bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Number of Injury Events Associated With the Critical Size of Bipolar Bone Defects in Rugby Players With Traumatic Anterior Shoulder Instability
Authors: Hasegawa Yoshinori , Kawasaki Takayuki , Nojiri Shuko , Sobue Shogo , Kaketa Takefumi , Gonda Yoshinori , Itoigawa Yoshiaki , Kaneko Kazuo 
Published: August 2019

Background: The size of a glenoid bone defect is responsible for reduction in shoulder stability and is correlated with the number of instability events. Biomechanical studies have suggested that it should be considered concomitantly with the Hill-Sachs lesion as “bipolar” bone defects for assessing structural degradation, but the definitive number of instability events associated with the critical size has not been investigated. Purpose: To (1) confirm that the number of instability events is the predictor of a critical size of bipolar bone defects and (2) demonstrate the cutoff value of the number of instability events for these defects in rugby players with traumatic anterior shoulder instability. Study Design: Cross-sectional study; Level of evidence, 3. Methods: One-hundred forty-four rugby players with anterior shoulder instability underwent morphologic evaluation for glenoid and Hill-Sachs lesions by computed tomography and determination of the critical (a glenoid bone defect of ≥25% or an off-track Hill-Sachs lesion) and subcritical (a glenoid bone defect of ≥13.5%) size of bipolar bone defects. In the primary analysis, the prevalence of the critical and subcritical size of bipolar bone defects was investigated. In the secondary analysis, the authors explored the predictors for these bone defects and determined the cutoff value correlating with the critical and subcritical size of bipolar bone defects by applying receiver operating characteristic curves. Results: The primary analysis revealed that the prevalence of critical and subcritical size of bipolar bone defects was 20.8% and 61.8% of 144 shoulders, respectively. In the secondary analysis, multiple logistic regression analysis demonstrated that the total number of shoulder instability events and dominant shoulder were the significant factors associated with the critical and subcritical size of bipolar bone defects. The cutoff value for the number of instability events that correlated with critical bipolar bone defects was 6 for the dominant and 9 for the nondominant shoulder, whereas it was 4 for the dominant and 5 for the nondominant shoulder for subcritical bipolar bone defects. Conclusion: The number of shoulder instability events and the dominant shoulder were the predictors for the critical and subcritical size of bipolar bone defects for a shoulder with traumatic instability. Four injury events should herald caution when treating rugby players with shoulder instability.
Clinical Pharmacy Practice Patterns Among North Carolina Rural Hospitals
Authors: Lanier Cameron , Moss Jason , Tunney Robert , Baird Ruthanne , Kelly Kim 
Published: August 2019

Introduction: Rural hospitals are isolated without adequate funding needed to provide for clinical services offered at larger health systems. The purpose of this study is to determine the clinical pharmacy services available and desired by rural hospitals in North Carolina. Methods: This prospective, cross-sectional, survey was distributed to a cohort of rural pharmacy directors and managers at rural hospitals across North Carolina. Data collected pertained to characteristics of the hospital and pharmacy, pharmacy director, clinical services, and responder impressions on their ability to maintain or enhance clinical services. Responses were summarized utilizing descriptive statistics and free-responses were coded for similar themes. Results: Seventeen respondents (32.6%) completed the survey. Clinical activities varied, as did characteristics of the hospitals and staff. Improved patient care is the primary reason why hospital pharmacies expand their clinical participation (46.7%). Pharmacy directors believed growth of clinical activities was a long-term goal while reporting regulations, staff, and finances as barriers to growth. Conclusion: Clinical pharmacy services vary in NC rural hospitals. Directors exhibit a willingness to expand clinical responsibilities. Rural hospital pharmacy directors desire pharmacists to be active clinically in patient care, but face barriers in reaching that goal.
Can education and training improve the adoption of a psychosocial group treatment by dementia services?
Authors: Cheung Gary , Peri Kathy 
Published: August 2019

