bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Rate of Canine Retraction and Secondary Outcomes Associated With Conventional Fixed Orthodontic Treatment and Minimally Invasive Techniques (MOPs): A Randomized Control Trial
Authors: Parihar Ajit Vikram , Verma Shivam , Chaturvedi TP , Kumar Naresh , Prasanth A Kavin , Sahoo Rojalin 
Published: November 2020

Introduction: The objective of the study was to assess the rate of canine retraction and secondary outcomes associated with conventional fixed orthodontic treatment (CFO) and CFO with micro-osteoperforation (CFO + MOP), that is, anchorage loss, root resorption, vitality of tooth, pain and discomfort level during the procedure. Methods: A total of 16 patients with Class II Division 1 malocclusion who required upper first premolar extraction with lower non-extraction/single incisor extraction were divided into the test group (MOP) and positive control group (CFO + MOP) for a split-mouth study. Both maxillary canines were retracted with nickel–titanium (NiTi) closed coil springs. Patients were reviewed after 24 hours, 7 days, 28 days, and 4, 8, and 16 weeks to assess the rate of tooth movement, anchorage loss, root resorption, vitality of tooth, pain and discomfort level. Results: There was a statistically significant difference in the rate of tooth movement between the CFO and CFO + MOP groups after the first 4 weeks ( P-value = .026), whereas no statistically significant difference was observed at 8, 12, and 16 weeks ( P-value = .33, .99, and .08, respectively). In the CFO group, there was no statistically significant difference in tooth movement between different time intervals ( P-value > .05). There was no significant difference in root resorption between the groups. The pain level was higher in the MOP group in the first 24 hours ( P-value < .05) after the procedure. Later on, the difference in pain level between the groups was not significant ( P-value > .05). The vitality of retracted canines in both groups was healthy. Conclusion: The study recommends that the CFO + MOP procedure has substantial potential to be used as an adjunct to the routine mechanotherapy for faster tooth movement, as it may reduce the treatment time by half in the first 4 weeks after the MOP procedure. There are no potential differences in anchorage loss, tipping, vitality, and apical and lateral root resorption between the CFO and CFO + MOP groups. This trial was registered at Clinical Trial Registry, India.
Occupational therapists’ experiences of enabling people to participate in sport
Authors: Bullen Deborah , Clarke Channine 
Published: November 2020

Introduction In response to growing demands on health and social care services there is an emphasis on communities addressing the needs of local populations to improve lives and reduce inequalities. Occupational therapists are responding to these demands by expanding their scope of practice into innovative settings, such as working with refugees, the homeless and residents of nursing homes, and within sport and leisure environments. The benefits of sport are widely acknowledged, and this paper argues that occupational therapists could play a pivotal role in enabling people to participate. Method This qualitative study drew on a phenomenological approach and used interviews and thematic analysis to explore five occupational therapists’ experiences of enabling people to participate in sport. Findings Findings revealed that participants demonstrated the uniqueness of occupational therapy when enabling people to participate in sport and practised according to their professional philosophy. There were opportunities to reach wider communities and promote the value of occupational therapy by collaborating with organisations, but there were also challenges when working outside of traditional settings. Conclusion The study emphasises the unique skills occupational therapists can bring to this setting. It highlights opportunities to expand their practice, to forge new partnerships in sports and leisure environments, and to address the national inactivity crisis.
Changes in Matrix Components in the Developing Human Meniscus
Authors: Fedje-Johnston William , Tóth Ferenc , Albersheim Melissa , Carlson Cathy S. , Shea Kevin G. , Rendahl Aaron , Tompkins Marc 
Published: November 2020

