bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Static and Dynamic Stretching With Strengthening Exercises in Patients With Patellofemoral Pain Who Have Inflexible Hamstrings: A Randomized Controlled Trial
Authors: Lee Jin Hyuck , Jang Ki-Mo , Kim Eunseon , Rhim Hye Chang , Kim Hyeong-Dong 
Published: August 2020

Background: Patellofemoral pain (PFP) syndrome is closely associated with muscle tightness. However, studies regarding the effects of stretching exercises on PFP patients with inflexible hamstrings are scarce. The aim of the study was to compare the effects between static and dynamic hamstring stretching in patients with PFP who have inflexible hamstrings. Hypothesis: Compared with static hamstring stretching, dynamic hamstring stretching will improve the parameters of hamstring flexibility, knee muscle strength, muscle activation time, and clinical outcomes in this patient population. Study Design: Prospective randomized controlled trial. Level of Evidence: Level 2. Methods: A total of 46 patients (25, static stretching; 21, dynamic stretching) participated. Hamstring flexibility was assessed according to the popliteal angle during active knee extension. Muscle strength and muscle activation time were measured using an isokinetic device. Clinical outcomes were evaluated using the visual analog scale (VAS) for pain and the anterior knee pain scale (AKPS). Results: There were no differences in hamstring flexibility and knee muscle strength of the affected knees between the groups ( P > 0.05). Significantly improved muscle activation time and clinical outcomes of the affected knees were observed in the dynamic stretching group compared with the static stretching group (all Ps < 0.01 for hamstring, quadriceps, VAS, and AKPS). Conclusion: In patients with PFP who have inflexible hamstrings, dynamic hamstring stretching with strengthening exercises was superior for improving muscle activation time and clinical outcomes compared with static hamstring stretching with strengthening exercises. Clinical Relevance: Clinicians and therapists could implement dynamic hamstring stretching to improve function and reduce pain in patients with PFP who have inflexible hamstrings.
Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker of renal injury in patients with ureteric stones: a pilot study
Authors: Bolgeri Marco , Whiting Danielle , Reche Antonio , Manghat Padmini , Sriprasad Seshadri 
Published: August 2020

Objective: The role of neutrophil gelatinase-associated lipocalin in renal obstruction remains unclear. The aim of this study is to assess neutrophil gelatinase-associated lipocalin kinetics and its potential role as a biomarker of renal damage in acute ureteric colic. Methods: Thirty-six patients with acute ureteric colic were prospectively recruited and compared with two control groups. Blood and urine samples for plasma neutrophil gelatinase-associated lipocalin and urinary neutrophil gelatinase-associated lipocalin levels were obtained at various time points. Results: There were significantly higher levels of urinary neutrophil gelatinase-associated lipocalin and the urinary neutrophil gelatinase-associated lipocalin/creatinine ratio at presentation when comparing patients with acute ureteric colic to healthy controls ( P=0.002 and P=0.004, respectively). In patients with acute ureteric colic managed with surgical intervention ( n=27) there was a significant reduction in plasma neutrophil gelatinase-associated lipocalin ( P=0.001) and an increase in the urinary neutrophil gelatinase-associated lipocalin/creatinine ratio 6 hours postoperatively ( P=0.03). Eight of nine patients managed conservatively for acute ureteric obstruction had spontaneous stone passage at follow-up (median 26 days) with a significant reduction in the urinary neutrophil gelatinase-associated lipocalin/creatinine ratio ( P=0.03). Conclusion: The observation of a reduction in plasma neutrophil gelatinase-associated lipocalin and urinary neutrophil gelatinase-associated lipocalin levels following relief of renal obstruction due to ureteric stones suggests the potential role of neutrophil gelatinase-associated lipocalin as a biomarker in this scenario and in the follow-up setting as a potential marker of relief of obstruction. Level of evidence: 3b
On Justice in Pedagogical Contexts
Authors: Benner Dietrich 
Published: August 2020

