bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Does Isolated Medial Patellofemoral Ligament Reconstruction Influence Patellar Height?
Authors: Luceri Francesco , Roger Julien , Randelli Pietro Simone , Lustig Sébastien , Servien Elvire 
Published: February 2020

Background:Reconstruction of the medial patellofemoral ligament (MPFL) is the gold standard treatment for recurrent patellar dislocation. Patella alta has been reported in about half of patients with recurrent patellofemoral instability.Hypothesis:MPFL reconstruction (MPFLr) has a beneficial role in the correction of patellar height in patients with mild patella alta (Caton-Deschamps index [CDI] between 1.20 and 1.40).Study Design:Case series; Level of evidence, 4.Methods:Skeletally mature patients, with no history of previous or concomitant knee surgical procedures, who underwent isolated MPFLr using hamstring autograft for recurrent patellar instability between 2005 and 2018, were included in this study. The authors calculated CDI, modified Insall-Salvati index (MISI), and Blackburne-Peel index (BPI) ratios. Measurements done by 2 independent observers were calculated and used to compare pre- and postoperative patellar height (patella alta: CDI >1.20).Results:A total of 89 patients (95 knees) were included in the study, with a mean age of 25.0 years (range, 15.0-45.0 years). There were 70% women and 30% men. We found patella alta in 35.8% of cases preoperatively. Among them, 79.4% had reduced patellar height indices, within normal limits, postoperatively (mean follow-up, 18.4 ± 12.0 months). All the ratios showed a significant reduction in patellar height after surgery (CDI: 0.19 [range, –0.05, 0.60]; MISI: 0.22 [–0.14, 0.76]; BPI: 0.18 [–0.08, 0.59]; P < .00001). The CDI of 79.4% of the study knees was reduced to within normal limits postoperatively. The CDI was maintained within normal limits postoperatively in 93.4% of the knees with normal patellar height and reduced to normal in 50% of the knees with severe patella alta before surgery . No patient reported patella infera before surgery, whereas this condition was found in 8.2% of study patients postoperatively. A moderate correlation was reported between preoperative radiographic indices and their reduction after surgery (CDI: P < .001, ρ = 0.39; MISI: P < .001, ρ = 0.39; BPI: P < .001, ρ = 0.48).Conclusion:The higher the preoperative patellar height, the more important is the lowering effect of MPFLr using the hamstring for patellar instability. Bony procedures should not be indicated in patients with patellar instability and a CDI between 1.20 and 1.40.
Lateral Meniscus Posterior Root Lesion Influences Anterior Tibial Subluxation of the Lateral Compartment in Extension After Anterior Cruciate Ligament Injury
Authors: Zheng Tong , Song Guan-yang , Feng Hua , Zhang Hui , Li Yue , Li Xu , Zhang Zhi-jun , Ni Qian-kun , Feng Zheng 
Published: February 2020

Background: The lateral meniscus posterior root (LMPR) lesion further decreases dynamic knee stability after anterior cruciate ligament (ACL) injury owing to the loss of the “wedge effect” maintained by the posterior horn of the lateral meniscus. However, the effect of LMPR lesions on the static tibiofemoral relationship in extension after ACL injuries is not determined. Purpose: To (1) determine the effect of LMPR lesions on anterior tibial subluxation of the lateral compartment (ATSLC) in extension in patients with ACL injuries and to (2) identify the LMPR-related factors associated with excessive ATSLC in extension. Study Design: Cohort study; Level of evidence, 3. Methods: Between January 2015 and December 2017, 405 consecutive patients with diagnosed ACL injuries who underwent primary ACL reconstructions were retrospectively reviewed. Among them, 45 patients with combined ACL injuries and LMPR lesions (ACL+LMPR group) and 51 patients with isolated ACL injuries (ACL group) were identified. Values of ATSLC in extension were measured on preoperative supine magnetic resonance imaging and classified into high grade (≥6 mm) and low grade (<6 mm). The mean ATSLC in extension and the proportion of patients with high-grade ATSLC in extension were compared between the groups by univariate analysis. In the ACL+LMPR group, predictors of high-grade ATSLC in extension—including age, sex, body mass index, affected side, cause of injury, period from injury (<12 or ≥12 weeks), LMPR lesion pattern (radial tear or root avulsion), and meniscofemoral ligament integrity (intact or impaired)—were assessed by univariate analysis and multivariate logistic regression analysis. Results: The mean ATSLC in extension in the ACL+LMPR group was significantly greater than that in the ACL group (5.6 mm vs 3.1 mm; P = .001). The proportion of patients with high-grade ATSLC in extension in the ACL+LMPR group was also significantly larger than that in the ACL group (44.4% vs 15.7%; P = .002). In addition, the root avulsion (instead of radial tear) (odds ratio, 28.750; 95% CI, 2.344-352.549; P = .009) and the period from injury ≥12 weeks (odds ratio, 17.095; 95% CI, 1.207-242.101; P = .036) were determined to be the 2 independent predictors of high-grade ATSLC in extension. However, age, sex, body mass index, affected side, cause of injury, and meniscofemoral ligament integrity were not. Conclusion: After ACL injuries, concomitant LMPR lesion further increased ATSLC in extension. Chronic LMPR avulsion was associated with high-grade ATSLC in extension.
Interventions to ensure follow-up of positive fecal immunochemical tests: An international survey of screening programs
Authors: Selby Kevin , Senore Carlo , Wong Martin , May Folasade P , Gupta Samir , Liang Peter S 
Published: February 2020

