bluuebunny/crossref_metadata_2025_split huggingface dataset:
Refinement of the Montreal Instrument for Cat Arthritis Testing, for Use by Veterinarians: detection of naturally occurring osteoarthritis in laboratory cats
Authors: Klinck Mary P , Monteiro Beatriz P , Lussier Bertrand , Guillot Martin , Moreau Maxim , Otis Colombe , Steagall Paulo VM , Frank Diane , Martel-Pelletier Johanne , Pelletier Jean-Pierre , del Castillo Jérôme RE , Troncy Eric 
Published: September 2017

Objectives Feline osteoarthritis causes pain and disability. Detection and measurement is challenging, relying heavily on owner report. This study describes refinement of the Montreal Instrument for Cat Arthritis Testing, for Use by Veterinarians. Methods A video analysis of osteoarthritic (n = 6) and non-osteoarthritic (n = 4) cats facilitated expansion of scale items. Three successive therapeutic trials (using gabapentin, tramadol and oral transmucosal meloxicam spray) in laboratory cats with and without natural osteoarthritis (n = 12–20) permitted construct validation (assessments of disease status sensitivity and therapeutic responsiveness) and further scale refinements based on performance. Results Scale osteoarthritic sensitivity improved from phase I to phase III; phase III scale total score ( P = 0.0001) and 4/5 subcategories – body posture ( P = 0.0006), gait ( P = 0.0031), jumping (0.0824) and global distance examination ( P = 0.0001) – detected osteoarthritic cats. Total score inter-rater (intra-class correlation coefficients [ICC] = 0.64–0.75), intra-rater (ICC = 0.90–0.91) and overall internal consistency (Cronbach’s alpha = 0.85) reliability were good to excellent. von Frey anesthesiometer-induced paw withdrawal threshold increased with gabapentin in phase I, in osteoarthritic cats ( P <0.001) but not in non-osteoarthritic cats ( P = 0.075). Night-time activity increased during gabapentin treatment. Objective measures also detected tramadol and/or meloxicam treatment effects in osteoarthritic cats in phases II and III. There was some treatment responsiveness: in phase I, 3/10 subcategory scores improved ( P <0.09) in treated osteoarthritic cats; in phase II, 3/8 subcategories improved; and in phase III, 1/5 subcategories improved ( P <0.096). Conclusions and relevance The revised scale detected naturally occurring osteoarthritis, but not treatment effects, in laboratory cats, suggesting future potential for screening of at-risk cats. Further study is needed to confirm reliability, validity (disease sensitivity and treatment responsiveness) and clinical feasibility, as well as cut-off scores for osteoarthritic vs non-osteoarthritic status, in client-owned cats.
Morphological variation of the caudal fossa of domestic cat skulls assessed with CT and geometric morphometrics analysis
Authors: Gordon Caroline R , Marchant Thomas W , Lodzinska Joanna , Schoenebeck Jeffrey J , Schwarz Tobias 
Published: September 2017

Objectives This study aimed to investigate differences and demonstrate a normal range of morphological variation of the caudal fossa of the cranium of domestic cats. Methods CT scans of 32 domestic cat heads of 11 breeds were included. Isosurfaces from skulls were characterised through three-dimensional geometric morphometrics using geographical landmarks placed on the internal surface of the caudal fossa and foramen magnum. Raw data was transformed with a Procrustes fit and coordinate covariance was analysed by principal components to establish breed- and sex-level differences. Skulls were also classified according to the number of concavities along the mid-sagittal vermiform impression. Differences were investigated between breed groups and sex, and correlation was sought with age. Results Analyses revealed size-independent differences in occipital bone morphology across breeds and sex; however, no clustering was evident. Most variability was observed at the exoccipital bones, ventral portion of the supraoccipital bone, dorsum sellae of the basisphenoid and the osseous tentorium cerebelli. No statistically significant differences were identified via two-sample t-tests between breed groups or sexes. No statistically significant correlation using Spearman rho correlation coefficient was identified with age. Conclusions and relevance The feline caudal fossa displays a wide range of intra- and inter-breed variation, not linked to age or sex. Concavities along the vermiform impression have not previously been described. As advanced imaging modalities are becoming more frequently used for domestic felids, an established range of normality is important for discriminating pathological changes from anatomical variances.
Can urologists accurately stage and grade urothelial bladder cancer by assessing endoscopic photographs?
Authors: Dekalo Snir , Matzkin Haim , Mabjeesh Nicola J 
Published: September 2017

