bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of open and endovascular infra-inguinal revascularization are poor in young patients with atherosclerotic peripheral artery disease but do not differ between genders
Authors: Yuan Fang , Tracci Margaret C , Clouse W Darrin , Robinson William P 
Published: November 2022

Objectives The effect of gender on the outcomes of revascularization procedures in young patients with premature atherosclerotic peripheral arterial disease (PAD) is not known. The objective of this study was to compare short-term and long-term outcomes between young males and females undergoing infra-inguinal revascularization procedures. Methods We examined postoperative outcomes of male and female PAD patients under the age of 55 who underwent infra-inguinal revascularization procedures at a single tertiary institution from 2011 to 2019. Primary outcomes included 30-day morbidity, patency of the revascularization procedures, and major adverse limb events (MALE). Secondary outcomes included survival, amputation rate, reintervention rate, improvement of ankle-brachial index (ABI), and number of reinterventions. Results Eighty-one infra-inguinal revascularization procedures (46 endovascular and 35 open procedures) were reviewed including 45 procedures in 37 males and 36 procedures in 31 females. Fifty-three (65.4%) of the procedures were performed in patients with chronic limb-threatening ischemia symptoms. The rest were treated for life-disabling claudication. The female patients were younger, had higher body mass index, and were more likely to have diabetes, hyperlipidemia, or chronic obstructive pulmonary disease in comparison to males. Thirty-day major adverse cardiovascular event was 0.0% and MALE was 16.0%. Mean follow-up was 806.2 days. At 1 year, primary patency was 34.4 ± 6.2%, primary assisted patency was 52.7 ± 6.5%, secondary patency was 61.8 ± 6.3%, and MALE-free rate was 47.0 ± 6.4%. For secondary outcomes at 1 year, amputation-free rate was 92.5 ± 3.2%, reintervention-free rate was 50.2 ± 6.4%, and survival was 96.2 ± 2.6%. By the end of the study, overall mortality rate was 14.8% and major amputation rate was 13.6%. No major differences were observed between males and females among these outcomes. A smaller improvement in ABI after revascularization was noted in females compared to males (female 0.2 ± 0.2 vs male 0.4 ± 0.2, p = .04). Among patients who required reintervention, females required a higher number of reinterventions than males (female 1.7 ± 2.5 vs male 0.8 ± 1.1, p = .03). Conclusions There were no significant differences in short-term and long-term outcomes between males and females under the age of 55 after infra-inguinal revascularization. Poor patency, high MALE rate, and high mid-term mortality, and amputation rates after revascularization in young PAD patients highlight the need for improved strategies to treat premature PAD.
Preoperative MELD score predicts mortality and adverse outcomes following radical cystectomy: analysis of American College of Surgeons National Surgical Quality Improvement Program
Authors: Ayoub Christian Habib , Dakroub Ali , El-Asmar Jose M. , Ali Adel Hajj , Beaini Hadi , Abdulfattah Suhaib , El Hajj Albert 
Published: November 2022

Background: The model for end-stage liver disease (MELD) has been widely used to predict the mortality and morbidity of various surgical procedures. Objectives: We aimed to correlate a high preoperative MELD score with adverse 30-day postoperative complications following radical cystectomy. Design and Methods: Patients who underwent elective, non-emergency radical cystectomy were identified from the American College of Surgeons–National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2017. Patients were categorized according to a calculated MELD score. The primary outcomes of this study were 30-day postoperative mortality, morbidity, and length of hospital stay following radical cystectomy. For further sensitivity analysis, propensity score matching was used to yield a total of 1387 matched pairs and primary outcomes were also assessed in the matched cohort. Results: Compared with patients with a MELD < 10, those with MELD ⩾ 10 had significantly higher rates of mortality [odds ratio (OR) = 1.71, p = 0.004], major complications (OR = 1.42, p < 0.001), and prolonged hospital stay (OR = 1.29, p < 0.001) on multivariate analysis. Following risk-adjustment for race, propensity-matched groups revealed that patients with MELD score ⩾ 10 were significantly associated with higher mortality (OR = 1.85, p = 0.008), major complications (OR = 1.34, p < 0.001), yet similar length of hospital stay (OR = 1.17, p = 0.072). Conclusion: MELD score ⩾ 10 is associated with higher mortality and morbidity in patients undergoing radical cystectomy compared with lower MELD scores. Risk-stratification using MELD score may assist clinicians in identifying high-risk patients to provide adequate preoperative counseling, optimize perioperative conditions, and even consider nonsurgical alternatives.
Concordance between coding sources of burn size and depth across Australian and New Zealand specialist burn services
Authors: Perkins Monica , Cleland Heather , Gabbe Belinda J , Tracy Lincoln M 
Published: November 2022

