bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk and Survival of Third Primary Cancers in a Population-Based Cohort of Breast Cancer Patients
Authors: Morais Samantha , Gonçalves Elisabete , Fontes Filipa , Rodrigues Jéssica , Calisto Rita , Bento Maria José , Lunet Nuno
Published: January 2022

Introduction: The growing number of women diagnosed with breast cancer (BCa) together with high survival has resulted in an increasing population of survivors at risk of subsequent primary cancers. This study aimed to estimate the long-term risk and survival of third primary cancers (TPCs) among females with a first primary BCa. Methods: Breast first primary cancers (FPCs) from the Portuguese North Region Cancer Registry, diagnosed between 2000 and 2010 (n = 15,981), were followed for a TPC (December 31, 2015) and death from any cause (June 30, 2021). The cumulative incidence of and mortality among TPCs were estimated. To compare survival, female patients with a TPC were matched (1:1, by age group, years between FPC and second primary cancer [SPC] diagnosis, and SPC location) to FPC + SPC patients without a TPC. Results: Overall, 67 (0.4% of FPCs and 5.4% of SPCs) TPCs were diagnosed. The most common TPC sites were digestive, breast, and female genital organs. Among all FPCs, the 15-year cumulative incidence (95% confidence interval [CI]) of a TPC was 0.69% (0.47–0.90%) and among SPCs, 7.21% (4.99–9.43%). The 15-year cumulative mortality of TPCs and matched patients was 70.0% and 51.5%, respectively. For TPCs, compared to matched SPC only patients, the age-adjusted hazard ratio (95% CI) for death was 2.86 (1.61–5.07). Discussion/Conclusion: The most common TPC sites were digestive, breast, and female genital organs, with a 15-year cumulative incidence of 0.69% among FPCs. TPCs had a worse long-term survival compared to patients with an SPC only.
Helicobacter pylori
Infection Is Associated With Carotid Intima and Media Thickening: A Systematic Review and Meta‐Analysis
Authors: Simon Orsolya Anna , Görbe Anikó , Hegyi Péter , Szakó Lajos , Oštarijaš Eduard , Dembrovszky Fanni , Kiss Szabolcs , Czopf László , Erőss Bálint , Szabó Imre
Published: January 2022

Background

Helicobacter pylori
(
H. pylori
) infection affects ≈4.4 billion people worldwide. Several studies suggest that this pathogen impacts the digestive system, causing diverse and severe conditions, and results in extragastrointestinal disorders like vascular diseases. Our study aims to examine the association between
H. pylori
infection and carotid intima‐media thickness.

Methods and Results

Electronic databases (MEDLINE, Embase, CENTRAL, Web of Science, and Scopus) were searched for studies, comparing the thickness of the carotid intima‐media in
H. pylori
–infected and noninfected individuals listed until October 20, 2020. Statistical analyses were performed using the random effects meta‐analysis of model of weighted mean differences with the corresponding 95% CI using the DerSimonian and Laird method. The protocol was registered in advance in PROSPERO (International Prospective Register of Systematic Reviews; CRD42021224485). Thirteen studies were found meeting inclusion criteria for our systematic review and meta‐analysis, presenting data on the thickness of the carotid intima‐media considering the presence of
H. pylori
infection. Altogether, 2298 individuals’ data were included (1360
H. pylori
positive, 938 negative). The overall carotid intima‐media thickness was significantly larger among infected patients compared with uninfected participants (weighted mean difference: 0.07 mm; 95% CI, 0.02–0.12;
P
=0.004; I
2
=91.1%;
P
<0.001). In case of the right common carotid artery, the intima‐media thickening was found to be significant as well (weighted mean difference, 0.08 mm; 95% CI, 0.02–0.13,
P
=0.007; I
2
=85.1%;
P
<0.001), while it showed no significance in the left common carotid artery (weighted mean difference, 0.12 mm; 95% CI, −0.05 to 0.28,
P
=0.176; I
2
=97.4%;
P
<0.001).

Conclusions

H. pylori
infection is associated with increased carotid intima‐media thickness. Therefore, the infection may indirectly contribute to the development of major vascular events.
Attention and Locality: On Clause-Boundedness and Its Exceptions in Multiple Sluicing
Authors: Barros Matthew , Frank Robert
Published: January 2022

We provide an account of clause-boundedness in multiple sluicing that also captures its exceptions. Clause-boundedness arises whenever an embedded clause’s subject is not coreferential with a topical discourse referent in the embedding clause. Our account ties clause-boundedness to discourse factors. We discuss implementations that import sensitivity to information structure into the syntax, and compare our approach with recent work—in particular, Grano and Lasnik 2018 and “short source” accounts (most recently, Abels and Dayal 2017, 2021)—and demonstrate that these accounts both under- and overgenerate. The empirical coverage of our account argues against purely syntacticized agreement-based approaches to clause-boundedness.
An Intersectional Perspective on Female Mobility in the Hebrew Bible
Authors: Uusimäki Elisa
Published: January 2022

