bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autistic adults’ subjective experiences of hoarding and self-injurious behaviors
Authors: Goldfarb Yael , Zafrani Osnat , Hedley Darren , Yaari Maya , Gal Eynat 
Published: February 2021

Restrictive and Repetitive Behaviors and Interests represent a core feature of autism since the earliest conceptualization of the condition. Related behaviors, such as hoarding and self-injurious behaviors, are under-researched in adulthood, resulting in limited knowledge about their various manifestation through the life span. This study expands our understanding of hoarding and self-injurious behaviors through subjective experiences shared by autistic adults. Ten adults with an autism diagnosis (aged 18–55 years, five females) participated in semi-structured, in-depth interviews. Thematic analysis identified a cluster of behaviors related to hoarding and self-injurious behaviors. Further analysis sub-categorized each theme according to the underlying purpose of the behavior. Hoarding behaviors were motivated by (1) a need for emotional aids, (2) disposing difficulties, and (3) collecting items related to special interests. Reasons for engaging in self-injurious behaviors were (1) an urge for sensory stimulation and (2) emotional regulation purposes. Discussion focuses on the underlying motives of the participants for engaging in these behaviors, in respect to current research knowledge. Relations to the general construct of Restrictive and Repetitive Behaviors and Interests are discussed along with implications for research and practice. Lay abstract Hoarding and self-injurious behaviors are relatively common in autism, but knowledge about their expressions in adulthood is scarce. Through interviews collecting subjective experiences of autistic adults, these behaviors were explored, and categorized to their underlying purposes. Findings portray the occurrence of these behaviors in the lives of autistic adults, their self-regulatory purposes, and their relationship to other behaviors in the domain of Restrictive and Repetitive Behaviors and Interests.
Sprint performance and force-velocity profiling does not differ between artificial turf and concrete
Authors: Shahab Samad , Steendahl Ida B , Ruf Ludwig , Meyer Tim , Van Hooren Bas 
Published: February 2021

Purpose Force-velocity-power (F-v-P) profiling can illustrate an individual’s sprinting capabilities, but no study has explored the effect of different running surfaces on F-v-P outcomes. Method Twelve elite youth football players (age 16.3 ± 0.5 years, mass 67.3 ± 5.4 kg, height 176.2 ± 4.6 cm) performed two 30 m sprints on concrete and artificial turf in a randomised order on two testing days. Differences between surfaces were determined using repeated-measures ANOVA (P < 0.05), whilst the coefficient of variation (CV), smallest worthwhile change and standard error of measurement were calculated to quantify reliability. Results No significant differences were found between surfaces over the average of two days. High reliability was evident for 30 m sprint time, theoretical maximum horizontal velocity and ratio of force on both surfaces (CV≤∼5%), while the remaining outputs were not reliable (CV >10%). Conclusion These findings show that F-v-P profiling does not differ between concrete and artificial turf. However, higher variability on the more unfamiliar concrete surface suggests that the testing surface should match the playing surface. Since the standard error of measurement is larger than the smallest worthwhile change, the ability of this method to monitor seasonal changes may be limited in youth elite soccer players.
High-dose tamoxifen in high-hormone-receptor-expressing advanced breast cancer patients: a phase II pilot study
Authors: Su Yanhong , Zhang Yarui , Hua Xin , Huang Jiajia , Bi Xiwen , Xia Wen , Wang Xinyue , Huang Zhangzan , Song Chenge , Zhong Yongyi , Shi Yanxia , Wang Shusen ,   South China Breast Cancer Group (SCBCG), Fan Wei , Yuan Zhongyu 
Published: February 2021

