bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transfemoral Prosthetic Socket Designs: A Review of the Literature
Authors: Brodie Melissa , Murray Laura , McGarry Anthony 
Published: November 2021

ABSTRACT

Introduction
The prosthetic socket is the interface that connects the human body to the artificial limb and allows transmission of body weight and forces during gait. The review purpose is to assess the quality of scientific evidence and compare this for a variety of available transfemoral socket designs. Comparisons will be made of socket biomechanics, metabolic efficiency and comfort, and the advantages/disadvantages associated with each design.

Methods
Socket designs included were quadrilateral (quad), ischial containment (IC), Marlo Anatomical Socket, subischial, high-fidelity (HiFi), and the Socket-less Socket. A literature review was conducted in five online databases: Compendex, Embase, PubMed, ProQuest Materials Science, and ProQuest Biological Science, using Boolean search terms and truncation of relevant keywords. Included articles were published between 1989 and 2018. A predetermined methodological criterion was used in conjunction with a modified version of the Oxford Levels of Evidence to assess and grade the quality of selected articles.

Results
Thirteen clinical studies were included in this review. Based on the chosen search strategy and quality criterion, this review found a limited, low-quality evidence base for all included socket designs. All articles, except one, compared the various socket designs (quad, quad and MAS, MAS, subischial, and HiFi) against an IC socket as this was deemed the “standard of care” design.

Conclusions
Although IC attained the highest volume of evidence, this socket design was not proven to be superior. The variety of biomechanical features pertaining to each socket design provides several advantages/disadvantages. Recommendations are made for future research.

Clinical Relevance
Findings from this literature review promote knowledge and understanding of transfemoral socket design by highlighting the underlying theory, strengths, and weaknesses of each design acknowledged to facilitate improved evidence-based practice.
Upper-Limb Prosthetic Maintenance Data: A Retrospective Analysis Study
Authors: Nagaraja Vikranth H. , Cheng Runbei , Slater David Henderson , Thompson Mark S. , Bergmann Jeroen H.M. 
Published: November 2021

ABSTRACT

Introduction
Understanding repair patterns of upper-limb (UL) prosthetic devices have received little attention compared with their lower-limb counterparts. This study focuses on a retrospective analysis of anonymized UL prosthetic maintenance data to establish if there were any patterns of repairs at a regional prosthetic limb-fitting center in the United Kingdom. A secondary aim of this study is to describe the patient demographics of this center.

Methods
Data containing prosthetic repair log and demographic description (n = 212) were acquired through our clinical partners and subjected to statistical analyses.

Results
On average, each client visited the center 0.2 times/year for a new device and 0.9 times/year for maintenance-related activities. It is found that the repair rates are generally higher for body-powered devices (1.28 visits/device per year) compared with passive (0.94 visits/device per year) and externally powered devices (0.90 visits/device per year). In keeping with the typical UK UL-deficient population, there is a high male-to-female ratio, and higher instances of traumatic amputations were noticed for males at the center. There is a very high preponderance of congenital cases and an overall emphasis on prescribing passive devices to a majority of patients at the center.

Conclusions
The data from our study are similar to previously published data from other centers and show a consistent pattern in terms of relative rates of maintenance attendances for different types of UL prostheses.

Clinical Relevance
This study provides a longitudinal perspective and insights on ever-changing requirements (prostheses and related care) of the users at the level of a regional limb-fitting center. This study underscores current gaps in prosthetic device durability/reliability and opens up avenues for improvement of prosthetic services and devices.
Combining Foot Drop Stimulation Devices with Gait Training Improves Gait, Active Ankle Movement of Chronic Poststroke Individuals
Authors: Cunha Maira Jaqueline da , Pinto Camila , Zanfir Bruna , Cimolin Veronica , Pagnussat Aline Souza 
Published: November 2021

ABSTRACT

Introduction
Foot drop stimulator (FDS) devices induce positive clinical effects on foot drop secondary to stroke. Literature does not establish a recommended period or a standard intensity of stimulation to achieve training and therapeutic effects in individuals after stroke.
The objective of this study was to evaluate the training and therapeutic effects of 2 weeks of FDS use combined with intensive treadmill gait training in chronic poststroke individuals.

