bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does cycling induced by functional electrical stimulation enhance motor recovery in the subacute phase after stroke? A systematic review and meta-analysis
Authors: Ambrosini Emilia , Parati Monica , Ferriero Giorgio , Pedrocchi Alessandra , Ferrante Simona 
Published: July 2020

Objective: To investigate the effects of cycling with functional electrical stimulation on walking, muscle power and tone, balance and activities of daily living in subacute stroke survivors. Data Sources: Ten electronic databases were searched from inception to February 2020. Review methods: Inclusion criteria were: subacute stroke survivors (<6 months since stroke), an experimental group performing any type of cycling training with electrical stimulation, alone or in addition to usual care, and a control group performing usual care alone. Two reviewers assessed eligibility, extracted data and analyzed the risks of bias. Standardized Mean Difference (SMD) or Mean Difference (MD) with 95% Confidence Intervals (CI) were estimated using fixed- or random-effects models to evaluate the training effect. Results: Seven randomized controlled trials recruiting a total of 273 stroke survivors were included in the meta-analyses. There was a statistically significant, but not clinically relevant, effect of cycling with electrical stimulation compared to usual care on walking (six studies, SMD [95% CI] = 0.40 [0.13, 0.67]; P = 0.004), capability to maintain a sitting position (three studies, MD [95% CI] = 7.92 [1.01, 14.82]; P = 0.02) and work produced by the paretic leg during pedaling (2 studies, MD [95% CI] = 8.13 [1.03, 15.25]; P = 0.02). No significant between-group differences were found for muscular power, tone, standing balance, and activities of daily living. Conclusions: Cycling training with functional electrical stimulation cannot be recommended in terms of being better than usual care in subacute stroke survivors. Further investigations are required to confirm these results, to determine the optimal training parameters and to evaluate long-term effects.
Process evaluation of the Cancer Home-Life Intervention: What can we learn from it for future intervention studies?
Authors: la Cour Karen , Gregersen Oestergaard Lisa , Brandt Åse , Offersen Sara Marie Hebsgaard , Lindahl-Jacobsen Line , Cutchin Malcolm , Pilegaard Marc Sampedro 
Published: July 2020

Background: The Cancer Home-Life Intervention showed no significant effects, and examination of the processes affecting or inhibiting outcomes is relevant. Aim: To evaluate the Cancer Home-Life Intervention for its processes of implementation, mechanisms of impact and contextual factors. Design: Process evaluation conducted alongside the randomised controlled trial, using quantitative and qualitative methods (ClinicalTrials.gov NCT02356627). The Cancer Home-Life Intervention is a tailored, occupational therapy–based programme. Setting/participants: This study took place in participants’ homes and at hospital. A total of 113 home-dwelling adults (⩾18 years) with advanced cancer who had received the Cancer Home-Life Intervention were included, together with five intervention-therapists. Results: All 113 participants (100%) received a first home visit; 32 participants (26%) received a second visit; and 4 participants (3%) received a third visit. Median number of delivered intervention components were 3 (interquartile range: 2; 4). Identified barriers for effect included unclear decision process for intervention dosage; participants’ low expectations; participants’ lack of energy; and insufficient time to adopt new strategies. The trial design constituted a barrier as the intervention could only be provided within a specific short period of time and not when relevant. Intervention components working to solve practical everyday problems, enhance enjoyment and increase a sense of safety were perceived as useful. Conclusion: Future interventions can benefit from inclusion criteria closely related to the intervention focus and clear procedures for when to continue, follow-up and terminate intervention. Decisions about dose and timing may benefit from learning theory by taking into account the time and practice needed to acquire new skills.
Perfusion promotes endothelialized pore formation in high concentration fibrin gels otherwise unsuitable for tube development
Authors: Zippusch Sarah , Helms Florian , Lau Skadi , Klingenberg Melanie , Schrimpf Claudia , Haverich Axel , Wilhelmi Mathias , Böer Ulrike 
Published: July 2020

