bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone Cysts and Osteolysis in Ankle Replacement
Authors: Najefi Ali-Asgar , Ghani Yaser , Goldberg Andrew J. 
Published: September 2020

Background: Total ankle replacements (TARs) have higher rates of osteolysis than hip or knee replacements. It is unclear whether this is a pathologic immunologic process in response to wear debris, or expansion of pre-existing osteoarthritic bone cysts. We aimed to determine the incidence of bone cysts in patients with end-stage ankle arthritis prior to surgery and review the literature on bone cysts and osteolysis in relation to TAR. Methods: This is a descriptive/prevalence study in which all patients with end-stage ankle arthritis underwent plain radiographic imaging and computed tomographic (CT) scans prior to TAR surgery. Their imaging was assessed for the presence of cysts, measured on sagittal, axial, and coronal slices of the CT scan at the widest diameter. All cysts that would be removed as a result of the bone resection for the implant were excluded using digital analysis software. We assessed 120 consecutive patients with mean age of 63.4 years. Results: Seventeen patients (14%) did not have any bone cysts based on CT images. Ten patients (8%) had cysts that would have been completely removed by surgery, leaving 93 patients for analysis (78%). In 60% of these cases, the cysts were not seen on the plain radiographs. In 39 patients (33%), the cysts were greater than 5 mm in size. The medial (36%) and lateral malleoli (33%) were the most common location for the cysts (mean diameter 4.6±2.0 and 4.2±2.3 mm, respectively). Conclusion: Bone cysts outside of the resection margins for a TAR were present in 78% of patients with ankle arthritis prior to undergoing surgery. In 30% of cases, cysts were greater than 5 mm in size. In 60% of cases, the cysts were not seen on plain radiographs. Preoperative 3-dimensional imaging can provide a foundation to observe and quantify cyst presence, expansion, and time of onset in the postoperative setting. Level of Evidence: Level IIc, diagnostic/prevalence study.
Optical Coherence Tomography Angiography in idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN) syndrome: A case report
Authors: Ouederni Meriem , Sassi Hela , Chelly Zied , Nefaa Fehmy , Cheour Monia 
Published: September 2020

Purpose: Since its first description by Chang et al. in 1995, the diagnosis of Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN) syndrome has been based on the findings of Fundus Fluorescein Angiography (FFA). Our purpose was to describe the utility of optical coherence tomography angiography (OCT-A) in its diagnosis and management. Case description: A 40-year-old female presented with bilateral blurred vision. Her best corrected visual acuity was at 8/10. Fundus examination revealed blurred disc margins, perivascular exudates, arterial sheaths and retinal hemorrhages bilaterally. FFA showed staining of the optic disc with dye leakage in the right eye, a punctuate hyperfluorescence of the temporosuperior artery in the left eye, bilateral vascular sheathing and capillary dropout. OCT-A showed simultaneous presence of papillary aneurysm and neovascularization of the optic nerve head in the right eye, a papillary aneurysm in the left eye and bilateral capillary non-perfusion. Our patient was diagnosed with IRVAN syndrome. Oral steroids associated with panretinal laser photocoagulation and intravitreal injection of bevacizumab in the right eye resulted in vanishing of the papillary neovascularization with no recurrence on OCT-A at 10-month follow-up. Conclusions: OCT-A is an additional tool to FFA for visualization of arterial macroaneurysms and retinal neovascularization without the interference of dye leakage. It well demarcates nonperfused areas and ensures follow-up of retinal neovascularization. Its limitations are the limited field of view and the low sensitivity in detecting arteriolar dilations. Thus, OCT-A is unable to outplace FFA but should be considered alternately with it for non-invasive follow-up of IRVAN syndrome.
A systematic review and meta-analysis of survivorship and wear rates of metal and ceramic heads articulating with polyethylene liners in total hip arthroplasty
Authors: Gosling Oliver B , Ferreri Thomas G , Khoshbin Amir , Whitehouse Michael R , Atrey Amit 
Published: September 2020

