bluuebunny/crossref_metadata_2025_split huggingface dataset:
Teleconsultation in orthopaedic surgery: A systematic review and meta-analysis of patient and physician experiences
Authors: Melian Christina , Kieser David , Frampton Christopher , C Wyatt Michael 
Published: September 2020

Introduction The primary purpose of this review was to evaluate patient and physician preference and satisfaction for teleconsultation in orthopaedic surgery compared to traditional face-to-face consultation. In addition, we evaluated the effects of teleconsultation on patient length of visit, healthcare costs, range of motion (ROM), pain, quality of life (QOL), and ongoing management plans. Methods A systematic review of MEDLINE, Embase, Web of Science, and Cochrane Library was conducted according to PRISMA guidelines. Randomised control trials and case control studies comparing teleconsultation with traditional, face-to-face consultation in the management of orthopaedic conditions were included. The primary outcome measures were patient and physician preference and satisfaction. Secondary outcomes included patient length of visit, healthcare costs, ROM, pain, QOL, and ongoing management plans. Results A total of 13 articles meeting the eligibility criteria were included for systematic review and 8 for meta-analysis. There was no significant difference in patient satisfaction, length of visit, or time spent with the physician between the telemedicine and in-office control group. The mean difference of patient preference for telemedicine was significantly higher in the telemedicine group compared to the in-office visit group (OR 1.44, 95% CI 1.12–1.87, p = 0.005). Discussion Telemedicine was not inferior to face-to-face office visits in regard to patient and physician preference and satisfaction. Therefore, it would be an effective adjunct to face-to-face office visits, serving as a mechanism of triage and long-term continuity of care.
Combining the Passeo-18 Lux Drug-Coated Balloon and the Pulsar-18 Bare Metal Stent: 12- and 24-Month Outcomes of the BIOLUX 4EVER Investigator-Initiated Trial
Authors: Deloose Koen , Bosiers Marc , Peeters Patrick , Verbist Jürgen , Maene Lieven , Beelen Roel , Keirse Koen , Hendriks Jeroen , Lauwers Patrick , Wauters Jeroen , Verschueren Merel 
Published: September 2020

Purpose: To report the outcomes after treating stenotic or occluded femoropopliteal lesions with a drug-coated balloon (DCB) followed by the implantation of a thin-strut self-expanding bare metal stent in the BIOLUX 4EVER trial ( ClinicalTrials.gov identifier NCT02211664). Materials and Methods: The prospective, multicenter, physician-initiated BIOLUX 4-EVER trial was conducted at 5 centers in Belgium and enrolled 120 patients (mean age 70.9±10.5 years; 79 men) with symptomatic stenotic or occluded de novo femoropopliteal lesions. A fifth of the patients had diabetes mellitus and nearly half had previous peripheral artery interventions. The lesions were a mean 83.3±49.5 mm long with a mean reference vessel diameter of 5.26±0.59 mm. Lesions were treated with a Passeo-18 Lux DCB followed by the implantation of a Pulsar-18 bare metal stent. Follow-up visits were conducted at 1, 6, 12, and 24 months postprocedure; the main outcome was primary patency at 12 months. Results: Technical success was obtained in all patients. Primary patency was observed in 89.9% of patients (95% CI 84.0% to 95.8%) at 12 months and in 83.5% at 24 months (95% CI 89.9% to 97.3%), and freedom from target lesion revascularization was 93.6% (95% CI 89.9% to 97.3%) and 86.1% (95% CI 79.9% to 92.3%), respectively. Ten patients died throughout the course of the trial (90.7% survival at 24 months), all of noncardiovascular causes. The ankle-brachial index improved from 0.68±0.09 at baseline to 0.93±0.11 and 0.93±0.12 at 12- and 24-month follow-up visits (p<0.001). An improvement of at least 1 Rutherford category was observed in 91 of 94 patients (96.8%) at 12 months and 78 of 83 patients (93.4%) at 24 months (p<0.001). Conclusion: The combination of a Passeo-18 Lux DCB followed by a Pulsar-18 stent implantation produced safe and effective outcomes in the treatment of femoropopliteal lesions at up to 24 months. Adding paclitaxel to the bare nitinol stent platform by predilating with a Passeo-18 Lux DCB seems to increase efficacy at 1 and 2 years compared with the use of bare metal stents only, which were investigated in the precursor 4-EVER study.
The Pupil Diameter as a Possible Indicator of Neurodegenerative Diseases and Response to Acetylcholinesterase Inhibitors Therapy: In-Depth Measurements Following Topical Administration of Tropicamide and Pilocarpine
Authors: Nuzzi Raffaele , Bojino Alessandro , Polito Maria Sole , Luppi Chiara , Tridico Federico , Massaia Massimiliano 
Published: September 2020

