bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Virtual stent” – clinical evaluation and user experience of on-the-fly stent simulation in treatment of cerebral aneurysms
Authors: Luecking Hannes , Birkhold Annette , Hoelter Philip , Lang Stefan , Goelitz Philipp , Schmidt Manuel , Mrochen Anne , Brandner Sebastian , Doerfler Arnd 
Published: October 2021

Background Predicting final stent position can be challenging when treating cerebral aneurysms. Third-Party software proved helpful in selecting proper stents in treatment planning. Recent angiographic systems provide basic stent simulation capabilities integrated in the post-processing software to simulate stent position. Goal of this analysis was to evaluate the simulation process and correlation with definite stent position. Materials and Methods Thirty-three datasets with fusiform (n = 10) and saccular (n = 23) aneurysms, treated with stent or flow-diverter, were processed. A “virtual stent” of the same (nominal) size was simulated and its position was compared to the treatment result. Simulated length was rated in five grades (too short, shorter, equal, longer, too long), with regard to side-branches, anchoring zone etc. Simulation quality (centerline recognition/adherence to vessel margins) was rated in three grades (no, minor or major corrections required). Results Simulation was successful in 32/33 cases (97%), with one abortive attempt (3%). In 27/33 simulations (82%), there was no need for centerline refinement. Minor corrections were necessary in four and major corrections in two cases. Simulated nominal length was rated “equal” in 14/33 (42%) cases and “shorter” or “longer” – but within acceptable range – in each 9/33 (27%) cases. Conclusion Basic stent simulation tools available with genuine angiographic workplace software can provide good simulation capabilities without need for third-party equipment. They can facilitate treatment planning and help to avoid shortage of devices. Yet, lack of calculation of foreshortening in large vessel diameters leaves the user to rely on their experience to account for device-specific properties.
Comparing self-reported vs. parent/caregiver reported levels of social participation for young adults with intellectual disabilities: A pilot study
Authors: Espiritu Elena Wong , Michaels Natalie N , Schmidt Kathryn , Gegen Margaret , King Halle R. , Miller Cara , Munro Hannah , Uzzell-Baggett Karon 
Published: October 2021

Background: This study focused on the level of satisfaction of social participation reported by young adults with intellectual disabilities, and the comparison of these levels to those reported by their caregivers. Methods: Fifteen young adults with intellectual disabilities and their parents/caregivers completed the Patient-Reported Outcomes Measurement Information System Satisfaction with Participation in Discretionary Social Activities–Calibrated Items (PROMIS SF–Social Sat DSA) and the Satisfaction with Social Roles and Activities–Short Form (Neuro-QoL SF). Results: Reports from these young adults were compatible to that of the general population. There was general agreement on the Social Sat DSA between the individuals and their caregivers, but there were differences between groups on the Neuro-QoL SF, with the caregivers typically giving higher scores ( p = .025). Conclusion: This pilot study demonstrates the importance of involving both the individuals with intellectual disabilities, and their parents/caregivers when conducting survey research. Further research is encouraged.
Reconstruction of hook grip function of the fingers in patients with traumatic brachial plexus injury
Authors: Hara Yuki , Nishiura Yasumasa , Yoshii Yuichi , Asakawa Shunsuke , Matsumoto Yukei , Ochiai Naoyuki 
Published: October 2021

We described a reconstruction method for restoring hook grip function of the fingers in patients with total brachial plexus injury. The paralysed latissimus dorsi muscle was transferred to the upper limb as a pedicle flap and sutured to the flexor digitorum profundus tendons. The muscle was then reanimated with two intercostal donor nerves to the thoraco-dorsal nerve. Fourteen young adult patients (mean 23 years, range 17 to 32 years) with traumatic brachial plexus injury who underwent reconstruction using this technique from 2000 to 2019. After mean follow-up of 65 months (range 20 to 170), finger flexion of strength greater than or equal to M3 was achieved in 10 of the 14 patients. The mean weight that could be lifted using a hook grip was 2.6 kg, and that which could be lifted with both hands was 4.1 kg. The intercostal nerve-innervated latissimus dorsi muscle transfer can provide useful hook grip hand function without the need to sacrifice donor vessels or healthy muscles. Level of evidence: IV
Jet-Induced Blood Release From Human Fingertips: A Single-Blind, Randomized, Crossover Trial
Authors: Xu Jiali , McKeage James W. , Ruddy Bryan P. , Nielsen Poul M. F. , Taberner Andrew J. 
Published: October 2021