This article explores literary representations of female mobility in the Hebrew Bible. While it is often assumed that women barely moved in the ancient world, the study shows that the Hebrew Bible gives witness to a vast spectrum of travelling agents. The texts do not offer direct access to socio-historical realities, but as documents of cultural history, they are argued to hint at and echo the variety of the phenomenon in ancient Israel. It is not meaningful to speak of the travelling women as a collective, however, as the motives for their movement are tied to various socioeconomic contexts, ranging from slavery to economic migration to foreign policy. While class is fundamental to ancient female mobility, the sources also reveal the significance of other intersecting differences such as age, sexuality, kinship, ethnicity, or religion displayed by the (in)voluntary travelling agents.
The Quest for Equal Rights: The Women’s Movement in Germany and its Care-based Argumentation
Authors: Dechert Andre , Kinnebrock Susanne
Published: January 2022

Building upon the Three-Level Model of the Public Sphere, we (a) analyse how women’s associations in Germany, both during the Wilhelmine era and in the days of the early Federal Republic of Germany, interlinked women’s care work with demands for equality, and (b) examine the public responses to women’s associations’ use of care as the basis for their argumentation. To accomplish these goals, we discuss the results of a standardised content analysis of three feminist magazines from these two eras (Centralblatt, Welt der Frau, and Informationen für die Frau) and supplement the results with a historical-hermeneutic analysis of selected articles, an approach that provides contextualised and detailed insights. Furthermore, we analyse the corresponding discourse in mass media and politics by focusing on major legislative changes and presenting the results of our hermeneutic analysis of selected articles from two periodicals with a strong focus on socio-political issues (Die Hilfe and Der Spiegel).
The first complete specimen of the deep-water shrimp Batella praecipua De Grave, 2004 (Crustacea: Decapoda: Alpheidae)
Authors: ASHRAFI HOSSEIN , ĎURIŠ ZDENĚK , ANKER ARTHUR
Published: January 2022

The deep-water alpheid shrimp Batella praecipua De Grave, 2004 was originally described based on two incomplete specimens, both with their first chelipeds missing, collected at 400–440 m off New Caledonia. During the recent KANADEEP 1 expedition in the Coral Sea in 2017, the first complete specimen of B. praecipua was collected at a depth of 370–380 m. The morphology of this specimen is presented in detail, with emphasis on the highly diagnostic chelipeds, which are described and illustrated for the first time. A slight intraspecific variation of B. praecipua is reported and a DNA barcode (CO1) is provided for this species. The main differences between the three presently known species of Batella Holthuis, 1955 are discussed.
The Economic Rationale of United States v. Google
Authors: Bet Germán , Blair Roger D. , Donna Javier D.
Published: January 2022

In 2020, the Department of Justice (DOJ) filed an antitrust suit against Google alleging that Google has unlawfully monopolized the markets for general search services, search advertising, and general search text advertising. The complaint raises questions involving market definition, monopoly power, and monopolizing conduct. In this article, we examine these issues through the lens of microeconomic principles. Our analysis finds that there is a sound economic rationale for the DOJ’s complaint.
Design and Implementation of a COVID-19 Case Investigation Program: An Academic–Public Health Partnership, Arizona, 2020
Authors: Ledesma Daniela , Maroofi Hanna , Sabin Susanna , Dennehy Timothy J. , Truong Jasmine M. , Meyer Laura G. , Salik McMillan , Scott Sarah , White Jessica R. , Collins Jennifer , Mrukowicz Christina , Charifson Mia , Shafer Michael S. , Jehn Megan
Published: January 2022

From May through July 2020, Arizona was a global hotspot for new COVID-19 cases. In response to the surge of cases, local public health departments looked for innovative ways to form external partnerships to address their staffing needs. In collaboration with the Maricopa County Department of Public Health, the Arizona State University Student Outbreak Response Team (SORT) created and implemented a virtual call center to conduct public health case investigations for COVID-19. SORT officially launched a dedicated COVID-19 case investigation program after 3 weeks of program design and training. From June 29 through November 8, 2020, SORT recruited and trained 218 case investigators, completed 5000 case patient interviews, and closed 10 000 cases. Our team also developed process improvements to address disparities in case investigation timeliness. A strong infrastructure designed to accommodate remote case investigations, paired with a large workforce, enabled SORT to provide additional surge capacity for the county’s high volume of cases. University-driven multidisciplinary case investigator teams working in partnership with state, tribal, and local public health staff members can be an effective tool for supporting a diverse and growing public health workforce. We discuss the essential design factors involved in building a university program to complement local COVID-19 response efforts, including workflows for case management, volunteer case investigator recruitment and training, secure technology platforms for conducting case investigations remotely, and robust data-tracking procedures for maintaining quality control and timely case reporting.
A New Approach to Detecting Cheating in Sensitive Surveys: The Cheating Detection Triangular Model
Authors: Meisters Julia , Hoffmann Adrian , Musch Jochen
Published: January 2022