Background: Treatment of meniscal tears is necessary to maintain the long-term health of the knee joint. Morphological elements, particularly vascularity, that play an important role in meniscal healing are known to change during skeletal development. Purpose: To quantitatively evaluate meniscal vascularity, cellularity, collagen, and proteoglycan content by age and location during skeletal development. Study Design: Descriptive laboratory study. Methods: Medial and lateral menisci from 14 male and 7 female cadavers aged 1 month to 11 years were collected and evaluated. For each meniscus, histologic and immunohistologic techniques were used to establish the ratio of the area of proteoglycan (safranin O) positivity to the total area (proteoglycan ratio), collagen type I and type II immunostaining positivity, number of blood vessels, and cell density. These features were evaluated over the entire meniscus and also separately in 5 circumferential segments: anterior root, anterior horn, body, posterior horn, and posterior root. Additionally, cell density and number of blood vessels were examined in 3 radial regions: inner, middle, and periphery. Results: Age was associated with a decrease in meniscal vessel count and cell density, while the proteoglycan ratio increased with skeletal maturity. Differences in vessel counts, cellular density, and proteoglycan ratio in different anatomic segments as well as in the inner, middle, and peripheral regions of the developing menisci were also observed. Collagen immunostaining results were inconsistent and not analyzed. Conclusion: The cellularity and vascularity of the developing meniscus decrease with age and the proteoglycan content increases with age. All of these parameters are influenced by location within the meniscus. Clinical Relevance: Age and location differences in meniscal morphology, particularly in the number of blood vessels, are expected to influence meniscal healing.
No Correlation Between Depth of Acetabuloplasty or Postoperative Lateral Center-Edge Angle on Midterm Outcomes of Hip Arthroscopy With Acetabuloplasty and Labral Repair
Authors: Johannsen Adam M. , Ruzbarsky Joseph J. , Pierpoint Lauren A. , Soares Rui W. , Briggs Karen K. , Philippon Marc J. 
Published: November 2020

Background: The treatment of pincer deformity in hip arthroscopy remains controversial, with some authors advocating that over resection may risk early joint deterioration. The role of acetabular resection depth and postoperative acetabular morphology on postoperative outcomes has yet to be defined. Purpose/Hypothesis: This study measures the influence of acetabular resection depth and postoperative lateral center-edge angle (LCEA) on minimum 5-year patient-reported outcomes (PROs), revision rates, and conversion to total hip arthroplasty using a single surgeon’s prospective database. We hypothesized that patients with acetabular resections >10°, as measured by LCEA, or patients with postoperative LCEA outside the normal range of 25° to 35° would have lower PROs, higher revision rates, and higher conversion to total hip arthroplasty at midterm follow-up. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 192 patients who underwent primary hip arthroscopy with acetabuloplasty and labral repair by a single surgeon with a minimum 5-year follow-up met the inclusion criteria. Preoperative and postoperative LCEAs were measured on supine anteroposterior radiographs, and patients were divided into cohorts based on LCEA and acetabular resection depth. Cohorts for postoperative LCEA were <20° (dysplasia), 20° to 25° (borderline dysplasia), 25° to 35° (normal), and >35° (borderline overcoverage). Cohorts for acetabular resection depth were <5°, 5° to 10°, and >10° difference from preoperative to postoperative LCEA. Outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 12-Item Short Form Health Survey, modified Harris Hip Score, Hip Outcome Score, satisfaction scores, revision rates, and conversion to arthroplasty rates. Results: Patients significantly improved in all outcome score measures at final follow-up. There were no statistically significant differences in PRO scores or conversion to total hip arthroplasty between any cohorts in the postoperative LCEA group. There were more revisions in the 25° to 35° cohort than the other cohorts ( P = .02). The 5-10° resection depth cohort demonstrated a higher postoperative WOMAC score ( P = .03), but otherwise no statistically significant differences were seen between resection depth cohorts in the remaining postoperative outcomes scores, revision rates, or conversion to total hip arthroplasty rates. Conclusion: Patients with postoperative LCEA values outside the normal reference range and with large resections perform similar to those with normal postoperative LCEA values and smaller resections at a minimum 5-year follow-up.
Early Implantation as a Main Predictor of Response to Vagus Nerve Stimulation in Childhood-Onset Refractory Epilepsy
Authors: Russo Angelo , Hyslop Ann , Gentile Valentina , Chiarello Daniela , Messana Tullio , Miller Ian , Zucchelli Mino , Lima Mario , Ragheb John , Pini Antonella , Cordelli Duccio Maria , Resnick Trevor , Jayakar Prasanna , Duchowny Michael 
Published: November 2020

