bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic Accuracy of Clinical Tests for Subscapularis Tears: A Systematic Review and Meta-analysis
Authors: Lädermann Alexandre , Collin Philippe , Zbinden Olivia , Meynard Timon , Saffarini Mo , Chiu Joe Chih-Hao
Published: September 2021

Background:

Previous systematic reviews and meta-analyses on the diagnostic accuracy of shoulder clinical tests do not reach conclusions regarding subscapularis tears.

Purpose:

To compare the diagnostic accuracy of commonly used clinical tests for subscapularis tears.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

An electronic literature search was conducted using Medline, Embase, and the Cochrane Library/Central. Eligibility criteria were original clinical studies reporting the diagnostic accuracy of clinical tests to diagnose the presence of rotator cuff tears involving the subscapularis.

Results:

The electronic literature search returned 2212 records, of which 13 articles were eligible. Among 8 tests included in the systematic review, the lift-off test was most frequently reported (12 studies). Four tests were eligible for meta-analysis: bear-hug test, belly-press test, internal rotation lag sign (IRLS), and lift-off test. The highest pooled sensitivity was 0.55 (95% CI, 0.28-0.79) for the bear-hug test, while the lowest pooled sensitivity was 0.32 (95% CI, 0.13-0.61), for the IRLS. In all tests, pooled specificity was >0.90.

Conclusion:

Among the 4 clinical tests eligible for meta-analysis (bear-hug test, belly-press test, IRLS, and lift-off test), all had pooled specificity >0.90 but pooled sensitivity <0.60. No single clinical test is sufficiently reliable to diagnose subscapularis tears.

Registration:

PROSPERO (CRD42019137019).
Evaluation of Spontaneous Swallow Frequency in Healthy People and Those With, or at Risk of Developing, Dysphagia: A Review
Authors: Bulmer Joseph M. , Ewers Caroline , Drinnan Michael J. , Ewan Victoria C.
Published: September 2021

Dysphagia is a common and frequently undetected complication of many neurological disorders and of sarcopoenia in ageing persons. Spontaneous swallowing frequency (SSF) has been mooted as a possible tool to classify dysphagia risk. We conducted a review of the literature to describe SSF in both the healthy population and in disease-specific populations, in order to consider its utility as a screening tool to identify dysphagia. We searched Medline, Embase, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials databases. Metadata were extracted, collated and analysed to give quantitative insight. Three hundred and twelve articles were retrieved, with 19 meeting inclusion and quality criteria. Heterogeneity between studies was high (I2 = 99%). Mean SSF in healthy younger sub-groups was 0.98/min [CI: 0.67; 1.42]. In the Parkinson’s sub-group, mean SSF was 0.59/min [0.40; 0.87]. Mean SSF in healthy older, higher risk and dysphagic populations were similar (0.21/min [0.09; 0.52], 0.26/min [0.10; 0.72] and 0.30/min [0.16; 0.54], respectively). SSF is a novel, non-invasive clinical variable which warrants further exploration as to its potential to identify persons at risk of dysphagia. Larger, well-conducted studies are needed to develop objective, standardised methods for detecting SSF, and develop normative values in healthy populations.
List of Theses in Foreign Missions and Related Subjects Accepted during the Academic Year 1958–1959
Authors: Person Laura
Published: September 2021

The compiler expresses gratitude to the professors of missions and all other persons who through reports, or otherwise, have made the following compilation of theses possible,

The theses reported are principally in the field of world missions and the eoumenical church, or are related to subjects of especial interest to students and scholars in missions, and were written during the years of 1958 and 1959. There are also included essays written in past years which seem to be of pertinent interest and which were not included in previous lists. Such titles have been designated by a star preceding the name of the author. The annotations which follow various titles have been written by the professors who reported them. Theses which concern rural or agricultural missions arc included in the general list and may be found as a group in the Index. The report includes papers from 61 theological schools and seminaries and from 15 universities.

Except where indicated, inquiries concerning a title should not be addressed to the Missionary Research Library but to the school where a thesis has originated or, in certain specified oases, to University Microfilms, Inc., Ann Arbor, Michigan. An index to subjects will be found an page 12.
List of theses in Foreign Missions and Related Subjects Accepted during the Academic Year 1960–1961
Authors: Person Laura
Published: September 2021

The compilar expresses gratitude to the professors of missions and all other persons who through roperts, or otherwise, have made the following compilation of theses possible.

The theses reported ore principally in the field of world missions and the ecumenical church, or are related,’ to subjects of espacial interest to students and scholars in missions, and were written during the years 1960 and 1961. The annotations which follow some of the titles have been written by the professors who reported them. As a matter of policy, B.D. and M.R.E. theses are no longer included. The report includes papers from 18 theological schools and seminaries and from 10 universities and colleges.