Objective: Cognitive stimulation therapy (CST) is a psychosocial group treatment for people with dementia. The aims of this project were to (a) evaluate the effectiveness of a one-day training workshop; (b) measure the uptake of CST following the workshops; and (c) explore the barriers of implementing CST. Method: Ten workshops were conducted. Attendees completed a self-evaluation at the end of the training day and were later invited to complete an online survey enquiring about implementation. Results: Two hundred and fourteen workshop attendees completed the self-evaluation. The mean self-rated knowledge and skills for conducting and facilitating CST (1 = No skills, 5 = Very good skills) was 2.3 (SD = 1.2) and 4.3 (SD = 0.7) before and after the workshop, respectively ( p = 0.000). The mean self-rated confidence for applying learning to conducting and facilitating CST was 4.2 (SD = 0.7) (1 = Not confident, 5 = Very confident). There were 11 CST programmes started after the workshops and another 10 sites were in the process of starting CST programmes. The main barriers of implementation were lack of staff time/funding and problems of finding suitable participants with dementia. Conclusions: The one-day training workshop is an effective method to disseminate CST. Addressing the barriers identified could improve the adoption of CST in practice.
Assessment of Bioabsorbable Hydroxyapatite for Secondary Bone Grafting in Unilateral Alveolar Clefts
Authors: Sakamoto Yoshiaki , Sakamoto Teruo , Ishii Tekenobu , Kishi Kazuo 
Published: August 2019

Purpose: To evaluate the utility and efficacy of bioabsorbable hydroxyapatite and collagen complex (HA/Col) for secondary bone grafting in unilateral alveolar clefts. Patients and Methods: Between 2015 and 2016, 21 patients with unilateral cleft lips and alveolar clefts were enrolled. In group I, a cancellous iliac bone graft was placed at the alveolar cleft (6 males, 5 females). In group II, a bioabsorbable HA/Col was placed at the alveolar cleft (4 males, 7 females). Results: The groups did not differ in age, cleft volume, or surgical duration. There was a significant difference in intraoperative blood loss between the 2 groups (6.7 ± 1.89 mL in group II vs 38.8 ± 9.73 mL in group I [ P < .01]). The use of patient-controlled intravenous analgesia was also significantly lower in group II than in group I (2.2 ± 1.9 times vs 12.2 ± 4.4 times [ P < .01]). Only 1 female in group II who had maxillary sinusitis did not achieve osteosynthesis. With the exception of this patient, the 12-month bone volumes in groups I and II were 0.567 ± 0.066 and 0.596 ± 0.073 mL, respectively, without significant difference ( P = .18). Conclusion: Compared with an autogenous bone, bioabsorbable HA/Col significantly reduces postoperative pain. In addition, the use of HA/Col alone produced the same result as an autologous bone and is effective in filling the alveolar cleft.
Outcomes of Primary Tibiotalocalcaneal Nailing for Complicated Diabetic Ankle Fractures
Authors: Ebaugh M. Pierce , Umbel Benjamin , Goss David , Taylor Benjamin C. 
Published: August 2019

Background: Ankle fractures in patients with complicated diabetes have significantly increased the rates of complications and poorer functional outcomes when treated nonoperatively, and there have been only modest reductions when treated operatively. We hypothesized that the minimally invasive, robust construct that tibiotalocalcaneal fixation with an intramedullary nail offers would result in high rates of limb salvage, acceptable rates of complications, and less loss of function, in this difficult patient population. Methods: This was an institutional review board–approved retrospective study of 27 patients with complicated diabetes who underwent tibiotalocalcaneal nailing of their ankle fracture as a primary treatment without formal joint preparation. Patients with complicated diabetes were defined as having neuropathy, nephropathy, and/or peripheral vascular disease. The mean clinical follow-up was 888 days. Patients were screened for associated risk factors. Data were collected on surgical complications. The outcomes measured included length of hospital stay, loss of ambulatory level, amputation, and time to death. The mean age was 66 years with an average body mass index of 38 and hemoglobin A1c of 7.4. Six fractures were open. Results: The limb salvage rate was 96%. The average hospital stay was 6 days, and the mean time to weightbearing was 6.7 weeks. The fracture union rate was 88%. The surgical complication rate was 18.5%, with no instances of malunions, symptomatic nonunions, or Charcot arthropathy. Eight patients died by final follow-up (mean, 1048 days). An ambulatory level was maintained in 81% of the patients. Conclusion: With high limb salvage rates, relatively early weightbearing, maintained ambulatory level, and acceptable complication rates, we believe our technique can be considered an appropriate approach to increase the overall survivability of threatened limbs and lives in this patient population. Level of Evidence: Level IV, retrospective case series.
Welfare of cats 5–29 months after perineal urethrostomy: 74 cases (2015–2017)
Authors: Slater Margaret R , Pailler Sharon , Gayle J’mai M , Cohen Illoneete , Galloway Erin L , Frank Kristen A , DeClementi Camille 
Published: August 2019