Background The percentage of total body surface area (%TBSA) burned and burn depth provide valuable information on burn injury severity. Objective This study investigated the concordance between The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes and expert burn clinicians in assessing burn injury severity. Method We conducted a retrospective population-based review of all patients who sustained a burn injury between July 1, 2009, and June 30, 2019, requiring admission into a specialist burn service across Australia and New Zealand. The %TBSA burned (including the percentage of full thickness burns) recorded by expert burn clinicians within the Burns Registry of Australia and New Zealand (BRANZ) were compared to ICD-10-AM coding. Results 20,642 cases (71.5%) with ICD-10-AM code data were recorded. Overall, kappa scores (95% confidence interval [CI]) for burn size ranged from 0.64 (95% CI 0.63–0.66) to 0.86 (95% CI 0.78–0.94) indicating substantial to almost perfect agreement across all %TBSA groups. When stratified by depth, the lowest agreement was observed for < 10% TBSA and < 10% full thickness (kappa 0.03; 95% CI 0.02–0.04) and the highest agreement was observed for burns of ≥ 90% TBSA and ≥ 90% full thickness (kappa 0.72; 95% CI 0.58–0.85). Conclusion Overall, there was substantial agreement between the BRANZ and ICD-10-AM coded data for %TBSA classification. When %TBSA classification was stratified by burn depth, greater agreement was observed for larger and deeper burns compared with smaller and superficial burns. Implications Greater consistency in the classification of burns is needed.
Rapid land use conversion in the Cerrado has affected water transparency in a hotspot of ecotourism, Bonito, Brazil
Authors: Chiaravalloti Rafael Morais , Tomas Walfrido Moraes , Uezu Alexandre , Shirai Henrique Yugo , Guaraldo Eliane , Aoki Camila , de Arruda Botelho Maria Tereza , Salvadori Juliane Ferreira 
Published: November 2022

Background Brazil is the largest exporter of soybeans worldwide. Albeit its economic importance, soybean expansion has led to important land use and land cover changes. In this paper, we evaluate the impact of soybean expansion on ecotourism, using as a case study of the Prata River (Bonito), Brazil; tourist destination where over 30,000 tourists per year came to float in crystal waters. Methods We first evaluated land cover and land use change in the region between 2010 and 2020, checking how and where soybean plantations have expanded. Second, based on monthly data of water transparency of the Prata River, Bonito, we created five possible models considering monthly rainfall and three categories of soybean expansion (slow, rapid and medium). The models were tested through generalized linear regression analysis and ranked through AIC and AIC weight. Results Our results show that soybean expanded from occupying 4% of the river basin in 2010 to 23% in 2020, expanding mostly over pasture areas (31%) and native vegetation (12.9%). We also showed that while soybean plantation was expanding rapid between 2014 and 2016, it played a significant role in increasing the number of days the water in the Prata River was classified as very turbid. Conclusion Our results emphasize the need for soybean expansion planning, considering better management of the soil (non-tilling), common agreements between different stakeholders and the scale up of initiatives that are already in place in the region (e.g. planning of the locations of legal reserves in a way that complement the environmental protection areas (e.g. Águas de Bonito), seting aside of conservation areas ("Área Prioritária Banhados") and payment for ecosystem service schemes) . Implications for conservation Our research shows the importance of considering the different impacts soybean may have on the landscape. We present clear paths to reduce possible economic and environmental impacts, and present the importance to scale up innitiatives that are already in place in the region, such as payment for ecosystem services schemes and protection of watersheds.
Real-life effectiveness of transitioning from paliperidone palmitate 1-monthly to paliperidone palmitate 3-monthly long-acting injectable formulation
Authors: Corbeil Olivier , Essiambre Anne-Marie , Béchard Laurent , Roy Audrey-Anne , Huot-Lavoie Maxime , Brodeur Sébastien , Chandrasena Ranjith , Thériault Chantale , Crocker Candice , Melun Jean-Pierre , Tibbo Phil , Demers Marie-France , Roy Marc-André 
Published: November 2022

