bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of cranial electrotherapy stimulation on preoperative anxiety and blood pressure during anesthetic induction in patients with essential hypertension
Authors: Kang Hee Won , Kim Hyun Joong , Kim Woon Young , Min Won Kee , Min Too Jae , Lee Yoon Sook , Kim Jae Hwan
Published: August 2020

Objective

Cranial electrotherapy stimulation (CES) is a non-invasive treatment that improves symptoms such as anxiety and pain. The purpose of this study was to analyze the effect of CES pretreatment on levels of preoperative anxiety, pain, and hemodynamic responses—especially changes in blood pressure—during anesthetic induction in patients with essential hypertension.

Methods

Eighty patients undergoing general anesthesia were randomly assigned to receive either no pretreatment (control group, n = 40) or CES pretreatment (CES group, n = 40). Anxiety scores, systolic and diastolic blood pressures, mean arterial pressure, and heart rate were measured in the general ward the evening before surgery, as well as in the preoperative holding area, operating room, and after intubation. Withdrawal responses to rocuronium injection were also measured.

Results

Anxiety scores in the operating room were significantly lower in the CES group. Withdrawal responses to rocuronium injection were also significantly lower in the CES group. There were no significant differences in hemodynamic values between the two groups.

Conclusions

CES pretreatment reduces both preoperative anxiety levels and withdrawal responses to rocuronium injection. However, it does not have a significant effect on hemodynamic responses.
Physical deviation and precocious puberty among school-aged children in Leshan City: an investigative study
Authors: Wei Qiong , Wu Ming , Li Yu-Lin , Rao Rui , Li Song , Cen Qin , Wu Hua , Lv Li , Huang Mao , Ge Yu-Ping , Lu Zhi-Li , Wen Yao-Ping , Cao Ying , Liu Ting-Ting , Wang Li
Published: August 2020

Objective

We investigated physical deviation and precocious puberty among school-aged children in Leshan City, to provide a theoretical basis for the management of precocious puberty in children.

Methods

We selected 12 primary schools of Leshan City using a cluster random sampling method and conducted physical examinations among healthy students aged 4 12 years. A total of 11,000 students were recruited (5502 boys and 5498 girls). We measured body mass index (BMI), and participants were tested for precocious puberty according to the Tanner stages and standard maps. Nutritional status was also evaluated.

Results

Obese and overweight children accounted for a high proportion of participants; the prevalence of underweight was the lowest. The prevalence of obesity among boys was higher than that in girls. Precocious puberty was mainly observed in girls, particularly those age 7 years old. The prevalence of precocious puberty among overweight and obese children was higher than that in children with normal weight.

Conclusion

We identified a significant sex difference in precocious puberty among children in Leshan City. Overweight and obesity may be associated with precocious puberty.
Unusual coexistence of first and second branchial fistulas: clinical case and review of the literature
Authors: Liu Danqing , Li Guangqi , Qiu Jun , Wang Jianyan , Pei Genwang
Published: August 2020

Branchial fistulas are uncommon in the clinical setting. The coexistence of first and second branchial fistulas has not been previously reported. We herein describe a 12-year-old girl who presented with a 2-year history of repeated swelling and purulence behind the right earlobe and neck. According to the patient’s physical and auxiliary examination findings, she was diagnosed with coexisting first and second branchial fistulas, both of which were completely removed by surgery. No clinical signs of fistula recurrence were present at the patient’s 20-month postoperative follow-up. Ipsilateral coexisting first and second branchial fistulas are very rare; thus, a false-positive diagnosis can easily occur if the doctor does not carefully perform specialized physical examinations. Surgery is an effective method for treating this condition. Adequate preoperative imaging preparation is imperative to ensure the most effective course of treatment. The purpose of this article is to improve clinicians’ awareness of this disease, thereby effectively reducing the rates of missed diagnosis and recurrence.
Epistaxis in hospitalized patients with COVID-19
Authors: Dell’Era Valeria , Dosdegani Riccardo , Valletti Paolo Aluffi , Garzaro Massimiliano
Published: August 2020

Spontaneous epistaxis in patients with COVID-19 can represent a clinical challenge with respect to both the risk of contamination and the treatment options. We herein present the data of 30 patients with COVID-19 who developed spontaneous epistaxis while hospitalized at Eastern Piedmont Hospital during March and April 2020. All patients received low-molecular-weight heparin during their hospital stay and required supplementary oxygen therapy either by a nasal cannula or continuous positive airway pressure. Both conditions can represent risk factors for developing epistaxis. Prevention of crust formation in patients with rhinitis using a nasal lubricant should be recommended. If any treatment is required, appropriate self-protection is mandatory.
Collaboration between Law Enforcement Agencies in Combating Cybercrime: Implications of a Taiwanese Case Study about ATM Hacking
Authors: Wang Shun-Yung Kevin , Hsieh Ming-Li , Chang Charles Kuang-Ming , Jiang Pin-Syuan , Dallier Douglas J.
Published: August 2020

