bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcutaneous electrical nerve stimulation improves walking capacity and reduces spasticity in stroke survivors: a systematic review and meta-analysis
Authors: Kwong Patrick WH , Ng Gabriel YF , Chung Raymond CK , Ng Shamay SM 
Published: December 2017

Objective: To evaluate (1) the effectiveness of transcutaneous electrical nerve stimulation (TENS) at improving lower extremity motor recovery in stroke survivors and (2) the optimal stimulation parameters for TENS. Review methods: A systematic search was conducted for studies published up to October 2017 using eight electronic databases (CINAHL, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, PEDro, PubMed and Web of Science). Randomized controlled trials that evaluated the effectiveness of the application of TENS at improving lower extremity motor recovery in stroke survivors were assessed for inclusion. Outcomes of interest included plantar flexor spasticity, muscle strength, walking capacity and balance. Results: In all, 11 studies met the inclusion criteria which involved 439 stroke survivors. The meta-analysis showed that TENS improved walking capacity, as measured by either gait speed or the Timed Up and Go Test (Hedges’ g = 0.392; 95% confidence interval (CI) = 0.178 to 0.606) compared to the placebo or no-treatment control groups. TENS also reduced paretic plantar flexor spasticity, as measured using the Modified Ashworth Scale and Composite Spasticity Scale (Hedges’ g = –0.884; 95% CI = –1.140 to −0.625). The effect of TENS on walking capacity in studies involving 60 minutes per sessions was significant (Hedges’ g = 0.468; 95% CI = 0.201–0.734) but not in study with shorter sessions (20 or 30 minutes) (Hedges’ g = 0.254; 95% CI = –0.106–0.614). Conclusion: The results support the use of repeated applications of TENS as an adjunct therapy for improving walking capacity and reducing spasticity in stroke survivors.
Programming Serious Games as a Master Course: Feasible or Not?
Authors: Xinogalos Stelios 
Published: December 2017

Background. Higher education on simulation & gaming has a long history with several master degrees offered by Universities worldwide. Currently, the popularity of Serious Games (SGs) has resulted in an increased interest on relevant master degrees. Despite the large number of master degrees on games in general, the literature on designing and evaluating relevant courses in higher education is rather limited. Aim. This article aims at contributing on the field of SGs higher education by reporting on the design and evaluation of a graduate course on ‘SGs Programming’. The course aims at providing students a holistic overview of SGs design, development and evaluation in a single course offered at a master degree that is not dedicated to simulation & gaming. The main goal of the pilot study presented was to investigate whether the proposed course can fulfill its objectives, as well as to draw conclusions on the design and deployment of the course that would be of interest to educators in the field of SGs. Method. In order to evaluate the course in terms of students’ satisfaction and outcomes a specially designed questionnaire was filled in and analyzed, along with students’ performance in their artifacts and final exams. Results. The results of the questionnaire combined with students’ performance show that the course fulfilled its goals in a high degree. Conclusions. Teaching SGs design and programming in a single master course is feasible by applying an iterative, project-based and microworld approach, utilizing both educational and professional tools and programming languages.
Effect of CT on Management Plan in Malleolar Ankle Fractures
Authors: Kumar Ashwani , Mishra Puneet , Tandon Anupama , Arora Rajesh , Chadha Manish 
Published: December 2017

Background: Conventionally ankle fractures have been classified using plain radiographs. Because of complex 3-dimensional anatomy and complexity of injuries, plain radiographs may not always be able to clearly depict the complete fracture pattern. There is a paucity of studies regarding the utility of computed tomography (CT) scanning in malleolar ankle fractures (MAFs). Hence, we conducted this study to further understand the role of the CT scan in MAFs. Methods: A prospective study of 56 consecutive malleolar ankle fractures was conducted. In the first evaluation by a team of 3 observers, a management plan was made based on plain radiographs. All patients received a CT scan evaluation with a standard protocol. The second evaluation by the same team included formulating an operative plan based on the CT. Results: In 13 (23.2%) cases, the management plan changed after CT evaluation. In most of the cases, the change in the management plan included an alteration in fixation of the posterior malleolus followed by lateral malleolus in 4 cases. Most of the changes took place in AO 44 type C followed by types B and A. Maximum change was noted in trimalleolar fractures followed by bimalleolar and unimalleolar. The most common morphological characteristic fracture identified on CT scan that was not evident on plain radiography was Chaput fracture in 17 cases. Conclusion: CT scan evaluation of MAFs changed the management plan in a significant number of cases, especially if the fractured fragment included a posterior malleolus, AO type C, and/or if 2 or more malleoli were fractured as noted on plain x rays. Level of Evidence: Level IV, case series.
The design and development of MyT1DHero: A mobile app for adolescents with type 1 diabetes and their parents
Authors: Holtz Bree E , Murray Katharine M , Hershey Denise D , Richman Joshua , Dunneback Julie K , Vyas Arpita , Wood Michael A 
Published: December 2017

