bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Angiographic Dissection Classification Systems in the Femoropopliteal Arteries Using IVUS Validation and Reliability Testing
Authors: Allan Richard Barry , Wise Nadia Clare , Wong Yew Toh , Delaney Christopher Luke 
Published: October 2021

Purpose: Objective assessment of dissection severity is difficult. Recognition of this has led to the creation of classification systems. This study investigated the performance of the National Heart Lung and Blood Institute (NHLBI) and Kobayashi systems at differentiating severity of femoropopliteal dissection using intravascular ultrasound (IVUS) as the reference standard. Comparison between the 2 systems and the inter- and intra-observer reliability were also investigated. Materials and Methods: Angiographic and IVUS imaging was assessed in 51 cases sourced from a RCT investigating the use of IVUS in femoropopliteal disease. A total of 2 readers independently scored the angiography images according to NHLBI and Kobayashi dissection classification systems and a consensus score was obtained for each system in each case. The NHLBI classification was condensed into 3 grades of dissection to allow comparison between systems. Dissection length, dissection arc, minimum lumen area, and lumen area stenosis were obtained from the IVUS imaging. IVUS parameters were compared between grades of severity for both systems. Agreement in grading between the systems was assessed and IVUS parameters for each level of dissection severity were compared between systems. Inter and intra-observer agreement tested for each system. Results: Dissection was present on IVUS in 92.2% (47/51) of cases and angiography identified 78.7% (37/47) of these. No difference was present in any IVUS parameters between mild and severe dissections with either classification system. No difference in IVUS findings was present for the same grades of dissection between systems. The 2 systems agreed on severity grade in 47 of 51 cases. The inter-observer agreement was for NHLBI was k=0.549 and k=0.627 for Kobayashi. Intra-observer agreement for NHLBI was k=0.633 and k=0.633 and for Kobayashi was k=0.657 and k=0.297. Conclusion: The lack of difference in IVUS parameters between mild and severe dissection for the NHLBI and Kobayashi systems raises doubts about their ability to effectively differentiate dissection severity. Weak to moderate reliability suggests that variability in interpreting dissection may be higher than acceptable. IVUS imaging is more sensitive for detecting dissection than angiography and research is required to establish the value of adding IVUS to dissection classification systems.
Olivopontocerebellar degeneration associated with 3-hydroxy-3-methylglutaric aciduria in a domestic shorthair cat
Authors: West Natalie , Matiasek Kaspar , Rusbridge Clare 
Published: October 2021

Case summary A rescue charity-owned 6-month-old neutered female domestic shorthair cat was presented with progressive tetraparesis, increased extensor muscle tone and signs of spinocerebellar ataxia, including hypermetria. The cat’s male sibling, with similar progressive neurological signs, had been euthanased 2 months previously. An inherited metabolic disorder was suspected. Urine for determination of organic acid concentration was obtained and the cat was prescribed carnitine and taurine supplementation. The cat was euthanased 3 months later following progressive neurological signs, including ataxia, tetraparesis, tendency to fall, bilateral absent menace response and intention tremor. A selective post-mortem examination was obtained, taking samples from the brain, cervical spinal cord, tibial branch of the sciatic nerve, muscle, liver and kidneys. Organic acid analysis results received after euthanasia revealed a marked elevation of 3-hydroxy-3-methylglutaric acid (45 mmol/mol creatine [normal range 0–2]) and isovalerylglycine (27 mmol/mol creatinine [normal range 0–2]). 3-Hydroxy-3-methylglutaric acid was deemed clinically relevant as it is a metabolite of 3-hydroxy-3-methylglutaryl-CoA lyase, the enzyme involved in the final step of leucine degradation. Post-mortem examination revealed diffuse, chronic-active, severe olivoponto-(spino)-cerebellar degeneration. Relevance and novel information This is the first report of 3-hydroxy-3-methylglutaric aciduria in the veterinary literature and the first description of the neuropathology of this disorder in any species. 3-Hydroxy-3-methylglutaric aciduria in humans occurs rarely and is due to a deficiency in 3-hydroxy-3-methylglutaryl-coenzyme A lyase.
Minimally invasive spinal surgery in a young cat with vertebral hypertrophy
Authors: Sakamoto Karin , Nozue Yuta , Murakami Mami , Nakata Kohei , Nakano Yukiko , Soga Shinya , Maeda Sadatoshi , Kamishina Hiroaki 
Published: October 2021

