bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are Implant Choice and Surgical Approach Associated With Biceps Tenodesis Construct Strength? A Systematic Review and Meta-regression
Authors: Aida Hiroshi F. , Shi Brendan Y. , Huish Eric G. , McFarland Edward G. , Srikumaran Uma 
Published: October 2019

Background: Despite the increasing use of biceps tenodesis, there is a lack of consensus regarding optimal implant choice (suture anchor vs interference screw) and implant placement (suprapectoral vs subpectoral). Purpose/Hypothesis: The purpose was to determine the associations of procedural parameters with the biomechanical performance of biceps tenodesis constructs. The authors hypothesized that ultimate failure load (UFL) would not differ between sub- and suprapectoral repairs or between interference screw and suture anchor constructs and that the number of implants and number of sutures would be positively associated with construct strength. Study Design: Meta-analysis. Methods: The authors conducted a systematic literature search for studies that measured the biomechanical performance of biceps tenodesis repairs in human cadaveric specimens. Two independent reviewers extracted data from studies that met the inclusion criteria. Meta-regression was then performed on the pooled data set. Outcome variables were UFL and mode of failure. Procedural parameters (fixation type, fixation site, implant diameter, and numbers of implants and sutures used) were included as covariates. Twenty-five biomechanical studies, representing 494 cadaveric specimens, met the inclusion criteria. Results: The use of interference screws (vs suture anchors) was associated with a mean 86 N–greater UFL (95% CI, 34-138 N; P = .002). Each additional suture used to attach the tendon to the implant was associated with a mean 53 N–greater UFL (95% CI, 24-81 N; P = .001). Multivariate analysis found no significant association between fixation site and UFL. Finally, the use of suture anchors and fewer number of sutures were both independently associated with lower odds of native tissue failure as opposed to implant pullout. Conclusion: These findings suggest that fixation with interference screws, rather than suture anchors, and the use of more sutures are associated with greater biceps tenodesis strength, as well as higher odds of native tissue failure versus implant pullout. Although constructs with suture anchors show inferior UFL compared with those with interference screws, incorporation of additional sutures may increase the strength of suture anchor constructs. Supra- and subpectoral repairs provide equivalent biomechanical strength when controlling for potential confounders.
Acromial fracture after reverse total shoulder arthroplasty: a systematic review
Authors: Lau Simon C , Large Richard 
Published: October 2019

Background The reverse total shoulder arthroplasty has become the most common method of arthroplasty of the shoulder. The complication of acromial or scapular stress fracture deserves consideration to describe incidence and determine whether prosthetic design or patient factors act as risk factors. Methods A systematic review of the literature was performed including the EMBASE, Medline and the Cochrane Library in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results The search returned 565 articles. After exclusion, 25 papers remained. In total, 208 fractures were reported in the literature, with an overall incidence of 5% and stress fractures were more common than post-traumatic ones; 24 fractures underwent osteosynthesis and there were nine revision arthroplasty surgeries. Outcomes worsened after fracture – whether treated with surgery or not. In patients with scapular base fractures, there was an improvement in functional outcome scores after surgery. Heterogeneous reporting of the risk factors prior to fractures, treatment methods and outcomes made recommendations weak. Discussion Acromial stress fracture after reverse total shoulder arthroplasty occurs relatively commonly but is poorly reported in the literature. It is unclear whether immobilisation, fixation or revision arthroplasty is the best treatment, although fixation may offer a better outcome. In future, reports should aim for greater consistency to allow a better understanding of this condition.
Return to Sport After Arthroscopic Superior Labral Anterior-Posterior Repair: A Systematic Review
Authors: Thayaparan Aarabi , Yu James , Horner Nolan S. , Leroux Timothy , Alolabi Bashar , Khan Moin 
Published: October 2019