Background: Tumor progression following endocrine therapy is considered to indicate resistance to endocrine drugs due to a variety of mechanisms. An insufficient dose of endocrine drugs is one of the causes for treatment failure in some patients with high hormone-receptor (HR)-expressing advanced breast cancer. This study aimed to explore the efficacy of high-dose tamoxifen (TAM) treatment in patients with advanced breast cancer with highly expressed HR. Materials & methods: This was a single-arm, phase II pilot study that enrolled patients with advanced breast cancer with high HR expression (estrogen receptor ⩾60% and/or progesterone receptor ⩾60%) following routine endocrine therapy. All enrolled patients received a high-dose of TAM (100 mg/day) until disease progression. The primary endpoint was progression-free survival (PFS). The secondary endpoints included objective response rate (ORR), clinical benefit rate (CBR), overall survival (OS), and safety. Exploratory endpoints included the predictive value of 16α-18F-17β-fluoroestradiol quantitative positron emission tomography/computed tomography (18F-FES PET/CT) for treatment efficacy. Results: A total of 30 patients were enrolled between September 2017 and February 2019. The median PFS was 6 months [95% confidence interval (CI) 4.9–7.1] and the median OS was 15.6 months (95% CI 8.3–22.9). Five patients experienced a partial response (PR) and none experienced a complete response (CR), with an ORR of 16.7% and CBR of 33.3%. No severe adverse events were observed. Lesions with 18F-FES maximum standardized uptake value (SUVmax) ⩾4 had a significantly longer PFS [median 9.2 months, (95% CI 6.9–11.6)] compared with lesions with a 18F-FES SUVmax <4 [median 4.8 months, (95% CI 3.9–5.6); p = 0.022]. Conclusion: A high-dose of TAM is effective and safe for patients with advanced breast cancer with high HR expression. 18F-FES SUVmax values may predict the local clinical benefits of high-dose TAM . Trial Registration: [ClinicalTrials.gov identifier: NCT0304565]
Effect of DASH Diet Versus Healthy Dietary Advice on the Estimated Atherosclerotic Cardiovascular Disease Risk
Authors: Said Marwa S. , El Sayed Inas T. , Ibrahim Eman E. , Khafagy Ghada M. 
Published: February 2021

Introduction: Cardiovascular disease (CVD) is the most leading cause of mortality worldwide. Changes in diet can reduce subclinical cardiac injury and inflammation in parallel with reductions of other CVD risk factors. Aim: The study aimed to evaluate the beneficial effect of the DASH diet versus usual healthy dietary advice (HDA) on the estimated risk of atherosclerotic cardiovascular disease (ASCVD). Methods: It was a prospective interventional nonrandomized controlled study, conducted on 92 participants attending Family Medicine Outpatient Clinics, Cairo University. The participants were assigned to 2 dietary groups, the DASH and HDA groups, for 12 weeks. All subjects were subjected to anthropometric measurement, assessment of lipid profile, and the estimated cardiovascular risk pre-and post-intervention. Results: The estimated cardiovascular risk was reduced significantly in both the DASH and HDA groups, with no statistically significant difference between the 2 groups regarding the risk reduction. By comparing the percent change between pre and post-intervention in both DASH and HDA groups, the following are the results: BMI dropped by 6.5% versus 2.5%, systolic blood pressure decreased by 6.9% and 4.1%, fasting blood sugar dropped by 5.5% and 3.1%, total cholesterol dropped by 5.2% and 3.1%, LDL dropped by 8.2%, and 3.1%, and HDL increased by 8.2% and 2.4%, in DASH and HDA groups, respectively. Conclusion: Both the DASH diet and HDA are associated with improvement in CVD risk factors. Although better risk factors decline with the DASH diet, there was no statistically significant difference between the 2 groups.
Prior Admissions as a Risk Factor for Readmission in Patients Surgically Treated for Femur Fractures: Implications for a Potential Hip Fracture Bundle
Authors: Erlichman Robert , Kolodychuk Nicholas , Gabra Joseph N. , Dudipala Harshitha , Maxhimer Brook , DiNicola Nicholas , Elias John J. 
Published: February 2021

Introduction: Hip fractures are a significant economic burden to our healthcare system. As there have been efforts made to create an alternative payment model for hip fracture care, it will be imperative to risk-stratify reimbursement for these medically comorbid patients. We hypothesized that patients readmitted to the hospital within 90 days would be more likely to have a recent previous hospital admission, prior to their injury. Patients with a recent prior admission could therefore be considered higher risk for readmission and increased cost. Methods: A retrospective chart review identified 598 patients who underwent surgical fixation of a hip or femur fracture. Data on readmissions within 90 days of surgical procedure and previous admissions in the year prior to injury resulting in surgical procedure were collected. Logistic regression analysis was used to determine if recent prior admission had increased risk of 90-day readmission. A subgroup analysis of geriatric hip fractures and of readmitted patients were also performed. Results: Having a prior admission within one year was significantly associated (p < 0.0001) for 90-day readmission. Specifically, logistic regression analysis revealed that a prior admission was significantly associated with 90-day readmission with an odds ratio of 7.2 (95% CI: 4.8-10.9). Discussion: This patient population has a high rate of prior hospital admissions, and these prior admissions were predictive of 90-day readmission. Alternative payment models that include penalties for readmissions or fail to apply robust risk stratification may unjustly penalize hospital systems which care for more medically complex patients. Conclusions: Hip fracture patients with a recent prior admission to the hospital are at an increased risk for 90-day readmission. This information should be considered as alternative payment models are developed for hip fracture care.
Tibia vara in Asians: Myth or fact? Verification with three-dimensional computed tomography
Authors: Ho Jade Pei Yuik , Merican Azhar Mahmood , Ayob Khairul Anwar , Sulaiman Shahrul-Hisham , Hashim Muhammad Sufian 
Published: February 2021