Case summary A 2-year-old neutered female Scottish Fold cat was presented with an 8-week history of progressive back pain, paraparesis and decrease of postural reactions in both pelvic limbs. MRI showed spinal cord compression from both ventral sides, which originated from the T4 vertebral body and pedicle. The lesion compressing the spinal cord had a bone-like density on CT, and endoscopic surgery was performed to excise it. Histopathological examination of the resected tissue showed no evidence of malignancy and the lesion was diagnosed as vertebral hypertrophy. After surgery, the neurological status of the cat gradually improved. The cat was ambulant at the follow-up evaluation 2 weeks after surgery. Six months later, hindlimb paresis had improved considerably, and no recurrence was observed on CT. Relevance and novel information This is the first description of thoracic vertebral canal stenosis due to hypertrophy of a single vertebra in a young cat. Excision of the hypertrophic vertebra by endoscopic surgery is less invasive than open surgery and may give a good prognosis.
Spinal ectopic choroid plexus papilloma in a cat
Authors: Tabanez Joana , Beck Samuel , Driver Colin , Rusbridge Clare 
Published: October 2021

Case summary A 10-year-old male neutered Russian Blue cat was presented with a 2-month history of progressive non-ambulatory paraparesis. Spinal MRI revealed a well-demarcated, compressive intradural extramedullary mass at the level of T1 vertebra. The mass had subtle hyperintensity on T2-weighted images, was isointense on T1-weighted images and had diffuse, marked enhancement following gadolinium administration. Neuroaxis MRI, including limited brain sequences, excluded other visible lesions. Thoracic and abdominal radiographs were unremarkable. The mass was resected via a dorsal C7–T2 laminectomy and durotomy. Histopathology revealed a neoplasm composed of columnar-to-polygonal cells forming bilayered palisading patterns with a few apical cilia. Three mitoses were noted in 10 high-power fields. This was consistent with an epithelial neoplasm and initially a metastatic adenocarcinoma was considered most likely. Full-body CT with contrast and including the brain found rhinitis but did not identify any additional neoplastic foci. Biopsies of the nasal cavity and fine-needle aspiration of the spleen and liver were unremarkable. On immunohistochemical evaluation, pan-cytokeratin and E-cadherin immunolabelling was observed; however, synaptophysin, thyroglobulin, chromogranin A and glial fibrillary acidic protein was not detected. This, along with the histological morphology and absence of a primary tumour, was compatible with an ectopic choroid plexus neoplasm. Follow-up performed at 3, 14 and 24 months postoperatively revealed neurological improvement without recurrence. Relevance and novel information We describe the presentation, histopathological and immunohistochemical features and outcome of a case of a rare ectopic choroid plexus neoplasm in the spinal cord of a cat.
Clinical presentation, MRI, histopathology and outcome in a cat with immune-mediated masticatory myositis
Authors: Armellini Marco , Sánchez Lluís , Lorek Andrea , Shelton G Diane , De Risio Luisa 
Published: October 2021

Case summary A 4-year-old female spayed domestic shorthair cat was presented with facial swelling, ocular discharge and intermittent bilateral exophthalmos. Haematology revealed mild eosinophilia. Serum biochemistry showed a markedly elevated creatine kinase activity. MRI of the head revealed diffuse and severe changes of the masticatory muscles, including irregular areas compatible with fluid or necrosis within the abnormal muscle tissue. Cytological analysis of the left temporal muscle revealed eosinophilic and macrophagic inflammation. Bacterial and fungal cultures were negative. Serological titres against Toxoplasma gondii were compatible with previous exposure. A canine ELISA against masticatory muscle type IIM fibre proteins was positive at 1:4000 (reference interval <1:100). Histopathological examination of the left temporalis muscle revealed moderately severe and multifocal myositis. A diagnosis of immune-mediated masticatory myositis was made and immunosuppressive therapy was started. The cat initially responded to tapering doses of prednisolone, but subsequent relapses required therapy modulation. At the time of writing, 27 months after the initial diagnosis, the cat was in remission, but was diagnosed with diabetes mellitus, probably secondary to chronic glucocorticoid use. Relevance and novel information To our knowledge, this is the first case report to describe the MRI appearance of masticatory myositis in a cat and the second to describe the clinical presentation, histopathology, response to treatment and outcome in a cat with this condition.
Minimal Clinically Important Difference and Patient Acceptable Symptom State in Patients With Knee Osteoarthritis Treated With PRP Injection
Authors: Boffa Angelo , Andriolo Luca , Franceschini Marco , Di Martino Alessandro , Asunis Emanuela , Grassi Alberto , Zaffagnini Stefano , Filardo Giuseppe 
Published: October 2021