Objective Colorectal cancer screening programs frequently report problems ensuring adequate follow-up of positive fecal immunochemical tests (FITs). We investigated strategies implemented by ongoing screening programs to improve follow-up for FIT-positive participants, and explored associations between interventions and reported rates of follow-up. Methods We submitted an electronic survey to 58 colorectal cancer screening programs or affiliated researchers. Primary outcomes were the proportion of program participants with a positive FIT completing diagnostic colonoscopy, and patient, provider, and system-level interventions used to improve follow-up. We compare mean colonoscopy completion at six months in programs with and without interventions. Results Thirty-five programs completed the survey (60% response). The mean proportion of participants with a positive FIT who completed colonoscopy was 79% (standard deviation 16%). Programs used a mean of five interventions to improve follow-up. Programs using patient navigators had an 11% higher rate of colonoscopy completion at six months ( p = 0.05). Programs sending reminders to primary care providers when no colonoscopy has been completed had a 12% higher rate of colonoscopy completion ( p = 0.03). Other interventions were not associated with significant differences. Conclusions Almost all programs employ multiple interventions to ensure timely follow-up of positive FIT. The use of patient navigators and provider reminders is associated with higher rates of colonoscopy completion.
Technology Intensity and Employment in the Indian Economy
Authors: Paul Shampa , Lal Kaushalesh 
Published: February 2020

The article investigates the impact of technology on employment in key sectors of the Indian economy. The analysis encompasses services and manufacturing sectors. The services sectors include firms engaged in financial and non-financial segments, while manufacturing sector consists of firms engaged in production of consumer goods. The findings suggest that indicators that have affected employment in manufacturing sector are size of operations, import of capital goods and better human resource (HR) practices, while in financial services sector, the factors affecting employment are better HR policies, profitability and expenditure on Information and Communications Technology (ICT). Whereas in non-financial sector firms, import of capital goods and expenditure on training and welfare of workforce significantly influenced employment. The distinguishing finding is that association between employment creation and age of firms is negative in financial services sector, while age of firm is immaterial in manufacturing and non-financial sectors. The study uses Prowess database for the period between 2011–2012 and 2015–2016. JEL: O14, O15, O33
Nepali Linguistic Validation of the Velopharyngeal Insufficiency Effects on Life Outcomes Instrument: VELO-Nepali
Authors: Lindeborg Michael M. , Shakya Pramila , Pradhan Bhawani , Rai Shiba Kala , Gurung Kabita Bhattarai , Niroula Suman , Rayamajhi Badri , Chaudhary Hema , Gaire Bhagwati , Mahato Naina , Rana Lila , Rokaya Phana , Shrestha Nilam , Shrestha Renuka , Tamang Januka , Joshi Hemanta Dhoj , Gaha Pushpa , Khorja Dhana Kumari , Mitnick Carole D. , Rai Shankar Man , Shaye David A. 
Published: February 2020

Objective: To translate and validate the velopharyngeal insufficiency (VPI) effects on life outcomes (VELO) instrument into Nepali, and test its internal consistency and validity. Design: Quality-of-life instrument translation and validation. Setting: Community served by Nepal’s craniofacial referral hospital. Participants: Twenty-three postpalatoplasty children with VPI, 19 family guardians of VPI cases, and 29 non-VPI controls. Interventions: The VELO instrument was translated to Nepali by 2 independent bilingual translators, reconciled, backward-translated, compared, and modified using patient cognitive interviews. All VPI children, guardians, and controls completed the VELO-Nepali. Main Outcome Measure(s): The VELO internal consistency was evaluated using Cronbach α coefficient. Concurrent validity and discriminant validity were assessed using 2-sample t test: assuming unequal variances. Results: The VELO was translated and optimized using cognitive interviews. The VELO-Nepali demonstrated excellent internal consistency, with Cronbach α coefficients of 0.93, 0.94, and 0.90 for VPI cases, guardians of VPI cases, and non-VPI controls, respectively. The VELO-Nepali exhibited strong discriminant validity between VPI cases ([Formula: see text] = 45.4, standard deviation [SD] = 22.1) and non-VPI controls ([Formula: see text] = 84.9, SD = 12.3), ( P < .001). The VELO-Nepali showed strong concurrent validity with similarities in VPI case scores ([Formula: see text] = 45.4, SD = 22.1), and guardian scores ([Formula: see text] = 52.9, s = 22.8; P = .473). Conclusion: The translated VELO-Nepali demonstrates strong internal consistency, discriminant validity, and concurrent validity, and can assess quality of life for Nepali VPI patients. This instrument represents the first VPI quality of life assessment validated in Nepali, and supports the feasibility of its implementation in other low- and low-middle-income countries.
Neutrophil–lymphocyte ratio as a prognostic factor for survival in patients with advanced renal cell carcinoma (Turkish Oncology Group Study)
Authors: Hizal Mutlu , Sendur Mehmet AN , Yasar Hatime Arzu , Bir Yucel Kadriye , Arslan Cagatay , Ucar Gokhan , Karakaya Serdar , Taban Hakan , Kucukarda Ahmet , Erturk Ismail , Bilgin Burak , Yıldırım Nuriye , Demirci Umut , Kılıckap Saadettin , Cicin Irfan , Karadurmus Nuri , Yalcin Bulent , Ürün Yüksel 
Published: February 2020

