bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Outcomes and Predictive Factors for Failure With Isolated MPFL Reconstruction for Recurrent Patellar Instability: A Series of 211 Reconstructions With a Minimum Follow-up of 3 Years
Authors: Sappey-Marinier Elliot , Sonnery-Cottet Bertrand , O’Loughlin Padhraig , Ouanezar Herve , Reina Fernandes Levi , Kouevidjin Biova , Thaunat Mathieu 
Published: May 2019

Background: Reconstruction of the medial patellofemoral ligament (MPFL) is widely acknowledged as an integral part of the current therapeutic armamentarium for recurrent patellar instability. The procedure is often performed with concomitant bony procedures, such as distalization of the tibial tuberosity or trochleoplasty in the case of patella alta or high-grade trochlear dysplasia, respectively. At the present time, few studies have evaluated the clinical effectiveness of MPFL reconstruction as an isolated intervention. Purpose: To report the clinical outcomes of isolated MPFL reconstruction in cases of patellar instability and to identify predictive factors for failure. Study Design: Case series; Level of evidence, 4. Methods: A retrospective analysis of prospectively collected data was performed, including all patients who had undergone isolated MPFL reconstruction between January 2008 and January 2014. Preoperative assessment included the Kujala score, assessment of patellar tracking (“J-sign”), and radiographic features, such as trochlear dysplasia according to Dejour classification, patellar height with the Caton-Deschamps index (CDI), tibial tubercle–trochlear groove distance, and patellar tilt. The Kujala score was assessed postoperatively. Failure was defined by a postoperative patellar dislocation or surgical revision for recurrent patellar instability. Results: A total of 239 MPFL reconstructions were included; 28 patients (11.7%) were uncontactable and considered lost to follow-up. Thus, 211 reconstructions were analyzed with a mean follow-up of 5.8 years (range, 3-9.3 years). The mean age at surgery was 20.6 years (range, 12-48 years), and 55% of patients were male. Twenty-seven percent of patients had a preoperative positive J-sign, and 93% of patients had trochlear dysplasia (A, 47%; B, 25%; C, 15%; D, 6%). The mean CDI was 1.2 (range, 1.0-1.7); mean tibial tubercle–trochlear groove distance, 15 mm (range, 5-30 mm); and mean patellar tilt, 23° (range, 9°-47°). The mean Kujala score improved from 56.1 preoperatively to 88.8 ( P < .001). Ten failures were reported that required surgical revision for recurrent patellar instability (4.7%). Uni- and multivariate analyses highlighted 2 preoperative risk factors for failure: patella alta (CDI ≥1.3; odds ratio, 4.9; P = .02) and preoperative positive J-sign (odds ratio, 3.9; P = .04). Conclusion: In cases of recurrent patellar instability, isolated MPFL reconstruction would appear to be a safe and efficient surgical procedure with a low failure rate. Preoperative failure risk factors identified in this study were patella alta with a CDI ≥1.3 and a preoperative positive J-sign.
Effect of Posterior Capsule Tightness and Humeral Retroversion on 5 Glenohumeral Joint Range of Motion Measurements: A Cadaveric Study
Authors: Rosa Dayana P. , Camargo Paula R. , Borstad John D. 
Published: May 2019