Indirect questioning techniques such as the randomized response technique aim to control social desirability bias in surveys of sensitive topics. To improve upon previous indirect questioning techniques, we propose the new Cheating Detection Triangular Model. Similar to the Cheating Detection Model, it includes a mechanism for detecting instruction non-adherence, and similar to the Triangular Model, it uses simplified instructions to improve respondents’ understanding of the procedure. Based on a comparison with the known prevalence of a sensitive attribute serving as external criterion, we report the first individual-level validation of the Cheating Detection Model, the Triangular Model and the Cheating Detection Triangular Model. Moreover, the sensitivity and specificity of all models was assessed, as well as the respondents’ subjective evaluation of all questioning technique formats. Based on our results, the Cheating Detection Triangular Model appears to be the best choice among the investigated indirect questioning techniques.
Rare complication of ureteral double-J stenting after ureteroscopy: pelvic ectopic renal parenchymal perforation
Authors: Huang Chaoyou , Liu Junbo , Mao Juan , Yu Luolian , Gong Lifeng , Lai Fei
Published: January 2022

Scarce data are available on pelvic ectopic renal parenchymal perforation. However, this complication might lead to serious consequences. Clinicians should pay attention to the early identification and treatment of this complication. We herein report the first case of pelvic ectopic renal parenchymal perforation caused by a double-J stent after ureteroscopy. Compared with previously reported cases of renal parenchymal perforation not involving an ectopic kidney, our case involved no renal capsule hematoma and no other serious complications. Our primary management strategy was to review relevant examinations and tests, perform close monitoring, and instruct the patient to stay in bed. The patient recovered smoothly after the ureteral stent was removed 1 month postoperatively.
Departure Timing Preference during Extreme Weather Events: Evidence from Hurricane Evacuation Behavior
Authors: Jiang Fan , Meng Sisi , Halim Nafisa , Mozumder Pallab
Published: January 2022

Hurricane evacuation has become an increasingly complicated activity in the U.S. as it involves moving many people who live along the Atlantic coast and Gulf coast within a very limited time. A good deal of research has been conducted on hurricane evacuation, but only a limited number of studies have looked into the timing aspect of evacuation. This paper intends to contribute to the literature on evacuation timing decisions by investigating what factors influence the time preference at the household level. Two hurricane survey data sets were used to analyze household evacuation behaviors across the Gulf coast as well as the Northeast and Mid-Atlantic coast in a comparative perspective. Using the Heckman selection model, we examined various factors identified in the literature on the two possible outcomes (evacuation and early evacuation). We found that the most important determinants of evacuation were prior evacuation experience, evacuation orders, and risk perceptions, while the most important determinants of early evacuation were prior evacuation experiences, days spent at the evacuation destination, and the cost of evacuation. Socioeconomic factors also influenced the two decisions but differently. These results provide implications for future hurricane evacuation planning and for improving emergency management practices.
Papilledema: A Review of the Pathophysiology, Imaging Findings, and Mimics
Authors: Guarnizo Angela , Albreiki Danah , Cruz Juan Pablo , Létourneau-Guillon Laurent , Iancu Dana , Torres Carlos
Published: January 2022

Increased intracranial pressure is the most common cause of papilledema. Multiple etiologies such as cerebral edema, hydrocephalus, space occupying lesions, infection, and idiopathic intracranial hypertension among others should be considered. Imaging plays a critical role in the detection of pathologies that can cause papilledema. MRI with contrast and CE-MRV, in particular, are key for the diagnosis of idiopathic intracranial hypertension. This review will focus in common and infrequent causes of papilledema, the role of imaging in patients with papilledema as well as its potential mimickers.
Disparities in the Diagnosis, Treatment, and Survival Rate of Cervical Cancer among Women with and without Disabilities
Authors: Choi Jin Young , Yeob Kyoung Eun , Hong Seung Hwa , Kim So Young , Jeong Eun-Hwan , Shin Dong Wook , Park Jong Heon , Kang Gil-won , Kim Hak Soon , Park Jong Hyock , Kawachi Ichiro
Published: January 2022

Introduction

Not much is known regarding the disparities in cancer care between women with and without disabilities.

Objectives

The aim of this study was to investigate the potential disparities in the diagnosis, treatment, and survival of women with cervical cancer with and without disabilities.

Methods

We performed a retrospective cohort study and linked the National Disability Database, Korean Central Cancer Registry, and Korean National Health Insurance claims database. Charlson comorbidity index was used for adjusting the comorbidity. The study population comprised 3 185 women with disabilities (physical/brain, communication, mental, cardiopulmonary, and other impairment) who were diagnosed with cervical cancer and 13 582 age- and sex-matched women without disability who were diagnosed with cervical cancer for comparison.

Results

Distant metastatic stage (7.7% vs 3.7%) and unknown stage (16.1% vs 7.0%) were more common in cervical cancer women with grade 1 disabilities, compared with women without disabilities. Women with cervical cancer with disabilities were less likely to undergo surgery (adjusted odds ratio (aOR) 0.81, 95% confidence interval (CI) 0.73–0.90) or chemotherapy (aOR 0.86, 95% CI 0.77–0.97). Lower rate of surgery was more evident in patients with physical/brain impairment (aOR 0.46, 95% CI 0.37–0.58) and severe mental impairment (aOR 0.57, 95% CI 0.41–0.81). The overall mortality risk was also higher in patients with disabilities (adjusted hazard ratio (aHR) 1.36, 95% CI 1.25–1.48).

