bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Osteoarthritis Development at a Median 25 Years After Anterior Cruciate Ligament Reconstruction Using a Patellar Tendon Autograft
Authors: Lindanger Line , Strand Torbjørn , Mølster Anders Odd , Solheim Eirik , Fischer-Bredenbeck Cornelia , Ousdal Olga Therese , Inderhaug Eivind 
Published: March 2022

Background: Few studies have investigated the outcome ≥20 years after an anterior cruciate ligament reconstruction (ACLR) with a bone–patellar tendon–bone autograft, and there is a wide range in the reported rates of radiographic osteoarthritis (OA). Purpose: To report on radiographic OA development and to assess risk factors of knee OA at a median 25 years after ACLR with a bone–patellar tendon–bone autograft. Study Design: Case-control study; Level of evidence, 3. Methods: Unilateral ACLRs performed at a single center from 1987 to 1994 were included (N = 235). The study population was followed prospectively with clinical testing and questionnaires. Results from the 3-month, 12-month, and median 25-year follow-up are presented. In addition, a radiographic evaluation was performed at the final follow-up. Radiographic OA was defined as Kellgren-Lawrence grade ≥2 or having undergone ipsilateral knee replacement surgery. Possible predictors of OA development included patient age, sex, time from injury to surgery, use of a Kennedy ligament augmentation device, any concomitant meniscal surgery, and return to preinjury sports after surgery. Results: At long-term follow-up, 60% (141/235) of patients had radiographic OA in the involved knee and 18% (40/227) in the contralateral knee ( P < .001). Increased age at surgery, male sex, increased time between injury and surgery, a Kennedy ligament augmentation device, and medial and lateral meniscal surgery were significant predictors of OA development in univariate analyses. Return to preinjury level of sports after surgery was associated with less development of OA. In the multivariate model, medial meniscal surgery and lateral meniscal surgery were independently associated with OA development. The adjusted odds ratio was 1.88 (95% CI, 1.03-3.43; P = .041) for medial meniscal surgery and 1.96 (95% CI, 1.05-3.67; P = .035) for lateral meniscal surgery. Patients who had developed radiographic signs of OA had significantly lower Knee injury and Osteoarthritis Outcome Score and Lysholm scores at long-term follow-up. Conclusion: At 25 years after ACLR, 60% of patients had developed OA in the involved knee, and these patients reported significantly lower subjective outcomes. Medial meniscal surgery and lateral meniscal surgery were independent predictors of OA development at long-term follow-up.
Computational comparison and experimental performance analysis on heat pipes using concentrating solar parabolic trough collector
Authors: Kumar P Ravindra , Babu Nelakuditi N , Prasad K Lakshmi 
Published: February 2022

The heat pipes in solar applications uses are important and it is significantly growing nowadays. Capable of meeting the world’s challenges with a threat to the climate; a shortage of conventional energy sources, usually fossil fuels, high electricity costs, and it is inexpensive; therefore, the renewable energy of solar energy is an excellent source, reaching total amount of energy is 34,00,000 EJ in each year, all over the world. This is between 7000 and 8000 times the annual global primary energy consumption. Thereby, a Concentrating Solar Parabolic Trough Collector is suggested in this paper, which can be used to analyze the performance of various heat pipes. Using solar parabolic trough collector to analyze the performance of different heat pipes rather than considering the supply of electric power input. Using a parabolic trough collector that concentrates solar energy on an evacuated tube heat pipe, which converts radiation energy into electrical energy heat, the experimental work demonstrates the use of solar energy. Condensers, evaporators, and three heat pipes consisting of aluminum galvanized iron, and stainless steel materials are the main components. A porous wick structure and an ammonia solution-filled working fluid consist of each heat pipe. Continuously recirculating the working fluid through temperature variation. The readings are taken using connected thermocouples on three heat pipes by continuously varying the mass flow rate. The vacuum pressure gauge to maintain the heat pipes generates the vacuum inside space. At various mass flow rates of heated water from the parabolic trough collector, experimentation was also performed. The result of this study calculates the mass flow rate at the end of the process of the different heat pipes used here. Furthermore, different inclinations are estimated in a variety of situations, such as at temperatures of 15°, 30°, 45°, and 60°. In the experimental analysis, outlet temperatures of heat pipes are measured and the temperature distribution contours are evaluated using the analysis of computational fluid dynamics.
Virtual Reality Instructional Design in Orthopedic Physical Therapy Education: A Mixed-Methods Usability Test
Authors: Hartstein Aaron J. , Verkuyl Margaret , Zimney Kory , Yockey Jean , Berg-Poppe Patti 
Published: February 2022

