bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraoperative radiation exposure in hip arthroscopy: a systematic review
Authors: Shah Ajay , Nassri Mohammed , Kay Jeffrey , Simunovic Nicole , Mascarenhas Vasco V , Andrade Antonio J , Marin-Peña Óliver R , Ayeni Olufemi R 
Published: November 2019

Fluoroscopy is used in hip arthroscopy (HA) for portal placement, instrument localisation, and guidance in bony resection. The recent increase in arthroscopic hip procedures may place patients and surgeons at risk for increased radiation exposure and radiation-induced complications. The purpose of the current systematic review was to assess intraoperative radiation exposure in HA. The systematic review was conducted according to PRISMA guidelines; inclusion criteria were studies assessing radiation exposure in HA. 9 studies including 994 patients were included. Mean age was 38.6 years and 48% (436 of 906) were female. Mean time of fluoroscopy exposure was 0.58 minutes. Dose area product was 129.5 cGycm2. Mean intraoperative absorbed radiation dose studies was 12.6 mGy. Mean intraoperative effective dose was 0.48 mSv. The mean occupational exposure to the surgeon per case was 0.0031 mSv. Higher patient body mass index (BMI) correlated to greater patient effective and cumulative dose ( p < 0.05, r = 0.404), and greater occupational exposure ( p < 0.001, r = 0.460). Increasing surgeon experience decreased fluoroscopy time ( p = 0.039) and radiation dose ( p = 0.002). Radiation dose and effective dose were well under the thresholds for deterministic effects (2 Gy) and annual radiation exposure for occupational workers (20 mSv). Intraoperative radiation exposure to patients and surgeons is within acceptable annual radiation limits. Ensuring careful selection of perioperative imaging modalities, proper protective shielding, specifically the use of leaded eyeglasses, and optimal C-arm positioning are key strategies to reduce radiation exposure to patients and surgeons alike.
Responding to the mental health consequences of the 2015–2016 terrorist attacks in Tunisia, Paris and Brussels: implementation and treatment experiences in the United Kingdom
Authors: Cyhlarova Eva , Knapp Martin , Mays Nicholas 
Published: November 2019

Objectives To explore whether the Screen and Treat Programme to support United Kingdom citizens potentially affected by terrorist attacks in Tunisia (2015), Paris (2015) and Brussels (2016) was effective in identifying and referring people to mental health services, to examine the programme’s acceptability to users and to understand how agencies involved worked together. Methods Individuals offered screening by the programme (n = 529) were invited to participate in the study and were sent a questionnaire. Follow-up interviews were conducted with questionnaire respondents who consented and with employees of agencies involved in the programme’s planning and delivery. Seventy-seven people affected by the attacks completed questionnaires, 35 of those were also interviewed, and 1 further person only participated in an interview. Eleven people from agencies organizing and delivering the programme and five clinician-managers were also interviewed. Results Most service users said the attacks had a major impact on their lives. Many reported anxiety, depression, difficulty going out or travelling, sleep problems, panic attacks, flashbacks and hyper-vigilance. A third had reduced their working hours and a similar proportion had taken sick leave. Two-thirds sought help from their General Practitioner (GP) before being contacted by the programme, but almost all thought their GP had not been helpful in dealing with post-traumatic stress disorder (PTSD) or referring to appropriate care. Several people were prescribed psychotropic medication; only a few were referred to mental health professionals. Many participants used help offered by organizations external to National Health Service, with mixed experiences. Waiting times for treatment varied from no delay to a few months. Most interviewees thought the programme should have started sooner and provided more information about sources of support. Most users found treatment received via the programme helpful. Professionals involved in organizing and delivering the programme thought that bureaucratic delays in setting it up were key limitations on effectiveness. Clinician interviewees thought an outreach approach was needed to identify at-risk individuals. Conclusions Users who took part in the programme were satisfied with their treatment, although many thought it should have been offered sooner. Funding and data sharing between agencies were the main barriers to timely contact with affected individuals. Self-referral, GP identification of PTSD and GP referral to appropriate care were regarded as ineffective, suggesting that people affected by similar future incidents should be supported better and assisted more promptly to access treatment.
Investigation on crushing behavior of laminated conical absorbers with different arrangements under axial loading
Authors: Akhavan Attar Ali , Kazemi Mahdi 
Published: November 2019