Vascularization of tissue engineered implants is crucial for their survival and integration in the recipient’s body. Pre-vascularized, fibrin-based implants offer a solution since low concentration fibrin hydrogels (1 mg/mL) have been shown to promote tube formation of endothelial cells in co-culture with adipogenic stem cells. However, higher fibrinogen concentrations (> 20 mg/mL) enabling the fabrication of stable implants are necessary. We here characterized fibrin gels of 1–30 mg/mL for their rheological properties and whether they support tube formation of endothelial cell–adipogenic stem cell co-cultures for up to 7 days. Moreover, 20 mg/mL gels containing preformed channels and endothelial cell–adipogenic stem cell co-culture were perfused continuously in a customized flow chamber with 3.9 dyn/cm2 for 12 days and analyzed for capillary formation. Rheology of fibrin gels showed increasing stability proportional to fibrinogen concentration with 20 mg/mL gels having a storage module of 465 Pa. Complex tube networks stable for 7 days were observed at 1–5 mg/mL gels whereas higher concentrations showed initial sprouting only. However, perfusion of 20 mg/mL fibrin gels resulted in endothelialized pore formation in several layers of the gel with endothelial cell–adipogenic stem cell co-culture. Thus, perfusion supports the formation of capillary-like structures in fibrin gels that are too dense for spontaneous tube formation under static conditions. Future studies are necessary to further increase pore density and to investigate proper nutrition of tissue-specific target cells in the scaffold.
Is the Emergency Department an Inappropriate Venue for Code Status Discussions?
Authors: Miller Daniel G. , Vakkalanka J. Priyanka , Swanson Morgan B. , Nugent Andrew S. , Hagiwara Yuya 
Published: July 2020

Background: Historically, it has been assumed that the Emergency Department (ED) is a place for maximally aggressive care and that Emergency Medicine Providers (EMPs) are biased towards life-prolonging care. However, emphasis on early recognition of code status preferences is increasingly making the ED a venue for code status discussions (CSDs). In 2018, our hospital implemented a policy requiring EMPs to place a code status order (CSO) for all patients admitted through the ED. We hypothesized that if EMPs enter CSDs with a bias toward life-prolonging care, or if the venue of the ED biases CSDs towards life-prolonging care, then we would observe a decrease in the percentage of patients selecting DNR status following our institution’s aforementioned CSO mandate. Methods: We present a retrospective analysis of rates of DNR orders placed for patients admitted through our ED comparing six-month periods before and after the implementation of the above policy. Results: Using quality improvement data, we identified patients admitted through the ED during pre (n=7,858) and post (n=8,069) study periods. We observed the following: after implementation DNR preference identified prior to hospital admission from the ED increased from 0.4% to 5.3% (relative risk (RR) 12.5; 95% CI: 5.2-29.9), defining CS in the ED setting at the time of admission increased from 2.4% to 98.6% (p <0.001), and DNR orders placed during inpatient admission was unchanged (RR=0.97 (95% CI = 0.88-1.07)). Discussion: Our results suggest that the ED can be an appropriate venue for CSDs.
Periorbital lipogranuloma after facial injection of autologous fat: A retrospective study of 18 cases
Authors: Yu Xiuting , Yan Huan , Xiao Lihua , Hei Yan 
Published: July 2020

Objective: To investigate the clinical features of patients who develop periorbital lipogranuloma after injection of autologous fat. Methods: This retrospective case series included 18 patients who developed a periorbital mass or swelling after undergoing injection of autologous fat for facial augmentation. The patients’ medical records were reviewed for clinical history, radiologic findings, and treatment outcomes. Results: All patients were women aged 24 to 50 years (mean, 31.6 years). Five patients (27.8%) involved both orbits. Presenting eye symptoms were a palpable mass (61.1%), eyelid swelling (44.4%), and ptosis (16.7%). The interval between the final injection and onset of eye symptoms ranged from 1 to 36 months (mean, 11.5 months). Thirteen patients underwent radiologic imaging. Fifteen patients received only one injection of autologous fat and three received two injections with the cryopreserved fat used in the second injection. Surgical excision was performed in 12 patients to remove the mass and identify the pathologic abnormalities. No recurrence was found during 1 year of follow-up. Two of the six patients who had refused treatment showed spontaneous resolution at the 6-month visit. Conclusion: Periorbital lipogranuloma after facial injection of autologous fat should be considered as a specific orbital disease entity for which MRI is an effective examination method. Surgery is warranted for this condition when conservative treatment is ineffective.
Optical coherence tomography angiography findings of fellow eye of proliferative macular telangiectasia type 2: Long term study
Authors: Singh Sumit Randhir , Fraser-Bell Samantha , Dogra Avantika , Sahoo Niroj Kumar , Gabrielle Pierre-Henry , Lupidi Marco , Al-Sheikh Mayss , Borrelli Enrico , Sacconi Riccardo , Querques Giuseppe , Chhablani Jay 
Published: July 2020

