bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hemostatic effect and safety evaluation of the absorbable macroporous polysaccharides composite hemostatic material prepared by a green fabrication approach
Authors: Wu Lihao , Ren Kang , Chen Gong , Wang Hongjian , Li Hongwei , Xu Ling 
Published: November 2022

Carboxymethyl chitosan is widely used in the medical field such as wound healing and other medical fields. We previously fabricated the absorbable macroporous polysaccharides composite hemostatics (AMPCs) mainly composed of carboxymethyl chitosan which possess excellent hemostatic effect. To further elucidate the impact of CMCTs on the hemostatic effect and biosafety of AMPCs, carboxymethyl chitosan with different properties were used to prepare AMPCs. By comparing the physical and chemical properties, AMPCs performed high water absorption ability, especially Group 1 (swelling ratio reached 5792%), which facilitated the rapid formation of blood clots. It was confirmed by blood clotting index (BCI) and blood coagulation tests in vitro that Group 1 showed a slightly higher coagulation capacity than groups 2 and 3, which may be due to the positive charge on the surface of the cations in the salts attaches to the negative charge on the surface of the red blood cells, an electrostatic neutralization reaction occurs. The biosafety was a preliminary evaluation by implanted AMPCs into the back of Sprague-Dawley rats and the tissue was harvested after feeding for 28 days. The AMPCs exhibited good biosafety for whole blood and major organs during the degradation in vivo: during the degradation of AMPCs, excluding changes in some serum indicators, no tissue necrosis or inflammatory cell infiltration was observed in these organs, either by gross observation or histological analysis. These findings demonstrate that expecting to develop a highly functional and safe hemostatic agent based on Group 1 for rapid hemostasis applications in emergencies.
Audiologists’ Perceptions of Hearing Healthcare Resources and Services in South Africa’s Public Healthcare System
Authors: Bhamjee Aaqilah , le Roux Talita , Schlemmer Kurt , Graham Marien Alet , Mahomed-Asmail Faheema 
Published: November 2022

Background: Hearing loss poses a significant burden globally. Its prevalence is exceptionally high in countries across the African region, where healthcare resources and services remain inaccessible. This study aimed to describe audiologists’ perceptions regarding hearing healthcare resources and services within South Africa’s public healthcare system. Methods: A national self-developed telephonic survey was conducted with audiologists in public healthcare system hospitals across South Africa, with the final sample comprising 100 audiologists. Results: Most (82%) audiologists indicated that their hospitals did not have adequate hearing healthcare resources to render efficient audiology services to patients. Binaural amplification devices (invasive and non-invasive) for adults with bilateral hearing loss who adhered to the criteria for these devices were perceived to be unavailable in most hospitals. Audiologists also perceived that universal newborn hearing screening services, adult aural rehabilitation services, and follow-up care for all hearing devices post-warranty expiration were limited. Conclusion: Efforts should be made to upsurge hearing healthcare resources, including increasing the financial budgets allocated to audiology resources so that increased diagnostic and screening audiology equipment and hearing devices can be procured where required, and additional audiologists can be employed within the South African public sector hospitals where needed.
A natural history of temporary tube feeding care at a children’s hospital: A prospective audit of medical records
Authors: Syrmis Maryanne , Frederiksen Nadine , Reilly Claire , Bell Kristie 
Published: November 2022

