bluuebunny/crossref_metadata_2025_split huggingface dataset:
Consideration of pelvic tilt at the time of preoperative planning improves standing acetabular position after robotic-arm assisted total hip arthroplasty
Authors: Hepinstall Matthew S , Coden Gloria , Salem Hytham S , Naylor Brandon , Matzko Chelsea , Mont Michael A 
Published: September 2021

Introduction: Approximately half of dislocating total hip arthroplasties (THAs) demonstrate acetabular component position within traditional safe zones. It is unclear if postoperative functional acetabular position can be reliably improved by considering preoperative pelvic tilt. We investigated whether standing cup position targets could be more accurately achieved by considering preoperative standing pelvic tilt in addition to bone landmarks when planning for robot-assisted THA. Methods: We reviewed 146 THAs performed by a single surgeon using computed tomography-based 3-dimensional planning and robotic technology to guide acetabular reaming and component insertion. Planning for 73 consecutive cases started at 40° of inclination and 22° of anteversion relative to the supine functional plane and was adjusted to better match native hip anatomy. Planning for the next 73 cases was modified to consider standing pelvic position based on standing preoperative radiographs. We compared groups to determine the rate when cups were placed outside our standing targets of 15–30° anteversion and 35–50° inclination. Results: Cup position proved to be reliable in both groups, with 83% of cups in the anatomic planning cohort and 90% of cups in the functional planning cohort achieving standing targets for both anteversion and inclination ( p = 0.227). Variances were lower in the functional planning group: 9.4° versus 15.8° of inclination ( p = 0.079) and 18.3° versus 26.1° of anteversion ( p = 0.352). The range of functional positions was narrower in the functional planning group: 35.7–47.5° versus 31.8–54.9° of inclination and 16.7–35.0° versus 10.1–35.9° of anteversion. Discussion: Our results suggest enhanced planning that considers pelvic tilt, when coupled to a precision tool to achieve the plan, can reliably achieve target standing component positions. Considering preoperative functional pelvic position may improve postoperative functional acetabular component placement in THA, but the clinical benefit of this has yet to be confirmed.
Simplified biplanar classification for heterotopic ossification is more predictive of patient-reported outcomes than the Brooker classification after anterior total hip arthroplasty
Authors: Onsen Leonard T , Ouyang Vivian W , Jimenez Andrew E , Monahan Peter F , Lall Ajay C , Domb Benjamin G 
Published: September 2021

Background: Heterotopic ossification (HO) commonly occurs after total hip arthroplasty (THA) and can adversely impact clinical outcomes. The purpose of this study is to propose a more reliable HO grading method that is better predictive of patient-reported outcomes (PROs) after THA than the Brooker classification. Methods: 513 THAs (62 ± 10 years old) were reviewed. The incidence and grade of HO was evaluated using the Brooker grading system and a simplified biplanar classification system (grade 1: ⩾1 cm between bone on both anteroposterior and lateral views, grade 2: <1 cm between bone on either view). The modified Harris Hip Score (mHHS), Forgotten Joint Score (FJS), and visual analogue scale (VAS) for pain were collected at minimum of 2 years after surgery and were compared between HO grades using multiple regression models. Results: The incidence of HO varied by Brooker grade (grade 1, 23.4%; grade 2, 22.4%; grade 3, 7.2%; grade 4, 0%) and biplanar grade (grade 1: 45.6%; grade 2: 7.4%). The biplanar classification demonstrated higher interobserver reliability than the Brooker classification (κ = 0.95 and 0.91, respectively). Brooker grade 3 HO decreased the mHHS by 6.5 (standard error: 2.7) but did not have a significant effect on FJS or VAS. Biplanar grade 2 HO decreased the mHHS by 9.9 (standard error: 2.7), the FJS by 12.9 (standard error: 4.51) and increased the VAS pain score by 0.81 (standard error: 0.35). The Cox test was used to compare the fit of regression models and determined the biplanar classification was a significantly better predictor than the Brooker classification ( p < 0.001). Conclusions: Biplanar grade 2 HO had a significant negative influence on PROs. Contrary to previous literature, these results show clinical significance of non-bridging HO. Compared with the Brooker classification, the biplanar classification has greater interobserver reliability and is more predictive of outcomes after THA.
Common ground, different path: Ulnar artery access for interventional neurovascular procedures
Authors: Manzoor Muhammad U. , Almulhim Ibrahim A. , Alrashed Abdullah A. , Alturki Abdulrahman Y. , Alghabban Fatimah A. , Al-Qahtani Sultan M. 
Published: September 2021

