bluuebunny/crossref_metadata_2025_split huggingface dataset:
The long-term outcome of simple trapeziectomy
Authors: Yeoman Thomas F. M. , Stone Oliver , Jenkins Paul J. , McEachan Jane E. 
Published: June 2018

The aim of this study was to investigate the long-term outcome of simple trapeziectomy by a single surgeon and to compare this with pre-operative function. Two hundred and five patients completed the shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH) and the EuroQoL five-dimensional questionnaire (EQ-5D) scores at a mean of 8.2 (range 3.5–17) years after simple trapeziectomy. There were no pre-operative scores available, so case controls were selected from our prospective database to compare pre- and post-operative patient-reported outcome measures. The mean QuickDASH score of the post-operative matched group was 37 (SD 17.0) and the mean EQ-5D was 0.56 (SD 0.31). The mean QuickDASH score of the pre-operative group was 54 (SD 17.0). The mean difference in QuickDASH between the pre- and post-operative groups was 17 (95% CI: 8 to 26, p = 0.0003). This study demonstrated a significant and sustained improvement in patient-reported function after simple trapeziectomy. It supports that simple trapeziectomy is a simple, safe and effective treatment for advanced trapeziometacarpal joint arthritis. Level of evidence: IV
Evaluation of the impact of body mass index on warfarin requirements in hospitalized patients
Authors: Tellor Katie B. , Nguyen Steffany N. , Bultas Amanda C. , Armbruster Anastasia L. , Greenwald Nicholas A. , Yancey Abigail M. 
Published: June 2018

Background: Despite well established empiric dose adjustments for drug and disease-state interactions, the impact of body mass index (BM) on warfarin remains unclear. The objective of this study is to evaluate warfarin requirements in hospitalized patients, stratified by BMI. Methods: This retrospective review included two cohorts of patients: cohort A (patients admitted with a therapeutic international normalized ratio (INR)) and cohort B (newly initiated on warfarin during hospitalization). Exclusion criteria included: age under 18 years, pregnancy, INR (goal 2.5–3.5), and warfarin thromboprophylaxis post orthopedic surgery. The primary outcome was mean total weekly dose (TWD) of warfarin based on weight classification: underweight (BMI <18 kg/m2), normal/overweight (BMI 18–29.9 kg/m2), obese (BMI 30–39.9 kg/m2), and morbidly obese (BMI ⩾ 40 kg/m2). Data were extracted from two community hospitals in reverse chronologic order during July 2015–June 2013 until both study institutions evaluated 100 patients per cohort in each BMI classification or until all patients had been evaluated within the prespecified timeframe. Results: A total of 585 patients were included in cohort A (26 underweight, 200 normal/overweight, 200 obese, 159 morbidly obese). There was a statistically significant difference in TWD as determined by one-way analysis of variance ( p < 0.05). A Tukey post hoc test revealed a statistically significantly higher TWD in morbidly obese (41.5 mg) compared with underweight (25.6 mg, p < 0.05), normal/overweight (28.8 mg, p < 0.05) and obese patients (32.4 mg, p < 0.05). In cohort B, 379 patients were evaluated (9 underweight, 166 normal/overweight, 152 obese, 52 morbidly obese). Overall, 191 patients had a therapeutic INR on discharge (88.9% underweight, 52.4% normal/overweight, 44.1% obese, 55.8% morbidly obese, p = 0.035). Of those, there was a statistically significant difference in TWD ( p = 0.021) with a higher TWD in the morbidly obese (41 mg) compared with underweight patients (24.4 mg, p = 0.017). Conclusions: Based on the results of this study, morbidly obese patients may require higher TWD to obtain and maintain a therapeutic INR.
Accuracy of HbA1c as Monitored by External Quality Assessment and Compared With Patient Mean Values
Authors: Nordin Gunnar 
Published: June 2018

