bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Risk of Iatrogenic Peroneal Nerve Injury in Lateral Meniscal Repair and Safe Zone to Minimize the Risk Based on Actual Arthroscopic Position: An MRI Study
Authors: Chuaychoosakoon Chaiwat , Boonsri Pattira , Tanutit Pramot , Laohawiriyakamol Teeranan , Boonriong Tanarat , Parinyakhup Wachiraphan 
Published: May 2022

Background: Lateral meniscal repair using an all–inside meniscal repair device involves a risk of iatrogenic peroneal nerve injury. To our knowledge, there have been no previous studies evaluating the risk of injury with the knee in the standard operational figure-of-4 position with joint dilatation in arthroscopic lateral meniscal repair. Purpose: To evaluate and compare the risk of peroneal nerve injury and establish the safe and danger zones in repairing the lateral meniscus through the anteromedial, anterolateral, or transpatellar portal in relation to the medial and lateral borders of the popliteal tendon (PT). Study Design: Descriptive laboratory study. Methods: Using axial magnetic resonance imaging (MRI) studies of knees in the figure-of-4 position with joint fluid dilatation at the level of the lateral meniscus, we drew direct lines to simulate a straight all–inside meniscal repair device deployed from the anteromedial, anterolateral, and transpatellar portals to the medial and lateral borders of the PT. If the line passed through or touched the peroneal nerve, a risk of iatrogenic peroneal nerve injury was noted, and measurements were made to determine the safe and danger zones for peroneal nerve injury in relation to the medial or lateral border of the PT. Results: Axial MRI images of 29 adult patients were reviewed. Repairing the lateral meniscus through the anteromedial portal in relation to the lateral border of the PT and through the anterolateral portal in relation to the medial border of the PT had a 0% risk of peroneal nerve injury. The “safe zone” in relation to the medial border of the PT through the anterolateral portal was between the medial border of the PT and 9.62 ± 4.60 mm medially from the same border. Conclusion: It is safe to repair the body of the lateral meniscus through the anteromedial portal in the area lateral to the lateral border of the PT or through the anterolateral portal in the area medial to the medial border of the PT. Clinical Relevance: There is a risk of iatrogenic peroneal nerve injury during lateral meniscal repair. Thus, we recommend repairing the lateral meniscal tissue through the anteromedial portal in the area lateral to the lateral border of the PT and using the anterolateral portal in the area medial to the medial border of the PT, as neither of these approaches resulted in peroneal nerve injury. Additionally, the surgeon can decrease this risk by repairing the meniscal tissue using the all–inside meniscal device in the safe zone area.
SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour: A Systematic Review
Authors: Sinyor Mark , Zaheer Rabia , Webb Roger T. , Knipe Duleeka , Eyles Emily , Higgins Julian P.T. , McGuinness Luke , Schmidt Lena , Macleod-Hall Catherine , Dekel Dana , Gunnell David , John Ann 
Published: May 2022

Objective The COVID-19 pandemic has had a complex impact on risks of suicide and non-fatal self-harm worldwide with some evidence of increased risk in specific populations including women, young people, and people from ethnic minority backgrounds. This review aims to systematically address whether SARS-CoV-2 infection and/or COVID-19 disease confer elevated risk directly. Method As part of a larger Living Systematic Review examining self-harm and suicide during the pandemic, automated daily searches using a broad list of keywords were performed on a comprehensive set of databases with data from relevant articles published between January 1, 2020 and July 18, 2021. Eligibility criteria for our present review included studies investigating suicide and/or self-harm in people infected with SARS-CoV-2 with or without manifestations of COVID-19 disease with a comparator group who did not have infection or disease. Suicidal and self-harm thoughts and behaviour (STBs) were outcomes of interest. Studies were excluded if they reported data for people who only had potential infection/disease without a confirmed exposure, clinical/molecular diagnosis or self-report of a positive SARS-CoV-2 test result. Studies of news reports, treatment studies, and ecological studies examining rates of both SARS-CoV-2 infections and suicide/self-harm rates across a region were also excluded. Results We identified 12 studies examining STBs in nine distinct samples of people with SARS-CoV-2. These studies, which investigated STBs in the general population and in subpopulations, including healthcare workers, generally found positive associations between SARS-CoV-2 infection and/or COVID-19 disease and subsequent suicidal/self-harm thoughts and suicidal/self-harm behaviour. Conclusions This review identified some evidence that infection with SARS-CoV-2 and/or COVID-19 disease may be associated with increased risks for suicidal and self-harm thoughts and behaviours but a causal link cannot be inferred. Further research with longer follow-up periods is required to confirm these findings and to establish whether these associations are causal.
Impact on Poly(Vinyl chloride) of trimethoprim schiff bases as stabilizers
Authors: Al-Tikrity Emaad TB , Yaseen Anaheed A , Yousif Emad , Ahmed Dina S , Al-Mashhadani Mohammed H 
Published: May 2022

