bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors related to residual gallbladder calculi formation using computed tomography and magnetic resonance imaging combined with clinical data
Authors: Yin Zudong , Zhu Yanyan , Li Zhangzhu , Jiang Xiangsen , An Wei , Yin Liang , Yu Lei 
Published: September 2020

Objective We aimed to investigate risk factors related to remnant gallbladder (RGB) stones. Methods This retrospective study included 73 patients with RGB, in groups with and without RGB calculi. Univariate analyses were used to identify nine variables associated with RGB calculi: sex, age, body mass index (BMI), time to detection, surgical method, length of RGB, angle of RGB and common hepatic duct (CHD), choledocholithiasis, and remnant cholecystitis. Multivariate logistic regression was performed to assess independent predictors of RGB stones. A receiver operating characteristic (ROC) curve was used to estimate model accuracy and determine cut-off values of independent predictors. Results We enrolled 73 patients, 33 with and 40 without RGB stones. Univariate analyses showed that age, BMI, time to detection, length of RGB, angle of RGB and CHD were predictors for RGB calculi. Multivariate analyses indicated that time to detection, length of RGB, and angle of RGB and CHD were independent predictors for RGB calculi. The area under the ROC curve of the model was 0.940. Cut-off values of the three indicators were 1.5 years, 2.25 cm, and 22.5°, respectively. Conclusion Time to detection, length of RGB, and angle of RGB and CHD were independent predictors of RGB calculi.
Effectiveness of App-Based Cognitive Screening for Dementia by Lay Health Workers in Low Resource Settings. A Validation and Feasibility Study in Rural Tanzania
Authors: Paddick Stella-Maria , Yoseph Marcella , Gray William K. , Andrea Damas , Barber Robyn , Colgan Aoife , Dotchin Catherine , Urasa Sarah , Kissima John , Haule Irene , Kisoli Aloyce , Rogathi Jane , Safic Ssenku , Mushi Declare , Robinson Louise , Walker Richard W. 
Published: September 2020

Background: The majority of people with dementia live in low-and middle-income countries (LMICs). In sub-Saharan Africa (SSA) human-resource shortages in mental health and geriatric medicine are well recognized. Use of technological solutions may improve access to diagnosis. We aimed to assess the diagnostic accuracy of a brief dementia screening mobile application (app) for non-specialist workers in rural Tanzania against blinded gold-standard diagnosis of DSM-5 dementia. The app includes 2 previously-validated culturally appropriate low-literacy screening tools for cognitive (IDEA cognitive screen) and functional impairment (abbreviated IDEA-IADL questionnaire). Methods: This was a 2-stage community-based door-to-door study. In Stage1, rural primary health workers approached all individuals aged ≥60 years for app-based dementia screening in 12 villages in Hai district, Kilimanjaro Tanzania. In Stage 2, a stratified sub-sample were clinically-assessed for dementia blind to app screening score. Assessment included clinical history, neurological and bedside cognitive assessment and collateral history. Results: 3011 (of 3122 eligible) older people consented to screening. Of these, 610 were evaluated in Stage 2. For the IDEA cognitive screen, the area under the receiver operating characteristic (AUROC) curve was 0.79 (95% CI 0.74-0.83) for DSM-5 dementia diagnosis (sensitivity 84.8%, specificity 58.4%). For those 358 (44%) completing the full app, AUROC was 0.78 for combined cognitive and informant-reported functional assessment. Conclusions: The pilot dementia screening app had good sensitivity but lacked specificity for dementia when administered by non-specialist rural community workers. This technological approach may be a promising way forward in low-resource settings, specialist onward referral may be prioritized.
Nursing Care for Patients With Acute Mania: Exploring Experiential Knowledge and Developing a Standard of Good Care—Results of the Delphi Study
Authors: Goossens Peter J. J. , de Velde Harsenhorst Rita , van Lankeren Jacobine E. , Testerink Annelies E. , Daggenvoorde Thea H. 
Published: September 2020