Background: The accuracy and trueness of results from a laboratory test, such as the HbA1c test, should not be taken for granted but must be checked continuously. A tool for this is the participation in external quality assessment (EQA) for all laboratories performing the HbA1c-test. An additional possibility to detect changes in trueness is to monitor variations in patient cohort mean or median values that is not explained by changes in treatment or selection of patients. Methods: Results reported to an EQA scheme for HbA1c during 20 years have been extracted from Equalis database. The results are compared to current analytical performance specifications (APS) and to the mean HbA1c levels for the Swedish population of persons with type 2 diabetes. Results: The accuracy of the HbA1c test has improved during the period. The hospital lab methods used in Sweden now fulfil APS agreed by professional organizations in Sweden. The accuracy for point-of-care tests (POCT) methods vary over time and fulfil APS for some periods. The bias found for some of the methods might explain changes seen in patient mean values for HbA1c in Sweden during the period 2007-2017. Conclusions: The global standardization of HbA1c has resulted in an improved comparability for HbA1c-results worldwide. But even small variation in trueness for the methods in use might have important impact on mean HbA1c values for cohorts of patients. When a systematic error is observed for a specific method it is therefore essential that manufacturers correct the method without delay.
The Reality of Well-Being-Focused Design in Dementia Care: A Case Study of Acute Dementia Wards in the United Kingdom
Authors: Catt Megan , Giridharan Renganathan 
Published: June 2018

Objective: The study explored design for well-being within dementia care by investigating the adoption of well-being-focused design in real-world practice, through observing National Health Service (NHS) wards. Background: Design for well-being is an approach that considers the psychological and physiological effects of architecture to improve health and well-being. The high psychological care requirement for dementia patients makes them a significant group to study in the evaluation of current hospital facilities. Methods: A literature review was conducted to frame the current theoretical perception of the key characteristics of a good environment for dementia care. A framework was generated to summarize and used as an assessment tool in a series of observational visits to NHS wards. Interviews with clinical staff focused on care outcomes and practicalities of implementing well-being-focused design, considering the historical and economical context. Key findings from the observations and interviews were analyzed for recurring themes. Results: The ward observations and interviews provided insight into the current progression of well-being-led design in NHS hospitals in England. The research highlights key areas of success and factors that inhibit further progression. Conclusions: The case studies showed a good degree of ambition to utilize well-being-focused design, with belief among staff that the physical environment has a substantial role in the health and well-being of patients. Staff also felt that this approach is most effective for those in the less advanced stages of dementia. Despite the high level of support, the current degree of implementation appears to be varied.
Physical Activity in Patients Treated With Peritoneal Dialysis: A Systematic Review and Meta-analysis
Authors: Thangarasa Tharshika , Imtiaz Rameez , Hiremath Swapnil , Zimmerman Deborah 
Published: June 2018

Background: Exercise has been shown to be of benefit in the general population and in patients with chronic diseases. Despite a lack of compelling evidence, patients with end-stage kidney disease (ESKD) treated with peritoneal dialysis (PD) are often discouraged from participating in exercise programs that include weight lifting due to concerns about the development of hernias and leaks. The actual effects of physical activity with or without structured exercise programs for patients on PD remain unclear. Objective: To determine the risks and benefits of physical activity in the ESKD population treated with PD. Design: Systematic review and meta-analysis. Setting: Included all studies that met our criteria regardless of country of origin. Patients: Adult patients with ESKD treated with PD. Measurements: Descriptive and quantitative analysis of our primary and secondary outcome variables. Methods: We searched MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials for observational and interventional studies examining the effects of physical activity in patients on PD. A systematic review and meta-analysis was conducted of the identified studies. The primary outcomes of interest included patient-centered outcomes of mental health, physical functioning, fatigue, quality of life, and adverse events. Secondary outcomes included nutritional measures, lipid profile, blood pressure changes, maximum heart rate, resting heart rate, maximal oxygen consumption, muscle development, cognitive function, and markers of inflammation. Results: Of 1828 studies identified by the literature search, 12 met the inclusion criteria including 6 interventional and 6 observational studies. There was limited information on the patient important outcomes. However, there is some evidence for improvements in burden of kidney disease, physical function, and some mental health measures with physical activity. Limitations: Lack of well-designed randomized controlled trials impaired our ability to determine the benefits and risks of increasing physical activity. Conclusions: There is limited evidence of benefit with increased levels of physical activity in PD patients. Further research is needed to define the exercise program that is likely to be of most benefit to patients treated with PD.
Serum interleukin 6 and cancer antigen 125 in the non-invasive diagnosis of endometriosis
Authors: Tanmahasamut Prasong , Preukthanathorn Ratthiporn , Dangrat Chongdee 
Published: June 2018

