bluuebunny/crossref_metadata_2025_split huggingface dataset:
II–3 Compliance and the Bone Fusion Rate of Low-Intensity Pulsed Ultrasound (LIPUS) Treatment
Authors: Yukihiro Arai , Yoshinobu Watanabe , Nobuyuki Takenaka , Taketo Kurozumi , Takashi Suzuki , Narutaka Katoh , Motoyuki Takaki , Hirotaka Kawano , Takashi Matsushita 
Published: September 2019

Objective:
The aim of this study is to clarify the necessity of the compliance (usage) rate to succeed bone union by LIPUS treatment device in the long bone fracture and the clavicular fracture.

Materials and Methods:
The subjects are 229 cases who were treated with the LIPUS device whose utilization rate was known after the surgical operation for fresh fractures, from 2008 to 2017. We have defined the LIPUS compliance rate (Number of days during which LIPUS was actually used/Number of days during which LIPUS was rented × 100). We have evaluated that LIPUS compliance rate. In a retrospective cohort study, outcomes were obtained that bone union was succeeded by LIPUS treatment alone. We investigated the compliance rate of LIPUS therapy equipment, conducted χ2 test of univariate analysis, and conducted Receiver Operator Characteristic (ROC) analysis on how much should be used.

Results:
Two hundred twenty-one Bones (96.5%) were bone union with LIPUS alone but 8 bones (3.5%) needed additional medical surgery. The average of compliance rate for LIPUS therapy was 75.9%. In the case of low compliance of LIPUS usage, there were failures of LIPUS treatment which is significant (P < 0.01). The cutoff value of the compliance rate in the ROC analysis was 57.1% (sensitivity 79.2%, specificity 75%, AUC [Area Under the Curve] = 0.779), for significantly difference in bone fusion ratio.

Conclusion:
The compliance (usage) rate of LIPUS treatment must be at least 60% to expect effective bone union.
Promoting Family Engagement in the ICU: Experience From a National Collaborative of 63 ICUs*
Authors: Kleinpell Ruth , Zimmerman Jerry , Vermoch Kathleen L. , Harmon Lori A. , Vondracek Hugh , Hamilton Rebekah , Hanson Bruce , Hwang David Y. 
Published: September 2019

Objectives:
As part of an improvement program targeting ICU, a national collaborative was launched to help hospitals implement patient- and family-centered care engagement initiatives.

Design:
Ten-month quality improvement collaborative.

Setting:
Guided by a national patient and family advisory group, participating teams implemented an individual project including open visitation; integrating families on rounds; establishing a patient and family advisory committee; using patient and family diaries, among others.

Subjects:
Sixty-three adult and PICU teams from both academic and community hospitals in 34 states participated.

Interventions:
Monthly team calls, quarterly webinars, newsletters, an online eCommunity, and team reporting assignments were used to facilitate project implementation.

Measurements and Main Results:
The Family Satisfaction with Care in the ICU 24 was used to assess family satisfaction. Clinician perceptions were assessed with the Institute for Patient- and Family-Centered Care Self-Assessment Inventory. Thematic analysis was used to explore narrative data captured from team reports of project barriers, facilitators, and the experience of participating in the collaborative. A total of 2,530 family member and 3,999 clinician surveys were completed. Postimplementation, family members reported statistically significant increases in overall family satisfaction, satisfaction with decision-making, and satisfaction with quality of care (Family Satisfaction with Care in the ICU mean score change range 0.83–1.24; p ≤ 0.027). Clinicians reported that opportunities for families to participate as members of the care team increased. Major barriers included lack of buy-in and ability to promote change in the clinical setting, managing the workload of implementation, and funding to support initiatives.

Conclusions:
A national collaborative format was useful to assist ICU teams to implement patient- and family-engagement initiatives. Enlisting stakeholder support, engaging unit-based champions, and highlighting benefits of family engagement can help ICU teams to promote family member involvement and engagement.
Experience with the Rapid Interactive Test for Autism in Toddlers in an Autism Spectrum Disorder Diagnostic Clinic
Authors: Lemay Jean-François , Amin Parthiv , Langenberger Shauna , McLeod Scott 
Published: September 2019

ABSTRACT:

Objective:
To examine the psychometric properties of the Rapid Interactive Screening Test for Autism in Toddlers (RITA-T) in an autism spectrum disorder (ASD) clinic for children aged 18 to 36 months.