Background: The aim of this study is to assess whether pupillary modifications following ocular anticholinergic and cholinergic drugs can identify subjects with neurodegenerative diseases from early stages. Methods: 51 subjects were divided into 3 groups, according to different neurodegenerative diseases, and compared with a control group of 10 patients. Pupil diameter has been measured at different times after topical administration of tropicamide 0.01% in the right eye. Then, topical administration of pilocarpine 0.06% has been performed, followed by pupillary constriction measurement. Pupillary response rates were stratified according to acetylcholinesterase inhibitors intake. Results: Observed mydriasis and pupillary constriction was similar in all study groups at all evaluation times. Patients without acetylcholinesterase inhibitors intake presented greater mydriasis. Conclusions: Although it was not possible to observe significant differences among groups in terms of pupillary response, the analysis of pupillary features may become an useful tool to detect efficacy of acetylcholinesterase inhibitors.
The Successful Treatment of an Ilio-Iliac Fistula and Aneurysms Affecting the Abdominal Aortic and Iliac Arteries via Endovascular Stent Graft Repair
Authors: Sueyoshi Eijun , Iwano Yusuke , Oka Taiga , Nishimura Takamasa , Honda Takahide , Kawaguchi Yutaro , Koike Hirofumi , Nagayama Hiroki , Sakamoto Ichiro , Uetani Masataka 
Published: September 2020

Spontaneous ilio-iliac arteriovenous fistula (AVF) associated with aneurysms affecting the abdominal aortic and iliac arteries is a rare condition. The classical clinical symptoms of ilio-iliac AVF include high-output heart failure, abdominal pain, abdominal bruits and thrills, a pulsatile abdominal mass, and venous congestion symptoms (leg edema and hematuria). The prompt repair of AVF is necessary to restore the patient’s hemodynamics.  We report a case in which a patient with aneurysms affecting the abdominal aortic and iliac arteries and an ilio-iliac AVF presented with high-output heart failure and leg ischemia and was successfully treated via endovascular stent graft repair.
Doxycycline treatment of high-risk COVID-19-positive patients with comorbid pulmonary disease
Authors: Yates Paul A. , Newman Steven A. , Oshry Lauren J. , Glassman Robert H. , Leone Ashton M. , Reichel Elias 
Published: September 2020

Infection with novel SARS-CoV-2 carries significant morbidity and mortality in patients with pulmonary compromise, such as lung cancer, autoimmune disease, and pneumonia. For early stages of mild to moderate disease, care is entirely supportive. Antiviral drugs such as remdesivir may be of some benefit but are reserved for severe cases given limited availability and potential toxicity. Repurposing of safer, established medications that may have antiviral activity is a possible approach for treatment of earlier-stage disease. Tetracycline and its derivatives (e.g. doxycycline and minocycline) are nontraditional antibiotics with a well-established safety profile, potential efficacy against viral pathogens such as dengue fever and chikungunya, and may regulate pathways important in initial infection, replication, and systemic response to SARS-CoV-2. We present a series of four high-risk, symptomatic, COVID-19+ patients, with known pulmonary disease, treated with doxycycline with subsequent rapid clinical improvement. No safety issues were noted with use of doxycycline. Doxycycline is an attractive candidate as a repurposed drug in the treatment of COVID-19 infection, with an established safety profile, strong preclinical rationale, and compelling initial clinical experience described here. The reviews of this paper are available via the supplemental material section.
Outcome of antidepressant drug discontinuation with taperingstrips after 1–5 years
Authors: Groot Peter C. , van Os Jim 
Published: September 2020

