bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of time taken to obtain an arterial blood gas result at the bedside using the ProximaTM point of care machine vs. a standard remote arterial blood gas analyser: A randomized controlled trial
Authors: Mitchell Kay , Salmon Karen E , Egbosimba David , Troughton Gavin , Grocott Mike PW 
Published: December 2020

Introduction The ProximaTM point of care (POC) device enables arterial blood gas (ABG) samples to be analysed without the nurse leaving the patient. The benefits of this for work efficiency have not been evaluated. Methods We compared the time taken to obtain an ABG result using ProximaTM versus a standard ABG sampling system. Twenty patients were randomized to ABG sampling using ProximaTM, or a standard ABG system. Nurses were observed performing all ABG sampling episodes for a minimum of 24 hours and no more than 72 hours. Results The mean time taken to obtain a result using ProximaTM was 4:56 (SD = 1:40) minutes compared to 6:31 (SD = 1:53) minutes for the standard ABG technique (p < 0.001). Mean time away from the patient's bedside was 3.07 (SD = 1:17) minutes using the standard system and 0 minutes using ProximaTM (p < 0.001). Conclusions Reduced time for blood gas sampling and avoidance of time away from patients may have significant patient safety and resource management implications, but the clinical and financial significance were not evaluated.
Factors affecting return to work after surgical treatment of trapeziometacarpal joint osteoarthritis
Authors: van der Oest Mark J. W. , Teunissen Joris S. , Poelstra Ralph , Feitz Reinier , Burdorf Alex , Selles Ruud W ,   the Hand-Wrist Study Group
Published: December 2020

This study aimed to identify factors contributing to the timing of return to work after surgical treatment of trapeziometacarpal joint osteoarthritis and to calculate the costs of lost productivity. We included 627 patients with paid employment who underwent trapeziectomy and ligament reconstruction with tendon interposition. Time to return to work was measured through filling online questionnaires and analysed using survival analysis at 6 weeks and 3, 6 and 12 months after the surgery. Patients also filled in the Michigan Hand Outcomes Questionnaire. Costs of lost productivity were calculated using the human capital method. After 1 year, 78% of the patients returned to work. The median time to return to work was 12 weeks. Factors that significantly affected the time to return to work were occupational intensity (light, moderate or heavy physical labour), whether the dominant hand was treated and the Michigan Hand Outcomes Questionnaire work score and hand function score of the unoperated side at baseline. The costs of lost productivity were estimated at €11,000 on the patient level, resulting in €16.8 million on the Dutch population level per year. Level of evidence: II
A systematic review of the association between fibromyalgia and functional gastrointestinal disorders
Authors: Erdrich Sharon , Hawrelak Jason A. , Myers Stephen P. , Harnett Joanna E. 
Published: December 2020

Background: Fibromyalgia and functional gastrointestinal disorders (FGID) including irritable bowel syndrome (IBS) are common conditions presenting in clinical settings and are more prevalent in women. While the relationship between IBS and fibromyalgia has been demonstrated, a review of the prevalence of the broader group of FGID in adults with fibromyalgia has not been undertaken. The aim of this review was to systematically review the published literature, identifying the comorbidity of FGID in people with fibromyalgia, and to discuss the clinical implications, limitations of current research and areas of interest for future research Methods: Medline, Embase, CINAHL and Web of Science were searched during June 2019. Results were screened for original research articles meeting established criteria for identification of FGID in adults diagnosed with fibromyalgia. Results: A total of 14 studies involving 1340 adults with fibromyalgia, 363 healthy controls and 441 adults with other pathologies were included in this review. Only 1 of the 14 studies included surveyed the full range of FGID . Functional gut disorders were matched to Rome II criteria for reporting and comparison. In addition to increased abdominal pain and functional bloating or gas, IBS of mixed-pattern and constipation-types appear to be more prevalent than diarrhoea-predominant IBS in adults with fibromyalgia. Conclusion: This review confirms previous reports that IBS is common in people living with fibromyalgia and suggests that IBS-mixed and constipation types predominate. An association with a range of FGID other than IBS is suggested, but data are limited. Research exploring the association between fibromyalgia and functional gastrointestinal dysfunction beyond IBS are warranted.
Clinical features and surgical outcomes of major urological interventions during cytoreductive surgery and hyperthermic intraperitoneal chemotheraphy
Authors: Düzgün Özgül , Kalın Murat , Sobay Resul , Özkan Ömer Faruk 
Published: December 2020