Abstracts In this paper, the crushing properties of conical tubes made of stainless steel 430 have been investigated with different arrangements under quasi-static axial load both experimentally and numerically. For numerical investigation, nonlinear finite element method simulation is conducted using LS-Dyna software. In the experimental tests, the specimens with the height, major diameter, minor diameter and thickness of 150, 70, 50 and 1 mm are considered, respectively. Different combinations of layers are prepared using different cross-sections. A total of seven different arrangements have been designed in three distinct groups with constant mass and the crushing behavior has been extracted for them. To ensure the validity of the simulation results, several specimens which have the thickness of 1 mm have been tested experimentally. Comparing the results indicates the consistency of the experimental and numerical data. According to the obtained results, it is observed that with increasing the number of layers, the energy absorption capacity is increased; moreover, the peak load is increased by 75.2%. In fact, with increasing the number of layers, increasing trend is observed in peak load, and contrary to the initial expectations, this trend is not linear. It is also observed that by changing the layer arrangement and the layer number, the mean crushing force can increase approximately three times.
Outcome Measures for Acute Submassive Pulmonary Embolisms at a Community-Based Hospital Using Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis
Authors: Hooks Brandon , Sharma Vinay , Taylor Gavin , Wadhwani Sumeet , Ehtesham Muhammad 
Published: November 2019

Purpose: Ultrasound-facilitated, catheter-directed, low-dose fibrinolysis (USAT) appears to provide promising results for the management of acute submassive pulmonary embolisms (ASMPEs) at tertiary care centers. This study assessed outcome measures at a community-based hospital systems and compared results to known studies. Materials and Methods: This is a single-center, retrospective study assessing clinical outcomes of the EkoSonic Endovascular System intervention for ASMPEs performed by three surgical 3 subspecialties (interventional radiology, interventional cardiology, and vascular surgery) part of a pulmonary embolism response team (PERT). We reviewed 146 PERT activations from June 2013 to December 2017. Eighty-three patients with ASMPEs underwent USAT. Results: Our study showed greater differences ( P = .01) between baseline and follow-up pulmonary artery systolic pressures (20.9 ± 9.8 mm Hg [n = 14]) compared to the ULTIMA study (12.3 ± 10 mm Hg [n = 30]). Our length-of-stay measures were shorter (6.1 ± 5.1 [n = 83]; P = .0001) compared to the SEATTLE II study (8.8 ± 5.0 [n = 150]). Preprocedure transthoracic echocardiograms (TTEs) were performed for 54 (65%) of 83 patients. Postprocedure TTEs at 48 hours was performed for 52 (62%) of 83 patients. Use of TTEs before and after intervention did not change outcomes. Intracranial hemorrhage was not observed in our patient population. There was no difference in outcomes between the three subspecialties in our study. Conclusions: Use of USAT in a community-based hospital PERT has similar outcomes to tertiary care centers. Furthermore, similar outcomes were observed between the three subspecialties suggesting development of a comprehensive care team for management of ASMPEs.
A technical note on intra-arterial cone-beam computed tomography for the evaluation of flow-diverter stents: Image quality differences between diluted and non-diluted contrast medium
Authors: Kocer Naci , Kandemirli Sedat G , Ruijters Daniel , Mantatzis Michalis , Kizilkilic Osman , Islak Civan 
Published: November 2019