Background: The major joint registries report better survivorship for ceramic on polyethylene over metal on polyethylene bearings in total hip arthroplasty and it is generally accepted that this is due to a lower polyethylene wear rate. We used evidence synthesis to compare survivorship, polyethylene wear rates and metal ion levels for metal-on-polyethylene (MoP) and ceramic-on-polyethylene (CoP) bearings. If wear rates are not dissimilar in vivo this difference in revision rate may have another cause. Modular junctions are a potential source of corrosion and it is postulated that this may result in higher revision rates. Methods: We performed a systematic review and meta-analysis comparing the survivorship of MoP and CoP bearings. Odds ratio (95% CI) of revision was calculated. Mean difference (MD) and 95% confidence intervals (CI) were used to compare secondary outcomes of polyethylene wear and metal ion levels. Meta-analysis was performed with a Mantel-Haenszel Random-Effects Model. Results: 6 randomised controlled trials were included. There was no statistically significant difference between MoP and CoP revision rate (OR 1.04; 95% CI, 0.37–2.90, I2 = 0%, p = 0.94), linear bearing wear (MD 0.00 mm; 95% CI, −0.05 –0.05, I2 = 98%, p = 0.90), nor volumetric bearing wear (MD 33.57 mm3; 95% CI, −215.56–282.70, I2 = 98%, p = 0.79). No studies evaluated metal ion levels. Conclusions: We found no evidence of a difference in revision rates nor linear and volumetric wear between MoP and CoP bearings in the randomised controlled trials currently available. Our study therefore does not advocate the additional cost associated with the use of ceramic heads in combination with polyethylene bearings in order to minimise revision rates. This contrasts the findings of in vitro studies and the major joint registries.
Evaluation of the effect of core lattice topology on the properties of sandwich panels produced by additive manufacturing
Authors: Monteiro JG , Sardinha M , Alves F , Ribeiro AR , Reis L , Deus AM , Leite M , Vaz M Fátima 
Published: September 2020

Sandwich structures are frequently used in automotive, aerospace and marine industries, as they provide adequate functional properties. The two-dimensional regular hexagonal cell shape, i.e. honeycomb is the most used core structure in sandwich panels. Recently, a new type of cellular structures composed of lattice struts has been proposed, as they combine high stiffness, strength and energy absorption with low weight. The main purpose of this research is to investigate the effect of the lattice topology on the flexural behaviour of sandwich panels. Five lattice geometries inspired in crystalline structures were designed, namely, body-centred parallelepiped, body-centred parallelepiped with struts in z-axis, body- and face-centred parallelepiped with struts in z-axis, face-centred parallelepiped with struts in z-axis and parallelepiped simple. The relative density of all the lattices was kept constant as 0.3. Both numerical and experimental approaches were used to evaluate the flexural properties and failure behaviour of the sandwich structures under three-point bending tests. The numerical analysis was undertaken with the finite element software NX Nastran. Taking advantage of additive manufacturing technologies, material extrusion was used to produce polylactic acid samples with the configurations aforementioned. The sandwich panels are composed by a single layer formed by the lattice core and two thin plates, at the bottom and top. The three parts of the panel were manufactured all together. The simulation results indicate that, among the lattices studied, topologies body-centred parallelepiped with struts in z-axis and body- and face-centred parallelepiped with struts in z-axis exhibit higher strength, while body- and face-centred parallelepiped with struts in z-axis shows higher stiffness and higher energy absorption, attaining values that do not differ much from the ones obtained with a two-dimensional hexagonal cellular structure, with the same relative density. As a consequence, some of the geometries studied may have the potential to be considered as alternatives to conventional structures in the design of sandwich structures.
Brachioradialis Muscle Tendon Transposition in Extensor Pollicis Longus Reconstruction: Anatomical Study and a New Surgical Approach
Authors: De Francesco Francesco , Pugliese Pierfrancesco , De Francesco Marialuisa , Pangrazi Pier Paolo , Riccio Michele 
Published: September 2020

