bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of mobile and fixed unicompartmental knee arthroplasty and risk factors for revision
Authors: Saylık Murat , Yenigul Ali Erkan , Atıcı Teoman 
Published: August 2022

Objectives In this study, we aimed to evaluate the outcomes of patients undergoing unilateral knee arthroplasty (UKA) and to analyze risk factors that may lead to revision in patients who undergo UKA. Methods We included patients who underwent mobile or fixed UKA owing to osteoarthritis and who had at least 24 months of follow-up in the postoperative period. We recorded information on patient age, sex, side, body mass (kg/m2), follow-up duration, Knee Society Score, Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain, WOMAC function, WOMAC stiffness, mechanical axle angle, femoral component compliance, tibial component compliance, accumulated experience of the surgeon, and revision status. Results In total, we evaluated 131 knees in 118 patients. 50 (38%) who underwent mobile UKA and 81 (62%) who underwent fixed UKA. The effect of obesity on mobile and fixed UKA revision was significant. The likelihood of revision decreased with greater experience of the surgeon performing UKA. Conclusion Our study showed that the clinical results of mobile and fixed UKA procedures are similar. We also revealed that obesity poses a risk for revision in both fixed and mobile UKA, and the revision rate decreases with increased experience of the surgeon.
Childhood Adversity and Mental Health Outcomes Among University Students: A Longitudinal Study
Authors: Bhattarai Asmita , King Nathan , Adhikari Kamala , Dimitropoulos Gina , Devoe Dan , Byun Jin , Li Melanie , Rivera Daniel , Cunningham Simone , Bulloch Andrew G.M. , Patten Scott B. , Duffy Anne 
Published: August 2022

Background Mental health concerns are common among university students and maybe elevated among those with specific risk exposures. The study examined the association between childhood adversities and mental health outcomes among undergraduate university students and assessed whether psychosocial and behavioral factors mediate those associations. Methods The Queen’s University Student Well-Being and Academic Success Survey identified two large cohorts of first-year undergraduate students entering university in Fall 2018 and 2019 ( n = 5,943). At baseline, students reported sociodemographic information, family-related mental health history, childhood physical abuse, sexual abuse, peer bullying, and parental separation or divorce. Baseline and follow-up surveys in Spring 2019, Fall 2019, and Spring 2020 included validated measures of anxiety (7-item Generalized Anxiety Disorder) and depressive symptoms (9-item Patient Health Questionnaire ), non-suicidal self-harm, and suicidality, along with psychological processes and lifestyle variables. Repeated measures logistic regression using Generalized Estimating Equations was used to characterize the associations between childhood adversities and mental health outcomes and examine potential mediation. Results Adjusting for age, gender, ethnicity, familial mental illness, and parental education, any childhood abuse (odds ratio: 2.89; 95% confidence interval, 2.58 to 3.23) and parental separation or divorce (odds ratio: 1.29; 95% confidence interval, 1.12 to 1.50) were significantly associated with a composite indicator of mental health outcomes (either 9-item Patient Health Questionnaire score ≥10 or 7-item Generalized Anxiety Disorderscore ≥10 or suicidality or self-harm). The association with childhood abuse weakened when adjusted for perceived stress, self-esteem, and insomnia (odds ratio: 2.05; 95% confidence interval, 1.80 to 2.34), and that with parental divorce weakened when adjusted for self-esteem (odds ratio: 1.17; 95% confidence interval, 1.00 to 1.36). Conclusion Childhood abuse and parental separation or divorce were associated with mental health concerns among university students. Childhood adversities may impact later mental health through an association with stress sensitivity, self-esteem, and sleep problems. The findings suggest that prevention and early intervention focusing on improving sleep, self-esteem, and coping with stress while considering the individual risk profile of help-seeking students may help support student mental health.
Preparing simvastatin nanoparticles by a combination of pH-sensitive and timed-release approaches for the potential treatment of ulcerative colitis
Authors: Fardafshari Fereshteh , Taymouri Somayeh , Minaiyan Mohsen , Tavakoli Naser 
Published: August 2022