Background: Stopping antidepressants is often difficult due to withdrawal. Taperingstrips were developed to facilitate antidepressant discontinuation according to the recently described Horowitz-Taylor method, allowing for personalised titration of discontinuation to the intensity of withdrawal. A taperingstrip consists of antidepressant or other medication, packaged in a 28-day roll of small daily pouches, each with the same or slightly lower dose than the one before it. We previously reported that the short-term success rate of antidepressant taperingstrips was 71%. Here, we examine longer-term outcome after 1–5 years. Methods: Patients whose doctor had ordered taperingstrips between January 2015 and December 2019 were sent a questionnaire for participation in anonymised research in January 2020. Of 1012, 483 participated, of whom 408 (85%) had attempted antidepressant tapering. Results: Of the 408 patients included, 192 (47%) had used strips for tapering venlafaxine, 142 (35%) for paroxetine and 74 (18%) for other antidepressants. Median length of antidepressant use was 4 years, and most (61%) had tried to come off without taperingstrips at least once. After 1–5 years, 270 patients (66%) remained off antidepressants after tapering their antidepressant, 6 (2%) had successfully reduced their medication, 87 (21%) had restarted due to (self-reported) relapse, 35 had restarted for another indication (9%), and 10 (3%) reported another outcome. People with more severe experience of withdrawal prior to tapering, and people who had been on antidepressants for a shorter period of time, were more likely to remain off medication after 1–5 years. Conclusion: The previously reported 71% short-term success rate of taperingstrips in the most severely affected group, was matched by a 68% rate after 1–5 years. The evidence-based approach of personal tapering to counter withdrawal, as used for drugs causing withdrawal, for example, benzodiazepines, may represent a simple solution for an important antidepressant-related public health problem, without extra costs.
Law and medical practice: A comparative vignette survey of cardiologists in Norway and Denmark
Authors: Bjorvatn Afsaneh , Magnussen Anne-Mette , Wallander Lisa 
Published: September 2020

Objective: This article explores the implications of legal regulation for medical discretion and decision-making in Norway and Denmark. Methods: The article is based on a cross-national cross-sectional survey exploring cardiologists’ assessments of patient eligibility for specialist health care. Forty-two cardiologists in Norway and 48 in Denmark were presented with two standardized case vignettes in the form of patient referrals and were asked to assess whether the patient was eligible for treatment by a specialist, and if so, what waiting time would be assigned to the patient. Results: Primarily based on descriptive statistics, our findings indicate interesting similarities and variations. While there was only minor variation across the countries in cardiologists’ professional assessments about a patient with a more severe condition, judgements of eligibility for specialist treatment varied for a patient with a less severe medical condition. Moreover, Danish cardiologists distinguished between the more severe and less severe conditions to a much lesser extent when assessing eligibility for specialist treatment. For waiting times, there was considerable variation at the general level, from 1 week to 6 months. The assigned waiting times were on average double those for Norwegian cardiologists compared with their Danish counterparts. Denmark’s legal standardization of waiting times appears to lead to shorter waiting times than those prescribed by Norway’s legal regulations. Conclusion: For a single clear overall intention with a new policy, simpler legal regulations may be more effective than very detailed and specific requirements. If policymakers’ overall intention is for medical doctors to make complex decisions involving the prioritization of patients, then more individualized regulations seem to be a better tool.
Validation of 9-Grid Scheme for Localizing Osteochondral Lesions of the Talus
Authors: Martin Kevin D. , McBride Trevor J. , Horan Dylan P. , Haleem Amgad , Huh Jeannie , Groth Adam , Dawson Laura K. 
Published: September 2020

Background: A 9-grid scheme has been integrated into the foot and ankle literature to help clinicians and researchers localize osteochondral lesions of the talus (OLTs). We hypothesized that fellowship-trained orthopedic foot and ankle surgeons would have a high rate of intra/inter-observer reliability when localizing OLTs, therefore validating the scheme. Methods: We queried our institution’s foot and ankle radiographic database for magnetic resonance images with OLTs. Each MRI was reviewed by the senior author, and 2 key images (widest OLT diameter) from each tangential view were copied and combined onto one slide. Fifty consecutive deidentified images of ankles were then sent to 4 practicing fellowship-trained foot and ankle surgeons. Each was asked to identify which zone the OLT was localized within. A radiologist’s report served as the control. Statistical analyses were performed using Cohen and Fleiss kappa tests. Results: The reviewers demonstrated majority consensus on 45/50 images with substantial agreement for zones 4 and 6. The interobserver reliability was moderate with a κ = 0.55. The mean intraobserver reliability was substantial, with a κ = 0.79. A musculoskeletal radiologist determined there were 3 lesions in zone 7, 18 lesions in zone 4, and 29 lesions in zone 6. Conclusion: This study is the first to critically evaluate the 9-grid scheme and its reliability among orthopedic foot and ankle surgeons. Our study found that the 9-grid scheme is an accurate method of localization for OLTs with high intra- and moderate interobserver reliability between surgeons. Level of Evidence: Level IV, retrospective diagnostic study.
Clinical application of sodium-glucose cotransporter 2 inhibitor into a real-world setting of heart failure care
Authors: Tanaka Atsushi , Node Koichi 
Published: September 2020

