bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association of Level of Internet Use with Suicidal Ideation and Suicide Attempts in South Korean Adolescents: A Focus on Family Structure and Household Economic Status
Authors: Lee Seo Yoon , Park Eun-Cheol , Han Kyu-Tae , Kim Seung Ju , Chun Sung-Youn , Park Sohee 
Published: March 2016

Objective: To examine the association between the level of Internet addiction and suicidal ideation and suicide attempts in South Korean adolescents, focusing on the roles of family structure and household economic status. Methods: Data from 221 265 middle and high school students taken from the 2008–2010 Korea Youth Risk Behavior Web-based Survey were used in this study. To identify factors associated with suicidal ideation/attempts, multiple logistic regression analysis was performed. The level of Internet use was measured using the simplified Korean Internet Addiction Self-assessment Tool. Results: Compared with mild users of the Internet, high-risk users and potential-risk users were more likely to report suicidal ideation (nonuser, odds ratio [OR] 1.10, 95% confidence interval [CI] 1.05 to 1.15; potential risk, OR 1.49, 95% CI: 1.36 to 1.63; high risk OR 1.94, 95% CI 1.79 to 2.10) or attempts (nonuser, OR 1.33, 95% CI 1.25 to 1.42; potential risk, OR 1.20, 95% CI 1.04 to 1.38; high risk, OR 1.91, 95% CI 1.71 to 2.14). The nonuser group also had a slightly higher risk of suicidal ideation/attempts compared with mild users. This association appeared to vary by perceived economic status and family structure. Conclusions: Our study suggests that it is important to attend to adolescents who are at high risk for Internet addiction, especially when they do not have parents, have stepparents, or perceive their economic status as either very low or very high.
Ibuprofen-conjugated hyaluronate/polygalacturonic acid hydrogel for the prevention of epidural fibrosis
Authors: Lin Cheng-Yi , Peng Hsiu-Hui , Chen Mei-Hsiu , Sun Jui-Sheng , Chang Chih-Ju , Liu Tse-Ying , Chen Ming-Hong 
Published: March 2016

The formation of fibrous tissue is part of the natural healing response following a laminectomy. Severe scar tissue adhesion, known as epidural fibrosis, is a common cause of failed back surgery syndrome. In this study, by combining the advantages of drug treatment with a physical barrier, an ibuprofen-conjugated crosslinkable polygalacturonic acid and hyaluronic acid hydrogel was developed for epidural fibrosis prevention. Conjugation was confirmed and measured by 1D 1H NMR spectroscopy. In vitro analysis showed that the ibuprofen-conjugated polygalacturonic acid–hyaluronic acid hydrogel showed low cytotoxicity. In addition, the conjugated ibuprofen decreased prostaglandin E2 production of the lipopolysaccharide-induced RAW264.7 cells. Histological data in in vivo studies indicated that the scar tissue adhesion of laminectomized male adult rats was reduced by the application of our ibuprofen-conjugated polygalacturonic acid-hyaluronic acid hydrogel. Its use also reduced the population of giant cells and collagen deposition of scar tissue without inducing extensive cell recruitment. The results of this study therefore suggest that the local delivery of ibuprofen via a polygalacturonic acid-hyaluronic acid-based hydrogel reduces the possibility of epidural fibrosis.
Long-term organ damage accrual and safety in patients with SLE treated with belimumab plus standard of care
Authors: Bruce I N , Urowitz M , van Vollenhoven R , Aranow C , Fettiplace J , Oldham M , Wilson B , Molta C , Roth D , Gordon D 
Published: March 2016

