overall higher scores in quality of life and functional outcome. The number of needs and distress level were lower in sarcoma centers with APN service. No differences were found with respect to patients’ fear of progression.

Conclusions
Most of the ePROMs proved to be reasonable in clinical practice. PA-F12 has shown low clinical relevance.

Implications for Practice
Using ePROMs appears to be reasonable to obtain clinically relevant patient information and to evaluate the quality of care in sarcoma centers.