Materials and Methods
The study design was a quasiexperimental clinical trial. Participants underwent gait training on a treadmill associated with FDS stimulation for 20 minutes, five times a week for 2 weeks. Gait analysis was measured at pre-training and 2 weeks after the training with FDS off/on mode.

Results
Sixteen chronic poststroke individuals were included. One participant was excluded from the analysis due to data processing fault. After the period of training, and with the orthosis on mode on, individuals ameliorated the active dorsiflexion and increased the distance covered, that is, positive training effect of FDS use. Training and therapeutic effects were not observed in other outcomes.

Conclusions
Our results demonstrated a positive training effect on ankle active movement during gait. FDS combined with gait training is able to increase the total distance walked after 2 weeks of treatment.

Clinical Relevance
FDS ameliorated the active dorsiflexion and increased the distance covered in people with chronic poststroke. Our results suggest a positive training effect of FDS that can guide physiotherapists in their clinical practice.
Examination of Near Point of Convergence Scores in High-School Athletes: Implications for Identifying Binocular Vision Dysfunction After Concussion Injury
Authors: Del Rossi Gianluca 
Published: November 2021

Objective:
To identify normative near point of convergence (NPC) data for healthy high-school–aged athletes (13-19 years old) and determine the percentage of individuals with NPC scores that fall outside the currently accepted clinical cutoff value of 5 cm. Another objective was to determine the relationship between sex, concussion history, and attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD) with NPC scores, if any.

Design:
Case series.

Setting:
High-school sports medicine clinic.

Patients (or Participants):
Near point of convergence was assessed in 718 high-school student athletes (141 females and 577 males) with an average age of 15.96 ± 1.16 years.

Interventions:
None.

Main Outcome Measures:
An accommodation convergence ruler was used to measure NPC. Near point of convergence scores were repeated a total of 3 times and the mean used for all statistical analyses.

Results:
The NPC scores for all participants averaged 3.58 cm, and the intraclass correlation coefficient for the 3 repeated measurements was 0.956. Approximately 20% of mean NPC scores were above the accepted upper limit of 5 cm. Although a statistically significant effect for sex was identified, the difference between them was considered clinically insignificant. No relationship between NPC and history of concussion or ADD/ADHD was identified.

Conclusions:
Results indicate that in high-school–aged subjects, approximately 20% of individuals may have NPC values that fall outside the current critical cutoff value and may lead to incorrect diagnosis of ocular dysfunction. In addition, NPC does not seem to be affected by the history of concussion or a diagnosis of ADD/ADHD.
The nurse practitioner's role in addressing chronic sequelae of Lyme disease as a climate change related disease
Authors: Nicholas Patrice , Evans Linda A. , Albert Marisa , Kelly Debra , Michelson Naomi 
Published: November 2021

ABSTRACT
A major health consequence of climate change is an increased prevalence of vector-borne diseases due to changes in temperatures and the environments in which vectors can survive and carry out transmissible activity. Because of climate change, emerging health challenges related to the warming of the planet have led to an increase in vector-borne diseases in broadening geographic areas. Individuals affected with Lyme disease may present with a variety of symptoms, which highlights the importance of illness recognition to ensure that a patient can receive timely treatment and effective support. Despite the focus on early detection and treatment of acute Lyme disease, chronic health problems associated with Lyme disease are an emerging problem in the 21st century. This article focuses on the role of nurse practitioners and members of the health professional team in the recognition, clinical care, patient education, and management of increasing rates of chronic Lyme disease.
Readability and quality assessment of internet-based patient education materials related to deep vein thrombosis
Authors: Qadeer Muhammad Abrar , Kelly Martin , Lenehan Brian 
Published: November 2021