Background: Urinary system resections and reconstructions are needed in peritoneal carcinomatosis due to abdominal malignancies. The effect of hyperthermic intraperitoneal chemotherapy on these urological procedures after reconstruction remains uncertain. The aim of the study is to evaluate major urological interventions during cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in complex abdominal malignancies with peritoneal carcinomatosis. Methods: Forty-four cases underwent surgical intervention related to the urinary system among 208 cases who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy because of peritoneal carcinomatosis. Urinary system procedures performed in these patients (radical-partial cystectomy, partial ureter resection ureteroneocystostomy, ureteroureterostomy, nephrectomy) were evaluated in terms of postoperative morbidity–mortality and survival. Results: Urinary system resections were performed during cytoreductive surgery in a total of 44 cases. The mean age was 54 years (20–73). Patients were diagnosed with peritoneal carcinomatosis due to colorectal cancer in 21 (47.8%), ovarian cancer in nine (20.4%), sarcomatosis in five (11.4%), cervical cancer in four (9%) and other cancers (mesothelioma, uterus, breast, gastric) in five (11.4%) cases. Total nephrectomy was performed in three cases and partial nephrectomy in one case. Cystectomy was performed in 21 cases; 16 of these were partial and five were total cystectomies. Ureteroureterocystostomy with double J was performed in four cases and ureteroneocystostomy in 12 cases. While Clavian–Dindo grade 3–4 complications were seen in nine cases (20.4%), three cases (6.8%) became exitus during the first 30-day follow-up. Conclusions: Although urinary system involvements have been regarded as inoperable in the past, we think that with adequate experience radical urinary interventions performed in suitable patients can be carried out with acceptable morbidity and mortality as seen in our series.
Patient Perceptions of Landscape and Abstract Art in Inpatient Cardiac Units: A Cross-Sectional Survey
Authors: Finkel Jennifer , Printz Bellamy , Gallagher Lisa M. , Au Adrian , Shibuya Kelly , Bethoux Francois 
Published: December 2020

Purpose: The purpose of this exploratory study was to capture the influence of artwork in the hospital corridors within cardiothoracic inpatients. Background: This study builds on previous research to determine the preferred types of artwork (landscape vs. abstract) in the hospital setting as well as the influence of the art itself. Methods: Participants engaged in surveys with predefined single-choice responses and semistructured one-on-one interviews. Results: Data were obtained from 45 participants, 15 from each of the units (Landscape, Abstract, or Mixed). A higher percentage of participants reported a positive impact on the Landscape Unit; however, the positive responses on the Abstract and Mixed Units were also notable. Eighty-two percent of responses from patients on the Abstract Unit were positive, as were 82% from the Landscape Unit and the Mixed Unit. Conclusions: Although landscape was preferred, abstract and mixed art also had positive responses and abstract did not have a negative effect. All genres of art have a place in a hospital; however, strategies should be developed that include more education, engagement, and interpretation of the artwork.
Detecting Articular Cartilage and Meniscus Deformation Effects Using Magnetization Transfer Ultrashort Echo Time (MT-UTE) Modeling during Mechanical Load Application: Ex Vivo Feasibility Study
Authors: Jerban Saeed , Kasibhatla Akhil , Ma Yajun , Wu Mei , Chen Yanjun , Guo Tan , Wan Lidi , Szeverenyi Nikolaus , Chang Eric Y. , Du Jiang 
Published: December 2020