Purpose: To report the characteristics of non-proliferative fellow eyes in patients with unilateral proliferative macular telangiectasia type 2 (MacTel). Methods: This was a multicenter, retrospective study and included fellow eyes of eyes with subretinal neovascular membrane (SRNVM). Multimodal imaging including fundus photography, optical coherence tomography (OCT), and OCT angiography (OCTA) was performed. OCT and OCTA measurements included central macular thickness (CMT), subfoveal choroidal thickness (SFCT), foveal avascular zone (FAZ) area and qualitative parameters such as distortion or enlargement of FAZ, increased inter-vascular spacing, dilated, tortuous vessel at margin of FAZ, crowding of vessel, and loss of choriocapillaris (CC). Results: Thirteen fellow eyes of 13 patients with mean age of 63.6 ± 12.0 years were included. Fellow eyes had various stages of the diseases – stage 2 (four eyes), 3 (six eyes), and 4 (three eyes). OCTA showed increased intervascular spacing (8; 61.5%), dilated (11; 84.6%), and elongated vessels (8; 61.5%) at the margin of the FAZ, crowding of vessels (6; 46.2%), capillary non-perfusion areas outside the FAZ (4; 30.8%), and areas of CC loss (4; 30.8%). Mean follow-up was 9.1 ± 12.9 months. Out of six eyes with follow-up of ⩾12 months, two developed SRNVM at 18 and 33 months with OCTA showing crowding and entanglement of dilated retinal vessels in deep capillary plexus at baseline which corresponded to the area affected by SRNVM. Conclusion: Fellow eyes of proliferative MacTel showed established disease stages on OCTA with progressive capillary crowding and entanglement of vessels likely corresponding to the future site of SRNVM.
Vessel-Sealing Capability of Novel Microwave Sealer: Experimental Study in Animal Models
Authors: Dang Khiem Tran , Naka Shigeyuki , Yamada Atsushi , Mukaisho Ken-ichi , Tani Tohru 
Published: July 2020

Background. Ultrasonically activated dissectors (UADs) and radiofrequency-based devices have been considered excellent surgical devices because of their reliability and flexibility. Meanwhile, microwave-based devices have demonstrated potential with their unique heating mechanism. This study aims to compare the sealing function of a newly invented forceps-like microwave sealer (MS) with that of currently available UADs. Materials and Methods. MS and 2 examples of UADs (Harmonic Focus+ [HF+] and Sonicision [SNC]) were employed to perform mesenterectomies (in vivo) and sealing sizable vessels (ex vivo). Vessel diameter, seal time, burst pressure (BP), sealing completion, and instrument sticking were recorded. The samples underwent histological investigation for thermal damage evaluation. Results. During mesenterectomies, MS required 3 seconds and 30 W to secure a complete seal. The BP achieved by the MS seal was higher than that of HF+ and SNC on arteries (851 ± 203.7 vs 682.4 ± 287.3, P < .05; vs 833.1 ± 251.2 mmHg, P = .4523, respectively) but was not statistically different on veins (324.9 ± 203.5 vs 460.1 ± 320.3 vs 508.3 ± 350.7 mmHg, P = .215). In all trials, MS caused less sticking but exhibited similar heat-induced alterations to UADs. MS’s thermal spread was not statistically more extended than that of UADs on either arteries or veins. Conclusions. MS was capable of not only sealing tiny vessels but also achieving high-pressure endurance on sizable vessels. Its forceful grasping and synchronous heating process helped create solid stumps with an acceptable thermal spread.
Type IIIB and IV hypoplastic thumb reconstruction with non-vascularized fourth metatarsal
Authors: Liu Bo , Chen Shanlin , Chow Esther Ching San , Li Pengcheng , Liu Kun , Yang Chen 
Published: July 2020

