bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiographic Follow-up After Normal Ultrasound Screening of the Hip in Breech Infants
Authors: Kim Nak Tscheol , Yang Hee Jin , Choi Chang Won , Park Moon Seok , Sung Ki Hyuk 
Published: January 2022

Background:
Breech presentation is one of the most important risk factors for developmental dysplasia of the hip, and all breech infants should be screened. The necessity of further follow-up of developmental dysplasia of the hip after normal clinical and sonographic screening is a controversial subject. The purpose of this study to identify the incidence of delayed dysplasia in breech infants after normal ultrasound screening and the necessity of further clinical and radiologic follow-up in these patients.

Methods:
We included the 292 breech babies (128 boys and 164 girls) who showed normal hip ultrasound screening results. To determine the incidence of delayed radiographic dysplasia, anteroposterior hip radiographs were taken between 12 and 24 months of age to measure the acetabular index (AI).

Results:
The mean AI values were 22.8±3.4 in boys and 24.9±3.1 in girls. Applying the Tönnis criteria, 29 patients (9.9%) were considered to have delayed radiographic dysplasia (16 boys and 13 girls). No significant difference was found in any demographic variables between babies with and without delayed radiographic dysplasia. None of these 29 infants underwent any treatment for radiographic dysplasia. Applying Kuong’s criteria to 292 infants, only 2 patients (0.7%) demonstrated radiographic dysplasia on the hip anteroposterior radiographs taken at 14 months.

Conclusions:
The incidence of radiographic dysplasia significantly varied depending on which criteria were applied. In order to find out more accurate incidence rates of delayed radiographic dysplasia, large-scale studies of the normative AI data for Korean infants are required.

Level of Evidence:
Prognostic Level III.
Thread Delamination in 4.5 mm AO Cannulated Screws: A Small Case Series in the Pediatric Trauma Population
Authors: Murawski Christopher D. , Reddy Rajiv P. , Tisherman Robert T. , Bosch Patrick P. , Grudziak Jan S. , Mendelson Stephen A. , Ward W. Timothy , Olgun Zeynep Deniz 
Published: January 2022

Background:
Thread delamination associated with cannulated screws have been reported but likely represent an under-recognized complication in the orthopaedic literature. The purpose of this study is to report the occurrence of repeated hardware failures through thread delamination in the setting of a commonly used orthopaedic cannulated screw implant in a small cohort involving pediatric fracture care at a single academic level I trauma center.

Methods:
Between August 2015 and December 2020, 9 cases of hardware failure associated with 4.5 mm arbeitsgemeinschaft für osteosynthesefragen cannulated stainless-steel screws were identified within a pediatric orthopaedic division at a single academic level I trauma center. Three cases were excluded, and 6 cases of thread delamination were retrospectively reviewed.

Results:
Six cases of thread delamination comprised a cohort of patients with a mean age of 13.7 years (range: 12 to 15 y). All cases involved 4.5 mm arbeitsgemeinschaft für osteosynthesefragen cannulated screws, including 5 partially threaded and 1 fully threaded screw. Five cases involved open reduction and internal fixation of incarcerated medial humeral epicondylar fragments and the other case was an open reduction and internal fixation of a displaced medial malleolar fracture. Five of these occurred within a recent 18-month period of time. There were 4 cases of partial, distal thread delamination, 1 case of partial proximal thread delamination and another case of complete thread delamination which had unwound into the tibiotalar joint and required an anterior ankle arthrotomy to retrieve the thread. None of the 5 patients in this series who currently harbor a retained thread have experienced symptoms because of this issue.

Conclusions:
Thread delamination associated with cannulated screw implantation likely represents an under-reported phenomenon in orthopaedic surgery. In cases where retained, delaminated threads exist, these do not appear to cause short-term concern.

Level of Evidence:
Level IV—case series.
Surgical Treatment of the Intraspinal Rib Head Dislocation in Children With Dystrophic Scoliosis Secondary to Type 1 Neurofibromatosis
Authors: Gao Rongxuan , Guo Dong , Zhang Xuejun , Sun Baosheng , Yao Ziming , Cao Jun , Long Clara Y. , Bai Yunsong , Liu Haonan 
Published: January 2022

Background:
The purpose of this study was to explore the surgical treatment of intraspinal rib head dislocation (IRH) in children with dystrophic scoliosis secondary to type 1 neurofibromatosis (NF1-DS).

