bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clutter in Electronic Medical Records
Authors: Moacdieh Nadine , Sarter Nadine 
Published: January 2015

Objective: The objective was to use eye tracking to trace the underlying changes in attention allocation associated with the performance effects of clutter, stress, and task difficulty in visual search and noticing tasks. Background: Clutter can degrade performance in complex domains, yet more needs to be known about the associated changes in attention allocation, particularly in the presence of stress and for different tasks. Frequently used and relatively simple eye tracking metrics do not effectively capture the various effects of clutter, which is critical for comprehensively analyzing clutter and developing targeted, real-time countermeasures. Method: Electronic medical records (EMRs) were chosen as the application domain for this research. Clutter, stress, and task difficulty were manipulated, and physicians’ performance on search and noticing tasks was recorded. Several eye tracking metrics were used to trace attention allocation throughout those tasks, and subjective data were gathered via a debriefing questionnaire. Results: Clutter degraded performance in terms of response time and noticing accuracy. These decrements were largely accentuated by high stress and task difficulty. Eye tracking revealed the underlying attentional mechanisms, and several display-independent metrics were shown to be significant indicators of the effects of clutter. Conclusion: Eye tracking provides a promising means to understand in detail (offline) and prevent (in real time) major performance breakdowns due to clutter. Application: Display designers need to be aware of the risks of clutter in EMRs and other complex displays and can use the identified eye tracking metrics to evaluate and/or adjust their display.
Nystagmus Discordance with 2‐Dimensional Videonystagmography in Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo
Authors: VanDerHeyden Crystal M. , Carender Wendy J. , Heidenreich Katherine D. 
Published: January 2015

ObjectiveThe Dix‐Hallpike test is a standard component of the videonystagmography test battery and can diagnose posterior semicircular canal benign paroxysmal positional vertigo. The purpose of this study is to determine the prevalence of discordant, equivocal, and concordant nystagmus tracings in active posterior semicircular canal benign paroxysmal positional vertigo when compared directly with the eye video.Study DesignCase series with chart review of patients diagnosed with posterior semicircular canal benign paroxysmal positional vertigo by 2‐dimensional videonystagmography from August 1, 2007, to August 1, 2012.SettingA tertiary vestibular test laboratory.Subjects and MethodsNinety‐six adults (4 had bilateral involvement) with posterior semicircular canal benign paroxysmal positional vertigo were included. A total of 100 videos with accompanying videonystagmography tracings were reviewed to determine nystagmus trajectory as well as globe position. Descriptive statistics were used to describe prevalence. Fisher exact test was used to compare proportions.ResultsSixty‐two percent of cases involved benign paroxysmal positional vertigo of the right posterior semicircular canal, while 38% involved the left posterior semicircular canal. The prevalence of discordant, equivocal, and concordant tracings was 65% (65/100), 29% (29/100), and 6% (6/100). All tracing errors involved the horizontal channel. There was no association between tracing accuracy and the ear of involvement or globe position (P >. 05).ConclusionsTwo‐dimensional videonystagmography tracings are not reliable for identifying nystagmus trajectory in posterior semicircular canal benign paroxysmal positional vertigo.
Impact of Nonaspirin Nonsteroidal Anti‐inflammatory Agents and Acetaminophen on Sensorineural Hearing Loss
Authors: Kyle Meghann E. , Wang James C. , Shin Jennifer J. 
Published: January 2015