AbstractFor years there have been concerns whether the results of large-scale clinical trials that include limited specific patient populations can be applied to patients in real-world clinical practice. Therefore, it is crucially important to verify whether emerging evidences obtained from large-scale clinical trials on limited specific patient populations can be applied to patients at real-world clinical settings. Recent cardiovascular outcome trials with sodium-glucose cotransporter 2 (SGLT2) inhibitors showed a consistent risk reduction of approximately 30% for hospitalization for heart failure (HF), and the SGLT2 inhibitors had a great potential to be effective for prevention of HF in a wide variety of type 2 diabetes (T2D) patients independent of their history of HF or cardiovascular disease (CVD). Furthermore, the DAPA-HF trial also demonstrated that dapagliflozin proved clinically effective in patients with HF with reduced ejection fraction regardless of diabetes, suggesting its robust benefits in some specific patients with HF. According to these evidences, SGLT2 inhibitor is increasingly recognized as an emerging and promising option to reduce the risk of HF in patient with T2D. To use appropriately SGLT2 inhibitors for HF prevention in the real-world setting, it would be required to determine the optimal patient population who can receive better clinical benefits from SGLT2 inhibitors. In this commentary, based on the current understandings and lessons learned from the most recent studies, we discussed the importance of future research on the safety and efficacy of SGLT2 inhibitor in clinical situations of HF other than those examined in previous cardiovascular outcome trials.
SARS-CoV-2/COVID-19 and advances in developing potential therapeutics and vaccines to counter this emerging pandemic
Authors: Rabaan Ali A. , Al-Ahmed Shamsah H. , Sah Ranjit , Tiwari Ruchi , Yatoo Mohd. Iqbal , Patel Shailesh Kumar , Pathak Mamta , Malik Yashpal Singh , Dhama Kuldeep , Singh Karam Pal , Bonilla-Aldana D. Katterine , Haque Shafiul , Martinez-Pulgarin Dayron F. , Rodriguez-Morales Alfonso J. , Leblebicioglu Hakan 
Published: September 2020

AbstractA novel coronavirus (SARS-CoV-2), causing an emerging coronavirus disease (COVID-19), first detected in Wuhan City, Hubei Province, China, which has taken a catastrophic turn with high toll rates in China and subsequently spreading across the globe. The rapid spread of this virus to more than 210 countries while affecting more than 25 million people and causing more than 843,000 human deaths, it has resulted in a pandemic situation in the world. The SARS-CoV-2 virus belongs to the genus Betacoronavirus, like MERS-CoV and SARS-CoV, all of which originated in bats. It is highly contagious, causing symptoms like fever, dyspnea, asthenia and pneumonia, thrombocytopenia, and the severely infected patients succumb to the disease. Coronaviruses (CoVs) among all known RNA viruses have the largest genomes ranging from 26 to 32 kb in length. Extensive research has been conducted to understand the molecular basis of the SARS-CoV-2 infection and evolution, develop effective therapeutics, antiviral drugs, and vaccines, and to design rapid and confirmatory viral diagnostics as well as adopt appropriate prevention and control strategies. To date, August 30, 2020, no effective, proven therapeutic antibodies or specific drugs, and vaccines have turned up. In this review article, we describe the underlying molecular organization and phylogenetic analysis of the coronaviruses, including the SARS-CoV-2, and recent advances in diagnosis and vaccine development in brief and focusing mainly on developing potential therapeutic options that can be explored to manage this pandemic virus infection, which would help in valid countering of COVID-19.
Detecting multiple spatial disease clusters: information criterion and scan statistic approach
Authors: Takahashi Kunihiko , Shimadzu Hideyasu 
Published: September 2020

Abstract
Background
Detecting the geographical tendency for the presence of a disease or incident is, particularly at an early stage, a key challenge for preventing severe consequences. Given recent rapid advancements in information technologies, it is required a comprehensive framework that enables simultaneous detection of multiple spatial clusters, whether disease cases are randomly scattered or clustered around specific epicenters on a larger scale. We develop a new methodology that detects multiple spatial disease clusters and evaluates its performance compared to existing other methods.

