bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Horizontal Impeding Force Gait Training on Older Adult Push-Off Intensity
Authors: CONWAY KATIE A. , CRUDUP KEYAIRA L. , LEWEK MICHAEL D. , FRANZ JASON R. 
Published: August 2020

ABSTRACT

Introduction
Aging and many gait pathologies are often characterized by deficits in push-off intensity (i.e., propulsive ground reaction forces and peak ankle moment and power output) during walking. Unfortunately, conventional interventions such as progressive resistance training, designed to enhance calf muscle mechanical output, generally fail to translate strength gains to functional improvements in habitual push-off intensity.

Methods
Horizontal impeding forces applied to the body’s center of mass systematically augment the mechanical output required from muscle–tendon units spanning the ankle during the push-off phase of walking, which could convey long-term benefits via training. Therefore, the purpose of this study was to investigate the preliminary efficacy of a 6-wk horizontal impeding force training paradigm on improving habitual push-off intensity in 11 healthy but not physically active older adults (age = 76 ± 4 yr, 6 females and 5 males).

Results
We found that older adults significantly (P < 0.05) increased measures of isometric strength by 18%, maximum walking speed by 10%, and 6-min walk test distance by 9% as a result of horizontal impeding force training. As a more clinically significant contribution of this work, we found that those subjects also increased habitual peak ankle moment and peak ankle power during push off after training by a significant 10% and 15%, respectively (P ≤ 0.036).

Conclusions
We conclude that the use of horizontal impeding forces in older adults improves their maximum muscular and walking capacities while encouraging access to newfound strength gains, thereby improving habitual push-off intensity during walking.
What’s New for Clinical Whole-body MRI (WB-MRI) in the 21st Century
Authors: Tunariu Nina , Blackledge Matthew , Messiou Christina , Petralia Giuseppe , Padhani Anwar , Curcean Sebastian , Curcean Andra , Koh Dow-Mu 
Published: August 2020

Whole-body MRI (WB-MRI) has evolved since its first introduction in the 1970s as an imaging technique to detect and survey disease across multiple sites and organ systems in the body. The development of diffusion-weighted MRI (DWI) has added a new dimension to the implementation of WB-MRI on modern scanners, offering excellent lesion-to-background contrast, while achieving acceptable spatial resolution to detect focal lesions 5 to 10 mm in size. MRI hardware and software advances have reduced acquisition times, with studies taking 40–50 min to complete. The rising awareness of medical radiation exposure coupled with the advantages of MRI has resulted in increased utilization of WB-MRI in oncology, paediatrics, rheumatological and musculoskeletal conditions and more recently in population screening. There is recognition that WB-MRI can be used to track disease evolution and monitor response heterogeneity in patients with cancer. There are also opportunities to combine WB-MRI with molecular imaging on PET-MRI systems to harness the strengths of hybrid imaging. The advent of artificial intelligence and machine learning will shorten image acquisition times and image analyses, making the technique more competitive against other imaging technologies.
Stereotactic body radiotherapy for adrenal oligometastasis in lung cancer patients
Authors: Arcidiacono Fabio , Aristei Cynthia , Marchionni Alessandro , Italiani Marco , Fulcheri Cristian Paolo Luca , Saldi Simonetta , Casale Michelina , Ingrosso Gianluca , Anselmo Paola , Maranzano Ernesto 
Published: August 2020

