bluuebunny/crossref_metadata_2025_split huggingface dataset:
Calibration of an item bank in 474 orthopedic patients using Rasch analysis for computer-adaptive assessment of anxiety
Authors: Kallinger Selina , Scharm Henry , Boecker Maren , Forkmann Thomas , Baumeister Harald 
Published: April 2019

Objective: To calibrate an item bank of anxiety-related questions for use in orthopedic patients within a computer-adaptive test. Design: This is a psychometric study. Setting: The sample of orthopedic patients was recruited in two orthopedic rehabilitation clinics in Germany. Subjects: A total of 474 orthopedic rehabilitation patients were recruited for this study. Interventions: Not applicable. Main measures: The main measure is an adapted version of an existing anxiety item pool for cardiovascular rehabilitation patients. Results: The results of the confirmatory factor analysis and Mokken analysis confirmed a one-factor structure and double monotonicity. An anxiety item bank (48 items) could be developed and calibrated using Rasch analysis. It fitted to the Rasch model with a non-significant item–trait interaction ( χ2(203) = 172.59; P = .94) and was free of differential item functioning. Unidimensionality could be verified and the person separation reliability was .96. The category threshold parameters varied between 4.72 and 3.16 (7.88 logits). Conclusion: The unidimensional anxiety item bank provides the basis for a computer-adaptive test to assess a wide range of anxiety in rehabilitation patients with orthopedic diseases with very good psychometric characteristics.
Synthesis of docosahexaenoic acid–loaded silver nanoparticles for improving endothelial dysfunctions in experimental diabetes
Authors: Hussein JS , Rasheed W , Ramzy T , Nabeeh M , Harvy M , El-Toukhy S , Ali O , Raafat J , El-Naggar M 
Published: April 2019

Objective: To investigate the ability of docosahexaenoic acid (DHA)-loaded silver nanoparticles (AgNPs) in facilitating the incorporation of DHA in the cell membrane, improve cell membrane structure, and attenuate endothelial dysfunction in experimental diabetes. Methods: DHA/AgNPs were prepared using a nanoprecipitation technique. Fifty male albino rats were used in this study; 10 of them were served as the control group and 40, as the experimental groups, were injected with streptozotocin. Then, the experimental groups were subdivided into diabetic, diabetic treated with DHA, diabetic treated with AgNPs, and diabetic treated with DHA/AgNPs groups. Results: DHA/AgNPs have small spherical size as proved from ultraviolet–visible spectroscopy, transmission electron microscope, dynamic light scattering, and scanning electron microscope techniques. Cell membrane cholesterol and triglycerides showed a significant elevation in the diabetic group compared to the control, but treatment with DHA and DHA/AgNPs caused a significant reduction in both. Treatment with AgNPs and DHA/AgNPs caused a significant improvement in asymmetric dimethylarginine and nitric oxide levels compared to the diabetic group. Cell membrane fatty acids showed that omega-6 polyunsaturated fatty acids (PUFAs) were significantly elevated, while omega-3 PUFA were significantly reduced in the diabetic group compared to the control. There is a significant improvement in the levels of fatty acids in all groups after treatment with DHA, silver, or DHA/AgNPs. Conclusion: DHA/AgNPs are potent agents for the improvement of diabetic complication and endothelial dysfunction in experimental diabetes.
Association between the interferon regulatory factor 5 rs2004640 functional polymorphism and systemic lupus erythematosus: an updated meta-analysis
Authors: Bae S C , Lee Y H 
Published: April 2019

