bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting Amputation and Multiple Debridements in Tooth Knuckle Injuries
Authors: Smith H.R. , Conyard C. , Loveridge J. , Gunnarsson R. 
Published: February 2019

Background: Tooth knuckle injuries can be expensive to treat and may necessitate amputation in some cases. Several limitations exist in the literature regarding our knowledge around the factors predicting amputation and the need for multiple debridements in treating this injury.Methods: A historic cohort study of 321 patients treated for tooth knuckle injuries was undertaken. Twenty-one demographic, clinical and laboratory variables were collected. Two outcome measurements were collected - the need for amputation and the need for more than one surgical debridement. A multivariate logistic regression was performed to determine the relationship between the predictor variables and the outcome measurements.Results: Of the 321 patients examined, 1.6% required amputations and 25% required multiple debridements. Osteomyelitis was found to be a major predictor for amputation in these patients (OR = 35). Delayed presentation (OR = 1.1) and diabetes (OR = 2.6) were found to significantly increase the risk of requiring multiple debridements.Conclusions: Our models were able to predict what patients were at the greatest risk for amputation and multiple debridement. Reducing rates of osteomyelitis and delays in presentation may help reduce the incidence of amputation and reoperation in this injury.
Ulnar Variance in Scaphoid Fractures: Retrospective Analysis of 182 Cases
Authors: Osinga Rik , Estermann L. , Klein H.J. , Schibli-Beer S. , Jandali A.R. , Hug U. 
Published: February 2019

Background: Literature provides little and controversial evidence regarding the influence of ulnar variance (UV) on the incidence of scaphoid fractures. The aim of this retrospective study was to assess UV in a large number of patients with acute scaphoid fracture in comparison to a control group of the same population. Methods: During a two year period, 182 patients with acute scaphoid fractures (fracture group) and 182 ethnicity-, gender- and age-matched patients with wrist contusions (control group) were treated in three non-university hospitals. Using standardized digital wrist radiographs, UV values were measured by means of the method of perpendiculars by two independent examiners. The UV values of the fracture group were then compared to the UV values of the control group. Results: Analyses of the agreement between the two raters resulted in a good to excellent inter-item correlation of 0.89, with a high intra-class coefficient of 0.93 (95% confidence interval: 0.87–0.95). Mean (SD) UV value was -0.82 mm (1.77) in the fracture group and 0.27 mm (1.44) in the control group. Paired sample t-test showed a significant difference between the two groups (p < 0.0001). Conclusions: According to this study, patients with scaphoid fractures are significantly more likely to show a negative UV than matched patients with wrist contusions.
Citation Analysis of Articles about Hand Surgery Published in Orthopaedic and Hand Surgery Journals
Authors: Fujihara Yuki , Fujihara Nasa , Yamamoto Michiro , Hirata Hitoshi 
Published: February 2019

Background: To date, little is known about the characteristics of highly cited studies in hand surgery compared with other orthopaedic subspecialties. We aimed to assess the position of hand surgery within the orthopedic surgery literature. Methods: We conducted a bibliographic analysis using the Web of Science database to review 1,568 articles published between January 2012 and December 2012 in 4 relevant general orthopedic and 2 hand surgery journals. We used the number of citations within 3 years of publication to measure the impact of each paper. To analyze prognostic factors using logistic regression analysis, we extracted data on orthopedic subspecialty, published journal, location of authorship, and type of study for all articles. For clinical studies, we also recorded details on study design and sample size. Results: Of eligible hand surgery articles (n = 307), the majority (62%) were case reports/series. Only 19% were comparative studies, comprising a significantly smaller proportion of comparative studies from other subspecialties in general orthopedic journals. Systematic reviews/meta-analyses generated a significantly higher number of average citations, whereas educational reviews were consistently cited less frequently than other study types (14.9 and 6.1 average citations, respectively). Being published in the Journal of Bone and Joint Surgery, American volume, having authorship in North America or Europe and Australia, focusing on subspecialties like hip & knee, sports, or shoulder, utilizing a comparative or randomized clinical trial study design, and having a larger sample size increased the odds of receiving more citations. Conclusions: Clinical studies related to hand surgery published in general orthopedic journals are most often of lower quality study design. Having a larger sample size or using a comparative study or randomized clinical trial design can improve the quality of study and may ultimately increase the impact factor of hand surgery journals.
Cross-Shaped Bone Grafting and Locking Plate Fixation for Arthrodesis of the Trapeziometacarpal Joint: Surgical Technique and Early Mobilization
Authors: Muramatsu Keiichi , Tominaga Yasuhiro , Hashimoto Takahiro , Taguchi Toshihiko 
Published: February 2019

