bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of finger position on pinch strength
Authors: Walukonis Kelsey , Beasley Jeanine , Boerema Rachel , Powers Jamie , Anderson Kirk 
Published: January 2018

Introduction Pinch strength is a widely used measurement of hand function, but digit position on the pinch gauge has not been described in the literature. The aim of this study was to assess for differences in tip, lateral, and three-jaw-chuck pinch force when the digits are placed on the groove or bridge of a Bernadette and Linda pinch gauge. Methods Thirty-six healthy volunteers each pinched six times in random order: one for each type of pinch force with the digits placed in each position. Results There were no significant differences in pinch strength measurements based on digit position, except for three-jaw-chuck pinch which was slightly higher on the groove. Equivalence was found within one pound for tip and lateral pinch but not for three-jaw-chuck. Conclusion Variations in finger position may result in similar pinch strength measurements for tip and lateral pinch. Clinicians may reliably assess lateral and tip pinch using either position; however, standardized positioning is still recommended.
Long-term clinical outcome of two-stage revision surgery for infected hip arthroplasty using cement spacer
Authors: Kang Joon-Soon , Shin Eun-Ho , Roh Tae-Hoon , Na Yeop , Moon Kyoung Ho , Park Joo-Hyun 
Published: January 2018

Introduction: Periprosthetic joint infection (PJI) is a terrible complication after hip arthroplasty. Clinical feature of culture-negative PJI (CN-PJI) has not been well studied till now. In our study, we retrospectively analyzed long-term clinical results after two-stage revision arthroplasty using an antibiotic-impregnated cement spacer for CN-PJI. The purpose of this study is to investigate the clinical features and prognosis of CN-PJI after hip arthroplasty and to compare these with those of culture-positive PJI (CP-PJI). Methods: We retrospectively reviewed 15 CN-PJI cases and 70 CP-PJI cases following hip arthroplasty. The average follow-up period was 7.4 years (5–11.7 years). The demographics, laboratory findings, the time interval between antibiotic-impregnated cement spacer insertion and revision arthroplasty, and recurrence of infection were analyzed. Results: The CN-PJI group showed a significantly higher incidence of prior antibiotic use ( p = 0.004) and lower serum C-reactive protein (CRP) level ( p = 0.001) than the CP-PJI group. Normalized time interval of CRP level in CN-PJI was shorter than that of CP-PJI group. The mean interval time for two-stage exchange arthroplasty was also significantly lower ( p = 0.049) in the CN-PJI group than the CP-PJI group. There was no case of treatment failure or major complication in CN-PJI group. Conclusion: The CN-PJI group after total hip arthroplasty could be treated successfully by two-stage exchange arthroplasty without any complications. Clinical course and prognosis of CN-PJI group was also better compared with that of CP-PJI group. Therefore, culture negativity of PJI cannot be always a poor prognostic factor for the treatment.
Fracture lines and comminution zones in OTA/AO type 23C3 distal radius fractures: The distal radius map
Authors: Misir Abdulhamit , Ozturk Kahraman , Kizkapan Turan Bilge , Yildiz Kadir Ilker , Gur Volkan , Sevencan Ahmet 
Published: January 2018

Objective: This study was designed to define fracture lines and comminution zones in OTA/AO 23C3 distal radius fractures from axial computed tomography (CT) images that would influence surgical planning, development of new classifications, and possible implant designs. Methods: Thirty-four consecutive OTA/AO 23C3 fractures treated by a single surgeon between January 2014 and December 2014 were analyzed. For each fracture, maps of the fracture lines and zones of comminution were drawn. Each map was digitized and graphically superimposed to create a compilation of fracture lines and zones of comminution. Based on this compilation, major and minor fracture lines were identified and fracture patterns were defined. Results: All major fracture lines were distributed in the central region of the radius distal articular surface. There is a recurrent fracture pattern with a comminution zone including the scaphoid and lunate fossa; Lister’s tubercle; and ulnar, volar, and radial zones. Conclusion: It is important for the practicing surgeon to understand these four main fragments. Knowledge of this constant pattern should influence the development of new classifications and possible implant designs.
Medial Patellofemoral Ligament Reconstruction Reduces Radiographic Measures of Patella Alta in Adults
Authors: Woodmass Jarret M. , Johnson Nick R. , Cates Robert A. , Krych Aaron J. , Stuart Michael J. , Dahm Diane L. 
Published: January 2018