Introduction Assessment of urothelial bladder cancer during cystoscopy or transurethral resection of bladder tumour has a significant impact on the urologist's decision-making: treatment with simple outpatient fulguration, required depth of resection, and need of immediate post-surgical intravesical therapy. These choices depend heavily on the urologist's ability to accurately assess pre-biopsy tumour stage and grade. The aim of the study was to determine whether evaluation of photographs taken during transurethral resection of bladder tumour can reliably characterize a tumour’s stage and grade. Methods Smartphone photographs of 50 urothelial bladder cancer cases were taken at the beginning of transurethral resection of bladder tumour and individually presented to seven senior urologists. All urologists were blinded to the final pathological report and to any other urological evaluation. Each one was asked to rate the tumour as low vs high grade and noninvasive Ta vs noninvasive T1 or muscle invasive. Results were compared with final pathology. Individual appraisal and the majority's opinion were evaluated. Results Urologists have correctly predicted tumour stage and grade in 63.5% of cases (222 of 350, average of 32 out of 50 accurate assessments). The final majority assessment was correct in 40 of 50 cases (80%). Sensitivity and specificity of the final results for the diagnosis of T1 or higher were 80% and 88.6%, respectively. Sensitivity and specificity for Ta low grade were 83.3% and 80%, respectively. Conclusions To the best of our knowledge, this is the first documented attempt to evaluate urologists' ability to assess urothelial bladder cancer stage and grade using endoscopic photographs. Urologists can usually identify stage and grade of urothelial bladder cancer but accuracy increases when multiple senior urologists examine the same photographs and achieve majority consensus. Presenting photographs of urothelial bladder cancer to a team of urologists may lead to an excellent decision regarding type and extent of surgical treatment and substantiate appropriate post-surgical management.
A week of pain in the emergency department
Authors: Thornton Hilary Sarah , Reynolds Joseph , Coats Timothy J 
Published: September 2017

Background: Pain is a common complaint in patients attending the emergency department (ED), and historically, it is under-assessed and undertreated. Previous research is heterogeneous and does not well describe pain in EDs over time. Our aim was to describe pain in a UK ED using a sample that included every adult attendance over the course of 1 week. Methods: We retrospectively reviewed every adult attendance (N = 1872) over 1 week to the ED of a large English NHS District General Hospital. We noted the initial pain score and, if the initial score was ≥5, the final recorded pain score. We categorised attendances as ‘illness’ or ‘injury’. Results: In all, 62.1% of patients had a pain score recorded, of whom 50.7% had a pain score of zero. Median pain score was 6/10 in patients with pain; 58% had a second score recorded. More patients with illness than injury had a second score recorded. Most patients had an improvement in their pain; however, around one-third had no change or worse pain at the end of their ED stay. Conclusion: We have defined the incidence, severity and change in pain in an ED over 1 week. This information will underpin the design of future studies aimed at improving patient care in this important area of emergency medicine practice.
Target range of motion at 3 months after arthroscopic rotator cuff repair and its effect on the final outcome
Authors: Tonotsuka Hisahiro , Sugaya Hiroyuki , Takahashi Norimasa , Kawai Nobuaki , Sugiyama Hajime , Marumo Keishi 
Published: September 2017