Background: There is a common perception among surgeons that Asian tibiae are significantly more varus compared to non-Asians, contributed both by an acute medial tibial proximal angle (MPTA) and diaphyseal bowing. Insight into the normative morphology of the tibia allows generation of knowledge towards disease processes and subsequently planning for corrective surgeries. Methods: Computed tomography (CT) scans of 100 normal adult knees, aged 18 years and above, were analysed using a 3-dimensional (3D) analysis software. All tibiae were first aligned to a standard frame of reference and then rotationally aligned to the tibial centroid axis (TCAx) and the transmalleolar axis (tmAx). MPTA was measured from best-fit planes on the surface of the proximal tibia for each rotational alignment. Diaphyseal bowing was assessed by dividing the shaft to three equal portions and establishing the angle between the proximal and distal segments. Results: The mean MPTA was 87.0° ± 2.2° (mean ± SD) when rotationally aligned to TCAx and 91.6° ± 2.7° when aligned to tmAx. The mean diaphyseal bowing was 0.1° ± 1.9° varus when rotationally aligned to TCAx and 0.3° ± 1.6° valgus when aligned to tmAx. The mean difference when the MPTA was measured with two different rotational alignments (TCAx and tmAx) was 4.6° ± 2.3°. No statistically significant differences were observed between males and females. Post hoc tests revealed statistically significant difference in MPTA between different ethnic sub-groups. Conclusion: The morphology of the proximal tibiae in the disease-free Asian knee is inherently varus but not more so than other reported populations. The varus profile is contributed by the MPTA, with negligible diaphyseal bowing. These implications are relevant to surgical planning and prosthesis design.
The Recenter: an augmented Bankart. Results with a minimum follow-up of 2 years
Authors: Picard Kevin , Werthel Jean-David , Toussaint Bruno , Bauer Thomas , Hardy Alexandre 
Published: February 2021

Objectives: The objective was to evaluate the clinical results of a new surgical technique to improve the Bankart repair by adding a prosthetic block called the Recenter. Methods: Thirty-two patients were retrospectively included in this multicenter study. Five patients were lost to follow-up. The surgical indications were similar to those for a standard Bankart repair. A metal implant called a Recenter was inserted in the anterior inferior glenoid and fixed with two TightRopes. A Bankart repair was then performed over the implant. All the patients had a follow-up CT scan and a clinical examination. The mean follow-up period was 37 months (29-47). The mean ISIS score was 2.42 (0-6). Results: Twenty-six patients aged 33.9 ± 10.2 (16-50) years were included. Patients presented with an average of 2.4 ± 3.2 (0-12) true dislocations prior to surgery and 6.1 ± 8.5 (0-30) subluxations. The time that had elapsed between the occurrence of the first symptoms and surgery was 6.8 ± 6.9 years. The last follow-up showed a residual VAS score of 1.3. The mean Walch-Duplay score was 78.9 ± 21.4 - SD (range 5-100), the mean ROWE score, 88.5 ± 15.9 - SD (30-100) and the mean SST score, 90.6 ± 14.5 - SD (41.6-100). 77.8% of the patients (n=21) had no apprehension, 11.1% (n=3) were apprehensive, 7.4% (n=2) were afraid of the possibility of luxation and 3.7% (n=1) had a recurrence. In terms of satisfaction, 59.3% were very satisfied, 33.3% satisfied and 7.4% dissatisfied with their operation. Concerning the CT study, we found no shifting of material or ballooning of the TightRope tunnels. Conclusion: The Recenter showed a recurrence rate of 4% (1 patient) with an average follow-up of 3 years. Despite a small number of patients, the Recenter appears to be a worthwhile addition to the arthroscopic Bankart technique.
Discoid lateral meniscus instability in children. Part I - Clinical presentation of instability combined with MRI and arthroscopic findings
Authors: Vandergugten Simon , Bauwens Paul-Henri , Fiquet Charles , Raux Sebastien , Chotel Franck 
Published: February 2021