Background: The trapeziometacarpal joint is the second most common site of osteoarthritis in the hand and the most frequent one to require surgery. Arthrodesis of the trapeziometacarpal joint is recognized as one of the valuable technique but unfortunately there has been wide variation in the union rate. The purpose of this study was to evaluate a new arthrodesis technique involving a cross-shaped bone graft and locking plate fixation. Methods: Eleven male patients diagnosed as Eaton’s stage III osteoarthritis of the trapeziometacarpal join were treated in our institute. The mean patient age was 62 years (range 50 to 80 years). At the day after surgery, physical therapy was started and free use of the hand was permitted. Results: Patients showed radiographic evidence of trapeziometacarpal joint union after an average postoperative period of 8.3 weeks (range 6–12 weeks). The VAS pain score significantly decreased from 7.2 points preoperatively to 0.4 points after surgery. Mean side pinch strength increased significantly from 3.8 kg (53% compared to unaffected side) prior to surgery to 6.2 kg (86%). The DASH score improved from 38.6 (range 34.1–43.2) preoperatively to 17.0 (6.8–22.7) postoperatively. Conclusions: These data suggested that our technique is a successful procedure for the trapeziometacarpal joint arthrodesis. Cross-shaped bone grafts have the advantages of restoring thumb length and providing internal stabilization, especially for rotational force. No complications arose at the bone harvest site of the iliac crest. The procedure seems to be technically demanding, particularly for adapting the bone graft to perfectly match the shape of the defect.
Clinical Outcomes of Zone 2 Flexor Tendon Repairs Using the Modified Lim/Tsai Technique
Authors: Chang Min Kai , Acharyya Sanchalika , Lim Zeus Yiwei , Tay Shian Chao 
Published: February 2019

Background: The single looped suture modified Lim/Tsai technique is widely used for flexor tendon repairs. It has been shown to possess better biomechanical properties and require less repair time per tendon as compared to the double looped suture original Lim/Tsai technique. However, there is no clinical data on the modified technique.Methods: The retrospective study included zone 2 flexor tendon repairs made using the modified Lim/Tsai technique from January 2008 to December 2014. Clinical outcome was assessed using the revised Strickland and Glogovac criteria, which categorises repairs based on the total active motion of the repaired digit.Results: Sixty-two patients with 74 digits were included. The overall mean total active motion was 122°. The overall satisfactory outcome of the modified Lim/Tsai technique was 81.1%. The rupture rate of the modified Lim/Tsai technique was 2.7%. Using multivariate linear regression model, we found that outcomes were negatively influenced by subzone 2C and crush/saw injuries, but not by concomitant neurovascular injuries or post-operative follow-up duration.Conclusions: Based on this retrospective study of patients with zone 2 flexor tendon injuries, the clinical outcomes of modified and original Lim/Tsai techniques are comparable. As such, there is no clinical evidence favouring one over the other.
Contact-free unconstraint respiratory measurements with load cells under the bed in awake healthy volunteers: breath-by-breath comparison with pneumotachography
Authors: Isono Shiroh , Nozaki-Taguchi Natsuko , Hasegawa Makoto , Kato Shinichiro , Todoroki Shinsuke , Masuda Shigemi , Iida Norihito , Nishimura Toshiaki , Noto Masatoshi , Sato Yasunori 
Published: February 2019