Background: Although several injection-based treatments have been proposed to address knee osteoarthritis (OA), it is often difficult to understand the clinical relevance of the obtained results. The psychometric measures of minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) were developed to better interpret study findings. Purpose: To establish the MCID and the PASS for the International Knee Documentation Committee (IKDC) Subjective score and the Knee injury and Osteoarthritis Outcome Score (KOOS) in patients treated with intra-articular platelet-rich plasma (PRP) injections for knee OA. Study Design: Case series; Level of evidence, 4. Methods: This study included 215 patients with knee OA (68% men, 32% women; age, 53.2 ± 11.3 years; body mass index, 26.8 ± 4.3 kg/m2) who underwent intra-articular PRP injections. Patients were assessed through the IKDC Subjective score and KOOS subscales, and the MCID and the PASS for both measures were independently calculated at 6 and 12 months post-injection. The MCID was calculated using the value equal to half of the standard deviation of the overall cohort improvement. The PASS was assessed using a 2-point scale ( satisfied or not satisfied), with threshold values being detected through a receiver operating characteristic curve analysis and the Youden index to maximize the sensitivity and the specificity of the threshold values. Results: All scores improved significantly from baseline to 6 months and baseline to 12 months ( P < .001 for all scores). All scores were stable from 6 to 12 months except for the KOOS Quality of Life subscale, which improved further ( P = .033). For the IKDC, the MCID values were 8.6 and 8.5 points and the PASS scores were 59.7 and 62.1 at 6 and 12 months, respectively. Overall, the MCID and the PASS for all KOOS subscales remained constant at the 2 follow-up points. The percentage of patients who achieved the MCID and the PASS was higher than 85% at both 6 and 12 months post-injection. Conclusion: This study provided the MCID and PASS thresholds for the IKDC and KOOS scores in patients with knee OA treated with PRP injections. These psychometric measures may allow a better interpretation of the clinical relevance of injection-based treatment outcomes for knee OA.
Reliability of Preoperative Planning Method That Considers Latent Medial Joint Laxity in Medial Open-Wedge Proximal Tibial Osteotomy
Authors: Ryu Dong Jin , Lee Sung-Sahn , Jung Eui Yub , Kim Joo Hwan , Shin Tae Soo , Wang Joon Ho 
Published: October 2021

Background: Soft tissue laxity around the knee joint has been recognized as a crucial factor affecting correction error during medial open-wedge proximal tibial osteotomy (MOWPTO). Medial laxity in particular, which represents the changes in joint-line convergence angle (JLCA), affects soft tissue correction. Purpose: The purpose of this study was to quantify medial laxity and develop a preoperative planning method that considers medial laxity. Study Design: Cohort study; Level of evidence, 3. Methods: This study retrospectively reviewed 139 knees in 117 patients who underwent navigation-assisted MOWPTO from January 2014 to July 2019 for symptomatic medial compartment osteoarthritis with varus alignment >5°. We compared the results of 2 preoperative planning methods: conventional Miniaci (n = 47) and latent medial laxity reduction (LMLR) (n = 92). We evaluated the incidence of undercorrection, acceptable correction, and overcorrection. The radiologic parameters were analyzed using multiple linear regression with a stepwise selection model to establish an equation for the optimal preoperative planning method. The intraclass correlation coefficients (ICCs) of intraobserver, interobserver, and intermethod reliability were calculated. Results: The Miniaci method showed a higher incidence of overcorrection (55.3%) than the LMLR method (22.8%) at postoperative 6 months ( P = .0006). Multiple linear regression with a stepwise selection model revealed a high correlation coefficient ( R 2 = 0.888) for the following equation: Adjusted planned correction angle = 0.596 + 0.891 × Target correction angle – 0.255 × Δ JLCA valgus. Upon simplification, the following equation showed the highest intermethod ICC value (0.991): Target correction angle – ⅓Δ JLCA valgus, while the Miniaci method showed a relatively low ICC value of 0.875. Conclusion: There was a risk of overcorrection after MOWPTO using the conventional Miniaci method. An equation that considers medial laxity may help during preoperative planning for optimal correction during MOWPTO.
Knowledge Management-Based Nursing Care Educational Training: A Key Strategy to Improve Healthcare Associated Infection Prevention Behavior
Authors: Ahsan Ahsan , Dewi Elvira S. , Suharsono Tony , Setyoadi Setyoadi , Soplanit Venny G. , Ekowati Shilfi I. , Syahniar Nabila P. , Sirfefa Ratna S. , Kartika Annisa W. , Ningrum Evi H. , Noviyanti Linda W. , Laili Nurul 
Published: October 2021