Background Physical therapy education benefits from innovative and authentic learning opportunities. However, factors that influence the acceptance of educational technology must be assessed prior to curricular adoption. The purpose of this study was to assess the perceived ease of use and perceived usefulness of a virtual reality (VR) learning experience developed to promote the clinical decision-making of student physical therapists. Methods A VR learning experience was developed, and an established two-stage usability test assessed player experience as well as the user’s perception of both ease of use and usefulness. Two experts evaluated the VR learning experience and provided feedback. Six student physical therapists and five faculty members completed the VR experience, responded to two questionnaires, and participated in a semi-structured interview to further assess ease of use and utility. Results High levels of perceived ease of use, perceived usefulness, and positive player experiences were reported by both faculty and student users. Faculty users perceived a significantly greater amount of educational and clinical utility from the VR simulation than did student users. Semi-structured interviews revealed themes related to ease of use, benefits, modeling of professional behaviors, and realism. Conclusion Quantitative data supported faculty and student users’ perceptions of ease of use, utility towards learning, practical application, and several constructs related to user experience. Qualitative data provided recommendations to modify design features of the VR experience. This study provides a template to design, produce, and assess the usability of an immersive VR learning experience that may be replicated by other health professions educators where current evidence is limited.
Home-Based Palliative Care Organizations Struggle to Survive and Thrive in a Competitive Market
Authors: Rahman Anna , Coulourides Kogan Alexis , Lewis Nicole , Lomeli Sindy , Enguidanos Susan 
Published: March 2022

Background New opportunities to expand home-based palliative care (HBPC) highlight the need for novel data that explores how HBPC providers currently navigate this nascent business. Objectives To investigate how HBPC providers and their organizations sustain their operations in a rapidly evolving market. Study Design This was an exploratory, qualitative study. Setting We conducted focus groups with staff of nine HBPC organizations that held provider contracts with a large California insurance provider. Measurement A research team member experienced in qualitative methods conducted semi-structured focus group interviews with HBPC agency staff who were knowledgeable about their agency’s patient recruitment and enrollment processes. Interview sessions of roughly an hour long were audio-recorded and transcribed verbatim. We used thematic analysis procedures to identify codes and themes. Results We identified seven themes: market competition, market diversity, HBPC reimbursement, service standardization, hiring practices, marketing, strategic enrollment processes, and outcomes monitoring. The participants called for more standardization in their field. In discussing key business operations—hiring, marketing, patient enrollment, outcomes monitoring—they demonstrated inventiveness and willingness to innovate in order to succeed in a complex healthcare sector. Conclusion Our study expands on the literature by providing a glimpse of the challenges encountered by HBPC providers and their organizations and the myriad strategies they undertake to navigate a health-service area that lacks standardized practice and payment guidelines. Our findings suggest that HBPC agencies will continue to struggle in the absence of standardization in practice, payment, and quality oversight.
Elementary School Nurses’ Perceptions Regarding Menstruation Education: An Exploratory Study
Authors: Sweeney Erin N. , Fisher Christine M. , Adkins Megan M. 
Published: March 2022