Context: Superior labral anterior-posterior (SLAP) lesions often result in significant sporting limitations for athletes. Return to sport is a significant outcome that often needs to be considered by athletes undergoing the procedure. Objective: To evaluate return to sport among individuals undergoing arthroscopic SLAP repair. Data Sources: Four databases (MEDLINE, EMBASE, PubMed, and Cochrane) were searched from database inception through January 29, 2018. Study Selection: English-language articles reporting on return-to-activity rates after arthroscopic SLAP repairs were included. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Data including patient demographics, surgical procedure, and return to activity were extracted. The methodological quality of included studies was evaluated using the Methodological Index for Non-Randomized Studies (MINORS) tool. Results: Of 1938 screened abstracts, 22 articles involving a total of 944 patients undergoing arthroscopic SLAP repair met inclusion criteria. Of the total included patients, 270 were identified as overhead athletes, with 146 pitchers. Across all patients, 69.6% (657/944 patients) of individuals undergoing arthroscopic SLAP repair returned to sport. There was a 69.0% (562/815 patients) return to previous level of play, with a mean time to return to sport of 8.9 ± 2.4 months (range, 6.0-11.7 months). The return-to-sport rate for pitchers compared with the return-to-activity rate for nonpitchers, encompassing return to work and return to sport, was 57.5% (84/146 patients) and 87.1% (572/657 patients), respectively, after arthroscopic SLAP repair. Conclusion: Arthroscopic SLAP repair is associated with a fair return to sport, with 69.6% of individuals undergoing arthroscopic SLAP repair returning to sport. SLAP repair in pitchers has significantly decreased return to sport in comparison with nonpitching athletes. Athletes on average return to sport within 9 months postoperatively.
Electronic Advice Request System for Nephrology in Alberta: Pilot Results and Implementation
Authors: Bello Aminu K , Zaidi Deenaz , Braam Branko , Chou Sophia , Courtney Mark , Deved Vinay , Glassford Jodi , Jindal Kailash , Klarenbach Scott , Osman Mohammed , Scott-Douglas Nairne , Shurraw Sabin , Thompson Stephanie , Manns Braden , Hemmelgarn Brenda , Tonelli Marcello 
Published: October 2019

Background: Residents of rural areas of Alberta face significant barriers regarding access to specialist care, resulting in delays in provision of optimal care. Electronic referral and consultation systems are promising tools for facilitating timely access to specialist care, especially for people living in rural locations. Objective: To report our initial experience with the launch of an electronic advice request system for ambulatory kidney care in Alberta, Canada. Methods: We analyzed electronic advice requests for nephrology services in Alberta after the system’s pilot launch, from October 2016 to December 2017. Data for province-wide advice request utility by primary care providers (PCPs) were extracted from Alberta Netcare for analysis. Results: The total number of electronic advice requests directed to nephrology was 118 (mean number of requests: 2 per week). Only 31 (26.3%) of the cases required a face-to-face clinic visit with a nephrologist. Most (87; 73.7%) cases were managed by PCPs with ongoing nephrologist support via the advice request tool. Typical nephrologist response time was 5.7 ± 0.6 (mean ± SEM) days. Conclusion: These preliminary data suggest that the electronic advice request program has potential to enhance timely access to specialist kidney care and minimize unnecessary nephrologist visits while reducing response time. Broad implementation of this system may have a substantial positive impact on health outcomes and improve cost-effectiveness for nephrology care in the long term, particularly in rural communities of Alberta.
Validation of an HIV/AIDS Stigma Measure for Children Living with HIV and Their Families
Authors: Vreeman Rachel Christine , Scanlon Michael Lawrence , Tu Wanzhu , Slaven James , McAteer Carole , Aluoch Josephine , Ayaya Samuel , Nyandiko Winstone Mokaya 
Published: October 2019