Poly(vinyl chloride) PVC materials are used in many industrial and household outdoor applications which exposed to sunlight ultraviolet. This exposure motivates photo-degradation of the PVC and hence, reduces its life time and leads to undesirable physical properties. Herein, three new Schiff bases containing a trimethoprim moiety were investigated as photo-stabilizers for poly(vinyl chloride) against photo-decomposition. Merely 0.5% by weight of these Schiff bases was mixed with the polymer to form blend films with thickness of (40 µm). The films were irradiated for a period of time from 0 to 300 h and the irradiation impact on the PVC stabilization was monitored every 50 h. The efficiency of these additives as photo-stabilizers was investigated as a function of different parameters during the course of irradiation, such as weight loss, growing carbonyl and alkene groups as well as the surface morphology of the prepared films. The changes during irradiation were obvious for the blank films in comparison to the films containing the new additives. Therefore, these Schiff bases were found to act as photo-degradation inhibitors through reducing the elimination of hydrogen chloride molecules and as free radical scavengers or peroxide decomposers.
Preliminary Report of the Safety and Tolerability of 1 Hz Repetitive Transcranial Magnetic Stimulation in Temporal Lobe Epilepsy
Authors: Gersner Roman , Oberman Lindsay M. , Sanchez Maria J , Chiriboga Nicolas , Kaye Harper L , Pascual-Leone Alvaro , Zangen Abraham , Rotenberg Alexander 
Published: May 2022

Background Low frequency (≤1 Hz) repetitive transcranial magnetic stimulation (rTMS) has been shown to suppress cortical excitability and is beginning to be trialed for the treatment of refractory epilepsy. Purpose As a step toward a larger trial, the current pilot study was aimed to test the tolerability and safety of temporal lobe rTMS using H-coil for the treatment of temporal lobe epilepsy (TLE). Research Design 1800 pulses of active or sham rTMS were applied 5 days a week for 2 weeks over the temporal lobe of the affected hemisphere. Results Nine participants were enrolled and randomized to verum or sham stimulation. One participant dropped out from the sham group after 5 rTMS sessions. In-session, 3 patients had typical seizures during sham stimulation. One patient had seizures also during active stimulation (albeit fewer than during sham). Minor reported adverse events during stimulation otherwise included transient neck pain and headache, and were reported in equal numbers in both groups. Major adverse events were not reported. Our results indicate that H-coil rTMS was well-tolerated. Conclusion Given the relatively high prevalence of individuals with TLE who are treatment-resistant and the preliminary results of this study, we suggest that a larger safety and efficacy trial of 1 Hz rTMS for the treatment of TLE is warranted.
Diffusion magnetic resonance imaging of normal-appearing white matter in multiple sclerosis: correlation with brain volume and clinical disability
Authors: Larassati Hana , Pandelaki Jacub , Estiasari Riwanti , Prihartono Joedo , Firdausia Salsabila , Yunus Reyhan Eddy , Mulyadi Rahmad 
Published: May 2022

Background Diffusion magnetic resonance imaging (MRI) abnormalities in multiple sclerosis (MS) are not limited to lesions, but have also been observed in the white matter that appears normal on conventional MRI sequences, known as normal-appearing white matter (NAWM). There is evidence of microstructural processes occurring in the NAWM. Objective To assess the correlation between NAWM apparent diffusion coefficient (ADC) and fractional anisotropy (FA) with brain volume and clinical disability in MS. Methods Brain MRI from 33 MS patients were included. ADC and FA measurements of the genu, body, and splenium of corpus callosum (CC) were done. ADC and FA values were analyzed to measure their correlation with brain volume from MR volumetry and clinical disability represented by Expanded Disability Status Scale (EDSS). Results The mean ADC of CC NAWM was .93 ×10−3 mm2/s (±.13 SD), and the mean FA .72 (±.12 SD). ADC and FA of CC NAWM were significantly correlated with the ratio of brain volume to intracranial volume (R = −0,70 and 0,78 respectively), and with EDSS (R = .52 and −.59 respectively). Conclusion There were significant correlations between ADC and FA of NAWM with brain volume and EDSS of MS patients. Further longitudinal studies were needed to evaluate the potential of diffusion MRI in the evaluation of MS.
Successful Aortic Remodeling Through the Candy-Plug Technique for Chronic Type B Aortic Dissection
Authors: Shimizu Haruna , Katayama Keijiro , Takata Yoshiaki , Inoue Risa , Emura Shogo , Takasaki Taiichi , Takahashi Shinya 
Published: May 2022