Inquiries concerning a title should not be addressed to the Missionary Research Library but to the school where a thesis has originated. An index to subjects will be found on page 8.
The Scope and Vitality of Orthodox Missionary Activity
Authors: Calian Carnegie Samuel
Published: September 2021

The substance of this article first appeared in The International Review of Missions Vol. LII, No. 205 (January 1963), under the title “Eastern Orthodoxy's Renewed Concern for Mission”. Permission has been obtained from the IRM for the publication ‘of this revised and expanded account. Dr. Calian currently is Visiting Professor of Theology at The Theological Seminary of the University of Dubuque, Dubuque, Iowa. Special attention is called to the many other works quoted or to which reference is made in the footnotes.
Biblical Israel and the Modern State
Authors: Holladay William
Published: September 2021

(Christians involved in mission in the Middle East must grapple constantly with issues raised by the state of Israel, and by Arab attitudes toward that nation. This month's Bulletin presents an analysis of some of these issues, by the Professor of Old Testament at the Near East School of Theology, Beirut, Lebanon. This paper is a condensation of a lecture delivered in January, 1968, at the University Christian Center Forum in Beirut. It is available in pamphlet form (from University Christian Center, Box 235, Beirut, Lebanon) under the title, Zionism — Judaism: Is the Old Testament Zionist?)
D. T. Niles - in Appreciation
Authors: Thomas Winburn T.
Published: September 2021

Author's Note

Ceylonese world-churchman D. T. Niles died in Vellore, India on July 17, 1970. Following an operation and radiation therapy for cancer of the face, the malignancy cleared. The immediate cause of his passing was a post-operative blood-clot.

When, a week following Dr. Niles’ death, I was asked to prepare this article, I accepted only because lest by our silence, we, his friends, fail to note our appreciation for having known and worked with one of Christ's giants of this or any age. A definitive biographical article should be written. I make no pretension to having written it. The pressures of the time allowed me, at the same time I was making preparations for a month's fact-finding trip to Indo-China, forced me to draw heavily upon my recollections of D. T. as friend and colleague, as having him a guest in my house and being a guest in his home, as co-staff members at various regional and international ecumenical conferences. Each of his friends could have written of him in equally laudatory terms, but quite differently. So gifted was he in the work of Christ's Kingdom, he touched each life in a particular way, according to the needs of the person involved.

To write objectively with tears in one's spirit is a difficult assignment.
Economic Activities in Support of Early Protestant Missions
Authors: Danker William J.
Published: September 2021

Martin Luther's ideal in missions called for their execution by the ordinary Christian witnessing individually in his calling and offering his life to Christ in serving the world under the rubric of the universal priesthood of all believers.

However, inhabitants of inland Germany were not in the best geographical position to participate in early voyages of discovery, commerce and conquest. And on some rare occasions when they had the opportunity to play a major role Luther's hope that the individual Christian would be a witness for the love and mercy of Christ was apparently loomed to disappointment.
Mutational patterns and their correlation to CHIP-related mutations and age in hematological malignancies
Authors: Stengel Anna , Baer Constance , Walter Wencke , Meggendorfer Manja , Kern Wolfgang , Haferlach Torsten , Haferlach Claudia
Published: September 2021

Acquired somatic mutations are crucial for the development of most cancers. We performed a comprehensive comparative analysis of the mutational landscapes and their correlation with CHIP-related (clonal hematopoiesis of indeterminate potential) mutations and patient age of 122 genes in 3096 cases of 28 different hematological malignancies. Differences were observed regarding (1) the median number of mutations (highest, median n = 4; lowest, n = 0); (2) specificity of certain mutations (high frequencies in atypical chronic myeloid leukemia [aCML; ASXL1, 86%], follicular lymphoma [FL; KMT2D, 87%; CREBBP, 73%], hairy cell lymphoma [BRAF, 100%], lymphoplasmacytic lymphoma [MYD88, 98%; CXCR4, 51%], myeloproliferative neoplasm [MPN; AK2, 68%]); (3) distribution of mutations (broad distribution within/across the myeloid/lymphoid lineage for TET2, ASXL1, DNMT3A, TP53, BCOR, and ETV6); (4) correlation of mutations with patient’s age (correlated with older age across entities: TET2, DNMT3A, ASXL1, TP53, EZH2, BCOR, GATA2, and IDH2; younger age: KIT, POT1, RAD21, U2AF2, and WT1); (5) correlation of mutation number per patient with age. Moreover, we observed high frequencies of mutations in RUNX1, SRSF2, IDH2, NRAS, and EZH2 in cases comprising at least 1 DTA (DNMT3A, TET2, ASXL1) mutation, whereas in cases without DTA mutations, TP53, KRAS, WT1, and SF3B1 were more frequent across entities, suggesting differences in pathophysiology. These results give further insight into the complex genetic landscape and the role of DTA mutations in hematological neoplasms and define mutation-driven entities (myelodysplastic syndrome/MPN overlap; secondary acute myeloid) in comparison with entities defined by chromosomal fusions (chronic myeloid leukemia; myeloid/lymphoid neoplasm with eosinophilia).
Waterpipe smoking and subsequent cigarette and e-cigarette use: a cohort study
Authors: Hanewinkel Reiner , Morgenstern Matthis , Sargent James D. , Goecke Michaela , Isensee Barbara
Published: September 2021

Aim

We tested the hypothesis that waterpipe smoking increases the likelihood to try conventional and electronic cigarettes.