Background Design of flow-diverter stents for flexibility, tractability, and low profile limits their radiopacity on conventional digital subtraction angiography. Cone-beam computed tomography (CBCT) offers higher spatial resolution for the evaluation of flow-diverter stents. However, CBCT requires optimal dilution and timing of contrast medium for simultaneous visualization of the stent, arterial lumen, and vessel wall. There are only limited data on the effects of different contrast dilutions on CBCT image quality in neurointerventional applications. Materials and methods In our institution, intra-arterial CBCTs were acquired during stent deployment and at follow-ups with 10% diluted contrast. We had recently started acquiring intra-arterial CBCTs with non-diluted contrast. Retrospective analysis of our flow-diverter data identified eight cases with different aneurysm locations who had intra-arterial CBCT with 10% diluted contrast immediately after flow-diverter stent deployment and with non-diluted contrast technique during follow-ups. For each case, the image quality between diluted and non-diluted contrast techniques was compared qualitatively by assessing stent visualization and quantitatively by plotting gray-scale intensity values along the vessel lumen. Results In two sets of CBCT images per each case, there was no substantial difference between diluted and non-diluted CBTC techniques for the evaluation of stent architecture and lumen opacification. Gray-scale intensity values perpendicular to the lumen revealed similar intensity values along the neighboring parenchyma, vessel wall, and lumen for the two different contrast techniques. Conclusion Intra-arterial CBCT angiography can be performed without contrast dilution and still achieve adequate image quality in certain cerebral aneurysms treated with flow diverter. The non-diluted contrast technique avoids the time loss during preparation of diluted contrast and installation of diluted contrast to the injector in angiography suites with a single power injector.
Methodological reporting in feasibility studies: a descriptive review of the nursing intervention research literature
Authors: Mailhot Tanya , Goulet Marie-Hélène , Maheu-Cadotte Marc-André , Fontaine Guillaume , Lequin Pierre , Lavoie Patrick 
Published: November 2019

Background In reaction to weaknesses in feasibility studies reporting, the Consolidated Standards of Reporting Trials (CONSORT) statement published an extension for feasibility studies in 2016. Aim The aim of this study was to systematically review and appraise the reporting of feasibility studies in the nursing intervention research literature based on the CONSORT statement extension for feasibility studies. Method Papers published prior to January 2018 that described feasibility studies of nursing interventions were retrieved. Components of feasibility studies were coded, and code frequencies were analysed. Results The review included 186 papers. Although most papers ( n = 142, 76.3%) included the label ‘pilot’ or ‘feasibility’ in their title, reporting for other components generally did not adhere to one or several CONSORT recommendations. Most papers reported objectives ( n = 116, 62.4%), designs ( n = 95, 51%), or rationales for sample size ( n = 165, 88.7%) that were incongruent with the purpose of feasibility studies. Discussion This review results in two main implications for nursing research. First, we noted that the reporting of feasibility studies is weak. While all papers described feasibility studies, almost half focused exclusively on testing the effectiveness of an intervention. Second, we identified rationales for sample size along with key references that could offer guidance in reporting feasibility studies while being coherent with the CONSORT recommendations.
Comparison of the capability of risk stratification evaluation between two‐ and three‐dimensional speckle‐tracking strain in pre‐capillary pulmonary hypertension
Authors: Liu Bing‐Yang , Wu Wei‐Chun , Zeng Qi‐Xian , Liu Zhi‐Hong , Niu Li‐Li , Tian Yue , Luo Qin , Zhao Zhi‐Hui , Quan Rui‐Lin , Lin Jing‐Ru , Wang Hao , He Jian‐Guo , Xiong Chang‐Ming 
Published: November 2019

To investigate and compare the value of right ventricular longitudinal strain detected by two‐dimensional and three‐dimensional speckle‐tracking echocardiography in risk stratification evaluation in pre‐capillary pulmonary hypertension. We consecutively screened 66 patients diagnosed with pre‐capillary pulmonary hypertension in our center. According to the risk assessment recommended by 2015 European Society of Cardiology Guidelines, all participants were classified into low‐ and intermediate‐high‐risk group. Two‐dimensional and three‐dimensional strains were measured using off‐line softwares (GE EchoPAC version 201 and TomTec, 4D RV Function 2.0). Fifty‐seven pre‐capillary pulmonary hypertension patients (average 35 years old, 18 males and 39 females) were finally enrolled in our study, 32 (56.1%) were classified in low‐risk group, while 25 (43.9%) were in the intermediate‐high‐risk group. Clinical data associated with disease severity, such as N‐terminal pro‐brain natriuretic peptide (r = 0.574, P < 0.001), peak oxygen consumption (r = –0.484, P < 0.001), and 6‐min walking distance (r = –0.356, P = 0.008) were significantly correlated with two‐dimensional right ventricular longitudinal strain; while the correlations with three‐dimensional right ventricular longitudinal strain were weaker. Receiver operating characteristic curves for the detection of intermediate‐high risk stratification showed two‐dimensional right ventricular longitudinal strain had the best predictive capacity (area under curve, 0.82, 95% CI: 0.71–0.93, P < 0.001). Univariate and Multivariate Logistic regression analyses identified two‐dimensional right ventricular longitudinal strain as an independent predictor (OR: 1.42, 95% CI: 1.18–1.71, P < 0.001) of intermediate‐high risk stratification in this cohort of pre‐capillary pulmonary hypertension patients, the predictive capacity retained (OR: 1.45, 95% CI: 1.18–1.78, P < 0.001) after adjusted by age, gender, and body mass index, while three‐dimensional speckle‐tracking echocardiography parameters were not. In conclusion, when used for the detection of intermediate‐high risk stratification in pre‐capillary pulmonary hypertension, two‐dimensional right ventricular longitudinal strain was better than three‐dimensional right ventricular longitudinal strain.
The prognostic value of DLCO and pulmonary blood flow in patients with pulmonary hypertension
Authors: Stadler Stefan , Mergenthaler Nicoletta , Lange Tobias J. 
Published: November 2019

