bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Facility Volume on Patient Safety Indicator Events After Transsphenoidal Pituitary Surgery
Authors: Lemdani Mehdi S. , Choudhry Hannaan S. , Tseng Christopher C. , Fang Christina H. , Sukyte‐Raube Donata , Patel Prayag , Eloy Jean Anderson 
Published: April 2022

AbstractObjectivesTo investigate the impact of facility volume on Patient Safety Indicator (PSI) events following transsphenoidal pituitary surgery (TSPS).Study DesignRetrospective database review.SettingNational Inpatient Sample database (2003‐2011).MethodsThe National Inpatient Sample was queried for TSPS cases from 2003 to 2011. Facility volume was defined by tertile of average annual number of TSPS procedures performed. PSIs, based on in‐hospital complications identified by the Agency of Healthcare Research and Quality, and poor outcomes, such as mortality and tracheostomy, were analyzed.ResultsAn overall 16,039 cases were included: 804 had ≥1 PSI and 15,235 had none. A greater proportion of male to female (5.8% vs 4.3%) and Black to White (7.0% vs 4.5%) patients experienced PSIs. There was an increased likelihood of poor outcome (odds ratio [OR], 3.1 [95% CI, 2.5‐3.7]; P < .001) and mortality (OR, 30.1 [95% CI, 18.5‐48.8]; P < .001) with a PSI. The incidence rates of PSIs at low‐, intermediate‐, and high‐volume facilities were 5.7%, 5.1%, and 4.2%, respectively. Odds of poor outcome with PSIs were greater at low‐volume facilities (OR, 3.3 [95% CI, 2.4‐4.4]; P < .001) vs intermediate (OR, 3.1 [95% CI, 2.1‐4.2]; P < .001) and high (OR, 2.5 [95% CI, 1.7‐3.8]; P < .001). Odds of mortality with PSIs were greater at high‐volume facilities (OR, 43.0 [95% CI, 14.3‐129.4]; P < .001) vs intermediate (OR, 40.0 [95% CI, 18.5‐86.4]; P < .001) and low (OR, 17.3 [95% CI, 8.0‐37.7]; P < .001).ConclusionPSIs were associated with a higher likelihood of poor outcome and mortality following TSPS. Patients who experienced PSIs had a lower risk of poor outcome but increased mortality at higher‐volume facilities.
History of Otolaryngology: Globus Pharyngeus as “Globus Hystericus”
Authors: Lechien Jerome R. , Baudouin Robin , Hans Stéphane , Akst Lee M. 
Published: April 2022

AbstractGlobus pharyngeus is the uncomfortable sensation of a “lump in the throat,” and at present it has many recognized pathophysiologic causes. However, until relatively recently, this condition was often labeled “globus hystericus” and was thought to be a manifestation of hysteria or anxiety. In this commentary, we briefly review the history surrounding the initial treatment of globus pharyngeus sensation as a hysterical condition rooted in anxiety/psychological causes; then, we briefly review the emerging evidence that roots globus pharyngeus sensation within a constellation of pathophysiologies that are related to pharyngoesophageal inflammation and irritation rather than psychological disorders.
A Comparison of Mesenchymal Stem Cell-derived Hepatocyte-like Cells and HepG2 Cells for Use in Drug-Induced Liver Injury Studies
Authors: Perera Dananjaya , Soysa Preethi , Wijeratne Sumedha 
Published: April 2022

Liver cell lines obtained from hepatomas, for example, HepG2 cells, are commonly used in drug toxicity studies. However, functional hepatocyte-like cells derived from mesenchymal stem cells (MSCs) could be a better option for use in the study of drug metabolism and toxicity. Overdose of acetaminophen (APAP) and excess alcohol consumption are common causes of liver damage. The objective of the present study was to investigate the use of MSC-derived hepatocyte-like cells (MSCdH) in the assessment of drug-induced liver injury (by using APAP and ethanol), and to compare the toxic effects observed in the MSCdH with those exhibited by HepG2 cells. MSCs were isolated from umbilical cord and their functionality confirmed by their ability to differentiate into adipocytes, osteocytes and hepatocyte-like cells. It was shown that the MSCs successfully differentiated into hepatocyte-like cells, and these cells were further characterised by using various enzyme assays and by assessing albumin secretion and urea synthesis. Cytotoxicity was evaluated in the HepG2 and MSCdH after exposure to ethanol and APAP, with cell viability being determined by using the MTT assay. After exposure to ethanol and to APAP, cell viability decreased in a concentration-dependent manner for both types of hepatocytes. The respective EC50 values of ethanol-induced toxicity for HepG2 and MSCdH cells were 2.5% and 1.3% v/v ( p < 0.001); for APAP-induced toxicity they were 19.1 mM and 12.6 mM ( p < 0.001). These findings show that there is a distinct difference between the two types of hepatocytes in terms of APAP-induced and ethanol-induced liver injury.
Female gender: A significant barrier to access cataract surgery in rural Gurugram, Haryana, India
Authors: Sharma Neeraj , Sharma Chetna 
Published: April 2022

