bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation of Preoperative Radiographic Severity With Disability and Symptom Severity in Hallux Valgus
Authors: Matthews Michael , Klein Erin , Acciani Alyse , Sorensen Matthew , Weil Lowell , Weil Lowell S. , Fleischer Adam 
Published: April 2019

Background: Some US insurance companies have recently started to require minimum angular measurements, for coverage decisions, in patients seeking operative correction for symptomatic hallux valgus. This logic naturally assumes that the magnitude of radiographic bunion deformity is related to the magnitude of patient’s presenting symptoms and/or disability. Methods: We conducted an analysis of existing data in our practice to determine whether patient-reported symptoms and disability prior to bunion surgery correlated with preoperative radiographic measurements commonly used to quantify hallux valgus severity. Symptoms and disability level were determined using patient-reported preoperative Foot and Ankle Outcome Score (FAOS), a validated instrument commonly used in hallux valgus assessment. Spearman correlation coefficient was then used to quantify the strength of any correlations. Preoperative data from 107 patients (107 feet) with mean age of 49.3 ± 13.8 years who underwent isolated osseous hallux valgus surgery within our practice between June 1, 2016, and July 30, 2018, were available. Results: No radiographic variable achieved even a moderate correlation with any of the FAOS subscales with the exception of tibial sesamoid position with FAOS Pain (rho=0.402, P = .01) in patients aged 56 years and older. The direction of this correlation was positive, indicating that greater preoperative sesamoid abnormalities were paradoxically associated with less presenting pain (ie, higher FAOS Pain scores). Conclusion: It would appear that radiographic severity of bunion deformity is not well correlated with symptom level and/or disability and, we would argue, should not play a role in coverage decisions for patients presenting for hallux valgus surgery. Level of Evidence: Level IV, retrospective case series.
No effect of femoral canal jet-lavage on the stability of cementless stems in primary hip arthroplasty: a randomised RSA study with 6 years follow-up
Authors: Zampelis Vasileios , Flivik Gunnar , Kesteris Uldis 
Published: April 2019

Introduction: In contrast to cemented hip prostheses, the effect of washing the bone bed with jet-lavage prior to insertion of cementless stem components in primary hip arthroplasty (THA) is unclear. Jet-lavage potentially decreases the risk of fat embolisation during rasping and stem insertion and might help in avoiding bacterial contamination. An earlier animal study has shown less debris and better-organised trabecular structure of new bone when jet-lavage was used. We hypothesised that the primary stability of cementless femoral stems implanted after jet-lavage of the femoral canal prior to stem insertion would improve with earlier stabilisation, as measured with Radiostereometry (RSA), compared with insertion without prior jet-lavage. Methods: 40 patients with primary osteoarthritis operated on with a cementless titanium grit blasted stem are included in the study. The patients were randomised to either jet-lavage or control without any lavage of the femoral canal prior to insertion of the prosthesis. The stem migration pattern was measured with RSA at 0, 3, 12, 24 and 72 months. Results: At 6 years, 19 patients remained for analysis in the jet-lavage and 18 in the control group. We found no difference in extent or pattern of migration as measured with RSA. Both groups seemed to have stabilised within 3 months after a slight subsidence and retroversion. No stem was revised or considered loose as measured with RSA. Conclusions: Washing the bone bed with jet-lavage prior to insertion of cementless stems does not affect the stability of cementless femoral components. No adverse effects were observed.
Reliability of Medical History Reporting in Older Adults With and Without Cognitive Impairment
Authors: Curcio Nicholas , Wilmoth Kristin , LoBue Christian , Cullum C Munro 
Published: April 2019

Background: Clinical diagnosis of cognitive disorders depends on accurate reporting of medical history, yet little is known about the reliability and the validity of such reports, particularly in older patients with and without cognitive impairment. Methods: In 2 studies, we examined the reliability and the validity of reported histories of select medical events in adults with and without cognitive impairment from a large national cohort. Results: Information from subjects (N1 = 3664), obtained from 2 time points, 6 to 12  months apart, was consistent across most medical events, regardless of the diagnostic group (range = 97.6%-100% agreement; Cohen κ range = 0.712-0.945), with few exceptions. Validity analyses (N2 = 382) revealed that 3 of 5 medical events assessed showed substantial agreement between self-report information and clinician diagnosis. Conclusions: These data represent some of the first to demonstrate the reliability and the validity of reported select medical events in older adults with and without cognitive impairment.
Illinois Department of Motor Vehicle Customers’ Reasons for (Not) Registering as an Organ Donor
Authors: Reynolds-Tylus Tobias , Quick Brian L. , King Andy J. , Moore Miriam 
Published: April 2019