Background: When patients diagnosed with bipolar disorder are suffering from acute mania (involuntary), hospitalization is often necessary. Patients are often quite disruptive, which makes it difficult to regulate their behavior and manage them in their current condition. The nursing team must also ensure the safety of the other patients on the ward. Nursing practice in this domain appears to draw primarily on tradition and experience. Aims: To achieve consensus on a standard for nursing practice for patients suffering from mania who are admitted to a closed psychiatric ward. Methods: Previously, professionals, patients, and informal caregivers in the Netherlands were interviewed about the nursing care and their lived experiences. Based on these findings and on the results of a literature review, 89 statements were formulated. A three-round Delphi study among professionals, patients, and informal caregivers was carried out. The accepted statements were summarized. Results: In the first round, 71 statements were accepted, none were rejected, and for 18 statements, no consensus could be reached. These were reformulated and presented in a second round. Thirteen of these statements were accepted, none were rejected, and five statements needed to be reformulated and were presented in the third and final round of this Delphi study. In this final round, all statements were accepted. Conclusions: Consensus was reached among professionals, patients, and informal caregivers in the Netherlands about essential and valuable components of nursing care for patients suffering from acute mania who are admitted to a closed psychiatric ward.
Secondary intra-arterial chemotherapy and/or intravitreal chemotherapy as salvage treatment for retinoblastoma
Authors: Mirzayev Ibadulla , Gündüz Ahmet Kaan , Yavuz Kıvılcım , Şekkeli Mehmet Zahid , Özalp Ateş Funda Seher , Ünal Emel , Taçyıldız Nurdan 
Published: September 2020

Purpose: To evaluate the results of secondary intra-arterial chemotherapy (IAC) and/or intravitreal chemotherapy (IVC) as a salvage treatment for retinoblastoma (RB). Materials and Methods: The medical records of 31 (20 male, 11 female) cases (with 38 eyes) who underwent secondary IAC and/or IVC between February 2010 and June 2019 were retrospectively reviewed. Results: Thirteen (41.9%) cases had unilateral and 18 (58.1%) had bilateral RB. According to the International Classification of RB, 6 (15.8%) eyes had group B, 9 (23.7%) eyes had group C, 16 (42.1%) eyes had group D, and 7 (18.4%) eyes had group E RB at diagnosis. All patients underwent six-cycle intravenous chemotherapy as primary treatment and 8 eyes received external radiotherapy before IAC/IVC. Secondary IAC was performed in 21 (55.3%) eyes, IVC in 10 (26.3%) eyes, and IAC + IVC in 7 (18.4%) eyes. External radiotherapy was applied in 2 (5.3%) eyes after IAC/IVC, one of which was later enucleated. In total, 17 (44.7%) eyes undergoing secondary IAC/IVC treatments were enucleated. Metastasis and death were not observed in any case during the mean follow-up period of 59.3 (median 61, range: 10–98) months. Discussion: Although 60.5% of the eyes undergoing IAC/IVC consisted of groups D and E RB, globe salvage and survival rates were 55.3% and 100.0%, respectively. External radiotherapy was required in 5.3% of the eyes after IAC/IVC. In conclusion, IAC and IVC are safe and effective treatment methods in eyes with RB unresponsive to other eye-preserving treatments and those demonstrating recurrence.
Miniscrew-assisted single-tooth distraction osteogenesis to align an ankylosed infraoccluded maxillary central incisor: A case report
Authors: Shahroudi Atefe Saffar , Golmohammadi Shima 
Published: September 2020

The ankylosis of permanent incisors is usually caused by trauma. In a growing patient, the ankylosed tooth fails to move along with the vertical growth of the remaining alveolar process, which results in an infraoccluded tooth, gingival margin disharmony and unaesthetic smile. This case report presents an 23-year-old female patient whose maxillary right central incisor (tooth number 11) had been traumatised eight years earlier. A vertical discrepancy of about 4 mm was exhibited between teeth 11 and 12. To reposition the crown and gingival margins of the ankylosed tooth to an ideal level, single-tooth dento-osseous osteotomy and distraction of the block of bone containing the tooth was planned. In order to separate the roots of adjacent teeth for opening a space for osteotomy incision, fixed orthodontic treatment with multibracket appliances was initiated on her maxilla. After five weeks, a single-tooth dento-osseous osteotomy was performed using a piezoelectric device. To move the tooth in occlusal and buccal directions, two temporary anchorage devices (miniscrews) on her mandible and interarch elastics were applied. Approximately three weeks later, the ankylosed tooth successfully had an ideal position—relative to the adjacent teeth—and a harmonious gingival margin was achieved by minor gingivoplasty on all incisors.
Assessing the Necessity of Routine Crossmatching for Blood Transfusion in Renal Transplantation
Authors: Cheung Douglas , Reynolds Luke , Peng Melin , Lee Jason , Stewart Robert , Pace Kenneth , Honey R. John D’Arcy , Ordon Michael 
Published: September 2020