Background: Non-adherence to antipsychotics in schizophrenia is associated with an increased risk of psychotic relapse and hospitalization, a risk that is reduced with the use of long-acting injectable (LAI) antipsychotics. Randomized clinical trials (RCTs) have demonstrated the efficacy of paliperidone palmitate 3-monthly (PP3M) for psychotic relapse prevention in schizophrenia, but it remains poorly documented among individuals treated in real-life settings who can benefit the most out of LAIs. Objectives: The objective of this study was to evaluate the effectiveness of PP3M in relapse prevention among patients with schizophrenia. Methods: This is a multicentre retrospective study conducted in four outpatients’ clinics across Canada. All consecutive patients with a main diagnosis of schizophrenia who initiated PP3M between June 2016 and March 2020 were included. The primary outcome was psychotic relapse, defined using broad and clinically relevant criteria. Results: Among 178 consecutive patients who were switched to PP3M, the 12-month relapse rate was 18.5% and the relapse-free survival probability was 0.788 (95% confidence interval [CI] = 0.725–0.856). Comorbid diagnoses of personality disorders and substance use disorders were associated with hazard rates (HRs) of 3.6 (95% CI = 1.8–7.3, p < 0.001) and 3.1 (95% CI = 1.6–6.2), respectively. Increased psychopathology severity was associated with an increased likelihood of relapse, while having a job or being in school was protective. Conclusion: These findings reinforce the necessity of conducting research in patients with comorbid psychiatric disorders who are typically underrepresented in RCTs, yet overrepresented in real-life settings, in order to better inform and guide clinical practice.
Understanding the use of telehealth in the context of the Family Nurse Partnership and other early years home visiting programmes: A rapid review
Authors: Morrison Kathleen , Hughes Thomas , Doi Lawrence 
Published: November 2022

Overview This rapid review sought to understand the use of telehealth in early parenthood programmes sharing similarities with the Family Nurse Partnership. Methods A rapid review protocol was developed in accordance with Cochrane Rapid Reviews Methods Guidance. Medline, Cochrane Library, and CINAHL databases were searched. Inclusion criteria were developed using population, intervention, comparator, outcome, study design, and timeframe components. Two reviewers searched, screened, and extracted data. AMSTAR was used for critical appraisal. Results were synthesised narratively. Results Searches yielded 18 studies out of 881 for inclusion. Findings were identified across seven domains: acceptability and accessibility; therapeutic relationships; flexibility offered by telehealth; participation and engagement; confidentiality and privacy; equipment and technical considerations; and training and support. Conclusion Telehealth provides unique opportunities to improve access to early years health services for young mothers. However, considerable accessibility barriers remain in the form of connectivity issues, access to appropriate technology, and the acceptability of remote healthcare delivery. This review presents a timely overview of the opportunities and challenges associated with the use of telehealth in early parenthood and family-based programmes.
What Are the Effects of Posterior Corrective Surgery, With or Without Thoracoplasty, on Pulmonary Function in Adolescent Idiopathic Scoliosis? A Systematic Review and Meta-analysis
Authors: Turner Henry , McManus Robin , Kiely Pat 
Published: November 2022