Methods

In 2017 and 2018, 2752 German adolescents (mean age: 14.9 years), who had never tried conventional cigarettes or e-cigarettes, took part in a longitudinal survey with a 6-month observational period. Multiple regression analyses tested the association between waterpipe use at baseline and first experimentation with e-cigarettes at follow-up. The models adjusted for risk-taking propensity (sensation seeking and experimentation with alcohol and marijuana), age, sex, migration background, type of school and peer substance use.

Results

Some 381 adolescents (12.5% of the survey population) reported waterpipe smoking at baseline. The overall initiation rate during the 6 months was 4.9% (n=134) for conventional cigarettes and 10.5% (n=288) for e-cigarettes. Prior waterpipe smoking significantly predicted cigarette use (adjusted relative risk (ARR)=1.81, 95% CI 1.19–2.76), as well as e-cigarette use (ARR=3.29, 95% CI 2.53–4.28). In addition, a significant interaction between waterpipe use and sensation seeking was found (ARR=0.56, 95% CI 0.33–0.95), with waterpipe use being more predictive of later e-cigarette initiation for lower sensation-seeking individuals.

Discussion

Waterpipe use predicted both later cigarette and e-cigarette use independent of all other assessed risk factors, indicating that waterpipe use might be a risk factor on its own. The results suggest that the association was stronger for adolescents with a lower risk-taking propensity, which brings this group into focus for prevention efforts. However, further research is needed to understand whether these associations are causal.
Prediction of COPD by the single-breath nitrogen test and various respiratory symptoms
Authors: Olofson Jan , Bake Björn , Bergman Bengt , Vanfleteren Lowie E.G.W. , Svärdsudd Kurt
Published: September 2021

Early identification of subjects running an increased risk of contracting COPD enables focus on individual preventive measures. The slope of the alveolar plateau of the single-breath nitrogen washout test (N2-slope) is a sensitive measure of small-airway dysfunction. However, its role remains unexplored in predicting hospital admission or death related to COPD,i.e.incident COPD events, in relation to the presence of various respiratory symptoms.

A random population sample of 625 men, aged 50 (n=218) or 60 years (n=407), was followed for 38 years for incident COPD events. At baseline, a questionnaire on respiratory symptoms and smoking habits was collected, spirometry and the single-breath nitrogen test were performed, and the N2-slope was determined. Proportional hazard regression (Cox regression) analysis was used for the prediction model.

The N2-slope improved the prediction of COPD events significantly beyond that of respiratory symptoms weighted all together and other covariates (hazard ratio 1.63, 95% CI 1.20–2.22; p<0.005), a prediction applicable to subjects without (p=0.001) and with (p<0.05) airway obstruction. Dyspnoea and wheezing were the most predictive symptoms. The combination of the N2-slope and number of respiratory symptoms notably resulted in an effective prediction of incident COPD events even in nonobstructive subjects, as evidenced by a predicted incidence of ∼70% and ∼90% for a very steep N2-slope combined with many respiratory symptoms in subject without and with airway obstruction, respectively.

The alveolar N2-slope should be considered in the critical need for further research on early diagnosis of COPD.
Diagnostic value of biomarkers for paediatric urinary tract infections in primary care: systematic review and meta-analysis
Authors: Boon Hanne A. , Struyf Thomas , Bullens Dominique , Van den Bruel Ann , Verbakel Jan Y.
Published: September 2021

Background

Accurate diagnosis of urinary tract infection is essential as children left untreated may suffer permanent renal injury.

Aim

To compare the diagnostic values of biomarkers or clinical prediction rules for urinary tract infections in children presenting to ambulatory care.

Design and setting

Systematic review and meta-analysis of ambulatory care studies.

Methods

Medline, Embase, WOS, CINAHL, Cochrane library, HTA and DARE were searched until 21 May 2021. We included diagnostic studies on urine or blood biomarkers for cystitis or pyelonephritis in children below 18 years of age. We calculated sensitivity, specificity and likelihood ratios. Data were pooled using a bivariate random effects model and a Hierarchical Summary Receiver Operating Characteristic analysis.

Results

Seventy-five moderate to high quality studies were included in this review and 54 articles in the meta-analyses. The area under the receiver-operating-characteristics curve to diagnose cystitis was 0.75 (95%CI 0.62 to 0.83, n = 9) for C-reactive protein, 0.71 (95% CI 0.62 to 0.80, n = 4) for procalcitonin, 0.93 (95% CI 0.91 to 0.96, n = 22) for the dipstick test (nitrite or leukocyte esterase ≥trace), 0.94 (95% CI 0.58 to 0.98, n = 9) for urine white blood cells and 0.98 (95% CI 0.92 to 0.99, n = 12) for Gram-stained bacteria. For pyelonephritis, C-reactive protein < 20 mg/l had LR- of 0.10 (95%CI 0.04–0.30) to 0.22 (95%CI 0.09–0.54) in children with signs suggestive of urinary tract infection.