Background: Lancet pricks are often poorly received by individuals with diabetes; jet injection may allow lancet-free blood sampling. We examine whether the technique of jet injection can release sufficient blood from the fingertip to enable measurement of blood glucose concentration. In addition, we assess the effect of jet shape and cross-sectional area on fluid release, blood dilution, and perceived pain. Methods: A randomized, single-blind, crossover study was conducted on 20 healthy volunteers who received interventions on four fingertips: a lancet prick, and jet injection of a small quantity of saline solution through three differently shaped and sized nozzles. Released fluid volume, blood concentration, and glucose concentration were assessed immediately after the intervention. Pain perception and duration, and any skin reactions, were evaluated both immediately and 24 hours after the intervention. Results: Jet injection released sufficient blood from the fingertip to conduct a glucose measurement. A slot-shaped nozzle released the most blood, although less than a lancet, with slightly higher pain. The blood glucose levels estimated from the extracted fluid showed a mean absolute percentage error of 25%. There was no consistent evidence that a jet injection leads to different skin reactions at the intervention site relative to a lancet prick. Conclusions: Fingertip penetration by jet injection can release a volume of fluid sufficient for blood glucose measurement. Jet injection with a slot-shaped nozzle and/or a nozzle with larger outlet area helps to release more fluid. This technique may enable blood sampling, glucose concentration measurement, and insulin delivery to be performed in a single device.
Comparison of Short-Term Outcomes After Total Ankle Replacement and Ankle Arthrodesis: An ACS-NSQIP Database Study
Authors: Anigian Kendall , Ahn Juhno , Wallace S. Blake , Manchanda Kshitij , Liu George T. , Raspovic Katherine M. , Van Pelt Michael , Wukich Dane K. , Lalli Trapper A. J. 
Published: October 2021

Over the past 2 decades, several studies comparing intermediate- and long-term outcomes after total ankle replacement (TAR) versus ankle arthrodesis (AA) have reported differing rates of complications and outcomes. Recently, there has been a dramatic increase in patients undergoing TARs without any epidemiologic studies examining the short-term and perioperative complications. The purpose of this prognostic study was to compare perioperative outcomes after TAR and AA using data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database between 2012 and 2017. Patient data were collected from the NSQIP database for surgeries between January 2012 and December 2017 using Current Procedural Terminology codes 27700, 27702, 29899, and 27870. Patients were excluded if treated for fracture, infection, or revision procedures. The outcomes of interest were readmission and reoperation related to initial surgery, surgical site infections, and hospital length of stay. There were 1214 patients included—1027 (84.6%) TAR and 187 (15.4%) AA. The TAR patients were older, had a lower body mass index, and were less likely to have insulin-dependent diabetes. Readmission rate and length of stay was similar between groups. Multivariate regression revealed higher anesthesia severity scores ( P = .0007), diabetes mellitus ( P = .029), and AA ( P = .049) had positive correlations with adverse outcomes. We report a lower complication rate with TAR than previously described. AA arthrodesis is associated with a higher risk of perioperative complications, including deep surgical site infections and reoperations. There were no differences between the 2 groups comparing superficial infection, wound dehiscence, or readmissions in the first 30 days. Levels of Evidence: Level V.
Designing an integrated, nurse-driven and home-based digital intervention to improve insulin management in under-resourced settings
Authors: Ngassa Piotie Patrick , Wood Paola , Webb Elizabeth M. , Hugo Johannes F.M. , Rheeder Paul 
Published: October 2021