Background: Altered glenohumeral joint range of motion can be caused by increased humeral retroversion (HR) and/or posterior capsule tightness (PCT). To make informed clinical decisions, it is vital to understand how HR and PCT alterations, individually and in combination, affect joint range of motion measurements. Purpose: To evaluate the effect of experimental tissue alterations on clinical range of motion measures. Study Design: Controlled laboratory study. Methods: Five clinical measurements were quantified in 8 fresh-frozen cadavers under 4 experimentally created conditions: baseline (no alterations), HR condition (20° increase in HR by transecting the bone), PCT condition (20% decrease in length via thermal energy), and PCT + HR combined. Clinical measurements included bicipital forearm angle, low flexion, glenohumeral internal and external rotation, and horizontal adduction. All measurements were taken by the same blinded tester. Separate 1-factor repeated measures analyses of variance were used to evaluate the effect of the alterations on each clinical measurement. Results: There was a significant main effect of condition for bicipital forearm angle ( P = .02, F = 4.03), low flexion ( P = .02, F = 3.86), internal rotation ( P = .03, F = 3.65), and external rotation ( P < .001, F = 15.15) but not for horizontal adduction ( P = .29, F = 1.33). The HR condition resulted in a decreased bicipital forearm angle of 16.1° and 15.8° as compared with the PCT and PCT + HR conditions, respectively. When compared with baseline, the PCT + HR condition decreased the low flexion test by 13.5°, and the HR condition decreased internal rotation range of motion by 14.2°. All conditions increased external rotation when compared with baseline. Conclusion: Greater measurement changes were noted in both HR conditions, suggesting that bony alterations influence motion to a greater extent than posterior capsule alterations. Clinical Relevance: Clinicians should be aware that humeral retroversion will influence the measurement of posterior shoulder tightness.
Parents’ Experiences and Nurses’ Perceptions of Decision-Making About Childhood Immunization
Authors: Mossey Sharolyn , Hosman Shelly , Montgomery Phyllis , McCauley Karen 
Published: May 2019

Background Immunization in Canada is recommended not mandated, granting parents discretionary decision-making power regarding their child’s immunization status. Uptake of childhood immunization at present falls below national targets. Nurses who interact with parents in the clinical setting may witness parents’ decision-making experiences, attitudes, and opinions inclusive of vaccine hesitancy. Purpose The aim of this study is to understand parents’ and nurses’ experiences of decision-making about childhood immunization, specifically measles-mumps-rubella and/or diphtheria-tetanus-acellular pertussis. Methods Thorne’s interpretative description approach was used to understand parents’ and nurses’ experiences and perspectives about immunization. The sample was 6 nurses and 16 parents residing in northeastern Ontario. Results Common to all participants was the goal of protection. Motivated by child protection, parents carried out three broad actions, searching for information, deliberating the information and sources to determine the relative benefits and risks of immunization, and bearing responsibility for their decision to accept, delay, or decline immunization. Nurses were motivated by child protection and population health. Conclusion Implications for nursing included integration of immunization competencies in nursing curricula, ongoing professional development, validation of parental actions for child protection, nurse-led education sessions, and engaging parents through social media to support access to reputable information.
Cancer worry frequency vs. intensity and self-reported colorectal cancer screening uptake: A population-based study
Authors: Vrinten Charlotte , Stoffel Sandro , Dodd Rachael H , Waller Jo , Lyratzopoulos Yoryos , von Wagner Christian 
Published: May 2019

Objectives Many studies of cancer worry use items measuring frequency or intensity. Little is known about how each of these relate to cancer screening uptake. This study compared the association between worry frequency vs. intensity and colorectal cancer screening intention/uptake. Methods Across four surveys (2014–2016), we collected data from 2878 screening-eligible men and women (aged 60–70) in England. Measures included single-items assessing cancer worry frequency and intensity, and a derived combination of both. We also assessed self-reported past faecal occult blood testing uptake (ever vs. never), intention to participate when next invited (yes vs. no), and demographics. Using logistic regression, we compared a model containing sociodemographic characteristics (Model 1), with four models adding cancer worry frequency (Model 2), intensity (Model 3), both (Model 4), or the combined measure (Model 5). Results A model with cancer worry intensity and demographics (Model 3) explained significantly more variance in uptake and intention ( R2 = 0.068 and 0.062, respectively) than demographics alone (Model 1: R2 = 0.058 and 0.042; p < 0.001), or a model with demographics and cancer worry frequency (Model 2: R2 = 0.059 and 0.052; p < 0.001). The model was also equally as effective as models including both the frequency and intensity items (Model 4: R2 = 0.070 n.s. and 0.062 n.s.), or using the derived combination of both (Model 5: R2 = 0.063 n.s. and 0.053 n.s.). Conclusion A single item measure of cancer worry intensity appeared to be most parsimonious for explaining variance in colorectal cancer screening intention and uptake.
What cancer patients actually know regarding medical cannabis? A cross-sectional survey with a critical analysis of the current attitudes
Authors: Cortellini Alessio , Porzio Giampiero , Cofini Vincenza , Necozione Stefano , Giusti Raffaele , Marchetti Paolo , Aloe Spiriti Maria A , Costanzi Andrea , Peris Flaminia , Ravoni Giulio , Spinelli Giuseppe , Ficorella Corrado , Verna Lucilla 
Published: May 2019