This chart audit characterized the natural history of temporary tube feeding use at a children’s hospital between 1 November 2018 and 30 November 2019. Data were collected from the decision-making phase until tube removal or 4 months post-tube insertion. Children’s tube feeding journeys were described, and associations determined between patient and service-related variables and outcomes of tube feeding duration and being discharged with a feeding tube. Four hundred and 94 patients were followed with a median age of 1.0 years (IQR 3.6). Many had respiratory illnesses ( n = 213, 43%) and received feeding tubes for inadequate oral intake related to acute illness ( n = 279, 57%). Seventy-one new feeding tubes were inserted per month (SD 27.63). Fifty-nine per cent of patients ( n = 290) received allied health consults. Although 40% of patients ( n = 199) experienced complications, most patients ( n = 460, 93%) ceased tube feeding within 4 months. Outcomes were associated with age, medical condition, reflux, primary reason for tube feeding, allied health consult, complication type, tube weaning plans and referral for longer-term feeding devices. Results highlighted a critical need for risk identification from the decision-making stage and standardization of practices during all phases of temporary tube feeding care.
Mechanical thrombectomy for large vessel occlusion between 6 and 24 h: outcome comparison of DEFUSE-3/DAWN eligible versus non-eligible patients
Authors: Dittrich Tolga D , Sporns Peter B , Kriemler Lilian F , Rudin Salome , Nguyen Anh , Zietz Annaelle , Polymeris Alexandros A , Tränka Christopher , Thilemann Sebastian , Wagner Benjamin , Altersberger Valerian L , Piot Ines , Barinka Filip , Hänsel Martin , Gensicke Henrik , Engelter Stefan T , Lyrer Philippe A , Sutter Raoul , Nickel Christian H , Katan Mira , Peters Nils , Michels Lars , Kulcsár Zsolt , Karwacki Grzegorz M , Pileggi Marco , Cereda Carlo , Wegener Susanne , Bonati Leo H , Fischer Urs , Psychogios Marios , De Marchis Gian Marco 
Published: November 2022

Background: The DEFUSE-3 and DAWN trials showed that mechanical thrombectomy (MT) improves the outcome of selected patients with anterior circulation large vessel occlusions (LVO) up to 24 h after stroke onset. However, it is unknown whether only those patients fulfilling the trial inclusion criteria benefit, or whether benefit is seen in a broader range of patients presenting between 6 and 24 h. Aims: We determined whether fulfilling the DEFUSE-3 and DAWN selection criteria affects outcomes in MT patients in clinical practice. Methods: We reviewed adult patients with LVO treated with MT between 6 and 24 h after stroke onset at five Swiss stroke centers between 2014 and 2021. We compared two groups: (1) patients who satisfied neither DEFUSE-3 nor DAWN criteria (NDND) and (2) those who satisfied DEFUSE-3 or DAWN criteria (DOD). We used logistic regression to examine the impact of trial eligibility on two safety outcomes (symptomatic intracranial hemorrhage [sICH] and all-cause mortality at 3 months) and two efficacy outcomes (modified Rankin Score [mRS] shift toward lower categories and mRS of 0–2 at 3 months). Results: Of 174 patients who received MT, 102 (59%) belonged to the NDND group. Rates of sICH were similar between the NDND group and the DOD group (3% vs. 4%, p = 1.00). Multivariable regression revealed no differences in 3-month all-cause mortality (aOR 2.07, 95% CI 0.64–6.84, p = 0.23) or functional outcomes (mRS shift: acOR 0.81, 95% CI 0.37–1.79, p = 0.60; mRS 0–2: aOR 0.91, 95% CI 0.31–2.57, p = 0.85). Conclusion: Among adult patients with LVO treated with MT between 6 and 24 h, safety and efficacy outcomes were similar between DEFUSE-3/DAWN eligible and ineligible patients. Our data provide a compelling rationale for randomized trials with broader inclusion criteria for MT.
The efficacy of sensory neural entrainment on acute and chronic pain: A systematic review and meta-analysis
Authors: Maddison Rhys , Nazar Hamde , Obara Ilona , Vuong Quoc C 
Published: November 2022