Objective The aim of this study is to determine whether the functional interferon regulatory factor 5 ( IRF5) polymorphism rs2004640 is associated with susceptibility to systemic lupus erythematosus (SLE) in multiple ethnic populations. Methods A meta-analysis was conducted on the T allele of the IRF5 rs2004640 polymorphism in all study participants as well as each ethnic population. Results Twenty research articles that included 28 comparative studies of 20,892 patients and 24,930 controls were included in the meta-analysis. The Asian population had a much lower prevalence of the T allele than any other study population at 28%, and the European population had the highest prevalence of the T allele at 52%. Meta-analysis showed an association between the IRF5 rs2004640 polymorphism and SLE in all participants (odds ratio = 1.472, 95% confidence interval = 1.370–1.582, p < 0.001). Analysis after stratification by ethnicity indicated that the IRF5 rs2004640 T allele is significantly associated with SLE in Europeans, Asians, Latin Americans and Arabs. Conclusions This meta-analysis confirms that the IRF5 rs2004640 polymorphism is associated with SLE susceptibility in different ethnic groups, and that its prevalence is ethnicity dependent.
Management of severe stifle trauma: 1. Stifle luxation
Authors: Addison Elena , Conte Alessandro 
Published: April 2019

Practical relevance: Traumatic stifle joint luxation is an uncommon but severe injury. There is usually rupture of several stabilising structures of the joint including the cruciate ligaments, collateral ligaments, joint capsule and menisci. Successful management of this condition requires good anatomical knowledge and repair or replacement of all damaged structures to achieve adequate joint reduction and stability. Better understanding of the treatment options available will aid clinical decision-making. Clinical challenges: Due to the significant joint instability associated with these injuries, surgical repair is challenging. The use of a temporary transarticular pin to hold the stifle joint in anatomic reduction greatly aids ligament repair or replacement. Postoperative joint immobilisation has traditionally been recommended to protect the primary repair and aid periarticular fibrosis, but prolonged immobilisation can have deleterious long-term effects on the joint. Thus recommendations for the duration of postoperative immobilisation vary between 2 and 6 weeks. Also, due to their independent, outdoor lifestyle, affected cats may have been involved in a significant trauma with important concurrent injuries that need to be addressed prior to the orthopaedic repair. Evidence base: Published data is limited, with reports including only a small number of cats. The information and recommendations in this article have therefore been drawn from the available literature, the authors’ experience and preliminary data from an ongoing multicentre retrospective study (unpublished). Aims: The aims of this article are to give the reader as thorough a summary as possible of the diagnosis, treatment, outcome and complications of traumatic stifle luxation.
Mathematical morphology for microaneurysm detection in fundus images
Authors: Joshi Shilpa , Karule PT 
Published: April 2019

Aim: Fundus image analysis is the basis for the better understanding of retinal diseases which are found due to diabetes. Detection of earlier markers such as microaneurysms that appear in fundus images combined with treatment proves beneficial to prevent further complications of diabetic retinopathy with an increased risk of sight loss. Methods: The proposed algorithm consists of three modules: (1) image enhancement through morphological processing; (2) the extraction and removal of red structures, such as blood vessels preceded by detection and removal of bright artefacts; (3) finally, the true microaneurysm candidate selection among other structures based on feature extraction set. Results: The proposed strategy is successfully evaluated on two publicly available databases containing both normal and pathological images. The sensitivity of 89.22%, specificity of 91% and accuracy of 92% achieved for the detection of microaneurysms for Diaretdb1 database images. The algorithm evaluation for microaneurysm detection has a sensitivity of 83% and specificity 82% for e-ophtha database. Conclusion: In automated detection system, the successful detection of the number of microaneurysms correlates with the stages of the retinal diseases and its early diagnosis. The results for true microaneurysm detection indicates it as a useful tool for screening colour fundus images, which proves time saving for counting of microaneurysms to follow Diabetic Retinopathy Grading Criteria.
Initial Experience With Viabahn VBX as the Bridging Stent Graft for Branched and Fenestrated Endovascular Aneurysm Repair
Authors: Mafeld Sebastian , Annamalai Ganesan , Lindsay Thomas F. , Zhong Iris , Tarulli Emidio , Mironov Oleg , Tan Kong-Teng 
Published: April 2019

