bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anatomic versus reverse shoulder arthroplasty: a mid-term follow-up comparison
Authors: Schoch Bradley S , King Joseph J , Zuckerman Joseph , Wright Thomas W , Roche Chris , Flurin Pierre-Henri 
Published: May 2020

Background Anatomic total shoulder arthroplasty improves pain and function with a reported reoperation rate of approximately 1% per year. With improved glenoid fixation, reverse shoulder arthroplasty implants may outperform anatomic total shoulder arthroplasty. We evaluate the functional outcomes and reoperation rate of anatomic total shoulder arthroplasty versus reverse shoulder arthroplasty at a minimum eight-year follow-up or revision. Methods Between 2005 and 2010, 187 shoulders (137 anatomic total shoulder arthroplasty, 50 reverse shoulder arthroplasty) were retrospectively reviewed at a mean of 8.8 years. The mean age at surgery was 67 years. Females were more commonly treated with reverse shoulder arthroplasty. Both groups had similar body mass index and comorbidities. Outcome measures evaluated included abduction, forward elevation, external rotation, internal rotation, Simple Shoulder Test, Constant score, American Shoulder and Elbow Score, University of California Los Angeles Shoulder score, and Shoulder Pain and Disability Index. Results At follow-up, anatomic total shoulder arthroplasty demonstrated greater overhead range of motion and external rotation. All patient-reported outcomes remained similar between groups. Reverse shoulder arthroplasty patients were more likely to rate shoulders as much better or better after surgery (90% versus 67%, p = 0.004). Complications were observed in 24% of anatomic total shoulder arthroplasties and 8% of reverse shoulder arthroplasties (p = 0.02). Reoperation was more common in anatomic total shoulder arthroplasties (23% versus 4%, p = 0.003). Discussion At mid-to-long-term follow-up, reverse shoulder arthroplasties demonstrated significantly fewer complications and reoperations than anatomic total shoulder arthroplasties. Despite similar patient-reported outcomes, reverse shoulder arthroplasty patients were more likely to be satisfied with their shoulder.
Cardiac patient care during a pandemic: how to reorganise a heart failure unit at the time of COVID-19
Authors: Agostoni Piergiuseppe , Mapelli Massimo , Conte Edoardo , Baggiano Andrea , Assanelli Emilio , Apostolo Anna , Alimento Marina , Berna Giovanni , Guglielmo Marco , Muratori Manuela , Susini Francesca , Palermo Pietro , Pezzuto Beatrice , Salvioni Elisabetta , Sudati Anna , Vignati Carlo , Merlino Luca 
Published: May 2020

To date, the pandemic spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has involved over 100 countries in a matter of weeks, and Italy suffers from almost 1/3 of the dead cases worldwide. In this report, we show the strategies adopted to face the emergency at Centro Cardiologico Monzino, a mono-specialist cardiology hospital sited in the region of Italy most affected by the pandemic, and specifically we describe how we have progressively modified in a few weeks the organization of our Heart Failure Unit in order to cope with the new COVID-19 outbreak. In fact, on the background of the pandemic, cardiovascular diseases still occur frequently in the general population, but we observed consistent reduction in hospital admissions for acute cardiovascular events and a dramatic increase of late presentation acute myocardial infarction. Despite a reduction of healthcare workers number, our ward has been rearranged in order to take care of both COVID-19 and cardiovascular patients. In particular according to a triple step procedure we divided admitted patients in confirmed, suspected and excluded cases (respectively allocated in “red”, “pink” and “green” separated areas). Due to the absence of definite guidelines, our aim was to describe our strategy in facing the current emergency, in order to reorganize our hospital in a dynamic and proactive manner. To quote the famous Italian writer Alessandro Manzoni ‘It is less bad to be agitated in doubt than to rest in error.’
Assessment of Obstetrics and Gynecology Residents’ Knowledge of Basic Obstetric Sonography and Psychomotor Evaluation With Motion Analysis Using a Computer-Based Simulator
Authors: Mohammad Sundus H. , Sommerich Carolyn M. , Butwin Angela N. , Evans Kevin D. 
Published: May 2020