Background: There are few validated tools to measure stigma, particularly among children living with HIV and their families. Methods: This study was nested within a larger study that followed 240 child–caregiver dyads (children aged 10-15 years) at 8 clinics in western Kenya. The stigma instrument was administered to all child–caregiver dyads at 2 time points 6 months apart. The primary end point was to construct validity assessed by comparison to criterion constructs using generalized estimating equation models. Results: Mean age of child participants was 12.3 years and 52% were female. Generally, caregivers reported experiencing higher levels of HIV stigma compared to their children. Children (9%) and caregivers (14%) reported that HIV stigma made them feel stressed, anxious, and depressed. Child and caregiver stigma items showed high construct validity by emotional and behavioral outcomes. Conclusions: The stigma instrument showed high validity when compared to emotional and behavioral outcomes.
Reversal of a rheologic cardiomyopathy following hematopoietic stem cell transplantation for sickle cell disease
Authors: Sachdev Vandana , Hsieh Matthew , Jeffries Neal , Noreuil Anna , Li Wen , Sidenko Stanislav , Hannoush Hwaida , Limerick Emily , Wilson Delon , Tisdale John , Fitzhugh Courtney 
Published: October 2019

Key PointsCardiac morphology improves significantly as early as 3 months after HSCT for SCD; these changes are maintained up to 1 year. Diastolic dysfunction is associated with mortality, and this study shows improvements in diastolic measures and other functional parameters.
Groundwater and connected ecosystems: an overview of groundwater body status assessment in Croatia
Authors: Brkić Željka , Kuhta Mladen , Larva Ozren , Gottstein Sanja 
Published: October 2019

AbstractBackgroundCroatia, as a Member State of the European Union, has to shape its water policy in accordance with the European Union Water Framework Directive. One of the tasks is to determine whether groundwater are susceptible to anthropogenic changes that would result in a significant surface water status reduction as well as terrestrial and aquatic ecosystems that directly depend on the groundwater.MethodsQuality and quantity data on groundwater and surface water, as well as ecosystems data were collected from multiple sources. Data were analyzed for the selection groundwater associated aquatic and groundwater-dependent ecosystems. Chemical time series data were analyzed and compared with the national guideline limits set by the Croatian water quality standard. The impact of the groundwater abstraction on the groundwater-dependent ecosystem was considered by analyzing the aquifer hydrogeological characteristics, as well as location of the pumping site in relation of the ecosystem, the pumping rate and groundwater level or discharge.ResultsIn karst areas of Croatia, groundwater-dependent aquatic ecosystems are predominant; while in the Pannonian area of Croatia, typically, there are groundwater-dependent terrestrial ecosystems. The status of groundwater bodies was defined as good. The analyzed chemical parameters are at acceptable concentration levels. Groundwater abstraction does not adversely affect most ecosystems. However, many springs that are captured for the water supply dry up in the summer. Given that this is also a common phenomenon at springs not captured, it has to be expected that such environments will be inhabited by organisms that have already adjusted to these conditions. Many different bioindicators have been found to indicate a good chemical and quantitative state of groundwater.ConclusionsTo increase the degree of reliability, research monitoring has been proposed. The monitoring should reduce knowledge gaps including an increase of knowledge of the status of the ecosystems, the definition boundary conditions and threshold values of a good quantitative and qualitative status for individual ecosystems. In future prospects, unavoidable focus has to be climate change that may compromise the availability of groundwater resources.
Identifying ‘avoidable harm’ in family practice: a RAND/UCLA Appropriateness Method consensus study
Authors: Carson-Stevens Andrew , Campbell Stephen , Bell Brian G. , Cooper Alison , Armstrong Sarah , Ashcroft Darren , Boyd Matthew , Prosser Evans Huw , Mehta Rajnikant , Sheehan Christina , Sheikh Aziz , Avery Anthony 
Published: October 2019

Abstract

Background
Health care-related harm is an internationally recognized threat to public health. The United Kingdom’s national health services demonstrate that upwards of 90% of health care encounters can be delivered in ambulatory settings. Other countries are transitioning to more family practice-based health care systems, and efforts to understand avoidable harm in these settings is needed.

