bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of the face-to-face consultation on decisional conflict in complex decision-making in multiple sclerosis: A pilot study
Authors: Wilkie David Daniel , Solari Alessandra , Nicholas Richard St. John 
Published: October 2020

Background The role of face-to-face consultations in medicine is increasingly being challenged. Disease activity, national guidelines, life goals e.g. pregnancy, multiple therapies and side effects need to be considered on starting disease modifying treatments (DMTs) in people with multiple sclerosis (pwMS). Objectives We studied the impact of a face-to-face consultation on decision making, using decisional conflict (DC) as the primary outcome. Methods Prospective cohort study of 73 pwMS attending clinics who were making decisions about DMTs followed for one year. Prerequisites and consultation features were measured with the SURE scale for DC used as the primary outcome at baseline and at one year. Results The patient activation measure (PAM) was the only driver prior to the consultation associated with DC (p = 0.02) showing those less engaged were more likely to have DC. Overall, 51/73 (70%) of people made their treatment decision or reinforced a former decision during the consultation. We found making a treatment decision between the original consultation and the follow-up was associated with resolving DC (p = 0.008). Conclusions Patient engagement impacts DC but the HCP delivering the optimal Shared Decision Making (SDM) approach is additionally significant in reducing DC. In complex decisions there is a clear role for face-to-face consultations in current practice.
Accuracy of acetabular cup placement using an angle-adjusting alignment guide with laser pointer in total hip arthroplasty
Authors: Okanoue Yusuke , Aso Koji , Dan Junpei , Takaya Shogo , Izumi Masashi , Kawakami Teruhiko , Ikeuchi Masahiko 
Published: October 2020

Purpose: To evaluate cup-positioning accuracy in total hip arthroplasty (THA) using a novel angle-adjusting alignment guide with laser pointer and determine whether level of surgical experience affects accuracy of cup placement or not. Methods: We included 117 hips in 104 patients who underwent THA using the novel guide. We retrospectively reviewed 44 hips in 40 patients who underwent THA before the novel guide was introduced. We compared differences in cup angles between the novel guide group and the conventional guide group as well as the discrepancies in targeted angles between the experienced surgeon group and the inexperienced surgeon group. Results: There were 114/117 hips (97.4%) within the Lewinnek safe zone in the novel guide group and 32/44 hips (72.7%) within the safe zone in the conventional guide group. There were significantly fewer outliers in the novel guide group ( p < 0.001). In the experienced surgeon group, the mean absolute errors in inclination and anteversion were 2.0 ± 1.7° and 2.1 ± 2.3°, respectively; which were not significantly different from those in the inexperienced surgeon group (2.3 ± 2.1° and 2.8 ± 2.3°, respectively). Conclusion: The novel angle-adjusting alignment guide with laser pointer is a simple tool that provides better accuracy of cup position than that obtained using conventional guides. Accurate cup placement is possible using the novel guide, regardless of surgeons’ experience.
The advantage of navigation for knee with lateral femoral bowing in total knee arthroplasty
Authors: Nam Jun Ho , Song Suk-Kyoon , Cho Myung-Rae , Kang Dae-Won , Choi Won-Kee 
Published: October 2020

Purpose: We have analyzed the surgical outcomes of primary total knee arthroplasty (TKA) using computer-assisted (CA) navigation in terms of postoperative coronal alignment depending on preoperative lateral femoral bowing. Methods: We conducted a retrospective study of patients who have undergone navigated primary TKA from January 2016 through January 2020. Two hundred and ninety-nine cases with lateral femoral bowing of 3° or less were assigned to group 1, 95 cases of lateral femoral bowing between 3° and 5° were assigned to group 2, and 89 cases with lateral femoral bowing of more than 5° were assigned to group 3. The postoperative mechanical hip–knee–ankle (mHKA) angle was measured from scanograms, which were taken 3 months after surgery. The appropriate range of coronal alignment was set as 0 ± 3°. Results: The number of outliers of mHKA occurred was 31 cases (10.4%) in group 1, 17 cases (17.9%) in group 2, and 17 cases (19.1%) in group 3. There was a significant correlation between the degree of lateral femoral bowing and the occurrence rate of mHKA outliers. Multiple variables logistic regression analysis showed occurrence rate of outliers in group 3 to be 2.04 times higher than group 1. After adjusting the patient’s age, sex, body mass index, and preoperative HKA deformity, the occurrence rate of outliers in group 3 was still 1.96 times higher than group 1. Conclusion: The benefit of CA navigation during TKA in obtaining coronal alignment within 0 ± 3° may be lessened when the preoperative lateral femoral bowing is severely advanced.
Systematic Review of Preinjury Mental Health Problems as a Vulnerability Factor for Worse Outcome After Sport-Related Concussion
Authors: Iverson Grant L. , Williams Michael W. , Gardner Andrew J. , Terry Douglas P. 
Published: October 2020

