bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomechanical Evaluation of Passive Back-Support Exoskeletons in a Precision Manual Assembly Task: “Expected” Effects on Trunk Muscle Activity, Perceived Exertion, and Task Performance
Authors: Madinei Saman , Alemi Mohammad Mehdi , Kim Sunwook , Srinivasan Divya , Nussbaum Maury A. 
Published: January 2020

Objective To assess the efficacy of two different passive back-support exoskeleton (BSE) designs, in terms of trunk muscle activity, perceived low-back exertion, and task performance. Background BSEs have the potential to be an effective intervention for reducing low-back physical demands, yet little is known about the impacts of different designs in work scenarios requiring varying degrees of symmetric and asymmetric trunk bending during manual assembly tasks. Method Eighteen participants (gender balanced) completed lab-based simulations of a precision manual assembly task using a “grooved pegboard.” This was done in 26 different conditions (20 unsupported; 6 supported, via a chair), which differed in vertical height, horizontal distance, and orientation. Results Using both BSEs reduced metrics of trunk muscle activity in many task conditions (≤47% reductions when using BackX™ and ≤24% reductions when using Laevo™). Such reductions, though, were more pronounced in the conditions closer to the mid-sagittal plane and differed between the two BSEs tested. Minimal effects on task completion times or ratings of perceived exertion were found for both BSEs. Conclusion Our findings suggest that using passive BSEs can be beneficial for quasi-static manual assembly tasks, yet their beneficial effects can be task specific and specific to BSE design approaches. Further work is needed, though, to better characterize this task specificity and to assess the generalizability of different BSE design approaches in terms of physical demands, perceived exertion, and task performance. Application These results can help guide the choice and application of passive BSE designs for diverse work scenarios involving nonneutral trunk postures.
Postdemocracy, Postpolitics, and Populism: Fresh Political Thinking and Podemos
Authors: Monedero Juan Carlos 
Published: January 2020

The failure of the Keynesian model in the 1970s opened the way for a neoliberal model that works at an economic level by privileging financial capital and at a political level as a rational frame of reference for a new postdemocratic “common sense.” Populism has both a collision dimension (a supposedly nonideological take on the neoliberal crisis) and an institutional dimension (a heavily ideological conception of proposals aimed at overcoming current political impasses). Within the Spanish political party Podemos, a debate has emerged between Ernesto Laclau’s “empty signifiers” and the theory put forward by Boaventura de Sousa Santos. The former is stronger on the deconstituent dimension, but only the latter is capable of formulating post-neoliberal agendas. The primacy of discourse in Laclau’s theory of populism impedes the construction of a new political subject and the consideration of a new identity. In contrast, Santos’s theory, especially his emphasis on “translation,” lends itself to a more transformative political practice in that it widens the spectrum of what is possible. El fracaso del modelo keynesiano en la década de 1970 abrió el camino para un modelo neoliberal que funciona a nivel económico privilegiando el capital financiero y a nivel político como un marco de referencia racional para un nuevo “sentido común” posdemocrático. El populismo tiene tanto una dimensión de la colisión (una visión supuestamente no ideológica de la crisis neoliberal) y una dimensión institucional (una concepción fuertemente ideológica de las propuestas destinadas a superar los actuales impases políticos). Dentro del partido político español Podemos, ha surgido un debate entre los “significantes vacíos” de Ernesto Laclau y la teoría presentada por Boaventura de Sousa Santos. La primera es más fuerte en la dimensión desconstituyente, pero solo la segunda es capaz de formular agendas post-neoliberales. La primacía del discurso en la teoría del populismo de Laclau impide la construcción de un nuevo sujeto político y consideración de una nueva identidad. En contraste, la teoría de Santos, especialmente su énfasis en “traducción,” se presta a una práctica política más transformadora, ya que amplía el espectro de lo que es posible.
Oral health status of children and adolescents with autism spectrum disorder: A systematic review of case-control studies and meta-analysis
Authors: Lam Phoebe PY , Du Rennan , Peng Simin , McGrath Colman PJ , Yiu Cynthia KY 
Published: January 2020