BackgroundCardiac output is a prognostic marker in patients with pulmonary hypertension. Pulmonary blood flow as a surrogate for cardiac output can be measured non‐invasively by inert gas rebreathing. We hypothesized that pulmonary blood flow can predict outcome in patients with pulmonary hypertension.MethodsFrom January 2009 to January 2012, we measured pulmonary blood flow by inert gas rebreathing in outpatients with pulmonary hypertension. Patients with pulmonary hypertension confirmed by right heart catheterization and a valid inert gas rebreathing maneuver were followed until January 2016. The investigated outcome was all‐cause mortality.ResultsWe included 259 patients (mean age 65 ± 13 years, 53% female) with pulmonary hypertension and classified into groups 1 (n = 103), 2 (n = 26), 3 (n = 80), and 4 (n = 50) according to the current pulmonary hypertension classification system. The median time between pulmonary hypertension diagnosis and inert gas rebreathing was 9 (IQR 0; 36) months. During a median follow‐up time of 51 (IQR 20; 68) months, 109 patients (42%) died. Parameters significantly associated with survival (in order of decreasing statistical strength) were diffusion capacity of the lung for carbon monoxide (DLCO), 6‐minute walk distance (6‐MWD), age, NTpro‐BNP, WHO functional class, group 3 pulmonary hypertension, and tricuspid annular plane systolic excursion (TAPSE), while baseline hemodynamics and pulmonary blood flow were not. In multivariable Cox regression analysis, DLCO, age, 6‐MWD, and TAPSE remained significant and independent predictors of the outcome. DLCO as the strongest parameter also significantly predicted survival in aetiological subgroups except for group 4.ConclusionsDLCO is a strong and independent predictor for survival in patients with pulmonary hypertension of different aetiologies, while pulmonary blood flow measured by inert gas rebreathing is not.
Reliability and Validity of the HIV Disability Questionnaire (HDQ) with Adults Living with HIV in the United States
Authors: O’Brien Kelly Kathleen , Kietrys David , Galantino Mary Lou , Parrott James Scott , Davis Tracy , Tran Quang , Aubry Rachel , Solomon Patricia 
Published: November 2019

Objectives: To assess measurement properties of the HIV Disability Questionnaire (HDQ) among adults with HIV in the United States. Methods: We administered the HDQ, World Health Organization Disability Assessment Schedule II (WHODAS 2.0), and a demographic questionnaire. For internal consistency reliability, we calculated Cronbach α and Kuder-Richardson-20 (KR-20) statistics for disability and episodic scores, respectively (≥0.80 acceptable). For test–retest reliability, we calculated intraclass correlation coefficients (>0.8 acceptable). For construct validity, we tested 15 a priori hypotheses assessing correlations between HDQ and WHODAS 2.0 scores. Results: Of the 128 participants, the majority were males (68%), median age 51 years, taking antiretroviral therapy (96%). Cronbach α ranged from 0.88 (social inclusion) to 0.93 (uncertainty). The KR-20 ranged from 0.86 (cognitive) to 0.96 (uncertainty). Intraclass correlation coefficients ranged from 0.88 (physical, cognitive, social inclusion) to 0.92 (mental–emotional). Of the 15 hypotheses, 13 (87%) were confirmed. Conclusions: The HDQ demonstrates internal consistency reliability, test–retest reliability, and construct validity when administered to a sample of adults with HIV in the United States.
Changes of Bipolar Bone Defect Size After Arthroscopic Bankart Repair for Traumatic Anterior Shoulder Instability: Evaluation Using a Scoring System and Influence on Postoperative Recurrence
Authors: Nakagawa Shigeto , Uchida Ryohei , Yokoi Hiroyuki , Sahara Wataru , Mae Tatsuo 
Published: November 2019