The goal of this study is to determine whether the female gender is a barrier for the access to cataract surgery in the rural population of Gurugram district, Haryana, India. The data of consecutive 100 male and 100 female patients operated for cataract surgery at Department of Ophthalmology, University-affiliated hospital were studied. Data pertaining to age of the patients, visual acuity of the operated and better eye, maturity of the cataract at time of surgery, type of cataract surgery opted were analysed. Visual impairment was considered when visual acuity of the better eye was less than 6/18 (0.32).Two types of cataract surgery were offered to the patients: manual small-incision cataract surgery (SICS) and phacoemulsification. Independent t-tailed test was used to analyse data to ascertain female gender as a barrier to access cataract surgery. The findings indicate that the difference in age at the time of surgery between men and women was not statistically significant ( p = .327). The analysis of visual impairment in the operated eye of men and women was also not statistically significant ( p = .173). However, the analysis of visual impairment in the better eye was strongly suggestive of gender bias with statistically significant results ( p = .001). In total, 71% male and 56% female patients opted for phacoemulsification surgery, whereas 44% women and 29% men chose less-expensive manual SICS surgery. The study indicates that females had severe visual impairment in the better eye at the time of surgery and also opted for a less-expensive option indicating less financial freedom and decision-making power.
Evaluation and Correlation Between Pharyngeal Space, Mandible, and Tongue in Two Different Facial Patterns
Authors: Sana Safiya , Kondody Rony T. , Swamy Karthik , Fatima Asma 
Published: April 2022

Introduction: Respiratory function has a direct relationship with the pharyngeal airway dimension and mandibular morphology. The objective of the present study was to compare and correlate pharyngeal airway, mandibular morphology, and tongue position in hyperdivergent and normodivergent patterns using standard cephalometric radiographs. Materials and Methods: A total of 130 individuals with age 13 to 19 years, with no craniofacial skeletal abnormalities, were taken. The individuals were divided into 2 groups based on their Frankfort mandibular angle (FMA). Group I consist of 65 hyperdivergent individuals (34 males, 31 females) with FMA >28. Group II consisted of 65 normodivergent individuals (28 males, 37 females) with FMA >25 to <28. For statistical analysis, variables were analyzed by unpaired t-test, with P value <.05. Correlation between the pharyngeal space and the other variables was analyzed with the Pearson correlation test. Results: Upper pharyngeal airway space in hyperdivergent growth pattern exhibited a significant negative correlation with ramus width (r = −0.02 and P = .028). Gonial angle showed a statistically significant inverse correlation with lower pharyngeal airway space (r = −0.398 and P = .029). A-point-nasion-B-point (ANB), saddle angle, posterior tongue space, tongue gap, and pharyngeal airway among normodivergent subjects, showed a statistically significant negative correlation. Conclusion: The present study showed a significant relationship between pharyngeal airway space, craniofacial morphology, and tongue position suggesting that narrower airway space may be a causative factor for altered dentofacial skeletal patterns. Reduced ramus width, lowered tongue, and narrower posterior pharyngeal wall might be a balancing mechanism set for morphological imbalance in hyperdivergent pattern.
2019 British Association of Sexual Health and HIV National Clinical Audit of timelines to be seen, test results and treatment for Chlamydia trachomatis
Authors: Fitzgerald Naomi , Anderson Elizabeth Rachel , Apea Vanessa , Curtis Hilary , Goodall Lisa 
Published: April 2022

