bluuebunny/crossref_metadata_2025_split huggingface dataset:
Augmented Ligament Reconstruction Partially Restores Hindfoot and Midfoot Kinematics After Lateral Ligament Ruptures
Authors: Boey Hannelore , Verfaillie Stefaan , Natsakis Tassos , Vander Sloten Jos , Jonkers Ilse 
Published: May 2019

Background: Altered kinematics and persisting ankle instability have been associated with degenerative changes and osteochondral lesions. Purpose: To study the effect of ligament reconstruction surgery with suture tape augmentation (isolated anterior talofibular ligament [ATFL] vs combined ATFL and calcaneofibular ligament [CFL]) after lateral ligament ruptures (combined ATFL and CFL) on foot-ankle kinematics during simulated gait. Study Design: Controlled laboratory study. Methods: Five fresh-frozen cadaveric specimens were tested in a custom-built gait simulator in 5 different conditions: intact, ATFL rupture, ATFL-CFL rupture, ATFL-CFL reconstruction, and ATFL reconstruction. For each condition, range of motion (ROM) and the average angle (AA) in the hindfoot and midfoot joints were calculated during the stance phase of normal and inverted gait. Results: Ligament ruptures mainly changed ROM in the hindfoot and the AA in the hindfoot and midfoot and influenced the kinematics in all 3 movement directions. Combined ligament reconstruction was able to restore ROM in inversion-eversion in 4 of the 5 joints and ROM in internal-external rotation and dorsiflexion-plantarflexion in 3 of the 5 joints. It was also able to restore the AA in inversion-eversion in 2 of the 5 joints, the AA in internal-external rotation in all joints, and the AA in dorsiflexion-plantarflexion in 1 of the joints. Isolated ATFL reconstruction was able to restore ROM in inversion-eversion and internal-external rotation in 3 of the 5 joints and ROM in dorsiflexion-plantarflexion in 2 of the 5 joints. Isolated reconstruction was also able to restore the AA in inversion-eversion and dorsiflexion-plantarflexion in 2 of the joints and the AA in internal-external rotation in 3 of the joints. Both isolated reconstruction and combined reconstruction were most successful in restoring motion in the tibiocalcaneal and talonavicular joints and least successful in restoring motion in the talocalcaneal joint. However, combined reconstruction was still better at restoring motion in the talocalcaneal joint than isolated reconstruction (1/3 for ROM and 1/3 for the AA with isolated reconstruction compared to 1/3 for ROM and 2/3 for the AA with combined reconstruction). Conclusion: Combined ATFL-CFL reconstruction showed better restored motion immediately after surgery than isolated ATFL reconstruction after a combined ATFL-CFL rupture. Clinical Relevance: This study shows that ligament reconstruction with suture tape augmentation is able to partially restore kinematics in the hindfoot and midfoot at the time of surgery. In clinical applications, where the classic Broström-Gould technique is followed by augmentation with suture tape, this procedure may protect the repaired ligament during healing by limiting excessive ROM after a ligament rupture.
The course of hematocrit value along the length of a dialyzer’s fiber: Hemoconcentration modeling and validation methods
Authors: Poorkhalil Ali , Mouzakis Foivos , Kashefi Ali , Mottaghy Khosrow 
Published: May 2019

Objectives: Contemporary therapies for chronic kidney disease patients encompass a wide range of hemodialysis treatments, most of which rely greatly on dialyzers and hemofilters. The filtration process taking place in these devices with respect to the hemodynamic characteristics of the flow, has not yet been fully investigated. This study aims at improving the understanding of hemodynamics in a dialyzer by employing experimental methods and mathematical models. Methods: A semiempirical model has been formulated based on the principles of hemodynamics, considering the dominant phenomena of filtration-backfiltration and the corresponding driving forces. An in vitro hemodialysis circuit was accordingly assembled for experimental data acquisition, and subsequently for model validation. The circuit consisted of two dialyzers arranged in sequential order, in pursuance of increasing the number of sampling points. Fresh, heparinized porcine blood was used throughout the course of this study. Pressure and flow data obtained from in vitro investigations with the hemodialysis circuit were used as an input for the semiempirical model. Findings: The model predicted a substantial divergence in the course of hematocrit value along the length of the hollow fibers, which is corroborated by the experimental data. Particularly in certain operational conditions, hematocrit rose from 25% at the inlet to 65% halfway along the dialyzers’ length, to end at 30% at the outlet. Conclusion: Validation of the model’s predictions with experimental data demonstrated a very good agreement, confirming the model’s accuracy. Potential implementation of the model in clinical practice in the future might contribute greatly to an improved hemodialysis experience.
Software Reviews
Authors: Wiseman Richard 
Published: May 2019