Purpose: Evaluate obstetrics and gynecology (OB/Gyn) residents’ current obstetric sonography knowledge, confidence, and psychomotor skills to provide clinical preceptors with a greater understanding of how to approach teaching sonography to residents. Methods: Ten OB/Gyn residents were assessed on their sonographic performance by measuring psychomotor skills and evaluating diagnostic accuracy of images. At the conclusion of the assessment, residents received feedback and completed a survey to establish their current confidence level in performing and interpreting sonograms. Results: Motion analysis revealed excessive transducer movements made by the residents when acquiring images, particularly in terms of angular movement. The median score on the assessment template was 33 out of 66 points (interquartile range, 26.75–42.5), where residents had difficulty acquiring all required criteria for first-trimester dating and biometry views/measurements, determining fetal situs, and identifying landmarks to ensure intended anatomy is visualized. Conclusions: Absence of formalized sonography training creates a need for clinical preceptors to teach basic anatomy/landmarks, transducer movements, and criteria for dating and biometry views/measurements. This poses a challenge for preceptors at high-volume sites; thus, high-fidelity simulation could be part of a solution. Simulation can provide residents with the opportunity to develop basic sonography skills outside of clinical, then refine and build upon those skills with preceptors.
Tight versus standard blood pressure control on the incidence of myocardial infarction and stroke: an observational retrospective cohort study in the general ambulatory setting
Authors: Park Bumsoo , Budzynska Katarzyna , Almasri Nada , Islam Sumaiya , Alyas Fanar , Carolan Rachel L. , Abraham Benjamin E. , Castro-Camero Pamela A. , Shreve Maria E. , Rees Della A. , Lamerato Lois 
Published: May 2020

Abstract
Background
The 2017 American College of Cardiology and American Heart Association guideline defined hypertension as blood pressure (BP) ≥ 130/80 mmHg compared to the traditional definition of ≥140/90 mmHg. This change raised much controversy. We conducted this study to compare the impact of tight (TBPC) versus standard BP control (SBPC) on the incidence of myocardial infarction (MI) and stroke.

Methods
We retrospectively identified all hypertensive patients in an ambulatory setting based on the diagnostic code for 1 year at our institution who were classified by the range of BP across 3 years into 2 groups of TBPC (< 130 mmHg) and SBPC (130–139 mmHg). We compared the incidence of new MI and stroke between the 2 groups across a 2-year follow-up. Multivariate analysis was done to identify independent predictors for the incidence of new MI and stroke.

Results
Of 5640 study patients, the TBPC group showed significantly less incidence of stroke compared to the SBPC group (1.5% vs. 2.7%, P < 0.010). No differences were found in MI incidence between the 2 groups (0.6% vs. 0.8%, P = 0.476). Multivariate analysis showed that increased age independently increased the incidence of both MI (OR 1.518, 95% CI 1.038–2.219) and stroke (OR 1.876, 95% CI 1.474–2.387), and TBPC independently decreased the incidence of stroke (OR 0.583, 95% CI 0.374–0.910) but not of MI.

Conclusions
Our observational study suggests that TBPC may be beneficial in less stroke incidence compared to SBPC but it didn’t seem to affect the incidence of MI. Our study is limited by its retrospective design with potential confounders.
Knowledge, attitudes and skills of dementia care in general practice: a cross-sectional study in primary health settings in Beijing, China
Authors: Wang Meirong , Xu Xiaojingyuan , Huang Yafang , Shao Shuang , Chen Xiaolei , Li Jing , Du Juan 
Published: May 2020

AbstractBackgroundGeneral practitioners (GPs) play a significant role in dementia care. However, the knowledge and attitudes of them towards dementia care are poorly characterized. The present study aimed to investigate GPs’ knowledge, attitudes and skills of dementia care in primary health settings in Beijing.MethodsA cross-sectional survey was conducted in 27 community health service centers (CHSCs) in Beijing. The GPs’ knowledge, attitudes and skills were assessed utilizing the Alzheimer’s Disease Knowledge Scale (ADKS), Dementia Care Attitude Scale (DCAS) and self-designed questionnaire, respectively.ResultsA total of 341 participants returned the questionnaire. The overall mean score of GPs’ dementia knowledge measured by the ADKS was 21.42 (SD = 2.73) out of 30 (71.4%), GPs’ attitudes to dementia care was 36.25 (SD = 5.12) out of 50 (72.5%), and GPs’ self-confidence on dementia care skills was 53.93 (SD = 9.57) out of 75 (71.9%). GPs’ overall knowledge towards dementia care was limited and the attitudes were generally positive. They had low level recognition of their roles towards dementia care. The majority of GPs believed that dementia care was within a specialist’s domain not that of general practice.ConclusionGPs demonstrate low levels of dementia knowledge and skills, but express generally positive attitudes towards dementia in this study. It is much needed to translate detailed dementia care handbook, and adequate dementia knowledge training for GPs into practice to improve care outcomes for people with dementia in China. In addition, dementia management should be covered in the national basic package of public health services in primary care.
Experiences of integrating community volunteers as extensions of the primary care team to help support older adults at home: a qualitative study
Authors: Gaber Jessica , Oliver Doug , Valaitis Ruta , Cleghorn Laura , Lamarche Larkin , Avilla Ernie , Parascandalo Fiona , Price David , Dolovich Lisa 
Published: May 2020