An increasing number of cybercrimes has presented new global challenges to law enforcement agencies that traditionally operate within designated geographical jurisdictions and patrol territories. The borderless nature of cyberspace has brought substantial opportunities—both legal and illegal—to its users, and many local law enforcement agencies have encountered motivated offenders taking advantage of the globally connected Internet and causing damage locally and transnationally. This study examines a high-profile case of European criminals who hacked into a Taiwanese financial institution—First Commercial Bank (FCB)—and programmed its ATMs to “spit out” cash netting the thieves $2.6 million US dollars in 2016 summer. Before the incident of FCB, this European criminal group committed more than a hundred similar ATMs hackings, victimizing dozens of financial institutions across several European countries, and profiting over one billion Euros. FCB is the only case revealing specific details about the modus operandi of ATM hacking thus far, in addition to disclosing reactions from law enforcement. By analyzing qualitative data collected from different branches of law enforcement involved in the investigations, this unique case study underscores the importance of national-local law enforcement collaboration in fighting transnational cybercrime. Empirical implications are particularly valuable in the law enforcement context of “turf jealousies” when defending homeland security.
Steep Posterior Tibial Slope and Excessive Anterior Tibial Translation Are Predictive Risk Factors of Primary Anterior Cruciate Ligament Reconstruction Failure: A Case-Control Study With Prospectively Collected Data
Authors: Ni Qian-kun , Song Guan-yang , Zhang Zhi-jun , Zheng Tong , Feng Zheng , Cao Yan-wei , Feng Hua , Zhang Hui
Published: August 2020

Background:

Steep posterior tibial slope (PTS) and excessive anterior tibial translation (ATT) have been identified as important anatomic risk factors for anterior cruciate ligament (ACL) injury, which have raised concerns about clinical outcomes after primary ACL reconstruction (ACLR).

Purpose:

To investigate anatomic risk factors of primary ACLR failure and to determine the cutoff values of PTS and ATT for predicting primary ACLR failure.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

Between November 2015 and May 2017, a total of 215 consecutive patients with clinically diagnosed noncontact ACL injuries who underwent primary anatomic ACLR were retrospectively analyzed. Among them, 25 patients who showed complete discontinuity of ACL fibers on final follow-up magnetic resonance imaging scans were allocated into the failure group (study group). They were matched 1:2 to 50 control participants who showed clear and continuous ACL fibers on magnetic resonance imaging scans (control group). PTS and ATT were measured on preoperative weightbearing whole leg lateral radiographs and compared between the groups. The cutoff values of PTS and ATT for predicting primary ACLR failure were determined by the receiver operating characteristic curve. Moreover, predictors of primary ACLR failure were assessed by multivariate logistic regression analysis, including sex, age, body mass index, concomitant meniscal tears, degree of pivot-shift test, and KT-1000 arthrometer side-to-side difference, PTS, and ATT.

Results:

PTS and ATT values in the study group were significantly higher than those in the control group (mean ± SD: PTS, 17.2°± 2.2° vs 14.4°± 2.8°; ATT, 8.3 ± 3.4 mm vs 4.1 ± 3.1 mm; P < .001). The cutoff values of PTS and ATT for predicting primary ACLR failure were 17° (sensitivity, 66.7%; specificity, 90.9%) and 6 mm (sensitivity, 87.5%; specificity, 79.5%), respectively. Additionally, PTS ≥17° (odds ratio, 15.6; 95% CI, 2.7-91.5; P = .002) and ATT ≥6 mm (odds ratio, 9.9; 95% CI, 1.9-51.4; P = .006) were determined to be risk factors of primary ACLR failure, whereas sex, age, body mass index, concomitant meniscal tears, degree of the pivot-shift test, and KT-1000 arthrometer side-to-side difference were not.

Conclusion:

In this study, PTS ≥17° and ATT ≥6 mm, as measured on weightbearing whole leg radiographs, were identified to be predictive risk factors of primary ACLR failure. This study adds to the existing knowledge about potential surgical indications of simultaneous slope-reducing high tibial osteotomy to mitigate the primary ACLR failure rate.
Evaluating the Strength of Local Legislative Frameworks to Protect Farmland: City of Richmond and Metro Vancouver, British Columbia
Authors: Connell David J.
Published: August 2020

In this exploratory paper, we introduce a new method of plan quality evaluation to measure strength of policy focus. We demonstrate how the method can be applied to evaluate the strength of farmland protection policy in two local governments in the Province of British Columbia, Canada: the City of Richmond and Metro Vancouver Regional District. The method aims to not only describe strengths and weaknesses but also measure aspects of quality that help explain why a legislative framework is good. We suggest that this approach complements methods to evaluate effectiveness of farmland protection policies.
Non-Suicidal Self-Injury, Neuroticism, and Ethnic Identity in Young Latina Adults
Authors: Madubata Ijeoma J. , Cheref Soumia , Eades Natasha D. , Brooks Jasmin R. , Talavera David C. , Walker Rheeda L.
Published: August 2020

Rates of non-suicidal self-injury (NSSI) are elevated among Latinas; however, few studies have examined patterns of NSSI and associated risk in this population. The purpose of this study was to examine the association between neuroticism and NSSI, along with the conditional effect of ethnic identity on such an association for first-, second-, and third-generation Latina young adults. Participants were 701 emerging adult Latinas who completed measures of self-harm, personality traits, and ethnic identity. Results showed ethnic identity as moderating the association between neuroticism and self-harm in second-generation Latinas. These findings provide some insight into the cultural impact of both ethnic identity and generational status on self-harm for Latinas with high levels of neuroticism.
Mentorship and Training to Increase Diversity of Researchers and Practitioners in the Field of Aging and Alzheimer’s Disease: A Scoping Review of Program Characteristics
Authors: Ureña Stephanie , Ingram Lucy A. , Leith Katherine , Lohman Matthew C. , Resciniti Nicholas , Rubin Lindsey , Miller Maggi C. , Friedman Daniela B.
Published: August 2020