Children and adolescents with autism spectrum disorder are thought to be more vulnerable to oral diseases than typically developing individuals due to cariogenic dietary habits, self-injurious behaviors, and increased barriers to dental care services. This review aimed to summarize current evidence comparing the oral health status of people diagnosed with and without autism spectrum disorder. Study selection and screening, data extraction, risk of bias assessment, and quality-of-evidence evaluation was conducted using the Grading of Recommendations Assessment Development and Evaluation approach and performed independently by two reviewers. A total of 16 studies were found eligible for qualitative synthesis and 15 were included in quantitative analysis. When comparing children and adolescents diagnosed with and without autism spectrum disorder, significantly higher prevalence of bruxism was identified. Individuals diagnosed with autism spectrum disorder were also found to have significantly lower salivary pH. However, no statistically significant differences in terms of caries prevalence and severity, oral hygiene and periodontal status, prevalence of malocclusion, dental traumatic injuries, as well as salivary flow rate and buffering capacity were found. The quality of evidence of each outcome was graded as very low mainly due to the overall high risk of bias, considerable heterogeneity, and imprecision. Lay Abstract Children and adolescents diagnosed with Autism Spectrum Disorder (ASD) are thought to be more vulnerable to oral diseases than typically-developing individuals. This is due to their increased barriers to dental care services, self-harm behaviors and dietary habits that may favor tooth decay. In this review, we summarized the current evidence comparing the oral health status of children and adolescents diagnosed with and without ASD. After a systematic search in the literature, we found that the salivary pH of individuals diagnosed with ASD was significantly lower, but the results were not clinically significant that can increase their risks to tooth decay. We also found weak evidence suggesting a higher percentage of children and adolescents diagnosed with ASD having the habit of tooth grinding compared with their neurotypical counterparts. When comparing salivary flow rate, tooth decay, gum diseases, tooth malalignment and tooth trauma; no significant differences were found between the two groups. The findings did not suggest ASD as a predisposing factor to oral diseases: other factors including sugary diet and inadequate oral hygiene may play a more important role. We also call for further research to establish more concrete association between ASD and oral diseases.
Endovascular coil embolization of proximal middle cerebral artery aneurysms has better outcomes than other middle cerebral artery aneurysms: A retrospective study
Authors: Sato Hirotaka , Haraguchi Koichi , Takahashi Yasuhiro , Ohtaki Shunya , Shimizu Tadakazu , Matsuura Nobuyuki , Ogane Kazumi , Ito Takeo 
Published: January 2020

Purpose Although some authors proposed that coil embolization in middle cerebral artery (MCA) aneurysms is a useful and effective alternative, the characteristics of the aneurysms may be different at each location. We compared the results of coil embolization of proximal middle cerebral artery aneurysms with those of other middle cerebral artery aneurysms. Methods Data from 46 patients with 50 aneurysms were retrospectively evaluated. We defined the aneurysms inside of the insular cortex as proximal MCA (pMCA) aneurysms and those outside of the insular cortex as non-proximal MCA (npMCA) aneurysms. The results of the occlusion were divided into classes 1, 2, and 3 of the Raymond scale. We collected the results of the occlusion from the operative notes supplied by a neuroendovascular specialist. Results Univariate analysis identified favorable results for pMCA aneurysms (class 1: pMCA = 22 npMCA = 11; P < 0.01). In the radiological follow-up results, we achieved class 1 in 29 patients (69%; pMCA = 21 and npMCA = 8; P < 0.01). Side wall type aneurysms (pMCA = 14, npMCA = 2; P < 0.01) and the number of branches from the neck of ≤1 (pMCA = 14, npMCA = 2; P < 0.01) were significantly recognized at the pMCA. Conclusions Proximal middle cerebral artery aneurysm clipping is difficult because the origin of the lenticulostriate arteries is often hidden behind the aneurysmal dome. In the present study, endovascular coil embolization for pMCA aneurysms obtained better results than that for npMCA aneurysms because of the morphological characteristics. Endovascular coil embolization seems to be efficacious for pMCA aneurysms as compared with npMCA aneurysms.
Proteinuria as an independent predictor of stroke: Systematic review and meta-analysis
Authors: Kelly Dearbhla M , Rothwell Peter M 
Published: January 2020