Background Complete extension of the thumb and activation of the extensor pollicis longus (EPL) tendon are fundamental to ensure maximum function. Many EPL repair techniques are described in the literature. Methods The authors present an alternative technique using the brachioradialis (BR) tendon. Thirty patients with injuries of the EPL tendon in zone 8 were studied. In all cases, neither direct suture repair nor traditional tendon transfer was possible. Results Thumb extension was restored in all patients with satisfactory extension recovery. All patients achieved excellent extension; good functional results were observed in 2 cases, and in 1 case satisfactory results were achieved using the Geldmacher assessment and the Kapandji assessment. The overall results were rated as excellent, good, fair, or poor according to the Quick Disabilities of the Arm, Shoulder, and Hand Scale. Discussion The BR tendon was suitable to treat all cases, in particular injuries occurring near Lister’s tubercle, due to its appropriate length for tenorrhaphy albeit with a short distal head.
Prevalence of Ganglion Cyst Formation After Wrist Arthroscopy: A Retrospective Longitudinal Analysis of 2420 Patients
Authors: Rochlin Danielle H. , Perrault David , Sheckter Clifford C. , Fox Paige , Yao Jeffrey 
Published: September 2020

Background Dorsal wrist ganglion cysts arise from the leakage of synovial fluid through tears in the scapholunate ligament and/or dorsal wrist capsule. An analogous disruption of the dorsal capsule is created with routine portal placement during wrist arthroscopy. We hypothesized that wrist arthroscopy would predispose to wrist ganglions. Methods Using the Truven MarketScan Outpatient Services Database from 2015 to 2016, patients who underwent wrist arthroscopy and developed an ipsilateral wrist ganglion were identified. Exclusion criteria included ganglion diagnosis preceding arthroscopy and bilateral pathology. Postoperative ganglion diagnosis was modeled with logistic regression. Predictor variables included age, gender, comorbidities, and arthroscopic procedure. Results In all, 2420 patients underwent wrist arthroscopy. Thirty (1.24%) were diagnosed with an ipsilateral wrist ganglion at a mean time of 4.0 months (standard deviation: 2.4, range: 0.2-9.0). Significant predictors of ganglion diagnosis included female gender (odds ratio [OR]: 4.0, P < .01) and triangular fibrocartilage complex and/or joint debridement (OR: 0.13, P < .01). By comparison, among all 24,718,751 outpatients who had not undergone wrist arthroscopy, 39,832 patients had a diagnosis of a wrist ganglion cyst (0.16%). Conclusions Wrist arthroscopy is associated with a postoperative rate of ganglion cyst formation that is nearly 8 times the rate in the general population. Additional studies are needed to investigate techniques that minimize the risk of this complication.
Use of electronic recruitment methods in a clinical trial of adults with gout
Authors: Miller Hailey N , Charleston Jeanne , Wu Beiwen , Gleason Kelly , White Karen , Dennison Himmelfarb Cheryl R , Ford Daniel E , Plante Timothy B , Gelber Allan C , Appel Lawrence J , Miller Edgar R , Juraschek Stephen P 
Published: September 2020