Methods:
The RITA-T (level 2 screening instrument) was integrated into an ASD screening and diagnostic process for evaluating children aged 18 to 36 months who were referred to a pediatric tertiary care center. Scoring of the RITA-T to differentiate ASD from non-ASD developmental concerns was evaluated. Screening instrument measurements included sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR−).

Results:
From a total of 239 participants aged 18 to 36 months (males = 78% and females = 22%), 201 (84%) were diagnosed with ASD (4:1 male-to-female ratio). An ASD diagnosis was significantly associated with RITA-T scores, with ASD patients scoring higher than non-ASD patients [F (1,235) = 170, mean difference: males 9.21, mean difference: females 12.4, p < 0.001]. The RITA-T score was not statistically correlated with age or sex. The optimal cutoff score of ≥14 was determined from a receiver operator curve analysis (area under the curve = 0.953). In the study group, with a cutoff score of ≥14, the RITA-T showed a sensitivity of 0.97, specificity of 0.71, PPV of 0.95, NPV of 0.79, LR+ of 3.33, and LR− of 0.05.

Conclusion:
The RITA-T, as a level 2 screening instrument for ASD, exhibits discriminative psychometric properties similar to previously published results. When integrated into an ASD screening and diagnostic process for families for whom concerns about ASD have been raised with their children aged 18 to 36 months, the RITA-T helps to predict a best-estimate clinical diagnosis of ASD.
Preclinical Animal Models in Facial Transplantation
Authors: Ramly Elie P. , Kantar Rami S. , Alfonso Allyson R. , Diaz-Siso J. Rodrigo , Rodriguez Eduardo D. 
Published: September 2019

Background:
The technical feasibility and clinical applicability of facial transplantation (FT) have been demonstrated, yet animal models with different technical nuances and allograft compositions continue to be developed. We sought to provide a comprehensive appraisal of the current scope and value of animal models in FT.

Methods:
A comprehensive review of the literature was performed to identify all studies relevant to preclinical animal FT. Abstracts, texts, and references were screened. Both large and small animal models in studies including survival experimental arms were included. Purely anatomical or cadaveric animal studies were excluded, as were non-English language articles.

Results:
Twenty-nine unique models were identified, including 10 large (nonhuman primate, swine, and canine) and 19 small (rabbit, rat, and mouse) animal models. Orthotopic models were described in 70% of large and 73.7% of small animal studies. One study described a 2-stage rat FT model. Nerve coaptations were performed in 20.7% of all models (1 canine, 1 rabbit, and 4 rat models). One rat model allowed the study of both functional recovery and cortical reintegration of the allograft. Survival rates and immunological outcomes varied per model and protocol.

Conclusions:
A comprehensive review of animal models in FT shows redundancy spanning a variety of species, allograft compositions, and experimental designs. Although initial studies have focused on safety and technical feasibility, recent advances present specific opportunities for refining our understanding of functional and immunological challenges. As clinical experience continues to evolve, animal models may play an increasingly modest yet targeted role in FT.
Service based comparison of group cognitive behavior therapy to waiting list control for chronic fatigue syndrome with regard to symptom reduction and positive psychological dimensions
Authors: Heald Adrian , Barber Louise , Jones Helen Lyon , Farman Sanam , Walther Andreas 
Published: September 2019

Abstract

Background:
Although chronic fatigue syndrome (CFS) sometimes referred to as myalgic encephalomyelitis (ME) is a very challenging condition to treat, there is evidence that individual cognitive behavioral therapy (ICBT) can be effective for treatment and management of its symptoms. Furthermore, group cognitive behavioral therapy (GCBT) is emerging as promising treatment for the condition.
The aim of the present study was to explore further the effectiveness of GCBT in a routine clinical setting and to investigate associated positive psychological effects related to GCBT.

Methods:
In this pragmatic, non-randomized, controlled trial, 28 people acted as their own waiting list control by completing a range of measures 8 weeks prior to taking part in the GCBT. The intervention consisted of 8 consecutive weeks of 2.5-hour sessions.