Conclusion

Women with cervical cancer with disabilities, especially with severe disabilities, were diagnosed at later stages, received less treatment, and had higher mortality rates, compared with patients who lacked disabilities. Social support and policies, along with education for women with disabilities, their families, and healthcare professionals, are needed to improve these disparities.
Glutaminolysis and the Control of Neural Progenitors in Neocortical Development and Evolution
Authors: Gkini Vasiliki , Namba Takashi
Published: January 2022

Multiple types of neural progenitor cells (NPCs) contribute to the development of the neocortex, a brain region responsible for our higher cognitive abilities. Proliferative capacity of NPCs varies among NPC types, developmental stages, and species. The higher proliferative capacity of NPCs in the developing human neocortex is thought to be a major contributing factor why humans have the most expanded neocortex within primates. Recent studies have shed light on the importance of cell metabolism in the neocortical NPC proliferative capacity. Specifically, glutaminolysis, a metabolic pathway that converts glutamine to glutamate and then to α-ketoglutarate, has been shown to play a critical role in human NPCs, both in apical and basal progenitors. In this review, we summarize our current knowledge of NPC metabolism, focusing especially on glutaminolysis, and discuss the role of NPC metabolism in neocortical development, evolution, and neurodevelopmental disorders, providing a broader perspective on a newly emerging research field.
Exploring outcome measures with cognitive stimulation therapies and how these relate to the experiences of people with dementia: A narrative literature review
Authors: Ward Alison R , Thoft Diana Schack , Lykkegaard Sørensen Ann
Published: January 2022

A narrative literature review was undertaken to consider the outcome measures used in research on cognitive stimulation therapy (CST), cognitive training (CT) and cognitive stimulation (CS) interventions. This review extends findings from previous reviews by including a broad range of study methodologies, both qualitative and quantitative, and explored whether participant experiences of taking part in the research are discussed. A database search identified 1261 articles matching the search criteria, with 29 included in this review. Studies tended to use the manualised CST model, with 11 other models identified. Randomised control trials were chosen as the most used method to explore impact. Across the studies, 65 different outcome measures were used with people with dementia, and only four studies used a qualitative approach. Little information is provided on the assessment process in terms of time taken, assessor, or of the experience of the person with dementia. There is heterogeneity of measures used, within and across domains, and number, and agreement or consistency of measures would provide greater comparability across CS studies. Gaps in reporting were noted on the detail of the assessment process and the experience of people with dementia taking part in this research.
Generation of a tendon-like tissue from human iPS cells
Authors: Tsutsumi Hiroki , Kurimoto Ryota , Nakamichi Ryo , Chiba Tomoki , Matsushima Takahide , Fujii Yuta , Sanada Risa , Kato Tomomi , Shishido Kana , Sakamaki Yuriko , Kimura Tsuyoshi , Kishida Akio , Asahara Hiroshi
Published: January 2022

Tendons and ligaments are essential connective tissues that connect the muscle and bone. Their recovery from injuries is known to be poor, highlighting the crucial need for an effective therapy. A few reports have described the development of artificial ligaments with sufficient strength from human cells. In this study, we successfully generated a tendon-like tissue (bio-tendon) using human induced pluripotent stem cells (iPSCs). We first differentiated human iPSCs into mesenchymal stem cells (iPSC-MSCs) and transfected them with Mohawk (Mkx) to obtain Mkx-iPSC-MSCs, which were applied to a newly designed chamber with a mechanical stretch incubation system. The embedded Mkx-iPSC-MSCs created bio-tendons and exhibited an aligned extracellular matrix structure. Transplantation of the bio-tendons into a mouse Achilles tendon rupture model showed host-derived cell infiltration with improved histological score and biomechanical properties. Taken together, the bio-tendon generated in this study has potential clinical applications for tendon/ligament-related injuries and diseases.
Duplex ultrasound derived maximal systolic acceleration can be a reliable and rapid alternative to ankle brachial pressure indices for the diabetic population with lower extremity arterial disease; a prospective, observational cohort study
Authors: Williamson Hannah Michelle , Bartlett Matthew , Desai Mital
Published: January 2022

Objectives: Ankle brachial pressure index (ABPI) is limited for diabetic patients. This can have costly impacts upon patient's quality of life along with healthcare budgets, with diabetic care equating to approximately 10% of NHS expenditure.11 We aimed to determine whether ultrasound waveform parameters are an alternative for quantifying lower extremity peripheral arterial disease (PAD) where ABPI is unreliable. Design: This was a prospective, observational study. Waveform parameters, systolic rise time (SRT), maximal systolic acceleration (AccMax) and peak systolic velocity (PSV) were recorded at ankle and compared to the ABPI and an aorta-ankle duplex ultrasound scan (DUS) as gold standard. Setting: Measurements were obtained by a Clinical Vascular Scientist at the Royal Free Hospital. Participants: Participants (≥18yrs) with known PAD, but without previous vascular intervention were allocated to non-diabetic control ( n = 24) and diabetic test groups ( n = 22). Outcome measures: The primary outcome measure was the correlation of novel ultrasound derived indices to PAD severity. The secondary outcome was the efficacy of this correlation in the diabetic population. Results: AccMax was most powerful in detecting PAD in both groups when compared to ABPI in the controls ( r = 0.805; p < 0.01) and to DUS in control and test groups ( r = −0.633 to −0.643; p < 0.01). In the test group, PSV did not consistently quantify PAD. SRT measurements were inconclusive throughout. Conclusion: AccMax is a rapid alternative tool for diagnosing PAD in diabetic patients. With further research, this simple test may prove useful for monitoring PAD progression in patients unsuitable for ABPI, reducing the need for lengthy repeat duplex scans.
A 15-year-old with chest pain: An unexpected etiology
Authors: Loza Samantha , Tallman Brandon , Hanson Keith , Rainey Shane
Published: January 2022