Objective: To report our experience on stereotactic body radiotherapy (SBRT) in adrenal metastases from lung cancer. Methods: 37 oligometastatic lung cancer patients with 38 adrenal metastases submitted to SBRT were retrospectively analyzed. SBRT was delivered by volumetric modulated arc therapy (VMAT) or helical tomotherapy (HT). Primary study end point was local recurrence-free survival (LR-FS) and secondary end points were distant-progression free survival (d-PFS) and overall survival (OS). Results: Median age was 67 years and primary tumor was non-small-cell lung cancer in 27 (73%) and small-cell lung cancer in 10 (27%) patients. Adrenal metastases were in the left side in 66% cases. Median prescribed dose was 30 Gy in 5 fractions for a median biologically equivalent dose (α/β ratio 10  Gy, BED10) of 48 Gy. Most patients (62%) were submitted to SBRT alone, while the others (38%) received chemo-, immune- or target- therapies. Median follow-up was 10.5 months, median OS 16 months and median d-PFS 3 months. 27 (70%) patients obtained a local control with a median LR-FS of 32 months. LR-FS was significantly related to BED10 with a better LC with BED10 ≥72 Gy, 1- and 2 year LR-FS rates were 54.1±11.6% and 45±12.7% vs 100 and 100% for BED ≤59.5 Gy and BED ≥72 Gy, respectively (p = 0.05). There was no severe toxicity. Conclusion: SBRT was effective and safe in lung cancer adrenal metastases. A dose–response relationship was found between BED10 >72 Gy and better local control. No significant toxicity was registered thanks to the respect of dose constraints and suspension of chemo- and target-therapies. Advances in knowledge: SBRT with a BED10 >72 Gy is an effective treatment for adrenal oligometastatic lung cancer patients.
Utilising previous radiographs: the principle of dose optimisation
Authors: Akbarian Tefaghi Farnaz , Adams Ashok , Makdissi Jimmy 
Published: August 2020

Objective: In dentistry, imaging is the most frequently used diagnostic tool. As a result, a steady increase in the use of imaging modalities are leading to an increase in healthcare cost and in patients’ radiation exposure. Results: 67-year-old patient attended for a surgical removal of lower left third molar. A sectioned panoramic radiograph showed an incidental finding of a well-defined, unilocular radiolucency apical to the lower left second and third molars. This was partially superimposed over the outline of the ID canal. A Stafne’s bone cavity was considered as the most likely diagnosis. Further imaging was considered due to location not being fully below the ID canal as usually described in the literature. Reviewing previous imaging on PACS revealed the patient has had a CT angiogram of the head and neck 5 years prior. This showed a lingual bone defect of the surface of the mandible in the region of interest. The extension of the submandibular gland into the defect confirmed the likely nature of Stafne’s bone cavity. Conclusion: This case highlights the essential role of reviewing (if in the same practice) or requesting (from a different practice) previous images. The international Commission for Radiological Protection regularly publishes data relating to the principles of dose reduction; Justification, Optimisation and Limitation. All examinations have to be justified to ensure the benefit to the patient outweigh the risk and radiation should be kept as low as reasonably achievable.
Parental risk perceptions of child exposure to thirdhand smoke and related factors
Authors: Intarut Nirun 
Published: August 2020

Background: Thirdhand smoke (THS) exposure is linked to lung cancer, asthma, and chronic diseases, especially in children. The parental risk perception of THS exposure in children has rarely been reported. The objective of this study was to test the association between sociodemographic factors and parental risk perceptions of child exposure to thirdhand smoke (PRPCETS) in residential homes with a child or children aged from one to five years old. Methods: This study used secondary data from the Smoke Free Home intervention trial. 336 participants were included and analyzed. PRPCETS was assessed by self-administered questionnaire. Multiple logistic regression was used to test the factors related to parental risk perception to the harm of thirdhand smoke. Results: The overall prevalence of disagreement that THS might be harmful to children was 22.02% (95% CI: 17.59%, 26.45%). Factors associated with PRPCETS were being over 50-years-old (OR: 2.15; 95%CI: 1.05, 4.41); attending school for more than six years (OR: 2.08; 95%CI: 1.07, 4.08); being unemployed (OR: 6.98; 95% CI, 1.41, 34.71); and the number of smokers in the home ≥2 persons (OR: 2.48; 95%CI: 1.41, 4.36). Conclusions: Our findings show the factors related to PRPCETS as follows; aged over 50, duration of school attendance less than six years, no job status, and having ≥2 smokers in the home. Further studies should investigate parental knowledge of and attitude towards thirdhand smoke exposure.
Exploring factors that influence the practice of Open Science by early career health researchers: a mixed methods study
Authors: Zečević Ksenija , Houghton Catherine , Noone Chris , Lee Hopin , Matvienko-Sikar Karen , Toomey Elaine 
Published: August 2020