In this study, an emulsion solvent evaporation method was used to produce Eudragit RL (ERL) nanoparticles (NPs) loaded with simvastatin (SIM) for the treatment of ulcerative colitis (UC). Accordingly, the effects of different formulation variables on the properties of NPs were evaluated using the Box-Behnken design. The optimized NPs were then coated by Eudragit FS30D (EFS30D). Drug release was studied in different physiological environments. Colitis was induced by 3% of acetic acid in rats, which received NPs of SIM (10 mg/kg/day), mesalazine (150 mg/kg/day), blank NPs and normal saline orally for 5 days. Macroscopic histopathological evaluation and biochemical analysis, including myeloperoxidase (MPO) activity and malondialdehyde (MDA) level in the colon tissues, were carried out in this study. The optimized SIM-ERL NPs showed the particle size of 182.48 ± 4.57 nm, the polydispersity index of 0.29 ± 0.12, the zeta potential of 26.45 ± 4.57 mV, drug loading % of 34.64 ± 0.48, the encapsulation efficiency % of 98.68 ± 0.69, and the release efficiency % of 35.78 ± 1.37. Coating the optimized NPs with EFS30D caused an increase in particle size and a decrease in the zeta potential of NPs. The optimized SIM-EFS30D/RL NPs improved the macroscopic and histopathological scores. Also, MPO activity and MDA level were reduced significantly by NPs, as compared to the control group. Therefore, this drug delivery system can be an alternative to the previous treatments of UC.
Retrospective Comparison of Midterm Survivorship, Radiographic, and Clinical Outcomes of the INBONE II and Salto Talaris Total Ankle Arthroplasty Systems
Authors: Rajan Lavan , Kim Jaeyoung , Cronin Samantha , Cororaton Agnes , Day Jonathan , Gagne Oliver , Henry Jensen , Deland Jonathan , Demetracopoulos Constantine , Ellis Scott J. 
Published: August 2022

Background: Prior studies on the INBONE II and Salto Talaris total ankle arthroplasty (TAA) systems have reported promising outcomes for both implants. This retrospective study aimed to compare the midterm differences between INBONE II and Salto Talaris TAA. Methods: Between 2007 and 2015, a total of 44 INBONE II consecutive cases and 85 Salto Talaris consecutive cases had minimum 5-year clinical and radiographic follow-up. Preoperative and midterm survivorship, postoperative Foot and Ankle Outcome Score (FAOS), and radiographic measures including tibiotalar alignment (TTA), medial distal tibial angle (MDTA), and sagittal tibial angle (STA) were compared. Results: Survivorship to revision was 97.6% (95% CI, 93.1%-100%) for the INBONE II group and 97% (95% CI, 93%-100%) for the Salto Talaris group ( P = .93). Survivorship to reoperation was significantly different: 95.5% for the INBONE II and 76.4% for Salto Talaris ( P = .021). Postoperative FAOS pain ( P = .01), symptoms ( P = .004), and sports activity ( P = .02) scores were significantly higher in the INBONE II group. The INBONE group had greater preoperative deformity (varus TTA P < .001, valgus TTA P = .02, valgus MDTA P = .005). Conclusion: Although both implants had similar longevity and postoperative alignment, the INBONE II resulted in greater clinical improvement and fewer reoperations than the Salto Talaris at midterm follow-up. Level of Evidence: Level III, retrospective cohort study.
Dual Approach to Talar Dome Increases Access for Fracture Care Without Osteotomy
Authors: Campbell Megan L. , Lenz Amy L. , Peterson Andrew C. , DeKeyser Graham J. , Haller Justin M. , O’Neill Dillon C. 
Published: August 2022