Background: The role of interleukin 6 in endometriosis has been extensively studied but results were inconsistent. The purpose of this study was to determine the performance of serum interleukin 6 and serum cancer antigen 125 for non-invasive diagnosis of endometriosis. Methods: In this prospective diagnostic study, 100 reproductive women who underwent laparoscopy were studies. Patients were divided into endometriosis group (n = 60) and control group (n = 40). Blood samples were taken preoperatively for analysis of serum interleukin 6 and cancer antigen 125 levels. Results: Level of serum interleukin 6 and cancer antigen 125 in endometriosis group were significantly higher than those in control group (1.93 versus <1.50 pg/mL and 41.85 versus 11.86 IU/mL, respectively). A cutoff level of interleukin 6 at 1.52 pg/mL provided sensitivity of 63.3%, specificity of 55%, positive predictive value of 67.9%, and negative predictive value of 50%. The threshold level of cancer antigen 125 at 31 IU/mL had sensitivity of 70%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 69%. The combined test had sensitivity of 86.7%, specificity of 60%, positive predictive value of 76.5%, and negative predictive value of 75%. The area under receiver operating characteristic curve of serum interleukin 6, cancer antigen 125, and combined test were 0.614, 0.945, and 0.945, respectively. Conclusion: Serum interleukin 6 is not suitable to be a candidate of serum marker for the diagnosis of endometriosis. Serum cancer antigen 125 is better than interleukin 6 for detection of endometriosis stage III/IV. Both of them had low performance for diagnostic test in minimal to mild endometriosis. The combined test does not add more benefit than using cancer antigen 125 alone.
The role of fractures on pathologic bone in healing of proximal humerus unicameral bone cysts
Authors: Kim Min-Cheol , Joo Sang-Don , Jung Sung-Taek 
Published: June 2018

Purpose: To evaluate the role of fractures on pathologic bone in healing of proximal humerus unicameral bone cysts (UBCs) and investigate the clinical factors that affect healing of UBCs after fractures on pathologic bone. Methods: This prospective study was carried out between 2002 and 2014. We evaluated 56 patients with a UBC accompanying fractures on pathologic bone in the proximal humerus. Clinical data were collected from the patients’ medical records. Age, gender, degree of fracture displacement, location of cyst, and cyst size were investigated, and we assessed how these factors affected cyst healing. Results: The overall healing rate of UBCs 1 year after fracture was 66% (37 of 56 cases). The healing rate was significantly lower in pubescent patients (10–14 years old; 45%) than in those who were 9 years old (76%) or 15 years old (80%). The rate of healing of fractures in the metaphysis (53%) was lower than that of breaks in the diaphysis (85%). The mean cyst ratio was 1.31 in the 37 patients who experienced cyst healing within 1 year and 1.79 in the 19 patients who needed surgical treatment within 1 year. Conclusion: In latent lesions and in patients who are older (after puberty), UBCs of the humerus after fracture have better clinical results than do active lesions and those in younger patients (before puberty). Fractures on pathologic bone in proximal humerus UBCs often dramatically decrease cyst size, and patients with such fractures have excellent clinical results in terms of healing rate.
Hamstring Autograft in ACL Reconstruction: A 13-Year Predictive Analysis of Anthropometric Factors and Surgeon Trends Relating to Graft Size
Authors: Ramkumar Prem N. , Hadley Michael D. , Jones Morgan H. , Farrow Lutul D. 
Published: June 2018