Context: Organ donation campaigns are maximized when promotional messages address salient issues among the intended audience. A diverse sample (N = 1573) was recruited to identify the reasons for (not) registering as an organ donor. Objective: Relying on an established coding scheme, an updated explanation for why individuals register (or not) as organ donors is provided. Moreover, registration trends with respect to race, biological sex, and age is presented. Method: Participants exiting Department of Motor Vehicle offices (N = 12) were surveyed to understand their reasons for registering and not registering as organ donors. Results: Benefits of donation followed by prior registration, rational arguments, and personal experiences represented nearly 90% of the coded responses for registering. Conversely, negative beliefs, decisional uncertainty, perceived disqualification, no reason, general fear/disgust, and lack of opportunity constituted nearly 90% of the coded responses for not registering as an organ donor. Whites and Latinx individuals were more likely to register as organ donors compared to African Americans. Participants in the lower (18-24) and upper (65+) age brackets had the lowest donor registration rates. Conclusion: Promotional efforts should continue to target younger and older audience segments with information about organ donation as well as African Americans. Results from the current study suggest emphasizing the benefits of organ donation as well as overcoming negative beliefs, decisional uncertainty, and perceived disqualifications.
Cognitive Function of Elderly Persons in Japanese Neighborhoods: The Role of Street Layout
Authors: Koohsari Mohammad Javad , Nakaya Tomoki , McCormack Gavin R. , Shibata Ai , Ishii Kaori , Yasunaga Akitomo , Oka Koichiro 
Published: April 2019

Objectives:The aims of this study were to examine (a) associations of two metric and space syntax measures of street layout with the cognitive function of Japanese older adults and (b) the extent to which objectively assessed physical activity mediated such associations.Methods:Cross-sectional data from 277 older adults who lived in Japan were used. Street layout attributes were objectively calculated for each participant’s geocoded home location. The Mini-Mental State Examination was used to evaluate cognitive function. Physical activity was objectively assessed with accelerometers.Results:There was a statistically significant negative association between street integration and the odds of having cognitive impairment. Objectively assessed physical activity did not attenuate this relationship.Conclusions:Our findings provide unique evidence regarding the importance of the topological aspects of street layouts in (re)designing neighborhoods to support mental illness.
Establishing an electronic health record–supported approach for outreach to and recruitment of persons at high risk of type 2 diabetes in clinical trials: The vitamin D and type 2 diabetes (D2d) study experience
Authors: Aroda Vanita R , Sheehan Patricia R , Vickery Ellen M , Staten Myrlene A , LeBlanc Erin S , Phillips Lawrence S , Brodsky Irwin G , Chadha Chhavi , Chatterjee Ranee , Ouellette Miranda G , Desouza Cyrus , Pittas Anastassios G ,   for the D2d Research Group
Published: April 2019

Aims To establish recruitment approaches that leverage electronic health records in multicenter prediabetes/diabetes clinical trials and compare recruitment outcomes between electronic health record–supported and conventional recruitment methods. Methods Observational analysis of recruitment approaches in the vitamin D and type 2 diabetes (D2d) study, a multicenter trial in participants with prediabetes. Outcomes were adoption of electronic health record–supported recruitment approaches by sites, number of participants screened, recruitment performance (proportion screened who were randomized), and characteristics of participants from electronic health record–supported versus non–electronic health record methods. Results In total, 2423 participants were randomized: 1920 from electronic health record (mean age of 60 years, 41% women, 68% White) and 503 from non–electronic health record sources (mean age of 56.9 years, 58% women, 61% White). Electronic health record–supported recruitment was adopted by 21 of 22 sites. Electronic health record–supported recruitment was associated with more participants screened versus non–electronic health record methods (4969 vs 2166 participants screened), higher performance (38.6% vs 22.7%), and more randomizations (1918 vs 505). Participants recruited via electronic health record were older, included fewer women and minorities, and reported higher use of dietary supplements. Electronic health record–supported recruitment was incorporated in diverse clinical environments, engaging clinicians either at the individual or the healthcare system level. Conclusion Establishing electronic health record–supported recruitment approaches across a multicenter prediabetes/diabetes trial is feasible and can be adopted by diverse clinical environments.
Ankle Arthrodesis With Structural Grafts Can Work for the Salvage of Failed Total Ankle Arthroplasty
Authors: Halverson Adam L. , Goss David A. , Berlet Gregory C. 
Published: April 2019