Objective To examine long-term organ damage and safety following treatment with belimumab plus standard of care (SoC) in patients with systemic lupus erythematosus (SLE). Methods Pooled data were examined from two ongoing open-label studies that enrolled patients who completed BLISS-52 or BLISS-76. Patients received belimumab every four weeks plus SoC. SLICC Damage Index (SDI) values were assessed every 48 weeks (study years) following belimumab initiation (baseline). The primary endpoint was change in SDI from baseline at study years 5–6. Incidences of adverse events (AEs) were reported for the entire study period. Results The modified intent-to-treat (MITT) population comprised 998 patients. At baseline, 940 (94.2%) were female, mean (SD) age was 38.7 (11.49) years, and disease duration was 6.7 (6.24) years. The mean (SD) SELENA-SLEDAI and SDI scores were 8.2 (4.18) and 0.7 (1.19), respectively; 411 (41.2%) patients had organ damage (SDI = 1: 235 (23.5%); SDI ≥ 2: 176 (17.6%)) prior to belimumab. A total of 427 (42.8%) patients withdrew overall; the most common reasons were patient request (16.8%) and AEs (8.5%). The mean (SD) change in SDI was +0.2 (0.48) at study years 5–6 ( n = 403); 343 (85.1%) patients had no change from baseline in SDI score (SDI +1: 46 (11.4%), SDI +2: 13 (3.2%), SDI +3: 1 (0.2%)). Of patients without organ damage at baseline, 211/241 (87.6%) had no change in SDI and the mean change (SD) in SDI was +0.2 (0.44). Of patients with organ damage at baseline, 132/162 (81.5%) had no change in SDI and the mean (SD) change in SDI was +0.2 (0.53). The probability of not having a worsening in SDI score was 0.88 (95% CI: 0.85, 0.91) and 0.75 (0.67, 0.81) in those without and with baseline damage, respectively (post hoc analysis). Drug-related AEs were reported for 433 (43.4%) patients; infections/infestations (282, 28.3%) and gastrointestinal disorders (139, 13.9%) were the most common. Conclusion Patients with SLE treated with long-term belimumab plus SoC had a low incidence of organ damage accrual and no unexpected AEs. High-risk patients with pre-existing organ damage also had low accrual, suggesting a favorable effect on future damage development.
Telemedicine for ophthalmic consultation services: use of a portable device and layering information for graders
Authors: Woodward Maria A , Bavinger J Clay , Amin Sejal , Blachley Taylor S , Musch David C , Lee Paul P , Newman-Casey Paula Anne 
Published: March 2016

Introduction We compared remote, image-based patient consultations to in-person consultations at emergency department and inpatient hospital settings. Methods Patients evaluated by the ophthalmic consultation services (gold standard) were imaged over a two-week period. A trained study coordinator took anterior segment photographs (AS) and posterior segment photographs (PS) with a portable camera (PictorPlus, Volk Optical, Cleveland, OH). Ophthalmologists (graders) determined photograph quality, presence of pathology, and their confidence in disease detection. At a separate session, graders reassessed photographs accompanied by a one-sentence summary of demographics and chief complaint (CHx). We computed accuracy and reliability statistics. Results We took AS photographs of 24 eyes of 15 patients and PS photographs of 39 eyes of 20 patients. The majority of images were rated as acceptable or excellent in quality (AS: 89–96%; PS: 70–75%). Graders detected AS pathology with 62–81% sensitivity based on photographs, increasing to 87–88% sensitivity with photographs plus CHx. Graders detected PS pathology with 79–86% sensitivity based on a photograph only, increasing to 100% sensitivity with photographs plus CHx. Discussion In this pilot study, there is evidence that portable ophthalmic imaging technologies could enable ophthalmologists to remotely evaluate anterior and posterior segment eye diseases with good sensitivity. The ophthalmologist could detect ocular pathology on photographs more accurately if they were provided brief clinical information.
The value of preoperative embolization in large and giant solid cerebellar hemangioblastomas
Authors: Sultan Ahmed , Hassan Tamer , Aboul-Enein Hisham , Mansour Osama , Ibrahim Tamer 
Published: March 2016