Study Design Systematic review and meta-analysis Objectives This study’s objective is to provide a critical review of the current literature regarding the changes in pulmonary function (PF) in Adolescent idiopathic scoliosis (AIS) patients who have undergone posterior spinal fusion and instrumentation (PSF), with and without thoracoplasty (TP). Methods A comprehensive search was performed using the following databases: EMBASE, PubMed, EBSCOhost (CINAHL and Medline) and OpenGrey. Our focus was on studies that compared pre-and postoperative percent-predicted values of forced vital capacity (%FVC) or forced expiratory volume in 1 second (%FEV1) in AIS patients who had undergone PSF, with and without TP, with a minimum 2-year follow-up. The risk of bias for included studies was assessed using the ROBINS-I (“Risk Of Bias In Non-randomised Studies - of Interventions”) tool. Mean change scores were depicted using forest plots. Results Fifteen studies met our inclusion criteria. The results of our analysis suggest that PSF with TP caused a significant deterioration of %FVC in individuals with moderate AIS, with no significant effect on %FEV1. It also showed a minor improvement of FEV1% in individuals with moderate AIS after PSF only, but no significant change in %FVC. Conclusions PSF with TP caused a significant deterioration of % FVC while PSF alone caused a minor improvement of FEV1% in individuals with moderate AIS with a minimum 2-year follow-up.
Ultrasound Imaging and Prevalence of Intrasheath Peroneal Tendon Subluxation in Asymptomatic Volunteers
Authors: Kanal Shefali , Gross Christopher E. , Hoch Caroline P. , Davis Leah 
Published: November 2022

Category: Ankle; Other Introduction/Purpose: Intrasheath peroneal tendon subluxation is typically an incidental finding in athletes with sports-related injuries and is characterized by a temporary reversal in the anteroposterior positions of the peroneus longus (pL) and peroneus brevis (pB) tendons within their common tendon sheath. It is currently unclear whether intrasheath subluxation represents normal physiologic or pathologic tendon motion. This study aims to determine the normal variation in motion of supramalleolar pB and pL tendons in multiple ankle positions and to determine the overall prevalence of intrasheath tendon subluxation in asymptomatic volunteers. Methods: Static sonographic images of the peroneal tendons in 22 asymptomatic volunteers were collected in the neutral position, in eight fixed ankle positions (active and passive pronation, dorsiflexion, supination, and plantarflexion), and during dynamic ankle circumduction. The center of each tendon in relation to the lateral fibular cortex and in relation to each other was measured in each position and used to calculate absolute and percentage displacement. Two-way ANOVA was used to determine the significance of passive versus active motion and two-tailed paired sample t-test was used to compare the mean displacement of pL and pB in active and passive positions. Results: Intrasheath subluxation was not visualized in any static position but was visualized in 33% of patients during active ankle circumduction, regardless of direction or laterality. Percent displacement was greatest in active ankle plantarflexion (55%) for pB and in active pronation (34%) for pL. A statistically significant difference in the tendon positions in relation to each other was found in the anteroposterior direction (p=0.026), but there were no statistically significant differences between active and passive motions or with ankle positioning. A non-painful ankle 'snap' was palpated by the sonographer in all cases of intrasheath subluxation. Conclusion: Intrasheath subluxation is a fairly common occurrence seen in one third of our volunteers. Our results suggest that a snapping ankle in otherwise asymptomatic patients is highly suggestive of intrasheath peroneal tendon subluxation and can be well-documented with dynamic ultrasound. Establishing the normal ranges of motion of supramalleolar peroneal tendons may assist in the evaluation of patients with lateral ankle pain.
The Fall and Rise of Total Ankle Arthroplasty: A Database Analysis of Procedural Incidence Between 2009 and 2019
Authors: Karzon Anthony L. , Bariteau Jason T. , Coleman Michelle M. , Kadakia Rishin J. , Jacobson Joseph E. , Labib Sameh (Sam) A. 
Published: November 2022

