bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Surgical Site Infection in Pediatric Cochlear Implantation
Authors: Quimby Alexandra E. , Grose Elysia , Reddy Deepti , Webster Richard , Malic Claudia , Vaccani Jean‐Philippe 
Published: June 2022

AbstractObjectiveTo determine risk factors for surgical site infection (SSI) after cochlear implantation (CI) in pediatric patients.Study DesignCase‐control study.SettingA total of 150 hospitals contributing data to the ACS‐NSQIP Pediatric database (American College of Surgeons National Surgical Quality Improvement Program) in North America and worldwide.MethodsPediatric patients (aged <18 years) undergoing CI during the years 2012 to 2017 were identified in the ACS‐NSQIP Pediatric database. Uni‐ and multivariable logistic regression analyses were used to determine the odds ratios (ORs) of SSI (including superficial incisional, deep incisional, organ/space) occurring up to 30 days postoperatively.ResultsA total of 79 SSIs occurred over a 5‐year period (n = 5146). Longer operative time significantly increased the odds of SSI (OR, 1.965; 95% CI, 1.205‐3.289). Younger age was also found to raise the odds of SSI, with decreased odds associated with each 6‐month increase in age (OR, 0.887; 95% CI, 0.814‐0.958).ConclusionLonger operative time and younger age appear to significantly increase the odds of SSI in pediatric CI. Body mass index, recent steroid use, American Society of Anesthesiologists class, bilateral vs unilateral implantation, and hospital length of stay do not appear to significantly influence SSI risk. These findings must be interpreted in the context of the limitations inherent to adverse events reporting, which are mitigated by the stringent manner of data collection by the ACS‐NSQIP, and those inherent to the definition of SSI. Future prospective studies should investigate the impact of reducing operative time on the risk of SSI and other complications in pediatric CI.
From adversity to advice: Survival threats as a trigger for sustained engagement with external business support in small firms
Authors: Jibril Halima , Wishart Maria , Roper Stephen 
Published: June 2022

This article analyses the relationship between the experience of a crisis and advice seeking in small firms. Although the benefits of business advice and support to smaller firms are well documented, smaller firms are often reluctant to seek external advice, relying instead on informal routines and a focus on daily operations. Conceptualising crisis as a trigger for advice seeking, and using survey data from 2089 small firms, we find a strong and significant relationship between experiencing a crisis and seeking external business advice up to five years after the crisis. This sustained effect on advice seeking is particularly strong for firms who also sought advice at the time of the crisis. Additionally, we find that the effect of a business crisis on sustained advice seeking is stronger for firms subject to a crisis with external origins.
Trends in Cleft lip and/or Palate Prevalence at Birth in Mexico: A National (Ecological) Study Between 2003 and 2019
Authors: Cerón-Zamora Eduardo , Scougall-Vilchis Rogelio José , Contreras-Bulnes Rosalía , González-López Blanca Silvia , Veras-Hernández Miriam Alejandra , Lucas-Rincón Salvador Eduardo , Escoffié-Ramirez Mauricio , Medina-Solís Carlo Eduardo , Maupomé Gerardo 
Published: June 2022

Objective To describe trends in cases and prevalence at birth rates of cleft lip and/or palate (CL/P) in Mexico between 2003 and 2019. Design Ecological study. Setting Multiple data sources systematically collected into a national epidemiological surveillance data warehouse. Participants National Live Birth Information System. Main Outcome Measure(s) Both cases and prevalence at birth rates of CL/P in Mexico within a 17-year period were used as dependent variables. Results At the national level there were 23 184 new cases of CL/P (average of 1364 per year) in the 32 states of Mexico, with an average prevalence at birth rate of 0.53 per 1000 live births. The states with the highest prevalence at birth rates of CL/P during the period were Hidalgo (1.59) and Jalisco (1.32), while the states with the lowest rates were Nayarit (0.22) and Durango (0.29). A slight decrease in both cases (z = −2.41, P = .016) and prevalence at birth rates (z = −2.58, P = .010) of CL/P was observed at the national level. States such as Durango, Puebla, Chiapas, Guerrero, Oaxaca, Mexico City, State of Mexico, Coahuila and Jalisco showed a clear downward trend ( P < .05) in their prevalence at birth of CL/P between 2003 and 2019, while in Hidalgo its trend was upward ( P = .05). Significant differences by sex and region were observed ( P < .05). Conclusion Some states consistently had the highest or lowest prevalence of CL/P. Decreasing trends in the overall prevalence at birth rates were observed. More detailed, epidemiological studies are necessary to adequately characterize CL/P in the Mexican population.
Association of Esophageal Squamous Cell Carcinoma With the Interaction Between Poor Oral Health and Single Nucleotide Polymorphisms in Regulating Cell Cycles and Angiogenesis: A Case-Control Study in High-Incidence Chinese
Authors: Zhao Renjia , Li Xiaoxiao , Yang Xiaorong , Zhang Tiejun , Lu Ming , Ye Weimin , Jin Li , Suo Chen , Chen Xingdong 
Published: June 2022