Background: It is difficult to predict who will experience prolonged health problems after sustaining a sport-related concussion. Purpose: To synthesize the literature and conduct a gap analysis on the association between preinjury mental health problems and clinical outcome from sport-related concussion. Study Design: Systematic review; Level of evidence, 4. Methods: Data sources were PubMed, PsycINFO, MEDLINE (and MEDLINE in Process), CINAHL, Cochrane Library, EMBASE, SPORTDiscus, Scopus, and Web of Science. Studies published before February 2019 that addressed preinjury mental health problems as a possible predictor of worse clinical outcome or clinical recovery from concussion were eligible for inclusion. Results: Of 4013 studies screened, 358 full texts were reviewed, and 12 studies involving 3761 participants (n = 471 [12.5%] with preexisting mental health problems) were ultimately included. The participants with a preinjury history of mental health problems were at greater risk for having persistent symptoms or worse outcome in 9 of 12 studies. The studies had major methodological differences, and most studies were not focused on mental health as a primary predictor or prognostic factor. Rather, they included it as a secondary or tertiary predictor. The sample sizes with preinjury mental health problems in most studies were small or very small (ie, <25). The age of onset, type, course, severity, and duration of mental health problems were not defined. The extent to which mental health problems were present before the season, during baseline testing, was not reported. Conclusion: Preinjury mental health problems appear to confer risk for worse clinical outcome after sport-related concussion. Future research is needed to (1) examine this risk factor in large representative populations of middle school students, high school students, and collegiate athletes; (2) quantify the risk for each mental health condition; (3) understand the mechanisms underlying this increased risk; and (4) develop more refined treatment and rehabilitation approaches for these student-athletes.
Preoperative Knee Instability Affects Residual Instability as Evaluated by Quantitative Pivot-Shift Measurements During Double-Bundle ACL Reconstruction
Authors: Kawanishi Yusuke , Nozaki Masahiro , Kobayashi Makoto , Yasuma Sanshiro , Fukushima Hiroaki , Murase Atsunori , Takenaga Tetsuya , Yoshida Masahito , Kuroyanagi Gen , Kawaguchi Yohei , Nagaya Yuko , Murakami Hideki 
Published: October 2020

Background: The pivot-shift test is an important indicator of functional outcomes after anterior cruciate ligament (ACL) reconstruction (ACLR). Preoperative instability as indicated by the pivot-shift test is associated with residual instability after ACLR. Few studies have used quantitative means to evaluate the pivot shift after ACLR. Purpose: To investigate the relationship between preoperative and residual instability and to identify the risk factors for residual instability by using quantitative measurements of the pivot shift. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 91 patients undergoing primary double-bundle ACLR were retrospectively enrolled. Quantitative measurements of instability for ACL-deficient knees (ACLD) and uninjured contralateral knees (intact) preoperatively, as well as ACLR knees intraoperatively, were performed under general anesthesia using the pivot-shift test, with inertial sensors to measure acceleration and external rotational (ER) angular velocity. The ratios of intact to ACLD (ACLD/I) and intact to ACLR (ACLR/I) were measured. Patients who showed an ACLR/I of >1 were classified into the residual instability group, and those with an ACLR/I of ≤1 were classified into the noninstability group. Regarding demographic, surgical, and quantitative measurement factors, between-group comparisons and multivariate logistic regression were conducted for predictors of residual instability. Receiver operating characteristic curves were used to evaluate the correlations between ACLD/I and ACLR/I and the cutoff value of ACLD/I in predicting residual instability. Results: The predictive factors for intraoperative residual instability included female sex (odds ratio [OR], 0.3 [95% CI, 0.1-0.9]; P = .034) and ACLD/I for acceleration (OR, 1.6 [95% CI, 1.2-2.1]; P < .001), and ACLD/I for ER angular velocity (OR, 1.9 [95% CI, 1.2-3.1]; P = .013). Correlations between ACLD/I and ACLR/I were moderate with respect to both acceleration ( r = 0.435; P < .001) and ER angular velocity ( r = 0.533; P < .001). The cutoff points for ACLD/I were 4.9 for acceleration (sensitivity, 65.1%; specificity, 85.7%; area under the curve [AUC], 0.76) and 2.4 for ER angular velocity (sensitivity, 80.0%; specificity, 50.0%; AUC, 0.74). Conclusion: Greater preoperative instability was a risk factor for residual instability as measured intraoperatively by a quantitatively evaluation in the pivot shift during ACL reconstruction. Quantitative measurements of instability during the pivot shift mechanism under general anesthesia may enable surgeons to predict postoperative residual instability.
Epidemiology of Traumatic and Overuse Injuries in Swiss Professional Male Ice Hockey Players
Authors: Brunner Romana , Bizzini Mario , Niedermann Karin , Maffiuletti Nicola A. 
Published: October 2020