Objective: We describe a multicenter experience with vagus nerve stimulator implantation in pediatric patients with drug-resistant epilepsy. Our goal was to assess vagus nerve stimulation efficacy and identify potential predictors of favorable outcome. Methods: This is a retrospective study. Inclusion criteria: ≤18 years at time of vagus nerve stimulator implantation, at least 1 year of follow-up. All patients were previously found to be unsuitable for an excisional procedure. Favorable clinical outcome and effective vagus nerve stimulation therapy were defined as seizure reduction >50%. Outcome data were reviewed at 1, 2, 3, and 5 years after vagus nerve stimulator implantation. Fisher exact test and multiple logistic regression analysis were employed. Results: Eighty-nine patients met inclusion criteria. Responder rate (seizure frequency reduction >50%) at 1-year follow-up was 25.8% (4.5% seizure-free). At last follow-up, 31.5% had a favorable outcome and 5.2% were seizure free. The only factor significantly predicting favorable outcome was time to vagus nerve stimulator implantation, with the best outcome achieved when vagus nerve stimulator implantation was performed within 3 years of seizure onset. Implantation between 3 and 5 years after epilepsy onset correlated with better long-term seizure freedom (13.3% at T5). Overall, 65.2% of patients evidenced improved quality of life at last follow-up. However, 12.4% had adverse events, but most were mild and disappeared after 3-4 months. Conclusions: Early vagus nerve stimulator implantation within 5 years of seizure onset was the only predictor of favorable clinical outcome in pediatric patients. Improved quality of life and a low incidence of significant adverse events were observed.
Opicapone (Ongentys): A New COMT Inhibitor for the Treatment of Parkinson’s Disease
Authors: St. Onge Erin , Vanderhoof Michelle , Miller Shannon 
Published: November 2020

Objective To describe the safety and efficacy of opicapone, a newly Food and Drug Administration–approved catechol- O-methyltransferase (COMT) inhibitor, as an adjunctive treatment to levodopa/carbidopa in patients with Parkinson’s disease (PD) experiencing off episodes. Data Sources A literature search through PubMed and International Pharmaceutical Abstracts (January 2000 to October 2020) was conducted using the following search terms: Ongentys, opicapone, COMT inhibitor, Parkinson’s disease, and Parkinson’s. Study Selection and Data Extraction Articles selected included those describing preclinical and clinical studies examining the pharmacokinetics, efficacy, and/or safety of opicapone. Data Synthesis In preclinical trials, opicapone demonstrated marked S-COMT inhibition, despite its short half-life, while maintaining an acceptable safety and efficacy profile. Results from phase 3 clinical trials further supported the safety and efficacy of opicapone as an adjunct to levodopa. In addition, opicapone, at a dose of 50 mg once daily, was shown to be superior to placebo and noninferior to entacapone in reducing time spent in the off state. Adverse effects commonly reported with opicapone include dyskinesias, constipation, hypotension/syncope, increased blood creatine kinase, and decreased weight. Relevance to Patient Care and Clinical Practice Additional medications, such as COMT inhibitors, become necessary adjunctive treatments as the disease progresses. Compared to other COMT inhibitors currently on the US market, opicapone offers the advantage of once-daily dosing. Conclusion Opicapone is a safe and effective COMT inhibitor shown to reduce off episodes in patients with PD.
Doomed peripheral intravenous catheters: Bad Outcomes are similar for emergency department and inpatient placed catheters: A retrospective medical record review
Authors: Kache Shawn , Patel Sunny , Chen Nai-Wei , Qu Lihua , Bahl Amit 
Published: November 2020