Background BASHH/MEDFASH (Medical Foundation for HIV and Sexual Health) Standards for the Management of Sexual Health Services 20141 set out a number of recommendations regarding time between contacting a service to being seen, time to receiving results, and time to treatment. This audit investigated if UK practice is compliant with BASHH standards of care in terms of: Time to patient being seen after contacting sexual health services, time to chlamydia (CT) NAAT (nucleic acid amplification test) results and time from positive CT result to treatment. Methods All UK level 2 (non-specialist) and level 3 (specialist) sexual health clinics were invited to take part. Data were collected via a survey of sexual health clinics and a retrospective case-note review of the last 40 people aged 16 or over per service seen with chlamydia but not syphilis or gonorrhoea. Cases were identified using the SHHAPT (Sexual Health and HIV Activity Types) National STI Surveillance code for chlamydia (C4). Results There were responses from 221 sites. 67% of sites reported offering both appointment and walk-in access, 26.2% appointment-only, 6.8% walk-in only. The mean turn-away rate of individuals seeking walk-in access on the last open day was 6.1%. There were variations in local service specification turnaround times for chlamydia nucleic acid amplification test results; 32% of sites reported no specified turnaround time. Case note audit of individuals seen with chlamydia showed 74.1% of individuals were tested for chlamydia at a level 3 clinic, 11.8% at a level 2 sexual health clinic, 7.3% used a self-sampling kit requested online and 3.9% tested at a different setting. 92.1% of individuals who initially tested at a sexual health service had an attempted notification within 10 working days of a positive chlamydia test. 95% of individuals were treated within a sexual health service. Overall, 94.0% of individuals were treated within 15 working days of the test result. Conclusion When missing data were excluded, patient initiated GUM/level 3 attenders seen within 2 working days met the audit standard as did patient access to results within 10-working days for those whose initial CT NAAT sample was taken at a GUM/level 3 clinic and treatment within 3 weeks for GUM/level 3 attenders. Patients offered to be seen/assessed within 2 working days and lab report within 5 working days did not meet the audit standard. Recommendations include ensuring that laboratory turn-around times are included in contracts or service level agreements for clinical services, and local monitoring of these. Dates when individuals first seek to access sexual health services should also be recorded and used to monitor performance in comparison with access standards.
Sore and tired. A qualitative study exploring the symptom experience of youth with bronchiectasis
Authors: Blamires Julie , Dickinson Annette , Byrnes Catherine A , Tautolo El Shadan 
Published: April 2022

This qualitative study was conducted to explore the experiences of youth living with bronchiectasis in New Zealand (NZ). Semi-structured interviews were conducted with youth with bronchiectasis. Key themes were identified using an inductive approach through constant comparative analysis and guided by Thorne’s interpretive description (ID). Fifteen young people of mixed ethnicity (nine females and six males) aged between 13 and 23 years participated. Three key themes ‘sore and tired’, ‘life interrupted and ‘looking after self’ were identified. This paper will focus on ‘sore and tired’ and its three subthemes which describe the participants symptom experience. While there was variability in physical symptom patterns, cough, soreness and fatigue were prominent features impacting physical, emotional and social aspects of day-to-day life. All identified pervasive and profound fatigue as significant. The identification of prodromal symptoms provides opportunity for greater appreciation of the varied and personal symptom experience of young people with bronchiectasis. Early identification of these symptoms and inclusion within management plans for escalating treatment has the potential to improve outcomes, reducing delays in seeking additional medical management and preventing further exacerbation.
A Systematic Review of Propensity Score Matching in the Orthopedic Literature
Authors: Arguelles Gabriel R. , Shin Max , Lebrun Drake G. , DeFrancesco Christopher J. , Fabricant Peter D. , Baldwin Keith D. 
Published: April 2022

Background: Propensity score matching (PSM) is a statistical technique used to reduce bias in observational studies by controlling for measured confounders. Given its complexity and popularity, it is imperative that researchers comprehensively report their methodologies to ensure accurate interpretation and reproducibility. Purpose: This systematic review sought to define how often PSM has been used in recent orthopedic research and to describe how such studies reported their methods. Secondary aims included analyzing study reproducibility, bibliometric factors associated with reproducibility, and associations between methodology and the reporting of statistically significant results. Methods: PubMed and Embase databases were queried for studies containing “propensity score” and “match*” published in 20 orthopedic journals prior to 2020. All studies meeting inclusion criteria were used for trend analysis. Articles published between 2017 and 2019 were used for analysis of reporting quality and reproducibility. Results: In all, 261 studies were included for trend analysis, and 162 studies underwent full-text review. The proportion of orthopedic studies using PSM significantly increased over time. Seventy-one (41%) articles did not provide justification for covariate selection. The majority of studies illustrated covariate balance through P values. We found that 19% of the studies were fully reproducible. Most studies failed to report the use of replacement (67.3%) or independent or paired statistical methods (34.0%). Studies reporting standardized mean differences to illustrate covariate balance were less likely to report statistically significant results. Conclusion: Despite the increased use of PSM in orthopedic research, observational studies employing PSM have largely failed to adequately report their methodology.
Characterizing Fast and Slow Progressors in Anterior Circulation Large Vessel Occlusion Strokes
Authors: Mohammaden Mahmoud H , Haussen Diogo C , Pisani Leonardo , Al-Bayati Alhamza R , Bhatt Nirav R , Jillella Dinesh V , Bianchi Nicolas A , Belagaje Samir R , Frankel Michael R , Nogueira Raul G 
Published: April 2022