Background: Patellar height has long been considered a risk factor for patellofemoral instability. However, recent pediatric literature demonstrated a reduction in patellar height measurements following medial patellofemoral ligament (MPFL) reconstruction. Purpose: To assess the mean change in patellar height and the percentage of skeletally mature patients with patellar height ratios reduced to within-normal limits following MPFL reconstruction. Study Design: Case series; Level of evidence, 4. Methods: Adult patients undergoing primary MPFL reconstruction for recurrent lateral patellar instability between 2005 and 2013 were identified. Pre- and postoperative (within 1 year of surgery) lateral knee radiographs were assessed for patellar height indices, including Caton-Deschamps, Blackburne-Peel, and Insall-Salvati ratios. The change in patellar height and the number of patients reduced from abnormal to normal patellar height ratios following MPFL reconstruction were assessed. Results: Overall, 32 adult patients were included in the study, with a mean age of 25.7 years (range, 18-55 years). There were 21 women (66%) and 11 men (34%). Insall-Salvati, Blackburne-Peel, and Caton-Deschamps ratios all demonstrated significant reductions in patellar height between pre- and postoperative lateral knee radiographs ( P < .001). All 3 indices showed a reduction in the number of patients meeting the criteria for patella alta following MPFL reconstruction. A total of 64% of patients had an abnormal preoperative Caton-Deschamps ratio reduced to within normal limits postoperatively. Conclusion: MPFL reconstruction provides a consistent reduction in patellar height measurements. The Caton-Deschamps ratio was reduced to the reference range following MPFL reconstruction in 64% of patients with preoperative patella alta. Surgeons treating patellofemoral instability should expect a reduction in patellar height after ligament reconstruction, which may affect the need for more invasive distalization procedures.
Development and validation of the Dutch Stroke Score for predicting disability and functional outcome after ischemic stroke: A tool to support efficient discharge planning
Authors: de Ridder Inger R , Dijkland Simone A , Scheele Maaike , den Hertog Heleen M , Dirks Maaike , Westendorp Willeke F , Nederkoorn Paul J , van de Beek Diederik , Ribbers Gerard M , Steyerberg Ewout W , Lingsma Hester F , Dippel Diederik WJ 
Published: January 2018

Introduction We aimed to develop and validate a prognostic score for disability at discharge and functional outcome at three months in patients with acute ischemic stroke based on clinical information available on admission. Patients and methods The Dutch Stroke Score (DSS) was developed in 1227 patients with ischemic stroke included in the Paracetamol (Acetaminophen) In Stroke study. Predictors for Barthel Index (BI) at discharge (‘DSS-discharge’) and modified Rankin Scale (mRS) at three months (‘DSS-3 months’) were identified in multivariable ordinal regression. The models were internally validated with bootstrapping techniques. The DSS-3 months was externally validated in the PRomoting ACute Thrombolysis in Ischemic StrokE study (1589 patients) and the Preventive Antibiotics in Stroke Study (2107 patients). Model performance was assessed in terms of discrimination, expressed by the area under the receiver operating characteristic curve (AUC), and calibration. Results At model development, the strongest predictors of Barthel Index at discharge were age per decade over 60 (odds ratio = 1.55, 95% confidence interval (CI) 1.41–1.68), National Institutes of Health Stroke Scale (odds ratio = 1.24 per point, 95% CI 1.22–1.26) and diabetes (odds ratio = 1.62, 95% CI 1.32–1.91). The internally validated AUC was 0.76 (95% CI 0.75–0.79). The DSS-3 months, additionally consisting of previous stroke and atrial fibrillation, performed similarly at internal (AUC 0.75, 95% CI 0.74–0.77) and external validation (AUC 0.74 in PRomoting ACute Thrombolysis in Ischemic StrokE (95% CI 0.72–0.76) and 0.69 in Preventive Antibiotics in Stroke Study (95% CI 0.69–0.72)). Observed outcome was slightly better than predicted. Discussion: The DSS had satisfactory performance in predicting BI at discharge and mRS at three months in ischemic stroke patients. Conclusion If further validated, the DSS may contribute to efficient stroke unit discharge planning alongside patients' contextual factors and therapeutic needs.
Assessment of the Use of Adrenocorticotropic Hormone in Psoriatic Arthritis
Authors: Madan Elena , Garber Caren , Saraiya Ami , Gottlieb Alice B. 
Published: January 2018