Objectives: Diversity is needed within the aging and Alzheimer’s disease and related dementias (ADRD) research and practice workforce to comprehensively address health inequities faced by underrepresented minority (URM) older adults. We conducted a scoping review of training programs designed to diversify the pool of researchers and practitioners in the field of aging and ADRD. Methods: Online database searches yielded 3976 articles published from 1999 to 2019. Fourteen studies met the inclusion criteria. Results: All programs were from the United States and included URM populations. Nine programs included students, one targeted university faculty, and four targeted clinical staff. Only five programs were guided by theory. Discussion: Our review identified URMs’ desire for culturally diverse and representative mentorship, the need for career development support at various training stages, and the importance of incorporating theory to program design. It also identified key characteristics for future program development, creation of systematic evaluation standards, and opportunities for promotion.
Nonlinear vibration absorbers for ropeway roller batteries control
Authors: Carboni Biagio , Arena Andrea , Lacarbonara Walter
Published: August 2020

This work investigates a nonlinear passive control strategy designed to reduce the peak accelerations in ropeway roller batteries systems by deploying an array of nonlinearly visco-elastic vibration absorbers. The control effectiveness is compared with that of an equivalent array made of linearly visco-elastic absorbers. A nonlinear parametric model describing the interactions between the different parts of this mechanical multibody system previously developed by the present authors is here extended to include the passive vibration control system aimed to mitigate the acceleration peaks induced by the vehicles transit at different operational speeds. To this aim, a set of linearly visco-elastic vibration absorbers is first optimized through the Differential Evolution (DE) algorithm seeking to minimize the area below the frequency-response curves of the linear equations of motion. Then, a new group of nonlinearly visco-elastic absorbers, that can be largely tuned (i.e., they can exhibit either softening or hardening behaviors), is proposed to mitigate the accelerations induced in the roller by the vehicle transit. These nonlinearly visco-elastic absorbers are optimized by means of the DE algorithm and comparisons with the control achieved by the linear absorbers are carried out to show the higher performance of the proposed nonlinear device. A possible design of the nonlinearly visco-elastic absorber, based on the hysteresis of a wire rope assembly undergoing flexural cycles, is also proposed and discussed.
Large eddy simulation coupled with immersed boundary method for turbulent flows over a backward facing step
Authors: Yang Dandan , He Sida , Shen Lian , Luo Xianwu
Published: August 2020

In the present work, large eddy simulation coupled with immersed boundary (LES-IB) method is applied to simulate a backward facing step (BFS) flow, which is a canonical fluid dynamics problem involving flow separation, recirculation and reattachment that are common in many practical applications. The computed reattachment length, a primary parameter to evaluate the overall performance of the numerical method, shows promising accuracy in the present work compared to the alternative numerical simulations. Based on the mean velocity profiles at four representative locations, there is fairly well quantitative agreement among the present LES-IB, DNS and the experiment. The results reveal that the reverse flow in the reattachment region leads to little over-prediction of the reattachment length compared to the DNS result. Furthermore, second-order statistics are in good agreement with the reference data in spite of discrepancies in the recirculation and reattachment region owing to complex flow structure, verifying the accuracy of the present method. In addition, the instantaneous flow fields are also analyzed to show the capability of the present LES-IB method in vortex-capture, and one may see the transient process of flow separation based on the analysis of Lagrangian coherent structure (LCS).
Seeing change in urban informal settlements with social network analysis
Authors: Kasper Eric
Published: August 2020

This paper examines the changes to social networks of people living in seven informal settlements in Raipur, India, who, in line with the “Indian Alliance” model of community organizing, worked with NGO partners to form local associations in their settlements. These associations were meant to help the participants and their fellow settlement residents to access more secure housing through the Rajiv Awas Yojana (RAY) policy. This paper presents findings from a quantitative social network analysis, demonstrating the impact of the organizing efforts in reshaping their relationship structures and strengthening their agency. These findings were tested for resonance and further fleshed out with qualitative details by going through the analysis with participants. Finally, this paper offers reflections on incorporating technical research methods into organizing and action research interventions, affirming the notion that people living in informal settlements are well placed to generate and make use of sophisticated data on their own communities and cities.
The role of shale gas in shaping the U.S. long-run CO2 emissions
Authors: Chen Y.-H. Henry , Reilly John M , Paltsev Sergey
Published: August 2020

The shale gas boom in the U.S. has lowered the U.S. CO2 emissions in recent years mainly through substitution of gas for coal in power generation. Will the shale gas boom reduce the emissions in the long-run as well? To study this, we consider a counterfactual without the shale gas boom based on a general equilibrium modeling for the 2011 U.S. economy. To enhance the power sector modeling, the supply responses of coal-fired and gas-fired generations are calibrated to existing research. We find that if gas prices remain at 2007 levels in 2011, only a model setting that allows very little reduction in electricity demand, reflecting a short-run demand response, generates an increase in economy-wide emissions. For all other cases, the higher gas price under the counterfactual will have a dampening effect on economic activities and consequently lowers economy-wide emissions, even though the power sector emissions may increase due to the gas-to-coal switch. In other words, without any policy intervention, although the shale gas boom could reduce emissions in the short run, it may lead to higher emissions in the long run if the low gas prices persist. Our finding suggests that extrapolating the current decline in emissions due to the shale gas boom to the distant future could be misleading. Instead, if curbing emissions is the goal, rather than depending upon the cheap gas, policies and measures for cutting emissions remain imperative.
Ensuring Educational Escape-Room Success: The Process of Designing, Piloting, Evaluating, Redesigning, and Re-Evaluating Educational Escape Rooms
Authors: Eukel Heidi , Morrell Briyana
Published: August 2020

Background.