Access to health-related internet information has increased dramatically during the past decade. A significant proportion of this information has been demonstrated to be set at too high a level for general comprehension. The goal of this study was to evaluate the readability and quality of information available on the internet relating to deep vein thrombosis (DVT). A search for ‘DVT’ and ‘Deep Vein Thrombosis’ was performed on five most commonly accessed search engines. Top hundred websites were reviewed. Website authorship was classified. Each site was assessed using the recognized quality and readability scoring systems. The presence of the health on the net foundation code of conduct (HON-code), a reported quality-assurance marker, was noted.
The majority of web sites (45%) were academic or physician compiled. Only 36% of the websites were HON-code certified. HON-code certified sites achieved significantly greater DISCERN and Journal of the American Medical Association (JAMA) scores. Seventy-three percent of the websites were above the recommended sixth-grade readability level. Flesch--Kincaid readability test (FRES) of more than half of the websites (56%) was below 60, which makes them fairly difficult to read by general public.
Internet information relating to DVT is of variable quality and largely set at an inappropriate readability level. Given this variability in quality, healthcare providers should direct patients to known sources of reliable, readable online information. Identification of reliable sources may be aided by known markers of quality such as HONcode certification and to educate them to use academic and physician-provided sites which have been shown to contain better-quality information. Moreover, academic and physician-compiled websites should be written in a fashion appropriate for general public consumption.
Fatty liver and cerebrovascular disease: plausible association and possible mechanisms
Authors: Khanna Sahil , Parikh Neal S. , VanWagner Lisa B. 
Published: November 2021

Purpose of review
Nonalcoholic fatty liver disease (NAFLD) is a common comorbidity and has wide ranging extrahepatic manifestations, including through cardiometabolic pathways. As such, there is growing interest in the impact of NAFLD on cerebrovascular disease and brain health more broadly. In this review, we assess recent research into understanding the association between NAFLD and brain health while highlighting potential clinical implications.

Recent findings
Mechanistically, NAFLD is characterized by both a proinflammatory and proatherogenic state, which results in vascular inflammation and neurodegeneration, potentially leading to clinical and subclinical cerebrovascular disease. Mounting epidemiological evidence suggests an association between NAFLD and an increased risk and severity of stroke, independent of other vascular risk factors. Studies also implicate NAFLD in subclinical cerebrovascular disease, such as carotid atherosclerosis and microvascular disease. In contrast, there does not appear to be an independent association between NAFLD and cognitive impairment.

Summary
The current literature supports the formulation of NAFLD as a multisystem disease that may also have implications for cerebrovascular disease and brain health. Further prospective studies are needed to better assess a temporal relationship between the two diseases, confirm these early findings, and decipher mechanistic links.
Are robots the future? A case for robotic pyeloplasty as the gold standard treatment in ureteropelvic junction obstruction
Authors: Beale Robert , Sicilila Sabrina , Riestra Paola , Albala David M. 
Published: November 2021

Purpose of review
Robotic pyeloplasty is still a relatively novel procedure. Clinically, early studies have shown high success rates, decreased complication rates, decreased length of hospital stay, and better cosmetic results. This goal of this article is to argue for the use of robotic pyeloplasty as the gold standard of ureteropelvic junction obstruction (UPJO) treatment. Results of studies that have compared robotic pyeloplasty with other procedures currently used are reviewed.

Recent findings
Our study, a comprehensive review of published outcomes of robotic pyeloplasty and alternative therapies, consisted of 666 pediatric patients and 653 adult patients. Our review coincided with the previously established studies that robotic pyeloplasty shows equivalent surgical success rates as previous standard of care treatments. Open pyeloplasty has fallen out of favor as standard of care due to the increased length of hospital stay, increased adverse events, and the undesirable aesthetics.

Summary
The use of robotic pyeloplasty has shown to have clinical outcomes that are consistent with other intervention for UPJO, with a potential decrease in length of stay and morbidity. More work has to be done to develop ways to decrease cost of the robot to help establish it as the gold standard for UPJO treatment.
Extramammary Paget's Disease of genitourinary origin
Authors: Narayan Vikram M. , Master Viraj A. 
Published: November 2021

Purpose of review
Extramammary Paget's Disease (EMPD) is an uncommon intra-epithelial malignancy, affecting primarily apocrine gland-bearing skin. EMPD is often considered an orphan diagnosis given its rarity. This review provides a contemporary overview of EMPD management.