Background: There is a growing global movement towards open science and ensuring that health research is more transparent. It is vital that the researchers are adequately prepared for this research environment from early in their careers. However, the barriers and enablers to practicing open science for early career researchers (ECRs) have been explored to a limited extent. This study aimed to explore the views, experiences and factors influencing open science practices amongst ECRs working in health research. Methods: Semi-structured individual interviews were conducted with a convenience sample of ECRs working in health research. Participants also completed surveys regarding the factors influencing open science practices. Thematic analysis was used to analyse the qualitative data and descriptive statistical analyses were used to analyse survey data. Results: 14 ECRs participated. Two main themes were identified from interview data; Valuing Open Science and Creating a Culture for Open Science. Within ‘Valuing Open Science’, participants spoke about the conceptualisation of open science to be open across the entire research cycle, and important for producing better and more impactful research for patients and the public. Within ‘Creating a Culture of Open Science’ participants spoke about a number of factors influencing their practice of open science. These included cultural and academic pressures, the positives and negatives of increased accountability and transparency, and the need for more training and supporting resources to facilitate open science practices. Conclusion: ECRs see the importance of open science for beneficially impacting patient and public health but many feel that they are not fully supported to practice open science. Resources and supports including education and training are needed, as are better incentives for open science activities. Crucially, tangible engagement from institutions, funders and researchers is needed to facilitate the development of an open science culture.
Service Design for a Holistic Customer Experience: A Process Framework
Authors: Bellos Ioannis , Kavadias Stylianos 
Published: August 2020

Modern service design practices conceptualize services as multistep processes. At each step, customers derive an uncertain value, which depends on a functional benefit and a subjective experience. The latter may depend on experiences realized at previous steps. Service designs determine the provider effort at each step given that customers prefer less-variable experiences, and enable a holistic perspective of the overall experience. We quantify two factors that shape service designs: the type of steps ((i) routine steps, where effort increases the functional benefit and decreases the experience variability, and (ii) nonroutine steps, where effort increases the functional benefit at the expense of higher variability) and a holistic coupling factor (at each step, the design is determined not only by experience realizations at predecessor steps but also by how it can shape subsequent experiences). The optimal efforts depend on the combination of these two factors, giving rise to actionable design rules. For a positive coupling factor, step type homogeneity leads to “spread the effort” designs (complementary efforts), whereas a negative coupling factor suggests focusing the effort on a few key steps at the expense of the rest of the service (substitutable efforts). Step type heterogeneity reverses these recommendations. Moreover, when the customer experience unfolds according to a nonstationary process with serial correlation, the effort at each step is determined by an impact zone defined by the steps surrounding the focal service step. Stronger correlation always induces higher effort, whereas weaker correlation may induce less effort in services with heterogeneous step types.This paper was accepted by Serguei Netessine, operations management.
Direct versus indirect transfer for traumatic brain injury to James Cook University Hospital: a retrospective study
Authors: Vats A , Roy D , Prasad MK 
Published: August 2020

Introduction Patients with traumatic brain injury are referred to the neurosurgical unit at James Cook University Hospital, Middlesbrough, either from local accident and emergency departments (direct transfer from the scene) or from other hospitals (indirect transfer). This study looked at the outcome in both groups. Material and methods This was a retrospective observational study using trauma audit research network data for patients treated for traumatic brain injury at the neurosurgery department at the neurosurgical unit at James Cook University Hospital. Results A total of 356 patients with traumatic brain injury were admitted under the care of neurosurgeons; 143 (40%) of these patients had a neurosurgical procedure. Of the patients undergoing a neurological procedure, 111 patients were transferred directly while 32 were indirect transfers; 213 patients were managed conservatively. Of those managed conservatively, 165 were transferred directly while 48 were indirect transfers. We compared the length of hospital stay and Glasgow Outcome Scale score for the patients based on whether they were conservatively managed or required surgery in the direct and indirect transfer groups. The difference in the length of stay in the surgical and conservative groups following direct and indirect transfer was insignificant (p = 0.07). The time to the operation in direct and indirect transfer was also not statistically significant (p = 0.06). Conclusion Patients are as safe, if not safer, by reaching the nearest trauma unit with facilities for resuscitation and imaging.
Colonoscopy and flexible sigmoidoscopy for follow-up of patients with left-sided diverticulitis
Authors: Abdulazeez Z , Kukreja N , Qureshi N , Lascelles S 
Published: August 2020