Background: Small-diameter autograft hamstring grafts have been linked to graft failure after anterior cruciate ligament (ACL) reconstruction. The frequency of hamstring autografts that actually meet ideal size criteria remains unknown. Purpose: To examine a large cohort of patients to (1) evaluate sizing variability among a large cohort of surgeons and (2) identify patient factors most predictive of hamstring autograft size. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 1681 ACL reconstructions with hamstring autograft were analyzed as completed by 11 surgeons over a 13-year period. Patient demographics (age, height, weight, body mass index, sex) and intraoperative details (including graft diameter and strands) were extracted. Univariate and multivariate regression analyses were performed to correlate patient demographics with graft size and to develop a predictive model for hamstring graft size. Results: The mean height and weight of patients included in this study were 172.7 cm and 80.1 kg, respectively; 59% of patients were male. The mean diameters of hamstring autografts were 8.4 mm and 8.2 mm for the tibial and femoral ends of the graft, respectively. A total of 55.1% of grafts were ≤8 mm. Mixed-effects linear modeling revealed that height, weight, sex, and use of ≥5 strands correlated with graft size ( P < .001), while age did not. The predictive multivariate model based on the statistically relevant factors demonstrated a moderate correlation ( r = 0.39, R2 = 0.150), illustrated a predictive equation, and proved height to be the greatest determinant of graft size. Conclusion: Marked variability in graft size distribution was found among surgeons, and more than half of all grafts did not reach the ideal size for hamstring autograft ACL reconstruction. A predictive equation including anthropometric factors may be able to provide the expected graft size. The risk of early graft failure may be mitigated with preoperative consideration of anthropometric factors—most importantly, height—in preparation for possible augmentation, additional strands, or alternative graft sources.
NK-cell activation is associated with increased HIV transcriptional activity following allogeneic hematopoietic cell transplantation
Authors: Hogan Louise E. , Körner Christian , Hobbs Kristen , Simoneau Camille R. , Thanh Cassandra , Gibson Erica A. , Palmer Christine D. , Pandit Alisha , Marty Francisco M. , Kuritzkes Daniel R. , Jost Stephanie , Ritz Jerome , Henrich Timothy J. 
Published: June 2018

Key Points
Graft-versus-host effects may lead to HIV-1 reactivation and cell death of infected pre-HCT CD4+ T cells. Natural killer cell activation correlates with in vitro HIV-1 transcriptional activity in the setting of HCT.
Sarcopenia increases the risk for mortality in patients who undergo amputation for diabetic foot
Authors: Kim You Keun , Lee Ho Seong , Ryu Jae Jung , In Lee Hye , Seo Sang Gyo 
Published: June 2018

AbstractBackgroundAlthough there have been reports that diabetes affects the prevalence of sarcopenia, no studies have examined the relationship between sarcopenia and mortality in patients undergoing leg amputation. The purpose of this study is to determine whether sarcopenia affects the mortality rate of patients undergoing diabetic foot amputation.MethodsFrom among patients who underwent limb amputation for diabetes complications, this study included 167 patients who underwent abdominal CT within 1 year of amputation. We defined sarcopenia using sex‐specific cut‐off points for the L3 skeletal muscle index. The 5‐year survival rate was analyzed. All patients were divided into two groups and compared according to the presence of sarcopenia. The mortality rate according to sarcopenia was assessed via the Kaplan‐Meier method and log‐rank test. Uni‐ and multivariate Cox regression analyses evaluated factors associated with survival rate.ResultsAmong the total of 167 patients, the overall 5‐year mortality rate was 52.7%. Of the 112 patients with sarcopenia, the 5‐year mortality rate was 60.7%. Of the 55 patients without sarcopenia, the 5‐year mortality rate was 36.4%. Kaplan‐Meier analysis showed a high mortality of the sarcopenia group in the univariate (p = 0.016) and multivariate (p = 0.047) analysis.ConclusionsOur study is the first to analyze the relationship between diabetic amputation and sarcopenia. Sarcopenia increases the risk of mortality in patients who undergo amputation for diabetic foot. Therefore, patients with diabetes should be careful to prevent sarcopenia with enough regular exercise as well as prevent diabetic foot disease.
Supervoxel-based segmentation of 3D imagery with optical flow integration for spatiotemporal processing
Authors: Huang Xiaohui , Yang Chengliang , Ranka Sanjay , Rangarajan Anand 
Published: June 2018