Methods:
From 2006 to 2019, 32 of 128 patients with NF1-DS were found to have IRH and enrolled in this study. There were 19 boys and 13 girls with an average age of 8.8±2.6 years. Patients were divided into 2 groups: group A (n=25) without IRH resection and group B (n=7) with IRH resection. The intraspinal rib proportion (IRP), apical vertebra rotation, apical vertebral translation, main thoracic curve Cobb angle, trunk shift and thoracic kyphosis, lumbar lordosis, and sagittal vertebral axis were measured before and after the operation. Spinal injury was graded based on the American Spinal Injury Association (ASIA) Impairment Scale.

Results:
The study group had a total of 42 IRH. The mean follow-up duration was 46.1±28.7 months. The preoperative IRP in both groups was similar (35.5±14.3% vs. 31.2±15.3%, P=0.522). The postoperative IRP was lower in group B (18.5±11.2% vs. 0%, P=0.002). The IRP in group A decreased from preoperative (31.2±15.3%) to postoperative (18.5±11.2%) (P<0.05). There was no significant difference in the apical vertebra rotation, apical vertebral translation, main thoracic curve Cobb angle, trunk shift, thoracic kyphosis, lumbar lordosis, and sagittal vertebral axis between the 2 groups before surgery and after surgery. Four patients with nerve injury caused by the IRH had full neurological recovery postoperatively. All patients were ASIA grade E at the last follow-up.

Conclusions:
The surgical treatment of IRH in children with NF1-DS should be determined on the basis of the presence of preoperative neurological symptoms. This study supports the practice of correcting spinal deformities only in patients with mild or no spinal cord injury. If there are obvious neurological symptoms, IRH resection is necessary to relieve spinal cord compression to recover nerve function.

Level of Evidence:
Level III.
Effect of ulinastatin on the inflammatory response after video-assisted thoracic lobectomy in patients with lung cancer: a randomized controlled study
Authors: Hwang Won Jung , Joo Min A. , Joo Jin 
Published: January 2022

Abstract

Background:
The first-line treatment for lung cancer is surgical resection, and one-lung ventilation (OLV) is the most basic anesthetic management method in lung surgery. During OLV, inflammatory cytokines are released in response to the lung tissue damage and promote local and contralateral lung damage through the systemic circulation. We designed a randomized, prospective study to evaluate the effect of the urinary trypsin inhibitor (UTI) ulinastatin on the inflammatory response after video-assisted thoracic lobectomy in patients with lung cancer.

Methods:
Adult patients aged 19 to 70 years, who were scheduled for video-assisted thoracic lobectomy surgery to treat lung cancer between May 2020 and August 2020, were enrolled in this randomized, prospective study. UTI (300,000 units) mixed with 100 mL of normal saline in the ulinastatin group and 100 mL of normal saline in the control group was administered over 1 h after inducing anesthesia.

Results:
The baseline (T0) interferon-γ (IFN-γ)/interleukin-4 (IL-4) ratio was not different between the groups (6941.3 ± 2778.7 vs. 6954.3 ± 2752.4 pg/mL, respectively; P
> 0.05). The IFN-γ/IL-4 ratio was significantly higher in ulinastatin group at 30 min after entering the recovery room than control group (20,148.2 ± 5054.3 vs. 6674.0 ± 2963.6, respectively; adjusted P < 0.017).

Conclusion:
Administering UTI attenuated the anti-inflammatory response, in terms of INF-γ expression and the IFN-γ/IL-4 ratio, after video-assisted thoracic surgery in lung cancer patients.

Trial registration:
Clinical Research Information Service of Korea National Institute of Health (CRIS), KCT0005533.
Association of the Effectiveness of Eye Drop Self-instillation and Glaucoma Progression
Authors: Rajanala Alekya P. , Prager Alisa J. , Park Meghan S. , Tanna Angelo P. 
Published: January 2022

Précis:
Among patients with glaucoma or ocular hypertension, ineffective self-instillation of eye drops was associated with an increased long-term risk of progression or advancement of treatment to incisional surgery.

Purpose:
The purpose of this study was to evaluate the association between the efficacy of self-instillation of eye drops and long-term glaucoma outcomes.

Methods:
In a previous study, video recordings of eye drop self-instillation by patients with glaucoma or ocular hypertension were graded as effective or ineffective depending on whether the patient successfully instilled at least 1 drop on the right ocular surface. Glaucomatous progression was then retrospectively defined as retinal nerve fiber layer thinning as measured by either optical coherence tomography, visual field progression, or need for incisional glaucoma surgery as determined by a glaucoma specialist unaware of patient performance in the eye drop instillation study. Subjects with at least 2 follow-up optical coherence tomography or visual field studies were included in the current study.