Background: Ice hockey injury patterns in Europe were last evaluated in the 1990s. Purpose: The aim of this study was to assess the frequency, type, location, and incidence of traumatic injuries, as well as the prevalence and relative effect of overuse injuries in professional male ice hockey players. Study Design: Descriptive epidemiology study. Methods: Traumatic injuries were assessed using a standardized injury report form over a 1-year period (including the preparatory phase and season). The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire was used to determine overall and substantial overuse injuries and their relative effect on ice hockey players. Results: Five Swiss National League teams participated in the study. From a total of 321 recorded injuries, 179 led to time loss from sport. The game-related time-loss injury incidence during the season was 88.6/1000 player-game hours.Time-loss injuries affected mainly the hip/groin/thigh region (23%), followed by the head (17%). Most time-loss injuries were classified as muscle strains (24%), followed by concussions (18%). The most common injury mechanism involved collision with an opponent’s body (31%), and right forward players (23%) were most likely to report a game-related injury. Most injuries (27%) occurred within the defending zone along the boards. The average prevalence rates of all overuse and substantial overuse injuries were 49% and 13%, respectively. The hip/groin displayed the highest average prevalence for all overuse problems (16%), translating to the highest relative effect. Conclusion: Muscle strains and concussions were the most frequent time-loss injuries in Swiss professional ice hockey players. The hip/groin was the most affected region for both traumatic and overuse injuries.
National Prevalence of Disability and Clinical Accommodations in Medical Education
Authors: Meeks Lisa M , Case Ben , Plegue Melissa , Moreland Christopher J , Jain Sharad , Taylor Nichole 
Published: October 2020

Background: This study aimed to evaluate and report the national prevalence of disability across undergraduate medical education (UME) and examine differences in the category of disability, and accommodation practices between allopathic (MD)- and osteopathic (DO)-granting programs. Methods: Between May 20 and June 30, 2020, 75% of institutional representatives at eligible DO schools responded to a web-based survey. The survey assessed the aggregate prevalence of disabled DO students, prevalence of DO students by category of disability, and prevalence of accommodations granted. Descriptive statistics were used to summarize results. Using 2019 MD data, comparisons were made between MD and DO programs to calculate overall prevalence and differences in accommodation practices across undergraduate medical education. Results: DO-granting programs reported a disability prevalence of 4.27% of the total enrollment. Attention-deficit/hyperactivity disorder (ADHD), psychological disabilities, and chronic health disabilities were reported most frequently. DO-granting programs reported higher rates of ADHD than the MD-granting program. The national pooled prevalence of disability across MD- and DO-granting programs was 4.52%. MD-granting programs reported a higher number of students with disabilities and higher rates of psychological disabilities when compared with DO-granting programs. One hundred percent of DO students disclosing disability received some form of accommodation. General clinical accommodations were more frequently provided in MD-granting programs when compared to DO-granting programs. Conclusions: This study provides the first comprehensive prevalence of US medical student disability and accommodations. Additionally, these data may serve as a benchmark for DO programs, with implications for curricular development, instructional planning and disability support, and resource allocation in medical education.
Shoot and Post: The Making of Educational Videos
Authors: Naik Jaee M. , Thieringer Florian M. , Beck-Broichsitter Benedicta , Girod Sabine , Naik Milind N. 
Published: October 2020