Introduction: Routine crossmatch of packed red blood cells (pRBCs) is completed preoperatively at many centers despite conflicting evidence on the incidence of blood transfusions with renal transplantation. In the current economic climate, resource adjudication should be judicious and medically appropriate. The objective of this study was to determine the incidence, timing, and predictors of early postoperative pRBC transfusion in patients undergoing renal transplantation. Methods: A retrospective review of all patients undergoing renal transplantation at our institution from January 2013 to May 2016 was performed. Demographic, biochemical, and clinical parameters were recorded. The primary outcome was early postoperative transfusion, defined as an intraoperative transfusion or within 2 days of surgery. Multivariable logistic regression was performed to identify associations with early postoperative transfusion. Results: We identified 428 patients during the study period (average age 55 years, 60% male, 30% obese, 67% deceased donor, and 43% preoperative antithrombotic use). Forty (9.3%) patients required early postoperative transfusion (mean: 2.8 pRBCs/transfusion) and most did not require blood urgently. Only 20 (4.7%) patients required a transfusion intraoperatively or on the same day of surgery. Lower preoperative hemoglobin (per g/L unit: odds ratio [OR]: 0.943), female gender (OR: 2.752), and preoperative antithrombotic use (OR 2.369) were associated with a need for early postoperative transfusion. Conclusion: Transfusion in the early postoperative period following renal transplantation was less than 10%, suggesting that routine crossmatch may not be necessary for all patients. Preoperative hemoglobin, female gender, and preoperative antithrombotic use were associated with increased risk and may be useful to risk-stratify patients who require crossmatch.
The reliability and validity of novel clinical strength measures of the upper body in older adults
Authors: Legg Hayley S , Spindor Jeff , Dziendzielowski Reanne , Sharkey Sarah , Lanovaz Joel L , Farthing Jonathan P , Arnold Cathy M 
Published: September 2020

Introduction Research investigating psychometric properties of multi-joint upper body strength assessment tools for older adults is limited. This study aimed to assess the test–retest reliability and concurrent validity of novel clinical strength measures assessing functional concentric and eccentric pushing activities compared to other more traditional upper limb strength measures. Methods Seventeen participants (6 males and 11 females; 71 ± 10 years) were tested two days apart, performing three maximal repetitions of the novel measurements: vertical push-off test and dynamometer-controlled concentric and eccentric single-arm press. Three maximal repetitions of hand-grip dynamometry and isometric hand-held dynamometry for shoulder flexion, shoulder abduction and elbow extension were also collected. Results For all measures, strong test–retest reliability was shown (all ICC > 0.90, p < 0.001), root-mean-squared coefficient of variation percentage: 5–13.6%; standard error of mean: 0.17–1.15 Kg; and minimal detectable change (90%): 2.1–9.9. There were good to high significant correlations between the novel and traditional strength measures (all r > 0.8, p < 0.001). Discussion The push-off test and dynamometer-controlled concentric and eccentric single-arm press are reliable and valid strength measures feasible for testing multi-joint functional upper limb strength assessment in older adults. Higher precision error compared to traditional uni-planar measures warrants caution when completing comparative clinical assessments over time.
Diabetes Mellitus—A Risk Factor for the Development of Lumbar Disc Degeneration: A Retrospective Study of an Indian Population
Authors: Kakadiya Ghanshyam , Gandbhir Viraj , Soni Yogesh , Gohil Kushal , Shakya Akash 
Published: September 2020