BackgroundChanges to the power of neural oscillations in cortical and sub-cortical structures can change pain perception. Rhythmic sensory stimulation is a non-invasive method that can increase power in specific frequencies of neural oscillations. If the stimulation frequency targets those frequencies related to pain perception, such as alpha or theta frequencies, there can be a reduction in perceived pain intensity. Thus, sensory neural entrainment may provide an alternative to pharmacological intervention for acute and chronic pain. This review aimed to identify and critically appraise the evidence on the effectiveness of sensory entrainment methods for pain perception.MethodsWe undertook a systematic search across Medline, Embase, PsycInfo, Web of Science and Scopus in November 2020 to identify studies investigating the efficacy of sensory entrainment on adults. We assessed studies for their quality using the PRISMA checklist. A random-effects model was used in a meta-analysis to measure the effect of entrainment on pain perception.ResultsOur systematic review yielded nine studies fitting the search criteria. Studies investigated the effect of visual and auditory entrainment on pain intensity rating, electrophysiological markers of pain and amount of analgesia needed during surgery. The meta-analysis suggests that alpha (8–13 Hz) sensory entrainment is effective for acute pain perception, whereas theta (4–7 Hz) entrainment is effective for chronic pain.ConclusionsAlthough there is heterogeneity in the current evidence, our review highlights the potential use of sensory entrainment to affect acute and chronic pain. Further research is required regarding the timing, duration and frequency of the stimulation to determine the best application for maximum efficacy.
Defining covert recording: A qualitative study exploring the experiences of clinicians when a patient records a hospital clinical encounter using a smartphone without consent
Authors: Ryan Laura , Weir Kelly A , Maskell Jessica , Bevan Lily , Le Brocque Robyne 
Published: November 2022

Background Patients use their smartphones to covertly record their clinical encounters in hospital. However, this issue is poorly understood. Insight into the clinician perspective will help inform policies and practices that deliver safe environments for patients and clinicians. Objective This study aimed to gain a deep understanding of clinician attitudes and behaviours when a patient covertly records a hospital clinical encounter using a smartphone. Methods Semi-structured interviews were undertaken with 20 hospital clinicians. Participants were recruited via purposive and snowball sampling. Interviews were conducted in person or via Microsoft Teams. Interviews were digitally audio recorded and transcribed. Data was analysed using thematic analysis. Results Most of the 20 participants reported they had either suspected or experienced a patient covertly recording a clinical encounter. Covert recordings occurred across a broad range of clinical disciplines and contexts. Themes were identified from participant perspectives, including discernment of patient intention, likeliness to consent to the recording if asked, anticipated risks and potential benefits associated with the covert recording. These themes have led to the categorisation of three forms of covert recording: (1) Intentional Covert Recording (2) Inadvertently – Covert Recording, and (3) Beneficial Covert Recording. Conclusion Clinicians have varied experiences and responses when a patient covertly records a clinical encounter. Findings indicate that nuanced strategies may be required to support clinicians to manage covert recording, whilst balancing the needs of patients.
Repair of Acute Grade 3 Combined Posterolateral Corner Avulsion Injuries Using an Enhanced Fixation Technique
Authors: Moran Jay , Kahan Joseph B. , Schneble Christopher A. , McLaughlin William M. , Green Joshua S. , Gillinov Stephen M. , Cheng Ryan , Patel Rohan R. , Jimenez Andrew E. , LaPrade Robert F. , Schenck Robert C. , Medvecky Michael J. 
Published: November 2022

Background: Previous studies have suggested that surgical repair of the posterolateral corner (PLC) may be inferior to reconstruction. Hypothesis: We hypothesized that acute repair (<3 weeks) of avulsion-type PLC multiligament knee injuries with no midsubstance injury would lead to lower failure rates than previously reported for PLC repair. Study Design: Case series; Level of evidence, 4. Methods: A total of 28 patients with multiligament knee injuries who underwent acute repair between January 2007 and June 2018 of a PLC avulsion injury with no evidence of midsubstance tearing were included. All PLC avulsion injuries were treated using a transosseous Krackow suture pull-through technique without graft augmentation. Outcome metrics included lateral joint-space widening with varus stress, patient-reported clinical varus instability, patient-reported outcome measures (PROMs), and any subsequent revision or salvage procedure. Results: The mean time from injury to repair was 8.1 ± 5 days. At a mean follow-up of 2 years (range, 3-90 months), clinical varus stress examination at 30° demonstrated a significant reduction in lateral compartment opening, from 9 ± 3 mm preoperatively to 0 ± 3 mm ( P < .0001). The failure rate was calculated to be 10.7% (3/28), which was significantly lower than the failure rate from a 2016 systematic review (38%, 17/45; P = .015). Of the 28 patients, 21 (75%) had PROM scores. Patients who underwent staged bi-cruciate reconstructions (n = 5) had significantly higher subjective International Knee Documentation Committee (IKDC) (87.2 vs 65.5; P = .014) and Lysholm (90.5 vs 75.2; P = .029) scores compared to patients with untreated bi-cruciate injuries (n = 9). Patients with peroneal nerve injury (n = 4) had significantly lower IKDC (58.2 vs 80.8; P = .0045) and Tegner (3.2 vs 5.4; P = .047) scores than those without peroneal nerve injury (n = 17). The mean IKDC and Lysholm scores at final follow-up were 73.4 ± 24.0 and 80.8 ± 23.1 at 7.1 years (range, 2.3-10.6 years) of follow-up. Conclusion: Repair of acute grade 3 combined PLC avulsion injuries using a transosseous Krackow suture pull-through technique demonstrated a failure rate of 10.7%. Patients who underwent a staged cruciate reconstruction(s) had higher subjective outcome scores than those who had cruciate injuries left untreated. Peroneal nerve injury was associated with lower outcome scores.
Differences in Outcomes Between Tendon Transfer Treatments of Congenital Clubfoot in Cerebral Palsy
Authors: Chu Alice , Hanna Aedan , Hanna Adeeb J. , McGrath Aleksandra , Kaushal Neil , Edobor-Osula Folorunsho 
Published: November 2022

