bluuebunny/crossref_metadata_2025_split huggingface dataset:
One-Year Outcomes of Total Meniscus Reconstruction Using a Novel Fiber-Reinforced Scaffold in an Ovine Model
Authors: Patel Jay M. , Merriam Aaron R. , Culp Brian M. , Gatt Charles J. , Dunn Michael G. 
Published: February 2016

Background: Meniscus injuries and resulting meniscectomies lead to joint deterioration, causing pain, discomfort, and instability. Tissue-engineered devices to replace the meniscus have not shown consistent success with regard to function, mechanical integrity, or protection of cartilage. Purpose: To evaluate a novel resorbable polymer fiber–reinforced meniscus reconstruction scaffold in an ovine model for 52 weeks and assess its integrity, tensile and compressive mechanics, cell phenotypes, matrix organization and content, and protection of the articular cartilage surfaces. Study Design: Controlled laboratory study. Methods: Eight skeletally mature ewes were implanted with the fiber-reinforced scaffold after total meniscectomy, and 2 additional animals had untreated total meniscectomies. Animals were sacrificed at 52 weeks, and the explants and articular surfaces were analyzed macroscopically. Explants were characterized by ultimate tensile testing, confined compression creep testing, and biochemical, histological, and immunohistochemical analyses. Cartilage damage was characterized using the Mankin score on histologic slides from both the femur and tibia. Results: One sheep was removed from the study because of a torn extensor tendon; the remaining 7 explants remained fully intact and incorporated into the bone tunnels. All explants exhibited functional tensile loads, tensile stiffnesses, and compressive moduli. Fibrocartilagenous repair with both types 1 and 2 collagen were observed, with areas of matrix organization and biochemical content similar to native tissue. Narrowing in the body region was observed in 5 of 7 explants. Mankin scores showed less cartilage damage in the explant group (femoral condyle: 3.43 ± 0.79, tibial plateau: 3.50 ± 1.63) than in the meniscectomy group (femoral condyle: 8.50 ± 3.54, tibial plateau: 6.75 ± 2.47) and were comparable with Mankin scores at the previously reported 16- and 32-week time points. Conclusion: A resorbable fiber-reinforced meniscus scaffold supports formation of functional neomeniscus tissue, with the potential to prevent joint degeneration that typically occurs after total meniscectomy. Further studies with improvements to the initial mechanics of the scaffold and testing for longer time periods are warranted. Clinical Relevance: Meniscectomy is an extremely common orthopaedic procedure, and few options currently exist for the treatment of significant loss of meniscus tissue. Successful development of a tissue-engineered meniscus scaffold could substantially reduce the incidence of postmeniscectomy joint degeneration and the subsequent procedures used for its treatment.
Fidelity After SECOND LIFE Facilitator Training in a Sexual Risk Behavior Intervention
Authors: Tschannen Dana , Yaksich Joseph D. , Aebersold Michelle , Villarruel Antonia 
Published: February 2016

Background. Intensive facilitator training is a critical component to enable the use of Evidence-Based Interventions (EBIs) by communities. Such training ensures that program’s essential elements are implemented with fidelity. Many EBI training programs require resource- and time-intensive face-to-face training, eliminating participation from some community-based organizations due to significant costs and time away from work. The ¡CUÍDATE! (TAKE CARE OF YOURSELF!) program aimed at improving the sexual health of Latino youth is one such EBI limited in widespread dissemination by its current face to face format. The purpose of this study was to examine the efficacy of training by assessing whether facilitators who attended the virtual ¡CUÍDATE! facilitator training in SECOND LIFE™ implemented the ¡CUÍDATE! curriculum with fidelity (e.g. adherence to the curriculum and competent delivery) to adolescent youth. Methods. Using a descriptive design, community-based facilitators (n=19) attended virtual SECOND LIFE™ ¡CUÍDATE! training. Post-training facilitators implemented two identical ¡CUÍDATE! sessions with two groups of adolescents and were instructed to audio record the sessions. The research team reviewed a random, stratified subset of the audio files (n=57) using the standardized curriculum as the standard to determine implementation fidelity adherence and fidelity competency. Results.Fidelity adherence for the ¡CUÍDATE! training for both sessions was high (91.2%) (e.g. the activities were presented as intended). Fidelity competency of facilitators was also high, with the overall quality of the program sessions being 3.95 (SD 1.18, scale 1 to 5). Both fidelity measures (i.e., adherence and competency) improved from implementation of the first to the second session with 100% adherence to the curriculum reported for all facilitators in the second session. Overall quality of the program sessions also improved from the first (x=3.67, SD 1.37) to the second (x=4.43, SD 0.53) session. Discussion. The efficacy of facilitator training using a virtual platform was shown to result in high levels of implementation fidelity, and thus may be a viable platform for widespread national training. Virtual training provides an avenue for reaching community-based agencies that work with adolescent youth and have limited resources for training expenses. Future studies will explore the use of virtual reality for other types of inter-professional education.
Evaluation of Pain, Dyspnea, and Goals of Care Among Adults With Cystic Fibrosis: A Comprehensive Palliative Care Survey
Authors: Chen Elaine , Killeen Kathryn M. , Peterson Sarah J. , Saulitis Anna K. , Balk Robert A. 
Published: February 2016