Background: There is no consensus surgical treatment algorithm for talar body fractures, with authors recommending both soft tissue–only and osteotomy-based approaches. This study evaluates talar dome access via dual approaches to the talar dome through anterolateral transligamentous (ATL) and modified posteromedial (mPM) approaches. Methods: Ten cadaveric legs (5 matched pairs) were included. An mPM approach, between flexor hallucis longus and Achilles tendon, and an ATL approach, utilizing the anterolateral interval with transection of anterior talofibular ligament and calcaneofibular ligament, were performed on each specimen. Order of approach was alternated within each pair. Accessible dome surface area (DSA) was outlined by drilling with a 1.6-mm Kirschner wire at the visualized talar dome margin both with and without 4 mm of tibiotalar distraction using an external fixator. Specimens were analyzed by computed tomography (CT). Primary outcome was accessible DSA. Student t tests compared DSA accessed by different exposure methods. Results: An initial mPM approach exposed 25.6% and 33.6% of DSA without and with distraction ( P = .002). An initial ATL approach accessed 47.0% and 58.1% of DSA without and with distraction, respectively ( P = .003). Accessibility via dual approaches was 71.7% and 93% of DSA without and with distraction with an initial ATL approach and 71.3% and 87.5% of DSA without and with distraction with an initial mPM approach ( P = .96 and .37, respectively). The central talar dome was inaccessible in an almond-shaped area, tapered at the medial and lateral ends. Anterior, lateral, and posterior articular margins were able to be fully exposed, often with overlapping exposure between posterior and anterior approaches, with distraction reliably improving lateral visualization. Conclusion: Dual approaches provided access to greater than 70% and 85% of talar DSA without and with distraction, respectively. Order of approach did not significantly affect exposure and thus should be determined by surgeon discretion. These results may promote soft tissue–only treatment strategies in talar body fracture care with an extensile exposure of the talar dome surface. Careful preoperative planning optimizes the advantages of this approach. Level of Evidence: Level IV, case series.
Ocular toxicity following carboplatin chemotherapy for neuroendocrine tumour of the bladder
Authors: Ng Jia , Sadiq Muhayman , Mansoor Qasim 
Published: August 2022

Introduction Carboplatin is a commonly used platinum analogue chemotherapeutic agent that is similar to cisplatin but is known to be better tolerated. This case report outlines a case of ocular toxicity following carboplatin chemotherapy used for the management of a neuroendocrine tumour of the bladder. Case report A 70-year-old man with a history of neuroendocrine bladder cancer underwent chemotherapy with carboplatin and etoposide. He presented 4 weeks following his fourth chemotherapy cycle with a 1-week history of right eye blurriness. The patient had suffered a similar episode 2 weeks following his third chemotherapy cycle in his left eye. Carboplatin-induced ocular toxicity was suspected and his vision remained stable following cessation of carboplatin chemotherapy. Discussion Current literature on carboplatin-induced ocular toxicity remains scanty, however, previous cases have reported symptoms beginning 5 days to 2 weeks following carboplatin use. Visual disturbance in the form of altered colour vision, blind spot, blurred vision and metamorphopsia have been reported by previous literature. This case report emphasised a case of bilateral sequential blurring of vision following carboplatin chemotherapy. Conclusion It remains critical for ophthalmologists and oncologists to look out for ocular side effects of chemotherapy due to its devastating effects.
Safety, Feasibility and Economic Analysis of Same Day Discharge Following Elective Percutaneous Coronary Intervention
Authors: Hyasat Kais , Femia Giuseppe , Alzuhairi Karam , Ha Andrew , Kamand Joseph , Hasche Edmund , Rajaratnam Rohan , Lo Sidney , Almafragy Hamid , Liou Kevin , Chiha Joseph , Asrress Kaleab 
Published: August 2022

Background: Advances in percutaneous coronary intervention (PCI) has made the possibility of facilitating same day discharge (SDD) of patients undergoing intervention. We sought to investigate the feasibility, safety and economic impact of such a service. Methods: We retrospectively collected data on all patients undergoing outpatient PCI at our institution over a 12-month period. We included in-hospital and 30-day major adverse cardiac events (MACE), vascular complications, acute kidney injury and any re-hospitalisations. We analysed the cost effectiveness of SDD compared to overnight admission post PCI and staged PCI following diagnostic angiography. Results: A total of 147 patients undergoing PCI with 129 patients deemed suitable for SDD (88%). Mean age was 65.7 years. Most patients had type C lesions (60.3%); including 4 chronic total occlusions (CTOs). At 30-day follow-up there were no MACE events (0%). There were 10 (7.8%) re-hospitalisations of which majority (70%) were non cardiac presentations. We also included cost analysis for an elective PCI with SDD, which equated to $2090 per patient (total of $269 610 for cohort). Elective PCI with an overnight admission was $4440 per patient (total of $572 760 for cohort), an additional $2350 per patient (total $303 150). Total cost of an angiogram followed by a staged PCI with an overnight stay was $4700 per patient (total $606 300). Conclusion: SDD is safe and feasible in the majority of patients that have elective coronary angiography that require PCI. SDD leads to a significant reduction in total cost and hospital stay of patients undergoing elective PCI.
Measuring coping in multiple sclerosis: The Coping Index-MS
Authors: Young Carolyn A , Mills Roger J , Langdon Dawn , Rog David J , Sharrack Basil , Kalra Seema , Majeed Tahir , Footit David , Harrower Tim , Nicholas Richard S , Ford Helen L , Woolmore John , Johnstone Clare , Thorpe John , Paling David , Ellis Cathy , Hanneman C Oliver , Tennant Alan 
Published: August 2022