Objectives: The initial clinical presentation of the discoid lateral meniscus (DLM) in children is highly variable and can be difficult to assess. The aim of this study was to focus on the meniscal instability associated with DLM and to correlate clinical, MRI and arthroscopic data. Methods: Between 2008 and 2018, 93 children and adolescents with 114 DLMs who underwent surgery in a referral center were included. Based on the anamnesis and clinical data, three types of meniscal instability of increasing severity were defined: occasional ("lock"), regular ("clock") and permanent ("block") instability. These findings were correlated with preoperative MRI data and arthroscopic findings according to Ahn’s classification, and as a result we were able to propose a DLM classification based on clinical or MRI data or both combined. Results: A wide variety of presentations was noted with 18 different types when clinical, MRI and arthroscopic characteristics were combined. 94% of the symptomatic DLMs for which surgery was performed showed instability due to meniscocapsular separation. Clinically, there were "lock", "clock" and "block" instability in 2%, 50% and 31% of DLMs respectively. Preoperative MRI indicated no meniscal shift and an anterocentral, posterocentral or central shift in 41%, 9%, 22% and 28% of the DLMs, respectively. Arthroscopic findings indicated no lesions, or an MC-A, MC-P or PLC type lesion in 6%, 46%, 15% and 33% of DLMs respectively. The most frequent presentations were “clocked” knees with MC-A lesions and “blocked” knees with PLC lesions. Only in 60% of the cases was a good level of correspondence noted between the different data. Conclusion: The association of meniscal instability and symptomatic DLM in children should be accepted as a certainty. “Locked”, “clocked” and “blocked” knees could represent different stages of increasing severity in the natural history of DLM instability.
The use of ultrasound during Anterolateral Ligament (ALL) reconstruction improves femoral positioning
Authors: Cavaignac Etienne , Mouarbes Dany , Castoldi Marie , Berard Emilie , Nicolas Reina 
Published: February 2021

Objectives: We developed a minimally invasive technique for ALL reconstruction with the gracilis tendon folded in two strands. This is done by palpating the bone contours or under ultrasound control. Our hypothesis is that ultrasound control improves the positioning of the graft. Methods: We conducted a prospective controlled before-after study. All the patients who had an anatomical ALL reconstruction surgery were included. Patients for whom the postoperative control radiographs of a strict cross-section of the knee did not meet the quality criteria were excluded. The first 60 patients included were palpated for lateral epicondyle location, and for the next 60 patients ultrasound was used. The primary endpoint was the distance measured along an antero-posterior and proximo-distal axis between the graft insertion point and the theoretical ALL insertion point. The comparative analysis was carried out by student’s t-test. We determined the number of subjects to be included at 60 per group by assuming a minimum of 90% of grafts ≤5 mm in the "US" group versus 50% in the "palpation" group. Results: 120 patients were included in 2 groups of 60 (US vs. palpation) with no statistical difference. The mean anteroposterior distance between the theoretical point and the point identified in the palpation group was 6.3 mm (+/- 2.4) and 1.2 mm (+/- 1.1) in the ultrasound group (p<0.001). Conclusion: Our hypothesis was confirmed. Ultrasound control improves the positioning of the ALL graft.
Should postoperative thromboprophylaxis be used after anterior cruciate ligament reconstruction?
Authors: Iniguez Xavier Bayle , Cassard Xavier , Vinciguerra Bruno , Murgier Jérôme 
Published: February 2021