Methods
A novel framework for spatial multiple-cluster detection is developed. The framework directly stands on the integrated bases of scan statistics and generalized linear models, adopting a new information criterion that selects the appropriate number of disease clusters. We evaluated the proposed approach using a real dataset, the hospital admission for chronic obstructive pulmonary disease (COPD) in England, and simulated data, whether the approach tends to select the correct number of clusters.

Results
A case study and simulation studies conducted both confirmed that the proposed method performed better compared to conventional cluster detection procedures, in terms of higher sensitivity.

Conclusions
We proposed a new statistical framework that simultaneously detects and evaluates multiple disease clusters in a large study space, with high detection power compared to conventional approaches.
Analysis of long-term outcomes in 44 patients following pelvic exenteration due to cervical cancer
Authors: Lewandowska Agnieszka , Szubert Sebastian , Koper Krzysztof , Koper Agnieszka , Cwynar Grzegorz , Wicherek Lukasz 
Published: September 2020

Abstract
Background
Pelvic exenteration (PE) may be associated with prolonged overall survival (OS) in selected patients with advanced or recurrent cervical cancer. However, the factors related to improved survival following PE are not clearly defined. The aim of this study was to perform a retrospective analysis of OS rates in a group of patients undergoing PE in order to identify the factors related to improved long-term outcomes.

Methods
Our study group consisted of 44 patients, including 21 squamous cell cancer (SCC) patients, 22 patients with adenocarcinomas (AC) of the cervix, and one patient with undifferentiated cervical carcinoma. The patients were categorized according to the type of surgery, namely, primary surgery (12 patients) or surgery due to cancer recurrence (32 patients).

Results
In the group of patients with recurrent cervical cancer, we found that improved OS correlated with the SCC histological type and the presence of vaginal fistula. The need for reoperation within 30 days and the presence of severe adverse events significantly worsened the prognosis. We found a non significant trend toward improved survival in those patients with tumor-free margins. Lymph node metastases, the initial stage of the disease, the time to recurrence, and a history of hysterectomy had no impact on patients’ OS. In the group of patients undergoing primary PE, we observed a trend toward improved survival among those diagnosed with vaginal fistula.

Conclusions
Pelvic exenteration seemed to improve the long-term outcomes for patients with SCC cancer recurrence and vaginal fistula whose surgery was unrelated to severe adverse events.
Economic linkage between urban development and livelihood of peri-urban farming communities in Ethiopia (policies and practices)
Authors: Mohammed Idris , Kosa Abdella , Juhar Nuredin 
Published: September 2020

AbstractAs urban expands into peripheral areas, peri-urban indigenous farmers lose their land and highly vulnerable to negative externalities of urbanization. The aim of the study is to assess the economic linkage between urban development and the livelihood of peri-urban farming communities, focus on current practice and policies. From Ethiopia, Amara regional state was selected. Through multistage sampling, five municipalities (Debra Birhan, Shewa Robit, Kombolcha, Dessie, and Woldia) were taken as the sample from Amara regional state. Interviews were conducted with 30 municipalities’ officials of the selected town. Questionnaires collected from 200 respondents of peri-urban evicted farmers. As the findings of the study suggest, peri-urban farmers’ evictions from their indigenous land for land re-development are the continuous process that negatively affects the livelihood of farming communities. The factors that contribute for urban expansion in Amara regional state are economic policy reform, the creation of enabling the environment for private investors, the unsatisfied demand of urban dwellers for residential, and expansion of public sector projects. A collaborative effect of policy limitations, potential conflicts, unplanned livelihood, and poor saving habits of peri-urban farmers, lack of municipality intervention and lack of good governance negatively affect the livelihood of peri-urban farmers and jeopardize the image of government. The forwarded solutions are municipalities should have fully implemented urban policies, should have work on mutual benefits of concerned stakeholders, farmers’ background should be recorded and continuous follow up of evicted farmers livelihood should be practiced.