Introduction The prevalence of diverticular disease has been increasing in the western world over the last few decades, causing a growing burden on health care systems. This study compared the uses of flexible sigmoidoscopy with colonoscopy as a follow-up investigation for patients diagnosed with acute left-sided diverticulitis and to evaluate the need for using either procedure. Materials and methods A retrospective study of 327 patients diagnosed with acute diverticulitis was carried out. Of this total, 240 patients with left-sided diverticulitis diagnosed via computed tomography were included. These patients were categorised into two equal groups: the first 120 patients underwent colonoscopy and the second 120 patients underwent flexible sigmoidoscopy. Results All colonoscopes and flexible sigmoidoscopes confirmed the computed tomography diagnosis of sigmoid diverticular disease with no major new findings. All colonoscopes and flexible sigmoidoscopes were reported as having no complications, with nine colonoscopes reported as being difficult compared with only three flexible sigmoidoscopes. All biopsies were reported as no malignancy. Full bowel preparation was required in all colonoscopes, compared with no preparation required for flexible sigmoidoscopes. Conclusions There is no evidence to support the routine use of endoscopic evaluation after an episode of left-sided diverticulitis diagnosed on computed tomography if no worrying radiological findings have been reported. This study supports similar findings from other studies and therefore we disagree with The Royal College of Surgeons of England (Association of Coloproctology of Great Britain and Ireland recommendations) commissioning guide, which advocates routine surveillance of the colon.
Efficacy and Safety of Endoscopic Full-Thickness Resection in the Colorectum: Results From the German Colonic FTRD Registry
Authors: Meier Benjamin , Stritzke Bettina , Kuellmer Armin , Zervoulakos Philipp , Huebner Georg Hermann , Repp Michael , Walter Benjamin , Meining Alexander , Gutberlet Klaus , Wiedbrauck Thomas , Glitsch Anne , Lorenz Albrecht , Caca Karel , Schmidt Arthur 
Published: August 2020

INTRODUCTION:
Endoscopic full-thickness resection (EFTR) is a powerful option for resection of colorectal lesions not amenable to conventional endoscopic resection. The full-thickness resection device (FTRD) allows clip-assisted EFTR with a single-step technique. We report on results of a large nationwide FTRD registry.

METHODS:
The “German colonic FTRD registry” was created to further assess efficacy and safety of the FTRD System after approval in Europe. Data were analyzed retrospectively.

RESULTS:
Sixty-five centers contributed 1,178 colorectal FTRD procedures. Indications for EFTR were difficult adenomas (67.1%), early carcinomas (18.4%), subepithelial tumors (6.8%), and diagnostic EFTR (1.3%). Mean lesion size was 15 × 15 mm and most lesions were pretreated endoscopically (54.1%). Technical success was 88.2% and R0 resection was achieved in 80.0%. R0 resection was significantly higher for subepithelial tumor compared with that for other lesions. No difference in R0 resection was found for smaller vs larger lesions or for colonic vs rectal procedures. Adverse events occurred in 12.1% (3.1% major events and 2.0% required surgical treatment). Endoscopic follow-up was available in 58.0% and showed residual/recurrent lesions in 13.5%, which could be managed endoscopically in most cases (77.2%).

DISCUSSION:
To date, this is the largest study of colorectal EFTR using the FTRD System. The study demonstrated favorable efficacy and safety for “difficult-to-resect” colorectal lesions and confirms results of previous studies in a large “real-world” setting. Further studies are needed to compare EFTR with other advanced resection techniques and evaluate long-term outcome.
Colonoscopy Outcomes in Average-Risk Screening Equivalent Young Adults: Data From the New Hampshire Colonoscopy Registry
Authors: Butterly Lynn F. , Siegel Rebecca L. , Fedewa Stacey , Robinson Christina M. , Jemal Ahmedin , Anderson Joseph C. 
Published: August 2020

INTRODUCTION:
Data are needed to further inform the American Cancer Society recommendation to begin colorectal cancer (CRC) screening at age 45. We used the New Hampshire Colonoscopy Registry to compare the prevalence of advanced neoplasia (AN) in an “average-risk screening equivalent” group aged 45–49 years with patients aged 50–54 years and older receiving screening colonoscopy.