The implementation of educational escape rooms has shown great value in learner outcomes. The design of such simulations requires a thoughtful, well-defined process.

Objective.

The purpose of this article is to encourage educational escape room designers to use a thoughtful, methodical, iterative process to ensure quality, educational capacity, and a positive learner experience.

Application.

When designing an educational escape room, designers should consider implementing a cyclic design process: design, pilot, evaluate, redesign, re-evaluate, and repeat.

Discussion.

A methodological process for educational escape room design can promote deep learning and positive student perceptions.
Carrying Out Rapid Qualitative Research During a Pandemic: Emerging Lessons From COVID-19
Authors: Vindrola-Padros Cecilia , Chisnall Georgia , Cooper Silvie , Dowrick Anna , Djellouli Nehla , Symmons Sophie Mulcahy , Martin Sam , Singleton Georgina , Vanderslott Samantha , Vera Norha , Johnson Ginger A.
Published: August 2020

Social scientists have a robust history of contributing to better understandings of and responses to disease outbreaks. The implementation of qualitative research in the context of infectious epidemics, however, continues to lag behind in the delivery, credibility, and timeliness of findings when compared with other research designs. The purpose of this article is to reflect on our experience of carrying out three research studies (a rapid appraisal, a qualitative study based on interviews, and a mixed-methods survey) aimed at exploring health care delivery in the context of COVID-19. We highlight the importance of qualitative data to inform evidence-based public health responses and provide a way forward to global research teams who wish to implement similar rapid qualitative studies. We reflect on the challenges of setting up research teams, obtaining ethical approval, collecting and analyzing data in real-time and sharing actionable findings.
Cleft Lip and Palate in Ectodermal Dysplasia
Authors: Ganske Ingrid M. , Irwin Tim , Langa Olivia , Upton Joseph , Tan Wen-Hann , Mulliken John B.
Published: August 2020

Objective:

Ectodermal dysplasia (ED) comprises multiple syndromes that affect skin, hair, nails, and teeth, and sometimes are associated with orofacial clefting. The purpose of this study is to (1) identify the prevalence and characteristics of cleft lip and/or palate (CL/P) in patients with ED and (2) describe the management and outcomes.

Design:

Retrospective review from 1990 to 2019.

Patients:

All patients with ED treated at Boston Children's Hospital.

Main Outcomes Measures:

Prevalence of CL/P was calculated and clinical details recorded: phenotypic anomalies, cleft type, operative treatment, and results of repair.

Results:

Of 170 patients with a purported diagnosis of ED, 24 (14%) had CL/P. Anatomic categories were bilateral CL/P (67%), unilateral CL/P (8%), and cleft palate only (25%). The most common ED syndrome (37%) was ectrodactyly, ectodermal dysplasia, and cleft lip/palate (EEC). Pathogenic variants in TP63 were the most frequent finding in the 11 patients who had genetic testing. Aberrations from a typical clinical course included failure of presurgical dentofacial orthopedics, dehiscence of nasolabial adhesion, and total palatal absence requiring free-flap construction. Two patients had prolonged postoperative admission for respiratory infection. High fistula (8%) and velopharyngeal insufficiency (33%) rates reflected the predominance of bilateral complete forms.

Conclusions:

As in other types of syndromic CL/P, cleft phenotypic expression in ED is more severe than the general cleft population. Further studies are needed to correlate genotype and phenotype for the distinct syndromes included in the ED spectrum.
Moving Toward a New Model of Sexual Consent: The Development of the Process-Based Consent Scale
Authors: Glace Alyssa M. , Zatkin Judith G. , Kaufman Keith L.
Published: August 2020

Measuring attitudes and behaviors associated with sexual consent is crucial to research addressing sexual violence, as lack of consent is a defining feature thereof. This research developed and validated the Process-Based Consent Scale to address concerns associated with missing components of existing consent scales. The factor structure was supported by an exploratory factor analysis (EFA) and subsequent confirmatory factor analysis (CFA). The scale contains three subscales: ongoing consent, communicative sexuality, and subtle coercion. Results indicated good convergent and concurrent validity. Future research should consider using this tool to measure attitudes and behaviors related to sexual consent and coercion.
Involvement of C677T MTHFR variant but not A1298C in methotrexate-induced toxicity in acute lymphoblastic leukemia
Authors: Frikha Rim , Jemaa Maha Ben , Frikha Fakher , Turki Ines , Elloumi Moez , Keskes Leila , Kamoun Hassen , Rebai Tarek
Published: August 2020

Background

Methotrexate (MTX) is a key drug in acute lymphoblastic leukemia (ALL) treatment; it inhibits DNA replication by blocking the conversion of 5, 10 Methylenetetrahydrofolate to 5-methylene tetrahydrofolate by methylenetetrahydrofolate reductase (MTHFR). Variants of the Methylenetetrahydrofolate reductase (MTHFR) and MTX related toxicities were largely investigated in several populations, nevertheless, the results are conflicting.

