bluuebunny/crossref_metadata_2025_split huggingface dataset:
What do patients expect from osteosynthetic stabilization of proximal tibial fractures?
Authors: Hellinger Lena , Keppler Alexander M. , Ihle Christoph , Stuby Fabian , Saier Tim 
Published: May 2020

Aims and Objectives: Surgical treatment of proximal tibial fractures is often associated with complications and postoperative limitations in knee motion. Unrealistic patient expectations of the operation may lead to dissatisfaction with the surgical outcome despite successful surgery. The hypothesis of this study was that patients with proximal tibial fracture have very high expectations of surgical intervention in terms of painlessness, return to work and sport ability. Further, underestimation of the risk for the development of secondary gonarthrosis was hypothesized. Materials and Methods: From 2017-2018, n=79 patients (n=35 w, mean age 48 years ±13.6 years) with proximal tibial fracture were prospectively and consecutively enrolled at three level A trauma centers. Preoperatively, demographic data, fracture classification according to AO classification, the HSS -Knee Surgery Expectations Survey using the 4-point Likert scale, the workload according to REFA criteria and the non-standardized expectations regarding the return to work/sport ability and the secondary risk for developing gonarthrosis were collected and analysed. A statistical significance of p<0.05 was assumed. Results: 81% (n=63) of the patients expect a maximum duration of incapacity for work of 12 weeks regardless of age, gender and workload (n.s.). 74% (n=58) expect a return to work and 70% (n=55) a return to sport with no or only minor restrictions. Younger patients (younger than 55 years) had significantly higher expectations of an unrestricted return to work (p=0.045) and sport (p=0.04). Gender and workload had no significant influence on this expectation (n.s.). 33% (n=26) do not expect any residual pain postoperatively, regardless of activity. Younger patients expect significantly less residual pain than older patients (p=0.03). 92% (n=73) expect a completely normal knee joint or only minor differences to a healthy knee, regardless of age, gender and workload (n.s.). At least 72% (n=57) of the patients consider an unrestricted or only slightly restricted knee function to be at least important, regardless of age, sex and workload (n.s.). 29% (n=23) of the patients, regardless of age, sex and workload (n.s.) assume that the operation prevents secondary gonarthrosis. Conclusion: The results confirm our hypothesis that patients have very high expectations of the surgical treatment of proximal tibial fractures. For younger patients in particular, an unrestricted return to sport, work and painlessness is very important. The risk assessment regarding developing secondary gonarthrosis seems unrealistic. This study should help surgeons to discuss realistic expectations and results of osteosynthetic stabilization of proximal tibial fractures with their patients in order to improve patients’ satisfaction.
Comparable surgery time for robotic assisted total knee arthroplasty after initial learning curve
Authors: Savov Peter , Tücking Lars-René , Windhagen Henning , Ettinger Max 
Published: May 2020

Aims and Objectives: In the past years, further development in knee replacement still continues. Computer-assisted surgery techniques in total knee arthroplasty (TKA) are on the rise. One point of criticism is the prolonged time of surgery and associated cost as known from old techniques like navigation. The primary objective of this study was to determine the learning curve for the time of surgery and accuracy in implant positioning for an imageless robotic system for TKA. Materials and Methods: In this prospective study, the first 30 robotic-assisted TKA from a single senior surgeon were analyzed with regard to time of surgery and accuracy of implant position on the basis of the intraoperative plan and the postoperative x-rays. This data was compared to the last 30 manual TKAs of the same surgeon with the same prosthesis. Evaluation of the learning curve was performed with CUSUM analysis. The time of surgery after finishing the learning curve in the robotic group was compared to the manual group. Results: The learning curve in the robotic group for surgery time was finished after 11 cases. The robotic experience did not affect the accuracy of implant positioning, such as limb alignment and restoration of the joint line. The mean absolute deviation of the postoperative limb alignment to the intraoperative plan was 2° (+/- 1,1). The mean absolute deviation of the medial proximal tibial (mPTA) and distal lateral femoral angle (dLFA) was 1° (+/- 0,9) for both. The mean surgery time in the robotic group after finishing the learning curve was 66 minutes (+/- 4,2) and in the total manual group 67 minutes (+/- 3,5) (n.s.). Conclusion: After finishing the initial learning curve of 11 cases for robotic-assisted TKA the time of surgery is equal to the manual conventional technique. However, there is no learning curve for implant positioning with the imageless robotic system. The implementation of the intraoperative plan is accurate to 1° with the robotic system.
Functional outcome in patients following cartilage regenerative treatement: outcome at minimum follow-up of 12 months
Authors: Zantop Thore , Zantop Christian , Hönninger Anja , Hauner Dominik , Warminski Przemyslaw , Angele Peter 
Published: May 2020