Background: In South Africa, initiating insulin for people with type 2 diabetes and subsequent titration is a major challenge for the resource-constrained healthcare system. Inadequate support systems in primary care, including not being able to access blood glucose monitors and test strips for self-monitoring of blood glucose, results in patients with type 2 diabetes being referred to higher levels of care. In primary care, initiation of insulin may be delayed due to a shortage of healthcare workers. The delayed initiation of insulin is also exacerbated by the reported resistance of both healthcare providers and people with type 2 diabetes to start insulin. In South Africa, telehealth provides an opportunity to overcome these challenges and manage insulin therapy in primary care. Methods: We describe the development of a digital health intervention including the framework used, the theoretical approach and subsequent implementation strategies. Results: This intervention is an innovative, nurse-driven and app-enabled intervention called ‘the Tshwane Insulin Project intervention’. The Tshwane Insulin Project intervention was designed and evaluated using the framework recommended by the Medical Research Council for complex interventions. The Tshwane Insulin Project intervention was developed in four sequential phases: planning, design, implementation and evaluation. The Tshwane Insulin Project intervention followed the Integrated Chronic Disease Management framework to facilitate implementation and acceptability. The Tshwane Insulin Project comprises a facility-level intervention, where nurses evaluate patients and initiate insulin, an individual-level intervention where community healthcare workers visit patients at their homes to follow-up and provide educational information, while using telehealth to enable physician-directed insulin titration if needed, and a community-level intervention aimed at empowering community healthcare workers to support people living with diabetes and raise awareness of diabetes. Conclusion: The technological advancements in digital health and telemedicine present an opportunity to improve diabetes care in resource-limited countries. This work can inform those intending to develop and implement complex interventions in primary healthcare in developing countries.
Olfactory-Specific Quality of Life Outcomes after Endoscopic Endonasal Surgery of the Sella
Authors: Raikundalia Milap D. , Huang Ryan J. , Chan Lyndon , Truong Tracy , Kuchibhatla Maragatha , Merchant James , Hachem Ralph Abi , Codd Patrick J. , Zomorodi Ali R. , Teitelbaum Jordan I. , Goldstein Bradley J. , Jang David W. 
Published: October 2021

Objective To assess olfactory outcomes as measured by an olfactory-specific quality of life (QOL) questionnaire in patients undergoing EESBS for sellar lesions. Design Retrospective case series. Setting Tertiary academic medical center. Participants In total, 36 patients undergoing EESBS for lesions limited to the sella were evaluated. Main Outcome Measures The following were performed before and three months after surgery: 22-Item Sinonasal Outcomes Test (SNOT-22), University of Pennsylvania Smell Identification Test (UPSIT), and the Assessment of Self-reported Olfactory Functioning (ASOF), which has three domains: subjective olfactory capability scale (SOC), smell-related problems (SRP), and olfactory-related quality of life (ORQ). Results Median age at surgery was 52.5 years, with a median tumor size of 1.8 cm (range: 0.2 to 3.9 cm). Pre- and postoperative median scores were 35 [34, 36.2] and 34.5 [32, 36] for UPSIT, 21 [7.5, 33.5] and 21.5 [6.8, 35.7] for SNOT-22, 10 [9, 10] and 9 [8, 10] for ASOF-SOC, 5 [4.8, 5] and 4.5 [4, 5] for ASOF-SRP, and 5 [5, 5] and 5 [4.5, 5] for ASOF-ORQ. There was no significant change in the two of the three domains of the ASOF. Correlation between ASOF and UPSIT scores were weak. Older age and larger tumor size were associated with worsened olfaction after surgery. Conclusions Patients did not experience significant changes in olfactory-specific QOL three months after EESBS, as measured by two domains of the ASOF. The ASOF may serve as a useful adjunctive tool for assessing olfaction after surgery. The lack of correlation between UPSIT and ASOF suggests the need for more research in subjective olfactory-related quality of life after surgery.
Autonomy supportive and controlling leadership as antecedents of work design and employee well-being
Authors: Sarmah Pallavi , Van den Broeck Anja , Schreurs Bert , Proost Karin , Germeys Filip 
Published: October 2021