Background To describe the prognostic value of neutrophil–lymphocyte ratio and its effect on survival in in patients with advanced renal cell carcinoma. Methods We retrospectively analyzed 331 patients. The cut-off value of neutrophil–lymphocyte ratio was specified as “3” which is mostly close—and also clinically easily applicable—to the median neutrophil–lymphocyte ratio level of our study group. High group is identified as neutrophil–lymphocyte ratio >3 (n = 160) and low group is identified as neutrophil–lymphocyte ratio ≤3 (n = 163). Results A total of 331 (with 211 male and 120 female) patients were enrolled to study. The median age of the patients was 58. The International Metastatic RCC Database Consortium risk score is calculated for the 72.8% (n = 241) of the study group and among these patients, favorable, intermediate, and poor risk rates were 22, 45.2, and 32.8%. The total usage of tyrosine kinase inhibitors reached 78% of the patients. The median overall survival was 32 months versus 11 months in the neutrophil–lymphocyte ratio low and high groups, respectively (HR: 0.49 (95% CI 0.37–0.65), p < 0.001). Conclusion In conclusion, the pre-treatment value of elevated neutrophil–lymphocyte ratio might be a predictor of poor overall survival in advanced renal cell carcinoma patients.
Objective cyclodeviation measurement in normal subjects by means of Cyclocheck® application
Authors: Simiera Justyna , Ordon Agata Joanna , Loba Piotr 
Published: February 2020

Purpose: To evaluate the range of cyclodeviation in normal individuals by means of Cyclocheck® application recently designed by the authors and freely available at www.cyclocheck.com . Methods: Healthy subjects with normal muscle balance, best-corrected visual acuity of ⩾0.8, and stereopsis on Randot charts of ⩽100 s of arc were included in the study. Two separate digital fundus photographs were taken of each eye of every patient. The disk-foveal angle was calculated using the Cyclocheck® application. The average result of the disk-foveal angle measurements were considered for data analysis. Results: A total of 131 patients met inclusion criteria for the study population. The mean value of the disk-foveal angle in the whole study group (both right and left eye) was 6.39° ± 2.72° with 5.26° ± 2.56° (range from −0.4° to 12.55°) in the right eye and 7.52° ± 2.39° (range from 1.25° to 12.76°) in the left eye. The mean value of the disk-foveal angle of the left eye was greater by 2.26° than that of the right eye. Conclusion: Cyclocheck® software allows easy assessment of cyclodeviation. Normal individuals present with a positive value of the disk-foveal angle with a certain spread of the results. The analysis of obtained measurements revealed a significant asymmetry between both eyes with the left eye being more excyclodeviated in an otherwise orthotropic population, which remains a subject for further investigations.
How do frontline staff use patient experience data for service improvement? Findings from an ethnographic case study evaluation
Authors: Locock Louise , Montgomery Catherine , Parkin Stephen , Chisholm Alison , Bostock Jennifer , Dopson Sue , Gager Melanie , Gibbons Elizabeth , Graham Chris , King Jenny , Martin Angela , Powell John , Ziebland Sue 
Published: February 2020