As a first step towards preparation of a collection of reviews of computer-assisted career guidance packages, guidelines for evaluation of such packages were published in the Journal (Vol. 2, No. 1, pp. 40–42). Comments on the guidelines, which were prepared by Dr Esther Care, were sought from readers. These and other guidelines formed the basis of a document sent to potential reviewers of packages for this special edition. The process began by consulting practitioners, publishers and others knowledgeable in the field to ensure that as wide a range as possible of systems available in Australia would be covered in the reviews. Letters were sent to publishers and distributors requesting descriptive information about the nature of each system, its intended clients, cost and hardware requirements. For each system, a representative list of purchasers was requested from the distributor or publisher. These lists were used to ensure that a wide range of practitioners and regions of Australia would be encompassed in the reviews. We are also particularly pleased to have information from two neighbouring countries, New Zealand and Singapore, about systems developed and in use there. From the lists provided, two purchasers of each system were selected from different types of organisations and from different states or territories. Letters inviting reviews were sent, together with the document of suggested guidelines for comment. It was stressed that the guidelines were no more than that, and that comment in any form would be welcome. Not all potential reviewers approached were able to undertake the task and a few “reserves” were called upon. Nevertheless a good cross-section of types of users and almost all regions of Australia are represented in the replies. The entries in the Journal are either directly as submitted or have been paraphrased from the summary comments made in response to the guidelines. In each of the latter cases, the paraphrased material was confirmed by the reviewer as an accurate reflection of the comments made.
Efficacy of Motivational Interviewing to Enhance Advance Directive Completion in Latinos With Chronic Illness: A Randomized Controlled Trial
Authors: Nedjat-Haiem Frances R. , Cadet Tamara J. , Amatya Anup , Thompson Beti , Mishra Shiraz I. 
Published: May 2019

Background: End-of-life (EOL) care for Latinos with chronic illness is a critically important problem. Latinos with chronic illness suffer worse health outcomes and poorer quality of care due to various issues occurring in care delivery systems. Latinos are less likely than non-Hispanic whites to prepare an advance directive (AD) for health-care decision-making that impacts treatment decisions for when EOL is near. Advance care planning (ACP) interventions tailored specifically for Latinos have rarely been implemented. Objective: The primary aim examines whether a motivational interviewing (MI) intervention increased rates of AD documentation among older Latinos. The secondary aim was to examine whether MI improved communication with providers and family members. Methods: We pilot tested a randomized controlled trial with older Latinos >50 years with one or more chronic illnesses, including cancer. Participants were randomly assigned to usual care (UC) receiving ACP education alone versus treatment (TX), which received ACP education, plus MI counseling including interactive decisional support, emotional support, and barrier navigation. Results: Results of logistic regression indicate TX group participants were significantly more likely to document an AD than UC, however were less ready to talk with health-care providers or family members. Those reporting navigational barriers for talking about dying is difficult showed a significant negative relationship for AD completion even with significant intervention effects. Conclusion: When using MI to motivate individuals toward ACP EOL conversations other factors are important to consider. Further research is needed, especially among Latinos to understand best practices for ACP education and counseling for EOL care.
Intellectual Equipoise and Challenges: Accruing Patients With Advanced Cancer to a Trial Randomizing to Surgical or Nonsurgical Management (SWOG S1316)
Authors: Deutsch Gary B. , Deneve Jeremiah L. , Al-kasspooles Mazin F. , Nfonsam Valentine N. , Gunderson Camille C. , Secord Angeles Alvarez , Rodgers Phillip , Hendren Samantha , Silberfein Eric J. , Grant Marcia , Sloan Jeff , Sun Virginia , Arnold Kathryn B. , Anderson Garnet L. , Krouse Robert S. 
Published: May 2019