Background: Coping in multiple sclerosis (MS) refers to cognitive and behavioural efforts to manage stresses imposed by the illness. Existing generic and disease-specific coping scales do not meet modern guidelines for scale development and cannot produce interval-level metrics to allow for change scores. Objective: The main aim of this study was to develop a brief patient-reported outcome measure for coping in MS, capable of interval-level measurement. Methods: Qualitative work in 43 people with MS leads to a draft scale which was administered to 5747 participants, with longitudinal collection in 2290. A calibration sample of 1000 subjects split into development and validation sets was used to generate three scales consistent with Rasch model expectations. Results: The total Coping Index-MS (CI-MS-T), CI-MS-Internal (CI-MS-I) and CI-MS-External (CI-MS-E) cover total, internal and externally focused coping. All three scales are capable of interval-level measurement. Trajectory analysis of 9000 questionnaires showed two trajectories in CI-MS-T: Group 1 showed a low level of coping with slight decline over 40 months, while Group 2 had a better and stable level of coping due to improving CI-MS-I which compensated for the deteriorating CI-MS-E over time. CI-MS-T < 30 identified group membership at baseline. Conclusion: The CI-MS-T, CI-MS-I and CI-MS-E, comprising 20 items, provide interval-level measurement and are free-for-use in not-for-profit settings.
Progressive motor impairment from “critical” demyelinating lesions of the cervicomedullary junction
Authors: Jackson-Tarlton Caitlin S , Flanagan Eoin P , Messina Steven Anthony , Barakat Benan , Ahmad Rowaid , Kantarci Orhun H , Weinshenker Brian G , Keegan B Mark 
Published: August 2022

Background: Progressive motor impairment anatomically associated with a “critical” lesion has been described in primary demyelinating disease. Most “critical” lesions occur within the spinal cord. Objective: To describe the clinical and radiological features of “critical” lesions of the cervicomedullary junction (CMJ). Methods: Observational study on people presenting with a CMJ lesion associated with primary demyelinating disease-related progressive motor impairment. Clinical data were extracted by chart review. Brain and spinal cord magnetic resonance images were reviewed to characterize the CMJ lesion and determine additional demyelination burden. Results: Forty-one people were included: 29 (71%) had progression from onset and 12 (29%) had a relapse onset (secondary progressive) course. Most had progressive hemiparesis (21 (51%)) or progressive quadriparesis (15 (37%)) with a median Expanded Disability Status Scale (EDSS) of 5.5 (2.0–8.5) at last follow-up. No “critical” CMJ lesion enhanced; most were bilateral (25 (61%)). Brain magnetic resonance images were otherwise normal in 16 (39%) or with a restricted demyelination burden in 15 (37%). Cervical and thoracic cord MRIs were without additional lesions in 25 (61%) and 22/37 (59%), respectively. Conclusion: CMJ “critical” lesions can correlate with progressive motor impairment even with few or no additional magnetic resonance imaging (MRI) lesions. Lesion location is an important determinant of progressive motor impairment in demyelinating disease.
Use of follow-on disease-modifying treatments for multiple sclerosis: Consensus recommendations
Authors: Brownlee Wallace J , Wolf Christian , Hartung Hans-Peter , Dingermann Theo , Anshasi Nadia , Clark Richard AC , Trojano Maria , Selmaj Krzysztof , Uitdehaag Bernard MJ , Tur Carmen , Wuerfel Jens , Dallmann Gabriele , Witte Julian , Sintzel Martina , Bobrovnikova Olga , Cohen Jeffrey A 
Published: August 2022