Background/aims: Electronic-based recruitment methods are increasingly utilized in clinical trials to recruit and enroll research participants. The cost-effectiveness of electronic-based methods and impact on sample generalizability is unknown. We compared recruitment yields, cost-effectiveness, and demographic characteristics across several electronic and traditional recruitment methods. Methods: We analyzed data from the diet gout trial recruitment campaign. The diet gout trial was a randomized, controlled, cross-over trial that examined the effects of a dietary approaches to stop hypertension (DASH)–like diet on uric acid levels in adults with gout. We used four electronic medical record and four non-electronic medical record–based recruitment methods to identify and recruit potentially eligible participants. We calculated the response rate, screening visit completion rate, and randomization rate for each method. We also determined cost per response, the screening, and randomization for each method. Finally, we compared the demographic characteristics among individuals who completed the screening visit by recruitment method. Results: Of the 294 adults who responded to the recruitment campaign, 51% were identified from electronic medical record–based methods. Patient portal messaging, an electronic medical record–based method, resulted in the highest response rate (4%), screening visit completion rate (37%), and randomization rate (21%) among these eight methods. Electronic medical record–based methods ($60) were more cost-effective per response than non-electronic medical record–based methods ($107). Electronic-based methods, including patient portal messaging and Facebook, had the highest proportion of White individuals screened (52% and 60%). Direct mail to non-active patient portal increased enrollment of traditionally under-represented groups, including both women and African Americans. Conclusion: An electronic medical record–based recruitment strategy that utilized the electronic medical record for participant identification and postal mailing for participant outreach was cost-effective and increased participation of under-represented groups. This hybrid strategy represents a promising approach to improve the timely execution and broad generalizability of future clinical trials.
Principal authentic leadership and teacher engagement in Kuwait’s educational reform context
Authors: Alazmi Ayeshah Ahmed , Al-Mahdy Yasser F Hendawy 
Published: September 2020

Scholars have asserted that a school principal’s authentic leadership can raise the engagement of teachers under their charge. This paper delves into this consideration, within the context of Kuwaiti educational reform, by investigating the extent to which principal authentic leadership (PAL) affects teacher engagement (TE) by enhancing their occupational self-efficacy (OSE). The study used a non-experimental, predictive survey design, obtaining data from 333 teachers in 25 primary schools in Kuwait. The study tested a set of hypotheses drawn from a conceptualized model developed from previous research studies using structural equation modelling (SEM). Results indicated the validation of this model describing how PAL affects teacher OSE and TE. Data analysis from this study indicated that PAL has a significant, positive effect upon TE, as does OSE. Furthermore, OSE mediates the relationship between PAL and TE. These findings contribute to our understanding for the effects of authentic leadership in Kuwait. As such, this study offers insight into how Kuwaiti policymakers may improve and support school leadership practices to realize the aims of the nation’s educational reform goals. Additionally, this study builds upon, and extends, the foundations established in earlier research endeavours regarding school principal leadership within centralized education systems and outside Western society.
A cross-sectional study of factors predicting readmission in Thais with coronary artery disease
Authors: Polsook Rapin , Aungsuroch Yupin 
Published: September 2020

Background Coronary artery disease is a major cause of morbidity and mortality with high readmission rates. Hospital readmissions for coronary artery disease contribute to rising healthcare costs and are a marker of quality of care. Despite this, prior studies have found that readmission rates vary widely. Aims This study aims to determine the impact of social support, depression, comorbidities, symptom severity, quality of life and readmission among coronary artery disease patients in Thailand. Methods A total of 321 coronary artery disease patients from tertiary care hospitals across all regions of Thailand were recruited for this study. Data were analysed using multiple regression analysis. Results The coefficient for social support (beta = −0.22) was found to be significant ( p < 0.05), whereas comorbidity, symptom severity, depression and quality of life were not significant. Thus, social support was found to be the most significant predictive factor for readmission. Conclusions Accordingly, when designing effective nursing interventions, nurses should promote social support interventions for coronary artery disease patients to improve the quality of care, decrease readmission rates and improve patients' quality of life.
Exploratory factor analysis of the Just Culture Assessment Tool for nursing education
Authors: Walker Danielle , Hromadik Lora , Altmiller Gerry , Barkell Nina , Toothaker Rebecca , Powell Kevin 
Published: September 2020