Aims and Objectives: Full thickness cartilage defects may be devastating for the patients. Even though, the surgical options have improved, only limited information for returning to sports. Aim of this study was therefore to compare the functional outcome and the return to sports rate of patients following cartilage regenerative treatment at a minimum follow up of 12 months. Materials and Methods: A total of 50 Patients (32 male, 18 female) undergoing cartilage regeneration using a Matrix-associated chondrocyte transplantation (MACT, Novocart, TETEC, Aesculap) (27 femorotibial, 23 patellofemoral) were evaluated at a minimum follow-up of 12 months. Follow-up was performed using a multifactorial functional analysis including isokinetic strength measurements (BTE-primus), proprioceptive tests (MTF tests), a tapping test and a 3d-motion analysis (myomotion, Noraxon) during single leg squats, bilateral drop jumps and single leg hop tests. Agility was assessed using a lateral speedchase (Globalspeed, Hemsbach). Clinical results were recorded using Tegner and Lysholm score. Results: Patients showed a Lysholm score of 86,3 +/-10,3 and 84,0 +/-13,9 for male and female, respectively. The tegner score was significantly reduced when compared to preoperatively (male 4,72 +/-1,6, female 4,75 +/-1,5). Thigh circumference was reduced by an average of 3,6 cm for male and 4,4 cm for female patients. The tapping test revealed no differences between male and female patients providing a leg symmetry index (LSI) of 102,0 (+/-8,4) with an overall average frequency of 10,14 (+/-1,27). During single leg squat male patients had a significantly lower knee flexion of 55,8 (+/-8,5) of the postoperative leg compared to the non-injured leg (62,2 +/-8,2) whereas the knee abduction was -6.8 (+/-15,1) and -11,8 -11,82 (+/-16,6) for the postoperatively and non-injured leg, respectively. Evaluating the single leg hop, the LSI of distance values was 90,8 (+/-11,9) and for height values 84,0 (+/-16,0) for the male patients. There was a trend towards reduced ROM with regard to knee flexion of the injured leg to the non-injured. Cutting time during lateral speedchase showed a LSI of 98,29 (+/-13,8) and 99,44 (+/-8,2) for male and female patients, respectively. Conclusion: This prospective analysis of patients following cartilage regeneration implicates that the use of a multifactorial “return-to-sports” analysis 12 months postoperatively provides a good correlation to the clinical outcome and scores. At this FU point, Patients following MACT show knee joint function that is close to normal.
Patients outcome after distal femur- and proximal tibia replacement
Authors: Graulich Tilman , Kranz Caroline , Korallus Christoph , Örgel Marcus , Haertle Marco , Omar Mohamed , Krettek Christian , Panzica Martin 
Published: May 2020