Recent findings
The mainstay of EMPD treatment centers around a high index of suspicion to allow for an early and accurate diagnosis, wide local or Mohs micrographic surgical excision with care paid toward the margin status, and thoughtful consideration for lymphadenectomy in patients with clinically positive regional disease. There is currently no consensus regarding adjuvant therapies or systemic therapies although with ongoing improvements in tumor biology and genomics, including molecular pathways and alterations specific to EMPD, targeted or combinatorial therapies may be on the horizon.

Summary
Clinicians caring for patients with EMPD should seek consultation from or if feasible, consider referral to high-volume, experienced centers with patients counseled and provided with frequent and close follow-up for disease recurrence or progression. Collaboration with groups such as the Global Society for Rare Genitourinary Tumors, and especially patient groups will be vital to designing trials and collaborative databases.
Why do African–American men face higher risks for lethal prostate cancer?
Authors: Nair Sujit S. , Chakravarty Dimple , Dovey Zachary S. , Zhang Xiangfu , Tewari Ashutosh K. 
Published: November 2021

Purpose of review
African–American men in the USA have a higher incidence of and mortality from prostate cancer (PCa), with a longstanding debate about the cause for these worse outcomes. This review examines differences in tumour biology and socioeconomics for African–American and Non-Hispanic White (NHW) men to answer the question ‘why AA men face higher risks for lethal PCa’ and draw a management consensus to redress the imbalance.

Recent findings
Recent evidence from over the past 2 years suggests the reasons why African–American men face a higher risk of lethal PCa are multifactorial, with contributions from differences in tumour biology as well as socioeconomic and healthcare access factors. Regarding tumour biology, genomic and transcriptome profiling suggests African–American men have upregulated expression of genes related to inflammatory pathways with downregulation of DNA repair genes. In contrast, NHW men have higher DNA repair pathways and metabolic pathways involving glycolysis and cell cycle activity. In addition, epidemiological evidence suggests equal healthcare access ensures equal PCa specific outcomes, implying African–American men's disease is not inherently more lethal. However, differences in tumour biology remain, which may explain specific differences in PCa incidence and the clinical findings of African–American men's increased response to immunotherapy and radiotherapy in recent trials.

Summary
Regardless of racial differences in disease outcomes and the factors causing them, African–American and NHW men seem to have diseases unique to their ancestry. This supports the exploration of personalized PCa treatment approaches, leveraging translational basic science research to uncover these differences and devise specific individualized methods therapeutic regimes to address them.
Creation and Implementation of a Preoperative Malignant Hyperthermia Screening Tool
Authors: Johnson Tirzah , Simmons Virginia C. , Figer Schwartz Sharon , Tola Denise H. 
Published: November 2021

Background:
Malignant hyperthermia (MH) is a potentially lethal pharmacogenetic disorder triggered by certain anesthetic agents. There is currently no standardized preoperative screening tool utilized to identify MH-susceptible individuals.

Local Problem:
This quality improvement (QI) project aimed to enhance preoperative screening for MH susceptibility (MHS) by implementing an evidence-based screening tool for surgical patients at 2 sites.

Methods:
This prospective descriptive QI project evaluated the success of implementing an MHS screening tool preoperatively and its impact on the anesthesia plan.

Interventions:
Anesthesia professionals included the screening tool in their preoperative interview for surgical patients so that positively screened patients could receive MH prevention measures.

Results:
A total of 95 patients at site A and 234 patients at site B were screened using the MH tool, a cumulative total of 21 patients were positively screened, and 1 anesthetic plan was altered.