Background Recently, radial artery access has gained popularity for interventional neurovascular procedures due to patient comfort and fewer complications. However, there are instances where the radial artery approach is not feasible. In such cases, trans-ulnar artery access (TUA) can offer an alternate route. There is limited data regarding neuro-interventional procedures performed via this approach. This study aims to evaluate the feasibility and safety of trans-ulnar approach for a wide range of interventional neurovascular procedures. Materials and methods The data for all patients who underwent ulnar artery access for diagnostic or interventional neuroradiology procedures was retrospectively collected between September 2020 and March 2021. Patient demographics, procedural details, procedure success, and complications were recorded. Results During the study period, 23 patients underwent 24 trans-ulnar approach procedures. The mean age of patients was 50.1 ± 14.2 years. Fourteen diagnostic cerebral angiograms and ten interventional procedures were performed. All procedures were successfully completed via trans-ulnar approach without a switch to alternate access. No major access site complication was observed. Conclusion Ulnar artery access is a safe and feasible option for neurovascular procedures. It can be effectively utilized for diagnostic cerebral angiography and a wide range of interventional procedures.
A mixed method study into obstetric sonographer-led-discharge and other forms of sonographer role extension
Authors: Kettlewell LS , Richards SP 
Published: September 2021

Introduction Sonographer-led-discharge was proposed in a maternity unit to provide a holistic service, cut waiting times, ease staffing pressures and increase job satisfaction. This study explored sonographers’ experiences and perspectives of this new extended role and other areas of non-obstetric role extension. Understanding these will inform future practice and the success of the proposed obstetric sonographer-led-discharge and career structure. Methods A mixed methodology, cross-sectional study was performed, with a purposive, non-probability sample using an online data collection tool. The data were analysed using descriptive statistics and thematic analysis. Results In total, 93 sonographers participated in the study. Of these, 25% of sonographers currently practising obstetric ultrasound said they would not undertake the proposed obstetric sonographer-led-discharge role extension although 90% of the participants said role extension provides job satisfaction. Several themes emerged from the data, including job satisfaction, benefits to the hospital, improved patient pathway, time, personal factors, litigation and intra- and interprofessional resistance. A total of 54% of staff currently performing a role extension have experienced either inter- or intraprofessional conflict and only 48.5% said their workload was manageable. Conclusions The data collected suggested that, with training and support, the proposed obstetric sonographer-led-discharge role is an appropriate role extension for sonographers. These findings support the premise of the proposed sonographic career structure, although the inter- and intraprofessional resistance identified in the study could form a significant barrier if it is not appropriately considered and managed.
Electrical stimulation to treat tinnitus: a meta-analysis and systemic review of randomized controlled trials
Authors: Yang Ting , Zhang Jin , Wang Bing , Zhang Wen , Xu Min , Yang Shuangyuan , Liu Hui 
Published: September 2021

