bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of contralateral versus ipsilateral electroacupuncture for analgesia and rehabilitation after unilateral total knee arthroplasty: a randomized controlled trial
Authors: Huang Hai , Tang Kangmin , Song Xiuling , Zhao Ling , Liang Yongying , Xu Hui , Xiao Lianbo , Chen Yuelai 
Published: December 2023

Purpose: Total knee arthroplasty (TKA) is a treatment for advanced knee osteoarthritis. Since postoperative pain affects rehabilitation, this study aimed to determine whether electroacupuncture (EA) contralateral to the surgical site is more effective than ipsilateral EA or sham EA in terms of relieving postoperative pain and promoting post-TKA rehabilitation. Methods: In this parallel, single-blind randomized controlled trial, 114 patients undergoing unilateral TKA were assigned to the contralateral EA (EA on the contralateral side + sham EA on the ipsilateral), ipsilateral EA (EA on the ipsilateral + sham EA on the contralateral side), or sham EA (sham EA on both sides) groups (n = 38 each). Treatment was performed once daily on postoperative days 1–3. The visual analog scale (VAS) scores, additional opioid doses via patient-controlled analgesia (PCA) pump, Hospital for Special Surgery (HSS) knee scores, active/passive range of motion (AROM/PROM), swelling around the knee joint, and Hamilton anxiety scale (HAMA) scores were used for postoperative evaluation. Results: At 3 days postoperatively, the VAS scores, HSS scores, AROM/PROM, swelling around the knee, and HAMA scores in the contralateral EA and ipsilateral EA groups were significantly improved compared with baseline. In addition, VAS scores, HSS scores, PROM and swelling around the knee were significantly better in the contralateral and ipsilateral EA groups than in the sham EA group, but similar in the two true EA groups. Furthermore, PCA additional dose release was significantly higher in the sham EA group than in the two true EA groups (which did not significantly differ). At 10 days postoperatively, the HSS scores, AROM/PROM, and HAMA scores were better in the contralateral and ipsilateral EA groups than in the sham EA group, but similar in the two true EA groups. Conclusion: Contralateral EA is more effective than sham EA for treating postoperative pain following TKA, but has an analgesic effect similar to that of ipsilateral EA. Trial registration number: ChiCTR1800020297 (Chinese Clinical Trial Registry)
Diagnosis and management of systemic mastocytosis in a community hematology setting
Authors: Dranitsaris George , Neuhalfen Heather , Peevyhouse Aaron , Powell Dakota , Miller Kerri , Green Teresa , Graff Tara 
Published: December 2023

Background Systemic mastocytosis (SM) is a rare and potentially severe hematologic disorder characterized by the clonal proliferation of mast cells (MCs) into various organs. The clinical manifestations of advanced SM are caused by the uncontrolled release of cytokines and vasoactive amines from MC and disease-induced organ dysfunction. Patients with SM typically present with symptoms such as flushing, pruritus, diarrhea, and headaches, but outcomes following active treatment have not been well characterized. In this study, the clinical characteristics, treatment patterns, and natural history of an SM patient cohort diagnosed and treated within a community hematology network in the United States is described. Methods We identified 105 patients who were diagnosed and managed in one of 19 community hematology clinics up to an index date of 1 October 2022. Data collection included patient and disease characteristics, baseline biochemistry and hematology, SM diagnostic criteria being met, biomarkers tested, CD2 and/or CD25 expression in MCs as well as serum tryptase levels at presentation. Data abstraction also included supportive care drugs and anticancer therapy used, treatment response, reason for discontinuation, and overall survival by disease subtype. Results A total of 105 SM patients were identified who met the inclusion criteria. The specific SM subtypes were indolent (47.6%), aggressive (9.5%), SM with an associated hematological neoplasm (19.0%), MC leukemia (1.9%), and subtype not documented (21.9%). Regardless of subtype, approximately 62% of patients did not receive SM-directed active therapy. Only 26% of patients with indolent systemic mastocytosis (ISM) received treatment compared to 65.6% with advanced subtypes. Relative to ISM cohort, the relative risk of death in patients with the advanced SM subtypes was approximately 15 times greater (hazard ratio = 15.0; 95% confidence interval: 3.3 to 66.5). Conclusions SM patients present with multiple underlying symptoms, within various disease subtypes that are difficult to diagnose in a timely manner. As a result, many patients do not receive active drug therapy for their disease. Therefore, greater disease awareness is required as well as new tools for earlier disease detection.
‘It’s a symbolic violence’: Autistic people’s experiences of discrimination at universities in Australia
Authors: Tan Diana Weiting , Rabuka Marion , Haar Tori , Pellicano Elizabeth 
Published: December 2023