Introduction Oral health and genetic factors can independently influence the risk of developing esophageal squamous cell carcinoma (ESCC). Objectives The primary objective of this study was to investigate the interactive effects of oral health and genetic factors on ESCC risk. Methods This was a matched case-control study with 927 ESCC patients and 1701 matched controls. We selected 101 candidate single nucleotide polymorphisms (SNPs) from 59 genes that were associated with ESCC. Oral health was assessed based on tooth-brushing frequency, tooth loss, and age at the time of first tooth loss. An unconditional logistic regression model was employed in which SNP–oral health interactions were assessed as risk factors for ESCC, after adjusting for age and sex. A genetic risk score (GRS) analysis was conducted. Results The association between GRS and ESCC and the synergistic effect of GRS and oral health on ESCC were examined. Daily frequency of tooth-brushing was found to interact with 5 SNPs, rs3765524, rs753724, rs994771, rs3781264, and rs11187842, to increase the risk of ESCC. In particular, individuals with genotype TT of rs3765524 who brushed their teeth less than twice a day had a 5.13-times higher risk of ESCC than those with genotype CC who brushed their teeth at least twice a day. Furthermore, tooth loss interacted with two SNPs: rs1159918 from ADH1B and rs3813867 from CYP2E1. Conclusion Oral health may interact with genetic factors increasing ESCC risk, which provides new insights into the relationship between ESCC and gene–lifestyle interactions which can be used for disease prevention.
Small Scale Enterprise Workers Require Attention: What Predicts the Level of Occupational Injuries?
Authors: Daba Chala , Atamo Amanuel , Gebrehiwot Mesfin 
Published: June 2022

Background: Occupational injuries are among the foremost public health problems that small scale enterprise workers are encountering. Most foregoing occupational injury studies focused on construction or welding industry workers which could underestimate the real level of occupational injuries recorded in small scale enterprises. Conversely, others deal with a combined level of injuries from both small scale and large scale enterprises. Therefore, this study examined the magnitude and predictors of occupational injuries among various categories of small scale enterprise workers in Ambo town (Ethiopia). Methods: An institutional-based cross-sectional study was employed among 408 small scale enterprise workers from September to October 2021. A multivariable logistic regression analysis was computed to identify factors associated with occupational injuries. Variables with P-value less than .05 were considered as significantly associated with occupational injuries. Results: The 1-year prevalence of occupational injuries was 39.5% (95% CI: 35-44). Age greater than 40 years (AOR = 2.84, 95% CI: 1.53-5.28), working for more than 8 hours per day (AOR = 2.2, 95% CI: 1.61-4.95), working during the night time (AOR = 2.1, 95% CI: 1.22-3.47), lack of workplace supervision (AOR = 2.55, 95% CI: 1.23-5.28), alcohol use (AOR = 1.95, 95% CI: 1.24-3.06), chewing khat (AOR = 2.01, 95% CI: 1.27-3.2), non-utilization of personal protective equipment (AOR = 1.55, 95% CI: 1.03-2.87), and lack of health and safety training (AOR = 2.05, 95% CI: 1.26-4.37) were important predictors of occupational injuries. Conclusions: Our findings indicated a substantial proportion of small scale enterprise workers experienced occupational injuries during the last year. Provision of health and safety training, continuous workplace supervisions, and provision and utilization of personal protective equipment are recommended.
Single-dose versus multiple-dose antibiotics prophylaxis for preventing caesarean section postpartum infections: A randomized controlled trial
Authors: Igwemadu Gerald Tochukwu , Eleje George Uchenna , Eno Enang Enang , Akunaeziri Uche Augustine , Afolabi Folashade Adeola , Alao Abayomi Ibukun , Ochima Onazi 
Published: June 2022

