bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasound elastography in the assessment of post-stroke muscle stiffness: a systematic review
Authors: Roots Jacqueline , Trajano Gabriel S , Fontanarosa Davide 
Published: April 2022

Abstract
Background
Post-stroke muscle stiffness is a major challenge in the rehabilitation of stroke survivors, with no gold standard in clinical assessment. Muscle stiffness is typically evaluated by the Modified Ashworth Scale or the Tardieu Scale; however, these can have low reliability and sensitivity. Ultrasound elastography is an advanced imaging technology that can quantitatively measure the stiffness of a tissue and has been shown to have good construct validity when compared to clinically assessed muscle stiffness and functional motor recovery.

Objective
The purpose of this article is to systematically review the literature regarding the change in muscle stiffness as measured by ultrasound elastography in stroke survivors.

Methods
Scopus, PubMed, Embase, CINAHL, MEDLINE and Cochrane Library were searched for relevant studies that assessed the change in stiffness of post-stroke muscle stiffness measured by ultrasound elastography following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Results
In total, 29 articles were identified, using either strain elastography and shear wave elastography to measure the stiffness of muscles in stroke survivors, most frequently in the biceps and medial gastrocnemius muscles. The stiffness was typically higher in the paretic compared to the non-paretic or healthy control. Other variations that increased the stiffness include increasing the joint angle and introducing a passive stretch or muscle activation. The paretic muscle has also been assessed pre- and post-treatment demonstrating a decrease in stiffness.

Conclusion
Ultrasound elastography is a promising imaging technology for determining the muscle stiffness in stroke survivors with need for a standardized imaging protocol.
Addressing the important error of missing surgical items in an operated patient
Authors: Susmallian Sergio , Barnea Royi , Azaria Bella , Szyper-Kravitz Martine 
Published: April 2022

Abstract
Background
We aim to analyze the characteristics of incidences of missing surgical items (MSIs) and to examine the changes in MSI events following the implementation of an MSI prevention program.

Methods
All surgical cases registered in our medical center from January 2014 to December 2019 were retrospectively analyzed.

Results
Among 559,910 operations, 154 MSI cases were reported. Mean patient age was 48.67 years (standard deviation, 20.88), and 56.6% were female. The rate of MSIs was 0.259/1000 cases. Seventy-seven MSI cases (53.10%) had no consequences, 47 (32.41%) had mild consequences, and 21 (14.48%) had severe consequences. These last 21 cases represented a rate of 0.037/1000 cases. MSI events were more frequent in cardiac surgery (1.82/1000 operations). Textile elements were the most commonly retained materials (28.97% of cases). In total, 15.86% of the cases were not properly reported. The risk factors associated with MSIs included body mass index (BMI) above 35 kg/m2 and prolonged operative time. After the implementation of the institutional prevention system in January 2017, there was a gradual decrease in the occurrence of severe events despite an increase in the number of MSIs.

Conclusion
Despite the increase in the rate of MSIs, an implemented transparency and reporting system helped reduce the cases with serious consequences. To further prevent the occurrence of losing surgical elements in a surgery, we recommend educating OR staff members about responsibility and obligation to report all incidents that are caused during an operation, to develop an event reporting system as well as "rituals" within the OR setting to increase the team's awareness to MSIs.
Trial registration Clinicaltrials.gov (NCT04293536). Date of registration: 08.01.2021. https://clinicaltrials.gov/ct2/show/NCT04293536.
ISO 10993 biological evaluation of novel hemostatic powder – 4SEAL®
Authors: Szymanski Lukasz , Golaszewska Kamila , Wiatrowska Anna , Dropik Monika , Szymanski Pawel , Gromadka Bartosz , Krakowiak Patrycja , Wierzchowska Justyna , Matak Damian 
Published: April 2022

Abstract

Background
Hemostasis plays a crucial role during every surgery allowing for a bloodless operating field. Fast and effective surgery leads to a reduced risk of postoperative complications. One of the latest methods for achieving homeostasis is using natural polysaccharide-based hemostatic powders. The study aimed to evaluate the biocompatibility according to the ISO 10993 standards of 4SEAL® Hemostatic powder.