In recent years, the number of autistic people entering university has increased in Australia and worldwide. While an encouraging trend, autistic students’ completion rates remain much lower than non-autistic students in Australia. Perhaps unsurprisingly, numerous studies investigating autistic people’s experiences at universities have identified stigma and discrimination as a significant barrier facing autistic people in higher education. In this study, our team of autistic co-researchers and non-autistic researchers co-produced an in-depth qualitative study to understand the contexts and circumstances in which autistic people felt stigmatised or experienced discrimination at universities in Australia. We interviewed 21 autistic people who either had completed at least one university course, or were studying a university course, or had enrolled in but discontinued at least one university course in Australia. Using reflexive thematic analysis, we identified four themes: (1) ‘My disability is something that people just don’t have a clue about’, (2) ‘the system is really stacked against you’, (3) the onus is on autistic students, and (4) ‘grit and stubbornness’. Based on these findings, we suggested implementing Universal Design for Learning, neurodiversity-affirming and trauma-informed practices, together with a participatory approach to better design university curricula, processes, and support services for autistic students. Lay Abstract Autistic students experience many challenges at university. One significant barrier identified in past research was autistic students’ experiences of discrimination (i.e. being treat differently) and stigma (being judged differently). Our research team included both autistic and non-autistic researchers who designed a project to help explore autistic students’ experiences of stigma and discrimination at Australian universities. We interviewed 21 autistic students who went to a university – some had completed qualifications, and some had not. From our interviews, we identified four themes: (1) ‘My disability is something that people just don’t have a clue about’, (2) ‘the system is really stacked against you’, (3) the onus is on autistic students, and (4) ‘grit and stubbornness’. As a result, we recommended changes in the way courses are written and taught so that autistic people have opportunities that meet their ways of learning. It is also important for university staff to understand the impact of trauma experienced by autistic people and that universities work together with autistic people to design courses and supports that include autistic ways of learning, accessible university processes and identify support needs.
Ultrasound Particle Image Velocimetry to Investigate Potential Hemodynamic Causes of Limb Thrombosis After Endovascular Aneurysm Repair With the Anaconda Device
Authors: Mirgolbabaee Hadi , van de Velde Lennart , Geelkerken Robert H. , Versluis Michel , Groot Jebbink Erik , Reijnen Michel M. P. J. 
Published: December 2023

Purpose: To identify potential hemodynamic predictors for limb thrombosis (LT) following endovascular aneurysm repair with the Anaconda endograft in a patient-specific phantom. Materials and Methods: A thin-walled flow phantom, based on a patient’s aortic anatomy and treated with an Anaconda endograft, that presented with a left-sided LT was fabricated. Contrast-enhanced ultrasound particle image velocimetry was performed to quantify time-resolved velocity fields. Measurements were performed in the same phantom with and without the Anaconda endograft, to investigate the impact of the endograft on the local flow fields. Hemodynamic parameters, namely vector complexity (VC) and residence time (RT), were calculated for both iliac arteries. Results: In both limbs, the vector fields were mostly unidirectional during the peak systolic and end-systolic velocity phases before and after endograft placement. Local vortical structures and complex flow fields were observed at the diastolic and transitional flow phases. The average VC was higher (0.11) in the phantom with endograft, compared to the phantom without endograft (0.05). Notably, in both left and right iliac arteries, the anterior wall regions corresponded to a 2- and 4-fold increase in VC in the phantom with endograft, respectively. RT simulations showed values of 1.3 to 6 seconds in the phantom without endograft. A higher RT (up to 25 seconds) was observed in the phantom with endograft, in which the left iliac artery, with LT in follow-up, showed 2 fluid stasis regions. Conclusion: This in vitro study shows that unfavorable hemodynamics were present mostly in the limb that thrombosed during follow-up, with the highest VC and longest RT. These parameters might be valuable in predicting the occurrence of LT in the future. Clinical Impact This in-vitro study aimed to identify potential hemodynamic predictors for limb thrombosis following EVAR using ultrasound particle image velocimetry (echoPIV) technique. It was shown that unfavorable hemodynamic norms were present mostly in the thrombosed limb. Owing to the in-vivo feasibility of the echoPIV, future efforts should focus on the evaluation of these hemodynamic norms in clinical trials. Thereafter, using echoPIV as a bedside technique in hospitals becomes more promising. Performing echoPIV in pre-op phase may provide valuable insights for surgeons to enhance treatment planning. EchoPIV is also applicable for follow-up sessions to evaluate treatment progress and avoid/predict complications.
Development of a resource-use measure to capture costs of diabetic foot ulcers to the United Kingdom National Health Service, patients and society
Authors: Cullen Katherine , Jones Mari , Sheehan Christina , Game Frances , Vedhara Kavita , Fitzsimmons Deborah 
Published: December 2023