Background Proteinuria has emerged as an important vascular risk factor for adverse cardiovascular events including stroke. Hypertension has been proposed as the principal confounder of this relationship but its role has not been systematically examined. Aim We aimed to determine if proteinuria remains an independent predictor of stroke after more complete adjustment for blood pressure. Summary of review We performed a systematic review, searching MEDLINE and EMBASE (to February 2018) for cohort studies or randomized controlled trials that reported stroke incidence in adults according to baseline proteinuria ± glomerular filtration rate. Study and participant characteristics and relative risks were extracted. Estimates were combined using a random effects model. Heterogeneity was assessed by χ 2 statistics and I2, and by subgroup strata and meta-regression, with a particular focus on the impact of more complete adjustment for blood pressure on the association. The quality of cohort studies and post hoc analyses was assessed using the Newcastle–Ottawa Scale. We identified 38 studies comprising 1,735,390 participants with 26,405 stroke events. Overall, the presence of any level of proteinuria was associated with greater stroke risk (18 studies; pooled crude relative risk 2.00, 95%CI 1.63–2.46; p < 0.001) even after adjustment for established cardiovascular risk factors (33 studies; pooled adjusted relative risk 1.72, 1.51–1.95; p < 0.001), albeit with considerable heterogeneity between studies (p < 0.001; I2 = 77.3%). Moreover, the association did not substantially attenuate with more thorough adjustment for hypertension: single baseline blood pressure measure (10 studies; pooled adjusted relative risk = 1.92, 1.39–2.66; p < 0.001); history or treated hypertension (four studies; pooled adjusted relative risk = 1.76, 1.13–2.75, p = 0.013); multiple blood pressure measurements over months to years (four studies; relative risk = 1.68, 1.33–2.14; p < 0.001). Conclusions Even after extensive adjustment for hypertension, proteinuria is strongly and independently associated with incident stroke risk, possibly indicating a shared renal and cerebral susceptibility to vascular injury that is not fully explained by traditional vascular risk factors.
Inconclusive evidence for the efficacy of tranexamic acid in reducing transfusions, postoperative infection or hematoma formation after primary shoulder arthroplasty: A meta-analysis with trial sequential analysis
Authors: Rojas Jorge , Srikumaran Uma , McFarland Edward G 
Published: January 2020

Background Tranexamic acid efficacy on clinically relevant adverse outcomes in patients undergoing shoulder arthroplasty has been contradictory. The aim of this review was to analyze whether tranexamic acid administration could decrease transfusions, infection and hematoma formation in patients undergoing shoulder arthroplasty. Methods PubMed, EMBASE, and the Cochrane Library were searched up to May 2019 for randomized controlled trials comparing tranexamic acid to placebo in shoulder arthroplasty. Random-effect models were performed to meta-analyze the evidence. Trial sequential analysis was used to calculate and to establish the conclusiveness of the evidence derived from the meta-analysis. Results Four randomized controlled trials comprising 375 patients were included. Meta-analysis showed no effect of tranexamic acid on transfusion rate (RR = 0.48 (adjusted 95% CI 0.05 to 3.85)). The possible effect of tranexamic acid on hematoma formation or infection rates after shoulder arthroplasty is non-estimable with the current evidence. The sample size necessary to reliably determine if tranexamic acid decreases transfusions, infection rates and hematoma formation is not available from the current literature as determined by the trial sequential analysis. Discussion While tranexamic acid has proven its efficacy in decreasing blood loss in shoulder arthroplasty, this meta-analysis of randomized controlled trials clarifies that there is currently no conclusive evidence for a positive effect of tranexamic acid upon transfusion rate, infection rates or hematoma formation in patients undergoing primary shoulder arthroplasty.
Effect of glenoid perforation during total shoulder arthroplasty on glenoid component cement fixation and suprascapular nerve
Authors: Pace Gregory I , Thomas Rachel A , Zale Connor L , Lewis Gregory S , Kim Raymond Y , Kim H Mike 
Published: January 2020