Background and Purpose Infarct growth rate (IGR) in acute ischemic stroke is highly variable. We sought to evaluate impact of symptom-reperfusion time on outcomes in patients undergoing mechanical thrombectomy (MT). Methods A prospectively maintained database from January,2012-August,2020 was reviewed. All patients with isolated MCA-M1 occlusion who achieved complete reperfusion(mTICI2C-3), had a witnessed symptom onset and follow-up MRI were included. IGR was calculated as final infarct volume (FIV)(ml)/symptom onset to reperfusion time(hours) and was dichotomized according to the median value into slow-(SP) versus fast-progressors (FP). The primary analysis aimed to evaluate the impact of symptom-reperfusion time on 90-day mRS in SP and FP. Secondary analysis was performed to identify predictors of IGR. Results A total of 137 patients were eligible for analysis. Mean age was 63 ± 15.4 years and median IGR was 5.13ml/hour. SP(n = 69) had higher median ASPECTS, lower median rCBF<30% lesion volume, higher proportion of favorable collaterals and hypoperfusion intensity ratio (HIR)<0.4, higher minimal mean arterial blood pressure before reperfusion, and lower rates of general anesthesia compared to FP(n = 68). Symptom-reperfusion time was comparable between both groups. SP had higher rates of 90-day mRS0-2(71.9%vs.38.9%,aOR;7.226,95%CI[2.431–21.482],p < 0.001) and lower median FIV. Symptom-reperfusion time was associated with 90-day mRS0-2 in FP (aOR;0.541,95%CI[0.309–0.946],p = 0.03) but not in SP (aOR;0.874,95%CI[0.742–1.056],p = 0.16). On multivariable analysis, high ASPECTS and favorable collaterals in the NCCT/CTA model, and low rCBF<30% and HIR<0.4 in the CTP model were independent predictors of SP. Conclusions The impact of symptom-reperfusion time on outcomes significantly varies across slow-versus fast-progressors. ASPECTS, collateral score, rCBF<30%, and HIR define stroke progression profile.
WEB vs coiling in ruptured aneurysms: A propensity score matched comparison of safety and efficacy
Authors: Nania Alberto , Gatt Simon , Banerjee Rohan , Syed Maaz BJ , Tiefenbach Jakov , Dobbs Nicholas , Du Plessis Johannes , Keston Peter , Downer Johnathan 
Published: April 2022

Background We aim to compare the safety and efficacy of WEB with coiling for acutely ruptured aneurysms. METHODS: All consecutive ruptured aneurysms with width suitable for WEB (2–10 mm) treated over 5 years (1/1/2015 to 31/12/2019) were included. We recorded WFNS, Fisher grade, patient demographics and aneurysm characteristics (size, location, D/W and aspect ratio, lobulation). Primary endpoints were mRS status at 3 months, aneurysm occlusion on latest available imaging follow-up, retreatment rate and procedural complications. We applied propensity score matching using aneurysm morphology (size, D/N ratio, ASPECT ratio and lobulation) to optimise matching for WEB versus coil comparison and minimise the effects of confounding. Result A total of 493 patients were identified, 97 treated with the WEB device. 1:1 propensity score matching was used to establish a matched group of 97 patients treated with coiling. The WEB arm showed 3% procedural complication rate, with no haemorrhagic complications and use of adjunctive device in 4%. Satisfactory occlusion on follow-up (mean 14 months) was 79%, with 19% retreatment rate. The coil arm had 8% complication rate, with use of an adjunctive device in 52% of cases (balloon 44%, stent 8%). Satisfactory occlusion on follow-up (mean 22 months) was 90%, with 8% retreatment rate. Conclusion Treatment of ruptured wide-necked bifurcation aneurysms with WEB has a lower complication rate than coiling with high rate of satisfactory occlusion. However, there was a higher retreatment rate when compared with patients treated with coiling. An adjunct device (balloon or stent), was used in over 50% of aneurysms in the coiling group.
Chemotherapy regimen choice and patient outcomes in early-stage triple-negative breast cancer: a retrospective analysis
Authors: Ghafouri Sanaz N. , Nayeri Rebecca W. , McAndrew Nicholas P. , Hurvitz Sara A. 
Published: April 2022