Study Design: Descriptive technical write-up. Objective: To describe the making of educational videos in 4 simple steps. Methods: There are 4 steps in the creation of an educational video, namely theme and script, preparation and equipment, filming, and postproduction. Results: The authors give details of each step of the video making process, with practical tips from personal experiences, product suggestions, and photo documentation. Conclusion: A 4-step approach to make high-quality educational videos for your patients, residents, and social media platforms is presented.
Is the Concept of Corporate Governance a Strategic Plan for Firms’ Optimum Capital Structure? Evidence from Manufacturing Companies
Authors: Das Chandrika Prasad , Agarwall Himanshu , Swain Rabindra Kumar 
Published: October 2020

The aim of the article is to examine the relationship as well as measure the impact of corporate governance as a strategic plan on capital structure decision of top Bombay Stock Exchange-listed manufacturing firms in India. Panel regression analysis is employed to estimate the relationship and measure the impact of corporate governance, namely, size, meetings, independent director, women director and audit committee meetings, on the capital structure mix (debt–equity ratio) of the sample corporate, during a 10-year period of 2008–2017. The results of study reveal that the components of corporate governance, namely, size, board meetings, independent director, and audit committee meetings have a positive association with the capital structure variable (debt–equity ratio) of the sample manufacturing companies. However, there is a negative relationship between the control variables (ROCE and NWTA) and the dependent variable of the sample corporate. Overall, as per the study results, a statistically significant impact prevails on the capital structure, of corporate governance variables, taken as a whole. This article adds on to the existing study by highlighting a new prospect of relation and influence of corporate governance on capital structure decisions. The statistical findings of the study provide evidence to the corporate sector in deciding the optimum capital structure, affecting its costs and performance, and to the regulatory authorities in framing and implementing corporate governance mechanisms more effectively and efficiently for improving the economy of the country.
Relationship Between N-Terminal Probrain Natriuretic Peptide (NT-Pro BNP) Level, Infarct Type and Infarct Volume in Ischemic Cerebrovascular Disease
Authors: Tekin Selma , Öncel Çağatay Hilmi , Özdemir Mehmet Bülent , Yaylalı Yalın Tolga , Tekin Işık , Güneş Özcan , Rota Simin , Kurbetli Nuriye 
Published: October 2020

Background: N-terminal probrain natriuretic peptide, which is a neurohormone produced mainly by the heart, is increased in acute ischemic cerebrovascular disease. Here we aimed to investigate the relationship of N-terminal probrain natriuretic peptide levels with cerebrovascular disease subtypes, infarct volume, and prognosis in cerebrovascular disease, and to determine if N-terminal probrain natriuretic peptide could be a biomarker for ischemic cerebrovascular disease. Methods: Consecutive 105 patients with a diagnosis of acute ischemic cerebrovascular disease and 50 healthy controls were examined for serum N-terminal probrain natriuretic peptide concentration, cerebrovascular disease subtypes, infarct volumes, and clinical outcomes with the National Institute of Health Stroke Scale assessment. Results: Mean N-terminal probrain natriuretic peptide values of cardioembolic group were significantly higher than lacunar infarct group ( P < .005) and transient ischemic attack group ( P = .005). There was a relation between worsening in the National Institute of Health Stroke Scale and elevation at N-terminal probrain natriuretic peptide ( P = .001). However, between N-terminal probrain natriuretic peptide levels and infarct volume, significant correlation was not detected ( P = .44). Conclusion: N-terminal probrain natriuretic peptide can be used as a valuable marker to distinguish between cardioembolic infarct and lacunar infarct. In addition, N-terminal probrain natriuretic peptide levels might be used as a biomarker for differential diagnosis of transient ischemic attack group and to provide insight into the prognosis.
Study of Dhat Syndrome in Men in West Bengal: A Clinic-Based Study
Authors: Chakraborty Abhijit , Mukhopadhyay Debshankar , Mandal Alok Kumar , Ghosh Srijit 
Published: October 2020