Methods
We developed 100 scenarios reflecting a range of diseases and informed by the World Health Organization definition of ‘significant harm’. Scenarios included different types of patient safety incidents occurring by commission and omission, demonstrated variation in timeliness of intervention, and conditions where evidence-based guidelines are available or absent. We conducted a two-round RAND / UCLA Appropriateness Method consensus study with a panel of family practitioners in England to define “avoidable harm” within family practice. Panelists rated their perceptions of avoidability for each scenario. We ran a k-means cluster analysis of avoidability ratings.

Results
Panelists reached consensus for 95 out of 100 scenarios. The panel agreed avoidable harm occurs when a patient safety incident could have been probably, or totally, avoided by the timely intervention of a health care professional in family practice (e.g. investigations, treatment) and / or an administrative process (e.g. referrals, alerts in electronic health records, procedures for following up results) in accordance with accepted evidence-based practice and clinical governance. Fifty-four scenarios were deemed avoidable, whilst 31 scenarios were rated unavoidable and reflected outcomes deemed inevitable regardless of family practice intervention. Scenarios with low avoidability ratings (1 s or 2 s) were not represented by the categories that were used to generate scenarios, whereas scenarios with high avoidability ratings (7 s 8 s or 9 s) were represented by these a priori categories.

Discussion
The findings from this RAND/UCLA Appropriateness Method study define the characteristics and conditions that can be used to standardize measurement of outcomes for primary care patient safety.

Conclusion
We have developed a definition of avoidable harm that has potential for researchers and practitioners to apply across primary care settings, and bolster international efforts to design interventions to target avoidable patient safety incidents that cause the most significant harm to patients.
Late delayed radiation-induced cerebral Arteriopathy by high-resolution magnetic resonance imaging: a case report
Authors: Chen Huan , Li Xiuhua , Zhang Xiaoyu , Xu Wenjuan , Mao Fei , Bao Mengxin , Zhu Meijia 
Published: October 2019

Abstract

Background
Radiation therapy can cause cerebral arteriopahty, resulting in ischemic stroke. We document late-delayed cerebral arteriopathy by high-resolution magnetic resonance imaging (HR-MRI) in a middle aged man who had cranial irradiation 19 years earlier.

Case presentation
A 45-year-old man was diagnosed with frontal lobe glioma 19 years ago and was treated with radiation after surgical resection. He was admitted to our hospital with an acute cerebral infarction in November 8, 2017. Traditional MRI examination and HR-MRI (sagittal, reconstruction of coronal and axial) were performed at admission. He was treated with prednisone (30 mg/day) and clinical symptoms disappeared after 3 months by telephone follow-up. Our patient complained of dizziness and blurred vision and traditional MRI examination indicated acute ischemic stroke in temporal lobe and occipital lobe and microbleeds. In order to define the exact mechanism of stroke, blood tests, auto-immune screening and thrombophilia were performed and results were normal. Electrocardiography and echocardiography were negative and cardiogenic cerebral embolism was excluded. In cerebrospinal fluid (CSF) examination, level of albumin and IgG were elevated. HR-MRI showed vessel wall thickening in T1-weighted imaging, narrow lumen in proton density imaging and vessel wall concentric enhancement in contrast-enhanced T1- weighted imaging. Combined with radiotherapy history, the patient was diagnosed with radioactive vasculitis.