Background: Prospective, randomized trials are needed to determine optimal treatment approaches for palliative care problems such as malignant bowel obstruction (MBO). Randomization poses unique issues for such studies, especially with divergent treatment approaches and varying levels of equipoise. We report our experience accruing randomized patients to the Prospective Comparative Effectiveness Trial for Malignant Bowel Obstruction (SWOG S1316) study, comparing surgical and nonsurgical management of MBO. Methods: Patients with MBO who were surgical candidates and had treatment equipoise were accrued and offered randomization to surgical or nonsurgical management. Patients choosing nonrandomization were offered prospective observation. Trial details are listed on www.clinicaltrials.gov (NCT #02270450). An accrual algorithm was developed to enhance enrollment. Results: Accrual is ongoing with 176 patients enrolled. Most (89%) patients chose nonrandomization, opting for nonsurgical management. Of 25 sites that have accrued to this study, 6 enrolled patients on the randomization arm. Approximately 59% (20/34) of the randomization accrual goal has been achieved. Patient-related factors and clinician bias have been the most prevalent reasons for lack of randomization. An algorithm was developed from clinician experience to aid randomization. Using principles in this tool, repeated physician conversations discussing treatment options and goals of care, and a supportive team–approach has helped increase accrual. Conclusions: Experience gained from the S1316 study can aid future palliative care trials. Although difficult, it is possible to randomize patients to palliative studies by giving clinicians clear recommendations utilizing an algorithm of conversation, allotment of necessary time to discuss the trial, and encouragement to overcome internal bias.
Ten-Year Trends of Utilization of Palliative Care Services and Life-Sustaining Treatments and Hospital Costs Associated With Patients With Terminally Ill Lung Cancer in the United States From 2005 to 2014
Authors: Hwang Jinwook , Shen Jay , Kim Sun Jung , Chun Sung-Youn , Kioka Mutsumi , Sheraz Faizan , Kim Pearl , Byun David , Yoo Ji Won 
Published: May 2019

Background: Palliative care services and life-sustaining treatments are provided to dying patients with lung cancer in the United States. However, data on the utilization trends of palliative care services and life-sustaining treatments of dying patients with lung cancer are not available. Methods: This study was a retrospective analysis of the National Inpatient Sample data (2005-2014) and included patients with lung cancer, aged ≥ 18 years, who died in the hospitals. Claims data of palliative care services and life-sustaining treatments that contained systemic procedures, local procedures, or surgeries were extracted. Compound annual growth rates (CAGRs) using Rao-Scott correction for χ2 tests were used to determine the statistical significance of temporal utilization trends of palliative care services and life-sustaining treatments and their hospital costs. Multilevel multivariate regressions were performed to identify factors associated with hospital costs. Results: A total of 120 144 weighted patients with lung cancer died in the hospitals and 41.9% of them received palliative care services. The CAGRs of systemic procedures, local procedures, surgeries, palliative care services, and hospital cost were 3.42%, 3.48%, 6.08%, 18.5%, and 5.0% (all P < .001), respectively. Increased hospital cost was attributed to systemic procedures (50.6%), local procedures (74.4%), and surgeries (68.5%; all P < .001), respectively. Palliative care services were related to decreasing hospital costs by 28.6% ( P < .001). Conclusion: The temporal trends of palliative care services indicate that their utilization has increased gradually. Palliative care services were associated with reduced hospital costs. However, life-sustaining treatments were associated with increased hospital costs.
Evaluation of the Efficacy of Rotational Corrections for Standard-Fractionation Head and Neck Image-Guided Radiotherapy
Authors: Kung Joseph S. , Tran William T. , Poon Ian , Atenafu Eshetu G. , Courneyea Lorraine , Higgins Kevin , Enepekides Danny , Sahgal Arjun , Chin Lee , Karam Irene 
Published: May 2019