Background. Treatment options after failed total ankle arthroplasty (TAA) are limited. This study reports midterm outcomes and radiographic results in a single-surgeon group of patients who have undergone ankle arthrodesis with intramedullary nail fixation and structural allograft augmentation following failed TAA. Methods. A retrospective review on patients who underwent failed TAA revision with structural femoral head allograft and intramedullary tibiotalocalcaneal (TTC) nail fixation was completed. Foot Function Index (FFI), American Orthopaedic Foot & Ankle Society (AOFAS) outcome scores, and radiographs were obtained at each visit with 5-year follow-up. Results. Five patients were followed to an average of 5.2 years (range 4.7-5.6). Enrollment FFI was 34.82 (range 8.82-75.88); at midterm follow-up it was 20.42 (range 0-35.38). Enrollment AOFAS scores averaged 66.6 (range 61-77); at midterm follow-up it was 70.33 (range 54-88). Radiographs showed union in 4 of 5 patients at enrollment and 2 of 3 patients at midterm. Conclusions. Utilization of TTC fusion with femoral head allograft is a salvage technique that can produce a functional limb salvage. Our results show continued improvement in patient-reported outcomes, with preservation of limb length and reasonable union rate. Levels of Evidence: Therapeutic, Level II: Prospective, comparative trial.
The Role of Relaxin-2 in Tissue Remodeling of Chronic Rhinosinusitis With Nasal Polyps
Authors: Li Yimin , Tan Guojing , Liu Jie , Ke Xia , Shen Yang , Huang Jiangju , Hu Guohua , Xiang Tingxiu , Yang Yucheng 
Published: April 2019

Background Relaxin is a small peptide hormone that regulates extracellular matrix remodeling and reduces fibrosis in a number of organs. Little is known about its impact on chronic rhinosinusitis with nasal polyps (CRSwNP); thus, we aimed to determine the expression of human H2 relaxin (relaxin-2) and its role in tissue remodeling in CRSwNP. Methods Patients were enrolled and divided into the following groups: CRS with NP (CRSwNP; n = 20), CRS without NP (CRSsNP; n = 20), and controls (n = 15). Tissue samples were analyzed by Masson trichrome staining for collagen, while the location and expression of relaxin-2, transforming growth factor beta 1 (TGF-β1), and phosphorylated (p) Smad2/Smad3 were analyzed by immunohistochemistry and Western blot. The expression of relaxin-2, Smad2, Smad3, and TGF-β1 mRNA was tested by quantitative polymerase chain reaction (qPCR). Ex vivo NP were treated with relaxin-2 (n = 15) or TGF-β1 (n = 15). Collagen type I (collagen I), relaxin-2, and TGF-β1 levels in the culture supernatants were examined by enzyme-linked immunosorbent assay, while pSmad2/Smad3 in culture pellets was analyzed by Western blot, and the expression of Smad2 and Smad3 mRNA was tested by qPCR. Results The collagen, relaxin-2, TGF-β1, and pSmad2/Smad3 protein expression levels were significantly decreased in the CRSwNP group compared with the CRSsNP group ( P < .05). The expression of relaxin-2, Smad2, Smad3, and TGF-β1 mRNA in the CRSsNP group was significantly higher than in the CRSwNP and control groups ( P < .05). Compared with the ex vivo controls, in CRSwNP, the levels of TGF-β1, collagen I, pSmad2/Smad3, Smad2, and Smad3 were markedly decreased after relaxin-2 treatment. However, relaxin-2, collagen I, pSmad2/Smad3, Smad2, and Smad3 were remarkably increased after TGF-β1 treatment. Conclusions The antifibrotic effects of relaxin-2 may play a role in tissue remodeling in CRSwNP, but the detailed mechanism deserves further study.
Riociguat for the treatment of transthyretin cardiac amyloidosis: data from a named patient use program in Austria
Authors: Duca Franz , Aschauer Stefan , Zotter‐Tufaro Caroline , Binder Christina , Kammerlander Andreas A. , Börries Benedikt , Agis Hermine , Kain Renate , Hengstenberg Christian , Mascherbauer Julia , Bonderman Diana 
Published: April 2019

