bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating the feasibility and acceptability of real-time visual feedback in reducing compensatory motions during self-administered stroke rehabilitation exercises: A pilot study with chronic stroke survivors
Authors: Lin Shayne , Mann Jotvarinder , Mansfield Avril , Wang Rosalie H , Harris Jocelyn E , Taati Babak 
Published: March 2019

Introduction Homework-based rehabilitation programs can help stroke survivors restore upper extremity function. However, compensatory motions can develop without therapist supervision, leading to sub-optimal recovery. We developed a visual feedback system using a live video feed or an avatar reflecting users' movements so users are aware of compensations. This pilot study aimed to evaluate validity (how well the avatar characterizes different types of compensations) and acceptability of the system. Methods Ten participants with chronic stroke performed upper-extremity exercises under three feedback conditions: none, video, and avatar. Validity was evaluated by comparing agreement on compensations annotated using video and avatar images. A usability survey was administered to participants after the experiment to obtain information on acceptability. Results There was substantial agreement between video and avatar images for shoulder elevation and hip extension (Cohen's κ: 0.6–0.8) and almost perfect agreement for trunk rotation and flexion (κ: 0.80–1). Acceptability was low due to lack of corrective prompts and occasional noise with the avatar display. Most participants suggested that an automatic compensation detection feature with visual and auditory cuing would improve the system. Conclusion The avatar characterized four types of compensations well. Future work will involve increasing sensitivity for shoulder elevation and implementing a method to detect compensations.
Abdominal wall endometriosis: A monocentric continuous series and review of the literature
Authors: Goksever Celik Hale , Karacan Tolga , Kaya Cihan , Uhri Mehmet , Savkli Ayse Ozge , Yalcin Bahat Pinar , Altintas Tansu , Usta Taner , Polat Ibrahim , Gorgen Husnu , Oral Engin 
Published: March 2019

Introduction: Endometriosis is characterized by the presence of endometrial cells anywhere outside the uterine cavity. Endometriosis has been encountered on surgical scars especially resulting from a cesarean section recently. Our aim was to investigate the patients with abdominal wall endometriosis in our clinics where all the patients having this disease are managed via surgical resection. We also compared them with the patients presented in the literature. Methods: A study was conducted on the patients with histopathological diagnosis of abdominal wall endometriosis as a case series. All the subjects were analyzed through a comprehensive medical assessment including documentation of the detailed history and physical and gynecological examination based on the patients’ medical records. Results: A total of 53 patients diagnosed with abdominal wall endometriosis were included in this study. The mean age and the mean body mass index of the patients were 32.6 ± 6.5 years and 25.2 ± 3.5 kg/m2, respectively. A total of 49 patients had at least one operation history, mainly cesarean section. The most common sites for abdominal wall endometriosis were skin and the region containing the rectus abdominis muscle and rectus sheath, 56.6% and 18.9% respectively. The main symptom was the pain getting worse during menstruation and the presence of a mass in all patients. The main diagnostic tools in all patients were detailed history and physical examination, ultrasonography, and then histopathological confirmation after surgical excision. Conclusion: Abdominal wall endometriosis is a common diagnosis mainly due to increased cesarean section rate. Clinical suspicion has the most important place in correct diagnosis and management of abdominal wall endometriosis.
Salter osteotomy without open reduction in the Tönnis type II developmental hip dysplasia: A retrospective clinical study
Authors: Gurger Murat , Demir Sukru , Yilmaz Mehmet , Once Gokhan 
Published: March 2019

Purpose: We aimed to evaluate the clinical and radiological outcomes of children older than 18 months who were treated with Salter osteotomy without open reduction for Tönnis type II hip dysplasia. Methods: Thirty-two type II hips of 24 patients were included in the study. The mean age was 43.22 (18–108) months. The mean follow-up period was 50 (24–142) months. Seven patients had left sided, nine had right sided, and eight had bilateral developmental dysplasia of the hip. All patients underwent closed reduction and Salter osteotomy. Preoperative and postoperative radiographs were assessed by measuring the center-edge (CE) angle of Wiberg, Smith’s c/b and h/b ratio, and acetabular index (AI). Patients were evaluated clinically according to McKay’s criteria and radiologically according to Severin criteria. The Kalamchi and MacEwen criteria were used in the evaluation of avascular necrosis. Results: The mean preoperative AI, CE angle, c/b, and h/b ratio were 36.7° (±4.1), 7.2° (±5.9), 0.9 (±0.08), and 0.05 (±0.04), respectively. The mean latest follow-up AI, CE angle, c/b, and h/b ratio were 18.2° (±1.7), 38.8° (±5.4), 0.6 (±0.03), and 0.19 (±0.04), respectively. The comparison of preoperative and postoperative radiological values revealed statistically significant improvement ( p < 0.01). On the latest physical examinations of the patients, 25 (78.1%) hips were rated excellent, and 7 (21.9%) were rated good according to the McKay criteria. The Severin classification determined 25 (78.1%) hips were grade I and 7 (21.9%) hips were grade II. Type I avascular necrosis (AVN) was seen in four (12.5%) hips. Three of these four hips were more superolateral in preoperative radiographs (c/b > 1 and h/b < 0.05). Conclusions: Salter osteotomy without open reduction is a good surgery option for Tönnis type II hip dysplasia, in which closed reduction can be performed. However, the risk of AVN should be kept in mind in more superolateral type 2 hips.
A Novel Arthroscopic Classification of Degenerative Medial Meniscus Posterior Root Tears Based on the Tear Gap
Authors: Kim Jae-Young , Bin Seong-Il , Kim Jong-Min , Lee Bum-Sik , Oh Sung-Mok , Cho Won-Joon 
Published: March 2019