Purpose: The postoperative protocol after arthroscopic rotator cuff repair (ARCR) is still controversial. Some surgeons recommend slower rehabilitation in order to improve the integrity of the repair, while others prefer early range-of-motion (ROM) exercise to avoid postoperative stiffness. The purpose of this study was to determine target ROM (T-ROM) measurements at 3 months after ARCR that are predictive of eventual full recovery without structural failure. Methods: The cases consisted of 374 shoulders in 360 patients who underwent primary ARCR and were followed up for at least 2 years. Forward flexion (FF) and side-lying external rotation (ER) were measured preoperatively at 3, 6, 9, 12, and 24 months after surgery, and the patients were divided into six subgroups according to the values for each type of ROM at 3 months (ROM-3M). In each subgroup, the final ROM at 24 months after surgery was compared to determine the T-ROM. The average ROMs with time and re-tear rate were then compared between the under-T-ROM and over-T-ROM groups. Results: The only significant difference in FF was between the 120–129° and 110–119° ROM-3M groups. Therefore, the T-ROM for FF was determined to be 120°. Similarly, the T-ROM for ER was determined to be 20°. Each ROM in the over-T-ROM group was significantly better than that in the under-T-ROM group at all assessments. There was no significant difference in the re-tear rate between the groups. Conclusion: To acquire sufficient ROM in 2 years without high re-tear rate, a target FF of 120° and ER of 20° should be achieved within 3 months after surgery.
State-Level Implementation of Health and Safety Policies to Prevent Sudden Death and Catastrophic Injuries Within Secondary School Athletics
Authors: Adams William M. , Scarneo Samantha E. , Casa Douglas J. 
Published: September 2017

Background: Sudden death and catastrophic injuries during sport can be attenuated with the implementation of evidence-based health and safety policies. However, the extent of the implementation of these policies within secondary school athletics is unknown. Purpose: To provide an assessment of the implementation of health and safety policies pertaining to the leading causes of sudden death and catastrophic injuries in sport within secondary school athletics in the United States. Study Design: Descriptive epidemiology study. Methods: A rubric for evidence-based practices for preventing the leading causes of death and catastrophic injuries in sport was created. The rubric comprised 5 equally weighted sections for sudden cardiac arrest, head injuries, exertional heat stroke, appropriate medical coverage, and emergency preparedness. State high school athletic association (SHSAA) policies, enacted legislation, and Department of Education policies were extensively reviewed for all 50 states and the District of Columbia. States meeting the specific criteria in the rubric, which required policies to be mandated for all SHSAA member schools, were awarded credit; the weighted scores were tabulated to calculate an aggregate score. States were then ranked from 1 (best) to 51 (worst) based on the aggregate score achieved. Results: The median score on the rubric was 47.1% (range, 23.00%-78.75%). States ranked 1 through 10 (from 78.75% to 56.98%) were North Carolina, Kentucky, Massachusetts, New Jersey, South Dakota, Missouri, Washington, Hawaii, Wisconsin, and Georgia, respectively. States ranked 11 through 20 (from 56.03% to 50.55%) were Arkansas, New York, Mississippi, West Virginia, Oregon, Illinois, Tennessee, Arizona, Texas, and District of Columbia, respectively. States ranked 21 through 30 (from 49.40% to 44.00%) were Virginia, Pennsylvania, Florida, New Mexico, Alabama, Maine, Rhode Island, Indiana, Nevada, and Utah, respectively. States ranked 31 through 40 (from 43.93% to 39.80%) were Ohio, Delaware, Alaska, Vermont, Louisiana, Maryland, Oklahoma, Connecticut, Idaho, and South Carolina, respectively. States ranked 41 through 51 (from 38.73% to 23.00%) were Michigan, North Dakota, Nebraska, New Hampshire, Kansas, Wyoming, Minnesota, Montana, Iowa, California, and Colorado, respectively. Conclusion: State scores ranged from 23.00% to 78.75% for the implementation of evidence-based best practices for preventing the leading causes of sudden death and catastrophic injuries (sudden cardiac arrest, traumatic head injuries, exertional heat stroke, and exertional sickling) in sport. Continued advocacy for the development and implementation of policies at the secondary school level surrounding sudden death and catastrophic injuries is warranted to optimize the health and safety of these student athletes.
Comparison of Clinical Failure Rates After 2 Techniques of Subpectoral Mini-Open Biceps Tenodesis: Sequence and Suture Passage Technique Matter
Authors: Schrock John B. , Kraeutler Matthew J. , Bravman Jonathan T. 
Published: September 2017