Rate of respiration is a fundamental vital sign. Accuracy and precision of respiratory rate measurements with contact-free load cell sensors under the bed legs were assessed by breath-by-breath comparison with the pneumotachography technique during two different dynamic breathing tasks in 16 awake human adults resting on the bed. The subject voluntarily increased and decreased the respiratory rate between 4 and 16 breaths/min ( n = 8) and 10 and 40 breaths/min ( n = 8) at every 2 breaths in 6 different lying postures such as supine, left lateral, right lateral, and 30, 45, and 60° sitting postures. Reciprocal phase changes of the upper and lower load cell signals accorded with the respiratory phases indicating respiratory-related shifts of the centroid along the long axis of the bed. Bland-Altman analyses revealed 0.66 and 1.59 breaths/min standard deviation differences between the techniques (limits of agreement: −1.22 to 1.36 and −2.96 to 3.30) and 0.07 and 0.17 breaths/min fixed bias differences (accuracy) (confidence interval: 0.04 to 0.10 and 0.12 to 0.22) for the mean respiratory rates of 10.5 ± 3.7 and 24.6 ± 8.9 breaths/min, respectively, regardless of the body postures on the bed. Proportional underestimation by this technique was evident for respiratory rates >40 breaths/min. Sample breath increase up to 10 breaths improved the precision from 1.59 to 0.26 breaths/min. Abnormally faster and slower respirations were accurately detected. We conclude that contact-free unconstraint respiratory rate measurements with load cells under the bed legs are accurate and may serve as a new clinical and investigational tool. NEW & NOTEWORTHY Four load cells placed under the bed legs successfully captured a centroid shift during respiration in human subjects lying on a bed. Breath-by-breath comparison of the breaths covering a wide respiratory rate range by pneumotachography confirmed reliability of the contact-free unconstraint respiratory rate measurements by small standard deviations and biases regardless of body postures. Abnormally faster and slower respirations were accurately detected. This technique should be an asset as a new clinical and investigational tool.
Running ground reaction forces across footwear conditions are predicted from the motion of two body mass components
Authors: Udofa Andrew B. , Clark Kenneth P. , Ryan Laurence J. , Weyand Peter G. 
Published: February 2019

Although running shoes alter foot-ground reaction forces, particularly during impact, how they do so is incompletely understood. Here, we hypothesized that footwear effects on running ground reaction force-time patterns can be accurately predicted from the motion of two components of the body’s mass (mb): the contacting lower-limb (m1 = 0.08mb) and the remainder (m2 = 0.92mb). Simultaneous motion and vertical ground reaction force-time data were acquired at 1,000 Hz from eight uninstructed subjects running on a force-instrumented treadmill at 4.0 and 7.0 m/s under four footwear conditions: barefoot, minimal sole, thin sole, and thick sole. Vertical ground reaction force-time patterns were generated from the two-mass model using body mass and footfall-specific measures of contact time, aerial time, and lower-limb impact deceleration. Model force-time patterns generated using the empirical inputs acquired for each footfall matched the measured patterns closely across the four footwear conditions at both protocol speeds ( r2 = 0.96 ± 0.004; root mean squared error  = 0.17 ± 0.01 body-weight units; n = 275 total footfalls). Foot landing angles (θF) were inversely related to footwear thickness; more positive or plantar-flexed landing angles coincided with longer-impact durations and force-time patterns lacking distinct rising-edge force peaks. Our results support three conclusions: 1) running ground reaction force-time patterns across footwear conditions can be accurately predicted using our two-mass, two-impulse model, 2) impact forces, regardless of foot strike mechanics, can be accurately quantified from lower-limb motion and a fixed anatomical mass (0.08mb), and 3) runners maintain similar loading rates (ΔFvertical/Δtime) across footwear conditions by altering foot strike angle to regulate the duration of impact. NEW & NOTEWORTHY Here, we validate a two-mass, two-impulse model of running vertical ground reaction forces across four footwear thickness conditions (barefoot, minimal, thin, thick). Our model allows the impact portion of the impulse to be extracted from measured total ground reaction force-time patterns using motion data from the ankle. The gait adjustments observed across footwear conditions revealed that runners maintained similar loading rates across footwear conditions by altering foot strike angles to regulate the duration of impact.
Impact of Baseline Features and Risk Factor Control on Cognitive Function in the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial
Authors: Turan Tanya N. , Al Kasab Sami , Smock Alison , Cotsonis George , Bachman David , Lynn Michael J. , Nizam Azhar , Derdeyn Colin P. , Fiorella David , Janis Scott , Lane Bethany , Montgomery Jean , Chimowitz Marc I. ,   MBChB for the SAMMPRIS Investigators
Published: February 2019

