bluuebunny/crossref_metadata_2025_split huggingface dataset:
What Is the Failure Rate After Arthroscopic Repair of Bucket-Handle Meniscal Tears? A Systematic Review and Meta-analysis
Authors: Costa Giuseppe Gianluca , Grassi Alberto , Zocco Gianluca , Graceffa Angelo , Lauria Michele , Fanzone Giuseppe , Zaffagnini Stefano , Russo Arcangelo 
Published: June 2021

Background: Meniscal repair has become the treatment of choice for meniscal tears, especially in the subset of bucket-handle meniscal tears (BHMTs). However, a comprehensive estimate of the corresponding failure rate is not available, thus maintaining doubts about the healing potential of these tears. Furthermore, a wide range of factors to predict high failure rates have been reported but with conflicting evidence. Purpose: To determine the failure rate after arthroscopic repair of BHMTs as reported in the literature, compare this with the failure rate of simple meniscal tears extracted from the same studies, and analyze the influence of factors previously reported to be predictive of meniscal repair failure. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: A systematic search was conducted by 2 independent reviewers using principal bibliographic databases (PubMed, Scopus, Cochrane Library, and EMBASE). After a stepwise exclusion process, 38 articles met the inclusion criteria. Failure rate data were analyzed with a random-effects proportional meta-analysis (weighted for individual study size), and forest plots were constructed to determine any statistically significant differences between BHMTs versus simple tears (longitudinal, radial, or horizontal), medial versus lateral BHMTs, isolated procedures versus repairs with concomitant anterior cruciate ligament reconstruction, and tears in red-red versus red-white zones. Moreover, a meta-regression analysis was conducted to evaluate the effect of patient age and sex, suture technique (in-out or all-inside), time from injury to surgery, mean number of stitches, and length of follow-up on failure rates. Results: The pooled failure rate was 14.8% (95% CI, 11.3%-18.3%; I2 = 77.2%). A total of 17 studies provided failure rates of both BHMT repairs (46/311 repairs) and simple tear repairs (54/546 repairs), demonstrating a significantly higher failure rate for BHMT repairs (risk ratio [RR] = 1.50; 95% CI, 1.05-2.15; I2 = 0%; P = .03). Medial BHMT repairs (RR = 1.94; 95% CI, 1.25-3.01; I2 = 0%; P = .003) and isolated repairs (RR = 1.77; 95% CI, 1.15-2.72; I2 = 0%; P = .009) had statistically higher risk of failure, but no statistically significant difference was found between tears in red-red versus red-white zones. Among the other factors evaluated with meta-regression, only the mean number of stitches showed a statistically significant effect on failure rates. Conclusion: Based on the currently available literature, this systematic review provides a reasonably comprehensive analysis of failure rate after arthroscopic BHMT repair; failure is estimated to occur in 14.8% of cases. Medial tears and isolated repairs were the 2 major predictors of failure.
Increased Posterior Tibial Slope Is Associated With Greater Risk of Graft Roof Impingement After Anatomic Anterior Cruciate Ligament Reconstruction
Authors: Song Guan-yang , Ni Qian-kun , Zheng Tong , Feng Hua , Zhang Zhi-jun , Zhang Hui 
Published: June 2021