Background: Caesarean section, a common obstetric surgical procedure, is a major predisposing factor for puerperal infections, requiring the need for antibiotic prophylaxis. Evidence suggests that single-dose antibiotic prophylaxis has comparable efficacy to multiple-dose antibiotic prophylaxis, but with a lower cost and risk of antibiotic resistance. However, single-dose antibiotic prophylaxis after caesarean section is not generally used in many centres in sub-Saharan Africa. Objective: This study aimed to compare the effectiveness of single- versus multiple-dose antibiotic prophylaxis to prevent post-caesarean section infections. Methodology: This open-label, randomized controlled trial involved 162 consenting patients admitted for caesarean section (elective or emergency) at the Federal Medical Centre Keffi. They were distributed randomly into treatment arm A or B. Subjects in both arms received intravenous ceftriaxone (1 g) and metronidazole (500 mg) 30–60 min before incision; subjects in arm B received additional parenteral doses for 48 h and then cefuroxime 500 mg tablets every 12 h and metronidazole 400 mg tablets every 8 h for 5 days. The patients were monitored for 2 weeks for evidence of wound infection, febrile morbidity and clinical endometritis. Result: There was no statistical difference in the incidence of wound infection (6.6% versus 7.4%; p = .882) and febrile morbidity (11.8% versus 11.1%, p = .807). However, clinical endometritis (0.0% versus 6.1%, p = .028) was statistically significant with none reported in the single-dose arm. Conclusion: Single-dose ceftriaxone and metronidazole is as effective as multiple doses for antibiotic prophylaxis to prevent post-caesarean section infections. Adoption of this approach in low-risk patients would reduce the cost of prophylactic antibiotics, workload for staff and antibiotic resistance.
Attention-deficit/hyperactivity disorder and ischemic stroke: A Mendelian randomization study
Authors: Du Runming , Zhou Yi , You Chong , Liu Kevin , King Daniel A , Liang Zhi-Sheng , Ranson Janice M , Llewellyn David J , Huang Jie , Zhang Zhenyu 
Published: June 2022

Background: Observational studies have found an association between attention-deficit/hyperactivity disorder (ADHD) and ischemic stroke. Aims: The purpose of this study was to investigate whether genetic liability to ADHD has a causal effect on ischemic stroke and its subtypes. Methods: In this two-sample Mendelian randomization (MR) study, genetic variants (nine single-nucleotide polymorphisms; P < 5 × 10-8) using as instrumental variables for the analysis was obtained from a genome-wide association study of ADHD with 19,099 cases and 34,194 controls. The outcome datasets for stroke and its subtypes were obtained from the MEGASTROKE consortium, with 40,585 cases and 406,111 controls. MR inverse variance-weighted method was conducted to investigate the effect of genetic liability to ADHD on ischemic stroke and its subtypes. Sensitivity analyses (median-based methods, MR-Egger, MR-robust adjusted profile scores, MR-pleiotropy residual sum and outlier) were also utilized to assess horizontal pleiotropy and remove outliers. Multivariable MR (MVMR) analyses were conducted to explore potential mediators. Results: Genetically determined ADHD (per 1 SD) was significantly associated with a higher risk of any ischemic stroke (AIS) (odds ratio (OR) = 1.15, 95% confidence interval (CI) = 1.05–1.25, P = 0.002) and large-artery atherosclerotic stroke (LAS) (OR = 1.40, 95% CI = 1.10–1.76, P = 0.005). The significant association was also found in sensitivity analyses and MVMR analyses. Conclusions: Genetic liability to ADHD was significantly associated with an increased risk of AIS, especially LAS. The association between ADHD and LAS was independent of age of smoking initiation but mediated by coronary artery disease.
Is lower urinary tract surgery without upper pole heminephrectomy safe and effective in the long-term treatment of duplex system ureterocele?
Authors: Uçan Ayşe Başak , Şencan Arzu , Temir Zehra Günyüz , Okur Özkan , Sönmez Gökçe , Öztürk Merve 
Published: June 2022