Background: Palliative care is increasingly important in the care of adults with cystic fibrosis (CF). Symptoms such as pain and dyspnea are prevalent, yet severity may be underestimated. Little information is available to describe patient preferences for end-of-life care (EOLC). The objective of this study was to describe patient perceptions about pain, dyspnea, and advance care planning. Methods: We developed a survey to assess pain, dyspnea, and EOLC in adults with CF. Questions were compiled and adapted from existing tools. The survey was administered to all patients in a single adult CF care center. Descriptive data were compiled as counts (proportions) and median (25th and 75th percentile). Mann Whitney U test was used to determine differences between individuals who experienced pain and dyspnea. A P value of .05 was utilized to determine significance. Results: Thirty-seven of 43 surveys were returned. Twenty-four percent reported chronic pain. Patients who reported pain with airway clearance had lower lung function (predicted forced expiratory volume in 1 [FEV1] 42% vs 65%, P < .05) and body mass index (19.6 vs 22.3, P < .05) than patients without pain. Those reporting dyspnea at rest had lower median FEV1 (28% vs 61%, P < .05). Patients with lower lung function are more likely to have considered end-of-life decisions (73% vs 31%, P < .05). Conclusion: Pain and dyspnea are common among adults with CF. Few had an advance directive in place, but most are open to discussing EOLC issues. Results of this single-center study may not represent the entire population, thus a multicenter investigation should be pursued.
Rate of Malunion Following Bi-plane Chevron Medial Malleolar Osteotomy
Authors: Bull Patrick E. , Berlet Gregory C. , Canini Cameron , Hyer Christopher F. 
Published: February 2016

Background: Access to the medial half of the talus can be challenging even with an osteotomy. Although several techniques are presented in the literature, critical evaluation of fixation, union, and alignment is lacking. The chevron medial malleolar osteotomy provides advantages of perpendicular instrumentation access and wide exposure to the medial talus. Postoperative displacement resulting in malunion, and possibly provoking ankle osteoarthritis, is a known complication. The present study describes our experience with the osteotomy. Methods: A consecutive series cohort of 50 bi-plane chevron osteotomies performed from 2004 to 2013 were evaluated. Forty-six were secured using 2 lag screws, and 4 were secured using 2 lag screws and a medial buttress plate. Radiographic studies performed at 2, 6, and 12 weeks and at final follow-up were analyzed for postoperative displacement, malunion, non-union, and hardware-related complications. Results: At initial postoperative follow-up, 47 of 50 had adequate radiographs for review, and 18 of 47 (38.3%) showed some displacement when compared to the initial osteotomy fixation position. By final follow-up, 15 of 50 (30.0%) had measurable incongruence. Hardware removal was performed in 13 (26.0%) cases at an average of 2.4 years postoperation. Conclusion: Bi-plane medial malleolar chevron osteotomy fixed with 2 lag screws showed a 30.0% malunion rate with an average of 2 mm of incongruence on final follow-up radiographs, which is higher than what has been reported in the literature. In our practice, we now use a buttress plate and more recently have eliminated postoperative osteotomy displacement. Level of Evidence: Level IV, retrospective case series.
Computed Tomographic Evaluation of Joint Geometry in Patients With End-Stage Ankle Osteoarthritis
Authors: Wiewiorski Martin , Hoechel Sebastian , Anderson Andrew E. , Nowakowski Andrej M. , DeOrio James K. , Easley Mark E. , Nunley James A. , Valderrabano Victor , Barg Alexej 
Published: February 2016