Background: Degenerative medial meniscus posterior root tears (MMPRTs) are reportedly associated with medial compartment osteoarthritis and meniscal extrusion with a displaced gap from the root insertion. However, degenerative MMPRTs have not yet been clearly classified according to arthroscopic findings. Purpose: To classify degenerative MMPRTs according to the tear gap and to investigate how the classification could reflect the joint condition properly. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent arthroscopic surgery, performed by a single orthopaedic surgeon, for degenerative MMPRTs between August 2006 and February 2017 were included. MMPRTs were classified according to tear patterns observed during arthroscopic surgery (type 1, incomplete root tear; types 2-5, complete root tears), with each type further divided by the size of the tear gap, defined as the degree of tear displacement from the root (type 2, no gap or overlapped; type 3, gap of 1-3 mm; type 4, gap of 4-6 mm; type 5, gap of ≥7 mm). We compared preoperative factors, including the Kellgren-Lawrence (K-L) grade, absolute extrusion, relative percentage of extrusion (RPE), tear gap on magnetic resonance imaging (MRI), and mechanical alignment, as well as intraoperative factors, including chondral wear at surgery, between each MMPRT type. Results: A total of 116 root tears were categorized according to this classification: type 1, 16.4% (19 knees); type 2, 9.5% (11 knees); type 3, 40.5% (47 knees); type 4, 25.0% (29 knees); and type 5, 8.6% (10 knees). Chondral wear of the medial femoral condyle (MFC) ( P = .001), K-L grade ( P = .001), meniscal extrusion ( P = .001), and tear gap on MRI ( P = .001) showed a tendency to increase with a higher tear type. Chondral wear (ρ for MFC = 0.388; ρ for MTP = 0.311), K-L grade (ρ = 0.390), and meniscal extrusion (ρ for absolute extrusion = 0.500; ρ for RPE = 0.451) showed a moderate correlation with tear type, whereas tear gap on MRI (ρ = 0.907) showed a strong correlation with tear type. Conclusion: Our study introduces a new classification based on the tear gap that can concisely describe a degenerative MMPRT. The classification system demonstrated that a higher tear type (increasing displacement of the tear gap in arthroscopic surgery) is associated with higher meniscal extrusion, severe chondral wear, and greater severity of arthritis.
Analysis of cardiovascular and arteriothrombotic adverse events in chronic-phase CML patients after frontline TKIs
Authors: Jain Preetesh , Kantarjian Hagop , Boddu Prajwal C. , Nogueras-González Graciela M. , Verstovsek Srdan , Garcia-Manero Guillermo , Borthakur Gautam , Sasaki Koji , Kadia Tapan M. , Sam Princy , Ahaneku Hycienth , O’Brien Susan , Estrov Zeev , Ravandi Farhad , Jabbour Elias , Cortes Jorge E. 
Published: March 2019