Background: Diabetic foot ulcers (DFUs) add a significant burden to the lives of people with diabetes in the United Kingdom. They can have a considerable impact on a patient’s daily life, with treatment requiring frequent changes of dressings and clinic attendances. Nurses and other allied health professionals (AHPs) within the community provide most wound care representing the primary cost driver. Aims: To collaboratively explore key resource use related to the management of DFUs to develop, and pilot, a participant-reported measure to inform economic evaluations. Methods: A literature search and semi-structured interviews determined health and non-health resource use in management of DFUs. A consensus view of the selected items was established in a modified Delphi study and further tested for acceptability and validity in a pilot study. Results: Primary care consultations with a podiatrist or orthotist, district nurse visits, out-of-hours and emergency care, scans and investigations, and consumables provided in clinics were rated as the most important resource use items. Conclusions: This work has informed the development of a measure that captures resource use considered important by the people most affected by DFUs; patients, family members and carers, and the healthcare professionals key to DFU management.
‘And then there was silence’: shaping practice through the experience of parents’ emotions
Authors: Levy Sharon 
Published: December 2023

Background: Spina bifida, the most common Neural Tube Defect occurring around 28 days following conception, is often discovered in a routine ultrasound examination. Nurses offer continuous support for families who care for children with disabilities, associated with this diagnosis. Aim: To articulate and analyse parents’ recollection of the emotions they experienced when they were informed by professionals that their unborn baby may have neurological disabilities. Method: Qualitative study, using participatory visual narrative method, engaging parents caring for young children with Spina bifida. Results: The emotions parents described, surfacing at the point of diagnosis, and the crafted stories they shared, demonstrated the significance and the long-lasting impact of their experience. Disclosing sensitive information and the way it is shared has a significant role in shaping how families adjust to caring for disabled children. Conclusion: Role and care transitions of parents who choose to keep their babies, despite their impending disability, is a lengthy and complex process. Nurses should be aware of and informed by the origin story, to offer appropriate support throughout this period. Policies to promote integration with services delivered by ‘not for profit’ organisations will benefit family-focused and person-centred care.
Ultrasound-based Accuro system versus traditional palpation technique for neuraxial anaesthesia: A systematic review and meta-analysis of randomised controlled trials
Authors: Sharapi Mahfouz , Afifi Eslam , Al Mawla Aya Mustafa , Yassin Mazen Negmeldin Aly , Awwad Sara Adel , El-Samahy Mohamed 
Published: December 2023

Introduction This review evaluates the efficacy and safety of Accuro, a handheld ultrasound device, compared to the palpation technique for neuraxial anaesthesia. Accuro provides real-time imaging guidance, potentially improving accuracy and efficiency. Methods A comprehensive search across six electronic databases identified randomised clinical trials comparing Accuro with palpation for neuraxial anaesthesia. Risk ratios or mean differences with 95% confidence intervals (CIs) were calculated using a random-effects model. Bias risk was evaluated using the Cochrane Risk of Bias tool. Results Five studies (n=369) met the inclusion criteria. Accuro showed a favourable risk ratio for first insertion success (1.44 [95% CI [1.01, 2.05], p=0.05]). It significantly reduced needle skin passes (MD −0.63; 95% CI [−1.05, −0.21]; p<0.01), but not needle redirection (MD −1.31; 95% CI [−2.71, 0.11]; p=0.07). Procedure time was shorter in palpation (MD 127.82; 95% CI [8.68, −246.97]; p=0.04). Four studies had a low risk of bias; one had some concerns. Conclusion Accuro can potentially improve success rates and reduce skin passes in neuraxial anaesthesia. Further trials with larger samples are needed, especially in patients with anticipated difficulties.
Efficiency and perceived safety of foot and ankle procedures performed on the preoperative stretcher versus operating room table
Authors: Lause Gregory E , Parker Emily B , Farid Alexander , Smith Jeremy T , Chiodo Christopher P , Martin Elizabeth A , Bluman Eric M 
Published: December 2023