Abstract
The past 20 years has seen a progressive evolution of computer vision algorithms for unsupervised 2D image segmentation. While earlier efforts relied on Markov random fields and efficient optimization (graph cuts, etc.), the next wave of methods beginning in the early part of this century were, in the main, stovepiped. Of these 2D segmentation efforts, one of the most popular and, indeed, one that comes close to being a state of the art method is the ultrametric contour map (UCM). The pipelined methodology consists of (i) computing local, oriented responses, (ii) graph creation, (iii) eigenvector computation (globalization), (iv) integration of local and global information, (v) contour extraction, and (vi) superpixel hierarchy construction. UCM performs well on a range of 2D tasks. Consequently, it is somewhat surprising that no 3D version of UCM exists at the present time. To address that lack, we present a novel 3D supervoxel segmentation method, dubbed 3D UCM, which closely follows its 2D counterpart while adding 3D relevant features. The methodology, driven by supervoxel extraction, combines local and global gradient-based features together to first produce a low-level supervoxel graph. Subsequently, an agglomerative approach is used to group supervoxel structures into a segmentation hierarchy with explicitly imposed containment of lower-level supervoxels in higher-level supervoxels. Comparisons are conducted against state of the art 3D segmentation algorithms. The considered applications are 3D spatial and 2D spatiotemporal segmentation scenarios. For the latter comparisons, we present results of 3D UCM with and without optical flow video pre-processing. As expected, when motion correction beyond a certain range is required, we demonstrate that 3D UCM in conjunction with optical flow is a very useful addition to the pantheon of video segmentation methods.
A semi-automatic and quantitative method to evaluate behavioral photosensitivity in animals based on the optomotor response (OMR)
Authors: Matsuo Megumi , Ando Yoriko , Kamei Yasuhiro , Fukamachi Shoji 
Published: June 2018

ABSTRACTThe optomotor response (OMR) is a locomotor behavior of animals that is induced by moving repetitive visual stimuli. This characteristic helps animals particularly when stabilizing and maintaining position in schools and herds. Here, we developed a simple but sensitive method for quantifying the OMR using medaka (Oryzias latipes) as a model. This method, which simply requires video-recorded behavior, free tracking software, and a generic spreadsheet program, enables the evaluation of spectral sensitivity by researchers with little knowledge about the behavioral characteristics of the test animal or of the OMR. Based on a manual method, we reported previously that wild-type and red-colorblind medaka exhibited an OMR up to λ=830 and 740 nm, respectively. However, the present method, which quantifies the OMR according to three parameters (starting time, duration, and total distance of swimming) that are calculated based on a series of x–y coordinates of the moving fish, supported that conclusion and further indicated that both strains perceive light at even longer wavelengths. This low-cost, quantitative, and semi-automatic method would widen the opportunities to unveil behavioral photosensitivity in animals of interest.This article has an associated First Person interview with the first author of the paper.
Evaluation of Simulation-Based Optimization in Grafting Labor Allocation
Authors: Masoud Sara , Son Young-Jun , Kubota Chieri , Tronstad Russell 
Published: June 2018

Abstract.Vegetable grafting is a labor-intensive operation with many management decisions. Labor management and resource planning are critical allocations in grafting nurseries, yet optimization is challenging due to the dynamic nature of workers’ performance in vegetable seedling propagation. To this end, we developed a simulation-based optimization framework for labor management to optimize labor allocation. This approach was evaluated by comparing its result with those suggested by selected domain experts (a plant scientist and a nursery manager). Furthermore, the simulation models were validated with a dataset from a developing tomato grafting company. Simulation-based optimization is demonstrated as an effective approach to find the optimal/near optimal labor allocation for horticultural nurseries, where discrete event simulation is used to represent the dynamics of the grafting work environment and meta-heuristics are used to devise optimal/ near optimal resource allocation strategies. Results reveal that a potential annual savings between $2,510 (0.6%) and $97,388 (20%) can be achieved for a grafting facility of 6 million plants per year. Keywords: Simulation-based optimization, Grafting, Labor allocation, Discrete event simulation.