Purpose: This article explores the question of what is meant by justice in pedagogical contexts and whether there is a proven pedagogical concept of justice at all, from which the public and scientific controversies about justice in pedagogical contexts can be judged. Design/Approach/Methods: Instead of developing a positive pedagogical concept of justice, this article analyzes pedagogical injustices and assigns them to different levels of the educational system. Findings: The result is a differentiated pedagogical phenomenology of injustices in pedagogical contexts, which at the same time shows starting points for possible changes. Originality/Value: The originality of this article is that an instrumentalization of education in the service of extra-pedagogical norms of justice is avoided and a pragmatic approach is developed, which shows how pedagogical injustices can be reduced. Although the arguments for this are developed on the basis of discourses held in Germany, they are of general and international importance.
Prevalence of Cardiac Risk Factors and Attitude toward Self-Risk Assessment among Cardiac Care Givers
Authors: Furnaz Shumaila , Karim Musa , Ali Sajjad , Haque Muhammad Tanzeel ul , Usman Muhammad Abdullah , Kumar Dileep , Siddiqi Tariq Jamal , Kazmi Khawar Abbas 
Published: August 2020

Objective: Aim of this survey was to assess the prevalence of cardiovascular diseases (CVD) risk factors and attitude toward self-risk assessment among cardiac care physicians (who did not have CVD history), at a tertiary care cardiac center in Pakistan. Design: In this survey we included cardiac care givers who had a minimum of 1 year of working experience in a cardiac care center. Participants: Participants with self-reported history of established diagnosis of CVD were excluded. Face-to-face interviews were conducted with the help of a structured questionnaire which consisted of demographic information, data regarding established CVD risk factors, self-awareness, and attitude toward CVD risk assessment. Results: A total of 126 participants were interviewed, out of which 20.6% (26) were females and mean age was 36.1±7.6 years. The most prevalent CVD risk factor was family history of CVD (33.3%) followed by smoking (14.3%) and 23.8% had body mass index of ≥27.5 kg/m2. Around 23% of the participants did not know their cholesterol levels, similarly more than 74% were not aware of their high-density lipoproteins levels. More than 76% had never assessed their CVD risk and more than 37% don’t know or don’t have any opinion about their own CVD risk. Conclusions: The present study reveals low prevalence of conventional cardiac risk factors and marginally higher tendency of modifiable risk factors, such as smoking and obesity, among the cardiac physicians. A large proportion of these cardiac physicians have not yet assessed their CVD risk.
Complete Versus Incomplete Surgical Resection in Intramedullary Ependymomas: A Systematic Review and Meta-analysis
Authors: Salari Farhad , Golpayegani Mehdi , Sadeghi-Naini Mohsen , Hanaei Sara , Shokraneh Farhad , Ahmadi Ayat , Khayat-kashani Hamid Reza , Vacarro Alexander R. , Rahimi-Movaghar Vafa 
Published: August 2020

Study Design: Systematic review. Objective: To compare outcomes of complete versus incomplete resection in primary intramedullary spinal cord ependymoma. Methods: A comprehensive search of the MEDLINE, CENTRAL, and Embase databases was conducted by 2 independent investigators. Random-effect meta-analysis and meta-regression with seven covariates were performed to evaluate the reason for the heterogeneity among studies. We also used individual patient data in the integrative analysis to compare complete and incomplete resection based on 4 outcomes: progression-free survival (PFS), overall survival (OS), postoperative neurological improvement (PNI), and follow-up neurological improvement (FNI). Results: A total of 23 studies were identified, including 407 cases. Significant heterogeneity among included studies was observed in risk estimates (I2 for PFS, FNI, and PNI were 49.5%, 78.3%, and 87.2%, respectively). The mean follow-up time across cases was 48.6 ± 2.35 months. Cox proportional multivariable analysis revealed that the complete resection can prolong PFS (model, hazard ratio = 0.18, CI 0.05-0.54, P = .004,) and improve the FNI (binary logistic regression, adjusted odds ratio = 16.5, CI 1.6-171, P = .019). However, PNI and OS were similar in patients with incomplete resected spinal cord ependymoma compared with complete resection (binary logistic regression respectively and Cox multivariable analysis, P > .5). Conclusion: The data presented in this study showed that OS was not significantly affected by the degree of surgery. However, complete resection of intramedullary ependymomas provides the optimal outcomes with longer PFS and better long-term neurological outcomes than incomplete resection.
Higher Body Mass Index Is Associated With Biochemical Changes in Knee Articular Cartilage After Marathon Running: A Quantitative T2-Relaxation MRI Study
Authors: Wang Zhongzheng , Ai Songtao , Tian Fei , Liow Ming Han Lincoln , Wang Shaobai , Zhao Jinzhong , Tsai Tsung-Yuan 
Published: August 2020