Methods
Chemical characterization (Headspace GC-MS, GC-MS, and ICP-MS), cytotoxicity, genotoxicity (MLA and AMES), endotoxin contamination, sensitization potential, intracutaneous reactivity, acute and subacute systemic toxicity with implantation, and pyrogenicity were evaluated to investigate the biocompatibility of the 4SEAL® Hemostatic powder. Studies were conducted according to ISO 10993 standards.

Results
The biocompatibility requirements according to ISO 10993-1 for 4SEAL® Hemostatic powder were met. Based on the conducted in-vitro studies, 4SEAL® Hemostatic powder shows a non-cytotoxicity and non-mutagenic potential. Also, the results of in vivo studies of 4SEAL® Hemostatic powder shows no signs of toxicity, non-sensitizing, non-irritating, and no pyrogenicity potential. In the chemical characterization of 4Seal® Hemostatic Powder, no compounds were identified above Analytical Evaluation Threshold (AET) and no elements with concentrations higher than element-specific PDE [μg/day] were detected.

Conclusions
4SEAL® Hemostatic powder is a promising new hemostatic agent with a wide range of potential applications and excellent biocompatibility.
Stunting and associated factors among children aged 6–59 months from productive safety net program beneficiary and non-beneficiary households in Meta District, East Hararghe zone, Eastern Ethiopia: a comparative cross-sectional study
Authors: Tesfaye Aklilu , Egata Gudina 
Published: April 2022

Abstract
Background
Undernutrition is one of the major public health problems affecting children in developing settings. Despite impressive interventions like productive safety net program (PSNP), there is limited information on the association between stunting and PSNP implementation in Ethiopia.

Methods
Community-based comparative cross-sectional study design was used among systematically selected 1555 children and their mothers/caregivers from households enrolled in PSNP and not, respectively, in Meta District east Ethiopia from 5th–20th of March 2017. Data were collected using pretested structured questionnaire. Measuring board was used to measure length/height of children. Length/height for age Z-score was generated using World Health Organization (WHO) Anthro version 3.2.2. Descriptive statistics was used to describe all relevant variables. Bivariable and multivariable logistic regression analyses were used to identify predictors of stunting. Odds ratio along with 95% confidence intervals were estimated to measure the strength of association. The statistical significance was declared at p value less than 0.05.

Results
The prevalence of stunting was 47.7%, 95% CI (44.1%, 51.5%) and 33.5%, 95% CI (29.9%, 36.9%) among children from households enrolled in PSNP and non-PSNP ones, respectively. Lack of maternal education [AOR = 3.39; 95% CI (1.12, 5.11)], women’s empowerment [AOR = 3.48; 95% CI (2.36, 5.12)] and fourth antenatal care visit [AOR = 4.2, 95% CI (2.5, 6.8)], practicing hand washing [AOR = 0.46; 95% CI (0.28, 0.76)], living in mid-land [AOR = 1.94, 95% CI (1.12, 3.35)] and low-land[AOR = 0.27: 95% CI (0.16, 0.45)] agro-ecological zones, PSNP membership [AOR = 1.82, 95% CI (1.14, 2.89)], childhood illness [AOR = 8.41; 95% CI (4.58, 12.76)], non-exclusive breastfeeding [AOR = 3.6; 95% CI (2.30, 4.80)], inadequate minimum dietary diversity [AOR = 4.7; 95% CI (3.0, 7.40)], child’s sex [AOR = 1.73, 95% CI (1.18, 2.53)] and age (24–59 months) [AOR = 3.2; 95% CI (1.6, 6.3)] were independent predictors of stunting.

Conclusions
The prevalence of stunting was high among children from households enrolled in PSNP. Stunting was significantly associated with maternal- and child-related factors. Therefore, women empowerment on household’s issues and improving infant and young child feeding practices could reduce the prevalence of stunting and its adverse consequences.
Morphometric analysis of the Filipino knee and its implication in total knee arthroplasty prosthesis design
Authors: Flores Cleff Lucero , San Juan Jose Antonio G. 
Published: April 2022

Abstract
Background
Prosthesis factors account for a quarter of the dissatisfaction rates among post-total knee replacement (TKR) patients. In the Philippines, the available prostheses have pre-determined sizes and dimensions that are based on Caucasian morphometric data. This can pose a problem, since according to previous studies Asian knees have smaller dimensions compared to Caucasians. Since there is a paucity of research looking into the fitness of these prostheses to the Filipino knee, this study was pursued.