We treated 16 patients with 17 hypoplastic thumbs (eight Type IIIB and nine Type IV) using a non-vascularized fourth metatarsal transfer with a rotational flap and multi-staged reconstruction. The average age at the first operation was 24 months. The average follow-up time was 46 months. All patients achieved reasonable hand function and were able to use the reconstructed thumb to grip small and large objects. The operated thumb achieved an average Kapandji score of 6.7 and average pinch strength of 0.9 kg. There were two cases of graft nonunion. All parents are satisfied with the function and appearance of the reconstructed thumb and donor foot. We conclude that non-vascularized fourth metatarsal transfer is a feasible reconstruction method for patients with Types IIIB and IV hypoplastic thumbs. The reconstruction allows for the preservation of a 5-digit hand with reasonable function and appearance and minimal donor site morbidity, although long-term growth of the metatarsals still need to be monitored. Level of evidence: IV
Community singing, wellbeing and older people: implementing and evaluating an English singing for health intervention in Rome
Authors: Corvo E , Skingley A , Clift S 
Published: July 2020

Aim: The aim of this research was to explore the transferability and effectiveness of the English Silver Song Clubs model for older people in a different social and cultural context, that is, in the capital city of Italy, Rome. Methods: A single condition, pretest, post-test design was implemented. Participants completed the following two questionnaires: EuroQoL-5 Dimension (EQ-5D) and York Short Form (SF)-12. Results: After the singing experience, participants showed a decrease in their levels of anxiety and depression. An improvement was also found from baseline to follow-up in reported performance of usual activities. The English study showed a difference between the singing and non-singing groups at 3 and 6 months on mental health, and after 3 months on specific anxiety and depression measures. This study (Rome) shows similar findings with an improvement on specific anxiety and depression items. Conclusion: Policy makers in different national contexts should consider social singing activities to promote the health and wellbeing of older adults as they are inexpensive to run and have been shown to be enjoyable and effective.
Improving wrist imaging through a multicentre educational intervention: The challenge of orthogonal projections
Authors: Snaith Beverly , Raine Scott , Fowler Lynsey , Osborne Christopher , House Sophie , Holmes Ryan , Tattersall Emma , Pierce Emma , Dobson Melanie , Harcus James W 
Published: July 2020

Introduction In relation to wrist imaging, the accepted requirement is two orthogonal projections obtained at 90°, each with the wrist in neutral position. However, the literature and anecdotal experience suggests that this principle is not universally applied. Method This multiphase study was undertaken across eight different hospitals sites. Compliance with standard UK technique was confirmed if there was a change in ulna orientation between the dorsi-palmar (DP) and lateral wrist projections. A baseline evaluation for three days was randomly identified from the preceding three months. An educational intervention was implemented using a poster to demonstrate standard positioning. To measure the impact of the intervention, further evaluation took place at two weeks (early) and three months (late). Results Across the study phases, only a minority of radiographs demonstrated compliance with the standard technique, with an identical anatomical appearance of the distal ulna across the projections. Initial compliance was 16.8% ( n = 40/238), and this improved to 47.8% ( n = 77/161) post-intervention, but declined to 32.8% ( n = 41/125) within three months. The presence of pathology appeared to influence practice, with a greater proportion of those with an abnormal radiographic examination demonstrating a change in ulna appearances in the baseline cohort ( p < 0.001) and the late post-intervention group ( p = 0.002) but not in the examinations performed two weeks after staff education ( p = 0.239). Conclusion Assessment of image quality is critical for diagnosis and treatment monitoring. Yet poor compliance with standard anatomical principles was evident. A simple educational intervention resulted in a transient improvement in wrist positioning, but the impact was not sustained over time.
Return to Work Following Arthroscopic Meniscal Allograft Transplantation
Authors: Agarwalla Avinesh , Liu Joseph N. , Christian David R. , Garcia Grant H. , Cvetanovich Gregory L. , Gowd Anirudh K. , Yanke Adam B. , Cole Brian J. 
Published: July 2020