Background: Increased posterior tibial slope (PTS) has been reported to be associated with irreducible anterior tibial subluxation in extension after anatomic anterior cruciate ligament (ACL) reconstruction (ACLR), which raises concerns about the greater risk of graft roof impingement (GRI) although the tibial tunnel is positioned anatomically. Hypothesis: Increased PTS would be associated with greater risk of GRI after anatomic ACLR. Study Design: Case-control study; Level of evidence, 3. Methods: Between January 2016 and December 2017, a total of 418 consecutive patients were diagnosed as having noncontact ACL injuries and underwent primary anatomic ACLR. Among them, 26 patients had ≥1 of the following features during the second-look arthroscopy: fractured/guillotined bundles at the tibial insertion or cyclops lesion. These patients were confirmed to have GRI and were allocated to the study group. They were also matched 1:2 to 52 control participants without GRI. PTS was measured on true lateral whole-leg radiographs. Intra-articular ACL graft signal intensity was evaluated on postoperative magnetic resonance imaging scans (mean, 32.8 months; range, 26-38 months) and divided into 3 grades (I, good; II, moderate; III, poor) based on degree of GRI. Moreover, anterior subluxation of the lateral compartment (ASLC) and medial compartment (ASMC) in extension relative to the femoral condyles were measured on postoperative magnetic resonance imaging scans and compared between the groups. In addition, predictors of GRI were evaluated using multivariate logistic regression analysis and included body mass index, PTS, pivot-shift test, KT-1000 side-to-side difference, and concomitant meniscal tears. Results: PTS in the study group was significantly higher than that in control group (mean ± SD, 13.8°± 1.5° vs 9.5°± 1.8°; P < .05). In the study group (n = 26), patients with grade III (poor) graft signal intensity (n = 9) showed significantly higher PTS than those with grade II (moderate; n = 17) (16.4°± 1.7° vs 12.4°± 1.3°; P < .05). Moreover, the mean postoperative ASLC and ASMC in extension were significantly larger in the study group than the control group (ASLC, 4.1 ± 1.3 vs 0.8 ± 0.4 mm; ASMC, 4.3 ± 1.5 vs 0.9 ± 0.3 mm; P < .05). Furthermore, the abnormal degree of PTS (≥12°) was determined to be an independent risk factor associated with GRI after anatomic ACLR (odds ratio, 9.0 [95% CI, 3.7-30.2]; P < .001), whereas body mass index, grade of pivot-shift test, KT-1000 side-to-side difference, and concomitant meniscal tears were not. Conclusion: Increased PTS (≥12°) was associated with greater risk of GRI after anatomic ACLR. This may provide additional information for counseling patients with greater risk of GRI.
The Application of Computerized Adaptive Testing to the International Knee Documentation Committee Subjective Knee Evaluation Form
Authors: Lee Donghoon , Rao Somnath , Campbell Richard E. , Plummer Otho R. , Tjoumakaris Fotios P. , Cohen Steven B. , Freedman Kevin B. 
Published: June 2021

Background: Patient-reported outcome measures (PROMs) are commonly used to monitor functional outcomes for clinical and research purposes; unfortunately, many PROMs include redundant, burdensome questions for patients. The use of predictive models to implement computerized adaptive testing (CAT) offer a potential solution to reduce question burden in outcomes research. Purpose: To validate the usage of an appropriate CAT system to improve the efficiency of the International Knee Documentation Committee (IKDC) Subjective Knee Form. Study Design: Cohort study (Diagnosis); Level of evidence, 2. Methods: Validation was based on electronically collected patient responses from 2 separate orthopaedic sports medicine clinics. Diagnoses included, but were not limited to, meniscal lesions, ligamentous injuries, and chondral defects. The CAT system was previously developed through analysis of an electronic knee PROM database that did not contain any of these cases. Results: A total of 2173 patient responses (1229 patients) were collected. The CAT model was able to reduce the question burden by a mean of 9.33 questions (45.1%). Higher CAT-predicted scores correlated strongly with higher actual scores ( r = 0.99; intraclass correlation coefficient = 0.99). The mean difference between the CAT-predicted score and the actual PROM score was 0.48 of a point on a scale of 0 to 100. Conclusion: The use of CAT systems, in conjunction with electronic PROMs, can accurately predict outcome scores for IKDC PROMs, while dramatically decreasing the number of questionnaire items needed for any given patient. By decreasing questionnaire burden, clinicians and researchers can potentially increase patient participation and follow-up in both clinical assessments and research trials.
Face-to-face versus Video Teleconference Group Cognitive Behavioural Therapy for Anxiety and Related Disorders: A Preliminary Comparison
Authors: Milosevic Irena , Cameron Duncan H. , Milanovic Melissa , McCabe Randi E. , Rowa Karen 
Published: June 2021