Methods
This study measured 675 knees of 675 adult Filipinos from January 2018 to December 2020. The morphometric measurements were performed on T1-weighted magnetic resonance images. The distal femoral morphometry included: the anteroposterior distance, lateral and medial anteroposterior distances, mediolateral distance, anterior and posterior mediolateral distances, and the femoral aspect ratio. The proximal tibial morphometry included: the anteroposterior distance, mediolateral distance, the medial and lateral anteroposterior distances, and the tibial aspect ratio. The patellar height, width, and thickness were also determined. Statistical analyses were done by using SPSS (version 26) and Microsoft Excel (version 2016).

Results
The mean femoral medial and lateral anteroposterior distances were 57.6 mm and 57.1 mm, respectively. The femoral mediolateral distance was 69.3 mm, and the mean femoral aspect ratio was 1.21. The mean proximal tibial antero-posterior and mediolateral distances were 45.3 mm and 71.9 mm, respectively. The mean tibial aspect ratio was 1.66. Most TKR prostheses can be fitted to the Filipino knee but underhang on the mediolateral aspect is commonly observed in both the femoral and tibial components. The mean patellar height and width of Filipinos were 39.6 mm and 42.6 mm, respectively while the average thickness was 23.1 mm.

Conclusion
Most prostheses available in the Philippine and Asian markets can be fitted into Filipino knees albeit the underhang observed in the mediolateral aspects of both femoral and tibial components. Potential patellar complications are unlikely given the adequate thickness. To avoid the potential mismatch, the best approach is to design a prosthesis aptly suited for the Filipino knees.
Increasing patient-reported allergies are not associated with pain, functional outcomes, or satisfaction following medial patellofemoral ligament reconstruction: a retrospective comparative cohort study
Authors: Bi Andrew S. , Shankar Dhruv S. , Vasavada Kinjal D. , Fisher Nina D. , Strauss Eric J. , Alaia Michael J. , Campbell Kirk A. 
Published: April 2022

Abstract
Background
Patient-reported allergies (PRAs) are often stigmatized as a potential nonmodifiable risk factor for increased pain and worse functional outcomes following surgery. However, there is a dearth of literature directly assessing the impact of PRAs on outcomes in sport surgeries such as medial patellofemoral ligament reconstruction (MPFLR). The purpose of our study was to determine whether PRAs were associated with worse outcomes following MPFLR.

Methods
We conducted a retrospective review of patients who underwent MPFLR at our institution from 2011 to 2019. Patients were included if they had at least 12 months of follow-up. PRAs were obtained from preoperative medical assessments and categorized by drug class. Demographic and perioperative data were obtained from electronic medical records. Postoperative outcomes were measured using a telephone survey and included recurrent instability, Visual analog scale (VAS) for pain, VAS for sports, Kujala score, MPFL-Return to Sport after Injury (MPFL-RSI) score, and overall satisfaction score. Multiple linear regression was used to determine association between PRAs and outcome measures, and p-values less than 0.05 were considered significant.

Results
The cohort included 141 MPFLR. Most patients were female (98, 70%) with an average age of 25 years (range 12–56 years). Average follow-up time was 47 months. Forty-seven patients (33%) reported at least one PRA. There were no significant differences in postoperative pain, functional outcomes, satisfaction, or return to sport between patients with or without PRAs (all p > 0.05). Absence of antibiotic PRAs was predictive of higher VAS (p < 0.007), but there were no other differences. There were no significant differences in outcomes between patients without PRAs, PRAs without a concomitant psychiatric disorder, or PRAs with a concomitant psychiatric disorder (all p > 0.05).