Conclusions

Clinical prediction rules including the dipstick test biomarkers can support family physicians while awaiting urine culture results. CRP and PCT have low accuracy for cystitis, but might be useful for pyelonephritis.
The yield of tuberculosis contact investigation in low- and middle-income settings: a systematic review and meta-analysis
Authors: Velleca Mariana , Malekinejad Mohsen , Miller Cecily , Abascal Miguel Lucia , Reeves Hailey , Hopewell Philip , Fair Elizabeth
Published: September 2021

Background

Contact investigation, the systematic evaluation of individuals in close contact with an infectious tuberculosis (TB) patient, is a key active case-finding strategy for global TB control. Better estimates of the yield of contact investigation can guide strategies to reduce the number of underreported and underdiagnosed TB cases, approximately three million cases per year globally. A systematic review (Prospero ID # CRD42019133380) and meta-analysis was conducted to update and enhance the estimates of the yield of TB contact investigation in low- and middle-income countries (LMIC). Pubmed, Web of Science, Embase and the WHO Global Index Medicus were searched for peer-reviewed studies (published between January 2006–April 2019); studies reporting the number of active TB or latent tuberculosis infection (LTBI) found through contact investigation were included. Pooled data were meta-analyzed using a random effects model and risk of bias was assessed.

Results

Of 1,644 unique citations obtained from database searches, 110 studies met eligibility criteria for descriptive data synthesis and 95 for meta-analysis. The pooled yields of contact investigation activities for different outcomes were: secondary cases of all active TB (defined as those bacteriologically confirmed or clinically diagnosed) 2.87% (2.61–3.14, I2 97.79%), bacteriologically confirmed active TB 2.04% (1.77–2.31, I2 98.06%), and LTBI 43.83% (38.11–49.55, I2 99.36%). Yields are interpreted as the percent of contacts screened who are diagnosed with active TB as a result of TB contact investigation activities. Pooled estimates were substantially heterogenous (I2 ≥ 75%).

Conclusions

This study provides methodologically rigorous and up-to-date estimates for the yield of TB contact investigation activities in low- and middle-income countries (LMIC). While the data are heterogenous, these findings can inform strategic and programmatic planning for scale up of TB contact investigation activities.
Combining stool and stories: exploring antimicrobial resistance among a longitudinal cohort of international health students
Authors: Kamenshchikova Alena , Wolffs Petra F. G. , Hoebe Christian J. P. A. , Penders John , Park Hyun Y. , Kambale Mateus S. , Horstman Klasien
Published: September 2021

Background

Antimicrobial resistance (AMR) is a global public health concern that requires transdisciplinary and bio-social approaches. Despite the continuous calls for a transdisciplinary understanding of this problem, there is still a lack of such studies. While microbiology generates knowledge about the biomedical nature of bacteria, social science explores various social practices related to the acquisition and spread of these bacteria. However, the two fields remain disconnected in both methodological and conceptual levels. Focusing on the acquisition of multidrug resistance genes, encoding extended-spectrum betalactamases (CTX-M) and carbapenemases (NDM-1) among a travelling population of health students, this article proposes a methodology of ‘stool and stories’ that combines methods of microbiology and sociology, thus proposing a way forward to a collaborative understanding of AMR.

Methods

A longitudinal study with 64 health students travelling to India was conducted in 2017. The study included multiple-choice questionnaires (n = 64); a collection of faecal swabs before travel (T0, n = 45), in the first week in India (T1, n = 44), the second week in India (T2, n = 41); and semi-structured interviews (n = 11). Stool samples were analysed by a targeted metagenomic approach. Data from semi-structured interviews were analysed using the method of thematic analysis.

Results

The incidence of ESBL- and carbapenemase resistance genes significantly increased during travel indicating it as a potential risk; for CTX-M from 11% before travel to 78% during travel and for NDM-1 from 2% before travel to 11% during travel. The data from semi-structured interviews showed that participants considered AMR mainly in relation to individual antibiotic use or its presence in a clinical environment but not to travelling.

Conclusion

The microbiological analysis confirmed previous research showing that international human mobility is a risk factor for AMR acquisition. However, sociological methods demonstrated that travellers understand AMR primarily as a clinical problem and do not connect it to travelling. These findings indicate an important gap in understanding AMR as a bio-social problem raising a question about the potential effectiveness of biologically driven AMR stewardship programs among travellers. Further development of the ‘stool and stories’ approach is important for a transdisciplinary basis of AMR stewardship.
Nomogram predicting the risk of three-year chronic kidney disease adverse outcomes among East Asian patients with CKD
Authors: Ye Huizhen , Chen Youyuan , Ye Peiyi , Zhang Yu , Liu Xiaoyi , Xiao Guanqing , Zhang Zhe , Kong Yaozhong , Liang Gehao
Published: September 2021

Background

Chronic kidney disease (CKD) is a common health challenge. There are some risk models predicting CKD adverse outcomes, but seldom focus on the Mongoloid population in East Asian. So, we developed a simple but intuitive nomogram model to predict 3-year CKD adverse outcomes for East Asian patients with CKD.

Methods

The development and internal validation of prediction models used data from the CKD-ROUTE study in Japan, while the external validation set used data collected at the First People’s Hospital of Foshan in southern China from January 2013 to December 2018. Models were developed using the cox proportional hazards model and nomogram with SPSS and R software. Finally, the model discrimination, calibration and clinical value were tested by R software.