Background: More than 30 million individuals participate in marathon running every year worldwide. As the popularity of marathon running continues to increase, it is essential for the purposes of injury prevention to understand the effects of marathon running on the knee cartilage. Purpose: To investigate the immediate effects of marathon running on knee articular cartilage and to determine the relationship between body mass index and cartilage biochemical composition. Study Design: Descriptive laboratory study. Methods: T2-relaxation magnetic resonance imaging (MRI) of knees in 18 nonprofessional marathoners (mean age, 35.6 ± 6.4 years) was performed before and after a full-length marathon. Three-dimensional models of the knee articular cartilage were reconstructed and divided into different regions of interest. The 3-dimensional models were then applied to corresponding T2-relaxation MRI maps to calculate T2 values in each region of interest. The mean values of the T2-relaxation times in each region of interest before and after the marathon were compared by use of the paired Student t test. The Pearson correlation coefficient between T2 change and runner body mass index (BMI) was calculated. Results: Postmarathon T2-relaxation times were significantly higher than premarathon values for patellofemoral cartilage (32.6 ± 12.1 vs 34.1 ± 10.9 ms; P < .01) and medial tibial cartilage (35.6 ± 11.7 vs 34.6 ± 12.0 ms; P = .01). The greatest increase was observed in the anterior part of the medial tibial cartilage. No statistically significant changes were seen in the T2-relaxation times of the lateral tibial and femoral cartilage. Postmarathon T2-relaxation elevation in the anteromedial knee tibiofemoral joint cartilage strongly correlated with body weight ( R = 0.6746; P = .03) and BMI ( R = 0.6989; P = .001). Changes in T2-relaxation times did not correlate with marathon time, height, age, or sex in any regions of interest. Conclusion: Marathon running leads to immediate postmarathon elevated T2-relaxation values within knee articular cartilage, suggesting biochemical content alteration. Additionally, runners with higher BMI may have greater changes in cartilage biochemical composition after a marathon. Further studies should investigate whether these changes are sustained over time to determine the relationship between immediate biochemical changes in cartilage composition and cartilage degeneration. Clinical Relevance: Runners with a higher BMI may carry a higher risk of anteromedial tibiofemoral cartilage degeneration compared with runners with lower BMI.
Physical Performance Improves With Time and a Functional Knee Brace in Athletes After ACL Reconstruction
Authors: Dickerson Laura C. , Peebles Alexander T. , Moskal Joseph T. , Miller Thomas K. , Queen Robin M. 
Published: August 2020

Background: Athletes who return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR) often have reduced physical performance and a high reinjury rate. Additionally, it is currently unclear how physical performance measures can change during the RTS transition and with the use of a functional knee brace. Purpose/Hypothesis: The purpose of this study was to examine the effects of time since surgery (at RTS and 3 months after RTS) and of wearing a brace on physical performance in patients who have undergone ACLR. We hypothesized that physical performance measures would improve with time and would not be affected by brace condition. Study Design: Controlled laboratory study. Methods: A total of 28 patients who underwent ACLR (9 males, 19 females) completed physical performance testing both after being released for RTS and 3 months later. Physical performance tests included the modified agility t test (MAT) and vertical jump height, which were completed with and without a knee brace. A repeated-measures analysis of variance determined the effect of time and bracing on performance measures. Results: The impact of the knee brace was different at the 2 time points for the MAT side shuffle ( P = .047). Wearing a functional knee brace did not affect any other physical performance measure. MAT times improved for total time ( P < .001) and backpedal ( P < .001), and vertical jump height increased ( P = .002) in the 3 months after RTS. Conclusion: The present study showed that physical performance measures of agility and vertical jump height improved in the first 3 months after RTS. This study also showed that wearing a knee brace did not hinder physical performance. Clinical Relevance: Wearing a functional knee brace does not affect physical performance, and therefore a brace could be worn during the RTS transition without concern. Additionally, physical performance measures may still improve 3 months past traditional RTS, therefore justifying delayed RTS.
Factors Associated With Patient Satisfaction Measured Using a Guttman-Type Scale
Authors: Versluijs Yvonne , Brown Laura E , Rao Mauna , Gonzalez Amanda I , Driscoll Matthew D , Ring David 
Published: August 2020