Category: Ankle; Other Introduction/Purpose: Cerebral palsy (CP) provides challenges when treating congenital clubfoot (CF) due to the presence of aberrant muscle tone and motor dysfunction. Split anterior tendon transfer (SPATT) and split posterior tendon transfer (SPOTT) are two ubiquitous treatments in the surgical repair of CP CF. Kling et. al. developed a three-tier grading system for documenting SPOTT outcomes; assigning excellent, good, or poor based on postoperative ambulation and functional dorsiflexion, this system has also been applied to SPATT recovery. The purpose of this study is to elucidate any difference in the outcomes of CP CF patients who receive SPOTT vs SPATT treatment. Methods: Following PRISMA guidelines a comprehensive search was conducted of PubMed, Cochrane, CINAHL, Scopus, and Web of Science. Collected publications represent all available literature on clubfoot. Articles were then screened by two independent reviewers at the title, abstract, and full-text level; only articles that detailed tendon-transfer treatment of pediatric patients with CF, CP, and contained three or more human subjects were included. Publications were excluded from screening if found to be duplicate articles, historical reviews, professional opinions, case reports, or contained non-human subjects. Two independent reviewers verified that each article met predetermined inclusion criteria at each level of screening. SAS statistical software was used to determine the relationship between positive and negative interventions outcomes, as well as patent demographics. Results: An initial search yielded 6,469 articles; after review 17 articles remained which described surgical tendon transfer: 12 (70.59%) split posterior tendon transfer (SPOTT) articles (mean-age 9.30 +- 2.57 years, mean follow-up length 60.03 +- 37.64 months), 5 (29.41%) split anterior tendon transfer (SPATT) articles (mean-age 10.12 +- 3.40 years mean follow-up length 64.16 +- 34.35 months). SPOTT papers included a total of 391 patients and 446 feet with a post-operative excellent & good rate of 90.48% and failure rate of 8.70%. SPATT papers included a total of 136 patients and 151 feet with a post-operative excellent & good rate of 71.22% and failure rate of 9.73%. Conclusion: These results show that the publication frequency of CP CF treatment by split posterior tendon transfer is higher than that of split anterior tendon transfer. Additionally, results of this systematic review indicate that there is a greater predicted positive outcome in SPOTT vs SPATT while there is no significant difference in predicted negative outcomes between procedures.
Evidence for Graft Materials Used in Hindfoot and Ankle Arthrodesis: A Systematic Literature Review
Authors: Covell Donald J. , Knight Ashley , Fitch David 
Published: November 2022

