bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do single-use medical devices containing biopolymers reduce the environmental impacts of surgical procedures compared with their plastic equivalents?
Authors: Unger Scott R , Hottle Troy A , Hobbs Shakira R , Thiel Cassandra L , Campion Nicole , Bilec Melissa M , Landis Amy E 
Published: May 2017

Background While petroleum-based plastics are extensively used in health care, recent developments in biopolymer manufacturing have created new opportunities for increased integration of biopolymers into medical products, devices and services. This study compared the environmental impacts of single-use disposable devices with increased biopolymer content versus typically manufactured devices in hysterectomy. Methods A comparative life cycle assessment of single-use disposable medical products containing plastic(s) versus the same single-use medical devices with biopolymers substituted for plastic(s) at Magee-Women’s Hospital (Magee) in Pittsburgh, PA and the products used in four types of hysterectomies that contained plastics potentially suitable for biopolymer substitution. Magee is a 360-bed teaching hospital, which performs approximately 1400 hysterectomies annually. Results There are life cycle environmental impact tradeoffs when substituting biopolymers for petroplastics in procedures such as hysterectomies. The substitution of biopolymers for petroleum-based plastics increased smog-related impacts by approximately 900% for laparoscopic and robotic hysterectomies, and increased ozone depletion-related impacts by approximately 125% for laparoscopic and robotic hysterectomies. Conversely, biopolymers reduced life cycle human health impacts, acidification and cumulative energy demand for the four hysterectomy procedures. The integration of biopolymers into medical products is correlated with reductions in carcinogenic impacts, non-carcinogenic impacts and respiratory effects. However, the significant agricultural inputs associated with manufacturing biopolymers exacerbate environmental impacts of products and devices made using biopolymers. Conclusions The integration of biopolymers into medical products is correlated with reductions in carcinogenic impacts, non-carcinogenic impacts and respiratory effects; however, the significant agricultural inputs associated with manufacturing biopolymers exacerbate environmental impacts.
Understanding Public Perceptions of Growing Economic Inequality
Authors: Franko William W. 
Published: May 2017

AbstractWhile most Americans appear to acknowledge the large gap between the rich and the poor in the United States, it is not clear whether the public is aware of recent changes in income inequality. Even though economic inequality has grown substantially in recent decades, studies have shown that the public's perception of growing income disparities has remained mostly unchanged since the 1980s. This research offers an alternative approach to evaluating how public perceptions of inequality are developed. Centrally, it conceptualizes the public's response to growing economic disparities by applying theories of macro-political behavior and place-based contextual effects to the formation of aggregate perceptions about income inequality. It is argued that most of the public relies on basic information about the economy to form attitudes about inequality and that geographic context—in this case, the American states—plays a role in how views of income disparities are produced. A new measure of state perceptions of growing economic inequality over a 25-year period is used to examine whether the public is responsive to objective changes in economic inequality. Time-series cross-sectional analyses suggest that the public's perceptions of growing inequality are largely influenced by objective state economic indicators and state political ideology. This research has implications for how knowledgeable the public is of disparities between the rich and the poor, whether state context influences attitudes about inequality, and what role the public will have in determining how expanding income differences are addressed through government policy.
Carotidynia in high-altitude travelers
Authors: Parra Andrea , Okada Tamuru , Lin Peter H 
Published: May 2017

Background Carotidynia is characterized by focal pain and tenderness of the carotid artery without associated hemodynamic or structural abnormalities. Carotid artery pathology has also been known to occur in high altitude due to aberrant baroreceptor response in the carotid bulb. Case Presentation We herein report two cases of high altitude-related idiopathic carotidynia. The first patient was a geologist who performed oil reserve survey in the Alaska Mountain, while the second patient was hiking in a mountain trail in Peru. Both patients developed acute onset of neck pain while traveling in high-altitude mountainous ranges. Carotid imaging showed transmural inflammation surrounding the carotid artery without intraluminal stenosis. Treatment with low-dose aspirin and nonsteroidal anti-inflammatory drug were initiated, which resulted in complete resolution of their symptom. Follow-up carotid ultrasound showed complete resolution of carotid inflammatory tissue density. Discussion This represents the first report linking carotidynia to high-altitude traveling.
Patients’ and healthcare professionals’ perceptions of self-management support interactions: Systematic review and qualitative synthesis
Authors: Franklin Marika , Lewis Sophie , Willis Karen , Bourke-Taylor Helen , Smith Lorraine 
Published: May 2017