Results:
Repeated measures analysis of covariance revealed significant improvements in physical fatigue (F = 28.31, P < .01, effect size d = 0.52), mental fatigue (F = 7.72, P < .01, effect size d = 0.22), and depressive symptoms (Beck depression inventory-fast screen for medical individuals [BDI-FS]: F = 11.43, P < .01, effect size d = 0.30; hospital anxiety and depression scale [HADS-D]: F = 16.72, P < .01, effect size d = 0.38) compared with the waiting list. Improvements in quality of life (F = 7.56, P < .01, effect size d = 0.23), hope (F = 15.15, P < .01, effect size d = 0.36), and optimism (F = 8.17, P < .01, effect size d = 0.23) were also identified, but no change was reported for anxiety levels. Global outcome measures revealed that the majority of the individuals found the treatment beneficial and were satisfied with the results.

Conclusion:
GCBT is a beneficial and cost-effective treatment that individuals find amenable in routine clinical practice for CFS. Additionally we have described important effects emerged on positive psychological dimensions such as hope and optimism potentially enhancing the overall benefit.
Fertility performance and the predictive value of the endometriosis fertility index staging system in women with recurrent endometriosis
Authors: Zhou Yong , Lin Li , Chen Zhengyun , Wang Yuan , Chen Chaolu , Li Enchun , Wu Ruijin 
Published: September 2019

AbstractThis study presents the postoperative pregnancy rate of women with recurrent endometriosis and evaluates the predictive value of the endometriosis fertility index (EFI) for the pregnancy.A total of 107 women who wished to conceive after surgery for recurrent endometriosis from January 2007 to December 2016 were included. The EFI score was calculated postoperatively. The receiver operator characteristic (ROC) curve was plotted to determine the most promising contributor to predicting pregnancy, and Kaplan–Meier (K–M) analysis was used to estimate the cumulative pregnancy rate (CPR).A total of 61 pregnancies were registered in 58 women and the remaining 49 patients failed to become pregnant. The EFI score was strongly associated with the postoperative fertility prognosis. The CPRs during the first 2 and 3 years postoperatively were 51.86% and 66.38%, respectively, and increased to 71.98% within the first 5 years postoperatively in patients with EFI scores≥5. However, the CPR was 26.00% during the first 2 years after surgery in individuals with EFI scores <5, and there was no increase in the CRP thereafter.Women suffering from recurrent endometriosis still experienced a probability of natural pregnancy, especially patients with EFI scores≥5. The EFI score had good predictive power for postoperative pregnancy in these patients.
Compare the prognosis of Da Vinci robot-assisted thoracic surgery (RATS) with video-assisted thoracic surgery (VATS) for non-small cell lung cancer
Authors: Guo Feng , Ma Dongjie , Li Shanqing 
Published: September 2019

Abstract
To determine if there are advantages to transitioning to Da Vinci robotics by a surgeon compared to the video-assisted thoracic surgical lobectomy.
A systematic electronic search of online electronic databases: PubMed, Embase, and Cochrane library updated on December 2017. Publications on comparison Da Vinci-robot-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) for non-small cell lung cancer were collected. Meta-analysis RevMan 5.3 software (The Cochrane collaboration, Oxford, UK) was used to analyze the combined pooled HRs using fixed or random-effects models according to the heterogeneity.
Fourteen retrospective cohort studies were included. No statistical difference was found between the 2 groups with respect to conversion to open, dissected lymph nodes number, hospitalization time after surgery, duration of surgery, drainage volume after surgery, prolonged air leak, and morbidity (P > .05).
Da Vinci-RATS lobectomy is a feasible and safe technique and can achieve an equivalent surgical efficacy when compared with VATS. There does not seem to be a significant advantage for an established VATS lobectomy surgeon to transition to robotics based on clinical outcomes.
Diagnostic test accuracy of an automated device as a screening tool for fall risk assessment in community-residing elderly
Authors: Castellini Greta , Gianola Silvia , Stucovitz Elena , Tramacere Irene , Banfi Giuseppe , Moja Lorenzo 
Published: September 2019