Purpose: Modern linear accelerators are equipped with cone beam computed tomography and robotic couches that can correct for errors in the translational (X, Y, Z) and rotational (α, β, γ) axes prior to treatment delivery. Here, we compared the positional accuracy of 2 cone beam registration approaches: (1) employing translational shifts only in 3 degrees of freedom (X, Y, Z), versus; (2) using translational-rotational shifts in 6 degrees of freedom (X, Y, Z, α, β, γ). Methods: This retrospective study examined 140 interfraction cone beam images from 20 patients with head and neck cancer treated with standard intensity-modulated radiation therapy. The cone beam images were matched to planning simulation scans in 3, then in 6 degrees of freedom, using the mandible, clivus, and C2 and C7 vertebrae as surrogate volumes. Statistical analyses included a generalized mixed model and was used to assess whether there were significant differences in acceptable registrations between the 2 correction methods. Results: The rates of improvement with corrections in 6 degrees of freedom for the mandible with a 5-mm expansion margin were 54.55% ( P = .793), for the clivus 85.71% ( P = .222), and for C7 87.50% ( P = .015). There was a 100% increase in acceptability for the C2 vertebra within the 5-mm margin ( P < .001). For the 3-mm expansion margin, the rates of improvement for the mandible, clivus, C2, and C7 were 63.16% ( P = .070), 91.30% ( P = .011), 84.21% ( P = .027), and 76.92% ( P < .001), respectively. Conclusions: Significant registration improvements with the use of rotational corrections with a 5-mm expansion margin are only seen in the C7 vertebra. At the 3-mm margin, significant improvements are found for the C2, C7, and clivus registrations, suggesting that intensity-modulated radiotherapy treatments for head and neck cancers with 3-mm planning target volume margins may benefit from corrections in 6 degrees of freedom.
Effects of using activity diary for goal setting in occupational therapy on reducing pain and improving psychological and physical performance in patients after total knee arthroplasty: A non-randomised controlled study
Authors: Hiraga Yuki , Hisano Shinya , Nomiyama Katsuhiro , Hirakawa Yoshiyuki 
Published: May 2019

Background Psychological factors have been reported to affect chronic pain and may lead to inactivity after total knee arthroplasty. This study aimed to determine whether the use of an activity diary for goal setting during occupational therapy would reduce pain, and improve psychological and physical performance in patients after total knee arthroplasty. Methods A total of 41 total knee arthroplasty participants from two cohorts were recruited in the study and allocated by convenience to either the experimental group using an activity diary (n = 20) or the control group (n = 21). Occupational therapy intervention (1–2 weeks postoperatively) to promote goal achievement was performed in both groups, and self-monitoring was performed in the diary group by using the activity diary. The outcome indices were Canadian Occupational Performance Measure, pain (resting pain, walking pain), pain catastrophizing (rumination, helplessness, and magnification), anxiety, depression, pain self-efficacy, and physical activity level. Data were evaluated by using analysis of variance analyses with post hoc tests. Results A time-by-group interaction emerged for Canadian Occupational Performance Measure, walking pain, pain catastrophizing, anxiety, depression, and physical activity level (p < 0.05), both favouring the diary group. The diary group also showed greater improvement in Canadian Occupational Performance Measure, walking pain, anxiety, and physical activity levels at four weeks postoperatively, compared to the control group (p < 0.05). Conclusion The use of the activity diary in this study increased occupational therapy effectiveness, reduced patients’ pain, and prevented a decline in physical performance. We believe that the use of an activity diary is an effective and feasible addition for total knee arthroplasty patients.
The outcome of bone graft surgery for nonunion of fractures of the scaphoid
Authors: Ammori Mohannad B. , Elvey Michael , Mahmoud Samer S. , Nicholls Alex J. , Robinson Simon , Rowan Clare , Spence Stephanie , Wade Ryckie G. , Karantana Alexia ,   the British Society for Surgery of the Hand Scaphoid Nonunion Group, Davis Tim R. C. 
Published: May 2019