A 15-year-old female with no significant past medical history presented to the emergency department with 1 day of substernal and pleuritic chest pain, chills, cough, and hematuria. She also had swelling of the face and ankles that resolved by presentation. She was found to have elevated troponin and brain natriuretic peptide during initial workup. Electrocardiogram was normal, but there were significant pleural effusions on chest x-ray. She was strep positive and had blood pressure up to 150/90, prompting admission for cardiac monitoring and cardiology consultation. Blood pressure decreased down to 125/72 without intervention. She was afebrile with unlabored breathing and normal saturations. She was clear to auscultation bilaterally, with no abdominal distension or hepatosplenomegaly, and edema was not evident on exam. There was mild erythema to the bilateral tonsillar pillars. Initial considerations included viral myocarditis, pericarditis, and atypical nephritic syndrome. Workup revealed elevated antistreptolysin antibodies, low C3 complement, negative antineutrophil cytoplasmic antibodies, and negative flu testing. Renal sonography was unremarkable. Cardiology recommended echocardiography, which confirmed pleural effusions but revealed no cardiac abnormalities. Urinalysis revealed hematuria and mild proteinuria. Diagnosis was found to be post-streptococcal glomerulonephritis complicated by fluid overload and left ventricular strain secondary to hypertensive emergency. Post-streptococcal glomerulonephritis is the most common cause of acute glomerulonephritis in children. The mechanism of disease is a proliferation and inflammation of the renal glomeruli secondary to immunologic injury, with deposition of immune complexes, neutrophils, macrophages, and C3 after complement activation. This leads to hematuria, proteinuria, and fluid overload. Edema is present in 65%–90% of patients, progressing to pulmonary involvement in severe cases. Cardiac dysfunction secondary to fluid overload is a potentially fatal outcome in the acute setting. Physicians should consider post-streptococcal glomerulonephritis for patients presenting with hypertension, cardiac/pulmonary pathology, or symptoms of acute heart failure in the context of strep infection.
Facilitators and barriers to using telepresence robots in aged care settings: A scoping review
Authors: Hung Lillian , Wong Joey , Smith Chelsea , Berndt Annette , Gregorio Mario , Horne Neil , Jackson Lynn , Mann Jim , Wada Mineko , Young Erika
Published: January 2022

Social isolation has been a significant issue in aged care settings, particularly during the COVID-19 pandemic, and is associated with adverse outcomes, including loneliness, depression, and cognitive decline. While robotic assistance may help mitigate social isolation, it would be helpful to know how to adopt technology in aged care. This scoping review aims to explore facilitators and barriers to the implementation of telepresence robots in aged care settings. Following the Joanna Briggs Institute scoping review methodology and the PRISMA extension for scoping reviews reporting guidelines, we searched relevant peer-reviewed studies through eight databases: CINAHL, MEDLINE, Cochrane, PsychINFO (EBSCO), Web of Science, ProQuest Dissertations and Theses Global, IEEE Xplore, and ACM Digital Library. Google was used to search gray literature, including descriptive, evaluative, quantitative, and qualitative designs. Eligibility includes: studies with people aged 65 years and older who interacted with a telepresence robot in a care setting, and articles written in English. We conducted a thematic analysis to summarize the evidence based on the constructs in the Consolidated Framework of Implementation Research. Of 1183 articles retrieved, 13 were included in the final review. The analysis yielded three themes: relative advantages, perceived risks and problems, and contextual considerations. The key facilitators to telepresence robot adoption are as follows: a feeling of physical presence, ease of use, mobility, and training. The barriers to implementation are as follows: cost, privacy issues, internet connectivity, and workflow. Future research should investigate the role of leadership support in implementation and practical strategies to overcome barriers to technology adoption in aged care settings.
Early detection of recurrent lung cancer: Enhancing-nodule in post-radiation fibrosis
Authors: Saha Rituparna , Ryan David , Hanrahan Emer , Dodd Jonathan D
Published: January 2022

Early detection of lung cancer recurrence on imaging is critical for better clinical prognosis. The ‘enhancing nodule in post-radiation fibrosis sign’ is an important sign which helps detect recurrent lung cancer early on CT chest.
Promoting Sustainable Financial Services Through the Adoption of eWallet Among Malaysian Working Adults
Authors: Che Nawi Noorshella , Mamun Abdullah Al , Hayat Naeem , Seduram Linda
Published: January 2022