Background In Italy medical cannabis is a prescription drug since 1998. Even though it could not be considered a therapy as such, it is indicated as a symptomatic treatment also in cancer patients, to cure iatrogenic nausea/vomiting and chronic pain. Patients and methods We conducted a knowledge survey about medical cannabis among cancer patients referred to two outpatient cancer care centers and a home care service. Results From February to April 2018, 232 patient were enrolled; 210 patients were on active disease-oriented treatment (90.5%), while 22 (9.5%) not. Eighty-one percent of the patients have heard about medical cannabis, but only 2% from healthcare professionals. Thirty-four percent of responders thought about using cannabis to treat one or more of their own health problems, especially pain (55%). Despite that, 18% of the participants believe that medical cannabis could have negative effects on their own symptoms. Patients with high educational level better knew cannabis (odds ratio = 3.52; 95% confidence interval: 1.07–11.53), and medical cannabis (odds ratio = 3.21; 95% confidence interval: 1.48–6.98), when compared to patient with low educational level. Patients who were on active disease-oriented treatment better knew medical cannabis (odds ratio = 3.91; 95% confidence interval: 1.26–12.11) compared to “out of treatment” patients. Metastatic patients were less informed about medical cannabis compared to patients on adjuvant treatment. Conclusions Our survey shows that most of Italian cancer patients know medical cannabis and a third of them have considered using cannabis to treat one (or more) of their own health problems. In the same time, they are poorly informed and do not tend to ask for information about medical cannabis to healthcare professionals.
Early versus delayed administration of granulocyte-colony stimulating factor following chemotherapy in pediatric patients with Ewing sarcoma
Authors: Al-Momani Deema , Al-Qasem Wiam , Kasht Rawan , Sultan Iyad 
Published: May 2019

Background The optimal timing of initiating granulocyte-colony stimulating factor following chemotherapy in pediatric patients has not been clearly defined. This study aimed to compare the administration of granulocyte-colony stimulating factor on day 1 versus day 3 postchemotherapy in pediatric patients with Ewing sarcoma. Method A retrospective study of pediatric patients with Ewing sarcoma who received granulocyte-colony stimulating factor following chemotherapy between January 2016 and September 2018 at a comprehensive cancer center. The institution’s chemotherapy protocol for Ewing sarcoma was modified in April 2017 to include granulocyte-colony stimulating factor initiation on day 3 instead of day 1 post-chemotherapy. Febrile neutropenia requiring hospitalization, duration of hospital stay, and chemotherapy delay were compared for patients before and after the protocol change. Results Over the study period, 250 cycles were evaluated with day 1 granulocyte-colony stimulating factor and 221 cycles with day 3 granulocyte-colony stimulating factor. There were no differences between the day 1 and day 3 groups in the number of cycles associated with Febrile neutropenia requiring hospitalization (34 vs. 19, p = 0.086), and the length of Febrile neutropenia-related hospitalization (mean 4 ± 2.1 vs. 4.6 ± 1.8, p = 0.123). However, delay in chemotherapy due to neutropenia was reported in significantly more cycles in the day 1 group, compared to the day 3 group (37 vs. 16, p = 0.01). Conclusions Febrile neutropenia resulting in hospital admission and the length of hospital stay was not different between pediatric patients with Ewing sarcoma who received granulocyte-colony stimulating factor on day 1 or day 3 post-chemotherapy. Chemotherapy delay due to neutropenia was higher in patients who received granulocyte-colony stimulating factor on day 1. Larger studies are required to fully determine the impact of delayed initiation of granulocyte-colony stimulating factor.
Preventive effect of exercise training on diabetic kidney disease in ovariectomized rats with type 1 diabetes
Authors: Souza Cláudia Silva , de Sousa Oliveira Bianca Silva , Viana Geovanildo Nascimento , Correia Thiago Macêdo Lopes , de Bragança Ana Carolina , Canale Daniele , Oliveira Márcio Vasconcelos , de Magalhães Amélia Cristina Mendes , Volpini Rildo Aparecido , de Brito Amaral Liliany Souza , de Jesus Soares Telma 
Published: May 2019