Abstract
Cardiovascular or arteriothrombotic adverse events (CV- or AT-AEs) are reported in chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors (TKIs). The incidence and characteristics across different TKI have not been systematically analyzed. We analyzed 531 patients treated with frontline TKIs in different prospective trials: imatinib 400 mg (n = 71) and 800 mg (n = 203), nilotinib (n = 108), dasatinib (n = 106), and ponatinib (n = 43). Characteristics and incidence of new-onset CV-AEs and AT-AEs were analyzed. Poisson regression models assessed factors associated with AE incidence. Median follow-up was 94 months (range, 2-195). Overall, 237 patients (45%) developed CV-AEs and 46 (9%) developed AT-AEs. Hypertension was the most common AE seen in 175 patients (33%; grade 3/4 in 17%). CV-AE and AT-AE incidence ratios (IRs) with 95% confidence intervals (CIs) were 8.6 (7.6-9.8) and 1.7 (1.2-2.2) per 100 person-years. Among the TKIs, ponatinib showed the highest IR (95% CI) for CV-AEs and AT-AEs at 40.7 (27.9-59.4) and 9.0 (4.1-20.1). In multivariate analysis, ponatinib therapy was associated with increased incidence rate ratio (IRR) for CV-AEs (4.62; 95% CI, 2.7-7.7; P &lt; .0001) and AT-AEs (6.38; 95% CI, 1.8-21.8; P &lt; .0001) compared with imatinib 400. In summary, there is an increased risk of CV-AEs (except hypertension) and AT-AEs in CML patients treated with newer TKIs, particularly with ponatinib. Patients on TKIs must be informed and closely monitored for vascular AEs. These studies were registered at www.clinicaltrials.gov as #NCT00048672, #NCT00038649, #NCT00050531, #NCT00254423, #NCT00129740, and #NCT01570868.
Stem cell transplantation for osteopetrosis in patients beyond the age of 5 years
Authors: Stepensky Polina , Grisariu Sigal , Avni Batia , Zaidman Irina , Shadur Bella , Elpeleg Orly , Sirin Mehtap , Hoenig Manfred , Schuetz Catharina , Furlan Ingrid , Beer Meinrad , von Harsdorf Stephanie , Bunjes Donald , Debatin Klaus-Michael , Schulz Ansgar S. 
Published: March 2019

Abstract
Osteopetrosis (OP) is a rare disease caused by defective osteoclast differentiation or function. Hematopoietic stem cell transplantation (HSCT) is the only curative treatment available in the infantile “malignant” form of OP. Improved clinical and genetic diagnosis of OP has seen the emergence of a cohort of patients with less severe and heterogeneous clinical presentations. This intermediate form of OP does not call for urgent intervention, but patients accumulate debilitating skeletal complications over years and decades, which are severe enough to require curative treatment and may also require intermittent transfusion of blood products. Here we present data from 7 patients with intermediate OP caused by mutations in TCIRG1 (n = 2), CLCN7 (n = 2), RANK (n = 1), SNX10 (n = 1), and CA2 (n = 1), who were transplanted between the ages of 5 to 30 years (mean, 15; median, 12). Donors were matched siblings or family (n = 4), matched unrelated (n = 2), or HLA haploidentical family donors (n = 1). Conditioning was fludarabine and treosulfan based. All 6 patients transplanted from matched donors are currently alive with a follow-up period between 1 and 8 years at time of publication (median, 4 years) and have demonstrated a significant improvement in symptoms and quality of life. Patients with intermediate OP should be considered for HSCT.
CRP-guided antibiotic treatment in acute exacerbations of COPD in hospital admissions
Authors: Prins H.J. , Duijkers Ruud , van der Valk Paul , Schoorl Marianne , Daniels Johannes M.A. , van der Werf Tjip S. , Boersma Wim G. 
Published: March 2019

The role of antibiotics in acute exacerbations of chronic obstructive pulmonary disease (COPD) is controversial and a biomarker identifying patients who benefit from antibiotics is mandatory. We performed a randomised, controlled trial in patients with acute exacerbations of COPD, comparing C-reactive protein (CRP)-guided antibiotic treatment to patient reported symptoms in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy, in order to show a reduction in antibiotic prescription.Patients hospitalised with acute exacerbations of COPD were randomised to receive antibiotics based either on the GOLD strategy or according to the CRP strategy (CRP ≥50 mg·L−1).In total, 101 patients were randomised to the CRP group and 119 to the GOLD group. Fewer patients in the CRP group were treated with antibiotics compared to the GOLD group (31.7%versus46.2%, p=0.028; adjusted odds ratio (OR) 0.178, 95% CI 0.077–0.411, p=0.029). The 30-day treatment failure rate was nearly equal (44.5% in the CRP groupversus45.5% in the GOLD-group, p=0.881; adjusted OR 1.146, 95% CI 0.649–1.187, p=0.630), as was the time to next exacerbation (32 days in the CRP groupversus28 days in the GOLD group, p=0.713; adjusted hazard ratio 0.878, 95% CI 0.649–1.187, p=0.398). Length of stay was similar in both groups (7 days in the CRP groupversus6 days in the GOLD group, p=0.206). On day-30, no difference in symptom score, quality of life or serious adverse events was detected.Use of CRP as a biomarker to guide antibiotic treatment in severe acute exacerbations of COPD leads to a significant reduction in antibiotic treatment. In the present study, no differences in adverse events between both groups were found. Further research is needed for the generalisability of these findings.
Randomised controlled trial of polysomnographic titration of noninvasive ventilation
Authors: Hannan Liam M. , Rautela Linda , Berlowitz David J. , McDonald Christine F. , Cori Jennifer M. , Sheers Nicole , Chao Caroline , O'Donoghue Fergal J. , Howard Mark E. 
Published: March 2019