ObjectiveTo perform a systematic review evaluating the association between sensorineural hearing loss and (1) nonsteroidal anti‐inflammatory drugs (NSAIDs) as a class, (2) NSAIDs available over the counter, (3) NSAIDs in short intravenous courses, (4) prescription NSAIDs utilized by patients without systemic inflammatory conditions, (5) prescription NSAIDs in patients with arthritides, and (6) acetaminophen with and without concomitant narcotic usage.Data SourcesComputerized searches of PubMed, EMBASE, and the Cochrane Library were updated through May 2014, along with manual searches and inquiries to topic experts.Review MethodsThe systematic review was performed according to an a priori protocol. Data extraction was performed by 2 independent investigators, and it focused on relevant audiologic measurements, methodological elements related to risk of bias, and potential confounders.ResultsThe 23 criterion‐meeting studies included a total of 92,532 participants, with mixed results. Sulindac was the only specific agent to have been studied with formal audiometry in a randomized double‐blind placebo‐controlled trial in which hearing was the reported primary outcome: Although an effect was seen in the unadjusted analysis (pure tone threshold > 15 dB, 9.3% vs 2.9%; relative risk [RR], 3.2; confidence interval [CI], 1.09‐9.55; P =. 02), the effect dissipated in the adjusted analysis (P =. 09). There was a significant effect on self‐reported hearing loss from NSAIDs as a class (RR, 1.21; CI, 1.11‐1.33), ibuprofen (RR, 1.13; CI, 1.06‐1.19), and acetaminophen (RR, 1.21; CI, 1.11‐1.33), but no formal audiometric data confirm or refute this suggested effect. Audiometry has demonstrated profound loss in some instances of acetaminophen‐narcotic combination ingestions.ConclusionsData are varied regarding the impact of NSAIDs and acetaminophen on population hearing health.
Differences in the Molecular Species of CA125 Across the Phases of the Menstrual Cycle
Authors: McLemore Monica R. , Miaskowski Christine , Lee Kathryn , Chen Lee-may , Aouizerat Bradley E. 
Published: January 2015

Background: CA125, a tumor-associated antigen, is primarily used to monitor epithelial ovarian cancer. There is evidence that different species of CA125 exist; however, it is not known if any of these species are present in healthy women during the menstrual cycle and if they are associated with serum concentrations of CA125. The purpose of this study was to determine if the molecular species of CA125 differ across the three phases of the menstrual cycle in healthy women. Methods: Healthy, Caucasian women between the ages of 18 and 39 were enrolled using strict criteria to exclude factors known to contribute to CA125 fluctuations. Menstrual cycle regularity was determined using calendars maintained by participants for 3 months. After cycle regularity was established, blood was drawn at three time points for Western blot analysis. Results: Western blot analysis yielded 17 distinct profiles (i.e., patterns of species) of CA125, with 80% of the sample exhibiting 5 common profiles. No differences in demographic characteristics and serum CA125 values were found among the various CA125 profiles. Conclusions: Different molecular species of CA125 exist in healthy women with regular menstrual cycles. These data provide evidence that CA125 is not a homogeneous molecular species. Future research should evaluate the molecular composition and the clinical importance of these species.
The ghost of Nora Batty: A qualitative exploration of the impact of footwear, bandaging and hosiery interventions in chronic wound care
Authors: Madden Mary 
Published: January 2015

Objective To explore the impact of footwear, bandaging and hosiery interventions in the everyday lives of women and men undergoing treatment for chronic, complex wounds in a city in England, UK. Methods This study draws on data generated in semi-structured interviews with patients exploring outcomes and impacts of undergoing treatment for leg and foot ulcers undertaken as part of a UK National Institute for Health Research funded study. Footwear, bandaging and hosiery are explored here as aspects of material culture, not only in functional terms as a treatment supporting or hindering healing but also as part of the means by which people receiving treatment for two of the most common complex, chronic wounds, leg ulcers and foot ulcers, negotiate and understand their embodied selves in everyday life. Findings Physical and social discomfort associated with interventions can lead to ambivalence about effectiveness. Not being able to dress appropriately impacts on the ability of people to feel comfortable and take part in special occasions and everyday events. In this context, the removal of bandaging or refusal to wear support hosiery which may be viewed as ‘non-compliance’ by a health professional may feel like a strategy of self-care or self-preservation from a patient perspective. Discussion The study of material culture explores how inanimate objects work and how they are worked with in carrying out social functions, regulating social relations and giving symbolic meaning to human activity. The interviews show some of the ways in which footwear, hosiery and bandaging play a role in controlling the boundaries between the private (wounded and potentially socially unacceptable smelly, leaky, embodied), self and the public presentation of self.
Chronic aortic root pressure-loading assessment model
Authors: Rakow Nancy , Barka Noah , Gerhart Renee , Grassl Erin , Green Michael , Rothstein Paul , Schu Carl , Kopcak Michael , Shecterle Linda M. , St.Cyr John A. 
Published: January 2015