<b><i>Background:</i></b> Cerebrovascular disease is an important cause of cognitive impairment. The aim of this study is to report the relationship between cognitive function and risk factors at baseline and during follow-up in the Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) trial. <b><i>Methods:</i></b> Subjects in the SAMMPRIS trial were included in this study. In order to have an assessment of cognitive function independent of stroke, patients with a stroke as a qualifying event whose deficits included aphasia or neglect were excluded from these analyses as were those with a cerebrovascular event during follow-up. The Montreal Cognitive Assessment (MoCA) score was used to assess cognitive impairment at baseline, 4 months, 12 months and closeout. Cognitive impairment was defined as MoCA &#x3c; 26. A multivariate analysis was performed to determine what risk factors were independent predictors of cognitive function at baseline, 12 months and closeout. Among patients randomized to aggressive medical management only, the percentage of patients with cognitive impairment was compared between patients in versus out of target for each risk factor at 12 months and closeout. <b><i>Results:</i></b> Of the 451 patients in SAMMPRIS, 371 patients met the inclusion criteria. MoCA &#x3c; 26 was present in 55% at baseline. Older age and physical inactivity were associated with cognitive impairment at baseline. Older age, non-white race, lower baseline body mass index, and baseline cognitive impairment were associated with cognitive impairment at 12 months. In the aggressive medical management group, at 12 months, physical inactivity during follow-up was the strongest risk factor associated with cognitive impairment. <b><i>Conclusion:</i></b> Cognitive impairment is common in patients with severe symptomatic intracranial atherosclerosis. Physical inactivity at baseline and during follow-up is a strong predictor of cognitive impairment.
Preoperative NT‐proBNP Predicts Midterm Outcome After Septal Myectomy
Authors: Song Changpeng , Wang Shengwei , Guo Ying , Zheng Xinxin , Lu Jie , Fang Xiaonan , Wang Shuiyun , Huang Xiaohong 
Published: February 2019

Background

The prognostic value of N‐terminal pro–brain natriuretic peptide (
NT
‐pro
BNP
) in patients with hypertrophic cardiomyopathy who underwent septal myectomy has not been well studied.

Methods and Results

We retrospectively evaluated
NT
‐pro
BNP
levels in 758 patients (46.1±13.8 years; median follow‐up, 936 days) who underwent septal myectomy in our center between March 2011 and April 2018. The median
NT
‐pro
BNP
level was 1450.5 (interquartile range 682.6‐2649.5) pg/mL. Overall, 22 (2.9%) patients died during follow‐up; of these, 86.4% were cardiovascular deaths. The 3‐year survival free from all‐cause mortality by tertile was 95.2% (95%
CI
91.1% to 97.4%;
NT
‐pro
BNP
>2080 pg/mL), 98.3% (95%
CI
94.6% to 99.5%;
NT
‐pro
BNP
, 947‐2080 pg/mL), and 99.2% (95%
CI
, 94.4% to 99.9%;
NT
‐pro
BNP
<947 pg/mL). The 3‐year survival rate free from cardiovascular mortality by tertiles was 95.2% in the highest tertile, 98.8% in the middle tertile, and 99.2% in the lowest tertile. Cox regression analysis indicated that Ln(
NT
‐pro
BNP
) was a significantly independent predictor of all‐cause mortality (hazard ratio 2.380, 95%
CI
1.356‐4.178,
P
=0.003) and cardiovascular mortality (hazard ratio 2.788, 95%
CI
1.450‐5.362,
P
=0.002). In addition, concomitant coronary artery bypass grafting for coronary artery disease was also an independent predictor of cardiovascular mortality (hazard ratio 5.178, 95%
CI
1.597‐16.789,
P
=0.006).

Conclusions

Increased preoperative
NT
‐pro
BNP
level is a strong predictor of midterm mortality in patients undergoing septal myectomy.
Artificially Sweetened Beverages and Stroke, Coronary Heart Disease, and All-Cause Mortality in the Women’s Health Initiative
Authors: Mossavar-Rahmani Yasmin , Kamensky Victor , Manson JoAnn E. , Silver Brian , Rapp Stephen R. , Haring Bernhard , Beresford Shirley A.A. , Snetselaar Linda , Wassertheil-Smoller Sylvia 
Published: February 2019

Background and Purpose—
We examine the association between self-reported consumption of artificially sweetened beverages (ASB) and stroke and its subtypes, coronary heart disease, and all-cause mortality in a cohort of postmenopausal US women.

Methods—
The analytic cohort included 81 714 women from the Women’s Health Initiative Observational Study, a multicenter longitudinal study of the health of 93 676 postmenopausal women of ages 50 to 79 years at baseline who enrolled in 1993 to 1998. This prospective study had a mean follow-up time of 11.9 years (SD of 5.3 years.) Participants who completed a follow-up visit 3 years after baseline were included in the study.