Background: Deformation of the talus and the distal tibia can be frequently observed during ankle joint osteoarthritis (OA). The aim of this study was to objectify these morphologic changes. We hypothesized that a flattening of the talus and a broadening of the distal tibia surface occurs in end-stage OA of the ankle joint. Methods: Twenty-seven computed tomography (CT) ankle joint examinations of unilateral ankle OA were matched by sex and age with 27 CT examinations of healthy ankle joints. Three-dimensional reformatting and measurements were performed with geometry analysis software. The following parameters were assessed: sagittal radius of the talus, talus height, and mediolateral and anteroposterior width of the distal tibial joint surface. Results: Medial, midsagittal, and lateral sagittal arc radii of osteoarthritic tali were significantly larger compared to tali of controls. There was a statistically significant difference in the height of the osteoarthritic talar dome in the medial and in the lateral frontal segment and in the medial central segment compared to tali of controls. The anteroposterior width and the sagittal curvature of the distal tibia was significantly larger in OA ankles than in the control group. The mediolateral measurements were comparable across both groups. Conclusion: Flattening of the talus appears to be more pronounced in the frontal aspect of the talus. The distal tibia broadens anteroposteriorly. These findings may contribute to better understanding of ankle OA development. Level of Evidence: Level III, retrospective comparative cohort study.
Characterization and Surgical Management of Achilles Tendon Sleeve Avulsions
Authors: Huh Jeannie , Easley Mark E. , Nunley James A. 
Published: February 2016

Background: An Achilles sleeve avulsion occurs when the tendon ruptures distally from its calcaneal insertion as a continuous “sleeve.” This relatively rare injury pattern may not be appreciated until the time of surgery and can be challenging to treat because, unlike a midsubstance rupture, insufficient tendon remains on the calcaneus to allow for end-to-end repair, and unlike a tuberosity avulsion fracture, any bony element avulsed with the tendon is inadequate for internal fixation. This study aimed to highlight the characteristics of Achilles sleeve avulsions and present the outcomes of operative repair using suture anchor fixation. Methods: A retrospective analysis was conducted on 11 consecutive Achilles tendon sleeve avulsions (10 males, 1 female; mean age 44 years) that underwent operative repair between 2008 and 2014. Patient demographics, injury presentation, and operative details were reviewed. Postoperative outcomes were collected at a mean follow-up of 38.4 (range, 12-83.5) months, including the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score, visual analog scale (VAS) for pain, plantarflexion strength, patient satisfaction, and complications. Results: Eight patients (72.7%) had preexisting symptoms of insertional Achilles disease. Ten of 11 (90.9%) injuries were sustained during recreational athletic activity. An Achilles sleeve avulsion was recognized preoperatively in 7 of 11 (64%) cases, where lateral ankle radiographs demonstrated a small radiodensity several centimeters proximal to the calcaneal insertion. Intraoperatively, 90.9% of sleeve avulsions had a concomitant Haglund deformity and macroscopic evidence of insertional tendinopathy. All patients healed after suture anchor repair. The average AOFAS score was 92.8 and VAS score was 0.9. Ten patients (90.9%) were completely satisfied. One complication occurred, consisting of delayed wound healing. Conclusions: Achilles tendon sleeve avulsions predominantly occurred in middle-aged men with preexisting insertional disease, while engaged in athletic activity. Suture anchor fixation, combined with addressing concomitant insertional pathology, was a reliable and safe technique for the operative management of Achilles tendon sleeve avulsions. The majority of patients returned to their preinjury levels of work and recreational activity. Level of Evidence: Level IV, retrospective case series.
Change in haematological and selected biochemical parameters measured in feline blood donors and feline whole blood donated units
Authors: Spada Eva , Proverbio Daniela , Baggiani Luciana , Bagnagatti De Giorgi Giada , Ferro Elisabetta , Perego Roberto 
Published: February 2016