Results:
The original study enrolled 119 patients. Sufficient follow-up data were available for 101 patients. Eighty-eight patients (87.1%) were effective in eye drop instillation at baseline. Mean follow-up was 5.1 years, during which time 73 patients (72.3%) had progression or underwent incisional surgery in either eye. A significantly higher proportion of patients in the ineffective group met the criteria for progression or underwent incisional surgery (effective: 68.2%; ineffective: 100%; N=101; P=0.017, Fisher exact test). Kaplan-Meier survival analyses showed a significantly faster time to reaching an endpoint in the ineffective group (N=101; P=0.012, log-rank test). There was no difference in age, baseline intraocular pressure, or baseline retinal nerve fiber layer thickness between the groups.

Conclusion:
Ineffective self-installation of eye drops was associated with an increased risk of glaucoma progression or treatment advancement to incisional surgery.
Does Note-taking Method Matter in Physical Therapy School?
Authors: Lorio Anne K. , Greenberg Daphne , Oshima T. C. , Gore Jane B. , Carruth Laura L. 
Published: January 2022

Introduction.
Personal technology devices are now a primary method of note-taking in graduate learning. This study compared student learning outcomes using laptops for digital note-taking compared with handwritten notes.

Review of Literature.
Various results were reported in the literature of which note-taking method in undergraduate and graduate levels of learning results in best learning outcomes.

Subjects.
Subjects were 117 first-year doctoral physical therapy students enrolled in a 3-week wound care course. The study was completed over 3 consecutive years.

Methods.
Subjects volunteered to either use their laptop for digital note-taking or take handwritten notes on slide handouts. After course completion, course grades were compared between the 2 different note-taking method groups.

Results.
A 1-way analysis of variance yielded no significant difference due to the method of note-taking on overall course grade F(1, 115) = .048 (P = .827). A 2-way analysis of variance yielded no significant interaction between the method of note-taking and gender, but the main effect of gender was significant, with female subjects scoring higher than male subjects. Another 2-way analysis of variance yielded a significant interaction between the method of note-taking and the age of the student F(1, 113) = 9.402 (P = .003), and a simple main effects analysis for age found a significant difference in course grade between the 2 note-taking methods for older students F(1, 113) = 8.923 (P = .003) but not for younger students. This indicates that the effect of note-taking method on the course grade depended on the age group, specifically the older group tended to perform better with handwritten notes.

Discussion and Conclusion.
With our findings focusing on graduate physical therapy students, we found that handwritten note-takers tended toward having higher course grades, but they did not significantly outperform the digital note-taking group. Our findings found that the age of student and handwritten note-taking resulted in significantly higher course grades. Female gender was also found to be a significant factor for improved classroom performance in this study.

Important and Relevance of Work.
Results from this study indicated that modality of note-taking may not matter for most students, but it may matter for older students. Older students performed better in the handwritten notes group, and these findings are important to share with course instructors and with older students who may be struggling in graduate coursework.
Validity of the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) in Patients With Dizziness
Authors: Herdman David , Picariello Federica , Moss-Morris Rona 
Published: January 2022

Hypothesis:
The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) will be a valid and reliable combined measure of depression and anxiety in people with vertigo and dizziness.

Background:
Co-occurrence of depressive, anxiety, and somatic symptoms are common. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale-7 (GAD-7) measure symptoms of depression and anxiety respectively, although measuring them separately may be suboptimal in people who have illness-related distress. There is some evidence that these scales can be combined in long-term conditions resulting in the PHQ-ADS, but validity is yet to be determined in people with vertigo and dizziness.

Methods:
Two separate datasets from a tertiary vestibular clinic were analyzed where the PHQ-ADS was completed at initial clinical assessment (n = 624) and while on a waiting list (n = 185). A cross-sectional design was used to examine the factor structure (confirmatory factor analysis), internal consistency (omega index), and construct validity (Pearson correlation coefficient) of the PHQ-ADS. Construct validity was determined against the dizziness handicap inventory (DHI).