Results—
Most participants (64.1%) were infrequent consumers (never or <1/week) of ASB, with only 5.1% consuming ≥2 ASBs/day. In multivariate analyses, those consuming the highest level of ASB compared to never or rarely (<1/wk) had significantly greater likelihood of all end points (except hemorrhagic stroke), after controlling for multiple covariates. Adjusted models indicated that hazard ratios and 95% confidence intervals were 1.23 (1.02–1.47) for all stroke; 1.31 (1.06–1.63) for ischemic stroke; 1.29 (1.11–1.51) for coronary heart disease; and 1.16 (1.07–1.26) for all-cause mortality. In women with no prior history of cardiovascular disease or diabetes mellitus, high consumption of ASB was associated with more than a 2-fold increased risk of small artery occlusion ischemic stroke hazard ratio =2.44 (95% confidence interval, 1.47–4.04.) High consumption of ASBs was associated with significantly increased risk of ischemic stroke in women with body mass index ≥30; hazard ratio =2.03 (95% confidence interval, 1.38–2.98).

Conclusions—
Higher intake of ASB was associated with increased risk of stroke, particularly small artery occlusion subtype, coronary heart disease, and all-cause mortality. Although requiring replication, these new findings add to the potentially harmful association of consuming high quantities of ASB with these health outcomes.
The Effect of Irrelevant Environmental Noise on the Performance of Visual-to-Auditory Sensory Substitution Devices Used by Blind Adults
Authors: Buchs Galit , Heimler Benedetta , Amedi Amir 
Published: February 2019

Abstract
Visual-to-auditory Sensory Substitution Devices (SSDs) are a family of non-invasive devices for visual rehabilitation aiming at conveying whole-scene visual information through the intact auditory modality. Although proven effective in lab environments, the use of SSDs has yet to be systematically tested in real-life situations. To start filling this gap, in the present work we tested the ability of expert SSD users to filter out irrelevant background noise while focusing on the relevant audio information. Specifically, nine blind expert users of the EyeMusic visual-to-auditory SSD performed a series of identification tasks via SSDs (i.e., shape, color, and conjunction of the two features). Their performance was compared in two separate conditions: silent baseline, and with irrelevant background sounds from real-life situations, using the same stimuli in a pseudo-random balanced design. Although the participants described the background noise as disturbing, no significant performance differences emerged between the two conditions (i.e., noisy; silent) for any of the tasks. In the conjunction task (shape and color) we found a non-significant trend for a disturbing effect of the background noise on performance. These findings suggest that visual-to-auditory SSDs can indeed be successfully used in noisy environments and that users can still focus on relevant auditory information while inhibiting irrelevant sounds. Our findings take a step towards the actual use of SSDs in real-life situations while potentially impacting rehabilitation of sensory deprived individuals.
Shared or Distinct Attentional Resources? Confounds in Dual Task Designs, Countermeasures, and Guidelines
Authors: Wahn Basil , Sinnett Scott 
Published: February 2019

Abstract
Human information processing is limited by attentional resources. That is, via attentional mechanisms humans select information that is relevant for their goals, and discard other information. While limitations of attentional processing have been investigated extensively in each sensory modality, there is debate as to whether sensory modalities access shared resources, or if instead distinct resources are dedicated to individual sensory modalities. Research addressing this question has used dual task designs, with two tasks performed either in a single sensory modality or in two separate modalities. The rationale is that, if two tasks performed in separate sensory modalities interfere less or not at all compared to two tasks performed in the same sensory modality, then attentional resources are distinct across the sensory modalities. If task interference is equal regardless of whether tasks are performed in separate sensory modalities or the same sensory modality, then attentional resources are shared across the sensory modalities. Due to their complexity, dual task designs face many methodological difficulties. In the present review, we discuss potential confounds and countermeasures. In particular, we discuss 1) compound interference measures to circumvent problems with participants dividing attention unequally across tasks, 2) staircase procedures to match difficulty levels of tasks and counteracting problems with interpreting results, 3) choosing tasks that continuously engage participants to minimize issues arising from task switching, and 4) reducing motor demands to avoid sources of task interference, which are independent of the involved sensory modalities.