Objectives The quality of whole blood (WB) units is influenced by many factors, starting with selection of donors and the method of blood collection. The aim of this study was to investigate the changes that occur in haematological and selected biochemical parameters in blood transferred from a feline blood donor to feline WB unit. Methods Data from 27 feline blood donations were used in this study. Cats were anaesthetised with a combination of tiletamine and zolazepam. Blood (10 ml/kg body weight to a maximum of 60 ml/cat) was collected in citrate–phosphate–dextrose–adenine (CPDA) anticoagulant. Lactated Ringer’s solution (10 ml/kg) was administered intravenously starting halfway through the donation. Haematological and selected biochemical parameters (complete blood count, free haemoglobin, % haemolysis, glucose, sodium, potassium, pH) were measured in the blood donor before donation and in the corresponding donated WB unit soon after collection. Results Significant decreases occurred between blood donor and WB unit in red blood cells (mean difference −1.06 × 1012/l; P <0.0001), haemoglobin (mean difference −1.6 g/dl; P <0.0001), haematocrit (mean difference −4.6%; P <0.0001), red cell distribution width (mean difference −0.9%; P = 0.0003), white blood cells (mean difference −2.17 × 109/l; P <0.0001), pH (mean difference −0.5; P <0.0001) and potassium (mean difference −1.4 mmol/l; P <0.0001). Significant increases occurred between blood donor and WB unit in platelets (mean difference +87.00 ×109/l; P = 0.0039), glucose (mean difference +25.42 mmol/l; P <0.0001) and sodium (mean difference +20 mmol/l; P <0.0001). Conclusions and relevance When using a blood collection protocol with intravenous fluid administration midway through the donation and a CPDA:blood ratio of 1:7, there were significant changes in both the haematological and biochemical characteristics between the blood donors and WB units. The majority of these changes may be the result of the anticoagulants used for storage. Understanding these changes may assist selection of blood donors and help prediction of the characteristics of the donated WB unit.
MACEs Not Associated With the Use of Biologic Therapy for Psoriasis in Real-World Clinical Practice
Authors: Kim Whan B. , Qiang Judy , Yeung Jensen 
Published: February 2016

Introduction: Previous reports have shown inconsistent findings with regard to the relationship between biologic therapy and risk for major adverse cardiovascular events (MACEs). Objectives: The aim of this study was to determine the overall rate of MACEs in a cohort of 398 patients. Methods: All patients treated with biologics for psoriasis at 2 academic centers in Toronto, Ontario, between September 2005 and September 2014 were considered for inclusion. Medical records were reviewed to identify MACEs. Results: A total of 398 patients were included. The median duration of disease was 19.8 years. Median time to biologic therapy withdrawal because of an adverse event was 23.5 months. In this cohort, no MACEs were identified in patients treated with biologic therapy. Conclusions: Biologic treatment for psoriasis was not associated with increased cardiovascular risk in this cohort. These results require validation in larger studies.
Switching codes and registers: An analysis of heritage Arabic speakers’ sociolinguistic competence
Authors: Albirini Abdulkafi , Chakrani Brahim 
Published: February 2016