Menarche can be a difficult transition for young people. With appropriate education, youth can feel more positively about the menstrual experience. Since many elementary teachers are not equipped with menstrual health knowledge, the education falls to the school nurse. However, it is unknown if school nurses feel comfortable communicating about menstruation with young people. The purpose of this study was to explore school nurses’ perceptions regarding menstrual health education in elementary schools (grades K-5). An online mixed-methods survey was established using Qualtrics. Through snowball sampling, 30 elementary school nurses responded. Using the Integrated Behavioral Model (IBM) as a framework, a deductive semantic thematic analysis was used to identify themes for each question. Data suggested that elementary school nurses would participate in professional development regarding menstrual health and hygiene. School health nurses are receiving limited knowledge/skills surrounding pedagogy and are not familiar with cultural differences when it comes to menstrual health.
Factors influencing emotional and behavioral problems in preschool children with cancer based on self-regulation shift theory
Authors: Pan Xiaorong , Mo Lin , Liu Qian , Guo Xiaoli , Zhang Shiqun 
Published: March 2022

Objective The objective is to investigate the factors influencing emotional and behavioral problems in preschool children with cancer and to provide a scientific basis for developing predictive intervention strategies. Methods We recruited 375 preschool children with cancer, from March 2019 to February 2020, via convenience sampling. The self-regulation shift theory was implemented as a theoretical framework and a structural equation model was applied to construct and validate this framework and to analyze the relationships among various influencing factors. Results Children’s effortful control, parent–child attachment, the family environment, family upbringing, parents’ marital quality, parents’ education level, and social support significantly affected children’s emotions and behaviors. Additionally, children’s effortful control and parent–child attachment mediated the effect of the family environment, family upbringing, and parents’ marital quality on children’s emotions and behaviors.” Conclusion This study identified several factors that influence children’s emotions and behaviors, which should be considered while developing predictive intervention strategies to promote children’s rehabilitation and improve parents’ education, thus offering improved support for children with cancer.
Laparoscopic Extraperitoneal Approach for Lateral Pelvic Node Dissection in Rectal Cancer: Techniques and Short-Term Outcomes
Authors: Kim Ji-Seon , Kim Jin , Baek Se-Jin , Park Hyunmi , Kwak Jung-Myun , Kim Seon-Hahn 
Published: March 2022

Background Lateral pelvic lymph node dissection has been performed selectively in rectal cancer cases; however, it involves highly skilled techniques because of the complex adjacent anatomical structures. Materials and Methods Laparoscopic EP-LPND was performed in Korea University Anam Hospital from June 2018, and short-term surgical outcomes were analyzed from June to December 2018. Among the patients with histologically diagnosed rectal adenocarcinoma, patients who were suspected Lateral pelvic lymph node metastasis at magnetic resonance imaging were selected for this procedure. Results Seven patients underwent laparoscopic extraperitoneal approach for lateral pelvic lymph node dissection in the study period. The mean number of retrieved lymph node was 4.57, and metastatic lymph nodes were identified in 3 patients (42.8%). All of the lymph nodes with suspected metastasis preoperatively were removed in postoperative images. There was no immediate postoperative complication beyond the moderate grade associated with lateral pelvic lymph node dissection. The median follow-up was 9 months, and there were no local recurrence nor complications related to sexual and voiding functions. Conclusions The laparoscopic extraperitoneal approach might be an efficient way to perform lateral pelvic lymph node dissection using the same principles as the conventional method without violation of the peritoneum.
Exploring the use of activity-based group therapy in increasing self-efficacy and subjective well-being in acute mental health
Authors: Ngooi Bi Xia , Wong Su Ren , Chen Janice Dehui , Yin Koh Vanessa Shi 
Published: March 2022