Objectives The objective of this study was to evaluate the long-term quality of life in cats following perineal urethrostomy. Methods This study comprised a retrospective case series of 74 cats with urinary obstructions that received perineal urethrostomies at the American Society for the Prevention of Cruelty to Animals (ASPCA) Animal Hospital between September 2015 and July 2017. Medical records were reviewed for information on the number of obstructions prior to surgery, urinary tract problems at the time of surgery and other potential factors influencing long-term welfare. Owners were surveyed by telephone and text 5–29 months after their cat’s surgery. Responses were compiled and analyzed to determine owner perception of welfare postsurgery, and to identify patterns in medical history and welfare outcomes. Results In total, 105 cat owners were eligible for the survey; 74 responded. Altogether, 100% of responding individuals reported at least the same quality of life postsurgery compared with the cat’s quality of life before demonstrating urinary problems (48% reported better). On a quality-of-life scale of 1–10 (10 = excellent), 100% of responding cat owners reported at least 7; 75% reported 10. Conclusions and relevance Quality-of-life outcomes for cats 5–29 months after receiving perineal urethrostomy surgery were reported to be very good. Given this finding, and that perineal urethrostomy surgery should mitigate future blockages, we suggest considering perineal urethrostomy surgery as a standard tool to manage urinary obstructions in cats. The needs of the specific client and patient, including risks, costs and welfare of the cats, should drive the options for management of urinary obstructions in male cats.
Comparison of long-, short-, and oblique-axis approaches for ultrasound-guided internal jugular vein cannulation: A network meta-analysis
Authors: Maitra Souvik , Bhattacharjee Sulagna , Baidya Dalim K 
Published: August 2019

Background: Comparison between various approaches of ultrasound (USG)-guided internal jugular vein cannulation, that is, short-axis out-of-plane approach, long-axis in-plane approach, and oblique-axis approach, is sparse. In this network meta-analysis of randomized controlled trials, all three approaches were evaluated to identify the best technique for USG-guided internal jugular vein cannulation. Methods: Randomized controlled trials comparing short-axis out-of-plane approach, long-axis in-plane approach, and oblique-axis approach in any combination (i.e. comparison of any two or all three) for USG-guided internal jugular vein cannulation were included in this meta-analysis. Bayesian network meta-analysis was conducted with a non-informative prior effect size and heterogeneity, and all results were reported as posterior median odds ratio with 95% credible interval. Results: Data of 658 patients from five randomized controlled trials were included in this meta-analysis. No difference was obtained in first attempt success rate of cannulation in three approaches (posterior median odds ratio between long-axis and short-axis view, oblique-axis and short-axis view, and long-axis and oblique-axis view were 0.67 (0.20, 2.08), 0.92 (0.09, 4.790), and 1.3420 (0.1680, 6.7820), respectively). No difference was seen in the incidence of carotid artery puncture and overall success rate of cannulation. Conclusion: All three commonly used approaches for USG-guided internal jugular vein cannulation, that is, short axis, long axis, and oblique axis, are comparable in terms of clinical utility and safety. There is insufficient evidence to recommend one approach over another for this purpose.
Automatic associations of breast cancer and heart disease with fruit and vegetables and physical activity
Authors: Berry Tanya R , Courneya Kerry S , Norris Colleen M , Rodgers Wendy M , Spence John C 
Published: August 2019