Noninvasive ventilation (NIV) settings determined during wakefulness may produce patient–ventilator asynchrony (PVA) during sleep, causing sleep disruption and limiting tolerance. This study investigated whether NIV titrated with polysomnography (PSG) is associated with less PVA and sleep disruption than therapy titrated during daytime alone.Treatment-naive individuals referred for NIV were randomised to control (daytime titration followed by sham polysomnographic titration) or PSG (daytime titration followed by polysomnographic titration) groups. Primary outcomes were PVA and arousal indices on PSG at 10 weeks. Secondary outcomes included adherence, gas exchange, symptoms and health-related quality of life (HRQoL).In total, 60 participants were randomised. Most (88.3%) had a neuromuscular disorder and respiratory muscle weakness but minor derangements in daytime arterial blood gases. PVA events were less frequent in those undergoing polysomnographic titration (median (interquartile range (IQR)): PSG 25.7 (12–68) events·h−1versuscontrol 41.0 (28–182) events·h−1; p=0.046), but arousals were not significantly different (median (IQR): PSG 11.4 (9–19) arousals·h−1versuscontrol 14.6 (11–19) arousals·h−1; p=0.258). Overall adherence was not different except in those with poor early adherence (<4 h·day−1) who increased their use after polysomnographic titration (mean difference: PSG 95 (95% CI 29–161) min·day−1versuscontrol −23 (95% CI −86–39) min·day−1; p=0.01). Arterial carbon dioxide tension, somnolence and sleep quality improved in both groups. There were no differences in nocturnal gas exchange or overall measures of HRQoL.NIV titrated with PSG is associated with less PVA but not less sleep disruption when compared with therapy titrated during daytime alone.
Nationwide cloud-based integrated database of idiopathic interstitial pneumonias for multidisciplinary discussion
Authors: Fujisawa Tomoyuki , Mori Kazutaka , Mikamo Masashi , Ohno Takashi , Kataoka Kensuke , Sugimoto Chikatoshi , Kitamura Hideya , Enomoto Noriyuki , Egashira Ryoko , Sumikawa Hiromitsu , Iwasawa Tae , Matsushita Shoichiro , Sugiura Hiroaki , Hashisako Mikiko , Tanaka Tomonori , Terasaki Yasuhiro , Kunugi Shinobu , Kitani Masashi , Okuda Ryo , Horiike Yasuoki , Enomoto Yasunori , Yasui Hideki , Hozumi Hironao , Suzuki Yuzo , Nakamura Yutaro , Fukuoka Junya , Johkoh Takeshi , Kondoh Yasuhiro , Ogura Takashi , Inoue Yoshikazu , Hasegawa Yoshinori , Inase Naohiko , Homma Sakae , Suda Takafumi 
Published: March 2019

Multidisciplinary discussion (MDD) requiring close communication between specialists (clinicians, radiologists and pathologists) is the gold standard for the diagnosis of idiopathic interstitial pneumonias (IIPs). However, MDD by specialists is not always feasible because they are often separated by time and location. An online database would facilitate data sharing and MDD. Our aims were to develop a nationwide cloud-based integrated database containing clinical, radiological and pathological data of patients with IIPs along with a web-based MDD system, and to validate the diagnostic utility of web-based MDD in IIPs.Clinical data, high-resolution computed tomography images and lung biopsy slides from patients with IIPs were digitised and uploaded to separate servers to develop a cloud-based integrated database. Web-based MDD was performed using the database and video-conferencing to reach a diagnosis.Clinical, radiological and pathological data of 524 patients in 39 institutions were collected, uploaded and incorporated into the cloud-based integrated database. Subsequently, web-based MDDs with a pulmonologist, radiologist and pathologist using the database and video-conferencing were successfully performed for the 465 cases with adequate data. Overall, the web-based MDD changed the institutional diagnosis in 219 cases (47%). Notably, the MDD diagnosis yielded better prognostic separation among the IIPs than did the institutional diagnosis.This is the first study of developing a nationwide cloud-based integrated database containing clinical, radiological and pathological data for web-based MDD in patients with IIPs. The database and the web-based MDD system that we built made MDD more feasible in practice, potentially increasing accurate diagnosis of IIPs.
Oxygen compared to air during exercise training in COPD with exercise-induced desaturation
Authors: Alison Jennifer A. , McKeough Zoe J. , Leung Regina W.M. , Holland Anne E. , Hill Kylie , Morris Norman R. , Jenkins Sue , Spencer Lissa M. , Hill Catherine J. , Lee Annemarie L. , Seale Helen , Cecins Nola , McDonald Christine F. 
Published: March 2019