Results:
A bi-factor PHQ-ADS model had good fit to the data (χ2 = 397.163, 249.763; comparative fit index [CFI] = 0.954, 0.919; Tucker-Lewis index [TLI] = 0.938, 0.892; root mean squared error of approximation [RMSEA] = 0.076, 0.098). The general distress factor explained 81 to 85% of the common variance between items. There were moderate to large significant positive correlations between the PHQ-ADS and DHI.

Conclusion:
The PHQ-ADS appears to have good structural validity in patients with vertigo and dizziness. Clinicians and researchers can use this scale where a composite psychological measure is desired.
Hearing Outcomes of Transmastoid Plugging for Superior Canal Dehiscence Syndrome by Underwater Endoscopic Surgery: With Special Reference to Transient Bone Conduction Increase in Early Postoperative Period
Authors: Kawamura Yoshinobu , Yamauchi Daisuke , Kobayashi Toshimitsu , Ikeda Ryoukichi , Kawase Tetsuaki , Katori Yukio 
Published: January 2022

Objective:
To investigate the influence on hearing of transmastoid plugging of the superior semicircular canal accompanied with membranous superior canal transection by underwater endoscopic ear surgery (UWEES) for the superior semicircular canal dehiscence syndrome.

Study Design:
Retrospective case review.

Setting:
Tertiary referral center.

Patients:
Seven patients underwent plugging with membranous superior canal transection with UWEES from 2017 to 2019.

Intervention:
Bone conduction (BC) thresholds (250, 500, 1000, 2000, 4000 Hz) were repetitively examined in early postoperative period.

Main Outcome Measures:
Subjective symptoms and pure-tone audiometry.

Results:
Transient BC threshold increase was detected in all cases in early postoperative period and hearing levels were ameliorated in 1 to 2 months. The mean maximum BC threshold elevations (dB) during the early postoperative period (within 1 mo) and the postoperative stable hearing period (after 2 mo) were 18.6 and 2.9 at 250 Hz, 24.3 and 8.6 at 500 Hz, 26.4 and 8.6 at 1000 Hz, 28.6 and 7.1 at 2000 Hz, and 30.0 and 0.8 (except for scale-out cases) at 4000 Hz. respectively. The mean maximum BC thresholds in the early period were significantly elevated compared with those in the stable period at each frequency (p < 0.01).

Conclusions:
Hearing outcomes of transmastoid plugging with transection of the membranous superior canal by using UWEES were found favorable in a long-term follow-up. However, it caused transient reversible hearing loss in all cases. The BC increase in early postoperative period may not cause permanent hearing loss but improvement for the surgical technique may still be necessary.
Inpatient Alcohol Cessation Counseling Is Associated With a Lower 30-Day Hospital Readmission in Acute Alcoholic Pancreatitis
Authors: Sorrento Cristina , Shah Ishani , Yakah William , Ahmed Awais , Tintara Supisara , Kandasamy Cinthana , Freedman Steven D. , Kothari Darshan J. , Sheth Sunil G. 
Published: January 2022

Background:
Alcohol use is a common cause of recurrent acute pancreatitis. Thus, guidelines recommend providing alcohol prevention resources during hospitalization. There is limited data on the real-world implementation of this recommendation. We aimed to assess how often inpatients admitted with alcohol-induced acute pancreatitis (AAP) receive counseling and to determine the impact of counseling on readmissions for AAP.

Methods:
We retrospectively studied patients admitted with AAP at a tertiary care center from 2008 to 2018. We compared demographics, clinical features, and outcomes in patients who did and did not receive counseling. Outcomes studied were the proportion of patients with AAP receiving counseling, and readmission rates for AAP at 30 days and 1 year.

Results:
A total of 243 patients with AAP were identified, of which 115 had inpatient alcohol counseling (47%). Demographic data were comparable between the 2 groups. Fewer patients receiving alcohol counseling were readmitted at 30 days compared with patients not receiving counseling (19.3% vs. 31.2%, P=0.048). At 1 year, the 2 groups had similar readmission rates. On multivariate analysis, patients who received counseling were half as likely to be readmitted in 30 days compared with those who did not receive counseling [odds ratio=0.52 (0.27, 0.98), P=0.046].