Purpose To describe the efficiency of the candy-plug technique using an Excluder aortic extender and obtain optimal aortic remodeling. Case A 46-year-old male patient had a history of acute type B aortic dissection and progressive dilation of the descending aorta (53 mm diameter) with a patent false lumen. He was treated with the candy-plug technique, using an Excluder aortic extender of 32-45 mm was placed and a 16-mm Amplatzer Vascular Plug II. No technical complications were observed in the patient. Good aortic remodeling was observed after 6 months, CT showed complete thrombosis of the false lumen and reduction of the maximum perpendicular diameter of the descending aorta from 53 to 47 mm. The diameter of the other proximal zones of the descending aorta was 45-47 mm, and the Excluder aortic extender changed into an elliptical shape. This is the first report of good aortic remodeling with an elliptical shape by performing the candy-plug technique. Discussion The candy-plug technique using an Excluder aortic extender is an improved method for occluding the false lumen as it provides improved aortic remodeling. The 2 indications for this surgery are limited. A large entry point in the descending abdominal aorta that is more peripheral than the candy-plug position must be visible on contrast-enhanced CT and the false lumen is not too large. We consider candy-plug placement in the true lumen central to the TEVAR to avoid occluding the artery of Adamkiewicz, since we have to avoid the thrombosis of the peripheral false lumen where a candy-plug was placed. Since it is unclear whether long-term results are satisfactory, we must continue to study chronic aortic type B dissection.
Individuals with Higher Levels of Physical Activity after Stroke Show Comparable Patterns of Myelin to Healthy Older Adults
Authors: Greeley Brian , Rubino Cristina , Denyer Ronan , Chau Briana , Larssen Beverley , Lakhani Bimal , Boyd Lara 
Published: May 2022

Background Myelin asymmetry ratios (MARs) relate and contribute to motor impairment and function after stroke. Physical activity (PA) may induce myelin plasticity, potentially mitigating hemispheric myelin asymmetries that can occur after a stroke. Objective The aim of this study was to determine whether individuals with higher levels of PA showed lower MAR compared to individuals with lower levels of PA. Methods Myelin water fraction was obtained from 5 bilateral motor regions in 22 individuals with chronic stroke and 26 healthy older adults. Activity levels were quantified with wrist accelerometers worn for a period of 72 hours (3 days). Higher and lower PA levels were defined by a cluster analysis within each group. Results MAR was similar regardless of PA level within the older adult group. Compared to the higher PA stroke group, lower PA stroke participants displayed greater MAR. There was no difference in MAR between the stroke and older adult higher PA groups. Within the lower PA groups, individuals with stroke showed greater MAR compared to the older adults. Arm impairment, lesion volume, age, time since stroke, and preferential arm use were not different between the PA stroke groups, suggesting that motor impairment severity and extent of brain damage did not drive differences in PA. Conclusion Individuals who have had a stroke and are also physically active display lower MAR (i.e., similar myelin in both hemispheres) in motor regions. High levels of PA may be neuroprotective and mitigate myelin asymmetries once a neurological insult, such as a stroke, occurs. Alternately, it is possible that promoting high levels of PA after a stroke may reduce myelin asymmetries.
High-Definition 3D Exoscope in Thyroid Surgery
Authors: Mercante Giuseppe , Costantino Andrea , De Virgilio Armando , Ferreli Fabio , Spriano Giuseppe 
Published: May 2022