Purpose: Percutaneous placement of transcatheter prosthetic aortic valves without cardiopulmonary bypass (CPB) continues to gain clinical acceptance. However, information on pressure-loading characteristics of the aortic root/annular areas is limited. For this reason, we designed a preclinical model, implanting an aortic root load transducer with a power source/telemetry system for chronic, conscious, loading data acquisition. This research study was conducted to determine whether an animal model could accurately measure in vivo loading. Methods: Preoperatively, echocardiography and magnetic resonance imaging were used to determine both aortic annular and sinotubular junction dimensions, as well as ascending aortic length. Six adult sheep were placed on CPB, aortic root and ascending aorta were skeletonized and the origins of both coronary ostia were identified. Cardiac arrest with myocardial protection with cold coronary blood cardioplegia was instituted. A properly sized aortic root load-sensing device, consisting of a transcatheter aortic valve with a ring load transducer was implanted via a left apical ventriculotomy. Verification of position was determined before closure of the ventriculotomy. Each animal was weaned from CPB, and closed in routine fashion with the power source of the device placed in a subcutaneous pocket. Results: There were no operative deaths or significant postoperative complications. Serial pressure-load sensing assessments in a conscious state produced reproducible proprietary data. Conclusions: This animal model allowed successful serial pressure-load sensing assessment of the aortic root/annular areas, providing a better physiological understanding of these anatomical inter-relationships. This added information could aid in future device designs with potential improved clinical outcomes.
Angiotensin II receptor blockade and skeletal muscle metabolism in overweight and obese adults with elevated blood pressure
Authors: Boutagy Nabil E. , Marinik Elaina L. , McMillan Ryan P. , Anderson Angela S. , Frisard Madlyn I. , Davy Brenda M. , Rivero Jose M. , Davy Kevin P. , Hulver Matthew W. 
Published: January 2015

Objectives: Whether angiotensin II receptor blockade improves skeletal muscle fatty acid oxidation in overweight and obese humans is unknown. The purpose of the study was to test the hypothesis that the angiotensin II receptor blocker, olmesartan, would increase fatty acid oxidation and the activity of enzymes associated with oxidative metabolism in skeletal muscle of overweight and obese humans. Methods: A total of 12 individuals (6 men and 6 women) aged 18–75 and with a body mass index ⩾25 kg/m2 were assigned to olmesartan or placebo for 8 weeks in a crossover fashion. Fatty acid oxidation was measured before and after each intervention by counting the 14CO2 produced from [1-14C] palmitic acid in skeletal muscle homogenates. Results: Fatty acid oxidation was not significantly different between treatment periods at baseline and post intervention. In addition, the enzyme activities of citrate synthase and β-hydroxyacyl-coenzyme A dehydrogenase in skeletal muscle homogenates did not differ between treatment periods at baseline or post intervention. Conclusions: Treatment with olmesartan for 8 weeks does not improve fatty acid oxidation or the activity of enzymes associated with oxidative metabolism in skeletal muscle from overweight and obese individuals. Taken together, our results indicate that improvements in skeletal muscle metabolism are not among the additional benefits of olmesartan that extend beyond blood pressure reduction.
Ankle Arthrodesis After Failed Total Ankle Replacement
Authors: Gross Christopher , Erickson Brandon J. , Adams Samuel B. , Parekh Selene G. 
Published: January 2015

Purpose: As the number of total ankle replacements (TARs) performed has risen, so has the need for revision. The purpose of this investigation was to perform a systematic review of clinical outcomes following a salvage ankle arthrodesis from a failed TAR to identify patient- and technique-specific prognostic factors and to determine the clinical outcomes and complications following an ankle arthrodesis for a failed TAR. Methods: We searched PubMed, Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for studies that analyzed ankle fusion after failed TAR with a minimum follow-up of 1 year. Results: We included 16 studies (193 patients). The majority of patients (41%) underwent the index TAR for rheumatoid arthritis. The majority of these revision surgeries were secondary to component loosening, frequently of the talar component (38%). In the cases that were revised to an ankle arthrodesis, 81% fused after their first arthrodesis procedure. The intercalary bone graft group and the blade plate group had the highest rate of fusion after the first attempt at fusion at 100%, whereas the tibiotalocalcaneal fusion with cage group had the lowest fusion rate at 50%. The overall complication rate was 18.2%, whereas the overall nonunion rate was 10.6%. Conclusion: A salvage ankle arthrodesis for a failed TAR results in favorable clinical end points and overall satisfaction at short-term follow-up if the patients achieve fusion. The bone graft fusion and blade plate group resulted in the highest first-attempt fusion rate, with a low complication rate. Future studies should include prospective, comparative control or surgical groups and use standardized outcome measurements that will make direct comparisons easier. Levels: Level IV: Systematic Review of Level IV Studies
Trends in Anterior Cruciate Ligament Reconstruction in the United States
Authors: Buller Leonard T. , Best Matthew J. , Baraga Michael G. , Kaplan Lee D. 
Published: January 2015