Background Solid cerebellar hemangioblastomas are highly vascular lesions and may cause catastrophic hemorrhage during excision. Methods This retrospective study enrolled 10 patients (7 men and 3 women, with a mean age of 38.2 ± 12.5 years) with solid cerebellar hemangioblastomas. All patients had a solitary tumor and underwent surgical resection of the lesion through a suboccipital approach. The basic features, serial radiographic examinations, and operative records were analyzed. Results The most common presenting symptoms were headache (100%), ataxia (100%), and long tract manifestations (60%). Three patients had experienced failed surgery previously due to massive intraoperative bleeding. Three patients were confirmed as having Von Hippel–Lindau disease. The average size of the tumor was 40.7 ± 8.7 mm in its maximal diameter (range 25–58 mm). Total endovascular occlusion obtained in six patients, near total occlusion in three patients, and incomplete occlusion in one patient. Nine (90.0%) patients underwent gross total resection and one (10.0%) underwent partial resection. After the primary surgery, eight (80.0%) patients experienced improvement in their symptoms, two (20.0%) maintained their pre-treatment status, and none showed neurological deterioration following tumor resection. Blood loss during surgery after embolization was minimal and controllable. Conclusion Preoperative embolization improves safety and efficacy of the microsurgical excision of such tightly located very vascular tumors. Embolization changes the concept of this lesion surgery into piecemeal removal rather than a total mass extraction technique. Liquid agents are superior to particles in obliteration of such lesions.
Elevational spatial compounding for enhancing image quality in echocardiography
Authors: Perperidis Antonios , McDicken Norman , MacGillivray Tom , Anderson Tom 
Published: March 2016

Introduction Echocardiography is commonly used in clinical practice for the real-time assessment of cardiac morphology and function. Nevertheless, due to the nature of the data acquisition, cardiac ultrasound images are often corrupted by a range of acoustic artefacts, including acoustic noise, speckle and shadowing. Spatial compounding techniques have long been recognised for their ability to suppress common ultrasound artefacts, enhancing the imaged cardiac structures. However, they require extended acquisition times as well as accurate spatio-temporal alignment of the compounded data. Elevational spatial compounding acquires and compounds adjacent partially decorrelated planes of the same cardiac structure. Methods This paper employs an anthropomorphic left ventricle phantom to examine the effect of acquisition parameters, such as inter-slice angular displacement and 3D sector angular range, on the elevational spatial compounding of cardiac ultrasound data. Results and conclusion Elevational spatial compounding can produce substantial noise and speckle suppression as well as visual enhancement of tissue structures even for small acquisition sector widths (2.5° to 6.5°). In addition, elevational spatial compounding eliminates the need for extended acquisition times as well as the need for temporal alignment of the compounded datasets. However, moderate spatial registration may still be required to reduce any tissue/chamber blurring side effects that may be introduced.
Does preoperative psychological status of patients affect postoperative pain? A prospective study from the Caribbean
Authors: Bradshaw Prisca , Hariharan Seetharaman , Chen Deryk 
Published: March 2016

Objectives: Patients with high anxiety states in the preoperative period often have more intense postoperative pain, despite adequate pain control during the intraoperative period. This study aimed to determine the relationship between the preoperative psychological status and the pain experienced postoperatively in a sample of Caribbean patients. Design and methods: A prospective study was conducted in elective surgical adult patients at a teaching hospital in the Caribbean. Patients’ preoperative psychological status was assessed using Hospital Anxiety and Depression Scale (HADS), and a preoperative ‘expected’ pain score was recorded. Postoperatively, ‘observed’ pain scores at 4 and 24 hours and the maximum pain score during 24 hours were recorded. Demographic data and clinical details including data regarding postoperative analgesia were collected. Expected and observed pain scores were compared between patients with and without anxiety and depression. Results: A total of 304 patients were enrolled. The overall prevalence of anxiety and depression was 43% and 27%, respectively, based on the HADS scores. There were significant associations between the postoperative pain scores and factors such as preoperative anxiety and depression (HADS) scores, preoperative expected pain scores, patient educational level, presence of preoperative pain and surgical duration. Age, gender, ethnicity and type of anaesthesia did not impact postoperative pain scores. Conclusion: The presence of preoperative anxiety and depression as indicated by HADS score may significantly influence postoperative pain. Other factors such as educational level, presence of preoperative pain and surgical duration may also impact postoperative pain. Some of these factors may be modifiable and must be addressed in the preoperative period.
Acute Vs Delayed ACL Reconstruction. Early Differences and Preliminary Two Year Results
Authors: Eriksson Karl , Barenius Björn 
Published: March 2016