Objective To review studies examining the experience of self-management support in patient–provider interactions and the shaping of goals through interactions. Methods We undertook a systematic review and thematic synthesis of the qualitative literature. We searched six databases (2004–2015) for published studies on the provision of self-management support in one-to-one, face-to-face, patient–provider interactions for obesity, type 2 diabetes mellitus and chronic obstructive pulmonary disease, with 14 articles meeting inclusion criteria. Results Themes identified from studies were (1) dominance of a traditional model of care, encompassing the provision of generic information, exclusion of the psychosocial and temporal nature of interactions and (2) a context of individual responsibility and accountability, encompassing self-management as patients’ responsibility and adherence, accountability and the attribution of blame. Interactions were constrained by consultation times, patient self-blame and guilt, desire for autonomy and beliefs about what constitutes ‘effective’ self-management. Discussion Encounters were oriented towards a traditional model of care delivery and this limited opportunity for collaboration. These findings suggest that healthcare professionals remain in a position of authority, limiting opportunities for control to be shared with patients and shared understandings of social context to be developed.
A university sport coach community of practice: Using a value creation framework to explore learning and social interactions
Authors: Bertram Rachael , Culver Diane M , Gilbert Wade 
Published: May 2017

Coaches often identify social learning situations as the most valuable and influential to their learning. Thus, researchers have proposed implementing social learning initiatives, in particular, the community of practice approach. The purpose of the present study was to explore how an existing coach community of practice was created and sustained in a university setting, and to assess what value was created by participating in the community of practice. Participants included four National Collegiate Athletic Association Division 1 coaches from a university in the Southwestern United States. Data collection included an individual interview with each coach. Interviews were analysed using a value creation framework. The findings revealed that the coaches created value within all five cycles of Wenger et al.’s framework. In particular, the coaches learned a number of coaching strategies, some of which they were able to implement, and as a result, observe benefits in their coaching and athletes’ performance.
Noncirrhotic hepatocellular carcinoma: etiology and occult hepatitis B virus infection in a hepatitis B virus-endemic area
Authors: Shim Chang Woo , Park Joong-Won , Kim So Hee , Kim Jin Sook , Kim Bo Hyun , Kim Sung Hoon , Hong Eun Kyung 
Published: May 2017

Background: Although hepatocellular carcinoma (HCC) usually develops in cirrhotic livers, a minority of cases occur in noncirrhotic livers (NCLs). We investigated etiology, clinicopathological features, and occult hepatitis B virus (HBV) infection (OBI) in patients with NCL HCC in an HBV-endemic area. Methods: A total of 710 patients who underwent resection or transplantation for HCC at the National Cancer Center (NCC), Korea, were enrolled. HCC and fibrosis stage were diagnosed pathologically. Results: A total of 178 patients (25%) did not have cirrhosis (NCL group). The main cause of HCC was HBV infection (77.2%), followed by cryptogenic disease (11.0%). The prevalence of NCL was 19.2%, 32.5%, 50.0%, and 48.7% among patients with HBV, hepatitis C virus (HCV), alcoholic, and cryptogenic disease, respectively ( p < 0.05); corresponding nonfibrosis rates were 8.1%, 0%, 19.0%, and 24.3%, respectively. The NCL group was significantly older, with a larger tumor size, smaller tumor number, lower tumor stage, and more frequent non-HBV etiology. Among non-HBV HCC cases, 130 (80.2%) had antibodies against HBV core (HBc) and 55 (38.5%) had OBI. OBI-positive rates of 0%, 31.8%, and 52.6% were detected among HCV, alcoholic, and cryptogenic HCC cases, respectively. OBI did not correlate with advanced fibrosis. The NCL and liver cirrhosis (LC) groups did not differ in median overall survival. Conclusion: Regardless of etiology, a significant number of HCC patients, including half of nonviral cases, did not have LC. Half of cryptogenic HCC cases had OBI. This study promotes an understanding of fibrosis and OBI among patients with HCC in an HBV-endemic area.
Osteochondral Allograft Transplantation and Opening Wedge Tibial Osteotomy: Clinical Results of a Combined Single Procedure
Authors: Hsu Albert C. , Tirico Luis E. P. , Lin Abraham G. , Pulido Pamela A. , Bugbee William D. 
Published: May 2017