Introduction Type 1 diabetes impacts approximately 1.25 m Americans, many of them young children. As a child grows, there is a transition towards independence and they must learn to manage their diabetes independently. The objective of this study was to design, develop and conduct a prototype test to assess the satisfaction and feasibility of a mobile app for adolescents with type 1 diabetes and their parents to aid in this transition. Methods Ten parent/adolescent groups used MyT1DHero for four weeks. They were given a pre-test/post-test survey regarding family conflict with three tasks of diabetes management and the general tone of family communication. At post-test they were asked questions regarding their satisfaction and perception of ease of use of the app. They also participated in short interviews regarding the app. Additionally, we used server data to examine actual app usage. Results The parents’ perceptions of conflict around the results of the blood sugar tests increased ( t(9) = 2.71, p = .02) as did perceptions of conflict around logging the blood sugar results ( t(9) = 3.67, p = .005). The adolescents perceived increased conflict surrounding the results around logging the blood sugars results ( t(9) = 3.09, p = .01).There was no change in the tone of general family communication. During the prototype testing, we discovered that the app crashed repeatedly and several of the functions were not working properly. In the interview data, three main themes emerged, app-crashing issues, problems with notifications and positive feedback. Discussion Through this process, all of the reported issues were corrected and new features were planned for subsequent versions. A smartphone application has the potential to be a novel intervention for engaging adolescents and their parents in positive communication to support type 1 diabetes management.
Comparison of open surgery and endovascular procedures as a therapeutic choice for visceral artery aneurysms
Authors: Song Chao , Dong Jian , Yu Guanyu , Zhou Jian , Xiang Feng , Pei Yifei , Lu Qingsheng , Jing Zaiping 
Published: December 2017

Objectives Visceral arterial aneurysms may be treated using open surgery or endovascular repair, but the best approach remains controversial. This was a retrospective study aiming to compare open surgery and endovascular treatment strategies for visceral arterial aneurysms. Methods The study included all 93 patients who were admitted with visceral artery aneurysms between January 2001 and January 2011 at the Department of Vascular Surgery, Changhai Hospital, Shanghai, China. All cases underwent either open or endovascular procedures. Overall survival and adverse events were compared between the groups. Success rate, blood loss, length of surgery, and length of hospital stay were also compared. The patients were followed up at three, six, and 12 months then every year until April 2014. Results Open surgery was performed on 34 patients and endovascular procedures on 59. There were no differences in characteristics of the patients between the open surgery and endovascular groups. The perioperative complication rate was 52.9 and 13.6% in the open surgery and endovascular groups, respectively. Mean follow-up was 36.8 months (range: 11 months to 10 years). The one- and five-year survival rates were 100 and 60.6%, respectively, in the open surgery group, compared to 100 and 84.5% in the endovascular group. Multivariate analysis for factors related to overall survival showed that there was a significant relationship with the treatment approach (HR = 0.479, 95%CI: 0.278–0.825; P = 0.008) and the presence of false aneurysm (HR = 2.929, 95%CI: 1.388–6.180, P = 0.005). Conclusions Endovascular repair could be considered as an effective method for visceral artery aneurysm. Endovascular repair showed lower perioperative complication rates and better long-term survival.
Dealing with the Media
Authors: Pirie Susan 
Published: December 2017