Background Arthritic glenoids are susceptible to vault perforation during total shoulder arthroplasty. We investigated the effects of glenoid perforation and subsequent cement extrusion on the suprascapular nerve and on the glenoid cement infiltration. Methods Total shoulder arthroplasty using three-pegged glenoid components were performed on 10 cadaveric shoulders assigned to two groups (perforation vs. control). In perforation group, the glenoids were reamed eccentrically and intentionally perforated medially through the central peg hole, whereas control group received perpendicular reaming with no perforation. Bone cement was applied to each peg. Spatial relationship between the extruded cement and the suprascapular nerve, and the amount of cement infiltration into the cancellous bone were evaluated. Results In perforation group, five specimens were perforated anteriorly, and two posteriorly. In the two posteriorly perforated specimens, the suprascapular nerve was in direct contact with extruded cement at the spinoglenoid notch. Perforation group showed significantly less cement infiltration into the cancellous bone than control group ( p = 0.008). Conclusions Glenoid perforation decreases the volume of cement infiltration into the cancellous bone potentially compromising glenoid component fixation. Glenoid perforation tends to occur anteriorly rather than posteriorly in arthritic glenoids; however, if perforation occurs posteriorly, the suprascapular nerve is at immediate risk from the extruded cement. Level of evidence: Basic science study.
Day case primary trans-urethral resection of bladder tumour (TURBT) as standard in a single UK centre. Should this be the new norm?
Authors: Austin Tomas , Robinson Richard , Wilby Daniel , Hall Stuart , Hodgson Dominic 
Published: January 2020

Objectives: A retrospective study was conducted to examine the feasibility and safety of performing trans-urethral resection of bladder tumour (TURBT) in newly diagnosed patients as a day case operation. Patients and methods: All patients who underwent a primary TURBT over a 12 month period were included. Data were collected on patient demographics, tumour characteristics, day case vs. inpatient admission, indications for inpatient admission, re-admission rates within 28 days, and surrogate markers for quality of resection including recurrence rates. Results: A total of 172 patients were included. TURBT was performed as a day case procedure on 138 patients (80.2%). Rates of re-admission within 28 days were 7.2% and 5.9% in the day case and inpatient cohorts respectively. One hundred and thirty (75.6%) patients had non-muscle invasive bladder cancer (NMIBC). Of these, 84 (64.6%) were found to have detrusor muscle in their specimens, and 86 (66.2%) received peri-operative mitomycin C. Twelve month recurrence rates were 12%, 27% and 33% for low, intermediate and high-risk NMIBC respectively. Conclusion: This study shows that day case surgery for TURBT is feasible in the majority of patients, with a low rate of re-admission. Our data suggest that day case TURBT is suitable as standard practice in our institution and should be considered by others. Level of evidence: 2b.
Could superior capsule findings be used as a predictor for partial bursal-sided rotator cuff tears?
Authors: Kanatlı Ulunay , Ayanoglu Tacettin , Esen Erdinc , Ataoglu Baybars , Ozer Mustafa , Cetinkaya Mehmet , Kaptan Ahmet Yigit 
Published: January 2020