Conclusions
In conclusion, PRAs with or without concomitant psychiatric diagnoses are not associated with worse postoperative pain, functional outcomes, or satisfaction following MPFLR with allograft, dispelling common misconceptions that increased number of allergies or psychiatric diagnoses lead to inferior surgical outcomes. Presence of antibiotic allergies was associated with lower VAS postoperative pain score. Future research should investigate the relationship between PRAs and other surgeries in the field of sports medicine.
Risk factors and trajectories of opioid use following total knee replacement
Authors: Ward Ralph , Taber David , Gonzales Haley , Gebregziabher Mulugeta , Basco William , McCauley Jenna , Mauldin Patrick , Ball Sarah 
Published: April 2022

Abstract
Background
Opioids are commonly used to manage orthopedic pain in those undergoing total knee arthroplasty (TKA). There are limited studies assessing patterns of perioperative opioid use and risk factors for chronic use in patients undergoing TKA.

Methods
This is a retrospective longitudinal cohort study of Medicaid enrollees undergoing TKA between 2014 and 2017 using de-identified medical and pharmacy claims. The primary outcome was chronic opioid use (opioid prescription filled 90–270 days following TKA). Trajectory group membership was determined by identifying distinct groups of patients with similar patterns of daily morphine milligram equivalent (MME) values during the postsurgery follow-up period.

Results
In total, 1666 TKA surgeries performed in 1507 patients were included; 69% of patients were classified as chronic opioid users. Multivariable analyses identified prior opioid use, high opioid doses during the month after TKA, concomitant mood therapies and benzodiazepines, and comorbid conditions as important risk factors. Group-based trajectory analysis identified five distinct post-TKA surgery opioid use phenotypes with several key characteristics predicting group membership.

Conclusions
This large-scale analysis demonstrated that chronic opioid use was common after TKA surgery and established several important risk factors for chronic use following TKA. Novel analysis revealed five distinct opioid use trajectories and identified key characteristics to help guide clinicians when determining perioperative opioid use. Results demonstrate that interventional studies attempting to reduce opioids after TKA are needed if reductions in long-term use are to be realized in this high-risk patient population.
Role of Vestibular Evoked Myogenic Potential (VEMP) in diagnosis of vestibular abnormalities in patients with type 2 diabetes mellitus
Authors: El-seady Israa Y , Abd El-Tawab Mohamed M , El-Shawaf Wessam I , El-Sehrawy Amr A 
Published: April 2022

Abstract
Objectives
To evaluate the role of ocular vestibular evoked myogenic potentials (oVEMP) in diagnosis of vestibular abnormalities among patients with type 2 diabetes mellitus (T2DM).

Methods
Eighty T2DM patients were selected for the study plus a group of 30 normal non-diabetic individuals. Both groups were assessed regarding oVEMP latency and amplitude.

Results
There were statistically significant differences in the latencies of N1 and P1 in patients with DM in comparison to controls in both the right and left ears although there was no significant difference between both groups regarding the amplitude of N1 and P1. We found that there were statistically significant differences in the latencies of N1 and P1 in patients with DPN in comparison with patients without DPN. Also, we found that there was no significant relation between duration of diabetes and VEMP latency. According to type of treatment, there was significant difference between diabetic patients on insulin therapy and those on hypoglycemic medications regarding latency of N1 and P1 (Table 6).

Conclusion
In patients with type 2 DM receiving primary health care, who are not seeking medical care due to sensory or balance decline, utricular function may be impaired even without history of falls.
Prognostic Value of Lateral Spread Response Recorded 1 Month After Microvascular Decompression for the Treatment of Hemifacial Spasm
Authors: Kim Minsoo , Cho Kyung Rae , Park Sang-Ku , Jeon Chiman , Park Kwan 
Published: April 2022

BACKGROUND:
The predictive value of intraoperative disappearance of the lateral spread response (LSR) during microvascular decompression surgery for hemifacial spasm treatment is unclear. Studies evaluating the clinical implications of the LSR recorded during the postoperative period are also limited.

OBJECTIVE:
To analyze the LSR 1 month postoperatively and to evaluate its prognostic value until 1 year postsurgery.

METHODS:
In total, 883 patients who underwent microvascular decompression between 2016 and 2018 were included. LSR was recorded preoperatively, intraoperatively before decompression, intraoperatively after decompression, and 1 month postoperatively. The outcomes were evaluated at 1 week, 1 month, and 1 year postoperatively.