Purpose: To evaluate the feasibility and safety of a novel balloon-expandable, heparin-bonded endoprosthesis (Viabahn VBX, W. L. Gore and Associates) when used as a bridging stent graft (BSG) with fenestrated and branched endovascular aneurysm repair (FB-EVAR). FB-EVAR and BSGs increase repair complexity with the potential for endoleak formation, stenosis, thrombosis, and graft migration. The mechanical construction of the Viabahn VBX and its antithrombogenic properties may provide an advantage for FB-EVAR over existing BSGs. The efficacy, safety, and clinical outcomes were assessed. Materials and Methods: Research ethics board approved, prospective, single arm cohort, pilot study of patients undergoing FB-EVAR between February 2017 and January 2018. Fenestrated and branched endovascular aneurysm repair was performed per the standard institutional protocol by a team composed of vascular surgeons and interventional radiologists. Viabahn VBX endografts were used for all intended visceral branches as long as appropriately sized devices were available (Under Investigational Testing Authorization from Health Canada). Patient characteristics, procedural details, and technical and clinical outcomes were reviewed and summarized. Results: FB-EVAR was performed in 13 patients (9 male and 4 female) mean age of 74 (range: 61-83) with a total of 41 Viabahn VBXs stents implanted. Mean maximum aneurysm size was 6.7 cm (range: 5.5-9.0 cm) and included 5 juxtarenal abdominal aortic aneurysms and 8 thoracoabdominal; 3 type V, 3 type IV, and 2 type III (Crawford Classification). The Viabahn VBX was successfully deployed in 40 (98%) of 41 of cases. At median follow-up of 223 days (range: 2-462), there was a (40/40) 100% Viabahn VBX patency rate. Seven endoleaks were identified intra- or post procedurally in 6 (46%) of 13 cases, including 1 type IB, 3 type II, 2 type III, and 1 unclassified. Nine complications occurred in 6 patients. Conclusion: The Viabahn VBX stent is a safe and effective BSG for FB-EVAR with no early stent thrombosis. Further evaluation is required to determine longer term stent efficacy.
Sample size calculation for stepped-wedge cluster-randomized trials with more than two levels of clustering
Authors: Teerenstra Steven , Taljaard Monica , Haenen Anja , Huis Anita , Atsma Femke , Rodwell Laura , Hulscher Marlies 
Published: April 2019

Background/Aims: Power and sample size calculation formulas for stepped-wedge trials with two levels (subjects within clusters) are available. However, stepped-wedge trials with more than two levels are possible. An example is the CHANGE trial which randomizes nursing homes (level 4) consisting of nursing home wards (level 3) in which nurses (level 2) are observed with respect to their hand hygiene compliance during hand hygiene opportunities (level 1) in the care of patients. We provide power and sample size methods for such trials and illustrate these in the setting of the CHANGE trial. Methods: We extend the original sample size methodology derived for stepped-wedge trials based on a random intercepts model, to accommodate more than two levels of clustering. We derive expressions that can be used to determine power and sample size for p levels of clustering in terms of the variances at each level or, alternatively, in terms of intracluster correlation coefficients. We consider different scenarios, depending on whether the same units in a particular level are repeatedly measured as a cohort sample or whether different units are measured cross-sectionally. Results: A simple variance inflation factor is obtained that can be used to calculate power and sample size for continuous and by approximation for binary and rate outcomes. It is the product of (1) variance inflation due to the multilevel structure and (2) variance inflation due to the stepped-wedge manner of assigning interventions over time. Standard and non-standard designs (i.e. so-called “hybrid designs” and designs with more, less, or no data collection when the clusters are all in the control or are all in the intervention condition) are covered. Conclusions: The formulas derived enable power and sample size calculations for multilevel stepped-wedge trials. For the two-, three-, and four-level case of the standard stepped wedge, we provide programs to facilitate these calculations.
The association between ICU admission and emergency hospital readmission following emergency general surgery
Authors: Gillies Michael A , Ghaffar Sadia , Harrison Ewen , Haddow Catriona , Smyth Lorraine , Walsh Timothy S , Pearse Rupert M , Lone Nazir I 
Published: April 2019