Patients with transthyretin cardiac amyloidosis (TTR CA) suffer from impaired exercise capacity, have a poor quality of life (QoL), and approved treatments are lacking. Stimulators of the soluble guanylate cyclase are promising new pharmaceuticals in the treatment armamentarium of heart failure patients. The aim of the present study was to report on the safety and efficacy of riociguat administration in patients with TTR CA. TTR CA patients received riociguat for 4–6 months within the frames of a national named patient use (NPU) program. Parameters of interest included changes in submaximal exercise capacity, invasive hemodynamic parameters, and QoL. Between March 2012 and June 2017, 86 CA patients were screened for the NPU program, of whom 13 TTR CA patients were eligible for participation. In our study cohort, riociguat had an acceptable tolerability profile. At follow‐up, we could detect slight improvements in median 6‐min walk distance (396 m [interquartile range (IQR) = 340–518] vs. 400 m [IQR = 350–570], P = 0.045), New York Heart Association class ≥ III (n = 7 [53.9%] vs. n = 0 [0.0%], P = 0.031), cardiac output (4.3 L/min [IQR = 3.9–5.1] vs. 4.5 L/min [IQR = 4.2–5.1], P = 0.022), diastolic pressure gradient (1.0 mmHg [IQR = −1.5–3.0) vs. −1.0 mmHg [IQR = −3.0–1.0], P = 0.049), and QoL (50.0% [IQR = 40.0–58.0] vs. 60.0% [IQR = 50.0–75.0], P = 0.021). Pulmonary arterial pressures were not altered. The present case series of TTR CA patients indicates that riociguat administration was safe and associated with minor clinical as well as hemodynamic improvements.
Seeing the quality improvement forest through the quality improvement trees: A meta-synthesis of case studies in Florida and Georgia
Authors: Livingood William C , Bilello Lori , Lukens-Bull Katryne 
Published: April 2019

Objectives: To identify important characteristics of quality improvement applications for population health and healthcare settings and to explore the use of quality improvement as a model for implementing and disseminating evidence-based or best practices. Methods: A meta-synthesis was used to examine published quality improvement case studies. A total of 10 published studies that were conducted in Florida and Georgia were examined and synthesized using meta-synthesis (a qualitative research methodology) for meaningful insights and lessons learned using defined meta-synthesis inclusion criteria. The primary focus of the analysis and synthesis were the reported processes and findings that included responses to structured questioning in addition to emergent results from direct observation and semi-structured open-ended interviewing. Results: The key insights for the use of quality improvement in public health and healthcare settings included (1) the essential importance of data monitoring, analysis, and data-based decision making; (2) the need to focus on internal mutable factors within organizations; (3) the critical role of quality improvement team group dynamics; (4) the value of using a quality improvement collaborative or multi-clinic quality council/committee for sharing and comparing performance on key metrics; and (5) the need to identify a quality improvement approach and methods for clarification as a structured quality improvement intervention. Conclusion: In addition to the advantages of using quality improvement to enhance or improve healthcare and public health services, there is also potential for quality improvement to serve as a model for enhancing the adoption of evidence-based practices within the context of dissemination and implementation research.
Implications of inflammation and insulin resistance in obese pregnant women with gestational diabetes: A case study
Authors: Al-ofi Ebtisam Aziz 
Published: April 2019