Purpose Evaluate the ability of patients to return to work (RTW) following arthroscopic meniscal allograft transplantation (MAT) for meniscal deficiency. Methods Consecutive patients undergoing MAT were retrospectively reviewed at a minimum of 2 years postoperatively. Patients completed a subjective work questionnaire, Visual Analogue Scale for pain, Single Assessment Numerical Evaluation, and satisfaction. Results Forty-seven patients who were employed within 3 years prior to surgery (average age: 30.2 ± 6.9 years) were contacted at an average of 3.5 ± 0.9 years postoperatively. Forty-six patients (97.8%) returned to work by 2.7 ± 2.6 months postoperatively, and 44 patients (93.6%) returned to the same level of occupational intensity. Patients who held sedentary, light, medium, or high intensity occupations were able to RTW at a rate of 100.0%, 100.0%, 88.9%, and 85.7% ( P = 0.4) by 1.1 ± 1.0 months, 2.5 ± 2.5 months, 3.5 ± 3.2 months, and 4.3 ± 2.8 months ( P = 0.3) postoperatively. Thirty-eight patients (80.9%) were at least somewhat satisfied, and 43 patients (91.5%) would still have the operation if presented the opportunity. No patient underwent revision MAT or conversion to arthroplasty. Conclusion In patients with painful meniscal deficiency, MAT provides a high rate of RTW (97.8%) by 2.7 ± 2.6 months postoperatively. However, some patients may be unable to return to their previous level of occupational intensity. Although statistically insignificant, patients with higher intensity occupations may have a lower rate and longer duration until RTW than those with less physically demanding occupations. Information regarding RTW is imperative for appropriately managing postoperative expectations.
Complexity is never simple: Intangible intensity and analyst accuracy
Authors: Ferrer Elena , Santamaría Rafael , Suárez Nuria 
Published: July 2020

We examine the relationship between intangible intensity and the accuracy of analyst forecasts. Using an international sample of 2,200 firms during 2000–2016, we show that analyst accuracy decreases significantly when intangible intensity grows. In exploring the determinants of this effect, we distinguish between firm risk and the risk associated with intangibles. Our results reveal the role of financial reporting quality, ownership structure, and institutional quality in moderating the relationship between intangible intensity and analyst accuracy. Analyst forecast accuracy acts as a channel through which the higher levels of information asymmetry associated with intangible intensity affect the cost of equity. Our results are robust to different intangible intensity measures; mandatory changes in financial reporting standards; the implementation of transparency rules in certain industry sectors; and financial crisis periods. We have devised alternative econometric tools that deal with potential sample selection bias and the dynamics of our empirical model. JEL CLASSIFICATION: G00, G14, G30, M41
The Compassionate Communities Connectors model for end-of-life care: a community and health service partnership in Western Australia
Authors: Aoun Samar M. , Abel Julian , Rumbold Bruce , Cross Kate , Moore Jo , Skeers Piari , Deliens Luc 
Published: July 2020

Background: There is an international drive towards increasing provision of community-led models of social and practical support for people living with advanced illness. Aim: This feasibility project aims to develop, implement and evaluate a model of community volunteers, identified as Compassionate Communities Connectors, to support people living with advanced life limiting illnesses/palliative care needs. The aims also include the development and evaluation of a training programme for volunteers and assessment of the feasibility, acceptability and preliminary effectiveness of this model of care. Methods: The approach seeks to map and mobilise people’s personal networks of care through the Connectors enlisting Caring Helpers (community volunteers). Up to 10 Connectors will be trained to work with at least 30 families selected by the palliative care service as requiring support. The primary outcome is the effect of the intervention on social connectedness. Secondary outcomes are the intervention’s effect on unplanned hospital utilisation, caregiver support needs, advance care plans and satisfaction with intervention for patients/carers, volunteers and service providers. Conclusion: It is expected that this intervention will enhance patient, carer and family social, psychological and practical support and reduce the need for dying people to be admitted to a hospital.