Aims and Objectives: Mega-knee-arthroplasty are rare and indications are heterogeneous after fracture, tumour and infection. The outcome after distal femur- and/or proximal tibia replacement are unclear. We therefore wanted to analyse the postoperative outcome in case of primary and revision surgery. We hypothesize that I) Implantation of distal femur- and/or proximal tibia replacement are associated with reduced range of motion and function compared to the contralateral side and II) implantation in case of primary surgery is associated with better outcome than in case of revision surgery. Materials and Methods: We retrospectively analysed all patients in our trauma department between 1998 and 2017 who underwent a MUTARS distal femur replacement or proximal tibia replacement (Implantcast GmbH, Buxtehude, Germany). We collected general patients’ data, rang of motion, determined the Toronto extremity selvage score (TESS), musculoskeletal tumour society score (MSTS), knee society score (KSS) and Western Ontario MacMaster questionnaire (WOMAC) Score. Knee extension and flexion force was measured. Results: We included 59 patients with a mean age of 65+/-20 years. Out of these we had 19 (32%) male and 40 (68%) female patients. Mean follow up (f/up) was 36+/-57 month (range: 1-218). Indication for R-TKA was periprosthetic fractures (n=14), tumour (n=16), infection (n=10), traumatic fracture (n=14), aseptic loosening (n=3) and pathologic fracture (n=2). Indication for primary implantation was given in 33 (56%) patients and for implantation in case of revision surgery in 26 (44%) patients. Mean TESS was 66+/-33, mean MSTS was 14+/-7, mean KSS was 49+/-30, mean WOMAC was 36+/-26. Mean flexion on the operated side was 83°+/-24° compared to the healthy side (115°+/-20°) (p<0.001). Mean extension force on the operated side at 60° was 20+/-12 (Nm) compared to 77+/-58 (Nm) on the not operated side (p=0.31). Mean flexion force on the operated side at 60° was 32+/-26 (Nm) compared to 53+/-42 (Nm) on the not operated side (p=0.43). In case of revision surgery significant worse function scores in the TESS and KSS could be overserved (both p<0.05). Conclusion: Implantation of a distal femur- and/or proximal tibia replacement are associated with loss of flexion, a trend to reduced extension and flexion power compared to the contralateral side. In case of primary surgery better functional results in terms of function Scores can be expected than in case of revision surgery.
Repair vs. Reconstruction for Acute Isolated ACL Tears- 2-Year Results of a Prospective Randomized Study
Authors: Glasbrenner Johannes , Kösters Clemens , Spickermann Lena , Kittl Christoph , Domnick Christoph , Herbort Mirco , Raschke Michael J. , Schliemann Benedikt 
Published: May 2020

Aims and Objectives: Recently, due to the development of new techniques, ACL repair has returned back into focus of experimental and clinical research. Newer studies highlight the fact that ACL repair can lead to satisfying functional results and healing rates. Aim of the present study was to compare the functional results after ACL repair in comparison to primary ACL reconstruction for acute isolated ACL tears. It was hypothesized, that functional results and knee joint stability after ACL repair are comparable to those after ACLR. Materials and Methods: A prospective randomized study (Level of evidence 1) including a total of 85 patients with acute ACL tears was performed. Patients were randomized to undergo either ACL repair or primary ACL reconstruction with a semitendinosus autograft. The preinjury activity level and function were recorded. Follow-up examinations were performed at six weeks, six, twelve and 24 months postoperatively. At each follow up, the Tegner activity scale, the International Knee Documentation Committee (IKDC) subjective score and the Lysholm score were acquired. Furthermore, anterior tibial translation (ATT) was evaluated by Rolimeter testing. The rate of recurrent instability and other complications were recorded. Results: 79 patients could be re-evaluated (follow-up rate 93%). No significant differences between ACL repair and ACLR were found for the Tegner, IKDC and Lysholm score at any time of the follow-up. ATT was increased in the ACL repair group (&#61508; ATT 1.9 vs. 0.9). This difference was statistically significant (p=0.0086). Seven patients (17%) of the ACL repair group presented with recurrent instability and underwent single-stage revision reconstruction with hamstring autografts. Another three patients showed increased laxity with insufficient healing after ACL repair but did not require revision. In the ACLR group, five patients (13%) sustained a re-tear after return to their previous activity level. However, in three cases, a two-staged revision was required. Recurrent instability was associated with young age and higher Tegner scores in both groups. Conclusion: Functional results after ACL repair for acute tears are comparable to those after ACLR. However, the rate of ACL insufficiency seems to be slightly increased after ACL repair. In the revision situation, single-stage revision was possible in all cases following primary repair, whereas after primary reconstruction, a two-staged revision had to be performed in three of five cases. The current study supports the use of ACL repair as an option to treat acute ACL tears.
Thermography in persistent postoperative pain after knee surgery
Authors: Friedrich David , Köhne Manuel 
Published: May 2020