Purpose: The purpose of this study was to investigate the relationship between the superior capsule tear patterns and synovitis with subacromial pathologies, such as bursal-sided rotator cuff tear and subacromial impingement syndrome. Methods: Fifty patients who underwent arthroscopic treatment for isolated bursal-sided tear were included in the study. Fifty more patients who underwent arthroscopic treatment for isolated Superior Labrum Anterior Posterior (SLAP) 2 lesion without pathology in the rotator cuff were included in the control group. Firstly, superior capsule tear and common synovitis on the rotator cable were assessed during glenohumeral joint examination. Coracoacromial Ligament (CAL) degeneration grading was performed according to the Royal Berkshire Hospital classification. Bursal-sided partial tear grading was done using Ellman classification. Whether or not there was a relationship between synovitis, classic capsule tear, plus reverse flap capsule tear, and partial bursal-sided tear existence. Results: There were 21 patients with reverse flap capsule tear in the study group and 3 patients in the control group. In addition, there were 13 patients with synovitis in the study group and 4 in the control group. Compared to the control group, there was also a significant positive correlation in the presence of both synovitis and reverse flap capsule tear with the presence of bursal-sided tear in the study group ( p = 0.000). There was, however, no significant difference between the presence of classical capsule tear and the presence of bursal-sided tear ( p = 0.485). Conclusion: This study shows that the presence of reverse flap capsule tear and synovitis was associated with partial bursal-sided tears. Therefore, if the reverse flap capsule tear or synovitis is detected in the superior capsule, the rotator cuff should be evaluated in more detail during subacromial bursoscopy in order not to miss a bursal-sided partial cuff tear.
Increased Cortical Thickness in Patients With Major Depressive Disorder Following Antidepressant Treatment
Authors: Nemati Samaneh , Abdallah Chadi G. 
Published: January 2020

Background Considering the slow-acting properties of traditional antidepressants, an important challenge in the field is the identification of early treatment response biomarkers. Reduced cortical thickness has been reported in neuroimaging studies of depression. However, little is known whether antidepressants reverse this abnormality. In this brief report, we investigated early cortical thickness changes following treatment with sertraline compared to placebo. Methods Participants (n = 215) with major depressive disorder were randomized to a selective serotonin reuptake inhibitor, sertraline, or to placebo. Structural magnetic resonance imaging scans were acquired at baseline and one week following treatment. Response was defined as at least 50% improvement in Hamilton rating scale for depression score at week 8. In a vertex-wise approach, we examined the effects of treatment, response, and treatment × response. Results Following correction for multiple comparisons, we found a significant effect of treatment, with widespread increase in cortical thickness following sertraline compared to placebo. Clusters with increased thickness were found in the left medial prefrontal cortex, right medial and lateral prefrontal cortex, and within the right parieto-temporal lobes. There were no sertraline-induced cortical thinning, and no significant response effects or treatment × response interactions. Conclusion Our findings suggest that cortical thickness abnormalities may be responsive to antidepressant treatment. However, a relationship between these early cortical changes and later treatment response was not demonstrated. Future studies would be needed to investigate whether those early effects are maintained at eight weeks and are associated with enhanced response.
Operative Approaches to Ankle and Hindfoot Arthroscopy
Authors: Carreira Dominic S. , Garden Steven R. , Ueland Thomas 
Published: January 2020

The role of arthroscopy in the management of ankle and hindfoot pathology management has increased greatly in recent years with the potential for lower complication rates, faster recovery, improved access, and improved outcomes when compared to open techniques. Procedural variations exist as techniques aim to optimize lesion access, decrease operative time, and improve patient safety. Our goal is to summarize the described approaches and patient positionings common in minimally invasive arthroscopic surgery for anterior, lateral, and posterior ankle pathologies. A survey of pathology organized by arthroscopic approach and a review of recent advances in concomitant lesion management may be useful when planning arthroscopic foot and ankle surgery. Level of Evidence: Level V, expert opinion.