Dear AfPP We have recently had an incident where members of the press contacted theatres directly requesting information relating to a high profile patient who was undergoing emergency surgery. As the incident happened at night when there was minimal staff throughout the whole hospital, we were unable to access the usual resources for dealing with press enquiries. The incident has created discussion among staff as to how a similar incident should be dealt with in future, and also in relation to professional codes of conduct and patient confidentiality. We are also aware that one of our consultant surgeons wishes to involve the media in filming an operative procedure and we are concerned about this proposal. Can AfPP advise on these issues? Anxious from Aberdeen
Surgical Management of Fractured Neck of Femur
Authors: Malik Atif A. , Kell Peter , Khan Wasim S. , Ihsan Khan M. H. , Dunkow Paul 
Published: December 2017

The fractured neck of femur is the classically described fracture in osteoporotic elderly patients. Further, the fracture has a strong predominance in post-menopausal women and, although relatively uncommon in both children and young adults, where present in this age group it is usually the result of significant trauma. In elderly patients, with an already weakened bone, even minimal trauma may be sufficient to cause fracture and as such a fractured neck of femur is often referred to as a fragility fracture.
Anaesthetic Medicines: Back to Basics
Authors: Cox Felicia , Bhudia Nisha 
Published: December 2017

Anaesthesia has developed since the first description of curare. Today there are a myriad of anaesthetic and analgesic medicines available. This article explores the function of medicines in a patient ' s perioperative journey and describes how pharmacokinetics and pharmacodynamics play such a large role. The different routes of administration are described and the main categories of anaesthetic medicines outlined. The characteristics and precautions associated with the different classes of medicines are highlighted. NB Unless otherwise indicated all information related to a medicine ' s dose, pharmacokinetics and pharmacodynamics have been sourced from the Special Product Characteristics (SPC) of individual medicines available from the electronic Medicines Compendium at www.medicines.org.uk .
The Obese Patient. Anaesthetic Issues: Airway and Positioning
Authors: Bale Emma , Berrecloth Richard 
Published: December 2017

The authors have combined experience of over forty years working within the NHS and private hospitals as registered operating department practitioners. It is widely accepted that obesity is a growing problem in the populations of all developed and, increasingly, developing countries. It is also agreed that this sector of the population present specific challenges when required to undergo general anaesthesia. What is not so evident is a universal approach to assessing, predicting and overcoming these challenges. Furthermore, where there is the presentation of a clearly high risk patient, there can be limitations in optimizing the environment for reasons such as saving time, a lack of resources or sheer apathy. This article reviews the challenges, assessment and solutions available to the clinician faced with a high BMI patient with particular reference to the technique of ramping.
Inadvertent Perioperative Hypothermia: A Literature Review
Authors: Knaepel Abigail 
Published: December 2017

Up to 70% of surgical patients develop hypothermia perioperatively. Inadvertent hypothermia can be caused by a cold operating theatre, anaesthetic effects, exposure to the environment and administration of cold intravenous or irrigation fluids. The adverse effects of unplanned hypothermia include increased blood loss, morbid cardiac events, impaired wound healing and increased mortality. Preventing unplanned hypothermia increases patient comfort and prevents associated complications. It can be achieved by simple preventative measures (Burger &Fitzpatrick 2009, Lynch et al 2010).
The Rapid Sequence Spinal for Category 1 Caesarean Section: Anaesthetic Trainee Knowledge and Practice
Authors: Jigajinni Sv , Rajala B , Sharawi N El 
Published: December 2017

Rapid sequence induction of general anaesthesia (GA) is the fastest anaesthetic technique in a category-1 caesarean section (C1CS) for foetal distress. Recently rapid sequence spinal anaesthesia (RSS) has been explored as a technique to avoid the potential risks of GA in such cases. Out of hours, trainee anaesthetists are often required to provide anaesthesia for these emergencies. We surveyed their practices when performing a RSS. The aim of a RSS is to rapidly and safely achieve anaesthesia for C1CS, while optimising foetal oxygenation and preparing for possible GA. It requires anaesthetic skill, team work and communication. Many trainees understood the principles of the RSS, however, a significant number did not. Practice varied widely and no trainee had received any formal RSS training. Training for junior anaesthetists and those working in obstetric theatres, in the conduct of the RSS is crucial, to ensure safe practice, avoid delays in delivery and safely avoid the risks associated with GA in the C1CS.
Neurosurgical versus Endovascular Treatment of Subarachnoid Haemorrhage Caused by Ruptured Cerebral Aneurysm: Comparison of Patient Outcomes
Authors: Kamensky J 
Published: December 2017