Background/Objectives Self-efficacy is a key component in mental health recovery and improvement in well-being. Mental illness is often resultant of environmental stressors, highlighting the importance of coping skills. Occupational therapists commonly utilise activity-based group therapy to encourage use of activities as coping strategies. However, there has been little research concerning these groups and their role in enhancing self-efficacy in behavioural-based coping skills. This study aimed to explore factors that affect behavioural-based coping self-efficacy during activity-based group therapy in an acute mental health ward. It investigates the relationships between (1) behavioural-based coping self-efficacy with overall mental health self-efficacy and (2) mental health self-efficacy and subjective well-being. Methods Immediately after the first group, participants completed a post-group questionnaire. Participation level was also rated. At discharge, the participants were asked to complete the UK Office of National Statistics subjective well-being tool and the Mental Health Self-Efficacy Scale. Descriptive statistics, independent sample t-tests and one-way analysis of variance were done to examine possible covariates and confounders of all outcome variables. General linear models were then conducted. Results Post-group questionnaire reflected moderate-high self-efficacy (M = 6.92, SD = 2.48) and positive well-being with higher happiness scores (M = 7.42, SD = 2.20) and lower anxiety scores (M = 3.79, SD = 2.85). Coping self-efficacy significantly predicted overall mental health self-efficacy ( p = .014), which in turn significantly predicted positive domains of well-being. Conclusions Performing behavioural-based coping strategies in groups can enhance coping self-efficacy and positive well-being, with possible positive influence on mental health self-efficacy and well-being at discharge.
Mid-term outcomes of the use of endoanchors during thoracic endovascular aortic repair in multicentre analysis
Authors: Reyes Valdivia Andrés , Milner Ross , Heijmen Robin , Riambau Vicente , Rousseau Hervé , Tinelli Giovanni , Kotelis Drosos , Zanabili Al-Sibbai Ahmad A , Pitoulias Georgios , Zúñiga Claudio Gandarias , de Beaufort Hector W L , Panagiotis Doukas , Chaudhuri Arindam 
Published: February 2022

Objective To describe mid-term outcomes of the use of EndoAnchors as an adjunct for arch and thoracic endovascular aortic repair (TEVAR). Methods A retrospective multicentre series from nine centres using the Heli-FX EndoAnchor System (Medtronic Inc, Minneapolis, USA) at TEVAR over May 2014–May 2019 is presented. The study is registered at ClinicalTrials.gov with number NCT04100499. The primary outcome was freedom from Type I endoleak at EndoAnchors deployments; secondary outcomes included evaluation of aortic wall penetration (AWP) at first computed tomography scan, EndoAnchor-related issues and mortality. Results 54 high-risk patients (35 males/19 females, age 73 ± 11 years) with arch, thoracic and thoracoabdominal aneurysmal disease (3 chronic post-dissection and one patch pseudoaneurysm), with a mean neck length 19.7 ± 6.6 mm that were treated with multiple hybrid and endovascular techniques were included. A total of 329 EndoAnchors were used with a mean of 6.1 ± 2.5 per patient. Overall adequate AWP was 86%, whereas arch (Ishimaru’s zones 0–2) deployments achieved 80.6% when compared to 87.3% in descending thoracic aorta (dTA); although there was no statistical significance. Freedom from type I endoleaks was 88% at 2 year follow-up, due to 4 type IA endoleaks, two of them successfully treated, one with conservative treatment due to complexity of repair and remaining patient died 1 year later due to endograft infection. There were reported five EndoAnchor-related issues; four losses and one renal stent-graft was crushed due to catheter deflection solved with balloon reinflation. None of the losses had clinical significance. Overall mortality is described for 7 (9.5%) patients, one of them aneurysm-related. Conclusions The adjunctive use of EndoAnchors in TEVAR and complex TEVAR procedures achieved acceptable outcomes at midterm in a high-risk series with hostile seal zones. Still, they should be still judiciously used as there is lack of data to suggest a more liberal use; therefore, the landing zone should not be compromised in favour of their use.
Multiple concomitant arterial aneurysms in Behçet’s disease
Authors: Hersant Jeanne , Maurel Blandine , Espitia Olivier 
Published: February 2022