Background: Obesity is one of the leading pregnancy risks for both the mother and the neonate. The prevalence of gestational diabetes mellitus has been increasing, especially with the increase in obesity in reproductive-aged women. A high body mass index, a sedentary lifestyle, a previous macrosomic infant, polycystic ovary syndrome and hypothyroidism are the main risk factors for gestational diabetes mellitus. Early gestational diabetes mellitus detection in high-risk individuals is a useful method for preventing further complications and/or preventing this disease by improving the patient’s lifestyle. Case presentation: A morbidly obese woman with a high body mass index (>36) at 24 weeks gestational age presented with several gestational diabetes mellitus risk factors. Her glucose tolerance test verified gestational diabetes mellitus, and, incidentally, her C-reactive protein level was elevated without obvious reason. Her plasma levels of inflammatory cytokines had also been assessed and were exaggerated. After lifestyle intervention, including weight management, the patient’s inflammatory mediators, including her C-reactive protein level, dropped. Therefore, this study aimed to identify the relationship between the patient’s inflammation and obesity. Conclusion: Antenatal C-reactive protein screening could be used throughout pregnancy to predict inflammation from high-risk pregnant women. This case scenario describes the interrelationships between inflammation, insulin resistance and adipokines, as well as the contributions of hypothyroidism and polycystic ovary syndrome. Further research should emphasise the relationships between inflammation and obesity in pregnancy.
Depressive symptomatology in a female patient with Tarlov cyst
Authors: Kontoangelos Konstantinos , Economou Marina , Katsi Vasiliki , Papageorgiou Charalambos 
Published: April 2019

Introduction: The spinal perineurial cyst is a rare anomaly of the nervous system. It is also known as Tarlov cyst, since it was described for the first time by Isadore M. Tarlov. The pathology is defined as a cystic dilatation between the perineurium and endoneurium of spinal nerve roots, located at the level of the spinal ganglion and filled with cerebrospinal fluid but without communication with the perineurial subarachnoid space. Case report: We present the case of a 56-year-old female who reported sudden onset of symptoms of a depressive symptomatology accompanied with acute pain in the lumbar area. Lumbosacral magnetic resonance imaging scan revealed Tarlov cysts. Discussion: Radiological investigations in patients with depressive symptomatology may be substantial.
Australian Football League Injury Characteristics Differ Between Matches and Training: A Longitudinal Analysis of Changes in the Setting, Site, and Time Span From 1997 to 2016
Authors: Hoffman Daniel T. , Dwyer Dan B. , Tran Jacqueline , Clifton Patrick , Gastin Paul B. 
Published: April 2019

Background: Injury surveillance has been used to quantify the scope of the injury burden in Australian football. However, deeper statistical analyses are required to identify major factors that contribute to the injury risk and to understand how these injury patterns change over time. Purpose: To compare Australian Football League (AFL) injury incidence, severity, prevalence, and recurrence by setting, site, and time span from 1997 to 2016. Study Design: Descriptive epidemiology study. Methods: A total of 15,911 injuries and medical illnesses recorded by team medical staff at each club were obtained from the AFL’s injury surveillance system and analyzed using linear mixed models with 3 fixed effects (setting, time span, site) and 1 random effect (club). All types of injuries and medical illnesses were included for analysis, provided that they caused the player to miss at least 1 match during the regular season or finals. Five-season time spans (1997-2001, 2002-2006, 2007-2011, and 2012-2016) were used for comparisons. Incidence rates were expressed at the player level. Recurrences were recoded to quantify recurrent injuries across multiple seasons. Results: Compared with training injuries, match injuries had a 2.8 times higher incidence per season per club per player (matches: 0.070 ± 0.093; training: 0.025 ± 0.043; P < .001). Match injuries resulted in 1.9 times more missed matches per club per season (matches: 17.2 ± 17.0; training: 9.1 ± 10.5; P < .001). and were more likely to be recurrences (matches: 11.6% ± 20.0%; training: 8.6% ± 21.8%; P < .001). From the 1997-2001 to 2007-2011 time spans, overall injury severity increased from a mean of 3.2 to 3.7 missed matches ( P ≤ .01). For the most recent 2012-2016 time span, injuries resulted in 3.6 missed matches, on average. Hip/groin/thigh injuries had the highest incidence (0.125 ± 0.120) and prevalence (19.2 ± 16.4) rates, and recurrences (29.3% ± 27.9%) were 15% more likely at this site than any other injury site. Conclusion: The risks of match injuries are significantly higher than those of training injuries in the AFL. Compared with the 1997-2001 time span, injuries became more severe during the 2007-2011 time span.