Background The relationship between postoperative intensive care (ICU) admission following emergency general surgery (EGS) and emergency hospital readmission has not been widely investigated. Methods Retrospective analysis of registry data for patients undergoing EGS in Scotland, 2005–2007. Exposure of interest was ICU admission status (direct from theatre; indirect after initial care on ward; no ICU admission). The primary outcome was emergency hospital readmission within 30 days of discharge. Results Thirty-seven thousand one hundred seventy-three patients were included in the analysis. Overall emergency readmission rate was 8% ( n = 2983): 2756 (7.8%) in patients without postoperative ICU admission; 155 (12.1%) with direct ICU admission and 65 (14.7%) with indirect ICU admission. Indirect ICU admission was associated with increased hospital readmission rates (HR 1.24 [1.03, 1.49]; p = 0.024) compared with direct ICU admission. ICU admission was associated with increased three-year readmission rates ( p = 0.006) and costs ( p < 0.001) compared with initial ward care. Conclusion Indirect ICU admission is associated with increased emergency hospital readmission and healthcare costs for patients undergoing EGS.
Antenatal depression and offspring health outcomes
Authors: Smith Alexandra , Twynstra Jasna , Seabrook Jamie A 
Published: April 2019

Background Depression is the most common mental disorder during pregnancy, with prevalence rates between 4% and 20%. The objective of this review was to synthesize the literature on the association between antenatal depression and offspring birth outcomes, as well as developmental, behavioral, and psychiatric outcomes. Methods A search of PubMed, Cochrane, and Medline databases was conducted for articles published until December 2017. Articles focusing on the effects of antenatal depression on the offspring were selected to be reviewed. Reference lists of all studies were examined for any missed articles. A total of 32 articles were included in this review. Results Antenatal depression is associated with preterm birth, excessive infant crying, and offspring mental health problems. Untreated antenatal depression is strongly associated with adverse effects on the infant nervous system. Conclusion Antenatal depression increases the likelihood of poor offspring health outcomes. Research should investigate whether medication use confounds this relationship.
Evaluation of intra- and inter-rater reliability and concurrent validity of the Italian version of the Jebsen–Taylor Hand Function Test in adults with rheumatoid arthritis
Authors: Savona Andrea , Ferralis Luca , Saffioti Marco , Tofani Marco , Nobilia Marta , Culicchia Greta , Berardi Anna , Servadio Annamaria , Galeoto Giovanni 
Published: April 2019

Introduction In rheumatoid arthritis, a reduction in hand function can lead to a decrease in health, with a consequent limitation of daily life activities and restriction in social participation. Evaluation plays a decisive role in the functional recovery process and in rehabilitation programs. The Jebsen–Taylor Hand Function Test is one of the most widely used non-diagnosis-specific assessment tools in rehabilitation. The aim of the study was to evaluate the intra-rater and inter-rater reliability and concurrent validity of the Italian version of the Jebsen–Taylor Hand Function Test (JTHFT-IT) in a population with rheumatoid arthritis. Methods The test’s reliability and validity were assessed by following international guidelines. Its internal consistency and intra- and inter-rater reliability were examined using Cronbach’s alpha coefficient and the intraclass correlation coefficient, respectively. Its concurrent validity was evaluated using Pearson’s correlation coefficient with a dynamometer instrument. Results The test was given to 108 people with rheumatoid arthritis. Cronbach’s alpha reported a value of 0.91 for the dominant hand and 0.87 for the non-dominant hand. Intra- and inter-rater reliability were evaluated with a subgroup of 30 individuals. Intraclass correlation coefficients ranged from 0.46 to 1.00 in the dominant and non-dominant hands. Pearson’s correlation between subtests and the dynamometer ranged from –0.14 to –0.59. Conclusions The present study supports the use of the JTHFT-IT as a measure of hand functionality in people with rheumatoid arthritis. It is an important tool for Italian professionals and it can be useful both in clinical practice to evaluate improvement after rehabilitation treatments and for research in hand rehabilitation.
Beyond the collaterals: Additional value of multiphase CTA in acute ischemic stroke evaluation
Authors: Volders D , Shewchuk JR , Marangoni M , Ni Mhurchu E , Heran MKS 
Published: April 2019