Background: A number of techniques are available for performing biceps tenodesis, the majority of which result in good or excellent outcomes. However, failure may result in pain and/or dissatisfying biceps deformity. Purpose: To compare the clinical failure rates of 2 methods of suture passage in subpectoral biceps tenodesis with suture anchors performed by the senior author. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective chart review was conducted of patients who underwent biceps tenodesis under the care of the senior author. Operative notes were used to determine whether the procedure was performed with a BirdBeak (BB) suture passer or a free needle (FN). Each subsequent clinical follow-up note was used to determine participation in physical therapy and duration, follow-up duration, and whether clinical tenodesis failure had occurred. Biceps tenodesis failure was defined as either cosmetic deformity (“Popeye” sign), pain at the tenodesis site, or need for revision. Results: Overall, 163 patients met the inclusion criteria (BB, n = 112; FN, n = 51). Mean follow-up was 5.3 months and 4.1 months in the BB and FN groups, respectively. Significantly more tenodesis failures occurred in the BB group (BB, 12%; FN, 2%, P = .042). Among all BB patients, 10% experienced failure due to cosmetic deformity, 2% required revision, and 4% had postoperative pain at the tenodesis site by latest follow-up. The 1 patient in the FN group who experienced failure presented with cosmetic deformity postoperatively. Conclusion: Biceps tenodesis with the use of an FN to pass the suture resulted in a significantly lower clinical failure rate compared with the use of a BB suture passer.
Developing an algorithm to identify patients with intracerebral haemorrhage secondary to a macrovascular cause
Authors: Wilson Duncan , Ogungbemi Ayokunle , Ambler Gareth , Jones Ifan , Werring David J , Jäger Hans R 
Published: September 2017

Introduction Determining the cause of spontaneous (non-traumatic) intracerebral haemorrhage (ICH) is critical to guide treatment and prognosis. We investigated whether small vessel disease (SVD) in addition to clinical and other radiological findings on acute neuroimaging predicts a low risk of a macrovascular cause (e.g. an arterio-venous malformation, aneurysm or dural arteriovenous fistula). Patients and methods We identified patients with acute spontaneous ICH who underwent acute non-contrast CT, CT angiography (CTA) and intra-arterial digital subtraction angiography (IADSA) at our institution from January 2010 to April 2014. Logistic regression including CTA result, SVD, age, pre-ICH hypertension and ICH location was used to derive a prediction model, validated using bootstrapping. Results 173 patients (46% female, median age 49) of whom 78 had a macrovascular cause on IADSA were included. Predictors of a macrovascular cause were: abnormal CTA (OR 67.4; p < 0.001); absence of SVD (OR 5.0; p = 0.019); and absence of pre-ICH hypertension (OR 3.4; p = 0.05). In our internally derived prediction model, the combination of CTA, SVD and pre-ICH hypertension predicted the likelihood of an underlying macrovascular cause (optimism-adjusted ROC area 0.919). Patients with negative CTA, SVD and pre-ICH hypertension have a low likelihood of an underlying macrovascular cause (1.8%). Discussion and conclusion A combination of CTA, SVD and pre-ICH hypertension predict the likelihood of finding a macrovascular cause in patients with acute spontaneous ICH, allowing informed decisions regarding the likely benefit and risk of IADSA.
Early Versus Delayed Weightbearing After Microfracture For Osteochondral Lesions Of the Talus
Authors: Deal James , Groth Adam , Ryan Paul 
Published: September 2017