Background: Dhat syndrome is a culture-bound syndrome of the Indian subcontinent. Traditional and cultural teachings through generations, and myths and misconceptions about sex are its principal contributing factors. Although prevalent, there is scarcity in studies on Dhat syndrome, particularly from Bengal. Aims and objectives: 1. To study the phenomenology of Dhat syndrome in men attending the out patients department (OPD). 2. To study the comorbid sexual and psychiatric disorders associated with Dhat syndrome. Methodology: This was a cross-sectional observational study conducted in the psychiatric OPD in a tertiary care medical college hospital in West Bengal. The duration of the study was 18 months. 122 patients were included in this study that fulfilled the inclusion and exclusion criteria. The diagnosis of Dhat syndrome was made as per International Classification of Diseases, Tenth Revision, diagnostic criteria for research (DCR) criteria. A semi-structured pro forma was used to obtain sociodemographic variables along with numerous physical and sexual symptoms. Mini International Neuropsychiatric Interview was applied for psychiatric comorbidities. Data were analyzed using Statistical Package for Social Studies 17 by SPSS Inc., Chicago. Results: 122 patients met the inclusion and exclusion criteria. Majority of patients were among age group of 20 to 30 years (60.7%). 56.6% were from the Muslim community and 43.4% were from the Hindu community. 54.1% population was unmarried and 39.3% were newly married. Routes of passage were night falls in 62.3% patients, and 52.5% patients pointed toward passage through urine. Many patients reported passage of semen more than one route. All patients (100%) complained about generalized weakness and thinning of semen. 66.4% had generalized body ache, 55.7% complain about headache, 60.7% decreased body glow, 50% had loss of appetite, 98.4% had decreased self-confidence, sleep disturbance was reported in 34.3% patients, 58.2% reported that their penis was becoming smaller, and 49.2% patients reported decreased sexual capability. The most common comorbid condition was sexual dysfunction (39.3%) followed by depressive disorders (27.9%). Premature ejaculation was found in 54.17% patients and erectile dysfunction in 33.33%. Conclusion: Dhat syndrome is a common culture-bound syndrome in Bengal. It is widespread in the Muslim community also. The importance of exploration of sexual comorbidities in Dhat syndrome is very much needed.
Role of red free imaging, retinal reflectance and fundus autofluorescence in Bietti crystalline dystrophy: case report
Authors: Surve Abhidnya , Balaji Akshaya , Azad Shorya Vardhan , Kumar Vinod , Vohra Rajpal , Venkatesh Pradeep 
Published: October 2020

Bietti crystalline dystrophy (BCD), a rare autosomal recessive hereditary disorder, is identified by its clinical features. It is characterised by crystalline deposits and hence called crystalline retinopathy. The retinopathy progresses with age, showing a decrease in the number of crystalline deposits and increase in the area of chorioretinal degeneration, which spreads in a centrifugal pattern. Thus, BCD can be confused with other disorders with crystalline-like deposits and chorioretinal degenerations. The red-free and near-infrared reflectance allows prominent visualisation of crystalline deposits that may be missed. The non-inferiority of red-free imaging and its wider availability could allow its use as a screening tool. The enhanced depth imaging optical coherence tomography shows crystalline deposits throughout the retina and outer retinal tubulation. Thus, multimodality imaging can act as an adjunct in diagnosis, monitoring and follow up in these cases, acting not only as a teaching tool but also giving an insight into the underlying pathophysiology of the disorder. Plain language summary Use of imaging in diagnosis of Bietti crystalline dystrophy Bietti crystalline dystrophy is a rare familial disorder but is not shown in all family members and may skip generations, as it has an autosomal recessive pattern of inheritance. It shows refractile yellow-white crystalline deposits and degenerative changes in the retina. These crystalline deposits disappear with age while degenerative changes increase and spread from centre to the periphery. This may cause difficulty in early detection, and confusion with similar degenerative diseases of the retina. The use of various imaging modalities can help in diagnosis and follow up of these cases. These modalities also provide understanding of the basic disease process.