Results

The development and internal validation data-sets included 797 patients (191 with progression [23.96%]) and 341 patients (89 with progression [26.10%]), respectively, while 297 patients (108 with progression [36.36%]) were included in the external validation data set. The nomogram model was developed with age, eGFR, haemoglobin, blood albumin and dipstick proteinuria to predict three-year adverse-outcome-free probability. The C-statistics of this nomogram were 0.90(95% CI, 0.89–0.92) for the development data set, 0.91(95% CI, 0.89–0.94) for the internal validation data set and 0.83(95% CI, 0.78–0.88) for the external validation data-set. The calibration and decision curve analyses were good in this model.

Conclusion

This visualized predictive nomogram model could accurately predict CKD three-year adverse outcomes for East Asian patients with CKD, providing an easy-to-use and widely applicable tool for clinical practitioners.
Association between social capital and depression among critically ill patients: evidence from a cross-sectional study in rural Shandong, China
Authors: Zhang Yaru , Li Jiajia , Fang Feng , Fu Wenhao
Published: September 2021

Background

With an increasing number of critically ill patients, attention should be paid to both their physical health and mental health. The objective of this study is to examine the links between depression and social capital among critically ill patients.

Methods

Data for 1043 patients with critical illnesses was collected with a stratified cluster random sampling method in rural Shandong, China. Depression symptoms were measured using a short form version of the Center for Epidemiologic Studies Depression Scale (CESD-10) and the total scores of them were dichotomized. We associated structural social capital with social networks, social participation, and social support. Cognitive social capital includes the degree of availability of social trust and reciprocity. Binary logistic regression was used to explore whether social capital was significantly associated with depression among patients with critical illnesses.

Results

We found that 68.5% of the critically ill patients in our sample population had depression. CESD-10 scores were negatively correlated with social capital, including occupations of their frequent contacts, social trust in relatives and friends, distance to the nearest medical institution and medical assistance convenience from non-spouse. In addition, low economic status, and low self-rated health were more significantly correlated with depression in critically ill patients.

Conclusions

Our findings suggest that more attention should be paid to the mental health of critically ill patients and more formal society, community and government support form given, particularly in rural China.
Validation of the Persian version of the Positive Mental Health Scale
Authors: Naghavi Azam , Teismann Tobias , Asgari Zahra , Eizadifard Razieh , Brailovskaia Julia
Published: September 2021

Background

Positive mental health (PMH) is a factor of far-reaching salutogenetic importance. The present study aimed at validating the Persian version of the Positive Mental Health Scale (PMH-Scale).

Methods

Reliability and validity of the Persian version of the PMH-Scale were established in an Iranian student sample (N = 573). Internal consistency, convergent and discriminant validity were investigated, and exploratory factor analysis was conducted. Furthermore, it was assessed how PMH scores moderate the association between depressive symptoms and suicide ideation/behavior.

Results

The Persian version of the PMH-Scale  was shown to have a unidimensional structure with excellent internal consistency, as well as good convergent and divergent validity. PMH differentiated between participants with higher vs. lower suicide risk. Furthermore, PMH proved to moderate the association between depressive symptoms and suicide ideation/behavior.

Conclusions

The results suggest that the PMH-Scale is a brief, reliable, and valid measure of subjective and psychological well-being that can be used in Iranian student samples and research settings.
Effect of low-dose amitriptyline on reducing pain in clinical knee osteoarthritis compared to benztropine: study protocol of a randomised, double blind, placebo-controlled trial
Authors: Wluka Anita E. , Urquhart Donna M. , Teichtahl Andrew J. , Hussain Sultana Monira , Forbes Andrew , Arnold Carolyn , Wang Yuanyuan , Cicuttini Flavia M.
Published: September 2021

Background

Knee osteoarthritis is a major cause of pain and disability. Pain control is poor, with most patients remaining in moderate to severe pain. This may be because central causes of pain, a common contributor to knee pain, are not affected by current treatment strategies. Antidepressants, such as amitriptyline, have been used to treat chronic pain in other conditions. The aim of this randomised, double blind, controlled trial, is to determine whether low dose amitriptyline reduces pain in people with painful knee osteoarthritis over 3 months compared to benztropine, an active placebo.

Methods/design

One hundred and sixty people with painful radiographic knee osteoarthritis will be recruited via clinicians, local and social media advertising. Participants will be randomly allocated in a 1:1 ratio to receive either low dose amitriptyline (25 mg) or active placebo (benztropine mesylate, 1 mg) for 3 months. The primary outcome is change from baseline in knee pain (WOMAC pain subscale) at 12 weeks. Secondary outcomes include change in function (total WOMAC) and the proportion of individuals achieving a substantial response (≥ 50% reduction in pain intensity, measured by Visual Analog Scale, VAS, from no pain to worst pain imaginable, 0-100 mm) and moderate response (≥ 30% reduction in pain intensity, measured by VAS) at 12 weeks. Intention to treat analyses will be performed. Subgroup analyses will be done.