This study investigated the effect of perceived usefulness, perceived ease of use, social influence, facilitating conditions, compatibility, and perceived trust on the intention and adoption of electronic wallet (eWallet) among working adults in Malaysia. The cross-sectional research design was adopted to gather quantitative data from 1,156 working adults via Google form link shared across the social media platform. The collected data were analyzed with partial least square structural equation modeling (PLS-SEM) tool using SmartPLS 3.1. The study outcomes revealed that perceived usefulness, perceived ease of use, facilitating conditions, compatibility, and perceived trust displayed significantly positive effect on both the intention to use and the adoption of eWallet. Additionally, the intention to use eWallet mediated the relationships of perceived usefulness, perceived ease of use, social influence, facilitating conditions, compatibility, and perceived trust with adoption to use eWallet. Household income significantly moderated the relationship between compatibility and intention to use eWallet. eWallet service providers and financial development policy making in Malaysia should focus on promoting the application of eWallet to uplift its social influence, besides enhancing consumer security to harness the adoption of eWallet amidst the public. Essentially, the intention-behavior gap needs to be bridged by exploring new factors that can affect the behavior.
The Impact of Prior Bariatric Surgery on Outcomes After Spine Surgery: A Systematic Review and meta-Analysis
Authors: Alhammoud Abduljabbar , Dalal Sidhant , Sheha Evan D. , Habibullah Nilofer Khan , Moghamis Isam Sami , Virk Sohrab , Gang Catherine Himo , Qureshi Sheeraz A
Published: January 2022

Study design

Systematic review and meta-analysis.

Objective

To compare outcomes and complication rates in patients undergoing bariatric surgery (BS) prior to spine surgery.

Methods

A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines comparing the outcomes of spine surgery between subjects with prior bariatric surgery to those who were considered obese with no prior bariatric surgery.

Results

A total of 183, 570 patients were included in the 4 studies meeting inclusion criteria. The mean patient age was 52.9 years, and the majority were female (68%). The two groups consisted of a total of 36, 876 patients with prior BS and 146, 694 obese patients without prior BS. The overall rate of complications in the prior BS group was 6.4% (4.5%–38.7%) compared to 11.9% (11.2%–55.4%) in the non-prior BS obese group with a statistically significant difference between the two groups. The prior BS group had lower rates of renal, neurological, and thromboembolic complications, with a lower mortality and readmission rate. In a subgroup undergoing cervical spine surgery, patients with prior BS had fewer cardiac, GI, and total complications. For patients undergoing thoracolumbar spine surgery, patients with prior BS had fewer thromboembolic and total complications.

Conclusion

Patients undergoing bariatric surgery prior to spine surgery had fewer renal, neurological, and thromboembolic complications as well as a decreased mortality and readmission rate.
Comparison of Suture-Button Fixation with Suture-Tape Augmentation and Trans-Syndesmotic Screw Fixation for Syndemosis Injury: A Biomechanical Study
Authors: Lee Hong Seop , Lee Hong S. , Young Ki Won , Lee Young Koo , Kim Woo Jong
Published: January 2022

Category:

Ankle; Basic Sciences/Biologics

Introduction/Purpose:

The treatment of syndesmotic injuries with ankle fractures is controversial. The purpose of this study was to compare the biomechanical properties of suture-button fixation with suture-tape augmentation with those of screw fixation.

Methods:

Ten matched pairs of human cadaver specimens were subjected to suture-button fixation with suture-tape augmentation or screw fixation. Each specimen underwent initial intact physiologic loading, consisting of 10 cycles of axial loading with peak of 750N, 10 cycles of external torsional loading with peak of 7.5Nm, and 10 cycles of combined axial and external torsional loading with peak of 750N and 7.5Nm at 0.05 Hz. Injuries of the anterior inferior tibiofibular ligament, tibiofibular interosseous membrane, posterior tibiofibular ligament and medial malleolar fracture were applied to each specimen. Postfixation cyclic loading consisted of 50 cycles of combinedaxial and external rotation loading with peak torques of 750 N and 7.5 Nm at a rate of 0.05 Hz. After postfixation loading, each specimen underwent failure loading by external rotation at 0.25 degrees/second. Failure torque and failure angle were measured.

Results:

Mean failure torques were 15.99 +- 8.88 Nm in the suture-button fixation with suture-tape augmentation and 17.10 +- 10.38 Nm in the screw group. There was no significant difference in average failure torque between two groups (p-value = 0.669)Average failure angle in screw-fixation group (39.37 +- 10.19 deg) was significantly lower than average failure angle suture- button fixation with suture-tape augmentation (56.64 +- 9.64 deg) (p-value = 0.001).Average rotational stiffness in screw-fixation group (0.53 +- 0.24 Nm/deg) was significantly higher than average rotational stiffness in suture-button fixation with suture-tape augmentation group (0.35 +- 0.19 Nm/deg) (p-value = 0.033).