Background: Foot and ankle surgeons often perform minor surgeries on the preoperative stretcher instead of the operating room table. We examined whether stretcher-based and operating room table-based procedures differed with respect to operating room efficiency and staff perceptions. Methods: We retrospectively reviewed medical records of patients undergoing minor foot and ankle surgery at an ambulatory surgery centre. We collected ‘time to start’, the duration between patient arrival in the operating room and incision time, and ‘time to exit’, the duration between procedure end time and patient exit from the operating room. Staff were surveyed regarding their perceptions of stretcher-based and operating room table-based procedures. Results: ‘Time to start’ was significantly shorter for stretcher-based procedures, but ‘time to exit’ was not. Seventeen (81%) staff members thought stretcher-based procedures increased operating room efficiency. Thirteen (62%) thought stretcher-based procedures bettered staff safety. Nineteen (91%) thought stretcher-based procedures were equivalent to or better than operating room table-based procedures for patient safety. Most (67%) would recommend stretcher-based procedures. Conclusion: We found small but significant time savings associated with stretcher-based procedures. Without adapting surgical scheduling practices, the impact of stretcher-based procedures on overall operating room efficiency is questionable. Nevertheless, the majority of OR staff think stretcher-based procedures increase OR efficiency and are safer for staff. Level of Evidence: Level IV, Retrospective case series.
Effects of Increasing Pitch Count on Pitch Type Ball Metrics and Release Height in High School Softball Pitchers
Authors: Downs Talmage Jessica , Friesen Kenzie B. , Fava Anthony , Everhart Kate , Oliver Gretchen D. 
Published: December 2023

Background: Softball research has investigated changes in physical characteristics, mechanics, and ball speed as elements of fatigue. However, the influence of pitch volume on ball metrics is unclear. The purpose of this study was to investigate the influence of pitch volume on ball performance and release metrics in softball pitchers across different pitch types. Hypothesis: As pitch volume increased, there would be a decrease in ball metrics of the fastball and changes in breaking pitches would be observed earlier than the fastball or changeup. Study Design: Descriptive laboratory study. Level of Evidence: Level 5. Methods: A total of 21 (15.4 ± 1.6 years; 1.6 ± 0.2 m; 76.0 ± 17.2 kg) softball pitchers participated. Procedures consisted of participants pitching a simulated game consisting of 100 pitches, taking a 30-minute break, and then throwing 12 pitches to simulate the first inning of a doubleheader. Participants randomly threw each pitch type (fastball, changeup, curveball, or dropball). Ball performance and release metrics were measured using a Rapsodo portable pitch tracker. Results: A 3 (time) by 4 (pitch type) multivariate analysis of variance revealed that pitch speed was significantly higher in the first inning compared with the last inning and the doubleheader inning. The fastball, curveball, and dropball revealed a significant difference in pitch speed between timepoints. Specifically, the curveball and dropball first-inning pitch speed was significantly greater than the last and doubleheader inning. Alternatively, the fastball had a significant increase in pitch speed from the last inning to the doubleheader inning. Conclusion: The typical 30-minute break given between games for doubleheaders may be sufficient recovery time for the fastball but not for the curveball and dropball. Clinical Relevance: The Rapsodo device is an accessible method of tracking ball performance and pitch release metrics and could be helpful in identifying when a pitcher may be experiencing performance detriments in response to increasing pitch count.
Adding Neurofeedback Training to Neuromuscular Training for Rehabilitation of Chronic Ankle Instability: A 3-Arm Randomized Controlled Trial
Authors: Yalfani Ali , Azizian Masoud , Gholami-Borujeni Behnam 
Published: December 2023