Objective Ultrashort echo time (UTE) magnetic resonance imaging (MRI) sequences have improved imaging of short T2 musculoskeletal (MSK) tissues. UTE-MRI combined with magnetization transfer modeling (UTE-MT) has demonstrated robust assessment of MSK tissues. This study aimed to investigate the variation of UTE-MT measures under mechanical loading in tibiofemoral cartilage and meniscus of cadaveric knee joints. Design Fourteen knee joints from young ( n = 8, 42 ± 12 years old) and elderly ( n = 6, 89 ± 4 years old) donors were scanned on a 3-T scanner under 3 loading conditions: load = 300 N (Load1), load = 500 N (Load2), and load = 0 N (Unload). UTE-MT sequences were performed at each loading condition. Macromolecular proton fraction (MMF) was calculated from UTE-MT modeling. Wilcoxon rank sum test was used to examine the MRI data differences between loading conditions. Results For young donors, MMF increased in all grouped regions of interest (meniscus [M], femoral articular cartilage [FAC], tibial articular cartilage [TAC], articular cartilage regions covered by meniscus [AC-MC], and articular cartilage regions uncovered by meniscus [AC-UC]) when the load increased from 300 to 500 N. The increases in MMF were significant for M (13.3%, P < 0.01) and AC-MC (9.2%, P = 0.04). MMF decreased in all studied regions after unloading, which was significant only for AC-MC (−8.9%, P = 0.01). For elderly donors, MRI parameters did not show significant changes by loading or unloading. Conclusion This study highlights the potential of the UTE-MT modeling combined with knee loading in differentiating between normal and abnormal knees. Average tissue deformation effects were likely higher and more uniformly distributed in the joints of young donors compared with elderly donors.
Value of high-density sign on CT images after mechanical thrombectomy for large vessel occlusion in predicting hemorrhage and unfavorable outcome
Authors: Portela de Oliveira Eduardo , Chakraborty Santanu , Patel Mihilkumar , Finitsis Stefanos , Iancu Daniela 
Published: December 2020

Purpose Cerebral hyperdensities can appear on head computed tomography (CT) images performed early after endovascular treatment (EVT) in patients with acute ischemic stroke and may be secondary to contrast staining or hemorrhagic transformation. The aim of this study was to determine how the high-density sign on CT affects mortality and clinical outcome and whether CT parameters predict hemorrhagic conversion or unfavorable outcome. Methods We retrospectively reviewed a database of patients who underwent EVT with mechanical thrombectomy for acute ischemic stroke over 7 years. Included were acute stroke patients with a CT examination within 24 h post-EVT with mechanical thrombectomy, demonstrating areas of hyperdensity. We evaluated morphologic characteristics of these lesions, location, CT Hounsfield units and largest area, as well as patient demographics, EVT methods and patient outcome. Results A total of 29 patients met the strict inclusion criteria. Complete recanalization was achieved in 58.6% (17/29). Seventeen (58.6%) cases of post-intervention cerebral hyperdensities were related to contrast staining and 12 (41.4%) cases to contrast staining and hemorrhage. Patient mortality was significantly higher in the hemorrhagic group (50.0% versus 5.9%, p = 0.003). The increased density on CT was associated with higher hemorrhagic risk (odds ratio 1.05, p = 0.036). Conclusion Patients with the high-density sign on CT images after mechanical thrombectomy for acute ischemic stroke demonstrated increased mortality and worse clinical outcome, primarily when these hyperdensities were related to hemorrhage. CT imaging parameters as higher density areas can help in the differentiation of hemorrhage from contrast staining.
Evidence-based clinical practice guidelines on the management of pain in older people – a summary report
Authors: Schofield Patricia , Dunham Margaret , Martin Denis , Bellamy Gary , Francis Sally-Anne , Sookhoo Dave , Bonacaro Antonio , Hamid Eshtar , Chandler Rebecca , Abdulla Aza , Cumberbatch Mike , Knaggs Roger 
Published: December 2020

Objective: The objective of this study is to develop an update of the evidence-based guidelines for the management of pain in older people. Design: Review of evidence since 2010 using a systematic and consensus approach is performed. Results: Recognition of the type of pain and routine assessment of pain should inform the use of specific environmental, behavioural and pharmacological interventions. Individualised care plans and analgesic protocols for specific clinical situations, patients and health care settings can be developed from these guidelines. Conclusion: Management of pain must be considered as an important component of the health care provided to all people, regardless of their chronological age or severity of illness. By clearly outlining areas where evidence is not available, these guidelines may also stimulate further research. To use the recommended therapeutic approaches, clinicians must be familiar with adverse effects of treatment and the potential for drug interactions.
Urology trainee perceptions of curriculum checkpoints and challenges to achieving a Certificate of Completion of Training: Results of a national survey
Authors: Harvey NJ , Ross DG 
Published: December 2020

