bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatial distribution of biopsy cores and the detection of intra-lesion pathologic heterogeneity
Authors: Calio Brian P. , Deshmukh Sandeep , Mitchell Donald , Roth Christopher G. , Calvaresi Anne E. , Hookim Kim , McCue Peter , Trabulsi Edouard J. , Lallas Costas D. 
Published: April 2019

Objectives: The objective of this study was to determine if spatial distribution of multiparametric magnetic resonance imaging–transrectal ultrasound (mpMRI-TRUS) fusion biopsy cores to the index lesion reveals trends in the detection of intra-lesion Gleason heterogeneity and a more optimal prostate biopsy strategy. Methods: Index lesion was the lesion with longest diameter on T2-weighted (T2W)-MRI. In cohort 1, fusion biopsy cores biopsies were taken in areas in the center of the target as well as 1 cm laterally on each side. For cohort 2, targeted biopsies were taken from the center of the lesion only. Heterogeneity was defined as difference in maximum Gleason score obtained from fusion cores in the center of the index lesion versus cores obtained from the periphery (cohort 1), or any difference in maximum Gleason score obtained from fusion cores targeted to the index lesion (cohort 2) compared with systematic 12 cores TRUS biopsy. Results: Ninety-nine consecutive patients (35 and 64 in cohorts 1 and 2, respectively) with median age (SD) and prostate-specific antigen (PSA) of 66.9 (±5.9) and 9.7 (±8.2) respectively, were included. Age, PSA, Prostate Imaging Reporting and Data System (PI-RADS) score, and preoperative MRI lesion size were not significantly different between cohorts. Gleason heterogeneity was observed at a significantly higher rate in cohort 1 versus cohort 2 (58% versus 24%; p = 0.041). In cohort 1, cores obtained from the center of the lesion had higher Gleason score than cores obtained from the periphery of the targeted lesion in 57% of cases. Conclusions: We demonstrate that there is observable tumor heterogeneity in biopsy specimens, and that increased number of cores, as well as cores focused on the center and periphery of the largest lesion in the prostate, provide more comprehensive diagnostic information about the patient’s clinical risk category than taking nonspecific cores targeted within the tumor.
Investigation of the Impact of Below-Knee Compression Garments on Markers of Exercise-Induced Muscle Damage and Performance in Endurance Runners: A Prospective Randomized Controlled Trial
Authors: Geldenhuys A. Grethe , Swart Jeroen , Bosch Andrew 
Published: April 2019

Background: Compression garment utilization is very popular among runners despite a lack of consensus in the literature regarding a beneficial impact. The aim of the study was to investigate the impact of training and competing with compression garments on exercise-induced muscle damage and performance in ultramarathon runners. Hypothesis: Compression garments will reduce the severity of exercise-induced muscle damage and improve performance in long-distance runners compared with control conditions. Study Design: Prospective, randomized controlled trial. Level of Evidence: Level 1. Methods: The study was conducted in healthy, uninjured endurance runners (n = 41) participating in a 56-km ultramarathon. The experimental group (n = 20; 14 males, 6 females) trained for 6 weeks and participated in the race wearing below-knee compression garments while the control group (n = 21; 15 males, 6 females) did not. Participants were tested on 4 occasions for various markers of exercise-induced muscle damage and running performance. Results: Ankle circumference measurements increased significantly less ( P = 0.01, Cohen d = 0.9) in the experimental group from immediately after until 2 days post-race compared with the control group. No further statistically significant changes were detected over time in midcalf circumferences, muscle architecture, or race performance. Selected pain ratings were statistically significant and worse in the experimental group. Conclusion: There are limited indications of a beneficial impact of compression garments with improvements in ankle circumference measurements. No ergogenic impact was detected. Clinical Relevance: There is limited evidence to support the continued utilization of commercially available below-knee compression garments during running for the purpose of muscle recovery or as a performance aid.
The Multiple Sclerosis Functional Composite and Symbol Digit Modalities Test as outcome measures in pediatric multiple sclerosis
Authors: Brenton J. Nicholas , Koshiya Hitoshi , Woolbright Emma , Goldman Myla D. 
Published: April 2019