METHODS:
Colonoscopies in adults older than 50 years of age usually have diagnostic indications of varying clinical significance. We combined patients older than 50 years with diagnostic indications (abdominal pain and constipation) expected to yield AN prevalence similar to screening low AN risk and those with a screening indication to form an “average-risk screening equivalent” group. We excluded high-risk indications (e.g., bleeding and anemia), surveillance examinations, and patients with a first-degree family history of CRC, incomplete examinations, and poor bowel preparation. We calculated prevalence/adjusted risks for AN (≥1 cm, villous, high-grade dysplasia, and CRC) and clinically significant serrated polyps (large [≥1 cm] hyperplastic polyps, sessile serrated polyp, traditional serrated adenomas, and proximal hyperplastic polyp ≥ 5 mm).

RESULTS:
In our sample (n = 40,812), AN prevalence was as follows: <40 years (1.1%), 40–44 years (3.0%), 45–49 years (3.7%), 50–54 years (3.6%), 55–59 years (5.1%), and 60+ years (6.7%) (P < 0.0001 across all groups). The prevalence of both AN and clinically significant serrated polyp was similar in the 45–49 and 50–54 years' age groups. Furthermore, the prevalence of AN increased significantly in the 40–44 group as compared to that in the <40 years group. Adjusted analyses confirmed these results. The diagnostic indications considered to have low risk were not predictive of AN.

DISCUSSION:
New Hampshire Colonoscopy Registry data, demonstrating an increase in AN risk starting at age 40 and a similar prevalence for individuals aged 45–49 and those ages 50–54, provide clinically useful evidence for optimization of prevention and the age to start screening. However, this is a complex issue involving additional considerations that will need to be addressed.
Endoscopic Surveillance of Duodenal Polyposis After Total Gastrectomy in Familial Adenomatous Polyposis
Authors: Shah Ravi S. , Mehta Neal , Mankaney Gautam , Walsh Matthew R. , Burke Carol A. , Bhatt Amit 
Published: August 2020

ABSTRACT
The lifetime incidence of duodenal polyposis in familial adenomatous polyposis (FAP) approaches 100%, and duodenal cancer is the most common malignancy once colectomy is performed. The incidence of gastric cancer is increasing in patients with FAP, and when gastric polyps with high-grade dysplasia or cancer are present, a total gastrectomy with Roux-en-Y esophagojejunostomy is indicated. The altered anatomy after surgery and presence of adhesions from a previous colectomy make endoscopic surveillance of the duodenum with standard equipment difficult. This case report highlights an approach to duodenal polyposis surveillance in FAP after total gastrectomy with Roux-en-Y esophagojejunostomy.
PROPUESTA PARA EL USO PERTINENTE DEL IDIOMA ESPAÑOL EN MEDICINA
Authors: D'Ottavio Alberto Enrique , D'Ottavio María Eugenia 
Published: August 2020

El empleo correcto del idioma español es de prioritaria relevancia para estudiantes y graduados en Medicina. En tal marco, este trabajo: (a) propone una factible secuencia reparadora en etapas de los “desaseos de la lengua”, (b) intenta proveer, a su través, herramientas valiosas para que los profesionales interactúen con personas de diferente nivel cultural sin deteriorar la comunicación, y (c) efectúa complementarias reflexiones sobre su eventual implementación. La primera etapa persigue evitar: barbarismos, anglicismos y solecismos (queísmos y dequeísmos, empleo inadecuado de los adverbios donde y cuando, incorrecta asociación de tiempos del modo subjuntivo con el tiempo condicional del modo indicativo, equivocado empleo de los verbos haber y hallar, disonante uso de muletillas y expletivos, despeño en redundancias y frecuente confusión entre siglas, sigloides y acrónimos). La segunda etapa se centra en conocer el verdadero significado de palabras desconocidas, y aún de aquéllas, supuestamente conocidas, así como en sus respectivas etimologías, y la última etapa incursiona en sinónimos, antónimos, parónimos, homónimos y epónimos.