Introduction Knowledge management-based nursing care has a positive effect in preventing healthcare associated infections (HAIs). Therefore, nursing professionals can utilize key strategies of knowledge management to support clinical decision making, reorganize nursing actions, and maximize patient outcomes. Objectives The aim of this study was to determine the effect of knowledge management-based nursing care educational training on HAI prevention behavior at the High Care Unit (HCU) of Saiful Anwar Hospital Malang. Methods A quasiexperimental design with a pretest, educational training intervention, and posttest were conducted on 15 nurses in the HCU of Saiful Anwar Hospital Malang, which lasted for 16 days. Furthermore, observation of nursing care documentation, nurses’ handwashing compliance, and presence of infection-causing bacteria in the HCU staff and environment (hands rub handle, medical record, and patient's bed) was carried out pre (day 1–7) and post training (day 10–16). Subsequently, educational training related to knowledge management-based nursing care was conducted for 2 days (day 8–9) by the Doktor Mengabdi Team of Universitas Brawijaya. Results The knowledge level and completeness of the nursing care documentation in the HCU room significantly increased after the training ( p < .05). Also, compliance to the six steps five moments of nurses’ handwashing increased after the training ( p > .05). Infection-causing bacteria were found in the HCU environment and staff before and after the training involving Pseudomonas stutzeri, Sphingomonas paucimobilis, Enterobacter cloacae, Staphylococcus aureus, Acinetobacter baumannii, Pasteurella pneumotropica, and Acinetobacter lwoffii. Therefore, increased knowledge of HCU nurses and complete documentation ( r = .890; p = .054), increased knowledge of HCU nurses and handwashing compliance ( r = .770; p = .086), and handwashing compliance and bacterial presence ( r = .816; p = .084) all had a positive correlation. Conclusion Knowledge management-based nursing care educational training increased infection prevention behavior in the HCU of Saiful Anwar Hospital Malang.
Indigenous Art and Bible-Illustration
Authors: Lehmann Arno 
Published: October 2021

We are happy to publish, with the author's permission, this important article by Professor Dr. Arno Lehmann, Dean of the Faculty of Theology, and Director of the Institute of Theology, of the Martin-Luther-Universität Halle-Wittenberg in Halle, East Germany. The article was first given as a lecture at the Study Conference on Bible Illustration at Edinburgh University, in September 1959, It was later published in Wissenschaftliche Zeitschrift der Martin-Luther-Universität Halle-Wittenberg, 9. Jahrg., Heft 1, February 1960. Dr. Lehmann is a specialist in the study of indigenous Christian art and has published “Von der Kunst der jungen Kirchen,” in Die Zeichen der Zeit (Berlin) 1953, and one of the few books on the subject, Die Kunat der jungen Kirchen (Berlin: Evangelische Verlagsanstalt, 1955). Its 255 pages include numerous plates, many of them colored, and a bibliography. In preparation for publication in Berlin in 1961 is a second Volume, Afrcasiatio Christian Art. We hope that this article will stimulate thinking and discussion throughout the Christian world. - Ed.
The Forthcoming Role of the Non-Christian Religious Systems as Contributory to Christian Theology
Authors: Jackson Herbert C. 
Published: October 2021