Objective: Telehealth is being increasingly incorporated into the delivery of mental health care and has received widespread attention during the COVID-19 pandemic for its ability to facilitate care during physical distancing restrictions. Videoconferencing is a common telehealth modality for delivering psychotherapy and has demonstrated similar outcomes to those of face-to-face therapy. Cognitive behavioural therapy (CBT) is the most common psychotherapy evaluated across various telehealth modalities; however, studies on CBT delivered via videoconference, particularly in a group therapy format, are lacking. Further, little research exists on videoconference group CBT for anxiety disorders. Accordingly, the present study compared the outcomes of group CBT for anxiety and related disorders delivered via videoconference versus face-to-face. Method: Using a non-randomized design, data on attendance, dropout, clinical outcomes, and functional impairment were collected from 413 adult outpatients of a tertiary care anxiety disorders clinic who attended a CBT group for panic disorder/agoraphobia, social anxiety disorder, generalized anxiety disorder (GAD), or obsessive-compulsive disorder delivered either face-to-face (pre-COVID-19 pandemic) or via videoconference (since the onset of COVID-19 pandemic). Outcomes were assessed using well-validated self-report measures. Data were collected pre-treatment, across 12 weekly sessions, and post-treatment. Intent-to-treat analyses were applied to symptom outcome measures. Results: Face-to-face CBT conferred only a slight benefit over videoconference CBT for symptom outcomes across all groups, but when assessed individually, only the GAD group showed greater symptom improvement in the face-to-face format. Effect sizes for significant differences between the delivery formats were small. Participants in videoconference groups tended to have slightly higher attendance rates in some instances, whereas functional improvement and treatment dropout were comparable across the delivery formats. Conclusions: Results provide preliminary evidence that videoconference group CBT for anxiety and related disorders may be a promising and effective alternative to face-to-face CBT. Additional research is needed to establish equivalence between these delivery formats.
Medicines Related Problems (MRPs) Originating in Primary Care Settings in Older Adults - A Systematic Review
Authors: Ude-Okeleke Rosetta Chinyere , Aslanpour Zoe , Dhillon Soraya , Umaru Nkiruka 
Published: June 2021

Background: As people age, they become increasingly vulnerable to the untoward effects of medicines due to changes in body systems. These may result in medicines related problems (MRPs) and consequent decline or deterioration in health. Aim: To identify MRPs, indicators of deterioration associated with these MRPs, and preventative interventions from the literature. Design and Setting: Systematic review of primary studies on MRPs originating in Primary Care in older people. Methods: Relevant studies published between 2001 and April 2018 were obtained from Medline (via PubMed), CINAHL, Embase, Psych Info, PASCAL, Scopus, Cochrane Library, Science Direct, and Zetoc. Falls, delirium, pressure ulcer, hospitalization, use of health services and death were agreed indicators of deterioration. The methodological quality of included studies was assessed using the Down and Black tool. Results: There were 1858 articles retrieved from the data bases. Out of these, 21 full text articles met inclusion criteria for the review. MRPs identified were medication error, potentially inappropriate medicines, adverse drug reaction and non-adherence. These were associated with indicators of deterioration. Interventions that involved doctors, pharmacists and patients in planning and implementation yielded benefits in halting MRPs. Conclusion: This Systematic review summarizes MRPs and associated indicators of deterioration. Appropriate interventions appeared to be effective against certain MRPs and their consequences. Further studies to explore deterioration presented in this systematic review is imperative.
Effect of fiber hybridization on mechanical, thermal, and water absorption behavior of HF/CF/HDPE composites
Authors: Srivastava Prashant , Sinha Shishir 
Published: June 2021