RESULTS:
The presence of preoperative and intraoperative LSR after decompression did not predict the postoperative outcome at 1 year. In 246 patients (27.9%), the postoperative LSR at 1 month was not identical to that recorded intraoperatively after decompression. Postoperative LSR at 1 month was associated with a worse outcome at 1 month (P < .0001) and 1 year (P = .0002) postoperatively. Patients with residual symptoms and a LSR 1 month postoperatively were more likely to show residual symptoms 1 year postoperatively, with a positive predictive value of 50.7%.

CONCLUSION:
Unlike the intraoperative LSR, the LSR at 1 month postoperatively showed prognostic value in predicting 1-year postoperative outcomes and was useful for identifying patients with a high risk of unfavorable outcomes. Thus, confirming the presence of postoperative LSR is necessary.
A mixture of innate cryoprotectants is key for freeze tolerance and cryopreservation of a drosophilid fly larva
Authors: Kučera Lukáš , Moos Martin , Štětina Tomáš , Korbelová Jaroslava , Vodrážka Petr , Des Marteaux Lauren , Grgac Robert , Hůla Petr , Rozsypal Jan , Faltus Miloš , Šimek Petr , Sedlacek Radislav , Koštál Vladimír 
Published: April 2022

ABSTRACTInsects that naturally tolerate internal freezing produce complex mixtures of multiple cryoprotectants (CPs). Better knowledge on composition of these mixtures, and on the mechanisms of individual CP interactions, could inspire development of laboratory CP formulations optimized for cryopreservation of cells and other biological material. Here, we identify and quantify (using high resolution mass spectrometry) a range of putative CPs in larval tissues of a subarctic fly, Chymomyza costata, which survives long-term cryopreservation in liquid nitrogen. The CPs proline, trehalose, glutamine, asparagine, glycine betaine, glycerophosphoethanolamine, glycerophosphocholine and sarcosine accumulate in hemolymph in a ratio of 313:108:55:26:6:4:2.9:0.5 mmol l−1. Using calorimetry, we show that artificial mixtures, mimicking the concentrations of major CPs in hemolymph of freeze-tolerant larvae, suppress the melting point of water and significantly reduce the ice fraction. We demonstrate in a bioassay that mixtures of CPs administered through the diet act synergistically rather than additively to enable cryopreservation of otherwise freeze-sensitive larvae. Using matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI), we show that during slow extracellular freezing trehalose becomes concentrated in partially dehydrated hemolymph where it stimulates transition to the amorphous glass phase. In contrast, proline moves to the boundary between extracellular ice and dehydrated hemolymph and tissues where it probably forms a layer of dense viscoelastic liquid. We propose that amorphous glass and viscoelastic liquids may protect macromolecules and cells from thermomechanical shocks associated with freezing and transfer into and out of liquid nitrogen.
Insights and Further Understanding of Radioactive Cesium Removal Using Zeolite, Prussian Blue and Graphene Oxide as Adsorbents
Authors: Yagyu Junya , Islam Md Saidul , Yasutake Hiroki , Hirayama Haruka , Zenno Hikaru , Sugimoto Akira , Takagi Shunji , Sekine Yoshihiro , Ohira Shin-Ichi , Hayami Shinya 
Published: April 2022

Abstract
The efficient removal of radioactive cesium (137Cs) from contaminated water around nuclear plants and/or after nuclear accidents has become an emerging issue since the Fukushima Daiichi Nuclear Power Plant (Fukushima, Japan) disaster on March 11, 2011. Herein, we have demonstrated and compared the adsorption performances of both 137Cs and 133Cs using three potential adsorbents, zeolite (ZL), Prussian blue (PB) and graphene oxide (GO), in deionized water and simulated seawater. The adsorption efficiencies are determined in terms of the adsorbent amount, initial Cs concentration, and the effect of other competing ions in the system. In addition, the practical application of the materials was justified by evaluating the elution/retention of the adsorbed Cs with different volumes of solvent. Significantly, we illustrated a practical validation of a purification route for 137Cs-contaminated fly ash generated from nuclear power plant accidents, while PB can be a potential adsorbent for large-scale implementation.