Almost half the patients referred to pulmonary rehabilitation with chronic obstructive pulmonary disease (COPD) desaturate during exercise. Although oxygen supplementation may ameliorate oxygen desaturation, the effects on outcomes of exercise training have not been rigorously evaluated. This study aimed to determine whether supplemental oxygen during exercise training was more effective than medical air in improving exercise capacity and health-related quality of life (HRQoL) in people with COPD.People with COPD who demonstrated oxygen desaturation <90% during the 6-min walk test were recruited to this multicentre trial with randomisation (independent, concealed allocation) to either an Oxygen group or Air group, blinding (participants, exercise trainers andEuropean Respiratory Journalassessors) and intention-to-treat analysis. Both groups received the respective gas from concentratorsvianasal prongs at 5 L·min−1during exercise training consisting of treadmill and cycle exercise, three times per week for 8 weeks. Primary outcomes were the endurance shuttle walk test (ESWT) time and Chronic Respiratory Disease Questionnaire (CRQ)-Total score.111 participants (60 males), mean±sdage 69±7 years, with moderate to severe COPD were recruited and 97 completed (Oxygen group n=52; Air group n=45). At the end of the 8-week training programme there were no between-group differences in change in ESWT (mean difference 15 s (95% CI −106–136 s) or change in CRQ-Total (0.0 points (95% CI −0.3–0.3 points)). Within-group changes at end-training were significant for ESWT and CRQ-Total (all p<0.01).Exercise capacity and HRQoL improved in both groups, with no greater benefit from training with supplemental oxygen than medical air.
A value-based evaluation of minimally invasive hysterectomy approaches
Authors: Danilyants Natalya , MacKoul Paul , van der Does Louise , Haworth Leah , Baxi Rupen 
Published: March 2019

AbstractBackgroundWith surgical care contributing to the rising healthcare costs around the globe, quantifying the value of surgical modalities is critical to pushing healthcare systems in the direction of greater sustainability. The purpose of this study was to assess and compare the value of minimally invasive hysterectomy approaches, as defined by operative outcomes and patient satisfaction relative to direct hospital costs.MethodsSequential mixed methods; retrospective chart review of all women (N = 2689) ≥ 18 years old who underwent hysterectomy for benign conditions from 2011 through 2013 at a suburban hospital in Maryland, USA; a mail survey of the same population was administered in June to October 2015. Procedures included laparoscopic supracervical hysterectomy (LSH), robotically assisted laparoscopic hysterectomy (RALH), total laparoscopic hysterectomy (TLH), laparoscopically assisted vaginal hysterectomy (LAVH), total vaginal hysterectomy (TVH), and laparoscopic retroperitoneal hysterectomy (LRH), a procedure that incorporates retroperitoneal dissection and ligation of the uterine arteries at their vascular origin. We estimated the value of each procedure by dividing quality over direct hospital costs, where quality was quantified by creating a summary composite score of the average operating time, estimated blood loss, complication and conversion rates, and patient satisfaction.ResultsThe majority of LRH and RALH procedures were performed by high-volume surgeons, while the majority of LSH and TVH procedures were performed by low-volume surgeons. RALH had the highest postoperative complication rate (11.4%;p < .0001). TVH had the highest intraoperative complication rate (9.6%;p < .0001) but lowest postoperative complication rate (1.8%;p < .0001). LRH had the shortest operating time (71.2 min;p < .0001) and lowest intraoperative complication rates (2.1%;p < .0001). LRH and TVH were the least costly ($4061 and $6416, respectively), while RALH was the most costly ($9354). LRH had the highest combined patient satisfaction score, followed by RALH, while TLH, LAVH, TVH, and LSH averaged similar scores.ConclusionLRH, TVH, and LAVH yielded the highest value scores; LSH, TLH, and RALH yielded the lowest. Healthcare costs continue to escalate, in large part due to innovations in medical technology. For healthcare stakeholders seeking to control costs without sacrificing quality, it is critical to operationalize the value of varying surgical techniques, including measures of surgeon experience, operative outcomes, costs, and patient satisfaction.