Conclusions:
We note that <50% of patients receive alcohol counseling. Patients receiving alcohol counseling were less likely to be readmitted at 30 days, inferring possible value in the intervention provided. Similar readmission rates at 1 year suggest that the single intervention may not have a durable effect on alcohol prevention.
Retrospective Assessment of Patient and Catheter Characteristics Associated With Malpositioned Central Venous Catheters in Pediatric Patients
Authors: Weber Mark D. , Conlon Thomas , Woods-Hill Charlotte , Watts Stephanie L. , Nelson Eileen , Traynor Danielle , Zhang Bingqing , Davis Daniela , Himebauch Adam S. 
Published: January 2022

OBJECTIVES:
The primary objective was to determine the prevalence and characteristics associated with malpositioned temporary, nontunneled central venous catheters (CVCs) placed via the internal jugular (IJ) and subclavian (SC) veins in pediatric patients.

DESIGN:
Single-center retrospective cohort study.

SETTING:
Quaternary academic PICU.

PATIENTS:
Children greater than 1 month to less than 18 years who had a CVC placed between January 2014 and December 2018.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The primary outcome was the CVC tip position located on the first postprocedural radiograph. CVC tip was defined as follows: “recommended” (tip location between the carina and two vertebral bodies inferior to the carina), “high” (tip location between one and four vertebral bodies superior to the carina), “low” (tip position three or more vertebral bodies inferior to the carina), and “other” (tip grossly malpositioned). Seven hundred eighty-one CVCs were included: 481 (61.6%) were in “recommended” position, 157 (20.1%) were “high,” 131 (16.8%) were “low,” and 12 (1.5%) were “other.” Multiple multinomial regression (referenced to “recommended” position) showed that left-sided catheters (adjusted odds ratio [aOR], 2.00, 95% CI 1.17-3.40) were associated with “high” CVC tip positions, whereas weight greater than or equal to 40 kg had decreased odds of having a “high” CVC tip compared with the reference (aOR, 0.45; 95% CI, 0.24–0.83). Further, weight category 20–40 kg (aOR, 2.42; 95% CI, 1.38–4.23) and females (aOR, 1.51; 95% CI, 1.01–2.26) were associated with “low” CVC tip positions. There was no difference in rates of central line–associated blood stream infection, venous thromboembolism, or tissue plasminogen activator usage or dose between the CVCs with tips outside and those within the recommended location.

CONCLUSIONS:
The prevalence of IJ and SC CVC tips outside of the recommended location was high. Left-sided catheters, patient weight, and sex were associated with malposition. Malpositioned catheters were not associated with increased harm.
Low hepatitis C virus-viremia prevalence yet continued barriers to direct-acting antiviral treatment in people living with HIV in the Netherlands
Authors: Isfordink Cas J. , Smit Colette , Boyd Anders , de Regt Marieke J.A. , Rijnders Bart J.A. , van Crevel Reinout , Ackens Robin P. , Reiss Peter , Arends Joop E. , van der Valk Marc 
Published: January 2022

Objective:
To describe hepatitis C virus (HCV)-viremia prevalence and barriers to direct-acting antiviral (DAA) treatment during unrestricted access to DAA in a nationwide cohort of people with HIV (PWH).

Design:
Retrospective analysis of prospectively collected data.

Methods:
We calculated yearly HCV-viremia prevalence as proportion of HCV RNA-positive individuals ever HCV-tested. We then included HCV-viremic individuals with ≥1 visit during the era of universal DAA-access (database lock = December 31, 2018). Based on their last visit, individuals were grouped as DAA-treated or -untreated. Variables associated with lack of DAA-treatment were assessed using targeted maximum likelihood estimation. In November 2020, physicians of DAA-untreated individuals completed a questionnaire on barriers to DAA-uptake and onward HCV-transmission risk.

Results:
Among 25 196 PWH, HCV-viremia decreased from 4% to 5% between 2000 and 2014 to 0.6% in 2019. Being DAA-untreated was associated with HIV-transmission route other than men who have sex with men, older age, infrequent follow-up, severe alcohol use, detectable HIV-RNA, HCV-genotype 3, and larger hospital size. With universal DAA-access, 72 of 979 HCV-viremic individuals remained DAA-untreated at their last visit. Of these, 39 were no longer in care, 27 remained DAA-untreated in care, and six initiated DAA since database lock. Most common physician-reported barriers to DAA-uptake were patient refusal (20/72, 28%) and infrequent visit attendance (19/72, 26%). Only one DAA-untreated individual in care was engaging in activities associated with onward HCV-transmission.

Conclusions:
Prevalence of HCV-viremic PWH is low in the Netherlands, coinciding with widespread DAA-uptake. Barriers to DAA-uptake appear mostly patient-related, while HCV-transmission seems unlikely from the few DAA-untreated in care.