Patient experience measures such as satisfaction are increasingly tracked and incentivized. Satisfaction questionnaires have notable ceiling effects that may limit learning and improvement. This study tested a Guttman-type (iterative) Satisfaction Scale (GSS) after a musculoskeletal specialty care visit in the hope that it might reduce the ceiling effect. We measured floor effects, ceiling effects, skewness, and kurtosis of GSS. We also assessed factors independently associated with GSS and the top 2 possible scores. In this cross-sectional study, 164 patients seeing an orthopedic surgeon completed questionnaires measuring (1) a demographics, (2) symptoms of depression, (3) catastrophic thinking in response to nociception, (4) heightened illness concerns, and (5) satisfaction with the visit (GSS). Bivariate and multivariable analyses sought associations of the explanatory variable with total GSS and top 2 scores of GSS. Accounting for potential confounding using multivariable analysis, lower satisfaction was independently associated with greater symptoms of depression (β: −0.03; 95% CI: −0.05 to −0.00; P = .047). The top 2 scores of the GSS were independently associated with women (compared to men: odds ratio [OR]: 2.12, 99% CI: 1.01-4.45, P = .046) and lower level of education (masters’ degree compared to high school; OR: 0.16, 95% CI: 004-0.61, P = .007). The GSS had no floor effect, a ceiling effect of 38%, a skewness of −0.08, and a kurtosis of 1.3. The 38% ceiling effect of the iterative (Guttman-style) satisfaction measure is lower than ordinal satisfaction scales, but still undesirably high. Alternative approaches for reducing the ceiling effect of patient experience measures are needed.
Effect on Foot Width With Triplanar Tarsometatarsal Arthrodesis for Hallux Valgus
Authors: Vaida Justin , Ray Justin J. , Shackleford Taylor L. , DeCarbo William T. , Hatch Daniel J. , Dayton Paul , McAleer Jody P. , Smith W. Bret , Santrock Robert D. 
Published: August 2020

Background: Foot width reduction is a desirable cosmetic and functional outcome for patients with hallux valgus. Triplanar first tarsometatarsal (TMT) arthrodesis could achieve this goal by 3-dimensional correction of the deformity. The aim of this study was to evaluate changes in bony and soft tissue width in patients undergoing triplanar first TMT arthrodesis. Methods: After receiving Institutional Review Board approval, charts were retrospectively reviewed for patients undergoing triplanar first TMT arthrodesis for hallux valgus at 4 institutions between 2016 and 2019. Patients who underwent concomitant first metatarsal head osteotomies (eg, Silver or Chevron) or fifth metatarsal osteotomies were excluded. Preoperative and postoperative anteroposterior weightbearing radiographs were compared to evaluate for changes in bony and soft tissue width. One hundred forty-eight feet from 144 patients (48.1 ± 15.7 years, 92.5% female) met inclusion criteria. Results: Preoperative osseous foot width was 96.2 mm, compared to 85.8 mm postoperatively ( P < .001). Preoperative soft tissue width was 106.6 mm, compared to 99.3 mm postoperatively ( P < .001). Postoperatively, patients had an average 10.4 ± 4.0 mm reduction (10.8% reduction) in osseous width and average 7.3 ± 4.0 mm reduction (6.8% reduction) in soft tissue width. Conclusions: Triplanar first TMT arthrodesis reduced both osseous and soft tissue foot width, providing a desirable cosmetic and functional outcome for patients with hallux valgus. Future studies are needed to determine if patient satisfaction and outcome measures correlate with reductions in foot width. Level of evidence: Level III, retrospective comparative study
COVID-19: interim guidance on rehabilitation in the hospital and post-hospital phase from a European Respiratory Society- and American Thoracic Society-coordinated international task force
Authors: Spruit Martijn A. , Holland Anne E. , Singh Sally J. , Tonia Thomy , Wilson Kevin C. , Troosters Thierry 
Published: August 2020