The continuation of work that undermines employee well-being necessitates an investigation into the antecedents of work design. Therefore, we examined how autonomy supportive and controlling leadership—as defined in self-determination theory (SDT)—relate to employees’ job resources, job demands, and well-being. Using a cross-sectional ( N = 501) and a daily diary study ( N = 123), we found that autonomy supportive leadership relates to employees’ work engagement via job resources both at the between- and within-person levels. However, only the cross-sectional study evidenced a relationship between autonomy supportive leadership and exhaustion via job resources. Controlling leadership related to exhaustion via job demands at the between-person level in both studies but not at the within-person level. Alongside implications for the literature on SDT, work design theory, the leadership literature, and workplace re-enchantment, we advance concomitant insights to practitioners. JEL CLASSIFICATION: I31, J81, M12
Motivational Interviewing Confidence and Perceived Competence Among Undergraduate and Graduate Dietetics Students
Authors: Savoie-Roskos Mateja R. , Brown Katie N. 
Published: October 2021

BACKGROUND Motivational interviewing (MI) aligns with the scope of practice and competency standards for Registered Dietitian Nutritionists; however, few dietitians receive adequate training. Furthermore, little is known about MI training within dietetics curricula. OBJECTIVE The objective of this study was to determine differences in undergraduate and graduate-level dietetics students’ confidence and perceived competence before/after taking a MI course. METHODS A 38-item pre–postsurvey was completed by students enrolled in a Basic and Advanced MI course at Utah State University. The survey included demographic questions and questions related to confidence and perceived competence using MI techniques. Paired t-tests were used to compare pre/post results and analysis of variance was used to compare groups. RESULTS Increased confidence and perceived competence were observed for Basic MI students (n = 72) ( P < .0001) and Advanced MI students (n = 32) ( P < .0001) after course completion. In the presurvey, Advanced MI students had higher confidence in 5 of 14 MI skills, higher competence in 2 of 11 MI skills, and higher overall MI competence scores ( P = .008) than Basic MI students. Following completion of the course, Advanced MI students had higher overall MI confidence scores ( P = .03). CONCLUSIONS Students’ confidence and perceived competence with using MI increased after taking a college-level MI course. Incorporating MI courses into dietetics curricula may be an effective way to increase confidence and perceived competence of using MI techniques and therefore improving communication between dietitians and patients.
Evaluating Prospective Patient-Reported Pain and Function Outcomes After Ankle and Hindfoot Arthrodesis
Authors: Mehta Manish P. , Mehta Mitesh P. , Sherman Alain E. , Mutawakkil Muhammad Y. , Bell Raheem , Patel Milap S. , Kadakia Anish R. 
Published: October 2021

Background: Hindfoot and ankle fusions are mechanically limiting procedures for patients. However, patient-reported outcomes of these procedures have not been well studied. This study assessed outcomes of hindfoot and ankle fusions by using Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function (PF) and Pain Interference (PI) Computer Adaptive Tests (CATs). Methods: Between 2014 and 2018, 102 patients were prospectively enrolled after presenting to a tertiary care facility for ankle and hindfoot fusions, including tibiotalar, tibiotalocalcaneal, subtalar, and triple arthrodeses. Study participants completed preoperative and 12-month postoperative PF and PI CATs. The differences between mean 12-month postoperative and preoperative PROMIS PF and PI T scores were analyzed with paired t tests. The relationship between the 12-month PF and PI differences for the overall sample and patient factors was examined using multiple regression modeling. Results: The sample had mean age of 57.69 years; 48% were male, and 55% were obese. Patients who underwent ankle and hindfoot arthrodesis had statistically significant improvements from preoperative to 12 months postoperative in mean PF (36.26±7.85 vs 39.38±6.46, P = .03) and PI (61.07±7.75 vs 56.62±9.81, P = .02). Triple arthrodesis saw the greatest increases in physical function (▵PF = 7.22±7.31, P = .01) and reductions in pain (▵PI = –9.17±8.31, P = .01), achieving minimal clinically important difference (MCID). Patients who underwent tibiotalar fusion had significant improvement in physical function (▵PF = 4.18±5.68, P = .04) and pain reduction that approached statistical significance (▵PI = –6.24±8.50, P = .09), achieving MCID. Older age (≥60 years ) was associated with greater improvements in PF ( β = 0.20, P = .07) and PI ( β = –0.29, P = .04). Preoperative PF and PI T scores were significantly associated with the 12-month change in PF and PI T scores, respectively ( β = –0.74, P < .01; β = –0.61, P < .01). Conclusion: Hindfoot and ankle fusions are procedures with favorable patient outcomes leading to increased physical function and decreased pain at 12 months postoperation relative to preoperation. Level of Evidence: Level II, prospective comparative study.
Six-Minute Walk Test in Individuals With Unilateral Lower Limb Amputations
Authors: Younesian Hananeh , Ouellet Raphaël , Legrand Thomas , Turcot Katia 
Published: October 2021