The aim of this critical review is to determine whether endovascular treatment (EVT) of a subarachnoid haemorrhage (SAH) has better patient outcomes than neurosurgical treatment (NST). A review of six cohort studies (listed in Table 1) was carried out and the main findings were summarised in the conclusion. In addition the list of author's recommendations is included at the end of the paper. Theatre practitioners involved in neurosurgery might find this review useful in enhancing their understanding of how SAH is currently treated. It could also bring some insights about the reasons why a particular modality of the treatment was chosen for their patient.
Sexual health knowledge and practices and STI/HIV prevalence among long-distance truck drivers in Peru
Authors: García Patricía J , Fazio Boris , Bayer Angela M , Lizarraga Aldo G , Chiappe Marina , La Rosa Sayda , Lazo Marcela , López Lorena , Valderrama María , Cárcamo César P 
Published: December 2017

Objectives: HIV and other sexually transmitted infections remain a challenge globally and many key groups have yet to be studied. Evidence shows that truck drivers may have high-risk behaviors and higher sexually transmitted infection/HIV prevalence because they are a highly mobile population. However, there is little to no information on this group in Peru. Therefore, we explored the sexual health knowledge and practices and carried out sexually transmitted infection/HIV testing among male truck drivers and their assistants in Peru. Methods: We conducted a cross-sectional study utilizing cell phone-based behavioral surveys and sexually transmitted infection testing, including HIV, syphilis, gonorrhea, and chlamydia, with truck drivers and their assistants who were traveling on two major international highways in Peru. Results: A total of 1150 truck drivers and assistants participated. Participants were middle-aged men (average age = 39.8 years), 96.0% had complete secondary education, 78.4% were in stable relationships, and 88.7% earned more than minimum wage. The majority were aware of sexually transmitted infections/HIV, but very few recognized sexually transmitted infection symptoms. Few participants (under 5%) reported recent sexually transmitted infection symptoms. Prevalence of sexually transmitted infections was also low: no one had gonorrhea; 0.1% had HIV; 0.4% had recent syphilis infection (rapid plasma reagin ≥1:8); and 2.0% had chlamydia. The prevalence of these diseases is not different from that of the general population in Peru. Conclusion: When compared to other truck drivers worldwide, Peruvian truck drivers appear to have a lower risk of HIV/sexually transmitted infections. This may be since Peruvian drivers are older, more educated, have higher income, and spend fewer days away from home than their peers globally.
Comparative study of surgical and conservative treatments for fifth metatarsal base avulsion fractures (type I) in young adults or athletes
Authors: Wu Gen-Bin , Li Bing , Yang Yun-Feng 
Published: December 2017

Purpose: This study aimed to investigate the therapeutic effects and complications of minimally invasive surgery in treating displaced avulsion fractures (2–3 mm) of fifth metatarsal base zone I in young adults or athletes. Methods: Forty-six patients with displaced fifth metatarsal base avulsion fractures were assigned to operative and nonoperative groups by randomization. Patients in nonoperative group were immobilized with plaster, while patients in operative group were treated with closed reduction and fixation with a percutaneous screw. Results: All patients were followed up for 14 months on average (ranging from 12 to 24 months). All cases got primary union except for three patients in nonoperative group with malunion and two with frequent mild to moderate plantar pain. The American Orthopaedic Foot and Ankle Society score was significantly better in operative group at 6 months after treatment ( p < 0.05) but not significantly different at 12 months after treatment ( p > 0.05). The average time of full weight bearing and returning to work was significantly shorter in operative group than nonoperative group ( p < 0.05). Conclusion: In young adults or athletes with displaced avulsion fractures of fifth metatarsal base zone I, closed reduction and percutaneous screw fixation provides anatomical stable fixation and early mobilization.
楚简中“犀”字新释读*
Authors: 顾史考  
Published: December 2017