Objective

This study aimed to assess the prevalence of MTHFR SNVs: C677>T and A1298>C in Tunisian patients with ALL and the relation to the frequency of drug-induced complications.

Methods

28 ALL patients were included in the study. They were treated according to EORTOC, in which a high dose of MTX (HDMTX) was prescribed. A toxicity score (ST) is calculated for each patient, summing the grades of toxicities. Genotyping of MTHFR variants was done with a PCR-based restriction fragment length polymorphism assay.

Results

The toxicity’s score (TS) was higher with C677T variant compared to wild genotype (C677C) (TS = 4; IC95% [−2.65–13.32] versus TS = 2.5; IC95% [1.65–4.55], respectively; p = 0.2); but lower with the A1298C mutation compared to those with the wild genotype (A1298A) (TS = 2.5; IC95% [0.48–4.77], versus TS =3; IC95% [1.9–5.69], p = 0.4). HDMTX-related toxicity is associated with the 677CT genotype in ALL patients (RR = 1.41, p = 0.2); not for the A1298C [OR = 0.46, [0.08–2.61], p = 0.18].

Conclusion

Our preliminary findings highlight the impact of the C677T variant of MTHFR, but not the A1289C; in HD-MTX chemotherapy-related adverse effects in younger Tunisian ALL.
Development of a tool to allocate inpatient specialized pharmacy resources at a comprehensive cancer center
Authors: Smith Adam T , Kennerly-Shah Julie M , Kusoski Carolyn L
Published: August 2020

Purpose

Develop an objective tool to align the needs of inpatient services at a Comprehensive Cancer Center with the available resources of hematology/oncology clinical specialist pharmacists.

The shift of the pharmacy profession from product-centered to patient-centered care has expanded the scope of practice of the clinical pharmacist and their ability to specialize in a therapeutic area. However, these specialized resources are limited. The pharmacy department at The James Comprehensive Cancer Center at The Ohio State University Wexner Medical Center developed a tool to objectively determine which inpatient services would receive the most benefit from having a hematology/oncology clinical specialist pharmacist on their healthcare team. A Steering Committee was created to determine the necessary metrics needed across the 29 inpatient services at The James, and data was collected from the electronic medical record. The metrics evaluated were: patient acuity, inpatient intravenous anticancer administrations, inpatient oral anticancer administrations, presence of an outpatient anticancer treatment plan for patients admitted for an inpatient stay, and the use of high-risk hematology/oncology therapies.

Conclusion

A novel and data-driven tool was created to allocate hematology/oncology clinical specialist pharmacists across a Comprehensive Cancer Center. Annual use of this objective tool can aid institutions in appropriate distribution of limited hematology/oncology specialized pharmacy resources.
Most of patients with femoral derotation osteotomy for posterior extraarticular hip impingement and high femoral version would do surgery again
Authors: Lerch Till D , Schmaranzer Florian , Steppacher Simon D , Ziebarth Kai , Tannast Moritz , Siebenrock Klaus A
Published: August 2020

Aims:

To assess (1) hip pain and function and ROM; (2) subsequent surgeries, complications; and (3) subjective satisfaction and PROMs in patients undergoing femoral derotation osteotomies.

Methods:

Femoral derotation subtrochanteric osteotomies to treat symptomatic posterior extraarticular ischiofemoral hip impingement were performed in 23 patients (25 hips) between 2013 and 2017. The mean age was 26 ± 8 years (96% female) with a minimum 2-year follow-up (mean follow-up of 4 ± 1 years). Surgical indication was a positive posterior impingement test and limited external rotation (mean 16° ± 8°) in extension in patients with abnormal high femoral version (mean 46° ± 9, measured on CT scans with the Murphy method) and high McKibbin instability index (mean 67°). Femoral osteotomies were combined with a surgical hip dislocation in 96% for cam resection and labrum or cartilage treatment. Preoperative MRI and 3D-CT with dynamic impingement simulation were evaluated.

Results:

(1) The posterior impingement test decreased significantly from preoperatively 100% to 4% ( p  < 0.001). External rotation in extension increased significantly ( p  < 0.001) from preoperative 16° ± 8 to 44° ± 16°. The MdA score increased significantly from 14 ± 1 to 16 ± 2 ( p  < 0.001) points. (2) At follow-up, all 25 hips were preserved. No conversion to THA and no revision osteosynthesis was performed. 64% underwent complete hardware removal. (3) 80% of the patients reported at follow-up that they would undergo surgery again. Subjective satisfaction (SHV) increased significantly ( p  < 0.001) from preoperatively 24% to 84% postoperatively.