Background: As patents for multiple sclerosis (MS) therapies expire, follow-on disease-modifying treatments (FO-DMTs) become available at reduced cost. Concerns exist that cheaper FO-DMTs are used simply to reduce healthcare costs. However, the well-being of people with MS should take priority. Objectives: To identify best practices for FO-DMT development and use by agreeing on principles and consensus statements through appraisal of published evidence. Methods: Following a systematic review, we formulated five overarching principles and 13 consensus statements. Principles and statements were voted on by a multidisciplinary panel from 17 European countries, Argentina, Canada and the United States. Results: All principles and statements were endorsed by >80% of panellists. In brief, FO-DMTs approved within highly regulated areas can be considered effective and safe as their reference products; FO-DMTs can be evaluated case by case and do not always require Phase III trials; long-term pharmacovigilance and transparency are needed; there is lack of evidence for multiple- and cross-switching among FO-DMTs; and education is needed to address remaining concerns. Conclusion: Published data support the use of FO-DMTs in MS. The consensus may aid shared decision-making. While our consensus focused on Europe, the results may contribute to enhanced quality standards for FO-DMTs use elsewhere.
Conducting caregiver focus groups on autism in the context of an international research collaboration: Logistical and methodological lessons learned in South Africa
Authors: Guler Jessy , Stewart Kearsley A , de Vries Petrus J , Seris Noleen , Shabalala Nokuthula , Franz Lauren 
Published: August 2022

Most autism research has been conducted in high-income countries, with participants typically from White, upper-middle-income families. Given the disparities experienced by autistic individuals living in underserved communities globally, there is a critical need for research to include individuals from culturally, linguistically, socioeconomically, and geographically diverse backgrounds to understand their unique needs. Qualitative research has the potential to describe the “lived experience” of families historically underrepresented in the autism literature. Here we describe the logistical and methodological challenges of conducting focus group discussions with 22 caregivers of young autistic children living in Cape Town, South Africa. Logistical challenges included (1) recruitment, (2) response rate, and (3) resource access. Methodological challenges included (1) participant background and experiences, (2) interpersonal dynamics, and (3) research ethics. We present recommendations based on lessons learned to reduce these challenges and improve rigorous qualitative research practices in similar low-resource contexts. Lay abstract Most of the autism research to date has been conducted in high-income countries, with children and families typically from White, upper-middle-income backgrounds. However, we know there are significant inequalities that exist which influence how autistic individuals from diverse, underserved communities can access services they need. As many of these individuals have not been included in the majority of autism research to date, there is much we do not know about these individuals’ life experiences, which are critically needed to better inform the development and implementation of care for families from historically underrepresented groups. In this article, we describe the research process we took to conduct focus group discussions with 22 caregivers of young autistic children living in Cape Town, South Africa. We specifically describe the lessons we learned in implementing these focus groups and provide recommendations aimed at how to best reduce logistical and methodological challenges moving forward to improve research conducted in similar low-resource contexts.
Blood culture positivity in patients with acute appendicitis: A propensity score–matched prospective cohort study
Authors: Sula Sami , Han Tatu , Marttila Harri , Haijanen Jussi , Löyttyniemi Eliisa , Sippola Suvi , Grönroos Juha , Hakanen Antti J. , Salminen Paulina 
Published: August 2022

Background and objective: The prevalence of bacteremia in acute appendicitis is unknown. We aimed to assess prevalence and predictive factors of bacteremia in adult patients with appendicitis. Methods: In this prospective propensity score–matched cohort study, patients were recruited as part of one single-center prospective observational study assessing appendicitis microbiology in concurrence with two randomized controlled trials on non-operative treatment of uncomplicated acute appendicitis. All patients evaluated for enrollment in these three trials between April 2017 and December 2018 with both a confirmed diagnosis of appendicitis and available blood culture on admission were included in this study. Potential predictive factors of bacteremia (age, sex, body mass index (BMI), body temperature, C-reactive protein (CRP), leukocyte count, comorbidities, symptom duration, and appendicitis severity) were assessed. Prevalence of bacteremia was determined by all available blood cultures followed by propensity score matching using sex, age, BMI, CRP, leukocyte count, and body temperature of the patients without available blood culture. Results: Out of the 815 patients with appendicitis, 271 patients had available blood culture and the prevalence of bacteremia was 12% (n = 33). Based on propensity score estimation, the prevalence of bacteremia in the whole prospective appendicitis cohort was 11.1%. Bacteremia was significantly more frequent in complicated acute appendicitis (15%; 29/189) compared with uncomplicated acute appendicitis (5%; 4/82) (p = 0.015). Male sex (p = 0.024) and higher body temperature (p = 0.0044) were associated with bacteremia. Conclusions: Estimated prevalence of bacteremia in patients with acute appendicitis was 11.1%. Complicated appendicitis, male sex, and higher body temperature were associated with bacteremia in acute appendicitis.