Objectives: This exploratory research examined if breast cancer or heart disease is automatically associated with physical activity compared to fruit and vegetable stimuli; if reading messages about reducing risk of breast cancer or heart disease through physical activity and fruit and vegetable consumption would affect automatic associations; and if automatic associations were related to intentions to be physically active or consume fruit and vegetables. Methods: Participants were 80 women who completed pretest measures of automatic associations, then read a breast cancer, heart disease, or control message, followed by posttest measures. Results: There was a significant association of breast cancer–related words with fruit and vegetables compared to physical activity. Heart disease was also more strongly associated with fruit and vegetables than physical activity at pretest but not at posttest. There were no other significant findings. Conclusion: This research highlights that fruit and vegetables rather than physical activity are more strongly associated with perceptions of breast cancer and heart disease. Automatic associations are an attitudinal construct, and the strength of association between fruit and vegetables, rather than physical activity, indicates how messages may be processed.
Categorization of single cuneiform fractures and investigation of related injuries: A 10-year retrospective study
Authors: Choi Jun Young , Lee Dong Joo , Ngissah Reuben , Nam Bum Joon , Suh Jin Soo 
Published: August 2019

Purpose: The purpose of this study was to define the fracture type and investigate the injuries related to single medial, intermediate, or lateral cuneiform fracture. Methods: From January 2008 to December 2018, 30 consecutive patients (30 cases) who were treated in the single institution for the single cuneiform fractures were reviewed retrospectively. Each fracture was categorized by location and type (intra- or extra-articular avulsion, axial compression, and direct blow). We also investigated the related foot bone fractures or dislocations on the affected side. Results: Twenty-one, one, and eight cases with single medial, intermediate, and lateral cuneiform bone fractures, respectively, were identified. More than two-thirds of the single cuneiform fractures were observed in the medial cuneiform bone. The single medial cuneiform fracture was associated with various types of foot injuries including Lisfranc injury, naviculo-cuneiform joint dislocation, or calcaneo-cuboidal dislocation. Single lateral cuneiform fractures were more frequently observed than single intermediate cuneiform fractures. Conclusion: More than two-thirds of the single cuneiform fractures were observed in the medial cuneiform bone. Most intra-articular avulsion fractures were associated with high-energy trauma. Level of Evidence: 4
Universal Representation: Systemic Benefits and the Path Ahead
Authors: Nash Lindsay 
Published: August 2019

Executive Summary At a time when politics, financial considerations, and a push for expediency put pressure on the US immigration system, it can be difficult to have faith in the adjudicatory process. Case resolution quotas, directives that constrain courts’ ability to render justice in individual cases, and executive decisions that contract immigration judges’ discretion contribute to an immigration system that looks less and less like judicial adjudication of some of the highest-stakes cases in our legal system and more like a ministerial claims-processing scheme. A ray of hope exists, however, in the proliferation of public defender–style systems that offer universal representation to those facing deportation. This essay describes the genesis and expansion of the universal representation movement — a project based on the idea that indigent individuals should be entitled to counsel regardless of the apparent merits or political palatability of their case. It describes the benefits of such a program to the immigration adjudication system writ large. Beyond the oft-cited increase in success rates for individuals represented and the benefits to the communities in which such programs are located, universal representation promotes the integrity of the court system and strengthens an adjudicatory procedure that, for too long, has functioned primarily to expeditiously churn through cases. Finally, looking forward, it considers some of the challenges this movement faces as it grows and it identifies areas for further expansion.
Higher risk of intracranial aneurysms and subarachnoid haemorrhage in siblings of families with intracranial aneurysms
Authors: Zuurbier CCM , Greving JP , Rinkel GJE , Ruigrok YM 
Published: August 2019