Conclusion:

Suture-button fixation with suture-tape augmentation for ankle syndesmotic injury provides similar torsional strength to that of screw fixation and has lower stiffness than screw fixation. Therefore, Suture-button fixation with suture-tape augmentation can be considered as an alternative treatment option for syndesmosis injury.
Bulk Osteochondral Allograft for Osteochondral Lesions of the Talus: A Systematic Review
Authors: Azam Mohammad , Davey Martin S. , Colasanti Christopher , Mercer Nathaniel P. , Hurley Eoghan T. , Shimozono Yoshiharu , Kennedy John G.
Published: January 2022

Category:

Ankle

Introduction/Purpose:

The use of bulk osteochondral allograft (OCA) is often warranted in patients with a large osteochondral lesion of the talus (OLT). Previous literature reported that bulk OCA has high failure and revision rates, suggesting these procedures should be thought of as an intermediate step, buying time before arthrodesis or arthroplasty is required. However, recent studies suggest that the long-term survival of bulk OCA has improved and that these procedures may provide a definitive solution for large OLT. The purpose of this study was to systematically review the literature to ascertain the outcomes of bulk OCA for OLT.

Methods:

Two independent reviewers performed the literature search based on PRISMA guidelines, utilizing the EMBASE, MEDLINE, and The Cochrane Library Databases. Studies were included if they reported outcomes of OLTs which were managed by bulk OCA.

Results:

Overall, 9 studies with 112 patients (55.4% males) including 115 ankles with a mean follow-up of 72.7 (8 - 240) months were included in this review. Pre-operative OLT characteristics showed that 68.4% were medial lesions, with a mean lesion size of 3.04cm2 (0.7 - 6.1 cm2). Overall, 23.5% of patients required revision surgery following bulk OCA; 10.4% (12/115) underwent subsequent arthrodesis, 1.7% (2/115) underwent revision osteochondral grafting and 9.6% (11/115) underwent arthroscopic debridement. Radiological outcomes reporting graft failure was 21.3% (13/61), joint space narrowing was 25.2% (29/115) and cysts were present in 19.5% (15/77) of cases.

Conclusion:

Patients experience satisfactory patient-reported clinical outcomes in the medium term following bulk OCA in the management of OLT. Despite recent advances in graft procurement and storage radiological graft failure and the requirement for additional surgeries still remain. At this time can only be recommended in cases that are refractory to other treatments and where the patient is aware that this may be a temporizing procedure before arthroplasty or arthrodesis.
Defining Reference Values for the Anatomical Axis of Syndesmosis and Landmark for the Clamp Placement to Minimize Malreduction
Authors: Bhimani Rohan , Ashkani-Esfahani Soheil , Lubberts Bart , Guss Daniel , Kerkhoffs Gino , DiGiovanni Christopher W. , Waryasz Gregory R.
Published: January 2022

Category:

Ankle; Sports; Trauma

Introduction/Purpose:

Malreduction of the fibula within the incisura is often caused by an eccentric clamp or screw placement and short fibular length. Weightbearing computed tomography (WBCT) has proven to be a reliable method to diagnose syndesmotic instability and can be used as a template to determine the syndesmotic axis and optimal position to place the clamp. We aimed to determine the anatomic axis of the syndesmosis, or the trans-syndesmotic angle (TSA) in healthy individuals on WBCT, and to see if side-to-side and gender based variations exist. We also aimed to determine the clamp's medial tine placement along the trans-syndesmotic axis.

Methods:

The study group was made up of patient population without ankle injury who underwent bilateral foot and ankle WBCT imaging (n = 100; 200 ankles). Measurements on bilateral WBCT images included: 1) TSA at 1cm, 2cm, and 3cm proximal to tibial plafond, respectively; 2) Medial tine of the clamp positioning at 1cm and 2 cm along the syndesmotic axis. The medial tine clamp position was described in terms of the percentage of anterior to posterior tibial diameter from the anterior cortical boundary. In addition, the aforementioned TSA measurements were compared to historically defined 30 degrees of syndesmotic axis. Paired t-test was used to compare side to side and gender based differences. A p-value < 0.05 was considered statistically significant.

Results:

In the uninjured healthy population, the mean trans-syndesmotic angles were 17.60, 21.60, and 24.10 at 1cm, 2cm, and 3cm proximal to the tibial plafond respectively. The clamp's medial tine should be positioned 24.7% and 21.3% of the AP tibial cortical distance, posterior to the anterior tibial cortex at 1cm and 2 cm proximal to the tibial plafond. There was no significant side to side or gender based differences for any of the measurements. Additionally, all three weightbearing TSA measurements were significantly larger than the historically defined syndesmotic angle of 30 degrees (p<0.001).

Conclusion:

Preoperative WBCT imaging provides a reliable template to determine TSA and to plan optimal clamp tine positioning along the syndesmotic axis. Our study has established normal ranges for cross-sectional syndesmotic axis measurements during weight-bearing and established that no differences exist between laterality and gender in patients without syndesmotic injury.
Efficacy of Hook-Type Locking Plate and Cancellous Screw in the Treatment of Displaced Medial Malleolar Fractures in Elderly Patients
Authors: Choi Seung-myung , Cho Byung-Ki
Published: January 2022

Category:

Trauma; Ankle

Introduction/Purpose:

We aimed to compare the midterm radiologic and clinical results between hook-type LCP and conventional malleolar screws for elderly medial malleolar fractures. We hypothesized that elderly patients treated with the hook- type locking compression plate (LCP) would have better fracture healing and clinical outcomes than those treated with cancellous lag screws, with fewer postoperative complications.