Background and aims: Tinnitus is one of the most common otological symptoms that patients experience, and it can be debilitating. No effective drug treatments are available for tinnitus, although considerable research investigating its mechanisms and possible treatments is underway. Electrical stimulation has been considered a promising and well-tolerated therapeutic strategy for tinnitus. This meta-analysis study was aimed to investigate the efficacy, safety and tolerability of electrical stimulation in patients with tinnitus. Methods: Relevant studies were retrieved from the Embase, PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature (CBM), Wanfang and Weipu databases. The Tinnitus Handicap Inventory (THI) and the visual analogue scale (VAS) which focus on loudness and distress evaluation (0–10 points) were used to assess perceived tinnitus suppression after treatment. Subgroup analysis was also performed based on different stimulating areas and methods, follow-up times, tinnitus duration and electrical current intensity. Review Manager 5.4 software was used for data synthesis, and Stata 15.1 software was used for analyses of publication bias and sensitivity. Results: Our meta-analysis included 11 studies involving a total of 447 patients with tinnitus. The results showed that electrical stimulation significantly reduced THI scores [mean difference (MD) = −9.69; 95% confidence interval (CI) = −14.25, −5.13; p < 0.0001; I2 = 80%] and VAS scores between the two groups (VAS loudness scores, MD = −0.72; 95% CI = −1.20, −0.25; VAS distress scores, MD = −0.90; 95% CI = −1.17, −0.63). In addition, subgroup analysis showed that THI scores in electrical stimulation group of different stimulating areas and methods follow-up times, tinnitus duration and electrical current intensity were generally reduced, regardless of the acute or subacute tinnitus group or left temporoparietal area (LTA) group with no statistical significance between two groups. Conclusion: Overall, electrical stimulation may be an effective and well-tolerated treatment option for tinnitus.
Intramuscular BoNT/A injections cause an inflammatory response in the muscle tissue of rats
Authors: Pingel Jessica , Pacolet Alexander , Elfving Betina , Ledri Litsa N 
Published: September 2021

Objectives The purpose of the present study was to investigate whether intramuscular BoNT/A injections cause an systemic inflammatory response and a local inflammatory response in the muscle tissue. Methods Thirty-two male Sprague Dawley rats treated with BoNT/A (i.m., 1IU) were divided in four groups, depending on the time of BoNT/A injection (2 days before, 1, 2, and 4 weeks before the experiment). Bio-Plex Pro Rat Cytokine 23-plex Multiplex Assay (Bio-Rad, USA). Results Systemic inflammation: 17 cytokines (IL1-α ( p = 0.005), IL-1β ( p = 0.01), IL-2 ( p = 0.04), IL-4 ( p = 0.03), IL-6 ( p = 0.03), IL-10 ( p = 0.02), IL12(p70) ( p = 0.03), IL-13 ( p = 0.04), IL-17 ( p = 0.03), GM-CSF ( p = 0.03), INF-γ ( p = 0.03), MIP-1α ( p = 0.03), MIP-3α ( p = 0.04), RANTES ( p = 0.001), TNF-α ( p = 0.04), vascular endothelial growth factor ( p = 0.03), and MCP-1 ( p = 0.02)) showed significantly higher expression levels 2 days after intramuscular BoNT/A injections compared to other time points (1, 2, and 4 weeks). Local inflammation: 12 cytokines (IL-1β ( p = 0.02), IL-6 ( p = 0.002), IL-10 ( p = 0.02), IL-13 ( p = 0.04), IL-17 ( p = 0.02), TNF-α ( p = 0.001), GM-CSF ( p = 0.01), M-CSF ( p = 0.04), MIP-1α ( p = 0.04), MIP-3α ( p = 0.002), RANTES ( p = 0.02), and MCP-1( p = 0.004)) showed higher expression levels 2 and/or 4 weeks after intramuscular BoNT/A injections compared to the other time points (2 days and 1 week). Conclusion Intramuscular BoNT/A injections result in a rapid systemic inflammatory response that only lasts a couple of days. At the same time, intramuscular BoNT/A injections cause an inflammatory response locally in the muscle with significantly higher cytokine levels 2 and/or 4 weeks after injections.
Management of Peritonsillar Abscesses in Adults: Survey of Otolaryngologists in Canada and the United States
Authors: Forner David , Noel Christopher W. , Grant Amy , Hong Paul , Corsten Martin , Wu Vincent , Taylor S. Mark , Trites Jonathan R. B. , Rigby Matthew H. 
Published: September 2021