Conclusion
Radiation-induced cerebrovascular damages could be a lasting progress, which we cannot ignore. HR-MRI can provide sensitive and accurate diagnostic assessment of radiation-induced arteritis and may be a useful tool for the screening of causes of cryptogenic stroke.
Euthanasia requests in dementia cases; what are experiences and needs of Dutch physicians? A qualitative interview study
Authors: Schuurmans Jaap , Bouwmeester Romy , Crombach Lamar , van Rijssel Tessa , Wingens Lizzy , Georgieva Kristina , O’Shea Nadine , Vos Stephanie , Tilburgs Bram , Engels Yvonne 
Published: October 2019

Abstract

Background
In the Netherlands, in 2002, euthanasia became a legitimate medical act, only allowed when the due care criteria and procedural requirements are met. Legally, an Advanced Euthanasia Directive (AED) can replace direct communication if a patient can no longer express his own wishes. In the past decade, an exponential number of persons with dementia (PWDs) share a euthanasia request with their physician. The impact this on physicians, and the consequent support needs, remained unknown. Our objective was to gain more insight into the experiences and needs of Dutch general practitioners and elderly care physicians when handling a euthanasia request from a person with dementia (PWD).

Methods
We performed a qualitative interview study. Participants were recruited via purposive sampling. The interviews were transcribed verbatim, and analyzed using the conventional thematic content analysis.

Results
Eleven general practitioners (GPs) and elderly care physicians with a variety of experience and different attitudes towards euthanasia for PWD were included. Euthanasia requests appeared to have a major impact on physicians. Difficulties they experienced were related to timing, workload, pressure from and expectations of relatives, society’s negative view of dementia in combination with the ‘right to die’ view, the interpretation of the law and AEDs, ethical considerations, and communication with PWD and relatives. To deal with these difficulties, participants need support from colleagues and other professionals. Although elderly care physicians appreciated moral deliberation and support by chaplains, this was hardly mentioned by GPs.

Conclusions
Euthanasia requests in dementia seem to place an ethically and emotionally heavy burden on Dutch GPs and elderly care physicians. The awareness of, and access to, existing and new support mechanisms needs further exploration.
Plasma peroxiredoxin changes and inflammatory cytokines support the involvement of neuro-inflammation and oxidative stress in Autism Spectrum Disorder
Authors: Abruzzo P. M. , Matté A. , Bolotta A. , Federti E. , Ghezzo A. , Guarnieri T. , Marini M. , Posar A. , Siciliano A. , De Franceschi L. , Visconti P. 
Published: October 2019

Abstract

Background
It has been established that children with Autism Spectrum Disorders (ASD) are affected by oxidative stress, the origin of which is still under investigation. In the present work, we evaluated inflammatory and pro-oxidant soluble signature in non-syndromic ASD and age-matched typically developing (TD) control children.

Methods
We analyzed leukocyte gene expression of inflammatory cytokines and inflammation/oxidative-stress related molecules in 21 ASD and 20 TD children. Moreover, in another—comparable—group of non-syndromic ASD (N = 22) and TD (N = 21) children, we analyzed for the first time the protein expression of the four members of the antioxidant enzyme family of peroxiredoxins (Prx) in both erythrocyte membranes and in plasma.

Results
The gene expression of IL6 and of HSP70i, a stress protein, was increased in ASD children. Moreover, gene expression of many inflammatory cytokines and inflammation/oxidative stress-related proteins correlated with clinical features, and appeared to be linked by a complex network of inter-correlations involving the Aryl Hydrocarbon Receptor signaling pathway. In addition, when the study of inter-correlations within the expression pattern of these molecules was extended to include the healthy subjects, the intrinsic physiological relationships of the inflammatory/oxidative stress network emerged. Plasma levels of Prx2 and Prx5 were remarkably increased in ASD compared to healthy controls, while no significant differences were found in red cell Prx levels.

Conclusions
Previous findings reported elevated inflammatory cytokines in the plasma of ASD children, without clearly pointing to the presence of neuro-inflammation. On the other hand, the finding of microglia activation in autoptic specimens was clearly suggesting the presence of neuro-inflammation in ASD. Given the role of peroxiredoxins in the protection of brain cells against oxidative stress, the whole of our results, using peripheral data collected in living patients, support the involvement of neuro-inflammation in ASD, and generate a rational for neuro-inflammation as a possible therapeutic target and for plasma Prx5 as a novel indicator of ASD severity.