Background Just culture has been identified as a vital component of safety culture by national and international organisations. In a just culture, emphasis is not placed on blaming individuals for errors but rather on examining personal and system processes that can best support safety and prevent reoccurrence. Although those in the practice arena have worked to implement the concepts of just culture, the same is not true in nursing education, leaving nursing students lacking the pre-requisite knowledge, skills and attitudes to implement just culture in practice on graduation. Aims Assessment of this phenomena is the essential first step to align nursing education with practice in promoting just culture as a mechanism for patient safety. The purpose of this paper is to further refine the Just Culture Assessment Tool-Nursing Education through exploratory factor analysis. Methods The Just Culture Assessment Tool-Nursing Education was adapted from the Just Culture Assessment Tool, an instrument created for the practice setting. Validity and reliability were established for the Just Culture Assessment Tool-Nursing Education in a study of 800 nursing students to assess their perceptions and understanding of just culture with their nursing programmes. Using the previously conducted data, an exploratory factor analysis was conducted. Results Factor analysis supports six subscales, similar to that of the Just Culture Assessment Tool. However, individual items were loaded into different subscales. All subscales demonstrated good reliability. Factor analysis supported further refinement of two items to improve the instrument’s ability to capture data. Conclusions Perceptions of just culture differ between experienced providers and nursing students; nursing students have less experience with reporting errors. Factor analysis of Just Culture Assessment Tool-Nursing Education items demonstrated these differences, supporting modification of items by the instrument developers. An ‘if’ statement for students to consider their possible actions rather than experience was added to two items to better capture data from nursing students when completing the assessment.
Nimotuzumab plus platinum-based chemotherapy versus platinum-based chemotherapy alone in patients with recurrent or metastatic nasopharyngeal carcinoma
Authors: Zhu Yunshu , Yang Sheng , Zhou Shengyu , Yang Jianliang , Qin Yan , Gui Lin , Shi Yuankai , He Xiaohui 
Published: September 2020

Background: Palliative chemotherapy has been the mainstay treatment for patients with recurrent or metastatic nasopharyngeal carcinoma (R/M-NPC). However, little is known about the efficacy and toxicity of nimotuzumab (NTZ) – a monoclonal antibody drug targeting epidermal growth factor receptor – plus chemotherapy (CT) versus CT alone for these patients. Methods: The database at Cancer Hospital of Chinese Academy of Medical Sciences was queried for patients diagnosed with NPC who received CT with or without NTZ between 2004 and 2018. Treatment compliance, survival outcomes, and adverse effects were compared among these groups. Results: Records of 70 patients with R/M-NPC were reviewed: 21 (30%) received NTZ plus CT (NTZ+CT) and 49 (70%) received CT. CT regimens included gemcitabine plus platinum, taxane plus platinum (TP), and fluorouracil plus platinum. Comparing the CT group with NTZ+CT group, the median follow up was 62 months (range = 3–133) versus 59 months (range = 9–117); median progression free survival was 7.5 [95% confidence interval (CI) 6.552–8.381] months versus 8.5 (95% CI 6.091–10.976) months, p = 0.424; median overall survival (OS) was 25.6 (95% CI 18.888–32.379) months versus 48.6 (95% CI 35.619–61.581) months, p = 0.017, respectively. Multivariable analysis established treatment group (CT versus NTZ+CT) as an independent prognostic factor for OS (hazard ratio, 0.5; 95% CI 0.255–0.979; p = 0.043). No significant difference with regard to toxicities was observed between the two groups. Among them, a subgroup analysis was performed in 53 (75.7%) patients who received TP with or without NTZ, which showed similar results. Conclusion: Our findings suggested that NTZ+CT provides a novel treatment option and prolongs survival significantly for R/M-NPC.
Right heart catheterization for pulmonary hypertension during the coronavirus disease 2019 pandemic
Authors: Qaiser Kanza N. , Lane James E , Tonelli Adriano R. 
Published: September 2020

Right heart catheterization is an essential diagnostic modality in the evaluation of pulmonary hypertension. The coronavirus disease 2019 pandemic has resulted in deferral of elective procedures including right heart catheterization. The benefits of proceeding with right heart catheterization, such as further characterization of hemodynamic subtype and severity of pulmonary hypertension, initiation of targeted pulmonary arterial hypertension therapy, as well as further hemodynamic testing, need to be carefully balanced with the risk of potentially exposing both patients and health care personnel to coronavirus disease 2019 infection. This review article aims to provide best clinical practices for safely performing right heart catheterization in pulmonary hypertension patients during the coronavirus disease 2019 pandemic.