Aims: This study focuses on heritage speakers’ ability to use their Arabic varieties and English in the construction of narratives of personal experience. This is critical because English, Colloquial Arabic (CA), and Standard Arabic (SA) are part of the sociolinguistic reality of the families and communities in which many heritage Arabic speakers live. Design: The study compares and contrastes heritage speakers’ Arabic and English narratives with respect to codes, registers, and functions in the narratives. Data and analysis: Fifteen Arabic and 15 English narratives from five participants, fluent in Arabic and English, were analyzed qualitatively and quantitatively. Findings: The results reveal that, despite their fluency in their heritage language, respondents lack the sociolinguistic competence to socially and pragmatically deploy CA and SA appropriately in their narratives. In the Arabic narratives, respondents alternated frequently between CA and SA, but they were not always able to maintain the asymmetrical functions of CA and SA. English was used mainly as a compensation strategy, yet participants were able to integrate contextually appropriate English registers in discourse. In the English narratives, participants switched parsimoniously to Arabic for fillers and culturally specific terms and expressions. Moreover, they displayed a greater register control based on the events in their narratives. Originality: This is one of few studies focusing on the sociolinguistic competence of heritage Arabic speakers. It is the first study to examine the distribution and functions of Arabic varieties and English in personal narratives rendered in Arabic and English. Implications: The study indicates that a full understanding of heritage language acquisition requires an evaluation of the sociolinguistic aspects of language use. Heritage speakers are influenced by contextual factors and by the lack of a community of practice, elements that are key in understanding their sociolinguistic competence.
Maximizing efficiency and diagnostic accuracy triage of acute stroke patients: A case-control study
Authors: Zuckerman Scott L , Sivaganesan Ahilan , Zhang Chi , Dewan Michael C , Morone Peter J , Ganesh Kumar Nishant , Mocco J 
Published: February 2016

Background Recent data have demonstrated that mechanical thrombectomy (MT) is beneficial for patients presenting within zero to six hours of symptom onset after stroke. However, transferring all patients with possible strokes for endovascular therapy and MT would be inefficient and costly. We conducted a case-control study to identify a subset of the National Institutes of Health Stroke Scale (NIHSS) to identify patients with large-vessel occlusion (LVO) to a high degree of specificity, in order to select those patients for whom transfer is most appropriate. Methods Acute code stroke alerts presenting to a comprehensive stroke center from 2012 to 2013 (779) and corresponding NIHSS were collected. All patients had vascular imaging and 125 demonstrated LVO (cases) and were compared to 272 small-vessel strokes and stroke mimics (controls). Demographics of both groups and modified receiver operating characteristic (ROC) curves were generated for each combination of three NIHSS items to optimize specificity of LVO for those who would benefit from MT. Results The average NIHSS of cases was higher than controls (12.5 vs. 6.5, p < 0.0001). The subset of three NIHSS items with the largest modified AUC (optimized for specificity) was maximum “Arm,” “Sensory,” and “Extinction.” Using a cutoff of seven out of a total 10 possible points, the sum score for these items has 90.2% specificity and 16.0% sensitivity for LVO. Conclusion We present a validated three-question subset of the NIHSS for those who would benefit from MT with a high degree of specificity.
The importance of protection glasses during neuroangiographies: A study on radiation exposure at the lens of the primary operator
Authors: Tavares JB , Sacadura-Leite E , Matoso T , Neto LL , Biscoito L , Campos J , Sousa-Uva A 
Published: February 2016

Background In interventional neuroradiology, few operators routinely use radiation protection glasses. Moreover, in most centers, radiation dose data only accounts for whole body dose without specific information on lens dose. In 2012, the International Commission on Radiological Protection advised that the threshold limit value for the lens should be 20 mSv/year instead of the previous 150 mSv/year limit. The purpose of this study was to compare the radiation dose in the operator’s lens during real diagnostic and interventional neuroangiographies, either using or without lead protection glasses. Methods Using the Educational Direct Dosimeter (EDD30 dosimeter), accumulated radiation dose in the lens was measured in 13 neuroangiographies: seven diagnostic and six interventional. Operators with and without radiation protection glasses were included and the sensor was placed near their left eye, closest to the radiation beam. Results Without glasses, the corrected mean dose of radiation in the lens was 8.02 µSv for diagnostic procedures and 168.57 µSv for interventional procedures. Using glasses, these values were reduced to 1.74 µSv and 33.24 µSv, respectively. Conclusion Considering 20 mSv as the suggested annual limit of equivalent dose in the lens, neuroradiologists may perform up to 2,494 diagnostic procedures per year without protecting glasses, a number that increases to 11,494 when glasses are used consistently. Regarding intervention, a maximum of 119 procedures per year is advised if glasses are not used, whereas up to 602 procedures/year may be performed using this protection. Therefore, neuroradiologists should always wear radiation protection glasses.