Introduction First-degree relatives of patients with familial aneurysmal subarachnoid hemorrhage have an increased risk of unruptured intracranial aneurysms and aneurysmal subarachnoid hemorrhage. We assessed whether the type of kinship of first-degree relatives of aneurysmal subarachnoid hemorrhage patients influences this risk. Patients and methods We used all available data from the prospectively collected database of families consulting our outpatient clinic between 1994-2016. We constructed pedigrees for all families with ≥2 first-degree relatives with aneurysmal subarachnoid hemorrhage or unruptured intracranial aneurysms. The proband was defined as the first family member with aneurysmal subarachnoid hemorrhage who sought medical attention. We compared both the proportion of aneurysmal subarachnoid hemorrhage and unruptured intracranial aneurysms in proband's first-degree relatives by calculating relative risks (RR) with children as the reference. Results We studied 154 families with 1,105 first-degree relatives of whom 146 had aneurysmalsubarachnoid hemorrhage. Unruptured intracranial aneurysms were identified in 63 (19%) of the 326 screened relatives. Siblings had a higher risk of aneurysmal subarachnoid hemorrhage (RR:1.62, 95% CI:1.12–2.38) and parents a lower risk (RR:0.44, 95% CI:0.24–0.81) than children. Siblings also had a higher risk of unruptured intracranial aneurysms (RR:2.28, 95% CI:1.23–4.07, age-adjusted RR:2.04, 95% CI:1.07–3.92) than children. Conclusion: Siblings of patients with aneurysmal subarachnoid hemorrhage have a significanthigher risk of both unruptured intracranial aneurysms and aneurysmal subarachnoid hemorrhage and parents have a lower risk of aneurysmal subarachnoid hemorrhage than children. Discussion: Type of kinship is a relevant factor to consider in risk prediction and screening advice in families with familial aneurysmal subarachnoid hemorrhage.
Triple Arthrodesis for Adult-Acquired Flatfoot Deformity
Authors: Erard MAJ Uma E. , Sheean MAJ Andrew J. , Sangeorzan Bruce J. 
Published: August 2019

Originally described as a means to address fixed deformities or uncontrolled movement of the hindfoot observed in paralytic foot deformities, triple arthrodesis has evolved into a powerful procedure for the correction of a variety of foot deformities. Over the past decade, multiple advances have been made with respect to diagnostic imaging, fixation options, bone graft substitutes, and postoperative regimens. While this operation requires experience and skill to execute, when properly performed, it allows for correction of deformity and a plantigrade and ideally pain-free foot for ambulation. The purpose of this review is to highlight advances in the procedure and its application to the rigid planovalgus foot. Level of Evidence: Level V, review.
Primary glaucoma surgery in Fuchs’ heterochromic uveitis: a comparison of trabeculectomy versus deep sclerectomy
Authors: Walkden Andrew , Mercieca Karl , Perumal Divya , Anand Nitin 
Published: August 2019

Background: Deep sclerectomy offers the potential advantage of less postoperative inflammation and better survival in Fuchs’ patients. The aim of this study was to compare survival and safety profiles of Fuchs’ heterochromic uveitis patients undergoing trabeculectomy or deep sclerectomy. Methods: A retrospective study was conducted of two separate cohorts who had undergone either trabeculectomy or deep sclerectomy. Patient demographics, best-corrected visual acuity, intraocular pressure, antimetabolite used, postoperative complications and subsequent procedures were analysed. Results: In total, 13 trabeculectomy patients and 14 deep sclerectomy patients were included. Mean preoperative intraocular pressure was similar at 30.1 mmHg in the trabeculectomy group and 35.9 mmHg in the deep sclerectomy group, with no significant difference between the two ( p = 0.22). Kaplan–Meier survival outcomes for success at <22 mmHg and <19 mmHg showed no significant differences between the groups and this was also the case for intraocular pressure at 3 years (analysis of variance; p = 0.47). Conclusion: Both procedures appear to have similar efficacy and safety profiles, suggesting that both are effective.
The association of CMV with NK-cell reconstitution depends on graft source: results from BMT CTN-0201 samples
Authors: Rashidi Armin , Luo Xianghua , Cooley Sarah , Anasetti Claudio , Waller Edmund K. , Brunstein Claudio G. , Cichocki Frank , Weisdorf Daniel J. , Miller Jeffrey S. 
Published: August 2019

Key Points
CMV reactivation was associated with the maturation of reconstituting NK cells from BM, but not PB, unrelated donor grafts. CMV reactivation was associated with CD8+, but not CD4+, T-cell recovery, more so after BM than PB unrelated donor grafts.