Background There is an increasing number of pediatric multiple sclerosis (MS) clinical trials occurring; however, data validating outcome metrics that accurately capture functional disability within pediatric cohorts are limited. Objective The aim of this study was to investigate the ability of the MS Functional Composite (MSFC) and Symbol Digit Modalities Test (SDMT) to distinguish functional disability in pediatric MS patients. Methods A total of 20 pediatric MS patients and 40 age and sex-matched controls completed the SDMT and MSFC components: a timed 25-foot walk (T25FW); 9-hole peg test (9HPT); and paced auditory serial addition test (PASAT). Z scores for MS patients were created for each test based on control means. MS patients underwent Expanded Disability Status Scale (EDSS) examination. Results Pediatric MS patients exhibited low levels of disability on EDSS, median [range]: 1.5 [1.0–3.0]. Compared with controls, MS patients performed significantly lower on SDMT ( p = 0.0002) and all MSFC components: T25FW ( p = 0.001), 9HPT ( p = 0.01), and PASAT ( p = 0.004). SDMT and MSFC performance were not correlated with EDSS. Conclusions Despite low levels of neurologic disability as measured by EDSS, pediatric patients with MS exhibit impaired performance in leg function, upper limb fine motor function, and auditory/visuospatial processing speeds, supporting the value of the MSFC and SDMT in this population. Longitudinal studies are needed to further validate their utility.
Patient Participation During Anterior Cruciate Ligament Reconstruction Improves Comprehension, Satisfaction, and Functional Outcomes: A Simple Way to Improve Our Practices
Authors: Courtot Louis , Ferre Fabrice , Reina Nicolas , Marot Vincent , Chiron Philippe , Berard Emilie , Cavaignac Etienne 
Published: April 2019

Background: It is estimated that 28% of patients are dissatisfied after anterior cruciate ligament (ACL) reconstruction, in part because they do not understand the procedure well enough. Purpose: To assess the postoperative comprehension, satisfaction, and functional outcomes of 2 patient groups: 1 undergoing a standard surgical procedure (standard group) and 1 involved in their surgery (participation group). Study Design: Cohort study; Level of evidence, 2. Methods: Over a 4-month period, 62 patients were included: 31 in the standard group and 31 in the participation group. The preoperative information, surgical technique, anesthesia, and postoperative course were identical in both groups. Patients in the participation group were allowed to watch the arthroscopic portion of their surgery live on a video screen, and standardized information was given to these patients during the arthroscopic phase. Self-administered questionnaires were given to assess comprehension (Matava score), satisfaction (visual analog scale [VAS] for satisfaction, Net Promoter Score [NPS], and Evaluation du Vécu de l’Anesthésie LocoRégionale [EVAN-LR]), and outcomes (International Knee Documentation Committee [IKDC] form and Anterior Cruciate Ligament–Return to Sport after Injury [ACL-RSI] scale) between groups. Results: Postoperative comprehension was significantly improved in the participation group, as the Matava score increased by a mean of 7.1 ± 5.3 points versus 2.7 ± 5.6 points in the standard group ( P = .0024). The mean VAS satisfaction score immediately after surgery was 9.8 ± 0.6 in the participation group versus 8.9 ± 1.9 in the standard group ( P = .0033); this difference was still present at 1 year postoperatively (9.8 ± 0.6 vs 9.1 ± 1.7, respectively; P = .0145). The NPS was 96.8% in the participation group versus 64.5% in the standard group ( P = .0057) in the immediate postoperative period and 100.0% in the participation group versus 71.0% in the standard group at 1 year postoperatively ( P = .0046). The mean total EVAN-LR score was 89.1 ± 6.5 in the participation group and 84.6 ± 9.9 in the standard group ( P = .0416). At 1 year postoperatively, the mean IKDC score was 86.0 ± 7.5 in the participation group versus 80.0 ± 7.4 in the standard group ( P = .0023). The mean ACL-RSI score was 80.9 ± 7.7 in the participation group versus 74.3 ± 8.4 in the standard group ( P = .0019). Conclusion: Involving patients in their ACL reconstruction surgery improves their understanding of the procedure and their satisfaction with their care, which results in better outcomes at 1 year postoperatively.
Predictors of survival in non-metastatic renal cell cancer after surgery: A retrospective analysis
Authors: Zemni Ines , Mansouri Houyem , Haddad Sabrine , Ayadi Mohamed Ali , slimene Maher , Bouzaiene Hatem , Ben Hassouna Jamel , Rahal Khaled 
Published: April 2019