The composite materials are present in nature since the prehistoric era. Applications of fiber-based composite materials are increasing day by day in our society to overcome the raised environmental and economic concerns. Hence, waste fiber can be utilized as the best resource to develop composites. The present study deals with the impact of hybridization on the mechanical, thermal, and water absorption behavior of hair and coir fiber-based hybrid composites. The compression molding technique was used to develop the hybrid composites with fixed fiber content (15 wt.%) and was also varied the relative weight percentage of hair and coir fibers [(100% HF), (75% HF/25% CF), (50% HF/50% CF), (25% HF/75% CF) and (100% CF)] in reinforcing phase with HDPE composites S1, S2, S3, S4, and S5, respectively. The composite S2 was achieved superior mechanical attributes as compared to other hybrid/non-hybrid composites. The composite S2 was improved the tensile strength 5% and 35.2% more in comparison to composites S1 and S5, respectively. The thermal behavior (TGA, DTG, and DTA) was also influenced by the blending ratio of fibers of composites. The 5% and 50% weight losses of composite S2 were observed at higher temperature 343.8°C and 465.8°C as compare to other composites, which showed the thermal stability of composites S2. SEM analysis was used to investigate the strength of the fiber-matrix interface, which was shown a significant connection between mechanical and thermal behaviors. The crystallinity of hybrid and non-hybrid composites was examined by using the X-ray diffraction (XRD) analyzer and composite S2 was achieved 326 × 10−9 m crystal size at 21.053° peak position with wavelength 1.5406 × 10−10 m for Cu. The water absorption test was used to examine the moisture resistivity of composite materials, which was helpful to increase the applications of materials in humid areas.
Transition Experiences of Indian Nurses Into Australian Mental Health System
Authors: Joseph Bindu , Olasoji Michael , Moss Cheryl , Cross Wendy 
Published: June 2021

Introduction: In the past decade, there has been an influx of migrant nurses from India to Australia. Migrant professionals have specific transition needs associated with working in Mental Health (MH). This study aimed to explore the transition experience of overseas trained nurses from India working in Australian MH settings. Method: Hermeneutic phenomenology was the methodological approach used in the study. The participants ( N = 16) were overseas trained nurses from India. Data were collected through in-depth interview and analysed using thematic analysis. Results: The findings resulted in the identification of the following themes: (1) Living in dual culture, (2) Loneliness, (3) Discrimination, and (4) Feeling incomplete. Discussion: It is evident that the transition to work in MH in Australia was a journey of mixed experiences. While certain findings of this study are comparable with experiences of migrant nurses in other settings, it provides insight into those that are working in MH.
Enabling Players to Develop Theories of Change for Sustainable Development: A Serious Game
Authors: Tribaldos Theresa , Schneider Flurina 
Published: June 2021

Introduction Sustainable development and sustainability transformations have reached high urgency on national and international agendas and involve new knowledge and learning processes. Transdisciplinary co-production of knowledge as a research approach in combination with the methodological elaboration of theories of change have potential to support transformative learning processes. Both approaches engage with questions about the actors involved, impact pathways, or the role of power and agency in a given context. Intervention We introduce the THEORY OF CHANGE GAME, which applies theory of change thinking to transdisciplinary projects aiming for sustainable development. A combination of board and card game, it evolves around collaborative discussions. Method We explain the iterative development rounds of the game through several game sessions in different settings and analyse whether and how the game supports social learning for sustainable development. To assess social learning, we draw on the typology developed by Baird et al. (2014) , which includes cognitive, relational, and normative learning. Results The iterative development rounds took place first in academic settings and then in a non-academic event. Our observations during the game and the debriefing rounds after the game demonstrate that social learning takes place in the form of cognitive and relational learning. Verified findings on normative learning would need other assessment approaches. Discussion and conclusion Several development rounds supported the design of a game that is suitable to support social learning for sustainable development. We see the potential of the game mainly in cognitive and relational learning. Further work on gamification elements could help to enhance the entertainment component of the game.
Sharing COMFORT Communication Training With Healthcare Professionals in Nairobi, Kenya: A Pilot Webinar Series
Authors: Wittenberg Elaine , Alabere Regina Ogechi , Beltran Emeline , Goldsmith Joy V. , Moledina Shabnam 
Published: June 2021