Discussion

This study will provide high level evidence regarding the effectiveness of low dose amitriptyline compared to benztropine in reducing pain and improving function in knee OA. This trial has the potential to provide an effective new therapeutic approach for pain management in knee osteoarthritis, with the potential of ready translation into clinical practice, as it is repurposing an old drug, which is familiar to clinicians and with a well described safety record.

Trial registration

Australian New Zealand Clinical Trials Registry prior to recruitment commencing (ACTRN12615000301561, March 31, 2015, amended 14 December 2018, February 2021). Additional amendment requested 18 July 2021.
The epidemiology and etiology of adhesive capsulitis in the U.S. Medicare population
Authors: Sarasua Sara M. , Floyd Sarah , Bridges William C. , Pill Stephan G.
Published: September 2021

Background

Adhesive capsulitis (AC) of the shoulder, also known as frozen shoulder, causes substantial pain and disability. In cases of secondary AC, the inflammation and fibrosis of the synovial joint can be triggered by trauma or surgery to the joint followed by extended immobility. However, for primary AC the inciting trigger is unknown. The burden of the disorder among the elderly is also unknown leading to this age group being left out of therapeutic research studies, potentially receiving delayed diagnoses, and unknown financial costs to the Medicare system. The purpose of this analysis was to describe the epidemiology of AC in individuals over the age of 65, an age group little studied for this disorder. The second purpose was to investigate whether specific medications, co-morbidities, infections, and traumas are risk factors or triggers for primary AC in this population.

Methods

We used Medicare claims data from 2010–2012 to investigate the prevalence of AC and assess comorbid risk factors and seasonality. Selected medications, distal trauma, and classes of infections as potential inflammatory triggers for primary AC were investigated using a case–control study design with patients with rotator cuff tears as the comparison group. Medications were identified from National Drug codes and translated to World Health Organization ATC codes for analysis. Health conditions were identified using ICD9-CM codes.

Results

We found a one-year prevalence rate of AC of approximately 0.35% among adults aged 65 years and older which translates to approximately 142,000 older adults in the United States having frozen shoulder syndrome. Diabetes and Parkinson’s disease were significantly associated with the diagnosis of AC in the elderly. Cases were somewhat more common from August through December, although a clear seasonal trend was not observed. Medications, traumas, and infections were similar for cases and controls.

Conclusions

This investigation identified the burden of AC in the US elderly population and applied case–control methodology to identify triggers for its onset in this population. Efforts to reduce chronic health conditions such as diabetes may reduce seemingly unrelated conditions such as AC. The inciting trigger for this idiopathic condition remains elusive.
Both intraoperative medial and lateral soft tissue balances influence intraoperative rotational knee kinematics in bi-cruciate stabilized total knee arthroplasty: A retrospective investigation
Authors: Takagi Kentaro , Inui Hiroshi , Taketomi Shuji , Yamagami Ryota , Kono Kenichi , Kawaguchi Kohei , Sameshima Shin , Kage Tomofumi , Tanaka Sakae
Published: September 2021

Background

Tibial internal rotation following total knee arthroplasty (TKA) is important in achieving favorable postoperative clinical outcomes. Studies have reported the effect of intraoperative soft tissue balance on tibial internal rotation in conventional TKA, no studies have evaluated the effects of soft tissue balance at medial or lateral compartments separately on tibial internal rotation in bi-cruciate stabilized (BCS) TKA. The purpose of this study was to clarify the relationship between medial or lateral component gaps and rotational knee kinematics in BCS TKA.

Methods

One hundred fifty-eight knees that underwent BCS TKA were included in this study. The intraoperative medial and lateral joint laxities which was defined as the value of component gap minus the thickness of the tibial component were firstly divided into two groups, respectively: Group M-stable (medial joint laxity, ≤ 2 mm) or Group M-loose (medial joint laxity, ≥ 3 mm) and Group L-stable (lateral joint laxity, ≤ 3 mm) or Group L-loose (lateral joint laxity, ≥ 4 mm). And finally, the knees enrolled in this study were divided into four groups based on the combination of Group M and Group L: Group A (M-stable and L-stable), Group B (M-stable and L-loose), Group C (M-loose and L-stable), and Group D (M-loose and L-loose). The intraoperative rotational knee kinematics were compared between the four Groups at 0°, 30°, 60°, and 90° flexion, respectively.

Results

The rotational angular difference between 0° flexion and maximum flexion in Group B at 30° flexion was significantly larger than that in Group A at 30° flexion (*p < 0.05). The rotational angular difference between 30° flexion and maximum flexion in Group B at 30° flexion was significantly larger than that in Group D at 30° flexion (*p < 0.05). The rotational angular differences between 30° or 90° flexion and maximum flexion in Group B at 60° flexion were significantly larger than those in Group A at 60° flexion (*p < 0.05).

Conclusion

Surgeons should pay attention to the importance of medial joint stability at midflexion and lateral joint laxities at midflexion and 90° flexion on a good tibial internal rotation in BCS TKA.
The utilization of perfused cadaver simulation in urologic training: a pilot study
Authors: McClelland Daniel , O’Connor Luke P. , Barnard John , Hajiran Ali , Crigger Chad , Trump Tyler , Bacharach Emma , Elbakry Amr , Werner Zach , Morley Chad , Grabo Daniel , Luchey Adam
Published: September 2021

Background

We sought to determine if participating in a surgical training session using perfused fresh human cadavers (PFHC) had a positive effect on urology residents’ confidence in performing open and endoscopic procedures.