Background A 39-amino-acid peptide of the natural form of adrenocorticotropic hormone (ACTH) was designed to provide a prolonged release after administration by intramuscular or subcutaneous injection. It is FDA-approved as adjunctive therapy for psoriatic arthritis for short-term administration. Clinical data on the safety of ACTH in psoriatic arthritis is limited. Objective To assess the safety data for the use of ACTH in psoriatic arthritis and compare it with the safety data for corticosteroids. Methods We conducted a systematic review of the literature pertaining to the safety of ACTH versus corticosteroids in psoriatic arthritis. We queried the PubMed database for studies evaluating (i) ACTH and Acthar in psoriatic arthritis using the search terms “psoriatic arthritis” and “ACTH” or “acthar” or “adrenocorticotropic hormone” and (ii) ACTH and Acthar in RA or psoriatic arthritis using the terms “rheumatoid arthritis” or “psoriatic arthritis” and “ACTH” or “acthar” or “adrenocorticotropic hormone.” We placed no time limits on either search. From the search results, we selected studies that emphasize safety data. Due to limited psoriatic arthritis-related data, we included data related to rheumatoid arthritis (RA). Results The current body of knowledge surrounding the safety of ACTH in psoriatic arthritis is limited. Twenty studies met our inclusion criteria, 14 of which directly compared ACTH to corticosteroids in either psoriatic arthritis or RA. Of these, five studies reported comparable safety between the two, four studies reported more adverse events with ACTH, two studies reported more adverse events with corticosteroids, and three studies were inconclusive. Conclusion There is no clear evidence that ACTH is safer than corticosteroids for psoriatic arthritis.
A Systematic Review of Concomitant Bullous Pemphigoid and Psoriasis
Authors: Donnelly Kevin M. , Ferris Laura K. , Kaffenberger Jessica A. 
Published: January 2018

Background Many reports in the medical literature describe patients with concurrent psoriasis and bullous pemphigoid (BP), but little is known about these patients. Objective: To characterize patients with concurrent BP and psoriasis and their disease course. Methods We performed a systematic review of the English literature for all documented cases of coexistent BP and psoriasis. Results Our search yielded 76 cases meeting inclusion criteria. The male-to-female ratio was 2.3:1. The average age of onset of BP was 65 years. Prior to BP eruption, 38% of the patients had acute worsening of their psoriasis. Ultraviolet radiation therapy was the most cited cause of BP outbreak (25%). The most used systemic treatments for BP outbreak were corticosteroids (45%) and methotrexate (18%). Conclusion Patients with BP and psoriasis are clinically distinct. Providers should be aware of the association between these diseases and be able to choose treatments that do not exacerbate either disease.
Secukinumab Provides Clearer Skin and Better Control on Patient-Reported Psoriasis Symptoms of Itching, Pain, and Scaling than Placebo and Etanercept
Authors: Strober Bruce , Sigurgeirsson Bárður , Popp Georg , Sinclair Rodney , Krell James , Stonkus Sigitas , Septe Marcis , Elewski Boni E. , Gottlieb Alice B. , Zhao Yang , Herrera Vivian , Mordin Margaret , Odom Dawn , Papavassilis Charis , Nyirady Judit , Lebwohl Mark 
Published: January 2018

Background Secukinumab, a fully human anti-interleukin 17A monoclonal antibody, has demonstrated rapid, strong, and sustained efficacy in moderate-to-severe plaque psoriasis. Objective To measure treatment effect on psoriasis-related itching, pain, and scaling during the first 12 weeks of treatment. Methods ERASURE and FIXTURE were double-blind, multicenter, phase 3 studies in adults randomly assigned to secukinumab (300 mg or 150 mg), placebo, or etanercept (FIXTURE only). Improvements in itching, pain, and scaling and their bothersomeness, proportions of responders and proportions reporting complete symptom relief were compared. Results Subjects treated with secukinumab reported significantly greater symptom improvement versus etanercept and placebo as well as bothersomeness reduction (all P < 0.01). The proportion of symptom responders and proportions reporting complete relief favored secukinumab. Limitations Approximately 39% of patients provided data on psoriasis-related itching, pain, and scaling. Conclusions Secukinumab significantly improves patient-reported itching, pain, and scaling compared with etanercept and placebo over 12-week psoriasis treatment.
Frequency, Prevalence, and Burden of Flares on Patients with Moderate to Severe Psoriasis: A Retrospective Cross-Sectional Analysis
Authors: Hsu Ming-Ann , Lucas James , Wood Robert , Cappelleri Joseph C. , Piercy James 
Published: January 2018