Study Design: A retrospective study. Objectives: To determine the association between type-2 diabetes mellitus (T2DM) and the severity of lumbar disc degeneration disease (LDDD). Methods: We included 199 patients with low back pain (LBP) who visited our hospital from 2016 to 2018. All patients were divided into 3 groups as per inclusion criteria. Group A, patients without DM (n = 75); group B, patients with controlled DM (n = 72); and group C, patients with uncontrolled DM (n = 52). The patients were further subdivided into group B1, DM duration ≤10 years (n = 38); group B2, DM duration >10 years (n = 34); group C1 DM duration ≤10 years (n = 28); and group C2, DM duration >10 years (n = 24). Sex, age, body mass index, occupation, smoking history, alcohol use, and duration of T2DM were recorded. The severity of LDDD was evaluated using the 5-level Pfirrmann grading system. Operated patients’ disc materials were sent for histological examination. Results: Demographic data showed no difference among groups ( P > 0.5), except age. Patients with DM showed more severe disc degeneration compared with patients without DM. The average Pfirrmann scores between groups A and B1 had no difference; groups B2, C1, and C2 showed higher average Pfirrmann scores than group A ( P < 0.05). Groups B2 and C2 showed higher average Pfirrmann scores than groups B1 and C1 ( P < 0.05). Groups C1 and C2 showed higher average Pfirrmann scores than groups B1 and B2 ( P < 0.05). The severity of LDDD was significantly related to DM duration in both groups B and C ( P < 0.05). DM groups showed increased disc apoptosis and matrix aggrecan fragmentation, disc glycosaminoglycan content and histological analysis were significantly different; the results are similar to Pfirrmann score results. Conclusions: DM duration >10 years and uncontrolled DM were risk factors for LDDD.
Spinal Deformity Surgery in Pediatric Patients With Cerebral Palsy: A National-Level Analysis of Inpatient and Postdischarge Outcomes
Authors: Lee Nathan J. , Fields Michael , Boddapati Venkat , Mathew Justin , Hong Daniel , Sardar Zeeshan M. , Selber Paulo R. , Roye Benjamin , Vitale Michael G. , Lenke Lawrence G. 
Published: September 2020

Study Design: Retrospective cohort. Objective: To provide a national-level assessment of the short-term outcomes after spinal deformity surgery in pediatric patients with cerebral palsy. Methods: A national, prospectively collected database was queried to identify pediatric (≤18 years) patients with cerebral palsy, who underwent spinal fusion surgery from 2012 to 2017. Separate multivariate analyses were performed for the primary outcomes of interest including extended length of stay (>75th percentile, >8 days), and readmissions within 90 days after the index admission. Results: A total of 2856 patients were reviewed. The mean age ± standard deviation was 12.8 ± 2.9 years, and 49.4% of patients were female. The majority of patients underwent a posterior spinal fusion (97.0%) involving ≥8 levels (79.9%) at a teaching hospital (96.6%). Top medical complications (24.5%) included acute respiratory failure requiring mechanical ventilation (11.4%), paralytic ileus (8.2%), and urinary tract infections (4.6%). Top surgical complications (40.7%) included blood transfusion (35.6%), wound complication (4.9%), and mechanical complication (2.7%). The hospital cost for patients with a length of hospital stay >8 days ($113 669) was nearly double than that of those with a shorter length of stay ($68 411). The 90-day readmission rate was 17.6% (mean days to readmission: 30.2). The most common reason for readmission included wound dehiscence (21.1%), surgical site infection (19.1%), other infection (18.9%), dehydration (16.9%), feeding issues (14.5%), and acute respiratory failure (13.1%). Notable independent predictors for 90-day readmissions included preexisting pulmonary disease (odds ratio [OR] 1.5), obesity (OR 3.4), cachexia (OR 27), nonteaching hospital (OR 3.5), inpatient return to operating room (OR 1.9), and length of stay >8 days (OR 1.5). Conclusions: Efforts focused on optimizing the perioperative pulmonary, hematological, and nutritional status as well as reducing wound complications appear to be the most important for improving clinical outcomes.
Enhancing Mentoring in Palliative Care: An Evidence Based Mentoring Framework
Authors: Krishna Lalit Kumar Radha , Tan Lorraine Hui En , Ong Yun Ting , Tay Kuang Teck , Hee Jia Min , Chiam Min , Chia Elisha Wan Ying , Sheri Krish , Tan Xiu Hui , Teo Yao Hao , Kow Cheryl Shumin , Mason Stephen , Toh Ying Pin 
Published: September 2020