Conclusions:

Femoral derotation subtrochanteric osteotomies for the treatment of posterior extraarticular ischiofemoral hip impingement are safe and improve posterior hip pain and function and external rotation in mostly female patients with high femoral version and a high McKibbin instability index.
Neurogenic Orthostatic Hypotension: State of the Art and Therapeutic Strategies
Authors: Kalra Dinesh K , Raina Anvi , Sohal Sumit
Published: August 2020

Neurogenic orthostatic hypotension (nOH) is a subtype of orthostatic hypotension in which patients have impaired regulation of standing blood pressure due to autonomic dysfunction. Several primary and secondary causes of this disease exist. Patients may present with an array of symptoms making diagnosis difficult. This review article addresses the epidemiology, pathophysiology, causes, clinical features, and management of nOH. We highlight various pharmacological and non-pharmacological approaches to treatment, and review the recent guidelines and our approach to nOH.
Central Venous Catheter Thrombosis in Cancer: A Multi-Centre Retrospective Study Investigating Risk Factors and Contemporary Trends in Management
Authors: Haggstrom Lucy , Parmar Gurdeep , Brungs Daniel
Published: August 2020

Objectives:

Central venous access is needed to facilitate chemotherapy for many cancer patients. Central venous catheter-related thrombosis (CVCT) is a major complication that can cause significant morbidity and mortality. We sought to explore the rate of CVCT in a general cancer population in Australia and to identify factors associated with increased risk of thrombosis.

Design:

This is a multi-centre retrospective cohort study.

Setting and participants:

We analysed key patient, treatment, and cancer-related factors for 317 patients with cancer and central venous catheters inserted for systemic therapy.

Main outcome measures:

Symptomatic CVCT confirmed with imaging and management of patients with CVCT.

Results:

A total of 402 cases of central line insertion were analysed. Central venous catheter-related thrombosis occurred in 24 patients (6.0%). Having a peripherally inserted central catheter (PICC; HR = 3.78, 95% CI = 1.28-11.19, P = .02) compared with an implantable port and a body mass index of ⩾25.0 kg/m2 (HR = 3.60, 95% CI = 1.31-9.85, P = .01) were independently associated with increased risk of thrombosis. Central venous catheter-related thrombosis was managed mostly with removal of the catheter (19 of 24 cases) and anticoagulation, including direct-acting oral anticoagulants in 5 patients.

Conclusions:

This work explored rates of CVCT in a general cancer population, observing increased rates in those with PICCs or increased body mass index.
Implementation of Dynamic Lycra® Orthoses for Arm Rehabilitation in the Context of a Randomised Controlled Feasibility Trial in Stroke: A Qualitative study Using Normalisation Process Theory
Authors: Delvaux Joke , John Alexandra , Wedderburn Lucy , Morris Jacqui
Published: August 2020

Objective:

To explore how non-research funded rehabilitation practitioners implemented dynamic Lycra® orthoses for arm recovery after stroke into rehabilitation practice, as part of a feasibility randomised controlled trial.

Design:

Qualitative interview study.

Setting:

Two in-patient stroke units and associated rehabilitation units.

Subjects:

Fifteen purposefully selected stroke rehabilitation practitioners involved in delivery of dynamic Lycra® orthoses as part of a feasibility randomised controlled trial.

Methods:

Semi-structured interviews conducted at the end of the trial. Interviews examined their experiences of orthosis implementation. Normalisation Process Theory structured the interview guide and informed data analysis. NVivo software supported data analysis.

Results:

Practitioners intuitively made sense of the intervention in the face of uncertainty about its precise mechanisms of action (Normalisation Process Theory construct: coherence) and espoused commitment to the research, despite uncertainty about orthosis effectiveness (cognitive participation). They did however adapt the intervention based on perceived therapeutic need, their own skillsets and stroke survivor preference (collective action). They were uncertain about benefits (reflexive monitoring). Across the 4 theoretical constructs, ambivalence about the intervention was detected.

Conclusions:

Ambivalence interfered with implementation – but only to an extent. ‘Good-enough’ coherence, cognitive participation, collective action and reflexive monitoring were sufficient to initiate normalisation – as long as implementation did not undermine the relationship between practitioner and stroke survivor. Ambivalence stemmed from practitioners’ uncertainty about the intervention theory and mechanisms of action. Making intervention mechanisms of action more explicit to practitioners may influence how they implement and adapt a research intervention, and may determine whether those processes undermine or enhance outcomes.
The Incidence and Prevalence of Uveitis in Psoriasis: A Systematic Review and Meta-Analysis
Authors: Lam Megan , Steen Jeremy , Lu Justin Di , Vender Ronald
Published: August 2020

Background

The systemic effects and comorbidities of psoriasis include ocular disorders, such as uveitis. Patients with psoriatic arthritis in particular have been demonstrated to have an elevated risk for developing uveitis. Presently, the risk of uveitis in psoriasis has yet to be fully elucidated and this systematic review seeks to address this gap.

Objective

To examine the prevalence and incidence of uveitis in psoriasis patients compared to non-psoriasis patients.

Methods

We conducted a systematic review search on MEDLINE, Embase, and CENTRAL electronic databases with no lower limit on year of publication.

Results

Fourteen articles met our inclusion criteria, with a total of 234 143 psoriasis subjects. Two studies found that participants with severe psoriasis were at a greater risk of uveitis than those with mild psoriasis. A random-effects meta-analysis of the 3 studies, which reported risk of incidence of uveitis in psoriasis patients compared to non-psoriasis controls, found a pooled risk ratio of 1.29 (95% CI, 1.10-1.51), indicating an increased risk of uveitis in psoriasis. Three studies compared risk of uveitis in psoriatic arthritis with psoriasis-only participants, all finding that psoriatic arthritis was associated with a greater risk of uveitis.