Objective: The study aimed to retrospectively evaluate postoperative results of patients with duplex system ureterocele (DSU) who underwent endoscopic ureterocele incision (UI), lower urinary tract reconstruction (LUTR) or both, and investigate the necessity of upper pole heminephrectomy (UPH) in ureterocele treatment. Patients and methods: In total, 44 patients with DSU who were operated on in December 2005 and December 2018 were evaluated for patient characteristics, ureterocele location, differential renal function (DRF), vesicoureteral reflux (VUR), postoperative incontinence, proteinuria, hypertension and urinary tract infection (UTI). Results: UI was performed in 27 of 44 cases (61.3%) as the first-line treatment. Ten of them (37%) had no urinary infection or renal function loss at a mean of 3 years (1.5–7 years). LUTR was needed in 17 patients after UI due to VUR in 14 patients and bladder outlet obstruction (BOO) in 3 patients. In total, 34 patients who underwent LUTR, proteinuria or incontinence were not detected in the mean 6 years’ follow-up. Thirty-three patients (97%) had identical renal scans and similar DRF before and after the operation. No patient underwent UPH. Conclusion: UI must be considered the first-line treatment in DSU in infancy. In older patients, especially with VUR, LUTR is effective and safe and UPH mostly is not necessary. Level of evidence: 4
Scrotal exploration for acute testicular pain: A contemporary UK series from a tertiary centre
Authors: Maynard William , Shanmugathas Nimlan , Mundell Alexandra , Yassin Mussab , Bertoncelli-Tanaka Mariana , Morley Roland , Minhas Suks 
Published: June 2022

Objectives: The objective of this study was to assess the evaluation and operative outcomes of patients attending a single urology centre with acute testicular pain (ATP) who underwent scrotal exploration. We sought to determine adherence to the Royal College of Surgeons England (RCS) commissioning guide on testicular torsion, clinical and radiological features predictive of torsion, time-dependent salvage rates and surgical technique in a contemporary cohort. Patients and Methods: A single-centre retrospective review was carried out from 2015 to 2020. All patients presenting with acute testicular pain undergoing surgical exploration were included. Results: 140 patients were identified, median age 16 years, 40 had testicular torsion (TT) (30%) where nausea (positive predictive value (PPV) 51.7%, p = 0.009) and abnormal testis lie (PPV 50%, p = 0.008) were more frequent. TT was the most common diagnosis if presenting <4 hours (44%), and in patients 13–16 years (62%). Time-to-surgery from the assessment was <3 hours in 109 of 128 (85.2%). The overall salvage rate was 74.4%, with salvage rates of 100% at 6 hours from the onset of pain. Viable tissue was seen on histology in 30% of orchidectomies, up to 25 hours from the onset of pain. Discussion: Surgical exploration <6 hours from the onset of pain is the threshold for salvage in TT. Clinical findings should be combined with patient age and time to presentation to aid diagnosis. Patients between 13 and 16 years are at the highest risk of TT and frequently present early following the onset of pain. Given the heterogenicity of surgical management and the highest risk of TT to the paediatric population, speciality organisations should produce definitive guidance on the management of TT. Level of evidence: OCEBM Level 3 evidence
The genetic landscape of germlineDDX41variants predisposing to myeloid neoplasms
Authors: Li Peng , Brown Sara , Williams Margaret , White Thomas , Xie Wei , Cui Wei , Peker Deniz , Lei Li , Kunder Christian A. , Wang Huan-You , Murray Sarah S. , Vagher Jennie , Kovacsovics Tibor , Patel Jay L. 
Published: June 2022