Objective To evaluate the outcome of patients who have undergone simultaneous osteotomy and osteochondral allograft (OCA) transplantation. Our hypothesis is that use of high tibial osteotomy and fresh OCA in a combined procedure is safe and effective without increasing morbidity in comparison to OCA alone. Design A case series of 17 patients underwent tibial osteotomy and simultaneous OCA during a single surgery. Osteotomy was indicated when axial alignment was within the affected compartment. Patients had a minimum of 2 years of follow-up after surgery. The mean graft size was 8.7 cm2, with 82% located on the medial femoral condyle alone and 18% involving the medial femoral condyle and one or more other sites. Data collection included demographics, osteotomy correction, graft site(s) and area, and clinical evaluation. Failure was defined as conversion to arthroplasty. Results Two of 17 patients (12%) failed at a mean of 9.3 years. The remaining 15 patients (88%) had intact allografts with mean survival of 8.1 years (SD 3.3). Five patients (29%) had an additional procedure, all undergoing osteotomy hardware removal. Of those with surviving allografts, mean pain and function scores improved significantly from the preoperative to postoperative assessment and International Knee Documentation Committee total scores improved significantly from 40.9 ± 15.4 preoperative to 75.5 ± 24.0 at latest follow-up ( P = 0.003); 92% of patients were satisfied with the results of the surgery. No postoperative complications occurred. Conclusion Combining high tibial osteotomy and OCA in properly selected patients is safe and effective.
What we see when we digitize pain: The risk of valorizing image-based representations of fibromyalgia over body and bodily experience
Authors: Manivannan Vyshali 
Published: May 2017

Fibromyalgia is chronic pain of unknown etiology, attended by fatigue and affective dysfunction. Unapparent to the unpracticed eye or diagnostic image, it is denied the status of “real” suffering given to visually confirmable disorders. It is my customary mode of existence: a contingent landscape of swinging bridges that may or may not give way, everything a potential threat or deprivation. I don’t express it within the framework of acute pain, but I am evaluated by traditional biomedical standards anyway. Ultimately, the diagnostic image of pain, and the medical and academic discourse used to interpret it, determines my functionality. Such a stance dismisses bodily senses and alternate ways of knowing in pursuit of the ocularcentric objectivity promised by digital health technologies, whose vision remains chained to the interpretive, discursive strategies of human operators and interpreters. A new poetics of pain is critical not only for rewriting the dominant metaphors that construct and delimit our imaginings of pain but also for rewiring the use and reading of digital technologies, wherein the digital image becomes the new site of the hermeneutic exercise, even when the suffering body lies in plain view. This facilitates a failure to listen and touch in patient care, and the imposition of a narrative based on visual evidence, translated into sanitized language, at the cost of intercorporeality. If pain strips sufferers of a voice, my body and its affects should be allowed to speak.
Outcome of Expedited Rotator Cuff Surgery in Injured Workers: Determinants of Successful Recovery
Authors: Razmjou Helen , Boljanovic Dragana , Lincoln Sandra , Holtby Richard , Gallay Stephen , Henry Patrick , Macritchie Iona ,   WCP Consortium, Borthwick Cheryl , Mayer Lauren , Roknic Carolyn , Shore Deborah , Kamino Allison , Grossman Julie , Hill Joanne , Singh Gargi , Travers Niki , Yanofsky Loraine , Wilson Marni , Sumar Shellina , Savona Alicia , De Medeiros Filomena , Mann Helen , Champsi Aisha , Chau Stefanie , Medeiros Danielle , Richards Robin R. 
Published: May 2017