Objective: To determine the views of urology trainees regarding training checkpoints/waypoints, and challenges to achieving a Certificate of Completion of Training (CCT). Methods: A novel survey was devised and distributed to evaluate urology trainee perceptions of the challenges in achieving the current CCT requirements as well as their views on the ST4 waypoint, indicative numbers (INs), workplace-based assessments (WBAs) and critical condition case-based discussions. Results: Of 347 trainees, 59 (17.0%) returned completed surveys from 13 of 19 training regions. The most significant challenges in achieving CCT as perceived by all trainees were, from highest to lowest: publication requirements, paediatric urology experience, achieving FRCS (Urol), INs and WBAs. All questions relating to ST4 waypoints were answered positively by a majority of respondents. Conclusions: The findings of this survey suggest that trainees will approve of the forthcoming changes in training assessment and outcomes embedded within the 2021 curriculum. The ST5 checkpoint, in particular, is an opportunity to better match trainees and placements and will underpin successful ‘phasing’ of training. A future study will inform the success of ‘embedding’ the 2021 curriculum and subsequently play a crucial part in the continuous improvement of urological training. Level of evidence: Not applicable for this multicentre audit.
Protocol for randomized controlled trial of electric stimulation with high-volt twin peak versus placebo for facial functional recovery from acute Bell’s palsy in patients with poor prognostic factors
Authors: Loyo Myriam , McReynold Margaret , Mace Jess C , Cameron Michelle 
Published: December 2020

Background Electric stimulation (ES) can prevent muscle atrophy and promote tissue healing and therefore may help prevent sequelae of Bell’s palsy but due to lack of high-quality studies, the effectiveness of ES in Bell’s palsy remains controversial. Here we describe a protocol to evaluate the effects of monophasic high volt ES in patients with Bell’s palsy and poor prognosis for recovery. Results This is a protocol for a prospective, double-blinded, randomized, placebo-controlled study. Participants include adults with acute Bell’s palsy with poor prognosis for full recovery due to complete paralysis or being over age 60. ES will be a monophasic, high-volt pulsed waveform, 100μsec pulse duration, 35 hertz, motor-level intensity. Follow up will be at months 1, 2, 3 and 6. The primary outcome will be the proportion of patients with complete recovery using the eFACES tool. Secondary outcomes include patient reported quality of life measured by FaCE and the synkinesis assessment questionnaires, objective photographs, time to complete recovery, adverse effects, and tolerability. Conclusion This protocol has the potential to provide high quality evidence regarding the effects, up to 6 months after onset, of pulsed monophasic high-volt ES for patients with acute Bell’s palsy and poor prognosis for complete recovery.
An Innovative Meta-Systematic Review into the Landscape of Literature and the Concluding Evidence on the Quality of Life of Patients Using Two Implant Supported Mandibular Complete Denture Prosthesis
Authors: Rajaraman Vaishnavi , Nallaswamy Deepak , Ganapathy Dhanraj M. , Ashok V. 
Published: December 2020

Aim: The aim of this systematic review is to analyze the existing evidence on the quality of life of patients completely edentulous in the mandible. Materials and Methods: A search questionnaire was formulated using population intervention comparison outcome (PICO) analysis, and a comprehensive search was initiated in PubMed Central, Medline, Cochrane, and Google Scholar databases for the related topics. Manuscripts published till December 2019 were included in this review. Out of the 63 articles obtained from searching all databases, 27 studies were excluded based on the title and abstract. Out of the remaining 36 studies, 12 were excluded based on the inclusion and exclusion criteria of our interest and 24 were included on the basis of core data. Results: One review author identified randomized trials meeting inclusion criteria for this review. Two review authors extracted data and assessed study quality. The oral health-related quality of life in completely edentulous mandibular patients wearing implant-supported overdentures was better when compared to conventional tissue-supported complete denture, and a minimum two implant-supported mandibular complete denture has sufficient improvement in oral health-related quality of life. Conclusion: There are about more than 170 reviews and clinical trials that have been published in support of the same for the past two decades. Thus, the clinicians may not be tempted in placing additional implants in well-formed mandibular edentulous ridges. To enhance the understanding of mandibular implant overdenture treatment, clinicians must scrutinize the existing evidence and formulate a protocol by striking a balance between efficient and evidence based treatment.
Association of Serum Vitamin D Levels and Stress Fractures in Collegiate Athletes
Authors: Millward David , Root Allison D. , Dubois Jeremy , Cohen Randall P. , Valdivia Luis , Helming Bruce , Kokoskie Justin , Waterbrook Anna L. , Paul Stephen 
Published: December 2020