ObjectiveThe management of peritonsillar abscess (PTA) has evolved over time. We sought to define contemporary practice patterns for the diagnosis and treatment of PTA.Study DesignCross‐sectional survey.SettingThe 15‐question survey was distributed to members of the Canadian Society of Otolaryngology–Head and Neck Surgery (CSO) and the American Academy of Otolaryngology–Head and Neck Surgery (AAO‐HNS).MethodsAn iterative, consensus‐based process was used for survey development. Primary outcomes were to determine methods of diagnosis and first‐line treatments for PTA. Exploratory, secondary outcomes were analyzed using multivariable logistic regression models.ResultsThe survey response rate was 12.6% (n = 1176). Most participants were attending staff (86%) in a community hospital setting (60%) and had been in practice for more than 20 years (38%). Most respondents (78%) indicated that at least half of the time, cross‐sectional imaging had already been performed before they were consulted. Half of respondents (49%) indicated that they perform incision and drainage of the abscess as first‐line treatment, while few (16%) provide medical management alone. In exploratory analysis, participants from the AAO‐HNS had higher odds of imaging already being performed before consultation (odds ratio [OR], 11.7; 95% CI, 4.6‐29.4) and increased odds of using medical management alone as a first‐line treatment (OR, 2.4; 95% CI, 1.3‐4.2) compared to respondents from the CSO.ConclusionThere is wide practice variation in the diagnosis and management of acute, uncomplicated PTA among otolaryngologists in Canada and the United States. The use of cross‐sectional imaging and medical management alone may differ between countries of practice.
Platelet variability index: a measure of platelet count fluctuations in patients with immune thrombocytopenia
Authors: Li Na , Heddle Nancy M. , Nazy Ishac , Kelton John G. , Arnold Donald M. 
Published: September 2021

Abstract
Fluctuations in platelet count levels over time may help distinguish immune thrombocytopenia (ITP) from other causes of thrombocytopenia. We derived the platelet variability index (PVI) to capture both the fluctuations in platelet count measurements and the severity of the thrombocytopenia over time. Raw PVI values, ranging from negative (less severe thrombocytopenia and/or low fluctuations) to positive (more severe thrombocytopenia and/or high fluctuations) were converted to an ordinal PVI score, from 0 to 6. We evaluated the performance characteristics of the PVI score for consecutive adults with thrombocytopenia from the McMaster ITP Registry. We defined patients with definite ITP as those who achieved a platelet count response after treatment with intravenous immune globulin or high-dose corticosteroids and possible ITP as those who never received ITP treatment or did not respond to treatment. Of 841 patients with thrombocytopenia, 104 had definite ITP, 398 had possible ITP, and 339 had non-ITP thrombocytopenia. For patients with definite ITP, the median PVI score was 5 [interquartile range (IQR) 5, 6] for patients with possible ITP, the median PVI score was 3 (1, 5); and for patients with non-ITP thrombocytopenia, the median PVI score was 0 (0, 2). A high PVI score correlated with the diagnosis of definite ITP even when calculated at the patient’s initial assessment, before any treatment had been administered. Platelet count fluctuations alone contributed to the specificity of the overall PVI score. The PVI score may help clinicians diagnose ITP among patients who present with thrombocytopenia for evaluation.
Development of a Csy4-processed guide RNA delivery system with soybean-infecting virus ALSV for genome editing
Authors: Luo Yanjie , Na Ren , Nowak Julia S. , Qiu Yang , Lu Qing Shi , Yang Chunyan , Marsolais Frédéric , Tian Lining 
Published: September 2021

AbstractBackgroundA key issue for implementation of CRISPR-Cas9 genome editing for plant trait improvement and gene function analysis is to efficiently deliver the components, including guide RNAs (gRNAs) and Cas9, into plants. Plant virus-based gRNA delivery strategy has proven to be an important tool for genome editing. However, its application in soybean which is an important crop has not been reported yet. ALSV (apple latent spherical virus) is highly infectious virus and could be explored for delivering elements for genome editing.ResultsTo develop a ALSV-based gRNA delivery system, theCas9-basedCsy4-processedALSVCarry (CCAC) system was developed. In this system, we engineered the soybean-infecting ALSV to carry and deliver gRNA(s). The endoribonuclease Csy4 effectively releases gRNAs that function efficiently in Cas9-mediated genome editing. Genome editing of endogenous phytoene desaturase (PDS) loci and exogenous 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS) sequence inNicotiana. benthamiana(N. benthamiana) through CCAC was confirmed using Sanger sequencing. Furthermore, CCAC-induced mutagenesis in two soybean endogenousGW2paralogs was detected.ConclusionsWith the aid of the CCAC system, the target-specific gRNA(s) can be easily manipulated and efficiently delivered into soybean plant cells by viral infection. This is the first virus-based gRNA delivery system for soybean for genome editing and can be used for gene function study and trait improvement.
National multi-stakeholder meetings: a tool to support development of integrated policies and practices for testing and prevention of HIV, viral hepatitis, TB and STIs
Authors: Simões Daniel , Matulionyté Raimonda , Stoniene Loreta , Wysocki Piotr , Kowalska Justyna , Gasbarrini Nadia , Cosmaro Lella , Blažić Tatjana Nemeth , Dišković Arian , Dominković Zoran , Jovovic Iva , Razmiene Ilona , Maffeo Manuel , Jakobsen Stine F. 
Published: September 2021