Background The high-definition 3D exoscope is an innovative and promising tool that was recently introduced in the clinical practice. It may be used during open surgical procedures to enhance the ability to perform precise dissection of fine structures. We describe our preliminary experience with the 3D exoscope in thyroid surgery, discussing potential advantages of this system. Methods A high-definition 3D exoscope (3D VITOM®) mounted on the VERSACRANETM holding system (Karl Storz, Tuttlingen, Germany) was used to perform open thyroid surgery. Results The 3D exoscope was used in three patients without significant intra-operative delay or complications. Both thyroidectomy and central compartment dissection were performed. The 3D exoscope allows to perform precise dissection in the identification and preservation of the recurrent laryngeal nerve and the parathyroid glands. Conclusions 3D exoscope-assisted thyroid surgery seems to be feasible and safe. Further studies should be encouraged to analyze potential clinical benefit in the post-operative period.
Therapy professionals in critical care: A UK wide workforce survey
Authors: Twose Paul , Terblanche Ella , Jones Una , Bruce James , Firshman Penelope , Highfield Julie , Jones Gemma , Merriweather Judith , Newey Vicky , Newman Helen , Rock Claire , Wallace Sarah 
Published: May 2022

Introduction National guidelines suggest recommended staffing levels for therapies. The aim of this study was to capture information on existing staffing levels, roles and responsibilities and service structures. Methods An observational study using online surveys distributed to 245 critical care units across the United Kingdom (UK). Surveys consisted of a generic and five profession specific surveys. Results Eight hundred sixty-two responses were received from 197 critical care units across the UK. Of those that responded, over 96% of units had input from dietetics, physiotherapy and SLT. Whereas only 59.1% and 48.1% had an OT or psychology service respectively. Units with ring fenced services had improved therapist to patient ratios. Discussion There is significant variation in access to therapists for patients admitted to critical care in the UK, with many services not having services for core therapies such as psychology and OT. Where services do exist, they fall below the recommended guidance.
The Launch of the iCoDE Standard Project
Authors: Xu Nicole Y. , Nguyen Kevin T. , DuBord Ashley Y. , Klonoff David C. , Goldman Julian M. , Shah Shahid N. , Spanakis Elias K. , Madlock-Brown Charisse , Sarlati Siavash , Rafiq Azhar , Wirth Axel , Kerr David , Khanna Raman , Weinstein Scott , Espinoza Juan 
Published: May 2022

Introduction: The first meeting of the Integration of Continuous Glucose Monitor Data into the Electronic Health Record (iCoDE) project, organized by Diabetes Technology Society, took place virtually on January 27, 2022. Methods: Clinicians, government officials, data aggregators, attorneys, and standards experts spoke in panels and breakout groups. Three themes were covered: 1) why digital health data integration into the electronic health record (EHR) is needed, 2) what integrated continuously monitored glucose data will look like, and 3) how this process can be achieved in a way that will satisfy clinicians, healthcare organizations, and regulatory experts. Results: The meeting themes were addressed within eight sessions: 1) What Do Inpatient Clinicians Want to See With Integration of CGM Data into the EHR?, 2) What Do Outpatient Clinicians Want to See With Integration of CGM Data into the EHR?, 3) Why Are Data Standards and Guidances Useful?, 4) What Value Can Data Integration Services Add?, 5) What Are Examples of Successful Integration?, 6) Which Privacy, Security, and Regulatory Issues Must Be Addressed to Integrate CGM Data into the EHR?, 7) Breakout Group Discussions, and 8) Presentation of Breakout Group Ideas. Conclusions: Creation of data standards and workflow guidance are necessary components of the Integration of Continuous Glucose Monitor Data into the Electronic Health Record (iCoDE) standard project. This meeting, which launched iCoDE, will be followed by a set of working group meetings intended to create the needed standard.
Accuracy of head computed tomography scoring systems in predicting outcomes for patients with moderate to severe traumatic brain injury: A ProTECT III ancillary study
Authors: Wu Haijun , Wright David W , Allen Jason W , Ding Victoria , Boothroyd Derek , Glushakova Olena Y , Hayes Ron , Jiang Bin , Wintermark Max 
Published: May 2022