Conclusions:
This MHS screening tool has the potential to prevent MH episodes when used consistently by staff.
“Magic” Number of Treadmill Sessions Needed to Achieve Meaningful Change in Gait Speed After Stroke
Authors: Balinski Mariah , Madhavan Sangeetha 
Published: November 2021

Abstract
The purpose of this systematic review was to determine the number of treadmill training sessions needed to make a meaningful change in gait speed for chronic stroke survivors. Relevant databases were searched up through February 2020. Articles were included if they fit the following criteria: stroke onset more than 5 mos, intention to treat with traditional treadmill training, and gait speed included as an outcome. Change in gait speed after intervention was used to classify treadmill groups as responders (at least 0.1 m/sec change) or nonresponders (less than 0.1 m/sec change). Seventeen articles met our criteria, resulting in a total of 19 intervention groups. Ten groups were classified as responders and completed a mean of 30.5 sessions within 6 wks, whereas nonresponders completed 20.4 sessions within 10 wks, indicating that at least 30 treadmill sessions (preferably in a period of 10 wks and at least 40 mins per session) is necessary to reach a meaningful change in gait speed. Although these trends were noted between the responder and nonresponder groups, no firm conclusions can be drawn regarding the “magic” number of sessions chronic stroke survivors should perform given the low correlation between number of sessions and change in gait speed.
Effect of Extensor Muscle Strength on Meniscus Damage Progression in Subjects Without Radiologic Knee Osteoarthritis
Authors: Li Mingyang , Nie Yong , Li Kang , Zeng Yi , Wu Yuangang , Liu Yuan , Wu Limin , Shen Bin 
Published: November 2021

Background
It has been demonstrated that high extensor strength decreases knee osteoarthritis symptomatic progression. However, few studies have detected a significant association between extensor strength and structural progression.

Methods
Participants in the Osteoarthritis Initiative with both muscle strength and meniscus assessment, Kellgren-Lawrence grade 1 or less, and body mass index less than 30 were enrolled. In a separate-sex analysis, participants were divided into the high and low strength groups, referring to the median value. Meniscus progression according to the Magnetic Resonance Imaging Osteoarthritis Knee Score was compared between the two groups at 12 mos (393 females and 229 males) and 24 mos (340 females and 208 males).

Results
In females, less overall medial meniscus progression (11.1% [17/153] vs. 23.2% [32/138], P = 0.04), less medial meniscal medial extrusion (5.2% [8/155] vs. 12.5% [18/144], P = 0.04), and less medial meniscal anterior extrusion progression (0% [0/108] vs. 5.3% [6/113], P = 0.03) were present in the high strength group at 24 mos. In males, no significant difference was detected between the high strength group and the low strength group.

Conclusions
In females, higher extensor muscle strength was associated with a decreased risk of medial meniscus progression in medial and anterior extrusion.
Focal Peripheral Neuropathies Observed in Patients Diagnosed With COVID-19
Authors: Liu Eric A. , Salazar Tomas , Chiu Elisa , Fleming Talya K. , Bagay Leslie , Brown David P. , Cuccurullo Sara J. 
Published: November 2021

Abstract
A growing number of studies have documented a wide variety of neurological manifestations associated with the novel SARS-CoV-2 (COVID-19). Of the available literature, cranial neuropathies and central nervous system disorders, such as encephalopathy and ischemic strokes, remain the predominant discussion. Limited investigations exist examining peripheral neuropathies of those with COVID-19. This case series discusses eight patients who tested positive for COVID-19 and presented with localized weakness after a prolonged course of mechanical ventilation (>21 days). We retrospectively reviewed all patients’ charts who received electrodiagnostic evaluation between March and November 2020 in the outpatient clinic or in the acute care hospital at the JFK Medical Center/JFK Johnson Rehabilitation Institute and Saint Peter's University Hospital of New Jersey. A total of eight COVID-19–positive patients were identified to have a clinical presentation of localized weakness after a prolonged course of mechanical ventilation. All patients were subsequently found to have a focal peripheral neuropathy of varying severity that was confirmed by electrodiagnostic testing. Patient demographics, clinical, and electrodiagnostic findings were documented. The findings of local weakness and focal peripheral neuropathies after diagnosis of COVID-19 raise significant questions regarding underlying pathophysiology and overall prognosis associated with COVID-19.