Abstract
We aimed to determine the accuracy and failure of OAK device, an automated screening, for the assessment of fall risk in a prospective cohort of healthy adults aged over 65 years. The algorithm for fall risk assessment of the centers for disease control and prevention (CDC) was used as reference standard. Of the 183 individuals recruited, the CDC algorithm classified 80 as being at moderate/high risk and 103 at low risk of falling. OAK device failure incidence was 4.9% (confidence interval [CI] upper limit 7.7%), below the preset threshold for futility-early termination of the study (i.e., not above 15%). The OAK device showed a sensitivity of 84% and a specificity of 67% (receiver operating characteristic [ROC] area 82%; 95% confidence interval [CI] 76–88%), not reaching the preplanned target sensitivity (not lower than 85%). Diagnostic accuracy was not far from the sensitivity levels similar to those obtained with other fall risk assessment. However, some limitations can be considered.
ClinicalTrials.gov identifier: NCT02655796.
Therapeutic efficacy of zolpidem combined with cognitive-behavioral therapy on primary insomnia
Authors: Song Ying , Liang Bing 
Published: September 2019

Abstract

Background:
In this study, we intend to assess the efficacy of zolpidem combined with cognitive-behavioral therapy (CBT) for patients with primary insomnia (PI).

Methods:
A predefined search strategy will be used to search for associated literature from inception to the July 1, 2019: PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, Google Scholar, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure with no language limitation. In addition, we will also retrieve reference lists of included studies and relevant reviews, as well as the conference proceedings. All randomized controlled trials related to the zolpidem and CBT for PI will be included. Two authors will perform study selection, data collection, and study quality, respectively. We will also apply RevMan 5.3 software for statistical analysis.

Results:
This study will provide a comprehensive overview of the available evidence of the benefits and safety of zolpidem and CBT for PI. Primary outcomes are sleep quality and severity of sleep disorders. Secondary outcomes consist of sleep-onset latency, total sleep duration, sleep efficiency, and frequency and adverse events.

Conclusion:
The results of this study will inform clinical and policy decisions regarding the benefits and harm of zolpidem and CBT for patients with PI.

PROSPERO registration number:
PROSPERO CRD42019142796.
Primary repair for injury of medial collateral ligament during total-knee arthroplasty
Authors: Jin Cheng , Zhao Jia-Yi , Santoso Asep , Song Eun-Kyoo , Chan Chee-Ken , Jin Quan-He , Ko Jee-Wook , Seon Jong-Keun 
Published: September 2019

Abstract
The aim of this study was to determine whether primary repair for intraoperative injury of the medial collateral ligament (MCL) can achieve satisfactory clinical results when compared to the clinical results of patients with no MCL injury. Simultaneously, we sought to determine the differences between 2 methods of primary repair (anchor suture and staple) in terms of their clinical outcomes.
In our institute, 3897 total-knee arthroplasties (TKAs) were performed between 2003 and 2014. Sixty-five patients who suffered an MCL injury during the TKA procedure and in whom the injury was repaired with a suture anchor or staple (suture anchor: 36 vs staple: 29) were studied. A matched group of 65 patients without an MCL injury was selected to serve as the control group. Subjective feelings of instability and functional outcomes were assessed using the knee society (KS) score and the Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC). Objective stability was evaluated by the measurement of opening angles in extension and at 30° of knee flexion on valgus stress radiographs. The clinical outcomes and stability results were compared between the suture anchor and staple methods.
The KS and WOMAC scores in patients who received primary repair of MCL injury during TKA improved from 50.6 ± 13.1 to 87.3 ± 7.3 (P < .001) and 65.9 ± 14.4 to 17.7 ± 6.6 (P < .001), respectively. However, there were no statistically significant differences in the KS (P = .84) and WOMAC (P = .71) scores when comparing the group that received primary repair to the control group. Radiographic stability also showed no differences between the repair and control groups in extension and at 30° of flexion (P = .48 and P = .11, respectively). In the subgroups, there were no significant differences between the suture anchor and staple repair methods in terms of stability and clinical outcomes.
Primary repair of an MCL injury during TKA may have clinical outcomes comparable to that in the no MCL injury group. Both staple and suture anchor repair methods could provide excellent clinical and stability outcomes in these types of cases, although a further cohort study is required to validate our results.
Management of giant benign fibrous histiocytoma in the spinal region with pleural involvement
Authors: Liu Shuzhong , Zhou Xi , Song An , Huo Zhen , Yao Siyuan , Wang Yipeng , Liu Yong 
Published: September 2019