Background Several types of head CT classification systems have been developed to prognosticate and stratify TBI patients. Objective The purpose of our study was to compare the predictive value and accuracy of the different CT scoring systems, including the Marshall, Rotterdam, Stockholm, Helsinki, and NIRIS systems, to inform specific patient management actions, using the ProTECT III population of patients with moderate to severe acute traumatic brain injury (TBI). Methods We used the data collected in the patients with moderate to severe (GCS score of 4–12) TBI enrolled in the ProTECT III clinical trial. ProTECT III was a NIH-funded, prospective, multicenter, randomized, double-blind, placebo-controlled clinical trial designed to determine the efficacy of early administration of IV progesterone. The CT scoring systems listed above were applied to the baseline CT scans obtained in the trial. We assessed the predictive accuracy of these scoring systems with respect to Glasgow Outcome Scale—Extended at 6 months, disability rating scale score, and mortality. Results A total of 882 subjects were enrolled in ProTECT III. Worse scores for each head CT scoring systems were highly correlated with unfavorable outcome, disability outcome, and mortality. The NIRIS classification was more strongly correlated than the Stockholm and Rotterdam CT scores, followed by the Helsinki and Marshall CT classification. The highest correlation was observed between NIRIS and mortality (estimated odds ratios of 4.83). Conclusion All scores were highly associated with 6-month unfavorable, disability and mortality outcomes. NIRIS was also accurate in predicting TBI patients’ management and disposition.
Peri-Articular Injection of Tranexamic Acid Reduce Blood Loss and Transfusion Requirement During Total Knee Arthroplasty: A Meta-analysis
Authors: Liu Yue , Shan Duo , Tian Peng , Li Zhi-jun , Xu Gui-jun , Fu Xin 
Published: May 2022

Background The aim of this meta-analysis was to evaluate the efficacy and safety of peri-articular injection of tranexamic acid (TXA) during total knee arthroplasty (TKA) from clinical controlled trials. Method Eligible scientific articles published prior to October 2021 were retrieved from the PubMed, Springer, ScienceDirect and Cochrane Library databases. The statistical analysis was performed with RevMan 5.1. Result 2 RCTs and 3 non-RCTs met the inclusion criteria. Meta-analysis showed significant differences in terms of hemoglobin reduction (MD = −1.04, 95% CI: −1.33 to −.76, P < .00001), total blood loss (MD = −342.80.70, 95% CI: −437.52 to −248.08, P < .00001), drainage volume (MD = −297.24, 95% CI: −497.26 to −97.23, P = .004) and blood transfusion rate (OR = .30, 95% CI: .14 to .62, P = .001) were found in the control group. No postoperative infection and deep venous thrombosis were found between 2 groups. Conclusion Peri-articular injection of TXA can effectively decrease perioperative blood loss and blood transfusion rate without increasing the incidence of postoperative complications during TKA.
Ligament Augmentation Reconstruction System (LARS) for Ankle Lateral Ligament Reconstruction in Higher-Risk Patients: A 5-Year Prospective Cohort Study
Authors: Porter Mark D. , Trajkovska Aleksandra , Georgousopoulou Ekavi 
Published: May 2022

Background: The modified Broström-Gould (MBG) procedure is the gold standard for patients with chronic ankle instability (CAI), but it is relatively contraindicated for patients with higher body weight or generalized ligamentous laxity (GLL). The use of the ligament augmentation reconstruction system (LARS) is an alternative. Hypothesis: It was hypothesized that clinical outcomes would be similar in patients with increased body weight (>90 kg) or GLL, relative to controls. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 66 patients satisfying the inclusion criteria were invited to participate and were divided into 3 groups: controls (no risk factors for inferior clinical outcome), patients with body weight >90 kg, and patients with GLL (Beighton score, ≥5 of 9). All patients underwent imbrication of the lateral collateral ligament complex augmented with the LARS. Primary outcomes of interest were Tegner activity scale (TAS) and Foot and Ankle Outcome Score (FAOS) subscale scores. Secondary outcomes were recurrence of ankle instability, the need for further surgery, and/or complications. Patients were reviewed at 2 and 5 years postoperatively, and outcomes between groups were compared using repeated-measures analysis of variance. Results: Complete data were available for 63 patients (21 patients in each group). TAS improved in all groups from preoperatively to 2 years and 5 years postoperatively ( P < .001 for all). Relative to the controls, the TAS scores were lower in the >90-kg group at 2 years and 5 years ( P < .001 for both periods), while the GLL group had similar scores to controls at both postoperative periods. Both the >90-kg and the GLL groups showed no significant difference in improvement on any FAOS subscale scores relative to the controls, at both 2 and 5 years postoperatively. There were no recurrences, repeat surgeries, or major complications. Conclusion: Relative to controls, patients with body weight >90 kg or GLL had similar FAOSs, and TAS scores were lower in the >90-kg group, at 2 and 5 years, after the use of the LARS to augment lateral collateral ligament imbrication for CAI. Use of the LARS in this manner is a viable option in patients for whom the MBG procedure is relatively contraindicated.