Objectives Improving patient experience is widely regarded as a key component of health care quality. However, while a considerable amount of data are collected about patient experience, there are concerns this information is not always used to improve care. This study explored whether and how frontline staff use patient experience data for service improvement. Methods We conducted a year-long ethnographic case study evaluation, including 299 hours of observations and 95 interviews, of how frontline staff in six medical wards at different hospital sites in the United Kingdom used patient experience data for improvement. Results In every site, staff undertook quality improvement projects using a range of data sources. Teams of health care practitioners and ancillary staff engaged collectively in a process of sense-making using formal and informal sources of patient experience data. While survey data were popular, ‘soft’ intelligence – such as patients’ stories, informal comments and observations – also informed staff’s improvement plans, without always being recognized as data. Teams with staff from different professional backgrounds and grades tended to make more progress than less diverse teams, being able to draw on a wider net of practical, organizational and social resources, support and skills, which we describe as team-based capital. Conclusions Organizational recognition, or rejection, of specific forms of patient experience intelligence as ‘data’ affects whether staff feel the data are actionable. Teams combining a diverse range of staff generated higher levels of ‘team-based capital’ for quality improvement than those adopting a single disciplinary approach. This may be a key mechanism for achieving person-centred improvement in health care.
Unmet needs in clinical nutrition in oncology: a multinational analysis of real-world evidence
Authors: Caccialanza Riccardo , Goldwasser Francois , Marschal Oliver , Ottery Faith , Schiefke Ingolf , Tilleul Patrick , Zalcman Gerard , Pedrazzoli Paolo 
Published: February 2020

Background: Knowledge about cancer-related malnutrition and the use of clinical nutrition (CN) in the real-world setting are lacking. We investigated diagnosis and treatment frequency of malnutrition in a multinational survey to identify unmet needs in cancer patients’ care. Methods: Retrospective analyses were conducted on data from three administrative healthcare datasets from France ( n = 570,727), Germany ( n = 4642) and Italy ( n = 58,468). Data from France described frequency and timing of malnutrition diagnosis in hospitalized gastrointestinal cancer patients. The German data detailed home parenteral nutrition (HPN) use in cancer patients with stage III/IV cancers. The Italian data analysed three cohorts: metastatic with CN, metastatic without CN, and patients without metastatic disease. Results: In France, malnutrition diagnosis at first hospitalization occurred in 10% of patients, 13% were subsequently diagnosed, and 77% had no malnutrition diagnosis. In Germany, 16% of patients received HPN. Patients started HPN around 3 months before death. In Italy, 8.4% of metastatic cancer patients received CN; average time between metastasis diagnosis and first CN prescription was 6.6 months. Average time between first CN prescription and death was 3.5 months. Conclusions: These data indicate that in the real-world clinical practice, cancer-related malnutrition is under-recognized and undertreated. CN often appears to be prescribed as an end-of-life intervention or is not prescribed at all. Appropriate CN use remains challenging, and current practice may not allow optimal oncologic outcomes for patients at nutritional risk. Improving awareness of malnutrition and generating further evidence on clinical and economic benefits of CN are critical priorities in oncology.
The Global Crisis and its Consequences
Authors: Sideri Sandro 
Published: February 2020

The first section of the paper identifies the immediate causes of a crisis that is both severe and global. The second section examines the unsustainable imbalance that feeds the current crisis: more than two billion people under-consume and save, while a few hundred million borrow and live beyond their means. This imbalance rests on, and at the same time strengthens, the huge and often widening income gaps between, and within, countries, including the redistribution in favor of capital and highly skilled labor caused by globalization and technological change. The third section explores the effects of the crisis and the problems that it is creating, including those generated by the way in which it is being handled and the “exit strategy” that will eventually be used. The crisis is accelerating the shift of power toward Asia, because the US is increasingly perceived as the destabilizer of the world economy, but until the imbalance is eliminated, the financialization of the global economy is brought under control and productive investment replaces the speculative activity of financial capitals, other crises are bound to follow. Which means that any future international order that emerges from the current mess must abandon the present economic growth model, while integrating globalization with regionalism. These two processes are already underway and may perhaps result in a more balanced and multipolar world system.
The Political Economy of Nature
Authors: McCusker Brent 
Published: February 2020

This article explores the dialectics of land use and livelihoods to formulate a political economy of nature approach to studying the production of nature. Rather than solely postulate “drivers” and “feedbacks” between changes in land use and livelihoods as change=population+affluence+technology (or some closely related variant) as is so often done in the mainstream land use literature, it is argued here that change is co-produced as households/agents negotiate axes of contradictions in their attempts to reproduce themselves and produce nature for exchange. I examine this relationship by mobilizing a non-deterministic variant of dialectics to generate a parallel epistemology for studying land use that explores change in the context of two recent trends in the agrarian change literature, namely depeasantaization and deproletarianization. As both of these processes entail a reconfiguration of rural production (manifest in changing land use and livelihoods), the approach taken here will provide insight and clarity to those debates. I examine the moment of sublation as a source of change in the landscape, both physical and economic. I intentionally consider this approach as parallel and complimentary to positivist studies on land use and land cover change, rather than as a alternative framework, for reasons that are made explicit within the article. The findings from this research help to link land use changes to broader societal changes in ways that will be helpful to understanding linked climate and human change from a critical perspective.