Aims and Objectives: Background: Postoperative persistent pain occurs in approximately 10% of surgically treated patients. It incapacitates and reduces quality of life in those affected. The aetiology is poorly understood, predictive factors are currently unknown, diagnosis and therapy are difficult. Objectives: To evaluate the benefit of dermal thermography in the diagnosis and therapy of persistent postoperative pain. Study design: retrospective, Level of evidence IV Materials and Methods: A single surgeon performed highly standardized ACL reconstructions, arthroscopies and total endoprotheses of the knee. Patients were seen six weeks postoperative for clinical and thermographic evaluation. Regions of interest were defined for the affected knee, a control region defined for the contralateral knee. The thermographic image was used to pinpoint a site for subcutaneous local anaesthesia. The clinical evaluation was then repeated. Results: Patients in total (n=133), arthroscopy (n=21), total endoprothesis (n=42), ACL (n=50). If the temperature difference (TD) between the site of pathology and the average ipsilateral knee temperature was negative, pathology was classified as hypothermic (n=19), otherwise hyperthermic (n=94). Arthroscopically treated patients showed a TD of 0,88 ± 0,39 °C in hyperthermic (n=12) and -0,811 ± 0,623 °C in hypothermic (n=9) knees. Prosthetically treated patients showed a TD of 1,29 ± 0,51 °C in hyperthermic (n=37) and -0,88 ± 0,33 °C in hypothermic (n=5) knees. ACL treated patients showed a TD of 1,20 ± 0,48 °C in hyperthermic (n=45) and -0,62 ± 0,41 °C in hypothermic (n=5) knees. The difference in temperature between the site of pathology and the average temperature of the ipsilateral knee was significant for all subgroups: arthroscopy-hypothermic p < 0,001, arthroscopy-hypothermic p < 0,005; endoprothesis-hyperthermic p < 0,001, endoprothesis-hypothermic p < 0,004; ACL-hyperthermic p < 0,001, ACL-hypothermic p < 0,027. In contrast to the hyperthermic groups (for all p < 0,001), there was no significant difference between the site of pathology and the contralateral control region in the hypothermic groups. All patients reported a reduction of pain and better mobility after subcutaneous infiltration with Scandicain 2% at the thermographically defined site of pathology. Conclusion: Thermography is useful to pinpoint sites of pathology in persistent postoperative pain. Two types of thermal abnormality could be identified at the site of pathology: hypo- and hyperthermic. Local anaesthesia at the site of pathology resulted in pain reduction and improved mobility. Further studies are necessary to understand the postoperative thermal changes in order to devise a suitable therapy.
Analyzing passenger and freight vehicle movements from automatic-Number plate recognition camera data
Authors: Hadavi Sheida , Rai Heleen Buldeo , Verlinde Sara , Huang He , Macharis Cathy , Guns Tias 
Published: May 2020

AbstractModern urban-transport planning requires evidence-based insights into current transport flows to better understand the needs and impacts of policymaking. Urban transport includes passenger and freight vehicles, which have different behavior, and the need for such a separation is often ignored in research and practice [1]. New digital data sources provide an opportunity to better understand urban transport and identify where policy interventions are required. We review the literature on digital counting techniques to monitor transport flows, including loops, Automatic-Number Plate Recognition (ANPR) cameras and floating car data. We further investigate the potential of ANPR cameras, which are widely deployed, and which can be augmented with vehicle category information. This article presents the methodology that we follow for transforming raw augmented ANPR camera data into practical knowledge for city planners. Our is aim is to provide a better understanding of passenger and freight vehicle movements and stops, identifying similarities and differences between vehicle categories. We demonstrate our methodology on a case study for the Mechelen-Willebroek district in Belgium, encompassing augmented data from 122 ANPR cameras for a period of two weeks. Additionally, we also look at the car-reduced zone and how time restrictions affect the different vehicle categories’ actions. The findings are validated with GPS data from heavy-good vehicles in the same period. The potential of augmented ANPR camera data and promising themes and applications of this data source are illustrated through the case study.
Clinical outcomes and anesthetic management of pregnancies with placenta previa and suspicion for placenta accreta undergoing intraoperative abdominal aortic balloon occlusion during cesarean section
Authors: Li Peng , Liu Xia , Li Xiangkui , Wei Xinchuan , Liao Juan 
Published: May 2020

Abstract
Background
This retrospective study aimed to compare the clinical outcomes of parturients with placenta previa (PP) and placenta accreta (PA) according to their severity, when they were managed with intraoperative abdominal aortic balloon occlusion (IAABO) during cesarean section.

Methods
We retrospectively examined 57 cases of PP and suspicion for PA in which IAABO was performed during cesarean section between April 2014 and June 2016. Based on preoperative examination and clinical risk factors, patients were divided into the low suspicion PA group and the high suspicion PA group. We compared the demographic characteristics, methods of anesthesia, intra- and postoperative parameters, and maternal and neonatal outcomes.