Background: Work-related rotator cuff injuries are a common cause of disability and employee time loss. Purpose: To examine the effectiveness of expedited rotator cuff surgery in injured workers who underwent rotator cuff decompression or repair and to explore the impact of demographic, clinical, and psychosocial factors in predicting the outcome of surgery. Study Design: Case series; Level of evidence, 4. Methods: Injured workers who were seen at a shoulder specialty program and who underwent expedited arthroscopic rotator cuff decompression or repair were observed for a period of 6 to 12 months based on their type of surgery and recovery trajectory. The primary outcome measure was the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form. The impact of surgery was assessed by whether the change in the ASES score exceeded the minimal clinically important difference (MCID) of 17 points. Secondary outcomes were range of motion (ROM), medication consumption, and work status. Results: One hundred forty-six patients (43 women [29%], 103 men [71%]; mean age, 52 years; SD, 8 years) completed the study. Sixty-seven (46%) patients underwent rotator cuff repair. The mean time between the date the patient consented to have surgery and the date of surgery was 82 (SD, 44) days. There was a statistically significant improvement in ASES score and ROM and work status (52 returned to regular duties and 59 to modified duties) ( P < .0001). Eighty-four percent (n = 122) of patients exceeded the MCID of 17 points. Individual factors that affected patient overall disability were preoperative ASES, work status prior to surgery, access to care, and autonomy at work. Achieving a minimal clinically meaningful change was influenced by perceived access to care, autonomy and stress at work, and overall satisfaction with the job. Conclusion: Expedited rotator cuff surgery improved disability, ROM, and work status in injured workers. Successful recovery after work-related shoulder injuries may further be facilitated by improving the psychosocial work environment and increasing access to care.
Three-Dimensional CT Evaluation of Tunnel Positioning in ACL Reconstruction Using the Single Anteromedial Bundle Biological Augmentation (SAMBBA) Technique
Authors: Buscayret Florent , Temponi Eduardo Frois , Saithna Adnan , Thaunat Mathieu , Sonnery-Cottet Bertrand 
Published: May 2017

Background: Remnant preservation may confer important advantages in the anterior cruciate ligament (ACL)–reconstructed knee. However, the presence of a large remnant may obscure visualization and impair the ability to correctly place tunnels during surgery. Purpose: To determine whether tunnel placement during anatomic ACL reconstruction using the single anteromedial bundle biological augmentation (SAMBBA) technique is consistent and precise when a large native remnant is preserved. Study Design: Case series; Level of evidence, 4. Methods: Included in this study were 99 patients undergoing an ACL reconstruction during which at least 50% of the native ACL was preserved. The femoral tunnel was created using an outside-in specific guide. The tibial tunnel was positioned in the anteromedial region of the ACL footprint, and the remnant was carefully preserved while drilling and passing the semitendinosus graft through it. Postoperatively, 3-dimensional computed tomography (3D CT) was used to evaluate tunnel placement. The mean tunnel locations were calculated and the standard deviation was used to evaluate precision of positioning. Inter- and intrareader agreement were determined to assess reliability of evaluation of tunnel position. Results: The center of the femoral tunnel was positioned at a mean 19.4% (SD, 2%) of the depth of the notch and a mean 23.1% (SD, 3.5%) of the lateral wall height. The center of the tibial tunnel was positioned at a mean 36.3% (SD, 3.8%) of the anteroposterior length of the tibial plateau and at a mean 47.0% (SD, 2.7%) of the mediolateral width. The small standard deviations demonstrate that this technique allows precise tunnel placement. The tunnel positions achieved were consistent with previous anatomic studies of femoral and tibial anteromedial bundle insertion. Intra- and interobserver reliability were high. Conclusion: Three-dimensional CT evaluation demonstrated that despite the presence of a large remnant, placement of femoral and tibial tunnels for anatomic ACL reconstruction using the SAMBBA technique is consistent and precise.
Flexion Posteroanterior Radiographs Affect Both Enrollment for and Outcomes After Injection Therapy for Knee Osteoarthritis
Authors: Meyer Maximilian A. , Leroux Timothy S. , Levy David M. , Tilton Annemarie K. , Lewis Paul B. , Yanke Adam B. , Cole Brian J. 
Published: May 2017