Introduction: The survivorship of peripheral intravenous catheters (PIVCs) placed in hospitalized patients is shockingly poor and leads to frequent reinsertions. We aimed to evaluate differences in failure rates and IV insertion practices for PIVCs that are placed in the emergency department (ED) compared to those placed in the inpatient (IP) setting. Methods: We conducted a retrospective electronic medical record review of PIVC survival at a single-site suburban, academic tertiary care referral center with 130,000 annual ED visits and 1100 inpatient beds. Adult patients admitted requiring at least one PIVC were included. The primary outcome was incidence of premature failure of PIVCs. Secondary outcomes included dwell time, completion of therapy, catheter diameter, and site of insertion as they relate to PIVC survival. Results: Between January 2018 and July 2019, 90,743 IV catheters were included from 47,272 unique patient encounters in which 35,798 and 54,945 catheters were placed in the ED and IP units, respectively. There was no significant difference in failure rate between the ED and IP PIVCs, with 53.1% of ED PIVCs failing and 53.4% of IP PIVCs failing ( p = 0.35). Mean dwell time for ED PIVCs was 3.4 days compared to a mean of 3.2 days for IP placed PIVCs ( p < 0.001). 48% of ED PIVCs achieved completion of therapy at the first insertion compared to 59% of IP PIVCs ( p < 0.001). The antecubital fossa and forearm had the lowest failure rate of 53% and 50%, respectively, and 22 gauge PIVCs had the highest failure rate of 60.5%. Conclusion: PIVCs have similar poor survival rates regardless of ED versus IP location of the insertion. The forearm and antecubital fossa sites should be preferentially used. Smaller diameter (22G) catheters have highest complications and poorest survival regardless of site of insertion. Larger diameter catheters (18 or 20 gauge) may offer improved outcomes.
An electronic, unsupervised patient-reported Expanded Disability Status Scale for multiple sclerosis
Authors: Romeo Andrew R , Rowles William M , Schleimer Erica S , Barba Patrick , Hsu Wan-Yu , Gomez Refujia , Santaniello Adam , Zhao Chao , Pearce Jennifer R , Jones JB , Cree Bruce C , Hauser Stephen L , Gelfand Jeffrey M , Stewart Walter F , Goodin Douglas S , Bove Riley M 
Published: November 2020

Background: In persons with multiple sclerosis (MS), the Expanded Disability Status Scale (EDSS) is the criterion standard for assessing disability, but its in-person nature constrains patient participation in research and clinical assessments. Objective: The aim of this study was to develop and validate a scalable, electronic, unsupervised patient-reported EDSS (ePR-EDSS) that would capture MS-related disability across the spectrum of severity. Methods: We enrolled 136 adult MS patients, split into a preliminary testing Cohort 1 ( n = 50), and a validation Cohort 2 ( n = 86), which was evenly distributed across EDSS groups. Each patient completed an ePR-EDSS either immediately before or after a MS clinician’s Neurostatus EDSS evaluation. Results: In Cohort 2, mean age was 50.6 years (range = 26–80) and median EDSS was 3.5 (interquartile range (IQR) = [1.5, 5.5]). The ePR-EDSS and EDSS agreed within 1-point for 86% of examinations; kappa for agreement within 1-point was 0.85 ( p < 0.001). The correlation coefficient between the two measures was 0.91 (<0.001). Discussion: The ePR-EDSS was highly correlated with EDSS, with good agreement even at lower EDSS levels. For clinical care, the ePR-EDSS could enable the longitudinal monitoring of a patient’s disability. For research, it provides a valid and rapid measure across the entire spectrum of disability and permits broader participation with fewer in-person assessments.
Health professionals’ experience of nursing home residents’ consumption of alcohol and use of psychotropic drugs
Authors: Johannessen Aud , Tevik Kjerstin , Engedal Knut , Helvik Anne-Sofie 
Published: November 2020

Background: Nursing home (NH) residents are in most cases in older ages and use prescription drugs. As alcohol interacts with many commonly prescribed drugs, NH residents may be more vulnerable to the effects of alcohol. Aim: To investigate the experiences of health professionals in Norwegian NHs when it comes to residents' alcohol consumption and use of psychotropic drugs, and the facilitation of such use in the NH. Method: Focus-groups and individual interviews with NH health professionals were performed in 2017 and 2018. The data were analysed using content analysis. Findings: Two main themes emerged: (1) the balancing of alcohol consumption, and (2) the use of psychotropic drugs. Each of these themes involved reasoning, which revealed that the informants in general had little attention regarding alcohol consumption among residents, and few institutions had policies regarding serving and consumption of alcohol. The informants reported an increased attention regarding use of psychotropic drugs and a tendency towards less use of psychotropic drugs among the residents than before, but few informants reported use of standardised observations tools of symptoms related to prescribing and discontinuation of drugs. Conclusion: Alcohol policies or procedures related to alcohol consumption were uncommon at the NH that the interviewees of this study represented, and the professionals regarded infrequent serving and consumption of alcohol among the residents as a part of everyday life. In cases when residents frequently consumed alcohol, the professionals used dialogue to underpin the adherent risks and they also tried to control the consumption of the resident in different ways. The interviewees were aware of various side-effects of psychotropic drugs; they were also aware of their effects in combination with alcohol.
Informal and Incidental Learning in the time of COVID-19
Authors: Watkins Karen E. , Marsick Victoria J. 
Published: November 2020