Objectives: Anterior cruciate ligament (ACL) reconstruction is the ligament surgery that is performed most often in France. The French Society of Anesthesia-Resuscitation (SFAR) recommends systematic thromboprophylaxis in the postoperative period. The objective of this study was to evaluate the incidence of symptomatic phlebitis after ACL reconstruction. The hypothesis was that it is the same with or without thromboprophylaxis. Methods: This was a retrospective multicentric, multi-operator, case control study. Of the four operators concerned, two did not prescribe postoperative thromboprophylaxis except in special cases (major risk factors) and two prescribed low molecular weight heparin for ten days. All patients who underwent primary ACL reconstruction surgery between 1 July 2018 and 15 February 2020 were followed up by telephone within a minimum of 3 months. All follow-up letters were also consulted to cross-check information. All patients with a history of thromboembolic events (TE) or those who had undergone multiple ligament surgery were excluded. Results: 249 patients were re-contacted in the anticoagulant free group and 221 in the anticoagulant group. The 2 groups were similar. The mean age was 29 years. 60% were male. There were 2 cases of phlebitis in each group. The initial hypothesis was therefore confirmed with an equivalent incidence of symptomatic phlebitis with or without postoperative anticoagulation. In fact, the incidence of symptomatic TE reported with or without thromboprophylaxis in the different Swedish, American and English registries varied from 0.2 to 0.5%, whereas in studies to identify asymptomatic TE, the incidence was 9 to 14%. Our study has some limitations, notably due to the retrospective nature and the absence of ultrasound analysis. However, loss of information is low given that the study is recent and considering the study population. Furthermore, we identified no risk factors. Conclusion: The incidence of symptomatic phlebitis after ACL reconstruction is equivalent with or without thromboprophylaxis. This raises the question of the need for postoperative thromboprophylaxis, particularly in patients without risk factors. National recommendations could be made based on these findings and those in the international literature.
The stability of outcomes of cancellous autografts with acellular membrane for extended osteochondritis of the knee. Outcomes for 22 AMIC® grafts at an average follow-up of 4 years
Authors: Pauvert Adrien , Chainard Caroline Vincelot , Buisson Xavier , Robert Henri 
Published: February 2021

Objectives: Loss of osteochondral substances resulting from osteochondritis dissecans (OCD) of the knee are arthrogenic in the long term. When they exceed 2 cm2, the Autologous Matrix Induced Chondrogenesis (AMIC®) technique is one of the methods used in France. The objective of this study was to evaluate the medium-term results of the AMIC® technique. Methods: This was a consecutive, prospective, single-center, single-operator series of 22 patients (13 men, 9 women, mean age 28 years (15-51)) treated by AMIC® (spongy bone graft + sutured collagen membrane) between September 2011 and November 2016. Previous surgery had been performed on 17 patients. According to the ICRS classification, the lesion was stage IV in 21 cases and stage III in 1 case. The sites were: condylar: 19 cases, patellar: 2 cases and trochlear: 1 case. The mean surface area was 3.6 cm2 (2-8) and the depth was 0.5 mm (0.4-0.8). All the patients were functionally assessed by an independent examiner using validated functional scores for these indications (KOOS, subjective IKDC). Student’s T tests were used. Results: At a mean follow-up of 4 years (minimum 2 years) all but 2 patients had significantly improved (In preop. IKDC: 44±14 and KOOS: 56±17). In these 2 cases, the postoperative scores remained unchanged over the years: one patient had had several surgeries before the graft and a 51-year-old female patient had an extensive lesion of 6.9 cm2. The mean IKDC and KOOS scores were 73±18 and 78±15 and then 77±16 and 81±14 respectively, at 1 and 4 years (p> 0.05 for IKDC and KOOS). Regrettably there were 2 complications: 1 arthrolysis 1 year after surgery and 1 algodystrophy. Conclusion: Few techniques are available in France for extensive symptomatic osteochondral lesions. AMIC® is a reliable, one-step, reproducible, inexpensive technique for loss of substance due to OCD with stable results as of 1 year after surgery.
Knowledge-Behavior Gap on COVID-19 among Older People in Rural Thailand
Authors: Vicerra Paolo Miguel Manalang 
Published: February 2021

This study analyzed the difference between rural and urban older adults in Thailand regarding the relationship between the knowledge and behavior toward the prevention of contracting COVID-19. Path analysis was used to observe if the performance of protective behaviors was affected by the level of knowledge that older people have about the disease. This study used the Impact of COVID-19 on Older Persons in Thailand survey collected across the five regions of the country. Rural residents benefited from community network of village health volunteers who provided information during the pandemic but, they had disadvantages on accessing newer media sources, mainly the internet, for the latest developments on COVID-19. Rural older adults had a higher level of knowledge about COVID-19 than those in urban areas; no difference was observed regarding their behavior to prevent themselves from being infected. The knowledge-behavior gap was viewed as a mechanism of cognitive avoidance because of overwhelming unprecedented information.