Data on 806 patients undergoing bone graft surgery for a scaphoid fracture nonunion were retrospectively collected at 19 centres in the United Kingdom. Each centre contributed at least 30 cases. Sufficient data were available in 462 cases to study factors that influenced the outcome of surgery. Overall union occurred in at least 69%, and nonunion in at least 22%, with 9% of cases having ‘uncertain union status’. Union appeared to be adversely influenced by smoking and the time between acute scaphoid fracture and nonunion surgery, with adjusted odds ratios of 1.8 and 2.4, respectively, but neither achieved the pre-determined significance level of 0.003. The type of bone graft (vascular vs non-vascular; iliac crest vs distal radius) did not appear to influence outcome. Further large multicentre prospective studies with clear definitions of ‘union’ and other factors are needed to clarify whether modification of surgical technique can influence union. Level of evidence: IV
Patients’ perception of quality of life after traumatic brachial plexus injury – a qualitative study
Authors: Verma Chhaya V , Yardi Sujata , Puri Vinita , Vora Tanvee 
Published: May 2019

Introduction Advancements in reconstructive surgery for traumatic brachial plexus injury explain the need for better rehabilitation programmes. Therefore, an understanding of an individual patient’s perception through their journey of treatment for a traumatic brachial plexus injury is needed. Methods Thirteen patients with traumatic brachial plexus injury were selected using non-probability purposive sampling. Data were collected in the form of in-depth face-to-face interviews in a clinic setting of a tertiary government hospital using an explorative qualitative method. An interview guide comprising open-ended, nondirective semi structured questions was used and data were analyzed using an interpretative phenomenological approach. Results Eleven subthemes under the overarching theme of patient perception were identified. These subthemes illustrate perception of each individual participants’ journey of treatment for traumatic brachial plexus injury. Conclusion Our study following a qualitative approach throws light on the impact of injury and an adult individual’s perception and may thereby help to develop a more comprehensive and holistic approach towards patient care.
Mechanical Stability of the Prodisc-C Vivo Cervical Disc Arthroplasty: A Preliminary, Observational Study Using Radiostereometric Analysis
Authors: van Hooff Miranda L. , Heesterbeek Petra J. C. , Spruit Maarten 
Published: May 2019

Study Design: Prospective cohort study. Objective: To investigate the primary stability of the Prodisc-C Vivo cervical disc arthroplasty with regard to the adjacent cervical vertebrae using radiostereometric analysis (RSA), and to monitor its clinical performance. Methods: Sixteen patients with degenerative cervical disc disease were included. RSA radiographs were obtained at the first postoperative day, at 6 weeks, 3 months, and 6 months postoperatively. Migration (translation [mm]) of the superior and inferior implant components were measured with model-based RSA, expressed along the 3 orthogonal axes, and calculated as total translation. Clinical outcomes were Neck Disability Index, numeric rating scales for neck and arm pain, Likert-type scales for satisfaction, and adverse events. Range of motion was reported as C2-C7 flexion-extension mobility (ROM). Results: At final follow-up, no significant increase over time in median total translation was found. One inferior and 3 superior components subsided but were asymptomatic. ROM remained stable and clinical outcomes improved over time. Although 3 patients were unsatisfied and 3 adverse events occurred, this was not related to translation of the components. Conclusions: On a group level, both components of the Prodisc-C Vivo cervical disc arthroplasty remained stable over time and below the clinical threshold of 1 mm. Individual outliers for translation were not clinically relevant and probably related to settling of the components into the vertebral endplates. RSA allowed us to perform a preliminary but accurate study on the micromotion of a new cervical disc replacement in a small sample size, without putting large numbers of patients at risk.