This study evaluated the effects of moderate regular physical exercise on lipid peroxidation, inflammation and renal function and structure in streptozotocin (STZ)-induced ovariectomized diabetic rats. Twenty-four Wistar rats were anesthetized and submitted to bilateral ovariectomy. The rats were divided into four experimental groups: ovariectomized control (OC), ovariectomized trained control (OTC), ovariectomized diabetic (OD), ovariectomized trained diabetic (OTD). The OTD and OTC groups were submitted to treadmill running for four weeks before to diabetes mellitus (DM) induction with STZ (40 mg/kg, i.v) or vehicle injection, respectively, and continued the training for another eight weeks after the injections. Urine samples were collected 24 h after the last training session, and blood samples and kidneys were collected after euthanasia. Our results showed that physical exercise attenuated the loss of body weight and postprandial glucose and improved physical capacity in the OTD group. Lower serum creatinine levels, glycosuria, and proteinuria were also observed in this group. There was no difference in 17β-estradiol levels between the experimental groups. The glomerular and tubulointerstitial changes were attenuated in the OTD group. Expressions of macrophages, lymphocytes, fibronectin, TGF-β1, and NF-κB were reduced in the glomeruli of OTD group. Exercise also reduced macrophages, lymphocytes, and TGF-β1 expression in the tubulointerstitial compartment of the renal cortex of this group. In addition, increased levels of TBARS in the renal cortex of diabetic rats were prevented by exercise in the OTD group. In conclusion, our study shows that physical exercise exerted a renoprotective effect against the progression of diabetic kidney disease in ovariectomized rats.Impact statementTo date, no studies have been found evaluating the effects of physical exercise on renal function and structure changes in ovariectomized rats with type 1 diabetes. Therefore, this work emerges with an important tool for strengthening and expanding innovative research on exercise with potential for the prevention of renal diseases in ovariectomized diabetic rats, and future development of studies that seek to increase scientific knowledge about the beneficial effects of physical exercise on renal diseases in humans.
Optimal Approach to Lobectomy for Non-Small Cell Lung Cancer: Systemic Review and Meta-Analysis
Authors: Ng Calvin S.H. , MacDonald John K. , Gilbert Sebastien , Khan Ali Z. , Kim Young T. , Louie Brian E. , Blair Marshall M. , Santos Ricardo S. , Scarci Marco , Shargal Yaron , Fernando Hiran C. 
Published: May 2019

Objective Video-assisted thoracic surgery (VATS) lobectomy was introduced over 25 years ago. More recently, the technique has been modified from a multiport video-assisted thoracic surgery (mVATS) to uniportal (uVATS) and robotic (rVATS), with proponents for each approach. Additionally most lobectomies are still performed using an open approach. We sought to provide evidence-based recommendations to help define the optimal surgical approach to lobectomy for early stage non-small cell lung cancer. Methods Systematic review and meta-analysis of articles searched without limits from January 2000 to January 2018 comparing open, mVATS, uVATS, and rVATS using sources Medline, Embase, and Cochrane Library were considered for inclusion. Articles were individually scrutinized by ISMICS consensus conference members, and evidence-based statements were created and consensus processes were used to determine the ensuing recommendations. The ACC/AHA Clinical Practice Guideline Recommendation Classification system was used to assess the overall quality of evidence and the strength of recommendations. Results and recommendations One hundred and forty-five studies met the predefined inclusion criteria and were included in the meta-analysis. Comparisons were analyzed between VATS and open, and between different VATS approaches looking at oncological outcomes (survival, recurrence, lymph node evaluation), safety (adverse events), function (pain, quality of life, pulmonary function), and cost-effectiveness. Fifteen statements addressing these areas achieved consensus. The highest level of evidence suggested that mVATS is preferable to open lobectomy with lower adverse events (36% versus 42%; 88,460 patients) and less pain (IIa recommendation). Our meta-analysis suggested that overall survival was better (IIb) with mVATS compared with open (71.5% versus 66.7% 5-years; 16,200 patients). Different VATS approaches were similar for most outcomes, although uVATS may be associated with less pain and analgesic requirements (IIb). Conclusions This meta-analysis supports the role of VATS lobectomy for non-small cell lung cancer. Apart from potentially less pain and analgesic requirement with uVATS, different minimally invasive surgical approaches appear to have similar outcomes.
Effects of spermidine supplementation on cognition and biomarkers in older adults with subjective cognitive decline (SmartAge)—study protocol for a randomized controlled trial
Authors: Wirth Miranka , Schwarz Claudia , Benson Gloria , Horn Nora , Buchert Ralph , Lange Catharina , Köbe Theresa , Hetzer Stefan , Maglione Marta , Michael Eva , Märschenz Stefanie , Mai Knut , Kopp Ute , Schmitz Dietmar , Grittner Ulrike , Sigrist Stephan J. , Stekovic Slaven , Madeo Frank , Flöel Agnes 
Published: May 2019