Aim: To investigate the prognostic significance of clinical and pathological factors of non-metastatic renal cell cancer after surgery. Patients and methods: We conducted a retrospective cohort study based on the records of patients with non-metastatic renal cancer submitted to radical or partial nephrectomy between 2000 and 2015 in Salah-Azaiez Institute. Results: Median follow-up was 38 months (interquartile range: 20–64). Five-year overall and disease-free survival were 53.8% and 43.1%. In the multivariate setting, lymph node invasion (p = 0.01), clear cell renal carcinoma subtype (p = 0.014), and tumor necrosis (p = 0.009) were the only independent statistically significant predictors of disease-free survival, while Fuhrman grade (p = 0.025), clear cell renal carcinoma subtype (p = 0.044), and TNM stage (0.041) were the only factors correlated with overall survival. Conclusion: For patients with non-metastatic renal cell carcinoma, independent predictors of disease-free survival and overall survival were clear cell renal cell carcinoma, Fuhrman grade, TNM stage, lymph node invasion, and tumor necrosis. Such information could be used to guide the intensity of follow-up and identify high-risk patients who can be targeted for adjuvant therapy trials.
Effects of nintedanib in patients with idiopathic pulmonary fibrosis by GAP stage
Authors: Ryerson Christopher J. , Kolb Martin , Richeldi Luca , Lee Joyce , Wachtlin Daniel , Stowasser Susanne , Poletti Venerino 
Published: April 2019

We conducted apost hocanalysis to assess the potential impact of GAP (gender, age, physiology) stage on the treatment effect of nintedanib in patients with idiopathic pulmonary fibrosis.Outcomes were compared in patients at GAP stage IversusII/III at baseline in the INPULSIS® trials.At baseline, 500 patients were at GAP stage I (nintedanib 304, placebo 196), 489 were at GAP stage II (nintedanib 296, placebo 193) and 71 were at GAP stage III (nintedanib 38, placebo 33). In nintedanib-treated patients, the annual rate of decline in forced vital capacity (FVC) was similar in patients at GAP stage I and GAP stage II/III at baseline (−110.1 and −116.6 mL·year−1, respectively), and in both subgroups was lower than in placebo-treated patients (−218.5 and −227.6 mL·year−1, respectively) (treatment-by-time-by-subgroup interaction p=0.92). In the nintedanib group, the number of deaths was 43.8% of those predicted based on GAP stage (35versus79.9). In the placebo group, the number of deaths was 59.8% of those predicted based on GAP stage (33versus55.2).In conclusion, data from the INPULSIS® trials suggest that nintedanib has a similar beneficial effect on the rate of FVC decline in patients at GAP stage IversusII/III at baseline.
Coupling Labor Codes of Conduct and Supplier Labor Practices: The Role of Internal Structural Conditions
Authors: Bird Yanhua , Short Jodi L. , Toffel Michael W. 
Published: April 2019