Methods

Urology residents at our institution participated in a surgical training session in the West Virginia University Fresh Tissue Training Program, which utilized fresh cadavers with vascular perfusion. The session consisted of performing different urologic procedures (open and endoscopic) on the perfused fresh human cadavers (PFHC). Residents were given a survey to rate their confidence in different urologic procedures before, after, and 6 months after the session. Each procedure on the survey had 3–6 questions associated with it, with scores ranging from 0 (no confidence) to 4 (great confidence). Scores for each procedure before and after the session were compared.

Results

Six residents participated in the session. There was an increase in the score for every procedure performed after the session. Scores at 6 month follow up remained higher than the pre-session scores.

Conclusion

PFHCs offer an excellent opportunity to teach a wide variety of urologic procedures to residents. Incorporation of PFHCs may be very useful in urologic training, and further studies on its use are warranted.
Preoperative aspartate transaminase/alanine transaminase ratio as a prognostic biomarker in primary non-muscle-invasive bladder cancer: a propensity score-matched study
Authors: Cheng Xiaofeng , Zhou Xiaochen , Yi Ming , Xu Song , Zhang Cheng , Wang Gongxian
Published: September 2021

Purpose

To evaluate the prognostic value of the aspartate transaminase/alanine transaminase (AST/ALT) ratio in primary non-muscle-invasive bladder cancer (NMIBC) using propensity score matching (PSM) analysis.

Methods

We retrospectively collected the clinical and pathological data from 314 patients with primary NMIBC who underwent transurethral resection of bladder tumor. The full cohorts were divided into a low AST/ALT ratio group and a high AST/ALT ratio group according to the optimal cut-off value which was obtained based on the analysis of the receiver operating characteristic curve for the 3-year recurrence-free survival (RFS). After 1:1 PSM, the correlation between preoperative AST/ALT ratio and survival prognosis was evaluated by Kaplan–Meier analysis with log-rank tests. The independent prognostic factors for RFS and progression-free survival (PFS) were also analyzed.

Results

The optimum cutoff value of the preoperative AST/ALT ratio was 1.40. Before PSM, a high AST/ALT ratio was correlated with the larger proportion of age > 60 years (P = 0.007) and the worse pathological T stage (P < 0.001). After PSM, patients with a high AST/ALT ratio had poorer RFS and PFS than patients with a low AST/ALT ratio (allP < 0.001). In addition, multivariate Cox regression analysis indicated that preoperative AST/ALT ratio was considered as an independent prognostic factor of RFS (HR 2.865; 95%CI 1.873–4.381;P < 0.001) and PFS (HR 4.771; 95%CI 2.607–8.734;P < 0.001) in patients with primary NMIBC.

Conclusions

The high AST/ALT ratio group tended to have poorer RFS and PFS than the low AST/ALT ratio group. Our results also indicated that the elevated preoperative AST/ALT ratio could be seen as a useful prognostic biomarker for predicting early disease recurrence and progression in patients with primary NMIBC.
Three-dimensional alveolar bone assessment of mandibular molars for immediate implant placement: a virtual implant placement study
Authors: Chen Haida , Wang Wei , Gu Xinhua
Published: September 2021

Background

To elucidate the anatomical features of the mandibular molar region to allow safe immediate implant placement.

Methods

Cone-beam computed tomography images of 150 patients (600 teeth) were reviewed retrospectively. The virtual implants were placed in the mandibular first and second molar region. The anatomic structures of the mandible and inter-radicular septum were both categorized into three types. The relationship between implant and inferior alveolar nerve (IAN), and the horizontal distance from the implant surface to the bone wall were analyzed. Variables were compared using a student’s t-test, or Mann–Whitney U test.

Results

Type U (39.0%) and type S (56.0%) were the most common in the first molar, while type U (67.7%) and type M (54.7%) had the highest prevalence rate in the second molar. The mean distance from the level where the virtual implant was completely surrounded by bone to IAN was 7.06 mm. The mean horizontal widths from the implant to the mesial and distal socket wall were 1.59 mm and 1.89 mm. The widths of the inter-radicular septum and the distances from implant to the buccal and lingual plate on different sections were significantly associated with tooth position (P < .05).

Conclusions

In the first molar region, the implant is suggested to be placed in the center of the inter-radicular septum, while in the second molar region, the mesial root socket could be considered. Immediate implant placement in the mandibular second molar sockets shows a high risk of IAN injury, lingual perforation, and inadequate primary stability.
A dissemination strategy to promote relational coordination in the veterans health administration: a case study
Authors: Connelly Brigid , Battaglia Catherine , Gilmartin Heather M.
Published: September 2021

Background

Large healthcare institutions like the Veterans Health Administration (VA) continually seek best practices to improve clinical care. Relational coordination is an evidence-based organizational theory of communicating and relating to coordinate work and drive performance outcomes. Implementing relational coordination-guided practices can be difficult due to challenges with spreading information across large systems. Using social marketing theory and evidence-based dissemination strategies, we developed an evidence-based dissemination plan to educate and motivate researchers and operational staff to study and implement relational coordination in the VA.