Background: The combination of a glenoid defect and a Hill-Sachs lesion in shoulders with traumatic anterior instability has been termed bipolar bone loss, and the preoperative size of these lesions has been reported to influence postoperative recurrence of instability after arthroscopic Bankart repair. Purpose: To investigate the influence of postoperative bipolar bone defect size on postoperative recurrence of instability. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 64 male collision/contact athletes (69 shoulders) were evaluated for a minimum of 2 years after surgery, and the pre- and postoperative sizes of both lesions (glenoid defect and Hill-Sachs) were evaluated retrospectively with 3-dimensional computed tomography. The sports played by the athletes included rugby (n = 28 shoulders), American football (n = 24 shoulders), and other collision/contact sports (n = 17 shoulders). Glenoid defects and Hill-Sachs lesions were classified into 5 size categories and assigned scores from 0 (no defect) to 4 (very large defect). Patients were then classified according to the total score (sum of the scores for both lesions). The influence of pre- and postoperative bipolar bone defect sizes on recurrence of instability was investigated by using the total scores for bipolar bone defects. The influence of postoperative glenoid morphology (normal preoperative glenoid, preoperative glenoid erosion, bone union after arthroscopic bony Bankart repair [ABBR], or nonunion after ABBR) was also investigated, as well as changes in shoulders with a preoperative off-track Hill-Sachs lesion. Results: Of 69 shoulders, 15 (21.7%) developed recurrent instability after surgery. The postoperative recurrence rate was 0% in shoulders with a total score ≤1, while the recurrence rate was consistently higher in shoulders with a total score ≥2 at both pre- and postoperative evaluation (mean, 28.8% and 32.6%, respectively). Postoperative recurrence was uncommon when there was a normal preoperative glenoid or bone union after ABBR, while it was frequent in shoulders with preoperative glenoid erosion or shoulders with nonunion after ABBR and a total score ≥2. An off-track lesion was recognized in 9 shoulders preoperatively. It was transformed to on-track lesions in 4 of the 5 shoulders showing bone union after ABBR, and there was no recurrence in the 5 shoulders with bone union. In contrast, postoperative recurrence of instability occurred in 3 of the 4 shoulders without bone union. Conclusion: Postoperative recurrence was influenced by the pre- and postoperative size of bipolar bone defects. Recurrence was uncommon if bone union was achieved after ABBR, even if there had been an off-track lesion preoperatively.
Improving the Pediatric Procedural Experience: An Analysis of Pain, Anxiety, and Satisfaction
Authors: Crumm Caitlin E , Camp Elizabeth A , Khalil Maha , Chumpitazi Corrie E 
Published: November 2019

Objective: The purpose of this investigation was to compare self-reported and perceived pain and anxiety among patients, caregivers, and providers before, during, and after common emergency department (ED) procedures while evaluating the impact of commonly used adjuncts on overall satisfaction. Methods: A prospective observational study of children undergoing painful procedures in an ED was conducted from January 2015 to March 2017. Before, during, and after the procedure, patients older than 3 years of age rated their pain and anxiety. At the same time points, the provider and caregiver rated their impression of the patient’s pain, and the caregiver also rated the patient’s anxiety. After the procedure, satisfaction was elicited from the caregiver and the provider. Results: A total of 257 children were enrolled: 150 for intravenous line placement, 53 for wound repair, and 44 for a variety of other procedures. Caregivers rated pain higher than providers before, during, and after the procedure ( P values <0.001, <0.001, and 0.003, respectively). Caregivers rated anxiety higher than patients before, during and after the procedure ( P values <0.001, 0.03, and 0.002, respectively). Providers were less satisfied with the 1- to 2-year age-group compared to the 8+ years age groups ( P values 0.01 and 0.002). Conclusions: Caregiver perception of pain and anxiety of the patient exceeds provider and sometimes patient reports. The youngest children present a challenge for caregivers and providers and have lower satisfaction compared to older groups.