AbstractBackgroundGiven the global increase in the aging population and age-related diseases, the promotion of healthy aging is one of the most crucial public health issues. This trial aims to contribute to the establishment of effective approaches to promote cognitive and brain health in older individuals with subjective cognitive decline (SCD). Presence of SCD is known to increase the risk of objective cognitive decline and progression to dementia due to Alzheimer’s disease. Therefore, it is our primary goal to determine whether spermidine supplementation has a positive impact on memory performance in this at-risk group, as compared with placebo. The secondary goal is to examine the effects of spermidine intake on other neuropsychological, behavioral, and physiological parameters.MethodsThe SmartAge trial is a monocentric, randomized, double-blind, placebo-controlled phase IIb trial. The study will investigate 12 months of intervention with spermidine-based nutritional supplementation (target intervention) compared with 12 months of placebo intake (control intervention). We plan to recruit 100 cognitively normal older individuals with SCD from memory clinics, neurologists and general practitioners in private practice, and the general population. Participants will be allocated to one of the two study arms using blockwise randomization stratified by age and sex with a 1:1 allocation ratio. The primary outcome is the change in memory performance between baseline and post-intervention visits (12 months after baseline). Secondary outcomes include the change in memory performance from baseline to follow-up assessment (18 months after baseline), as well as changes in neurocognitive, behavioral, and physiological parameters (including blood and neuroimaging biomarkers), assessed at baseline and post-intervention.DiscussionThe SmartAge trial aims to provide evidence of the impact of spermidine supplementation on memory performance in older individuals with SCD. In addition, we will identify possible neurophysiological mechanisms of action underlying the anticipated cognitive benefits. Overall, this trial will contribute to the establishment of nutrition intervention in the prevention of Alzheimer’s disease.Trial registrationClinicalTrials.gov,NCT03094546. Registered 29 March 2017—retrospectively registered.Protocol versionBased on EA1/250/16 version 1.5
The Importance of Being Frank
Authors: Xin Wendy Veronica 
Published: May 2019

AbstractThis essay reads several “hidden” scenes in Jane Austen's Emma. Willfully drawing attention to stray details—an impulsive trip to London to get his hair cut, the mysterious gift of a piano, and a broken pair of spectacles—Frank Churchill uses these incidents to turn the narrator's attention, and the town's gossip, away from his secret engagement to the impoverished Jane Fairfax. In these oft-ignored and easily forgotten scenes, Frank performs an astonishing ontological trespass: flaunting his plot only to better conceal it, the literary character seems nearly possessed by a shadow of omniscience itself, wielding a sort of all-pervasive knowledge of the plot that is usually reserved for the narrator's exclusive access. Although critics have interpreted free indirect discourse as an authorial elision of individual consciousness, a ventriloquizing of characters' thoughts that dispossesses the subjects of such discourses, this essay suggests that Frank Churchill's fluency in the language of plotting captures the double bind of power and dispossession nestled within social performance. Plotting, I argue, emerges as a form of social know-how, both encouraged and curbed by the aesthetic requirements of novelistic emplotment writ large. In this light, literary characters who engage in plotting stand at a site of conversion, where an aspect of fiction seen as narrowly aesthetic becomes a technique for representing structures of social self-consciousness cultivated under conditions of precarity.