Abstract
Background
Country level policies and practices of testing and care for HIV, viral hepatitis and sexually transmitted infections are lagging behind European recommendations on integration across diseases. Building on previous experiences and evidence, the INTEGRATE Joint Action arranged four national stakeholder meetings. The aim was to foster cross-disciplinary and cross-disease collaborations at national level as a vehicle for strengthened integration of testing and care services. This article presents the methodology and discusses main outcomes and recommendations of these meetings.

Methods
Local partners in Croatia, Italy, Lithuania and Poland oversaw the planning, agenda development and identification of key persons to invite to ensure that meetings addressed main challenges and issues of the respective countries. Invited national stakeholders represented policy and public health institutions, clinical settings, testing sites and community organisations. National experts and experts from other European countries were invited as speakers and facilitators. Main topic discussed was how to increase integration across HIV, viral hepatitis and sexually transmitted infections in testing and care policies and practice; tuberculosis was also addressed in Lithuania and Italy.

Results
The agendas reflected national contexts and the meetings provided a forum to engage stakeholders knowledgeable of the national prevention, testing and care systems in interaction with international experts who shared experiences of the steps needed to achieve integration in policies and practice. The evaluations showed that participants found meetings relevant, important and beneficial for furthering integration. Of the respondents 78% agreed or strongly agreed that there was a good representation of relevant national stakeholders, and 78% that decision/action points were made on how to move the agenda forward. The importance of securing participation from high level national policy makers was highlighted. Outcomes were nationally tailored recommendations on integrated policies and strategies, diversification of testing strategies, stigma and discrimination, key populations, cost effectiveness, surveillance and funding.

Conclusions
Shifting from single to multi-disease approaches require collaboration among a broad range of actors and national multi-stakeholder meetings have proven excellent to kick-start this. Face-to-face meetings of key stakeholders represent a unique opportunity to share cross-sectoral perspectives and experiences, identify gaps in national policies and practices and agree on required next steps.
Mapping the PHQ-8 to EQ-5D, HUI3 and SF6D in patients with depression
Authors: Abdin Edimansyah , Chong Siow Ann , Seow Esmond , Tan Kelvin Bryan , Subramaniam Mythily 
Published: September 2021

AbstractBackgroundThere is limited evidence of mapping clinical instruments to a generic preference-based instrument in Asian patient populations. The current study aims to map the eight-item Patient Health Questionnaire depression scale (PHQ-8) onto the EuroQol Five-Dimension (EQ-5D), the Health Utilities Index Mark 3 (HUI3) and the Short Form Six-Dimension (SF-6D) which helps to inform future cost-utility analyses of treatments for depression.MethodsA total of 249 participants who had completed PHQ-8, EQ-5D, SF-6D and HUI3 questionnaires were included in the analyses. A beta regression mixture model was used to map the utility scores as a function of PHQ-8 total scores, PHQ-squared, age and gender. The predictive accuracy of the models was examined using mean absolute error and root mean square error.ResultsThe results were compared against two common regression methods including Ordinary Least Square (OLS) and Tobit regression models. The mean age of the sample was 36.2 years (SD = 11.1). The mean EQ-5D-3L, EQ-5D-5L, HUI3 and SF-6D utility scores were 0.615, 0.709, 0.461 and 0.607, respectively. The EQ-5D-3L, EQ-5D-5L and SF-6D utility scores were best predicted by the beta mixture regression model consisting of PHQ-8 total sores, PHQ-squared, and covariates including age and gender. The HUI3 was best predicted by the OLS regression model.ConclusionsThe current study provides important evidence to clinicians and researchers about the mapping algorithms that can be used in economic evaluation among patients with depression.