The Problem COVID-19 has brought challenges to all sectors of society, from leadership at the top to service at the front lines. Learning (and unlearning) by its very nature will play an outsize role in our reinvention and renewal. Much of that learning will be informal and incidental learning. How can complexity science help us think about informal and incidental learning in a pandemic and how might we develop our capacity to productively learn given these turbulent circumstances? The Recommendation Workplace educators are encouraged to take a complexity perspective on their work post-COVID-19 and to enlarge their repertoire of responses to learning needs to include informal and incidental learning. A critical role for these individuals will be to help workers increase their skill in being proactive, critically reflective, creative, and playful as they learn informally. We encourage use of design thinking—coupled with knowledge-intensive tools, data visualization modeling, imagination, and abductive reasoning—to reframe how we learn in times of complexity in the time of COVID-19. The Stakeholders All of us have to learn our way through during this great reset. Every sector, every workplace, will be affected by the changes wrought by a pandemic and an economy in jeopardy. Thus all who learn and particularly those of us who help shape and guide workplace learning have a stake in understanding complexity and how to enhance informal and incidental learning as a strategically important response to these times.
Open Conversion After Endovascular Aneurysm Sealing: Technical Features and Clinical Outcomes in 44 Patients
Authors: Zerwes Sebastian , Kiessling Johanna , Liebetrau Dominik , Jakob Rudolf , Gosslau Yvonne , Bruijnen Hans-Kees , Hyhlik-Duerr Alexander 
Published: November 2020

Purpose To evaluate the technical features and clinical results after open conversion for complications following endovascular aneurysm sealing (EVAS). Materials and Methods From July 2013 to February 2020, 44 patients (mean age 72±8 years; 36 men) underwent an open conversion due to EVAS complications in a single center. Data were collected on patient characteristics, reasons for conversion, characteristics and duration of the procedure, condition of the polymer, blood loss, time in the intensive care unit (ICU), and intra/postoperative complications. The main outcome measure was mortality at 30 days and in follow-up. Data are presented as the median (IQR) and absolute range. Results On average, the open conversion took place 3 years after the initial EVAS implantation [median 37 months (IQR 23, 50); range 0–64]. Most patients were converted due migration (82%), aneurysm growth (77%), and/or endoleak (75%), with 21 patients (48%) having all 3 events. Less frequent diagnoses were aneurysm rupture (n=7), aortic infection (n=3), technical failure during implantation (n=2), and graft thrombosis (n=1). The majority of patients (n=26) were asymptomatic and converted electively, but 9 were operated on urgently and 9 emergently (7 late rupture and 2 due to technical failure). The median procedure duration was 178 minutes (IQR 149, 223; range 87–417), the median blood loss was 1100 mL (IQR 600, 2600; range 300–5000). Polymer degradation was mentioned in the operative reports of 18 cases (41%). Patients stayed a median of 3 days (IQR 2, 7; range 1–35) in the ICU, while the median length of stay in the hospital was 14 days (IQR 10, 20; range 0–93). The 30-day mortality was 23% (n=10). During a median follow-up of 3 months (IQR 0, 11; range 0–38), no additional deaths occurred, but 12 patients suffered from an adverse event. There were 3 cases of wound dehiscence after laparotomy, 2 cases of leg ischemia, 2 cases of renal failure, and individual cases of urinary obstruction, urinoma, paralytic ileus, gastrointestinal bleeding, and postoperative delirium. A non-elective setting was associated with a significantly increased mortality of 33% in urgent cases and 56% in emergent cases (p=0.007). Based on these results an algorithm for the management of EVAS complications was developed. Conclusion The significantly increased mortality associated with nonelective conversions highlights the need for active surveillance. The presented algorithm offers a structured tool to avoid emergency conversions.