AbstractGermline DDX41 variants are the most common mutations predisposing to acute myeloid leukemia (AML)/myelodysplastic syndrome (MDS) in adults, but the causal variant (CV) landscape and clinical spectrum of hematologic malignancies (HMs) remain unexplored. Here, we analyzed the genomic profiles of 176 patients with HM carrying 82 distinct presumably germline DDX41 variants among a group of 9821 unrelated patients. Using our proposed DDX41-specific variant classification, we identified features distinguishing 116 patients with HM with CV from 60 patients with HM with variant of uncertain significance (VUS): an older age (median 69 years), male predominance (74% in CV vs 60% in VUS, P = .03), frequent concurrent somatic DDX41 variants (79% in CV vs 5% in VUS, P &lt; .0001), a lower somatic mutation burden (1.4 ± 0.1 in CV vs 2.9 ± 0.04 in VUS, P = .012), near exclusion of canonical recurrent genetic abnormalities including mutations in NPM1, CEBPA, and FLT3 in AML, and favorable overall survival (OS) in patients with AML/MDS. This superior OS was determined independent of blast count, abnormal karyotypes, and concurrent variants, including TP53 in patients with AML/MDS, regardless of patient’s sex, age, or specific germline CV, suggesting that germline DDX41 variants define a distinct clinical entity. Furthermore, unrelated patients with myeloproliferative neoplasm and B-cell lymphoma were linked by DDX41 CV, thus expanding the known disease spectrum. This study outlines the CV landscape, expands the phenotypic spectrum in unrelated DDX41-mutated patients, and underscores the urgent need for gene-specific diagnostic and clinical management guidelines.
Outcomes following treatment for ADA-deficient severe combined immunodeficiency: a report from the PIDTC
Authors: Cuvelier Geoffrey D. E. , Logan Brent R. , Prockop Susan E. , Buckley Rebecca H. , Kuo Caroline Y. , Griffith Linda M. , Liu Xuerong , Yip Alison , Hershfield Michael S. , Ayoub Paul G. , Moore Theodore B. , Dorsey Morna J. , O’Reilly Richard J. , Kapoor Neena , Pai Sung-Yun , Kapadia Malika , Ebens Christen L. , Forbes Satter Lisa R. , Burroughs Lauri M. , Petrovic Aleksandra , Chellapandian Deepak , Heimall Jennifer , Shyr David C. , Rayes Ahmad , Bednarski Jeffrey J. , Chandra Sharat , Chandrakasan Shanmuganathan , Gillio Alfred P. , Madden Lisa , Quigg Troy C. , Caywood Emi H. , Dávila Saldaña Blachy J. , DeSantes Kenneth , Eissa Hesham , Goldman Frederick D. , Rozmus Jacob , Shah Ami J. , Vander Lugt Mark T. , Thakar Monica S. , Parrott Roberta E. , Martinez Caridad , Leiding Jennifer W. , Torgerson Troy R. , Pulsipher Michael A. , Notarangelo Luigi D. , Cowan Morton J. , Dvorak Christopher C. , Haddad Elie , Puck Jennifer M. , Kohn Donald B. 
Published: June 2022

Abstract
Adenosine deaminase (ADA) deficiency causes ∼13% of cases of severe combined immune deficiency (SCID). Treatments include enzyme replacement therapy (ERT), hematopoietic cell transplant (HCT), and gene therapy (GT). We evaluated 131 patients with ADA-SCID diagnosed between 1982 and 2017 who were enrolled in the Primary Immune Deficiency Treatment Consortium SCID studies. Baseline clinical, immunologic, genetic characteristics, and treatment outcomes were analyzed. First definitive cellular therapy (FDCT) included 56 receiving HCT without preceding ERT (HCT); 31 HCT preceded by ERT (ERT-HCT); and 33 GT preceded by ERT (ERT-GT). Five-year event-free survival (EFS, alive, no need for further ERT or cellular therapy) was 49.5% (HCT), 73% (ERT-HCT), and 75.3% (ERT-GT; P &lt; .01). Overall survival (OS) at 5 years after FDCT was 72.5% (HCT), 79.6% (ERT-HCT), and 100% (ERT-GT; P = .01). Five-year OS was superior for patients undergoing HCT at &lt;3.5 months of age (91.6% vs 68% if ≥3.5 months, P = .02). Active infection at the time of HCT (regardless of ERT) decreased 5-year EFS (33.1% vs 68.2%, P &lt; .01) and OS (64.7% vs 82.3%, P = .02). Five-year EFS (90.5%) and OS (100%) were best for matched sibling and matched family donors (MSD/MFD). For patients treated after the year 2000 and without active infection at the time of FDCT, no difference in 5-year EFS or OS was found between HCT using a variety of transplant approaches and ERT-GT. This suggests alternative donor HCT may be considered when MSD/MFD HCT and GT are not available, particularly when newborn screening identifies patients with ADA-SCID soon after birth and before the onset of infections. This trial was registered at www.clinicaltrials.gov as #NCT01186913 and #NCT01346150.
Evaluation of elastic stiffness in bolted timber joints for applying turn-of-nut method
Authors: Matsubara Doppo , Teranishi Masaki 
Published: June 2022

AbstractThe mechanical performance of bolt joints in wooden structures is known to vary significantly with the initial tightening force (axial force) of the bolts during the construction work. When a joining method that considers axial force is applied to a structure, the control of the axial force is important. This study attempts to evaluate the elastic stiffness of bolted timber joints during tightening for the purpose of applying the turn-of-nut tightening method, one of the methods for controlling axial force. Considering the elastic stiffness of joints during tightening as a series spring model using the spring constant of the bolt and the embedment spring constant of the washer, elastic stiffness is calculated using the washer embedment spring constant obtained through a washer embedment test. This result is compared with the elastic stiffness obtained through the tightening test using four species of timber. It was found that while the washer embedment spring constant varies greatly with timber species, the calculated values agreed well with the test results.