Results
The two groups showed similar demographic characteristics and intraoperative outcomes. Four women underwent cesarean hysterectomy. Eight neonates were admitted to the neonatal intensive care unit and three did not survive. Neonatal Apgar scores were significantly higher in the low suspicion PA group. Eight patients experienced postoperative femoral artery thrombosis and one patient complicated hematoma in the front wall of the common femoral artery. Patients who received neuraxial anesthesia showed significantly lower intraoperative blood loss, lower intraoperative, postoperative and total blood transfusion and shorter surgery than patients who received general anesthesia.

Conclusions
Our data suggested that the severity of aberrant placental position does not affect intraoperative blood loss during a cesarean section while the IAABO is performed. We propose that neuraxial anesthesia is preferred for conducting these surgeries without contraindications.
Cigarette smoking and smokeless tobacco use among male south Asian migrants in the United Arab Emirates: a cross-sectional study
Authors: Ali Raghib , Loney Tom , Al-Houqani Mohammed , Blair Iain , Aziz Faisal , Al Dhaheri Salma , El Barazi Iffat , Soteriades Elpidoforos S. , Shah Syed M. 
Published: May 2020

AbstractBackgroundFew data were available on smoking and smokeless tobacco use in South Asian migrants in the United Arab Emirates (UAE). This study aimed to identify the prevalence and correlates of cigarette smoking and smokeless tobacco use in male South Asian migrants in the UAE.MethodsWe used a cross-sectional study to recruit a random representative sample of male South Asian migrants, including Indian (n = 433), Pakistani (n = 383) and Bangladeshi (n = 559) nationalities. We used multivariable logistic regression analysis to identify significant correlates of cigarettes smoking and smokeless tobacco use.Results1375 South Asian migrant adult males participated in the study (response rate 76%) with a mean age of 34 years (SD ± 10). The overall prevalence of cigarette smoking was 28% (95%CI 25–30%) and smokeless tobacco use was 11% (95%CI 10–13%). The prevalence of current cigarette smoking was 21, 23, and 37% among participants from India, Pakistan and Bangladesh, respectively. The prevalence of current smokeless tobacco use was 6, 12, and 16% for Indian, Pakistani, and Bangladeshi participants, respectively. Among study participants, Bangladeshi nationality, hypertension, and alcohol use were significant correlates of current cigarette smoking. Significant correlates of smokeless tobacco use included increased age, less than college level education, alcohol use, and Pakistani or Bangladeshi nationality.ConclusionsCurrent smoking and smokeless tobacco use in South Asian migrants represent a significant public health burden in the UAE. Effective public health measures are needed to reduce tobacco use in this migrant population.
LncRNA WTAPP1 promotes cancer cell invasion and migration in NSCLC by downregulating lncRNA HAND2-AS1
Authors: Zhang Li , Jin Chengyan , Yang Guiyun , Wang Bin , Hua Peiyan , Zhang Yan 
Published: May 2020

AbstractBackgroundLong non-coding RNA (lncRNA) Wilms Tumor 1 Associated Protein Pseudogene 1 (WTAPP1) has been reported to be a critical player in the angiogenesis and migration of endothelial progenitor cells, while its involvement in cancer biology remains unknown. This study was carried out to investigate the role of WTAPP1 in non-small cell lung cancer (NSCLC).MethodsThe expression of WTAPP1 and lncRNA HAND2 Antisense RNA 1 (HAND2-AS1) in plasma and tissues from NSCLC patients was detected by qRT-PCR. A 5-year follow-up study was carried out to explore the prognostic value of WTAPP1 for NSCLC. Overexpression experiments were performed to analyze the interaction between WTAPP1 and HAND2-AS1. Cell invasion and migration were evaluated by Transwell assays.ResultsThe expression of WTAPP1 was upregulated in NSCLC. The survival analysis showed that low plasma levels of WTAPP1 were accompanied with high survival rate. HAND2-AS1 was downregulated in NSCLC and inversely correlated with WTAPP1 across tumor tissues. Overexpression of WTAPP1 resulted in downregulation of HAND2-AS1 in NSCLC cells, while overexpression of HAND2-AS1 did not affect the expression of WTAPP1. Overexpression of WTAPP1 led to promoted, while overexpression of HAND2-AS1 resulted in inhibited invasion and migration of NSCLC cells. In addition, overexpression of HAND2-AS1 partially attenuated the effects of overexpressing WTAPP1. In addition, WTAPP1 did not affect cancer cell proliferation.ConclusionWTAPP1 may promote cancer cell invasion and migration in NSCLC by downregulating lncRNA HAND2-AS1.