BackgroundPatients with coronavirus disease 2019 (COVID-19) or post-COVID-19 will probably have a need for rehabilitation during and directly after the hospitalisation. Data on safety and efficacy are lacking. Healthcare professionals cannot wait for published randomised controlled trials before they can start these rehabilitative interventions in daily clinical practice, as the number of post-COVID-19 patients increases rapidly. The Convergence of Opinion on Recommendations and Evidence process was used to make interim recommendations for rehabilitation in the hospital and post-hospital phases in COVID-19 and post-COVID-19 patients, respectively.Methods93 experts were asked to fill out 13 multiple-choice questions. Agreement of directionality was tabulated for each question. ≥70% agreement on directionality was necessary to make consensus suggestions.Results76 (82%) experts reached consensus on all questions based upon indirect evidence and clinical experience on the need for early rehabilitation during the hospital admission, the screening for treatable traits with rehabilitation in all patients at discharge and 6–8 weeks after discharge, and around the content of rehabilitation for these patients. It advocates for assessment of oxygen needs at discharge and more comprehensive assessment of rehabilitation needs, including physical as well as mental aspects 6–8 weeks after discharge. Based on the deficits identified, multidisciplinary rehabilitation should be offered with attention on skeletal muscle and functional as well as mental restoration.ConclusionsThis multinational task force recommends early, bedside rehabilitation for patients affected by severe COVID-19. The model of pulmonary rehabilitation may suit as a framework, particularly in a subset of patients with long-term respiratory consequences.
Properties of beta oscillations in Dup15q syndrome
Authors: Saravanapandian Vidya , Frohlich Joel , Hipp Joerg F. , Hyde Carly , Scheffler Aaron W. , Golshani Peyman , Cook Edwin H. , Reiter Lawrence T. , Senturk Damla , Jeste Shafali S. 
Published: August 2020

AbstractBackgroundDuplications of 15q11.2-q13.1 (Dup15q syndrome) are highly penetrant for autism, intellectual disability, hypotonia, and epilepsy. The 15q region harbors genes critical for brain development, particularlyUBE3Aand a cluster of gamma-aminobutyric acid type A receptor (GABAAR) genes. We recently described an electrophysiological biomarker of the syndrome, characterized by excessive beta oscillations (12–30 Hz), resembling electroencephalogram (EEG) changes induced by allosteric modulation of GABAARs. In this follow-up study, we tested a larger cohort of children with Dup15q syndrome to comprehensively examine properties of this EEG biomarker that would inform its use in future clinical trials, specifically, its (1) relation to basic clinical features, such as age, duplication type, and epilepsy; (2) relation to behavioral characteristics, such as cognition and adaptive function; (3) stability over time; and (4) reproducibility of the signal in clinical EEG recordings.MethodsWe computed EEG power and beta peak frequency (BPF) in a cohort of children with Dup15q syndrome (N= 41, age range 9–189 months). To relate EEG parameters to clinical (study 1) and behavioral features (study 2), we examined age, duplication type, epilepsy, cognition, and daily living skills (DLS) as predictors of beta power and BPF. To evaluate stability over time (study 3), we derived the intraclass correlation coefficients (ICC) from beta power and BPF computed from children with multiple EEG recordings (N= 10, age range 18–161 months). To evaluate reproducibility in a clinical setting (study 4), we derived ICCs from beta power computed from children (N= 8, age range 19–96 months), who had undergone both research EEG and clinical EEG.ResultsThe most promising relationships between EEG and clinical traits were found using BPF. BPF was predicted both by epilepsy status (R2= 0.11,p= 0.038) and the DLS component of the Vineland Adaptive Behavior Scale (R2= 0.17,p= 0.01). Beta power and peak frequency showed high stability across repeated visits (beta power ICC = 0.93, BPF ICC = 0.92). A reproducibility analysis revealed that beta power estimates are comparable between research and clinical EEG (ICC = 0.94).ConclusionsIn this era of precision health, with pharmacological and neuromodulatory therapies being developed and tested for specific genetic etiologies of neurodevelopmental disorders, quantification and examination of mechanistic biomarkers can greatly improve clinical trials. To this end, the robust beta oscillations evident in Dup15q syndrome are clinically reproducible and stable over time. With future preclinical and computational studies that will help disentangle the underlying mechanism, it is possible that this biomarker could serve as a robust measure of drug target engagement or a proximal outcome measure in future disease modifying intervention trials.