Background: Growing concerns over ethical issues in mentoring in medicine and surgery have hindered efforts to reinitiate mentoring for Palliative Care (PC) physicians following the easing of COVID-19 restrictions. Ranging from the misappropriation of mentee’s work to bullying, ethical issues in mentoring are attributed to poor understanding and structuring of mentoring programs, underlining the need for a consistent approach to mentoring practices. Methods: Given diverse practices across different settings and the employ of various methodologies, a novel approach to narrative reviews (NR)s is proposed to summarize, interpret, and critique prevailing data on novice mentoring. To overcome prevailing concerns surrounding the reproducibility and transparency of narrative reviews, the Systematic Evidenced Based Approach (SEBA) adopts a structured approach to searching and summarizing the included articles and employed concurrent content and thematic analysis that was overseen by a team of experts. Results: A total of 18 915 abstracts were reviewed, 62 full text articles evaluated and 41 articles included. Ten themes/categories were ascertained identified including Nature; Stakeholders; Relationship; Approach; Environment; Benefits; Barriers; Assessments; Theories and Definitions. Conclusion: By compiling and scrutinizing prevailing practice it is possible to appreciate the notion of the mentoring ecosystem which sees each mentee, mentor, and host organization brings with them their own microenvironment that contains their respective goals, abilities, and contextual considerations. Built around competency based mentoring stages, it is possible to advance a flexible yet consistent novice mentoring framework.
Endoscopic Treatment of Posterior Ankle Impingement Secondary to Os Trigonum in Recreational Athletes
Authors: Nikolopoulos Dimitrios , Safos George , Moustakas Konstantinos , Sergides Neoptolemos , Safos Petros , Siderakis Athanasios , Kalpaxis Dimitrios , Moutsios-Rentzos Andreas 
Published: September 2020

Background: The os trigonum (OT)—the most common accessory bone of the foot—although usually asymptomatic, may cause posterior ankle impingement syndrome (PAIS), which may be a severely debilitating problem for recreational or competitive athletes. The aim of the present study was to evaluate effectiveness of posterior ankle arthroscopy and to assess the outcome in the treatment of PAIS secondary to OT impingement or OT fractures within a group of young athletes and their return to previous sports level. Methods: From 2011 to 2018, a retrospective review of 81 recreational athletes of mean age 27.8 years was performed. All patients were diagnosed with PAIS due to OT pathology and were operated on endoscopically with resection of the OT. Pre- and postoperative clinical evaluation were performed at 3 months, 1 year, and 2 years based on visual analog scale (VAS), ankle range of motion (ROM), American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, and the Foot & Ankle Disability Index (FADI) scores, in a follow-up of at least 2 years. Results: VAS score was significantly improved from an average of 7.5 (5-9) preoperatively to 1.9 (1-3) at 3 months postoperatively and to 0.6 (0-2) and 0.3 (0 -1) at 1 and 2 years postoperatively. Ankle ROM was significantly improved from an average of 24.8 (10-35) preoperatively to 58.0 (50-65) at 3 months postoperatively and to 64.0 (50-65) at 1 year and 64.7 (60-65) at 2 years postoperatively. AOFAS and FADI scores were significantly improved from 39.4 (18-55) and 49.7 (42.3-62.5) preoperatively to 85.2 (74-89) and 87.3 (81.7-88.5) postoperatively at 3 months to 97.7 (85-100) and 97.9 (93.3-100) postoperatively at 1 year, respectively ( P < .001). Only 5 patients dropped to a lower activity level. There were 5 complications (4 transient). Conclusion: Endoscopic treatment of PAIS due to OT pathology demonstrated excellent results. Posterior ankle arthroscopy was an effective treatment and allowed for a prompt return to a high activity level of their athletic performance. Level of Evidence: Level IV, therapeutic study / retrospective case series.