Background: The anterior cruciate ligament (ACL) is the most frequently injured ligament in the knee for which surgery is performed. United States national estimates of ACL reconstruction vary widely. Purpose: This study sought to use the most recently available Centers for Disease Control and Prevention data to investigate changes in the utilization of inpatient and ambulatory surgery for ACL tears in the United States. Study Design: Descriptive epidemiology study. Methods: The National Survey of Ambulatory Surgery, conducted in 1994, 1995, 1996, and 2006 (data from 1994, 1996, and 2006 were used in the study), and the National Hospital Discharge Survey, conducted between 1990 and 2007, were used to identify cases of ACL reconstruction. The data were analyzed for trends in demographics, treatment, and utilization. Results: Between 1994 and 2006, the population-adjusted estimate of the rate of ACL reconstructions increased by 37% (33.0/100,000 capita or 86,837 total procedures to 45.1/100,000 capita or 134,421 total procedures). There was an increase in the proportion of females undergoing reconstruction in both the ambulatory (30% to 40%) and inpatient (29% to 47%) settings over the study period, with a 304% increase in the sex-adjusted estimate of the rate of female ambulatory procedures between 1994 and 2006. Age-adjusted estimates of the rates of ambulatory ACL reconstruction increased among all age groups, with a 924% increase in patients less than 15 years of age. Concurrent meniscectomy remained relatively constant in the ambulatory (37% to 40%) and inpatient (37% to 33%) settings between 1994 and 2007. Private insurance was the largest compensator, representing 77% of cases in 2006. Between 1994 and 2006, the use of peripheral nerve blocks during ambulatory surgery increased from 0.7% to 30.8%. Conclusion: The rate of ACL reconstruction increased dramatically between 1990 and 2007 based on the National Survey of Ambulatory Surgery and National Hospital Discharge Survey databases, which represents the most up-to-date publicly available data. Knowledge of this increase and national practice patterns may aid policy makers and surgeons in appropriately allocating health care resources to ensure quality patient care.
Anterior Cruciate Ligament Reconstruction
Authors: Arcuri Francisco , Barclay Fernando , Nacul Ivan 
Published: January 2015

Introduction: The most recent advances in ACL reconstruction try to reproduce the anatomic femoral and tibial footprints as close as possible. Creating independent tunnels would allow an optimal of the entry point and the femoral tunnel obliquity, and together with an adequate reamer diameter they wouldreproduce with greater certainty the anatomy. Objective: To compare the radiographic parameters of the femoral and tibial tunnel positions in two groups of patients, one operated with a transtibial and other with transportal anatomic techniques. Materials and Methods: From December 2012 to December 2013, 59 patients with a primary ACL reconstruction divided in two groups, a trans tibial technique (TT), 19 patients, and an transportal one (TP) with 40 patients were prospectively evaluated with AP and lateral X-rays. The femoral tunnel angle, the insertion site with respect of the Blumensaat line, the trans osseous distance, the tibial tunnel position as a percentage of the tibial plateau in the AP and lateral views. And finally the tibial tunnel angle in the AP and Lateral views. Results: The femoral tunnel angle was in the TP group of 45,92º and in the TT one 24,53º, p 0,002. The insertion site percentage of the Blumensaat line was of 20,96 in TP and 20,74 in the TT, p 0,681.Trans osseous distance was in the TP of 3,43 cm and in the TT of 4,79 cm, p <0,000. The tibial tunnel position as a percentage in the AP tibial plateau was of 44,35 in TP and of 40,80 TT with a p of 0,076. The tibial tunnel position as a percentage of the lateral tibial plateau was of 28,70 in TP and 34,53 in TT with a p 0,367. Tibial tunnel angle in the AP was of 73,48º in TP and 62,81 in TT with a p of 0,002, and in the lateral plateau of 114,69º in TP and 112,79º in TT with a p of 0,427. Conclusion: It is possible to create tibial and femoral tunnel in optimal positions but not equal between both groups. Creating independent tunnels allow a more anterior and vertical tibial tunnel allowing a better coverage of the tibial footprint. A transportal femoral tunnel would allow a better inclination angle and a lesser trans-osseous distance, technical details that would allow a better coverage of the femoral footprint.
High Tibial Valgus Osteotomy and Concomitant Anterior Cruciate Ligament Reconstruction. Which is the most appropriate surgical technique?
Authors: Paz Matías Costa , Deré Juan José , Yacuzzi Carlos Heraldo 
Published: January 2015