Background Psoriasis impairs health-related quality of life (HRQoL). Objective To improve understanding of flare burden in patients with moderate to severe psoriasis. Methods A retrospective, cross-sectional study comparing data in U.S. patients with and without psoriasis flares. Physicians identified flaring patients as those not in remission, or in remission < 12 weeks, with worsening/unstable disease progression. Results Overall health status (EQ-5D-3L) was reduced in flaring versus matched non-flaring patients ( P = .001); this difference was clinically meaningful (> 0.074 difference in absolute value). Reduced HRQoL and activity impairment, measured by Dermatology Life Quality Index ( P = .0178) and Work Productivity and Activity Impairment Questionnaire ( P = .0002), respectively, were observed in flaring versus non-flaring patients. Anxiety was associated with flaring ( P = .0139). Flaring patients were less satisfied with treatment effectiveness than non-flaring patients ( P < .0001). The flaring group experienced a median of two flares over 12 months. Conclusion Flares are associated with reduced health status and HRQoL and lower treatment satisfaction.
Patient Satisfaction Scores and Standard of Care Compliance in Patients on Biologic Therapy for Psoriasis
Authors: Abittan Brian J. , Bonomo Lauren , Conway Steven , Alesia Ahmad , Gantz Madeline , Lebwohl Mark G. 
Published: January 2018

Background Under the Affordable Care Act, patient satisfaction scores are used to determine reimbursements. There are limited data studying the correlation of patient satisfaction with physician adherence to standard of care practice. Objective To examine the correlation between patient satisfaction scores and provider adherence to tuberculosis (TB) monitoring in psoriasis patients on biologic therapy. Methods A multicenter retrospective chart review was conducted evaluating physicians’ compliance with TB testing. TB testing compliance was measured and Press Ganey scores of providers from the same time period were obtained. Results The correlation constant among providers was 0.41, suggesting no linear relationship between compliance and patient satisfaction scores. Conclusions This study did not show a correlation between increased patient satisfaction scores and adherence to appropriate medical standards of care. This contributes to the body of evidence suggesting that these scores are an unsuitable determinant of physician compensation. Further studies controlling multiple variables and with greater power are needed.
Ring1A and Ring1B inhibit expression of Glis2 to maintain murine MOZ-TIF2 AML stem cells
Authors: Shima Haruko , Takamatsu-Ichihara Emi , Shino Mika , Yamagata Kazutsune , Katsumoto Takuo , Aikawa Yukiko , Fujita Shuhei , Koseki Haruhiko , Kitabayashi Issay 
Published: January 2018

Key PointsMOZ-TIF2 AML cells harboring deletion of Ring1A/B lose self-renewal capacity. Gli-similar 2 promotes differentiation of MOZ-TIF2 AML cells and is derepressed in Ring1A/B-knockout cells.
Mutational dynamics of early and late relapsed childhood ALL: rapid clonal expansion and long-term dormancy
Authors: Spinella Jean-François , Richer Chantal , Cassart Pauline , Ouimet Manon , Healy Jasmine , Sinnett Daniel 
Published: January 2018

Key Points
Two distinct evolutionary patterns govern early and late relapse. Evolutionary patterns suggest a mutation-driven resistance for early relapses and a re-expansion of dormant cells for late ones.
ARDS: challenges in patient care and frontiers in research
Authors: Bos Lieuwe D. , Martin-Loeches Ignacio , Schultz Marcus J. 
Published: January 2018

This review discusses the clinical challenges associated with ventilatory support and pharmacological interventions in patients with acute respiratory distress syndrome (ARDS). In addition, it discusses current scientific challenges facing researchers when planning and performing trials of ventilatory support or pharmacological interventions in these patients.Noninvasive mechanical ventilation is used in some patients with ARDS. When intubated and mechanically ventilated, ARDS patients should be ventilated with low tidal volumes. A plateau pressure <30 cmH2O is recommended in all patients. It is suggested that a plateau pressure <15 cmH2O should be considered safe. Patient with moderate and severe ARDS should receive higher levels of positive end-expiratory pressure (PEEP). Rescue therapies include prone position and neuromuscular blocking agents. Extracorporeal support for decapneisation and oxygenation should only be considered when lung-protective ventilation is no longer possible, or in cases of refractory hypoxaemia, respectively. Tracheotomy is only recommended when prolonged mechanical ventilation is expected.Of all tested pharmacological interventions for ARDS, only treatment with steroids is considered to have benefit.Proper identification of phenotypes, known to respond differently to specific interventions, is increasingly considered important for clinical trials of interventions for ARDS. Such phenotypes could be defined based on clinical parameters, such as the arterial oxygen tension/inspiratory oxygen fraction ratio, but biological marker profiles could be more promising.
Quantitative analysis of phantom studies of 111In and 68Ga imaging of neuroendocrine tumours
Authors: Jönsson L. , Stenvall A. , Mattsson E. , Larsson E. , Sundlöv A. , Ohlsson T. , Hindorf C. 
Published: January 2018