Conclusions

In summary, our findings suggest that psoriasis is associated with an increased risk of uveitis, with or without psoriatic arthritis.
The reliability of language-switch costs in bilingual one- and two-digit number naming
Authors: Contreras-Saavedra Carla E , Koch Iring , Schuch Stefanie , Philipp Andrea M
Published: August 2020

Aims and objectives/purpose/research questions:

Language-switch costs, which denote worse performance in language-switch than in language-repetition trials, appear to be a robust finding in bilingual language switching. The aim of the present study was to examine the intraindividual reliability of language-switch costs by means of a number-naming task with German-English bilinguals.

Design/methodology/approach:

In a cued language-switching paradigm, participants ( n = 36) switched between German and English. They performed a number-naming task in three different conditions: one-digit numbers; two-digit numbers with decade 10; and two-digit numbers with decade 20.

Data and analysis:

We examined the experimental effects with an analysis of variance (reaction time and error rate as the dependent variables), using trial language, language sequence and number condition as independent variables. In addition, we calculated the split-half reliability of language-switch costs (across all conditions) as well as the correlations of language-switch costs between the different conditions.

Findings/conclusions:

While significant language-switch costs emerged in all three number conditions, our results demonstrate a medium-sized correlation between the three experimental conditions. The split-half reliability shows a moderate to strong correlation between the odd- and even-numbered trials in the experiment.

Originality:

On the one hand, the present study extends the observation of language-switch costs from one-digit number naming to the more complex naming of two-digit numbers. On the other hand, and theoretically even more important, we explored the reliability of language-switch costs in a bilingual number-naming task by calculating both split-half reliability and correlations between different number conditions.

Significance/implications:

The results indicated that while language-switch costs are a robust experimental effect on the group level, they appear to be less well suited for correlational approaches. This also suggests that caution should be exerted when language-switch costs are used to diagnose the ability of an individual to perform language control.
Three-Year Results of the IN.PACT SFA Japan Trial Comparing Drug-Coated Balloons With Percutaneous Transluminal Angioplasty
Authors: Soga Yoshimitsu , Iida Osamu , Urasawa Kazushi , Saito Shigeru , Jaff Michael R. , Wang Hong , Ookubo Hiroko , Yokoi Hiroyoshi
Published: August 2020

Purpose:

To evaluate the 3-year safety and effectiveness of the MDT-2113 (IN.PACT Admiral) drug-coated balloon (DCB) vs percutaneous transluminal angioplasty (PTA) in a Japanese population with femoropopliteal occlusive disease.

Materials and Methods:

The multicenter, prospective, IN.PACT SFA Japan randomized controlled trial ( ClinicalTrials.gov identifier NCT01947478) was an independently adjudicated study evaluating Japanese participants randomized 2:1 to DCB (n=68) or PTA (n=32). The effectiveness endpoint was primary patency through 36 months, defined as freedom from clinically-driven target lesion revascularization (CD-TLR) and freedom from restenosis (by duplex ultrasound). The effectiveness endpoint was evaluated using the Kaplan-Meier method; estimates are presented with the 95% confidence intervals (CIs). The safety composite endpoint was freedom from device- and procedure-related death through 30 days and freedom from major target limb amputation and clinically-driven target vessel revascularization through 36 months.

Results:

Primary patency by Kaplan-Meier estimate was higher in the DCB group (68.9%, 95% CI 57.5% to 80.2%) vs the PTA group (46.9%, 95% CI 29.6% to 64.2%) at 36 months (log-rank p=0.001). The CD-TLR rates were 14.9% (10/67) for the DCB group and 20.7% (6/29) for PTA (p=0.554). The safety composite endpoint occurred in 83.6% (56/67) of DCB participants and 75.9% (22/29) of PTA participants (p=0.402). All-cause death was similar between groups at 36 months [DCB 6.0% (4/67) vs PTA 6.9% (2/29), p>0.999), with no device- or procedure-related deaths in either group.

Conclusion:

The final report of the IN.PACT SFA Japan trial showed that the IN.PACT Admiral DCB is safe and had durable outcomes through 3 years in Japanese participants with femoropopliteal occlusive disease.
Comparison of Cerebral Embolic Events Between Right and Left Upper Extremity Access During Fenestrated/Branched Endovascular Aortic Repair
Authors: Mirza Aleem K. , Tenorio Emanuel R. , Marcondes Giulianna B. , Lima Guilherme B. B. , Macedo Thanila A. , Mendes Bernardo C. , Oderich Gustavo S.
Published: August 2020

Purpose:

To evaluate the incidence and outcomes of cerebral embolic events when using right (RUE) vs left upper extremity (LUE) access for fenestrated/branched endovascular aneurysm repair (f/bEVAR).

Materials and Methods:

A retrospective review was conducted of 290 consecutive patients enrolled in a physician-sponsored Investigational Device Exemption study to evaluate f/bEVAR between 2013 and 2018. Of these, 270 patients (93%) had an upper extremity access with 12-F sheaths, including 205 patients (mean age 75±8 years; 147 men) with LUE and 65 patients (mean age 73±8 years; 42 men) with RUE access. Outcome measures were technical success, procedural metrics, major adverse events (MAEs), any stroke or transient ischemic attack (TIA), and mortality.