Abstract
Background
Increasing the integration of community volunteers into primary health care delivery has the potential to improve person-focused, coordinated care, yet the use of volunteers in primary care is largely unexplored. Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) is a multi-component intervention involving trained community volunteers functioning as extensions of primary care teams, supporting care based on older adults’ health goals and needs. This study aimed to gain an understanding of volunteer experiences within the program and client and health care provider perspectives on the volunteer role.

Methods
This study used a qualitative descriptive approach embedded in a pragmatic randomized controlled trial. Participants included Health TAPESTRY volunteers, health care providers, volunteer coordinator, and program clients, all connected to two primary care practice sites in a large urban setting in Ontario, Canada. Data collection included semi-structured focus groups and interviews with all participants, and the completion of a measure of attitudes toward older adults and self-efficacy for volunteers. Qualitative data were inductively coded and analyzed using a constant comparative approach. Quantitative data were summarized using descriptive statistics.

Results
Overall, 30 volunteers and 64 other participants (clients, providers, volunteer coordinator) were included. Themes included: 1. Volunteer training: “An investment in volunteers”; 2. Intergenerational volunteer pairing: “The best of both worlds”; 3. Understanding the volunteer role and its scope: “Lay people involved in care”; 4. Volunteers as extensions of primary care teams: “Being the eyes where they live”; 5. The disconnect between volunteers and the clinical team: “Is something being done?”; 6. “Learning… all the time”: Impacts on volunteers; and 7. Clients’ acceptance of volunteers.

Conclusions
This study showed that it is possible to integrate community volunteers into the primary care setting, adding human connections to deepen the primary care team’s understanding of their patients. Program implementation suggestions that emerged included: using role play in training, making volunteer role boundaries and specifications clear, and making efforts to connect volunteers and the primary care team they are supporting. This exploration of stakeholder voices has the potential to help improve volunteer program uptake and acceptability, as well as volunteer recruitment, retention, and training.

Trial registration
For RCT: https://clinicaltrials.gov/ct2/show/NCT02283723, November 5, 2014.
Notalgia paresthetica: clinical features, radiological evaluation, and a novel therapeutic option
Authors: Mülkoğlu Cevriye , Nacır Barış 
Published: May 2020

AbstractBackground/objectiveNotalgia paresthetica (NP) is a sensory neuropathy characterized by localized pruritus and pain, presenting with or without a well-circumscribed hyperpigmented patch in the upper back. Abnormal sensations, such as burning, numbness, and paresthesia are often present in patients with NP. In this study, we clinically and radiologically analyzed patients with NP. The literature contains studies describing lidocaine treatments involving intravenous and topical applications for NP. We also investigated the effect of intradermal lidocaine injection on patients with NP.MethodsA total of 80 patients (45 patients with NP and 35 suffering from dorsalgia without NP) were included in the study. The age, gender and body mass index (BMI) of the patients, and the characteristics of their symptoms were recorded. The severity of pain and pruritus was assessed by the Visual Analog Scale (VAS). Radiography and magnetic resonance imaging of the spine were performed. In this study, we intradermally administered lidocaine diluted with saline into the upper back over three sessions. 1 cc 2% lidocaine was diluted with 5 cc 0.9% saline, and a total of 6 cc lidocaine mixture was obtained. The injection was performed locally at 1-cm intervals around the hyperpigmented patch and segmentally along the C2-T6 spinous processes. These patients were called for a follow-up at the second and fourth weeks and third month.ResultsThere was no statistically significant difference between the two groups in terms of age, BMI, VAS-pain score, and duration of symptoms (p > 0.05 for all). Forty-six cervical and/or thoracic degenerative changes or herniated nucleus pulposus (HNP) were detected in patients with NP. There was a significantly higher number of HNP at the C6–7 segment and cervical degenerative changes in the NP group (p < 0.05). The VAS-pain and VAS-pruritus scores were significantly decreased at all follow-up sessions, and improvement was sustained by lidocaine up to the third month.ConclusionCervical degenerative changes and HNP of the C6–7 segment seem to be contributing factors for NP. Local lidocaine can be effective for pain relief and pruritus in NP.
Extrastriatal 123I-FP-CIT SPECT impairment in Parkinson’s disease – the PPMI cohort
Authors: Nicastro Nicolas , Garibotto Valentina , Burkhard Pierre R. 
Published: May 2020