Abstract
Background
Nuclear medicine imaging of neuroendocrine tumours is performed either by SPECT/CT imaging, using 111In-octreotide or by PET/CT imaging using 68Ga-radiolabelled somatostatin analogs. These imaging techniques will give different image quality and different detection thresholds for tumours, depending on size and activity uptake. The aim was to evaluate the image quality for 111In-SPECT and 68Ga-PET imaging, i.e. the smallest volume possible to visualize for different source-to-background activity ratios. The accuracy of quantification of lesion volume and activity was also investigated to develop an objective evaluation for radionuclide therapy eligibility.
The phantom study was performed using the NEMA IEC Body Phantom with six hot spheres having inner diameters of 10, 13, 17, 22, 28, and 37 mm, filled with either 68Ga or 111In with sphere-to-background ratios (SBRs) of no background activity, 5:1, 2.5:1, and 1.25:1. Activity ratios of 1.25:1 and 2.5:1 are clinically found for lesions close to the liver and spleen. Clinical acquisition and reconstruction protocols were applied. Line profiles were drawn to evaluate the smallest detectable volume within a given SBR. Recovery curves based on threshold-based VOIs, threshold-based VOIs adapted to the background and CT-based ROIs were obtained for all SBRs and sphere diameters, allowing for quantification.

Results
The 10-mm sphere was not possible to detect in SPECT images. It was detectable in PET images for SBRs of 2.5:1 and higher. In a background corresponding to the activity uptake in the liver, spheres larger than 22–37 mm were detectable in the 111In-SPECT images and spheres larger than 13–22 mm were detectable in the 68Ga-PET images. The maximum activity concentration was accurately quantified for spheres larger than 22 mm in the PET images; however, the quantification was impaired by sphere size and background activity.

Conclusions
It was not possible to detect the 10-mm sphere in any of the SPECT images. In a background corresponding to the activity uptake in the liver, spheres larger than approximately 30 mm were visible in the 111In-SPECT images and spheres larger than approximately 17 mm were visible in the 68Ga-PET images. Sphere diameter and background activity strongly affect the possibility of a correct quantification.
Impact of Breast Cancer Early Detection Training on Rwandan Health Workers’ Knowledge and Skills
Authors: Pace Lydia E. , Dusengimana Jean-Marie Vianney , Keating Nancy L. , Hategekimana Vedaste , Rugema Vestine , Bigirimana Jean Bosco , Costas-Chavarri Ainhoa , Umwizera Aline , Park Paul H. , Shulman Lawrence N. , Mpunga Tharcisse 
Published: January 2018

PurposeIn April 2015, we initiated a training program to facilitate earlier diagnosis of breast cancer among women with breast symptoms in rural Rwanda. The goal of this study was to assess the impact of the training intervention in breast cancer detection on knowledge and skills among health center nurses and community health workers (CHWs).MethodsWe assessed nurses’ and CHWs’ knowledge about breast cancer risk factors, signs and symptoms, and treatability through a written test administered immediately before, immediately after, and 3 months after trainings. We assessed nurses’ skills in clinical breast examination immediately before and after trainings and then during ongoing mentorship by a nurse midwife. We also examined the appropriateness of referrals made to the hospital by health center nurses.ResultsNurses’ and CHWs’ written test scores improved substantially after the trainings (overall percentage correct increased from 73.9% to 91.3% among nurses and from 75.0% to 93.8% among CHWs ( P < .001 for both), and this improvement was sustained 3 months after the trainings. On checklists that assessed skills, nurses’ median percentage of actions performed correctly was 24% before the training. Nurses’ skills improved significantly after the training and were maintained during the mentorship period (the median score was 88% after training and during mentorship; P < .001). In total, 96.1% of patients seen for breast concerns at the project’s hospital-based clinic were deemed to have been appropriately referred.ConclusionNurses and CHWs demonstrated substantially improved knowledge about breast cancer and skills in evaluating and managing breast concerns after brief trainings. With adequate training, mentorship, and established care delivery and referral systems, primary health care providers in sub-Saharan Africa can play a critical role in earlier detection of breast cancer.