Background: Triple-negative breast cancer (TNBC) is associated with a poor prognosis when compared to hormone receptor–positive breast cancers. Anthracycline-based regimens (ABRs) are mainstay for treatment of non-metastatic TNBC. However, anthracyclines are associated with an increased risk of potentially life-threatening adverse effects. We sought to evaluate outcomes in patients with early TNBC treated with ABRs versus those treated with anthracycline-sparing regimens (ASRs). Methods: All patients treated for stage I–III TNBC who had undergone curative-intent surgery at a large academic medical center between January 2013 and May 2018 were included in this retrospective study. Event-free survival (EFS) and disease-free survival (DFS) were the primary endpoints, with overall survival (OS) as a secondary endpoint and were defined as per standardized STEEP criteria. Kaplan–Meier, multivariable Cox regression, and log-rank tests were used to define key survival and treatment-related differences between subjects treated with ABRs versus ASRs. Results: One hundred thirty-two patients met inclusion criteria with a median follow-up of 55.9 months. Twenty-seven patients (20%) had disease recurrence and 20 (15%) died. Patients in the ABR group were more likely to have nodal involvement (chi-square p = 0.011). Patients treated with ABRs ( n = 26, 20%) compared with ASRs ( n = 106, 80%) had significantly shorter median EFS (32.4 months vs not reached (NR), p < 0.001), DFS (26.2 months vs NR, p < 0.001), and OS (49.2 months vs NR, p < 0.001). The shorter survival observed in the ABR group persisted after adjusting for nodal status and on multivariate analysis. Of the 26 ABR-treated patients, 9 (35%) had an anthracycline added after suboptimal response to an ASR. Regardless of reason for anthracycline inclusion, the survival outcomes were similar. No cardiac or secondary leukemic events were observed in either group. Conclusion: ABRs were associated with shorter EFS, DFS, and OS, even after adjusting for certain high-risk clinical features.
Finding consensus for hamstring surgery in ambulatory children with cerebral palsy using the Delphi method
Authors: Kay Robert M , McCarthy James , Narayanan Unni , Rhodes Jason , Rutz Erich , Shilt Jeffrey , Shore Benjamin J , Veerkamp Matthew , Shrader M Wade , Theologis Tim , Van Campenhout Anja , Pierz Kristan , Chambers Henry , Davids Jon R , Dreher Thomas , Novacheck Tom F , Graham Kerr 
Published: April 2022

Purpose: There is marked variation in indications and techniques for hamstring surgery in children with cerebral palsy. There is particular uncertainty regarding the indications for hamstring transfer compared to traditional hamstring lengthening. The purpose of this study was for an international panel of experts to use the Delphi method to establish consensus indications for hamstring surgery in ambulatory children with cerebral palsy. Methods: The panel used a five-level Likert-type scale to record agreement or disagreement with statements regarding hamstring surgery, including surgical indications and techniques, post-operative care, and outcome measures. Consensus was defined as at least 80% of responses being in the highest or lowest two of the five Likert-type ratings. General agreement was defined as 60%–79% falling into the highest or lowest two ratings. There was no agreement if neither of these thresholds was reached. Results: The panel reached consensus or general agreement for 38 (84%) of 45 statements regarding hamstring surgery. The panel noted the importance of assessing pelvic tilt during gait when considering hamstring surgery, and also that lateral hamstring lengthening is rarely needed, particularly at the index surgery. They noted that repeat hamstring lengthening often has poor outcomes. The panel was divided regarding hamstring transfer surgery, with only half performing such surgery. Conclusion: The results of this study can help pediatric orthopedic surgeons optimize decision-making in their choice and practice of hamstring surgery for ambulatory children with cerebral palsy. This has the potential to reduce practice variation and significantly improve outcomes for ambulatory children with cerebral palsy. Level of evidence: level V.