In response to media exposés and activist group pressure to eliminate exploitive working conditions, multinational companies have pushed their suppliers to adopt labor codes of conduct and improve their labor practices to meet the standards set forth in these codes. Yet little is known about the extent to which suppliers are improving their labor practices to conform to codes of conduct, especially in organizations in which legitimacy structures like codes compete with productivity-driving incentive structures. We theorize that the presence of particular internal structures will affect the extent to which suppliers’ labor practices will become more tightly aligned—or coupled—with their formal commitments to adhere to labor codes. Specifically, we theorize high-powered productivity incentives to be associated with less coupling, and being certified to management system standards and having workers’ unions to be associated with more coupling. We also argue that these efficiency and managerial structures will moderate each other’s relationship to coupling, and that certification and unions will each increase the other’s positive association with coupling. Using social audit data on 3,276 suppliers in 55 countries, we find evidence that supports our hypotheses. Our focus on the internal structural composition of suppliers extends the decoupling literature by theorizing and demonstrating conditions under which suppliers’ core organizational functions are likely to be buffered from change by legitimacy structures. Furthermore, our findings suggest important strategic considerations for managers selecting supplier factories and provide key insights for the design of transnational sustainability governance regimes. The online appendix is available at https://doi.org/10.1287/orsc.2018.1261 .
An Analysis of A Bidirectional School Nurse-Led Text-Messaging Service
Authors: Wales Nicola , Sayer Lynn 
Published: April 2019

Aim: To analyse a school nurse led bi-directional text messaging service provided to young people aged 11–19 in two inner London boroughs. Background: School nurses play a key role in providing early advice and support to the school-aged population. The ability to access a school nurse has been recognised by young people as something that needs to improve and suggestions of being able to text a school nurse have been made. ChatHealth is a bi-directional text messaging system that allows young people aged 11–19 to ask a school nurse for advice and support via an anonymous short messaging system (SMS). Arguably, ChatHealth offers more opportunities than traditional access methods to reach more young people. However, due to the relatively new concept, there is a limited evidence base regarding its effectiveness. Methods: An audit of documentary data was completed to analyse the uptake and outcomes of ChatHealth in the local area. Content analysis was carried out analysing 26 conversation transcripts and a staff questionnaire was distributed to gain a better understanding of the role of the school nurse delivering ChatHealth. Findings: The ChatHealth service appears to be proactive in offering an efficient response to a variety of physical, emotional, sexual health and appointment queries, additionally, the uptake of the service has supplemented the established face-to-face contacts. In the local area, emotional health is the most common type of query being received from young people and the topic school nurses feel least confident in responding to. School nurses identify the benefits of ChatHealth in improving young people's access and in enhancing the visibility of the school nursing service and did not identify it as an inconvenience to their current workload.
Mechanisms of failure and survival of total femoral endoprosthetic replacements
Authors: Medellin M. R. , Fujiwara T. , Clark R. , Stevenson J. D. , Parry M. , Jeys L. 
Published: April 2019

AimsThe aim of this study was to evaluate the prosthesis characteristics and associated conditions that may modify the survival of total femoral endoprosthetic replacements (TFEPR).Patients and MethodsIn all, 81 patients treated with TFEPR from 1976 to 2017 were retrospectively evaluated and failures were categorized according to the Henderson classification. There were 38 female patients (47%) and 43 male patients (53%) with a mean age at diagnosis of 43 years (12 to 86). The mean follow-up time was 10.3 years (0 to 31.7). A survival analysis was performed followed by univariate and multivariate Cox regression to identify independent implant survival factors.ResultsThe revision-free survival of the implant was 71% at five years and 63.3% at ten years. Three prostheses reached 15 years without revision. The mean Musculoskeletal Tumor Society score in the group was 26 (23 to 28). The mechanisms of failure were infection in 18%, structural failures in 6%, tumour progression in 5%, aseptic loosening in 2%, and soft-tissue failures in 1%. Prostheses used for primary reconstruction after oncological resections had lower infection rates than revision implants (8% vs 25%; p = 0.001). The rates of infection in silver-coated and non-silver-coated prosthesis were similar (17.4% vs 19.%; p = 0.869). The incidence of hip dislocation was 10%. Rotating hinge prosthesis had a lower failure rate than fixed hinge prosthesis (5.3% vs 11%). After Cox regression, the independent factors associated with failures were the history of previous operations (hazard ratio (HR) 3.7; p = 0.041), and the associated arthroplasty of the proximal tibia (HR 3.8; p = 0.034). At last follow-up, 11 patients (13%) required amputation.ConclusionTFEPR offers a reliable reconstruction option for massive bone loss of the femur, with a good survival when the prosthesis is used as a primary implant. The use of a rotating hinge at the knee and dual mobility bearing at the hip may be adequate to reduce the risk of mechanical and soft-tissue failures. Infection remains the main concern and there is insufficient evidence to support the routine use of silver-coated endoprosthesis. Cite this article: Bone Joint J 2019;101-B:522–528.
A randomized controlled trial investigating the value of patient-specific instrumentation for total knee arthroplasty in the Canadian healthcare system
Authors: Teeter M. G. , Marsh J. D. , Howard J. L. , Yuan X. , Vasarhelyi E. M. , McCalden R. W. , Naudie D. D. R. 
Published: April 2019