Background: Neurofeedback training (NFT) can aid in the treatment of the abnormal patterns of the brain brought on by physical injury, enhancing cognitive and behavioral abilities. The present study aimed to compare the effectiveness of combining neuromuscular training (NMT) and NFT (NMT+NFT) with NMT alone in rehabilitating athletes with chronic ankle instability (CAI). Hypothesis: NMT+NFT will be more effective than NMT alone. Study Design: A 3-arm, single-blind randomized controlled trial. Level of Evidence: Level 2. Methods: A total number of 62 athletes, aged 18 to 25 years, with CAI, participated in this study. The study subjects were allocated randomly to 3 groups: 21 cases in the control group, 21 cases in the combination group (CG) receiving NMT+NFT, and 20 cases in the neuromuscular group (NG) practicing NMT alone, undergoing exercises related to their groups for 8 weeks. Data were recorded and analyzed before and after the 8-week training program. The primary outcome measures were postural sway indices; secondary outcomes included ankle proprioception and biopsychosocial indices. Results: NMT+NFT was more effective than NMT alone in terms of improving postural control during single- and 2-legged standing positions under the conditions of eyes closed and eyes open, proprioception at 20° of plantar flexion, as well as anxiety and depression in athletes with CAI. However, the findings revealed that NMT+NFT and NMT alone could both improve such indices. Conclusion: NMT+NFT as a treatment protocol improved postural control, ankle proprioception, anxiety, and depression greater than NMT alone. Clinical Relevance: A combined protocol of NFT and NMT led to greater improvement compared with NMT alone. NFT was recommended as an adjunct therapy in the rehabilitation of athletes suffering from CAI.
Association of brain arterial diameters with demographic and anatomical factors in a multi-national pooled analysis of cohort studies
Authors: Del Brutto Victor J , Khasiyev Farid , Liu Minghua , Spagnolo-Allende Antonio , Qiao Ye , Melgarejo Arias Jesus D , Guzman Vanessa A , Igwe Kay C , Sanchez Danurys L , Andrews Howard , Morales Clarissa D , Farrell Meagan T , Bassil Darina T , Seshadri Sudha , Wagner Ryan G , Mngomezulu Victor , Manly Jennifer , Elkind Mitchell SV , Berkman Lisa , Romero Jose R , Maestre Gladys E , Del Brutto Oscar H , Brickman Adam M , Venketasubramanian Narayanaswamy , Chen Christopher , Robert Caroline , Hilal Saima , Rundek Tatjana , Wasserman Bruce A , Gutierrez Jose 
Published: December 2023

Background and Purpose Brain arterial diameters are markers of cerebrovascular disease. Demographic and anatomical factors may influence arterial diameters. We hypothesize that age, sex, height, total cranial volume (TCV), and persistent fetal posterior cerebral artery (fPCA) correlate with brain arterial diameters across populations. Methods Participants had a time-of-flight MRA from nine international cohorts. Arterial diameters of the cavernous internal carotid arteries (ICA), middle cerebral arteries (MCA), and basilar artery (BA) were measured using LAVA software. Regression models assessed the association between exposures and brain arterial diameters. Results We included 6,518 participants (mean age: 70 ± 9 years; 41% men). Unilateral fPCA was present in 13.2% and bilateral in 3.2%. Larger ICA, MCA, and BA diameters correlated with older age (Weighted average [WA] per 10 years: 0.18 mm, 0.11 mm, and 0.12 mm), male sex (WA: 0.24 mm, 0.13 mm, and 0.21 mm), and TCV (WA: for one TCV standard deviation: 0.24 mm, 0.29 mm, and 0.18 mm). Unilateral and bilateral fPCAs showed a positive correlation with ICA diameters (WA: 0.39 mm and 0.73 mm) and negative correlation with BA diameters (WA: −0.88 mm and −1.73 mm). Regression models including age, sex, TCV, and fPCA explained on average 15%, 13%, and 25% of the ICA, MCA, and BA diameter interindividual variation, respectively. Using height instead of TCV as a surrogate of head size decreased the R-squared by 3% on average. Conclusion Brain arterial diameters correlated with age, sex, TCV, and fPCA. These factors should be considered when defining abnormal diameter cutoffs across populations.