Background: Knee injection therapy is less effective for severe osteoarthritis (OA), specifically Kellgren-Lawrence (KL) grade 4. Patient selection for knee injection trials has historically been based on extension anteroposterior (AP) radiographic evaluation; however, emerging evidence suggests that KL grading using a flexion posteroanterior (PA) radiograph more accurately and reproducibly predicts disease severity. The impact of radiographic view on patient selection and outcome after knee injection therapy remains unknown. Hypothesis: A 45° flexion PA radiograph will reveal more advanced knee OA in certain patients. These patients will report worse pre- and postinjection outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Four raters independently graded extension AP and flexion PA radiographs from 91 patients previously enrolled in a knee injection trial. Patients determined to have KL grade 4 OA by any rater on extension AP radiographs were excluded. Among included patients, those upgraded to KL grade 4 on flexion PA radiographs by at least 2 raters constituted group 2, while all remaining patients constituted group 1. Demographic data and patient-reported outcome scores before injection and at 6 weeks, 3 months, 6 months, and 12 months postinjection were compared between groups. Results: Overall, 64 patients met the inclusion criteria, of which 19 patients (30%) constituted group 2. Compared with group 1, patients in group 2 were older (58.7 vs 52.3 years, P = .02), had worse visual analog scale pain scores before (6.6 vs 5.3, P = .03) and 6 months after injection (5.3 vs 3.5, P = .01), had less improvement in both Lysholm (8.5 vs 20.5, P = .02) and Short Form–12 physical component (–2.2 vs 1.7, P = .03) scores from preinjection to 6 months postinjection, and had less improvement in both Lysholm (1.6 vs 13.1, P = .03) and Knee injury and Osteoarthritis Outcome Score sport subscale (–2.1 vs 16, P = .01) scores from preinjection to 12 months postinjection. Conclusion: One in 3 patients considered to have mild to moderate knee OA on extension AP radiography is upgraded to severe knee OA (KL grade 4) on flexion PA radiography. These patients report worse preinjection outcomes, worse pain scores at short-term follow-up, and decreased improvement in knee function scores between 6 months and 1 year postinjection.
An evaluation of automated chest radiography reading software for tuberculosis screening among public- and private-sector patients
Authors: Rahman Md Toufiq , Codlin Andrew J. , Rahman Md Mahfuzur , Nahar Ayenun , Reja Mehdi , Islam Tariqul , Qin Zhi Zhen , Khan Md Abdus Shakur , Banu Sayera , Creswell Jacob 
Published: May 2017

Computer-aided reading (CAR) of medical images is becoming increasingly common, but few studies exist for CAR in tuberculosis (TB). We designed a prospective study evaluating CAR for chest radiography (CXR) as a triage tool before Xpert MTB/RIF (Xpert).Consecutively enrolled adults in Dhaka, Bangladesh, with TB symptoms received CXR and Xpert. Each image was scored by CAR and graded by a radiologist. We compared CAR with the radiologist for sensitivity and specificity, area under the receiver operating characteristic curve (AUC), and calculated the potential Xpert tests saved.A total of 18 036 individuals were enrolled. TB prevalence by Xpert was 15%. The radiologist graded 49% of CXRs as abnormal, resulting in 91% sensitivity and 58% specificity. At a similar sensitivity, CAR had a lower specificity (41%), saving fewer (36%) Xpert tests. The AUC for CAR was 0.74 (95% CI 0.73–0.75). CAR performance declined with increasing age. The radiologist grading was superior across all sub-analyses.Using CAR can save Xpert tests, but the radiologist's specificity was superior. Differentiated CAR thresholds may be required for different populations. Access to, and costs of, human readers must be considered when deciding to use CAR software. More studies are needed to evaluate CAR using different screening approaches.