Aims The purpose of the present study was to compare patient-specific instrumentation (PSI) and conventional surgical instrumentation (CSI) for total knee arthroplasty (TKA) in terms of early implant migration, alignment, surgical resources, patient outcomes, and costs. Patients and Methods The study was a prospective, randomized controlled trial of 50 patients undergoing TKA. There were 25 patients in each of the PSI and CSI groups. There were 12 male patients in the PSI group and seven male patients in the CSI group. The patients had a mean age of 69.0 years (sd 8.4) in the PSI group and 69.4 years (sd 8.4) in the CSI group. All patients received the same TKA implant. Intraoperative surgical resources and any surgical waste generated were recorded. Patients underwent radiostereometric analysis (RSA) studies to measure femoral and tibial component migration over two years. Outcome measures were recorded pre- and postoperatively. Overall costs were calculated for each group. Results There were no differences (p > 0.05) in any measurement of migration at two years for either the tibial or femoral components. Movement between one and two years was < 0.2 mm, indicating stable fixation. There were no differences in coronal or sagittal alignment between the two groups. The PSI group took a mean 6.1 minutes longer (p = 0.04) and used a mean 3.4 less trays (p < 0.0001). Total waste generated was similar (10 kg) between the two groups. The PSI group cost a mean CAD$1787 more per case (p < 0.01). Conclusion RSA criteria suggest that both groups will have revision rates of approximately 3% at five years. The advantages of PSI were minimal or absent for surgical resources used and waste eliminated, and for meeting target alignment, yet had significantly greater costs. Therefore, we conclude that PSI may not offer any advantage over CSI for routine primary TKA cases. Cite this article: Bone Joint J 2019;101-B:565–572.
Combined total hip and knee arthroplasty during the same hospital admission
Authors: Almaguer A. M. , Cichos K. H. , McGwin Jr G. , Pearson J. M. , Wilson B. , Ghanem E. S. 
Published: April 2019

Aims The purpose of this study was to compare outcomes of combined total joint arthroplasty (TJA) (total hip arthroplasty (THA) and total knee arthroplasty (TKA) performed during the same admission) versus bilateral THA, bilateral TKA, single THA, and single TKA. Combined TJAs performed on the same day were compared with those staged within the same admission episode. Patients and Methods Data from the National (Nationwide) Inpatient Sample recorded between 2005 and 2014 were used for this retrospective cohort study. Postoperative in-hospital complications, total costs, and discharge destination were reviewed. Logistic and linear regression were used to perform the statistical analyses. p-values less than 0.05 were considered statistically significant. Results Combined TJA was associated with increased risk of deep vein thrombosis, prosthetic joint infection, irrigation and debridement procedures, revision arthroplasty, length of stay (LOS), and in-hospital costs compared with bilateral THA, bilateral TKA, single THA, and single TKA. Combined TJA performed on separate days of the same admission showed no statistically significant differences when compared with same-day combined TJA, but trended towards decreased total costs and total complications despite increased LOS. Conclusion Combined TJA is associated with increased in-hospital complications, LOS, and costs. We do not recommend performing combined TJA during the same hospital stay. Cite this article: Bone Joint J 2019;101-B:573–581.