Category: Arthroscopy Introduction/Purpose: Bone marrow stimulation techniques, specifically arthroscopic microfracture, have become the therapy of choice for osteochondral lesions of the talus (OLTs) less than 15 mm2 in size. Traditionally, the microfracture site is protected with a postoperative non-weightbearing period of 6-8 weeks. However, recent research has suggested postoperative early weight bearing (EWB) after microfracture may produce outcomes equivalent to delayed weight bearing (DWB). We performed a prospective, randomized trial to determine whether the results of EWB after microfracture for OLTs are equivalent to DWB. Methods: We randomized 37 patients (37 ankles) undergoing arthroscopic microfracture for OLTs to either EWB or DWB protocols. The EWB cohort was allowed to bear weight as tolerated two weeks after surgery, while the DWB cohort was held non-weightbearing until six weeks postoperatively. We collected demographic data, mechanism of injury, lesion size and stage, Numeric Rating System pain scores (NRS), and American Academy of Orthopaedic Surgery Foot and Ankle Questionnaire (AAOS) functional scores preoperatively, then at 6 weeks, 3 months, 6 months, 1 year, and 2 years postoperatively. Results: There were no differences between the two cohorts in terms of patient age, mechanism of injury, lesion size, or lesion stage. The mean age at surgery was 34.1 years (range 21-50 years). 70.4% of the lesions were lateral, 22.2% were medial, and the remainder were central. The EWB group demonstrated statistically significant improvement in AAOS scores at the six week follow-up appointment. There were no significant AAOS score differences at the other time points. NRS pain scores were not significantly different at any time point. Both groups showed mild deterioration of results over time. Conclusion: Early weightbearing after microfracture for OLTs was associated with improved AAOS scores in the short term, without demonstrating poorer function or pain at 2 year follow up. This study supports early weightbearing after arthroscopic microfracture for osteochondral lesions of the talus.
Second-Look Arthroscopic Evaluation and Clinical Outcome after the Supramalleolar Osteotomy for the Medial Compartment Ankle Osteoarthritis
Authors: Jung Hong-Geun , Eom Joon-Sang , Lee Dong-Oh , Sun Mao Yuan , Kang Hwa Jun 
Published: September 2017

Category: Ankle, Ankle Arthritis, Arthroscopy, Hindfoot Introduction/Purpose: This study aimed to evaluate the clinical and radiological outcomes of asymmetric ankle osteoarthritis after supramalleolar osteotomy (SMO) without BMSP(bone marrow stimulation procedure) and confirm cartilage recovery by second look arthroscopy. The hypothesis was that SMO without BMSP for medial compartment ankle osteoarthritis would show tibio-talar articular cartilage regeneration in the medial compartment, as well as satisfactory clinical and radiological outcomes. Methods: We retrospectively reviewed 20 ankles of 18 consecutive patients who were followed up for over 1 year after SMO from August 2007 to February 2013. Visual analog scale (VAS) pain scores and the AOFAS ankle-hindfoot scores were used for the functional evaluations. The tibial anterior surface angles and the tibial lateral surface angles were measured on radiographs, and the ankle osteoarthritis was classified by the Takakura stage. Among the 20cases, 19 caseshad ankle arthroscopy performedprior to SMO, and second-look ankle arthroscopywas performed in 14 cases at postoperative 1 year. Tibio-talarcartilage regeneration was evaluatedaccording to the modified Outerbridge classification for the 12 cases that had undergone SMO without a bone marrow–stimulating procedure (BMSP). Results: The mean VAS and AOFAS scores significantly improved from 6.7 preoperatively to 1.2 postoperatively and from 60.9 preoperatively to 87.9 postoperatively, respectively (P<0.05). The mean TAS and TLS angles significantly improved from 83.5? and 76.5preoperatively to 94.4? and 80.3? postoperatively respectively (P<0.05). All preoperative TakakurastageIIIa cases and 1 case of preoperative stage IIIb improved to postoperative stage II. At 2nd look arthroscopy, articular cartilage regeneration of the medial compartment of the tibio-talar joint was observed in 10 of 12 cases (83%), whereas cartilage deterioration was not observed in any case.Cartilage grading, however, did not show correlations with clinical outcomes. Conclusion: SMO without BMSP for medial compartment ankle osteoarthritis demonstrated marked tibio-talar articular cartilage regeneration in the medial compartment (83%) by second look arthroscopy, as well as satisfactory clinical and radiological outcomes.