Background: The 6-minute walk test (6MWT) is one of the common clinical tests to assess rehabilitation progress and needs in individuals with lower-limb amputation (iLLAs). However, the analysis of this test is mostly limited to the distance parameter. The first aim was to investigate effort intensity and spatiotemporal parameters of 6MWT in iLLAs using inertial measurement units (IMUs) and heart rate (HR) monitor, and second, to assess physical, physiological, and pain-related aspects of fatigue over 6MWT. Methods: Eleven unilateral iLLAs (57.91±15.63 years old) participated in this study. To evaluate HR and spatiotemporal parameters over 6MWT, data were classified using 6 intervals of 1 minute each (I1-I6). The pain level of participants was estimated using the visual analog scale (VAS). Results: Our results showed that the means of normalized HR gradually increased over 6MWT (I1: 61.59±10.73 HRmax%, I6: 70.15±12.26 HRmax%, P = .003). Variability of HR during the first interval of 6MWT was higher than the others ( P < .05). The stance ratio of the gait cycle increased over 6MWT ( P < .05). Cadence and speed decreased over 6MWT ( P < .05). VAS score after 6MWT was significantly higher than before 6MWT ( P = .016). Conclusion: In this preliminary study, effort intensity over 6MWT gradually increased because of enhancement of HR. Deterioration of speed and cadence and enhancement of stance ratio over 6MWT imply potential physical aspects of fatigue and instability. Level of Evidence: Level III, retrospective comparative study.
Serial Intralesional Steroid Injection for Subglottic Stenosis: Systemic Side Effects and Impact on Surgery‐Free Interval
Authors: Neevel Andrew J. , Schuman Ari D. , Morrison Robert J. , Hogikyan Norman D. , Kupfer Robbi A. 
Published: October 2021

ObjectivesIn‐office serial intralesional steroid injections (SILSIs) have become a commonly used treatment for subglottic stenosis. We characterized the impact of SILSIs on the time between operating room visits and incidence of glucocorticoid systemic side effects.Study DesignRetrospective case series.SettingAcademic tertiary care center.MethodsAll patients with subglottic stenosis receiving SILSIs at 1 institution from 2016 to 2020 were included. Surgery‐free interval was compared using paired t tests. Side effect incidence was calculated with Kaplan‐Meier methodology for visualization.ResultsNineteen patients and 207 procedures were included. The majority of patients were White (95%) and female (95%) and had idiopathic subglottic stenosis (53%). Mean surgery‐free interval for all patients was 8.7 months (95% CI, 5.6‐11.8) before initiating SILSIs. Of 11 patients with calculable surgery‐free interval, 10 experienced improvement, with a mean surgery‐free interval increase of 4.6 months (95% CI, 2.4‐6.7). Seven patients have not required surgery since initiation of SILSIs, with a mean follow‐up time of 28 months (95% CI, 25‐31). Noncutaneous systemic side effects occurred at a mean 3.2 months (95% CI, 2.4‐4.0) from first injection and included Cushing’s syndrome, increased intraocular pressure, central serous chorioretinopathy, and new insulin requirement in the setting of diabetes.ConclusionsNinety‐one percent of patients who initiated SILSIs and had a subsequent return to the operating room experienced a mean 4.6‐month increase in surgery‐free interval. Systemic side effects of glucocorticoids occurred in 32% of patients after initiating SILSIs. This should be considered in preprocedure counseling and side effect monitoring during treatment.