Category: Ankle; Ankle Arthritis; Hindfoot; Trauma Introduction/Purpose: Ankle osteoarthritis accounts for one of the most common ankle joint pathologies. Although total ankle arthrodesis has been the mainstay treatment for degenerative end-stage ankle arthritis, the popularity of total ankle arthroplasty has been on the rise due improved implant design, technologies, and postoperative outcomes. Yet, there remains a paucity of epidemiologic data in recent years on the incidence of total ankle arthroplasty in the United States. We hypothesize that stratified incidences of patients undergoing this procedure in the last decade has risen. Methods: The Truven MarketScan database was queried to identify patients who underwent total ankle arthroplasty from January 2009 to December 2019 based on CPT coding. Population estimates from the US Census Bureau were used to calculate the annual incidence of total ankle arthroplasty. Volume and incidence were estimated for annual sums, gender, age subgroups, and four statistical geographical regions of the U.S. Results: In total, 41,060 total ankle arthroplasty procedures were identified in the database from 2009 to 2019. Annual volumes have increased significantly by 136.1%, from 2,180 to 5,147 total procedures nationwide. Procedural incidence reported per 1,000,000 people significantly increased by 120.8%, at 15.9 in 2019. Significant growth in incidence was demonstrated in males and females below the age of 65 years with the highest annual incidence found in people under the age of 54. Incidence stratified by region rose in all regions of the United States with the South and West seeing the most notable increases. Conclusion: The epidemiology of TAA has yet to be clarified in recent years. We found that annual volumes and incidence of TAA has increased in the past decade. Growth in incidence was demonstrated in both sexes > 54 years as well as in all regions of the US. While ankle arthroplasty succeeds in mitigating certain complications associated with arthrodesis such as impaired ankle motion, gait changes and adjacent joint arthritis, orthopedic surgeons must remain mindful of the significant consequences associated with revision ankle arthroplasty. Describing epidemiology with stratified procedural incidence can help orthopedists adapt to the ever-evolving changes in the field.
Does the Radiographic Lateral View of the Lesser Toe Matter in a Trauma? A Retrospective Analyses of 378 Radiographs
Authors: Kitaki Danilo P. , Gonçalves João Paulo P. 
Published: November 2022

Category: Trauma; Lesser Toes Introduction/Purpose: Evaluate the importance of a radiographic lateral view in diagnosing lesser toes traumatic conditions. Methods: Between January 2018 and March 2018, 378 radiographs of 126 patients evaluated in an emergency care hospital for trauma in the lesser toe were retrospectively evaluated for presence of lesser toes traumatic conditions. Patients were selected if a complete series of radiographs were performed, anteroposterior (AP), lateral (LA) and Oblique (OB). Radiographs of the same patient were duplicated and divided in two groups: standard group (AP and OB) and complete group (AP + LA + OB). Images were examined by four independent examiners with different degrees of experience. Each examiner randomly evaluated the same patient twice (one for each group). Kappa index was used to evaluate intra and inter-examiner concordance, and the two- proportion equality test was used to calculate statistical significance. Results: Mean age of patients was 37,2 years (4-85yr), 144 injuries were diagnosed in standard group (28,6%) and 266 injuries (52,8%) in complete group (p<0,001). Individually, each examiner had an improvement in the number of lesions diagnosed when comparing group assessment (p<0,001). Kappa index was superior to 0,60 for all examiners in standard group. Conclusion: Addition of true lateral view was able to detect misdiagnosed injuries in lesser toes trauma and improved the number of diagnosed lesions in 84,6%.