Results:

Technical success was higher (p=0.04) for LUE (99.6%) vs RUE access (98.4%). Patients treated via RUE access more often had extent I-III thoracoabdominal aortic aneurysms (57% vs 39%, p=0.03). Procedural metrics were similar for LUE vs RUE sides, including endovascular time (255±80 vs 246±83 minutes, respectively; p=0.23), fluoroscopy time (84±32 vs 90±35 minutes, respectively; p=0.80), and contrast volume (156±57 vs 153±56 mL, respectively; p=0.82). Total radiation exposure was significantly higher for LUE vs RUE access (2463±1912 vs 1757±1494 mGy, respectively; p=0.02). There were 2 deaths (1%) at 30 days or during hospital admission, both unrelated to access site complications. MAEs occurred in 32% of patients who had LUE and 26% of those who had RUE access (p=0.44). Five patients (2%) had embolic stroke and none had TIA. Embolic strokes were ipsilateral to the access side in 4 patients and affected the posterior circulation in 3. Two patients (1%) had hemorrhagic strokes. The incidence of stroke was 3% for LUE and 2% for RUE access (p>0.99).

Conclusion:

Fenestrated/branched stent-graft repair was associated with low rates of cerebral embolic events and no significant difference between the right vs left upper extremity approach.
A Review of Therapeutic Effects and the Pharmacological Molecular Mechanisms of Chinese Medicine Weifuchun in Treating Precancerous Gastric Conditions
Authors: Gu Zhijian , Ling Jianghong , Cong Jun , Li Dan
Published: August 2020

Patients with precancerous gastric conditions are at a high risk for gastric carcinoma. The Chinese medicine Weifuchun (WFC) is used in treating chronic superficial gastritis and in postoperative adjuvant treatment of gastric cancer. Both monotherapy and combination therapy of WFC with other drugs can result in a favorable therapeutic outcome. WFC can dramatically improve clinical outcomes in patients with gastric precancerous lesions by targeting multiple pathways including pathways involved in the pharmacological action of Radix Ginseng Rubra (red ginseng), Rabdosia amethystoides, and fried Fructus Aurantii, including regulation of NF-κB, RUNX3/TGF-beta/Smad, Hedgehog (Hh) and Wnt signaling pathways, modulation of the expression of oncogenes and tumor suppressor genes, and indirect inhibition of Helicobacter pylori (Hp) by maintaining gastric microbial ecosystem. In this review, we will discuss the clinical efficacy and therapeutic regimen of WFC for gastric precancerous lesions and the molecular mechanisms involved. This review will highlight WFC-based therapeutic strategies in disrupting progress to gastric cancer and provide more information on the pharmacological mechanisms of WFC and its clinical application for the treatment of precancerous gastric lesions.
Evaluation of Imaging Windows for Tau PET Imaging Using 18F-PI2620 in Cognitively Normal Individuals, Mild Cognitive Impairment, and Alzheimer’s Disease Patients
Authors: Chotipanich Chanisa , Nivorn Monchaya , Kunawudhi Anchisa , Promteangtrong Chetsadaporn , Boonkawin Natphimol , Jantarato Attapon
Published: August 2020

Background:

The study aimed to evaluate the appropriate uptake-timing in cognitively normal individuals, mild cognitive impairment (MCI), and Alzheimer’s disease (AD) patients, using 18F-PI 2620 dynamic PET acquisition.

Methods:

Thirty-four MCI patients, 6 AD patients, and 24 cognitively normal individuals were enrolled in this study. A dynamic 18F-PI 2620 PET study was conducted at 30-75 minutes post-injection in these groups. Co-registration was applied between the dynamic acquisition PET and T1-weighted MRI to delineate various cortical regions. The standardized uptake value ratio (SUVR) was used for quantitative analysis. P-mod software with the Automated Anatomical Labeling (AAL)-merged atlas was employed to generate automatic volumes of interest for 11 brain regions.

Results:

The curves in most brain regions presented an average SUVR stability at 30-40 minutes post-injection in each group. The appropriate uptake-timing interval of 18F-PI 2620 was 30-75 minutes post injection for AD group and 30-40 minutes post injection for both cognitively normal individuals and MCI groups.

Conclusion:

Short uptake time around 30-40 minutes post-injection would be more comfortable and convenient for all patients, especially in those with dementia who were unable to stay motionless for long periods of scanning time in the scanner.
Left Anterior Thoracotomy Minimally Invasive Aortic Valve Replacement Following Left Pneumonectomy
Authors: Mace James E. , Vardas Panos N. , Lewis Clifton T. , Eudailey Kyle W.
Published: August 2020

We report the case of a 59-year-old man referred for aortic valve replacement for severe, symptomatic aortic insufficiency who underwent a minimally invasive left anterior thoracotomy aortic valve replacement. This approach was facilitated by his history of a left pneumonectomy for lung cancer 7 years prior to presentation, which resulted in a significant left mediastinal shift. The cannulation strategy and exposure were analogous to what would be expected from a standard right anterior thoracotomy minimally invasive aortic valve replacement. The minimally invasive approach allowed for early extubation and mobilization in a patient with moderate baseline pulmonary dysfunction.
An Alternative Technique of Off-Pump Glenn Procedure
Authors: Kumar Rupesh , Barwad Parag W. , Mandal Banashree
Published: August 2020

The bidirectional Glenn surgery is a life-saving palliative surgery in patients with univentricular cardiac anatomy and physiology. This procedure can be performed either under cardiopulmonary bypass (CPB) or off CPB. In this article, we will present a new innovative technique, which was performed on 6 individuals of age ranging from 2 to 18 years and followed up over a few months, which is effective, less morbid, as well as simple, safe, economically more viable, and is easily reproducible.