The author of this article, the Rev. Herbert C. Jackson, Ph.D., will on July 1, 1961, become the new Director of the Missionary Research Library (see MRL News). Dr. Jackson is now Professor of Comparative Religion and Missions and Chairman of the Historical Division, the Southern Baptist Theological Seminary, Louisville, Kentucky. He studied at William Jewell College and Southern Baptist Theological Seminary, and received his M.A. and Ph.D. degrees at Yale University. He is an ordained minister of the American Baptist Convention and served as a missionary of the American Baptist Foreign Mission Society in India for six years. Recently he spent a year on faculty fellowship, studying at the University of Ceylon and travelling throughout Asia. Professor Jackson has taught missions at Eastern Baptist Theological Seminary and at Southern Baptist Theological Seminary since 1954. He is a member of the North American Advisory Committee of the International Missionary Council. Dr. Jackson's stimulating study of the relation of non-Christian religious systems to Christian theology was given as an address at Southern Baptist Theological Seminary in September, 1960. - Ed.
Christian Approach to Now-Christian Faiths: A Selected Bibliography on the World's Living Religions
Authors: Rahbar Daud , Cragg A. Kenneth 
Published: October 2021

In the March issue of the Occasional Bulletin we published a masterly article by an American missionary scholar on the relation of non-Christian religious systems to Christian theology. In this issue we are privileged to publish a paper by a Pakistani scholar whose brilliant research on the ethical doctrine of the Qur'an has just come from the press, under the title God of Justice. Dr. Rahbar's father was Chairman of the Department of Persian Studies at the Punjab University in Pakistan and Principal of the Oriental College of that University. Dr. Daud Rahbar took his M.A. degree in Arabia Literature from the Punjab University in 1947. Since then he has continued his studies at Cambridge University and has taught at Cambridge, McGill University in Montreal, Ankara University, and Hartford Theological Seminary where he is at present visiting Professor of Urdu and Pakistan Studies. Dr. Rahbar is a Christian. His paper, “Christian Approach to Non-Christian Faiths,” was read at the Consultation sponsored by the South Asia Committee of the D.F.M., October 31, 1960. It is followed by a review of Dr. Rahbar's new book, written especially for the MRL Occasional Bulletin by Dr. A. Kenneth Cragg, author of The Call of the Minaret, Sandals at the Mosoue, and other books.
An Attempt at a Theological Analysis of Missionary Motivation
Authors: Niebuhr H. Richard 
Published: October 2021

This article represents a paper prepared under the direction of the Research Committee of the Division of Foreign Missions of the National Council of the Churches of Christ in the U.S.A. and presented in April, 1951, as part of the American preparatory study on The Missionary Obligation of the Church”, the theme of the Enlarged Meeting of the International Missionary Council in Willingen. Germany, in 1952 So far as we know, it has never been published. It is presented now because of its intrinsic value and because it is as timely as it was a decade ago, if not more so. Un his death in 1962, Dr. Niebuh was for many years Professor of Theology and Christian Ethics in the Yale University Divinary School. The article is published with the kind permission of Mrs. H. Richard Niebuhr.
Christian Vocation and the Missionary Call
Authors: Long Charles H. 
Published: October 2021

This is a reprint of an article prepared as a part of the International Missionary Council Study of “The Missionary Obligation of the Church”, preparatory to the Enlarged Meeting of the IMC held in Willingen, Germany, in July 1952 and published in The International Review of Missions, Vol. 39 (1950), pp. 409–417. It is reprinted by permission from the IRM, from the Overseas Department of the National Council of the Protestant Episcopal Church in the U. S. A., and from the author. The Reverend Charles H. Long, Jr. served for many years as a missionary in China under the Protestant Episcopal Church. This article is chosen for reprinting because it deals with an issue perhaps more live and crucial than was the case a decade ago, and because it is apropos of a new study of missionary motivation, training, and withdrawal being undertaken by the Missionary Research Library.
Religious Syncretism in the Caribbean: A Study of the Persistence of African and Indian Belief
Authors: Wipfler William L. 
Published: October 2021

It is generally assumed that a “higher” culture will inevitably absorb or eradicate a “lower” culture with which it comes in contact. While it is obvious that the cultures of the conquerors have prevailed as the directing force in the various areas of the Caribbean, it is also true that they have never eliminated the influence of those religions with which they came in contact from the very beginning of the era of colonization. It is the purpose of this study, therefore, to examine two specific areas of contact (Mexico and Haiti) and attempt to: (1) Discover the factors within colonial development that contributed to the persistence of primitive religion; (2) Consider which elements of primitive religion have persisted; and, (3) Consider which elements of the Christian religion were readily accepted, reinterpreted and integrated into the folk religion.