Abstract

Rationale:
Benign fibrous histiocytoma with pleural involvement in spinal region is a highly unusual disease with no standard curative managements yet. The objective of this study is to report an extremely rare case of a giant benign fibrous histiocytoma with pleural involvement in spinal region successfully operated by posterior spinal surgery. The management of these unique cases has yet to be well-documented.

Patient concerns:
A 23-year-old man presented with a 2-month history of continuous and progressive back pain. A giant, expanding lesion of the T7 vertebral and paraspinal region with pleural involvement was identified.

Diagnoses:
Computed tomography scan and magnetic resonance imaging of spine showed expanding lesion of the T7 vertebral and paraspinal region involving the right thoracic cavity, which presented as a solid tumor. Postoperative pathology confirmed the diagnosis of thoracic benign fibrous histiocytoma.

Interventions:
The patient underwent thoracic spinal canal decompression, complete tumor resection, pleural defect repair, and T4 to T10 internal fixation procedure via a posterior approach.

Outcomes:
The patient's symptom improved significantly after the surgery, and the postoperative period was uneventful at the 2-year follow-up visit. There were no complications associated with the operation during the follow-up period.

Lessons:
In summary, the tumor's clinical features, imaging results, and pathological characteristics are unique. Combined efforts of specialists from orthopedics, thoracic surgery, neurosurgery, pathology, and medical oncology led to the successful diagnosis and management of this patient. Giant benign fibrous histiocytoma with pleural involvement in spinal region, although rare, should be part of the differential diagnosis when the patient presents with back pain and radiculopathy. We recommend the posterior or 1-stage anterior–posterior combined approach for complete resection of the giant thoracic benign fibrous histiocytoma when the tumor has caused severe symptoms or neurological deficits.
Renal and pulmonary thrombotic microangiopathy triggered by proteasome-inhibitor therapy in patient with smoldering myeloma
Authors: Cassol Clarissa A. , Williams Michael P.A. , Caza Tiffany N. , Rodriguez Sophia 
Published: September 2019

Abstract

Rationale:
Thrombotic microangiopathy (TMA) is a group of clinical syndromes characterized by excessive platelet activation and endothelial injury that leads to acute or chronic microvascular obliteration by intimal mucoid and fibrous thickening, with or without associated thrombi. It frequently involves the kidney but may involve any organ or system at variable frequencies depending on the underlying etiology. Among its numerous causes, drug toxicities and complement regulation abnormalities stand out as some of the most common. A more recently described association is with monoclonal gammopathy. Lung involvement by TMA is infrequent, but has been described in Cobalamin C deficiency and post stem-cell transplantation TMA.

Patient concerns:
This is the case of a patient with smoldering myeloma who received proteasome-inhibitor therapy due to retinopathy and developed acute renal failure within one week of therapy initiation.

Diagnoses:
A renal biopsy showed thrombotic microangiopathy. At the time, mild pulmonary hypertension was also noted and presumed to be idiopathic.

Interventions:
Given the known association of proteasome-inhibitor therapy with thrombotic microangiopathy, Bortezomib was discontinued and dialysis was initiated.

Outcomes:
Drug withdrawal failed to prevent disease progression and development of end-stage renal disease, as well as severe pulmonary hypertension that eventually lead to the patient's death.

Lessons:
To our knowledge, this is the first reported case of pulmonary involvement by TMA associated with monoclonal gammopathy which appears to have been triggered by proteasome-inhibitor therapy. Clinicians should be aware of this possibility to allow for more prompt recognition of pulmonary hypertension as a potential manifestation of monoclonal gammopathy-associated TMA, especially in patients also receiving proteasome-inhibitors, so that treatment aiming to slow disease progression can be instituted.