Methods:

In total, 258 patients treated with a hook-type locking plate (hook LCP group: 121 patients) or partially threaded cancellous lag screws (screw group: 137 patients) over 65 years of age with at least 36 months' follow-up were included in this retrospective study. Radiographic assessments included the union rate and interval to fracture union. Clinical assessment was performed using the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, Olerud and Molander score (OMAS), visual analog scale (VAS) pain score, and postoperative complications.

Results:

The comminuted fracture rate was higher in the hook LCP group than in the screw group ( p < .001). The interval to fracture union was significantly shorter in the LCP group than in the screw group (10.2 +- 7.0 vs. 12.3 +- 6.7, p =.015). There were no significant differences between the two groups regarding AOFAS, OMAS, and VAS pain scores at the final follow- up. There was a trend toward a lower rate of complications, including revision procedures, in the hook LCP group than in the screw group (19.9% vs. 28.5%, p =.107 and 6.6% vs. 13.9%, p =.074). The overall cost in the hook LCP group was 5.8% lower than that of the screw group despite the higher cost of the hook-type LCP.

Conclusion:

Hook-type LCP may be an alternative option for treating medial malleolar fractures with comminution in elderly patients.
Patient Reported and Functional Outcomes for Revision Lateral Ankle Ligament Reconstruction
Authors: Dworak Theodora C. , Cohen Bruce E. , Davis W. Hodges , Ellington J. Kent , Jones Carroll P. , Shawen Scott B. , Irwin Todd A.
Published: January 2022

Category:

Sports; Ankle

Introduction/Purpose:

Despite multiple surgical treatment options for revision lateral ankle ligament reconstruction surgery, few studies describe the functional or patient reported outcomes. The purpose of this study is to describe the patient reported and functional outcomes for patient who required revision lateral ankle ligament reconstruction.

Methods:

We present follow-up of 26 patients who underwent revision lateral ankle ligament reconstruction between January 2010 and December 2019 at a single institution. Clinical notes and operative reports were reviewed to determine surgical techniques. Patient reported outcomes were completed using the Foot and Ankle Outcome Score (FAOS), Visual Analog Scale Pain, Visual Analog Scale for Ankle Instability, and Visual Analog Scale for Satisfaction. Functional outcome was evaluated with the hop test. Ankle stability was evaluated on physical exam with anterior drawer and inversion stress test.

Results:

Initial ligament reconstruction consisted of Brostrom (n=15), Brostrom Evans (n=3), Allograft (n=2) and Unknown (n=6). Revision lateral ligament reconstruction consisted of Brostrom (n=15), Brostrom Evans (n=2) and Allograft (n=9). Median follow up time after revision was 22 months. At last follow up, 20 patients (76.9%) had grade 0 inversion stress and anterior drawer test indicating stability. Median FAOS ADL sub score was 97 and median FAOS Symptom sub score was 79. Median VAS Pain was 3, median VAS Instability was 3 and median VAS satisfaction was 9.5. The single-leg hop test (Limb Symmetry Index %) was completed by 18 patients, with median score of 86.4% compared to their non-operative extremity. Six patients had persistent pain, three of which required additional surgery.

Conclusion:

The high majority of patients that require revision lateral ankle ligament reconstruction maintain a stable ankle on exam and are satisfied with their surgical results. Functional outcomes are similar but not symmetrical to their non-operative extremity.
Correction of Ankle Varus Deformity using Patient Specific Dome Shaped Osteotomy Guides Designed on Weight Bearing CT
Authors: Faict Sebastian , Burssens Arne , Kristian Buedts
Published: January 2022

Category:

Ankle Arthritis; Hindfoot

Introduction/Purpose:

Dome shaped supramalleolar osteotomies are a well-established treatment option for correcting ankle deformity. However, the procedure remains technically demanding and is limited by a two-dimensional (2-D) radiographic planning of a three-dimensional (3-D) deformity. Therefore, we implemented a weight-bearing CT-scan (WBCT) to plan a 3-D deformity correction using patient specific guides.

Methods:

A 3-D guided dome shaped supramalleolar osteotomy was performed to correct ankle varus deformity in a cohort of 5 patients with a mean age of 53,8 years (range: 47-58). WBCT images were obtained to generate 3-D models, which enabled a deformity correction using patient specific guides. These technical steps are outlined and associated with a retrospective analysis of the clinical outcome using the EFAS score, Foot and Ankle Outcome Score (FAOS) and Visual Analog Pain scale (VAS). Radiographic assessment was performed using the tibial anterior surface angle (TAS), tibiotalar angle (TTS), talar-tilt angle (TTA), hindfoot angle (HA), tibial lateral surface angle (TLS) and tibial rotation angle (TRA).

Results:

The mean follow-up was 40,8 months (range 8-65) and all patients showed improvements in the EFAS score, FAOS and VAS (p < 0.05). A 3-month postoperative WBCT confirmed healing of the osteotomy site and radiographic improvement of the TAS, TTS and HA (p<0.05), but the TTA and TRA did not change significantly (p>0.05).

Conclusion:

Dome shaped supramalleolar osteotomies using 3-D printed guides designed on WBCT, are a valuable option in correcting ankle varus deformity and mitigates the technical drawbacks of free-hand osteotomies.