Category: Hindfoot; Ankle Introduction/Purpose: There is a wide range of graft materials available to supplement hindfoot and ankle arthrodesis procedures. These include autograft, allografts, and bone graft substitutes. While these various materials are commonly used, the level of evidence to support each has not been widely explored. The purpose of this study was to conduct a systematic literature review to evaluate the level of evidence that exists for each of these materials to inform clinical decision making towards optimal patient outcomes. Methods: A systematic literature review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The search was conducted using the Embase, MEDLINE, and Cochrane Controlled Register of Trials databases in May 2019 for studies published in English since January 1, 2009. The review included all studies published with patients who were at least 18 years of age needing graft material for hindfoot or ankle arthrodesis. Two independent reviewers reviewed all abstracts for inclusion. Disagreements were resolved by a third reviewer for consensus. Results: The search returned 3,547 records, of which 35 were included. Autograft and allograft had the largest number of studies, most of which were retrospective case series. Recombinant human platelet-derived growth factor BB with beta-tricalcium phosphate (rhPDGF-BB/β-TCP) and autograft were supported by the highest levels of evidence, each having four randomized controlled trials (RCTs). B2A was the only other material in an RCT, but with only24 subjects. Allograft and off-label use of recombinant human bone morphogenetic protein (rhBMP) were supported mainly by retrospective case series. Another assessment of quality was the endpoints. Fusion status was assessed by computed tomography (CT) and/or radiographs, with CT considered superior. Seventeen (17) studies used CT, but the definition of fusion varied from a high barrier of 'at least 50% osseous bridging' in 6 autograft, 5 rhPDGF-BB/β-TCP, 1 rhBMP, 1 demineralized bone matrix, and 1 B2A studies to a lower or undefined criteria in other studies. Conclusion: This literature review reveals the use of grafting materials is supported by a wide range of evidence quality. Most are supported by Level IV evidence, with the exceptions of autograft and rhPDGF-BB/β-TCP. Both are supported by multiple Level I studies. When looking at the methods for assessing fusion status, less than half of studies used CT. Of these, autograft and rhPDGF-BB/β-TCP both had at least 5 studies using CT while other materials had at most 1 study. Surgeons may wish to consider the availability of high-quality evidence, or the lack of, when selecting grafting materials.
Tantalum Spacer Augmentation of Large Bony Defects in Hindfoot Arthrodesis
Authors: Delman Connor , Kazemi Soroush , Afzal Najiba , Haffner Max R. , Giza Eric , Kreulen Christopher D. 
Published: November 2022

Category: Ankle Arthritis; Hindfoot Introduction/Purpose: Tibiotalocalcaneal (TTC) arthrodesis is a common surgical technique used in the treatment of various hindfoot pathologies. Large osseus defects are particularly challenging with a high rate of graft collapse and nonunion when using autograft or allograft. Porous tantalum has emerged as a favorable osteoconductive material to address sizeable hindfoot defects. The purpose of this study was to review the radiographic outcomes and complications associated with tantalum spacer augmentation in hindfoot arthrodesis. Methods: A retrospective review was performed of all patients who underwent a hindfoot arthrodesis augmented with a metal spacer (Trabecular MetalTM) from 2012 to 2020 at a single institution. Patients [endif]–>18 years of age who had a large, hindfoot osseus defect were included in the study. Surgeries were performed by two fellowship-trained foot and ankle orthopaedic surgeons. The primary outcomes assessed were presence of radiographic union, post-operative complications, and return to the operating room. Results: Fourteen patients were identified who underwent hindfoot arthrodesis with the use of a Trabecular MetalTM augment. Two of the 14 patients were lost to follow-up resulting in a total of 12 patients with an average age of 59 years (range, 42 - 74). The average length of follow-up was 26 months (range, 4 - 56). Four patients had plain radiographs at final follow-up compared to 7 patients who had CT scans performed. Nine patients underwent TTC fusion with a retrograde intramedullary nail (MedShape DynaNail) and three patients underwent isolated subtalar (ST) fusion. Ten of 12 fusions were augmented using reamer irrigator aspirator (RIA) autograft and two patients received autograft from either the tibia or fibula. Of the 12 patients, 10 achieved radiographic evidence of union for a union rate of 83%. There were three patients who required reoperations: one hypertrophic nonunion, one surgical site infection, and one symptomatic hardware. Conclusion: Tantalum provides a great structural option for patients undergoing TTC or ST fusion in the setting of large hindfoot bony defects. This method combined with the use of autograft and adequate biomechanical stabilization can produce reliable results. Functional outcomes are needed to capture the utility of this technique in attaining longterm clinical results.