Abstract
Background
Neuropathological data and nuclear medicine imaging show extensive serotonergic impairment in Parkinson’s disease (PD). We undertook a case-controlled analysis of 123I-FP-CIT SPECT images to measure extrastriatal serotonergic transporters (SERT) in PD using the Parkinson’s Progression Markers Initiative (PPMI) cohort.

Methods
We included all PD (n = 154) and Control subjects (n = 62) with available 123I-FP-CIT SPECT imaging and high-resolution T1-weighted MRI for coregistration (PD: mean age 61.6 years, 62% male, disease duration 26 months, MDS-UPDRS III score 22). 123I-FP-CIT SPECT images were processed with PETPVE12 using an exploratory voxel-wise analysis including partial-volume effect correction. Linear regressions were performed in the PD group to assess correlations between region of interest 123I-FP-CIT uptake and clinical motor and non-motor impairment.

Results
Compared to Controls, PD exhibited an uptake reduction in bilateral caudate nucleus, putamen, insula, amygdala and right pallidum (family-wise error (FWE)-corrected p <  0.05). While lower putaminal uptake on the contralateral side to clinically more affected side was associated with higher MDS-UPDRS III score (p = 0.022), we found a trend association between higher geriatric depression scale and lower pallidum uptake (p = 0.09). Higher SCOPA-AUT gastrointestinal subscore was associated with lower uptake in mean putamen and caudate nucleus (p = 0.01 to 0.03), whereas urological subscore was inversely correlated with mean caudate nucleus, putamen, and pallidum uptake (p = 0.002 to 0.03). REM sleep behaviour disorder screening questionnaire was associated with lower 123I-FP-CIT binding in caudate nucleus, putamen and pallidum (all p <  0.05). No significant association was found for Montreal Cognitive Assessment (all p > 0.45) or excessive daytime sleepiness (all p > 0.29).

Conclusions
In addition to the well-established striatal deficit, this study provides evidence of a major extrastriatal 123I-FP-CIT impairment, and therefore of an altered serotonergic transmission in early PD.
A competing risk nomogram predicting cause-specific mortality in patients with lung adenosquamous carcinoma
Authors: Wu Xiao , Yu Wenfeng , Petersen R. H. , Sheng Hongxu , Wang Yiqing , Lv Wang , Hu Jian 
Published: May 2020

Abstract
Background
Adenosquamous carcinoma (ASC) is an uncommon histological subtype of lung cancer. The purpose of this study was to assess the cumulative incidences of lung cancer-specific mortality (LC-SM) and other cause-specific mortality (OCSM) in lung ASC patients, and construct a corresponding competing risk nomogram for LC-SM.

Methods
Data on 2705 patients with first primary lung ASC histologically diagnosed between 2004 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The cumulative incidence function (CIF) was utilized to calculate the 3-year and 5-year probabilities of LC-SM and OCSM, and a competing risk model was built. Based on the model, we developed a competing risk nomogram to predict the 3-year and 5-year cumulative probabilities of LC-SM and the corresponding concordance indexes (C-indexes) and calibration curves were derived to assess the model performance. To evaluate the clinical usefulness of the nomogram, decision curve analysis (DCA) was conducted. Furthermore, patients were categorized into three groups according to the tertile values of the nomogram-based scores, and their survival differences were assessed using CIF curves.