Methods

In this case study, we used the four Ps (product, price, place, promotion) of social marketing theory to develop a 2-phase dissemination strategy. In phase one, we created and distributed relational coordination information and invited VA staff to join the Relational Coordination Research Collaborative. In phase two, dissemination efforts targeted researchers ready to implement relational coordination within existing programs of research. Process and outcome measures included dissemination, engagement and adoption data and a post-project survey. Quantitative results were calculated using descriptive statistics. Survey text responses were analyzed using deductive content analysis and a structured categorization matrix.

Results

Phase one included social media dissemination, virtual and in-person presentations, as well as phone and email communication between project staff and the target audience. In total, 47 VA staff became members of the Relational Coordination Research Collaborative and 27 routinely participated in online research seminars. In phase 2, 13 researchers expressed interest in studying relational coordination and 5 projects were selected to participate. Multiple relational coordination-related trainings and publications originated from this program.

Conclusions

Dissemination approaches that involved personalized, one-on-one efforts (e.g., phone or email) seemed to be more effective at disseminating relational coordination compared to social media or online presentations. Participants in phase 2 agreed that relational coordination should be adopted in the VA but indicated that cost would be a barrier. Results support the importance of evidence-based dissemination planning that address the unique costs and benefits of programs.
Educational associations with missed GP appointments for patients under 35 years old: administrative data linkage study
Authors: McQueenie Ross , Ellis David A. , Fleming Michael , Wilson Philip , Williamson Andrea E.
Published: September 2021

Background

There is an evidence gap about whether levels of engagement with public services such as schools and health care affect people across the lifespan. Data on missed patient appointments from a nationally representative sample of Scottish general practices (GP) (2013–2016) were probabilistically linked to secondary school pupil data. We tested whether school attendance, exclusions (2007–2011) or lower educational attainment (2007–2016) was associated with an increased risk of missing general practice appointments.

Methods

School attendance data were classified into quartiles of possible days attended for years we had data. School exclusions were derived as a categorical variable of ‘ever excluded’. Attainment data were categorised via the Scottish Credit and Qualifications Framework (SCQF) level 3 or 6; a cumulative measure of attainment on leaving school. The associations between school attendance, exclusions and attainment and risk of missing medical appointments were investigated using negative binomial models, offset by number of GP appointments made and controlling for potential confounders.

Results

112,534 patients (all aged under 35) had GP appointment and retrospective school attendance and exclusion data, and a subset of 66,967 also had attainment data available. Patients who had lower attendance, had been excluded from school or had lower educational attainment had an increased risk of missing GP appointments (all rate ratios > 1.40).

Conclusions

This study provides the first evidence from a population-representative sample in a high-income country that increased numbers of missed appointments in health care are associated with reduced school attendance, higher levels of school exclusion and lower educational attainment. Insights into the epidemiology of missingness across public services can support future research, policy and practice that aim to improve healthcare, health outcomes and engagement in services.
Feline thymidine kinase 1: molecular characterization and evaluation of its serum form as a diagnostic biomarker
Authors: Wang Liya , Sharif Hanan , Saellström Sara , Rönnberg Henrik , Eriksson Staffan
Published: September 2021

Background

Thymidine kinase 1 (TK1) catalyzes the initial phosphorylation of thymidine in the salvage pathway synthesis of dTTP, an essential building block of DNA. TK1 is a cytosolic enzyme with its highest level during the S-phase of the cell cycle. In cancer cells TK1 is upregulated and excess TK1 is leaked into the blood. Therefore, serum TK1 has been used as biomarker for cancer diagnosis and prognosis in human medicine. Feline TK1 shows high sequence similarity to TK1 from other species. The aim of this study was to characterize feline TK1 and evaluate if serum TK1 can be used as a diagnostic biomarker.

Results

Feline TK1 was cloned, expressed and affinity purified. The purified feline TK1 phosphorylated not only pyrimidine deoxyribonucleosides but also pyrimidine ribonucleosides and to some extent purine deoxynucleosides. A number of anticancer and antiviral nucleoside analogs also served as substrates with fairly high efficiency. ATP and dATP were the preferred phosphate donor. Serum TK1 activity in felines with malignant diseases was significantly higher than that in healthy individuals. ROC analysis revealed an area under the curve (AUC) of 0.98 with a sensitivity of 0.83 and a specificity of 0.95 for felines with lymphoma. Serum TK1 activity in felines with IBD or inflammatory disease was within the same range as healthy ones. Furthermore, in felines with lymphoma serum TK1 activity returned to normal levels in response to treatment.

Conclusion

Feline TK1 has high specific activity and a broader substrate specificity in comparison with TK1 from other species. Serum TK1 activity in felines with malignant diseases is significantly higher than that in normal felines and in felines with inflammatory diseases. These results suggest that serum TK1 may be a promising biomarker for the diagnosis and monitoring of malignant diseases and for the differential diagnosis of certain inflammatory disease.