Purpose Multiphase computed tomography angiography (MP-CTA) is an innovative imaging tool that can give those managing acute ischemic stroke temporal information on degree and extent of pial collateral arterial filling in the affected brain. We sought to estimate the incidence of false-positive or -negative evaluation of the carotid bifurcation or intracranial thrombus on single-phase CTA (SP-CTA) compared with MP-CTA. Material and methods A single-center, retrospective consecutive review was conducted of imaging and clinical records of 150 patients in two months who presented with neurological symptoms with a National Institutes of Health Stroke Scale score ≥ 2 and who received an MP-CTA as part of their investigative work-up. The cohort consisted of 52.3% male and 47.7% female patients. Median individual age was 68 years (interquartile range 60–79). Extracranial and intracranial vessel images of the initial early arterial phase were evaluated and compared with late arterial and early venous phase images. Results In the cohort of 150 patients, in three patients (2%) SP-CTA would have led to an incorrect diagnosis and management without MP-CTA–acquired source imaging. The three scenarios represented differentiating a carotid string sign from internal carotid artery occlusion, determining the appearance and extent of thrombus in carotid T-occlusion, and differentiating slow flow and contrast mixing-related artifacts from intraluminal thrombus. Conclusions In addition to improving assessment of collateral circulation in acute stroke patients, MP-CTA is also useful in assessing specific flow-related scenarios for which SP-CTA may give spurious results.
Intramedullary Stabilization of Pubic Ramus Fractures in Elderly Patients With a Photodynamic Bone Stabilization System (IlluminOss)
Authors: Oikonomidis Stavros , Alabsi Ahmad , Ashqar Ghazi , Graf Markus , Sobottke Rolf 
Published: April 2019

Introduction: A photodynamic bone stabilization system (PBSS) is a percutaneous operating method that provides intramedullary stabilization. The purpose of the study was to assess the clinical and radiological outcome after treatment of pubic ramus fractures with the PBSS. Materials and Methods: In a retrospective study, patients with osteoporotic pubic ramus fractures were included. The patients were treated with the PBSS in a percutaneous method. In the routine follow-up examination, pain was measured with the visual analog scale (VAS) and the type of mobilization was verified. Computer tomography of the pelvis was carried out in the follow-up examination (mean of 7.5 months after surgery) to investigate bone healing. Results: A total of 32 patients (25 females and 7 males) were included in the study. The average hospital stay was 16.5 ± 7.9 days (range: 5-37 days) and the mean operation time was 116.8 ± 47.1 minutes (range: 33-255 minutes). Two cases of wound infections and 1 case of misplacement of the PBSS implant with revision surgery have been documented. The mean VAS score for pelvic/hip pain at the day of inpatient discharge was 4.4 ± 1.4 (range: 2-7). A total of 25 patients could attend the follow-up examination 7.5 ± 1.7 months (range: 6-14) after the procedure, reporting a mean VAS for pelvic/hip pain of 3.0 ± 2.2 (range: 0-8). A total of 11 patients could walk without an orthopedic walking device, 7 patients needed underarm crutches, 6 patients used a walker-rollator, and 1 patient was immobilized. Consolidated pubis ramus fractures were described in 24 (96%) cases. Discussion: The results of our study reveal adequate clinical and radiological outcomes after treatment of osteoporotic pubic ramus fractures with the PBSS. This is the first study investigating the outcome after treating pubic ramus fractures with the PBSS. Conclusion: Based on our findings, the PBSS is an alternative to known techniques for the stabilization of the pubic ramus.
Sources of Finance, Innovation and Exportability in Asia: Cross-country Evidences
Authors: Singh Prakash , Maiti Dibyendu 
Published: April 2019

Sunk costs determine the level of productivity and exportability of a firm according to the modern trade theory. While productivity rise requires finance for innovation and technology adoption from external sources, this article attempts to argue that sources of finance would be detrimental to the innovation ability of firms. Although formal banking finance suffers from asymmetric information, it is less risky to invest on R&D compared to that of non-banking sources and capital market. In other words, the fund received from formal banking source raises innovation, and, thereby, exportability of firms and financing from other sources involve higher cost and limit innovation capacity and exportability. Analysis of firm-level database provided by the World Bank Enterprise Survey confirms that firms depend more on formal banking source for investment in innovation, and this is found to be significant in explaining innovation and exportability. JEL Codes: F20, F36