Results
The 3-year and 5-year cumulative mortalities were 49.6 and 55.8% for LC-SM and 8.2 and 11.8% for OCSM, respectively. In multivariate analysis, increasing age, male sex, no surgery, and advanced T, N and M stages were related to a significantly higher likelihood of LC-SM. The nomogram showed good calibration, and the 3-year and 5-year C-indexes for predicting the probabilities of LC-SM in the validation cohort were both 0.79, which were almost equal to those of the ten-fold cross validation. DCA demonstrated that using the nomogram gained more benefit when the threshold probabilities were set within the ranges of 0.24–0.89 and 0.25–0.91 for 3-year and 5-year LCSM, respectively. In both the training and validation cohorts, the high-risk group had the highest probabilities of LC-SM, followed by the medium-risk and low-risk groups (both P < 0.0001).

Conclusions
The competing risk nomogram displayed excellent discrimination and calibration for predicting LC-SM. With the aid of this individualized predictive tool, clinicians can more expediently devise appropriate treatment protocols and follow-up schedules.
Gender differences and occupational factors for the risk of obesity in the Italian working population
Authors: Di Tecco C. , Fontana L. , Adamo G. , Petyx M. , Iavicoli S. 
Published: May 2020

Abstract
Background
Obesity is a multifactorial condition and a major risk factor associated with several non-communicable diseases, such as cardiovascular disease, and with a higher risk of premature death and disability. Sex-specific factors have key roles and must be taken into consideration in studying occupational factors associated with the risk of obesity. The aim of this study was to investigate gender differences in body mass index (BMI) in a large cohort representative of Italian workers and, correlating this index with several demographic and occupational variables, to verify sex- and work-dependent differences in the risk of obesity.

Methods
We utilized data from INSuLa, a cross-sectional, nationally representative survey of the Italian worker population conducted in 2013 by the Italian Workers’ Compensation Authority to investigate health and safety at work. Analyses were run on a sample of 8000 Italian workers, aged from 16 to 64 years. Logistic regression models were employed to assess gender differences in the relation between occupational characteristics and BMI. We adjusted for age, education, variables related to health protection at work, and chronic conditions and diseases.

Results
There were several significant differences in the BMI between males and females, linked to some occupational factors. For instance, female shift workers were 1.32 times (95% CI 1.11–1.57) more likely to be overweight or obese than normal-weight workers, and this association was maintained when controlling for confounders. The likelihood of overweight or obesity among women who worked 1–2 night shifts per week was significantly higher – 1.5-1.6 times – than those on day shifts.

Conclusions
Gender-specific differences in occupational factors associated with the risk of obesity are useful with a view to characterizing this risk and helping identify workplace-targeted intervention strategies.
Outcomes of occipitocervical fixation using a spinous process screw in C2 as a third anchor point for occipitocervical fixation: a case presentation
Authors: Liu Guanyi , Li Qing , Sheng Feng , Xu Nanjian , Li Ming , Wang Yang , Ma Weihu 
Published: May 2020

Abstract
Background
Posterior occipitocervical fixation and fusion are often required to address occipitocervical instability. Safe, stable internal fixation with screws is vital for the success of such surgery. Thus, poor selection of an internal fixation technique may cause fixation and fusion failure, possibly leading to neurovascular injury. Hence, in certain cases, such as in patients with severe instability of an occipitocervical deformity or osteoporosis, we hypothesized that having a third anchor point (a screw in C2) could enhance the stability of the occipitocervical fixation.

Case presentation
A 31-year-old man with occipitocervical deformity and spinal cord edema underwent a traditional occipitocervical fixation procedure but with the addition of a spinous process screw in C2 as a third anchor point. The procedure included posterior internal fixation and fusion. The occipitocervical fixation was completed by inserting occipital screws, bilateral C2 pedicle screws, C3 lateral mass screws, and a spinous process screw in C2 as a third anchor point. There were no neurovascular complications or incision-site infections. Postoperatively, radiography and computed tomography showed that the occipitocervical reduction and internal fixation had resulted in good spinal alignment, and magnetic resonance imaging showed no obvious spinal cord compression. At 4 months after the surgery, fusion was observed, and the occipitocervical screws remained well positioned. The patient continued to be monitored for 24 months postoperatively. At the 24-month follow-up visit, the muscle strength of the limbs was grade 5, and the patient’s sensation function had improved over his preoperative condition.

Conclusions
Use of a C2 spinous process screw as a third anchor point may enhance the stability of occipitocervical fixation. Further biomechanical and clinical studies are needed to validate this result.