Background: Low vitamin D levels along with high-intensity athletic training may put an athlete at increased risk for a stress fracture. Purpose: To assess whether supplementation with vitamin D is associated with a reduced risk of stress fractures in college athletes. We also assessed differences in vitamin D levels among athletes participating in outdoor versus indoor sports. Study Design: Cohort study; Level of evidence, 2. Methods: The study participants included 802 National Collegiate Athletic Association Division I intercollegiate athletes (497 men and 305 women) on a sports team for at least 1 semester from 2012 to 2018. All athletes who had a baseline vitamin D level in their medical record were included. Athletes with vitamin D levels <40 ng/mL were given vitamin D supplements. We assessed differences in the rate of stress fracture among those who maintained or improved vitamin D levels to ≥40 ng/mL and those who did not, as well as differences in average baseline vitamin D levels by sport type (indoor vs outdoor). Results: The rate of stress fracture was 12% higher (95% CI, 6-19; P < .001) for those who remained low in vitamin D compared with those who were low at baseline but improved their vitamin D status to ≥40 ng/mL. The rate of stress fracture was also 12% higher (95% CI, 5-18; P < .001) for those who had low vitamin D levels compared with those who maintained normal levels. The mean baseline vitamin D values were significantly higher for men participating in outdoor sports versus indoor sports. For men, the mean vitamin D level was 5.7 ng/mL higher (95% CI, 0.9-10.5; P = .01) in outdoor athletes. For women, the mean vitamin D level was 3.7 ng/mL higher (95% CI, –0.58 to 8.03; P < .04) for outdoor versus indoor sports. Conclusion: Study results indicated that correcting low serum vitamin D levels reduces the risk of stress fracture. This study also presented evidence that athletes who participate in indoor sports may be at greater risk for vitamin D deficiency than those who compete in outdoor sports.
Minimal Damage to the Supinator Muscle After the Double-Incision Technique for Distal Biceps Tendon Repair
Authors: Blonna Davide , Olivero Alberto , Galletta Claudia , Greco Valentina , Castoldi Filippo , Fracassi Matteo , Davico Marco , Rossi Roberto 
Published: December 2020

Background: The effect of the double-incision technique on the supinator muscle is unclear. Purpose: The aim of this study was to quantify fatty atrophy of the supinator muscle and map the area of muscle damage. Study Design: Case series; Level of evidence, 4. Methods: A total of 19 male patients (median age, 43 years) who underwent distal biceps tendon repair were included in the analysis. Patients with a minimum of 12 months of follow-up were included. The following variables were analyzed: range of motion; shortened version of Disabilities of the Arm, Shoulder and Hand (QuickDASH) score; Summary Outcome Determination (SOD) score; and isokinetic peak force and endurance in supination. Quantitative analysis and mapping of fatty infiltration of the supinator muscle were based on the calculation of proton density fat fraction on magnetic resonance imaging scans of both elbows using the IDEAL (Iterative Decomposition of Echoes of Asymmetrical Length) sequence. Results: At an average follow-up of 24 months (range, 12-64 months), the median SOD score was 9.0 (95% CI, 7.8-9.4), and the mean QuickDASH score was 6.7 (95% CI, 0.0-14.1). A difference of 17% in peak torque was measured between repaired and nonrepaired elbows (repaired elbow: 9.7 N·m; nonrepaired elbow: 11.7 N·m; P = .11). Endurance was better in the repaired elbow than the nonrepaired elbow (8.4% vs 14.9% work fatigue, respectively; P = .02). The average fat fraction of the supinator muscle was 19% (95% CI, 16%-21%) in repaired elbows and 14% (95% CI, 13%-16%) in contralateral elbows ( P = .04). The increase in fat fraction was located in a limited area between the radius and ulna at the level of the bicipital tuberosity. Conclusion: The assessment of the supinator muscle showed a limited increase in fat fraction between the radius and ulna at the level of the bicipital tuberosity. No significant effect on supination strength was highlighted.