Background Behçet’s disease (BD) is a rare form of systemic vasculitis that affects small to large vessels. It is characterized by mucocutaneous, pulmonary, cardiovascular, gastrointestinal, and neurological manifestations. Large vessel involvement may occur in a third of cases. Veins are usually more affected than arteries. Furthermore aneurysms are the most frequent arterial complication. Case presentation A 41-year-old man presented with multiple arterial aneurysms. He had previous medical history of a right popliteal aneurysm treated with a reversed femoro-popliteal venous bypass, long-term steroids and immunosuppressive treatment. On admission, diagnostic computed tomography angiography revealed multiple aneurysms, including an 87 mm aneurysm of the femoro-popliteal bypass and an abdominal aortic and left common iliac artery aneurysm. He received an intensification of medical treatment with methylprednisolone and infliximab intravenous infusion. Aorto iliac artery aneurysms were treated by infrarenal bifurcated stent graft implantation. The aneurysm of the venous femoro-popliteal bypass was treated by explantation and prosthetic repair. One month later, he presented with acute right limb ischemia related to occlusion of the right limb of the stent graft despite anticoagulation which was treated by mechanical thrombectomy. Conclusions Vascular BD can worsen the vascular outcome after surgery. Except in an urgent context, BD must be controlled before surgery. This case report illustrates the importance of combined medical and surgical management, with first BD activity control with corticosteroids and immunosuppressive treatment, then surgical or endovascular treatment.
Prevalence of antinuclear antibodies in inflammatory bowel disease and seroconversion after biological therapy
Authors: García María José , Rodríguez-Duque Juan Carlos , Pascual Marta , Rivas Coral , Castro Beatriz , Raso Sandra , López-Hoyos Marcos , Arias-Loste María Teresa , Rivero Montserrat 
Published: March 2022

Background: Estimates of detectable antinuclear antibodies (ANA) prevalence vary widely, from 6% in healthy populations to 50–80% in patients with autoimmune disease. However, there is a lack of evidence about the overall prevalence in inflammatory bowel disease (IBD) and ANA seroconversion after the beginning of biological therapy. Objectives: The aim of the study was to investigate the overall prevalence of ANA in IBD patients, their relationship with different treatments, clinical outcomes and the seroconversion rate of ANA in patients treated with biological therapy. Methods: Ambispective observational study including all consecutive IBD patients was carried out. Information about the presence of ANA, disease phenotype, duration, activity, complications, and past and current treatments were transversally collected. Retrospectively, in patients with detectable ANA, data regarding previous ANA detection and the diagnosis of lupus-like syndrome (LLS) was gathered. Results: A total of 879 IBD patients were included. We observed a detectable ANA prevalence of 13.6%. The presence of ANA was frequently associated with biological therapy (36/118) and decreased when immunomodulators were combined to this therapy (7/32). Of 78 patients with ANA prior to the beginning of biological therapy, a seroconversion rate of 28.8% was observed after a mean of 3.14 years. Only 1 patient suffered LLS. Conclusion: Our study showed a prevalence of detectable ANA higher than the expected in healthy population. The presence of ANA was lower when immunomodulator therapy is associated. The ANA seroconversion rate is relevant after the initiation of biological treatment nevertheless, the risk of LLS appeared to be marginal.
Reoperations After Percutaneous Endoscopic Transforaminal Decompression for Treating Lumbar Spinal Stenosis: Incidence and Predictors
Authors: Wang Tianyi , Wang Aobo , Zang Lei , Fan Ning , Wu Qichao , Lu Xuanyu , Yuan Shuo 
Published: February 2022

Study Design Retrospective cohort study. Objectives The main purpose of the present study was to report the incidence and identify predictors of reoperation in patients with lumbar spinal stenosis (LSS) treated with percutaneous endoscopic transforaminal decompression (PETD). Methods This study retrospectively reviewed consecutive patients with LSS who underwent PETD at our center between January 2016 and July 2020. The incidence of reoperations was calculated. We then designed a surgical period-matched case-control study to identify predictors among demographic data, clinical baseline data, and imaging parameters. Results This study identified 496 eligible patients. 33 (6.7%) patients underwent reoperation with a mean follow-up of 3 years, consisting 22 (4.4%) at the index level and 11 (2.2%) at the adjacent levels. There were significant differences in age and age-adjusted Charlson comorbidity index (AACCI) between the two groups, with younger age (P = .004) and lower AACCI (P = .019) in reoperation group. Age was identified as the sole independent predictor (P = .006). The duration of symptoms ≥12 months (P = .034) and the presence of heart problems (P = .012) were recognized as specific predictors among patients younger than 65 years. Conclusions In a mean follow-up of 3 years, the incidence of reoperation in LSS treated with PETD was 6.7%. A younger age was the independent predictor for reoperation. Younger patients with the duration of symptoms ≥12 months or without heart problems were more likely to undergo a second operation. Prospective randomized controlled trials are required to confirm these findings.