Background: Communication training for healthcare providers is evident in the context of the COVID-19 global pandemic, however training opportunities are not available in countries with limited resources. Objectives: To investigate perceived comfort in communication about end-of-life and palliative care among healthcare providers in Nairobi, Kenya and to evaluate a pilot webinar-based communication training series. Methods: Through a partnership with a research hospital in Nairobi, healthcare providers engaged an online survey to assess perceived comfort in communication and prior educational training in communication. The COMFORT communication model was used to develop and pilot a webinar-based communication training series to meet training needs. Pre-post measures of comfort in communication and post-curriculum evaluation were used to evaluate the webinars. Results: Survey findings from 94 healthcare providers demonstrated that communication training is most needed when patient/family culture is different from provider. Physicians reported less comfort in communication than nurses and other professionals, especially in communication with family about spiritual or religious concerns. Nurses reported more overall training in palliative care communication topics than physicians and other disciplines. The 3-part webinar series increased communication comfort for physicians and nurses, was highly rated, and participants reported that they would recommend COMFORT webinar training to colleagues. Conclusion: Webinar-based platforms for communication training show promise for meeting communication training needs of healthcare providers.
Interventions in an Ambulatory Setting to Prevent Progression to Severe Disease in Patients With COVID-19: A Systematic Review
Authors: O Murchu Eamon , Spillane Susan , Byrne Paula , O’Neill Michelle , Harrington Patricia , Ryan Máirín 
Published: June 2021

Objective: To conduct a systematic review on the effectiveness and safety of pharmacological and nonpharmacological interventions, in the ambulatory setting, aimed at preventing severe disease in patients with COVID-19. Data Sources: Electronic databases (PubMed, EMBASE, and EuropePMC) were searched on January 6, 2021. Study Selection and Data Extraction: A systematic review was conducted, adhering to PRISMA guidelines. The quality of individual trials was assessed using the Cochrane Risk-of-Bias Tool 2, and the certainty of evidence was assessed using GRADE. Data Synthesis: The collective search retrieved 3818 citations. Eight trials relating to 9 pharmacological interventions were identified. No evidence for nonpharmacological interventions was identified. Low certainty evidence of effectiveness in preventing severe disease was found for fluvoxamine (absolute difference: −8.7%; 95% CI: −1.8% to −16.4%) and bamlanivimab plus etesevimab (absolute difference: −4.9%; 95% CI: −0.8% to −8.9%). Both trials were limited by small sample sizes and short durations of follow-up. In addition, very low certainty evidence of effect was found for ivermectin plus doxycycline and sulodexide. Based on published data, insufficient evidence of effect was found for bamlanivimab (monotherapy), casirivimab plus imdevimab, ivermectin (monotherapy), nitazoxanide, and peginterferon lambda. Relevance to Patient Care and Clinical Practice: This review assessed all ambulatory treatments for COVID-19 that may improve patient outcomes and reduce hospitalizations. Conclusion: Recent trials have shown promising results for a number of pharmacological agents to treat COVID-19 in the ambulatory setting. However, larger, more robust trials are needed to support the routine use of these agents outside of monitored clinical trials.
Involvements of choroidal vascular structures with local treatments in patients with diabetic macular edema
Authors: Kase Satoru , Endo Hiroaki , Takahashi Mitsuo , Yokoi Masahiko , Ito Yuki , Katsuta Satoshi , Sonoda Shozo , Sakamoto Taiji , Ishida Susumu , Kase Manabu 
Published: June 2021

Purpose: To examine changes of the choroidal morphology in patients with diabetic macular edema (DME) before and after local treatments. Methods: This study was on 20 eyes with DME, observed for more than 24 months. All patients underwent laser photocoagulation (Laser), sub-tenon triamcinolone acetonide injection (TA), or intravitreal aflibercept injection (IVA). Central macular and choroidal thicknesses (CMT/CCT), and choroidal vascular structures consisting of the total choroidal area (TCA), luminal area (LA), and stromal area (SA) were measured by a binarization method. The ratios of LA in TCA were eventually determined as the L/C ratio in each case. Results: The L/C ratio significantly decreased for 24 months in patients with DME ( p = 0.01), whereas no significant differences were noted in other parameters including TCA, LA, SA, or CCT. Among patients treated with Laser ± TA ± IVA, a significant correlation was found between a high L/C ratio at pretreatment and a lower cumulative number of injections (1–2 times/24 months) ( p = 0.04). The L/C ratio in pretreatment showed a significantly inverse correlation with CMT (−0.60, p = 0.02) and subsequent BCVA (logMAR) (−0.59, p = 0.03). Conclusion: This study highlighted that the L/C ratio in pretreatment might predict a change of the visual acuity in DME.