Introduction: The aim of this study is to evaluate advantages of close vs. open HTO of a group of patients who underwent a one-stage combined operation for chronic ACL rupture and early medial compartment arthritis. Material and Methods: We retrospective evaluated two series of patients operated on for anterior cruciate ligament (ACL) reconstruction combined with high tibial valgus osteotomy (HTO) for chronic anterior knee instability associated with medial tibio femoral osteoarthritis. Close HTO using rigid plate fixation and ACL reconstruction with bone patellar tendon bone graft was performed in Group A (7 patients). An open HTO using Puddu plate and ACL reconstruction with hamstring tendon graft was performed in Group B (9 patients). The mean age in Group A was 41 years old with an average varus of 8 degrees. Mean age in Group B was 42 years old and with 4 degrees of varus. Lysholm Score, HSS and Radiographs were performed. Results: Group A obtained a mean Lysholm score of 94, mean HSS of 91. Group B showed a mean Lysholm score of 83, mean HSS of 87. The mean follow-up was 5 years in both groups. In all cases osteotomies consolidated. Discussion: Technically we found that open HTO with hamstrings had several advantages such as lower risk of peroneal nerve injury, use of one incision, no problems as regards graft length, possibility of fixing the graft in the proximal tibia, maintenance of tibial slope and preservation of bone stock. The Open HTO need of osseous graft, may produce patella baja and the risk of nonunion is higher. This technique is indicated for relaxed medial collateral ligament. As regards the Close HTO there may be possibilities of a peroneal nerve injury, it may decrease the tibial slope, patellar ascent, loss of bone, the need to disrupt either the fibula or proximal tibio-fibular joint and may generate instability in the posterolateral corner and the screws could compromise the tunnels path. The advantages are provision of bone to bone contact with excellent union rates and the potential for full early weight-bearing. Conclusion: In spite of these issues, both procedures relieved pain and restored knee stability and the choice will depend on each particular case.
ISAKOS Classification of Meniscal Tears. Intra and Interobserver Reliability.
Authors: Fresneda Mariano J. , Dere Juan J. , Yacuzzi Carlos H. , Paz Matías Costa 
Published: January 2015

Objectives: To analyze the intra and interobserverreliability of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification of meniscal tears. Methods: Thearthroscopic classification of meniscal lesions created by the ISAKOS was used. Thirty one arthroscopic videos, made between June and December 2013,with different meniscal tear characteristics were analyzedby three orthopedic surgeons (two specialists in knee surgery and a fellowship), twice at an interval of 30 days. The Kappa Coefficients (k) was used to assess the intraobserver reliability and intraclass correlation coefficient (ICC) for interobserverreliability. Results: The averageintraobserver reliability was for the first observer 51%, the second 65% and the third 58%, reaching moderate agreement according to the Kappa coefficient used by Landis and Koch. Regarding interobserver reliability, good agreement (ICC = 0.71) was obtained as the intraclass correlation coefficient. The whole results were significantlystatical (p <0.05). Conclusion: While this classification provides a detailed description of meniscal lesions, the intraobserver reliability did not reach the optimum values obtained despite having on average a moderate agreement. However interobserver reliability results showed on average 70% of agreement (good agreement), which can affirm that the agreement and interobserver reliability is acceptable.