摘要 在上海博物馆藏战国楚竹书、清华大学藏战国竹简等楚国竹书中，数次出现一个隶定为“𡰥”之字，亦即相当于古字书所谓的古文“夷”字，或乃谓即古文“仁”字。楚简中，此字一般可以读为“夷”、“鸤”、“迟”等被归为脂部之字，或即可以视为“犀”字之省。然笔者认为在某些文例当中，此一“犀”省之字或可读为之部的“哉”或“载”，而本文乃从声韵学及文例对比的角度去探索此种可能，看其是否存有足以立说的依据。
关于普宁藏本《密咒圆因往生集》的一处八思巴字拼写
Authors: 宋洪民  
Published: December 2017

摘要 普宁藏本《密咒圆因往生集》的八思巴字拼写中“垢”字作 gow，与拼写范本《蒙古字韵》不符，后者作ghiw。尽管 gow 的形式在表音上更准确，但却不符合系统的要求。于是乎就造成了被视作拼写范本的《蒙古字韵》中“垢”拼作 ghiw 成为通行规范形式，而 gow 的拼写形式则只能视作仅此一见的一个例外。
In Vitro Evaluation of a Novel Image Processing Device to Estimate Surgical Blood Loss in Suction Canisters
Authors: Konig Gerhardt , Waters Jonathan H. , Hsieh Eric , Philip Bridget , Ting Vicki , Abbi Gaurav , Javidroozi Mazyar , Tully Griffeth W. , Adams Gregg 
Published: December 2017

BACKGROUND:
Clinicians are tasked with monitoring surgical blood loss. Unfortunately, there is no reliable method available to assure an accurate result. Most blood lost during surgery ends up on surgical sponges and within suction canisters. A novel Food and Drug Administration–cleared device (Triton system; Gauss Surgical, Inc, Los Altos, CA) to measure the amount of blood present on sponges using computer image analysis has been previously described. This study reports on performance of a complementary Food and Drug Administration–cleared device (Triton Canister System; Gauss Surgical, Inc, Los Altos, CA) that uses similar image analysis to measure the amount of blood in suction canisters.

METHODS:
Known quantities of expired donated whole blood, packed red blood cells, and plasma, in conjunction with various amounts of normal saline, were used to create 207 samples representing a wide range of blood dilutions commonly seen in suction canisters. Each sample was measured by the Triton device under 3 operating room lighting conditions (bright, medium, and dark) meant to represent a reasonable range, resulting in a total of 621 measurements. Using the Bland–Altman method, the measured hemoglobin (Hb) mass in each sample was compared to the results obtained using a standard laboratory assay as a reference value. The analysis was performed separately for samples measured under each lighting condition. It was expected that under each separate lighting condition, the device would measure the various samples within a prespecified clinically significant Hb mass range (±30 g per canister).

RESULTS:
The limits of agreement (LOA) between the device and the reference method for dark (bias: 4.7 g [95% confidence interval {CI}, 3.8–5.6 g]; LOA: −8.1 g [95% CI, −9.7 to −6.6 g] to 17.6 g [95% CI, 16.0–19.1 g]), medium (bias: 3.4 g [95% CI, 2.6–4.1 g]; LOA: −7.4 g [95% CI, −8.7 to −6.1 g] to 14.2 g [95% CI, 12.9–15.5 g]), and bright lighting conditions (bias: 4.1 g [95% CI, 3.2–4.9 g]; LOA: −7.6 g [95% CI, −9.0 to −6.2 g] to 15.7 g [95% CI, 14.3–17.1 g]) fell well within the predetermined clinically significant limits of ±30 g. Repeated measurements of the samples under the various lighting conditions were highly correlated with intraclass correlation coefficient of 0.995 (95% CI, 0.993–0.996; P < .001), showing that lighting conditions did not have a significant impact on measurements. Hb mass bias was significantly associated with hemolysis level (Spearman ρ correlation coefficient, −0.137; P = .001) and total canister volume (Spearman ρ correlation coefficient, 0.135; P = .001), but not ambient illuminance.

CONCLUSIONS:
The Triton Canister System was able to measure the Hb mass reliably with clinically acceptable accuracy in reconstituted blood samples representing a wide range of Hb concentrations, dilutions, hemolysis, and ambient lighting settings.