Objectives: Historically acute ACL reconstruction has been avoided due to reports of early rehabilitation problems with stiffness. Are these reports still valid today with modern arthroscopic techniques? Methods: 70 patients with a high recreational activity level (Tegner ≥6) who presented with a acute ACL injury were randomized to an acute reconstruction within 8 days from the injury or delayed reconstruction after 6-10 weeks. Four surgeons performed the ACL reconstructions with quadrupled semitendinosus tendon grafts and endobutton and metallic interference screw fixation. The rehabilitation training was performed at the same physiotherapy center for all patients. The follow up at 6 and 24 months included ROM, Lachman, Rolimeter, pivot shift, one leg hop, IKDC, KOOS, Lysholm and Tegner activity level. Results: There were no differences between the groups in ROM, IKDC, activity level or laxity at 6 months. Four patients had a combined extension and flexion deficit of more than 15 degrees, two from each group. In the acute group 79% had an objective IKDC grade A or B compared with 73% in the delayed group. The one leg hop index above 90% was found in 50% in the acute group and 24% in the delayed group (p=0.04). Functional data for the 2-year follow up are not available at the time of abstract writing. The median activity level according to Tegner was restored to pre-injury levels in both groups after one year, and was stationary at 2 years. The visual analogue scale (VAS) response to the question “How is your knee working on a scale from 0-100? (100 = best)” revealed 81 in the acute and 71 in the delayed group (p=0.1). To the question “How does your knee affect your activity level on a scale from 0-100? (100 = no affection)” the mean score was 75 in the acute group and 67 in the delayed group (p=0.3). At one and two years the KOOS was statistically similar between the groups but with slightly higher subscale “Sport and recreation” scores, 85 in the acute group at 2 years compared to 78 in the delayed group (p=0.2). At the meeting preliminary results regarding functional tests and additional procedures for the groups will be presented. Conclusion: No negative effects of an acute ACL reconstruction were found at 6 months follow up. Preliminary 2 year results point in the same direction. Acute reconstruction of the ACL seems to be safe and a potential benefit might be decreased loss of muscle function. Further analysis of the 2 year results is needed before final conclusions can be drawn.
Overview of the AOA National Joint Replacement Registry
Authors: Clarnette Richard , Graves Stephen , Lekkas Christina 
Published: March 2016

Objectives: Report the findings of the AOANJRR ACL Registry Pilot pilot study to determine the feasibility of establishing an ACL Registry in Australia. Methods: The study involved both patient (pre and post-operative questionnaire) and surgeon (ACL operative data form) derived data collection. The Patient Reported Outcome Measures (PROMs) collected are the KOOS short form, a further two subscales taken from the KOOS long form (Quality of Life; and Function, Sports and Recreation Activities), and the Marx Activity Scale. A variety of approaches were used to maximize the collection of PROMs. The proportion of procedures provided by each hospital was determined by comparison to government separation data. Results: Nine hospitals nationwide were involved with the study, with 803 patients recruited. Collection of surgeon reported data achieved was 99.9%. Collection of PROMs data showed that 55% of patients notified at 6 months and 58.5% of patients notified at 12 months responded. The proportion of all ACL procedures undertaken at each hospital and included in the study varied considerably. Conclusion: The study has shown that it is possible to collect surgeon derived data for those patients recruited for the study. The collection of PROMs however is more problematic.
Use of Technetium Bone Scan to Help Predict Whether Patella Resurfacing Will Be Successful in Treating Pain Following Primary TKR
Authors: Fine Stephen , Watson Anna 
Published: March 2016

Objectives: Anterior knee pain is not uncommon following primary TKR. The AOANJRR (2014) reports that 12.1% of revisions of primary TKR are for patellofemoral pain. Patella resurfacing does not always relieve this pain. The objective of this study is to investigate whether a technetium bone scan after TKR will predict success of a subsequent patella resurfacing. Methods: Observational Case Series. This is a retrospective review of patients of a single orthopaedic surgeon over a 22 year period. Patients who had subsequent isolated patella resurfacing (or patella resurfacing plus tibial insert exchange) of a primary TKR were identified and contacted by telephone. All had bone scans performed in their workup to patella resurfacing. Bone scan was considered positive if the radiologist reported greater uptake in the patella than elsewhere in the knee. Three patient outcome measures were used: Satisfaction (very satisfied, satisfied, dissatisfied, very dissatisfied); Pain relief (excellent, good, no improvement, worse); “Would you have the surgery again?” (yes, no). Correlation was made between results of bone scans and patient outcome measures. Results: 35 patients were identified who underwent subsequent patella resurfacing of a primary TKR. 22 were contactable and eligible for the study. The average time from primary knee replacement to patella resurfacing was 6 years, 4 months. The average time from the patella resurfacing to interview was 3 years, 8 months. 17 of the patients did not have their patella resurfaced at the primary procedure. 5 had loose patella buttons. 3 had replacement of their tibial polyethylene insert at the same time as patella resurfacing. There were 15(68%) positive bone scans. Of these, 14(93%) were very satisfied or satisfied. There was a single case (7%) who was dissatisfied. 14(93%) had excellent or good pain relief, 1(7%) had no improvement. 14 patients said that they would have the surgery again, 1 would not. There were 7(32%) negative bone scans. Of these, 2(29%) were very satisfied or satisfied and 5(71%) were dissatisfied. 2(29%) had excellent or good pain relief, 5(71%) had no improvement. 4 patients said that they would have the surgery again, 3 would not. Conclusions: In patients with a painful primary TKR, technetium bone scan may be a useful additional tool to help predict which patients will benefit from subsequent patella resurfacing
Radiological Outcomes and Operative Time following Total Knee Arthroplasty using Accelerometer-based, Portable Navigation versus Conventional Inter-Medullary Alignment Guides
Authors: MacDessi Samuel , Solayar GN , Thatcher N , Chen Darren B 
Published: March 2016

Objectives: Accelerometer-based, portable navigation instrumentation is a new method of achieving desired resection alignments in total knee arthroplasty (TKA). Methods: After randomisation and the application of exclusion criteria, 79 knees were analysed. 42 patients which underwent TKA using conventional intra-medullary (IM) alignment guides were compared to 37 patients with the use of accelerometer-based, portable navigation device (KneeAlign; OrthoAlign Inc, Aliso Viejo, California). Radiographic results were obtained from post-operative computer-tomography following the CT Perth Protocol. Results: In the IM cohort, 81.0% of patients had a coronal alignment within 3° of a neutral mechanical axis (vs 83.8% with KneeAlign, p=0.74), 81.0% had a femoral coronal alignment within 2° of perpendicular to the femoral mechanical axis (vs 89.2% with KneeAlign, p=0.31), and 92.9% had a tibial coronal alignment within 2° of perpendicular to the tibial mechanical axis (vs 81.1% with KneeAlign, p=0.12). Regarding sagittal alignment, the IM cohort had 90.5% of patients with femoral component alignment within 2° of optimum (vs 91.9% with KneeAlign, p=0.83) and 92.9% had a tibial component alignment within 2° of the optimal tibial slope (vs 89.2% with KneeAlign, p=0.57). The mean tourniquet time (from incision to completion of coronal bone resections) in the IM cohort was 16.5± 8.9 minutes vs 22.2 ± 7.6 minutes in the KneeAlign cohort (p<0.003). Conclusion: Accelerometer-based, portable navigation has a statistically similar outcome in alignment following TKA as IM guides. It is noted that using the portable navigation device does prolong surgical time compared to conventional IM surgery and this may be due to the learning curve.